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A Case Series Analysis of Dental Extractions' Outcome in Cats with Chronic Gingivostomatitis Carrying Retroviral Disease. Animals (Basel) 2021; 11:ani11113306. [PMID: 34828037 PMCID: PMC8614259 DOI: 10.3390/ani11113306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/12/2021] [Accepted: 11/17/2021] [Indexed: 12/03/2022] Open
Abstract
Simple Summary Feline chronic gingivostomatitis (FCGS) is a chronic, painful, oral inflammatory disease, which can be associated with retroviral disease comorbidity’s, namely feline immunodeficiency virus (FIV) and feline leukaemia virus (FeLV). A total 111 case series of cats affected by this oral disease, treated with dental extractions, were analyzed retrospectively, considering if they carried or not one of these retroviral diseases. Cats with lingual ulcers, independently from their retroviral status, were 2.7 times more prone to have a worse response to dental extractions than cats without lingual ulcers. When compared with cats without retroviral disease, FeLV-positive cats presented less proliferative lesions and tended to have more lingual ulcers. Furthermore, these cats had a significantly worse outcome, with 7.5 times more chances of having no improvement. Abstract This study aims to evaluate and compare the clinical outcome after dental extractions of cats with FCGS infected with feline immunodeficiency virus (FIV) and feline leukaemia virus (FeLV). A retrospective case series included cats with diagnosis of FCGS, availability of detailed clinical records, full-mouth dental radiographs, and retroviral disease test results. Effectiveness of surgical treatment (EOT) was registered. Three groups were defined: control, FIV and FeLV. In this study, 111 cats were included: 60 controls, 29 FIV- and 22 FeLV-positive cats. When compared with control cases, FeLV-positive cats had significantly less proliferative stomatitis lesions, and they tended to have more lingual ulcers. Concurrently, FeLV-positive cats had significantly less tooth resorptive lesions. No other significant differences in FCGS clinical signs were found between groups. FeLV-positive cats had a significantly worse outcome after dental extractions compared to the other groups. In fact, FeLV-positive cats had 7.5 times more chances of having no improvement after dental extractions. This study concludes that the response to dental extractions in FeLV-positive cats is significantly worse, when comparing to cats that do not carry retroviral disease. Therefore, it is important to acknowledge the effect of FeLV status on the prognosis of these cats.
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Baka RD, Soubasis N, Oevermann A, Koutinas CK, Polizopoulou ZS. Severity of neurological signs in feline hypertensive encephalopathy may be reflected through brain histopathological lesions. VETERINARY RECORD CASE REPORTS 2021. [DOI: 10.1002/vrc2.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Rania D. Baka
- School of Veterinary Medicine Faculty of Health Sciences Aristotle University of Thessaloniki Thessaloniki Greece
| | - Nektarios Soubasis
- School of Veterinary Medicine Faculty of Health Sciences Aristotle University of Thessaloniki Thessaloniki Greece
| | - Anna Oevermann
- Department of Clinical Research and Veterinary Public Health Vetsuisse Faculty University of Bern Bern Switzerland
| | - Christos K. Koutinas
- School of Veterinary Medicine Faculty of Health Sciences Aristotle University of Thessaloniki Thessaloniki Greece
| | - Zoe S. Polizopoulou
- School of Veterinary Medicine Faculty of Health Sciences Aristotle University of Thessaloniki Thessaloniki Greece
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Pugliese M, Voslarova E, Biondi V, Passantino A. Clinical Practice Guidelines: An Opinion of the Legal Implication to Veterinary Medicine. Animals (Basel) 2019; 9:E577. [PMID: 31430919 PMCID: PMC6720978 DOI: 10.3390/ani9080577] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 08/12/2019] [Accepted: 08/14/2019] [Indexed: 12/13/2022] Open
Abstract
The strengthening of the bond between humans and animals has changed the landscape of the veterinary profession. This has, in turn, led the legal system to assess damages in veterinary malpractice and liability cases more carefully, paying attention to the possibility of using clinical practice guidelines (CPGs) to prove whether the defendant veterinarian contravened or not the standard of care. In this era of evidence-based veterinary medicine, CPGs are becoming an integral part of many aspects of veterinary practice, even if CPGs do not have the force of law and are situated halfway between ethical rules and legal requirements. Although guidelines have been used for several years, there seems to be a general lack of recognition of the medical and legal ramifications of CPGs for veterinarians. This creates ambiguity and inconsistency in the care that veterinary practitioners provide, compromises the care animals receive, and prevents the courts from assessing veterinarian competence in a systematic and rational way. On the basis of these considerations, this article discusses the legal implications of CPGs in veterinary medicine for dogs and cats and explores how the law may treat CPGs in the future. Redefining the CPGs should be a priority for veterinary profession. NOTE: The authors chose to use the terms "companion animal," "pet," and "small animal" interchangeably throughout this article, as all three are commonly in use and refer to the same animals (dogs and cats).
