Journal of Feline Medicine and Surgery最新文献

ObjectivesFeline cutaneous squamous cell carcinoma (cSCC) is a malignant tumour arising from squamous epithelium and accounts for 15% of all skin tumours, commonly involving the nasal planum, pinnae and eyelids. Electrochemotherapy (ECT) combines the application of short high-voltage electric pulses with intravenous or intralesional administration of cytotoxic agents to enhance the efficacy of chemotherapy. This study aimed to investigate the efficacy of ECT with intravenously administered bleomycin in the treatment of different stages of cSCC (T1-T4).MethodsA total of 23 cats with cSCC located on the nasal planum (19/23), lip (1/23), eyelid (1/23), metacarpal pad (1/23) and temporal region (1/23) were included in this retrospective study. Cats were excluded if they did not have a histological or cytological diagnosis of cSCC or if records were incomplete. All cats were treated following a standard protocol with intravenous bleomycin before electroporation of cSCC lesions. Cats were staged according to the World Health Organization staging system: T1 (10/23), T2 (4/23), T3 (1/23) and T4 (8/23). Data on treatment adverse effects and response were collected.ResultsThe median follow-up after initial treatment was 136 days (range 7-1763). Common adverse effects were local effects in 13/23 cats consisting of erythema, desquamation (dry/moist), ulceration and crusting. Complete response (CR) was achieved in 65.3% of cases, partial response in 13%, stable disease in 8.7% and progressive disease in 13%. Eight cats received a second ECT treatment, with 4/8 cats achieving CR after the second treatment. The overall response rate was 78.3%. The recurrence rate was 26.7%, with a disease-free interval of 466 days.Conclusions and relevanceECT is effective in treating T1 and T2 cSCC and can be considered a relevant treatment alternative for these cases.

ObjectivesThis study aimed to describe the clinical characteristics, MRI findings, treatment and outcome in cats presumptively diagnosed with intramedullary intervertebral disc extrusions.MethodsA retrospective review was conducted of medical records and MRI data from cats presumptively diagnosed with intramedullary intervertebral disc extrusions. Long-term outcome (⩾6 months) was assessed through medical records, questionnaires completed by the owners or both.ResultsA total of 12 cats met the inclusion criteria. All presented with peracute or acute clinical signs, with nine having confirmed (n = 3) or possible (n = 6) external trauma based on history, physical examination or MRI findings. Seven cats were ambulatory and five were non-ambulatory. Eight cats presented with urinary incontinence; none exhibited faecal incontinence. Neuroanatomical localisation included the T3-L3 (n = 7) and L4-S3 (n = 5) spinal cord segments. MRI showed an intramedullary intervertebral disc extrusion at the following sites: T12-T13 (n = 1), T13-L1 (n = 1), L1-L2 (n = 2), L2-L3 (n = 2), L4-L5 (n = 3) and L5-L6 (n = 3). All cats underwent treatment and were discharged after a median hospitalisation time of 4 days (range 3-14). All non-ambulatory cats with available follow-up information (4/5) regained ambulation by the time of the short-term (<6 weeks) or long-term (⩾6 months) assessment. Moreover, all cats either retained or regained urinary continence by the time of discharge, the short-term (<6 weeks) or the long-term (⩾6 months) assessment. Overall, nine cats achieved a successful outcome and were considered functional pets at the short-term (<6 weeks) and/or long-term (⩾6 months) follow-up. Two cats were lost to follow-up, and one cat had perceived persistent generalised discomfort.Conclusions and relevanceMost cats presumptively diagnosed with an intramedullary intervertebral disc extrusion showed a favourable outcome with treatment in this study. This condition should be considered in cats presenting with peracute or acute signs of T3-L3 or L4-S3 spinal cord dysfunction, especially if there is a history or indication of trauma.

