Underlying medical conditions in cats with presumptive psychogenic alopecia

OBJECTIVE: To identify underlying medical conditions in cats with a presumptive diagnosis of psychogenic alopecia. DESIGN: Case series. ANIMALS: 21 adult cats referred with a presumptive diagnosis of psychogenic alopecia. PROCEDURES: A detailed behavior and dermatologic questionnaire was completed by the primary caregiver, and complete behavioral and dermatologic examinations were performed. A standard diagnostic testing protocol that included cytologic examination of skin scrapings, fungal culture of hairs, evaluation of responses to parasiticides and an exclusion diet, assessment for atopy and endocrinopathies, and histologic examination of skin biopsy specimens was used to establish a definitive diagnosis in all cats. Cats that did not respond to an elimination diet were treated with methylprednisolone acetate to determine whether pruritus was a factor. RESULTS: Medical causes of pruritus were identified in 16 (76%) cats. Only 2 (10%) cats were found to have only psychogenic alopecia, and an additional 3 (14%) cats had a combination of psychogenic alopecia and a medical cause of pruritus. An adverse food reaction was diagnosed in 12 (57%) cats and was suspected in an additional 2. All cats with histologic evidence of inflammation in skin biopsy specimens were determined to have a medical condition, but of 6 cats without histologic abnormalities, 4 had an adverse food reaction, atopy, or a combination of the 2, and only 2 had psychogenic alopecia. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that psychogenic alopecia is overdiagnosed in cats. Thorough diagnostic testing should be done before ascribing a behavioral cause to hair loss in cats.     

Cardiopulmonary effects of a ketamine hydrochloride/acepromazine combination in healthy cats.

The effect of a ketamine hydrochloride/acepromazine combination on the cardiopulmonary function of 11 healthy cats was studied. Test parameters included cardiac output, measured by thermodilution, heart rate, respiratory rate, arterial blood pressure (systolic, diastolic and mean) and arterial blood gas analysis. Values for systemic vascular resistance, cardiac index and stroke volume were calculated. The cardiac output, cardiac index, stroke volume, arterial blood pressure and arterial blood pH decreased significantly (p less than 0.006). The arterial CO2 increased significantly (p less than 0.006). All changes occurred during the five to 45 minute postinduction time period. The heart rate, respiratory rate, arterial O2 and systemic vascular resistance were not significantly altered. The anesthetic regime maintained an adequate plane of surgical anesthesia for 30-45 minutes.     

Naturally-occurring chronic renal disease in Australian cats: a prospective study of 184 cases

OBJECTIVE: To describe cases of naturally occurring feline chronic renal disease (CRD) in a defined population of Sydney. DESIGN: Prospective case series. METHODS: The inclusion criteria were the presence of a serum creatinine concentration above the reference range with either inadequately concentrated urine (urine specific gravity < or = 1.035), necropsy findings consistent with CRD, renal proteinuria or persistent azotaemia despite rehydration. Cats were excluded if a specific aetiology was identified ante or post mortem. Patients were divided into two categories (renal insufficiency or renal failure) on the basis of history, physical findings and serum creatinine concentration. The gender and age of cats with CRD was compared to an estimated Australian urban pet cat population. The breeds of cats with CRD were compared to the breeds of cats visiting the respective veterinary hospital where possible. Breed and gender comparisons were made using Fisher's exact tests. Age comparisons were made using Mann-Whitney U tests. The age at which cats were diagnosed with CRD was compared between veterinary hospitals using a Kruskal-Wallis test. RESULTS: One hundred and eighty-four (99 female; 85 male) cats fulfilled the inclusion criteria. Amongst cats with CRD, males (median 12 years) were significantly younger than females (median 15 years; p = 0.001). The overall proportion of male and female cats with CRD was similar to that of the reference urban cat population (p = 0.41), however, between the ages of 9 and 11 years, male cats with CRD were over-represented (p = 0.038). Patients diagnosed with renal insufficiency (123 cats; median age 15 years) were significantly older than patients diagnosed with renal failure (61 cats; median age 11 years; p = 0.0001).The age at diagnosis of cats with CRD differed significantly between veterinary hospitals (p = 0.002). CONCLUSION: Male cats with CRD were significantly younger than female cats with CRD. Younger cats were more likely to be diagnosed at an advanced stage of disease than older cats. The age at which cats were diagnosed with CRD was influenced by the clinic the cats attended. Whether these differences reflect differences in the aetiology of CRD or in the rate of disease progression warrants further investigation. Breed did not appear to play a significant role in the development of CRD in this survey.     

