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Webster J, Marchesi F, Gunn-Moore D, Haining H, Ridyard AE. Disseminated Mycobacterium avium infection in a cat on long-term ciclosporin therapy and potential latent infection of an in-contact cat. JFMS Open Rep 2022; 8:20551169221109442. [PMID: 35966901 PMCID: PMC9373128 DOI: 10.1177/20551169221109442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Case summary An 8-year-old domestic shorthair cat receiving long-term ciclosporin treatment was evaluated for a history of weight loss and hyporexia. The main clinical finding was a cluster of enlarged mesenteric lymph nodes. Cytological examination of fine-needle aspirates showed granulomatous inflammation with abundant acid-fast bacilli. A diagnosis of Mycobacterium avium complex (MAC) infection was confirmed by PCR. The cat’s clinical condition deteriorated rapidly despite appropriate antibiotic treatment and it was euthanased 2 weeks after initial presentation due to development of severe paraparesis and ataxia. Post-mortem examination revealed granulomatous inflammation affecting multiple lymph nodes and other organs with intrahistiocytic acid-fast bacilli consistent with mycobacteria when stained using Ziehl–Neelsen stain. Another cat in the same household was screened for infection using the interferon gamma release assay (IGRA), with the result being consistent with infection by non-tuberculous mycobacteria (NTM), which includes MAC; however, it had no grossly detectable disease. Relevance and novel information This case report is an unusual presentation of disseminated MAC infection in a cat, which remains a rare diagnosis. Clinicians should be aware of unusual and rare presentations of this infection. The clinical findings, progression of disease and histopathology results add to the current clinical database for feline disseminated MAC infections. Another cat in the same household tested positive for NTM by IGRA without any gross disease. This was suggestive of latent MAC infection which, to our knowledge, has not been previously reported in an in-contact cat.
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Affiliation(s)
- Jade Webster
- Small Animal Hospital, University of Glasgow, Glasgow, UK
| | | | - Danièlle Gunn-Moore
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, University of Edinburgh, Edinburgh, UK
| | - Hayley Haining
- Veterinary Diagnostic Services, University of Glasgow, Glasgow, UK
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Munro MJL, Byrne BA, Sykes JE. Feline mycobacterial disease in northern California: Epidemiology, clinical features, and antimicrobial susceptibility. J Vet Intern Med 2020; 35:273-283. [PMID: 33346952 PMCID: PMC7848370 DOI: 10.1111/jvim.16013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 12/06/2020] [Accepted: 12/07/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Mycobacterial infections in cats are challenging to treat and incompletely described. HYPOTHESIS/OBJECTIVES To describe the features of mycobacterial infections in cats from northern California. ANIMALS Nineteen cats, all with nontuberculous mycobacterial (NTM) infections; 4 with Mycobacterium avium infection, 15 with rapid-growing mycobacterial (RGM) infection. METHODS Retrospective study. Cases with positive mycobacterial culture, species identification, and susceptibility testing were included. Descriptive statistics were used. Fisher's exact test and Mann-Whitney U test were used for comparisons between M avium and RGM infections (P ≤ .05). RESULTS Rapid-growing mycobacterial cases included Mycobacterium smegmatis (9), Mycobacterium fortuitum (4), Mycobacterium abscessus (1), and Mycobacterium thermoresistibile (1). Mycobacterium avium infections were more likely than RGM infections to be disseminated (3/4 vs 0/15; P = .004). Disease of the skin/subcutis (15/15 vs 0/4; P < .001) and outdoor access (14/15 vs 0/4; P = .001) were primary features of RGM infections. Resistance to fluoroquinolones and aminoglycosides was common among M avium isolates. A high prevalence of resistance to third- and fourth-generation cephalosporins was noted in RGM species. Death/euthanasia was noted only in M avium cases (3/4). Twelve of 15 cats with RGM infection had available follow-up; 4 of these cats achieved remission. CONCLUSIONS AND CLINICAL IMPORTANCE The most prevalent RGM species isolated from cats from northern California are M smegmatis and M fortuitum. Susceptibility to prescribed antimicrobials does not appear to guarantee treatment success. Combination drug treatment is recommended. Repeat culture and susceptibility testing should be performed when disease is persistent/relapsing.
