Case summary A 10-year-old, castrated male domestic shorthair cat presented with stertor and severe respiratory distress caused by intratracheal masses occluding the majority of the tracheal lumen. Conventional endoscopic forceps biopsy yielded small tissue fragments, which were insufficient for a definitive histopathological diagnosis. Given the perceived high risk of tracheal resection and anastomosis, bronchoscopic cryotherapy with a 1.1 mm, flexible cryoprobe was performed for cryobiopsy and cryo-debulking. The masses occluded 80–90% of the lumen and were completely removed with cryotherapy, with immediate clinical improvement and decreased airway resistance (279 to 31 cmH 2 O/l/s). Haemorrhage was mild and controllable, and recovery was uneventful. Histopathology revealed tracheal myxosarcoma, a neoplasm not previously described in the feline trachea. The cat remained free of clinical signs for 7 weeks, after which clinical signs recurred, with radiographic evidence of regrowth. Pulmonary function testing suggested no substantial ventilatory compromise compared with preoperative findings; therefore, continued observation was chosen given the early recurrence. Three months after the initial intervention, bronchoscopy was repeated owing to gradually worsening clinical signs and confirmed tumour regrowth occluding approximately 50% of the lumen. A second cryotherapy session again achieved complete debulking and rapid resolution of signs. Relevance and novel information This report documents the first described tracheal myxosarcoma in a cat and demonstrates that bronchoscopic cryobiopsy can overcome the limitations of forceps biopsy while providing concurrent, airway-sparing palliative debulking. Bronchoscopic cryotherapy could serve as a feasible, minimally invasive diagnostic and therapeutic intervention for intraluminal tracheal masses in cats.
Case summary A 1-year-old, male castrated domestic shorthair cat presented for chronic mobility decline and muscle stiffness, first noted at 3 months of age, and persistently elevated serum creatine kinase levels (>19,000–53,000 IU/l). Clinical examination revealed macroglossia and selective hypertrophy of cervical and appendicular muscles. Neurologic evaluation indicated a myopathic gait without pain or neurologic deficits. Muscle biopsy was supportive of muscular dystrophy (MD) and immunohistochemistry demonstrated loss of the sarcoglycan complex with complete absence of all tested sarcoglycan proteins, consistent with a diagnosis of sarcoglycan-deficient MD. These findings contrast with prior feline reports that were mostly limited to reduction or absence of beta-sarcoglycan on immunostaining without overt clinical evidence of MD. A follow-up echocardiogram revealed mild to moderate right ventricular changes without indications for treatment. At 2 months after diagnosis, the patient remained clinically static, suggesting a relatively slow progression despite absent sarcoglycan expression. Relevance and novel information This case represents the first reported feline sarcoglycanopathy characterized by the absence of all tested sarcoglycan subunits on immunohistochemistry and concurrent presentation of classic Duchenne-like MD signs, including macroglossia and muscular hypertrophy. It expands the phenotypic spectrum of muscular dystrophies in cats, underscoring parallels to limb-girdle muscular dystrophies in humans and dogs. Given the cat’s static clinical course and diagnostic overlap with dystrophinopathies, this case suggests sarcoglycan-deficient MD in cats may present with a broader spectrum of severity than previously appreciated. The findings support the potential utility of feline sarcoglycanopathies, when phenotypically consistent with forms appreciated in other species, as spontaneous animal models for comparative medical research.
Case summary:A 1-year-old, male neutered Persian cat presented to the emergency room with acute, severe wheezing and coughing after the introduction of a new kitten to the household. The patient progressed to hypoxemic respiratory failure consistent with acute respiratory distress syndrome (ARDS) and required mechanical ventilation. RT-PCR testing from a conjunctival and deep pharyngeal swab confirmed feline calicivirus infection. Because of refractory hypoxemia and declining lung compliance (2.4 ml/cmH2O), novel therapy with intratracheal porcine surfactant (Curosurf) was attempted. A dose of 1.5 ml/kg was administered over 60 s. After administration, pulmonary compliance improved to 3.1 ml/cmH2O. The patient was weaned from the ventilator on day 10; however, severe laryngeal swelling necessitated a temporary tracheostomy. The patient died on day 15 from tracheal stenosis and obstruction of the stoma site by granulation tissue. Relevance and novel information:To the authors' knowledge, this is the first report describing the development of ARDS from calicivirus pneumonia and the use of porcine surfactant in the treatment of ARDS in a cat. The administration of surfactant resulted in objective improvements in lung compliance.
