COMPUTED TOMOGRAPHIC CHARACTERISTICS OF THE THYROID GLANDS IN EIGHT HYPERTHYROID CATS PRE‐ AND POSTMETHIMAZOLE TREATMENT COMPARED WITH SEVEN EUTHYROID CATS

Hyperthyroidism is the most common feline endocrinopathy; thyroid computed tomography (CT) may improve disease detection and methimazole dose selection. Objectives of this experimental pre‐post with historical case‐control study were to perform thyroid CT imaging in awake or mildly sedated hyperthyroid cats, compare thyroid gland CT appearance in euthyroid and hyperthyroid cats pre‐ and postmethimazole treatment, and determine whether thyroid size or attenuation correlate with methimazole dose needed for euthyroidism. Premethimazole treatment, eight hyperthyroid cats received CT scans from the head to heart, which were compared to CT of seven euthyroid cats. Total thyroxine levels were monitored every 3–4 weeks. Postmethimazole CT was performed 30 days after achieving euthyroid status. Computed tomography parameters recorded included thyroid length, width, height, attenuation, and heterogeneity. Median time between CT was 70 days (53–213 days). Mild sedation was needed in five hyperthyroid cats premethimazole, and none postmethimazole. Thyroid volume was significantly larger in hyperthyroid cats compared to euthyroid cats (785.0 mm³ vs. 154.9 mm³; P = 0.002) and remained unchanged by methimazole treatment (?4.5 mm3; P = 0.50). Thyroid attenuation and heterogeneity decreased with methimazole treatment (96.1 HU vs. 85.9 HU; P = 0.02. 12.4 HU vs. 8.1 HU; P = 0.009). Methimazole dose ranged from 2.5 to 10 mg daily with a positive correlation between pretreatment thyroid gland volume and dose needed to achieve euthyroidism (P = 0.03). Euthyroid and hyperthyroid cats are easily imaged awake or mildly sedated with CT. Methimazole in hyperthyroid cats significantly lowers thyroid attenuation and heterogeneity, but not size.     

Hepatic CT attenuation differs in three species of freshwater turtles and hepatic Hounsfield units increase with folliculogenesis in wild Blanding's turtles (Emydoidea blandingii)

Freshwater turtle species are suffering from anthropocentric‐caused population declines, making preservation of professionally managed populations increasingly important. Turtles under professional care have an increased risk to develop hepatic lipidosis, potentially resulting in early death. Computed tomography can provide an antemortem screening for increased fatty liver composition. A goal of this prospective analytical cross‐sectional study was to assess the hepatic attenuation measured as Hounsfield units (HU) in a wild population of a freshwater turtle species, and then compare hepatic HU to freshwater turtles under professional care. Ninety‐five wild Blanding's turtles (BT; Emydoidea blandingii) as well as 10 Vietnamese Pond turtles (VPT; Mauremys annamensis) and six Northern Snake‐Necked turtles (NSNT; Chelodina oblonga) under professional care underwent CT with quantification of hepatic HU. Hepatic HU were correlated to serum chemistry findings and the presence of follicles was recorded in BT. The mean (±SD) hepatic attenuation for 95 wild BT was 97.5 HU ±9.6. There were significant differences in hepatic attenuation among VPT, NSNT, and BT, with median HU values (range) of 5.39 HU (–6.45 to 61.50), 71.74 HU (59.44‐94.49), and 95.43 HU (74.41‐124.56), respectively. Aspartate aminotransferase (AST) values had a weak negative correlation to HU with a coefficient of –0.85 (P < .001). The hepatic attenuation was significantly higher for individuals undergoing folliculogenesis (P = .007). The decreased HU values were significantly negatively correlated with AST values. Findings supported the use of CT as an aid for guiding future management practices in freshwater turtles.     

