Echocardiographic and electrocardiographic findings in Irish Wolfhounds eating high-pulse or low-pulse diets

BACKGROUND

Apparently healthy dogs of various breeds eating nontraditional, high-pulse diets can have larger left ventricular diameter, lower systolic function, and more ventricular premature complexes (VPCs) compared with dogs eating traditional, low-pulse diets. It is unknown whether Irish Wolfhounds eating high-pulse diets have similar cardiac abnormalities.

HYPOTHESIS/OBJECTIVES

To compare electrocardiographic and echocardiographic findings between Irish Wolfhounds eating high- or low-pulse diets.

ANIMALS

Ninety-seven Irish Wolfhounds.

METHODS

Retrospective study of Irish Wolfhounds that had echocardiography performed at dog shows between October 2018 and May 2021. Demographic information, echocardiographic measurements, cardiac rhythm (1-minute lead II rhythm strip), and main diet were recorded retrospectively. Diets were classified as high-pulse or low-pulse based on the presence and location of pulses (peas, lentils, chickpeas, or dry beans) on the ingredient list.

RESULTS

Thirty-five of 97 Irish Wolfhounds (36%) were eating high-pulse diets and 62 of 97 (64%) were eating low-pulse diets. There were no significant differences between diet groups in echocardiographic measurements. A significantly higher percentage of dogs in the high-pulse diet group (6/35 [17%]) had VPCs compared with those in the low-pulse diet group (1/62 [2%]; effect size = 0.15 [95% confidence interval: 0.004-0.31]; P = .005).

CONCLUSIONS AND CLINICAL IMPORTANCE

In this retrospective study of apparently healthy Irish Wolfhounds, high-pulse diets were associated with a higher prevalence of VPCs which could represent early cardiac abnormalities.

Untargeted metabolomic profiling of dogs with myxomatous mitral valve disease and congestive heart failure shows metabolic differences associated with the presence of cardiac cachexia

OBJECTIVE

To determine the effects of cardiac cachexia on the metabolomic profile in dogs with myxomatous mitral valve disease (MMVD).

ANIMALS

3 groups of dogs with MMVD enrolled between November 30, 2018, and April 7, 2022: (1) Dogs with congestive heart failure (CHF) and cachexia (CHF-cachexia group; n = 10); (2) dogs with CHF that had no cachexia (CHF-no cachexia group; n = 10); and (3) dogs with asymptomatic disease (American College of Veterinary Internal Medicine [ACVIM] Stage B2) with no cachexia (B2 group; n = 10).

METHODS

Metabolomic profiles were analyzed from serum samples using ultra-high-performance liquid chromatography-tandem mass spectroscopy. Dogs in the 3 groups were compared, with statistical significance defined as P < .05 with a low false discovery rate (q < .10) and nominal statistical significance defined as P < .05 but q > .10.

RESULTS

Numerous metabolites were significantly (n = 201) or nominally significantly (n = 345) different between groups. For example, when comparing the CHF-cachexia vs CHF-no cachexia groups, lipids were the predominant metabolite differences, including many medium- and long-chain dicarboxylates and dicarboxylate acylcarnitines. For comparisons of the CHF-cachexia vs B2 groups and the CHF-no cachexia vs B2 groups, amino acids, nucleotides, and cofactors/vitamins were the predominant metabolite differences.

CLINICAL RELEVANCE

Some significant metabolite differences were identified between dogs with and without cardiac cachexia.

Dilated cardiomyopathy of possible dietary origin in a cat

An 11-year-old spayed female domestic shorthaired cat was diagnosed with severe dilated cardiomyopathy (DCM) and congestive heart failure. The cat had been eating cat foods that were high in pulses (e.g. peas, lentils, chickpeas). Neither plasma nor whole blood taurine concentrations were deficient. Primary treatment included furosemide, pimobendan, and clopidogrel, and changing to diets that did not contain pulses (a taurine supplements was not administered). The cat's clinical signs improved, high-sensitivity cardiac troponin I concentrations decreased, and echocardiographic measurements stayed relatively stable for over one year after initiating cardiac medications and changing the diet. Ultimately, the cat was euthanized for worsening congestive heart failure 374 days after the diagnosis of DCM. Infectious disease testing during the time of clinical surveillance was negative. Routine histopathology of the heart was unremarkable, but electron microscopy of the left ventricle showed large numbers of mitochondria of variable size and structure. A moderate number of lamellar bodies and autophagic vacuoles also were noted. This case report illustrates an unusual case of a cat with DCM unrelated to taurine deficiency. The relative roles of diet change, cardiac medications, and a dedicated owner are unclear, but this cat's relatively long survival time is similar to that seen after diet change in dogs and cats with DCM eating high-pulse diets.

Epidural analgesia and emergency delivery for presumed fetal compromise: post-hoc analysis of RAVEL multicenter randomized controlled trial

OBJECTIVE

To investigate the association between epidural analgesia (EDA) vs patient-controlled remifentanil analgesia (PCRA) and emergency delivery for presumed fetal compromise, in relation to birth-weight quintile.

METHODS

This was a post-hoc per-protocol analysis of the RAVEL multicenter equivalence randomized controlled trial. Non-anomalous singleton pregnancies between 36 + 0 and 42 + 6 weeks' gestation were randomized at the time of requesting pain relief to receive EDA or PCRA. The primary outcome was emergency delivery for presumed fetal compromise. Secondary outcomes included mode of delivery and neonatal outcomes. Analysis was performed according to birth-weight quintile and was corrected for relevant confounding variables.

RESULTS

Of 619 pregnant women, 336 received PCRA and 283 received EDA. Among women receiving EDA, 14.8% had an emergency delivery for presumed fetal compromise, compared with 8.3% of women who received PCRA. After adjusting for parity, women receiving EDA had higher odds of presumed fetal compromise compared to those receiving PCRA (odds ratio, 1.69 (95% CI, 1.01-2.83)). A statistically significant linear-by-linear association was observed between presumed fetal compromise and birth-weight quintile (P = 0.003). The incidence of emergency delivery for presumed fetal compromise was highest in women receiving EDA and delivering a neonate with a birth weight in the lowest quintile.

CONCLUSIONS

Intrapartum EDA is associated with a higher rate of emergency delivery for presumed fetal compromise compared to treatment with PCRA. Birth-weight quintile is a strong predictor of this outcome, independent of pain management method. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

Pit bull-type breeds with dilated cardiomyopathy eating nontraditional diets improve after diet change (2015-2022)

OBJECTIVE

To compare signalment, clinical signs, diet, echocardiographic findings, and outcome for pit bull-type breeds diagnosed between 2015 and 2022 with dilated cardiomyopathy (DCM) or with DCM diagnosed by a cardiologist but that did not meet all study echocardiographic criteria (DCM-C).

ANIMALS

91 dogs with DCM and 11 dogs with DCM-C.

PROCEDURES

Data were collected on clinical findings, echocardiographic measurements, and diet at the time of diagnosis (for 76/91 dogs); echocardiographic changes; and survival.

RESULTS

For dogs with diet information available for time of diagnosis, 64/76 (84%) dogs were eating nontraditional commercial diets, while 12/76 (16%) were eating traditional commercial diets. There were few differences between diet groups at baseline, with congestive heart failure and arrhythmias common in both groups. Thirty-four dogs with known baseline diet and diet change status had follow-up echocardiograms between 60 and 1,076 days later (traditional diet, n = 7; nontraditional diet that changed diets, 27; and nontraditional diet group without diet change, 0). Dogs in the nontraditional diet group that changed diets had a significantly greater decrease in normalized left ventricular diameter (diastolic, P = .02; systolic, P = .048) and the left atrium-to-aorta ratio (P = .002) and a significantly greater increase in fractional shortening (P = .02) compared to dogs eating traditional diets. Dogs eating nontraditional diets with diet change (n = 45; P < .001) and dogs eating traditional diets (12; P < .001) had a significantly longer survival time compared to dogs eating nontraditional diets without diet change (4). Dogs with DCM-C also had significant echocardiographic improvements after diet change.

