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.

Cutaneous MCTs: associations with spay/neuter status, breed, body size, and phylogenetic cluster.

Certain breeds are known to be overrepresented among mast cell tumor (MCT) patients, but other risk factors have not been evaluated. This study presents results from a case-control study of 252 dogs with grade 2 or grade 3 cutaneous MCT. Increased risk for MCT development was found in spayed females (adjusted odds ratio [OR], 4.11), boxers (adjusted OR, 6.09), Labrador retrievers (adjusted OR, 3.95), pugs (adjusted OR, 3.17), golden retrievers (adjusted OR, 2.12), the mastiff and terrier phylogenetic cluster (adjusted OR, 3.19), and breeds classified as large (adjusted OR, 2.10) or giant (adjusted OR, 5.44). Additional studies are needed to evaluate the role of these and other potential risk factors in MCT development.

Incidence and treatment of feline renal lymphoma: 27 cases.

OBJECTIVES: Lymphoma is the most common feline hematopoietic malignancy. Incidence of renal lymphoma has not been reported as a subset of a large population of feline lymphoma cases. Previous studies have reported renal lymphoma as both a singular entity as well as a component of multicentric disease. The clinical presentation, diagnostic evaluation, therapy and outcomes related to renal lymphoma have not been reported since Mooney et al in 1987. This retrospective study aimed to describe the incidence of renal lymphoma, clinical signs, treatment and survival. METHODS: Using a database of cats diagnosed with lymphoma between January 2008 and October 2017, cats with renal lymphoma were selected for further analysis. Cases were retrospectively staged according to Mooney et al (1987) and Gabor et al (1998). Data collected included age, clinical signs, clinicopathologic data, diagnostic imaging findings, lymphoma diagnostic method(s), treatment protocol(s) and survival time. Analyses comparing median survival based on therapy administered, renal lymphoma vs multicentric lymphoma, central nervous system involvement, presence of azotemia, anemia and International Renal Interest Society (IRIS) stage at diagnosis were performed. RESULTS: From a population of 740 cats with lymphoma, 27 cats had renal lymphoma (incidence, 3.6%), and 14 of those cats had multicentric lymphoma. Fewer stage IV and V cases were identified in this data set compared with Mooney et al; however, not all cats were completely staged. Median survival (range) for cats receiving corticosteroids alone compared with those receiving an L-CHOP (L-asparaginase, vincristine, cyclophosphamide, doxorubicin, prednisolone)-based protocol was 50 days (20-1027 days) in the corticosteroid group and 203 days (44-2364 days) for the L-CHOP group (P = 0.753) for cats that died secondary to lymphoma. CONCLUSIONS AND RELEVANCE: Neither clinical stage nor other factors were predictive of survival. Prospective studies are required to determine the optimal chemotherapy protocol.

Safety and efficacy of a ribose-cysteine supplement to increase erythrocyte glutathione concentration in healthy dogs.

OBJECTIVE: To evaluate the safety of oral administration of a d-ribose-l-cysteine (RibCys) supplement to dogs and the effect of this supplementation on erythrocyte glutathione (GSH) concentration. ANIMALS: 24 healthy adult dogs. PROCEDURES: In a randomized, double-blinded, controlled trial, dogs received 500 mg of a RibCys supplement or placebo (n = 12/group), PO, every 12 hours for 4 weeks. Dogs were evaluated weekly by means of a physical examination, CBC, serum biochemical analysis, urinalysis, and owner-completed quality-of-life questionnaire. Erythrocyte GSH concentration was measured on day 0 (ie, the day before treatment began) and weekly during supplementation. RESULTS: No dose-limiting adverse effects were noted in any dog. Two dogs in each group had mild, self-limiting diarrhea and anemia. No significant increase in erythrocyte GSH concentration was noted in either group at any time point. Two dogs in the RibCys group had improved skin and coat health and improved clinical signs of osteoarthritis. No clinical or owner-perceived improvements were noted in the placebo group. CONCLUSIONS AND CLINICAL RELEVANCE: The RibCys supplement was safe and well tolerated in all dogs. Owners reported improvements in dermatologic and orthopedic conditions in some dogs in the RibCys group. No significant differences were observed in erythrocyte GSH concentration before or after RibCys treatment. This lack of significant differences may have been attributable to the use of healthy dogs, which would not be expected to have depleted GSH concentrations. Given the observed safety profile of RibCys, additional research is warranted to explore the potential usefulness of RibCys supplementation in dogs with cancer and those undergoing treatment for cancer.