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Affiliation(s)
- Matthew J L Munro
- Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, Davis, California, USA.,Department of Veterinary Clinical Sciences, The Melbourne Veterinary School, University of Melbourne, Werribee, Victoria, Australia
| | - Barbara A Byrne
- Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California, Davis, Davis, California, USA
| | - Jane E Sykes
- Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, Davis, California, USA.,Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, California, USA
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Colombo S, Sartori R. Ciclosporin and the cat: Current understanding and review of clinical use. J Feline Med Surg 2019; 20:244-255. [PMID: 29478396 DOI: 10.1177/1098612x17748718] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Practical relevance: Ciclosporin (CsA) is a systemic immuno-modulatory drug widely used to treat immune-mediated diseases in humans and veterinary species. CsA was registered for use in cats in the USA and Europe in 2011, and is indicated for the treatment of chronic allergic dermatitis at a recommended daily dose of 7 mg/kg PO. AUDIENCE This review will be of interest to all veterinarians working with cats, given the wide range of potential applications of CsA and its safety profile. Although the drug is currently only licensed to treat chronic allergic dermatitis in cats, a small number of reports describe its use in non-dermatological conditions. Evidence base: This article reviews the mechanism of action, pharmacokinetics, drug interactions, adverse effects and clinical use of CsA, both for the licensed indication and for off-label use in the feline patient. Information presented has been summarised from the existing literature on CsA, with specific interest in studies carried out in cats. For its licensed indication, chronic allergic dermatitis, evidence provided includes randomised, placebo or prednisolone-controlled studies (EBM grade I) and prospective or retrospective open trials.
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Affiliation(s)
- Silvia Colombo
- Servizi Dermatologici Veterinari, via Felice Musazzi 24, Legnano (MI), 1-20025, Italy
| | - Roberta Sartori
- Servizi Dermatologici Veterinari, via Felice Musazzi 24, Legnano (MI), 1-20025, Italy
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Pekkarinen H, Airas N, Savolainen LE, Rantala M, Kilpinen S, Miuku O, Speeti M, Karkamo V, Malkamäki S, Vaara M, Sukura A, Syrjä P. Non-tuberculous Mycobacteria can Cause Disseminated Mycobacteriosis in Cats. J Comp Pathol 2018; 160:1-9. [PMID: 29729715 PMCID: PMC7094269 DOI: 10.1016/j.jcpa.2018.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 01/11/2018] [Accepted: 02/21/2018] [Indexed: 11/30/2022]
Abstract
Mycobacteriosis caused by non-tuberculous mycobacteria (NTM) is a rising concern in human medicine both in immunocompromised and immunocompetent patients. In cats, mycobacteriosis caused by NTM is considered mostly to be a focal or dermal infection, with disseminated disease mostly caused by Mycobacterium avium. We describe three cases of disseminated mycobacteriosis in cats, caused by Mycobacterium malmoense, Mycobacterium branderi/shimoidei and M. avium, with no identified underlying immunosuppression. In all cases, extracellular mycobacteria were seen in the pulmonary epithelium, intestinal lumen and glomerular tufts, which could affect the shedding of the organism. The present study highlights the importance of mycobacteriosis as a differential even in immunocompetent animals. Considering the close relationship of owners and pets and the potential presence of free mycobacteria in secretions, cats should be considered as a possible environmental reservoir for mycobacteria.
