Showing papers in "Journal of Feline Medicine and Surgery in 2011"
TL;DR: The goal of these guidelines is to provide useful information for handling cats that can lead to reduced fear and pain for the cat, Reinforced veterinarian—client—cat bond, trust and confidence, and thus better lifelong medical care for theCat.
Abstract: Background The number of pet cats is increasing in most countries, often outnumbering pet dogs, yet cats receive less veterinary care than their canine counterparts.1 Clients state the difficulty o...
168 citations
TL;DR: Comparing physiologic parameter data gathered from cats in the home environment with those gathered in a veterinary hospital environments may help practitioners recognize that physiologic abnormalities can sometimes be due to transportation or environmental stress rather than medical illness.
Abstract: Physiologic parameters such as blood pressure, rectal temperature, heart rate, and respiratory rate are an important part of the medical assessment of a patient. However, these factors can potentially be affected by stress. The purpose of this study was to compare physiologic parameter data gathered from cats in the home environment with those gathered in a veterinary hospital. Thirty healthy cats were evaluated both at home and at Colorado State University's Veterinary Medical Center. Doppler systolic blood pressure, temperature, heart rate, and respiratory rate were recorded, and the differences between the values obtained in the home and veterinary clinic environments were evaluated using the Wilcoxon sign rank test. A significant difference was found in blood pressure, heart rate, and respiratory rate between the home and veterinary hospital environments. This information may help practitioners recognize that physiologic abnormalities can sometimes be due to transportation or environmental stress rather than medical illness.
129 citations
TL;DR: Cats diagnosed with FLUTD were more often males and kept strictly indoors, when compared with a ‘reference population’, and there was a higher amount of red blood cells in the urine sediment in cats diagnosed with urethral plugs and urolithiasis, whereas cats with bacterial cystitis and urology had aHigher amount of whiteBlood cells in their sediment.
Abstract: A study was made on causes of lower urinary tract disease in cats, and to investigate whether demographic data and factors related to husbandry might influence the occurrence of a particular diagnosis. The study was a prospective, descriptive, and analytical study of primary cases of feline lower urinary tract disease (FLUTD) in Norway. Only cats sampled by cystocentesis were included in the present study. Of the 119 cats included, 28.6% were diagnosed with obstructive FLUTD. The majority of cats were diagnosed with feline idiopathic cystitis (FIC) (55.5%). Urethral plugs were the second most common diagnosis (21.0%), whereas bacterial cystitis and urolithiasis each were diagnosed in 11.8%. Nearly one-third (28.6%) of the cats diagnosed with urolithiasis had significant bacteriuria. Thus, significant bacteriuria was diagnosed in a total of 15.1% of the cats. There were no significant differences in the urine specific gravity, pH and amount of epithelial cells in the urine sediment in the different aetiological categories of FLUTD. There was a higher amount of red blood cells in the urine sediment in cats diagnosed with urethral plugs and urolithiasis, whereas cats with bacterial cystitis and urolithiasis had a higher amount of white blood cells in their sediment. Regarding demographic data and factors related to husbandry, cats diagnosed with FLUTD were more often males and kept strictly indoors, when compared with a 'reference population'.
98 citations
TL;DR: Cats with recurrence had significantly lower urine pH at presentation, and Ionised calcium was significantly higher in survivors compared to non-survivors, and the prevalence of hypocalcaemia was lower.
Abstract: Feline lower urinary tract diseases in general, and urethral obstruction (UO) in particular, are common clinical conditions in cats. The aims of this study were to identify risk factors for UO, to characterise clinical and clinicopathological signs, outcome and recurrence, as well as risk factors for mortality and recurrence. Eighty-two cats with UO were compared to 82 sex and time matched controls. The mean age of cats with UO was significantly lower compared to controls, while the mean body weight was higher. The proportion of indoors–outdoors cats was significantly lower in the study group compared to the control group, and the proportion of cats consuming only dry food was higher. Overall mortality was 8.5%. Ionised calcium was significantly higher in survivors compared to non-survivors, and the prevalence of hypocalcaemia was lower. Recurrence in 6 months and 2 years were 22% and 24%, respectively. Cats with recurrence had significantly lower urine pH at presentation.
93 citations
TL;DR: It is concluded that MSC could be transferred safely by ultrasound-guided intrarenal injection in cats, but that alternative sources and routes of MSC therapy should be investigated.
