Prevalence of and risk factors for feline hyperthyroidism in Hong Kong

A study was conducted to determine the prevalence of and potential risk factors for feline hyperthyroidism in Hong Kong. Serum total thyroxine (T(4)) was measured in 305 cats aged 10 years and older that presented at various veterinary clinics in Hong Kong. The prevalence of hyperthyroidism (T(4)>50 nmol/l) within this population was 3.93% and there was no significant difference in prevalence between healthy (3.16%) and sick (4.37%) cats. Older cats (>15 years) were more likely to be affected and domestic shorthair cats were less likely to be diagnosed with hyperthyroidism than the other breeds combined. No specific association between the development of feline hyperthyroidism and food type was observed. The prevalence of feline hyperthyroidism in Hong Kong was less than that reported for most other parts of the world, despite the presence of previously identified risk factors.     

Evaluation of Environmental, Nutritional, and Host Factors in Cats with Hyperthyroidism

The pathologic changes associated with hyperthyroidism (adenomatous hyperplasia, adenoma of the thyroid gland) have been well characterized in cats, but the pathogenesis of these changes remains unclear. In this research, we undertook a case-control study to search for potential risk factors for this disease. Owners of 379 hyperthyroid and 351 control cats were questioned about their cats' exposure to potential risk factors including breed, demographic factors, medical history, indoor environment, chemicals applied to the cat and environment, and diet. The association between these hypothesized risk factors and outcome of disease was evaluated by conditional logistic regression. Two genetically related cat breeds (ie, Siamese and Himalayan) were found to have diminished risk of developing hyperthyroidism. Cats that used litter had higher risk of developing hyperthyroidism than those that did not. Use of topical ectoparasite preparations was associated with increased risk of developing hyperthyroidism. Compared with cats that did not eat canned food, those that ate commercially prepared canned food had an approximate 2-fold increase in risk of disease. When these 4 variables (breed, use of cat litter, consumption of canned cat food, and use of topical ectoparasite preparations) from the univariate analysis were selected for further study as candidate risk factors and analyzed by multivariate conditional logistic regression, a persistent protective effect of breed (ie, Siamese or Himalayan) was found. In addition, results suggested a 2- to 3-fold increase in risk of developing hyperthyroidism among cats eating a diet composed mostly of canned cat food and a 3-fold increase in risk among those using cat litter. In contrast, the use of commercial flea products did not retain a strong association. The results of this study indicate that further research into dietary and other potentially important environmental factors (eg, cat litter) is warranted.     

Epidemiologic study of relationships between consumption of commercial canned food and risk of hyperthyroidism in cats

OBJECTIVE: To determine whether the increasing prevalence of feline hyperthyroidism is the result of aging of the cat population and whether consumption of canned foods at various times throughout life is associated with increased risk of hyperthyroidism. DESIGN: Retrospective and case-control studies. STUDY POPULATION: Medical records of 169,576 cats, including 3,570 cats with hyperthyroidism, evaluated at 9 veterinary school hospitals during a 20-year period, and 109 cats with hyperthyroidism (cases) and 173 cats without hyperthyroidism (controls). PROCEDURE: Age-adjusted hospital prevalence of hyperthyroidism was calculated by use of Veterinary Medical Database records. On the basis of owners' questionnaire responses, logistic regression was used to evaluate associations between consumption of canned food and development of hyperthyroidism. RESULTS: Age-specific hospital prevalence of feline hyperthyroidism increased significantly from 1978 to 1997. Overall, consumption of pop-top canned (vs dry) food at various times throughout life and each additional year of age were associated with greater risk of developing hyperthyroidism. In female cats, increased risk was associated with consumption of food packaged in pop-top cans or in combinations of pop-top and non-pop-top cans. In male cats, increased risk was associated with consumption of food packaged in pop-top cans and age. CONCLUSIONS AND CLINICAL RELEVANCE: These findings suggest that the increasing prevalence of feline hyperthyroidism is not solely the result of aging of the cat population and that canned foods may play a role.     

