Treatment of feline lymphoma using a 12-week, maintenance-free combination chemotherapy protocol in 26 cats

The diagnostic relevance of mesenteric lymph node biopsy in small intestinal lymphoma in cats

BACKGROUND

Regional lymph nodes are frequently sampled in cats with suspected intestinal lymphoma; however, their diagnostic value has not been explored.

OBJECTIVES

To investigate whether histologic and immunohistochemical analysis of mesenteric lymph nodes correlates with the diagnosis of intestinal lymphoma in cats.

ANIMALS

One hundred 2 client-owned cats diagnosed with intestinal lymphoma.

METHODS

Retrospective study. The inclusion criteria required a full-thickness biopsy of the small intestine and concurrent excision of mesenteric lymph nodes. Histologic and immunophenotypic analyses were performed on intestinal biopsies and corresponding lymph nodes. Selected nodal samples diagnosed with reactive lymph nodes underwent clonality testing.

RESULTS

Transmural T-cell lymphomas, encompassing small and large cell types, were predominant (64 cases, 62.7%), with large B-cell lymphomas being more frequently transmural (68.8%) than mucosal (31.2%). Among all lymph nodes examined, 44 (43.1%; 95% CI: 33.9%-52.8%) exhibited neoplastic infiltration. Among cases of small cell lymphoma, 51 out of 72 (70.8%; 95% CI: 59.4%-80.1%) showed no nodal involvement. Clonality results correctly identified 19/30 (63.3%; 95% CI: 45.5%-78.2%) reactive lymph nodes. Concerns were raised regarding clonal identification in the remaining cases and potential misdiagnoses based on phenotypic characteristics.

CONCLUSION AND CLINICAL IMPORTANCE

The study underscores the potential drawbacks of relying solely on mesenteric lymph nodes for diagnosing intestinal lymphomas in cats, particularly small cell subtypes. It emphasizes the importance of full-thickness biopsies for assessing transmural infiltration and recommends caution when utilizing mesenteric lymph nodes for histologic, immunohistochemical and clonality evaluations in mucosal lymphomas. Despite limitations, this research highlights the need for comprehensive diagnostic strategies in cats with intestinal lymphoma.

Feline high-grade and large granular lymphocyte alimentary lymphomas treated with COP- or CHOP-based chemotherapy: A multi-centric retrospective study of 57 cases

Specific data regarding outcome of cats with high-grade and large granular lymphocyte alimentary lymphoma (HGAL and LGL, respectively) treated with multi-agent chemotherapy are scarce. The aims of this multi-centric, retrospective study were to describe the outcome of cats with HGAL and LGL treated with COP- or CHOP-based chemotherapy and to identify potential prognostic factors. Cats with a cytological or histological diagnosis of HGAL or LGL lymphoma treated with COP- or CHOP-based protocol as first-line chemotherapy were included. Data regarding diagnosis, staging, treatment and follow-up were collected. Fifty-seven cats treated with CHOP (n = 37) or COP (n = 20) protocols were included. Complete response (CR), partial response (PR), stable disease (SD) and progressive disease (PD) were observed in 20%, 22%, 36% and 22% of cats, respectively, for an overall response rate of 42%. Median progression-free interval (PFI) was 148 days and overall median survival time (OST) was 131 days. Cats achieving CR, PR or SD showed significantly longer PFI (p < .01) and OST (p < .015) compared with cats with PD. Other positive prognostic factors in multi-variate analysis were rescue treatment (p < .001) and absence of lymph node involvement (p < .03). Negative prognostic factors were diffuse infiltration of the gastrointestinal tract (p = .035) and infiltration of a non-haematopoietic organ (p < .01).

Novel Treatments for Lymphoma

Lymphoma is a common disease in companion animals. While conventional chemotherapy has the potential to induce remission and prolong life, relapse is common and novel treatments are needed to improve outcome. This review discusses recent modifications/adjustments to conventional standard of care therapy for canine and feline lymphoma, options for treatment or relapsed/refractory disease, and cutting-edge immunotherapy and small molecule-based approaches that are in varying stages of regulatory approval.

