Smoke exposure in cats: 22 cases (1986-1997).

OBJECTIVE: To review clinical findings and clinical course for cats exposed to smoke in residential fires and to determine clinical variables that may have prognostic importance. DESIGN: Retrospective study. ANIMALS: 22 cats admitted to our veterinary teaching hospital between 1986 and 1997 with a history of smoke exposure during a residential fire. PROCEDURE: Medical records were reviewed for history, clinical signs, physical examination findings, changes in respiratory tract signs, initial hematologic analysis, treatment, results of thoracic radiography, and outcome. RESULTS: Fifteen of 22 (68%) cats were categorized in the uncomplicated group, 5 (23%) in the complicated group, and 2 (9%) were discharged after a short period because of financial considerations. Twenty (91%) cats survived, but 2 (9%) were euthanatized because of severe respiratory compromise or neurologic changes. Predominant thoracic radiographic changes were diffuse interstitial pattern (6 cats) and focal alveolar pattern (5). The majority (8/13) of cats that were stable or had improved by the day after admission had an uncomplicated clinical course while hospitalized, whereas cats that were worse on the day after admission tended to have a complicated clinical course. CONCLUSIONS AND CLINICAL RELEVANCE: Cats that survive a residential fire and are admitted to a hospital have a good chance to be discharged. Cats that do not have signs of respiratory tract dysfunction at admission probably will not develop severe respiratory complications. For cats with signs of respiratory dysfunction at admission, better prognostic information will be determined by monitoring progression of the respiratory condition on the day after admission.     

Clinical, radiographic, and pathologic features of bronchiectasis in cats: 12 cases (1987-1999)

OBJECTIVE: To determine clinical, radiographic, and pathologic features of bronchiectasis in cats. DESIGN: Retrospective study. ANIMALS: 12 cats with histologic evidence of bronchiectasis. PROCEDURE: Information on signalment, body weight, clinical signs of respiratory disease, concurrent diseases, method by which lung tissue specimens were obtained (surgical biopsy or necropsy), and histopathologic findings was obtained by reviewing medical records from January 1987 to June 1999 for cats with confirmation of bronchiectasis by histologic examination. Available thoracic radiographs were reviewed by a board-certified radiologist. RESULTS: Bronchiectasis was most commonly identified in older male cats. Clinical signs referable to the lower portion of the respiratory tract were detected in only 5 cats but, when evident, were usually chronic (duration > 1 year). Radiographic pattern of bronchiectasis was cylindrical in 4 cats, and in 1 of these cats, a saccular pattern was also identified. For most cats, bronchiectasis was detected in a single lung lobe. Radiographic evidence of bronchiectasis was not detected in 2 cats. Concurrent respiratory diseases included chronic bronchitis and bronchiolitis, neoplasia, bronchopneumonia, endogenous lipid pneumonia, and emphysema. CONCLUSIONS AND CLINICAL RELEVANCE: Bronchiectasis appears to be an uncommon respiratory tract disorder that predominantly affects older male cats. Thoracic radiography may not be sensitive for the diagnosis of bronchiectasis in cats. Bronchiectasis in cats appears to be a sequela of chronic inflammatory bronchopulmonary diseases, especially chronic bronchitis, neoplasia, and bronchopneumonia.     

Endogenous lipid pneumonia in cats: 24 cases (1985-1998)