ObjectivesThe aim of this study was to determine whether feline personality would affect the scores obtained with the Glasgow Feline Composite Measure Pain Scale (CMPS-Feline) and the Feline Grimace Scale (FGS), as well as the mechanical thresholds (MTs), both pre- and postoperatively.MethodsCats scheduled for elective neutering were included in the study. After at least 12 h of acclimatisation, the cats' personalities were classified, based on the Feline-ality Assessment, as either 'independent' or 'social', always by the same investigator. Then, a second independent investigator assigned FGS and CMPS-Feline scores and measured the MTs with a mechanical algometer before (baseline) and after elective surgical neutering. Either a t-test or Mann-Whitney statistics, depending on data distribution, was used to compare continuous variables between independent and social cats.ResultsA total of 29 cats undergoing either orchiectomy or ovariectomy were included in the study. Of them, 14 were classified as independent and 15 as social. Preoperatively, the independent cats had higher CMPS-Feline (2.8 ± 1.6; P = 0.014) and FGS (0, range 2-1; P = 0.025) scores than the social cats (1.3 ± 1.2 and 0, range 0-0, respectively). Postoperatively, CMPS-Feline (P = 0.011) and FGS (P = 0.009) scores were higher in the independent cats (3, range 3-5 and 2, range 1-3, respectively) than in the social cats (2, range 1-3 and 1, range 0-1, respectively). MTs did not differ between personality groups either preoperatively or postoperatively. Within personality groups, there were no differences between pre- and postoperative study variables.Conclusions and relevanceFeline personality affects the reliability of both the CMPS-Feline and FGS. This should be considered when these scales are used to assess perioperative pain in clinical cats and to titrate analgesic drugs to effect.

ObjectivesThe aim of the present study was to evaluate the feasibility and safety of percutaneous ultrasound- and fluoroscopy-guided cholecystostomy drain placement.MethodsAn experimental cadaveric study was conducted on 16 cat cadavers weighing between 2.5 and 6.4 kg. Two drain systems were tested for percutaneous ultrasound- and fluoroscopy-guided placement: the nephrostomy component of a subcutaneous urethral bypass system (SUB-nephrostomy drain) and a paediatric percutaneous access set (paediatric-nephrostomy drain). Ultrasound-guided cholecystocentesis was performed via the 8th-12th intercostal space. Using a Seldinger technique, a guidewire was advanced into the gallbladder over which the drains were then passed under fluoroscopic control. Protocol modification was required mid experiment. Gallbladders were filled via catheterisation of the common bile duct before cholecystocentesis. After fluoroscopy-confirmed cholecystostomy drain placement, CT scans were performed to assess drain position, iatrogenic organ injuries and leakage. Leak pressure testing was performed followed by anatomic dissection. Organ injuries were recorded and classified as minor, moderate or severe.ResultsSUB-nephrostomy drain placement was performed in 15 cats and placement into the gallbladder was feasible in two: one was passed before and one after technique modification. Paediatric-nephrostomy drain placement was tested in one cat. The gallbladder could not accommodate the drain size, placement was not feasible and the device was not further tested. A CT scan of the two cats with drain placement showed a moderate amount of free peritoneal contrast, no pleural space penetration and one liver injury. Leakage occurred at a pressure of 4.5 cm H₂O. For all drains, injuries recorded during anatomic dissection were to the liver, pleural space and gallbladder. The majority of injuries were classified as minor.Conclusions and relevancePercutaneous placement of cholecystostomy drains was not feasible with the method and devices tested. Further studies are needed to investigate alternative techniques in cats.

Practical relevance: Physical rehabilitation (physiotherapy) involves restoring a patient's movement and function following an injury, illness or trauma. It can be used for acute and chronic conditions and, in some cases, the techniques are used as a preventive treatment. Some therapies can also provide pain relief, which can be especially helpful when analgesic drugs are contraindicated in a patient. In recent years, there has been increasing interest in the application of physiotherapy to small animals, and while physical rehabilitation has traditionally been used more commonly for canine than feline patients, as cats can benefit just as much as dogs, this trend is changing. A multidisciplinary team is involved and identifying when a cat is painful and prioritizing therapies accordingly is crucial.