CLINICAL RELEVANCE

Congestive heart failure and arrhythmias were common in pit bull-type breeds with DCM. Those eating nontraditional diets that changed diets had significant improvements in echocardiographic measurements after diet change.

Comparison of echocardiography, biomarkers and taurine concentrations in cats eating high- or low-pulse diets

OBJECTIVES

There are ongoing investigations into diet-associated dilated cardiomyopathy in dogs, but there has been minimal investigation into possible diet-associated dilated cardiomyopathy in cats. The objective of this study was to compare cardiac size and function, cardiac biomarkers and taurine concentrations in healthy cats eating high- vs low-pulse diets. We hypothesized that cats eating high-pulse diets would have larger hearts, lower systolic function and higher biomarker concentrations than cats eating low-pulse diets and that there would be no difference in taurine concentrations between the diet groups.

METHODS

Echocardiographic measurements, cardiac biomarkers, and plasma and whole-blood taurine concentrations were compared between cats eating high- and low-pulse commercial dry diets in a cross-sectional study.

RESULTS

There were no differences between the high- (n = 21) and low-pulse (n = 31) diet groups with regard to age, sex and breed, but more cats in the high-pulse group were overweight or obese (67% vs 39%; P = 0.05). Diet duration was not different in the groups, but the range was wide (6-120 months). No differences were found between the diet groups for key cardiac measurements, biomarker concentrations, or plasma or whole-blood taurine concentrations. However, there were significant negative correlations between diet duration and measures of left ventricular wall thickness in the high-pulse, but not the low-pulse, diet group.

CONCLUSIONS AND RELEVANCE

This study did not detect significant associations between high-pulse diets and cardiac size, function and biomarkers, but the secondary observation of significant negative correlations between time on high-pulse diets and left ventricular wall thickness warrants further evaluation.

Metabolomic profiling in dogs with dilated cardiomyopathy eating non-traditional or traditional diets and in healthy controls

Dilated cardiomyopathy (DCM), caused by genetic and environmental factors, usually progresses to heart failure, a major cause of death in elderly people. A diet-associated form of DCM was recently identified in pet dogs eating non-traditional (NT) diets. To identify potential dietary causes, we analyzed metabolomic signatures and gene set/pathway enrichment in (1) all dogs based on disease, diet, and their interactions and (2) dogs with DCM based on diet. Metabolomic analysis was performed in 38 dogs with DCM eating NT diets (DCM-NT), 8 dogs with DCM eating traditional diets, 12 healthy controls eating NT diets, and 17 healthy controls eating traditional diets. Overall, 153 and 63 metabolites differed significantly between dogs with DCM versus healthy controls and dogs eating NT versus traditional diets, respectively, with 12 metabolites overlapping both analyses. Protein-protein interaction networks and gene set enrichment analysis identified 105 significant pathways and gene sets including aging-related pathways (e.g., nuclear factor-kappa B, oxidative damage, inflammation). Seventeen metabolites differed significantly in dogs with DCM eating NT versus traditional diets (e.g., fatty acids, amino acids, legume biomarkers), suggesting different mechanisms for primary versus diet-associated DCM. Our multifaceted metabolomic assessment of DCM in dogs highlighted diet's role in some forms of DCM.

Comparison of echocardiographic measurements and cardiac biomarkers in healthy dogs eating nontraditional or traditional diets

BACKGROUND

There has been a recent association between nontraditional diets and development of diet-associated dilated cardiomyopathy (DCM) in dogs.

HYPOTHESIS/OBJECTIVES

To compare echocardiographic measurements and cardiac biomarkers between healthy dogs eating nontraditional vs traditional diets. We hypothesized that dogs eating nontraditional diets would have lower measures of systolic myocardial performance compared to dogs eating traditional diets.

ANIMALS

Forty-six healthy dogs: 23 eating nontraditional diets and 23 eating traditional diets.

METHODS

Prospective, cross-sectional study. Dogs were divided into groups based on diet ingredients. Dogs underwent 2-dimensional (2D), 3-dimensional (3D), and Doppler echocardiographic examinations and analysis of plasma N-terminal prohormone of B-type natriuretic peptide, serum cardiac troponin I, and whole blood and plasma taurine concentrations.

RESULTS

Mean 2D ejection fraction (EF) was lower for dogs eating nontraditional diets (48.65 ± 7.42%) vs dogs eating traditional diets (56.65 ± 4.63%; P < .001; mean difference 8.0% [4.0%-12.0%] 95% confidence interval [CI]). Mean 3D EF was lower for dogs eating nontraditional diets (45.38 ± 7.35%) vs dogs eating traditional diets (57.58 ± 4.84%; P < .001; 12.0% [8.0%-16.0%] 95% CI). Mean 2D left ventricular end-systolic volumes, indexed to body weight, were significantly higher in dogs eating nontraditional diets (1.46 ± 0.08 mL/kg) vs dogs eating traditional diets (1.06 ± 0.08 mL/kg; P = .002; 0.4 mL/kg [0.18-0.62 mL/kg] 95% CI).

CONCLUSIONS AND CLINICAL IMPORTANCE

Healthy dogs eating nontraditional diets had lower indices of systolic function and larger left ventricular volumes compared to dogs eating traditional diets. Screening of apparently healthy dogs eating nontraditional diets might allow for early detection of diet-associated DCM.

Gastrointestinal signs and a need for nutritional management may persist long term in dogs and cats undergoing resection of the ileocolic junction: 35 cases (2008-2020)

OBJECTIVE

To evaluate the effects of ileocecocolic junction (ICJ) resection on gastrointestinal signs, biochemical parameters, and nutritional variables in dogs and cats.

ANIMALS

20 dogs and 15 cats that underwent ICJ resection between January 2008 and June 2020.

PROCEDURES

Medical records of dogs and cats that underwent ICJ resection were reviewed, and clinical signs, laboratory abnormalities, and nutritional information were obtained. Additional follow-up information was obtained by contacting primary care veterinarians or owners. A subset of dogs (n = 6) and cats (2) were evaluated in the hospital via clinical examination, clinicopathologic testing, nutritional testing, and abdominal ultrasound.

RESULTS

Twenty dogs and 15 cats underwent resection of the ICJ for treatment of a variety of conditions. Ten of 20 dogs (50%) and 11/15 cats (73%) were reported by their owners to have a good long-term outcome based on the lack of long-term gastrointestinal signs or the ability to control gastrointestinal signs with diet and supplements alone. Despite owner-reported good outcomes, long-term diarrhea, weight loss, and muscle loss were common. Of the 6 dogs evaluated in the hospital, 3/6 (50%) had muscle loss, 2/6 (33%) had low taurine concentrations, and 1 dog each had low cobalamin, folate, 25-hydroxyvitamin D, and ionized calcium. Neither of the 2 cats evaluated in the hospital had nutritional abnormalities identified.

CLINICAL RELEVANCE

Owners should be informed of the possibility of long-term gastrointestinal clinical signs and the potential need for long-term nutritional management after ICJ resection.

Untargeted global metabolomic profiling of healthy dogs grouped on the basis of grain inclusivity of their diet and of dogs with subclinical cardiac abnormalities that underwent a diet change

OBJECTIVE

To compare metabolomic profiles of dogs eating grain-free (GF) versus grain-inclusive (GI) diets (1) for healthy dogs at baseline and (2) for dogs with subclinical cardiac abnormalities at 12 months after a diet change.

SAMPLE

Serum samples from 23 dogs eating GF diets and 79 dogs eating GI diets, of which 17 (8 eating a GF diet and 9 eating a GI diet) were reevaluated 12 months after a diet change.

