Diagnosis of Feline Pancreatic Disease

Webb, C. B. and C. Trott (2008). "Laparoscopic diagnosis of pancreatic disease in dogs and cats." J Vet Intern Med 22(6): 1263-6.

Despite advances in diagnostic testing, the diagnosis of many pancreatic diseases is not straightforward. The pancreatic-lipase immunoreactivity (PLI) assay is sensitive and specific for pancreatic disease, but cannot identify the source of the inflammation. Pancreatic disease may be due to many different causes, such as acute nonsuppurative or chronic lympoplasmacytic pancreatitis, or pancreatitis secondary to another disease process such as inflammatory bowel disease or bile duct obstruction. Noninvasive imaging methods such as ultrasound or radiology have variable degrees of sensitivity and specificity. The gold standard for the diagnosis of exocrine pancreatic disease in animals remains biopsy and histopathology. Laparoscopy offers a minimally invasive route by which to obtain pancreatic biopsies. In this retrospective case series, the medical records of 18 dogs and 13 cats examined between 1999 and 2007 at Colorado State University that underwent laparoscopy during which observation or biopsy of the pancreas was recorded were examined. The presenting complaints, imaging studies, and histopathologic findings were recorded. For comparison, all hospital admissions were searched for animals with the same presenting complaints and of those it was determined which animals had exploratory surgery and their pancreas biopsied. In 14 animals a laparoscopic biopsy of the pancreas resulted in a histopathologic diagnosis when the sonographic findings or the gross assessment failed to do so. Results of this study suggests that laparoscopy is a safe and potentially underutilized diagnostic tool in animals where exocrine pancreatic disease is a prominent differential diagnosis, as in dogs and cats examined for vomiting, anorexia, or both.
>> PubMed Abstract

Related articles:
Richter, K. P. (2001). "Laparoscopy in dogs and cats." Vet Clin North Am Small Anim Pract 31(4): 707-27, ix.
>>PubMed Abstract

Zoran, D. L. (2006). "Pancreatitis in cats: diagnosis and management of a challenging disease." J Am Anim Hosp Assoc 42(1): 1-9.
>>PubMed Abstract

More on cat health: Winn Feline Foundation Library

Webb, C. B. and C. Trott (2008). "Laparoscopic diagnosis of pancreatic disease in dogs and cats." J Vet Intern Med 22(6): 1263-6.

Despite advances in diagnostic testing, the diagnosis of many pancreatic diseases is not straightforward. The pancreatic-lipase immunoreactivity (PLI) assay is sensitive and specific for pancreatic disease, but cannot identify the source of the inflammation. Pancreatic disease may be due to many different causes, such as acute nonsuppurative or chronic lympoplasmacytic pancreatitis, or pancreatitis secondary to another disease process such as inflammatory bowel disease or bile duct obstruction. Noninvasive imaging methods such as ultrasound or radiology have variable degrees of sensitivity and specificity. The gold standard for the diagnosis of exocrine pancreatic disease in animals remains biopsy and histopathology. Laparoscopy offers a minimally invasive route by which to obtain pancreatic biopsies. In this retrospective case series, the medical records of 18 dogs and 13 cats examined between 1999 and 2007 at Colorado State University that underwent laparoscopy during which observation or biopsy of the pancreas was recorded were examined. The presenting complaints, imaging studies, and histopathologic findings were recorded. For comparison, all hospital admissions were searched for animals with the same presenting complaints and of those it was determined which animals had exploratory surgery and their pancreas biopsied. In 14 animals a laparoscopic biopsy of the pancreas resulted in a histopathologic diagnosis when the sonographic findings or the gross assessment failed to do so. Results of this study suggests that laparoscopy is a safe and potentially underutilized diagnostic tool in animals where exocrine pancreatic disease is a prominent differential diagnosis, as in dogs and cats examined for vomiting, anorexia, or both.
>> PubMed Abstract

Related articles:
Richter, K. P. (2001). "Laparoscopy in dogs and cats." Vet Clin North Am Small Anim Pract 31(4): 707-27, ix.
>>PubMed Abstract

Zoran, D. L. (2006). "Pancreatitis in cats: diagnosis and management of a challenging disease." J Am Anim Hosp Assoc 42(1): 1-9.
>>PubMed Abstract

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Remission of Diabetes in Cats

Sieber-Ruckstuhl, N. S., S. Kley, et al. (2008). "Remission of diabetes mellitus in cats with diabetic ketoacidosis." J Vet Intern Med 22(6): 1326-32.

