Abstract
This is the fifth and best book in Dr. August's Consultations in Feline Internal Medicine series. I have all of them and have read them all.
John August is a native of Surrey, England. He received his pre-veterinary education at Eastbourne College in Sussex, England, and graduated with honors from the Royal Veterinary College at the University of London in 1973 becoming a member of the Royal College of Veterinary Surgeons. He earned a Masters of Science degree at Auburn University and became a diplomate in the American College of Veterinary Internal Medicine (ACVIM) in Internal Medicine. He taught at Virginia-Maryland Regional College of Veterinary Medicine and then at Texas A&M. He presently is lead instructor on two federally-funded projects providing distance learning through two-way compressed video and the world-wide web, and shares responsibility for the feline internal medicine service at the Texas A&M Veterinary Medical Teaching Hospital.
His previous Consultations in Feline Internal Medicine, volumes 1, 2, 3, and 4 were published by the W.B. Saunders Company in 1991, 1994, 1997 and 2001, respectively.
This book is so very readable unlike Sherding's The Cat Disease and Clinical Management or Ettinger's Textbook of Veterinary Internal Medicine which always put me to sleep and were my last resort for information.
The book is written in 10 sections which are divided into 78 chapters. Many of the authors are familiar and tops in their field: Clarke Atkins, Joe Bartges, Ellen Behrend, Tony Buffington, Sharon Center, Dennis Chew, Joan Coates, Duncan Ferguson, Theresa Fossum, Philip Fox, Brenda Griffin, Margarethe Hoenig, Lynelle Johnson, Claudia Kirk, Michael Lappin, Jody Lulich, Andrew Mackin, Stanley Marks, Karen Moriello, Carl Osborne, Mark Papich, Mark Peterson, David Polzin, Cynthia Powell, Jacquie Rand, Craig Ruax, Patricia Schenck, Harriet Syme, Severine Tasker, Lauren Trepanier, Robert Washabau, Michael Willard, Alice Wolf and Debra Zoran. Each chapter is listed in the index along with the topic headings for that chapter and the page where that topic begins. The topic headings also appear at the beginning of each chapter like an outline so it is easy to navigate this book.
Here are some excerpts:
“FCV [Feline Calicivirus] is an RNA virus, characterized by high rates of mutation and high antigenic and genetic diversity. Although vaccination against caliciviruses is practiced commonly, these vaccines have incomplete efficacy.” (Janet Foley: Calicivirus: Spectrum of Disease, p.6)
That comment puts into question Fort Dodge's “Are you ready to tame the new breed of Calicivirus” campaign!
“Cats with FORLs [Feline Odontoclastic Resorptive Lesions] have significantly higher serum 25-hydroxyvitamin D (250HD) concentrations than cats without FORLs. Cats with FORLs are significantly more likely to have detectable calcitonin (CT) in their serum. Many commercially available cat foods contain excess concentrations of vitamin D.”
“Classic clinical and laboratory signs of vitamin D toxicosis include vomiting, increased serum 250HD concentrations, hypercal-cemia, hyperphosphatemia, azotemia and decreased specific gravity. In this study, cats with FORLs vomited significantly more often than cats without FORLs. The risk of FORLs increased by 2 per cent for each nmol/L elevation of 250HD.” (Kenneth Lyon: Odontoclastic Resorptive Lesions, p.69)
“Compared with dogs with liver disease, feline ALP and yGT increase only modestly and do not reflect drug or glucocorticoid induction.” (p89)
“Prothrombin formed in the absence of vitamin K is not converted to thrombin.” (p.90)
“…because of the cholestatic nature of feline liver disorders, total bilirubin concentrations are more sensitive as a test for liver disease in this species.” Then Dr. Center shows in charts that 90% of cats with extrahepatic bile duct occlusion [EBDO] and 72% of cats with hepatic lipidosis [HL] have higher levels of conjugated vs. unconjugated bilirubin while 70% of cats with hemolytic anemia [HA] have higher levels of unconjugated vs. conjugated bilirubin. (p.95-96) (Sharon Center: Current Considerations for Evaluating Liver Function)
“…the half-life of cobalamin in healthy cats is approximately 13 days, whereas in two cats with inflammatory bowel disease, the half-life was reduced to approximately 5 days.” (p. 122)
“Neoplastic cells also require cobalamin, and cobalamin deficiency theoretically may reduce the rate of growth and aggressiveness of lymphoid neoplasms.” (p. 125)
(Craig Ruaux: Cobalamin in the Diagnosis and Treatment of Chronic Gastrointestinal Disease)
“In a recent study of 434 cats, diagnostic disagreement between serum ionized and total calcium concentrations was 40 per cent.” (p.157)
“Lymphosarcoma and squamous cell carcinoma are the two most common, each accounting for approximately 33 per cent of cases of malignancy-associated hypercalcemia. Serum PTHrP concentration may be elevated but can be undetectable, because malignancy-associated hypercalcemia may be due to synthesis of other cytokines by the tumor.” (p. 163) “All commercial cat foods provide vitamin D in excess of the minimal requirements, but most companies do not routinely measure or provide information regarding the actual vitamin D content in their products because of expense and difficulty in the measurement.” (p. 164)
“A diagnosis of aluminum intoxication should be considered in cats receiving aluminum salt intestinal phosphate binders, although these cats closely resemble all features of idiopathic hypercalcemia. With aluminum intoxication, removal of aluminum-containing phosphate binders should eventually result in resolution of hypercalcemia, but resolution may take months attributable to bone stores of aluminum. Newer generation phosphate binders such a sevelamer hydrochloride and lanthanum carbonate do not contain aluminum, but we have little experience with these drugs, and there are no data on safety or efficacy in cats.” (p. 166) (Patricia Schenck, Dennis Chew, Ellen Behrend: Update on Hypercalcemic Disorders)
“Up to 12 per cent of cats with nonthyroidal illness that do not have hyperthyroidism have high free T4 concentrations for reasons that are unclear.”