EFFECTS OF TWO CONTRAST INJECTION PROTOCOLS ON FELINE AORTIC AND HEPATIC ENHANCEMENT USING DYNAMIC COMPUTED TOMOGRAPHY

This prospective study compared aortic and hepatic enhancement achieved using a contrast injection protocol with a fixed rate of 5 ml/s vs. that achieved using a protocol with fixed injection duration of 20 s in eight cats. Cats were assigned into two groups (Group 1, rate 5 ml/s; Group 2, duration 20 s). The dose of contrast was the same in both groups (740 mgI/kg). Regions of interest (ROI) were drawn in the aorta and liver for transverse scans acquired at the hepatic hilus. Time to peak aortic enhancement occurred significantly earlier in Group 1 (M = 11s, SD = 1.63) than in Group 2 (M = 25.5 s, SD = 2.51). Peak aortic enhancement was significantly higher in Group 1 (M = 1906.51 HU, SD = 368.64) than in Group 2 (M = 745.08 HU, SD = 201.84). Duration of aortic enhancement equal to or above 300 HU was statistically longer in Group 2 (M = 24.5 s, SD = 8.39) than in Group 1 (M = 10 s, SD = 1.63). There were no significant differences in time to peak liver enhancement, peak liver enhancement, or duration of hepatic arterial phase between groups. Findings supported the hypothesis that longer injection duration results in a broader bolus geometry with a longer time to peak and a lower peak aortic enhancement in cat. This strong influence of injection duration on timing of aortic enhancement may help future users optimize protocols for CT angiography of the aorta and multiphasic evaluation of the liver, pancreas, and small intestine.     

COMPARISON OF LUNG ATTENUATION AND HETEROGENEITY BETWEEN CATS WITH EXPERIMENTALLY INDUCED ALLERGIC ASTHMA,NATURALLY OCCURRING ASTHMA AND NORMAL CATS

Airway remodeling is a prominent feature of feline allergic asthma but requires biopsy for characterization. Computed tomography (CT) has appeal as a minimally invasive diagnostic test. The purpose of this prospective case–control study was to compare indices of airway remodeling between cats with experimentally induced, spontaneous asthma and healthy unaffected cats using CT. We hypothesized that experimental and spontaneous feline asthma would have similar CT airway remodeling characteristics and that these would be significantly different in healthy cats. Experimentally induced asthmatic research cats (n = 5), spontaneously asthmatic pet cats (n = 6), and healthy research cats (n = 5) were scanned unrestrained using a 64‐detector row CT scanner. Inspiratory breath‐hold CT scans were also performed in experimentally induced asthmatic and healthy cats. Mean ± extent variation of lung attenuation for each cat was determined using an airway inspector software program and CT images were scored for lung heterogeneity by a board‐certified veterinary radiologist who was unaware of cat group status. Groups were compared using one‐way ANOVA (unrestrained scans) and the Student's t‐test (anesthetized scans) with significance defined as P < 0.10. Experimentally asthmatic and spontaneously asthmatic cats had significantly (P = 0.028 and P = 0.073, respectively) increased lung attenuation compared to healthy cats. Heterogeneity scores were higher in experimentally induced asthmatic cat than in healthy cats. Objective quantification of lung heterogeneity and lung volume did not differ among the three groups (P = 0.311, P = 0.181, respectively). Findings supported our hypothesis. Inspiratory breath‐hold anesthetized CT scans facilitated discrimination between asthmatic and healthy cats in comparison to unrestrained CT scans.     

Clinical application of computed tomography for the diagnosis of feline hepatic lipidosis

The usefulness of computed tomography (CT) for the diagnosis of feline hepatic lipidosis (FHL) was evaluated. Liver CT number was 54.7+/-5.6 HU (mean+/-SD) in 26 healthy cats. We fast 6 healthy cats for 72 hr to induced FHL experimentally and the cats were assessed by CT and serum biochemical analysis. Liver CT number of the six cats was 53.8+/-3.0 HU before fasting, 46.8+/-2.4 HU after fasting, and 50.2+/-3.6 HU two weeks after restarted feeding. The decreased CT number was associated with the elevation of serum non-esterified fatty acid (NEFA) and beta-hydroxybutyrate levels. These results indicate that measurement of CT number of the liver is an effective procedure for the diagnosis of FHL.     

