Abstract
A Case of Feline Gastrointestinal Eosinophilic Sclerosing Fibroplasia Associated with Zygomycetes Fungi
Jorge Castro-López1,2, Mireia Fernández2, Ana R de Sousa3 and Natalia Majó3
1Department of Animal Medicine and Surgery, Veterinary Faculty, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
2Fundació Hospital Clínic Veterinari UAB, Barcelona, Spain
3Department of Animal Health and Anatomy, Veterinary Faculty, UAB, Barcelona, Spain
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Feline gastrointestinal eosinophilic sclerosing fibroplasia (FGESF) is a recently reported gastrointestinal disease that mainly consists of eosinophilic inflammation with nodules composed of collagen and myofibroblasts, and may produce similar clinical signs to intestinal obstruction.
A 9-month-old entire male Persian kitten was referred for investigation of acute haematemesis and melaena. On physical examination, the patient presented with a low body condition score, pale mucous membranes and an abdominal mass. Abnormal haematological findings included severe anaemia, mild neutrophilia and moderate eosinophilia, and mild hypoproteinaemia. Abdominal radiographs showed a dilated and thickened wall of a small intestinal loop, compatible with obstruction. Abdominal ultrasound examination revealed a marked thickening of the pyloric and duodenal wall, and enlarged mesenteric lymph nodes, compatible with neoplasia and inflammation. Coagulation tests were normal. Retrovirus status was negative. On exploratory laparotomy, a mass was observed that involved the pylorus and proximal duodenum. The owner elected for euthanasia. The histopathological diagnosis was severe FGESF with intralesional zygomycetes in the pylorus, duodenum and lymph nodes.
The name FGESF was proposed in one report describing 25 cases. The most frequent clinical findings of FGESF are vomiting, weight loss and eosinophilia. It affects mainly the pyloric sphincter and mesenteric lymph nodes. The cause is unknown, but FGESF has been associated with bacterial infections (Gram-positive and Gram-negative rods, and Gram-positive cocci) but not previously with fungal infections. The fungi in this case were likely ingested and may have colonised the ulcerated and necrotic surface of the lesion or were found as saprophytes. Noteworthy in the histopathology were the arrangement of the inflammation around the zygomycetes and the presence of the same fungi in draining lymph nodes, suggesting that they may have played a role in lesion development. Fungal culture was not performed; hence, we are currently trying to determine the species by polymerase chain reaction. To the authors’ knowledge, this is the first report of FGESF associated with zygomycete fungi.
Acceptance of the Uraemic Toxin Binder, AST-120, by Cats when Mixed with Food
Annette Bögel, Gerald F Beddies and Bernard H Schmidt
Global Drug Discovery Animal Health, Discovery Pharmaceutical Specialties, Bayer Animal Health GmbH, Leverkusen, Germany
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AST-120 (Kureha Corp, Tokyo, Japan) is a novel carbon-based oral adsorbent of uraemic toxins. The compound, registered in Japan as Kremezin for human use and as Covalzin for veterinary use, is currently in clinical development in North America and Europe for use in cats with chronic kidney disease. As for all chronic oral medications of cats, voluntary acceptance of the treatment is vital for owner compliance and therapeutic success. The goal of the present study was therefore to evaluate the acceptance of AST-120 by cats when mixed with moist food. In order to challenge the drug with even more stringent conditions than to be faced in practice, the doses tested exceeded the maximal theoretical exposure achieved with the proposed posology, ie, 360 mg/kg, by a factor of 3x and 5x, respectively.
The experiment was designed as an explorative, randomised, non-blinded study with three parallel groups and two study periods of 2 weeks each. Sixteen adult healthy European shorthair cats were allocated randomly to one of three groups: group A (n = 6, 1080 mg AST-120/kg body weight), group B (n = 6, 1800 mg AST-120/kg body weight) and group C (n = 4, untreated controls). During the initial period, the ‘control period’, all cats were fed diet only (Science Plan, Hill’s with beef taste, Hill’s Pet Nutrition GmbH) in order to acclimatise them to the test conditions of individual feeding and to determine their individual feed requirements and feeding habits. In the second study period, the diet was supplemented daily with AST-120 according to the random group allocation of the animals. The voluntary consumption of the food was monitored. Moreover, systemic tolerance of the intake of AST-120 was evaluated by body weight, food consumption, physical examinations and daily observations.
The treatment with AST-120 was well accepted by the cats. Food consumption behaviour was unchanged in all groups as compared to the control period, and no differences in feeding behaviour of the treatment groups A and B were observed in the treatment period compared to the untreated control group C. General health was undisturbed in all cats throughout the study. Body weights remained stable in all three groups and no treatment-related changes in the general characteristics of faeces occurred.
It is concluded that AST-120 mixed with moist food is very well accepted and tolerated by cats, even at very high doses of up to 1800 mg/kg body weight.
