Evaluation of tumescent local anesthesia in cats undergoing unilateral mastectomy.

OBJECTIVE: To evaluate the analgesic efficacy and safety of tumescent local anesthesia (TLA) in cats undergoing unilateral mastectomy. STUDY DESIGN: Prospective clinical trial. ANIMALS: A total of 12 ovariohysterectomized female cats. METHODS: All animals were premedicated with pethidine (4 mg kg-1) intramuscularly (IM), followed by induction of anesthesia with propofol (5 mg kg-1) intravenously and maintenance with isoflurane in oxygen. A refrigerated TLA solution (15 mL kg-1, 8 °C) was injected using a Klein cannula. The solution was composed of 0.5 mL of epinephrine (1 mg mL-1) and 40 mL of 2% lidocaine added to 210 mL lactated Ringer's solution (final lidocaine concentration 0.32%). Heart and respiratory rates, systolic arterial blood pressure, temperature and oxygen saturation were measured during anesthesia. Blood samples were collected from the jugular vein for measurement of plasma lidocaine concentration using high performance liquid chromatography. Postoperative pain scores were evaluated hourly for 6 hours. Analgesic rescue was performed with tramadol (2 mg kg-1) IM and meloxicam (0.15 mg kg-1) subcutaneously. RESULTS: Plasma lidocaine concentration peaked at 90 minutes after injection of TLA, but no concentration considered toxic for the species was measured. The median postoperative analgesia time was 6 hours after injection of TLA. CONCLUSIONS: This study found that TLA prevented sympathetic response to noxious stimuli during anesthesia and provided satisfactory postoperative analgesia in cats submitted to total unilateral mastectomy, with no apparent signs of toxicity. CLINICAL RELEVANCE: TLA can prevent sympathetic stimulation resulting from noxious stimuli during anesthesia, promoting good intraoperative conditions, proving to be a viable addition to analgesia in cats submitted to a total unilateral mastectomy.

Histologic evaluation of Ki-67 and cleaved caspase-3 expression in feline mammary carcinoma.

Objectives The purpose of this study was to evaluate histopathologic aspects of, and the expression of Ki-67 and cleaved caspase-3 in, feline mammary carcinoma (FMC). Methods Feline mammary tumors were surgically obtained by mastectomy from 30 female cats and were fixed with formalin and embedded in paraffin wax. Four-micron sections were stained with hematoxylin and eosin for histopathologic diagnosis. Ki-67 and cleaved caspase-3 were analyzed by immunohistochemistry. Results Samples were histologically confirmed as FMC. Positive immunostaining was observed in all cancer samples for both nuclear Ki-67 and cleaved caspase-3, with a mean positive staining percentage of 27.5% and 21.2%, respectively. No statistically significant correlations between Ki-67 and cleaved caspase-3 were observed within FMC. Conclusions and relevance A high proliferation index was found in feline mammary tumors. This is the first study evaluating cleaved caspase-3 expression in FMC.

Adjuvant chemotherapy with mitoxantrone for cats with mammary carcinomas treated with radical mastectomy.

OBJECTIVES: The purpose of this study was to investigate the disease-free interval, survival time and adverse events of a combined treatment approach in cats with mammary malignant tumors using radical mastectomy and adjuvant mitoxantrone. METHODS: All cats underwent surgery to remove the mammary chain containing the tumors. A 3 cm margin was obtained around removed tumors. For staging purposes, regional inguinal lymphadenectomy was performed in all cases. After histopathology, cats were staged according to the World Health Organization's (WHO) staging system. Chemotherapy with mitoxantrone was started 15-30 days after surgery (6 mg/m(2) IV every 21 days for four cycles) with the objective of delaying metastasis. RESULTS: Three cats were intact, one cat was early spayed, four cats were late spayed and four cats were spayed at an unknown age. Based on the WHO's staging system, six cats were classified as stage I and six cats as stage III. The median disease-free interval and survival time were 360 and 480 days, respectively. Four (33%) cats received four doses of mitoxantrone, four (33%) cats received three doses and four (33%) cats received only one dose. The most frequent adverse effects of chemotherapy were azotemia, anorexia, leukopenia and vomiting. CONCLUSIONS AND RELEVANCE: Adjuvant mitoxantrone chemotherapy may be an option for feline mammary tumors. Further, sufficiently powered, randomized prospective trials are necessary to determine if mitoxantrone is superior, inferior or equivalent to doxorubicin in the adjuvant setting.

Esophageal stricture caused by rib osteoma in a cat: case report.