Feline non-regenerative anemia: Diagnostic and treatment recommendations.

PRACTICAL RELEVANCE: Non-regenerative anemia, or anemia with reticulocytopenia, is a daily diagnosis in feline practice. CLINICAL CHALLENGES: The disease processes underlying non-regenerative anemia are many and diverse. A major diagnostic evaluation may be required to correctly diagnose and treat the underlying cause. AUDIENCE: All veterinarians caring for cats will face the diagnostic and therapeutic challenge of non-regenerative anemia. Readers will benefit from the review of diagnostic testing and therapeutic options for non-regenerative anemia. EVIDENCE BASE: This review summarizes the currently available literature informing diagnostic and treatment recommendations related to non-regenerative anemia. The evidence available to support the recommendations in this review is graded as low and includes predominantly expert opinion, case reports and cases series, on which the authors' interpretation/consensus is based.

Feline large-cell lymphoma following previous treatment for small-cell gastrointestinal lymphoma: incidence, clinical signs, clinicopathologic data, treatment of a secondary malignancy, response and survival.

OBJECTIVES: Lymphoma is a common and clinically important malignancy in cats. Development of a second malignancy has been reported previously in 7-14% of cats with small-cell gastrointestinal (GI) lymphoma. The aim of our study was to describe the incidence, clinical signs, clinicopathologic data, response to therapy and outcomes in cats diagnosed with large-cell lymphoma following treatment for small-cell GI lymphoma. METHODS: Medical records from a single referral specialty hospital were reviewed for all cats with lymphoma diagnosed between 2008 and 2017. The cases with a diagnosis of small-cell GI lymphoma followed by a diagnosis of any large-cell lymphoma and complete outcome data were selected for further review. RESULTS: Seven hundred and forty cats with a diagnosis of lymphoma were identified. Twelve cats (12/121) treated for small-cell GI lymphoma followed by a diagnosis of any anatomic form of large cell lymphoma were identified. Nine cats met the study inclusion criteria and were used in analyses. Mean event-free survival time from small-cell GI lymphoma diagnosis until diagnosis of large-cell lymphoma was 543 days, with a median survival time of 615 days. Mean event-free survival time from large-cell lymphoma to death was 55 days, with a median survival time of 24.5 days. Hematocrit, albumin and total protein were significantly decreased when cats developed large-cell lymphoma compared with their values at the time of small-cell lymphoma diagnosis. CONCLUSIONS AND RELEVANCE: Large-cell lymphoma occurred in 9.9% (12/121) of cats treated for small-cell GI lymphoma. Feline practitioners should include large-cell lymphoma on their list of differential diagnoses in cats diagnosed with small-cell GI lymphoma developing weight loss, anemia, hypoalbuminemia and hypoproteinemia.

A comparison of risk factors for metastasis at diagnosis in humans and dogs with osteosarcoma.

BACKGROUND: Canine osteosarcoma (OS) is a relevant spontaneous model for human OS. Identifying similarities in clinical characteristics associated with metastasis at diagnosis in both species may substantiate research aimed at using canine OS as a model for identifying mechanisms driving distant spread in the human disease. METHODS: This retrospective study included dog OS cases from three academic veterinary hospitals and human OS cases from the Surveillance, Epidemiology, and End Results program. Associations between clinical factors and metastasis at diagnosis were estimated using logistic regression models. RESULTS: In humans, those with trunk tumors had higher odds of metastasis at diagnosis compared to those with lower limb tumors (OR = 2.38, 95% CI: 1.51, 3.69). A similar observation was seen in dogs with trunk tumors compared to dogs with forelimb tumors (OR = 3.28, 95% CI 1.36, 7.50). Other associations were observed in humans but not in dogs. Humans aged 20-29 years had lower odds of metastasis at diagnosis compared to those aged 10-14 years (OR = 0.67, 95% CI: 0.47, 0.96); every 1-cm increase in tumor size was associated with a 6% increase in the odds of metastasis at diagnosis (95% CI: 1.04, 1.08); compared to those with a white, non-Hispanic race, higher odds were observed among those with a black, non-Hispanic race (OR: 1.51, 95% CI: 1.04, 2.16), and those with a Hispanic origin (OR 1.35, 95% CI: 1.00, 1.81). CONCLUSION: A common mechanism may be driving trunk tumors to progress to detectable metastasis prior to diagnosis in both species.

