Abstract
A total of 25 clinical/ research abstracts were accepted for presentation at the poster session held during the 2013 World Feline Veterinary Congress in Barcelona, Spain, June 26–30, 2013.
Long-Term Palliative Treatment of a Nasal Anaplastic Sarcoma With Robenacoxib in One Cat
1Clínica Veterinaria Bendinat, Mallorca, Spain
2Clínica Veterinaria Ayavet, Boadilla del Monte, Madrid
3Clínica Veterinaria Bahía, Bahía Grande, Mallorca
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An 11-year-old indoor female spayed Burmilla cat was presented with a 4-week history of sneezing, coughing and bilateral serous, progressing to serosanguineous, nasal discharge. The cat was anorexic. There was no previous history of upper respiratory signs.
On physical examination a unilateral (right nostril) haemorrhagic discharge and loud stridor were detected. Under general anaesthesia, a flush of each nostril with 10 ml of saline solution retrieved two firm tissue masses of 1 and 2 cm. Submandibular lymph node FNA cytology was unremarkable. Thoracic x-rays were normal. There was remission of all clinical signs upon recovery from anaesthesia. Pathological examination of the masses showed an anaplastic tumour. Immunohistochemistry was performed, revealing a diagnosis of anaplastic sarcoma. On magnetic resonance imaging, there was a large (length 8 cm x height 6 cm x width 4 cm) mass invading the ventral two-thirds of both nasal cavities, with associated turbinate lysis. This mass extended from the canine to the ethmoid bone and into the nasopharynx up to the presphenoid sinus. There was partial erosion/lysis of the palatine bone on the right side. It was staged as T3 N0 M0.
Radiotherapy treatment was offered but declined by the owners. Inmunohistochemistry of the tumour was performed with COX-2 polyclonal antibodies and showed weak to moderate cytoplasmic to perinuclear immunostaining in about 30% of the tumour cells. Palliative treatment with a COX-2 selective NSAID (robenacoxib 6 mg/cat q24h) was initiated. At the time of writing, 18 months later, the cat was still alive and free of clinical signs.
Nasal tumours account for 1–8% of all tumours in cats, with lymphoma and adenocarcinoma the more frequently described. Radiotherapy is the treatment of choice for non-lymphoid neoplasia. Prognosis in the case of untreated tumours is poor. COX-2 expression of feline tumours is variable.
To the authors’ knowledge, this is the first report of a large nasal anaplastic sarcoma treated only with a COX-2 selective NSAID drug after inmunohistochemistry staining for COX-2 expression. Although it cannot be proved that the survival in this case was a direct effect of the drug, palliative treatment with COX-2 preferential or selective NSAIDs should be offered to owners of cats with nasal sarcomas who decline other treatments before euthanasia, irrespective of the size and extension of the tumour.
Treatment of Naturally Notoedres Cati Infested Cats With a Combination of Imidacloprid 10%/ Moxidectin 1% Spot on (Advocate/Advantage Multi; Bayer)
1Kapriol Bt, Sümeg, Hungary
2Bayer Animal Health GmbH, Leverkusen, Germany
3KLIFOVET AG, Munich, Germany
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Notoedric mange (feline scabies) is a rare, highly contagious disease of cats and kittens caused by Notoedres cati, which can infest other animals and humans. The efficacy and safety of 10% imidacloprid/1% moxidectin (Advocate/Advantage Multi Spot-on for cats; Bayer) against natural N cati infestation in cats was investigated. Sixteen cats were randomly assigned to a treatment group or negative control group. The treatment group received a single treatment of the product according to label instructions. The control group remained untreated. Five cats from the control group were treated with the product at the end of the study and observed for a further 28 days to increase the number of treated animals. Skin scrapings and mite counts were performed 28 days post-treatment. Notoedric skin lesion assessments with clinical scoring were performed regularly. Five animals had to be removed prematurely from the study population for various reasons. The number of viable N cati mites in all treated animals 28 days post-treatment was zero, compared with 2.8 ± 3.0 in the control group, being significantly lower for the treated cats. The resulting efficacy was 100%. Clinical cure based on skin lesion assessment was achieved 28 days post-treatment in 100% of all treated animals completing 28 study days. Advocate showed a high therapeutic efficacy in curing N cati infestations and clinical signs of feline scabies when applied at the minimum therapeutic dose of 10 mg imidacloprid/1 mg moxidectin/kg body weight. The product was well tolerated and no treatment-related adverse reactions were recorded.
Appreciation of Domestic Pet Cats as a Function of Sex Role in a Brazilian Population
Daniela Ramos1, Sarah Ellis2, Marina Arena1, Marcela Albino1, Bruno Schiefer1, José Hernandez3 and
1Faculty of Veterinary Medicine, University of Sao Paulo, Brazil
2School of Life Sciences, University of Lincoln, UK
3Department of Psychology Foundations, Rio de Janeiro State University, Brazil
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Cat ownership is predominantly biased towards females. For example, in the UK, it is estimated that there are 3.5 times more female than male cat owners. What causes the gender difference in ownership is unknown but possible answers may lie in the history of the human–cat relationship, where cats were traditionally always cared for by the females of households and may therefore have become stereotyped as a female’s animal. Furthermore, in some countries, the cat is portrayed as feminine (eg, Bastet in Egyptian religion) and thus further stereotyped to be associated with the female. It could, therefore, be hypothesised that cat ownership and associated appreciation of cats is stereotyped to be predominantly a feminine trait which may exist regardless of gender.
