Diagnosis of Feline Respiratory Mycoplasma Infection
Bioguard Corporation In cats, ’mucosal’ mycoplasma infections typically cause ocular and respiratory disease, and less frequently neurological or joint disease. These Mycoplasma species are distinct to the haemotropic mycoplasmas that target red blood cells, causing hemolytic anemia in cats. Mycoplasma felis is typically associated with Upper Respiratory Tract Disease (URTD) in cats. Transmission M. felis is mainly transmitted from an infected cat to an in-contact one by aerosol, but also by grooming. Stresses, including overcrowding environments, concurrent respiratory viral infections, and poor hygienic situations, may promote transmission of the infection between cats. Clinical symptoms Mycoplasma felis is typically associated with URTD but sometimes it may be associated with lower respiratory tract infections. Common clinical signs include clear or colored discharge from the eyes or nose, coughing, sneezing, conjunctivitis, chemosis, lethargy, and anorexia. Lower respiratory tract infections can result in pneumonia with fever, cough, tachypnoea, and lethargy. Diagnosis Culture of mycoplasmas can be used to demonstrate infection, but it takes time for culture and rapid transport of samples to the laboratory is required. Demonstration of organisms via real-time PCR is increasingly being used to circumvent the difficulties with culture, Treatment Antimicrobial therapy is commonly used to treat mycoplasma respiratory infections. Doxycycline is a good first line agent because it is well tolerated by cats and relatively narrow in spectrum. The recommended dose is 5 mg/kg, PO, q12h or 10 mg/kg, PO, q24 (Lappin et al., 2017). Oxytetracycline or chlortetracycline ophthalmic ointment can be used q6h in addition as topical treatment. References: Vekšins A. Feline upper respiratory tract disease – Computed tomography and laboratory diagnostic. Vet World. 2022 Jul;15(7):1880-1886. Framst I, Ramesh P, Cai HY, Maboni G. Complete genome sequences of Mycoplasma cynos and Mycoplasma felis isolated from dogs and cats with infectious respiratory disease. Microbiol Resour Announc. 2024 Apr 11;13(4):e0124323.
Tritrichomonas Infection in Cat
Bioguard Corporation Tritrichomonas foetus is a significant cause of large bowel diarrhea and persistent colitis in cats. These pear-shaped organisms have three anterior flagella and one posterior flagellum. They have a distinctive undulating membrane, which gives them a similar appearance to Giardia. However, they do not form cysts and are transmitted directly from one host to another as trophozoites. The infection is most prevalent among young cats living in close quarters, such as in densely populated catteries and shelters. A notable investigation into purebred show cats discovered a 31% infection rate among 117 cats spanning 89 catteries, as detailed in Gookin’s 2004 study Clinical Signs Some cats infected with T. foetus may not exhibit any symptoms, particularly older cats that are in good health. However, most cats with T. foetus infection suffer from mild to severe lymphoplasmacytic and neutrophilic colitis, which causes recurrent episodes of large bowel diarrhea that may vary in consistency from semiformed to “cow pie” and emit a foul odor. Diarrhea may contain fresh blood or mucus. Insevere cases, kittens may experience painful anal irritation, fecalincontinence, or even rectal prolapse. Affected cats usually maintain a healthy appearance and good body condition overall. The presence of diarrhea can be exacerbated by other intestinal infections or parasites, particularly Giardia and ryptosporidium. Diagnosis To confirm the infection of T. foetus, there are three methods available – direct fecal microscopy, fecal culture, and fecal polymerase chain reaction (PCR) assay. Direct fecal microscopy involves identifying the motile trophozoites T. foetus in fresh wet smears of diarrheic feces taken directly from the rectum. This method identifies the organisms in about 14% of cases and is less effective with formed or dried feces. In cats who have been treated with antibiotics recently, the detection rate decreases. Trichomonads, which resemble Giardia in size and shape, can be distinguished by their unique undulating membrane and rapid, jerky motility, contrasting with Giardia’s “falling leaf” movement. Fecal culture can be done in-house or at a specialized lab. It helps increase the chances of identifying the organisms. In specific cases, a saline flush might be performed by inserting a catheter through the cat’s anus to wash the colon with saline, followed by aspiration of fecal material. Fecal PCR is the most accurate method for identifying T. foetus. To perform this test, the fecal sample should not