Lily toxicity in the cat

Lilies are commonly kept flowering ornamental plants that are used in holiday celebrations, weddings, and funerals, and in various floral arrangements. Lilies of genera Lilium and Hemerocallis (day lilies) have been shown to cause nephrotoxicity in cats. Confusion arises because so many different plants are called lilies. Members of the genus Convallaria (lily of the valley), while sparing on the kidneys, elicit toxic effects because they possess potent cardiac glycosides similar to digitalis. Even more confusing as to which lilies are toxic is the fact that many hybrids exist. The majority of the public do not know that lilies can be dangerous to cats and, in fact, cannot correctly identify the plants in their own homes. Cats have been shown to be extremely sensitive to the toxic effects of lilies. As little as 2 leaves or part of a single flower have resulted in deaths. It should be pointed out that the whole plant-petals, stamen, leaves, and pollen are toxic. The exact toxic dose and the precise toxins responsible for renal damage are currently unknown. The quick onset of clinical signs suggests a rapid absorption rate of the toxin. The renal tubular epithelium appears to be the target of the toxin. Studies indicate that it is the water-soluble fraction of the lily that is nephrotoxic. In cats, clinical signs of lily intoxication include salivation, vomiting, anorexia, and depression. Polyuric renal failure leads to dehydration and anuric renal failure and death results. No analytic verification of lily ingestion is currently available. Successful treatment includes initiation of fluid diuresis before the onset of anuric renal failure. Once anuria develops, peritoneal dialysis or hemodialysis is the only potential treatment. Differential diagnoses of lily poisoning include any potential cause of acute renal failure in a cat. Prognosis is excellent if fluid diuresis is started before anuric renal failure has developed. The public must be made aware of potentially toxic ornamental house plants.     

Acute renal failure caused by lily ingestion in six cats

Acute renal failure was diagnosed in 6 cats that had ingested Easter lily or tiger lily plants. All 6 were treated medically; 2 underwent hemodialysis. Three cats survived the acute episode, and although they had chronic renal failure, they survived for more than 1.5 years. Two cats died despite aggressive medical management, including hemodialysis. One cat was euthanatized shortly after the diagnosis was made. Three of the cats were oliguric or anuric at the time of initial examination, and all 3 died. None of the 3 cats that survived had oliguria or anuria. Various members of the lily family (Liliaceae) can cause nephrotoxicosis in cats, but the toxic principle is not known. Although the prognosis for full recovery of cats with lily toxicosis is poor, long-term survival is possible with supportive care. The prognosis appears to be better for cats with nonoliguric renal failure.     

Possible Hemolytic Uremic Syndrome in Three Cats After Renal Transplantation and Cyclosporine Therapy

OBJECTIVE: To describe the clinical history of 3 cats with possible hemolytic uremic syndrome (HUS) after renal transplantation. STUDY DESIGN: This case series documents historical findings, physical examination findings, clinical pathologic features, necropsy and histopathologic findings of 3 cats with possible HUS. RESULTS: Two cats had chronic renal failure; 1 cat had acute renal failure secondary to ethylene glycol toxicity. A renal transplant was performed in each of the 3 cats without obvious problems. Complications that would support a diagnosis of HUS, including anemia, thrombocytopenia, and azotemia occurred within 24 hours in 1 cat, within 8 days in a second cat, and 2 months after transplantation in the third cat. In 2 cats, HUS was likely secondary to cyclosporine immunosuppression. In the third cat, HUS may have been secondary to allograft rejection. Renal biopsies from all 3 cats were suggestive of HUS. CONCLUSION AND CLINICAL RELEVANCE: In human beings, HUS in transplant recipients may occur secondary to immunosuppressive drugs, vascular rejection, or recurrence of original disease. Graft loss occurred in all 3 cats in this study and the mortality rate was 100%. Clinicians caring for these patients need to be aware of this disorder because early recognition and treatment is critical in the management of post-transplant HUS.     