In order to answer this question, a convenience sample of 303 Brazilian residents completed two questionnaires; the first consisted of the Bem Sex Role Inventory (BSRI), which provides an assessment of masculinity, femininity and androgeny derived from self-reported personality traits. The second asked respondents about their cat ownership status, their appreciation of cats and their beliefs regarding cats’ intelligence. Seventy-five percent of respondents (227) were female, of which 33.9% were cat owners, while 34.2% of the 76 male respondents were cat owners. BRSI revealed respondents’ sex roles were: 19.9% feminine, 21.6% masculine, 30.9% androgynous and 27.6% undifferentiated. Regardless of gender, femininity scores (but not masculinity scores) were positively correlated both with appreciation of cats (Pearson correlation, r = 0.154; P = 0.007) and cats’ intelligence (Pearson correlation, r = 0.204; P <0.001). Respondents’ sex role was not associated with owning a cat (χ2 test = 10.197, P = 0.335) as might have been expected. However, many factors beyond appreciating cats are likely to influence ownership (eg, financial constraints, spare time).
Further studies exploring whether such relationships between sex roles and appreciation of other companion animals would help decipher whether the link between femininity and cat lovers is unique to the domestic cat.
Prevalence of and Risk Factors for Feline Obesity in Six Rescue Shelters in the UK
School of Veterinary Medicine and Science, University of Nottingham, UK
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The definition of animal obesity is controversial. Feline obesity has been linked to secondary diseases, such as diabetes mellitus and osteoarthritis. Many different methods have been used to determine obesity prevalence. No studies have identified the prevalence of feline obesity within UK shelters. The aim of this study was to estimate the prevalence of adult feline obesity within six cat shelters and identify risk factors for obesity.
Obesity was assessed using visual body condition score (vBCS), physical body condition score (pBCS) and weight measurements. Cat information and shelter information was recorded to assess risk factors for obesity. Inter-observer reliability of vBCS and pBCS was measured.
The overall prevalence of obesity in adult cats using vBCS (score >3) was 34.04% (n = 141) and using pBCS (score >5) was 53.26% (n = 92). When using pBCS, colour (P = 0.014), age (P = 0.000) and length of stay (P = 0.002) were risk factors for obesity. There was wide variety in shelter demographics, which may influence levels of obesity. Inter-observer reliability was higher for vBCS than for pBCS.
Prevalence of feline obesity within the six shelters was high, so further work is required with respect to prevention, identification and treatment of obesity in cats in shelters in the UK.
Viability Score for Newborn Cats
Facultad de Ciencias Veterinarias y Ambientales, Universidad Juan Agustín Maza, Mendoza
Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, CABA, Argentina
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The main feature of the feline neonatal period is the physical, physiological and immunological immaturity of the kittens, which puts individuals at risk. The aim of this study was to devise a viability scoring method for newborn kittens, based on simple parameters and giving a score from 0–10, according to the state of the newborn, to enable the likelihood of survival to be deduced. The rating system that has been devised applies to neonates born by caesarean section and vaginal delivery (with and without epidural anaesthesia) and can be performed at the moment of birth until day 10 of life.
A series of tests was carried out immediately after birth and up to 10 days of life in order to determine the health of the newborns, to assess their correct adaptation to the environment and to infer survival.
A total of 1500 kittens were studied, taking into account the following parameters:
Body temperature (BT): normal reference value ≥36 °C
Heart rate (HR): normal reference interval 200–220/min
Respiratory rate (RR): normal reference value ≥20/min
Sucking reflex (RS): Baseline: Over six consecutive sucks score 2, three to six consecutive sucks 1, and fewer than three consecutive sucks 0
Infrastructure for neonatology (IN): equipment and expertise available within the veterinary clinic.
Adding the points for the variables we obtained a score that determines survival rates, offering a score for viability.
Using the Table as a reference, we scored from 0–10 the newborn status, and deduced the survival percentage. As the score decreases, the likelihood (percentage) of kitten survival decreases.
Viability scoring system for newborn cats
Spinal Extradural Empyema in Three Cats: Diagnostic Imaging, Laboratory Results, Treatment and Outcome
1Peace Avenue Veterinary Clinic, Mongkok, Hong Kong
2PathLab Medical Laboratories Ltd
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Spinal extradural empyema is rare. Three cases are presented. Case 1 was a 3-month-old female entire Exotic cat, presented with a 2-week history of pyrexia and non-ambulatory paraparesis. Blood tests showed leukocytosis with lymphocytosis. Lumbar myelography demonstrated extradural compression. Cerebrospinal fluid (CSF) analysis showed blood contamination and negative coronavirus PCR. Histopathological examination of the extradural mass and lamina of L2 revealed pyogranulomatous inflammation and reactive new bone formation with inflammation, respectively. Eubacterial FISH (fluorescence in situ hybridisation) on specimens could not identify any bacteria.
Case 2 was a 3-year-old male neutered Persian cat with an insidious onset of paraparesis that progressed to non-ambulation over 3 weeks. Radiography revealed fused vertebral bodies T13 to L1 resulting from an old spinal injury. Lumbar myelography demonstrated extensive extradural compression from T10 to L2 vertebral bodies. Inflammatory CSF was evident. Surgery revealed extradural purulent material which yielded a heavy growth of Pasteurella multocida.
Case 3 was a 2-year-old female neutered domestic shorthair cat presenting with a tail base wound, paraplegia, equivocal deep pain perception and a flaccid tail. MRI revealed significant cord swelling and extradural compression in the cauda equina, and evidence of connection between the wound and the spine. A scanty growth of Sphingomonas paucimobilis was yielded from the wound. Urine, blood and CSF cultures were negative. Repeated MRI 6 days later showed resolution of the extradural lesion and reduced cord swelling.
Outcome was excellent in all cases following surgical decompression (cases 1 and 2) and appropriate antibiosis based on culture and sensitivity tests (cases 2 and 3). Spinal extradural empyema has to be considered as one of the differential diagnoses in young cats presenting with paraparesis.
