Principles of treatment for vaccine-associated sarcomas

In the last decade, there has been a great deal of information surrounding the etiology, diagnosis, and treatment of feline vaccine-associated sarcomas. The presence of a mass in areas used for subcutaneous or intramuscular injections should alert the clinician to the possibility of a vaccine-associated sarcoma. Early detection and subsequent treatment is paramount to limit local invasion and distant metastasis. The current data are suggesting that a team approach with multi-modality therapy is the appropriate way to address this disease. In the following article, we will discuss the history/incidence, pathology, diagnosis, and current treatment options, which include a combination of surgery, radiation, and chemotherapy for vaccine-associated sarcomas.     

Results of a phase II clinical trial on the use of ifosfamide for treatment of cats with vaccine-associated sarcomas

OBJECTIVE: To determine clinical activity and toxic effects of ifosfamide when used to treat cats with vaccine-associated sarcoma (VAS). ANIMALS: 27 cats with a nonresectable, recurrent, or metastatic VAS. PROCEDURE: Each cat received ifosfamide (900 mg/m(2) of body surface area) as an IV infusion during a 30-minute period. Diuresis by infusion of saline (0.9% NaCl) solution and administration of mesna were used to prevent urothelial toxicosis. Treatments were administered every 3 weeks, and tumor response was assessed after the second treatment. All ifosfamide-associated toxic effects were graded in accordance with predetermined criteria. RESULTS: 61 treatments were administered to 27 cats (median, 2 treatments/cat; range, 1 to 4 treatments/cat). After ifosfamide treatment, 1 cat had a complete response and 10 had partial responses for an overall response rate of 11 of 27 (41%; 95% confidence interval [CI], 25% to 59%). Responses lasted from 21 to 133 days (median, 70 days; 95% CI, 60 to 113 days). The acute dose-limiting toxicosis was neutropenia, which was detected 5 to 28 days (median, 7 days) after treatment. Median nadir neutrophil count was 1,600 cells/muL (range, 200 to 5,382 cells/microL). Nine (33%) cats had adverse gastrointestinal effects (primarily salivation during the ifosfamide infusion and inappetence after treatment). Two cats were euthanatized because of severe nephrotoxicosis, and 1 cat developed pulmonary edema during diuresis. CONCLUSIONS AND CLINICAL RELEVANCE: Ifosfamide has antitumor activity against VAS in cats and is tolerated well by most cats. Ifosfamide should be evaluated as an adjuvant treatment for cats with VAS.     

Temporal occurrence and environmental risk factors associated with cytauxzoonosis in domestic cats

Cytauxzoon felis is a tick-transmitted protozoan parasite of domestic and wild felids in the south-central and southeastern United States. Infection of domestic cats (Felis domesticus) with C. felis is typically acute and characterized by fever, anorexia, listlessness, anemia, icterus and usually death within 19-21 days. To determine the temporal occurrence and environmental risk factors associated with infection of C. felis in domestic cats from Oklahoma, information in the electronic medical records from the Oklahoma Animal Disease Diagnostic Laboratory (OADDL) and Boren Veterinary Medical Teaching Hospital (BVMTH) was retrospectively searched. A total of 232 cytauxzoonosis cases from 1995 to 2006 from OADDL (n=180) and 1998 to 2006 from BVMTH (n=52) were combined and analyzed. The number of cytauxzoonosis cases remained relatively consistent from year to year. Diagnosis of C. felis infection in domestic cats followed a bimodal pattern with a peak in the number of cases in April, May, and June followed by a second smaller peak in August and September. The majority (n=72; 31.0%) of cytauxzoonosis cases were diagnosed in May. No cases of C. felis infection were diagnosed in December and only a few (n=10; 4.3%) cases were observed from November through March during the 12-year period. In cases for which the client's address was available, geographic coordinates were assigned and landscape characteristics were quantified within a 100-m radius of each cytauxzoonosis case location. Of cytauxzoonosis cases (n=41) with a known client address, a majority (n=28; 68.3%) occurred in low density residential areas and more cases (n=8; 19.5%) were found in urban edge habitat than expected at random. Locations of diagnosed cytauxzoonosis cases were significantly associated with more wooded (31.8+/-4.03%) cover and closer (55.5+/-18.45m) proximity to natural or unmanaged areas than randomly selected control sites. Practicing and diagnostic veterinarians can expect to see a distinct temporal pattern in cases of cytauxzoonosis and more cases can be expected in domestic cats living in close proximity to environments that support tick vectors and bobcats.     