Effects of Concurrent Ronidazole and Probiotic Therapy in Cats with Tritrichomonas Foetus-Associated Diarrhoea
Stephanie M Lalor and Danièlle A Gunn-Moore
Royal (Dick) School of Veterinary Studies, Division of Veterinary Clinical Sciences, The University of Edinburgh, Scotland, UK
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This was a prospective double-blinded placebo-controlled trial designed to determine if there was a beneficial effect to giving a probiotic in addition to ronidazole for the treatment of Tritrichomonas foetus-associated diarrhoea in cats. The probiotic used was Pro-Kolin Enterogenic (PKE, Protexin; Probiotics International), which contains the probiotic Enterococcus faecium, several prebiotics, alpha-glucan butyrogenic and a patented mucopolysaccharide starch.
The trial involved using ronidazole at 10–30 mg/kg q24h orally for 2 weeks. The cats were also started on either a placebo or probiotic on the same day as ronidazole (classified as day 1) and this was continued for 4 weeks. A total of 26 cats met the inclusion criteria: 13 in group A (placebo) and 13 in group B (PKE-treated).
All of the cats in the study were purebred cats. The mean age of cats in group A was 9.8 months (range 3–28 months) and the mean age in group B was 10.8 months (range 2–24 months). There was no significant difference between the ages (P >0.05). All cats, with the exception of one in group A, had concurrent infections detected by faecal polymerase chain reaction. The duration of follow-up was 2–32 weeks, and there was no significant difference between the mean duration of follow-up between the groups (P >0.05).
Both groups improved significantly over the course of treatment with regards to faecal scoring and body weight (P <0.05). However, cats that received the probiotic were significantly less likely to have a relapse in clinical signs (P = 0.021). There were eight relapses in group A and only two relapses in group B. No side effects were noted in the trial.
This study demonstrated that although 10–30 mg/kg orally q24h of ronidazole for 2 weeks for the treatment of T foetus-associated diarrhoea was not associated with side effects and resulted in an improvement in clinical signs, the addition of probiotics decreased the risk of a relapse following the end of treatment. Further studies are warranted to investigate the mechanism by which probiotics reduce the incidence of clinical relapses.
Feline Ventral Abdominal Angiosarcoma: A Cat Treated with Toceranib Phosphate and Metronomic Chemotherapy
Jorge Castro-López1, Nuria Bermúdez2, Jorge Martínez3, Josep Tusell2 and Josep Pastor1
1Department of Animal Medicine and Surgery, Veterinary Faculty, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
2Veterinary Hospital Balmes, Barcelona, Spain
3Department of Animal Health and Anatomy, Veterinary Faculty, UAB, Barcelona, Spain
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Angiosarcoma is an extremely rare malignant neoplasm that originates from endothelial cells. This tumour is referred to mainly as undifferentiated lymphangiosarcoma (LSA) and should be differentiated from haemangiosarcoma (HSA), although this may be difficult. The abdominal area is commonly affected.
A 10-year-old, male neutered domestic shorthair cat was referred for reddish discolouration of abdominal skin with serosanguineous discharge. Abdominal skin showed bruising, pain, and had a nodular consistency and fluid pockets. The only haematological abnormality was a mild normocytic normochromic anaemia. Coagulation tests were normal. Retrovirus status and fluid bacterial culture were negative. Thoracic radiographs and abdominal ultrasound were normal. The differential diagnoses were infection, inflammation and neoplasia. Incisional biopsies were obtained and histopathology showed an undifferentiated angiosarcoma of the ventral abdomen.
The cat was treated with toceranib phosphate (TP) at 1.67 mg/kg PO on a Monday, Wednesday and Friday schedule. Metronomic chemotherapy (MC) included chlorambucil at 2 mg/m2 PO and meloxicam at 0.01 mg/kg PO on a Tuesday, Thursday and Saturday schedule, and famotidine at 0.5 mg/kg PO every day. Partial remission was achieved at 18 days and remained for 36 days. After this, the tumour began to regrow aggressively and the patient developed anorexia; therefore, his owners elected for euthanasia.
No therapeutic protocol has been reported to be clearly superior for cutaneous LSA or HSA. Angiosarcomas could express proangiogenic factors such as vascular endothelial growth factor (VEGF) and platelet-derived growth factor receptor (PDGFR), and as TP and MC have antiangiogenic activity they may be considered as new treatment options. Moreover, MC may act as an immunomodulator. The most common side effects of TP in cats are anorexia and weight loss. Currently, we are awaiting confirmation of LSA diagnosis by PROX-1 immunohistochemistry. To the authors’ knowledge, this is the first case report of feline ventral abdominal angiosarcoma treated with TP and MC.
Early Molecular Diagnosis of an Effusive FIP Outbreak in Antibody-Negative Kittens
Elizabeth M Graham1, Kate Went2, Fabienne Serra3, Dawn Dunbar1, Manuel Fuentes1, Michael McDonald1 and Mark W Jackson1
1School of Veterinary Medicine, University of Glasgow, Bearsden, Glasgow, UK
2Colne Valley Veterinary Practice, off Maudlyn Road, Colchester, UK
3CIML, Parc Scientifique et Technologique de Luminy, Marseille, France
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A fatal outbreak of effusive feline infectious peritonitis (FIP) was confirmed in a litter of four British Shorthair kittens from a closed breeding colony. All four kittens developed pleural and peritoneal effusions, and were euthanased or died within a 3-week period. Samples from three kittens were submitted to the Infectious Diseases Unit, Veterinary Diagnostic Services, University of Glasgow.
