CASE REPORT Minimal change glomerulopathy in a cat Brianna BacklundDVM 1 * , Rachel E CiancioloVMD, DACVP 2 , Audrey K Cook BVM&S, MRCVS, DACVIM, DECVIM (CA) 1 , Fred J Clubb DVM, PhD, MS, DACLAM 3 , George E Lees DVM, MS, DACVIM 1 1 Department of Small Animal Clinical Sciences, Texas A&M College of Veterinary Medicine and Biomedical Sciences, College Station, TX, USA 2 Department of Population Health and Pathobiology, North Carolina State University College of Veterinary Medicine, Raleigh, NC, USA 3 Veterinary Pathobiology, Texas A&M College of Veterinary Medicine and Biomedical Sciences, College Station, TX, USA A 6-year-old domestic shorthair male castrated cat was evaluated for sudden onset of vomiting and anorexia. A diagnosis of hypereosinophilic syndrome (HES) was made, and the cat was treated with imatinib mesylate. The cat had an initial clinical improvement with the normalization of the peripheral eosinophil count. After approximately 8 weeks of treatment, lethargy and anorexia recurred despite the normal eosinophil count and a significant proteinuric nephropathy was identified. Treatment with imatinib was discontinued. Ultrasound guided renal biopsies exhibited histologic, ultrastructural, and immunostaining changes indicative of a minimal change glomerulopathy (MCG) which has not previously been reported in the literature in a cat. The proteinuria and HES initially improved while the cat was treated with more traditional medications; however, both the problems persisted for 30 months that the cat was followed subsequently. Previous studies demonstrating the safety and efficacy of imatinib in cats do not report any glomerular injury or significant adverse drug reactions, and the exact cause of this cat’s proteinuric nephropathy is uncertain. Nonetheless, the possibility of an adverse drug reaction causing proteinuria should be considered when initiating treatment with imatinib in a cat. Date accepted: 8 December 2010 Ó 2011 Published by Elsevier Ltd on behalf of ISFM and AAFP. A 6-year-old neutered male domestic shorthair cat was evaluated by the Feline Internal Medicine service atTexas A&M University College of Veterinary Medicine and Biomedical Sci- ences with a 2-week history ofvomiting,diarrhea, and hyporexia. He had no history of previous illness, was up-to-date with monthly flea/tick/heartworm preventatives and was a strictly indoor cat with no other cats in the household. Upon examination, the cat was bright, alert and re- sponsive, with a body weight of 5.2 kg (11.4 lbs). Tem- perature (100.2F), heart rate (162 bpm), and respiratory rate (42 breaths per min) were within normal limits. Thoracic auscultation demonstrated normal bronchovesicular sounds and a regular, synchronous heart beat with no appreciable murmurs or arrhythmias. Abdominal palpation revealed a full urinary bladder but was otherwise unremarkable. A complete blood count (CBC) indicated an eosinophilia (Table 1), but was other- wise unremarkable. Routine serum biochemical param- eters were within their reference intervals. Urinalysis showed a concentrated urine with evidence of mild pro- teinuria. Serum folate was mildly decreased at 5.1 mg/l (reference interval 10e22 mg/dl), cobalamin was within its reference interval, and feline pancreatic lipase immu- noreactivity was increased at 13.7 mg/dl (reference inter- val 2e6.8 mg/dl). Heartworm antigen and antibody tests were both negative. Abdominal ultrasound revealed an enlarged spleen (1 cm in thickness) with normal archi- tecture and parenchyma. Ultrasound guided aspirates of the liver and spleen showed a moderate and a marked eosinophilic infiltrate, respectively. Routine treatment with fenbendazole (Panacur; Inter- vet, DE) (50 mg/kg PO q 24 h for 3 days) was adminis- tered. Based on the cytologicresults,hematologic findings, and clinical signs, the cat was diagnosed with hypereosinophilic syndrome (HES) and treatment with imatinib mesylate (Gleevec; Novartis Pharmaceuti- cals, NJ) (9.6 mg/kg PO q 24 h) was initiated. The cat was re-evaluated 1 week after starting imati- nib therapy.The absolute eosinophil countwas, and he was reportedly improving in overall attitude and ap- petite. When another recheck was performed 24 days af- ter initiating imatinib therapy, the peripheral eosinophil count was normal and results of a serum biochemical profile were within the reference intervals. At home he was reportedly having intermittent hyporexia,some vomiting,and weight loss (weighing 5.0 kg (11 lbs)) *Corresponding author. E-mail: bbacklund@piepermemorial.com Journal of Feline Medicine and Surgery (2011) 13, 291e295 doi:10.1016/j.jfms.2010.12.011 1098-612X/11/040291+05 $36.00/0 Ó 2011 Published by Elsevier Ltd on behalf of ISFM and AAFP.