Journal of Feline Medicine and Surgery

Seventeen cats were presented with acute onset of complex partial seizures with orofacial involvement (salivation, facial twitching, lip smacking, chewing, licking or swallowing), motor arrest (motionless starring) and behavioural changes. In 11 cats hippocampal necrosis (HN) was confirmed by histopathology. In a further six cats hippocampal changes were suggested by magnetic resonance imaging. The mean monitoring time of eight cats which were not euthanased in the acute phase of the disease, was 408 days (60–908): four cats are still alive. In all surviving cases, the owners reported a good quality of life. We conclude that an acute cluster of complex partial seizures with orofacial involvement are often associated with HN and that HN is not necessarily a fatal condition. Supportive and antiepileptic therapy can result in remission. The long-term outcome can be good to excellent; therefore, euthanasia should be avoided in the acute phase of the signs.

Recurrent constipation is a common problem in cats. Laxatives often are the cornerstone for management of recurrent constipation; however, there is a paucity of published research on laxative use in cats. This study investigated the safety and palatability of polyethylene glycol (PEG3350) in normal cats. All cats consumed the PEG3350 laxative for 4 weeks without changes in weight or food intake. In all cats soft stools were achieved. Effective doses varied widely in experimental cats, so individualized dosing is important. Mild, non-clinical hyperkalemia was noted although the cause is unknown.

This study evaluates the effect of dietary protein content on renal parameters in 23 healthy spayed female cats. The objective was to determine if cats eating diets high in protein will have higher serum urea nitrogen (UN) and creatinine values without a detectable change in kidney function, as assessed by urinalysis. A single random cross-over design was used. Cats were fed a standard maintenance diet for at least 1 month prior to the dietary trial. They were fed in two phases. For the first phase, cats were randomly assigned to receive either a high protein [HP = 46% metabolizable energy (ME)] or low protein (LP = 26% ME) diet. For the second phase, cats were fed whichever diet they were not fed during the phase I period. Blood and urine samples were collected at 2-week intervals for the duration of the study (10 weeks). UN, albumin, alanine aminotransferase and urine specific gravity were significantly higher, and creatinine and phosphorus were significantly lower (P < 0.05) when cats were fed the HP diet as compared to when they were fed the LP diet, although none of the mean values were found to be outside of the corresponding reference interval. Dietary intake can result in clinically significant changes in UN and statistically significantly changes in several other biochemical analytes, although all analytes are likely to remain within normal reference intervals. Therefore, an accurate dietary history is necessary to help determine if renal parameters are being influenced by diet in a particular patient.

The Bayer Multistix are commonly used for detection and estimation of feline glucosuria by veterinarians and cat owners. A newer product, the Purina Glucotest, utilizes the same enzymatic technology for detection of glucose, but has been designed for home use as a litter additive that allows interpretation of glucosuria over an 8-h period. The objectives of this study were to assess the sensitivity, specificity, and accuracy of the Glucotest and Multistix, and to assess the 8-h color stability of the Glucotest. Overall, the Glucotest had greater sensitivity and specificity than the Multistix, and more accurately estimated urine glucose concentration if evaluated at least 30 min after exposure to urine. A significant lack of agreement between the results obtained immediately after exposure to urine vs after 30 min and 8 h contradicts the 8-h color stability claim, but the change in urine glucose concentration estimation over time resulted in improved test accuracy at the 30 and 480 min time points.

Anal sac adenocarcinoma is uncommon in cats. We report the outcome of multi-modality therapy in two cats (surgery, definitive radiotherapy and systemic chemotherapy) and surgery alone in two cats. All received surgical excision of the primary tumour followed by radiotherapy and carboplatin chemotherapy in two cases. Both cats that underwent multimodal therapy developed distant metastatic disease and one developed recurrence of the primary tumour. One cat that underwent surgery alone with incomplete margins also developed rapid recurrence. Overall survival times were 89, 161 and 169 days. One cat that had complete surgical excision is still alive without recurrence 425 days postoperatively. Whilst the role of radiation in the local control of this disease is yet to be defined, clearly a more effective systemic therapy is required before such aggressive local treatment can be routinely recommended.

