Bellwether Magazine

Volume 1 Number 47 Summer 2000 Article 7

Summer 2000

23rd Annual Feline Symposium

Joan Capuzzi University of Pennsylvania

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Recommended Citation Capuzzi, Joan (2000) "23rd Annual Feline Symposium," Bellwether Magazine: Vol. 1 : No. 47 , Article 7. Available at: https://repository.upenn.edu/bellwether/vol1/iss47/7

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he Twenty-Third Annual The donor cat is brought into the surgical possible poor owner compliance. Feline Symposium was held area 30-45 minute prior to the recipient. Among all the cats receiving renal on March 25, 2000 at VHUP. Once the donor vessels and ureter have transplantation at VHUP, the postopera- T been prepared for a nephrectomy, the tive complications that were treated suc- The event was well attended and recipient is brought into surgery and pre- cessfully included renal infarction, sad- supported by Sheba® and Mrs. pared to receive the kidney. The renal dle thrombus, seizures, bladder atony Robert V. Clark, Jr. and Mrs. Edith vessels are anastomosed (end-to-side) to and associated ureteral obstruction, and M. Young. Mr. Richard Gebhardt the recipient’s aorta and caudal vena fever of unknown origin. again narrated the Parade of cava. A ventral midline cystotomy is then Renal transplantation is a revolution- Breeds. Following are summaries done, and the ureteral mucosa is attached ary development in feline medicine. of the presentations. to the bladder mucosa. One of the native When tethered to careful case selection, kidneys is biopsied and a gastrostomy postoperative intensive care, and early Update on the Renal tube placed. The incisions are closed and recognition of complications, renal trans- the recipient is taken to the intensive plantation can restore quality—and quan- Transplant Program care for close monitoring. The donor tity—of life to cats in renal failure. recovers in the regular fluid ward. idney transplantation is the freshest “The key to success with these approach used to combat the most K patients is intensive post-operation man- pervasive—and perhaps deadliest—dis- FELV and FIV— agement to try to prevent complications,” ease in geriatric cats: renal failure. Dr. Dr. Aronson said. “Furthermore, she Lillian Aronson, assistant professor of Differences and added, the owner needs to realize that surgery at VHUP, discussed the method- this is a commitment for the life of the Similarities ology and potential complications of cat.” This commitment includes continu- renal transplantation, and data from the eline leukemia virus (FeLV) and al immunosuppressive therapy and regu- first two years of the program at VHUP. Ffeline immunodeficiency virus (FIV) lar visits to the referring veterinarian for VHUP’s renal transplantation pro- cause immunodeficiency syndromes that bloodwork and evaluation. gram began in early 1998. Since then, 30 can greatly impact the quality of life of Dr. Aronson cited some statistics cats (25 domestic shorthairs and five our cats. Dr. Lesley King, associate pro- regarding postsurgical outcome in kidney purebred cats) diagnosed with end-stage fessor of critical care at the School, transplant patients at VHUP. Nineteen of renal failure have received kidney trans- explained the differences and similarities the 30 cats that have received kidney plants here. The causes of renal failure in between FeLV and FIV. transplants at VHUP are currently alive these cases included chronic interstitial Three subfamilies of retroviruses are and thriving; sixteen of these are over nephritis (50%), nephroliths and/or important in domestic cats: the one year post-transplant. Complications ureteroliths of kidneys/ureters (20%) spumaviruses, which typically do not in the surviving cats include three cases polycystic kidney disease (7%) and cause disease; the oncornaviruses—like of diabetes, possibly associated with unknown in 6 cats. FeLV—which potentially cause immuno- chronic immunosuppressive therapy, and Careful patient selection is crucial to a suppression and cancer; and the one case of a parathyroid gland tumor; successful medical outcome of renal lentiviruses—or “slow” viruses—such as the tumor has been removed and the cat transplantation, Dr. Aronson explained. FIV, which cause immunosuppression. is doing well. Kidney recipients must be healthy; pre- The latter two viruses are quite patho- Of the cats that are no longer alive, operative tests include routine blood- genic in cats. three died in the perioperative period work, FELV/FIV test, serum T4, urinaly- “The viruses FeLV and FIV certainly prior to discharge—one from a possible sis and urine culture, chest/abdominal cause some of the most serious health coagulopathy, one from hypotension radiographs, echocardiography and problems that we see in cats today,” Dr. associated with a hemoabdomen, and the abdominal ultrasound. King said. third from pancreatitis and pleural effu- Prior to surgery, recipient cats are Both viruses consist of a RNA core, sion. Seven cats died following dis- given a protein-restricted diet, phosphate which is surrounded by structural charge—two from calcium oxalate stone binders, blood transfusions to correct any formation in the new kidney (14 month anemias, and intravenous fluids. and two years, post operatively), three Immunosuppression, which reduces the from infection secondary to immunosup- likelihood of organ rejection, is accom- pressive therapy, two cats with system plished by the administration of toxoplasmosis infection four months and cyclosporine and prednisone, started two six months post-op, one cat from an days prior to surgery. infection of her peg tube site, one from The surgeries on the donor and recipi- ureteral obstruction secondary to scar tis- ent cats are performed simultaneously. sue formation at the graft site, and one of

