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Clinical outcome and diseases associated with extreme neutrophilic leukocytosis in cats: 104 cases (1991-1999).

OBJECTIVE: To describe diseases, prognosis, and clinical outcomes associated with extreme neutrophilic leukocytosis in cats. DESIGN: Retrospective study. ANIMALS: 104 cats with extreme neutrophilic leukocytosis. PROCEDURE: Medical records from 1991 to 1999 were examined to identify cats that had > or =50,000 WBC/microl with > or =50% neutrophils. Signalment, absolute and differential WBC counts, rectal temperature, clinical or pathologic diagnosis, duration and cost of hospitalization, and survival time were reviewed. RESULTS: Mean age of cats was 8.3 years, mean WBC count was 73,055 cells/microl, and mean absolute neutrophil count was 59,046 cells/microl. Mean duration of hospitalization was 5.9 days, and mean cost of hospitalization was $2,010. Twenty-nine (28%) cats were febrile, and 63 (61%) cats died. Overall median survival time was 30 days. Cats with neoplasia were nearly 14 times as likely to die unexpectedly as cats with other diseases. CONCLUSIONS AND CLINICAL RELEVANCE: Extreme neutrophilic leukocytosis was associated with a high mortality rate. The prognostic importance of extreme neutrophilic leukocytosis should not be overlooked. Cats and dogs have similar diseases, mortality rates, and treatment costs associated with extreme neutrophilic leukocytosis.

Animals↗

Acute renal failure caused by lily ingestion in six cats.

Acute renal failure was diagnosed in 6 cats that had ingested Easter lily or tiger lily plants. All 6 were treated medically; 2 underwent hemodialysis. Three cats survived the acute episode, and although they had chronic renal failure, they survived for more than 1.5 years. Two cats died despite aggressive medical management, including hemodialysis. One cat was euthanatized shortly after the diagnosis was made. Three of the cats were oliguric or anuric at the time of initial examination, and all 3 died. None of the 3 cats that survived had oliguria or anuria. Various members of the lily family (Liliaceae) can cause nephrotoxicosis in cats, but the toxic principle is not known. Although the prognosis for full recovery of cats with lily toxicosis is poor, long-term survival is possible with supportive care. The prognosis appears to be better for cats with nonoliguric renal failure.

Acute Kidney Injury↗

Prevalence of feline leukemia virus infection and serum antibodies against feline immunodeficiency virus in unowned free-roaming cats.

OBJECTIVE: To determine prevalence of FeLV infection and serum antibodies against feline immunodeficiency virus (FIV) in unowned free-roaming cats. DESIGN: Cross-sectional serologic survey. ANIMALS: 733 unowned free-roaming cats in Raleigh, NC, and 1,143 unowned free-roaming cats in Gainesville, Fla. RESULTS: In Raleigh, overall prevalence of FeLV infection was 5.3%, and overall seroprevalence for FIV was 2.3%. In Gainesville, overall prevalence of FeLV infection was 3.7%, and overall seroprevalence for FIV was 4.3%. Overall, FeLV prevalence was 4.3%, and seroprevalence for FIV was 3.5%. Prevalence of FeLV infection was not significantly different between males (4.9%) and females (3.8%), although seroprevalence for FIV was significantly higher in male cats (6.3%) than in female cats (1.5%). CONCLUSIONS AND CLINICAL RELEVANCE: Prevalence of FeLV infection and seroprevalence for FIV in unowned free-roaming cats in Raleigh and Gainesville are similar to prevalence rates reported for owned cats in the United States. Male cats are at increased risk for exposure to FIV, compared with female cats.

Animals↗

Ultrasonographic findings in cats with clinical, gross pathologic, and histologic evidence of acute pancreatic necrosis: 20 cases (1994-2001).

