Journal of Feline Medicine and Surgery

Feline infectious peritonitis (FIP) is considered a fatal disease. Three cats with dry form FIP were treated with Polyprenyl Immunostimulant. Two of the three cats are still on treatment and are alive and well 2 years after diagnosis. The third cat survived 14 months but was treated for only 4.5 months. Further studies are necessary to assess the potential of the Polyprenyl Immunostimulant.

A 15-month-old cat presented for evaluation of worsening generalized proprioceptive ataxia. Computed tomography of the cervical spine revealed the presence of a compressive extradural bony mass involving the dorsal aspect of C1. Surgical exploration and debulking of the mass was performed. Histological evaluation of the mass revealed fibrovascular tissue consistent with a vascular hamartoma. This mass was deemed to be originating from the soft tissue associated with the C1 vertebra with subsequent bony proliferation. Surgical debulking of the mass resulted in complete resolution of clinical signs with no evidence of recurrence 2 years after surgery.

Cutaneous infection caused by rapidly growing mycobacteria is a relatively uncommon condition in cats, with variable response rates to surgical debulking and aggressive antibiotic therapy. To date, there have been very few case reports of this disease, especially in the United States. This study reviews a series of cases of cats with rapidly growing cutaneous mycobacterial infections from the south-eastern United States. A majority of the cats were spayed female domestic shorthairs. The median age at onset of clinical signs was 8 years. A majority of cats presented with characteristic lesions in multiple locations, and half of the cats had a known incidence of trauma preceding the development of clinical signs. Mycobacterium fortuitum was the most frequently cultured organism. Cats were treated with a variety of antibiotics for a median of 12 months, and half of them underwent surgical debulking of infected tissue. Five out of the 10 cats reached clinical resolution, while five did not. Those that did resolve required a median of 7 months of antibiotic treatment following diagnosis, and had been lesion-free for a median of 24 months at the time this study was completed. Those that did not resolve were treated for a median of 20 months following diagnosis, two of which were still being treated at the time this study was completed.

This report describes a nosocomial outbreak of feline calicivirus (FCV) associated virulent systemic disease (VSD) in a French veterinary teaching hospital in 2005. The outbreak started in March and resolved within 1 month. Signs, clinical course, clinicopathological findings and lesions were typical of FCV-induced VSD. FCV infection was confirmed by quantitative reverse transcriptase-polymerase chain reaction (RT-PCR). Among the eight infected cats, two had to be euthanased, three died, and three recovered after medical treatment. Virus could not be confined inside the animal hospital and on two occasions, students' own cats became infected. Subsequent genetic sequencing studies confirmed that the eight cats were infected with the same strain of virus, and that it was distinct from those involved in the US and UK outbreaks of VSD. Virulence and viral excretion patterns of the isolated strain were further characterised by experimental infection.

Empiric antibiotic therapy is often employed to treat feline chronic rhinosinusitis (CRS), however, collection of samples for culture should result in improved antibiotic selection and development of less antibacterial resistance. This study evaluated the effect of sampling method on culture results in 44 cats and found that aerobic and anaerobic cultures were positive significantly more often from nasal flush samples than from tissue biopsy samples. Frequency of positive Mycoplasma species culture did not differ between the two sampling methodologies, although results were discordant in eight sample pairs. Mycoplasma species were cultured from flush samples only in three cats and from biopsy samples only in five cats. These results suggest that a nasal flush sample is adequate for determining the presence of bacterial organisms in feline nasal disease, however, failure to culture Mycoplasma species from a nasal flush must be interpreted with caution.

Feline herpesvirus 1 (FHV-1) infection is extremely common in cats and is frequently associated with morbidity because of recurrent ocular and respiratory clinical signs of disease. Enterococcus faecium strain SF68 is an immune-enhancing probiotic used as a dietary supplement. In this pilot study, 12 cats with chronic FHV-1 infection were administered either SF68 or a placebo, monitored for clinical signs of disease, monitored for FHV-1 shedding, and evaluated for FHV-1 specific humoral and cell-mediated immune responses and fecal microbiome stability. Fecal microbial diversity was maintained throughout the study in cats supplemented with SF68, but decreased in cats fed the placebo, indicating a more stable microbiome in cats fed SF68. While clinical results varied among individual cats, the overall findings suggest that administration of the probiotic lessened morbidity associated with chronic FHV-1 infection in some cats. Additional study is warranted to determine efficacy in a clinical setting.

