A pilot study using synthetic feline facial pheromone for the management of feline idiopathic cystitis

Synthetic feline facial pheromone (FFP) (Feliway; Ceva Animal Health) was assessed for the management of cats with recurrent feline idiopathic cystitis (FIC). Nine of 12 cats completed the randomised, double-blinded, placebo-controlled, crossover pilot study. They had their environment treated daily with either FFP or placebo for 2 months, after which time the treatment groups were reversed. Owners used visual analogue scales to define the severity of their cat's clinical signs and behavioural changes. Five (56%) of the owners stated that their cat's overall health was better when they were using FFP. Four (44%) of the owners noticed no difference between when using the FFP and when using the placebo. While there were no statistical differences between the two treatment groups there was a trend for the cats exposed to FFP to show fewer days with clinical signs of cystitis (FFP total, mean per cat+/-standard deviation, 30, 4.3+/-6.7; placebo 69, 9.9+/-19.1), a lower overall clinical score (1667, 238+/-476; 2009, 287+/-425), a reduced number of episodes of cystitis (9, 1.3+/-2.0; 10, 1.4+/-2.1) and reduced negative behavioural traits (e.g., less aggression and fear) (-128, -18.3+/-65.8; -73, -10.4+/-35.1).     

A case of recurrent feline idiopathic cystitis: The control of clinical signs with behavior therapy

Feline idiopathic cystitis (FIC), is the most common medical cause of elimination change in the cat, and hence is an important differential when working up cats presenting with inappropriate elimination. A recent case-control study found that case cats were more likely than the control population to be male, overweight, and pedigreed, but the study also found that several stress factors were “flare factors” associated with the onset of a bout of clinical signs. A 5-year-old male, neutered, domestic shorthaired cat presented with recurrent bouts of dysuria and hematuria. A full medical work up eliminated other causes, leading to the diagnosis of FIC. On behavioral assessment, the cat was found to be one of 6 within the household. He showed no signs of regarding any of the other cats as part of his social group. A program of behavior therapy was instituted, which involved ensuring the patient had a separate “core area” and easy access to important resources. In addition, visual access to cats from outside the household was restricted. The cat was followed up for a period of 7 months. There was no further recurrence of clinical signs for 6 months, after which clinical signs returned. Further investigation revealed that this outbreak occurred 2 days after the owner confined the cats in close proximity again. This case provides an interesting example of how bouts of clinical signs in FIC cats can often be linked to specific “stressful” events, and how such outbreaks can be reduced or prevented through the implementation of a specific program of behavior therapy.     

A study of environmental and behavioural factors that may be associated with feline idiopathic cystitis

The cause of cystitis in many cats remains unknown. The aim of this study was to determine whether or not any environmental or behavioural factors, particularly those that could be considered potentially stressful, were associated with feline idiopathic cystitis (FIC). The questionnaire-based study involved comparing 31 cats with FIC to 24 cats in the same households that did not have cystitis. They were also compared with a control population of 125 clinically healthy cats. Compared with the live-in controls and the control population, the cats with FIC were significantly more likely to be male, overweight and pedigree. Several stress factors were found to be associated with FIC. The factor that stood out most prominently was living with another cat with which there was conflict. The findings support the hypothesis that stress may be implicated in some cases of FIC.     

Tolerability and efficacy of benazepril in cats with chronic kidney disease

The objective of the study was to test the effect of the angiotensin-converting enzyme inhibitor (ACEI) benazepril in cats with chronic kidney disease (CKD). A total of 192 cats with CKD with an initial plasma creatinine concentration > or = 2 mg/dL (> or = 177 micromol/L) and urine specific gravity < or = 1.025 were recruited into a double-blind, parallel-group, prospective, randomized clinical trial. Cats received daily (q24h) PO placebo (n = 96) or benazepril x HCl at a dosage of 0.5-1.0 mg/kg (n = 96) for up to 1,119 days. Most cats were fed exclusively a diet containing low amounts of phosphate, protein, and sodium. Benazepril produced a significant reduction in proteinuria, assessed by the urine protein-to-creatinine ratio (UPC, P = .005). This effect of benazepril was present in all subgroups tested, including cats with UPC <0.2, although the effect was largest in cats with higher UPCs. Plasma protein was maintained at higher concentrations with benazepril as compared with placebo during treatment in cats with initial UPC <1 (P = .038 versus P = .079 for all cats). There was no difference in renal survival time between the 2 groups when all 192 cats were compared. Mean +/- SD renal survival times were 637 +/- 480 days with benazepril and 520 +/- 323 days with placebo (P = .47). Mean +/- SD renal survival times in the 13 cats with initial UPC > or = 1 were 402 +/- 202 days with benazepril and 149 +/- 90 days with placebo (P = .27). Cats with initial UPC > or = 1 treated with benazepril had better appetite (P = .017) as compared with those treated with placebo. Benazepril was well tolerated. In conclusion, benazepril decreased proteinuria in cats with CKD.     

