Nanocrystalline silver dressing and subatmospheric pressure therapy following neoadjuvant radiation therapy and surgical excision of a feline injection site sarcoma

CLINICAL SUMMARY: This is the first clinical report of use of a combination of nanocrystalline silver and subatmospheric pressure therapy to treat a resistant wound infection, following tumour removal and radiation therapy, in a difficult-to-manage surgical site in a cat. PRACTICAL RELEVANCE: The therapy was well tolerated and the authors suggest it is a valid treatment protocol for management of non-healing or infected wounds in the cat.     

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).     

Hepatic and metabolic changes in surgical colic patients: a pilot study

Objective – To determine: (1) changes in blood ammonia, bile acid (BA), bilirubin, triglyceride, and glucose concentrations and liver enzyme activities in perioperative colic patients and (2) the association between these laboratory findings and short‐term survival. Design – Prospective observational clinical study. Animals – Thirty‐two adult horses undergoing exploratory celiotomy for colic. Interventions – None. Measurements and Main Results – Blood samples were collected preoperatively and at 24–36 and 72–84 hours postoperatively and analyzed for blood ammonia, BA, bilirubin, triglyceride, and glucose concentrations and sorbitol dehydrogenase (SDH) and gamma glutamyl transferase (GGT) activities. Short‐term survival was defined as survival to hospital discharge. Data were analyzed using a Fisher's exact test and analysis of variance. Mildly increased blood ammonia concentrations were present in 2 horses at admission. Postoperative blood ammonia concentrations were within reference intervals in all horses. There were increases in liver enzyme activities as well as in BA, triglyceride, and total bilirubin concentrations. Horses with markedly increased admission BA concentrations and SDH activities did not survive. BA concentrations and SDH activities decreased postoperatively. There was no association between GGT activity and survival; GGT activity remained increased postoperatively. Blood triglyceride concentration was increased in almost all horses postoperatively; horses that did not survive had higher triglyceride concentrations at 24–36 hours postoperatively than horses that survived. Conclusion – Alterations in metabolism and hepatobiliary function are common in colic patients. The results of this study provide further prognostic indices for colic patients and highlight areas for improvement in patient management.     

Prognosis after surgical excision of canine melanomas.

One hundred and thirty-four dogs from which melanomas had been excised were studied until death or for at least 2 years after surgery. Seven of 49 (14%) intraoral and lip tumours and 52 of 85 (61%) skin tumours were histologically benign; in spite of this, three of seven (43%) "benign" oral and four of 52 (8%) "benign" skin lesions led to the eventual death of the host. Thirty eight of 42 (90%) dogs with a histologically malignant melanoma of the lip or oral cavity died because of the tumour but only 15 of 33 (45%) with malignant skin melanomas died. Six of 59 (10%) dogs with a tumour of mitotic index 2 or less died from the tumour 2 years after surgery compared to 19 of 26 (73%) dogs having a tumour with a mitotic index of 3 or more.     

Evaluation of leukocyte counts and neutrophil‐to‐lymphocyte ratio as predictors of local recurrence of feline injection site sarcoma after curative intent surgery

Local recurrence (LR) is the major concern in the treatment of feline injection‐site sarcoma (FISS). Pretreatment leukocyte counts and ratios have been reported as diagnostic and/or prognostic markers in human and canine oncology. The aim of this retrospective study was to explore the prognostic impact on LR and overall survival time (OST) of pretreatment neutrophil‐to‐lymphocyte ratio (NLR), white blood cell count (WBCC), neutrophil count (NC) and lymphocyte count (LC) in cats with surgically excised FISS. Eighty‐two cats with histologically confirmed FISS at first presentation, without distant metastases, and with available pretreatment haematological analyses were retrospectively enrolled. The correlation of NLR, WBCC, NC, LC with tumour variables and patient variables was explored. NLR was correlated with tumour size (P = .004), histological pattern of tumour growth (P = .024) and histotype (P = .029), while WBCC and NC were associated with ulceration (P = .007, P = .011) and pattern of growth (P = .028, P = .004). No significant relationships emerged between LC and any of the considered variables. The impact of NLR, WBCC, NC, LC on LR and OST was then estimated in univariate and multivariate analysis. In univariate analysis, NLR, WBCC and NC were significant prognostic factors for both LR and OST. NLR, WBCC and NC remained prognostic in multivariate analysis for LR but not for OST. When NLR, WBCC and NC were jointly analysed, WBCC was the marker with the greater impact on LR. Preoperative NLR, WBCC and NC may aid in identifying cats at higher risk of LR.     

