Journal of Feline Medicine and Surgery最新文献

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.

ObjectivesThe purpose of this study was to evaluate the accuracy of visual weight estimation by veterinary students for free-roaming cats presented in traps during trap-neuter-return (TNR) events and identify variables that predict the percentage difference between estimated and actual weights.MethodsDuring five TNR events, veterinary students, veterinarians and technicians visually estimated weights for 308 cats. Actual cat weights were measured, and the accuracy of visual estimates was evaluated using the percentage of estimates within 10% (PW10) and 20% (PW20) of actual weight. Predictors of percentage difference were analyzed using mixed-effects linear regression. Dosing accuracy of the induction cocktail was assessed by comparing estimate-derived drug doses to the target range.ResultsStudent estimates achieved a PW20 accuracy of 44%, lower than veterinarians (56%) but higher than technicians (35%). Accuracy within 10% (PW10) was limited across all groups, with students achieving 14% compared with veterinarians at 33%. Dosing based on student estimates fell within the target range for 85% of cases, compared with 95-96% for veterinarians, technicians and consensus estimates. Systematic errors included overestimating lighter cats and underestimating heavier cats, with posture and using kilograms vs pounds also affecting accuracy.Conclusions and relevanceAlthough student estimates were less accurate than those by veterinarians, dosing derived from these estimates was clinically acceptable in most cases. Training on systematic biases and leveraging consensus estimates may improve accuracy. Integrating veterinary student weight estimates into TNR programs is feasible with appropriate safeguards, including training on systematic estimate biases, estimate consensus and post-induction monitoring.

ObjectivesFeline intervertebral disc disease (IVDD), historically an uncommonly described problem, is being increasingly documented in the current literature. The objective of this systematic review was to consolidate existing knowledge of feline IVDD, identify possible prognostic factors and assist by offering clearer guidelines when managing a feline spinal patient.MethodsA systematic search of two databases was conducted using keywords related to feline IVDD. Studies with cats diagnosed with IVDD, including treatment and outcome details, were reviewed. Prognostic factors were evaluated for their impact on overall outcomes.ResultsA total of 57 studies with 1113 cats were identified after the reviewing process and 23 studies with 93 cats remained for statistical analysis. Most cats (59%) had lumbar spine involvement, followed by thoracolumbar (31%) and cervical (5%) segments. Intervertebral disc extrusion was the most common diagnosis (65/93), followed by intervertebral disc protrusion (16/93) and acute non-compressive nucleus pulposus extrusion (12/93). Deep pain perception was preserved in 87% of cats. Surgical intervention was performed in 75/93 cats while 17/93 were treated conservatively, with 1/93 being euthanased intraoperatively. Overall, 85% of cats had a positive outcome, 11% had a negative outcome and outcomes were undetermined in 4% of cases. Possible influencing factors analysed included breed, sex, age (in years and life stage), weight, affected spinal segment, number of affected discs, micturition status, treatment choice, deep pain perception and IVDD type. No statistically significant prognostic factors (P >0.05) were identified.Conclusions and relevanceAlthough no specific prognostic factors could be identified, the systematic review suggests that feline IVDD has a predominantly positive prognosis regardless of treatment choice. Given the low evidence level and small sample size, further multicentre, prospective studies with larger cohorts are required to establish reliable prognostic factors for feline IVDD.

Fluorescent in-situ hybridisation (FISH) facilitates visualisation of intracellular bacteria in tissues. There is little research looking at the role of intracellular bacteria in inflammatory disease within feline medicine.To determine whether bacteria are present in feline cardiac, hepatic and renal tissues where inflammation has been identified and compare the location of any bacteria with areas of inflammation within those tissues.Study group (SG) cases were selected from Ross University School of Veterinary Medicine's pathology archive, 2012-2022. 23 cases fulfilled inclusion requirements. Three sequential sections were assessed by FISH (using eubacterial and non-eubacterial probes) and hematoxylin-eosin staining. Control group (CG) cases were selected from the same archive (n=6) where death was trauma-related; no other disease states were noted; the same three tissues were available for testing. Known bacteria-positive sections were included with each batch of slides processed to confirm successful hybridization.52.12%, CI 30.6-73.2 SG cases demonstrated bacteria within some or all tissues tested. 78.3%, CI 56.3-92.5 demonstrated the presence of inflammatory cells (IC) in one or more tissues. Of the IC-positive SG cases, 61.1%, CI 35.7-82.7 demonstrated bacteria by FISH; the presence of bacteria in either the liver or kidney, was frequently associated with the presence of IC 77.7%, CI 40.0-97.2 cases and 80%, CI 28.4-99.5 cases respectively. In these, IC distribution did not match bacterial distribution. Of CG cases, 83.3%, CI 35.9-99.6 were negative for IC. Notably, in the IC-negative CG cases, two were positive for bacteria by FISH 40%, CI 5.3-85.3. Pearson-Chi2-test demonstrated a Chi2 of 0.71; P=0.40.Despite this pilot study being limited by a small sample size, bacteria were successfully detected within FFPE samples of feline heart, liver and kidney. We demonstrated that bacteria may not co-locate with all instances of inflammation, suggesting the need for greater vigilance for the presence of fastidious bacteria and/or low-grade infection.

