Prognostic factors in cats with feline panleukopenia

Background: Feline panleukopenia is a highly contagious and often lethal disease. Objective: The purpose of the study was to identify prognostic factors for survival of cats with panleukopenia. Animals: Between 1990 and 2007, 244 cats were diagnosed with panleukopenia in the Clinic of Small Animal Medicine, LMU University of Munich, Germany. Diagnosis was established by electron microscopy, polymerase chain reaction of feces or blood, antigen ELISA of feces, pathognomonic histopathological lesions at necropsy, or some combination of these procedures. Methods: Medical records of each cat were evaluated retrospectively. Results: Survival rate was 51.1%. No significant correlation was found between outcome and living conditions, age, vaccination status (unvaccinated versus one or more vaccines administered), or severity of clinical signs. However, of the vaccinated cats, none had received a vaccine later than 12 weeks of age as a kitten. Nonsurvivors had significantly lower leukocyte and thrombocyte counts at presentation compared with survivors. The relative risk of death for patients with <1,000/μL leukocytes was 1.77 times as high as in patients with a leukocyte count of 1,000–2,500/μL (P= .038), and 1.85 times as high as in patients with >2,500/μL leukocytes (P= .001). The likelihood of a fatal outcome was higher when serum albumin concentration was <30 g/L or serum potassium concentration <4 mmol/L. Conclusions and Clinical Importance: Vaccination strategies that do not include vaccination of kittens beyond 12 weeks of age may not be adequate to prevent panleukopenia. Leukopenia, thrombocytopenia, hypoalbuminemia, and hypokalemia are negative prognostic factors in cats with panleukopenia.     

N-acetyl-beta-D-glucosaminidase index as an early biomarker for chronic kidney disease in cats with hyperthyroidism

Background: Hyperthyroid cats are at risk of developing azotemic chronic kidney disease (CKD) and diagnostic tools currently used to screen for CKD in hyperthyroid cats are either unreliable or impractical.
Hypothesis: Urine N -acetyl-β- d -glucosaminidase index (NAG_i) is a good biomarker for azotemic CKD in hyperthyroid cats.
Animals: Twenty-four newly diagnosed nonazotemic hyperthyroid cats and 10 healthy cats.
Methods: All cats were evaluated for hyperthyroidism at baseline. Hyperthyroid cats were treated with methimazole and reevaluated once euthyroid. At the end of the study, cats were divided into 3 groups: healthy cats, nonazotemic, and azotemic euthyroid cats. Baseline group characteristics were compared to predict azotemic CKD. The influence of treatment on NAG_i was evaluated.
Results: Baseline NAG_i was significantly different among groups ( P = .004). Azotemic cats had a higher median value (13.12 U/g) when compared with healthy cats (1.38 U/g). With NAG_i >2.76 U/g, negative and positive predictive values for development of azotemia were 77.7 and 50%, whereas the combination of a urine specific gravity (USG) ≤1.035 and T₄ >7.80 μg/dL enhanced predictive values to 88.9 and 83.3%, respectively. NAG_i values decreased significantly over time in treated nonazotemic cats.
Conclusions and Clinical Relevance: Baseline NAG_i did not differentiate azotemic from nonazotemic euthyroid cats. NAG_i could be used to assess renal function during medical therapy allowing the clinician to adjust methimazole dosage accordingly. The combination of USG and T₄ could optimize identification of appropriate candidates for permanent treatment of hyperthyroidism.     

Prognostic factors in cats with chronic kidney disease

BACKGROUND: Chronic kidney disease (CKD) is a common cause of morbidity and mortality in cats. HYPOTHESIS: Some baseline variables are associated with shorter survival times in cats with CKD. ANIMALS: Client-owned cats. METHODS: Cats with CKD with initial plasma creatinine concentration > or =2.0 mg/dL and urine specific gravity (USG) < or = 1.025 were recruited into a prospective clinical trial that compared benazepril with a placebo. We describe baseline variables in 190 cats and their influence on renal survival time in the placebo group (95 cats), which was followed for up to 1,097 days. Renal survival time was defined as the time from initiation of therapy to the need for parenteral fluid therapy, euthanasia, or death related to renal failure. RESULTS: Of the 95 cats treated with a placebo, 58 were censored and 37 reached the renal survival end point (died, n = 0; euthanized, n = 17; parenteral fluids, n = 12; parenteral fluids followed by euthanasia, n = 8). Increased plasma creatinine concentration, increased urine protein-to-creatinine ratio (UPC), and increased blood leukocyte count were significantly (P < .01) associated with a shorter renal survival time and were independent risk factors. Increased concentrations of plasma phosphate or urea, and lower blood hemoglobin concentration or hematocrit were significantly (P < .01) associated with a shorter renal survival time and were dependent risk factors, because they also were significantly (P < .01) correlated with plasma creatinine concentration at baseline. CLINICAL IMPORTANCE: Several variables were significantly associated with a shorter renal survival time in cats with CKD.     

