Ureterolitíase bilateral em um gato de sete meses de idade

Feline ureteral obstruction can have several causes; however, ureterolithiasis has been increasing in occurrence. The restriction of urinary flow induced by the obstruction has harmful consequences to the body and can lead to acute renal failure. Calcium oxalate ureterolithiasis is reported in older cats, aged mean 12 years old. A case of bilateral ureteral obstruction in a 7-month-old mixed breed cat is described in this report. Imaging tests such as abdominal ultrasonography, radiography and excretory urography were performed to determine the diagnosis. The surgical procedure of bilateral ureterotomy was then performed, which allowed the improvement of the urinary flow of both kidneys and the resolution of clinical signs caused by uremia. The quantitative analysis of both uroliths revealed the composition of 100% monohydrate calcium oxalate. Calcium oxalate stones can also cause ureteral obstruction in young cats; although, are less common in this age. When conservative treatment fails, surgical intervention becomes necessary for the rapid return of renal function. To author’s knowledge this is the first report of a ureterolithiasis caused by calcium oxalate in a young cat.A obstrução ureteral em gatos pode ter diversas causas, entretanto, a ureterolitíase vem apresentando um aumento na sua ocorrência. A restrição do fluxo urinário induzida pela obstrução traz consequências graves ao organismo, podendo levar a insuficiência renal aguda. A ureterolitíase por cálculos de oxalato de cálcio é relatada em gatos mais velhos, com média de idade de 12 anos. Um caso de obstrução ureteral bilateral em um gato, SRD, com sete meses de idade é descrito nesse relato. Exames de imagem, como ultrassonografia e radiografia abdominais e urografia excretora, foram realizados para confirmar o diagnóstico. O procedimento cirúrgico de ureterotomia bilateral foi então realizado, permitindo a melhora do fluxo urinário de ambos os rins e dos sinais clínicos de uremia. A análise quantitativa de ambos os urólitos revelou a composição de 100% oxalato de cálcio monohidratado. Cálculos de oxalato de cálcio são um diagnóstico diferencial para obstrução ureteral também em gatos jovens, apesar de serem menos comuns. Quando há falha no tratamento conservador, a intervenção cirúrgica torna-se necessária para o rápido restabelecimento e preservação da função renal. No conhecimento dos autores, esse é o primeiro relato de ureterolitíase causada por oxalato de cálcio em um gato jovem

Adenocarcinoma acinar pulmonar primário em gato : relato de caso

Among the diseases that cause dyspnea in felines, primary pulmonary neoplasia is rare and tends to affect senile cats. This study reports the case of a seven teen year old FeLV infected cat who was diagnosed acinar adenocarcinoma of the lung and kidney metastasis. It presented prostration and anorexia and was hospitalized with dyspnea and pleural effusion. Chest radiography indicated increased radiopacity in the cranial portion of the right hemithorax, compatible with presence of intrathoracic mass and the cytologic analysis of pleural effusion suggested feline infectious peritonitis. The animal died two days after, and the definitive diagnosis was concluded after necropsy and histopathological examination. Pulmonary adenocarcinoma should be included with differential diagnosis of respiratory diseases in cats, especially the elderly.Entre as doenças que causam dispneia em felinos, a neoplasia pulmonar primária é rara e costuma acometer gatos senis. Este trabalho tem por objetivo relatar o caso de um felino, de 17 anos, portador do vírus da leucemia felina, diagnosticado com adenocarcinoma acinar pulmonar primário com metástase no rim e na pleura parietal. O paciente apresentava histórico inespecífico, sendo as principais queixas prostração e anorexia, e foi internado apresentando dispneia e efusão pleural. A radiografia torácica indicou aumento da radiopacidade na porção cranial do hemitórax direito, compatível com presença de neoformação intratorácica. A citologia da efusão foi sugestiva de peritonite infecciosa felina. O animal veio a óbito dois dias após o atendimento inicial e o diagnóstico definitivo foi determinado por meio da necropsia e da avaliação histológica. O adenocarcinoma pulmonar deve ser incluído como diagnóstico diferencial de doenças respiratórias em gatos, principalmente idosos

