Effect of cilobradine in cats with a first episode of congestive heart failure due to primary cardiomyopathy.

INTRODUCTION: Heart rate (HR) is often elevated in cats with cardiomyopathies (CMPs). Pharmacologic modulation of HR may reduce cardiac morbidity and mortality. OBJECTIVES: To investigate the effects of cilobradine vs. placebo, regarding time to cardiac mortality or morbidity in cats with first episode of congestive heart failure (CHF) due to primary CMP. ANIMALS: Three hundred and sixty-seven client-owned cats with primary CMP that had presented with a first episode of CHF at 50 centers in Europe. Per-protocol population comprised 193 cats (n = 89 cilobradine, n = 104 placebo). An interim analysis for futility was planned. METHODS: Prospective, randomized, placebo-controlled, double-blinded, multicenter clinical trial. Primary outcome variable was the time to a composite of cardiac mortality or cardiac morbidity. RESULTS: Median time to primary outcome was 84 days (95% confidence interval [CI]: 63-219 days) in the cilobradine group (CG) and 203 days in the placebo group (95% CI: 145-377 days) with observed hazard ratio of 1.44, indicating a higher hazard for the CG (P = 0.057). Mean HR was 28 beats per minute (bpm) lower at Day 7 (P < 0.0001) and remained 29 bpm lower at Day 360 (P = 0.026) in the CG than that in the placebo group. Although the number of adverse events did not differ, there were more serious adverse events in the CG. CONCLUSIONS: Heart rate reduction by cilobradine in cats with a first episode of CHF due to primary CMP did not reduce cardiac mortality and morbidity.

[Protein-losing enteropathy in Rottweilers]. / Protein-losing enteropathy bij de Rottweiler.

OBJECTIVES: To describe the signs, histopathological features, and treatment outcome of a not previously described protein-losing enteropathy (PLE) in Rottweiler dogs. METHODS: A retrospective study involving 17 Rottweilers referred for PLE. Data on sex, age, presenting signs, histopathological diagnosis, and treatment outcome were collected. The canine inflammatory bowel disease activity index (CIBDAI) score was calculated, to quantify disease severity. Endoscopic intestinal biopsies were evaluated according to the guidelines of the World Small Animal Veterinary Association (WSAVA) gastrointestinal standardization group. RESULTS: Presenting signs were watery diarrhoea and weight loss. In all dogs with PLE in this study, the abnormalities found were consistent with a form of inflammatory bowel disease. Some of the dogs had a secondary infection with Giardia or Cyniclomyces guttulatus. In 10 dogs (59%) the CIBDAI score was 9 or higher, indicative of severe disease. Histopathological findings revealed lymphoplasmacellular enteritis, with lymphangiectasia in 14 (82%) dogs and eosinophil infiltration in 10 (59%) dogs. Eleven (65%) dogs were euthanized or died because of the intestinal disease. Kaplan-Meier analysis revealed a median survival time of 5 months, with a 1-year survival rate of 47%. Seven (4%) dogs were disease-free after treatment with immunosuppressants and dietary measures, but some relapsed (median disease-free interval 21 months). CLINICAL SIGNIFICANCE: In Rottweilers presenting with chronic diarrhoea and weight loss, clinicians should consider the presence of severe PLE, which has a poor prognosis.

Emesis in dogs: a review.

Emesis is a common presenting sign in small animal practice. It requires a rational approach to management that is based upon a sound understanding of pathophysiology combined with logical decision making. This review, which assesses the weight of available evidence, outlines the physiology of the vomiting reflex, causes of emesis, the consequences of emesis and the approach to clinical management of the vomiting dog. The applicability of diagnostic testing modalities and the merit of traditional approaches to management, such as dietary changes, are discussed. The role and usefulness of both traditional and novel anti-emetic drugs is examined, including in specific circumstances such as following cytotoxic drug treatment. The review also examines areas in which common clinical practice is not necessarily supported by objective evidence and, as such, highlights questions worthy of further clinical research.

[Endoscopic removal of foreign bodies from cats or dogs]. / Endoscopisch verwijderen van vreemde voorwerpen uit hond of kat.

Foreign bodies in the airways or intestines of dogs or cats are a common problem in companion animal practice. Improved endoscopic techniques, together with their greater availability, mean that it is often possible to remove the foreign body endoscopically, making surgery unnecessary. This article describes 53 cats and dogs in which a foreign body was detected and, where possible, removed. Results are compared with those in the literature. Practical guidelines for foreign body removal in specific cases are described, focusing on therapy and prognosis.

Pulsatile secretion pattern of growth hormone during the luteal phase and mid-anoestrus in beagle bitches.

