Spontaneous pneumothorax in 35 cats (2001-2010)

Survey of Gastrointestinal Parasites and Lungworms in Cats and Dogs from Terceira and São Miguel Islands, Azores

Parasitic diseases can affect animal health and welfare, and they may also constitute a danger to public health, particularly in island ecosystems. Fecal samples were collected from 205 dogs and 115 cats on the islands of São Miguel and Terceira, Azores archipelago (Portugal), using the Willis flotation technique and modified Baermann method, for further analysis. The overall prevalence of gastrointestinal parasitism in dogs was 53%, with the following results: Ancylostomatidae (hookworms) (42.44%), Trichuris vulpis (17.56%), Toxocara canis (12.68%) and Cystoisospora spp. (4.39%). In cats, the overall prevalence was also 53%, with the following results: Toxocara cati (31.3%), Ancylostomatidae (30.43%), Cystoisospora spp. (14.78%) and Trichuris sp. (0.87%). The prevalence of lungworms was 0.49% in canines and 20.87% in felines, with Angiostrongylus vasorum and Aelurostrongylus abstrusus species being detected in dogs and cats, respectively. The present survey detected a high prevalence of gastrointestinal infection, in both dogs and cats, probably because the samples came mainly from kennels and catteries and due to the peculiar climatic conditions in this insular territory, with mild temperature and high relative humidity. A considerable prevalence of aelurostrongylosis was also detected (20.87%), so it should be included in the list of differential diagnoses of diseases concerning the respiratory tract in cats of the archipelago.

Successful resolution of a continuous pneumothorax using canine xeno-blood patch pleurodesis in a cat

Case summary

An 11-year-old male neutered cat was referred to The Ohio State University's Veterinary Teaching Hospital after being diagnosed with pleural effusion by a referral veterinarian. After thoracocentesis, analysis of the effusion was consistent with chyle. Echocardiography, radiographs and bloodwork were used to diagnose hypertrophic cardiomyopathy phenotype and left-sided congestive heart failure, suspected to be secondary to uncontrolled hyperthyroidism. While initiating medical therapy, repeated thoracocenteses were required. A severe pneumothorax developed, necessitating placement of bilateral thoracostomy tubes. A thoracic CT scan did not reveal a cause for the pneumothorax; therefore, it was suspected to have occurred secondarily to an iatrogenic laceration of the parenchyma during thoracocentesis. An autologous blood patch pleurodesis was considered contraindicated so instead the cat was administered a blood patch using blood from a canine blood donor. The cat's respiratory status remained stable without additional intervention. At 30 h after blood patch pleurodesis, the thoracostomy tubes were removed and thoracic radiographs revealed near resolution of the pleural effusion and pneumothorax. The cat remained subclinical and was discharged from the hospital 48 h after the blood patch pleurodesis. Upon follow-up at 4 and 8 weeks after discharge, the cat was alive and had no complications or adverse reactions from the blood patch pleurodesis.

Relevance and novel information

This case documents the first report of a xeno-blood patch pleurodesis performed in a cat using blood from a canine donor. The cat had a successful discharge from the hospital with no adverse reactions from the xeno-blood patch pleurodesis.

Retrospective study of 540 cats with respiratory diseases in Japan (2003-2020)

BACKGROUND

Few epidemiological studies on respiratory medicine and the relationship between clinical signs and various respiratory diseases in cats have been reported.

OBJECTIVES

This retrospective study aimed to investigate the prevalence and breed predisposition to feline respiratory diseases in Japan and determine the association between clinical signs, duration and type of respiratory diseases.

METHODS

The medical records of cats with feline respiratory diseases were examined to obtain information on age, sex, breed, final diagnosis, clinical signs and duration. The odds ratios (ORs) and 95% confidence intervals were calculated to evaluate breed predispositions. Mann-Whitney U, Kruskal-Wallis and Dunn's tests were used to assess the duration of clinical signs.

RESULTS

This study included 540 cats with 615 respiratory diagnoses. The American Shorthair breed was predisposed to bronchopneumonia (BP; OR: 5.0) and pulmonary tumour (PT; OR: 3.6), while the Russian Blue breed exhibited a predisposition to inflammatory lower airway diseases (OR: 3.4), BP (OR: 6.1) and interstitial lung diseases (OR: 11.1). Similarly, the Scottish Fold breed displayed predisposition to PTs (OR: 5.8). The duration of clinical signs among nasal diseases, nasopharyngeal diseases and lower tracheal/bronchial and pulmonary diseases differed significantly (p = 0.001, p = 0.012, p < 0.0001, respectively).

