Marginal resection and infracyanine green-mediated photodynamic therapy in the management of feline eyelid squamous cell carcinoma: Two cases.

OBJECTIVE: Describe the presenting features, surgical procedure, and clinical outcomes of two cats managed with marginal resection and photodynamic therapy (PDT) for eyelid squamous cell carcinoma (SCC). ANIMALS STUDIED: A 12-year-old female spayed domestic shorthair cat (case 1) and a 10-year-old female spayed domestic shorthair cat (case 2). PROCEDURES: Following marginal resection of the eyelid neoplasm, hemostasis was achieved using a handheld cautery unit then 1 mL of infracyanine green was injected into the surgical wound bed. Photodynamic therapy was performed using an 810 nm diode laser in two consecutive steps: (i) six cycles at 500 mW for 30 s per cycle, using a rapid movement; then (ii) one (case 1) or two cycles (case 2) of 30 s at 2000 mW, using a slow deliberate movement to effect (charred surface). RESULTS: Histopathology was consistent with SCC resected with incomplete margins in both cats. Follow-up duration was 416 and 161 days in case 1 and case 2, respectively. Consecutive exams and photo-documentation (in clinic or by owners) showed appropriate healing of the lower eyelid, with a smooth lid margin, and no evidence of tumor regrowth or ocular irritation. Subtle trichiasis was noted in case 1 on day 185, but not at the last follow-up. CONCLUSIONS AND CLINICAL RELEVANCE: Marginal resection followed by PDT may be a valid alternative to complete surgical resection of periocular SCC in cats. The procedure was easy to perform, post-operative recovery was uncomplicated, and neither cat developed recurrent disease during the follow-up period.

Clinical use of uncovered balloon-expandable metallic biliary stents for treatment of extrahepatic biliary tract obstructions in cats and dogs: 11 cases (2012-2022).

OBJECTIVE: To describe the application of uncovered balloon-expandable metallic biliary stents for treatment of extrahepatic biliary obstructions (EHBOs) and the outcomes for dogs and cats treated for EHBO with this technique. STUDY DESIGN: Retrospective single institutional study. ANIMALS: Eight dogs and three cats treated at the Veterinary Specialty Hospital of San Diego for EHBO between January 2012 and February 2022. METHODS: Data collected from the medical records included signalment, presenting complaint, laboratory and imaging findings, surgical findings, hospitalization time, complications, and follow-up information. RESULTS: Median duration of short-term follow up was 16 days (6-45 days). Improved biochemical abnormalities and resolution of clinical signs were recorded in 10/11 cases. Two dogs died within 2 weeks of surgery. One dog developed systemic inflammatory response syndrome 5 days postoperatively and was euthanized; the cause of death in the second case was unknown. Long-term follow up was available in seven cases, with a median duration of 307.5 days (62-2268 days). Bile-duct patency was maintained for at least 356-622 days (median: 446 days) in three cats and 62-2268 days (median: 650.5 days) in four dogs with long-term follow up available. One cat had recurrent obstruction with choledocholiths 446 days postoperatively. One stent was removed 614 days postoperatively due to recurrent cholangiohepatitis. CONCLUSION: Uncovered balloon-expandable metallic biliary stents were placed successfully and relieved EHBO in all cases that survived to discharge. CLINICAL SIGNIFICANCE: Use of uncovered balloon-expandable metallic biliary stents should be considered as an alternative to temporary choledochal luminal stenting or cholecystoenterostomy to manage EHBO.

Outcome of video-assisted thoracoscopic treatment of idiopathic chylothorax in 15 cats.

OBJECTIVE: To evaluate the outcomes and complications of video-assisted thoracoscopic (VATS) treatment of chylothorax in cats. STUDY DESIGN: Multi-institutional retrospective study. ANIMALS: Fifteen client-owned cats. METHODS: The medical records of cats undergoing thoracoscopic thoracic duct ligation (TDL) for treatment of idiopathic chylothorax were reviewed. Cats undergoing additional procedures including thoracoscopic pericardectomy and/or laparoscopic cisterna chyli ablation (CCA)_were included. Follow up was obtained through communication with the referring veterinarian or owner. RESULTS: All cats underwent thoracoscopic TDL. Thirteen cats underwent simultaneous pericardectomy and two cats underwent laparoscopic CCA without pericardectomy. Conversion from a thoracoscopic to open approach was necessary in 2/15 (13%) of thoracic duct ligations and 1/11 (9%) of pericardectomies. The most common postoperative complication was persistent pleural effusion in five cats (33%). Four of 15 cats (27%) died or were euthanized prior to hospital discharge following surgery. Recurrence of effusion occurred in 1/7 (14%) of cats that sustained resolution of the effusion at the time of surgery with a median follow up of 8 months. The overall mortality attributed to chylothorax was 47%. CONCLUSION: Thoracoscopic treatment of idiopathic chylothorax resulted in a low incidence of intraoperative complications or conversion in the study population; however, mortality related to feline idiopathic chylothorax remained high. CLINICAL SIGNIFICANCE: While VATS treatment of idiopathic chylothorax is technically feasible, further consideration of the underlying pathology and current treatment algorithm is needed to improve outcomes as this remains a frustrating disease to treat in the feline population.

