Clinical/research abstracts accepted for presentation at AAFP Conference 2018

AAFP Conference poster session

A total of 13 clinical/research abstracts were accepted for either oral presentation or inclusion in a poster session held during the 2018 AAFP Conference in Charlotte, NC, USA, 27–30 September.

Treatment of Acid–Base and Electrolyte Disorders in Cats with Urethral Obstruction

Fernanda VA da Costa¹, Gabriela C Schaefer², Stella de F Valle³, Félix HD González³

¹Department of Animal Medicine, College of Veterinary Medicine, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil

²Postgraduate Program in Veterinary Science, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil

³Department of Veterinary Clinical Pathology, College of Veterinary Medicine, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil

Email: [e-mail]

Purpose: The purpose of this study was to describe the acid–base and electrolyte status of male cats with urethral obstruction treated with either regular insulin and dextrose or regular insulin and dextrose associated with sodium bicarbonate, and to correlate these data with the outcome. Summary of background/objectives, methods, results and conclusions: Urethral obstruction in male cats is a common and potentially life-threatening condition, characterized by severe metabolic, electrolyte and acid–base disturbances. A prospective study was conducted to evaluate the acid–base and electrolyte status of 15 male cats prior to and after treatment.

Data were obtained from cats with urethral obstruction presented to Rio Grande do Sul Federal University Teaching Hospital, Brazil. Venous blood was collected in a lithium heparinized syringe and immediately analyzed in a portable analyzer (i-STAT, EG7+; Abbott Laboratories) for blood pH, gas and electrolytes prior to any intervention and after treatment. All cats received analgesic therapy, were given balanced electrolyte intravenous fluid therapy (lactated Ringer’s solution proportionally to dehydration, with bolus administration to hypotensive patients [10–20 ml/kg]), warmed for body temperature control, corrected for hypoglycemia and underwent decompressive cystocentesis; patients with dyspnea were also given oxygen therapy. Correction of ionized hypocalcemia was performed using 10% calcium gluconate (0.5–1.5 ml/kg in 15 mins, IV). Cats with hyperkalemia and acidosis were divided into two groups: nine cats (group 1) received intravenous regular insulin (0.25–0.5 units/kg) associated with dextrose (2 g/unit of insulin) and four cats (group 2) were treated with a combination of the previous protocol and intravenous slow infusion of 8.4% sodium bicarbonate (bicarbonate = body weight x 0.3 x base excess/2). After stabilization, all patients were anesthetized for urethral catheterization with diazepam 0.25 mg/kg and propofol 2 mg/kg or more, intravenously, if necessary, and remained hospitalized for supportive care. A second blood sample from group 1 was obtained 48–72 h after presentation. A second blood sample from group 2 was obtained 20–30 mins after bicarbonate administration and a third blood sample 48–72 h after presentation. The patients were classified according to their outcome 48–72 h after presentation as survivors and non-survivors.

In group 1, one cat died (11%) while, in group 2, two cats died (50%) within this period. Short-term mortality was substantially higher in the group treated with insulin and dextrose associated with sodium bicarbonate compared with the group treated with insulin and dextrose alone.

Despite the knowledge that acidemia is harmful to the body, the use of bicarbonate as an alkalinizing agent is controversial due to its potential adverse effects, including paradoxical intracellular acidosis. The use of sodium bicarbonate could be beneficial in cats with urethral obstruction and hyperkalemia because blood pH elevation leads to potassium shift from the extracellular to intracellular compartment. However, in the present study the patients remained hyperkalemic even after bicarbonate therapy.

This is a preliminary study with a number of limiting factors, including small sample size and a lack of evaluation of other factors that may be related to mortality. We suggest that further studies are conducted to evaluate the effects of bicarbonate therapy in cats with urethral obstruction.

Fecal Score and Endoparasites in a Population of Domestic Cats from Rio De Janeiro, Brazil

Nilcéia de V Ramos, Luciano A Barros, Flavya Mendes-de-Almeida

Faculdade de Veterinária, Universidade Federal Fluminense, Niterói, RJ, Brazil

Email: [e-mail]

Purpose: The aim of this study was to observe whether fecal score in cats can be associated with the presence of gastrointestinal parasites. Summary of background/objectives, methods, results and conclusions: The presence of pasty or diarrheic stools, both in the shelter and home environment, is a common reason for the administration of antiparasitic drugs. Anthelmintics in different formulations and antimicrobials such as sulfadimethoxine combined with metronidazole are easily obtained over the counter in pet shops in Brazil. The indiscriminate and preventive use of these products is frequent and is often encouraged by clinicians, especially when there is softening of the feces, even without previous examination proving the real need for treatment. Fecal examination prior to treatment provides the option of either not treating when there are no positive samples, or targeted treatment when in many cases only one species is involved in parasitism, and the use of broad spectrum medications is unnecessary and can lead to resistance.