CASE SUMMARY: A 6-year-old male domestic shorthair cat presented with frequent food regurgitation and dysphagia. Plain thoracic radiographs revealed a calcified mass overlying the topography of the mediastinum, as well as dilation of the cervical portion of the esophagus due to an accumulation of food. Endoscopic examination showed a severe extraluminal esophageal stricture at the mediastinum entrance. Surgery and a gastric tube were declined by the cat's owner, with palliative support preferred. However, 1 year later, the cat presented with severe cachexia, dysphagia, salivation, dehydration and inspiratory dyspnea. Thoracic computed tomography was performed to evaluate the possibility of surgical resection. A mass of bone density originating in the second left rib was observed. The mass did not appear to have invaded adjacent structures but marked compression of the mediastinal structures was observed. Surgical resection was performed and a prosthetic mesh was used to reconstruct the thoracic wall. Transient Horner's syndrome developed in the left eye postoperatively, and was resolved within 4 weeks. Histopathology revealed a benign osteoma. Thirty-two months after surgery, the cat was well and free of disease. RELEVANCE AND NOVEL INFORMATION: Rib tumors should be included in a differential diagnosis in cats with extraluminal esophageal stricture. CT should be performed for treatment planning. Surgical treatment was curative in this case.

Successful subtotal orbitectomy in a cat with osteoma.

CASE SUMMARY: A 14-year-old Siamese neutered male cat was evaluated for anorexia and a left periorbital mass. Skull radiographic findings showed a well-defined lesion resembling new compact bone formation without destruction. A subtotal orbitectomy was indicated. The tumor was removed intact with a normal tissue margin of at least 1 cm. There were no postsurgical complications. Histopathologic examination revealed an osteoma. The cat returned to normal appetite and activity 15 days after surgery. Six months after surgery, there were no gross signs of recurrence. RELEVANCE AND NOVEL INFORMATION: Periorbital tumors are infrequently diagnosed in companion animals and most are malignant. In this case, the diagnosis was orbital osteoma. The most commonly affected bone for osteoma in cats is the mandibular bone; few cases have been identified in orbital bones. Orbital surgery has the potential to be challenging owing to complex anatomy, difficult exposure and the tendency to bleed. Surgical complications are common. In this case, although the disease was advanced, subtotal orbitectomy was successfully performed.

Avaliação do perfil clínico e laboratorial de gatos hipertireoideos com ou sem lobo tireoidiano aumentado a palpação cervical / Clinical and laboratorial evaluation of hyperthyroid domestic cats with or without palpable thyroid gland

O hipertireoidismo é a endocrinopatia mais comum em gatos idosos. Devido à natureza progressiva da doença, a identificação de um estágio subclínico se torna essencial para melhor controle da doença. O presente estudo compreendeu um levantamento da frequência de gatos hipertireoideos durante o período de março de 2007 a abril de 2008, no estado do Rio de Janeiro. O objetivo deste trabalho foi avaliar os aspectos clínicos, laboratoriais e ecocardiográficos em uma população de gatos domésticos com hipertireoidismo naturalmente adquirido, com ou sem lobo tireoidiano palpável. A seleção dos animais foi realizada através da detecção do valor de tiroxina (T4) total acima dos valores de referência com a técnica de radioimunoensaio. Os animais foram divididos em dois grupos com base na identificação do aumento da tireoide à palpação: Grupo I (tireoide não palpável) e Grupo II (tireoide palpável). Avaliações clínica e laboratoriais completas foram realizadas em todos os gatos do estudo. A avaliação clínica incluiu avaliação comportamental, peso, escore de condição corporal, pele e pelagem, auscultação cardiopulmonar, palpação tireoidiana e aferição da pressão arterial sistólica. Além do T4 total, os seguintes exames laboratoriais foram realizados: hemograma, ureia, creatinina, alanina aminotransferase (ALT), fosfatase alcalina (FA) e glicose. Trinta e um animais foram submetidos à avaliação cardíaca, através de ecocardiograma. Dos 178 animais avaliados, 51 foram incluídos nesse estudo por apresentarem aumento sérico da T4. Vinte e seis animais foram inclusos no Grupo I e vinte e cinco no Grupo II. Os parâmetros clínicos, laboratoriais e ecocardiográficos foram muito semelhantes entre os dois grupos. No entanto, os níveis séricos de T4 total foram significativamente menores nos gatos com tireoide não palpável. Todo gato acima de sete anos deve ser avaliado para presença de hipertireoidismo através da palpação tireoidiana e avaliação sérica de tiroxina total, pois muitos gatos sem sinais clínicos apresentam hipertireoidismo e o diagnóstico precoce permite diminuir os efeitos sistêmicos da doença em órgãos como fígado, rins e coração.

