Use of Total Parenteral Nutrition in Dogs: 209 Cases (1988-1995)

The medical records of 209 dogs receivingtotal parenteral nutrition (TPN) over a 84-month period were examined retrospectively to determine patient profiles, frequency and type of complications, and prognostic factors affecting clinical outcome. TPN administration accounted for 895 patient days. Dogs with diarrhea or vomiting associated with gastrointestinal disease, pancreatitis, or renal failure constituted the largest proportion of patient receiving TPN. The median duration of TPN administration was 3.5 days (range 0.05 to 25 days). The median length of hospitalization before initiation of TPN was 1.5 days (range 0.05 days to 15 days). and this durationwas not associated with survival. Metabolic complications were frequent (329 of 473 complications observed) and were due predominantly to hyperglycemia. Mechanical (118 of 473) and septic (26 of 473) complications occurred less commonly. The overall mortality rate for dogs receiving TPN was 48.8%. Our conclusion: TPN can be a beneficial mode of therapy for carefully selected dogs that have impaired gastrointestinal function (parvovirus, pancreatitis, or inflammatory bowel disease) and are expected to be anorectic for morethan 5 days.     

A Retrospective Study of the Use of Total Parenteral Nutrition in Dogs and Cats

The records of all dogs and cats receiving total parenteral nutrition (TPN) over a 43-month period were examined retrospectively. Dextrose, amino acids, lipids, electrolytes, and vitamins were administered by central venous catheter according to published nutrient recommendations; 72 dogs and 12 cats were studied, accounting for 380 patient days of TPN. Duration of TPN administration was 1–14 days with a mean of 4.5 days. Most animals required TPN because of gastrointestinal dysfunction, and more than half of them gained weight during TPN administration. Mechanical complications were frequent. Metabolic complications, especially lipid and glucose intolerance, were also commonly seen. Septic complications were the least frequently encountered, but resulted in patient morbidity and may have contributed to mortality. Most animals receiving TPN were returned to enteral nutrition and discharged. For critically ill animals unable to tolerate enteral alimentation, TPN can be supportive therapy in the treatment of the primary disease.     

Antiplatelet effects and pharmacodynamics of clopidogrel in cats

OBJECTIVE: To evaluate antiplatelet effects and pharmacodynamics of clopidogrel in cats. DESIGN: Original study. ANIMALS: 5 purpose-bred domestic cats. PROCEDURE: Clopidogrel was administered at dosages of 75 mg, p.o., every 24 hours for 10 days; 37.5 mg, p.o., every 24 hours for 10 days; and 18.75 mg, p.o., every 24 hours for 7 days. In all cats, treatments were administered in this order, with at least 2 weeks between treatments. Platelet aggregation in response to ADP and collagen and oral mucosal bleeding times (OMBTs) were measured before and 3, 7, and 10 days (75 and 37.5 mg) or 7 days (18.75 mg) after initiation of drug administration. Serotonin concentration in plasma following stimulation of platelets with ADP or collagen was measured before and on the last day of drug administration. Platelet aggregation, OMBT, and serotonin concentration were evaluated at various times after drug administration was discontinued to determine when drug effects were lost. RESULTS: For all 3 dosages, platelet aggregation in response to ADP platelet aggregation in response to collagen, and serotonin concentration were significantly reduced and OMBT was significantly increased at all measurement times during drug administration periods. All values returned to baseline values by 7 days after drug administration was discontinued. No significant differences were identified between doses. None of the cats developed adverse effects associated with drug administration. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that administration of clopidogrel at dosages ranging from 18.75 to 75 mg, p.o., every 24 hours, results in significant antiplatelet effects in cats.     

