Pre-analytical challenges from adsorptive losses associated with thiamine analysis

Thiamine (vitamin B1) is an essential vitamin serving in its diphosphate form as a cofactor for enzymes in the citric acid cycle and pentose-phosphate pathways. Its concentration reported in the pM and nM range in environmental and clinical analyses prompted our consideration of the components used in pre-analytical processing, including the selection of filters, filter apparatuses, and sample vials. The seemingly innocuous use of glass fiber filters, glass filter flasks, and glass vials, ubiquitous in laboratory analysis of clinical and environmental samples, led to marked thiamine losses. 19.3 nM thiamine was recovered from a 100 nM standard following storage in glass autosampler vials and only 1 nM of thiamine was obtained in the filtrate of a 100 nM thiamine stock passed through a borosilicate glass fiber filter. We further observed a significant shift towards phosphorylated derivatives of thiamine when an equimolar mixture of thiamine, thiamine monophosphate, and thiamine diphosphate was stored in glass (most notably non-silanized glass, where a reduction of 54% of the thiamine peak area was observed) versus polypropylene autosampler vials. The selective losses of thiamine could lead to errors in interpreting the distribution of phosphorylated species in samples. Further, some loss of phosphorylated thiamine derivatives selectively to amber glass vials was observed relative to other glass vials. Our results suggest the use of polymeric filters (including nylon and cellulose acetate) and storage container materials (including polycarbonate and polypropylene) for thiamine handling. Losses to cellulose nitrate and polyethersulfone filters were far less substantial than to glass fiber filters, but were still notable given the low concentrations expected in samples. Thiamine losses were negated when thiamine was stored diluted in trichloroacetic acid or as thiochrome formed in situ, both of which are common practices, but not ubiquitous, in thiamine sample preparation.

Subclinical thiamine deficiency results in failed reproduction in Arctic foxes

Thiamine deficiency can result in life-threatening physiological and neurological complications. While a thiamine-deficient diet may result in the onset of such symptoms, the presence of thiaminase - an enzyme that breaks down thiamine - is very often the cause. In such instances, thiaminase counteracts the bioavailability and uptake of thiamine, even when food-thiamine levels are adequate. Here, we report on a case of failed reproduction in seven Arctic fox (Vulpes lagopus) breeding pairs kept at a captive breeding facility, including the presentation of severe thiamine deficiency symptoms in two male foxes. Symptoms included ataxia, obtundation, truncal sway, star-gazing and visual impairment. Blood tests were inconclusive, yet symptoms resolved following treatment with a series of thiamine hydrochloride injections, thereby verifying the diagnosis. A fish-dominated feed, which for the first time had been frozen for a prolonged period, was identified as the likely source of thiaminase and subsequent deterioration in the animals' health. Symptoms in the two males arose during the annual mating period. All seven breeding pairs at the captive breeding station failed to reproduce - a phenomenon never recorded during the captive breeding facility's preceding 17-year operation. Relating our findings to peer-reviewed literature, the second part of this case report assesses how thiamine deficiency (due to thiaminase activity) likely resulted in subclinical effects that impaired the production of reproduction hormones, and thereby led to a complete breeding failure. While previous work has highlighted the potentially lethal effects of thiamine deficiency in farmed foxes, this is, to our knowledge the first study showing how subclinical effects in both males and females may inhibit reproduction in foxes in general, but specifically Arctic foxes. The findings from our case report are not only relevant for captive breeding facilities, but for the welfare and management of captive carnivorous animals in general.

