Objectives: Mycobacterium bovis , a member of the Mycobacterium tuberculosis complex, can infect cats and has proven zoonotic risks for owners. Infected cats typically present with a history of outdoor lifestyle and hunting behaviour, and cutaneous granulomas are most commonly observed. The aim of this study is to describe an outbreak of tuberculous disease commencing with six young cats, living exclusively indoors in five different households across England, being presented to separate veterinarians across the UK with a variety of clinical signs. Methods: Investigations into the pyogranulomatous lesions, lymphadenopathy and/or pulmonary disease of these cases consistently identified infection with M bovis . Infection was confirmed by PCR, where possible, or was indicated with a positive interferon-gamma release assay (IGRA), where material for PCR was unavailable. In-contact, cohabiting cats were screened by IGRA and follow-up testing was undertaken/advised where results were positive. A lifestyle investigation was undertaken to identify the source of infection. Results: Six clinically sick cats and seven in-contact cats were identified with evidence of M bovis infection. Five clinical cases were either too sick to treat or deteriorated despite therapy, giving a mortality rate of 83%. Lifestyle investigations revealed the common factors between clusters to be that affected cats had mycobacterial infections speciated to M bovis , were exclusively indoor cats and were fed a commercially available raw food product produced by a single manufacturer. The Food Standards Agency, Animal & Plant Health Agency, Public Health England and the food manufacturer concerned have been notified/informed. Other possible sources of exposure for these cats to M bovis were explored and were excluded, including wildlife contact, access to raw milk, the presence of rodent populations inside the buildings in which the cats lived and exposure to known infectious humans. Conclusions and relevance: Upon investigations, our results provide compelling, if circumstantial, evidence of an association between the commercial raw diet of these cats and their M bovis infections.

Mycobacterium (M.) bovis can infect cats and is a demonstrated zoonosis. We describe an outbreak of M. bovis in pet cats across England and Scotland associated with feeding a commercial raw food diet. Forty‐seven cats presented with (pyo)granulomatous lesions, lymphadenopathy, pulmonary and/or alimentary disease over a one‐year period where M. bovis infection was suspected or definitively diagnosed, and the cats all consumed the same specific brand of commercial raw venison pet food. Infection with M. bovis genotype 10:a was confirmed by culture and DNA typing of isolates in a small number of cases (n = 5); PCR was used in combination with or as an alternative to culture (n = 12) and/or infection with a Mycobacterium tuberculosis complex group organism was strongly suggested by positive responses to an interferon‐gamma release assay (IGRA; n = 34). Asymptomatic at‐risk cats were screened by IGRA, identifying a further 83 infected cats. The five culture‐positive cases were distributed across areas of England and Scotland at low risk of endemic bovine tuberculosis. Investigations revealed affected cats were mainly indoor‐only, and had been fed the same commercial raw food as at least part of their diet. This diet was recalled by the manufacturer due to failure of statutory meat inspection of the component venison. As far as possible, other sources of infection were explored and excluded, including wildlife contact, access to raw milk and living with people with active M. bovis infection. Four owners and one veterinary surgeon were found to have high likelihood of latent tuberculosis infection. One owner required treatment. Although it was not possible to conclusively demonstrate a zoonotic origin for these infections, neither was it possible to eliminate the possibility. Our results provide compelling evidence that the commercial raw diet of these cats was the likely route of M. bovis infection in this outbreak of cases.

Mycobacterial infections are a major concern in veterinary medicine because of the difficulty achieving an etiological diagnosis, the challenges and concerns of treatment, and the potential zoonotic risk. Mycobacterium kansasii, a slow-growing non-tuberculous mycobacteria, causes disease in both humans and animals. While infections have been well described in humans, where it may be misdiagnosed as tuberculosis, there are fewer reports in animals. Only four cases have been reported in the domestic cat. This case report describes systemic M. kansasii infection in two sibling indoor-only cats that presented two and half years apart with cutaneous disease that was found to be associated with osteolytic and pulmonary pathology. Infection with M. kansasii was confirmed in both cats by polymerase chain reaction on fine-needle aspirate of a lumbosacral soft tissue mass in one cat and on a tissue punch biopsy of a skin lesion in the other; interferon-gamma release assay inferred M. avium-complex and M. tuberculosis-complex infection in the two cats, respectively. Both patients made a full recovery following antimicrobial therapy with rifampicin, azithromycin, and pradofloxacin (plus N-acetyl cysteine in cat 2). This report highlights successful treatment of systemic M. kansasii mycobacteriosis in the cat and the challenge of accurately diagnosing this infection.

Objectives: To identify and describe histological and immunohistochemical criteria that may differentiate between skin and lymph node lesions associated with Mycobacterium (M.) bovis and M. microti in a diagnostic pathology setting.Materials and Methods: Archived skin and lymph node biopsies of tuberculous lesions were stained with haematoxylin and eosin, Ziehl‐Neelsen and Masson's Trichrome. Immunohistochemistry was performed to detect the expression of calprotectin, CD3 and Pax5. Samples were scored for histological parameters (i.e. granulomas with central necrosis versus small granulomas without central necrosis, percentage necrosis and/or multinucleated giant cells), number of acid‐fast bacilli (bacterial index) and lesion percentage of fibrosis and positive immunohistochemical staining.Results: Twenty‐two samples were examined (M. bovis n=11, M. microti n=11). When controlling for age, gender and tissue, feline M. bovis‐associated lesions more often featured large multi‐layered granulomas with central necrosis. Conversely, this presentation was infrequent in feline M. microti‐associated lesions, where small granulomas without central necrosis predominated. The presence of an outer fibrous capsule was variable in both groups, as was the bacterial index. There were no differences in intralesional expression of immunohistochemical markers.Clinical Significance: Differences in the histological appearance of skin and lymph node lesions may help to infer feline infection with either M. bovis or M. microti at an earlier stage when investigating these cases, informing clinicians of the potential zoonotic risk. Importantly, cases of tuberculosis can present with numerous acid‐fast bacilli. This implies that a high bacterial index does not infer infection with non‐zoonotic non‐tuberculous mycobacteria.

Mycobacterial infections in cats and dogs are often overlooked in veterinary practice, despite representing a significant risk to the health of both animals and people. This paper will review the most important features of companion animal mycobacteriosis, focusing on tuberculosis (TB), as it is seen commonly in cats in the UK. The underlying epidemiology of mycobacterial infections, their clinical presentations, diagnostic options and the principles of treatment are discussed, as well as the zoonotic risk these infections may pose, and the key role the veterinary nursing team can play in the care of these patients.