Abstract: The feasibility of autologous intrarenal mesenchymal stem cell (MSC) therapy in cats with chronic kidney disease (CKD) was investigated. Six cats (two healthy, four with CKD) received a single unilateral intrarenal injection of autologous bone marrow-derived or adipose tissue-derived MSC (bmMSC or aMSC) via ultrasound guidance. Minimum database and glomerular filtration rate (GFR) via nuclear scintigraphy were determined pre-injection, at 7 days and at 30 days post-injection. Intrarenal injection did not induce immediate or long-term adverse effects. Two cats with CKD that received aMSC experienced modest improvement in GFR and a mild decrease in serum creatinine concentration. Despite the possible benefits of intrarenal MSC injections for CKD cats, the number of sedations and interventions required to implement this approach would likely preclude widespread clinical application. We concluded that MSC could be transferred safely by ultrasound-guided intrarenal injection in cats, but that alternative sources and routes of MSC therapy should be investigated.
89 citations
TL;DR: Results suggest that a long-term maintenance dose of 0.02 mg/kg of meloxicam can be safely administered to cats older than 7 years even if they have CKD, provided their overall clinical status is stable, and may slow the progression of renal disease in some cats suffering from both CKD and DJD.
Abstract: Medical records (2005-2009) of a feline-only practice were searched for cats with degenerative joint disease (DJD) treated using meloxicam. DJD was diagnosed by the presence of at least two of the following: (i) altered mobility (observed by the owner), (ii) abnormal physical findings, (iii) characteristic radiographic changes. The primary study cohort consisted of cats older than 7 years that had received meloxicam for variable intervals in excess of 6 months, and for which complete records were available. These cats were subdivided according to whether detectable chronic kidney disease (CKD) was present ('renal group'), or not ('non-renal group'), and, for the 'renal group', according to the cat's IRIS category. Serum biochemistry, urinalysis (including urine specific gravity [USG]), body mass and condition score were monitored regularly. Progression of CKD in the 'renal group' and 'non-renal group' of cats was compared to two groups of age- and IRIS-matched control cats not receiving meloxicam (from the same clinic, over the same time period). The study was thus a case-control design, with two study groups. Thirty-eight cats with DJD receiving long-term meloxicam therapy met the inclusion criteria. Of these, 22 cats had stable CKD at the start of treatment (stage 1, eight cats; stage 2, 13 cats; stage 3, one cat). No cats initially had an elevated urinary protein to creatinine ratio. The remaining 16 cats initially had normal renal analytes and adequately concentrated urine. The median age of the 'renal' and 'non-renal' meloxicam groups was 15.5 and 13.4 years, respectively. The median treatment duration was 467 days in the 'renal group' and 327 days in the 'non-renal group'. After titration (to the lowest effective dose), the median maintenance dose was 0.02 mg/kg/day in both groups (range 0.015-0.033 mg/kg/day). There was no difference in sequential serum creatinine concentration or USG measurements between the 'non-renal group' treated with meloxicam compared to control cats not treated with meloxicam. There was less progression of renal disease in the 'renal group' treated with meloxicam compared to the age- and IRIS-matched cats with CKD not given meloxicam. These results suggest that a long-term maintenance dose of 0.02 mg/kg of meloxicam can be safely administered to cats older than 7 years even if they have CKD, provided their overall clinical status is stable. Long-term meloxicam therapy may slow the progression of renal disease in some cats suffering from both CKD and DJD. Prospective studies are required to confirm these findings.
83 citations
TL;DR: Investigation of feline mycobacterial disease from cats with cutaneous lesions or masses found at exploratory laparotomy shows that knowing the cat's geographic location can be helpful, while the nature of the clinical presentation is less useful.
Abstract: This study investigated 339 cases of feline mycobacterial disease from cats with cutaneous lesions or masses found at exploratory laparotomy. Tissue samples were submitted to the Veterinary Laboratories Agency for mycobacterial culture over a 4-year period to December 2008. The study assessed which species of culturable mycobacteria were involved, where the cats lived, and their clinical presentation (physical findings, serum biochemistry, radiography, feline leukaemia virus and feline immunodeficiency virus status). Mycobacterium microti was cultured from 19%, Mycobacterium bovis 15%, Mycobacterium avium 7%, non-M avium non-tuberculous mycobacteria 6%, with no growth in 53% of samples. M microti, M bovis and M avium were found in almost mutually exclusive clusters within Great Britain (GB) (ie, M bovis in South-West England/Wales/Welsh Border, M avium in eastern England and M microti south of London and in South-West Scotland). While differences were seen in the clinical presentation and distribution of lesions caused by the different infections, these were not sufficiently different to be diagnostic. Cats commonly presented with single or multiple cutaneous lesions (74%), which were sometimes ulcerated or discharging, located most frequently on the head (54%). Lymph nodes were usually involved (47%); typically the submandibular nodes. Systemic or pulmonary signs were rarely seen (10–16%). When a cat is suspected of having mycobacteriosis, accurate identification of the species involved helps to determine appropriate action. Our findings show that knowing the cat’s geographic location can be helpful, while the nature of the clinical presentation is less useful. Most cases of feline mycobacterial disease in GB are cutaneous.