Diabetes mellitus (DM) is one of the most common endocrine disorders in cats. DM in cats appears most similar to type 2 DM in humans, with obesity being a strong risk factor. A serious complication of DM in cats is diabetic ketoacidosis (DKA), a hyperglycemic emergency. While remission has been reported in up to 50% of cats with DM, remission in cats with severe DKA has not been reported. The purpose of this study was to evaluate medical records of cats presenting with DKA with diabetic remission and to compare them with those of cats with DKA without diabetic remission and those of cats with uncomplicated DM and diabetic remission. In this retrospective case review, the records of 12 cats with DKA and 7 cats with uncomplicated DM were analyzed. Of the cats with DKA, 7 experienced remission. These cats had more components of a stress leukogram and had pancreatic disease more often than did cats with uncomplicated DM and diabetic remission. They also had been treated more often with glucocorticoids. The researchers conclude that complete or partial remission of DM in cats presenting with DKA is possible. This finding is important as it may influence the willingness of owners and veterinarians to treat cats presenting with DKA.
>> PubMed Abstract

Related articles:
Zeugswetter, F. and M. Pagitz (2008). "Ketone measurements using dipstick methodology in cats with diabetes mellitus." J Small Anim Pract. [Epub ahead of print]
>> PubMed Abstract

Bruskiewicz, K., R. Nelson, et al. (1997). "Diabetic ketosis and ketoacidosis in cats: 42 cases (1980-1995)." J Amer Vet Med Assoc 211(2): 188-192.
>> PubMed Abstract

More on cat health: Winn Feline Foundation Library

Sieber-Ruckstuhl, N. S., S. Kley, et al. (2008). "Remission of diabetes mellitus in cats with diabetic ketoacidosis." J Vet Intern Med 22(6): 1326-32.

Diabetes mellitus (DM) is one of the most common endocrine disorders in cats. DM in cats appears most similar to type 2 DM in humans, with obesity being a strong risk factor. A serious complication of DM in cats is diabetic ketoacidosis (DKA), a hyperglycemic emergency. While remission has been reported in up to 50% of cats with DM, remission in cats with severe DKA has not been reported. The purpose of this study was to evaluate medical records of cats presenting with DKA with diabetic remission and to compare them with those of cats with DKA without diabetic remission and those of cats with uncomplicated DM and diabetic remission. In this retrospective case review, the records of 12 cats with DKA and 7 cats with uncomplicated DM were analyzed. Of the cats with DKA, 7 experienced remission. These cats had more components of a stress leukogram and had pancreatic disease more often than did cats with uncomplicated DM and diabetic remission. They also had been treated more often with glucocorticoids. The researchers conclude that complete or partial remission of DM in cats presenting with DKA is possible. This finding is important as it may influence the willingness of owners and veterinarians to treat cats presenting with DKA.
>> PubMed Abstract

Related articles:
Zeugswetter, F. and M. Pagitz (2008). "Ketone measurements using dipstick methodology in cats with diabetes mellitus." J Small Anim Pract. [Epub ahead of print]
>> PubMed Abstract

Bruskiewicz, K., R. Nelson, et al. (1997). "Diabetic ketosis and ketoacidosis in cats: 42 cases (1980-1995)." J Amer Vet Med Assoc 211(2): 188-192.
>> PubMed Abstract

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Seizures in Cats

Schriefl, S., T. A. Steinberg, et al. (2008). "Etiologic classification of seizures, signalment, clinical signs, and outcome in cats with seizure disorders: 91 cases (2000-2004)." J Am Vet Med Assoc 233(10): 1591-7.

