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Besson J, Brissot H, Azoulay F, Benzimra P, Fritz J. Spontaneous cecal perforation in a cat diagnosed with ultrasonography. Vet Radiol Ultrasound 2024; 65:275-278. [PMID: 38459956 DOI: 10.1111/vru.13355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 02/17/2024] [Accepted: 02/22/2024] [Indexed: 03/11/2024] Open
Abstract
An 8-year-old cat was presented for an acute history of anorexia, marked abdominal pain, and hyperthermia. Ultrasonography showed a cecal perforation with focal steatitis and adjacent free gas bubbles, consistent with focal peritonitis. Surgery confirmed the imaging findings. An enterectomy was performed with the removal of the cecum and ileocolic valve, and anastomosis between the ileum and colon was performed. Histology revealed transmural enteritis and chronic severe pyogranulomatous peritonitis with intralesional plant fragments.
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Affiliation(s)
- Julie Besson
- Department of Imaging, Azurvet Veterinary Specialists Centre, Saint-Laurent-du-Var, France
| | - Hervé Brissot
- Department of Soft Tissue Surgery, Azurvet Veterinary Specialists Centre, Saint-Laurent-du-Var, France
| | - Florian Azoulay
- Department of Imaging, Azurvet Veterinary Specialists Centre, Saint-Laurent-du-Var, France
| | | | - Julien Fritz
- Department of Imaging, Azurvet Veterinary Specialists Centre, Saint-Laurent-du-Var, France
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2
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Taylor S, Gruen M, KuKanich K, X Lascelles BD, Monteiro BP, Sampietro LR, Robertson S, Steagall PV. 2024 ISFM and AAFP consensus guidelines on the long-term use of NSAIDs in cats. J Feline Med Surg 2024; 26:1098612X241241951. [PMID: 38587872 DOI: 10.1177/1098612x241241951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
PRACTICAL RELEVANCE Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used and are effective for the management of pain in cats. These Guidelines will support veterinarians in decision-making around prescribing NSAIDs in situations of chronic pain, to minimise adverse effects and optimise pain management. Information is provided on mechanism of action, indications for use, screening prior to prescription, use in the presence of comorbidities, monitoring of efficacy, and avoidance and management of adverse effects. CLINICAL CHALLENGES The cat's unique metabolism should be considered when prescribing any medications, including NSAIDs. Chronic pain may be challenging to detect in this species and comorbidities, particularly chronic kidney disease, are common in senior cats. Management of chronic pain may be complicated by prescription of other drugs with the potential for interactions with NSAIDs. EVIDENCE BASE These Guidelines have been created by a panel of experts brought together by the International Society of Feline Medicine (ISFM) and American Association of Feline Practitioners (AAFP). Information is based on the available literature, expert opinion and the panel members' experience.
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Affiliation(s)
- Samantha Taylor
- Panel ChairInternational Society of Feline Medicine, International Cat Care, Tisbury, Wi Itshire, UK
| | - Margaret Gruen
- Comparative Pain Research Laboratory; and Behavioural Medicine Service - Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, NC, USA
| | - Kate KuKanich
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, KS, USA
| | - B Duncan X Lascelles
- Translational Research in Pain (TRiP) Program and Comparative Pain Research and Education Centre (CPREC), North Carolina State University, NC, USA
| | - Beatriz P Monteiro
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Universite de Montreal, Saint-Hyacinthe, QC, Canada
| | | | - Sheilah Robertson
- Lap of Love Veterinary Hospice, Lutz, FL, USA; and Courtesy Lecturer, Shelter Medicine Program, University of Florida, FL, USA
| | - Paulo V Steagall
- Department of Veterinary Clinical Sciences and Centre for Animal Health and Welfare, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, SAR China; and Department of Clinical Sciences, Faculty of Veterinary Medicine, Universite de Montreal, Saint-Hyacinthe, QC, Canada
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3
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Angelou V, Fiska A, Tsingotjidou A, Patsikas M, Papazoglou LG. Surgical Anatomy of the Gastrointestinal Tract in Cats. Animals (Basel) 2023; 13:2670. [PMID: 37627461 PMCID: PMC10451872 DOI: 10.3390/ani13162670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/14/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023] Open
Abstract
In cats, the gastrointestinal tract is one of the regions in which surgical procedures are most frequently performed by veterinary surgeons; therefore, knowledge of the surgical anatomy of the feline gastrointestinal tract is of high importance. The main surgical procedures performed include gastrotomy, gastrectomy, enterotomy, and enterectomy, as well as procedures in the liver and pancreas. There are also anatomical differences between dogs and cats, increasing the need for deep knowledge of the anatomy treated in the different surgical approaches. The aim of the present review is to describe in detail the anatomy of the gastrointestinal tract in cats highlighting the anatomical regions of significant importance in different surgical procedures.
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Affiliation(s)
- Vasileia Angelou
- Unit of Surgery and Obstetrics, Companion Animal Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54627 Thessaloniki, Greece; (V.A.); (L.G.P.)
| | - Aliki Fiska
- Department of Anatomy, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece;
| | - Anastasia Tsingotjidou
- Laboratory of Anatomy, Histology and Embryology, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54627 Thessaloniki, Greece;
| | - Michael Patsikas
- Laboratory of Diagnostic Imaging, Department of Clinical Studies, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54627 Thessaloniki, Greece
| | - Lysimachos G. Papazoglou
- Unit of Surgery and Obstetrics, Companion Animal Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54627 Thessaloniki, Greece; (V.A.); (L.G.P.)
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Pavone G, Castellucci B, Pavone S, Stefanetti V, Vitolo C, Mangiaterra S. Unusual Case of Biliary Peritonitis in a Dog Secondary to a Gastric Perforation. Vet Sci 2023; 10:384. [PMID: 37368770 DOI: 10.3390/vetsci10060384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/25/2023] [Accepted: 05/31/2023] [Indexed: 06/29/2023] Open
Abstract
Biliary peritonitis is a pathological condition representing a medical emergency with a high risk of mortality. This condition is reported in both human and veterinary medicine following biliary tract rupture, extrahepatic biliary obstructions, gallbladder rupture, trauma, or duodenal perforation. In this report, the first-ever case of biliary peritonitis due to gastric perforation in a Bobtail purebred dog is described, which was probably induced by the administration of nonsteroidal anti-inflammatory drugs (NSAIDs). After an elective splenectomy and castration, the dog was referred to our hospital for medical management for inappetence, mental depression, and multiple episodes of gastric vomits with traces of blood. Clinical diagnostic tests showed the presence of biliary peritonitis. Due to worsening clinical conditions, the patient was subjected to euthanasia. Macroscopic examination showed a free brownish abdominal effusion and the presence of perforating ulcer of the stomach pylorus region.