Outcomes of 15 dogs and two cats with metabone fractures treated with fluoroscopically guided normograde metabone pinning.

OBJECTIVE: To report the outcomes of 15 dogs and two cats with metabone fractures treated with fluoroscopically guided normograde metabone pinning (FGNMP). STUDY DESIGN: Retrospective case series. ANIMALS: A total of 15 client owned dogs and two cats with 57 metabone fractures. METHODS: Description of FGNMP and reporting of the following data: signalment, pre- and postoperative radiographs, intramedullary pin diameter used, anesthesia, surgery and coaptation times, duration to normal weightbearing and bone union, postoperative care and complications. RESULTS: Median surgery time was 54 min (range: 26-99), median duration of coaptation was 14 days (range: 1-5 weeks), median time to normal weightbearing was 16 days (range: 2-45) and median time to bone union was 6 weeks (range: 4-12). All cases had at least 12 months of post-surgical follow-up with a median follow-up of 18 months (range: 12-70). No major complications occurred. Mild radiographic changes associated with subchondral bone sclerosis were noted on follow-up radiographs in 13/57 fractures. All cases returned to normal gait and full (15) or acceptable (2) function. CONCLUSION: In this study, FGNMP was an effective and safe technique for metabone fracture repair, requiring only short-term external coaptation in most patients. Time to bone union and return to normal function compared favorably to previously reported techniques. CLINICAL RELEVANCE: Fluoroscopically guided normograde metabone pinning provides an alternative technique for treatment of metabone fractures.

Presentation, diagnosis, and outcomes of cats undergoing surgical treatment of ectopic ureters.

OBJECTIVE: To describe the signalment, treatment, complications, and outcomes of cats treated surgically for ectopic ureters. STUDY DESIGN: Retrospective, multi-institutional study. ANIMALS: Twelve client-owned cats. METHODS: Medical records of cats diagnosed with unilateral or bilateral ectopic ureters were reviewed and analyzed. Data reported included signalment, clinical signs, diagnostics, open celiotomy, or cystoscopic surgical interventions, and outcomes. RESULTS: Seven of the 12 cats in the study population were female or female spayed and the median age at time of presentation was 4 years, with an interquartile range (IQR) of 6 months-14 years. Presurgical diagnostic imaging diagnosed ectopic ureters by abdominal ultrasound (8/10), contrast enhanced computed tomography (3/3), fluoroscopic urography (3/4), or cystoscopy (6/7). Eight of 12 cats had extramural ectopic ureters and six cats were affected bilaterally. Eight affected cats underwent ureteroneocystostomy, one cat underwent neoureterostomy, two cats underwent cystoscopic laser ablation, and one cat underwent nephroureterostomy. Immediate postoperative complications occurred in three cats; one cat required additional surgical intervention. Short-term complications occurred in three cats, and long-term complications in two cats. All cats that underwent surgical or cystoscopic intervention had improvement of their urinary incontinence scores, with complete resolution in 11 cats. CONCLUSION: Surgical correction of ectopic ureters in cats is associated with good long-term outcomes. Ectopic ureters in cats are commonly extramural and bilateral. Postoperative outcomes were acceptable and there were few postoperative complications, with varying forms of surgical correction. CLINICAL SIGNIFICANCE: Ectopic ureters in cats are rare but urinary incontinence can be corrected or improved successfully with surgery.

Laparoscopic partial pancreatectomy of the left limb using a harmonic scalpel in nine cats.

OBJECTIVE: To describe a laparoscopic technique and outcome for partial pancreatectomy in cats. STUDY DESIGN: Prospective cohort study. ANIMALS: Nine cats. METHODS: Laparoscopic pancreatectomy was performed using a single incision laparoscopic surgery port and an additional 5.5 mm port. The left pancreatic limb was dissected, sealed and divided at the level of the splenic vein insertion to the portal vein using a harmonic device. Surgical time and complications were recorded. The weight and length of the resected pancreatic limb was recorded. Pre- and postoperative trypsin-like immunoreactivity (TLI), pancreatic lipase immunoreactivity (PLI), and hemoglobin A1C were documented. RESULTS: Laparoscopic partial pancreatectomy was performed successfully in all cats. One grade 1 intraoperative complication occurred (1/9; 11%) resulting in minor hemorrhage from a caudal splenic vein branch. A grade 2 postoperative complication occurred within 3 days after surgery in one cat (1/9; 11%), involving localized, sterile peritonitis in the region of the pancreatic angle. Signs resolved with conservative management. No cats exhibited signs of pancreatitis postoperatively. Long-term, mean TLI decreased by 37% ± 38% (p = .03) following partial pancreatectomy, while PLI and A1C were unchanged. All cats were alive and clinically well at last follow-up 250 to 446 days following surgery. CONCLUSIONS: Laparoscopic partial pancreatectomy using a harmonic device is effective in cats, and offers a minimally-invasive alternative to open surgical pancreatectomy techniques. Laparoscopic pancreatectomy of the left limb results in adequate exocrine and endocrine function in the long-term.