This study describes radiographic changes associated with mycobacterial infection in 33 domestic cats confirmed by culture or interferon-gamma testing. Infection was seen most frequently in adult (average age 5.7 years; range 1.5–12 years), non-pedigree (87%; 27/31), neutered male cats (69%; 22/32). The most common infections were Mycobacterium microti (60%; 18/30) and Mycobacterium bovis (37%; 11/30); Mycobacterium avium and Mycobacterium malmoense were infrequently cultured (3% of each; 1/30). Radiographs were available for the thorax (24 cats), abdomen (eight), appendicular skeleton (11) and head (three). Radiographic changes affected the thorax most commonly, consisting of bronchial (46%; 11/24), alveolar (38%; 9/24), nodular unstructured interstitial (38%; 9/24) or unstructured interstitial (25%; 6/24) lung patterns, which were often mixed. Perihilar or sternal lymphadenopathy were common (42%; 10/24), particularly perihilar lymphadenopathy (25%; 6/24). Skeletal changes were found in the distal antebrachium (three), pes (two), maxilla, scapula, spine, manus, femur, and tarsus (one each). Changes were typically osteolytic (73%; 8/11), often permeative osteolytic (64%; 7/11).

Osteoproliferative changes were seen in three cats and soft tissue swelling in five cats, which were adjacent to the bony abnormality in four cats. Other changes included submandibular soft tissue swelling, marked aortic, aortic root and brachiocephalic trunk calcification, and soft tissue swelling with calcification in the distal antebranchium which was not involving bone. Abdominal changes were uncommon (seen in 2/8 cats) and consisted of hepatomegaly and hepatosplenomegaly. In summary, radiographic changes were varied, no lesion was pathognomic for mycobacterial infection, and pathology was seen most commonly in the thorax.

The objective of the study was to characterize the signalment, clinicopathologic data, and diagnostic imaging of cats with urate urolithiasis, as well as the salts of uric acid present in the uroliths. A retrospective analysis of feline urate uroliths submitted to the GV Ling Urinary Stone Analysis Laboratory between 2000 and 2008 was included. From these data, records were assimilated from referring veterinarians (143); furthermore, all recorded cases from within the William R Pritchard Veterinary Medical Teaching Hospital (16) were included. Median values for the complete blood count and chemistry panels available were within the reference intervals, when provided, with only a few outliers present. Of all cases evaluated, seven had a portosystemic shunt (PSS). Cats with urate uroliths and a PSS were younger than cats without a PSS (2 years vs 7 years). The pathogenesis of urate uroliths in cats is poorly understood. Most cats were not completely evaluated for a PSS, however, clinicopathologic parameters indicating hepatic dysfunction were seldom noted; more sensitive diagnostics such as serum bile acids were rarely performed to confirm or negate the presence of a shunt. Studies are warranted to evaluate pathogenesis of urate uroliths to tailor proper management and breeding strategies.

Physiologic parameters such as blood pressure, rectal temperature, heart rate, and respiratory rate are an important part of the medical assessment of a patient. However, these factors can potentially be affected by stress. The purpose of this study was to compare physiologic parameter data gathered from cats in the home environment with those gathered in a veterinary hospital. Thirty healthy cats were evaluated both at home and at Colorado State University's Veterinary Medical Center. Doppler systolic blood pressure, temperature, heart rate, and respiratory rate were recorded, and the differences between the values obtained in the home and veterinary clinic environments were evaluated using the Wilcoxon sign rank test. A significant difference was found in blood pressure, heart rate, and respiratory rate between the home and veterinary hospital environments. This information may help practitioners recognize that physiologic abnormalities can sometimes be due to transportation or environmental stress rather than medical illness.

