Journal of Feline Medicine and Surgery最新文献

Case series summary: This case series describes four cats with decompensated congestive heart failure and fulminant cardiogenic pulmonary oedema (CPE) that did not respond to conventional treatment and oxygen therapy, and subsequently developed hypoxaemic respiratory failure. The cats were anaesthetised to enable endotracheal intubation, manually ventilated with 100% oxygen and postural drainage was performed immediately to evacuate pulmonary oedema. Afterwards, the cats were extubated and transitioned to high-flow nasal oxygen (HFNO). HFNO allowed significant improvement in the respiration parameters without causing clinical complications. In three of the cats, the procedure was successful; duration of HFNO ranged between 4 and 44 h, and they were successfully weaned off the HFNO therapy. One cat required re-intubation due to HFNO-response failure and was ultimately euthanased. Another cat was euthanased 5 days later due to the severity of its underlying disease.

Relevance and novel information: This is the first report describing the combined technique of postural drainage and HFNO in cats with decompensated CPE. This combined technique could be a life-saving option for cats that fail to respond to conventional therapies and for which positive pressure ventilation is not an option.

Objectives: The aim of the study was to evaluate the association between triage body temperature (BT) and outcome in cats presenting to the emergency department (ED).

Methods: A retrospective observational study was conducted on cats presented to the ED. BT, clinical diagnosis and outcome were recorded. BT was categorised as follows: normothermia (37.8-39.7°C); hyperthermia (⩾39.8°C); mild hypothermia (36.8-37.7°C); moderate hypothermia (35.6-36.7°C); severe hypothermia (33.1-35.5°C); and critical hypothermia (⩽33°C). Outcome in the ED was categorised as death, euthanasia, hospital admission and discharge. Outcome at hospital discharge was evaluated in patients admitted to the intensive care unit (ICU). Systemic inflammatory response syndrome (SIRS) was identified in patients. No-SIRS cats were divided into three disease categories (urinary system, cardiovascular and miscellanea) and SIRS cats into four categories (urinary system, cardiovascular, trauma and miscellanea). The presence of sepsis was evaluated. Non-parametric statistics were used.

Results: A total of 1440 cats were included. The hospital mortality rate was 21.9%. Hypothermia in the ED was reported in 510 (35.4%) cats, normothermia in 849 (59%) cats and hyperthermia in 81 (5.6%) cats. In the ED, the median temperature in non-survivors (35.4°C, 95% confidence interval [CI] 34.6-36.3) was significantly lower than in survivors (38.2°C, 95% CI 38.1-38.3; P <0.0001). The risk of non-survival in the ED was significantly higher in cats with a decreased BT, progressively increasing with the severity of hypothermia (P <0.0001). Furthermore, BT was significantly associated with a higher risk of mortality in the ICU (P <0.0001). A diagnosis of sepsis was associated with a high prevalence of hypothermia (79/124 cats, 63.7%) and a higher risk of non-survival (odds ratio [OR] 2.62, 95% CI 1.52-4.54; P = 0.0006). The mortality risk significantly increased in SIRS cats with a cardiovascular disease (OR 8.27, 95% CI 4.09-16.68; P <0.0001).

Conclusions and relevance: Hypothermia is common in cats at ED admission and is significantly associated with outcome. Triage hypothermia might identify patients with sepsis or SIRS complicated by comorbidities, such as cardiovascular and urinary diseases.

Objectives: This study aimed to assess left atrial (LA) size in healthy cats using cardiovascular MRI (cMRI) and to compare this with LA size assessed by two-dimensional echocardiography. The hypothesis was that cMRI would accurately determine LA size in domestic cats.

Methods: A prospective comparative study was performed. Six healthy cats were selected for the study. Standard two-dimensional echocardiography was performed with and without general anaesthesia. cMRI was conducted under general anaesthesia. A comprehensive analysis of LA mass and function measurements was performed to determine the consistency and correlation of LA size and function indicators between two-dimensional echocardiography and cMRI.

Results: Our study found that intraobserver variability for cMRI measurements was lower than that for two-dimensional echocardiography. Compared with cMRI, echocardiography under anaesthesia significantly overestimated maximal LA volume (LAVmax_2D, P <0.01) and significantly underestimated minimal LA volume (LAVmin_2D, P <0.01). The LAVmin measured by two-dimensional echocardiography exhibited the highest consistency (intraclass correlation coefficient = 0.857) and correlation (R = 0.75, P <0.01) with LAVmin measured by cMRI. The linear regression equation was LAVmin_ cMRI = 0.891 × LAVmin_2D + 0.304.

Conclusions and relevance: cMRI represents a reproducible method for assessing LA mass in domestic cats. This study underscored the importance of echocardiography in veterinary cardiology, and the LAVmin measured by two-dimensional echocardiography may reflect the true LAVmin.

