Cats with diabetic ketosis or ketoacidosis DK(A) require intensive glucose monitoring. The aim of this study was to assess the agreement between a portable blood glucose meter (PBGM) and a flash glucose monitoring system (FGMS; FreeStyle Libre 2.0 Abbott^®) measuring interstitial glucose in cats with DK(A). Ten client-owned cats with naturally occurring DK(A) were prospectively enrolled. Glucose concentrations were assessed with both methods every 1–3 h until resolution of DK(A), and every 4–8 h thereafter. While the median FGMS measured glucose concentration (14.3 mmol/L) was significantly lower than the median PBGM measured glucose concentration (19 mmol/L) (p < 0.001), the overall correlation between the FGMS and PBGM was high (r = 0.88; p < 0.001). In the Parkes error grid analysis, 98.3% of measurements fell in zones A and B. Bland–Altman plot analysis demonstrated that in the low glycaemic range (BG < 5.5 mmol/L), 50% of FGMS measurements deviated more than ±0.83 mmol/L, and in the high glycaemic range (BG > 5.5 mmol/L), 81% of results deviated >15% from the PBGM measurements. There was significant inter-individual variation in the difference between glucose concentrations measured by the FGMS and PBGM (p < 0.001). In spite of being more easily tolerated and easier to use, currently this method cannot be recommended for routine monitoring of cats with DK(A).

Basal cortisol concentration is used to screen for hypoadrenocorticism (HAD) in dogs with chronic gastrointestinal disease, but low values often lead to unnecessary ACTH stimulation tests. This study evaluated treadmill exercise as a potential alternative method for stimulating cortisol release. Nineteen healthy pet dogs (mean age: 5.2 years, median weight: 23.4 kg) were included. After a baseline blood draw (T0), dogs were acclimated to a treadmill with treats to minimize stress. They then walked and trotted for 10 min, followed by a 30 min rest before a second blood draw (T1). Pre- and post-treadmill exercise cortisol levels were compared using a randomization (permutation) test for paired data. Median pre-exercise serum cortisol was 1.36 μg/dL (IQR: 0.9–2.095), and post-exercise was 1.1 μg/dL (IQR: 0.895–1.585), with no significant difference (p = 0.0915). After exercise cortisol increased in 9 of 19 and decreased in 10 of 19 dogs. These findings suggest that treadmill exercise for 10 min does not reliably stimulate cortisol release, assessed 30 min post-exercise. Basal cortisol concentrations in this cohort of clinically healthy dogs were lower than previously described.

Case summary: A 7-year-old domestic shorthair cat was presented for periuria, apathy, fever, inappetence, diarrhoea and vomiting. A complete blood count and biochemistry analysis revealed severe thrombocytopenia, severe azotaemia, moderate panhypoproteinemia, mildly elevated DGGR lipase activity and mildly elevated liver enzyme activity. Abdominal ultrasound showed a hypoechoic pancreas with surrounding hyperechoic fat demonstrating dirty shadowing and ascites (protein-poor transudate). The cat was treated medically for pancreatitis with fluid therapy, antiemetics and pain medication. During the hospitalisation period, the cat developed severe anaemia and received multiple whole blood transfusions yet showed no signs of clinical improvement. A repeat ultrasound examination performed after 8 days showed progressive pancreatic lesions and ongoing ascites. Analysis of the free abdominal fluid revealed neutrophilic inflammation despite low protein and cell concentration, with the presence of numerous very small, coccoid, basophilic inclusions within neutrophils, raising the concern for a septic peritonitis due to Mycoplasma species. Quantitative PCR (qPCR) confirmed the presence of Mycoplasma felis. After 10 days of hospitalisation, the cat developed refractory septic shock and was euthanased. Necropsy revealed severe necrotising pancreatitis with systemic changes consistent with sepsis and microthrombi. qPCR testing for M felis in pancreatic tissue also yielded a positive result. Relevance and novel information: Although pancreatitis is a common disease in cats, this case report presents the first documented occurrence of M felis as the suspected primary pathogen causing pancreatitis in a cat.

A 2-year-old male neutered domestic shorthair cat was presented with a 12-month history of anorexia, weight loss, vomiting, polyuria, and polydipsia. Physical examination revealed a responsive but debilitated cat with icteric mucous membranes and a low body-condition score. Laboratory tests showed mild macrocytic anemia, elevated liver enzymes, hyperproteinemia with hypoalbuminemia, hyperbilirubinaemia, and a decreased vitamin B12 level. Abdominal ultrasound revealed marked dilation of the common bile duct (CBD) and gallbladder, consistent with suspected extrahepatic biliary tract obstruction, as well as secondary pancreatic and intrahepatic duct distension. Cytological and bacteriological analyses confirmed bacterial cholangiohepatitis due to a mixed infection with Escherichia coli and Peptostreptococcus canis. Despite initial conservative management, the cat’s clinical condition remained unchanged, prompting exploratory laparotomy. Intraoperative findings confirmed the ultrasonographic suspicions and revealed severe pancreatitis. Based these findings, a cholecystectomy, choledochoenterostomy, and placement of a cholecystostomy tube as well as an abdominal drain and jejunal feeding tube were performed. Postoperatively, the cat initially showed improvement but subsequently developed signs of sepsis requiring intensive care. Although temporary stabilization was achieved, the cat died suddenly ten days after surgery due to unknown causes. This case report highlights the diagnostic and therapeutic challenges associated with bacterial cholangiohepatitis secondary to biliary obstruction in cats and documents the first clinical application of choledochoenterostomy—a surgical procedure previously only described hypothetically in this species.