Practical relevance: Chronic kidney disease (CKD) is common in senior cats. Early diagnosis can facilitate interventions to slow progression and minimise clinical signs. Management according to the International Renal Interest Society (IRIS) staging system for CKD can lead to prolonged survival and an excellent quality of life for affected cats. Aim: The ‘2026 iCatCare consensus guidelines on the diagnosis and management of chronic kidney disease in cats’ provide information on the pathogenesis of CKD, guidance on making a diagnosis and staging of disease, and practical content on medical and nutritional treatment. They also discuss optimising the home and veterinary clinic environment to positively influence mental wellbeing and, in turn, physical health, as well as working with the whole veterinary team and caregivers to slow disease progression and maximise quality of life. Clinical challenges: Affected cats may show minimal or no clinical signs in the early stages of CKD, which can result in a delay in diagnosis. The condition is generally progressive and management requires consideration of multiple factors in order to address clinical signs. Complications such as hypercalcaemia, hypertension, proteinuria and anaemia may develop, requiring treatment. Moreover, as advancing age is a risk factor for CKD, cats may have important comorbidities that need to be balanced, with impacts on the kidney. Caring for a cat with CKD can result in caregiver burden. Hence, supporting caregivers, contextualising monitoring to the individual cat, and involving both the veterinary and nursing teams is important. Evidence base: These Guidelines have been created by a panel of experts brought together by International Cat Care (iCatCare) Veterinary Society. Information is based on the available literature, expert opinion and the panel members’ experience. Specific abbreviations: ACE = angiotensin-converting enzyme; ACKD = acute-on-chronic kidney disease; AKI = acute kidney injury; ARB = angiotensin receptor blocker; CKD = chronic kidney disease; CKD-MBD = CKD–mineral and bone disorder; FGF23 = fibroblast growth factor 23; GFR = glomerular filtration rate; iCa = ionised calcium; ICGN = immune-complex glomerulonephritis; IRIS = International Renal Interest Society; PTH = parathyroid hormone; SDMA = symmetric dimethylarginine
ObjectivesThe aim of this study was to evaluate tolerability of a COP/DOX protocol, where cats received COP (vincristine, cyclophosphamide, and prednisolone) induction weekly for 6 weeks followed by doxorubicin (DOX) consolidation every three weeks for 6 doses. A secondary objective was to evaluate the efficacy of COP/DOX protocol in this cohort of cats.MethodsRecords were retrospectively reviewed for cats with high-grade lymphoma treated with the COP/DOX protocol from 2005-2024. Data collected included signalment, method of diagnosis, tumor location, staging, baseline diagnostics, drug dosages, adverse events, re-staging diagnostics and treatment response. Progression free survival (PFS) and survival time (ST) were estimated using the Kaplan-Meier method and compared across selected variables using log-rank test. ResultsTwenty-seven cats met inclusion criteria. The most common form of lymphoma was gastrointestinal in 33.3% of cats. The number of cats achieving a maximal response of clinical remission (CR) and partial remission (PR) throughout COP were 10 (37.0%) and 12 (44.4%), respectively. Of the 5 cats that had stable disease (SD) or progressive disease (PD) during COP, 1 achieved PR on doxorubicin. Four cats (14.8%) did not respond either to the COP or DOX part of the protocol. The overall response rate at 6 weeks after initiation of COP/DOX was 77.7%. PFS was 98 days (Interquartile range (IQR) 41 - 141) and MST was 154 days (IQR 102 - 546). The cats that had CR at the completion of DOX had PFS of 554.5 days and MST of 546 days. High grade adverse events included grade 3 and 4 neutropenia (n=3 for each) during COP. Lymphocyte: monocyte ratio and response at the completion of DOX were significantly associated with PFS and MST.Conclusions and relevanceWe conclude that the COP/DOX protocol was well tolerated by this population. PFS and MST were similar to previous reports. The COP/DOX protocol is an effective treatment approach for cats with lymphoma.