Clinical outcomes for 20 cats with congenital extrahepatic portosystemic shunts treated with ameroid constrictor ring attenuation (2002-2020).

OBJECTIVE: To report the clinical perioperative, short-term, and long-term outcomes for cats undergoing ameroid ring constrictor (ARC) attenuation of a congenital extrahepatic portosystemic shunt (EHPSS). STUDY DESIGN: Retrospective case series from a single veterinary teaching hospital (2002-2020). ANIMALS: Twenty client-owned cats with EHPSS. METHODS: Data collected from medical records included signalment, history, physical examination, clinicopathologic testing, medications, diagnostic imaging, intraoperative findings, perioperative complications, and postoperative clinical outcomes. Long-term clinical outcome was obtained from a standardized owner interview or medical records. RESULTS: Perioperative complications were reported in five cats out of 20, including blindness (two cats), ascites (one cat), head pressing (one cat), and seizures and death (one cat). Short-term clinical outcome was excellent in 14/18 cats, good in 2/18 cats, and poor in 2/18 cats that were available for follow up, and long term clinical outcome was excellent in 15/18, good in 1/18 cats, and poor in 2/18 cats that were available for follow up. CONCLUSION: Long-term clinical outcome was good or excellent in 16/18 of cats available for follow up. Perioperative complications were reported in five cats. CLINICAL SIGNIFICANCE: Surgical attenuation of EHPSS with an ARC can result in resolution of clinical signs and biochemical abnormalities in the majority of cats. The perioperative complication rate for feline patients with EHPSS attenuated with an ARC was lower than reported historically. Seizures may persist in the long term despite normal bile acid stimulation test results, complete blood count, and biochemistry analysis.

Video-Assisted Ventral Bulla Osteotomy to Remove a Bullet Foreign Body in a Cat.

A 7 yr old castrated male domestic shorthair presented for assessment of a chronic left head tilt, losses of balance, and positional nystagmus. A computed tomographic scan of the head revealed several fragments of a metallic foreign body in the left tympanic cavity. The foreign material was removed under endoscopic assistance through a minimally invasive ventral bulla osteotomy. No complications were noted during the immediate postoperative period. Follow-up 5 mo after surgery revealed complete resolution of the neurological signs with no evidence of recurrence. Foreign bodies associated with middle ear infection have not been previously reported in the cat. They should now be included in the differential diagnosis of vestibular disease. Endoscopic-assisted foreign body removal in the middle ear seems to be a safe and efficient way to retrieve small foreign bodies in bullae in cats.

Spontaneous cecal perforation in a cat diagnosed with ultrasonography.

An 8-year-old cat was presented for an acute history of anorexia, marked abdominal pain, and hyperthermia. Ultrasonography showed a cecal perforation with focal steatitis and adjacent free gas bubbles, consistent with focal peritonitis. Surgery confirmed the imaging findings. An enterectomy was performed with the removal of the cecum and ileocolic valve, and anastomosis between the ileum and colon was performed. Histology revealed transmural enteritis and chronic severe pyogranulomatous peritonitis with intralesional plant fragments.

Combined cholecystotomy, retrograde hydropulsion, and choledochal stenting to treat extrahepatic biliary tract obstruction in 3 cats.

Extrahepatic biliary tract obstruction (EHBO) is uncommonly encountered in cats. Surgical treatment aims to decompress the biliary tract and insure bile duct patency. In veterinary medicine, cholecystotomy is not widely used in practice. The objective was to describe the use of cholecystotomy, retrograde hydropulsion of choleliths, and choledochal stenting to remove choleliths from the extrahepatic biliary tract back in the gallbladder. Three adult domestic shorthair cats were presented with anorexia, lethargy, and vomiting. Serum biochemistry revealed hyperbilirubinemia and increased hepatic enzymes. Abdominal ultrasonography showed evidence of EHBO requiring surgical intervention. Choleliths were localized in the proximal and middle portions of the common bile duct (CBD) in the first case, in the distal portion of the CBD and within the major duodenal papilla in the second case, and in the middle and distal portions of the CBD in the third case. Cholecystotomy was followed by retrograde hydropulsion of the choleliths into the gallbladder, after which choledochal stenting was performed. Complications were defined as major when requiring additional medical or surgical treatment, or minor when not. Three major complications were reported. In 2 cases, severe anemia requiring blood transfusion occurred 24 h postoperatively; in 1 case, EHBO recurrence was encountered 41 d postoperatively. All cats were discharged within 4 d following surgery. Two cats were still alive at 12 and 14 mo after surgery, respectively. In the last case, owners refused revision surgery and the cat was euthanized. Key clinical message: Cholecystotomy combined with retrograde hydropulsion of choleliths permitted removal of choleliths and decompression of the biliary tract in 3 cats. Major complications included severe anemia and EHBO recurrence.