79 citations
TL;DR: It is suggested that urethral plugs might be an important cause or contributing factor of obstruction in FIC, which seems to occur mainly in susceptible cats in combination with a deficient environment.
Abstract: Feline idiopathic cystitis (FIC) is the most common cause of feline lower urinary tract disease (FLUTD). This retrospective, case-controlled study evaluated possible risk factors associated with FIC and compared different clinical presentations in 64 cats with FIC. Several risk factors known to be involved in FLUTD were identified as playing a role in FIC. Of the stressful situations considered, most did not occur with increased frequency in cats with FIC compared to controls, except for a house move. The presence of pyuria, haematuria and an increased urine protein:creatinine ratio were significantly higher in obstructed males compared with non-obstructed males. An obstruction was significantly more likely in cats with struvite crystalluria compared with cats without struvite crystalluria. These findings suggest that urethral plugs might be an important cause or contributing factor of obstruction in FIC. Episodes of FIC seem to occur mainly in susceptible cats in combination with a deficient environment.
78 citations
TL;DR: Daily oromucosal treatment with 0.1 MU of rFeIFN-ω was associated with a significant improvement of clinical lesions (caudal stomatitis and alveolar/buccal mucositis) and a decrease of pain scores from D0 to D90, although no such statistical improvement was noticed in the prednisolone group.
Abstract: Chronic caudal stomatitis with alveolar/buccal mucositis in calicivirus-positive cats is the most severe presentation of feline chronic gingivostomatitis. Refractory cases are helped by antibiotic and anti-inflammatory treatments often including glucocorticoids. In order to evaluate the comparative efficacy of oromucosal administration of recombinant feline interferon omega (rFeIFN-ω) versus oral administration of glucocorticoids, a randomised, multi-centre, controlled, double-blind study was performed in 39 cats. The progression of behavioural, clinical and lesional scores was assessed over 90 days. Daily oromucosal treatment with 0.1 MU of rFeIFN-ω was associated with a significant improvement of clinical lesions (caudal stomatitis and alveolar/buccal mucositis) and a decrease of pain scores from D0 to D90. Although no such statistical improvement was noticed in the prednisolone group, there was, however, no significant difference between the two groups for most of the parameters, except pain at D60 and D90.
72 citations
TL;DR: Treating FHV-1 ocular disease with a wide range of antiviral treatments requires good clinical judgement, with assessment of factors such as severity and stage of clinical disease, patient and owner compliance, and financial considerations.
Abstract: Practical relevance Feline herpesvirus-1 (FHV-1) is a major cause of feline morbidity. Following exposure to the virus, virtually all cats become persistently infected and many of these will develop recrudescent disease on one or more occasions during their lifetime. Acute ocular herpetic disease manifests as conjunctivitis, corneal ulceration and keratitis, and can be severe and painful. Repeated bouts of recrudescent ocular disease can lead to progressive corneal pathology that can be ultimately blinding in affected cats. Global importance FHV-1 has a worldwide distribution, with reported exposure rates in some cat populations of up to 97%. As such it is a significant cause of clinical disease in the global cat population. Patient group Young and adolescent cats are most at risk of acute primary disease, and the vast majority of these will become persistently infected. Around half of all persistently infected cats will shed virus at some stage in their life and these may develop recrudescent ocular disease. Clinical challenges Treatment of FHV-1 ocular disease is challenging. Antiviral medications may be expensive, and require good owner and patient compliance. Clinical responses in patients can be variable. Selecting the appropriate therapeutic approach requires good clinical judgement, with assessment of factors such as severity and stage of clinical disease, patient and owner compliance, and financial considerations. Evidence base Although a wide range of antiviral treatments is available, few have been tested in controlled clinical trials. Therapeutic decisions are, therefore, often based on results of in vitro studies, case-based reports and anecdote. Large, masked, controlled clinical trials are required in order to determine the efficacy of the antiviral drugs currently available to treat FHV-1.
69 citations
TL;DR: The optimal age for neutering, traditionally deemed to be between 5 and 8 months, is now questioned, as short- and longer-term studies demonstrate no significant behavioural and physical advantages conferred by traditional-age neutering.
Abstract: Practical relevance Neutering kittens at an early age, typically between 6 and 14 weeks, has received increasing attention and gained prominence in recent years, particularly in the United States and in shelter medicine in the UK However, in private practice it has yet to be generally endorsed Global importance Among many of the animal welfare charities, early neutering is seen as a crucial step in conquering and controlling cat overpopulation Clinical challenges Physiological differences between kittens and adult cats are very important to consider before undertaking elective early neutering Increased sensitivity to drugs, prolongation of effects and a limited capacity for cardiovascular compensation are the principal anaesthetic concerns in kittens Evidence base The optimal age for neutering, traditionally deemed to be between 5 and 8 months, is now questioned, as short- and longer-term studies demonstrate no significant behavioural and physical advantages conferred by traditional-age neutering Furthermore, a number of safe anaesthetic and surgical protocols have been documented that produce lower morbidity and similar mortality rates in early-age neuters compared with traditional-age neuters
TL;DR: It is concluded that cholangitis is not a common cause of feline mortality and results suggest that liver enzyme activity may not predict degree of inflammation, highlighting the need to obtain biopsy samples from multiple sites.
