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Noh D, Jo H, Shin H, Lee SK, Choi S, Lee K. Feline gastrointestinal eosinophilic sclerosing fibroplasia in two cats: Serial ultrasonographic and computed tomography findings. VET MED-CZECH 2024; 69:177-183. [PMID: 38841129 PMCID: PMC11148708 DOI: 10.17221/2/2024-vetmed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 04/17/2024] [Indexed: 06/07/2024] Open
Abstract
A 6-month-old Ragdoll and 9-year-old Russian Blue cat presented with vomiting. Ultrasonography and computed tomography showed a pyloric antrum mass with wall layering loss and regional lymphadenopathy in the Ragdoll kitten. The Russian Blue cat only presented with muscularis layer thickening throughout the jejunum; however, despite medications, it later progressed to a mass with wall layering loss on the serial ultrasound. Both cats underwent surgery, and feline gastrointestinal eosinophilic sclerosing fibroplasia (FGESF) was histologically confirmed. FGESF should be considered for gastrointestinal masses demonstrating wall layering loss and lymphadenopathy, even in kittens, and intestinal muscularis layer thickening that is refractory to medications.
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Affiliation(s)
- Daji Noh
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Kyungpook National University, Daegu, Republic of Korea
- 24 Africa Animal Medical Center, Daejeon, Republic of Korea
| | - Hyeeun Jo
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Hyunguk Shin
- 24 Africa Animal Medical Center, Daejeon, Republic of Korea
| | - Sang-Kwon Lee
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Sooyoung Choi
- College of Veterinary Medicine, Kangwon National University, Chuncheon, Republic of Korea
| | - Kija Lee
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Kyungpook National University, Daegu, Republic of Korea
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Černá P, Lopez‐Jimenez C, Fukushima K, Nakashima K, Nakagawa T, Adam F, Groth A, Denning A, Israeliantz N, Gunn‐Moore DA. Clinicopathological findings, treatment, and outcome in 60 cats with gastrointestinal eosinophilic sclerosing fibroplasia. J Vet Intern Med 2024; 38:1005-1012. [PMID: 38205893 PMCID: PMC10937490 DOI: 10.1111/jvim.16992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 01/02/2024] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Gastrointestinal eosinophilic sclerosing fibroplasia (GESF) in cats presents as mass(es) associated with the gastrointestinal tract, mesentery, and abdominal lymph nodes. HYPOTHESIS/OBJECTIVES To report the clinicopathological findings, treatment, and outcome of cats with GESF. ANIMALS Sixty client-owned cats diagnosed with GESF. METHODS Retrospective review of medical records of cats with histopathologically confirmed GESF. RESULTS The median age was 5.4 years (interquartile range [IQR], 3.3-8.9.); 30% were Domestic Shorthairs and 12% were Domestic Longhair cats, with the most prevalent pedigree breeds being Ragdolls (25%), Exotic Shorthair (10%) and Persian (8%) cats. The median duration of clinical signs was 90 days (IQR, 17.5-247.0); the most common clinical signs were weight loss (60%), hyporexia/anorexia (55%), chronic vomiting (37%), lethargy (35%) and chronic diarrhea (27%). Masses were located in the small intestine (32%), stomach (27%), ileocolic junction (15%), colon (10%), lymph node (8%) and mesentery (8%) and 15% of cats had >1 mass. Eosinophilia was present in 50% and hypoalbuminemia in 28% of cats. The mass was removed surgically in 37% of cases. Most cats (98%) were treated with corticosteroids. Survival was not statistically different between cats treated with surgical resection and cats treated with medical therapy alone, 88% of the cats were still alive at the time of writing. CONCLUSIONS AND CLINICAL IMPORTANCE GESF is an important differential diagnosis for abdominal masses in cats, and has a much better prognosis than previously reported.
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Affiliation(s)
- Petra Černá
- Department of Clinical SciencesColorado State UniversityFort CollinsColoradoUSA
- Small Animal ClinicThe University of Veterinary Sciences BrnoBrnoCzech Republic
| | | | | | | | | | - Fiona Adam
- North Downs Specialist ReferralsBletchingleyUK
| | - Anna Groth
- North Downs Specialist ReferralsBletchingleyUK
| | | | - Nicolas Israeliantz
- The Royal (Dick) School of Veterinary StudiesUniversity of EdinburghMidlothianUK
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3
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Rolph MJ, Bolfa P, Cavanaugh SM, Rolph KE. Fluorescent In Situ Hybridization for the Detection of Intracellular Bacteria in Companion Animals. Vet Sci 2024; 11:52. [PMID: 38275934 PMCID: PMC10821249 DOI: 10.3390/vetsci11010052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/10/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024] Open
Abstract
FISH techniques have been applied for the visualization and identification of intracellular bacteria in companion animal species. Most frequently, these techniques have focused on the identification of adhesive-invasive Escherichia coli in gastrointestinal disease, although various other organisms have been identified in inflammatory or neoplastic gastrointestinal disease. Previous studies have investigated a potential role of Helicobacter spp. in inflammatory gastrointestinal and hepatic conditions. Other studies evaluating the role of infectious organisms in hepatopathies have received some attention with mixed results. FISH techniques using both eubacterial and species-specific probes have been applied in inflammatory cardiovascular, urinary, and cutaneous diseases to screen for intracellular bacteria. This review summarizes the results of these studies.
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Affiliation(s)
| | | | | | - Kerry E. Rolph
- Center for Integrative Mammalian Research, Ross University School of Veterinary Medicine, Basseterre P.O. Box 334, Saint Kitts and Nevis
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Wheatley MA, Stowe DM, Mochizuki H. Eosinophilic cavitary effusions in cats: 48 cases (2010-2020). Vet Clin Pathol 2023; 52:681-690. [PMID: 37788981 DOI: 10.1111/vcp.13295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 07/05/2023] [Accepted: 07/17/2023] [Indexed: 10/05/2023]
Abstract
BACKGROUND Eosinophilic effusions are commonly defined as effusions with ≥10% eosinophils. Eosinophilic cavitary effusions are infrequently observed in cats, with few case reports comprising the majority of the recent literature. OBJECTIVE The objective was to review disease associations of cats with eosinophilic cavitary effusions and to assess if a lower threshold of eosinophils (5%-9%) may warrant consideration of similar etiologies associated with effusions with ≥10% eosinophils. METHODS Cytology reports were retrospectively reviewed for all feline cavitary effusions submitted for fluid analysis from 2010 to 2020 at a veterinary teaching hospital. Cases were included if the manual leukocyte differential included ≥5% eosinophils and separated into 5%-9% and ≥10% eosinophils groups. Patient records were reviewed for associated medical conditions. RESULTS A total of 669 effusions were submitted from 579 cats; 50 effusions from 48 cats had a leukocyte differential with ≥5% eosinophils. The eosinophil proportion was ≥10% in 22 cats; the most common underlying cause was neoplasia (10/22, 45%), followed by inflammatory disease (4/22, 18%), cardiac disease (3/22, 14%), suspect neoplasia (3/22, 14%), and undetermined (2/22, 9%). The underlying causes for the 26 cats with 5%-9% eosinophils were similar; neoplasia (8/26, 31%), cardiac disease (6/26, 23%), inflammatory disease (4/26, 15%), suspect neoplasia (3/26, 12%), undetermined (3/26, 12%), and idiopathic chylothorax (2/26, 8%). Cats with eosinophil proportions ≥10% in the fluid exhibited peripheral eosinophilia more frequently (35%) compared to those with 5%-9% eosinophils (5%). CONCLUSIONS Consistent with the current literature, neoplasia, particularly lymphoma, remains a primary consideration for cats with eosinophilic effusions. Previously unreported associated diseases included cardiovascular and inflammatory disorders. Our findings suggest an eosinophil differential of 5%-9% is seen with similar etiologies considered for classically defined eosinophilic effusions.
