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Biomedical subjects

J M Kruger

Publications and source records attributed to J M Kruger.

At least 37 records · Page 2Linked to original sources

Cystocentesis. Diagnostic and therapeutic considerations.

The diagnostic and therapeutic value of cystocentesis has been recognized for over 80 years. In feline patients with nonobtrusive lower urinary tract diseases (LUTD), normal patients, or patients with nonurinary disorders, diagnostic cystocentesis circumvents many of the potential problems associated with collection of urine specimens by normal micturition, manual compression of the urinary bladder, or catheterization. In patients with obstructive LUTDs, therapeutic cystocentesis temporarily halts the adverse effects of obstructive uropathy and may provide additional time to remove or bypass the obstructive lesion. In our experience, cystocentesis has been associated with few significant side effects; however, it may induce mild transient microscopic hematuria which may be indistinguishable from pathologic hematuria associated with many naturally occurring feline LUTDs.

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Biologic behavior of feline lower urinary tract diseases.

This case represents the typical presentation and natural progression of idiopathic lower urinary tract disease in cats. As depicted, it generally occurs in young cats. Cats often have evidence of hematuria with minimal or no leukocyturia. In this cat, clinical signs and hematuria subsided in 3 days. Tristan was evaluated monthly for 1 year. During this period, a recurrence of clinical signs or hematuria did not occur.

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Feline urethral plugs. Etiology and pathophysiology.

Feline urethral plugs commonly are composed of large quantities of matrix mixed with minerals (especially struvite). However, some urethral plugs are composed primarily of matrix, some consist of sloughed tissue, blood, and/or inflammatory reactants, and a few are composed primarily of aggregates of crystalline minerals. The formation of matrix-crystalline urethral plugs may be analogous to the preparation of fruit jello.

Animals↗

Inherited and congenital diseases of the feline lower urinary tract.

Congenital urinary tract disorders of young cats may result from heritable (genetic) or acquired disease processes that affect differentiation and growth of the developing urinary tract, or from similar disease processes that eventually affect the structure or function of the mature urinary system. Although congenital diseases of the feline lower urinary tract are uncommon, clinical signs associated with these anomalies may be indistinguishable from those of other acquired causes of lower urinary tract disease. Early detection and proper management of congenital disorders may result in restoration of urinary bladder and urethral function and/or progressive urinary tract dysfunction.

Animals↗

A feline herpesvirus-1 recombinant with a deletion in the genes for glycoproteins gI and gE is effective as a vaccine for feline rhinotracheitis.

Using a site-directed mutagenesis technique we constructed a new feline herpesvirus-1 recombinant strain containing a deletion in two genes encoding glycoproteins gI and gE. These proteins may have a role in virulence, the establishment of latency, and viral recurrence as shown in other herpesviruses of the varicella and simplex types. This recombinant was characterized and used to immunize juvenile cats against virulent virus challenge. Significant protection resulted from vaccination of cats by the subcutaneous route.

Alphaherpesvirinae↗

Acute onset of hypokalemia and muscular weakness in four hyperthyroid cats.

Sudden onset of muscular weakness and ventroflexion of the neck were identified in 4 hyperthyroid cats. In each cat, the onset of clinical signs was associated with an acute decrease in serum potassium concentration. The cause for hypokalemia was undetermined, but could have resulted from deficits in total body potassium content or shifts of potassium from the extracellular space into the intracellular space. The 4 cats responded to administration of potassium. Hyperthyroid cats may be prone to disturbances in potassium homeostasis. Clinicians should be aware of potential changes in potassium homeostasis during the treatment of cats with hyperthyroidism.

Acute Disease↗

Changes in renal function associated with treatment of hyperthyroidism in cats.