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Affiliation(s)
- Giovanni Pavone
- Futuravet Veterinary Referral Center, 62029 Tolentino, Italy
| | | | - Silvia Pavone
- Istituto Zooprofilattico Sperimentale dell'Umbria e delle Marche 'Togo Rosati', Via G. Salvemini, 1, 06126 Perugia, Italy
| | | | - Chiara Vitolo
- Futuravet Veterinary Referral Center, 62029 Tolentino, Italy
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Bottero E, Pierini A, Ruggiero P, Cattaneo D, Campanile A, Benvenuti E. Gastroduodenal ulceration detected endoscopically in cats: retrospective study of 61 patients. J Feline Med Surg 2022; 24:e347-e352. [PMID: 35848606 PMCID: PMC10812314 DOI: 10.1177/1098612x221109802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The aim of this study was to describe the endoscopic appearance of gastroduodenal ulcers (GDUs), and to assess the clinical, ultrasonographic and histological data, as well as long-term follow-up, in cats. METHODS The medical record databases of five veterinary endoscopists were evaluated between January 2016 and 2020, in a retrospective study. Cats with at least one gastric or duodenal ulcer detected by endoscopic examination were included. All the medical records of the selected cats were reviewed and information was collected regarding breed, age, sex, neuter status, medical history, clinical signs, and ultrasonographic, endoscopic and histological findings. The cats were evaluated at 6, 12 and 18 months. RESULTS Sixty-one cats with a median age of 9.0 years (range 2.0-16.0) were included in the study. The most common complaints were vomiting (n = 55; 90%) and hyporexia (n = 40; 66%); haematemesis was reported in 12 (20%) cats. Endoscopy showed GDUs in the following locations: gastric body in 28 cats (46%), antropyloric area in 34 cats (56%), fundus in 13 cats (21%) and duodenum in eight cats (13%). A single GDU was found in 42 cats (69%) and multiple GDUs were seen in 19 cats (31%). Histopathological evaluation revealed benign lesions in 33 (54%) cats and malignant lesions in 28 (46%; 24 high-grade lymphoma, one low-grade lymphoma and three carcinoma). High-grade lymphoma was detected only in the stomach. Cats diagnosed with malignant GDUs (median 10.5, range 4-16) were significantly older than cats with benign lesions (P = 0.002). CONCLUSIONS AND RELEVANCE GDUs are common and were detected in 5.1% of cats undergoing an upper gastrointestinal endoscopy. The risk of a malignant ulcer increases proportionally with each year of increasing age. GDU location, number and morphological appearance do not provide any indication of the nature of the ulcer; however, duodenal ulcers are frequently benign. Endoscopic examination facilitates the early and minimally invasive detection of GDUs in cats.
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Affiliation(s)
| | - Alessio Pierini
- Pisani Carli Chiodo Veterinary Centre, Luni Mare, La Spezia, Italy
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Novel Multicentric Hepatic Lymphoma with Extrahepatic Biliary Obstruction Associated with Duodenal Perforation in a Cat. Case Rep Vet Med 2021; 2021:5808886. [PMID: 34925932 PMCID: PMC8677407 DOI: 10.1155/2021/5808886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 11/06/2021] [Indexed: 11/18/2022] Open
Abstract
An 11-year-old male castrated domestic shorthair cat was presented for evaluation due to clinical deterioration and potential extrahepatic biliary obstruction (EHBO). Further investigations confirmed EHBO and revealed severe and previously unreported comorbidities. On initial examination, the cat was markedly icteric with a poor body condition score and severe muscle wasting. Serum chemistry and complete blood count showed evidence of cholestasis and anemia. Primary diagnostics and therapeutics targeted these abnormalities. Abdominal ultrasound revealed peritoneal effusion, multifocal mixed echogenic hepatic and splenic foci, small intestinal thickening, cholelithiasis, choledocholithiasis, and common bile duct and pancreatic duct dilation with evidence of obstruction. Peritoneal effusion cytology confirmed septic peritonitis. Hepatic and splenic cytology was consistent with lymphoma. Based on these results, euthanasia was elected by the owners of the animal. Necropsy confirmed the ultrasound diagnoses, septic peritoneal effusion associated with a duodenal perforation, multiorgan lymphoma, and common bile duct carcinoma. Flow cytometry classified the lymphoma as a double-negative phenotype of T-cell lymphoma (CD3+ and CD5+, but CD4- and CD8-) present in the duodenum and liver and suspected in the spleen which has previously not been reported in cats. This case report documents a cat with EHBO caused by multiple disease processes including a novel T-cell lymphoma phenotype, biliary carcinoma, duodenal perforation and septic abdomen, and choleliths, as well as inflammatory hepatobiliary disease.
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Barandun MA, Mullins RA, Rytz U. Billroth II procedure for the treatment of spontaneous gastrointestinal perforation in two cats. J Am Vet Med Assoc 2021; 259:1325-1331. [PMID: 34727055 DOI: 10.2460/javma.20.04.0241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
CASE DESCRIPTION A 9-year-old castrated male domestic shorthair cat (cat 1) and a 10-year-old castrated male Maine Coon cat (cat 2) were presented for recurrent feline lower urinary tract disease after receiving outpatient care from their primary veterinarians. CLINICAL FINDINGS Physical examination findings for both cats were initially within reference limits. After a short period of hospitalization, both cats developed peritoneal effusion; results of cytologic analysis of a sample of the fluid were consistent with septic peritonitis. During exploratory laparotomy, perforation of the pylorus or proximal portion of the duodenum secondary to ulceration was identified. TREATMENT AND OUTCOME Both cats underwent partial duodenectomy, partial gastrectomy (pylorectomy), and gastrojejunostomy (Billroth II procedure). The cats recovered from surgery and returned to a normal quality of life; however, each had mild episodes of anorexia but maintained a stable body weight. Cat 2 required additional surgery for trichobezoar removal 7 weeks later but recovered quickly. At 7 months after trichobezoar removal, cat 2 developed intermittent vomiting, but clinicopathologic, abdominal ultrasonographic, and upper gastrointestinal tract endoscopic findings were within reference limits. At 9 (cat 2) and 13 (cat 1) months after the Billroth II procedure, both cats were reported to be in good general health and without gastrointestinal signs. CLINICAL RELEVANCE In both cats, the Billroth II procedure was technically straightforward and associated with a full recovery and good medium- to long-term quality of life. A Billroth II procedure could be considered for treatment of cats with large mural lesions in the pyloroduodenal region.