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Affiliation(s)
- Meagan A Wheatley
- Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Devorah M Stowe
- Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Hiroyuki Mochizuki
- Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
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Müller TR, Penninck DG, Webster CRL, Conrado FO. Abdominal ultrasonographic findings of cats with feline infectious peritonitis: an update. J Feline Med Surg 2023; 25:1098612X231216000. [PMID: 38095890 PMCID: PMC10811767 DOI: 10.1177/1098612x231216000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
OBJECTIVES The aim of this study was to describe the abdominal ultrasonographic findings in cats with confirmed or presumed feline infectious peritonitis (FIP). METHODS This was a retrospective study performed in an academic veterinary hospital. The diagnosis of FIP was reached on review of history, signalment, clinical presentation, complete blood count, biochemistry panel, peritoneal fluid analysis, cytology and/or histopathology results from abnormal organs, and/or molecular testing (immunohistochemical or FIP coronavirus [FCoV] RT-PCR). Cats with confirmed FIP by molecular testing or with a highly suspicious diagnosis of FIP were included. Abdominal ultrasound examination findings were reviewed. RESULTS In total, 25 cats were included. Common clinical signs/pathology findings included hyperglobulinemia (96%), anorexia/hyporexia (80%) and lethargy (56%). Abdominal ultrasound findings included effusion in 88% and lymphadenopathy in 80%. Hepatic changes were noted in 80%, the most common being hepatomegaly (58%) and a hypoechoic liver (48%). Intestinal changes were noted in 68% of cats, characterized by asymmetric wall thickening and/or loss of wall layering, with 52% being ileocecocolic junction and/or colonic in location. Splenic changes were present in 36% of cats, including splenomegaly, mottled parenchyma and hypoechoic nodules. Renal changes were present in 32%, encompassing a hypoechoic subcapsular rim and/or cortical nodules. Mesenteric and peritoneal abnormalities were seen in 28% and 16% of cats, respectively. Most cats (92%) had two or more locations of abdominal abnormalities on ultrasound. CONCLUSIONS AND RELEVANCE The present study documents a wider range and distribution of ultrasonographic lesions in cats with FIP than previously reported. The presence of effusion and lymph node, hepatic and/or gastrointestinal tract changes were the most common findings, and most of the cats had a combination of two or more abdominal abnormalities.
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Affiliation(s)
- Thiago R Müller
- Department of Clinical Sciences, Tufts University, Cummings School of Veterinary Medicine, North Grafton, MA, USA
| | - Dominique G Penninck
- Department of Clinical Sciences, Tufts University, Cummings School of Veterinary Medicine, North Grafton, MA, USA
| | - Cynthia RL Webster
- Department of Clinical Sciences, Tufts University, Cummings School of Veterinary Medicine, North Grafton, MA, USA
| | - Francisco O Conrado
- Department of Comparative Pathobiology, Tufts University, Cummings School of Veterinary Medicine, North Grafton, MA, USA
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Kim JY, Hwang TS, Jung DI, Song KH, Song JH. Case report: Lymphocytic-plasmacytic and eosinophilic enterocolitis presented with marked eosinophilia and basophilia in a cat. Front Vet Sci 2023; 10:1153702. [PMID: 37732139 PMCID: PMC10507168 DOI: 10.3389/fvets.2023.1153702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 08/23/2023] [Indexed: 09/22/2023] Open
Abstract
Inflammatory bowel disease is a common condition in cats, characterized by recurring gastrointestinal signs with histologic evidence of intestinal inflammation. A 9-month-old neutered male Sphynx cat was presented with a 5-week history of vomiting and hematochezia. Conservative patient management with a therapeutic gastrointestinal formula, antibiotics, and antiemetics resulted in a positive response to treatment, with relapse of signs when the medications were discontinued. A new finding of marked eosinophilia and basophilia was identified 3 months after the initial presentation. Colonoscopy revealed cecal erosions and a surgical biopsy with histopathology confirmed a diagnosis of lymphocytic-plasmacytic and eosinophilic enterocolitis. For this diagnosis, the patient was treated with prednisolone, tylosin, and metronidazole. Antibiotics were gradually tapered as the cat showed clinical improvement. The patient showed resolution of the gastrointestinal signs, and the numbers of eosinophils and basophils returned within the reference range 8 weeks after the treatment began. Basophilia and eosinophilia has been reported in conjunction with feline T-cell lymphoma. However, marked basophilia accompanying eosinophilia is extremely rare in cats with inflammatory bowel disease. We herein provide clinical details, including ultrasonography, endoscopy, histopathology, and disease course of feline lymphocytic-plasmacytic and eosinophilic enterocolitis with marked basophilia and eosinophilia. This case highlights the importance of considering enteritis as potential diagnoses when eosinophilia and basophilia are concurrently observed in cats.
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Affiliation(s)
- Jin-Young Kim
- Department of Veterinary Internal Medicine, College of Veterinary Medicine, Chungnam National University, Daejeon, Republic of Korea
| | - Tae-Sung Hwang
- Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University, Jinju, Republic of Korea
| | - Dong-In Jung
- Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University, Jinju, Republic of Korea
| | - Kun-Ho Song
- Department of Veterinary Internal Medicine, College of Veterinary Medicine, Chungnam National University, Daejeon, Republic of Korea
| | - Joong-Hyun Song
- Department of Veterinary Internal Medicine, College of Veterinary Medicine, Chungnam National University, Daejeon, Republic of Korea
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Pawenski M, Smola CC, Dionne T, Larson M. Histopathologic diagnosis and patient characteristics in cats with small intestinal obstructions secondary to trichobezoars. J Feline Med Surg 2023; 25:1098612X231196231. [PMID: 37747322 PMCID: PMC10812032 DOI: 10.1177/1098612x231196231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
OBJECTIVES The aim of the present study was to describe the distribution of gastrointestinal histopathology findings associated with gastrointestinal obstructions secondary to trichobezoar formation in cats. METHODS A total of 100 surgical gastrointestinal biopsies were obtained from 44 cats with gastrointestinal obstructions secondary to a trichobezoar. Medical records, including signalment, type and duration of clinical signs, surgical reports and histopathologic analysis, were reviewed for each cat. RESULTS Biopsies taken near the site of the trichobezoar were more likely to show neutrophilic inflammation and mucosal erosion/ulceration compared with biopsies taken elsewhere in the small intestine. Lymphoplasmacytic and mixed lymphocytic and eosinophilic populations were the most common histopathologic findings from all biopsies followed by alimentary small cell lymphoma. Biopsy samples were more likely to represent a diagnosis of alimentary lymphoma in cats older than 10 years. CONCLUSIONS AND RELEVANCE Gastrointestinal biopsies taken at the time of surgery in cats with trichobezoar obstructions may represent an important diagnostic tool for further evaluation of potential feline chronic enteropathy. Biopsies taken at the site of the obstruction should be interpreted cautiously as the presence of a trichobezoar may induce an acute inflammatory reaction. The resultant histologic interpretation at this site may not represent the chronic state of the intestinal mucosa, supporting the utility of obtaining multiple biopsies orad and aborad to the obstruction.
