A 3 year old, female spayed dilute tortoiseshell cat presented on referral to the Cornell University Hospital for Animals (CUHA) on July 14, 2016, for a 2-3 week history of lethargy, decreased appetite and a right sided abdominal mass (presumptive enlarged kidney). She was found as a stray two years prior with a damaged tail that was amputated. At that time she was also diagnosed with FeLV. Six months prior to her current presentation she developed right sided facial paralysis, followed by mild uveitis, corneal ulceration, and keratoconjunctivitis sicca. Upon presentation for the current problems, on July 12, 2016 her primary care veterinarian performed a physical exam revealing that the patient had lost 1 pound, had a significantly enlarged right kidney confirmed by radiographic imaging, but was otherwise unremarkable apart from the historical OD findings. Point of care blood work revealed no significant abnormalities except for a mild increase in SDMA (20 ug/dL (0-14)) and mild decreases in albumin (2.5 g/dL (2.6-3.9)), ALT (12 U/L (27-158)) and ALP (5 U/L (12-59)). Abdominal radiographs revealed a large mass in her right cranial abdomen (presumptively an enlarged right kidney). Urinalysis collected via cystocentesis revealed a USG of 1.035, 2+ protein, a small amount of cocci, 1+ blood, and a few squamous cells. The rDVM did not provide any treatments and referred to CUHA for further evaluation.

On presentation to the CUHA Oncology service on July 14, 2016, the patient’s physical exam revealed a Grade IV/VI left systolic parasternal heart murmur, reduced facial sensation OD (historical), a painful palpable mass in the right mid abdomen and ventral abdominal hypotrichosis. Her problem list was as follows: inappetance, lethargy, painful abdominal mass, FeLV positive and a grade IV/VI left parasternal heart murmur. A CBC and blood smear was performed to evaluate cell morphology and population, there were no significant abnormalities. A repeat urinalysis was performed to evaluate kidney function and to rule out an infection, the urinalysis showed a USG of 1.023 and 2+ protein. Thoracic radiographs were clinically normal. Abdominal ultrasound revealed an asymmetrical renomegaly secondary to bilateral renal masses and the right medial iliac lymph node was moderately enlarged. Ultrasound guided fine needle aspirates of the right kidney were obtained and smears were made. Cytologic evaluation revealed large lymphocytes admixed with ruptured cells and histiocytes, and thus a diagnosis of lymphoma with reactive histiocytosis was given.

The prognosis for renal lymphoma is poor with a median survival time of 3 months; in a cat with FeLV the survival time is shorter. The patient’s owners chose to pursue palliative care treatment with prednisolone and pregabalin rather than an intensive, injectable chemotherapy protocol. As of July 21, 2016 the patient is doing well at home, although her appetite is still reduced. This presentation will focus on how renal lymphoma usually presents in cats and the association between FeLV and lymphoma.