Biochemical Testing for Feline Heart Disease

Zimmering, T. M., F. Meneses, et al. (2009). "Measurement of N-terminal proatrial natriuretic peptide in plasma of cats with and without cardiomyopathy." American Journal of Veterinary Research 70(2): 216-222.

Nt-proANP is a natriuretic peptide produced in the cardiac muscle cells of the atria. In humans, ANP concentrations are used to distinguish people with chronic heart failure and monitor progression of the disease, survivability, and the efficacy of cardiac interventions. Two recent studies in cats indicated that plasma ANP concentrations were higher in cats with cardiomyopathy (CM) than in healthy cats. This study looked at 43 cats that were divided into three groups: control cats, cats with cardiomyopathy without congestive heart failure (CM without CHF), and cats with cardiomyopathy with congestive heart failure (CM with CHF). All cats had a physical examination, assessment of clinicopathologic variables that included plasma thyroxine concentration, thoracic radiography, and echocardiography. Each cat was assigned to one of the three groups based on results of these findings. A blood sample was taken from all 43 cats for a plasma Nt-proANP concentration using a human ELISA test kit. The first goal of the study was to determine whether Nt-proANP concentrations in cats with CM differ from concentrations in healthy cats. A second goal was to determine if there was a difference in values between cats with CM and no CHF from those cats that had CM with CHF. The results showed significant difference in Nt-proANP concentrations between the control cats that were healthy and the group with CM without CHF. The values were much higher in those cats assessed with CM only. The cats with CM with CHF had even significantly higher concentrations of Nt-proANP than the elevated values noted for the cats with CM and no CHF. Nt-proANP measurement could aid in the assessment of cats with cardiomyopathy and might be useful as a screening marker for the disease. The assay also has the potential for distinguishing between cats with CM without CHF and cats with CM and CHF. [VT]
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Related articles:
Connolly, D. J., R. J. Soares Magalhaes, et al. (2008). "Circulating natriuretic peptides in cats with heart disease." J Vet Intern Med 22(1): 96-105.
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Biondo, A. W., E. J. Ehrhart, et al. (2003). "Immunohistochemistry of atrial and brain natriuretic peptides in control cats and cats with hypertrophic cardiomyopathy." Vet Pathol 40(5): 501-6.
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Pain Management for Special Feline Cases

Mathews, K. A. (2008). "Pain management for the pregnant, lactating, and neonatal to pediatric cat and dog." Vet Clin North Am Small Anim Pract 38(6): 1291-308, vi-vii.

The majority of the information available to veterinarians on pain management for small animals is for the mature patient. Pregnant and lactating queens and neonates have received little attention or investigation. Unfortunately, this means that pain management is often avoided for these patients, due to concerns over adverse effects. The purpose of this review article is to focus on commonly available analgesics for these special patients. During pregnancy, opioids are the preferred analgesic for both women and animals. For example, opioids may be used to control pain associated with caesarean section with little or no effect on neonates. For lactating animals, opioids and non-steroidal anti-inflammatory drugs may be used. Opioids are also often used for pediatric patients, while non-steroidal anti-inflammatories are avoided in animals under 6 weeks of age. The risks and benefits of each class of drug, as well as a table of drugs and dosages are included. Dissemination of such information will help provide pain relief to some of the most vulnerable patients in veterinary medicine. [SL]
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Related articles:
Dyson, D. H. (2008). "Perioperative Pain Management in Veterinary Patients." The Veterinary clinics of North America. Small animal practice 38(6): 1309-1327.
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Robertson, S. and P. Taylor (2004). "Pain management in cats - past, present and future. Part 2. Treatment of pain - clinical pharmacology." J Fel Med Surg 6(5): 321-333.
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Feline Eosinophilic Keratitis

Spiess, A. K., J. S. Sapienza, et al. (2009). "Treatment of proliferative feline eosinophilic keratitis with topical 1.5% cyclosporine: 35 cases." Vet Ophthalmol 12(2): 132-7.