We measured glomerular filtration rate (GFR) estimated by plasma disappearance of 99mTc-labeled diethylenetriaminepentaacetic acid, serum concentrations of thyroxine (T4), creatinine, and urea nitrogen, and urine specific gravity in 13 cats with naturally acquired hyperthyroidism before and 30 days after treatment by bilateral thyroidectomy, and in a group of 11 control cats. Mean (+/- SD) serum T4 concentration decreased from a pretreatment value of 120.46 (+/- 39.21) nmol/L to a posttreatment value of 12.15 (+/- 6.26) nmol/L (P < 0.0001; reference range, 10 to 48 nmol/L). Treatment of hyperthyroidism resulted in a decrease in mean (+/- SD) glomerular filtration rate, from 2.51 (+/- 0.69) ml/kg of body weight/min to a posttreatment value of 1.40 (+/- 0.41) ml/kg/min (P < 0.0001). Mean serum creatinine concentration increased from 1.26 (+/- 0.34) mg/dl to 2.05 (+/- 0.60) mg/dl (P < 0.01). Mean serum urea nitrogen concentration increased from 26.62 (+/- 6.83) mg/dl to a mean postthyroidectomy concentration of 34.92 (+/- 8.95) mg/dl (P < 0.01). All changes were significant. Two cats developed overt renal azotemia after treatment of hyperthyroidism. Our results provide further evidence that treatment of hyperthyroidism can result in impaired renal function. In addition, our results suggest that, in some instances, thyrotoxicosis might mask underlying chronic renal insufficiency.

Animals↗

Lymphocytic/plasmacytic colitis in cats: 14 cases (1985-1990).

Lymphocytic/plasmacytic colitis was diagnosed in 14 cats during a 5-year period. Purebred cats were affected significantly (P < 0.001) more often than were nonpurebred cats. Six cats were male and 8 were female. Mean age at onset of clinical signs was 5.1 years (range, 0.5 to 9 years). Hematochezia, observed in 13 cats, was the most commonly reported sign; diarrhea was reported in 11 cats. Mildly high serum alanine transaminase activity and hypokalemia were frequent biochemical abnormalities. Campylobacter sp was cultured from the feces of 1 cat. On endoscopic examination, petechia and hyperemia of the colonic mucosa were detected in 7 of 8 cats. Cats were initially treated with dietary management alone or with a combination of dietary and pharmacologic management. Clinical signs in 7 of 11 treated cats completely resolved, whereas signs in 3 cats were considered improved. One cat was euthanatized when an inadequate response to treatment was observed. Most cats were eventually maintained on dietary management alone.

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The role of uropathogens in feline lower urinary tract disease. Clinical implications.

Bacterial, fungal, and parasitic uropathogens have small but significant roles as causative agents in naturally occurring feline lower urinary tract disease. However, the exact cause of hematuria, dysuria, and/or urethral obstruction remains unknown in a large percentage of cats. Feline calicivirus, feline syncytia-forming virus, bovine herpesvirus-4, mycoplasmas, and ureaplasmas are potential uropathogens whose etiopathogenic roles in idiopathic feline lower urinary tract disease remain, as of yet, unresolved.

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Lymphocytic/plasmacytic gastroenteritis in cats: 14 cases (1985-1990).

Over a 5-year period, lymphocytic/plasmacytic gastroenteritis was diagnosed in 14 cats. Purebred cats were affected significantly (P less than 0.025) more often than nonpurebred cats. Mean age at onset of clinical signs was 6.8 years (range, 1 to 13 years); 11 cats were male. Vomiting and weight loss, each reported in 10 of 14 cats, were the most common clinical signs. Diarrhea was reported in 7 of 14 cats. Alopecia was found in 4 of 14 cats. High hepatic enzyme activities and low plasma protein concentrations were frequent biochemical findings. Hyperemia, hemorrhage, and a roughened or "cobblestone" mucosa were visualized by endoscopy in only 2 of 8 cats with duodenal disease and in 2 of 5 cats with gastric disease. Lymphocytic/plasmacytic inflammation was detected in biopsy specimens from the stomach or duodenum or both in all cats; the duodenum was affected most commonly. Degree of inflammation frequently varied among gastric, duodenal, and colonic specimens from the same cat. Glucocorticoid treatment and dietary management adequately controlled clinical signs in 7 cats, but treatment was ineffective in 6 cats, 5 of which were euthanatized because of severity of clinical signs.

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Clinical evaluation of cats with lower urinary tract disease.