contain any litter. This technique detects the organism’s DNA traces in the cat’s stool. It’s best to conduct testing on cats that have not received antibiotics for at least two weeks for the most accurate test results. Antibiotics can temporarily reduce the number of T. foetus, leading to false negatives. Treatment Often, many approaches for treating chronic diarrhea have been tried unsuccessfully before a true diagnosis of T. foetus is confirmed. Tritrichomonas foetus is resistant to most antibiotics and is extremely difficult to eradicate (Gookin 2001). Numerous antibiotics have been evaluated. Some antibiotics reduce the number of organisms and improve the diarrhea without eliminating the infection, so diarrhea relapses whenever antibiotics are stopped. Diarrhea is typically refractory to corticosteroids. The most successful treatment for eliminating T. foetus is ronidazole (30 mg/kg PO, once or twice daily for 14 days). The side effects in some cats include lethargy, decreased appetite, and neurotoxicity. Cats with neurotoxic signs usually improve when the drug is stopped, but recovery can take 1 to 4 weeks. Ronidazole should not be used in pregnant and nursing queens or in very young kittens. Ronidazole is not approved for veterinary or human use, but some pharmacies compound chemical grade ronidazole for veterinary use. Because of its bitter taste, ronidazole compounded in gel caps is better tolerated than flavored suspension. When prescribing ronidazole obtain informed consent and instruct owners to wear protective gloves when handling it. Management of Tritrichomonas foetus Infection In cases where cats show mild or sporadic symptoms of diarrhea caused by T. foetus, and treatment is not possible due to potential side effects, costs, or the owner’s preferences, it is important to know that diarrhea may naturally go away with time, which can take up to two years. However, such cats are likely to remain lifelong carriers of the parasite. The outlook for cats receiving treatment is generally positive. A majority of treated cats exhibit better stool consistency in just a few days, though diarrhea might linger briefly as related secondary inflammation subsides. Nonetheless, around 25% of cases might experience a continuous infection despite initial treatment. Fortunately, T. foetus has a short lifespan outside its host and is easily neutralized by common disinfectants. To mitigate infection risks, it’s advised to uphold strict litter box cleanliness through daily cleansing, isolate cats under treatment, minimize stress factors, prevent overcrowding, and implement regular screenings in breeding and shelter settings whenever feasible.
Kidney Diseases in Cats
Lloyd Alexandria Chavez, R.M.T Cats possess a pair of kidneys located on either side of their abdomen, playing a crucial role in eliminating waste from their system. These organs are also key in regulating the balance of fluids, minerals, and electrolytes in the body, conserving water and protein, and supporting blood pressure and the production of red blood cells through the production of the hormone erythropoietin. Kidney disease in cats can manifest in several forms and can stem from various causes, typically classified into either acute or chronic categories. Acute kidney injury occurs when the kidneys are suddenly damaged, potentially impairing their function. This condition can affect both pets and humans and may result in diminished kidney performance. Fortunately, acute kidney injury can often be reversible, with approximately half of those affected—be they pets or humans—able to recover. The kidneys have a remarkable capacity for self-repair, provided the initial cause of injury is addressed and any exacerbating factors are eliminated. Recovery prospects depend on several factors, including the cause of the injury, its severity, whether other bodily systems are involved, the availability of treatments such as hemodialysis, and adherence to medical guidance.Chronic kidney disease (CKD), on the other hand, is frequently diagnosed in older cats and is characterized by a progressive decline in kidney function. Symptoms of CKD in cats include increased thirst and urination, reduced appetite, weight loss, vomiting, and a dull coat. CKD is an incurable condition that worsens over time, resulting from gradual kidney damage over months or years. Its progression and symptom onset are more gradual compared to acute kidney disease, which can emerge rapidly following significant kidney damage from causes such as infections or toxic substances like antifreeze or lilies. Cats with acute kidney disease typically exhibit severe symptoms swiftly. SYMPTOMS In the initial stages of chronic kidney disease (CKD), there may be no noticeable