5-year-old Male, Feline, British Shorthair

This case was discussed in virtual Abdominal Rounds with Donald E. Thrall DVM, PhD, DACVR in January 2021.

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History: Straining in the litter box. Not urinating for 24 hours, then lethargic. Mostly outdoors.

Imaging: Lateral and ventrodorsal radiographs of the abdomen were acquired.

Findings:

  • The urinary bladder is mildly distended. The opacity of the urinary bladder is homogeneous. There is no evidence of cystic or urethral calculi. There is no evidence of a urethral plug.
  • There is a nodular appearance to the fat stores in the retroperitoneal space, inguinal region, mesentery and subcutaneous regions.
  • There is reduced acetabular coverage of the femoral heads bilaterally and a large osteophyte on the cranial margin of the right acetabulum.

Conclusions:

  • There is no evidence of urolithiasis. This does not rule out non-mineralized calculi or soft tissue lesions of the urinary tract.  A cause of the straining was not identified.
  • There could be pain associated with posturing to urinate as a result of the coxofemoral osteoarthritis however this is not definitive.
  • The nodular appearance to the fat stores is concerning for steatitis, possibly associated with vitamin E deficiency.  Artifact associated with the image processing algorithm is not likely given the heterogeneity of the nodular appearance.

Discussion:

There is not a definitive diagnosis of pansteatitis in this patient but the similarity in appearance provides an opportunity for discussion of this uncommon syndrome. (Niza, Vilela, & Ferreira, 2003).  Pansteatitis results from inadequate Vitamin E, which is a potent antioxidant.  Inadequate Vitamin E can be due to inadequate dietary intake but overconsumption is more common.  For example, ingestion of high levels of unsaturated fatty acids, such as in oily fish species, depletes Vitamin E.  Without the antioxidant effects, unsaturated fatty acids in the lipids of cellular membranes are very vulnerable to oxidative damage, thus leading to peroxide formation.  These reactive peroxides result in fat necrosis. 

                The clinical signs of pansteatitis are vague but include fever, lethargy, inappetence, and, most notably, pain on palpation of the skin.  As mentioned above, there is not a definitive diagnosis of pansteatitis in this patient, and there was no mention of pain upon palpation, but the radiographic appearance should at least suggest the possibility of this rare condition with investigation of the diet.

References:

Niza, M., Vilela, C., & Ferreira, L. (2003). Feline pansteatitis revisited: hazards of unbalanced home-made diets. Journal of Feline Medicine and Surgery, 5, 271-277.

Photo by Kasya Shahovskaya on Unsplash

3 comments

  1. Hello , the cat is a little obese, the thoracic and extra abdominal structures are normal, the abdominal structures: he presents a very distended bladder with a fluid density (urine) and or tissue content in the cranial part with a very wide bladder neck with aeric density. the size of the kidneys is greater than 2 and a half times the L2 which pushes the colon down ventrally. differential diagnosis : -struvite lithiasis -mass at the neck of the bladder which exerts a weary mass effect on the urethra. Additional examination: ultrasound

  2. Obese cat with BCS 9/9. In the abdomen the bladder is overdistended with normal content, no evidence of radiopaque sediment or stones in the urinary tract. Fracture of the lateral transverse process of L7; irregular profile cranially to the right acetabulum consistent with displaced fracture of the ilium. Fat strain in the inguinal tissues consistent with posdinle panniculitis.

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