31 Jul 2017
Alex Gough looks at a study into the most common acquired cardiac disorders of cats, plus others, in his latest Research Review.
Alex Gough
Job Title
Hypertrophic cardiomyopathy (HCM) is one of the most common acquired cardiac disorders of cats, and diagnosis includes echocardiographic measurements of the left ventricle and left atrial sizes.
Visser et al1 performed a study to evaluate whether right ventricular structural and functional abnormalities were present in cats with HCM.
A total of 81 cats underwent a retrospective two-dimensional echocardiographic study, including measurements of right atrial diameter, right ventricular free wall thickness and right ventricular internal diameter, as well as measurements of right ventricular function – 26 cats were healthy controls, 31 had subclinical HCM, and 24 had HCM and congestive heart failure. Right heart size was increased and right ventricular function was decreased in cats with HCM and congestive heart failure compared to the healthy controls.
The authors concluded right ventricular remodelling and reduced function occur in some cats with HCM, and this may correlate with the clinical severity. They noted the right ventricle appeared to be involved in HCM and recommended echocardiographic assessment of the right ventricle in cats with HCM.
Hypertriglyceridaemia is familial in some breeds and can predispose to pancreatitis. The mainstay of treatment is diet and bezafibrate has been used in humans to treat hypertriglyceridaemia.
De Marco et al2 performed a prospective, uncontrolled clinical trial involving 46 dogs to assess the safety and efficacy of the drug in the treatment of hypertriglyceridaemia. All the dogs had elevated triglyceride levels and 33 also had elevated cholesterol levels. Sixteen of the dogs had primary hyperlipidaemia and 30 had secondary hyperlipidaemia, for example, due to hyperadrenocorticism and hypothyroidism.
In 42 dogs, triglyceride concentrations were normal after 30 days of treatment, and cholesterol was normal in 22 out of the 33 dogs in which it was elevated. No adverse effects were noted. The authors concluded bezafibrate appeared to be a safe and effective drug for the treatment of hyperlipidaemia in dogs.
The hyoid apparatus holds the larynx in place, and supports the pharynx and tongue. Fractures of the bones that make up the hyoid apparatus occasionally occur.
Ruth et al3 performed a retrospective review of CT studies for unrelated conditions to assess the prevalence and morphology of hyoid bone injury. A total of 293 dogs and 100 cats were included in the study. Hyoid fracture or luxation was present in 3.1% of dogs, but none of the cats. The epihyoid bone was most frequently fractured.
The authors note hyoid fracture may be an incidental finding in dogs.
Acute kidney injury (AKI) is an important life-threatening condition.
Bruchim et al4 performed a study to assess the value of urinary heat shock protein 72 as a marker for AKI in dogs. A total of 53 dogs were included in the study – 11 healthy controls, 10 with urinary tract infection, 11 with CKD, 8 with acute decompensating CKD and 13 with AKI. Urinary heat shock protein 72/urinary creatinine ratio (uHSP72/uCr) was found to be higher in the AKI group compared to the control and urinary tract infection groups. The ratio was significantly higher in dogs that did not survive AKI.
The authors concluded uHSP72/uCr measurements gave useful diagnostic and prognostic information for AKI.
Prolotherapy, or proliferation therapy, is a treatment considered by some to be a form of alternative medicine that involves injection of an irritant solution into a joint space or a ligament or tendon.
Sherwood et al5 performed a randomised, double-blind, placebo-controlled, prospective pilot study to evaluate the efficacy of intra-articular injection of dextrose for treatment of elbow or stifle OA in dogs. Ten dogs were included in the study and evaluated in various ways, including orthopaedic examination, lameness scoring, Canine Brief Pain Inventory (CBPI), gait analysis and radiography. The CBPI score was significantly less improved than the placebo group after 6 to 12 weeks, and no significant difference occurred in other scores.
The authors noted the procedure was easily performed and well-tolerated, but did not show any significant benefits.
Ectopic ureters are congenital disorders in which the ureter opens in the incorrect position, leading to incontinence. These are often corrected surgically. Noël et al6 performed a retrospective study of 47 dogs – 36 females and 11 males – that had undergone surgical correction of ectopic ureters to assess long-term outcome; 28 cases were unilateral and 19 were bilateral.
Procedures performed were neoureterostomy, ureteroneocystotomy and nephroureterectomy, and 15 dogs also had colposuspension performed. Postoperative continence scores were improved by additional medication, while 81% of cases had a good to excellent long-term score for continence. Neutering was not associated with an increased risk of recurrence of incontinence.
Another week, another technique for treating cruciate ligament rupture.
Biskup et al7 performed a prospective pilot study to assess the outcome of an intra-articular decellularised allograft technique. Ten dogs with unilateral cruciate rupture underwent the technique, in which a deep digital flexor tendon allograft was placed in the stifle using a femoral cross pin, with tibial washers and screws.
Radiography, owner questionnaires and force plate analysis were used to assess outcome up to 12 months post-surgery. Owner-reported pain levels improved, as did force plate analysis measures.
The authors concluded this technique is associated with a functional clinical outcome, but better understanding of the long-term behaviour of the graft is required.
