Diagnosis of Feline Pancreatic Disease

Webb, C. B. and C. Trott (2008). "Laparoscopic diagnosis of pancreatic disease in dogs and cats." J Vet Intern Med 22(6): 1263-6.

Despite advances in diagnostic testing, the diagnosis of many pancreatic diseases is not straightforward. The pancreatic-lipase immunoreactivity (PLI) assay is sensitive and specific for pancreatic disease, but cannot identify the source of the inflammation. Pancreatic disease may be due to many different causes, such as acute nonsuppurative or chronic lympoplasmacytic pancreatitis, or pancreatitis secondary to another disease process such as inflammatory bowel disease or bile duct obstruction. Noninvasive imaging methods such as ultrasound or radiology have variable degrees of sensitivity and specificity. The gold standard for the diagnosis of exocrine pancreatic disease in animals remains biopsy and histopathology. Laparoscopy offers a minimally invasive route by which to obtain pancreatic biopsies. In this retrospective case series, the medical records of 18 dogs and 13 cats examined between 1999 and 2007 at Colorado State University that underwent laparoscopy during which observation or biopsy of the pancreas was recorded were examined. The presenting complaints, imaging studies, and histopathologic findings were recorded. For comparison, all hospital admissions were searched for animals with the same presenting complaints and of those it was determined which animals had exploratory surgery and their pancreas biopsied. In 14 animals a laparoscopic biopsy of the pancreas resulted in a histopathologic diagnosis when the sonographic findings or the gross assessment failed to do so. Results of this study suggests that laparoscopy is a safe and potentially underutilized diagnostic tool in animals where exocrine pancreatic disease is a prominent differential diagnosis, as in dogs and cats examined for vomiting, anorexia, or both.
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Related articles:
Richter, K. P. (2001). "Laparoscopy in dogs and cats." Vet Clin North Am Small Anim Pract 31(4): 707-27, ix.
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Zoran, D. L. (2006). "Pancreatitis in cats: diagnosis and management of a challenging disease." J Am Anim Hosp Assoc 42(1): 1-9.
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Remission of Diabetes in Cats

Sieber-Ruckstuhl, N. S., S. Kley, et al. (2008). "Remission of diabetes mellitus in cats with diabetic ketoacidosis." J Vet Intern Med 22(6): 1326-32.

Diabetes mellitus (DM) is one of the most common endocrine disorders in cats. DM in cats appears most similar to type 2 DM in humans, with obesity being a strong risk factor. A serious complication of DM in cats is diabetic ketoacidosis (DKA), a hyperglycemic emergency. While remission has been reported in up to 50% of cats with DM, remission in cats with severe DKA has not been reported. The purpose of this study was to evaluate medical records of cats presenting with DKA with diabetic remission and to compare them with those of cats with DKA without diabetic remission and those of cats with uncomplicated DM and diabetic remission. In this retrospective case review, the records of 12 cats with DKA and 7 cats with uncomplicated DM were analyzed. Of the cats with DKA, 7 experienced remission. These cats had more components of a stress leukogram and had pancreatic disease more often than did cats with uncomplicated DM and diabetic remission. They also had been treated more often with glucocorticoids. The researchers conclude that complete or partial remission of DM in cats presenting with DKA is possible. This finding is important as it may influence the willingness of owners and veterinarians to treat cats presenting with DKA.
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Related articles:
Zeugswetter, F. and M. Pagitz (2008). "Ketone measurements using dipstick methodology in cats with diabetes mellitus." J Small Anim Pract. [Epub ahead of print]
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Bruskiewicz, K., R. Nelson, et al. (1997). "Diabetic ketosis and ketoacidosis in cats: 42 cases (1980-1995)." J Amer Vet Med Assoc 211(2): 188-192.
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Seizures in Cats

Schriefl, S., T. A. Steinberg, et al. (2008). "Etiologic classification of seizures, signalment, clinical signs, and outcome in cats with seizure disorders: 91 cases (2000-2004)." J Am Vet Med Assoc 233(10): 1591-7.

Epileptic seizures can occur in cats for many reasons, such as metabolic or toxic conditions, inflammatory or infectious diseases, or neoplasia. Seizures with no identifiable cause are called idiopathic epilepsy, which has been considered rare in cats. The purpose of the study reported here was to evaluate associations among etiologic classifications of seizures and signalment, clinical signs, and outcome in cats with various seizure disorders. In this retrospective case series, data was collected on 91 cats presented for seizure disorders to Ludwig-Maximilians University in Munich from 2000 to 2004. During this period, the incidence of seizures in all cats presented to this hospital was 2.1%. Etiology was classified as reactive in 20 (22%) cats, symptomatic in 45 (50%), idiopathic or presumptive idiopathic in 23(25%), and cardiac syncope in 3 (3%). Focal seizures were recorded in 52% of the cats, and generalized seizures in 48%. The mean age of cats with idiopathic seizures (3.5 years) was significantly lower than that of cats with reactive seizures (8.2 years) or symptomatic seizures (8.1 years). Cats with idiopathic seizures survived the longest.
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Related articles:
Timmann, D., S. Cizinauskas, et al. (2008). "Retrospective analysis of seizures associated with feline infectious peritonitis in cats." J Feline Med Surg 10(1): 9-15.
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Bailey, K. S., C. W. Dewey, et al. (2008). "Levetiracetam as an adjunct to phenobarbital treatment in cats with suspected idiopathic epilepsy." J Am Vet Med Assoc 232(6): 867-72.
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Feline Muscular Dystrophy

Martin, P. T., G. D. Shelton, et al. (2008). "Muscular dystrophy associated with alpha-dystroglycan deficiency in Sphynx and Devon Rex cats." Neuromuscul Disord.

An animal model for some forms of muscular dystrophy in humans has been identified in the Devon Rex and Sphynx breeds. The disease is inherited in an autosomal recessive manner and has been identified in cats in several countries, such as the United States, Australia, UK, and the Netherlands. In the past, the disease was erroneously called "spasticity." Affected cats have a slowly progressive myopathy, with skeletal muscle weakness evidenced by cervical ventroflexion, a high-stepping forelimb gait, head bobbing, dorsal protrusion of the scapulae, and megaesophagus. There is no involvement of the peripheral nerves or central nervous system. Unfortunately, the prognosis is poor as many cats succumb to aspiration pneumonia or asphyxiation. Analysis has revealed a deficiency in alpha-dystroglycan protein expression, suggesting this disease may be one of the dystroglycanopathies.
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Related articles:
Malik, R., K. Mepstead, et al. (1993). "Hereditary myopathy of Devon Rex cats." J Sm Anim Pract 34(11): 539-546.
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