Summary : An 18 month-old cat presented with sneezing, nasal congestion, nasal discharge and clinical signs of Horner’s syndrome. There was no improvement following medical treatment. A nasopharyngeal polyp was seen originating from the right tympanic bulla on a CT image. Resection of the polyp via soft-palate incision resolved the respiratory clinical signs, but the neurological signs remained. Based on MRI findings, inflammatory tissue was removed from the right tympanic bulla via ventral osteotomy one month after the first surgery. No further clinical signs were noted and many neurological signs were improved following surgery. The tissues resected from these surgeries were histologically diagnosed as an inflammatory polyp. The present case suggests that inflammatory polyps involving the bulla and nasopharynx may cause Horner’s syndrome and upper respiratory disturbance in cats, possibly requiring surgery at both sites. A sample for a PCR test, obtained from the nasopharyngeal area sixteen months following surgery, was positive for Mycoplasma felis , but it was not concluded that Feline mycoplasma infection caused the inflammatory nasopharyngeal polyp in the cat.
Summary : A 14-year-old spayed long-haired mixed breed cat underwent forelimb amputation to treat a synovial sarcoma of the right forelimb. The cat was in good condition for 2 days postsurgery but suddenly became anorexic, and her general condition deteriorated. Blood tests showed leukopenia (1,790/ μl ) with neutrophil depletion (1,110/ μl ). Subsequently, the cat showed mild azotemia, an elevated serum total bilirubin concentration and jaundice. Abdominal ultrasonography revealed pancreatic swell-ing, and qualitative testing for feline pancreatic-specific lipase yielded a strongly positive result. The cat was diagnosed with postoperative acute pancreatitis of unknown causes and underwent medical treatment for pancreatitis. The treatment resulted in improved blood test results and an improved general condition. Eight months after the first visit, the cat remains in good general condition. This case revealed that acute pancreatitis can occur after surgery without intraperitoneal manipulation in cats. Veterinarians should recognize that feline leukopenia is one early clinical symptom of acute pancreatitis in cats.
Summary : A 12-year-old castrated Weimaraner was referred to our hospital with an acute onset of tetraparesis. Intervertebral disk extrusion at the level of C5-6 was diagnosed based on diagnostic imaging, and a left-sided hemilaminectomy at the lesion was performed. During the operation, the extruded disk material was turned out to be covered with the membranous tissue, and stripping of the membranous tissue resulted in severe bleeding. Observation of the surgical field after removal of the interverte bral material revealed that the membranous tissue was the internal vertebral venous plexus. In this case, it was difficult to confirm the internal vertebral venous plexus because the venous plexus was compressed by the laterally prolapsed disk material and there was no blood flow.
Summary : An 11-month-old spayed Kinkalow cat (crossbreed of an American curl and a Munchkin) presented with acute vomiting and anorexia. Radiographic and ultrasound examinations revealed two mass lesions: one in the abdominal cavity and one originating from the thoracic wall. Histopathological examination of the mass revealed a malignant peripheral nerve sheath tumor characterized by highly dysplastic and pleomorphic mesenchymal cells that were positive for anti-S100 antibody. The patient underwent surgery, and two tumor lesions were completely resected. However, on day 490, thoracic radiography revealed signs of lung metastasis, and the patient died of presumptive lung metastasis 520 days after the initial evaluation. We found no published clinical reports on malignant peripheral schwannoma in the abdominal cavities of cats at an early age; thus, the case seemed rare. Additionally, only two cases of metastasis of this tumor type have been reported to date. In these reports, tumor cell pleomorphism and multiple mass formations were considered possible causes of the metastasis.
Summary : Currently, there has been an increased risk of ureterolithiasis in cats; most of these stones are calcium oxalate ones, and responsible for ureteral obstruction. Feline ureteral obstruction may occur due to either the stone itself or may be secondary to ureteral fibrosis or granuloma formation. Due to the absence of stones in some cases, a workup for suspected ureteral obstruction is recommended if ultrasonography shows dilatation of the renal pelvis or ureter. While obstruction of a single ureter is less likely to cause serious injury, stricture of both ureters requires urgent treatment. In cases of calcium oxalate stones, surgery is often indicated. Once acute renal injury sets in, even with the resolution of ureteral obstruction, fibrosis of renal tubular interstitium is likely to advance, further progressing to chronic renal disease. This article focuses on the causes, pathological changes, clinical manifestations, diagnostic modalities, treatment modalities, and prognostic management of feline ureterolithiasis.
