Successful phage-antibiotic therapy of P. aeruginosa implant-associated infection in a Siamese cat.

Antibiotic-resistant pathogens are a growing global issue, leading to untreatable infectious diseases in both humans and animals. Personalized bacteriophage (phage) therapy, the use of specific anti-bacterial viruses, is currently a leading approach to combat antibiotic-resistant infections. The implementation of phage therapy has primarily been focused on humans, almost neglecting the impact of such infections on the health and welfare of companion animals. Pets also have the potential to spread resistant infections to their owners or the veterinary staff through zoonotic transmission. Here, we showcase personalized phage-antibiotic treatment of a cat with a multidrug-resistant Pseudomonas aeruginosa implant-associated infection post-arthrodesis surgery. The treatment encompassed a tailored combination of an anti-P. aeruginosa phage and ceftazidime, precisely matched to the pathogen. The phage was topically applied to the surgical wound while the antibiotic was administered intramuscularly. After two treatment courses spanning 7 and 3 weeks, the surgical wound, which had previously remained open for five months, fully closed. To the best of our knowledge, this is the first case of personalized phage therapy application in felines, which provides further evidence of the effectiveness of this approach. The successful outcome paves the way for personalized phage-antibiotic treatments against persistent infections therapy in veterinary practice.

Neuropathic pain in cats: Mechanisms and multimodal management.

PRACTICAL RELEVANCE: Chronic pain is a significant welfare concern in cats, and neuropathic pain, which arises from aberrant processing of sensory signals within the nervous system, is a subcategory of this type of pain. To comprehend this condition and how multimodal pharmacotherapy plays a central role in alleviating discomfort, it is crucial to delve into the anatomy of nociception and pain perception. In addition, there is an intricate interplay between emotional health and chronic pain in cats, and understanding and addressing the emotional factors that contribute to pain perception, and vice versa, is essential for comprehensive care.Clinical approach:Neuropathic pain is suspected if there is abnormal sensation in the area of the distribution of pain, together with a positive response to trial treatment with drugs effective for neuropathic pain. Ideally, this clinical suspicion would be supported by confirmation of a lesion at this neurolocalisation using diagnostic modalities such as MRI and neuroelectrophysiology. Alternatively, there may be a history of known trauma at that site. A variety of therapies, including analgesic, anti-inflammatory and adjuvant drugs, and neuromodulation (eg, TENS or acupuncture), can be employed to address different facets of pain pathways.Aim:This review article, aimed at primary care/ general practitioners, focuses on the identification and management of neuropathic pain in cats. Three case vignettes are included and a structured treatment algorithm is presented to guide veterinarians in tailoring interventions.Evidence base:The review draws on current literature, where available, along with the author's extensive experience and research.

Responsible ownership and health education can reduce the time of sporotrichosis treatment in domestic cats.

Sporotrichosis is a widespread fungal infection that affects skin and subcutaneous tissues in humans and animals. In cats, it is displayed as nodules, ulcers and lesions on the nasal and respiratory mucosa. Antifungal treatment of cats is crucial but many cases are difficult, thus resulting in discontinue of the treatment, with disastrous consequences for the animal, encouraging contamination of the environment, other animals and people. The effects of responsible ownership education and health education for owners of cats with feline sporotrichosis as well as the interval between veterinary consultations on treatment outcomes for three groups of owners and their pet cats were evaluated in this study. The responsible ownership education and health education strategies consisted in videos in easy and accessible language for people with any level of education and were presented during consultations for two of the three groups included. The time between appointments was two weeks for two of the groups, and four weeks for one of the groups. The median of treatment time for the group without educational activities was 138 days, while for the other two groups it was 77.5 days and 86 days. It was found a significative reduction in the treatment time in the groups exposed to Responsible ownership education videos. There was no contamination of those responsible for home treatment, and the interval between monthly appointments did not impact on cure or death rates compared to the interval between fortnightly appointments. All these results can be applied to feline sporotrichoses treatment protocols increasing the owners treatment adherence and reducing either, the treatment discontinuation and the treatment costs and helps to control zoonotic sporotrichosis. The importance of attractive and comprehensible educational strategies as part of the feline sporotrichosis treatment protocol for the promotion of one health was highlighted.