symptoms as the kidneys are still able to function adequately. However, as the disease progresses and the kidneys become increasingly impaired, symptoms will begin to manifest. These symptoms can develop gradually and may be subtle, making them difficult to detect. They include: DIAGNOSIS Chronic kidney disease is diagnosed through a series of blood and urine tests that measure levels of specific substances indicative of kidney function. These tests not only confirm the presence of kidney issues but also aid veterinarians in staging the disease, which helps in understanding its severity. The key laboratory tests include: Together, these tests provide a comprehensive assessment of kidney health, allowing for accurate diagnosis and staging of chronic kidney disease in cats. TREATMENT While it’s not possible to cure chronic kidney disease (CKD) or undo the damage that has occurred, steps can be taken to slow its progression and alleviate the symptoms. In cases where a cat is diagnosed with CKD and is showing signs of illness, the initial course of treatment may include: This treatment regimen aims to manage the symptoms and complications associated with CKD, improving the quality of life for cats living with this condition. Sources: https://www.pdsa.org.uk/pet-help-and-advice/pet-health-hub/conditions/chronic-kidney-disease-in-cats#:~:text=FAQs-,Overview,vomiting%2C%20and%20poor%20coat%20condition. https://www.petmd.com/cat/conditions/urinary/kidney-disease-cats https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7379052/
Kidney Disease in Cats
Chavezlloyd Alexandria Baldago A cat has two kidneys, one on each side of the abdomen, and they play a vital role in filtering waste from the body. Additionally, the kidneys serve to regulate the body’s balance of fluids, minerals, and electrolytes. They conserve water and protein and play an important role in maintaining blood pressure and red blood cell production by making a hormone called erythropoietin. There are different types of kidney disease in cats and various underlying causes. These often develop into one of two categories: acute or chronic. Acute kidney injury is when the kidneys suddenly get damaged, which can sometimes make them work less effectively. It can happen in both small animals (like pets) and humans, and it might or might not lead to reduced kidney function. The good news is that acute kidney injury can often be turned around, with about half of the affected individuals, whether they are pets or people. The kidneys have a special ability to heal themselves if the problem that caused the injury is gone, and things that were making the injury worse stop. The chances of getting better depend on a few things, like what caused the kidney injury (if it can be fixed or not), how bad it is, if other parts of the body are affected, whether treatments like hemodialysis are available, and how well the person or pet follows the doctor’s advice. Chronic kidney disease, or CKD, is a common issue in older cats. It makes their kidneys work less effectively. Some signs of CKD in cats are drinking more water, peeing more, eating less, losing weight, throwing up, and having a rough coat. Unfortunately, there’s no cure for CKD, and it gets worse as time goes on. CKD results from damage to the kidneys that develops slowly over months and years and tends to cause symptoms which slowly progress. This is different from acute kidney disease, which develops if something suddenly causes a large amount of damage to the kidneys such as an infection or a poison such as antifreeze or lilies. Cats with acute kidney disease tend to develop serious symptoms very quickly SYMPTOMS Chronic kidney disease might not cause any symptoms in the early stages because the kidneys are still able to manage. Once the kidneys have been significantly damaged and are unable to cope, the symptoms will start to appear. Some can appear very slowly and can be hard to spot. Symptoms include: DIAGNOSIS Chronic kidney disease can be diagnosed using blood and urine tests. These tests detect raised levels of certain substances that may indicate the kidneys aren’t working properly. If necessary, these test results will also help the vet grade the cat’s kidney disease, which indicates how serious it is. Laboratory tests include: TREATMENT It’s not possible to cure chronic kidney disease or reverse the damage that has already been done, but it is possible to slow it down and reduce the symptoms. If your cat is poorly when they are diagnosed with chronic kidney disease, initial treatment might include: Sources: https://www.pdsa.org.uk/pet-help-and-advice/pet-health-hub/conditions/chronic-kidney-disease-in-cats#:~:text=FAQs-,Overview,vomiting%2C%20and%20poor%20coat%20condition.