6 Symposia for Breeders & Owners Feline proteins and protected by a lipoprotein to small quantities of virus, viral antibod- are also prone to respiratory and intesti- envelope. This envelope consists of anti- ies against the gp70 antigen are formed, nal tract disease and skin lesions. gens, such as the gp70 molecule in the infection is eliminated, and lifetime FeLV is diagnosed by antigen tests case of FeLV, which enable the virus to immunity develops (42 percent of (ELISA or IFA), and positive results are attach to and infect the host cells. exposed cats). If the inoculum is large or obtained only when the virus is actively “Cats’ cells have specially designed the cat is immunosuppressed, the virus replicating. Negative results to these tests receptors on their surfaces to link into spreads hematogenously to other sites, therefore occur in cats with latent infec- this virus,” Dr. King explained. “The two particularly the intestines and the bone tions. False positives may occur with have evolved together over probably marrow (28 percent of exposed cats). ELISA testing, and should be confirmed thousands of years.” These cats, 85 percent of which die with- with IFA. A third test, polymerase chain Once the FeLV or FIV viruses attach in 3.5 years of diagnosis, are capable of reaction (PCR), can theoretically detect to cell membrane receptors, they pene- transmitting the virus to other cats. Alter- virus in latently infected cats that are trate the target cell and shed this enve- natively, in about 30% of cats the virus negative on ELISA and IFA. Positive lope. Using the enzyme reverse tran- dies out and is eliminated from the cat, results may also be seen during the acute scriptase, a DNA copy of the viral RNA but the cat does not develop an immune phase of FeLV infection; if this scenario is made. A provirus is then formed and response and is susceptible to re-infec- is suspected, these cats should be retest- integrated into the cat cell DNA. Follow- tion in the future. In a small percentage ed two to three months later. ing integration, most cat cells then repli- of exposed cats, latent infections can In the case of FIV, antibodies may not cate the virus. occur in which the virus is present in the be present until six weeks after infection, Both fragile viruses, FeLV and FIV cat but not replicating. Latent infections but then the cat will remain positive for are readily inactivated by heat, desicca- can potentially revert to viremia and dis- life. The ELISA test is highly sensitive tion and light. They are not transmitted ease if the cat becomes stressed. for FIV antibodies, and the Western blot by transient contact with other cats or In the case of FIV—the feline coun- test is thought to be the definitive test. with fomites, such as cages or brushes. terpart to human immunodeficiency virus There are no “cures” for FeLV or FIV. Hence, owners need not delay before (HIV)—the host is infected for life. Fol- However, immunomodulator therapies introducing a new cat into a household lowing inoculation, a fever, enlarged and reverse transcriptase inhibitors (i.e., formerly occupied by an infected cat. lymph nodes and a transient drop in the AZT) may be used to manage infection FeLV is present in high concentration white blood cell count occur about four or delay the spread of the virus. in the saliva and respiratory secretions of weeks after infection. These low-grade For both viruses, prevention is key, infected cats. Transmission requires pro- signs may persist for several months, Dr. King said. This involves preventing longed, intimate, moist contact between after which time the cat appears normal, cats from roaming free and, in the case cats, such as occurs when cats groom even though the virus is still replicating of FeLV, vaccinating. Dr. King also rec- each other. In single-cat households in its system. Eventually these cats ommended a stepwise program for where there is no known exposure to the develop immune deficiency, after which removal of FeLV from catteries: Test all virus, infection incidence is less than one mean survival time is an estimated two cats for FeLV. Remove infected cats, percent. In exposed multi-cat house- years. clean all dishes and other fomites, and holds, the rate is 28 percent. Amongst FeLV and FIV cause a host of clinical prevent movement of cats in or out of the stray cat population, nearly one per- signs. “The most important thing that the cattery. Retest all cats 12 weeks after cent of cats are infected with FeLV. these retroviruses do to cats is cause a the first test to detect incubating infec- FIV, which replicates in the salivary dramatic and profound immunosuppres- tions. Lift the quarantine once all cats glands, is also shed in large quantities in sion,” said Dr. King. have had tested negative on two consec- the saliva. Unlike FeLV, it is not easily Cats infected with either virus are utive tests, and test all new cats prior to transmitted by prolonged, intimate con- prone to the development of opportunis- introduction. tact, such as grooming. Transmission tic infections, such as hemo- occurs primarily through bites. Disease bartonellosis and demodectic incidence is highest amongst those cats mange. FeLV can also cause that are more prone to fighting, such as malignant mutations resulting male and stray cats. Amongst free-roam- in lymphoma and leukemia; ing cat populations, disease incidence is other problems include ane- as high as 17 percent. In confined cat mia, enteritis, infertility/abor- populations, such as catteries, it is about tion, and skeletal and neuro- one percent. logic abnormalities. FIV FeLV replicates in the pharynx and infection, on the other hand, local lymph nodes. Once transmitted, is characterized by one of three things happens. In cats with gingivitis/stomatitis and neu- good immune function that are exposed rologic signs. Infected cats