Short- and long-term follow-up of glomerular and tubular renal markers of kidney function in hyperthyroid cats after treatment with radioiodine

Hyperthyroidism can mask co-existing chronic kidney disease (CKD). Previous studies showed that post-treatment renal azotemia can be predicted by pre-treatment assessment of glomerular filtration rate (GFR). We hypothesized that treatment of hyperthyroidism may have different effects on glomerular and tubular function and these changes might be predicted by additional pre-treatment variables than GFR.     

Diagnostic and prognostic utility of surface electrocardiography in cats with left ventricular hypertrophy

Objectives

To assess the ability of electrocardiography (ECG) to predict left ventricular hypertrophy (LVH) in the cat and to investigate the prognostic value of selected ECG variables in cats with LVH.

Dilated cardiomyopathy in cats: survey of veterinary cardiologists and retrospective evaluation of a possible association with diet

Introduction/objectivesThe objectives were to conduct a survey of cardiologists on their recent experiences with cats that have dilated cardiomyopathy (DCM) and to retrospectively review individual cases of feline DCM.Animals, materials and methodsPart one: A survey was distributed to cardiologists with questions regarding caseload and clinical management of cats with DCM diagnosed over the past two years. Part two: Cardiologists completing the survey were invited to submit data from cats recently diagnosed with DCM. Data on signalment, clinical signs, diet, echocardiographic measurements and outcome were recorded.ResultsPart one: From 52 completed surveys, many cardiologists responded that measuring and supplementing taurine and recommending a diet change in cats with DCM are common practices. Few (15%) cardiologists reported an increase in the number of feline DCM cases over the past two years, although some had cases that improved even if taurine deficiency was not present. Part two: Twenty of 37 (54%) cats ate low pea/lentil (low PL) diets, and 14/37 (38%) ate high PL diets at the time of diagnosis; three had incomplete diet information. Two of 13 cats (15%) in which taurine was measured had levels below the reference range. After adjusting for other variables, cats eating high PL diets that changed diets after diagnosis had a significantly longer survival time than that of cats eating high PL diets that did not change diets after diagnosis (P = 0.025).ConclusionsAdditional research is warranted to determine whether there could be a possible association between diet and DCM in cats.     

Comparison of the effects of ivabradine and atenolol on heart rate and echocardiographic variables of left heart function in healthy cats

Background: Ivabradine is a novel negative chronotropic drug used for treatment of ischemic heart disease in people. Little is known about its effects and safety in cats. Hypothesis/Objectives: Ivabradine is not inferior to atenolol with regard to clinical tolerance, heart rate (HR) reduction, and effects on cardiac function in healthy, lightly sedated cats. Animals: Ten healthy laboratory cats. Methods: Physical examination, systolic blood pressure measurement, and transthoracic echocardiography were performed in all cats at baseline and after oral administration (4 weeks each) of ivabradine (0.3 mg/kg q12h) and atenolol (6.25 mg/cat q12h; 1.0–1.7 mg/kg) in a prospective, double‐blind, randomized, active‐control, fully crossed study. A priori noninferiority margins for the effects of ivabradine compared with atenolol were set at 50% (f= 0.5) based on predicted clinical relevance, observer measurement variability, and in agreement with FDA guidelines. Variables were compared by use of 2‐way repeated measures ANOVA. Results: Ivabradine was clinically well tolerated with no adverse events observed. HR (ivabradine, P < .001; atenolol, P < .001; ivabradine versus atenolol, P= .721) and rate‐pressure product (RPP) (ivabradine, P < .001; atenolol, P= .001; ivabradine versus atenolol, P= .847) were not different between treatments. At the dosages used, ivabradine demonstrated more favorable effects than atenolol on echocardiographic indices of left ventricular (LV) systolic and diastolic function and left atrial performance. Conclusions and Clinical Importance: Ivabradine is not inferior to atenolol with regard to effects on HR, RPP, LV function, left atrial performance, and clinical tolerance. Clinical studies in cats with hypertrophic cardiomyopathy are needed to validate these findings.     