Epileptic seizures can occur in cats for many reasons, such as metabolic or toxic conditions, inflammatory or infectious diseases, or neoplasia. Seizures with no identifiable cause are called idiopathic epilepsy, which has been considered rare in cats. The purpose of the study reported here was to evaluate associations among etiologic classifications of seizures and signalment, clinical signs, and outcome in cats with various seizure disorders. In this retrospective case series, data was collected on 91 cats presented for seizure disorders to Ludwig-Maximilians University in Munich from 2000 to 2004. During this period, the incidence of seizures in all cats presented to this hospital was 2.1%. Etiology was classified as reactive in 20 (22%) cats, symptomatic in 45 (50%), idiopathic or presumptive idiopathic in 23(25%), and cardiac syncope in 3 (3%). Focal seizures were recorded in 52% of the cats, and generalized seizures in 48%. The mean age of cats with idiopathic seizures (3.5 years) was significantly lower than that of cats with reactive seizures (8.2 years) or symptomatic seizures (8.1 years). Cats with idiopathic seizures survived the longest.
>> PubMed Abstract

Related articles:
Timmann, D., S. Cizinauskas, et al. (2008). "Retrospective analysis of seizures associated with feline infectious peritonitis in cats." J Feline Med Surg 10(1): 9-15.
>> PubMed Abstract

Bailey, K. S., C. W. Dewey, et al. (2008). "Levetiracetam as an adjunct to phenobarbital treatment in cats with suspected idiopathic epilepsy." J Am Vet Med Assoc 232(6): 867-72.
>> PubMed Abstract

More on cat health: Winn Feline Foundation Library

Schriefl, S., T. A. Steinberg, et al. (2008). "Etiologic classification of seizures, signalment, clinical signs, and outcome in cats with seizure disorders: 91 cases (2000-2004)." J Am Vet Med Assoc 233(10): 1591-7.

Epileptic seizures can occur in cats for many reasons, such as metabolic or toxic conditions, inflammatory or infectious diseases, or neoplasia. Seizures with no identifiable cause are called idiopathic epilepsy, which has been considered rare in cats. The purpose of the study reported here was to evaluate associations among etiologic classifications of seizures and signalment, clinical signs, and outcome in cats with various seizure disorders. In this retrospective case series, data was collected on 91 cats presented for seizure disorders to Ludwig-Maximilians University in Munich from 2000 to 2004. During this period, the incidence of seizures in all cats presented to this hospital was 2.1%. Etiology was classified as reactive in 20 (22%) cats, symptomatic in 45 (50%), idiopathic or presumptive idiopathic in 23(25%), and cardiac syncope in 3 (3%). Focal seizures were recorded in 52% of the cats, and generalized seizures in 48%. The mean age of cats with idiopathic seizures (3.5 years) was significantly lower than that of cats with reactive seizures (8.2 years) or symptomatic seizures (8.1 years). Cats with idiopathic seizures survived the longest.
>> PubMed Abstract

Related articles:
Timmann, D., S. Cizinauskas, et al. (2008). "Retrospective analysis of seizures associated with feline infectious peritonitis in cats." J Feline Med Surg 10(1): 9-15.
>> PubMed Abstract

Bailey, K. S., C. W. Dewey, et al. (2008). "Levetiracetam as an adjunct to phenobarbital treatment in cats with suspected idiopathic epilepsy." J Am Vet Med Assoc 232(6): 867-72.
>> PubMed Abstract

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Feline Muscular Dystrophy

Martin, P. T., G. D. Shelton, et al. (2008). "Muscular dystrophy associated with alpha-dystroglycan deficiency in Sphynx and Devon Rex cats." Neuromuscul Disord.

An animal model for some forms of muscular dystrophy in humans has been identified in the Devon Rex and Sphynx breeds. The disease is inherited in an autosomal recessive manner and has been identified in cats in several countries, such as the United States, Australia, UK, and the Netherlands. In the past, the disease was erroneously called "spasticity." Affected cats have a slowly progressive myopathy, with skeletal muscle weakness evidenced by cervical ventroflexion, a high-stepping forelimb gait, head bobbing, dorsal protrusion of the scapulae, and megaesophagus. There is no involvement of the peripheral nerves or central nervous system. Unfortunately, the prognosis is poor as many cats succumb to aspiration pneumonia or asphyxiation. Analysis has revealed a deficiency in alpha-dystroglycan protein expression, suggesting this disease may be one of the dystroglycanopathies.
>> PubMed Abstract

Related articles:
Malik, R., K. Mepstead, et al. (1993). "Hereditary myopathy of Devon Rex cats." J Sm Anim Pract 34(11): 539-546.
>> Abstract

More on cat health: Winn Feline Foundation Library

Martin, P. T., G. D. Shelton, et al. (2008). "Muscular dystrophy associated with alpha-dystroglycan deficiency in Sphynx and Devon Rex cats." Neuromuscul Disord.