Case summary An 8-year-old, male domestic shorthair cat presented with a firm mass in the right inguinal region. Microscopic evaluation of the surgically excised mass revealed a soft tissue sarcoma (STS), with features most consistent with a malignant nerve sheath tumor (MNST), infiltrating the epididymis of an atrophic intra-inguinal cryptorchid testis. The tumor showed classical Antoni A and B patterns on histopathology, with spindle cells arranged in short interlacing fascicles, and a mitotic count of 14 per 10 high-power fields, supportive of a malignant form. Immunohistochemistry revealed positive labeling of the neoplastic cells for the markers S-100 and vimentin, while labeling for glial fibrillary acidic protein was negative; these findings supported the diagnosis of MNST. Relevance and novel information Nerve sheath tumors (NSTs) in cats are not uncommon neoplasms, typically arising from cutaneous or subcutaneous nerves of the head, neck or limbs. NSTs arising from visceral sites appear relatively rare, and there are no previously published reports describing such a tumor associated with a cryptorchid testis. This case expands the documented anatomical distribution of feline NSTs and underlines the fact that they may occur at visceral sites as well as within the skin and subcutis. It also highlights the need to include NST in the list of tumors that may arise within or be associated with the testes, cryptorchid or otherwise, and to consider neoplasia arising within a cryptorchid testis as a potential differential for an inguinal swelling in an intact male cat.
Case summary A domestic longhair cat in Australia was referred to an ophthalmology service with the complaint of lens opacity. An incipient cataract was diagnosed in the right eye and an intumescent cataract with an equatorial lens capsule rupture in the left eye. The patient was being treated for diabetes mellitus, and previous concerns for the eyes had included conjunctivitis and left-sided periocular swelling and epiphora. Systemic work-up performed over the 7 months before ophthalmic referral included complete blood counts, biochemistry, serology (feline immunodeficiency virus, feline leukaemia virus, toxoplasmosis, cryptococcosis), thoracic radiographs, and ocular ultrasound and electroretinography performed before phacoemulsification. The patient did not have evidence of active uveitis at the initial ophthalmological examination, and historical serology excluded some common infectious causes of uveitis. The cataracts were treated successfully by phacoemulsification in both eyes, restoring vision. However, an intraocular lens was implanted only in the right eye, as the pre-existing lens capsule tear in the left eye precluded intraocular lens placement. Based on the medical history and clinical presentation, diabetes mellitus was suspected to be the cause of the cataracts. Relevance and novel information Intumescent cataracts are reported in humans and dogs but have rarely been reported in domestic cats. Nonetheless, the intumescent cataract in this patient had similar characteristics to those in diabetic canine cataracts.
Case summary A 4-year-and-8-month-old, neutered male American Shorthair cat presented with acute hindlimb paralysis and was diagnosed with aortic thromboembolism (ATE) secondary to hypertrophic cardiomyopathy. Despite initial treatment, the cat developed anuric acute kidney injury (AKI), possibly due to ischaemia-reperfusion injury. As referral for haemodialysis was declined, peritoneal dialysis (PD) was initiated using a closed round drainage catheter and manually performed exchanges. Although serum creatinine levels continued to rise during PD, the cat remained clinically stable, and urination resumed on day 8 of PD (day 15 of hospitalisation). The cat was discharged on day 21 with marked improvement in renal parameters and remained stable without recurrence at follow-up. Relevance and novel information This case represents a rare report of a cat that developed anuric AKI after ATE and survived to discharge through PD with almost normalised renal values, despite an initial lack of improvement lasting for several days. A number of challenges were encountered, including the lack of standardised feline PD protocols, difficulty in evaluating dialysis efficacy and absence of guidelines for the optimal duration of PD in anuric patients. Despite these limitations, intensive supportive care and continued PD led to favourable clinical outcomes. This case highlights the potential role of PD as a life-saving renal replacement therapy in feline patients with thromboembolism-induced AKI when haemodialysis is unavailable.