Abstract: Forty-four cats diagnosed with moderate to severe cholangitis at necropsy are described The population comprised 086% of all feline necropsies performed during the 22-year study period Liver specimens were classified as acute neutrophilic cholangitis (ANC), chronic neutrophilic cholangitis (CNC), lymphocytic cholangitis (LC) or chronic cholangitis associated with liver fluke infestation (CC) based on the World Small Animal Veterinary Association (WSAVA) classification scheme ANC (seven) and CNC (33) comprised the majority of cases In contrast to previous descriptions, overlap was seen in clinical findings between ANC and CNC subtypes Results suggest that liver enzyme activity may not predict degree of inflammation Severity of inflammation varied between liver sections in individual cats, underscoring the need to obtain biopsy samples from multiple sites Inflammatory bowel disease (50%), pancreatitis (60%), or both (32%) commonly accompanied cholagitis We conclude that cholangitis is not a common cause of feline mortality Most cats that succumb to cholangitis have ANC or CNC, and concurrent disease contributes to death in many
TL;DR: Erythrocyte-stimulating agents (ESAs) have been developed to counteract the effects of decreased erythropoietin production by the kidneys, and have 83% similarity in amino acid sequence to the feline hormone.
Abstract: Patient group It is estimated that 15–30% of geriatric cats will develop chronic kidney disease (CKD), and that 30–65% of these cats will develop anemia as their renal disease worsens. Anemia of renal disease is multifactorial in its pathogenesis, but the main cause is reduced production of erythropoietin, a renal hormone that controls the bone marrow's production of red blood cells, as kidney disease progresses.Practical relevance It is important to recognize the presence of anemia of renal disease so that adequate treatment may be instituted to improve quality of life and metabolic function. Erythrocyte-stimulating agents (ESAs), such as epoetin alfa, epoetin beta and darbepoetin alfa, have been developed to counteract the effects of decreased erythropoietin production by the kidneys. These treatments, which are the focus of this review, have 83% similarity in amino acid sequence to the feline hormone. On average, the target packed cell volume (>25%) is reached within 3–4 weeks of ESA therapy.Clinical c...
TL;DR: In this paper, the authors discuss the importance of early diagnosis and treatment of systemic hypertension in the feline population and discuss the relationship that systemic hypertension may have with proteinuria and the progression of kidney disease.
Abstract: Practical relevance The increased availability of indirect blood pressure monitoring devices in clinical practice over the past decade has highlighted the significance of systemic hypertension in the feline population. Without routine monitoring and appropriate intervention, cats with undiagnosed systemic hypertension may first be presented with sudden-onset blindness as a consequence of either hyphaema or retinal detachment. Clinical challenges The primary aim in the early diagnosis and treatment of systemic hypertension is prevention of hypertensive target organ damage (with respect to the eye, kidney, cardiovascular and central nervous systems, in particular). A prerequisite is a knowledge of the pathophysiological mechanisms and disease conditions that may contribute to the development of hypertension. This allows the clinician to determine those cases in which blood pressure assessment and longitudinal monitoring is essential and can assist in determining appropriate therapeutic strategies for control of blood pressure. Recent studies have also begun to explore the relationship that systemic hypertension may have with proteinuria and the progression of kidney disease. Patient group The geriatric cat appears most susceptible to the development of systemic hypertension, and monitoring of systolic blood pressure is often advocated as part of a routine health screen in cats over 9–12 years old. Consideration must also be given to cats suspected of having an underlying disease such as chronic kidney disease or hyperthyroidism, or which are receiving therapeutic agents, irrespective of their age. Evidence base Much of our understanding of the pathogenesis of feline hypertension is extrapolated from studies performed in experimental animal models or in human patients, and interspecies differences are often poorly understood.
TL;DR: It is concluded that an acute cluster of complex partial seizures with orofacial involvement are often associated with HN and that HN is not necessarily a fatal condition, and that euthanasia should be avoided in the acute phase of the signs.
Abstract: Seventeen cats were presented with acute onset of complex partial seizures with orofacial involvement (salivation, facial twitching, lip smacking, chewing, licking or swallowing), motor arrest (motionless starring) and behavioural changes. In 11 cats hippocampal necrosis (HN) was confirmed by histopathology. In a further six cats hippocampal changes were suggested by magnetic resonance imaging. The mean monitoring time of eight cats which were not euthanased in the acute phase of the disease, was 408 days (60–908): four cats are still alive. In all surviving cases, the owners reported a good quality of life. We conclude that an acute cluster of complex partial seizures with orofacial involvement are often associated with HN and that HN is not necessarily a fatal condition. Supportive and antiepileptic therapy can result in remission. The long-term outcome can be good to excellent; therefore, euthanasia should be avoided in the acute phase of the signs.
