Extranodal B Cell Lymphoma in the Trachea of a Domestic Cat

Background: Primary tracheal tumors are considered uncommon in veterinary medicine and among them extranodal tracheal lymphoma, which is a neoplastic type, has rarely been described, especially with the use of immunophenotyping. Consequently, there is a lack of knowledge inherent to the characteristics of this tumor type in felines and as a result little information on how to deal with animals affected by this disease. Therefore, there is a need for more studies focusing on this matter. The objective of this work is to report a case of extranodal B cell lymphoma in the trachea of a domestic cat and point out the clinical and pathological characteristics of this neoplastic type.Case: A 5-year-old domestic cat, of an oriental breed, was taken to a veterinary clinic exclusively for cats in Rio de Janeiro, Brazil. The main complaint was difficulty in breathing and loss of appetite and historical data included intolerance to exercise. A clinical examination confirmed inspiratory dyspnea and upper respiratory sounds. Hematological and serum biochemical exams did not evidence any noteworthy changes and the cat was considered negative for feline viral leukemia and feline immunodeficiency viruses through serological and molecular testing. However, in the radiographic examination of the thoracic cervical region, an opacity was observed that occluded part of the tracheal lumen and this was suggestive of a mass in the initial third of the trachea, measuring 0.5 cm in diameter. The animal was stabilized and then 24 h after admission underwent inspection of the oral cavity and a biopsy of the tracheal mass was performed. Cytology of the specimen was suggestive of lymphoma. The treatment of choice was: lomustine with a single, oral dose of 10 mg; vincristine sulfate with a single intravenous dose of 0.75 mg/m²; and methylprednisolone acetate with a single intramuscular dose of 20 mg. A second radiograph taken 24 h after the chemotherapy showed that the tracheal mass had shrunk to 0.3 cm in diameter. Seven days after the treatment adopted for lymphoma, the mass was no longer visible. Histopathological analysis and immunohistochemistry supported the diagnosis of B cell lymphoma. A 36-month follow-up after the initial admission showed that the cat was in good health, without any respiratory signs and/or alterations in imaging tests that could suggest neoplastic recurrence.Discussion: The majority of animals with tracheal lymphoma are more than seven years old; thus, this report is one of the few that describes this tumor type in a young cat, and therefore highlights the importance of considering tracheal lymphoma as a differential diagnosis in young cats with clinical findings compatible with this condition. The successful treatment carried out here was attributed to the immunophenotyping of the neoplasia, because when B cell trachea lymphoma is diagnosed early and correctly there is usually a good prognosis. Type T lymphomas exhibit a poorer clinical response through therapy than B cell lymphomas. As far as the authors know, this is only the fifth report in which immunophenotyping of a tracheal lymphoma in a cat has been performed. The relevance of studies involving the immunohistochemistry of this tumor type in cats is asserted, so that the differentiation between B or T cell lymphomas can provide greater accuracy in dealing with animals affected with this disease

FREQUÊNCIAS DOS TIPOS SANGUÍNEOS E TÍTULOS DOS ALOANTICORPOS EM FELINOS DOMÉSTICOS

A área da hemoterapia necessita de testes de compatibilidade sanguínea confiáveis, como a tipagem sanguínea, para se evitarem possíveis reações transfusionais, mas em felinos é também importante para se evitar a isoeritrólise neonatal. Transfusões sanguíneas realizadas entre felinos doadores e receptores que não possuem compatibilidade sanguínea podem refletir em reação transfusional aguda, particularmente severa quando o sangue tipo A é transfundido em um gato tipo B, pois geralmente este último possui altos níveis de aloanticorpos de ocorrência natural. Portanto, o conhecimento da frequência dos tipos sanguíneos da população de gatos de uma região pode auxiliar na determinação dos riscos de reações transfusionais e de ocorrência de isoeritrólise neonatal. Tais riscos podem ser prevenidos com a tipagem sanguínea em casos de transfusão. Foram coletadas 100 amostras sanguíneas de felinos para a realização da tipagem sanguínea com plasmas reagentes anti-A e anti-B conhecidas e titulações de aloanticorpos anti-A e anti-B dos plasmas armazenados. A distribuição das frequências dos grupos sanguíneos foi 96% de felinos com tipo sanguíneo A e 4% de felinos com tipo sanguíneo B, não sendo encontrado na amostra populacional de felino tipo AB. Há um grande risco de reação adversa através da transfusão sanguínea randomizada entre felinos não tipados previamente. Palavras-chave: gatos; imunohematologia; medicina transfusional; tipagem sanguínea