Eosinophilic keratitis is a progressive corneal disease seen in cats of any age. While the etiology is unknown, an immune-mediated response to feline herpesvirus is a suspected cause. The disease is unilateral in up to 75% of cases. The lesions are typically raised, irregular, white to pink masses. Scrapings of the lesions contain eosinophils, mast cells, and mixed inflammatory cells. Treatment is with topical corticosteroids, although some cases become refractory. Relapse is common if treatment is discontinued. The purpose of this study was to evaluate the efficacy of topical cyclosporine for feline eosinophilic keratitis. The disease was diagnosed by clinical appearance and corneal cytology in 35 cats. The mean age of affected cats was 6 years. Topical cyclosporine was administered either two or three times daily. The minimum follow up period was 5 months. Improvement was seen in 89% of cats. Recurrence was seen in 23% of cases. The researchers conclude that topical cyclosporine is an effective treatment for the majority of cats with eosinophilic keratitis, and that chronic, often life-long therapy is recommended. [SL]
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Related articles:
Andrew, S. E. (2008). "Immune-mediated canine and feline keratitis." The Veterinary clinics of North America. Small animal practice 38(2): 269-290.
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Moore, P. A. (2005). "Feline corneal disease." Clin Tech Small Anim Pract 20(2): 83-93.
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Evaluation of Kidney Function in Cats

Heiene, R., B. S. Reynolds, et al. (2009). "Estimation of glomerular filtration rate via 2- and 4-sample plasma clearance of iohexol and creatinine in clinically normal cats." American Journal of Veterinary Research 70(2): 176-185.

Large numbers of elderly cats develop renal disease. Survival time after diagnosis is variable. The ability to estimate glomerular filtration rate (GFR) could lead to early detection of renal disease and allow earlier institution of therapeutic measures that protect renal function. GFR is considered the overall best indicator of renal function in healthy and diseased animals and is estimated by measurement of clearance of a marker substance. This study used 51 cats to compare 2 methods for estimating GFR, evaluate the effect of ages and body size and their interaction on GFR estimates, and establish reference ranges for GFR in clinically normal cats. The two contrast markers evaluated were iohexol and creatinine. No adverse drug reactions were noted with the use of iohexol for GFR estimation. GFR values were established in all the cats in the study. A difference in estimated GFR between young and old cats was not evident in this study. The study did find a small but significant effect of body size on estimated GFR and this was more important than the effect of age. The 4-sample method was a convenient and reliable means to establish GFR in cats with values considered normal or near normal. The 2-sample method also provided acceptable approximations for GFR and worked well in non-sedated cats. However, the 4-sample method is more accurate in cats with low renal function. Since body weight should be taken into account for estimating GFR, further studies are indicated to provide more information. [VT]
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Related articles:
van Hoek, I., H. P. Lefebvre, et al. (2008). "Plasma clearance of exogenous creatinine, exo-iohexol, and endo-iohexol in hyperthyroid cats before and after treatment with radioiodine." J Vet Intern Med 22(4): 879-885.
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van Hoek, I., E. Vandermeulen, et al. (2007). "Comparison and reproducibility of plasma clearance of exogenous creatinine, exo-iohexol, endo-iohexol, and 51Cr-EDTA in young adult and aged healthy cats." J Vet Intern Med 21(5): 950-8.
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Response to Vaccinations in Cats

Lappin, M. R., J. Veir, et al. (2009). "Feline panleukopenia virus, feline herpesvirus-1, and feline calicivirus antibody responses in seronegative specific pathogen-free cats after a single administration of two different modified live FVRCP vaccines." Journal of Feline Medicine & Surgery 11(2): 159-162.

