Clinicoepidemiological profile and risk factors associated with mortality in traumatized cats admitted to a veterinary teaching hospital in Brazil

Data Platform for Animal Mortality Information System (DATASIMA): Monitoring Companion Animal's Euthanasia Causes in City of João Pessoa, Brazil

The literature regarding causes of animal mortality varies greatly in how it evaluates and describes reasons for euthanasia, showing a clear need for tools to identify, standardize, and map diseases. This study describes the application of the Animal Mortality Information System Database (DATASIMA) to monitoring and georeferencing animal mortality. An observational study was conducted on the dogs and cats euthanized at the Municipal Center for Environmental and Zoonotic Surveillance in João Pessoa, Paraíba. The deaths were reported through DATASIMA, an online platform created and developed in Brazil, which is aimed at observing animal mortality through the Animal Death Declaration between April and September 2022. A total of 403 euthanized animals were recorded, including 204 dogs and 199 cats. The most common diseases leading to euthanasia were as follows: (i) Sporotrichosis (171 cats); (ii) Leishmaniasis (75 dogs); (iii) Distemper (35 dogs); (iv) Trauma from vehicle collisions (ten dogs and nine cats). The DATASIMA platform proved to be an effective system for keeping records and reporting causes of animal mortality. Through georeferencing, it was possible to map areas with higher frequencies of zoonotic outbreaks in the municipality studied, thus providing useful data to implement health promotion strategies.

Triage body temperature predicts outcome in cats at emergency department admission: a retrospective study of 1440 cases (January 2018 to December 2021)

OBJECTIVES

The aim of the study was to evaluate the association between triage body temperature (BT) and outcome in cats presenting to the emergency department (ED).

METHODS

A retrospective observational study was conducted on cats presented to the ED. BT, clinical diagnosis and outcome were recorded. BT was categorised as follows: normothermia (37.8-39.7°C); hyperthermia (⩾39.8°C); mild hypothermia (36.8-37.7°C); moderate hypothermia (35.6-36.7°C); severe hypothermia (33.1-35.5°C); and critical hypothermia (⩽33°C). Outcome in the ED was categorised as death, euthanasia, hospital admission and discharge. Outcome at hospital discharge was evaluated in patients admitted to the intensive care unit (ICU). Systemic inflammatory response syndrome (SIRS) was identified in patients. No-SIRS cats were divided into three disease categories (urinary system, cardiovascular and miscellanea) and SIRS cats into four categories (urinary system, cardiovascular, trauma and miscellanea). The presence of sepsis was evaluated. Non-parametric statistics were used.

RESULTS

A total of 1440 cats were included. The hospital mortality rate was 21.9%. Hypothermia in the ED was reported in 510 (35.4%) cats, normothermia in 849 (59%) cats and hyperthermia in 81 (5.6%) cats. In the ED, the median temperature in non-survivors (35.4°C, 95% confidence interval [CI] 34.6-36.3) was significantly lower than in survivors (38.2°C, 95% CI 38.1-38.3; P <0.0001). The risk of non-survival in the ED was significantly higher in cats with a decreased BT, progressively increasing with the severity of hypothermia (P <0.0001). Furthermore, BT was significantly associated with a higher risk of mortality in the ICU (P <0.0001). A diagnosis of sepsis was associated with a high prevalence of hypothermia (79/124 cats, 63.7%) and a higher risk of non-survival (odds ratio [OR] 2.62, 95% CI 1.52-4.54; P = 0.0006). The mortality risk significantly increased in SIRS cats with a cardiovascular disease (OR 8.27, 95% CI 4.09-16.68; P <0.0001).

CONCLUSIONS AND RELEVANCE

Hypothermia is common in cats at ED admission and is significantly associated with outcome. Triage hypothermia might identify patients with sepsis or SIRS complicated by comorbidities, such as cardiovascular and urinary diseases.