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8
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Cook S, Greensmith T. Supporting the intoxicated patient: toxicants affecting the gastrointestinal and hepatobiliary systems. IN PRACTICE 2020. [DOI: 10.1136/inp.m3152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Chumbler NS, Schildt JC, Mawby DI, Papich MG. Use of intravenous lipid therapy in a cat with carprofen overdose. Clin Case Rep 2020; 8:653-657. [PMID: 32274029 PMCID: PMC7141744 DOI: 10.1002/ccr3.2772] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 12/08/2019] [Accepted: 12/18/2019] [Indexed: 11/06/2022] Open
Abstract
Intravenous lipid emulsion (ILE) was administered to a cat with no adverse effects. This case report postulates that ILE can be used for the treatment of carprofen toxicity in cats and supports the lipid sink theory as the main mechanism of action.
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Affiliation(s)
- Nathan S Chumbler
- University of Tennessee College of Veterinary Medicine Knoxville TN USA
| | - Julie C Schildt
- University of Tennessee College of Veterinary Medicine Knoxville TN USA
| | - Diane I Mawby
- University of Tennessee College of Veterinary Medicine Knoxville TN USA
| | - Mark G Papich
- North Carolina State University College of Veterinary Medicine Raleigh NC USA
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Mate de Haro L, Moreno‐Aguado B, Martí J, Kelly D. Spontaneous gastric rupture presenting as severe pneumoperitoneum in a cat with presumed idiopathic gastric ulceration. VETERINARY RECORD CASE REPORTS 2020. [DOI: 10.1136/vetreccr-2019-001049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Luis Mate de Haro
- Medicine ServiceSouthern Counties Veterinary SpecialistsRingwoodHampshireUK
| | | | - Juan Martí
- Department of SurgerySouthern Counties Veterinary SpecialistsRingwoodHampshireUK
| | - Darren Kelly
- Medicine ServiceSouthern Counties Veterinary SpecialistsRingwoodHampshireUK
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11
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Murrell J. Perioperative use of non‐steroidal anti‐inflammatory drugs in cats and dogs. IN PRACTICE 2018. [DOI: 10.1136/inp.k3545] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Yi EM, Leech E. Topical flurbiprofen toxicosis in a cat. J Vet Emerg Crit Care (San Antonio) 2017; 27:707-712. [DOI: 10.1111/vec.12638] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 11/26/2015] [Accepted: 12/29/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Elizabeth M. Yi
- VCA Emergency Animal Hospital and Referral Center; San Diego CA 92108
| | - Elizabeth Leech
- VCA Emergency Animal Hospital and Referral Center; San Diego CA 92108
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Daure E, Ross L, Webster CRL. Gastroduodenal Ulceration in Small Animals: Part 1. Pathophysiology and Epidemiology. J Am Anim Hosp Assoc 2017; 53:1-10. [DOI: 10.5326/jaaha-ms-6635] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
ABSTRACT
Gastroduodenal ulceration in small animals is a complex and important comorbidity that occurs when the physiological homeostasis of the gastrointestinal tract is disrupted secondary to administration of medications or the presence of local or systemic diseases. The aim of this article is to provide a comprehensive review of the veterinary literature regarding the pathophysiology, epidemiology, and risk factors associated with gastroduodenal ulceration in small animals. Pertinent concepts from the human literature will be integrated into the discussion. This article serves as an introduction to the second part of this series, which will review current evidence regarding the use of H2-receptor antagonists and proton pump inhibitors in small animals.
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Affiliation(s)
- Evence Daure
- From the Centre Vétérinaire Daubigny, Quebec, Canada (E.D.); and the Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts (L.R., C.R.L.W.)
| | - Linda Ross
- From the Centre Vétérinaire Daubigny, Quebec, Canada (E.D.); and the Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts (L.R., C.R.L.W.)
| | - Cynthia R. L. Webster
- From the Centre Vétérinaire Daubigny, Quebec, Canada (E.D.); and the Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts (L.R., C.R.L.W.)
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Robertson SA, Taylor PM. Pain management in cats—past, present and future. Part 2. Treatment of pain—clinical pharmacology. J Feline Med Surg 2016; 6:321-33. [PMID: 15363764 DOI: 10.1016/j.jfms.2003.10.002] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 10/13/2003] [Accepted: 10/20/2003] [Indexed: 10/26/2022]
Abstract
Opioids have an unjustified reputation for causing mania in cats, but with refinements in dosing they are now used successfully in this species. The mu-opioid agonists are generally considered the best analgesics. Morphine (0.1–0.3 mg/kg) is effective in a clinical setting. Methadone (up to 0.5 mg/kg) has a similar profile to morphine. Pethidine (Demerol, meperidine; 2–5 mg/kg) is a useful analgesic with a faster onset but shorter duration of action than morphine. Oxymorphone and hydromorphone (0.05–0.1 mg/kg) are widely used in the USA. These opioids are more potent (up to 10 times), and longer acting than morphine in cats. Butorphanol (0.1–0.4 mg/kg) is a mu-opioid antagonist that produces its analgesic actions through kappa agonist activity. It rapidly reaches a ceiling effect, is short acting and is a weaker analgesic than pure mu opioids. Buprenorphine (0.01–0.02 mg/kg), a partial mu-agonist, is the most popular opioid used in small animal practice in the UK, other parts of Europe, Australia and South Africa. In clinical studies it has produced better analgesia than several other opioids and appears to be highly suitable for perioperative pain management in cats. NSAIDs are also used in cats for pain management, although cats metabolise these differently from other species. With appropriate dosing, carprofen (1–4 mg/kg) and meloxicam (0.3 mg/kg) have proved highly effective with few side effects. The use of ketoprofen (2 mg/kg), tolfenamic acid (4 mg/kg) and vedaprofen (0.5 mg/kg) has been reported in cats. Other less traditional analgesics such as ketamine, medetomidine and local anaesthetics are also used for clinical pain management. The transmucosal, transdermal and epidural routes offer novel methods for administration of analgesic drugs and have considerable potential for improving techniques in feline pain management.
