Encephalo-myelopathy in young cats

Nineteen cats, aged three to 16 months, developed neurological signs including hindleg paralysis, head shaking, nystagmus, defective vision and reduced proprioception. Most of the animals were in cat colonies in research centres and were derived from specific pathogen-free stock. One was referred from veterinary practice. Over 40 per cent of litters could be affected constituting a serious commercial loss. Wallerian degeneration affected long tracts in the spinal cord and variously in the brain stem and cerebral white matter. In seven animals there was loss of Purkinje cells in the cerebellum and in eight there was neuronal loss in the spinal cord. Gliosis accompanied all changes. Although no viral agent was isolated the clinical pattern of the disease and evidence from other cases reported in the literature suggest an infectious cause.     

Disseminated Mycobacterium avium infection in young cats: overrepresentation of Abyssinian cats

Disseminated Mycobacterium avium-intracellulare complex (MAC) infection was diagnosed in 10 young cats (1-5 years of age) from Australia or North America between 1995 and 2004. A further two cats with disseminated mycobacteriosis (precise agent not identified) were recognised during this period. Of the 12, 10 were Abyssinian cats, one was a Somali cat and one was a domestic shorthair cat. None of the cats tested positive for either FeLV antigen or FIV antibody. The clinical course of these infections was indolent, with cats typically presenting for weight loss, initially in the face of polyphagia, with a chronicity of up to several months. Additional clinical features included lower respiratory tract signs and peripheral lymphadenomegaly. A marked diffuse interstitial pattern was evident in thoracic radiographs, even in cats without overt respiratory involvement. Hair clipped to perform diagnostic procedures tended to regrow slowly, if at all. Diagnosis was generally made by obtaining representative tissue specimens from mesenteric lymph nodes, liver or kidney at laparotomy, or from a popliteal lymph node. The primary antecedent event was most likely colonisation of either the alimentary or respiratory tract, followed by local invasion and eventual lymphatic and haematogenous dissemination. Nine cases were treated using combination therapy with agents effective for MAC infection in human patients. Two cats are still undergoing initial therapy and have responded. Of the remaining seven, all responded during long courses (5-14 months) of clarithromycin combined with either clofazimine or rifampicin, and a fluoroquinolone or doxycycline. Of these, three cats remain well (with durations between 2 months and 2 years following therapy); two developed recurrent disease (at 3 months and 2 years, respectively, following therapy) and have restarted therapy. The remaining two cats improved 1 year and 5 months, respectively, after diagnosis but ultimately succumbed. The two cats in which therapy was restarted have improved dramatically. Certain lines of Abyssinian and Somali cats likely suffer from a familial immunodeficiency that predisposes them to infection with slow-growing mycobacteria such as MAC.     

Evaluation of the white-coat effect in cats

The diagnosis and management of systemic hypertension in cats requires a reliable method for measurement of systemic arterial blood pressure (BP) in clinical patients. Unfortunately, the setting of a clinical practice and the act of measuring BP might raise BP and heart rate (HR), an effect referred to as the white-coat effect in human patients. The purpose of the present study was to determine if a white-coat effect was experienced by cats. Radiotelemetric implants were used to measure BP and HR in 13 conscious cats in a research colony while undisturbed in their cages and while subjected to simulated visits to a veterinarian's office. The white-coat effect was taken to be the difference between the overall 24-hour average value for parameters of BP and HR and the corresponding value during the simulated office visit. A white-coat effect was observed in cats. In healthy cats, the systolic BP measured during the examination period of the simulated office visit exceeded the 24-hour average systolic BP by 17.6+/-1.5 mm Hg. However, marked heterogeneity occurred in the pattern and magnitude of the increase in systolic BP above the 24-hour baseline and the increase varied between 75.3 and -27.2 mm Hg for the healthy cats. Variation in response to the simulated office visit was observed among cats and among visits by the same cat. During an office visit, the magnitude of the white-coat effect tended to decrease, but not disappear, over time. The magnitude of the white-coat effect varied when cats were subjected to 5 repeat office visits, but did not diminish in the group as a whole. The mean increase in systolic BP during the examination (22.3+/-0.9 mm Hg) was greater (P < .05) in cats with renal insufficiency. Although the heterogeneity of response expected from companion animals might be greater than that observed in these colony cats, these results indicate that veterinarians should carefully consider the white-coat effect in evaluation of BP in cats. A quiet, undisturbed environment and adequate time for acclimation should be included in the standard protocol for measurements of BP. Because of day-to-day variation in the white-coat effect in individual cats, multiple serial measurements following a standard protocol should provide the best estimate of BP in cats.     