Recent advances in the treatment of vaccine-associated sarcomas.

This article reviews the background information about vaccine-associated sarcomas followed by diagnostic procedures essential to understand how to determine the extent of the primary and metastatic tumor as well as to understand the general health of the patient. It also addresses the importance of understanding the nonmedical needs of the client who is faced with this perplexing problem.     

Analysis of prognostic factors associated with injection-site sarcomas in cats: 57 cases (2001-2007)

OBJECTIVE: To identify prognostic factors in cats with injection-site sarcomas (ISSs). DESIGN: Retrospective case series. ANIMALS: 57 cats with ISSs. PROCEDURES: Medical records of cats were reviewed with regard to sex, age, anatomic site of tumor, tumor size, histologic grade, excision of a primary tumor versus excision of a recurrent ISS, use of excision alone versus excision plus adjuvant therapy, local tumor recurrence, and development of distant metastasis to predict overall survival time (ie, time from tumor excision to death). RESULTS: In univariate analyses, local recurrence and development of distant metastasis were significantly associated with survival time in cats. On multivariate analysis, development of distant metastasis remained a significant prognostic factor. Histologic grade was associated with distant metastasis, with cats having grade 3 tumors being significantly more likely to develop metastasis than cats with grade 1 and 2 tumors. Factors associated with local recurrence of ISSs were not identified. CONCLUSIONS AND CLINICAL RELEVANCE: The development of distant metastasis, which may occur later during the course of the disease, was identified as a prognostic factor for overall survival time in cats with ISSs. In addition, cats with histologic grade 3 ISSs should be considered for further interventional studies with chemotherapy to prevent the high rate of distant metastasis.     

Aberrant p53 expression in feline vaccine-associated sarcomas and correlation with prognosis

Eighty spontaneously occurring feline vaccine-associated sarcomas (VAS) were evaluated to determine the immunohistochemical expression of the tumor suppressor gene p53. Sixty-five of 80 VAS (81%) exhibited positive immunoreactivity with Mab240, a murine monoclonal antibody that specifically recognizes mutated p53. Only 44 of 81 tumors (55%) were positive with rabbit polyclonal antibody CM-1. CM-1 often yielded nonspecific staining of nonneoplastic tissues. Nonspecific staining was greatly reduced or absent with Mab240. Cytoplasmic staining for p53 was a consistent pattern of VAS, occurring in 44% of tumors evaluated. Cats with tumors that exhibited cytoplasmic p53 had significantly shorter time to tumor recurrence compared to those cats with tumors that exhibited nuclear p53 staining (P = 0.0284), but no significant difference in survival outcome was observed. Immunohistochemical detection of p53 offers a prognostic tool for VAS, and, because abnormal p53 expression appears to be a common feature of feline VAS, molecular targeting of mutant p53, may offer a promising new therapeutic opportunity for this cancer.     

A case-control study of factors associated with development of clinical disease due to West Nile virus, Saskatchewan 2003

