Use of propofol for anesthesia in cats with primary hepatic lipidosis: 44 cases (1995-2004)

OBJECTIVE-To determine morbidity and fatalities in cats with hepatic lipidosis that received propofol to facilitate placement of a feeding tube. STUDY DESIGN-Retrospective case series. ANIMALS-44 Cats with presumed primary hepatic lipidosis anesthetized for placement of a feeding tube. PROCEDURES-Medical records from January 1995 through December 2004 were reviewed to identify cats that matched the inclusion criteria (histologic confirmation of hepatic lipidosis, anesthetized for placement of feeding tube, complete intensive care unit [ICU] records, and recorded outcome). Data extracted included age, body weight, sex, anesthetic drugs, drug dosages, type of feeding tube, duration of anesthesia, number of hours in ICU, administration of blood products, and survival until discharge from ICU. RESULTS-44 Cats (21 females and 23 males) were included in the analysis. Age range was 3 to 15 years (median, 8 years), and body weight ranged from 1.8 to 9.0 kg (4.0 to 19.8 lb), with a median of 4.8 kg (10.6 lb). Twenty-seven cats were administered propofol. There was no significant association between the use of propofol or the dosage of propofol and any risk factor, need for blood products, number of hours in the ICU, or survival. There was no significant difference between cats that received propofol and cats that did not receive propofol with regard to interval until discharge from the ICU. CONCLUSIONS AND CLINICAL RELEVANCE-The use of propofol did not increase morbidity or fatalities in cats with primary hepatic lipidosis. Thus, propofol can be used in these cats for placement of a feeding tube.     

Ocular disease in FeLV-positive cats: 11 cases (1981-1986).

A total of 147 cats positive for FeLV were retrospectively studied to determine the incidence of ocular disease. Of those cats, 97 had clinical cases of the disease and 50 were artificially infected with the virus. The incidence of ocular disease among FeLV-positive cats with clinical signs of disease was less than 2%, and represented less than 0.1% of the total feline cases for the 5-year period studied. The only ocular findings that could be associated with FeLV were pupillary and motility abnormalities. Retinal hemorrhage and subsequent degeneration found in experimentally infected and naturally infected cats were secondary to profound anemia, which was secondary to FeLV infection. On the basis of the literature and our findings, FeLV is not a major cause of primary or secondary ocular disease in the cat. Anterior uveal disease (iris bombé) was detected in 1 of 147 FeLV-positive cats, and the incidence of secondary infectious disease was zero.     

Hypokalemia in cats: 186 cases (1984-1987)

Retrospective review of serum biochemical data obtained from 501 cats over a 3-year period (1984-1987) indicated that 186 (37%) had hypokalemia (serum potassium concentration less than 4.1 mEq/L). After adjusting for disease diagnosis, cats fed either of 2 commercial diets were 4 times more likely to be hypokalemic than cats fed other diets. Odds ratios (OR; measure of association), adjusted for diet type, were calculated to determine the odds of hypokalemia for a given disease, compared with odds of normokalemia for the same disease. Chronic renal failure (OR = 14.4), hepatic disease (OR = 5.7), systemic infectious diseases (viral or bacterial; OR = 2.7), and neuromuscular or CNS disease (OR = 2.4) were all significantly associated (P less than 0.05) with the occurrence of hypokalemia. Significant differences in age or sex between hypokalemic and normokalemic cats were not found. Within the group of 186 hypokalemic cats, hypercholesterolemia (89 cats; 48%), hyperglycemia (88 cats; 47%), high serum urea nitrogen concentration (86 cats; 46%), hyperchloridemia (80 cats; 43%), and high serum creatinine concentration (73 cats; 39%) were the most common biochemical abnormalities. When disease diagnosis was compared among cats with severe hypokalemia (serum potassium concentration less than 3.0 mEq/L) and those with moderate hypokalemia, cats with severe hypokalemia were 3.5 times more likely to have chronic renal failure than cats with less severe hypokalemia.(ABSTRACT TRUNCATED AT 250 WORDS)     

Hyperadrenocorticism in cats: seven cases (1978-1987)

