Consultations in Feline Internal Medicine, Volume 6, 6th
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CONSULTATIONS IN FELINE INTERNAL MEDICINE ISBN: 978-1-4160-5641-6
Copyright © 2010 by Saunders, an imprint of Elsevier Inc.
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Notice
Knowledge and best practice in this field are constantly changing. As new research and
experience broaden our knowledge, changes in practice, treatment and drug therapy may
become necessary or appropriate. Readers are advised to check the most current
information provided (i) on procedures featured or (ii) by the manufacturer of each
product to be administered, to verify the recommended dose or formula, the method and
duration of administration, and contraindications. It is the responsibility of the
practitioner, relying on their own experience and knowledge of the patient, to make
diagnoses, to determine dosages and the best treatment for each individual patient, and to
take all appropriate safety precautions. To the fullest extent of the law, neither the
Publisher nor the Authors assume any liability for any injury and/or damage to persons or
property arising out of or related to any use of the material contained in this book.
The Publisher
Previous volumes copyrighted 2006, 2001, 1997, 1994, 1991
International Standard Book Number 978-1-4160-5641-6
Vice President and Publisher: Linda Duncan
Senior Acquisitions Editor: Anthony Winkel
Senior Developmental Editor: Shelly Stringer
Publishing Services Manager: Catherine Jackson
Senior Project Manager: David Stein
Design Direction: Charlie Seibel
Cover Art: Olek Kuperberg
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This book is dedicated to the memory of my mother,
Andrée August.
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John R. August
vii
Preface
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There always seemed to be a cat in my home when I was this book, and also to the breadth of their expertise and
growing up in southeast England in the 1950s and 1960s. experience in feline medicine. From a slightly selfish
At that time, cats were more popular as companion standpoint, I also like to think that it has a little to do
animals in Europe than in the United States. It was no with the evolving recognition of Consultations in Feline
surprise then that I should be tagged as the person who Internal Medicine as a respected resource for our
would be willing to see the feline patients when I arrived profession.
in the United States for my internship in the early 1970s. Some other important recognitions are in order for my
The label stuck, and I have enjoyed riding the wave of colleagues at Elsevier. Dr. Anthony Winkel, Senior Acqui-
the surging popularity of cats as companion animals and sitions Editor, Veterinary Medicine, deserves my special
family members ever since. By sheer luck, I was in the thanks for the guidance, mentorship, and motivation
right place at the right time. Over the years, I have had that he has provided me throughout the preparation of
the good fortune to travel to South America regularly, this volume. I also want to recognize Tony for his special
and I have watched with great interest how cats are now commitment to the striking design and professional
assuming new roles in the family and society in those layout of this book. Ms. Shelly Stringer, Senior Develop-
countries. I owe a special thanks to my colleagues in mental Editor, has been a tower of strength, making sure
South America who have invited me to their beautiful that the loop has been closed on thousands of details
countries, and who have provided me with such gracious during the processing of all of the manuscripts, and
hospitality during my professional visits. It has been a maintaining communications among the more than one
special privilege for me to watch feline medicine evolve hundred contributors and section editors. Lastly, it has
as a discipline internationally during my career. been a pleasure working again with David Stein, Senior
Each volume of Consultations in Feline Internal Medicine Project Manager; I always know that the project will be
takes 3 years to prepare, and carefully complements pre- completed with immaculate attention to detail and dead-
vious books in the series. Purposefully, this book is not a lines when it is placed in David’s hands.
comprehensive treatise on feline medicine. Rather, it is I must thank my wife Janet who once again tolerated
an in-depth collection of timely topics that will be of my insistence that obligations to this book should super-
unique interest to progressive feline practitioners when sede projects around our house and family vacations
the book is published and beyond. I entrust the respon- during the past year. My university has been generous
sibility of choosing the subject matter and contributing this year in providing me with some extra time away
authors of each volume to the eleven section editors, who from clinic duty to complete this project, and for that I
are international leaders in their respective disciplines. am very grateful. Texas A&M University continues to give
Reflecting my own belief as an internist that scientific priority to the health and welfare of cats in its profes-
nutrition is a foundation of good health, we have included sional and postgraduate programs, offering a rotation in
a new section in this volume devoted to the relationship feline internal medicine for fourth-year students. In July
between nutrition and health and disease. 2008, we initiated a 3-year small animal internal medi-
Organizing sections and authoring chapters within cine residency with a feline focus, with the intent of
strict time deadlines for a book like Consultations in Feline preparing the next generation of feline internists.