CONCLUSIONS

The results suggest that some popular breeds in Japan are predisposed to feline respiratory diseases, especially the American Shorthair, Russian Blue and Scottish Fold breeds. The characteristics of occurrence, clinical signs and duration of each disease will aid in diagnosing, treating, preventing and elucidating the pathophysiology of feline respiratory disease.

Efficacy of a spot-on formulation containing 280 mg/ml fluralaner and 14 mg/ml moxidectin (Bravecto® Plus) in the prevention of cat aelurostrongylosis under field conditions

Aelurostrongylus abstrusus is the most important respiratory nematode of domestic cats. Effective control options are crucial to protect health and welfare of cats and to reduce the spread of aelurostrongylosis in both enzootic and free regions. The present study evaluated the efficacy of a spot-on formulation containing 280 mg/ml fluralaner and 14 mg/ml moxidectin (Bravecto® Plus, MSD) in the prevention of aelurostrongylosis in cats under field conditions. One hundred and fifty-two cats from Italy, Hungary and Bulgaria, were randomly divided in two groups, one treated with Bravecto® Plus on Study Days (SDs) 0 and 84 (74 cats, IVP Group) and one left untreated (78 cats, control group). Faecal samples were collected from all animals on SDs 42 ± 4, 84, 126 ± 4 and 168 ± 4 and subjected to the Baermann's technique and species-specific PCR for A. abstrusus. Each cat was subjected to a clinical examination on SDs 0, 84 and 168 ± 4 to check health condition and possible adverse events. The results of the faecal analysis were statistically analyzed for treatment group differences in the percentage of cats negative to the Baermann's test and PCR and percentage of reduction of fecal larvae counts as the primary and secondary efficacy criteria, respectively. The percentage of negative cats was higher in the IVP group compared to the control group and the percentage of reduction of fecal larvae counts in the IVP group compared to the control group was 100%. These results show that two administrations of Bravecto Plus® spot-on 12 weeks apart were safe and effective in the prevention of aelurostrongylosis for a period of almost 6 months.

Metastrongyloid Infection with Aelurostrongylus abstrusus, Troglostrongylus brevior, Oslerus rostratus and Angiostrongylus chabaudi in Feral Cats from the Canary Islands (Spain)

Lungworms are a major cause of feline respiratory disease, frequently underdiagnosed due to its presentation of symptoms being similar to that of other feline respiratory pathologies. Epidemiological data about these nematodes are scarce in the Canary Islands (Spain). Given the veterinary importance of these parasites, the aim of the present study was to improve the current epidemiological knowledge of the lungworm species that could be affecting feral cats in this archipelago. A total of 29 feral cats from La Gomera were analyzed. The respiratory tract of each animal was inspected and the nematodes obtained were identified by morphological keys and molecular techniques. Metastrongylids were detected to be widely distributed throughout the island with a prevalence of 55.2% (16/29). The species Aelurostrongylus abstrusus, Troglostrongylus brevior, Oslerus rostratus and Angiostrongylus chabaudi were identified. Also, coinfections with A. chabaudi and O. rostratus were detected in two animals. The present study shows a high diversity of lungworms in feral cats in La Gomera, with the first report of A. chabaudi and T. brevior for the Canary Archipelago and the first citation of A. chabaudi in cats for Spain. The wide distribution and high prevalence found in this study indicate a high risk of exposure to pulmonary infections in cats.

Suspected Primary Spontaneous Asymptomatic Pneumothorax in a Cat

Spontaneous pneumothorax (SPT) is a documented emergency of the respiratory tract condition classified as either primary or secondary based on the presence of underlying pulmonary conditions. All reported SPT in the feline literature are evaluated for respiratory clinical signs. Primary SPT without underlying pathology or without clinical signs is not reported in cats. This case report describes a 10-year-old domestic longhair cat that was referred for evaluation of chronic lethargy with severe azotemia and placement of a subcutaneous ureteral bypass (SUB) system. Prior to presentation, the cat was diagnosed with renal insufficiency and treated medically with no resolution. Clinical examination under sedation revealed right-sided renomegaly. Thoracic radiographs revealed gas in the caudodorsal pleural space and concurrent pulmonary atelectasis. No respiratory clinical signs were present. Thoracic CT showed two pulmonary bullae, one located in the right caudal lung lobe and one in the cranial segment of the left cranial lung lobe. Abdominal ultrasound showed a right-sided ureteral obstruction. Medical management was elected for the spontaneous pneumothorax. A SUB was placed to address the ureteral obstruction; no complications were noted during recovery. The cat was free of clinical signs of respiratory disease after a follow-up time of nine months. This is the first reported case of a cat diagnosed with a nonclinical suspected primary spontaneous pneumothorax with no concurrent predisposing pulmonary pathology.