Giant cell hepatitis in two young cats

A very rare case of the liver lesion characterized by formation of multinucleated giant hepatocytes with inflammatory cell infiltration were observed in two young (1.5 years and 2 years old) cats bearing thymic malignant lymphoma. Histopathological features of this liver lesion were very similar to giant cell hepatitis (GCH) in human neonates and infants. Therefore, the lesion was diagnosed as feline GCH.     

Evaluation of the safety of fenbendazole in cats

OBJECTIVE: To evaluate the safety of fenbendazole in domestic cats. ANIMALS: 28 six- to seven-month old domestic short-hair cats. PROCEDURE: Cats were randomly assigned to 1 of 3 treatment groups or a control group (n = 7/group). Cats in the treatment groups were given fenbendazole at a dosage of 50, 150, or 250 mg/kg, PO, every 24 hours for 9 days; control cats were given a placebo. A fecal examination, coagulation tests, serum biochemical analyses, CBC, and urinalyses were performed before and 5, 9, and 21 days after initiation of treatment; cats were closely monitored for adverse reactions. After the last dose of fenbendazole was given, 4 control cats and 4 cats given fenbendazole at the highest dosage were euthanatized, and necropsies were performed. RESULTS: None of the cats developed any adverse reactions. For cats in the control and all treated groups, laboratory test results were within reference limits, and there were no significant differences in results of laboratory tests among groups. No gross or histologic lesions were identified in the control or treated cats that were euthanatized. CONCLUSIONS AND CLINICAL RELEVANCE: Fenbendazole administered to healthy cats at a dosage 5 times the dosage and 3 times the duration approved for use in dogs and wild felids did not cause any acute or subacute adverse reactions or pathologic changes. Results suggest that cats may be safely treated with fenbendazole.     

Echocardiographic parameters in healthy young adult Sphynx cats

The objective of this retrospective study is to determine normal reference values for 2-Dimension (2D) and Motion-mode (M-mode) echocardiographic parameters in nonsedated healthy young adult Sphynx cats and to compare them to those of the domestic shorthair (DSH). 131 Sphynx cats underwent cardiac screening prior to breeding. The control group consisted of 30 healthy adult domestic cats. A complete cardiac ultrasound was performed on all cats using right parasternal long and short axis views. There were few echocardiographic parameters in the Sphynx that differed from those of the healthy DSH. Only the left atrial (LA) dimension in 2D and M-mode, the left atrial/aortic (LA/Ao) ratio and the internal dimension of the left ventricle in systole (LVIDs) measured with M-mode were different. In conclusion, although the heart of Sphynx cat can often have a particular 2-D echocardiographic appearance, the M-mode cardiac dimensions are similar to those of the DSH.     

Studies on the pharmacokinetics and pharmacodynamics of mirtazapine in healthy young cats

Mirtazapine pharmacokinetics was studied in 10 healthy cats. Blood was collected before, and at intervals up to 72 h after, oral dose of 3.75 mg (high dose: HD) or 1.88 mg (low dose: LD) of mirtazapine. Liquid chromatography coupled to tandem mass spectrometry was used to measure mirtazapine, 8-hydroxymirtazapine and glucuronide metabolite concentrations. Noncompartmental pharmacokinetic modeling was performed. Median half-life was 15.9 h (HD) and 9.2 h (LD). Using Mann-Whitney analysis, a statistically significant difference between the elimination half-life, clearance, area under the curve (AUC) per dose, and AUC(∞) /dose of the groups was found. Mirtazapine does not appear to display linear pharmacokinetics in cats. There was no significant difference in glucuronidated metabolite concentration between groups. Pharmacodynamics was studied in 14 healthy cats administered placebo, LD and HD mirtazapine orally once in a crossover, blinded trial. In comparison with placebo, cats ingested significantly more food when mirtazapine was administered. No difference in food ingestion was seen between HD and LD, but significantly more behavior changes were seen with the HD. Limited serum sampling during the pharmacodynamic study revealed drug exposure comparable with the pharmacokinetic study, but no correlation between exposure and food consumed. Mirtazapine (LD) was administered daily for 6 days with no drug accumulation detected.     