Relationship between hydration estimate and body weight change after fluid therapy in critically ill dogs and cats

Objective: To characterize the relationship between clinical estimates of hydration in dogs and cats admitted to an intensive care unit (ICU) and changes in their body weight following 24–48 hours of fluid therapy. Design: Outcome study. Setting: ICU at a veterinary teaching hospital (VTH). Animals: A total of 151 dogs and 42 cats with various medical disorders that had not had surgery within 48 hours of admission into the ICU were consecutively admitted into the study. Animals with any condition predisposing to excess fluid loss or retention were excluded: heart disease, sepsis, trauma, pancreatitis, pleural or pericardial effusion, ascites, and pathologic oliguria. Animals that acquired any of the following during the observation period were excluded: gastrointestinal fluid loss, edema or diseases predisposing to edema, oliguria, diuretic therapy, and body fluid drainage or hemorrhage. Fluid therapy was ordered based on estimate of hydration at admission. Other treatments were not modified or withheld. Interventions: Physiologic data were collected at the time of admission and 24–48 hours later. Measurements and main results: Hydration was estimated on admission to the ICU using clinical judgement with no supporting laboratory data. Each admitting clinician used this estimate to plan fluid therapy. Fluid therapy was defined as the administration of any enteral or parenteral fluids as well as any decision to withhold fluids. Paired measurements taken on admission and at 24–48 hours included packed cell volume (PCV), total plasma solids (TS), and body weight. Amount and type of fluids or blood products administered were noted. Neither clinician estimates of dehydration nor baseline PCV or TS predicted clinically significant changes in body weight following fluid therapy, and there was no relationship between weight change and changes in PCV or TS. Conclusions: A clinical diagnosis of dehydration in our ICU does not predict weight gain following fluid therapy. Neither baseline PCV/TS nor changes in these measurements following 24–48 hours of fluid therapy predicted changes in body weight.     

Nutritional Support In Pancreatitis: A Retrospective Study

The medical records of animals with pancreatitis that received nutritional support were evaluated. Over a five year period (1989–1994), 16 patients with pancreatitis (14 dogs and 2 cats) received nutritional support. Affected animals commonly exhibited vomiting, diarrhea, and weight loss, as well as multiple clinicopathological abnormalities.
Total parenteral nutrition (TPN) was used in 13 of the cases, while two animals received partial parenteral nutrition (PPN), and one was fed through a jejunostomy tube. The duration of nutritional support ranged from one to 13 days, with a mean of 6.6 days. Three of the animals receiving TPN had complications resulting from the nutritional support, including hyperglycemia, hyperammonemia, and hyperlipidemia. The survival rate for all 16 cases was 56% (9 of 16).
A variety of nutritional support techniques can be successfully used in animals with pancreatitis and are associated with few complications, most of which can be managed with adjustments in treatment regimen.     

Retrospective Study of Streptokinase Administration in 46 Cats with Arterial Thromboembolism

A retrospective evaluation was performed on 46 cats with arterial thromboembolism (ATE) that were treated with streptokinase (SK). Significant heart disease was diagnosed in 45/46 cats, and 21/46 cats had congestive heart failure. Variable dosing schemes of streptokinase were administered within 1–20 hours following the onset of clinical signs (median = 5.5 hours). There was no difference between survivors (S) and non-survivors (NS), based on time of administration of SK after onset of clinical signs. Twenty-five (54%) of the cats had return of pulses within 2–24 hours of treatment. Fourteen (30%) of the cats had return of motor function between 9 hours and 6 days. Fifteen of the cats (33%) were discharged from the hospital, 18 (39%) died in the hospital, and 13 (28%) cats were euthanized due to complications or poor response to treatment. Four of 5 cats (80%) with single limb dysfunction survived to hospital discharge. Life threatening hyperkalemia was diagnosed in 16 cats (35%) after SK administration. Hyperkalemia was more likely to occur with the longer duration of SK infusion. Eleven cats (24%) developed clinical signs of bleeding following SK administration and 3 of these cats required a blood transfusion. Laboratory testing documented coagulopathy following SK administration in 11 out of 17 cats tested. Hypothermia and azotemia prior to SK administration and the development of hyperkalemia were negatively associated with survival.     

