Journal of Feline Medicine and Surgery最新文献

ObjectivesThe aim of the present study was to evaluate the sedative and echocardiographic effects of dexmedetomidine (DEX) administered via intranasal (IN) and intramuscular (IM) routes in cats.MethodsThis randomised, blinded crossover study involved eight healthy adult cats. Cats were randomly allocated to receive DEX 10 μg/kg via either the IN or IM routes. Sedation, mechanical nociception and muscle relaxation were subjectively assessed and physiological variables recorded at baseline and at 5 min intervals for up to 40 mins after drug delivery. Echocardiography was performed 15 mins after delivery.ResultsIn both treatment groups, sedation assessment scores significantly increased compared with baseline values (P <0.05). At 25-35 mins after delivery, only the IN group exhibited a significant decrease in mechanical nociception scores compared with baseline (P = 0.041, P = 0.042, P = 0.026). DEX delivery via both routes resulted in significant reductions in pulse rate (P <0.05). In the IM group, mean arterial blood pressure measurements 35-40 mins after delivery were significantly lower than baseline (P = 0.012, P = 0.012). Fractional shortening significantly decreased in both the IN and IM groups compared with baseline (P = 0.016 and P = 0.049, respectively). Both routes caused reductions in cardiac systolic function, with no significant difference between the two routes. Vomiting occurred in half of the IN group (4/8) and in all cats of the IM group (8/8), with a significantly lower incidence in the IN group (P = 0.046).Conclusions and relevanceIN delivery of-DEX provided comparable sedation, increased tolerance to mechanical nociception and muscle relaxation effects while causing fewer adverse effects than IM-DEX. Both routes similarly reduced cardiac contractile function. Thus, IN-DEX at a dose of 10 μg/kg is a viable alternative to IM-DEX for sedation in healthy cats.

Case series summaryFour domestic cats treated surgically for complex fractures of the proximal femur were included in this retrospective case series. Medical records from October 2021 to January 2023 were reviewed for cats presenting with high-energy trauma resulting in comminuted proximal femoral fractures. All cats underwent surgical stabilisation using a lateral approach extended by complete release of the vastus lateralis muscle to improve visualisation and access. Follow-up included physical and radiographic evaluation and completion of the Feline Musculoskeletal Pain Index (FMPI). The modified approach facilitated better visualisation and implant placement. The mean surgical time was 76 mins. Bone healing was observed in three cases with available follow-up, with FMPI scores indicating complete recovery. One case required revision surgery. Minor complications were resolved. Two cats died later from unrelated trauma.Relevance and novel informationComplete release of the vastus lateralis muscle enhanced exposure and facilitated successful treatment of complex proximal femoral fractures in cats without direct approach-related complications. This technique may be beneficial when standard exposure is insufficient in feline proximal femoral fractures.

ObjectivesTopical treatments, along with systemic oral antifungals, are the mainstay of infection and environmental control for cats with dermatophytosis in animal shelters. This study aimed to provide realistic expectations of the performance of three commonly used topical treatments to help shelters minimize the length of stay and optimize feline welfare.MethodsA prospective, randomized, semi-blinded clinical trial compared treatment success and time to cure for miconazole chlorhexidine (MC) and hydrogen peroxide (HP) shampoos vs lime sulfur (LS) using a non-inferiority model. Cats with Microsporum canis were enrolled at four US animal shelters, treated with oral itraconazole and randomized into three topical treatment groups. Treatment success was defined as mycological cure by 7 weeks, while inferiority was defined as requiring more than 1 additional week to achieve cure.ResultsA total of 76 cats were enrolled. LS significantly outperformed both alternatives in cure by 7 weeks. Time to cure analysis showed significant differences between LS (mean 27 days, range 7-45) vs MC (37, 14-62) (P = 0.04) and LS vs HP (36, 11-65) (P = 0.06). Although alternative products took significantly longer to cure, confidence intervals (CIs) around the difference of means included the inferiority margin: LS vs MC (9.66, 95% CI 0.7-18.5) and LS vs HP (8.54, 95% CI 0.44-16.6). Therefore, inferiority of the alternative products was suggestive but inconclusive. After controlling for confounders, a Cox proportional hazards analysis confirmed significantly poorer performance of MC (P = 0.003) and HP (P = 0.032) vs LS. Younger age also significantly prolonged treatment (P = 0.039), while intake type, co-housing and low body condition score did not. Shelter staff ratings showed no differences between products in terms of treatment unpleasantness, difficulty or cat reactions.Conclusions and relevanceIn this study, LS outperformed HP and MC in treating cats with M canis. Younger cats took a longer time to achieve cure. If shelters or practitioners wish to use an alternative topical treatment to LS, then HP should be considered.

