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Wun MK, Broughton-Neiswanger LE, Villarino NF. Comparison of serum SDMA and creatinine as a biomarker for the detection of meloxicam-induced kidney injury in cats. Front Vet Sci 2024; 11:1395505. [PMID: 38812562 PMCID: PMC11133641 DOI: 10.3389/fvets.2024.1395505] [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: 03/04/2024] [Accepted: 05/02/2024] [Indexed: 05/31/2024] Open
Abstract
Introduction Serum symmetric dimethylarginine (SDMA) and creatinine are commonly used biomarkers of renal function in cats. We hypothesize that the serum analytes creatinine and SDMA are equally effective at detecting impaired renal function caused by meloxicam-induced renal injury in cats. Our primary objective was to compare serum concentrations of SDMA and creatinine in cats before, during, and after induction of renal injury from repeated dosages of meloxicam in the context of a small pilot study. Methods This follow-up study results from data collected in a well-controlled study that included 12 healthy female adult purpose-bred cats. Cats in the treatment group received meloxicam 0.3 mg/kg subcutaneously (SC) every 24 h for 31 days. Cats in the control group received saline (0.1 mL SC). Renal injury was defined as the presence of tubular damage, basement membrane damage, and/or interstitial inflammation in histological sections of kidney tissue. Serum creatinine and SDMA concentration were measured every 4 days. Results In the control group, no cats developed renal azotemia. In the treatment group, four out of six cats developed elevated serum creatinine and histopathological evidence of renal injury. Three of these cats developed an elevation in serum SDMA. The time to the development of renal azotemia using serum creatinine or SDMA was not significantly different (p > 0.05). Discussion In this pilot study, there was no evidence that serum SDMA was superior to serum creatinine at detecting impaired renal function caused by meloxicam-induced renal injury in cats.
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Affiliation(s)
- Matthew K. Wun
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA, United States
| | - Liam E. Broughton-Neiswanger
- Department of Veterinary Microbiology and Pathology, College of Veterinary Medicine, Washington State University, Pullman, WA, United States
| | - Nicolas F. Villarino
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA, United States
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2
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Taylor S, Gruen M, KuKanich K, X Lascelles BD, Monteiro BP, Sampietro LR, Robertson S, Steagall PV. 2024 ISFM and AAFP consensus guidelines on the long-term use of NSAIDs in cats. J Feline Med Surg 2024; 26:1098612X241241951. [PMID: 38587872 PMCID: PMC11103309 DOI: 10.1177/1098612x241241951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
PRACTICAL RELEVANCE Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used and are effective for the management of pain in cats. These Guidelines will support veterinarians in decision-making around prescribing NSAIDs in situations of chronic pain, to minimise adverse effects and optimise pain management. Information is provided on mechanism of action, indications for use, screening prior to prescription, use in the presence of comorbidities, monitoring of efficacy, and avoidance and management of adverse effects. CLINICAL CHALLENGES The cat's unique metabolism should be considered when prescribing any medications, including NSAIDs. Chronic pain may be challenging to detect in this species and comorbidities, particularly chronic kidney disease, are common in senior cats. Management of chronic pain may be complicated by prescription of other drugs with the potential for interactions with NSAIDs. EVIDENCE BASE These Guidelines have been created by a panel of experts brought together by the International Society of Feline Medicine (ISFM) and American Association of Feline Practitioners (AAFP). Information is based on the available literature, expert opinion and the panel members' experience.
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Affiliation(s)
- Samantha Taylor
- Panel ChairInternational Society of Feline Medicine, International Cat Care, Tisbury, Wi Itshire, UK
| | - Margaret Gruen
- Comparative Pain Research Laboratory; and Behavioural Medicine Service - Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, NC, USA
| | - Kate KuKanich
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, KS, USA
| | - B Duncan X Lascelles
- Translational Research in Pain (TRiP) Program and Comparative Pain Research and Education Centre (CPREC), North Carolina State University, NC, USA
| | - Beatriz P Monteiro
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Universite de Montreal, Saint-Hyacinthe, QC, Canada
| | | | - Sheilah Robertson
- Lap of Love Veterinary Hospice, Lutz, FL, USA; and Courtesy Lecturer, Shelter Medicine Program, University of Florida, FL, USA
| | - Paulo V Steagall
- Department of Veterinary Clinical Sciences and Centre for Animal Health and Welfare, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, SAR China; and Department of Clinical Sciences, Faculty of Veterinary Medicine, Universite de Montreal, Saint-Hyacinthe, QC, Canada
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3
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Soltero-Rivera M, Goldschmidt S, Arzi B. Feline chronic gingivostomatitis current concepts in clinical management. J Feline Med Surg 2023; 25:1098612X231186834. [PMID: 37548475 PMCID: PMC10811996 DOI: 10.1177/1098612x231186834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
PRACTICAL RELEVANCE Feline chronic gingivostomatitis (FCGS) is a debilitating disease for cats and a challenge for veterinarians and cat caregivers alike. Recent literature indicates that the disease is immune-mediated in nature and likely associated with a chronic viral infection in patients with higher alpha diversity of their subgingival microbiome. The immune-mediated nature of FCGS includes both local as well as systemic effects, and the transcriptomic analysis of affected patients supports these findings. TREATMENT OPTIONS Localized therapy in the form of surgical extraction of all, or nearly all, teeth continues to be the mainstay of treatment. For cats that do not respond to surgical management, medical management, in the form of immunosuppressive or immunomodulatory therapy, remains an option. Analgesia is of fundamental importance. Immunomodulation utilizing mesenchymal stromal cell therapy provides an alternative treatment avenue for refractory patients and likely targets the chronic viral infection present in this disease. The potential for treatment stratification and use of novel systemic treatment options may be revealed as the molecular pathways involved in this disease are better described. AIMS This review outlines current and emerging concepts linking available science pertaining to FCGS and clinical management of the disease. EVIDENCE BASE The article draws on the best evidence base at this juncture and is also driven by the authors' collective experience of working on the disease for over a decade.
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Affiliation(s)
| | - Stephanie Goldschmidt
- Department of Surgical and Radiological Sciences, University of California, Davis, CA, USA
| | - Boaz Arzi
- Department of Surgical and Radiological Sciences, University of California, Davis, CA, USA; and Veterinary Institute for Regenerative Cures, School of Veterinary Medicine, University of California, Davis, CA, USA
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4
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Deabold K, Montalbano C, Miscioscia E. Feline Osteoarthritis Management. Vet Clin North Am Small Anim Pract 2023; 53:879-896. [PMID: 36964025 DOI: 10.1016/j.cvsm.2023.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2023]
Abstract
Feline osteoarthritis is common; despite vague clinical signs, it can result in mobility impairment and quality of life concerns. An integrative approach to management may include analgesic medications, dietary modifications, nutraceuticals, environmental modifications, physical rehabilitation, acupuncture, and regenerative medicine. Management of concurrent disease and consideration for patient tolerance and owner compliance are critical in formulating a treatment plan in cats with osteoarthritis.
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Affiliation(s)
- Kelly Deabold
- Department of Comparative, Diagnostic and Population Medicine, College of Veterinary Medicine, University of Florida, 2015 SW 16th Avenue, Gainesville, FL 32608, USA
| | | | - Erin Miscioscia
- Department of Comparative, Diagnostic and Population Medicine, College of Veterinary Medicine, University of Florida, 2015 SW 16th Avenue, Gainesville, FL 32608, USA.
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5
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Wun MK, Leister E, King T, Korman R, Malik R. Acute kidney injury in 18 cats after subcutaneous meloxicam and an update on non-steroidal anti-inflammatory drug usage in feline patients in Australia. Aust Vet J 2023; 101:90-98. [PMID: 36470590 DOI: 10.1111/avj.13222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 10/29/2022] [Accepted: 11/19/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Acute kidney injury (AKI) is a well-known but poorly documented adverse effect of non-steroidal anti-inflammatory drugs (NSAIDs) in cats. We aimed to describe instances of NSAID-associated AKI in cats and survey Australian veterinarians on NSAID use in acute settings. METHODS Medical records of cats that developed an AKI subsequent to the administration of meloxicam were obtained by searching the databases of seven practices in Queensland, as well as by contemporaneously contacting select veterinary colleagues of the authors in both general and specialist small animal practice. An online questionnaire was created for the survey, and the URL distributed to Australian practitioners. RESULTS A total of 18 cases were retrieved, all of which received injectable meloxicam. The indication(s) for its use and the dosage prescribed were within the manufacturer's recommendations for Australian veterinarians. The majority of cases (13/18 cats) received the label dose of 0.3 mg/kg subcutaneously (SC) on the day of the procedure. In 12/18 cats, the injection was given in association with general anaesthesia or sedation. Fourteen cats survived to hospital discharge. Of 187 survey respondees, 89% routinely administered NSAIDs for surgery-related analgesia, with 98% prescribing meloxicam and 84% of these giving it SC. Ninety percent of respondees routinely administered NSAIDs for non-surgical-related analgesia, with 99% prescribing meloxicam and 35% of those giving it SC. CONCLUSIONS AND RELEVANCE We strongly recommend that practitioners avoid prescribing meloxicam SC in cats. This recommendation is emphatic in situations where concurrent dehydration and/or hypotension are possible.
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Affiliation(s)
- M K Wun
- Veterinary Specialist Services, Underwood, Australia
- Animal Referral Hospital Brisbane, Sinnamon Park, Australia
| | - E Leister
- Pet Intensive Care Unit, Underwood, Australia
| | - T King
- Veterinary Specialist Services, Underwood, Australia
| | - R Korman
- Veterinary Specialist Services, Underwood, Australia
| | - R Malik
- Centre for Veterinary Education, B22, The University of Sydney, Camperdown, Australia
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6
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Keepman SJ, Pellin MA. Low dose meloxicam is safe and tolerable when combined with toceranib phosphate in cancer-bearing cats. J Feline Med Surg 2022; 24:1187-1194. [PMID: 34923878 PMCID: PMC10812370 DOI: 10.1177/1098612x211067023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Non-steroidal anti-inflammatory drugs (NSAIDs) are infrequently utilized in cats due to concern for renal compromise; however, recent studies demonstrate tolerability of low dose meloxicam. Toceranib phosphate is used to treat several feline cancers and is well tolerated. This study aimed to determine the tolerability and adverse event profile of combined toceranib and low dose meloxicam in cancer-bearing cats. Secondary goals involved assessing anticancer tumor efficacy and impact upon quality of life and analgesia. METHODS Cats with any cancer not involving the kidneys were eligible. The study adopted a conventional 3 + 3 dose escalation design. Toceranib was administered every other day at a standard dose with meloxicam administered in an escalating fashion in subsequent cohorts, at a starting dose of 0.01 mg/kg on opposite days to toceranib, up to a maximum of 0.02 mg/kg daily, based upon previous safety studies. Laboratory work, blood pressure, tumor measurements, pain score and client-completed quality-of-life surveys were recorded every 2-4 weeks during the 12-week study period. RESULTS Twenty-one cats were enrolled. When combined with toceranib, a meloxicam dose of 0.02 mg/kg q24h was safe and well tolerated, with no cats being withdrawn due to adverse events from the drug combination. The majority of cats demonstrated clinical benefit with stable to mildly improved tumor measurements, quality of life and pain scores. CONCLUSIONS AND RELEVANCE Low dose meloxicam combined with toceranib is safe and well tolerated in cancer-bearing cats. Continued patient recruitment and data collection are needed to determine the maximum tolerated dose of meloxicam. The results of our study will guide further phase II/III trials.