Predicting recovery of urination control in cats after sacrocaudal injury: a prospective study

O bjectives : To determine whether intact tail base pain sensation predicts control of urination after sacrocaudal fracture-subluxation in cats.
M ethods : Twenty–one cats affected by sacrocaudal fracture-subluxation were diagnosed routinely by radiography. The ability of each cat to detect a painful stimulus applied to the tail base was tested by application of pressure using a standard surgical instrument. Cats were then hospitalised for up to 30 days and categorised according to whether they showed control of urination. A value of P<0·05 was regarded as significant. The results were analysed to produce data regarding sensitivity, specificity and the positive and negative predictive value of the test.
R esults : All 11 cats that had intact tail base sensation showed control of urination within three days. Four of the 10 cats without tail base pain sensation did not recover control of urination by day 30.
C linical S ignificance : Intact tail base sensation predicts control of urination and is therefore a useful screening test.     

Effects of clomipramine hydrochloride on dominance-related aggression in dogs.

OBJECTIVE: To compare effects of the serotonergic drug clomipramine hydrochloride with those of placebo for treatment of dominance-related aggression in dogs. DESIGN: Randomized, placebo-controlled, double-blind clinical trial. ANIMALS: 28 neutered dogs > 1 year old with dominance-related aggression. PROCEDURE: Dogs displaying > or = 3 aggressive episodes/wk toward > or = 1 human family member in response to identifiable behavioral triggers were included in the study. Owners were instructed not to change patterns of interaction with their dogs during the study. After 2 weeks of baseline observations, dogs were treated for 6 weeks with clomipramine (1.5 mg/kg [0.7 mg/lb] of body weight, q 12 h; n = 15) or placebo (13). Responses to triggers were assigned the following aggression scores: no response, 0; growl or lip curl, 1; snap or bite, 2. Mean scores for responses to triggers were obtained during the 2-week pretreatment period (baseline) and during the first and second weeks, third and fourth weeks, and fifth and sixth weeks of treatment. At the end of the study, owners assigned a score designed to evaluate their overall perceived change in aggressiveness; this was referred to as the global score. RESULTS: Mean aggression scores decreased at the fifth and sixth week of treatment in both groups, compared with baseline scores. However, mean scores between groups were not different. Global scores, assigned by the owner, generally reflected changes in mean aggression scores. CONCLUSIONS AND CLINICAL RELEVANCE: Compared with placebo, clomipramine administered to dogs at the dosage recommended for treatment of separation anxiety did not reduce aggressiveness toward human family members.     

Feline polycystic kidney disease in Persian and other cats: a prospective study using ultrasonography

OBJECTIVE: To determine the prevalence of feline polycstic kidney disease in Persian cats presented to the University of Melbourne Veterinary Clinic and Hospital between February and August 1999. DESIGN: A prospective clinical study using client owned animals was performed. PROCEDURE: Two hundred and fifty Persian cats, ranging in age from 13 weeks to 10 years, were presented to the University of Melbourne Veterinary Clinic and Hospital for ultrasound examination of both kidneys. The cats were placed in dorsal and lateral recumbency and alcohol and ultrasonic coupling gel were applied to the skin. The kidneys were examined ultrasonographically in longitudinal, sagittal and transverse planes. Results were recorded for each cat at the time of examination as either negative or positive for PKD. In addition 14 Exotics (short-haired Persians), 4 Ragdolls and 3 British Short-Hair cats were examined. RESULTS: Forty five percent of Persian cats examined were found to be positive for feline polycystic kidney disease on the basis of presence of anechoic cysts within the renal parenchyma. These cats ranged in age from 13 weeks to 10 years. Fifty per cent of the Exotic cats were positive for polycystic kidney disease whereas all Ragdolls and British Short Hairs were negative for the disease. Only one positive cat was reported to be showing clinical signs of renal disease. CONCLUSION: The prevalence of feline polycstic disease in Persian cats presented to the University of Melbourne between February and August 1999 was 45%. Exotic cats were found to have the slightly higher incidence of 50%.     

Comparative oxidative metabolic profiles of clomipramine in cats, rats and dogs: preliminary results from an in vitro study

The objectives of this in vitro study were to describe cytochrome-dependent metabolism of clomipramine in canine and feline microsomes, compare metabolic profiles between cats, rats and dogs, and investigate a potential gender-related difference in metabolic activity between male and female cats. Pooled liver microsomes were incubated with clomipramine, where species and gender-specific reactions were initiated by the addition of a nicotinamide adenine dinucleotide phosphate regenerating system and quenched with methanol at 0, 5, 15, 30, 45 and 60 min, and 0, 30, 60, 90, 120, 180, 240 and 360 min respectively. Liquid chromatography tandem mass spectrometry was used to measure clomipramine and its metabolites. Preliminary results showed that cat microsomes biotransformed clomipramine slower and less efficiently than rat and dog microsomes. Moreover, gender differences in metabolic profiles suggested that male cat microsomes may be less efficient demethylators and hydroxylators than female cat microsomes. As gender metabolic differences may carry clinical significance for this antidepressant, further studies are warranted.     

