Cat Gagging/retching

RE: Cat Gagging/retching

Robin Grimmer — Fri, 18 Sep 2015 23:20:02 GMT

It probably is just an infection picked up from the cattery, but your cat has been anorexic for a few days now anc is dehydrated so needs some fluids and nutritional support. Might be one best for the ooh clinic where they can repeat the electrolytes. Edta contamination is a possibility, but would expect low Ca. Haemolysis also possible as a cause of hyperkalaemia. Urine sg will quickly differentiate renal from pre-renal.

RE: Cat Gagging/retching

Kirsten Simpson — Fri, 18 Sep 2015 22:53:09 GMT

Heya, sorry today turned out mental busy. Saw the cat back, still not eating, and is now sneezing. Normothermic, rest of examination normal. Took some bloods but only managed enough for Biochem as started panicking and drooling profusely which stopped once left to settle. Bloods came back with a hyperkalaemia that they think might be artefactual or metabolic acidosis (which doesnt fit the clinical signs), and a mildly increased urea and chloride.

Another vet saw it yesterday whilst I was in thestre, and with it now sneezing we are thinking a viral URT issue, bordetella even?? But with this hyperkalaemia, I am trying to think about weird things like ethylene glycol tox which would fit the hyperchloraemia and inc potassium. Ive seen that before and this doesnt fit that. Specially with no dramatic azotaemia. We have no endoscope here so I wasnt able to retrograde examine the choanae of the nose nor visualise further down the throat than was visible with an otoscope. He was never showing nasal signs until I saw him in consult today So now i'm wishing I did forced nasal flush. Im pretty stumped to be honest :/ We cant do elecs in house which I would LOVE to repeat tomorrow. Im in two minds to tell the owner to take him to OOH to get some bloods repeated. Could he have Addisons?? Ive never ever seen it in cats before but with that Na:K ratio?? If it is true...

Also now thinking that the gagging/retching and drooling is dysphagia. But why? If it is Addisons there is a case that presented with Dysphagia due to muscle weakness. Going to heavily advise OOH for cont of IVFT that I'll start tomorrow morning and repeat bloods. Ah jeez. This is driving me nuts. To bed with me!

RE: Cat Gagging/retching

Evelyn Barbour-Hill — Fri, 18 Sep 2015 17:11:52 GMT

Oh and have a look down the ears while you're there.

RE: Cat Gagging/retching

Kate Richardson — Fri, 18 Sep 2015 17:09:16 GMT

[quote user="Evelyn Barbour-Hill"]Before you do any blood sampling, just consider what you imagine you might discover from blood results.[/quote]

I was thinking outside the square a little so bloods for checking for other reasons the cat may not be eating, but I like to have electrolytes esp potasium in inappetant cats. Haematology can be useful for determining if inflammatory, neutrophilic v lymphocytic inflammation.

RE: Cat Gagging/retching

Evelyn Barbour-Hill — Fri, 18 Sep 2015 15:40:01 GMT

[quote user="Aine Seavers"] If you syringe in a small amount of water -does that trigger an episode or does that ease the issue and/or then gets thrown back up [/quote]

An easy test which should always be part of one's clinical examination in such cases.

[quote user="Kirsten Simpson"]Any help would be most welcome![/quote]

You are with the cat, not me, so I can't tell you what to do: whether to treat symptomatically and investigate if it doesn't rapidly improve, or to investigate straight away. I'd only say that I would rather investigate such things sooner rather than later, on the whole.

Standard investigation: not necessarily in this order, and modify according to circumstances: radiograph chest, trachea, larynx, pharynx (could be a tiny metallic foreign body, you never know) and consider barium swallow; endoscopy with flexible instrument, retrograde into nasopharynx till you've visualised it all right up to choanae, and larynx, trachea down to carina, oesophagus down to cardiac sphincter. Endoscope orthograde through nostrils if you can. Pass Jackson cat cather through each nostril, flushing with saline as you go (don't forget a proper throat pack!!). Flush each nostril forcibly with saline with just the nozzle of the syringe inside the nares, and see what if anything comes out on the throat pack. After that, endoscope the nasopharynx again and see what you can see. (Be careful to swab or suck all fluid and mucus away when you've finished).

Before you do any blood sampling, just consider what you imagine you might discover from blood results.

RE: Cat Gagging/retching

Martin Atkinson — Fri, 18 Sep 2015 15:16:40 GMT

[quote user="Clive Ansell"]

Sorry - misread the post. Took it cat was eating and drinking ok.

[/quote]+1. Note to self: read post thoroughly before answering. Nonetheless I still think that after a reasonable look in its mouth and oro-pharynx had revealed NAD in consult, I would have given NSAID and antibiotic on day one, not sure an opening with corticosteroids was the best gambit (I assume I read that bit correctly).