Triple phase computed tomography of the pancreas in healthy cats

While the availability and use of computed tomography (CT) continues to grow, no study has described the size and multiphase CT appearance of the normal feline pancreas. This information is important to not only allow more accurate identification and differentiation of disease, but it may also be useful in assessing pancreatic function. In this prospective analytical study, we described a triple phase CT protocol of the pancreas for use in sedated cats and the attenuation, enhancement pattern, size, and volume of the pancreas for a group of healthy cats. Fifteen healthy cats were enrolled in the study and a standardized protocol for acquiring arterial, portal, and delayed phase CT images of the pancreas was developed and described. The pancreas was hypo to isoattenuating to both the liver and spleen in all phases in the majority of cats with a homogenous enhancement pattern noted in all 15. Mean pancreatic attenuation was 48, 79, 166, and 126 Hounsfield units (HU) respectively on precontrast, arterial, portal, and delayed phase images. In addition, mean height, length, and width of the left lobe of the pancreas were larger than the right lobe in all 15 cats. There were no associations between volume and volume: body weight ratio with age (P = 0.6518, P = 0.6968) or sex (P = 0.7013, P = 0.2043). This baseline information may be beneficial for use in future studies characterizing pancreatic disease in cats as well as future research studies evaluating pancreatic endocrine function.     

COMPUTED TOMOGRAPHIC CHARACTERISTICS OF PRESUMED NORMAL CANINE ABDOMINAL LYMPH NODES

Though identification of lymph nodes is essential in staging cancer patients, little has been reported about the CT features of canine abdominal lymph nodes. The purpose of this retrospective study was to describe the visibility, location, and characteristics of abdominal lymph nodes in abdominal CT studies of dogs considered unlikely to have lymphadenopathy. The relationship between the number of identified lymph nodes and intraabdominal fat ranking, body weight, and slice thickness was also investigated. A total of 19 dogs were included. At least two jejunal lymph nodes and both left and right medial iliac lymph nodes were identified in all dogs. Colic lymph nodes were not identified in any of the dogs. Visualization of all other lymph nodes varied. There were significantly more lymph nodes visible in dogs with more intraabdominal fat (P < 0.0001). No correlation between the number of identified lymph nodes and body weight (P = 0.64) or slice thickness (P = 0.76) was found. Though most of all identified lymph nodes had an elongated shape, a rounded shape was most common in splenic, pancreaticoduodenal, renal, ileocolic and caudal mesenteric lymph nodes. Most lymph nodes had a homogeneous structure before and following the intravenous administration of contrast medium. Some lymph nodes had a slightly irregular structure or were relatively more hyper attenuating in the periphery than centrally before and/or after contrast administration. Mean attenuation before contrast was 37 Hounsfield Units (HU) (range 20–52 HU), and 109 HU after contrast (range 36–223 HU). Findings indicated that the CT visibility, characteristics of different abdominal lymph nodes may be variable in dogs.     

Liver glutathione concentrations in dogs and cats with naturally occurring liver disease

OBJECTIVE: To determine total glutathione (GSH) and glutathione disulfide (GSSG) concentrations in liver tissues from dogs and cats with spontaneous liver disease. SAMPLE POPULATION: Liver biopsy specimens from 63 dogs and 20 cats with liver disease and 12 healthy dogs and 15 healthy cats. PROCEDURE: GSH was measured by use of an enzymatic method; GSSG was measured after 2-vinylpyridine extraction of reduced GSH. Concentrations were expressed by use of wet liver weight and concentration of tissue protein and DNA. RESULTS: Disorders included necroinflammatory liver diseases (24 dogs, 10 cats), extrahepatic bile duct obstruction (8 dogs, 3 cats), vacuolar hepatopathy (16 dogs), hepatic lipidosis (4 cats), portosystemic vascular anomalies (15 dogs), and hepatic lymphosarcoma (3 cats). Significantly higher liver GSH and protein concentrations and a lower tissue DNA concentration and ratio of reduced GSH-to-GSSG were found in healthy cats, compared with healthy dogs. Of 63 dogs and 20 cats with liver disease, 22 and 14 had low liver concentrations of GSH (micromol) per gram of tissue; 10 and 10 had low liver concentrations of GSH (nmol) per milligram of tissue protein; and 26 and 18 had low liver concentrations of GSH (nmol) per microgram of tissue DNA, respectively. Low liver tissue concentrations of GSH were found in cats with necroinflammatory liver disease and hepatic lipidosis. Low liver concentrations of GSH per microgram of tissue DNA were found in dogs with necroinflammatory liver disease and cats with necroinflammatory liver disease, extrahepatic bile duct occlusion, and hepatic lipidosis. CONCLUSIONS AND CLINICAL RELEVANCE: Low GSH values are common in necroinflammatory liver disorders, extrahepatic bile duct occlusion, and feline hepatic lipidosis. Cats may have higher risk than dogs for low liver GSH concentrations.     