Efficacy of Long-Term Treatment With Telmisartan Oral Solution on Quality of Life and Disease Progression in Cats With Chronic Kidney Disease
1Boehringer Ingelheim Vetmedica GmbH, Ingelheim, Germany
2Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim, Germany
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Urine protein:creatinine ratio (UPC) was measured in 224 cats presenting with chronic kidney disease (CKD) treated once daily with telmisartan oral solution (1 mg/kg body weight) or benazepril (0.5–1 mg/kg body weight). Secondary clinical variables for appetite and survival were also measured for both groups.
Overall mean UPC values on day 180 were decreased in both groups compared with baseline. The mean UPC decrease on day 180 was greater in cats treated with telmisartan (-0.05) than in cats treated with benazepril (-0.02) (PPS-population). The results of the non-inferiority analysis for the primary variable proteinuria demonstrated that treatment with telmisartan is at least as efficacious as the reference standard benazepril.
Furthermore, mean UPC decrease from baseline was most significantly pronounced in the subgroup of cats with UPC baseline ≥0.4 (P<0.05) treated with telmisartan on days 7, 30, 60, 90 and 180. In the population subset of cats treated with benazepril, decrease from baseline was significant only on days 7 and 30. The overall median reduction in proteinuria from baseline was -0.2 for telmisartan and -0.1 for benazepril.
A positive trend was observed in improvement of appetite in 17.6% of cats treated with telmisartan by day 30 of treatment. Appetite was improved in 10% of cats treated with benazepril by day 120.
All-cause mortality was numerically lower for cats in the telmisartan treatment group (13/112) compared with cats in the benazepril treatment group (22/112) (ITT-population). Mortality from euthanasia because of CKD was also numerically lower for cats treated with telmisartan (9/112) compared with cats treated with benazepril (14/112) (ITT- population).
The results of this study support the use of telmisartan for the reduction of proteinuria associated with CKD, resulting in improvement of quality of life in cats treated with telmisartan.
Globe Penetration in a Cat Following Maxillary Nerve Block for Dental Surgery
1Grove Lodge Veterinary Hospital, Worthing, UK
2CytoPath Ltd, Ledbury, UK
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An elegant and contemporary approach to pain management in feline dentistry involves the use of multimodal and pre-emptive analgesia. The use of drugs in this way maximises analgesic provision and reduces the risk of amplification of postoperative pain. Peripheral neural blockade describes the use of local anaesthetic agents to selectively block specific nerves, thus desensitising certain regions of the body or head (regional anaesthesia or nerve block). These techniques are the most common form of perioperative pain control in human dentistry and the overall risk associated with these techniques appears to be low. Feline patients may benefit from local anaesthetic techniques under general anaesthesia, as decreased perioperative pain may result in better autonomic stability and reduced cardiovascular, respiratory or central nervous system (CNS) depression, contributing to a safer anaesthetic, smooth recovery and rapid discharge from the hospital.
Local anaesthetic drugs are relatively safe when used with care. Placement of the agent is critical in both ensuring efficacy and reducing unwanted side effects. Complications may arise as a direct result of the procedure itself, or due to the toxicity of the drug used. To the authors’ knowledge, there have been no reports in the literature of local complications and only one report of a severe, systemic complication arising from a regional anaesthetic technique in the cat. It may be that complications arising from veterinary dental regional anaesthesia are genuinely rare. Alternatively, it may be that they are under-reported.
A case report of globe penetration in a cat following maxillary nerve block for dental surgery is described. Twenty-four hours after the dental procedure the cat presented with blepharospasm and anterior uveitis. The eye was unsalvageable despite intense medical management and was enucleated. Histopathology of the globe indicated a penetrating scleral injury, consistent with a needle tract, with associated retinal detachment and endophthalmitis. The reporting is not aimed to deter veterinary professionals from performing nerve blocks in the cat; on the contrary, it should serve as a reminder to be conscious of oral anatomy with regards to local anaesthetic placement in the feline species.
Use of Serum Amyloid a for Long-Term Monitoring in Three Cats With Pancreatitis
1Hospital Felino Ventas, Madrid, Spain
2Clinica Veterinaria Ronda Sur, Murcia, Spain
3Universidad de Veterinaria de Murcia, Murcia, Spain
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Acute phase proteins (APPs) are a group of proteins that show rapid changes in blood concentration in response to infection and tissue damage. In cats, serum amyloid A (SAA) is one of the major APPs and is thought to be useful as a marker of inflammation. Time-course changes in the concentration of SAA were measured in three cats with pancreatitis over a 200-day period.
SAA concentration was increased at the onset of disease and gradually decreased over 5 days of treatment with an improvement in the clinical condition in all three cases. SAA analysis was undertaken periodically post-treatment in the three cats and two of them showed SAA values inside the reference interval (<5 mg/l) at each sampling; these corresponded with a healthy status of the cats with no significant findings in physical examination and in routine haematological and biochemical profiles.
However, one of the cats experienced acute vomiting and anorexia on day 200. The most striking change in the analytical profile was a major increase in SAA (84 mg/l). Biopsy and histopathological examination of the pancreas was performed and revealed extensive necrosis of the fat tissue around the pancreas; in the pancreatic parenchyma infiltration of many neutrophils and macrophages around the area of necrosis with congestion and oedema was observed. These findings indicated that this cat probably had an episode of pancreatitis.
These findings suggest that SAA concentration may be a useful marker for evaluating response to treatment in cats with pancreatitis. In addition a major increase in SAA in a cat undergoing treatment for pancreatitis could raise suspicion about a relapse of the disease.
