Why Feline Kidney Insufficiency is Still Tricky to TreatMarch 13, 2015Gary Norsworthy, DVM, Dipl. ABVP (Feline), owner of Alamo Feline Health Center in San Antonio, believes veterinarians should be careful when using the term “kidney failure” in talking to cat owners. To determine kidney function, creatinine and BUN (blood urea nitrogen) tests are conducted. Kidney failure occurs in a dog in which the creatinine value from blood tests is over 2.5 mg/dl, giving a dog a month or two to live. A creatinine number over 2.4 signals kidney trouble for a cat, yet actual kidney failure for a cat doesn’t start until that number reaches 5.0 or 5.5 mg/dl, Dr. Norsworthy said. Poor word choice can come into play when a veterinarian gets blood test results back with a creatinine value over 2.4 for a cat, he said. “Many cats are diagnosed with kidney failure that don’t have failure,” he said. Insufficiency Norsworthy said that in such cases he advises practitioners to use the term “kidney insufficiency,” a phrase he considers more accurate to describe cats in this range. “That’s an important distinction,” he said. “If you use the term ‘failure,’ owners wonder if their cat’s about to die. So cats often get euthanized when they shouldn’t.” With proper …
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What You Need to Know About Jaw LockingMarch 13, 2015Originally published in the February 2015 issue of Veterinary Practice News Last month, we discussed differential diagnoses for cats that are unable to close their mouths. One possible cause for cats’ and dogs’ inability to close the mouth is open-mouth jaw locking, which is rare enough that you may not have learned of it in veterinary school. Photo © 2012, John R. Lewis, University of Pennsylvania Figure 1: Open-mouth jaw locking in a Persian cat. Note the mouth is locked open so wide that there is no contact between maxillary and mandibular teeth. The slight shift of the mandible to the right suggests locking is occurring on the right. Clinical Signs and Etiology In cases of open-mouth jaw locking (OMJL), cats and dogs present with the mouth wide open, and the lower jaw often has shifted to the side where the coronoid process (the tip of the ramus) is locking on the ventrolateral aspect of the zygomatic arch (Figure 1). On presentation, patients may be drooling, pawing at the face and vocalizing. The defining clinical trait that allows OMJL to be distinguished from other possible causes of inability to close the mouth on conscious examination is that …
Rabies Booster Works in Some Exposed PetsJanuary 26, 2015Pets whose rabies vaccination has expired will likely survive exposure to the deadly virus if they are quickly given a booster, according to Kansas State University researchers. The discovery also means that pet owners potentially could choose short-term quarantine of such animals at home rather than euthanasia. Many states now require unvaccinated pets that are exposed to rabies to be quarantined for six months at an animal control facility, a costly proposition for owners faced with paying thousands of dollars in kennel bills. “This has the potential to save a lot of pets’ lives,” said Michael Moore, DVM, MPH, the project manager at the Kansas State University Veterinary Diagnostic Laboratory. “Our hope is that now animals with an out-of-date vaccination status that are exposed to rabies will be allowed to be handled the same as dogs and cats with up-to-date vaccinations. They will be given a booster and a 45-day observation at home.” The study, published Jan. 15 in the Journal of the American Veterinary Medical Association, was the first to present scientific data on animals with out-of-date rabies vaccinations, Kansas State reported. Most of the 74 dogs and 33 cats that Dr. Moore and his colleagues …
How To Sort Out Cats That Can't Close Their MouthsJanuary 21, 2015Originally published in the January 2015 issue of Veterinary Practice News I’ve had a run of feline patients who presented with the inability to close their mouth. Coincidentally, a recently published review in the Journal of Veterinary Dentistry discussed diagnoses behind the inability to close the mouth.1 Let’s review some of the more common causes. Differential Diagnoses When a cat is suddenly unable to close its mouth, there are only a handful of differentials: Temporomandibular joint (TMJ) luxation; TMJ fracture or caudal mandible fracture; Open-mouth jaw locking; Acquired dental malocclusion; Mandibular neurapraxia (a.k.a. trigeminal neuropathy or trigemninal neuritis). The patient history and comprehensive physical examination provide clues for an accurate diagnosis. If no history of trauma exists and no signs of head trauma are seen, TMJ luxation and TMJ/caudal mandibular fractures are unlikely. Caudal mandibular fractures and TMJ fractures may result in a shift of the mandible and an inability to close the mouth. Symphyseal separation or parasymphyseal fracture will not typically cause an inability to close the mouth, therefore if a cat presents with symphyseal separation and is unable to close the mouth, this suggests additional trauma caudally, usually in the form of a TMJ luxation or caudal mandibular/TMJ …
Another Zebra Diagnosis: Feline Pyogenic GranulomaJanuary 7, 2015Originally published in the December 2014 issue of Veterinary Practice News Case Discussion Fonzie, a 12-year-old neutered male domestic shorthair cat, was presented for evaluation of a proliferative, bleeding, friable mass arising from the gingiva and mucosa of the dorsolateral surface of the right caudal mandible. Appetite was normal, but the patient did have a history of occasionally exhibiting abnormal chewing motions. The mass had been present for approximately three months and was removed by Fonzie’s primary care veterinarian approximately one month before presentation to me. Biopsy submitted by the primary care veterinarian revealed ulcerated and inflamed granulation tissue. Although the mass appeared to be completely excised on histopathology, it recurred within a few weeks postoperatively. At the time of presentation to me, the mass was approximately 1.5 mm x 1.0 mm x 0.8 mm, located in the area of a missing right mandibular first molar (tooth 409, Figure 1). John R. Lewis, Northstar Vets Figure 1. Pyogenic granuloma in the area of the missing mandibular first molar tooth of a cat. A dental radiograph of the right caudal mandible revealed no osseous involvement and no evidence of retained roots (Figure 2). No other areas of the …
Abbott Releases 24-Hour Feline Pain DrugDecember 23, 2014Cats recovering from surgery may rest peacefully overnight with the use of a new 24-hour pain control drug from Abbott Animal Health. The Abbott Park, Ill., veterinary drug maker today announced the launch of Simbadol (buprenorphine injection) across the United States, five months after the medication received Food and Drug Administration approval. Simbadol is indicated for postoperative pain control in cats and is formulated to minimize the need for overnight dosing. The drug is the first and only FDA-approved opioid analgesic for cats to provide 24-hour pain control in a single dose, according to Abbott. The Washington State University College of Veterinary Medicine is among the first users of Simbadol. Tammy Grubb, DVM, Ph.D., an assistant professor of anesthesia and analgesia, called the drug “an important advancement for cats and for veterinarians.” “We can be comfortable that our patients have adequate analgesia, even through the night,” Dr. Grubb said. Available in 10mL multidose vials, Simbadol is distributed by MWI Veterinary Supply, Henry Schein Animal Health and Midwest Veterinary Supply.