Spontaneous Pneumothorax: Management and Prognosis

This review article will review treatment and prognosis of spontaneous pneumothorax in dogs and cats. The advantages of surgical and medical management in dogs and cats, as well as current treatment practices, including autologous blood pleurodesis and small-bore chest tubes, will be discussed.

Spontaneous Pneumothorax: Pathophysiology, Clinical Presentation and Diagnosis

Spontaneous pneumothorax, which may have an acute or insidious onset in dogs and cats, results in respiratory difficulty and has the potential to be life threatening.^1-3 Dogs commonly develop spontaneous pneumothorax due to bullae or blebs, while cats typically have underlying inflammatory disease, like feline allergic airway disease. Urgent therapeutic intervention is essential in animals with respiratory distress. The recommended therapeutic strategies are typically different in each of these species due to underlying etiology. The first part of this review article will focus on physiology, clinical presentation, and diagnosis of spontaneous pneumothorax in dogs and cats. Advances in diagnostics, especially the recent utility of point of care ultrasound, will be discussed. The second part of the series will provide an overview of therapeutic options and management of patients with spontaneous pneumothorax, as well as information on prognosis.

Treatment and outcome of spontaneous pneumothorax secondary to suspected migrating vegetal foreign body in 37 dogs

BACKGROUND

The aim of this study is to describe surgical findings, treatment and outcome of spontaneous pneumothorax (SP) secondary to suspected migrating vegetal foreign body (MVFB).

METHODS

This retrospective study included dogs with computed tomography (CT) consistent with SP suspected to be secondary to MVFB that underwent thoracic surgery. They were divided into two groups according to whether CT identified (group 1) or only suspected (group 2) an MVFB.

RESULTS

Thirty-seven dogs were included (twenty-one in group 1 and 16 in group 2). An MVFB was identified during surgery in 18 of 21 of cases of group 1 and in 10 of 16 of group 2. An agreement between lobes affected on CT and surgical findings was observed in 34 of 40 lobes. In nine of 37 of cases, a lung perforation was identified without evidence of MVFB. Thirty-nine lobectomies were performed: 15 complete and 24 partial. No recurrence of pneumothorax was observed. In four dogs, a second surgery was necessary to remove an MVFB 1.5 to 3 months after the initial surgery due to secondary draining tracts.

CONCLUSION

Surgical approach planed with CT resolved SP in all cases before discharge with excellent short-term outcome and no major complication. CT was reliable to assess perforated lung lobes in 85% of cases. Clinical signs of delayed draining tract developed in 33% of cases where surgery failed to find an MVFB identified on CT.

Cat Respiratory Nematodes: Current Knowledge, Novel Data and Warranted Studies on Clinical Features, Treatment and Control

The nematodes Aelurostrongylus abstrusus, Troglostrongylus brevior and Capillaria aerophila are the most important parasites inhabiting the airways of cats. They are receiving growing attention from academia, pharmaceutical companies and veterinarians, and are now considered a primary cause of respiratory diseases in feline clinical practice and parasitology. In the past few years, several studies have been conducted in both natural and experimental settings to increase knowledge, provide new insights and fill gaps on respiratory parasitoses of cats. Awareness and knowledge of clinical scenarios towards appropriate and timely diagnosis and prompt and efficacious treatment options have become a priority to investigate. At the same time, chemopreventative approaches have been evaluated to assess the geographical spreading of these parasites and the rise in the number of clinical cases in cat populations of different countries. Given the intense accumulation of novel data, this review presents and discusses the state of the art and the latest updates on the clinical features, treatment, and control of major respiratory parasitoses of cats. Moreover, food for thought is also provided with the aim of spurring on new studies in the near future.

