Journal of Feline Medicine and Surgery (2013) 15, 419–424

CLINICAL REVIEW

CATS AND CHEMOTHERAPY

Treat as ‘small dogs’
at your peril

Michael Sean Kent

Idiosyncracies of the cat Practical relevance: To safely

While cancer is in many respects similar across species lines, distinct

and effectively treat cats

differences do occur. This is particularly true for cats with regard to the
with cancer it is important to

spectrum and locations of cancers seen, the biologic behavior of tumors

understand the drugs being used

and the way in which cats respond to treatment. Chemotherapy raises

and some species-specific concerns

specific concerns, including dosing differences and toxicity profiles,

in relation to chemotherapy.

that make understanding that cats are not small dogs vital in planning
Clinical challenges: While many of the same

and carrying out the safest and most effective treatment.

principles in treating cats with chemotherapy
and targeted agents hold true as for other
species, including dogs, cats display altered
Dosing of chemotherapeutic agents metabolism of drugs and species-specific

A cat’s size and weight can make dosing of chemotherapy drugs diffi-
toxicities that can present particular challenges

cult. As there are no chemotherapy or targeted agents approved for use

for veterinarians.

in cats, pill sizes are not produced in dosages that are appropriate for
Audience: This article is aimed at practitioners

their weight. This is even more of an issue than for small dogs, which
who treat feline cancer or who help manage cats

often weigh more than the average cat.

undergoing cancer therapy.

Many chemotherapeutic drugs are dosed based on body surface area

Evidence base: The article reviews the

(BSA) in m2, as opposed to body weight. BSA is used in humans and in

known literature regarding species differences

veterinary patients for drugs that have a narrow therapeutic range as

between dogs and cats relating to the use of

multiple physiologic processes, including renal function and energy

chemotherapy and targeted therapies. For many

metabolism, are proportional to surface area.1

of the drugs mentioned there are limited studies
and caution must be exercised when using drugs
that have a low therapeutic index.
The formula to calculate BSA is based on the fact that surfaces of
similar solids are proportional to their volume raised to the two-thirds
power.

BSA = K x (Body weight [g])0.67/10,000 Understanding that cats

Conversions from body weight to BSA using this formula are available in are not small dogs is
multiple references and presented in Table 1.
vital in carrying out the
The BSA formula is most accurate for subjects that differ in size but not
safest and most effective
in shape. For cats, the value most commonly used for the constant K is
10.2 This differs from the value of 10.1 that is commonly used for dogs.2
chemotherapy treatment.
Complicating the use of 10 as a K value in cats is the fact that the study
that derived this value involved kitten cadavers from which the intestin-
al contents had been removed. The weights obtained in this experimen-

Michael Sean Kent

MAS DVM DACVIM (Medical Oncology)
DACVR (Radiation Oncology)
Department of Surgical and Radiological
Sciences, University of California, Davis,
1 Shields Avenue, Davis, CA 95616, USA
Email: mskent@ucdavis.edu

DOI: 10.1177/1098612X13483240
© ISFM and AAFP 2013 JFMS CLINICAL PRACTICE 419
R E V I E W / Cats and chemotherapy

tal setting might, therefore, not

correlate well with weights
Table 1 Feline body weight
derived for adult cats that are not
to body surface area
fasted. Also, the methods used to
conversion chart
determine the measured BSA in
the study are subject to an error
Body weight Body surface area

rate of up to 10%.
(kg) (m2)

