Evaluation of a Therapeutic Diet for Feline Degenerative Joint Disease

Background: Feline degenerative joint disease (DJD) is common and there are no approved therapies for the alleviation of the associated pain. Objective: To test a diet high in eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) content and supplemented with green‐lipped mussel extract and glucosamine/chondroitin sulfate (test‐diet) for its pain‐relieving and activity‐enhancing effects in cats with painful, mobility‐impairing DJD over a 9‐week period. Animals: Forty client‐owned cats. Methods: Randomized, controlled, blinded, parallel group, prospective clinical study. Cats with no detectable systemic disease, and with at least 1 appendicular joint with radiographic evidence of DJD where manipulation elicited an aversive response were included. Cats were randomly allocated to the test‐diet or control diet (C‐diet). Outcome measures were subjective owner and veterinarian assessments, and objective activity monitoring (accelerometry). Nonparametric statistics were used to evaluate changes within and between groups for both subjective and objective data, and locally weighted scatterplot smoothing regression analysis was used to predict activity changes. Results: The primary objective outcome measures indicated that activity declined significantly (P < .001) in the C‐diet group, significantly increased (P < .001) in the test‐diet group and there was a significant difference between the groups (P < .001). Conclusion and Clinical Importance: A diet high in EPA and DHA and supplemented with green‐lipped mussel extract and glucosamine/chondroitin sulfate improved objective measures of mobility. Dietary modulation might be 1 method to use to improve mobility in cats with DJD‐associated pain.     

Feline Degenerative Joint Disease

Objective: To critically review and collate published information on feline degenerative joint disease (DJD) and identify areas in which information is lacking.
Study Design: Critical literature review.
Methods: Literature search through Pub Med, Commonwealth Agricultural Bureau Abstracts published in the English Language, or translated into English (January 1940–August 2008).
Results: Although there are no prospective studies, the prevalence of radiographic DJD appears to be high and can be associated with clinical signs of decreased mobility. There appears to be a mismatch between radiographic and clinical examination findings (pain response). There is little information on the cause of DJD in different joints. There are no fully validated subjective or objective assessment systems for the measurement of chronic DJD-associated pain in the cat. Development of a feline model of chronic DJD-associated pain may speed the development and evaluation of candidate pain-alleviating compounds and treatments.
Conclusions: The high prevalence of feline DJD and lack of information about it, suggests further investigation is needed.
Clinical Relevance: Feline DJD occurs with high frequency, and yet there is little to guide the clinician on prevention or treatment.     

Thromboelastographic Evaluation of Dogs with Acute Liver Disease

Background

Given the liver''s pivotal role in hemostasis and fibrinolysis, the coagulopathy accompanying hepatic disease is complex.

Hypothesis/Objectives

To prospectively evaluate kaolin‐activated thromboelastography (TEG) in dogs with acute liver disease (ALD) and compare with plasma‐based coagulation tests.

Animals

Twenty‐one dogs with a diagnosis of ALD based on recent onset of clinical signs accompanied by increases in serum bilirubin concentration and alanine aminotransferase activity.

Methods

Clinical presentation, CBC, serum biochemistry, platelet count, prothrombin time (PT), activated partial thromboplastin time (aPTT), and TEG analysis were evaluated in 21 dogs with a subset also having fibrinogen, antithrombin (AT) activity, protein C (PC) activity, d‐dimers, and von Willebrand''s factor (vWF) activity analyzed. A PT >1.5 times the upper limit of normal defined acute liver failure (ALF).

Results

Dogs with ALD had mean increases in R, K, LY30, PT, aPTT, and vWF activity, and decreases in angle, maximal amplitude (MA), G, AT activity, and PC activity. The TEG results defined dogs as hypocoagulable (11/21), normocoagulable (8/21), or hypercoagulable (2/21). Increases in LY30 defined 8/21 dogs as hyperfibrinolytic. Hypocoagulable and hyperfibrinolytic dogs had lower fibrinogen and PC activity than dogs without these abnormalities. Overall, ALF dogs had greater increases in K and LY30, and decreases in MA, G, and PC activity than dogs with less severe hepatic impairment. Results for MA and LY30 were positively correlated with serum bilirubin concentration and white blood cell count, and negatively correlated with serum cholesterol concentration.

Conclusions and Clinical Importance

ALD dogs have a range of coagulation abnormalities that trend toward hypocoagulability and hyperfibrinolysis as functional impairment occurs.     