Intoxicação por amitraz em um gato

A 4-month-old male Himalayan cat presented with clinical signs of acute lethargy and motor incoordination after being treated with amitraz for parasite control. On clinical examination, the patient was lethargic and ataxic with severe pulicosis, hypothermia, pale mucous membranes, bradycardia, weak femoral pulses, hyperglycemia, and bilateral mydriasis. Blood tests revealed non-regenerative hypochromic microcytic anemia. Serum alanine levels were elevated tenfold. The patient received supportive treatment with atipamezole (an α2-adrenergic antagonist) at a dose of 0.1 mg/kg intramuscularly. After 24 h of hospitalization and constant monitoring, the patient recovered and was discharged. The published literature showed that the active ingredient amitraz is effective in the treatment of some parasitic diseases in cats, such as scabies and demodicosis; therefore, it is still used for this purpose. Given the small therapeutic margin of this insecticide, veterinarians should caution owners about its potential toxicity. This report emphasized the significance of amitraz intoxication in feline species and the success of the treatment, which should be initiated in the first hour after intoxication.Um gato da raça Himalaia, macho, com quatro meses de idade, apresentou sinais clínicos de letargia aguda e incoordenação motora após ser medicado com amitraz para controle de parasitas. No exame clínico, o paciente se apresentava letárgico e atáxico, com pulicose grave, hipotermia, mucosaspálidas, bradicardia, pulso femoral fraco, hiperglicemia e midríase bilateral. O exame de sangue revelou anemia microcítica hipocrômica não regenerativa. Os níveis séricos de ALT estavam 10x elevados. O paciente recebeu tratamento de suporte e administração de atipamezol (antagonista α2-adrenérgico) na dose de 0,1 mg/kg por via intramuscular. Após 24 horas de internação e acompanhamento constante, o paciente se recuperou e recebeu alta. Dados publicados na literatura demonstram que o princípio ativo amitraz é eficaz no tratamento de algumas doenças parasitárias em gatos como sarna e demodicose e, portanto, ainda é utilizado para esta finalidade. Dada a pequena margem terapêutica deste inseticida, os veterinários devem informar os proprietários sobre o seu potencial de toxicidade. O objetivo deste relato é enfatizar a importância da intoxicação por amitraz na espécie felina e o sucesso do tratamento, que deve ocorrer nas primeiras horas após a intoxicação

Clinical and nutritional follow-up of cats with chronic kidney disease fed with a renal prescription diet

Background: The use of prescription diets for cats with chronic kidney disease (CKD) is one of the main management approach of this disease in cats, and is considered a renoprotective strategy that may promote increased survival and/or improve quality of life, according to the stage of CKD. Besides that, nutritional assessment is important to monitor the maintenance of quality of life of the patients and their response to disease, especially those with chronic conditions. The aim of this study was to follow the clinical and nutritional status of cats with chronic kidney disease (CKD) IRIS stages II, III and IV fed with a renal prescription diet, followed for 12 months. Materials, Methods & Results: Patients were fed exclusively with a dry renal prescription diet and medications for the management of CKD were prescribed when needed. Exclusion criteria were cats that already received a renal prescription diet or medications for the treatment of CKD. Cats were evaluated every 2 months, considering body weight (BW), body condition score (BCS), muscle mass score (MMS), clinical and laboratory parameters. In all assessments, a complete blood count and biochemistry were performed by conventional methods with the patient fasted for 12 h. In addition, urinalysis, urine protein:creatinine ratio (UPC) and urine culture were performed from a urine sample collected by cystocentesis. The quantitative variables were tested for their stability on consecutive assessments using the non-parametric Friedman test, and did not present significant variation during follow-up, except for systolic blood pressure (SBP). Eight cats with a diagnosis of CKD were included in the study and 6 of them remained in the same CKD stage during follow-up. On cat died due to an unrelated CKD cause. Regarding nutritional assessment, 5 of 7 cats maintained BW during the 12 months. Of these, 4 also maintained MMS and BCS. Three of 7 cats presented a decrease in MMS, 2 of which presented also a decreased BW and one maintained BW. Discussion: IRIS staging results combined with Friedman’s analysis demonstrated that the diet and the clinical management were effective in the non-progression of CKD in this study. As renal injury is not expected to be reversed in CKD, the maintenance of cats in the same IRIS stages and the minimum variation of the parameters is considered a positive result in this study. Hypertensive cats started on antihypertensive therapy during the study, achieving adequate control of SBP in most cases, what can justify the variation of this clinical parameter over the 12 months. Hyperphosphatemia was a frequent alteration, included stage II cats, and presented a positive response to nutritional and medical therapy. Despite CKD staging progression was not observed in most cats using serum creatinine as a single parameter, some cats presented BW and MMS reduction, which may have influenced this result. Weight loss and muscle wasting may have occurred by several reasons, including periods of hyporexia, presence of concomitant diseases, aging process or reduced protein content on renal prescription diets. This study enhances the importance of the association of clinical and nutritional management in the maintenance of cats with CKD. We suggest that other studies are done during longer periods of time and with a larger sample to support the results found. We also suggest new studies to evaluate the protein requirements for cats with CKD