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Affiliation(s)
- H Pekkarinen
- Department of Veterinary Biosciences, Faculty of Veterinary Medicine, PO Box 66, University of Helsinki, Finland.
| | - N Airas
- Department of Veterinary Biosciences, Faculty of Veterinary Medicine, PO Box 66, University of Helsinki, Finland
| | - L E Savolainen
- Department of Clinical Microbiology, University of Helsinki and Helsinki University Hospital, HUSLAB, Finland
| | - M Rantala
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, PO Box 57, University of Helsinki, Finland
| | - S Kilpinen
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, PO Box 57, University of Helsinki, Finland
| | - O Miuku
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, PO Box 57, University of Helsinki, Finland
| | - M Speeti
- Herttoniemi Veterinary Clinic, Hiihtomäentie 35, Finland
| | - V Karkamo
- Pathology Research Unit, Finnish Food Safety Authority Evira, Mustialankatu 3, Helsinki, Finland
| | - S Malkamäki
- Department of Veterinary Biosciences, Faculty of Veterinary Medicine, PO Box 66, University of Helsinki, Finland
| | - M Vaara
- Department of Clinical Microbiology, University of Helsinki and Helsinki University Hospital, HUSLAB, Finland
| | - A Sukura
- Department of Veterinary Biosciences, Faculty of Veterinary Medicine, PO Box 66, University of Helsinki, Finland
| | - P Syrjä
- Department of Veterinary Biosciences, Faculty of Veterinary Medicine, PO Box 66, University of Helsinki, Finland
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Backel K, Cain C. Skin as a marker of general feline health: Cutaneous manifestations of infectious disease. J Feline Med Surg 2017; 19:1149-1165. [PMID: 29068251 DOI: 10.1177/1098612x17735764] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Practical relevance: Infectious disease in feline patients often presents a diagnostic challenge. This article reviews the most relevant viral, bacterial and protozoal diseases and their cutaneous manifestations. Many of the diseases discussed have overlapping presentations or may mimic more common noninfectious disease processes. The purpose of the article is to reinforce knowledge of common and uncommon infectious diseases, help practitioners identify possible infectious dermatoses, create a comprehensive and prioritized differential list, and provide guidance for the diagnosis of these diseases. A working knowledge of these clinical syndromes is important if what is thought to be a case of a common disease does not respond to conventional management. AUDIENCE This review is aimed at veterinarians who treat cats and especially those with an interest in feline dermatology. Tables are included to allow the reader to formulate a concise list of differential diagnoses for clinically similar presentations. The diagnostic approach to a case of ulcerative facial dermatitis is reviewed in a Case Notes quiz. Evidence base: This article includes up-to-date information regarding dermatologic manifestations of less commonly encountered feline cutaneous infectious diseases. Information has been drawn from the published, peer-reviewed literature and the most recent textbook chapters with a particular aim of describing and differentiating clinical lesions and the diagnostic approach to cutaneous disease, especially in unusual cases.
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Affiliation(s)
- Katherine Backel
- Department of Clinical Sciences and Advanced Medicine, University of Pennsylvania, School of Veterinary Medicine, 3900 Spruce Street, Philadelphia, PA 19104, USA
| | - Christine Cain
- Department of Clinical Sciences and Advanced Medicine, University of Pennsylvania, School of Veterinary Medicine, 3900 Spruce Street, Philadelphia, PA 19104, USA
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O'Halloran C, Dobromylskyj M. Clinical mycobacterial diseases of companion animals: part I. ACTA ACUST UNITED AC 2017. [DOI: 10.12968/coan.2017.22.6.325] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Conor O'Halloran
- Royal (Dick) School of Veterinary Studies and the Roslin Institute, Easter Bush Campus, The University of Edinburgh EH25 9RG
| | - Melanie Dobromylskyj
- Finn Pathologists, Histopathology Department, One Eyed Lane, Weybread, Diss, Norfolk IP21 5TT
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Avian Mycobacteriosis: Still Existing Threat to Humans. BIOMED RESEARCH INTERNATIONAL 2016; 2016:4387461. [PMID: 27556033 PMCID: PMC4983314 DOI: 10.1155/2016/4387461] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 05/31/2016] [Accepted: 06/19/2016] [Indexed: 12/26/2022]
Abstract
The nontuberculous mycobacteria are typically environmental organisms residing in soil and water. These microorganisms can cause a wide range of clinical diseases; pulmonary disease is most frequent, followed by lymphadenitis in children, skin and soft tissue disease, and rare extra pulmonary or disseminated infections. Mycobacterium avium complex is the second most common cause of pulmonary mycobacterioses after M. tuberculosis. This review covers the clinical and laboratory diagnosis of infection caused by the members of this complex and particularities for the treatment of different disease types and patient populations.