Determination of Antimicrobial Susceptibility of Coagulase-Positive Staphylococcus Isolated From Healthy Cats
Department of Clinic Sciences, University of Chile, Santiago, Chile
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Bacteriological cultures were performed on coagulase-positive Staphylococcus strains isolated from the skin of 66 healthy cats. The aim of this study was to determinate the antimicrobial susceptibility of these strains to 12 of the most frequently used antimicrobials in small animal dermatology practice. A BBl Crystal diagnostic kit was used to identify coagulase-positive Staphylococcus and the antimicrobial susceptibility was obtained through the Kirby Bauer diffusion disc method.
Thirty coagulase-positive Staphylococcus strains were isolated (45.5%). Sixteen (53.3%) strains were S intermedius, nine (30%) S aureus and five (16.7%) S schleiferi subsp coagulans. 73.3% of the isolates showed resistance to at least one drug (see Table) and 66.7% were resistant to ampicillin. S aureus strains were the less resistant strains. Five strains were resistant to more than one drug, including two that were resistant to nine antimicrobials.
Antimicrobial susceptibility of Staphylococcus strains
Prevalence of Primary Diseases and Evidence of Endothelial Dysfunction in Cats With Hypertension
1Klifovet AG, Munich, Germany
2Small Animal Clinic, Hörstein, Germany
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About 400 cats were preselected from three European countries based on their history of being hypertensive. Cats were classified as such if systolic blood pressure (SBP) was ≥165 mmHg (average of five measurements each visit within 15 mmHg deviation) on two separate visits within 2 weeks to rule out white-coat effect. Blood pressure was measured using high definition oscillometry (HDO). Seventy-seven cats fulfilled all criteria. The hypertension was associated with chronic kidney disease (CKD) in 33.8%, hyperthyroidism in 24.7% and heart disease in 7.8% of the cats. In 27.3% no primary disease was diagnosed (idiopathic hypertension).
In addition to blood pressure, pulse wave analysis (PWA) was performed using HDO MDS software (S+BmedVET). Pre-systolic amplitude (PSA) was measured in % of the maximum mean arterial pressure (MAP). Early PSAs are significant for vascular tone and help to differentiate between normal endothelial function (EF), vasodilation and vasoconstriction. Excitement and disease-induced impairment of arterial compliance may be distinguished. The higher the PSA values the more they indicate a dependent increase in systemic vascular resistance (as expected, for example, with activation of RAAS). Angiotensin II, being a very potent vasoconstrictor, can be influenced by drugs like ACE inhibitors which may influence PSA.
Around 36% of the cats with CKD showed an increase in PSA measurements at both visits of 40–59%; 15.4% of the CKD cats showed PSA >60%. Cats with PSA >60% had not been treated so far. Cats treated with ACE inhibitors showed a PSA <60%. Elevated PSA was also seen in animals with other diseases influencing EF (diabetes, hyperthyroidism, etc). In cats with idiopathic hypertension, PSA varied more between the two measurements. PSA values ≥40% were found in 38.1%, while an increase in PSA was found in 14.3%. In 28.6% of the animals, the PSA decreased in the second measurement, indicating an influence of excitement at the previous visit.
These results show for the first time that the non-invasive evaluation of EF is possible using HDO-PWA. Hypertensive cats with CKD have demonstrably higher PSA than cats with other underlying diseases. In the group of cats with idiopathic hypertension, stable PSA values ≥40% and an increase in PSA may both support the existence of an underlying disease in early stage. These animals will need further follow-up to identify the disease.
Prevalence and Risk Factors for Feline Leukaemia Virus and Feline Immunodeficiency Virus Infection in Cats in UK Shelters
School of Veterinary Medicine and Science, University of Nottingham, UK
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The current prevalence of feline immunodeficiency virus (FIV) and feline leukaemia virus (FeLV) in shelter cats in the UK is unknown. While welfare organisations spend considerable amounts of money testing cats for these viruses, in many cases funding will not permit every animal to be tested. Knowledge of the disease prevalence and the associated risk factors for infection would allow better understanding of test results and would permit shelters to prioritise animals for testing.
This study aimed to estimate the prevalence of FIV and FeLV in cats entering two shelters during a 1-year period. Using test results, clinical records and other associated information gathered from a total of 726 cats, risk factors including gender, neutered status, age and clinical signs were assessed for each of the diseases.
The study found that FIV (3.0–11.2%) was more prevalent than FeLV (0–2.9%) in both shelters and that the prevalence of both viruses was higher in cats from an urban background. Male cats and cats with skin signs, in particular abscesses, were significantly associated with FIV infection.
Further work studying an increased number of shelters would aid in the understanding of disease prevalence and associated risk factors and would thus advise testing protocol.
Nephrolithiasis and Ureterolithiasis Prevalence in Cats With Chronic Kidney Disease Presented at the University of Sao Paulo Veterinary Hospital
Marcela M Pimenta1, Archivaldo Reche-Júnior1,
1Department of Veterinary Medicine, University of Săo Paulo, Săo Paulo, Brazil
2Clinique Vétérinaire DeLorimier-Rosemont, Montreal, Canada
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Nephrolithiasis and/or ureterolithiasis were investigated by means of ultrasonography in 72 cats with chronic kidney disease (CKD) stage II according to IRIS (International Renal Interest Society) criteria. Calculi of renal origin (nephrolithiasis or ureterolithiasis) were diagnosed in 46 (63.88%) cats.
The median age of the cats presented with CKD without calculi was 7.41 years (5.5–9.32) and cats with CKD and calculi was 8.21 years (7.15–9.28) (P = 0.274). Cats with CKD and calculi had smaller kidneys than cats with CKD without calculi.
The length of the kidney was measured in the longitudinal plane. The average longitudinal measurement of the right kidney was 3.25 cm and 3.61 cm in cats with and without calculi, respectively (P = 0.009). Similarly, the left kidney size differed significantly between the two groups – the average longitudinal measurement was 3.21 cm for cats with CKD and calculi, and 3.69 cm for cats with CKD without calculi.