PROCEDURES

Metabolomic profiles were developed by means of ultrahigh-performance liquid chromatography-tandem mass spectroscopy of serum samples. Baseline results for the GF group were compared with those for the GI group. Dogs from both groups with subclinical cardiac abnormalities were transitioned to a GI, pulse-free, intervention diet, and samples collected 12 months later were compared between diet groups. Statistical significance for biochemical group differences was defined as P < .05 with a false discovery rate (q) < .10.

RESULTS

Baseline differences in lipid metabolism and amino acid metabolism were found between the GF and GI diet groups. There were 46 metabolites that were higher and 82 metabolites that were lower in the GF group (n = 23), compared with the GI group (79). Comparison of the GF (n = 8) and GI (9) groups 12 months after the diet change showed only 6 metabolites that were higher and 11 metabolites that were lower in the GF group, compared with the GI group.

CLINICAL RELEVANCE

Metabolomic pathway differences between dogs eating GF versus GI diets highlight the important effect of diet in metabolomics analyses. The clinical importance of these differences and how they might relate to cardiac disease in dogs remains undetermined.

Dilated cardiomyopathy in cats: survey of veterinary cardiologists and retrospective evaluation of a possible association with diet

INTRODUCTION/OBJECTIVES

The objectives were to conduct a survey of cardiologists on their recent experiences with cats that have dilated cardiomyopathy (DCM) and to retrospectively review individual cases of feline DCM.

ANIMALS, MATERIALS AND METHODS

Part one: A survey was distributed to cardiologists with questions regarding caseload and clinical management of cats with DCM diagnosed over the past two years. Part two: Cardiologists completing the survey were invited to submit data from cats recently diagnosed with DCM. Data on signalment, clinical signs, diet, echocardiographic measurements and outcome were recorded.

RESULTS

Part one: From 52 completed surveys, many cardiologists responded that measuring and supplementing taurine and recommending a diet change in cats with DCM are common practices. Few (15%) cardiologists reported an increase in the number of feline DCM cases over the past two years, although some had cases that improved even if taurine deficiency was not present. Part two: Twenty of 37 (54%) cats ate low pea/lentil (low PL) diets, and 14/37 (38%) ate high PL diets at the time of diagnosis; three had incomplete diet information. Two of 13 cats (15%) in which taurine was measured had levels below the reference range. After adjusting for other variables, cats eating high PL diets that changed diets after diagnosis had a significantly longer survival time than that of cats eating high PL diets that did not change diets after diagnosis (P = 0.025).

CONCLUSIONS

Additional research is warranted to determine whether there could be a possible association between diet and DCM in cats.

Investigation of diets associated with dilated cardiomyopathy in dogs using foodomics analysis

Dilated cardiomyopathy (DCM) is a disease of the heart muscle that affects both humans and dogs. Certain canine diets have been associated with DCM, but the diet-disease link is unexplained, and novel methods are needed to elucidate mechanisms. We conducted metabolomic profiling of 9 diets associated with canine DCM, containing ≥ 3 pulses, potatoes, or sweet potatoes as main ingredients, and in the top 16 dog diet brands most frequently associated with canine DCM cases reported to the FDA (3P/FDA diets), and 9 non-3P/FDA diets. We identified 88 named biochemical compounds that were higher in 3P/FDA diets and 23 named compounds that were lower in 3P/FDA diets. Amino acids, amino acid-derived compounds, and xenobiotics/plant compounds were the largest categories of biochemicals that were higher in 3P/FDA diets. Random forest analyses identified the top 30 compounds that distinguished the two diet groups with 100% predictive accuracy. Four diet ingredients distinguished the two diet groups (peas, lentils, chicken/turkey, and rice). Of these ingredients, peas showed the greatest association with higher concentrations of compounds in 3P/FDA diets. Moreover, the current foodomics analyses highlight relationships between diet and DCM in dogs that can identify possible etiologies for understanding diet-disease relationships in dogs and humans.

Retrospective study of dilated cardiomyopathy in dogs

Background

The United States Food and Drug Administration is investigating possible diet‐associated dilated cardiomyopathy (DCM) in dogs and cats.

Objectives

To retrospectively review DCM cases for signalment, diet information, echocardiographic changes, and survival.

Animals

Client‐owned dogs (n = 71).

Methods

Medical records of dogs diagnosed with DCM between January 1, 2014 and September 30, 2018 were reviewed. Dogs were grouped into “traditional” or “nontraditional” diet categories and whether or not diet was changed after diagnosis.

Results

For dogs eating nontraditional diets, those that had their diets changed had a larger percentage decrease in normalized systolic left ventricular internal dimension (P = .03) and left atrial:aorta ratio (P < .001) compared to those that did not have their diets changed. Survival time was significantly longer for dogs with DCM eating nontraditional diets that had their diets changed (median survival, 337 days; range, 9‐1307 days) compared to dogs eating nontraditional diets that did not have their diets changed (median survival, 215 days; range, 1‐852 days; P = .002).

Conclusions and Clinical Importance

Dogs with DCM eating nontraditional diets can experience improvement in cardiac function after diet change but additional research is needed to examine possible associations between diet and DCM.

Echocardiographic, morphometric and biomarker changes in female cats followed from 6 to 24 months of life

OBJECTIVES

The aim of the study was to evaluate cardiac size and early growth through echocardiographic, body weight (BW), body condition score (BCS), morphometric and biomarker changes in cats followed from 6 to 24 months of age.

METHODS

Twenty-four female European shorthair colony cats were evaluated at birth for BW and at 6, 12, 18 and 24 months of age for BW, BCS, head length (HL) and head width (HW), N-terminal pro B-type natriuretic peptide (NT-proBNP), insulin-like growth factor-1 (IGF-1) and echocardiographic measurements.

RESULTS

BCS, HW, left ventricular free wall in diastole, left atrium diameter and aortic diameter increased significantly between 6 and 12 months, while BW, HL and interventricular septum in diastole increased significantly between 6, 12 and 18 months, and BW decreased significantly between 18 and 24 months. NT-proBNP decreased significantly between 6 and 12 months. IGF-1 increased significantly between 6 and 12 months but decreased significantly between 12 and 18 months.

CONCLUSIONS AND RELEVANCE

This study prospectively evaluated changes in echocardiographic measurements, BW, BCS, HL, HW, IGF-1 and NT-proBNP in cats during the first 2 years of life. Results show a comparable change over time for different variables. These findings contribute to the understanding of a possible relationship between cardiac measures and body size from young age through to adulthood.

Usefulness of muscle condition score and ultrasonographic measurements for assessment of muscle mass in cats with cachexia and sarcopenia

OBJECTIVE

To compare muscle condition scores (MCSs) and muscle ultrasonographic measurements in cats with and without muscle loss and to evaluate repeatability and reproducibility of MCS assessment.

ANIMALS

40 cats of various ages, body condition scores (BCSs), and MCSs.

PROCEDURES

A prospective cross-sectional study was conducted. Body weight, BCS, MCS, epaxial muscle height (EMH), vertebral epaxial muscle score (VEMS), and forelimb epaxial muscle score (FLEMS) were assessed in each cat. The MCS for each cat was assessed 3 separate times by each of 5 raters.

RESULTS

The MCS was significantly correlated with EMH (r = 0.59), VEMS (r = 0.66), and FLEMS (r = 0.41). For MCS, the overall value of the κ coefficient for interrater agreement (reproducibility) was 0.43 and the overall value of the κ coefficient for intrarater agreement (repeatability) ranged from 0.49 to 0.76.

CONCLUSIONS AND CLINICAL RELEVANCE

Ultrasonographic measurements of muscle may be useful for assessing muscle loss in individual cats over time. However, for the cats of this study, no advantage was observed for assessment of VEMS or FLEMS over EMH. Substantial repeatability and moderate reproducibility were shown when MCS was used for assessment of muscle mass in cats. Prospective ultrasonographic studies are warranted to evaluate the usefulness of MCS and EMH assessment for evaluation of changes in muscle mass of cats over time.

