Relationship Between Degenerative Joint Disease,Pain, and Bartonella spp. Seroreactivity in Domesticated Cats

Background

Recently, a potential association was identified between Bartonella exposure and arthritides in mammalian species other than cats.

Hypothesis/Objectives

We hypothesized that Bartonella exposure is associated with more severe degenerative joint disease (DJD) and a greater burden of DJD‐associated pain in client‐owned cats.

Animals

Ninety‐four client‐owned cats (6 months to 20 years old), ranging from clinically unaffected to severely lame because of DJD.

Methods

Using physical examination and radiography, pain and radiographic scores were assigned to each part of the bony skeleton. Sera were tested for Bartonella henselae, B. koehlerae, and B. vinsonii subsp. berkhoffii (genotypes I, II, and III) antibodies using immunofluorescence antibody assays. Variables were categorized and logistic regression used to explore associations.

Results

Seropositivity to Bartonella was identified in 33 (35.1%) cats. After multivariate analysis controlling for age, total DJD score (OR, 0.51; 95% CI, 0.26–0.97; P = .042), appendicular pain score (OR, 0.33; 95% CI, 0.17–0.65; P = .0011), and total pain score (OR, 0.35; 95% CI, 0.17–0.72; P = .0045) were significantly inversely associated with Bartonella seroreactivity status, indicating that cats with higher DJD and pain scores were less likely to be Bartonella seropositive.

Conclusions and Clinical Importance

Based upon this preliminary study, Bartonella spp. seropositivity was associated with decreased severity of DJD and decreased DJD‐associated pain in cats. Additional studies are needed to verify these findings, and if verified, to explore potential mechanisms.     

Detection of Clinically Relevant Pain Relief in Cats with Degenerative Joint Disease Associated Pain

Background

Detection of clinically relevant pain relief in cats with degenerative joint disease (DJD) is complicated by a lack of validated outcome measures and a placebo effect.

Hypothesis/Objectives

To evaluate a novel approach for detection of pain relief in cats with DJD.

Animals

Fifty‐eight client‐owned cats.

Methods

Prospective, double‐masked, placebo‐controlled, stratified, randomized, clinical study. Enrolled cats were 6–21 years of age, with owner‐observed mobility impairment, evidence of pain in at least 2 joints during orthopedic examination, and overlapping radiographic evidence of DJD, and underwent a 2‐week baseline period, 3‐week treatment period with placebo or meloxicam, and 3‐week masked washout period. Outcome measures were evaluated at days 0, 15, 36, and 57.

Results

Both groups significantly improved after the treatment period (day 36) on client‐specific outcome measures (CSOM) and feline musculoskeletal pain index (FMPI) (P < .0001 for both); there was no difference between the groups on CSOM or FMPI score improvement. After the masked washout period, more cats that received meloxicam during the treatment period had a clinically relevant decrease in CSOM score (P = .048) and FMPI score (P = .021) than cats that received placebo.

Conclusions and Clinical Importance

Using both a client‐specific and a general clinical metrology instrument, owners of cats with DJD were able to detect evident recurrence of clinical signs after withdrawal of active medication than after withdrawal of placebo, and that this study design might be a novel and useful way to circumvent the placebo effect and detect the efficacy of pain‐relieving medications.     

Radiological Pathology and Diagnosis of Degenerative Joint Disease in the Stifle Joint of the Dog

Abstract— —Preliminary radiographic studies of the stifle joints of twelve young, clinically-normal and twelve older, clinically-lame dogs in both non-weight-bearing and weight-bearing conditions were conducted. Radiographic changes of degenerative joint disease were periarticular osteophytes, subchondral bone sclerosis, attrition of subchondral bone, narrowing and collapse of the joint space, subluxation or rotation of the bones forming the joint. Certain of these changes were fully appreciated only on radiographs made in the weight-bearing position. Résumé— —L'auteur a effectué une étude radiologique préliminaire de l'articulation rotulienne chez douze jeunes chiens cliniquement normaux et chez douze chiens plus âgés préentant des boiteries, le membre postérieur étant étudié en position de détente et en position d'appui. Les altérations radiologiques de l'arthropathie dégénérative étaient les suivantes: ostéophytes péri-articulaires, ostéosclérose sous-chondrale, attrition de l'os sous-chondral, rétrécissement ou effondrement de la cavité articulaire, subluxation ou rotation des os de l'articulation. Certaines de ces altérations n'étaient pleinement manifestes que sur radiographie du membre en position d'appui. Zusammenfassung— —Vorläufige Röntgenuntersuchungen der Kniegelenke von zwölf jungen, klinisch normalen und zwölf älteren, klinisch lahmen Hunden im nicht-lasttragenden und im lasttragenden Zustand wurden durchgeführt. Radiographisch markante Veränderungen durch degenerative Gelenkkrankheiten waren periartikuläre Osteophyten, subchondrale Knochensklerose, Abnutzung subchondralen Knochens, Verengung und Kollabieren des Gelenkraums und Subluxation oder Rotation der das Gelenk bildenden Knochen. Bestimmte dieser Veränderungen wurden vollständig nur auf den Röntgenaufnahmen erkannt, die in den lasttragenden Positionen aufgenommen wurden.     