Cholécystotomie combinée, hydropulsion rétrograde et pose de stent cholédocien pour traiter l'obstruction des voies biliaires extra-hépatiques chez 3 chats. Les obstructions biliaires extra-hépatiques (OBEH) sont peu fréquentes chez le chat. Le traitement chirurgical vise à lever l'obstruction et s'assurer de la perméabilité des voies biliaires. En médecine vétérinaire, la cholécystotomie est une technique peu pratiquée. L'objectif de ce rapport de cas était de décrire l'utilisation de la cholécystotomie, de l'hydropulsion rétrograde des cholélithes et d'une prothèse endoluminale cholédoquale (PEC) pour repousser les cholélithes présents dans les voies biliaires extrahépatiques dans la vésicule biliaire (VB).Trois chats européens adultes ont été présentés pour anorexie, léthargie et vomissements. La biochimie sérique a révélé une hyperbilirubinémie et une augmentation des enzymes hépatiques. L'échographie abdominale a mis en évidence une OBEH nécessitant une intervention chirurgicale. Les cholélithes étaient situés dans la portion proximale et moyenne du canal cholédoque pour le premier cas; dans la portion distale et la papille duodénale majeure dans le second cas; dans la portion moyenne et distale pour le troisième cas. Une cholécystotomie a été suivie d'une rétro-hydropulsion des cholélithes dans la VB, puis une PEC a été placée. Les complications ont été définies comme majeures lorsqu'elles nécessitaient un traitement médical ou chirurgical supplémentaire, ou mineures lorsqu'elles n'en nécessitaient pas.Trois complications majeures ont été rapportées : chez 2 cas, une anémie sévère a été observée 24 h après l'intervention, nécessitant une transfusion sanguine; chez un cas, une récidive d'obstruction biliaire a eu lieu à 41 jours postopératoire. Tous les patients sont sortis de l'hôpital dans les 4 jours suivant l'opération. Deux cas étaient encore en vie 12 et 14 mois après l'intervention. Pour le dernier cas, la seconde chirurgie a été refusée par les propriétaires et le chat a été euthanasié.Message clinique clé :La cholécystotomie combinée à l'hydropulsion rétrograde des cholélithes a permis le retrait de cholélithes obstructives (dont certaines distales) et la décompression du tractus biliaire chez 3 chats. Les complications majeures incluaient une anémie sévère et une récidive d'obstruction biliaire.(Traduit par les auteurs).

Successful surgical resection of a multilobular osteochondrosarcoma arising from the costal cartilage in a cat.

A 10-year-old neutered male cross-bred cat was referred to our clinic for a solid mass tightly fixed to the right side of the thoracic wall from the 2nd to 4th ribs. Computed tomography revealed the mass had remarkable calcifications and arose from the 3rd costal cartilage. After removal, it was diagnosed histopathologically as a multilobular osteochondrosarcoma (MLO). For tumor resection, extremely wide surgical margins included 6 costal cartilages and 3 sternal segments were required; however, the tumor was successfully resected, followed by reconstruction of the thoracic wall using artificial materials. The cat recovered uneventfully and was good in health for ~4 y. This is apparently the first report of surgical resection of MLO from the costal cartilage of a cat. Key clinical message: To our knowledge, this is the first report of MLO from the costal cartilage in a cat, demonstrating aggressive surgical resection despite extremely wide surgical margins.

Résection chirurgicale réussie d'un ostéochondrosarcome multilobulaire provenant du cartilage costal chez un chatUn chat croisé mâle castré de 10 ans a été référé à notre clinique pour une masse solide bien fixée sur le côté droit de la paroi thoracique de la 2e à la 4e côte. La tomodensitométrie a révélé que la masse présentait des calcifications remarquables et provenait du 3e cartilage costal. Après retrait, il a été diagnostiqué histopathologiquement comme un ostéochondrosarcome multilobulaire (MLO). Pour la résection tumorale, des marges chirurgicales extrêmement larges comprenaient 6 cartilages costaux et 3 segments sternaux; cependant, la tumeur a été réséquée avec succès, suivie d'une reconstruction de la paroi thoracique à l'aide de matériaux artificiels. Le chat s'est rétabli sans incident et était en bonne santé pendant environ 4 ans. Il s'agit apparemment du premier rapport de résection chirurgicale de MLO du cartilage costal d'un chat.Message clinique clé:À notre connaissance, il s'agit du premier rapport de MLO du cartilage costal chez un chat, démontrant une résection chirurgicale agressive malgré des marges chirurgicales extrêmement larges.(Traduit par Dr Serge Messier).

Gallbladder carcinoid in a cat.

Carcinoids are rare tumors that originate from neuroendocrine system cells. There has apparently only been 1 report in the veterinary medical literature of a cat with a gallbladder carcinoid, with no long-term follow-up information available from that case. Furthermore, apparently only 9 dogs with gallbladder carcinoids have been reported, again with no long-term follow-up. This case report describes the clinical presentation, surgical appearance, histopathologic and immunohistochemical findings, postoperative adjuvant chemotherapy treatment, and long-term outcome of a domestic longhair cat with a gallbladder carcinoid. The diagnosis of a gallbladder carcinoid in the present case was based on histologic and immunohistochemical findings. Clinical signs of a gallbladder carcinoid are nonspecific and ultrasonographic findings may not be definitive; however, it should be considered as a potential differential diagnosis in cats with lesions of the gallbladder or in the region of the gallbladder. The prognosis is poor, with a potentially high metastatic rate. In the present case, metastasis occurred 7 mo postoperatively despite adjuvant therapy, and the survival time was only 10 mo from the time of diagnosis. Key clinical message: This case report describes the clinical presentation, surgical appearance, histopathologic and immunohistochemical findings, postoperative adjuvant treatment, and long-term outcome of a cat with a gallbladder carcinoid, which should be considered as a potential differential diagnosis in cats with lesions of the gallbladder or in the region of the gallbladder.

