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Hatunen SL, Anderson JG, Bell CM, Campos HC, Finkelman MD, Shope BH. A retrospective case series on bisphosphonate related osteonecrosis of the jaw in 20 cats. Front Vet Sci 2024; 11:1436988. [PMID: 39247125 PMCID: PMC11377274 DOI: 10.3389/fvets.2024.1436988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Accepted: 08/05/2024] [Indexed: 09/10/2024] Open
Abstract
Introduction This retrospective study highlights the salient aspects of a series of feline patients affected with bisphosphonate related osteonecrosis of the jaw. Though more commonly published in human literature, this presentation is rare in cats. The authors hope that this study will assist in making this a more globally known entity with subsequent improved prognosis. Methods Data was retrospectively obtained from the medical records between 2015 and 2021 of 20 cats with Medication Related Osteonecrosis of the Jaw. Data included patient information, clinical history, presenting complaint, systemic diseases, details referable to hypercalcemia and treatment thereof, bisphosphonate specifics (dose and duration), clinical presentation of the lesion, diagnostic testing including radiographic and histopathologic descriptions, treatment, and outcome. Results Pertinent results include that all 20 cats who developed Medication Related Osteonecrosis of the Jaw had been treated for idiopathic hypercalcemia with the bisphosphonate medication alendronate. Eighty-five percent of the cases had prior dental extractions at the site of MRONJ lesion. Ninety-five percent of the affected cats required a surgical procedure to control the disease. Thirty-five percent of cases required at least one revision surgery after the initial procedure was performed. Diagnosis of MRONJ was made by a correlation of diagnostic findings and patient history. No single diagnostic, or combination was pathognomonic for lesion diagnosis. As well, there were no statistically significant associations between patient variables assessed and the overall patient outcome. Discussion The case series reveals that cats with feline idiopathic hypercalcemia treated with alendronate may be at a risk for development of MRONJ, a serious oral condition with significant morbidity. Prior dental extraction sites in patients concurrently treated with bisphosphonate medications were often associated with MRONJ lesions. Therefore, any needed dental surgery should be performed prior to the use of bisphosphonates where possible. The authors have also included a relevant comparative literature review.
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Affiliation(s)
| | - Jamie G Anderson
- School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Cynthia M Bell
- Specialty Oral Pathology for Animals, Geneseo, IL, United States
| | - Hugo C Campos
- School of Dental Medicine, Tufts University, Boston, MA, United States
| | | | - Bonnie H Shope
- Veterinary Dental Services LLC., Boxborough, MA, United States
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Rzeszutek U, Allerton F, Au C, Bras I, Briggs A, Broome H, Gamston T, Parton S, Raj J, Rossell GM, Russell O, Sparks T, Bazelle J. Assessment of alendronate and dietary treatment in the management of feline idiopathic ionised hypercalcaemia and ionised hypercalcaemia associated with chronic kidney disease: 29 cases (2016-2022). J Small Anim Pract 2024. [PMID: 38961721 DOI: 10.1111/jsap.13755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 04/04/2024] [Accepted: 05/28/2024] [Indexed: 07/05/2024]
Abstract
OBJECTIVES This retrospective cohort multicentre study aimed to characterise the signalment, clinicopathologic data, complications and the association between treatment and outcome (the reduction in ionised calcium concentration) in cats with idiopathic or chronic kidney disease-associated ionised hypercalcaemia managed with alendronate and standard treatment or standard treatment alone, and to compare the outcome between the two groups. MATERIALS AND METHODS Medical records for cats diagnosed with idiopathic or chronic kidney disease-associated ionised hypercalcaemia were retrospectively reviewed. Cats treated with alendronate and standard treatment were assigned to the alendronate group and cats treated with standard treatment alone were assigned to the control group. The standard treatment was defined as dietary modification and/or monitoring of ionised calcium concentrations and management of complications secondary to hypercalcaemia. The follow-up period was selected as 6 months. RESULTS Twenty-nine cats were enrolled in the study. Nine cats were included in the control group and 20 cats in the alendronate group. A significant reduction in serum ionised calcium was observed in both groups between the baseline and the follow-up visit; however, this reduction did not differ significantly between both groups (the mean change in the ionised calcium concentration in alendronate and control group was -0.18 and -0.17, respectively). Suspected bisphosphate-related osteonecrosis of the jaw was reported in one cat receiving alendronate. CLINICAL SIGNIFICANCE In this study, similar reduction in serum ionised calcium concentration was observed in cats with ionised hypercalcaemia treated with diet alone and in cats treated with diet and alendronate. These results should be interpreted with caution, as the study was underpowered for meaningful statistical comparison. Cats receiving alendronate should be monitored for the development of adverse reactions, including osteonecrosis of the jaw.
