Characterization of Oral Pathology in Cats Affected by Patellar Fracture and Dental Anomaly Syndrome (PADS).

Patellar fracture and dental anomaly syndrome (PADS) is a congenital bone disease of cats that is characterized by atraumatic bone fractures (most commonly the patella), the persistence of deciduous teeth, and impaction of permanent teeth. Jaw swelling due to osteomyelitis is often the reason that cats with PADS are presented for veterinary dental care. The clinical history, oral examination findings, dental radiological findings, and histopathology were evaluated for 13 cats with dental and skeletal pathology consistent with PADS, including 9 with osteomyelitis. Cats in this study were predominantly domestic shorthair (12 of 13 cats), and there was no apparent sex predilection. All cats had multiple persistent deciduous teeth and multiple impacted permanent teeth, although the number of persistent and impacted teeth varied. Osteomyelitis of the jaw typically occurred within the first 4 years of life. Osteomyelitis of the mandible was 4 times more common than osteomyelitis of the maxilla. Histologically, osteomyelitis was chronic, neutrophilic, and osteoproliferative. Necrotic bone was confirmed in 67% of osteomyelitis lesions. Histological evaluation of jaws without inflammation demonstrated abnormal amounts of unmodeled bone, abnormally dense bone, and retention of cartilage in the caudal mandible. Three cats in the study had mandibular distoclusion and 2 had concurrent paronychia. To obtain a favorable clinical outcome in PADS cats with jaw swelling, prompt and aggressive surgical treatment of osteomyelitis is required. Extraction of persistent deciduous teeth and impacted permanent teeth is recommended when there is associated periodontitis or osteomyelitis.

Gastric diverticula in six cats: a case series (2011-2020).

CASE SERIES SUMMARY: Gastric diverticulum (GD) is a rare condition that is described adequately in humans but has not been reported in cats. This case series describes six cats with GD, including three that were published in a previous abstract. All cats presented for a variety of gastrointestinal disorders, including chronic vomiting, weight loss and anorexia, and underwent negative contrast radiography to diagnose GD. All but one cat underwent surgical resection of the GD via partial gastrectomy, while the remaining cat was euthanized. Resection of the GD was associated with reduction of reported clinical signs. RELEVANCE AND NOVEL INFORMATION: Gastric diverticula have never been reported in the cat. Negative contrast radiography appears to be a superior imaging technique in the diagnosis of feline GD. In cats with a vague chronic history, including vomiting, anorexia and weight loss, GD should be considered among the differential diagnoses. Further study and more cases need to be identified to better assess clinical problems referable to GD in the absence of other comorbidities. Maine Coon cats with GD appear to be over-represented.

Treatment of pelvic fractures in cats with patellar fracture and dental anomaly syndrome.

OBJECTIVES: The aim of this study was to describe the treatment and outcome of acetabular and other pelvic fractures in cats with patellar fracture and dental anomaly syndrome (PADS) and to provide advice on how to manage these cases in practice. METHODS: Data were collated on cats with PADS that were reported to have sustained pelvic fractures or had fractures or fissures of the pelvis identified on submitted radiographs. The details of the fractures were recorded, in addition to any treatment and outcome information. RESULTS: Of the 215 cases reported with PADS, 58 cats (27%) were found to have pelvic fractures, none of which were known to have resulted from significant trauma. There were 101 fractures in total and of these 15 were treated with surgery, including 10 acetabular fractures, two ilial, two pubic and one ischial fracture. Screw loosening and loss of fracture reduction was seen in four of the surgically treated fractures (two pubic fractures, one ilial and one acetabular fracture). Fourteen cats were euthanased as a direct result of a fracture occurring. While most pelvic fractures healed uneventfully, some cats remained intermittently lame, but it was not always possible to determine the cause of the lameness from the information available and because all cats had concurrent patellar fractures. CONCLUSIONS AND RELEVANCE: Many of the pelvic fractures healed with conservative management. Fractures involving articular surfaces such as acetabular fractures may benefit from surgical stabilisation as surgery may offer the benefits of articular fracture repair with improved joint congruency and a faster return to normal activity.

Treatment of humeral condylar fractures and humeral intracondylar fissures in cats with patellar fracture and dental anomaly syndrome.