In a prospective study, 141 cats with hematuria, dysuria, urethral obstruction, or combinations of these signs were evaluated by contemporary diagnostic methods and compared with 26 clinically normal cats (controls). Specific diagnosis was established in 45% (64/141) of cats affected with lower urinary tract disease (LUTD). Crystalline matrix plug-induced urethral obstruction was diagnosed in 21% (30/141) of affected cats, uroliths were identified in 21% (30/141) of affected cats, uroliths with concomitant bacterial urinary tract infection (UTI) were identified in less than 2% (2/141) of affected cats, and bacterial UTI alone was identified in less than 2% (2/141) of cats with LUTD. Viruses, mycoplasmas, and ureaplasmas were not isolated from urine samples collected from affected or control cats. Bovine herpesvirus 4 (BHV-4)-neutralizing antibodies were not detected in any serum sample obtained from cats with LUTD or from control cats. In contrast, BHV-4 antibodies were detected by an indirect immunofluorescent antibody (IFA) test in sera obtained from 31% (44/141) of cats with LUTD and 23% (6/26) of control cats. The prevalence of positive BHV-4 IFA test results in affected cats was not significantly different from that observed in control cats. Significant association was not apparent between positive BHV-4 IFA test results and clinical diagnosis, abnormal laboratory findings, or cat age. However, the number of male cats with BHV-4 IFA titer was significantly (P less than 0.02, chi 2 test) greater than that of female cats. Detection of BHV-4 antibodies in approximately 30% of affected and control cats indicates prior virus exposure. Further investigations are warranted to clarify the specific role of BHV-4 in cats with naturally acquired LUTD.

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Medical dissolution of feline struvite urocystoliths.

The efficacy of a diet designed to facilitate dissolution of feline magnesium ammonium phosphate (struvite) uroliths was evaluated in 30 cases of urolithiasis, sterile struvite uroliths dissolved in a mean of 36 days after initiation of dietary treatment. In 5 cases of urolithiasis, struvite urocystoliths associated with urease-negative bacterial urinary tract infection dissolved in a mean of 23 days after initiation of dietary and antimicrobial treatment. In 3 cases of urolithiasis, struvite urocystoliths associated with urease-positive staphylococcal urinary tract infection dissolved in a mean of 79 days after initiation of dietary and antimicrobial treatment. Dissolution of uroliths in cats fed the treatment diet was associated with concomitant remission of dysuria, hematuria, and pyuria, and reduction in urine pH and struvite crystalluria. In one case, a urocystolith composed of 100% ammonium urate, and in another case, a urolith composed of 60% calcium phosphate, 20% calcium oxalate, and 20% magnesium ammonium phosphate did not dissolve.

Amoxicillin↗

Clinicopathologic analysis of herpesvirus-induced urinary tract infection in specific-pathogen-free cats given methylprednisolone.

The clinicopathologic manifestations of bovid herpesvirus-4 (BHV-4; FCAHV strain)-induced infection of the lower portion of the urinary tract were characterized in 12 adult neutered male and 6 female specific-pathogen-free cats, and were compared with those in 12 neutered male control cats. Six neutered male and 6 female cats were given immunosuppressive doses of methylprednisolone acetate prior to inoculation of their urinary bladders with BHV-4. Six neutered male control cats were given immunosuppressive doses of methylprednisolone acetate prior to inoculation of their urinary bladders with uninfected tissue culture control inoculum. Six additional neutered male control cats were exposed only to uninfected tissue culture control inoculum. All cats were observed for 90 days following inoculation. Dysuria and gross hematuria were observed in only 1 BHV-4-exposed cat. Radiographic abnormalities of the lower portion of the urinary tract were not observed. Microscopic hematuria, crystalluria, and lipiduria were identified with similar frequency in BHV-4-exposed and control cats. Results of urine culturing for bacteria, mycoplasma, ureaplasma, and viruses were negative. Viruses were not isolated from blood leukocytes collected from exposed or control cats. Three to 6 weeks after inoculation, high concentrations of BHV-4 serum antibodies were detected in all exposed cats by an indirect fluorescent antibody test. Light microscopic examination of the urinary tract revealed multifocal lymphoid cystitis in 2 BHV-4-exposed cats. Except for suppurative bronchitis in 1 BHV-4-exposed cat given glucocorticoids, morphologic differences in urinary and extraurinary tissues were not observed. In urinary bladder tissue collected 90 days after inoculation, BHV-4 was reisolated from urinary bladder explants of all but 1 exposed cat. Virus was also isolated from a kidney explant of 1 exposed male cat, and spleen cell co-cultures of 1 exposed female cat given glucocorticoids.(ABSTRACT TRUNCATED AT 250 WORDS)

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Clinicopathologic and pathologic findings of herpesvirus-induced urinary tract infection in conventionally reared cats.