The objective of this study was to observe if there is an association between the fecal score and the presence of gastrointestinal parasites in a population of domestic cats living in a shelter. The number of positive or negative samples was recorded. The results were compiled for determination of statistical significance by χ² test, using EPI Info 3.5.2. Eighty-six cats were included in the study. All cats were fed dry and wet commercial food, had resided in the shelter for at least a month and were up to 6 years old. The feces were collected individually and processed by the Sheather’s sugar solution technique and categorized into firm, pasty and liquid. The microscopy slides were examined using a x 10 objective or x 40 when needed.

Optical microscopy findings included Cystoisospora species oocysts and eggs of the nematodes Toxocara and Ancylostoma species. Thirty-four samples (39.5%) from the 86 animals contained at least one parasitic life form in the feces (see Table). Sixty-nine percent of the cats (59/86) had received anthelmintic medication up to 3 months prior to the study, and 44.1% (15/34) still had nematodes in the stool samples. There was no significant difference with respect to sex, age or endoparasite burden according to fecal score (P ≥0.05). Pasty fecal samples were more frequent among cats up to 6 months old (χ² = 7.71; P = 0.021).

Table 1

Endoparasites in a population of domestic cats according to different categories of fecal score

Category		Firm		Pasty		Liquid
		No. of positive/category total	%	No. of positive/category total	%	No. of positive/category total	%
Sex	Male	6/25	24	6/14	42.9	1/3	33.3
	Female	13/26	50	8/18	44.4	-	-
Age	<6 months	9/22	40.9	12/19	37.5	-	-
	>6 months to 2 years	5/15	33.3	2/9	22.2	-	-
	3-6 years	5/14	35.7	0/4	-	1/3	33.3
Endoparasites	Cystoisospora species	2/51	3.9	3/32	9.4	-	-
	Toxocara species	7/51	13.7	5/32	15.6	-	-
	Ancylostoma species	5/51	9.8	2/32	6.2	-	-
	Cystoisospora species + Toxocara species	1/51	2	0/32	-	-	-
	Ancylostoma species +Toxocara species	4/51	7.8	4/32	12.5	1/3	33.3

The present study demonstrated the importance of prior fecal examination to avoid unnecessary administration of antiparasitic drugs, especially in kittens.

Analysis of Causes of Feline Infertility in a Cattery: A Review of Medical Records and Histopathologic Diagnoses

Aime K Johnson¹, Dan Jandrlich², Eva Sartin³, Kelly Joiner³, Douglas Martin⁴

¹Auburn University College of Veterinary Medicine, Department of Clinical Sciences, Auburn, AL, USA

²Heart of Suwanee Animal Hospital, Suwanee, GA, USA

³Auburn University College of Veterinary Medicine, Department of Pathobiology, Auburn, AL, USA

⁴Auburn University College of Veterinary Medicine, Scott-Ritchey Research Center and Department of Anatomy, Physiology and Pharmacology, Auburn, AL, USA

Email: [e-mail]

Purpose: The purpose of this study was to determine the most common causes of infertility in breeding females that are no longer producing litters of kittens.

Summary of background/objectives, methods, results and conclusions: Feline breeding colonies are important to the feline industry by preserving traits desirable for a particular breed or by maintaining medically valuable genetic traits in research settings. Work in the domestic feline population can also be extrapolated to endangered wild feline populations. As breeding females age, their reproductive efficiency declines. Knowing the causes and average age of infertility will allow management decisions to be made for the betterment of the queen.

The medical records of 70 queens retired from breeding from a research colony were examined for litter size and number, fertility over their lifespan, and age and reason for retirement. Sections of uterus and ovaries were evaluated using gross examination and histopathology for a subset of these (46 queens).

The average age of initial breeding was 10.6 months. Over their breeding career, queens were exposed to an average of four males, and produced an average of 5.1 litters. The average number of years in the breeding colony was 5 years and 7 months, with only 40% of cats still producing litters after 5 years of age (average of 1.5 successful litters per cat per year). The litter size decreased over time from 3.8 kittens during the first year of breeding (70 queens) to 2.8 kittens by year 6 (34 queens). The percentage of queens that failed to produce a litter was 20% (14/70 queens) during the first breeding year, 19% (12/62) in year 2, and 34% (20/59) and 33% (14/43), respectively, in years 3 and 4. The infertility rate increased to 44% (16/36) in year 5 and was 32% (11/34) by year 6, with only 34 of the original 70 queens still producing.

