The use of oral recombinant feline interferon omega in two cats with type II diabetes mellitus and concurrent feline chronic gingivostomatitis syndrome

Feline Chronic Gingivostomatitis Syndrome (FCGS) is a common disease in clinical practice. Among the therapeutic options available, long-acting corticosteroids are frequently used due to their anti-inflammatory and immunosuppressive properties. Although they may improve the clinical symptoms, they can lead to a progressive form of the disease that becomes refractory to treatment. Furthermore, their direct relationship with type II diabetes mellitus (DM) is well known. Consequently, these drugs are controversial and not recommended for routine management of FCGS. Recombinant feline interferon-omega (rFeIFN-ω) is an immunomodulatory compound. Recently, its daily oral administration has been shown to be successful in treating refractory cases of FCGS. This case study describes two clinical cases of type II DM complicated by FCGS. Both animals were calicivirus positive and they had been previously treated with long-acting corticosteroids, which may have been the major cause of DM. The two cats were treated with glargine insulin (Lantus, starting dose 1 IU/cat twice daily (BID)), achieving remission 10 and 18 weeks later respectively. Considering the difficulty with control of FCGS in these animals, an oral daily dose of rFeIFN-ω was started as an alternative to long-acting corticosteroids. In both cats oral clinical signs gradually improved and 60 days after the start of therapy the owners reported a significant relief of pain during mastication. According to the authors’ knowledge, this is the first case report that describes the successful use of rFeIFN-ω in the management of FCGS in type II diabetic cats, in which long-acting corticosteroids are contraindicated.     

Feline immune-based polyarthritis: a study of thirty-one cases

Non-infective polyarthritis in the cat is classified into erosive (feline rheumatoid arthritis and feline periosteal proliferative polyarthritis) and non-erosive (feline systemic lupus erythematosus, feline idiopathic polyarthritis) forms. Criteria are used to identify each group. Clinically, all forms are similar. Affected cats are stiff, unwilling to move and may resent any form of handling. Joints are usually swollen and painful on manipulation. Some cases are pyrexic and inappetent. Radiography demonstrates destructive changes within joints in the erosive forms and also the periosteal new bone, characteristic of the periosteal proliferative form. Soft tissue thickening is also demonstrated. Tests for the autoantibodies rheumatoid factor and antinuclear antibody are important in the diagnosis of rheumatoid arthritis and systemic lupus erythematosus. Treatment is with anti-inflammatory and immunosuppressive agents (prednisolone, cytotoxic drugs). Cats with the rheumatoid and periosteal proliferative types do not recover but some manage to cope with the lameness. Cats with idiopathic polyarthritis can make a complete recovery although cases associated with myeloproliferative disease have a hopeless prognosis.     

Systemic therapies for joint disease in horses.

Systemic therapies for joint disease may be prescribed when a single joint is involved or when multiple sites are affected. The precise therapeutic regimen recommended depends on the duration,cause, and site(s) of injury and is often an adjunct to intra-articular or supportive therapies. If the clinical signs of joint disease are acute and moderate in severity, nonsteroidal anti-inflammatory drugs are often administered to alleviate pain and inflammation.When aiming for more of a generalized maintenance or chondro-protective regimen, an alternative medication, such as hyaluronan,polysulfated glycosaminoglycan, or a nutraceutical will commonly be prescribed.     

Drug therapy in cats: a therapeutic category approach

The third article of this 4-part series discusses drug therapy in cats by therapeutic category. Specifically, the use of drugs to control infections, pain, fever, inflammation, cancer, and selected parasites is described. In addition, the use of hormonally related drugs and selected miscellaneous drugs in cats is addressed. Drugs emphasized are those for which use in cats is frequently associated with adverse reactions or drugs for which use is limited to illnesses that tend to be unique in cats.     

Nonsteroidal anti-inflammatory drugs in cats: a review

OBJECTIVE: To review the evidence regarding the use of nonsteroidal anti-inflammatory drugs (NSAIDs) in cats. DATABASES USED: PubMed, CAB abstracts. CONCLUSIONS: Nonsteroidal anti-inflammatory drugs should be used with caution in cats because of their low capacity for hepatic glucuronidation, which is the major mechanism of metabolism and excretion for this category of drugs. However, the evidence presented supports the short-term use of carprofen, flunixin, ketoprofen, meloxicam and tolfenamic acid as analgesics in cats. There were no data to support the safe chronic use of NSAIDs in cats.     