Internal Medicine takes an enormous amount of time and In closing, I hope that the sixth volume of this series
intellectual effort, and the section editors and authors all exceeds your expectations and that it will become an
deserve my very sincere thanks for their contributions to important resource for your professional activities. A
this project. During the final year of preparation of this project of this size truly is a team effort, and it is a real
book, I have had the opportunity to edit all of the chap- privilege for me to contribute in this way to the rapidly
ters three times, and I continue to be very impressed by evolving discipline of feline internal medicine.
the complexity and scope of the chapters. That these
authors should go well beyond the call of duty when John August
writing their chapters is a testament to the seriousness College Station, Texas
with which they took their invitation to contribute to
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ix
Section Editors
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Ellen N. Behrend, VMD, PhD, Diplomate ACVIM Professor
Department of Clinical Sciences
College of Veterinary Medicine
Auburn University
Auburn, Alabama, USA
Endocrine and Metabolic Disease
Joan R. Coates, DVM, MS, Diplomate ACVIM (Neurology)
Associate Professor
Department of Veterinary Medicine and Surgery
College of Veterinary Medicine
University of Missouri
Columbia, Missouri, USA
Neurology
Ann E. Hohenhaus, DVM, Diplomate ACVIM (Oncology, Internal
Medicine)
Chairman
Department of Medicine
The Animal Medical Center
New York, New York, USA
Hematopoietic and Lymphatic Systems
x Section Editors
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India F. Lane, DVM, MS, EdD, Diplomate ACVIM
Associate Professor, Director of Educational Enhancement
Department of Small Animal Clinical Sciences
College of Veterinary Medicine
The University of Tennessee
Knoxville, Tennessee, USA
Urinary System
Julie Levy, DVM, PhD, Diplomate ACVIM
Maddie’s Professor of Shelter Medicine
Department of Small Animal Clinical Sciences
College of Veterinary Medicine
University of Florida
Gainesville, Florida, USA
Infectious Diseases
Matthew W. Miller, DVM, MS, Diplomate ACVIM (Cardiology)
Professor
Department of Small Animal Clinical Sciences
College of Veterinary Medicine and Biomedical Sciences
Texas A&M University
College Station, Texas, USA
Cardiology and Respiratory Disorders
Karen A. Moriello, DVM, Diplomate ACVD
Clinical Professor of Dermatology
Department of Medical Sciences
School of Veterinary Medicine
University of Wisconsin
Madison, Wisconsin, USA
Dermatology
Section Editors xi
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Kenita S. Rogers, DVM, MS, Diplomate ACVIM (Internal Medicine,
Oncology)
Professor, Associate Dean for Professional Programs
Department of Small Animal Clinical Sciences
College of Veterinary Medicine and Biomedical Sciences
Texas A&M University
College Station, Texas, USA
Oncology
Margaret R. Slater, DVM, PhD
Senior Director of Epidemiology
Animal Health Services
ASPCA
Urbana, Illinois, USA
Population Medicine
Jörg M. Steiner, medvet, Drmedvet, PhD, Diplomate ACVIM,
ECVIM-CA
Associate Professor
Department of Small Animal Clinical Sciences
College of Veterinary Medicine and Biomedical Sciences
Texas A&M University
College Station, Texas, USA
Gastrointestinal System
Debra L. Zoran, DVM, PhD, Diplomate ACVIM
Associate Professor
Department of Small Animal Clinical Sciences
College of Veterinary Medicine and Biomedical Sciences
Texas A&M University
College Station, Texas, USA
Nutrition in Health and Disease
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xiii
Contributors
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Hasan Albasan, DVM, MS, PhD Claudia J. Baldwin, DVM, MS, Diplomate