OBJECTIVE: To determine clinical signs, radiographic and histologic abnormalities, and concurrent diseases in cats with endogenous lipid pneumonia (EnLP) and to determine the pathologic importance of EnLP in cats. DESIGN: Retrospective study. ANIMALS: 24 cats. PROCEDURE: Medical records of cats in which EnLP was confirmed by histologic examination of necropsy specimens were reviewed. Information collected from the medical records included signalment, body weight, clinical signs, and results of clinicopathologic tests. Thoracic radiographs were reviewed by a radiologist; histologic specimens were reviewed by a pathologist. RESULTS: All cats had nonspecific clinical abnormalities, such as lethargy, anorexia, or weight loss; 16 had signs of respiratory tract disease. All cats had concurrent systemic diseases, and clinicopathologic abnormalities were reflective of these conditions. Nonspecific abnormalities were detected on thoracic radiographs from 9 of 11 cats. Most cats had macroscopic, multifocal, subpleural lesions; inflammatory infiltrates, cholesterol clefts, and multinucleated giant cells were common. Ten cats had an underlying obstructive pulmonary disease that was the likely cause of EnLP. Lesions of EnLP were not considered to be severe enough or extensive enough to be the cause of death in any of these cats. CONCLUSIONS AND CLINICAL RELEVANCE: EnLP is an uncommon respiratory tract disorder of cats with no pathognomonic clinical, laboratory, or radiographic findings. Although EnLP was not the cause of death in any of these cats, results of the present study do suggest that EnLP may be a marker for potentially severe underlying obstructive pulmonary disease.     

Use of keyhole lung biopsy for diagnosis of interstitial lung diseases in dogs and cats: 13 cases (1998-2001)

OBJECTIVE: To characterize interstitial lung diseases (ILDs) and evaluate use of keyhole lung biopsy for diagnosis of ILDs in dogs and cats. DESIGN: Retrospective study. ANIMALS: 11 dogs and 2 cats. PROCEDURE: Medical records of dogs and cats undergoing keyhole lung biopsy to confirm ILDs were reviewed. Signalment, clinical signs, results of thoracic radiography and other respiratory diagnostic tests, postoperative complications, and patient outcome were analyzed. RESULTS: Clinical respiratory signs included cough, tachypnea, exercise intolerance, and hemoptysis. Thoracic radiographic abnormalities included interstitial, alveolar, and bronchointerstitial patterns and multiple discrete pulmonary nodules. Lung biopsy and histologic examination revealed interstitial pulmonary fibrosis, bronchiolitis obliterans with organizing pneumonia, or unclassified lesions. Outcome after biopsy included no response to treatment, euthanasia, partial or complete remission while receiving medication, and cure. CONCLUSIONS AND CLINICAL RELEVANCE: Recognition and classification of ILDs in dogs and cats are likely to be important in guiding appropriate treatment and providing accurate prognostic information. Ancillary respiratory diagnostic tests are beneficial in ruling out infectious and neoplastic disorders that may mimic ILDs; however, their present use in the diagnosis of ILDs is limited. Results suggest that keyhole lung biopsy is an effective means for obtaining a specimen for histologic diagnosis in dogs and cats with ILDs.     

Clinical findings and diagnostic value of post-traumatic thoracic radiographs in dogs and cats with blunt trauma

Objective: To characterize the clinical findings in dogs and cats that sustained blunt trauma and to compare clinical respiratory examination results with post‐traumatic thoracic radiography findings. Design: Retrospective clinical study. Setting: University small animal teaching hospital. Animals, interventions and measurements: Case records of 63 dogs and 96 cats presenting with a history of blunt trauma and thoracic radiographs between September 2001 and May 2003 were examined. Clinical signs of respiratory distress (respiratory rate (RR), pulmonary auscultation) and outcome were compared with radiographic signs of blunt trauma. Results: Forty‐nine percent of dogs and 63.5% of cats had radiographic signs attributed to thoracic trauma. Twenty‐two percent of dogs and 28% of cats had normal radiographs. Abnormal auscultation results were significantly associated with radiographic signs of thoracic trauma, radiography score and presence and degree of contusions. Seventy‐two percent of animals with no other injuries showed signs of thoracic trauma on chest radiographs. No correlation was found between the radiographic findings and outcome, whereas the trauma score at presentation was significantly associated with outcome and with signs of chest trauma but not with the radiography score. Conclusion: Thoracic trauma is encountered in many blunt trauma patients. The RR of animals with blunt trauma is not useful in predicting thoracic injury, whereas abnormal chest auscultation results are indicative of chest abnormalities. Thorough chest auscultation is, therefore, mandatory in all trauma animals and might help in the assessment of necessity of chest radiographs.     