The Use of Diets in the Diagnosis and Treatment of Common Gastrointestinal Diseases in Dogs and Cats.

The nutritional health of dogs and cats is important to pet owners around the world. Nutrition is inextricably linked to the health of the gastrointestinal system and vice versa. Gastrointestinal signs, such as vomiting, diarrhea, anorexia, or weight loss, are one of the most common reasons that dog and cat owners make non-routine appointments with veterinarians. Those patients are evaluated systematically to identify and/or rule out the causes of the symptoms. Some causes of chronic diarrhea are within the gastrointestinal tract while others are secondary to pathogenic factors outside the digestive system. Some useful biomarkers of chronic intestinal disease (enteropathy) exist in serum and feces. After determination that the clinical signs are due to primary gastrointestinal disease and that there is no parasitism, specific diets are used for at least two weeks. There are several types of diets for pets with chronic enteropathies. There are limited ingredient diets and hydrolyzed protein diets with reduced levels of allergens. There are also highly digestible and fiber-enhanced diets. Some diets contain probiotics and/or prebiotics. If symptoms do not improve and the patient is stable, a diet from a different class may be tried. For chronic enteropathies, the prognosis is generally good for symptom resolution or at least improvement. However, if interventions with novel diets do not ameliorate the symptoms of chronic enteropathy, then antibiotic, anti-inflammatory, or immunosuppressant therapy or further, more invasive diagnostics such as taking an intestinal biopsy, may be indicated. Pancreatitis is a common gastrointestinal disease in dogs and cats and patients may present with mild to severe disease. Many patients with mild to moderate disease can be successfully treated with early supportive care, including feeding a low-fat diet. A novel pharmaceutical, fuzapladib (Panoquell-CA1) looks very promising for treating more severe forms of acute pancreatitis in dogs. Maintenance on a low-fat diet may prevent pancreatitis in at-risk dogs. Future advances in medicine will allow pet owners and veterinarians to use dietary management to maximize the health of their dogs and cats.

Basic triage in dogs and cats: Part III.

Background: Emergency cases can be presented at any time of the day or night. All small animal practitioners need to have the skills to triage and stabilize common emergency cases, even if the ultimate goal is to refer the animal to another facility. Objective and procedure: The third and final part of this 3-part review article series discusses arrhythmias typical in emergency cases and the approach to animals that are presented with an inability to stand up and walk normally. A stepwise method to categorize and stabilize these cases is outlined, along with helpful tips to optimize the referral experience, if indicated. Results: Recognizing and knowing how to treat tachy- and bradyarrhythmias is important in stabilizing a dog's or cat's condition. Understanding how to differentiate the various reasons that a dog or cat is unable to stand on its own allows a veterinarian to both treat and communicate outcome expectations for those animals. Conclusion and clinical relevance: Do not refer emergent cases before basic stabilization is completed. Many emergency cases can either be worked up by the primary veterinarian or sent to a referral clinic on an appointment basis after appropriate stabilization steps have occurred.

