Barnard Laura R, Leblond Guillaume, Nykamp Stephanie G, Gaitero Luis
Ontario Veterinary College Health Sciences Centre, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada.
Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada.
JFMS Open Rep. 2015 Jul 27;1(2):2055116915597239. doi: 10.1177/2055116915597239. eCollection 2015 Jul-Dec.
A 10-year-old neutered male domestic shorthair cat presented for evaluation of acute onset of paraplegia with loss of nociception and thoracolumbar spine hyperesthesia and no history of trauma. Activated partial thromboplastin time (aPTT) was markedly prolonged, and specific coagulation factor testing revealed a factor IX level of 4% of normal activity, confirming the presence of mild hemophilia B. Prior abnormal bleeding had occurred at the time of castration as a kitten, as well as with laceration to a toe. Advanced imaging, including computed tomography (CT) and magnetic resonance imaging (MRI) of the thoracolumbar spine, confirmed the presence of multifocal intradural and intramedullary spinal cord hemorrhage through demonstration of focal ring enhancement on CT and multifocal areas of signal void on gradient echo T2* images on MRI. Despite factor IX supplementation through the use of fresh frozen plasma transfusions and normalization of the aPTT time, the cat's neurological status did not improve. Owing to repeated urinary tract infections, with increasing resistance to antibiotic therapy, the cat was ultimately euthanized. Post-mortem examination showed no evidence of another underlying primary pathology for the hematomyelia.
To our knowledge, this case demonstrates the first reported occurrence of spontaneous hematomyelia secondary to hemophilia B in a cat.
一只10岁已绝育的雄性家猫前来就诊,评估急性截瘫伴痛觉丧失和胸腰椎感觉过敏,无外伤史。活化部分凝血活酶时间(aPTT)显著延长,特异性凝血因子检测显示因子IX水平为正常活性的4%,证实存在轻度乙型血友病。该猫在幼年去势时以及脚趾撕裂时曾出现过异常出血。包括胸腰椎计算机断层扫描(CT)和磁共振成像(MRI)在内的高级影像学检查,通过CT上的局灶性环形强化以及MRI梯度回波T2*图像上的多灶性信号缺失,证实存在多灶性硬膜内和脊髓内出血。尽管通过输注新鲜冰冻血浆补充因子IX且aPTT时间恢复正常,但该猫的神经状态并未改善。由于反复发生尿路感染,且对抗生素治疗的耐药性增加,该猫最终实施安乐死。尸检未发现脊髓出血性病变的其他潜在原发性病理证据。
据我们所知,该病例是首次报道的猫因乙型血友病继发自发性脊髓出血性病变。