Combined Hypofractionated Radiotherapy and Chemotherapy Versus Hypofractionated Radiotherapy Alone for Cats with Localized Sinonasal Lymphoma

Despite considering hypofractionated radiotherapy (HRT) a useful treatment option for feline localized sinonasal lymphoma (stage I), the benefits of additional chemotherapy remain controversial. This retrospective cohort study evaluated the efficacy of the early initiation of chemotherapy in combination with HRT (HRTC) to prolong the progression-free survival (PFS) and overall survival (OS) in cats with localized sinonasal lymphoma compared with HRT alone. While 24 eligible cats received HRT alone (HRT group), 18 received HRTC (HRTC group). The total median administered dose was 35 Gy, with one fraction per week, for a median of five fractions. In the HRTC group, the chemotherapy protocol was cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP)-based and cyclophosphamide, vincristine, and prednisolone (COP)-based in 14 (78%) and 4 cats (22%), respectively. Cats in the HRTC group had significantly longer PFS (677 versus 104 days; P = .04) and OS (983 versus 263 days; P = .04) than those in the HRT group. Considering the poor outcome in the HRT group despite the cats having received rescue chemotherapy for progressive disease, the early initiation of additional chemotherapy along with HRT may be recommended for feline localized sinonasal lymphoma.

Pegylated asparaginase in feline high-grade lymphoma: clinical results of single injection and continued incorporation into a modified COP regimen

OBJECTIVES

The aim of this retrospective study was to determine the response to a single injection of pegylated asparaginase ('pegaspargase') and to assess the tolerability and outcome of prolonged incorporation of pegaspargase into a modified COP (cyclophosphamide, vincristine, prednisolone) regimen in pegaspargase sensitive cats.

METHODS

Fifty-six client-owned cats with confirmed macroscopic high-grade lymphoma at any anatomical site were included. Treatment was commenced with a single pegaspargase injection. Cats showing an objective response were eligible to continue therapy with pegaspargase incorporated into a modified COP protocol and had their survival analysed using the Kaplan-Meier method and log-rank test.

RESULTS

Objective response to pegaspargase was reported in 46 cats (82%), including 21 (38%) complete and 25 (44%) partial responses. Thirty-four responders continued therapy with pegaspargase-COP as the first-line treatment. Of these, 31 cats (92%) achieved complete remission with a median duration of the first remission (disease-free survival [DFS]) of 816 days. The median overall survival time (OST) for all 34 cats treated with pegaspargase-COP was 181 days. Response to the initial pegaspargase injection before COP initiation was significantly associated with DFS (P = 0.04) and OST (P = 0.001). Median DFS/OST for cats with complete response to initial pegaspargase injection was significantly longer compared with those with partial remission (>1273 days/>2066 days vs 77 days/108 days, respectively). Cats with gastric lymphoma showed a significantly longer survival (OST 854 days, 1- and 2-year survival rate 57.1%) compared with cats with intestinal lymphoma (OST 102 days, 1-year survival rate 0%). The pegaspargase-COP protocol was generally well tolerated, but two deaths were likely attributable to treatment-related toxicity during the maintenance phase. Importantly, none of the cats experienced hypersensitivity, despite multiple repeated treatments with pegaspargase.

CONCLUSION AND RELEVANCE

Pegaspargase is an effective agent for feline lymphoma. Its incorporation into a COP chemotherapy protocol may confer a survival benefit, especially in cats with complete response to pegaspargase. Treatment is generally well tolerated, but careful monitoring is recommended. Further studies are required to assess the benefits of pegaspargase as monotherapy or as part of different multi-agent chemotherapy regimens.