Initial clinical signs were reported in two kittens aged 13 weeks. Both presented with lethargy and bicavitary effusions. Effusion samples from both kittens tested negative for feline coronavirus (FCoV) antibodies by immunofluorescence and Western blot assays. Histopathology on tissue sections from one kitten proved inconclusive. However, high FCoV RNA levels were detected in effusions from both kittens using reverse transcriptase real-time PCR (RT-qPCR). A third kitten died aged 14 weeks, but was not sampled. Histological evidence of pyogranulomatous inflammation and vasculitis in multiple organs confirmed a diagnosis of effusive FIP in a fourth kitten, euthanased aged 16 weeks. The effusion from this kitten tested positive for both FCoV antibodies (titre 160) and viral RNA.
Outbreaks of FIP are uncommon, and may be associated with genetic predisposition, horizontal transfer of feline infectious peritonitis virus (FIPV) or immunosuppression. All four kittens had completed a 7-day pulse of antifungal treatment for dermatophytosis 1 week prior to initial presentation (5 mg/kg q24h PO itraconazole, Elanco Animal Health). The presence of dermatophytosis within the breeding colony suggested possible underlying immunosuppression, a potential predisposing cause of this outbreak. The FCoV RT-qPCR assay proved a reliable and early diagnostic test for effusive FIP when more conventional methods failed.
Changes in Fat Free Mass (FFM) in Cats Undergoing Radioactive Iodine Therapy
Natalie C Finch, C Philippa Welsh and Angie Hibbert
School of Veterinary Sciences, University of Bristol, Langford, Bristol, BS40 5DU, UK
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An increase in body weight in hyperthyroid cats following restoration of euthyroidism is well documented. The increase in body weight is assumed to be related to an increase in muscle mass; however, there are no studies which have sought to explore this. It is difficult to measure muscle mass directly in a clinical setting; however, fat free mass (FFM) is considered to correlate with muscle mass. The study objective was to explore the change in FFM in cats undergoing radioactive iodine therapy.
Client-owned cats presented to The Feline Centre, Langford Veterinary Services, for radioactive iodine therapy were recruited into the study. All cats were otherwise healthy and free of significant concurrent disease. Total thyroxine concentration (T4), serum creatinine concentration (Cr), body weight (BW) and FFM were determined pre- and 3 weeks post-radioiodine treatment. FFM was calculated using a previously validated feline-specific prediction formula: FFM = −0.164 + (0.41 x BW) + (0.054 x FLH) x (0.098 x RFLC) – (0.028 x HLH), where BW is body weight (kg), FLH is forelimb height (cm), RFLC is right forelimb circumference (cm) and HLH is hindlimb height (cm). Change in variables over time was explored using the Wilcoxon signed rank test.
Ten cats were included in the study. Median (range) T4, Cr, BW and FFM pre-iodine treatment were 178 (73–275) nmol/l, 61 (50–120) µmol/l, 3.39 (2.27–4.23) kg and 2.64 (2.22–2.88) kg, respectively. Median (range) T4, Cr, BW and FFM post-iodine treatment were 13 (12–174) nmol/l, 97 (49–131) µmol/l, 3.67 (2.46–4.74) kg and 2.77 (2.10–3.01) kg, respectively. All variables changed significantly over time (T4 P = 0.005, Cr P = 0.021, BW P = 0.005 and FFM P = 0.037). The median (range) percentage increase in BW and FFM was 9.66 (5.97–32.8) % and 4.99 (–5.22–9.08) %, respectively.
The present study demonstrates changes in T4, Cr, BW and FFM in cats undergoing radioactive iodine therapy and may suggest that the change in BW is related to a change in FFM. Further studies, including a larger number of cats, are required to explore relationships between changes in these variables pre- and post-radioiodine therapy.
Using a Quick Identification Scheme for Staphylococcus Intermedius Strains Isolated from Dogs and Cats
Dégi János, Cristina T Romeo and Catana Nicolae
Faculty of Veterinary Medicine, Timisoara, Romania
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Staphylococcal infections in dogs and cats are common in the form of localised infections with a variable clinical course.
Samples from 246 dogs and cats with various diseases were collected from ear, skin, perianal and genital secretions. Samples were cultured on agar containing 5% defibrinated sheep blood poured into Petri dishes. Subcultures obtained were characterised by: mannitol fermentation on Chapmann’s agar, maltose fermentation on Difco agar with a pH indicator, and by API Staph strips (bioMérieux Clinical Diagnostics). Haemolytic activity was assessed using 5% blood agar containing four types of blood: sheep, rabbit, dog and ox. Evidence of bound coagulase activity was assessed using the Prolex Staph Latex Kit (Pro-Lab Diagnostics), with the development of small coagulates after mixing colony samples and reagent indicating the presence of bound coagulase.