Understanding and mitigating thiaminase activity in silver carp

A deficiency of thiamine (vitamin B1), an essential cofactor for enzymes involved in metabolic processes, can be caused by the enzyme thiaminase. Thiaminase in food stocks has been linked to morbidity and mortality due to thiamine depletion in many ecologically and economically important species. Thiaminase activity has been detected in certain bacteria, plants, and fish species, including carp. The invasive silver carp (Hypophthalmichthys molitrix) presents an enormous burden to ecosystems throughout the Mississippi River watershed. Its large biomass and nutritional content offer an attractive possibility as a food source for humans, wild animals, or pets. Additionally, harvesting this fish could alleviate some of the effects of this species on waterways. However, the presence of thiaminase would detract from its value for dietary consumption. Here we confirm the presence of thiaminase in several tissues from silver carp, most notably the viscera, and systematically examine the effects of microwaving, baking, dehydrating, and freeze-drying on thiaminase activity. Certain temperatures and durations of baking and microwaving reduced thiaminase activity to undetectable levels. However, caution should be taken when carp tissue is concentrated by processes without sufficient heat treatment, such as freeze-drying or dehydration, which results in concentration, but not inactivation of the enzyme. The effects of such treatments on the ease of extracting proteins, including thiaminase, and the impact on data interpretation using the 4-nitrothiophenol (4-NTP) thiaminase assay were considered.

Evaluation of blood thiamine concentration in hospitalized dogs with and without critical illness

OBJECTIVE

To evaluate blood thiamine concentration in healthy and critically ill hospitalized dogs over 72 hours of hospitalization and to identify any association of thiamine concentration with patient morbidity and mortality.

DESIGN

Prospective, observational, clinical study.

SETTING

University veterinary teaching hospital.

ANIMALS

Thirty-one hospitalized healthy dogs and 37 dogs with critical illness. Dogs with critical illness had nonseptic (n = 24) or septic (n = 13) etiologies.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

Whole blood EDTA samples were collected within 24 hours of admission and 72 hours later. Samples were stored at -80°C and batch analyzed. Total thiamine (tB1) and thiamine diphosphate (TDP) concentrations were measured using high-performance liquid chromatography, and free thiamine concentration was determined using liquid chromatography with tandem mass spectrometry. Collected patient data included CBC, biochemistry profile, plasma lactate concentration, shock index, Acute Patient Physiologic and Laboratory Evaluation Score (APPLE_fast ) score, comorbid conditions, and patient outcome. Approximately 92% of tB1 present in whole blood is measured as TDP. TDP concentration was strongly correlated with tB1 (R = 0.97, P < 0.0001). Thiamine concentration, represented by TDP, was not different at admission or at 72 hours in all dogs. TDP concentration was lower in septic dogs requiring surgery at admission (P = 0.044) and 72 hours later (P = 0.008), compared to dogs not requiring surgery. TDP concentration was not different between dogs with and without stable chronic diseases at any time point. Older dogs had lower TDP concentration. Positive correlations were seen between TDP and body weight, APPLE_fast score, and WBC count. Critically ill dogs with lower admission plasma lactate concentration were more likely to have an increase in thiamine over time (P = 0.0142).

CONCLUSIONS

Differences in thiamine concentration were not identified in hospitalized healthy or critically ill dogs. Further investigation into the clinical relevance of thiamine deficiency is indicated in septic dogs undergoing surgery.

Composition and thermal processing evaluation of yeast ingredients as thiamin sources compared to a standard vitamin premix for canned cat food

