Feline Systemic Disease Study
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Questions and Answers

Which of the following was found to NOT be a significant risk factor for the development of ABK?

  • Concurrent administration of cyclosporine and prednisolone
  • Administration of corticosteroids
  • Systemic cyclosporine therapy
  • Oral prednisolone (correct)

    • What is considered a significant risk factor for the development of ABK according to the findings?

  • Chlamydophila felis infection
  • Systemic administration of corticosteroids
  • Oral cyclosporine administration
  • Systemic cyclosporine therapy (correct)

    • Which commonly diagnosed systemic condition was highlighted among the cats studied?

  • Hyperthyroidism
  • Diabetes mellitus
  • Feline leukemia virus (FeLV) infection (correct)
  • Chronic renal failure

    • What is the age range in which ABK has been reported in cats?

    <p>One to four years</p> Signup and view all the answers

    Which bacterium is mentioned as a possible cause of disruption in corneal architecture in cats?

    <p>A bacterial species from culture</p> Signup and view all the answers

    Which condition did cats have that led to the diagnosis of bilateral ABK in the study by Evans et al.?

    <p>Immune-mediated hemolytic anemia (IMHA)</p> Signup and view all the answers

    What type of viral infection is associated with cats that may have ABK?

    <p>Feline infectious peritonitis virus</p> Signup and view all the answers

    How many of the cats studied were systemically healthy at the time of ABK onset?

    <p>Two out of twelve cats were systemically healthy.</p> Signup and view all the answers

    What does the curled appearance of Descemet's membrane suggest about the corneal condition in cats?

    <p>The curled appearance suggests rupture and potential chronic degeneration of the membrane.</p> Signup and view all the answers

    Of the eyes affected by ABK in the studied cats, how many remained sighted at the last follow-up?

    <p>Thirteen out of seventeen eyes remained sighted.</p> Signup and view all the answers

    What combinations of diagnostic tests were performed on a subset of cats with ABK?

    <p>Corneal cytology, aerobic bacterial culture, FHV-1 PCR, virus isolation, and/or histopathology.</p> Signup and view all the answers

    What systemic conditions were specifically noted in the context of ABK in the study?

    <p>The study focused on the administration of systemic corticosteroid or immunosuppressive therapy.</p> Signup and view all the answers

    How did the length of systemic therapy in ABK-affected cats compare to non-ABK-affected cats?

    <p>ABK-affected cats had a therapy duration approximately 2.5 times longer.</p> Signup and view all the answers

    Which breed of cat was specifically mentioned in relation to inherited corneal dystrophy?

    <p>Manx cat</p> Signup and view all the answers

    What effect is associated with the enzymatic corneal stromal degradation in the context of ABK?

    <p>It yields collagen fiber breakdown.</p> Signup and view all the answers

    Was there a significant association found between onset of ABK and other systemic or dermatological medications?

    <p>No, there was no significant association found.</p> Signup and view all the answers

    What type of dosages of systemic therapy were the majority of ABK-affected cats receiving?

    <p>Anti-inflammatory or immunosuppressive dosages.</p> Signup and view all the answers

    What does the investigation suggest is warranted regarding ABK development in cats?

    <p>Continued investigations into the underlying etiology are warranted.</p> Signup and view all the answers

    What concurrent ocular condition was present in some cats at the time of ABK diagnosis?

    <p>Superficial corneal ulcers.</p> Signup and view all the answers

    What percentage of the studied cats had a recorded systemic disease?

    <p>100% of the cats had systemic disease.</p> Signup and view all the answers

    Study Notes

    Feline Acute Bullous Keratopathy (ABK) Overview

    • ABK is characterized by the rapid imbibition of aqueous humor into the cornea, causing disruption of collagen structure and corneal shape deformation.
    • Primarily documented in young cats aged 1 to 4 years, with rare instances in older cats, such as a 14-year-old.

    Associations with Systemic Disease

    • Out of 12 cats, 10 had been diagnosed with ongoing systemic diseases.
    • A strong correlation exists between systemic corticosteroid and cyclosporine A treatments and the onset of ABK (P < 0.001).
    • Prednisolone was administered to 8 out of 10 affected cats, typically at doses of 1–2 mg/kg every 12–24 hours.

    Systemic Therapy Risks

    • Out of the cats receiving prednisolone, 5 were also treated with cyclosporine at doses between 1.5–7 mg/kg.
    • Cyclosporine therapy has been identified as a significant risk factor for developing ABK (P < 0.001), while prednisolone was not statistically significant (P = 0.10).

    Investigated Infectious Agents

    • Potential infectious agents considered include:
      • Bacteria: Chlamydophila felis, Mycoplasma spp., and others through culture and PCR.
      • Protozoa: Toxoplasma gondii, assessed via serum antibody titers.
      • Viruses: Feline herpesvirus type 1, feline infectious peritonitis virus, feline leukemia virus, and feline immunodeficiency virus, tested through various diagnostic assays.