Retrospective evaluation of parenteral nutrition in alpacas: 22 cases (2002-2008)

Background: Parenteral nutrition is an important method of nutritional support in hospitalized animals, but minimal information has been published on its use in camelids. Hypothesis/Objectives: The purpose of this study was to characterize the use of total parenteral nutrition (TPN) in alpacas, evaluate the formulations used, and determine potential complications. Animals: Twenty‐two alpacas hospitalized at the Tufts Cummings School for Veterinary Medicine (site 1: n = 8) and the Ohio State University Veterinary Teaching Hospital (site 2: n = 14). Methods: A retrospective analysis of all alpacas that received TPN between 2002 and 2008 was performed to assess clinical indications, clinical and clinicopathologic data, and outcome. Results: The most common underlying diseases in animals receiving TPN were gastrointestinal dysfunction (n = 16), hepatic disease (n = 2), and neoplasia (n = 2). Several metabolic abnormalities were identified in animals (n = 20/22) before TPN was initiated, including lipemia (n = 12/22), hyperglycemia (11/22), and hypokalemia (n = 11/22). Median age was significantly lower for site 1 cases (0.1 years; range, 0.01–11.0) compared with those from site 2 (4.9 years; range, 0.1–13.7; P= .03). Animals at site 2 also had a longer duration of hospitalization (P= .01) and TPN administration (P= .004), as well as higher survival rate (P < .02). Twenty‐one of 22 alpacas developed at least 1 complication during TPN administration. Metabolic complications were most prevalent (n = 21/22) and included hyperglycemia (n = 8/21), lipemia (n = 7/21), hypokalemia (n = 3/21), and refeeding syndrome (n = 3/21). Conclusions and Clinical Importance: TPN is a feasible method of nutritional support for alpacas when enteral feeding is not possible. Prospective studies are warranted to determine optimal TPN formulations for alpacas.     

Rebound hyperglycemia following overdosing of insulin in cats with diabetes mellitus

Posthypoglycemic hyperglycemia (rebound hyperglycemia) after overdosing of insulin was diagnosed in 6 cats with diabetes mellitus. Administration of excessive insulin induced hypoglycemia within 4 to 8 hours, followed by rebound hyperglycemia. Diagnosis was made by serial blood glucose determinations during a 20- to 24-hour period after insulin administration. Four cats had a history of difficulty in regulating the diabetic state. In 2 cats, rebound hyperglycemia was diagnosed on routine serial blood glucose determinations. All of the cats were hyperglycemic for most of the day. Rebound hyperglycemia was observed with both intermediate (neutral protamine hagedorn) and long-acting (protamine zinc iletin) insulins, and the range of insulin doses at which the disorder developed overlapped previously determined therapeutic doses for these insulins in the cat. Urine glucose and single afternoon blood glucose determinations were inadequate and potentially misleading in monitoring diabetic cats receiving excessive amounts of insulin.     

Comparison of pharmacokinetics of fentanyl after intravenous and transdermal administration in cats

OBJECTIVE: To compare pharmacokinetic and pharmacodynamic characteristics of fentanyl citrate after IV or transdermal administration in cats. ANIMALS: 6 healthy adult cats with a mean weight of 3.78 kg. PROCEDURE: Each cat was given fentanyl IV (25 mg/cat; mean +/- SD dosage, 7.19 +/- 1.17 mg/kg of body weight) and via a transdermal patch (25 microg of fentanyl/h). Plasma concentrations of fentanyl were measured by use of radioimmunoassay. Pharmacokinetic analyses of plasma drug concentrations were conducted, using an automated curve-stripping process followed by nonlinear, least-squares regression. Transdermal delivery of drug was calculated by use of IV pharmacokinetic data. RESULTS: Plasma concentrations of fentanyl given IV decreased rapidly (mean elimination half-life, 2.35 +/- 0.57 hours). Mean +/- SEM calculated rate of transdermal delivery of fentanyl was 8.48 +/- 1.7 mg/h (< 36% of the theoretical 25 mg/h). Median steady-state concentration of fentanyl 12 to 100 hours after application of the transdermal patch was 1.58 ng/ml. Plasma concentrations of fentanyl < 1.0 ng/ml were detected in 4 of 6 cats 12 hours after patch application, 5 of 6 cats 18 and 24 hours after application, and 6 of 6 cats 36 hours after application. CONCLUSIONS AND CLINICAL RELEVANCE: In cats, transdermal administration provides sustained plasma concentrations of fentanyl citrate throughout a 5-day period. Variation of plasma drug concentrations with transdermal absorption for each cat was pronounced. Transdermal administration of fentanyl has potential for use in cats for long-term control of pain after surgery or chronic pain associated with cancer.     