Vitamin D status in cats with cardiomyopathy

BACKGROUND

Low vitamin D concentrations have been associated with advanced heart disease and poorer outcomes in people and dogs. Vitamin D status typically is assessed by serum 25(OH)D concentration. However, cats also produce notable amounts of a C-3 epimer of 25(OH)D (3-epi).

HYPOTHESIS/OBJECTIVES

Determine if vitamin D status, estimated by 25(OH)D₃ alone or combined with 3-epi (summation vitD), is lower in cats with cardiomyopathy (CM) compared to clinically normal (N) cats and if indicators of disease severity are associated with vitamin D status.

ANIMALS

Privately owned cats, 44 with CM and 56 N.

METHODS

Cross-sectional observational study using clinical and echocardiographic findings, diet history, and serum 25(OH)D₃ and 3-epi measurements.

RESULTS

Cat age was negatively related to vitamin D status. Summation vitD was lower in CM cats (median = 47.1 ng/mL) compared to N cats (median = 58.65 ng/mL) both before (P = .03) and after (P = .04) accounting for age. However, 25(OH)D₃ became nonsignificant between CM and N cats after age was included. Summation vitD was related positively to survival time and fractional shortening (FS), but negatively to left atrial enlargement (LAE) severity, both before and after accounting for age. For 25(OH)D₃ alone, only survival time and FS remained significant after including age.

CONCLUSIONS AND CLINICAL IMPORTANCE

We report 25(OH)D₃ and 3-epi concentrations in CM and N cats. Age had an important (negative) relationship to vitamin D status. After accounting for age, summation vitD was lower in CM cats. Vitamin D status was related positively to survival time and FS, but negatively to LAE severity.

Validation and preliminary data from a health-related quality of life questionnaire for owners of dogs with cardiac disease

BACKGROUND

Cardiac disease in dogs impacts the quality of life (QoL) of their owners, but owners' QoL has not been comprehensively assessed in this population.

OBJECTIVES

To develop, validate, and provide preliminary data from a health-related QoL (hrQoL) questionnaire for owners of dogs with cardiac disease.

SUBJECTS

A total of 141 owners of dogs with cardiac disease were studied.

METHODS

An owner hrQoL (O-hrQoL) questionnaire containing 20 items related to areas of a person's life that could be impacted by caring for a dog with cardiac disease was developed and administered to owners of dogs with cardiac disease. The highest possible total score was 100, with higher scores indicating a worse hrQoL. Readability, internal consistency, face and construct validity, and item-total correlations were assessed.

RESULTS

Median O-hrQoL score was 35 (range, 0-87). The questionnaire had good internal consistency (Cronbach's α = 0.933), construct validity (Spearman's r = 0.38-0.53; Kendall's τ = 0.30-0.43; P < .001), and item-total correlation (Spearman's r = 0.44-0.79; Kendall's τ = 0.34-0.66; all P < .001). Fifty percent of owners indicated a negative effect of dogs' cardiac disease on their own QoL, but all owners responded that caring for their dogs either had strengthened (n = 76; 53.9%) or had no effect on their relationship with their dog (n = 65; 46.1%).

CONCLUSIONS AND CLINICAL IMPORTANCE

The O-hrQoL questionnaire had good validity, and results suggest that owners' QoL is significantly impacted by caring for dogs with cardiac disease. Additional research on effective approaches to minimizing the negative effects of a dog's cardiac disease on the owner is warranted.

Current Standards and Practices Within the Therapy Dog Industry: Results of a Representative Survey of United States Therapy Dog Organizations

Organizations that deliver animal-assisted interventions (AAIs), as well as those that train, evaluate, and register therapy dogs, have proliferated in recent decades in the United States (U.S.). Each of these organizations has its own policies and procedures for screening, evaluating, and instructing dogs and their owners/handlers, but little is currently known about the range of different practices that exist nationwide. The aim of this project was to survey a representative, national sample of U.S. therapy dog organizations to investigate commonalities and differences in the types of practices in current use and to compare these to recommendations in existing published guidelines. The findings suggest the need for further research, and highlight a number of areas relating to dog welfare, human safety, and infection control in which many organizations were inconsistent in their adherence to existing guidelines. Of particular concern with regard to animal welfare was the finding that approximately half of the organizations surveyed imposed no time limit on the length of visits. Also, given the potential for zoonotic disease transmission, the finding that only a small minority of organizations prohibit the feeding of raw meat diets and treats to visiting dogs is concerning. This information will help to raise awareness among facilities with therapy animal programs and assist in the development of future best practices within the therapy dog industry.

Cardiac cachexia in cats with congestive heart failure: Prevalence and clinical, laboratory, and survival findings

BACKGROUND

Cardiac cachexia is common in people and dogs with congestive heart failure (CHF). However, the prevalence and effects of cardiac cachexia in cats are unknown.

OBJECTIVES

To determine the prevalence of cachexia and its associations with clinical laboratory and survival data in cats with CHF.

ANIMALS

One hundred twenty-five cats with CHF.

METHODS

Medical records of cats evaluated during a 40-month period were retrospectively reviewed to identify cats with cardiac cachexia using 7 different definitions. Clinical, laboratory, and survival data were compared between cats with and without cachexia.

RESULTS

Prevalence of cachexia ranged from 0 to 66.7% for the 7 definitions, with a prevalence of 41.6% using muscle condition score (MCS). Cats with cachexia (determined by MCS) were older (P < .001), more likely to have pleural effusion (P = .003), had significantly higher blood urea nitrogen (P < .001) and neutrophil concentrations (P = .01), and significantly lower body condition score (P < .001), body weights (P < .001), hematocrit (P = .007), and hemoglobin concentrations (P = .009). Survival time for cats with cachexia (determined by MCS) was significantly shorter than for cats without cachexia (P = .03). Cats that were underweight (P = .002) and cats with dilated cardiomyopathy (DCM) also had shorter survival times (P = .04).

CONCLUSIONS AND CLINICAL IMPORTANCE

The association between cachexia and reduced survival time emphasizes the importance of identifying and addressing this common problem in cats with CHF.

Evaluation of the use of muscle condition score and ultrasonographic measurements for assessment of muscle mass in dogs

OBJECTIVE

To evaluate repeatability and reproducibility of muscle condition score (MCS) in dogs with various degrees of muscle loss; to compare MCS, muscle ultrasonographic measurements, and quantitative magnetic resonance (QMR) measurements; and to identify cutoff values for ultrasonographic measurements of muscle that can be used to identify dogs with cachexia and sarcopenia.

ANIMALS

40 dogs of various age, body condition score (BCS), and MCS.

PROCEDURES

A prospective cross-sectional study was conducted. Body weight, BCS, QMR measurements, thoracic radiographic measurements, and muscle ultrasonographic measurements were assessed once in each dog. The MCS for each dog was assessed 3 separate times by 4 separate raters.

RESULTS

For the MCS, overall κ for interrater agreement was 0.50 and overall κ for intrarater agreement ranged from 0.59 to 0.77. For both interrater and intrarater agreement, κ coefficients were higher for dogs with normal muscle mass and severe muscle loss and lower for dogs with mild and moderate muscle loss. The MCS was significantly correlated with age (r = -0.62), vertebral epaxial muscle score (VEMS; r = 0.71), forelimb epaxial muscle score (FLEMS; r = 0.58), and BCS (r = 0.73), and VEMS was significantly correlated (r = 0.84) with FLEMS. Cutoff values for identification of mild muscle loss determined by use of VEMS and FLEMS were 1.124 and 1.666, respectively.

CONCLUSIONS AND CLINICAL RELEVANCE

MCS had substantial repeatability and moderate reproducibility for assessment of muscle mass in dogs. Prospective studies of MCS, VEMS, and FLEMS for assessment of muscle mass in dogs are warranted.