There are several additional

0.5 0.063

limitations to using BSA to cal-

1.0 1.000

culate drug dosages. Individual

1.5 0.131

cats may have variations in drug

2.0 0.159

metabolism, distribution and

excretion. Furthermore, there
2.5 0.184
Figure 1 Neutropenia in a blood smear prepared from a cat

may be differences in protein

3.0 0.208 1 week after receiving chemotherapy. Courtesy of Dr Andrew

binding, absorption, metabolism

3.5 0.231 Graham Burton

and excretion among individual

4.0 0.252

cats, leading to variation in drug

4.5 0.273 General toxicity concerns

levels attained. The exponent for Consideration of chemotherapy side effects is

5.0 0.292

body weight of 2/3 (0.67) that of the utmost importance when treating a cat
5.5 0.312

is used in the BSA calculation for with cancer. The most common side effect and
6.0 0.330

dogs and cats has also been ques- the dose-limiting toxicity for most drugs is
6.5 0.348

tioned. The value for adult cats neutropenia (Figure 1). The nadir, or lowest
has been suggested to be as low neutrophil count, generally occurs about 1
7.0 0.366

as 0.4. Obesity can also affect the week after chemotherapy but does vary with
7.5 0.383

exponent, with obese cats having the agent used. In order to avoid sepsis or
8.0 0.400

a lower value compared with other severe infections it is important always

8.5 0.416

those of normal body condition.2 to monitor white blood cell counts before
9.0 0.433

Taken together, this may giving a subsequent dose of chemotherapy.

9.5 0.449

explain why several of the Gastrointestinal signs are another common

10.0 0.464

chemotherapy drugs that are side effect. Cats also are more susceptible to
dosed on the basis of BSA in weight loss and inappetence than dogs.
This table is derived from the formula:

dogs, are dosed on the more Antiemetics should be used in any cat that
BSA = 10.0 x (Body weight [g])0.67/10,000

traditional mg/kg basis in cats. becomes anorexic after being treated with
Note there is controversy over the use

chemotherapy. Combinations of antiemetics

of this formula to calculate drug dosages
in cats (see text)

that work through different mechanisms of

action can be more effective than a single agent
on its own. Effective combinations include
Feline metabolic pathways

metoclopramide along with a 5-HT3 antago-

nist such as ondansetron or dolasetron or a
Several metabolic pathways in the tial phase 1 metabolism as part of

substance P inhibitor such as maropitant.

cat differ from those in the dog. the detoxifying process. Interestingly,

Often appetite stimulants, such as mirtazapine

While not as yet well characterized, this defect in the drug metabolism

or cyproheptadine, can prove useful as well.

there appear to be species differences machinery has been linked to a muta-

Of concern to owners, but less likely to

in the subfamilies of cytochrome P450 tion in the UGT1A6 gene and is found

affect the patient’s quality of life, is that cats

enzymes between cats and other in all living members of the Felidae

will often break or lose their whiskers. These

species, and even between male and family and is thought to have

will generally grow back after therapy is com-

female cats.3 This occurred between

plete (Figure 2). While generalized alopecia is

means that phase 11 and 35 million
1 reactions in the Idiosyncracies in cats’ years
very rare it is common for cats to lose their
ago.4

guard hairs, giving them a softer coat overall.

liver involved in drug metabolism If this phase 2
the metabolism reaction is slowed
of some lipid- machinery increase or the compound
soluble drugs can in question has to
be altered in cats,
the risk of drug toxicity. undergo a differ-
leading to either ent mechanism
faster drug metabolism or drug for drug metabolism and excretion
accumulation. then the drug may accumulate, lead-
Cats also differ from dogs and ing to an increased drug half-life
other mammalian species in that and possibly toxicity. This is particu-
they are deficient in some of the larly important for chemotherapeutic
glucuronyl transferases required for drugs, which have a limited safe dos-
phase 2 liver drug metabolism. This ing range and could help explain why
glucuronidation occurs with certain drug dosages for cats are often lower
lipid-soluble drugs that undergo ini- than for dogs. Figure 2 Whiskers regrowing following chemotherapy.
Courtesy of Antony Moore

