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Malik R, Wun MK, King T, Korman R. Letter to the Editor: Acute kidney injury following subcutaneous meloxicam administration. J Vet Pharmacol Ther 2024; 47:235-236. [PMID: 38426603 DOI: 10.1111/jvp.13437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 02/21/2024] [Indexed: 03/02/2024]
Affiliation(s)
- Richard Malik
- Centre for Veterinary Education, The University of Sydney, Sydney, New South Wales, Australia
| | - Matthew K Wun
- College of Veterinary Medicine, Washington State University, Pullman, Washington, USA
| | - Terence King
- Veterinary Specialist Services, Underwood, Brisbane, Queensland, Australia
| | - Rachel Korman
- Cat Specialist Services, Underwood, Brisbane, Queensland, Australia
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2
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Krekis A, King JN, D'Arcy-Howard D, Stapleton N, Elliott J, Pelligand L. Effect of meloxicam or robenacoxib administration timing on renal function and postoperative analgesia in cats undergoing ovariohysterectomy: A randomized, blinded, controlled clinical trial. J Vet Pharmacol Ther 2024; 47:175-186. [PMID: 38235901 DOI: 10.1111/jvp.13427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 12/10/2023] [Accepted: 01/08/2024] [Indexed: 01/19/2024]
Abstract
We evaluated the effect of administration timing of meloxicam and robenacoxib on renal function, platelet cyclo-oxygenase and perioperative analgesia in 60 cats undergoing ovariohysterectomy, in a prospective randomized blinded controlled study. Twelve cats were randomly allocated to one subcutaneous treatment group: meloxicam (0.2 mg/kg) or robenacoxib (2 mg/kg) at admission (MA, RA), at induction (MI, RI) and robenacoxib at the end of surgery (RE). All cats received the same anaesthesia protocol. Plasma renin activity (PRA), plasma creatinine, drug concentrations and serum thromboxane (TxB2) were measured sequentially. Anaesthesia significantly increased PRA, as activity at end of the surgery was higher than 2 h later (mean ± SD: 26.6 ± 2.8 versus 10.0 ± 3.9 ng/mL/h). PRA remained higher at 2 h post-surgery in admission groups compared to induction groups (p = .01). Serum TxB2 was lower with meloxicam than robenacoxib (p = .001), and was lower in the MA than each robenacoxib group at catheter placement. Admission groups (16/24 from RA and MA groups) received earlier rescue analgesia than other groups (p = .033). In conclusion, the renin-angiotensin system was activated during anaesthesia despite cyclo-oxygenase inhibition, possibly due to hypotension or surgical stimulation. There was no effect of drug or timing on the markers of renal function but one cat receiving meloxicam at induction had suspected IRIS grade II acute kidney injury.
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Affiliation(s)
| | | | - Duncan D'Arcy-Howard
- Department of Clinical Science and Services, Beaumont Sainsbury Animal Hospital, Royal Veterinary College, University of London, London, UK
| | - Nadene Stapleton
- Department of Clinical Science and Services, Beaumont Sainsbury Animal Hospital, Royal Veterinary College, University of London, London, UK
| | - Jonathan Elliott
- Department of Comparative Biomedical Sciences, Royal Veterinary College, University of London, London, UK
| | - Ludovic Pelligand
- Department of Comparative Biomedical Sciences, Royal Veterinary College, University of London, London, UK
- Department of Clinical Science and Services, Queen Mother Hospital for Animals, Royal Veterinary College, University of London, London, UK
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3
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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 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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4
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Menéndez S, Cabezas MA, Gomez de Segura IA. Attitudes to acute pain and the use of pain assessment scales among Spanish small animal veterinarians. Front Vet Sci 2023; 10:1302528. [PMID: 38164392 PMCID: PMC10758136 DOI: 10.3389/fvets.2023.1302528] [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: 09/26/2023] [Accepted: 11/13/2023] [Indexed: 01/03/2024] Open
Abstract
Evaluation of acute pain in dogs and cats is the basis for an appropriate treatment and improved well-being. The difficulties involved in pain assessment pose a challenge for veterinarians, and recent findings indicate that the most effective tools available-validated pain assessment scales-may not be widely utilized. Objectives This study aimed to characterize the level of concern among Spanish veterinarians regarding acute pain in companion animals. Additionally, it sought to determine whether this concern correlates with the utilization of optimal assessment tools. Methods A survey was conducted to explore Spanish veterinarians' attitudes toward pain and its assessment. The survey was distributed through two most prominent small animal veterinary associations, the Spanish association for veterinary anesthesia and analgesia, as well as key industry players committed to proactive pain management. Descriptive analysis of the collected data was performed using Excel and SPSS. Results A total of 292 veterinarians participated in the study. A high level of concern regarding pain in dogs and cats was determined where 44% of surveyed veterinarians assessed pain in all patients. Despite an awareness of validated pain scales, only 28% used them. The preferred scales were the Glasgow CMPS for dogs (94%) and the Feline Grimace Scale for cats (93%). Among respondents who do not use these validated tools, there was a considerable interest in incorporating these scales into practice (85%) and considered lack of training was the most relevant issue (32%). Other challenges to scale utilization were identified, including constraints related to time, staffing, and the need to establish a habit. Conclusions and relevance Spanish small animal veterinarians demonstrated a strong awareness to pain in their patients and employed various methods for pain assessment. However, a limited use of validated tools was identified and likely attributed to challenges such as a lack of established routine, time constraints, insufficient personnel, and, notably, a knowledge gap among veterinarians who do not employ pain assessment scales. The most commonly used scales were the Glasgow CMPS for dogs and the FGS for cats. Overall, these results suggest a window of opportunity for the implementation of training programs in small animal pain assessment at a national level.