Evaluation of dietary and environmental risk factors for hyperthyroidism in cats

OBJECTIVE: To identify dietary and environmental risk factors for hyperthyroidism in cats. DESIGN: Case-control study. ANIMALS: 100 cats with hyperthyroidism and 163 control cats. PROCEDURE: Medical records were examined, and owners completed a mailed questionnaire. Data collected included information regarding demographic variables, environmental exposures, and diet, including preferred flavors of canned cat food. RESULTS: Case cats were significantly less likely to have been born recently than control cats. Housing; exposure to fertilizers, herbicides, or plant pesticides; regular use of flea products; and presence of a smoker in the home were not significantly associated with an increased risk of disease, but cats that preferred fish or liver and giblets flavors of canned cat food had an increased risk. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that cats that prefer to eat certain flavors of canned cat food may have a significantly increased risk of hyperthyroidism.     

Evaluation of a feline viral rhinotracheitis-feline calicivirus disease vaccine.

An attenuated respiratory disease vaccine against feline viral rhinotracheitis (FVR) and feline calicivirus (FCV) disease was evaluated for safety and efficacy in specific-pathogen-free cats. Twenty cats were vaccinated twice intramuscularly, with 28 days between vaccinations. Ten unvaccinated cats were used as contact controls. Adverse effects were not noticed after vaccination, and the vaccinal virus did not spread to contact controls. Arithmetical mean serum-neutralizing titers against vaccinal FCV strain F9 and challenge FCV strain 255 were 1:13 and 1:15 at 28 days after the 1st inoculation. These titers increased to 1:45 and 1:196 after the 2nd inoculation. After challenge exposure of vaccinated cats to virulent FCV 255 virus, mean titers increased to 1:129 and 1:865, respectively for F9 and 255 viruses. The F9 postchallenge mean titer for vaccinated cats was 21.5 times higher than that for the 8 contact controls that survived challenge exposure. The arithmetical mean serum neutralizing titer for FVR was low (1:2) after the 1st vaccination, but increased to 1:35 after the 2nd vaccination. Challenge exposure to virulent FVR virus resulted in a marked anamnestic immune response (mean titer of 1:207, compared with 1:12 for contact controls). In general, vaccinated cats remained alert and healthy after challenge exposure with FCV-255, whereas unvaccinated contact control cats developed definite signs of FCV disease, including central nervous system (CNS) depression (6 of 10) and dyspnea indicative of pneumonia (5 of 10). Two controls died of severe pneumonia. A mild fibrile response was detected in 28% of vaccinated cats, compared with a more severe febrile response in 78% of control cats. Some vaccinated cats developed minute lingual ulcers that did not appear to be detrimental to the health of the cat. After FVR challenge exposure, vaccinated cats were free of serious clinical signs. Five of 18 vaccinated cats had mild signs of FVR, including an occasional sneeze, low temperature, and mild serous lacrimation for 1 or 2 days. Contact controls developed definite clinical signs of FVR. The combined FVR-FCV vaccine appears to be safe and reasonably efficacious. Vaccination against FCV disease and FVR should be part of the routine feline immunization program.     

Risk factors and clinical presentation of cats with feline idiopathic cystitis

Feline idiopathic cystitis (FIC) is the most common cause of feline lower urinary tract disease (FLUTD). This retrospective, case-controlled study evaluated possible risk factors associated with FIC and compared different clinical presentations in 64 cats with FIC. Several risk factors known to be involved in FLUTD were identified as playing a role in FIC. Of the stressful situations considered, most did not occur with increased frequency in cats with FIC compared to controls, except for a house move. The presence of pyuria, haematuria and an increased urine protein:creatinine ratio were significantly higher in obstructed males compared with non-obstructed males. An obstruction was significantly more likely in cats with struvite crystalluria compared with cats without struvite crystalluria. These findings suggest that urethral plugs might be an important cause or contributing factor of obstruction in FIC. Episodes of FIC seem to occur mainly in susceptible cats in combination with a deficient environment.     

Risk factors for feline hyperthyroidism in the UK

O bjectives : Previous studies of cats in the USA and New Zealand have identified a number of risk factors for the development of hyperthyroidism including feeding of canned cat food and being non-purebred. The objective of this study was to examine these and other risk factors in cats from London, UK.
M ethods : A questionnaire-based case-control study of hyperthyroidism in cats greater than eight years of age was undertaken. Cases and controls were recruited from two groups of first opinion clinics in London, UK (five locations in total). The two-page questionnaire investigated details of lifestyle, diet and exposure to environmental chemicals. Data analysis included multivariable analysis of risk factors using binary logistic regression.
R esults : One hundred and nine hyperthyroid cats and 196 control cats were surveyed. Increasing age, non-pure breed, use of a litter box, more than 50 per cent wet food in the diet, a diet that included fish and exposure to food in a can were identified as risk factors for the development of hyperthyroidism using multivariable analysis.
C linical S ignificance : Risk factors for hyperthyroidism in cats from the UK appear similar to those of other countries. Exposure to food packaged in a can was identified as the major risk factor for the development of hyperthyroidism.     