Triage de base chez les chiens et les chats : Partie III. Mise en contexte: Les cas d'urgence peuvent être présentés à toute heure du jour ou de la nuit. Tous les praticiens des petits animaux doivent avoir les compétences nécessaires pour trier et stabiliser les cas d'urgence courants, même si le but ultime est de référer l'animal vers un autre établissement. Objectif et procédure: La troisième et dernière partie de cette série d'articles de synthèse en trois parties traite des arythmies typiques des cas d'urgence et de l'approche des animaux présentant une incapacité à se lever et à marcher normalement. Une méthode par étapes pour catégoriser et stabiliser ces cas est décrite, ainsi que des conseils utiles pour optimiser l'expérience de référence, si cela est indiqué. Résultats: Reconnaître et savoir comment traiter les tachy- et bradyarythmies est important pour stabiliser l'état d'un chien ou d'un chat. Comprendre comment différencier les différentes raisons pour lesquelles un chien ou un chat est incapable de se tenir seul permet au vétérinaire de traiter et de communiquer les attentes en matière de résultats pour ces animaux. Conclusion et pertinence clinique: Ne référez pas les cas urgents avant que la stabilisation de base ne soit terminée. De nombreux cas d'urgence peuvent être traités par le vétérinaire initial ou envoyés à une clinique de référence sur rendez-vous après que les mesures de stabilisation appropriées ont été prises.(Traduit par Dr Serge Messier).

Alpha-chloralose poisoning in 25 cats: clinical picture and evaluation of treatment with intravenous lipid emulsion.

OBJECTIVES: The aims of this study were to describe the clinical picture and progression in cats with alpha-chloralose (AC) intoxication and to determine if treatment with intravenous (IV) lipid emulsion (ILE) influenced either the serum concentration of AC or the clinical signs. METHODS: Cats with suspected AC poisoning admitted to a university small animal hospital were included. The cats were randomised into two groups: one receiving 20% ILE at a dose of 300 mg/kg as a 2 min bolus, followed by a 1500 mg/kg continuous rate infusion over 30 mins (IL+ group) and the other receiving IV fluid therapy with Ringer's acetate (IL- group). Serum samples were drawn at 0, 2, 12 and 24 h after admission. Samples were tested for AC with a novel validated, quantitative, ultra-high-performance liquid chromatography-tandem mass spectrometry method. Vital and predefined clinical signs were noted at the times of sampling and patients were scored using a previously described intoxication severity score. Telephone interviews were conducted after discharge to assess outcome. RESULTS: A total of 25 cats were enrolled: 13 cats in the IL+ group and 12 in the IL- group. The most common clinical signs at presentation were tremor (n = 22, 88.0%), cranial nerve deficits (n = 20, 80.0%) and bradycardia (n = 19, 76.0%). No significant difference in AC concentration or change in intoxication score over time was found between the IL+ and IL- groups at any time point (P >0.05). All cats recovered within 72 h. CONCLUSIONS AND RELEVANCE: ILE did not have any effect on the AC serum concentration or clinical signs in AC-poisoned cats. All cats survived until follow-up. In cats with an acute onset of the described neurological signs, AC intoxication is an important differential diagnosis with an excellent prognosis.

Basic triage in dogs and cats: Part II.

Background: Emergency cases can be presented at any time of the day or night. All small animal practitioners need to have the skills to triage and stabilize common emergency cases, even if cases are ultimately referred to another facility. Objective and procedure: The second part of this 3-part review article series discusses animals that collapse at home as well as dogs and cats with bleeding. A stepwise approach to categorize and stabilize these cases is outlined, along with helpful tips to optimize the referral experience, if indicated. Results: Having a robust and methodical approach to animals that collapse is important for many emergency cases, as the causes and treatment methods vary. Bleeding can lead to acute death if left untreated and knowing the steps to stop bleeding is important for patient stabilization. Conclusion and clinical relevance: Do not refer emergent cases before completing basic stabilization. Many emergency cases do not require emergent referral and can be worked up by the primary veterinarian or sent to a referral clinic on an appointment basis after appropriate stabilization steps have occurred.