Significant improvement in thiamin retention of canned cat food has not been achieved by altering processing conditions. Some ingredients, such as yeasts, may supply thiamin able to withstand thermal processing. Therefore, the study objective was to evaluate yeast ingredients as thiamin sources for canned cat food. Six yeast ingredients were screened for thiamin content, and values ranged from 9.9–4,283.8 mg/kg dry matter basis (DMB). Treatments for thermal processing were arranged as a 2×4 factorial with 2 levels of vitamin premix (with or without) and 4 yeast ingredients (NY = none and LBV, BY, or EA from the ingredient screening). Replicates (n = 3) were processed in a horizontal still retort to an average lethality of 79.23 minutes. Thiamin degradation was analyzed as a mixed model with pre-retort thiamin content as a covariate and production day as a random effect. Main effects of vitamin premix and yeast and their interaction were significant at P-values less than 0.05. The Fisher’s LSD post hoc comparison test was used to separate means. On average, experimental formulas retained 33.75% thiamin. The main effect of vitamin premix (average -42.9 mg/kg DMB) was not significant (P > 0.05). Thiamin degradation between NY (-31.3 mg/kg DMB) and BY (-33.8 mg/kg DMB) was similar (P > 0.05) whereas EA (-40.5 mg/kg DMB) and LBV (-55.6 mg/kg DMB) lost more (P < 0.05) thiamin than NY. The experimental formula of EA with vitamin premix (-70.3 mg/kg DMB) lost more (P < 0.05) thiamin than no yeast, BY, or EA without vitamin premix (average -17.4 mg/kg DMB) and all others (average -57.3 mg/kg DMB) were intermediate (P > 0.05). In summary, thiamin from yeast ingredients didn’t exhibit better thermal stability than thiamin mononitrate. However, those ingredients with similar degradation levels or uniquely high thiamin levels may provide added value.

Commercial vs Homemade Cat Diets: What you need to know

PRACTICAL RELEVANCE

A feeding plan recommendation for cats, both healthy and with disease, should include diet choice, amounts to feed and the feeding method. Diet choice can be complex owing to the abundance of products, sometimes with conflicting marketing messages, and the prevalence of information with no scientific basis. It is important to be aware of the specific challenges of both commercial and homemade diets. Moreover, a nutritional assessment is a prerequisite when recommending a diet to ensure that it is safe, appropriate for the cat's life stage and nutritious for long-term feeding.

COMMERCIAL VS HOMEMADE DIETS

There are a variety of commercial diets available, allowing considerable customisation. These products are regulated and can be tested to determine nutritional adequacy and safety, although as the industry is partly self-regulated, choice of manufacturer is important. Properly formulated homemade diets can be customised to the patient and are a good option when no commercial product that meets the patient's needs exists. Homemade diets can be an owner preference. A serious limitation is the lack of testing, potentially affecting safety and also resulting in a reliance on database information to determine nutritional adequacy. Generic homemade diet recipes (eg, sourced from the internet) have additional risks of deficiencies and imbalances, and are not recommended. Homemade diets should be devised by a veterinary nutrition specialist with consideration of both patient and owner factors.

CLINICAL CHALLENGES

Dietary misinformation, which is all too readily available on the internet, may result in owners making questionable feeding choices for their pets. A homemade diet may be requested by owners based on the perception that there are poor ingredients in commercial foods. The veterinary healthcare team needs to have good evidence-based information to present to owners about diet choice.

EVIDENCE BASE

Several decades of research on feline nutrition forms the basis for nutritional requirements and dietary recommendations. There are varying degrees of evidence regarding requirements for each nutrient, and a lack of data on the effects of different types of processing on nutrient needs.

Relationship between a plant-based 'vegan' pet food and clinical manifestation of multiple nutrient deficiencies in two cats

A topical subject in human nutrition is the steadily growing number of people choosing to limit or completely avoid all animal-derived food products either for moral dilemma, health concerns or both. To meet people's will of applying their dietary choices to their domestic animals, the pet food industry answered by launching on the market some plant-based diets. This leads to concerns about whether these diets are adequately formulated to satisfy the target species nutritional requirements, especially for cats which are still considered strict carnivores. This case report follows a 2-year-old male neutered Main Coon and a 1-year-old female spayed Domestic Shorthair cat, presented to the nutrition service of the University of Toulouse, France. Reason for consultation was lethargy with in anamnesis a recent dietary transition to a plant-based pet food. Dysorexia, lethargy and muscle waste were present at first consultation. Progressive weight loss developed during follow-ups. A macrocytic, non-regenerative anaemia with serum folates below reference were the main clinical features. Analysis of pet food showed multiple nutrients below minimum recommendation at the average daily intake of both cats. Folic acid supplementation improved dysorexia, and subsequent reintroduction of animal-derived ingredients in the diet restored appetite, weight and a normal mentation in both cases.

