Feline respiratory distress

Question 1

List 3 essential principals for the initial assessment of cats with acute respiratory distress

Answer 1

• Gentle handling; hands off, minimal restraint
• prompt supportive treatment; cage rest, oxygen, sedation (butorphanol 0.3-0.5mg/kg IM)
• rapid assessment; clinical history, brief physical exam

Question 2

List the 5 most common causes of respiratory distress in cats

Answer 2

Pleural effusion
Pulmonary oedema
Chronic bronchial disease
Trauma
Upper respiratory disease
** others may include pain, stress, hyperthermia, anaemia, pneumonia.

Question 3

List 3 potential therapies eg three therapeutic questions to consider in feline respiratory distress

Answer 3

• is thoracocentesis indicated
• is frusemide indicated
• are corticosteroids indicated

Question 4

List likely differentials for acute inspiratory distress

Answer 4

• pleural effusion
• pneumothorax
• laryngeal disease (usually audible disease)

Question 5

Describe a restrictive pattern

Answer 5

Rapid, shallow, symmetrical

Question 6

List differentials for restrictive patterns

Answer 6

Pulmonary oedema, interstitial pneumonia

Question 7

Describe major differentials for expiratory or obstructive respiratory patterns

Answer 7

Lower airway disease

Question 8

Discuss the benefits of cardiac auscultation in respiratory distress

Answer 8

Almost all cats are tachycardic with stress.
Murmurs are unreliable (may be related to anaemia, pyrexia, stress), although louder murmurs are more suggestive.
Gallop rhythms and dysrhythmias are usually significant.

Question 9

What should be evaluated for in tFAST exams of dyspnoeic cats

Answer 9

1. Pleural fluid
2. Mediastinal mass
3. Abdominal organs
4. Enlarged left atrium
5. B-lines

Question 10

Discuss ProBNP snap tests in dyspnoeic cats

Answer 10

• can be run on blood or pleural effusion - which may be less stressful to acquire.
• CHF in a positive test is possible/likely
• CHF in a negative test is very unlikely.

Question 11

Discuss the use of thoracocentesis in dyspnoeic cats (indications, contraindications)

Answer 11

• therapeutic and diagnostic for pleural effusions, pneumothorax.
• most is well tolerated. Restraint is required, may be stressful/exacerbate the condition.
• complications are rare, even if the tap is negative. Risk is pneumothorax.

Question 12

Discuss the use of radiographs in dyspnoeic cats

Answer 12

Should be avoided unless less stressful tests are non-productive.
DV only, never restrain in lateral.

Question 13

Discuss the use of frusemide in the dyspnoeic cat

Answer 13

• therapeutic for pulmonary oedema. May have a bronchodilator effect.
• 2-4mg/kg IM/IV then 1-2mg/kg Q8h-12h.
  May cause dehydration, decreased pulmonary perfusion, increased viscosity of inflammatory infiltrates.

Question 14

Discuss the use of terbutaline in dyspnoeic cats

Answer 14

• therapeutic for bronchial disease. 0.01mg/kg IM/IV Q8h-12h.
• may precipitate tachycardia and hypotension in CHF

Question 15

Discuss the use of corticosteroids in dyspnoeic cats

Answer 15

• indicated for bronchial disease eg asthma. 0.25-0.5mg/kg IM or IV.
• may cause fluid retention and worsen CHF.