A 6-year-old male neutered domestic cat presented with esophageal obstruction and underwent endoscopic balloon dilation; however, the esophagus was perforated during the procedure. Thoracotomy was performed to enable visualization of the condition of the esophagus. Extensive esophageal stenosis was observed, and it was considered impossible to remove the stenosis and anastomose the esophagus. Therefore, a Nelaton catheter (NC) was passed through the lumen of the stenosis site and was used as a mold to maintain the esophageal lumen, enabling the passage of saliva. The NC was left in place in the esophagus for 3 months while the cat was fed through a gastrostomy tube. After removal of the NC, the cat was able to eat soft food without regurgitation and/or vomiting, and has survived for more than 3 years. The use of a NC to reconstruct the esophageal lumen may be a good option in a cat with life-threatening esophageal constriction.
Toshihiko SATO1)*, Yoshiaki ABE2), Kunihiro IIZUKA3), Tsuguaki OIKAWA4), Norihiro OOTA5), Mitsuru KINAI6), Kazuko TAKASAWA7) and Hiroyuki HATAKEYAMA8) 1) Sato Animal Hospital, 1-14 Miyashita-cho, Ichinoseki-shi, Iwate 021-0013, Japan 2) Iwate Animal Medical Center, 512 Sakurayashiki, Mizusawa, Oshyu-shi, Iwate 023-0865, Japan 3) Hiro Animal Clinic, 2-5-18 Kagano, Ishimori, Nakata-cho, Tome-shi, Miyagi 987-0601, Japan 4) Oikawa Animal Hospital, 8-35 Tsuchisawa Towa-cho, Hanamaki-shi, Iwate 028-0114, Japan 5) Aluf Animal Hospital, 15-207-15 Murasakino Kitakami-shi Iwate 024-0004, Japan 6) Elle Animal Clinic, 1-5-12 Tokiwadai, Kitakami-shi, Iwate 024-0012, Japan 7) Takasawa Animal Hospital, 3-4-22 Noda-cho, Kamaishi-shi, Iwate 026-0054, Japan 8) Hiiragi Animal Hospital, 125-1 Ooami, Sanuma, Hazama-cho, Tome-shi, Miyagi 987-0511, Japan
Summary : A male 12-year-old miniature dachshund with sudden onset of vomiting and anorexia presented to the veterinary teaching hospital of Yamaguchi University. Blood laboratory examination revealed increased levels of liver enzymes and inflam matory markers. Computed tomography and ultrasonography of the abdominal cavity revealed gas and/or stones in the dog’s gallbladder. Gas was also suspected within the abdominal space, suggesting gall bladder rupture and subsequent peritonitis. Exploratory laparotomy was scheduled 5 days after the first admission, during which we removed the highly-inflamed gallblad -der, which was tightly adhered to the surrounding hepatic lobes. The resected gallbladder was macroscopically dissociated into two layers, internal and external. Histopathological examination of the surgical specimen revealed purulent inflammation in the gallbladder wall with severe necrosis, and Enterococcus spp. were isolated from the gallbladder contents. Because Enterococcus spp. have been reported to induce a similar gallbladder condition in human medicine, the diagnosis in our patient was considered to be emphysematous cholecystitis induced by bacterial infection leading to a damage to the gallbladder. The dog recovered uneventfully after surgery.
A 5 years old, spayed domestic short-hair cat presented because of difficulty opening the mouth and loss of appetite. A firm-swelling was found on her left temporal area. The cat was FeLV negative. Surgical exploration was performed for biopsy and volume reduction. The pathological diagnosis was osteochondroma. The tumor could not be removed completely at two additional surgeries. Fifty-three months after the first surgery, remaining tumor growth decelerated, which was accompanied by the appearance of radio-transparent areas inside of the tumor. The long axis of the tumor increased about 1.3 mm during the final 59 months. The tumor remained in her left temporal area for more than 10 years; the cat continued to be able to eat normally. She died of unknown causes at 16 years of age, with no obvious metastasis and/or acute growth.
