S. F. Foster

Gastroduodenal Ulceration in Cats: Eight Cases and a Review of the Literature

Gastroduodenal ulceration (GU) and blood loss was diagnosed in eight cats and compared with 25 previously reported cases of feline GU. Cats with GU presented in a critical condition. Clinical signs consistent with gastrointestinal bleeding were infrequently identified although anaemia was a common finding. Non-neoplastic causes of feline GU tended to have a shorter clinical course with ulcers confined to the stomach. Conversely, cats with tumour-associated GU usually had a more protracted clinical course, weight loss, and ulcers located in the stomach for gastric tumours and the duodenum for extra-intestinal tumours. In this series, definitive diagnosis was possible for cats with neoplasia (gastric tumours and gastrinoma), however, it was difficult to precisely identify the underlying aetiology in cats with non-neoplastic GU. Prompt stabilisation with a compatible blood transfusion, surgical debridement or resection, antibiotic and antiulcer therapy, and treatment of the underlying disease, if identified, was successful in the majority of cases. The prognosis for cats with appropriately managed GU depended on the underlying aetiology, but even cats with neoplasia could be successfully palliated for prolonged periods.

Cerebral Cryptococcal Granuloma in a Cat

A 7-year-old cat was presented for seizures. Cerebrospinal fluid cytology and serology were consistent with a diagnosis of toxoplasmosis. The cat was treated with clindamycin but seizures continued and additional neurological signs developed over 6 months. A mass lesion was identified in the left cerebral hemisphere using magnetic resonance imaging (MRI). The lesion enhanced after gadolidium and a tumour was considered likely. Histologically, the lesion proved to be a cryptococcal granuloma and retrospective serology confirmed that the cat had cryptococcosis at its initial presentation. This report provides the first description in the veterinary literature of the MRI appearance of a cerebral cryptococcoma and emphasises the importance of performing cryptococcal antigen determination in cats with signs of intracranial disease.

Lower Respiratory Tract Infections in Cats Reaching beyond empirical therapy

Practical relevance Lower respiratory tract infections (LRTIs) in cats can be due to bacteria, parasites, fungi and viruses. This review details the practical investigation of these infections and highlights specific therapy where possible. The aim is to avoid the all-too-frequent temptation in practice to treat cats with lower respiratory tract signs empirically for feline bronchial disease (FBD)/asthma. This is potentially hazardous as immunosuppressive therapy for FBD/asthma could exacerbate disease due to a LRTI. Empirical treatment of suspected LRTI is also difficult to recommend given the wide range of potential pathogens. Clinical challenges Making a clinical ante-mortem diagnosis of LRTI in a cat can be challenging. Consistent historical, clinical, haematological and radiographic abnormalities are often lacking and findings may be non-specific. Astute clinical acumen, thorough investigation and high quality laboratory analysis are usually required for a diagnosis. Bronchoalveolar lavage, if feasible, and tests for lungworm should be routine in cats with lower respiratory tract signs. Lung fine needle aspiration may be useful in cases of diffuse or nodular pulmonary disease. Histopathology is rarely employed in ante-mortem investigations. Evidence base The authors have reviewed a substantial body of literature to provide information on many of the reported bacterial, parasitic, fungal and viral pathogens, including some that occur in Asia. Attention has been given to specific therapy for each pathogen, with evidence-based comments when there is a deviation from routine recommendations.

Detection and identification of mycobacteria in fixed stained smears and formalin‐fixed paraffin‐embedded tissues using PCR

OBJECTIVE To determine the feasibility of using polymerase chain reaction to amplify DNA from methanol-fixed, Romanowsky-stained and Ziehl-Neelsen-stained smears to confirm the presence of mycobacteria. MATERIALS AND METHODS Tissue was obtained from 10 archival slides and 27 slides from a prospective series of consecutive cases. Phosphate buffered saline (500 μL) was pipetted onto a stained smear (on a glass slide) using a disposable filtered pipette tip. The material adherent to the slide was scraped from its surface and drawn up into the saline. Routine DNA extraction and purification was carried out before nested polymerase chain reaction testing targeting the 16S-23S internal transcribed spacer region or a TaqMan real-time polymerase chain reaction. The real-time polymerase chain reaction was also used on thick sections cut from formalin-fixed paraffin-embedded tissue blocks from 24 canine leproid granulomas. RESULTS Mycobacterial DNA was detected in 34 of 37 slides. Polymerase chain reaction products could not be amplified from three archived smears stained using the Ziehl-Neelsen acid-fast method, probably because its harsher fixation damaged the DNA. With the nested polymerase chain reaction, species identification using internal transcribed spacer sequence analysis was achieved in all instances, diagnosing a wide range of mycobacteria. The real-time polymerase chain reaction detected Mycobacterium sp. CLG DNA within all 24 formalin-fixed paraffin-embedded specimens tested. CLINICAL SIGNIFICANCE This technique should provide a non-invasive and cost-effective means of diagnosing mycobacterial infections.

Cerebral cryptococcal granuloma in a cat: pp. 201-206

In the December issue of Journal of Feline Medicine and Surgery, the following case report was published with several errors. The corrected version of this case report follows in full. The publishers apologise for this error. A 7-year-old spayed domestic shorthaired cat presented with a history of having two seizures in the previous 6 weeks. During the seizures, the cat lost consciousness, paddled its limbs, rolled and urinated. There were no pre-ictal signs but the cat was weak and unable to walk normally in the post-ictal period.