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Nafe LA, Leach SB. Treatment of feline asthma with ciclosporin in a cat with diabetes mellitus and congestive heart failure. J Feline Med Surg 2014; 17:1073-6. [PMID: 25527351 DOI: 10.1177/1098612x14563342] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A 5-year-old domestic shorthair cat that had been previously diagnosed with diabetes mellitus was presented for episodes of coughing and respiratory distress. Diagnostic testing revealed congestive heart failure secondary to hypertrophic cardiomyopathy and concurrent asthma. All clinical signs and eosinophilic airway inflammation resolved with oral ciclosporin while the cat was concurrently receiving medications for treatment of heart failure (furosemide and enalapril). Ciclosporin should be considered for treatment of feline asthma in patients with concurrent diseases (eg, diabetes mellitus, severe heart disease) that may contraindicate use of oral glucocorticoid therapy.
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Affiliation(s)
- Laura A Nafe
- Department of Veterinary Clinical Sciences, Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, OK, USA
| | - Stacey B Leach
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA
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9
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Gunn-Moore DA. Feline mycobacterial infections. Vet J 2014; 201:230-8. [DOI: 10.1016/j.tvjl.2014.02.014] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2013] [Revised: 12/12/2013] [Accepted: 02/09/2014] [Indexed: 10/25/2022]
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10
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Lloret A, Hartmann K, Pennisi MG, Gruffydd-Jones T, Addie D, Belák S, Boucraut-Baralon C, Egberink H, Frymus T, Hosie MJ, Lutz H, Marsilio F, Möstl K, Radford AD, Thiry E, Truyen U, Horzinek MC. Mycobacterioses in Cats. J Feline Med Surg 2013; 15:591-7. [DOI: 10.1177/1098612x13489221] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Overview: Mycobacterial infections are important in humans and animals. Cats can be infected by several Mycobacterium species, which may cause different syndromes, mainly tuberculosis, atypical or non-tuberculous mycobacteriosis and leprosy. In recent years, awareness has increased about how to recognise and confirm these infections. More cases are diagnosed today, which probably means that the disease has escaped detection in the past. Infection: Most cases in cats are cutaneous, presenting as nodules in the skin and draining tracts, ulceration and local lymphadenopathy; however, systemic dissemination may also occur. Diagnosis: Definitive diagnosis is difficult when the bacterium cannot be detected by histology or culture. However, species confirmation is essential for treatment and prognosis, so material for culture and polymerase chain reaction should be submitted in every suspected case. Treatment: Treatment is challenging. A combination of two or three antibiotics is needed, and treatment must be continued for some months, which makes owner compliance especially difficult in cats. Zoonotic risk: There is a zoonotic risk associated with some mycobacterial species. Concerns should be communicated in every case of an immunocompromised owner in contact with an infected cat.
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11
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Batchelor DJ, Devauchelle P, Elliott J, Elwood CM, Freiche V, Gualtieri M, Hall EJ, Den Hertog E, Neiger R, Peeters D, Roura X, Savary-Bataille K, German AJ. Mechanisms, causes, investigation and management of vomiting disorders in cats: a literature review. J Feline Med Surg 2013; 15:237-65. [PMID: 23403690 DOI: 10.1177/1098612x12473466] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Vomiting is a common presenting complaint in feline practice. This article differs from previous reviews in that it is an evidence-based review of the mechanisms, causes, investigation and management of vomiting in the domestic cat. Published evidence was reviewed, and then used to make recommendations for clinical assessment, diagnosis, antiemetic drug treatment, dietary management and monitoring of cats presenting with vomiting. The strength of the evidence on which recommendations are made (and areas where evidence is lacking for cats) has been highlighted throughout.