Summary: A mass protruding from the bladder trigon was found during ovariohysterectomy in a 12-year-old miniature dachshund. Since it was diagnosed as a malignant ganglioneuroma by the biopsy of the protruding area, full-thickness excision including normal bladder wall around the tumor was performed. The excised lesion was re-diagnosed as a malignant ganglioneuroma based on additional immunohistochemical examination. Neither recurrence nor metastasis was detected 35 months after the second surgery.
A female 9-year-old miniature dachshund with transitional cell carcinoma of the bladder and urethra presented to the veterinary teaching hospital of Yamaguchi University. We performed total cystectomy, urethrectomy, vaginectomy, and subsequent urinary diversion using a small intestinal conduit. Urine output from the small intestinal conduit was observed immediately after surgery. Contrast-enhanced computed tomography confirmed sufficient blood flow within the small intestinal conduit tissue and urinary discharge into the lumen. The dog’s quality of life was acceptable long-term; however, she died 495 days after surgery, possibly secondary to systemic tumor metastasis. This surgical technique is a possible treatment for transitional cell carcinoma widely invading the lower urinary tract in dogs.
Summary : We aimed to identify a technique for performing ultrasound-guided paravertebral block (PVB) and to determine the related isoflurane-sparing effects and potential complications during ovariohysterectomy in cats. Forty-two healthy female cats were used in the study, and we divided the cats into five groups according to five different PVB procedures. Under general an esthesia with isoflurane, paravertebral intermuscular injections of lidocaine hydrochloride (L), dexmedetomidine hydrochloride (D), lidocaine hydrochloride and dexmedetomidine hydrochloride (LD), or lidocaine hydrochloride and medetomidine hydro chloride (LM), were used as PVB. To evaluate the effects of the administration route, we evaluated lidocaine PVB using a femoral intramuscular injection of dexmedetomidine hydrochloride (LDIM) or medetomidine hydrochloride (LMIM). Ultrasound-guided PVB was performed bilaterally in the second to third intervertebral paravertebral space. After each procedure, we recorded time-sequential changes in end-tidal isoflurane concentration (ETISO), heart rate (HR), and blood pressure (BP). Compared with the reference control, ETISO increased by 15% with increasing HR and/or BP, whereas ETISO decreased with decreasing BP (<60 mmHg). Ataxia and urinary