Confusing cat

Re: Confusing cat

Mark Hedberg — Thu, 07 Jun 2012 12:30:04 GMT

I know of one that makes a lovely artificial reef! :) Home to lots of lovely fish ;)

Re: Confusing cat

bob lehner — Thu, 07 Jun 2012 12:03:02 GMT

[quote user="Bob Russell"]

I agree. We have a QBC machine that lies so badly I have stopped using it

[/quote]

Indeed - they're as much use as a bicycle is to your average fish.

Re: Confusing cat

Bob Russell — Thu, 07 Jun 2012 11:34:06 GMT

[quote user="Michael Woodhouse"]

[quote user="Andrew Kent"]I also find in house white cell counts and differential to be very unreliable so you may find a smear analysis or external haematology would have given a different picture. Andy

[/quote]

I agree. We have a QBC machine that lies so badly I have stopped using it. Looking at the buffy coat on the PCV gives a ball park figure and a smear gives a good enough impression, and even I can spot non-segmented neutrophils.

[/quote]

We used to have a QBC machine and it was as accurate as holding the sample up to the light, turning three times anticlockwise and guessing!

We had the Vetscan3 and that was a little better but still some guessing. We now have the Haemat 5 which is pretty consistent with external labwork BUT sadly does not examine a smear so we still need to send samples away!

Re: Confusing cat

Stephen Courtney — Thu, 07 Jun 2012 00:18:58 GMT

I'm happy to tap an obvious ascites case in all but the most fractious cats - it hurts no different than a vaccine or any other injection - use a 23 gauge blue needle, either 5/8 or 1 inch depending on size of cat, body condition etc. I do cystos all the time in consult, often with the owner holding, so see this as no different.

Re: Confusing cat

David Mills — Wed, 06 Jun 2012 23:46:22 GMT

Also useful as a first look in a cat with suspected CHF and no/few funds is to quickly measure LA with an ultrasound scanner - its a very simple, very sensitive way of deciding whether heart is likely responsible for dyspnoea - can be carried out with simple US machines. If its more than 16.5mm in diameter you're looking at significant heart disease. (R sided failure on own very rare) There was a recent retrospective review of GP cases in JSAP showing LA size to be the most sensitive indicator of cardiogenic dyspnoea; murmurs were inconsistent finding and cannot be relied upon.

Septic peritonitis is usually a diagnosis of smell more than anything. Agree with the above that tapping any swollen abdomen at admit gives a very clear indication of the underlying cause. There is no evidence behind the referral clinician's oft-quoted shouldn't be done blind - passing the needle slowly minimises any risk.

Re: Confusing cat

James Laidlaw — Wed, 06 Jun 2012 23:35:05 GMT

[quote user="Michael Woodhouse"]

[quote user="Busybee"]My main question is why no increase in white cells on bloods?[/quote]

Because these conditions can be consumptive! Some of the worse infections can present with reduced WBC count. Any band neutrophils/left shift?

If I am presented with a big belly the first thing I will do is a tap (after history and exam). Many cats will tolerate a 21G needle conscious and you can formulate a plan based on that, rather than spend all this money to PTS the cat.

[/quote] Me too. I got told off by a referral clinician for tapping a dog "blindly" once as we had no ultrasound, but we found blood and that's what directed them to the referral clinic. Turned out to be hepatitis (viral) so quite glad it went away to them in the end. I think there's relatively few complications from a clean/sterile site and small gauge needle - but it can be particularly informative.

Re: Confusing cat

Michael Woodhouse — Wed, 06 Jun 2012 22:35:58 GMT

[/quote]

Re: Confusing cat

Andrew Kent — Wed, 06 Jun 2012 22:33:39 GMT

I also find in house white cell counts and differential to be very unreliable so you may find a smear analysis or external haematology would have given a different picture. Andy

Re: Confusing cat

Busybee — Wed, 06 Jun 2012 22:32:35 GMT

Our machine doesn't measure band neutrophils :(

I did consider tapping and now it is something I will definitely do first line in the future. My (senior) colleague was convinced it was due to it's heart and therefore was treated as such.

Lesson learnt.

Re: Confusing cat

Michael Woodhouse — Wed, 06 Jun 2012 22:27:06 GMT

[quote user="Busybee"]My main question is why no increase in white cells on bloods?[/quote]

Because these conditions can be consumptive! Some of the worse infections can present with reduced WBC count. Any band neutrophils/left shift?