Case series summaryThe objective of this study was to report the clinical presentation, diagnostic evaluation and outcome of ectopic ureter treatment in four female cats. Medical records of cats diagnosed with ectopic ureter between 2016 and 2021 were reviewed. Cats were included if they had a confirmed diagnosis of an extramural (three cases) or intramural (one case) ectopic ureter and underwent either surgical correction using an intravesicular end-to-side neoureterocystostomy technique or cystoscopic laser ablation. Information obtained from the medical records included history, signalment, clinicopathological data, imaging findings, treatment performed, postoperative complications and long-term clinical follow-up. Four female cats with unilateral ectopic ureters were identified, all of which (4/4) presented with urinary incontinence, with half (2/4) also having recurrent urinary tract infections. Pre-treatment diagnostics revealed three cases of extramural and one case of intramural ectopic ureters.Relevance and novel informationSurgical correction was performed using intravesicular end-to-side neoureterocystostomy for the three cats with an extramural ectopic ureter and cystoscopic laser ablation for the cat with an intramural ectopic ureter. Long-term follow-up showed no recurrence of urinary incontinence or of lower urinary tract signs after ectopic ureter treatment (median follow-up 1705 days). This study demonstrates that both intravesicular end-to-side neoureterocystostomy and cystoscopic laser ablation are effective and safe long-term treatment options for cats with unilateral ectopic ureters.

The use of cannabinoids from hemp, which is classified as a cultivar of Cannabis sativa with up to 0.3% delta-9-tetrahydrocannabinol by USA federal definitions, is becoming increasingly popular in veterinary medicine. Owners frequently ask about their utility in a variety of conditions, including predominantly osteoarthritis, behavioral management, cancer, dermatitis and seizure disorders. Cannabinoid clinical utility, particularly cannabidiol (CBD) in dogs, is gradually emerging, while evidence for its use in cats remains limited. Several newer publications around the pharmacokinetics of CBD and cannabidiolic acid in cats show dramatic differences in bioavailability, elucidating that not all formulations are similar regarding serum or plasma concentrations. To date, although the pharmacokinetics look favorable, there are a handful of clinical studies on feline acute/chronic pain states and fear/anxiety/stress, alongside some pre-clinical studies where there is a potential for clinical translation. These limited studies, combined with positive owner and veterinary practitioner anecdotes, suggest there may be more opportunities for further pilot investigations to refine dosing and product selection for more randomized, placebo-controlled studies across several morbidities in the future.