Hyperthyroidism is the most common endocrine disorder of older cats. Due to the progressive nature of the disease, the identification of a subclinical stage is essential in order to have a better control of the disease. The present study was a survey of the frequency of feline hyperthyroidism in Rio de Janeiro, from March, 2007 to April, 2008. The purpose of this study was to perform an evaluation of the clinical, laboratorial and echocardiographic aspects in a feline population of naturally acquired hyperthyroidism, with or without palpable thyroid gland. The selection of the cats was done by the documentation of an elevation of total thyroxine (TT4) levels by radioimmunoassay. The animals were divided in two groups according to the thyroid palpation: group I (non-palpable thyroid lobe) and group II (palpable thyroid lobe). Laboratorial and complete clinical evaluations were performed in all cats. The clinical evaluation included behavioral evaluation, body weight, body condition, dermatologic, cardiopulmonary auscultation, thyroid palpation and systolic blood pressure reading. Besides the TT4, the following exams were performed: urea, creatinine, alanine aminotransferase (ALT), alkaline phosphatase (ALP) and glucose. Thirty one cats had an echocardiogram performed. On the basis of TT4 concentrations, 51 of the 178 cats were classified as hyperthyroid. One or more enlarged thyroid glands were palpated in 25 of the 51 hyperthyroid cats and were included at Group II. Twenty six cats didn't palpable thyroid gland and were included at Group I. Clinical, laboratorial and echocardiographic parameters were similar between the two groups. However, the TT4 levels were significantly lower in the non-palpable thyroid group. All geriatric cats must be thyroid gland palpable on clinic examination and have TT4 measured. Many hyperthyroid cats may be asymptomatic and early diagnosis prevents organ damage such as liver, kidneys and heart.

Duodenal perforation caused by Rhizomucor species in a cat.

UNLABELLED: CLINICAL SUMMARY: A 7-month-old female Persian cat presented with gastrointestinal (GI) necrosis and perforation caused by Rhizomucor species. Unfortunately, the cat died of bacterial peritonitis and sepsis before a definitive diagnosis, based on histopathology and fungal culture, was achieved. PRACTICAL RELEVANCE: This appears to be the first reported case of GI disease caused by Rhizomucor species in a cat. Mucorales infections typically cause acute and rapidly progressive disease. As illustrated by this case, clinicians should be alert to the potentially fatal consequences of an opportunistic Rhizomucor species infection in their feline patients.

Radiation therapy for feline cutaneous squamous cell carcinoma using a hypofractionated protocol.

The objective of this paper was to evaluate the efficacy of a hypofractionated radiation protocol for feline facial squamous cell carcinoma (SCC). Twenty-five histologically confirmed SCCs in 15 cats were treated with four fractions of 7.6-10Gy each, with 1 week intervals. The equipment used was a linear accelerator Clinac 2100 delivering electron beam of 4 or 6MeV, and a bolus of 5 or 10mm was used in all lesions. Of the lesions, 44% were staged as T4, 16% as T3, 8% as T2 and 32% as T1. Of the irradiated lesions, 40% had complete response, 12% had partial response and 48% had no response (NR) to the treatment. For T1 tumors, 62.5% had complete remission. Mean overall survival time was 224 days. Owners requested euthanasia of cats having NR to the treatment. Mean disease free time was 271 days. Side effects observed were skin erythema, epilation, ulceration and conjunctivitis, which were graded according to Veterinary Radiation Therapy Oncology Group (VRTOG) toxicity criteria. Response rates found in this study (52%) were lower when compared to other protocols, probably due to technique differences, such as fractionation schedule, bolus thickness and energy penetration depth. However, the hypofractionated radiation protocol was considered safe for feline facial SCC. Modifications of this protocol are being planned with the objective of improving the cure rates in the future.

Catheter-induced urethral trauma in cats with urethral obstruction.

Fifteen cats were evaluated with urethral obstruction. Penile trauma by catheterization was the major indication for perineal urethrostomy. Ten cats had developed a urethral stricture and five had rupture of the urethra following medical management. All cats had abnormalities in penis and/or prepuce and/or scrotal sacs including hyperemia or swelling. Perineal urethrostomy was performed in all cases and they were evaluated for 6 months after surgery. Few complications were noted. Urinary tract infection was the most frequent complication observed. The clients considered their cats to have a good quality of life following surgery.

Management of the traumatic oronasal fistula in the cat with a conical silastic prosthetic device.

Management of a traumatic oronasal fistula with a prosthetic device in an 8-year-old male neutered domestic shorthair cat is described. The animal had fallen from a height of three stories at the age of 1 year. The fall had resulted in a fracture of the hard palate and a split in the palatal mucosa. Two surgical attempts to close the defect had been unsuccessful and an autopolymerizable acrylic resin prosthesis had produced unsatisfactory results. The management of the chronic traumatic fistula with a conical prosthetic device was fast, easy and efficient. The device was removed and a second one was put in place after 2 years. This method would appear particularly useful for obturation of large palatal defects that have failed to heal after attempts at surgical closure and is an alternative treatment for debilitated cats which may not be candidates for longer surgical procedures.