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ObjectiveAfter the 2012 Reassessment Campaign on Veterinary Resuscitation (RECOVER) CPR Guidelines, this is an update of evidence-based consensus guidelines for Basic Life Support (BLS), advanced life support (ALS), and periarrest monitoring.DesignThese RECOVER CPR Guidelines were generated using a modified version of the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system for evidence evaluation and translation of this evidence into clear and actionable clinical instructions. Prioritized clinical questions in the Population, Intervention, Comparator, and Outcome (PICO) format were used as the basis to conduct systematic literature searches by information specialists, to extract information from relevant publications, to assess this evidence for quality, and finally to translate the findings into treatment recommendations. These recommendations were reviewed by the RECOVER writing group and opened for comment by veterinary professionals for 4 weeks.SettingTransdisciplinary, international collaboration in university, specialty, and emergency practice.ResultsA total of 40 worksheets were prepared to evaluate questions across the 3 domains of BLS, ALS and Monitoring, resulting in 90 individual treatment recommendations. High-dose epinephrine is no longer recommended, and atropine, if used, is only administered once. Bag-mask ventilation is prioritized over mouth-to-nose ventilation in nonintubated animals. In addition, an algorithm for initial assessment, an updated CPR algorithm, a rhythm diagnosis tool, and an updated drug dosing table are provided.ConclusionsWhile the majority of the BLS and ALS recommendations remain unchanged, some noteworthy changes were made due to new evidence that emerged over the past 10 years. Indirectness of evidence remains the largest impediment to the certainty of guidelines formulation and underscores an urgent need for more studies in the target species of dogs and cats.

ObjectiveTo systematically review evidence and devise treatment recommendations for basic life support (BLS) in dogs and cats and to identify critical knowledge gaps.DesignStandardized, systematic evaluation of literature pertinent to BLS following Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. Prioritized questions were each reviewed by 2 Evidence Evaluators, and findings were reconciled by BLS Domain Chairs and Reassessment Campaign on Veterinary Resuscitation (RECOVER) Co-Chairs to arrive at treatment recommendations commensurate to quality of evidence, risk to benefit relationship, and clinical feasibility. This process was implemented using an Evidence Profile Worksheet for each question that included an introduction, consensus on science, treatment recommendations, justification for these recommendations, and important knowledge gaps. A draft of these worksheets was distributed to veterinary professionals for comment for 4 weeks prior to finalization.SettingTransdisciplinary, international collaboration in university, specialty, and emergency practice.ResultsTwenty questions regarding animal position, chest compression point and technique, ventilation strategies, as well as the duration of CPR cycles and chest compression pauses were examined, and 32 treatment recommendations were formulated. Out of these, 25 addressed chest compressions and 7 informed ventilation during CPR. The recommendations were founded predominantly on very low quality of evidence and expert opinion. These new treatment recommendations continue to emphasize the critical importance of high-quality, uninterrupted chest compressions, with a modification suggested for the chest compression technique in wide-chested dogs. When intubation is not possible, bag-mask ventilation using a tight-fitting facemask with oxygen supplementation is recommended rather than mouth-to-nose ventilation.ConclusionsThese updated RECOVER BLS treatment recommendations emphasize continuous chest compressions, conformation-specific chest compression techniques, and ventilation for all animals. Very low quality of evidence due to absence of clinical data in dogs and cats consistently compromised the certainty of recommendations, emphasizing the need for more veterinary research in this area.

ObjectiveTo systematically review the evidence and devise clinical recommendations on advanced life support (ALS) in dogs and cats and to identify critical knowledge gaps.DesignStandardized, systematic evaluation of literature pertinent to ALS following Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. Prioritized questions were each reviewed by Evidence Evaluators, and findings were reconciled by ALS Domain Chairs and Reassessment Campaign on Veterinary Resuscitation (RECOVER) Co-Chairs to arrive at treatment recommendations commensurate to quality of evidence, risk:benefit relationship, and clinical feasibility. This process was implemented using an Evidence Profile Worksheet for each question that included an introduction, consensus on science, treatment recommendations, justification for these recommendations, and important knowledge gaps. A draft of these worksheets was distributed to veterinary professionals for comment for 4 weeks prior to finalization.SettingTransdisciplinary, international collaboration in university, specialty, and emergency practice.ResultsSeventeen questions pertaining to vascular access, vasopressors in shockable and nonshockable rhythms, anticholinergics, defibrillation, antiarrhythmics, and adjunct drug therapy as well as open-chest CPR were reviewed. Of the 33 treatment recommendations formulated, 6 recommendations addressed the management of patients with nonshockable arrest rhythms, 10 addressed shockable rhythms, and 6 provided guidance on open-chest CPR. We recommend against high-dose epinephrine even after prolonged CPR and suggest that atropine, when indicated, is used only once. In animals with a shockable rhythm in which initial defibrillation was unsuccessful, we recommend doubling the defibrillator dose once and suggest vasopressin (or epinephrine if vasopressin is not available), esmolol, lidocaine in dogs, and/or amiodarone in cats.ConclusionsThese updated RECOVER ALS guidelines clarify the approach to refractory shockable rhythms and prolonged CPR. Very low quality of evidence due to absence of clinical data in dogs and cats continues to compromise the certainty with which recommendations can be made.

BackgroundGlanzmann's thrombasthenia (GT) is a congenital platelet disorder affecting approximately 1:1 000 000 people globally and characterized by impaired platelet aggregation and clot retraction. Autosomal recessive, loss-of-function, variants in ITGA2B or ITGB3 of the αIIbβ3 receptor cause the disease in humans. A cat affected by Glanzmann's and macrothrombocytopenia was presented to the UC Davis VMTH.Hypothesis/objectivesSevere thrombopathia in this cat has an underlying genetic etiology.AnimalsA single affected patient, 2 age-matched clinically healthy controls, and a geriatric population (n = 20) of normal cats.MethodsPhysical examination and clinical pathology tests were performed on the patient. Flow cytometry and platelet aggregometry analyses for patient phenotyping were performed. Patient and validation cohort gDNA samples were extracted for Sanger sequencing of a previously identified ITGA2B (c.1986delC) variant. Reverse transcriptase PCR was performed on patient and healthy control PRP samples to verify ITGA2B variant consequence.ResultsA novel c.1986_1987insCC autosomal recessive variant in ITGA2B was identified. This variant was absent in a population of 194 unrelated cats spanning 44 different breeds. Complete loss of ITGA2B transcript and protein expression was verified by RT-PCR and flow cytometry, explaining the underlying etiology of GT, and likely macrothrombocytopenia, in this cat.Conclusions and clinical importanceThis study emphasizes the role of precision medicine in cardiovascular disease of cats and identified yet another variant that may be of utility for screening in the feline population. This study provides a small-volume, standardized, successful protocol for adequate platelet RNA isolation and subsequent molecular assessment of gene expression in cats.

ObjectiveExtracellular vesicles (EVs) derived from mesenchymal stromal cells (MSCs) are promising avenues in regenerative medicine, offering unique immunomodulatory and regenerative properties with lower immunogenicity. This study delves into the distinctive features of EVs extracted from feline adipose-derived MSCs (ASCs) and placenta-derived MSCs (PMSCs). The tissues were collected from 11 female cats aged between 4 and 7 years old.SampleEVs extracted from MSCs from discarded fetal membranes from 7 female cats and SC adipose tissue from 11 cats.MethodsWe comprehensively explored morphological characteristics, mitochondrial density, surface markers, and pro- and anti-inflammatory mediators, uncovering notable differences between ASCs and PMSCs.ResultsMorphologically, ASCs exhibit a spindle-shaped form in contrast to the spherical morphology of PMSCs. Proliferation and clonogenic potential assessments reveal the faster proliferation and robust clonogenic nature of ASCs, suggesting their potential vital role in regenerative processes. Surface marker expression analysis indicates a significantly higher expression of multipotency-associated markers in ASCs, suggesting their superior proregenerative potential. Phenotyping of EVs demonstrates distinctive features, with CD9 expression suggesting varied EV secretion patterns. Notably, PMSCs exhibit superior CD81 expression, indicating their potential as preferred donors of mitochondria. Pro- and anti-inflammatory mediators analyzed at mRNA and microRNA levels reveal higher RNA content in EVs compared to source cells, emphasizing the potential of EVs in directing regenerative processes. Differential microRNA expression in EVs derived from ASCs hints at their regulatory roles in anti-inflammatory and immunometabolic processes.Clinical relevanceThis study lays a foundation for understanding the nuances between ASCs and PMSCs, which is crucial for harnessing the full therapeutic potential of MSCs and their EVs in tissue repair and regeneration.

While shifts in gut microbiota have been studied in diseased states, the temporal variability of the microbiome in cats has not been widely studied. This study investigated the temporal variability of the feline dysbiosis index (DI) and the abundance of core bacterial groups in healthy adult cats. The secondary aim was to evaluate the relationship between the fecal abundance of Clostridium hiranonis and the fecal concentrations of unconjugated bile acids. A total of 142 fecal samples collected from 17 healthy cats were prospectively included: nine cats with weekly collection over 3 weeks (at least four time points), five cats with monthly collection over 2 months (three time points), and three cats with additional collections for up to 10 months. The DI remained stable within the reference intervals over two months for all cats (Friedman test, p > 0.2), and 100% of the DI values (n = 142) collected throughout the study period remained within the RI. While some temporal individual variation was observed for individual taxa, the magnitude was minimal compared to cats with chronic enteropathy and antibiotic exposure. Additionally, the abundance of Clostridium hiranonis was significantly correlated with the percentage of fecal primary bile acids, supporting its role as a bile acid converter in cats.