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Affiliation(s)
- S A Robertson
- Department of Large Animal Clinical Sciences, University of Florida, Gainesville, FL, USA
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Bernardin F, Martinez Rivera L, Ragetly G, Gomes E, Hernandez J. Spontaneous gastrointestinal perforation in cats: a retrospective study of 13 cases. J Feline Med Surg 2014; 17:873-9. [DOI: 10.1177/1098612x14558894] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives The aim of this study was to describe the clinical characteristics and the frequency of malignant vs non-malignant causes for spontaneous gastrointestinal perforation in cats. Methods The medical records of cats diagnosed as having gastrointestinal perforation between August 2010 and July 2013 were reviewed. Diagnosis was confirmed by exploratory surgery. Patients with incomplete records, perforation due to external trauma, leakage at previous enterotomy or anastomotic sites, or foreign bodies were excluded. Each record was examined for different information pertaining to signalment, medical history, clinical and clinicopathological data, imaging findings, abdominal fluid examination, surgical findings, histopathological examination, treatment received after surgery and outcome. Results Thirteen cats were included. Five of these cats had concurrent illnesses, including viral upper respiratory tract disease, pancreatitis and chronic kidney disease. Two cats had previously received non-steroidal anti-inflammatory drugs and four had received corticosteroids. Clinical signs and clinicopathological abnormalities were not specific. Six of 13 patients were diagnosed during surgery with gastric perforations, four patients with duodenal perforations and three patients with jejunal perforations. Histopathological examination of the ulcerated wall was performed in 11/13 cats. Alimentary lymphoma was diagnosed in six cats. Non-neoplastic lesions (lymphocytic– plasmacytic inflammatory bowel disease, necrotic suppurative enteritis) were observed in the other five cats. The major limitation of the study was the small sample size. Conclusions and relevance Lymphoma may be a frequent cause of spontaneous perforation in cats. Therefore, histological examination of ulceration is essential in all cases. The direct and sole implication of anti-inflammatory administration in a gastrointestinal perforation is not clearly established in this study.
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Affiliation(s)
- Fanny Bernardin
- Internal Medicine Department, Centre Hospitalier Vétérinaire Frégis, Arcueil, France
| | - Laura Martinez Rivera
- Internal Medicine Department, Centre Hospitalier Vétérinaire Frégis, Arcueil, France
| | - Guillaume Ragetly
- Internal Medicine Department, Centre Hospitalier Vétérinaire Frégis, Arcueil, France
| | - Eymeric Gomes
- Internal Medicine Department, Centre Hospitalier Vétérinaire Frégis, Arcueil, France
| | - Juan Hernandez
- Internal Medicine Department, Centre Hospitalier Vétérinaire Frégis, Arcueil, France
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Holt D, Agnello K. Peritoneum. FELINE SOFT TISSUE AND GENERAL SURGERY 2014. [PMCID: PMC7149698 DOI: 10.1016/b978-0-7020-4336-9.00026-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Syrcle JA, Gambino JM, Kimberlin WW. Treatment of pyloric stenosis in a cat via pylorectomy and gastroduodenostomy (Billroth I procedure). J Am Vet Med Assoc 2013; 242:792-7. [DOI: 10.2460/javma.242.6.792] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Digestive System, Liver, and Abdominal Cavity. THE CAT 2012. [PMCID: PMC7158306 DOI: 10.1016/b978-1-4377-0660-4.00023-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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KING JN, HOTZ R, REAGAN EL, ROTH DR, SEEWALD W, LEES P. Safety of oral robenacoxib in the cat. J Vet Pharmacol Ther 2011; 35:290-300. [DOI: 10.1111/j.1365-2885.2011.01320.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Cariou MPL, Halfacree ZJ, Lee KCL, Baines SJ. Successful surgical management of spontaneous gastric perforations in three cats. J Feline Med Surg 2010; 12:36-41. [PMID: 20123485 DOI: 10.1016/j.jfms.2009.12.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND In the veterinary literature, feline gastroduodenal ulcer disease has been described only in individual case reports or retrospective studies reporting small numbers of cats. Although its canine counterpart is commonly encountered, less is known about factors predisposing cats to gastroduodenal ulceration and potentially perforation. Similarly the outcome following treatment is not well reported in this species. REPORTED RISK FACTORS In dogs, hepatic disease and administration of non-steroidal anti-inflammatory drugs (NSAIDs) have been reported as the two most common causes of gastroduodenal ulceration. In cats, only one clinical report so far has implicated an NSAID as a risk factor for spontaneous gastroduodenal perforation. FINDINGS AND PRACTICAL RELEVANCE This report describes the historical and physical findings, as well as the treatment and outcome, in three cats with spontaneous gastric perforation that were receiving anti-inflammatory medication immediately prior to presentation. It highlights the importance of thorough patient evaluation in any cat presenting with non-specific clinical signs and a history of anti-inflammatory drug administration.
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Affiliation(s)
- Matthieu P L Cariou
- Queen Mother Hospital for Animals, Royal Veterinary College, North Mymms, Hatfield, Hertfordshire AL9 7TA, UK.
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Steagall P, Moutinho F, Mantovani F, Passarelli D, Thomassian A. Evaluation of the adverse effects of subcutaneous carprofen over six days in healthy cats. Res Vet Sci 2009; 86:115-20. [DOI: 10.1016/j.rvsc.2008.04.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2007] [Revised: 03/01/2008] [Accepted: 04/15/2008] [Indexed: 02/02/2023]
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Carroll GL, Simonson SM. Recent developments in nonsteroidal antiinflammatory drugs in cats. J Am Anim Hosp Assoc 2007; 41:347-54. [PMID: 16267058 DOI: 10.5326/0410347] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Pain, particularly chronic pain, is an underestimated ailment in cats. Veterinarians tend to under-diagnose and under-treat pain in this aloof and stoic species. Until recently, there was only one analgesic (i.e., butorphanol) approved in the United States for use in cats; but many analgesics, particularly opioids, have been used extra-label for this purpose. Nonsteroidal antiinflammatory drugs (NSAIDs) have been used sparingly in cats because of safety concerns, which are less of an issue with the newer agents. Meloxicam is the only NSAID labeled for use in cats in the United States, but other agents are available in this country and are labeled for use in cats in other countries.