Metabolic and hormonal alterations in cats with hepatic lipidosis

Hepatic lipidosis in cats is a commonly diagnosed hepatobiliary disease of unknown cause. The purpose of this prospective study was to characterize the blood hormone and lipid status of cats with hepatic lipidosis, and to compare this status to that of cats with other types of liver disease and to control cats. Twenty-three cats with hepatic disease were assigned to 1 of 2 groups on the basis of cytopathologic or histopathologic examination of the liver: group 1, hepatic lipidosis (n = 18); or group 2, cholangiohepatitis (n = 5). Ten healthy young adult cats were used as controls. Food was withheld from control animals for 24 hours before blood collection. Concentrations of plasma glucagon and serum insulin, cortisol, thyroxine, triglycerides, cholesterol, phospholipids, and nonesterified fatty acids (NEFAs) were determined in all cats, in addition to routine hematologic and serum biochemical testing. Cats with hepatic lipidosis had higher serum NEFA concentrations than cats with cholangiohepatitis or control cats (P < .05). Cats with cholangiohepatitis had higher serum cholesterol and phospholipid concentrations than those of cats with lipidosis or control cats (P < .05); their plasma glucagon concentrations were higher than those of control cats (P < .05), but were not different from those of cats with hepatic lipidosis. Serum insulin concentrations were significantly higher in control cats than in diseased cats (P < .05), but neither serum insulin nor the insulin to glucagon ratio was significantly different among the cats with hepatic disease. The high concentration of NEFAs in cats with hepatic lipidosis suggests that at least 1 factor in the pathogenesis of this syndrome may involve the regulation of hormone-sensitive lipase.     

COMPARISON BETWEEN COMPUTED TOMOGRAPHY AND 99m TC‐ PERTECHNETATE SCINTIGRAPHY CHARACTERISTICS OF THE THYROID GLAND IN CATS WITH HYPERTHYROIDISM

Scintigraphy is currently the reference standard for diagnosing feline hyperthyroidism; however, computed tomography (CT) is more widely available in veterinary practice. The purposes of this prospective study were to describe the CT appearance of thyroid glands in cats with hyperthyroidism and compare CT findings with findings from ^99mTc–pertechnetate scintigraphy. Twenty‐five adult hyperthyroid cats were included. Plain CT images were acquired for each cat and the following characteristics recorded for each thyroid lobe: visibility, delineation, position, attenuation, shape, and subjective size. Scintigraphic images were also acquired and the following characteristics recorded: radiopharmaceutical uptake, delineation, ectopic foci, shape, and subjective size. In CT images, thyroid lobes were most commonly found between the second and fourth cervical vertebrae, dorsolateral to the trachea. Affected thyroid lobes (based on scintigraphy reference standard) were most commonly oval and moderately enlarged in CT images. A heterogeneous attenuation pattern (isoattenuating to adjacent soft tissues with hypo‐ and hyperattenuating foci) was most commonly found in affected thyroid lobes. A positive correlation (P < 0.01) was identified between CT and scintigraphy for left‐to‐right thyroid lobe size relationship and subjective size of the larger thyroid lobe. The CT estimated mass was significantly higher (median = 148.8; range = [0;357.6]) for the more active thyroid lobe compared to the less active thyroid lobe (median = 84.6; range = [0;312.3]); (W = 154; P < 0.01). Findings indicated that CT may not reliably differentiate unilateral vs. bilateral hyperthyroidism in cats; however, CT may be a reliable alternative test for correctly identifying the more active thyroid lobe.     