Objectives: The objective of this study was to evaluate the impact of liposomal bupivacaine (LB) as part of an opioid-sparing multimodal analgesic protocol on postoperative pain control in cats undergoing limb amputation surgery compared with traditional pain management protocols more heavily reliant on injectable opioid and non-opioid analgesics.

Methods: Medical records of 29 cats that underwent forelimb or hindlimb amputation were reviewed to evaluate postoperative systemic pain medications utilized, appetite and time to discharge as presumptive gauges of postoperative pain. Statistical analysis of the data included Wilcoxon's rank-sum test and Fisher's exact test.

Results: Of the 29 cats, seven (24%) did not receive LB and 22 (76%) did. No statistically significant differences were found between the two groups in the outcome variables evaluated. The median time to eating was similar (6.0 h in the LB group vs 5.0 h in the non-LB group), the median time to discharge was shorter in the LB group (25.0 h vs 42.0 h in the non-LB group) and the median time to discontinuation of opioids in the LB treatment group was shorter than the non-LB group (18.0 h in LB group vs 22.0 h non-LB). A lower proportion of the LB group needed adjuvant systemic analgesics compared with the non-LB group (5% LB vs 29% non-LB).

Conclusions and relevance: The addition of liposomal bupivacaine to an analgesic protocol after limb amputation in cats is associated with reduced opioid dosing, earlier return to eating and earlier hospital discharge. The use of LB may minimize the negative side effects associated with systemic opioid administration and therefore decrease patient morbidity. Future studies are needed to definitively compare LB efficacy and safety for postoperative pain control and traditional systemic analgesic medications.

Objectives: Cardiovascular complications are well known in humans with autosomal dominant polycystic kidney disease (PKD), but limited data exist for cats. This study aimed to assess echocardiographic changes, cardiac troponin I (cTnI) levels and systolic blood pressure (SBP) in Persian cats with PKD to detect early cardiac abnormalities.

Methods: In total, 52 Persian and mixed-Persian cats were enrolled, with 26 cats in the control group and 26 diagnosed with PKD via ultrasound due to the unavailability of genetic testing. Although genetic testing is the gold standard for definitive diagnosis, this study utilised high-sensitivity ultrasound as an alternative diagnostic tool. This method aligns with existing literature supporting its effectiveness in detecting PKD, particularly in regions where genetic testing is not accessible. Echocardiographic examinations employed M-mode and two-dimensional echocardiography to measure the diastolic thickness of the interventricular septum and the left ventricular free wall. Doppler ultrasonography was used to measure SBP and cTnI serum levels were determined using a Monobind-ELISA kit.

Results: Median SBP and cTnI levels in PKD cats were 155 mmHg and 85.80 ng/l, respectively, which was significantly higher than the control group (P ⩽0.001). Interventricular septum in systole, as well as diastolic thickness of the interventricular septum and the left ventricular free wall, was significantly elevated in PKD cats compared with controls (P ⩽0.001). No significant differences were observed in other echocardiographic parameters.

Conclusions and relevance: Asymptomatic PKD-affected Persian cats exhibited elevated SBP and cardiac structural changes; however, the clinical significance of these findings remains uncertain due to a lack of long-term follow-up. While early cardiac changes may be present, further research is necessary to establish their clinical relevance and guide appropriate management strategies. Monitoring PKD cats is advised, but a direct clinical impact is not confirmed at this stage.

Objectives: To investigate the pathogenicity of feline herpesvirus-1 (FHV-1) to the cornea, FHV-1 strains isolated from feline eyes with dendritic ulcers were subjected to genomic analysis to determine whether FHV-1 vaccine strains are involved in the formation of dendritic ulcers.

Methods: All open reading frame (ORF) sequences of the three F2 strains (Virbac, Intervet and Merial) and the FHV-1 clinical isolates from cats registered in GenBank were compared to detect nucleotide variants unique to the F2 strains, with those nucleotides then being used for simple genotyping of the F2 strains. In all isolates from feline eyes with dendritic ulcers, the regions including nucleotide variants of the F2 strain were amplified with PCR and sequenced. Isolates with nucleotide variants of the F2 strain were then subjected to next-generation sequencing to determine their full genome sequences, which were compared with all ORF sequences of the three F2 strains.

Results: Analysis of ORF sequences for simplified genotyping of F2 strains detected a single nucleotide variant in ORF28 and in ORF44. These were considered to be nucleotide variants unique to the F2 strain. Among the four FHV-1 isolates from eyes of four cats with dendritic ulcers, nucleotide variants of the F2 strain were detected in 1/4 strains (the NS strain). Next-generation sequencing of the NS strain was performed, and all ORF sequences of the NS strain were compared with the those of the three F2 strains. All ORF sequences of the NS strain were completely identical to those of two F2 strains (Virbac and Intervet) and some clones of the Merial vaccine strain.

Conclusions and relevance: The F2 strain was isolated from an eye with a dendritic ulcer, indicating that the strain has the potential to replicate in the corneal epithelium and form lesions.