Effect of cross-match on packed cell volume after transfusion of packed red blood cells in transfusion-naïve anemic cats.

BACKGROUND: Novel feline RBC antigens might contribute to decreased efficacy of RBC transfusion and increased incidence of acute transfusion reactions (ATR). OBJECTIVES: To examine the effect of major cross-match in transfusion-naïve anemic cats on the incidence of acute immunologic transfusion reaction and transfusion efficacy for up to 24 hours after transfusion. ANIMALS: Forty-eight client owned transfusion-naïve anemic cats. METHODS: Prospective, randomized, controlled study. All transfusion-naïve cats receiving packed red blood cells (pRBC) transfusions from January 2016 to August 2017 were eligible for inclusion. Cats in the study group received cross-match and blood type compatible pRBCs and cats in the control group received noncross-matched blood type compatible pRBCs. Incidence of ATR and change in PCV after transfusion was recorded. RESULTS: No significant difference in incidence of transfusion reactions between cross-matched and noncross-matched groups (CM+ 4/24; 17%, CM- 7/24; 29%, P = .16). No significant difference between groups in mean change in PCV after transfusion scaled to dose of pRBCs administered at any time point after transfusion (immediate: CM+ 0.62 ± 0.59, CM- 0.75 ± 0.48, P = .41; 1 hour: CM+ 0.60 ± 0.66, CM- 0.74 ± 0.53, P = .43; 12 hours: CM+ 0.70 ± 0.55, CM- 0.66 ± 0.60, P = .81; 24 hours: CM+ 0.64 ± 0.71, CM- 0.55 ± 0.48, P = .70). CONCLUSIONS AND CLINICAL IMPORTANCE: Our results do not support use of the major cross-match test to increase efficacy of, and to decrease adverse events associated with, RBC transfusion in AB blood typed transfusion-naïve cats.

Evaluation of the relationship between clinical variables and thromboelastographic findings in dogs with protein-losing nephropathy.

OBJECTIVE: To determine whether hypercoagulability in proteinuric dogs, defined by thromboelastography (TEG), is related to the degree of proteinuria, presence of systemic arterial hypertension, presence of hypoalbuminemia, or reduced antithrombin activity. DESIGN: Prospective study of client-owned dogs. Data collected from each patient included signalment, body weight, urine protein-to-creatinine ratio (UPC), serum albumin concentration, TEG values, noninvasive arterial blood pressure, and AT activity. Hypercoagulability was diagnosed by TEG and odds ratios for other measurements were assessed by univariate logistic regression. SETTING: Urban referral center and teaching hospital. ANIMALS: Seventy-six dogs with protein-losing nephropathy (PLN) based on UPC, diagnosed between Oct 2009 and Oct 2012. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The prevalence of hypercoagulability was 89%. No statistically significant associations were detected between hypercoagulability and UPC, serum albumin, noninvasive blood pressure, or AT activity (all P > 0.05). The prevalence of thromboembolism was 6.6%. CONCLUSIONS: Hypercoagulability was prevalent in dogs with PLN but could not be predicted based upon the presence or degree of proteinuria, systemic arterial hypertension, hypoalbuminemia, or low AT activity. The prevalance of thromboembolism was low in this population with PLN.

Canine Cutaneous and Subcutaneous Soft Tissue Sarcoma: An Evidence-Based Review of Case Management.

Canine cutaneous and subcutaneous soft tissue sarcomas (STS) account for 20.3% of malignant neoplasms of the skin. This article makes recommendations for the diagnosis, treatment, and follow-up in dogs with STS, using evidence-based medicine concepts. Although our review of the literature on the management of canine STS found many of the studies to be less than rigorous, board-certified specialists in internal medicine, surgery, pathology, oncology, and radiation oncology were able to make several recommendations based on the literature review: cytology and biopsy are important for presurgical planning; wide (>3 cm margins) surgical excision decreases the likelihood of tumor recurrence; the use of a histologic grading scale is useful in predicting biologic behavior; and, in select cases, chemotherapy and radiation therapy may be beneficial adjunct treatments to surgical excision. More research is necessary to determine minimum size of surgical margins, the impact of radiation therapy on incompletely resected tumors, the ideal chemotherapy protocol for high grade STS, and the optimal methods of monitoring dogs for tumor recurrence and metastasis.