Long-term outcome of cats treated conservatively or surgically for peritoneopericardial diaphragmatic hernia: 66 cases (1987-2002)

OBJECTIVE: To determine long-term outcome of cats treated conservatively or surgically for peritoneopericardial diaphragmatic hernia (PPDH). DESIGN: Retrospective study. ANIMALS: 67 cats with PPDH. PROCEDURE: Medical records of cats with a diagnosis of PPDH made from 1987 through 2002 were reviewed. Information regarding long-term outcome was obtained from owners. RESULTS: Prevalences of PPDH in domestic longhair and Himalayan cats were significantly greater and prevalence of PPDH in domestic shorthair cats was significantly lower than prevalence of PPDH in the hospital cat population over the 15-year study period. Historical problems most commonly related to the respiratory and gastrointestinal tracts. Peritoneopericardial diaphragmatic hernia was the primary diagnosis in 40 cats and an incidental finding in 27 cats. One cat died prior to arrival at the Veterinary Medical Teaching Hospital. Thirty-seven of 66 cats were treated surgically, and 29 were treated conservatively. The postoperative mortality rate was 14%. Postoperative complications developed in 29 of 37 cats, the most common of which was hyperthermia. Two of 22 conservatively treated cats had progression of clinical signs necessitating surgical intervention or resulting in death. Owner satisfaction with treatment choice and long-term outcome was rated as very satisfied by 88% of owners of surgically treated cats and 68% of owners of conservatively treated cats. CONCLUSIONS AND CLINICAL RELEVANCE: Cats with overt clinical signs attributable to PPDH are good candidates for surgical herniorrhaphy. Postoperative complications may develop but are generally minor and self-limiting. Long-term outcome of cats treated conservatively or surgically was rated as very good by most owners.     

Phase I clinical trial evaluating STI571 in tumor bearing cats

Introduction: STI571 (Gleevec, imatinib mesylate) is a receptor tyrosine kinase inhibitor with selectivity for Bcr‐Abl, platelet‐derived growth factor (PDGF), stem cell factor (SCF), and c‐Kit. Side effects with use in humans include vomiting, diarrhea, nausea, myalgia, edema, and cutaneous reactions. Renal and hepatic toxicity have also been reported. In dogs, there is significant hepatic toxicity at sub‐clinical doses. The purpose of this prospective study was to determine the toxicity level and potential treatment protocol in tumor bearing cats. Methods: A phase I clinical trial was performed in client owned cats using an escalating dose of STI571 in tumor bearing cats. Cats included in the study had a histologic diagnosis of fibrosarcoma or other tumors and were staged with CBC, biochemical profile, thoracic radiographs, and abdominal ultrasound. None of the cats received concurrent chemotherapy, but those previously treated with surgery, radiation therapy, or chemotherapy, were not excluded. The initial starting dose was 5 mg/cat PO SID and was gradually increased to 10 and 20 mg/cat PO SID at a 2–6 week interval depending on laboratory work and disease progression. A repeat physical examination, CBC, and biochemical profile, were performed every 2 weeks for 2 rechecks, then every 4 weeks. Results: Six cats were enrolled in the study. Four cats had oral squamous cell carcinoma, and two cats had cutaneous fibrosarcoma. One cat demonstrated leukocytosis, increased liver enzymes, and signs of acute renal failure two weeks after initiating therapy (5 mg PO SID). No dose escalation was made in this cat. Five cats endured dose escalations of 10 mg PO SID in two cats and 20 mg PO SID in three cats and were treated for 2–4 months. None of these cats experienced any signs of toxicity as measured by CBC and biochemical profile. Conclusions: Only one cat experienced toxicity that may have been associated with low dose administration of STI571. As most cats tolerated the drug without an adverse effect, further evaluation of STI571 in a phase II clinical trial is warranted.     

Evaluation of dietary and environmental risk factors for hyperthyroidism in cats

OBJECTIVE: To identify dietary and environmental risk factors for hyperthyroidism in cats. DESIGN: Case-control study. ANIMALS: 100 cats with hyperthyroidism and 163 control cats. PROCEDURE: Medical records were examined, and owners completed a mailed questionnaire. Data collected included information regarding demographic variables, environmental exposures, and diet, including preferred flavors of canned cat food. RESULTS: Case cats were significantly less likely to have been born recently than control cats. Housing; exposure to fertilizers, herbicides, or plant pesticides; regular use of flea products; and presence of a smoker in the home were not significantly associated with an increased risk of disease, but cats that preferred fish or liver and giblets flavors of canned cat food had an increased risk. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that cats that prefer to eat certain flavors of canned cat food may have a significantly increased risk of hyperthyroidism.     