Recurrent demyelination and remyelination in 37 young Bengal cats with polyneuropathy

Background: With the exception of diabetic neuropathy, polyneuropathy associated with hyperchylomicronemia, and a few inherited polyneuropathies, peripheral neuropathies are poorly characterized in cats. A chronic polyneuropathy is described in a cohort of young Bengal cats. Objective: To characterize the clinical and histopathological features of a chronic‐relapsing peripheral neuropathy in young Bengal cats. Animals: Thirty‐seven young Bengal cats with clinical weakness consistent with peripheral neuropathy. Methods: Bengal cats were included in this study after a diagnosis of polyneuropathy was confirmed by muscle and peripheral nerve biopsy specimens. Pathological changes were characterized at the light and electron microscopic level and by morphometry. Clinical information and long‐term outcome from case records of Bengal cats with histologically confirmed peripheral neuropathy were then assessed. Results: Nerve fiber loss within distal intramuscular nerve branches was a consistent finding in young Bengal cats with polyneuropathy. The most common abnormalities in peripheral nerve biopsies included inappropriately thin myelin sheaths and thinly myelinated fibers surrounded by supernumerary Schwann cell processes, indicative of repeated cycles of demyelination and remyelination. Recovery was common. Response to treatment could not be determined. Conclusions and Clinical Importance: A chronic‐relapsing form of polyneuropathy associated primarily with episodes of demyelination and remyelination was identified in young Bengal cats. The prognosis for recovery is good, although relapses are possible and there can be residual motor deficits.     

Effect of cilobradine in cats with a first episode of congestive heart failure due to primary cardiomyopathy

IntroductionHeart rate (HR) is often elevated in cats with cardiomyopathies (CMPs). Pharmacologic modulation of HR may reduce cardiac morbidity and mortality.ObjectivesTo investigate the effects of cilobradine vs. placebo, regarding time to cardiac mortality or morbidity in cats with first episode of congestive heart failure (CHF) due to primary CMP.AnimalsThree hundred and sixty-seven client-owned cats with primary CMP that had presented with a first episode of CHF at 50 centers in Europe. Per-protocol population comprised 193 cats (n = 89 cilobradine, n = 104 placebo). An interim analysis for futility was planned.MethodsProspective, randomized, placebo-controlled, double-blinded, multicenter clinical trial. Primary outcome variable was the time to a composite of cardiac mortality or cardiac morbidity.ResultsMedian time to primary outcome was 84 days (95% confidence interval [CI]: 63–219 days) in the cilobradine group (CG) and 203 days in the placebo group (95% CI: 145–377 days) with observed hazard ratio of 1.44, indicating a higher hazard for the CG (P = 0.057). Mean HR was 28 beats per minute (bpm) lower at Day 7 (P < 0.0001) and remained 29 bpm lower at Day 360 (P = 0.026) in the CG than that in the placebo group. Although the number of adverse events did not differ, there were more serious adverse events in the CG.ConclusionsHeart rate reduction by cilobradine in cats with a first episode of CHF due to primary CMP did not reduce cardiac mortality and morbidity.     

Diagnostic accuracy of plasma atrial natriuretic peptide concentrations in cats with and without cardiomyopathies

Objectives

Plasma atrial natriuretic peptide (ANP) levels have been reported to be elevated in cats with cardiomyopathy. We investigated the diagnostic accuracy of plasma ANP concentration as an indicator of the severity of cardiomyopathies.

Peritoneal dialysis in cats with acute kidney injury: 22 cases (2001-2006)

Background: Peritoneal dialysis (PD) has been described for use in animals with acute kidney injury refractory to fluid therapy. However, no study has examined the use of PD in a large group of cats. Hypothesis: PD is an important adjunctive therapy to treat acute kidney injury in cats. Animals: The medical records of 22 cats with acute kidney injury that had received PD were examined. Animals were excluded if acute uremia was a result of postrenal causes such as uroabdomen or urethral obstruction. Methods: Medical records were reviewed for the following: indication for PD, outcome, number of cycles performed, survival time, and predialysis and postdialysis results for blood urea nitrogen (BUN), creatinine, potassium, chloride, sodium, phosphorus, total protein, and albumin concentrations, and urine output.

Results:

Indications for PD include acute‐on‐chronic kidney injury, acute kidney injury caused by toxins, bilateral ureteroliths, bilateral ureteral ligation as a complication of ovariohysterectomy, and unknown causes. The median survival time for all cats on PD was 4 days, although the median survival time for the cats that were discharged was 774 days. The most common complications were dialysate retention and sequestration of dialysate SC. There was a significant (P< .05) decrease between predialysis and postdialysis results for BUN, creatinine, potassium, phosphorus, total protein, and albumin concentrations. There was a significant (P< .05) difference in survival times between sexes. Conclusions and Clinical Importance: PD is an effective option for treatment of cats with acute kidney injury refractory to fluid therapy.     

Prevalence and risk factors for cats testing positive for feline immunodeficiency virus and feline leukaemia virus infection in cats entering an animal shelter in New Zealand

Abstract

AIMS

To estimate the prevalence of cats testing positive for antibodies to feline immunodeficiency virus (FIV) and feline leukaemia virus (FeLV) antigens in domestic cats entering a New Zealand animal shelter, based on a commercial point-of-care ELISA, to identify risk factors associated with cats testing positive, and to compare the results obtained from the ELISA with those obtained using PCR-based testing.