Clinical and laboratory findings and survival time associated with cardiac cachexia in dogs with congestive heart failure

BACKGROUND

Cardiac cachexia, loss of muscle mass associated with congestive heart failure (CHF), is associated with increased morbidity and shorter survival times in people, but an association between cardiac cachexia and survival has not been reported in dogs.

OBJECTIVES

To determine the prevalence of cachexia and its associations with clinical, laboratory, and survival data in dogs with CHF.

ANIMALS

Two hundred sixty-nine dogs with CHF.

METHODS

Retrospective cohort study. Cachexia was defined by 1 of 2 definitions: (1) mild, moderate, or severe muscle loss or (2) weight loss of ≥5% in 12 months or less. Variables were compared between dogs with and without cachexia.

RESULTS

One hundred thirty of 269 dogs (48.3%) had cardiac cachexia based on muscle loss, whereas 67 of 159 dogs (42.1%) with pre-evaluation body weights had cachexia based on weight loss. Dogs with cachexia (based on muscle loss) were significantly older (P = .05), more likely to have a cardiac arrhythmia (P = .02), had higher chloride concentrations (P = .04), and had a lower body condition score (P < .001), hematocrit (P = .006), hemoglobin (P = .006), and albumin (P = .004) concentrations. On multivariable analysis, cachexia (P = .05), clinically important tachyarrhythmias (P < .001), azotemia (P < .001), and being under- or overweight (both P = .003) were associated with shorter survival times.

CONCLUSIONS AND CLINICAL IMPORTANCE

Cardiac cachexia in common in dogs with CHF and is associated with significantly shorter survival. This emphasizes the importance of preventing, diagnosing, and treating muscle loss in dogs with CHF.

Determinants of pet food purchasing decisions

The objective of this study was to identify determinants of pet food purchasing decisions. An online survey was administered via e-mail, newsletters, and social media. A total of 2181 pet owners completed the survey: 1209 dog owners and 972 cat owners; 26% of respondents were animal professionals. Pet food characteristics ranked the highest were health and nutrition, quality, ingredients, and freshness. The veterinary healthcare team was reported to be the primary (43.6%) and most important source of nutrition information for pet owners; Internet sources were the primary information source for 24.6% of respondents. Most pet owners reported giving equal (53.1%) or more priority (43.6%) to buying healthy food for their pets compared with themselves. Results suggest that pet owners face numerous challenges in determining the best diet to feed their pets.

Comparison of computed tomographic attenuation values for epaxial muscles in old and young dogs

OBJECTIVE To determine whether the degree of CT attenuation of muscle would differ between healthy old and young dogs. ANIMALS 10 healthy old (> 8 years old) and 9 healthy young (1 to 5 years old) Labrador Retrievers with a body condition score of 5 or 6 on a 9-point scale. PROCEDURES CT was performed with the dogs mildly sedated. A freehand closed polygon tool was used to define the outer margin of the left epaxial muscles on each transverse image obtained from the cranial to caudal endplates of T13. The CT attenuation values from every voxel from within these regions of interest were exported from DICOM software as a single dataset in an extensible markup language file. From these data, mean CT attenuation values were calculated for each dog and these mean values were compared between age groups. RESULTS Mean CT attenuation values for the epaxial muscles were significantly lower in old dogs than in young dogs. A significant negative correlation (r = -0.74) was identified between mean CT attenuation values and dog age. CONCLUSIONS AND CLINICAL RELEVANCE In addition to loss of skeletal muscle mass, low muscle CT attenuation values suggested that the old dogs in this study also had greater muscle fat content than did young dogs. Additional studies are warranted to evaluate qualitative and quantitative muscle changes in old dogs.

A pilot study investigating circulating trimethylamine N-oxide and its precursors in dogs with degenerative mitral valve disease with or without congestive heart failure

BACKGROUND

Pathophysiologic mechanisms for the development and progression of degenerative mitral valve disease (DMVD) remain elusive. Increased concentrations of circulating trimethylamine N-oxide (TMAO) and its precursors choline and l-carnitine are associated with the presence and severity of heart disease in people.

OBJECTIVES

To determine if differences exist in plasma concentrations of TMAO, choline, or l-carnitine among dogs with DMVD and congestive heart failure (CHF), dogs with asymptomatic DMVD, and healthy control dogs.

ANIMALS

Thirty client-owned dogs: 10 dogs with CHF secondary to DMVD, 10 dogs with asymptomatic DMVD, and 10 healthy control dogs.

METHODS

A pilot cross-sectional study in which echocardiography was performed and fasting plasma concentrations of TMAO, choline, and l-carnitine (total and fractions) were measured.

RESULTS

TMAO (P = .03), total l-carnitine (P = .03), carnitine esters (P = .05), and carnitine esters to free carnitine ratio (E/F ratio; P = .05) were significantly higher in dogs with CHF compared to those with asymptomatic DMVD. TMAO (P = .02), choline (P = .01), total l-carnitine (P = .01), carnitine esters (P = .02), free carnitine (P = .02), and E/F ratio (P = .009) were significantly higher in dogs with CHF compared to healthy controls.

CONCLUSIONS AND CLINICAL IMPORTANCE

Dogs with CHF secondary to DMVD had higher concentrations of TMAO compared to both asymptomatic DMVD dogs and healthy controls. Larger prospective studies are warranted to determine if TMAO plays a role in the development or progression of DMVD or CHF.

Clinical findings and survival time in dogs with advanced heart failure

Background

Dogs with advanced heart failure are a clinical challenge for veterinarians but there are no studies reporting clinical features and outcome of this population.

Hypothesis/Objectives

To describe clinical findings and outcome of dogs with advanced heart failure caused by degenerative mitral valve disease (DMVD).

Animals

Fifty‐four dogs with advanced heart failure because of DMVD.

Methods

For study purposes, advanced heart failure was defined as recurrence of congestive heart failure signs despite receiving the initially prescribed dose of pimobendan, angiotensin‐converting‐enzyme inhibitor (ACEI), and furosemide >4 mg/kg/day. Data were collected for the time of diagnosis of Stage C heart failure and time of diagnosis of advanced heart failure. Date of death was recorded.

Results

At the diagnosis of advanced heart failure, doses of pimobendan (n = 30), furosemide (n = 28), ACEI (n = 13), and spironolactone (n = 4) were increased, with ≥1 new medications added in most dogs. After initial diagnosis of advanced heart failure, 38 (70%) dogs had additional medications adjustments (median = 2 [range, 0‐27]), with the final total medication number ranging from 2‐10 (median = 5). Median survival time after diagnosis of advanced heart failure was 281 days (range, 3‐885 days). Dogs receiving a furosemide dose >6.70 mg/kg/day had significantly longer median survival times (402 days [range, 3‐885 days] versus 129 days [range 9‐853 days]; P = .017).

Conclusions and Clinical Importance

Dogs with advanced heart failure can have relatively long survival times. Higher furosemide dose and non‐hospitalization were associated with longer survival.

Quantitative assessment of muscle in dogs using a vertebral epaxial muscle score

Muscle loss associated with disease (cachexia) or with aging (sarcopenia) is common in dogs, but clinically relevant methods for quantifying muscle loss are needed. We previously validated an ultrasound method of quantifying muscle size in dogs in a single breed. The goal of this study was to assess the variability and reproducibility of the Vertebral Epaxial Muscle Score (VEMS) in other dog breeds. Static ultrasound images were obtained from 38 healthy, neutered dogs of 5 different breeds between 1- and 5-years-old. The maximal transverse right epaxial muscle height and area at the level of the 13th thoracic vertebra (T13) were measured. Length of the 4th thoracic vertebra (T4) was measured from thoracic radiography. Ratios of the muscle height and area to vertebral length (height/T4 and area/T4, respectively) were calculated to account for differences in body size among breeds. Reproducibility testing was performed on 2 dogs of each breed (26% of the total) to determine intra- and inter-investigator reproducibility, as well as intra-class correlation. Mean height/T4 = 1.02 ± 0.18 and mean area/T4 = 3.32 ± 1.68. There was no significant difference for height/T4 (P = 0.10) among breeds, but breeds were significantly different in area/T4 (P < 0.001). Intra-class correlation ranged from 0.80 to 0.99. Testing showed better reproducibility for height/T4 compared to area/T4. The VEMS using height/T4 was valid and reproducible for healthy dogs of different sizes and body conformations. Studies assessing this technique in dogs with congestive heart failure and other diseases associated with muscle loss are warranted.