Eye movements in demyelinating, autoimmune and metabolic disorders

PURPOSE OF REVIEW

In the last three decades, the use of eye movements and vestibular testing in many neurological disorders has accelerated, primarily because of practical technologic developments. Although the acute vestibular syndrome is a prime example of this progress, more chronic neurologic and systemic disorders have received less attention. We focus here on recent contributions relating vestibular and ocular motor abnormalities in inflammatory, demyelinating, metabolic, and peripheral nervous system disorders RECENT FINDINGS: Vestibular abnormalities have been identified in acute demyelinating neuropathies (AIDP), in novel genetic mutations responsible for CANVAS (cerebellar ataxia, neuropathy vestibular areflexia syndrome), and in other inherited neuropathies (variants of Charcot-Marie-Tooth disease). In addition, there are differentiating characteristics between the most common CNS demyelinating disorders: multiple sclerosis and neuromyelitis optica (NMO). We summarize new information on Vitamin D metabolism in benign paroxysmal positional vertigo (BPPV), followed by a brief review of the vestibular and ocular motor findings in Wernicke's encephalopathy. We conclude with findings in several paraneoplastic/autoimmune disorders.

SUMMARY

This literature review highlights the impact of a careful vestibular and ocular motor evaluation in common neurologic disorder, not only for the initial diagnosis but also for monitoring disease and rehabilitation. A careful examination of eye movements and vestibular function, supplemented with new video techniques to quantify the findings, should be part of the standard neurologic examination.

Clinical reasoning in feline vestibular syndrome: which presenting features are the most important?

OBJECTIVES

The aim of this study was to evaluate whether clinical variables from the history, clinical presentation, and physical and neurological examinations of cats with vestibular syndrome were statistically predictive of the underlying diagnosis.

METHODS

In total, 174 cats presenting with vestibular syndrome between January 2010 and May 2019 were investigated. Univariate statistical analysis of clinical variables was performed and those statistically associated with a diagnosis were retained for multivariable binary logistic regression modelling.

RESULTS

The seven most prevalent diagnoses represented 95% of vestibular presentations, which included: otitis media/interna (n = 48), idiopathic vestibular syndrome (n = 39), intracranial neoplasia (n = 24), middle ear polyp (n = 17), feline infectious peritonitis (n = 13), thiamine deficiency (n = 13) and intracranial empyema (n = 11). Idiopathic vestibular syndrome was commonly associated with non-purebred cats and had 17.8 times the odds of an improving clinical progression (95% confidence interval [CI] 1.3-250.0; P = 0.03). Intracranial neoplasia was associated with older age and chronic onset of clinical signs, and was significantly more likely to have a central vestibular neuroanatomical localisation (95% CI 8.5-344,349,142.0; P = 0.015) with postural deficits on neurological examination. Thiamine deficiency was more common in female cats, with 52.6 times the odds of a waxing and waning clinical progression (95% CI 1.2-1000; P = 0.038) and 6.8 times the odds of presenting with bilateral vestibular signs (95% CI 1.0-45.7; P = 0.047) and wide excursions of the head (95% CI 1.0-45.7; P = 0.047). Middle ear polyps were associated with 8.8 times the odds of presenting with Horner syndrome (95% CI 1.5-50.0; P = 0.015).

CONCLUSIONS AND RELEVANCE

Although it may be difficult to identify the underlying diagnosis in cats with vestibular syndrome from the presenting features alone, there are instances in which discrete clinical features may help to guide clinical reasoning when evaluating cats with vestibular presentations.