Evaluation of the effects of stress in cats with idiopathic cystitis

OBJECTIVE: To determine the effects of stress in cats with feline idiopathic cystitis (FIC) by evaluating bladder permeability, sympathetic nervous system function, and urine cortisol:creatinine (C:Cr) ratios during periods of stress and after environmental enrichment. DESIGN: Prospective study. ANIMALS: 13 cats with FIC and 12 healthy cats. PROCEDURE: Cats subjected to an acute-onset moderate stressor for 8 days received IV injections of fluorescein. Serum fluorescein concentrations were determined and compared with those of controls to evaluate bladder permeability, and urine C:Cr ratios were compared to evaluate function of the hypothalamic-pituitary-adrenal (HPA) axis. Plasma catecholamine concentrations were analyzed in a subset of cats. After 8 days of moderate stress, cats were moved to an enriched environment, and tests were repeated after 21 days. RESULTS: Serum fluorescein concentrations were significantly higher in cats with FIC at all time points. In the cats in which plasma catecholamine concentrations were determined, concentrations of dihydroxyphenylalanine, norepinephrine, and dihyroxyphenylglycol were significantly higher in cats with FIC at all time points, whereas no differences in urine C:Cr ratio between groups were observed. CONCLUSION AND CLINICAL RELEVANCE: Cats with FIC appeared to have altered bladder permeability, most notably during the period of initial stress. The increase in plasma dihydroxyphenylalanine concentration suggests that there may be stress-induced increase in the activity of tyrosine hydroxylase, which catalyzes the rate-limiting step in catecholamine synthesis. In contrast, no effects of stress on C:Cr ratios were observed, which suggests there was dissociation between the sympathetic nervous system and HPA-axis responses to stress.     

Effect of isoflurane anesthesia on hemodynamics following the administration of an angiotensin-converting enzyme inhibitor in cats

The objective of this study was to evaluate the hemodynamics of the anesthetic isoflurane in healthy cats given angiotensin-converting enzyme inhibitor (ACEI). The 7 healthy young cats and 3 old cats were received placebo or enalapril 0.5 mg/kg orally. The change in systolic arterial pressure from the baseline to 30 min postanesthesia in the ACEI group was significantly higher than in the placebo group (mean +/- SD: -39 +/- 13% vs. -17 +/- 12%, respectively). The present study indicated that general anesthesia may induce hypotension after the administration of an ACEI.     

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.     

Risk factors and clinical presentation of cats with feline idiopathic cystitis

Feline idiopathic cystitis (FIC) is the most common cause of feline lower urinary tract disease (FLUTD). This retrospective, case-controlled study evaluated possible risk factors associated with FIC and compared different clinical presentations in 64 cats with FIC. Several risk factors known to be involved in FLUTD were identified as playing a role in FIC. Of the stressful situations considered, most did not occur with increased frequency in cats with FIC compared to controls, except for a house move. The presence of pyuria, haematuria and an increased urine protein:creatinine ratio were significantly higher in obstructed males compared with non-obstructed males. An obstruction was significantly more likely in cats with struvite crystalluria compared with cats without struvite crystalluria. These findings suggest that urethral plugs might be an important cause or contributing factor of obstruction in FIC. Episodes of FIC seem to occur mainly in susceptible cats in combination with a deficient environment.     

Amoxycillin and clavulanic acid combination in the treatment of experimentally induced bacterial cystitis in cats

Clavulanic acid (CA) competitively inhibits beta-lactamase hydrolysis of penicillins in vitro. Treatment with amoxycillin combined with clavulanic acid (A-CA) was compared with placebo in a blind study in cats with experimental cystitis caused by Escherichia coli demonstrating in vitro resistance to amoxycillin. Bacterial cystitis was induced in 20 cats by bladder infusion of 5 ml of 0.05 per cent alcoholic salicylic acid followed after 24 hours by a brain-heart infusion broth of E coli (10(8) colony forming units ml-1) previously found to be resistant to amoxycillin in vitro (minimum inhibitory concentration over 512 micrograms ml-1). Four days after infection, cats were randomly divided into two groups of 10 and treated with amoxycillin combined with clavulanic acid or placebo for 10 days. When compared to the placebo-treated group, the A-CA treated group showed: reduced quantitative bacterial counts in urine on days 7 (P less than 0.001) and 14 (P less than 0.02); reduced culture positive urine on days 7 (P less than 0.001) and 14 (P less than 0.001); and less severe inflammation on histological examination of the bladder and urethra (P less than 0.01). It was concluded that A-CA was effective in reducing the bacterial count and reducing the histopathological changes in the bladder and urethra in an experimental model of acute bacterial cystitis in cats infected with an E coli demonstrating in vitro resistance to amoxycillin.     