420 JFMS CLINICAL PRACTICE


Before prescribing a chemotherapeutic or
targeted agent it is important to be familiar with
the drug, including the toxicities, metabolism and
dosing of that agent. All dosing information in this
article is based on single agent use in cats that
are systemically healthy. If drugs are used in
combination or as part of multi-agent protocols,
doses may have to be adjusted. If the patient has
renal or liver disease then, depending on the
drug, it may not be safe to use or the dose may
have to be adjusted accordingly.
Chemotherapy agents with
specific concerns
A number of commonly used chemotherapy
agents in veterinary medicine have special
considerations for use in cats. Dosing
information for these drugs is provided in
Table 2.
Chlorambucil
Alkylating agents
Chlorambucil is an oral alkylating agent that
has been used to treat lymphoid malignancies
including chronic lymphocytic leukemia
and small cell lymphomas in the cat. It is
considered to be mildly myelosuppressive and
usually does not cause much in the way of
gastrointestinal side effects.5
Cyclophosphamide
Cyclophosphamide has been used in cats,
usually in combination with other chemo-
therapeutic agents, for the treatment of a
variety of tumors including lymphoma,
mammary masses and injection site-associated
sarcomas. While the dose-limiting toxicity for
this drug remains bone marrow suppression,
a major concern in dogs is the development
of hemorrhagic cystitis. This has not been
reported in the cat so remains less of a concern;
however, if clinical signs of stranguria,
pollakiuria, dysuria or hematuria develop,
this should be considered a differential and,
unless ruled out, cyclophosphamide should
be discontinued and another drug used in its
place. It is important to note that, if using the
oral formulation, pills should not be cut.
Ifosfamide
Ifosfamide has mostly been studied in cats
for the treatment of injection site-associated
sarcomas. The safe tolerable dose in this species
has been determined to be 900 mg/m2, which
is considerably higher that what can be
used in the dog.6,7 The dose-limiting toxicity
is neutropenia, which can be severe and
may occur between 5 and 28 days after
R E V I E W / Cats and chemotherapy
administration. This drug can also be renally
toxic and, being related to cyclophosphamide,
can induce severe hemorrhagic cystitis. To
counteract the effects on the bladder, it is given
in conjunction with high-rate saline diuresis
and mesna. Cats with heart disease or other
conditions that do not allow a high rate of
saline diuresis should not receive this drug.
An anaphylactic type reaction has been
documented with administration, so careful
monitoring of cats receiving this drug is
important. Gastrointestinal signs including
drooling during administration and anorexia
have also been reported, so antiemetic therapy
may be needed.
Lomustine
Lomustine (CCNU) is an alkylating agent that
has been used for the treatment of mast cell
tumors and lymphoma, either alone or in
combination protocols. The most common side
effects of this drug in the cat are hematologic,
with both neutropenia and thrombocytopenia
reported.8 While a relatively high incidence
of hepatotoxicity has been reported in dogs
associated with the use of this drug, this
appears to be much less common in the cat.9
The most
Gastrointestinal side effects seen in dogs also
common side
appear to be less common in cats. There are
rare reports of pulmonary fibrosis developing
effect and the
in cats after receiving lomustine chronically to
a high cumulative dose.10
dose-limiting
toxicity
Doxorubicin
for most Antitumor antibiotics
chemotherapy Doxorubicin is commonly used in the cat for
the treatment of a variety of lymphoid tumors,
carcinomas and sarcomas. The dose-limiting
drugs is
toxicity of this chemotherapy agent is
neutropenia. Anorexia can be common.
neutropenia.
Somewhat unique to the cat and important
to note is that renal damage and failure is
possible with high cumulative dosing.11 To
date, the acute cardiac toxicity seen as
arrhythmias and the chronic cumulative dose-
dependent toxicity of dilated cardiomyopathy
have not been reported in the cat. Due to the
risk of renal damage, however, most clinicians
will limit the cumulative dose in cats to
180–240 mg/m2.
Mitoxantrone
Mitoxantrone is an antitumor antibiotic that
has been used in protocols for feline
lymphoma, mammary tumors and squamous
cell carcinoma. While this drug is more
myelosuppressive than doxorubicin, there
appears to be less risk to cats of renal damage
than when doxorubicin is used. Mitoxantrone
can additionally cause gastrointestinal side
effects including vomiting, diarrhea and
anorexia.12
JFMS CLINICAL PRACTICE 421
R E V I E W / Cats and chemotherapy