On histopathology, 11/46 (24%) cases showed atrophy of the uterus and ovaries, characterized by deficient numbers of endometrial glands and ovarian follicles, respectively. Evidence of pyometra, cystic endometrial hyperplasia (CEH) and endometritis was found in 31/46 (67%) queens, with an additional 10 queens removed from breeding for clinical evidence of CEH and pyometra (no histopathology performed). Twenty-one of the 38 (55%) queens that were diagnosed with one (26%) or a combination (58%) of the pathologies listed, started showing signs of infertility by 3 years of age.

These data suggest that mature, continuously breeding female cats may show signs of infertility (missed breedings, reduced litter size) as early as 3 years of age, which may be a result of undiagnosed CEH, endometritis, pyometra and/or ovarian cysts. Management of breeding queens should include periodic ultrasound examinations to monitor for ovarian cysts and CEH starting at 3 years of age, and retiriement of animals from breeding once signs of infertility are present, as early as 3–5 years of age.

Topical Oral 1-Tetradecanol Complex in the Treatment of Periodontal Diseases in Cats

James MG Anthony

Elite Science, Red Bank Veterinary Hospital, NJ, USA

Email: [e-mail]; [e-mail]

Purpose: The purpose of this study was to investigate whether topical application of esterified fatty acids to cats with periodontal disease slows the progression of the disease.

Summary of background/objectives, methods, results and conclusions: Periodontal disease is a very common condition in cats and the disease worsens as time goes on. It can result in loss of dentition and surrounding bone, as well as pain, oral inflammation, halitosis and bacteremia. The release of bacteria affects other organs, such as the heart, liver and kidneys. It is speculated that bacteria from the oral cavity have resulted in septicaemia.

Home care, such as brushing the teeth or oral rinses with antiseptic solutions, is often discontinued as it can be difficult to perform in some cats. Topical application of esterified fatty acids in rabbits with periodontal disease has been shown to slow down the progression of this disease and inhibit bone loss.

In this study, a group of cats with existing periodontal disease was anesthetized and given a thorough oral examination. After 6 weeks of treatment with esterified fatty acids applied to their oral cavity every other day the cats were again anesthetized and given another thorough oral examination. Periodontal scores were significantly decreased after 6 weeks of treatment.

This treatment could offer a safe, economical procedure that would be easy for cats’ care-givers to perform at home, with the potential to improve the health and welfare of cats affected by periodontal disease.

Shock Index Evaluation in Cats

Fernanda VA da Costa¹, Leandro Fadel², Silvana B Vidor³, Elissandra da Silveira³, Marina Cândido⁴, Gabriela da Cruz Schaefer³, Glaucia Bueno Pereira Neto⁵, Rodrigo Cardoso Rabelo^6,7

¹Department of Animal Medicine, College of Veterinary Medicine, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil

²Faculty of Veterinary Medicine – Lutheran University of Brazil – ULBRA, Canoas, Brazil; Vettie Veterinary Clinic, Porto Alegre, Brazil

³Postgraduate Program in Veterinary Science, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, RS, Brazil

⁴College of Veterinary Medicine, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil

⁵Veterinary Hospital of the Faculty of Agronomy and Veterinary Medicine, University of Brasilia, Brasília, DF, Brazil

⁶Intensivet Veterinary Consulting

⁷Brasília University, Brasília, DF, Brazil

Email: [e-mail]

Purpose: The aims of this study were to determine if the shock index (SI) can be used as a parameter for shock diagnosis in cats and whether this index can be used for monitoring and predicting the mortality of cats in shock.

Summary of background/objectives, methods, results and conclusions: In humans and dogs, the evaluation of heart rate (HR) and systolic arterial blood pressure (SAP) can be used as an early indicator of hypovolemia and prognosis if the SI (SI = HR/SAP) is increased. However, there are no available data about SI in cats.

In this study, the SI was recorded from feline emergency patients at the time of arrival (0 h), and 6 h and 24 h after arrival at the emergency entrance at the Veterinary Clinics Hospital of the Federal University of Rio Grande do Sul, Brazil. The patients were divided in two groups: those that survived and those that died. Data collected included HR, SAP, lactatemia, rectal temperature (T_central), peripheral temperature (T_peripheral), vasoconstriction evidence, and final outcome (death or recovery). The vasoconstriction criteria included: absence of intestinal borborygmi on abdominal auscultation, hypochromic mucosa, absent femoral pulse, capillary filling time >2 s and ΔT (ΔT = T_central – T_peripheral) >8°C.