Case summary A 15-year-old, male neutered domestic shorthair cat presented with anuria due to urethral obstruction. The cat had a history of several urinary and systemic comorbidities at the time of presentation. Velagliflozin therapy had been started recently after a new diagnosis of diabetes mellitus. A mixed urinary tract infection caused by Escherichia coli and Candida albicans was diagnosed. The cat was initially managed with urinary catheterisation, antibiotics and antifungals, showing a favourable response. However, recurrent urinary obstruction occurred, requiring multiple urinary catheterisations. Approximately 2 weeks after presentation, urethral rupture was diagnosed using contrast urography. Urethrostomy was declined and the cat was ultimately euthanased.Relevance and novel information The most frequent adverse effect reported in human patients treated with sodium-glucose cotransporter 2 inhibitors (SGLT2is) is mycotic genitourinary infection, particularly caused by C albicans. Several risk factors have been identified in humans; however, this association has not been previously demonstrated in cats. This is the first report describing a urinary tract infection caused by C albicans in a cat treated with velagliflozin. These findings emphasise the importance of monitoring for this potential adverse effect in cats receiving SGLT2is, particularly in those with comorbidities, and encourage further evaluation of SGLT2is as a putative risk factor for C albicans urinary tract infections in these patients.
Case summary:A 4-year-old, neutered male domestic cat was presented with an indolent, non-ulcerated and painless subcutaneous nodule on the left hindlimb. Abdominal ultrasonography revealed generalized lymphadenomegaly and splenomegaly with a honeycomb pattern. The cat tested negative for feline leukemia virus and feline immunodeficiency virus. Fine-needle aspiration of the lesion showed mixed inflammatory cells, including eosinophils and macrophages containing small intracytoplasmic basophilic inclusions considered suspicious for Leishmania-like organisms. The mass was surgically excised for histopathological and molecular evaluation. Histopathology demonstrated eosinophilic granulomatous inflammation with secondary furunculosis, without unequivocal visualization of amastigotes. Quantitative RT-PCR was positive for Leishmania species, and conventional PCR targeting the ITS-1 gene, followed by sequencing, showed 99.62% identity with Leishmania infantum. No anti-Leishmania treatment was administered because the lesion was completely excised, the cat remained clinically well and specific anti-Leishmania drugs are not readily accessible in Costa Rica. At the 7-month follow-up, no recurrence of the nodule was observed. Relevance and novel information:This report describes the first molecular detection of L infantum in a Costa Rican domestic cat and the first record from the country's Central Valley. The case highlights the diagnostic challenges of feline Leishmania infection and supports Leishmania infection among the differential diagnoses for feline cutaneous nodules in Central America. It also underlines the need for further studies on the epidemiological role of cats in a One Health context.
Case summary A 9-year-old, male castrated domestic shorthair cat was presented for evaluation of progressive right pelvic limb lameness. Orthopedic examination revealed a weightbearing lameness of the right pelvic limb and a mass over the medial aspect of the right stifle, which elicited pain upon palpation. Preoperative complete blood count and serum biochemistry panel were unremarkable. Radiographs and CT identified a mass at the level of the distal femur, with focal mineralization and enlargement of the right semimembranosus muscle. Incisional biopsy suggested osteochondroma, osteochondromatosis and chondroma. The mass was marginally excised, with histopathology consistent with an intramuscular osteochondroma. The cat returned to normal activity and is currently healthy and alive 3 years postoperatively without evidence of recurrence. Relevance and novel information Soft tissue osteochondroma is a rare condition that can occur intramuscularly, and to the authors’ knowledge, this condition has not been previously reported at this location in a feline patient. Based on this report, although considered rare, clinical awareness of this tumor may aid practitioners in identifying intramuscular osteochondroma as a differential for firm intramuscular masses. Intramuscular osteochondroma carries a fair-to-good prognosis dependent on the location in an otherwise clinically healthy cat.