Clinical course, diagnostic findings and necropsy diagnosis in dyspneic cats with primary pulmonary parenchymal disease: 15 cats (1996–2002)

Objective: Correlate the necropsy diagnosis with the history, diagnostic findings, and clinical course of dyspneic cats with primary lung parenchymal disease. Design: Retrospective study. Setting: Matthew J. Ryan Veterinary Hospital of the University of Pennsylvania. Animals: Client‐owned cats over 6 months of age hospitalized in the Intensive Care Unit (ICU) with a primary problem of respiratory distress that had pulmonary parenchymal disease on thoracic radiographs, and a complete necropsy. Interventions: None. Measurements and main results: Cats included were assigned into 2 groups based on the pulmonary histopathology: inflammatory (n=8) and neoplastic (n=7) disease. No statistical difference was found between the groups with regard to age, body weight, clinical signs, duration of clinical signs, physical examination findings, thoracic radiography, duration of hospitalization, treatment, and outcome. Cats with neoplasia had a statistically higher mean total white blood cell count (26.60 k/μL±10.41) than those with inflammatory lung disease (11.59 k/μL±4.49; P=0.026). Cats with bacterial or viral pulmonary disease had a significantly shorter median duration of illness (5 days, range 1–7 days) than all other cats (30 days, range 7–365 days; P=0.0042). Ultrasound guided pulmonary fine‐needle aspiration (FNA) provided an accurate diagnosis in 5/5 cases. Conclusions: Forty‐seven percent of cats with pulmonary parenchymal disease had neoplasia. The clinical diagnosis was difficult to obtain ante‐mortem; lung FNA appeared to be the most helpful diagnostic tool in these cases.     

Clinical evaluation of commercially available urinary acidification diets in the management of idiopathic cystitis in cats

OBJECTIVE: To compare recurrence of signs of lower urinary tract disease (LUTD) in cats with idiopathic cystitis that were fed the dry or canned formulation of a commercial diet designed to result in production of an acidic urine. DESIGN: Prospective trial. ANIMALS: 54 client-owned cats with idiopathic cystitis that was diagnosed on the basis of a history of abnormal micturition, abnormal results on urinalysis, radiography, or cystoscopy, and lack of an alternative diagnosis. PROCEDURE: Cats were assigned to be fed the canned or dry formulation of the diet. Reevaluations conducted at 2 and 16 weeks, and at 6 and 12 months included a physical examination, CBC and serum biochemical analysis (except week 2), blood gas analysis, and urinalysis. Regular telephone contacts were also made. The study was discontinued after 12 months or if signs of LUTD recurred. RESULTS: Signs of LUTD did not recur in 16 of 18 cats fed the canned diet, and 17 of 28 cats fed the dry diet (chi 2, P < 0.05). Seven cats were reevaluated at recurrence. Owners of remaining cats in which signs of LUTD recurred declined to have their pets reexamined. A different problem (bacterial urinary tract infection) was identified in only 1 cat on reevaluation. Eight cats were lost to follow-up evaluation. CLINICAL IMPLICATIONS: Feeding this commercial canned urinary acidifying diet may reduce the proportion of cats with idiopathic cystitis that will have recurrence of signs of LUTD within a 12-month period.     