To date, 14 random-bred cats with a mean age of 4.2 years have been evaluated. In these patients, it was possible to relate an SI >2 with a high mortality risk. During the study, 50% of the patients died; their mean SI increased from 1 at 0 h to 1.64 in the first 6 h and 2.5 in the 24 h of hospitalization, which represents an increase of more than 100% during the first 24 h of hospitalization. The mean SI of the surviving patients remained stable at 1.54 during the 24 h evaluation. The mean HR of surviving cats was 163 bpm and increased to 178 bpm in the first 24 h of hospitalization, while in non-surviving cats it was 148 bpm and increased to 169 bpm in the same period. The mean SAP in the surviving cats was 110 mmHg and increased to 137 mmHg in the first 24 h of hospitalization, while in those that died it was 118 mmHg and later reduced to 102 mmHg. Lactatemia was above the reference interval (2.5 mmol/l) in 70% of the patients, with a mean of 2.08 mmol/l in the surviving patients and 4.27 mmol/l in the patients that died. The main indications for emergency care were: trauma, feline infectious peritonitis, feline leukemia virus infection, anemia, urethral obstruction and pancreatitis.

These results are promising in demonstrating that the SI index may possibly be used as a minimally invasive and early method to indicate the outcome of care of cats admitted to emergency services.

Pemphigus Foliaceus in a Cat

Camila F Pinto^1,2, Analice C M Severino¹, Luciana Pithon¹

¹Pompeia Veterinary Hospital, São Paulo, SP, Brazil

²FMU College of Veterinary Medicine, São Paulo, SP, Brazil

Email: [e-mail]

Purpose: A case of pemphigus foliaceus in a cat and treatment with prednisolone as monotherapy, with efficacy and rapid improvement of the lesions, is reported.

Case description: The pemphigus complex is a group of autoimmune diseases that can affect cats, although it occurs only rarely in feline species. Pathogenesis of the disease involves autoantibodies targeting a component of the adhesion molecules on keratinocytes, which results in formation of acantholytic keratinocytes. Acantholysis is expressed by the dissociation of epidermal cells due to the action of autoantibodies directed towards desmosomal antigens. Pemphigus foliaceus (PF) is the most common form of pemphigus, but there is little information on the pathogenesis of PF in cats, although eruptions caused by drugs and resembling feline PF have been reported.

The most commonly affected patients are cats of undefined breeds and domestic shorthair cats. The lesions begin mainly in the ear, nasal plane, paws and periocular region. Involvement of the pinnae, trunk, limbs and tail has also been reported in some cats. Clinical appearance of PF in cats is most commonly described as pustular eruption or pustular dermatosis. Pustules are transient, and crusts, scales, alopecia and erosions are commonly observed. The typical lesion is a pustule, and histopathology is the gold standard for diagnosis. Some cats may respond to glucocorticoid monotherapy, but commonly concurrent treatment with other immunomodulatory medications may be required. The treatment protocol targets immunosuppression.

This case report discusses an 8-year-old male cat of undefined breed that was admitted to the Pompeia Veterinary Hospital, Brazil, with a history of showing disseminate dermatologic lesions for approximately 15 days, without having undergone any previous treatment. Lesions evolved rapidly to the dorsum, pinnae, periocular area, tail, pelvic limbs, face and abdomen. Distribution of the lesions was asymmetrical, and there was no involvement of the paws. The owner reported only mild pruritus. During the appointment, disseminated hemorrhagic crusts with associated scale and alopecia were observed (Figure 1).

Figure 1

Hemorrhagic crusts with associated scale and alopecia

A complete blood count, biochemical profile and feline immunoassay testing (SNAP FIV/FeLV Combo Test; IDEXX Laboratories) were performed before starting treatment. The immunoassay was negative. All blood parameters and the biochemical profile were normal. Cytology of the lesions showed inflammatory cells and rare cocci. Definitive diagnosis was based on biopsy and histopathologic examination of the lesions, which showed subcorneal pustular neutrophilic dermatitis with areas of erosion and ulceration, and small numbers of acantholytic cells with active acantholysis. These findings led to a final diagnosis of PF.

Initial treatment comprised prednisolone 2 mg/kg q24h. Evident improvement of the lesions was observed after 15 days of treatment (Figure 2). At the time of writing, the patient was undergoing a prednisolone reduction regimen without recurrence. It can be concluded that prednisolone monotherapy may be an effective treatment for PF in cats.

Figure 2

Evident improvement of the lesions after 15 days of treatment with prednisolone

Hydrophobic Sand: Uses and Techniques

Alon Rosenberg

Coastline Global, Palo Alto, CA, USA

Email: [e-mail]

Purpose: The purpose of the study was to demonstrate that using a hydrophobic sand to collect a urine sample would produce identical results to the incumbent method (cystocentesis), thereby validating the technique to be a widespread practice as a more convenient and standardized method of urine collection.

Summary of background/objectives, methods, results and conclusions: The majority of feline urine samples today are collected by cystocentesis, which is an invasive procedure that induces stress in both the cat and the person collecting the sample. High stress levels may also have a significant impact on pH levels and other parameters, in some cases rendering the diagnosis inconclusive. In looking at alternatives, this study evaluated the efficacy of a new and revolutionary technology of using unique hydrophobic sand, which is biodegradable, non-invasive, cat friendly and completely painless when collecting feline urine samples.