Case summary A 4-week-old, male domestic shorthair kitten presented with congenital abnormalities of the rectum and perineal region, including defecation through an aberrant opening within the scrotal area. Positive-contrast radiography and ultrasonography confirmed type II anal atresia with a ventral rectocutaneous fistula. An abnormally positioned urethra was also identified, coursing dorsally to the penile structure. Surgical transposition of the fistulous tract and reconstruction of the anal sphincter were performed using a fistula-flap technique to restore normal defecation. Recovery was uneventful, and spontaneous defecation resumed within 2 weeks. At a 20-month follow-up, the patient remained clinically well. Relevance and novel information This case represents the first documented use of a fistula-flap technique to successfully correct type II atresia ani with rectocutaneous fistula in a male feline patient, demonstrating that the technique can be safely adapted to different anorectal malformation patterns.
Case summary A 2-year-old castrated male domestic shorthair cat presented with severe lethargy, hyporexia, dehydration and poor body condition. The incidence of polyuria/polydipsia was unknown because of the presence of multiple other cats in the household. Laboratory findings revealed severe hypernatraemia, isosthenuria, haemoconcentration and moderate azotaemia. MRI of the head demonstrated partial hypoplasia/aplasia of the hypothalamus and pituitary gland, confirming congenital central diabetes insipidus; additional endocrine testing excluded other causes. Initial fluid therapy improved the azotaemia and stabilised the haematocrit; however, hypernatraemia persisted until desmopressin therapy was initiated. The cat was successfully managed in the long term with gradually titrated oral desmopressin, achieving normalisation of electrolytes. Relevance and novel information This report details the first documented case of central diabetes insipidus in an adult cat, attributed to presumed partial aplasia of the hypothalamus and pituitary gland, with no other hormonal deficiencies.
Case summary A 4-year-old, female spayed domestic shorthair cat was presented to the Michigan State University emergency service for evaluation of vomiting 4 days after exposure to vitamin D supplements. On intake, the patient was found to have ionized hypercalcemia and azotemia. The patient was hospitalized for calciuresis therapy including fluid diuresis, diuretics, steroids, bisphosphonates and a nasogastric feeding tube. She was discharged and presented for a recheck evaluation and was then hospitalized a second time for the same therapy as her first hospitalization. Eventually the patient was discharged for at-home care with subcutaneous fluids and oral medications because of financial constraints. Approximately 52 days after exposure, the cat was noted to have persistently normal ionized calcium and all medications were discontinued. Relevance and novel information This case provides a unique example of acute vitamin D toxicosis in a cat and a financially conservative approach in treating a toxicity with a significant half-life.
Case summary A 12-year-old male neutered domestic shorthair cat was referred with severe polyphagia, polydipsia, polyuria, weight gain and signs of neurologic disease, including blindness, head tilt, and ataxia. Magnetic resonance imaging (MRI) identified a suprasellar mass consistent with a pituitary macroadenoma. Hypersomatotropism (HST) was diagnosed based on phenotypic changes compatible with acromegaly and an abnormally high serum insulin-like growth factor 1 (IGF-1) concentration (1253 ng/ml). Medical treatment with cabergoline monotherapy (10 μg/kg PO q24h) was prescribed. Progressive improvement of clinical signs was observed, accompanied by a gradual decrease in serum IGF-1 concentrations. Based on clinical and hormonal response, the dosing interval was sequentially extended to q48h and subsequently to q72h. By week 16 of treatment, signs of neurologic disease had resolved and serum IGF-1 concentrations decreased to values within the reference interval (749 ng/ml), while visual deficits persisted. By week 30, signs of neurologic disease remained absent, serum IGF-1 concentration was maintained within the reference interval, and diabetes mellitus did not develop. Cabergoline was well tolerated, with mild gastrointestinal signs reported early in the course of treatment. Relevance and novel information This report describes a non-diabetic cat with HST secondary to a pituitary macroadenoma achieving sustained clinical and biochemical control with cabergoline monotherapy. This case demonstrates that a dopamine agonist might be an effective medical option in selected non-diabetic cats with HST, even in the presence of a large pituitary mass and signs of neurologic disease.