Oral and dental diseases are commonplace in cats, imposing a responsibility on primary care veterinarians to provide high quality oral healthcare for their feline patients. While patient assessment begins with an examination of the conscious cat, further assessment under anesthesia is necessary for the purposes of radiography and treatment, making anesthesia an essential component of feline dentistry. Because feline patients with oral and dental diseases, as well as those convalescing from surgery, generally experience pain, multimodal perioperative analgesia and anesthesia are standard features of oral and dental care. The '2025 FelineVMA feline oral health and dental care guidelines' are coauthored by a Task Force of board-certified veterinary specialists and a veterinary technician specialist in dentistry convened by the Feline Veterinary Medical Association (FelineVMA). These experts have compiled evidence-guided recommendations for optimal oral health and dental care, including therapeutic interventions, in general feline practice. The focus is on the most commonly encountered oral and dental diseases in cats. These include periodontal disease, early-onset gingivitis, tooth resorption, endodontic disease and tooth trauma, feline chronic gingivostomatitis, developmental abnormalities such as malocclusion, and oral masses and growths, as well as various miscellaneous conditions. An extensive bibliography provides additional resources that extend beyond the topics reviewed in these Guidelines. Caregivers should be active participants in their cat's oral and dental healthcare. Veterinary team members can empower their patients' caregivers by educating them on signs of oral and dental disease in their cats and by providing home care guidance for maintaining oral and dental health. In any high-performing practice that cares for cats, the entire practice team are advocates for oral and dental care, and are knowledgeable about the principles of prevention and treatment of this important assortment of diseases.

ObjectivesThis study investigated the presence of nucleated red blood cells (NRBCs) in the circulation as a prognostic factor in critically ill cats.MethodsCritically ill cats were prospectively included over 11 months if they fulfilled at least 3/4 systemic inflammatory response syndrome (SIRS) criteria or if their general condition was severely reduced. All cats underwent a physical examination and blood collection for haematological and clinical chemical parameters, including NRBCs at admission and during hospitalisation. Outcome was defined as survival to 28 days after discharge from hospital. For manual microscopic NRBC count, 300 nucleated cells were examined and recorded as relative NRBC count (rNRBC). Absolute NRBC (aNRBC) numbers were calculated from those values: aNRBC = rNRBC × (white blood cell [WBC]/100).ResultsNRBCs, and most commonly metarubricytes, were detected in 25/94 critically ill cats. Primary underlying diseases were infectious (n = 10), neoplastic (n = 33), metabolic (n = 29), cardiovascular (n = 10), neurological (n = 5) and miscellaneous (n = 7). A positive correlation of absolute NRBCs with corrected WBCs (r = 0.448) was observed. After 28 days, 18 cats were still alive and 76 cats did not survive. Mortality did not differ between NRBC-positive and NRBC-negative cats (P = 0.641). Absolute NRBC count was 0.382 × 10⁹/l (range 0.032-28.990) and did not differ between survivors and non-survivors. Anaemia was not associated with NRBCs. All but one of the six NRBC-positive cats on day 2 did not survive.Conclusions and relevanceNRBCs can be observed in the blood of critically ill cats; however, their occurrence did not have a prognostic value.

ObjectivesThe aim of the present study was to identify the prevalence of corneal injury in cats undergoing general anesthesia (GA) while receiving prophylactic ocular lubrication, identify risk factors for corneal injury and quantify the effect of GA on tear production in cats.MethodsA total of 42 cats undergoing GA for non-ophthalmic procedures were included. Before GA, an ocular examination including a Schirmer tear test-1 (STT-1) and fluorescein stain (FS) was performed. Prophylactic lubrication was administered at the time of anesthetic induction and repeated every 15 mins until extubation. At 1 h after extubation, STT-1 and FS were performed and repeated hourly for 4 h. A Shapiro-Wilk test and paired t-test compared STT-1 results before and after GA. Logistic regression was used to analyze corneal injury and possible risk factors for corneal injury.ResultsNo cats developed FS uptake consistent with corneal ulceration. In total, 14 cats and 23 (27.4%) eyes developed corneal erosion at all time points. There was a significant decrease in tear production at all four time points after GA. Pre-medication opioid choice and corneal exposure were identified as significant risk factors for corneal injury.Conclusions and relevanceCorneal ulceration did not develop after GA in this study. There was a significant decrease in tear production in cats for at least 4 h after GA. Cats appear to have a higher prevalence of corneal injury after GA compared with dogs. Frequent eye lubrication is recommended for feline patients during and after GA.