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Affiliation(s)
- Samuel J Keepman
- School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA
| | - MacKenzie A Pellin
- School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA
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Drug-Dosing Adjustment in Dogs and Cats with Chronic Kidney Disease. Animals (Basel) 2022; 12:ani12030262. [PMID: 35158584 PMCID: PMC8833495 DOI: 10.3390/ani12030262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 01/13/2022] [Accepted: 01/18/2022] [Indexed: 11/17/2022] Open
Abstract
Chronic kidney disease is a common kidney disorder in adult and aged dogs and cats; the management of associated complications and comorbidities generally requires a life-long medical treatment to ensure a good quality of life of affected patients. However, indications and the literature on drug dosing in dogs and cats with chronic kidney disease are often lacking. The aim of this review is to revise the current literature on drug dosing in canine and feline patients with renal impairment, with a special focus on the most commonly used medications to manage chronic kidney disease and possible comorbidities.
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8
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Gruen ME, Myers JAE, Tena JKS, Becskei C, Cleaver DM, Lascelles BDX. Frunevetmab, a felinized anti-nerve growth factor monoclonal antibody, for the treatment of pain from osteoarthritis in cats. J Vet Intern Med 2021; 35:2752-2762. [PMID: 34724255 PMCID: PMC8692178 DOI: 10.1111/jvim.16291] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 10/06/2021] [Accepted: 10/12/2021] [Indexed: 12/20/2022] Open
Abstract
Background Frunevetmab, a felinized antinerve growth factor monoclonal antibody, effectively decreases osteoarthritis (OA) pain in cats. Objective To evaluate the efficacy of frunevetmab given at monthly intervals in a randomized, placebo‐controlled, parallel‐group, double‐blind superiority study. Animals Two hundred seventy‐five client‐owned cats with naturally‐occurring OA pain and associated mobility impairment and disability. Methods Randomized, placebo‐controlled, parallel‐group, double‐blind, superiority study. Following screening, cats received frunevetmab (nominal dose of 1.0 mg/kg, SC [effective dose range of 1.0‐2.8 mg/kg]) or placebo on days 0, 28, and 56. Outcome measures were owner questionnaires and veterinary physical and orthopedic evaluations at days 28, 56, and 84. Success/failure rates (and numbers needed treat, NNT) and change in scores (and standardized effect size, ES) were analyzed. Results Frunevetmab (182) and placebo (93) treated cats were enrolled and received at least 1 treatment. Significant improvement with frunevetmab over placebo occurred at days 28 and 56 for the client specific outcome measures (CSOM) questionnaire (success rates and total scores [NNT of 9 and ES of 0.3 at day 56]); at days 28 and 56 for owner‐assessed global treatment response; and at days 56 and 84 for veterinarian‐assessed joint pain (ES of 0.18 at day 56). Adverse events did not differ between groups, except skin disorders which collectively occurred significantly more frequently in frunevetmab treated (32/182 cats) vs placebo (8/93 cats). Conclusions and Clinical Importance Frunevetmab has the potential to address a critical gap in the treatment of pain because of osteoarthritis in cats.
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Affiliation(s)
- Margaret E Gruen
- Translational Research in Pain (TRiP) Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA.,Behavioral Medicine, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA.,Comparative Pain Research and Education Center, North Carolina State University, Raleigh, North Carolina, USA
| | - Jamie A E Myers
- Veterinary Medicine Research and Development, Zoetis Inc, Kalamazoo, Michigan, USA
| | - Jezaniah-Kira S Tena
- Veterinary Medicine Research and Development, Zoetis Inc, Kalamazoo, Michigan, USA
| | - Csilla Becskei
- Veterinary Medicine Research and Development, Zoetis Belgium SA, Zaventem, Belgium
| | - Dawn M Cleaver
- Veterinary Medicine Research and Development, Zoetis Inc, Kalamazoo, Michigan, USA
| | - B Duncan X Lascelles
- Translational Research in Pain (TRiP) Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA.,Comparative Pain Research and Education Center, North Carolina State University, Raleigh, North Carolina, USA.,Thurston Arthritis Center, UNC School of Medicine, Chapel Hill, North Carolina, USA.,Center for Translational Pain Research, Department of Anesthesiology, Duke University, Durham, North Carolina, USA
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9
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Spencer S, Wheeler-Jones C, Elliott J. Hypoxia and chronic kidney disease: Possible mechanisms, therapeutic targets, and relevance to cats. Vet J 2021; 274:105714. [PMID: 34252550 DOI: 10.1016/j.tvjl.2021.105714] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 07/01/2021] [Accepted: 07/06/2021] [Indexed: 10/20/2022]
Abstract
There is mounting evidence that kidney ischaemia/hypoxia plays an important role in feline chronic kidney disease (CKD) development and progression, as well as in human disease and laboratory animal models. Ischaemic acute kidney injury is widely accepted as a cause of CKD in people and data from laboratory species has identified some of the pathways underlying this continuum. Experimental kidney ischaemia in cats results in morphological changes, namely chronic tubulointerstitial inflammation, tubulointerstitial fibrosis, and tubular atrophy, akin to those observed in naturally-occurring CKD. Multiple situations are envisaged that could result in acute or chronic episodes of kidney hypoxia in cats, while risk factors identified in epidemiological studies provide further support that kidney hypoxia contributes to spontaneously occurring feline CKD. This review evaluates the evidence for the role of kidney ischaemia/hypoxia in feline CKD and the proposed mechanisms and consequences of kidney hypoxia. As no effective treatments exist that substantially slow or prevent feline CKD progression, there is a need for novel therapeutic strategies. Targeting kidney hypoxia is one such promising approach, with therapies including those that attenuate the hypoxia-inducible factor (HIF) pathway already being utilised in human CKD.
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Affiliation(s)
- Sarah Spencer
- Comparative Biomedical Sciences, The Royal Veterinary College, Royal College Street, London NW1 0TU, UK.
| | - Caroline Wheeler-Jones
- Comparative Biomedical Sciences, The Royal Veterinary College, Royal College Street, London NW1 0TU, UK
| | - Jonathan Elliott
- Comparative Biomedical Sciences, The Royal Veterinary College, Royal College Street, London NW1 0TU, UK
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10
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Ray M, Carney HC, Boynton B, Quimby J, Robertson S, St Denis K, Tuzio H, Wright B. 2021 AAFP Feline Senior Care Guidelines. J Feline Med Surg 2021; 23:613-638. [PMID: 34167339 PMCID: PMC10812122 DOI: 10.1177/1098612x211021538] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The '2021 AAFP Feline Senior Care Guidelines' are authored by a Task Force of experts in feline clinical medicine and serve as an update and extension of those published in 2009. They emphasize the individual patient evaluation and the process of aging, with references to other feline practice guidelines for a more complete discussion of specific diseases. Focusing on each cat encourages and empowers the owner to become a part of the cat's care every step of the way. A comprehensive discussion during the physical examination and history taking allows for tailoring the approach to both the cat and the family involved in the care. Videos and analysis of serial historical measurements are brought into the assessment of each patient. These Guidelines introduce the emerging concept of frailty, with a description and methods of its incorporation into the senior cat assessment. Minimum database diagnostics are discussed, along with recommendations for additional investigative considerations. For example, blood pressure assessment is included as a minimum diagnostic procedure in both apparently healthy and ill cats. Cats age at a much faster rate than humans, so practical timelines for testing frequency are included and suggest an increased frequency of diagnostics with advancing age. The importance of nutrition, as well as senior cat nutritional needs and deficiencies, is considered. Pain is highlighted as its own syndrome, with an emphasis on consideration in every senior cat. The Task Force discusses anesthesia, along with strategies to allow aging cats to be safely anesthetized well into their senior years. The medical concept of quality of life is addressed with the latest information available in veterinary medicine. This includes end of life considerations like palliative and hospice care, as well as recommendations on the establishment of 'budgets of care', which greatly influence what can be done for the individual cat. Acknowledgement is given that each cat owner will be different in this regard; and establishing what is reasonable and practical for the individual owner is important. A discussion on euthanasia offers some recommendations to help the owner make a decision that reflects the best interests of the individual cat.
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Affiliation(s)
| | - Hazel C Carney
- WestVet Emergency and Specialty Center, Garden City, ID, USA
| | - Beth Boynton
- College of Veterinary Medicine, Western University of Health Sciences, Pomona, CA, USA
| | - Jessica Quimby
- The Ohio State University, Department of Veterinary Clinical Sciences, Columbus, OH, USA
| | - Sheilah Robertson
- Senior Medical Director, Lap of Love Veterinary Hospice, Lutz, FL, USA
| | | | - Helen Tuzio
- Forest Hills Cat Hospital, Middle Village, NY, USA
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11
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Gruen ME, Myers JAE, Lascelles BDX. Efficacy and Safety of an Anti-nerve Growth Factor Antibody (Frunevetmab) for the Treatment of Degenerative Joint Disease-Associated Chronic Pain in Cats: A Multisite Pilot Field Study. Front Vet Sci 2021; 8:610028. [PMID: 34124212 PMCID: PMC8195238 DOI: 10.3389/fvets.2021.610028] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 04/06/2021] [Indexed: 01/21/2023] Open
Abstract
Background: Pain management for cats with degenerative joint disease (DJD) remains a critical unmet need. Recent work has shown promise for a feline-specific anti-nerve growth factor monoclonal antibody (frunevetmab) to deliver safe and effective pain management. Our objectives were to evaluate the efficacy and safety of frunevetmab administered twice using two administration routes (subcutaneous and intravenous) compared to placebo. Methods: This was a randomized placebo-controlled, double-masked study. After a week-long pain and activity baseline, 126 cats were randomized to receive injections of frunevetmab (IV then SC; n = 42 or SC then SC; n = 43) or placebo (IV then SC; n = 41) on Days 0 and 28. Owners completed questionnaires on Days 14, 28, 42, and 56. Accelerometry data were collected continuously throughout. Results: Owner questionnaire results showed significant improvement in frunevetmab-treated cats [compared to placebo; (p < 0.05)] at Days 42 and 56; no difference was found between routes of administration for frunevetmab. All groups had decreased objectively measured weekly activity from baseline; frunevetmab-treated cats had a mean decrease of 0.9%, while placebo-treated cats had a mean decrease of 9.3%. Treatments were generally well-tolerated. The majority of adverse events included dermatitis/alopecia related to activity-monitor collars; these occurred in a higher percentage of frunevetmab, compared to placebo, treated cats. Conclusions and Clinical Relevance: Treatment with frunevetmab provided improvements in owner ratings of mobility over treatment with placebo; these results were supported by objectively measured accelerometry. Frunevetmab has the potential to address a critical gap in the treatment of chronic pain in cats.
