Carlo M. Mortellaro

Bilateral orbital and nasal aspergillosis in a cat.

Abstract A 12‐year‐old, 4 kg, castrated male Persian cat was referred with a 2‐month history of sneezing and bilateral mucopurulent nasal discharge. Rhinoscopically acquired nasal biopsies at this time revealed bilateral lymphoplasmacytic rhinitis. A tapering dose of oral prednisone caused the complete remission of the clinical signs, but 2 months after discontinuation of the therapy, the rhinitis recurred and the OD became exophthalmic. Computed tomography showed a soft tissue mass in both sides of the nasal cavity, both frontal sinuses, the right orbit, and to a lesser extent the left orbit. A fine needle aspirate of the right orbit revealed pyogranulomatous inflammation and Aspergillus spp. hyphae. Repeat nasal biopsy demonstrated multi‐focal necrosis and a mixed inflammatory cell process which now included macrophages and scattered septate fungal hyphae. A few days later the cat became bilaterally blind and a contrast enhancing lesion involving the optic chiasm was found on magnetic resonance imaging. Despite a poor prognosis, therapy consisted of exenteration of the right orbit and trephination of both frontal sinuses before the planned initiation of medical antifungal therapy. Unfortunately, the cat died of cardiac arrest intraoperatively. Aspergillus fumigatus was cultured from both orbits at necropsy. Orbital aspergillosis has been rarely reported in cats and its relationship with lymphoplasmacytic rhinitis is unclear. In this patient lymphoplasmacytic rhinitis or previous antibiotic/corticosteroid therapy may have allowed secondary fungal invasion of the nasal mucosa and subsequently both orbits and the brain. Alternatively, Aspergillus infection may have preceded the lymphoplasmacytic rhinitis.

Amniotic membrane transplantation for the treatment of feline corneal sequestrum: pilot study.

OBJECTIVES To describe and evaluate the use of equine amniotic membrane trans-plantation after lamellar keratectomy for the treatment of corneal sequestrum in cats. METHODS Six cats (seven eyes) of various breed and ages with corneal sequestra were treated surgically with lamellar keratectomy and amniotic membrane transplantation. All the sequestra and a small piece of the amniotic membranes used for each surgery were submitted for histopathologic examination. RESULTS Five of the seven eyes showed minimal level of scarring in the cornea and good transparency. No recurrences of the sequestra have been noted during the follow-up period (3-9 months). One eye had necrosis of the amniotic membrane 2 weeks after the surgery. The sequestrum of this eye showed a high level of bacterial contamination on histopathology. Three months later the same cat developed a descemetocele in the area where the necrotic amniotic membrane was rejected. A second eye developed a perforation under the amniotic membrane two weeks after the surgery. The sequestrum of this eye was deep and without vascularization. CONCLUSION Amniotic membrane transplantation after lamellar keratectomy was a valid procedure for surgical treatment of corneal sequestrum in cats. The procedure resulted in excellent cosmesis and functional vision in five of seven eyes; although case selection is important, particularly to exclude the very deep and non-vascularized sequestra.

Nasal rhinosporidiosis in dogs: four cases from Europe and a review of the literature.

This paper describes four cases of canine rhinosporidiosis which occurred in Italy in 1994 and 1995. Four dogs with a history of exposure to the muddy environment of rice fields, developed respiratory signs. Rhinoscopy revealed nasal polypoid lesions with a characteristic gross appearance due to the presence of multiple, tiny, white-yellowish spots representing sporangia filled with spores. In cytological samples obtained by brushing, many spores were present in an inflammatory background. Histologically, the polyps consisted of fibrovascular tissue embedding sporangia in different developmental stages, and free spores which elicited a severe pyogranulomatous inflammation. All the dogs were treated surgically and the condition did not recur in two cases during a years follow- up and in the other two cases during two years.

Use of episcleral cyclosporine implants in dogs with keratoconjunctivitis sicca: pilot study

PURPOSE To describe the use, tolerability, and efficacy of episcleral silicone matrix cyclosporine (ESMC) implants in dogs with keratoconjunctivitis sicca (KCS). METHODS Retrospective study. ESMC implants (1.9 cm length, 30% wt/wt CsA in silicone; with approximately 12 mg of CsA loaded into them) were used in dogs with KCS responsive to topical CsA (good candidate, GC) or not responsive (poor candidate, PC). Ocular surface inflammation scores, Schirmer tear test (STT) values, and ocular discharge quantity were evaluated and compared. RESULTS Twenty-seven eyes (15 dogs) received an ESMC implant for KCS; 15 eyes were considered GC, and 12 were considered PC. Both GC eyes and PC eyes showed a significant increase in STT values (increase of 7.7 and 8.5 mm/min; P = 0.023 and P = 0.003, respectively) after placement of ESMC implants (mean follow-up 18 ± 2 and 10.4 ± 15 months, respectively). Clinical signs improved significantly in both groups during the same follow-up, with reduction in conjunctival hyperemia (P < 0.001), corneal neovascularization (P = 0.004), corneal opacity (P = 0.003), and ocular discharge (P = 0.002). ESMC implants were well tolerated by all dogs, but two eyes lost the device at 12-months and 1-week follow-up, respectively. CONCLUSIONS Results from this study suggest that the EMSC implants were well tolerated and efficacious in dogs with KCS responsive to topical CsA as well as dogs with poor response to topical therapy. Further study is needed to determine the duration of efficacy and optimal dose of CsA.