Serum Cytokine Profiling in Cats with Acute Idiopathic Cystitis

Background

Feline idiopathic cystitis (FIC) is a common lower urinary tract disorder of domestic cats that resembles interstitial cystitis/painful bladder syndrome (IC/PBS) in humans. Diagnosis of FIC is based on clinical signs and exclusion of other disorders because of a lack of specific pathologic findings or other objective biomarkers. Cytokines are potential noninvasive biomarkers to define the presence, severity, and progression of disease, and response to treatment.

Objectives

The objective of this pilot study was to determine concentrations of selected cytokines in serum from healthy cats and cats with acute FIC.

Animals

Serum samples from 13 healthy cats and from 12 cats with nonobstructive acute FIC were utilized.

Methods

Multiplex analysis of 19 cytokines (CCL2, CCL5, CXCL1, CXCL12, CXCL8, Flt3L, GM‐CSF, IFN‐γ, IL‐12 (p40), IL‐13, IL‐18, IL‐1β, IL‐2, IL‐4, IL‐6, PDGF‐BB, SCF, sFas, and TNF‐α) was performed with a commercially available feline‐specific multiplex bead‐based assay.

Results

Mean serum concentrations of IL‐12 (p40; P < 0.0001), CXCL12 (P = 0.002), IL‐18 (P = 0.032), and Flt3L (P = 0.0024) were significantly increased in FIC cats compared to healthy cats. GM‐CSF, IL‐1b, IL‐2, and PDGF‐BB were undetectable or detected in an insufficient number of cats to allow meaningful comparisons.

Conclusions and Clinical Importance

We have identified increased serum concentrations of pro‐inflammatory cytokines and chemokines CXCL12, IL‐12, IL‐18, and Flt3L in FIC‐affected cats. These findings suggest potential candidates for noninvasive biomarkers for diagnosis, staging, and therapeutic outcome monitoring of affected cats and provide additional insight into the etiopathogenesis of FIC.     

Clinical evaluation of multimodal environmental modification (MEMO) in the management of cats with idiopathic cystitis

This prospective observational study evaluated client-reported recurrence of lower urinary tract signs (LUTS) and other signs of abnormalities in cats with idiopathic cystitis after institution of multimodal environmental modification (MEMO). Forty-six client-owned indoor-housed cats with idiopathic cystitis, diagnosed based on a history of recurrent LUTS and evidence of absence of urolithiasis or bacterial urinary tract infection were studied. In addition to their usual care, clients were offered recommendations for MEMO based on a detailed environmental history. Cases were followed for 10 months by client contact to determine the effect of MEMO on LUTS and other signs. Significant (P<0.05) reductions in LUTS, fearfulness, nervousness, signs referable to the respiratory tract, and a trend (P<0.1) toward reduced aggressive behavior and signs referable to the lower intestinal tract were identified. These results suggest that MEMO is a promising adjunctive therapy for indoor-housed cats with LUTS, and should be followed up with prospective controlled clinical trials.     

Clinical efficacy of the acyclic nucleoside phosphonate 9-(2-phosphonylmethoxypropyl)-2,6-diaminopurine (PMPDAP) in the treatment of feline immunodeficiency virus-infected cats

In in vitro studies, the acyclic nucleoside phosphonate 9-(2-phosphonylmethoxypropyl)-2,6-diaminopurine (PMPDAP) inhibited the replication of feline immunodeficiency virus (FIV). No information about its clinical efficacy is available so far. The aim of this prospective placebo-controlled, double-blinded study was to evaluate the antiviral efficacy of PMPDAP in cats naturally infected with FIV. Twenty cats were randomly assigned to two treatment groups receiving either PMPDAP (25 mg/kg) or placebo twice per week subcutaneously for 6 weeks. The general health status (Karnofsky's score), clinical signs, laboratory, immunological, and surrogate parameters were evaluated. No significant differences were found between PMPDAP- and placebo-treated cats, although cats treated with PMPDAP showed a tendency for improvement in their Karnofsky's score and clinical signs. Haematological side effects were noted in the PMPDAP-treated cats. Thus, PMPDAP may be an option in treating cats if it becomes available for veterinarians, but side effects have been monitored.     