OBJECTIVES:The aim of the study was to determine whether post-admission oral gabapentin improves stress indices and handling tolerance in hospitalized cats. METHODS:In this double-blind, randomized, placebo-controlled, parallel-design trial, healthy client-owned cats were enrolled. After initial exam, cats received a 100-mg gabapentin or placebo capsule. At ninety minutes, a second examination, venipuncture, and brief dorsal positioning were performed. Five stress behaviors (struggling, vocalization, repelling, hypersalivation, mouth breathing), compliance, and enclosure activity score (1, sedate; 5, very active) were recorded; blood glucose, lactate, serum cortisol, and lymphocyte count were measured. Serum gabapentin concentrations were obtained 90-minutes post-capsule. RESULTS:Thirty cats (15 cats/group) were included in analysis. In the 15 cats that received gabapentin, median gabapentin dose was 21.7 mg/kg (range, 14.3-28.1 mg/kg), yielding a median serum concentration 16.4 mcg/mL (range, 1.3-24.5 mcg/mL). Most cats gabapentin-treated cats exhibited less stress behaviors (86%; 13/15) and better compliance for handling during examination (73%; 11/15) at 90-minutes post-capsule compared with 20% (3/15) and 26% (4/15), respectively, in placebo cats. Between group differences were not detected for behavioral or compliance scores during venipuncture or dorsal positioning. Enclosure activity scores in the gabapentin group decreased from median 3 at baseline to 2 from 90-360 minutes post dose (120, 240, and 300 minutes; P <0.05, respectively), consistent with mild sedation. Blood lactate and cortisol concentrations were lower in gabapentin group than placebo group (P = 0.002 and P = 0.04, respectively). CONCLUSIONS AND RELEVANCE:A 100-mg oral dose of gabapentin provides modest improvement in stress behaviors during examination and favorably alters select physiologic stress markers within 90 minutes of administration, with sustained reductions in kennel activity. Findings support incorporating gabapentin within a multimodal, low stress approach for cats presenting without pre appointment medication, while maintaining contingency plans for additional sedation as needed.
ObjectivesThis study aimed to determine the occurrence of gastric Helicobacter species colonization in cats with confirmed gastrointestinal disease and to investigate possible associations between Helicobacter species colonization and gastric histopathological changes. It also aimed to identify the Helicobacter species present in cats in countryX.MethodsPrivately owned cats were prospectively enrolled between May 2018 and December 2022. Regardless of the reason for presentation, the owners of all cats presented to the cat clinic during that time period were systematically interviewed regarding chronic gastrointestinal signs. Cats with suspected chronic gastrointestinal disease underwent non-invasive diagnostic evaluation, and those with persistent suspicion proceeded to gastrointestinal biopsies. Full-thickness gastric and small intestinal biopsies were collected from each cat to evaluate histopathological lesions and to determine the presence and localization of Helicobacter species in the stomach. A total of 154 cats that underwent biopsies were included in the study. A subset of Helicobacter-positive samples was further analyzed to the species level using the nanopore sequencing technique.ResultsAll cats had chronic small intestinal disease. Of these, 79% had inflammatory enteropathy and 21% had lymphoma. Helicobacter species were detected in 75% of cats. Colonization with multiple Helicobacter species was common, with Helicobacter heilmannii being the most prevalent species. Gastritis was present in 58% of cats and occurred with similar frequency in both small intestinal diseases. The presence of Helicobacter species was significantly associated with lymphoplasmacytic gastritis. However, the density of bacterial colonization was not associated with gastritis severity.Conclusions and relevanceOur findings indicate that colonization by Helicobacter species is common in cats with gastrointestinal clinical signs and is associated with chronic lymphoplasmacytic gastritis. Nevertheless, the causal relationship between Helicobacter species and gastritis cannot be established with this study design due to the lack of a control group. Most cats were colonized with mixed Helicobacter species.
