Recognizing uterine torsion as a differential diagnosis in pregnant cats with severe anemia to provide appropriate and timely care in the absence of a definitive presurgical diagnosis.

A pregnant female domestic longhair cat ~8 mo of age was referred to the Western College of Veterinary Medicine (Saskatoon, Saskatchewan) for a diagnostic evaluation of severe anemia (PCV: 10.8%) after a 2-day period of lethargy. A CBC, serum biochemistry profile, FeLV/FIV testing, and abdominal radiographs were completed and did not determine a cause for the anemia. Abdominal ultrasonography identified 1 viable and 6 nonviable and fetuses, anechoic fluid in the uterus, and a mild volume of peritoneal effusion. A whole-blood transfusion and C-section with ovariohysterectomy were performed even though a definitive presurgical diagnosis for the anemia had not yet been established. Exploratory surgery revealed a left uterine horn torsion with a necrotic base, severe congestion, and 7 nonviable fetuses. Following surgery, the queen made a full clinical recovery. Key clinical message: Uterine torsion can be easily overlooked as a cause of severe anemia due to the relative infrequency of this condition in cats and the low sensitivity of ultrasonography to provide a definitive presurgical diagnosis. Client communication must emphasize the need for a prompt surgical intervention to establish the diagnosis and to save the cat, despite poor rates of neonatal survival. Once the animal is stabilized after surgery, further diagnostic tests and procedures are indicated if the cause of anemia has not yet been identified.

Reconnaître la torsion utérine comme un diagnostic différentiel chez les chattes gestantes souffrant d'anémie sévère afin de fournir des soins appropriés et opportuns en l'absence d'un diagnostic pré-chirurgical définitif. Une chatte domestique à poils longs, âgée d'environ 8 mois, a été référée au Western College of Veterinary Medicine (Saskatoon, Saskatchewan) pour une évaluation diagnostique d'anémie sévère (hématocrite : 10,8 %) après une période de léthargie de 2 jours. Une formule sanguine complète, un profil biochimique sérique, des tests FeLV/FIV et des radiographies abdominales ont été réalisés et n'ont pas permis de déterminer la cause de l'anémie. L'échographie abdominale a identifié 1 foetus viable et 6 non viables, du liquide anéchoïque dans l'utérus et un léger volume d'épanchement péritonéal. Une transfusion de sang total et une césarienne avec ovariohystérectomie ont été réalisées même si le diagnostic pré-chirurgical définitif de l'anémie n'avait pas encore été établi. La chirurgie exploratoire a révélé une torsion de la corne utérine gauche avec une base nécrotique, une congestion sévère et 7 foetus non viables. Après l'opération, la chatte s'est complètement rétablie cliniquement.Message clinique clé:La torsion utérine peut facilement être négligée comme cause d'anémie sévère en raison de la rareté relative de cette affection chez le chat et de la faible sensibilité de l'échographie pour fournir un diagnostic pré-chirurgical définitif. La communication avec le client doit souligner la nécessité d'une intervention chirurgicale rapide pour établir le diagnostic et sauver le chat, malgré de faibles taux de survie néonatale. Une fois l'animal stabilisé après la chirurgie, d'autres tests et procédures de diagnostic sont indiqués si la cause de l'anémie n'a pas encore été identifiée.(Traduit par Dr Serge Messier).

Computed tomographic and bronchoscopic diagnosis of Oslerus osleri infection in a dog.

A 16-month-old Sarplaninac Shepherd cross dog presented for a 1-month history of a productive cough that was unresponsive to an empirical 10-day course of cephalexin. Thoracic computed tomography (CT) showed multifocal, well-defined, smoothly marginated, soft tissue attenuating, minimally contrast enhancing nodular airway mural thickenings protruding into the airway lumen in the caudal trachea and principal bronchi. These nodules were also visualized on bronchoscopy, and cytology revealed parasitic larvae consistent with Oslerus osleri. The dog was treated with oral fenbendazole for 26 days. Clinical signs resolved within 3 weeks of treatment initiation and had not relapsed at 7-month follow-up.

Online survey to determine client perceptions of feline chronic lower airway disease management: response to therapy, side effects and challenges encountered.

OBJECTIVES: The first aim of this survey was to report client experiences associated with the administration of common medications, particularly glucocorticoids and bronchodilators, in managing cats with feline lower airway disease (FLAD). The second aim was to ascertain client perception of response to treatment and level of satisfaction. METHODS: This was a prospective cross-sectional study. An online survey was distributed worldwide to cat owners caring for cats with a chronic cough. Only cats reported to have FLAD were included. RESULTS: A total of 153 complete responses describing cats with FLAD were analyzed. Glucocorticoids and bronchodilators were the predominantly prescribed therapeutics for 140/153 (92%) and 80/153 (52%) of FLAD cats, respectively. Oral and inhalant administration routes were reported most commonly: glucocorticoids (64% oral and 75% inhalant) and bronchodilators (21% oral and 88% inhalant). A review of how air quality could be improved was conducted for 54% of cats. Almost half (43%) of owners reported adverse effects secondary to glucocorticoid administration, the most frequent being polyphagia (26%) and polydipsia (21%). Only 10% of owners reported bronchodilator-associated side effects, with restlessness (9%) being the most common. Difficulties giving glucocorticoid or bronchodilator tablets orally were reported for 33% and 71% of owners, respectively. Glucocorticoid or bronchodilator inhalant therapies were difficult to administer for 28% and 31% of owners, respectively. Frequency and severity of coughing were significantly lower after at least 2 months of treatment, with median numerical input on a slider scale (0-100) of 48 and 42 before, and 10 and 7 after treatment, respectively (P <0.0001). Median numerical input of owner satisfaction was 83%. CONCLUSIONS AND RELEVANCE: Despite significant improvements in client-reported responses to treatment, challenges associated with the administration of medications and their adverse effects still exist. Promoting awareness of client experiences can facilitate appropriate follow-up, guidance and empathy to further optimize outcomes.