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Affiliation(s)
- U Rzeszutek
- Davies Veterinary Specialists, Shillington, UK
| | - F Allerton
- Willows Veterinary Specialists, Solihull, UK
| | - C Au
- Eastcott Veterinary Hospital, Swindon, UK
| | - I Bras
- North Downs Specialist Referrals, Bletchingley, UK
| | | | - H Broome
- University of Liverpool Small Animal Teaching Hospital, Liverpool, UK
| | - T Gamston
- Dick White Referrals, Six Mile Bottom, UK
| | | | - J Raj
- Southfields Veterinary Specialists, Basildon, UK
| | - G M Rossell
- Northwest Veterinary Specialists, Runcorn, UK
| | - O Russell
- University of Cambridge Queen's Veterinary School Hospital, Cambridge, UK
| | - T Sparks
- Waltham Petcare Science Institute, Waltham, UK
| | - J Bazelle
- Davies Veterinary Specialists, Shillington, UK
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Vergara-Hernandez FB, Nielsen BD, Popovich JM, Panek CL, Logan AA, Robison CI, Ehrhardt RA, Johnson TN, Chargo NJ, Welsh TH, Bradbery AN, Leatherwood JL, Colbath AC. Clodronate disodium does not produce measurable effects on bone metabolism in an exercising, juvenile, large animal model. PLoS One 2024; 19:e0300360. [PMID: 38626145 PMCID: PMC11020481 DOI: 10.1371/journal.pone.0300360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 02/23/2024] [Indexed: 04/18/2024] Open
Abstract
Bisphosphonates are commonly used to treat and prevent bone loss, but their effects in active, juvenile populations are unknown. This study examined the effects of intramuscular clodronate disodium (CLO) on bone turnover, serum bone biomarkers (SBB), bone mineral density (BMD), bone microstructure, biomechanical testing (BT), and cartilage glycosaminoglycan content (GAG) over 165 days. Forty juvenile sheep (253 ± 6 days of age) were divided into four groups: Control (saline), T0 (0.6 mg/kg CLO on day 0), T84 (0.6 mg/kg CLO on day 84), and T0+84 (0.6 mg/kg CLO on days 0 and 84). Sheep were exercised 4 days/week and underwent physical and lameness examinations every 14 days. Blood samples were collected for SBB every 28 days. Microstructure and BMD were calculated from tuber coxae (TC) biopsies (days 84 and 165) and bone healing was assessed by examining the prior biopsy site. BT and GAG were evaluated postmortem. Data, except lameness data, were analyzed using a mixed-effects model; lameness data were analyzed as ordinal data using a cumulative logistic model. CLO did not have any measurable effects on the skeleton of sheep. SBB showed changes over time (p ≤ 0.03), with increases in bone formation and decreases in some bone resorption markers. TC biopsies showed increasing bone volume fraction, trabecular spacing and thickness, and reduced trabecular number on day 165 versus day 84 (p ≤ 0.04). These changes may be attributed to exercise or growth. The absence of a treatment effect may be explained by the lower CLO dose used in large animals compared to humans. Further research is needed to examine whether low doses of bisphosphonates may be used in active juvenile populations for analgesia without evidence of bone changes.
