Journal of Feline Medicine and Surgery最新文献

Objectives: To assess the clinical efficacy, safety and outcomes of legally prescribed and compounded GS-441524, with or without prior remdesivir, in cats with confirmed or highly suspected feline infectious peritonitis (FIP) in the Netherlands. A standardised diagnostic and treatment protocol was used to evaluate clinical response, adverse effects and prognostic factors.

Methods: This prospective, multicentre study included 127 client-owned cats with FIP, enrolled between June and November 2023 from three Dutch veterinary clinics. Diagnosis followed AAFP/EveryCat guidelines, incorporating clinical findings, laboratory data, imaging, cytology and reverse transcription quantitative polymerase chain reaction (RT-qPCR) performed on either fine-needle aspirates or effusion. Cats were treated for a minimum of 12 weeks with oral GS-441524, with some initially receiving intravenous remdesivir before transitioning to oral therapy. Dosing was based on disease form (effusive, non-effusive, ocular, neurological). Follow-up included physical examinations and clinicopathological monitoring. Descriptive statistics, Kaplan-Meier survival analysis and Cox regression were used for data analysis.

Results: Of the 127 cats, 55.9% had effusive, 19.6% non-effusive, 16.5% ocular and 7.8% neurological FIP; 21.3% showed mixed forms. Most cats were <2 years old (87.4%), male (77.2%) and purebred (60.6%). Common clinical signs included lethargy (93%) and inappetence (83%). Overall survival was 78%. Ocular FIP had the highest survival (100%), while neurological FIP had the lowest (60%). Elevated serum bilirubin and creatinine concentrations at presentation were associated with reduced survival. Adverse effects were generally mild and transient, with vomiting (33%) and diarrhoea (29%) most commonly reported.

Conclusions and relevance: This study confirms that GS-441524, with or without prior remdesivir, is an effective and well-tolerated treatment for naturally occurring FIP. Clinical improvement was typically rapid; resolution of laboratory abnormalities took longer. These findings support the legal use of GS-441524 in feline practice and highlight the need for further research to refine treatment protocols.

ObjectivesThis study aimed to develop a standardized ostectomy guide for the ventral femoral head and neck ostectomy (vFHO) in cats. We aimed to assess the guide's accuracy for maximizing removal of a clinically acceptable amount of bone without sacrificing soft tissue attachments.MethodsCT scans of 18 cats with normal femoral morphology were obtained to determine ideal ostectomy planes and generate 3D-printed femurs. A standardized ostectomy guide was designed, printed and used to perform the ostectomies on printed bones as well as three cadavers via vFHO. Post-operative CT scans were obtained. Covariates including age, sex, castration status, body weight, side, and neck inclination and version angles were recorded. Ostectomies were assessed by comparing actual vs. ideal ostectomy angles and percentage of femoral head and neck removed using CT scan data, and by blinded evaluation of printed bones with vFHO. Mixed-effects models were used for statistical analysis.ResultsThe ideal and actual ostectomy angles in the 3D-printed femur models were statistically equivalent (p < 0.005), while the percentage of femur removed was not (p = 0.080), until two outlier specimens (smallest/youngest) were excluded, after which both measurements became statistically equivalent (p = 0.001). No covariates significantly influenced outcomes. Visual assessment from a blinded surgeon found 75% of ostectomies acceptable; unacceptable ostectomies had either over-removal of the greater trochanter or incomplete neck resection. Cadaveric testing confirmed the guide's usability, with practical application and adequate exposure via previously described ventral approach.Conclusions and relevanceThis study demonstrated that while a standardized vFHO ostectomy guide in cats was practical to use and produced ostectomies statistically equivalent to ideal cuts, occasional over- or under-resection and the risk of damaging the greater trochanter preclude clinical application at this stage, highlighting the need for further design optimization.