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Affiliation(s)
- Sandra Menéndez
- Department of Animal Medicine and Surgery, University Complutense, Madrid, Spain
| | - Miguel Angel Cabezas
- Department of Animal Medicine and Surgery, University Complutense, Madrid, Spain
- Dolorvet, Anestesia y analgesia veterinaria, Madrid, Spain
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Steagall PV, Monteiro BP, Marangoni S, Moussa M, Sautié M. Fully automated deep learning models with smartphone applicability for prediction of pain using the Feline Grimace Scale. Sci Rep 2023; 13:21584. [PMID: 38062194 PMCID: PMC10703818 DOI: 10.1038/s41598-023-49031-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 12/03/2023] [Indexed: 12/18/2023] Open
Abstract
This study used deep neural networks and machine learning models to predict facial landmark positions and pain scores using the Feline Grimace Scale© (FGS). A total of 3447 face images of cats were annotated with 37 landmarks. Convolutional neural networks (CNN) were trained and selected according to size, prediction time, predictive performance (normalized root mean squared error, NRMSE) and suitability for smartphone technology. Geometric descriptors (n = 35) were computed. XGBoost models were trained and selected according to predictive performance (accuracy; mean square error, MSE). For prediction of facial landmarks, the best CNN model had NRMSE of 16.76% (ShuffleNetV2). For prediction of FGS scores, the best XGBoost model had accuracy of 95.5% and MSE of 0.0096. Models showed excellent predictive performance and accuracy to discriminate painful and non-painful cats. This technology can now be used for the development of an automated, smartphone application for acute pain assessment in cats.
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Affiliation(s)
- P V Steagall
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada.
- 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, Hong Kong, China.
| | - B P Monteiro
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - S Marangoni
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - M Moussa
- Plateforme IA-Agrosanté, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - M Sautié
- Plateforme IA-Agrosanté, Université de Montréal, Saint-Hyacinthe, QC, Canada
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Low D, Williams J. Surgical Management Of Feline Biliary Tract Disease: Decision-making and techniques. J Feline Med Surg 2023; 25:1098612X231206846. [PMID: 37933545 PMCID: PMC10812002 DOI: 10.1177/1098612x231206846] [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: 11/08/2023]
Abstract
PRACTICAL RELEVANCE Diseases of the hepatobiliary system are not uncommon in first-opinion practice. The anatomy of the feline hepatobiliary tract differs from that of dogs and may predispose cats to inflammatory hepatobiliary disease. Case management can be challenging, and the prognosis is variable and dependent on the underlying disease process. CLINICAL CHALLENGES Biliary tract disease in the cat has non-specific clinical signs that overlap with those of diseases of other body systems. Diagnostic tests of the hepatobiliary system are widely available, but interpretation of results can be challenging. Deciding on medical or surgical management can also be challenging; for example, various degrees of cholestasis may be seen with different diseases and disease severities, and will influence the decision to manage the patient medically or surgically. Surgery is indicated in cases of bile peritonitis, severe cholestasis, focal neoplasia or disease that is refractory to medical management. Intensive perioperative and postoperative management, with 24 h hospitalisation facilities, is essential. AUDIENCE This review article is written for the small animal general/primary care practitioner, with an emphasis on decision-making in the surgical management of feline hepatobiliary disease. EVIDENCE BASE Evidence available in the published literature is reviewed and presented, and the inherent limitations are discussed.
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Affiliation(s)
| | - John Williams
- Vets Now 24/7 Hospital Manchester, Whitefield, Manchester M45 6TQ, UK
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7
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Goodwin W, Monteiro BP, Grimm K, Steagall PV. Letter to Editor in response to "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; 101:411-412. [PMID: 37587769 DOI: 10.1111/avj.13279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 07/29/2023] [Indexed: 08/18/2023]
Affiliation(s)
- W Goodwin
- Veterinary Anaesthesia and Analgesia Chapter of Australian and New Zealand College of Veterinary Scientists
| | - B P Monteiro
- World Small Animal Veterinary Association Global Pain Council
| | - K Grimm
- American College Veterinary Anesthesia and Analgesia
| | - P V Steagall
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint Hyacinthe, QC, Canada
- Department of Veterinary Clinical Sciences, Centre for Animal Health and Welfare, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong, Hong Kong SAR, China
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8
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Wun MK, Malik R. Response to Goodwin et al. Aust Vet J 2023; 101:413-416. [PMID: 37587847 DOI: 10.1111/avj.13283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 07/29/2023] [Indexed: 08/18/2023]
Affiliation(s)
- M K Wun
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, Washington State, USA
| | - R Malik
- Centre for Veterinary Education, B22, The University of Sydney, Sydney, New South Wales, Australia
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Marangoni S, Beatty J, Steagall PV. An ethogram of acute pain behaviors in cats based on expert consensus. PLoS One 2023; 18:e0292224. [PMID: 37768967 PMCID: PMC10538801 DOI: 10.1371/journal.pone.0292224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 09/16/2023] [Indexed: 09/30/2023] Open
Abstract
An improved understanding of behaviors reflecting acute pain in cats is a priority for feline welfare. The aim of this study was to create and validate a comprehensive ethogram of acute pain behaviors in cats that can discriminate painful versus non-painful individuals. An inventory of behaviors (ethogram) with their respective descriptors was created based on a literature review of PubMed, Web of Science and CAB Abstracts databases. The ethogram was divided into ten behavior categories that could be evaluated by duration and/or frequency: position in the cage, exploratory behaviors, activity, posture and body position, affective-emotional states, vocalization, playing (with an object), feeding, post-feeding and facial expressions/features. Thirty-six behaviors were analyzed independently by four veterinarians with postgraduate qualifications in feline medicine and/or behavior as (1) not relevant, (2) somewhat relevant, (3) quite relevant or (4) highly relevant and used for content (I-CVI) and face validity. Items with I-CVI scores > 0.67 were included. Twenty-four behaviors were included in the final ethogram. Thirteen items presented full agreement (i.e., I-CVI = 1): positioned in the back of the cage, no attention to surroundings, feigned sleep, grooming, attention to wound, crouched/hunched, abnormal gait, depressed, difficulty grasping food, head shaking, eye squinting, blepharospasm and lowered head position. Seven descriptors were reworded according to expert suggestions. The final ethogram provides a detailed description of acute pain behaviors in cats after content and face validity and can be applied to the characterization of different acute painful conditions in hospitalized cats.