(Mark Peterson: Diagnostic Methods for Hyperthyroidism, p. 194)
“In my [Freedman] private practice, a series of cats have been evaluated that had a palpable goiter detected during routine health examination. In about two thirds of these cats, a history of weight loss could be elicited, more that 33 per cent had heart murmurs and 20 per cent were tachycardic. However, none of the cats had serum TT4 or FT4 concentrations above the reference range nor had serious nonthyroidal illness that could suppress the TT4 and FT4 concentrations. Surgery was performed to remove the enlarged thyroid lobe: no significant morbidity occurred. On histopathology, approximately 80 per cent of the cats had adenomatous hyperplasia, 15 per cent had cystic changes and 5 per cent had an adenoma.” (p.209)
“Goitrogenic compounds in food or the environment generally reduce the efficiency of thyroid hormone synthesis by the thyroid gland, increasing TSH secretion secondarily and leading to thyroidal enlargement. Aside from iodine, most dog and cat foods contain relatively high levels of goitrogenic compounds such a phthalates. Cats fed a soy-containing diet had higher TT4 and FT4 concentrations than cats fed a soy-free diet.” (p.212)
“In a review of approximately 500 cats per year necropsied at The Animal Medical Center from 1970 to 1984, an average of less than two cats per year were found to have gross evidence of thyroidal enlargement of any etiology in the period before 1977, when the first cat with hyperthyroidism was diagnosed at that institution. Since 1977, both the prevalence of thyroidal pathological abnormalities and the associated clinical state of hyperthyroidism have been detected at a markedly increasing frequency, with the present incidence potentially as high as about one in 50 cats examined.” (p.213) (Duncan Ferguson, Richard Freedman: Goiter in Apparently Euthyroid Cats)
“In a study of 50 cats (24 ovariohysterectomized and 26 sexually intact queens) all ovariohysterectomized queens tested positive and 24 of 26 sexually intact queens tested negative for LH. Based on these results, the sensitivity of the ICG Status-LH Assay [Synbiotics] (the likelihood of a positive result in a spayed cat) was determined to be 100 per cent. The specificity of the test (the likelihood of a negative result in a sexually intact queen) was determined to be 92 per cent. In other words, all spayed cats tested positive, but if the test is negative, an 8 per cent chance still exists that the cat has been spayed.” (p. 221)
“Relaxin is the only hormone specific to pregnancy recognized presently in cats. Plasma concentrations increase 20 to 30 days after mating and remain elevated throughout pregnancy and for the first few days after birth. Although serum progesterone concentrations are elevated during pregnancy, they are not helpful for diagnosis because they do not differ significantly in pregnant and pseudopregnant queens.” (p.224) (Brenda Griffin: Diagnostic Usefulness of and Clinical Syndromes Associate with Reproductive Hormones)
Interested in dermatology? Want to know more about plasma cell pododermatitis, idiopathic facial dermatitis of Persian cats, auricular chondritis, or feline sarcoids? Good photos, too!
(Joan Rest: Controversial and Emerging Diseases, p.267-278)
“At the time of this writing, most published reports of transdermal application of drugs to cats showed that absorption was incomplete, nonexistent, or highly inconsistent among cats.”
(Mark Papich: Drug Therapy in Cats: Precautions and Guidelines, p.280)
How to perform bilateral trephination of the frontal sinuses in a cat.
(John August, Anne Bahr: Chronic Upper Respiratory Disease: Principles of Diagnosis and Management, p.359)
How to place a pleuroperitoneal shunt to treat chylothorax.
(Theresa Fossum: Chylothorax, p. 374)
Want to know how to perform a neurological exam on a cat? Really good photos and lots of them! Joan Coates, Jonathan Levine: Performing the Neurological Examination, p. 449-461)
Excellent flow chart to aid in diagnosing vestibular disease in cats! Simon Platt: Vetibular Disorders, p.535)
As you can see, I really like this book and hope you will, too!
I will be reviewing Jacquie Rand's Problem-based Feline Medicine in the next issue.