Clinical efficacy and tolerance of an extract of green-lipped mussel (Perna canaliculus) in dogs presumptively diagnosed with degenerative joint disease

AIM: To evaluate the efficacy and tolerance of an extract of green-lipped mussel (GLME) in the management of mild-to-moderate degenerative joint disease (DJD) in dogs. METHODS: Eighty-one dogs presumptively diagnosed with DJD were treated orally daily with either GLME or a placebo for 56 days, in a double-blind, placebo-controlled study. In an uncontrolled open-label extension to the study, all dogs were treated with GLME for an additional 56 days (from Days 57-112). Clinical signs were subjectively scored by the owners, and findings of detailed musculoskeletal examinations were scored by one veterinarian. Efficacy was assessed from a qualitative comparison of the proportion of dogs with improved clinical signs, and a quantitative comparison of the scores of the musculoskeletal examinations, between groups. Haematological and biochemical analyses and reports by owners of possible adverse drug reactions were used to screen for evidence of toxicity. RESULTS: There was close agreement between assessments by the veterinarian and owners. The clinical signs of DJD in both GLME-treated and placebo groups improved significantly over baseline by Day 28; this improvement continued over the entire course of the study. There were no significant differences between groups on Day 28. On Day 56, a higher proportion of dogs in the GLME-treated group had improved clinical signs (p=0.018), and GLME-treated dogs had marginally better (p=0.053) musculoskeletal scores than dogs in the placebo group. The differences between the groups were no longer apparent by Day 112, by which time the former placebo group had been receiving GLME for 56 days in the open-label phase of the study. The proportion of dogs in the former placebo group that had improved by Day 112 (29/32; 91%) was significantly greater (p=0.012) than the proportion improved at Day 56 (15/37; 41%). No signs of toxicity were apparent. CONCLUSIONS AND CLINICAL RELEVANCE: GLME had a beneficial effect on the clinical signs of dogs presumptively diagnosed with mild-to-moderate DJD. Long-term therapy may be required before improvement is apparent.     

Evaluation of the clinical efficacy of benazepril in the treatment of chronic renal insufficiency in cats

BACKGROUND: Chronic renal insufficiency (CRI) is a common disease in cats. Angiotensin-converting enzyme inhibitors (ACEI) have beneficial effects in humans with CRI by reducing the loss of protein in the urine and increasing life expectancy. HYPOTHESIS: The ACEI benazepril has beneficial effects on survival, clinical variables, or both as compared with placebo in cats with CRI. ANIMALS: 61 cats with naturally occurring CRI. METHODS: The cats were enrolled into a prospective, randomized, double-blind, placebo-controlled clinical trial. Cats received placebo or 0.5-1 mg/kg benazepril once daily for up to 6 months. RESULTS: Urine protein/urine creatinine ratios were significantly (P < .05) lower with benazepril as compared with placebo at days 120 and 180. Three cats with placebo and 1 cat with benazepril were removed prematurely from the study because of deterioration of CRI or death. Cats were classified into 4 stages of CRI according to the International Renal Interest Society (IRIS) classification scheme. Incidence rates of cats with IRIS classification stage 2 or stage 3 that remained in stage 2 or 3 without progressing to stage 4 were higher with benazepril (93 +/- 5%) as compared with placebo (73 +/- 13%). CLINICAL IMPORTANCE: These results suggest a potential for benazepril to delay the progression of disease, extend survival time, or both in cats with CRI.     

Effects of a selective serotonin reuptake inhibitor on urine spraying behavior in cats.

OBJECTIVE: To determine the effectiveness of a readily available selective serotonin reuptake inhibitor (SSRI), fluoxetine hydrochloride, on reducing problem urine spraying in cats. DESIGN: Randomized placebo-controlled double-blind clinical trial. ANIMALS: 17 neutered cats > 1 year old with objectionable urine spraying behavior. Procedure-Owners recorded urine-spraying events for 2 weeks (baseline). Cats that vertically marked a mean of > or = 3 times per week were treated for 8 weeks with fluoxetine or fish-flavored liquid placebo. If urine spraying was not reduced by 70% by weeks 4 through 5, the dosage was increased by 50% for weeks 7 and 8. After discontinuation of treatment at the end of 8 weeks, owners recorded daily urine marks for another 4 weeks. RESULTS: The mean (+/- SE) weekly rate of spraying episodes in treated cats was 8.6 (+/- 2.0) at baseline, decreased significantly by week 2 (1.7 +/- 0.6), and continued to decrease by weeks 7 and 8 (0.4 +/- 0.2). The mean weekly spraying rate of cats receiving placebo was 7.8 (+/- 1.5) at baseline, decreased only slightly during week 1 (5.5 +/- 1.8), and did not decline further. When treatment was discontinued after 8 weeks, the spraying rate of cats that had received treatment varied. The main adverse reaction to the drug was a reduction in food intake, which was observed in 4 of 9 treated cats. CONCLUSIONS AND CLINICAL RELEVANCE: Administration of fluoxetine hydrochloride for treatment of urine spraying in cats can be expected to considerably reduce the rate of urine marking. The frequency of spraying before treatment is predictive of the spraying rate when the drug is discontinued.     