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Affiliation(s)
- Sabrine Marangoni
- Faculté de Médecine Vétérinaire, Département de Sciences Cliniques, Université de Montréal, Saint-Hyacinthe, Québec, Canada
| | - Julia Beatty
- Department of Veterinary Clinical Sciences and Centre for Companion Animal Health and Welfare, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong, China
| | - Paulo V. Steagall
- Faculté de Médecine Vétérinaire, Département de Sciences Cliniques, Université de Montréal, Saint-Hyacinthe, Québec, Canada
- Department of Veterinary Clinical Sciences and Centre for Companion Animal Health and Welfare, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong, China
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10
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Eigner DR, Breitreiter K, Carmack T, Cox S, Downing R, Robertson S, Rodan I. 2023 AAFP/IAAHPC feline hospice and palliative care guidelines. J Feline Med Surg 2023; 25:1098612X231201683. [PMID: 37768060 PMCID: PMC10812026 DOI: 10.1177/1098612x231201683] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
The '2023 AAFP/IAAHPC Feline Hospice and Palliative Care Guidelines' are authored by a Task Force of experts in feline hospice and palliative care convened by the American Association of Feline Practitioners and the International Association for Animal Hospice and Palliative Care. They emphasize the specialized communication skills and ethical considerations that are associated with feline hospice and palliative care, with references to other feline practice guidelines for a more complete discussion of specific diseases, feline pain management best practices and cat friendly interactions. A comprehensive, multi-step hospice consultation allows for tailoring the approach to both the cat and the family involved in the care. The consultation includes establishing 'budgets of care', a concept that greatly influences what can be done for the individual cat. The Guidelines acknowledge that each cat and caregiver will be different in this regard; and establishing what is reasonable, practical and ethical for the individual cat and caregiver is important. A further concept of the 'care unit' is introduced, which is extrapolated from human hospice and palliative care, and encourages and empowers the caregiver to become a part of the cat's care every step of the way. Ethical considerations include a decision-making framework. The importance of comfort care is emphasized, and the latest information available about how to assess the quality of a cat's life is reviewed. Emotional health is as equally important as physical health. Hence, it is fundamental to recognize that compromised physical health, with pain and/or illness, impairs emotional health. A limited discussion on euthanasia is included, referring to the AAFP's End of Life Educational Toolkit for recommendations to help the caregiver and the veterinary professional ensure a peaceful passing and transition - one that reflects the best interests of the individual cat and caregiver.
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Affiliation(s)
| | | | - Tyler Carmack
- Caring Pathways USA, Hampton Roads Veterinary Hospice, Virginia Beach, VA, USA
| | - Shea Cox
- BluePearl Pet Hospice, Mars Veterinary Health, Temecula, CA, USA
| | - Robin Downing
- The Downing Center for Animal Pain Management, Windsor, CO, USA
| | | | - Ilona Rodan
- Cat Behavior Solutions, Cat Care Clinic, Madison, WI, USA
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Herlofson EAG, Tavola F, Engdahl KS, Bergström AF. Evaluation of primary wound healing and potential complications after perioperative infiltration with lidocaine without adrenaline in surgical incisions in dogs and cats. Acta Vet Scand 2023; 65:21. [PMID: 37312211 DOI: 10.1186/s13028-023-00686-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/03/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND Pre-emptive local analgesia with the use of lidocaine is practised increasingly in veterinary medicine as part of applied multimodal analgesia, despite its controversial impact on wound healing. The purpose of this prospective, randomised, double-blinded, placebo-controlled clinical study was to evaluate if preoperative subcutaneous infiltration of lidocaine has a negative impact on primary wound healing of surgical incisions. Fifty-two companion animals (3 cats and 49 dogs) were enrolled in the study. The inclusion criteria were as follows: American Society of Anaesthesiologists (ASA) score I or II, a minimum body weight of 5 kg, and a planned incisional length of at least 4 cm. Surgical incisions were infiltrated subcutaneously with lidocaine without adrenaline or NaCl (placebo). Follow-up questionnaires for owners and veterinarians and thermography of the surgical wound were used to assess wound healing. Antimicrobial use was documented. RESULTS There was no significant difference in either the total score or the individual assessment points between the treatment and the placebo group on the owner or the veterinary questionnaires in regard to primary wound healing (P > 0.05 for all comparisons). No significant difference was found between the thermography results of the treatment and placebo group (P = 0.78), and there was no significant correlation between the total score from the veterinary protocol and thermography results (Spearman's correlation coefficient - 0.10, P = 0.51). Surgical site infections developed in 5/53 (9.4%) surgeries and its occurrence varied significantly between the treatment and the placebo group as all cases of infection were in the placebo group (P = 0.05). CONCLUSION The results of this study indicate that lidocaine used as a local anaesthetic did not affect wound healing in patients with ASA scores I-II. The results suggest that lidocaine infiltration in surgical incisions can be safely used to reduce pain.