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Affiliation(s)
- Michela Pugliese
- Department of Veterinary Sciences, University of Messina, Polo Universitario Annunziata, 98168 Messina, Italy
| | - Eva Voslarova
- Department of Animal Protection, Welfare and Behaviour, Faculty of Veterinary Hygiene and Ecology, University of Veterinary and Pharmaceutical Sciences Brno, 612 42 Brno, Czech Republic
| | - Vito Biondi
- Department of Veterinary Sciences, University of Messina, Polo Universitario Annunziata, 98168 Messina, Italy
| | - Annamaria Passantino
- Department of Veterinary Sciences, University of Messina, Polo Universitario Annunziata, 98168 Messina, Italy.
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Colombo S, Sartori R. Ciclosporin and the cat: Current understanding and review of clinical use. J Feline Med Surg 2018; 20:244-255. [PMID: 29478396 PMCID: PMC10816290 DOI: 10.1177/1098612x17748718] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Practical relevance: Ciclosporin (CsA) is a systemic immuno-modulatory drug widely used to treat immune-mediated diseases in humans and veterinary species. CsA was registered for use in cats in the USA and Europe in 2011, and is indicated for the treatment of chronic allergic dermatitis at a recommended daily dose of 7 mg/kg PO. AUDIENCE This review will be of interest to all veterinarians working with cats, given the wide range of potential applications of CsA and its safety profile. Although the drug is currently only licensed to treat chronic allergic dermatitis in cats, a small number of reports describe its use in non-dermatological conditions. Evidence base: This article reviews the mechanism of action, pharmacokinetics, drug interactions, adverse effects and clinical use of CsA, both for the licensed indication and for off-label use in the feline patient. Information presented has been summarised from the existing literature on CsA, with specific interest in studies carried out in cats. For its licensed indication, chronic allergic dermatitis, evidence provided includes randomised, placebo or prednisolone-controlled studies (EBM grade I) and prospective or retrospective open trials.
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Affiliation(s)
- Silvia Colombo
- Servizi Dermatologici Veterinari, via Felice Musazzi 24, Legnano (MI), 1–20025, Italy
| | - Roberta Sartori
- Servizi Dermatologici Veterinari, via Felice Musazzi 24, Legnano (MI), 1–20025, Italy
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Budgeon C, Hardie RJ, McAnulty JF. A Carrel patch technique for renal transplantation in cats. Vet Surg 2017; 46:1139-1144. [DOI: 10.1111/vsu.12705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 03/31/2017] [Accepted: 04/11/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Casey Budgeon
- Department of Surgical Sciences; University of Wisconsin-Madison; Madison Wisconsin
| | - Robert J. Hardie
- Department of Surgical Sciences; University of Wisconsin-Madison; Madison Wisconsin
| | - Jonathan F. McAnulty
- Department of Surgical Sciences; University of Wisconsin-Madison; Madison Wisconsin
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Aronson LR. Update on the Current Status of Kidney Transplantation for Chronic Kidney Disease in Animals. Vet Clin North Am Small Anim Pract 2016; 46:1193-218. [DOI: 10.1016/j.cvsm.2016.06.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Brown CA, Munday JS, Mathur S, Brown SA. Hypertensive Encephalopathy in Cats with Reduced Renal Function. Vet Pathol 2016; 42:642-9. [PMID: 16145210 DOI: 10.1354/vp.42-5-642] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The clinical, hemodynamic, and pathologic features of hypertensive encephalopathy in two cats with reduced renal mass are described. The cats developed a progressive syndrome of lethargy, ataxia, blindness, stupor, and seizures following an abrupt increase in blood pressure associated with a surgical reduction in renal mass. The cats had severe gross brain edema, evidenced by cerebellar changes of caudal coning and cranial displacement over the corpora quadrigemina and cerebral changes of widening and flattening of the gyri. Histologically, interstitial edema was most pronounced in the cerebral white matter. Hypertensive vascular lesions were present as hyaline arteriolosclerosis in one cat and hyperplastic arteriolosclerosis in the other. Rare foci of parenchymal microhemorrhages and necrosis were also observed. Systemic hypertension (especially severe or rapidly developing) accompanied by neurologic signs and the pathologic findings of diffuse brain edema with cerebral arteriolosclerosis are consistent with an etiologic diagnosis of hypertensive encephalopathy.
