PUO in a cat

RE: PUO in a cat

Bob Russell — Mon, 14 Jan 2019 13:02:36 GMT

[quote user="David Mills"]

[quote user="Bob Russell"]Final diagnosis - typhlitis, [/quote]

How was this definitively diagnosed, out of interest?

Did treatment include corticosteroids?

[/quote]

Referral to Anderson Moores, ultrasound imaging done. No corticosteroids!

I doubt I would be able to find the caecum, let alone identify it as inflamed but then I am a mere mortal!!

RE: PUO in a cat

Anthony Dennison — Mon, 14 Jan 2019 11:05:13 GMT

[quote user="Joyce Whitehead"]Have you tried Periactin to get appetite going?[/quote]

Can you still get periactin? Thought it had been discontinued?

I had a PUO cat present to me on Friday. Gave a one off NSAID, back in this morning with his brother for vaccination. Temp gone and eating again but shaking his head - he had an ulcer on his tongue. Anything abnormal on oral exam?

RE: PUO in a cat

Robin Grimmer — Mon, 14 Jan 2019 08:35:13 GMT

Update - cat is now fine, temperature back to normal. He did really well after the clam la and Dex on Saturday so I repeated it today and sent him on his way. I think to be fair he was starting to improve before I gave him the steroid. His temp was 105 on first presentation which is why I didn't give steroid straight away, maybe I should have done? Owner is very relieved, and so am I! Thanks for all the input.

RE: PUO in a cat

David Mills — Sat, 12 Jan 2019 23:39:27 GMT

[quote user="Bob Russell"]Final diagnosis - typhlitis, [/quote]

How was this definitively diagnosed, out of interest?

Did treatment include corticosteroids?

RE: PUO in a cat

Michael Woodhouse — Sat, 12 Jan 2019 12:48:36 GMT

[quote user="David Mills"]Dexamethasone...without wanting to sound like Anthony Todd I bet it fixes this cat [/quote]

Agree. That's all I'd have done on day one and had a look the next day and considered bloods, abs etc at that point.

RE: PUO in a cat

Julie Innes — Sat, 12 Jan 2019 12:44:53 GMT

[quote user="Bob Russell"](I did have to check typhlitis in the dictionary I am ashamed to admit!)[/quote]

Me too!

RE: PUO in a cat

Thomas Johnson — Sat, 12 Jan 2019 11:53:47 GMT

[quote user="Robin Grimmer"]

I take your point but I'm always more concerned with anorexia in cats if it goes on for more than a few days.

[/quote]

Definitely, I put an oesophagostomy tube in a cat with hepatic lipidosis earlier this week so I completely understand the concern.

RE: PUO in a cat

Bob Russell — Sat, 12 Jan 2019 11:06:31 GMT

I had a really problematic PUO a couple of weeks ago. Very similar presentation but did not respond as expected and continued to go downhill.

We all decided that it should go where it would get first class nursing care so was referred.

Final diagnosis - typhlitis, a change of antibiotic cover and a couple of days of nursing and it was home.

I still think most of these have an infection lurking somewhere and often not identified.

If budget is limited then a change of antibiotics and that magic shot of corticosteroids as suggested by David Mills does sort the majority out.

(I did have to check typhlitis in the dictionary I am ashamed to admit!)

RE: PUO in a cat

Robin Grimmer — Sat, 12 Jan 2019 10:43:46 GMT

I take your point but I'm always more concerned with anorexia in cats if it goes on for more than a few days.

RE: PUO in a cat

Thomas Johnson — Sat, 12 Jan 2019 09:35:09 GMT

[quote user="Robin Grimmer"]

Thanks for input. He's been unwell since Monday, first seen Wednesday evening. I have been sending him home overnight. I think he may be turning a corner. Overnight he had drunk water for the first time, passed faeces but still not eaten. He's looking brighter this morning and temperature was only 39. I've given him Valium this morning and he's eaten a whole pouch. Have given clam la and Dex to see him over the weekend and also some mirtazipine. Had b12 yesterday.

[/quote]

I always find it difficult to know how soon to really worry with cases like this, I sometimes wonder if we expect them to improve too quickly. If you or I get a nasty bout of flu we could be laid up with a high temperature for a week, and while NSAIDs will probably make us feel a bit better they're not going to get us back to normal, and the only reason we'll eat or drink anything is because we know we have to, not because we want to.

RE: PUO in a cat

Robin Grimmer — Sat, 12 Jan 2019 09:17:17 GMT

RE: PUO in a cat

Thomas Johnson — Sat, 12 Jan 2019 08:45:23 GMT

[quote user="Robin Grimmer"]Temperature has come down a little more today than yesterday but still elevated. Only the metacam seems to make a difference.[/quote]

How long has he been unwell for? It'll be interesting to see how he gets on at home, I often only hospitalise cases like this during the day and send them home overnight as quite a lot of cats won't eat in the hospital, I also worry that they don't rest and sleep properly while they're with us which won't help with them getting better.

RE: PUO in a cat

David Mills — Fri, 11 Jan 2019 22:52:05 GMT

Dexamethasone...without wanting to sound like Anthony Todd I bet it fixes this cat

RE: PUO in a cat

Kate Richardson — Fri, 11 Jan 2019 21:58:22 GMT

If he’s been inappetant for a while check potassium and correct if low

otherwise try different analgesia such as methadone or buprenorphine and never hurts to give maropitant (helps with nausea, pain relief) and B12, always think pancreatitis

Mirtazipine as appetite stimulant.

RE: PUO in a cat

Joyce Whitehead — Fri, 11 Jan 2019 19:54:59 GMT

Have you tried Periactin to get appetite going? Could it be renal in origin - pyelonephritis or similar? Might just be slow to get going but I often find if you can once get the cat eating they will carry on.