Clinicopathologic manifestations of induced infection of the feline lower urinary tract with bovid herpesvirus-4 (BHV-4, strain FCAHV) were characterized in 6 conventionally reared adult cats (2 sexually intact males, 2 castrated males, and 2 females). Two additional control cats were exposed with noninfected cell culture control inoculum. Clinical and radiographic signs of lower urinary tract disease were not observed in exposed or control cats. Microscopic hematuria was detected in urine samples collected by cystocentesis from 4 to 6 exposed cats and 1 of 2 control cats. Results of culture of urine for bacteria, mycoplasmas, ureaplasmas, and viruses were consistently negative. Low titer of serum BHV-4 (strain FCAHV)-neutralizing antibodies was detected in 4 of 6 exposed cats, but not in controls. Gross abnormalities of the urinary tract were not observed in any cat. Light microscopic examination of serial sections of the lower urinary tract revealed mild focal lymphoid cystitis in 2 of 6 exposed cats, one of which also had increased amounts of connective tissue and proliferation of blood vessels in the urinary bladder lamina propria. Ninety days after initial exposure, BHV-4 (strain FCAHV) was reisolated from explanted urinary bladder tissues of 5 of 6 exposed cats. Virus was not isolated from tissues of control cats. It was concluded that BHV-4 (strain FCAHV) establishes persistent urinary tract infection in conventionally reared adult male and female cats. However, persistent BHV-4 infection in cats may remain clinically inapparent.

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Relationship of nutritional factors to the cause, dissolution, and prevention of feline uroliths and urethral plugs.

Feline lower urinary tract disease is often associated with uroliths and urethral plugs. Uroliths and urethral plugs are composed of variable quantities of matrix and a variety of minerals (including struvite, calcium oxalate, ammonium urate, calcium phosphate, and cystine). Knowledge of nutritional factors associated with the pathophysiology of uroliths and urethral plugs facilitates the modification of diets for the dissolution of several minerals contained within them.

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Genetic and serologic analysis of feline cell-associated herpesvirus-induced infection of the urinary tract in conventionally reared cats.

The genetic and antigenic nature of feline cell-associated herpesvirus (FeCAHV) was characterized by use of DNA restriction endonuclease analysis, and direct and indirect fluorescent antibody (FA) techniques. Serologic responses of 6 conventionally reared cats with induced FeCAHV urinary tract infection were retrospectively evaluated, using an indirect FA test. The EcoRI, HindIII, and Pst I restriction endonuclease cleavage patterns of FeCAHV DNA were similar to those of bovid herpesvirus 4 (BHV-4; DN599 strain) DNA. Specific fluorescence was observed when FeCAHV-inoculated cell monolayers were reacted with fluorescein-conjugated BHV-4 (DN599 strain) antiserum. Conversely, specific fluorescence was also observed when feline anti-FeCAHV serum and fluorescein-conjugated caprine anti-feline IgG was reacted with BHV-4 (DN599 strain)-infected cell monolayers. At postinoculation week 10, serum antibody titer in cats with FeCAHV-induced urinary tract infection ranged from 1:2,560 to 1:10,240, as measured by use of indirect FA testing. It was concluded that FeCAHV is a member of the BHV-4 group. In addition, the FeCAHV indirect FA test provides a sensitive and specific means of evaluating FeCAHV antibody concentration in exposed cats.

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Etiopathogenesis and biological behavior of feline vesicourachal diverticula. Don't just do something--stand there.

Asymptomatic microscopic urachal remnants located at the vertex of the urinary bladder are common in cats. Because they reduce the tensile strength of the bladder wall at this location, they represent risk factors for development of acquired macroscopic diverticula in cats with lower urinary tract disorders. Elimination of the underlying cause of lower urinary tract disease is frequently associated with resolution of acquired macroscopic vesicourachal diverticula.

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