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Affiliation(s)
- C A Brown
- Athens Diagnostic Laboratory, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA.
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Sutherland BJ, McAnulty JF, Hardie RJ. Ureteral Papilla Implantation as a Technique for Neoureterocystostomy in Cats Undergoing Renal Transplantation: 30 Cases. Vet Surg 2016; 45:443-9. [DOI: 10.1111/vsu.12476] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Revised: 06/30/2015] [Accepted: 07/01/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Brian J. Sutherland
- Department of Surgical Sciences, School of Veterinary Medicine; University of Wisconsin-Madison; Madison Wisconsin
| | - Jonathan F. McAnulty
- Department of Surgical Sciences, School of Veterinary Medicine; University of Wisconsin-Madison; Madison Wisconsin
| | - Robert J. Hardie
- Department of Surgical Sciences, School of Veterinary Medicine; University of Wisconsin-Madison; Madison Wisconsin
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Lappin MR, VanLare KA, Seewald W, Roycroft LM, Scorza AV, King S, Roberts ES. Effect of oral administration of cyclosporine on Toxoplasma gondii infection status of cats. Am J Vet Res 2015; 76:351-7. [PMID: 25815576 DOI: 10.2460/ajvr.76.4.351] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate whether anti-inflammatory doses of cyclosporine activate Toxoplasma gondii in chronically infected cats or potentiate infection in cats exposed for the first time. ANIMALS 30 T gondii-negative cats. PROCEDURES Cats were assigned to 1 of 3 groups (10 cats/group). Group 1 (control) cats were administered a placebo for 126 days; group 2 cats were administered a placebo for 84 days, followed by cyclosporine at 7.5 mg/kg/d, PO, for 42 days; and group 3 cats were administered cyclosporine at 7.5 mg/kg/d, PO, for 126 days. Cats were orally inoculated with T gondii on day 42. Results for fecal flotations, PCR assays, and histologic examinations and IgM and IgG titers were analyzed. Cyclosporine concentrations were measured on selected days. RESULTS All cats were infected by T gondii and developed signs of self-limiting gastrointestinal tract infection. Group 3 had the highest incidence and severity of CNS and pulmonary histopathologic findings typical of toxoplasmosis. One cat in group 3 died of systemic toxoplasmosis; that cat had a cyclosporine concentration of 1,690 ng/mL. Group 2 cats infected with T gondii before cyclosporine administration did not have repeated oocyst shedding. Group 3 cats shed fewer oocysts for a shorter time than did control cats of group 1. CONCLUSIONS AND CLINICAL RELEVANCE Oral administration of cyclosporine in accordance with the protocol for this study did not potentiate the enteroepithelial phase of T gondii infection. Cats with high cyclosporine blood concentrations at the time of primary T gondii infection may be at risk of developing systemic toxoplasmosis.
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Affiliation(s)
- Michael R Lappin
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523
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Nafe LA, Leach SB. Treatment of feline asthma with ciclosporin in a cat with diabetes mellitus and congestive heart failure. J Feline Med Surg 2014; 17:1073-6. [PMID: 25527351 DOI: 10.1177/1098612x14563342] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A 5-year-old domestic shorthair cat that had been previously diagnosed with diabetes mellitus was presented for episodes of coughing and respiratory distress. Diagnostic testing revealed congestive heart failure secondary to hypertrophic cardiomyopathy and concurrent asthma. All clinical signs and eosinophilic airway inflammation resolved with oral ciclosporin while the cat was concurrently receiving medications for treatment of heart failure (furosemide and enalapril). Ciclosporin should be considered for treatment of feline asthma in patients with concurrent diseases (eg, diabetes mellitus, severe heart disease) that may contraindicate use of oral glucocorticoid therapy.