Long-term safety, efficacy and palatability of oral meloxicam at 0.01-0.03 mg/kg for treatment of osteoarthritic pain in cats

Osteoarthritis is a chronic, painful condition that is now recognised as affecting a large proportion of cats. Non-steroidal anti-inflammatory drugs (NSAIDs) have proven efficacy in dogs and humans but there are limited published data on the use of NSAIDs in the long-term management of this condition in cats. This prospective study aimed to assess the long-term safety and palatability of oral meloxicam and its efficacy in treating osteoarthritic pain in cats when given at a dose of 0.01-0.03 mg/kg once daily. Forty cats diagnosed with osteoarthritis completed the trial with a mean treatment duration of 5.8 months. Gastrointestinal upset in 2/46 (4%) cats was the only adverse effect noted. No deleterious effect on renal function was detected in cats studied. Owners subjectively assessed treatment efficacy as good or excellent in 34/40 (85%) of cases. The results of this study showed oral meloxicam to be safe and palatable long-term treatment for osteoarthritis in cats when given with food at a dose of 0.01-0.03 mg/kg.     

Pharmacology and therapeutics of non-steroidal anti-inflammatory drugs in the dog and cat: 2 Individual agents

The general pharmacology of the non-steroidal anti-inflammatory drugs (NSAIDs) used in dogs and cats has been described in part 1 of this review (Lees and others 1991). This paper outlines the properties of the individual agents as they are used in small animal practice. The NSAIDs which have been used extensively in small animals include the older agents such as Aspirin, cinchophen and phenylbutazone. These agents have previously been used empirically by extrapolation of dosages from other species and by clinical experience. Studies are now available which provide a scientific rationale for the dosage rate recommended. A number of new drugs have recently been licensed for use in the dog or may be licensed in the near future. These include flunixin, carprofen and tolfenamic acid and the data generated from these products provides very useful information for formulating I effective dosage regimens. There are also some NSAIDs such as piroxicam which have been investigated in the dog because they have particular properties which may be of use in common clinical conditions and others, such as Paracetamol and Ibuprofen, which are readily available to the public and which owners may administer to dogs or cats at toxic doses.     

Treatment of proliferative feline eosinophilic keratitis with topical 1.5% cyclosporine: 35 cases

Objective  Proliferative feline eosinophilic keratitis is a chronic keratopathy caused by a suspected immune mediated response to an unknown antigenic stimulus. The purpose of this study is to demonstrate the efficacy of topical 1.5% cyclosporine solution in proliferative feline eosinophilic keratitis.
Methods  Thirty-five cats were treated topically with 1.5% cyclosporine A between 1997 and 2007. Eosinophilic keratitis was diagnosed by clinical appearance and evidence of eosinophils and/or mast cells in corneal cytology. The patients were treated with topical cyclosporine (1.5%) twice (26 of 35, 74.3%) and three times (9 of 35, 25.7%) daily. The minimum period for follow-up was 5 months.
Results  The age of the patients ranged from 2 to 13 years with a mean age of 6.0 years. Twenty-two were neutered males, and 13 were females. The represented breeds were 30 DSH, 3 DLH, one Siamese and one Maine Coon. Cytologic examination of a corneal scrape revealed the presence of eosinophils in 34 of 35 specimens, and mast cells in 25 of 35 specimens. Improvement in the treated eyes was seen in 31 cats (88.6%). Four animals (11.4%) did not respond to the treatment with topical cyclosporine. Recurrences were seen in seven (22.6%) cases. Blepharitis was noted as an infrequent side effect.
Conclusion  Based on our findings, topical cyclosporine (1.5%) is an effective treatment of proliferative feline eosinophilic keratitis in the vast majority of cases. Recurrences were mainly associated with poor owner compliance. Chronic, often lifelong therapy with medications is thus recommended.     

Feline systemic fungal infections.

Systemic fungal diseases are important diagnostic considerations in all sick cats, particularly in cats with ocular symptoms. The most common ocular manifestation of these diseases is posterior uveitis (choroiditis); however, anterior uveitis is sometimes present and is usually secondary to the inflammation in the posterior segment. Occasionally, adnexal diseases such as blepharitis, inflammation of the nictitating membrane, and ocular discharge may be present in cats with systemic mycoses. The prognosis for cats with systemic fungal diseases has changed with the advent of the triazole antifungal drugs. In the past, the prognosis was guarded to poor for survival of the cat. Today, with prolonged antifungal therapy, many cats recover completely from their disease. The prognosis for return of vision for eyes affected with systemic fungal disease is still guarded. Often, even if the infection is controlled systemically, the retina is severely damaged and may remain nonfunctional.     