Hyperglycemic, hyperosmolar syndrome in feline diabetics: 17 cases (1995–2001)

Objective: The purposes of this study were to characterize the hyperglycemic, hyperosmolar syndrome (HHS), also known as nonketotic hyperosmolar diabetes, in cats; to determine the prevalence of HHS in the diabetic cat population in the emergency room; to document the outcome in cats with HHS; and to identify any predisposing factors or predictors of survival. Design: Retrospective study. Setting: An emergency service at a veterinary teaching hospital located in a major metropolitan area. Animals: The case records of 17 cats with hyperglycemic, hyperosmolar syndrome presenting from 1995 to 2001 were evaluated. An additional 37 cats with diabetic ketoacidosis and 80 cats with diabetes mellitus served as comparison groups. Interventions: None. Measurements and main results: Signalment, history, physical examination findings, clinico‐pathologic data, concurrent disease, and outcome were recorded. Hyperglycemic, hyperosmolar syndrome was seen in older cats that were often long‐standing diabetics receiving insulin for many months. Client concerns included polydipsia, polyuria, and lethargy. Neurologic and respiratory signs occurred frequently. Evaluation at presentation revealed profound dehydration, lactic acidosis, and azotemia. Serious concurrent diseases that likely contributed to the development of the HHS crisis were diagnosed in 88% (15/17) of the HHS cats. The most common concurrent diseases were renal failure, respiratory compromise, infection, congestive heart failure, neoplasia, and gastrointestinal tract disease. Pancreatitis and hepatic disease did not occur frequently in this diabetic cat population. Sixty‐five percent of HHS cats did not survive the initial hospitalization, with most dying or being euthanized within 10 hours of presentation. The long‐term survival rate was low (12%). Conclusions: HHS is a serious life‐threatening form of diabetic crisis and cats with HHS often have other severe systemic diseases. Cats with diabetes and concurrent disease, especially renal failure and congestive heart failure, are at increased risk of HHS and should be closely monitored for signs of crisis. The mortality rate for HHS cats is high.     

Itraconazole for the Treatment of Cryptococcosis in Cats

Itraconazole was used in 35 cats with cryptococcosis. Treatment response was determined by comparing clinical signs before, during, and after treatment. It could not be evaluated in 7 cats because they died during treatment from causes unrelated to cryptococcosis. Of the remaining 28 cats, treatment response was classified as success in 16 cats (57%), as improvement in 8 cats (29%), and as a failure in 4 (14%). The failures were due to death or euthanasia from drug toxicity (1 cat), progressive fungal disease (2 cats), and relapse 1 year after treatment (1 cat). The cats that improved did not undergo a 1 -year posttreatment evaluation because they were lost to follow-up (3 cats), died or were euthanatized for other reasons (4 cats), or had a noncompliant owner (1 cat). For the 16 cats in which treatment was successful, the median itraconazole dose was 13.8 mg/kg body weight daily (range, 10.9 to 26.7 mg/kg/d), and the median duration of treatment was 8.5 months (range, 4 to 16 months). Five of these cats had previously been treated unsuccessfully with ketoconazole.     

Disease prevalence among dogs and cats in the United States and Australia and proportions of dogs and cats that receive therapeutic diets or dietary supplements

OBJECTIVE: To estimate disease prevalence among dogs and cats in the United States and Australia and proportions of dogs and cats that receive therapeutic diets or dietary supplements. DESIGN: Telephone survey. Sample Population-Dog and cat owners located in 5 geographic areas. PROCEDURES: A telephone survey was administered to dog and cat owners. RESULTS: Of 18,194 telephone calls that were made, 1,104 (6%) were to individuals who owned at least 1 dog or cat and agreed to participate. Information was collected for 635 dogs and 469 cats. Only 14 (1%) respondents indicated that their pet was unhealthy, but 176 (16%) indicated that their pets had 1 or more diseases. The most common diseases were musculo-skeletal, dental, and gastrointestinal tract or hepatic disease. Many owners (n = 356) reported their pets were overweight or obese, but only 3 reported obesity as a health problem in their pets. Owners of 28 (2.5%) animals reported that they were feeding a therapeutic diet, with the most common being diets for animals with renal disease (n = 5), reduced-calorie diets (5), and reduced-fat diets (4). Owners of 107 of 1,076 (9.9%) animals reported administering dietary supplements to their pets. Multivitamins (n = 53 animals), chondroprotective agents (22), and fatty acids (13) were the most common dietary supplements used. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that most dogs and cats reported by their owners to have a health problem were not being fed a therapeutic diet. In addition, the rate of dietary supplement use was lower than that reported for people.     