Hyperadrenocorticism was diagnosed in 7 cats with concurrent diabetes mellitus. Four cats had pituitary adenoma with bilateral adrenocortical hyperplasia, 1 cat had pituitary carcinoma with bilateral adrenocortical hyperplasia, 1 cat had adrenocortical carcinoma, and 1 cat had adrenocortical adenoma of the left adrenal gland. One year later, adrenocortical adenoma involving the right adrenal gland also was diagnosed in this cat. Clinical signs included polyuria and polydipsia (n = 7), development of pot-bellied appearance (n = 5), dermatologic alterations (n = 5), lethargy (n = 3), weight loss (n = 3), dyspnea/panting (n = 2), and recurrent bacterial infections (n = 2). In 6 cats, the diagnosis of hyperadrenocorticism was established before death on the basis of results of the ACTH stimulation test (n = 3) and the dexamethasone screening test (n = 5). Pituitary-dependent hyperadrenocorticism was differentiated from adrenocortical neoplasia on the basis of results of the dexamethasone suppression test (n = 4), endogenous ACTH concentration (n = 3), results of abdominal radiography and ultrasonography (n = 3), and exploratory celiotomy (n = 1). Four cats died or were euthanatized without treatment attempts. Treatment with mitotane followed by 60Co teletherapy was ineffective in one cat with pituitary adenoma. One cat with pituitary carcinoma died one week after bilateral adrenalectomy. Bilateral adrenocortical adenomas were removed surgically in the affected cat.     

Blastomycosis in cats: five cases (1979-1986)

Medical records of 5 cats with blastomycosis examined at the University of Tennessee Veterinary Teaching Hospital from 1979 to 1986 were reviewed. Clinical signs of blastomycosis varies depending on the organ(s) affected, but respiratory tract disease was most common, followed by CNS signs and ocular problems. A definitive diagnosis was made by identification of characteristic fungal organisms in biopsy or necropsy specimens. Two cats treated with amphotericin B did not respond to treatment and died or were euthanatized. The lungs, brain, eyes, and lymph nodes commonly were affected, but one cat had only cutaneous and regional lymph node involvement. The respiratory tract appeared to be a common primary site of infection, with dissemination to other organ systems. The typical host response was a pyogranulomatous cellular infiltrate with numerous fungal organisms evident.     

Cryptosporidiosis in neonatal calves: 277 cases (1986-1987)

From January 1986 through December 1987, 277 cases of cryptosporidiosis in calves were diagnosed by the South Dakota State University Diagnostic Laboratory. Cryptosporidium sp was the only pathogen identified in 142 (51.3%) of the calves. Concurrent infections with rotavirus, coronavirus, Escherichia coli, Salmonella sp, bovine viral diarrhea virus, or other pathogens were identified in the remaining 135 calves. After elimination of cases involving autolyzed specimens or calves with chronic diarrhea, records of 11 calves with acute, severe cryptosporidiosis were identified in which Cryptosporidium sp was the only pathogen.     

Pulmonary thromboembolism in dogs: 47 cases (1986-1987)

Medical records of 47 dogs with pulmonary thromboembolism were reviewed. Middle-aged to older dogs predominated and dyspnea and arterial hypoxemia were consistent clinical findings. Thoracic radiographic findings were variable. Cardiac disease, neoplasia, hyperadrenocorticism, disseminated intravascular coagulation, and sepsis were identified most frequently. Multiple disease processes were identified in 64% of the dogs.     

Food hypersensitivity in cats: 14 cases (1982-1987)

Food hypersensitivity was diagnosed in 14 cats. Clinical signs varied; pruritus (100%), alopecia (64%), and papules (21%) were the ones most commonly observed. Pruritus was localized principally to the head or to the neck or ear region in 42% of the cats. Diagnosis was made on the basis of resolution of clinical signs when cats were fed a restricted ("hypoallergenic") diet, and recurrence of signs when cats were fed their original diet or other food. The most common allergens (on the basis of dietary challenge exposure) were fish and dairy products. Age or sex predilection was not observed, and 9 (64%) of the cats were domestic shorthairs. Owners could not relate the onset of clinical signs with a recent change in diet. Three cats had concurrent flea bite, inhalant, or flea collar hypersensitivity.     

Pulmonary thromboembolism in cats: 29 cases (1987-1997)

