Andrew H Sparkes

AAFP-AAHA Feline Life Stage Guidelines

Background and goals Cats have become the most popular pet in the United States, yet statistics about veterinary care for cats remain troubling. 1 Although most owners consider their cats to be family members, cats are substantially underserved, compared with dogs. In 2006, owners took their dogs to veterinarians more than twice as often as cats, averaging 2.3 times/year, compared with 1.1 times/year for cats, and significantly more dogs (58%) than cats (28%) were seen by a veterinarian one or more times/year. 2 Cat owners often express a belief that cats ‘do not need medical care’. Two reasons for this misconception are that signs of illness are often difficult to detect, and cats are perceived to be self-sufficient. 2 One role of the veterinarian is to develop a partnership with cat owners that will pave the way for a lifelong health care plan. These guidelines aim to outline an evidence-based life stage wellness program to aid the veterinary medical team in delivering the best comprehensive care for cats. Specific goals are to provide: Recommendations for optimal health care for cats throughout the different life stages. Practical suggestions and tools to facilitate improved veterinary visits and to enhance the client-veterinarian clinical encounter. A foundation from which to access sources of additional information. Life stage classification Distinct life stages (age groups) in cats are not well defined, in part because individual animals and body systems age at different rates, a process that is influenced by many factors. These guidelines follow one convenient classification (see box below). These age designations help to focus attention on the physical and behavioral changes that occur at different stages (eg, congenital defects in kittens, obesity prevention in the junior cat). It must be recognized, however, that any age groupings are inevitably arbitrary demarcations along a spectrum, and not absolutes. Evidence-based health care Supporting references for specific recommendations are supplied where possible, and any previously published guidelines on particular topics are referred to where relevant. Readers should note, however, that the guidelines panel was hampered in its efforts by the relative paucity of disease incidence data by age group that is available, and there is an urgent need for research to guide the future of evidence-based feline health care. 3

ISFM AND AAFP CONSENSUS GUIDELINES Long-term use of NSAIDs in cats

NSAIDs and cats Non-steroidal anti-inflammatory drugs (NSAIDs) are an important class of drug in feline medicine, having analgesic, anti-inflammatory and antipyretic activity. While most published data on their use in this species relate to short-term (often perioperative) therapy, there is increasing evidence of the value of these drugs in treating chronic pain in cats (for example, that associated with degenerative joint disease), and some NSAIDs have now become licensed for long-term use in cats in some geographies. Most of our knowledge of therapeutic mechanisms or adverse drug reactions associated with NSAIDs is extrapolated from work in other species, and there is a paucity of published data relating to cats. Guidelines These guidelines have been drawn together by an expert panel, which have reviewed the current literature on long-term NSAID use in cats and other species, and developed guidance on their use based on this information. The aim is to provide practical information for veterinarians to encourage appropriate NSAID therapy whenever cats will benefit from the use of these drugs.

Owners ‘perception of their cats’ quality of life during COP chemotherapy for lymphoma

Questionnaires regarding the perceptions of chemotherapy and its impact on the quality of life (QoL) of their cat were received from owners of 31 cats treated for lymphoma between 2002 and 2006 with COP (cyclophosphamide, vincristine, prednisolone) chemotherapy. The QoL scores prior to the onset of cancer (mean 9.5, range 6–10) were significantly higher than the ratings given after the onset of cancer but before commencement of chemotherapy (mean 3.9, range 1–9.4). The QoL scores during chemotherapy (mean 6.3, range 1–10) were also significantly lower than prior to the onset of cancer, but significantly higher during treatment than prior to starting treatment. Adverse effects were experienced by 27 (87%) cats during the course of chemotherapy. Twenty-five (83%) of clients were happy they treated their cat and 27 owners (87%) would treat another cat. The results suggest that COP chemotherapy is perceived by owners to be tolerated by cats.

2013 AAFP Feline Vaccination Advisory Panel Report

Rationale: This Report was developed by the Feline Vaccination Advisory Panel of the American Association of Feline Practitioners (AAFP) to provide practical recommendations to help clinicians select appropriate vaccination schedules for their feline patients based on risk assessment. The recommendations rely on published data as much as possible, as well as consensus of a multidisciplinary panel of experts in immunology, infectious disease, internal medicine and clinical practice.

COX-1 and COX-2 Expression in Feline Oral Squamous Cell Carcinoma

This study demonstrated immunohistochemically the expression of cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) in feline oral squamous cell carcinoma (FOSCC), with primary polyclonal antibodies raised against human epitopes. COX-2 immunolabelling was intracytoplasmic and, in some neoplastic cells, perinuclear; it was demonstrated in a small proportion (< or = 1%) of neoplastic cells and its intensity was usually mild to moderate. In contrast, all neoplastic tissues showed extensive nuclear and cytoplasmic COX-1 immunolabelling. Cytoplasmic COX-1 immunolabelling was less intense than nuclear labelling in neoplastic tissue. In the adjacent histologically normal oral mucosa, COX-2 immunolabelling was absent. The cytoplasmic and nuclear intensity and distribution of COX-1 immunolabelling was significantly higher in neoplastic tissue than in adjacent normal oral mucosa. The results indicate that COX-1 and COX-2 are overexpressed in FOSCC, but the clinical and pathophysiological significance of this finding remains to be determined.