Feline infectious peritonitis (FIP) is a multisystemic, generally lethal immuno-inflammatory disease of domestic cats caused by an infection with a genetic variant of feline coronavirus, referred to as the FIP virus (FIPV). We leveraged data from four different antiviral clinical trials performed at the University of California, Davis. Collectively, a total of 60 client-owned domestic cats, each with a confirmed diagnosis of naturally occurring FIP, were treated with a variety of antiviral compounds. The tested therapies included the antiviral compounds GS-441524, remdesivir, molnupiravir and allogeneic feline mesenchymal stem/stroma cell transfusions. Four client-owned cats with FIP did not meet the inclusion criteria for the trials and were not treated with antiviral therapies; these cats were included in the data set as untreated FIP control cats. ELISA and Western blot assays were performed using feline serum/plasma or ascites effusions obtained from a subset of the FIP cats. Normalized tissue/effusion viral loads were determined in 34 cats by a quantitative RT-PCR of nucleic acids isolated from either effusions or abdominal lymph node tissue. Twenty-one cats were PCR "serotyped" (genotyped) and had the S1/S2 region of the coronaviral spike gene amplified, cloned and sequenced from effusions or abdominal lymph node tissue. In total, 3 untreated control cats and 14 (23.3%) of the 60 antiviral-treated cats died or were euthanized during (13) or after the completion of (1) antiviral treatment. Of these 17 cats, 13 had complete necropsies performed (10 cats treated with antivirals and 3 untreated control cats). We found that anticoronaviral serologic responses were persistent and robust throughout the treatment period, primarily the IgG isotype, and focused on the viral structural Nucleocapsid and Membrane proteins. Coronavirus serologic patterns were similar for the effusions and serum/plasma of cats with FIP and in cats entering remission or that died. Viral RNA was readily detectable in the majority of the cats in either abdominal lymph node tissue or ascites effusions, and all of the viral isolates were determined to be serotype I FIPV. Viral nucleic acids in cats treated with antiviral compounds became undetectable in ascites or abdominal lymph node tissue by 11 days post-treatment using a sensitive quantitative RT-PCR assay. The most common pathologic lesions identified in the necropsied cats were hepatitis, abdominal effusion (ascites), serositis, pancreatitis, lymphadenitis, icterus and perivasculitis. In cats treated with antiviral compounds, gross and histological lesions characteristic of FIP persisted for several weeks, while the viral antigen became progressively less detectable.

Background Key Findings Conclusions There is little information on the prevalence of auscultatory abnormalities in anemic cats. This study aimed to describe the prevalence of cardiac murmurs and gallop sounds in a population of anemic and nonanemic cats presenting to an emergency room (ER) and to assess whether the prevalence of auscultatory abnormalities was influenced by the severity of anemia.Records of cats presenting to an ER between May 2021 and May 2022 or receiving a blood transfusion between September 2019 and January 2022 were retrospectively analyzed for presence of a murmur or gallop sound. Cats with known structural heart disease were excluded. A murmur was found in 56 of 185 (30%) anemic cats compared with 11 of 102 (11%) nonanemic cats (p < 0.001), with a higher proportion in cats with PCV <16% (p < 0.001). Twenty‐five of 185 (14%) anemic cats had a gallop compared with 4 of 102 (4%) nonanemic cats (p = 0.009), with the highest proportion in cats with PCV 11%–20% (p < 0.001). Echocardiography was performed on 17 of 185 anemic cats; 8 had normal echocardiograms and 9 demonstrated evidence of chamber dilation without left ventricular wall thickening, consistent with anemia.Abnormalities on auscultation are common in anemic cats presenting to the ER, with a higher prevalence in more severely anemic cats. [ABSTRACT FROM AUTHOR]

Background Objectives Animals Methods Results Conclusions and Clinical Importance Obesity is a risk factor for diabetes mellitus, which commonly coexists with pancreatitis in cats. However, obesity has not previously been associated with pancreatitis in cats.To evaluate factors affecting serum concentrations of pancreatic lipase immunoreactivity (fPLI), trypsin‐like immunoreactivity (fTLI), cobalamin and folate in clinically healthy lean, overweight and obese, or diabetic cats.Seventy‐nine client‐owned cats (27 healthy lean [LN, BCS 4‐5/9], 30 healthy overweight and obese [OW, BCS 7‐9/9], and 22 diabetic [DM]) were included.Cross‐sectional study. The cats underwent physical examination, and blood tests. Linear regression models compared differences in fPLI, fTLI, cobalamin, and folate concentrations. Fisher's exact test assessed the proportions of cats with fPLI and fTLI indicative of pancreatitis, and hypocobalaminemia. A random forest algorithm identified explanatory variables for cats having fPLI levels indicative of pancreatitis.No LN cats, while 6/30 (20%) of OW and 10/22 (45%) of DM cats had fPLI concentrations indicative of pancreatitis. Body condition score (P = .02) and body weight (P = .002) were positively associated with fPLI levels in LN and OW cats. Higher fPLI, and lower cobalamin concentrations were associated with higher age across groups.Body condition score and body weight were associated with higher fPLI levels in nondiabetic cats. A larger proportion of OW and DM cats had fPLI concentrations indicative of pancreatitis compared to LN cats. Whether this indicates subclinical pancreatitis remains to be determined. Hypocobalaminemia was less frequent in OW compared to DM cats. [ABSTRACT FROM AUTHOR]

Objective: The objective of this case series is to describe the indications, methodology, and short-term outcomes of three cats with severe azotemia managed with pleural dialysis. Case summary: Three cats were presented separately to the emergency room (ER) on referral for severe azotemia of varying etiologies. Despite aggressive medical and/or surgical management, none of the cats showed improvement in their blood urea nitrogen (BUN) or creatinine values. Renal replacement therapy was recommended, but for varying reasons, the patients were unable to undergo a traditional extracorporeal method, such as intermittent hemodialysis (IDH). Instead, pleural dialysis was performed, and all three cats showed improvement in their renal values during and after their treatment. No significant complications were documented as a result of pleural dialysis. Two of the three cats were discharged from the hospital and the third cat was humanely euthanized due to poor prognosis. New or unique information provided: Pleural dialysis is a novel therapeutic procedure that is not documented in veterinary or human literature. This method of renal replacement therapy was well-tolerated and had no reported complications. Careful case selection and risk-benefit analysis should be considered before attempting this procedure. Further studies are necessary to further define the utility of this therapeutic intervention, evaluate the incidence of complications, and determine long term outcomes following the procedure. [ABSTRACT FROM AUTHOR]

OBJECTIVE To assess the perioperative analgesic effects of bilateral ultrasound (US)-guided quadratus lumborum block (QLB) using low-volume (LV) or high-volume (HV) bupivacaine, compared to a control group, in cats undergoing ovariectomy. ANIMALS 48 healthy female cats. METHODS Cats were sedated with IM dexmedetomidine (5 µg/kg), ketamine (1 mg/kg), and methadone (0.2 mg/kg) followed by IV propofol induction and isoflurane maintenance. Cats were randomly assigned to 3 groups of 16 patients each: QLB-LV group (0.3 mL/kg/side), QLB-HV group (0.5 mL/kg/side), and control group (no QLB). Bilateral, in-plane, US-guided QLB was performed with lateral approach at the L2 transverse process with bupivacaine 0.2%. Physiological variables were recorded intraoperatively by a masked investigator. If intraoperative nociception occurred, fentanyl (1 µg/kg) was administered IV. Rescue postoperative analgesia (buprenorphine, 0.2 mg/kg) was administered in case of a Feline Grimace Scale score ≥4 after a 4-hour evaluation period. RESULTS In the control group, heart rate (HR) was higher than the QLB-LV group during the first ovarian manipulation (P < .001) and higher than the QLB-HV group during both ovarian manipulations (P < .001 and P = .006). The need for intraoperative rescue analgesia and postoperative pain scores were significantly higher in the QLB-LV (P = .005 and P = .047) and control (P < .001 and P < .001) groups compared to the QLB-HV group. Buprenorphine was administered once in the control group. No clinical signs of bupivacaine toxicity or QLB complications were observed. CLINICAL RELEVANCE Bilateral US-guided QLB-HV may effectively provide perioperative analgesia in feline patients undergoing ovariectomy. [ABSTRACT FROM AUTHOR]

Background: Limited information is available on electrolyte abnormalities in cats with chronic inflammatory enteropathy (CIE). Hypothesis/Objectives: Report the prevalence of electrolyte abnormalities in cats with CIE compared to other gastrointestinal disorders, and determine their association with disease and outcome variables in cats with CIE. Animals: Three hundred twenty‐eight client‐owned cats from 2 referral hospitals: CIE (132), alimentary small cell lymphoma (29), acute gastroenteritis (48), and healthy controls (119). Methods: Retrospective study comparing serum electrolyte concentrations at time of diagnosis among the 4 groups of cats, and associations with clinical signs, intestinal mucosal fibrosis scores, treatment subclassification and outcome in CIE. Results: Cats with CIE had lower sodium and higher potassium concentrations and lower sodium: potassium ratios compared with healthy cats (P <.001, P =.01, and P <.001, respectively). Cats with CIE and a duodenal mucosal fibrosis score of 2 had lower sodium and lower total calcium concentrations compared with cats that had a score of 0 (P =.02 and P =.01). Cats with CIE and a colonic mucosal fibrosis score of 1 had higher potassium concentrations and lower sodium: potassium ratios compared with cats that had a score of 0 (P =.03 and P =.01). Cats with CIE that died as a result of their disease had higher potassium concentrations and lower sodium: potassium ratios compared to cats that were alive (P =.02 and P =.01). Conclusions and Clinical Importance: Electrolyte abnormalities occur with CIE and, in particular, in cats with higher fibrosis scores and worse outcomes. Further research should aim to determine the pathogenesis of these findings and identify novel therapeutic targets for cats with CIE. [ABSTRACT FROM AUTHOR]