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Affiliation(s)
- Fernando B. Vergara-Hernandez
- Department of Animal Science, College of Agricultural and Natural Resources, Michigan State University, East Lansing, Michigan, United States of America
- School of Veterinary Medicine, College of Natural Resources and Veterinary Medicine, Universidad Santo Tomas, Viña del Mar, Chile
| | - Brian D. Nielsen
- Department of Animal Science, College of Agricultural and Natural Resources, Michigan State University, East Lansing, Michigan, United States of America
| | - John M. Popovich
- Center for Neuromusculoskeletal Clinical Research, College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan, United States of America
| | - Char L. Panek
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States of America
| | - Alyssa A. Logan
- School of Agriculture, College of Basic and Applied Sciences, Middle Tennessee State University, Murfreesboro, Tennessee, United States of America
| | - Cara I. Robison
- Department of Animal Science, College of Agricultural and Natural Resources, Michigan State University, East Lansing, Michigan, United States of America
| | - Richard A. Ehrhardt
- Department of Animal Science, College of Agricultural and Natural Resources, Michigan State University, East Lansing, Michigan, United States of America
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States of America
| | - Tyler N. Johnson
- Department of Chemical Engineering and Materials Science, College of Engineering, Michigan State University, East Lansing, Michigan, United States of America
| | - Nicholas J. Chargo
- Department of Physiology, College of Natural Science, Michigan State University, East Lansing, Michigan, United States of America
| | - Thomas H. Welsh
- Department of Animal Science, College of Agriculture & Life Sciences, Texas A&M University, College Station, Texas, United States of America
| | - Amanda N. Bradbery
- Department of Animal and Range Sciences, College of Agriculture, Montana State University, Bozeman, Montana, United States of America
| | - Jessica L. Leatherwood
- Department of Animal Science, College of Agriculture and Natural Resources, Tarleton State University, Stephenville, Texas, United States of America
| | - Aimee C. Colbath
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States of America
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Meneghetti LM, Perry KL. Management of insufficiency fractures associated with long-term bisphosphonate therapy in a cat. JFMS Open Rep 2023; 9:20551169231183752. [PMID: 37581124 PMCID: PMC10423456 DOI: 10.1177/20551169231183752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/16/2023] Open
Abstract
Case summary A 10-year-old spayed female domestic medium hair cat presented after sustaining atraumatic insufficiency fractures of the right calcaneus and the left tibia approximately 6 weeks apart. Chronic alendronate therapy had been ongoing for 9 years for the management of previously diagnosed idiopathic hypercalcemia. The right calcaneal fracture was managed non-operatively due to minimal functional impairment. The left tibial fracture was managed via open reduction and internal fixation with orthogonal plating. Alendronate therapy was discontinued at the time of the fracture repair with prednisolone being used to manage the hypercalcemia. Despite rapid clinical improvement, the tibial fracture had a protracted healing course, with clinical union only being achieved 22 weeks postoperatively. At 17 months postoperatively, the idiopathic hypercalcemia remained well controlled. Gait assessment, orthopedic examination and orthogonal radiographs performed at this time revealed resolution of left pelvic limb lameness, a normal orthopedic examination of the left pelvic limb and no evidence of implant-associated complications. Monitoring is ongoing but at the time of publication, no further fractures have occurred. Relevance and novel information As reported in humans, this case report gathers evidence of associations between bisphosphonate treatment and the occurrence of insufficiency fractures in cats, and provides evidence that stress reactions may precede their development. If bisphosphonate therapy is utilized in the long term, serial radiographic monitoring for signs of impending fracture may be warranted. Fracture repair can be successful in cats that have received long-term bisphosphonate therapy, but delayed healing should be anticipated and implant choices made accordingly.
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Affiliation(s)
- Lauren M Meneghetti
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA
| | - Karen L Perry
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA
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Kurtz M, Desquilbet L, Maire J, Da Riz F, Canonne-Guibert M, Benchekroun G, Maurey C. Alendronate treatment in cats with persistent ionized hypercalcemia: A retrospective cohort study of 20 cases. Vet Med (Auckl) 2022; 36:1921-1930. [PMID: 36181368 DOI: 10.1111/jvim.16508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 07/19/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Limited information is available concerning treatment of ionized hypercalcemia in cats. HYPOTHESIS/OBJECTIVES Describe clinical findings in a cohort of cats with persistent ionized hypercalcemia and evaluate long-term tolerance and efficacy of alendronate in these patients. ANIMALS Twenty cats with persistent ionized hypercalcemia of undetermined origin, presented for routine or referral consultation at the teaching hospital of Maisons-Alfort (France). METHODS Medical records were retrospectively reviewed. Cats were divided into Group 1 (cats that received alendronate as well as other treatments, n = 11) and Group 2 (cats that did not receive alendronate, n = 9). Survival analysis (Kaplan-Meier method, log-rank test, and Cox proportional hazard models) was conducted to compare time to selected outcomes. RESULTS Azotemia was present in 15 cats (75%). Alendronate treatment was administered and well tolerated during the entire follow-up period (median, 9.5 months; interquartile range [IQR], 6.3; 27) in all cats from Group 1, except in 1 cat that developed severe hypophosphatemia, prompting treatment discontinuation. Univariate analysis determined that alendronate treatment was significantly associated with shorter time to reach a 15% decrease in ionized calcium concentration (iCa) from baseline during follow-up (119 days vs median not reached, P = .02). This association was no longer significant after adjustment for age and initial iCa. CONCLUSIONS AND CLINICAL IMPORTANCE Alendronate overall was well tolerated with chronic use in this cohort, and can be considered a treatment option for persistent ionized hypercalcemia in cats.
