Journal of Feline Medicine and Surgery最新文献

ObjectivesThe present study evaluated the safety and efficacy of intravenous, allogeneic uterine-derived mesenchymal stem cells (UMSCs) for client-owned cats with refractory feline chronic gingivostomatitis (FCGS).MethodsThis was a 90-day prospective, multi-site, baseline-controlled, clinical trial involving 46 cats with refractory FCGS after partial- or full-mouth extractions. Cats received two doses of 20 million UMSCs, 14 days apart. Effectiveness was evaluated at days 14, 28, 60 and 90 using owner-reported assessment of overall response (ORA), client-specific outcome measures (CSOM) of quality-of-life improvement and veterinarian-assessed global oral lesion score (GOLS) tissue healing. Safety assessments included clinical observations and clinical pathology.ResultsTreatment success rates at days 28, 60 and 90 were 61.4% (27/44), 76.3% (29/38) and 78.8% (26/33) for CSOM; 65.9% (29/44), 73.7% (28/38) and 75.8% (25/33) for ORA; and 31.8% (13/44), 47.5% (18/38) and 45.5% (15/33) for GOLS. CSOM and GOLS on day 14 after a single dose were 52.3% (23/44) and 25.0% (11/44), respectively. Cats treated within 6 months of tooth extraction had greater improvement in GOLS. There were no statistically significant differences in outcomes between cats with partial- or full-mouth extractions. Adverse events were generally mild and transient, with most related to underlying disease. All six serious adverse events were either unlikely to be due to, or in one case inconclusively attributed to, UMSC therapy.Conclusions and relevanceRepeated intravenous UMSC therapy was well tolerated and demonstrated clinically meaningful improvement in quality of life in cats with refractory FCGS within 2 weeks of treatment. In addition, oral lesions continued to improve over time. These results support the safe and effective use of UMSCs for this life-threatening condition.

This article reviews the importance of a team approach in feline chronic pain management for optimal outcomes. It discusses the role of different stakeholders and the importance of collaboration, communication and strategies for improved experiences for cats and caregivers on their journey. Chronic pain is maladaptive and negatively impacts on all domains of animal welfare. It can occur by itself, but most commonly is secondary to other chronic conditions. Ensuring that cats suffering from chronic pain are managed effectively requires a collaborative approach between all stakeholders, including client care staff, veterinarians, veterinary nurses or technicians, veterinary support staff and clinic management, as well as the cat and the caregiver. The journey starts with clinical signs displayed by the cat and perceived by the caregiver, and ends, for most cases, with end-of-life considerations. Diagnosis of chronic pain and design of a treatment plan result from a partnership between the caregiver and veterinary team. Management of chronic pain is focused on maintaining quality of life while empowering caregivers to be part of the healthcare team, avoiding adverse effects from medication and balancing comorbidities. The journey for cats and their caregivers is influenced by numerous factors, including the clinical condition of the cat and the caregiver's response to different burdens, but mostly by the care they receive from the clinic and veterinary teams involved in the process. Empathetic communication is paramount and helps to optimise the cat's care while supporting caregivers.

ObjectivesThe aim of this study was to determine if there were any characteristic features of urethral ruptures (URs) on plain radiographs of cats.MethodsA retrospective, multicentre, case-control study was conducted. Radiographs including the perineum of 22 cats with UR and 70 cats without UR were blindly assessed by two reviewers, scrutinising for features including a perineal bulge, heterogeneous perineal tissue and visibility of the urinary bladder.ResultsA significant association was identified between URs and a perineal bulge (P ⩽0.003), resulting in a sensitivity of 95.5% and a specificity in the range of 38.6-47.1%, and between the presence of URs and a larger perineal bulge size (P <0.001). URs secondary to traumatic accidents were associated with a larger perineal bulge than those secondary to iatrogenic rupture. Cats with URs were more likely to have heterogeneous perineal tissue (P <0.001). There was a significant association between pelvic fractures and a perineal bulge (P ⩽0.001), but not between pelvic fractures and URs (P = 0.783). Binary logistic regression revealed associations between the reviewers' suspicion for a UR and the reviewers' recommendation for a lower urinary tract contrast study (LUTS) and a confirmed UR (P <0.001). There was no significant association between an invisible urinary bladder and the presence of a UR (P ⩾0.243).Conclusions and relevanceIdentification of a perineal bulge or heterogeneous perineal tissue in a cat may raise suspicion for a UR, especially in the absence of musculoskeletal injury, which is crucial in reducing time to diagnosis and, therefore, treatment. However, because of the low specificity, correlation with the clinical findings and confirmation or exclusion via a LUTS remains necessary. Visibility of a urinary bladder does not exclude UR.