REASON FOR PERFORMING STUDY: West Nile virus (WNV) was first diagnosed in Saskatchewan equids in 2002. AWNV epidemic was considered highly likely for 2003, which would provide a unique opportunity to study all aspects of WNV subclinical infection and clinical disease development in a relatively naive population. HYPOTHESIS: There are individual equid attributes and management risk factors associated with development of clinical disease. Specifically, this study could address the question of vaccine efficacy for the prevention of development of clinical disease. METHODS: A case-control study was conducted in the summer of 2003 during a province-wide outbreak of WNV. Between 5 and 10 equids were sampled from each of 23 case premises with clinical disease and 23 control premises with no apparent or confirmed clinical disease. Data were analysed to identify risk factors for the development of clinical disease. RESULTS: The proportion of equids serologically positive for natural exposure to West Nile virus was 64% (193/300). Nonvaccinated equids were 23 times (95%CI limits 3.0, 168.5, P = 0.002) more likely to develop clinical disease than those vaccinated. The estimate of vaccine efficacy in this field study was 96% (95%CI limits 67%, 99%). CONCLUSIONS: The study demonstrated that vaccination was strongly associated with the prevention of clinical disease. POTENTIAL RELEVANCE: Vaccination is an effective, practical method of prevention of clinical disease.     

Evaluation of risk factors associated with development of postoperative ileus in horses

OBJECTIVE: To determine factors associated with development of postoperative ileus (POI) in horses undergoing surgery for colic. DESIGN: Prospective case-control study. ANIMALS: 251 horses undergoing colic surgery, of which 47 developed POI. PROCEDURE: Signalment, history, clinicopathologic data, pre- and postoperative treatments, lesions, complications, costs, and outcome were recorded for all horses during hospitalization. RESULTS: Variables associated with increased odds of POI included small intestinal lesion, high PCV, and increased duration of anesthesia. There was modest evidence that pelvic flexure enterotomy and intraoperative administration of lidocaine may have reduced the odds of developing POI. CONCLUSIONS AND CLINICAL RELEVANCE: Findings during the preoperative and intraoperative periods can be used to identify horses at increased risk of POI. Reducing surgical and anesthetic duration should decrease the incidence of POI.     

Injection site sarcomas in cats

Feline injection-site sarcomas have mostly been associated with the administration of vaccines. Although the pathogenesis remains largely unknown, it is believed that the inflammatory reaction caused from the injection of the compound leads to uncontrolled proliferation of fibroblasts and myofibroblasts that in a subset of cats undergo malignant transformation. Pretreatment evaluation and proper planning of the therapy are essential. Because of the aggressive nature of these tumors, a multimodality treatment approach is being recommended. A combination of surgery and radiation therapy with or without chemotherapy appears to be providing the best prognosis.     

Prevalence and risk factors for the development of diabetes mellitus in Swedish cats

Background

The prevalence and risk factors for the development of feline diabetes mellitus (FDM) in Swedish cats have not previously been reported. The objective of the present pilot study was to indicate prevalence and possible risk factors for FDM in Swedish cats. Twenty diabetic cats from the database at the University Animal Hospital in Uppsala participated in the study, and these were matched with 20 healthy controls on sex and age. A mail-and-telephone questionnaire focusing on diet, activity and obesity was used.

Results

The prevalence of FDM during the years 2000–2004 based on the results of the hospital records in the present study was 21 per 10,000 cats. The diabetic cats were on average 9 years old when the disease signs were discovered (median, min-max 2–15). Among FDM cases, it was more common to be male (n=17 males vs n=3 females; P≤0.05). Ten out of twenty owners to cases (50%) reported their cats to be obese at the time of the diagnosis (median 9 years, min-max 2–15), as compared to five out of twenty (25%) controls at the same age. The median BW at the time for diagnosis was 5.5 kg (min-max 2.0-9.0) for cases, and 5.0 kg (min-max 3.0-8.0 kg) for controls, respectively. Despite that both cases and controls had the same median age at the time of the study (13 years, min-max 3–18), a significantly higher number of controls were alive at that age (n=16 controls vs 8 cases; P≤0.05). A significantly higher proportion of cases that were obese at the time of the FDM diagnosis were dead at the time of the study compared to the proportion of controls that were obese at a similar age (P≤0.05).The diets given at the time for diagnosis for cases compared to diet of the controls at a similar time were mainly commercial foods, and controls consumed a higher proportion of dry foods compared to cases (medians 79 vs 44% of DM intake/d, respectively; P≤0.05). Cases were less active compared to the controls (2.3 and 3.2 h/d, respectively; P≤0.05).