Association between ovarihysterectomy and feline mammary carcinoma

The etiopathogenesis of feline mammary carcinoma is not well understood. Although putative, risk factors include breed, reproductive status, and regular exposure to progestins. An association between age at ovarihysterectomy (OHE) and mammary carcinoma development has not been established. Therefore, a case-control study was performed to determine the effects of OHE age, breed, progestin exposure, and parity on feline mammary carcinoma development. Cases were female cats diagnosed with mammary carcinoma by histological examination of mammary tissue. Controls were female cats not diagnosed with mammary tumors selected from the same biopsy service population. Controls were frequency matched to cases by age and year of diagnosis. Questionnaires were sent to veterinarians for 308 cases and 400 controls. The overall questionnaire response rate was 58%. Intact cats were significantly overrepresented (odds ratio [OR] 2.7, confidence interval [CI] = 1.4-5.3, P < .001) in the mammary carcinoma population. Cats spayed prior to 6 months of age had a 91% reduction in the risk of mammary carcinoma development compared with intact cats (OR 0.9, CI = 0.03-0.24). Those spayed prior to 1 year had an 86% reduction in risk (OR 0.14, CI = 0.06-0.34). Parity did not affect feline mammary carcinoma development, and too few cats had progestin exposure to determine association with mammary carcinoma. Results indicate that cats spayed before 1 year of age are at significantly decreased risk of feline mammary carcinoma development.     

Lack of circulating thyroid stimulating immunoglobulins in cats with hyperthyroidism

Although feline hyperthyroidism has become a commonly diagnosed disorder of older cats, the underlying etiology remains unknown. Pathological findings of adenomatous hyperplasia involving both thyroid lobes in most hyperthyroid cats suggests the possibility that feline hyperthyroidism may be similar to human Graves' disease, which results from high circulating levels of thyroid stimulating immunoglobulins (TSIs). To exclude high circulating levels of TSIs as the cause of feline hyperthyroidism, we measured intracellular concentrations of cyclic adenosine monophosphate (cAMP) in functioning rat thyroid cells (FRTL-5) incubated with IgG extracted from hyperthyroid cat serum. Since TSIs stimulate thyroid hormone secretion through activation of cAMP, their presence can be evidenced in vitro by generation of high cAMP concentrations in cultured thyroid cells. No significant difference was found in intracellular cAMP concentrations in FRTL-5 cells incubated with IgG from normal versus hyperthyroid cats. In contrast, IgG from a human patient with Graves' disease caused substantially more cAMP generation than either normal human IgG or IgG from the cats of this study. These results indicate that feline hyperthyroidism does not result from high circulating concentrations of TSI and, in that respect, is not analogous to Graves' disease.     

Risk factors for time to diagnosis of feline upper respiratory tract disease in UK animal adoption shelters

Feline upper respiratory tract disease (URTD), mainly caused by feline calicivirus (FCV) and feline herpesvirus, is a major cause of disease outbreaks in feline accommodation such as animal shelters, catteries and multi-cat households. We conducted a longitudinal, yearlong study in five UK feline animal shelters to identify risk factors for the time to diagnosis of URTD. We were especially interested in risk factors that could be identified at the time the cat entered the shelter. Shelter staff recorded data for 1434 cats during 2002–2003. Most of the cats were domestic shorthair cats and were from private households, or were stray or abandoned. Sixty cats without clinical signs of URTD at entry had URTD diagnosed (typically within the first month at the centre). We used two multivariable models: one was a Cox proportional-hazards model, and the other a regression analyses with complementary log–log model.The hazard varied substantially between shelters and was considerably lower for the shelter that had a purpose-built admissions unit with its own isolation facilities. The hazard was greater for purebred cats (HR 4.3–5.0) and for neutered cats (HR 2.0). The hazard was also typically greater if the centre had a greater proportion of cats present with URTD. The analyses suggested that the centre-level risk factors were more important in determining hazard than cat-level risk factors.     

Feline caliciviral disease: experimental immunoprophylaxis.