Comparison of feline water consumption between still and flowing water sources: A pilot study

This study evaluated whether cats show a preference for a still or flowing water source for daily water consumption. Nine individually housed cats were randomly assigned to a still or flowing water source and consumption rates were measured over four consecutive 22 hour test periods. The mean water consumption rate for the flowing water source (115.44mL) was higher than for the still water source (109.83mL) but that difference was not statistically significant. It appeared that individual cats had a strong preference for one water source compared to the other, but a group preference was not established. Additional research is necessary to determine whether the factor of still compared to flowing water influences consumption rates for individual cats and if this is an important factor for the species.     

FC-41 A prospective pilot study on the use of cyclosporin on feline allergic diseases

This study evaluated the efficacy of Phytopica^TM, a proprietary blend of standardised plant extracts, in canine atopic dermatitis (AD). One hundred twenty dogs with perennial AD were recruited on the basis of history and clinical signs, and a positive intradermal allergen test or rFcεRIα serology to perennial allergens. Other pruritic dermatoses were eliminated by antimicrobial treatment, skin scrapings, Sarcoptes serology, flea control and a 6-week food trial. Exclusion criteria included antimicrobial therapy within 7 days, antihistamines within 14 days, oral/topical glucocorticoids or cyclosporin within 28 days, and parenteral glucocorticoids, essential fatty acids or immunotherapy within 56 days of entry into the study. Dogs [minimum Canine Atopic Dermatitis Extent and Severity Index (CADESI) = 25] were randomly allocated to receive placebo, 100, 200 or 400 mg/kg Phytopica^TM daily for 12 weeks. Their CADESI was assessed every 4 weeks. A modified intention-to-treat population was analysed. The mean reductions in CADESI scores at the end of treatment compared to baseline were 4.4% (100 mg/kg; n  = 30), 23.4% (200 mg/kg; n  = 29, P  < 0.01), 8.5% (400 mg/kg; n  = 29) and 3.9% (placebo; n  = 29). For more severely affected dogs (minimum CADESI ≥ 50 at baseline), there was significant reduction in mean CADESI score (29.3%, P  = 0.038) only in the 200 mg/kg treatment group ( n  = 14). In conclusion, this study demonstrates that Phytopica^TM is an effective nonsteroidal treatment for canine AD.
Funding: Phytopharm plc.     

Tissue damage at the injection site after intramuscular injection of drugs

Tissue damage at the injection site has been described after intramuscular injection of antibiotics, chemotherapeutics, vitamins, lidocaine, diazepam and digoxin in dogs, swine, cows, sheep and hens.The damage caused by substances commonly used in drug vehicles has also been examined and compared with the effects of saline and distilled, sterile water. After intramuscular injection of saline or sterile water little or no tissue reaction has been observed, while vehicles containing glycerol formal or propylene glycol caused damage to muscle tissue.The investigations show that both the drug itself and the vehicles may cause tissue damage. In the development of drug preparations for intramuscular administration, which cause minimal tissue damage, it is therefore important to consider all the components of the preparation.From the point of view of international collaboration it will be of great importance that standard methods are generally accepted for the evaluation of new drugs and for the estimation and prediction of tissue damage after their intramuscular injection.