ObjectivesTo determine the prevalence of increased serum high-sensitivity cardiac troponin I (hs-cTnI) concentrations in cats with acute blunt trauma and assess associations with trauma severity, clinicopathological variables, echocardiographic findings, and short-term outcome.MethodsThirty-nine cats presenting within 48 hours of blunt trauma were prospectively enrolled. All cats underwent physical examination, Animal Trauma Triage scoring, thoracic radiography, electrocardiography, echocardiography, complete blood count, serum biochemistry, NTproBNP testing, and hs-cTnI measurement. Associations between hs-cTnI concentrations and clinical, laboratory, echocardiographic, and outcome variables were assessed. Receiver operating characteristic (ROC) analysis was performed as an exploratory assessment of prognostic performance.ResultsIncreased hs-cTnI concentrations were detected in 34/39 cats (87%; 95% CI 72-96%). A significant ordinal association was identified between trauma severity and hs-cTnI class (linear-by-linear association, p=0.036), although the overall Fisher-Freeman-Halton test was not significant (p=0.088). Hs-cTnI concentrations correlated positively with urea, creatinine, neutrophil count, ALT, NLR, blood glucose, IVSd, and LVPWd, and negatively with LVIDd. Increased left ventricular wall thickness was identified in 10/39 cats and was associated with higher hs-cTnI concentrations (p=0.033). No traumatic cardiac rupture, pericardial effusion, or pleural effusion were observed. Electrocardiographic abnormalities were detected in 6/39 cats and were not associated with hs-cTnI concentrations. Seven cats (18%) died during hospitalization. Increased urea concentration , white blood cell count, and neutrophil count were associated with non-survival. ROC analyses were considered exploratory because of the limited number of outcome events.Conclusions and relevanceIncreased hs-cTnI concentrations were common in cats with acute blunt trauma and were associated with leukocyte variables, renal function markers, and subtle echocardiographic abnormalities. These findings suggest that hs-cTnI may reflect a multifactorial biological response involving myocardial stress or injury, systemic disease severity, altered renal handling, and possible underlying subclinical cardiac disease. Further studies are needed to clarify the relative contribution and clinical significance of these mechanisms.
ObjectivesGS-441524 is effective against feline infectious peritonitis (FIP), but potential renal toxicity remains debated. Renal health was assessed in cats with FIP undergoing antiviral treatment.MethodsCats with confirmed FIP (n = 80) receiving oral GS-441524 for 42 days were assessed before (day 1; D1), during (D7, D42), and after treatment (D84, D183). Assessments included urine specific gravity (USG), urine protein:creatinine ratio (UPC), urinary cystatin B (uCysB), urine protein electrophoresis, serum creatinine, urea and symmetric dimethylarginine (SDMA).The term potential renal dysfunction was used for cats fulfilling the following criteria: creatinine >140 µmol/l or SDMA ≥ 18 µg/dl and USG <1.035. Serum amyloid A (SAA) and alpha-1-acid glycoprotein (AGP) were assessed in serum, feline coronavirus (FCoV) RNA in blood and urine (D1-D42).ResultsAt baseline, 97.5% of cats had creatinine concentrations <140 µmol/l; by D183, 23.8% exceeded this threshold (D1-D183: PD <0.0001). Potential renal dysfunction criteria were met in 2.5% of cats at baseline and 8.8% at D183. In contrast, uCysB was increased in 83.8% of cats at D1 and declined during treatment (D1-D183: PD <0.0001). Cats with uCysB >100 ng/ml had higher UPC values (PMWU <0.0001). Most cats had elevated AGP and SAA at baseline, which normalised during treatment (D1-D42: PD <0.0001). Proteinuria (UPC >0.2) was present in 91.3% on D1 and 3.8% on D183; urine protein electrophoresis at D1 revealed predominantly tubular and mixed patterns. Urine was more frequently FCoV RNA-positive than blood on D1 (68.8%/61.3%), but not on D7 (16.3%/45.0%).Conclusions and relevanceTreatment reversed FIP-associated renal abnormalities and inflammation observed at baseline. A small subset of cats met criteria compatible with potential renal dysfunction during the study. Whether these findings reflect delayed FIP-related renal insults or adverse antiviral effects remains unknown but indicate that treatment should not be extended unnecessarily.
OBJECTIVES:The increasing use of computed tomography (CT) in feline medicine necessitates the optimization of radiation protocols to adhere to ALARA principles. This prospective study aimed to evaluate the impact of patient positioning dorsoventral (DV) versus ventrodorsal (VD) on radiation doses absorbed by the ocular lenses and the thyroid gland during feline cranial CT. METHODS:Seventy cats were divided into two equal groups (DV, n = 35; VD, n = 35). Radiation doses were measured using thermoluminescent dosimeters (TLD-100) placed at the anatomical projections of the target organs. RESULTS:While no statistically significant difference was observed in ocular lens doses between the groups (p > 0.05), VD positioning resulted in a 24.4% reduction in the mean radiation dose absorbed by the thyroid gland compared to the DV position (1.33 ± 0.17 mGy vs. 1.76 ± 0.35 mGy, respectively; p = 4.97 × 10⁻⁹). This reduction is attributed to the "natural shielding" effect provided by the dorsal axial skeleton and epaxial muscles in the VD position. CONCLUSIONS AND RELEVANCE:VD positioning offers a significant dosimetric advantage for protecting the thyroid gland without requiring additional equipment or compromising diagnostic quality. Adopting the VD position as a routine standard in feline cranial CT is recommended to minimize radiation exposure to the thyroid gland.
