Faecal Occult Blood Test

Case of the Month (Emma Scurrell June 2013)

Key-Gaskell syndrome in a cat

Post-mortem examination was performed in the case of a 2-year-old male neutered cat with suspected Key-Gaskell syndrome. The cat had had bilateral mydriasis, third eyelid protrusion, decreased tear production, dry mucous membranes and megaoesophagus, the last of which had resulted in regurgitation. 

Fig 1. Ganglion within the periadrenal gland tissue. The arrows indicate necrotic ganglionic neurons.

Fig 2. Scattered throughout the ganglion are necrotic ganglionic neurons (black arrows) that appear as shrunken hypereosinophilic neurons with pyknotic or absent nuclei. The blue arrow indicates a healthy ganglion cell for comparison.  


Final Diagnosis

Autonomic ganglionic neuron necrosis and depletion


The clinical signs and histopathology are typical of feline dysautonomia, also known as Key-Gaskell syndrome. Loss of autonomic function accounts for most of the clinical signs. The cause is not known but similar to equine dysautonomia (‘grass-sickness’), a toxico-infectious aetiology is suspected. The clinical signs in cats are often acute and can include dilated pupils, protrusion of the third eyelid, dry mucous membranes, megaoesophagus, constipation, vomiting and dehydration. The histopathology in these cases reveals degeneration and loss of the ganglion cells within the peripheral autonomic ganglia, nuclei of cranial nerves and spinal cord. Dysautonomia has also been reported in dogs.

Previous Monthly Cases

Hypertensive Retinopathy January 2010
FIP in a cat - uncommon presentation February 2010
Phaeohyphomycosis    March 2010 
Scleral Rupture April 2010
Canine and feline epulides May 2010
Erythema multiforme in a labrador retreiver June 2010
Keloidal fibrosarcoma in a labrador retreiver July 2010
Cutaneous epitheliotropic lymphoma  August 2010 
Benign cutaneous histiocytoma  September 2010 
Iridociliary adenoma October 2010
Proliferative thrombovascular necrosis of the pinnae November 2010
Signet-ring cell carcinoma in the stomach of a dog December 2010
Cutaneous infiltrative lipoma in a labrador January 2011

Tonsillar squamous cell carcinoma February 2011
Canine orbital meningioma March 2011
"Lung-digit" syndrome in a cat April 2011
Hepatic amyloidosis in a cat May 2011
Haemophagocytic histiocytic sarcoma June 2011
Alternaria spp. infection in an immunocompromised dog July 2011
Ocular manifestation of lymphoma in a cat  August 2011
Kerion dermatophytosis in a Cocker spaniel September 2011
Subcuticular coenurus in a rabbit  October 2011
Optic nerve glioma in a dog November 2011
Malignant transformation of a viral papilloma in a dog  December 2011
Uveodermatological syndrome in an Akita
January 2012
Cutaneous angiostomatosis in a dog  February 2012
Transitional cell carcinoma in a dog  March 2012
Corneal inclusion cysts in a dog   April 2012
Extraskeletal osteosarcoma in a dog  May 2012
Subungual melanoma in a dog  June 2012
Retrobulbar grass seed in a dog   July 2012
Lungworm infection associated with hypercalcaemia in a dog  August 2012
Conjunctival melanoma in a dog  September 2012
Pneumocystis infection in a Cavalier King Charles Spaniel  October 2012
Fungal keratitis and secondary endophthalmitis in a horse November 2012
Myeloid leukaemia with lymph node invasion in a dog    December 2012
Cutaneous toxoplasmosis in a cat   January 2013
Glomerulonephritis in a dog  February 2013
Splenic mast cell tumour in a cat  March 2013
Laryngeal rhabdomyoma in a dog  April 2013
Mycobacterial infection in an eye May 2013

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Faecal Occult Blood Test