Diagnosis and management of a case of retroperitoneal eosinophilic sclerosing fibroplasia in a cat

Thieme, Maureen E; Olsen, Anastasia M; Woolcock, Andrew D; Miller, Margaret A; Simons, Micha C

Physical examination revealed tachycardia (heart rate 230 beats per min [bpm]; reference interval [RI] 160-220 bpm), tachypnea (70 breaths per min; RI 10-40 breaths/ min), body condition score 3/9 and an unkempt coat. A firm sublumbar mass was palpated in the caudodorsal abdomen, with soft stool palpated in the region cranial to the mass. No pain was elicited on abdominal palpation. The sublumbar mass was palpable on rectal examination, with no other abnormalities noted. Results of laboratory analysis of blood samples revealed a leukocytosis of 24.2 K/µl (RI 6.0-18.0 K/µl) characterized by a mature neutrophilia of 17.4 K/µl (RI 3.0-12.0 K/µl) and eosinophilia of 2.2 K/µl (RI 0.1-1.5 K/µl), and hyperproteinemia (8.5 g/dl; RI 5.5-7.1 g/dl) characterized by hyperglobulinemia (5.3 g/dl; RI 2.3-3.8 g/dl). Serum total T4 was measured and T4 concentrations were 1.6 µg/dl (RI 2.4-4.6 µg/dl), consistent with probable sick euthyroid syndrome. Histoplasma antigen enzyme immunoassay was negative. Serum protein electrophoresis revealed a polyclonal gammopathy, characterized by elevations in alpha-2 (1.2 g/dl; RI 0.4-0.9 g/dl), beta (1.0 g/dl; RI 0.3-0.9 g/dl) and gamma (2.7 g/dl; RI 0.3-2.5 g/dl) fractions.