Scoring system for sick hospitalized cat

Hayes G, Mathews K, Doig G, et al. The feline acute patient physiologic and laboratory evaluation (Feline APPLE) score: a severity of illness stratification system for hospitalized cats. J Vet Intern Med 2011;25:26-38.

This study’s objective was to construct and validate an accurate, user-friendly score to stratify illness severity or mortality risk prediction in hospitalized cats. This was an observational cohort study of 600 cats admitted to a teaching hospital’s intensive care unit.  Diagnosis-independent illness severity scores are available for humans, dogs, and horses. No such scores are available for cats. Two important points must be considered in regards to score use. First, the scores have been constructed and validated on patient data obtained over the initial 24 hours after hospital admission, for patients requiring IV support or close monitoring. Second, the scores are designed to risk stratify populations, not to prognosticate individual patients. Use of scores to stratify patients to facilitate protocols, i.e. treatment regimen establishment, is acceptable. Use of scores for withdrawal of care protocols is contraindicated. The study found that an 8-variable model showed better predictive performance than a 5-variable model, and would be the optimal model to use when possible. The 8-variable model includes mentation score, temperature, mean arterial pressure, lactate, PCV, urea, chloride, and body cavity fluid score. The 5-variable score, i.e. mentation score, temperature, mean arterial pressure, lactate, and PCV, requires only “bench top” or clinical variables that may be more accessible in some circumstances. Therefore, 2 scoring systems have been developed that offer a robust measure of illness severity and facilitate objectification of illness severity in clinical research.  [VT]

Related articles:

Hayes G, Mathews K, Doig G, et al. The acute patient physiologic and laboratory evaluation (APPLE) score: a severity of illness stratification system for hospitalized dogs. J Vet Intern Med 2010;24:1034-1047.

More on cat health: Winn Feline Foundation Library

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Hayes G, Mathews K, Doig G, et al. The feline acute patient physiologic and laboratory evaluation (Feline APPLE) score: a severity of illness stratification system for hospitalized cats. J Vet Intern Med 2011;25:26-38.

This study’s objective was to construct and validate an accurate, user-friendly score to stratify illness severity or mortality risk prediction in hospitalized cats. This was an observational cohort study of 600 cats admitted to a teaching hospital’s intensive care unit.  Diagnosis-independent illness severity scores are available for humans, dogs, and horses. No such scores are available for cats. Two important points must be considered in regards to score use. First, the scores have been constructed and validated on patient data obtained over the initial 24 hours after hospital admission, for patients requiring IV support or close monitoring. Second, the scores are designed to risk stratify populations, not to prognosticate individual patients. Use of scores to stratify patients to facilitate protocols, i.e. treatment regimen establishment, is acceptable. Use of scores for withdrawal of care protocols is contraindicated. The study found that an 8-variable model showed better predictive performance than a 5-variable model, and would be the optimal model to use when possible. The 8-variable model includes mentation score, temperature, mean arterial pressure, lactate, PCV, urea, chloride, and body cavity fluid score. The 5-variable score, i.e. mentation score, temperature, mean arterial pressure, lactate, and PCV, requires only “bench top” or clinical variables that may be more accessible in some circumstances. Therefore, 2 scoring systems have been developed that offer a robust measure of illness severity and facilitate objectification of illness severity in clinical research.  [VT]

Related articles:

Hayes G, Mathews K, Doig G, et al. The acute patient physiologic and laboratory evaluation (APPLE) score: a severity of illness stratification system for hospitalized dogs. J Vet Intern Med 2010;24:1034-1047.

More on cat health: Winn Feline Foundation Library

Join us on Facebook

Follow us on Twitter

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Really? The Claim: For Better Hydration, Drink Coconut Water

Not long ago, few athletes had heard of coconut water, but sales have skyrocketed, largely because of its reputation as a healthy and natural source of electrolytes.



Pure coconut water contains many electrolytes, like sodium, the critical one lost during sweating. But many commercial varieties have less sodium than is found in juice straight from a coconut or in traditional sports drinks. An 8.5 ounce serving of Vita Coco 100% Pure Coconut Water, for example, contains 30 milligrams of sodium and 15 grams of carbohydrates. An eight-ounce serving of Gatorade Pro 02 Perform is equal in carbs (14 grams) but has more sodium (200 milligrams).

A recent study by Consumerlab.com, an independent laboratory, found that two of the most popular varieties, Vita Coco and O.N.E. Coconut Water, contained even less sodium and magnesium than advertised. Only Zico Natural contained the amount of sodium listed on its label (160 milligrams).



Few studies have looked directly at coconut water and exercise. In one, researchers had subjects run for 90 minutes in hot temperatures and then tested the effects of plain water, a sports drink, coconut water or a sodium-enriched coconut water in the two hours after exercise. While all remained “somewhat dehydrated,” the sodium-enriched coconut water worked as well as the sports drink.



Sports drinks serve a purpose among elite athletes and those who exercise for long periods. But for those who exercise at a moderate intensity for an hour or less, water is probably the better choice.

Not long ago, few athletes had heard of coconut water, but sales have skyrocketed, largely because of its reputation as a healthy and natural source of electrolytes.