7 Symposia for Breeders & Owners Feline

Professor of Medicine at the School, most prevalent, and type AB by far the Feline Blood Types gave the symposium lecture on feline rarest. The occurrence of type B blood blood types, and discussed their perti- varies in frequency by breed and geo- and Histocompatibility nence to transfusion medicine and cat graphic region. breeding. In a study of feline blood groups con- Issues Presently, only one blood group sys- ducted by Dr. Giger’s laboratory at the lood type compatibility is crucial to tem is recognized in cats. The AB blood School, over 15,000 cats have been Bthe success of a transfusion, as well group system has three blood types: A, B typed since 1986. In the northeastern part as to the health of a newborn kittens. Dr. and AB. The type A allele is dominant of the country, nearly every cat has type Urs Giger, Charlotte Newton Sheppard over the B allele and the AB type is sep- A blood, type B cats comprise 0.3 per- arately inherited. Of these, type A is the cent of the population, one to two per- Mrs. Clark and Mrs. Young Honored At the 23rd Annual Feline Symposium Dean Kelly honored Mrs. Robert V. Clark, Jr. and Mrs. Edith Young for their support of the School and the Feline Symposium. He presented the Bellwether Medal to each. Following are the citations: Elizabeth Dunn Clark Edith M.Young Elizabeth Dunn Clark, for more than three decades you have Over many, many years, Edith M.Young, you have graced the been a compassionate and generous supporter and a most val- School of Veterinary Medicine and its leadership with your ued ambassador to the University of Pennsylvania School of incredible Scottish humor and zestful spirit. We are delighted to Veterinary Medicine. Four School deans have cherished your embrace you as one of our special friends. As a loyal supporter wonderfully devoted friendship and ardent spirit. They have val- over the past three decades, we are particularly proud to call ued your enthusiastic dedication to you our international ambassador. animal health concerns. Your earnest pursuit of the dissem- You have rescued and cared for a ination of feline health issues and multitude of unwanted and neglected concerns shared with breeders and animals, numbers too great to esti- feline owners through the Feline Sym- mate, and have been a tenacious posium, have earned you the respect advocate for animal welfare. Myriad of your peers. Your outstanding humane organizations have benefit- involvement has been a major compo- ted from your magnanimous generos- nent of its success and your participa- ity and sage guidance in their tion on the Committee has been endeavors. invaluable. An exhibitor of Labrador retriev- Rescuing and caring for unwanted ers and a renowned breeder, you animals, here and abroad, you have have set the highest standard of been a staunch and successful pro- excellence for the dog fancy to exem- moter for animal welfare. Many plify. Springfield Farm’s champion humane societies are grateful for Labradors, in addition to nine other Mrs. Young, Dean Kelly, Mrs. Clark. your munificence and counsel in their breeds, have been prominently hon- endeavors. Your extraordinary ored over the years in shows throughout the United States. thoughtfulness has served as an example for others to emulate. Integrally involved over the past two decades to the growth We are grateful for your boundless concern and consideration and success of the School’s Feline Symposium, Elizabeth Dunn for all animals and your selfless support of all organizations Clark and the Feline Symposium are synonymous. You have dedicated to animal interests. contributed immensely to the dissemination of feline health In recognition for your participation and counsel to the issues and concerns shared with breeders and feline owners Feline Symposium Committee, and in particular to the School of through this important educational symposium. Veterinary Medicine, we present to you, Edith M.Young, the Elizabeth Dunn Clark, in recognition of your accomplishments University of Pennsylvania School of Veterinary Medicine’s for all animals and their welfare and on the occasion of the 2000 Bellwether Medal. Feline Symposium, the University of Pennsylvania School of Vet- erinary Medicine presents to you the Bellwether Medal. Saturday, March 25, 2000 School of Veterinary Medicine Feline Symposium 2000 Saturday, March 25, 2000 School of Veterinary Medicine Feline Symposium 2000