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Affiliation(s)
- Laura A Nafe
- Department of Veterinary Clinical Sciences, Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, OK, USA
| | - Stacey B Leach
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA
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Yeates JW. Ethical considerations in feline renal transplantation. Vet J 2014; 202:405-7. [DOI: 10.1016/j.tvjl.2014.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Revised: 10/07/2014] [Accepted: 10/08/2014] [Indexed: 10/24/2022]
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Wormser C, Mariano A, Holmes ES, Aronson LR, Volk SW. Post-transplant malignant neoplasia associated with cyclosporine-based immunotherapy: prevalence, risk factors and survival in feline renal transplant recipients. Vet Comp Oncol 2014; 14:e126-e134. [DOI: 10.1111/vco.12120] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 09/10/2014] [Accepted: 09/11/2014] [Indexed: 01/20/2023]
Affiliation(s)
- C. Wormser
- Department of Surgery; University of Pennsylvania; Philadelphia Pennsylvania USA
| | - A. Mariano
- Department of Clinical Sciences; Tufts University; North Grafton Massachusetts USA
| | - E. S. Holmes
- Veterinary Specialty Hospital of the Carolinas; Cary North Carolina USA
| | - L. R. Aronson
- Department of Surgery; University of Pennsylvania; Philadelphia Pennsylvania USA
| | - S. W. Volk
- Department of Surgery; University of Pennsylvania; Philadelphia Pennsylvania USA
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Lommer MJ. Efficacy of Cyclosporine for Chronic, Refractory Stomatitis in Cats: A Randomized, Placebo-Controlled, Double-Blinded Clinical Study. J Vet Dent 2013; 30:8-17. [DOI: 10.1177/089875641303000101] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Sixteen cats with chronic stomatitis, that had previously undergone premolar-molar or full-mouth extractions, were randomly assigned a group to receive 2.5 mg/kg cyclosporine or placebo orally twice daily. Neither the clinician nor the clients were aware of the group assignments. Cats were evaluated prior to treatment and every 2 weeks for 6 weeks using a 30 point Stomatitis Disease Activity Index (SDAI) score. Mean improvement in SDAI scores among cats in the treatment group after 6 weeks was 52.7 %. This was significantly different from the mean improvement (12.2 %) of cats in the placebo group. During the 6 week study period, 7 of the 9 cats in the treatment group (77.8 %) showed a > 40 % improvement in SDAI score, while 1 of 7 cats in placebo group (14.3 %) showed a > 40 % improvement in SDAI score. This difference was statistically significant. Individual variability in the absorption of orally-administered cyclosporine was high. Trough whole-blood cyclosporine levels ranged from 32.1 ng/ml to 1,576.2 ng/ml. At the end of the 6 week observation period, there was a statistically significant difference among cats with trough whole-blood cyclosporine levels > 300 ng/ml (72.3 % improvement) compared with cats with cyclosporine levels < 300 ng/ml (28.2 % improvement). Whole-blood cyclosporine levels > 300 ng/ml were associated with significant improvement in oral inflammation in cats with chronic stomatitis that had previously undergone premolar-molar or full-mouth extraction.
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Affiliation(s)
- Milinda J. Lommer
- From Aggie Animal Dental Center, 487 Miller Avenue, Mill Valley, CA 94941
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Nakamura RK, Tompkins E, Bianco D. Therapeutic options for immune-mediated thrombocytopenia. J Vet Emerg Crit Care (San Antonio) 2012; 22:59-72. [DOI: 10.1111/j.1476-4431.2011.00705.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2011] [Accepted: 11/25/2011] [Indexed: 01/15/2023]
Affiliation(s)
| | | | - Domenico Bianco
- Internal Medicine Department; Veterinary Specialists of the Valley; Woodland Hills; CA; 91364
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Aronson LR, Stumhofer JS, Drobatz KJ, Hunter CA. Effect of cyclosporine, dexamethasone, and human CTLA4-Ig on production of cytokines in lymphocytes of clinically normal cats and cats undergoing renal transplantation. Am J Vet Res 2011; 72:541-9. [DOI: 10.2460/ajvr.72.4.541] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Schmiedt CW, Hurley KAE, Tong X, Rakhmanova VA, Po CL, Hurley DJ. Measurement of plasma renin concentration in cats by use of a fluorescence resonance energy transfer peptide substrate of renin. Am J Vet Res 2009; 70:1315-22. [PMID: 19878012 DOI: 10.2460/ajvr.70.11.1315] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the use of a commercially available 5-carboxyfluorescein-based, intramolecularly quenched, fluorescence resonance energy transfer (FRET) peptide substrate of renin for measurement of plasma renin concentration in cats. SAMPLE POPULATION Plasma samples obtained during a previous study of renal autograft ischemia-reperfusion injury in 10 cats and samples of fetal bovine serum containing recombinant human renin (rh-renin). PROCEDURES Experiments involving samples of fetal bovine serum containing rh-renin were conducted to identify a suitable control vehicle, optimal substrate concentration, and appropriate duration of incubation. With the use of the identified assay conditions, a standard curve was constructed to allow conversion of relative fluorescent units into values of renin concentration (ng/mL). Subsequently, plasma samples obtained from cats before and after renal autograft ischemia-reperfusion injury were assayed to determine endogenous renin concentration. RESULTS Under conditions of a 1:50 substrate dilution and 4-hour incubation period, the assay detected small amounts of rh-renin in fetal bovine serum. A linear relationship (R(2) = 0.996) between the relative fluorescent units generated and exogenous rh-renin concentration was evident. The assay detected renin in plasma samples obtained from cats after renal autograft ischemia-reperfusion, and renin concentrations on days 1 and 2 after transplant differed significantly. CONCLUSIONS AND CLINICAL RELEVANCE The study data indicated that the assay involving the FRET peptide substrate of renin is potentially a rapid and specific method for measurement of plasma renin concentration in cats.