A decrease in the urine concentrating ability was also reported in the cats with calculi. The average urine specific gravity in cats with CKD and calculi was 1.030 and in cats with CKD without calculi was 1.050 (P = 0.013).
There were no differences between groups in the other parameters investigated such as plasma total calcium, phosphorus, sodium, potassium and parathyroid hormone (PTH) concentrations. The median values of ionized calcium were near the upper normal limit in both groups. Furthermore, arterial blood pressure was measured, remaining unchanged in both groups.
It can be concluded that nephrolithiasis and/or ureterolithiasis are common findings in cats with CKD and these results reinforce the need for imaging in cats with CKD, even asymptomatic individuals.
Early-Stage Animal Hoarders: Are These Owners of Large Numbers of Adequately Cared for Cats?
D Ramos1, N da Cruz1,
1Faculty of Veterinary Medicine and Animal Science, University of Săo Paulo, Săo Paulo, Brazil
2School of Life Sciences, University of Lincoln, Lincoln, UK
3Department of Foundations of Psychology, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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Animal hoarding is a spectrum-based condition in which hoarders are often reported to have had normal and appropriate pet-keeping habits in childhood and early adulthood. Historically, research has focused largely on well established clinical animal hoarders, with little work targeted towards the onset and development of animal hoarding. This study investigated whether a Brazilian population of owners of what might typically be considered an excessive number of cats (20 or more) were more likely to share the commonly reported psychological and demographic profile of animal hoarders than owners of one to two cats drawn from the same population. Psychological traits measured were attachment to pets (Lexington Attachment to Pets Scale), anxiety, depression (Hospitalized Anxiety and Depression Scale) and hoarding behaviour (Saving Inventory-Revised).
Owners of 20 or more cats were significantly older (P <0.001), displayed significantly higher pet attachment scores (P <0.01), and displayed significant correlations between hoarding behaviour and anxiety (P <0.001), and hoarding behaviour and depression (P <0.05). Such a profile demonstrates greater similarities to clinical animal hoarders than to typical cat owners on these particular measures, although additional disparities with clinical animal hoarders exist in the areas of functioning, veterinary care and home organisation.
Taking this information together, the studied population may represent the understudied group of early-stage animal hoarders. However, external factors such as culture and societal animal control policies should not be overlooked at this stage as alternative explanations for pet keeping at levels that might be considered excessive.
Feline Urinoma: A Case Report and Literature Review
BalmesVet Clínica Veterinaria, Barcelona, Spain
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Urinoma (paraureteral uriniferous pseudocyst or paraureteral pseudocyst) is a retroperitoneal accumulation of extravasated urine contained within a fibrous sac without epithelial lining. Although in the human and veterinary literature urinoma has been reported as a consequence of a variety of abnormalities, in feline medicine it has been reported only after trauma.
A 6-year-old female Bengal cat was presented for evaluation after trauma. Physical examination, cell blood count, biochemistry profile and thoracic radiography did not reveal any abnormalities. Abdominal ultrasound showed urinary bladder rupture, which was surgically repaired. Five weeks after surgery, a palpable mass located cranially to the urinary bladder was detected. After surgical excision, several samples were submitted for histopathological analysis, which revealed sterile lipoid necrotic tissue.
Two months after the second surgery the owner presented the cat for investigation of constipation and a mass in the abdomen. Abdominal ultrasound showed a fluid-filled cavity in the retroperitoneal space. This cavity rose up from the ureter; thus, mass excision including ipsilateral nephrectomy was performed. Samples for histopathological analysis were taken. A renal profile, including blood urea nitrogen and creatinine, was performed before and after surgery, and results for both parameters were between normal ranges. Histopathological analysis revealed serofibrinous exudate and encapsulated necrotic tissue compatible with urinoma.
Although urinoma is not a frequent pathology in cats, we suggest including it in the differential diagnosis of any case that involves a history of trauma, abdominal surgery or urinary tract obstructive/proliferative disease. To the authors’ knowledge, there are only four paraureteral urinoma cases reported in the veterinary literature (two of them in cats), which highlights the need for additional research.
Characterisation of Telmisartan in Cats
1Boehringer Ingelheim Vetmedica GmbH, Ingelheim, Germany
2Boehringer Ingelheim Vetmedica, St Joseph, MO, USA
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Telmisartan was recently licensed for use in cats for the reduction of proteinuria associated with chronic kidney disease (CKD). A series of studies was conducted to evaluate the characteristics of telmisartan oral solution in cats.
Telmisartan is rapidly absorbed after oral administration, with a Tmax of 0.5 h. The bioavailability of orally administered telmisartan is 33%. The mean terminal elimination half-life (t½) of telmisartan is approximately 7.7 h. With repeated dosing, telmisartan reaches steady-state concentrations rapidly with no clinically relevant evidence of accumulation.
A recently published study confirmed that cats quite effectively and rapidly glucuronidate telmisartan. Feline liver tissue showed the highest capacity for in vitro glucuronidation in the species studied, including dogs and humans. Confirming these in vitro results, telmisartan glucuronide is detected as the major circulating metabolite in cat plasma, with elimination almost exclusively in the faeces.
Telmisartan was demonstrated to significantly inhibit pressor response induced by administration of angiotensin II to anaesthetised cats compared with placebo 24 h after dosing, supporting once daily use. These data are consistent with blockade of the angiotensin II type 1 (AT1) receptor, which is the established mechanism of action of telmisartan in other species. This effect of telmisartan is expected in all vascular beds, including the kidney. The dose-dependent reduction in blood pressure seen with telmisartan may be beneficial in hypertensive cats with CKD. Up to 65% of cats with CKD suffer from hypertension.