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Affiliation(s)
- Gwendolyn L Carroll
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, Texas A & M University, College Station, Texas 77843, USA
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Wegner K, Robertson SA. Dose-related thermal antinociceptive effects of intravenous hydromorphone in cats. Vet Anaesth Analg 2007; 34:132-8. [PMID: 17316394 DOI: 10.1111/j.1467-2995.2006.00311.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To describe the dose-related thermal antinociceptive effects of intravenous (i.v.) hydromorphone in cats. STUDY DESIGN Randomized, blinded, crossover design. ANIMALS Seven adult cats (3.5-7.4 kg), two spayed females, and five neutered males. METHODS Hydromorphone (0.025, 0.05, or 0.1 mg kg(-1)) was administered i.v.. Skin temperature and thermal threshold were measured before and at selected time points to 720 minutes post-administration. Statistical analysis of mean thermal threshold and skin temperatures over time for each dose and between doses was by way of a split-plot model and post hoc Bonferroni t-tests. p < 0.05 was considered significant. RESULTS A significant difference from baseline for mean thermal threshold was identified for the 0.05 mg kg(-1) dose (5-80 minutes, peak thermal threshold 46.9 +/- 6.2 degrees C) and 0.1 mg kg(-1) dose (5-200 minutes, peak thermal threshold 54.9 +/-0.2 degrees C). The thermal threshold was significantly greater after the 0.1 mg kg(-1) dose from 5 to 200 minutes compared to the 0.025 mg kg(-1) and 0.5 mg kg(-1) doses. The thermal threshold was significantly greater from 35 to 80 minutes for the 0.05 mg kg(-1) dose when compared with the 0.025 mg kg(-1) dose. Skin temperature was significantly increased from 35 to 140 minutes following the 0.1 mg kg(-1) dose. CONCLUSIONS A dose-related antinociceptive effect was demonstrated for i.v. hydromorphone in cats. CLINICAL RELEVANCE Hydromorphone at doses less than 0.1 mg kg(-1) has a modest antinociceptive effect and a short duration of action. At a dose of 0.1 mg kg(-1) i.v., onset of analgesia is rapid with a clinically useful duration of effect, but is associated with a rise in skin temperature.
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Affiliation(s)
- Kirsten Wegner
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610-0136, USA
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Lascelles BDX, Court MH, Hardie EM, Robertson SA. Nonsteroidal anti-inflammatory drugs in cats: a review. Vet Anaesth Analg 2007; 34:228-50. [PMID: 17451496 DOI: 10.1111/j.1467-2995.2006.00322.x] [Citation(s) in RCA: 106] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To review the evidence regarding the use of nonsteroidal anti-inflammatory drugs (NSAIDs) in cats. DATABASES USED PubMed, CAB abstracts. CONCLUSIONS Nonsteroidal anti-inflammatory drugs should be used with caution in cats because of their low capacity for hepatic glucuronidation, which is the major mechanism of metabolism and excretion for this category of drugs. However, the evidence presented supports the short-term use of carprofen, flunixin, ketoprofen, meloxicam and tolfenamic acid as analgesics in cats. There were no data to support the safe chronic use of NSAIDs in cats.
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Affiliation(s)
- B Duncan X Lascelles
- Comparative Pain Research Laboratory, Department of Clinical Sciences, North Carolina State University, Raleigh, NC 27606, USA.
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26
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Clark TP. The Clinical Pharmacology of Cyclooxygenase-2–Selective and Dual Inhibitors. Vet Clin North Am Small Anim Pract 2006; 36:1061-85, vii. [PMID: 16984827 DOI: 10.1016/j.cvsm.2006.07.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Over the past decade, there have been several nonsteroidal anti-inflammatory drugs (NSAIDS) introduced in veterinary medicine with an increased gastrointestinal safety profile consistent with a cyclooxygenase (COX)-1-sparing effect. More recently, an NSAID with additional 5-lipoxygenase (5-LOX) activity has also been approved for use. Although it is tempting to equate in vitro COX-2/COX-1 and 5-LOX inhibition to overall in vivo safety, the data do not support this approach. The true overall safety for any individual compound is based on its evaluation in laboratory margin-of-safety studies, reproductive safety studies, and blind multicenter field studies in client-owned animals. Therefore, when choosing a COX-2-selective or dual-inhibitor NSAID for clinical use, all in vivo data must be taken into account to understand comparative safety, and continued use must be based on the drug's performance in the individual being treated. Until head-to-head trials in multicenter blind studies are published, comments on comparative safety and effectiveness must be reserved.
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Affiliation(s)
- Terrence P Clark
- Department of Biology Research and Technology Acquisitions, Elanco Animal Health, A Division of Eli Lilly and Company, 2001 West Main Street, GL14, Greenfield, IN 46140, USA.
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Infectious Uveitis. CONSULTATIONS IN FELINE INTERNAL MEDICINE 2006. [PMCID: PMC7149972 DOI: 10.1016/b0-72-160423-4/50006-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Pypendop BH, Ilkiw JE, Robertson SA. Effects of intravenous administration of lidocaine on the thermal threshold in cats. Am J Vet Res 2006; 67:16-20. [PMID: 16426206 DOI: 10.2460/ajvr.67.1.16] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the effects of IV administration of lidocaine on thermal antinociception in conscious cats. ANIMALS 6 cats. PROCEDURE 2 experiments were performed in each cat (interval of at least 2 months). In experiment 1, lidocaine pharmacokinetics were determined for each conscious cat following IV administration of a bolus of lidocaine (2 mg/kg). In experiment 2, data from experiment 1 were used to calculate appropriate doses of lidocaine that would achieve predetermined plasma lidocaine concentrations in the cats; lidocaine (or an equivalent volume of saline [0.9% NaCl] solution as the control treatment) was administered IV to target pseudo-steady-state plasma concentrations of 0, 0.5, 1, 2, 5, and 8 microg/mL. Skin temperature and thermal threshold were determined at the start of the experiment (baseline) and at each concentration. Samples of venous blood were obtained at each target concentration for plasma lidocaine concentration determination. RESULTS In experiment 2, actual plasma lidocaine concentrations were 0.00 +/- 0.00 microg/mL, 0.25 +/- 0.18 microg/mL, 0.57 +/- 0.20 microg/mL, 1.39 +/- 0.13 microg/mL, 2.33 +/- 0.45 microg/mL, and 4.32 +/- 0.66 microg/mL for target plasma concentrations of 0, 0.5, 1, 2, 5, and 8 microg/mL, respectively. Compared with baseline values, no significant change in skin temperature or thermal threshold was detected at any lidocaine plasma concentration (or saline solution equivalent). Skin temperature or thermal threshold values did not differ between lidocaine or control treatments. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that these moderate plasma concentrations of lidocaine did not affect thermal antinociception in cats.