Sixteen cats were used to compare the cardiovascular and anesthetic effects of remifentanil (REMI) or alfentanil (ALF) in propofol-anesthetized cats undergoing ovariohysterectomy. After premedication with acepromazine, anesthesia was induced and maintained with a constant rate infusion of propofol (0.3 mg/kg/min). REMI or ALF infusions were administered simultaneously with propofol. Heart rate (HR), systolic arterial pressure (SAP), pulse oximetry (SpO2), rectal temperature (RT), and response to surgical stimulation were recorded at predefined time points during anesthesia. Data [mean ± standard deviation (SD)] were analyzed by analysis of variance (ANOVA) for repeated measures followed by a Dunnett's test and Student t-test (P < 0.05). SAP was significantly lower in ALF group than in REMI group. Extubation time was significantly shorter in REMI than in ALF group. Overall infusion rate of REMI and ALF was 0.24 ± 0.05 mg/kg/min and 0.97 ± 0.22 mg/kg/min, respectively. The combination of propofol and REMI or ALF provided satisfactory anesthesia in cats undergoing ovariohysterectomy.

This study describes signalment, history, antibiotic administered, clinical signs observed, therapy, and outcome of anaphylactic events within 4 h following ophthalmic administration of an antibiotic to cats. Data came from survey responses (45 cats) or Federal Drug Administration reports (16 cats). Cat age (7 weeks—19 years), breed, and gender ranged widely. Most were healthy (87%) prior to anaphylaxis. Ophthalmic antibiotics commonly were administered for conjunctival (65%) or corneal (11%) disease, or ocular lubrication (7%) and contained bacitracin, neomycin, and polymyxin B (44%), or oxytetracycline and polymyxin B (21%). Polymyxin B was present in all cases. Vaccines or other drugs were also administered to 51% of cats. In 56% cases, anaphylaxis occurred within 10 min of drug application. Most (82%) cats survived. Although a causal association was not proved, ophthalmic antibiotic administration preceded anaphylaxis in all cats. Like other drugs, ophthalmic antibiotics should be used only when indicated.

Medical records (2005–2009) of a feline-only practice were searched for cats with degenerative joint disease (DJD) treated using meloxicam. DJD was diagnosed by the presence of at least two of the following: (i) altered mobility (observed by the owner), (ii) abnormal physical findings, (iii) characteristic radiographic changes. The primary study cohort consisted of cats older than 7 years that had received meloxicam for variable intervals in excess of 6 months, and for which complete records were available. These cats were subdivided according to whether detectable chronic kidney disease (CKD) was present (‘renal group’), or not (‘non-renal group’), and, for the ‘renal group’, according to the cat's IRIS category. Serum biochemistry, urinalysis (including urine specific gravity [USG]), body mass and condition score were monitored regularly. Progression of CKD in the ‘renal group’ and ‘non-renal group’ of cats was compared to two groups of age- and IRIS-matched control cats not receiving meloxicam (from the same clinic, over the same time period). The study was thus a case—control design, with two study groups. Thirty-eight cats with DJD receiving long-term meloxicam therapy met the inclusion criteria. Of these, 22 cats had stable CKD at the start of treatment (stage 1, eight cats; stage 2, 13 cats; stage 3, one cat). No cats initially had an elevated urinary protein to creatinine ratio. The remaining 16 cats initially had normal renal analytes and adequately concentrated urine. The median age of the ‘renal’ and ‘non-renal’ meloxicam groups was 15.5 and 13.4 years, respectively. The median treatment duration was 467 days in the ‘renal group’ and 327 days in the ‘non-renal group’. After titration (to the lowest effective dose), the median maintenance dose was 0.02 mg/kg/day in both groups (range 0.015–0.033 mg/kg/day). There was no difference in sequential serum creatinine concentration or USG measurements between the ‘non-renal group’ treated with meloxicam compared to control cats not treated with meloxicam. There was less progression of renal disease in the ‘renal group’ treated with meloxicam compared to the age- and IRIS-matched cats with CKD not given meloxicam. These results suggest that a long-term maintenance dose of 0.02 mg/kg of meloxicam can be safely administered to cats older than 7 years even if they have CKD, provided their overall clinical status is stable. Long-term meloxicam therapy may slow the progression of renal disease in some cats suffering from both CKD and DJD. Prospective studies are required to confirm these findings.