Finally, a controlled, randomised crossover study was conducted to investigate the palatability of telmisartan oral solution (4 mg/ml) in cats compared with a placebo oral suspension widely considered highly palatable in cats. Acceptance of telmisartan oral solution was assessed as good or very good in 91.7% of all treatments.
In conclusion, telmisartan is rapidly absorbed following oral administration and is metabolised very effectively in the cat with nearly exclusive biliary elimination, avoiding burden to the kidneys. The significant inhibition of the AT1 receptor over 24 h supports the once daily use of telmisartan oral solution in cats and the dose-dependent reduction in blood pressure is a potential benefit to cats with CKD, which often suffer from hypertension. Telmisartan oral solution is well accepted by cats.
Calcium:creatinine Urinary Ratio. A Predictor of Occurrence of Nephrolithiasis in Cats?
Marcela M Pimenta1,
1Department of Veterinary Medicine, University of Săo Paulo, Săo Paulo, Brazil
2Clinique Vétérinaire DeLorimier-Rosemont, Montreal, Canada
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Urine samples obtained by cystocentesis from 107 cats were submitted for calcium:creatinine urinary ratio evaluation in four distinct groups – cats with chronic kidney disease (CKD) (i, with renal or ureteral calculi [n = 45] and ii, without renal or ureteral calculi [n = 25]), and cats without CKD (iii, with renal or ureteral calculi [n = 14] and iv, without renal or ureteral calculi [n = 23]).
Statistical difference was observed (P <0.001) when comparing values among groups using Kruskal-Wallis statistic test. Subsequently, to analyse where the difference occurred, non-parametric Tukey test was performed and P values were established (Figure 1).
Calcium:creatinine (Ca:Creat) urinary ratio in the four groups of cats
The results showed relevant statistically different values for calcium:creatinine urinary ratio between the groups of cats without CKD, with the presence of calculi resulting in a higher ratio (P = 0.012). This difference is enhanced when comparing groups 1 and 4 (P ≤0.001), suggesting that cats that form nephroliths or ureteroliths have higher urinary calcium excretion, especially those with CKD. Considering that most renal/ureteral calculi found in cats nowadays are calcium compounds, one can conclude that calcium:creatinine ratio can be a value tool to predict a tendency towards calcium stone formation.
Feline Exocrine Pancreatic Carcinoma: A Series of Three Cases
1Gattos – Feline Medicine Specialty Clinic, Săo Paulo, Brazil
2Department of Pathology, School of Veterinary Medicine and Animal Science, University of Săo Paulo, Brazil
3CVAP – Veterinary Center of Pathologic Anatomy, Săo Paulo, Brazil
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Three cases of exocrine pancreatic carcinoma were diagnosed based on clinical signs, abdominal ultrasound and histopathology of pancreatic tissue. Historical findings included anorexia, lethargy, chronic vomiting, weight loss and jaundice. On physical examination, two cats were jaundiced and had cranial abdominal palpable masses (cases 1 and 2) and one cat had splenomegaly (case 3).
All cats had elevated pancreatic lipase immunoreactivity (fPLI) (mean = 27.67 µg/l; normal <3.5 µg/l). Two cases presented with extra-hepatic biliary duct obstruction and alterations in pancreatic echogenicity (1 and 2), one of them with pancreatic masses (case 2). One cat had only multiple splenic and hepatic nodules on ultrasound (case 3), with no apparent pancreatic involvement. Alanine aminotransferase and aspartate transaminase were elevated in all cases, with total bilirubin elevated in two cases (1 and 2).
The cats were submitted for exploratory laparotomy (all cases), for cholecystoenterostomy (cases 1 and 2) and splenectomy (case 3), as well as collection of tissue biopsies. All cats had an oesophagostomy tube placed for enteral support.
Histological pancreatic evaluation showed that tumours were formed by acinar structures lined by irregular cuboidal cells, anisokaryosis, anisocytosis and low mitotic index, with marked inflammatory reaction (neutrophils, lymphocytes and plasma cells). In case 3, the spleen and liver nodules were metastases; in addition, cases 1 and 2 had infiltration of carcinoma in the duodenum, common bile duct and sphincter. Cases 1 and 2 also had lymphoplasmacytic enteritis and cholangitis.
The mean survival after surgery was 10 days (14, 2 and 14 days, respectively).
Pancreatic neoplasia should be considered in cases of extra-hepatic bile duct obstruction, as well as in cats with high fPLI values, emphasising the importance of histological characterisation and differentiation between chronic pancreatitis and neoplasia. Observation for inflammatory cells in the liver and intestines, as well as neoplastic changes, is also recommended.
Influence of Age and Gender on Redox Balance in Healthy Cats
Department of Animal Pathology, Veterinary Faculty of Lugo, University of Santiago de Compostela, Spain
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There is growing evidence that oxidative stress (OS) significantly impairs organic function and is considered causally related to cellular senescence and death. The scope of the present study was to evaluate if the redox balance varies in relation to age and gender in healthy cats. The study was carried out using 38 healthy cats classified by gender and age. To quantify the oxidative status of this species, we determined the oxidative damage as serum reactive oxygen metabolites (ROM) and the total serum antioxidant capacity (SAC). In addition, we used the ratio between ROM and SAC as a measure of the oxidative balance, with higher values corresponding to higher oxidative stress (OSi).
Our results suggest that the male population is at risk of developing diseases associated with oxidative stress in adults, when compared with females, especially in the age range of between 2 and 7 years (see Table). The redox imbalance present in young male cats suggests that nutritional strategies should focus on providing early additional antioxidant support, mainly to males, to improve their lifespan and quality of life in later periods, avoiding an OS status that predisposes to chronic processes in senior male cats. Further clinical trials relating to factors that influence OS in cats are strongly recommended.