Background: Gabapentin is often administered PO for preappointment or in‐hospital anxiolysis in cats. A previous study reported mild changes on the neurologic examination after administration. Objectives: Investigate the effects of gabapentin on anxiety, sedation, compliance, and neurologic examination in 2 age groups of cats. Animals: Thirty‐one young cats and 12 geriatric cats perceived by their owners to be healthy and neurologically normal. Methods: Prospective double‐blinded clinical crossover study. Assessment of baseline sedation and anxiety was performed before initial neurologic examinations and after gabapentin administration (100 mg/cat). Assessments were repeated 90 to 120 minutes after administration. Ease of handling pregabapentin and postgabapentin was assessed in the younger cats. All examinations were performed by a board‐certified veterinary neurologist and scoring of examinations was performed by a different, masked board‐certified neurologist. Results: Sixteen cats (50%) in the younger cohort and 6 cats (50%) in the geriatric cohort exhibited an increase in their overall neurologic examination score postgabapentin administration, mainly through new or progressive postural reaction deficits and gait changes. Anxiety and sedation scores were significantly changed in the geriatric population (P <.01, P =.004, respectively); however, only sedation scores were significantly increased in the younger cats after gabapentin administration (P =.004). Conclusions and Clinical Importance: All study participants showed mild neurologic changes after gabapentin administration, most markedly noted in the geriatric population. Dose reduction of gabapentin for preappointment anxiolysis and neurologic examination in geriatric patients should be considered. [ABSTRACT FROM AUTHOR]

Background: The proportion of cats with hypertrophic cardiomyopathy (HCM) that lose systolic anterior motion of the mitral valve (SAM) in the long term is unknown. Hypothesis/Objectives: Cats with HCM will lose SAM in the long term. Loss of SAM will be associated with greater age, longer scan‐interval, and altered left ventricular (LV) dimensions. Animals: Sixty unsedated cats with HCM, not receiving beta blockers or pimobendan. Methods: A retrospective cohort study from 2 referral centers. Cats were eligible if they had been diagnosed with HCM and had a repeat echocardiogram ≥1 year later. Clinical and echocardiographic data of the left heart variables were collected. Results: Thirty‐eight cats had SAM at the initial scan. After a median follow‐up time of 2.1 years (range: 1.0‐5.9), 7 cats had lost SAM (18%) and 5 cats (23%) gained SAM. On follow‐up, cats with SAM at the initial scan had a larger left atrium (P =.037), lower left atrial fractional shortening (P =.014), greater LV internal diameter in end‐systole (P =.002), and lower LV fractional shortening (P <.001). Four cats with SAM developed congestive heart failure. There were no new cases of congestive heart failure or change in left heart variables in cats without SAM at the initial scan. The gain or loss of SAM was not associated with age or time between scans. Conclusions and Clinical Importance: Similar proportions of cats gained or lost SAM. Cats with SAM at baseline had more evidence of disease progression than cats without SAM. [ABSTRACT FROM AUTHOR]

Background: Monitoring serum phosphorus concentrations is crucial in the management of chronic kidney disease in cats. The diurnal variation of serum phosphorus concentration may affect clinical assessment. Hypothesis/Objectives: Characterize the diurnal variation of serum phosphorus concentration in cats and determine the associations between changes in serum phosphorus concentration and several metabolites of phosphorus metabolism. Animals: Six apparently healthy, intact male, specific‐pathogen‐free cats were housed in a photoperiod, humidity, and temperature‐controlled facility. Methods: Blood sampling was performed hourly for 24 hours to obtain the serum concentrations of phosphorus, ionized calcium, parathyroid hormone, and calcidiol. Results were analyzed using linear mixed‐effect models to determine the significance of diurnal variation and associations between serum phosphorus concentrations and other metabolites over time. Results: Diurnal variation in serum phosphorus concentration was noted with an apex around 11:00 followed by gradually declining concentrations to reach the nadir around 23:00. The serum phosphorus concentration again increased through the early morning on the next day. An approximately 25% difference in serum phosphorus concentration at the apex and the nadir was documented. A non‐linear relationship between the serum concentrations of phosphorus and ionized calcium over time was identified. Conclusions and Clinical Importance: Diurnal variations of serum phosphorus concentration and associations between the trending of serum phosphorus and ionized calcium concentrations were evident in a group of clinically healthy adult cats housed in a controlled environment. These findings can help in the interpretation of clinical and research data regarding calcium and phosphorus metabolism and kidney health in cats. [ABSTRACT FROM AUTHOR]

Background: Minimizing harm from antimicrobials requires use of the narrowest spectrum drug, at an effective dose for the minimum effective duration. Many prescribers are not currently following these guidelines. To address suboptimal antimicrobial use, the underlying reasons must be understood. Objectives: To identify factors influencing choices of antimicrobial drug, dose, and duration for companion animals. Subjects: Twenty‐two veterinarians treating companion animals in Australia. Diversity of participants was deliberately sought. Methods: Semistructured interviews were conducted online. Two case studies were discussed, and then a range of broader questions was posed. Transcripts were analyzed thematically, using an inductive approach. Results: Few participants chose guideline‐concordant management for the case studies. Prescribing choices were influenced by a complex array of factors associated with the clinical case, pet owner, drug, veterinarian, veterinary colleagues, and external factors. Key factors driving broad‐spectrum antimicrobial use included a sense of safety, habit, ease of administering the drug (especially in cats), pharmaceutical marketing, and the self‐perpetuating dispensary cycle. Many participants were concerned about antimicrobial resistance, but insufficiently informed about how to minimize this risk. Several participants believed that longer duration of treatment and ensuring patients finish a predetermined course would decrease the risk of antimicrobial resistance and improve clinical outcomes. Conclusions and Clinical Importance: Veterinarians are engaged with the concept of antimicrobial stewardship, but face numerous practical barriers and require more information. In particular, improved education is needed on enhancing patient safety by minimizing both spectrum of activity and duration of treatment, and dispelling myths about "finishing the course." [ABSTRACT FROM AUTHOR]

Background: It is well known that the T10–T11 intervertebral disc space is usually narrower than the adjacent intervertebral disc spaces in most dogs. However, whether the T10–T11 disc space is narrower than the adjacent disc spaces is not well‐established in cats. Objectives: To measure the intervertebral disc space width of the T10–T11 disc space and to compare it with that of the adjacent disc spaces using radiography and magnetic resonance imaging (MRI). Methods: In Groups 1 (101 clinically normal cats) and 2 (32 cats without spinal diseases from T8 to T13), dorsal width (DW), central width (CW) and ventral width (VW) of the T8–T13 disc spaces were measured by radiography or MRI. Significant differences of the DW, CW and VW among disc spaces measured by radiography and MRI were evaluated. Intra‐ and interobserver reliabilities were measured by intraclass correlation coefficient. Results: In Groups 1 and 2 using radiography, the DW and CW of the T10–T11 disc space were significantly narrower than those of adjacent disc spaces (p < 0.05). The DW of the T8–T12 disc spaces was significantly narrower than that of the T12–T13 disc space in Group 1 using radiography. In Groups 1 and 2 using radiography, the CW and VW of the T8–T11 disc spaces were significantly narrower than those of the T11–T13 disc spaces. In Group 2 using MRI, the DW of the T10–T11 disc space was significantly narrower than that of the T11–T13 disc spaces. The VW of the T8–T11 disc spaces was significantly narrower than that of the T11–T13 disc spaces. Conclusion: The T10–T11 intervertebral disc space on radiography is statistically narrower than the adjacent intervertebral disc spaces in normal cats. The cranial thoracic intervertebral disc spaces (T8–T11) are usually narrower than the caudal thoracic intervertebral disc spaces (T11–T13) on radiography and MRI. [ABSTRACT FROM AUTHOR]

Objective: The objectives of this study were to compare the body temperatures between pregnant and nonpregnant cats from two sites, lacrimal caruncle temperature (LCT) and rectal temperature (RT), and to compare intraocular pressure (IOP) between pregnant and nonpregnant cats. Animal studied: This study was performed on 13 pregnant and 16 anoestrous cats. Procedures: The gestation period of the pregnant cats ranged from 20 to 45 days. A vaginal smear was also performed to determine the sexual cycles of nonpregnant cats. The IOP was measured using a rebound tonometer. Results: The pregnant cats (38 ± 0.7°C) exhibited a lower RT than the nonpregnant cats (38.5 ± 0.5°C) (p < 0.05). No significant differences existed between the pregnant and nonpregnant groups in the right (R)‐LCT or left (L)‐LCT (p > 0.05). The average LCT temperature measured 32.30 ± 2.23°C in cats. The right (R)‐IOP in pregnant cats (17.69 ± 5.6 mm Hg) was significantly lower than in nonpregnant cats (22.37 ± 5.27 mm Hg) (p < 0.029). Pregnant cats exhibited a significantly lower left (L)‐IOP value (17.69 ± 5.76 mm Hg) compared to nonpregnant cats (23.18 ± 5.55 mm Hg) (p < 0.015). Conclusion: This study presents a preliminary report that documents a noteworthy reduction in RT in pregnant cats (38 ± 0.7°C) as compared to cats in anoestrus. Pregnancy also has an effect on the IOP. It was hypothesised that the hormonal changes induced by pregnancy in cats would have a substantial impact on IOP and RT. Although body temperature can be measured using LCT, RT should still be utilised as the reference measurement site. [ABSTRACT FROM AUTHOR]