Primary Intestinal Fibrosarcoma in Cats

Background: Fibrosarcomas are malignant neoplasms of mesenchymal origin and can have different symptoms depending on the species, age, location and etiopathogenesis. Intestinal tumors in domestic cats are common and the small intestine is the most common site; however, fibrosarcomas are rare in the intestine of all animal species. This work reports intestinal fibrosarcoma in 2 domestic cats and aims to clarify and present information concerning this neoplastic type in the gastrointestinal tract of this species.Cases: We report 2 cases of intestinal fibrosarcoma in domestic felines (Felis catus). Cat 1. A 14-year-old female Persian breed, domestic cat, was taken to the Feline Sector of the Veterinary Hospital of Small Animals (HVPA) of the Federal Rural University of Rio de Janeiro (UFRRJ). The main complaint was chronic constipation and rectal prolapse. The clinical examination revealed an ulcerated mass, measuring 4.0 cm x 1.7 cm. Cat 2. A 10-year-old female undefined breed, domestic cat, was taken to the private clinic. The main complaint was diarrhea with bloody and rectal prolapse. The clinical examination revealed nodule measuring 2.5 cm in diameter. The surgical option decided upon was to use the rectal pull-through technique in both animals. The patients had no trans-surgical or postoperative complications. The material collected during the surgical interventions was analyzed macroscopically and fixed in 10% buffered formalin for 24 h and then sent to the Histopathology Laboratory of the Pathological Anatomy Sector (SAP) at UFRRJ for the cat 1 and in private laboratoryfor the cat 2. After fixation, it was cleaved for routine microscope exam using Hematoxylin and Eosin (HE) stains and for the histochemical method of Masson’s Trichrome staining technique. Complementary immunohistochemistry tests and electron microscopy were also performed. The patients were followed up clinically, showing complete remission of the clinical signs and survival for approximately 1 year after the neoplastic resection. Discussion: There are few reports of intestinal fibrosarcomas in veterinary medicine, therefore, little is known about racial predilection, age, sex or biological behavior. As far as these authors know, this is the 6th and 7th report of this neoplasm with a primary site in the large intestine in this species. The morphological diagnosis of fibrosarcoma is relatively simple, whereas, in some cases the differential diagnosis for tumors of the peripheral nerve sheath, leiomyosarcomas and gastrointestinal stromal tumor (GIST) can be extremely difficult. The immunohistochemistry technique in these cases may not be particularly useful. The fibrosarcoma diagnosis was also confirmed by electron microscopy since no evidence was found that could lead to a neuronal origin, thus excluding tumors such as neurofibrosarcoma and schawnoma, corroborating the immunohistochemical examination. The surgical management of tumor resection with wide safety margins (minimum 2 cm) remains the “gold standard” therapy for dealing with fibrosarcomas since they have a low response rate to chemotherapy and radiotherapy and the use of these therapies as an adjuvant is controversial. The advantages of thistechnique are related to the surgical time, simplicity, easy access and reduction in the risk of abdominal contamination. Histopathological, immunohistochemistry and electron microscopy evaluations were sufficient to enable the diagnosis of an intestinal fibrosarcoma in both cats. The occurrence of this neoplasm with intestinal involvement in the feline species is rare; therefore, this description is important as it provides information about epidemiology, associated signs, differential diagnoses, biological behavior, treatment and prognosis. Keywords: feline, intestine, mesenchymal, tumors, neoplasm, rectal pull-through

Histoplasmose pulmonar grave em um gato doméstico: tratamento com Anfotericina B e Itraconazol