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Affiliation(s)
| | | | - Trysta Dionne
- BluePearl Veterinary Partners Clearwater, Clearwater, FL, USA
| | - Melinda Larson
- BluePearl Veterinary Partners Clearwater, Clearwater, FL, USA
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Febo E, Del Signore F, Bernabò N, Paolini A, Simeoni F, De Bonis A, Rosto M, Canal S, Vignoli M. Ultrasonography and Sonoelastography Characteristics of Benign vs. Malignant Mesenteric Lymph Nodes in Cats: An Update. Animals (Basel) 2023; 13:2664. [PMID: 37627454 PMCID: PMC10451840 DOI: 10.3390/ani13162664] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/11/2023] [Accepted: 08/11/2023] [Indexed: 08/27/2023] Open
Abstract
(1) Background: Strain elastography (SE) is an ultrasound-based technique able to non-invasively assess tissue elasticity, with malignant tissues being stiffer than normal tissues. The purpose of the study was to evaluate the diagnostic performance of SE to differentiate feline mesenteric benign and malignant lymph nodes (LNs) using a multivariate approach including both SE results and B-mode ultrasound and color Doppler findings. (2) Methods: Feline enlarged mesenteric LNs were evaluated using B-mode ultrasound, color Doppler ultrasonography, and SE. Short-to-long axis ratios, borders, echogenicity, hilum, vascular flow distribution, elastographic patterns, and strain ratios were recorded. Histological and/or cytological diagnosis was available for each LN. (3) Results: A total of 88 LNs were included, 46 (52.3%) benign and 42 (47.7%) malignant; in the benign group, 40 LNs had a diagnosis of reactive hyperplasia (group A) and 6 eosinophilic sclerosing lymphadenitis (group B), while in the malignant group 42 had a diagnosis of lymphoma (group C). The principal component analysis approach showed evidence that by combining B-mode- and color Doppler-based scores with SE scores, the three groups of LNs can be accurately distinguished. (4) Conclusions: Our results demonstrate that a multivariate sonographic approach combining B-mode ultrasound, color Doppler ultrasonography, and SE can accurately distinguish benign from malignant LNs, thus helping in the clinical advice of feline patients.
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Affiliation(s)
| | - Francesca Del Signore
- Department of Veterinary Medicine, University of Teramo, Località Piano D’ Accio, 64100 Teramo, Italy; (E.F.); (N.B.); (F.S.); (A.D.B.); (M.R.); (S.C.); (M.V.)
| | | | - Andrea Paolini
- Department of Veterinary Medicine, University of Teramo, Località Piano D’ Accio, 64100 Teramo, Italy; (E.F.); (N.B.); (F.S.); (A.D.B.); (M.R.); (S.C.); (M.V.)
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Soltero-Rivera M, Goldschmidt S, Arzi B. Feline chronic gingivostomatitis current concepts in clinical management. J Feline Med Surg 2023; 25:1098612X231186834. [PMID: 37548475 PMCID: PMC10811996 DOI: 10.1177/1098612x231186834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
PRACTICAL RELEVANCE Feline chronic gingivostomatitis (FCGS) is a debilitating disease for cats and a challenge for veterinarians and cat caregivers alike. Recent literature indicates that the disease is immune-mediated in nature and likely associated with a chronic viral infection in patients with higher alpha diversity of their subgingival microbiome. The immune-mediated nature of FCGS includes both local as well as systemic effects, and the transcriptomic analysis of affected patients supports these findings. TREATMENT OPTIONS Localized therapy in the form of surgical extraction of all, or nearly all, teeth continues to be the mainstay of treatment. For cats that do not respond to surgical management, medical management, in the form of immunosuppressive or immunomodulatory therapy, remains an option. Analgesia is of fundamental importance. Immunomodulation utilizing mesenchymal stromal cell therapy provides an alternative treatment avenue for refractory patients and likely targets the chronic viral infection present in this disease. The potential for treatment stratification and use of novel systemic treatment options may be revealed as the molecular pathways involved in this disease are better described. AIMS This review outlines current and emerging concepts linking available science pertaining to FCGS and clinical management of the disease. EVIDENCE BASE The article draws on the best evidence base at this juncture and is also driven by the authors' collective experience of working on the disease for over a decade.
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Affiliation(s)
| | - Stephanie Goldschmidt
- Department of Surgical and Radiological Sciences, University of California, Davis, CA, USA
| | - Boaz Arzi
- Department of Surgical and Radiological Sciences, University of California, Davis, CA, USA; and Veterinary Institute for Regenerative Cures, School of Veterinary Medicine, University of California, Davis, CA, USA
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Duclos AA, Wolfe A, Mooney CT. Intrathoracic eosinophilic sclerosing fibroplasia with intralesional bacteria in a cat. JFMS Open Rep 2023; 9:20551169231199447. [PMID: 37927535 PMCID: PMC10621301 DOI: 10.1177/20551169231199447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023] Open
Abstract
Case summary A 9-year-old neutered female domestic shorthair cat was presented for investigation of a cranial mediastinal mass. Moderate peripheral eosinophilia and mild-to-moderate polyclonal gammopathy were identified. A thoracoabdominal CT scan documented a cranial mediastinal mass encircling the trachea. Ultrasound-guided fine-needle aspiration and core-needle biopsy were performed, but cytology and histopathology were inconclusive. Surgical debulking was performed. Further histological samples identified severe pyogranulomatous and eosinophilic fibrosing mediastinitis, consistent with feline eosinophilic sclerosing fibroplasia. Gram staining and fluorescence in situ hybridisation (FISH) identified numerous Gram-positive coccoid bacteria. Eosinophilia and hyperglobulinaemia resolved after surgery and combined antimicrobial and immunosuppressive therapy. The cat died 3 months later after developing acute haemorrhagic diarrhoea and dyspnoea. Relevance and novel information Eosinophilic sclerosing fibroplasia is reportedly mainly confined to the gastrointestinal tract in cats. Less commonly, extragastrointestinal cases have been described. Lesions in the mediastinal or sternal lymph nodes have been reported, all in association with evident gastrointestinal involvement. The presence of pleural effusion was variable in these cases. To the authors' knowledge, this is the first report of eosinophilic sclerosing fibroplasia presenting due to lower respiratory signs in a cat. Intralesional bacteria were identified using Gram staining and FISH examination. The presence of intralesional bacteria in the normally sterile mediastinal tissue may support the involvement of penetrating injuries in the pathogenesis of the disease. Eosinophilic sclerosing fibroplasia should be suspected in any cat with abdominal and/or thoracic masses, particularly if associated with peripheral eosinophilia and polyclonal gammopathy.