Assessment of melamine and cyanuric acid toxicity in cats.

The major pet food recall associated with acute renal failure in dogs and cats focused initially on melamine as the suspect toxicant. In the course of the investigation, cyanuric acid was identified in addition to melamine in the offending food. The purpose of this study was to characterize the toxicity potential of melamine, cyanuric acid, and a combination of melamine and cyanuric acid in cats. In this pilot study, melamine was added to the diet of 2 cats at 0.5% and 1%, respectively. Cyanuric acid was added to the diet of 1 cat at increasing doses of 0.2%, 0.5%, and 1% over the course of 10 days. Melamine and cyanuric acid were administered together at 0%, 0.2%, 0.5%, and 1% to 1 cat per dose group. No effect on renal function was observed in cats fed with melamine or cyanuric acid alone. Cats dosed with a combination were euthanized at 48 hours after dosing because of acute renal failure. Urine and touch impressions of kidneys from all cats dosed with the combination revealed the presence of fan-shaped, birefringent crystals. Histopathologic findings were limited to the kidneys and included crystals primarily within tubules of the distal nephron, severe renal interstitial edema, and hemorrhage at the corticomedullary junction. The kidneys contained estimated melamine concentrations of 496 to 734 mg/kg wet weight and estimated cyanuric acid concentrations of 487 to 690 mg/kg wet weight. The results demonstrate that the combination of melamine and cyanuric acid is responsible for acute renal failure in cats.     

Outdoor fecal deposition by free-roaming cats and attitudes of cat owners and nonowners toward stray pets, wildlife, and water pollution

OBJECTIVE: To estimate cat population size, management, and outside fecal deposition and evaluate attitudes of cat owners and nonowners to stray animal control, water pollution, and wildlife protection. DESIGN: Cross-sectional survey. SAMPLE POPULATION: 294 adult residents of Cayucos, Los Osos, and Morro Bay, Calif. PROCEDURES: Telephone survey. RESULTS: The region's cat population was estimated at 7,284 owned and 2,046 feral cats, and 38% of surveyed households owned a mean of 1.9 cats/household. Forty-four percent of cats defecated outside >75% of the time. Annual fecal deposition (wet weight) by owned cats in the 3 communities was estimated to be 77.6 tonnes (76.4 tons). Cat owners were more likely to oppose cat licensing and impounding stray cats and support trap-neuter-return for stray cats and less likely to be concerned about water pollution, than were noncat owners. CONCLUSIONS AND CLINICAL RELEVANCE: Feral cats represented a sizeable proportion (22%) of the free roaming cats in this area and could be contributing 30.0 tonnes (29.5 tons) of feces to the environment per year. However, feral cats are not the principal source of fecal loading because owned cats defecating outdoors contribute an estimated 77.6 tonnes (76.4 tons) or 72% of the annual outdoor fecal deposition.     

Gastrointestinal parasites of domestic cats in Perth, Western Australia

A study was conducted to determine the prevalence of gastrointestinal parasites in a sample of domestic cats in Perth and the knowledge of their owners about the control and potential for zoonotic transmission of these parasites. Faecal samples (418), collected from cats originating from five sources, were examined by microscopy and questionnaires administered to cat owners. Forty randomly selected samples were also screened using PCR in order to detect cysts of Giardia and oocysts of Cryptosporidium that may have been present in a faecal sample at very low levels. The overall prevalence of gastrointestinal parasites in domestic cats by microscopy was 8.6%. Pet shop kittens had the highest parasite prevalence (34.3%), followed by cats and kittens from breeding establishments (15.8%), refuge cats and kittens (8.3%), privately owned cats (2.3%), and boarding cats and kittens (1.6%). Surprisingly, 80% of the 40 cats tested by PCR were positive for Giardia duodenalis and 10% for Cryptosporidium. None of these cats were positive on microscopy. After adjusting for other factors with multiple logistic regression, kittens less than 6 months of age, and cats living in households with more than one cat or with a dog were significantly more likely to be parasitised. In the logistic regression model, the presence of parasitism was also significantly influenced by the number of anthelmintic doses administered in the 12 month period prior to the study. The majority (64.5%) of cat owners were aware that feline parasites could be transmitted to humans, however less than half (42.8%) were aware of the modes of transmission to humans.     

