Clinical communication — Kliniese meededeling Cerebral cysticercosis in a cat

INTRODUCTION Cerebral cysticercosis, also known as neurocysticercosis, caused by the larval stage (metacestode) Cysticercus cellulosae of Taenia solium (Cyclophyllida: Taeniidae), has been identified as a major public health problem in African populations. T. solium has an indirect life-cycle. With the extremely rare exception (experimental infection only) of the white-handed gibbon (Hylobates (Hylobates) lar), the only final host of T. solium is man who contracts the infection by ingesting pork containing cysticerci. Heteroinfection or autoinfection of man by ingesting eggs of T. solium will lead to the development of cysticerci in nearly every organ and tissue of the body, most commonly in the subcutaneous tissues and muscles of the tongue, neck or ribs, next in the eye and then in the brain. Besides its normal intermediate host, the domestic pig, the metacestode of T. solium has been reported from a wide range of terrestrial as well as a few marine mammals. Apart from man, cases of cerebral cysticercosis have been reported in both domestic dogs and to a lesser extent in cats. Indiscriminate defaecation by humans, observed in both urban and rural areas of South Africa, exposes wandering dogs and cats to infection with C. cellulosae. This report describes the first case of C. cellulosae infection in a cat in South Africa. CASE HISTORY A 10-month-old, neutered male domestic short-hair cat was presented to Radiokop Animal Clinic in Johannesburg, South Africa, for acute onset of ataxia which resolved after flunixin (Finadyne, Schering-Plough Animal Health) at 1 mg/kg intramuscularly and enrofloxacin (Baytril 5 % injectable solution, Bayer Animal Health Division) at 5 mg/kg subcutaneously were given. Three months later the cat had a relapse starting with nausea, salivation and vomition, 6 hours after vaccination against feline rhinotracheitis, panleukopaenia, calici virus infection (Felocell CVR, Pfizer Animal Health) and rabies (Quantum R, Schering-Plough Animal Health) as well as simultaneous deworming with a combination of praziquantel and pyrantel pamoate (Drontal cat tablets, Bayer Animal Health Division) at the dose recommended by the manufacturer. The cat was treated with 1 mg atropine (Atropine 0.5 injection, Centaur) given intravenously and a combination of procaine penicillin and benzathine benzylpenicillin (Duplocillin, Intervet SA) at 26.5 mg/kg intramuscularly. The following day, fluids were administered subcutaneously as well as enrofloxacin (Baytril 5 % injectable solution, Bayer Animal Health Division) at 5 mg/kg subcutaneously as well as 0.4 mg dexamethasone (Dexa 0.2 % Phenix, Logos Agvet) subcutaneously. Convulsions started that were treated with 5 mg diazepam (Valium, Roche). The convulsions progressed to nystagmus. Routine biochemistry revealed raised alanine aminotransferase (116 U/ ), mild hypercalaemia (5.4 mmol/ ), low urea (5.4 mmol/ ), hyperalbuminaemia (41 g/ ) and hyperglycaemia (9 mmol/ ) (Table 1). The haematology results showed a slight increase in haemoglobin (14.6 g/d ), low platelet count (151 000 × 10 ) and eosinopaenia (0/ ) (Table 2). Faecal flotation as well as serological tests for feline immunodeficiency virus and feline leukaemia virus were negative. On the following day the cat was referred to Bryanston Veterinary Hospital, Johannesburg. Clinical presentation consisted of diffuse central nervous signs including collapse, convulsions, falling to the left, anisocora with unresponsive pupils, blindness, left eye more mydriatic than right, lateral and verticle nystagmus (varied with position), rigid forelimbs and hyper-reflexic hind limbs. Temperature, pulse and respiration were normal. Urine analysis revealed a specific gravity of 1.030, pH 8 and a glucose trace. The urine sediment showed some debris. A basal ammonia reading was zero. Hepatic ultrasound and fine-needle aspirate revealed mild hepatic lipidosis. Cisternal puncture did not yield any cerebrospinal fluid (CSF). Initial treatment included