TL;DR: These guidelines provide criteria with which to evaluate the animal and the diet, as well as key feeding and environmental factors, so that a plan for optimizing the animal's nutritional status can be instituted.
Abstract: Objectives Careful assessment of the nutritional needs of cats and dogs must be taken into consideration in order to maintain optimum health, be part of a treatment regimen for a diseased state, or to maximize the quality of life in all animals. The goal of these World Small Animal Veterinary Association (WSAVA) Guidelines is that a nutritional assessment and specific nutritional recommendation is made for every patient on every visit. This will become known as the 5th Vital Assessment (5VA), following the four vital assessments of temperature, pulse, respiration and pain that are already addressed on each patient interaction. Evaluation of nutritional status A brief screening evaluation of nutritional status can be routinely and seamlessly performed during the history-taking and physical examination of every patient. Nutrition-related risk factors that can be easily identified from the history and physical examination include age (growing or old), suboptimal body condition score (overweight or thin), muscle loss, atypical or homemade diet, medical conditions or changes in appetite. An extended evaluation would follow if one or more risk factors is identified on screening. These guidelines provide criteria with which to evaluate the animal and the diet, as well as key feeding and environmental factors. In addition, recommendations for interpretation, analysis and action are included so that a plan for optimizing the animal's nutritional status can be instituted. Team approach Client compliance with nutritional recommendations requires input from the veterinarian, veterinary technicians/nurses and hospital staff. A team approach to continuous nutritional education, implementation of appropriate protocols, and focused client communication, utilizing these WSAVA Nutritional Assessment Guidelines, is key to reaching this 5VA goal.
TL;DR: Over a 3.5-year period, fecal samples from 1322 cats from two shelters and affiliated foster homes in upstate New York were processed for parasite detection, and 18 different parasites ranging in prevalence from 0.2% to 21% were recovered.
Abstract: Over a 3.5-year period, fecal samples from 1322 cats from two shelters and affiliated foster homes in upstate New York were processed for parasite detection by both 1.18 spg zinc sulfate and 1.3 spg sugar double centrifugal flotation. In 50.9% of the samples at least one parasite was detected. Overall, 18 different parasites ranging in prevalence from 0.2% to 21% were recovered. The most prevalent parasites of foster and shelter cats in this study were Cystoisospora species and Toxocara cati (21% prevalence, each). In order of percentage of positive samples, other findings were: Giardia species (8.9%), Aelurostrongylus abstrusus (6.2%), taeniid eggs (3.9%), Cryptosporidium species (3.8%), Aonchotheca species (3.7%), Eucoleus species (2.3%), Ancylostoma species (2.2%), Cheyletiella species (2.0%), Dipylidium caninum (1.1%), Otodectes species, Toxoplasma-like oocysts and Sarcocystis species (0.8% each), Demodex and Spirometra species (0.4% each), and Alaria species and Felicola subrostratus (0.2% each).
TL;DR: Feline systemic hypertension is most commonly a complication of renal disease and hyperthyroidism, both diseases of older feline patients, and the probability of having at least one of these two diseases is high.
Abstract: Practical relevance The clinical importance of feline hypertension has been recognised for many years and most feline practitioners are quite familiar with this syndrome. Once systemic hypertension is identified, long-term management of the patient is needed to avoid catastrophic (eg, blindness due to retinal detachment) or subtle (eg, accelerated renal damage) target organ damage. Patient group Feline systemic hypertension is most commonly a complication of renal disease and hyperthyroidism, both diseases of older feline patients. By 15 years of age, the probability of having at least one of these two diseases is high. As well cared for cats are living longer, optimal long-term management of feline hypertension in patients with concurrent diseases is an issue of clinical importance. Clinical challenges Obtaining accurate blood pressure measurements in patients that are anxious, fractious or just plain uncooperative remains a significant issue in feline medicine, as does confident analysis of results from these patients. Diagnostics Careful measurement of systolic blood pressure using Doppler or oscillometric techniques in conjunction with evaluation for evidence of hypertensive choroidopathy (funduscopic examination) and hypertensive cardiac changes (thoracic auscultation) are essential to the diagnosis of systemic hypertension in cats. Other diagnostic techniques, including evaluation of renal and thyroid function, are needed to detect the underlying disease condition. Evidence base Numerous well-designed clinical studies have greatly advanced our understanding of the most appropriate methods of diagnosis and therapy of feline hypertension.
TL;DR: Clinical guidance aimed at all veterinarians in feline or small animal practice who either currently practise transfusion medicine or plan to do so is provided.