Staphylococcus intermedius strains formed colonies of 1–3 mm that were S type, creamy, convex, glossy, non-pigmented or whitish in colour, while Staphylococcus aureus colonies were similar in shape and size, but had a golden yellow colour.
S aureus fermented mannitol on Chapmann’s agar both aerobically and anaerobically, while with S intermedius this only occurred aerobically, also being a late fermentation. On Difco agar with 1% maltose and bromocresol blue as pH indicator, all S aureus strains fermented maltose, while no S intermedius strains gave positive reactions in this medium. The API Staph system allowed definitive differentiation of S aureus and S intermedius strains.
The results show that S intermedius can be identified and differentiated from other staphylococci isolated from dogs and cats, based on the following characteristics: colony appearance, haemolysis, and fermentation of maltose and mannitol.
Based on these features we identified 108 strains of S intermedius, 74 isolates from dogs and 34 isolates from cats.
This work was carried out as part of project POSDRU/89/1.5/S/62371.
Factors Affecting Neuter Status at Six Months of Age in a Kitten Cohort
C Philippa Welsh, Jane K Murray, Natalie C Finch and Timothy J Gruffydd-Jones
School of Veterinary Sciences, University of Bristol, Langford, Bristol, BS40 5DU, UK
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Neutering has traditionally been recommended at 6 months of age in cats. The study objectives were to assess the proportion of cats neutered by 6 months of age and factors associated with neuter status.
Kittens aged 6–16 weeks were recruited prospectively to a longitudinal study (www.bris.ac.uk/vetscience/cats). Data were obtained from owner-completed questionnaires at recruitment and at 6.5–7 months of age. Demographic and lifestyle factors were assessed for potential association with neuter status using logistic regression analysis. Risk factors with a univariable P <0.2 were considered for inclusion in the multivariable model.
Of the 751 kittens included in the study, 3.2% (n = 24) had been neutered at the time of recruitment (median [range] age 15 [10–16] weeks), and 5.2% (n = 39) were planned for breeding use by their owners. These groups were excluded from analysis of risk factors affecting neuter status. Of the remaining cats, 76.0% (516/679) were neutered by 6 months. Multivariable logistic regression analysis revealed that the likelihood of not being neutered at 6 months was significantly increased for cats that were not insured (P = 0.001, OR = 2.2), had not received second vaccination (P <0.001, OR = 4.1), were not obtained from an animal welfare organisation (P <0.001, OR = 2.7), and belonged to owners that were planning to neuter at 7 months of age or older (P <0.001, OR = 7.9).
These results suggest that vaccination and sourcing a kitten from a welfare organisation lead to an increased likelihood of neutering, and this is likely due to the advice and recommendations of veterinary practices and animal welfare centre staff.
Genetic-Based Diagnostics for the Domestic Cat
Leslie A Lyons1, Richard Malik2, Timothy J Gruffydd-Jones3 and Barbara Gandolfi1
1Population Health & Reproduction, School of Veterinary Medicine, University of California – Davis, Davis, CA, USA
2Centre for Veterinary Education, University of Sydney, Sydney, NSW, Australia
3The Feline Centre, School of Veterinary Science, University of Bristol, Langford, UK
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Diagnostics for veterinary medicine have expanded to the field of genetics. Genetic mutations have been identified for many feline diseases and traits that can provide definitive diagnoses as to the cause of a health concern. The rapid advancement of low cost genome sequencing technologies will allow veterinarians to sequence the genome of a patient to help provide personalized health care in the coming future.
Disease mutations available as commercial tests
Currently, approximately 35 genes contain over 50 mutations that cause feline health problems or alterations in the cat’s appearance. Mutations have been identified that would resolve conditions such as polycystic kidney disease, hypertrophic cardiomyopathy (HCM), ‘kitten wasting’, retinal dyplasia and various neuromuscular disorders. Many of the known disease mutations are available as commercial tests (see table) and are submitted for testing by the veterinarian or by the owner, prior to the veterinary visit. Knowledge of the presence of the mutations will help determine immediate treatment and long-term prognosis for feline patients. In the case of breeding programs, the presence of the mutation will imply risk to offspring and breeding should be managed to prevent the disease presentation and to eradicate the mutant genes from the population.
Evaluation of Versifel FeLV, A New Inactivated Feline Leukaemia Virus Vaccine with a Three-Year Duration of Immunity, Under Field Conditions in Italy
Stephen M Wilson1, Gillian Saunders1, Andy Scobey2, Tedd Childers2, Gordon H Sture2 and James R Thompson2
1VMRD, Pfizer Animal Health, Belgium
2Pfizer Animal Health, Kalamazoo, USA
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The safety and efficacy of a new vaccine against feline leukaemia virus (FeLV) was examined in 141 adult cats and 47 kittens in areas of Italy with high prevalence of FeLV infection. Animals received either the vaccine (n = 142) or control product (n = 46) as two vaccinations 21 days apart.