Retrospective evaluation of the neutrophil-to-lymphocyte ratio as a prognostic marker in cats with blunt trauma (2018-2021): 177 cases

OBJECTIVE

To investigate the utility of the neutrophil-to-lymphocyte ratio (NLR) as a prognostic marker in cats with blunt trauma.

DESIGN

Retrospective study from January 2018 to December 2021.

SETTING

University teaching hospital.

ANIMALS

Medical records of 177 cats admitted with blunt trauma were evaluated. History, clinical findings, blood cell count-based ratios, thoracic radiographs on presentation, and outcome were reviewed. The Animal Trauma Triage (ATT) score was assessed in each cat and classified as mild (1-3), moderate (4-7), and severe trauma (≥8). Forty-eight healthy blood donor cats served as the control population. NLR, neutrophil counts, and lymphocyte counts were compared between cats with blunt trauma and controls, and among trauma patients.

INTERVENTIONS

None MEASUREMENTS AND MAIN RESULTS: NLR, neutrophil counts, and lymphocyte counts significantly differ in cats with blunt trauma compared to controls (p < 0.001), and NLR was higher in patients with thoracic trauma (p = 0.044). Nonsurvivors had lower lymphocyte counts (p = 0.041), although those values do not appear to be clinically relevant. A significant increase in NLR was observed with increasing severity of trauma (p < 0.001). The NLR was not associated with the length of hospitalization, intensive care assistance, or mortality.

CONCLUSION

NLR is a widely available diagnostic tool, which can be used in addition to ATT to assess trauma severity, although in our study it was not predictive of the outcome.

Potential Factors Influencing Complete Functional Recovery in Traumatized Unowned Cats with Orthopedic Lesions-A Cohort Study

The management of unowned cats is an emerging problem, with public institutions and citizens' concerns regarding their care and arrangement. Little is known regarding the outcome of traumatic orthopedic injuries in these patients. Indeed, complete functional recovery (CFR) should be the goal of treatment for return to their original location or adoption. The aim was to identify clinical factors influencing CFR in traumatized unowned cats with orthopedic lesions. This category of cats referred by the veterinary public service over three years was enrolled. Various clinical variables were retrospectively collected from the medical records and evaluated by nominal logistic analysis. Forty-eight unowned cats were enrolled, with a median estimated age of 24 (1-180) months and a body weight of 3 (0.7-5) kg. Thirty-four (71%) patients reached CFR. Estimated age, body weight, time from trauma to therapeutic intervention, spine involvement, presence of comorbidities, hospitalization time, and the radiographic score results were significantly associated with CFR. A longer time to therapeutic intervention seemed to be associated with a better outcome. Probably, cats severely traumatized did not live long enough to be evaluated and treated. Lighter cats experienced more severe consequences following blunt trauma. Younger and lighter cats bore a higher risk of panleukopenia-related death.

Surgical interventions and outcome in a population of feline trauma patients

OBJECTIVE

To determine signalment, injury type, trauma severity score, and outcome of feline trauma patients undergoing surgical (emergency room [ER] and operating room [OR]) and nonsurgical treatments in addition to time to surgery, specialty services involved, and cost in the OR surgery population.

DESIGN

Retrospective evaluation of medical record and hospital trauma registry data on feline trauma cases.

SETTING

University teaching hospital.

ANIMALS

Two hundred and fifty-one cats presenting for traumatic injury between May 2017 and July 2020.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

Demographics and outcomes were compared for cats undergoing surgical intervention in an OR (12%, 31/251) or an ER (23%, 58/251) setting and feline trauma patients without surgical intervention (65%, 162/251). Between the 2 surgical groups, 99% survived to discharge compared to 73.5% of the nonsurgical group (P < 0.0001). For the OR surgical cohort, electronic medical records were reviewed to determine the specialty surgery service involved, time to and duration of anesthesia and surgery, and visit cost. The most common surgery services involved were orthopedics (41%, 12/29) and dentistry (38%, 11/29), and the most common surgeries performed were mandibular fracture stabilization (8/29) and internal fixation for long bone fractures (8/29). The ER surgical group had a significantly lower Animal Trauma Triage score than the OR group (P < 0.0001), but a significant difference was not found between OR surgical and nonsurgical groups (P = 0.0553). No difference in modified Glasgow Coma Scale score was found between any groups.