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Affiliation(s)
- Bruno H Pypendop
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA 95616, USA
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30
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Shimamura S, Shimizu M, Kobayashi M, Hirao H, Tanaka R, Yamane Y. Megaesophagus was complicated with Billroth I gastroduodenostomy in a cat. J Vet Med Sci 2005; 67:935-7. [PMID: 16210807 DOI: 10.1292/jvms.67.935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A seven-year-old, female, domestic short hair cat was presented with a history of chronic anorexia. Radiographic examination revealed a large space-occupying calcified mass in the abdominal cavity. The mass was located in pylorus and did not extend into the duodenum and surrounding tissues. Billroth I gastroduodenostomy was conducted to remove the mass. Histopathological examination of the mass showed a lymphoma. Although Recovery following the operation was excellent, the patient showed intermittent vomiting unrelated to feeding. Radiographical examination revealed a megaesophagus, which was assumed to be a complication of the Billroth I procedure, since the condition was not observed before the procedure.
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Affiliation(s)
- Shunsuke Shimamura
- Department of Veterinary Surgery, Faculty of Agriculture, Tokyo University of Agriculture and Technology, Tokyo, Japan
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Abstract
In the past 10 years, great strides have been made in the field of feline analgesia. A better understanding of the cat's unique metabolism has led researchers to realize that extrapolation across species boundaries is unwise,and this has resulted in feline-specific studies. The opioids are now used more commonly in cats, with good analgesic effect and few side effects. Excellent acute pain management is achievable in cats by using opioids, NSAIDs, alpha2-agonists, and local anesthetics. Although much of the research data has compared the use of single drugs, a multimodal approach using agents that work at different parts of the pain pathway is commonly used in clinical settings, with added benefit. Compared with dogs, few pain-scoring systems have been developed for cats, and this remains an important goal. Management of chronic pain in cats is a challenge because of the potential problems with long-term NSAID use; however, reports of low doses given at extended intervals are encouraging. As we gain experience with less traditional analgesics, such as amitriptyline, amantadine, and gabapentin, and critically evaluate complimentary therapies, our ability to provide comfort to this population of cats will improve.
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Affiliation(s)
- Sheilah A Robertson
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, PO Box 100136, Gainesville, FL 32610-0136, USA.
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32
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Giuliano EA. Nonsteroidal anti-inflammatory drugs in veterinary ophthalmology. Vet Clin North Am Small Anim Pract 2004; 34:707-23. [PMID: 15110980 DOI: 10.1016/j.cvsm.2003.12.003] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Uveitis is a common sequela to many ocular diseases. Primary treatment goals for uveitis should be to halt inflammation, prevent or control complications caused by inflammation, relieve pain, and preserve vision. Systemic and topical NSAIDs are essential components of the pharmaceutic armamentarium currently employed in the management of ocular inflammation by general practitioners and veterinary ophthalmologists worldwide. NSAIDs effectively prevent intraoperative miosis; control postoperative pain and inflammation after intraocular procedures, thus optimizing surgical outcome; control symptoms of allergic conjunctivitis;alleviate pain from various causes of uveitis; and circumvent some of the unwanted side effects that occur with corticosteroid treatment. Systemic NSAID therapy is necessary to treat posterior uveitis, because therapeutic concentrations cannot be attained in the retina and choroid with topical administration alone, and is warranted when diseases, such as diabetes mellitus or systemic infection, preclude the use of systemic corticosteroids. Risk factors have been identified with systemic and topical administration of NSAIDs. In general, ophthalmic NSAIDs may be used safely with other ophthalmic pharmaceutics; however, concurrent use of drugs known to affect the corneal epithelium adversely, such as gentamicin, may lead to increased corneal penetration of the NSAID. The concurrent use of NSAIDs with topical corticosteroids in the face of significant preexisting corneal inflammation has been identified as a risk factor in precipitating corneal erosions and melts in people and should be undertaken with caution[8]. Clinicians should remain vigilant in their screening of ophthalmic and systemic complications secondary to drug therapy and educate owners accordingly. If a sudden increase in patient ocular pain (as manifested by an increase in blepharospasm, photophobia, ocular discharge, or rubbing)is noted, owners should be instructed to contact their veterinarian promptly.
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Affiliation(s)
- Elizabeth A Giuliano
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, 379 East Campus Drive, Columbia, MO 65211, USA.