Research Associate ACVIM
Department of Veterinary Clinical Sciences Associate Professor
College of Veterinary Medicine Department of Veterinary Clinical Sciences
University of Minnesota College of Veterinary Medicine
St. Paul, Minnesota, USA Iowa State University
Purine Uroliths Ames, Iowa, USA
Shelter Population Health Management
Heidi S. Allen, DVM, Diplomate ACVIM
Staff Internist Vanessa R.D. Barrs, BVSc (Hons), MVCS,
The Internal Medicine Department FACVSc (Feline Medicine)
The Hope Center for Advanced Veterinary Medicine Senior Lecturer in Small Animal Medicine
Vienna, Virginia, USA Valentine Charlton Cat Centre
Therapeutic Approach to Cats with Chronic Faculty of Veterinary Science
Diarrhea The University of Sydney
Sydney, New South Wales, Australia
Karin Allenspach, DrMedVet, PhD, FVH, Pyothorax
Diplomate ECVIM-CA Upper Respiratory Tract Aspergillosis
Lecturer Diagnosis and Treatment of Low-Grade
Department of Veterinary Clinical Sciences Alimentary Lymphoma
The Royal Veterinary College
University of London Joseph W. Bartges, DVM, PhD, Diplomate
Hatfield, Hertfordshire, United Kingdom ACVIM, ACVN
Antiemetic Therapy Professor of Medicine and Nutrition
The Acree Endowed Chair of Small Animal Research
Eva Axnér, DVM, PhD, Diplomate ECAR Department of Small Animal Clinical Sciences
Associate Professor College of Veterinary Medicine
Department of Clinical Sciences University of Tennessee
Division of Reproduction Knoxville, Tennessee, USA
Swedish University of Agricultural Sciences Dietary Therapy of Diseases of the Lower Urinary
Uppsala, Sweden Tract
Catteries: Reproductive Performance and
Problems Julia A. Beatty, BSc (Hons), BVM, PhD,
FACVSc (Feline Medicine), MRCVS
Kerry Smith Bailey, DVM, Diplomate ACVIM Senior Lecturer in Small Animal Medicine
(Neurology) Faculty of Veterinary Science
Staff Neurologist Hospital Director, Valentine Charlton Cat Centre
Oradell Animal Hospital, Inc. University of Sydney
Paramus, New Jersey, USA Sydney, New South Wales, Australia
Novel Anticonvulsant Therapies Pyothorax
Upper Respiratory Tract Aspergillosis
Diagnosis and Treatment of Low-Grade
Alimentary Lymphoma
xiv Contributors
Allyson C. Berent, DVM, Diplomate ACVIM Ruthanne Chun, DVM, Diplomate ACVIM
Staff Veterinarian (Oncology)
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Department of Clinical Studies—Philadelphia Clinical Associate Professor
School of Veterinary Medicine Department of Medical Sciences
University of Pennsylvania School of Veterinary Medicine
Philadelphia, Pennsylvania, USA University of Wisconsin
Urological Interventional Techniques in the Madison, Wisconsin, USA
Feline Patient Urinary Tract Tumors
Barbara Bighignoli, PhD David B. Church, BVSc, PhD, MACVSc,
Department of Animal Science MRCVS
University of Milan Professor
Milan, Italy Department of Veterinary Clinical Sciences
Blood Types of the Domestic Cat The Royal Veterinary College
University of London
Paul B. Bloom, DVM, Diplomate ACVD, Hatfield, Hertfordshire, United Kingdom
ABVP (Canine and Feline) Acromegaly
Assistant Adjunct Professor
Department of Small Animal Clinical Sciences Joan R. Coates, DVM, MS, Diplomate ACVIM
College of Veterinary Medicine (Neurology)
Michigan State University Associate Professor
East Lansing, Michigan, USA Department of Veterinary Medicine and Surgery
Anatomy of the Ear in Health and Disease College of Veterinary Medicine
University of Missouri
Mark W. Bohling, DVM, PhD, Diplomate Columbia, Missouri, USA
ACVS Tremor Syndromes
Assistant Professor
Department of Small Animal Clinical Sciences Leah A. Cohn, DVM, PhD, Diplomate ACVIM
College of Veterinary Medicine Associate Professor
University of Tennessee Department of Veterinary Medicine and Surgery
Knoxville, Tennessee, USA College of Veterinary Medicine
A Review of Neutering Cats University of Missouri