RE: Cat Gagging/retching

Clive Ansell — Fri, 18 Sep 2015 15:01:57 GMT

Sorry - misread the post. Took it cat was eating and drinking ok.

RE: Cat Gagging/retching

Robin Grimmer — Fri, 18 Sep 2015 14:56:23 GMT

This cat is NOT eating and drinking - read the OP properly.

Next day not eating or drinking

Yesterday still not eating or drinking and more depressed

The OP saw the cat this morning but we don't know what the result was yet.

RE: Cat Gagging/retching

Clive Ansell — Fri, 18 Sep 2015 14:44:46 GMT

cat goes into cattery for 5 days, comes out gagging, and is eating and drinking well. Was it pyrexic?

Why not treat symptomatically in the first instance, as it is likely a viral infection, with nsaid +/- ab's?

Why the need to jump in with euga, oropharyngeal swabs, or chest rads. If it responds to treatment they may not be needed. Of course, if no improvement then investigate.

RE: Cat Gagging/retching

Martin Atkinson — Fri, 18 Sep 2015 14:31:07 GMT

[quote user="Robin Grimmer"]

If still anorexic then would be good candidate for a naso-oesophageal tube as would be worried about hepatic lipidosis in an anorexic obese cat. You could place one at the same time as you take rads etc.

[/quote]OP says is eating and drinking.

RE: Cat Gagging/retching

Robin Grimmer — Fri, 18 Sep 2015 14:27:58 GMT

RE: Cat Gagging/retching

Aine Seavers — Fri, 18 Sep 2015 12:49:06 GMT

did you check under the tongue esp the frenulum, any lesions on side of tongue ? what about lymph nodes, temperature ?Agree weird it was allowed into cattery without vaccines. Any history of bones etc esp chicken wish bone? If you syringe in a small amount of water -does that trigger an episode or does that ease the issue and/or then gets thrown back up .xray may be in order.

RE: Cat Gagging/retching

Aine Seavers — Fri, 18 Sep 2015 12:46:46 GMT

RE: Cat Gagging/retching

Kate Richardson — Fri, 18 Sep 2015 12:39:07 GMT

Given the recent history of cattery exposure, viruses top of the list, but I would like bloods and a chest xray ideally to make sure nothing else going on; could be lung pathology causing increased mucus secretion, but I guess you would have seen evidence of mucus accumulating around larynx when examined, but not necessarily.

What dose of dex did he have (when you say tiny)?

RE: Cat Gagging/retching

Martin Atkinson — Fri, 18 Sep 2015 11:09:33 GMT

[quote user="Robin Grimmer"]

How was it allowed in cattery if not vaccinated? Sounds viral, take an oropharyngeal swab.

[/quote]Missed the bit about the vaccination & cattery so agree but I don't see the point of taking a swab for viruses as you're not likely to treat these and any treatment will be aimed at alleviating symptoms and preventing secondary infection so still vote for a course of antibiotic.

RE: Cat Gagging/retching

Kirsten Simpson — Fri, 18 Sep 2015 11:03:48 GMT

The cat is due in at 11:10 so will see how he is! I agree, I think it's viral more than anything else as his oropharynx looked so fine! I managed to get an otoscope down a bit of his proximal oesophagus and there were no obvious abrasions/inflammation noted. It's a mystery! Fingers crossed he is a bit better today...

RE: Cat Gagging/retching

Robin Grimmer — Fri, 18 Sep 2015 10:18:28 GMT

How was it allowed in cattery if not vaccinated? Sounds viral, take an oropharyngeal swab.

RE: Cat Gagging/retching

Martin Atkinson — Fri, 18 Sep 2015 10:12:27 GMT

If its eating and drinking an oesophageal FB is unlikely and you say you had a look down the oesophagus - was that with an endoscope or just proximal oro-pharynx? IME if there is no obvious FB or mass this is likely to be a pharyngitis so I would give a course of antibiotic before anything else.

Funnily enough I had something similar this week, fussy owner possibly over-exaggerating the problem as it never once showed any symptoms on my watch but it had a dental procedure with extractions the week before. Failed to respond to injection of Carprodyl overnight so I gave it a GA to examine it properly and scoped the oesophagus, reflected the soft palate but NAD and all tooth sockets healing nicely. However we noticed its pads had dried tarry substance on them and postulated that he'd licked that off and had irritated his mouth. So we washed the feet, he was hyper-salivating as he was recovering so had an injection of Cerenia and sent him home. Haven't heard back but they've now gone on holiday.