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Affiliation(s)
- Erica Anna Gumpert Herlofson
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | | | - Karolina Siri Engdahl
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala, Sweden.
| | - Annika Filippa Bergström
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala, Sweden
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12
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Kramer BM, Hellyer PW, Rishniw M, Kogan LR. Anesthetic and analgesic techniques used for cats undergoing ovariohysterectomies in general practice in the United States. Vet Anaesth Analg 2023:S1467-2987(23)00080-6. [PMID: 37230820 DOI: 10.1016/j.vaa.2023.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 04/29/2023] [Accepted: 04/30/2023] [Indexed: 05/27/2023]
Abstract
OBJECTIVE To better document anesthetic and analgesic protocols used by veterinarians in general practice within the United States (US) when performing elective ovariohysterectomy in cats. STUDY DESIGN Cross-sectional survey. POPULATION Veterinary practitioners in the US who are members of the Veterinary Information Network Inc. (VIN). METHODS An online anonymous survey was distributed to VIN members. The survey included questions pertaining to preanesthetic evaluation, premedication, induction, monitoring and maintenance protocols, and postoperative analgesia and sedation protocols when performing ovariohysterectomy in cats. RESULTS A total of 1324 veterinarians completed the survey. Respondents (number; %) reported performing preanesthetic laboratory tests [packed cell volume (256; 19.3%), complete blood cell count (893; 67.4%) and biochemistry panels (1101; 83.2%)] and preanesthetic examinations (1186; 89.6%) on the morning of surgery. The most frequently administered drugs for premedication were dexmedetomidine (353; 26.7%) and buprenorphine (424; 32.0%). The most frequently administered induction agent was propofol (451; 61.3%), and isoflurane (668; 50.4%) was the most common agent for maintenance of anesthesia. The majority of respondents reported placing intravenous catheters (885; 66.8%), administering crystalloid fluids (689; 52.0%) and providing heat support (1142; 86.3%). Participants reported using perioperative and postoperative analgesia including opioids (791; 59.7%), non-steroidal anti-inflammatory drugs (NSAIDs; 697; 52.6%) and NSAIDs dispensed for home use (665; 50.2%). Cats were commonly released home on the day of surgery (1150; 86.9%), and most participants reported contacting owners for follow-up within 1-2 days (989; 74.7%). CONCLUSIONS AND CLINICAL RELEVANCE Anesthetic protocols and management techniques for routine feline ovariohysterectomy differ widely among US veterinarians who are VIN members, and results from this study may be of use to evaluate anesthetic practices from this population of veterinarians.
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Affiliation(s)
- Brittany M Kramer
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA.
| | - Peter W Hellyer
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | | | - Lori R Kogan
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
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13
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Kreisler RE, MacDonald LJ, Mensing RN, Hoffmann ER, Keary CG, Padilla KN, Norris JW. Effects of peripheral active warming and passive insulation on core body temperature during feline ovariohysterectomy: a multi-arm randomized clinical trial. J Feline Med Surg 2023; 25:1098612X231157585. [PMID: 36867072 PMCID: PMC10812009 DOI: 10.1177/1098612x231157585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
OBJECTIVES Hypothermia is a common complication of anesthesia, particularly in cats. Some veterinarians insulate the extremities of cats as a preventive measure, and there is evidence that heating the extremities of dogs decreases the rate of heat loss from the core. This study investigated whether active warming or passive insulation of the extremities of cats resulted in a slower decrease in rectal temperature during anesthesia. METHODS Female cats were assigned via block randomization to passive (cotton toddler socks), active (heated toddler socks) or control group (uncovered extremities). Rectal temperature was monitored every 5 mins from induction through return to trap/carrier (final temperature). Multivariable linear regression models were used to compare temperature (rate change and final) between groups. RESULTS There were 164 cats with 1757 temperature readings. Mean total duration of anesthesia was 53 ± 13 mins. The temperature of all groups decreased linearly over time (all P <0.0001), with the rates of temperature decrease being -0.039°F/min (95% confidence interval [CI] -0.043 to -0.035)/-0.022°C (95% CI -0.024 to -0.019), -0.039°F/min (95% CI -0.042 to -0.035)/-0.022°C (95% CI -0.023 to -0.019) and -0.029°F/min (95% CI -0.032 to -0.025)/-0.016°C (95% CI -0.018 to -0.014) for the control, passive and active groups, respectively. The control, passive and active groups had median final temperatures of 98.4°F (interquartile range [IQR] 97.6-99.4)/36.9°C (IQR 36.4-37.4), 98.0°F (IQR 97.2-98.7)/36.7°C (IQR 36.2-37.1) and 99.1°F (IQR 97.7-100.0)/37.3°C (IQR 36.5-37.8), respectively. After controlling for weight, postinduction temperature and duration of anesthesia, and as compared with controls, the final temperature of the active group was predicted to be 0.54°F (95% CI 0.03-1.01)/0.3°C (95% CI 0.02-0.56) greater (P = 0.023), while the passive group was not significantly different (P = 0.130). CONCLUSIONS AND RELEVANCE The rate of rectal temperature decrease was significantly slower for the active group compared with the other groups. Although the cumulative difference in final temperature reading was modest, superior materials might enhance performance. Cotton toddler socks alone did not slow the rate of temperature decrease.