The number of available antiseizure medications with demonstrated efficacy in cats is limited. As such, there is a need to evaluate the pharmacokinetics of newer medications so that proper dosing regimens can be made. Brivaracetam (BRV) is a more potent analogue of levetiracetam, and is Food and Drug Administration approved for use in people. The goal of this study was to describe the pharmacokinetics of intravenous and oral doses of BRV in healthy cats. A cross‐over study involving eight healthy cats, that were administered 10 mg of BRV intravenously as a bolus and orally in the fasted state. Blood samples were collected over 24 h. Analysis was performed using liquid chromatography‐mass spectrometry. Data were subjected to non‐compartmental analysis. Median (min–max) of maximal concentration, time to maximal concentration, area under the curve, elimination half‐life and oral absolute bioavailability were 902 (682–1036) ng/mL, 0.6 (0.5–2.0) h, 6.4 (5.2–7.2) h, 8145 (6669–9351) ng × h/mL and 100% (85–110) respectively. BRV appeared to be well tolerated by all cats. A single dose of BRV is well tolerated both orally and intravenously. Maximal concentrations are produced rapidly and within the human reference interval considered to be therapeutic. [ABSTRACT FROM AUTHOR]

To describe an ultrasound-guided suprazygomatic approach to the trigeminal nerve block in cat cadavers. Prospective descriptive study. Ten feline cadaver heads. A 25:75 methylene blue–iopamidol mixture (0.1 mL cm–1 cranium length) was injected into 10 cadaver heads using an ultrasound-guided suprazygomatic approach. A computed tomography (CT) scan was performed to identify contrast presence at the orbital fissure, foramen rotundum and ovale, followed by anatomical dissection to identify staining of the pterygopalatine fossa (PPF), extraconal retrobulbar area, mandibular and maxillary nerves. Descriptive statistics were used to summarize results. A total of 20 injections were performed. Of these, 1/20 misinjection occurred and excluded from further reporting. The volume of injectate was 0.9 (0.9–1.1) mL [median (range)]. Staining of the PPF, extraconal space, maxillary and mandibular nerves over more than 6 mm was achieved in 19/19 (100%), 18/19 (95%), 17/19 (89%) and 19/19 (100%) of injections, respectively. CT showed presence of contrast within 5 mm of the orbital fissure, foramen rotundum and ovale in 18/19 (95%), 19/19 (100%) and 19/19 (100%) of the injections, respectively. No intracranial migration was observed. This cadaver study illustrates that the suprazygomatic ultrasound-guided trigeminal nerve injection technique can successfully stain the PPF, retrobulbar cone extraconally, mandibular and maxillary nerves. Consequently, this technique has the potential to be used in vivo in cats to desensitize areas innervated by the trigeminal nerve. [ABSTRACT FROM AUTHOR]

Phase 1: to determine the feasibility of desensitizing ventral branches of spinal nerves within the rectus sheath using an ultrasound-guided rectus sheath block (USRSB). Phase 2: to determine the effect of preoperative USRSB on intraoperative responses to surgical stimulation and postoperative pain. Cadaveric study and prospective, randomized, blinded, parallel-arm clinical trial. A group of five cat cadavers and 37 shelter-owned cats undergoing ovariohysterectomy. Phase 1: anatomical dissection was performed on one uninjected cadaver. Abdominal walls were dissected in four cadavers (eight hemiabdomens) following bilateral USRSB using 1:1 new methylene blue and 0.5% bupivacaine (0.8 mL kg–1 total). Phase 2: preoperative bilateral USRSB was performed with 0.8 mL kg–1 of 0.25% bupivacaine (RSB) or equivalent volume of 0.9% saline (CONTROL). Intraoperative systolic arterial blood pressure (SAP), heart rate (HR), respiratory rate (f R) and vaporizer setting (vap%) were recorded before skin incision, during celiotomy and abdominal wall closure. In recovery, cats were administered robenacoxib (2 mg kg–1; CONTROL) or 0.9% saline (0.1 mL kg–1; RSB) subcutaneously. Postoperative pain was evaluated for 6 hours using the Glasgow Composite Measure Pain Scale. Phase 1: spinal nerves T9–L3 were identified within the rectus sheath, and stained in 0%, 40%, 63%, 75%, 100%, 88%, 50% and 13% of hemiabdomens, respectively. Phase 2: 37 cats were included (RSB, n = 17; CONTROL, n = 20). Intraoperatively, SAP, HR and f R were not significantly different between groups. Vap% was significantly lower in RSB during celiotomy (p = 0.036) and closure (p = 0.044). Postoperatively, RSB cats were 5.3 times (95% CI 1.8–8.3) more likely to require rescue analgesia than CONTROL cats. During surgery, USRSB with bupivacaine offered minor benefits and provided markedly less postoperative analgesia than robenacoxib, indicating that relying on USRSB provides insufficient postoperative analgesia for ovariohysterectomy in cats. [ABSTRACT FROM AUTHOR]

The cerebral cortex comprises many distinct regions that differ in structure, function, and patterns of connectivity. Current approaches to parcellating these regions often take advantage of functional neuroimaging approaches that can identify regions involved in a particular process with reasonable spatial resolution. However, neuroanatomical biomarkers are also very useful in identifying distinct cortical regions either in addition to, or in place of functional measures. For example, differences in myelin density are thought to relate to functional differences between regions, are sensitive to individual patterns of experience, and have been shown to vary across functional hierarchies in a predictable manner. Accordingly, the current study provides quantitative stereological estimates of myelin density for each of the 13 regions that make up the feline auditory cortex. We demonstrate that significant differences can be observed between auditory cortical regions, with the highest myelin density observed in the regions that comprise the auditory core (i.e., the primary auditory cortex and anterior auditory field). Moreover, our myeloarchitectonic map suggests that myelin density varies in a hierarchical fashion that conforms to the traditional model of spatial organization in auditory cortex. Taken together, these results establish myelin as a useful biomarker for parcellating auditory cortical regions, and provide detailed estimates against which other, less invasive methods of quantifying cortical myelination may be compared. [ABSTRACT FROM AUTHOR]

Oocyte cryopreservation is not yet considered a reliable technique since it can reduce the quality and survival of oocytes in several species. This study determined the effect of different concentrations of antifreeze protein I (AFP I) on the vitrification solution of immature cat oocytes. For this, oocytes were randomly distributed in three groups and vitrified with 0 μg/mL (G0, 0 μM); 0.5 μg/mL (G0.5, 0.15 μM), or 1 μg/mL (G1, 0.3 μM) of AFP I. After thawing, oocytes were evaluated for morphological quality, and compared to a fresh group (FG) regarding actin integrity, mitochondrial activity and mass, reactive oxygen species (ROS) and glutathione (GSH) levels, nuclear maturation, expression of GDF9 , BMP15 , ZAR-1 , PRDX1 , SIRT1, and SIRT3 genes (normalized by ACTB and YWHAZ genes), and ultrastructure. G0.5 and G1 presented a higher proportion of COCs graded as I and while G0 had a significantly lower quality. G1 had a higher percentage of intact actin in COCs than G0 and G0.5 (P < 0.05). There was no difference (P > 0.05) in the mitochondrial activity between FG and G1 and they were both higher (P < 0.05) than G0 and G0.5. G1 had a significantly lower (P < 0.05) mitochondrial mass than FG and G0, and there was no difference among FG, G0, and G0.5. G1 had higher ROS than all groups (P < 0.05), and there was no difference in GSH levels among the vitrified groups (P > 0.05). For nuclear maturation, there was no difference between G1 and G0.5 (P > 0.05), but these were both higher (P < 0.05) than G0 and lower (P < 0.05) compared to FG. Regarding gene expression, in G0 and G0.5, most genes were downregulated compared to FG, except for SIRT1 and SIRT3 in G0 and SIRT3 in G0.5. In addition, G1 kept the expression more similar to FG. Regardless of concentration, AFP I supplementation in vitrification solution of immature cat oocytes improved maturation rates, morphological quality, and actin integrity and did not impact GSH levels. In the highest concentration tested (1 μg/mL), AFP maintained the mitochondrial activity, reduced mitochondrial mass, increased ROS levels, and had the gene expression more similar to FG. Altogether these data show that AFP supplementation during vitrification seems to mitigate some of the negative impact of cryopreservation improving the integrity and cryosurvival of cat oocytes. [Display omitted] • The use of AFP I in the vitrification solution of immature cat oocytes improved their maturation rate. • AFP I also improved the morphological quality and actin integrity of immature vitrified cat oocytes. • In the highest concentration tested (1 μg/mL), AFP I kept the gene expression more similar to fresh oocytes. • 1 μg/mL of AFP I seems to be the suitable concentration for improving oocyte vitrification in this species. [ABSTRACT FROM AUTHOR]