Abstract: Practical relevance Blood transfusions are a potentially life-saving procedure that are within the reach of most small animal practitioners. Only minimal equipment is required.Patient group Any cat with clinical signs attributable to a reduced red blood cell mass that is affecting oxygen transport (as a result of reduced packed cell volume or acute blood loss) is a potential candidate for a transfusion.Clinical challenges Although the principles of transfusion medicine are not complicated, there can be fatal consequences if certain steps are omitted.Diagnostics Blood typing kits and blood filters are readily available from veterinary wholesalers, laboratories and blood banking services.Evidence base Over the past three decades, a substantial body of clinical research and reports has built up covering feline blood types and transfusion medicine. This article draws on that research to provide clinical guidance aimed at all veterinarians in feline or small animal practice who either currently practise transf...
TL;DR: The packed cell volume, bilirubin, AST, potassium, and sodium levels were established to predict disease staging and survival time and indicate that the cat can survive for at least 2 weeks, less than 2 weeks and less than 3 days, respectively.
Abstract: Fifty-one cats histopathologically confirmed to have been naturally infected by feline infectious peritonitis (FIP), were collected to analyse the clinical and laboratory findings and to characterise disease staging. Effusive FIP was found in 33 cats, non-effusive FIP in 12 cats, and mixed-type in six cats. Highly significant decreases in haematocrit and albumin levels and an increase in total bilirubin level were noted in both effusive and non-effusive FIP, at first presentation and before death. In serial blood examinations of the effusive group, anaemia and increases in bilirubin and aspartate aminotransferase (AST) were observed from 2 weeks to 0-3 days before death. The packed cell volume, bilirubin, AST, potassium, and sodium levels were established to predict disease staging and survival time. Cumulative points ranging from 0 to 4, 5 to 11 and excess of 12, indicate that the cat can survive for at least 2 weeks, less than 2 weeks and less than 3 days, respectively.
TL;DR: This review draws on recent literature relating to epidemiology, CNS involvement and advanced diagnostic imaging to update clinicians regarding research findings relevant to clinical practice.
Abstract: Disease summary Cryptococcosis, principally caused by Cryptococcus neoformans and Cryptococcus gattii, is the most common systemic mycosis of cats worldwide. Cats may be infected following inhalation of spores from the environment, with the nasal cavity suspected as being the initial site of colonization and subsequent infection. Other sites of infection in cats are the skin, lungs, lymph nodes, central nervous system (CNS), eyes and, occasionally, periarticular connective tissue. Cryptococcosis can be diagnosed using serology (antigen testing), cytologic examination of smears, histopathology or culture. Treatment of localized disease is generally successful using azole antifungal drugs; however, cats with CNS involvement or disseminated disease require additional treatment with amphotericin B, with or without flucytosine. The prognosis is variable, depending on host and pathogen factors. Some cats require long-term (>1 year) treatment or indefinite therapy. Patient group Cats of any breed, gender and age may be affected. Retroviral status does not appear to be a risk factor for developing cryptococcosis and indoor cats are not protected from disease. Global importance Feline cryptococcosis occurs worldwide, but is most frequently reported in Australia, western Canada and the western United States. Species and molecular type vary in different geographical regions and may affect clinical presentation and antifungal susceptibility patterns. Clinical challenges Serologic tests that detect cryptococcal antigen in serum are sensitive and specific, but false negatives can occur in cats with localized disease. Long-term drug therapy can be expensive and has the potential for toxicity. The extent to which the pathogenicity and antifungal susceptibility is affected by molecular type is currently under study. Evidence base This review draws on recent literature relating to epidemiology, CNS involvement and advanced diagnostic imaging to update clinicians regarding research findings relevant to clinical practice.
TL;DR: The review begins by discussing initial triage and neurological examination, and then focuses, in turn, on assessment and management of the ‘tail pull’ injury, the diagnosis andmanagement of urinary tract rupture, and the approach to managing specific pelvic fractures.
Abstract: Practical relevance Cats commonly present with pelvic trauma following road traffic accidents (RTAs). A logical step-wise approach to diagnostics and subsequent management can significantly improve...
TL;DR: A substantial body of literature is reviewed to provide information on many of the reported bacterial, parasitic, fungal and viral pathogens, including some that occur in Asia, with evidence-based comments when there is a deviation from routine recommendations.
