Feline tuberculosis caused by Mycobacterium bovis infection of domestic UK cats associated with feeding a commercial raw food diet.

Mycobacterium (M.) bovis can infect cats and is a demonstrated zoonosis. We describe an outbreak of M. bovis in pet cats across England and Scotland associated with feeding a commercial raw food diet. Forty-seven cats presented with (pyo)granulomatous lesions, lymphadenopathy, pulmonary and/or alimentary disease over a one-year period where M. bovis infection was suspected or definitively diagnosed, and the cats all consumed the same specific brand of commercial raw venison pet food. Infection with M. bovis genotype 10:a was confirmed by culture and DNA typing of isolates in a small number of cases (n = 5); PCR was used in combination with or as an alternative to culture (n = 12) and/or infection with a Mycobacterium tuberculosis complex group organism was strongly suggested by positive responses to an interferon-gamma release assay (IGRA; n = 34). Asymptomatic at-risk cats were screened by IGRA, identifying a further 83 infected cats. The five culture-positive cases were distributed across areas of England and Scotland at low risk of endemic bovine tuberculosis. Investigations revealed affected cats were mainly indoor-only, and had been fed the same commercial raw food as at least part of their diet. This diet was recalled by the manufacturer due to failure of statutory meat inspection of the component venison. As far as possible, other sources of infection were explored and excluded, including wildlife contact, access to raw milk and living with people with active M. bovis infection. Four owners and one veterinary surgeon were found to have high likelihood of latent tuberculosis infection. One owner required treatment. Although it was not possible to conclusively demonstrate a zoonotic origin for these infections, neither was it possible to eliminate the possibility. Our results provide compelling evidence that the commercial raw diet of these cats was the likely route of M. bovis infection in this outbreak of cases.

Investigation of pathological haemorrhage in Maine Coon cats.

OBJECTIVE: Afibrinogenaemic haemorrhage was previously reported in a Maine Coon cat. Two littermates subsequently died from surgical non-haemostasis, suggesting a hereditable coagulopathy. METHODS: We prospectively recruited cats which were: a) Maine Coons with pathological haemorrhage (group 1, n=8), b) healthy familial relatives of group 1 (group 2, n=13) and c) healthy Maine Coons unrelated to groups 1 and 2 (group 3, n=12). Coagulation tests: prothrombin time, activated partial thromboplastin time and thrombin clotting time (TCT) were performed on citrated plasma along with quantification of fibrinogen. Routine haematological examination was performed on EDTA-anticoagulated blood collected contemporaneously. RESULTS: Thirty-three blood samples were analysed. Fibrinogen concentrations were significantly reduced in groups 1 (P<0.01) and 2 (P<0.01) compared with group 3. Similarly, TCT was found to be significantly extended in group 1 (P<0.01) and group 2 (P=0.02) with respect to group 3. CONCLUSIONS: Dysfibrinogenaemia was identified in clinical cases and their healthy relatives, suggesting that this may represent a hereditary condition of Maine Coon cats. Clinicians should be aware of the increased potential for non-haemostasis in this cat breed and consider assessing clotting function before (elective) surgery.

Chronic Rhinitis in the Cat: An Update.

The etiology of feline chronic rhinitis is incompletely understood and often is a diagnosis of exclusion. History, clinical signs, and investigations performed to reach this diagnosis are discussed. Several treatment options are provided, although cure of this frustrating disease is rarely achieved.

Tuberculosis due to Mycobacterium bovis in pet cats associated with feeding a commercial raw food diet.