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Affiliation(s)
- Antoine A Duclos
- Small Animal Clinical Studies, School of Veterinary Medicine, University College Dublin, Dublin, Ireland
| | - Alan Wolfe
- Pathobiology, School of Veterinary Medicine, University College Dublin, Dublin, Ireland
| | - Carmel T Mooney
- Small Animal Clinical Studies, School of Veterinary Medicine, University College Dublin, Dublin, Ireland
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Martineau M, Tilmant C, Risco Castillo V, Guillot J, Reyes-Gomez E, Benchekroun G, Freiche V. A case of feline gastrointestinal eosinophilic sclerosing fibroplasia associated with fungal colonisation: endoscopic features, treatment and follow-up. JFMS Open Rep 2023; 9:20551169231165246. [PMID: 37205163 PMCID: PMC10185866 DOI: 10.1177/20551169231165246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2023] Open
Abstract
Case summary A 5-year-old castrated male domestic shorthair cat presented with a 3-month history of weight loss, chronic diarrhoea and vomiting. Examination revealed a large proximal duodenal lesion eventually diagnosed as feline gastrointestinal eosinophilic sclerosing fibroplasia (FGESF) associated with fungal filaments. Histological examination was performed following endoscopic biopsy. Direct examination and mycological culture of the duodenal biopsies revealed the presence of a siphomycetous fungus, which was further identified as Rhizopus microsporus. Treatment with prednisolone and ciclosporin for 3 months led to complete resolution of the clinical signs and marked improvement of the endoscopic lesions. Specific fungal treatment with amphotericin B was poorly tolerated. Relevance and novel information To the best of our knowledge, this is the first report of the characterisation of a siphomycetous fungus associated with FGESF lesions, and the first endoscopic description and diagnosis of FGESF without surgical biopsies. We hypothesise that the presence of R microsporus occurred because of disrupted mucosal integrity.
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Affiliation(s)
- Michael Martineau
- National Veterinary School of Alfort, CHUVA,
Internal Medicine Unit, Maisons-Alfort, France
- Department of Internal Medicine, Frégis
Veterinary Hospital Centre, Arcueil, France
| | - Cyril Tilmant
- National Veterinary School of Alfort, CHUVA,
Internal Medicine Unit, Maisons-Alfort, France
- Department of Internal Medicine, Olliolis
Veterinary Clinic, Ollioules, France
| | - Veronica Risco Castillo
- Department of Parasitology and Mycology,
National Veterinary School of Alfort, BioPôle Alfort, Maisons-Alfort, France
| | - Jacques Guillot
- Department of Dermatology, Parasitology, and
Mycology, Oniris, Nantes, France
| | - Edouard Reyes-Gomez
- Department of Anatomical Pathology, National
Veterinary School of Alfort, BioPôle Alfort, Maisons-Alfort, France
| | - Ghita Benchekroun
- National Veterinary School of Alfort, CHUVA,
Internal Medicine Unit, Maisons-Alfort, France
| | - Valerie Freiche
- National Veterinary School of Alfort, CHUVA,
Internal Medicine Unit, Maisons-Alfort, France
- Valerie Freiche DVM, DESV-IM, PhD, Ecole Nationale
Vétérinaire d'Alfort, CHUVA, Unité de Médecine Interne, 7 avenue du Général de Gaulle,
Maisons-Alfort 94704, France
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12
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Bottero E, Pierini A, Ruggiero P, Cattaneo D, Campanile A, Benvenuti E. Gastroduodenal ulceration detected endoscopically in cats: retrospective study of 61 patients. J Feline Med Surg 2022; 24:e347-e352. [PMID: 35848606 PMCID: PMC10812314 DOI: 10.1177/1098612x221109802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The aim of this study was to describe the endoscopic appearance of gastroduodenal ulcers (GDUs), and to assess the clinical, ultrasonographic and histological data, as well as long-term follow-up, in cats. METHODS The medical record databases of five veterinary endoscopists were evaluated between January 2016 and 2020, in a retrospective study. Cats with at least one gastric or duodenal ulcer detected by endoscopic examination were included. All the medical records of the selected cats were reviewed and information was collected regarding breed, age, sex, neuter status, medical history, clinical signs, and ultrasonographic, endoscopic and histological findings. The cats were evaluated at 6, 12 and 18 months. RESULTS Sixty-one cats with a median age of 9.0 years (range 2.0-16.0) were included in the study. The most common complaints were vomiting (n = 55; 90%) and hyporexia (n = 40; 66%); haematemesis was reported in 12 (20%) cats. Endoscopy showed GDUs in the following locations: gastric body in 28 cats (46%), antropyloric area in 34 cats (56%), fundus in 13 cats (21%) and duodenum in eight cats (13%). A single GDU was found in 42 cats (69%) and multiple GDUs were seen in 19 cats (31%). Histopathological evaluation revealed benign lesions in 33 (54%) cats and malignant lesions in 28 (46%; 24 high-grade lymphoma, one low-grade lymphoma and three carcinoma). High-grade lymphoma was detected only in the stomach. Cats diagnosed with malignant GDUs (median 10.5, range 4-16) were significantly older than cats with benign lesions (P = 0.002). CONCLUSIONS AND RELEVANCE GDUs are common and were detected in 5.1% of cats undergoing an upper gastrointestinal endoscopy. The risk of a malignant ulcer increases proportionally with each year of increasing age. GDU location, number and morphological appearance do not provide any indication of the nature of the ulcer; however, duodenal ulcers are frequently benign. Endoscopic examination facilitates the early and minimally invasive detection of GDUs in cats.
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Affiliation(s)
| | - Alessio Pierini
- Pisani Carli Chiodo Veterinary Centre, Luni Mare, La Spezia, Italy
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13
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Goffart LM, Durand A, Dettwiler M, Vincenti S. Feline gastrointestinal eosinophilic sclerosing fibroplasia presenting as a rectal mass. JFMS Open Rep 2022; 8:20551169221114330. [PMID: 35966900 PMCID: PMC9373184 DOI: 10.1177/20551169221114330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Case summary A 9-year-old neutered male cat was referred owing to dyschezia and weight loss. Abdominal CT revealed a heterogeneous mass in the rectum and thickening of one caudal mesenteric lymph node. The mass induced a focal rectal obstruction. Cytological evaluation of fine-needle aspirates showed signs of mixed inflammation for the rectal mass and a reactive lymph node. Because a definite diagnosis was not achieved, complete resection of the mass via a dorsal approach to the rectum was attempted. Histopathology confirmed complete removal and diagnosed feline gastrointestinal eosinophilic sclerosing fibroplasia (FGESF). The cat was treated with psyllium husks and lactulose after surgery. In the postoperative year, the owner reported normal behaviour, food intake and defecation of the patient. Dyschezia reoccurred 14 months after surgery. Imaging revealed recurrence of a rectal mass. Owing to clinical deterioration, the owner elected for euthanasia. Relevance and novel information This is the first report of rectal FGESF with dyschezia and weight loss as the main clinical signs. The case demonstrates an acceptable outcome for more than 1 year without additional immunosuppressive therapy, and emphasises that FGESF must be considered as a differential diagnosis for rectal masses in cats.
