Successful treatment of an intra-pelvic fungal pseudomycetoma causing constipation and hypercalcaemia in a Persian cat

Abstract

This case report describes the successful treatment of a Persian cat diagnosed with intra-abdominal fungal pseudomycetoma causing hypercalcaemia and constipation due to an extra-luminal mechanical obstruction of the colon. Treatment included surgical excision, supportive care and itraconazole for 6 months.

What is your diagnosis? Caudal abdominal mass in a cat

“…Successful treatment was reported in one cat following a combination of surgical excision, supportive care, and prolonged antifungal therapy. 5 To the best of our knowledge, this is the first report describing the cytologic appearance of fungal hyphae from a feline intra-abdominal DPM. The cytologic features were similar to a previous case report of dermal DPM in cat, 2 including the presence of thin linear fungal hyphae and abundant granular basophilic material (Splendore-Hoeppli reaction).…”

“…Lymphatic involvement was noted in a single cat 3 ; however, systemic dissemination has not otherwise been reported. In rare cases of intra‐abdominal feline DPM, the organism is thought to gain access to the abdominal cavity following contamination during a surgical procedure 4,5 . In this case, the cat underwent ovariohysterectomy 6 months prior under potentially unsanitary conditions, and the mass appeared to form around the uterine stump.…”

“…Feline intra-abdominal DPMs tend to be chronic lesions, with cats presenting months to years after the organism is suspected of having gained abdominal access. 4,5 Clinical signs often reflect the compressive nature of the DPM on nearby structures such as the colon and bladder. Weight loss and lethargy are commonly reported.…”

“…The overall prognosis is poor, and most cats are euthanized within a few days of presentation. Successful treatment was reported in one cat following a combination of surgical excision, supportive care, and prolonged antifungal therapy 5 …”

Invasive fungal infections and oomycoses in cats: 1. Diagnostic approach

“…Hypercalcaemia may be present due to monocyte and macrophage activation within pyogranulomas; increased expression of 25-hydroxyvitamin D 3 1a-hydroxylase then results in hypervitaminosis D. This has been reported in histoplasmosis, blastomycosis and dermatophytic pseudomycetoma. 28 , 32 , 33 Other serum biochemical changes in IFIs/IFLIs reflect specific organ involvement.…”