Hepatotoxicity of stanozolol in cats

OBJECTIVE: To determine hepatotoxicity of stanozolol in cats and to identify clinicopathologic and histopathologic abnormalities in cats with stanozolol-induced hepatotoxicosis. DESIGN: Clinical trial and case series. ANIMALS: 12 healthy cats, 6 cats with chronic renal failure, and 3 cats with gingivitis and stomatitis. PROCEDURES: Healthy cats and cats with renal failure were treated with stanozolol (25 mg, i.m., on the first day, then 2 mg, p.o., q 12 h) for 4 weeks. Cats with gingivitis were treated with stanozolol at a dosage of 1 mg, p.o., every 24 hours. RESULTS: Most healthy cats and cats with renal failure developed marked inappetence, groomed less, and were less active within 7 to 10 days after initiation of stanozolol administration. Serum alanine transaminase (ALT) activity was significantly increased in 14 of 18 cats after stanozolol administration, but serum alkaline phosphatase activity was mildly increased in only 3. Four cats with serum ALT activity > 1,000 U/L after only 2 weeks of stanozolol administration had coagulopathies; administration of vitamin K resolved the coagulopathy in 3 of the 4 within 48 hours. All 18 cats survived, and hepatic enzyme activities were normal in all cats tested more than 4 weeks after stanozolol administration was discontinued. Two of the 3 cats with gingivitis developed evidence of severe hepatic failure 2 to 3 months after initiation of stanozolol treatment; both cats developed coagulopathies. Histologic evaluation of hepatic biopsy specimens from 5 cats revealed diffuse hepatic lipidosis and cholestasis without evidence of hepatocellular necrosis. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that stanozolol is hepatotoxic in cats.     

Use of a nonionic detergent (Triton WR 1339) in healthy cats to assess hepatic secretion of triglyceride

OBJECTIVE: To determine whether a nonionic detergent (Triton WR 1339) can be used in cats to assess hepatic secretion of triglyceride. ANIMALS: 28 healthy cats. PROCEDURE: Triton WR 1339 was administered IV according to the following schedule: 5, 50, 150, and 250 mg/kg of body weight. Control cats did not receive an injection or received 0.9% NaCl or PBS solutions at the same osmolarity and volume as the 250 mg/kg group. Blood samples were collected throughout the 48-hour period after administration for determination of triglyceride and cholesterol concentrations and for RBC morphology and osmotic fragility studies. RESULTS: Administration of Triton WR 1339 at 150 and 250 mg/kg caused profound hypertriglyceridemia. Triglyceride concentrations increased in a curvilinear fashion for the first 2 hours and remained increased for approximately 24 hours. Area under the time-concentration curve for triglyceride at 5 hours differed significantly among groups. At 12 and 24 hours, cholesterol was significantly higher in cats receiving 250 mg/kg. The most dramatic changes in osmotic fragility and RBC morphology were in cats receiving 250 mg/kg; 1 of these cats developed severe icterus and died 5 days later. Feeding rice and casein before administering Triton WR 1339 at 150 mg/kg did not appear to affect the hypertriglyceridemia response. CONCLUSIONS AND CLINICAL RELEVANCE: Triton WR 1339 can be administered IV to cats at a rate of 150 mg/kg to assess hepatic triglyceride secretion, although some cats may have increased RBC osmotic fragility. Higher dosages caused substantial adverse effects, whereas lower dosages did not alter plasma triglyceride concentration.     