Carcinoïde de la vésicule biliaire chez un chat. Les carcinoïdes sont des tumeurs rares qui prennent leur origine des cellules du système neuroendocrinien. Dans la littérature médicale vétérinaire il n'y aurait qu'un seul cas rapporté d'un chat avec un carcinoïde de la vésicule biliaire, sans aucune information de suivi à long terme disponible pour ce chat. Également, il y aurait 9 cas rapportés de chiens avec des carcinoïdes de la vésicule biliaire, mais encore là aucun suivi à long terme. Le cas présenté ici décrit la présentation clinique, l'apparence chirurgicale, les trouvailles histopathologiques et immunohistochimiques, le traitement post-opératoire par chimiothérapie adjuvante, et le devenir à long terme d'un chat domestique à poil court avec un carcinoïde de la vésicule biliaire. Dans le cas présent, le diagnostic de carcinoïde de la vésicule biliaire était basé sur les trouvailles histologiques et immunohistochimiques. Les signes cliniques d'un carcinoïde de la vésicule biliaire sont non-spécifiques et les trouvailles échographiques pourraient ne pas être concluantes; toutefois, il devrait être considéré comme un diagnostic différentiel possible chez des chats avec des lésions à la vésicule biliaire ou dans la région de la vésicule biliaire. Le pronostic est mauvais, avec un risque élevé de métastases. Dans le cas présent, des métastases sont apparues 7 mo post-chirurgie malgré une chimiothérapie adjuvante, et le temps de survie a été de 10 mo à compter du moment du diagnostic.Message clinique clé:Ce rapport de cas décrit la présentation clinique, l'apparence chirurgicale, les trouvaille histologiques et immunohistochimiques, la thérapie adjuvante postopératoire, et le résultat à long-terme pour un chat avec un carcinoïde de la vésicule biliaire, qui devrait être considéré comme un diagnostic différentiel potentiel chez les chats avec des lésions à la vésicule biliaire ou dans la région de la vésicule biliaire.(Traduit par Dr Serge Messier).

Kidney sparing during surgical treatment of an adrenocortical carcinoma with renal vein invasion in a cat.

A 15-year-old domestic shorthair cat was presented with gastrointestinal signs, polyuria, polydipsia, and weakness. Abdominal bruit ("whooshing" sound from turbulent blood flow) and hypertension (systolic blood pressure: 200 mmHg) were present. A left adrenal gland mass was detected with abdominal ultrasonography; a subsequent CT examination identified a mass and a thrombus in the ipsilateral renal vein. Adrenalectomy and venotomy were completed but nephrectomy was not necessary. Histological diagnosis was an adrenocortical carcinoma. There were no clinical signs at a follow-up examination 30 mo after surgery. Key clinical message: This report describes successful surgical management of feline adrenocortical carcinoma with renal vein invasion without kidney damage. This case suggests that, after correct diagnosis and in well-selected cases, surgery to remove adrenal tumors and thrombi in cats, despite renal vein invasion, can be done with excellent short- and long-term outcomes.

Sauvegarde des reins lors du traitement chirurgical d'un carcinome corticosurrénalien avec invasion des veines rénales chez un chatUn chat domestique à poil court de 15 ans a été présenté avec des signes gastro-intestinaux, une polyurie, une polydipsie et une faiblesse. Des bruits abdominaux (« sifflement ¼ provenant d'un flux sanguin turbulent) et une hypertension (pression artérielle systolique: 200 mmHg) étaient présents. Une masse de la glande surrénale gauche a été détectée à l'échographie abdominale; un examen tomodensitométrique ultérieur a identifié une masse et un thrombus dans la veine rénale ipsilatérale. La surrénalectomie et la veinotomie ont été réalisées mais la néphrectomie n'a pas été nécessaire. Le diagnostic histologique était un carcinome corticosurrénalien. Il n'y avait aucun signe clinique lors d'un examen de suivi 30 mois après l'intervention chirurgicale.Message clinique clé:Ce rapport décrit la prise en charge chirurgicale réussie du carcinome corticosurrénalien félin avec invasion des veines rénales sans lésion rénale. Ce cas suggère qu'après un diagnostic correct et dans des cas bien sélectionnés, une intervention chirurgicale visant à éliminer les tumeurs surrénales et les thrombi chez les chats, malgré l'invasion des veines rénales, peut être réalisée avec d'excellents résultats à court et à long terme.(Traduit par Dr Serge Messier).

Computed tomography angiography features of a retroperitoneal extra-adrenal paraganglioma in a cat.