Inflammatory Bowel Disease in Cats
Sushant Sadotra Feline inflammatory bowel disease (IBD) is a chronic condition that affects a cat’s gastrointestinal (GI) tract. The walls of the GI tract become thickened due to the infiltration of inflammatory cells, disrupting the cat’s ability to digest and absorb food properly. Although IBD can affect cats of any age, middle-aged and older cats are more prone to it. The exact cause of IBD remains unknown, but current evidence suggests that it may result from an abnormal interaction between the immune system, diet, bacterial populations in the intestines, and other environmental factors. Genetic abnormalities in the immune system are also believed to play a role in feline IBD, based on similarities to IBD in humans and dogs. Depending on the region of the GI tract and the type of inflammatory cells involved, IBD can manifest in different forms. If the stomach is inflamed, it is called gastritis; if the small intestine is inflamed, it is called enteritis, and if the colon is inflamed, it is called colitis. Lymphocytic plasmacytic enteritis is the most common form of IBD, where inflammatory lymphocytes and plasma cells attack the small intestine. Eosinophils, another type of inflammatory white blood cell, may also be involved in feline IBD, but are usually part of a mixed population of inflammatory cells. Neutrophilic IBD, which involves neutrophils, and granulomatous IBD, which involves macrophages, are two less common forms of IBD. In some cases, IBD can cause inflammation of other abdominal organs, such as the liver and pancreas. It is important to identify the type of IBD affecting a cat through appropriate diagnostic procedures to provide the best possible treatment and management. Clinical symptoms: Feline IBD is often characterized by a set of common clinical signs that include weight loss, vomiting, decreased appetite, diarrhea, lethargy, and bloody stools. The severity and frequency of these signs can vary depending on which parts of the gastrointestinal tract are inflamed. For instance, if the inflammation is situated in the stomach or higher regions of the small intestine, the cat may experience chronic vomiting. Conversely, inflammation in the colon is more likely to cause diarrhea, with or without blood in the stool. Diagnosis When it comes to making a diagnosis of feline IBD, it is important to conduct a thorough workup since many of the symptoms of IBD can overlap with other diseases. To determine the root cause of the symptoms, your veterinarian will most likely recommend conducting baseline blood work, fecal examinations, X-rays, or an abdominal ultrasound to check for metabolic disease, feline leukemia, parasitic or bacterial infections, hyperthyroidism, and certain types of cancer. Intestinal lymphoma, a form of cancer, can be particularly challenging to distinguish from IBD in cats. Additionally, a veterinarian may also measure the levels of B vitamins B12 and folate in the bloodstream, as IBD can hinder the absorption of these vitamins from the GI tract. Finally, a hypoallergenic food trial may be conducted to rule out food allergy as a possible cause. To further diagnose feline IBD, a biopsy is required to evaluate the tissue under a microscope. Increased numbers of inflammatory cells in the intestinal wall indicate the presence of IBD. Endoscopy and surgery are two methods of performing gastrointestinal biopsies, both of which require general anesthesia. However, surgery may be recommended for patients with suspected liver or pancreatic disease to biopsy these organs as well. Treatment If you suspect that your furry friend has intestinal parasites, it is important to consult with a veterinarian who will recommend appropriate treatment. The initial steps usually involve a combination of dietary changes and medications. Since there is no one-size-fits-all solution, your vet may need to experiment with different diet and medication combinations to determine the best therapy for your pet. Dietary Management If your cat is suffering from Inflammatory Bowel Disease (IBD), it is likely that dietary allergens are playing a role. Your veterinarian may suggest undergoing a food trial using hypoallergenic diets to help alleviate the symptoms. These diets include protein or carbohydrate sources that your cat has never consumed before. Some common initial choices are diets based on rabbit, duck, or venison. In case the symptoms do not improve with a hypoallergenic diet, your cat may benefit from diets that are high in fiber, low in fat, and easily digestible. It is important to note that it may take several weeks or even longer for your cat to show signs of improvement after a diet change. During any food trial, it is crucial to eliminate all other food sources, including table scraps, flavored medications, and treats. Medical Treatment Reference