Efficacy of oral supplementation with L-lysine in cats latently infected with feline herpesvirus

OBJECTIVE: To examine the effects of orally administered L-lysine on clinical signs of feline herpesvirus type 1 (FHV-1) infection and ocular shedding of FHV-1 in latently infected cats. ANIMALS: 14 young adult, FHV-1-naive cats. PROCEDURE: Five months after primary conjunctival inoculation with FHV-1, cats were rehoused and assigned to receive 400 mg of L-lysine in food once daily for 30 days or food only. On day 15, all cats received methylprednisolone to induce viral reactivation. Clinical signs of infection were graded, and viral shedding was assessed by a polymerase chain reaction assay throughout our study. Peak and trough plasma amino acid concentrations were assessed on day 30. RESULTS: Fewer cats and eyes were affected by conjunctivitis, and onset of clinical signs of infection was delayed on average by 7 days in cats receiving L-lysine, compared with cats in the control group; however, significant differences between groups were not demonstrated. Significantly fewer viral shedding episodes were identified in the treatment group cats, compared with the control group cats, after rehousing but not following corticosteroid-induced viral reactivation. Mean plasma L-lysine concentration was significantly increased at 3 hours but not at 24 hours after L-lysine administration. Plasma arginine concentration was not significantly altered. CONCLUSIONS AND CLINICAL RELEVANCE: Once daily oral administration of 400 mg of L-lysine to cats latently infected with FHV-1 was associated with reduced viral shedding following changes in housing and husbandry but not following corticosteroid administration. This dose caused a significant but short-term increase in plasma L-lysine concentration without altering plasma arginine concentration or inducing adverse clinical effects.     

Evaluation of extended-release diltiazem once daily for cats with hypertrophic cardiomyopathy

Serum diltiazem concentrations were evaluated following either 30 mg or 60 mg of an extended-release diltiazem administered orally once daily to 13 cats. Sequential blood samples were obtained over 24 hours. Both dosages usually resulted in elevated serum concentrations of >200 ng/mL at 6, 12, 18, and 24 hours. The 30-mg dosage was sometimes associated with low serum concentrations of <50 ng/mL at 18 and 24 hours. The 60-mg dosage (9.3 to 14.8 mg/kg) was associated with lethargy, gastrointestinal disturbances, and weight loss in nine (36%) of 25 client-owned cats. Gastrointestinal disturbances were recognized within 1 week, and weight loss was detected after 2 to 6 months of treatment.     

Hemodynamic effects of methylprednisolone acetate administration in cats

OBJECTIVE: To investigate the mechanisms by which corticosteroid administration may predispose cats to congestive heart failure (CHF). ANIMALS: 12 cats receiving methylprednisolone acetate (MPA) for the treatment of dermatologic disorders. PROCEDURE: The study was conducted as a repeated-measures design. Various baseline variables were measured, after which MPA (5 mg/kg, IM) was administered. The same variables were then measured at 3 to 6 days and at 16 to 24 days after MPA administration. Evaluations included physical examination, systolic blood pressure measurement, hematologic analysis, serum biochemical analysis, thoracic radiography, echocardiography, and total body water and plasma volume determination. RESULTS: MPA resulted in a substantial increase in serum glucose concentration at 3 to 6 days after administration. Concurrently, RBC count, Hct, and hemoglobin concentration as well as serum concentrations of the major extracellular electrolytes, sodium and chloride, decreased. Plasma volume increased by 13.4% (> 40% in 3 cats), whereas total body water and body weight slightly decreased. All variables returned to baseline by 16 to 24 days after MPA administration. CONCLUSIONS AND CLINICAL RELEVANCE: These data suggest that MPA administration in cats causes plasma volume expansion as a result of an intra to extracellular fluid shift secondary to glucocorticoid-mediated extracellular hyperglycemia. This mechanism is analogous to the plasma volume expansion that accompanies uncontrolled diabetes mellitus in humans. Any cardiovascular disorders that impair the normal compensatory mechanisms for increased plasma volume may predispose cats to CHF following MPA administration.     