OBJECTIVES: Mycobacterium bovis, a member of the Mycobacterium tuberculosis complex, can infect cats and has proven zoonotic risks for owners. Infected cats typically present with a history of outdoor lifestyle and hunting behaviour, and cutaneous granulomas are most commonly observed. The aim of this study is to describe an outbreak of tuberculous disease commencing with six young cats, living exclusively indoors in five different households across England, being presented to separate veterinarians across the UK with a variety of clinical signs. METHODS: Investigations into the pyogranulomatous lesions, lymphadenopathy and/or pulmonary disease of these cases consistently identified infection with M bovis. Infection was confirmed by PCR, where possible, or was indicated with a positive interferon-gamma release assay (IGRA), where material for PCR was unavailable. In-contact, cohabiting cats were screened by IGRA and follow-up testing was undertaken/advised where results were positive. A lifestyle investigation was undertaken to identify the source of infection. RESULTS: Six clinically sick cats and seven in-contact cats were identified with evidence of M bovis infection. Five clinical cases were either too sick to treat or deteriorated despite therapy, giving a mortality rate of 83%. Lifestyle investigations revealed the common factors between clusters to be that affected cats had mycobacterial infections speciated to M bovis, were exclusively indoor cats and were fed a commercially available raw food product produced by a single manufacturer. The Food Standards Agency, Animal & Plant Health Agency, Public Health England and the food manufacturer concerned have been notified/informed. Other possible sources of exposure for these cats to M bovis were explored and were excluded, including wildlife contact, access to raw milk, the presence of rodent populations inside the buildings in which the cats lived and exposure to known infectious humans. CONCLUSIONS AND RELEVANCE: Upon investigations, our results provide compelling, if circumstantial, evidence of an association between the commercial raw diet of these cats and their M bovis infections.

Adaptive Comparative Judgment: A Tool to Support Students' Assessment Literacy.

Comparative judgment in assessment is a process whereby repeated comparison of two items (e.g., assessment answers) can allow an accurate ranking of all the submissions to be achieved. In adaptive comparative judgment (ACJ), technology is used to automate the process and present pairs of pieces of work over iterative cycles. An online ACJ system was used to present students with work prepared by a previous cohort at the same stage of their studies. Objective marks given to the work by experienced faculty were compared to the rankings given to the work by a cohort of veterinary students (n=154). Each student was required to review and judge 20 answers provided by the previous cohort to a free-text short answer question. The time that students spent on the judgment tasks was recorded, and students were asked to reflect on their experiences after engaging with the task. There was a strong positive correlation between student ranking and faculty marking. A weak positive correlation was found between the time students spent on the judgments and their performance on the part of their own examination that contained questions in the same format. Slightly less than half of the students agreed that the exercise was a good use of their time, but 78% agreed that they had learned from the process. Qualitative data highlighted different levels of benefit from the simplest aspect of learning more about the topic to an appreciation of the more generic lessons to be learned.

Assessment of five formulae to predict post-transfusion packed cell volume in cats.

This retrospective study aimed to identify the most accurate formula for estimating the increase in packed cell volume (PCV) after whole blood transfusion of cats, as several formulae have been reported but not validated. Forty cats, of varying breeds and gender, were included from two referral institutions after database searches over a 13 year period. Five formulae were used to calculate an estimated post-transfusion PCV based on the re-working of formulae for determining the volume of donor blood to be transfused; three formulae were derived from those previously reported in the feline literature and two from human paediatric medicine, where a similar mean blood volume has been described. Cats were subdivided into two groups, the first consisting of 17 cats with non-regenerative anaemia and the second consisting of 23 cats with ongoing losses such as haemolysis and haemorrhage; it was hypothesised that formulae could be more accurate for group 1 cats, whereas formulae applied to group 2 cats could have overestimated the post-transfusion PCV. Bland-Altman analysis was performed for all cats to compare the actual increase in PCV with the calculated increase for the five formulae. Formula 1 (PCV % increase = volume of blood transfused in ml/2 × bodyweight in kg) performed best overall and is easy to calculate; however, no single formula was highly accurate at predicting the PCV increase after whole blood transfusion in cats and, owing to the wide confidence intervals, these formulae should be applied judiciously in the clinical setting.

Chronic rhinitis in the cat.

The cause of feline chronic rhinitis is incompletely understood and it is often a diagnosis of exclusion. History, clinical signs, and investigations performed to reach this diagnosis are discussed. Several treatment options are provided, although cure of this frustrating disease is rarely achieved.

Mycoplasma species in cats with lower airway disease: improved detection and species identification using a polymerase chain reaction assay.