Respiratory Tract Disease Complex in Cats
Sushant Sadotra, PhD/Diagnostic specialist Feline respiratory disease (FRD) syndrome or feline upper respiratory tract disease complex is a common infection in cats caused mainly by Feline Herpesvirus (FHV-1), Feline Calicivirus (FCV), Chlamydophila felis, Mycoplasma spp., and Bordetella bronchiseptica. About 90% of all upper respiratory infections are caused by FHV-1 and FCV. Common Symptoms: · Sneezing · Nasal congestion · Conjunctivitis (inflammation of the membranes lining the eyelids) · Discharge from the nose or eyes (clear, purulent, or cloudy containing pus). · Difficulty breathing · Ulcers in the mouth Less specific symptom · Less appetite · Lethargy · Fever · Enlarged lymph nodes · Blepharospasm (squinting) Sources of infection: · Susceptible cats can get an infection by contagious particles in saliva or secretions from the nose or eyes shredded by an infected cat. · Most cases are associated with direct contact · Natural transmissions can also occur via aerosol droplets. Stress may also cause a secondary course of illness. Real-Time PCR for Diagnosis: A definitive diagnosis is based on clinical signs and laboratory testing for the isolation and identification of the infection. The Polymerase chain reaction (PCR) test is one of the sensitive tests and most reliable for detecting the presence of infectious agents. PCR detects the genomic material of the pathogen and determines its presence in the host. It is often more sensitive and specific than other available tests. However, false negative results are still expected. In the case of patients with latent herpes infections where the FHV-1 is found in the trigeminal ganglion can give negative PCR results. In the case of Chlamydophila, 2-3 days of antibiotic treatment for patients can also have negative PCR results. Samples of ocular, nasal, or caudal pharyngeal secretions for PCR assay are best for the diagnosis and identification of causative agents. Sample collection tips: · Ocular: Moisten with tears/exudate well or firmly swab both of the conjunctival sacs with a sterile swab. · Clinical lesions: Prefer to swab from the nasal and pharyngeal areas. After sample collection, place the swab into the preservation buffer and mix thoroughly. If not for immediately use, please keep the mixture at 4°C (no more than 3 days) until nucleic acid extraction.
Introduction to Feline Hypertrophic Cardiomyopathy
Maigan Espinili Maruquin It is important to be aware that some of the diseases your pets may have are actually inherited. In cats, there are myocardial diseases that can be breed- related. The most common myocardial disease in cats is Hypertrophic cardiomyopathy (HCM), wherein abnormal thickening of the walls of the left ventricle (LV) is observed [1]. First time described in cats in 1977 [2], it has been reported to have a prevalence of around 14.7% in apparently healthy cats [3-5]. In humans, the HCM is considered a genetic disease [6-8], whereas occurrences of the disease were observed in mix- breeds [9], Persian [10], and American shorthair cats [11], while an HCM caused by mutation was identified in Maine coon [12] and ragdoll [13]. The HCM are diagnosed at mean of 5-7 years, although all ages can get the disease [6]. On the other hand, some cat breeds including Maine Coons [14]; Sphynx [15], and Ragdoll [16] were reported on earlier onset of under 2 years old [3]. Cats that are diagnosed with HCM are also recorded to develop congestive heart failure (CHF), arterial thromboembolism (ATE), or sudden cardiac death (SCD) [1, 17, 18]. Clinical Presentation When cats visit the clinics, routine veterinary examinations are conducted, and during auscultation, signs like arrhythmias, gallop sounds, or murmurs can be detected [6, 19, 20]. Respiratory distress is a manifestation of heart failure in diseased cats, whereas, some cats display hypothermia and pre-renal azotemia. On the other hand, the murmurs in cats may vary in intensity form moment to moment, and are commonly associated with dynamic and labile phenomena [6]. Diagnosis Fig. 1. Approach to the asymptomatic cat with suspected heart disease. BP, blood pressure; PCV, packed cell volume; T4, thyroxine [1] The feline HCM are primarily diagnosed on echocardiographic