ObjectivesThe objective of this study was to evaluate the occurrence of voltage-gated potassium channel (VGKC) antibodies and the pattern of MRI changes in cats with complex partial seizures with orofacial involvement (CPSOFI), as well as to investigate whether there are factors influencing survival that could be used as prognostic markers in those cats.MethodsCats with CPSOFI were identified retrospectively. The following data were retrieved from the hospital database: signalment, age at first seizure and presentation, the presence of antibodies against VGKC (leucine-rich glioma inactivating factor 1 (LGI1), contactin-associated protein 2 (CASPR2)) and cerebrospinal fluid (CSF) analysis findings. Brain MRI scans were evaluated for T2 and/or fluid-attenuated inversion recovery (FLAIR) hippocampal hyperintensity and hippocampal contrast enhancement by a radiologist. The correlation between being positive for VGKC antibodies and MRI hippocampal hyperintensity was investigated.ResultsSerum antibodies against VGKC were found in 31.4% of cats, with 10/11 positive cats having antibodies against LGI1 and 1/11 against CASPR2. MRI T2/FLAIR hippocampal hyperintensities and T1 contrast enhancement were seen in 57.1% and 27.1% of cats, respectively. There was a weak correlation between those antibodies and MRI changes (phi coefficient 0.12). The following factors did not influence survival on multivariable regression analysis either for all cats together or when the cats that died were evaluated separately: age at first seizure, breed, sex, T2/FLAIR hippocampal hyperintensity, being positive for VGKC antibodies and prednisolone treatment.Conclusions and relevanceThere are no consistent findings on MRI or on testing for VGKC antibodies in all cats with CPSOFI. None of the factors investigated can be used to predict outcomes.

ObjectivesThis study aimed to investigate the emetic effect of medetomidine, determine the best dose for clinical practice and investigate any adverse effects at different doses.MethodsIn this prospective, observational study, 10, 20, 30 and 40 µg/kg of medetomidine was administered intramuscularly (IM) to cats after ingestion of foreign substances, to induce emesis. The success rate, frequency, time after injection, sedation score and adverse effects were recorded. If induction of emesis was not successful after 10 or 20 µg/kg medetomidine, a second bolus of medetomidine (20 µg/kg IM) was administered 10 mins later.ResultsA total of 58 cats were included after foreign material ingestion. Emesis was achieved with all doses of medetomidine (39/58), whereby the highest success rate was reached with 20 µg/kg (13/17). The success rate after the first injection was not statistically different between the different medetomidine doses (P = 0.457). The median time to emesis after the first injection of medetomidine for all cats was 5 mins (range 3-14). The sedation score was lower after 10 µg/kg medetomidine compared with 40 µg/kg (P = 0.013). The most common adverse effect was sedation. Medetomidine was antagonised with atipamezole in 47/58 cats.Conclusions and relevanceMedetomidine is an effective drug for inducing emesis in cats and is a reasonable alternative to other alpha₂-agonists. The most successful dose with the least adverse effects was 20 µg/kg IM.

ObjectivesIt is often suggested in the literature that the anatomy of the extrahepatic portal vein (EHPV) in dogs and cats is similar. Nevertheless, variations and contradictions in the tributaries of the EHPV in cats have been described. Therefore, the aim of this study was to describe the normal anatomical variations of the tributaries of the EHPV in a large cohort of cats.MethodsA retrospective, descriptive, cross-sectional study of abdominal CT angiography (CTA) scans was performed. Cats that underwent CTA between January 2020 and July 2024 were reviewed in consensus by three observers. Cats with vascular anomalies or CTA scans in which the EHPV or its tributaries could not be accurately evaluated were excluded.ResultsA total of 52 CTA scans were included. The splenic vein (SV) was consistently present in all cats as the most caudally inserting vein in the EHPV. The left gastric vein (LGV) entered the EHPV directly in 42/52 cats and, in 36 of those, the LGV was the most cranial vein entering the EHPV. In 28 cats with direct insertion, a second branch of the LGV entered the SV. In eight cats, a single LGV entered the SV, as is typically seen in dogs. In the remaining two cats, the LGV was not identified. In 34/52 cats, the gastroduodenal vein entered the EHPV, as described in dogs, whereas in the remaining 18 cats, the right gastric vein and cranial pancreaticoduodenal vein entered the EHPV together.Conclusions and relevanceVarious anatomical variations of the inserting veins in the EHPV were identified. Knowledge about the variation in normal anatomy of the EHPV and its tributaries is important, especially to evaluate complex pathologies of the EHPV, such as vascular anomalies and EHPV thromboses.