ObjectivesThis study aimed to detect hypoglycaemia episodes and evaluate glucose dynamics and glycaemic variability in insulin-treated diabetic and healthy cats using a continuous glucose monitoring system (CGMS). Blood glucose curves are useful for managing insulin-dependent diabetes mellitus (DM) but may miss the nadir and peak.MethodsA CGMS with a 7-day recording period (range 2.2-22.2 mmol/l) was implanted in six healthy and 10 insulin-treated diabetic cats to obtain 24-h glucose curves. For each cat, mean, minimum and maximum glucose concentration, SD and coefficient of variation (CV) were calculated for the daytime and night-time.ResultsMost diabetic cats removed sensors prematurely, but 24-h curves were obtained in all; the only adverse effect of the device was mild local skin irritation. In healthy cats, nights had higher SD (0.6 mmol/l [range 0.2-0.8] vs 0.4 mmol/l [range 0.2-0.6]; P = 0.037) and CV (13% [range 5-23] vs 10% [range 4-16]; P = 0.041) compared with the days; mean, minimum and maximum glucose concentration showed no diurnal-nocturnal differences. In diabetic cats, no differences were observed for mean, minimum and maximum glucose concentrations, SD and CV. Hypoglycaemia episodes (<3.5 mmol/l) occurred in five healthy and four diabetic cats, either during the day or night. Compared with well-controlled diabetic cats, those with moderate to poor control had higher mean and maximum glucose concentrations during the 24 h and had higher SD during the day than at night.Conclusions and relevanceContinuous glucose monitoring revealed increased nocturnal glycaemic variability in healthy cats but not in diabetic cats. Furthermore, cats with moderately to poorly controlled DM had higher diurnal glycaemic variability than those well controlled. Low glucose concentrations occurred in both groups and at any time, emphasising the benefit of 24-h glucose curves in diabetic cats.

ObjectivesThe aim of the study was to evaluate the efficacy and safety of capromorelin to manage weight loss in cats with unintended weight loss, as occurs in chronic kidney disease (CKD), in a randomized, masked, placebo-controlled, multicenter clinical field study.MethodsA total of 176 client-owned cats with existing CKD and unintended weight loss of 5% or more were enrolled. Cats were randomized 2:1 to receive capromorelin or a vehicle placebo orally once daily for 55 days. Changes in body weight and safety parameters were monitored throughout the study.ResultsBody weight increased progressively with time in the capromorelin group and decreased in the placebo group. For the effectiveness population data sample (n = 112), mean change in body weight from day 0 to day 55 was +5.18% (95% confidence interval [CI] 3.45-6.91) with capromorelin and -1.65% (95% CI -3.82 to 0.55) with placebo. The treatment effect (capromorelin minus placebo) from day 0 to day 55 was +6.81% (95% CI 4.21-9.42) with P <0.0001, representing +0.25 kg (95% CI 0.15-0.35) body weight. Hypersalivation was observed only in the capromorelin group (P <0.0001). For all other adverse events (AEs), there was no significant difference between the treatment groups: in the capromorelin group 96/118 (81.4%) cats and in the placebo group 41/58 (70.7%) cats had at least one reported AE (P = 0.3650).Conclusions and relevanceCapromorelin was safe and effective, and provides a valuable new option to maintain or increase body weight in cats with CKD.

This study aimed to evaluate the effects on intraoperative physiological parameters and adverse event occurrence and the post-operative analgesic efficacy of combined grapiprant and tapentadol in cats undergoing elective ovariohysterectomy, through two multidimensional pain scales.Sixty mixed-breed female cats were enrolled in a randomized, prospective, blinded study. The animals were evenly distributed into four groups (n = 15 per group). Fifty-one animals completed the study, the control group received placebo (CON, n = 11), while the grapiprant group (GRA, n = 13) received grapiprant (3.8 ± 0.5 mg/kg), the tapentadol group (TAP, n = 13) received tapentadol (5.3 ± 1.2 mg/kg), and the grapiprant-tapentadol group (GT, n = 13) received a combination of grapiprant (4.2 ± 0.5 mg/kg) and tapentadol (5 ± 0.6 mg/kg), orally one hour prior to initiation of the standardized anaesthesia protocol and surgical procedure. Physiological parameters were monitored during surgery, and post-operative pain was assessed for 6 hours following extubation using the UFESP-SF and the FGS, administered by two treatment-blinded evaluators.No adverse effects or statistically significant differences in physiological parameters were observed between groups. The assessment of pain scores showed good reliability, with Intraclass correlation coefficient values of 0.89 for the FGS and 0.91 for the UFESP-SF, supporting inter-rater agreement for both instruments. At 3 hours postoperatively, FGS scores differed significantly between CON and GT groups (p = 0.0363). Rescue analgesia requirements also varied among groups (p = 0.0110): GT required rescue at 3 hours, compared with 1 hour in CON (p = 0.0007) and 2 hours in GRA (p = 0.0058).The results of this study showed that the analgesic effect of the grapiprant-tapentadol combination lasted up to 3 hours in the postoperative period, which was longer than the 2 hours of grapiprant and tapentadol alone, without compromising intraoperative physiological stability.