Aims: To assess agreement of bacterial culture results from samples taken from nasal discharge, the nasal cavity and nasal biopsy from dogs and cats with nasal disease. Methods: Nineteen dogs and 21 cats with different nasal diseases (chronic rhinitis, n = 30; neoplasia, n = 7; sinonasal aspergillosis, n = 3) were prospectively enrolled in the study. Nasal swabs were taken bilaterally from nasal discharge at the nares, the nasal cavity, and one nasal mucosal biopsy per side. All samples were subjected to aerobic bacterial culture. Kappa statistics were used to evaluate agreement for the most prevalent bacterial species between sampling sites. Results: A positive culture result for at least one bacterial species was detected in 80% of samples from nasal discharge/nares, 92% of nasal cavity samples, and 75% of biopsy samples. The mean agreement between the three sampling sites for positive vs. negative culture results was never greater than moderate and the precision of the estimates of agreement varied widely. The most frequently isolated bacterial species in dogs were Staphylococcus pseudintermedius, Staphylococcus spp. and Streptococcus spp. In cats, Pasteurella spp. and Staphylococcus felis were the bacterial species cultured most frequently. For the most prevalent cultured species, Staphylococcus spp., mean agreement between sites was never greater than fair and the precision again varied widely. Conclusion: This study indicates that bacterial culture results in feline and canine nasal disease are site-specific and there was no evidence from this study for consistency between sites within a patient for many bacterial species. Consequently, if bacterial culture results from nasal swabs are used to guide therapeutic antimicrobial choice, different treatments may be selected depending on the site of culture. As a consequence, there is no evidence from this study that nasal bacterial cultures should be recommended as a routine diagnostic measure. [ABSTRACT FROM AUTHOR]

A 3‐year‐old neutered male domestic medium‐hair cat presented for sudden onset of vomiting and anorexia. Ultrasonographically, severe distension of the cecum by hyperechoic material associated with variable posterior attenuation was identified. The cecum was surgically excised. A retention cyst cecal mucocele complicated by mucosal ulceration and inflammation was diagnosed. A literature review of this well‐described lesion in humans, once described in dogs but as yet undescribed in cats, is briefly presented. [ABSTRACT FROM AUTHOR]

MRI is widely used for the detection and characterization of brain lesions. There is a growing interest in the potential benefits of quantitative MRI (qMRI) in veterinary brain lesion diagnosis. Yet, the use of data processing tools in the veterinary field is not as democratized as for the diagnosis of human brain pathologies. Several reviews have addressed the characterization of brain lesions in cats and dogs. None of them is specifically focused on quantitative MRI data processing techniques for the diagnosis of brain lesions in the veterinary field. This paper aims to provide an overview of the evolution of qMRI on cats and dogs both in the clinical and preclinical fields. We analyze the achievements in the field as well as the remaining challenges in the diffusion of data processing tools for veterinary brain lesions characterization. [ABSTRACT FROM AUTHOR]

Traumatic atlantoaxial hyperflexion is considered rare in cats, and only a few case reports have been published. There are other conditions that can result in a peracute onset of neurological signs localized to the cervical spinal cord segments, including acute noncompressive nucleus pulposus extrusion, ischemic myelopathy, or vertebral fractures. Appropriate treatment for these conditions can only be initiated after an accurate diagnosis has been obtained. The aim of this observational, retrospective, single‐center, descriptive case series study was to describe the clinical presentation, imaging characteristics, and short‐term outcome of eight cats presented with suspected traumatic atlantoaxial hyperflexion. Young male healthy domestic shorthair cats were overrepresented (7/8) and typically presented with a peracute, nonprogressive, nonpainful, nonlateralizing C1–C5 myelopathy (tetraplegia or nonambulatory tetraparesis) following a road traffic accident or head trauma. All MRI studies demonstrated a solitary, focal, ill‐defined intramedullary lesion immediately dorsal to the dens of the axis, affecting both grey and white matter. All cats were treated medically. In 50% of the cats, the neurological grade improved at discharge or short‐term follow‐up, 25% of the cats recovered completely, one cat was static at short‐term follow‐up, and one cat was euthanized due to persistent forebrain signs and lack of neurological improvement. [ABSTRACT FROM AUTHOR]

Radiotherapy (RT) for lung or liver tumors can be challenging due to respiration‐induced organ motion (RIOM). There are some methodological solutions to minimize RIOM. We explored a new approach to evaluate the feasibility and reproducibility of RIOM during RT with five total client‐owned tumor‐bearing animals using a remote‐triggered breath‐hold ventilator under general anesthesia during image acquisition and RT. There was one stereotactic body radiotherapy, one conventionally fractionated definitive intent, and three conventionally fractionated palliative intent RT cases. Based on repeated cone beam CT, there were no treatment table shifts required prior to initiating beam on. No clinically significant complications such as hypotension occurred during anesthesia. This technique appeared to be safe in this group of patients and was easily clinically implemented and highly reproducible. More complete follow‐up data and larger studies are needed to evaluate clinical outcomes with this breath‐hold ventilator technique in veterinary RT. [ABSTRACT FROM AUTHOR]

A 3‐year‐old cat was presented for an abdominal ultrasound examination with apathy and anemia. The US revealed the enlargement of the left kidney with a hypoechoic subcapsular thickening. An abnormal, tortuous vessel was visible in the medulla with arterial flow on pulsed‐wave Doppler examination. The CT examination confirmed the ultrasound findings and a presumptive diagnosis of the intraparenchymal renal aneurysm was made. Four days later, the cat presented again with a worsening of its condition. The US features were suggestive for that of an aneurysm rupture. [ABSTRACT FROM AUTHOR]

Objective Animal Studied Methods Results Conclusion To describe a novel surgical approach to conjunctivorhinostomy for feline nasolacrimal duct obstruction.A client‐owned 4‐year‐old female spayed domestic shorthair cat presented with chronic unilateral nasolacrimal duct obstruction of the right eye.Following obstruction confirmation via complete ophthalmic examination and dacryocystorhinography, conjunctivorhinostomy was performed under general anesthesia, and an indwelling sub‐palpebral lavage (SPL) line was placed to facilitate the formation of a new pathway for tear drainage. Specifically, the SPL footplate was sutured to the ventral conjunctival fornix with 5‐0 nylon and 6‐0 vicryl while the tubing was passed through the new pathway and the distal end of the tubing trimmed and tucked into a perinasal subcutaneous pocket. Two skin sutures closed the perinasal pocket and were removed 2 weeks postoperatively.No immediate postoperative complications occurred. At 6 weeks and 6 months postoperatively, the distal SPL tubing was dislodged and visible out of the right nostril. This was uneventfully trimmed shorter, and no further complications occurred. The SPL component was easily removed 11 months postoperatively without complication. The patient's clinical signs dramatically improved; she was comfortable over 2 years after surgery.To the authors' knowledge, this is the first report of using an SPL as an indwelling catheter for nasolacrimal duct surgery via conjunctivorhinostomy in a cat. This technique eliminated external stent sites for the patient, which was associated with a short use of an e‐collar, and utilized materials readily available in a specialty hospital. [ABSTRACT FROM AUTHOR]

Objective Materials and Methods Results Conclusions To evaluate the success and failure rate of photoactivated chromophore for keratitis—corneal cross‐linking (PACK‐CXL) therapy in a single population of dogs and cats. To identify the usefulness of the PACK‐CXL based on ulcer depth and establish a cutoff at which this procedure could be recommended. To analyze the influence of the different variables in corneal healing time and to report the presence of secondary endothelial damage and cataract formation.Medical records of dogs and cats with presumptive infectious keratitis which underwent accelerated epithelium‐off PACK‐CXL between 2016 and 2023 were reviewed and analyzed.Records for 369 animals were included, and the overall success rate for healing was 97% (range 4–74 days and no rescue procedure). The second success (re‐epithelialization <30 days and no rescue procedure) rate was 86%, and a total of 40 eyes needed more than 1 month for the corneal repair. Corneal ulcers were classified in three categories based on the depth: 0%–33% (46%), 34%–66% (37.4%), and 67%–100% (16.5%). The cutoff at which PACK‐CXL had a higher probability of failure was with ulcer depth >66.5%. Animals who suffered from keratomalacia and hypopyon at presentation, or were treated with topical serum or gentamicin after PACK‐CXL showed an increase in epithelial healing time (EHT). Increasing age, brachycephalic conformation, keratomalacia alone, and deeper ulcers were identified as risk factors for the treatment outcome. Secondary endothelial injury or cataract formation was not noted in this study.Accelerated PACK‐CXL is a non‐invasive, adjunctive treatment to medical therapy, which can be used in presumed infectious keratitis with a high probability of success. However, it is important to take in consideration the patient age, skull conformation, presence of keratomalacia, and the ulcer depth. [ABSTRACT FROM AUTHOR]