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Affiliation(s)
- Margaret E. Gruen
- Translational Research in Pain Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States
- Behavioral Medicine, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States
- Comparative Pain Research and Education Center, North Carolina State University, Raleigh, NC, United States
| | - Jamie A. E. Myers
- Veterinary Medicine Research and Development, Zoetis, Inc., Kalamazoo, MI, United States
| | - B. Duncan X. Lascelles
- Translational Research in Pain Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States
- Comparative Pain Research and Education Center, North Carolina State University, Raleigh, NC, United States
- Thurston Arthritis Center, University of North Carolina (UNC) School of Medicine, Chapel Hill, NC, United States
- Department of Anesthesiology, Center for Translational Pain Research, Duke University, Durham, NC, United States
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12
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KuKanich K, George C, Roush JK, Sharp S, Farace G, Yerramilli M, Peterson S, Grauer GF. Effects of low-dose meloxicam in cats with chronic kidney disease. J Feline Med Surg 2021; 23:138-148. [PMID: 32594827 PMCID: PMC10741344 DOI: 10.1177/1098612x20935750] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Meloxicam therapy may benefit cats with degenerative joint disease, and retrospective studies suggest it could slow kidney disease progression and increase survival. This study aimed to prospectively evaluate the renal effects of low-dose meloxicam treatment (0.02 mg/kg/day) over 6 months in cats with chronic kidney disease (CKD). METHODS Twenty-one cats with stable International Renal Interest Society stage 2 or 3 CKD were recruited and randomized to placebo or meloxicam groups. Cats were evaluated at baseline and at 1, 3 and 6 months, including blood pressure, chemistry, symmetric dimethylarginine (SDMA), glomerular filtration rate (GFR), urinalysis, urine protein:creatinine ratio (UPC), urine transforming growth factor-beta (β):creatinine ratio, urine clusterin, urine cystatin B and serum inosine. RESULTS No statistical difference was observed in systolic blood pressure, blood urea nitrogen, creatinine, SDMA, GFR, urine transforming growth factor-β:creatinine ratio, urine clusterin, urine cystatin B or serum inosine in cats receiving meloxicam vs placebo. Mean UPC was greater in the meloxicam group (0.33) than the placebo group (0.1) at 6 months (P = 0.006). Four cats had meloxicam discontinued owing to potential (mainly gastrointestinal) adverse effects. CONCLUSIONS AND RELEVANCE No decline in renal excretory function was observed when meloxicam was administered to cats with CKD. However, gastrointestinal adverse effects were observed, and cats that received meloxicam had greater proteinuria at 6 months than cats that received placebo. As proteinuria is associated with negative outcomes (progression of azotemia and hypertension) in cats with CKD, this finding suggests that meloxicam should be used with caution in cats with CKD and UPC monitored. Until further research is available, clinicians should weigh the risk of potential increased proteinuria against quality of life benefits when considering meloxicam for analgesia in cats with renal disease.
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Affiliation(s)
- Kate KuKanich
- Department of Clinical Sciences, College
of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
| | - Christopher George
- Department of Clinical Sciences, College
of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
- Blue Pearl Veterinary Partners, Tacoma,
WA, USA
| | - James K Roush
- Department of Clinical Sciences, College
of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
| | - Sherry Sharp
- Department of Clinical Sciences, College
of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
| | | | | | | | - Gregory F Grauer
- Department of Clinical Sciences, College
of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
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13
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Dowgray N, Comerford E. Feline musculoskeletal ageing: How are we diagnosing and treating musculoskeletal impairment? J Feline Med Surg 2020; 22:1069-1083. [PMID: 33100170 PMCID: PMC10814220 DOI: 10.1177/1098612x20965832] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
PRACTICAL RELEVANCE An understanding of the process of musculoskeletal ageing - which all senior and geriatric cats will experience - is vital to maintaining the health and welfare of our ageing cat population. CLINICAL CHALLENGES Assessment of the feline musculoskeletal system is not always straightforward. Diagnosis of impairment relies on input from owners and veterinarians in terms of visual observation, and clinical and orthopaedic examination, in addition to diagnostic imaging. AUDIENCE This review is written for the primary care veterinary team. AIMS The goals are to raise awareness and improve clinical diagnosis of musculoskeletal impairment as a result of ageing. The article also reviews therapeutic options and considers the evidence available for the prevention/deceleration of musculoskeletal ageing and impairment. EVIDENCE BASE There is good evidence of a high prevalence of osteoarthritis (OA) and degenerative joint disease (DJD) in older cats. There is also good evidence to indicate that functional impairment and chronic pain are sequelae of musculoskeletal disease. However, there is a paucity of information for what is best practice for the management and treatment of musculoskeletal impairment in a clinical situation. There is also a lack of evidence on how prevention of central stimulation of the nervous system caused by musculoskeletal impairment and, in turn the development of chronic pain, can be avoided.
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Affiliation(s)
| | - Eithne Comerford
- Institute of Life Course and Medical Sciences and School of Veterinary Science, University of Liverpool, UK
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Chalifoux NV, Kaiman G, Drobatz KJ, Thawley VJ. Evaluation of renal and hepatic blood value screening before non-steroidal anti-inflammatory drug administration in dogs. J Small Anim Pract 2020; 62:12-18. [PMID: 33035358 DOI: 10.1111/jsap.13230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 08/20/2020] [Accepted: 08/26/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To evaluate the potential association between signalment, history and physical examination findings and elevated renal and hepatic blood values before non-steroidal anti-inflammatory drug administration in dogs. Secondary objectives were to investigate clinicopathologic differences between dogs that were and were not prescribed a non-steroidal anti-inflammatory drug. MATERIALS AND METHODS Medical records of 81 dogs that underwent renal and hepatic blood value screening before drug administration via a non-steroidal anti-inflammatory drug blood panel were reviewed retrospectively. Patient signalment, history and physical examination findings were recorded. RESULTS Six (7%) dogs had an elevated blood urea nitrogen, 2 (2%) dogs had an elevated creatinine, 24 (30%) dogs had an elevated alanine aminotransferase, 29 (36%) had an elevated aspartate aminotransferase and 14 (17%) had an elevated alkaline phosphatase. Forty-five (56%) dogs had an elevation in at least 1 renal or hepatic blood value. Dogs less than 8 years of age and with a longer duration of clinical signs were less likely to have an elevated renal or hepatic blood value. Dogs with elevated hepatic blood values were less likely to be prescribed a non-steroidal anti-inflammatory drug; however, this was not true for elevated renal parameters alone. CLINICAL SIGNIFICANCE The results of this preliminary study suggest that blood value screening before non-steroidal anti-inflammatory drug administration may be important for dogs greater than 8 years of age. Hepatic enzyme elevations may play a greater role in clinical decision making in comparison to renal parameters.
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Affiliation(s)
- N V Chalifoux
- From the Department of Clinical Sciences & Advanced Medicine, University of Pennsylvania, School of Veterinary Medicine, 3900 Delancey Street, Philadelphia, Pennsylvania, 19104, USA
| | - G Kaiman
- From the Department of Clinical Sciences & Advanced Medicine, University of Pennsylvania, School of Veterinary Medicine, 3900 Delancey Street, Philadelphia, Pennsylvania, 19104, USA
| | - K J Drobatz
- From the Department of Clinical Sciences & Advanced Medicine, University of Pennsylvania, School of Veterinary Medicine, 3900 Delancey Street, Philadelphia, Pennsylvania, 19104, USA
| | - V J Thawley
- From the Department of Clinical Sciences & Advanced Medicine, University of Pennsylvania, School of Veterinary Medicine, 3900 Delancey Street, Philadelphia, Pennsylvania, 19104, USA
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Chun N, Canapp S, Carr BJ, Wong V, Curry J. Validation and Characterization of Platelet-Rich Plasma in the Feline: A Prospective Analysis. Front Vet Sci 2020; 7:512. [PMID: 32851053 PMCID: PMC7431485 DOI: 10.3389/fvets.2020.00512] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 07/03/2020] [Indexed: 12/17/2022] Open
Abstract
Objective: To quantitate key parameters of the platelet-rich plasma (PRP) product from a commercially available system1 in healthy, adult felines. Materials and methods: A prospective study was performed from January 2019 to April 2019. 11 adult, healthy cats were used to prospectively analyze a commercially available PRP system1. A whole blood sample and a PRP sample that was processed immediately following blood draw according to the manufacturer's protocol were collected from each cat. The mean whole blood and PRP product platelet, RBC, WBC, neutrophil, monocyte, and lymphocyte concentrations were determined. The mean PRP product values were compared to the mean whole blood baseline values using a paired t-test with significance established at p = 0.05. Results: Mean platelet concentration was significantly increased (p = 0.0155). Mean RBC concentration was significantly decreased (p < 0.0001). Mean neutrophil concentration was significantly decreased (p < 0.0001). There was no statistically significant difference in mean WBC, monocyte, and lymphocyte concentrations. Clinical Relevance: The analyzed PRP system increased platelet concentration, while significantly reducing the RBC and neutrophil concentrations. Further study is warranted to determine the clinical applications and efficacy of PRP in felines, and the ideal concentrations of and relationships between platelets, red blood cells, and leukocytes needed for therapeutic effect.
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Affiliation(s)
- Nicole Chun
- Veterinary Orthopedic and Sports Medicine, Annapolis Junction, MD, United States
| | - Sherman Canapp
- Veterinary Orthopedic and Sports Medicine, Annapolis Junction, MD, United States.,Orthobiologic Innovations, LLC, Annapolis Junction, MD, United States
| | - Brittany Jean Carr
- Veterinary Orthopedic and Sports Medicine, Annapolis Junction, MD, United States
| | - Valerie Wong
- IDEXX BioResearch, West Sacramento, CA, United States
| | - Jeff Curry
- Orthobiologic Innovations, LLC, Annapolis Junction, MD, United States
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Scherk M. Complex Disease Management: Managing a Cat with Comorbidities. Vet Clin North Am Small Anim Pract 2020; 50:811-822. [PMID: 32389353 DOI: 10.1016/j.cvsm.2020.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Many older cats often suffer concurrently from multiple conditions. By focusing on the common concerns, rather than conflicting requirements, a management program can be devised. Optimize hydration, nutrition, and ensure comfort though providing analgesia and a low-stress environment in which the patient's feline-specific nature is respected both in the clinic and at home. Additional requirements, such as hyperphosphatemia or hypokalemia, can be met using treatments outside of diet, if necessary.