Pneumonectomy is the resection of all lung lobes from one side of the thorax. The clinical findings, treatment and outcome of four cases of feline chronic pyothorax managed with exploratory thoracotomy and pneumonectomy are reported. All cases were initially medically managed with thoracic drain placement and antibiosis. However, resolution was not achieved with medical therapy and diagnostic imaging findings consistent with an area of abscessation or marked lung lobe consolidation were identified, supporting a decision for surgical management. Surgical exploration was performed via median sternotomy and, on the basis of gross inspection, non-functional lung was removed. A left-sided pneumonectomy was performed in three cats and a right-sided pneumonectomy in one. All cases survived to discharge and an excellent quality of life was reported on long-term follow-up. Pneumonectomy appears to be well tolerated in the cat.

This report describes a cat that suffered pelvic urethral rupture associated with multiple pelvic fractures. A vaginourethroplasty was performed as a salvage procedure, via intrapelvic anastomosis of the proximal urethra to the caudal vagina, following failure of a primary urethral anastomosis. Urinary diversion was achieved via tube cystostomy and a vagino-urethral catheter was maintained for 3 days postoperatively. Anterograde cystourethrography was performed at 7 days and 14 days postoperatively. Absence of contrast leakage from the vagino-urethral anastomosis was documented at 14 days postoperatively and the tube cystostomy was removed. An Escherichia coli urinary tract infection was treated following removal of the tube cystostomy and subsequent urine culture revealed no evidence of urinary tract infection. The cat retained normal urinary continence and elimination behaviour during the 7-month follow-up period. Vaginourethroplasty could be considered as a salvage option for management of traumatic pelvic urethral rupture in the neutered female cat.

A 13-year-old male neutered domestic shorthair cat presented with an acute onset of dyspnoea. Thoracic radiographs revealed marked, bilateral, caudal lung lobe consolidation. A diagnosis of anatomically mixed T-cell lymphoma with pulmonary, renal and alimentary involvement was confirmed on histopathology. Pulmonary involvement in cases of feline lymphoma is uncommon and the radiographic appearance of pulmonary lymphoma is highly variable. Lung lobe consolidation has been described with primary lung tumours in cats, but not previously in association with pulmonary lymphoma. This unusual presentation serves to alert practitioners to the possibility of lymphoma as a cause of severe bronchopulmonary disease in the cat.

This paper describes a cat with severe localised infections with Cryptococcus neoformans/gattii species complex and Mycobacterium avium affecting the subcutis and underlying fascia and bone of the right pelvic limb. The simultaneous isolation of both pathogens in this patient was unexpected and posed unique issues concerning both diagnosis and clinical management. The aetiopathogenesis of this infection is discussed in relation to aspects of diagnosis and therapy.

Feline parotid salivary duct sialocele is an uncommon disorder that has been previously reported in association with traumatic rupture of the duct in only two cats. Both cases were successfully treated by proximal duct ligation. We describe the successful surgical treatment of a parotid duct sialocele, secondary to spontaneous salivary duct stenosis, in an adult domestic shorthair cat. The cat was referred for assessment of a recurrent fluid-filled swelling on the left side of the face. Cytology of the aspirated fluid was consistent with serous saliva. The anatomical localisation of the lesion and the nature of the fluid were indicative of parotid gland/duct involvement. Retrograde sialography by parotid duct cannulation was unsuccessful because the left parotid duct opening was stenosed and obstructed by scar tissue. Surgical exploration revealed a parotid salivary duct sialocele, which was completely removed along with the parotid gland without complications.