There is some evidence that Mycoplasma species may be associated with lower airway disease in cats. Retrospective and prospective studies were carried out on a total population of 76 cats but failed to identify any cases of Mycoplasma species infection by bacterial culture alone. The overall prevalence of bacterial infection (15.8%) was also lower than that identified in previous studies. When a molecular detection technique, the PCR-DGGE, was employed the prevalence of Mycoplasma species detected was 15.4%, with M felis, M gateae and M feliminutum species identified, although the significance of these Mycoplasma species in feline lower airway disease remains in question. However, the PCR-DGGE technique allowed species identification and indicated the presence of M feliminutum, a species not previously isolated from the lower airways of cats.

Nasopharyngeal disease in cats: 1. Diagnostic investigation.

PRACTICAL RELEVANCE: Nasal discharge, sneezing and upper respiratory noise are frequent presenting signs in feline practice. CLINICAL CHALLENGES: The small nasal cavity of the cat can make visualisation of lesions challenging. In addition, investigations may identify only secondary complications of a disease process, rather than the initial aetiological agent. GLOBAL IMPORTANCE: Nasopharyngeal disease is a worldwide problem. However, fungal disease shows regional variations in prevalence. AUDIENCE: This review, aimed at general practitioners as well as those undertaking more specialist investigations in feline respiratory disease, aims to provide practical guidance on the approach necessary to obtain a diagnosis in cats with nasopharyngeal disease. It should also help to explain why a specific diagnosis may not always be possible. EQUIPMENT: While access to endoscopy and computed tomography is advantageous, extensive information can be gained from equipment readily available in all practices. EVIDENCE BASE: The information presented in this article is based on peer-reviewed publications and the clinical experience of the authors.

Nasopharyngeal disease in cats: 2. Specific conditions and their management.

PRACTICAL RELEVANCE: Nasopharyngeal disease is a common presenting problem in feline medicine. CLINICAL CHALLENGES: The management of feline nasopharyngeal disease can be challenging at a number of levels. In many cases, a specific diagnosis may remain elusive. Some conditions may not be curable so owners need to understand the requirement for long-term management. In addition, treatment may be compromised by poor patient compliance. AUDIENCE: This review, which is directed at any clinicians involved in the management of cats with nasopharyngeal disease, discusses acute rhinitis (cat 'flu) and a variety of conditions causing chronic rhinosinusitis/chronic nasopharyngeal disease. The intention is to assist treatment decision making by reviewing the most appropriate therapies from the options available for these patients. EVIDENCE BASE: The information presented in this article is based on peer-reviewed publications and the clinical experience of the authors.

CNS disease in the cat: current knowledge of infectious causes.

PRACTICAL RELEVANCE: Neurological disease is a relatively common reason for referral, constituting approximately 10% of the feline referral caseload. Nearly one-third to one-half of these cases may be infectious in origin. As such, an awareness of infectious diseases causing central nervous system (CNS) signs in cats, and their clinical diagnosis and management, is relevant to anyone dealing with cats on a regular basis. GLOBAL IMPORTANCE: Some conditions (eg, rabies) are more common in certain countries than others. Conditions such as feline infectious peritonitis (FIP) and toxoplasmosis are of global significance. PATIENT GROUP: Many infectious diseases may affect any feline population. Some, such as FIP, are more common in pedigree households, whereas others such as toxoplasmosis, feline immunodeficiency virus (FIV) or feline leukaemia virus (FeLV) infections, are more likely to affect a single cat with an outdoor lifestyle. EQUIPMENT: All patients benefit from thorough history taking and clinical, neurological and ophthalmic examinations, which all require minimal equipment. Infectious diseases may often be diagnosed on blood samples; however, definitive diagnosis may require more extensive investigation involving cerebrospinal fluid analysis or advanced imaging necessitating access to computed tomography or magnetic resonance imaging. EVIDENCE BASE: The information in this review, which summarises current knowledge of infectious diseases affecting the CNS, is collated from publications on the infectious diseases comprising previous research papers, review articles, case series, case reports and textbooks, supplemented by the clinical experience of the authors.

Prevalence of Tritrichomonas foetus infection in cats with diarrhoea in the UK.

Faecal samples from 111 cats with diarrhoea that were living in the UK were submitted for the assessment of Tritrichomonas foetus infection by polymerase chain reaction (PCR). Sixteen (14.4%) samples were found to be positive. In agreement with studies from the USA, infected cats were predominantly of a year of age or less and of a pedigree breed, with Siamese and Bengal cats specifically over-represented in this population.