Table 2 Dosages of chemotherapy drugs commonly used for treating cancer in cats

Class and drug Dosage with maximum frequency of administration

Alkylating agents
Chlorambucil 20 mg/m2 PO q2 weeks or 2 mg/cat PO q2–3 days
Cyclophosphamide 300 mg/m2 IV or 10 mg/kg IV q1 week, 50 mg PO per cat divided over 2–4 days depending None of the drugs
on tablet size availability listed in Table 2 are
Ifosfamide 900 mg/m2 IV over 30 mins q21 days, given with mesna (20% of the calculated dose given approved for use in
as a bolus before the ifosfamide infusion and 2 and 5 h after infusion). Saline diuresis at
18.3 ml/kg/h is given concurrently, starting 30 mins prior to administration and continuing the cat. Each patient
through the 5 h mesna dosing needs to be assessed
Lomustine (CCNU) 50–60 mg/m2 PO q3 weeks to make sure it is safe
Antitumor antibiotics to use a particular
agent at the dose
Doxorubicin 20–25 mg/m2 IV or 1 mg/kg IV q3 weeks. Generally do not exceed 240 mg/m2 cumulative dose
listed in the table.
Mitoxantrone 5.5–6.0 mg/m2 IV q3 weeks
Even with ‘safe’
Platinum agents
dosing, some cats
Cisplatin No safe systemic dose will become ill and
Carboplatin 200–240 mg/m2 or 10 mg/kg IV q3 weeks experience side
Vinca alkaloids effects. Furthermore,
Vincristine 0.5 mg/m2 IV or 0.025 mg/kg IV q1 week if used in combination
Vinblastine 1.5 mg/m2 IV q1 week chemotherapy
Miscellaneous agents protocols, the dosing
L-asparaginase 400 IU/kg IM or SC, usually used once; minimum time between doses q7 days of the drug is likely to
Prednisone/prednisolone 1–2 mg/kg q24h to q12h need adjusting.

Cisplatin Vincristine
Platinum agents Vinca alkaloids

While the safe intralesional Vincristine has mostly

use of cisplatin has been used in cats as part of
been reported in cats, combination protocols to
its systemic use is contra- treat lymphoma (Figure 3).
indicated and, at most While relatively sparing of
doses, lethal. In dogs the the bone marrow, it can
organ system of concern is cause gastroenteritis and
the renal system; in cats it anorexia in the cat.
is the respiratory system. Peripheral neuropathy is
At doses as low 40 mg/m2 also a reported toxicity in
cats have been reported to cats.16
develop pleural effusion,
pulmonary edema and dyspnea, leading to Vinblastine
death. On necropsy examination this was Like vincristine, vinblastine is mostly used
Figure 3 Cat receiving
a dose of vincristine

associated with an inflammatory reaction in for treating lymphoma, but it has also been
chemotherapy for its high

the lungs.13 studied as a treatment for mast cell tumors.

grade intestinal lymphoma

While more myelosuppressive than vincristine,

Carboplatin the risk of gastrointestinal side effects is lower.
Although in the same class of drugs as cisplatin,
carboplatin can be given safely to cats, and has
been used for the treatment of a variety of L-asparaginase
Miscellaneous agents

carcinomas and sarcomas. The reported dose
that is safe to give is less than that for dogs.
Neutropenia is the dose-limiting side effect
of this drug and can occur 7–21 days after
administration.14 Some cats are more affected
than others and it may be possible to escalate the
dose to as high as 240 mg/m2 IV in some cats.15
Nephrotoxicity has been reported and so
carboplatin should be used with care in cats
with renal insufficiency. Renal function should
always be monitored in cats receiving this drug.
L-asparaginase, which is an enzyme derived
from Escherichia coli, catalyses the amino acid
L-asparagine to aspartic acid and ammonia. It
has been used in cats for the treatment of
lymphoid tumors as it depletes whole body L-
asparagine and tumor cells have a decreased or
absent ability to produce this amino acid. Since
normal cells are able to produce this amino acid
and lymphoid neoplasms have a relatively
high requirement for this amino acid, this agent
is able to selectively kill tumor cells.