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Affiliation(s)
- Chad W Schmiedt
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA.
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PASTER ERINR, MEHL MARGOL, KASS PHILIPH, GREGORY CLARER. Hypophosphatemia in Cats After Renal Transplantation. Vet Surg 2009; 38:983-9. [DOI: 10.1111/j.1532-950x.2009.00588.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Boyd L, Langston C, Thompson K, Zivin K, Imanishi M. Survival in Cats with Naturally Occurring Chronic Kidney Disease (2000-2002). J Vet Intern Med 2008; 22:1111-7. [DOI: 10.1111/j.1939-1676.2008.0163.x] [Citation(s) in RCA: 133] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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SCHMIEDT CHADW, DELANEY FERNA, McANULTY JONATHANF. ULTRASONOGRAPHIC DETERMINATION OF RESISTIVE INDEX AND GRAFT SIZE FOR EVALUATING CLINICAL FELINE RENAL ALLOGRAFTS. Vet Radiol Ultrasound 2008; 49:73-80. [DOI: 10.1111/j.1740-8261.2007.00321.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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KUGA K, NISHIFUJI K, IWASAKI T. Cyclosporine A Inhibits Transcription of Cytokine Genes and Decreases The Frequencies of IL-2 Producing Cells in Feline Mononuclear Cells. J Vet Med Sci 2008; 70:1011-6. [DOI: 10.1292/jvms.70.1011] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Kazufumi KUGA
- Department of Veterinary Medicine, Faculty of Agriculture, Tokyo University of Agriculture and Technology
| | - Koji NISHIFUJI
- Department of Veterinary Medicine, Faculty of Agriculture, Tokyo University of Agriculture and Technology
- Laboratory of Veterinary Internal Medicine, Division of Animal Life Sciences, Institute of Symbiotic Science and Technology, Graduate School, Tokyo University of Agriculture and Technology
| | - Toshiroh IWASAKI
- Department of Veterinary Medicine, Faculty of Agriculture, Tokyo University of Agriculture and Technology
- Laboratory of Veterinary Internal Medicine, Division of Animal Life Sciences, Institute of Symbiotic Science and Technology, Graduate School, Tokyo University of Agriculture and Technology
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Case JB, Kyles AE, Nelson RW, Aronson L, Kass PH, Klose TC, Bailiff NL, Gregory CR. Incidence of and risk factors for diabetes mellitus in cats that have undergone renal transplantation: 187 cases (1986–2005). J Am Vet Med Assoc 2007; 230:880-4. [PMID: 17362164 DOI: 10.2460/javma.230.6.880] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare incidence of diabetes mellitus in cats that had undergone renal transplantation with incidence in cats with chronic renal failure, compare mortality rates in cats that underwent renal transplantation and did or did not develop diabetes mellitus, and identify potential risk factors for development of posttransplantation diabetes mellitus (PTDM) in cats. DESIGN Retrospective case series. ANIMALS 187 cats that underwent renal transplantation. PROCEDURES Medical records were reviewed. RESULTS 26 of the 187 (13.9%) cats developed PTDM, with the incidence of PTDM being 66 cases/1,000 cat years at risk. By contrast, the incidence of diabetes mellitus among a comparison population of 178 cats with chronic renal failure that did not undergo renal transplantation was 17.9 cases/1,000 cat years at risk, and cats that underwent renal trans-plantation were 5.45 times as likely to develop diabetes mellitus as were control cats with chronic renal failure. The mortality rate among cats with PTDM was 2.38 times the rate among cats that underwent renal transplantation but did not develop PTDM. Age, sex, body weight, and percentage change in body weight were not found to be significantly associated with development of PTDM. CONCLUSIONS AND CLINICAL RELEVANCE Results suggest that cats that undergo renal transplantation have an increased risk of developing diabetes mellitus, compared with cats with chronic renal failure, and that mortality rate is higher for cats that develop PTDM than for cats that do not.