The use of semiconductor diode laser for deflation and coagulation of anterior uveal cysts in dogs, cats and horses: a report of 20 cases

OBJECTIVE: To describe semiconductor diode laser use for anterior uveal cyst deflation and coagulation in dogs, horses and cats. ANIMALS STUDIED: The presenting clinical signs, surgical technique and postoperative results for four dogs, nine horses and seven cats with anterior uveal cysts treated with diode laser are described. Treated cysts were of sufficient size and/or number to potentially impair vision, damage the corneal endothelium, or increase intraocular pressure (IOP). One dog with free-floating cysts exhibited 'fly biting' behavior. Cysts were suspected of causing shying on the affected side and/or head-shaking behavior in seven horses. Cysts were free floating within the anterior chamber in dogs, occurred in the corpora nigrum in horses and were attached to the posterior iris surface in cats. In cats, shallowing of the anterior chamber and dyscoria were observed. In all cats prior to cyst deflation, IOP increased after pharmacologic pupil dilation. Cats were more likely than dogs and horses to have bilateral and multiple cysts. PROCEDURE: Two dogs and all horses were treated without general anesthesia and two dogs and all cats were treated under general anesthesia. Diode laser was used to perforate, deflate and coagulate the cysts. RESULTS: Postoperatively, all eyes were free of discomfort or significant inflammation and minimal or no topical or systemic anti-inflammatory therapy was required. Abnormal behavior improved or resolved in all cases. In all cats, IOP 24 h after photocoagulation was lower than the postdilation IOP. Cysts did not recur, but new cysts were discovered in several cases. CONCLUSION: Semiconductor diode laser coagulation of anterior uveal cysts is safe, effective and noninvasive.     

FELINE HYPERTHYROIDISM: EFFICACY OF TREATMENT USING VOLUMETRIC ANALYSIS FOR RADIOIODINE DOSE CALCULATION

Hyperthyroidism was diagnosed in 80 cats with thyroid scintigraphy using technetium pertechnetate. These cats were subsequently treated with radioiodine using a modified fixed dose method based on the volume of hyperfunctioning thyroid tissue calculated from the pertechnetate scans. The medical records and thyroid scintigrams were evaluated retrospectively. Follow-up was obtained on the cats to evaluate treatment success. Several parameters were evaluated in an attempt to identify a difference between treatment success and failure. Cats that failed to become euthyroid after one dose of radioiodine had a significantly higher pretreatment serum thyroxine level, had a significantly larger volume of hyperfunctioning thyroid tissue on scintigrams, and cats receiving oral versus intravenous radioiodine were over represented. Based on our results we conclude: 1) the administration of a dose of radioiodine based solely on the volume of hyperfunctioning thyroid tissue as estimated from the pertechnetate scan may be inadequate for those patients with extremely elevated serum thyroxine levels or large thyroid glands, and 2) oral administration of radioiodine is not recommended for the treatment of feline hyperthyroidism.     

In vitro effects and in vivo efficacy of a novel cyclooxygenase-2 inhibitor in cats with lipopolysaccharide-induced pyrexia

OBJECTIVE: To determine cyclooxygenase (COX)-2 selectivity, pharmacokinetic properties, and in vivo efficacy of firocoxib (ML-1,785,713) in cats. ANIMALS: 5 healthy male and 14 healthy female domestic shorthair cats. PROCEDURE: Selectivity of firocoxib for inhibiting COX-2 was determined by comparing the potency for inhibiting COX-1 with that of COX-2 in feline blood. Pharmacokinetic properties were determined after i.v. (2 mg/kg) and oral (3 mg/kg) administration in male cats. In vivo efficacy was evaluated in female cats with lipopolysaccharide (LPS)-induced pyrexia with administration of firocoxib 1 or 14 hours before LPS challenge. RESULTS: Blood concentrations resulting in 50% inhibition of COX-1 and COX-2 activity in vitro were 75 +/- 2 microM and 0.13 +/- 0.03 microM, respectively, and selectivity for inhibiting COX-2 relative to COX-1 was 58. Firocoxib had moderate to high oral bioavailability (54% to 70%), low plasma clearance (4.7 to 5.8 mL/min/kg), and an elimination half-life of 8.7 to 12.2 hours. Firocoxib at doses from 0.75 to 3 mg/kg was efficacious in attenuating fever when administered to cats 1 or 14 hours before LPS challenge. CONCLUSIONS AND CLINICAL RELEVANCE: Firocoxib is a potent COX-2 inhibitor and is the only selective COX-2 inhibitor described for use in cats to date. It is effective in attenuating febrile responses in cats when administered 14 hours before LPS challenge, suggesting it would be suitable for once-a-day dosing. Because selective COX-2 inhibitors have an improved therapeutic index relative to nonselective nonsteroidal anti-inflammatory drugs in humans, firocoxib has the potential to be a safe, effective anti-inflammatory agent for cats.     