Effect of Weight Gain and Subsequent Weight Loss on Glucose Tolerance and Insulin Response in Healthy Cats

The effects of weight gain and subsequent weight loss on glucose tolerance and insulin response were evaluated in 12 healthy cats. Intravenous glucose tolerance tests (IVGTT) were performed at entry into the study, after a significant gain of body weight induced by feeding palatable commercial cat food ad libitum, after a significant loss of body weight induced by feeding a poorly palatable purified diet to discourage eating and promote fasting, and after recovery from fasting when body weight had returned to pre-study values and cats were eating commercial foods. A complete physical examination with measurement of body weight was performed weekly, a CBC and serum biochemistry panel were evaluated at the time of each IVGTT, and a liver biopsy specimen obtained 2 to 4 days after each IVGTT was evaluated histologically for each cat. Mean serum glucose and insulin concentrations after glucose infusion and total amount of insulin secreted during the second 60 minutes and entire 120 minutes after glucose infusion were significantly (P > .05) increased after weight gain, as compared with baseline. At the end of weight loss, cats had hepatic lipidosis and serum biochemical abnormalities consistent with feline hepatic lipidosis. There was a significant (P > .05) increase in mean serum glucose concentration and t_1/2, and a significant (P > .05) decrease in mean serum insulin concentration and the glucose disappearance coefficient (K) after glucose infusion for measurements obtained after weight loss, compared with those obtained after weight gain and at baseline. Insulin peak response, insulino-genic index, and total amount of insulin secreted during the initial 10 minutes, 20 minutes, and 60 minutes after glucose infusion were decreased markedly (P > .05), compared with measurements obtained after weight gain and at baseline. In addition, the total amount of insulin secreted for 120 minutes after glucose infusion was decreased markedly (P > .05) in measurements obtained after weight loss, compared with those obtained after weight gain. At the end of recovery, all cats were voluntarily consuming food, serum biochemical abnormalities identified after weight loss had resolved, the number and size of lipid vacuoles in hepatocytes had decreased, and results of IVGTT were similar to those obtained at baseline. These findings confirmed the reversibility of obesity-induced insulin resistance in cats, and documented initial deterioration in glucose tolerance and insulin response to glucose infusion when weight loss was caused by severe restriction of caloric intake.     

Lipid Composition of Hepatic and Adipose Tissues From Normal Cats and From Cats With Idiopathic Hepatic Lipidosis

The purpose of this study was to characterize the lipid classes in hepatic and adipose tissues from cats with idiopathic hepatic lipidosis (IHL). Concentrations of triglyceride, phospholipid phosphorus, and free and total cholesterol were determined in lipid extracts of liver homogenates from 5 cats with IHL and 5 healthy control cats. Total fatty acid composition of liver and adipose tissue was also compared. Triglyceride accounted for 34% of liver by weight in cats with IHL (338 ± 38 mg/g wet liver) versus 1% in control cats {9.9 ±1.0 mg/g wet liver, P < .001). The mass of cholesterol ester was significantly higher in triglyceride-free (TG-free) liver from cats with IHL (741 ± 340 μg/g TG-free wet liver) compared to healthy cats (31 ± 11 μg/g TG-free wet liver, P < .05). Total fatty acid composition of hepatic tissue in the 2 groups differed; pa Imitate was higher (19.5 ± 1.1% of total fatty acids in cats with IHL versus 9.2 ± 2.7% in controls, P < .05), stearate was lower (8.5 ± 0.8% versus 16.8 ± 1.1%, P < .05), oleate was higher (41.2 ± 1.6% versus 31.1 ± 1.8%, P < .05), and arachidonate was lower (1.2 ± 0.2% versus 6.0 ± 0.9%, P < .05). The total fatty acid composition of adipose tissue also differed between the 2 groups; palmitate was higher (25.2 ± 1.2% in cats with IHL versus 21.3 ± 0.6% in controls, P < .05), total monounsaturated fatty acids were higher (48.4 ± 1.0% versus 45.0 ± 0.8%, P < .05), linoleate was lower (13.3 ± 1.6% versus 17.5 ± 0.9%, P < .05), total (n-6) fatty acids were lower (13.8 ± 1.38% versus 18.4 ± 0.83%, P < .05), linolenate was lower (0.2 ± 0.04% versus 0.7 ± 0.06%, P < .05), and total (n-3) fatty acids were lower (0.3 ± 0.02% versus 1.3 ± 0.32%, P < .05). The fatty acid composition of both liver and adipose tissue was similar for stearate, oleate, linoleate, and linolenate in cats with IHL. These results support the hypothesis that the origin of hepatic triglyceride in cats with IHL is the mobilization of fatty acids from adipose tissue.     