Researchers at Colorado State University evaluated the antibody response of cats to a single inoculation of one of two modified live vaccines containing feline panleukopenia virus (FPV), feline herpesvirus (FHV) and feline calicivirus (FCV). These pathogens commonly infect cats, and some cats at greatest risk, such as those in shelters or pet stores, may suffer severe disease, or even death. In these situations, rapid onset of immunity following vaccination is needed. The investigators sought to determine the timing of seroconversion in 10 seronegative cats following a single vaccination with either an intranasal vaccine or one given subcutaneously (both are commercially available vaccines). This study had limitations, in that the number of cats tested were small, and protection was evaluated by antibody levels only. In addition, the cats tested were adults not kittens; thus, the ability to break through maternal immunity could not be evaluated. Nevertheless, results were informative. While all cats developed detectable FPV and FCV antibody titers; only two cats developed detectable FHV-1 antibody titers indicating two vaccinations are required for adequate protection. For FPV and FHV-1, there were no differences in seroconversion rates between the cats that were given the intranasal versus the injectable vaccine. However, for FCV, the cats that were administered the IN FVRCP vaccine were more likely to seroconvert earlier than cats that were administered the injectable vaccine. These results suggest that the FVRCP vaccine administered IN should be considered in populations of FCV naive cats with high risk of exposure. [MK]
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Related articles:
Lappin, M. R., R. W. Sebring, et al. (2006). "Effects of a single dose of an intranasal feline herpesvirus 1, calicivirus, and panleukopenia vaccine on clinical signs and virus shedding after challenge with virulent feline herpesvirus 1." J Feline Med Surg 8(3): 158-63.
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Lappin, M. R., J. Andrews, et al. (2002). "Use of serologic tests to predict resistance to feline herpesvirus 1, feline calicivirus, and feline parvovirus infection in cats." J Am Vet Med Assoc 220(1): 38-42.
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Atenolol for Hyperthyroid Cats

Henik, R. A., R. L. Stepien, et al. (2008). "Efficacy of atenolol as a single antihypertensive agent in hyperthyroid cats." Journal of Feline Medicine & Surgery 10(6): 577-582.

Hypertension is a common complication of hyperthyroidism and chronic renal disease in cats. Various drugs may be used to treat feline hypertension, but the drug of choice appears to be amlodipine due to its efficacy and low incidence of adverse effects. However, in cats with hypertension caused by hyperthyroidism, beta-blocking drugs such as atenolol have been suggested to slow the heart rate and block effects of thyroid hormone on the cardiovascular system. While atenolol has been shown to be ineffective in treating hypertension associated with chronic renal disease, it has not been previously investigated for treatment of cats with hyperthyroidism. In this retrospective study, 20 hyperthyroid cats with systolic blood pressure over 160 mmHg were treated with atenolol (1-2 mg/kg, PO, BID). All cats were treated for a minimum of 5 days before reassessment and treatment with radioactive iodine. While both heart rate and systolic blood pressure decreased in the cats, successful clinical control of blood pressure was not achieved in 70% of the cases. The investigators concluded that while atenolol successfully controls heart rate in hyperthyroid cats, the addition of another drug is needed to treat hypertension.
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Related articles:
Trepanier LA. Pharmacologic management of feline hyperthyroidism. Vet Clin North Am Small Anim Pract. 2007 Jul;37(4):775-88
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Feline Thyroid Palpation Techniques

Paepe, D., P. Smets, et al. (2008). "Within- and between-examiner agreement for two thyroid palpation techniques in healthy and hyperthyroid cats." Journal of Feline Medicine & Surgery 10(6): 558-565.

The most common endocrine disorder of senior cats is hyperthyroidism. Early diagnosis and treatment can prevent serious complications. One of the most important diagnostic tools is palpation of the thyroid gland for enlargement, a standard part of the physical examination, especially for senior cats. There are two thyroid palpation techniques for cats described in the literature. The classic technique has the cat in a sitting position with the neck extended. Another technique has the cat standing with the head elevated and turned to one side. The diagnostic value of these techniques has not been compared. In this prospective study, 9 client-owned hyperthyroid cats and 10 healthy control cats were examined twice by 3 blind-folded clinicians using each palpation technique. A score from 1 to 6 was assigned to thyroid gland size each time. After clipping the hair of the ventral neck region, a final palpation session was performed, followed by ultrasonography of the gland. The classic palpation technique led to smaller within- and between-examiner differences. Clipping the hair coat did not make a significant difference. While both thyroid palpation techniques had good within- and between-examiner results, the investigators concluded that the classic palpation technique is preferred.
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Related Articles:
Norsworthy, G., V. Adams, et al. (2002). "Relationship between semi-quantitative thyroid gland palpation and total thyroxine concentration in cats with an without hyperadrenocorticism." J Fel Med Surg 4(3): 139.
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Norsworthy, G., V. Adams, et al. (2002). "Palpable thyroid and parathyroid nodules in asymptomatic cats." J Fel Med Surg 4(3): 145.
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Chronic sinusitis and Bartonella in Cats

Berryessa NA, Johnson LR, Kasten RW, Chomel BB. Microbial culture of blood samples and serologic testing for bartonellosis in cats with chronic rhinosinusitis. Journal of the American Veterinary Medical Association. 2008;233(7):1084-1089.

