Yokoyama Nozomu, Kinoshita Ryohei, Ohta Hiroshi, Okada Kazuki, Shimbo Genya, Sasaoka Kazuyoshi, Nagata Noriyuki, Sasaki Noboru, Morishita Keitaro, Nakamura Kensuke, Kagawa Yumiko, Takiguchi Mitsuyoshi
Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Japan.
Veterinary Teaching Hospital, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Japan.
JFMS Open Rep. 2023 Nov 24;9(2):20551169231209917. doi: 10.1177/20551169231209917. eCollection 2023 Jul-Dec.
An 8-year-old neutered male domestic shorthair indoor cat was presented with an 8-week history of intermittent vomiting, anorexia and weight loss that had been unresponsive to supportive treatment. Abdominal ultrasound revealed plication of the small intestine and fluid accumulation proximal to the lesion, and a linear foreign body was suspected. An exploratory celiotomy showed cocoon-like encapsulation of the entire intestine. Surgical adhesiolysis and full-thickness biopsy were performed, and histopathologic examination revealed mild thickening of the visceral peritoneum with fibrin deposition, as well as mild neutrophil and lymphocyte infiltration. These findings were compatible with sclerosing encapsulating peritonitis (SEP). The cat recovered well postoperatively and was discharged the next day. Prednisolone was administered for 7 weeks to prevent recurrence of SEP. Five months after surgery, the cat was re-presented with anorexia and chronic vomiting. Based on the clinical examination findings, recurrent SEP was suspected. At the second surgery, surgical adhesiolysis was repeated and a bioresorbable hyaluronate-carboxymethylcellulose membrane was used to cover the serosal surface and thus prevent adhesion formation. Histopathologic findings of the peritoneal biopsy specimen confirmed SEP. Long-term prednisolone treatment (1 mg/kg for the first dose and 0.5 mg/kg every 48 h for maintenance) was administered postoperatively. The cat survived for more than 1239 days without recurrence.
To our knowledge, this is the first report of SEP in a cat with long-term survival. The use of a bioresorbable hyaluronate-carboxymethylcellulose membrane and long-term prednisolone treatment may have prevented short-term and long-term recurrence, respectively, in this case.
一只8岁已绝育的雄性家养短毛室内猫，出现间歇性呕吐、厌食和体重减轻8周，对支持性治疗无反应。腹部超声显示小肠折叠以及病变近端有积液，怀疑有线性异物。剖腹探查术显示整个肠道呈茧状包裹。进行了手术粘连松解和全层活检，组织病理学检查显示脏腹膜轻度增厚伴有纤维蛋白沉积，以及轻度中性粒细胞和淋巴细胞浸润。这些发现符合硬化性包裹性腹膜炎（SEP）。这只猫术后恢复良好，第二天出院。给予泼尼松龙7周以预防SEP复发。术后5个月，这只猫再次出现厌食和慢性呕吐。根据临床检查结果，怀疑SEP复发。在第二次手术中，再次进行手术粘连松解，并使用可生物吸收的透明质酸 - 羧甲基纤维素膜覆盖浆膜表面以防止粘连形成。腹膜活检标本的组织病理学结果证实为SEP。术后给予长期泼尼松龙治疗（首剂1 mg/kg，维持剂量每48小时0.5 mg/kg）。这只猫存活超过1239天且未复发。
据我们所知，这是首例猫SEP长期存活的报告。在本病例中，使用可生物吸收的透明质酸 - 羧甲基纤维素膜和长期泼尼松龙治疗可能分别预防了短期和长期复发。
