Concomitant multiple myeloma and probable phaeochromocytoma in a cat

Cervone, Mario

Complete ocular examination revealed inconsistent menace response and bilateral focal areas of retinal detachment, haemorrhage and oedema. On auscultation, a cardiac gallop rhythm was detected, associated with an increased respiratory rate and normal breathing sounds. Systolic arterial blood pressure (SAP) measured by the Doppler method was repeatedly high (mean 280 mmHg; three measurements performed daily on four separate days). Urinalysis (specific gravity, urinary dipstick and urinary sediment examination) revealed a urine specific gravity of 1.020, without further abnormalities. The urinary protein:creatinine ratio was 0.2. Complete blood count (CBC) and biochemistry results are summarised in Table 1 . CBC values revealed mild, non-regenerative anaemia (haematocrit 28%; reference interval [RI] 30-45%). Biochemistry revealed hyperproteinaemia (97 g/l; RI 60-80 g/l), hypoalbuminaemia (23 g/l; RI 25-39 g/l) and hyperglobulinaemia of 74 g/l. Serum protein electrophoresis revealed a spike in the gamma region (47 g/l; RI 12-32 g/l) (Figure 1a ). The appearance of this spike was suggestive of oligoclonal gammopathy. Serum agar gel immunodiffusion and immunoelectrophoresis identified the M-protein as monoclonal IgG lambda type (Figure 1b ). To rule out potential infectious causes of monoclonal gammopathy, serological testing for feline leukaemia virus and feline immunodeficiency virus (SNAP FIV/FeLV Combo Test; IDEXX Laboratories) was undertaken. This was negative, as was indirect immunofluorescence for feline coronavirus and Ehrlichia species antibodies.