Idiopathic hypertrophic osteopathy in a cat

This report describes the first case of idiopathic hypertrophic osteopathy (HO) in a cat. No causes for the bone pathology were found following evaluation of the physical and laboratory examinations (complete blood count, albumin, creatinine, urea, alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase and gamma-glutamyltransferase and urinalysis), and after histopathological evaluation of organs at necropsy. Based on the radiographic, clinical and anatomopathological findings, idiopathic HO was diagnosed.This report describes the first case of idiopathic hypertrophic osteopathy (HO) in a cat. No causes for the bone pathology were found following evaluation of the physical and laboratory examinations (complete blood count, albumin, creatinine, urea, alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase and γ-glutamyltransferase and urinalysis), and after histopathological evaluation of organs at necropsy. Based on the radiographic, clinical and anatomopathological findings, idiopathic HO was diagnosed.

Cutaneous asthenia (Ehlers–Danlos-like syndrome) of Burmese cats

Summary of cases: A 6-month-old Burmese kitten developed focal skin lesions following a routine ovariohysterectomy. These were eventually attributed to the patient struggling during catheter placement and induction of anaesthesia. The lesions were caused by fluid extravasation in the subcutis and ischaemic necrosis of the overlying dermis, giving rise to an eschar-like appearance. Such lesions have been seen previously in Burmese cats with cutaneous asthenia and it is thought that they arise due to poor collagenous support for dermal blood vessels. An increased skin extensibility index (>23%) supported a diagnosis of cutaneous asthenia (Ehlers–Danlos-like syndrome), which has been reported as an inherited condition of Burmese cats in Australia, New Zealand and Europe. An additional Burmese cat with cutaneous asthenia is presented in detail, with lifetime follow-up and further salient observations by the owner, a veterinarian. Photographs of three other affected Burmese cats are provided to illustrate the range of presentations encountered with this condition. All five affected cats were presented with eschars, atrophic alopecia and increased skin extensibility, while one cat also had skin ulcers. Routine histopathological examination, including use of special stains such as trichrome, was unhelpful in establishing the diagnosis. Clinical review: The clinical features of this genetic disease of Burmese cats are reviewed, especially in relation to the postulated ‘vasculopathy’ that gives rise to characteristic skin lesions. Long term management of this condition is discussed briefly.

Practical urinalysis in the cat 1: Urine macroscopic examination ‘tips and traps’

Series outline: This is the first article in a two-part series on urinalysis in the cat. The focus of Part 1 is urine macroscopic examination. Part 2, to appear in the May 2016 issue, discusses urine microscopic examination. Practical relevance: Urinalysis is an essential procedure in feline medicine but often little attention is paid to optimising the data yielded or minimising factors that can affect the results. Clinical challenges: For the best results, appropriately collected urine should be prepared promptly by specialist laboratory personnel for the relevant tests and assessed by a clinical pathologist. This is invariably impractical in clinical settings but careful attention can minimise artefacts and allow maximum useful information to be obtained from this seemingly simple process. Audience: Clinical pathologists would be familiar with the information provided in this article, but it is rarely available to general or specialist practitioners, and both can potentially benefit. Equipment: Most of the required equipment is routinely available to veterinarians. However, instructions have been provided to give practical alternatives for specialist procedures in some instances. Evidence base: Evidence for much of the data on urinalysis in cats is lacking. Validation of the human equipment used routinely, such as dipsticks, is also lacking. As such, the evidence base for feline urinalysis is quite poor and information has largely been extrapolated from the human literature. Information from feline studies has been included where available. In addition, practical clinicopathological and clinical observations are provided.

Practical urinalysis in the cat

Series outline: This is the second article in a two-part series on urinalysis in the cat. The specific focus is urine microscopic examination. Part 1, which appeared in the March 2016 issue, discussed urine macroscopic examination. Practical relevance: Urinalysis is an essential procedure in feline medicine but often little attention is paid to optimising the data yielded or minimising factors that can affect the results. Clinical challenges: For the best results, appropriately collected urine should be prepared promptly by specialist laboratory personnel for the relevant tests and assessed by a clinical pathologist. This is invariably impractical in clinical settings but careful attention can minimise artefacts and allow maximum useful information to be obtained from this seemingly simple process. Audience: Clinical pathologists would be familiar with the information provided in this article, but it is rarely available to general or specialist practitioners, and both groups can potentially benefit. Equipment: Most of the required equipment is routinely available to veterinarians. However, instructions have been provided to give practical alternatives for specialist procedures in some instances. Evidence base: The evidence base for feline microscopic urinalysis is quite poor and information has largely been extrapolated from the human literature. Information from feline studies has been included where available. In addition, practical clinicopathological and clinical observations are provided.

Lower respiratory tract infections in cats. Reaching beyond empirical therapy [J Feline Med Surg 2011; 13: 313–32.]

Erratum An error in the frequency of dosing of clindamycin appears on pages 324 and 325 of the above article. The correct dose of clindamycin is 12.5 mg/kg q12h PO. The authors would like to apologise to readers of the journal for any inconvenience caused. Addendum A further case of confirmed pulmonary rhodococcosis has been reported since the acceptance of this article: Passamonti F, Lepri E, Coppola G, et al. Pulmonary rhodococcosis in a cat. J Feline Med Surg 2011; 13: 283–85. One other suspected case has also been reported: Fairley RA, Fairley NM. Rhodococcus equi infection of cats. Vet Dermatol 1999; 10: 43–46. Susan Foster BVSc MVetClinStud FACVSc* and Patricia Martin BVSc MVSc