ObjectivesTo investigate the prevalence of hypo- and hypercobalaminemia in a cohort of cats with diverse disease pathologies and to assess associations with signalment and disease characteristics.MethodsResidual blood from cats presented to a large veterinary referral hospital during a 24-month period was used for serum B12 quantification. All cats requiring blood collection as part of diagnostic investigations were eligible for inclusion regardless of clinical presentation. Serum B12 concentration was assessed according to signalment, body weight, body condition score, primary affected body system and type of disease pathology as derived from the clinical notes.ResultsA total of 229 cats were enrolled: 128 male (119 neutered, 9 entire) and 101 female (88 neutered, 13 entire). Of these, 176 were domestic shorthair or longhair, and 53 were purebred. The median age was 9.9 years and median body weight 4.1 kg. Of the 229 cats, 80 (34.9%) had high, 86 (37.6%) normal, 18 (7.9%) borderline, and 45 (19.7%) low serum B12. Median serum B12 concentration was higher in cats aged <8.0 years than ≥8.0 years, and there was a weak but significant negative correlation between age and serum B12. Median serum B12 concentration was lower in cats weighing <3.0 kg than in those ≥3.0 kg, and a weak but significant positive correlation was found between body weight and serum B12 concentration. No associations were found between serum B12 and sex, breed, body condition score, affected body system, or pathology type.Conclusions and relevanceVitamin B12 aberrations were common in this cohort of cats, approximately a third and a fifth having abnormally high and low serum concentrations respectively. Serum vitamin B12 concentration declined with advancing age, and hypocobalaminemia was more prevalent in cats with body weights <3.0kg. Hypo- and hypercobalaminemia were documented in cats with a wide variety of clinical presentations, and no specific disease associations were elucidated.
OBJECTIVES:The APGAR score systematically evaluates key physiological parameters to identify vulnerable neonates. APGAR assesses heart rate, respiratory rate and pattern, muscle tone, reflex irritability, and mucous membrane colour, with a low score indicating the need for intervention. In kittens, pre-weaning mortality rate is unacceptably high (approximately 15.8%1), underscoring the need for early vitality assessments. Few studies have evaluated the predictive value of APGAR scoring in kittens. This study aimed to assess potential predictions of survival in newborn kittens. METHODS:Forty kittens from 11 litters (litter size range 3-6) were assessed within 12 hours of birth. APGAR score and three neonatal reflexes (rooting, suckling strength, and positional righting) were assessed. In addition, blood lactate levels, weight, SpO₂, and temperature were also recorded. RESULTS:Mortality rate was 8/40 (20%) within 4 weeks. In a Cox proportional hazards model, APGAR and reflex scores were significantly associated with survival outcomes (Hazard Ratio (HR) = 0.52, P = 0.004; HR = 0.44, P = 0.004, respectively), indicating that a one-point increase in score was associated with reduced hazard of death. Furthermore, APGAR and reflex scores were significantly associated (P = 0.001). Higher SpO₂ was protective (HR = 0.93, P = 0.006), whereas temperature (HR = 0.66, P = 0.058) and birth weight (HR = 0.96, P = 0.089) showed nonsignificant associations. Larger litter size was associated with lower APGAR scores, reduced temperature, and lower birth weight. Time to examination did not influence the predictive scores (APGAR or reflex), although temperature increased with time from birth (P = 0.009). CONCLUSIONS AND RELEVANCE:These findings indicate that APGAR and reflex scores are strong predictors of survival in kittens.