A questionnaire-based study of gestation, parturition and neonatal mortality in pedigree breeding cats in the UK

This study was based on a convenience-sampling questionnaire study of pedigree cat breeding in the UK. Data were collated for the births of 1056 litters from 14 different pedigree breeds and 942 different households. Significant relationships between various outcomes and relevant predictors were assessed by multiple linear regression or logistic regression as appropriate. The overall mean gestation length of 65.1 days varied significantly between the breeds (P<0.0001), and larger litter sizes were associated with shorter gestation lengths (P=0.04). The mean litter size of 4.6 kittens also varied significantly according to breed (P<0.0001). The weight of kittens born alive (overall mean 93.5 g) increased with longer gestation lengths (P=0.0003), decreased with larger litter sizes (P<0.0001) and varied between the breeds (P<0.0001). A total of 8.0% of pregnancies resulted in a caesarean section, with a higher risk associated with smaller litter sizes (P=0.002). Although the frequency of caesarean sections varied from 0 to 18.5% between individual breeds, breed itself was not shown to have a significant independent effect on this likelihood. A mean of 7.2% of all the kittens were stillborn, which varied according to breed (P=0.0003), and the risk of a stillborn kitten increased with litter size (P=0.0001), and with the presence of congenital defects in the litter (P=0.0002). The mean kitten mortality between birth and 8 weeks of age was 9.1%, and the majority of these occurred in the first week of life. Parturition intervals varied widely. The duration of first stage of labour was less than 2 h in 82.9% of cats. The interval between the birth of the first and last kitten was less than 6 h in 85.7%, but more than 48 h in three cats. A maximum of 48 h was recorded between the births of individual kittens in unassisted deliveries.

Oral malignant melanoma – the effect of coarse fractionation radiotherapy alone or with adjuvant carboplatin therapy

Abstract A retrospective study was undertaken of dogs presented to the Animal Health Trust for treatment of oral malignant melanoma, without radiographic evidence of pulmonary metastases. Group 1 (n = 13) received radiotherapy of the primary and any lymph node metastases (4 weekly fractions of 9 Gy); and group 2 (n = 15) were treated the same but additionally received between two and six doses carboplatin at 300 mg m(-2) every 3 weeks. Median survival times for the two groups were 307 and 286 days, respectively (P > 0.05). In addition, carboplatin therapy did not significantly reduce the proportion of dogs dying due to metastases (three from group 1 and four from group 2). We found no evidence of a beneficial effect of carboplatin therapy over radiotherapy alone.

MRI characteristics of suspected acute spinal cord infarction in two cats, and a review of the literature

A 10-year-old neutered male Persian cat and a 4-year-old spayed female domestic shorthair (DSH) cat were evaluated for acute-onset severe lateralising tetraparesis and hemiplegia, respectively. Both cats also had left-sided Horners syndrome. Neurological examination of the cats localised the lesion to cranial to C5 in the Persian and the left cervical intumescence (C6–T2) in the DSH. Physical examinations were otherwise generally unremarkable. Routine laboratory tests and spinal radiography were normal for the Persian cat and were not performed for the DSH cat. A cerebrospinal fluid (CSF) tap was attempted for the Persian cat but aborted because of gross blood contamination, and was not performed for the DSH cat. Magnetic resonance imaging (MRI) of the Persian cat revealed a lesion within the spinal parenchyma at segments C1 to C3 (slightly more left-sided) which was iso- to hypointense on T1-weighted scans and hyperintense on T2-weighted scans, and which enhanced slightly with gadolinium. MRI of the DSH cat revealed a lesion within the spinal parenchyma at segment C7 (predominantly left-sided) which was hypointense on T1-weighted scans and hyperintense on T2-weighted gradient echo scans. Contrast was not administered. The MRI findings in both cases were highly suggestive of acute spinal cord infarction, based upon comparison to human cases. Both cats made full neurological recoveries with supportive treatment only. This paper describes two cases of suspected acute spinal cord infarction in the cat, demonstrates the potential diagnostic value of MRI, and discusses the clinical syndrome of this condition with a brief review of published cases.

16S rDNA comparison demonstrates near identity between an United Kingdom Haemobartonella felis strain and the American California strain

A handful of North American (USA) strains of the uncultured erythrocytotrophic pathogen of cats, Haemobartonella felis, have been differentiated by comparison of the 16S rRNA gene sequences. Using this approach, an UK strain was characterised, providing an identity for a non-USA H. felis for the first time. This strain shared close phylogenetic homology with the USA Californian strain.

ISFM Consensus Guidelines on the Practical Management of Diabetes Mellitus in Cats

Practical relevance: Diabetes mellitus (DM) is a common endocrinopathy in cats that appears to be increasing in prevalence. The prognosis for affected cats can be good when the disease is well managed, but clinical management presents challenges, both for the veterinary team and for the owner. These ISFM Guidelines have been developed by an independent, international expert panel of clinicians and academics to provide practical advice on the management of routine (uncomplicated) diabetic cats. Clinical challenges: Although the diagnosis of diabetes is usually straightforward, optimal management can be challenging. Clinical goals should be to limit or eliminate clinical signs of the disease using a treatment regimen suitable for the owner, and to avoid insulin-induced hypoglycaemia or other complications. Optimising bodyweight, feeding an appropriate diet and using a longer acting insulin preparation (eg, protamine zinc insulin, insulin glargine or insulin detemir) are all factors that are likely to result in improved glycaemic control in the majority of cats. There is also some evidence that improved glycaemic control and reversal of glucose toxicity may promote the chances of diabetic remission. Owner considerations and owner involvement are an important aspect of management. Provided adequate support is given, and owners are able to take an active role in monitoring blood glucose concentrations in the home environment, glycaemic control may be improved. Monitoring of other parameters is also vitally important in assessing the response to insulin. Insulin adjustments should always be made cautiously and not too frequently – unless hypoglycaemia is encountered. Evidence base: The Panel has produced these Guidelines after careful review of the existing literature and of the quality of the published studies. They represent a consensus view on practical management of cats with DM based on available clinical data and experience. However, in many areas, substantial data are lacking and there is a need for better studies in the future to help inform and refine recommendations for the clinical management of this common disease.