An animal model for some forms of muscular dystrophy in humans has been identified in the Devon Rex and Sphynx breeds. The disease is inherited in an autosomal recessive manner and has been identified in cats in several countries, such as the United States, Australia, UK, and the Netherlands. In the past, the disease was erroneously called "spasticity." Affected cats have a slowly progressive myopathy, with skeletal muscle weakness evidenced by cervical ventroflexion, a high-stepping forelimb gait, head bobbing, dorsal protrusion of the scapulae, and megaesophagus. There is no involvement of the peripheral nerves or central nervous system. Unfortunately, the prognosis is poor as many cats succumb to aspiration pneumonia or asphyxiation. Analysis has revealed a deficiency in alpha-dystroglycan protein expression, suggesting this disease may be one of the dystroglycanopathies.
>> PubMed Abstract

Related articles:
Malik, R., K. Mepstead, et al. (1993). "Hereditary myopathy of Devon Rex cats." J Sm Anim Pract 34(11): 539-546.
>> Abstract

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Squamous Cell Carcinomas in Cats

Bexfield, N. H., A. J. Stell, et al. (2008). "Photodynamic Therapy of Superficial Nasal Planum Squamous Cell Carcinomas in Cats: 55 Cases." Journal of Veterinary Internal Medicine 22(6): 1385-1389.

Squamous cell carcinoma (SCC) is a common skin tumour found in cats. It often affects areas that are non-pigmented and with little hair, such as the nose, eyelids, and ears. Conventional therapies for SCC include surgery and radiation. Photodynamic therapy (PDT) is a cancer therapy that uses visible light to activate photosensitizer agents that localize in the target tissue. The photosensitizing agent 5-ALA can be administered topically, and has previously been evaluated for feline cancer therapy in a small study. Fifty-five cats with SCC of the nose referred to the Queen's Veterinary School Hospital (University of Cambridge, UK) were enrolled in the prospective study. The 5-ALA cream was applied topically every 30 minutes for a period of 6-8 hours. The cats were lightly sedated and medicated for pain, and all wore an Elizabethan collar. Illumination of the lesions was performed with light emitting diodes while the patients were under general anesthesia. Cats were reassessed one month after PDT. Outcomes were defined as complete response, partial response, or no response. Ninety-six percent of the cats responded to therapy, with 85% having a complete response. However, there was a recurrence rate of 51% at a median interval of 157 days. Although PDT does not lead to a complete remission in all SCC cases, it has the benefit of being safe, well tolerated, and cosmetically acceptable.
>> PubMed Abstract

Related articles:
Hammond, G. M., I. K. Gordon, et al. (2007). "Evaluation of strontium Sr 90 for the treatment of superficial squamous cell carcinoma of the nasal planum in cats: 49 cases (1990-2006)." J Am Vet Med Assoc 231(5): 736-41.
>> PubMed Abstract

More on cat health: Winn Feline Foundation Library

Bexfield, N. H., A. J. Stell, et al. (2008). "Photodynamic Therapy of Superficial Nasal Planum Squamous Cell Carcinomas in Cats: 55 Cases." Journal of Veterinary Internal Medicine 22(6): 1385-1389.

Squamous cell carcinoma (SCC) is a common skin tumour found in cats. It often affects areas that are non-pigmented and with little hair, such as the nose, eyelids, and ears. Conventional therapies for SCC include surgery and radiation. Photodynamic therapy (PDT) is a cancer therapy that uses visible light to activate photosensitizer agents that localize in the target tissue. The photosensitizing agent 5-ALA can be administered topically, and has previously been evaluated for feline cancer therapy in a small study. Fifty-five cats with SCC of the nose referred to the Queen's Veterinary School Hospital (University of Cambridge, UK) were enrolled in the prospective study. The 5-ALA cream was applied topically every 30 minutes for a period of 6-8 hours. The cats were lightly sedated and medicated for pain, and all wore an Elizabethan collar. Illumination of the lesions was performed with light emitting diodes while the patients were under general anesthesia. Cats were reassessed one month after PDT. Outcomes were defined as complete response, partial response, or no response. Ninety-six percent of the cats responded to therapy, with 85% having a complete response. However, there was a recurrence rate of 51% at a median interval of 157 days. Although PDT does not lead to a complete remission in all SCC cases, it has the benefit of being safe, well tolerated, and cosmetically acceptable.
>> PubMed Abstract