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Kurzfassung Gewebeschäden an der Injektionsstelle liessen sich nach der intramuskulären Verabreichung von u. a. Antibiotika, chemotherapeutischen Erzeugnissen, Vitaminpräparaten, Lidokain, Diazepam und Digoxin bei Hunden, Schweinen, Kühen, Schafen oder Hühnern feststellen.Dabei wurde die irritierende Wirkung der üblicherweise in den Bindemitteln enthaltenen Substanzen untersucht und mit der Wirkung von salinem und destilliertem, sterilem Wasser verglichen. Bindemittel, die Formalglyzerin oder Propylenglykol enthalten, verursachten eine Schädigung des Muskelgewebes.Die erwähnten Untersuchungen ergaben, dass sowohl das Medikament selbst, als auch das Bindemittel Gewebeschäden hervorrufen können. Daher ist bei der Entwicklung von Arzneimitteln, deren gewebeschädigende Wirkung bei intramuskulärer Verabreichung minimal sein soll, darauf zu achten, dass alle Bestandteile des Präparates geprüft werden.Für eine internationale Zusammenarbeit dürfte es von grosser Bedeutung sein, dass die unterschiedlichen Bewertungsmethoden für neue Medikamente allgemeingültig festgelegt werden; dies gilt auch für die Einschätzung oder vorherige Bestimmung der lokalen Schädigung durch die intramuskuläre Injektion.

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Resume L'effet de lésion tissulaire au point d'injection a été décrit après l'injection intramusculaire d'antibiotiques, de chimiothérapeutiques, de vitamines, lidocaine, diazepam et digoxine chez des chiens, porcs, moutons ou poules. L'effet d'irritation des substances communément utilisées dans les excipients a été examiné et comparé à l'effet de l'eau salée et distillée ou de l'eau sterile. Les excipients contenant du glycérol formaldéhyde ou du propylène glycol ont provoqué des lésions du tissu musculaire.Les études citées révèlent que le médicament lui-même comme les excipients peuvent provoquer des lésions tissulaires. Aussi fautil tenir compte, pour la mise au point de préparations pharmaceutiques pour l'administration par voie intramusculaire ne causant qu'une lésion minimale des tissus, de tous les composants entrant dans la préparation.Du point de vue de la collaboration internationale, il sera très important que les différentes méthodes d'évaluation des nouveaux médicaments soient unanimement acceptées ainsi que les méthodes utilisées pour l'estimation ou la prédiction de lésions locales après injection intramusculaire.

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Riassunto Viene descritta l'azione lesiva osservata nei tessuti nel punto di inoculazione per via intramuscolare dei farmaci per uso veterinario, quali antibiotici, chemioterapici, vitamine, lidocaina, diazepam e digoxin. Le osservazioni sono state eseguite su cani, suini, bovini, ovini, o polli.L'effetto irritante di sostanze d'uso comune in eccipienti farmaceutici è stato confrontato con l'effetto dell'acqua distillata sterile e della soluzione fisiologica, pure sterile.Gli eccipienti contenenti glicerina o glicole propilenico hanno provocato lesioni nel tessuto muscolare. Dalle indagini descritte appare evidente che sia il farmaco che gli eccipienti possono provecare danni ai tessuti. Pertanto, al fine di migliorare i preparati farmaceutici per somministrazione intramuscolare che possono provocare lesioni anche minime nei tessuti, è importante prendere in considerazione tutti i componenti dei preparati stessi.Dal punto di vista di una collaborazione internazionale, è di grande importanza che i vari metodi di esame dei nuovi farmaci siano unanimente accettati, compresi i metodi untilizzati per l'esame e la prevenzione dei danni locali conseguenti alla inoculazione per via intramuscolare.

     

Ex vivo viability of canine and feline sarcomas: a pilot study

Assay-based chemotherapeutic protocols are common in human gynecologic oncology, most notably for patients with ovarian or breast cancer. The current study examines ex vivo incubation conditions necessary for the assessment of sarcomatous tumor response to potential chemotherapeutic drugs. Slices of sarcomatous tumors were incubated in one of two culture media. Viability indices were measured and compared across time and between media. Neither medium was sufficient to support the growth of sarcomatous tumor tissue slices based on the indices studied. It is likely that sarcomatous tumors require a different approach for ex vivo assessment than their epithelial counterparts. Our long-term goal is to incubate tumor slices with chemotherapeutic agents to predict the in vivo tumor response based on the maintenance or loss of slice viability within this system.     