An owner survey of toys,activities, and behavior problems in indoor cats

The objective of this study was to survey the owners regarding the frequency and duration of their daily interactions with their indoor cats, the provision of toys and activities by the cat owners, and the prevalence of 6 selected behavior problems (aggression to owner, aggression to visitors, periuria, inappropriate defecation, inter-household cat aggression, and intercat aggression to outdoor cats). The sample population was 277 clients from 5 veterinary practices who presented their domestic cat for anything except a behavior problem. The average number of toys and activities reported by owners per cat was 7, and the most common toys/activities used by owners in this survey were furry mice (64%), catnip toys (62%), and balls with bells (62%). A total of 78% of the owners reported that they leave the cat's toy(s) available all the time. All owners reported playing with their cat, whereas most owners (64%) played with their cat more than 2 times per day and reported play bout durations of 5 (33%) or 10 minutes (25%). Owners who reported play bout time of 5 minutes or more reported fewer behavioral problems than those with play bouts of 1 minute (P < 0.05). A total of 61% of the owners reported that their cat engaged in 1 or more of the 6 selected behavior problem(s), but only 54% of the owners who reported behavior problems in their cats reported that they had talked to their veterinarian about the problem. The 2 most frequently reported behavior problems were aggression to the owners (36%) and periuria (24%). Female cats were 50% less likely to be reported to have 1 or more behavior problems than males despite an equal sex distribution in the survey population (P < 0.05). The relationship between individual behavior problems and individual toys and activities was evaluated by use of a logistic stepwise regression. These findings are discussed as they relate to the understanding of behavioral needs of indoor-housed cats and the potential role of environmental enrichment in the home setting.     

Incidence of and risk factors for diabetes mellitus in cats that have undergone renal transplantation: 187 cases (1986-2005)

OBJECTIVE: To compare incidence of diabetes mellitus in cats that had undergone renal transplantation with incidence in cats with chronic renal failure, compare mortality rates in cats that underwent renal transplantation and did or did not develop diabetes mellitus, and identify potential risk factors for development of posttransplantation diabetes mellitus (PTDM) in cats. DESIGN: Retrospective case series. ANIMALS: 187 cats that underwent renal transplantation. PROCEDURES: Medical records were reviewed. RESULTS: 26 of the 187 (13.9%) cats developed PTDM, with the incidence of PTDM being 66 cases/1,000 cat years at risk. By contrast, the incidence of diabetes mellitus among a comparison population of 178 cats with chronic renal failure that did not undergo renal transplantation was 17.9 cases/1,000 cat years at risk, and cats that underwent renal trans-plantation were 5.45 times as likely to develop diabetes mellitus as were control cats with chronic renal failure. The mortality rate among cats with PTDM was 2.38 times the rate among cats that underwent renal transplantation but did not develop PTDM. Age, sex, body weight, and percentage change in body weight were not found to be significantly associated with development of PTDM. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that cats that undergo renal transplantation have an increased risk of developing diabetes mellitus, compared with cats with chronic renal failure, and that mortality rate is higher for cats that develop PTDM than for cats that do not.     

Efficacy of doxorubicin as an induction agent for cats with lymphosarcoma

OBJECTIVE: To determine the efficacy of doxorubicin when used alone in inducing remission in cats with lymphosarcoma. DESIGN: Prospective multi-institutional study of naturally occurring disease. METHODS: Cases were accrued from veterinary institutions in Australia and New Zealand after obtaining consent from informed owners. Cats were treated with doxorubicin every 3 weeks for three treatments. If there was no response to the first dose of doxorubicin or if the cat relapsed during the doxorubicin regimen, the cat was withdrawn from the trial and either euthanased or treated with other agents. Age, breed, gender and anatomic site of the lymphosarcoma (multicentric, alimentary, mediastinal, extranodal) were recorded for each cat. Clinical remission was assessed before each treatment by physical examination, radiography, ultrasonography and computed tomography where appropriate. Complete remission was defined as the disappearance of all clinical signs and clinically detectable tumour. RESULTS: Twenty-one cases were accrued over a 2-year-period but only 19 were available for data analysis. Young Siamese cats were over-represented and all cats with mediastinal tumours were young Siamese. There was a significant difference between the mean ages of cats with mediastinal or multicentric lymphosarcoma (mean +/- SD: 3.5 +/- 3.0 and 4.3 +/- 2.6 years, respectively) and cats with alimentary or extranodal LSA (11.4 +/- 0.9 and 11.0 +/- 0.9 years, respectively). Of 19 cats treated with doxorubicin alone, 6 (32%) had complete remission, 6 (32%) had partial remission and 7 (36%) did not respond. CONCLUSIONS: The results suggest that doxorubicin cannot be recommended as a single agent for treatment of feline lymphosarcoma because of the rather poor remission rate achieved.     