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Affiliation(s)
- Rachael E Kreisler
- Department of Primary Care, Animal Health Institute, College of Veterinary Medicine, Midwestern University, Glendale, AZ, USA
| | - Lauren J MacDonald
- Department of Primary Care, Animal Health Institute, College of Veterinary Medicine, Midwestern University, Glendale, AZ, USA
| | - Rachel N Mensing
- College of Veterinary Medicine, Midwestern University, Glendale, AZ, USA
| | - Emma R Hoffmann
- College of Veterinary Medicine, Midwestern University, Glendale, AZ, USA
| | - Carissa G Keary
- College of Veterinary Medicine, Midwestern University, Glendale, AZ, USA
| | - Kayla N Padilla
- College of Veterinary Medicine, Midwestern University, Glendale, AZ, USA
| | - Jeffrey W Norris
- Department of Pharmacology, College of Graduate Studies, Midwestern University, Glendale, AZ, USA
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14
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Malo A, Cheng AJ, Ruel HLM, Monteiro BP, Lutevele N, Marangoni S, Garbin M, Watanabe R, Steagall PV. Randomised, prospective, blinded, clinical trial of opioid-free injectable anaesthesia with or without multimodal analgesia in kittens undergoing ovariohysterectomy. J Feline Med Surg 2023; 25:1098612X231158582. [PMID: 36943182 PMCID: PMC10812012 DOI: 10.1177/1098612x231158582] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
OBJECTIVES This study compared an opioid-free injectable anaesthetic protocol with or without multimodal analgesia in kittens undergoing ovariohysterectomy. METHODS In this prospective, randomised, blinded, clinical trial, 29 healthy kittens (mean ± SD weight 1.55 ± 0.46 kg; aged 10 weeks to 6 months) were included. Anaesthesia was performed with an intramuscular injection of ketamine (4 mg/kg), dexmedetomidine (40 μg/kg) and midazolam (0.25 mg/kg). In the multimodal group (MMG), cats (n = 14) received meloxicam (0.1 mg/kg SC) and intraperitoneal bupivacaine 0.25% (2 mg/kg), whereas the same volume of saline was administered in the control group (CG; n = 15). Atipamezole (0.4 mg/kg IM) was given 15 mins after ovariohysterectomy. Postoperative pain was assessed using the UNESP-Botucatu multidimensional feline pain assessment scale - short form. Rescue analgesia (buprenorphine 0.02 mg/kg IM in MMG/CG and meloxicam 0.1 mg/kg SC in CG) was administered if pain scores were ⩾4/12. Soft food intake (after 2 and 60 mins) was evaluated at specific time points postoperatively. Statistical analyses were performed with linear models and post-hoc pairwise comparison with Benjamini-Hochberg corrections (P <0.05). RESULTS The prevalence of rescue analgesia was higher in the CG (n = 15/15) than the MMG (n = 1/14; P <0.001). Pain scores at 1 h, 2 h and 4 h postoperatively were higher in the CG (4.1 ± 2.8, 4.8 ± 3.0 and 5.3 ± 1.2, respectively) than in the MMG (1.6 ± 1.0, 1.1 ± 1.0 and 0.9 ± 0.8, respectively; P <0.001). Food intake (%) at 1 h postoperatively was higher in the MMG after 2 and 60 mins (10.4 ± 9 and 71.9 ± 29, respectively) than in the CG (1.4 ± 2 and 13.9 ± 7, respectively; P <0.001). CONCLUSIONS AND RELEVANCE This opioid-free protocol using multimodal analgesia produced adequate postoperative pain relief, while almost eliminating the need for rescue analgesia in kittens undergoing ovariohysterectomy. Pain decreased food intake.