OBJECTIVE: To determine ultrasonographic findings in cats with clinical, gross pathologic, and histologic evidence of acute pancreatic necrosis. DESIGN: Retrospective study. ANIMALS: 20 cats. PROCEDURE: Ultrasound reports and permanent ultrasonographic images were reviewed, and ultrasonographic findings were recorded. Thoracic and abdominal radiographs were also reviewed, when available. Anatomic localization of pancreatic necrosis was determined from the gross pathology report; duration and severity of pancreatic necrosis were determined by reviewing histologic specimens. The presence of concurrent disease was recorded from the final pathology report. RESULTS: The pancreas was considered ultrasonographically normal in 10 cats and was not observed in 3. Ultrasonographic findings were considered compatible with pancreatitis in the remaining 7 cats. Gross pathologic findings indicated that pancreatitis was multifocal in all 7 of these cats; histologically, pancreatitis was acute or subacute in 5 and associated with severe or moderate necrosis in 6. In the remaining 13 cats, gross pathologic findings indicated that pancreatitis was multifocal (n = 8) or focal (2), or gross pathologic findings were normal (3). Histologically, pancreatitis was peracute or acute in 11 of these 13 cats and associated with severe or moderate necrosis in 8. Thoracic and abdominal radiographic findings were nonspecific. CONCLUSIONS AND CLINICAL RELEVANCE: Results of ultrasonography were consistent with a diagnosis of pancreatitis in only 7 of 20 cats with acute pancreatic necrosis in the present study. This suggests that new diagnostic criteria must be established if abdominal ultrasonography is to be an effective tool in the diagnosis of pancreatitis in cats.

Acute Disease↗

Traumatic diaphragmatic hernia in cats: 34 cases (1991-2001).

OBJECTIVE: To determine whether signalment, duration of hernia, clinical signs, contents of hernia, CBC and serum biochemical abnormalities, concurrent injuries, perioperative treatment and administration of analgesics, results of intraoperative anesthetic monitoring data, or level of training of the veterinarian performing the herniorrhaphy was associated with mortality rate after surgical repair of traumatic diaphragmatic hernia in cats. DESIGN: Retrospective study. ANIMALS: 34 cats. PROCEDURE: Review of medical records and a telephone follow-up with owners and referring veterinarians were performed. RESULTS: Mean age of affected cats was 3.6 years; cats that survived to the time of discharge were significantly younger than cats that died or were euthanatized. Tachypnee was the most common clinical sign at hospital admission; cats that survived to the time of discharge had significantly higher respiratory rates than cats that died or were euthanatized after surgery. Postoperative complications developed in 50% of cats; tachypnea and dyspnea were most common. Mortality rate was not associated with duration of hernia or results of preoperative CBC and serum biochemical analyses, but was significantly associated with concurrent injuries. Mortality rate was not associated with hernia contents, intraoperative use of positive inotropes or corticosteroids, episodes of hypotension or severe hypoxia during anesthesia, or level of training of the veterinarian performing the surgery. CONCLUSIONS AND CLINICAL RELEVANCE: Cats that are older or have low to mildly increased respiratory rates and concurrent injuries are more likely to die after surgical repair of traumatic diaphragmatic hernia.

Animals↗

Appendicular arterial tumor embolization in two cats with pulmonary carcinoma.

A 13-year-old neutered male Persian cat and an 11-year-old neutered female Persian cat were examined because of an acute onset of lameness. In both cats, conscious proprioception and reflexes were diminished in the affected limb. In 1 cat, no blood flow was detected in the left brachial artery with a Doppler ultrasonic flow detector, whereas blood flow in the right brachial artery was easily documented. In the other cat, the right femoral pulse was not palpable. Neither cat had any echocardiographic evidence of cardiac disease. In both cats, treatment was primarily supportive. One cat died, and the other was euthanatized. At necropsy, lung lobe consolidation was seen. Microscopically, there was multifocal infiltration of the lung parenchyma with cuboidal to columnar neoplastic epithelial cells. Neoplastic epithelial cells of similar morphology were identified in nodular masses in sections of muscle, and intravascular tumor emboli were identified obliterating small and large arterioles. Immunohistochemical staining of pulmonary and muscular tissue for pan-cytokeratin antigen revealed intense cytoplasmic staining of neoplastic cells. Staining for factor VIII-related antigen confirmed that clusters of neoplastic cells represented intravascular emboli. Clinical signs in the cats were attributed to arterial occlusion by tumor emboli.

Animals↗

Control of urine marking by use of long-term treatment with fluoxetine or clomipramine in cats.