Distinctive peripheral lymph node hyperplasia of young cats

Peripheral lymph node enlargement was found in 14 of a series of 132 feline lymph node biopsy specimens. Six of nine cats tested had antibodies for feline leukemia virus (FeLV). Half of the cats were clinically normal while the remainder had fever, lethargy, anorexia, and hepatosplenomegaly. There was severe distortion of lymph nodal architecture with variable loss of discernible follicles and sinuses. Histiocytes, lymphocytes, immunoblasts, and plasma cells were present in expanded paracortical regions which encroached on, and occasionally effaced, lymphoid follicles. Postcapillary venules were numerous and prominent throughout the paracortex. The lymphadenopathy was most commonly transient (86% of cases) with subsequent development of lymphoma in one cat. Lymph nodes from seven kittens with experimental FeLV infection were compared with spontaneously enlarged lymph nodes; four of seven had B and T lymphocyte hyperplasia with normal nodal architecture. Three had partial loss of nodal architecture as a result of expanded paracortical regions populated largely by histiocytes and lymphocytes. Proliferation of postcapillary venules was not prominent in nodes from FeLV-infected cats. The cause of spontaneous lymph node hyperplasia of young cats was not determined. However, the similarity of lesions to those of kittens with experimental FeLV infection and the association with FeLV by serologic tests in six of nine cats suggest that this retrovirus may be involved in the pathogenesis of the lesion.     

Evaluation of craniotomy in dogs and cats

Over a reporting period of 5 years, craniotomy was performed in 26 dogs and 5 cats with various intracranial lesions. X-ray computed tomography was performed in all animals prior to surgery. Twenty dogs and all cats had intracranial neoplasms; of these, 14 were meningioma, and 11 represented a wide variety of brain tumors and skeletal tumors. Three dogs were treated surgically for traumatic, open-skull fractures with cerebral damage, and 3 underwent biopsy to evaluate chronic inflammatory brain disease. The overall medium survival time was 212 days, the 1-year survival rate was 39%, and the 2-year survival rate was 20%. Dogs and cats with meningioma survived a mean 198 and 485 days, respectively, with 1-year survival rates of 30% for dogs and 50% for cats. The overall median survival time for animals with tumors other than meningeal intracranial neoplasms was 414 days, with a 1-year survival rate of 40%. The death of 19% of all animals could be related to the combination of advanced brain disease and surgery. Because fatality seldom occurred as a direct result of surgery, morbidity and mortality associated with craniotomy in pet animals can be seen as acceptably low. In 29 of 34 craniotomies, dura mater defects were left unsutured and no adverse effects were seen.     