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Affiliation(s)
- Joseph B Case
- Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, CA 95616, USA
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Iwai S, Endo K, Kobayashi E. Training protocol for feline renal transplantation, using rat vascular anastomosis. Microsurgery 2006; 26:8-12. [PMID: 16444718 DOI: 10.1002/micr.20202] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Renal transplantation (RTx) has been a potential treatment for renal failure in pet cats. We developed a training protocol for the microsurgical skills required for feline RTx using rat vessels, which are the same size as the feline renal artery and vein. Using interrupted sutures, the transected abdominal aorta was reestablished in an end-to-end fashion. Venous anastomosis was performed with a continuous running suture in an end-to-side fashion between the portal vein and inferior vena cava. In the arterial anastomotic model, technical errors were checked by postoperative hemorrhaging. Those failures in the venous anastomotic model, technical errors were confirmed by the rat's death. Histological examinations of the epithelialization at the anastomotic site were evaluated in both groups. After training, nine cases of feline RTx were performed safely, using an adequate microsurgical technique.
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Affiliation(s)
- Satomi Iwai
- Endo Animal Hospital, Endo Clinical Veterinary Research Corp., Tochigi, Japan
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Chen YJ, Kyles AE, Gregory CR. In vitro evaluation of the effect of a novel immunosuppressive agent, FTY720, on the function of feline neutrophils. Am J Vet Res 2006; 67:588-92. [PMID: 16579750 DOI: 10.2460/ajvr.67.4.588] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To use in vitro assays to evaluate the effects of a novel immunosuppressive agent, FTY720, on biological functions (migration, phagocytosis, and production of reactive-oxygen species [ROS]) of feline peripheral neutrophils and determine the cytotoxic effects of FTY720 on feline peripheral neutrophils. SAMPLE POPULATION Peripheral neutrophils obtained from 8 healthy cats. PROCEDURE Peripheral neutrophils were isolated from blood samples obtained from the 8 cats and exposed to the phosphorylated form of FTY720 (FTY720-P). A fluorescence-based in vitro evaluation of migration was performed. Phagocytosis of microbes and production of ROS were evaluated by use of a 2-color flow cytometry system. Samples of whole blood obtained from the cats were incubated with various concentrations of FTY720-P, fluorescein-labeled Staphylococcus aureus, and dihydroethidium. Cytotoxic effects were evaluated by use of propidium iodide staining. RESULTS Addition of FTY720-P caused a slight non-significant decrease in phagocytosis and production of ROS by feline peripheral neutrophils. Migration activity of feline peripheral neutrophils was significantly increased by the addition of FTY720-P. Addition of FTY720-P at concentrations considered for clinical use did not increase the death rate of feline peripheral neutrophils. CONCLUSIONS AND CLINICAL RELEVANCE FTY720 does not inhibit critical functions of feline peripheral neutrophils in vitro.
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Affiliation(s)
- Yi-Je Chen
- Comparative Transplantation Laboratory, Department of Surgical and Radiological Sciences and Center for Companion Animal Health, School of Veterinary Medicine, University of California, Davis, CA 95616-8745, USA
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Iwai S, Endo K, Hakamata Y, Gregory CR, Kobayashi E. Use of nonpenetrating vascular closure staples in feline renal transplantation. Microsurgery 2006; 26:13-6. [PMID: 16444725 DOI: 10.1002/micr.20203] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Renal transplantation is a potential treatment for irreversible renal failure in pet cats. Our aim is to reduce warm ischemic time by using nonpenetrating vascular closure staples (VCS), thereby improving graft survival. Experimental cats were divided into the VCS group (n = 4; autotransplantation) or suture group (n = 6; allotransplantation). The renal artery was anastomosed with the external iliac artery in an end-to-end fashion, and the renal vein was attached to the external iliac vein in an end-to-side fashion. Warm ischemic time as well as arterial and venous anastomotic times were measured. Cats in the suture group were administrated cyclosporine and prednisolone orally after transplantation. Ischemic and anastomotic times in the VCS group were significantly reduced compared with the suture group. Two of 6 allografts had a ureteral anastomotic stricture, and 4 allografts were rejected. Histological findings of autografts showed normal structure. In conclusion, VCS staples were useful in feline renal transplantation.