Single-modality palliative radiotherapy versus palliative radiotherapy after chemotherapy failure for cats with nasal lymphoma

Published studies describing outcomes for cats with nasal lymphoma (NLSA) receiving first-line palliative radiation (PRT) versus PRT after chemotherapy failure are currently lacking. The aims of this retrospective observational study were to compare outcomes for cats with NLSA that were treated with these two methods. A total of 48 cats were included in analyses; 32 receiving PRT alone and 16 receiving PRT after chemotherapy failure. The treatment response, progression-free survival (PFS), disease-specific survival (DSS), overall survival (OS), and incidence rate of systemic disease were compared between the two groups. The overall response rate (ORR) was calculated from the same target lesions between pre-RT (within a week before starting PRT) and post-RT (on date of PRT completion) by computed tomography (CT) imaging. The ORR was 94% in cats that received PRT alone, 13 had a complete response (CR) and 17 had a partial response (PR). The ORR was 88% in cats that received PRT after chemotherapy failure, with five having CR and nine with PR. There were no significant differences in the ORR between the two groups. The PFS, DSS, and OS significantly increased in the cats that received PRT alone compared to the cats that received PRT after chemotherapy failure (median PFS: 336 vs 228 days, P = 0.0012, median DSS: 360 vs 242 days, P = 0.0025, median OS: 346 vs 242 days, P = 0.0036, respectively). The incidence rate of systemic disease significantly increased in 75% (12/16) of cats receiving PRT after chemotherapy failure compared to 41% (13/32) of cats receiving PRT alone. The results suggested that clinical outcomes may improve in cats with NLSA with first-line PRT compared to PRT after chemotherapy failure.

Effects of Chemotherapy on Hematological Parameters and CD4+/CD8+ Ratio in Cats with Mediastinal Lymphoma and Seropositive to Feline Leukemia Virus

Simple Summary

Mediastinal lymphoma is the most commonly diagnosed tumor in cats with feline leukemia virus infection (FeLV). The cyclophosphamide, vincristine, and prednisolone (COP) chemotherapeutic protocol is widely used and has achieved high complete-response (CR) rates with a long disease-free interval (DFI), and a long median survival time (MST), with low toxicity. The CD4⁺/CD8⁺ ratio is used to assess immunity in retroviral infected cats. This study was performed on 18 FeLV-infected cats with mediastinal lymphoma. The complete blood count, creatinine, alanine aminotransferase, and CD4⁺/CD8⁺ ratio were measured four times before treating with chemotherapy in the 1st, 2nd, 3rd, and 4th weeks. The white blood cell (WBC) counts, neutrophils, packed cell volume (PCV), and mean corpuscular volume (MCV) changed, while the CD4⁺/CD8⁺ ratio was not found to be significantly different. These results suggested that COP chemotherapy is safe as a treatment for FeLV-infected cats with mediastinal lymphoma.

Abstract

The objective of this study was to evaluate the effect of the COP chemotherapeutic protocol on hematological parameters, CD4⁺/CD8⁺ ratio, and the mortality of 18 client-owned FeLV-infected cats with mediastinal lymphoma. The complete blood count, creatinine, alanine aminotransferase, and CD4⁺/CD8⁺ ratio were measured four times before treating with chemotherapy in the 1st, 2nd, 3rd, and 4th weeks. The white blood cell (WBC) counts at the 1st week were significantly different from the 2nd, 3rd, and 4th inductions (p = 0.0075, p = <0.0001, and p = 0.0271, respectively). The neutrophils at the 1st week were significantly different from the 2nd and 3rd inductions (p = 0.0179, and p < 0.0001, respectively). The packed cell volume (PCV) at the 1st week was significantly differed from the 2nd, 3rd, and 4th induction times (p = 0.0029, p = 0.0006, and p = 0.0029, respectively. The mean corpuscular volume (MCV) at the 1st week was significantly different from the 4th week (p = 0.0145). We found that chemotherapy did not cause any significant change in the CD4⁺/CD8⁺ ratio (p-value 0.7407). The Kaplan–Meier curves showed the median survival time (MST) for the cats with a CD4⁺/CD8 ratio of less than 1 after the 1st week of chemotherapy was 134 days. This suggested that COP chemotherapy was a safe treatment for FeLV-infected cats with mediastinal lymphoma.