Triage de base chez les chiens et les chats : Partie II. Contexte: Les cas d'urgence peuvent être présentés à toute heure du jour ou de la nuit. Tous les praticiens des petits animaux doivent avoir les compétences nécessaires pour trier et stabiliser les cas d'urgence courants, même si les cas sont finalement transférés vers un autre établissement. Objectif et procédure: Le deuxième de cette série de trois articles traite des animaux qui s'effondrent à la maison ainsi que des chiens et des chats qui saignent. Une approche par étapes pour catégoriser et stabiliser ces cas est décrite, ainsi que des conseils utiles pour optimiser l'expérience de référence, si elle est indiquée. Résultats: Avoir une approche robuste et méthodique face aux animaux qui s'effondrent est important dans de nombreux cas d'urgence, car les causes et les méthodes de traitement varient. Les saignements peuvent entraîner une mort aiguë s'ils ne sont pas traités et connaître les étapes à suivre pour arrêter le saignement est important pour la stabilisation du patient. Conclusion et pertinence clinique: Ne référez pas les cas urgents avant d'avoir terminé la stabilisation de base. De nombreux cas d'urgence ne nécessitent pas de référence urgente et peuvent être traités par le vétérinaire initial ou envoyés à une clinique de référence sur rendez-vous après que les mesures de stabilisation appropriées ont été prises.(Traduit par Dr Serge Messier).

Basic triage in dogs and cats: Part I.

Background: Emergency cases can present at any time of the day or night. All small animal practitioners need to have the skills to triage and stabilize common emergency cases even if they ultimately aim to refer the patient to another facility. Objectives and procedures: The first part of this 3-part review article series covers respiratory distress and seizures. A stepwise approach to categorize and stabilize these cases is outlined, along with helpful tips to optimize the referral experience, if indicated. Results: Having a strong methodical approach to animals in respiratory distress optimizes treatment. Similarly, achieving cessation of seizures, along with having a good understanding of the causes of seizures, allows for patient stabilization. Conclusion and clinical relevance: Do NOT refer emergent cases before completing basic stabilization. Many emergency cases do not require emergent referral and can be worked up by the primary veterinarian or sent to a referral clinic on an appointment basis after appropriate stabilization steps are completed.

Triage de base chez les chiens et les chats : Partie I. Contexte: Les cas urgents peuvent se présenter à tout moment du jour ou de la nuit. Tous les médecins vétérinaires en pratique des petits animaux doivent avoir les compétences pour effectuer un triage et stabiliser les cas urgents fréquents même s'ils prévoient ultimement référer le patient à un autre établissement. Objectifs et procédures: La première partie de cet article de revue en 3 parties traite de la détresse respiratoire et des convulsions. Une approche progressive pour catégoriser et stabiliser ces cas est présentée, avec des conseils utiles pour optimiser l'expérience de référencement, si nécessaire. Résultats: Avoir une approche méthodique solide lors de cas de détresse respiratoire chez les animaux permet d'optimiser le traitement. De manière similaire, être capable de maîtriser les convulsions tout en ayant une bonne compréhension de leurs causes, permettent une meilleure stabilisation du patient. Conclusion et pertinence clinique: Ne PAS procéder au référencement de cas urgents avant d'avoir terminé une stabilisation de base. Plusieurs cas urgents ne nécessitent pas d'être référé en urgence et peuvent être pris en charge par le médecin vétérinaire primaire ou transféré à une clinique de référence après la prise d'un rendez-vous une fois qu'une stabilisation adéquate ait été complétée.(Traduit par Dr Serge Messier).

Heterogeneity of mesenchymal stem cells as a limiting factor in their clinical application to inflammatory bowel disease in dogs and cats.