Allogenic blood patch pleurodesis for continuous pneumothorax in three cats

Case series summary

Following diaphragmatic herniorrhaphy, three cats developed a continuous pneumothorax. All three cats required continuous suction to evacuate air from the thoracic cavity. Despite continuous suction, the pneumothorax persisted for all cats and blood patch pleurodesis (BPP) was performed using blood donor cats. All three cats had resolution of their pneumothorax within 24 h of BPP.

Relevance and novel information

This is the first report of BPP used in feline patients. More recently autologous BPP has been reported for use in dogs and humans, with a reportedly high success rate. BPP may allow timely resolution of continuous pneumothorax in cats and provide an alternative treatment option to prolonged medical management or surgical intervention. Allogenic blood from a donor cat may be necessitated in feline BPP when cardiovascular instability is appreciated in these small patients.

Broncholithiasis associated with lower airway inflammation and subsequent pyothorax in a cat

Case summary

A 12-year-old female spayed domestic shorthair cat presented with history of a long-term chronic cough that had worsened during the previous 2 months. Thoracic radiographs revealed numerous mineral opacities throughout the lung fields. Multiple bronchial plugs of pale yellow material were present on bronchoscopy, consistent with broncholithiasis. Bronchoalveolar lavage cytology revealed a mild neutrophilic inflammation and bacterial culture was negative. The cat was diagnosed with chronic inflammatory lower airway disease and broncholithiasis, suspected to be due to mineralisation of secretions in the bronchial lumen. The cat was treated for 6 years with oral prednisolone and responded well to treatment. Six years later, the cat developed severe respiratory distress and died. Post-mortem examination identified chronic multifocal broncholithiasis, pulmonary abscessation and pyothorax.

Relevance and novel information

Broncholithiasis is a very rare condition in feline medicine; however, we are reporting a new case and it should be considered as a differential diagnosis for chronic coughing in cats, especially when other common causes have been ruled out and the radiographic findings are suggestive of it. We hypothesise that pathogenesis of the pulmonary abscessation and pyothorax in our patient was, at least partially, due to broncholithiasis. Pleural disease should be considered a complication of broncholithiasis.

[Spontaneous pneumothorax in cats: two case reports and literature review]

Spontaneous pneumothorax (SP) is a non-traumatic accumulation of air in the pleural cavity. This case report describes a cat with SP as a result of primary pulmonary adenocarcinoma. A second cat was diagnosed with primary pulmonary adenocarcinoma and asthma. A thoracostomy tube was inserted in the first cat while in the second cat a thoracostomy tube was placed and lobectomy of the right cranial and middle lung lobes was performed. Both cats died following treatment. The current literature reviewed here covers the comparative etiologies of SP as well as clinical presentation, diagnostic work-up, therapy and prognosis in cats. A total of 64 cases of cats with secondary spontaneous pneumothorax reported in nine articles are discussed. To our knowledge, there has been no previous description in the literature regarding primary SP in cats. Based on prior case reports, surgery was performed in 16% (10 cats) of SP cases. The current review demonstrates that depending on the underlying lung disease, cats with SP have a careful short-term prognosis because 39 of 64 cats (60%) were discharged.

Perianesthetic Mortality in Domestic Animals

Autopsy of animals that die in the perianesthetic period allows identification of anesthetic and surgical complications as well as preexisting disease conditions that may have contributed to mortality. In most studies to date investigating perianesthetic mortality in animals, inclusion of autopsy data is very limited. This retrospective study evaluated autopsy findings in 221 cases of perianesthetic death submitted to a veterinary diagnostic laboratory from primary care and referral hospitals. Canine ( n = 105; 48%) and feline ( n = 90; 41%) cases predominated in the study, involving elective (71%) and emergency (19%) procedures. The clinical history provided to the pathologist was considered incomplete in 42 of 221 cases (19%), but this history was considered essential for evaluating the circumstances of perianesthetic death. Disease had been recognized clinically in 69 of 221 animals (31%). Death occurred in the premedication or sedation ( n = 19; 9%), induction ( n = 22; 11%), or maintenance ( n = 73; 35%) phases or in the 24 hours postanesthesia ( n = 93 animals; 45%). Lesions indicative of significant natural disease were present in 130 of 221 animals (59%), mainly involving the heart, upper respiratory tract, or lungs. Surgical or anesthesia-associated complications were identified in 10 of 221 cases (5%). No lesions were evident in 80 of 221 animals (36%), the majority of which were young, healthy, and undergoing elective surgical procedures. Lesions resulting from cardiopulmonary resuscitation were identified in 75 of 221 animals (34%). Investigation of perianesthetic death cases should be done with knowledge of prior clinical findings and antemortem surgical and medical procedures; the autopsy should particularly focus on the cardiovascular and respiratory system, including techniques to identify pneumothorax and venous air embolism.