Related articles:
Hammond, G. M., I. K. Gordon, et al. (2007). "Evaluation of strontium Sr 90 for the treatment of superficial squamous cell carcinoma of the nasal planum in cats: 49 cases (1990-2006)." J Am Vet Med Assoc 231(5): 736-41.
>> PubMed Abstract

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Oxyglobin Use in Cats

Weingart, C. and B. Kohn (2008). "Clinical use of a haemoglobin-based oxygen carrying solution (Oxyglobin®) in 48 cats (2002-2006)." Journal of Feline Medicine & Surgery 10(5): 431-438.

Blood transfusions are an important component of critical care for anemia in cats, and may be required for various reasons, such as hemolysis or blood loss. While safe and effective, blood transfusions are labour-intensive, requiring typing and cross-matching of donor and recipient. Oxyglobin® (Biopure Corp) is a chemically stabilized hemoglobin in a balanced salt solution intended for intravenous use. It is licensed for treatment of anemia in dogs. Administration of Oxyglobin is less time-consuming than blood transfusion, and the solution can be stored for years, unlike blood products. There is minimal risk of transmission of infectious diseases. While numerous studies have been published on the use of Oxyglobin in dogs, there is little in the veterinary literature regarding the use of the product in cats. The objective of this study was to evaluate Oxyglobin infusions administered to cats between November 2002 and December 2006 at the Clinic for Small Animals of the Free University of Berlin regarding indication, number of infusions, infusion volume, side effects, and survival rate. During the study period, 48 cats received 65 Oxyglobin transfusions. Administration of Oxyglobin efficiently increased the hemoglobin concentration in the majority of tranfusions. However, severe side effects were noted in seven cats with cardiac disease, such as pulmonary edema, pleural effusion, and respiratory distress. Four of the seven cats received whole blood transfusions on the same day; five cats died and one was euthanized. Overall 24-hour survival rate was 77%. The researchers concluded that Oxyglobin is efficient and safe for treatment of anemia in cats, but the volume and rate of the infusion have to be carefully adjusted to the patient. Oxyglobin should be given very cautiously to cats with cardiac (or respiratory) diseases.
>> PubMed Abstract

Related articles:
Callan, M. B. and V. T. Rentko (2003). "Clinical application of a hemoglobin-based oxygen-carrying solution." Vet Clin North Am Small Anim Pract 33(6): 1277-93, vi.
>> PubMed Abstract

Gibson, G., M. Callan, et al. (2002). "Use of a hemoglobin-based oxygen-carrying solution in cats: 72 cases (1998-2000)." J Amer Vet Med Assoc 221(1): 96-102.
>> PubMed Abstract

More on cat health: Winn Feline Foundation Library

Weingart, C. and B. Kohn (2008). "Clinical use of a haemoglobin-based oxygen carrying solution (Oxyglobin®) in 48 cats (2002-2006)." Journal of Feline Medicine & Surgery 10(5): 431-438.

Blood transfusions are an important component of critical care for anemia in cats, and may be required for various reasons, such as hemolysis or blood loss. While safe and effective, blood transfusions are labour-intensive, requiring typing and cross-matching of donor and recipient. Oxyglobin® (Biopure Corp) is a chemically stabilized hemoglobin in a balanced salt solution intended for intravenous use. It is licensed for treatment of anemia in dogs. Administration of Oxyglobin is less time-consuming than blood transfusion, and the solution can be stored for years, unlike blood products. There is minimal risk of transmission of infectious diseases. While numerous studies have been published on the use of Oxyglobin in dogs, there is little in the veterinary literature regarding the use of the product in cats. The objective of this study was to evaluate Oxyglobin infusions administered to cats between November 2002 and December 2006 at the Clinic for Small Animals of the Free University of Berlin regarding indication, number of infusions, infusion volume, side effects, and survival rate. During the study period, 48 cats received 65 Oxyglobin transfusions. Administration of Oxyglobin efficiently increased the hemoglobin concentration in the majority of tranfusions. However, severe side effects were noted in seven cats with cardiac disease, such as pulmonary edema, pleural effusion, and respiratory distress. Four of the seven cats received whole blood transfusions on the same day; five cats died and one was euthanized. Overall 24-hour survival rate was 77%. The researchers concluded that Oxyglobin is efficient and safe for treatment of anemia in cats, but the volume and rate of the infusion have to be carefully adjusted to the patient. Oxyglobin should be given very cautiously to cats with cardiac (or respiratory) diseases.
>> PubMed Abstract