ObjectivesTo develop an ultrasound-guided pericapsular knee desensitization (PKD) technique targeting the medial (MAN), lateral (LAN) and posterior (PAN) articular branches of the saphenous, common fibular and tibial nerves, and to evaluate its accuracy in domestic feline cadavers.MethodsIn Phase I, six pelvic limbs from three cadavers underwent ultrasonographic evaluation and gross dissection to describe the course of the MAN, LAN and PAN and identify anatomical and sonographic landmarks for PKD. In Phase II, bilateral PKD was performed in eight cadavers (16 limbs) using 0.1 ml (low-volume, LV) or 0.2 ml (high-volume, HV) of dye per nerve, with volumes randomly assigned between limbs. MAN and PAN injections were performed under ultrasound guidance through a single medial percutaneous approach, whereas LAN injections were landmark-guided. Dissection was used to assess dye distribution around target nerves, the joint capsule and parent nerves.ResultsThe MAN was consistently located within the distal subsartorial canal alongside the descending genicular vessels, the PAN coursed adjacent to the popliteal vessels, and the LAN ran superficially near the fibular head and lateral head of the gastrocnemius muscle. Overall success was 23/24 injections (95.8%; 95% CI 78.9-99.9%) in the LV group and 21/24 (87.5%; 95% CI 67.6-97.3%) in the HV group. Both volumes stained the MAN, LAN and PAN trajectories and the medial, caudal and lateral surfaces of the knee joint capsule without intracapsular injection.Conclusions and relevanceUltrasound-guided PKD is feasible in domestic feline cadavers, and small injection volumes (0.1-0.2 ml per nerve) reliably reach pericapsular compartments containing the principal articular branches while largely sparing major motor nerves. These findings provide an anatomical and technical basis for future clinical evaluation of PKD for perioperative and chronic knee pain management in cats.
OBJECTIVES:This study aimed to develop and evaluate an in-house flow cytometry-based direct antiglobulin test (DAT) for detecting IgG-bound platelet in cats, and to investigate the prevalence of DAT positivity and associated risk factors among thrombocytopenic cats. METHODS:Platelets were identified by CD41/61 expression, and platelet-bound IgG was assessed by flow cytometry. A diagnostic cutoff for the percentage of IgG-positive platelets was established using 100 healthy cats and preliminarily evaluated in 50 cats with severe thrombocytopenia (platelet count <20,000/µL) before being applied to the remaining 411 thrombocytopenic cats (platelet count <200,000/µL) to determine the prevalence of DAT positivity and its associations with platelet count, breed, age, and sex. RESULTS:Healthy cats showed 0-10% IgG-positive platelets, and a cutoff of >10% was established. Using this threshold, 105/461 (22.8%) thrombocytopenic cats were classified as DAT positive. DAT positive cats had significantly lower platelet counts than DAT negative cats (median 4,000/µL; mean 12,562/µL vs 34,000/µL; mean 47,956/µL; P <0.05), and the percentage of IgG-bound platelets was inversely correlated with platelet count (r = -0.38; P = 0.048). No breed association was identified. Cats aged 5 years were more likely to be DAT positive, whereas neutered male cats were less likely to be DAT positive. CONCLUSIONS AND RELEVANCE:Flow cytometry-based DAT is a useful adjunctive diagnostic tool for assessing suspected immune-mediated platelet destruction in thrombocytopenic cats. Younger cats may be at increased risk, whereas neutered male cats may be at lower risk. However, the interpretation of a DAT positive test result should be made alongside assessment of clinical findings and investigations for underlying causes of thrombocytopenia.
ObjectivesTo investigate how different owner-cat interaction types influence stress and owner-bonding in pet cats with different attachment styles, using salivary cortisol and oxytocin as physiological indicators.MethodsTwenty pet cats were classified into secure, insecure-anxious, or insecure-avoidant attachment styles using the Secure Base Test. Owners engaged in four types of interactions with their cats at home on separate days. Saliva samples were collected before and after each interaction and analyzed for cortisol and oxytocin concentrations. The effects of attachment style, interaction type, and time on hormonal changes were examined.ResultsSignificant interactive effects of attachment style and time, as well as interaction type and time, were observed for both cortisol and oxytocin. Passive interactions were associated with increased oxytocin and decreased cortisol, whereas forced interactions showed an opposite pattern. Secure cats exhibited more positive hormonal responses to human interactions compared with insecure cats, which showed increased cortisol or limited hormonal changes. Insecure cats also showed higher basal oxytocin levels than secure cats.Conclusions and relevanceHuman-cat interactions trigger changes in cortisol and oxytocin levels, depending on the interaction type and cat's attachment style. These findings highlight the importance of considering individual cat attachment differences when promoting appropriate interaction strategies to improve cat welfare and human-cat relationships.
