Dyspnoeic cat with weight loss

RE: Dyspnoeic cat with weight loss

Beats — Tue, 07 Mar 2017 12:27:15 GMT

[quote user="Virginia Campbell"]Were the owners smokers?[/quote]

I don't know.

RE: Dyspnoeic cat with weight loss

Virginia Campbell — Tue, 07 Mar 2017 12:21:11 GMT

Thanks for the update. Poor cat, how unlucky. Were the owners smokers?

RE: Dyspnoeic cat with weight loss

Beats — Tue, 07 Mar 2017 09:53:10 GMT

Squamous cell carcinoma was final diagnosis.

RE: Dyspnoeic cat with weight loss

Beats — Fri, 30 Dec 2016 12:21:03 GMT

some follow-up:

breathing not really improved significantly on further exam, giving another 2 weeks with more steroids/abs and applied moxidectin, but anticipate euthanasia at that stage if not sooner if respiratory distress becomes severe again.

RE: Dyspnoeic cat with weight loss

Virginia Campbell — Wed, 21 Dec 2016 09:26:53 GMT

[quote user="Martin Atkinson"] BAL shouldn't be a risk the amount of fluid you're putting in there is minimal, albeit I did induce a life threatening asthma attack in one cat with a BAL but I think that was just because the fluid was too cold.[/quote]

Have heard people advise Bricanyl first - both to allow saline to get further down and pick up more interesting crud, and also to reduce risk of bronchospasm.

RE: Dyspnoeic cat with weight loss

Martin Atkinson — Wed, 21 Dec 2016 09:04:10 GMT

[quote user="Beats"]What further investigations would you have in mind as being most helpful?[/quote]I think you've answered that question yourself. BAL shouldn't be a risk the amount of fluid you're putting in there is minimal, albeit I did induce a life threatening asthma attack in one cat with a BAL but I think that was just because the fluid was too cold.

[quote user="Virginia Campbell"]there is a fair bit of Aleurostrongylus around Belfast and says, "Have you put an Advocate on that?" without breaking stride past a rad of grubby cat lungs on the way through the Xray room)[/quote]If it was a dog I'd be thinking Angiostrongylus but see very little lungworm in cats so don't know if they get the same characteristic pattern on rads.

[quote user="ruths"]My impression is that cats cough due to asthma and not much else[/quote]My experience of asthma in cats is that there is usually very little to see on X-ray.

RE: Dyspnoeic cat with weight loss

ruths — Wed, 21 Dec 2016 08:16:30 GMT

Sorry- pressed send too soon

I'be seen some pretty scuzzy looking kings with cats with asthma

the only thing here is that the diaphragm isn't particularly flattened

RE: Dyspnoeic cat with weight loss

ruths — Wed, 21 Dec 2016 08:09:15 GMT

My impression is that cats cough due to asthma and not much else

Im on my phone so it's hard to look at the X-rays but from here it does look like there's a bronchial component to this.

I think that would be high on my list at this stage

RE: Dyspnoeic cat with weight loss

Virginia Campbell — Wed, 21 Dec 2016 00:23:41 GMT

Think the worming is worth doing. Saw a pair of ill 6mo cats (full brothers) with very scruffy lungs do very well after treatment (they got abs as well- Ronaxon I think- but one of our senior vets reckons there is a fair bit of Aleurostrongylus around Belfast and says, "Have you put an Advocate on that?" without breaking stride past a rad of grubby cat lungs on the way through the Xray room)

RE: Dyspnoeic cat with weight loss

Beats — Wed, 21 Dec 2016 00:03:43 GMT

thanks kate, o'll send you a message.

my issue with bal is concern re killing the cat getting the sample (not to mention need to be confident in my assessment that ain't cardiogenic pulmonary edema first - I've called these wrong before and failed to give furosemide when indicated). would consider once more stable, but by that stage by definition have response to ytreatment and tend to find results fairly unhelpful at best of times and especially after treatment first. I was more thinking of trial treatment and response with follow-up rads +/- bal in couple of weeks if doing well. do you ever do a trans tracheal wash in cat if want to airway sample but afraid to ga and is this any safer and easy enough to do?

re tb, always a hard call. if do bal and granulomatous inflammation or otherwise suspicious then can do culture, but has been on treatment takes months etc. PCR through leeds would be too pricey for owners to consider worthwhile diagnostic. ZN staining on bal has pretty low sensitivity I reckon and if positive opens can o worms without knowing which species involved. There were no obvious skin lesions present on brief exam at time. local gov lab would do culture on PM if euth on basis of suspected mycobacterial infection.

I was minded to treat with veraflox for few days and see if consistent response, if not switch to steroids (or maybe give both together for few days first). if genuinely think tb a likely diagnosis then possibly treating with steroids to see if clinical improvement and then radiograph would make more sense (i.e. if not steroid responsive likely best euth irrespective of precise pathology present).

I would consider blds to include fiv, but thought diagnostic yield likely to be low re treatment decisions and extra handling might have been detrimental to cat. how often is hematology that useful? biochem might point to other organ involvement, but again unlikely to steer things very much?

plan to worm as well just 'n case

RE: Dyspnoeic cat with weight loss

Kate Richardson — Tue, 20 Dec 2016 22:43:40 GMT

BAL initially

haematology might be useful

if you want me to post on ISFM forum am happy to if you message me

danielle gunn Moore worth contacting re possibility of this being TB

RE: Dyspnoeic cat with weight loss

Beats — Tue, 20 Dec 2016 21:08:55 GMT

Thanks, Neil and Martin!

Great points.

What further investigations would you have in mind as being most helpful?

I gave some colvasone and marbocyl and left in cage with oxygen for the day - was more settled breathing wise (RR down to 40-60/min from 80+/min, not mouth breathing and grooming again) and eating by end of day.

No pleural or peritoneal fluid identified with ultrasound. VERY subjective ultrasound of left atrium (in unrestrained patient) looked ok size-wise.

RE: Dyspnoeic cat with weight loss

Martin Atkinson — Mon, 19 Dec 2016 13:06:53 GMT

My first thought was neoplasia but the consolidation doesn't look discrete enough, so TB is a reasonable call. I think there is also some peritoneal fluid so this suggests more multi-system involvement but can't rule out cardiac failure. More of a work-up is required - its not a get out clause its a necessity.

RE: Dyspnoeic cat with weight loss

Neil Wheadon — Mon, 19 Dec 2016 12:46:43 GMT

Starter for 10

I would divide thorax radiographs between cardiac and pulmonic.

The cardiac shadow looks normal, the trachea dips as expected and the caudal vena cava looks at the correct angle

There is lung consolidation in both caudal lungs and on the left middle lobe (there are 3 on the left, 4 on the right)

No pleural effusion

Therefore you should consider diseases that causes consolidation. Infectious/Tumours/Fluid?

To me this looks like consolidation and I would put feline TB on the list, however further investigation required, that's my get out clause.

Interesting case, thankyou

Neil

PS Spondylosis, that's quite unusual in this age of cat