Treatment of 46 cats with porcine lente insulin--a prospective, multicentre study

This prospective, multicentre, non-blinded, open study followed 46 cats with diabetes mellitus during treatment with porcine lente insulin (also known as porcine insulin zinc suspension, Caninsulin, Intervet) for 16+/-1 weeks (stabilization phase), with additional monitoring of some cats (n=23) for a variable period. At least three of the following were present at initial presentation: appropriate history of clinical signs consistent with diabetes mellitus, glucosuria, blood glucose greater than 15 mmol/l and fructosamine greater than 380 micromol/l. Insulin treatment was started at a dose rate of 0.25-0.5 IU/kg body weight twice daily, with a maximum starting dose of 2 IU/injection. Twenty-eight of the cats were classed as reaching clinical stability during the study, in 23 of these cats this was during the stabilization phase. Seven cats went into remission during the stabilization phase and one of the cats in week 56. Clinical signs of hypoglycaemia, significantly associated with a dose of 3 units or 0.5 IU/kg or more per cat (twice daily), were observed in nine of the 46 cats during the stabilization phase and concomitant biochemical hypoglycaemia was recorded in most cases. Biochemical hypoglycaemia, recorded in 6% of the blood glucose curves performed during the stabilization phase, was significantly associated with a dose rate of 0.75 IU/kg or more twice daily. This further highlights the need for cautious stepwise changes in insulin dose. The protocol used in the present study is suitable for and easy to use in practice. This study confirmed the efficacy and safety of porcine lente insulin (Caninsulin) in diabetic cats under field conditions.     

Control of urine marking by use of long-term treatment with fluoxetine or clomipramine in cats

OBJECTIVES: To determine whether clomipramine differs from fluoxetine in reducing feline urine marking; whether reduction of marking continues in cats treated >8 weeks; whether recurrence of marking, after abrupt drug withdrawal, is less in cats treated >8 weeks; and whether cats that are successfully treated but resume marking after drug withdrawal can be successfully treated again with the same drug regimen. DESIGN: Positive-controlled, double-masked clinical trial. ANIMALS: 22 neutered cats (2 females, 20 males) > or =1 year old with objectionable urine marking. PROCEDURE: Cats that marked vertically > or =3 times/wk were treated with fluoxetine (1 mg/kg [0.45 mg/lb], q 24 h, PO) or clomipramine (0.5 mg/kg [0.23 mg/lb], q 24 h, PO) for 16 weeks, and efficacy was compared. Recurrence of marking was determined after abrupt withdrawal of fluoxetine at 16 or 32 weeks. Reduction in marking in cats treated with fluoxetine for 8 weeks after returning to marking following drug withdrawal was compared with the initial 8 weeks of successful treatment. RESULTS: Efficacy of fluoxetine and clomipramine was similar. Treatment >8 weeks revealed increasing efficacy in reduction of marking. Return of marking after termination of fluoxetine administration occurred in most cats. Cats successfully treated initially with fluoxetine responded similarly to repeated treatment. CONCLUSIONS AND CLINICAL RELEVANCE: Clomipramine and fluoxetine were equivalent in treating urine marking. Longer treatment increased efficacy. Most cats return to marking after abrupt drug withdrawal. A second course of treatment can be expected to be as effective as the first.     

P-41 Psychogenic alopecia by fur-plucking in a family of seal-point Siamese cats: three cases

Melanodermas and leukodermas are conditions involving skin pigment changes. Vitiligo, an acquired leukoderma, is an uncommon canine and feline skin disorder, with a likely autoimmune pathogenesis. It is seen more frequently in young adult purebred animals and has no apparent sex predisposition. In Brazil the first report of vitiligo was in 1986. In a 16-year period, 12 cases of vitiligo, including 11 dogs (six Rottweilers, two Doberman pinschers, one great dane, one boxer, and one mongrel dog) and one cat (Siamese), were diagnosed at our hospital. Diagnosis was based on history, physical examination, Wood´s lamp examination, and histopathologic evaluation (H&E and Masson-Fontana stains). Among the dogs, seven were male with a mean age of 34.5 months. The clinical evolution was known in five patients. Skin lesions included leukotrichia (100%) and leukoderma of the nose (100%), buccal mucosa (66.5%), lips (85.7%), and footpads (8.5%). Leukonychia was rarely seen. The only lesion in the cat was depigmented footpads.
Funding: Self-funded.     