Background: Histoplasmosis is a systemic mycosis whose etiologic agent is the fungus Histoplasma capsulatum. This fungal infection, which is the second most frequent systemic mycotic fungal disease in felines in the United States, has rarely been found in cats in Brazil. This paper reports on a case of acute pulmonary histoplasmosis in a domestic cat treated with oral itraconazole associated with amphotericin B administered subcutaneously. This treatment resulted in clinical remission of the patient’s symptoms, as evidenced by radiographic follow-ups.Case: A domestic cat suffering from acute dyspnea was taken to a veterinary clinic. The animal was subjected to emergency oxygen therapy, and kept at rest through sedation with midazolam. A physical examination revealed normally colored mucosa, 8% dehydration, bristly fur, body condition score 2/9, tachypnea with respiratory rate of 100 breaths per minute and expiratory dyspnea. The radiographic examination showed marked opacification of all the pulmonary fields, with a mixed pattern (interstitial and alveolar) of heterogeneous appearance and diffuse distribution, which are changes consistent with an inflammatory infectious process (pneumonia). A cytological analysis of the pleural fluid revealed round to oval-shaped intracytoplasmic structures, varying in size from 2 to 4 μm, inside foamy macrophages, consistent with Histoplasma capsulatum. Based on the diagnosis of pulmonary histoplasmosis, and in view of the patient’s acute respiratory distress, it was decided to treat the cat using itraconazole associated with amphotericin B. Itraconazole was administered orally at a dose of 100 mg/cat every 24 h, while amphotericin B was administered subcutaneously at a dose of 0.5 mg/kg, combined with 100 mL of sodium chloride 0.9% and 100 mL of 5% glycated serum, with monitoring of serum concentrations of symmetric dimethylarginine (SDMA). Amphotericin B was administered every 48 h up to the 7th dose, followed by three times a week up to the 11th dose, and then twice a week up to the 16th dose. The animal was released from the veterinary hospital 10 days after its admission, showing a considerably improved respiratory condition and a respiratory rate of 40 breaths per minute. Continuation of the antifungal treatment with itraconazole was prescribed, maintaining the same dose and frequency of administration until a new recommendation would be made, as well as frequent return visits for the administration of amphotericin B and reassessment of the animal. The administration of amphotericin B was discontinued when the animal’s respiratory condition stabilized; hence, the feline received a total of 16 doses of the drug. The animal showed remission of clinical respiratory symptoms, confirmed by follow-up chest X-rays, which revealed significantly less radiodense pulmonary parenchyma in response to treatment with itraconazole and amphotericin B. Five months after beginning its treatment, the cat is being treated orally with itraconazole (100 mg/cat, every 24 h), without recrudescence of the clinical symptoms.Discussion: To date, six cases of feline histoplasmosis have been reported in Brazil, only one of which had pulmonary involvement and was treated successfully. The use of oral itraconazole associated with subcutaneous amphotericin B has proved to be effective for the treatment of acute pulmonary histoplasmosis in domestic cats. Note that a rapid diagnosis of pulmonary disease is essential in order to immediately implement a combined drug therapy linked with monitoring to ensure the protocol is safe for the patien