Evaluation of serum feline trypsin-like immunoreactivity for the diagnosis of pancreatitis in cats

OBJECTIVE: To evaluate serum feline trypsin-like immunoreactivity (fTLI) concentration and results of abdominal ultrasonography, CBC, and serum biochemical analyses for diagnosis of pancreatitis in cats. DESIGN: Prospective study. ANIMALS: 28 cats with clinical signs compatible with pancreatitis. PROCEDURE: Serum fTLI concentrations were determined, and abdominal ultrasonography, CBC, and serum biochemical analyses were performed prior to histologic evaluation of pancreatic, hepatic, and intestinal specimens. On the basis of histologic results, cats were categorized as having a normal pancreas (n = 10), pancreatic fibrosis with ongoing inflammation (9), pancreatic fibrosis without inflammation (4), and acute necrotizing pancreatitis (5). Serum fTLI concentrations and results of CBC, serum biochemical analyses, and histologic evaluation of hepatic and intestinal specimens were compared among groups. RESULTS: Significant differences in serum fTLI concentrations or any hematologic or biochemical variable were not detected among the 4 groups of cats. Median serum fTLI concentrations were 51 micrograms/L (range, 18 to 200 micrograms/L) in cats with a normal pancreas, 32 micrograms/L (range, 12 to > 200 micrograms/L) in cats with pancreatic fibrosis and ongoing inflammation, 124 micrograms/L (range, 36 to > 200 micrograms/L) in cats with pancreatic fibrosis without ongoing inflammation, and 30 micrograms/L (range, 24 to 84 micrograms/L) in cats with acute necrotizing pancreatitis. We detected a high prevalence of concurrent hepatic and intestinal tract disease in cats with pancreatitis. CONCLUSIONS AND CLINICAL RELEVANCE: In cats with clinical signs of pancreatitis, serum fTLI concentration is poorly associated with histopathologic diagnosis.     

Lower respiratory tract infections in cats: 21 cases (1995-2000)

Twenty-one lower respiratory tract infections diagnosed in cats at University of Sydney Veterinary Centre between 1995 and 2000 were identified retrospectively. Patient records were analysed to determine historical, clinical, clinicopathologic and radiographic features of lower respiratory tract infections. Response to therapy was also assessed. Infectious agents identified were Mycoplasma spp., Pasteurella spp., Bordetella bronchiseptica, Salmonella typhimurium, Pseudomonas sp., Mycobacterium thermoresistible, Cryptococcus neoformans, Toxoplasma gondii, Aelurostrongylus abstrusus and Eucoleus aerophilus. The study provides a detailed retrospective analysis of infectious lower respiratory tract disease in this population of cats.     

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.     

Radiographic, ultrasonographic, and endoscopic findings in cats with inflammatory bowel disease of the stomach and small intestine: 33 cases (1990-1997).

OBJECTIVE: To characterize imaging findings in cats with confirmed inflammatory bowel disease (IBD) of the upper gastrointestinal tract (i.e., stomach and small intestine) and relate these findings to clinical signs and histologic changes. DESIGN: Retrospective study. ANIMALS: 32 cats with clinical and histopathologic diagnoses of IBD. PROCEDURE: Medical records were reviewed for signalment, clinical signs, clinicopathologic findings, radiographic and ultrasonographic findings, and results of endoscopic examination. Histologic findings were reviewed and characterized by severity and type of inflammatory infiltrate. RESULTS: All cats had 1 or more clinical signs (e.g., vomiting, diarrhea, weight loss, and anorexia) consistent with IBD. Lymphocytic and plasmacytic infiltrates were observed in histologic sections of gastrointestinal tissue. Crypt distortion, villous blunting and fusion, and fibrosis were most commonly seen in cats with moderate or severe IBD. Clinicopathologic findings of some cats included anemia, leukocytosis or leukopenia, hypocholesterolemia, and hyper- or hypoproteinemia. Abnormalities were not found on abdominal radiographic views in 9 of 9 cats. However, contrast studies using barium revealed radiographic abnormalities in 1 of 3 cats. In 13 of 17 cats, abdominal ultrasonography revealed several intestinal abnormalities (e.g., poor intestinal wall layer definition, focal thickening) and large mesenteric lymph nodes with hypoechoic changes consistent with IBD. Endoscopic observation revealed findings (e.g., erythema, plaques, mucosal friability) consistent with inflammation in 9 of 18 cats. CONCLUSIONS AND CLINICAL RELEVANCE: Compared with endoscopy of the gastrointestinal tract or abdominal radiography, clinical signs and ultrasonographic findings appear to have the best association with histologic grade of IBD in cats.     

