Journal of Veterinary Internal Medicine最新文献

Background: The proportion of cats with hypertrophic cardiomyopathy (HCM) that lose systolic anterior motion of the mitral valve (SAM) in the long term is unknown.

Hypothesis/objectives: Cats with HCM will lose SAM in the long term. Loss of SAM will be associated with greater age, longer scan-interval, and altered left ventricular (LV) dimensions.

Animals: Sixty unsedated cats with HCM, not receiving beta blockers or pimobendan.

Methods: A retrospective cohort study from 2 referral centers. Cats were eligible if they had been diagnosed with HCM and had a repeat echocardiogram ≥1 year later. Clinical and echocardiographic data of the left heart variables were collected.

Results: Thirty-eight cats had SAM at the initial scan. After a median follow-up time of 2.1 years (range: 1.0-5.9), 7 cats had lost SAM (18%) and 5 cats (23%) gained SAM. On follow-up, cats with SAM at the initial scan had a larger left atrium (P = .037), lower left atrial fractional shortening (P = .014), greater LV internal diameter in end-systole (P = .002), and lower LV fractional shortening (P < .001). Four cats with SAM developed congestive heart failure. There were no new cases of congestive heart failure or change in left heart variables in cats without SAM at the initial scan. The gain or loss of SAM was not associated with age or time between scans.

Conclusions and clinical importance: Similar proportions of cats gained or lost SAM. Cats with SAM at baseline had more evidence of disease progression than cats without SAM.

Background: Before the discovery of effective antiviral drugs, feline infectious peritonitis (FIP) was a uniformly fatal disease of cats. Multiple antiviral treatments have been recognized, but optimization of treatment protocols is needed.

Objective: To evaluate the efficacy of PO molnupiravir (MPV; EIDD-2801) to treat effusive FIP.

Animals: Ten cats with naturally occurring effusive FIP and 10 historical control cats with effusive FIP treated with PO GS-441524.

Methods: A single-center, prospective, open-label longitudinal, non-inferiority trial with historical controls. Ten cats with FIP were enrolled and treated with PO MPV (10-15 mg/kg PO q12h) for 84 days. Cats were evaluated at 0, 6, and 16 weeks, and the proportion of cats in clinical remission at 16 weeks was determined. Survival and clinicopathologic features were compared with historical control cats with effusive FIP treated with PO GS-441524.

Results: Eight of the 10 cats treated with MPV survived and were in remission at 16 weeks. The 2 non-survivors died in the first 24 hours of treatment. No adverse events that necessitated discontinuation of treatment were observed. Survival of cats treated with PO MPV was non-inferior to historic control cats treated with PO GS-441524 (5/9 [55%] survived), with a difference in survival of 25% (90% confidence interval, -9.3% to 59.3%). Clinicopathologic features associated with FIP normalized during the study period, and no differences in clinicopathologic data at each study time point were observed when comparing cats treated with MPV and GS-441524.

Conclusions and clinical importance: Molnupiravir is an effective antiviral treatment for effusive FIP.

Background: Monitoring serum phosphorus concentrations is crucial in the management of chronic kidney disease in cats. The diurnal variation of serum phosphorus concentration may affect clinical assessment.

Hypothesis/objectives: Characterize the diurnal variation of serum phosphorus concentration in cats and determine the associations between changes in serum phosphorus concentration and several metabolites of phosphorus metabolism.

Animals: Six apparently healthy, intact male, specific-pathogen-free cats were housed in a photoperiod, humidity, and temperature-controlled facility.

Methods: Blood sampling was performed hourly for 24 hours to obtain the serum concentrations of phosphorus, ionized calcium, parathyroid hormone, and calcidiol. Results were analyzed using linear mixed-effect models to determine the significance of diurnal variation and associations between serum phosphorus concentrations and other metabolites over time.

Results: Diurnal variation in serum phosphorus concentration was noted with an apex around 11:00 followed by gradually declining concentrations to reach the nadir around 23:00. The serum phosphorus concentration again increased through the early morning on the next day. An approximately 25% difference in serum phosphorus concentration at the apex and the nadir was documented. A non-linear relationship between the serum concentrations of phosphorus and ionized calcium over time was identified.

Conclusions and clinical importance: Diurnal variations of serum phosphorus concentration and associations between the trending of serum phosphorus and ionized calcium concentrations were evident in a group of clinically healthy adult cats housed in a controlled environment. These findings can help in the interpretation of clinical and research data regarding calcium and phosphorus metabolism and kidney health in cats.

Background: Limited information is available on gastric diseases in neonatal foals as compared with extensive studies in young, adult, and geriatric horses. Reports on fetuses are scarce.

Objectives: Assess at necropsy stomachs of horse, donkey and mule fetuses in the third trimester of gestation to characterize lesions present during intrauterine life.

Animals: Forty-six fetal stomachs from both sexes (21 horses, 21 donkeys, and 4 mules) in the third trimester of gestation were collected from a processing plant immediately after slaughter.

Methods: Measurements of longitudinal and transverse axes, weight and volume and gastric fluid pH were taken, and glandular and squamous mucosae were inspected. All findings of the gastric mucosa and measurements of the stomachs were presented descriptively. Groups were compared statistically, with significance level set at P < .05 for all evaluations.

Results: All gastric contents had pH >5.8, and mules had larger stomachs and higher weights compared with horses (P < .05). Macroscopic lesions were classified as hyperemic, punctate, and erosive. Histopathologically, lesions were consistent with a chronic inflammatory process.

Conclusions and clinical importance: Our study provides evidence of macroscopic and histopathological lesions in the gastric mucosae of equid fetuses in the last trimester of gestation. Relevant information for perinatology and neonatology is provided regarding the prevalence and classification of preulcerous lesions in equids before birth.

Background: Minimizing harm from antimicrobials requires use of the narrowest spectrum drug, at an effective dose for the minimum effective duration. Many prescribers are not currently following these guidelines. To address suboptimal antimicrobial use, the underlying reasons must be understood.

Objectives: To identify factors influencing choices of antimicrobial drug, dose, and duration for companion animals.

Subjects: Twenty-two veterinarians treating companion animals in Australia. Diversity of participants was deliberately sought.

Methods: Semistructured interviews were conducted online. Two case studies were discussed, and then a range of broader questions was posed. Transcripts were analyzed thematically, using an inductive approach.

Results: Few participants chose guideline-concordant management for the case studies. Prescribing choices were influenced by a complex array of factors associated with the clinical case, pet owner, drug, veterinarian, veterinary colleagues, and external factors. Key factors driving broad-spectrum antimicrobial use included a sense of safety, habit, ease of administering the drug (especially in cats), pharmaceutical marketing, and the self-perpetuating dispensary cycle. Many participants were concerned about antimicrobial resistance, but insufficiently informed about how to minimize this risk. Several participants believed that longer duration of treatment and ensuring patients finish a predetermined course would decrease the risk of antimicrobial resistance and improve clinical outcomes.

Conclusions and clinical importance: Veterinarians are engaged with the concept of antimicrobial stewardship, but face numerous practical barriers and require more information. In particular, improved education is needed on enhancing patient safety by minimizing both spectrum of activity and duration of treatment, and dispelling myths about "finishing the course."