Bone lesions in cats with anemia induced by feline leukemia virus

Polyostotic cortical hyperostosis in an 8-week-old cat with a 3-year follow-up

A 2 month-old female cat, mixed breed, was referred for difficulty moving and severe enlargement of the mandible and limbs. Polyostotic cortical hyperostosis was diagnosed based on diagnostic imaging and histopathological changes of the mandible and limbs. Marked cortical bone thickening was detected on radiographs and CT scan images. The diaphyses of both radii and ulnae, together with the mandibular rami and bodies, were most severely affected. The many similarities shared with the human condition, Caffey's disease, are discussed.

Polyostotic hyperostosis in a domestic shorthair cat

CLINICAL PRESENTATION

An 11-year-old male neutered domestic shorthair cat was presented for investigation of weight loss and inappetence. On physical examination there was palpable enlargement and thickening of many bones, and this finding was confirmed radiographically. PROPOSED DIAGNOSIS: Based on clinical, radiological and histopathological findings, a polyostotic bone disease, best described as generalised idiopathic hyperostosis, was diagnosed. This condition has not been reported in cats previously. Canine and human diseases with similarities to this presentation are discussed.

Musculoskeletal oddities in the cat: an overview of some curious causes of lameness

PRACTICAL RELEVANCE

Cats, both young and old, can suffer a variety of weird and wonderful musculoskeletal conditions that are a cause of lameness. These include developmental, metabolic and nutritional bone diseases, ectopic mineralisation disorders, conditions that cause lameness or exercise intolerance and primarily or secondarily affect muscle, and lastly pad conditions.

CLINICAL CHALLENGES

These conditions are mostly rare and can be challenging to diagnose. The aim of this review is to bring these conditions to the attention of practitioners so that, if they are encountered, further research around the topic can be undertaken. Radiographic changes and diagnostic tests that can be used to try to confirm diagnoses are described.

EVIDENCE BASE

These unusual causes of lameness are the subject of multiple single case reports or small case series, many of which are relatively old. The evidence presented here is drawn from these articles. However, it is not possible within the scope of this review to discuss all the conditions in as much detail as they may warrant, or to make reference to every article relating to them.

Osteopetrosis-like disease in a cat with respiratory distress

Magnetic resonance (MR) and computed tomography (CT) were performed in an 8-year-old, spayed female cat with chronic effort respiration at the inspiration phase and stertor. Increased bone opacity in the areas of the head, neck and thorax were observed on radiography. MR images showed no signal intensity on both transverse T1WI and T2WI of the nasal cavity. CT revealed increased bone density and hypertrophy of the nasal turbinate and a narrowed nasal passage. From these results, we concluded this case had osteopetrosis-like disease, and that the respiratory distress was caused by hypertrophy of the nasal turbinate.

Generalized osteosclerosis in a cat

A 12-year-old, neutered male, domestic long-hair cat was evaluated for a 6-month history of inspiratory stertor and epiphora. In computed tomography of the skull and pelvis, and radiographs of the thorax, right femur and stifle there was generalized osteosclerosis, with obliteration of the nasal turbinates and nasolacrimal duct obstruction. The cat also had a large fibrosarcoma involving the right pelvic limb. Osteosclerosis is a rare disorder that is poorly understood but has been described in several species. Various manifestations, potential causes, and radiologic findings of osteosclerosis are discussed.

Retroviruses and bone diseases

In 1980, retroviruses were shown to be pathogenic to humans, and experimentation on animals involving retroviruses as causal agents of tumors and degenerative diseases of bone, brain, and lung gained interest. Osteopetrosis, which can be either inherited in rodents or retrovirally induced in cats, is exemplary. Because of replication cycle, retroviruses can be propagated not only as infectious agents but also as cellular genes. If a retroviral infection occurs in germ line cells, the viral genes, which must integrate in the host's DNA, can be passed on to the progeny and inherited as Mendelian characteristics. Therefore, a retroviral etiology could account for diseases that present either as sporadic (infectious) or familial (inherited), although they may be similar in their clinical manifestations. This approach led to the finding of 2 new human retroviruses: 1 in a patient who had sporadic benign osteopetrosis, and the other in a patient who had sporadic paraarticular osteoma. In both patients, the retrovirus was isolated from mononuclear blood cells, not from bone cells, because of the links between bone and the immune system. A systematic search for retroviruses in patients who have sporadic bone disease, which also may appear as inherited disease, has yet to be performed. Patients with sporadic disease could be managed by antiretroviral agents such as Zidovudin.