OBJECTIVE: To determine clinical signs, clinicopathologic abnormalities, radiographic findings, histologic abnormalities, and predisposing factors or diseases in cats with pulmonary thromboembolism (PTE). DESIGN: Retrospective study. ANIMALS: 29 cats in which PTE was confirmed at necropsy. PROCEDURE: Information on signalment, body weight, history, results of physical examination, results of CBC and serum biochemical analyses, whether PTE was suspected prior to death, type of indwelling venous catheter and duration of venous catheterization, results of thoracic radiography, and whether cats had any concurrent diseases was obtained from medical records. RESULTS: PTE was identified in cats of various ages (median, 8.7 years), weights (median, 4.1 kg [9 lb]), and breeds. The most common owner-reported problems included lethargy (17 cats), anorexia (14), weight loss (10), and difficulty breathing (8); physical abnormalities included lethargy (21), tachypnea or dyspnea (16), and dehydration (13). Clinicopathologic abnormalities reflected concurrent or underlying diseases. Common radiographic abnormalities included pulmonary vessel abnormalities (11), pleural effusion (8), and peripheral noncircumscribed consolidations (6). Underlying or predisposing conditions, including cardiac disease (12), neoplasia (10), corticosteroid administration (8), disseminated intravascular coagulation (5), protein-losing nephropathy (4) or enteropathy (4), immune-mediated hemolytic anemia (2), and sepsis (2) were identified in all cats. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that PTE can develop in cats of any age, sex, or breed. Because PTE is a serious, potentially life-threatening disease, it should be suspected in cats with thoracic radiographic changes suggestive of uneven distribution of blood flow between lung lobes, especially in cats that have predisposing factors or diseases.     

Disseminated histoplasmosis in cats: 12 cases (1981-1986)

Anemia, weight loss, lethargy, fever, anorexia, and interstitial lung disease were the predominant clinical findings in 12 cats with disseminated histoplasmosis. Some cats were examined because of dysfunction or lesions of bone, eyes, or skin. In most cases, the clinical signs were observed by the owner for 4 weeks or less before seeking veterinary care. Young cats were most commonly affected, with 7 of the 12 cats less than or equal to 1 year old. Identification of Histoplasma organisms in bone marrow aspirates was used to confirm the diagnosis of histoplasmosis in 11 of the 12 cats. Histoplasma infection of multiple organs was found at necropsy. In this study, disseminated histoplasmosis had a higher prevalence in cats than in dogs at the same veterinary medical teaching hospital. Feline disseminated histoplasmosis was not associated with FeLV infection. Treatment was attempted in 7 of the 12 cats.     

Severe sepsis in cats: 29 cases (1986-1998)

OBJECTIVE: To document the clinical, clinicopathologic, and pathologic findings in cats with severe sepsis, identify abnormalities unique to this species, and identify criteria that could be used antemortem to diagnose the systemic inflammatory response syndrome in cats. DESIGN: Retrospective study. ANIMALS: 29 cats confirmed to have severe sepsis at necropsy. PROCEDURE: Pertinent history, physical examination findings, and results of hematologic and biochemical testing were extracted from medical records. RESULTS: Clinical diagnoses included pyothorax, septic peritonitis, bacteremia secondary to gastrointestinal tract disease, pneumonia, endocarditis, pyelonephritis, osteomyelitis, pyometra, and bite wounds. Physical examination findings included lethargy, pale mucous membranes, poor pulse quality, tachypnea, hypo- or hyperthermia, signs of diffuse pain on abdominal palpation, bradycardia, and icterus. Clinicopathologic abnormalities included anemia, thrombocytopenia, band neutrophilia, hypoalbuminemia, low serum alkaline phosphatase activity, and hyperbilirubinemia. Necropsy findings included multi-organ necrosis or inflammation with intralesional bacteria. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that severe sepsis in cats is characterized by lethargy, pale mucous membranes, signs of diffuse abdominal pain, tachypnea, bradycardia, weak pulses, anemia, hypoalbuminemia, hypothermia, and icterus. Recognition of this combination of clinical findings should facilitate the diagnosis of severe sepsis in cats.     

Clinical features of salmonellosis in cats: six cases (1981-1986)

Of 6 cats with salmonellosis, only cats 1, 4, and 5 manifested clinical signs of gastroenteritis. In cats 2 to 5, salmonellosis was characterized by fever, a left-shifted leukogram, and vague nonspecific signs of illness. Salmonellae were isolated from blood and feces of cats 1 to 4, and from extraintestinal sites as part of a mixed gram-negative bacterial flora in cats 5 and 6. Of 4 cats with Salmonella bacteremia, cats 2, 3, and 4 were successfully treated with trimethoprim-sulfadiazine, amoxicillin, and/or chloramphenicol; treatment with cephapirin was ineffective in 3 cats. In some cats, salmonellosis was observed as a chronic febrile illness without specific gastrointestinal signs or as a localized tissue infection.     

