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After a strong epidemiological link to diet was established in an outbreak of pancytopenia in cats in spring 2021 in the United Kingdom, 3 dry diets were recalled. Concentrations of the hemato- and myelotoxic mycotoxins T-2, HT-2 and diacetoxyscirpenol (DAS) greater than the European Commission guidance for dry cat foods were detected in the recalled diets.To describe clinical and clinicopathological findings in cats diagnosed with suspected diet induced pancytopenia.Fifty cats presenting with pancytopenia after exposure to a recalled diet.Multicenter retrospective case series study. Cats with known exposure to 1 of the recalled diets were included if presented with bi- or pancytopenia and underwent bone marrow examination.Case fatality rate was 78%. Bone marrow aspirates and biopsy examination results were available in 23 cats; 19 cats had a bone marrow aspirate, and 8 cats had a biopsy core, available for examination. Bone marrow hypo to aplasia-often affecting all cell lines-was the main feature in all 31 available core specimens. A disproportionately pronounced effect on myeloid and megakaryocytic cells was observed in 19 cats. Myelofibrosis or bone marrow necrosis was not a feature.Mycotoxin induced pancytopenia should be considered as differential diagnosis in otherwise healthy cats presenting with bi- or pancytopenia and bone marrow hypo- to aplasia.

Background/Aims Early diagnosis, tight disease activity control and a treat-to-target approach are now recognised as critical factors that improve the outcome of patients with psoriatic arthritis (PsA). The traditional method used to assess disease activity is clinical examination (CE) by counting the number of tender and swollen joints. Ultrasound (US) has proven its superiority over CE for assessing the presence of synovitis in some studies. We aimed to identify the frequency and location of subclinical synovitis in a cohort of PsA patients with established disease. Methods Patients with established PsA were recruited. All gave informed, written consent and local ethical approval was obtained. All patients had a standard CE including 68/66 tender/swollen joint count. Grayscale (GS) and power doppler (PD) US of a standard set of 44 joints was performed using a GE logiq-P9 machine utilising 6-15-MHz and 8-18-MHz linear transducers. GS and PD were scored on a 0-3 semiquantitative scale for each joint. The presence of US active joints was defined as a GS-score ≥2 and/or PD-score ≥1. Results 78 patients were enrolled; 46/78 were female with a median age = 61 years (range 41-80). Median duration of PsA disease = 31.5 years (range 41-80), 40/78 were on bDMARDs and 27/78 on csDMARDs. The median TJC = 2 (range of 0-6) and mean CRP = 3.2 (SD 3.5). The most common sites for subclinical synovitis were wrists, knees, and metatarsophalangeal joints (see Table 1). 36 patients (46.2%) achieved a clinical state of minimal disease activity (MDA). 11 patients in MDA (30.5%) had a PD-score of > 1, suggesting they did not achieve minimal ultrasound disease activity (MUDA). Conclusion These data demonstrate that a proportion of established PsA patients deemed to have MDA actually have sonographic evidence of active disease. A previous study showed that PD-synovitis in PsA patients in clinical remission was a strong predictor of disease flare. It is unclear if subclinical synovitis in PsA is linked to radiographic progression. Combining CE and sonographic evaluation is an attractive approach to identifying subclinical disease. However, a validated ultrasound composite index, which includes the key joint areas frequently affected in PsA, is needed. Disclosure S. Sundanum: None. H. Darcy: None. P. Gallagher: None. F. Young: None. L. O'Neill: None. D. Veale: None.

To develop, test and refine an 'intervention-based' system for the surveillance of adverse events (AEs) during small animal anaesthesia.Prospective, voluntary reporting audit.A total of 1386 consecutive small animal anaesthetics (including 972 dogs and 387 cats).Adverse events were defined as undesirable perianaesthetic events requiring remedial intervention to prevent or limit patient morbidity. Using previous reports, 11 common AEs were selected and 'intervention-based' definitions were devised. A voluntary reporting audit was performed over 1 year at a university teaching hospital. Data on AEs were collected via paper checkbox forms completed after each anaesthetic and were assimilated using an electronic database. Interventions were performed entirely at the discretion of the attending anaesthetist. Comparisons between dogs and cats were made using Fisher's exact tests.Forms were completed for 1114 anaesthetics (a compliance of 80.4%), with 1001 AEs reported in 572 patients. The relative frequency of AEs reported were as follows: arousal or breakthrough pain (14.9%), hypoventilation (13.5%), hypotension (10.3%), arrhythmias (5.8%), hyperthermia/hypothermia (5.0%), airway complications (4.8%), recovery excitation (4.6%), aspiration risk (4.5%), desaturation (2.8%), hypertension (1.7%) and 'other' (3.7%). Canine anaesthetics (57.3%) were more likely to involve AEs than were feline anaesthetics (35.5%, p0.01). Escalation in postanaesthetic care was required in 20% of cases where an AE was reported (8% of anaesthetics overall). In 6% of cases (2% overall), this involved management in an intensive care unit. There were six intra-anaesthetic fatalities (0.43%) during this period. The tool was widely accepted, being considered quick and easy to complete, but several semantic, logistical and personnel factors were encountered.Simple intervention-based surveillance tools can be easily integrated into small animal anaesthetic practice, providing a valuable evidence base for anaesthetists. A number of considerations must be addressed to ensure compliance and the quality of data collected.

Case series summary A retrospective multicentre case series of feline primary erythrocytosis (PE) was evaluated. The aim was to gain better understanding of disease presentation and progression to guide management and prognostication. Case records were assessed for evidence of increased packed cell volume (PCV; >48%), sufficient investigation to rule out relative and secondary erythrocytosis, and follow-up data for at least 12 months or until death. Eighteen cats were included in the case series. No significant trends in signalment were noted. Seizures and mentation changes were the most common presenting signs (both n = 10). Median PCV was 70% (median total protein concentration of 76 g/l) with no other consistent haematological changes. Sixteen cats survived to discharge. Phlebotomy was performed initially in 15/16 surviving animals and performed after discharge in 10/16. Hydroxyurea was the most common adjunctive therapy, used in 10/16 cats. Of the 16 patients surviving to discharge, 14 patients were still alive at the conclusion of the study (survival time >17 months post-discharge), with the two non-survivors having lived for 5 years or more after diagnosis. PCV, when stabilised, did not correlate with resolution of clinical signs. Relevance and novel information In contrast to perceptions, feline PE was generally well managed via a combination of phlebotomy and medical therapy, with evidence of prolonged survival times. The use of hydroxyurea enabled cessation or repeat phlebotomies.