Inflammatory bowel disease (IBD) is a major subtype of chronic enteropathies in dogs and cats. Conventional drugs such as immunomodulatory medicines as glucocorticoids and/or other anti-inflammatory are mainly applied for treatment. However, these drugs are not always effective to maintain remission from IBD and are limited by unacceptable side effects. Hence, more effective and safe therapeutic options need to be developed. Mesenchymal stem cells (MSCs) are multipotent stem cells with a self-renewal capacity, and have immunomodulatory, anti-inflammatory, anti-fibrotic, and tissue repair properties. Therefore, the application of MSCs as an alternative therapy for IBD has great potential in veterinary medicine. The efficacy of adipose tissue-derived MSC (ADSC) therapy for IBD in dogs and cats has been reported, including numerous studies in animal models. However, treatment outcomes in clinical trials of human IBD patients have not been consistent with preclinical studies. MSC-based therapy for various diseases has received widespread attention, but various problems in such therapy remain, among which no consensus has been reached on the preparation and treatment procedures for MSCs, and cellular heterogeneity of MSCs may be an issue. This review describes the current status of ADSC therapy for canine and feline IBD and summarizes the cellular heterogeneity of canine ADSCs, to highlight the necessity for further reduction or elimination of MSCs heterogeneity and standardization of MSC-based therapies.

Feline ventral abdominal wall angiosarcoma: haemangiosarcoma or lymphangiosarcoma? Clinical and pathological characteristics in nine cases.

OBJECTIVES: Angiosarcomas are rare malignant mesenchymal neoplasms of endothelial cell origin with a predilection to the ventral abdominal wall in cats. Larger case series describing this entity are lacking. METHODS: Two referral centre laboratory databases were searched for angiosarcoma of the ventral abdominal wall. Nine cases with a histological diagnosis were included. Immunohistochemistry (factor VIII and PROX-1 antibodies) was used to phenotype them as haemangiosarcoma or lymphangiosarcoma. RESULTS: All cats presented with a ventral abdominal mass, five of which were producing a serosanguinous discharge. Eight underwent tumour staging and pulmonary metastases were suspected in one cat (but not histologically confirmed). With histopathology alone, a diagnosis of angiosarcoma and lymphangiosarcoma was made in four and five cases, respectively. After immunohistochemistry, five cases had a haemangiosarcoma phenotype and four had a lymphangiosarcoma phenotype, including two cases of lymphangiosarcoma that were reclassified as hemangiosarcoma. Eight cats received treatment (either surgery with or without adjuvant therapies or medical management alone). Six cats were euthanased due to local disease progression. The median survival time for haemangiosarcoma was 166 days (range 137-381), and for lymphangiosarcoma it was 197 days (range 67-208). Two cats with haemangiosarcoma remained alive for a follow-up period of 329 and 580 days, respectively. CONCLUSIONS AND RELEVANCE: Feline ventral abdominal angiosarcomas are rare locally aggressive neoplasms. While histology often provides a diagnosis of angiosarcoma, immunohistochemistry is ultimately required to differentiate between haemangiosarcoma and lymphangiosarcoma phenotypes. Further studies are required to evaluate whether the different phenotypes have an impact on treatment response and outcome.

Open trial of recombinant Der f 2 pullulan-conjugated immunotherapy in cats.

BACKGROUND: Allermmune HDM (Zenoaq) is a recombinant Dermatophagoides farinae 2 (Der f 2) pullulan-based immunotherapy vaccine whose efficacy on house dust mite allergic dogs has been demonstrated. There is no published information on its use in cats. OBJECTIVES: The objective of the study was to evaluate the safety and short-term effects of Allermmune HDM in Dermatophagoides farinae (Df)-sensitised cats. MATERIALS AND METHODS: Eleven cats diagnosed with atopic skin syndrome received Allermmune weekly for six weeks then monthly for three months (total duration 18 weeks). On Weeks 0, 6 and 18 clinical lesions were assessed by the Feline Dermatitis Extent and Severity Index (FEDESI); owners assessed pruritus with a 10-cm Visual Analog Scale (pVAS). Concurrent medication use was recorded. The allergen-specific immunoglobulin (Ig)E were measured before study inclusion with a commercial serological assay. RESULTS: There were no evident adverse effects. FEDESI and pVAS improved significantly after six weeks (p = 0.001 and p = 0.01, respectively). The pretreatment Df-specific IgE levels were significantly higher in the cats with improved clinical scores than in the cats with no clinical score change (p = 0.009). CONCLUSIONS AND CLINICAL RELEVANCE: Allermmune HDM may be safe in cats and has the potential to alleviate signs of atopic skin syndrome. Allergen-specific IgE levels may represent an efficacy marker. Controlled studies of longer duration and larger sample size are worth pursuing.