ObjectivesThis study described the pharmacokinetics of bupivacaine after bilateral maxillary and caudal inferior alveolar nerve blocks in adult cats under general anesthesia.MethodsTen healthy adult cats (4.8 ± 0.8 kg) were included in a randomized, prospective trial. Anesthetic protocol included acepromazine-methadone-propofol-isoflurane. Each cat randomly received 0.2 (BUPI2) or 0.3 mL (BUPI3) per site of bupivacaine 0.5% (4 and 6 mg per cat, respectively) (n = 5/group). Blood was collected before (time 0) and at 2, 7, 20, 30, 60, 120, 240, 360, 480 and 600 minutes after all dental blocks. Plasma concentrations of bupivacaine were analyzed using liquid chromatography-tandem mass spectrometry. The pharmacokinetics of bupivacaine were described using a non-compartmental analysis.ResultsDoses of bupivacaine were significantly different (BUPI2: 0.88 ± 0.14 mg/kg; BUPI3: 1.22 ± 0.21 mg/kg). For BUPI2 and BUPI3, maximum bupivacaine plasma concentrations (Cmax) were 825 ± 299 and 926 ± 197 ng/mL at 5.0 ± 2.7 and 9.6 ± 5.8 min (Tmax); area under the curve (AUC) to last measured concentration was 142 ± 36 and 180 ± 60 min*µg/mL; clearance was 5.2 (2) and 4.6 (13) mL/min/kg; elimination half-life was 245 ± 54 and 278 ± 90 min and mean residence time to the last measured concentration was 185 (32) and 196 (76) min, respectively. Concentrations of bupivacaine were detected up to 600 minutes (72 ± 22 in BUPI2 and 104 ± 55 ng/mL in BUPI3).Conclusions and relevanceBilateral maxillary and caudal inferior alveolar nerve blocks using two volumes and doses of administration produced Cmax below those reported to cause toxicity in cats. Further studies are warranted to investigate the pharmacodynamics of dental blocks in cats.

ObjectiveThis study aimed to develop a sensitive detection method and investigate Feline Chaphamaparvovirus (FeChPV) in cats from southwestern China.MethodsA SYBR Green I-based qPCR assay targeting the VP1 gene was established and validated. It was applied to 87 diarrheic cat fecal samples (2021-2023). Near-full-length genomes of positive samples were sequenced for phylogenetic, structural, and selection analysis.ResultsThe qPCR assay showed high sensitivity (50.9 copies/μL) and reproducibility (CV < 4.0%). FeChPv was detected in 22 (25.3%) of the 87 cats with diarrhoea. Four strains shared 97.6-99.5% identity with global isolates and formed a distinct clade within Asian lineages. A consistent Val→Ile mutation at VP1-340 was identified under positive selection and can induce conformational changes.Conclusions and relevanceWe provide a reliable tool for FeChPV detection and reveal unique evolutionary features of local strains, supporting further research into its pathogenesis and spread.

Objectives: Vaginal cytology has a broadly recognized value for estrous cycle staging due to the responsiveness of the vaginal epithelium to estrogens causing changes in the cellular pattern. Unlike the bitch, vaginal cytology is not routinely used in queens. The aim of this study was to characterize vaginal cytological patterns and standardize its interpretation in female cats.

Methods: Thirty-nine vaginal smears were collected from 33 intact queens using a simple and quick procedure with little if any physical restraint, analyzed for cellularity, clearing, epithelial cell types, and the presence of red blood cells or neutrophils. Queens were classified in different estrous phases based on reproductive history and serum progesterone levels.

Results: The 39 vaginal smears were classified as proestrus (N=1), estrus (N=9), interestrus (N=10), diestrus (N=9) and anestrus (N=9). One vaginal smear was not allocated to any cycle phase because the queen was diagnosed with pyometra. Cellularity was poor in 21/39 smears from which 8 were from queens in estrus. Cytological estrus was characterized by ≥ 90% keratinized epithelial cells, unlike previously reported, and presence of clearing in scarce to modestly cellular smear.

