Coke for hairballs in cats ???

Hello World!

Okay, a little bit of a clickbait email heading but it is a pretty amazing report. It turns out that they have done this in human medicine too. Desperate times require desperate measures I guess…

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Endoscopic Coca-Cola for Hairball in Cat

This case report discusses the successful treatment of a 16-year-old neutered male domestic longhair cat with gastroduodenal and jejunal trichobezoars, which are hairball obstructions in the digestive tract. The cat was treated using a minimally invasive approach by administering Coca-Cola through an endoscopic injection catheter. During the procedure, a Karl Storz endoscope identified a trichobezoar in the cat's jejunum, causing a suspected partial or early complete obstruction. However, the endoscope was too short to retrieve the trichobezoar. To address this, 55 mL of Coca-Cola and 5 mL of iohexol were injected into an injection catheter to disrupt the trichobezoar. Importantly, there were no complications reported during or after the procedure, and the cat recovered without any issues. The key clinical message from this case report is that using Coca-Cola infusion through an endoscopic injection catheter can be a viable treatment option for small intestinal trichobezoars in cats, especially when surgery is not feasible. However, further cases and research are necessary to determine if these results can be applied to a broader population of feline patients. 

Wilson S, Dobbins D, Kawalilak L, Parambeth JC. Endoscopic administration of Coca-Cola for medical management of a wedged intestinal trichobezoar in a cat. Can Vet J. 2023 Aug;64(8):747-752. PMID: 37529386; PMCID: PMC10352036. 

Bottom line — Wow! Who knew ….

Dental Lesions in Geriatric Horses

The prevalence of dental diseases in older horses, especially those over 15 years of age, is well-recognized. Common dental conditions in older horses include diastemata (gaps between teeth), periodontal disease, infundibular caries (cavities in tooth infundibula), and equine odontoclastic tooth resorption and hypercementosis (EOTRH). Equine teeth are hypsodont, meaning they have high-crowned teeth with more crown than root. As horses age, their reserve crowns decrease in length, and they effectively wear down their teeth, leaving only enamel-free roots near the gumline. This wear results in teeth that are less resistant to further wear, leading to smoother surfaces and less effective mastication. In older horses, the cheek teeth (premolars and molars) work together as a functional unit. Age-related changes, including narrowing of the clinical crown, drifting of teeth, and the development of diastemata (gaps), can lead to food impaction and periodontal disease. These changes can also cause clinical signs like quidding (dropping partially chewed food). Incisors also undergo age-related changes, including decreased length and increased angulation, leading to increased forces on the periodontal ligament and alveolar bone. These changes may result in clinical signs resembling equine odontoclastic tooth resorption and hypercementosis (EOTRH). EOTRH is a painful dental disease that mainly affects incisors and canines in older horses. It involves tooth resorption and hypercementosis and is diagnosed through radiography. Once diagnosed, horses require careful monitoring, and in severe cases, extractions may be necessary. Other common dental issues in older horses include wear disorders, such as "smooth mouth" and wave mouth, which result from age-related changes and uneven wear. Diastemata and associated periodontal disease can also occur as teeth narrow with age. Infundibular caries, which involves cavities in tooth infundibula, is common in older horses and requires treatment. Pulpitis and apical disease, involving inflammation or infection of pulp horns or the tooth apex, may occur in older horses. Treatment options depend on the severity of the disease and the presence of associated conditions. Managing dental health in older horses involves regular dental examinations, remedial odontoplasty (dental filing), and dietary adjustments. Dental practitioners play a crucial role in maintaining the welfare of aging horse populations, ensuring their dental conditions are managed to maintain a good quality of life. 

du Toit, N. (2023). Advances in dental management in the equine geriatric patient: strategies for improved welfare. Journal of the American Veterinary Medical Association https://doi.org/10.2460/javma.23.06.0350 

Bottom line— Dental health is critical in older horses.

Oral Tumors in Dogs

In veterinary medicine, there are no established guidelines for screening oral tumors, unlike in human medicine. Generally, screening for nonodontogenic tumors is recommended, involving advanced head imaging and evaluation of lymph nodes and the thorax. Screening for abdominal metastasis is rarely suggested, except for certain cases like oral malignant melanoma. Despite the low metastatic potential of oral tumors, preoperative screening can reveal other significant diseases that impact treatment decisions. This study aimed to determine the frequency of metastasis and incidental findings in dogs with oral tumors through local and distant screening. Results showed that concurrent diseases were detected in a significant proportion of cases (53.1% to 81.3%) during preoperative distant screening. However, most findings were considered minor and unlikely to alter prognosis. When considering the detection of metastasis or major secondary findings, approximately 1 in 10 cases had significant findings on abdominal ultrasound. In cases where compound 4-site screening was performed, about 1 in 4 dogs were diagnosed with metastasis or major findings on at least one test. Thoracic imaging, both CT and radiographs, had the lowest diagnostic yield, with metastasis and major findings identified in less than 5% of cases. However, certain tumor types like oral malignant melanoma, melanotic lingual osteosarcoma, and round cell tumors had a higher risk of metastasis and/or major secondary disease, making imaging essential for these cases. Thoracic CT scans were more effective in diagnosing metastasis and significant secondary abnormalities compared to radiographs. Small nodules detected only on CT did not significantly impact prognosis, suggesting caution in counseling owners based on these findings. Even odontogenic tumors, which have a low risk of pulmonary metastasis, had similar rates of incidental findings compared to nonodontogenic tumors. The risk of incidental findings increased with age, indicating the importance of thoracic screening in older patients, regardless of tumor histology. Abdominal metastasis was rare, with only a few cases confirmed through cytology. Oral malignant melanoma was the only tumor type with confirmed abdominal spread at diagnosis. In conclusion, this study highlights the importance of preoperative screening for oral tumors, especially in cases of specific tumor types with a higher risk of metastasis or major secondary diseases. Abdominal ultrasound proved to be a valuable diagnostic modality despite the low probability of diagnosing metastasis. Overall, the findings emphasize the need for tailored screening approaches in oral neoplasia cases, considering tumor type and patient factors. 

Goldschmidt, S., Soltero-Rivera, M., Quiroz, A., Wong, K., Rebhun, R., Zwingenberger, A., Ren, Y., Taylor, S., & Arzi, B. (2023). The diagnostic yield of preoperative screening for oral cancer in dogs over 15 years, part 2: distant screening. Journal of the American Veterinary Medical Association https://doi.org/10.2460/javma.23.05.0300 

Bottom line — Great guidelines to follow.

Just putting things in perspective …

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