Twenty cats were divided into three groups (young/middle-aged/older) and were selected at random. They had no prior clinical history. A 5 ml cystocentesis urine sample was drawn from each cat and placed into a test tube. The same cat was allowed to freely urinate in a litter box containing Kit4Cat (Coastline Global) hydrophobic sand (from a freshly opened bag). The cats being studied frequently buried their urine, exhibiting their natural behavior, requiring the lab technician to move the sand aside to expose the buried urine before collecting it with a pipette. All the samples were then submitted to a commercial laboratory for urinalysis, with each sample being given a different name so that the lab would not know that each cat had provided two samples (one from cystocentesis and the other using Kit4Cat).

The results indicated that there was perfect agreement (pH, urine specific gravity, chemistry screen, sediment exam) between the Kit4Cat samples and the cystocentesis samples for all 20 cats. The two techniques provided the same laboratory urinalysis results for each cat tested, with no anomalies or artefacts whatsoever. We also found that this unique hydrophobic sand will reduce the time spent collecting urine, costs and animal stress, as well as improving animal welfare. In addition, this method will free up the veterinarian’s time, as a technician or pet owner can perform the sample collection.

Impact of General Anesthesia on Serum Symmetric Dimethylarginine Concentration in Cats

Shinichi Namba^1,2, Ryo Kitamura¹, Takao Amaha¹, Masahiko Befu¹, Tomone Zama¹, Taku Moriwaki¹, Shohei Kumono¹, Saki Shichijo¹

¹Marble Veterinary Medical Center, Fujisawa, Kanagawa, Japan

²Laboratory of Veterinary Biochemistry, Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Fujisawa, Kanagawa, Japan

Email: [e-mail]

Purpose: This study aimed to evaluate serum symmetric dimethylarginine (SDMA) concentration before and after general anesthesia with propofol induction and isoflurane maintenance when performing various surgical procedures in cats.

Summary of background/objectives, methods, results and conclusions: Although serum levels of creatinine (sCr) and blood urea nitrogen (BUN) are routinely used biomarkers of kidney function, these are inadequate for the early detection of kidney dysfunction because levels of these biomarkers increase only after severe histopathological damage in the kidneys. Commonly, increments in sCr depend on the muscle mass and injury, and BUN is affected by factors such as gastrointestinal bleeding and hydration status. SDMA is a structural isomer of the endogenous nitric oxide synthase inhibitor, asymmetric dimethylarginine, which is metabolized by dimethylarginine dimethylaminohydrolase; however, SDMA is eliminated by renal excretion. This study aimed to investigate the serum levels of SDMA, BUN and sCr before and after general anesthesia in cats.

We anesthetized all client-owned cats using propofol induction and isoflurane maintenance (n = 31). All blood samples were collected 2–4 h before the induction of anesthesia and immediately after the completion of surgical procedures including castration (n = 13), ovariohysterectomy (n = 7), dental care (n = 8) and gastrointestinal surgery (n = 3). The infusion rate of lactated Ringer’s solution during surgery was 5 ml/kg/h. SDMA levels were measured at IDEXX Laboratories and sCr and BUN levels at the Marble Veterinary Medical Center.

In all cats anesthetized with propofol induction and isoflurane maintenance, serum SDMA levels measured after anesthesia induction (17.10 ± 4.33 g/dl) were significantly higher than those measured before anesthesia induction (12.39 ± 3.18 g/dl; P <0.001) (Figure 1). However, sCr and BUN levels, which are traditional biomarkers of renal function, remained unaltered before and after anesthesia induction. In addition, BUN and sCr levels were not significantly correlated with SDMA levels (r = 0.07 and r = 0.01, respectively).

Figure 1

Serum symmetric dimethylarginine (SDMA) concentrations before and after general anesthesia induction. Each column is shown with 5–95 percentiles

In this study, although we observed a considerable elevation in the serum SDMA concentration after general anesthesia induction, no elevation was noted in sCr and BUN levels, suggesting that serum SDMA concentration is a sensitive biomarker for kidney function in cats. Moreover, the infusion rate of the lactated Ringer’s solution could be inadequate at 5 ml/kg/h when anesthetizing cats with propofol induction and isoflurane maintenance. Hence, further investigation of factors affecting serum SDMA concentrations and infusion rate during anesthesia in cats is warranted.

Adipose-Derived Stem Cell Therapy for Feline Chronic Kidney Disease: A Review of 40 Clinical Cases

Robert J Harman, Susan Harman, Carolyn Wrightson

VetStem, Poway, CA, USA

Email: [e-mail]

Purpose: A retrospective analysis of 40 cases of feline chronic kidney disease (CKD) and outcomes after therapy with adipose-derived stem cells is discussed.

