Oral glucosamine and the management of feline idiopathic cystitis

Oral glucosamine was compared to a placebo for the management of cats with feline idiopathic cystitis (FIC) in a randomised, double-blinded, placebo-controlled, study. Forty cats with a history of recurrent cystitis due to FIC were divided into two groups and treated daily per os with either 125 mg N-acetyl glucosamine or a placebo for six months. Owners graded their cats' clinical signs at the beginning and end of the study, and kept daily diaries documenting signs of cystitis using visual analogue scales. Further episodes of cystitis were seen in 26 (65%) of the cats during the study. Affected cats experienced a mean of five recurrences (range 1-19) with each recurrence lasting a mean of four days (range 1-64 days). There were no significant differences between the two groups when considering the owners assessments of the mean health score (P>0.5), the average monthly clinical score (P=0.22) or the average number of days with clinical signs (P=0.28). Two cats suffered from such severe recurrent urethral obstruction that they were euthanased; they were both in the placebo group. Compared to the start of the study the majority of cats in both groups improved significantly (P<0.001) (mean health score of each group at the start was 0.5+/-SD 0.5, compared to glucosamine 4.4+/-0.7 and placebo 3.9+/-1.6 at the end). This is believed to have occurred because the owners of 36 of the 40 cats (90%) started feeding more canned cat food. The urine specific gravity at the start of the trial was significantly higher (mean 1.050+/-SD 1.007) than when reassessed one month later (1.036+/-1.010, P<0.01).     

Clinical improvement in feline herpesvirus 1 infected cats by oral low dose of interleukin-12 plus interferon-gamma

Feline herpesvirus 1 (FHV-1) is a widespread cat pathogen inducing rhinitis, conjunctivitis and corneal ulcers. To alleviate acute FHV-1-induced disease, antiviral agents are used often with antibiotics. But sometimes, these treatments, as well as conventional doses of cytokines have moderate efficacy and/or collateral effects. Herein we have investigated the effects of low dose interleukin (IL)-12 plus interferon (IFN)-gamma, prepared by Sequential Kinetic Activated (SKA), on the treatment of FHV-1 infection. Twenty-five, unvaccinated FHV-1-positive cats were recruited into a prospective, randomized, placebo-controlled, double-blinded clinical trial. Fifteen cats were treated for 6 months with oral low doses of SKA IL-12 plus IFN-gamma and 10 cats were treated with placebo. At 1, 6 and 12 months (follow-up) after the beginning of treatment, clinical assessment, PCR assay and blood count were carried out. At follow-up, in treated group, we observed significant (p < 0.05) improvements in clinical signs and PCR became negative in 12/15 cats (80%). In placebo, 10/10 cats were PCR-positive, with improvements (30%) or worsening (70%) in clinical signs. Blood values were normal in both groups.Our results show that the low dose therapy, based on activated solutions of IL-12 plus IFN-gamma, represents a novel approach to treat FHV-1 infection in cats.     

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).     

Surgical approach for tentorial meningiomas in cats: a review of six cases

The surgical technique for removal of tentorial meningiomas is described on six cats using a unilateral temporal supracerebellar transtentorial approach. Complete gross tumour resection was achieved in four of six cats. In one cat, only subtotal resection was achieved. One cat died shortly after surgery because of extensive cerebral haemorrhage. The surgical approach, combined with cisternal or ventricular cerebrospinal fluid puncture and an open-window technique (tumour fenestration and enucleation) provided sufficient visibility and tumour accessibility without excessive manipulation of the brain parenchyma. In all patients, a postoperative transient worsening of the clinical signs was observed. The neurological signs resolved with time with the exception of blindness in two cats. All five surviving cats were monitored for a mean follow-up time of 19 months (median 20 months; range 6-30 months). All patients died or were euthanased because of tumour regrowth within the follow-up period. Although challenging, surgical treatment is a useful therapeutic measure in the treatment of cats presenting with tentorial meningiomas.     