Abstract: Practical relevance Lower respiratory tract infections (LRTIs) in cats can be due to bacteria, parasites, fungi and viruses. This review details the practical investigation of these infections and highlights specific therapy where possible. The aim is to avoid the all-too-frequent temptation in practice to treat cats with lower respiratory tract signs empirically for feline bronchial disease (FBD)/asthma. This is potentially hazardous as immunosuppressive therapy for FBD/asthma could exacerbate disease due to a LRTI. Empirical treatment of suspected LRTI is also difficult to recommend given the wide range of potential pathogens. Clinical challenges Making a clinical ante-mortem diagnosis of LRTI in a cat can be challenging. Consistent historical, clinical, haematological and radiographic abnormalities are often lacking and findings may be non-specific. Astute clinical acumen, thorough investigation and high quality laboratory analysis are usually required for a diagnosis. Bronchoalveolar lavage, if feasible, and tests for lungworm should be routine in cats with lower respiratory tract signs. Lung fine needle aspiration may be useful in cases of diffuse or nodular pulmonary disease. Histopathology is rarely employed in ante-mortem investigations. Evidence base The authors have reviewed a substantial body of literature to provide information on many of the reported bacterial, parasitic, fungal and viral pathogens, including some that occur in Asia. Attention has been given to specific therapy for each pathogen, with evidence-based comments when there is a deviation from routine recommendations.
TL;DR: Its practicality, low cost and sensitivity validate cytopathology as a safe technique for the presumptive diagnosis of sporotrichosis in cats.
Abstract: Sporotrichosis is caused by Sporothrix schenckii. The cat is the animal species most affected by this mycosis and plays an important role in the zoonotic transmission of this disease. The definitive diagnosis is made by isolation of the fungus in culture; however, cytopathological examination is frequently used in cats. Medical records from cats treated at Instituto de Pesquisa Clinica Evandro Chagas/Fiocruz, Rio de Janeiro, Brazil, between 2004 and 2006 were reviewed. Criteria for inclusion were a diagnosis by isolation of S schenckii in culture and cytopathological examination of the same lesion as that used for collection of the culture material. Eight hundred and six cats were included in the study. Yeast-like structures suggestive of S schenckii were observed in 636 cases. The sensitivity of the method was 78.9%. Its practicality, low cost and sensitivity validate cytopathology as a safe technique for the presumptive diagnosis of sporotrichosis in cats.
TL;DR: Limited evidence-based studies are published regarding management of feline upper and lower urinary tract CaOx stone disease, making this a difficult condition to manage in some cats.
Abstract: Practical relevance Calcium oxalate (CaOx) containing stones are among the most common of the urinary tract stones identified in cats.Risk factors Risk factors for CaOx stone formation include such things as breed, gender and diet; stress and obesity have also been hypothesized to be risk factors for this disease.Management approach A tailored, individual management strategy for preventing CaOx stone recurrence is important and should include addressing the diet, environment and any other comorbid conditions present. Increasing the cat's moisture intake is one of the key mechanisms for preventing recurrence.Clinical challenges CaOx ureterolithiasis has emerged as a difficult and sometimes life-threatening problem for cats. In those cats where stones are found incidentally, periodic monitoring may be required to assess for disease progression. Interventional procedures such as ureteral stent placements are now increasingly being performed for recurrent cases or those with larger stone burdens. Periodic rad...
TL;DR: The prevalence of FeLV viraemia in cats with lymphoma was 20.8%.
Abstract: In the past, feline leukaemia virus (FeLV) infection, and also latent FeLV infection, were commonly associated with lymphoma and leukaemia. In this study, the prevalence of FeLV provirus in tumour tissue and bone marrow in FeLV antigen-negative cats with these tumours was assessed. Seventy-seven diseased cats were surveyed (61 antigen-negative, 16 antigen-positive). Blood, bone marrow, and tumour samples were investigated by two polymerase chain reaction (PCR) assays detecting deoxyribonucleic acid (DNA) sequences of the long terminal repeats (LTR) and the envelope (env) region of the FeLV genome. Immunohistochemistry (IHC) was performed in bone marrow and tumour tissue. None of the antigen-negative cats with lymphoma was detectably infected with latent FeLV. The prevalence of FeLV viraemia in cats with lymphoma was 20.8%. This suggests that causes other than FeLV play a role in tumourgenesis, and that latent FeLV infection is unlikely to be responsible for most feline lymphomas and leukaemias.
TL;DR: The physiology of aldosterone production and the pathophysiology of primary hyperaldosteronism is reviewed, and the currently available literature on the feline disease is summarised.