OBJECTIVES: The aim of this study is to describe the treatment and outcome of humeral condylar fractures and humeral intracondylar fissures in cats with patellar fracture and dental anomaly syndrome (PADS) and to provide advice on how to manage these cases in practice. METHODS: Data were collated on cats with PADS that were reported to have sustained humeral fractures or had fractures or fissures of the humerus identified on radiographs. The details of the fractures were recorded in addition to any treatment and outcome information. RESULTS: Of the 207 cases reported with PADS, 18 cats (8.7%) were found to have humeral condylar fractures, none of which was known to have resulted from significant trauma. Where treatment occurred, it involved the placement of transcondylar positional or lag screws. In some cases additional implants, including supracondylar bone plates and screws or Kirschner wires (K-wires), were used. Follow-up data revealed that only two cats were euthanased owing to the presence of the humeral fractures, with at least eight achieving some degree of recovery of function. CONCLUSIONS AND RELEVANCE: These humeral fractures all have the characteristics of stress insufficiency fractures, being simple isolated fractures that are short oblique, with increased radio-density at the fracture line and occurring following minimal or no trauma. Humeral intracondylar fissures were identified in two cats and it is possible that some of the other fractures may have occurred secondary to pre-existing fissures. To our knowledge, no prior reports exist of fissures in cats that do not meet the criteria for PADS. Surgical repair primarily consisted of the placement of transcondylar lag or positional screws with, in some cases, adjunct implants such as bone plates and screws or K-wires. Though there were insufficient data to determine the prognosis for these fractures in the long term, unlike patellar fractures, many of these fractures will heal if treated appropriately.

Methionine restriction decreases visceral fat mass and preserves insulin action in aging male Fischer 344 rats independent of energy restriction.

Reduced dietary methionine intake (0.17% methionine, MR) and calorie restriction (CR) prolong lifespan in male Fischer 344 rats. Although the mechanisms are unclear, both regimens feature lower body weight and reductions in adiposity. Reduced fat deposition in CR is linked to preservation of insulin responsiveness in older animals. These studies examine the relationship between insulin responsiveness and visceral fat in MR and test whether, despite lower food intake observed in MR animals, decreased visceral fat accretion and preservation of insulin sensitivity is not secondary to CR. Accordingly, rats pair fed (pf) control diet (0.86% methinone, CF) to match the food intake of MR for 80 weeks exhibit insulin, glucose, and leptin levels similar to control-fed animals and comparable amounts of visceral fat. Conversely, MR rats show significantly reduced visceral fat compared to CF and PF with concomitant decreases in basal insulin, glucose, and leptin, and increased adiponectin and triiodothyronine. Daily energy expenditure in MR animals significantly exceeds that of both PF and CF. In a separate cohort, insulin responses of older MR animals as measured by oral glucose challenge are similar to young animals. Longitudinal assessments of MR and CF through 112 weeks of age reveal that MR prevents age-associated increases in serum lipids. By 16 weeks, MR animals show a 40% reduction in insulin-like growth factor-1 (IGF-1) that is sustained throughout life; CF IGF-1 levels decline much later, beginning at 112 weeks. Collectively, the results indicate that MR reduces visceral fat and preserves insulin activity in aging rats independent of energy restriction.

2016 AAFP Guidelines for the Management of Feline Hyperthyroidism.

CLINICAL CONTEXT: Since 1979 and 1980 when the first reports of clinical feline hyperthyroidism (FHT) appeared in the literature, our understanding of the disease has evolved tremendously. Initially, FHT was a disease that only referral clinicians treated. Now it is a disease that primary clinicians routinely manage. Inclusion of the measurement of total thyroxine concentration in senior wellness panels, as well as in diagnostic work-ups for sick cats, now enables diagnosis of the condition long before the cat becomes the classic scrawny, unkempt, agitated patient with a bulge in its neck. However, earlier recognition of the problem has given rise to several related questions: how to recognize the health significance of the early presentations of the disease; how early to treat the disease; whether to treat FHT when comorbid conditions are present; and how to manage comorbid conditions such as chronic kidney disease and cardiac disease with treatment of FHT. The 2016 AAFP Guidelines for the Management of Feline Hyperthyroidism (hereafter referred to as the Guidelines) will shed light on these questions for the general practitioner and suggest when referral may benefit the cat. SCOPE: The Guidelines explain FHT as a primary disease process with compounding factors, and provide a concise explanation of what we know to be true about the etiology and pathogenesis of the disease.The Guidelines also:Distill the current research literature into simple recommendations for testing sequences that will avoid misdiagnosis and separate an FHT diagnosis into six clinical categories with associated management strategies.Emphasize the importance of treating all hyperthyroid cats, regardless of comorbidities, and outline the currently available treatments for the disease.Explain how to monitor the treated cat to help avoid exacerbating comorbid diseases.Dispel some of the myths surrounding certain aspects of FHT and replace them with an evidence-based narrative that veterinarians and their practice teams can apply to feline patients and communicate to their owners. EVIDENCE BASE: To help ensure better case outcomes, the Guidelines reflect currently available, evidenced-based knowledge. If research is lacking, or if a consensus does not exist, the expert panel of authors has made recommendations based on their extensive, cumulative clinical experience.