Case-based clinical reasoning in feline medicine

Whitehead, Martin; Canfield, P. J.; Johnson, Robert; O’Brien, Carolyn; Malík, Richard

doi:10.1177/1098612x16643251

Cited by 7 publications

(3 citation statements)

References 16 publications

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“…4 The authors coined the term ‘lung–digit syndrome’, thereby giving people a more accessible moniker or ‘generic illness script’ with which to remember the entity. 5 Subsequently, variations of the theme were reported, with some cats having tumour emboli mimicking aortic thromboembolism due to primary cardiac disease, 6 some cats having vertebral metastasis resulting in back pain and/or transverse myelopathy, other cats having ocular metastasis, while still other cats had nodules in skeletal muscle instead of, or as well as, digital involvement. 2,4 …”

Section: Introductionmentioning

confidence: 99%

Metastatic pulmonary carcinomas in cats (‘feline lung–digit syndrome’): further variations on a theme

Thrift¹,

Greenwell²,

Turner³

et al. 2017

Journal of Feline Medicine and Surgery Open Reports

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Case series summaryThe aim of this retrospective case series was to describe seven cases where cats with primary lung tumours were presented because of metastases to extra-pulmonary sites (‘feline lung–digit syndrome’). Specifically, we wanted to emphasise less typical case descriptions where tumour emboli resulted in lesions developing in the musculature (including the muscles of the head), skin or distal aorta.Relevance and novel informationThe cases are presented to increase clinical awareness of this entity in feline practice, especially when characteristic combinations of clinical signs are present. When clinicians have a high index of suspicion for these presentations, radiology (thorax and digits) or ultrasound (distal aorta), combined with collection of fine needle aspirate specimens for cytology, are usually sufficient to secure a definitive diagnosis. Novel information in this series includes CT and MRI findings from some cases. Typically, needle aspiration or biopsy targeting the skin, digits and lesions in musculature is far easier compared with sampling the primary tumour site in the lungs. The differential diagnosis and investigation of multiple digital lesions is also considered.

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Section: Introductionmentioning

confidence: 99%

Metastatic pulmonary carcinomas in cats (‘feline lung–digit syndrome’): further variations on a theme

Thrift¹,

Greenwell²,

Turner³

et al. 2017

Journal of Feline Medicine and Surgery Open Reports

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“…Based on this characteristic “illness script” or anchoring heuristic (ie, true anchor), EIHS/CSS was considered the most likely diagnostic possibility. 14 – 16 This logical shortcut facilitated the rapid selection of appropriate diagnostic tests and a cogent targeted treatment regimen. Unfortunately, additional investigations specific to MH were not undertaken, as the caffeine contracture test is invasive and thus expensive (as it requires collection of a muscle biopsy under general anesthesia, plus the costs of testing at a specialist human laboratory), and the halothane-challenge test was considered an unacceptable risk to the patient, especially as IV dantrolene was not readily available.…”

Section: Discussionmentioning

confidence: 99%

Exercise-induced hyperthermia syndrome (canine stress syndrome) in four related male English springer spaniels

Thrift¹,

Wimpole²,

Child³

et al. 2017

VMRR

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ObjectiveThis retrospective study describes the signalment, clinical presentation, diagnostic findings, and mode of inheritance in four young male English springer spaniel dogs with presumptive canine stress syndrome.Materials and methodsAppropriate cases were located through medical searches of medical records of two large private referral centers. Inclusion criteria comprised of English springer spaniel dogs with tachypnea and hyperthermia that subsequently developed weakness or collapse, with or without signs of hemorrhage, soon after a period of mild-to-moderate exercise. The pedigrees of the four affected dogs, as well as eleven related English springer spaniels, were then analyzed to determine a presumptive mode of genetic inheritance.ResultsFour dogs met the inclusion criteria. All four were male, suggesting the possibility of a recessive sex-linked heritable disorder. Pedigree analysis suggests that more dogs may be potentially affected, although these dogs may have never had the concurrent triggering drug/activity/event to precipitate the clinical syndrome. There was complete resolution of clinical signs in three of the four dogs with aggressive symptomatic and supportive therapy, with one dog dying during treatment.ConclusionDogs with canine stress syndrome have the potential for rapid recovery if treated aggressively and the complications of the disease (eg, coagulopathy) are anticipated. All four dogs were male, suggesting the possibility of a recessive sex-linked mode of inheritance. Further genetic analyses should be strongly considered by those involved with the English springer spaniel breed, either with a genome-wide association study using canine single-nucleotide polymorphism arrays or whole-genome sequencing of affected and closely related dogs.

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“…System 1 requires less mental energy and operates fast but is more prone to mistakes owing to different cognitive biases, heuristics (‘rules of thumb’) and affective states. 31–35 System 2, however, is more analytical and problem-oriented, operating more slowly and deliberately, requiring more time and mental effort. 31–33 Different strategies have been recommended to minimize cognitive error that originates in cognitive biases afflicting the decision making process, particularly in system 1.…”

Section: Discussionmentioning

confidence: 99%

Renal transitional cell carcinoma with bilateral ocular metastasis in a cat

Grader¹,

Southard²,

Neaderland

2016

Journal of Feline Medicine and Surgery Open Reports

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Case summary A 4-year-old, spayed female, domestic shorthair cat was presented for evaluation due to a 4 day history of inappetence and lethargy. Physical examination revealed mild dehydration and blindness of the left eye. Abnormal imaging findings included a well-margined soft tissue mass with irregular central cavity located in the dorsal aspect of the caudal lung lobe. Cytological examination of the mass revealed chronic inflammation with hemorrhage. Tests for parasitic and fungal diseases were negative. Ophthalmic examination 17 days after the cat was initially presented revealed severe diffuse pathology of both retinas. Left renomegaly was noted 22 days after the initial presentation, and cytological examination of samples obtained from the right vitreous, left kidney and the pulmonary mass yielded atypical epithelial cells exhibiting malignant changes. Post-mortem examination following euthanasia revealed renal transitional cell carcinoma with metastasis to both eyes, lungs and skeletal muscle. Immunohistochemical evaluation of the neoplastic cells in the eye revealed moderate cytoplasmic reactivity for CK7. CK20 immunohistochemistry was negative.Relevance and novel information To the best of our knowledge, this is the first report of renal transitional cell carcinoma with ocular metastasis in a cat. In addition, this report describes immunohistochemistry results of transitional cell carcinoma in a cat using CK7 and CK20.

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Case-based clinical reasoning in feline medicine

Cited by 7 publications

References 16 publications

Metastatic pulmonary carcinomas in cats (‘feline lung–digit syndrome’): further variations on a theme

Metastatic pulmonary carcinomas in cats (‘feline lung–digit syndrome’): further variations on a theme

Exercise-induced hyperthermia syndrome (canine stress syndrome) in four related male English springer spaniels

Renal transitional cell carcinoma with bilateral ocular metastasis in a cat

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