Comparison of the in vitro antiproliferative effects of five immunosuppressive drugs on lymphocytes in whole blood from cats

OBJECTIVE: To compare the in vitro immunosuppressive effects of cyclosporine and 4 novel immunosuppressive drugs on lymphocytes in whole blood collected from healthy cats. SAMPLE POPULATION: Whole blood samples collected from 10 healthy adult domestic shorthair cats. PROCEDURE: Mitogen-stimulated lymphocyte proliferation in whole blood incubated with and without various concentrations of cyclosporine, tacrolimus, sirolimus, mycophenolic acid (MPA), or A771726 was measured by use of [3H]thymidine incorporation. Drug concentrations that resulted in a 50% inhibition of mitogen-induced proliferation (IC50) were calculated. Lymphocyte viability was determined by use of the trypan blue dye exclusion method. RESULTS: An obvious dose-response relationship for the antiproliferative effects of each drug was detected. Mean IC50 determined with concanavalin A was 46 nM for cyclosporine, 9 nM for tacrolimus, 12 nM for sirolimus, 16 nM for MPA, and 30 mM for A771726, whereas with pokeweed mitogen, mean IC50 was 33 nM for cyclosporine, 5 nM for tacrolimus, 15 nM for sirolimus, 14 nM for mycophenolic acid, and 25 mM for A771726. Mitogen-stimulated and nonstimulated lymphocytes remained viable, regardless of drug evaluated. CONCLUSIONS AND CLINICAL RELEVANCE: Tacrolimus, sirolimus, MPA, and A771726 inhibited in vitro mitogen-stimulated proliferation of feline lymphocytes in a dose-dependent manner. These novel immunosuppressive drugs may be useful for management of immune-mediated inflammatory diseases and prevention and treatment of rejection in cats that undergo organ transplantation.     

Feline heartworm disease: a clinical review

Feline heartworm disease is caused by the filarial nematode Dirofilaria immitis, and is transmitted by mosquitoes in heartworm-endemic areas worldwide. While dogs are the definitive hosts for this parasite, cats can also be infected, and the overall prevalence in cats is between 5% and 10% of that in dogs in any given area. The spectrum of feline presentations varies from asymptomatic infections to chronic respiratory signs, sometimes accompanied by chronic vomiting to acute death with no premonitory signs. Ante-mortem diagnosis can be challenging and relies on a combination of tests, including antigen and antibody serology, thoracic radiography and echocardiography. As treatment with heartworm adulticidal drugs can be life-threatening and heartworm infection in cats is often self-limiting, infected cats are frequently managed with supportive treatment (corticosteroids, bronchodilators, and anti-emetics). Surgical removal of filariae using extraction devices may be considered in some acute cases where immediate curative treatment is necessary, but filarial breakage during the procedure may result in an acute fatal shock-like reaction. Necropsy findings are mainly pulmonary and include muscular hypertrophy of the pulmonary arteries and arterioles on histopathology. A number of safe and effective macrocytic lactone drugs are available for prophylaxis in cats. These drugs can kill a range of larval and adult life-cycle stage heartworms, which may be advantageous in cases of owner compliance failure or when heartworm infection status is undetermined at the time prophylaxis is commenced. An index of suspicion for feline heartworm disease is warranted in unprotected cats with respiratory signs, and perhaps chronic vomiting, in areas where canine heartworm disease is endemic. Many cats, once diagnosed and with appropriate supportive care and monitoring, will resolve their infection and be free of clinical signs.     