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Affiliation(s)
- Satomi Iwai
- Division of Organ Replacement Research, Center for Molecular Medicine, Jichi Medical School, Tochigi, Japan
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Kadar E, Sykes JE, Kass PH, Bernsteen L, Gregory CR, Kyles AE. Evaluation of the prevalence of infections in cats after renal transplantation: 169 cases (1987-2003). J Am Vet Med Assoc 2005; 227:948-53. [PMID: 16190595 DOI: 10.2460/javma.2005.227.948] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the prevalence of infections developing postoperatively, document the contribution of infection to increased risk of death, and identify risk factors associated with the development of infectious complications in cats after renal transplantation. DESIGN Retrospective study. ANIMALS 169 cats that received renal allograft transplants. PROCEDURES Medical records of cats receiving renal transplants at the University of California from January 1987 through December 2003 were reviewed. RESULTS 47 infections developed in 43 of 169 cats. Bacterial infections were most common (25/47 cats), followed by viral (13/47), fungal (6/47), and protozoal (3/47) infections. The median duration from transplant surgery to development of infection was 2.5 months. Infection was the second most common cause of death after acute rejection of the transplant, accounting for 14% of deaths overall. Cats with concurrent diabetes mellitus had a significantly increased risk of developing an infection after renal transplantation. Sex, increasing age, concurrent neoplasia, and previous treatment for transplant rejection were not associated with development of infection. CONCLUSIONS AND CLINICAL RELEVANCE Infection was a common complication and an important cause of death or euthanasia in cats after renal transplantation. Development of diabetes mellitus after transplantation significantly increased the risk of infection.
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Affiliation(s)
- Elissa Kadar
- Veterinary Medical Teaching Hospital, University of California, Davis, CA 95616, USA
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Mehl ML, Kyles AE, Pollard R, Jackson J, Kass PH, Griffey SM, Gregory CR. Comparison of 3 techniques for ureteroneocystostomy in cats. Vet Surg 2005; 34:114-9. [PMID: 15860101 DOI: 10.1111/j.1532-950x.2005.00008.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To compare 3 techniques for ureteroneocystostomy in cats. STUDY DESIGN Experimental surgical study. ANIMALS Fifteen adult cats. METHODS Cats (15) had ureteroneocystostomy with ureteronephrectomy of the contralateral kidney: 5 cats had an intravesical mucosal apposition technique (modified Leadbetter-Politano; intravesical-MA group), 5 cats had extravesical ureteroneocystostomy (modified Lich Gregoir) using a simple continuous suture pattern (extravesical-SC group) and 5 cats had an extravesical technique using a simple interrupted suture pattern (extravesical-SI group). Renal function was evaluated by measuring serum creatinine concentration. Ultrasonographic assessment of the kidney and ureteroneocystostomy site was performed the day after surgery, twice weekly for 3 weeks and once weekly for the remainder of the study. Cats were euthanatized 50 days after surgery. The kidney and ureter removed at surgery, the remaining kidney, ureter, ureteroneocystostomy site, and bladder were examined histologically. RESULTS Two extravesical-SC cats were euthanatized because of azotemia and uroabdomen, and 1 died acutely at day 4 for unknown reasons. In the intravesical-MA and extravesical-SI cats, the serum creatinine concentration increased after surgery, peaking at a mean (+/-SD) of 9.4+/-2.4 mg/dL and 4.9+/-3.3 mg/dL on day 3, and decreasing to 3.4+/-5.7 mg/dL and 1.5+/-0.4 mg/dL on day 7, respectively. The extravesical-SI technique was associated with consistently lower serum creatinine concentrations for the first week after surgery compared with the other techniques. The mean serum creatinine concentration was within the reference range in cats in the intravesical-MA and extravesical-SI groups by days 10 and 5, respectively. Renal pelvic dilatation occurred in all cats but resolved more rapidly in cats after extravesical techniques. There was no significant difference in serum creatinine concentrations or renal pelvic dilation between the intravesical-MA and extravesical-SI techniques. Bladder mass height at the anastomosis site was significantly larger and persisted for longer with intravesical-MA technique. CONCLUSION An extravesical-SI technique is seemingly the choice for ureteroneocystostomy in cats with undilated ureters. Renal pelvic dilation on ultrasound examination should be expected after ureteroneocystostomy in cats. CLINICAL RELEVANCE An extravesical ureteroneocystostomy technique using a simple interrupted pattern for anastomosis should be considered in cats undergoing renal transplantation.
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Affiliation(s)
- Margo L Mehl
- Veterinary Medical Teaching Hospital, the Department of Surgical and Radiological Sciences, and the Comparative Pathology Laboratory, University of California-Davis, Davis, CA 95616, USA.
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Abstract
The most common cause of ureteral obstruction in dogs and cats is ureteral calculi. Common clinical signs associated with ureteral obstruction include abnormalities in urination, persistent urinary tract infection, abdominal pain, vomiting, anorexia, weight loss,and depression or lethargy. Medical management of ureteral obstruction includes fluid diuresis, muscle relaxants, and treatment of azotemia using nephrostomy tubes or hemodialysis. Surgical techniques used to restore patency to the ureter include ureterotomy,partial ureterectomy and ureteroneocystostomy, and ureteral resection and anastomosis. Lithotripsy has been used in dogs to remove ureteral calculi. Renal function can be preserved if complete ureteral obstruction is relieved within several days of onset.