Solitary plasmacytoma of bone in two successfully treated cats

This is the first report of feline solitary plasmacytoma of bone. We describe the clinical, clinico-pathological, radiographic and pathological findings of two successfully treated cats with long-term follow-up. The first case presented with spinal pain and neurological deficits. Radiographs demonstrated sclerosis of lumbar vertebra L6 and a myelogram confirmed interference to flow of contrast in the L4-7 region. A biopsy of L6 revealed neoplastic plasma cell infiltration. There was no evidence of paraproteinaemia on serum protein electrophoresis. The cat underwent hypofractionated megavoltage radiotherapy. Clinical signs resolved completely and 4 years after diagnosis the cat remains well and has no electrophoretically detectable paraproteinaemia. The second case presented with neurological deficits of the tail and spinal radiographs revealed extensive osteolysis of the sacrum. A biopsy of sacral bone demonstrated neoplastic plasma cell infiltration. The animal was normoglobulinaemic. The cat improved clinically with induction chemotherapy (melphalan and methylprednisolone). The same chemotherapeutics were continued at maintenance doses for 4.3 years, at which time there was recurrence of neurological deficits and a palpable sacral mass. Cytological examination of a fine needle aspirate confirmed recurrence of plasma cell neoplasia. A low concentration monoclonal paraproteinaemia was detected. Vincristine was administered resulting in resolution of neurological deficits and a palpably smaller sacral mass. Eighteen months into vincristine therapy, there was recurrence of clinical signs and the cat was euthanased, more than 6 years after the initial diagnosis.     

Therapeutic effects of recombinant feline interferon-omega on feline leukemia virus (FeLV)-infected and FeLV/feline immunodeficiency virus (FIV)-coinfected symptomatic cats

The clinical efficacy of a recombinant feline interferon, rFeIFN-omega, was evaluated for the treatment of cats presented with clinical signs associated with feline leukemia virus (FeLV) infection and FeLV/feline immunodeficiency virus (FIV) coinfection in the field. In this multicentric, double-blind, placebo-controlled trial, 81 cats meeting the inclusion criteria were randomly placed into 2 groups and treated subcutaneously with rFelFN-omega (1 million [M]U/kg per day) or placebo once daily for 5 consecutive days in 3 series (day 0, 14, 60). The cats were monitored for up to 1 year for clinical signs and mortality. During the initial 4-month period, interferon (IFN)-treated cats (n = 39) had significantly reduced clinical scores compared with placebo (n = 42), with all cats having received concomitant supportive therapies. Compared with the control, the IFN-treated group showed significantly lower rates of mortality: 39% versus 59% (1.7-fold higher risk of death for controls) at the 9-month time point and 47% versus 59% (1.4-fold higher risk of death for controls) at the 12-month time point. The IFN treatment was associated with minor but consistent improvement in abnormal hematologic parameters (red blood cell count, packed cell volume, and white blood cell count), apparently underlying the positive effects of IFN on clinical parameters. These data demonstrate that rFeIFN-omega initially has statistically significant therapeutic effects on clinical signs and later on survival of cats with clinical signs associated with FeLV infection and FeLV/FIV coinfection.     

Effect of feline interferon-omega on the survival time and quality of life of cats with feline infectious peritonitis

BACKGROUND: There is no therapy with proven efficacy to treat cats with feline infectious peritonitis (FIP). HYPOTHESIS: Feline interferon-omega (FeIFN-omega) prolongs survival time and increases quality of life in cats with FIP. ANIMALS: Thirty-seven privately owned cats were subjects of this study. METHODS: The study was performed as a placebo-controlled double-blind trial. Feline infectious peritonitis was confirmed by histology or immunostaining of feline coronavirus (FCoV) antigen in effusion or tissue macrophages or both. The cats were randomly selected for treatment with either FeIFN-omega or a placebo. All cats received adjunctive treatment with glucocorticoids and antibiotics and passive immunization with Feliserin. RESULTS: There was no statistically significant difference in the survival time of cats treated with FeIFN-omega versus placebo or in any other variable evaluated (with the exception of the lymphocyte count). The cats survived between 3 and 200 days (median, 9 days). There was only 1 long-term survivor (> 3 months), and the cat was in the FeIFN-omega group. CONCLUSION AND CLINICAL RELEVANCE: No effect of FeIFN-omega on survival time or quality of life could be demonstrated in this study.     

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.     

Subtotal Colectomy for the Treatment of Obstipation Secondary to Pelvic Fracture Malunion in Cats

Eleven cats in which subtotal colectomy with end-to-end jejunocolostomy was performed for the treatment of chronic obstipation secondary to pelvic fracture malunion were followed for at least 18 months. Seven cats had no recurrence of clinical signs and no longterm complications. In two cats, constipation was less severe and occurred less frequently; however, medical treatment was still required. In one cat, watery diarrhea gradually changed to semiformed feces of normal consistency by month 6; the cat was clinically normal at month 18. One cat had recurrence of constipation and was euthanatized after 2 years of medical treatment.     