ObjectivesThe goal of the present study was to screen two cat populations for osteoarthritis. There are an estimated 60 million cats in the USA, with a growing body of evidence identifying a high percentage of them as suffering from osteoarthritis (OA); however, many are undiagnosed. New tools, such as the Feline Osteoarthritis Checklist, are available for use in practice to help screen cats for OA.MethodsWorking with the same general small animal practice, one population of cats was retrospectively screened for OA using historical methods, including physical examination and owner engagement. These results were then numerically evaluated to a similar prospective population using the Feline OA Checklist as a screening tool. Five general practice veterinary clinics with feline patients participated in both parts of this study, providing a total of 502 cat medical records for the retrospective phase of this study and 437 completed screening forms in the prospective phase of this study.ResultsOf the cats in the retrospective phase of the study, 1% had orthopedic-related issues when methods of identification such as oral history and physical examination were used. When the Feline OA Checklist was used as a screening tool in a prospective population, 39% of cats were identified as demonstrating at least one behavior consistent with OA.Conclusions and relevancePain recognition is the first step of pain management, and the use of the Feline OA Checklist can help improve feline health and welfare by easily and readily identifying these patients. Utilizing tools such as the Feline OA Checklist to screen all cats in practice offers veterinary practitioners an efficient way to identify the impact of feline OA and begin alleviating pain-related suffering.

ObjectivesFeline osteoarthritis (OA) is a common, degenerative joint condition that is an important cause of chronic pain in cats. Cannabinoids have shown potential in reducing pain and inflammation in OA, but research in cats is limited. This study aimed to assess the safety and efficacy of a cannabidiol (CBD)/cannabidiol acid (CBDA) paste would in cats with OA. We hypothesised that CBD/CBDA paste would reduce pain scores and would be safe for use without significant adverse effects.MethodsIn this randomised, double-blinded, placebo-controlled crossover study, client-owned cats with OA were assigned to two study groups and received a 6-week course of both CBD/CBDA paste and a placebo. During the initial consultation and following appointments, cats underwent orthopaedic examination pain assessment with the North Carolina State University Translational Research in Pain (TRiP) Feline Musculoskeletal Pain Index scoring system and blood examination. Owners filled in a bi-weekly questionnaire (Dutch Orthopaedic Rating for Feline Osteoarthritis Pain, DORFOP). TRiP and DORFOP scores were analysed using mixed-effects models. Clinical chemistry in week 6 was compared using paired t-tests.ResultsA total of 26 cats participated in the study. Of these, 12 dropped out primarily because of their refusal to eat the CBD/CBDA paste, and, in some cases, vomiting was reported. Fourteen cats were left to complete the study. CBD/CBDA paste significantly reduced TRiP and DORFOP scores after 6 weeks of administration, with changes in DORFOP starting after 2 weeks. No differences in clinical biochemistry were observed between the placebo and CBD/CBDA paste at week 6.Conclusions and relevanceCBA/CBDA paste effectively reduced pain in cats, but the high drop-out rate is concerning. Further research with larger sample sizes and longer treatment durations is needed to confirm these findings.

ObjectivesThe aim of the study was to compare the neutrophil:lymphocyte ratio (NLR) and platelet:neutrophil ratio (PNR) in cats with or without hypertrophic cardiomyopathy (HCM) and cardiogenic arterial thromboembolism (CATE) and to evaluate their prognostic significance in cats with HCM.MethodsHealthy cats and cats with HCM and CATE were prospectively enrolled between 2018 and 2020. Complete blood count and echocardiogram were performed. NLR and PNR were compared between cats in healthy, HCM and CATE groups. Outcome data, including cause of death, time to death and progression of HCM, were collected via review of medical record and owner interviews. Associations between time to cardiac-related mortality, NLR and PNR were analyzed using Kaplan-Meier curves and the Cox proportional hazards regression model.ResultsA total of 110 cats were enrolled, including 42 healthy cats, 57 cats with HCM (37 stage B1, 9 stage B2, 11 stage C) and 11 cats with CATE. Cats with CATE had the highest NLR (5.8, range 3.1-12.7) compared with HCM (P = 0.03) and healthy cats (P ⩽0.0001), while NLR was higher in cats with HCM (3.3, range 1.8-5.1) compared with healthy controls (P = 0.04). PNR was lower in cats with CATE (16.6, range 13.2-27.9) compared with healthy cats (P = 0.0027). Although PNR did not differ between cats in the healthy and HCM groups (P >0.9), HCM-affected cats with PNR below 40 had a significantly lower median survival time (1093-1185 days) compared with those with PNR above 40 (P = 0.03). Cats with PNR below 40 at the time of HCM diagnosis also had a significant risk (hazard ratio 9.8; P = 0.03) of cardiac-related mortality.Conclusions and relevancePNR is an accessible and cost-effective hematological biomarker that outperforms NLR and echocardiographic findings in cats with early subclinical HCM. Alterations in NLR and PNR in cats with HCM and CATE suggest a potential role of systemic inflammation in feline HCM.