OBJECTIVES: To determine whether clomipramine differs from fluoxetine in reducing feline urine marking; whether reduction of marking continues in cats treated >8 weeks; whether recurrence of marking, after abrupt drug withdrawal, is less in cats treated >8 weeks; and whether cats that are successfully treated but resume marking after drug withdrawal can be successfully treated again with the same drug regimen. DESIGN: Positive-controlled, double-masked clinical trial. ANIMALS: 22 neutered cats (2 females, 20 males) > or =1 year old with objectionable urine marking. PROCEDURE: Cats that marked vertically > or =3 times/wk were treated with fluoxetine (1 mg/kg [0.45 mg/lb], q 24 h, PO) or clomipramine (0.5 mg/kg [0.23 mg/lb], q 24 h, PO) for 16 weeks, and efficacy was compared. Recurrence of marking was determined after abrupt withdrawal of fluoxetine at 16 or 32 weeks. Reduction in marking in cats treated with fluoxetine for 8 weeks after returning to marking following drug withdrawal was compared with the initial 8 weeks of successful treatment. RESULTS: Efficacy of fluoxetine and clomipramine was similar. Treatment >8 weeks revealed increasing efficacy in reduction of marking. Return of marking after termination of fluoxetine administration occurred in most cats. Cats successfully treated initially with fluoxetine responded similarly to repeated treatment. CONCLUSIONS AND CLINICAL RELEVANCE: Clomipramine and fluoxetine were equivalent in treating urine marking. Longer treatment increased efficacy. Most cats return to marking after abrupt drug withdrawal. A second course of treatment can be expected to be as effective as the first.

Administration, Oral↗

Epidemiologic features of Campylobacter infection among cats in the upper midwestern United States.

OBJECTIVE: To describe the epidemiologic features of Campylobacter infection among cats in the Minneapolis-Saint Paul metropolitan area. DESIGN: Prevalence survey. ANIMALS: 152 cats examined at 3 private veterinary clinics and an animal humane society. PROCEDURES: Fecal samples were submitted for bacterial culture for Campylobacter spp. To determine the duration of Campylobacter carriage, follow-up fecal samples were collected from cats with positive Campylobacter culture results. RESULTS: Campylobacter organisms were cultured from 37 of the 152 (24%) fecal samples. Campylobacter isolates were identified as Campylobacter upsaliensis (29 cats), Campylobacter jejuni (2), and Campylobacter coli (1); species of the remaining 5 isolates could not be determined. Campylobacter organisms were isolated from 36 of the 122 (30%) cats that were < or = 1 year old but from only 1 of the 30 (3%) cats that were > 1 year old, and shedding was more common during the summer and fall months. No association between Campylobacter shedding and clinical signs of disease was identified. For 4 of 13 cats from which follow-up fecal samples were obtained, duration of Campylobacter carriage could not be determined because Campylobacter organisms were isolated from all follow-up samples. For the remaining 9 cats, median duration of Campylobacter carriage was 44 days. CONCLUSIONS AND CLINICAL RELEVANCE: C. upsaliensis can commonly be isolated from the feces of overtly healthy kittens in the Midwest United States. Because carriage may be prolonged, veterinarians should encourage good hand hygiene among owners of cats, especially among owners with new kittens in their household.

Animals↗

Palliative use of a stent for colonic obstruction caused by adenocarcinoma in two cats.

CASE DESCRIPTION-Two adult male castrated cats were evaluated because of a history of constipation, tenesmus, or intermittent vomiting. CLINICAL FINDINGS-Radiography and ultrasonography revealed luminal narrowing in the colon of 1 cat and a colonic mass in the other. A histopathologic diagnosis of colonic adenocarcinoma was made in both cats. TREATMENT AND OUTCOME-Under fluoroscopic guidance, a self-expanding metallic stent was advanced over a wire and across the area of colonic stenosis and deployed. One cat had progressive weight loss but maintained a normal appetite, energy, and a high quality of life. Fecal continence was maintained, and tenesmus was rarely observed. The cat was euthanized because of tumor metastasis 274 days after the colonic stent was placed. The other cat retained fecal continence, and the owners reported subjective improvement in the severity of tenesmus, compared with that prior to stent placement. The cat was euthanized 19 days after stent placement because of perceived decreased quality of life. CLINICAL RELEVANCE-The use of self-expanding metallic stents for alleviation of colonic obstruction secondary to adenocarcinoma in cats appears to be effective. This technique provides a simple, quick, nonsurgical option for palliation in cats with advanced metastatic or systemic disease in which surgical resection may not be possible or warranted.