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Griffin MA, Culp WTN, Giuffrida MA, Ellis P, Tuohy J, Perry JA, Gedney A, Lux CN, Milovancev M, Wallace ML, Hash J, Mathews K, Liptak JM, Selmic LE, Singh A, Palm CA, Balsa IM, Mayhew PD, Steffey MA, Rebhun RB, Burton JH, Kent MS. Lower urinary tract transitional cell carcinoma in cats: Clinical findings, treatments, and outcomes in 118 cases. J Vet Intern Med 2019; 34:274-282. [PMID: 31721288 PMCID: PMC6979092 DOI: 10.1111/jvim.15656] [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: 12/12/2018] [Accepted: 10/14/2019] [Indexed: 12/28/2022] Open
Abstract
Background Lower urinary tract transitional cell carcinoma (TCC) is an important but rarely described disease of cats. Objectives To report the clinical characteristics, treatments, and outcomes in a cohort of cats with lower urinary tract TCC and to test identified variables for prognostic relevance. Animals One‐hundred eighteen client‐owned cats with lower urinary tract carcinoma. Methods Medical records were retrospectively reviewed to obtain information regarding clinical characteristics, treatments, and outcomes. Recorded variables were analyzed statistically. Results Median age of affected cats was 15 years (range, 5.0‐20.8 years) and median duration of clinical signs was 30 days (range, 0‐730 days). The trigone was the most common tumor location (32/118; 27.1%) as assessed by ultrasound examination, cystoscopy, or both. Treatment was carried out in 73 of 118 (61.9%) cats. Metastatic disease was documented in 25 of 118 (21.2%) cats. Median progression‐free survival and survival time for all cats were 113 days (95% confidence interval [CI], 69‐153) and 155 days (95% CI, 110‐222), respectively. Survival increased significantly (P < .001) when comparing cats across the ordered treatment groups: no treatment, treatment without partial cystectomy, and treatment with partial cystectomy. Partial cystectomy (hazard ratio [HR], 0.31; 95% CI, 0.17‐0.87) and treatment with nonsteroidal anti‐inflammatory drugs (HR, 0.55; 95% CI, 0.33‐0.93) were significantly associated with longer survival times. Conclusions and Clinical Importance The results support treatment using partial cystectomy and NSAIDs in cats with TCC.
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Affiliation(s)
- Maureen A Griffin
- School of Veterinary Medicine, University of California-Davis, Davis, California
| | - William T N Culp
- School of Veterinary Medicine, University of California-Davis, Davis, California
| | - Michelle A Giuffrida
- School of Veterinary Medicine, University of California-Davis, Davis, California
| | - Peter Ellis
- School of Veterinary Medicine, University of California-Davis, Davis, California
| | - Joanne Tuohy
- College of Veterinary Medicine, Colorado State University, Fort Collins, Colorado
| | - James A Perry
- School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Allison Gedney
- School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Cassie N Lux
- College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee
| | - Milan Milovancev
- Carlson College of Veterinary Medicine, Oregon State University, Corvallis, Oregon
| | - Mandy L Wallace
- College of Veterinary Medicine, University of Georgia, Athens, Georgia
| | - Jonathan Hash
- College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
| | - Kyle Mathews
- College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
| | - Julius M Liptak
- VCA Canada-Alta Vista Animal Hospital, Ottawa, Ontario, Canada
| | - Laura E Selmic
- College of Veterinary Medicine, University of Illinois, Urbana, Illinois
| | - Ameet Singh
- Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Carrie A Palm
- School of Veterinary Medicine, University of California-Davis, Davis, California
| | - Ingrid M Balsa
- School of Veterinary Medicine, University of California-Davis, Davis, California
| | - Philipp D Mayhew
- School of Veterinary Medicine, University of California-Davis, Davis, California
| | - Michele A Steffey
- School of Veterinary Medicine, University of California-Davis, Davis, California
| | - Robert B Rebhun
- School of Veterinary Medicine, University of California-Davis, Davis, California
| | - Jenna H Burton
- School of Veterinary Medicine, University of California-Davis, Davis, California
| | - Michael S Kent
- School of Veterinary Medicine, University of California-Davis, Davis, California
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Abstract
This article reviews the mechanisms of action, clinical use, and recent scientific evidence for the use of nonsteroidal antiinflammatory drugs, grapiprant, acetaminophen (paracetamol), metamizole (dipyrone), and corticosteroids in pain management. The discussion is presented with an emphasis on the treatment of acute pain.
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Nivy R, Segev G, Rimer D, Bruchim Y, Aroch I, Mazaki-Tovi M. A prospective randomized study of efficacy of 2 treatment protocols in preventing recurrence of clinical signs in 51 male cats with obstructive idiopathic cystitis. J Vet Intern Med 2019; 33:2117-2123. [PMID: 31400046 PMCID: PMC6766499 DOI: 10.1111/jvim.15594] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 08/01/2019] [Indexed: 11/20/2022] Open
Abstract
Background Urethral obstruction (UO) is a common complication of feline idiopathic cystitis (FIC). Robust treatment recommendations to prevent its recurrence are scarce. Objectives To evaluate meloxicam treatment for prevention of clinical recrudescence in male cats with obstructive FIC. Animals Fifty‐one client‐owned cats. Methods Prospective, randomized clinical trial. Every male cat with FIC‐associated UO was deemed eligible for the study and was recruited during hospitalization. After discharge, cats were treated with phenoxybenzamine and alprazolam for 2 weeks, with (24 cats) or without (27 cats) low‐dose meloxicam (0.025 mg/kg/day PO) and monitored for 6 months. Results Cumulative number (%) of cats with recurrent UO at 10 days, 1‐, 2‐, and 6‐months after discharge was 1 (2%), 2 (4%), 4 (8%), and 8 (16%), respectively. Overall, 12 (24%) cats experienced signs of recurrent FIC within 6 months, with (8 cats) or without (4 cats) concurrent UO. No difference in the cumulative incidence of UO within 6 months was detected with addition of meloxicam (odds ratio [95% confidence interval], 0.63 [0.13‐2.97]; P = .70). All cats were alive at 6 months. Conclusions and Clinical Importance No clinical benefit was detected with the addition of low‐dose meloxicam to phenoxybenzamine and alprazolam treatment for 2 weeks after discharge. Nevertheless, this study was underpowered to identify potential differences, and its findings must be corroborated in larger studies.
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Affiliation(s)
- Ran Nivy
- Veterinary Teaching Hospital and Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Gilad Segev
- Veterinary Teaching Hospital and Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Dar Rimer
- Veterinary Teaching Hospital and Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Yaron Bruchim
- Veterinary Teaching Hospital and Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Itamar Aroch
- Veterinary Teaching Hospital and Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Michal Mazaki-Tovi
- Veterinary Teaching Hospital and Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
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Goich M, Bascuñán A, Faúndez P, Valdés A. Multimodal analgesia for treatment of allodynia and hyperalgesia after major trauma in a cat. JFMS Open Rep 2019; 5:2055116919855809. [PMID: 31245022 PMCID: PMC6582303 DOI: 10.1177/2055116919855809] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Case summary A 2-year-old polytraumatized male cat was admitted to a teaching hospital for correction of a defective inguinal herniorrhaphy. Upon arrival, the cat showed signs of neuropathic pain, including allodynia and hyperalgesia. Analgesic therapy was initiated with methadone and metamizole; however, 24 h later, the signs of pain continued. Reparative surgery was performed, and a multimodal analgesic regimen was administered (methadone, ketamine, wound catheter and epidural anesthesia). Postoperatively, the cat showed signs of severe pain, assessed using the UNESP-Botucatu multidimensional composite pain scale. Rescue analgesia was initiated, which included methadone, bupivacaine (subcutaneous wound-diffusion catheter) and transversus abdominis plane block. Because the response was incomplete, co-adjuvant therapy (pregabalin and electroacupuncture) was then implemented. Fourteen days after admission, the patient was discharged with oral tramadol and pregabalin for at-home treatment. Relevance and novel information Neuropathic pain is caused by a primary lesion or dysfunction in the nervous system and is a well-described complication following trauma, surgical procedures such as hernia repair, and inadequate analgesia. The aims of this report are to: (1) describe a presentation of neuropathic pain to highlight the recognition of clinical signs such as allodynia and hyperalgesia in cats; and (2) describe treatment of multi-origin, severe, long-standing, ‘mixed’ pain (acute inflammatory with a neuropathic component). The patient was managed using multiple analgesic strategies (multimodal analgesia), including opioids, non-steroidal anti-inflammatory drugs, locoregional anesthesia, co-adjuvant drugs and non-pharmacological therapy (electroacupuncture).
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Affiliation(s)
- Mariela Goich
- Escuela de Medicina Veterinaria, Facultad de Ciencias de la vida, Universidad Andres Bello
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Monteiro B, Steagall PVM, Lascelles BDX, Robertson S, Murrell JC, Kronen PW, Wright B, Yamashita K. Long-term use of non-steroidal anti-inflammatory drugs in cats with chronic kidney disease: from controversy to optimism. J Small Anim Pract 2019; 60:459-462. [PMID: 31081136 DOI: 10.1111/jsap.13012] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 03/16/2019] [Accepted: 03/28/2019] [Indexed: 11/29/2022]
Abstract
This is the first of a series of capsule reviews published by the World Small Animal Veterinary Association - Global Pain Council (WSAVA-GPC). Each of these short articles provides a brisk assessment of the scientific evidence in specific aspects of pain management, including analgesic techniques, recommendations and controversies surrounding their use. In this first capsule review, the scientific evidence available on the long-term use of non-steroidal anti-inflammatory drugs in cats with concomitant chronic pain and chronic kidney disease is discussed.
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Affiliation(s)
- B Monteiro
- Clinical Sciences, University of Montreal, Montreal, Quebec, J2S 2M2, Canada
| | - P V M Steagall
- Clinical Sciences, University of Montreal, Montreal, Quebec, J2S 2M2, Canada
| | - B D X Lascelles
- Translational Research in Pain Program, Comparative Pain Research and Education Center, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, 27606, USA
| | - S Robertson
- Lap of Love Veterinary Hospice, 1780 N US Highway 41, Lutz, FL 33549, USA
| | - J C Murrell
- Highcroft Veterinary Referrals, Whitchurch, Bristol, BS14 9BE, UK
| | - P W Kronen
- Veterinary Anaesthesia Service - International, Winterthur 8400, Switzerland
| | - B Wright
- Mistral Vet, Fort Collins, Colorado 80534, USA
| | - K Yamashita
- Small Animal Clinical Sciences, Rakuno Gakuen University, Ebetsu, Hokkaido 069-8501, Japan
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Murrell J. Perioperative use of non‐steroidal anti‐inflammatory drugs in cats and dogs. IN PRACTICE 2018. [DOI: 10.1136/inp.k3545] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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ABSENCE OF ACUTE TOXICITY OF A SINGLE INTRAMUSCULAR INJECTION OF MELOXICAM IN GOLDFISH ( CARASSIUS AURATUS AURATUS): A RANDOMIZED CONTROLLED TRIAL. J Zoo Wildl Med 2018; 49:617-622. [PMID: 30212321 DOI: 10.1638/2018-0077.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Meloxicam is a nonsteroidal anti-inflammatory drug with preferential cyclooxygenase-2 inhibitory activity. It is frequently used in veterinary medicine, including in fish species. The efficacy and safety of meloxicam, however, has not yet been reported in adult fish. The purpose of this study was to evaluate the acute toxicity of a single intramuscular injection of meloxicam in goldfish ( Carassius auratus auratus). Following 3 wk of acclimation, 32 goldfish were randomly assigned to two groups of 16 individuals. Fish from the treatment group received a single intramuscular injection of 5 mg/kg meloxicam, while the fish from the control group received a single intramuscular injection of a 0.9% sodium chloride solution using a similar volume (1 ml/kg). No external lesions, mortality, or modifications in behavior or position in the water column were noted during the following 72 hr. Three days after the initial injection, all fish were euthanized by immersion in a solution of tricaine methanesulfonate. Complete postmortem and histologic evaluations were performed for each fish. Hemorrhage and muscular necrosis were observed at the site of injection in fish from both groups. Multiple granulomas of undetermined etiology were detected in numerous organs from fish of both groups. No statistically significant differences were detected in regard to the lesions observed in these two groups. This study demonstrates that a single intramuscular injection of meloxicam at a dosage of 5 mg/kg does not cause acute toxicity in goldfish.
