Successful treatment of cervical spinal epidural empyema secondary to grass awn migration in a cat

Spinal epidural empyema (SEE) represents a severe pyogenic infection of the epidural space. Clinical signs of the disease are non-specific--increased body temperature, intense neck pain, neurological signs of a transverse myelopathy--and can lead to severe and permanent neurological deficits. This report describes the diagnosis and successful surgical treatment of cervical SEE secondary to grass awn migration in a cat. Although it is uncommon, this disease should be suspected in cats with progressive myelopathy. Early diagnosis and emergency surgery combined with antibiotic therapy are required to allow a complete recovery.     

Feline cholecystitis and acute neutrophilic cholangitis: clinical findings, bacterial isolates and response to treatment in six cases

Clinicopathological findings from six cats with confirmed cholecystitis or acute neutrophilic cholangitis are presented. Historical findings included lethargy and anorexia or inappetence of up to five days duration. On physical examination all cats were pyrexic and four out of six were jaundiced and had cranial abdominal pain. Bile samples were obtained by cholecystocentesis at exploratory coeliotomy (two cases) or by percutaneous, ultrasound-guided cholecystocentesis (four cases). Gall bladder rupture and bile peritonitis occurred subsequent to ultrasound-guided cholecystocentesis in one case. The most common bacterial isolate was Escherichia coli (four cases); E coli was isolated alone in two cases, in combination with a Streptococcus species (one case) and in combination with a Clostridium species (one case). Streptococcus species alone was isolated from one case, as was Salmonella enterica serovar Typhimurium. The latter is the first reported case of Salmonella-associated cholecystitis in a cat. Concurrent pancreatic or intestinal disease was detected histologically in three cases. All cases were treated with antimicrobials based on in vitro susceptibility results. Treatment was successful in five cases. One cat with concurrent diffuse epitheliotropic intestinal lymphoma was euthanased. Percutaneous ultrasound-guided cholecystocentesis is an effective, minimally-invasive technique enabling identification of bacterial isolates in cats with inflammatory hepatobiliary disease.     

Trauma-induced growth abnormalities of the distal radius in three cats

Three immature cats with growth abnormalities of the distal radius secondary to trauma were presented between July 2001 and July 2003. Initial injuries included a Salter-Harris type II fracture of the distal radial physis in one cat, fractures of the styloid process of the ulna in two cats, and metacarpal fractures in one cat. The cats were between 3.5 and 4.5 months of age at the time of injury. Damage to the distal radial physis resulted in a variable degree of shortening of the radius in all cats. Asymmetrical closure caused widening of the lateral aspect of the radiocarpal joint space in two cats. Elbow incongruity was not observed. One cat was treated with osteotomies of the radius and ulna and realignment of the radius, stabilised with external skeletal fixation. Another was treated by ulnar ostectomy alone. Radius and ulna osteotomies and distraction osteogenesis of the radius were performed in the third cat. Clinical outcome was satisfactory in all three cases.     

Use of pentosan polysulphate in cats with idiopathic, non-obstructive lower urinary tract disease: a double-blind, randomised, placebo-controlled trial

Idiopathic feline lower urinary tract disease (FLUTD) is a common clinical entity where different treatments, for example glycosaminoglycans (GAGs) such as pentosan polysulphate (PPS), are advocated. However, few treatments have been investigated by well-controlled clinical trials. This paper compares the use of PPS in FLUTD compared to placebo. Of the 18 cats in the experiment, nine were treated with PPS and nine were treated with placebo with subcutaneous injections of 3mg/kg PPS or placebo day 1, 2, 5 and 10. The study was double-blind, randomised and placebo-controlled. Revaluation was performed after 5 and 10 days, 2 weeks, 2, 6 and 12 months. There were no statistically significant differences concerning clinical signs between groups during treatment or at re-evaluation, except for pretreatment stressful events where PPS-treated cats had experienced significantly more stressful events compared to cats treated with placebo before entering the study. Six cats (33%) showed recurrence of clinical signs during the entire study period, and only one of these cats had more than one recurrent episode. One cat (placebo) was euthanased 7 days after initial treatment because of recurrence of clinical signs. Another cat (placebo) was euthanased due to other reasons after 6 months. At 2 weeks two cats (placebo and PPS) showed clinical signs. At 2 months re-evaluation one cat showed mild clinical signs. At 6 and 12 months all remaining 16 cats were healthy. Idiopathic, non-obstructive FLUTD is a self-limiting disease with good short-term and excellent long-term prognosis without treatment. Whether or not PPS may be beneficial in a subpopulation of cats with continuous or frequently recurring clinical signs may be elucidated in forthcoming double-blind, randomised and placebo-controlled trials including only this subpopulation of cats.     