Evaluation of echocardiography and cardiac biomarker concentrations in dogs with gastric dilatation volvulus

OBJECTIVE

To assess abnormalities in concentrations of cardiac troponin I (cTnI), lactate, and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in relation to arrhythmias, echocardiographic measurements, and survival in dogs with gastric dilatation volvulus (GDV).

DESIGN

Prospective observational study.

SETTING

University hospital.

ANIMALS

Twenty-two dogs with naturally occurring GDV.

SAMPLES

Concentrations of cTnI, plasma lactate, and NT-proBNP were recorded at presentation to the emergency room, the time closest to echocardiography, and the highest recorded concentrations during hospitalization.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

Cardiac rhythms were categorized on a 0-4 scale (0 = no ventricular premature complexes [VPCs], 1 = single VPCs, 2 = bigeminy or trigeminy, 3 = couplets or triplets, and 4 = R-on-T phenomenon or ventricular tachycardia). Echocardiography was performed 6-18 hours postoperatively. Fifteen dogs had ventricular arrhythmias during hospitalization (Grade 1 [n = 9], Grade 4 [n = 6]). The highest recorded cTnI concentration was significantly higher in the dogs with Grade 4 (P = 0.002) or Grade 1 (P = 0.001) arrhythmias compared to dogs without arrhythmias. Plasma lactate was significantly correlated with left ventricular internal diameter in diastole (r = -0.52, P = 0.01) and systole (r = -0.57, P = 0.006), left ventricular free wall in diastole (LWDd, r = 0.59, P = 0.004), and interventricular septal thickness in diastole (IVDs, r = 0.65, P = 0.001). Dogs that did not survive to 1 week postdischarge (3/22) had a significantly thicker LVWd (P = 0.04) and IVSd (P = 0.05), and received significantly less fluids in the first 24 (P = 0.02) and 48 hours (P = 0.03) of hospitalization.

CONCLUSIONS

Concentrations of cTnI and NT-proBNP increased during hospitalization, but only cTnI concentrations were significantly higher in dogs with a higher arrhythmia grade. Additional research on the potential role of serial measurement of biomarkers in dogs with GDV is warranted.

Post-operative Salmonella surgical site infection in a dog

Following decompressive surgery for degenerative lumbosacral stenosis, a 6-year-old German shepherd dog developed a subcutaneous infection at the surgical site and discospondylitis at the lumbosacral intervertebral disc. Salmonella enterica subsp. enterica, serotype Dublin was recovered from the surgical site. Salmonella of a different serovar was isolated from a sample of the raw meat-based diet that the owner fed the dog.

Feline Hypertrophic Cardiomyopathy: A Spontaneous Large Animal Model of Human HCM

Hypertrophic cardiomyopathy (HCM) is a common disease in pet cats, affecting 10-15% of the pet cat population. The similarity to human HCM, the rapid progression of disease, and the defined and readily determined endpoints of feline HCM make it an excellent natural model that is genotypically and phenotypically similar to human HCM. The Maine Coon and Ragdoll cats are particularly valuable models of HCM because of myosin binding protein-C mutations and even higher disease incidence compared to the overall feline population. The cat overcomes many of the limitations of rodent HCM models, and can provide enhanced translation of information from in vitro and induced small animal models to human clinical trials. Physicians and veterinarians working together in a collaborative and interdisciplinary approach can accelerate the discovery of more effective treatments for this and other cardiovascular diseases affecting human and veterinary patients.

Development and initial validation of the Cat HEalth and Wellbeing (CHEW) Questionnaire: a generic health-related quality of life instrument for cats

OBJECTIVES

The aims of the study were to define factors that owners consider relevant to the health-related quality of life (HRQoL) of cats, to develop an instrument based on this information, and to evaluate the validity and reliability of the final instrument (the Cat HEalth and Wellbeing [CHEW] Questionnaire).

METHODS

Psychometric research techniques and guidance from the US Food and Drug Administration on outcome measures were used to develop a valid and reliable instrument. Fifty-four cat owners and caregivers participated in the qualitative research, while 1303 cat owners were included in the quantitative validation phase (development dataset, n = 648; validation dataset, n = 655). A random subset of cat owners (n = 391) also participated in test-retest evaluation. Qualitative research was used to generate a draft instrument, which was then subjected to quantitative validation techniques. These included item reduction, domain identification, data quality assessment, and exploratory and confirmatory analysis to develop a final instrument, which underwent confirmatory reliability and validity assessment.

RESULTS

A draft instrument with 11 domains and 100 items based on qualitative research underwent online quantitative validation testing which refined the instrument to eight domains and 33 items. Confirmatory reliability and validity assessment showed that the final instrument had good validity, was able to discriminate between cats by age and overall health status, and demonstrated good internal and test-retest reliability.

CONCLUSIONS AND RELEVANCE

The CHEW Questionnaire was developed and validated. Additional research is needed to verify its ability to differentiate cats with and without disease, and to assess its potential as a screening tool.

Comparison of carbohydrate content between grain-containing and grain-free dry cat diets and between reported and calculated carbohydrate values

Objectives The aim of this study was to compare the carbohydrate content of grain-containing and grain-free dry cat diets and compare major protein and carbohydrate sources of these diets. Methods This was a cross-sectional study of 77 randomly selected dry cat diets (42 grain-containing, 35 grain-free). Reported carbohydrate values were compared between grain-containing and grain-free cat diets. A subset of 25% of diets from each category (grain-containing and grain-free) was analyzed and nitrogen-free extract was calculated as an estimate of carbohydrate content. These calculated values were compared with reported values from the manufacturer. Animal- and plant-sourced ingredients were also compared between grain-containing and grain-free diets. Results Mean reported carbohydrate content of the grain-free diets (n = 35) was lower than the grain-containing diets (n = 41; 64 ± 16 vs 86 ± 22 g/1000 kcal; P <0.001). Reported carbohydrate values were higher than analyzed nitrogen-free extract (n = 20; 79 ± 30 vs 73 ± 27 g/1000 kcal; P = 0.024). Poultry ( P = 0.009) and soy (P = 0.007) were less common in grain-free diets than in diets containing grain. The alternative carbohydrate sources of chickpeas, lentils, peas, potato, sweet potato and cassava/tapioca were more common ( P <0.05) in grain-free diets than in diets containing grain. Conclusions and relevance This sample of grain-free diets had lower mean reported carbohydrate content than grain-containing diets, but there was considerable overlap between groups and individual diets' carbohydrate/nitrogen-free extract content varied widely.

Dog attachment and perceived social support in overweight/obese and healthy weight children

The development of effective and sustainable interventions to treat childhood obesity remains both a priority and a challenge. Previous studies support that dogs provide social support in overweight adults in obesity interventions, but the child-dog relationship is not as well understood. The goal of the study was to examine the child-dog relationship among children to inform novel childhood obesity interventions including dogs. A cross-sectional study was conducted in the Living Laboratory® at the Museum of Science, Boston in 2015. Children aged 8-13, with a dog in the household, answered surveys on pet attachment (Pet Relationship Scale), perceived social support from parents and close friends (Child and Adolescent Social Support Scale), and had a height and weight measurement taken for calculation of body mass index percentile. Overweight and obese children (≥ 85th body mass index percentile) had greater mean attachment score to their dog and less mean perceived social support from their parents and friends combined compared to healthy weight children (73.1 ± 5.6 vs. 68.5 ± 7.2, p = 0.037; 110.5 ± 13.5 vs. 122.9 ± 14.8, p = 0.015, respectively; n = 43). In conclusions, children who are overweight/obese report greater mean dog attachment and lower mean perceived social support, supporting the concept that pet dogs are considered part of overweight/obese children's social support networks. Future studies are warranted to evaluate the impact of including pet dogs as additional health support in child obesity interventions.