Bacteriuria in cats with feline lower urinary tract disease: a clinical study of 134 cases in Norway

Feline lower urinary tract disease (FLUTD) is considered to be one of the most common diagnoses in feline patients. Several authors have concluded that feline idiopathic cystitis is the most common cause of FLUTD, whereas infectious cystitis is diagnosed in only 2% of the cases. In the period from January 2003 to February 2005, 134 cats that presented with signs of lower urinary tract disorders were included in a study at the Norwegian School of Veterinary Science. Ninety-seven percent were first opinion cases. All the cats went through a physical examination, and blood samples were collected for haematology and clinical chemistry. The urine analysis included urine stix, specific gravity, microscopic examination of the sediment and microbiological culturing. The urine samples were collected as voided mid-stream urine samples, by catheter or by cystocentesis and the method used was registered. Of the 134 cats included in the study, 37% were diagnosed as having obstructive and 63% as having non-obstructive FLUTD. In total 44 cats (33%) were diagnosed with bacteriuria, exceeding 10(3) colony forming units per millilitre (cfu/ml) and 33 (25%) of these cats had bacterial growth exceeding 10(4) cfu/ml, either alone or in combination with crystals and/or uroliths. Six cats (18%) with bacterial growth exceeding 10(4) cfu/ml were older than 8 years. No significant difference was found between the sampling methods performed with regard to bacteriuria. This study indicates that bacteriuria may have been underdiagnosed in Norwegian cats with clinical signs of FLUTD. It also confirms the importance of microbiological culturing in first opinion cases with FLUTD and that a skilled operator can get representative samples regardless the choice of method.     

Diagnosis and treatment of pyogranulomatous panniculitis due to Mycobacterium smegmatis in cats

Four cats with extensive pyogranulomatous panniculitis and dermatitis due to Mycobacterium smegmatis were evaluated over an eight-month period. All were treated initially with doxycycline (50 mg per cat every eight to 12 hours) for several weeks, then subjected to radical surgical excision of infected tissues. Reconstructive surgery utilising advancement flaps was required to close wounds without undue tension. Postoperatively, the cats received parenteral gentamicin (2 mg/kg every eight hours) for three to five days, followed by orally administered ciprofloxacin (62.5 mg per cat every eight hours or 125 mg per cat every 12 hours) for three to six months. Infection was eradicated in all the cats, with no signs of recurrence 15 to 23 months after surgery.     

Effect of thyroid hormone supplementation on survival of euthyroid dogs with congestive heart failure due to systolic myocardial dysfunction: a double-blind, placebo-controlled trial

Nineteen euthyroid dogs of 12 breeds with echocardiographic signs of dilated cardiomyopathy (DCM) and radiographic and clinical signs of congestive heart failure (CHF) were evaluated in a randomised, double-blind, and placebo-controlled study. The dogs received either thyroxine or placebo as an adjunct to digoxin, furosemide and propranolol. The group assignment of individual dogs and serum concentrations of thyroid hormones remained unknown to owners and investigators during the entire study period. Dogs were evaluated clinically and with electrocardiography (ECG), thoracic radiography, echocardiography and measurement of total thyroxine (tT4) and thyroid stimulating hormone (TSH) before beginning of the trial, and then one week, 2 months, 6 months and yearly after initial examination, and, when applicable, at the time of euthanasia. End-point of the study was euthanasia (n = 17) due to severe congestive heart failure or sudden death (n = 2). Survival times ranged from 17 to 1030 days (median 187 days) in the placebo group, and from 18 to 1000 days (median 73 days) in the treatment group. There was no statistically significant difference in survival times between the treatment group and the placebo group (p = 0.46). Post mortem and histopathologic examinations revealed the attenuated wavy fiber type of DCM in 11 dogs, and myocardial infarcts, arteriosclerosis and chronic valvular disease in one dog. In conclusion, there was a wide range in survival times of dogs treated with digoxin, furosemide and propranolol. Adding thyroid hormones to the treatment did not significantly influence survival.     