Effect of short-term oral and inhaled corticosteroids on airway inflammation and responsiveness in a feline acute asthma model

The objective of this study was to investigate whether high-dose inhaled fluticasone propionate (FP), alone or in combination with salmeterol (SAL), is as effective as oral prednisolone in reducing airway inflammation and obstruction in cats with experimentally-induced acute asthma. Six cats sensitised to Ascaris suum (AS) were enrolled in a prospective controlled therapeutic trial and underwent four aerosol challenges, at 1-month intervals with AS allergen. The allergen - stimulated animals received four consecutive days treatment with either oral prednisolone at 1mg/kg twice daily, 500 μg of FP inhaled twice daily, or a combination of FP/SAL at 500 μg/50 μg inhaled twice daily, respectively, according to a randomised cross-over design. Treatment-related changes in lung function, airway responsiveness (AR) and bronchoalveolar lavage fluid (BALF) cytology were assessed. Barometric whole-body plethysmography (BWBP) was used for the assessment of respiratory variables and AR. No significant differences in respiratory rate or Penh (an estimate of airflow limitation measured by BWBP) were detected among treatment groups. Allergen-induced airway hyper-responsiveness was significantly inhibited by all three steroid treatments (P<0.05). The mean BALF eosinophil percentage (±SEM) was lower after oral and inhaled corticosteroid treatment and these changes were significant for groups receiving prednisolone and the FP/SAL combination. Findings suggest high-dose FP, particularly in combination with SAL, is effective in ameliorating airway inflammation and hyper-responsiveness in this model of acute feline asthma, and highlight the potential use of these drugs in cats experiencing acute exacerbations of the naturally occurring disease.     

非甾体抗炎药在猫临床疼痛管理中的应用

疼痛是猫常见且多发的问题,诱发原因很多。近几年,随着国内外兽医对宠物猫的慢性疼痛问题以及临床中疼痛管理日益重视,疼痛管理已成为临床兽医必须面对的重要课题之一。非甾体抗炎药因其解热、抗炎和镇痛的特性而逐渐被广泛应用于动物医学。国内有关非甾体类抗炎药在猫临床疼痛管理中的应用少见报道。主要就国外发表的一些关于猫长期使用非甾体抗炎药的相关文献进行综述,以期为非甾体抗炎药在猫临床疼痛管理中的进一步应用提供参考。     

Chronic oral infections of cats and their relationship to persistent oral carriage of feline calici-, immunodeficiency, or leukemia viruses.

Two hundred and twenty-six cats from the Veterinary Medical Teaching Hospital (VMTH), a cat shelter, and a purebred cattery were tested for chronic feline calicivirus (FCV), feline leukemia virus (FeLV) and feline immunodeficiency virus (FIV) infections. Chronic oral carriage of FCV was present in about one-fifth of the cats in each of the groups. FIV infection was not present in the purebred cattery, was moderately prevalent (8%) in the pet population of cats examined at the VMTH for various complaints and was rampant in the cat shelter (21%). Unexpectedly high FeLV infection rates were found in the hospital cat population (28%) and in the purebred cattery (36%), but not in the cat shelter (1.4%). FCV and FeLV infections tended to occur early in life, whereas FIV infections tended to occur in older animals. From 43 to 100% of the cats in these environments had oral cavity disease ranging from mild gingivitis (23-46%), proliferative gingivitis (18-20%), periodontitis (3-32%) and periodontitis with involvement of extra-gingival tissues (7-27%). Cats infected solely with FCV did not have a greater likelihood of oral lesions, or more severe oral disease, than cats that were totally virus free. This was also true for cats infected solely with FeLV, or for cats dually infected with FeLV and FCV. Cats infected solely with FIV appeared to have a greater prevalence of oral cavity infections and their oral cavity disease tended to be more severe than cats without FIV infection. FIV-infected cats that were coinfected with either FCV, or with FCV and FeLV, had the highest prevalence of oral cavity infections and the most severe oral lesions.     

Subclinical airway inflammation despite high-dose oral corticosteroid therapy in cats with lower airway disease

Management of feline chronic lower airway disease focuses on controlling clinical signs and decreasing airway inflammation. This retrospective study evaluated the correlation between the resolution of clinical signs in cats with lower airway disease receiving oral glucocorticoids with the resolution of inflammation based on bronchoalveolar lavage fluid (BALF) cytology. Ten cats diagnosed with lower airway disease based on characteristic clinical signs and inflammatory BALF cytology received oral glucocorticoids for at least 3 weeks. They were required to have resolution of clinical signs and BALF collected while asymptomatic and still receiving glucocorticoids. Cats received prednisolone or prednisone (average dose of 1.8±0.2mg/kg daily) for 35.7±5.5 days. Three cats had resolution of clinical signs and lacked inflammatory BALF cytology; seven had persistent inflammatory BALF cytology despite resolution of clinical signs. Given that subclinical inflammation during high-dose glucocorticoid treatment was common, current recommendations to taper therapy based on resolution of clinical signs should be re-evaluated.