Identification and characterization of an idiopathic pulmonary fibrosis-like condition in cats

Interstitial lung diseases are a heterogeneous group of disorders with a variety of causes. In veterinary medicine, such lung diseases with a prominent fibrotic component of unknown etiology are often called idiopathic pulmonary fibrosis (IPF). In human medicine, this term is reserved for a distinct disease entity with specific histologic findings labeled as usual interstitial pneumonia (UIP). We identified 23 cats displaying histologic criteria of UIP The purpose of this retrospective study is to describe the presentation and response to therapy of these cats to better define this disease entity. All but 2 cats were middle aged to older (median 8.7 years), with no apparent sex or breed predisposition. Complaints included respiratory distress (n = 18) and cough (13). Duration of signs was less than 6 months in 17 cats. Physical-examination abnormalities included tachypnea, inspiratory or mixed inspiratory and expiratory effort, and adventitial lung sounds. No consistent hematologic or biochemical abnormalities, parasites, or positive serologic results for feline retroviruses, heartworms, or toxoplasmosis were present. Radiographic changes included dense patchy or diffuse interstitial, bronchiolar, and alveolar infiltrates. Analysis of bronchial lavage fluid revealed mild neutrophilic inflammation (n = 6) with no consistent pathogen growth. Clinical condition of 5 cats worsened after lavage. Coincident pulmonary neoplasia was identified in 6 cats. Response to therapy (corticosteroids, antibiotics, bronchodilators, and diuretics) was poor, and most cats died within days to months. Cats with histologic changes compatible with UIP had signs that mimicked many of the clinical findings of human IPF, and treatment response was similarly unrewarding.     

Clinical signs and left atrial size in cats with cardiovascular disease in general practice

Objectives : To evaluate population characteristics, clinical signs and simple echocardiographic measurements of a general practice population of cats, in identifying characteristics that reliably distinguish cats with heart disease from others, including those with respiratory disease, using widely available techniques. Methods : Cats presented with heart disease (n=103), respiratory disease (n=19) and a normal group (n=29) were prospectively recruited. All cats were subject to full clinical examination, echocardiography and additional diagnostic procedures as appropriate to establish definitive diagnosis. Cats were classified as Group 1: no heart disease ± respiratory disease; Group 2: heart disease with no clinical signs; Group 3: heart disease with clinical signs. Murmur, gallop sound and arrhythmia prevalence and left atrial size were compared between the groups. Results : Low heart rates prevailed in Group 3. Murmurs were prevalent in Group 2, but in Group 3 prevalence was significantly lower. Dyspnoea, gallop sounds, arrhythmias and left atrial diameter were significantly different between groups. Clinical Significance : Heart rate is unreliable for diagnosing heart failure in cats. Absence of murmur is prevalent in cats with clinical signs of heart failure, but arrhythmia and gallop sounds are prevalent. Echocardiographic measurement of left atrial diameter >16.5 mm may distinguish heart failure from respiratory disease in general practice.     