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Gorissen BMC, Uilenreef JJ, Bergmann W, Meijer E, van Rietbergen B, van der Staay FJ, Weeren PRV, Wolschrijn CF. Effects of long-term use of the preferential COX-2 inhibitor meloxicam on growing pigs. Vet Rec 2017; 181:564. [PMID: 29066475 DOI: 10.1136/vr.104175] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 07/03/2017] [Accepted: 09/04/2017] [Indexed: 01/11/2023]
Abstract
Meloxicam, a preferential COX-2 inhibitor, is a commonly used NSAID in pigs. Besides having potential side effects on the gastrointestinal tract, this type of drug might potentially affect osteogenesis and chondrogenesis, processes relevant to growing pigs. Therefore, the effects of long-term meloxicam treatment on growing pigs were studied. Twelve piglets (n=6 receiving daily meloxicam 0.4 mg/kg orally from 48 until 110 days of age; n=6 receiving only applesauce (vehicle control)) were subjected to visual and objective gait analysis by pressure plate measurements at several time points. Following euthanasia a complete postmortem examination was performed and samples of the talus and distal tibia, including the distal physis, were collected. Trabecular bone microarchitecture was analysed by microCT scanning, bone stiffness by compression testing and growth plate morphology using light microscopy. Animals were not lame and gait patterns did not differ between the groups. Pathological examination revealed no lesions compatible with known side effects of NSAIDs. Trabecular bone microarchitecture and growth plate morphology did not differ between the two groups. The findings of this in vivo study reduce concerns regarding the long-term use of meloxicam in young, growing piglets.
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Affiliation(s)
- Ben M C Gorissen
- Department of Pathobiology, Anatomy and Physiology Division, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Joost J Uilenreef
- Department of Clinical Sciences of Companion Animals, Anaesthesiology Division, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Wilhelmina Bergmann
- Department of Pathobiology, Division of Pathology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Ellen Meijer
- Department of Farm Animal Health, Behaviour and Welfare Group, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Bert van Rietbergen
- Department of Biomedical Engineering, Orthopaedic Biomechanics Division, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Franz Josef van der Staay
- Department of Farm Animal Health, Behaviour and Welfare Group, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - P René van Weeren
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Claudia F Wolschrijn
- Department of Pathobiology, Anatomy and Physiology Division, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
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Summa NM, Guzman DSM, Larrat S, Troncy E, Bird DM, Lair S, Fitzgerald, G. Evaluation of High Dosages of Oral Meloxicam in American Kestrels (Falco sparverius). J Avian Med Surg 2017. [DOI: 10.1647/2015-150] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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26
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Monteiro BP, Klinck MP, Moreau M, Guillot M, Steagall PVM, Pelletier JP, Martel-Pelletier J, Gauvin D, del Castillo JRE, Troncy E. Analgesic efficacy of tramadol in cats with naturally occurring osteoarthritis. PLoS One 2017; 12:e0175565. [PMID: 28403198 PMCID: PMC5389833 DOI: 10.1371/journal.pone.0175565] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 03/28/2017] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES This study aimed to (1) compare outcome assessments in normal and osteoarthritic cats and (2) evaluate the analgesic efficacy of tramadol in feline osteoarthritis (OA), in a prospective, randomised, blinded, placebo-controlled, crossover design. METHODS Twenty cats were included after clinical examination, blood work and full body radiographs were performed. In Phase 1, outcome assessments aimed to differentiate normal (n = 5; i.e. exempt of any radiographic and clinical sign of OA) from OA (n = 15) cats. In Phase 2, OA cats were treated twice daily with a placebo (PG: cornstarch 15 mg) or tramadol (TG: 3 mg/kg) orally for 19 days, with a 3-month washout period between treatments. Evaluations were performed in normal and OA cats at baseline and consisted of: 1) peak vertical force (PVF) after staircase exercise; 2) telemetered night-time motor activity (NMA); and 3) response to mechanical temporal summation (RMTS). After treatment, PVF, NMA and RMTS evaluations were repeated in OA cats. Data were analysed with mixed model methods with an alpha-threshold of 5%. RESULTS Phase 1: 1) PVF (% of body weight; mean ± SD) was higher in normal (59 ± 10.5) than in OA cats (50.6 ± 5.7) (p = 0.005); 2) NMA (no unit) was not different between groups; 3) RMTS (number of stimuli; median (range)) was higher in normal [29.5 (23.5-30)] than in OA cats [14 (8.5-28)] (p < 0.0001). Phase 2: PVF, NMA and RMTS presented a treatment effect (p = 0.024, p = 0.008 and p = 0.018, respectively). No clinically important adverse-effects were observed. CONCLUSION Outcome assessments such as kinetics (PVF) and evaluation of central sensitisation (RMTS) are discriminant of OA status. Mobility measured by NMA was not discriminant of OA status, however it increased in OA cats with tramadol treatment. Nociceptive hypersensitivity quantified by RMTS was evident in OA cats and was responsive to tramadol treatment.
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Affiliation(s)
- Beatriz P. Monteiro
- GREPAQ (Animal Pharmacology Research Group of Quebec), Faculty of Veterinary Medicine–Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Mary P. Klinck
- GREPAQ (Animal Pharmacology Research Group of Quebec), Faculty of Veterinary Medicine–Université de Montréal, Saint-Hyacinthe, QC, Canada
- Osteoarthritis Research Unit, Research Center of the University of Montreal Hospital Centre, Montreal, QC, Canada
| | - Maxim Moreau
- GREPAQ (Animal Pharmacology Research Group of Quebec), Faculty of Veterinary Medicine–Université de Montréal, Saint-Hyacinthe, QC, Canada
- Osteoarthritis Research Unit, Research Center of the University of Montreal Hospital Centre, Montreal, QC, Canada
| | - Martin Guillot
- GREPAQ (Animal Pharmacology Research Group of Quebec), Faculty of Veterinary Medicine–Université de Montréal, Saint-Hyacinthe, QC, Canada
- Osteoarthritis Research Unit, Research Center of the University of Montreal Hospital Centre, Montreal, QC, Canada
| | - Paulo V. M. Steagall
- Department of Clinical Sciences, Faculty of Veterinary Medicine–Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Jean-Pierre Pelletier
- Osteoarthritis Research Unit, Research Center of the University of Montreal Hospital Centre, Montreal, QC, Canada
| | - Johanne Martel-Pelletier
- Osteoarthritis Research Unit, Research Center of the University of Montreal Hospital Centre, Montreal, QC, Canada
| | - Dominique Gauvin
- GREPAQ (Animal Pharmacology Research Group of Quebec), Faculty of Veterinary Medicine–Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Jérôme R. E. del Castillo
- GREPAQ (Animal Pharmacology Research Group of Quebec), Faculty of Veterinary Medicine–Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Eric Troncy
- GREPAQ (Animal Pharmacology Research Group of Quebec), Faculty of Veterinary Medicine–Université de Montréal, Saint-Hyacinthe, QC, Canada
- Osteoarthritis Research Unit, Research Center of the University of Montreal Hospital Centre, Montreal, QC, Canada
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Monteiro BP, Klinck MP, Moreau M, Guillot M, Steagall PVM, Edge DK, Pelletier J, Martel‐Pelletier J, Gauvin D, del Castillo JRE, Troncy E. Analgesic efficacy of an oral transmucosal spray formulation of meloxicam alone or in combination with tramadol in cats with naturally occurring osteoarthritis. Vet Anaesth Analg 2016; 43:643-651. [DOI: 10.1111/vaa.12360] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Accepted: 12/26/2015] [Indexed: 01/30/2023]
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King JN, King S, Budsberg SC, Lascelles BDX, Bienhoff SE, Roycroft LM, Roberts ES. Clinical safety of robenacoxib in feline osteoarthritis: results of a randomized, blinded, placebo-controlled clinical trial. J Feline Med Surg 2016; 18:632-42. [PMID: 26058587 PMCID: PMC10816385 DOI: 10.1177/1098612x15590870] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
OBJECTIVES The objective of this study was to evaluate the clinical safety of the non-steroidal anti-inflammatory drug (NSAID) robenacoxib in cats with osteoarthritis. Degenerative joint disease, including osteoarthritis, is highly prevalent in cats and many cases have associated pain and impaired mobility. Although NSAIDs are used routinely to control pain and inflammation in cats with osteoarthritis, there are safety concerns because of the high concurrent prevalence of chronic kidney disease (CKD) and the paucity of data on the safety of these drugs in target clinical populations. METHODS A total of 194 cats with osteoarthritis were recruited and randomly allocated to receive either robenacoxib at a dosage of 1.0-2.4 mg/kg (n = 95) or placebo (n = 99) tablets PO q24h for 28 days. Safety was assessed in 193 cats, including a subgroup of 40 animals with concurrent CKD, defined as serum creatinine concentration ⩾1.6 mg/dl and urine specific gravity <1.030. Safety endpoints included reports of adverse events, results of clinical examinations, including body weight, and clinical chemistry and hematology variables. RESULTS In all 193 cats and the subgroup of 40 animals with concurrent CKD, there were no differences between groups in frequencies of reported adverse events, body weight change or results of serum or urine chemistry or hematology variables. CONCLUSIONS AND RELEVANCE Robenacoxib was well tolerated when administered daily for 1 month in cats with osteoarthritis, including cats with evidence of concurrent CKD. There was no clinical indication of damage to the gastrointestinal tract, kidney or liver.