incontinence were not detected with any procedure, postoperatively, and no HR- and BP-related complications necessitating immediate treatment occurred. ETISO was significantly lower in the LD group compared with the L group. In particular, the LD group showed continuous decreases in ETISO. No significant difference in ETISO was observed between the L, LM, and LMIM groups. Ultrasound-guided PVB with lidocaine and dexmedetomidine resulted in a significant isoflurane-sparing effect and is a potentially appropriate method for inducing analgesia for feline ovariohysterectomy.
がん性疼痛の中でも特に骨転移によるものは重度の痛みを伴う。今回、通常の疼痛管理では痛みをコントロールできない悪性毛包上皮腫の胸椎骨転移をきたした犬に対して、胸椎を中心とした硬膜外カテーテルを留置し局所麻酔薬の単回投与を繰り返したところ、明らかな副作用は観察されず、良好な疼痛管理が可能であった。犬の骨転移を伴うがん性疼痛に対して硬膜外鎮痛は有効な鎮痛手段になりうると考えられた。
3歳7ヶ月齢、体重6.5 kgのパグが軟口蓋過長による呼吸困難を疑われ来院した。口腔内診査では軽度軟口蓋過長が認められたほか、右上顎第3前臼歯が臨床的欠歯であり、左上顎第2前臼歯が半埋伏であった。CT画像診断では左右上顎から鼻腔にかけて嚢胞による気道の狭窄が認められた。過長部軟口蓋の切除後も呼吸困難は継続して認められたことから、嚢胞の切除手術を実施した。左右各々の嚢胞内には埋伏歯が認められ、病理組織検査結果から含歯性嚢胞と診断した。嚢胞の切除後に患者の呼吸状態は顕著に改善し、術後280日でのCT検査では嚢胞の再発は認められなかった。手術から500日経過した現在も呼吸状態は良好である。短頭種犬では外鼻孔の狭窄や軟口蓋過長などの上部気道の狭窄を生じる疾患が多く認められるが、歯原性嚢胞の発生も他犬種と比較して多くみられることから、呼吸困難を生じた際の鑑別診断の1つとして考えるべきである。しかしながら埋伏歯に伴う歯原性嚢胞では臨床症状を伴うことが少ないため発見が遅れがちである。そのため臨床的欠歯を認めた場合には早期に診断を行う必要性があり、歯科処置の際には常に口腔内レントゲン検査を行うべきである。
膀胱タンポナーデにより排尿困難を呈した3歳5ヶ月齢の去勢済み雑種猫において、術前の血液凝固系検査で著しいAPTTの延長が認められた。本症例は凝固因子活性検査の結果、第XII因子欠損症と診断された。本症例における膀胱タンポナーデの原因として、FLUTIやカテーテル挿入による医原性損傷が主たる要因として考えられたが、憎悪因子の1つとして第XII因子欠損症が関与していた可能性が疑われた。
6歳11ヶ月齢のウサギが外陰部からの出血を主訴に受診した。X線検査で子宮の腫瘍と診断し、卵巣子宮摘出術を実施した。右子宮角には35×50 mmの腫瘤が、左子宮角には直径10–20 mmの腫瘤がビーズ状に認められた。病理組織および免疫組織学的検査で右子宮角の腫瘤は乳頭状腺癌、左子宮角の腫瘤は平滑筋腫と診断した。術後の経過は良好で3年9ヶ月間生存することができ、10歳8ヶ月齢時に胸部疾患を認め死亡した。
歩行困難を呈したトイ・プードルの進行性膝蓋骨内-外両方性脱臼の3症例に遭遇した。それぞれの症例に対し内側支帯強化術を含む外科的治療を行った結果良好な成績が得られた。内側膝蓋大腿靭帯の組織学的検索では、小径のコラーゲン細線維が顕著で、さらには結合組織疾患を連想させるような異形なコラーゲン細線維の所見が認められた。この所見から、犬の膝蓋骨内外両方性脱臼は膝関節周囲の緩みが進行する疾患である可能性が示唆された。そこで関節周囲組織の弛緩による再脱臼防止のためには、従来の脱臼整復法に加え、本症例で実施した非吸収性縫合糸による内側支帯強化術が有効であり本疾患の治療方法の選択肢の一つとなると考えられた。
犬の片側椎弓切除術にモルヒネ0.2 mg/kg/時間-リドカイン3 mg/kg/時間-ケタミン0.6 mg/kg/時間の持続静脈内投与（MLK-CRI）によるマルチモーダル術中鎮痛法を臨床応用した。MLK-CRIによって、顕著な循環抑制を生じることなくセボフルランの麻酔要求量約27%まで減少できたが（p<0.05）、調節呼吸の必要性が高く、抜管時間が延長した。MLK-CRIは犬臨床例に有用であるが、呼吸管理と麻酔回復の延長に注意が必要であると考えられた。
胸水貯留のため、1ヶ月前から呼吸の悪化を呈した9歳避妊メスの雑種猫が来院した。特発性乳び胸と診断した。全身麻酔下にて胸腔カテーテルを設置し、低圧持続吸引器に常時接続した。第9病日の試験的開胸術で、重度の線維性胸膜炎による肺葉辺縁の鈍化、右前葉一部、右中葉、左前葉の無気肺を確認した。心嚢膜亜全切除術、胸腔内大網固定術、胸腔カテーテルとPEGチューブの設置を行った。術後も胸腔内の低圧持続吸引を継続し、退院後も飼い主がシリンジによる1日3回の胸水除去と陰圧維持管理を継続した。胸水の貯留は徐々になくなり、第90病日に胸腔カテーテルを抜去した。その後、約7ヶ月が経過しているが、胸水の再貯留は認められず、拡張不全を呈していた肺葉の再拡張が認められた。本症例により、特発性乳び胸に続発した線維性胸膜炎による肺葉の拡張不全は、長期間の陰圧維持管理により改善する可能性がある事が示唆された。
