Transient hyperlipidaemia and anaemia in kittens

Therapy for feline secondary hypertriglyceridemia with fenofibrate

OBJECTIVES

The aim of this study was to assess the short-term safety and efficacy of fenofibrate in controlling secondary hypertriglyceridemia in cats.

METHODS

This was a prospective cohort study. Seventeen adult cats with hypertriglyceridemia (serum triglycerides [TG] >160 mg/dl) were enrolled. Cats received a median dose of 5 mg/kg (range 3.2-6) fenofibrate (q24h PO) for 1 month. Serum TG, total cholesterol (TC), creatine kinase and liver enzymes (alanine aminotransferase, aspartate aminotransferase and alkaline phosphatase) were evaluated before (t0) and after 1 month (t1) of fenofibrate treatment.

RESULTS

The causes of secondary hypertriglyceridemia were diabetes mellitus (DM; 29.4%), obesity (29.4%), hyperadrenocorticism (HAC) and DM (11.7%), HAC without DM (5.9%), hypersomatotropism (HST) and DM (5.9%), hypothyroidism (5.9%), long-term treatment with glucocorticoids (5.9%) and chylothorax (5.9%). Serum TG (t0 median 920 mg/dl [range 237-1780]; t1 median 51 mg/dl [range 21-1001]; P = 0.0002) and TC (t0 median 278 mg/dl [range 103-502]; t1 median 156 mg/dl [range 66-244]; P = 0.0001) concentrations showed a significant decrease after 1 month of fenofibrate treatment. Fifteen cats normalized their TG concentration at t1 (88.2%). Of the eight cats that were hypercholesterolemic at t0, six (75%) normalized their TC concentrations at t1. One of 17 cats (5.9 %) presented with diarrhea; the remaining 16 did not show any adverse effects.

CONCLUSIONS AND RELEVANCE

DM and obesity are the most common endocrine causes of secondary hyperlipidemia, although it can also be found in cats with HAC, HST or hypothyroidism. This study suggests that fenofibrate treatment was associated with reduction and normalization of TG and TC concentrations in cats with moderate and severe hypertriglyceridemia, regardless of the cause of secondary hypertriglyceridemia. Further work should focus on controlled studies with a greater number of cases.

Hypertriglyceridemia Acute Pancreatitis: Animal Experiment Research

In recent years, the number of acute pancreatitis cases caused by hypertriglyceridemia has increased gradually, which has caught the attention of the medical community. However, because the exact mechanism of hypertriglyceridemic acute pancreatitis (HTG-AP) is not clear, treatment and prevention in clinical practice face enormous challenges. Animal models are useful for elucidating the pathogenesis of diseases and developing and testing novel interventions. Therefore, animal experiments have become the key research means for us to understand and treat this disease. We searched almost all HTG-AP animal models by collecting many studies and finally collated common animals such as rats, mice and included some rare animals that are not commonly used, summarizing the methods to model spontaneous pancreatitis and induce pancreatitis. We sorted them on the basis of three aspects, including the selection of different animals, analyzed the characteristics of different animals, different approaches to establish hypertriglyceridemic pancreatitis and their relative advantages and disadvantages, and introduced the applications of these models in studies of pathogenesis and drug therapy. We hope this review can provide relevant comparisons and analyses for researchers who intend to carry out animal experiments and will help researchers to select and establish more suitable animal experimental models according to their own experimental design.

Nitric oxide show its survival role by NO-PKC pathway through cGMP-dependent or independent on the culture of cerebella granular neurons

The role of nitric oxide in the development of neurons is conflicting. In the present work, cerebellar granule neurons (CGNs) were used as a model to assess the survival role of nitric oxide and to find novel signal transduction pathways related to this role. It is reported that sustained inhibition of nitric oxide production induces apoptosis in differentiated cerebellar granule neurons. The antagonist (MK-801, or ODQ)-induced decrease of cell viability, caspase-3 activated, the expression of P-PKC decreased, which were normalized by the provision of the sodium nitroprusside, an NO donor. The data show that blockade of NO production induces apoptotic death in differentiating CGC through activation of caspase-3. This study provides direct evidence that NO plays an active role in sustaining the survival of developing CGNs and that NO-PKC pathway is important for the survival of CGNs in vitro. The endogenous NO exerts its effects in cGMP-dependent manner while the exogenous NO in cGMP-independent manner.

Transient hyperlipidemia in a litter of kittens

OBJECTIVE

To describe an entire litter of kittens with severe hyperlipidemia and subsequent successful, low-cost treatment that included high protein enteral support and parasite control. Previous case studies of similarly affected kittens have focused on a genetic etiology and on advanced interventions. The role of negative energy balance and additional factors influencing hyperlipidemia, as well as treatment and prognosis are discussed.

CASE SUMMARY

Three of 6 kittens died or were euthanized due to severe clinical signs attributable to multiorgan failure associated with subacute hyperlipidemia. The remaining 3 kittens, although subclinical, were found to have similar biochemical abnormalities, including severe anemia and hypertriglyceridemia. Flea treatment and weaning with assisted enteral support prevented the worsening of clinical signs and returned biochemical parameters to within reference intervals.

UNIQUE INFORMATION PROVIDED

Transient hyperlipidemia in kittens has been previously reported and successfully treated with administration of oxygen, blood transfusion, and diet change; these treatment recommendations may not always be financially feasible, resulting in euthanasia of affected kittens. In contrast, this report describes a successful, low-cost, outpatient approach of flea control, weaning, and introduction of a high protein enteral diet. It also highlights the importance of screening and treating seemingly unaffected littermates, provides new, previously unreported biochemical and histopathology findings, and proposes that negative energy balance is a significant factor in the development of transient hyperlipidemia in kittens.