Simple Summary: The lateral thoracic wall of cats is innervated by the rami cutanei laterales (RCL) emerging from the intercostales nerves from the second to the twelfth thoracic spinal nerve (T). The ultrasound-guided deep serratus plane (DSP) block is a technique that aims to desensitise these RCL to provide analgesia of the lateral wall of the thorax cranial to the 8th rib. This study aimed to assess the distribution of a mixture of dye and contrast media injected in the fascial plane constituted by the lateral aspect of the intercostales externi muscles and the ribs and the medial aspect of the serratus ventralis thoracis muscle. To fulfil this objective, 14 cat cadavers were employed, and a mixture of methylene blue and iopromide 50:50 was injected in the target fascial plane at the laterocaudal aspect of the 5th rib. Cadavers were then subjected to a computed tomographic exam and anatomical dissection. Our results showed staining of the RCL of the intercostales nerves from T2 to T7. These results show that the DSP block could provide analgesia to the lateral aspect of the cranial wall in cats. The serratus plane block is an ultrasound-guided anaesthetic technique that aims to provide analgesia to the lateral thoracic wall cranial to the 8th rib. This block can be performed in a superficial (between the latissimus dorsi and the serratus ventralis thoracis (SVT) muscles) or deep plane (between the intercostales externi and the SVT muscles). This study aimed to assess the distribution and nerve staining of a mixture of 0.4 mL kg−1 of methylene blue and iopromide 50:50 performing a deep serratus plane (DSP) block at the level of the 5th rib. We hypothesise that this technique would be feasible and could stain the rami cutanei laterales (RCL) of the intercostales nerves cranial to the 8th rib in cat cadavers. This study was divided into two phases. Phase 1 consisted of an anatomical study of the thoracic wall (2 cadavers). Phase 2 consisted of the ultrasound-guided injection of the aforementioned mixture and the assessment of its distribution by computed tomography and anatomical dissection (12 cadavers). Contrast media spread a median of 5.5 (2.5–7.5) intercostal spaces. The dye stained a median of 3 (0–5) RCL, affecting RCL 2 (17.39%), RCL 3 (57.17%), RCL 4 (78.26%), RCL 5 (91.30%), RCL 6 (78.26%), and RCL 7 (8.70%) within the DSP. Occasionally, the rami dorsales laterales and the thoracicus longus nerve were stained. Based on these findings, the DSP block performed with a volume of 0.4 mL kg−1 of an anaesthetic could provide analgesia in the area innervated from T4 to T6. [ABSTRACT FROM AUTHOR]

Background: Colonic stenosis is a rare postoperative complication of ovariohysterectomy in cats, leading to dyschezia and fecal diameter reduction. In cats, while there are reports of colonic stenosis after midline approach ovariohysterectomy, there are no specific reports of flank approach ovariohysterectomy. Case presentation: This report describes a severe case of a one-year-old British shorthair female cat presenting with gastrointestinal signs, including dyschezia and reduced fecal diameter, three weeks after flank approach ovariohysterectomy. Despite abdominal radiography, proctography with barium sulfate, colonoscopy, CT, and hematological analysis, the cause of colonic stenosis remained unclear. During exploratory laparotomy, an annular tissue band was found encircling the descending colon, resulting in severe local stenosis. After excision of the tissue band, the presenting clinical signs of the cat were rapidly improved. This result suggests that colonic stenosis caused by tissue band should be considered when diagnosing postoperative complications in flank approach ovariohysterectomy in cats. Conclusion: Colon stenosis due to annular tissue band restriction should be considered one of the differentials for postoperative complications in flank approach ovariohysterectomy in cats. [ABSTRACT FROM AUTHOR]

Nocardia infections in cats most commonly present as subcutaneous wounds, or less commonly, as pneumonia, purulent pleurisy and disseminated disease. Abdominal involvement is rarely reported, and to date, localised retroperitoneal infection has only been reported in people. This report describes a five‐year‐old domestic shorthair cat living in Canberra, Australia, that presented with a two‐month history of pyrexia and inappetence progressing to anorexia. Ultrasonography showed a large retroperitoneal mass incorporating both ureters. Euthanasia was elected because of the guarded prognosis. Necropsy examination revealed the mass to be comprised of extensive pyogranulomatous inflammation with fibrosis, Splendore–Hoeppli phenomenon and filamentous Gram‐positive bacteria. Culture and MALDI‐TOF mass spectrometry identified the causative agent as Nocardia brasiliensis. N. brasiliensis is commonly diagnosed as a cause of cutaneous nocardiosis in Australian human patients, but to date has only been reported in one cat from the United States and one dog from Australia. A treatment approach that might have been used in such a case is provided even though the cat's owners elected not to proceed with surgical intervention. [ABSTRACT FROM AUTHOR]

The cardiac conduction system in large carnivores, such as the African lion (Panthera leo), represents a significant knowledge gap in both veterinary science and in cardiac electrophysiology. Short QT intervals have been reported from zoo‐kept, anaesthetized lions, and our goal was to record the first ECGs from wild, conscious lions roaming freely, and compare them to zoo‐kept lions under the hypothesis that short QT is unique to zoo‐kept lions. Macroscopic and histological examinations were performed on heart tissue removed from nine healthy zoo lions. ECGs were recorded from the nine anaesthetized zoo‐kept lions, and from 15 anaesthetized and conscious wild lions in Africa. Our histological and topographical description of the lion's heart matched what has previously been published. In conscious lions, the ECG recordings revealed a mean heart rate of 70 ± 4 beats/min, with faster heart rates during the night. PQ and QT intervals were heart rate dependent in the conscious lions. Interestingly, QT intervals recorded in wild lions were markedly longer than QT intervals from zoo lions (398 ± 40 vs. 297 ± 9 ms, respectively; P < 0.0001). Anaesthesia or heart rate did not account for this difference. We provide a comprehensive description of the cardiac anatomy and electrophysiology of wild and zoo‐kept lions. QT intervals were significantly shorter in zoo lions, suggesting functional disparities in cardiac electrophysiology between wild and zoo‐kept lions, potentially related to physical fitness. These findings underscore the plasticity of cardiac electrophysiology and may be of value when reintroducing endangered species into the wild and when managing lions in human care. [ABSTRACT FROM AUTHOR]

Cardiac lymphoma is uncommon in cats and is rarely considered as a differential diagnosis for congestive heart failure. A 10-year-old neutered male domestic short-haired cat with clinical histories of feline immunodeficiency virus, diabetes mellitus, and congestive heart failure was humanely euthanized. Post-mortem evaluation demonstrated a massively infiltrative round cell neoplasm of the heart, resulting in CHF. Immunohistochemistry of neoplastic tissue was consistent with diffuse large B-cell lymphoma. This case demonstrates a peculiar presentation of cardiac diffuse large B-cell lymphoma, with chronic feline lentiviral infection possibly contributing to disease initiation and progression. [ABSTRACT FROM AUTHOR]

Background and Aim: Feline lymphomas are categorized based on the location of tumor cells, with anatomical classifications including alimentary, mediastinal, multicentric, and extranodal forms. Accurate diagnosis and classification of feline lymphoma are paramount for enhancing treatment and prognosis. T-cell lymphomas are CD3 positive, while B-cell lymphomas exhibit positive for CD20, CD79a, and paired box 5 (PAX5). The aims of this study were (1) to classify feline lymphoma in each anatomical subtype using the World Health Organization (WHO) classification to provide information on epidemiological findings; (2) to investigate the expression and detection of B-cell lymphoma, various antibodies will be used, with the addition of PAX5, for clearer results; and (3) to gather more extensive information about feline lymphoma in Thailand, particularly in the Bangkok area. Materials and Methods: From 2011 to 2023, 86 sample tissues were submitted for routine pathological examination at the Department of Pathology, Faculty of Veterinary Science, Chulalongkorn University. Immunohistochemistry (IHC) was performed to detect an immunophenotype of PAX5, CD79a, CD20 (B-cell lineage), and CD3 (T-cell lineage). Eighty-six formalin-fixed, paraffin-embedded lymphoma tissues were prepared on silane-coated slides. After IHC, all cases were classified according to the WHO classification. Results: The most common form of lymphoma in this study was extranodal lymphoma at 37.2% (32/86), followed by multicentric lymphoma at 31.3% (27/74), mediastinal lymphoma at 17.4% (15/86), and alimentary lymphoma at 14% (12/86). Most extranodal lymphoma cases were in the nasal region. From the anatomical form, multicentric and extranodal lymphomas were predominantly diffuse large B-cell high-grade, while mediastinal lymphomas were small low-grade B-cell lymphomas. Alimentary lymphomas occur in various types, with most being the B-cell type. Conclusion: This study indicates that extranodal lymphoma and extranodal lymphoma are the most frequent presentations found in cats in Bangkok. Mediastinal and alimentary lymphomas still occur. The utilization of various B-cell markers in combination could aid pathologists in distinguishing between various stages of B-cell maturation, assessing tumor cell heterogeneity, and determining the phenotype in scenarios where there is a loss of common B-cell markers diffuse large B-cell lymphomas is the most prevalent subtype of feline lymphoma. Significantly, relying solely on immunochemistry with one parameter may not be sufficient for a definitive diagnosis of B-cell lymphoma, as another parameter may also be necessary. [ABSTRACT FROM AUTHOR]

