Evaluation of a Quality‐of‐Life Tool for Cats with Diabetes Mellitus

Background: Success in management of diabetes mellitus (DM) is defined as improvement of blood glucose concentrations and clinical signs. However, the psychological and social impact of DM and its daily treatment regimen on quality of life (QoL) of both animal and owner is uncertain. Hypothesis/Objectives: To design, validate, and apply a diabetic pet and owner‐centered, individualized measure of impact of DM (DIAQoL‐pet). Animals/Subjects: Two hundred and twenty‐one owners of insulin‐treated diabetic cats were recruited to complete the DIAQoL‐pet. Methods: Discussions and pilot surveys with clinicians and owners of diabetic cats led to the design of 29 specific DM‐associated QoL questions. Owners of diabetic cats completed the finalized survey. Each item was scored according to impact frequency and perceived importance. An item‐weighted impact score (IWIS) for each item was calculated, as was an average‐weighted impact score (AWIS) by averaging all IWISs. Principal component analysis and Cronbach's α calculation assessed the measure's reliability. Two overview questions measured overall QoL and diabetes‐dependent QoL. Results: The DIAQoL‐pet showed high reliability (Cronbach α 0.83). The AWIS was ?1.76 ± 2.4 (mean ± SD). Areas reported as most negatively impacting QoL included: “boarding difficulties” (IWIS ± SD: ?4.67 ± 5.3), “owner wanting more control” (?4.34 ± 4.7), “difficulties leaving cat with friends or family” (?4.21 ± 4.7), “worry” (?4.10 ± 3.9), “worry hypo” (?3.67 ± 3.5), “social life” (?3.48 ± 3.9), “costs” (?3.04 ± 3.8), and “work life” (?3.03 ± 3.7). Forty‐one percent of owners believed their cat's life would be “a little better” without DM. Conclusions and Clinical Importance: The DIAQoL‐pet proved robust and identified specific areas most negatively impacting on diabetic cats and their owners' QoL. This tool warrants further investigation for use in clinical or research settings.     

State‐of‐the‐Art‐Review: Immunomodulatory effects of opioids

Objective – To review the immunomodulatory effects of opioids. Data Sources – Original research publications and review articles using the PubMed search engine with the following keywords – opioids, morphine, immuomodulation, and immunosuppression. Veterinary and Human Data Synthesis – Opioids have been shown to modulate the immune system in animal models by affecting both the acquired and innate arms of the immune system. Natural killer cell activity, T‐cell proliferation, antibody production, phagocytic cell function, and cytokine production have all been shown to be affected by opioids. Many of these effects are reversed by opioid antagonists. Opioids have also been shown to induce sepsis in laboratory animals. Opioid administration alters immune parameters in healthy humans at analgesic doses and may increase the risk of infection in some patient populations. Conclusions – While opioids remain the most powerful and widely used analgesics available, their negative effects on the immune system are well established in the laboratory setting. Thoughtful consideration should be given to the use of certain opioids in critically ill patients, especially those with pre‐existing immunocompromise.     

Serodiagnosis of Burkholderia mallei Infections in Horses: State‐of‐the‐art and Perspectives

Burkholderia mallei causes glanders or farcy in solipeds, a disease that must be reported to the OIE (Office International des Epizooties, Paris, France). The number of reported outbreaks has increased steadily during the last decade. Serodiagnosis is hampered by the considerable number of false‐positives and ‐negatives of the internationally prescribed tests. The major problem leading to low sensitivity and specificity of complement fixation test (CFT) and enzyme‐linked immunosorbent assay (ELISA) has been linked to the test antigens currently used, i.e. crude preparations of whole cells. Future perspectives for the development and evaluation of serological test kits using well‐characterized single antigens are discussed in the light of recent molecular research on B. mallei and the closely related saprozoonotic agent B. pseudomallei.     

Preliminary validation of a point‐of‐care ethylene glycol test for cats

Objective – To evaluate the sensitivity and specificity of a newly available, semi‐quantitative, cage‐side test for the detection of ethylene glycol (EG) toxicosis in cats. Design – Prospective, laboratory study. Setting – University teaching hospital. Animals – This study utilized samples from 57 cats, whose blood had been anticoagulated with EDTA and submitted to the hospital's laboratory for a complete blood count. Samples were centrifuged, and the plasma separated, aliquoted, and immediately frozen at ?30 °C. Interventions – Samples were randomly divided into 2 primary groups (Group 1: no EG added, Group 2: EG added). Twenty microliters of plasma from each of the Group 1 samples was applied directly to the test strip. Plasma samples from Group 2 had EG added at different concentrations to achieve approximate final concentrations of 20, 60, or 80 mg/dL. These samples were then applied to the test strip. Measurements – Two readers who were blinded to the sample preparation procedure and isolated from each other were asked to categorically interpret the colorimetric reaction on the randomly presented test strips. Main Results – The agreement of the 2 reviewers at the 3 different levels of EG concentrations (20, 60, 80 mg/dL) were 0.7, 0.7, and 0.5, respectively. Thus, the readers demonstrated substantial agreement while reading the 2 lower concentrations, while at 80 mg/dL the level of agreement was moderate. Overall, the sensitivity of the assay increased as the concentration of EG increased (reviewer 1: 67%, 67%, 86%; reviewer 2: 56%, 89%, 100%), while the specificity of the assay decreased with increasing concentrations of EG (reviewer 1: 77%, 45%, 50%; reviewer 2: 77%, 53%, 25%). Conclusions: Because of the likelihood for false negatives and false positives, results from this test must be viewed in light of clinical data and should not be relied upon as a lone diagnostic test.