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Affiliation(s)
- Jonathan N King
- Elanco Animal Health, Clinical Development, Basel, Switzerland
| | - Stephen King
- Elanco Animal Health, New Product Development, Greensboro, NC, USA
| | - Steven C Budsberg
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - B Duncan X Lascelles
- Comparative Pain Research Laboratory, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA Center for Comparative Medicine and Translational Research, North Carolina State University, Raleigh, NC, USA Center for Pain Research and Innovation, School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - Stephen E Bienhoff
- Elanco Animal Health, New Product Development, Greensboro, NC, USA Current address: AlcheraBio LLC, Clinical Services, Edison, NJ, USA
| | - Linda M Roycroft
- Elanco Animal Health, New Product Development, Greensboro, NC, USA
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Generalized enrichment analysis improves the detection of adverse drug events from the biomedical literature. BMC Bioinformatics 2016; 17:250. [PMID: 27333889 PMCID: PMC4918084 DOI: 10.1186/s12859-016-1080-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 05/11/2016] [Indexed: 01/12/2023] Open
Abstract
Background Identification of associations between marketed drugs and adverse events from the biomedical literature assists drug safety monitoring efforts. Assessing the significance of such literature-derived associations and determining the granularity at which they should be captured remains a challenge. Here, we assess how defining a selection of adverse event terms from MeSH, based on information content, can improve the detection of adverse events for drugs and drug classes. Results We analyze a set of 105,354 candidate drug adverse event pairs extracted from article indexes in MEDLINE. First, we harmonize extracted adverse event terms by aggregating them into higher-level MeSH terms based on the terms’ information content. Then, we determine statistical enrichment of adverse events associated with drug and drug classes using a conditional hypergeometric test that adjusts for dependencies among associated terms. We compare our results with methods based on disproportionality analysis (proportional reporting ratio, PRR) and quantify the improvement in signal detection with our generalized enrichment analysis (GEA) approach using a gold standard of drug-adverse event associations spanning 174 drugs and four events. For single drugs, the best GEA method (Precision: .92/Recall: .71/F1-measure: .80) outperforms the best PRR based method (.69/.69/.69) on all four adverse event outcomes in our gold standard. For drug classes, our GEA performs similarly (.85/.69/.74) when increasing the level of abstraction for adverse event terms. Finally, on examining the 1609 individual drugs in our MEDLINE set, which map to chemical substances in ATC, we find signals for 1379 drugs (10,122 unique adverse event associations) on applying GEA with p < 0.005. Conclusions We present an approach based on generalized enrichment analysis that can be used to detect associations between drugs, drug classes and adverse events at a given level of granularity, at the same time correcting for known dependencies among events. Our study demonstrates the use of GEA, and the importance of choosing appropriate abstraction levels to complement current drug safety methods. We provide an R package for exploration of alternative abstraction levels of adverse event terms based on information content. Electronic supplementary material The online version of this article (doi:10.1186/s12859-016-1080-z) contains supplementary material, which is available to authorized users.
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Gruen ME, Thomson AE, Griffith EH, Paradise H, Gearing DP, Lascelles BDX. A Feline-Specific Anti-Nerve Growth Factor Antibody Improves Mobility in Cats with Degenerative Joint Disease-Associated Pain: A Pilot Proof of Concept Study. J Vet Intern Med 2016; 30:1138-48. [PMID: 27334504 PMCID: PMC5153962 DOI: 10.1111/jvim.13972] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 04/05/2016] [Accepted: 04/28/2016] [Indexed: 12/12/2022] Open
Abstract
Background Neutralizing antibodies against nerve growth factor (NGF) are analgesic in rodent models, naturally occurring degenerative joint disease (DJD) pain in dogs, and chronic pain in humans. Objectives To evaluate the efficacy of a fully felinized anti‐NGF antibody (NV‐02) for the treatment of DJD pain and mobility impairment in cats. Animals Thirty‐four client‐owned cats with DJD‐associated pain and mobility impairment. Methods In a placebo‐controlled, pilot, masked clinical study, cats were randomized to a single treatment with NV‐02 (0.4 mg/kg SC [n = 11] or 0.8 mg/kg SC [n = 12]) or placebo (saline, SC [n = 11]). Activity was measured objectively. Additionally, owners completed clinical metrology instruments (client‐specific outcome measures [CSOM] and feline musculoskeletal pain index [FMPI]) on days 0 (screening), 14 (baseline), 35, 56, and 77. A repeated‐measures model was used to evaluate the objective activity data. Results NV‐02 significantly increased objectively measured activity overall (P = .017) and at 2 (P = .035), 3 (P = .007), 4 (P = .006), 5 (P = .007), and 6 (P = .017) weeks after treatment. CSOM scores (P = .035) and pain (P = .024) showed a significant effect of treatment 3 weeks after administration. In the treatment group, 83% of the owners correctly identified the treatment administered compared with 45% of owners in the placebo group (P = .013). No treatment‐related adverse effects were identified. Conclusions These pilot data demonstrate a 6‐week duration positive analgesic effect of this fully felinized anti‐NGF antibody in cats suffering from DJD‐associated pain.
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Affiliation(s)
- M E Gruen
- Comparative Pain Research Program, NCSU College of Veterinary Medicine, Raleigh, NC.,Comparative Medicine Institute, NCSU College of Veterinary Medicine, Raleigh, NC
| | - A E Thomson
- Comparative Pain Research Program, NCSU College of Veterinary Medicine, Raleigh, NC
| | - E H Griffith
- Department of Statistics, NC State University, Raleigh, NC
| | - H Paradise
- Comparative Pain Research Program, NCSU College of Veterinary Medicine, Raleigh, NC
| | - D P Gearing
- Nexvet Australia Pty Ltd, Melbourne, VIC, Australia
| | - B D X Lascelles
- Comparative Pain Research Program, NCSU College of Veterinary Medicine, Raleigh, NC.,Comparative Medicine Institute, NCSU College of Veterinary Medicine, Raleigh, NC.,Center for Pain Research and Innovation, UNC Dental School, Chapel Hill, NC
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Pieper K. [Perioperative pain therapy in dogs and cats - an overview]. TIERAERZTLICHE PRAXIS AUSGABE KLEINTIERE HEIMTIERE 2016; 44:200-8. [PMID: 27223267 DOI: 10.15654/tpk-160084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Accepted: 05/10/2016] [Indexed: 11/13/2022]
Abstract
Undermanaged pain leads to negative systemic effects that may greatly disturb our patients' welfare. Therefore, a pain assessment tool should be routinely implemented into clinical practice. Validated pain assessment tools are available for dogs and cats. Advanced analgesic therapy follows the principle of a multimodal approach. This means that different analgesic drugs, which act on different targets within the nociceptive pathway, are combined to achieve the desired analgesic effects. In addition to opioids, nonsteroidal anti-inflammatory drugs and local anaesthetics, α2-receptor-agonists, ketamine and gabapentin as well as different nonpharmacologic analgesic techniques are used within the framework of a multimodal analgesic plan.
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Affiliation(s)
- Korbinian Pieper
- Dr. Korbinian Pieper, Chirurgische und Gynäkologische Kleintierklinik, der Ludwig-Maximilians-Universität München, Veterinärstraße 13, 80539 München, E-Mail:
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Abstract
PRACTICAL RELEVANCE The reported incidence of hip dysplasia (HD) in cats varies dramatically between studies, but the condition is likely more common than we realise. There is little doubt that cats with HD and associated osteoarthritis (OA) suffer pain, and this warrants appropriate therapy. DIAGNOSTIC CHALLENGES Clinical signs of HD in cats are often gradual in onset, making them difficult to appreciate, but may include inactivity, pelvic limb lameness, difficulty jumping and climbing stairs, and reluctance to squat to defecate. Often lameness is bilateral, and can be particularly difficult to recognise. The most common radiographic finding is an abnormally shallow acetabulum. Subluxation, however, is not consistently associated with OA in cats and therefore the role that joint laxity plays in disease progression remains uncertain. Degenerative changes of the femoral head and neck seem to develop later than in the dog, and are less marked. THERAPEUTIC CHALLENGES The majority of cats respond to non-surgical management with environmental modulation, physical therapy, dietary modulation, weight loss, nutraceuticals and drug therapy. Should non-surgical management not provide sufficient relief, two salvage surgical options are available: femoral head and neck excision (FHNE) and total hip replacement (THR). While there is a risk of complications with micro-THR, the positive outcomes that have been reported indicate that it should be considered in the treatment of coxofemoral pathology in cats in the same way that THR is considered for larger dogs, especially given the inconsistent results associated with FHNE. Monitoring the effect of treatment is challenging as the assessment of pain in cats is complex and there is no validated scoring system or owner-completed questionnaire yet available for cats. EVIDENCE BASE There is a paucity of clinical reports focusing solely on HD in cats. The author draws on a combination of published studies, in cats, dogs and humans, as well as personal clinical experience.
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Affiliation(s)
- Karen Perry
- Veterinary Medical Center, Michigan State University, 736 Wilson Road, East Lansing, MI 48824-1314, USA
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Sparkes AH, Caney S, Chalhoub S, Elliott J, Finch N, Gajanayake I, Langston C, Lefebvre HP, White J, Quimby J. ISFM Consensus Guidelines on the Diagnosis and Management of Feline Chronic Kidney Disease. J Feline Med Surg 2016; 18:219-39. [PMID: 26936494 PMCID: PMC11148907 DOI: 10.1177/1098612x16631234] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
PRACTICAL RELEVANCE Chronic kidney disease (CKD) is one of the most commonly diagnosed diseases in older cats. In most cats, CKD is also a progressive disease and can be accompanied by a wide range of clinical and clinicopathological changes. These ISFM Consensus Guidelines have been developed by an independent panel of clinicians and academics to provide practical advice on the diagnosis and management of this complex disease. CLINICAL CHALLENGES Although CKD is a common clinical problem in cats, the manifestations of disease vary between individuals. Thus there is a need for careful and repeat evaluation of cats with CKD and adjustment of therapy according to individual needs. In addition to addressing problems arising from CKD and improving quality of life (QoL) for the patient, therapy may also target slowing the underlying progression of disease and hence prolonging life. While maintaining QoL is of paramount importance in our patients, this can be challenging when multiple therapies are indicated. In some cases it is necessary to prioritise therapy, given an understanding of what is likely to most benefit the individual patient. EVIDENCE BASE In preparing these Guidelines, the Panel has carefully reviewed the existing published literature, and has also graded the quality of evidence for different interventions to help to provide practical recommendations on the therapeutic options for feline CKD. This is a field of veterinary medicine that has benefited from some excellent published clinical research and further research findings will undoubtedly modify the recommendations contained in these Guidelines in the future.