Faecal samples were collected from 57 clinically healthy kittens presented for initial vaccination, in the UK. Routine bacteriological examination identified Salmonella species in one and Campylobacter species in five samples. Polymerase chain reaction (PCR) detected the presence of Campylobacter species in a further four samples. Routine parasitological examination revealed Toxocara species ova in nine (including four kittens stated to have been administered an anthelmintic) and Isospora species in four samples. No Giardia or Cryptosporidium species were detected by routine methods. A Giardia species enzyme-linked immunosorbent assay (ELISA) test kit designed for use in cats was positive in three kittens. A similar test kit designed for use in humans was negative in all samples and produced negative results even when known positive samples were tested. Potentially pathogenic enteric organisms were detected in 19 kittens by routine methods and 26 (prevalence 45%) by all methods. The high prevalence in asymptomatic kittens highlights the possibility that the detection of these organisms in kittens with gastrointestinal disease may be an incidental finding.

Feline pancreatitis is a commonly suspected illness and it has been proposed that some cases of feline pancreatitis may be caused by infection with Toxoplasma gondii or Bartonella species. Feline pancreatic lipase immunoreactivity (fPLI) is a test performed on serum that is commonly combined with other clinical findings as an indirect aid in the diagnosis of pancreatitis. The purpose of this study was to determine if there are associations between fPLI concentration and the presence of serum antibodies against T gondii or Bartonella species. Serum samples from 458 cats, for which serum fPLI concentrations had already been determined, were assayed by enzyme-linked immunosorbent assay for the presence of T gondii immunoglobulin (Ig) G (IgG) and IgM antibodies, and Bartonella species IgG antibodies. The association between fPLI concentration and T gondii or Bartonella species antibodies was determined. No statistically significant association was found between fPLI concentration and T gondii or Bartonella species antibodies, suggesting that serological tests for the organisms are not useful in cases with increased fPLI concentration.

Human diabetic patients routinely self-adjust their insulin dose using a protocol and home monitoring, and perform equally well or outperform physician directed adjustments. The objective of this study was to report the outcome of home monitoring of diabetic cats by owners using a protocol aimed at achieving euglycaemia, using ultra-low carbohydrate diets (≤10% metabolisable energy) and the insulin analogue glargine for >10 weeks and/or until remission was achieved. Fifty-five cats diagnosed with diabetes mellitus, whose owners joined the online German Diabetes-Katzen Forum, were included. An overall remission rate of 64% was achieved in the cohort. Significantly higher remission rates were observed if good glycaemic control was achieved soon after diagnosis: 84% for cats started on the protocol within 6 months of diagnosis went into remission, and only 35% for cats that began more than 6 months after diagnosis (P<0.001). Only one mild clinical hypoglycaemic episode occurred observed despite tight blood glucose control. In conclusion, intensive blood glucose control is safe and effective in diabetic cats using home monitoring and treatment with glargine.

Glycaemic control and remission probabilities were compared in 24 newly diagnosed diabetic cats treated twice daily with either glargine, protamine zinc (PZI) or lente insulin and fed a low carbohydrate diet. After day 17, the probability of remission was substantially higher for cats with lower mean 12 h blood glucose concentrations on day 17, irrespective of insulin type. Glargine-treated cats had lower mean 12 h blood glucose concentrations on day 17 than PZI- or lente-treated cats, and all eight glargine-treated cats achieved remission compared to three PZI- and two lente-treated cats. The probability of remission was greater for cats treated with glargine than cats treated with PZI or lente insulin. In newly diagnosed diabetic cats, twice daily treatment with glargine provides better glycaemic control and higher probability of remission compared to twice daily treatment with PZI or lente insulin. Good glycaemic control soon after diagnosis is associated with increased probability of remission and should be the goal of insulin therapy.