examination, which recognizes basic patterns that are intuitive [21], with ventricular wall thickness that is equal to or exceed 6 mm [6, 22]. Respiratory distress is reported to display left atrial enlargement. However, echocardiographic examination has limitations [1] and there is no definitive, gold-standard to diagnose HCM, unless there is a hypothetical and flawless molecular or genetic testing [6]. The LV wall thickness has no exact value allowable, and body weight can affect its thickness [1]. An increase of cTn-I in plasma concentration indicates its sensitivity and specificity as a biomarker to provide myocardial damage severity and prognosis information. On the other hand, the N-terminal pro B-type natriuretic peptide (NT-proBNP) assay may provide ongoing myocardial stress, however, full cardiac evaluation shall be performed to detect its cause of elevation [1]. Myocyte enlargement and interstitial fibrosis were observed, along with disorganized spatial arrangement of myocytes in histopathological examination [3, 23] Genetic testing for single point mutation that affects MYBPC3 in Maine coon cats (A31P) [12] and ragdolls (R820W) [13] are commercially available. Autosomal dominant inheritance were reported in both breeds [1]. Therapy and Management For asymptomatic cats with HCM, diltiazem or beta-blockers were reported to improve physical condition. Meanwhile, Diltiazem is administered at three times a day as a licensed formulation in UK to manage cases of HCM [21]. In a study conducted by Rishniw, M. and P.D. Pion in 2011, participatiing clinicians used furosemide for evident CHF, and most of them also used and ACEIs, while for cases with substantial dynamic LVOT obstruction, β-blockers were used by most [24]. Altering the progression of HCM in the pre- or subclinical stage is an approach that is ideal in the absence of safe and efficient therapy [1]. References Luis Fuentes, V. and L.J. Wilkie, Asymptomatic Hypertrophic Cardiomyopathy: Diagnosis and Therapy. Veterinary Clinics: Small Animal Practice, 2017. 47(5): p. 1041-1054. Tilley, L.P., et al., Primary myocardial disease in the cat. A model for human cardiomyopathy. Am J Pathol, 1977. 86(3): p. 493-522. Gil-Ortuño, C., et al., Genetics of feline hypertrophic cardiomyopathy. 2020. 98(3): p. 203-214. Paige, C.F., et al., Prevalence of cardiomyopathy in apparently healthy cats. J Am Vet Med Assoc, 2009. 234(11): p. 1398-403. Payne, J.R., D.C. Brodbelt, and V. Luis Fuentes, Cardiomyopathy prevalence in 780 apparently healthy cats in rehoming centres (the CatScan study). J Vet Cardiol, 2015. 17 Suppl 1: p. S244-57. Abbott, J.A., Feline Hypertrophic Cardiomyopathy: An Update. Veterinary Clinics: Small Animal Practice, 2010. 40(4): p. 685-700. Maron, B.J., et al., American College of Cardiology/European Society of Cardiology clinical expert consensus document on hypertrophic cardiomyopathy. A report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents and the European Society of Cardiology Committee for Practice Guidelines. J Am Coll Cardiol, 2003. 42(9): p. 1687-713. Maron, B.J., Hypertrophic cardiomyopathy: a systematic review. Jama, 2002. 287(10): p. 1308-20. Kraus, M.S., C.A. Calvert, and G.J. Jacobs, Hypertrophic cardiomyopathy in a litter of five mixed-breed cats. J Am Anim Hosp Assoc, 1999. 35(4): p. 293-6. Marin L, V.S., Boon J, et al., Left ventricular hypertrophy in a closed colony of Persian cats [abstract]. J Vet Intern Med 1994. 8:143. Meurs KM, K.M., Towbin J, et al., Familial systolic anterior motion of the mitral valve and/or hypertrophic cardiomyopathy is apparently inherited as an autosomal dominant trait in a family of American shorthair cats. J Vet Intern Med, 1997. 11:138. Meurs, K.M., et al., A cardiac myosin binding protein C mutation in the Maine Coon cat with familial hypertrophic cardiomyopathy. Hum Mol Genet, 2005. 14(23): p. 3587-93. Meurs, K.M., et al., A substitution mutation in the myosin binding protein C gene in ragdoll hypertrophic cardiomyopathy. Genomics, 2007. 90(2): p. 261-4. Kittleson, M.D., et al., Familial hypertrophic cardiomyopathy in maine coon cats: an animal model of human disease. Circulation, 1999. 99(24): p. 3172-80. Chetboul, V., et al., Prospective echocardiographic and tissue Doppler screening of a large Sphynx cat population: Reference ranges, heart disease prevalence and genetic aspects. Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology, 2012. 14. Borgeat, K., et al., The influence of clinical and genetic factors on left ventricular wall thickness in Ragdoll cats. J