Summary of background/objectives, methods, results and conclusions: CKD in the cat is a major cause of debilitation and death. Recent reviews suggest that CKD may be the number 1 cause of morbidity and mortality in the aged cat. Therapies available include medical management, dietary control, dialysis and kidney transplant. For most cat owners, dialysis and kidney transplant are beyond economic and practical reach. In the past decade, refereed journal articles have been published showing the possibility of using mesenchymal stem cells as a therapeutic option. The authors hypothesized that intravenous mesenchymal stem cell therapy could improve the clinical course of CKD. This study examines the data from 40 clinical cases treated by veterinarians using intravenous administration of adipose-derived stem cells for CKD.

A cell therapy protocol was developed for a clinical research program of cats with CKD. For enrollment in the program, the veterinarian submitted age, weight, breed, physical examination, complete blood count, clinical chemistry and urinalysis. Some cases had blood pressure and renal ultrasound performed. Animals that had significant urinary tract infections, genetic renal disease or significant non-renal disease(s) were excluded. For each case, an intra-abdominal adipose sample was surgically collected and shipped refrigerated to a central processing laboratory where the stromal vascular fraction (SVF) was isolated from the sample by methods previously reported. The initial dose (unfrozen) was returned in a 5 ml volume of saline for infusion. Repeat doses were provided to the veterinarian based upon clinical response. All initial doses were fresh SVF except for one patient where cultured cells were used. Repeat doses were either frozen/thawed SVF or culture expanded as available.

A total of 40 cats were treated and had adequate pre- and post-treatment data for analysis. The average age of the cats was 12.2 years and the average body condition score was 3.0/5.0. The average dose was 4.92 x 10⁶ nucleated cells using a Nucleocounter, with an average number of initial doses per case of 1.8 and total doses of 3.3. Clinical pathology data reported for pre-treatment, at 180 days and at 330 days, respectively, averaged as follows: blood urine nitrogen (BUN) 61.9, 52.0, 60.8; creatinine 3.96, 3.03, 3.78. By day 180, on average, BUN had improved by 15.9% and creatinine had improved by 23.5%.

There was a trend to significant improvement in BUN and creatinine at 180 days. Improvement in these parameters was seen through to an average of 330 days in a population of significantly diseased patients in which these parameters would have been expected to deteriorate. There were no reported adverse events in the treated cats. This study was not blinded and this limitation makes outcome conclusions more difficult; however, the study measures indicate that the therapy may be providing clinical benefit with low risk. Additional controlled studies are planned to further evaluate the benefit of cell therapy in CKD.

Using Big Data to Explore the Relationships between Signalment and Weight in Over 13 Million Cats

Adam J Campigotto¹, Zvonimir Poljak¹, Elizabeth A Stone², Deborah Stacey³ Theresa M Bernardo³

¹Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada

²Department of Clinical Studies, University of Guelph, Guelph, ON, Canada

³Department of Computer Science, University of Guelph, Guelph, ON, Canada

Email: [e-mail]

Purpose: The objective of this study was to determine the impact of breed and gender on the change in body weight at each year of age in cats.

Summary of background/objectives, methods, results and conclusions: Having knowledge of body weight development during a lifetime of various cat breeds can provide vital health information for both pet owners and veterinarians treating these animals, guiding discussions on obesity and weight loss as cats age. There is very little information available on the weight of various breeds at different stages of life. Using electronic medical records can help to fill this knowledge gap by exploring the historical weights of a large number of cats over many years, allowing information to be explored on both frequently and infrequently seen breeds.

This study was performed using body weight gathered from cats from 3972 veterinary clinics in the US and Canada from 1981–2016. Data were collected via electronic management records, and the anonymized data were made available through a veterinary diagnostic company (IDEXX Laboratories). Records from over 19 million patients were included in the study population prior to data cleaning. Descriptive statistics were explored on this dataset. For further analysis, linear regression was performed to determine the impact of signalment on weight of animals older than 1 year, leaving a total of 13 million patients for analysis.

Weight was found to be significantly related to breed, age, sex and reproductive status. Heavier breeds tended to reach a maximum average weight earlier in life. Neutered animals tended to reach a higher maximum average weight than intact animals. While this does not yet provide optimal weights to aim for, as no health status or body condition score is noted, it is a starting point for discussion between clients and veterinarians.

Effect of Waiting Room Experience on Feline Blood Pressure Measurement

Laura R Van Vertloo, Joyce M Carnevale, Meghann A Rosburg, Suzanne T Millman, Rebecca L Parsons, Katelyn K Schreiber

Iowa State University College of Veterinary Medicine, Ames, IA, USA

Email: [e-mail]

Purpose: The primary objective of this study was to examine the effects of two purported low stress interventions, clinic waiting location and a feline pheromone spray, on blood pressure (BP) in healthy cats. A secondary objective was to evaluate the reliability of BP data recorded between clinic visits.