Cyclophosphamide rescue therapy for relapsed low-grade alimentary lymphoma after chlorambucil treatment in cats

OBJECTIVES

The aims of this study were to evaluate the response, outcome and prognostic factors in cats with clinically presumed relapsed low-grade alimentary lymphoma (LGAL) receiving cyclophosphamide as a first-line rescue therapy after failing chlorambucil treatment.

METHODS

The medical records of 20 cats (from three institutions, between 2002 and 2017) treated with cyclophosphamide for relapsed LGAL after initial treatment with chlorambucil were retrospectively reviewed. Progression-free survival (PFS), overall survival time (OST) and the association of select variables with measures of outcome were assessed. Adverse events (AEs) were also described.

RESULTS

Eighteen cats (90%) achieved a complete clinical response (CR) for a median duration of 239 days. The median PFS was 215 days. The median OST was 1065 days. The only clinical factor associated with a longer PFS was achievement of a CR with cyclophosphamide treatment. Cyclophosphamide was associated with few and reversible constitutional, gastrointestinal and hematologic AEs.

CONCLUSIONS AND RELEVANCE

Cyclophosphamide appears to be a safe and effective first-rescue therapeutic option for cats with relapsed LGAL.

Treatment of feline gastrointestinal intermediate- or large-cell lymphoma with lomustine chemotherapy and 8 Gy abdominal cavity radiation therapy

OBJECTIVES

The goal of this study was to document the outcomes and toxicity of a novel multimodality treatment protocol for feline gastrointestinal intermediate- or large-cell lymphoma (FGL) in which cats were treated at 21-day intervals.

METHODS

This was a prospective, single-arm study. Twelve client-owned cats with cytologically diagnosed FGL were treated with a combination of abdominal cavity radiation therapy (RT; 8 Gy total dose administered in two 4 Gy fractions, 21 days apart), lomustine chemotherapy (approximately 40 mg/m2, administered orally at 21-day intervals for four treatments), prednisolone (5 mg PO q24h) and cobalamin (250 µg/week SC).

RESULTS

Three cats were euthanized prior to the second treatment and it was difficult to discern treatment-associated toxicity from progressive disease. Four of the remaining cats developed cytopenias, resulting in 7-14-day lomustine treatment delays and/or dose reductions. Six cats had a partial response to treatment and three had stable disease based on ultrasound at day 21 (50% overall response rate). Three of these six cats completed the study and lived >240 days; one died of refractory diabetes mellitus with no clinical evidence of FGL, and the other two died as a result of FGL. The median overall survival time was 101 days (95% confidence interval [CI] 9-240). The median progression-free survival time was 77 days (95% CI 8-212). Necropsies were performed in eight cats, which revealed multifocal lymphoma throughout the gastrointestinal tract and other organs.

CONCLUSIONS AND RELEVANCE

Oncological outcomes reported herein are comparable to those achieved with multiagent injectable chemotherapy (eg, CHOP). Treatment was seemingly well tolerated in most cats and was relatively cost-effective. It is therefore plausible that improved disease control may be achievable through continued optimization and intensification of the combinatorial chemoradiotherapy protocol.

Feline chronic enteropathy

Feline chronic enteropathy is a common disorder, especially in the senior cat population, with rising incidence over the past decade. Feline chronic enteropathy is considered an umbrella term comprising different diseases including food-responsive enteropathy, idiopathic inflammatory bowel disease and alimentary small cell lymphoma. However, differentiation between those diseases is often difficult in practice. This review will discuss the clinical approach to cats with chronic enteropathy, state-of-the-art diagnostic tests and pitfalls thereof as well as current therapeutic approaches. Although, much of the etiopathogenesis is still unknown, increased research efforts in this field have brought new insights into diagnostic and therapeutic options for these cats.

LOPH: a novel chemotherapeutic protocol for feline high-grade multicentric or mediastinal lymphoma, developed in an area endemic for feline leukemia virus

OBJECTIVES

The aim of this study was to establish the safety and efficacy of a novel multidrug lomustine-based chemotherapeutic protocol for cats with high-grade multicentric or mediastinal lymphoma, in an area endemic for feline leukemia virus (FeLV).

