I want to share the case of a feline patient that I recently had. It was presented to the clinic because of a recent cat fight, plus that it had a pre-existing mass on its foot that had recently grown considerably bigger. The cat got loose a few days before and came back all wet and covered in dirt. A big ulcerated mass with a draining tract was found on the chest once we clipped the hair. A cat with a cutaneous draining tract immediately rang a bell, and we knew it might not be just a fight wound. However, the client said that he actually witnessed the fight. Without knowing what exactly the mass on the chest was, we took chest radiographs to check for metastasis, as the foot pre-existing mass could have been anything from a granuloma to a tumor. Unfortunately, the cat had masses all over its lung field…no matter what caused it, it had to be something bad. Was it a bite wound on the chest with neoplasia on the feet and in the lung? Were those two masses related at all and how did they relate to the masses in the lung? Could the cat have contracted some infectious organism when it was outside that caused the chest mass? We were trying really hard to put everything together as the patient’s history and exam findings were taking us along different routes. We then did an impression smear of the exudates of the chest mass and were astonished by the result. There were numerous fungi, of a type that is extremely rare in our area. We started treatment immediately, however, the cat developed respiratory distress and became blind very quickly and we thought the treatment may not be able to catch up with the rapidly progressing disease. We even discussed euthanasia with the client, but we all agreed to give him more time to respond to treatment. As with many other things in life, miracles occur when you are not ready for them. The cat was much improved with several days of treatment.
Although we were excited about the improvement, we had a realistic talk with the client about how the cat may eventually succumb. Tests showed it was feline leukemia virus-positive, which is notorious for causing immunosuppression. We agreed to elect humane euthanasia if the cat’s quality of life became poor. An interesting fact about the fungal disease was that the client did mention that they had just moved from another state, where the fungus that the cat had is relatively prevalent.
Everything that can play a role played a role in this little story. Solving these problems is really like putting all the pieces of a puzzle together and you never know how important a single piece might be until the very end of the game. In addition, it’s tough but it’s such a realistic thing for us as veterinarians – we have to prepare the client for the worst in the face of a “miracle” that may be just temporary.