Conclusions

The results indicate that the proportions of dry foods in the diet, to perform low activity and to be obese could be identified as preliminary risk factors for FDM in Swedish cats, and should be taken into account in preventive measures as well as in the design of future epidemiological studies in this population.     

Environmental risk factors for the development of oral squamous cell carcinoma in cats

BackgroundRisk factors for oral squamous cell carcinoma (OSCC) in cats are derived from a single study dated almost 20 years ago. The relationship between inflammation of oral tissues and OSCC is still unclear.ObjectivesTo investigate previously proposed and novel potential risk factors for OSCC development, including oral inflammatory diseases.AnimalsHundred cats with OSCC, 70 cats with chronic gingivostomatitis (CGS), 63 cats with periodontal disease (PD), and 500 controls.MethodsProspective, observational case‐control study. Cats with OSCC were compared with an age‐matched control sample of client‐owned cats and cats with CGS or PD. Owners of cats completed an anonymous questionnaire including demographic, environmental and lifestyle information.ResultsOn multivariable logistic regression, covariates significantly associated with an increased risk of OSCC were rural environment (OR: 1.77; 95% CI: 1.03‐3.04; P = .04), outdoor access (OR: 1.68; 95% CI: 1.07‐2.63; P = .02), environmental tobacco smoke (OR: 1.77; 95% CI: 1.05‐3; P = .03), and petfood containing chemical additives (OR: 1.98; 95% CI: 1.04‐3.76; P = .04). Risk factors shared with CGS and PD were outdoor access and petfood containing chemical additives, respectively. A history of oral inflammation was reported in 35% of cats with OSCC but did not emerge as a risk factor.Conclusions and Clinical ImportanceThe study proposes novel potential risk factors for OSCC in cats. Although a history of inflammatory oral disease was not significantly more frequent compared with random age‐matched controls, OSCC shared several risk factors with CGS and PD.     

Clinical features and risk factors for development of urinary tract infections in cats

The clinical and diagnostic features of 155 cats with urinary tract infection (UTI) and 186 controls with negative urine culture/s were characterized retrospectively (signalment, clinical signs, urinalysis, urine culture, concurrent diseases, lower urinary tract diagnostic/therapeutic procedures). Multivariable logistic regression was used to identify risk factors associated with UTI. Cats of all ages were affected by UTI with no sex/breed predisposition. Lower urinary tract signs were absent in 35.5% of cats with UTI. Pyuria and bacteriuria had sensitivities of 52.9% and 72.9%, and specificities of 85.5% and 67.7% for detection of UTI, respectively. Risk factors significantly associated with increased odds of UTI were urinary incontinence [odds ratio (OR) = 10.78, P = 0.0331], transurethral procedures (OR = 8.37, P <0.0001), urogenital surgery (OR = 6.03, P = 0.0385), gastrointestinal disease (OR = 2.62, P = 0.0331), decreased body weight (OR = 0.81, P = 0.0259) and decreased urine specific gravity (OR = 0.78, P = 0.0055). Whilst not independently significant, renal disease and lower urinary tract anatomic abnormalities improved statistical model performance and contributed to UTI.     

An abattoir-based case-control study of risk factors for mycobacteriosis in Norwegian swine

An outbreak of mycobacteriosis in swine herds in southwestern Norway from autumn 1986 to 1990 is described. The prevalence of generalised infection in the pigs was higher than usual during the outbreak resulting in the condemnation of 0.3% of the swine carcasses in 1987. A case-control study involving 35 herds (17 herds with more than two tuberculous pigs at slaughter and 18 herds with no evidence of infection at slaughter) showed that an increased risk of infection was linked to combined production with sows and slaughter pigs in the same herd. The presence of birds in the pig house was another contributing risk factor. The standard of the ventilation system, covering of the feed tank, cleaning of the house less frequently than once a year and use of litter were not associated with tuberculous lesions.     