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Affiliation(s)
- Laura M Goffart
- Division of Clinical Surgery, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Alexane Durand
- Division of Clinical Radiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Martina Dettwiler
- Division of Clinical Pathology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Simona Vincenti
- Division of Clinical Surgery, Vetsuisse Faculty, University of Bern, Bern, Switzerland
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14
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Zampieri B, Church ME, Walsh K, Lennon EM. Feline eosinophilic sclerosing fibroplasia – a characteristic inflammatory response in sites beyond the gastrointestinal tract: case report and proposed nomenclature. JFMS Open Rep 2022; 8:20551169221117516. [PMID: 36003069 PMCID: PMC9393682 DOI: 10.1177/20551169221117516] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Case summary An adult male neutered Russian Blue cat presented for a right-sided nasal mass with
bilateral retropharyngeal and right mandibular lymphadenomegaly. Medial retropharyngeal
lymph node excision with nasal mass biopsy revealed eosinophilic sclerosing
lymphadenitis and eosinophilic and lymphoplasmacytic rhinitis, respectively. Bacterial
culture of the lymph node grew Pseudomonas aeruginosa, and treatment
with pradofloxacin was started. Despite initial improvement, clinical signs recurred
after 9 months, and fine-needle aspirates of the right mandibular and left medial
retropharyngeal lymph nodes showed eosinophilic and mastocytic infiltration. Bacterial
culture of the left medial retropharyngeal lymph node grew P
aeruginosa, and treatment with anti-inflammatory doses of prednisolone and,
later, marbofloxacin was instituted. Relevance and novel information This report describes a case of feline eosinophilic sclerosing lymphadenitis diagnosed
outside of the abdominal cavity and is the first case reported to be associated with
P aeruginosa. Feline eosinophilic sclerosing lymphadenitis should be
considered as a differential for lymphadenopathy occurring in areas other than the
abdominal cavity. Feline eosinophilic sclerosing lymphadenitis may develop in cats due
to a species-specific inflammatory response to chronic bacterial and fungal
infections.
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Affiliation(s)
- Bianca Zampieri
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Molly E Church
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Koranda Walsh
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Elizabeth M Lennon
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
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15
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Feline Gastrointestinal Eosinophilic Sclerosing Fibroplasia—Extracellular Matrix Proteins and TGF-β1 Immunoexpression. Vet Sci 2022; 9:vetsci9060291. [PMID: 35737343 PMCID: PMC9227513 DOI: 10.3390/vetsci9060291] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/23/2022] [Accepted: 06/11/2022] [Indexed: 11/17/2022] Open
Abstract
Feline gastrointestinal eosinophilic sclerosing fibroplasia (FGESF) has been described as an inflammatory disorder with an eosinophilic component with etiopathogenesis that is still unknown. Sixteen intestinal samples from two veterinary diagnostic services (2014–2017) were included in the study. A histopathological criterion classified the cases into three grades (mild, moderate, and severe) according to the distribution of the lesions and the course. An immunohistochemical study of collagen I, collagen III, fibronectin, and transforming growth factor β1 (TGF-β1) was performed in each case. An immunohistochemical study of mild grades shows greater collagen III immunoexpression, compared to collagen I and fibronectin, which suggests an “early” stage of fibrosis. In more intense grades, an increased immunoexpression of collagen I, compared to collagen III, suggests a “late” stage of fibrosis. Otherwise, the highest expression of TGF-β1 was observed in the moderate phase, due to the high proliferation of reactive fibroblast and intense inflammation. The results suggest that the inflammatory infiltrate is the trigger for the elevation in TGF-β1, altering the collagen type III:I ratio. In conclusion, immunohistochemical studies can be a very useful method in diagnosing cases of FGESF of mild grades and could help to apply a differential diagnosis regarding feline eosinophilic chronic enteritis (CEE) in the context of inflammatory bowel disease (IBD).
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16
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Derré MG, Findji L, McLauchlan G, Guilherme S. Surgical treatment of a circumferential oesophagogastric mass associated with a peritoneopericardial diaphragmatic hernia in a Maine Coon cat. JFMS Open Rep 2022; 8:20551169221090449. [PMID: 35547182 PMCID: PMC9083054 DOI: 10.1177/20551169221090449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Case summary A 7-month-old intact female Maine Coon presented with a 2-week history of vomiting. A peritoneopericardial diaphragmatic hernia (PPDH) and a mass arising from the cardia, protruding into the gastric lumen, were diagnosed using a combination of ultrasound and CT. An exploratory gastrotomy revealed a circumferential, irregular, ulcerated mass involving the submucosal layer of the cardia. This mass was excised by partial-thickness resection of the gastro-oesophageal wall. The PPDH was corrected and a gastrostomy feeding tube was placed under the same anaesthetic. Histopathologically, the most characteristic feature of this mass was a submucosal fibroplasia associated with marked ulceration and granulation tissue. No infectious or neoplastic cells were identified. The affected region of the gastric wall appeared narrowly excised. Resolution of clinical signs was achieved until the cat was lost to follow-up 12 months postoperatively. Relevance and novel information This is the first report of the surgical management of an oesophagogastric mass in a cat with a concurrent PPDH and no other underlying disease. A benign fibrous mass should be considered as a differential diagnosis of an oesophagogastric mass in feline patients with PPDH. While medical and surgical options are debated for the management of PPDH, symptomatic patients with a concurrent oesophagogastric mass are legitimate candidates for surgical herniorrhaphy to prevent further complications. Based on this case, prognosis can be considered good if surgical resection is complete.
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Affiliation(s)
- Maxime G Derré
- Fitzpatrick Referrals Oncology and Soft Tissue Hospital, Guildford, UK
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA
| | - Laurent Findji
- Fitzpatrick Referrals Oncology and Soft Tissue Hospital, Guildford, UK
| | - Gerard McLauchlan
- Fitzpatrick Referrals Oncology and Soft Tissue Hospital, Guildford, UK
| | - Sérgio Guilherme
- Fitzpatrick Referrals Oncology and Soft Tissue Hospital, Guildford, UK
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17
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Ewald N, Rödler F, Heilmann RM. [Chronic enteropathies in cats - diagnostic and therapeutic approach]. TIERAERZTLICHE PRAXIS AUSGABE KLEINTIERE HEIMTIERE 2021; 49:363-376. [PMID: 34670312 DOI: 10.1055/a-1584-9705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Chronic enteropathies are characterized by persistent or recurrent gastrointestinal signs including vomiting, diarrhoea, weight loss, anorexia and lethargy for a minimum duration of 3 weeks. Diagnosis is by excluding other disease processes and includes faecal examinations, blood screenings (e. g., thyroidal, pancreatic, liver dysfunctions, investigation for infectious diseases, vitamin B12 status), diagnostic imaging, histopathological evaluation using biopsies from several different gastrointestinal segments and the response to therapeutic trials. Chronic inflammatory enteropathies are classified as food-responsive enteropathy (FRE), antibiotic-responsive enteropathy (ARE), immunosuppressant-responsive or, similarly -refractory enteropathy (IRE). Small-cell (low-grade) alimentary lymphoma (LGAL), a crucial differential diagnosis, is predominantly seen in older cats. The feline chronic enteropathy activity index (FCEAI), a clinical scoring system, was established to objectively assess the severity of clinical illness and to evaluate the response to treatment. In general, the prognosis depends on the underlying aetiology. Cats diagnosed with FRE typically have a good long-term prognosis with adequate dietary management. The response to treatment varies in cats with IRE, with same cats experiencing frequent relapses of clinical signs and still others being non-responsive to treatment. Prognosis for LGAL, with adequate treatment, is usually fair to good (median survival time 510-704 days).