Adenocarcinoma↗

Risk factors associated with clinical signs of lower urinary tract disease in indoor-housed cats.

OBJECTIVE: To determine associations between environmental and cat-related factors and lower urinary tract signs in indoor-housed domestic cats. DESIGN: Case-control study. Animals-238 healthy cats, 157 cats with clinical signs of lower urinary tract disease, and 70 cats with other diseases. PROCEDURE: Data collected from owners of the cats were analyzed. Descriptive statistics, environmental variables, and physical and behavioral signs were analyzed by use of ANOVA and logistic regression analysis to assess which factors were associated with clinical signs of lower urinary tract disease. RESULTS: The only demographic or environmental factors associated with lower urinary tract signs were older age and months owned. In contrast, cats with clinical signs of lower urinary tract disease had significantly greater owner-observed gastrointestinal tract signs and scratching, fearful, nervous, and aggressive behaviors. CONCLUSIONS AND CLINICAL RELEVANCE: Lower urinary tract signs in indoor-housed cats may be more closely associated with cat-related factors than with demographic or environmental factors.

Age Factors↗

Clinical aspects of natural infection with Blastomyces dermatitidis in cats: 8 cases (1991-2005).

OBJECTIVE: To evaluate clinical and laboratory findings, treatment, and clinical outcome in cats with blastomycosis. DESIGN: Retrospective case series. ANIMALS: 8 cats with naturally occurring blastomycosis. PROCEDURES: Medical records of the University of Illinois Veterinary Teaching Hospital were searched for cases of blastomycosis in cats diagnosed via cytologic or histopathologic findings. Clinical and laboratory findings, treatment, and clinical outcome were determined. Radiographs were reviewed for the 8 cases. RESULTS: All cats were systemically ill. Respiratory tract signs and dermal lesions were most commonly observed. All cats had radiographic evidence of respiratory tract disease. Seven of the 8 cats had ill-defined soft-tissue opacities (nodules or masses) or alveolar consolidation of the lungs. Antemortem diagnosis was achieved cytologically in 6 of the 8 cats, and 3 were successfully treated and survived. CONCLUSIONS AND CLINICAL RELEVANCE: In contrast to previous reports, diagnosis was achieved antemortem in most of the cats (all by cytologic identification of the organism). Clinical signs, laboratory findings, and outcome were similar to previous descriptions of this rare disease in cats.

Animals↗

Prevalence of DNA of Mycoplasma haemofelis, 'Candidatus Mycoplasma haemominutum,' Anaplasma phagocytophilum, and species of Bartonella, Neorickettsia, and Ehrlichia in cats used as blood donors in the United States.

OBJECTIVE: To identify the prevalence of DNA of Mycoplasma haemofelis; 'Candidatus Mycoplasma haemominutum'; Anaplasma phagocytophilum; and species of Bartonella, Neorickettsia, and Ehrlichia in blood of cats used as blood donors in the United States. DESIGN: Prospective study. ANIMALS: 146 cats that were active blood donors. PROCEDURES: Environmental history was requested for each blood-donor cat from which a blood sample (mixed with EDTA) was available. Polymerase chain reaction assays capable of amplifying the DNA of the microorganisms of interest following DNA extraction from blood were performed. RESULTS: Overall, DNA of one or more of the infectious agents was detected in blood samples from 16 of 146 (11%) feline blood donors. Twenty-eight laboratory-reared cats housed in a teaching hospital had negative results for DNA of all organisms investigated. The DNA of at least 1 infectious agent was amplified from blood samples collected from 16 of 118 (13.6%) community-source cats; assay results were positive for 'Candidatus M haemominutum,' M haemofelis, or Bartonella henselae alone or in various combinations. Of the community-source cats allowed outdoors (n = 61) or with known flea exposure (44), DNA for a hemoplasma or B henselae was detected in 21.3% and 22.7%, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: When community-source cats, cats allowed outdoors, or cats exposed to fleas are to be used as blood donors, they should be regularly assessed for infection with M haemofelis, 'Candidatus M haemominutum,' and Bartonella spp, and flea-control treatment should be regularly provided.