Low-grade alimentary lymphoma (LGAL) was diagnosed by histological and immunohistochemical evaluation of full-thickness biopsies from multiple regions of the gastrointestinal tract collected during exploratory laparotomy in 17 cats. The most common clinical signs were weight loss (n=17) and vomiting and/or diarrhoea (n=15). Clinical signs were chronic in 11 cases. Abdominal palpation was abnormal in 12 cats, including diffuse intestinal thickening (n=8), an abdominal mass due to mesenteric lymph node enlargement (n=5) and a focal mural intestinal mass (n=1). The most common ultrasonographic finding was normal or increased intestinal wall thickness with preservation of layering. Ultrasound-guided fine-needle aspirates of mesenteric lymph nodes (n=9) were incorrectly identified as benign lymphoid hyperplasia in eight cats, in which the histological diagnosis from biopsies was lymphoma. There was neoplastic infiltration of more than one anatomic region of the gastrointestinal tract in 16/17 cats. The jejunum (15/15 cats) and ileum (13/14 cats), followed by the duodenum (10/12 cats), were the most frequently affected sites. Twelve cats were treated with oral prednisolone and high-dose pulse chlorambucil, two with a modified Madison–Wisconsin multiagent protocol and three with a combination of both protocols. Thirteen of the 17 cats (76%) had complete clinical remission with a median remission time of 18.9 months. Cats that achieved complete remission had significantly longer median survival times (19.3 months) than cats that did not achieve complete remission (n=4) (4.1 months; P=0.019). The prognosis for cats with LGAL treated with oral prednisolone in combination with high-dose pulse chlorambucil is good to excellent.

A 5-year-old, female Ragdoll cat was diagnosed with an intra-abdominal mycetoma involving the ileocaecal region. Diagnosis was obtained via histopathological examination following surgical resection of the mass and an ileocolic anastomosis. The initial surgery was complicated by lymphangiectasia, chylous abdominal effusion and mild bacterial leakage from the anastomosis site. A second, exploratory laparotomy was performed to augment the anastomosis with serosal patching and omentalisation and to investigate a cystic structure observed on follow-up abdominal ultrasound. Initial amoxycillin clavulanate (Clavulox; Pfizer Animal Health) therapy was ineffective, but clindamycin (Antirobe; Pfizer Animal Health) proved successful in resolving the infection. Abdominal actinomycetoma in the cat may be an under-diagnosed condition due to its close resemblance to neoplastic disease. Standard diagnostic and therapeutic regimens are commonly ineffective in Actinomyces species infections. Surgical resection along with adjunctive, long-term, selective antimicrobial therapy is effective and prognosis is good for localised lesions.

A 14-year-old male neutered domestic shorthair cat was admitted to the Veterinary Medical Center, University of Minnesota for evaluation of severe hind limb ataxia, atrophy and paresis. Diagnosis based on physical examination, neurological assessment and magnetic resonance imaging (MRI) was multifocal intervertebral disc disease (IVDD) with dorsal disc protrusion throughout the thoracic and cranial lumbar spine. The Oriental Medicine (OM) diagnosis (pattern identification) was painful obstruction (Bi) syndrome caused by phlegm-heat accumulation with blood stagnation in the spine. High dose prednisolone therapy (1.25 mg/kg PO, once daily) initially did not show any significant improvement in clinical signs. The cat was then treated with several modes of acupuncture treatment including dry needle acupuncture, electro-acupuncture and scalp acupuncture along with Tui-Na (hand manipulation in OM) and physical therapy. Significant improvements in mobility, proprioception and spinal posture were noticed and the cat was able to rise, walk and run 4 months after starting acupuncture treatments. This is the first case report of feline IVDD with multiple sites of disc compression which was successfully treated with several modes of acupuncture treatment.