Accuracy of ultrasonography in the detection of severe hepatic lipidosis in cats.

The accuracy of ultrasonography in detection of feline hepatic lipidosis was studied retrospectively. The following ultrasonographic criteria were associated positively with severe hepatic lipidosis: the liver hyperechoic, compared with falciform fat; the liver isoechoic or hyperechoic, compared with omental fat; poor visualization of intrahepatic vessel borders; and increased attenuation of sound by the liver. In a group of 36 cats with clinically apparent hepatobiliary disease and in which liver biopsy was done, liver hyperechoic, compared with falciform fat, was the best criterion for diagnosis of severe hepatic lipidosis with 91% sensitivity, 100% specificity, and 100% positive predictive value.     

Comparison of plasma, liver, and skeletal muscle carnitine concentrations in cats with idiopathic hepatic lipidosis and in healthy cats

Concentrations of total, free, and esterified carnitine were determined in plasma, liver, and skeletal muscle from cats with idiopathic hepatic lipidosis and compared with values from healthy cats. The mean concentrations of plasma, liver, and skeletal muscle total carnitine; plasma and skeletal muscle free carnitine; and plasma and liver esterified carnitine were greater (P less than 0.05) in cats with idiopathic hepatic lipidosis than in control cats. The mean for the ratio of free/total carnitine in plasma and liver was lower (P less than 0.05) in cats with idiopathic hepatic lipidosis than in control cats. These data suggest that carnitine deficiency does not contribute to the pathogenesis of feline idiopathic hepatic lipidosis.     

CLINICAL APPLICATION OF PATLAK PLOT CT‐GFR IN ANIMALS WITH UPPER URINARY TRACT DISEASE

Glomerular filtration rate (GFR), an important parameter of renal function, is difficult to assess clinically. Serum creatinine and blood urea nitrogen measurements lack sensitivity, whereas radionuclide determination of GFR is not always available and requires postinjection patient isolation. GFR can be determined using computed tomography (CT), most commonly via Patlak plot analysis. Four adult cats, two adult dogs, and a foal underwent abdominal CT under general anesthesia for various diseases of the upper urinary tract. CT‐GFR was measured with a single‐slice dynamic acquisition and Patlak plot analysis. In five animals, the total CT‐GFR appeared to be below normal, corresponding with mild (two animals) and moderate (two animals) increases of serum creatinine in four. In the two animals with normal or increased CT‐GFR, serum creatinine was within the reference values. A significant negative logarithmic relationship was found between CT‐GFR and serum creatinine values (P=0.008; r²=0.75). No complications occurred during or following CT‐GFR. CT examination provided clinically relevant information in 3/5 patients with possible ureteral obstruction and in 3/3 patients with suspected ureteral calculi. Single‐slice dynamic CT‐GFR was practical and provided clinically useful information in this small series of patients undergoing CT of the upper urinary tract. There was a significant relationship between CT‐GFR and serum creatinine values, which supports the clinical potential of CT‐GFR and justifies further investigation of this technique.     