Chronic rhinosinutitis (CRS) is a frequent and frustrating medical disorder of cats. A common finding is excessive accumulation of nasal mucus along with sneezing, nasal discharge, and turbinate bone damage. The underlying cause for this disease is most likely multifactorial and due to a mix of a viral infection, secondary bacterial infection, and a poorly developed immune response. Treatment has primarily been directed at the result of the disease instead of potential causes. Bartonella are blood borne organisms most likely transmitted to cats through exposure to flea feces. Bartonella have been implicated in nasal inflammation in small animals and often private clinicians will test for the organism along with treating with azithromycin on the assumption that Bartonella is present. This study consisted of 4 groups of cats. The first group (19 cats) was composed of cats with CRS whose diagnosis was based on having a mucopurulent discharge longer than 3 months. The remaining 3 control groups were cats with other nasal diseases (Group 2: 10 cats), cats with systemic disease with no nasal disease (Group 3: 15 cats), and healthy cats (Group 4: 15 cats). All cats in the study had serologic testing for Bartonella henselae and Bartonella clarridgeiae and microbial cultures of blood samples performed. In those cats where nasal disease was evaluated, a biopsy sample was taken for histologic examination and another biopsy sample saved for PCR assay to detect Bartonella. The results of the study showed no significant differences in seropositivity or culture results in cats with CRS compared to the results of the 3 control groups. A positive serologic test for Bartonella would most likely indicate exposure and not presence of infection from the organism. In addition, the PCR assays of the nasal tissue samples were negative indicating that Bartonella organisms do not play an important role in the pathogenesis of CRS as demonstrated in these cats. One limitation of the study was the small number of cats enrolled. The authors do recommend a continued need to look for an association between Bartonella and other chronic inflammatory diseases in cats. [VT]
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Related articles:
Johnson L, Foley J, DeCock H, al e. Assessment of infectious organisms associated with severe chronic rhinosinusitis in cats. J Amer Vet Med Assoc. 2005;227(4):579-585.
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Quimby JM, Elston T, Hawley J, Brewer M, Miller A, Lappin MR. Evaluation of the association of Bartonella species, feline herpesvirus 1, feline calicivirus, feline leukemia virus and feline immunodeficiency virus with chronic feline gingivostomatitis. J Feline Med Surg. Feb 2008;10(1):66-72.
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Obesity in Cats

Colliard L, Paragon B-M, Lemuet B, Bénet J-J, Blanchard G. Prevalence and risk factors of obesity in an urban population of healthy cats. Journal of Feline Medicine & Surgery. 2009;11(2):135-140.

Obesity in cats is generally defined as being 15% or more over ideal body weight. Cats are considered overweight when up to 15% over ideal body weight. Depending on the study, the incidence of overweight and obesity in cats in various countries ranges from 6 to 52%. This study, from the National Veterinary School in Alfort, France, was designed to determine prevalence and risk factors for obesity in cats in France, as well as owners' perceptions about the body condition of their pets. All owners presenting healthy cats for vaccination to the veterinary school between March and June 2006 were questioned by a veterinarian using a standardized form. Data was collected on 385 cats, with an average age of 3.5 years. Results indicated that 19% of the cats were found to be overweight and about 8% were found to be obese. Risk factors identified included male gender, neutered status (both male and female), and underestimation of the cat's body condition by the owner. Some factors, such as the presence of a child in the home, were associated with lowered risk. Unlike some previous studies, living indoors and living without another animal in the home were not significant risk factors. [SL]
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Related articles:
Laflamme DP. Understanding and managing obesity in dogs and cats. Vet Clin North Am Small Anim Pract. Nov 2006;36(6):1283-1295, vii.
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Roudebush P, Schoenherr WD, Delaney SJ. An evidence-based review of the use of nutraceuticals and dietary supplementation for the management of obese and overweight pets. J Am Vet Med Assoc. Jun 1 2008;232(11):1646-1655.
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