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Affiliation(s)
- Annie Malo
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Alice J Cheng
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Hélène LM Ruel
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Beatriz P Monteiro
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Nathanael Lutevele
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Sabrine Marangoni
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Marta Garbin
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Ryota Watanabe
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Paulo V Steagall
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
- Department of Veterinary Clinical Sciences, Centre for Companion Animal Health and Welfare, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong SAR, China
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15
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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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16
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Garbin M, Ruel HLM, Watanabe R, Malo A, Monteiro BP, Steagall PV. Analgesic efficacy of an ultrasound-guided transversus abdominis plane block with bupivacaine in cats: a randomised, prospective, masked, placebo-controlled clinical trial. J Feline Med Surg 2023; 25:1098612X231154463. [PMID: 36848291 PMCID: PMC10812078 DOI: 10.1177/1098612x231154463] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
OBJECTIVES This randomised, prospective, masked clinical trial evaluated the postoperative analgesic efficacy of an ultrasound-guided transversus abdominis plane block (TAPB) with bupivacaine in cats undergoing ovariohysterectomy. METHODS Thirty-two healthy adult female cats undergoing elective ovariohysterectomy were randomised to undergo TAPB with bupivacaine (treatment group [TG], n = 16) vs placebo (control group [CG], n = 16) in addition to preoperative analgesia with buprenorphine (0.02 mg/kg IM). All patients received a general anaesthetic and, before surgical incision, a bilateral two-point (subcostal and lateral-longitudinal) TAPB was performed using 1 ml/kg bupivacaine 0.25% (0.25 ml/kg/point) or saline. Each cat was assessed by a blinded investigator before premedication (0 h) and at 1, 2, 3, 4, 8, 10 and 24 h postoperatively using the UNESP-Botucatu Feline Pain Scale - short form. Buprenorphine (0.02 mg/kg IV) and meloxicam (0.2 mg/kg SC) were administered when pain scores were ⩾4/12. Ten hours postoperatively, meloxicam was administered to cats that did not receive rescue analgesia. Statistical analysis included Student's t-tests, Wilcoxon tests and χ2 tests, and a linear mixed model with Bonferroni corrections (P <0.05). RESULTS Of the 32 cats enrolled, three in the CG were excluded from the analysis. The prevalence of rescue analgesia was significantly higher in the CG (n = 13/13) than in the TG (n = 3/16; P <0.001). Only one cat in the CG required rescue analgesia twice. Pain scores were significantly higher in the CG compared with the TG at 2, 4 and 8 h postoperatively. Mean ± SD pain scores were significantly higher in the CG, but not in the TG, at 2 (2.1 ± 1.9), 3 (1.9 ± 1.6), 4 (3.0 ± 1.4) and 8 h postoperatively (4.7 ± 0.6) than at 0 h (0.1 ± 0.3). CONCLUSIONS AND RELEVANCE A bilateral ultrasound-guided two-point TAPB with bupivacaine in combination with systemic buprenorphine provided superior postoperative analgesia than buprenorphine alone in cats undergoing ovariohysterectomy.
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Affiliation(s)
- Marta Garbin
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Hélène LM Ruel
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Ryota Watanabe
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Annie Malo
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Beatriz P Monteiro
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Paulo V Steagall
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
- Department of Veterinary Clinical Sciences, Centre for Companion Animal Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong, China
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17
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Mills PC. Editor's note: Stone et al. letter to the editor. J Vet Pharmacol Ther 2023; 46:70. [PMID: 36621862 DOI: 10.1111/jvp.13108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 01/10/2023]
Affiliation(s)
- Paul C Mills
- School of Veterinary Science, The University of Queensland, Gatton Campus, Gatton, Queensland, Australia
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18
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Monteiro BP, Lee NHY, Steagall PV. Can cat caregivers reliably assess acute pain in cats using the Feline Grimace Scale? A large bilingual global survey. J Feline Med Surg 2023; 25:1098612X221145499. [PMID: 36649089 PMCID: PMC10812049 DOI: 10.1177/1098612x221145499] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVES This study aimed to investigate if cat caregivers could reliably assess acute pain using the Feline Grimace Scale (FGS), and if participant demographics could affect scores. METHODS An online survey in English and Spanish was advertised by International Cat Care and other platforms (March-May 2021) using convenience sampling. Eligible participants were caregivers >18 years old and non-veterinary health professionals. Participants and a group of eight veterinarians scored 10 images of cats with different levels of pain. Data were analysed using linear models and intraclass correlation coefficient (ICC; α <0.05). Interpretation of the ICC was <0.2 = poor; 0.21-0.4 = reasonable; 0.41-0.60 = moderate; 0.61-0.80 = good; and 0.81-1.0 = very good. RESULTS A total of 3039 responses were received with 1262 completed answers from 66 countries (86%, 11.1% and 2.9% identified as female, male or other, respectively). Scores for each action unit (AU; ear position, orbital tightening, muzzle tension, whiskers change and head position) and their sum (FGS score) were not significantly different between caregivers and veterinarians, except for muzzle (caregivers 0.9 ± 0.0; veterinarians 0.7 ± 0.1; P = 0.035). The ICC single (caregivers) was 0.65, 0.69, 0.58, 0.37, 0.38 and 0.65, respectively, for AU ears, eyes, muzzle, whiskers, head and sum of scores. Demographic variables did not affect FGS scores. CONCLUSIONS AND RELEVANCE Total FGS scores had good reliability when used by cat caregivers, regardless of demographic variables, showing the potential applicability of the instrument to improve feline pain management and welfare worldwide.