Abstract: Practical relevance Primary hyperaldosteronism is probably the most common adrenocortical disorder in cats. As in humans, it is often unrecognised, which excludes a potentially large number of cats from appropriate treatment. Patient group Affected cats present at a median age of 13 years (range 5–20 years). A breed or sex predilection has not been documented. The excessive secretion of mineralocorticoids usually leads to hypokalaemia and/or systemic arterial hypertension. Most affected cats present with muscular weakness and/or ocular signs of arterial hypertension. Diagnostics In any cat presenting with hypokalaemia and/or arterial hypertension, other potential causes should be excluded. The ratio of plasma aldosterone concentration to plasma renin activity (aldosterone:renin ratio) is currently the best screening test for feline primary hyperaldosteronism. Diagnostic imaging is required to differentiate between adrenocortical neoplasia and bilateral hyperplasia, and to detect any distant metastases. Clinical challenges The differentiation between adrenocortical neoplasia and bilateral hyperplasia is imperative for planning optimal therapy, but the limited sensitivity of diagnostic imaging may occasionally pose a problem. For confirmed unilateral primary hyperaldosteronism, unilateral adrenalectomy is the treatment of choice, and offers an excellent prognosis, but potentially fatal intra- and postoperative haemorrhage is a reported complication and risk factors have yet to be identified. Evidence base Only a few case reports are available on which to base the optimal diagnostic and therapeutic approach to feline primary hyperaldosteronism. This article reviews the physiology of aldosterone production and the pathophysiology of primary hyperaldosteronism, and summarises the currently available literature on the feline disease. Practical suggestions are given for the diagnostic investigation of cats with suspected primary hyperaldosteronism.
TL;DR: The study confirmed that histopathology and the presence of AFB are useful tools in the recognition of mycobacterial infection, but did little to help determine the species ofMycobacteria involved.
Abstract: This study investigated 339 cases of feline mycobacterial infection, with histopathology findings from 225 cases, and treatment and outcome information from 184 cases. Tissue samples from cats with cutaneous lesions or suspicious masses at exploratory laparotomy were submitted to the Veterinary Laboratories Agency for mycobacterial culture over a 4-year period to December 2008. The study reviewed the files for information about histopathology, treatment and outcome, and blindly reviewed histopathological changes (including staining for acid-fast bacteria [AFB]) in a sub-set of 45 cases. When a cat is suspected of having a mycobacterial infection, accurate identification of the species involved helps to determine possible treatment options and prognosis. The study confirmed that histopathology and the presence of AFB are useful tools in the recognition of mycobacterial infection. Unfortunately, they did little to help determine the species of mycobacteria involved. The study identified a group of cats that were negative for AFB at the primary laboratory, but from which mycobacteria could be cultured; commonly Mycobacterium bovis or Mycobacterium microti. The study also identified a group of cats which where culture negative, despite typical signs of mycobacterial infection and positive AFB staining. Many cases responded favourably to treatment (56% of the cases where information was available), and many cats gained complete remission (42%). However, relapses were common (64%) and often followed by pulmonary and/or systemic spread that may have resulted from treatment with short courses of single drugs. This study shows that the diagnosis and treatment of feline mycobacteriosis is complex and challenging.
TL;DR: A high prevalence of symptomatic T foetus infections in purebred cats in Germany was demonstrated and co-infection with other enteroparasites did not worsen clinical signs of trichomonosis.
Abstract: The aim of this study was to determine the prevalence of Tritrichomonas foetus infection and associated clinical signs in purebred cats in Germany, to investigate the role of co-infection, and identify determinants of infection. Faecal specimens accompanied by epidemiological questionnaires were scored and collected from 230 purebred cats. Faeces were examined for trichomonads and other enteroparasites. The prevalence of T foetus was 15.7% among cats and 18.5% among catteries. An abnormal faecal score and history of diarrhoea were observed in 64% and 61% of T foetus-positive cats, respectively, and correlated significantly with infection. Co-infection, observed in 36% of T foetus-infected cats, was not associated with diarrhoea. Norwegian Forest cats were infected significantly more often than other breeds. No association was found with any environmental factors. This study demonstrated a high prevalence of symptomatic T foetus infections in purebred cats in Germany. Co-infection with other enteroparasites did not worsen clinical signs of trichomonosis.
TL;DR: This report describes the clinical signs, eventual diagnosis and variable response to treatment in a cat in Switzerland with recurrent cutaneous M microti infection, and recommends that an aggressive diagnostic approach is taken.
Abstract: Overview Mycobacterium microti infection is infrequently described in cats in the veterinary literature. It can be one of a large number of possible differential diagnoses in a feline patient with dermal nodules and non-healing draining ulcers, and can occasionally spread to involve the lungs and/or other areas of the body. Case summary This report describes the clinical signs, eventual diagnosis and variable response to treatment in a cat in Switzerland with recurrent cutaneous M microti infection. Only after several diagnostic and therapeutic attempts, over more than 2 years, was the species of Mycobacterium finally identified and targeted therapy given. Practical relevance For any cat in which there is even a low suspicion of mycobacterial infection, the authors recommend that an aggressive diagnostic approach is taken. Tissue specimens should be collected and frozen early on, and, as soon as acid-fast bacilli are detected, samples should be sent to a mycobacterial reference laboratory for definitive identification. Literature review A review of the literature relating to the aetiopathogenesis, diagnosis and management of M microti infection in cats and dogs is included. This is supplemented with clinical and therapeutic experience gained from this case and other, unpublished cases managed over the past 15 years by one of the authors (DGM).