422 JFMS CLINICAL PRACTICE


A study evaluating the effects of L-
asparaginase treatment of feline lymphoma
showed reduced asparagine levels in cats by 2
days post-administration.17 These effects were
lost within 7 days of administration, which is a
much shorter duration of effect than reported
for the dog, which can last weeks. This may be
due to cats, being a true carnivore, consuming
high protein diets coupled with a high rate of
amino acid synthesis. The authors of the study
documented an overall response rate (complete
and partial responses) of 30% to single agent L-
asparaginase.17 While the reported response rate
is lower than that in dogs, there is demonstrated
clinical benefit in the use of L-asparaginase in
the treatment of feline lymphoma.
Side effects reported with the use of L-
asparaginase in cats are minimal; however,
since it is an exogenous protein an anaphylactic
reaction may potentially develop with
Targeted
repeated administration. Resistance to this
drug is common and due to upregulation of
therapies can
asparagine synthetase in the surviving tumor produce
cells. While not investigated, this is a likely
mechanism of tumor resistance in this species.
toxicity and
cats need to be
Corticosteroids
Prednisone and prednisolone, the most
monitored as
commonly used corticosteroids in cats, are
included as a component of cancer therapy
carefully as
in multiple lymphoma and mast cell tumor
protocols. While most veterinarians consider
if they were
prednisone and prednisolone to be equipotent
receiving
in the dog, this may not be so in the cat.
Prednisone must be converted by the liver to
traditional
its active form prednisolone. In one study
involving six healthy cats there were decreased
chemotherapy
blood levels of prednisolone when prednisone
drugs.
was administered compared with the same
dosage of oral prednisolone.18 The authors
concluded that either oral prednisone was not
as bioavailable as prednisolone or that hepatic
metabolism of prednisone to prednisolone was
not as efficient in cats. Given the small study
size and clinical evidence in multiple studies
that cats do respond to prednisone, more
investigation is needed before discontinuing
the use of this drug in cats.
Long-term corticosteroid use in the cat is
associated with the risk of diabetes mellitus
with insulin resistance, although this is more
of a problem with long-acting injectable
formulations.
Table 3 Drug dosages for targeted therapies in cats
Agent Dosage with maximum frequency of administration
Toceranib phosphate Unknown; possibly 2.75–3.25 mg/kg PO Monday, Wednesday, Friday or every other day
Imatinib mesylate 10 mg/kg PO q24h
Masitinib mesylate Unknown; possibly 50 mg/cat q24h to every other day
R E V I E W / Cats and chemotherapy
Targeted therapies
Over the past several years, targeted therapies
have been developed for the treatment of var-
ious canine cancers and approved for use in
melanoma and mast cell tumors. Their utility
in the treatment of other cancers is promising
and currently under investigation. While
presently there are no targeted agents
approved for use in cats, there are several
studies and reports in the literature of their use
(Table 3). It is important to realize that target-
ed therapies can have toxicities associated
with them and that cats receiving these agents
need to be monitored as carefully as those being
treated with traditional chemotherapy drugs.
Toceranib phosphate targets the Kit, VEGFR,
Toceranib phosphate
PDGFR and FLT-3 tyrosine kinase receptors.19
This drug, while not licensed for use in the cat,
is approved for use in the dog. Currently, there
is very limited data on its use in feline
medicine. When given at high doses (6.5
mg/kg q24h), vomiting, diarrhea, anorexia and
weight loss were reported.20 While there are
several ongoing clinical trials assessing the use
of this drug in cats, there are no published
studies in the cat and it should be used with
extreme caution and only if no other therapies
are available.
Imatinib mesylate is the prototypic small
Imatinib mesylate
molecule inhibitor that inhibits the tyrosine
kinase receptors BCR-Abl, PDGFR and C-Kit.
There have been a few studies investigating its
use for the treatment of mast cell tumors and
injection site-associated sarcomas in the cat.21,22
However, as this drug has had limited
evaluation in the cat, the full range of possible
toxicities is not known. In the published
literature there are reports of elevated liver and
renal enzymes, leukocytosis and a case report
of a cat developing proteinuria while being
treated with imatinib.23 The idiosyncratic
hepatotoxicity seen in dogs has not been
reported as a problem in cats.
Masitinib mesylate targets the tyrosine kinase
Masitinib mesylate
receptors c-Kit, PDGFR and Lyn. This drug is
currently approved for use in dogs in the
None of the drugs listed
in Table 3 are approved
for use in cats and
limited studies are
available. These drugs
should be used with
extreme caution.
JFMS CLINICAL PRACTICE 423
R E V I E W / Cats and chemotherapy