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33
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Al-Gizawiy MM, P Rudé E. Comparison of preoperative carprofen and postoperative butorphanol as postsurgical analgesics in cats undergoing ovariohysterectomy. Vet Anaesth Analg 2004; 31:164-74. [PMID: 15268687 DOI: 10.1111/j.1467-2987.2004.00180.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To compare carprofen to butorphanol, with regard to postsurgical analgesic effects, duration of analgesia, and adverse side effects. STUDY DESIGN Blinded, randomized clinical study. ANIMALS Seventy-one cats, 0.5-5 years of age, weighing 3.24 +/- 0.61 kg, undergoing ovariohysterectomy (OHE). METHODS Cats were premedicated with subcutaneous atropine (0.04 mg kg(-1)), acepromazine (0.02 mg kg(-1)), and ketamine (5 mg kg(-1)). Anesthesia was induced with ketamine (5 mg kg(-1)) and diazepam (0.25 mg kg(-1)) given intravenously, and maintained with isoflurane. There were three treatment groups: group C (4 mg kg(-1) carprofen SC at induction), group B (0.4 mg kg(-1) butorphanol SC at end of surgery), and group S (0.08 mL kg(-1) of sterile saline SC at induction and end of surgery). Behavioral data were collected using a composite pain scale (CPS), prior to surgery (baseline) and 1, 2, 3, 4, 8, 12, 16, 20, and 24 hours post-surgery. Interaction scores were analyzed separately. Cats with CPS scores >12 received rescue analgesia (meperidine, 4 mg kg(-1), intramuscular). RESULTS Sixty cats completed the study. The CPS scores did not differ significantly between groups C and B at any time period. CPS scores for groups B and C were significantly increased for 12 hours post-surgery, and in group S for 20 hours. Both group C and B CPS scores were significantly lower than group S in this 20-hour postoperative period, except at 4 hours (B and C) and at 3 and 8 hours (B alone). Interaction scores for group C returned to preoperative baseline 4 hours after surgery, while both groups B and S remained increased for at least 24 hours post-surgery. Nine cats required meperidine. CONCLUSION In this study, carprofen provided better postsurgical analgesia than butorphanol. Clinical relevance Neither drug completely abolished pain, however preoperative carprofen provided better pain control compared with postoperative butorphanol in the 24-hour period following OHE surgery in cats.
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Affiliation(s)
- Mona M Al-Gizawiy
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St Paul, MN, USA
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34
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Robertson SA, Taylor PM, Lascelles BDX, Dixon MJ. Changes in thermal threshold response in eight cats after administration of buprenorphine, butorphanol and morphine. Vet Rec 2003; 153:462-5. [PMID: 14584576 DOI: 10.1136/vr.153.15.462] [Citation(s) in RCA: 112] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Thermal thresholds were measured in eight cats after the intramuscular administration of morphine (0.2 mg/kg), buprenorphine (0.01 mg/kg) or butorphanol (0.2 mg/kg), doses commonly used in clinical practice; 0.9 per cent saline (0.3 ml) was injected as a control. Groups of six cats were used and each cat participated in at least two treatments, according to a randomised design. The investigator was blinded to the treatments. The thermal thresholds were measured with a testing device developed specifically for cats, and measurements were made before and five, 30, 45 and 60 minutes and two, four, six, 12 and 24 hours after the injections. There was no significant change in thermal threshold after the injection of saline. With butorphanol, the threshold was increased only at five minutes after the injection and was decreased two hours after the injection; with morphine it was increased from between four and six hours after the injection, and with buprenorphine it was increased from between four and 12 hours after the injection.
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Affiliation(s)
- S A Robertson
- Department of Clinical Veterinary Medicine, University of Cambridge, Madingley Road, Cambridge CB3 0ES
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35
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Egger CM, Glerum LE, Allen SW, Haag M. Plasma fentanyl concentrations in awake cats and cats undergoing anesthesia and ovariohysterectomy using transdermal administration. Vet Anaesth Analg 2003; 30:229-36. [PMID: 12925180 DOI: 10.1046/j.1467-2995.2003.00109.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To measure the plasma fentanyl concentrations achieved over time with transdermal fentanyl patches in awake cats and cats undergoing anesthesia and ovariohysterectomy. STUDY DESIGN Randomized prospective experimental study. ANIMALS Twenty-four purpose-bred cats. METHODS Cats were randomly assigned to three groups for Part I of a larger concurrent study. Group P received only a 25 micro g hour-1 transdermal fentanyl patch. Group P/A received the patch and anesthesia. Group A received only anesthesia. After a minimum 1-week washout period, the cats were randomly reassigned to two groups for Part II of the larger study. Group P/A/O received the patch, anesthesia and ovariohysterectomy. Group A/O received anesthesia and ovariohysterectomy. Patches were left in place for 72 hours and plasma samples were obtained for fentanyl analysis while the patches were in place, and for 8 hours after patch removal for cats in Group P, P/A, and P/A/O. RESULTS The 25 micro g hour-1 transdermal fentanyl patches were well tolerated by the cats in this study (mean body weight of 3.0 kg) and no overt adverse effects were noted. Mean plasma fentanyl concentrations over time, mean plasma fentanyl concentrations at specific times (8, 25, 49, and 73 hours after patch placement), time to first detectable plasma fentanyl concentration, time to reach maximum plasma fentanyl concentration, maximum plasma fentanyl concentration, mean plasma fentanyl concentration from 8 to 73 hours, elimination half-life, and total area under concentration (AUC) were not statistically different among the groups. CONCLUSIONS Halothane anesthesia and anesthesia/ovariohysterectomy did not significantly alter the plasma fentanyl concentrations achieved or pharmacokinetic parameters measured, when compared with awake cats. There was a high degree of individual variability observed both within and between groups of cats in parameters measured. CLINICAL SIGNIFICANCE The high degree of variability observed suggests that careful observation of cats with fentanyl patches in place is required to assess efficacy and any potential adverse effects. Anesthesia and anesthesia/ovariohysterectomy do not appear to alter plasma fentanyl concentrations achieved by placement of a 25 micro g hour-1 transdermal fentanyl patch when compared to cats not undergoing these procedures.
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Affiliation(s)
- Christine M Egger
- Department of Small Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA.
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36
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Abstract
Spontaneous pneumoperitoneum is an infrequently observed presentation in cats. This report details two cases of pneumoperitoneum in the cat. The first case was suspected to have been caused by a gastric perforation secondary to gastric lymphoma. The second case was caused by a perforated gastric ulcer in a cat that had been recently treated with corticosteroids and a non-steroidal anti-inflammatory drug.