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Affiliation(s)
- Nicole Ewald
- Kleintierzentrum am Schmelzbach, Fachpraxis für Kleintiermedizin
| | - Frauke Rödler
- Klinik für Kleintiere, Veterinärmedizinische Fakultät, Universität Leipzig
| | - Romy M Heilmann
- Klinik für Kleintiere, Veterinärmedizinische Fakultät, Universität Leipzig
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18
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Marsilio S. Differentiating Inflammatory Bowel Disease from Alimentary Lymphoma in Cats: Does It Matter? Vet Clin North Am Small Anim Pract 2021; 51:93-109. [PMID: 33187624 DOI: 10.1016/j.cvsm.2020.09.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Differentiation of feline inflammatory bowel disease and intestinal small cell lymphoma can be challenging, and some clinicians argue that it is unnecessary because prognosis and treatment are similar. Differentiation of feline inflammatory bowel disease and intestinal small cell lymphoma can be challenging and some clinicians argue that it is unnecessary since prognosis and treatment are similar. Altough the body of research on this topic has increased over time, we still know little about etiopathogenesis, progression, alternative treatment modalities and prognosis of the different forms of FCE. While differentiating IBD from SCL might not alter a single patients' disease course, further research efforts are required to alter the disease course for our feline patient population as a whole.
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Affiliation(s)
- Sina Marsilio
- Department of Veterinary Medicine and Epidemiology, UC Davis School of Veterinary Medicine, Tupper Hall, 1275 Med Science Drive, Davis, CA 95616, USA.
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19
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Eosinophilic pericardial effusion in a cat with complex systemic disease and associated peripheral eosinophilia. J Vet Cardiol 2021; 35:55-62. [PMID: 33823336 DOI: 10.1016/j.jvc.2021.03.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 02/20/2021] [Accepted: 03/01/2021] [Indexed: 11/22/2022]
Abstract
An 11-year-old domestic shorthair cat was referred for investigation of dry cough of 1-week duration and cardiomegaly. Echocardiography revealed pericardial effusion, and eosinophils were identified as the predominant cell type in fluid collected by pericardiocentesis. Thoracic computed tomography imaging and bronchoscopy were supportive of mild lower airway disease, while bronchoalveolar lavage confirmed eosinophilic inflammation and concurrent Mycoplasma felis infection. A few months after the initial presentation, there was clinical deterioration, and further investigation suggested intestinal lymphoma. It was hypothesized that pericardial effusion and lower airway inflammation were an early manifestation of hypereosinophilic syndrome, possibly as a paraneoplastic consequence of lymphoma.
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20
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Davidson GA, Taylor SS, Dobromylskyj MJ, Gemignani F, Renfrew H. A case of an intramural, cavitated feline gastrointestinal eosinophilic sclerosing fibroplasia of the cranial abdomen in a domestic longhair cat. JFMS Open Rep 2021; 7:2055116921995396. [PMID: 33747539 PMCID: PMC7905731 DOI: 10.1177/2055116921995396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Case summary A 5-year-old neutered male domestic longhair cat was presented for the investigation of a cranial abdominal mass following a 1-month history of inappetence and lethargy. Abdominal ultrasound revealed a large cavitated mass confluent with the mesenteric aspect of the descending duodenum. At surgery, the mass was found to involve the pylorus, proximal duodenum and pancreas, and was non-resectable. Histopathological examination of surgical biopsies revealed a non-neoplastic process involving eosinophils and fibroplasia. Relevance and novel information This case report describes an uncommon feline gastrointestinal pathology with an unusual appearance that may provide an additional differential diagnosis other than neoplasia or abdominal abscess when confronted with a cavitated abdominal mass in cats.
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21
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Černá P, Kilpatrick S, Gunn-Moore DA. Feline comorbidities: What do we really know about feline triaditis? J Feline Med Surg 2020; 22:1047-1067. [PMID: 33100169 PMCID: PMC10814216 DOI: 10.1177/1098612x20965831] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PRACTICAL RELEVANCE Feline triaditis describes concurrent pancreatitis, cholangitis and inflammatory bowel disease (IBD). The reported prevalence is 17-39% in ill referral patients. While the aetiology is poorly understood, it is known to include infectious, autoimmune and physical components. What is not known is whether different organs are affected by different diseases, or the same process; indeed, triaditis may be part of a multiorgan inflammatory disease. Feline gastrointestinal tract anatomy plays its role too. Specifically, the short small intestine, high bacterial load and anatomic feature whereby the pancreatic duct joins the common bile duct before entering the duodenal papilla all increase the risk of bacterial reflux and parenchymal inflammation. Inflammation may also be a sequela of bowel bacterial translocation and systemic bacteraemia. DIAGNOSTIC CHALLENGES Cholangitis, pancreatitis and IBD manifest with overlapping, vague and non-specific clinical signs. Cholangitis may be accompanied by increased serum liver enzymes, total bilirubin and bile acid concentrations, and variable ultrasonographic changes. A presumptive diagnosis of pancreatitis is based on increased serum pancreatic lipase immunoreactivity or feline pancreas-specific lipase, and/or abnormal pancreatic changes on ultrasonography, though these tests have low sensitivity. Diagnosis of IBD is challenging without histopathology; ultrasound findings vary from normal to mucosal thickening or loss of layering. Triaditis may cause decreased serum folate or cobalamin (B12) concentrations due to intestinal disease and/or pancreatitis. Triaditis can only be confirmed with histopathology; hence, it remains a presumptive diagnosis in most cases. EVIDENCE BASE The literature on feline triaditis, pancreatitis, cholangitis and IBD is reviewed, focusing on histopathology, clinical significance and diagnostic challenges. Current management recommendations are provided. Further studies are needed to understand the complex pathophysiology, and in turn improve diagnosis and treatment.
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Affiliation(s)
- Petra Černá
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado, and Small Animal Clinic, The University of Veterinary and Pharmaceutical Sciences, Brno, Czech Republic
| | | | - Danielle A Gunn-Moore
- The Royal (Dick) School of Veterinary Studies, and The Roslin Institute, University of Edinburgh, UK
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22
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McGregor O, Moore AS, Yeomans S. Management of a feline gastric stromal cell tumour with toceranib phosphate: a case study. Aust Vet J 2020; 98:181-184. [PMID: 31971262 DOI: 10.1111/avj.12921] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 01/08/2020] [Accepted: 01/08/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND A fifteen-year old, female spayed domestic longhaired cat was presented for a routine vaccination during which an incidental abdominal mass was palpated. After further inquiry, occasional vomiting was reported to occur once every few weeks to months, associated with no other gastrointestinal signs. CASE REPORT Ultrasonography revealed a gastric mass. Histopathology and immunohistochemistry confirmed a CD117 positive, smooth muscle actin and desmin negative neoplasm, consistent with a gastrointestinal stromal cell tumour (GIST). Treatment was initiated with toceranib phosphate resulting in stable disease for over eighteen months, and the patient was still alive at the time of writing. CONCLUSION GISTs are rare in cats and this is the first report of medical management of feline GIST using toceranib.