A Cross‐Sectional Study Examining the Prevalence and Risk Factors for Anti‐Microbial‐Resistant Generic Escherichia coli in Domestic Dogs that Frequent Dog Parks in Three Cities in South‐Western Ontario,Canada

Anti‐microbial resistance can threaten health by limiting treatment options and increasing the risk of hospitalization and severity of infection. Companion animals can shed anti‐microbial‐resistant bacteria that may result in the exposure of other dogs and humans to anti‐microbial‐resistant genes. The prevalence of anti‐microbial‐resistant generic Escherichia coli in the faeces of dogs that visited dog parks in south‐western Ontario was examined and risk factors for shedding anti‐microbial‐resistant generic E. coli identified. From May to August 2009, canine faecal samples were collected at ten dog parks in three cities in south‐western Ontario, Canada. Owners completed a questionnaire related to pet characteristics and management factors including recent treatment with antibiotics. Faecal samples were collected from 251 dogs, and 189 surveys were completed. Generic E. coli was isolated from 237 of the faecal samples, and up to three isolates per sample were tested for anti‐microbial susceptibility. Eighty‐nine percent of isolates were pan‐susceptible; 82.3% of dogs shed isolates that were pan‐susceptible. Multiclass resistance was detected in 7.2% of the isolates from 10.1% of the dogs. Based on multilevel multivariable logistic regression, a risk factor for the shedding of generic E. coli resistant to ampicillin was attending dog day care. Risk factors for the shedding of E. coli resistant to at least one anti‐microbial included attending dog day care and being a large mixed breed dog, whereas consumption of commercial dry and home cooked diets was protective factor. In a multilevel multivariable model for the shedding of multiclass‐resistant E. coli, exposure to compost and being a large mixed breed dog were risk factors, while consumption of a commercial dry diet was a sparing factor. Pet dogs are a potential reservoir of anti‐microbial‐resistant generic E. coli; some dog characteristics and management factors are associated with the prevalence of anti‐microbial‐resistant generic E. coli in dogs.     

Evaluation of a Therapeutic Diet for Feline Degenerative Joint Disease

Background: Feline degenerative joint disease (DJD) is common and there are no approved therapies for the alleviation of the associated pain. Objective: To test a diet high in eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) content and supplemented with green‐lipped mussel extract and glucosamine/chondroitin sulfate (test‐diet) for its pain‐relieving and activity‐enhancing effects in cats with painful, mobility‐impairing DJD over a 9‐week period. Animals: Forty client‐owned cats. Methods: Randomized, controlled, blinded, parallel group, prospective clinical study. Cats with no detectable systemic disease, and with at least 1 appendicular joint with radiographic evidence of DJD where manipulation elicited an aversive response were included. Cats were randomly allocated to the test‐diet or control diet (C‐diet). Outcome measures were subjective owner and veterinarian assessments, and objective activity monitoring (accelerometry). Nonparametric statistics were used to evaluate changes within and between groups for both subjective and objective data, and locally weighted scatterplot smoothing regression analysis was used to predict activity changes. Results: The primary objective outcome measures indicated that activity declined significantly (P < .001) in the C‐diet group, significantly increased (P < .001) in the test‐diet group and there was a significant difference between the groups (P < .001). Conclusion and Clinical Importance: A diet high in EPA and DHA and supplemented with green‐lipped mussel extract and glucosamine/chondroitin sulfate improved objective measures of mobility. Dietary modulation might be 1 method to use to improve mobility in cats with DJD‐associated pain.     

Prevalence of and Risk Factors for Degenerative Mitral Valve Disease in Dogs Attending Primary‐care Veterinary Practices in England

Background

To date, epidemiological studies on degenerative mitral valve disease (DMVD) in dogs have largely reported referral caseloads or been limited to predisposed breeds. Analysis of primary‐care data to identify factors associated with DMVD would help clinicians identify high‐risk individuals and improve understanding.

