A Pandora's box in feline medicine: presenting signs and surgical outcomes in 58 previously hoarded cats with chronic otitis media-interna.

OBJECTIVES: The aim of the present study was to report clinical findings, surgical complications and outcomes for previously hoarded cats treated surgically for otitis media-interna (OMI) and to investigate the risk factors for complications and poor outcomes. METHODS: A retrospective study was conducted of 58 cats from an institutional hoarding environment that underwent ventral bulla osteotomy (VBO). RESULTS: Inappetence was uncommon at presentation (9/58, 16%) compared with pruritus/alopecia (50%), nasopharyngeal signs (45%), otitis externa (OE) (79%) and otitis interna (OI) (ataxia ± head tilt/head excursions) in 40%. Purulent aural discharge occurred in 36% and polyps in 26%. The tympanic bulla wall was moderately or severely thickened radiographically in 38/108 (35%) ears. Cultures were positive for Streptococcus equi subspecies zooepidemicus in 26/48 (54%) cats. Of the 58 cats, 40 (69%) had complications after the first VBO and 19/30 (63%) after the second. Of 101 complications, 56 (55%), from 27/88 (31%) surgeries, were considered serious, including life-threatening perioperative complications in seven, OI in eight, prolonged anorexia in six and worsening of pruritus/alopecia in nine cases. Three cats developed xerostomia (dry mouth) after the second VBO. Pruritus/alopecia, nasopharyngeal signs, OE and purulent aural discharge resolved in a statistically significant proportion of cats but persisted in some. Full resolution of OI was uncommon. OI preoperatively, and surgery performed by a generalist (vs specialist) surgeon, were risk factors for OE at recheck (OI: odds ratio [OR] 4.35; 95% confidence interval [CI] 1.21-15.70; P = 0.02; surgery: OR 3.64; 95% CI 1.03-12.87; P = 0.045). No other prognostic indicators were identified. No variables tested were significantly associated with risk of serious complications or euthanasia. CONCLUSIONS AND RELEVANCE: Surgical management of chronic OMI was successful in most cases but was not benign and not always beneficial. The analysis was unable to identify clinically helpful outcome predictors. Optimal management of chronic feline OMI remains a challenge, particularly for animal shelters. Less invasive approaches and chronic medical management require further investigation.

Behavior and adoptability of hoarded cats admitted to an animal shelter.

OBJECTIVES: The aim of this study was to analyze the behavioral characteristics and success of adoption for previously hoarded cats. METHODS: Shelter records and post-adoption surveys were analyzed for hoarded cats ⩾6 months old at intake. A non-standard scoring system was used. Intake scores were allocated contemporaneously and socialization scores were applied retrospectively for three time points (TPs): 5-10 days post-intake (shelter TP), ⩽1 week post-adoption (home TP1) and >1 week post-adoption (home TP2). Adoption returns were compared between hoarded and non-hoarded cats. RESULTS: The study included 195 hoarded cats, of which 174 were adopted. Of 164 cats with intake scores, 86 (52%) were scored as 'friendly' at intake. Forty-five cats had socialization scores for all of the TPs, and of these, the percentages of 'supersocial' or 'social' decreased from 87% at the shelter TP to 47% at home TP1, then increased to 84% at home TP2. Most cats that scored as 'tense' at intake had supersocial or social scores at home TP2. Nine of the 88 cats with survey results had out-of-box (OOB) elimination in either the shelter or home but only 1/88 in both. Adopters expressed positive feelings for 42/43 cats for which feelings-based language was used in their survey responses. Notable behaviors, such as neediness, were recorded for 48/88 cats. Relationships with other household pets were typically positive. Eighteen of 174 hoarded (10%) and 188/2662 non-hoarded (7.1%) cats were returned post-adoption. Of these, six hoarded and 87 non-hoarded returns included behavioral reasons. There were no significant differences between hoarded and non-hoarded cats for total or behavioral returns. CONCLUSIONS AND RELEVANCE: Hoarded cats had high adoption rates, high adopter satisfaction and the potential for good emotional well-being in adoptive homes. Behavior at intake and OOB elimination in the shelter may not reflect post-adoption behavior. Behavior-based outcome decisions for these vulnerable animals should be deferred to allow time for habituation.

Fecal viral DNA shedding following clinical panleukopenia virus infection in shelter kittens: a prospective, observational study.

