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Peripheral arteriovenous fistula manifesting as antebrachial dermatopathy in a cat

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  • 1 Department of Companion Animal Medicine, Atlantic Veterinary College, Charlottetown, PE C1A 4P3, Canada.
  • | 2 Institute of Veterinary, Animal, and Biomedical Sciences, Massey University, Palmerston North 4442, New Zealand.
  • | 3 NZRadVet, 588 Taonui Rd RD5, Feilding 4775, New Zealand.
  • | 4 Institute of Veterinary, Animal, and Biomedical Sciences, Massey University, Palmerston North 4442, New Zealand.
  • | 5 New Zealand Veterinary Pathology, Massey University, Palmerston North 4442, New Zealand.
  • | 6 Institute of Veterinary, Animal, and Biomedical Sciences, Massey University, Palmerston North 4442, New Zealand.

Abstract

CASE DESCRIPTION A 13-year-old neutered male Abyssinian cat with a 4-month history of right forelimb edema and multifocal crusting lesions at the distal aspect of the antebrachium was referred to a veterinary teaching hospital for evaluation. Extensive hemorrhage from the lesions had been observed after self-grooming, and findings on histologic examination of a skin biopsy sample prior to referral were consistent with atypical dermal hemodynamics and inflammation.

CLINICAL FINDINGS Diffuse pitting edema and multifocal, 3- to 4-mm-diameter sanguineous crusting lesions affecting the antebrachium were observed distal to a pulsatile subcutaneous mass in the right elbow joint region that had a palpable thrill and auscultable bruit. No systemic abnormalities were detected.

TREATMENT AND OUTCOME Contrast-enhanced CT angiography with 3-D reconstruction identified an arteriovenous fistula with a large aberrant vessel coursing distally. Surgical ligation of an arterialized vein distal to the fistula without en bloc resection led to resolution of all clinical signs. The vascular anomaly was no longer patent when diagnostic imaging was repeated 5 months after surgery.

CLINICAL RELEVANCE Acquired arteriovenous fistulas can lead to bleeding skin lesions affecting the antebrachium in cats. Surgical ligation of an aberrant reverse-shunting vein distal to the fistula successfully resolved clinical signs in the cat of this report and may warrant investigation as a treatment option in cats with this condition.

Abstract

CASE DESCRIPTION A 13-year-old neutered male Abyssinian cat with a 4-month history of right forelimb edema and multifocal crusting lesions at the distal aspect of the antebrachium was referred to a veterinary teaching hospital for evaluation. Extensive hemorrhage from the lesions had been observed after self-grooming, and findings on histologic examination of a skin biopsy sample prior to referral were consistent with atypical dermal hemodynamics and inflammation.

CLINICAL FINDINGS Diffuse pitting edema and multifocal, 3- to 4-mm-diameter sanguineous crusting lesions affecting the antebrachium were observed distal to a pulsatile subcutaneous mass in the right elbow joint region that had a palpable thrill and auscultable bruit. No systemic abnormalities were detected.

TREATMENT AND OUTCOME Contrast-enhanced CT angiography with 3-D reconstruction identified an arteriovenous fistula with a large aberrant vessel coursing distally. Surgical ligation of an arterialized vein distal to the fistula without en bloc resection led to resolution of all clinical signs. The vascular anomaly was no longer patent when diagnostic imaging was repeated 5 months after surgery.

CLINICAL RELEVANCE Acquired arteriovenous fistulas can lead to bleeding skin lesions affecting the antebrachium in cats. Surgical ligation of an aberrant reverse-shunting vein distal to the fistula successfully resolved clinical signs in the cat of this report and may warrant investigation as a treatment option in cats with this condition.

Contributor Notes

Dr. Hyndman's present address is Surgery Service, Veterinary Emergency Clinic and Referral Centre, 920 Yonge St, Ste 117, Toronto, ON M4W 2J2, Canada.

Dr. Orbell's present address is Gribbles Veterinary, 840 Tremaine Ave, Roslyn, Palmerston North 4414, New Zealand.

Dr. Bray's present address is Fitzpatrick Referrals Oncology and Soft Tissue, Guildford Hospital, 70 Priestley Rd, Guildford, GU2 7AJ, England.

Address correspondence to Dr. Hyndman (philhyndman88@gmail.com).