Isfm Research Roundup

Isfm publishes a monthly summary of the latest feline research which they have generously shared with CQ. In the April 2023 issue of Research Round-up includes a large study of common disorders affecting cats in the uk followed by the non-medical but important topic of caregiver burden (the strain of caring for sick pets or people).

f inally, there are two urinary papers, which answer some questions about upper urinary tract urolithiasis, and urethral obstruction and the effects of COVID-19 pandemic lockdowns. We hope you enjoy reading these interesting summaries.

Title: Commonly diagnosed disorders in domestic cats in the UK and their associations with sex and age

Authors: o’Neill DG, Gunn-moore D, Sorrell S, mcAuslan H, Church DB, Pegram C, Brodbelt DC.

Journal: Journal of Feline Medicine and Surgery 25, doi:10.1177/1098612X231155016, 2023.

Background: understanding the prevalence of disorders that occur in cats and the associated potential risk factors enables more targeted veterinary interventions and the opportunity to increase caregiver awareness, which, in turn, improves feline welfare.

Aims of the study: t his study aimed to look at the prevalence of disorders in cats in the uK and their associations with sex and age.

Methods: t he study used a random sample of primary care veterinary records from cats seen in 2019 using the VetCompass epidemiological research programme. All disorders were reported on and associations with age and sex were assessed.

Results: t he population demographics skewed slightly towards a younger (median age 5.76 years for females compared with 5.59 years for males) female (50.1%) population of cats. most (88%) were non-pedigree cats and 66% of all cats had at least one disorder reported. male and older cats had a higher proportion of disorders reported, the most common being periodontal disease (15.2%), obesity (11.6%), dental disease (8.2%), overgrown nails (8.2%), flea infestation (5.1%) and heart murmurs (4.4%). Females had a statistically higher prevalence than males of poor quality of life (QoL), postoperative wound complication, overgrooming, flea bite hypersensitivity, overgrown nail(s) and hyperthyroidism. males had a higher prevalence than females for: periodontal disease, road traffic injury (RtA), heart murmur, lameness, obesity, abscess, wound and cat bite injury. Younger cats (<8 years) had a higher prevalence than older cats for four disorders: cat bite injury, flea infestation, RtA and postoperative wound complication. older cats (¦ 8 years) had a higher prevalence of lameness, abscess, cystitis, overgrooming, dental disease, constipation, being thin/underweight, osteoarthritis, haircoat disorder, anorexia, otitis externa, vomiting, cardiac dysrhythmia, weight loss, chronic kidney disease, disorder not diagnosed, periodontal disease, poor QoL, heart murmur, flea bite hypersensitivity, obesity, overgrown nail(s) and hyperthyroidism.

Limitations of the study: t his study is uK-based and findings cannot be extrapolated to other countries due to living conditions being different (risk of RtA, cat bite injury or flea infestation, for instance, are reduced in indoor cats). In addition, this is just a sample of the data, so it might not fully represent the uK and may be biased towards cats whose owners seek out and engage in veterinary care. Neuter status was not assessed as recording systems made the data unreliable.

Relevance to clinical practice: While this study is building off previous work from this group (o’Neill et al. 2014) and not necessarily showing anything ‘new’ for vets who work in general practice, this is a larger more robust data set and provides useful data to reinforce the message of the importance of annual wellness examinations in cats to monitor their weight, perform a dental assessment and check their nails, as well as carrying out other targeted diagnostics such as biochemistry.

References

O’Neill DG, Church DB, McGreevy PD, Thomson PC, Brodbelt DC. prevalence of disorders recorded in cats attending primary-care veterinary practices in england. Veterinary Journal 202, 286–91, 2014

You can access the full article here: https://journals.sagepub. com/doi/full/10.1177/1098612X2311550

Relevance to clinical practice: Caring for sick cats has an impact on their owners. t he strains of administering medications, adjustments to lifestyle, diet and feeding and other caring tasks must be considered in chronic disease management, and as vets we need to recognise and empathise with these challenges.

References

MB Spitznagel, ASG Updegraff, MP Twohig, MD Carlson & CM Fulkerson. Reducing occupational distress in veterinary medicine personnel with acceptance and commitment training: a pilot study. New Zealand Veterinary Journal 70, 319–25, 2022

You can access the full article here: https://journals.sagepub. com/doi/full/10.1177/1098612X221145835

Title: Caregiver burden in cat owners: a cross-sectional observational study

Authors: Spitznagel mB, Gober mW and Patrick K.

Journal: Journal of Feline Medicine and Surgery 25, doi:10.1177/1098612X221145835, 2023.

Background: Caregiver burden is the strain of caring for a sick relative or pet and has been shown mainly in dogs. Some data that is available for cats suggests the burden is lower in this species, but a large group of cats and their owners have not been studied. Caregiver burden is important to understand as it can affect the human-animal bond and decisions around euthanasia.

[Note: NZVJ has published an article by this author looking at the efficacy of a programme for veterinary personnel to reduce stress, burnout and transfer of caregiver burden – see Spitznagel et al. 2022]

Aims of the study: t his study aimed to examine caregiver burden in a large group of cat owners and compare the results with dog owners in order to examine the hypothesis that owners of sick cats would exhibit lower caregiver burden than owners of sick dogs.