No injection site reactions were seen in controls at any time during the study. In vaccinated animals, 13% cats showed an injection site reaction at some time during the course of the study. Up to and including day 35, 14/106 adult vaccinated cats were observed to have elevated rectal temperatures (≥39.5°C); three of these animals had episodes of fever shortly after vaccination, with one of them having fever after both vaccinations. The impact of vaccination on body weight was inconclusive as both controls and vaccinates were impacted.
After the first vaccination, increases in serum gp70 antibody titres were observed in both the kittens and adult cats, with 14.8% and 26% of kittens and cats (respectively) seropositive on day 21. By day 35, 2 weeks after the second vaccination, the percentage of seropositive kittens had increased to 70% and cats to 80.5%; thus supporting a vaccine-induced antibody response. Apart from four non-specific (weak) reactions in one control and three vaccinated adult cats, all other cats and kittens were negative for FeLV p27 antigen at all time points.
Based on the results obtained, it can be concluded that the new FeLV vaccine was safe and efficacious in inducing antibody responses under field conditions.
Pancreatic Islet Cell Carcinoma and Chronic Hypoglycaemia in a Birman Cat: Clinical and Pathological Evaluation Including the Use of Serum Fructosamine to Monitor Chronic Hypoglycaemia
Ildiko Plaganyi
Lort Smith Animal Hospital, North Melbourne, Victoria, Australia
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Insulinoma is a very rare endocrinopathy of cats, with only five cases published in the literature. This case report describes the clinical presentation, pathology and treatment of a cat with a pancreatic islet cell carcinoma and persistent hypoglycaemia. It highlights the use of serum fructosamine to monitor chronic hypoglycaemia, as well as the difficulty in obtaining accurate serum insulin concentrations.
An 11-year-old male Birman cat presented with clinical signs of persistent hypoglycaemia, which resolved after surgical removal of a 1.5 cm x 1.5 cm localised mass in the left limb of the pancreas. Histopathology confirmed a pancreatic islet cell carcinoma. Liver biopsy showed no evidence of metastasis.
The signs of hypoglycaemia recurred 16 months post-surgery, and laboratory evaluation confirmed concurrent inappropriately high serum insulin levels, as well as persistently low fructosamine levels. The high insulin levels were measured using the Linco porcine assay (Linco Research, Missouri).
Medical therapy in the form of monthly methylprednisolone injections was administered, and serial fructosamine levels showed no increase during 3 months of treatment. Weight gain was documented during this therapy.
The cat developed signs of neuroglycopenia 24 months after the original diagnosis and was euthanased. A necropsy confirmed the presence of a recurrent pancreatic islet cell carcinoma with metastasis to the peripancreatic lymph nodes and the liver. Immunohistochemistry results to confirm insulin secretion by the tumour were inconclusive.
Are Hospitalised Cats Stressed by Observing Another Cat Undergoing Routine Clinical Examination?
Emily Wallinder1, Angie Hibbert2, Suzanne Rudd2, Natalie Finch2, Kevin Parsons1, Emily Blackwell1 and Jo Murrell1
1School of Veterinary Sciences, Langford House, Langford, North Somerset, UK
2The Feline Centre, Langford Veterinary Services (LVS), Bristol, UK
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The ISFM and AAFP recommend using a dedicated examination room for clinical examination or procedures on hospitalised cats. This is to reduce stress in hospitalised cats that would otherwise witness the procedure. Currently there are no data to support this recommendation. Our aim was to investigate whether a validated clinical stress score (CSS) increases when one cat observes another cat being examined.
A CSS (score 1–7, where 1 represents minimal and 7 maximum stress) was used to assess hospitalised client-owned cats (n = 11) and a colony of research cats (n = 12) before (baseline), during and at time points after witnessing an unfamiliar cat undergoing clinical examination by the same veterinary nurse. The temperament characteristics of included cats were evaluated by means of an owner-completed questionnaire and an approach test, carried out immediately before the start of the study. Changes in CSS over time were compared using a Friedman analysis. Post-hoc testing was conducted with a Bonferroni correction applied. Correlations between CSS and temperament were investigated using Spearman’s rank correlation.
CSS scores were below 5 in all cats at all time points. Median (interquartile range) CSS scores were 2 (1–2), 2 (2–3), 3 (2–4), 3 (2–3) and 2 (2–3) for the time periods baseline, after the nurse entered the ward, after the cat to be examined entered the ward, during clinical examination of the cat, and 15 mins after the nurse and cat left the ward, respectively. There was a statistically significant difference in CSS over time, chi-square (23) = 61.636, P <0.005. CSS was significantly higher than baseline when the unfamiliar cat entered the ward and during clinical examination (P <0.002). There were no significant correlations between CSS at any time point and measures of temperament towards people and other cats in individual cats.
This small pilot study demonstrates that CSS increases in cats observing an unfamiliar cat before and during examination and supports the current recommendation to carry out clinical examination on hospitalised cats in a separate room from the hospital ward.