OBJECTIVES:Immune-mediated polyneuropathy (IMPN) manifests with generalized lower motor neuron (LMN) weakness and a remittent or relapsing clinical course. Evidence-based treatment recommendations for severely or chronically affected cats are limited. The objective of this study was to evaluate the clinical course and outcome of cats with IMPN following treatment with human intravenous immunoglobulins (hIVIg). METHODS:Medical records from two veterinary referral hospitals were reviewed (2018-2025) for cats with IMPN treated with hIVIg. Cats were treated with 1-2 g/kg hIVIg divided over 2-4 days (0.5 g/kg/day).Clinical information, diagnostic findings, treatment details and short- and long-term follow-up were evaluated retrospectively. Follow-up information was obtained from medical records and owner communication. Minimum follow-up duration was 8 months (8-51 months; median 17 months).Clinical course (partial and complete recovery, relapses) was compared between cats with acute/recent onset (4 cats) or chronic presentation (5 cats). RESULTS:Eight of nine cats exhibited clinical improvement following hIVIg administration, achieving ambulatory status (walking >5 steps) within a median of 4 days (2-8 days). One cat failed to respond to hIVIg but improved after subsequent prednisolone therapy. For the overall cohort, the median time to complete recovery was 20 days, while the median time to partial recovery was 14 days. Relapses occurred in four cats, but weakness was less severe, and all cats recovered again. The remaining five cats remained relapse-free. CONCLUSIONS AND RELEVANCE:Human IVIg was well tolerated in this small cohort, and rapid clinical improvement was observed in most treated cats. These findings suggest that hIVIg may be considered as a treatment option in selected cats with IMPN, including those with acute and chronic presentations. Larger prospective studies, including comparison with no treatment or corticosteroids, are warranted to further assess its efficacy.
Objectives This study aimed to evaluate the intraoperative opioid-sparing effect of quadratus lumborum block (QLB) using low-concentration bupivacaine combined with dexmedetomidine in cats undergoing ovariohysterectomy. Methods A total of 28 cats scheduled for ovariohysterectomy and classified as American Society of Anaesthesiologists status I were enrolled and randomly allocated to either a bupivacaine (0.125%) and saline (BS) or bupivacaine (0.125%) and dexmedetomidine (1 µg/kg) (BD) group. The cats underwent ultrasound-guided QLB in sternal recumbency using the allocated solution. If heart rate or mean arterial pressure increased by 20% or more from baseline during surgery, fentanyl (2 µg/kg IV) was administered as rescue analgesia. Postoperative pain was assessed 1, 2, 3, 6 and 12 h after extubation using the Short-Form UNESP-Botucatu Multidimensional Composite Pain Scale. Buprenorphine (0.02 mg/kg IM) was administered if the pain score was 4/12 or higher. Results The cumulative intraoperative dose of fentanyl was significantly lower in the BD group (1 µg/kg [range 0–6]) than in the BS group (2 µg/kg [range 0–8]; P = 0.030). No significant difference was observed between the groups in terms of the proportion of cats requiring intraoperative or postoperative rescue analgesia, postoperative pain scores at any time point, intraoperative physiological parameters or time-related variables. Conclusions and relevance QLB performed in sternal recumbency using low-concentration bupivacaine with dexmedetomidine was associated with a modest reduction in intraoperative opioid requirements during ovariohysterectomy in cats. However, as this study design could not differentiate between the local and systemic effects of dexmedetomidine, further research is needed to clarify their relative contributions and determine the optimal adjunctive dose.
Objectives Serial measurement of serum feline pancreatic lipase immunoreactivity (fPLI) and trypsin-like immunoreactivity (fTLI) concentrations in cats with chronic enteropathy (CE) has not been previously reported. The aim of the current observational study was to serially evaluate serum fPLI and fTLI concentrations in cats with different forms of CE. Methods A total of 60 cats with CE were included, diagnosed either with immunosuppressive-responsive enteropathy (IRE; n = 22), food-responsive enteropathy (FRE; n = 7) or low-grade intestinal T-cell lymphoma (LGITL; n = 32, one diagnosed previously as FRE progressed to lymphoma). Serum fPLI and fTLI concentrations were measured in 252 and 245 serum samples, respectively, from 60 cats with CE at initial presentation and during re-examination. Results Serum fPLI concentrations indicative of pancreatitis were found in 3/60 cats (one with IRE and two with LGITL) at initial presentation and in an additional 8/60 cats (four with IRE and four with LGITL) during treatment (24/252 serum samples). Serum fTLI concentrations indicative of exocrine pancreatic insufficiency were found in 2/60 cats (both with IRE) at initial presentation and during re-examination (n = 3/245). None of the cats with FRE had fPLI concentrations above or fTLI concentrations below the respective reference intervals (RIs). Conclusions and relevance Serum fPLI concentrations may fluctuate during treatment in a subset of cats with IRE or LGITL and, in some cats, are indicative of pancreatitis. Serum fTLI concentrations may vary within and outside the RI in a relatively small proportion of cats with IRE. The long-term clinical importance of these findings requires further study.