Oral Mucosa Bleeding Times of Normal Cats and Cats with Chediak-Higashi Syndrome or Hageman Trait (Factor XII Deficiency)

A commercially available, disposable blade in a spring-loaded cassette was used to measure oral mucosa bleeding times (OMBT) of ketamine/acepromazine-anesthetized cats. The OMBT were determined in cats homozygous for Chediak-Higashi syndrome (CHS, n = 7), cats heterozygous for CHS (n = 6), and cats homozygous for Hageman factor (factor XII) deficiency (n = 5). In addition, OMBT were determined in three groups of normal cats: random-source cats (n = 14), inbred normal relatives of the cats with CHS (n = 7), and inbred normal relatives of Hageman factor deficient cats (n = 9). No significant differences were found in the OMBT of the three groups of normal cats. The mean OMBT for all 30 normal cats was 1.9 minutes +/- 0.5 minutes s.d. Compared to the normal cats, those homozygous for CHS had significantly prolonged OMBT (14.1 +/- 3.3 minutes; p < 0.05). The mean OMBT of cats heterozygous for CHS (2.6 +/- 0.8 minutes) was also significantly longer than the OMBT of the combined normal group. The mean OMBT of the CHS heterozygotes, however, was not significantly longer than that of their normal relatives (OMBT = 1.8 +/- 0.5 minutes), probably because of the low number of cats in this subgroup of normals. As expected, the OMBT of cats homozygous for Hageman factor deficiency (2.3 +/- 0.3 minutes) were not significantly prolonged.     

Search and identification methods that owners use to find a lost cat

OBJECTIVE: To characterize the process by which owners search for lost cats and identify factors associated with time to recovery. DESIGN: Cross-sectional study. SAMPLE POPULATION: Owners of 138 cats lost in Montgomery County, Ohio, between June 1 and September 30, 2005. PROCEDURES: A telephone survey was conducted. RESULTS: 73 of the 138 (53%) cats were recovered; median time to recovery was 5 days (range, 0.5 to 81 days). Most cats (48 [66%]) that were recovered returned home on their own or were found in the neighborhood (5 [7%]); most other cats were recovered through posting of neighborhood signs (8 [11%]) or calling or visiting an animal agency (5 [7%]). The highest success rate for any of the search methods that were used was only 12% (posting neighborhood signs). Only 26 of the 138 (19%) cats had some type of identification at the time they were lost (ie, identification tag, rabies tag, or microchip). Owners allowed 82 (59%) cats to spend at least some time outdoors. The percentage of sexually intact cats recovered by their owners (4/16 [25%]) was significantly lower than the percentage of neutered cats recovered (69/122 [57%]). CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that the percentage of lost cats recovered by their owners is low, possibly in part because of the lack of use of traditional identification methods and the general acceptance that cats may roam. Veterinarians can help educate owners about the importance of identification and the need to keep cats indoors.     

Clinical features, survival times and COX-1 and COX-2 expression in cats with transitional cell carcinoma of the urinary bladder treated with meloxicam

Records of 11 cats with transitional cell carcinoma of the urinary bladder, which had been treated with meloxicam, were reviewed for signalment, duration of clinical signs prior to diagnosis, results of diagnostic imaging, whether or not concurrent surgery was performed and survival. Immunohistochemical expression of cyclo-oxygenase-1 (COX-1) and cyclo-oxygenase-2 (COX-2) was assessed in the tumours of seven cats. Tumour location varied greatly. The cats had a mean age of 13 years. Three cats had a previous diagnosis of feline idiopathic cystitis of up to 2008 days duration. Ten of the cats showed clinical improvement (reduction of haematuria and/or dysuria), with a mean survival time (MST) of 311 days (range 10-1064); 1-year survival of 50%. All seven bladders assessed for COX staining were COX-1 positive and five were COX-2 positive. The MST for the COX-2-positive cats was 123 days, the MST for the COX-2-negative cases was 375 days.