Association between Survival Time and Changes in NT-proBNP in Cats Treated for Congestive Heart Failure

Background

Reductions in N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) concentrations after treatment have been associated with improved survival in people with congestive heart failure (CHF), but have not been reported in cats with CHF.

Objectives

To evaluate changes in NT‐proBNP concentrations in cats with CHF after treatment and determine whether serial NT‐proBNP measurements provide prognostic information.

Animals

Thirty‐one client‐owned cats.

Methods

Prospective, observational study in cats with new onset CHF secondary to cardiomyopathy. Concentrations of NT‐proBNP were measured within 4 hours of admission to the hospital, on the day of discharge, and at re‐evaluation 7–10 days later.

Results

Median NT‐proBNP concentrations decreased significantly from admission (1,713 pmol/L [range, 160–3,784 pmol/L]) to discharge (902 pmol/L [range, 147–3,223 pmol/L]); P = .005) and from admission to re‐evaluation (1,124 pmol/L [range, 111–2,727 pmol/L]; P = .024). Median survival time was 109 days (range, 1–709 days), with 5 cats still alive at the time of analysis. Cats with a larger percent decrease in NT‐proBNP from admission to discharge had a longer survival time (P = .048). Cats with evidence of active CHF at the time of re‐evaluation (P = .010) and cats whose owners had difficulty administering medications (P = .045) had shorter survival times.

Conclusions and clinical importance

Cats with a larger percent decrease in NT‐proBNP during hospitalization and no evidence of CHF at the time of re‐evaluation had longer survival times. Additional studies are needed to determine whether NT‐proBNP can help guide treatment in cats with CHF.

Assessment of the responsiveness of the Cats' Assessment Tool for Cardiac Health (CATCH) Questionnaire

OBJECTIVES

To evaluate the responsiveness and optimal timing of a validated health-related quality of life questionnaire, and to assess the relationship between quality of life, severity of disease, and N-terminal pro B-type natriuretic peptide (NT-proBNP) in cats with acute congestive heart failure (CHF).

ANIMALS

Thirty client-owned cats with acute CHF.

METHODS

Echocardiography, International Small Animal Cardiac Health Council (ISACHC) stage, and NT-proBNP were assessed in cats within 36 h of admission. The Cats' Assessment Tool for Cardiac Health (CATCH) Questionnaire (range of 0-80, with 80 being the worst possible score) was completed by cat owners and ISACHC stage was assessed at the time of hospital discharge, 3 days after discharge, and 7-14 days after discharge. NT-proBNP concentration was reassessed 7-14 days after discharge.

RESULTS

The ISACHC stage at time of admission improved significantly by reevaluation 7-14 days after discharge (P < 0.001). The decrease in median NT-proBNP concentration from time of admission (655 pmol/L; range, 188 to >1500 pmol/L) to reevaluation (583 pmol/L; range, 41 to >1500 pmol/L) was not significant (P = 0.59). Median CATCH score was 26 (range, 0-70) at baseline, 19 (range, 0 to 61) at discharge, and 19 (range, 2-49) 7-14 days after discharge (P = 0.89). CATCH scores did not correlate with NT-proBNP concentrations or ISACHC stage.

CONCLUSIONS

These results suggest that the CATCH questionnaire requires further refinement for uses requiring a responsive instrument in cats with acute CHF.

Evaluation of Weight Loss Over Time in Cats with Chronic Kidney Disease

Background

Thin body condition and weight loss are common in cats with chronic kidney disease (CKD). However, the time course and progression of weight loss before and after diagnosis have not been thoroughly evaluated.

Hypothesis/Objectives

To describe weight loss in cats with CKD before and after diagnosis and its relationship to survival.

Animals

A total of 569 cats (55.5% females and 44.5% males) with CKD from 6 US veterinary practices for which International Renal Interest Society (IRIS) stage, age, date of CKD diagnosis, and at least two body weight measurements were available.

Methods

Body weight measurements were analyzed by time windows and polynomial growth curve analysis. Survival analysis was performed by Kaplan–Meier curves and log‐rank tests.

Results

Median age at diagnosis was 14.9 years (range, 5.0–22.8 years). Cats were categorized at diagnosis as IRIS stage 1 (n = 34 [6%]), stage 2 (n = 345 [61%]), stage 3 (n = 141 [25%]), and stage 4 (n = 49 [9%]). Median body weight at diagnosis was 4.2 kg (range, 1.6–9.9 kg). Cats lost a median of 8.9% of body weight in the 12 months before diagnosis, but weight loss was already present 3 years before diagnosis and accelerated after diagnosis of CKD. Cats <4.2 kg at the time of diagnosis had significantly shorter survival time compared to cats ≥ 4.2 kg at diagnosis (P < .0001).

Conclusions and Clinical Importance

Weight loss can be detected in cats before diagnosis of CKD, accelerates after diagnosis, and is associated with shorter survival. Tracking body weight may help clinicians in earlier diagnosis of CKD.

Salmonella bacteriuria in a cat fed a Salmonella-contaminated diet

CASE DESCRIPTION

A 9-year-old castrated male domestic shorthair cat was evaluated because of hematuria and weight loss after an 8-year history of intermittent signs of feline lower urinary tract disease (FLUTD). A complete diet history revealed that the cat was eating a commercial diet that does not undergo the same processing procedures as most pet foods and so might be at increased risk for bacterial contamination owing to a nonstandard industry cooking procedure.

CLINICAL FINDINGS

The cat had a history consistent with FLUTD, but bacteriologic culture of the urine revealed Salmonella organisms. Additional analysis revealed Salmonella enterica serotype I:ROUGH-O:g,m,s:- in samples of urine and feces as well as Salmonella enterica serotype Johannesburg and Salmonella enterica serotype Senftenberg in the diet.

TREATMENT AND OUTCOME

The cat responded positively to antimicrobial treatment for the Salmonella bacteriuria as well as to dietary and environmental management for the clinical signs associated with FLUTD.

CLINICAL RELEVANCE

Findings in this case highlighted an additional health consequence associated with ingestion of Salmonella-contaminated food. Such contamination is of particular concern with raw meat-based diets or diets that have not undergone standard industry cooking practices. Veterinarians should obtain a diet history for every companion animal during every evaluation to help with diagnosis and optimal treatment.

The Role of Veterinary Education in Safety Policies for Animal-Assisted Therapy and Activities in Hospitals and Nursing Homes

Animal-assisted activities (AAA) and animal-assisted therapy (AAT) programs are increasing in popularity, but current programs vary in their safety and health policies. Veterinarians can have an important role in ensuring the safety of both the animals and humans involved, but it is unclear how best to educate veterinary students to serve effectively in this role. Therefore, the goal of this study was to assess the knowledge gaps and perceptions of first-year veterinary students on health and safety aspects of AAA/AAT programs by administering a survey. This information could then guide future educational training in veterinary schools to address the knowledge gaps in this area. Formal education during the veterinary curriculum had not yet been provided to these students on AAA/AAT before the survey. Of 98 first-year veterinary students, 91 completed the survey. When asked about policies on visiting animals, 58% of students responded that nursing homes are required to have a policy and 67% responded that hospitals are required to have one. Three quarters of students reported that veterinarians, animal handlers, and facilities should share the responsibility for ensuring safe human-animal interaction in AAA/AAT programs. Most (82%) of the students responded that all or most national and local therapy animal groups prohibit animals that consume raw meat diets from participating in AAA/AAT programs. The results of this survey will help veterinary schools better identify knowledge gaps that can be addressed in veterinary curricula so future veterinarians will be equipped to provide appropriate public health information regarding AAA/AAT programs.

