Top 20 Feline Conditions Part 3

5 More Of The Top 20 Feline Conditions To Know For VTNE Success:

11. Feline infectious peritonitis (FIP)

Classic case: Young cat from multiple-cat housing (shelter,
cattery)
Waxing/waning fever, lethargy, anorexia, weight
loss
Asymmetric kidneys
Palpable abdominal fluid wave +/- pleural effusion on
thoracic rads
Anterior uveitis +/- neurologic signs
Dx:
Feline coronavirus (FCoV) mutates into the virus that
causes FIP Scottish fold with ascites from FIP.
Aspirate effusion: More common in purebreds, possibly
Viscous, straw-colored modified transudate assoc. w/ multi-cat living environments
Increased neutrophils and macrophages with protein >
3.5 mg/dl
Rivalta's test positive (drop retains shape in acetic acid
solution)
Hypoalbuminemia and hyperglobulinemia
(albumin/globulin ratio < 0.6)
CSF analysis: elevated protein and mononuclear
pleocytosis (may be neutrophilic)
Rx: Not curable
Immunosuppression: dexamethasone (can be given
intraperitoneal or intrathoracic if effusion present) or oral
prednisolone (preferred when no effusion present)
Immunomodulation: the following have been used with
mixed results:
Human interferon-alpha
Anterior uveitis secondary to FIP
Feline interferon-omega
Polyprenyl immunostimulant
Supportive care:
Fluids
Thoracocentesis and oxygen if dyspneic
Appetite stimulants (mirtazapine)
Pearls:
Historically, FIP was divided into two forms
We now know that these are different manifestations of the same disease
FIP cats with granulomas ("dry") will often develop effusion
FIP cats with effusions ("wet") also have microgranulomas
Prognosis is poor
FCoV is a common, benign virus that mutates into the aggressive virus that causes FIP
Transmitted through fecal-oral and indirect routes
Positive corona virus titer not sufficient to diagnose FIP (may be due to previous exposure to
FCoV)
12. Common cancers: mammary tumors, squamous cell carcinoma (SCC), lymphosarcoma
(LSA)
Classic case presentations:
Mammary tumors:
Unspayed female or was spayed after
several litters
Enlarged mammary gland or firm nodule
SCC:
Cutaneous:
Small, crusty or ulcerated sores on the head
(pinnae, nasal planum, eyelids) Actinic keratosis and eyelid squamous
White-haired cats cell carcinoma
Oral:
Senior/geriatric cats
Tongue, gingiva, sublingual
LSA:
Lymphadenopathy
Thickened bowl loops
Dx:
Mammary tumors:
Surgical excision/biopsy (fine-needle aspirate (FNA) can be misleading)
Thoracic radiographs (metastases to lungs and lymph nodes common)
SCC: wedge or excision biopsy
LSA: FNA, may require endoscopic or excisional biopsies during exploratory laparotomy
Rx:
Mammary tumors:
Unilateral mastectomy and regional lymph node removal (axillary and inguinal)
Adjunctive chemotherapies (doxorubicin)
Prevent by spaying cats before first estrus
SCC:
Cutaneous: surgical excision, cryosurgery, or strontium radiation
Oral: surgery often impossible, palliative NSAIDs
LSA:
Multiple agent chemotherapy, including doxorubicin
Small cell GI LSA treated with prednisolone and chlorambucil
Pearls:
Mammary tumors:
85-90% malignant
Anterior glands more commonly involved
Prognosis dependent on size of tumor at time of diagnosis. If < 2 cm prognosis is often
over 3 years. > 3 cm and survival is only 4-6 months
SCC: oral has a very poor prognosis with survival times ranging from 3-4 months
LSA:
30% of all feline tumors
FeLV is linked with most except GI form
FIV cats 5X more likely to develop LSA
Survival time with treatment for low-grade LSA can range from 6 months-1 year