Conclusion and relevance: Progesterone concentration is needed to differentiate interestrus from diestrus due to the mixed cell population on vaginal cytology. Keratinized vaginal cells are consistently found in anestrus smears of queens and should not lead clinicians to assume the queen is cycling. Neutrophils can be present in the different estrous cycles in cats without being associated with clinical signs of disease, unlike red blood cells. These findings demonstrate that vaginal cytology can be a useful tool in feline practice for managing reproductive presenting complaints.

ObjectivesThe study aimed to assess caregivers' perspectives on feline chronic kidney disease (CKD).MethodsPeople living in Portugal caring for a cat with CKD were invited to participate in an online questionnaire.ResultsIn total, 405 responses were considered, with most participants (n = 309, 76.3%) dealing with feline CKD for the first time. International Renal Interest Society (IRIS) CKD staging was explained to 260 (64.2%) respondents, but only 188 (46.4%) confirmed that blood pressure was assessed at diagnosis. The recommendation of a renal diet was received by 387 (95.6%) respondents, but only 341 (84.2%) gave it, and, of the latter, 139 (40.8%) were ultimately offering at least some non-renal food daily. Medications, supplements/nutraceuticals and subcutaneous fluid therapy were administered at home by 255 (63.0%), 204 (50.4%) and 205 (50.6%) respondents, respectively. Among the caregivers who used a phosphate binder (n = 123), at least 46 (37.4%) were giving it without food. After diagnosis, the caregiver-cat emotional bond remained the same, improved or worsened in 285 (70.4%), 106 (26.2%) and nine (2.2%) cases, respectively. Most respondents felt completely informed by their veterinarian (n = 331, 81.7%), complied with the recommended monitoring frequency (n = 377, 93.1%) and believed that their experience would not influence future decisions to get a new cat (n = 221, 54.6%). Clinical signs and proteinuria, the need for medication and nutraceuticals/supplements, the administration of erythrocyte-stimulating agents and subcutaneous fluids, and the monitoring frequency were higher (P <0.05) in cats at late IRIS CKD stages.Conclusions and relevanceMost caregivers surveyed felt informed; however, some recommendations were not completely followed. Veterinarian-caregiver communication must be improved to ensure greater adherence to medical recommendations, and an early diagnosis should be pursued to minimise the caregiver burden.

Practical relevance: Cardiomyopathies are a common condition and the leading cause of congestive heart failure (CHF) in cats; however, to date there have been limited therapeutic options available. Commonly used therapeutics include diuretics for CHF and antithrombotics 2 to reduce the risk of arterial thromboembolism (ATE), which do not directly affect myocardial function. This review summarizes the evidence for the use of pimobendan, a phosphodiesterase III inhibitor and calcium channel sensitizer, in feline cardiomyopathies. Potential benefits of pimobendan in cats include improved left ventricular systolic and diastolic function, reduced platelet aggregation, reduction in left atrial size, and improved left atrial and auricular systolic function.Drug details:Pimobendan is indicated for the treatment of CHF in conditions associated with systolic dysfunction (including dilated cardiomyopathy, restrictive cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy and some cases with non-specific phenotypes) and has been used in the treatment of CHF secondary to hypertrophic cardiomyopathy. A dosage of pimobendan of 0.25 mg/kg PO q12h is generally well tolerated, and an approved oral solution is now available in the UK, EU, USA, Japan and Australia, which may facilitate administration in some cats; it should be noted, however, that pimobendan is not licensed for use in cats and marketing authorizations may vary between countries. Adverse events are uncommon with pimobendan but include gastrointestinal upset (anorexia, vomiting), transient changes in heart rate and possible worsening arrhythmias at higher doses. The use of pimobendan is contraindicated in cats with fixed obstructions of the left or right ventricular outflow tract (ie, congenital heart disease - pulmonic or aortic valvular stenosis).

Audience: This article reviews the use of pimobendan in cats for primary care veterinarians and includes practical case examples that reflect the typical use and recommendations for usage of pimobendan by the authors.