Successful Surgical Treatment of Idiopathic Chylothorax in a Cat

Background: Chylothorax in cats represents a challenge due to the possibility of involvement of multiple etiologies and the harmful consequences resulting of the presence of the chylous effusion in the thorax. The causes include neoplasms in the thoracic cavity, heart disease and thoracic injuries. It is imperative that clinical nutritional and therapeutic and / or surgical management be immediate and directed to the treatment of the cause. The objective of this work was to report a case of idiopathic chylothorax in a domestic cat solved through surgical intervention and dietary maintenance applied.Case: A 4-year-old male cat, fed with diet for the age range of adult cats, was attended at the Veterinary Hospital of the Federal Rural University of Rio de Janeiro (HV - UFRRJ), with clinical complaint of difficulty breathing, inappetence, prostration and weight loss. In the clinical examination was verified intense tachypnea, presence of heart murmur, normocoratedmucosae, dehydration 7%. The animal was sedated to be submitted to radiographic examination of the thorax with pethidine and midazolam. Thoracic radiographs on the lateral, ventral-dorsal and orthostatic positions were realized and severe pleural effusion was observed in both hemitorax with drainage of 180 mL of lactescent fluid from the right hemithorax and 120 mL of left hemithorax liquid. Through analysis of cavity liquids the effusion was classified as chylous effusion. The hemogram showed a neutrophilic leukocytosis. Serum cholesterol and triglyceride concentrations (28 mg/dL and 43 mg/dL, respectively) were lower than the concentrations of the cavity liquid (67 mg/dL and 722 mg/dL, respectively).Ultrasound examination revealed no mass in the thoracic cavity and no changes in the pulmonary parenchyma. The echocardiographic examination was also performed and did not reveal any cardiac alterations. The initial treatment consisted of the clinical approach, through the exclusive alimentary management with low fat diet, in order to reduce toreduce the amount of chylous in the thorax. The rutine was administered at a dose of 250 mg/cat every 8 h orally. After 15 days, due to an unsatisfactory response to conservative treatment, surgical intervention was indicated. The technique used was pleural omentalization with block ligation of the thoracic duct without mesenteric lymphangiography together with pericardectomy and placement of the thoracic drain. During the postoperative period the animal remained under intensive care, with nasal oxygen therapy and intense analgesia during the first 72 h. After 20 days, the production of the chylous liquid was 2 mL/kg/ day, which made it possible to remove the drain. The cat received continuously with the exclusive diet of low fat to reduce the production of the chylous, without recurrence of chylous up to the present moment.Discussion: It is important to establish in a first approach of animals with chylous exudation the management of low-fat foods, along with appropriate pharmacological therapy, monitoring the patient in a constant and cautious way. If conservative clinical intervention is not satisfactory within 5 to 10 days, rapid surgical treatment is essential, due to the risk offibrosing pleuritis with consequent involvement of the pulmonary parenchyma, as occurred in this report. Duct ligation surgery and the pericardectomy was satisfactory for the resolution of the constant chylous production in the thorax of the animal, as well as the use of the low fat diet was essential to reduce the chylous effusion and fibrosing pleurisy, both the interventions made possible the maintenance of the patient’s health and well-being.Keywords: feline, cavitary fluid, quilting effusion, thoracic duct

FREQUENCY OF BLOOD GROUPS AND TITERS OF ALLOANTIBODIES IN DOMESTIC CATS

Hemotherapy requires reliable blood compatibility tests, such as blood typing, to avoid possible transfusion reactions in cats. However, it is also important to avoid neonatal isoerythrolysis. When blood transfusions are performed between incompatible feline donors and recipients, they may develop acute transfusion reactions, especially severe when type A blood is transfused into a type B cat because it has high levels of anti-A alloantibodies. Therefore, knowing on the blood type frequency in feline population of some region can help to determine the transfusion reaction risks and the occurrence of neonatal isoerythrolysis. Addicionally, such risks may be prevented through blood typing, in cases of transfusion. One hundred feline blood samples were collected and anti-A and anti-B blood reagent typing tests were performed, plus titration of alloantibodies of stored plasma. These tests showed a 96% frequency of type A blood and only 4% of type B blood among tested cats. We did not find any AB type blood cat. There is a great risk of adverse reactions after random blood transfusions between non-typed cats. Keywords: blood typing; cats; immunohematology; transfusion medicine