8 Symposia for Breeders & Owners Feline cent in the south were type B, and four tress in the blood recipient. “It can be dition to manage medically, NI is best to six percent in the west. In other parts quite devastating if mismatch blood is prevented, said Dr. Giger. “Prevention is of the world, type B domestic shorthair given,” explained Dr. Giger. “If matched accomplished by typing cats before cats are far more prevalent. For example, blood is transfused, these red blood cells breeding them. If you have a B queen, it 1 in France and Italy, over ten percent of survive for weeks to 2 /2 months, whereas should only be bred to a B tom cat.” You cats have blood type B, and one region if the blood is not matched, they last a can get your cat blood typed at your vet- of Australia has 26 percent. few hours to a few days and can cause erinarian’s clinic, by coming to VHUP or Just as marked is the variation in life-threatening reactions.” by sending a lavender top blood sample blood type frequencies by breed. The Hence, the importance of blood typ- to the Josephine Deubler Genetic Testing Penn study found that among ing or cross matching in Laboratory here at Penn Siamese and related breeds transfusion medicine. (www.vet.upenn.edu/penngen, or of cats, the type B blood type Blood typing is a simple [email protected] or (215) 898- does not exist. In Maine coon procedure that uses 3375). and Norwegian forest cats, reagents to identify the type B blood was found in type A and B blood sam- Feline Hip low percentage, and in ple. Blood compatibility breeds like Abyssinians, Bir- can also be determined Dysplasia— mans and Persians, in about from a blood cross match, 15 percent. Among breeds in which a sample of A Discussion with like the Devon, Cornish rex, donor red blood cells is British and exotic shorthair mixed with a sample of Emphasis on Maine cats the type B frequency is a recipient plasma and vice- Coon Cats striking 30+ percent. versa. To facilitate transfu- Stray, anti-A antibodies, sions in cats, VHUP main- lthough hip dysplasia is considered which are present in all type B cats, are tains a blood bank, with mostly type A, Aan affliction of the dog, new responsible for two life-threatening con- but also some B donors, and blood prod- research shows that it occurs more com- ditions: transfusion reactions and neona- ucts such as packed red blood cells and monly in cats than has previously been tal isoerythrolysis (NI). Type A cats have fresh frozen plasma to allow for storage realized. Dr. Todd Murphy, resident in low titers of anti-B antibodies in their and specific therapy. surgery at VHUP, described the patho- plasma, which can cause the former con- The second condition of blood incom- physiology of hip dysplasia and cited dition but not the latter. patibility is hemolysis in the newborn, statistical data regarding the occurrence Blood transfusions are given to cats referred to as neonatal erythrolysis (NI). of this potentially debilitating condition suffering from conditions of decreased Cats receive antibodies from the in cats. red blood cell production (i.e., renal fail- colostrum and milk in the first 24 hours Hip dysplasia is characterized by ure, feline leukemia [FeLV], feline postpartum to protect them against infec- incongruity of the coxofemoral joint immunodeficiency virus [FIV] and aplas- tions. However, the colostral/milk anti-A (hip), manifest as a loose fit between its tic anemia), hemolysis (i.e., immune- antibodies from type B queens may “ball” and “socket” components. The medicated, toxins and parasites), or blood attack red blood cells from a type A and result of this abnormal loading is degen- loss (i.e., flea infestation, gastrointestinal AB kittens. In NI, the kitten’s red blood erative joint disease (DJD)—or osteo- bleeding, cancer and clotting disorders). cells are lysed by the incompatible arthritis, pain and loss of joint function. A transfusion reaction is caused by the colostral antibodies. Dr. Giger determined “Hip laxity in the cat, as in the dog, is immediate destruction of the transfused that “NI is a common cause of fading kit- the primary risk factor for the develop- red blood cells by the patient’s antibodies ten syndrome and kitten mortality com- ment of degenerative joint disease,” said against the foreign blood type. It is mani- plex in certain purebred cats. Typically, Dr. Murphy. fested by such signs as urticaria, erythe- affected kittens are born healthy, but Two widely accepted screening meth- ma, facial swelling and respiratory dis- begin to fade within minutes to hours ods exist for the detection of hip dysplasia after they start nursing. They may acutely in cats and dogs. The first, developed by die or develop very dark red brown urine the Orthopedic Foundation for Animals from the lysed red blood cells. Kittens (OFA), dates back to the late 1960s. that survive this acute period become Using the OFA method, hip conformation anemic and jaundiced by about day three is evaluated radiographically (using one and often develop tail tip necrosis.” radiographic view) by three different radi- NI causes considerable mortality in ologists, and a subjective score produced the first week of life, particularly in based on a two out of three consensus. A purebred catteries, where the incidence newer diagnostic method, PennHIP¨, was of type B blood is higher. A difficult con- developed in the early 1980s. PennHIP