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Affiliation(s)
| | | | - Serge Chalhoub
- Faculty of Veterinary Medicine, University of Calgary, Canada
| | - Jonathan Elliott
- Department of Comparative Biomedical Sciences, Royal Veterinary College, UK
| | - Natalie Finch
- Bristol Renal, School of Clinical Sciences, University of Bristol, UK
| | | | | | - Hervé P Lefebvre
- Clinical Research Unit, National Veterinary School of Toulouse (ENVT), France
| | - Joanna White
- Small Animal Specialist Hospital, Sydney, Australia
| | - Jessica Quimby
- Department of Clinical Veterinary Sciences, Colorado State University, USA
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Frankel G, Kusno A, Louizos C. Five things every community pharmacist should know when dispensing for 4-legged patients. Can Pharm J (Ott) 2016; 149:99-106. [PMID: 27076821 DOI: 10.1177/1715163516628543] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Grace Frankel
- College of Pharmacy, University of Manitoba, Winnipeg, Manitoba
| | - Alby Kusno
- College of Pharmacy, University of Manitoba, Winnipeg, Manitoba
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de Vries M, Putter G. Perioperative anaesthetic care of the cat undergoing dental and oral procedures: key considerations. J Feline Med Surg 2015; 17:23-36. [PMID: 25527491 DOI: 10.1177/1098612x14560096] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
CLINICAL CHALLENGES Anaesthesia for dental and oral procedures in cats can be challenging and many factors need to be taken into consideration. Often it is older patients requiring these procedures and, while old age itself is not a contraindication for general anaesthesia, older patients tend to have limited homeostatic reserves and are, therefore, more prone to anaesthesia-induced insults of vital organs. Most sedative and anaesthetic agents have cardiovascular side effects, which may result in detrimental consequences in older patients in which organ reserves are likely reduced. AIMS The need for good patient assessment and management during the entire perianaesthetic period cannot be overemphasised. This article describes how both anaesthetic protocol and intravenous fluid therapy should be tailored to the individual cat's needs. Application of a multimodal analgesic protocol (the combination of different analgesic agents) and a balanced anaesthetic technique incorporating local nerve blocks is highly recommended and a particular focus of the review. The use of local anaesthetic agents for the latter not only provides optimal pre-emptive analgesia, but also reduces the amount of anaesthetic agents needed to maintain an adequate level of anaesthesia and, therefore, limits their side effects. Other key aspects of perianaesthetic care of the feline dental and oral patient include airway protection, monitoring and maintenance of body temperature, eye protection, and analgesia extending well into the post-anaesthetic period. EVIDENCE BASE The authors draw on their clinical experience and the referenced literature to provide a practical overview of this critical but often-overlooked aspect of feline dentistry.
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Criterion Validation Testing of Clinical Metrology Instruments for Measuring Degenerative Joint Disease Associated Mobility Impairment in Cats. PLoS One 2015; 10:e0131839. [PMID: 26162101 PMCID: PMC4498683 DOI: 10.1371/journal.pone.0131839] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Accepted: 06/06/2015] [Indexed: 11/19/2022] Open
Abstract
Introduction Degenerative joint disease and associated pain are common in cats, particularly in older cats. There is a need for treatment options, however evaluation of putative therapies is limited by a lack of suitable, validated outcome measures that can be used in the target population of client owned cats. The objectives of this study were to evaluate low-dose daily meloxicam for the treatment of pain associated with degenerative joint disease in cats, and further validate two clinical metrology instruments, the Feline Musculoskeletal Pain Index (FMPI) and the Client Specific Outcome Measures (CSOM). Methods Sixty-six client owned cats with degenerative joint disease and owner-reported impairments in mobility were screened and enrolled into a double-masked, placebo-controlled, randomized clinical trial. Following a run-in baseline period, cats were given either placebo or meloxicam for 21 days, then in a masked washout, cats were all given placebo for 21 days. Subsequently, cats were given the opposite treatment, placebo or meloxicam, for 21 days. Cats wore activity monitors throughout the study, owners completed clinical metrology instruments following each period. Results Activity counts were increased in cats during treatment with daily meloxicam (p<0.0001) compared to baseline. The FMPI results and activity count data offer concurrent validation for the FMPI, though the relationship between baseline activity counts and FMPI scores at baseline was poor (R2=0.034). The CSOM did not show responsiveness for improvement in this study, and the relationship between baseline activity counts and CSOM scores at baseline was similarly poor (R2=0.042). Conclusions Refinements to the FMPI, including abbreviation of the instrument and scoring as percent of possible score are recommended. This study offered further validation of the FMPI as a clinical metrology instrument for use in detecting therapeutic efficacy in cats with degenerative joint disease.
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Lanuza R, Rankin AJ, KuKanich B, Meekins JM. Evaluation of systemic absorption and renal effects of topical ophthalmic flurbiprofen and diclofenac in healthy cats. Vet Ophthalmol 2015; 19 Suppl 1:24-9. [PMID: 26119523 DOI: 10.1111/vop.12295] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To investigate systemic absorption and renal effects of topically applied ophthalmic flurbiprofen and diclofenac in healthy cats. ANIMALS STUDIED Twelve domestic shorthair cats. PROCEDURES Cats were randomly assigned to two treatment groups (n = 6) and administered one drop (approximately 40 μL) of either flurbiprofen 0.03% or diclofenac 0.1% in both eyes four times daily (6 am, 12 pm, 6 pm, and 12 am) for 14 days. Blood samples were collected on days 0, 4, 8, 14, 16, and 17 and analyzed by liquid chromatography and mass spectrometry for flurbiprofen and diclofenac plasma concentrations. A complete blood count (CBC), serum chemistry, and urinalysis were analyzed at the beginning of the study (Day 0) and at the end of topical drug administration (Day 15). RESULTS Both drugs demonstrated systemic absorption. Flurbiprofen was detected (mean ± SD) at day 4 (237 ± 65 ng/mL), day 8 (396 ± 91 ng/mL), day 14 (423 ± 56 ng/mL), day 16 (350 ± 66 ng/mL), and day 17 (270 ± 62 ng/mL), and diclofenac was detected (mean ± SD) at day 4 (130 ± 44 ng/mL), day 8 (131 ± 25 ng/mL), day 14 (150 ± 36 ng/mL), and sporadically on day 16 [corrected]. Flurbiprofen plasma concentration decreased slowly over 48 h after the last dose. No clinically significant abnormalities were noted in the serum blood urea nitrogen, creatinine, or urine specific gravity at the end of topical drug administration compared to the beginning of the study. CONCLUSIONS Flurbiprofen and diclofenac were systemically absorbed after topical administration four times daily to both eyes of healthy cats. Flurbiprofen reached higher plasma concentrations compared to diclofenac.
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Affiliation(s)
- Rick Lanuza
- Department of Clinical Sciences, Kansas State University, Manhattan, KS, USA
| | - Amy J Rankin
- Department of Clinical Sciences, Kansas State University, Manhattan, KS, USA
| | - Butch KuKanich
- Department of Anatomy and Physiology, Kansas State University, Manhattan, KS, USA
| | - Jessica M Meekins
- Department of Clinical Sciences, Kansas State University, Manhattan, KS, USA
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Preliminary evaluation of the efficacy of Steadfast TM Joint Supplement in captive exotic felids (Arabian leopard and cheetah). JOURNAL OF APPLIED ANIMAL NUTRITION 2015. [DOI: 10.1017/jan.2015.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
SummaryFeline degenerative joint disease causes pain and disability and therefore represents a welfare concern for captive animals. Alternatives to traditional pharmaceutical therapies are gaining popularity and this study aimed to evaluate the efficacy of an egg-shell membrane therapy in captive cheetahs and leopards. Seven animals were treated with SteadfastTM and monitored for radiographic changes (n = 6) and lameness score (n = 7) over a 42 day period. A reduction in lameness was determined over the course of the study (p = 0.01), and improved orthopaedic status detected in 50% (3/6) of animals via radiographic examination. Surprisingly, a negative dose response was detected, whereby animals receiving lower doses exhibited the most marked changes in lameness score. Despite the small sample size and subjective scoring of lameness, this preliminary study demonstrates the need for further investigation into the use of an eggshell membrane-based supplement to improve mobility in captive felids with degenerative joint disease.
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Epstein M, Rodan I, Griffenhagen G, Kadrlik J, Petty M, Robertson S, Simpson W. 2015 AAHA/AAFP Pain Management Guidelines for Dogs and Cats*. J Am Anim Hosp Assoc 2015; 51:67-84. [DOI: 10.5326/jaaha-ms-7331] [Citation(s) in RCA: 104] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Epstein ME, Rodan I, Griffenhagen G, Kadrlik J, Petty MC, Robertson SA, Simpson W. 2015 AAHA/AAFP Pain Management Guidelines for Dogs and Cats. J Feline Med Surg 2015; 17:251-72. [DOI: 10.1177/1098612x15572062] [Citation(s) in RCA: 94] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Rationale: The robust advances in pain management for companion animals underlie the decision of the American Animal Hospital Association (AAHA) and American Association of Feline Practitioners (AAFP) to expand on the information provided in the 2007 AAHA/AAFP Pain Management Guidelines. The 2015 Guidelines summarize and offer a discriminating review of much of this new knowledge. Relevance: Pain management is central to veterinary practice, alleviating pain, improving patient outcomes, and enhancing both quality of life and the veterinarian–client–patient relationship. These Guidelines support veterinarians in incorporating pain management into practice, improving patient care. Approaches: The management of pain requires a continuum of care that includes anticipation, early intervention, and evaluation of response on an individual patient basis. A team-oriented approach, including the owner, is essential for maximizing the recognition, prevention and treatment of pain in animals. Evidence base: The Guidelines include both pharmacologic and non-pharmacologic modalities to manage pain; they are evidence-based insofar as possible and otherwise represent a consensus of expert opinion. Behavioral changes are currently the principal indicator of pain and its course of improvement or progression, and the basis for recently validated pain scores. Post-surgical pain is eminently predictable but a strong body of evidence exists supporting strategies to mitigate adaptive as well as maladaptive forms. Chronic pain is dominated by degenerative joint disease (DJD), which is one of the most significant and under-diagnosed diseases of cats and dogs. DJD is ubiquitous, found in pets of all ages, and inevitably progresses over time; evidence-based strategies for management are established in dogs, and emerging in cats.
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Affiliation(s)
- Mark E Epstein
- TotalBond Veterinary Hospitals PC, 3200 Union Road, Gastonia, NC 28056, USA
| | - Ilona Rodan
- Cat Care Clinic and Feline-Friendly Consultations, 322 Junction Road, Madison, WI 53717, USA
| | - Gregg Griffenhagen
- Colorado State University School of Veterinary Medicine, 300 West Drake Road, Fort Collins, CO 80523, USA
| | - Jamie Kadrlik
- Pet Crossing Animal Hospital and Dental Clinic, 10861 Bloomington Ferry Road, Bloomington, MN 55438, USA
| | - Michael C Petty
- Arbor Pointe Veterinary Hospital/Animal Pain Center, 42043 Ford Road, Canton, MI 48187, USA
| | - Sheilah A Robertson
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824, USA
| | - Wendy Simpson
- Morrisville Cat Hospital, 100 Keybridge Drive, Suite A, Morrisville, NC 27560, USA
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Marino CL, Lascelles BDX, Vaden SL, Gruen ME, Marks SL. Prevalence and classification of chronic kidney disease in cats randomly selected from four age groups and in cats recruited for degenerative joint disease studies. J Feline Med Surg 2014; 16:465-72. [PMID: 24217707 PMCID: PMC4414065 DOI: 10.1177/1098612x13511446] [Citation(s) in RCA: 129] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Chronic kidney disease (CKD) and degenerative joint disease are both considered common in older cats. Information on the co-prevalence of these two diseases is lacking. This retrospective study was designed to determine the prevalence of CKD in two cohorts of cats: cats randomly selected from four evenly distributed age groups (RS group) and cats recruited for degenerative joint disease studies (DJD group), and to evaluate the concurrence of CKD and DJD in these cohorts. The RS group was randomly selected from four age groups from 6 months to 20 years, and the DJD group comprised cats recruited to four previous DJD studies, with the DJD group excluding cats with a blood urea nitrogen and/or serum creatinine concentration >20% (the upper end of normal) for two studies and cats with CKD stages 3 and 4 for the other two studies. The prevalence of CKD in the RS and DJD groups was higher than expected at 50% and 68.8%, respectively. CKD was common in cats between 1 and 15 years of age, with a similar prevalence of CKD stages 1 and 2 across age groups in both the RS and DJD cats, respectively. We found significant concurrence between CKD and DJD in cats of all ages, indicating the need for increased screening for CKD when selecting DJD treatments. Additionally, this study offers the idea of a relationship and causal commonality between CKD and DJD owing to the striking concurrence across age groups and life stages.