An attenuated feline calicivirus (FCV) was administered intramuscularly to specific-pathogen-free cats. Vaccination did not cause signs of illness. Oropharyngeal replication of attenuated FCV was not detected, nor was there evidence of virus transmission to contact-control cats. Antiviral neutralizing antibody was present in the serum of all vaccinated cats 7 days after they were given the 2nd intramuscular dose of immunogen. Vaccinated and control cats were challenge exposed to aerosols of a virulent FCV strain. All controls developed severe pneumonia and died within 7 days after this challenge exposure. In the vaccinated cats, signs of illness were absent or minimal; pulmonary lesions were milder and less extensive than those in the control cats. Feline calicivirus was isolated from ocular, nasal, and oropharyngeal swabbings from both control and vaccinated cats after viral challenge. Results indicate protective immunity to FCV disease can be induced by intramuscular administration of an attenuated FCV.     

Feline systemic hypertension: Diagnosis and management

PRACTICAL RELEVANCE: the clinical importance of feline hypertension has been recognised for many years and most feline practitioners are quite familiar with this syndrome. Once systemic hypertension is identified, long-term management of the patient is needed to avoid catastrophic (eg, blindness due to retinal detachment) or subtle (eg, accelerated renal damage) target organ damage. PATIENT GROUP: feline systemic hypertension is most commonly a complication of renal disease and hyperthyroidism, both diseases of older feline patients. By 15 years of age, the probability of having at least one of these two diseases is high. As well cared for cats are living longer, optimal long-term management of feline hypertension in patients with concurrent diseases is an issue of clinical importance. CLINICAL CHALLENGES: obtaining accurate blood pressure measurements in patients that are anxious, fractious or just plain uncooperative remains a significant issue in feline medicine, as does confident analysis of results from these patients. DIAGNOSTICS: careful measurement of systolic blood pressure using Doppler or oscillometric techniques in conjunction with evaluation for evidence of hypertensive choroidopathy (funduscopic examination) and hypertensive cardiac changes (thoracic auscultation) are essential to the diagnosis of systemic hypertension in cats. Other diagnostic techniques, including evaluation of renal and thyroid function, are needed to detect the underlying disease condition. EVIDENCE BASE: numerous well-designed clinical studies have greatly advanced our understanding of the most appropriate methods of diagnosis and therapy of feline hypertension.     

An investigation of predictors of renal insufficiency following treatment of hyperthyroidism in cats

To determine if routine pre-treatment clinical data can be used to predict the development of overt renal insufficiency following treatment of feline hyperthyroidism, we studied retrospectively all non-azotemic cats undergoing treatment for hyperthyroidism at our hospital. Medical records were reviewed for signalment, clinical signs, and serum biochemical, hematologic and urinalysis parameters before and after treatment for hyperthyroidism. Two groups - cats that developed post-treatment renal insufficiency, and those that did not - were compared. No significant differences could be detected between the groups with respect to the parameters measured. Our study suggests that the results of routine pre-treatment clinical data cannot be used to reliably predict renal function after treatment for hyperthyroidism, validating the necessity of a methimazole trial prior to definitive therapy. The widely held belief that cats with pre-treatment urine specific gravity>1.035 are at less risk for development of renal azotemia after treatment of hyperthyroidism seems unwarranted.     

Prevalence and risk factors for heartworm infection in cats from northern Florida

Necropsies were performed on 630 adult cats in northern Florida to determine the prevalence and risk factors for heartworm infection in cats of this region. Heartworms were identified in 4.9% of cats, and serological evidence of heartworm exposure was present in 17% of cats. Not all cats from which heartworms were recovered were seropositive for heartworm antigen or antibody. There was no association between heartworm infection and co-infection with feline leukemia virus (FeLV) or feline immunodeficiency virus (FIV). Male cats were at higher risk of infection with heartworm, FeLV, or FIV than were females. Because even a single heartworm can cause clinical disease or death in cats, the authors conclude that cats in this region should receive heartworm prophylaxis to prevent heartworm infection.     

Hyperthyroidism in four guinea pigs: clinical manifestations,diagnosis, and treatment

Hyperthyroidism was diagnosed in four guinea pigs by demonstration of an increased serum total thyroxine concentration. The main clinical signs were comparable with those observed in feline hyperthyroidism and included weight loss despite maintenance of appetite and a palpable mass in the ventral cervical region. Three animals were treated successfully with methimazole for between 13 and 28 months. Clinical signs and regular measurement of circulating total thyroxine concentrations appear to be convenient parameters for monitoring response to medical therapy.     