    Prior Observations and Research

    • Previous observations noted ABK incidents in cats receiving dexamethasone (Martin, 2005) and cases linked to immune-mediated conditions and cyclosporine therapy (Evans et al.).
    • Statistical analyses employed include Chi-square tests and Fisher's exact tests to investigate potential correlations among breed, gender, systemic diseases, and immunosuppressive treatments.

    Clinical Outcomes and Treatments

    • A variety of therapies utilized, including ophthalmic medications like 5% NaCl and antibiotics like Terramycin.
    • Surgical interventions included penetrating keratoplasty and other types of surgeries depending on the severity of each case.
    • The visual outcomes varied; some cats remained sighted, while others were blinded due to the severity of ABK.

    Limitations of the Study

    • Low sample size of affected cats and missing historical data may hinder comprehensive analysis.
    • Inclusion criteria were strict, reflecting the relative rarity of ABK, and may affect the generalizability of findings to broader cat populations.
    • Potential variations in drug dosages, treatment duration, and follow-up care noted, introducing possibilities for data skewing.

    Systemic Conditions of Affected Cats

    • Types of systemic diseases in the affected population included:
      • Immune-mediated hemolytic anemia (3 cases)
      • Inflammatory bowel disease (2 cases)
      • Other conditions: Feline leukemia virus, feline asthma, and chronic feline herpesvirus rhinitis.

    Study Notes on Acute Bullous Keratopathy in Cats

    • Objective: Investigate the possible association between systemic cyclosporine administration and the development of acute bullous keratopathy (ABK) in felines.
    • Study Population: Medical records of cats diagnosed with ABK from 2000 to 2008 were retrospectively analyzed.
    • Findings:
      • A total of 12 cats matched inclusion criteria from a population of 70,167.
      • Out of 24 eyes examined, 17 were affected by ABK.
      • 13 out of 17 affected eyes remained sighted during the last follow-up.
    • Diagnostic Tests:
      • Corneal cytology, bacterial culture, FHV-1 PCR, virus isolation, and histopathological analyses were conducted.
      • No infectious organisms were identified in the cases analyzed.
    • Histopathology:
      • Rupture in Descemet’s membrane was noted in two globes.
      • Multiple levels of corneal surface area were affected in various cases.
    • Systemic Disease Status:
      • Systemic diseases noted included FeLV, IMHA, inflammatory bowel disease (IBD), and chronic FHV-1 rhinitis.
      • Ten out of twelve cats had existing systemic diseases at the time of ABK diagnosis.
    • Treatment Data:
      • Medical and/or surgical interventions were used for managing ABK.
      • Systemic therapies included prednisolone and cyclosporine, among others, at various dosages and durations.
    • Clinical Outcomes:
      • Visual outcomes varied; at follow-up, many cats retained vision.
    • Important Observations:
      • Two of the diagnosed cats were systemically healthy at the onset of ABK.
      • Significant histological characteristics included endothelial attenuation, corneal edema, and formations of mucinous material.
    • Potential Implications:
      • Understanding the relationship between systemic immunosuppressive therapy and ocular conditions can inform further veterinary care and treatment protocols.
    • Conclusion:
      • Further research is required to clarify the relationship between systemic cyclosporine therapy and ABK in cats, as well as the underlying mechanisms contributing to this ocular condition.### ABK Development in Cats
    • ABK (anterior blepharitis keratitis) incidence in cats receiving oral cyclosporine is significantly higher compared to unaffected cats (P < 0.001).
    • Investigated a sample size of 5 ABK-affected cats versus 45 unaffected cats in a hospital population.
    • No significant link between ABK onset and other systemic or dermatological medications.

    Treatment and Risk Factors

    • Majority of ABK-affected cats had a history of systemic therapy prior to ABK development, differing from past case reports.
    • Cats were primarily treated with anti-inflammatory or immunosuppressive dosages.
    • The duration of therapy in ABK-affected cats was approximately 2.5 times longer than in non-ABK-affected cats diagnosed with the same systemic conditions.

    Theories of Etiology

    • Possible causes of ABK include inherited corneal stromal dystrophy and enzymatic degradation of the cornea leading to collagen breakdown.
    • Some cases linked to previous treatment with corticosteroids, either topical or systemic.
    • Inherited corneal dystrophy in specific breeds (e.g., Manx cat) identified as a precursor, progressing from anterior stromal edema to epithelial degradation.

    Cyclosporine

    • Cyclosporine A, an immunosuppressive drug from the soil fungus Tolypocladium inflatum, initially used to prevent organ transplant rejection and related interactions.

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    Description

    This quiz examines a study on systemic diseases in cats, focusing on the correlation between corticosteroid therapy and the development of ABK. It provides insights into the prevalence of systemic disease in diagnosed felines and the impact of treatment protocols.

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