Neuraxial morphine induced pruritus in two cats and treatment with sub anaesthetic doses of propofol

HistoryTwo cats were presented for orthopaedic surgery.Physical ExaminationWith the exception of the orthopaedic injuries found, clinical examination showed no abnormality.ManagementAs part of anaesthetic management, one cat received intrathecal morphine, the other epidural morphine. Following recovery, intense grooming was observed. After ensuring adequate analgesia this behaviour was interpreted as pruritus.In the first cat, pruritus was initially managed with medetomidine constant rate infusion (CRI) at 1 and 1.5 μg kg^?1 hour^?1. The lower dose produced sedation and no relief from pruritus, the higher dose ablated pruritus but induced sedation. Two propofol (lipid emulsion formulation) boli of 0.1 mg kg^?1 ablated pruritus without causing sedation. The second cat was successfully treated with four boli of 0.1 mg kg^?1 propofol over 20 minutes.Follow–upFollowing treatment with propofol, pruritus did not recur in either cat and both were discharged from the hospital.ConclusionsThis is the first clinical report of morphine–induced pruritus in cats and management with low–dose propofol. These cases suggest an antipruritic mechanism for lipid–formulation propofol.     

Dowel pinning for feline metacarpal and metatarsal fractures.

The goal of this retrospective study was to describe dowel pinning, and to compare the results of osteosynthesis and external coaptation of metacarpal and metatarsal fractures in cats. Evaluation of the medical records of 351 cats yielded 63 cats treated with dowel pinning, 35 cats treated with external coaptation and 14 cats treated with both methods within the same limb. All of the cats had been re-evaluated at an average of 2.8 years (six months - 15 years) postoperatively. Dowel pinning was superior to external coaptation when all fractured bones of a limb could be pinned. When internal fixation of multiple fractures was not feasible in all fractured bones due to comminution or fragments that were too short to pin, the outcome was not significantly different from cases treated with external coaptation alone. Malunion was seen in 16% of fractured bones in cats treated with external coaptation and occurred secondary to implant bending in 3% of fractured bones treated with dowel pinning. The latter refers to one operated cat, which had four metacarpal fractures in the same limb. Radiographs taken at re-evaluation showed implant migration within the medullary canal in two cats, although neither showed any signs of non-union or lameness. Non-union was seen in one operated cat, in which the fracture (MC IV) could not be completely reduced with a K-wire. Osteomyelitis did not occur. Dowel pinning is an easy, inexpensive and effective technique for repair of metacarpal and metatarsal fractures in cats.     

Treatment of fractures of the mandible and maxilla by mini titanium plate fixation systems in dogs and cats

Mini titanium plates were used to repair certain fractures of the maxilla and mandible in dogs and cats, under general anaesthesia. The location of the fractures treated were: corpus mandible, one dog; corpus mandible and symphysis, two dogs; caudal mandible, two dogs; rostral mandible, one dog; maxilla, one dog; nasal bone, one dog; corpus mandible and symphysis, one cat; caudal mandible, one cat; and maxilla, one cat. The healing periods varied from 6 to 9 weeks. In seven cases, implants were removed after a period of 3.5 to 18 months. In four cases the implants were left in place. The follow up period was between 8 and 36 months. In ten cases the procedure was successful, however in one case the outcome was not satisfactory due to a broken plate. There were no instances of dental malocclusion, nonunion, malunion, osteomyelitis or soft tissue infection. Eating, playing with toys, a fast transition to solid food and a quick return to normal jaw movements were observed. In our hands, the mini titanium plate fixation system was a safe and effective method for repairing certain maxillary and mandibular fractures in dogs and cats.     

Pustular calicivirus dermatitis on the abdomen of two cats following routine ovariectomy

An unusual form of calicivirus dermatitis is described in two cats. Two fully vaccinated cats were re-admitted for anorexia and depression following routine ovariectomy. Signs of upper respiratory disease were not present. One cat subsequently showed painful necrosis of the incision wound, the other one developed dyspnoea with pleural effusion and discrete tongue ulcers. Intact pustular lesions confined to the surgically prepared abdomen appeared in both cats, respectively, on days 11 and 9. The histopathological diagnosis was panepidermal pustulosis and necrotizing dermatitis. Positive immunohistochemical staining consistent with feline calicivirus antigen was detected in epithelial cells within pustular lesions. The cats were treated with antibiotics and ketoprofen. The cat with progressive dyspnoea was euthanized. The clinical signs in the other cat rapidly and completely resolved following glucocorticoid therapy. It is hypothesized that the reported cases may represent a distinct calicivirus-induced pustular dermatitis following ovariectomy.     