Pure coconut water contains many electrolytes, like sodium, the critical one lost during sweating. But many commercial varieties have less sodium than is found in juice straight from a coconut or in traditional sports drinks. An 8.5 ounce serving of Vita Coco 100% Pure Coconut Water, for example, contains 30 milligrams of sodium and 15 grams of carbohydrates. An eight-ounce serving of Gatorade Pro 02 Perform is equal in carbs (14 grams) but has more sodium (200 milligrams).

A recent study by Consumerlab.com, an independent laboratory, found that two of the most popular varieties, Vita Coco and O.N.E. Coconut Water, contained even less sodium and magnesium than advertised. Only Zico Natural contained the amount of sodium listed on its label (160 milligrams).



Few studies have looked directly at coconut water and exercise. In one, researchers had subjects run for 90 minutes in hot temperatures and then tested the effects of plain water, a sports drink, coconut water or a sodium-enriched coconut water in the two hours after exercise. While all remained “somewhat dehydrated,” the sodium-enriched coconut water worked as well as the sports drink.



Sports drinks serve a purpose among elite athletes and those who exercise for long periods. But for those who exercise at a moderate intensity for an hour or less, water is probably the better choice.

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2011 Winn/AVMF Excellence in Feline Research Award

Jody L. Gookin, DVM, PhD, DACVIM, is the winner of the 2011 Excellence in Feline Research Award from Winn and the American Veterinary Medical Foundation (AVMF).  Dr. Gookin is nationally recognized for her contributions to the field of gastroenterology, particularly infectious causes of feline diarrhea.  She and her colleagues are credited with the identification of Tritrichomonas foetus as a cause of diarrhea in domestic cats, and have worked for more than 12 years to establish its pathogenesis, develop diagnostic tools, discover the worldwide significance, and find an effective treatment for this common infection.   The award consists of $2500 and a crystal cat, the “Winnie.”  Winn President, Vicki Thayer, DVM, DABVP, made the announcement and presented the award at the annual convention of the American Veterinary Medical Association held in July in St. Louis. 

Dr. Jody Gookin

Dr. Gookin received her DVM degree from the University of California at Davis, and her PhD in gastrointestinal physiology at North Carolina State University.   She is a Diplomate of the American College of Veterinary Internal Medicine.  Dr. Gookin is currently an Associate Professor in the Department of Clinical Sciences at North Carolina State University. She received a Winn Feline Foundation research grant in 2007 to study the prevalence and risk factors for venereal Tritrichomonas foetus infection, and another in 2009 to study the prevalence, identity, and antimicrobial susceptibility of Enterococcus spp. infection in kittens.  In 2011, Dr. Gookin was awarded two Winn grants to study important intestinal infection of kittens caused by E. coli and Enterococcus.  Dr. Gookin was a featured speaker at the Winn Feline Foundation Symposium held in June, 2008.

Winn FelineFoundation and the AVMF join together annually to present two awards designed to promote and encourage feline health studies by both established veterinary research scientists and by those entering the field. In addition to the “Winnie”, a matching scholarship winner is selected from a large group of student applicants. This year’s scholarship winner is Dr. Jessica Balter.

Winn Feline Foundation and the AVMF are pleased to be associated in this effort to focus attention on care for “Every cat, every day.”   

Jody L. Gookin, DVM, PhD, DACVIM, is the winner of the 2011 Excellence in Feline Research Award from Winn and the American Veterinary Medical Foundation (AVMF).  Dr. Gookin is nationally recognized for her contributions to the field of gastroenterology, particularly infectious causes of feline diarrhea.  She and her colleagues are credited with the identification of Tritrichomonas foetus as a cause of diarrhea in domestic cats, and have worked for more than 12 years to establish its pathogenesis, develop diagnostic tools, discover the worldwide significance, and find an effective treatment for this common infection.   The award consists of $2500 and a crystal cat, the “Winnie.”  Winn President, Vicki Thayer, DVM, DABVP, made the announcement and presented the award at the annual convention of the American Veterinary Medical Association held in July in St. Louis. 

Dr. Jody Gookin

Dr. Gookin received her DVM degree from the University of California at Davis, and her PhD in gastrointestinal physiology at North Carolina State University.   She is a Diplomate of the American College of Veterinary Internal Medicine.  Dr. Gookin is currently an Associate Professor in the Department of Clinical Sciences at North Carolina State University. She received a Winn Feline Foundation research grant in 2007 to study the prevalence and risk factors for venereal Tritrichomonas foetus infection, and another in 2009 to study the prevalence, identity, and antimicrobial susceptibility of Enterococcus spp. infection in kittens.  In 2011, Dr. Gookin was awarded two Winn grants to study important intestinal infection of kittens caused by E. coli and Enterococcus.  Dr. Gookin was a featured speaker at the Winn Feline Foundation Symposium held in June, 2008.

Winn FelineFoundation and the AVMF join together annually to present two awards designed to promote and encourage feline health studies by both established veterinary research scientists and by those entering the field. In addition to the “Winnie”, a matching scholarship winner is selected from a large group of student applicants. This year’s scholarship winner is Dr. Jessica Balter.

Winn Feline Foundation and the AVMF are pleased to be associated in this effort to focus attention on care for “Every cat, every day.”   

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