Clinical challenges: Cats are typically not accustomed to regular handling or restraint and tend to become uninterested and frustrated quickly, which means they are often perceived as poor candidates for physiotherapy referral. As well as a cat's temperament, there are physical factors that may limit or exclude particular therapies; for instance, a cat's level of cardiovascular health. There can also be much variation with the success of different therapies - what works well in one individual might have no effect in another.

Aims: This article, the first in a two-part series, discusses the most common painful conditions in cats that can benefit from physical rehabilitation, as well as the importance of prioritizing the type of therapy depending on the individual patient. Part 2 discusses individual therapies and exercises for physical rehabilitation.

ObjectivesThis study aimed to evaluate factors associated with recurrence of clinical signs after balloon dilation in cats with nasopharyngeal stenosis (NPS).MethodsA retrospective multicentre study was conducted using data collected from the medical records of cats treated for NPS using balloon dilation. A total of 47 cats, each with a follow-up period of ⩾180 days, were included in the analysis of progression-free interval (PFI) and hazard ratio (HR) using Kaplan-Meier and Cox proportional hazards analyses.ResultsMultiple balloon dilations were planned for 26/47 cats. In total, 14 cats received three procedures and 12 cats received two. The dilations were performed at a median interval of 35 days (interquartile range [IQR] 29-39, range 15-127), regardless of transient recurrence. A single dilation was planned for the remaining 21 cats. Recurrence after the final balloon dilation occurred in 18/47 (38%) cats; in these cases, the median time from the final dilation to recurrence was 42 days (IQR 18-142, range 6-2303). The median PFI was 2303 days (range 6-2704), with 6-month and 1-year recurrence-free rates of 70% and 65%, respectively. Multivariate analysis revealed that performing planned multiple dilations was the only variable associated with improved PFI (HR 0.06, 95% confidence interval [CI] 0.01-0.30; P < 0.001). Specifically, cats undergoing planned multiple dilations had higher 6-month (92% vs 43%) and 1-year (88% vs 38%) progression-free rates than those undergoing a single dilation. No significant correlation was observed between PFI and the number of balloon dilation treatments.Conclusions and relevanceBalloon dilation repeated two or three times, regardless of any recurrence of signs, may assist in the long-term resolution of NPS in some cases.

ObjectivesThis study aimed to assess the prevalence of hypocobalaminaemia (B12 <400 pg/ml) and hypercobalaminaemia (B12 >1000 pg/ml), describe the clinicopathological abnormalities and the diagnostic imaging findings in a referral population of cats in the UK, and identify the underlying disease processes associated with both conditions.MethodsA retrospective study of cats that had their serum cobalamin concentration assessed between December 2016 and December 2023 at a single referral hospital; 216 cats were included. Patient outcome was established from the clinical records.ResultsA total of 76 (35%) cats had hypocobalaminaemia and 67 (31%) cats had hypercobalaminaemia. The most common diagnoses were chronic enteropathy (CE) in 39/76 (51%) hypocobalaminaemic cats and 39/67 (58%) hypercobalaminaemic cats (P = 0.001), and high-grade lymphoma in 14/76 (18%) hypocobalaminaemic cats and 11/67 (16%) hypercobalaminaemic cats (P = 0.438). The most common clinical signs were chronic vomiting in 36/76 (47%) hypocobalaminaemic cats and 24/67 (36%) hypercobalaminaemic cats (P = 0.005), hyporexia in 40/76 (53%) hypocobalaminaemic cats and 21/67 (31%) hypercobalaminaemic cats (P <0.001), and chronic diarrhoea in 12/76 (16%) hypocobalaminaemic cats and 21/67 (31%) hypercobalaminaemic cats (P = 0.001). The most common abnormalities identified on abdominal ultrasound were lymphadenomegaly and thickened intestines in 49/76 (64%) hypocobalaminaemic cats and 28/67 (42%) hypercobalaminaemic cats (P = 0.0025). Median survival time was 274 days in the hypocobalaminaemic group and 711 days in the hypercobalaminaemic group (P = 0.001). The hypocobalaminaemic cats exhibited significantly reduced survival time compared with hypercobalaminaemic cats (odds ratio 2.4 vs 0.4, respectively) (P <0.001).Conclusions and relevanceThis study suggests that cobalamin has limited diagnostic utility in differentiating between underlying disease processes; chronic diarrhoea and CE are more common in hypercobalaminaemic cats in contrast with the previous literature. Hypocobalaminaemia is associated with reduced survival in this cohort of cats; therefore, early cobalamin supplementation is recommended.