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12
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Lo AJ, Goldschmidt MH, Aronson LR. Osteomyelitis of the coxofemoral joint due to Mycobacterium species in a feline renal transplant recipient. J Feline Med Surg 2012; 14:919-23. [DOI: 10.1177/1098612x12454983] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A 4-year-old castrated male Russian Blue cat was evaluated for acute right hind limb lameness 18 months after receiving a renal transplant. Radiographs showed a subluxated right femoral head and lysis of the acetabulum and femoral neck. A femoral head and neck ostectomy was performed on the right coxofemoral joint. Histologic evaluation of the right femoral head revealed lesions indicative of a chronic, granulomatous osteomyelitis and periostitis associated with an intralesional Mycobacterium species. However, the cat’s clinical condition declined despite treatment and the owner elected humane euthanasia. All renal transplant recipients receive immunosuppressive therapy to prevent allograft rejection. The non-tuberculous mycobacterial infection of the coxofemoral joint was thought to develop secondary to long-term immunosuppressive treatment. This report illustrates the need to consider these rare opportunistic infections even many months to years following renal transplantation. Early awareness, stringent immunosuppressive drug monitoring and targeted treatment once a diagnosis has been made may be important in the successful management and prevention of mycobacterial infections in this population of patients.
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Affiliation(s)
- Annie J Lo
- Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Michael H Goldschmidt
- Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Lillian R Aronson
- Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Irwin KE, Beale KM, Fadok VA. Use of modified ciclosporin in the management of feline pemphigus foliaceus: a retrospective analysis. Vet Dermatol 2012; 23:403-e76. [DOI: 10.1111/j.1365-3164.2012.01069.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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14
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Infectious Diseases. THE CAT 2012. [PMCID: PMC7161403 DOI: 10.1016/b978-1-4377-0660-4.00033-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Aronson LR, Stumhofer JS, Drobatz KJ, Hunter CA. Effect of cyclosporine, dexamethasone, and human CTLA4-Ig on production of cytokines in lymphocytes of clinically normal cats and cats undergoing renal transplantation. Am J Vet Res 2011; 72:541-9. [DOI: 10.2460/ajvr.72.4.541] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Abstract
This article serves to review the various infectious diseases that affect the liver primarily or as a part of systemic infection. Although bacterial infections are probably the most common cause of infectious hepatitis, the clinician should be aware of other potential organisms and other commonly involved systems. Therefore, this article includes a description of common bacterial, mycobacterial, viral, fungal, protozoal, parasitic, and rickettsial diseases in dogs and cats.
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Affiliation(s)
- Shawn Kearns
- Angell Animal Medical Center-Boston, Boston, MA, USA.
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17
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Harrenstien LA, Finnegan MV, Woodford NL, Mansfield KG, Waters WR, Bannantine JP, Paustian ML, Garner MM, Bakke AC, Peloquin CA, Phillips TM. MYCOBACTERIUM AVIUM IN PYGMY RABBITS (BRACHYLAGUS IDAHOENSIS): 28 CASES. J Zoo Wildl Med 2006; 37:498-512. [PMID: 17315435 DOI: 10.1638/05-002.1] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The Columbia basin subpopulation of pygmy rabbit Brachylagus idahoensis was listed as endangered by the United States Fish and Wildlife Service in November 2001, and no pygmy rabbits have been seen in the wild since spring 2002. Captive propagation efforts have attempted to increase population size in preparation for reintroduction of animals into central Washington. Disseminated mycobacteriosis due to Mycobacterium avium has been the most common cause of death of adult captive pygmy rabbits. Between June 2002 and September 2004, mycobacteriosis was diagnosed in 28 captive adult pygmy rabbits (representing 29% of the captive population), in contrast to 18 adult pygmy rabbits dying of all other causes in the same time period. Antemortem and postmortem medical records were evaluated retrospectively to describe the clinical course of mycobacteriosis in pygmy rabbits, physical examination findings, and diagnostic test results in the diagnosis of mycobacteriosis in pygmy rabbits. Various treatment protocols, possible risk factors for mortality, and recommendations for prevention of mycobacteriosis were evaluated also. Compromised cell-mediated immunity appears to be the best explanation at this time for the observed high morbidity and mortality from mycobacterial infections in pygmy rabbits.