METHODS

This prospective study included owned cats, diagnosed (cytologically) with multicentric or mediastinal lymphoma and treated with the LOPH (lomustine, vincristine [Oncovin; Antibióticos do Brasil], prednisolone and hydroxydaunorubicin [doxorubicin]) protocol. A complete blood count was performed before every chemotherapy session and any significant abnormalities recorded as possible related toxicities. Median survival time (MST) and disease-free interval were estimated by Kaplan-Meier curves.

RESULTS

Twenty-one cats were included in this study. Nineteen (90.5%) tested positive for FeLV and were therefore considered to have persistent viremia. Complete response was reported in 81% (n = 17/21), while three had partial remission and one had no response. Seven cats finished the induction protocol within 20-31 weeks (23.1 ± 4.5; median 20) and all seven received a maintenance protocol. The MST (lymphoma-related survival) for the 21 cats was 214 days. The MST was 214 days for cats with mediastinal lymphoma (n = 13), but it was not reached for multicentric lymphoma (n = 8; P = 0.9). The MST of cats with persistent FeLV antigenemia was 171 days. Grade I anorexia and vomiting occurred in 19% of the cats (n = 4/21). Hematologic toxicity was found in 100% of the cats at some point during their treatment, but it was mostly grade I or II. Neutropenia, thrombocytopenia and anemia occurred in 16/21, 21/21 and 15/21 cats, respectively.

CONCLUSIONS AND RELEVANCE

The LOPH protocol was well tolerated by cats with lymphoma and persistent FeLV viremia, and resulted in a better MST than similar studies with other protocols. Novel studies and controlled trials are necessary in order to evaluate the efficacy of different protocols according to the lymphoma subtype, anatomic form and FeLV status.

Lomustine, methotrexate and cytarabine chemotherapy as a rescue treatment for feline lymphoma

Objectives

The aim of this study was to assess the efficacy and tolerability of lomustine, methotrexate and cytarabine chemotherapy as rescue treatment for feline lymphoma.

Methods

The medical records of 13 cats treated with lomustine, methotrexate and cytarabine for relapsed high-grade feline lymphoma, at a single institution between 2013 and 2018, were examined. All anatomical types were included. Data were analysed using descriptive statistics.

Results

Nine cats received all three drugs and four cats received only two drugs owing to progressive disease. In cats that received (or in which there was intention to treat with) all three drugs, 6/13 (46%) demonstrated a complete or partial response to chemotherapy. Treatment was generally well tolerated, although two cats experienced Veterinary Comparative Oncology Group (VCOG) grade 3 neutropenia and one cat experienced VCOG grade 3 thrombocytopenia. The median progression-free survival was 61 days (range 16–721 days).

Conclusions and relevance

CHOP-(cyclophosphamide, doxorubicin, vincristine, prednisolone) and COP-based protocols are established first-line chemotherapy for feline lymphoma, but standard rescue protocols are lacking. Lomustine has become a popular single-agent option, but prolonged or cumulative myelosuppression can result in treatment delays, risking relapse. Therefore, a multidrug lomustine-based protocol may be advantageous, and, from first principles, should also better overcome resistance. This study suggests that lomustine, methotrexate and cytarabine may represent an efficacious and well-tolerated protocol for feline lymphoma rescue.

Efficacy and toxicity of mustargen, vincristine, procarbazine and prednisone (MOPP) for the treatment of relapsed or resistant lymphoma in cats

OBJECTIVES

The aims of this study were to evaluate the safety of mustargen, vincristine, procarbazine and prednisone (MOPP) chemotherapy in the treatment of relapsed or refractory feline lymphoma, and to determine the overall response rate and median remission time with this protocol.

METHODS

The medical records of 38 cats with relapsed or refractory lymphoma treated with MOPP chemotherapy at three institutions (University of Pennsylvania, the Animal Medical Center, and VCA Western Veterinary Specialist and Emergency Centre) were examined. Information evaluated included patient signalment, feline immunodeficiency virus/feline leukemia virus status, anatomic location(s) of lymphoma, prior protocols (type and number), MOPP doses, MOPP response, remission duration, hematologic and biochemical parameters, and owner-reported adverse effects.