Diuretic effects of fenoldopam in healthy cats

Objective: To determine the effect of fenoldopam infusion on urine output, sodium excretion, creatinine clearance, and indirect blood pressure in healthy cats. Design: Prospective study. Setting: Veterinary medical teaching hospital. Animals: Eight purpose‐bred cats, 2–4 years old. Interventions: None. Measurements: Urine output was measured hourly for 12 hours before and after fenoldopam administration. Sodium excretion, modified creatinine clearance, and fractional sodium excretion were measured before and following fenoldopam administration. Urine specific gravity, central venous pressure, and systolic blood pressure were measured every 4 hours during the experiment. Main results: Compared with pre‐infusion values, urine output, sodium excretion, and fractional excretion of sodium increased significantly 6 hours after initiation of fenoldopam infusion. This increase was sustained throughout the observation period. The modified creatinine clearance decreased significantly following 2 hours of fenoldopam infusion, but increased significantly by 6 hours after infusion, the time of peak urine output. Changes in urine specific gravity mirrored changes in fractional sodium excretion, whereas the central venous pressure mirrored changes in modified creatinine clearance. The diuretic effect in cats was prevented when a dopamine receptor blocking agent was administered before fenoldopam infusion. Conclusion: Fenoldopam at a dose of 0.5 μg/kg/min induces diuresis in cats in a delayed manner. This increase appears to be due, in part, to dopamine receptor‐induced natriuresis. Changes in glomerular filtration rate may also occur.     

Retrospective evaluation of partial parenteral nutrition in dogs and cats

The purpose of this retrospective study was to evaluate the use of partial parenteral nutrition (PPN) in dogs and cats. The medical records of all dogs and cats receiving PPN between 1994 and 1999 were reviewed to determine signalment, reasons for use of PPN, duration of PPN administration, duration of hospitalization, complications, and mortality. Complications were classified as metabolic, mechanical, or septic. One hundred twenty-seven animals (80 dogs and 47 cats) were included in the study, accounting for 443 patient days of PPN. The most common underlying diseases were pancreatitis (n = 41), gastrointestinal disease (n = 33), and hepatic disease (n = 23). Median time of hospitalization before initiation of PPN was 2.8 days (range, 0.2-10.7 days). Median duration of PPN administration was 3.0 days (range, 0.3-8.8 days). Median duration of hospitalization was 7 days (range, 2-20 days). In the 127 animals receiving PPN, 72 complications occurred. These included metabolic (n = 43), mechanical (n = 25), and septic (n = 4) complications. The most common metabolic complication was hyperglycemia (n = 19), followed by lipemia (n = 17) and hyperbilirubinemia (n = 6). Most complications were mild and did not require discontinuation of PPN. Ninety-three (73.2%) of the 127 patients were discharged. All 4 animals with septic complications were discharged from the hospital. The presence, type, and number of complications did not impact the duration of hospitalization or outcome. However, animals that received supplemental enteral nutrition survived more often than those receiving PPN exclusively. Although PPN seems to be a relatively safe method of providing nutritional support, future studies are warranted to determine its efficacy.     