Columbia, Missouri, USA
Scott A. Brown, VMD, PhD, Diplomate Cytauxzoon Infections
ACVIM
Josiah Meigs Distinguished Professor and Head Audrey K. Cook, BVMS, MRCVS, Diplomate
Department of Small Animal Medicine and Surgery ACVIM, ECVIM-CA
College of Veterinary Medicine Clinical Associate Professor
University of Georgia Department of Small Animal Clinical Sciences
Athens, Georgia, USA College of Veterinary Medicine and Biomedical Sciences
Linking Treatment to Staging in Chronic Kidney Texas A&M University
Disease College Station, Texas, USA
Gastrointestinal Function Testing
Christine M. Budke, DVM, PhD
Assistant Professor Cynda Crawford, DVM, PhD
Department of Veterinary Integrative Biosciences Maddie’s Clinical Assistant Professor of Shelter
College of Veterinary Medicine and Biomedical Sciences Medicine
Texas A&M University Department of Small Animal Clinical Sciences
College Station, Texas, USA College of Veterinary Medicine
Understanding Population Dynamics Models: University of Florida
Implications for Veterinarians Gainesville, Florida, USA
Progress on Diagnosis of Retroviral Infections
Daniel L. Chan, DVM, MRCVS, Diplomate
ACVECC, ACVN Curtis W. Dewey, DVM, MS, Diplomate
Lecturer ACVIM (Neurology), ACVS
Department of Veterinary Clinical Sciences Associate Professor
The Royal Veterinary College Department of Clinical Sciences
University of London College of Veterinary Medicine
Hatfield, Hertfordshire, United Kingdom Cornell University
Critical Care Nutrition Ithaca, New York, USA
Antiemetic Therapy Novel Anticonvulsant Therapies
Contributors xv
Alison Diesel, DVM Lutz Froenicke, PhD
Resident in Dermatology Department of Population Health and Reproduction
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Department of Medical Sciences School of Veterinary Medicine
School of Veterinary Medicine University of California
University of Wisconsin Davis, California, USA
Madison, Wisconsin, USA Blood Types of the Domestic Cat
Medical Management of Otitis
Michele C. Gaspar, DVM, Diplomate ABVP
Brian A. DiGangi, DVM (Feline)
Resident in Shelter Medicine Consultant in Feline Internal Medicine
Department of Population Medicine and Diagnostic Veterinary Information Network
Sciences Davis, California, USA
College of Veterinary Medicine Alternative Modalities in Feline Practice
Cornell University
Ithaca, New York, USA Andrew Gendler, DVM
A Review of Neutering Cats Resident in Radiology
Department of Surgical Sciences
Joan Dziezyc, DVM, Diplomate ACVO School of Veterinary Medicine
Associate Professor University of Wisconsin
Department of Small Animal Clinical Sciences Madison, Wisconsin, USA
College of Veterinary Medicine and Biomedical Sciences Diagnostic Imaging of the Ear
Texas A&M University
College Station, Texas, USA Virginia L. Gill, DVM, Diplomate ACVIM
Ocular Tumors (Oncology)
Staff Oncologist
Danielle M. Eifler, DVM, Diplomate ACVIM Katonah Bedford Veterinary Center
(Neurology) Bedford Hills, New York, USA
Staff Neurologist Plasma Cell Disorders
Maine Veterinary Referral Center
Scarborough, Maine, USA Josephine S. Gnanandarajah, BVSc, MS
Tremor Syndromes Graduate Student
Department of Veterinary and Biomedical Sciences
Denise A. Elliott, BVSc (Hons), PhD, College of Veterinary Medicine
Diplomate ACVIM, ACVN University of Minnesota
Director of Scientific Affairs St. Paul, Minnesota, USA
Royal Canin USA Inc. Purine Uroliths
St. Charles, Missouri, USA
Nutritional Management of Chronic Kidney Richard E. Goldstein, DVM, Diplomate
Disease ACVIM, ECVIM-CA
Associate Professor
Michael A. Estrin, DVM, Diplomate ACVIM Department of Clinical Sciences
Graduate Student College of Veterinary Medicine
Boston University School of Public Health Cornell University
Boston, Massachusetts, USA Ithaca, New York, USA
Disseminated Intravascular Coagulation Commercial Pet Food–Related Nephrotoxicity