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Affiliation(s)
- Beatriz P Monteiro
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Montréal, Saint-Hyacinthe, Canada
| | - Netta HY Lee
- The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Campus, Roslin, UK
| | - Paulo V Steagall
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Montréal, Saint-Hyacinthe, Canada
- Department of Veterinary Clinical Sciences and Centre for Companion Animal Health and Welfare, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong SAR, China
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19
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Rogers‐Smith E. Dealing with pancreatitis in cats and dogs. IN PRACTICE 2022. [DOI: 10.1002/inpr.270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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20
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Taylor S, St Denis K, Collins S, Dowgray N, Ellis SLH, Heath S, Rodan I, Ryan L. 2022 ISFM/AAFP Cat Friendly Veterinary Environment Guidelines. J Feline Med Surg 2022; 24:1133-1163. [PMID: 36259498 PMCID: PMC10845436 DOI: 10.1177/1098612x221128763] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PRACTICAL RELEVANCE The '2022 ISFM/AAFP Cat Friendly Veterinary Environment Guidelines' (hereafter the 'Cat Friendly Veterinary Environment Guidelines') describe how the veterinary clinic environment can be manipulated to minimise feline patient distress. Many components of a veterinary clinic visit or stay may result in negative experiences for cats. However, much can be done to improve a cat's experience by making the veterinary clinic more cat friendly. Exposure to other cats and other species can be reduced, and adjustments made with consideration of the feline senses and species-specific behaviour. Caregivers can prepare cats for a clinic visit with appropriate advice. Waiting rooms, examination rooms, hospital wards and other clinic areas can be designed and altered to reduce stress and hence encourage positive emotions. Changes need not be structural or expensive in order to be effective and make a difference to the cats and, in turn, to cat caregivers and the veterinary team. Moreover, by improving the all-round experience at the veterinary clinic, there are positive effects on preventive healthcare, identification of and recovery from illness, and compliance with treatment. CLINICAL CHALLENGES Good feline healthcare necessitates visiting the veterinary clinic, which, simply by being outside of a cat's territory and familiar surroundings, may lead to negative experiences. Such experiences can trigger negative (protective) emotions and associated physiological stress, which can result in misleading clinical findings, patient distress, prolonged recovery from illness, further difficulties with handling at subsequent visits and potential veterinary personnel injury. There may be a mistaken belief that veterinary clinics must undergo significant renovation or building work to become cat friendly, and that, if species cannot be separated, then clinics cannot improve their care of cats. These Guidelines aim to dispel any such misconceptions and provide detailed practical advice. EVIDENCE BASE These Guidelines have been created by a Task Force of experts convened by the International Society of Feline Medicine and American Association of Feline Practitioners, based on an extensive literature review and, where evidence is lacking, the authors' experience. Endorsements: These Guidelines have been endorsed by a number of groups and organisations, as detailed on page 1161 and at icatcare.org/cat-friendly-guidelines and catvets.com/environment.
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Affiliation(s)
- Samantha Taylor
- International Society of Feline Medicine, International Cat Care, Tisbury, Wiltshire, UK
| | - Kelly St Denis
- St Denis Veterinary Professional Corporation, Powassan, Ontario, Canada
| | - Sarah Collins
- International Society of Feline Medicine, International Cat Care, Tisbury, Wiltshire, UK
| | - Nathalie Dowgray
- International Society of Feline Medicine, International Cat Care, Tisbury, Wiltshire, UK
| | | | - Sarah Heath
- Behavioural Referrals Veterinary Practice, Chester, UK
| | - Ilona Rodan
- Cat Behavior Solutions, Cat Care Clinic, Madison, WI, USA
| | - Linda Ryan
- Inspiring Pet Teaching, Fordingbridge, Hampshire, UK
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21
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Rodan I, Dowgray N, Carney HC, Carozza E, Ellis SLH, Heath S, Niel L, St Denis K, Taylor S. 2022 AAFP/ISFM Cat Friendly Veterinary Interaction Guidelines: Approach and Handling Techniques. J Feline Med Surg 2022; 24:1093-1132. [PMID: 36259500 PMCID: PMC10845437 DOI: 10.1177/1098612x221128760] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PRACTICAL RELEVANCE The '2022 AAFP/ISFM Cat Friendly Veterinary Interaction Guidelines: Approach and Handling Techniques' (hereafter the 'Cat Friendly Veterinary Interaction Guidelines') support veterinary professionals with feline interactions and handling to reduce the impact of fear and other protective (negative) emotions, in so doing enhancing feline welfare and In implementing these Guidelines, team satisfaction and cat caregiver confidence in the veterinary team will increase as the result of efficient examinations, better experience, more reliable diagnostic testing and improved feline wellbeing. Veterinary professionals will learn the importance of understanding and appropriately responding to the current emotional state of the cat and tailoring each visit to the individual. CLINICAL CHALLENGES Cats have evolved with emotions and behaviors that are necessary for their survival as both a predator and prey species. A clinical setting and the required examinations and procedures to meet their physical health needs can result in behavioral responses to protective emotions. Cat friendly interactions require understanding, interpreting and appropriately responding to cats' emotional states and giving them a perceived sense of control while performing the required assessment. EVIDENCE BASE These Guidelines have been created by a Task Force of experts convened by the American Association of Feline Practitioners and the International Society of Feline Medicine, based on an extensive literature review and, where evidence is lacking, the authors' experience. ENDORSEMENTS These Guidelines have been endorsed by a number of groups and organizations, as detailed on page 1127 and at catvets.com/interactions and icatcare.org/cat-friendly-guidelines.