Spinal lymphoma in cats: 21 cases (1976-1989).

Medical records of 21 cats with spinal lymphoma were reviewed. All cats were evaluated for neurologic deficits, although 85% of cats necropsied had multicentric disease. Eighty-one percent of cats had hind limb paresis. Results of FeLV tests were positive in 84.2% (16/19) of the cats, and 68.7% (11/16) of the cats had leukemic bone marrow. Spinal lymphoma was confirmed by necropsy in 13 cats, by examination of a biopsy specimen in 1 cat, and by examination of cells aspirated from an epidural lesion in 2 cats. In the remaining 5 cats, a presumptive diagnosis was made on the basis of neurologic examination findings, positive FeLV test results, and leukemic bone marrow. Nine cats were treated with chemotherapy alone. The complete remission rate was 50% in 6 cats given cyclophosphamide, vincristine, and prednisone. The median duration of complete remission was 14 weeks. Complete remissions were not observed in 3 cats given only corticosteroids. A single cat treated by laminectomy and postoperative chemotherapy had a prolonged remission (62 weeks). At necropsy, lymphoma of the CNS was limited to the vertebral canal in 10 of 13 cats; 2 cats had malignant tissue in the brain and vertebral canal, and in the remaining cat, the tumor extended into the brachial plexus. Most tumors extended over multiple vertebral bodies, and 4 cats had more than 1 level of spinal cord involvement. The lymphoma was high-grade lymphoblastic or immunoblastic type in all cats.     

Intracranial empyema: literature review and two novel cases in cats

OBJECTIVES: To review the literature on intracranial empyema and report two new cases in cats. METHODS: Literature review and case reports. RESULTS: Intracranial empyema has been rarely reported in small animals. In two novel cases in cats, the route of infection was postulated to be local extension from a retrobulbar abscess of odontogenic origin in one case and direct inoculation from a penetrating bite wound to the skull, confirmed at post-mortem examination, in the other. On magnetic resonance imaging of the first case, there was a contrast-enhancing large extra-axial fluid collection overlying the right cerebral hemisphere, consistent with subdural empyema. Infection was caused by an Actinomyces spp. This is the first report of successful treatment of intracranial empyema by craniotomy, drainage and antibiotics. CLINICAL SIGNIFICANCE: Intracranial empyema is a neurosurgical emergency. Favourable outcomes may be achieved with surgical decompression, antimicrobial therapy and intensive care.     

P-73 Evaluation of the practicality and efficacy of cryotherapy in feline cutaneous squamous cell carcinoma

Facial dermatitis in cats is a poorly understood clinical problem observed in Persian and Himalayan cats. This report describes three cases of idiopathic facial dermatitis in the Persian cat controlled with cyclosporine. The syndrome was observed in a 5-year-old intact female, a 1.5-year-old intact male, and a 3-year-old neutered male Persian cat. The lesions developed over 2 years, 2 months and 18 months, respectively. Cutaneous lesions were mainly localized to the face. A black patchy waxy exudate matted the hair, especially on the chin. Mild crusts and black exudate were also noted on the vulvar folds in one case and on the ventral aspect of the neck in another case. Erythematous, ceruminous otitis was observed in one case. The histopathological findings were exactly the same for all three cases and compatible with idiopathic facial dermatitis of the Persian cat, or eventually an allergic reaction. All cases were managed with cyclosporine (Neoral^® 6–7 mg/kg/day). Lesions were completely controlled after 4–6 weeks. During a 6-month follow-up for two cases, the lesions seemed to be more resistant to therapy. For these two cats, secondary infections with cocci and Malassezia occasionally occurred. No adverse reactions were observed in our three treated cats.
Funding: Self-funded.     