Intussusception in 12 cats

The medical records of 12 cats presented with intussusception and diagnosed at the University of Sydney Veterinary Teaching Hospital and the Sylvania Veterinary Hospital were reviewed. Eleven cats were less than one year old at the time of diagnosis. No breed or sex predilections were determined. The most consistent clinical signs were anorexia (83 per cent), weight loss (83 per cent) and a palpable abdominal mass (92 per cent). Vomiting (58 per cent) and diarrhoea (50 per cent) were seen less frequently in these cats compared with the reported incidence of these signs in dogs. In 10 cats the intussusception was corrected surgically. Manual reduction was successful in three of the cats but six required end-to-end anastomosis following intestinal resection and in one cat a typhlectomy was performed. Postoperative ileus complicated recovery in three cases. Recurrence of the intussusception at a different site occurred in two of these cases. One cat with recurrence of intussusception died and the cat with ileus but not recurrence was euthanased one month after the original surgery.     

The short-term clinical efficacy of amitriptyline in the management of idiopathic feline lower urinary tract disease: a controlled clinical study

In a controlled study, the effects of amitriptyline compared with that of a placebo in cats suffering from idiopathic Feline Lower Urinary Tract Disease (FLUTD) have been investigated. Thirty-six animals were selected by veterinary practitioners and treated with a placebo or 10mg amitriptyline once daily. All animals received concomitant antibiotic treatment. A total of 24 cats were included in the final assessment of the results. The severity of symptoms before and after treatment were compared between groups and showed no significant difference. Results indicated that the 7-day course of 10mg amitriptyline was not effective in the treatment of idiopathic FLUTD. Thus, it is considered not to be beneficial as a short-term therapy where the therapeutic results depend on peripheral effects of the drug. Long-term effects may be expected 4 or more weeks after the start of therapy and need to be further investigated.     

Balloon dilation for the treatment of chronic recurrent nasopharyngeal stenosis in a cat

Balloon dilation was used for the treatment of a recurrent nasopharyngeal stenosis in a cat with chronic stertorous breathing. The procedure was performed on three occasions at intervals of three and four months using a 15 mm valvuloplasty balloon dilation catheter. After the first dilation, clinical signs reappeared within two weeks due to re-stenosis. After the second dilation, all signs of nasopharyngeal disease disappeared, and did not recur. Endoscopic re-evaluation after four months revealed a markedly enlarged nasopharyngeal opening with some degree of stenosis, and a third balloon dilation was performed. Five months later, the cat remained without clinical signs, although some recurrence of the stenosis was visible endoscopically. Complications occurred after the first dilation, and included mild conchal necrosis and transient mucopurulent discharge. Balloon dilation is a minimally invasive technique and can be a successful procedure for treating nasopharyngeal stenosis in cats.     

Treatment-related toxicities in tumor-bearing cats treated with temozolomide alone or in combination with doxorubicin: a pilot assessment

A retrospective study assessing treatment-related toxicities in tumor-bearing cats treated with temozolomide (TMZ) alone or in combination with doxorubicin was conducted. TMZ was administered orally once a day for 5 days every 3 weeks at a dose of 20 mg/cat. Tumor response was evaluated with standard World Health Organization criteria and toxicity was monitored using veterinary co-operative oncology group-common terminology criteria for adverse events (VCOG--CTCAE) criteria. Ten tumor-bearing cats with various types of malignancies were treated with TMZ-based chemotherapy. Eight cats were evaluable for response. Two cats achieved a complete response, one achieved stable disease and five achieved a partial response. Four grade III and one grade IV hematological toxicities, and one grade IV gastrointestinal toxicity were observed. Four cats were euthanased as a result of apparent toxicity. One cat was euthanased as a result of severe and prolonged myelosuppression with fever. Three were euthanased for grade III pleural and pericardial effusions. Effusion was seen in cats treated with higher cumulative dose of TMZ (P = 0.0046). Planned additional case accrual was discontinued because of unacceptable levels of toxicity despite evidence of efficacy in some of the cats. Additional investigation is needed to elucidate this unexpected apparent cumulative toxicity.     

Necrosis of hippocampus and piriform lobe: clinical and neuropathological findings in two Italian cats

The present paper reports the clinical and neuropathological findings in two cats with a neuropathologically confirmed diagnosis of necrosis of the hippocampus and piriform lobe. The cats were presented because of acute onset of behavioural changes and complex partial seizures. The neurological examination suggested a forebrain lesion. The results of blood examination were within the normal range, and the cerebrospinal fluid (CSF) analysis and computed tomography (CT) scan in one cat did not show any abnormality. Despite therapy with diazepam (Valium; Roche) there was deterioration of the clinical signs and the cats were euthanased. The neuropathological examination revealed hippocampal necrosis that included the piriform lobe.     

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.     

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.     

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.