United States and Europe for the treatment of

mast cell tumors. It has been studied to some
degree in the cat, and a pharmacokinetic and
KEY POINTS
a dose escalation study have been published. < Cats are most obviously not small dogs when it comes to treating
The pharmacokinetic study reported a bio-
availability of approximately 60% and
cancer in general and using chemotherapy in particular.

suggested that an oral dose of 10–15 mg/kg

< While there are many more studies in the literature regarding

was needed to achieve adequate plasma

chemotherapy in dogs, more information on treating feline cancer

concentrations.24 In a safety study performed

is becoming available.

in healthy cats given 50 mg either daily or

< Targeted therapies have recently been developed, but more
every other day, some gastrointestinal signs
and other toxicity effects were seen, including
investigation is needed into the safe and proper dosing of

proteinuria, neutropenia and elevated

these agents in cats.
< Further studies are also required to identify the
creatinine levels.25 As the dosing and efficacy
have not been established in the cat this drug
frequency and presence of the mutations that

should be used with extreme caution.

these drugs target in feline cancers.

11 O’Keefe DA, Sisson DD, Gelberg HB, Schaeffer DJ and Krawiec

DR. Systemic toxicity associated with doxorubicin administra-
Funding

The author received no specific grant from any funding agency in
the public, commercial or not-for-profit sectors for the preparation
of this article.
Conflict of interest
tion in cats. J Vet Intern Med 1993; 7: 309–317.
12 Ogilvie GK, Moore AS, Obradovich JE, Elmslie RE, Vail DM,
Straw RC, et al. Toxicoses and efficacy associated with adminis-
tration of mitoxantrone to cats with malignant tumors. J Am Vet
Med Assoc 1993; 202: 1839–1844.
13 Knapp DW, Richardson RC, DeNicola DB, Long GG and Blevins

The author does not have any potential conflicts of interest to declare. WE. Cisplatin toxicity in cats. J Vet Intern Med 1987; 1: 29–35.
14 Hahn KA, McEntee MF, Daniel GB, Legendre AM and Nolan ML.
Hematologic and systemic toxicoses associated with carboplatin
administration in cats. Am J Vet Res 1997; 58: 677–679.
References