Summary of background/objectives, methods, results and conclusions: Systemic hypertension is a common consequence of multiple disease processes seen frequently in aging cats. When left untreated, hypertension can have serious consequences including damage to the eyes, kidneys, heart and central nervous system. Correctly identifying and adequately monitoring cats with systemic hypertension presents a significant challenge for feline practitioners, because the influence of stress can interfere with obtaining meaningful measurements. We hypothesized that reduced stress associated with bypassing the waiting room and the use of a feline pheromone spray would result in lower BP. We also hypothesized that cats would acclimate over time, with lower BP observed in readings from subsequent clinic visits.

This study was designed as a 2 x 2 factorial, with repeated measures over four weekly visits. Healthy adult cats (n = 38) were enrolled, and assigned to a random sequence of four treatment combinations to be performed over the four clinic visits. During a 10 min waiting period, cats were also assigned to receive a pheromone treatment with a towel sprayed with a feline pheromone (Feliway; Ceva) draped over the carrier (F) or control treatment with no towel and no pheromone (C). Cats were assigned to the waiting room (W) or taken directly to the exam room (E) to wait prior to BP measurement. Following the waiting period, BP measurements were collected using Doppler. A total of six BP measurements were obtained sequentially at each visit. A mixed model statistical analysis was performed, including waiting location, pheromone treatment, year and interactions in the model, with age and weight as covariates.

Contrary to our hypothesis, BP was not influenced by waiting location (P = 0.35; mean ± SE: W = 145.8 ± 1.8; E = 143.3 ± 1.9) or pheromone treatment (P = 0.92; F = 144.7 ± 1.8; C = 144.4 ± 1.8). There was a significant effect of visit, such that BP was elevated on the first visit relative to subsequent visits (P <0.05; 1 = 155.6 ± 2.6; 2 = 136.2 ± 2.6; 3 = 148.3 ± 2.6; 4 = 138.2 ± 2.6). However, the effect was not linear and the third visit was also elevated relative to visits 2 and 4 (P <0.01).

In conclusion, we did not find evidence to support the effects of these purported low stress interventions on BP. It is possible that these interventions were not enough to overcome other unidentified sources of stress. Further study is indicated to determine if other low-stress interventions may have an influence on feline BP measurement.

Feline Amylin is Faster to Aggregate Than Human Amylin and Increases During Pancreatitis

Luana Jotha-Mattos¹, Aline B Vieira², Marcelle da S M Castelo³, Aline S de M Queiroz³, Heloisa J M de Souza⁴, Nayro X de Castro³, Luís Mauricio T R Lima²

¹Federal University of Rio de Janeiro (UFRJ), CCS, Rio de Janeiro, RJ, Brazil

²Ross University School of Veterinary Medicine, Basseterre, St Kitts, USA

³College of Veterinary Medicine, Federal Fluminense University (UFF), Niterói, RJ, Brazil

⁴College of Veterinary Medicine, Federal Rural University of Rio de Janeiro (UFRRJ), Seropédica, RJ, Brazil

Email: [e-mail]

Purpose: The purpose of the study was to compare the aggregation pattern of feline, human and murine amylin and the amylin analogue pramlintide in vitro, as well as to evaluate feline amylinemia during pancreatitis.

Summary of background/objectives, methods, results and conclusions: Amylin is a pancreatic peptide hormone co-secreted along with insulin by the beta cells. Amylin has several actions including control of glucagonemia, gastric emptying and satiety. The amino acid sequence of amylin is amyloidogenic in cats and humans. Intracellular and extracellular amylin aggregation may be linked to the loss of beta cells that develops in cats and humans with type 2 diabetes mellitus. An amylin analogue called pramlintide was developed to treat obesity and diabetes in humans. Furthermore, recent studies have shown that amylin levels are increased during acute and chronic pancreatitis in humans. The aim of this study was to explore the aggregation pattern of feline, human and murine amylin, as well as the amylin analogue pramlintide in vitro. We also aimed to compare amylin levels between healthy lean cats and cats with diabetes mellitus or pancreatitis.

To evaluate amylin aggregation pattern, assays were performed with 10 μM peptide (feline, human or murine amylin, or pramlintide), 20 μM Thioflavin T (ThT; a specific amyloid fluorescent probe) and 50 mM Na₂HPO₄ buffer pH 7.0. The assays were performed in a Spectramax M5 plate reader, in 96-well plates at 25°C, with readings performed every 3 mins, with excitation and emission set at 440 nm and 482 nm, respectively, with a 475 nm cut-off filter. Data were imported using JSPK software and analyzed using SigmaPlot. To determine plasma amylin levels, 24 owned cats were evaluated (healthy lean = 10; diabetic = 8; pancreatitis = 6). All blood samples were collected into EDTA-containing tubes after overnight fasting. Amylin levels were determined using a human ELISA validated for cats. Synthetic feline amylin was used for the analytical curve.

