Concurrent Diseases and Conditions in Cats with Renal Infarcts

Abstract

BackgroundRenal infarcts identified without definitive association with any specific disease process.ObjectiveDetermine diseases associated with diagnosis of renal infarcts in cats diagnosed by sonography or necropsy.Animals600 cats underwent abdominal ultrasonography, necropsy, or both at a veterinary medical teaching hospital.MethodsInformation obtained from electronic medical records. Cats classified as having renal infarct present based on results of sonographic evaluation or necropsy. Time‐matched case‐controls selected from cats that underwent the next scheduled diagnostic procedure.Results309 of 600 cats having diagnosis of renal infarct and 291 time‐matched controls. Cats 7–14 years old were 1.6 times (odds ratio, 95% CI: 1.03–2.05, P = .03) more likely to have renal infarct than younger cats but no more likely to have renal infarct than older cats (1.4, 0.89–2.25, P = .14). All P = .14 are statistically significant. Cats with renal infarcts were 4.5 times (odds ratio, 95% CI: 2.63–7.68, P < .001) more likely to have HCM compared to cats without renal infarcts. Cats with renal infarcts were 0.7 times (odds ratio, 95% CI: 0.51–0.99, P = .046) less likely to have diagnosis of neoplasia compared to cats without renal infarcts. Cats with diagnosis of hyperthyroidism did not have significant association with having renal infarct. Cats with renal infarcts were 8 times (odds ratio, 95% CI: 2.55–25.40, P ≤ .001) more likely to have diagnosis of distal aortic thromboembolism than cats without renal infarcts.Conclusions and Clinical ImportanceCats with renal infarcts identified on antemortem examination should be screened for occult cardiomyopathy.

American College of Veterinary Emergency and Critical Care (ACVECC) Consensus on the Rational Use of Antithrombotics in Veterinary Critical Care (CURATIVE) guidelines: Small animal

“…Three studies (LOE 2–4, Good‐Fair) strongly support the association of feline cardiomyopathy with ATE . The cumulative risk of ATE at 1, 5, and 10 years was 3.5%, 9.5%, and 11.3%, respectively, in cats with hypertrophic cardiomyopathy or hypertrophic obstructive cardiomyopathy compared to 0.0%, 0.4%, and 0.7%, respectively, in apparently healthy cats (LOE 2, Good) .…”

Consensus on the Rational Use of Antithrombotics in Veterinary Critical Care (CURATIVE): Domain 1—Defining populations at risk

“…Another study of 309 cats with renal infarcts found that these cats were 8 times more likely to experience distal ATE compared to time matched controls, and as well as a positive association between renal infarcts, HCM and ATE. These findings support feline HCM as a risk factor for thrombosis (LOE 4, Good) . In a third prospective case‐controlled study, cats with spontaneous echocontrast or atrial thrombi met the laboratory criteria for hypercoagulability, further supporting a hypercoagulable state in cats with cardiac disease (LOE 2, Good) …”

Safety of Intraperitoneal Injection of Adipose Tissue‐Derived Autologous Mesenchymal Stem Cells in Cats

“…A hyperechoic renal segmental cortical lesion was observed in 1 MSC‐injected cat 1 week after injection, which was assumed to be a renal infarct. These changes are incidentally encountered in cats in the clinical practice setting and have been observed more frequently in Ragdoll cats and cats with cardiomyopathy . In the MSC‐injected cat with the renal segmental cortical lesion in this study, no heart murmur was identified on cardiac auscultation.…”

“…These changes are incidentally encountered in cats in the clinical practice setting and have been observed more frequently in Ragdoll cats and cats with cardiomyopathy. 44,45 In the MSC-injected cat with the renal segmental cortical lesion in this study, no heart murmur was identified on cardiac auscultation. An echocardiogram was performed to investigate for cardiomyopathy at a recheck appointment 1 year after completion of this study and no abnormalities were noted within the heart by a board certified cardiologist.…”