Retrospective Analysis of the Effects of Meloxicam on Longevity of Aged Cats with Pre-Existing Chronic Kidney Disease
Richard Gowan1, Randolph M Baral2, Amy E Lingard1, Melissa J Catt2, Laura Johnston3 and Richard Malik4
1The Cat Clinic, Melbourne, Australia
2Paddington Cat Hospital, Sydney, Australia
3Boehringer Ingelheim Animal Health, Ingelheim, Germany
4Centre for Veterinary Education, Sydney, Australia
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Chronic painful conditions affect the quality of life of cats and often require medical treatment. Chronic pain and chronic kidney disease (CKD) often coexist in aged cats. Meloxicam is currently the only non-steroidal anti-inflammatory drug (NSAID) registered for long-term use in the cat; however, NSAID data sheets list impaired kidney function as a contraindication. The objective of this study was to document the effect of long-term meloxicam therapy on longevity of aged cats with pre-existing CKD.
The medical records of two feline-only practices were searched for cats older than 7 years that had been treated continuously with meloxicam for a period of greater than 6 months, with complete medical records available for review. Pre-existing CKD was considered to be stable by ruling out pre- and post-renal azotaemia, and by demonstrating minimal changes in creatinine concentration and/or body weight in the 4–8 weeks prior to instituting meloxicam therapy.
A total of 82 cats met the inclusion criteria, of which 47 had CKD prior to treatment [14 cats IRIS stage 1, 28 cats stage 2 and five cats stage 3].
Using the Kaplan-Meier method, the median survival time of the CKD cats was estimated as 1608 days (95% confidence interval [1344–1919]), which compares favourably with published longevity of cats with CKD. At the time of analysis only 28 cats in the CKD group had died; three had CKD listed as the cause of euthanasia or death. The most common cause of death was neoplasia.
Results for pre-existing CKD group
Long-term oral meloxicam treatment does not appear to reduce the longevity of cats with pre-existent, stable IRIS stage 1–3 CKD. To address the need for both quality of life and longevity in cats with both chronic painful conditions and CKD, meloxicam can be considered as part of the therapeutic regimen.
Feline Intestinal Trichomonosis in Spain: 15 Cases
Diego Esteban1, David Arranz-Solís2, Martín Martí1, Luís M Ortega-Mora2 and Susana Pedraza-Díaz2
1Tot Cat Clínica Felina, Barcelona, Spain
2SALUVET, Dpto Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Madrid, Spain
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Tritrichomonas foetus is a protozoan parasite which has been identified as a venereal pathogen in cattle and more recently as an enteropathogen in cats. We describe here 15 cases of feline intestinal trichomonosis, its diagnosis, treatment and outcome.
Affected cats were mainly young (median age 2 years and 6 months), mostly purebred (93%) and suffered from continuous or intermittent diarrhoea (93%). Concurrent infections (Giardia species or Isospora felis) were identified in 26% of the cases. Laboratory diagnosis was attempted by direct examination of diluted faecal smears (100%), culture in InPouch TF (60%) and/or modified Diamond’s medium (40%), and/or polymerase chain reaction (80%). In six cats, the amplified PCR products (5.8S, ITS-1 and ITS-2 regions) were sequenced to determine speciation. After managing concurrent infections, treatment with oral ronidazole was recommended in eight cats, at a dose rate of 30 mg/kg q12h for 14 days (n = 2), 30 mg/kg q24h for 14 days (n = 4) and for 12 days (n = 1). One cat was treated at a dose of 10 mg/kg q24h due to its poor body condition.
Faecal smears were positive in 93%; when culture media were used 100% of the samples were positive; and the PCR was positive in 100% of the cultures and 83% of the faecal samples. Amplicon sequencing confirmed speciation and showed 99% homology with published sequences of T foetus found in cattle. All cats treated with ronidazole had resolution of diarrhoea but one case relapsed 10 days after the end of the treatment. In three cases adverse effects (neurological clinical signs) were observed after treatment. The cases that were not treated remained clinically normal after a median time of 4 months. One cat died after 3 months due to feline infectious peritonitis.
It is strongly recommended that T foetus is included in the differential diagnosis of diarrhoea in Spanish cats. Faecal smear analysis, culture and PCR can be used to confirm the diagnosis. Treatment is only advised when clinical signs are severe or persistent. Ronidazole is the treatment of choice, although it is not licensed for use in cats, and the risk of neurological clinical signs must be expected.