Triglyceride response following an oral fat tolerance test in Burmese cats, other pedigree cats and domestic crossbred cats

Primary lipid disorders causing fasting triglyceridaemia have been documented infrequently in Burmese cats. Due to the known increased risk of diabetes mellitus and sporadic reports of lipid aqueous in this breed, the aim of this study was to determine whether healthy Burmese cats displayed a more pronounced pre- or post-prandial triglyceridaemia compared to other cats. Serum triglyceride (TG) concentrations were determined at baseline and variably at 2, 4 and 6h after ingestion of a high-fat meal (ie, an oral fat tolerance test) in a representative sample of Burmese and non-Burmese cats. The median 4 and 6h serum TG concentrations were significantly higher in Burmese cats (4h - 2.8mmol/l; 6h - 8.2mmol/l) than in other pedigree and domestic crossbred cats (4h - 1.5mmol/l; 6h - 1.0mmol/l). The non-Burmese group had post-prandial TG concentrations ranging from 0.6 to 3.9mmol/l. Seven Burmese cats had post-prandial TG concentrations between 6.6 and 19.0mmol/l, five had concentrations between 4.2 and 4.7mmol/l, while the remaining 15 had post-prandial concentrations between 0.5 and 2.8mmol/l. None of these Burmese cats had fasting triglyceridaemia. Most Burmese cats with a 4 h TG > 6.0 mmol/l had elevated fasting very low density lipoprotein (VLDL) concentrations. This study demonstrates that a proportion of Burmese cats in Australia have delayed TG clearance compared to other cats. The potential repercussions of this observation with reference to lipid aqueous, pancreatitis and diabetes mellitus in Burmese cats are discussed.

Ocular lipid deposition and hyperlipoproteinaemia

In all species there are potential ocular manifestations when circulating lipoproteins are raised and these may be transient or permanent Many factors, both systemic and local, influence lipid influx and accumulation (progression) and lipid mobilisation and efflux (regression). In both humans and animals some types of lipid deposition will regress if the local and systemic factors involved in pathogenesis can be modified. There are inescapable parallels with the same phenomena in other tissues.Three types of corneal lipid deposition have been linked with hyperlipoproteinaemia. In corneal arcus, lipid is deposited preferentially in the warmest part of the cornea initially and, in people, the lipid remains almost exclusively extracellular. In animals, corneal arcus is associated with initial extracellular lipid deposition followed by the appearance of intracellular lipid and vascularisation, so that established corneal arcus tends to become more typical of lipid keratopathy. In humans, hyperlipoproteinaemia may be an associated systemic factor and early onset corneal arcus is a recognised feature of certain primary hyperlipoproteinaemias and their secondary phenotypes. In dogs, corneal arcus is always associated with hyperlipoproteinaemia. Corneal vascularisation is a ubiquitous feature of lipid keratopathy in all species and both necrotic fibroblasts and foam cells are common in progressive lesions. The extent and position of lipid deposition and the evolution of lipid keratopathy can be related to local ocular disease and circulating lipids and lipoproteins. Many aspects of the pathogenesis of lipid keratopathy are similar to those of atherogenesis. Hyperlipoproteinaemia, especially hypercholesterolaemia is the commonest systemic abnormality. In crystalline stromal dystrophy (Schnyder's crystalline stromal dystrophy) of the cornea there is no inflammatory element and no vascularisation. The dystrophy is associated with accumulation of lipid within the corneal fibroblasts, but typical foam cells are absent, the crystalline opacity involves the coolest part of the cornea, correlates with local fibroblast death, and is always bilateral. Hyperlipoproteinaemia, may be present, but this is not universally so.The objective of this paper is to evaluate the factors that may influence ocular involvement in hyperlipoproteinaemia. A comparative approach, utilising information available from studies of both ocular and non-ocular tissues, aids elucidation of the complex pathogenesis.

Influence of age and sex on plasma lipid and lipoprotein concentrations and associated enzyme activities in cats

OBJECTIVE

To determine effects of age and sex on plasma lipid and lipoprotein metabolism in cats.

ANIMALS

33 kittens and 16 adolescent, 23 adult, and 10 senior cats.

PROCEDURE

Plasma concentrations of cholesterol, triglyceride, and lipoprotein-cholesterol and activities of lipoprotein lipase, hepatic lipase, and lecithin:cholesterol acyl transferase (LCAT) were measured and compared within and among groups.

RESULTS

Plasma cholesterol and triglyceride concentrations were significantly higher in 5- and 7-week-old kittens, compared with the same kittens after weaning and cats in the other age groups. Cholesterol concentration was significantly less in 20-week-old kittens, compared with adolescent and adult cats. Lipid and lipoprotein-cholesterol concentrations were not significantly different among the adolescent, adult, and senior groups, nor did sex influence lipid and lipoprotein-cholesterol concentrations in these groups. Activities of lipoprotein and hepatic lipases were significantly less in senior cats, compared with the other groups. Activity of LCAT was highest in 20-week-old kittens and was greater in sexually intact adult and adolescent females, compared with their male counterparts. After castration, activities of hepatic lipase and LCAT significantly decreased in adolescent male cats.

CONCLUSIONS AND CLINICAL RELEVANCE

The upper limits of reference ranges for plasma cholesterol and triglyceride concentrations should be increased for kittens < 8 weeks of age. Low cholesterol concentrations in adolescent cats likely reflect high tissue demands for growth and steroidogenesis. Decrease in lipoprotein and hepatic lipase activity in senior cats could predispose this age group to hypertriglyceridemia, particularly in insulin-resistant cats or those fed a high fat diet.