All tested amylin analogues resulted in amyloid aggregation within 3 days. Feline amylin was the first to aggregate, reaching a maximum ThT signal at about 4 h. Next was human amylin, requiring about double this time (8 h) to reach maximum change in ThT fluorescence. Pramlintide took longer to aggregate, with a maximum achieved at about 12 h, followed by murine amylin, which took about 48 h to reach maximum aggregation. Regarding amylinemia, plasma amylin levels were significantly increased (P = 0.003) in diabetic cats compared with healthy lean cats. Interestingly, amylin levels during pancreatitis were higher than in both lean cats (P <0.0001) and diabetic cats (P = 0.004).

As far as we know, this is the first report about feline amylinemia during pancreatitis. We conclude that feline amylin is more amyloidogenic in vitro than human amylin, murine amylin and pramlintide. Plasma levels of amylin are greatly increased in cats with pancreatitis compared with lean and diabetic cats.

Pharmacokinetics and Pharmacodynamics of Buccally Administered Dexmedetomidine Gel (Sileo) in Healthy Adult Cats

Kristen Messenger¹, David Tamas¹, Alexandra Carlson¹, Mark G Papich¹, Heather Knych², Sharon Campbell³, Mira Korpivaara⁴

¹College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA

²College of Veterinary Medicine, University of California, Davis, CA, USA

³Zoetis, Parsipany, NJ, USA

⁴Orion Corporation, Orion Pharma, Turku, Finland

Email: [e-mail]

Purpose: Feline anxiety caused by noise phobias, transport, veterinary wellness visits and minor procedures is common, and may cause cat owners to avoid veterinary visits. There are few therapeutic options to treat anxiety in cats. A commercially available transmucosal buccal gel formulation of dexmedetomidine (Sileo; Zoetis) is available for use in dogs to treat noise aversion; however, there is no data regarding its use in cats. The objective of this study was to describe the pharmacokinetics and pharmacodynamics of buccally administered dexmedetomidine gel in healthy cats.

Summary of background/objectives, methods, results and conclusions: Six adult cats (three male, three female) received 5 μg/kg dexmedetomidine gel onto the buccal mucosa (cheek pouch), or 5 μg/kg dexmedetomidine IV in a randomized crossover design. Venous blood samples (collected via preplaced medial saphenous catheter), anxiety scores, sedation scores, heart and respiratory rates, and indirect blood pressure (Doppler) were obtained at baseline (prior to drug administration), and then at 0.17, 0.33, 0.67, 1, 1.5, 2, 4, 6, 8, 10 and 12 h after drug administration. The anxiety scoring system used in this study was based on a 1–7 categorical system developed by Turner and Kessler in 1997, where a score of 1 is fully relaxed, and a score of 7 is considered terrified. Venous blood samples for blood gases, electrolytes and lactate were collected and analyzed at baseline and 60 mins following dexmedetomidine administration. Plasma dexmedetomidine concentrations were analyzed using liquid chromatography with tandem mass spectrometry detection, using a method validated for feline plasma. Pharmacokinetic parameter estimates were obtained with non-compartmental methods, using commercially available pharmacokinetic modeling software (Phoenix WinNonLin, version 8.0). Data were analyzed using paired t-tests and repeated measures analysis of variance, and P <0.05 was considered significant.

Dexmedetomidine gel was easily administered and well tolerated by all cats, with no observed adverse effects. Subjectively, the cats were more relaxed and easier to handle after Sileo administration, but there was no statistically significant difference, compared with baseline values, in anxiety (P = 0.052) or sedation scores at any time point following buccal administration of dexmedetomidine gel. Median anxiety score prior to drug administration was 3.5, and reached the lowest value of 2.0 between 40 and 90 mins. Additionally, there was no significant difference in cardiorespiratory or blood gas variables following Sileo administration. Overall, systemic plasma concentrations of dexmedetomidine were low following buccal gel administration. The maximum plasma concentration of dexmedetomidine (median [range] was 0.26 (0.14–0.38) ng/ml and occurred at 60.0 (20.0–60.0) mins. The terminal half-life was 73.26 (48.36–136.8) mins. Systemic bioavailability of the gel was 25.84 (11.87–32.01)%.

This is the first study to describe the pharmacokinetic parameters and systemic bioavailability of buccally administered dexmedetomidine gel (Sileo) in healthy adult cats. The study demonstrates the safety of Sileo in cats following a dose of 5 μg/kg. Larger studies in clinical patients are warranted to further determine the anxiolytic effects of this dose in cats.