Lisa J. Forrest, VMD, Diplomate ACVR Thomas K. Graves, DVM, PhD, Diplomate
(Radiology, Radiation Oncology) ACVIM
Associate Professor, Associate Professor
Department of Surgical Sciences Department of Veterinary Clinical Medicine
School of Veterinary Medicine College of Veterinary Medicine
University of Wisconsin Associate Professor
Madison, Wisconsin, USA Division of Nutritional Sciences
Diagnostic Imaging of the Ear College of Agricultural, Consumer and Environmental
Sciences
Philip R. Fox, DVM, MS, Diplomate ACVIM University of Illinois
(Cardiology), ECVIM, ACVECC Urbana, Illinois, USA
Director Hyperthyroidism and the Kidneys
Caspary Research Institute
The Animal Medical Center
New York, New York, USA
Pathology of Primary Myocardial Disease
xvi Contributors
Brenda Griffin, DVM, MS, Diplomate ACVIM Ann E. Hohenhaus, DVM, Diplomate ACVIM
Assistant Professor (Oncology, Internal Medicine)
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Department of Population Medicine and Diagnostic Chairman
Sciences Department of Medicine
College of Veterinary Medicine The Animal Medical Center
Cornell University New York, New York, USA
Ithaca, New York, USA Selection of Treatment Protocols for Lymphoma
A Review of Neutering Cats
Edward Jazic, DVM, Diplomate ACVD
Meret E. Ricklin Gutzwiller, DVM, Dermatology for Animals
Diplomate ECVD Campbell, California, USA;
Department of Clinical Veterinary Medicine Dermatology Clinic for Animals
Dermatology Unit Gilbert, Arizona, USA
Vetsuisse Faculty Acne
University of Bern
Bern, Switzerland Lynelle R. Johnson, DVM, MS, PhD,
Use of Interferon Omega for Skin Diseases Diplomate ACVIM
Associate Professor
Katrin Hartmann, DVM, DMVH, Diplomate Department of Medicine and Epidemiology
ECVIM-CA School of Veterinary Medicine
Professor University of California
Clinic of Small Animal Medicine Davis, California, USA
College of Veterinary Medicine Bronchoscopy
Ludwig Maximilian University
Munich, Germany Mark C. Johnson, DVM, Diplomate ACVP
Influenza Infections (Clinical Pathology)
Diagnosis and Treatment of Feline Infectious Clinical Associate Professor
Peritonitis Department of Veterinary Pathobiology
College of Veterinary Medicine and Biomedical Sciences
Andrea M. Harvey, BVSc, DSAM (Feline), Texas A&M University
Diplomate ECVIM-CA, MRCVS College Station, Texas, USA
Feline Advisory Bureau Clinical Fellow in Feline The Dilemmas of Cytological Evaluation of the
Medicine Feline Lymph Node
Department of Clinical Veterinary Science
University of Bristol Robert J. Kemppainen, DVM, PhD
Bristol, North Somerset, United Kingdom Professor
Primary Hyperaldosteronism Department of Anatomy, Physiology, and
Pharmacology
Rebecka S. Hess, DVM, Diplomate ACVIM College of Veterinary Medicine
Associate Professor Auburn University
Department of Clinical Studies—Philadelphia Auburn, Alabama, USA
School of Veterinary Medicine Answers to Commonly Asked Endocrine
University of Pennsylvania Diagnostic Questions
Philadelphia, Pennsylvania, USA
Diabetic Emergencies Claudia A. Kirk, DVM, PhD, Diplomate
ACVIM, ACVN
Mark E. Hitt, DVM, MS, Diplomate ACVIM Professor and Head
Chief of Medicine Department of Small Animal Clinical Sciences
Atlantic Veterinary Internal Medicine College of Veterinary Medicine
Annapolis, Maryland, USA University of Tennessee
Inflammatory Liver Diseases Knoxville, Tennessee, USA
Dietary Therapy of Diseases of the Lower Urinary
Margarethe Hoenig, DVM, PhD Tract
Professor
Department of Veterinary Clinical Medicine Barbara Kohn, DVM, Diplomate ECVIM-CA
College of Veterinary Medicine Professor
University of Illinois Clinic for Small Animals
Urbana, Illinois, USA Faculty of Veterinary Medicine
Metabolism, Diet, and Obesity Free University of Berlin
Berlin, Germany
Immune-Mediated Hemolytic Anemia
