Gastrointestinal ultrasonographic findings in cats with Feline panleukopenia: a case series.

BACKGROUND: Feline panleukopenia virus (FPV) is very resistant and highly contagious and infects domestic cats and other felids. FPV is particularly widespread among sheltered cats, and is associated with high morbidity and mortality, causing severe gastroenteritis characterized by anorexia, lethargy, fever, dehydration, hemorrhagic diarrhea, and vomiting. There is currently no data on the ultrasonographic features of cats affected with FPV. This case series describes abdominal ultrasonographic findings in shelter cats with naturally-occurring FPV, and assesses whether are associated with clinical and laboratory findings. Cats affected by FPV were enrolled in the study if an abdominal ultrasound was performed within 12 hours of diagnosis. Clinical, laboratory and survival data were collected from medical records. Ultrasonographic examinations were reviewed for gastrointestinal abnormalities and their associations with the above data were explored. RESULTS: Twenty-one cats were included. Nine cats (42.9%) died and 12 (57.1%) recovered. Based on ultrasonography, the duodenum and jejunum showed thinning of the mucosal layer in 70.6% and 66.6% of cats, thickening of the muscular layer in 52.9% and 57.1% of cats, and hyperechogenicity of the mucosa in 41.2% and 33.3%. Jejunal hyperechoic mucosal band paralleling the submucosa and irregular luminal surface were both observed in 33.3% of the cats. Survival was positively associated with increased jejunal mucosal echogenicity (P = 0.003) and hyperechoic mucosal band (P = 0.003). Peritoneal free fluid was positively associated with vomiting (P = 0.002). CONCLUSIONS: This study provides ultrasonographic features of naturally-occurring FPV in cats, which, as expected, are compatible with gastroenteropathy. The most frequent findings were diffuse small intestine mucosal layer thinning, muscular layer thickening and mucosal hyperechogenicity, jejunal hyperechoic mucosal band and irregular luminal surface. Ultrasonographic features may be useful to complete the clinical picture and assess the severity of the gastroenteropathy in FPV cats. Prospective studies are needed to confirm ultrasonographic prognostic factors.

Treatment with Class A CpG Oligodeoxynucleotides in Cats with Naturally Occurring Feline Parvovirus Infection: A Prospective Study.

Feline parvovirus (FPV) causes severe gastroenteritis and leukopenia in cats; the outcome is poor. Information regarding specific treatments is lacking. Class A CpG oligodeoxynucleotides (CpG-A) are short single-stranded DNAs, stimulating type I interferon production. In cats, CpG-A induced an antiviral response in vivo and inhibited FPV replication in vitro. The aim was to prospectively investigate the effects of CpG-A on survival, clinical score, hematological findings, antiviral response (cytokines), viremia, and fecal shedding (real-time qPCR) in cats naturally infected with FPV. Forty-two FPV-infected cats were randomized to receive 100 µg/kg of CpG-A (n = 22) or placebo (n = 20) subcutaneously, on admission and after 48 h. Blood and fecal samples were collected on admission, after 1, 3, and 7 days. All 22 cats showed short duration pain during CpG-A injections. The survival rate, clinical score, leukocyte and erythrocyte counts, viremia, and fecal shedding at any time-point did not differ between cats treated with CpG-A (50%) and placebo (40%). Antiviral myxovirus resistance (Mx) gene transcription increased in both groups from day 1 to 3 (p = 0.005). Antibodies against FPV on admission were associated with survival in cats (p = 0.002). In conclusion, CpG-A treatment did not improve the outcome in cats with FPV infection. FPV infection produced an antiviral response.

Diabetic remission in a cat treated with an implantable pump to deliver insulin.

A diabetic cat was referred because of poor metabolic control and difficulties the owner experienced injecting insulin. A pump, telemetrically controlled with a smartphone, was implanted subcutaneously to deliver insulin. Before implantation, the pump reservoir was filled with a rapid-acting human recombinant insulin. The insulin was administered through continuous infusion or periodic boluses over 2 weeks while the cat was hospitalized and over another 2 weeks after discharge from the hospital. Adjustments of insulin dosage were performed based on blood glucose concentrations measured with a continuous blood monitoring system (CGMS). The cat achieved diabetic remission that is still lasting after 1 year. The treatment protocol adopted in this cat contributed to achieving remission. The owner's unwillingness to inject insulin into an uncooperative cat was circumvented with the implantable pump. Key clinical message: The implantable subcutaneous pump, telemetrically controlled by a smartphone, easily allowed the clinician to modify the type of administration and the amount of insulin delivered; the concurrent use of a CGMS allowed detection of sudden changes in blood glucose while limiting stress to the cat.

Rémission du diabète chez un chat traité avec une pompe implantable pour administrer l'insuline.Un chat diabétique fut référé pour cause de pauvre contrôle métabolique et des difficultés rencontrées par le propriétaire pour injecter l'insuline. Une pompe, contrôlée par télémétrie avec un téléphone intelligent, fut implantée sous-cutané afin d'injecter l'insuline. Avant l'implantation, le réservoir de la pompe fut rempli avec une insuline humaine recombinante à action rapide. L'insuline était administrée par infusion continue ou des bolus périodiques pendant une période de 2 semaines alors que le chat était hospitalisé et pendant un 2 semaines supplémentaires après avoir obtenu son congé de l'hôpital. Des ajustements du dosage de l'insuline furent effectués sur la base des concentrations de glucose sanguin mesurées par un système continu de surveillance du sang (CGMS). Une rémission du diabète fut possible pour ce chat et persiste toujours après 1 an. Le protocole de traitement adopté chez ce chat a contribué à atteindre cette rémission. La réticence du propriétaire à injecter l'insuline chez un chat non-collaborateur fut contournée par une pompe implantable.Message clinique important :La pompe implantable sous-cutanée, contrôlée par télémétrie avec un téléphone intelligent, a facilement permis au clinicien de modifier le type d'administration et la quantité d'insuline donnée; l'utilisation concomitante d'un CGMS a permis la détection de changements soudains dans la glycémie tout en limitant le stress au chat.(Traduit par Dr Serge Messier).

Survival time and prognostic factors in cats with newly diagnosed diabetes mellitus: 114 cases (2000-2009).

OBJECTIVE: To determine overall survival time and identify prognostic factors associated with survival time in cats with newly diagnosed diabetes mellitus. DESIGN: Retrospective case series. ANIMALS: 114 cats with newly diagnosed diabetes mellitus. PROCEDURES: Data for analysis included history, signalment, physical examination findings, hematologic and serum biochemical data, presence of ketoacidosis, and diagnosis of concurrent diseases at initial evaluation. The effects of possible predictors on survival time were determined by calculating hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS: Median survival time of diabetic cats was 516 days (range, 1 to 3,468 days); 70%, 64%, and 46% lived longer than 3, 6, and 24 months, respectively. Survival time was significantly shorter for cats with higher creatinine concentrations, with a hazard of dying approximately 5% greater for each increase of 10 µg/dL in serum creatinine concentration (adjusted HR, 1.005; 95% CI, 1.003 to 1.007). Ketoacidosis was not significantly associated with survival time (HR, 1.02; 95% CI, 0.590 to 1.78). CONCLUSIONS AND CLINICAL RELEVANCE: Cats with newly diagnosed diabetes mellitus had a fair to good prognosis. High serum creatinine concentration at diagnosis was associated with a poor outcome, likely because of the adverse effects of renal dysfunction. Ketoacidosis apparently was not associated with decreased survival time, suggesting that this complication should not necessarily be regarded as unfavorable.