Hyndman Philip S, Worth Andrew J, Owen Mark C, Jack Malcolm W, Orbell Geoff M B, Bray Jonathan P
J Am Vet Med Assoc. 2019 Feb 1;254(3):393-398. doi: 10.2460/javma.254.3.393.
CASE DESCRIPTION A 13-year-old neutered male Abyssinian cat with a 4-month history of right forelimb edema and multifocal crusting lesions at the distal aspect of the antebrachium was referred to a veterinary teaching hospital for evaluation. Extensive hemorrhage from the lesions had been observed after self-grooming, and findings on histologic examination of a skin biopsy sample prior to referral were consistent with atypical dermal hemodynamics and inflammation. CLINICAL FINDINGS Diffuse pitting edema and multifocal, 3- to 4-mm-diameter sanguineous crusting lesions affecting the antebrachium were observed distal to a pulsatile subcutaneous mass in the right elbow joint region that had a palpable thrill and auscultable bruit. No systemic abnormalities were detected. TREATMENT AND OUTCOME Contrast-enhanced CT angiography with 3-D reconstruction identified an arteriovenous fistula with a large aberrant vessel coursing distally. Surgical ligation of an arterialized vein distal to the fistula without en bloc resection led to resolution of all clinical signs. The vascular anomaly was no longer patent when diagnostic imaging was repeated 5 months after surgery. CLINICAL RELEVANCE Acquired arteriovenous fistulas can lead to bleeding skin lesions affecting the antebrachium in cats. Surgical ligation of an aberrant reverse-shunting vein distal to the fistula successfully resolved clinical signs in the cat of this report and may warrant investigation as a treatment option in cats with this condition.
一只13岁已绝育的雄性阿比西尼亚猫,右前肢水肿4个月,前臂远端有多灶性结痂病变,被转诊至一家兽医教学医院进行评估。自舔后病变部位出现大量出血,转诊前皮肤活检样本的组织学检查结果与非典型真皮血流动力学和炎症相符。
在右肘关节区域可触及震颤和闻及血管杂音的搏动性皮下肿块远端,观察到弥漫性凹陷性水肿和多灶性、直径3至4毫米的血性结痂病变,累及前臂。未检测到全身异常。
对比增强CT血管造影三维重建显示存在动静脉瘘,有一条大的异常血管向远端走行。在瘘管远端对动脉化静脉进行手术结扎而未进行整块切除,所有临床症状均得到缓解。术后5个月重复诊断性成像时,血管异常不再通畅。
后天性动静脉瘘可导致猫前臂出现出血性皮肤病变。在本报告的猫中,对瘘管远端异常的逆向分流静脉进行手术结扎成功缓解了临床症状,对于患有这种疾病的猫,这可能值得作为一种治疗选择进行研究。