Long-term survival of dogs with advanced malignant melanoma after DNA vaccination with xenogeneic human tyrosinase: a phase I trial.

PURPOSE: Canine malignant melanoma (CMM) is a spontaneous, aggressive, and metastatic neoplasm. Preclinical mouse studies have shown that xenogeneic DNA vaccination with genes encoding tyrosinase family members can induce antibody and cytotoxic T-cell responses, resulting in tumor rejection. These studies provided the rationale for a trial of xenogeneic DNA vaccination in CMM using the human tyrosinase gene. EXPERIMENTAL DESIGN: Three cohorts of three dogs each with advanced (WHO stage II, III, or IV) CMM received four biweekly i.m. injections (dose levels 100, 500, or 1500 micro g, respectively/vaccination) of human tyrosinase plasmid DNA i.m. via the Biojector2000 delivery device. RESULTS: Mild local reactions at injection sites were the only toxicities observed, with no signs of autoimmunity. One dog with stage IV disease had a complete clinical response in multiple lung metastases for 329 days. Two dogs with stage IV disease had long-term survivals (421 and 588+ days) in the face of significant bulky metastatic disease, and two other dogs with locally controlled stage II/III disease had long-term survivals (501 and 496 days) with no evidence of melanoma on necropsy. Four other dogs were euthanized because of progression of the primary tumor. The Kaplan-Meier median survival time for all nine dogs was 389 days. CONCLUSIONS: The results of this trial demonstrate that xenogeneic DNA vaccination of dogs with advanced malignant melanoma is a safe and potentially therapeutic modality. On the basis of these results, additional evaluation of this novel therapeutic is warranted in locally controlled CMM and advanced human melanoma.

Red blood cell transfusions in cats: 126 cases (1999).

OBJECTIVE: To determine the number of and reasons for RBC transfusions, incidence of acute transfusion reactions, prevalence of blood types, volume of blood administered, change in PCV, and clinical outcome in cats. DESIGN: Retrospective study. ANIMALS: 126 cats that received RBC transfusions. PROCEDURE: Medical records of cats that received whole blood or packed RBC transfusions were reviewed for signalment, blood type, pre- and post-transfusion PCV, volume of blood product administered, clinical diagnosis and cause of anemia, clinical signs of acute transfusion reactions, and clinical outcome. RESULTS: Mean volume of whole blood administered i.v. was 172 mL/kg (7.8 mL/lb) versus 9.3 mL/kg (4.2 mL/lb) for packed RBCs. Ninety-four percent of cats had blood type A. Mean increase in PCV among all cats was 6%. Fifty-two percent of cats had anemia attributed to blood loss, 10% had anemia attributed to hemolysis, and 38% had anemia attributed to erythropoietic failure. Acute transfusion reactions occurred in 11 cats. Sixty percent of cats survived until discharge. CONCLUSIONS AND CLINICAL RELEVANCE: RBC transfusions resulted in an increase in PCV in cats with all causes of anemia in this study. The rate of death was greater than in cats that did not receive transfusions, but seriousness of the underlying disease in the 2 groups may not be comparable. Death rate of cats that received transfusions was not attributable to a high rate of transfusion reactions. Results confirm that pretransfusion blood typing or crossmatching is required to minimize the risk of adverse reactions.

Importance of blood groups and blood group antibodies in companion animals.

Dogs, cats, birds, and ferrets are popular companion animals. Because these pets are considered by many to be family members, they are provided high-quality veterinary medical care, including blood transfusions. This article reviews the current status of blood groups in dogs, cats, birds, and ferrets and discusses the impact of blood groups on veterinary transfusion medicine. One blood group with 3 types has been described in the cat, whereas multiple blood groups have been described in the dog. Only rudimentary knowledge exists regarding pet bird blood groups, and, to date, the ferret appears to be unique because no blood groups have been described. Antibodies against blood group antigens also play a role in animal blood transfusions. Cats have naturally occurring alloantibodies; however, dogs do not appear to have clinically significant naturally occurring alloantibodies. Understanding the issues related to blood groups and blood group antibodies in companion animals will also benefit those using these species as research models for human diseases.

Case-control study of blood type, breed, sex, and bacteremia in dogs with immune-mediated hemolytic anemia.