A 7-year-old spayed female domestic shorthair cat was presented for evaluation of a large-volume abdominal space-occupying lesion. A computed tomography angiography examination detected a round retroperitoneal mass, in contact with the large abdominal vessels, characterized by an external hyperattenuating capsule and a larger hypoattenuating center. The capsule was soft-tissue attenuating with marked heterogenous contrast enhancement. The center was hypoattenuating pre- and post-contrast administration. The mass displaced both kidneys laterally and the descendent colon ventrally. The mesenteric veins and both phrenicoabdominal veins were markedly increased in diameter. However, the adrenals were not involved. On the excretory phase, no contrast enhancement was observed in either ureter, except for the proximal tract of the right ureter. At laparotomy, both ureters entered the mass that was adherent to the great abdominal vessels. The cytological diagnosis was retroperitoneal extra-adrenal paraganglioma. In cats, retroperitoneal extra-adrenal paragangliomas are very rare. This is the first computed tomography angiography report of a retroperitoneal extra-adrenal paraganglioma in a domestic cat. Key clinical message: This report describes the computed tomography angiography features of a rare case of a retroperitoneal extra-adrenal paraganglioma in a cat. These features could be taken into consideration to direct the diagnosis of a possible neuroendocrine origin for a retroperitoneal mass in a cat.

Caractéristiques de l'angiographie par tomodensitométrie d'un para-gangliome extra-surrénalien rétropéritonéal chez un chatUne chatte domestique à poils courts, âgée de 7 ans, stérilisée, a été présentée pour évaluation d'une lésion abdominale de grand volume occupant de l'espace. Un examen d'angiographie tomodensitométrique a détecté une masse rétropéritonéale ronde, en contact avec les gros vaisseaux abdominaux, caractérisée par une capsule externe hyper-atténuante et un centre hypo-atténuant plus large. La capsule présentait une atténuation des tissus mous avec une prise de contraste hétérogène marquée. Le centre était hypoatténuant avant et après l'administration le milieu de contraste. La masse a déplacé latéralement les deux reins et ventralement le côlon descendant. Le diamètre des veines mésentériques et des deux veines phrénico-abdominales était nettement augmenté. Cependant, les surrénales n'étaient pas impliquées. À la phase excrétrice, aucune augmentation de contraste n'a été observée dans les deux uretères, à l'exception du tractus proximal de l'uretère droit. Lors de la laparotomie, les deux uretères pénétraient dans la masse adhérente aux gros vaisseaux abdominaux. Le diagnostic cytologique était un paragangliome extra-surrénalien rétropéritonéal. Chez le chat, les para-gangliomes extra-surrénaliens rétropéritonéaux sont très rares. Il s'agit du premier rapport d'angiographie par tomodensitométrie d'un para-gangliome extra-surrénalien rétropéritonéal chez un chat domestique.Message clinique clé:Ce rapport décrit les caractéristiques de l'angiographie par tomodensitométrie d'un cas rare de paragangliome extra-surrénalien rétropéritonéal chez un chat. Ces caractéristiques pourraient être prises en considération pour orienter le diagnostic d'une éventuelle origine neuroendocrinienne d'une masse rétropéritonéale chez un chat.(Traduit par Dr Serge Messier).

Recognizing uterine torsion as a differential diagnosis in pregnant cats with severe anemia to provide appropriate and timely care in the absence of a definitive presurgical diagnosis.

A pregnant female domestic longhair cat ~8 mo of age was referred to the Western College of Veterinary Medicine (Saskatoon, Saskatchewan) for a diagnostic evaluation of severe anemia (PCV: 10.8%) after a 2-day period of lethargy. A CBC, serum biochemistry profile, FeLV/FIV testing, and abdominal radiographs were completed and did not determine a cause for the anemia. Abdominal ultrasonography identified 1 viable and 6 nonviable and fetuses, anechoic fluid in the uterus, and a mild volume of peritoneal effusion. A whole-blood transfusion and C-section with ovariohysterectomy were performed even though a definitive presurgical diagnosis for the anemia had not yet been established. Exploratory surgery revealed a left uterine horn torsion with a necrotic base, severe congestion, and 7 nonviable fetuses. Following surgery, the queen made a full clinical recovery. Key clinical message: Uterine torsion can be easily overlooked as a cause of severe anemia due to the relative infrequency of this condition in cats and the low sensitivity of ultrasonography to provide a definitive presurgical diagnosis. Client communication must emphasize the need for a prompt surgical intervention to establish the diagnosis and to save the cat, despite poor rates of neonatal survival. Once the animal is stabilized after surgery, further diagnostic tests and procedures are indicated if the cause of anemia has not yet been identified.