9 Symposia for Breeders & Owners Feline incorporates three different radiographic been performed in cats. views—hip extended, hip compressed and Kitty Breath—An Dental scaling-polishing and tooth extrac- hip distracted, subjective scores of degen- Update on Feline tion are the primary options for treating erative disease, and an objective A”dis- feline periodontal disease. Preventive mea- traction index” (DI) measurement. The DI Dental Disease sures include regular tooth brushing and use is an estimation of the risk for future of chlorhexidine. The most effective anti- ral disease can lead to widespread development of DJD. A DI of 0.1, for plaque agent, chlorhexidine is available in organ changes in the cat, and is best example, is almost a guarantee that hip O rinses, gels and chews (i.e., CET Forte combated with prevention. Dr. Colin Har- dysplasia will not develop. Chews). Two “dental diets” claim to retard vey, professor of surgery and dentistry at Dogs not uncommonly show clinical the accumulation of plaque: Hills Feline t/d VHUP, explained the significance of the signs of hip dysplasia, and many treatment and Friskies Feline Dental Diet, both of various types of oral diseases in cats, and options are available for them. Cats, how- which have been awarded the Seal of Accep- talked about preventive measures. ever, are rarely clinical for, or diagnosed tance of the Veterinary Oral Health Council. In a recent study of 14,000 cats in the with, hip dysplasia. For those rare cats that FORLs, the second most prevalent U.S., oral disease was found to be the most are diagnosed with hip dysplasia, the treat- feline oral condition, occur in about 50 commonly diagnosed medical problem. ment options are very limited. While percent of domestic cats aged four years The teeth, specifically, are often the gene- ample research has been done on canine or more. FORLS—or “neck lesions”—are sis of the disease. “Dental diseases are hip dysplasia, the research findings on hip “punched-out” areas on the surface of the major problems in cats,” said Dr. Harvey. dysplasia in cats are paltry. In fact, up until tooth at or below the gingival margin. The Dental lesions in cats are comprised of the early 1980s, only about six case prevalence of FORLs increases with the either periodontal disease or feline odon- reports of feline hip dysplasia existed. age of the cat, up until five or six years of toclastic resorptive lesions (FORLs). Peri- Several studies on feline hip dysplasia age, after which affected teeth tend to fall odontal disease takes the form of either recently have been conducted at VHUP. out or are extracted. gingivitis or the more serious periodonti- In one study, 140 Maine coon cats were A VHUP study found little correlation tis. Both begin with the deposition of evaluated over the last year-and-a-half. between FORLs and gingival redness, plaque on the teeth. In the absence of The average DI was a distressingly high plaque or tartar. Although they create soft- abrasive forces, the plaque becomes min- 0.61. Some 45 percent of these cats were ened areas that “catch” the dental explorer, eralized by salivary secretions, which diagnosed with radiographic signs of hip FORLS are best diagnosed radiographically. transform it into calculus (tartar). dysplasia. Three cats showed