Quadrigeminal cysts represent intracranial cystic accumulations of cerebrospinal fluid within the arachnoid mater at the level of the quadrigeminal cistern. Quadrigeminal cysts are rare in cats, with only one previous report in the veterinary literature. A 4-year-old, male-neutered Persian cat was presented with a 1-year duration of initially episodic, but later progressive, obtundation and collapse. Magnetic resonance imaging of the brain revealed a quadrigeminal cyst with marked compression of the adjacent neural structures, cerebellar herniation and obstructive hydrocephalus. Cystoperitoneal shunt placement was performed after the cat became refractory to medical therapy and this resulted in return of normal neurological status. The improvement in the neurological deficits following placement of a cystoperitoneal shunt in this case appeared to be correlated with resolution of the secondary effects (in particular the obstructive hydrocephalus) rather than resolution of the quadrigeminal cyst. Cystoperitoneal shunt placement was an effective long-term treatment option for the management of the quadrigeminal cyst in this cat.

This case report describes the clinical and magnetic resonance imaging (MRI) findings of a 3.5-year-old, male neutered, domestic shorthair cat with second order Horner's syndrome as the only clinical abnormality. The neuroanatomical pathway of the sympathetic innervation to the eye, differential diagnoses for Horner's syndrome in cats, and the interpretation of pharmacological testing are reviewed. The unusual MRI findings and the value of fat-suppressed MRI sequences are discussed.

A 5-year-old spayed female cat was evaluated for hyperthyroidism based on an elevated free thyroxine (T₄) measurement and bilaterally enlarged symmetric subcutaneous masses in the area of the thyroid glands. Physical examination revealed bilateral subcutaneous masses on either side of the cervical trachea. Blood was obtained for serum biochemical profile and thyroid function analysis. Mild hyperalbuminemia, mild hypercalcemia, and mildly increased alanine aminotransferase activity were identified. Serum concentrations of total and free thyroxine were within the reference interval. Cytologic analysis of fine-needle aspirates from one of the masses was suspicious for neoplasia. Nuclear scintigraphy revealed no abnormalities. Surgically obtained excisional biopsies of both masses were submitted for histopathology and diagnosed as bilateral dermoid cysts. After excisional biopsy, the patient recovered without incident. The histopathologic diagnosis of completely excised bilateral dermoid cysts indicated that no further medical or surgical intervention was required. This is the first report of a cat presenting with bilateral dermoid cysts in the area of the thyroid glands. Histopathologic examination was necessary to make a definitive diagnosis. Practitioners should include cysts in their list of differential diagnoses for ventral neck masses in cats.

The present report concerns a case of sporotrichosis in a 3-year-old male crossbred cat. After 9 months of oral itraconazole (20 mg/kg) therapy, all skin lesions had resolved with the exception of a single nodular lesion located on the bridge of the nose. Therefore, a combined therapy that included intralesional (IL) amphotericin B (1 mg/kg) was started. The lesion resolved completely after three weekly administrations of IL amphotericin B, given in concert with oral itraconazole. The cat remains well 1 year after discontinuing therapy, with no signs of recurrence.

Greece is a highly endemic country for Leishmania species. Canine cases of leishmaniosis are recorded in different parts of the country. However, no case of feline leishmaniosis has been reported yet. In the present study, the seroprevalence in cats was investigated as a first approach to measuring Leishmania spp. infection of this animal species, in Greece. For this purpose, blood serum samples from 284 stray adult cats, living in the major area of Thessaloniki (Northern Greece), were examined by enzyme-linked immunosorbent assay for the detection of anti-Leishmania spp. IgG. Eleven (3.87%) of the examined animals were found positive. The prevalence was lower in cats than in dogs coming from the same area, based on previous studies. Despite the low seroprevalence for Leishmania spp. in cats, leishmaniosis may be taken into consideration concerning the differential diagnosis of the feline diseases, especially in endemic areas.

Congenital limb deformities are rarely reported in cats. This paper describes the radiographic findings of congenital forelimb malformations in two cats. The radiographic changes were suggestive of an autopodium ectromelia associated with humero-ulnar synostosis in one case and zeugopodium ectromelia in the other case. Congenital feline limb deformities are poorly documented and, to the authors' knowledge, this is the first time that humero-ulnar synostosis has been reported in cats.