ObjectivesThe aim of this study was to describe renal ultrasonographic (US) findings in cats with confirmed renal lymphoma receiving chemotherapy and correlate them with clinical and clinicopathological findings.MethodsFor this multicenter retrospective study, cats were included if they had cyto-/histological confirmation of renal lymphoma, received multiagent chemotherapy, and US images of the kidneys before and after treatment were available. All images at T0 (diagnosis) and T1 (after chemotherapy) were reviewed. Oncology records were reviewed, and serum creatinine and blood urea nitrogen (BUN) concentrations were recorded, when available.ResultsA total of 24 cats (20 males, 4 females; median age 8 years) who underwent vincristine, cyclophosphamide and prednisolone (COP)-based chemotherapy were included. At T1 (median 33 days, range 20-60), 21 cats were considered to have experienced clinical benefit (20 with improved renal appearance on ultrasound, one with static appearance), two cats had stable clinical findings (one stable, one progressive ultrasound) and one cat clinically declined (progressive ultrasound). On ultrasonography, nephromegaly resolved in 12/20 cats, hypoechoic subcapsular rim disappeared in 6/17 and reduced in 7/17, and nodules and/or masses disappeared in 8/14 and reduced in 5/14 cats. Six cats had normal creatinine and BUN concentrations at both T0 and T1 (five improved and one with stable ultrasound findings); in 11 cats, the azotemia detected at T0 resolved at T1; four cats were persistently azotemic (all with reduced creatinine and BUN concentrations) and one cat became azotemic on T1 (progressive ultrasonography).Conclusions and relevanceAfter chemotherapy, kidneys affected by lymphoma commonly returned to their regular size; subcapsular rim, nodules and masses markedly reduced or completely resolved. US findings were often in agreement with clinical and clinicopathological findings.

ObjectivesThis study aimed to evaluate changes in serum insulin-like growth factor type 1 (IGF-1) concentrations in cats with hyperthyroidism before and after radioactive iodine (RAI) treatment, as well as investigate the correlation between thyroid volume and serum IGF-1 concentrations.MethodsA total of 13 cats with hyperthyroidism and 14 healthy controls were included. Serum total thyroxine (TT4)/thyroid-stimulating hormone (TSH) and IGF-1/insulin-like growth factor binding protein-3 (IGFBP-3) concentrations were measured using chemiluminescence immunoassay and ELISA, respectively, at presentation and 6 months after RAI treatment. The results were compared with thyroid volume measured using scintigraphy. Data are presented as median (interquartile range [IQR]) and analysed using non-parametric tests.ResultsSerum TT4 concentrations significantly decreased from 9.30 µg/dl (IQR 6.49-12.7) to 2.23 µg/dl (IQR 1.34-2.94) after RAI treatment (P <0.001), while TSH levels increased from 0.021 ng/ml (IQR 0.021-0.021) to 0.125 ng/ml (IQR 0.050-0.257) (P = 0.002). IGF-1 levels significantly increased from 329 ng/ml (IQR 240-479) to 572 ng/ml (IQR 402-1038) after RAI treatment (P = 0.011), while IGFBP-3 levels did not differ. Serum creatinine concentrations significantly increased from 1.3 mg/dl (IQR 1.2-1.6) to 2.0 mg/dl (IQR 1.7-2.3) after RAI treatment (P = 0.006). No correlation was observed between IGF-1 and any variable, except IGFBP-3 (r_s = 0.587; P = 0.039) in the pretreatment group. IGF-1 and body weight were significantly positively correlated after RAI treatment (r_s = 0.696; P = 0.011) but not before. In healthy cats, IGF-1 was negatively correlated with serum TT4 (r_s = -0.627; P = 0.019).Conclusions and relevanceThe increased serum IGF-1 concentrations after RAI treatment may reflect the restoration of anabolic status in cats with hyperthyroidism. In this study population, no correlation was found between thyroid volume and serum IGF-1 concentrations.