1 Price GS and Frazier DL. Use of body surface area (BSA)-based
dosages to calculate chemotherapeutic drug dose in dogs: I.
Potential problems with current BSA formulae. J Vet Intern Med
1998; 12: 267–271.
2 Hill RC and Scott KC. Energy requirements and body surface
area of cats and dogs. J Am Vet Med Assoc 2004; 225: 689–694.
3 Shah SS, Sanda S, Regmi NL, Sasaki K and Shimoda M.
Characterization of cytochrome P450-mediated drug metabo-
lism in cats. J Vet Pharmacol Ther 2007; 30: 422–428.
4 Shrestha B, Reed JM, Starks PT, Kaufman GE, Goldstone JV, Roelke
ME, et al. Evolution of a major drug metabolizing enzyme defect
in the domestic cat and other felidae: phylogenetic timing and
the role of hypercarnivory. PLoS One 2011; 6: e18046. DOI:
10.1371/journal.pone.0018046.
5 Stein TJ, Pellin M, Steinberg H and Chun R. Treatment of feline
gastrointestinal small-cell lymphoma with chlorambucil and glu-
cocorticoids. J Am Anim Hosp Assoc 2010; 46: 413–417.
6 Rassnick KM, Rodriguez CO, Khanna C, Rosenberg MP, Kristal O,
Chaffin K, et al. Results of a phase II clinical trial on the use of
ifosfamide for treatment of cats with vaccine-associated sarco-
mas. Am J Vet Res 2006; 67: 517–523.
7 Rassnick KM, Moore AS, Northrup NC, Kristal O, Beaulieu BB, Lewis
LD, et al. Phase I trial and pharmacokinetic analysis of ifosfamide
in cats with sarcomas. Am J Vet Res 2006; 67: 510–516.
8 Rassnick KM, Gieger TL, Williams LE, Ruslander DM, Northrup NC,
Kristal O, et al. Phase I evaluation of CCNU (lomustine) in tumor-
bearing cats. J Vet Intern Med 2001; 15: 196–199.
9 Musser ML, Quinn HT and Chretin JD. Low apparent risk of
CCNU (lomustine)-associated clinical hepatotoxicity in cats.
J Feline Med Surg 2012; 14: 871–875.
10 Skorupski KA, Durham AC, Duda L and Sorenmo KU.
Pulmonary fibrosis after high cumulative dose nitrosourea
chemotherapy in a cat. Vet Comp Oncol 2008; 6: 120–125.
15 Kisseberth WC, Vail DM, Yaissle J, Jeglum KA, Couto CG, Ward
H, et al. Phase I clinical evaluation of carboplatin in tumor-bear-
ing cats: a Veterinary Cooperative Oncology Group study. J Vet
Intern Med 2008; 22: 83–88.
16 Cho ES, Lowndes HE and Goldstein BD. Neurotoxicology of vin-
cristine in the cat. Morphological study. Arch Toxicol 1983; 52: 83–90.
17 LeBlanc AK, Cox SK, Kirk CA, Newman SJ, Bartges JW and
Legendre AM. Effects of L-asparaginase on plasma amino acid
profiles and tumor burden in cats with lymphoma. J Vet Intern
Med 2007; 21: 760–763.
18 Graham-Mize CA and Rosser EJ. Bioavailability and activity
of prednisone and prednisolone in the feline patient.
Vet Dermatol 2004; 15: 7–10.
19 London CA. Tyrosine kinase inhibitors in veterinary medicine.
Top Companion Anim Med 2009; 24: 106–112.
20 European Medicines Agency. Palladia: European Public
Assessment Report – Scientific Discussion. http://www.ema.
e u r o p a . e u / d o c s / e n _ G B / d o c u m e n t _ l i b r a r y / E PA R _ -
_Scientific_Discussion/veterinary/000150/WC500060743.pdf. 2009.
21 Lachowicz JL, Post GS and Brodsky E. A phase I clinical trial
evaluating imatinib mesylate (Gleevec) in tumor-bearing cats.
J Vet Intern Med 2005; 19: 860–864.
22 Isotani M, Yamada O, Lachowicz JL, Tamura K, Yagihara H, Fujino
Y, et al. Mutations in the fifth immunoglobulin-like domain of
kit are common and potentially sensitive to imatinib mesylate in
feline mast cell tumours. Br J Haematol 2010; 148: 144–153.
23 Backlund B, Cianciolo RE, Cook AK, Clubb FJ and Lees GE. Minimal
change glomerulopathy in a cat. J Feline Med Surg 2011; 13: 291–295.
24 Bellamy F, Bader T, Moussy A and Hermine O. Pharmacokinetics of
masitinib in cats. Vet Res Commun 2009; 33: 831–837.
25 Daly M, Sheppard S, Cohen N, Nabity M, Moussy A, Hermine O,
et al. Safety of masitinib mesylate in healthy cats. J Vet Intern
Med 2011; 25: 297–302.

424 JFMS CLINICAL PRACTICE

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