Proliferative and necrotizing otitis externa in four cats

Proliferative and necrotizing feline otitis externa is a rare disorder of unknown aetiology. This condition was diagnosed by skin biopsy in three adult domestic shorthair cats (3-5 years old) and one kitten (6 months old). The affected cats had large tan to dark brown-black coalescing plaques covering the concave surface of the pinnae and external ear canals. Friable material from the plaques and a thick exudate occluded the ear canals. The cats had a secondary bacterial and/or yeast otitis. Prior to the histopathological diagnosis, all cats received numerous otic preparations as well as oral antibiotics and corticosteroids without resolution. Histologically, all cases had strikingly similar changes; acanthosis with pronounced hair follicle outer root sheath hyperplasia and neutrophilic luminal folliculitis, follicular keratosis and individually necrotic keratinocytes in the outer root sheath of hair follicles. One case was documented via skin biopsy to have persisted for 4 years. The adult cats were treated with topical 0.1% tacrolimus and all showed marked improvement although one cat was lost to follow up. The lesions completely resolved with topical tacrolimus alone in one cat and topical tacrolimus in addition to oral prednisolone in another cat.     

P‐70 Idiopathic facial dermatitis of the Persian cat: three cases controlled with cyclosporine

Facial dermatitis in cats is a poorly understood clinical problem observed in Persian and Himalayan cats. This report describes three cases of idiopathic facial dermatitis in the Persian cat controlled with cyclosporine. The syndrome was observed in a 5‐year‐old intact female, a 1.5‐year‐old intact male, and a 3‐year‐old neutered male Persian cat. The lesions developed over 2 years, 2 months and 18 months, respectively. Cutaneous lesions were mainly localized to the face. A black patchy waxy exudate matted the hair, especially on the chin. Mild crusts and black exudate were also noted on the vulvar folds in one case and on the ventral aspect of the neck in another case. Erythematous, ceruminous otitis was observed in one case. The histopathological findings were exactly the same for all three cases and compatible with idiopathic facial dermatitis of the Persian cat, or eventually an allergic reaction. All cases were managed with cyclosporine (Neoral^® 6–7 mg/kg/day). Lesions were completely controlled after 4–6 weeks. During a 6‐month follow‐up for two cases, the lesions seemed to be more resistant to therapy. For these two cats, secondary infections with cocci and Malassezia occasionally occurred. No adverse reactions were observed in our three treated cats. Funding: Self‐funded.     

Brain abscess in seven cats due to a bite wound: MRI findings, surgical management and outcome

PRESENTATION AND LESION LOCALISATION: Seven adult domestic shorthair cats were presented with a 1- to 6-day history of progressive neurological signs. A focal skin puncture and subcutaneous swelling over the dorsal part of the head were detected on physical examination. Neurological examination indicated lesion(s) in the right forebrain in four cats, multifocal forebrain in one cat, left forebrain in one cat, and multifocal forebrain and brainstem in the remaining cat. In all cats, magnetic resonance imaging revealed a space-occupying forebrain lesion causing a severe mass effect on adjacent brain parenchyma. CLINICAL APPROACH AND OUTCOME: All cats were managed with a combination of medical and surgical treatment. At surgery a small penetrating calvarial fracture was detected in all cats, and a tooth fragment was found within the content of the abscess in two cats. The combination of surgical intervention, intensive care and intravenous antimicrobials led to a return to normal neurological function in five cats. PRACTICAL RELEVANCE: As this series of cases indicates, successful resolution of a brain abscess due to a bite injury depends on early recognition and combined used of antimicrobials and surgical intervention. A particular aim of surgery is to remove any skull and foreign body (tooth) fragments that may represent a continuing focus of infection.     

Dermatophytic pseudomycetomas in four cats

The aim of this retrospective study was to describe the clinical characteristics and treatment of four cats with dermatophytic pseudomycetoma. Four Persian cats, one female and three males, with age ranging from 1.4 to 5 years, were diagnosed with dermatophytic pseudomycetoma by histological examination and fungal culture. Wood's lamp examination revealed positive fluorescence of hairs in all four cats. Characteristic skin lesions consisted of multifocal, raised, firm and nodular to dome-shaped lesions varying in size from 1 to 8 cm in diameter, with ulcers or fistulas in some of the lesions. One cat was treated and cured with 3 months of oral itraconazole; lesions completely regressed, and at the time of writing there has been no recurrence. One cat was treated with surgical excision alone, and recurrence of lesions occurred after a disease-free interval of 15 months. Two cats were treated with surgical excision and systemic itraconazole therapy. Itraconazole therapy was started 1-2 months before surgery and continued for 3 months after surgery. Surgical margins were wide in both cats, and underlying adipose tissue and/or deeper fascia was removed. One cat relapsed, but had a disease-free interval of 18 months. The other cat has been disease free for 32 months. This case series suggests that aggressive, wide surgical excision and concurrent oral itraconazole are highly beneficial in treating dermatophytic pseudomycetoma in cats.     