Seeing the benefits, but not taking advantage of them: Dog and cat owners' beliefs about veterinary telemedicine.

BACKGROUND: Telemedicine offers benefits to clients and their animals, but potential disadvantages are also being debated. METHODS: Using a questionnaire, we investigated dog and cat owners' (N = 2117) use of and beliefs about telemedicine and whether beliefs impact past and expected future use. RESULTS: Although the majority of owners are aware that telemedicine can lead to the risk of something being missed, they see great potential in remote consultation in terms of usefulness for follow-up appointments or improving access to a specialist. However, only 12% of dog owners and 6% of cat owners have used telemedicine, and around 25% of owners who have never used it would be willing to use it in the future. Owners with a larger number of recent veterinary visits were more likely to have used telemedicine. LIMITATIONS: Although a definition of 'telemedicine' was provided, respondents may have had different perceptions of what this meant. CONCLUSION: Owners of dogs and cats recognise the potential benefits of telemedicine, but there is a mismatch with the actual uptake. This not only raises questions about the current availability of telemedicine but also should increase veterinary professionals' understanding of its potential benefits in veterinary practice.

A Review of Pet Food Recalls from 2003 Through 2022.

This is a review of U.S. Food and Drug Administration (FDA) recalls of products that are for dogs and cats which took place from 2003 through 2022. It includes recalls for pet foods (food, treats, and chews), ingredients, supplements (vitamins and minerals), and drugs. There were 3,691 recalls during this period: 51% were Class I, 35% were Class II, and 14% were Class III. Food items and ingredients accounted for the majority or 68%, drugs for 27%, and supplements (vitamins and minerals) accounted for 5% of these recalls. Recalls that could be associated with dogs only accounted for 42%, with cats only 18%, and with multiple species 40%. The primary reasons for the recalls were biological contamination at 35%, chemical contamination at 32%, and cGMP violations at 8%. Almost 25% of the total recalls in the past 20 years were due to a melamine incident in 2007/2008 (73% of those were Class I). Salmonella recalls for the 20 years accounted for 23% of the total recalls (94 % of those were Class I). Although the recalls for vitamins and minerals accounted for only 5.6% percent of the total, 70% of those were Class I and 30% Class II. Pet food is a complex part of the processed food industry, and the processing of pet food is subject to at least 40 different federal regulations. To avoid recalls and be successful, pet food manufacturers need a robust food safety culture to meet all of these requirements to produce a safe product. In contrast, the melamine contamination (an adulteration event) in 2007/2008 which resulted in animal deaths and recalls is a prime example of the need for an effective and robust supplier approval program in order to avoid fraudulent suppliers in the future.

Skin Disease and Behavior Changes in the Cat.

The health of the skin and coat of a cat is connected to the behavioral health of the animal. Stressed animals can cause lesions to their skin and coat such as alopecia, ulcers, and self-mutilation. On the other hand, localized or systemic health problems can cause stress, or pain, and therefore can increase overgrooming and poor skin health. When treating overgrooming and related skin lesions, all the physical and behavioral causes must be addressed through a multimodal approach.

Improving access to advanced veterinary care for rescued cats and dogs.