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Affiliation(s)
- Elizabeth M Hardie
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 4700 Hillsborough Street, Raleigh, NC 27606, USA.
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Bernsteen L, Gregory CR, Kyles AE, Griffey SM, Patz J. Microemulsified cyclosporine-based immunosuppression for the prevention of acute renal allograft rejection in unrelated dogs: preliminary experimental study. Vet Surg 2003; 32:213-9. [PMID: 12784197 DOI: 10.1053/jvet.2003.50027] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES To determine whether the microemulsified formulation of cyclosporine (MCsA; Neoral; Novartis A.G.), combined with azathioprine (Imuran; Glaxo Wellcome), and prednisolone (Delta-Cortef; Upjohn), would be effective in preventing acute renal allograft rejection in unrelated mongrel dogs. To document any toxic effects associated with this drug combination. STUDY DESIGN rospective, pilot study. ANIMALS Four healthy, adult, mongrel, canine renal allograft recipients. METHODS Heterotopic renal transplantation, with bilateral nephrectomy, was performed in 4 dogs. Allografts were harvested from 2 unrelated dogs that were to be euthanatized for reasons unrelated to this study. The dogs were treated for 100 days or until signs of illness or allograft rejection required euthanasia. Microemulsified cyclosporine (20 mg/kg/day), azathioprine (5 mg/kg every other day), and prednisolone (1 mg/kg/day) were administered for the prevention of acute rejection. Body weight, serum biochemistry profiles, complete blood counts, and trough whole-blood cyclosporine concentrations were measured throughout the study. Cyclosporine dose was adjusted to maintain a trough concentration of 400-500 ng/mL. Azathioprine dose was decreased if evidence of hepatotoxicity developed or if the total blood white cell count was <4,000 cells/micro L. The prednisolone was tapered by 0.25 mg/kg increments every 3 weeks and discontinued 14 days before the end of the study in the surviving dogs. Complications were recorded. A complete necropsy and histopathologic examination were performed in each recipient. RESULTS Two of the 4 dogs survived the 100-day period. One dog was euthanatized at 8 days because of an intestinal intussusception. One dog was euthanatized at 64 days because of a severe upper respiratory infection. At the time of death, these 2 dogs had plasma creatinine concentrations of 1.5 and 2.6 mg/dL, respectively, with no histopathologic evidence of allograft rejection. All dogs had transient weight loss (range, 4.6%-17.7% of preoperative body weight) between days 7 and 14. Two dogs had evidence of hepatotoxicity. The 2 dogs surviving to 100 days had normal serum creatinine concentrations and no clinical signs of rejection. One of these dogs had evidence of a grade IIa acute/active rejection based on the modified BANFF 97 histopathologic classification. The second dog had no evidence of rejection or inflammation within the allograft. CONCLUSIONS This preliminary experimental study shows that immunosuppression using MCsA, combined with azathioprine and prednisolone, may be effective in preventing acute renal allograft rejection in unrelated mongrel dogs for 100 days. Complications included ileocolic intussusception, upper respiratory infection, weight loss, and transient hepatotoxicity. CLINICAL RELEVANCE Immunosuppression using MCsA, azathioprine, and prednisolone may be effective in preventing acute renal allograft rejection in unrelated, mongrel dogs. This triple drug protocol is cost-effective and was easy to administer. Further investigation is warranted to minimize toxic effects and to determine the efficacy of prophylactic renal biopsies to detect and treat subclinical acute/active rejection.
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Affiliation(s)
- Lynda Bernsteen
- Comparative Transplantation Laboratory, Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616, USA
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Adin CA. Screening criteria for feline renal transplant recipients and donors. CLINICAL TECHNIQUES IN SMALL ANIMAL PRACTICE 2002; 17:184-9. [PMID: 12587285 DOI: 10.1053/svms.2002.36608] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Renal transplantation is associated with several potential complications. Early selection and appropriate screening of candidates has reduced the morbidity and mortality associated with this procedure in human beings. In veterinary medicine, the important process of identification and screening of candidates for renal transplantation occurs primarily in private general or specialty practice. This article reviews guidelines for screening of candidates for renal transplantation and related publications in both veterinary and human literature in an attempt to provide comprehensive information to practitioners involved in the selection process. It is anticipated that early referral of stable cats for renal transplantation will further improve the likelihood of a successful outcome.
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Affiliation(s)
- Christopher A Adin
- University of Florida, Department of Small Animal Clinical Sciences, College of Veterinary Medicine, P.O. Box 100126, Gainesville, FL 32610-0126, USA
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