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Baral RM, Metcalfe SS, Krockenberger MB, Catt MJ, Barrs VR, McWhirter C, Hutson CA, Wigney DI, Martin P, Chen SCA, Mitchell DH, Malik R. Disseminated Mycobacterium avium infection in young cats: overrepresentation of Abyssinian cats. J Feline Med Surg 2005; 8:23-44. [PMID: 16226469 DOI: 10.1016/j.jfms.2005.06.004] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2005] [Indexed: 01/01/2023]
Abstract
Disseminated Mycobacterium avium-intracellulare complex (MAC) infection was diagnosed in 10 young cats (1-5 years of age) from Australia or North America between 1995 and 2004. A further two cats with disseminated mycobacteriosis (precise agent not identified) were recognised during this period. Of the 12, 10 were Abyssinian cats, one was a Somali cat and one was a domestic shorthair cat. None of the cats tested positive for either FeLV antigen or FIV antibody. The clinical course of these infections was indolent, with cats typically presenting for weight loss, initially in the face of polyphagia, with a chronicity of up to several months. Additional clinical features included lower respiratory tract signs and peripheral lymphadenomegaly. A marked diffuse interstitial pattern was evident in thoracic radiographs, even in cats without overt respiratory involvement. Hair clipped to perform diagnostic procedures tended to regrow slowly, if at all. Diagnosis was generally made by obtaining representative tissue specimens from mesenteric lymph nodes, liver or kidney at laparotomy, or from a popliteal lymph node. The primary antecedent event was most likely colonisation of either the alimentary or respiratory tract, followed by local invasion and eventual lymphatic and haematogenous dissemination. Nine cases were treated using combination therapy with agents effective for MAC infection in human patients. Two cats are still undergoing initial therapy and have responded. Of the remaining seven, all responded during long courses (5-14 months) of clarithromycin combined with either clofazimine or rifampicin, and a fluoroquinolone or doxycycline. Of these, three cats remain well (with durations between 2 months and 2 years following therapy); two developed recurrent disease (at 3 months and 2 years, respectively, following therapy) and have restarted therapy. The remaining two cats improved 1 year and 5 months, respectively, after diagnosis but ultimately succumbed. The two cats in which therapy was restarted have improved dramatically. Certain lines of Abyssinian and Somali cats likely suffer from a familial immunodeficiency that predisposes them to infection with slow-growing mycobacteria such as MAC.
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Affiliation(s)
- Randolph M Baral
- Paddington Cat Hospital, 183 Glenmore Road, Paddington, NSW 2021, Australia.
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Kadar E, Sykes JE, Kass PH, Bernsteen L, Gregory CR, Kyles AE. Evaluation of the prevalence of infections in cats after renal transplantation: 169 cases (1987-2003). J Am Vet Med Assoc 2005; 227:948-53. [PMID: 16190595 DOI: 10.2460/javma.2005.227.948] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the prevalence of infections developing postoperatively, document the contribution of infection to increased risk of death, and identify risk factors associated with the development of infectious complications in cats after renal transplantation. DESIGN Retrospective study. ANIMALS 169 cats that received renal allograft transplants. PROCEDURES Medical records of cats receiving renal transplants at the University of California from January 1987 through December 2003 were reviewed. RESULTS 47 infections developed in 43 of 169 cats. Bacterial infections were most common (25/47 cats), followed by viral (13/47), fungal (6/47), and protozoal (3/47) infections. The median duration from transplant surgery to development of infection was 2.5 months. Infection was the second most common cause of death after acute rejection of the transplant, accounting for 14% of deaths overall. Cats with concurrent diabetes mellitus had a significantly increased risk of developing an infection after renal transplantation. Sex, increasing age, concurrent neoplasia, and previous treatment for transplant rejection were not associated with development of infection. CONCLUSIONS AND CLINICAL RELEVANCE Infection was a common complication and an important cause of death or euthanasia in cats after renal transplantation. Development of diabetes mellitus after transplantation significantly increased the risk of infection.
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Affiliation(s)
- Elissa Kadar
- Veterinary Medical Teaching Hospital, University of California, Davis, CA 95616, USA
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