Long-term follow-up of a case of feline leishmaniosis treated with a combination of allopurinol and meglumine antimoniate.

A 9-year-old domestic cat, positive for antibodies to feline immunodeficiency virus (FIV), was brought to a veterinary clinic with alopecia, ulcerative skin lesions, and upper respiratory tract (URT) signs. This was after being treated for suspected allergic dermatitis, without clinical improvement, for 2 y. Biopsy of the skin and fine-needle aspirates of the spleen and of the lymph nodes were taken which detected the presence of Leishmania amastigotes. Leishmania infection was further confirmed by detection of a high titer of anti-Leishmania antibodies (≥ 3200) with an indirect fluorescent antibody technique (IFAT) serology. After the diagnosis of feline leishmaniosis (FeL) was made, allopurinol and meglumine antimoniate were started and led to quick and complete clinical improvement. After 7 mo, allopurinol administration was briefly interrupted but was resumed following relapse of the skin lesions. One month later, the cat was treated for suspected acute kidney injury, which prompted reduction of the total daily dose of allopurinol by 50%. The cat remained clinically well, with complete resolution of the cutaneous and URT signs, for nearly 24 mo after the diagnosis of FeL; at which point it was euthanized for worsening cardiac disease. To our knowledge, this represents a rare case of successful treatment of FeL with a suspected nephrotoxic effect associated with long-term use of allopurinol. Further studies are required to clarify the relationship, if any, between leishmaniosis and congestive heart failure in cats.

Suivi à long terme d'un cas de leishmaniose féline traité par une association d'allopurinol et d'antimoniate de méglumine. Un chat domestique de 9 ans, positif pour les anticorps contre le virus de l'immunodéficience féline (FIV), a été présenté dans une clinique vétérinaire avec une alopécie, des lésions cutanées ulcéreuses et des signes des voies respiratoires supérieures (URT). Ceci après avoir été traité pour une suspicion de dermatite allergique sans amélioration clinique, pendant 2 ans. Une biopsie de la peau et des ponctions à l'aiguille fine de la rate et des ganglions lymphatiques ont été réalisées et ont détecté la présence d'amastigotes de Leishmania. L'infection à Leishmania a été confirmée par la détection d'un titre élevé d'anticorps sériques anti-Leishmania (≥ 3200) par une technique d'immunofluorescence indirecte (IFAT). Après le diagnostic de leishmaniose féline (FeL), un traitement à l'allopurinol et l'antimoniate de méglumine a été instauré et a entraîné une amélioration clinique rapide et complète. Après 7 mois, l'administration d'allopurinol a été brièvement interrompue mais a été reprise après la rechute des lésions cutanées. Un mois plus tard, le chat a été traité pour une lésion rénale aiguë suspectée, ce qui a entraîné une réduction de 50 % de la dose quotidienne totale d'allopurinol. Le chat est resté cliniquement en bonne santé, avec une résolution complète des signes cutanés et urinaires, pendant près de 24 mois après le diagnostic de FeL; à quel point il a été euthanasié pour aggravation de la maladie cardiaque.À notre connaissance, ceci représente un cas rare de traitement réussi de FeL avec un effet néphrotoxique suspecté associé à une utilisation à long terme d'allopurinol. D'autres études sont nécessaires pour clarifier la relation, le cas échéant, entre la leishmaniose et l'insuffisance cardiaque congestive chez les chats.(Traduit par Dr Serge Messier).

Feline coronavirus-associated myocarditis in a domestic longhair cat.

CASE SUMMARY: A 9-month-old entire male domestic longhair indoor cat presented with a 3-week history of fluctuating fever, weight loss and small intestine diarrhoea, which was unresponsive to antibiotics and supportive treatment. Abdominal ultrasound revealed severe jejunal and ileocolic junction intestinal wall thickening with loss of layering. An enterectomy was performed and histopathology revealed severe pyogranulomatous enteritis with vasculitits, compatible with the diagnosis of feline infectious peritonitis (FIP). Four days after surgery, the cat re-presented with anorexia and acute onset of expiratory dyspnoea. Echocardiography showed left ventricular hypertrophy and bilateral atrial enlargement. Congestive heart failure caused by hypertrophic cardiomyopathy was suspected and treatment with furosemide was started, which led to amelioration of the clinical signs. The following day, four-limb ataxia, hypermetria and bilateral uveitis were evident. Given the persistent anorexia and worsening of the clinical signs, the cat was humanely euthanized and a post-mortem examination was performed. Necropsy revealed multifocal pyogranulomatous lesions involving multiple organs (adrenal glands, kidneys, lungs, brain, myocardium, lymph nodes, liver), compatible with the diagnosis of FIP. Immunohistochemistry performed on the myocardium revealed feline coronavirus-positive macrophages associated with pyogranulomatous lesions, justifying a diagnosis of feline coronavirus-associated myocarditis. RELEVANCE AND NOVEL INFORMATION: To the authors' knowledge, the case described here represents the first published report of feline coronavirus-associated myocarditis. This should be considered as a possible differential diagnosis in cats presenting with cardiac-related signs and other clinical signs compatible with FIP.

Long-term incidence and risk of noncardiovascular and all-cause mortality in apparently healthy cats and cats with preclinical hypertrophic cardiomyopathy.

