Case Study

Lung nodules in a 14 year old MN DSH cat

A 14-year-old MN DSH cat with recent history of a normal blood work and a biopsy procedure of a lingual mass of unknown histopathology was presented for anorexia. The patient was treated with Convenia, Cyproheptadine, and Buprenex. A few days later the patient was admitted for supportive care and monitoring due to continued anorexia, and lethargy. The patient intermittently did well while in the hospital, but never seemed to fully recover.

A 14-year-old MN DSH cat with recent history of a normal blood work and a biopsy procedure of a lingual mass of unknown histopathology was presented for anorexia. The patient was treated with Convenia, Cyproheptadine, and Buprenex. A few days later the patient was admitted for supportive care and monitoring due to continued anorexia, and lethargy. The patient intermittently did well while in the hospital, but never seemed to fully recover.

Sonographic Differential Diagnosis

This is consistent with primary lung carcinoma or inflammatory disease. Thromboembolic disease is also possible. The patient was sedated 2 days later, and fine-needle aspirates were performed.

Image Interpretation

The right cranial and left cranial lung lobes contained hypoechoic consolidations.

DX

Pyogranulomatous inflammation with intralesional yeast, suggestive of candida.

Outcome

Primary protocol with broad-spectrum antibiotics and bronchodilation was indicated. The patient was discharged with Baytril, Prednisone, Laxatone, and Cyproheptadine. The patient was also administered subcutaneous fluids. After receiving cytology results, it was recommended that the patient discontinue Prednisone, continue with Baytril, and begin Itraconazole. After several months on Itraconazole the patient sustained a traumatic attack from a dog and due to complications was humanely euthanized.

Comments

The presence of candida which is a typical saprohyte is unknown but shouldn’t be found in the lung. A potential passage form the skin during sampling is another possibility here. We just report the reality here at sonopath.com:)

Clinical Differential Diagnosis

Oral pathology – metastatic disease (liver, lung, spleen). Post-surgery pathology – renal failure, liver failure, pulmonary or cardiac dysfunction, thrombo-embolic disease secondary to procedure/anesthesia.