Serial blood lactate concentrations in systemically ill dogs

BACKGROUND: Lactate concentration often is quantified in systemically ill dogs and interpreted based on human data. To our knowledge, there are no published clinical studies evaluating serial lactate concentrations as a prognostic indicator in ill dogs. OBJECTIVES: Our objective was to perform a prospective study, using multivariate analysis, to determine whether serial lactate concentrations were associated with outcome in ill dogs requiring intravenous fluids. METHODS: Eighty sick dogs had lactate concentrations evaluated, using an analyzer that measures lactate in the plasma fraction of heparinized whole blood, at 0 hours and 6 hours after initiation of treatment. Severity of illness and outcome (survivor, nonsurvivor) were determined by reviewing the patient's record 2 weeks after admission. Lactate concentrations, age, body weight, gender, and severity of illness were evaluated using multivariate analysis to determine their effects on outcome. RESULTS: Dogs with lactate concentrations greater than the reference interval at 6 hours were 16 times (95% confidence interval = 2.32-112.71 times, P <.01) more likely not to survive compared to dogs with lactate concentrations within the reference interval. Lactate concentrations above the reference interval at 0 hours were not significantly related to outcome. However, hyperlactatemia that did not improve by > or = 50% within 6 hours was significantly associated with mortality (P = .024). CONCLUSION: Dogs with a lactate concentration higher than the reference interval at 6 hours were more likely not to survive. These results indicate an association between lactate concentration and outcome and emphasize the importance of serial lactate concentrations in evaluating prognosis.     

Clinical outcome and diseases associated with extreme neutrophilic leukocytosis in cats: 104 cases (1991-1999)

OBJECTIVE: To describe diseases, prognosis, and clinical outcomes associated with extreme neutrophilic leukocytosis in cats. DESIGN: Retrospective study. ANIMALS: 104 cats with extreme neutrophilic leukocytosis. PROCEDURE: Medical records from 1991 to 1999 were examined to identify cats that had > or =50,000 WBC/microl with > or =50% neutrophils. Signalment, absolute and differential WBC counts, rectal temperature, clinical or pathologic diagnosis, duration and cost of hospitalization, and survival time were reviewed. RESULTS: Mean age of cats was 8.3 years, mean WBC count was 73,055 cells/microl, and mean absolute neutrophil count was 59,046 cells/microl. Mean duration of hospitalization was 5.9 days, and mean cost of hospitalization was $2,010. Twenty-nine (28%) cats were febrile, and 63 (61%) cats died. Overall median survival time was 30 days. Cats with neoplasia were nearly 14 times as likely to die unexpectedly as cats with other diseases. CONCLUSIONS AND CLINICAL RELEVANCE: Extreme neutrophilic leukocytosis was associated with a high mortality rate. The prognostic importance of extreme neutrophilic leukocytosis should not be overlooked. Cats and dogs have similar diseases, mortality rates, and treatment costs associated with extreme neutrophilic leukocytosis.     

Comparison of serum fructosamine and blood glycosylated hemoglobin concentrations for assessment of glycemic control in cats with diabetes mellitus.

OBJECTIVE: To correlate serum fructosamine concentrations with established measures of glycemic control and to compare serum fructosamine and blood glycosylated hemoglobin (GHb) concentrations as a means for assessing glycemic control in diabetic cats. DESIGN: Longitudinal cohort study. ANIMALS: 26 healthy cats, 5 cats with stress-induced hyperglycemia, 15 untreated diabetic cats, and 36 treated diabetic cats. PROCEDURE: Control of glycemia was classified and monitored and serum fructosamine and blood GHb concentrations were measured for 12 poorly controlled diabetic cats before and after improving glycemic control, 8 well-controlled treated diabetic cats before and after glycemic control deteriorated, and 5 cats with diabetes mellitus before and after onset of stress-induced hyperglycemia. RESULTS: Mean serum fructosamine and blood GHb concentrations were significantly higher in untreated diabetic cats, compared with healthy cats, and in 24 poorly controlled diabetic cats, compared with 12 well-controlled diabetic cats. Mean serum fructosamine and blood GHb concentrations decreased significantly in 12 poorly controlled diabetic cats after improving glycemic control and increased significantly in 8 well-controlled diabetic cats after glycemic control deteriorated. A significant stress-induced increase in mean blood glucose concentration was evident 12 hours after insulin administration, but not in 5 docile diabetic cats that became fractious. CLINICAL IMPLICATIONS: Serum fructosamine and blood GHb concentrations are clinically useful tools for monitoring control of glycemia in cats with diabetes mellitus.