Serological and Molecular Prevalence of Leishmania Infantum Infection in Cats from Southern Italy
Maria G Pennisi1, Tiziana Lupo2, Daniela Malara3, Marisa Masucci1, Antonella Migliazzo2 and Gabriella Lombardo4
1Public Health Department, University of Messina, Italy
2CReNaL, IZS Sicilia, Palermo, Italy
3Reggio Calabria, Italy
4Catania, Italy
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Leishmania infantum infection prevalence was investigated in 431 cats from three provinces of Sicily and two of Calabria. Cats were assessed by physical examination (n = 362), CBC (n = 149), protein serum electrophoresis (n = 167), FIV and FeLV tests (DUO-Speed BIO-VETO-TEST, France or FASTest, MegaCor, Austria) (n=350). L infantum infection was evaluated by means of immunofluorescent antibody test (IFAT, n = 419) and polymerase chain reaction (PCR, n = 207) on blood (BL, n = 203), lymph node (LN, n = 154) and conjunctival swabs (CS, n = 66). L infantum molecular detection was performed (BL and LN) on 128 cats with qualitative PCR and on 79 cats (BL, LN and CS) with real-time PCR. IFAT cut-off value was established at 1:80, based on results from sera of 52 cats from non-endemic areas (Scotland and Poland) and from five cats where L infantum isolation was obtained.
L infantum seroprevalence was 6.9% (titre range 80–2560). Overall molecular prevalence was 18.3%. BL, LN and CS samples were respectively L infantum positive in 7.8%, 11.7% and 16.7% of tested cats. The median parasite load was 70.5 Leishmania/ml (L/ml) in BL (range 10–770 L/ml), 10 L/sample in LN (range 1–1000 L/sample) and 2 L/sample in CS (range 1–14 L/sample). The total rate of L infantum infection (IFAT and/or PCR) was 13.9%. Cats ≥3 years of age had a significantly higher PCR prevalence (p = 0.02) compared to younger cats. No significant association was found between infection rate and gender, province and life style (outdoor vs indoor). Cats tested over the November to April period had a significantly higher L infantum seroprevalence (p = 0.03) and total rate of infection (p = 0.01) compared to cats tested during the May to October period. A FIV positive status was statistically associated with a L infantum positive IFAT (p = 0.0001) and a higher total rate of L infantum infection (p = 0.04). Cats with clinical signs had a higher chance of having a positive L infantum IFAT (P = 0.02) and a higher total rate of infection (P = 0.01).
Serological and molecular findings suggest that feline infection by L infantum occurs frequently in endemic areas; FIV infection and age >3 years are associated risk factors. The IFAT cut-off for feline L infantum infection can be set at 1:80, as in dogs. Conjunctival swabbing can be usefully used as a non-invasive sampling procedure, and is appropriate for extensive epidemiological studies.
Pilot Study on Efficacy and Safety of Tinidazole against Natural Tritrichomonas Foetus Infection in Cats
Maria G Pennisi1, Ettore Napoli1, Laura AM Ingrà2 and Maria F Persichetti1
1Public Health Department, University of Messina, Italy
2Catania, Italy
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Efficacy and safety of tinidazole was investigated in five cats with naturally acquired Tritrichomonas foetus infection. The drug was given at 30 mg/kg PO q24h for 14 days inside gastroresistant capsules coated with guar gum. T foetus infection was confirmed by InPouch TF-Feline (Biomed Diagnostics) (InP) and real-time PCR (Idexx Laboratories) before therapy (D0) and monitored after the end of therapy at the 15th ±1 day (D15) and at least two more times (D45 and D75). The cats were housed in individual cages and observed daily for side effects and faecal consistency evaluation (FS 1–7/7). Physical examination was performed at D0, D15, D45 and D75. CBC, biochemical profile, and real-time PCR for feline panleukopenia virus (FPV), feline coronavirus (FCoV), Giardia duodenalis, Toxoplasma gondii, Clostridium perfrigens (toxin A), Cryptosporidium species and Salmonella species were performed at D0 and D15. FCoV antibody (MegaScreen FLUO FCoV, MegaCor, Austria), FIV antibodies and FeLV p27 (FASTest FeLV-FIV, MegaCor, Austria) detection, faecal examination by zinc sulfate centrifugation flotation for 3 consecutive days (ZSF), sodium nitrate flotation (SNF) and Baermann (Bae) tests were done at D0.
At D0 all cats had polyphagia and weight loss; FS ranged 4–5/7 and faecal mucus (cats 3, 4), haematochezia (cats 1, 3), melaena (cat 4), upper respiratory tract disease (cats 1, 3, 4), asthma (cat 2), neutrophilic leukocytosis (cat 2), monocytosis (cats 2, 3) and mild non-regenerative anemia (cat 5) were observed. At D0 all cats were FIV positive and FeLV negative; four cats (cats 1–4) were positive for G duodenalis. One cat (cat 1) was positive for Cryptosporidium species at D15; two cats (cats 1, 2) were positive for FPV at D0 and D15, and one (cat 3) at D15; all cats were IFAT and PCR positive for FCoV at D0 and three (cats 1, 3, 4) PCR positive also at D15. All cats were negative on SNF, Bae and PCR for T gondii, C perfringens and Salmonella species.
All five cats tested negative by InP and Tf PCR at D15, D45 and D75; InP test performed two to four more times in each cat, between D15 and D75, was always negative.
After therapy FS generally improved (≤3/7) in all cats and mucus or blood were no longer noted in stools; monocytosis resolved (cats 2, 3). Body weight increased in three cats (cats 1, 3, 4). No side effects were observed; however, a mild increase in ALT, AST (cats 2, 4) or creatinine (cat 1) values was found.