OBJECTIVES: The objectives of this study were as follows: (1) to describe the AMC to the Rescue (AMCTTR) funding criteria and the application process; (2) to describe the distribution of species cared for through the program, the medical conditions treated in cats compared with those treated in dogs and the cost of that care; and (3) to define the successes and challenges of the program. METHODS: The AMCTTR database was reviewed for applications submitted between 1 January 2020 and 31 December 2022. Data collected included the following: the date of application; rescue organization seeking financial support; species; age of pet at time of application; expenditures funded by AMCTTR; and the method by which the rescue organization learned about AMCTTR. The animals in the AMCTTR database were sorted into two groups: those accepted for funding and those that did not meet funding criteria. The Animal Medical Center (AMC) medical record system was searched for the total number of individual animals, species and age seen at AMC during the study period. RESULTS: In total, 267 applications were reviewed and 190 applications from 134 cats, 52 dogs and four rabbits were accepted for advanced veterinary care funded by AMCTTR. Over the 3-year study period, US$612,564 were awarded and over half of those funds were awarded to cats. The average expenditure per animal during this time period was US$3224. The most common referrals to AMCTTR were made to ophthalmology, surgery and dentistry. CONCLUSIONS AND RELEVANCE: The needs of cats differed from dogs in that feline applications were most commonly submitted for ophthalmology or dentistry. Expenditures per cat were less than per dog because dogs were referred for more expensive orthopedic surgery. The need for advanced veterinary care for rescue animals is enormous, especially for cats. Programs that subsidize advanced veterinary care increase access to that care.

Use of cutting-edge RNA-sequencing technology to identify biomarkers and potential therapeutic targets in canine and feline cancers and other diseases.

With the growing interest in companion animals and the rapidly expanding animal healthcare and pharmaceuticals market worldwide. With the advancements in RNA-sequencing (RNA-seq) technology, it has become a valuable tool for understanding biological processes in companion animals and has multiple applications in animal healthcare. Historically, veterinary diagnoses and treatments relied solely on clinical symptoms and drugs used in human diseases. However, RNA-seq has emerged as an effective technology for studying companion animals, providing insights into their genetic information. The sequencing technology has revealed that not only messenger RNAs (mRNAs) but also non-coding RNAs (ncRNAs) such as long ncRNAs and microRNAs can serve as biomarkers. Based on the examination of RNA-seq applications in veterinary medicine, particularly in dogs and cats, this review concludes that RNA-seq has significant potential as a diagnostic and research tool. It has enabled the identification of potential biomarkers for cancer and other diseases in companion animals. Further research and development are required to maximize the utilization of RNA-seq for improved disease diagnosis and therapeutic targeting in companion animals.

Clinical management of feline chronic kidney disease in Portugal: a questionnaire-based study.

OBJECTIVES: The aim of the study was to characterise the clinical management of feline chronic kidney disease (CKD) by veterinary practitioners in Portugal. METHODS: A questionnaire-based study was designed to be completed by all veterinarians who had diagnosed and treated at least one case of feline CKD in the previous year. RESULTS: A total of 409 veterinary practitioners responded to the questionnaire, with approximately half of them diagnosing 2-5 cases of feline CKD per month (n = 219, 53.5%). Although a high proportion of these reported using the guidelines published by the International Renal Interest Society (n = 379, 92.7%), only 19.1% (n = 78) systematically performed systolic blood pressure (SBP) measurements in all of their patients. A renal diet was advised by almost all respondents (n = 406, 99.3%), but 36.9% (n = 150) of them considered that it represented less than 75% of the daily food intake for most of their patients. This dietary intervention was often prescribed regardless of stage (n = 298, 73.4%) and without a proper gradual diet transition. Appetite stimulants were frequently prescribed (n = 366, 89.5%), as well as a calcium channel blocker (n = 171, 41.8%) and an angiotensin-converting enzyme inhibitor (n = 245, 59.9%) to control systemic hypertension and proteinuria, respectively. Prescription of a phosphate binder was also common (n = 311, 76.0%). Regarding monitoring, 70.9% (n = 290) recommended that stable patients be reassessed every 2-3 months or more frequently, but only 35.7% (n = 146) were able to comply with this periodicity due to owners' constraints. CONCLUSIONS AND RELEVANCE: The findings showed that although most survey respondents are aware of international guidelines for the clinical management of cats with CKD, the SBP measurement still needs to be more systematic to allow proper substaging and detection of systemic hypertension. The monitoring frequency was lower than recommended. Furthermore, the introduction of a renal therapeutic diet should be refined to improve its acceptance rate.