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Affiliation(s)
- O McGregor
- Northside Veterinary Specialists, Terrey Hills, New South Wales, 2084, Australia
| | - A S Moore
- Veterinary Oncology Consultants, Lake Innes, New South Wales, 2446, Australia
| | - S Yeomans
- Clinical Pathology, Vetnostics, Macquarie Park, New South Wales, 2113, Australia
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23
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Griffin S. Feline abdominal ultrasonography: What's normal? What's abnormal? The diseased gastrointestinal tract. J Feline Med Surg 2019; 21:1047-1060. [PMID: 31648606 PMCID: PMC10814209 DOI: 10.1177/1098612x19880434] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
PRACTICAL RELEVANCE Abdominal ultrasound plays a vital role in the diagnostic work-up of many cats presenting to general and specialist practitioners. B-mode ultrasonography is likely the most widely used modality for imaging the gastrointestinal (GI) tract in cats and it can help in the diagnosis of GI masses, foreign bodies and disorders of the ileocaecocolic junction. CLINICAL CHALLENGES Despite ultrasonography being a commonly used modality, many practitioners are not comfortable performing an ultrasound examination or interpreting the resulting images. Even differentiating between normal variations and pathological changes can be challenging for all but the most experienced. For example, while for inflammatory conditions of the feline GI tract changes are frequently identified on ultrasound, there may occasionally be no changes to the appearance of the intestine; hence a 'normal' ultrasound does not exclude the possibility of inflammatory disease. AIM This review, part of an occasional series on feline abdominal ultrasonography, describes the appearance of a range of conditions that affect the feline GI tract; the normal GI tract is addressed in an accompanying article in this issue of JFMS. Aimed at general practitioners who wish to improve their knowledge and confidence in feline abdominal ultrasound, this review is accompanied by high-resolution images and videos available online as supplementary material. EQUIPMENT Ultrasound facilities are readily available to most practitioners, although use of ultrasonography as a diagnostic tool is highly dependent on operator experience. EVIDENCE BASE Information provided in this article is drawn from the published literature and the author's own clinical experience.
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Affiliation(s)
- Sally Griffin
- Radiology Department, Willows Veterinary Centre and Referral Service, Highlands Road, Shirley, Solihull B90 4NH, UK
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24
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Thieme ME, Olsen AM, Woolcock AD, Miller MA, Simons MC. Diagnosis and management of a case of retroperitoneal eosinophilic sclerosing fibroplasia in a cat. JFMS Open Rep 2019; 5:2055116919867178. [PMID: 31452913 PMCID: PMC6699013 DOI: 10.1177/2055116919867178] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Case summary A 4-year-old neutered male cat was presented with a 2-month history of
intermittent constipation that progressed to obstipation. Primary clinical
findings included a large, multi lobulated mass in the caudodorsal abdomen,
peripheral eosinophilia and hyperglobulinemia. Abdominal imaging revealed a
multilobulated, cavitated mass in the sublumbar region. Exploratory
celiotomy revealed multiple firm masses in the sublumbar retroperitoneal
space causing ventral displacement and compression of the descending colon
with extension of the masses into the pelvic canal. Histopathology was
consistent with feline gastrointestinal eosinophilic sclerosing fibroplasia
(FGESF). Aerobic culture was positive for Staphylococcus
aureus. The cat was treated with prednisolone (2 mg/kg PO
q24h), lactulose (0.5 g/kg PO q8h), amoxicillin/clavulanic acid (62.5 mg/cat
PO q12h for 1 month) and fenbendazole (50 mg/kg PO q24h for 5 days). Six
months postoperatively, the cat had no recurrence of clinical signs. Repeat
evaluation and imaging at day 732 postoperatively revealed marked
improvement of the abdominal mass, resolution of peripheral eosinophilia and
no clinical signs with continued prednisolone therapy (0.5 mg/kg PO
q24h). Relevance and novel information This is a report of a primary extramural FGESF lesion, and the first
description of characteristics of FGESF on CT. Previous evidence suggests
that the most favorable outcomes require immunosuppressive therapy and
complete surgical excision; however, this case demonstrates a favorable
outcome with medical management alone.
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Affiliation(s)
- Maureen E Thieme
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA
| | - Anastasia M Olsen
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA
| | - Andrew D Woolcock
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA
| | - Margaret A Miller
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA
| | - Micha C Simons
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA
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25
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Paulin MV, Couronné L, Beguin J, Le Poder S, Delverdier M, Semin MO, Bruneau J, Cerf-Bensussan N, Malamut G, Cellier C, Benchekroun G, Tiret L, German AJ, Hermine O, Freiche V. Feline low-grade alimentary lymphoma: an emerging entity and a potential animal model for human disease. BMC Vet Res 2018; 14:306. [PMID: 30305106 PMCID: PMC6180644 DOI: 10.1186/s12917-018-1635-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 09/28/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Low-grade alimentary lymphoma (LGAL) is characterised by the infiltration of neoplastic T-lymphocytes, typically in the small intestine. The incidence of LGAL has increased over the last ten years and it is now the most frequent digestive neoplasia in cats and comprises 60 to 75% of gastrointestinal lymphoma cases. Given that LGAL shares common clinical, paraclinical and ultrasonographic features with inflammatory bowel diseases, establishing a diagnosis is challenging. A review was designed to summarise current knowledge of the pathogenesis, diagnosis, prognosis and treatment of feline LGAL. Electronic searches of PubMed and Science Direct were carried out without date or language restrictions. RESULTS A total of 176 peer-reviewed documents were identified and most of which were published in the last twenty years. 130 studies were found from the veterinary literature and 46 from the human medicine literature. Heterogeneity of study designs and outcome measures made meta-analysis inappropriate. The pathophysiology of feline LGAL still needs to be elucidated, not least the putative roles of infectious agents, environmental factors as well as genetic events. The most common therapeutic strategy is combination treatment with prednisolone and chlorambucil, and prolonged remission can often be achieved. Developments in immunohistochemical analysis and clonality testing have improved the confidence of clinicians in obtaining a correct diagnosis between LGAL and IBD. The condition shares similarities with some diseases in humans, especially human indolent T-cell lymphoproliferative disorder of the gastrointestinal tract. CONCLUSIONS The pathophysiology of feline LGAL still needs to be elucidated and prospective studies as well as standardisation of therapeutic strategies are needed. A combination of conventional histopathology and immunohistochemistry remains the current gold-standard test, but clinicians should be cautious about reclassifying cats previously diagnosed with IBD to lymphoma on the basis of clonality testing. Importantly, feline LGAL could be considered to be a potential animal model for indolent digestive T-cell lymphoproliferative disorder, a rare condition in human medicine.