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Affiliation(s)
- Maxime Kurtz
- Department of Internal Medicine, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| | - Loïc Desquilbet
- Department of Clinical Epidemiology and Biostatistics, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France.,Ecole Nationale Vétérinaire d'Alfort, Université Paris Est Créteil, INSERM, IMRB, Maisons-Alfort, France
| | - Justine Maire
- Department of Internal Medicine, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| | - Fiona Da Riz
- Department of Internal Medicine, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| | - Morgane Canonne-Guibert
- Department of Internal Medicine, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France.,Ecole Nationale Vétérinaire d'Alfort, Université Paris Est Créteil, INSERM, IMRB, Maisons-Alfort, France
| | - Ghita Benchekroun
- Department of Internal Medicine, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France.,Ecole Nationale Vétérinaire d'Alfort, Université Paris Est Créteil, INSERM, IMRB, Maisons-Alfort, France
| | - Christelle Maurey
- Department of Internal Medicine, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
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Suva LJ, Cooper A, Watts AE, Ebetino FH, Price J, Gaddy D. Bisphosphonates in veterinary medicine: The new horizon for use. Bone 2021; 142:115711. [PMID: 33141069 DOI: 10.1016/j.bone.2020.115711] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 10/20/2020] [Accepted: 10/21/2020] [Indexed: 12/17/2022]
Abstract
Bisphosphonates (BPs) are characterized by their ability to bind strongly to bone mineral and inhibit bone resorption. However, BPs exert a wide range of pharmacological activities beyond the inhibition of bone resorption, including the inhibition of cancer cell metastases and angiogenesis and the inhibition of proliferation and apoptosis in vitro. Additionally, the inhibition of matrix metalloproteinase activity, altered cytokine and growth factor expression, as well as reductions in parameters of pain have also been reported. In humans, clinical BP use has transformed the treatment of post-menopausal osteoporosis, rare bone diseases such as osteogenesis imperfecta, as well as multiple myeloma and metastatic breast and prostate cancer, albeit not without infrequent but significant adverse events. Despite the well-characterized health benefits of BP use in humans, the evidence-base for the therapeutic efficacy of BPs in veterinary medicine is, by comparison, limited. Notwithstanding, BPs are used widely in small animal veterinary practice for the medical management of hyperparathyroidism, idiopathic hypercalcemia in cats, as well as for the palliative care of bone tumors which are common in dogs, and in particular, primary bone tumors such as osteosarcoma. Palliative BP treatment has also recently increased in veterinary oncology to alleviate tumor-associated bone pain. In equine veterinary practice, non-nitrogen-containing BPs are FDA-approved to control clinical signs associated with navicular syndrome in adult horses. However, there are growing concerns regarding the off-label use of BPs in juvenile horses. Here we discuss the current understanding of the strengths, weaknesses and current controversies surrounding BP use in veterinary medicine to highlight the future utility of these potentially beneficial drugs.