Association between Body Condition Score and Cancer Prognosis in Dogs with Lymphoma and Osteosarcoma

Background

In humans and rodents obesity appears to promote some cancers by increasing incidence, tumor aggressiveness, recurrence, and fatality. However, the relationship between obesity and cancer in dogs has not been thoroughly evaluated.

Hypothesis/Objectives

Whether body condition score (BCS) at the time of lymphoma (LSA) or osteosarcoma (OSA) diagnosis in dogs is predictive of survival time (ST) or progression‐free interval (PFI). We hypothesized that an overweight body state at the time of cancer diagnosis would be associated with negative outcomes.

Animals

Dogs with LSA (n = 270) and OSA (n = 54) diagnosed and treated between 2000 and 2010.

Methods

Retrospective case review. Signalment, body weight, BCS, cancer diagnosis and treatment, relevant clinicopathologic values, and survival data were collected. Dogs were grouped by BCS (underweight, ideal, and overweight) and ST and PFI were compared.

Results

Overall, 5.5% of dogs were underweight, 54.0% were ideal weight, and 40.4% were overweight at diagnosis. Underweight dogs with LSA had shorter ST (P = .017) than ideal or overweight dogs. BCS was not associated with ST for OSA (P = .474). Progression‐free interval did not differ among BCS categories for either cancer.

Conclusions and Clinical Importance

Obesity was not associated with adverse outcomes among dogs with LSA or OSA in this retrospective study; however, being underweight at the time of diagnosis of LSA was associated with shorter survival. More research is needed to elucidate the relationship between excessive body weight and cancer development and progression in dogs.

Pilot study of a myostatin antagonist in dogs with cardiac cachexia

OBJECTIVES

Cardiac cachexia, a loss of lean body mass caused by heart disease, often accompanies congestive heart failure (CHF). Blocking myostatin, which is a protein that inhibits muscle growth, appears to greatly enhance muscle size and strength in rodent models and human clinical trials. The objective of this study was to evaluate a dog-specific myostatin antagonist (CAP-031) in a pilot study to test its safety and efficacy in dogs with CHF and cardiac cachexia.

ANIMALS

Dogs with CHF and cardiac cachexia.

METHODS

Eligible dogs received four weekly subcutaneous injections of CAP-031. Endpoints were body weight, body condition score (BCS, on a 1-9 scale), muscle condition score (MCS, on a five-point scale, where 0 = no muscle loss and 4 = severe muscle loss), appetite, and a quality of life (QOL) score.

RESULTS

Seven dogs with CHF and moderate-to-severe cachexia were enrolled in the study. For the six dogs that completed the study, the median age was 8.8 years (range 6.4-10.6). At baseline, the median body weight was 27.0 kg (range 17.3-62.0), the median BCS was 4 (2-5), and median MCS was 3 (3-4). There were no significant changes in body weight, BCS, appetite, or QOL score. The change in MCS (from a median of 3 at baseline to a median of 2.5 at week 4) was not statistically significant (p = 0.06).

CONCLUSIONS

The myostatin antagonist appeared to be well tolerated in most dogs. Earlier identification of cachexia is important, and randomized, controlled trials of myostatin antagonists or other drugs to treat cardiac cachexia are needed.

Nutritional analysis and microbiological evaluation of commercially available enteral diets for cats

OBJECTIVE

To determine the prevalence of nutrients less than or greater than accepted standards in commercially available enteral diets for cats, and to identify contamination incidence in enteral diets for cats.

DESIGN

Prospective cross-sectional study.

SETTING

University teaching hospital.

SAMPLES

Seven commercial enteral diets for cats.

INTERVENTIONS

Labels were evaluated to determine if diets were intended to be nutritionally complete and balanced. One diet under storage techniques partially representative of clinical conditions was sampled on days 0, 1, 3, 5, and 7 of storage for aerobic bacterial culture.

MEASUREMENTS AND MAIN RESULTS

All 7 diets were analyzed for key nutrients and results were compared to Association of American Feed Control Officials (AAFCO) Nutrient Profiles for Adult Cats for maintenance and National Research Council recommended allowance (NRC-RA). From label information, 4 diets were classified as complete and balanced and 3 diets were classified as not complete and balanced. All 7 diets had at least 1 nutrient less than the AAFCO minimums and the NRC-RA. The total number of nutrients less than AAFCO minimums ranged from 3 to 9 (median = 4), with iron, potassium, and manganese being the most common. Concentrations of some nutrients were undetectable. None of the samples tested had a positive aerobic culture at baseline (day 0) or on subsequent samples from days 1, 3, 5, and 7 under any storage condition.

CONCLUSIONS

None of the diets analyzed met all of the minimum nutrient concentrations. While short-term feeding may not be of concern for an individual patient, clinicians should be aware of potential nutritional limitations when feeding enteral diets to ill or injured cats.

Expression Profiling of Circulating MicroRNAs in Canine Myxomatous Mitral Valve Disease

MicroRNAs (miRNAs) are small non-coding RNAs that have shown promise as noninvasive biomarkers in cardiac disease. This study was undertaken to investigate the miRNA expression profile in dogs with myxomatous mitral valve disease (MMVD). 277 miRNAs were quantified using RT-qPCR from six normal dogs (American College of Veterinary Internal Medicine Stage A), six dogs with MMVD mild to moderate cardiac enlargement (ACVIM Stage B1/B2) and six dogs with MMVD and congestive heart failure (ACVIM Stage C/D). Eleven miRNAs were differentially expressed (False Discovery Rate < 0.05). Dogs in Stage B1/B2 or C/D had four upregulated miRNAs, including three cfa-let-7/cfa-miR-98 family members, while seven others were downregulated, compared to Stage A. Expression of six of the 11 miRNAs also were significantly different between dogs in Stage C/D and those in Stage B1/B2. The expression changes were greater as disease severity increased. These miRNAs may be candidates for novel biomarkers and may provide insights into genetic regulatory pathways in canine MMVD.

Comparison of the nutrient composition of commercial dog milk replacers with that of dog milk

OBJECTIVE

To compare the nutrient composition of commercially available dog milk replacers with that of dog milk.

DESIGN

Prospective, cross-sectional study.

SAMPLE

5 dog milk samples and 15 samples of commercial dog milk replacers.

PROCEDURES

Dog milk and milk replacers were analyzed for concentrations of total protein, essential amino acids, sugars, total fat, essential fatty acids, calcium, and phosphorus. Energy density was calculated. Results from milk replacers were compared with the range of the concentration of each nutrient in milk samples from mature dogs as well as the National Research Council (NRC) recommendations for puppy growth.

RESULTS

Milk replacers varied widely in caloric density and concentration of nutrients such as calcium, protein, and fat. Calcium concentration was lower in 14 of 15 milk replacers than in the dog milk samples. Docosahexaenoic acid was undetectable in 12 of 15 milk replacers but present in all dog milk samples. All milk replacers had numerous essential nutrients outside of the range of the dog milk samples, and many had concentrations of amino acids, essential fatty acids, calcium, and phosphorus less than the NRC minimal requirement or recommended allowance. Compared with NRC recommendations, some dog milk samples had concentrations of total protein, linoleic acid, calcium, or phosphorus less than the recommended allowance.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggested that there was substantial variation in nutrient composition of 15 dog milk replacers and that some products were closer approximations of dog milk than others. Nearly all products would benefit from more appropriate calcium, amino acids, and essential fatty acids concentrations and better feeding directions.