A 7-year-old male, castrated, domestic shorthair cat was presented with a plantigrade stance of the left pelvic limb. An avulsion of the lateral head of the gastrocnemius muscle was diagnosed based on clinical examination and radiographic assessment. Surgical reduction and fixation were achieved with modified locking loop sutures through bone tunnels in the supracondylar tuberosity of the distal femur. Additionally, a temporary calcaneotibial positional screw was placed in order to neutralise forces on the gastrocnemius muscle. No postoperative complications were encountered and the cat made a full recovery.

A 6-year-old male neutered cat presented with blindness, lethargy, polydipsia, hyposthenuria and severe hypernatraemia. Central diabetes insipidus was demonstrated by means of a low measured anti-diuretic hormone (ADH) concentration in the face of hypernatraemia, and clinical response to supplementation with desmopressin. Magnetic resonance imaging of the brain showed a discrete mass in the region of the hypothalamus. The cat was euthanased and post-mortem histological examination demonstrated B cell lymphoma involving the brain, optic nerves, urinary bladder wall and diaphragm. To the authors' knowledge, this case report is the first to describe central diabetes insipidus caused by central nervous system lymphoma in the cat.

An 8-month-old owned European cat showing abdominal pain, fever, distended painful bladder and urinary blockage was presented. Intravenous fluids were immediately administered and, after sedation, a urinary catheter was applied. Blood and urine analysis revealed cystitis and a moderate-to-severe degree of renal failure. About 20 thread-like nematodes, identified as Capillaria plica larvae and fragments of adult stages, were found in the urine sediment. After treatment with an oral formulation of fenbendazole at 25 mg/kg q 12 h for 10 days, urinary signs and bladder worms disappeared. Cases of Capillaria species bladder worms in cats are rarely reported and most infected cats show no clinical signs, presumably because of a low parasite burden. In the present study, feline capillariosis was associated to urethral obstruction, severe difficulties in urination, cystitis and renal failures.

A 2-year-old, female spayed, domestic shorthair cat presented to the University of Missouri-Veterinary Medical Teaching Hospital (UMC-VMTH) with an approximately 11-month history of fluid-draining pockets along her ventral thorax and axillae. The skin in these regions was erythematous, and multiple areas drained a serous to serosanguinous fluid. Fluid-filled, nodules formed along the ventrum, but these nodules disappeared as fluid drained spontaneously. Histologic assessment of skin biopsies revealed areas of vascular proliferation extending along the deep margin of the section and rare instances of invasion into the superficial dermis. These vascular channels were devoid of cells, lined by variably pleomorphic endothelial cells which had a low mitotic index. Based on the mild to moderate pleomorphism, positive staining with prospero-related homeobox gene-1 (PROX-1), and the locally aggressive nature of the tumor, a final diagnosis of lymphangiosarcoma was made.

Knowledge of the occurrence of bacteriuria in adult, healthy cats is scarce in the scientific literature. A study was designed to investigate the occurrence of bacteriuria in healthy cats without current or previous signs of lower urinary tract disease. The study included 108 cats, 53 males (49.5%) and 55 females (50.5%). The cats ranged in age between 7 months and 18 years, with a mean age of 4.4 years and a median age of 4.0 years. Urine was obtained by cystocentesis from all the cats, and was submitted for bacteriological analyses. Urine and urine sediment was cultured on separate blood agar plates for quantification and species identification by standard procedures. Detection of ≤10³ colony forming units (cfu) per ml urine was defined as significant bacteriuria. Significant bacteriuria exceeding 10⁵ cfu/ml was detected in one sample with a combination of Enterococcus species and Staphylococcus species. There was no bacterial growth in the urine samples from 107 cats (99.1%). Results from our study indicate that the prevalence of bacteriuria in clinically healthy, adult cats is low. Also, that contamination of samples is rare when urine is collected by cystocentesis.