Effects of carnitine and taurine on fatty acid metabolism and lipid accumulation in the liver of cats during weight gain and weight loss

OBJECTIVE: To determine the effects of carnitine (Ca) or taurine (Ta) supplementation on prevention of lipid accumulation in the liver of cats. ANIMALS: 24 adult cats. PROCEDURE: Cats were fed a weight-gaining diet sufficient in n-6 polyunsaturated fatty acids (PUFAs), low in long-chain n-3 PUFAs (n-3 LPUFA), and containing corn gluten for 20 weeks. Cats gained at least 30% in body weight and were assigned to 4 weight-reduction diets (6 cats/diet) for 7 to 10 weeks (control diet, control plus Ca, control plus Ta, and control plus Ca and Ta). RESULTS: Hepatic lipids accumulated significantly during weight gain and weight loss but were not altered by Ca orTa after weight loss. Carnitine significantly increased n-3 and n-6 LPUFAs in hepatic triglycerides, decreased incorporation of 13C palmitate into very-low-density lipoprotein and hepatic triglycerides, and increased plasma ketone bodies. Carnitine also significantly increased weight loss but without altering the fat to lean body mass ratio. Taurine did not significantly affect any variables. Diets low in n-3 LPUFAs predisposed cats to hepatic lipidosis during weight gain, which was further exacerbated during weight loss. Mitochondrial numbers decreased during weight gain and weight loss but were not affected by treatment. Carnitine improved fatty acid oxidation and glucose utilization during weight loss without correcting hepatic lipidosis. CONCLUSIONS AND CLINICAL RELEVANCE: The primary mechanism leading to hepatic lipidosis in cats appears to be decreased fatty acid oxidation. Carnitine may improve fatty acid oxidation but will not ameliorate hepatic lipidosis in cats fed a diet low in n-3 fatty acids.     

ULTRASOUND ELASTOGRAPHY OF THE LIVER,SPLEEN, AND KIDNEYS IN CLINICALLY NORMAL CATS

A large amount of overlap exists in the B‐mode ultrasound appearance of normal and abnormal liver, spleen, and kidney tissues in cats. Therefore, invasive tissue sampling procedures remain the standard method for diagnosing diseases in these organs. The purpose of our study was to assess the feasibility of ultrasound elastography as a technique for improving noninvasive characterization of the feline liver, spleen, and kidneys. Elastography was performed on 10 unsedated, clinically healthy cats. Numeric (strain) values (0 = softest to 255 = firmest) assigned to color pixels within regions of interest resulted in median scores (interquartile ranges) of body wall, 207.50 (189.75–224.00); liver, 119.00 (105.00–138.25); spleen, 127.50 (121–00–142.00); right renal cortex, 83.50 (64.00–130.00); right renal near field, 125.50 (110.75–139.75); left renal cortex, 77.50 (52.00–116.25); and left renal near field, 126.00 (114.00–145.25). Strain values were not different between organs. Body wall median was the only significantly different value (P < 0.05). Strain ratio values of body wall:organ were as follows: liver, 1.76 (1.38–2.00); spleen, 1.68 (1.47–1.83); right renal cortex, 2.31 (1.61–3.15); right renal near field, 1.62 (1.41–2.01); left renal cortex, 2.66 (1.45–4.13); and left renal near field, 1.51 (1.29–1.89). Subjectively, hepatic and splenic parenchymal tissues were homogeneous in compressibility and similar in elasticity to one another. Renal cortical tissue was softer compared to medullary tissue. Findings indicated that ultrasound elastography is a feasible technique for objectively and subjectively characterizing the feline liver, spleen, and kidneys. Further research is needed in cats with confirmed diseases of these organs, to compare the diagnostic sensitivity of ultrasound elastography vs. B‐mode ultrasonography.     

EFFECT OF CONTRAST MEDIUM INJECTION DURATION ON PEAK ENHANCEMENT AND TIME TO PEAK ENHANCEMENT OF CANINE PULMONARY ARTERIES

Our goal was to investigate the effect of contrast medium injection duration on pulmonary artery peak enhancement and time to peak enhancement. Fourteen dogs were allocated into one of seven predefined weight categories, each category contained two dogs. Dogs in each weight category were assigned to group A or B. Animals in each group received a different contrast medium injection protocol. In group A, a fixed injection rate of 5 ml/s was used. In group B, the contrast injection rate was calculated as follows: flow rate=contrast volume/scan duration+10 s. Time to peak enhancement and peak enhancement of the main left and right pulmonary arteries were measured on single‐level, dynamic CT images for a fixed time of 30 s. Rank correlation (Spearman's) coefficients between injection duration and time to peak enhancement and between body weight and peak enhancement were calculated. For group A, there was a significant negative correlation between peak enhancement and weight (r=?0.94; P=0.005), while for group B, there was no significant correlation (r=?0.64 and P=0.18). There was a significant correlation between time to peak enhancement and injection duration in both groups (group A: r=0.99; P=0.006 and group B: r=0.85; P=0.02). In conclusion, injection duration is a key feature in a CT angiography injection protocol. A protocol with an injection duration adjusted to the scan duration seems to be particularly suitable for veterinary applications where a population with great weight variability is studied.     

