Dyspnoeic 1yo ME Ragdoll

RE: Dyspnoeic 1yo ME Ragdoll

Anthony Todd — Wed, 16 May 2018 17:37:02 GMT

[quote user="Michael Woodhouse"]I keep buying them, putting them down and can't find them again [/quote]

If it wasn't you I would make a suggestion.

RE: Dyspnoeic 1yo ME Ragdoll

Michael Woodhouse — Wed, 16 May 2018 10:46:05 GMT

[quote user="Anthony Todd"]We used those see-through refractometers[/quote]

I keep buying them, putting them down and can't find them again .

Maybe that's a job for the next work experience student - see if they can find the see through refractometer......

RE: Dyspnoeic 1yo ME Ragdoll

Joyce Whitehead — Wed, 16 May 2018 09:33:10 GMT

I’m with Chris and Jo too. I actually thought when I looked at the radiographs that I hadn’t seen a thymic lymphoma for ages, and I guess many of them in the 80s were due to FeLV. Sad cases always.

RE: Dyspnoeic 1yo ME Ragdoll

Julie Innes — Wed, 16 May 2018 08:30:31 GMT

I immediately thought of pyothorax as I had one in a similar cat of similar breed and age! No explanation. After chest drains and antibiotics he is fine

RE: Dyspnoeic 1yo ME Ragdoll

Jo Dyer — Wed, 16 May 2018 08:09:33 GMT

Agree with everything you've said Chris, especially this;

[quote user="Chris Barker"]Given the animal's age I would think thymic lymphosarcoma would be number one on my list[/quote]

Sadly we used to see a lot of these with FeLV in the 80's, and this is the exact same radiographic picture. I remember one heart-breaking situation where a lovely family lost both their kittens to this within a week of each other.

If you palpated the anterior ribcage area you could feel it was solid rather than springy. Also I think a lot of them were FeLV positive on testing.

I've just seen he's been PTS, sadly that is the only answer.

RE: Dyspnoeic 1yo ME Ragdoll

Chris Barker — Tue, 15 May 2018 19:35:18 GMT

In the VD you have evident pleural effusion - the outline of the heart cannot be made out which is a classic sign of such effusions. On the L there is a very slight separation of the lung from the ribs by a thin line of soft tissue density while the caudal lung lobes are rounded, pushed from their normal position filling the extremity of the chest cavity, overlying the liver shadow. Air bronchograms are visible in the cranial L lung fields. On the R side the separation of lung from the chest wall is far more marked. But what is most marked is the exclusion of the lung fields from the cranial chest, far more than I would expect from a simple effusion. An anterior mediastinal mass would fit the picture presented.

On the lateral view you have some suggestion of a caudal outline of the heart - this visualisation aided by the contrast between it and the falciform fat in front and ventral to the liver One cannot be certain but the diaphragm looks intact. One caudo-dorsal lung lobe is pushed downwards by a uniform soft tissue density - lets assume from the VD that this is the R lung crushed down by pleural effusion. Again an air bronchogram overlies the cranial-mid lung fields over the area that we presume contains the cardiac shadow. What we do not have is scalloping of the cranial-mid lung lobes as would be expected in simple pleural effusion. The lung is pushed caudally and there is a clear line running from heart base dorsally representing the junction between areas where the lung is (caudally) and isn't (cranially) The cranial mediastinum is a uniform soft tissue density Interpretation - unlikely to be lung, which has been displaced caudally. The trachea is highly, and evenly elevated throughout its length.

Differentials - Congestive cardiac failure with gross cardiac enlargement. Cranial mediastinal mass Plus all your fluids - pyothorax Haemothorax Chylothorax (though your thoracocentesis eliminates some of these)

Given the animal's age I would think thymic lymphosarcoma would be number one on my list, but a simple ultrasound examination of the chest should confirm presence/absence of anterior mediastinal mass while allowing an assessment of the heart (dilated/hyperttrophic)

RE: Dyspnoeic 1yo ME Ragdoll

Anthony Todd — Tue, 15 May 2018 17:40:40 GMT

[quote user="Judith Archbold"]FIP?[/quote]

Isn't/shouldn't the SG be much higher with FIP??

RE: Dyspnoeic 1yo ME Ragdoll

Judith Archbold — Tue, 15 May 2018 16:39:58 GMT

FIP?

RE: Dyspnoeic 1yo ME Ragdoll

Edward Jones — Tue, 15 May 2018 16:17:08 GMT

Cytology as ordered! It looks mostly like blood to me, although there is the odd round cell with a very large nucleus - not quite enough cytoplasm for a lymphocyte perhaps but I'm no cytologist. I can't do any better a picture, sorry! Protein on refractometry is 4.8g/L.

Martin has hit the nail on the head , and I doubt I would be posting if there were sufficient finances (i.e. wasn't having to work with one hand behind my back - and I've done more than I should have already). I discussed empirical drainage briefly but not recommended it - I feel that there's a primary lung lobe problem (even though it won't be common?).

It's a PTS. Thank you!

RE: Dyspnoeic 1yo ME Ragdoll

Anthony Todd — Tue, 15 May 2018 15:20:28 GMT

SG gives the vital info usually. We used those see-through refractometers; are they still around, just need a drop of whatever.

RE: Dyspnoeic 1yo ME Ragdoll

Anthony Dennison — Tue, 15 May 2018 15:02:36 GMT

[quote user="Jenny Boyd"]

Cytology...

[/quote]

+1 for this. Can check for neoplastic cells

RE: Dyspnoeic 1yo ME Ragdoll

Jenny Harris — Tue, 15 May 2018 14:58:44 GMT

Cytology...

RE: Dyspnoeic 1yo ME Ragdoll

Martin Atkinson — Tue, 15 May 2018 14:54:20 GMT

[quote user="Edward Jones"]There's little funds available and I've probably blown the budget already.[/quote]In which case there is little else you can do, drain the effusion and hope for the best that it was a one off idiopathic bleed, euthanasia is a viable treatment option.

Why do people buy exotic breeds when they have no money?!

RE: Dyspnoeic 1yo ME Ragdoll

Edward Jones — Tue, 15 May 2018 14:32:31 GMT

Thank you Emily. I hadn't yet done a thoracocentesis, but I was kicking myself a bit when you suggested pyothorax.

I've just done a sample to reveal dark red fluid - i.e. what seems to be frank blood. I confirmed with ultrasound that the thoracocentesis was accurate. There's some smokiness in the effusion consistent with blood.

Reading your message I would have put money on pyothorax, but the fluid is usually obviously purulent, is it?

Edit: the pleural fluid is settling out a bit now and the non-cellular part is clear (i.e. non-purulent, looks like normal serum).

RE: Dyspnoeic 1yo ME Ragdoll

Emily Rainbow — Tue, 15 May 2018 14:19:27 GMT

Did you get a sample of the effusion? Pyothorax?