OBJECTIVES:Investigation of factors associated with antimicrobial drug prescription (ADP) in cats receiving outpatient care is lacking, which limits antimicrobial stewardship efforts and benchmarking of veterinary antimicrobial use. This study aimed to identify factors associated with ADP in cats receiving outpatient care at a veterinary teaching hospital. METHODS:A retrospective analysis of electronic medical record data from cats receiving outpatient care at a veterinary teaching hospital in 2022 was performed. Subjects included 2,245 cats with 3,973 outpatient visits. The primary study outcome was receipt of systemic ADP during or immediately following an outpatient visit; an exploratory outcome was receipt of a "Watch" or "Reserve" (WR) ADP using the World Health Organization (WHO) Access-Watch-Reserve (AWaRe) classification adapted to include veterinary agents. Independent variables including patient demographics, hospital service, and owner sociodemographic factors were identified for model fitting using univariable logistic regression; multivariable models were built using generalized estimating equations. RESULTS:9.2% of outpatient visit records (367/3,973) were associated with ≥1 ADP. Factors significantly associated with receipt of ADP included patient sex, hospital service visited, veterinarian training status, visit duration, and urine culture performed. Among patients receiving any antimicrobial, factors associated with receipt of WHO-WR ADP included hospital service, visit date, receipt of >1 ADP, and history of a visit to any hospital service within the prior month. DISCUSSION AND CONCLUSIONS:These findings expand our understanding of antimicrobial usage in cats. This knowledge identifying factors associated with antimicrobial use can be used to refine local prescribing practices and supports the development of veterinary and One Health antimicrobial stewardship initiatives and veterinary antimicrobial use benchmarking metrics.
ObjectivesTo evaluate the efficacy of two different formulations of glucagon given by three different routes (subcutaneous; SQ, rectal, intranasal; IN) for correcting insulin-induced hypoglycaemia in cats and to describe any adverse effects and compare the time required for administration by each route.MethodsA randomized, nonblinded, sham-controlled crossover study was conducted in six healthy cats, with a 7-day washout period between treatments. Hypoglycemia was induced using a continuous rate infusion (CRI) of rapid-acting Lispro insulin. Glucagon nasal powder (single-dose, ready-to-use) was given intranasally and rectally and compared to subcutaneous glucagon injection and intranasal sham control. Blood glucose concentration (BG) was measured from samples collected at baseline (T-15), after induction of hypoglycemia (T0), and at 5-minute intervals for 30 minutes (min), and then at 15 min intervals for 1 hour (h) following glucagon administration. Plasma glucagon and potassium (K+) concentrations were measured at T-15, T0, and T15 and T30 following glucagon administration. The time taken to prepare and administer each treatment was recorded.ResultsMedian BG was 2.6 mmol/L at T0 and increased significantly following glucagon administration by all routes, reaching peak median concentrations of 11.2 mmol/L (intranasal), 9.7 mmol/L (rectal), and 10.15 mmol/L (subcutaneous). Plasma glucagon concentrations increased markedly by T15, with the highest concentrations observed following intranasal administration (1562 pmol/L), followed by subcutaneous (191.7 pmol/L) and rectal (158 pmol/L) routes of administration. Plasma potassium decreased following insulin administration and increased modestly by T30 following glucagon administration by all routes. No serious adverse effects occurred following glucagon administration.Conclusions and Clinical ImportanceTransmucosal glucagon effectively restores BG towards baseline following insulin-induced hypoglycemia with minimal side effects. The IN route resulted in the highest plasma glucagon and BG concentrations compared to the rectal and subcutaneous routes of administration. Further studies are needed to quantify the efficacy and safety of transmucosal glucagon in diabetic cats in response to spontaneous insulin-induced hypoglycemia.