Use of pentosan polysulphate in cats with idiopathic, non-obstructive lower urinary tract disease: a double-blind, randomised, placebo-controlled trial

Idiopathic feline lower urinary tract disease (FLUTD) is a common clinical entity where different treatments, for example glycosaminoglycans (GAGs) such as pentosan polysulphate (PPS), are advocated. However, few treatments have been investigated by well-controlled clinical trials. This paper compares the use of PPS in FLUTD compared to placebo. Of the 18 cats in the experiment, nine were treated with PPS and nine were treated with placebo with subcutaneous injections of 3mg/kg PPS or placebo day 1, 2, 5 and 10. The study was double-blind, randomised and placebo-controlled. Revaluation was performed after 5 and 10 days, 2 weeks, 2, 6 and 12 months. There were no statistically significant differences concerning clinical signs between groups during treatment or at re-evaluation, except for pretreatment stressful events where PPS-treated cats had experienced significantly more stressful events compared to cats treated with placebo before entering the study. Six cats (33%) showed recurrence of clinical signs during the entire study period, and only one of these cats had more than one recurrent episode. One cat (placebo) was euthanased 7 days after initial treatment because of recurrence of clinical signs. Another cat (placebo) was euthanased due to other reasons after 6 months. At 2 weeks two cats (placebo and PPS) showed clinical signs. At 2 months re-evaluation one cat showed mild clinical signs. At 6 and 12 months all remaining 16 cats were healthy. Idiopathic, non-obstructive FLUTD is a self-limiting disease with good short-term and excellent long-term prognosis without treatment. Whether or not PPS may be beneficial in a subpopulation of cats with continuous or frequently recurring clinical signs may be elucidated in forthcoming double-blind, randomised and placebo-controlled trials including only this subpopulation of cats.     

Attitudes toward and perceptions of free-roaming cats among individuals living in Ohio

OBJECTIVE: To characterize attitudes toward and perceptions of free-roaming cats among individuals living in Ohio. DESIGN: Cross-sectional study. SAMPLE POPULATION: Households in Ohio. PROCEDURES: A random-digit-dial telephone survey was performed, and 1,250 households were contacted. RESULTS: 703 of the 1,250 (56.2%) households completed interviews. Five hundred fifty-three (78.7%) participants reported seeing free-roaming cats at least occasionally, and 184 (26.2%) reported having fed free-roaming cats during the previous year. However, only 42 (22.8%) participants who fed free-roaming cats had ever taken one to a veterinarian, and 43 (23.4%) participants who fed free-roaming cats reported that at least one of the free-roaming cats had produced a litter in the preceding year. Differences existed between cat owners and other participants and among urban, suburban, and rural residents in regard to their attitudes toward free-roaming cats and the need for government regulations. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that free-roaming cats were common in Ohio, but that attitudes toward and perceptions of free-roaming cats differed between cat owners and other participants and among participants grouped on the basis of residential area. Thus, developing statewide approaches for regulating free-roaming cats may be challenging or unrealistic.     

Clinical, clinicopathologic, radiographic, and ultrasonographic abnormalities in cats with ureteral calculi: 163 cases (1984-2002)

OBJECTIVE: To determine clinical, clinicopathologic, radiographic, and ultrasonographic abnormalities in cats with ureteral calculi. DESIGN: Retrospective study. ANIMALS: 163 client-owned cats. PROCEDURE: Medical records were reviewed, and information on signalment, history, clinical signs, and results of clinicopathologic testing and diagnostic imaging was obtained. RESULTS: The number of cats in which ureterolithiasis was diagnosed each year increased progressively during the study period. Clinical signs tended to be non-specific and included inappetence, vomiting, lethargy, and weight loss. A combination of survey radiography and abdominal ultrasonography revealed ureteral calculi in 66 of 73 (90%) cats in which the diagnosis was confirmed at surgery or necropsy. Ultrasonography revealed that ureteral calculi were causing ureteral obstruction in 143 of 155 (92%) cats. One hundred thirty-four of 162 (83%) cats had azotemia, 84 of 156 (54%) had hyperphosphatemia, and 22 of 152 (14%) had hypercalcemia. Urinary tract infection was documented in 10 of 119 (8%). Fifty-eight of 76 (76%) cats with unilateral ureterolithiasis had azotemia and 33 (43%) had hyperphosphatemia, indicating impairment of renal function in the contralateral kidney or prerenal azotemia. Ultrasonographic imaging of the contralateral kidney in cats with unilateral ureteral calculi suggested that preexisting renal parenchymal disease was common in cats with ureterolithiasis. Ninety-one of 93 (98%) ureteral calculi contained calcium oxalate. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that abdominal imaging should be performed in all cats with chronic nonspecific signs or with acute or chronic renal failure to rule out ureterolithiasis. Preexisting renal disease may be common in cats with ureteral calculi.     

