Case Study

RAD – Osteoporosis, functional ileus, bronchointerstitial lung pattern, possible nephropathy in a 14 year old MN DSH cat

This 14 year old MN DSH cat has a history of colonic obstruction from the summer of 2015; bloodwork wnl at that time. Within the last month cat has developed moderate brown ocular and oral discharge, nasal wheezing on inspiration, mild weight loss. Heart and lungs ausculted normally. Has been on azithromycin x 7 days to no effect.

Physical Exam: Thin cat, upper respiratory dyspnea. Still ambulating well and BAR. Decreased appetite recently. CBC: HCT 38%

DX

Osteoporosis (marble bone disease); generalized functional gastrointestinal ileus; mild, likely age related, bronchointerstitial lung pattern; possible nephropathy; chronic healed fractures of the last third ribs

Image Interpretation

Right lateral, left lateral and VD thorax and abdomen- The patient was thin.
There was generalized osteopetrosis of the axial skeleton and multifocal
myelosclerosis of the long bones as imaged. Chronic healed rib fractures of the last
third ribs were noted. Moreover, moderate degenerative changes were associated with
the axial skeleton.
The lungs were moderately inflated.
The course of the trachea was within normal limits. There was no mediastinal
widening.
The cardiac silhouette was small and within normal limits for shape. The caudal vena cava was thin. The pulmonary vasculature was thin.
The lungs showed a mild generalized bronchiointerstitial pattern.
The serosal detail was maintained. The gastrointestinal tract revealed moderate
generalized and even dilation with gas.
The liver and spleen were within normal limits. The kidneys were plump and mildly
irregular in shape. The urinary bladder was small

Outcome

FeLV, lymphoblastic leukemia or myeloproliferative disorder, SLE related illness,
lymphoma, C-cell tumor, and chronic renal failure have been reported as possible
underlying causes to osteopetrosis.
Note that obliteration of the nasal turbinates and nasolacrimal duct obstruction has also
has been reported in a cat with osteosclerosis/-petrosis which was associated with
inspiratory stridor and epiphora.
The rib fractures are likely to be a consequence of the underlying osteopetrosis which
is associated with decreased biomechanical compliance.
The functional gastrointestinal ileus may be an expression of the underlying disease
such as chronic nephropathy, electrolyte imbalance, lymphoma or other. Also consider
primary gastrointestinal disorder or feline dysautonomia.
Screening for the aforementioned diseases is warranted and full abdominal ultrasound
is advised.