The effect of per os vs subcutaneous 123 iodine administration on percentage thyroidal radioactive iodine uptake in normal cats.

BACKGROUND: Historical and recent literature disagree on whether a higher PO 131 I dosage, compared to IV or SC routes, is required for successful resolution of spontaneous hyperthyroidism in cats, necessitating investigation into the effect of PO and injectable radioactive iodine administration on % thyroidal radioactive iodine uptake (RAIU). HYPOTHESIS/OBJECTIVES: To investigate the effect of PO and SC routes of 123 I administration on paired % thyroidal RAIU in euthyroid cats. Specifically, a 1.5-fold difference (50% relative change) was hypothesized, which in absolute terms can be expressed as a 3.25% increase in the mean %RAIU of 7.04% after PO 123 I administration to 10.56% after SC dosing. ANIMALS: Seven healthy euthyroid teaching-research colony cats. METHODS: A randomized, radiologist-blinded crossover study comparing %RAIU after PO and SC 123 I administration. RESULTS: Percentage thyroidal RAIU values (mean ± SD; 95% confidence interval) after PO (4.81% ± 1.63%; 3.30%-6.23%) and SC (5.26% ± 2.43%; 3.01%-7.51%) 123 I administration were associated with a median within-pair absolute difference of 0.2% (range: min, 0.1%-max, 4.9%). Statistical significance was not achieved (P = .45). Six of 7 cats had a within-pair absolute difference of 0.1% to 0.9% (relative change of 4%-20%), but a single outlier cat had a within-pair absolute difference of 4.9% (relative change of 108%). CONCLUSIONS AND CLINICAL IMPORTANCE: This study did not detect an effect of 123 I administration route on paired % thyroidal RAIU in euthyroid cats. However, a type 2 statistical error due to small sample size is possible.

Effects of dexmedetomidine on glucose homeostasis in healthy cats.

OBJECTIVES: Alpha(α)2-agonist administration has been documented to increase blood glucose concentrations in many species. The aim of this study was to further describe the effect of dexmedetomidine on glucose and its regulatory hormones in healthy cats. METHODS: A randomized crossover study using eight healthy cats with a 14 day washout period was used to assess the effect of dexmedetomidine (10 µg/kg IV) and saline on glucose, cortisol, insulin, glucagon and non-esterified fatty acid (NEFA) concentrations at 0, 20, 60, 120 and 180 mins post-administration. Glucose:insulin ratios were calculated for each time point. RESULTS: Within the dexmedetomidine group, significant differences (P <0.05) were detected: increased median (range) blood glucose concentrations at 60 mins (11.55 mmol/l [5.9-16.6 mmol/l]) and 120 mins (12.0 mmol/l [6.1-13.8 mmol/l]) compared with baseline (6.05 mmol/l [4.8-13.3 mmol/l]); decreased glucagon concentrations at 120 mins (3.8 pmol/l [2.7-8.8 pmol/l]) and 180 mins (4.7 pmol/l [2.1-8.2 pmol/l]) compared with baseline (11.85 pmol/l [8.3-17.2 pmol/l]); decreased NEFA concentrations at 60 mins (0.281 mmol/l [0.041-1.357 mmol/l]) and 120 mins (0.415 mmol/l [0.035-1.356 mmol/l]) compared with baseline (0.937 mmol/l [0.677-1.482 mmol/l]); and significantly larger (P <0.05) glucose:insulin ratios at 60 mins compared with baseline. Insulin and cortisol concentrations were not significantly changed after dexmedetomidine administration. CONCLUSIONS AND RELEVANCE: Feline practitioners should be aware of the endocrine effects associated with the use of α2-agonists, particularly when interpreting blood glucose concentrations. The transient effects of dexmedetomidine on glucose homeostasis are unlikely to significantly affect clinical practice.

Cardiopulmonary effects of using carbon dioxide for laparoscopic surgery in cats.

The cardiopulmonary effects of capnoperitoneum were investigated in 8 spontaneously breathing, young adult female cats undergoing laparoscopic pancreatic biopsy (intra-abdominal pressure 12 mmHg). Cats were premedicated with acepromazine and hydromorphone, induced with ketamine and diazepam, and maintained using an end-tidal isoflurane concentration of 1.13% in 100% oxygen. Direct systemic arterial blood pressure, heart and respiratory rates, end-tidal carbon dioxide (CO(2)), and isoflurane were recorded every 5 min before insufflation (baseline), during insufflation of the abdomen with CO(2), and following desufflation. Arterial blood samples were drawn at baseline, at 10 and 30 min of insufflation, and 5 min after desufflation for blood gases. The significant findings (P < 0.05) were as follows: insufflation produced an increase in heart rate (5 to 15 min and at 30 min), mean arterial blood pressure (25 to 30 min), and diastolic arterial blood pressure (10 to 30 min). After desufflation, respiratory rate increased for 15 min. The changes were within physiologically acceptable limits in these healthy, anesthetized cats despite no artificial maintenance of minute ventilation.