Case series summary The aim of this study was to describe the clinical findings, diagnostic results and response to both non-surgical and surgical therapy in cats with medial humeral epicondylitis (MHE). The medical records of one institution were searched for cats with a radiographically confirmed diagnosis of MHE where non-surgical therapy alone or both non-surgical and surgical therapy had been trialed. Nine cats (17 elbows) were included. None of the cats had a history of outdoor access. Orthopedic examination revealed pain upon palpation over the medial epicondyle (n = 15), elbow pronation/supination (n = 7) or carpal flexion (n = 7) and palpable mineralization distal to the medial epicondyle (n = 7). Epicondylitis was radiographically graded as mild (n = 8), moderate (n = 7) or severe (n = 2). CT was performed in 10 elbows and revealed additional information in seven, including intra-articular mineralized bodies in five elbows. Ultrasound was performed in four elbows and revealed fluid surrounding the flexor carpi ulnaris muscle. After non-surgical management, four cats showed no response, four showed a partial response and one showed a complete response. Cats with less advanced radiographic changes appeared to show more favorable responses. Four cats (seven elbows) underwent surgical treatment with ulnar neuritis being evident in all. Lameness resolved postoperatively in three cats (five elbows).Relevance and novel information An insidious onset of moderate-grade lameness associated with pain on palpation caudodistal to the medial epicondyle should increase the index of suspicion for MHE and prompt assessment for the presence of palpable mineralization and pain on carpal flexion. Ulnar neuritis is common in cats with MHE and they frequently present with free articular mineralized bodies. Radiographs can only detect advanced or chronic stages of MHE, by which time non-surgical management is likely to be ineffective. Earlier diagnosis using ultrasound may improve the prognosis after non-surgical management.

Osteoarthritis (OA) is a degenerative joint disease that is considered the primary source of chronic pain in cats, affecting well over a quarter of the feline population. Despite its prevalence, detection and diagnosis rates remain low, as many owners are unaware of the signs of feline OA. There is limited knowledge regarding the management of feline OA, with only 29 publications available, many of which lack rigorous methodology. Furthermore, most research focuses on the efficacy of non-steroidal anti-inflammatory drugs, while proposed alternatives to alleviate feline OA pain - such as food restriction, weight loss, adjunctive musculoskeletal treatments with biologics, physiotherapeutic modalities and lifestyle changes - are primarily based on human clinical studies and veterinary research on other species, which introduces a high risk of bias. New promising avenues are being explored with anti-nerve growth factor monoclonal antibodies; however, the long-term effects of repetitive administration, optimal conditions for administration and specific indications have yet to be described. Research from the Groupe de recherche en pharmacologie animale du Québec (GREPAQ) on pharmacological and non-pharmacological therapies for feline OA suggests that a shift in the OA management paradigm may be warranted. An omega-3 enriched diet has demonstrated therapeutic efficacy comparable to standard pharmacological treatments, without side effects and with high compliance. In addition, it was equally effective for cats with severe OA as for those with moderate OA. By establishing a theoretical framework for feline OA management based on robust scientific evidence, veterinarians will be better equipped to select treatments tailored to the diagnosed (or suspected) manifestations and mechanisms of OA pain, ultimately improving the health and well-being of their feline patients. Future research should explore the concomitant use of different therapeutic approaches, as they may offer superior outcomes compared with a single treatment through additive or synergistic effects.