Peritoneal dialysis in dogs and cats: 27 cases (1976-1987)

The records of 25 dogs and 2 cats treated with peritoneal dialysis during an 11-year period were evaluated. The indications for peritoneal dialysis were acute renal failure in 21 animals, chronic renal failure in 5 animals, and azotemia of undetermined cause in 1 animal. Peritoneal dialysis resulted in a significant (P less than 0.05) decrease in serum urea nitrogen concentration in 19 of the dogs and a significant (P less than 0.05) decrease in serum creatinine in 20 dogs. The most common complication of peritoneal dialysis was hypoalbuminemia (11 animals affected). Other common complications were dialysate retention/catheter obstruction (8 animals), peritonitis (6 animals), hypochloremia (6 animals), and subcutaneous leakage of dialysate (6 animals). Twelve dogs and 2 cats died during treatment, 6 dogs were euthanatized, and 1 dog was lost to follow-up evaluation. The remaining 6 dogs survived and were discharged from the hospital after successful peritoneal dialysis. On the basis of the results of this study, the authors concluded that peritoneal dialysis, although associated with a high complication rate, was a successful technique for reducing azotemia in dogs with acute and chronic renal failure. Survival rates were poor because of the severity of the underlying renal diseases.     

Horner's syndrome in dogs and cats: 49 cases (1980-1986)

Medical records of 49 dogs and cats with Horner's syndrome were reviewed. Causes included head, neck, and chest trauma, chronic otitis, cranial thoracic mass, and injury attributable to cleaning of the external ear canal. Cause could not be delineated in 54.5% of the dogs. Numerous diagnostic tests and pharmacologic challenge exposure with epinephrine were used to localize the site of injury. Resolution of all clinical signs was observed in 36 animals and required a mean of 7.7 weeks.     

Thyroid carcinoma causing hyperthyroidism in cats: 14 cases (1981-1986)

The medical records of 14 hyperthyroid cats with thyroid carcinoma were analyzed retrospectively regarding historical, physical, laboratory, and thyroid scintiscan findings, treatment, and treatment outcome. Breed predilection was not detected, and older castrated male cats were most commonly affected. The most common clinical signs detected by owners were weight loss, polydipsia, polyuria, polyphagia, hyperactivity, and anorexia. Physical examination findings included tachycardia, palpable cervical mass, hyperactivity, cardiac murmur, and abnormal coat. Common abnormal laboratory findings were high serum thyroxine and triiodo-thyronine concentrations and high serum alanine transaminase, alkaline phosphatase, and aspartate transaminase activities. Azotemia, hyperphosphatemia, and hyperglycemia were noticed less frequently. The most common thyroid scintiscan findings were multiple nodular areas of high radionuclide uptake in the cervical region, thoracic inlet, and cranial mediastinum. The most common morphologic diagnosis was mixed compact and follicular carcinoma, with follicular and papillary carcinomas being less common. Most cats responded well to treatment of the thyroid tumor, with rapid resolution of the historical and physical examination findings. The most common necropsy findings were local tumor invasion, regional lymph node metastases, cardiomyopathy, and interstitial nephritis.     

Epizootiologic patterns of diabetes mellitus in cats: 333 cases (1980-1986)

Medical records from 333 cats with diabetes mellitus were studied retrospectively, using epidemiologic methods to determine the incidence of and risk factors for diabetes mellitus in this species. Abstracts were derived, using the Veterinary Medical Data Program with its 17 participating academic institutions in the United States and Canada. A reference population of 135,651 cats was derived from the same hospital population and time span (July 1980 to June 1986). The incidence of diabetes mellitus in cats was determined to be 2.45 cases/1,000 cat-years-of-risk during the 6-year study period. Breed had no detectable effect on risk for diabetes mellitus. In contrast, body weight, age, gender, and neutering had a significant (P less than or equal to 0.01) effect. Body weight of cats was categorized as being less than or greater than or equal to 6.8 kg. The higher body weight, probably indicating obesity, contributed a 2.2-fold increase in risk, even after adjustment for age and gender (adjusted odds ratio). The etiologic fraction for high body weight was 3.8%, suggesting that an estimated 3.8% of cases of diabetes mellitus was attributable to this factor alone. Over 50% of diabetic cats were greater than 10 years old, and the etiologic fraction for age greater than 7 years alone was 73.5%. Age was a significant (P less than 0.001) and the most important single risk factor for development of the disease in cats, with adjusted odds ratios of 8.3 and 14.4 for age 7 to 10 years and greater than 10 years, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)     

Smoke exposure in cats: 22 cases (1986-1997).