Tracheal narrowing secondary to airway obstruction in two cats

Tracheal narrowing is described in two cats. In both cases, inspiratory radiographs demonstrated tracheal narrowing just cranial to the thoracic inlet; no narrowing was seen on expiratory radiographs. Magnetic resonance imaging revealed suspected nasal tumours in both cases, but no abnormalities were identified in the region of the narrowed trachea. Nasal biopsy confirmed intranasal lymphoma in one cat and nasal adenocarcinoma in the other. The former cat was treated with chemotherapy. The owner of the latter cat declined further treatment. The tracheal narrowing disappeared after the initiation of chemotherapy in the cat with intranasal lymphoma and it is suggested that the narrowing might have been associated with the nasal tumour. A careful evaluation of the airway, especially cranial to the narrowing, is recommended in cases of tracheal narrowing in cats.     

Successful treatment of four cases of feline cryptococcosis

Four cases of feline cryptococcosis, with lesions mainly confined to the nasal passages and skin, were treated orally with the antifungal agent, 5-fluorocytosine, augmented in two cases by intradermal injections of an autogeneous vaccine. The cats were all Siamese. Treatment was successful although one cat showed recurrence of skin lesions when 5-fluorocytosine therapy was discontinued, but the condition cleared after a further course of the agent. No untoward side-effects were observed.     

Evalution of an Epidural Intracranial Pressure Monitoring System in Cats

The accuracy of an inexpensive, easily implantable, epidural intracranial pressure (ICP) monitoring system was assessed in six normal cats by comparing measurements from this system to those obtained with a fiberoptic intraparenchymal monitoring system. The epidural monitoring system consisted of a three-way stopcock and saline-filled extension tubing, connected to a standard blood pressure transducer. Each cat was placed under halothane anesthesia and mechanically ventilated. Both an epidural and a fiberoptic intraparenchymal monitoring device were placed in the left cranium of each cat; correct placement was verified by computed tomography. Mean ICP values were simultaneously recorded from both monitoring devices. After obtaining baseline ICP measurements, the ICP was manipulated via ventilation, jugular compression, and pharmacologic agents. Arterial blood pressure levels, arterial blood gas values, end-tidal carbon dioxide levels, and end-tidal halothane levels were recorded throughout the study. Cerebral perfusion pressure was calculated for each level of ICP. Repeated measures analysis of variance method was used to compare mean ICP values between the two monitoring systems. No significant differences in ICP values obtained from the two systems were found (p>0.05) at any level of ICP. The results of this study show that the epidural monitoring system is a reliable alternative to the fiberoptic intraparenchymal ICP monitoring system in normal cats. The accuracy of the epidural monitoring system in pathologic states needs to be investigated.     

P‐36 Juvenile idiopathic nasal scaling in three Bengal cats

Affected cats were three Bengals, one male and two females, whose age at onset of lesions ranged from 13‐ to 20‐weeks old. Nasal planum scaling progressed to thick crusting, consequent exfoliation and exposure of underlying erosions. No signs of pruritus or pain were present but mild respiratory signs were noticed. In all cats, haematology and biochemistry were normal, they were FIV and FeLV negative, PCR for herpesvirus, calicivirus and Chlamydia were negative, and viral isolation for calicivirus and herpesvirus was negative. Wood's lamp examination was negative, as were bacterial and fungal cultures. Cytology showed exfoliating keratinocytes. A skin biopsy taken from one case showed no significant changes. Biopsies from the nasal planum of four dead cats with nondermatological conditions (controls) were collected for comparative studies. Morphometry to record the percentage of the granular layer (GL) and stratum corneum (SC) on the total thickness of the epidermis of the nasal planum was performed. The GL and SC accounted for 10.2 and 21.7% of the epidermal thickness in the affected cat, compared to 18.3 and 20.2%, respectively, in the controls. A significant reduction (P < 0.02) of the SC thickness was detected in the affected cat compared to controls. No treatment was instituted as all cats underwent complete (two cats) or nearly complete (one cat) resolution. The reported cases share the same breed, age at onset, type of lesions and a similar outcome. A reduction of the SC thickness in one of the affected cats was recorded. Therefore, an underlying congenital condition is suspected that manifests with high epidermal cell turnover and normal keratinization. Funding: Self‐funded.