Objectives: Acetate (ACE) and lactate (LAC)-containing balanced resuscitation fluids are commonly used for fluid therapy in cats. These fluids can influence acid-base and electrolyte status. This prospective randomised study compared two balanced crystalloid solutions regarding their effect on acid-base status, electrolytes and LAC concentrations in dehydrated cats after intravenous fluid therapy.

Methods: A total of 100 client-owned cats presenting to the emergency service with dehydration ⩾5% due to diarrhoea, vomiting or anorexia were included in this study. They were randomised to receive either ACE- (Sterofundin ISO; B Braun Vet Care) or LAC-containing (Ringer-Laktat nach Hartmann; B. Braun Vet Care) fluids for rehydration. Exclusion criteria were age <6 months, severe electrolyte abnormalities, severely increased creatinine or bolus therapy, and decompensated heart disease and liver diseases. Vital parameters were assessed and venous blood gas analysis was performed before and after fluid therapy. Data were analysed using the Mann-Whitney U-test and the Wilcoxon matched-pairs signed-rank test. The significance level was set at P ⩽0.05.

Results: Post-rehydration pH normalised, and bicarbonate and base excess increased in both groups. Anion gap and LAC and potassium concentrations decreased in both groups. No difference in electrolyte, acid-base status and LAC was observed between cats receiving ACE and cats receiving LAC.

Conclusions and relevance: Both fluids have similar effects on dehydrated cats' acid-base status and electrolyte and LAC concentrations. No significant differences in values were found between ACE- and LAC-containing resuscitation fluids. Blood LAC concentration decreased in both groups.

Objectives: The objective of this study was to compare plasma glucagon-like peptide-2 (GLP-2) concentrations in cats with chronic enteropathies (CE) with those of healthy cats.

Methods: Nineteen client-owned cats with a histopathologic diagnosis of either idiopathic chronic enteropathy (CIE) or low-grade lymphoma and six healthy client-owned cats were enrolled in a prospective study between 2 December 2021 and 9 June 2023. Fasted and postprandial plasma GLP-2 concentrations were measured via ELISA in CE cats at the time gastrointestinal biopsies were obtained and before CE treatment. In cats with a histopathologic diagnosis of CIE, plasma GLP-2 concentrations were re-evaluated after 1 month of CE treatment.

Results: There was no significant difference in plasma GLP-2 concentrations between healthy cats (0.53 ng/ml) and cats with CE (0.52 ng/ml). GLP-2 concentrations in cats with CIE were not significantly different following 1 month of treatment (0.43 ng/ml) from those at initial presentation (0.44 ng/ml).

Conclusions and relevance: GLP-2 can be successfully detected in the plasma of cats with CE. Based on the lack of differences observed between this population of CE cats and healthy cats, GLP-2 cannot be recommended as a biomarker of feline CE using this ELISA method. Further investigation of larger CE cat populations and analytic methods would be needed to determine the overall utility of GLP-2 evaluation in feline CE.

Objectives: Total thyroxine (TT4) evaluation is the most commonly used first-line test for the diagnosis and monitoring of cats with hyperthyroidism. Vcheck T4 is a point-of-care immunoassay that measures TT4 using a Vcheck V200 analyser. This study aimed to evaluate the analytic performance of the Vcheck T4 assay in feline sera and the agreement in the classification of normal, high and low TT4 concentrations of Vcheck T4 with those measured by an enzyme immunoassay (EIA).

Methods: Assay precision, reproducibility and linearity were evaluated for the Vcheck T4. For method comparison, TT4 concentrations in 73 serum samples were analysed by both methods.

Results: Vcheck T4 demonstrated good precision, reproducibility (intra- and inter-assay coefficients of variation between 3% and 13.5%) and linearity in the diagnostic range of <0.5 and >8 μg/dl. The correlation coefficient was 0.87, Passing-Bablok regression showed a proportional, but not constant bias, Bland-Altman plots revealed a mean difference of +0.5 μg/dl. The overall inter-rater agreement (K) between TT4 EIA and Vcheck results was substantial (K = 0.69), with 82.2% of concordant results. As a diagnostic test for hyperthyroidism, Vcheck T4 showed a sensitivity and specificity of 88.9% and 84.4%, and a positive predictive value (PPV) and negative predictive value (NPV) of 44.5% and 98.2%, respectively.

Conclusions and relevance: Vcheck T4 assay provided precise and reproducible results in substantial agreement with the EIA. Given the high NPV, Vcheck T4 is useful in ruling out hyperthyroidism when screening cats, but, based on low PPV, samples with results with high TT4 need to be analysed by another reference method. Further analysis with haemolytic, icteric and lipaemic samples is needed to assess the test performance. Finally, the reference intervals provided by the manufacturer require verification, and TT4 intervals specific to this method must be established in future studies.