Clinical and Nutritional Follow-up of Cats with Chronic Kidney Disease Fed with a Renal Prescription Diet

Background: The use of prescription diets for cats with chronic kidney disease (CKD) is one of the main management approach of this disease in cats, and is considered a renoprotective strategy that may promote increased survival and/or improve quality of life, according to the stage of CKD. Besides that, nutritional assessment is important to monitor the maintenance of quality of life of the patients and their response to disease, especially those with chronic conditions. The aim of this study was to follow the clinical and nutritional status of cats with chronic kidney disease (CKD) IRIS stages II, III and IV fed with a renal prescription diet, followed for 12 months. Materials, Methods & Results: Patients were fed exclusively with a dry renal prescription diet and medications for the management of CKD were prescribed when needed. Exclusion criteria were cats that already received a renal prescription diet or medications for the treatment of CKD. Cats were evaluated every 2 months, considering body weight (BW), body condition score (BCS), muscle mass score (MMS), clinical and laboratory parameters. In all assessments, a complete blood count and biochemistry were performed by conventional methods with the patient fasted for 12 h. In addition, urinalysis, urinary protein:creatinine ratio (UPC) and urine culture were performed from a urine sample collected by cystocentesis. The quantitative variables were tested for their stability on consecutive assessments using the non-parametric Friedman test, and did not present significant variation during follow-up, except for systolic blood pressure (SBP). Eight cats with a diagnosis of CKD were included in the study and 6 of them remained in the same CKD stage during follow-up. On cat died due to an unrelated CKD cause. Regarding nutritional assessment, 5 of 7 cats maintained BW during the 12 months. Of these, 4 also maintained MMS and BCS. Three of 7 cats presented a decrease in MMS, 2 of which presented also a decreased BW and one maintained BW.Discussion: IRIS staging results combined with Friedman’s analysis demonstrated that the diet and the clinical management were effective in the non-progression of CKD in this study. As renal injury is not expected to be reversed in CKD, the maintenance of cats in the same IRIS stages and the minimum variation of the parameters is considered a positive result in this study. Hypertensive cats started on antihypertensive therapy during the study, achieving adequate control of SBP in most cases, what can justify the variation of this clinical parameter over the 12 months. Hyperphosphatemia was a frequent alteration, included stage II cats, and presented a positive response to nutritional and medical therapy. Despite CKD staging progression was not observed in most cats using serum creatinine as a single parameter, some cats presented BW and MMS reduction, which may have influenced this result. Weight loss and muscle wasting may have occurred by several reasons, including periods of hyporexia, presence of concomitant diseases, aging process or reduced protein content on renal prescription diets. This study enhances the importance of the association of clinical and nutritional management in the maintenance of cats with CKD. We suggest that other studies are done during longer periods of time and with a larger sample to support the results found. We also suggest new studies to evaluate the protein requirements for cats with CKD