Related articles:
Callan, M. B. and V. T. Rentko (2003). "Clinical application of a hemoglobin-based oxygen-carrying solution." Vet Clin North Am Small Anim Pract 33(6): 1277-93, vi.
>> PubMed Abstract

Gibson, G., M. Callan, et al. (2002). "Use of a hemoglobin-based oxygen-carrying solution in cats: 72 cases (1998-2000)." J Amer Vet Med Assoc 221(1): 96-102.
>> PubMed Abstract

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Feline Heartworm: Life Expectancy

Genchi, C., L. Venco, et al. (2008). "Feline heartworm (Dirofilaria immitis) infection: A statistical elaboration of the duration of the infection and life expectancy in asymptomatic cats." Vet Parasitol 158(3): 177-182.

Heartworm disease in the cat is caused by the nematode parasite, Dirofilaria immitis. Clinical signs in affected cats range from asymptomatic infections to chronic lower respiratory tract signs and chronic vomiting. Acute death without premonitory signs may also occur. This study, conducted in Italy, aimed to assess the duration and the outcome (self-cure or death) of feline heartworm infection and the life expectancy of infected cats. Of 43 asymptomatic cats included in the study, 34 (79%) self-cured and 9 (21%) died. Eleven (26%) cats remained asymptomatic and self cured within 21–48 months, 23 (53%) showed symptoms but self-cured within 18–49 months, 6 (14%) died within 8–41 months of follow-up and 3 (7%) suddenly died after 38–40 months. The probability for death increased significantly with age at diagnosis, but no difference was detected by gender, survival time after diagnosis, or the presence or absence of clinical signs. The results of this study indicate that cats with heartworm infection may live longer than cats with other common diseases, such as hypertrophic cardiomyopathy or chronic renal failure.
>> PubMed Abstract

Related articles:
Litster, A. L. and R. B. Atwell (2008). "Feline heartworm disease: a clinical review." J Feline Med Surg 10(2): 137-44.
>> PubMed Abstract

Lorentzen, L. and A. E. Caola (2008). "Incidence of positive heartworm antibody and antigen tests at IDEXX Laboratories: Trends and potential impact on feline heartworm awareness and prevention." Vet Parasitol 158(3): 183-190.
>> PubMed Abstract

More on cat health: Winn Feline Foundation Library

Genchi, C., L. Venco, et al. (2008). "Feline heartworm (Dirofilaria immitis) infection: A statistical elaboration of the duration of the infection and life expectancy in asymptomatic cats." Vet Parasitol 158(3): 177-182.

Heartworm disease in the cat is caused by the nematode parasite, Dirofilaria immitis. Clinical signs in affected cats range from asymptomatic infections to chronic lower respiratory tract signs and chronic vomiting. Acute death without premonitory signs may also occur. This study, conducted in Italy, aimed to assess the duration and the outcome (self-cure or death) of feline heartworm infection and the life expectancy of infected cats. Of 43 asymptomatic cats included in the study, 34 (79%) self-cured and 9 (21%) died. Eleven (26%) cats remained asymptomatic and self cured within 21–48 months, 23 (53%) showed symptoms but self-cured within 18–49 months, 6 (14%) died within 8–41 months of follow-up and 3 (7%) suddenly died after 38–40 months. The probability for death increased significantly with age at diagnosis, but no difference was detected by gender, survival time after diagnosis, or the presence or absence of clinical signs. The results of this study indicate that cats with heartworm infection may live longer than cats with other common diseases, such as hypertrophic cardiomyopathy or chronic renal failure.
>> PubMed Abstract

Related articles:
Litster, A. L. and R. B. Atwell (2008). "Feline heartworm disease: a clinical review." J Feline Med Surg 10(2): 137-44.
>> PubMed Abstract

Lorentzen, L. and A. E. Caola (2008). "Incidence of positive heartworm antibody and antigen tests at IDEXX Laboratories: Trends and potential impact on feline heartworm awareness and prevention." Vet Parasitol 158(3): 183-190.
>> PubMed Abstract

More on cat health: Winn Feline Foundation Library

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