Zoetis Unveils FeLV, FIV Combo TestDecember 18, 2014Veterinary drug maker Zoetis Inc. this week began taking orders for a new test designed to diagnose both feline leukemia virus (FeLV) and feline immunodeficiency virus (FIV). Shipments are scheduled to begin Jan. 5. The Witness test kit uses Rapid Immuno Migration (RIM) technology to detect the presence of FeLV antigen and FIV antibodies within 10 minutes, according to the Florham, Park, N.J., company. No refrigeration or snapping—a common physical step in point-of-care diagnostic tests—is necessary. “Since the Witness FeLV-FIV test kit does not require refrigeration, it is easy to store, does not take up refrigerator space, and veterinarians don’t need to wait for it to come to room temperature to use,” said J. Michael McFarland, DVM, Dipl. ABVP, the group director of Companion Animal Veterinary Operations for Zoetis. The combination test rates at 92.9 percent sensitivity and 96.5 percent specificity for FeLV and 93.8 percent sensitivity and 93.4 percent specificity for FIV, the company added. Feline leukemia virus and feline immunodeficiency virus are potentially fatal. FeLV rates in the United States range from 2 to 4 percent of all cats and up to 13 percent or more of cats that are ill, very young or at high risk …
How To Manage Pain In Off-Label SpeciesDecember 8, 2014Originally published in the November 2014 issue of Veterinary Practice News The cat is the off-label species. About 80 percent of all drugs we use in cats are used off label. That includes lactated Ringer’s solution and prednisolone. Managing chronic pain is an off-label event in the cat as no products are FDA-approved for long-term management of feline pain. The situation is somewhat better for acute or post-op pain, but several very widely used options are also off label. Neither cat owners nor their veterinarians are happy to see a cat in pain. However, finding agents that relieve feline pain can be problematic. Some have side effects, and some work better as part of a multimodal approach. None is effective for all patients so a trial-and-error approach may be needed. How to Recognize Pain In the wild, sick cats are targets for predators, so cats have become experts at masking pain. Therefore, with the aid of cat owners supplying careful observations, veterinarians must ask the right questions to uncover the signs of pain. Important questions include: Unwillingness to jump/play Decreased appetite Inappropriate elimination Repeatedly over-grooming the same location Change in mood Treatment of Acute Pain Acute pain is usually due …
Study May Lead to Early Diagnosis of Feline Kidney DiseaseNovember 21, 2014An early-warning test for chronic kidney disease in cats may emerge from the development of a biomarker called SDMA. Oregon State University researchers worked with Idexx Laboratories on SDMA, or symmetric dimethylarginine, which they said can spot chronic kidney disease, a leading cause of death in older cats, much earlier than normal. Up to 35 percent of geriatric cats suffer from the disease, according to The Merck Veterinary Manual. A test based on the biomarker would allow veterinarians to identify the onset of kidney disease and order dietary changes and other therapies, Oregon State reported Thursday. Foods with lower levels of protein and phosphorus and added fish oil, antioxidants, L-carnitine and medium-chain triglycerides are known to help. “Damage from [the disease] is irreversible, but this is an important advance, in that we should be able to identify the problem earlier and use special diets to slow the disease,” said Jean Hall, DVM, MS, Ph.D., a professor in the College of Veterinary Medicine. The findings, published in The Veterinary Journal, involved a controlled study of 32 healthy but older cats, the university stated. The biomarker identified the onset of kidney disease an average of 17 months earlier and in …
AVMA Helps Cat Owners With Declaw DecisionNovember 19, 2014A free client handout designed to help practitioners talk to cat owners about declaw surgery is available through the American Veterinary Medical Association. The new document, available at www.avma.org/declaw, acknowledges that declawing cats is controversial and points out that scratching is normal feline behavior and that nail caps, frequent trims and positive reinforcement training are among the alternatives to an onychectomy. The AVMA House of Delegates this past July updated the organization’s policy on the declawing of domestic cats. The policy encourages client education about the surgery and its risks and urges that the owner make the final decision in consultation with a veterinarian. The handout, titled “Declaw …. or Not?” was produced by the AVMA Animal Welfare Committee. “The AVMA hopes to help veterinarians connect with cat owners to make the best decision for their cat and household,” Animal Welfare Division director Gail C. Golab, DVM, Ph.D., wrote on her AVMA@Work blog. The website also features assistant director Cia Johnson, DVM, MS, narrating a five-minute video about declawing.
