Cat with breathing problems - advice please!

Re: Cat with breathing problems - advice please!

Michael Woodhouse — Mon, 16 Jul 2012 00:40:55 GMT

Suppose with blood clots flying about a concurrent pulmonary embolus also possible.

Re: Cat with breathing problems - advice please!

Michael Woodhouse — Mon, 16 Jul 2012 00:40:16 GMT

I tend to think the rapid breathing is more a pain response than anything else. PTS was for the best.

Having attempted to treat an number of these cases you can spend a lot of money and never really seem to control the pain. I 'cured' one for it to recur a few weeks later.

Re: Cat with breathing problems - advice please!

amiveson — Sun, 15 Jul 2012 22:41:36 GMT

many thanks for the replies and advice - have also had a reply from a cardiologist colleague I emailed, basically in agreement too.

Given the situation/prognosis, the owners have opted for euthanasia for this cat

Re: Cat with breathing problems - advice please!

David Mills — Sun, 15 Jul 2012 21:54:08 GMT

If you've got access to JFMS there's a masterful review of ATE here:

http://www.ncbi.nlm.nih.gov/pubmed/22736680

Re: Cat with breathing problems - advice please!

David Mills — Sun, 15 Jul 2012 21:40:32 GMT

V likely cardiac. There appears to be patchy alveolar pattern caudally on the lateral and variously on the DV. HM only present in around 60-65% of cats with CV disease. Only way of saying definitively is a quick ultrasound of LA - if its greater than 16.5mm in width you're highly likely looking at CHF in association with these X-rays. As above, RF lameness is likely ATE.

I would stop the dex (contraindicated in CHF), give injectable frusemide at a good dose (4mg/kg TID IM) and wait and see. You can use ACEis if you like but a) absolutely no evidence for increasing MST in cats with CHF/CM; b) cats live as long on frusemide alone as they do on ACEis; c) they're expensive. I would switch to meth/morph for the RF.

Of course PTS is a kind option in this case. The RF will be exceedingly painful especially as blood flow returns. If the cat does regain function, prognosis is grave with a MST of 77 days for cats with concurrent CHF; ATE is excruciatingly painful, and will return. Neither aspirin nor clopidogrel have shown an increase in MST.

Tough case.

Re: Cat with breathing problems - advice please!

Stephen Courtney — Sun, 15 Jul 2012 21:24:50 GMT

Thromboembolism to right fore leg as a result of cardiomyopathy.

there is no budget for investigations so don't beat yourself up.

Your choices to offer the client are PTS and sympathy, or emprical treatment - fortekor, frusemide, prilactone, aspirin q3 days and PTS when she get s a bit older/ worse. If they aren't willing to pay for tablets then PTS is the only fair choice.

the client has tied your hands, given the age of the animal perfectly reasonably in my opinion. Make a sensible diagnosis based on clinical signs and act accordingly, after full discussion, and you cannot be held wanting.