Methods: An online survey was used to collect data and measure caregiver burden using previously validated tools. For sick animals, the diagnosis provided by the owner was reviewed by a veterinarian to categorise the information.

Results: t he study included 1085 pet owners, including 333 owners of sick cats, 492 owners of healthy cats and 260 owners of sick dogs. unsurprisingly, owners of sick cats showed a higher burden than owners of healthy cats, but also owners of sick dogs had a higher burden than owners of sick cats.

Limitations of the study: As with all surveys, this study may have selected for motivated pet owners and it did not include owner demographics, which can affect burden.

Title: Risk factors for upper urinary tract uroliths and ureteral obstruction in cats under referral veterinary care in the United Kingdom

Authors: Geddes RF, Davison LJ, Elliott J, Syme Hm, o'Neill DG.

Journal: Journal of Veterinary Internal Medicine 37, 567–77, 2023.

Background: upper urinary tract uroliths (uutu) affecting the kidney and ureter can cause acute kidney injury and the frequency of uutu has increased significantly over the past 20 years. most utuu are calcium oxalate (Cao x), and although all uutu originate in the kidney, not all nephroliths will migrate into the ureter; risk factors for migration are unknown. Studies suggest that nephroliths may behave in a benign fashion in older cats, but in younger patients the risk of ureteral obstruction and acute kidney injury may be higher. However this has not been well studied.

Aims of the study: t his study aimed to identify risk factors associated with a diagnosis of uutu, and to examine the risks for ureteral obstruction in cats with uutu

Methods: t his was a cross-sectional study examining case records from the Royal Veterinary College referral hospital from 2009–2019. Cases were included if diagnosed with at least one urolith in the kidney or ureter on imaging. Data on various factors potentially associated with uutu, and urolith analysis results if available, were extracted.

Results: t he overall prevalence of uutu during the 10-year study period was 4.6% (521 cats). Risk factors included older age (>4 years), female sex, and being a Ragdoll, tonkinese, Persian, British Shorthair or Burmese (compared with nonpurebred). Cats with ureteral obstruction were significantly younger than non-obstructive cases and had a significantly greater proportion of ionised hypercalcaemia. Younger age (<12 years), being female and having bilateral uutu were risk factors for obstructive uutu t he younger the cat, the higher the risk of obstructive uutu (cats 0–3.9 years had 4.3 times the odds for obstructive uutu compared with cats >12 years) and cats with obstructive uutu were more likely to be eating exclusively dry food. Around half (51.8%) of cats with utuu were diagnosed with chronic kidney disease (CKD).

Limitations of the study: t his was a retrospective study, variable investigations were performed, there was limited utuu analysis (for instance, it was assumed that a urolith was Cao x, unless there was evidence otherwise) and dietary data were incomplete.

Relevance to clinical practice: Younger cats with nephrolithiasis should be monitored for the development of ureteral obstruction, as should those with hypercalcaemia, cats fed exclusively dry food, and cats with bilateral nephroliths.

Female cats, and Burmese, tonkinese, British Shorthair, Ragdoll and Persian cats are at higher risk of uutu, and affected cats are likely to have concurrent CKD.

You can access the full article here: https://onlinelibrary.wiley. com/doi/epdf/10.1111/jvim.16659

Cats with FIC may be more susceptible to stress and anxiety due to an imbalance in their sympathetic and hypothalamicpituitary-adrenal system and increased norepinephrine receptors in the bladder. t he CoVID-19 pandemic caused changes in routines, including cat caregivers being confined at home, which could have a positive or negative effect on cats.

Aims of the study: t his study aimed to identify whether the CoVID-19 pandemic and stay-at-home orders impacted the prevalence of uo patients presenting to emergency rooms.

Methods: t he number of cats with uo presenting to two hospitals [in the uSA] over 20 weeks was calculated for the initial period of stay-at-home orders in 2020. t his was compared with the same period in 2018 and 2019 to account for confounding factors such as season. Prevalence was calculated after also recording the total number of cats presenting with any illness during these periods and excluding cats with cystic calculi.

Results: t here was a significant increase in patients presenting with uo in 2020 at one institution, and both institutions combined when compared with 2018 and 2019 (from 4.0% of cases in 2019 to 5.9% in 2020). At the second institution the number of cats with uo also increased but did not reach significance.

Limitations of the study: It is possible that owners at home noticed uo and presented their cats more often and at an earlier stage. Diagnostic work-up varied between cats with uo and environmental/routine changes due to CoVID-19 restrictions likely varied between homes. o ther factors known to increase FIC risk were not assessed.

Relevance to clinical practice: If we needed any more evidence that stress can be associated with lower urinary tract disease in cats, this paper provides it. t he findings emphasise the importance of asking caregivers about changes to the cat’s environment and routine when investigating cases of uo

You can access the full article here: https://journals.sagepub. com/doi/full/10.1177/1098612X221149377 l

Title: Association between the COVID-19 global pandemic and the prevalence of cats presenting with urethral obstruction at two university veterinary emergency rooms

Authors: Finstad JB, Rozanski EA and Cooper ES.

Journal: Journal of Feline Medicine and Surgery 25, doi:10.1177/1098612X221149377, 2023

Background: urethral obstruction (uo) is a very common presentation to primary care hospitals. It is commonly idiopathic and associated with feline idiopathic cystitis (FIC).