Mean values for redox balance depending on age and gender differences
A Novel Balloon Catheter Dilation Technique in a Cat With Nasopharyngeal Stenosis
Beatriz Aguilar1,
1Diagnosfera, Madrid, Spain
2Clínica Veterinaria Ayavet, Madrid, Spain
3Clínica Veterinaria Bendinat, Palma de Mallorca, Spain
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A 4-year-old indoor male, neutered domestic shorthair cat was presented with a history of chronic bilateral purulent nasal discharge and stridor. Head x-rays were taken and showed no abnormalities. After culture and sensitivity testing of the discharge a treatment consisting of nebulisation of saline solution, nasal flushing and antibiotics was instituted. There was resolution of the discharge, but the stridor persisted. The cat was referred for a CT scan and a nasopharyngeal stenosis with 2 mm maximum air flow diameter in the choanae was detected.
A 8 mm x 3 cm balloon catheter dilation under fluoroscopic (GE OEC Fluorostar 7900) guidance was instituted. In order to adequately place the catheter a Weasel wire 150 cm x 0.025″ guide was advanced in anterograde direction from the nostrils to the pharynx through the stenotic area. The tip was held in the pharynx with mosquito forceps and advanced to the oral cavity. The balloon catheter (8 mm x 3 cm) was introduced through the oral end of the guide under fluoroscopic control, in order to be placed in the optimal position for maximum dilation effect and also to limit the possibility of sliding. Prednisolone treatment (2 weeks at 2 mg/kg) was instituted. There was complete resolution of clinical signs.
Forty-five days post-dilation there was a relapse with bilateral purulent nasal discharge and stridor. A second dilation using the same technique was attempted with a balloon catheter of a larger diameter (12 mm x 4 cm). There was complete resolution of clinical signs and, at the time of writing, the cat remained free of clinical disease 5 months later.
To the authors’ knowledge this is the first time a feline nasopharyngeal stenosis has been completely resolved with the combination of a vascular wire guide and a balloon catheter under real-time fluoroscopic control, a technique allowing better balloon sliding control and, therefore, more effective dilation.
Injection Site Sarcomas in Cats: Treatment and Survival of 23 Cats in Barcelona
1Fundació Hospital Clínic Veterinari, Universitat Autónoma de Barcelona (UAB)
2Departament de Medicina i Cirurgia Animal, Facultat de Veterinaria UAB, Spain
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Prevalence of feline injection-site sarcomas (FISSs) in Spain is as yet unknown, but sporadic cases are diagnosed in primary and referral practices. Medical records of cats with FISS diagnosed between 2000 and 2011 were reviewed with regard to signalment, clinical presentation, diagnosis, treatment and survival. Criteria for inclusion were having a histological diagnosis, at least one type of treatment and a minimum of 6 months follow-up. Criteria for FISS diagnosis were the presence of a moderate or high grade sarcoma in the interscapular region (or other areas) where vaccines or other injections were known to have been administered and the finding of peripheral mononuclear inflammatory infiltrates. Statistical analysis was performed using software SPSS 19.0.
Twenty-three cats (five males, 18 females) ranging from 3–17 years (average 8.5 years) were included. The interscapular area was the most common location (16/23); other areas were thoracic wall (3/23), axillary area (3/23) and hind limb (1/23). Advanced imaging techniques (CT or MRI) were performed in 10 cats for presurgical evaluation. Radical surgery was performed in all cases. Chemotherapy (doxorubicin, 1 mg/kg every 3 weeks) was used in nine cats (six after surgery, one before surgery and two as palliative treatment). Five cats were treated with external radiation therapy (1.25 MV cobalt therapy Theratron-780) post-surgery in a human facility.
Overall survival ranged from 4 months to 10 years (average 1149 days). Median survival was 730 days. Ten cats were still alive at the end of the follow-up period. Four cats died of pulmonary metastatic disease, with an average survival time of 500 days. Relapses occurred in 13 cats after the first surgery with an average disease-free interval of 335 days. In 7/13 cats further relapses occurred with a shorter average disease-free interval (285 days second relapse, 180 days third relapse).
Median survival of cats treated only with surgery (1539 days) was better than for cats treated with surgery plus chemotherapy and/or radiation (724 days), but the difference was not statistically significant (P = 0.325). Median survival of cats was significantly (P = 0.018) higher for sarcomas with a diameter less of 2 cm (1624 days versus 844 days).
Ultrasonographic Aspects of the Renal Pelvis in 81 Cats With Ureterolithiasis
1College of Veterinary Medicine, University of Săo Paulo, Săo Paulo, Brazil
2Vetmasters Veterinary Specialists, Săo Paulo, Brazil
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In the past few years we have been seeing an increase in uroliths formed by calcium oxalate in cats with chronic kidney disease (CKD). Those calculi can migrate to the ureter causing pain, reduced appetite, weight loss, lethargy and hiding behaviour. Cats may also present with vomiting and anorexia when ureteral obstruction leads to azotaemia.
Ultrasonography is a complementary method that allows us to evaluate the ureter and detect calculi, with low cost and no anaesthesia or contrast media required. An ultrasound machine with good image resolution and appropriate transducers are needed, as well as an experienced examiner. Oftentimes the radiologist only assesses the ureter when signs of obstruction are present, such as hydronephrosis or pyelectasia with 10 mm width or more. Renal pelvic dilatation less than 10 mm width is associated with pyelonephritis or diuresis.
Ultrasonographic reports from 2009 to 2013 were reviewed and 81 cats were identified as having ureterolithiasis, with 102 ureters affected. Ultrasonographic images were reviewed to determine, based on renal pelvis aspects, which were obstructed. We found 45 (44.1%) obstructed ureters (renal pelvic dilation >10 mm width or hydronephrosis) and 57 (55.9%) without signs of outflow obstruction (renal pelvis normal or <10 mm width).