Anaplasma phagocytophilum↗

Human toxoplasmosis and cat contact in Costa Rica.

We studied the prevalence of antibody to Toxoplasma gondii in 883 Costa Ricans between the ages of 15 and 26 years (mean 20.3). There were seven populations, two rural and five urban. The overall antibody prevalence was 61.4%. Because antibody prevalence was 57.1% in the 14 people who ate raw meat, and 61.6% in the 294 people who consumed raw eggs, meat and eggs could be excluded as important modes of transmission. We ascertained the presence of cats, type of soil contact, and flooring in the kitchen for every residence in which each individual lived from birth until interviewed. The 66% of people who indicated contact with cats had an antibody prevalence of 64%, and those without contact 56% (P = 0.02). In six of the seven populations, we found a positive correlation between cat contact and antibody prevalence; hence these six were studied together, and San Ramon, with a negative correlation, was examined separately. In the San Jose metropolitan population and in the total urban sample, cat contact was associated with a significantly higher antibody prevalence (P < 0.01). It was found that humans, even without acknowledged soil contact, acquire infection inside houses, especially with cement floors, when cats defecate in the house. Humans also acquire infection in or around houses with wooden floors, where the crawl space is an often unrecognized refuge of cats and a source of persistent soil contamination. San Ramon was the urban area with the highest human-cat contact (77%) and with the highest antibody prevalence in cats (75%). Although suggesting equal opportunities for infection, irrespective of cat contact, we cannot be certain in a retrospective study in which most of the infections took place an average of 15 years earlier. The most frequent antibody titer in our Costa Rican population was 1:1,024 (21%), much higher than the most frequent titers in a Colombian (1:64 to 1:128) and a U.S. population (1:16) of comparable age.

Adolescent↗

Bartonella henselae and Bartonella clarridgeiae infection in domestic cats from The Philippines.

One hundred seven domestic cats from The Philippines were serologically tested to establish the prevalence of Bartonella infection. A subset of 31 of these cats also had whole blood collected to tentatively isolate Bartonella strains. Bartonella henselae and B. clarridgeiae were isolated from 19 (61%) of these cats. Bartonella henselae type I was isolated from 17 (89%) of the 19 culture-positive cats. Six cats (31%) were infected with B. clarridgeiae, of which four were coinfected with B. henselae. Sixty-eight percent (73 of 107) and 65% (70 of 107) of the cats had antibodies to B. henselae and B. clarridgeiae, respectively, detected by an immunofluorescence antibody (IFA) test at a titer > or = 1:64. When tested by enzyme immunoassay (EIA), 67 cats (62.6%) had antibodies to B. henselae and 71 cats (66.4%) had antibodies to B. clarridgeiae. Compared with the IFA test, the B. henselae EIA had a sensitivity of 90.4% and a specificity of 97%, with positive and negative predictive values of 98.5% and 82.5%, respectively. Similarly, the B. clarridgeiae EIA had a sensitivity of 97% and a specificity of 92% specificity, with positive and negative predictive values of 95.8% and 94.4%, respectively. The presence of antibodies to Bartonella was strongly associated with flea infestation. Domestic cats represent a large reservoir of Bartonella infection in the Philippines.

Animals↗

Duodenal gangliosidosis in a cat: ultrastructural study.

Ultrastructural changes similar to those seen in gangliosidosis in man were detected in the duodenal mucosa of a cat (cat 1). The N-acetylneuraminic acid concentration was determined from the duodenum of cat 1 and from a clinically normal cat (cat 2). The total amount of gangliosides in the duodenum of cat 1 was 100 times greater than in the duodenum of cat 2 per unit wet weight. The lyophilizate from the intestines of both cats gave a blue-violet color that was regarded as qualitatively positive for N-acetylneuraminic acid determination. In cat 1, membranous cytoplasmic bodies were in all cell types of the duodenal mucosa.