Ionized and total serum magnesium concentrations in feline renal transplant recipients

OBJECTIVE: To measure the blood concentrations of total and ionized serum magnesium in feline renal transplant recipients and to determine if there was a correlation between these concentrations and the development of neurological disorders after renal transplantation. STUDY DESIGN: Prospective clinical study. ANIMALS: Fourteen client-owned cats undergoing renal transplantation as a treatment for renal failure. Ten healthy adult cats were used to establish normal electrolyte concentrations. METHODS: Total and ionized serum magnesium as well as potassium and ionized calcium concentrations were measured in 14 renal transplant recipients at five intervals: preoperatively; immediately postoperatively; and 24, 48, and 120 hours postoperatively. The mean values from all 14 cats over each time interval were compared with the normal range. The serum concentration of these electrolytes, particularly magnesium, was evaluated in relation to the occurrence of neurological complications. RESULTS: Ninety-four percent of all ionized serum magnesium concentrations measured in clinical patients were below normal. Ninety percent of all total serum magnesium concentrations were within the normal range, and no cats had abnormally low total serum magnesium concentrations at any time. All clinical patients were hypocalcemic at all intervals. Sixty-six percent of all serum potassium concentrations were below normal. One cat in the study group experienced neurological problems, including seizures, in the immediate postoperative period. The signs appeared to be related to hypertension and responded to appropriate therapy. All electrolyte concentrations in this cat, including ionized magnesium, were within the same range of values as other clinical patients. CONCLUSIONS: Ionized serum magnesium concentrations are decreased in feline renal transplant recipients in the perioperative period; however, hypomagnesemia would not appear to be directly related to the development of neurological disorders. None of the study patients were hypomagnesemic when total serum magnesium concentrations were measured over the same intervals. In addition, ionized serum calcium concentrations and serum potassium concentrations are below normal in the perioperative period. CLINICAL SIGNIFICANCE: The specific clinical significance of these abnormalities is unknown. It is possible that the profound weakness and depression that is commonly seen in feline renal transplant recipients in the immediate postoperative period may be improved by supplementation with these electrolytes. Further work is needed to understand the implications of these abnormalities.     

Dietary patterns of cats with cardiac disease

OBJECTIVE: To determine nutrient intake and dietary patterns in cats with cardiac disease. DESIGN: Prospective study. ANIMALS: 95 cats with congenital cardiac disease or primary cardiomyopathy. PROCEDURES: Owners completed a standardized telephone questionnaire regarding their cat's diet and a 24-hour food recall to determine daily intake of calories, fat, protein, sodium, magnesium, and potassium. RESULTS: Of the 95 cats, 18 (19%) had a history of congestive heart failure and 73 (77%) had no clinical signs of cardiac disease. Fifty-five percent (52/95) of cats had concurrent disease. Inappetance was reported in 38% (36/95) of all cats and in 72% (68/95) of cats with a history of congestive heart failure. Most (57% [54/95]) cats received treats or table scraps on a regular basis. Approximately half the cats were receiving orally administered medications, supplements, or both. Only 34% (32/68) of owners used food to administer medications to cats. Cats consumed more than the Association of American Feed Control Officials (AAFCO) minimums for protein, sodium, potassium, and magnesium, and nearly all cats consumed more than the AAFCO minimum for fat. Daily nutrient intake was variable for all of the nutrients assessed. CONCLUSIONS AND CLINICAL RELEVANCE: Dietary intake in cats with cardiac disease was variable, but results for dietary supplement use, food use for medication administration, and treat feeding were different from those found in a similar study of dogs with cardiac disease. This information may be useful for treating and designing nutritional studies for cats with cardiac disease.