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Affiliation(s)
- R J Mellanby
- Queen's Veterinary School Hospital, University of Cambridge, Madingley, Road, Cambridge CB3 0ES
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37
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Liptak JM, Hunt GB, Barrs VRD, Foster SF, Tisdall PLC, O'Brien CR, Malik R. Gastroduodenal ulceration in cats: eight cases and a review of the literature. J Feline Med Surg 2002; 4:27-42. [PMID: 11869053 DOI: 10.1053/jfms.2001.0148] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Gastroduodenal ulceration (GU) and blood loss was diagnosed in eight cats and compared with 25 previously reported cases of feline GU. Cats with GU presented in a critical condition. Clinical signs consistent with gastrointestinal bleeding were infrequently identified although anaemia was a common finding. Non-neoplastic causes of feline GU tended to have a shorter clinical course with ulcers confined to the stomach. Conversely, cats with tumour-associated GU usually had a more protracted clinical course, weight loss, and ulcers located in the stomach for gastric tumours and the duodenum for extra-intestinal tumours. In this series, definitive diagnosis was possible for cats with neoplasia (gastric tumours and gastrinoma), however, it was difficult to precisely identify the underlying aetiology in cats with non-neoplastic GU. Prompt stabilisation with a compatible blood transfusion, surgical debridement or resection, antibiotic and antiulcer therapy, and treatment of the underlying disease, if identified, was successful in the majority of cases. The prognosis for cats with appropriately managed GU depended on the underlying aetiology, but even cats with neoplasia could be successfully palliated for prolonged periods.
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Affiliation(s)
- J M Liptak
- University Veterinary Centre Sydney, Faculty of Veterinary Science, The University of Sydney, NSW 2006, Australia
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38
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Hinton LE, McLoughlin MA, Johnson SE, Weisbrode SE. Spontaneous gastroduodenal perforation in 16 dogs and seven cats (1982-1999). J Am Anim Hosp Assoc 2002; 38:176-87. [PMID: 11908837 DOI: 10.5326/0380176] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The records of 23 dogs and cats diagnosed with spontaneous gastroduodenal perforation (GDP) were retrospectively reviewed. Survival was 63% in dogs and 14% in cats. Rottweilers <5 years of age were overrepresented. Clinical evidence of gastrointestinal bleeding was common in dogs but not in cats. Shock was an uncommon presenting condition in dogs and was not closely linked to outcome. In fact, progression of an ulcerating lesion to GDP was not associated with marked changes in symptoms exhibited by many patients in this study. Most GDPs were associated with histopathological evidence of subacute or chronic peritoneal reaction at the time of diagnosis. This suggests that diagnostic methods employed lacked sensitivity in identifying early perforating lesions, and that dramatic signs of acute abdomen following gastroduodenal perforation may not be as common as was previously thought.
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Affiliation(s)
- Laura E Hinton
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus 43210, USA
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Lascelles BD, Henderson AJ, Hackett IJ. Evaluation of the clinical efficacy of meloxicam in cats with painful locomotor disorders. J Small Anim Pract 2001; 42:587-93. [PMID: 11791773 DOI: 10.1111/j.1748-5827.2001.tb06034.x] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The ability of two non-steroidal anti-inflammatory drugs to modify the clinical manifestations of pain associated with locomotor disease was assessed. Sixty-nine cats with acute or chronic locomotor disorders were recruited from 14 first opinion UK veterinary practices and randomly allocated to one of two treatment groups. Group A received meloxicam drops (0.3 mg/kg orally on day 1 followed by 0.1 mg/kg daily for four more consecutive days) and group B received ketoprofen tablets (1.0 mg/kg orally once daily for five days). Each cat underwent a full clinical examination before treatment, 24 hours after initiation of treatment and 24 hours after completion of treatment. General clinical parameters (demeanour and feed intake) and specific locomotor parameters (weightbearing, lameness, local inflammation and pain on palpation) were scored using a discontinuous scale scoring system. The two groups did not differ in terms of age, weight, gender distribution or duration of clinical signs; nor did they differ in terms of general clinical or specific locomotor scores pretreatment. Both treatment regimens resulted in a significant improvement in demeanour, feed intake and weightbearing, and a significant reduction in lameness, pain on palpation and inflammation. No significant difference was observed between the two treatment groups with respect to any of the parameters measured and both treatments were associated with minimal observed side effects. Meloxicam and ketoprofen were found to be effective analgesics and well tolerated in cats with acute or chronic locomotor disorders when administered for short-term treatment (five days) in such cases. However, meloxicam was assessed to be significantly more palatable than ketoprofen.
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Affiliation(s)
- B D Lascelles
- College of Veterinary Medicine, University of Florida, Gainesville 32610, USA
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40
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Lee DD, Papich MG, Hardie EM. Comparison of pharmacokinetics of fentanyl after intravenous and transdermal administration in cats. Am J Vet Res 2000; 61:672-7. [PMID: 10850844 DOI: 10.2460/ajvr.2000.61.672] [Citation(s) in RCA: 66] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare pharmacokinetic and pharmacodynamic characteristics of fentanyl citrate after IV or transdermal administration in cats. ANIMALS 6 healthy adult cats with a mean weight of 3.78 kg. PROCEDURE Each cat was given fentanyl IV (25 mg/cat; mean +/- SD dosage, 7.19 +/- 1.17 mg/kg of body weight) and via a transdermal patch (25 microg of fentanyl/h). Plasma concentrations of fentanyl were measured by use of radioimmunoassay. Pharmacokinetic analyses of plasma drug concentrations were conducted, using an automated curve-stripping process followed by nonlinear, least-squares regression. Transdermal delivery of drug was calculated by use of IV pharmacokinetic data. RESULTS Plasma concentrations of fentanyl given IV decreased rapidly (mean elimination half-life, 2.35 +/- 0.57 hours). Mean +/- SEM calculated rate of transdermal delivery of fentanyl was 8.48 +/- 1.7 mg/h (< 36% of the theoretical 25 mg/h). Median steady-state concentration of fentanyl 12 to 100 hours after application of the transdermal patch was 1.58 ng/ml. Plasma concentrations of fentanyl < 1.0 ng/ml were detected in 4 of 6 cats 12 hours after patch application, 5 of 6 cats 18 and 24 hours after application, and 6 of 6 cats 36 hours after application. CONCLUSIONS AND CLINICAL RELEVANCE In cats, transdermal administration provides sustained plasma concentrations of fentanyl citrate throughout a 5-day period. Variation of plasma drug concentrations with transdermal absorption for each cat was pronounced. Transdermal administration of fentanyl has potential for use in cats for long-term control of pain after surgery or chronic pain associated with cancer.
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Affiliation(s)
- D D Lee
- Department of Companion Animal and Special Species Medicine, College of Veterinary Medicine, North Carolina State University, Raleigh 27606, USA
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