Journal of Feline Medicine and Surgery最新文献

Since 2020, the emergence and global dissemination of high pathogenicity avian influenza (HPAI) H5Nx clade 2.3.4.4b infection has had devastating effects in wild and domestic bird populations, and resulted in spillover events in many terrestrial and marine mammalian species, including susceptible captive big cat collections, and feral and domestic feline species. The recent outbreaks in dairy herds in the USA following proposed exposure to infection from wild birds, with subsequent spread to in-contact mammals, demonstrates successful interspecies transmission of this virus and warrants close monitoring. In this literature review, we provide an overview of HPAI H5N1 infection in feline species to date, focusing on domestic but also captive wild cats, looking at the epidemiology, clinical and pathological presentations and management, and a current perspective on risk, testing and strategies to prevent infection.

ObjectivesTo determine the clinical relevance of gallbladder sludge (GBS) in cats by assessing its association with neutrophilic cholangitis/cholangiohepatitis (NC/CH), bile culture results, serum biochemical abnormalities and ultrasonographic findings suggestive of pancreatitis or small intestinal thickening.MethodsA retrospective review was performed on 166 cats that underwent percutaneous ultrasound-guided cholecystocentesis. Data collected included ultrasonographic presence of GBS, bile culture and cytology results, liver enzyme activities, total bilirubin concentration and final diagnosis of NC/CH. Statistical associations were evaluated using Fisher's exact test and odds ratios (ORs).ResultsGBS was identified in 107/166 (64%) cats. There was no significant association between GBS and positive bile culture, bactibilia or NC/CH (P >0.84), nor with elevated alkaline phosphatase activity or total bilirubin (P >0.8). Cats with GBS were more likely to have normal alanine aminotransferase (ALT) activity compared with GBS-negative cats (OR 0.42; P = 0.025). Among GBS-positive cats, the presence of concurrent pancreatitis or intestinal thickening did not significantly increase the likelihood of NC/CH. A non-significant association was observed between elevated ALT activity and NC/CH in GBS-positive cats (OR 2.53; P = 0.135).Conclusions and relevanceGBS is a frequent ultrasonographic finding in cats but does not reliably predict biliary infection or inflammation. These findings suggest that GBS should not be used in isolation to guide antimicrobial therapy or bile sampling. Clinical judgment and supporting diagnostic data remain essential in evaluating suspected hepatobiliary disease.

Case series summaryFeline otitis media (FOM) is an inflammatory condition of the middle ear in cats. The bony septum of the tympanic bulla divides it into lateral and medial compartments, making general middle ear lavage insufficient for clearing the medial compartment. The effectiveness of video-otoscope (VO)-guided myringotomy and saline lavage of the middle ear has been recently demonstrated; however, recurrence was noted in some cases. In this study, we evaluated the efficacy and safety of VO-guided septum bulla fenestration (SBF) with lavage of the medial compartment in 31 cats (44 ears) diagnosed with FOM. The cases were retrospectively reviewed between August 2021 and November 2023. Diagnoses were based on clinical signs (eg, chronic otorrhea and vestibular signs), imaging (CT, MRI or radiography) and myringotomy findings. All cats underwent middle ear lavage followed by SBF to access the medial compartment. During myringotomy and SBF, the obtained samples were evaluated cytologically and clinical signs were monitored for at least 6 months. Significant additional effusion was drained from the medial compartment in 38 (86.4%) ears, and bacteria were identified on cytology in 5.3% of the samples. A total of 16 ears showed recurrence or persistent clinical signs; most responded to subsequent medical therapy or repeat lavage without requiring surgery. Overall, stable remission was achieved in 39/44 (88.6%) ears. No severe postoperative complications were observed; one cat had transient facial nerve paralysis and another had Horner's syndrome.Relevance and novel informationVO-guided SBF provided minimally invasive access to the medial compartment of the tympanic bulla, allowing lavage of otherwise inaccessible effusion. Most cases achieved stable remission, but recurrence occurred in some, indicating that SBF may serve as an adjunct therapy rather than a definitive solution. Further studies with extended follow-up are needed to clarify its long-term prognostic value.

ObjectivesThis study aimed to evaluate the association of anaemia and thrombocytopenia with the presence and severity of ocular lesions in cats.MethodsCats were prospectively recruited into four groups in this cross-sectional study: anaemic (A) (haematocrit level ⩽24%, n = 20), thrombocytopenic (T) (platelet count of ⩽200 × 10⁹/l, n = 10), anaemic and thrombocytopenic (AT) (n = 33) and healthy controls (C) (n = 20). All cats underwent a comprehensive ophthalmic examination, with lesions classified as absent, minor (isolated retinal haemorrhages) or major (diffuse retinal haemorrhages, hyphaema or intravitreal bleeding). Signalment, clinical signs, diagnostic test results and final diagnoses were collected from the medical records.ResultsOcular lesion prevalence was 20%, 10%, 48% and 0% in the A, T, AT and C groups, respectively. Among affected cats, minor and major lesions occurred in 67% and 33% of cases, respectively. All major lesions were observed in groups T and AT. Anaemia and thrombocytopenia were significantly associated with both the presence (P_anaemia = .001, P_{thrombocytopenia} = .002) and severity (P_anaemia <.001, P_{thrombocytopenia} = .006) of ocular lesions. A haematocrit value of ≤18.5% had a sensitivity of 91% and specificity of 58% for detecting ocular lesions.Conclusions and relevanceAnaemia and thrombocytopenia were significantly associated with the presence and severity of ocular lesions in cats in this study. Cats with concurrent anaemia and thrombocytopenia exhibited a higher prevalence of ocular lesions than those with either condition alone. This finding warrants further investigation into potential underlying mechanisms. Based on these results, any cat presenting with anaemia or thrombocytopenia should undergo a complete ophthalmic examination.

Practical relevance: Over the past 10 years, feline medicine has significantly advanced through the addition of new pharmaceuticals and alternative formulations available for cats, as well as improvements in the knowledge about existing agents. Through continued drug development, the therapeutic options for cats are expanding.

Clinical challenges: There are many speciesspecific clinical challenges encountered with the treatment of feline diseases. Additionally, therapeutic options can vary based on geography and change over time.

Evidence base: This review article discusses the current evidence for some of the newer therapeutic agents that are either presently available for use by feline medicine practitioners or are in development and undergoing clinical trials. Their recent introduction means the evidence for some of these medications is still emerging. The clinical use of these agents, available pharmacokinetic and pharmacodynamic data, and reported adverse effects in cats are presented.

Audience: The information in this article is relevant to all veterinarians who practice feline medicine.

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.