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Affiliation(s)
- Larry J Suva
- Department of Veterinary Physiology and Pharmacology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA.
| | - Alexis Cooper
- Department of Veterinary Physiology and Pharmacology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - Ashlee E Watts
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - Frank H Ebetino
- Department of Chemistry, University of Rochester, Rochester, NY, USA; BioVinc, Pasadena, CA, USA
| | - Joanna Price
- Royal Agricultural University, Cirencester, Gloucestershire, UK
| | - Dana Gaddy
- Department of Veterinary Integrative Biosciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
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Rogers‐Smith E, Whitley N, Elwood C, Reese D, Wong P. Suspected bisphosphate‐related osteonecrosis of the jaw in a cat being treated with alendronate for idiopathic hypercalcaemia. VETERINARY RECORD CASE REPORTS 2019. [DOI: 10.1136/vetreccr-2018-000798] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
| | - Nat Whitley
- Internal MedicineDavies Veterinary SpecialistsHigham GobionUK
| | - Clive Elwood
- Internal MedicineDavies Veterinary SpecialistsHigham GobionUK
| | - David Reese
- VetCT Consultants in TelemedicineFreemantleWestern AustraliaUK
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Larson MJ, Oakes AB, Epperson E, Chew DJ. Medication-related osteonecrosis of the jaw after long-term bisphosphonate treatment in a cat. J Vet Intern Med 2019; 33:862-867. [PMID: 30663796 PMCID: PMC6430911 DOI: 10.1111/jvim.15409] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 12/11/2018] [Indexed: 02/03/2023] Open
Abstract
A 12‐year‐old, neutered female, domestic medium hair cat was evaluated for a nonhealing, oral mucosal ulceration. The cat had a history of idiopathic hypercalcemia that had been treated with a bisphosphonate for 41 months. Oral examination identified exposed maxillary bone adjacent to a previous extraction site. Histopathology of the exposed bone and associated mucosa was most consistent with medication‐related osteonecrosis of the jaw. Treatment involved both medical and surgical interventions. Oral mucosal healing occurred after 6 months of treatment.
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Affiliation(s)
| | - Ashley B Oakes
- Tampa Bay Veterinary Specialists and Emergency Care Center, Largo, Florida
| | | | - Dennis J Chew
- Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, Columbus, Ohio
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Council N, Dyce J, Drost WT, de Brito Galvao JF, Rosol TJ, Chew DJ. Bilateral patellar fractures and increased cortical bone thickness associated with long-term oral alendronate treatment in a cat. JFMS Open Rep 2017; 3:2055116917727137. [PMID: 28890795 PMCID: PMC5580850 DOI: 10.1177/2055116917727137] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Case summary A 14-year-old cat presented with bilateral patellar fractures and radiographically thickened tibial cortices. This cat had been treated with alendronate for 8 years prior to presentation. To remove the subjectivity of the radiographic evaluation, tibial radiographs from 35 apparently healthy geriatric cats were used for comparison. Cortical and diaphyseal thickness were measured at the proximal and distal thirds of the tibia. Our cat had increased cortical bone thickness compared to that of the control cats. Relevance and novel information Treatment with bisphosphonates can lead to brittle bones and fractures after prolonged use in humans. This is the first description of fractures and cortical bone changes that may have been associated with prolonged bisphosphonate use in a cat. Radiographic measurements of cortical bone thickness may identify cats that are at increased risk for bone pathology secondary to prolonged alendronate use.
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Affiliation(s)
| | - Jon Dyce
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
| | - Wm Tod Drost
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
| | | | - Thomas J Rosol
- Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
| | - Dennis J Chew
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
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de Brito Galvão JF, Parker V, Schenck PA, Chew DJ. Update on Feline Ionized Hypercalcemia. Vet Clin North Am Small Anim Pract 2017; 47:273-292. [DOI: 10.1016/j.cvsm.2016.09.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Hardy BT, de Brito Galvao JF, Green TA, Braudaway SR, DiBartola SP, Lord L, Chew DJ. Treatment of ionized hypercalcemia in 12 cats (2006-2008) using PO-administered alendronate. J Vet Intern Med 2015; 29:200-6. [PMID: 25619515 PMCID: PMC4858073 DOI: 10.1111/jvim.12507] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 09/02/2014] [Accepted: 10/21/2014] [Indexed: 11/28/2022] Open
Abstract
Background Long‐term treatment of cats with ionized hypercalcemia using alendronate has not been evaluated. Hypothesis/Objectives Alendronate is well tolerated in treatment of ionized hypercalcemia in cats. Animals A total of 12 cats with ionized hypercalcemia. Methods Prospective study of 12 cats with ionized hypercalcemia of idiopathic origin was identified by telephone and email communication with a convenience sample of consulting veterinarians. Cats were treated with alendronate at a dose of 5–20 mg per feline PO q7d. Serum ionized calcium concentration (iCa) was measured before beginning treatment with alendronate, and after 1, 3, and 6 months of treatment. Alendronate dosage was adjusted according to iCa. Evaluation included physical examination, CBC, biochemistry profile, and diagnostic imaging. The owners and referring veterinarians were questioned about any observed adverse effects. The Wilcoxon matched‐pairs signed rank test was used to compare baseline iCa to iCa at different time periods. Results Alendronate treatment resulted in a decrease in iCa in all 12 cats. The median percentage change in iCa was −13.2%, −15.9%, and −18.1% (range, −29.6 to +7.6; −30.5 to −1.9; −45.8 to +1.5%) at the 1, 3, and 6 month time points, respectively. Baseline iCa was significantly different from 1 month (P = .0042), 3 months (P = .0005), and 6 months (P = .0015). No adverse effects were reported for any of the cats. Conclusions and Clinical Importance Alendronate was well tolerated and decreased iCa in most cats for the 6‐month period of observation.