Evaluation of inciting causes, alternative targets, and risk factors associated with redirected aggression in cats

OBJECTIVE: To identify inciting causes, alternative targets, and risk factors associated with redirected aggression in cats. DESIGN: Case-control study. ANIMALS: 19 cats with a history of redirected aggression and 64 cats with no such history. PROCEDURES: Medical records were reviewed to identify cats evaluated for problems with redirected aggression (case cats), in which the primary inciting stimulus and alternative target of aggression were clearly identifiable. Data obtained from the records and from follow-up interviews included details about the cats and incidents of redirected aggression. Owners of control cats were interviewed via telephone to obtain similar information on their cats. RESULTS: 22 incidents of redirected aggression were reported for the 19 case cats. In 95% of those incidents, loud noises or interactions with other cats were identified as the inciting stimuli. Case cats most commonly redirected their aggression toward the owner, followed by another cat living in the same household. Compared with control cats, case cats were more likely to have a sound phobia but were less likely to be outdoor cats. In addition, case cats were more likely to be from small households (相似文献   

A multicenter case-control study of risk factors for equine protozoal myeloencephalitis

OBJECTIVE: To identify risk factors for equine protozoal myeloencephalitis (EPM) among horses examined at 11 equine referral hospitals. DESIGN: Case-control study. ANIMALS: 183 horses with EPM, 297 horses with neurologic disease other than EPM (neurologic controls), and 168 horses with non-neurologic diseases (non-neurologic controls) examined at 11 equine referral hospitals in the United States. PROCEDURES: A study data form was completed for all horses. Data were compared between the case group and each of the control groups by means of bivariate and multivariate polytomous logistic regression. RESULTS: Relative to neurologic control horses, case horses were more likely to be > or = 2 years old and to have a history of cats residing on the premises. Relative to non-neurologic control horses, case horses were more likely to be used for racing or Western performance. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that cats may play a role in the natural epidemiology of EPM, that the disease is less common among horses < 2 years of age relative to other neurologic diseases, and that horses used for particular types of competition may have an increased risk of developing EPM.     

A cross-sectional study of risk factors for obesity in cats in New Zealand

This study was done to identify risk factors for obesity in an urban cat population in New Zealand. A door-to-door survey (conducted within the city limits of Palmerston North) obtained information on the diet, health and behaviour of 202 cats. One hundred and eighty-two of these cats were weighed and their back and leg lengths were measured. The interviewer's assessment of the body condition of each cat was the dependent variable used in this study. Variables that were identified as significant (p< or =0.1) following univariable analysis were grouped into one of the three models for stepwise logistic multiple regression (one each for cat characteristics, environmental and management variables and feeding variables). A combined logistic-regression analysis was performed on the significant variables identified from the three component models. In the combined model, only three variables were significant: the presence of dogs in a household (decreased odds of obesity), longer leg length and owners underestimating cats' body condition (both increased odds).     

Bovine tuberculosis in Northern Ireland: a case-control study of herd risk factors

This paper presents the results of the first formal epidemiological study in Northern Ireland of risk factors for bovine tuberculosis (TB) associated with farm boundaries, neighbours and wildlife. The study was designed as a case-control study and 427 dairy herds were investigated between December 1993 and January 1995. The case herds had more than 30 cattle, and herds in which the source of infection had been ascribed to purchased cattle were avoided. Data on the Department of Agriculture Animal Health Computer were used in conjunction with data collected through a questionnaire to examine a range of possible risk factors, including the number and nature of the farm boundaries, the number of neighbours and their TB history, the number of hedgerows, the presence of badger setts, whether badger carcases had been found on the land, and the possible presence of deer. A follow-up telephone survey was conducted to minimise bias. The results highlighted two main associations with TB breakdowns, the presence of badgers, and contiguous neighbours who had had confirmed TB breakdowns. The estimated aetiological fraction for both associations was approximately 40 per cent, suggesting that although infected cattle may have a significant role in the transmission of TB their importance relative to the badger may have been over-estimated in the Northern Ireland TB scheme. The contribution of the badger is possibly one of several main reasons for the lack of significant progress in TB eradication despite strenuous efforts associated with all aspects of the scheme.