Peripheral oedema and pleural effusion in a cat

RE: Peripheral oedema and pleural effusion in a cat

Anthony Todd — Sat, 25 Aug 2018 15:51:59 GMT

[quote user="Kara Gibson"]I know common things are common but if this had been an injury then I would have expected it to have resolved much quicker and without the aid of diuretics.[/quote]

Well the diuretics weren't for the injury, and even common injuries vary in their recovery rates.

RE: Peripheral oedema and pleural effusion in a cat

Kara Gibson — Fri, 24 Aug 2018 02:48:41 GMT

Quick update: the pleural fluid was negative for coronavirus which rules out FIP. I have not seen the cat back for exam yet as the owner can't make a recheck until next week but she tells me the fluid on the right side of the thorax has resolved on the increased dose of frusemide.

I know common things are common but if this had been an injury then I would have expected it to have resolved much quicker and without the aid of diuretics.

I'll update after I examine the cat again.

Thanks again for all your thoughts!

RE: Peripheral oedema and pleural effusion in a cat

Anthony Todd — Thu, 23 Aug 2018 17:48:38 GMT

Don't know where the cat is now, but I'm just wondering whether a whack [not malicious!!] couldn't also give the chest fluid and changes too??

My old mentor, Bill Doull, always said "my horses only get ordinary things wrong with them" and the extrathoracic subcutaneous"bruise" is pretty ordinary?

RE: Peripheral oedema and pleural effusion in a cat

Liz Barton — Wed, 22 Aug 2018 13:04:34 GMT

[quote user="Anthony Todd"]So where does the resolving "bruise" fit in? Coincidental and unrelated I reckon?[/quote]

Probably. If it resolves while the more concerning intrathoracic pathology is investigated then the bruise/seroma is likely a red herring. Although if there is a mass in the chest and the bruised area is overlying I suppose it could have underlying metastatic disease, which has bled (e.g. rhabdomyosarc of intracostals...). It would be odd, especially with intrathoracic component, and on the US didn't look attached to body wall. But I'm just speculating now! I'm no oncologist so happy to be corrected!

RE: Peripheral oedema and pleural effusion in a cat

Anthony Todd — Wed, 22 Aug 2018 07:16:08 GMT

[quote user="Liz Barton"] You'd be able to FNA this once effusion removed.[/quote]

So where does the resolving "bruise" fit in? Coincidental and unrelated I reckon?

RE: Peripheral oedema and pleural effusion in a cat

Liz Barton — Tue, 21 Aug 2018 23:38:06 GMT

[quote user="Kara Gibson"]

I agree about the static image but when I was scanning I could tell this was not lung atelectasis.

[/quote]

You should definitely be seeing a ST opacity around the heart apex on X-ray post drainage if that's the case. Worth repeating radiography once effusion has resolved, or if it doesn't resolve then you should be able to drain until the chest is pretty clear. You'd be able to FNA this once effusion removed.

RE: Peripheral oedema and pleural effusion in a cat

Anthony Todd — Tue, 21 Aug 2018 11:04:25 GMT

[quote user="Kara Gibson"]I highly doubt this was an injury[/quote]

Any other suggestions then? Not suggesting anything malicious, but cats do have traumatic incidents and everything to me suggests a bang of some sort [independent of the lung signs etc.]

I would expect more than one lesion if it was something systematic??

Resolving bruises can be pretty painless??

Sounds like it will resolve in time anyway.....

RE: Peripheral oedema and pleural effusion in a cat

Kara Gibson — Tue, 21 Aug 2018 05:15:00 GMT

I agree about the static image but when I was scanning I could tell this was not lung atelectasis.

The cat was certainly not uncomfortable at all and acting completely normally in herself. I highly doubt this was an injury, particularly given that the mild bruising has not resolved 10 days after she first presented.

I have considered clotting factors but she's not anemic, and had no issues at any of her venepuncture sites.

Thanks for all the suggestions so far !

RE: Peripheral oedema and pleural effusion in a cat

Anthony Dennison — Mon, 20 Aug 2018 19:14:16 GMT

[quote user="Liz Barton"]I'm wondering if you're just seeing a bit of lung atelectasis around the heart on your US image, with the pleural effusion surrounding making it look more prominent. I think you can follow a single, nice line of pericardium, but it's hard to tell from one static image. [/quote]

Yes that's a good possibility - on the moving image you would be able to tell if it's floating lung or attached to the heart.

RE: Peripheral oedema and pleural effusion in a cat

Liz Barton — Mon, 20 Aug 2018 18:34:57 GMT

[quote user="Kara Gibson"]Could this be a pericardial or heart tumour? [/quote]

I'm wondering if you're just seeing a bit of lung atelectasis around the heart on your US image, with the pleural effusion surrounding making it look more prominent. I think you can follow a single, nice line of pericardium, but it's hard to tell from one static image.

[quote user="Anthony Todd"]Sounds like an injury to me.[/quote]

I agree with Anthony that trauma does seem quite likely with the SQ swelling. We had an indoor cat in recently with bruising on it's side, and then a swelling suddenly appears and a formerly reduced body wall rupture became apparent. Turns out the cat had probably been caught in a door banging in the wind. Odd that it's not painful though; my case was definitely painful.

Might be worth checking clotting factors too.

Interesting case! Had the owners noted any other clinical symptoms at all? Weight loss / lethargy / inappetence / dyspnoea?

RE: Peripheral oedema and pleural effusion in a cat

Kara Gibson — Mon, 20 Aug 2018 12:27:22 GMT

That's up there in my list, have sent some pleural effusion for coronavirus PCR. Just weird it doesn't have any blood changes, not even just a non regenerative anaemia.

RE: Peripheral oedema and pleural effusion in a cat

Matt Hilary — Fri, 17 Aug 2018 13:27:15 GMT

FIP?

RE: Peripheral oedema and pleural effusion in a cat

Kara Gibson — Fri, 17 Aug 2018 08:01:30 GMT

I don't think so, indoor cat and much loved. The area was and remains completely non-painful!

RE: Peripheral oedema and pleural effusion in a cat

Anthony Todd — Fri, 17 Aug 2018 07:57:57 GMT

[quote user="Kara Gibson"]

10 days ago

peripheral oedema and bruising is so odd.

[/quote]

Sounds like an injury to me. Is this possible? Kick??