OBJECTIVE: To review clinical findings and clinical course for cats exposed to smoke in residential fires and to determine clinical variables that may have prognostic importance. DESIGN: Retrospective study. ANIMALS: 22 cats admitted to our veterinary teaching hospital between 1986 and 1997 with a history of smoke exposure during a residential fire. PROCEDURE: Medical records were reviewed for history, clinical signs, physical examination findings, changes in respiratory tract signs, initial hematologic analysis, treatment, results of thoracic radiography, and outcome. RESULTS: Fifteen of 22 (68%) cats were categorized in the uncomplicated group, 5 (23%) in the complicated group, and 2 (9%) were discharged after a short period because of financial considerations. Twenty (91%) cats survived, but 2 (9%) were euthanatized because of severe respiratory compromise or neurologic changes. Predominant thoracic radiographic changes were diffuse interstitial pattern (6 cats) and focal alveolar pattern (5). The majority (8/13) of cats that were stable or had improved by the day after admission had an uncomplicated clinical course while hospitalized, whereas cats that were worse on the day after admission tended to have a complicated clinical course. CONCLUSIONS AND CLINICAL RELEVANCE: Cats that survive a residential fire and are admitted to a hospital have a good chance to be discharged. Cats that do not have signs of respiratory tract dysfunction at admission probably will not develop severe respiratory complications. For cats with signs of respiratory dysfunction at admission, better prognostic information will be determined by monitoring progression of the respiratory condition on the day after admission.     

Electrolyte abnormalities associated with diarrhea in rhesus monkeys: 100 cases (1986-1987)

Serum electrolyte values from 100 rhesus monkeys with diarrhea were reviewed. The most frequent finding was hyponatremia (88%), with hypochloremia next most frequently detected (80%). Metabolic acidosis was less common (59%) and usually associated with high anion gap values. Associations between electrolyte abnormalities and age, housing, or case outcome were not found. Bacteriologic culturing was performed on fecal specimens from 90 monkeys. Campylobacter coli or C jejuni alone was isolated from 42 (46.7%) specimens, C coli and Shigella flexneri were isolated from 25 (27.8%) specimens, and S flexneri alone was isolated from 6 (6.7%) specimens. A pathogen was not isolated from 17 (18.9%) specimens. Hyponatremia, hypochloremia, acidosis, and high anion gap values were most severe in monkeys infected with Campylobacter sp, either alone or with concurrent S flexneri infection. Serum sodium concentrations less than 132 mEq/L and serum Cl concentrations less than 93 mEq/L were consistently associated with Campylobacter sp infection.     

Risk factors for acquired myasthenia gravis in cats: 105 cases (1986-1998)

OBJECTIVE: To determine prevalence of initial clinical signs and risk factors for acquired myasthenia gravis (MG) in cats. DESIGN: Retrospective case-control study. ANIMALS: 105 cats from the United States, Canada; and the United Kingdom with a confirmed diagnosis of acquired MG and 510 cats with other neuromuscular disorders, including generalized weakness, megaesophagus, and dysphagia (control group). PROCEDURES: Records were retrieved from a data-base containing results of serum samples tested for acetylcholine receptor antibodies. Signalment, including breed, age, and state or country of origin, month of onset, and initial clinical signs were obtained. An acetylcholine receptor antibody titer > 0.3 nmol/L was diagnostic for acquired MG. Unconditional logistic regression was used for statistical analysis. RESULTS: Compared with mixed-breed cats, the breed with the highest relative risk of acquired MG was the Abyssinian (including Somali). Significant differences between sexes were not detected. There was no compelling evidence for a difference in risk of developing MG between states or countries. Relative risk increased after 3 years of age. The most common clinical signs were generalized weakness without megaesophagus and weakness associated with a cranial mediastinal mass. Focal signs, including megaesophagus and dysphagia without signs of generalized weakness, were also evident. CONCLUSIONS AND CLINICAL RELEVANCE: A breed predisposition for acquired MG in Abyssinians (and related Somalis) was observed. Clinical signs were variable and included generalized weakness, megaesophagus, and dysphagia. A cranial mediastinal mass was commonly associated with MG in cats.     

Pleural effusion in cats: 82 cases (1987 to 1995)

Eighty-two cases of feline pleural effusion were identified and reviewed to assess the type of fluid, underlying disease process, predisposing conditions, historical and physical examination findings, laboratory and cytology data, response to treatment and outcome. Pertinent findings included a high occurrence of pleural effusion with mediastinal lymphoma (and other types of intrathoracic neoplasia), pyothorax, cardiomyopathy and feline infectious peritonitis virus infection. Sixteen cases, eight with chylous effusion, had no underlying disease identified. Cats with pyothorax and effusion secondary to trauma had the best prognosis for complete recovery. Otherwise, the outcome was variable and the prognosis was guarded to poor.