Animals↗

Histopathological pattern and humoral immune response to a crude exo-antigen and purified keratinase of Microsporum canis in symptomatic and asymptomatic infected cats.

In order to understand better the mechanisms involved in the diverse clinical patterns in Microsporum canis-infected cats, the histopathological features were compared in symptomatic and asymptomatic infected cats. Additionally, the IgG immune response to a crude exo-antigen and purified keratinase of M. canis was studied by ELISA in cats of various clinical and mycological status. Acute and subacute perifolliculitis and folliculitis occurred more frequently in symptomatic than asymptomatic cats. The latter usually displayed signs of chronic inflammation and a marked infiltration of superficial dermis by mast cells, which would suggest that these animals present similarities to chronically dermatophytic humans or animals. When using a crude M. canis antigen, all infected cats were shown to have significantly higher levels of specific IgG when compared to culture negative and mechanical carrier-cats. In these non-infected animals, specific IgG was more frequently detected in adults than in young animals. No difference in anti-crude antigen specific IgG was observed between symptomatic and asymptomatic infected cats, indicating that the presence of IgG is probably unrelated to the clinical status of cats. Anti-keratinase specific IgG was only detected in one of the infected cats.

Animals↗

Preclinical study in cats of the pro-photosensitizer 5-aminolevulinic acid.

OBJECTIVE: To determine whether feline cells were able to convert 5-aminolevulinic acid (ALA) to protoporphyrin IX (PpIX) in vivo and in vitro, whether i.v. administration of ALA to healthy cats resulted in adverse effects, and whether PpIX accumulated in a squamous cell carcinoma (SCC) of a cat. ANIMALS: 4 healthy adult cats and 1 adult cat with a cutaneous SCC. PROCEDURE: In vitro production of PpIX was determined by incubating Crandell feline kidney cells with ALA. Effects of ALA administration and in vivo production of PpIX were determined by administering ALA (100, 200, or 400 mg/kg of body weight) to healthy cats and collecting skin biopsy specimens for up to 24 hours after drug administration. Blood samples were collected for CBC and serum biochemical analyses, and necropsies were performed. Accumulation of PpIX in a SCC was determined by treating a cat with a facial SCC with ALA and collecting specimens of the tumor and adjacent grossly normal skin. RESULTS: Incubation of ALA with feline cells resulted in time- and dose-dependent cytoplasmic accumulation of PpIX in vitro. After i.v. ALA administration, PpIX was detected in all tissues examined, with the highest fluorescence intensity in epithelia and in squamous cell carcinoma. The tumor-to-skin fluorescence intensity ratio was 5. All cats developed hepatotoxicoses. CONCLUSIONS AND CLINICAL RELEVANCE: Results from this limited number of cats suggest that ALA may be a useful photosensitizer in cats, but that doses > 100 mg/kg, i.v., may not be safe.

Aminolevulinic Acid↗

Acetaminophen toxicosis in the cat.

Administration by the owner of three 325-mg (5-gr) tablets of acetaminophen (N-acetyl-p-aminophenol) to each of 2 adult Burmese cats was associated with severe illness of both cats and death of one. Administration of two 325-mg tablets to each of 2 experimental adult cats resulted in severe illness. Marked cyanosis was observed in experimental cats within 4 hours after administration of one 325-mg tablet. Cyanosis was apparently due to anoxia associated with conversion of hemoglobin to methemoglobin by acetaminophen or its metabolites. Anemia, hemoglobinuria, and icterus were subsequently observed in the cats. Anemia and hemoglobinuria were caused by intravascular hemolysis of red blood cells (RBC). Icterus was due to both lysis of RBC and hepatic necrosis. Facial edema developed in 3 of 4 cats, but the pathogenesis of this lesion was not determined. The doses of acetaminophen were extremely large; however, administration of comparable doses to cats by their owners is a potential hazard because the drug is available without prescription as a 325-mg tablet. From information available at present, it seems that acetaminophen administration to the cat causes more dramatic clinical signs and is more likely to be fatal than the same doses of salicylates. Because phenacetin is metabolized to acetaminophen, similar clinical signs may occur in cats given phenacetin.

Acetaminophen↗