Lungworm disease in cats: ABCD guidelines on prevention and management

OVERVIEW

Cardiopulmonary nematodes are emerging parasites of cats in Europe. A number of helminth parasites may be involved. The most prevalent lungworm in domestic cats is Aelurostrongylus abstrusus. Oslerus rostratus and Troglostrongylus species are found mainly in wild cats. The trichurid Capillaria aerophila has a low host specificity and is not uncommon in cats. Additionally the lung flukes Paragonimus species are reported in many species outside of Europe, including cats.

CLINICAL SIGNS

Lungworm infections may be asymptomatic, or cause mild to severe respiratory signs, dependent on the worm species and burden; mixed infections are observed. Kittens can be vertically infected and may develop a more severe disease. Affected cats show a productive cough, mucopurulent nasal discharge, tachypnoea, dyspnoea and, in severe cases, respiratory failure and death.

MANAGEMENT

Early diagnosis and treatment greatly improves the prognosis. First-stage larvae can be easily detected in fresh faecal samples; the Baermann migration method is the enrichment technique of choice, but takes 24 h. Lungworm larvae can be found in tracheal swabs and bronchoalveolar lavage fluid, but with less sensitivity than in faeces. Molecular methods have been developed that exhibit high specificity and sensitivity, and allow diagnosis in the prepatent phase. Treatment options include fenbendazole paste, milbemycin oxime/praziquantel and various spot-on formulations. Severe cases should receive prompt medical care in an intensive care unit.

PREVENTION

Avoiding predation is at present the only preventive measure for pulmonary worms with indirect life cycles.

ZOONOTIC RISK

C aerophila has zoonotic potential, causing severe pulmonary disease in humans. Some Paragonimus species are also of zoonotic concern.

Physical examination of the respiratory system

This article reviews the approach to a patient with respiratory distress, with a focus on clues obtained from the physical examination. Respiratory distress is a common reason for presentation of a companion animal to a veterinarian on an emergency basis, and thus the clinician should have a comfort level with the approach to these patients. Our discussion includes a basic review of respiratory pathophysiology and the differential diagnoses for hypoxemia. In the majority of cases, physical examination should allow localization of the cause of the respiratory problem to the upper airways, lower airways, pleural space, or pulmonary parenchyma. Such localization, coupled with signalment and historical clues, guides additional diagnostics and therapeutics based on the most likely differential diagnoses. Although managing a patient with respiratory distress can be challenging, a systematic approach such as the one presented here should ensure appropriate intervention in a timely fashion and maximize the chance of a good outcome.

Feline secondary spontaneous pneumothorax: a retrospective study of 16 cases (2000-2012)

OBJECTIVE

To describe the demographics, clinical characteristics, diagnostic findings, underlying etiologies, treatment, and outcome associated with secondary spontaneous pneumothorax (SSP) in cats; and to identify clinical feature differences among cats with asthma associated secondary spontaneous pneumothorax (AASSP) versus nonasthma-associated secondary spontaneous pneumothorax (NAASSP).

DESIGN

Retrospective case series.

SETTING

University teaching hospital.

ANIMALS

Sixteen client-owned cats with secondary spontaneous pneumothorax.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

Domestic short hair was the predominant breed in this study (n = 15). The median age was 8 years old (range: 7 weeks to 17 years) with no sex predilection. Fourteen cats were affected by multi-lobar pulmonary pathology of infectious, inflammatory, or neoplastic causes. Asthma was the most common cause of spontaneous pneumothorax (25%). Ten of 12 treated cats survived the initial episode of spontaneous pneumothorax to discharge with medical management, including all 4 cats with AASSP. Reoccurrence was documented in 4 cats. Pulmonary lobectomy was curative for 1 cat with congenital accessory lung lobe emphysema. No difference in clinical presentation was identified between cats with AASSP and cats with NAASSP.

CONCLUSIONS

Feline SSP is frequently associated with extensive pulmonary pathology. Supportive medical management is most appropriate, except in rare cases with focal congenital abnormalities that may benefit from surgical intervention. AASSP appears to carry a good prognosis for short-term outcome (survival to discharge). Clinical assessment, imaging, and invasive diagnostics were required to differentiate between AASSP and NAASSP.