Simple Summary: Management of stray cats in urban areas is an ongoing challenge in Australia, and many are euthanized, particularly in disadvantaged regions. The Australian Pet Welfare Foundation aimed to assess the impact of a free cat sterilization program in Ipswich, Queensland. Before that intervention, a situational analysis was conducted to evaluate cat and dog ownership behaviours. In a sample of 343 residents from the area, 35% owned cats, and 3% fed strays. Cats were mainly obtained from family or friends and shelters, while 53% of respondents owned dogs, mostly sourced from breeders and family acquaintances. A higher percentage of owned cats (91%; but only 74% for those aged 4 to <12 months) were sterilized compared to owned dogs (78%). Among cat owners, 51% contained their cats all the time and 18% at night. Our findings suggest that community-based sterilization programs targeting both owned and semi-owned cats, and assisting semi-owners in becoming owners, would assist in reducing unplanned litters and the stray cat population. It is also recommended that assistance with cat containment be provided where vulnerable native species are present in urban and peri-urban areas. These insights are crucial for developing effective policies aligned with One Welfare principles. Managing stray cats in urban areas is an ongoing challenge, and in Australia, many are euthanized. Most stray cats are from disadvantaged areas and are under 1 year of age. The Australian Pet Welfare Foundation intended to assess the impact of a free cat sterilization program in an area with high shelter intake of cats in the city of Ipswich, Queensland. The aims of this pre-intervention study were to undertake a situational analysis of cat ownership, semi-ownership and cat caring behaviours, and compare those in the same demographic with dog ownership and caring behaviours relating to sterilization rates, to provide a basis against which to assess the program's effectiveness. In a sample of 343 participants from that area, 35% owned cats and 3% fed stray cats. Cats were predominantly obtained from family or friends (31%) and shelters (20%). More respondents owned dogs (53%), which were most often sourced from breeders (36%) and family acquaintances (24%). More owned cats than owned dogs were sterilized (91% versus 78%). However, only 74% of cats aged 4 to <12 months were sterilized. Cat containment practices varied, with 51% of owners containing their cat(s) at all times, and a further 18% doing so at night. These results suggest the need for community-based programs that focus on sterilizing owned and semi-owned cats, and assisting semi-owners in becoming full owners to reduce stray cat populations and associated negative impacts. This includes assistance with cat containment where vulnerable native species are present. Public understanding of the causes and effective solutions for free-roaming cats, alongside legislative changes, are required to facilitate these efforts. Assistive programs aligned with One Welfare principles are expected to benefit the wellbeing of animals, humans and their environments. [ABSTRACT FROM AUTHOR]

Since the pandemic in 2019, coronaviruses (CoVs) have been a great concern for public health burden. The fact that CoVs can infect all animals including domestic ones and livestock points to a future pandemic even though interaction between human and wildlife animals is restricted. Moreover, interspecies transmission abilities of CoVs by mutations make them drastically risky not only for humans but also for animal health. Recently, a new CoV outbreak in cats in Cyprus, the so‐called FCoV‐23, has been realized. In addition to worries over animal health, any possible transmission to humans is now controversial. However, there have been limited characterization studies on FCoV‐23. Thus, we aimed to assess the possible transmission of FCoV‐23 to humans using in silico prediction tools. Accordingly, we first checked the binding affinities of receptor binding domain (RBD) of FCoV‐23 against feline target protein and its human homolog. Next, we randomly and rationally created mutations on the RBD sequence and evaluated the binding affinities using protein docking tools. Our results underlined that multiple mutations at the same time were needed for increased binding affinity towards human target protein, demonstrating that the probability of transmission to humans was extremely low when mutation rates were regarded. Still, further molecular studies are required to comprehensively conclude the possible transmission risk. [ABSTRACT FROM AUTHOR]

An 18-year-old female neutered Domestic Shorthair cat was referred for investigation of seizure-like episodes. Physical and neurological examination were unremarkable, as were systemic arterial blood pressure, cardiac troponin I, complete blood count and biochemistry profile. Diagnostic tests included transthoracic echocardiography which ruled out any structural cardiomyopathy, and electrocardiography which showed an underlying regular wide QRS-complex rhythm with pronounced shortening of the PR interval. Considering the findings, a diagnosis of suspected ventricular pre-excitation secondary to an accessory pathway was made. Further investigations were declined and, as no periods of tachycardia were seen on the five-minute electrocardiogram, no antiarrhythmic treatment was started. [ABSTRACT FROM AUTHOR]

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Background: Neurological conditions constitute approximately 10% of feline cases referred to veterinary clinics. Such cases often present manifestations of central nervous system (CNS) damage, including inflammatory lesions, neoplastic growth and structural and cellular transformations. Objectives: This study aimed at identifying histopathological changes in the CNS of cats that had succumbed to neurological symptoms. Methods: Microscopic evaluation of different sections within the CNS was conducted on 20 cats that had either died naturally or were euthanized due to neurological signs. After performing a necropsy, we examined the CNS tissues and conducted PCR testing to screen for possible viral infections, including feline infectious peritonitis (FIP), feline immunodeficiency virus (FIV) and feline leukemia virus (FeLV). Results: The majority of cases showed characteristic histopathologic lesions, notably mononuclear and suppurative meningoencephalitis, perivascular cuffing, disseminated intravascular coagulation (DIC), granulomatous meningoencephalitis, acute neuronal necrosis, liquefactive necrosis, epididymitis, thrombosis and demyelination. Among the 20 cats studied, 12 tested positive for FIP by PCR analysis, while 5 cats exhibited positive results for FIV. Also, FeLV PCR tests displayed positive results in 4 cats. No evidence of feline spongiform encephalopathy (FSE) was observed. Conclusion: This study is the first of its kind conducted in Iran. Based on the results, the most prevalent viral agents infecting cats' CNS were FIP, FIV and FeLV. The investigation revealed no evidence of FSE in cats with neurological signs. [ABSTRACT FROM AUTHOR]

The objective of this study was to establish an evaluation technique for the feline pelvic cavity using computed tomography (CT). Client-owned cats with a normal pelvis (n = 50) or pelvic stenosis (n = 3) were included. We categorized pelvic CT images in the normal pelvis group into two types according to pelvic cavity shape, then calculated the sacral index (SI), pelvic canal area (PCA), and PCA/sacral width index (PSI). The reference intervals of these variables were determined based on the results in the normal pelvis group. In the normal pelvis group, the PSI, unlike the SI and PCA, was not affected by body weight. In addition to high intraobserver and interobserver reproducibilities, the PSI showed no significant differences according to pelvic cavity shape. However, the SI exhibited significant differences among pelvic cavity shapes. In the stenosis group, the postoperative PSI in all cats was within the reference interval. However, the postoperative SI in one case was lower than the reference interval. The PSI may become a new method for evaluation of the pelvic cavity, including the pelvic floor. [ABSTRACT FROM AUTHOR]

Pimobendan is not currently approved for use in cats, although its usefulness in feline hypertrophic cardiomyopathy has been suggested. Reports indicate an increase in arrhythmic events following oral administration to healthy cats. Given the greater potency of intravenous administration compared to oral intake, it is conceivable that the incidence of arrhythmias may be increased following pimobendan injection. Therefore, this study aimed to investigate the proarrhythmic effects of pimobendan injection in cats. Five clinically healthy cats underwent physical examination, echocardiography, blood pressure measurements, and 24-hour Holter electrocardiography immediately before and after receiving pimobendan as an intravenous bolus dose of 0.15 mg/kg twice daily for 3 days. Additionally, a 24-hour Holter electrocardiography recording was conducted on the third day of pimobendan or placebo IV administration to assess heart rate, arrhythmias, and heart rate variability. Following pimobendan administration, there was a significant increase in total 24-hour heart rate. Echocardiography revealed a significant increase in mitral valve annulus systolic velocity (S') on the ventricular septal wall side, indicative of enhanced contractility. Only one cat exhibited paroxysmal ventricular tachycardia and an increase in the frequency of arrhythmic events. Conversely, in the remaining cats, a decreasing trend in the number of arrhythmias was observed. These findings indicate that intravenous administration of pimobendan may not be implicated in the onset of arrhythmias. Nevertheless, further research is warranted to explore the effects of intravenous pimobendan administration in cats with myocardial disease. [ABSTRACT FROM AUTHOR]

This study evaluated the antibacterial efficacy of 700 feline-derived lactic acid bacteria (LAB) strains against enteropathogenic Escherichia coli (EPEC), a common cause of diarrhea in cats. Following comprehensive screening, strains ZY25 and ZY35 were identified as the most effective, with inhibition zones of ≥22 mm. These strains demonstrated strong tolerance against stress conditions, such as low pH, bile salts, and gastrointestinal fluids, alongside high hydrophobicity and auto-aggregation abilities. Safety evaluations confirmed the absence of hemolytic activity, virulence factors, and antibiotic resistance genes. The antibacterial activity of these strains is attributed to the production of organic acids, particularly lactic acid and acetic acid. These findings suggest that strains ZY25 and ZY35 have potential as natural and effective probiotic treatments for managing EPEC-induced diarrhea in cats, thus offering an alternative to conventional antibiotics. [ABSTRACT FROM AUTHOR]

Background: This study updates the knowledge of current canine and feline endoparasitic prevalence in Finland. The previous studies reported intestinal worm prevalence of 5.9% in dogs and 7.1% in cats. We also determined the anthelmintic regime and background data of dogs and cats concerning Toxocara spp. infection. Altogether 664 canine and 379 feline (including 46 shelter cats') fecal samples from over six-month-old animals were examined with quantitative Mini-FLOTAC method using zinc sulfate with a specific gravity of 1.35. Of these samples, 396 canine and 89 feline samples were analyzed using the Baermann method for nematode larvae. A fenbendazole efficacy study was conducted with 12 animals positive for Toxocara spp. Results: Endoparasites were found in the feces of 3.5% of dogs, 3.6% of pet cats, and 41.3% of shelter cats. The most common findings in dogs were strongylid (1.7%) and Toxocara canis (0.9%) eggs. Trematode (0.4%), Eucoleus spp. (0.3%), taeniid (0.2%), and Trichuris vulpis (0.2%) eggs, and Cystoisospora spp. oocysts (0.2%) were also detected. One dog (0.2%) was positive for Crenosoma vulpis based on the Baermann method. Toxocara cati (3.3%), taeniid (0.6%), and trematode (0.3%) eggs were found in pet cats' samples. The findings in shelter cat samples were T. cati (34.8%), Eucoleus spp. (13.0%), Cystoisospora spp. oocysts (10.9%), taeniids (8.7%), and Toxoplasma gondii/Hammondia hammondii oocysts (2.2%). Fenbendazole efficacy was adequate in all treated animals, except one cat. The background data revealed 31.2% of dogs being dewormed less than once a year or never. Under twelve-month-old dogs and dogs that were dewormed twice a year were most likely to be T. canis- infected. Shelter cats, male cats, mixed-breed cats, cats that were dewormed two to four times a year, and cats with a history of parasitic infections were most likely to be T. cati infected. Conclusions: The prevalence of pet canine and feline intestinal parasites in Finland is low, particularly the Toxocara spp. prevalence. In free-roaming cats Eucoleus spp. is surprisingly prevalent. The parasite control strategies reported do not follow the ESCCAP guidelines. Typically, owners deworm their pets only once a year or less frequently. [ABSTRACT FROM AUTHOR]