Bronchoscopic findings in 48 cats with spontaneous lower respiratory tract disease (2002-2009)

Background: Diagnosis of lower respiratory disease requires collection of airway samples to confirm the etiology of disease. Bronchoscopic evaluation is commonly performed in dogs but less information is available in cats. Hypothesis: The presence and number of bronchoscopic abnormalities visualized during bronchoscopic evaluation of cats with lower respiratory disease will correlate with the type of disease and total and differential cell counts in bronchoalveolar lavage (BAL) fluid. Animals: Forty‐eight cats prospectively evaluated by a single bronchoscopist. Methods: Bronchoscopy was performed during clinical evaluation of cats presenting with cough, respiratory distress, or both. Cats were evaluated for airway hyperemia, stenosis, or collapse, mucus accumulation, bronchiectasis, and epithelial irregularities. Cats were placed into groups of bronchitis/“asthma,” pneumonia, or neoplasia based on BAL findings, histopathology, and response to appropriate medical therapy. Summation of bronchial abnormalities and total and differential cell counts were compared among groups. Results: Endobronchial abnormalities were common in cats with feline bronchitis/asthma, pneumonia, and neoplasia and no differentiating features were found. Excessive mucus accumulation was common (83%), followed by stenosis of bronchial openings and nodular epithelial irregularities (56%), airway hyperemia (54%), airway collapse (48%), and bronchiectasis (27%). Total bronchoscopic score and total cell count did not differ among groups, although differential cell counts were significantly different. A weak correlation (R²= 0.16, P= .006) between age and total bronchoscopic score was noted. Conclusions and Clinical Relevance: Bronchoscopic abnormalities are common in cats with lower respiratory tract disease, and visualization of the airways provides additional nonspecific clinical information in cats.     

Traumatic diaphragmatic hernia in cats: 34 cases (1991-2001)

OBJECTIVE: To determine whether signalment, duration of hernia, clinical signs, contents of hernia, CBC and serum biochemical abnormalities, concurrent injuries, perioperative treatment and administration of analgesics, results of intraoperative anesthetic monitoring data, or level of training of the veterinarian performing the herniorrhaphy was associated with mortality rate after surgical repair of traumatic diaphragmatic hernia in cats. DESIGN: Retrospective study. ANIMALS: 34 cats. PROCEDURE: Review of medical records and a telephone follow-up with owners and referring veterinarians were performed. RESULTS: Mean age of affected cats was 3.6 years; cats that survived to the time of discharge were significantly younger than cats that died or were euthanatized. Tachypnee was the most common clinical sign at hospital admission; cats that survived to the time of discharge had significantly higher respiratory rates than cats that died or were euthanatized after surgery. Postoperative complications developed in 50% of cats; tachypnea and dyspnea were most common. Mortality rate was not associated with duration of hernia or results of preoperative CBC and serum biochemical analyses, but was significantly associated with concurrent injuries. Mortality rate was not associated with hernia contents, intraoperative use of positive inotropes or corticosteroids, episodes of hypotension or severe hypoxia during anesthesia, or level of training of the veterinarian performing the surgery. CONCLUSIONS AND CLINICAL RELEVANCE: Cats that are older or have low to mildly increased respiratory rates and concurrent injuries are more likely to die after surgical repair of traumatic diaphragmatic hernia.     

Use of cis-bis-neodecanoato-trans-R,R-1,2-diaminocyclohexane platinum (II), a liposomal cisplatin analogue, in cats with oral squamous cell carcinoma

OBJECTIVE: To determine clinical response and toxic effects of cis-bis-neodecanoato-trans-R,R-1,2-diaminocyclohexane platinum (II) (L-NDDP) administered i.v. at escalating doses to cats with oral squamous cell carcinoma (SCC). ANIMALS: 18 cats with oral SCC. PROCEDURE: Cats that failed to respond to conventional treatment or had nonresectable tumors were included. Data included a CBC, serum biochemical analyses, urinalysis, cytologic examination of a fine-needle aspirate of enlarged lymph nodes, and thoracic and oral radiographs for clinical staging. A starting dose (75 to 100 mg/m2 of L-NDDP) was administered i.v.. At 21-day intervals, subsequent doses increased by the rate of 5 or 10 mg/m2. Response was evaluated every 21 days by tumor measurement and thoracic radiography. Quality of life was assessed by owners, using a performance status questionnaire. RESULTS: On average, cats received 2 treatments. Toxicoses included an intermittent, acute anaphylactoid-parasympathomimetic reaction, lethargy or sedation (< or = 24 hours), inappetence or signs of depression (< or = 72 hours), mild to moderate increase in hepatic enzyme activity, and melena. Pulmonary, renal, or hematopoietic abnormalities were not evident. Performance status surveys indicated normal behavior and grooming or decreased activity and self-care (19/20 assessments), ate well with or without assistance (15/20), and did not lose weight (15/20). Median survival time was 59.8 days (mean, 54.1 days). CONCLUSIONS AND CLINICAL RELEVANCE: L-NDDP was ineffective for treatment of cats with oral SCC. None of the cats had a complete or partial remission. Acute toxicoses and poor therapeutic response limit therapeutic usefulness of L-NDDP in cats, unless dosage, frequency, and administration procedures can be improved.     