Osteocondrodisplasia em um felino jovem da raça Scottish Fold: relato de caso

Os gatos Scottish Fold possuem um gene autossômico dominante que determina a ocorrência das orelhas dobradas para frente e graus variados de osteocondrodisplasia. Objetiva-se com este trabalho relatar um caso de osteocondrodisplasia em um gato jovem da raça Scottish Fold, destacando as características clínicas, patológicas e a conduta terapêutica adotada mediante o quadro clínico, visando difundir informações relacionadas ás particularidades deste padrão racial felino. Foi levado para atendimento clínico um gato doméstico da raça Scottish Fold, macho, com 12 meses de idade, devido à queixa de dificuldade locomotora. Na avaliação radiográfica as articulações társicas apresentaram-se hipoplásicas, com angulação anormal do eixo nos metatarsos, falanges e articulações relacionadas, compatível com osteocondrodisplasia. Já nas articulações coxofemorais evidenciou-se displasia coxofemoral leve. O tratamento consistiu na utilização de gabapentina, sulfato de condroitina e ômega-3. Este é o primeiro relato de osteocondrodisplasia em um Scottish Fold no Brasil. As deformidades osteoarticulares observadas no felino jovem da raça Scottish Fold com osteocondrodisplasia constituem uma preocupação, em função do comprometimento da qualidade de vida do paciente e ausência de um tratamento curativo para tal afecção, assim o estudo pôde expandir informações a respeito das características inerentes a este padrão racial

Extranodal B Cell Lymphoma in the Trachea of a Domestic Cat

Background: Primary tracheal tumors are considered uncommon in veterinary medicine and among them extranodal tracheal lymphoma, which is a neoplastic type, has rarely been described, especially with the use of immunophenotyping. Consequently, there is a lack of knowledge inherent to the characteristics of this tumor type in felines and as a result little information on how to deal with animals affected by this disease. Therefore, there is a need for more studies focusing on this matter. The objective of this work is to report a case of extranodal B cell lymphoma in the trachea of a domestic cat and point out the clinical and pathological characteristics of this neoplastic type.Case: A 5-year-old domestic cat, of an oriental breed, was taken to a veterinary clinic exclusively for cats in Rio de Janeiro, Brazil. The main complaint was difficulty in breathing and loss of appetite and historical data included intolerance to exercise. A clinical examination confirmed inspiratory dyspnea and upper respiratory sounds. Hematological and serum biochemical exams did not evidence any noteworthy changes and the cat was considered negative for feline viral leukemia and feline immunodeficiency viruses through serological and molecular testing. However, in the radiographic examination of the thoracic cervical region, an opacity was observed that occluded part of the tracheal lumen and this was suggestive of a mass in the initial third of the trachea, measuring 0.5 cm in diameter. The animal was stabilized and then 24 h after admission underwent inspection of the oral cavity and a biopsy of the tracheal mass was performed. Cytology of the specimen was suggestive of lymphoma. The treatment of choice was: lomustine with a single, oral dose of 10 mg; vincristine sulfate with a single intravenous dose of 0.75 mg/m²; and methylprednisolone acetate with a single intramuscular dose of 20 mg. A second radiograph taken 24 h after the chemotherapy showed that the tracheal mass had shrunk to 0.3 cm in diameter. Seven days after the treatment adopted for lymphoma, the mass was no longer visible. Histopathological analysis and immunohistochemistry supported the diagnosis of B cell lymphoma. A 36-month follow-up after the initial admission showed that the cat was in good health, without any respiratory signs and/or alterations in imaging tests that could suggest neoplastic recurrence.Discussion: The majority of animals with tracheal lymphoma are more than seven years old; thus, this report is one of the few that describes this tumor type in a young cat, and therefore highlights the importance of considering tracheal lymphoma as a differential diagnosis in young cats with clinical findings compatible with this condition. The successful treatment carried out here was attributed to the immunophenotyping of the neoplasia, because when B cell trachea lymphoma is diagnosed early and correctly there is usually a good prognosis. Type T lymphomas exhibit a poorer clinical response through therapy than B cell lymphomas. As far as the authors know, this is only the fifth report in which immunophenotyping of a tracheal lymphoma in a cat has been performed. The relevance of studies involving the immunohistochemistry of this tumor type in cats is asserted, so that the differentiation between B or T cell lymphomas can provide greater accuracy in dealing with animals affected with this disease

Undetectable proviral DNA and viral RNA levels after raltegravir administration in two cats with natural feline leukemia virus infection