Use of clomipramine in the treatment of anxiety-related and obsessive-compulsive disorders in cats

Objective To evaluate the efficacy and tolerance of a treatment protocol for anxiety-related and obsessive-compulsive disorders in cats.
Design A study was undertaken to assess the clinical response in cats diagnosed with anxiety-related or obsessive-compulsive disorders to a treatment regimen that included clomipramine and behaviour modification.
Procedure The study group of 11 cats was acquired through referral. A detailed behavioural and clinical history was obtained. Presenting signs were urine spraying in seven cases, overgrooming in three and excessive vocalisation in one. Clomipramine was administered orally once daily. The mean starting dose was 0.4 mg/kg. If necessary, the dose was adjusted according to the clinical response of each cat. A behaviour modification program was designed and the owner instructed on its implementation. Cats were to continue on medication for at least 1 month after clinical signs disappeared, then medication withdrawal was to be attempted by decreasing the clomipramine dose progressively at weekly intervals while the behaviour modification program continued.
Results In all cases the presenting clinical sign was largely improved or disappeared. One cat was removed from the study by the owner. Four cats became lethargic at higher doses, but this resolved when the clomipramine dose was reduced. The average maintenance dosage was 0.3 mg/kg once daily. Clomipramine withdrawal was attempted in two cases: the behaviour returned in one case and the medication was reinstated at 0.3 mg/kg twice daily.
Conclusion Clomipramine was effective in controlling the signs of anxiety-related and obsessive-compulsive disorders in 10 of 10 assessable cases when used in combination with behaviour modification. Clomipramine was well tolerated.     

Echocardiographic reference values in healthy cats sedated with ketamine hydrochloride

An M-mode echocardiographic examination was performed in a consistent manner in 30 clinically healthy cats under light ketamine hydrochloride sedation. There was a significant linear relationship between increasing body size and increasing cardiac dimensions for several echocardiographic values. Positive correlation existed between body weight and body surface area with aortic root, left ventricular caudal wall thickness (LVCW), interventricular septal thickness (IVS), IVS/LVCW, and mean velocity of circumferential fiber shortening (Vcf); there was a negative correlation between body weight and body surface area with left ventricular ejection time (LVET). Body surface area also correlated positively with percentage of ventricular minor axis dimensional change (% delta D). Positive correlations were recorded between left ventricular end-diastolic dimension (LVEDD) and left ventricular endsystolic dimension (LVESD), LVESD and LVET, LVCW and IVS, LVET (calculated by LVCW motion) and LVET (calculated by aortic valve motion), % delta D and Vcf, heart rate and Vcf, and Vcf (calculated using aortic valve motion to compute LVET) and Vcf (using LVCW motion to compute LVET). There were negative correlations between LVEDD and % delta D, LVEDD and Vcf, LVESD and Vcf, LVET and Vcf, LVET and heart rate, LVET and % delta D. Significant differences were recorded between means of echocardiographic reference values generated in this and other studies, except for LVESD.     

Effects of clomipramine hydrochloride on heart rate and rhythm in healthy dogs

OBJECTIVE: To determine the effects of clomipramine hydrochloride on heart rate and rhythm in dogs. ANIMALS: 17 healthy Beagles. PROCEDURES: In experiment 1, 8 dogs received placebo or clomipramine (20 mg/kg of body weight, q 24 h, PO) for 7 days in a 2-way crossover design. In experiment 2, 9 dogs were evaluated for 48 hours before and 24 hours after oral administration of clomipramine (4 or 12 mg/kg) in a 2-way crossover design. Electrocardiogram and heart rate were monitored continuously by use of telemetry. RESULTS: A significant diurnal rhythm in heart rate was detected; minimum values were recorded at night. Administration of 20 mg of clomipramine/kg induced a significant reduction in heart rate, with peak effect achieved approximately 12 hours after dosing. Administration of 4 or 12 mg of clomipramine/kg did not result in significant changes in heart rate. Sinoatrial and second-degree atrioventricular block and ventricular escape beats were observed during periods of slow heart rate in more dogs that received clomipramine (3 to 4 of 8 dogs), compared with dogs that received placebo (1 to 2 of 8 dogs), but this difference was not significant. CONCLUSIONS AND CLINICAL RELEVANCE: Short-term administration of clomipramine induced benign cardiovascular effects in dogs rather than the potentially dangerous arrhythmias or tachycardia reported following administration of tricyclic antidepressants to humans. Precautions regarding cardiovascular effects may not be needed for the use of clomipramine in healthy dogs.