Simple Summary: A variation in the Alström syndrome protein 1 (ALMS1) gene was recently identified as a possible cause of hypertrophic cardiomyopathy (HCM) in Sphynx cats. The primary aims of this study were to describe the prevalence of HCM in Sphynx cats in New Zealand, and to assess the association between HCM and ALMS1 gene. In this prospective study, 55 apparently healthy Sphynx cats from registered Sphynx breeders and pet owners in New Zealand were screened by a cardiologist. A total of 42 of these cats had a repeat cardiac examination after median 1.8 years (range: 1.6–2.2). The frequency of ALMS1 variant was 70.9%. At the median age of 5.8 years (range: 2.4–13.1), the prevalence of HCM was 40% (20 out of 55 cats). Three cats with HCM died during the study with congestive heart failure. Necropsy revealed that all three cats suffered a heart attack (myocardial ischemia or infarction). The ALMS1 gene was not associated with the HCM diagnosis. In summary, HCM is commonly diagnosed in this population, suggesting Sphynx cats are predisposed to this disease. The ALMS1 variant was also frequently detected; however, it was not associated with the HCM diagnosis in the studied population. Recently, hypertrophic cardiomyopathy (HCM) in Sphynx cats has been associated with a variant in the gene encoding Alström syndrome protein 1 (ALMS1). The primary aims of this study were to describe the prevalence of HCM in Sphynx cats in New Zealand, and to assess the association between HCM and the ALMS1 variant in this population. In this prospective study, 55 apparently healthy Sphynx cats from registered Sphynx breeders and pet owners in New Zealand were screened by a cardiologist. A total of 42 of these cats had a repeat cardiac examination after median 1.8 years (range: 1.6–2.2). The frequency of the ALMS1 variant was 70.9% (11 homozygous and 28 heterozygous). At the median age of 5.8 years (range: 2.4–13.1), the prevalence of HCM was 40% (20 out of 55 cats). Three cats with HCM died during the study with congestive heart failure. All three cats had focal but extensive myocardial ischemia or infarction at necropsy. The ALMS1 variant was not associated with the HCM diagnosis. In summary, HCM was common in the studied cohort, suggesting Sphynx cats are predisposed to this disease. While the ALMS1 variant was also frequently detected, it was not associated with HCM in this population. [ABSTRACT FROM AUTHOR]

There is a complex interplay between viral infection and host innate immune response regarding disease severity and outcomes. Neutrophil hyperactivation, including excessive release of neutrophil extracellular traps (NETs), is linked to exacerbated disease in acute COVID-19, notably in hospitalized patients. Delineating protective versus detrimental neutrophil responses is essential to developing targeted COVID-19 therapies and relies on high-quality translational animal models. In this study, we utilize a previously established feline model for COVID-19 to investigate neutrophil dysfunction in which experimentally infected cats develop clinical disease that mimics acute COVID-19. Specific pathogen-free cats were inoculated with SARS-CoV-2 (B.1.617.2; Delta variant) (n = 24) or vehicle (n = 6). Plasma, bronchoalveolar lavage fluid, and lung tissues were collected at various time points over 12 days post-inoculation. Systematic and temporal evaluation of the kinetics of neutrophil activation was conducted by measuring markers of activation including myeloperoxidase (MPO), neutrophil elastase (NE), and citrullinated histone H3 (citH3) in SARS-CoV-2-infected cats at 4 and 12 days post-inoculation (dpi) and compared to vehicle-inoculated controls. Cytokine profiling supported elevated innate inflammatory responses with specific upregulation of neutrophil activation and NET formation-related markers, namely IL-8, IL-18, CXCL1, and SDF-1, in infected cats. An increase in MPO-DNA complexes and cell-free dsDNA in infected cats compared to vehicle-inoculated was noted and supported by histopathologic severity in respiratory tissues. Immunofluorescence analyses further supported correlation of NET markers with tissue damage, especially 4 dpi. Differential gene expression analyses indicated an upregulation of genes associated with innate immune and neutrophil activation pathways. Transcripts involved in activation and NETosis pathways were upregulated by 4 dpi and downregulated by 12 dpi, suggesting peak activation of neutrophils and NET-associated markers in the early acute stages of infection. Correlation analyses conducted between NET-specific markers and clinical scores as well as histopathologic scores support association between neutrophil activation and disease severity during SARS-CoV-2 infection in this model. Overall, this study emphasizes the effect of neutrophil activation and NET release in SARS-CoV-2 infection in a feline model, prompting further investigation into therapeutic strategies aimed at mitigating excessive innate inflammatory responses in COVID-19. [ABSTRACT FROM AUTHOR]

The increased LH levels resulting from the absence of negative feedback after castration has been linked to long-term health issues. A need exists for an alternative contraceptive agent that functions without interfering the LH pathways. This study aimed to develop antibody fragments against the follicular-stimulating hormone receptor (anti-FSHr) using phage-display technology and evaluate its effects on Sertoli cell functions. Phage clones against the extracellular domain of dog and cat FSHr selected from an antibody fragment phagemid library were analyzed for binding kinetics by surface plasmon resonance. Sertoli cells were isolated from testes of adult animals (five dogs and five cats). Efficacy test was performed by treating Sertoli cell cultures (SCCs) with anti-FSHr antibody fragments compared with untreated in triplicates. Expressions of androgen binding protein (ABP), inhibin subunit beta B (IHBB) and vascular endothelial growth factor A (VEGFA) mRNA in SCCs were quantified by RT-qPCR. The results demonstrated that the molecular weight of the purified dog and cat anti-FSHr antibody fragment was 25 kDa and 15 kDa, respectively. Based on protein molecular weight, the antibody fragment of dogs and cats was therefore, so-called single-chain variable fragments (scFv) and nanobody (nb), respectively. The binding affinity with dissociation constant (K D) was 2.32 × 10−7 M and 2.83 × 10−9 M for dog and cat anti-FSHr antibody fragments, respectively. The cross-binding kinetic interactions between the dog anti-FSHr scFv and the cat ECD of FSHr could not be fitted to the curves to determine the binding kinetics. However, the cross-binding affinity K D between the cat anti-FSHr nb and the dog ECD FSHr was 1.75 × 10−4 M. The mRNA expression of ABP , IHBB and VEGFA in SCCs was less (P < 0.05) in both dogs (12.26, 4.07 and 5.11 folds, respectively) and cats (39.53, 14.07 and 20.29 folds, respectively) treated with anti-FSHr antibody fragments, indicating the Sertoli cell functions were suppressed. In conclusion, this study demonstrated the establishment of species-specific antibody fragments against FSHr in SCCs for dogs and cats. The fragment proteins illustrate potential to be developed as non-surgical contraceptive agent targeting FSHr in companion animals. • The anti-follicular stimulating hormone receptor (anti-FSHr) antibody fragment was developed in dogs and cats by biopanning. • The anti-FSHr antibody fragments demonstrated inhibitory function in the Sertoli cell cultures. • The anti-FSHr antibody fragments demonstrated species-spefic binding. [ABSTRACT FROM AUTHOR]

Introduction: This retrospective study highlights the salient aspects of a series of feline patients affected with bisphosphonate related osteonecrosis of the jaw. Though more commonly published in human literature, this presentation is rare in cats. The authors hope that this study will assist in making this a more globally known entity with subsequent improved prognosis. Methods: Data was retrospectively obtained from the medical records between 2015 and 2021 of 20 cats with Medication Related Osteonecrosis of the Jaw. Data included patient information, clinical history, presenting complaint, systemic diseases, details referable to hypercalcemia and treatment thereof, bisphosphonate specifics (dose and duration), clinical presentation of the lesion, diagnostic testing including radiographic and histopathologic descriptions, treatment, and outcome. Results: Pertinent results include that all 20 cats who developed Medication Related Osteonecrosis of the Jaw had been treated for idiopathic hypercalcemia with the bisphosphonate medication alendronate. Eighty-five percent of the cases had prior dental extractions at the site of MRONJ lesion. Ninety-five percent of the affected cats required a surgical procedure to control the disease. Thirty-five percent of cases required at least one revision surgery after the initial procedure was performed. Diagnosis of MRONJ was made by a correlation of diagnostic findings and patient history. No single diagnostic, or combination was pathognomonic for lesion diagnosis. As well, there were no statistically significant associations between patient variables assessed and the overall patient outcome. Discussion: The case series reveals that cats with feline idiopathic hypercalcemia treated with alendronate may be at a risk for development of MRONJ, a serious oral condition with significant morbidity. Prior dental extraction sites in patients concurrently treated with bisphosphonate medications were often associated with MRONJ lesions. Therefore, any needed dental surgery should be performed prior to the use of bisphosphonates where possible. The authors have also included a relevant comparative literature review. [ABSTRACT FROM AUTHOR]