Haematological disorders associated with feline retrovirus infections

Feline oncornavirus and lentivirus infections have provided useful models to characterize the virus and host cell factors involved in a variety of marrow suppressive disorders and haematological malignancies. Exciting recent progress has been made in the characterization of the viral genotypic features involved in FeLV-associated diseases. Molecular studies have clearly defined the causal role of variant FeLV env gene determinants in two disorders: the T-lymphocyte cytopathicity and the clinical acute immunosuppression induced by the FeLV-FAIDS variant and the pure red cell aplasia induced by FeLV-C/Sarma. Variant or enFeLV env sequences also appear to play a role in FeLV-associated lymphomas. Additional studies are required to determine the host cell processes that are perturbed by these variant env gene products. In the case of the FeLV-FAIDS variant, the aberrant env gene products appear to impair superinfection interference, resulting in accumulation of unintegrated viral DNA and cell death. In other cases it is likely that the viral env proteins interact with host products that are important in cell viability and/or proliferation. Understanding of these mechanisms will therefore provide insights to factors involved in normal lymphohaematopoiesis. Similarly, studies of FeLV-induced haematological neoplasms should reveal recombination or rearrangement events involving as yet unidentified host gene sequences that encode products involved in normal cell growth regulation. These sequences may include novel protoncogenes or sequences homologous to genes implicated in human haematological malignancies. The haematological consequences of FIV are quite similar to those associated with HIV. As with HIV, FIV does not appear to directly infect myeloid or erythroid precursors, and the mechanisms of marrow suppression likely involve virus, viral antigen, and/or infected accessory cells in the marrow microenvironment. Studies using in vitro experimental models are required to define the effects of each of these microenvironmental elements on haematopoietic progenitors. As little is known about the molecular mechanisms of FIV pathogenesis, additional studies of disease-inducing FIV strains are needed to identify the genotypic features that correlate with virulent phenotypic features. Finally, experimental FIV infection in cats provides the opportunity to correlate in vivo virological and haematological changes with in vitro observations in a large animal model that closely mimics HIV infection in man.

A new approach to the study of the origin of genetic diseases: retroviral etiology of osteopetrosis

The recent evidence of retroviral activity in a patient suffering from an atypical form of benign osteopetrosis suggests that it may represent the ancestral infectious form of a disease recognized until now only as a genetic disease. Therefore, making c-DNA probes from that virus should evidence retroviral-like sequences integrated in the genome of patients suffering from the inherited form of the disease. One of the goals of these investigations is to use these probes to map human "osteopetrosis" mutation(s) in the genome. A new approach is therefore defined for the study of these diseases, which although similar in their clinical manifestations, appear either as "sporadic" or "familial" cases: a retroviral etiology can account for this discrepancy. Another approach is also suggested for these kinds of disease, consisting of the search for retroviral sequences in a gene coding for an enzyme, when the main disease is associated with an apparently unrelated enzymatic deficiency. The insertion of retroviral sequence in a gene coding for an enzyme may result in both the disease and the inactivation of the gene. By comparing the genomic sequence of the enzyme in normal and pathological cases, the integrated retroviral gene(s) sequence will be available.