Inflammatory polyps of the nasal turbinates of cats: an argument for designation as feline mesenchymal nasal hamartoma.

Inflammatory polyps of the nasal turbinates (IPNT) in cats are benign growths that are histologically distinct from feline nasopharyngeal polyps. Most cats with IPNT are presented at less than 1 year of age with sneezing, noisy breathing and epistaxis, but without mucoid or mucopurulent nasal discharge. Histologically, IPNT are characterised by the presence of woven bone as part of the proliferating stroma and erythrocyte-filled spaces. These unique histological features are analogous to nasal hamartomas (NH) of children, specifically chondromesenchymal hamartoma (NCMH) and sinonasal fibro-osseous hamartoma (SFOH), which also result in signs of nasal obstruction, sneezing and epistaxis. In our study, clinical and histopathological features in five cats with IPNT were compared with published descriptions of NH in children. We conclude that the terminology ‘feline mesenchymal nasal hamartoma’ provides a more accurate description of the disease currently termed IPNT, and has the added advantage of being consistent with its human counterpart.

Tenovaginoscopic approach to the common digital flexor tendon sheath of adult cattle: Technique, normal findings and preliminary results in four clinical cases

The aim of this study was to describe the tenovaginoscopic approach to the bovine common digital flexor tendon sheath (CDFTS). A comparative anatomical, ultrasonographic and endoscopic study was undertaken using 26 healthy cadaver feet from adult dairy cows. Tenovaginoscopy was performed using a rigid, 30° arthroscope (length 18 cm; outer diameter 4mm) enabling a direct view of the synovial cavity and the following structures: digital flexor tendons, digital annular ligaments, lateral and medial pouches, three mesotendons, the vinculum of the superficial digital flexor tendon, and a slot-shaped opening in the manicaflexoria of the hind feet. Additionally, four clinical cases of septic tenosynovitis treated with lavage under tenovaginoscopic control were examined. Tenovaginoscopy represents a feasible, minimally invasive method for the diagnosis and treatment of septic tenosynovitis of the CDFTS, which allows the degree of alterations of the normal structures to be evaluated.

Diagnostic accuracy of brush cytology in canine chronic intranasal disease

BACKGROUND Most cases of canine chronic intranasal disease cannot be differentiated based on clinical examination alone, and biopsy is often required for a definitive diagnosis. Nonsurgical cytologic and histologic biopsy techniques represent desirable diagnostic approaches. OBJECTIVE The aim of this retrospective study was to determine the diagnostic accuracy of brush cytology in differentiating non-neoplastic and neoplastic diseases in dogs with chronic intranasal disease. METHODS Cytologic samples of lesions in dogs with chronic intranasal disease were obtained by brushing over a 12-year period. All dogs had complete physical examinations as well as radiographic, rhinoscopic, and cytologic evaluation. Histologic diagnosis, follow-up clinical information, or both were used as the gold standard, and dogs free of disease or with no progression of disease at 1 year were considered negative for neoplasia. Indicators of performance of brush cytology in detecting neoplasia were calculated and included sensitivity, specificity, positive and negative likelihood ratios, and diagnostic odds ratio. RESULTS Samples of nasal brushings from 138 dogs were evaluated. Of 62 cases of neoplastic disease, true-positive and false-negative diagnoses were made using cytologic evaluation in 44 (71.0%) and 18 (29.0%) cases, respectively. False-negative diagnoses of neoplasia were not attributed to low cellularity, but to the presence of inflammatory cells that masked neoplastic cells. Brush cytology had a sensitivity of 0.71, specificity of 0.99, positive likelihood ratio of 53.94, negative likelihood ratio of 0.29, and diagnostic odds ratio of 188.33. CONCLUSIONS Brush cytology has good diagnostic accuracy for chronic intranasal lesions in dogs.