Electrocardiographic assessment of hyperkalemia in dogs and cats

Objective: To determine if electrocardiogram (ECG) changes induced by hyperkalemia in clinical patients correspond with previously reported changes in experimental animals. Design: Prospective clinical study. Setting: Two private practice 24‐hour emergency and critical care facilities. Animals: Fifteen dogs and 22 cats with serum potassium levels >5.5 mEq/L. Interventions: None. Measurements: The following data were collected when hyperkalemia was documented: ECG (n=37), sodium and chloride (mEq/L) (n=35), total magnesium (mg/dL) (n=18), total calcium (mg/dL) (n=30), and venous pH (n=18). Animals were divided into five groups based on severity of hyperkalemia and ECG interpretation included rate, rhythm and P‐QRS‐T evaluation. Main Results: Twenty‐two of 37 (59%) of the ECGs were normal or revealed abnormalities that have not been previously described in conjunction with hyperkalemia. In dogs, there was no correlation (r=0) between potassium blood levels and heart rate (n=15). There was weak correlation (r=0.40; P=0.06) between potassium blood levels and heart rate in cats (n=22). The correlation was stronger (r=0.64; P<0.05) when data were compared in cats with serum potassium level >8.5 mEq/L (Groups 4 and Group 5; n=11). Conclusions: ECGs obtained from ill dogs and cats with hyperkalemia are inconsistent with ECGs from experimentally induced hyperkalemia. It is difficult to determine the clinical relevance of heart rate differences between cats with serum potassium levels >8.5 mEq/L and animals with experimentally induced hyperkalemia; this may be due to the presence of other biochemical abnormalities in diseased animals.     

A Retrospective Study of 77 Cats With Severe Hepatic Lipidosis: 1975–1990

The physical, clinicopathologic, and survival rates of 77 cats with severe spontaneous hepatic lipidosis are detailed in this report. Cats were subdivided into groups designated as idiopathic lipidosis if no other disease process was recognized, or secondary lipidosis if another disease process was diagnosed. Cats were also subdivided into groups designated as survivors or nonsurvivors on the basis of successful recuperation at 4 months after initial diagnosis. Differences between disease and survival groups were evaluated for significance. Overall, more female cats and middle-aged cats were affected. Presenting complaints of vomiting, anorexia, weakness, and weight loss were common. Physical assessment of most cats showed obvious hepatomegaly, jaundice, dehydration, and a weight loss ≥ 25% of usual body weight. Neurobehavioral signs indicative of hepatic encephalopathy, other than ptyalism and depression, were rare. Clinicopathologic features are characterized by hyperbilirubinemia and increased activities of serum ALT, AST, and ALP, with only small if any increase in γGT activity. Clinical features distinguishing cats with hepatic lipidosis from those with other serious cholestatic disorders include absence of hyperglobulinemia and low γGT activity relative to ALP activity. Although coagulation tests were abnormal in 45% of cats tested (n = 44), few cats showed clinical bleeding tendencies. Most cats received prophylactic vitamin K₁ therapy. Forty two cats received aggressive nutritional and supportive care and of these 55% survived. Cats with idiopathic disease were significantly younger, had significantly higher ALP activity and bilirubin concentration, and had a slightly better survival rate than cats with secondary lipidosis. Low PCV, hypokalemia, and an older age were significantly related to nonsurvival. Because of the variety of diets and food supplements used in case management, the influence of nutritional factors on survival could not be evaluated. (Journal of Veterinary Internal Medicine 1993; 7:349–359. Copyright © 1993 by the American College of Veterinary Internal Medicine.)