Congenital Lobar Emphysema in a Kitten with Concomitant Hiatal Hernia and Nutritional Secondary Hyperparathyroidism

Abstract

A 2 mo old domestic shorthair kitten was presented for acute respiratory distress and severe ambulatory difficulties. Thoracic radiography revealed hyperinflation of the left cranial lung lobe and a mass with soft-tissue/gas opacity in the caudal mediastinum, leading to the suspicion of congenital lung lobe emphysema and hiatal hernia. Decreased bone radiopacity and suspected pathological fractures were also present. Complete clinicopathological analyses showed significant ionized hypocalcemia and suspicion of secondary hyperparathyroidism related to an inadequate diet. Lung lobectomy and reduction of the hiatal hernia following a median sternotomy and a cranial laparotomy were performed. IV and oral supplementation of calcium led to a full recovery and improvement in the kitten’s walking. A histopathological analysis revealed pulmonary emphysema associated with hypoplastic and irregular bronchial cartilage. Congenital lobar emphysema is a rare disease in both humans and animals. This is the first veterinary report describing a kitten affected by congenital lobar emphysema combined with a hiatal hernia and additionally complicated by secondary nutritional hyperparathyroidism with a good long-term outcome.

Developmental lung disease in a cat associated with high probability of severe pulmonary hypertension: natural history, histopathology and genetic analysis

“…This case report highlights the clinical presentation, diagnostic evaluation and natural history of a cat with a histopathological diagnosis of DLD with a high probability of severe PH. Few cases of congenital lung disorders in cats are reported [4][5][6][7] and none to date had associated PH. In cats, DLDs are likely under-recognised as extensive diagnostic investigations are needed to exclude other causes, with lung tissue ultimately required for definitive diagnosis.…”

“…[1][2][3] This condition in cats has yet to be thoroughly described and classified. [4][5][6][7] A subset of DLD in children results in the development of pulmonary hypertension (PH), which is associated with a guarded prognosis and reduced survival. [8][9][10] Genetic variants may be associated with certain diffuse DLDs in children, including genomic alterations in the gene Forkhead Box F1 (FOXF1), which is a transcription factor critical in embryonic lung development.…”

“…1–3 This condition in cats has yet to be thoroughly described and classified. 4 –7 A subset of DLD in children results in the development of pulmonary hypertension (PH), which is associated with a guarded prognosis and reduced survival. 8 –10…”