Evaluation of the effects of premedication on gastroduodenoscopy in cats

OBJECTIVE: To evaluate the effects of hydromorphone, hydromorphone and glycopyrrolate, medetomidine, and butorphanol premedication on the difficulty and time required to pass an endoscope into the stomach and duodenum of cats anesthetized with ketamine and isoflurane. DESIGN: Randomized complete block crossover study. ANIMALS: 8 purpose-bred adult female cats. PROCEDURES: Each cat was premedicated and anesthetized 4 times with an interval of at least 7 days between procedures. Cats were premedicated with hydromorphone, hydromorphone and glycopyrrolate, medetomidine, or butorphanol administered IM. Twenty minutes after premedication, sedation was assessed by use of a subjective ordinal scale. Cats received ketamine administered IM, and 10 minutes later a cuffed orotracheal tube was placed and anesthesia maintained with isoflurane. Cats breathed spontaneously throughout the procedure. When end-tidal isoflurane concentration was stable at 1.4% for 15 minutes, endoscopy was begun. The times required to pass the endoscope through the cardiac and pyloric sphincters were recorded, and the difficulty of endoscope passage was scored by use of a subjective ordinal scale. RESULTS: No significant differences in difficulty or time required to pass the endoscope through the cardiac and pyloric sphincters were found among premedicant groups. Premedication with medetomidine resulted in the greatest degree of sedation and longest time to return to sternal recumbency. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that hydromorphone, hydromorphone and glycopyrrolate, medetomidine, and butorphanol at the doses tested can be used satisfactorily to premedicate cats prior to general anesthesia for gastroduodenoscopy.     

Evaluation of coagulation markers in the plasma of healthy cats and cats with asymptomatic hypertrophic cardiomyopathy

BACKGROUND: Thrombosis and arterial thromboembolism are frequent complications of feline cardiomyopathy, especially when associated with left atrial enlargement. Markers of activated coagulation may be used to evaluate the coagulation status of cats with hypertrophic cardiomyopathy (HCM) in relation to left atrial size. OBJECTIVES: The objective of this study was to compare plasma concentrations of thrombin-antithrombin complex (TAT), D-dimer, and fibrin degradation products (FDP) between clinically healthy cats and cats with HCM. Prothrombin time (PT), activated partial thromboplastin time (aPTT), and antithrombin activity were also compared and the association between left atrial (LA) size and coagulation results in cats with HCM was evaluated. METHODS: Blood samples from 19 clinically healthy cats and 20 cats with HCM were obtained. All cats with HCM were asymptomatic and had no signs of heart failure. LA diameter and LA to proximal aortic (Ao) diameter ratio (LA:Ao) were determined by echocardiography. RESULTS: Reference intervals for D-dimer and TAT concentrations in plasma of healthy cats were established as 0.09-0.32 microg/mL and 2.0-20.0 microg/L, respectively. TAT, D-dimer, and FDP concentrations were increased in 5, 3, and 2 cats with HCM, respectively. TAT and D-dimer concentrations, and PT and aPTT were not significantly different between groups. Antithrombin activity was significantly decreased in cats with HCM (P=.03) despite marked range overlap. LA and LA:Ao were not correlated with coagulation results. CONCLUSIONS: Laboratory evidence of hypercoagulability was found in 45% of cats with HCM. Left atrial size was not associated with laboratory evidence of hypercoagulability. Association between coagulation markers and risk of thrombosis has yet to be evaluated in cats with HCM.     

Evaluation of antiplatelet effects of ticlopidine in cats

OBJECTIVE: To determine whether ticlopidine exerts an antiplatelet effect, estimate the pharmacodynamics of ticlopidine, and evaluate any acute adverse effects associated with administration of ticlopidine in cats. ANIMALS: 8 domestic purpose-bred sexually intact male cats. PROCEDURE: Ticlopidine was administered orally (50 mg, q 24 h; 100 mg, q 24 h; 200 mg, q 24 h; and 250 mg, q 12 h). Each treatment period consisted of 10 days of drug administration. Platelet aggregation studies with adenosine diphosphate (ADP) and collagen and evaluation of oral mucosal bleeding times (OMBTs) were performed on days 3, 7, and 10 during each drug administration. Serotonin was measured to evaluate secretion at baseline and on day 10 for cats that received the 250-mg dosage. RESULTS: A significant reduction in platelet aggregation was detected in response to ADP on days 7 and 10 at 100 mg, on day 3 at 200 mg, and on days 3, 7, and 10 at 250 mg. A significant increase in the OMBT and decrease in serotonin release on day 10 at 250 mg was also detected; however, the cats had anorexia and vomiting at the 250-mg dosage. CONCLUSIONS AND CLINICAL RELEVANCE: Although there was a consistent antiplatelet effect at the 250-mg dosage, there was dose-dependent anorexia and vomiting that we conclude precludes the clinical usefulness of this drug in cats.