RESULTS

Overall, 70.3% of cats responded to MOPP chemotherapy. Among the responders, the median remission duration was 166 days. The most common adverse effects were neutropenia and gastrointestinal upset, which were reported in 18.4% of cats. In 55.3% of cats, no adverse effects were reported. In total, 30.8% of responders continued to respond 6 months following the initiation of MOPP, and 15.4% maintained a response 1 year after starting MOPP.

CONCLUSIONS AND RELEVANCE

MOPP is a safe protocol for the treatment of relapsed or refractory feline lymphoma, with a promising overall response rate and median remission time.

Outcomes in 40 cats with discrete intermediate- or large-cell gastrointestinal lymphoma masses treated with surgical mass resection (2005-2015)

OBJECTIVE

To report outcomes in cats with discrete intermediate- and large-cell gastrointestinal (GI) lymphoma masses after surgical resection.

STUDY DESIGN

Retrospective clinical case series.

ANIMALS

Forty client-owned cats in which intermediate- or large-cell GI lymphoma was diagnosed.

METHODS

Records of 40 cats in which discrete intermediate- or large-cell GI lymphoma masses were diagnosed between 2005 and 2015 were reviewed. Cats were included if they survived curative intent surgery and had a known outcome for at least two weeks. Postoperative death was permitted. Data collected included anatomic site, surgical margins, lymphoma subtype, chemotherapy use, and postoperative and long-term outcome (beyond two weeks).

RESULTS

Affected sites consisted of small intestines (n = 23), large intestines (n = 9), and stomach (n = 8). Thirty-six of 40 cats survived to discharge, and 31 cats were alive at suture removal. Median long-term follow-up of 22 cats was 111 days (range, 16-1407). Cats that survived to suture removal had a median survival time (MST) of 185 days (95% confidence interval: 72-465). Cats with large intestinal masses lived longer than those with small intestinal or gastric masses whether all cats (MST, 675, 64, 96 days, respectively; P = .03) or only those surviving to suture removal were considered. Complete surgical resection (n = 20) was positively associated with survival (370 vs 83 days, P = .016).

CONCLUSION

Most cats in this population survived the perioperative period, with MST similar to those reported historically with medical management.

CLINICAL SIGNIFICANCE

Surgical resection may be a reasonable consideration in cats with solitary lymphoma, particularly those with large intestinal masses.

Novel Treatments for Lymphoma

Lymphoma is a common disease in companion animals. Although conventional chemotherapy has the potential to induce remission and prolong life, relapse is common, and novel treatments are needed to improve outcome. This review discusses recent modifications/adjustments to conventional standard of care therapy for canine and feline lymphoma, as well as cutting-edge immunotherapy and small-molecule-based approaches that are in varying stages of regulatory approval.

Evaluation of the histopathological extent of neoplastic infiltration in intestinal tumours in cats

With the exception of intestinal lymphoma, surgery is the most commonly recommended treatment for solitary feline intestinal tumours. However, there is a lack of evidence to substantiate resection margin recommendations for these tumours. The aim of this study was to add knowledge concerning resection margins for discrete intestinal masses in cats. Thirty confirmed feline intestinal tumours removed at veterinary centres across the UK from March 2017 to March 2018 underwent histological assessment at the palpable edge of the intestinal tumour and then at every 1 cm increment to the surgeon‐cut tissue border in oral, aboral and mesenteric directions. Histological margin recommendations were developed for carcinoma and lymphoma tumour types and non‐lymphoma intestinal tumours collectively. Seventeen intestinal lymphomas, nine carcinomas, two sarcomas and two mast cell tumours were evaluated in this study. Seven of the nine intestinal carcinomas would have been completely removed with histological margins of 4 cm in oral and aboral directions. Both sarcomas and one mast cell tumour would have been removed in their entirety with 4 cm histological margins in oral and aboral directions. There was extensive and varied microscopic invasion of intestinal tissue away from discrete intestinal lymphomas in the majority of the cases in this study. There is increasing evidence in veterinary as well as human literature supporting the role of surgical resection in the treatment of discrete intestinal lymphoma. If surgery is to be considered this study supports the removal of the gross tumour only. A histological margin of 4 cm should be considered, where possible, for intestinal masses other than lymphomas.