Reconnaître la torsion utérine comme un diagnostic différentiel chez les chattes gestantes souffrant d'anémie sévère afin de fournir des soins appropriés et opportuns en l'absence d'un diagnostic pré-chirurgical définitif. Une chatte domestique à poils longs, âgée d'environ 8 mois, a été référée au Western College of Veterinary Medicine (Saskatoon, Saskatchewan) pour une évaluation diagnostique d'anémie sévère (hématocrite : 10,8 %) après une période de léthargie de 2 jours. Une formule sanguine complète, un profil biochimique sérique, des tests FeLV/FIV et des radiographies abdominales ont été réalisés et n'ont pas permis de déterminer la cause de l'anémie. L'échographie abdominale a identifié 1 foetus viable et 6 non viables, du liquide anéchoïque dans l'utérus et un léger volume d'épanchement péritonéal. Une transfusion de sang total et une césarienne avec ovariohystérectomie ont été réalisées même si le diagnostic pré-chirurgical définitif de l'anémie n'avait pas encore été établi. La chirurgie exploratoire a révélé une torsion de la corne utérine gauche avec une base nécrotique, une congestion sévère et 7 foetus non viables. Après l'opération, la chatte s'est complètement rétablie cliniquement.Message clinique clé:La torsion utérine peut facilement être négligée comme cause d'anémie sévère en raison de la rareté relative de cette affection chez le chat et de la faible sensibilité de l'échographie pour fournir un diagnostic pré-chirurgical définitif. La communication avec le client doit souligner la nécessité d'une intervention chirurgicale rapide pour établir le diagnostic et sauver le chat, malgré de faibles taux de survie néonatale. Une fois l'animal stabilisé après la chirurgie, d'autres tests et procédures de diagnostic sont indiqués si la cause de l'anémie n'a pas encore été identifiée.(Traduit par Dr Serge Messier).

Ultrasonographic features of a gastric submucosal lipoma in a cat: A case study.

A 7-year-old Korean shorthair cat was admitted to our hospital with chronic constipation. Abdominal ultrasonography incidentally revealed a focal asymmetric gastric mass. The mass was submucosal and hypoechoic without loss of wall layering. Histopathological examination revealed a gastric submucosal lipoma (GSL). Although there have been reports of gastric submucosal fat infiltration in cats, there have been no reports regarding GSL. To our knowledge, this is the first report describing the ultrasonographic characteristics of GSL in a cat. Gastric submucosal lipoma should be considered as a differential diagnosis when a focal hypoechoic submucosal mass without loss of wall layering in the stomach is observed on ultrasound images. Key clinical message: This case report describes the ultrasonographic characteristics of GSL in a cat and aims to provide useful information for the diagnosis of lipoma occurring in the feline gastrointestinal tract. The ultrasonographic features and histological results we describe should be helpful in diagnosing submucosal lipoma in cats with similar conditions.

Caractéristiques échographiques d'un lipome sous-muqueux gastrique chez un chat: une étude de casUn chat coréen à poil court âgé de 7 ans a été admis à notre hôpital pour constipation chronique. L'échographie abdominale a révélé de manière fortuite une masse gastrique focale asymétrique. La masse était dans la sousmuqueuse et hypoéchogène sans perte de stratification murale. L'examen histopathologique a révélé un lipome sous-mucosal gastrique (GSL). Bien qu'il y ait eu des rapports d'infiltration de graisse dans la sous-muqueuse gastrique chez le chat, aucun rapport n'a été signalé concernant le GSL. À notre connaissance, il s'agit du premier rapport décrivant les caractéristiques échographiques du GSL chez un chat. Le lipome sous-muqueux gastrique doit être envisagé comme diagnostic différentiel lorsqu'une masse sous-muqueuse hypoéchogène focale sans perte de stratification de la paroi de l'estomac est observée sur les images échographiques.Message clinique clé:Ce rapport de cas décrit les caractéristiques échographiques du GSL chez un chat et vise à fournir des informations utiles pour le diagnostic des lipomes survenant dans le tractus gastro-intestinal félin. Les caractéristiques échographiques et les résultats histologiques que nous décrivons devraient être utiles pour diagnostiquer le lipome sous-muqueux chez les chats présentant des conditions similaires.(Traduit par Dr Serge Messier).

Single institution retrospective study evaluating the frequency of implant removal and associated risk factors following open fracture fixation in 80 cases (2010-2020).

BACKGROUND: Open fractures occur commonly in small animals and are characterised by contamination of the fracture site. While never quantified, it is believed that open fractures stabilised with internal implants are at a higher risk for requiring explantation. This retrospective study determines the frequency and risk factors for explantation following use of internal fixation. Medical records of client-owned dogs and cats with an open fracture, between 2010 and 2020 stabilised using internal implants, were included. Data retrieved included signalment, cause and characterisation of the fracture, comorbidities, preexisting infections, and all details related to anesthesia and surgery. Pre-, Peri- and post-operative antibiotic use were detailed. All cases were followed to clinical union. Postoperative complications, including requirement for implant removal were recorded and classified as major or minor. Associations between potential risk factors and need for explantation were assessed. RESULTS: Of 80 cases, 72 (90%) were dogs and eight (10%) cats. Major complications were encountered in 23 (28.75%) cases and minor complications in 16 (20%) cases. Explantation was performed in 17 cases (21.25%). Out of 72 dogs, 13 required explantation (18%) whereas four of the eight cats needed implants removed (50%). Only diagnosis of postoperative infection was associated with an increased risk of explantation (RR 2.77; 95% CI 1.25; 6.15; p = 0.045). CONCLUSION: Approximately 1 in 5 open fractures stabilised using internal fixation can be anticipated to require explantation, with cats potentially being at a higher risk than dogs. Cases diagnosed with postoperative infection are at a higher risk for requiring implant removal.

Stenting of a partially obstructed nasolacrimal duct using a steerable angle-tipped hydrophilic guidewire in a cat.