Transient myocardial thickening: a retrospective analysis on etiological, clinical, laboratory, therapeutic, and outcome findings in 27 cats.

INTRODUCTION/OBJECTIVE: Transient myocardial thickening (TMT) in cats is a poorly characterized clinical entity. Therefore, this study aimed to provide descriptions of additional cats diagnosed with this clinical phenomenon. ANIMALS, MATERIALS, AND METHODS: For this multicenter observational retrospective study, cats diagnosed with TMT were searched in three medical databases. TMT was defined for cats with at least two echocardiograms showing an increased end-diastolic left ventricular wall thickness (LVWTd; i.e. ≥6 mm) at presentation and subsequent echocardiographic normalization (i.e. LVWTd <5.5 mm). Signalment, history, clinical, laboratory, therapeutic, and outcome data were retrieved. RESULTS: Twenty seven cats were included. The median age was 3 years. In 9/27 cats, an antecedent event was documented. At admission, 27/27 cats had evidence of myocardial injury (median value of cardiac troponin I 5.5 ng/mL), 25/27 cats had congestive heart failure, 13/27 cats had hypothermia, 8/27 cats had systemic hypotension, 7/27 cats had bradycardia, and 7/27 cats had electrocardiographic evidence of an arrhythmia. The median LVWTd was 6.4 mm. A potential cause of myocardial injury was identified in 14/27 cats. The median time from diagnosis to a significant reduction in LVWTd was 43 days. DISCUSSION: TMT can be diagnosed in a wide range of cats, including young subjects. An antecedent predisposing event and/or a possible causative trigger can be identified in some. The reduction in LVWTd that defines this phenomenon usually occurs over a variable time frame. CONCLUSIONS: This study represents the largest investigation of TMT in cats and provides additional information on this uncommon clinical entity.

Adeno-associated virus-vectored erythropoietin gene therapy for anemia in cats with chronic kidney disease.

BACKGROUND: A treatment of chronic kidney disease (CKD)-associated anemia in cats is needed. SB-001 is an adeno-associated virus-vectored (AAV)-based gene therapeutic agent that is administered intramuscularly, causing the expression of feline erythropoietin. HYPOTHESIS/OBJECTIVE: We hypothesized that SB-001 injection would lead to a sustained increase in PCV in cats with CKD-associated anemia. ANIMALS: Twenty-three cats with International Renal Interest Society (IRIS) Stage 2 to 4 CKD-associated anemia were enrolled at 4 veterinary clinics. METHODS: In a prospective clinical trial, cats were treated with 1 of 3 regimens of SB-001 (Lo 1.2 × 109 genome copies [GCs] on Day 0; Lo ± Hi [supplemental 2nd dose of 3.65 × 109 GC on Day 42]; Hi 3.65 × 109 GC IM on Day 0) and followed for 70 days. RESULTS: A response to SB-001 at any time between Day 28 and Day 70 was seen in 86% (95% confidence interval 65, 97%) of all cats. There was a significant (P < .003) increase in PCV from Day 0 to Day 28 (mean increase 6 ± 6 percentage points [pp]; n = 21), Day 42 (8 ± 9 pp; n = 21), Day 56 (10 ± 11 pp; n = 17), and Day 70 (13 ± 14 pp, n = 14). Twelve cats were hypertensive at baseline, 4 of which developed encephalopathy during the study. An additional 6 cats became hypertensive during the study. CONCLUSIONS AND CLINICAL IMPORTANCE: Results of this study suggest that SB-001 therapy represents a suitable single injection treatment that can address nonregenerative anemia in cats with CKD. It was generally well tolerated; however, hypertension and encephalopathy developed in some cats as previously described in association with erythropoiesis-stimulating agent therapy.