Objectives

To estimate the prevalence of and identify risk factors for DMVD in dogs attending primary‐care veterinary practices in England.

Animals

Cases were identified within the electronic patient records of 111,967 dogs attending 93 practices. Four hundred and 5 dogs were diagnosed with DMVD (diagnosed cases) and a further 3,557 dogs had a heart murmur (HM) consistent with DMVD (possible cases).

Methods

Retrospective cross‐sectional study design. Prevalence was adjusted for the sampling approach. Mixed effects logistic regression models identified factors associated with DMVD.

Results

Prevalence estimates of diagnosed DMVD and HMs consistent with DMVD (both diagnosed and possible cases) were 0.36% (95% confidence interval [CI]: 0.29–0.45) and 3.54% (95% CI: 3.26–3.84) respectively. In the multivariable analysis, males had higher odds of diagnosed DMVD than did females (odds ratio [OR] 1.40, 95% CI: 1.12–1.74). Insured dogs had increased odds of DMVD compared with noninsured dogs (OR 3.56, 95% CI: 2.79–4.55) and dogs ≥20 kg had approximately half the odds of DMVD diagnosis compared with dogs <20 kg (OR 0.51, 95% CI: 0.36–0.74). Strong associations between a DMVD diagnosis and individual breeds and age were identified.

Conclusions and Clinical Importance

Degenerative mitral valve disease was a common disorder in practice‐attending dogs. Knowledge of identified risk factors for DMVD could improve clinical diagnosis and direct future research.     

Cross‐Sectional Serosurvey of Avian Influenza Antibodies Presence in Domestic Ducks of Kathmandu,Nepal

Kathmandu, Nepal has been classified as a high‐risk area for highly pathogenic avian influenza (HPAI) by the Nepali Government. While ducks have an important role in the transmission of avian influenza viruses (AIV), including HPAI, seroprevalence of antibodies to AIV in domestic ducks of Kathmandu has never been assessed. The objectives of this study were (i) to estimate the prevalence of seroconversion to AIV in domestic ducks in major duck‐raising areas of Kathmandu and (ii) to assess the effect of age, sex, presence of swine and the number of ducks on the farm on the carriage of antibodies to AIV in these ducks. From April through July of 2011, a cross‐sectional study was conducted and a total of 310 ducks in the major duck‐raising areas of Kathmandu were sampled. The estimated prevalence of AIV antibodies was 27.2% [95% confidence interval (CI): 24.6–29.5]. Of 62 enrolled farms, 42% had at least one seropositive duck. Half of the enrolled farms also kept pigs of which 52% had at least one seropositive duck. Bivariate analysis indicated association between ducks' seroconversion to AIV and their age, sex and farm size. However, the final multivariable model, after controlling for clustering of ducks within farms, identified age as the only significant risk factor. Based on this model, ducks older than 1 year of age were more likely to be seropositive compared to ducks <6 months of age [odds ratio = 2.17 (1.07–4.39)]. These results provide baseline information about the AIV seroprevalence in domestic ducks in the major duck‐raising areas of Kathmandu and identify a high‐risk group that can be targeted in surveillance activities. Future studies should be conducted to differentiate the subtypes of AIV present among domestic ducks in Kathmandu, with particular interest in the presence of HPAI viruses.     

Treatment of Degenerative Joint Disease of the Horse: A Review and Commentary

Some of the predisposing factors for the development of degenerative joint disease, such as fatigue, early training, conformation defects, and others, are outlined. Swimming, a controlled weight-bearing exercise, is discussed and strongly recommended for treatment of degenerative joint disease in the horse. A brief review of counterirritants and vesicants, as well as current therapeutic suggestions, are presented. Cryotherapy, which is a relatively new form of counterirritation, is discussed. The benefits and limitations of radiation therapy are briefly discussed, and gamma rays are felt to be superior to x-rays. The most frequently used antiinflammatory drugs are discussed, and the two main categories, corticosteroids and nonsteroidal antiinflammatory drugs, are presented in detail. Among the nonsteroidal antiinflammatory drugs, hyaluronic acid, DMSO, and superoxide dismutase are presented and their mode of action, as well as benefits and disadvantages, are evaluated. Joint lavage is an effective tool in the management of joint disease, because it removes degenerative debris and inflammatory cells from the joint. The management of degenerative joint disease generally involves more than one of the therapeutic regimens mentioned. On the other hand, there is not a single treatment combination that is superior in all situations. The clinician treating degenerative joint disease must select the treatment regimen that works best for him and for the case to be treated. Such a choice must be based on a thorough understanding of applicable therapeutic agents and modes of physical therapy.