Unique presentation of normolipaemic cutaneous xanthoma in a cat

Ravens, PA; Vogelnest, Linda; Piripi, SA

doi:10.1111/avj.12115

Cited by 11 publications

(14 citation statements)

References 6 publications

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“…Macrophages phagocytose lipids, resulting in aggregations of characteristic foam cells and extracellular cholesterol deposition. 2 , 3 Foam cells may also arise from in situ lipid production by macrophages. Lipids can signal additional macrophages into existing xanthomas.…”

Section: Discussionmentioning

confidence: 99%

“…Lipids can signal additional macrophages into existing xanthomas. 3 In cats, cutaneous xanthomas may present as papules, plaques or nodules that are pale yellow to pink in colour and can be intact or ulcerated. 4 They often appear in the periauricular and periorbital regions 4 but have appeared inguinally 2 and at sites of previous trauma.…”

Section: Discussionmentioning

confidence: 99%

“… 15 However, there has been one report of a normolipaemic cat with idiopathic cutaneous xanthoma. 3 More specifically, hypercholesterolaemia can be caused by pancreatitis, hypoadrenocorticism, cholestasis and nephrotic syndrome. 13 The cat of this report was most likely affected by primary dyslipidaemia because abdominal ultrasonography, blood and urine analyses excluded the abovementioned conditions.…”

Section: Discussionmentioning

confidence: 99%

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Cutaneous xanthoma causing hypercalcaemia in a cat

Ma¹,

Romine²,

Hardcastle³

2022

Journal of Feline Medicine and Surgery Open Reports

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Case summary A 5-year-old male neutered cat weighing 3.56 kg presented owing to the development of two masses over the dorsal cervical and cranial thoracic areas, as well as weight loss, inappetence and vomiting. Diagnostic tests revealed a grossly lipaemic sample with hypercholesterolaemia (440 mg/dl; reference interval [RI] 90.0–205.0), hypercalcaemia (>16.0 mg/dl [RI 8.0–11.8]) and urine specific gravity 1.022 (RI ⩾1.035). When re-presented 9 months later, fasted blood analyses revealed elevated ionised calcium (1.87 mmol/l [RI 1.11–1.38]), persistently elevated total calcium, normal phosphate and persistent minimally concentrated urine with calcium oxalate dihydrate crystals. Ultrasound-guided fine-needle aspiration of the masses produced blood-tinged purulent fluid with negative culture results. Excisional biopsies of both masses were undertaken, and histopathology was consistent with cutaneous xanthoma. No organisms were identified with special staining, and deep-tissue culture did not grow bacteria or fungi. Postoperatively, repeat fasted biochemical analysis revealed persistent hypercholesterolaemia with normal triglycerides, and normalisation of ionised and total calcium levels. Based on these findings, a diagnosis of cutaneous xanthoma causing hypercalcaemia due to primary dyslipidaemia was made. The cat was reported to be significantly improved in comfort and energy levels postoperatively and a transition to a fat-restricted diet was instituted. Eight months after xanthoma removal no recurrence was reported. Relevance and novel information To our knowledge, this is the first report of cutaneous xanthoma and associated granulomatous inflammation causing hypercalcaemia due to dyslipidaemia in a cat. Familial hypercholesterolaemia is an example of a primary condition that could cause dyslipidaemia in cats, and further studies are warranted to better describe the genetic characteristics. Xanthoma formation and the resultant granulomatous inflammation should be considered in cases of hypercalcaemia.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Cutaneous xanthoma causing hypercalcaemia in a cat

Ma¹,

Romine²,

Hardcastle³

2022

Journal of Feline Medicine and Surgery Open Reports

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“…5 One atypical idiopathic presentation has been described with more diffuse irregularly nodular yellowish regions in a normolipaemic cat. 52 These lesions produce characteristic histopathology, and diagnosis of xanthoma from skin biopsies warrants systemic evaluation (Figure 11). 5…”

Section: The Cat With Nodules And/or Nodular Swellingmentioning

confidence: 99%

Skin as a marker of general feline health: Cutaneous manifestations of systemic disease

Vogelnest

2017

Journal of Feline Medicine and Surgery

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Practical relevance: Although most skin lesions occur due to diseases primarily affecting the skin, some reflect important systemic diseases. Such lesions may relate directly to the systemic disease, or may occur due to secondary skin diseases that develop because of immunosuppression. Early recognition of skin changes as a marker of systemic disease will maximise patient outcomes. Clinical challenges: In older or clearly debilitated cats presenting with skin disease, the potential for underlying systemic disease is often readily apparent. Similarly, cats presenting with severe ulcerative or multifocal nodular skin lesions, or with concurrent signs of systemic illness, will more instinctively prompt systemic evaluation. More challenging is the cat presenting with alopecic, scaling, erythemic and/or mildly crusted skin disease, with or without pruritus; hypersensitivities and infectious dermatoses are the most common considerations, but occasionally systemic disease underlies the skin changes. Knowing when screening laboratory testing, body imaging or other systemic diagnostics are indicated is not always straightforward. Evidence base: This article reviews cutaneous presentations of systemic diseases reported in the veterinary literature, and discusses important differential diagnoses. The author draws on clinical experience, published data on disease prevalence and case evaluations, and expert opinions on approach to common systemic problems to provide guidance on when investigation for underlying systemic disease is most appropriate.

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“…A case report describes the course of a female spayed Domestic Shorthair cat that initially presented with a several years' history of pruritus, which had been diagnosed as a combination of atopic dermatitis, flea bite hypersensitivity and adverse food reaction …”

Section: Small Animalsmentioning

confidence: 99%

In this issue – November 2013

Jackson¹

2013

Aust Veterinary J

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Small animalsThe first paper this month is a retrospective look at 17 cases of cutaneous adverse food reactions in cats that were presented to a dermatology referral service. 1 Each case was confirmed by a clear worsening of the skin of the cats when they were re-challenged with normal food after completing an elimination diet. They then had to improve once the test diet was repeated. Cats typically presented with severe, perennial, non-seasonally flaring pruritus. Home-prepared elimination diets were completed by 16 cats and 8 cats had initial poor response to minimum 6-week commercial hydrolysed protein diets.The adverse foods that were identified included fish, chicken, beef, commercial dry, and some canned foods. The authors discuss the challenges of diagnosing the condition, as there had to be strict adherence to the dietary trials. They discuss the limitations of their study, including that the response was based on the owners' observations and veterinary interpretation, rather than objective measures. As many cats have other concurrent dermatoses, responses to these trials may be very difficult to unravel. The next paper looks at the haematological and biochemical profiles of 192 sighthounds including Whippet, Greyhound, Italian Greyhound, Sloughi, Saluki, Borzoi, Pharaoh Hound and Azawakh breeds. These were compared with non-breed-specific laboratory reference intervals. 2 bs_bs_banner EDITORIAL EDITORIAL

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Unique presentation of normolipaemic cutaneous xanthoma in a cat

Abstract: A diffuse, planar form of cutaneous xanthoma occurring without associated lipaemia has not been previously reported in cats.

Cited by 11 publications

References 6 publications

Cutaneous xanthoma causing hypercalcaemia in a cat

Cutaneous xanthoma causing hypercalcaemia in a cat

Skin as a marker of general feline health: Cutaneous manifestations of systemic disease

In this issue – November 2013

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