BACKGROUND: Epidemiologic knowledge regarding noncardiovascular and all-cause mortality in apparently healthy cats (AH) and cats with preclinical hypertrophic cardiomyopathy (pHCM) is limited, hindering development of evidence-based healthcare guidelines. OBJECTIVES: To characterize/compare incidence rates, risk, and survival associated with noncardiovascular and all-cause mortality in AH and pHCM cats. ANIMALS: A total of 1730 client-owned cats (722 AH, 1008 pHCM) from 21 countries. METHODS: Retrospective, multicenter, longitudinal, cohort study. Long-term health data were extracted by medical record review and owner/referring veterinarian interviews. RESULTS: Noncardiovascular death occurred in 534 (30.9%) of 1730 cats observed up to 15.2 years. Proportion of noncardiovascular death did not differ significantly between cats that at study enrollment were AH or had pHCM (P = .48). Cancer, chronic kidney disease, and conditions characterized by chronic weight-loss-vomiting-diarrhea-anorexia were the most frequently recorded noncardiovascular causes of death. Incidence rates/risk of noncardiac death increased with age in AH and pHCM. All-cause death proportions were greater in pHCM than AH (65% versus 40%, respectively; P < .001) because of higher cardiovascular mortality in pHCM cats. Comparing AH with pHCM, median survival (study entry to noncardiovascular death) did not differ (AH, 9.8 years; pHCM, 8.6 years; P = .10), but all-cause survival was significantly shorter in pHCM (P = .0001). CONCLUSIONS AND CLINICAL IMPORTANCE: All-cause mortality was significantly greater in pHCM cats due to disease burden contributed by increased cardiovascular death superimposed upon noncardiovascular death.

Radiotherapy and pasireotide treatment of a growth hormone producing pituitary tumor in a diabetic dog.

An 8-year-old castrated male border terrier dog was diagnosed with acromegaly resulting from a growth hormone secreting pituitary tumor. Sixteen daily fractions of radiation therapy were delivered followed, approximately 1 year later, by administration of pasireotide. The aforementioned treatment was considered effective and should be further evaluated in similar cases.

Radiothérapie et traitement au pasiréotide pour une tumeur pituitaire produisant une hormone de croissance chez un chien diabétique. Un chien Terrier-Border castré âgé de 8 ans a été diagnostiqué avec de l'acromégalie découlant d'une tumeur pituitaire secrétant une hormone de croissance. Seize fractions quotidiennes de radiothérapie ont été administrées et ont été suivies, environ un an plus tard, de l'administration du pasiréotide. Le traitement précédemment mentionné a été considéré efficace et devrait être étudié de plus près dans des cas similaires.(Traduit par Isabelle Vallières).

Successful treatment of tracheal lymphoma in a Siamese cat.

CASE SUMMARY: An 8-year-old female spayed Siamese indoor cat presented with a 3 week history of inspiratory dyspnoea, stridor and open-mouth breathing after exercise. Laryngoscopy, tracheoscopy, bronchoscopy and retroflexed nasopharyngoscopy were performed, and identified a multilobulated intraluminal mass within the trachea. Brush cytology was performed on the mass but was inconclusive in providing a definitive diagnosis. A CT scan of the neck failed to identify an obvious intraluminal mass and was negative to contrast uptake. Surgery was performed and seven rings of the trachea were removed to enable the complete excision of the mass. Histopathology of the excised mass was consistent with B cell lymphoma. After surgery, chemotherapy treatment was started. At the time of writing, 20 months since diagnosis, the cat remained clinically well, with no clinical signs or recurrence of macroscopic disease on endoscopic evaluation. RELEVANCE AND NOVEL INFORMATION: Upper airway endoscopy was considered to be an essential diagnostic tool in this case presenting with signs of upper respiratory dyspnoea. Moreover, combined surgery and chemotherapy were considered effective treatments and positively affected the long-term prognosis of this patient.

Novel characteristics identified in two cases of feline cowpox virus infection.

CASE SERIES SUMMARY: This case series discusses novel characteristics identified in two cases of cowpox. One presented with upper airway signs, and was identified to have a focal laryngeal lesion. The other had central neurological signs at the terminal stages, with intracytoplasmic inclusion bodies identified within the cerebral hemispheres on histopathology. RELEVANCE AND NOVEL INFORMATION: Currently, cowpox would be an unlikely consideration in patients with neurological signs or upper respiratory noise. These cases both document novel presentations of cowpox infection, which clinicians should be aware of and consider as differential diagnoses in patients with these atypical presentations.

Sinonasal aspergillosis in a British Shorthair cat in the UK.

Case summary A 13-year-old, castrated male, British Shorthair cat presented for investigation of chronic, intermittent, bilateral epistaxis and stertor. CT revealed severe asymmetric bilateral intranasal involvement with extensive turbinate lysis, increased soft tissue attenuation and lysis of the sphenopalatine bone and cribriform plate. On retroflexed pharyngoscopy, a plaque-like mass occluded the choanae. Rostral rhinoscopic examination revealed extensive loss of nasal turbinates, necrotic tissue and mucosal fungal plaques in the left nasal cavity. The right nasal cavity was less severely affected. The nasal cavities were debrided extensively of plaques and necrotic tissue. Aspergillus fumigatus was isolated on fungal culture, and species identity was confirmed using comparative sequence analysis of the partial ß-tubulin gene. On histopathology of nasal biopsies, there was ulcerative lymphoplasmacytic and neutrophilic rhinitis, and fungal hyphae were identified on nasal mucosa, consistent with a non-invasive mycosis. The cat was treated with oral itraconazole after endoscopic debridement, but signs relapsed 4.5 months from diagnosis. Residual left nasal fungal plaques were again debrided endoscopically and oral posaconazole was administered for 6 months. Fourteen months from diagnosis, the cat remains clinically well with mild intermittent left nasal discharge secondary to atrophic rhinitis. Relevance and novel information This is the first case of rhinoscopically confirmed sinonasal aspergillosis to be diagnosed in a cat in the UK. Endoscopic confirmation of resolution of infection is useful in cases where mild nasal discharge persists after treatment.