Clinical Case Challenge

Oral Mass in a Cat

History and Physical Exam:  An 11-year-old, castrated male domestic shorthair cat presented for evaluation of a rapidly growing mass along his left rostral maxilla. The owners reported that hyperemia of the mucus membranes had been noticed in that region at his annual physical exam by his local veterinarian.  The lesion progressed over the next 5 months and caused loosening of his maxillary canine and incisor teeth.  The cat also had a history of hypertrophic cardiomyopathy and hyperthyroidism.  Physical examination revealed an approximate 3.5 x 3 x 2 cm gingival mass in the left rostral maxilla displacing the lip.  Additional findings included loose teeth, blood-tinged saliva, a moderately enlarged left mandibular lymph node, a palpable thyroid slip and a grade III/VI heart murmur. Continue reading

Clinical Case Challenge

Anxious Greyhound

Greyhound with Anxiety

An 8-year-old neutered male Greyhound was evaluated at the Tufts Animal Behavior Service for intermittent episodes of extreme anxiety. The first anxiety attack occurred in late October of 2008 and lasted for 3 days. Physical examination, CBC and serum biochemistry analysis performed by the referring veterinarian were within reference limits.

The dog had no history of cardiovascular or Continue reading

Clinical Case Challenge

Cranial Mediastinal Mass in an Old Dog

History: An 11 year-old, spayed female Labrador retriever presents for polyuria and polydipsia.  The owners report mild lethargy but the dog is otherwise doing well.  Physical examination reveals body condition 4/9 but is otherwise within normal limits for a dog of this age. A complete blood count is within normal limits.  The chemistry profile reveals total calcium 15.4 mg/dl (NR,  9.4-11.8), ionized calcium 1.7 mmol/L (NR, 1.12-1.40), creatinine  2.1 mg/dl (NR, 0.6-2.0), BUN 39 mg/dl (NR, 8-30).  Urinalysis reveals dilute urine with a specific gravity of 1.008.   Thoracic radiographs are taken (Figure 1) and an ultrasound-guided fine needle aspiration is performed..

Figure 1: Lateral thoracic radiograph demonstrating cranial mediastinal mass.

What are the differential diagnoses for this lesion?

Figure 2: Cytology of cranial mediastinal mass. Green arrows point to mast cells.

What is your diagnosis?  How would you treat this dog? Continue reading