Medical records of these affected animals described one or more signs such as pollakiuria, polydipsia, vomiting, lethargy, anorexia, weight loss, vocalisation and inappropriate urination. The high incidence of non-obstructive ureterolithiasis demonstrated in this study underlines the importance of assessing the ureter during ultrasonographic examination in cats with CKD presenting with nephrolithiasis, even where there is no evidence of pelvic dilation, since the presence of a ureterolith can be correlated with the signs or cause an outflow obstruction in a short period of time.
Off-Label Oral Use of Zoletil® in Cats: A Pilot Study
Medical and R&D Department, Virbac, Carros, France
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Zoletil (Virbac; France) is an injectable anaesthetic for balanced anaesthesia combining a dissociative (tiletamine) and a benzodiazepine (zolazepam) and is ideally suited for short- to medium-term interventions in domestic carnivores. Intramuscular, intravenous and subcutaneous use of this product has been reported in cats. Additionally, despite the fact that Zoletil is marketed as an injectable product, oral use is also reported in feral and fractious animals in the field.
The goal of this study was to evaluate the anaesthetic effects of the oral use of Zoletil in cats. For the purpose of the study eight healthy adult cats, males and females, 2–4 years old, were selected. Zoletil 50 was supplied in a sterile vial as a lyophilised powder and reconstituted with water for injections. Each cat received Zoletil orally at a dosage of either 15 mg/kg or 25 mg/kg. Each animal had a pre-anaesthetic evaluation and blood analysis performed by a veterinary practitioner. After administration of the product the following parameters were monitored: heart rate, respiratory rate, blood pressure and rectal temperature. The following data were recorded: time from administration to sternal and lateral recumbency, duration of orotracheal intubation and time to return to sternal recumbency. The overall quality of sedation/anaesthesia was scored, as was quality of recovery.
Oral administration of Zoletil rapidly induced sedation/anaesthesia and lateral recumbency in all animals (see Table, page 827). Intubation was possible in all animals; the 25 mg/kg animals were adequately relaxed for diagnostic or minor surgical procedures, while with 15 mg/kg only profound sedation was achieved. Individual variations were recorded in each group. One of the reasons for the relatively wide variations between animals is that the product has a bitter taste, causing excessive salivation in some individuals; this may have resulted in partial loss of the dosage in these cats. Administration of Zoletil powder with a palatable coating could be considered. Further investigation is needed.
Use of oral Zoletil for sedation/anaesthesia in cats
Feline Calicivirus Associated Virulent Systemic Disease (FCV-VSD): Report on the First Confirmed Case in Madrid (Spain)
1Veterinary Clinic Neko, Madrid, Spain
2Centre for Virus Research, University of Glasgow, UK
3Veterinary Pathology, School of Veterinary Science, Liverpool, UK and Veterinary Pathology, Faculty of Veterinary Medicine, Helsinki, Finland
4Merial, European Technical Services, Lyon, France
5Merial Spain, Marketing and Technical Services, Barcelona, Spain
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Feline calicivirus (FCV) is a highly infectious RNA virus that is widely spread among cats globally. Typically, FCV infection in cats is associated with an acute oral and upper respiratory tract disease, characterised by oral ulceration, ocular and nasal discharges and sneezing. However, recently, FCV-associated virulent systemic disease (FCV-VSD) has been described in the USA and Europe, characterised by systemic spread of the virus in the cat, severe clinical signs and a high mortality rate, even in vaccinated cats. The present report describes a suspected FCV-VSD outbreak in a shelter located in Madrid (Spain).
In October 2012, two adult shelter cats displayed respiratory and systemic signs which worsened until death occurred 48 h and 24 h after the onset of clinical signs. Both the clinical signs and the post-mortem findings were suggestive of FCV-VSD. Immunohistochemistry confirmed the presence of FCV in lung tissue from both cats and in the liver of one cat, and virus was isolated from the spleen of one cat, confirmed by the cytopathic effect observed in vitro. Genetic sequencing was ongoing at the time of writing.
The clinical signs and the course of the disease, together with the results of the clinicopathological and immunohistochemical examinations and virus isolation, provided evidence that at least one of these cats suffered from FCV-VSD. While further cases consistent with FCV-VSD have been suspected in Spain (unpublished data), this is the first clinical case in Spain that has been confirmed using a range of diagnostic tests.
Evaluation of Intact Parathyroid Hormone (PTHI) in Cats With Nephrolithiasis/Ureterolithiasis and Chronic Kidney Disease
Marcela M Pimenta1, Archivaldo Reche-Júnior1,
1Department of Veterinary Medicine, University of Săo Paulo, Săo Paulo, Brazil
2Clinique Vétérinaire DeLorimier-Rosemont, Montreal, Canada
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Renal secondary hyperparathyroidism has been recognized as a potential risk factor for feline urolithiasis. Currently, an increasing prevalence of renal and ureteral stones has been observed in cats, mainly calcium oxalate (CaOx) uroliths.
Seventy cats with chronic kidney disease (CKD) – stage II according to International Renal Interest Society criteria – were evaluated and divided into two groups: (1) CKD with urolithiasis (n = 46) and (2) CKD without urolithiasis (n = 24). There was no statistical significance between the groups in terms of age (P = 0.274).
Intact parathyroid hormone (PTHi) was evaluated using radioimmunoassay in all cats. There were no differences in the PTHi measurements between the two groups (P = 0.372) (see Table). The measurement unit used was pmol/l, with a cut-off interval between 0.4 and 2.5 pmol/l. Ionized calcium was also evaluated in both groups, but no difference was found (P = 0.445), despite an upper normal limit tendency in the calculi group (ie, median value = 1.39 mmol/dl).
PTHi values in cats with CKD
CI interval 95% upper and lower limits. †Non-parametric Mann-Whitney test
SD = standard deviation, SE = standard error