Guar-coated gastroresistant tinidazole oral formulation resolved Tf infection in five FIV positive cats and improved their clinical condition. Furthermore tinidazole treatment was effective against concomitant G duodenalis infection in the four affected cats.
Spontaneous Tracheal Laceration in a Cat with Asthma
Joaquín Albaladejo1,2, Esteban Bastida2, Miguel Quiles2 and Ángeles Carrión3
1Ronda Sur Veterinary Practice (Murcia, Spain)
2Emergency Veterinary Hospital of Región de Murcia (Murcia, Spain)
3V-Imagen, Ultrasound Mobile Service (Murcia, Spain)
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We describe, to the authors’ knowledge, the first case of spontaneous tracheal laceration in a cat, treated with surgery after being diagnosed using a computed tomography (CT) scan.
An 11-year-old Norwegian Forest indoor cat was presented with a history of sudden onset acute dyspnoea. It had been diagnosed with asthma 5 months before presentation, and had been treated with inhaled fluticasone q12h. Radiology of the chest revealed pneumomediastinum, pneumothorax and an image compatible with pulmonary lobe consolidation. A CT scan revealed a 4.9 mm x 1.4 mm laceration in the dorsal tracheal wall (T2–T3) with cranial and medial pulmonary lobe consolidation.
The tracheal laceration was corrected surgically and a left pulmonary lobectomy was also performed. On pathological examination, the resected lung revealed acute bronchopneumonia. There was no history of trauma, venipuncture or tracheal intubation that could have caused the tracheal laceration.
Similar cases have been described in humans, where chronic steroid therapy is a risk factor for tracheal rupture and laceration as the dorsal tracheal membrane can become compromised. This could also be true for cats. Age and chronic obstructive pulmonary disease have also been shown to be risk factors for tracheal rupture and laceration in humans. We propose the injury could occur due to an elevation in intratracheal pressure against a closed glottis (probably due to a cough episode), associated with chronic obstructive pulmonary disease, old age and chronic steroid therapy.
Survey of Owners’ Perceptions of Radioiodine Treatment of Feline Hyperthyroidism
Lara A Boland1, Jane K Murray1, Catherine P V Bovens1 and Angie Hibbert2
1School of Veterinary Sciences, University of Bristol, Bristol, UK
2The Feline Centre, Langford Veterinary Services, Bristol, UK
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Radioiodine (I131) is regarded as the ‘gold standard’ treatment for hyperthyroidism. The study aim was to examine factors that influence treatment choices of owners of hyperthyroid cats and their opinions following I131 treatment.
Surveys were sent to owners of all hyperthyroid cats referred for treatment with standard dose I131 at Langford Veterinary Services between 2002 and 2011 (I131; 264 cats), and to owners of non-I131 treated hyperthyroid cats seen at first opinion UK practices (control; 199 cats).
The response rate was 67.0% (310 returned; 175 I131, 135 control). Of 135 controls, 72 (53.3%) were unaware of I131 as a treatment option. Considering potential human health risks of I131, 139/234 (59.4%) respondents had no concerns. Considering impact of cost on the decision to treat with I131, 119/232 (51.3%) said this had no impact. Considering travel distance on their decision to treat with I131, 115/231 (49.8%) said this had no impact. Of 238 respondents, 155 (65%) chose to pursue I131 as a treatment option for one or more reasons including: owner’s own feelings, 101 (65.2%); veterinarian’s advice, 94 (60.6%); pilling difficulties, 69 (44.5%); concerns regarding risks of thyroidectomy, 52 (33.5%); lack of response to medical treatment, 31 (20%); medical treatment side effects, 23 (14.8%); post-thyroidectomy recurrence, 18 (11.6%); other reasons, 18 (11.6%). When asked about I131 treatment hospitalisation length, 32/156 (20.5%) respondents were extremely concerned for the possibility of: cat being unhappy, 130 (82.3%); owner missing the cat, 102 (64.6%); inappetence, 50 (31.6%); other pets missing the cat, 32 (20.3%); development of comorbid disease, 28 (17.7%); side effects, 25 (15.8%); other reasons, 14 (8.9%). Of 158 cats assessed for I131 treatment, 134 (84.8%) received it.
Owners assessed their cat’s quality of life (QoL), on a scale of 1 (very poor) to 10 (excellent), as 4 [1–10] (median [range]) pre-I131 (134 respondents), and 9 [1–10] post-I131 (131 respondents). Of 132 respondents, 104 (78.8%) were happy with both their decision to use I131 and outcome, 17 (12.9%) were happy with their decision to use I131 but were unhappy with the outcome, and 11 (8.3%) were dissatisfied.
Owners are often unaware of I131 as a treatment option. The cost of treatment, distance to travel for I131 and human health risks had low impact on treatment choice. Common concerns associated with hospitalisation for I131 treatment were for the cat to be unhappy and that the owner would miss the cat. Overall, 91% of owners were happy with the decision to treat their cat with I131.