CONCLUSIONS

Surgical intervention in feline trauma patients appears to be associated with higher survival rates, but no difference in mortality was found across surgery services. OR surgical intervention, in particular, orthopedic surgery, was associated with increased length of hospitalization, increased cost, and increased use of blood products.

Clinical parameters at time of admission as prognostic indicators in cats presented for trauma to an emergency centre in New Zealand: a retrospective analysis

OBJECTIVES

The aims of this study were to describe the clinical features of cats presented for trauma in a first-opinion and referral teaching hospital in New Zealand, and to determine the relationship between those features and outcome.

METHODS

The electronic medical records of cats presented for trauma to the Massey University Pet Emergency Centre between September 2013 and January 2019 were examined, from which the signalment, clinical parameters and patient outcomes were extracted. Cases were assigned an Animal Trauma Triage (ATT) score and Modified Glasgow Coma Scale (MGCS) score. Variables were selected for inclusion in a logistic regression model to predict survival, and backward elimination was used to find the minimal significant model.

RESULTS

In total, 530 cats met the inclusion criteria. The cause of injury was not known in the majority of cases (38.0%). The most common location of injury was the hindlimbs/pelvis/tail (n = 247; 41%), and skin lacerations/abrasions were the most common specific injury. Multivariate analysis revealed altered mentation (odds ratio [OR] 0.31, P = 0.029), hypothermia (rectal temperature <37.8°C [<100.04°F]; OR 0.45, P = 0.015) and an ATT score ⩾5 (OR 0.13, P <0.001) to be statistically significantly associated with mortality.

CONCLUSIONS AND RELEVANCE

Altered mentation and hypothermia are easily measurable perfusion parameter abnormalities associated with mortality in cats presenting with trauma. The ATT score appears to be an accurate prognostic indicator in cats presenting with trauma in New Zealand. These results highlight the importance of incorporating a hands-on triage examination in each cat that presents as an emergency after trauma.

Prospective evaluation of the Animal Trauma Triage Score and Modified Glasgow Coma Scale in 25 cats with high-rise syndrome

OBJECTIVES

The purpose of this study was to prospectively evaluate the prognostic utility of the Animal Trauma Triage Score (ATTS) and Modified Glasgow Coma Scale (MGCS) in cats with high-rise syndrome.

METHODS

ATTS and MGCS were obtained upon arrival from 25 client-owned cats presented for high-rise syndrome. Cases were followed during hospitalisation and several variables, including outcome, were recorded.

RESULTS

The mortality rate in this cohort of cats with high-rise syndrome was 16%. Univariate statistical analysis showed that lactate (P = 0.022), creatinine (P = 0.01), body weight (P = 0.036) and ATTS (P = 0.02) were higher and MGCS (P = 0.011) lower among non-survivors. Multivariable statistical analysis showed that ATTS was the only factor significantly associated with mortality (odds ratio 2.41, 95% confidence interval [CI] 1.02-5.71; P = 0.046). A receiver operating characteristics curve showed that ATTS was an excellent predictor of mortality (area under the curve 0.917, 95% CI 0.8-1.0; P = 0.009). An ATTS cut-off of 6.0 had a 75% sensitivity and 90% specificity for non-survival and a cut-off of 10 had a 25% sensitivity and 100% specificity for non-survival.

CONCLUSIONS AND RELEVANCE

ATTS is predictive of severity and outcome in cats with high-rise syndrome and can help facilitate decision-making by owners and veterinarians.