ABSTRACT
FOP is a rare genetic condition, described mainly in man and cats, characterized by progressive, painful debilitation and shortened lifespan. A 10-month-old neutered male Savannah cat was referred for progressive gait abnormalities and multifocal firm masses within the soft-tissues that were unresponsive to previous treatment. Diagnosis of FOP was based on histopathological evaluation of intralesional biopsies, which revealed osteo-cartilaginous metaplasia and fibrocellular proliferation with intralesional chondrogenesis and endochondral ossification. The cat was managed with 5 mg/kg BID enrofloxacin and hydrotherapy for 3 years until acute death. During that three-year period, the cat displayed consistent improvement in endurance, quality of life, and range of motion. Postmortem histopathology further confirmed the diagnosis of FOP via identification of intramuscular and intra-fascial ossification with lymphoplasmacytic infiltration, degeneration, and regeneration of adjacent myocytes. To the authors' knowledge, this is the first report of long-term enrofloxacin treatment and hydrotherapy for the management of FOP in a cat, leading to improved mobility and survival time, and the first report of FOP in an exotic breed cat.
Subject(s)
Hydrotherapy , Myositis Ossificans , Ossification, Heterotopic , Male , Animals , Myositis Ossificans/genetics , Myositis Ossificans/pathology , Myositis Ossificans/veterinary , Ossification, Heterotopic/genetics , Ossification, Heterotopic/pathology , Ossification, Heterotopic/veterinary , Enrofloxacin/therapeutic use , Quality of Life , Hydrotherapy/veterinaryABSTRACT
The Medical Access to Service project was initiated to broadly engage participants in the health system to collectively improve service integration and patient access to primary care and specialist medical services. The Conference Model (the Axelrod Group, Willmette, IL) was used as a change vehicle. The ideal design was translated into the creation of central access and triage (CAT) processes across medical specialties, development of prioritization tools and implementation of access and efficiency through Alberta AIM (access improvement measures) collaboratives for process re-engineering. The ultimate goal for all Albertans who need care is one point-of-access--one standardized process to ensure equal access for all regardless of where they live.
Subject(s)
Continuity of Patient Care/organization & administration , Health Services Accessibility/organization & administration , Patient-Centered Care/organization & administration , Referral and Consultation/organization & administration , Systems Integration , Total Quality Management/organization & administration , Alberta , Congresses as Topic , Health Care Reform/organization & administration , Humans , Medical Records , Models, Organizational , National Health Programs/organization & administration , Organizational Case Studies , Outcome and Process Assessment, Health Care , Program Development , Program Evaluation , Time Factors , Triage/organization & administration , Waiting ListsABSTRACT
An increase in the incidence of severe, invasive, systemic fungal infections has been noted over the last decade in human and veterinary medicine. Reports of drug resistance and therapeutic failure to currently available antifungal agents have also been on the rise. Many factors are likely to be involved in these trends, including immune suppression and the use of broad-spectrum antibiotics. The use of fungistatic drugs, suboptimal doses, compounded drugs, poorly absorbed drug formulations, and inadequate tissue penetrations of antifungals also contribute to the development of acquired resistance. Because of the unique chemical complexities of the antifungal agents, drug/drug and drug/food interactions may also play a significant role in poor therapeutic outcome. This review summarizes the pharmacology and toxicology of the antifungal agents in current use for systemic mycosis and introduces some of the newer antifungal agents that anecdotally show very promising results.