OBJECTIVE: To determine whether blood type, breed, or sex were risk factors for immune-mediated hemolytic anemia (IMHA) in dogs and whether bacteremia was common in dogs with IMHA. DESIGN: Case-control study. ANIMALS: 33 dogs with IMHA, 1,014 dogs without IMHA for which blood type (dog erythrocyte antigens 1.1, 1.2, 3, 4, 5, and 7) was known, 15,668 dogs without IMHA for which breed was known, and 15,589 dogs without IMHA for which sex was known. PROCEDURE: Blood type, breed, and sex distribution of dogs with IMHA were compared with data for control dogs with Fisher exact tests and by calculating odds ratios (ORs). Results of bacterial culture of blood samples were documented for dogs with IMHA, when available. RESULTS: Dog erythrocyte antigen 7 was associated with a significant protective effect (OR, 0.1) in Cocker Spaniels with IMHA (n = 10), compared with control dogs. Cocker Spaniels, Bichon Frise, Miniature Pinschers, Rough-coated Collies, and Finnish Spitz had a significantly increased risk of IMHA, as did female dogs (OR, 2.1). Blood samples from 12 dogs with IMHA were submitted for bacterial culture, and none had bacteremia. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that blood type, breed, and sex may play a role in IMHA in dogs.

Risk factors for sterile hemorrhagic cystitis in dogs with lymphoma receiving cyclophosphamide with or without concurrent administration of furosemide: 216 cases (1990-1996).

OBJECTIVES: To determine incidence and identify predisposing factors for sterile hemorrhagic cystitis (SHC) in dogs with lymphoma that were treated with cyclophosphamide and to evaluate whether furosemide administered i.v. concurrently with cyclophosphamide decreased the incidence of SHC. DESIGN: Retrospective study. ANIMALS: 216 dogs with lymphoma. PROCEDURE: Medical records of dogs with lymphoma that received cyclophosphamide chemotherapy in accordance with 1 of 2 protocols, with or without concurrent i.v. administration of furosemide, were examined. Data for the 2 groups were analyzed to determine the incidence and predisposing factors (age, breed, sex, weight, previous or preexisting disease, previous or preexisting urinary tract infection, neutropenia, azotemia, dose, and number of cyclophosphamide treatments) for cyclophosphamide-associated SHC. RESULTS: Cyclophosphamide-associated SHC developed in 12 of 133 (9%) dogs that had not received concurrent administration of furosemide and cyclophosphamide treatments; of the 83 dogs that had received furosemide, only 1 (1.2%) developed SHC. Dogs receiving cyclophosphamide and furosemide concurrently were significantly less likely to develop SHC than dogs that did not receive furosemide. Dogs with previous or preexisting immune-mediated disease were significantly more likely to develop cyclophosphamide-associated SHC. CONCLUSIONS AND CLINICAL RELEVANCE: Analysis of results suggested an association between i.v. administration of furosemide concurrently with cyclophosphamide and decreased incidence of cyclophosphamide-associated SHC. Incidence of cyclophosphamide-associated SHC was similar in treated dogs that did not receive concurrent furosemide to that observed for other studies in which cyclophosphamide was administered orally. Cyclophosphamide-associated SHC appeared to develop early during the course of chemotherapy when furosemide was not administered concurrently with cyclophosphamide.

Transfusion issues in the cancer patient.

Blood transfusions are a lifesaving but transient therapy used to correct deficiencies of blood cells and coagulation factors that occur in cancer patients. Anemia can occur in cancer patients as a result of hemolysis, blood loss, or bone marrow failure. The blood component most commonly recommended for the treatment of anemia is packed red blood cells. Coagulation disorders are common with hemangiosarcoma and diffuse hepatic tumors. Fresh frozen plasma is used as a source for replacement coagulation factors for the treatment of disseminated intravascular coagulation or other cancer-associated coagulopathies. Although thrombocytopenia and neutropenia can be the result of bone-marrow failure from tumor infiltration, chemotherapy, or radiation therapy, these platelets and neutrophils are rarely transfused to veterinary cancer patients. Pretransufsion testing consists of blood typing in cats, and cross matching in dogs and cats if the dog has previously been transfused. Cancer patients receiving transfusions should be monitored on a continual basis during and immediately following the transfusion to enable early identification of an adverse event, allowing the transfusion to be discontinued.

Feline exocrine pancreatic insufficiency: 16 cases (1992-2007).

Medical records of 16 cats diagnosed with exocrine pancreatic insufficiency (EPI) were reviewed. The diagnosis was confirmed with either a serum feline trypsin-like immunoreactivity (fTLI) concentration