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Affiliation(s)
- Mathieu V Paulin
- Université Paris-Est, École Nationale Vétérinaire d'Alfort, 7 Avenue du Général de Gaulle, 94700, Maisons-Alfort, France
| | - Lucile Couronné
- Hematology Department, Hôpital Universitaire Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris (APHP), Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,INSERM UMR 1163, CNRS ERL 8254, Institut Imagine, Paris, France
| | - Jérémy Beguin
- Internal Medicine Department, Université Paris-Est, École Nationale Vétérinaire d'Alfort, 7 Avenue du Général de Gaulle, 94700, Maisons-Alfort, France
| | - Sophie Le Poder
- UMR 1161 Virologie, INRA-ENVA-ANSES, Université Paris-Est, École Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| | - Maxence Delverdier
- Anatomical Pathology Department, Université de Toulouse, École Nationale Vétérinaire de Toulouse, 23 Chemin des Capelles, 31076, Toulouse Cedex, France
| | - Marie-Odile Semin
- Anatomical Pathology Department, Université de Toulouse, École Nationale Vétérinaire de Toulouse, 23 Chemin des Capelles, 31076, Toulouse Cedex, France
| | - Julie Bruneau
- Pathology Department, Hôpital Universitaire Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris (APHP), Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,INSERM 1163, Institut Imagine, Site Hôpital Universitaire Necker - Enfants Malades, Paris, France
| | - Nadine Cerf-Bensussan
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,UMR 1163, Laboratory of Intestinal Immunity, INSERM, Paris, France
| | - Georgia Malamut
- Gastroenterology Department, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris (APHP), Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,INSERM UMR 1163, Institut Imagine, Paris, France
| | - Christophe Cellier
- Gastroenterology Department, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris (APHP), Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,INSERM UMR 1163, Institut Imagine, Paris, France
| | - Ghita Benchekroun
- Internal Medicine Department, Université Paris-Est, École Nationale Vétérinaire d'Alfort, 7 Avenue du Général de Gaulle, 94700, Maisons-Alfort, France
| | - Laurent Tiret
- Inserm U955-E10 BNMS, IMRB, Université Paris-Est, École Nationale Vétérinaire d'Alfort, 94000, Maisons-Alfort, France
| | - Alexander J German
- Institute of Ageing and Chronic Disease, University of Liverpool, Leahurst Campus, Chester High Road, Neston, CH64 7TE, UK
| | - Olivier Hermine
- Hematology Department, Hôpital Universitaire Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris (APHP), Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,INSERM UMR 1163, CNRS ERL 8254, Institut Imagine, Paris, France
| | - Valérie Freiche
- Internal Medicine Department, Université Paris-Est, École Nationale Vétérinaire d'Alfort, 7 Avenue du Général de Gaulle, 94700, Maisons-Alfort, France.
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Kambe N, Okabe R, Osada H, Ogawa M, Kishimoto M, Fukushima R, Kondo H, Ohmori K. A case of feline gastrointestinal eosinophilic sclerosing fibroplasia limited to the mesentery. J Small Anim Pract 2018; 61:64-67. [PMID: 29708273 PMCID: PMC7166917 DOI: 10.1111/jsap.12847] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 10/06/2017] [Accepted: 11/16/2017] [Indexed: 11/29/2022]
Abstract
An entire, female, mixed‐breed cat of unknown age was presented with a 6‐week history of lethargy, anorexia and vomiting. There was an increase in the number of white blood cells in the blood, including neutrophils and eosinophils; moderate anaemia; ascites; and possible mesenteric peritonitis. Exploratory laparotomy revealed firm, multifocal small nodules in the mesentery. As the nodules were surgically unresectable, they were biopsied. Histologically, the nodules were composed of thin trabeculae of dense collagen fibres mixed with plump fibroblasts and numerous eosinophils, consistent with feline gastrointestinal eosinophilic sclerosing fibroplasia. Bacteria were not detected on histological examination of the nodules and cytology of the ascites. Remission of disease occurred following treatment with prednisolone and ciclosporin A for 22 days and antibiotics for 40 days. After remission, ciclosporin A was administered for 236 days and then discontinued. Eosinophilia also resolved after treatment with ciclosporin A. The cat is still alive and in good condition on day 689. This report describes what may be an atypical case of feline gastrointestinal eosinophilic sclerosing fibroplasia, lacking involvement of the gastrointestinal tract, and was apparently cured by treatment that involved ciclosporin A.
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Affiliation(s)
- N Kambe
- Cooperative Department of Veterinary Medicine, Faculty of Agriculture, Tokyo University of Agriculture and Technology, Fuchu, Tokyo, 183-8509, Japan
| | - R Okabe
- Cooperative Department of Veterinary Medicine, Faculty of Agriculture, Tokyo University of Agriculture and Technology, Fuchu, Tokyo, 183-8509, Japan
| | - H Osada
- Cooperative Department of Veterinary Medicine, Faculty of Agriculture, Tokyo University of Agriculture and Technology, Fuchu, Tokyo, 183-8509, Japan
| | - M Ogawa
- Cooperative Department of Veterinary Medicine, Faculty of Agriculture, Tokyo University of Agriculture and Technology, Fuchu, Tokyo, 183-8509, Japan
| | - M Kishimoto
- Cooperative Department of Veterinary Medicine, Faculty of Agriculture, Tokyo University of Agriculture and Technology, Fuchu, Tokyo, 183-8509, Japan
| | - R Fukushima
- Cooperative Department of Veterinary Medicine, Faculty of Agriculture, Tokyo University of Agriculture and Technology, Fuchu, Tokyo, 183-8509, Japan
| | - H Kondo
- Laboratory of Veterinary Pathology, College of Bioresource Sciences, Nihon University, Fujisawa, Kanagawa, 252-0880, Japan
| | - K Ohmori
- Cooperative Department of Veterinary Medicine, Faculty of Agriculture, Tokyo University of Agriculture and Technology, Fuchu, Tokyo, 183-8509, Japan
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Linton M, Buffa E, Simon A, Ashton J, McGregor R, Foster DJ. Extrahepatic biliary duct obstruction as a result of involuntary transcavitary implantation of hair in a cat. JFMS Open Rep 2015; 1:2055116915610359. [PMID: 28491390 PMCID: PMC5361986 DOI: 10.1177/2055116915610359] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2015] [Indexed: 11/15/2022] Open
Abstract
Case summary A 4-year-old male neutered domestic shorthair cat was referred for investigation of jaundice. The cat had a recent history of a skin laceration repair following trauma. Sequential serum biochemistry demonstrated increasing plasma bilirubin concentrations; abdominal ultrasonography revealed ongoing pancreatitis and apparent extrahepatic obstruction of the common bile duct. Exploratory laparotomy identified constriction of the common bile duct with foreign material (cat hair). The constricting band of hair was removed surgically; cholecystoduodenostomy was performed. Postsurgical quality of life is excellent with chronic treatment of tylosin, omeprazole and ursodeoxycholic acid. Relevance and novel information To our knowledge, this is the first reported case of extrahepatic biliary duct obstruction resulting from the intra-abdominal migration of a foreign body, in this case, hair shafts. The mechanism by which this occurred was likely a combination of physical constriction by the hair shafts and subsequent foreign body reaction surrounding this. This should be included in the differential diagnosis of a cat with jaundice.
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Affiliation(s)
- Michael Linton
- Eastside Veterinary Emergency and Specialists, Sydney, NSW, Australia
| | - Eugene Buffa
- Eastside Veterinary Emergency and Specialists, Sydney, NSW, Australia
| | - Adrian Simon
- Eastside Veterinary Emergency and Specialists, Sydney, NSW, Australia
| | | | - Ross McGregor
- Eastside Veterinary Emergency and Specialists, Sydney, NSW, Australia
| | - Darren J Foster
- Eastside Veterinary Emergency and Specialists, Sydney, NSW, Australia
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