Heterogeneity of Hypertrophy in Feline Hypertrophic Heart Disease

Eighty-six cats with non-dilated left ventricular myocardial hypertrophy were studied retrospectively. Cats were categorized by two-dimensional echocardiography as having symmetric ventricular hypertrophy (Type I), asymmetric with predominant septal thickening hypertrophy (Type II), and asymmetric hypertrophy with predominant free-wall thickening (Type III). The distribution of hypertrophy was judged subjectively and objectively. Subjective and objective results were similar (P= 0.03) although overlap existed between groups. Morphologic patterns (Types I, II, and III) were compared with breed, age, sex, heart rate, percent fractional shortening, left atrial size, serum creatinine concentration, and the presence (yes/no) of pleural effusion, pulmonary edema, pericardial effusion, heart murmur, dyspnea, thromboembolism, hyperthyroidism, and being alive at the time of study. Interventricular septal thickness, left ventricular free wall thickness, percent fractional shortening, and left atrial size additionally were compared to 3-month survival. Cats with Type HI hypertrophy were more likely to experience thromboembolism than cats with Type II hypertrophy (P= 0.05) and cats with Type I hypertrophy were more likely to have heart murmurs than cats with Type III (P= 0.02). No other significant associations were found in comparison to pattern of hypertrophy. Both left atrial size and percent fractional shortening significantly correlated with 3-month survival (P < 0.001 for each). The degree of interventricular septal wall thickness was associated with 3-month survival (P= 0.02) when known hyperthyroid cats were excluded from the study group, while left ventricular free wall thickness consistently was not associated with survival. This study demonstrates the heterogeneity of hypertrophy in cats with hyper-trophic heart disease and provides predictors of survival (left atrial size, percent fractional shortening, and interventricular septal wall thickness when compared with euthanasia/spontaneous death data).     

Prevalence of Feline Chlamydia psittaci and Feline Herpesvirus 1 in Cats with Upper Respiratory Tract Disease

The epidemiology of feline chlamydiosis and feline herpesvirus 1 (FHV1) infection in cats was determined using a duplex polymerase chain reaction assay. In cats with upper respiratory tract disease (URTD), prevalences of 66 (14.3%) of 462 cats and 98 (21.2%) of 462 cats were found for Chlamydia psittaci and FHV1, respectively. In cats without URTD, prevalences were 1/87 (1.1%) for both pathogens. Younger cats, cats sampled in summer, and cats with conjunctivitis were more likely to be positive for C psittaci than were cats sampled in other seasons and cats without conjunctivitis. Cats with recent contact with cats outside the household, cats with acute disease, and sneezing cats were more likely to be positive for FHV1 than were cats that had not had recent contact with cats outside the household, cats with chronic disease, and cats that were not sneezing. Purebred cats were less likely to be positive for FHV1 than were mixed breed cats and prevalence varied with year of sampling. Coinfection with both pathogens was lower than would be expected from their respective prevalences. Vaccinated cats were equally likely to be positive for FHV1 as unvaccinated cats. In sneezing cats FHV1 was more likely to be detected than C psittaci, particularly in acute cases, and when sneezing was not accompanied by conjunctivitis. Cats with reproductive disease concurrent with URTD were more likely to be infected with FHV1 than with C psittaci. Thus, the factors that should be considered in clinical diagnoses of C psittaci infections are the presence of conjunctivitis, age, and season, whereas contact with other cats, acute disease, and sneezing should be considered in diagnoses of FHV1 infection.     

The Role of Viruses in Feline Lower Urinary Tract Disease

Viruses have been implicated as causative agents in the etiopathogenesis of some forms of feline lower urinary tract disease (LUTD). This hypothesis was supported by isolation of feline calicivirus, bovine herpesvirus 4 (strain FeCAHV), and feline syncytia-forming virus from cats with naturally occurring LUTD, and by experimental studies of induced viral urinary tract infection. Results of early clinical studies yielded contradictory results concerning the role of viruses in feline LUTD. However, recent detection of bovine herpesvirus 4 antibodies in feline serum samples and discovery of calicivirus-like particles in crystalline/matrix urethral plugs obtained from cats with naturally occurring LUTD, suggests the need to reexamine the etiopathologic role of viruses using contemporary methods of virus identification and localization.     

Pulmonary Arteriography and Hemodynamics During Feline Heartworm Disease

The ability of aspirin to block arterial disease and thromboembolism of the pulmonary arteries was studied in heartworm-infected cats. Three groups of cats were transplanted with four heartworms per cat and studied. One group of eight cats (aspirin group) received aspirin (97.5 mg, twice a week) for the five-month infection and another group of eight cats served as the nontreated control group (nontreated group). Based upon the results of the first two groups, the third group (adjusted aspirin group) of six cats was studied in which the aspirin dosage was adjusted in order to maintain an inhibition of in vitro platelet aggregation. Cats were studied by nonselective pulmonary arteriograms before heartworm transplantation and by selective arteriograms, aortograms, and pulmonary hemodynamics five months after heartworm transplant. Pulmonary hypertension, (mean pulmonary artery pressures greater than 16 mmHg), was discovered in three cats with one cat in each group. There were no differences in the mean pulmonary artery pressure or vascular resistance between the groups. Many of the arterial diameters for the nontreated and aspirin groups were greater after the five-month infection than before heartworm infection. All of the postinfection caudal arteries were tortuous and had aneurysms. Some of the caudal lung lobes had perfused areas that appeared to have a hypervascular microvasculature. The proportion of obstructed right and left distal caudal pulmonary arteries and the resulting nonperfused area of the caudal lung lobe in the nontreated and aspirin treated groups were each greater than in the adjusted aspirin group.(ABSTRACT TRUNCATED AT 250 WORDS)