OBJECTIVE: This case report describes the successful correction of partial obstruction of the NL duct in a cat by means of a modified retrograde NL duct cannulation using a steerable angle-tipped hydrophilic guidewire (AH guidewire) following a paranasal incision. ANIMAL STUDIED: A 2-year-old neutered male American domestic shorthair cat was referred to the Purdue University Veterinary Hospital (PUVH) for chronic epiphora suspected secondary to nasolacrimal (NL) system obstruction. PROCEDURES: At the first visit, the cat had epiphora OD and facial dermatitis but no other abnormalities on physical and ophthalmic examinations. Computed tomography (CT)-dacryocystorhinography revealed partial obstruction of the NL duct secondary to stenosis near the distal root of the right maxillary third premolar (107). A digital three-dimensional (3D) model of the right maxilla and NL duct was created for inspection and virtual cannulation of the NL. The model was 3D printed and cannulation of the NL duct was rehearsed with various stent materials. Retrograde NL stenting with the guidance of a steerable angle-tipped hydrophilic guidewire was conducted following a paranasal incision. A urethral catheter was cannulated over the guidewire and maintained for 44 days. RESULTS: The epiphora resolved immediately after stenting. At 21 days post-stenting, the cat developed acute bullous keratopathy secondary to self-trauma which was treated with a third eyelid flap. On the final follow-up communication with the owner at 210 days post-stenting, no epiphora or any other concerns were reported. CONCLUSION: To the authors' knowledge, this is the first report of successful NL stenting and resolution of epiphora in a cat with a partial NL system obstruction.

Bilateral corneal dermoids associated with bilateral choroido-scleral colobomas in a cat: retinographic and optical coherence tomography study with surgical outcome and follow-up.

PURPOSE: To report a case of feline bilateral corneal dermoids, associated with unilateral iris coloboma and bilateral choroido-scleral colobomas in the same dorsolateral position, to describe retinographic and optical coherence tomography (OCT) characteristics, surgical outcome, and follow-up. ANIMAL STUDIED: A 9-month-old domestic shorthaired cat in which a full ophthalmoscopic examination was performed for evaluation of dermoids resulting in a diagnosis of associated iris coloboma in one eye and posterior colobomas in both eyes. PROCEDURES: Retinographies and OCT were performed under anesthesia to characterize the lesions of both fundi and allow surgical excision of the corneal dermoids. RESULTS: Ophthalmoscopy and retinographies revealed oval lesions in the dorsolateral fundi of both eyes. The lesions precisely mirrored their respective dermoids' (10-11 h OD and 1-2 h OS) clock positions, lacked a tapetum lucidum and choroidal vessels, and featured thin retinal vessels plunging to a posterior plane of the fundus. OCT crossline scans demonstrated preservation of retinal thickness and morphological layering in the fundic colobomas leading to the conclusion that the colobomas were purely choroido-scleral. The outcome of the surgical excision of the dermoids was satisfactory without hair recurrence and with acceptable corneal clarity making it possible to visualize the unilateral associated iris coloboma. Follow-ups did not reveal any fundic evolution nor retinal detachment. CONCLUSIONS: Retinographies and OCT made possible the characterization of choroido-scleral colobomas associated with corneal dermoids in this first reported case in a cat. We hypothesize that the recently described superior ocular sulcus might be the embryological link between these anomalies.

Extravesicular, two-layer, side-to-side ureteroneocystostomy combined with tension-relieving techniques for feline proximal ureteral obstruction: A retrospective study.

OBJECTIVE: To describe the surgical technique for extravesicular, two-layer, side-to-side ureteroneocystostomy combined with tension-relieving techniques (ETSUTT) for feline proximal ureteral obstruction and report clinical outcomes. STUDY DESIGN: Retrospective case series. ANIMALS: Ten privately-owned cats with ureteral obstruction near the ureteropelvic junction (UPJ). METHODS: Medical records were retrospectively reviewed for cats with ureteral obstruction close to the UPJ that underwent ETSUTT (2018-2021). The ETSUTT procedure consisted of a modified extravesicular technique (two-layer, side-to-side ureteroneocystostomy) and tension-relieving techniques (renal descensus, ureterocystopexy, and nephrocystopexy). RESULTS: All cats survived through discharge. In all cats, postoperative blood urea nitrogen and creatinine concentrations were decreased, compared with preoperative concentrations. Perioperative complications included ureteral catheter dislodgement (3), transient pollakiuria (2), and dysuria (1), but no specific treatments were required. Urinary tract infection was observed postoperatively in three of the 10 cats. The median follow-up was 648 days (min-max: 86-1229 days). Seven of the 10 cats were alive without recurrent ureteral obstruction at the end of this retrospective study. CONCLUSION: The ETSUTT procedure was successfully performed without major complications in cats with ureteral obstruction occurring near the UPJ. Use of ETSUTT provided a fair-to-good, long-term prognosis in cats that were otherwise difficult to manage. CLINICAL SIGNIFICANCE: This novel procedure, ETSUTT, was feasible, safe, and could be a viable treatment option for feline proximal ureteral obstruction, including the UPJ, especially for obstructions caused by stricture.