Thiamine deficiency in a dog associated with exclusive consumption of boiled sweet potato (Ipomoea batatas): Serial changes in clinical findings, magnetic resonance imaging findings and blood lactate and thiamine concentrations

Thiamine (vitamin B₁) is an essential nutrient that significantly influences ATP production in the body. It needs to be supplemented consistently through an exogenous source to prevent deficiency; however, it is easily affected by a variety of mitigating factors. Additionally, thiamine requirements can be influenced by an individual's dietary composition. The nervous system is particularly vulnerable to thiamine deficiency due to its high metabolic demand. Thiamine deficiency is typically diagnosed based on clinical signs, dietary history and response to thiamine administration. A 5‐year‐old neutered male Maltese Terrier dog presented with an acute onset of seizures and generalized ataxia. The dog was exclusively fed boiled sweet potato (Ipomoea batatas) as a primary diet source for 4 weeks. MR findings and hyperlactatemic conditions were consistent with thiamine deficiency, and the diagnosis was confirmed by measuring thiamine concentrations in blood using high‐performance liquid chromatography (HPLC). Appropriate thiamine supplementation and diet changes resulted in a rapid improvement in neurological signs. Repeated MR imaging 2 weeks after starting the treatment completely resolved the previously identified abnormalities, and repeated measurements of blood lactate and thiamine levels revealed complete recovery of the thiamine‐deficient status.

Recurrent seizures in cats: Diagnostic approach - when is it idiopathic epilepsy?

Practical relevance: Seizures are one of the most common neurologic problems recognized in cats, affecting approximately 1-3% of the general population. Treatment options and prognosis are closely related to the underlying cause, so it is important that veterinarians are familiar with the diagnostic approach to cats with seizures and options for medical management. Series outline: This is the first of a two-part article series that reviews the diagnosis and treatment of seizures in cats. Part 1 outlines the classification and terminology used to describe epilepsy and epileptic seizures in cats, and discusses some of the most common and unique causes of recurrent seizures in cats. The diagnostic approach to cats with recurrent seizures is addressed, as are criteria for the diagnosis of idiopathic epilepsy.

AUDIENCE

This review of recurrent seizures in cats is intended for all veterinarians who are facing the challenges of seizure diagnosis and management in the feline patient. Evidence base: Recommendations for diagnosis and management of feline seizure disorders have historically been extrapolated from the canine and human literature. The information and guidance provided in this two-part series is based on a review of the recent published literature addressing seizure disorders and antiepileptic treatment in cats, as well as the authors' clinical experience.

The Role of Thiamine and Effects of Deficiency in Dogs and Cats

Recent pet food recalls for insufficient dietary thiamine have highlighted the importance of adequate thiamine intake in dogs and cats, as thiamine is an essential dietary nutrient with a critical role in energy metabolism. Prolonged thiamine deficiency leads to clinical signs that can span several organ systems, and deficiency can be fatal if not reversed. In this review, the current knowledge of thiamine metabolism will be summarized. Dietary recommendations for dogs and cats will be discussed, and the risk factors and clinical signs associated with thiamine deficiency will be examined.

A real-time reporting system of causes of death or reasons for euthanasia: A model for monitoring mortality in domesticated cats in Taiwan

A novel, real-time mortality recording system was designed to collect mortality data in companion animals from veterinary hospitals in Taiwan. This retrospective study aims to introduce the system, and to utilize the data collected for further investigation of the lifespan and mortality of the domesticated cat population stratified by demographic variables. Our data revealed that 1325 domesticated cats were acquired between 2012 and 2014. The median age of the study population was 8.0 years (IQR 3.0–13.0; range 0.0–22.7). Neutered and purebred cats lived longer. The most common causes of death were renal and urologic disorders, followed by neoplasia, infection, cardiovascular disorders, and trauma. Independent factors for common causes were surveyed. Advanced age and neutering was found to be associated with death due to renal and urologic disorders as well as with neoplasia. In contrast, younger age was found to be associated with death due to trauma and infection; being unneutered and living in the capital city were found to be associated with death due to trauma. Being male or purebred was found to be associated with death due to cardiovascular disorders.