Toceranib phosphate use in cats

Toceranib phosphate is a tyrosine kinase inhibitor licensed for the treatment of non-resectable intermediate or high grade, recurrent, cutaneous mast cell tumours in dogs.

Merrick et al¹ performed a retrospective study to assess the safety of this drug in cats. Cats being treated with concurrent chemotherapy or NSAIDs were excluded from the study.

A total of 55 cats were included in the study, 55% of which had carcinoma. Haematological side effects included thrombocytopenia in 16.3% and neutropenia in 9.1% of cases. Azotaemia and alanine aminotransferase (ALT) elevations were also seen. Gastrointestinal side effects were seen in 22% of cases.

Overall, the authors considered the drug to be well-tolerated and suggested further research to evaluate efficacy.

Muscular workload during surgery

Some veterinary surgical procedures can be physically demanding.

Kilkenny et al² performed a pilot study to assess the muscular workload during open and laparoscopic surgery.

A total of 10 veterinary students were analysed using electromyography and a workload survey, while performing simulated open surgery, multiple-port laparoscopic surgery (MLS) and single-incision laparoscopic surgery (SLS). Muscle activity was generally higher during MLS and SLS compared to open surgery, and the students found the laparoscopic techniques more physically and mentally demanding, and stressful than the open surgical technique.

Tibial metaphyseal fractures in puppies

Tibial metaphyseal fractures in puppies are encountered uncommonly in practice.

Deahl et al³ performed a retrospective review of this injury in immature dogs.

A total of 18 dogs with 22 proximal tibial metaphyseal fractures were included in the study. All of the fractures were complete and curvilinear, with 16 displaced and 15 having angulation.

All the dogs were less than six months old and small breed, most weighing less than 5kg. A jump or fall of a short distance was the most common cause of the injury.

The authors noted, although an uncommon injury, proximal tibial metaphyseal fractures can occur with minimal trauma.

Neoplastic lesions

Enlargement of abdominal lymph nodes is often noted during ultrasonographic examinations. However, it can he hard to differentiate non-neoplastic lesions; for example, reaction to gastrointestinal disease from neoplastic change.

Davé et al⁴ performed a cross-sectional retrospective study to assess whether the echogenicity of the perinodal fat could help differentiate between benign and neoplastic lesions.

A total of 257 dogs and 117 cats with ultrasonographically determined abdominal lymphadenopathy and a cytological or histological diagnosis were included in the study.

In patients with hyperechoic perinodal fat, findings associated with malignancy included a larger long axis diameter, and in cats, a greater number of abnormal nodes.

Hyperechoic perinodal fat was associated with round cell neoplasia in dogs. Reactive lymph nodes were less likely to have hyperechoic perinodal fat.

The authors concluded hyperechoic perinodal fat was a non-specific finding, but nodes with this change are less likely to be reactive, and warrant sampling for cytology and/or histological diagnosis.

Idiopathic epilepsy and structural epilepsy in cats

Differentiating idiopathic epilepsy (IE) and structural epilepsy (SE) can be challenging, especially in cats that also are more likely to have epilepsy of structural origin than idiopathic, compared to dogs.

Stanciu et al⁵ performed a statistical study to ascertain which clinical features help distinguish IE from SE. A total of 110 cats were included in the study, 57% of which had IE and 43% SE.

Salivation during a seizure was found to be associated with IE, whereas abnormal interictal neurological examinations, vocalisation during a seizure and age greater than seven were associated with increased likelihood of SE.

Pedigree cats were 5.5 times more likely to have SE compared to non-pedigree cats.

IV bag contamination

Nosocomial infection related to IV fluid therapy can occur due to issues with sterility of the IV cannula, the giving set or the fluid itself.

Guillaumin et al⁶ performed an experimental study to assess the bacterial contamination of fluid and ports of IV fluid bags in an intensive care unit (ICU) and a veterinary emergency room (ER). Bags were hung in two locations at the ER and one in ICU for 11 days. The bags had a sterile needle inserted into them three times daily.

The fluid and swabs from the injection ports were cultured. No contamination was found between days zero and two, but contamination began between days two and four, and injection port contamination had reached 31% by day seven.

Contamination was more likely to occur when the bag was hung near a sink.

Anaphylaxis and sepsis

Anaphylaxis and sepsis are both acute, life-threatening conditions that can present with similar clinical signs, but require different treatment.

Walters et al⁷ performed a retrospective case-case study that compared 10 dogs with suspected anaphylaxis to 22 dogs with confirmed sepsis and systemic inflammatory response syndrome. Both groups of dogs had lethargy, depression, gastrointestinal signs and bleeding disorders.

Dogs in both groups also had free intracavitary fluid, thickened gall bladder walls and thickened, gas-filled or fluid-filled intestines. However, dogs with suspected anaphylaxis had higher eosinophil and ALT levels, and lower blood pH than dogs with sepsis, while the septic dogs had higher band neutrophils, globulins, and alkaline phosphatase and lower glucose levels.

The authors noted findings for anaphylaxis and sepsis were similar, and anaphylaxis should be considered if a septic focus can not be identified.