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Affiliation(s)
- Christina L Marino
- Department of Clinical Sciences, North Carolina State University, College of Veterinary Medicine, Raleigh, NC, USA
| | - B Duncan X Lascelles
- Comparative Pain Research Laboratory, Surgery Section, Department of Clinical Sciences, North Carolina State University, College of Veterinary Medicine, Raleigh, NC, USA Center for Comparative Medicine and Translational Research, North Carolina State University, Raleigh, NC, USA
| | - Shelly L Vaden
- Department of Clinical Sciences, North Carolina State University, College of Veterinary Medicine, Raleigh, NC, USA Center for Comparative Medicine and Translational Research, North Carolina State University, Raleigh, NC, USA
| | - Margaret E Gruen
- Comparative Pain Research Laboratory, Surgery Section, Department of Clinical Sciences, North Carolina State University, College of Veterinary Medicine, Raleigh, NC, USA Comparative Biomedical Sciences, North Carolina State University, College of Veterinary Medicine, Raleigh, NC, USA
| | - Steven L Marks
- Department of Clinical Sciences, North Carolina State University, College of Veterinary Medicine, Raleigh, NC, USA
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Leo C, Stell A, Borrego J, Martinez de Merlo E, Ruess-Melzer K, Lara-Garcia A. Evaluation of low-dose metronomic (LDM) cyclophosphamide toxicity in cats with malignant neoplasia. J Feline Med Surg 2014; 16:671-8. [DOI: 10.1177/1098612x13518938] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Oral administration of low-dose cyclophosphamide in pets with spontaneously occurring malignant neoplasms has become a common practice in veterinary medicine. The purpose of this retrospective study was to investigate toxicity events in cats with spontaneous malignancies receiving cyclophosphamide as a metronomic therapy for at least 1 month. The number and severity of clinical, haematological and biochemical adverse events were recorded according to the Veterinary Cooperative Oncology Group’s Common Terminology Criteria for Adverse Events v1.1 classification scheme. Twenty-four cats were enrolled in the study with a total number of 27 neoplasms: 13 sarcomas, 12 carcinomas, one melanoma and one neuroendocrine tumour. Seventeen cats presented with macroscopic disease, while seven had microscopic disease. Seven cats (29%) had metastasis either to the regional lymph nodes and/or distant sites at the time of study enrolment. Additional medications, administered concurrently, included non-steroidal anti-inflammatory drugs (17), toceranib (4) and thalidomide (7). Four cats showed grade I gastrointestinal toxicity during the first month of treatment, which was controlled with antiemetics. Overall, 2/24 cats (8%) showed grade I haematological toxicities and 1/24 (4%) showed grade I renal toxicity in the first 4 weeks. Median follow-up for all cats was 30 days (range 30–360 days). For the 15 cats with follow-up longer than 1 month the only additional toxicities observed were two grade III and one grade II azotaemia that occurred after 2 months of therapy. Low-dose cyclophosphamide seems to be a well-tolerated option for cats bearing primary or metastatic tumours. Evaluation of toxicity after long-term administration is still needed.
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Affiliation(s)
- Chiara Leo
- Oncology Service, Royal Veterinary College, University of London, London, UK
| | - Anneliese Stell
- Oncology Service, Royal Veterinary College, University of London, London, UK
| | - Juan Borrego
- Veterinary Institute of Comparative Oncology, Valencia, Spain
- Veterinary Hospital, University of Veterinary and Experimental Sciences, Catholic University of Valencia ‘San Vicente Martir’, Valencia, Spain
| | | | | | - Ana Lara-Garcia
- Oncology Service, Royal Veterinary College, University of London, London, UK
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Monaghan K, Nolan B, Labato M. Feline acute kidney injury: 1. Pathophysiology, etiology and etiology-specific management considerations. J Feline Med Surg 2013; 14:775-84. [PMID: 23087003 DOI: 10.1177/1098612x12464458] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PRACTICAL RELEVANCE Acute kidney injury (AKI) is a frequently recognized disease process in cats that requires immediate and aggressive intervention. A thorough understanding of the pathophysiologic processes underlying AKI and familiarity with the most common etiologies are essential for providing the most effective and timely therapy. Possessing this knowledge will also allow a more accurate prognosis to be given, and afford the best chance of a favorable outcome. CLINICAL CHALLENGES Feline patients often present with vague signs of AKI, which may delay treatment and adversely affect the prognosis. Their response to injury and treatment is often different to that of other species. AUDIENCE This two-part review article is directed at small animal practitioners as well as specialists. Part 1 reviews mechanisms underlying AKI in the cat, as well as etiologies and treatments related to some specific causes of AKI. EVIDENCE BASE The veterinary literature is limited with regards to the pathophysiology of AKI unique to the cat. However, there are numerous feline studies evaluating causes of AKI.
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Affiliation(s)
- Kelly Monaghan
- Department of Medical Sciences, University of Wisconsin-Madison, School of Veterinary Medicine, Madison, Wisconsin, USA.
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46
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Surdyk KK, Brown CA, Brown SA. Evaluation of glomerular filtration rate in cats with reduced renal mass and administered meloxicam and acetylsalicylic acid. Am J Vet Res 2013; 74:648-51. [DOI: 10.2460/ajvr.74.4.648] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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47
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Abstract
Adequate pain relief is usually achieved with the simultaneous use of two or more different classes of analgesics, often called multimodal analgesia. The purpose of this article is to highlight the use of perioperative multimodal analgesia and the need to individualize the treatment plan based on the presenting condition, and to adjust it based on the response to analgesia for a given patient. This case series presents the alleviation of acute pain in three cats undergoing different major surgical procedures. These cases involved the administration of different classes of analgesic drugs, including opioids, non-steroidal anti-inflammatory drugs, tramadol, ketamine, gabapentin and local anesthetics. The rationale for the administration of analgesic drugs is discussed herein. Each case presented a particular challenge owing to the different cause, severity, duration and location of pain. Pain management is a challenging, but essential, component of feline practice: multimodal analgesia may minimize stress while controlling acute perioperative pain. Individual response to therapy is a key component of pain relief in cats.
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48
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Charlton AN, Benito J, Simpson W, Freire M, Lascelles BDX. Evaluation of the clinical use of tepoxalin and meloxicam in cats. J Feline Med Surg 2013; 15:678-90. [PMID: 23349526 DOI: 10.1177/1098612x12473994] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Medical records where tepoxalin (Zubrin) or meloxicam (Metacam) were prescribed in cats were reviewed and data extracted. Comparisons were performed for exploring changes between pre- and post-non-steroidal anti-inflammatory drug course laboratory tests. Seventy-nine medical records fit the inclusion criteria (n = 57 and n = 22, tepoxalin and meloxicam, respectively). The median dosages administered were 13 and 0.029 mg/kg(/)day (tepoxalin and meloxicam, respectively). Median prescription durations were 11 (2-919) and 93 (4-1814) days for tepoxalin and meloxicam, respectively. Suspected adverse events were reported for tepoxalin (9%, 5/57 cats) and meloxicam (18%, 4/22 cats) a median of 774 and 448 days, respectively, after the prescription started. For cats prescribed meloxicam, there were several statistically significant changes for serum biochemistry and hematology parameters, but median values were within normal limits. These valuable clinical data suggest that tepoxalin and meloxicam are well tolerated in the clinical setting at the doses prescribed in this study.
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Affiliation(s)
- Anna N Charlton
- Comparative Pain Research Laboratory, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
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49
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Gow DJ, Garceau V, Pridans C, Gow AG, Simpson KE, Gunn-Moore D, Hume DA. Cloning and expression of feline colony stimulating factor receptor (CSF-1R) and analysis of the species specificity of stimulation by colony stimulating factor-1 (CSF-1) and interleukin-34 (IL-34). Cytokine 2012; 61:630-8. [PMID: 23260168 PMCID: PMC3573236 DOI: 10.1016/j.cyto.2012.11.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Accepted: 11/22/2012] [Indexed: 01/02/2023]
Abstract
Colony stimulating factor (CSF-1) and its receptor, CSF-1R, have been previously well studied in humans and rodents to dissect the role they play in development of cells of the mononuclear phagocyte system. A second ligand for the CSF-1R, IL-34 has been described in several species. In this study, we have cloned and expressed the feline CSF-1R and examined the responsiveness to CSF-1 and IL-34 from a range of species. The results indicate that pig and human CSF-1 and human IL-34 are equally effective in cats, where both mouse CSF-1 and IL-34 are significantly less active. Recombinant human CSF-1 can be used to generate populations of feline bone marrow and monocyte derived macrophages that can be used to further dissect macrophage-specific gene expression in this species, and to compare it to data derived from mouse, human and pig. These results set the scene for therapeutic use of CSF-1 and IL-34 in cats.
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50
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Gowan RA, Baral RM, Lingard AE, Catt MJ, Stansen W, Johnston L, Malik R. A retrospective analysis of the effects of meloxicam on the longevity of aged cats with and without overt chronic kidney disease. J Feline Med Surg 2012; 14:876-81. [DOI: 10.1177/1098612x12454418] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The study sought to examine the effect of long-term meloxicam treatment on the survival of cats with and without naturally-occurring chronic kidney disease at the initiation of therapy. The databases of two feline-only clinics were searched for cats older than 7 years that had been treated continuously with meloxicam for a period of longer than 6 months. Only cats with complete medical records available for review were recruited into the study.The median longevity in the renal group was 18.6 years [95% confidence interval (CI) 17.5–19.2] and the non-renal group was 22 years [95% CI 18.5–23.8]. The median longevity after diagnosis of CKD was 1608 days [95% confidence interval 1344–1919] which compares favourably to previously published survival times of cats with CKD. In both groups the most common cause of death was neoplasia. Long-term treatment with oral meloxicam did not appear to reduce the lifespan of cats with pre-existent stable CKD, even for cats in IRIS stages II and III. Therefore, to address the need for both quality of life and longevity in cats with chronic painful conditions, meloxicam should be considered as a part of the therapeutic regimen.
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Affiliation(s)
- Richard A Gowan
- The Cat Clinic, 1 Miller Street, Prahran, Melbourne, Australia
| | | | - Amy E Lingard
- The Cat Clinic, 1 Miller Street, Prahran, Melbourne, Australia
| | | | - Wibke Stansen
- Boehringer Ingelheim GmbH & Co KG, Ingelheim, Germany
| | - Laura Johnston
- Boehringer Ingelheim Animal Health GmbH, Ingelheim, Germany
| | - Richard Malik
- Centre for Veterinary Education, The University of Sydney, NSW, Australia
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