OBJECTIVES: The aims of this study were to determine the magnitude and duration of fecal viral DNA shedding after diagnosis of feline panleukopenia (FP) in a group of shelter cats using quantitative real-time PCR (qPCR); to assess the utility of a negative point-of-care test or the resolution of diarrhea and systemic signs as proxy measures for qPCR positivity; and to investigate patterns of additional enteric pathogens in relation to feline panleukopenia viral shedding duration. METHODS: Feline panleukopenia virus (FPV) infection in clinically affected shelter cats was confirmed by a commercial qPCR test. Observations were made on days 0, 3, 7, 14 and 21 post-diagnosis. Fecal flotation, FPV qPCR and the canine parvovirus IDEXX SNAP Parvo ELISA (SNAP) test were performed on fecal samples. RESULTS: Forty cats and kittens with confirmed panleukopenia were initially enrolled. Sixteen kittens were sampled until day 14, and 12 were followed to day 21. Median DNA viral copy numbers fell below the diagnostic cut-off by day 7, with 13/16, 6/16, 1/16 and 0/12 testing PCR-positive on days 3, 7, 14 and 21, respectively. The SNAP test was positive in 12/16 kittens on day 0 and only 3/16 on day 3. SNAP test results, diarrhea and systemic signs were inconsistent in relation to qPCR positivity post-diagnosis. Additional enteric pathogens were common. The presence of additional pathogen types was suggestive of a longer PCR shedding duration, but this was not tested statistically owing to the small sample size. CONCLUSIONS AND RELEVANCE: These findings suggest that cats should be isolated for at least 14 days after a diagnosis of FP, but that release from isolation after this point is reasonable, in association with a multifaceted infection control strategy. The study findings did not support using SNAP test results, diarrhea or systemic signs as proxy measures for virus shedding.

Diagnostic testing for feline panleukopenia in a shelter setting: a prospective, observational study.

OBJECTIVES: The aim of this study was to optimize the diagnosis of feline panleukopenia virus (FPV) infection in a shelter setting by: (1) comparing the results of the canine parvovirus IDEXX SNAP Parvo (SNAP) point-of-care ELISA with a commercial FPV quantitative real-time PCR (qPCR) test; (2) assessing whether vomit and anal/rectal swabs could be used for early diagnosis; and (3) clarifying the interpretation of weak-positive SNAP test results. METHODS: The study included shelter cats and kittens with incomplete or unknown vaccination history that had clinical signs suspicious for feline panleukopenia and fecal SNAP and PCR tests performed within 24 h of onset. Feces, anal/rectal swabs and vomit were tested using SNAP and PCR, with fecal PCR utilized as the reference standard. RESULTS: One hundred and forty-five cats were included. Seventeen were diagnosed with FPV infection and 62 were negative; 66 could not be individually designated because they were co-housed. Sensitivity was as follows: fecal SNAP 55% (n = 102; 95% confidence interval [CI] 32-77); swab SNAP 30% (n = 55; 95% CI 7-65); swab PCR 77% (n = 55; 95% CI 46-95); and vomit PCR 100% (n = 17; 95% CI 16-100). Specificity was high (96-100%) for all sample and test types. For PCR-positive fecal samples, true-positive SNAP tests (including weak positives) had significantly higher DNA viral copy numbers than false-negative SNAP tests (P = 0.0031). CONCLUSIONS AND RELEVANCE: The SNAP ELISA should be viewed as an initial diagnostic test to rule in feline panleukopenia. Positive fecal SNAP test results, including weak positives, are highly likely to be true positives in clinically affected animals. Negative results in clinically affected animals are unreliable and should be followed up with PCR testing.

Medical conditions and outcomes in 371 hoarded cats from 14 sources: a retrospective study (2011-2014).