Heartworm infection in cats: 50 cases (1985-1997)

OBJECTIVE: To characterize risk factors, clinical findings, usefulness of diagnostic tests, and prognosis in cats with naturally occurring heartworm infection (HWI). DESIGN: Retrospective study. ANIMALS: 50 cats with Dirofilaria immitis infection. PROCEDURE: Medical records, thoracic radiographs, and echocardiograms were reviewed and findings compared with appropriate reference populations. RESULTS: Findings suggested that male cats were not predisposed to HWI, domestic shorthair cats were at increased risk, and indoor housing was only partially protective. Fewer cases of HWI were identified in the final quarter of the year, compared with other periods, and prevalence is not apparently increasing. Signs of respiratory tract disease were most common, followed by vomiting. Infection was diagnosed incidentally in > 25% of cats; conversely, 10% of infected cats died suddenly without other clinical signs. Serologic tests were most useful for diagnosis, followed by radiography and echocardiography. Eosinophilia supported the diagnosis. Overall median survival time was 1.5 years but exceeded 4 years in cats surviving beyond the day of diagnosis. CONCLUSIONS AND CLINICAL RELEVANCE: Sex does not appear to be a risk factor for HWI in cats, and indoor housing provides only incomplete protection. Signs of respiratory tract disease (dyspnea and cough) are the strongest indicators of HWI in cats, and some radiographic evidence of infection is detected in most cases. Antibody screening for HWI in cats is efficacious, and antigen testing and echocardiography are most useful for making a definitive antemortem diagnosis.     

Pulmonary thromboembolism in cats: 29 cases (1987-1997)

OBJECTIVE: To determine clinical signs, clinicopathologic abnormalities, radiographic findings, histologic abnormalities, and predisposing factors or diseases in cats with pulmonary thromboembolism (PTE). DESIGN: Retrospective study. ANIMALS: 29 cats in which PTE was confirmed at necropsy. PROCEDURE: Information on signalment, body weight, history, results of physical examination, results of CBC and serum biochemical analyses, whether PTE was suspected prior to death, type of indwelling venous catheter and duration of venous catheterization, results of thoracic radiography, and whether cats had any concurrent diseases was obtained from medical records. RESULTS: PTE was identified in cats of various ages (median, 8.7 years), weights (median, 4.1 kg [9 lb]), and breeds. The most common owner-reported problems included lethargy (17 cats), anorexia (14), weight loss (10), and difficulty breathing (8); physical abnormalities included lethargy (21), tachypnea or dyspnea (16), and dehydration (13). Clinicopathologic abnormalities reflected concurrent or underlying diseases. Common radiographic abnormalities included pulmonary vessel abnormalities (11), pleural effusion (8), and peripheral noncircumscribed consolidations (6). Underlying or predisposing conditions, including cardiac disease (12), neoplasia (10), corticosteroid administration (8), disseminated intravascular coagulation (5), protein-losing nephropathy (4) or enteropathy (4), immune-mediated hemolytic anemia (2), and sepsis (2) were identified in all cats. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that PTE can develop in cats of any age, sex, or breed. Because PTE is a serious, potentially life-threatening disease, it should be suspected in cats with thoracic radiographic changes suggestive of uneven distribution of blood flow between lung lobes, especially in cats that have predisposing factors or diseases.     