A prospective study of postoperative surgical site infections in dogs and cats

OBJECTIVE: To assess postoperative surgical site infection (SSI) rate and to identify associated predictive factors. STUDY DESIGN: Prospective clinical study. ANIMALS: Dogs and cats that had surgery (1010 interventions) during 58 weeks from April 1999 to June 2000. METHODS: Data sheets were completed by clinicians. Patients were controlled for clinical evidence of SSI at suture removal. Two definitions of SSI ("infection" and "infection/inflammation") were developed specifically for this study and used for statistical analysis. Logistic regression models were built in order to identify significant predictive factors for SSI. RESULTS: Wounds with "infection/inflammation" occurred in 5.8% and "infected" wounds in 3% of patients. The outcome "infection" was associated with 3 major risk factors (duration of surgery, increasing number of persons in the operating room, dirty surgical site) and 1 protective factor (antimicrobial prophylaxis). The outcome "infection/inflammation" was associated with 6 significant factors (duration of anesthesia, duration of postoperative intensive care unit stay, wound drainage, increasing patient weight, dirty surgical site, and antimicrobial prophylaxis). CONCLUSIONS: SSI frequency in companion animals is comparable with the frequency observed in human surgical patients. Several significant predictive factors for SSI in small animals surgery were identified. CLINICAL RELEVANCE: Baseline information for SSI surveillance in our hospital and for comparison with other studies was defined. The factors identified may help to predict infections in surgical patients and to take adequate preventive measures for patients at risk.     

In vitro efficacy of doxorubicin and etoposide against a feline injection site sarcoma cell line

Feline injection site sarcoma (ISS) is a locally invasive tumor, in which surgical treatment is frequently combined with radiation or chemotherapy to improve tumor control. The focus of this study was to evaluate the cytotoxic effects of doxorubicin or etoposide on a feline injection site sarcoma cell line (JB) and to assess the impact of combining these drugs on cell death and cell cycle. Both single agent and combination drug administration increased cell death and significantly reduced the number of viable cells. Cells in G0/G1 were significantly reduced while the G2/M fraction was significantly increased following treatment. Collectively, combining doxorubicin and etoposide at the lower EC yielded comparable results to the EC50 of either drug alone in degree of cytotoxicity, level of apoptosis, and % of cells in G2/M. The results of this study indicate that doxorubicin and etoposide alone and in combination differentially alter ISS cell viability and cycle.     

Prospective open pilot study on the use of ciclosporin for feline allergic skin disease

OBJECTIVES: To evaluate the efficacy of ciclosporin in cats with allergic skin disease. METHODS: Ten cats with signs of allergic skin disease were administered ciclosporin daily at a dose of 3.6 to 8.3 mg/kg for one month. None of these cats had previously responded to a hypoallergenic diet trial, and all animals had previously been treated with endectoparasiticidal drugs, with no improvement two weeks before entering the trial. On days 0 and 30, owners assessed pruritus with a visual analogue scale, and veterinarians evaluated cutaneous lesions. RESULTS: All the cats had pruritus and erythema, five had alopecia, two had an eosinophilic plaque, one had miliary dermatitis and two had both alopecia and an eosinophilic plaque. Good or excellent improvement was observed in 40 per cent of cats for pruritus, 57 per cent of cats for alopecia and 60 per cent of cats for erythema. A significant decrease in mean scores was observed for pruritus only, while for erythema and alopecia, it was close to being significant (P < 0.052). CLINICAL SIGNIFICANCE: Ciclosporin may be helpful in symptomatically treating signs of feline allergic skin disease. However, it is important to remember that ciclosporin is not licensed for use in cats.     

Development of an injection site sarcoma shortly after meloxicam injection in an unvaccinated cat

A single dose of a rapidly-absorbed non-steroidal anti-inflammatory drug (NSAID) was injected into the subcutaneous tissue of the interscapular region of a 12.5-year-old cat. A mild swelling was noticed at the injection site 6 weeks later. This progressed into a 5 cm diameter mass which was removed 6 months after the injection had been given. An injection site sarcoma (ISS) was diagnosed histologically. As the cat had not been vaccinated for at least 12 years, the previous NSAID injection was considered to be a possible cause of the ISS. Inflammation is thought to be important in the development of ISS. If injection of a rapidly-absorbed NSAID can stimulate sufficient inflammation to promote the development of an ISS, other non-vaccine injections may also have the potential to influence ISS development. This suggests that injection of both vaccines and non-vaccine medications should be minimised to reduce the risk of ISS development.