The pulsatile secretion pattern of growth hormone was investigated during four stages of the luteal phase and during mid-anoestrus in six cyclic beagle bitches. Plasma samples were obtained via jugular venepuncture at 10 min intervals for 12 h at 19 +/- 2 (mean +/- SEM; luteal phase 1), 38 +/- 2 (luteal phase 2), 57 +/- 2 (luteal phase 3), 78 +/- 2 (luteal phase 4) and 142 +/- 4 days (mid-anoestrus) after ovulation. During all stages, growth hormone was secreted in a pulsatile fashion. The mean basal plasma growth hormone concentration during luteal phase 1 (2.2 +/- 0.3 microgram l(-1)) was significantly higher than that during luteal phase 4 (1.5 +/- 0.1 microgram l(-1)) and mid-anoestrus (1.4 +/- 0.2 microgram l(-1)). The mean area under the curve (AUC) above zero during luteal phase 1 (27.3 +/- 2.7 microgram l(-1) in 12 h) tended to be higher than that during luteal phase 4 (20.8 +/- 1.8 microgram l(-1) in 12 h) and mid-anoestrus (19.2 +/- 2.5 microgram l(-1) in 12 h). In contrast, the mean AUCs above the baseline during luteal phase 1 (1.1 +/- 0.5 microgram l(-1) in 12 h) and luteal phase 2 (1.2 +/- 0.5 microgram l(-1) in 12 h) were significantly lower than that during luteal phase 4 (2.8 +/- 0.5 microgram l(-1) in 12 h). In conclusion, the pulsatile secretion pattern of growth hormone changes during the luteal phase in healthy cyclic bitches: basal growth hormone secretion is higher and less growth hormone is secreted in pulses during stages in which the plasma progesterone concentration is high. It is hypothesized that this change is caused by a partial suppression of pituitary growth hormone release by progesterone-induced growth hormone production in the mammary gland. The progesterone-induced production of growth hormone in the mammary gland may promote the physiological proliferation and differentiation of mammary gland tissue during the luteal phase of the bitch by local autocrine-paracrine effects. In addition, progesterone-induced mammary growth hormone production may exert endocrine effects, such as hyperplastic changes in the uterine epithelium and insulin resistance.

Results of non-selective adrenocorticolysis by o,p'-DDD in 129 dogs with pituitary-dependent hyperadrenocorticism.

One hundred and twenty-nine dogs with pituitary-dependent hyperadrenocorticism were treated according to a protocol aimed at the complete destruction of the adrenal cortices by the administration of o,p'-DDD (mitotane) at a daily dose of 50 to 75 mg/kg bodyweight for 25 days. On the third day, glucocorticoid and mineralocorticoid supplementation was begun for the induced adrenocortical insufficiency. The first followup examination after completion of the 25-day course and the subsequent twice-yearly follow-up examinations included physical examination and measurements of plasma concentrations of sodium and potassium to optimise substitution therapy. In 19 dogs the full course of 25 days treatment could not be completed. Of the 110 dogs which received the full course of treatment, the administration had to be stopped temporarily in 32 because of side-effects, such as anorexia and vomiting. The actual dose of o,p'-DDD administered was not significantly different in the dogs with and without these side-effects. Clinical remission occurred in 111 dogs (86 per cent), of which 43 (39 per cent) had a relapse. The estimated one-year disease-free fraction was 77 per cent (95 per cent confidence interval [CI]: 67 to 85 per cent). The estimated one-year survival fraction was 80 per cent (95 per cent CI: 71 to 87 per cent), the two-year survival was 69 per cent (95 per cent CI: 59 to 78 per cent), and the three-year survival was 61 per cent (95 per cent CI: 49 to 71 per cent). The bodyweight and age of the dog, and vomiting occurring during the period of treatment, were positively correlated with the length of the disease-free period, whereas weakness during the treatment and resistance to dexamethasone suppression of the urinary corticoid/creatinine ratios at the start of the treatment were associated with a relatively short survival time.

Primary hyperparathyroidism in two cats.

Primary hyperparathyroidism (PHP) is an infrequently diagnosed disorder in cats. In this report the signs and symptoms of two cats with hypercalcaemia due to PHP are described, together with diagnostic approach, results of treatment, and immunohistochemical findings. A 9-year-old and a 13-year-old neutered male domestic shorthair cat were presented with signs of lethargy, anorexia, and vomiting. Both cats had persistent hypercalcaemia and normo- to hypophosphataemia. Cytological examination of a fine-needle aspiration biopsy sample of a palpable cervical mass revealed groups of benign glandular-epithelial cells in one cat. In the other cat no cervical mass was palpable. In this cat plasma parathyroid hormone (PTH) levels were measured repeatedly and these values exceeded the maximum reference value on two occasions. Following exclusion of other causes of hypercalcaemia both cats were subjected to neck surgery and in both a solitary parathyroid adenoma was removed. The adenomas contained an abundance of PTH, as demonstrated by immunohistochemical techniques. Plasma calcium and phosphate concentrations returned to within, reference ranges postoperatively. Recovery was uncomplicated and there were no signs of recurrence on follow-up examinations.

[Epidemic of nutritional polyneuropathy in the cat. Final report of the investigational team]. / Epidemie van alimentaire polyneuropathie bij de kat. Eindverslag onderzoeksteam.

In June 1996 companion animal practitioners received a report prepared by the Faculty Investigative Team on the outbreak of polyneuropathy among cats, and at the end of August a 'definitive' bulletin was circulated by Spillers Petfoods. The coccidiostatic drug salinomycin, which was present in the vitamin premix supplied by a third party, was considered the cause of the neuropathy. The investigative team is of the opinion that all veterinary practitioners in the Netherlands should receive a conclusive report about the epidemic because of the unique nature of the epidemic, which despite its sudden outbreak could be well documented, and because aspects of the affair merit the attention of veterinary practitioners.