Strong associations of nine-point body condition scoring with survival and lifespan in cats

OBJECTIVES

The objective of the study was to investigate the associations of a nine-point body condition score (BCS) with survival time and lifespan in cats.

METHODS

Electronic patient records from a cat-dominant primary practice in metropolitan Sydney, Australia, where the body condition of cats was regularly recorded using a nine-point BCS scale were obtained. The maximum BCS of each cat during the visits was used as the primary exposure variable. Two survival analyses were conducted to evaluate the associations of BCS with cats' survival and lifespan.

RESULTS

In total, 2609 cats met the selection criteria from 4020 cats screened. The median of the maximum BCS was 6 (interquartile range [IQR] 5-7). Compared with cats with a maximum BCS of 6, increased hazards of death were observed in cats with a maximum BCS of 3 (hazard ratio [HR] 4.67, 95% confidence interval [CI] 3.00-7.27), 4 (HR 2.61, 95% CI 1.95-3.49), 5 (HR 1.43, 95% CI 11.5-1.76) and 9 (HR 1.80, 95% CI 1.11-2.93). Median lifespan was 15.8 (IQR 13.5-17.6) years. Compared with cats reaching a maximum BCS of 6 in the same age group, cats reaching a maximum BCS of 4 (HR 4.15, 95% CI 1.26-13.67) or 5 (HR 1.75, 95% CI 1.07-2.85) between age 1 and 3 years, and a maximum BCS of 3 (HR 6.09, 95% CI 1.47-25.25) and 9 (HR 2.27, 95% CI 1.27-4.04) between the age of 3 and 11 years had shorter lifespans.

CONCLUSIONS AND RELEVANCE

There are significant associations of nine-point body condition scoring with survival and lifespan, and BCSs <5 and of 9 were found to be negatively associated with both. The study yielded information regarding a desirable BCS for cat longevity that veterinarians could consult with.

Owner perceptions of their cat's quality of life when treated with a modified University of Wisconsin-Madison protocol for lymphoma

Objectives The objectives of this study were to assess owner perceptions of their cat's quality of life during treatment for lymphoma with a doxorubicin-containing multi-agent chemotherapy protocol, whether various health-related parameters correlated with quality of life scores, and to assess owner satisfaction with the protocol. Methods A postal questionnaire was sent to the owners of 33 treated cats. Owners retrospectively assessed their cat's quality of life using a Likert scale (1-10) before lymphoma was diagnosed, at diagnosis and during chemotherapy. Owners assigned scores to various health-related parameters previously reported to affect quality of life at the three time points, and correlations with quality of life scores were sought. Owners were asked to rate the importance of these health-related parameters. Satisfaction with the protocol was investigated. Results Twenty questionnaires were completed (61% response rate). The median quality of life score before diagnosis (10, range 5-10) was higher than at diagnosis (3, range 1-9) ( P <0.05). The median quality of life score during chemotherapy (7, range 3-9) was lower than before diagnosis ( P <0.05) and higher than at diagnosis, but this was not statistically significant. Quality of life scores did not correlate with individual health-related parameter scores consistently; however, quality of life scores did correlate with appetite scores during chemotherapy. Appetite, vomiting and diarrhoea were parameters perceived as important in affecting quality of life. Most owners (75%) were happy they had treated their cat. Conclusions and relevance The quality of life scores observed were comparable to a previous study using cyclophosphamide, vincristine and prednisolone, employing the same scoring system. Although quality of life scores during chemotherapy were not significantly improved at diagnosis, owner satisfaction with the protocol was high. The factors perceived by owners to determine quality of life in their pets may be different to those previously conjectured, but appetite during chemotherapy remains important.