RADIOGRAPHIC AND ECHOCARDIOGRAPHIC ASSESSMENT OF LEFT ATRIAL SIZE IN 100 CATS WITH ACUTE LEFT‐SIDED CONGESTIVE HEART FAILURE

The aims of this study were to evaluate left atrial size in cats with acute left‐sided congestive heart failure. We hypothesized that left atrial size as determined by thoracic radiography can be normal in cats with acute left‐sided congestive heart failure. One hundred cats with acute left‐sided congestive heart failure in which thoracic radiography and echocardiography were performed within 12 h were identified. Left atrial size was evaluated using right lateral and ventrodorsal radiographs. Measurements were compared to two‐dimensional echocardiographic variables of left atrial size and left ventricular size. On echocardiography, left atrial enlargement was observed in 96% cats (subjective assessment) whereas maximum left atrial dimension was increased (>15.7 mm) in 93% cats. On radiographs left atrial enlargement (subjective assessment) was found in 48% (lateral view), 53% (ventrodorsal view), and 64% (any view) of cats whereas left atrial enlargement was absent in 36% of cats in both views. Agreement between both methods of left atrial size estimation was poor (Cohen's kappa 0.17). Receiver operating characteristic curve analysis identified a maximum echocardiographic left atrial dimension of approximately 20 mm as the best compromise (Youden index) between sensitivity and specificity in the prediction of radiographic left atrial enlargement. Left atrial enlargement as assessed by thoracic radiography may be absent in a clinically relevant number of cats with congestive heart failure. Therefore, normal left atrial size on thoracic radiographs does not rule out presence of left‐sided congestive heart failure in cats with clinical signs of respiratory distress.     

Evaluation of respiratory parameters at presentation as clinical indicators of the respiratory localization in dogs and cats with respiratory distress

Objective ? To describe clinical respiratory parameters in cats and dogs with respiratory distress and identify associations between respiratory signs at presentation and localization of the disease with particular evaluation between the synchrony of abdominal and chest wall movements as a clinical indicators for pleural space disease. Design ? Prospective observational clinical study. Setting ? Emergency service in a university veterinary teaching hospital. Animals ? Cats and dogs with respiratory distress presented to the emergency service between April 2008 and July 2009. Interventions ? None. Measurements and Main Results ? The following parameters were systematically determined at time of admission: respiratory rate, heart rate, temperature, type of breathing, movement of the thoracic and abdominal wall during inspiration, presence of stridor, presence and type of dyspnea, and results of thoracic auscultation. Abdominal and chest wall movement was categorized as synchronous, asynchronous, or inverse. Diagnostic test results, diagnosis, and outcome were subsequently recorded. Based on the final diagnoses, animals were assigned to 1 or more of the following groups regarding the anatomical localization of the respiratory distress: upper airways, lower airways, lung parenchyma, pleural space, thoracic wall, nonrespiratory causes, and normal animals. One hundred and seventy‐six animals (103 cats and 73 dogs) were evaluated. Inspiratory dyspnea was associated with upper airway disease in dogs and expiratory dyspnea with lower airway disease in cats. Respiratory noises were significantly associated and highly sensitive and specific for upper airway disease. An asynchronous or inverse breathing pattern and decreased lung auscultation results were significantly associated with pleural space disease in both dogs and cats (P<0.001). The combination is highly sensitive (99%) but not very specific (45%). Fast and shallow breathing was not associated with pleural space disease. Increased or moist pulmonary auscultation findings were associated with parenchymal lung disease. Conclusions ? Cats and dogs with pleural space disease can be identified by an asynchronous or inverse breathing pattern in combination with decreased lung sounds on auscultation.