Today's Veterinary Practice

SEP-OCT 2015

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TOday'S VeTerinary PracTice | September/October 2015 | tvpjournal.com cOnSider ThiS caSe Peer reviewed 42 Imaging radiographs of the thorax and right forelimb were performed under sedation. Thoracic radiographs revealed a solitary 2.9 cm (height) mass in the left caudal lung lobe (Figure 2). right forelimb radiographs suggested bone lysis of the P3 of digits 1 and 2. Skin Cytology Skin samples from the ulcerated areas of the nail beds were collected by scraping the surface of the skin with a scalp blade and then were stained with diff-Quik for cytologic evaluation. Bacterial rods and cocci were visualized. neutrophilic infammation and multinucleated epithelial cells were also present. Skin Pathology The skin samples were submitted to a clinical pathologist for analysis. Large clusters of neoplastic epithelial cells were noted, as well as many infammatory leukocytes, rods, and cocci. The pathologist's diagnosis was carcinoma, chronic neutrophilic infammation, and bacterial infection. The owner declined further diagnostics for the abdominal mass. DIAGNOSIS Initial Diagnosis combined with radiographic evidence, primary pulmonary carcinoma with metastasis to the digits of the right front foot and bacterial infection were tentatively diagnosed. Defnitive Diagnosis due to the presence of a mass in the lung and the lysis of the digits, the final diagnosis was primary bronchial carcinoma with metastasis to the digits, also known as lung-digit syndrome. cats with pulmonary neoplasia commonly have a history of increased lethargy, depression, anorexia, diarrhea, and vomiting. 1 Our patient showed signs of systemic disease, including anorexia, depression, digital pain, and lameness. however, of all cats with pulmonary neoplasia, only 25% to 50% present with respiratory signs over the course of their disease. 2,3 Since this patient did not show respiratory signs, he ft well into the defned clinical picture of primary metastatic bronchial adenocarcinoma. although little information is available, metastasis of a pulmonary neoplasm to the digits appears to be rare. in one report of 116 cases of feline primary pulmonary neoplasia, only one case had digital involvement. 4 Much like our patient, the most common presenting complaint for cats with metastasis to the digits is lameness and pain associated with one or more limbs. Differential Diagnosis The differential diagnosis for the skin lesions in this cat includes neoplasia, infectious paronychia (bacterial or fungal), and immune-mediated disease. 5 THERAPEUTIC OPTIONS Prognosis for cats with metastasis of primary pulmonary carcinoma to the digits is generally grave. advanced age may contribute to this shorter survival time, but treatment options are limited. a recent retrospective study of 36 cats with this condition found mean survival time to be 58 days (median, 64 days), with a range of 2 to 122 days. 4 Figure 2. This lateral radiograph shows an approximately 2.9 cm (height) soft tissue mass most likely residing in the left caudal lung lobe.

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