Perinephric Pseudocyst in a Two-Month-Old Female Cat

Background: Perinephric pseudocyst is defined as an accumulation of fluid in fibrous sacs surrounding one or both kidneys, and may be located in the subcapsular or extracapsular region. Histologically, it is characterized by the absence of an epithelial lining to the cyst wall and the term pseudocyst is used. This condition have been reported sporadically in cats, and is associated with chronic kidney disease, mainly in older animals. The diagnosis is based on imaging tests and the prognosis is related to the severity of renal dysfunction. The aim of this report is to describe an unusual presentation of perinephric pseudocyst in a very young female cat.Case: A mixed-breed 2-month-old female cat was evaluated for presenting abdominal distension and anatomical deformities of the limbs. Renomegaly on the left side was noted during abdominal palpation. On presentation, the serum creatinine was 134 μmol/L. Urinalysis showed mild proteinuria, presence of squamous and transitional cells, and rare bacteria. The urine specific gravity was 1.044 and urine protein to creatinine ratio was 0.23. Abdominal ultrasonography revealed a large anechoic subcapsular cyst on the left kidney, in adittion to dilatation of renal pelvis and calyces. The excretory urography showed left renomegaly, and the nephrogram and pyelogram were not clearly observed in this kidney, indicating unilateral deficiency in renal filtration. The cat was referred to unilateral left nephrectomy but died shortly before surgery. At necropsy,marked left kidney enlargment was observed (6.5 x 4.5 x 1.5 cm), with a cystic aspect, occupying almost the entire abdominal cavity. The cystic content was translucent and was compressing the renal parenchyma, resulting in hydronephrosis. The capsule forming the cyst wall was composed of connective tissue, characterizing the perinephric pseudocyst.Discussion: Reports show cases of perinephric pseudocyst affecting mostly older animals, above eight years old. In one retrospective study of 26 cases, 73% were male and the mean age was eleven years, ranging from four to 18 years old. Another study of 13 cases showed a mean age of 16 years. In this report, unexpectedly, the patient was too young comparedto these other cases, but the clinical presentation was similiar. Being a young animal, in the absence of ureterolithiasis or history of trauma, it is suggested a congenital origin for the disease. Loss of renal function and azotemia may occur in about 90% of the cases by compression of the renal parenchyma by the pseudocyst or due to associated interstitial fibrosis. In this case, the serum creatinine concentration was above the reference value proposed for pediatric patients therefore, the cat may be considered azotemic. Beyond that, the excretory urography indicated no proper excretory function on the left kidney. It is proposed that the renal function was being compensated by the contralateral kidney. The clinical and imaging findings of this case are compatible with perinephric pseudocyst, which was confirmed by necropsy and histopathologicalexamination. This condition is not commonly reported in cats of pediatric age, althought it must be considered as a differencial diagnosis to cats presenting abdominal distension and renomegaly, even young ones. Imaging tests were important in this case, not only to direct the diagnosis, but also contributing in evaluating the renal excretory function.Keywords: perirenal pseudocyst, pararenal cyst, feline

Anasarca associated with restrictive cardiomyopathy in cats

Background: Cardiomyopathies are a primary heart disorder and are one of the most causes of heart failure and sudden death in cats. Restrictive cardiomyopathy is a diastolic dysfunction resulting from endomyocardial fibrosis, with filling restriction and ventricular distention. In these cases, a poor outcome is expected. Anasarca in animals is often associated with dystocia secondary to congenital changes. In adults, this is a rare condition, since subcutaneous edema in animals with congestive heart failure is an uncommon finding. Therefore, this report describes clinical and pathological findings in an unusual presentation of anasarca in two adult cats with restrictive cardiomyopathy. Cases: A 12-year-old female mixed breed cat (case 1) and a 6-year-old male mixed-breed cat (case 2) were present on an emergent basis at the veterinary hospital with a history of respiratory distress. Case 1 showed on physical examination intense restrictive mixed dyspnea and lethargy, with muffled heart sounds and respiratory noises in cardiorespiratory auscultation. The cat exhibited abdominal distension resulting from ascites. Generalized subcutaneous edema was evident mainly in the abdominal and submandibular areas and the thoracic and pelvic limbs. In these regions, a positive Godet signal was observed. Thoracic radiography revealed pleural effusion, and the cat underwent fluid drainage on both sides of the thoracic cavity. Drainage material was sent to the laboratory for clinical analysis, which indicated that it was a modified transudate. The clinical signs worsened, and the cat was euthanized. In case 2, physical examination showed severe restrictive mixed dyspnea, lethargy, and low body temperature (< 32°C). Abdominal distension resulting from ascites and generalized edema in the subcutaneous tissue with a positive Godet sign was observed. On cardiorespiratory auscultation, cardiac sounds and breathing noises were muffled. Thoracic radiography revealed pleural effusion. The cat was immediately placed in an incubator for clinical stabilization with oxygen therapy and warm-up. After 2 h of hospitalization, thoracentesis and drainage of cavity fluids were performed, which were classified as modified transudate. The patient remained in critical condition during hospitalization, evolving to death. The two cats were referred for a complete post mortem examination. Grossly, both cats showed distension of the abdomen and marked edema of subcutaneous tissue, mainly in the abdominal, ventral cervical, and thoracic and pelvic members. In the abdominal and thoracic cavities, a moderate amount of serous-free liquid, slightly reddish was observed. The heart of both cats was enlarged, with a globose appearance and a slightly whitish epicardium. The left ventricular endocardium was mild and diffusely thick and whitish, in addition to moderate dilation of the left atrium. Histological analyses of the heart showed in both cats moderate and diffuse proliferation of fibrous connective tissue in the endocardial region. Discussion: Restrictive cardiomyopathy has major importance in feline medicine due to its severity and poor outcome. Pleural effusion, pulmonary edema, and ascites are common findings in cats with congestive heart failure; however, generalized subcutaneous edema is uncommon. To the author’s knowledge, there are no published cases in the literature of anasarca in adult cats with restrictive cardiomyopathy. In human cardiology, this presentation is commonly related to congestive heart failure, and it is reported under several conditions, such as restrictive cardiomyopathy and constrictive pericarditis. The present study suggests that anasarca should be included in the list of associated clinical signs suggestive of severe congestive heart failure, mainly related to restrictive cardiomyopathy