The aim of this study was to describe diffusion tensor imaging (DTI) and its derived parameters, such as apparent diffusion coefficient (ADC), fractional anisotropy (FA), radial diffusivity (RD) and axial diffusivity (AD) of the feline kidneys. Seventeen cats with clinically normal urinary tract underwent 3 Tesla MRI with DTI sequence (b-values of b=0,800 s/mm2, 15 diffusion directions). DTI images were analyzed and sampled in manually drawn regions of interest (ROIs) on 3 transverse slices, with 2 different sampling methods (small and large ROIs), on the cortex and on the medulla separately, and on the entire parenchyma. DTI images of the kidneys of 17 cats were analyzed. ADC, FA, RD, AD values differed significantly between cortex and medulla with both the sampling methods. The results of the present study indicate micro-structural similarities between feline and human kidneys. This study provides baseline data in healthy feline kidney for future potential application in the early diagnosis of renal pathologies in cats.
Feline xanthinuria is a rare autosomal recessive disorder of purine metabolism, due to genetic mutations in the xanthine dehydrogenase (XDH) gene. It is characterised by excessive excretion and accumulation of xanthine in the urine, which can lead to the formation of xanthine uroliths. Xanthine uroliths may be present in both upper and lower urinary tract, causing clinical signs associated with renal disease and feline lower urinary tract disorders (FLUTD). Hallmark diagnostic findings of xanthinuria are elevated xanthine and hypoxanthine, and reduced uric acid concentrations in serum and urine. Uroliths can be submitted for compositional analysis to confirm the presence of xanthine and definitive diagnosis for xanthinuria. Management involves dietary modification to purine restricted diets, and increased fluid intake. Commercially available renal diets are preferred over urinary diets due to their lower protein composition, and consulting veterinary nutritionists is strongly recommended. Urinary alkalisation is not considered effective method for the dissolution of xanthine uroliths due to their poor solubility. Despite these interventions, recurrence of xanthine urolithiasis can occur. Given the limited treatment options and risk of recurrence, feline xanthinuria is a life-long condition which requires ongoing management and monitoring to mitigate complications. This review will provide an overview of the current understanding of the pathophysiological, metabolic and genetic aspects of the disorder and discuss current diagnostic approaches, management strategies and clinical expectations of feline xanthinuria. Findings from this review highlight the need for greater recognition of feline xanthine urolithiasis as a cause of FLUTD, given current gaps in diagnostic methods and treatment options. A deeper understanding of the condition will help veterinarians accurately differentiate it from other causes of FLUTD and support further research aimed at improving detection, prevention, and management of xanthinuria.
Objectives The aim of this study was to analyse how demographics (breed, age, sex, neutering status), health and the environment (access to environmental features, weather and emotional state of the owner) affect the quality of life (QoL) of cats as measured by the Feline Quality of Life (FelQoL) questionnaire and its associated instrument. The result of this analysis was used to investigate the validity of the FelQoL questionnaire and instrument to inform pet owners and clinicians on the quantitative effects of different factors on feline wellbeing. Methods Responses from 1324 cat owners in the USA and UK were collected and used to compute the wellbeing dimensions characterised by FelQoL and to identify the demographics, health and environment of pet cats. Participants were clients of Banfield Pet Hospital, participants in the Bristol Cat Study or Mars employees. Statistical analysis was used to assess how demographics, health and environment affect the wellbeing scores and to further evaluate the validity of FelQoL. Results Results showed the effects of sex, age, health and environment on feline QoL that were compatible with clinical expectations and previous findings. Reference intervals that can be used to identify expected feline QoL across different circumstances and highlight potential causes of reduced wellbeing were also produced. Conclusions and relevance Our analysis suggests that FelQoL may be able to provide guidance on factors causing reduced feline wellbeing. FelQoL can also be used by cat owners to track QoL at home, instigating more intentional veterinary consultations when the wellbeing of a cat decreases even without obvious illness or injury. Further research, including targeted analysis of specific diseases and the exploration of longitudinal changes in FelQoL scores within individual cats over time will have the potential to assist with screening and quantification of effects of various factors on wellbeing and monitoring of targeted health plan interventions.