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Affiliation(s)
- B T Hardy
- Santa Cruz Veterinary Hospital, Santa Cruz, CA
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12
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Pamidronate disodium for palliative therapy of feline bone-invasive tumors. Vet Med Int 2014; 2014:675172. [PMID: 25013741 PMCID: PMC4071848 DOI: 10.1155/2014/675172] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Accepted: 04/17/2014] [Indexed: 12/01/2022] Open
Abstract
This study sought to quantify in vitro antiproliferative effects of pamidronate in feline cancer cells and assess feasibility of use of pamidronate in cats by assessing short-term toxicity and dosing schedule in cats with bone-invasive cancer. A retrospective pilot study included eight cats with bone invasive cancer treated with intravenous pamidronate. In vitro, pamidronate reduced proliferation in feline cancer cells (P < 0.05). One cat treated with pamidronate in combination with chemotherapy and two cats treated with pamidronate as a single agent after failing prior therapy had subjective clinically stable disease; median progression free interval in these cats from initial pamidronate treatment was 81 days. Three cats developed azotemia while undergoing various treatment modalities including nonsteroidal anti-inflammatory drugs and pamidronate. Median overall survival was 116.5 days for all cats and 170 days for cats with oral squamous cell carcinoma. Median progression free survival was 55 days for all cats and 71 days for cats with oral squamous cell carcinoma. Pamidronate therapy appears feasible for administration in cancer bearing cats with aggressive bone lesions in the dose range of 1-2 mg/kg every 21–28 days for multiple treatments. No acute or short-term toxicity was directly attributable to pamidronate.
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Batchelor DJ, Devauchelle P, Elliott J, Elwood CM, Freiche V, Gualtieri M, Hall EJ, Den Hertog E, Neiger R, Peeters D, Roura X, Savary-Bataille K, German AJ. Mechanisms, causes, investigation and management of vomiting disorders in cats: a literature review. J Feline Med Surg 2013; 15:237-65. [PMID: 23403690 PMCID: PMC10816764 DOI: 10.1177/1098612x12473466] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Vomiting is a common presenting complaint in feline practice. This article differs from previous reviews in that it is an evidence-based review of the mechanisms, causes, investigation and management of vomiting in the domestic cat. Published evidence was reviewed, and then used to make recommendations for clinical assessment, diagnosis, antiemetic drug treatment, dietary management and monitoring of cats presenting with vomiting. The strength of the evidence on which recommendations are made (and areas where evidence is lacking for cats) has been highlighted throughout.
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Abstract
Bisphosphonate use has increased in veterinary medicine over the last decade. During this time, bisphosphonate related osteonecrosis of the jaws (BRONJ) in human patients has been identified. Only recently was a dog model for BRONJ developed for human oral surgery and medicine. Veterinary patients treated with bisphosphonates may be at an increased risk for BRONJ There has been little, to no, investigation of potential long term side-effects of bisphosphonate use in veterinary patients; potential sequelae are unknown. The history of bisphosphonates, their use, and BRONJ in veterinary patients are discussed.
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Affiliation(s)
- Kevin Stepaniuk
- College of Veterinary Medicine, University of Minnesota, St. Paul, MN 55108, USA.
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