First case of degenerative mucinotic mural folliculitis in Brazil

The purpose of this report is to describe the first case of degenerative mucinotic mural folliculitis (DMMF) in Brazil. This dermathopathy has been described as a rare cause of alopecia and hyperkeratosis in cats. Severe forms have been linked to infection with Feline Immunodeficiency Virus (FIV). A 10-year-old neutered male Siamese cat was referred with a 40 days history of progressive hair loss. The cat had initial alopecia on the head, subsequently spreading to the neck, torso and limbs. The skin biopsy revealed degenerative mucinotic mural folliculitis. Distinct seropositive reaction against FIV. antigens was demonstrated by enzyme-linked immunosorbent assay and immunohistochemistry. Therapeutic response to glucocorticoid medication, immunomodulators and antibiotics was poor and the patient died from undetermined causes. DMMF should be included in the differential diagnosis of feline exfoliative dermatitis and alopecia. Early diagnosis through histopathological and immunohistochemical tests is extremely important in determining the prognosis and the best treatment

Restrictive expiratory dyspnea in a cat with idiopathic pulmonary fibrosis : case report

As doenças pulmonares intersticiais constituem um grupo de doenças difusas do parênquima pulmonar, no qual a fibrose pulmonar intersticial está incluída. Histologicamente, esta se caracteriza por hiperplasia de pneumócitos tipo II, hiperplasia ou hipertrofia de músculo liso e fibrose. Embora a patogenia da fibrose pulmonar intersticial não esteja bem elucidada, devido às semelhanças microscópicas encontradas nos pneumócitos tipo II em felinos e na forma familiar da doença em humanos, acredita-se que haja caráter genético para o seu desenvolvimento. Os sinais clínicos frequentemente relatados incluem desconforto respiratório, cianose, letargia e perda de peso. Devido ao caráter progressivo e à ausência de tratamento específico, a doença apresenta prognóstico desfavorável. Foi atendida uma gata de 12 anos de idade, com histórico de dispneia há 20 dias. Ao exame clínico, o animal apresentou dispneia expiratória restritiva, crepitação à ausculta torácica e foi visualizado padrão intersticial ao exame radiográfico do tórax. A paciente foi submetida à punção com agulha fina de tecido pulmonar e veio a óbito algumas horas após o procedimento, apresentando insuficiência respiratória aguda. No exame histológico do tecido pulmonar, foi verificada a ocorrência de fibrose pulmonar idiopática. O objetivo do presente trabalho é relatar um caso de dispneia expiratória restritiva em um felino doméstico devido à fibrose pulmonar idiopática, já que, segundo o conhecimento dos autores, não há nenhum relato da ocorrência da doença no país.Interstitial lung diseases are a group of diffuse parenchymal lung diseases in which interstitial lung fibrosis is included. Histologically, it is characterized by type II pneumocyte hyperplasia, hypertrophy or hyperplasia of smooth tissue and fibrosis. Although the pathogenesis of interstitial lung fibrosis has not been elucidated, due to the microscopic similarities found in type II pneumocytes in cats and familial form of the disease in humans, it is believed that there is a genetic trait for development. The frequently reported clinical signs include respiratory distress, cyanosis, lethargy, and weight loss. Due to the progressive nature and the absence of specific treatment, the disease has a poor prognosis. A 12-year-old cat with dyspnea for 20 days was assisted. The animal underwent fine needle aspiration of lung tissue and died few hours after the procedure, with acute respiratory failure. Upon histological examination of lung tissue, the occurrence of idiopathic pulmonary fibrosis was found. The aim of this study is to report a case of restrictive expiratory dyspnea in a domestic feline due to idiopathic pulmonary fibrosis, because, according to our knowledge, there is no report on the occurrence of the disease in our country