ObjectivesThe sedation quality of intramuscular (IM) alfaxalone and butorphanol in combination with midazolam was investigated in hyperthyroid cats undergoing suitability assessment for radioiodine treatment.MethodsA total of 60 hyperthyroid cats undergoing diagnostic investigations were randomly allocated to receive butorphanol (0.3 mg/kg IM) and midazolam (0.2 mg/kg IM) with either alfaxalone (2 mg/kg IM) (BMA2) or alfaxalone (3 mg/kg IM) (BMA3), or butorphanol (0.3 mg/kg IM) with alfaxalone (3 mg/kg IM) (BA3). If required, additional alfaxalone (0.2 mg/kg) was administered intravenously. Cat Stress Score, response to injection, time to lateral recumbency, sedation score at 10, 15 and 20 mins and subsequent 10-min intervals, additional alfaxalone requirements, and time to first administration, recovery quality (excellent, fair, poor) and adverse effects were assessed. Thyroxine concentrations, gabapentin treatment and assessors were recorded. Heart and respiratory rate and arterial haemoglobin saturation were monitored every 5 mins. Data were compared using χ² and Kruskal-Wallis testing. The multidimensional sedation score and predictors of sedation score were analysed using a mixed effect and linear regression model, respectively (P <0.05).ResultsNo significant predictors for sedation quality were identified. In all groups, the median sedation score was considered good and the median recovery score was fair. The sedation score over time across groups and cardiorespiratory variables were not significantly different. Additional alfaxalone was administered in 53 cats. In group BA3, additional alfaxalone was required significantly earlier (P = 0.043). Although sedated, muscle twitching was a commonly observed adverse effect in all groups, but head pawing was significantly increased in BA3 (P = 0.014).Conclusions and relevanceSedation and recovery quality were satisfactory with all protocols but the addition of midazolam prolonged sedation.

ObjectivesThe aim of the present study was to evaluate health-related quality of life (HRQoL) in cats with chronic kidney disease (CKD) and integrate these results with clinical data to identify factors associated with decreased HRQoL.MethodsCaregivers completed a validated HRQoL tool (VetMetrica) and clinical data (history, laboratory work, physical examination findings, etc) were collected. Vitality, comfort and emotional wellbeing (EWB) scores were compared between groups using non-parametric analyses as appropriate.ResultsData from 24 healthy cats and 68 cats with CKD were collected. Cats with CKD had significantly lower median vitality, comfort and EWB scores (vitality: 41.7, range 4.3-64; comfort: 36.1, range 21.2-59.6; EWB: 44.6, range 1.6-58.8) than healthy cats (vitality: 56.5, range 40.7-64; comfort: 59.6, range 34.2-59.6; EWB: 58.7, range 45.1-58.8) (P <0.0001 for all analyses). Cats with International Renal Interest Society (IRIS) stage 3 and 4 CKD had lower median EWB scores (30.8, range 1.6-54.4) than IRIS stage 1 and 2 CKD (47.3, range 11.2-58.8) (P = 0.04) and lower vitality scores (38.2, range 4.3-54.0) in comparison with IRIS stage 1 and 2 CKD (43.1, range 12.8-64.0) (P = 0.04). Cats with anaemia had lower median EWB scores (25.9, range 10.4-54.4) than those without (46.6, range 1.6-58.8) (P = 0.005), and haematocrit was positively correlated with EWB (P = 0.005, r = 0.33). Cats with abnormal appetite had lower median EWB scores (29.1, range 1.6-56.7) than cats with normal appetite (48.1, range 11.2-58.8) (P = 0.001). Cats with constipation had lower median comfort scores 29.5 (range 21.2-59.5) (P = 0.0003) and lower median EWB scores (22, range 1.6-58.8) (P = 0.008) than those without (comfort: 37.1, range 25.3-59.6; EWB: 47.9, range 11.2-58.8).Conclusions and relevanceCats with CKD have decreased HRQoL. Several modifiable clinical factors are associated with this decreased HRQoL.