clinical These lesions are quite painful, and best Once calculus is present, Dr. Harvey signs of hip dysplasia, such as reluctance treated by simple extraction of affected teeth. explained, “it’s much more difficult to cut to climb stairs or jump. Six cats had hip A fourth serious oral condition affect- off this cycle and go back to a clean tooth pain, and 11 cats had stifle pain or lame- ing cats is stomatitis, which is character- simply with a toothbrush—or a tasty ness. A cat with bad knees or hips is ized by diffuse, fire-red inflammation and mouse, in the case of a cat.” three times as likely to also have the painful ulceration in the mouth. Stomatitis The anaerobic environment created by other, said Dr. Murphy. This is yet anoth- is the pathologic result of an overexuber- the plaque attracts bacteria that accumu- er reason to try to reduce the occurrence ant immune response to bacteria in the late in the gingival pockets. Gingivitis— of hip dysplasia. mouth. Although it may respond to inflammation of the gingiva—is the result “We think and hope that tight hips antimicrobial and anti-inflammatory thera- of the body’s immune response to these will lead to tighter knees,” he said. py, stomatitis is most effectively treated bacteria. A condition that affects over 80 In another VHUP study, 78 domestic with extensive tooth extraction. percent of mature cats, gingivitis is shorthaired cats were radiographically Viral diseases also lead to serious oral reversible once the plaque is removed. evaluated for the presence of hip dyspla- problems in cats. Both feline herpes and The next step on the continuum of den- sia. The average DI was 0.42, which cor- calici viruses cause oral signs, chiefly tal disease is periodontitis, which occurs relates with a relatively loose hip. Some ulceration of the tongue, rendering eating in about half of cats aged four years or 22 percent of the cats had radiographic and drinking quite painful. Two other older. Characterized by the loss of attach- DJD, one had hip pain and lameness, and viruses—feline leukemia virus (FeLV) and ment tissue connecting the gingiva and the two had patellar luxation. feline immunodeficiency virus (FIV)— bone supporting the teeth in the jaws, In both dogs and cats, hip dysplasia is cause immune deficiency, which can facil- periodontitis is an irreversible condition. an inherited, polygenic, developmental itate secondary infections of the mouth. When periodontal disease—either gin- condition, its clinical manifestation While these oral syndromes are well givitis or periodontitis—is present, bac- impacted by environmental factors. Ear- recognized in cats, said Dr. Harvey, teremia can result from heavy chewing, lier diagnosis of hip dysplasia can facili- research is ongoing to further delineate the brushing or dental procedures. A positive tate efforts to prevent breeding these cats prevalence and etiology of these potential- association between severity of periodon- and propagating this genetic trait, Dr. ly serious oral problems in cats, and to tal disease and likelihood of distant organ Murphy explained. “We need to make a establish the most optimal treatments and changes has been demonstrated in dogs better cat if we can.” preventive measures for them. J.C. and people. Similar studies have not yet 10