Retroviral expression in mononuclear blood cells isolated from a patient with osteopetrosis (Albers-Schönberg disease)

We report the presence of reverse transcriptase activity in the supernatant of long-term culture of mononuclear blood cells (monocytes and lymphocytes) isolated from a 27-year-old patient suffering from benign osteopetrosis. The enzyme was purified to homogeneity according to the technique of Chandra and Steel, by chromatography, first on DEAE-cellulose (DE 52) and then on phosphocellulose (P11). After purification, the enzyme was characterized biochemically for its template specificity and ionic requirements. The purified enzyme was able to transcribe poly(rA).(dT)12-18 and poly(rC).(dG)12-18 very efficiently and had a marked preference for Mg2+ ions over Mn2+ ions. The pattern of ionic dependency for this enzyme is similar to that of reverse transcriptases purified from human lymphotropic viruses. The patient was tested and found sero-negative for HIV-1, HIV-2, and HTLV-I and seropositive (immunoglobulin G) for cytomegalovirus. Epstein-Barr virus nuclear antigens (EBNA) were detected in the patient's B lymphocytes. Since reverse transcriptase is the hallmark of retroviruses, we suggest that a retrovirus may be involved in the etiology of osteopetrosis.

Induction of aplastic anemia by intra-bone marrow inoculation of a molecularly cloned feline retrovirus

Intra-bone marrow inoculation of cells infected with molecularly cloned feline retrovirus (FeLV-C-Sarma [FSC]) associated with aplastic anemia was examined to test the hypothesis that cell-to-cell transmission of virus might facilitate marrow cell infection and anemogenesis, a possibility suggested by in-vitro co-culture experiments. IBM inoculation of either FSC-infected feline marrow cells or fibroblasts of weanling cats bypassed age-related restriction of FSC replication, initiated viremia, caused irreversible depletion of erythroid burst forming units, and induced rapid fatal aplastic anemia. A second significant finding observed with FSC infection was pronounced systemic lymphoid depletion. The direct bone marrow inoculation system described facilitates experimental study of retrovirus-target cell interactions involved in erythroid aplasia.

Myelofibrosis in cats with myelodysplastic syndrome and acute myelogenous leukemia

Bone marrow sections from 44 cats with myelodysplastic syndrome (MDS) or acute myelogenous leukemia (AML) were graded for reticulin content using light microscopic methods. Twenty-seven (61%) of the cats had slight to marked reticulin myelofibrosis. The association of myelofibrosis with possible pathogenetic factors, including megakaryocyte count, intramedullary lymphoid follicles, hemosiderin content, and FeLV antigenemia, was examined. No evidence was found that indicated a causal relationship between myelofibrosis and any of these factors.

Haemopoietic colony formation (BFU-E, GM-CFC) during the development of pure red cell hypoplasia induced in the cat by feline leukaemia virus

The GM-CFC assay for granulocyte-macrophage progenitors and the BFU-E and CFU-E assay for early and late erythroid progenitors from cat bone marrow were characterized. GM-CFC gave 59 +/- 4 to 118 +/- 6 colonies per 10(5) bone marrow cells using colony stimulating factors (CSF) from cat, mouse or human sources. The CFU-E and BFU-E assays gave 114 +/- 7 and 58 +/- 7 colonies respectively with optimum doses of erythropoietin. Irradiated cat bone marrow cells were good sources of CSF and of burst promoting activity for these assays. Kittens infected with feline leukaemia virus, subgroup C (FeLV-C), which induces pure red cell hypoplasia, showed the incidence of BFU-E decreased to 25-35% of controls as early as one week postinfection, and even lower values at later times. In contrast, the incidence of GM-CFC remained normal for several weeks. No evidence of inhibitory cells or of lack of stimulatory cells in the infected marrows was seen when they were cultured together with normal marrow in the BFU-E assay. Conversely, normal marrow cells were not able to restore BFU-E growth from infected marrow. This suggests a direct action of FeLV-C on early erythroid precursors. Infection with FeLV, subgroup A, which induces only a mild transitory anaemia, produces only a moderate decrease in the incidence of BFU-E.

Hematologic abnormalities preceding myeloid leukemia in three cats

Cytopenia were recognized in three cats infected with feline leukemia virus. In one cat, marrow blast cells were increased in number, and a diagnosis of aleukemic leukemia was made. The disease progressed slowly for 3 1/2 months before terminating in acute myelomonocytic leukemia, recognized as a blast crisis in blood. In the other two cats, neutropenia and altered granulopoiesis in bone marrow preceded development of myeloid leukemia.