Feline Upper Respiratory Tract Lymphoma Site, Cyto-histology, Phenotype, FeLV Expression, and Prognosis

Lymphoma is the most common feline upper respiratory tract (URT) tumor. Primary nasal and nasopharyngeal lymphomas have been evaluated as distinct pathological entities; however, data on their differing clinical behavior are missing. A total of 164 endoscopic- guided URT pinch biopsies were formalin fixed and routinely processed. Imprint cytological specimens were stained with May Grünwald-Giemsa. Immunohistochemistry for anti-CD20, CD3, FeLVp27, and FeLVgp70 was performed. Prognostic significance of clinicopathological variables was investigated by univariate and multivariate analysis. Lymphoma was diagnosed in 39 cats (24%). Most cats with lymphoma were domestic shorthair (32 [82%]), were male (F/M = 0.56), and had a mean age of 10.3 years (range, 1–16 years). Lymphomas were primary nasal in 26 cats (67%), nasopharyngeal in 6 (15%), and in both locations (combined lymphomas) in 7 cats (18%). Neoplastic growth pattern was diffuse in 35 cases (90%) and nodular in 4 (10%). Epitheliotropism was observed in 10 cases (26%). Tumor cells were large in 15 cases, were small and medium in 11 cases each, and 2 had mixed cell size. Submucosal lymphoplasmacytic inflammation was observed in 23 cases (59%). Cytology was diagnostic for lymphoma in 12 of 25 cases (48%). A B-cell origin prevailed (34 [87%]). Feline leukemia virus (FeLV) p27or gp70 antigen was detected in 21 lymphomas (54%). URT lymphomas were aggressive, with survival varying from 0 to 301 days (mean, 53 days). Epitheliotropism in 8 B-cell lymphomas (80%) and in 2 T-cell lymphomas (20%) correlated with prolonged survival. Age younger or older than 10 years had a negative prognostic value. Lymphoplasmacytic inflammation and FeLV infection may represent favoring factors for URT lymphoma development.

Elbow dysplasia and lesions of the medial coronoid process: correlation between tomographic and arthroscopic findings in thirty cases

ABSTRACT Elbow dysplasia and lesions of the medial coronoidprocess: correlation between tomographicand arthroscopic findings in thirty cases A. F. Botazzoli & F. Ferraresi & O. Travetti & F. M. Martini & C. M. Mortellaro & M. Di Giancamillo Published online: 21 August 2008 # Springer Science + Business Media B.V. 2008 Keywords Arthroscopy.Dog.Elbowdysplasia.X-raycomputerizedtomography(CT)IntroductionElbow dysplasia is an invalidating pathology with a not yet entirely clarified etiology, thatimplies a congenital and/or herditary-familiar nature, showing a particularly elevatedincidence in some canine breeds (Retrievers, Rottweiler, Newfoundland, Bernese mountaindog etc.) (Olsson 1975; Guthrie and Pidduck 1990). It can be revealed in various forms,(FCP,UAP,OCD,INC) and if it is not precociously diagnosed it also leads, sometimesinevitably, to forms of severe arthrosis (Olsson 1975; Hornof et al. 2000; Kunzel et al.2004; Blond et al. 2005). The diagnostic procedure consists, besides the clinicalexamination, of a standardized radiographic examination according to the indicationsfurnished by the International Elbow Working Group (IEWG), that however gives onlyinformation on the presence or lack of secondary osteoarthrosic damage (Van Bree and VanRyssen 1995; Hornof et al. 2000; Blond et al. 2005). For this reason, in the last decade theuse of second level imaging techniques as CT and arthroscopy, which has the undeniableadvantage to offer both diagnostic and therapeutic options, has increased (Van Bree andVan Ryssen 1995; Bardet 1997; Van Ryssen and Van Bree 1997; Hornof et al. 2000;Reichele et al. 2000; De Rycke et al. 2002; Rovesti 2002; Schultz et al. 2004; Blond et al.2005; Martini 2006). The present works is to be considered as a retrospective investigationperformed on 30 articulations affected by elbow dysplasia to find a possible correlationbetween CT and arthroscopic findings of different nature and degree, contextuallyanalyzing the possibilities and limits of each technique.

Per-endoscopic trans-tympanic traction for the management of feline aural inflammatory polyps: a case review of 37 cats.

Feline aural inflammatory polyps are benign growths originating from the tympanic cavity or the Eustachian tube. They usually occur in young cats, which present either signs of otitis externa and otitis media, or respiratory signs, depending on the direction of polyp growth. Neurological signs are also reported. Simple traction and ventral bulla osteotomy (VBO) are the most common techniques used for treating this condition in cats; corticosteroids are recommended to reduce risk of recurrence given the inflammatory nature of the disease. The most common complications after treatment are Horner’s syndrome, polyp recurrence and facial nerve paralysis. The aim of this report is to describe the per-endoscopic trans-tympanic traction (PTT) technique for treating feline aural inflammatory polyps and to report the short- and long-term follow-up of this procedure. PTT allowed resolution of the aural inflammatory polyps in 94% of cats during a mean long-term outcome of 19 months. Three cats (8%) developed Horner’s syndrome immediately after the PTT procedure, which resolved within a few weeks, and five cats had polyp recurrence (13.5%). Only two cats had a poor outcome and were diagnosed with chronic otitis media at 22 months, and chronic otitis media and polyp recurrence at 46 months after the PTT procedure, respectively. PTT was shown to be an effective technique for treating aural inflammatory polyps and registered fewer neurological complications (8%) than VBO (57–81%) or simple traction (43%), and a recurrence percentage (13.5%) similar to VBO (0–33%) and much lower than traction alone (57%).