Risk factors associated with feline urolithiasis

Urinary tract diseases are among the main reasons for consultation in veterinary clinics and hospitals. It affects animals of any age, breed and gender. Among the diseases that affect this system, urolithiasis is the second largest cause of clinical signs compatible with feline urinary tract disease. The term urolithiasis refers to the presence of uroliths in any region of the urinary tract, but it is more commonly seen in the bladder and urethra. Uroliths are classified based on the type of mineral present in their composition, therefore, quantitative and qualitative analyzes are important for a better therapeutic approach. The animals may suffer from the disease and be asymptomatic, or show nonspecific clinical signs, making the diagnosis difficult. The disease should not be seen as a single problem, but as a consequence of various disorders. As dietary, metabolic, genetic and infectious causes, as well as factors that potentiate the chance of development of uroliths such as breed, age, sex, age range, obesity, sedentary lifestyle, geographic region and climate. Thus, the knowledge of the factors that influence the formation of uroliths, as well as the understanding of the pathophysiology, are key elements for better alternatives of therapy and prevention. The recognition of these factors helps to identify susceptible populations, minimizing exposure and increasing the protection factors, which facilitates the diagnosis and treatment of patients with urolithiasis. The objective of this paper is to present the main risk factors involved in the formation of urinary lithiasis in felines.     

Canine and feline emergency room visits and the lunar cycle: 11,940 cases (1992-2002)

OBJECTIVE: To determine the frequency of canine and feline emergency visits with respect to the lunar cycle. DESIGN: Retrospective case series. ANIMALS: 11,940 dogs and cats evaluated on an emergency basis during an 11-year period. PROCEDURES: Date of emergency visit, signalment, and chief complaint were retrieved from a medical records database. Emergency type was categorized as animal bite, cardiac arrest, epilepsy, ophthalmic, gastric dilatation-volvulus, trauma, multiple diseases, neoplasia, or toxicosis. The corresponding lunar phase was calculated and recorded as new moon, waxing crescent, first quarter, waxing gibbous, full moon, waning gibbous, last quarter, or waning crescent. The effect of lunar phase on the frequency of emergency visits was evaluated by calculating relative risk. RESULTS: Of 11,940 cases, 9,407 were canine and 2,533 were feline. Relative risk calculations identified a significant increase in emergencies for dogs and cats on fuller moon days (waxing gibbous to waning gibbous), compared with all other days. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that more emergency room visits occurred on fuller moon days for dogs and cats. It is unlikely that an attending clinician would notice the fractional increase in visits (0.59 and 0.13 more canine and feline visits, respectively) observed in this study at a facility with a low caseload. If the study is repeated at a facility with a robust emergency caseload, these results may lead to reorganization of staffing on fuller moon dates. A prospective study evaluating these findings under conditions of high caseload is necessary to determine the clinical relevance.     

Incidence of positive heartworm antibody and antigen tests at IDEXX Laboratories: trends and potential impact on feline heartworm awareness and prevention

Data from the IDEXX Laboratories Reference Laboratory Network were retrospectively examined for feline heartworm testing trends in testing frequency, geographic bias, and prevalence for the years 2000--2006. Examination of the data supports the commonly held view that veterinarians do not embrace heartworm disease testing or prevention in cats to the same degree they do in dogs. Despite significant awareness and adoption of heartworm testing and prevention in dogs, we hypothesized that heartworm testing rates are lower for cats than for dogs despite a significant prevalence of feline infection. This is important because a perceived low rate of infection in cats is likely to manifest in a low adoption of testing and prevention. In reality, the overall feline heartworm antigen-positive rate is significant--on average 0.9% over the period studied--and in some regions was estimated to be as high as 4.6%. This compares with an average canine heartworm prevalence rate of 1.2%, a feline leukemia virus prevalence of 1.9%, and a feline immunodeficiency prevalence of 1.0%. Based on the low rate of testing and these prevalence rates, practitioners are routinely missing cases of adult feline heartworm infections and the recently defined heartworm-associated respiratory disease (H.A.R.D). Increased antigen testing would result in detection of a significant number of positive cases. In addition, this population of infected cats would represent the "tip of the iceberg" relative to the greater number of cats that have early infection or are at risk for infection.