Case summary:A 1-year-old, neutered male domestic shorthair cat with a several-day history of anorexia and lethargy presented to The Ohio State University Veterinary Medical Center. On physical examination, a mass-like lesion was palpated in the mid-abdomen. Abdominal radiographs, ultrasound and contrast-enhanced CT revealed a mass-like lesion associated with the right kidney. Unilateral nephrectomy with removal of the mass in its entirety was performed as the sole treatment modality, and histopathology revealed a renal nephroblastoma. Postoperatively, the cat was re-evaluated every 3-6 months. The cat continues to do well more than 3 years since diagnosis, which is longer than most published cases. Relevance and novel information:This report aims to describe a case of feline nephroblastoma managed solely by surgical treatment, with an unexpectedly long survival time.
Case summary A 21-week-old, male castrated domestic mediumhair cat presented with a history of acute, severe regurgitation. No abnormalities were detected on physical examination. Initial serum biochemistry identified marked elevation in creatine kinase (CK) (905,409 U/l, reference interval [RI] 50–400), which persisted after 24 h of supportive care (32,491 U/l, RI 50–400). Serology for Toxoplasma gondii was negative. Radiography and ultrasound found severe caudal oesophageal impaction. The kitten was euthanased; a post-mortem examination confirmed oesophageal food impaction and severe, focally extensive oesophageal necrosis. The underlying cause of the oesophageal impaction was not definitively determined. Other than the oesophageal necrosis, there were no other autopsy findings to explain the elevated CK. Relevance and novel information Oesophageal muscle necrosis may be associated with severe elevations in CK concentrations and oesophageal disease should be considered if there is no obvious trauma, polymyopathy or cardiac disease in feline patients with markedly elevated CK.
Case summary An 11-year-old domestic shorthair cat presented for evaluation of severe oral haemorrhage. The patient had documented flea infestation and a history of marked pruritus preceding the onset of bleeding. Clinical examination identified a solitary lesion on the rostral hard palate as the only apparent source of haemorrhage. Histopathological analysis of the lesion revealed features consistent with trauma-induced ulceration, including fibrino-suppurative inflammation and granulation tissue proliferation. Based on the lesion’s location, clinical history and histopathological findings, a diagnosis of Menrath ulcer was established, presumed to be secondary to excessive grooming behaviour associated with pruritic skin disease. Relevance and novel information This case report describes a feline patient diagnosed with a Menrath ulcer, managed through multiple blood transfusions and surgical closure of the palatal lesion. Concurrent treatment targeted the underlying pruritic skin disease, including antiparasitic therapy and corticosteroids for suspected flea allergy dermatitis. The patient was monitored over a 12-month follow-up period, during which no recurrence of oral haemorrhage was observed, supporting the efficacy of combined surgical and medical management in cases of Menrath ulceration.
Case summary A 1-year-old domestic cat was presented with lameness and progressive swelling of the right stifle joint. The condition had been present for 1 month; during the consultation, it was evident that the cat was not bearing weight on the limb, which also exhibited muscle atrophy and tremors, as well as signs of pain upon manipulation. After sedation, crepitus was noted at the femorotibial-patellar joint. Radiographic examination showed osteolysis, and during clinical exploration, tumor cells destroying the joint were confirmed by cytology. Surgical excision was performed via limb amputation, and the mass was found to measure 3 × 5 × 3 cm. Histopathological analysis showed a biphasic neoplasm composed of spindle-shaped mesenchymal-like cells and large epithelial-like cells. Normal joint structures, including the capsule and articular cartilage, were completely effaced by neoplastic infiltration, including similar neoplastic changes in distal femur and proximal tibia epiphyses, metaphyses and diaphyses. Tumor cells were immunopositive for either vimentin or cytokeratin. Based on the 2020 World Health Organization (WHO) classification, the tumor was diagnosed as a malignant synovial and perisynovial neoplasm. The cat died 3 months after surgery; at the owner’s request, no post-mortem examination was conducted. Relevance and novel information To the authors’ knowledge, this is the first reported case of malignant synovial and perisynovial neoplasia diagnosed in a juvenile cat in accordance with the 2020 WHO classification. This case provides new insights into the histopathological findings of this rare tumor type in feline patients.