13. Respiratory viruses: rhinotracheitis, calicivirus, chlamydiosis

Classic case: Kittens from shelters/rescues with fever, lethargy, and ocular/nasal discharge
Rhinotracheitis:
Rhinitis, clear nasal discharge
Conjunctivitis
Caused by feline herpesvirus 1 (FHV-1)
Calicivirus:
Tongue ulceration
 Gingivitis
Ptyalism
Chlamydiosis: ceonjunctivitis, first unilateral then
bilateral
Dx:
FHV-1 and calicivirus: presumptive by clinical signs.
Account for 90% of URIs in cats
Chlamydiosis: Primarily an ocular disease diagnosed by
the presence of inclusion bodies in conjunctival scrapings
Rx: Classic signs of acute viral
rhinotracheitis
FHV-1 and calicivirus: symptomatic and supportive care
Early use of antivirals medications (trifluoridine,
idoxuridine, cidofovir and famciclovir) are safe an effective when given orally
Chlamydiosis: doxycycline
Pearls:
Incubation period is 2-10 days
Isolate ill cats to prevent transmission
Vaccination does not prevent herpesvirus or calicivirus, but minimizes clinical signs
Secondary bacterial infections are common
Determining which virus is affecting the individual cat requires mouth or eye swabs for
culture or PCR
Once recovered, most cats become carriers and may continue to shed virus intermittently
Viruses are susceptible to 1:32 bleach solution for disinfection

14. Key toxicoses: acetaminophen, ethylene glycol (EG), pyrethrin/pyrethroid

Acetaminophen: Tylenol®
History of ingestion of at least 10 mg/kg
(regular strength tablets contain 325 mg,
extra strength contain 500 mg)
Lethargy, inappetence, weakness, depression
Dyspnea, vomiting
Facial and paw edema
Ethylene glycol (EG): antifreeze
Ataxic, stuporous
Depression Give xylazine or dexmedetomidine to
PU/PD induce vomiting
Pyrethrin/pyrethroid:
An over-the-counter "spot on" for flea control
Hx of recently treated family dog or use of a dog product on a cat
Seizures
Dx:
Acetaminophen: methemoglobin elevated in EDTA blood
EG: EG test kit (use before activated charcoal)
Pyrethrin/pyrethrod: history usually diagnostic or see greasy spot on fur
Rx:
Acetaminophen: aggressive decontamination
Xylazine or dexmedetomidine to induce vomiting
N-acetylcysteine (NAC, Mucomyst®), IV or PO
S-adenosylmethionine (SAMe), PO
Ascorbic acid, PO or injectable
+/- Oxygen support
EG: SOONER IS BETTER
If within 30-60 min of ingestion, induce vomiting and give activated charcoal
IV fluids with bicarbonate
If within 3 hrs, give fomepizole (4-MP), IV (much higher dose than for dogs)
If > 3 hrs, give ethanol in IV fluids
 Pyrethrin/pyrethroid:
Methocarbamol, IV
+/- Midazolam or propofol, IV
Bathe if few or no signs of toxicosis - use warm water and mild dishwashing detergent
Prognosis guarded to poor, based on how soon treatment is sought and dose received
Pearls:
Prompt treatment and client education are key
Gas anesthesia may be required to control refractory seizures

15. Eosinophilic skin disease

Classic case: Raised, reddened or yellow linear or circular plaques
on lips, footpads, ventral abdomen & thighs; mature cats.
Eosinophilic ulcer ("rodent ulcer")
Erythematous ulcer
Usually on upper lip
Nonpainful and nonpruritic
Eosinophilic plaque
Raised erythematous lesions
Medial thigh and abdomen
Peripheral eosinophilia and pruritus Eosinophilic ulcer
Eosinophilic granuloma
Yellow, orange, or pink lesions
Anywhere but mostly on caudal thighs (linear) and in oral cavity
Peripheral eosinophilia when lesions are in oral cavity
Females more often than males
Dx: Incisional or excisional biopsy
Rx:
Anti-inflammatory therapy with prednisolone or cyclosporine
Radiotherapy
Laser therapy
Surgical excision
Rx underlying cause (usually atopy or allergies)
Pearls:
Eosinophilic ulcers and plaques have been associated with flea or food allergies and atopy
Eosinophilic granulomas have been associated with mosquito bites
Secondary bacterial infections can occur
Response to glucocorticoid therapy is usually good
Typically, this is an allergic reaction to flea, mosquito, or mite bites

Images courtesy of Ann Wortinger (anterior uveitis), ColKorn1982 (skiing cat), Phaeton68 (FIP cat), Caroldermoid (cat with SCC), Wutsie
(vomiting cat), Kalumet (crusty kitten, eosinophilic ulcer), and Kopa (playing kitten).

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