OBJECTIVES: The aims of this study were to: (1) describe the source, route of surrender and signalment of hoarded cats relinquished to the Toronto Humane Society (THS); (2) document the prevalence of medical conditions by group (place of origin); (3) compare medical conditions between institutional hoarding (IH) and non-institutional hoarding (NIH) environments; and (4) report length of stay (LOS) and outcomes in hoarded and non-hoarded cats. METHODS: A retrospective, descriptive epidemiological study was performed using THS records from between July 2011 and June 2014. The prevalence of medical conditions was calculated for the different groups. Univariable logistic regression with a random intercept to account for autocorrelation among animals from the same group was used to examine the influence of IH and NIH environments on selected medical conditions. LOS and outcomes were calculated for hoarded and non-hoarded cats. RESULTS: Three hundred and seventy-one hoarded cats from 14 sources were included. The majority (n = 352/371) were surrendered voluntarily, many with the assistance of a community intermediary. Upper respiratory infection (URI) was the most common medical condition (38% of cats), followed by dermatological disease (30%). The prevalence of medical conditions varied substantially between groups. The odds of URI at intake (odds ratio [OR] 4.35, P = 0.044) and chronic URI (OR 23.70, P <0.0001) were significantly greater for IH compared with NIH. Adoption rates, euthanasia rates and LOS were similar for hoarded and non-hoarded cats. CONCLUSIONS AND RELEVANCE: The different prevalence of medical conditions in groups of hoarded cats indicates a continuum of harm and severity in animal hoarding. Hoarded cats can have LOS and live release rates comparable with non-hoarded cats. Cats from IH were significantly more likely to have chronic URI. This study highlights the need for a greater focus on IH, as well as the role of community intermediaries and the potential for a harm reduction approach to animal hoarding.

Assessment of real-time PCR cycle threshold values in Microsporum canis culture-positive and culture-negative cats in an animal shelter: a field study.

Objectives Real-time PCR provides quantitative information, recorded as the cycle threshold (Ct) value, about the number of organisms detected in a diagnostic sample. The Ct value correlates with the number of copies of the target organism in an inversely proportional and exponential relationship. The aim of the study was to determine whether Ct values could be used to distinguish between culture-positive and culture-negative samples. Methods This was a retrospective analysis of Ct values from dermatophyte PCR results in cats with suspicious skin lesions or suspected exposure to dermatophytosis. Results One hundred and thirty-two samples were included. Using culture as the gold standard, 28 were true positives, 12 were false positives and 92 were true negatives. The area under the curve for the pretreatment time point was 96.8% (95% confidence interval [CI] 94.2-99.5) compared with 74.3% (95% CI 52.6-96.0) for pooled data during treatment. Before treatment, a Ct cut-off of <35.7 (approximate DNA count 300) provided a sensitivity of 92.3% and specificity of 95.2%. There was no reliable cut-off Ct value between culture-positive and culture-negative samples during treatment. Ct values prior to treatment differed significantly between the true-positive and false-positive groups ( P = 0.0056). There was a significant difference between the pretreatment and first and second negative culture time points ( P = 0.0002 and P <0.0001, respectively). However, there was substantial overlap between Ct values for true positives and true negatives, and for pre- and intra-treatment time points. Conclusions and relevance Ct values had limited usefulness for distinguishing between culture-positive and culture-negative cases when field study samples were analyzed. In addition, Ct values were less reliable than fungal culture for determining mycological cure.

Comparison of real-time PCR with fungal culture for the diagnosis of Microsporum canis dermatophytosis in shelter cats: a field study.

Objectives Fungal culture requires at least 14 days for a final result, compared with 1-3 days for PCR. The study compared a commercial real-time dermatophyte PCR panel with fungal culture in cats in a shelter setting for: (1) diagnosis of Microsporum canis infection; and (2) determination of mycological cure. Methods This was a cross-sectional, observational study of cats with suspicious skin lesions or suspected exposure to dermatophytosis. Hair samples were collected for fungal culture and PCR prior to treatment and at weekly intervals until two negative culture results were obtained. Results One hundred and thirty-two cats were included, of which 28 (21.2%) were culture positive and 104 (78.8%) culture-negative for M canis. PCR correctly identified all culture-positive cats and 92/104 culture negative cats; there were 12 false-positive PCR results. The sensitivity and specificity of PCR were 100% (95% confidence interval [CI] 87.7-100) and 88.5% (95% CI 80.7-93.9), respectively. Data from 17 cats were available for assessment of mycological cure. At the time of the first and second negative fungal cultures, 14/17 (82.4%) and 11/17 (64.7%) tested PCR positive, respectively. Conclusions and relevance PCR showed high sensitivity and specificity for diagnosis of M canis dermatophytosis compared with fungal culture, but was unreliable for identifying mycological cure. False-positive results were relatively common. There were no false-negative PCR results and a negative PCR test was a reliable finding in this study. The ability to rapidly diagnose or rule out dermatophytosis could be a valuable tool to increase life-saving capacity in animal shelters.