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Affiliation(s)
- Ilona Rodan
- Cat Behavior Solutions, Cat Care Clinic, Madison, WI, USA
| | - Nathalie Dowgray
- International Society of Feline Medicine, International Cat Care, Tisbury, Wi ltshire, UK
| | | | | | | | - Sarah Heath
- Behavioural Referrals Veterinary Practice, Chester, UK
| | - Lee Niel
- Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Kelly St Denis
- St Denis Veterinary Professional Corporation, Powassan, Ontario, Canada
| | - Samantha Taylor
- International Society of Feline Medicine, International Cat Care, Wiltshire, Tisbury, UK
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22
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Monteiro BP, Lascelles BDX, Murrell J, Robertson S, Steagall PVM, Wright B. 2022
WSAVA
guidelines for the recognition, assessment and treatment of pain. J Small Anim Pract 2022. [DOI: 10.1111/jsap.13566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- B. P. Monteiro
- Department of Clinical Sciences, Faculty of Veterinary Medicine Université de Montréal 3200 rue Sicotte, Saint‐Hyacinthe Quebec Canada
| | - B. D. X. Lascelles
- Comparative Pain Research Laboratory and Surgery Section North Carolina State University 4700 Hillsborough Street Raleigh NC USA
| | - J. Murrell
- Highcroft Veterinary Referrals 615 Wells Rd, Whitchurch Bristol BS149BE UK
| | - S. Robertson
- Senior Medical Director Lap of Love Veterinary Hospice 17804 N US Highway 41 Lutz FL 33549 USA
| | - P. V. M. Steagall
- Department of Clinical Sciences, Faculty of Veterinary Medicine Université de Montréal 3200 rue Sicotte, Saint‐Hyacinthe Quebec Canada
| | - B. Wright
- Mistral Vet 4450 Thompson Pkwy Fort Collins CO 80534 USA
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23
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Taylor S, Chan DL, Villaverde C, Ryan L, Peron F, Quimby J, O’Brien C, Chalhoub S. 2022 ISFM Consensus Guidelines on Management of the Inappetent Hospitalised Cat. J Feline Med Surg 2022; 24:614-640. [PMID: 35775307 PMCID: PMC11107985 DOI: 10.1177/1098612x221106353] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
PRACTICAL RELEVANCE Inappetence may have many origins and, as a presenting sign or observation in the hospitalised patient, is common in feline practice. Nutritional assessment of every patient is encouraged, to identify the need for, and appropriate type of, intervention indicated. The impact of malnutrition may be significant on the feline patient, perpetuating illness, delaying recovery, slowing wound healing and negatively impacting gut health and immunity. Delayed intervention may result in the cat's deterioration; hence prompt control of contributing factors such as the underlying illness, pain, nausea, ileus and stress is vital to optimise voluntary food intake. Management is multimodal, comprising reduction of stress, medications and assisted nutrition in the form of tube feeding or parenteral nutrition. Use of antiemetic, analgesic, prokinetic and appetite stimulant medications may restore appetite, but placement of feeding tubes should not be delayed. Feeding tubes are generally well tolerated and allow provision of food, water and medication with minimal stress, although clinicians must be aware of complications such as stoma site infections and refeeding syndrome. CLINICAL CHALLENGES Cats are vulnerable to malnutrition owing to their unique metabolism and specific nutritional requirements. Moreover, their nature as a species means they are susceptible to stress in the hospital environment, which may result in reduced food intake; previous negative experiences may compound the problem. In particular, an inappropriate clinic environment and/or handling may cause or exacerbate inappetence in hospitalised patients, with negative impacts on recovery. Postponing interventions such as feeding tube placement to await improvement, owing to clinician or caregiver apprehension, may hinder recovery and worsen nutritional deficits. EVIDENCE BASE The 2022 ISFM Consensus Guidelines on Management of the Inappetent Hospitalised Cat have been created by a panel of experts brought together by the International Society of Feline Medicine (ISFM). Information is based on the available literature, expert opinion and the panel members' experience.
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Affiliation(s)
- Samantha Taylor
- International Society of Feline Medicine, Tisbury, Wiltshire, UK
| | - Daniel L Chan
- Department of Clinical Science and Services, Royal Veterinary College, North Mymms, Hertfordshire, UK
| | | | - Linda Ryan
- Inspiring Pet Teaching, Fordingbridge, Hampshire, UK
| | | | - Jessica Quimby
- Department of Veterinary Clinical Sciences, Ohio State University, Columbus, OH, USA
| | - Carolyn O’Brien
- Melbourne Cat Vets, 157 Westgarth Street, Fitzroy, Australia
| | - Serge Chalhoub
- Faculty of Veterinary Medicine, University of Calgary, Alberta, Canada
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24
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Zurita M, Craig A. Feline Diaphyseal Fractures: Management and treatment options. J Feline Med Surg 2022; 24:662-674. [PMID: 35775308 PMCID: PMC11107983 DOI: 10.1177/1098612x221106354] [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: 11/16/2022]
Abstract
PRACTICAL RELEVANCE Cats frequently present with diaphyseal fractures, which require treatment in order to achieve a good return to function. These fractures often occur due to significant trauma; for example, as a result of road traffic accidents, high-rise syndrome and dog bite wounds. The first priority is to ensure the patient is systemically well before embarking on any specific surgical treatment of a fracture. CLINICAL CHALLENGES Surgical management of diaphyseal fractures can be challenging due to the surgical approach for some bones being technically demanding, for example because of the presence of important neurovascular structures, and the small size of feline bones, which limits the choice of implant size and strength. Further, it may be difficult to visualise fracture alignment when using minimally invasive techniques, although the use of intraoperative fluoroscopy can aid with this, and malalignment can be common for some fracture repairs, particularly in cases where anatomical reconstruction is not possible. AIMS This review focuses on diaphyseal long bone fractures and aims to assist decision-making, with an overview of the management and treatment options available. EVIDENCE BASE Many textbooks and original articles have been published on aspects of managing fractures in small animals. The authors also provide recommendations based upon their own clinical experience.
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Affiliation(s)
- Maria Zurita
- Southern Counties Veterinary Specialists, Ringwood, Hampshire BH24 3JW, UK
| | - Andrew Craig
- Hamilton Specialist Referrals, High Wycombe, Buckinghamshire HP12 3SD, UK
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