Case series summary This report describes two cats diagnosed with diabetes mellitus who developed clinical signs consistent with congestive heart failure (CHF). Clinical and echocardiographic findings improved over time with stabilisation and optimisation of glycaemic management. Both cats presented with dyspnoea, hypotension and hypothermia. Thoracic radiographs demonstrated diffuse pulmonary infiltrates. Pleural effusion was identified in one case. Echocardiography revealed left ventricular thickening with left atrial enlargement. Laboratory abnormalities included hyperglycaemia, elevated fructosamine and increased N-terminal pro B-type natriuretic peptide (NT-proBNP) concentrations. After CHF therapy and insulin administration, both cats showed rapid clinical improvement, with NT-proBNP concentrations decreasing into the reference interval and improvement in echocardiographic parameters within weeks. One cat later again showed an increase in myocardial thickness and experienced recurrence of CHF during a period of poor glycaemic control, with subsequent improvement after intensified glycaemic management. Relevance and novel information To the authors’ knowledge, this is the first report describing cats diagnosed with diabetes mellitus who developed CHF accompanied by increased left ventricular wall thickness and left atrial enlargement on echocardiography, with subsequent improvement after clinical stabilisation and glycaemic management. These cases suggest a potential association between metabolic dysregulation and the occurrence of CHF in cats.
Case summary An 8-year-old, male neutered domestic shorthair cat was presented with acute onset of ataxia, apathy, hypersalivation and anorexia. Clinical examination revealed a swollen, bluish tongue tip, neurological deficits, hypothermia, hypotension and a left-sided systolic heart murmur with arrhythmia. Blood pressure was initially low but normalised after dobutamine therapy. Thoracic radiographs revealed cardiomegaly, and echocardiography confirmed a hypertrophic cardiomyopathy (HCM) phenotype with severe left atrial dilation, spontaneous echo contrast and suspected thrombus formation. MRI of the head showed absent contrast enhancement in the rostral two-thirds of the tongue and signal changes consistent with lingual infarction. Doppler ultrasound confirmed absent blood flow in the affected tongue region. Based on imaging, cardiac findings and clinical signs, a lingual artery thromboembolism was considered the most likely diagnosis. The patient was treated with anticoagulant therapy and supportive care, but because of worsening tongue swelling, functional impairment and underlying advanced heart disease, euthanasia was elected. Relevance and novel information To the authors’ knowledge, this case represents the first reported case of feline arterial thromboembolism affecting the lingual artery. Although HCM was the presumed cause, other thromboembolic risk factors, such as hyperthyroidism, could not be definitively excluded. This case emphasises the need to consider atypical thromboembolic presentations in cats with cardiac disease and highlights the diagnostic value of advanced imaging modalities in identifying uncommon sites of arterial obstruction.
Case summary A 15-year-old, spayed female domestic shorthair cat was evaluated for chronic progressive stertor, mucopurulent nasal discharge and intermittent apnoeic episodes. CT revealed a soft tissue mass occupying the nasopharynx and partially obstructing the choanae. Nasopharyngoscopy confirmed a firm, pale, multilobulated lesion. Partial endoscopic debulking of the mass was performed, although further sampling was limited by post-procedural haemorrhage. Histopathology demonstrated dense eosinophilic inflammation with marked sclerosing fibroplasia, consistent with feline eosinophilic sclerosing fibroplasia (FESF); no histological features suggestive of lymphoma, carcinoma, fungal disease or inflammatory polyps were identified. Prednisolone was initially administered to minimise the risk of post-procedural inflammatory nasopharyngeal stenosis and subsequently continued for 31 days after histological confirmation of FESF. Two months later, CT and nasopharyngoscopy demonstrated complete anatomical resolution with full remission of clinical signs. Relevance and novel information Nasopharyngeal involvement of FESF has not previously been reported; the condition is typically described in young to middle-aged cats with gastrointestinal disease. More recent reports describe its possible lymph node localisation in sites beyond the abdominal cavity. This case documents a geriatric-onset, extra-gastrointestinal presentation mimicking neoplasia or granulomatous disease. Diagnosis was achieved on biopsies obtained during partial debulking, and follow-up investigations confirmed complete anatomical resolution. This case expands the recognised anatomical and age spectrum of FESF and supports consideration of this entity in the differential diagnoses for nasopharyngeal masses in cats.