Feline leukemia virus (FeLV) infection was discovered over 50 years ago; however, the serious clinical changes associated with FeLV infection still have great importance in the diagnosis, prevention, and clinical management of symptomatic patients. Progressive infection with FeLV leads to a reduction in the patient’s life expectancy and quality of life. This report describes the use of an antiretroviral integrase inhibitor, raltegravir, in two cats with natural FeLV infection. Raltegravir was administered orally at a dose of 40 mg/ cat every 12 h in both cases. In case one, 13 weeks after starting raltegravir, RNA loads were undetectable, while proviral DNA loads were still detectable. In case two, proviral DNA loads were undetectable after 32 weeks of medication, while RNA loads were undetectable throughout the treatment. No adverse effects or laboratory test abnormalities were detected with the use of raltegravir in either patient. The patients are currently clinically healthy, still receiving the drug, and are under close observation. To our knowledge, this is the first report describing the use of raltegravir in naturally infected FeLV-positive cats and its effects on circulating viral load. Moreover, the patients described here were followed-up for a longer period than those in previously reported cases

Cholangiocarcinoma in Young Cats

Background: Cholangiocellular carcinoma is a malignant tumor that occurs mainly in elderly dogs and cats. Primary hepatobiliary neoplasms are considered rare in felines, although cholangiocarcinoma is the most common tumor type among malignant liver tumors in the species. The objective of this work is to report two cases of cholangiocarcinoma in young domestic cats, with three years old, and to approach clinical and pathological aspects to promote awareness of this type of injury in young animals, with a focus on prevention of predisposing factors.Cases: A 3-year-old male domestic cat (cat 1) had a history of progressive weight loss, persistent vomiting, diarrhea, and episodes of seizure. At the clinical examination was noted moderate degree of jaundice. In the biochemical exams it was verified as alteration hypoproteinemia, increase of urea and hyponatremia. Abdominal ultrasonography revealed a formation in the left epigastric region measuring 8.0 x 5.0 cm, with a diffusely heterogeneous parenchyma, suggestive of hepatic neoplasia, in addition to the presence of free abdominal fluid. Cavity fluid analysis was suggestive of carcinoma. A 3-year-old male domestic cat (cat 2), with history of hyporexia, emaciation and vomiting was taken to care. Physical examination showed moderate dehydration, hypocorous mucosa and presence of abdominal mass on palpation. The animal's serum biochemical assessment were verified as changes, increasing AST. Ultrasonographic examination showed an abdominal mass, located caudally to the spleen, with irregular shape, measuring approximately 4.7 cm suggestive of hepatic neoplasia, in addition to the presence of abdominal fluid. The hepatic cytology performed by fine needle aspiration was suggestive of carcinoma. After the clinical worsening of two cats and due unfavorable prognosis, euthanasia and necropsy were performed. In the macroscopic analysis of cat 1, numerous nodules of whitish and sometimes "umbilicate" coloration were observed in the liver, measuring up to three cm in diameter, distributed randomly by the hepatic parenchyma and with a soft consistency at cut. An ovoid-wicking mass, measuring 6.0 x 7.0 x 5.0 cm in diameter and coloring ranging from white to light brown was checked together. In the macroscopic evaluation of cat 2, numerous coalescing masses of whitish coloring measuring up to 6.0 cm in diameter were observed covering almost every hepatic parenchyma and also affecting the pancreas, with a soft consistency at cut. The microscopic findings of both cats were compatible with the diagnosis of cholangiocarcinoma. Considering the immunohistochemical profile, in both cases there was positivity for the CK Pan antibody and CEA and negativity for the CK20, TTF-1, Hepatocyte specific antigen, CD10 and CD56 antibodies.Discussion: Cholangiocarcinomas usually occur in elderly animals, with a mean age of 9 years, so it may be suggested that the cause of the disease in cat 1 and 2 was possibly related to the early and continuous presence of carcinogens. The biliary duct trematod Platynosomum fastosum, the chemical agents plutonium and americium, intestinal parasites such as Ancylostoma spp. and Trichuris vulpis, as well as the occurrence of chronic inflammations independent of etiology are commonly involved in the occurrence of cholangiocarcinoma. Clinical and anatomopathological observations made evident that these two young cats, with three years old, had metastatic cholangiocarcinoma. Thus, veterinary providers should be aware that this tumor type can occur in young animals and is mindful of means of prevention and / or recommended treatment of predisposing factors