Top 20 Feline Flashcards
feline
Feline Leukemia virus (FeLV)
Transmission/Path? CS? Dx? Tx? Prognosis? Who to test?
Transmission/Path
* Transmission mainly via saliva but also fomites, tears, urine, feces, transmammary
* Spreads through lymphoid tissues, eventually → bone marrow → peripheral viremia → shedding in 1-2 months after infection
* Some cats can overcome infection and neutralize
Clinical signs
* ADR +/- abdominal or thoracic masses, fever, lymphadenopathy
Diagnosis
Confirmatory = IFA for p27 antigen in leukocytes and platelets - detects if there was bone marrow sequestration and persistent infection
ELISA for p27 virus antigen in serum (snap test) or ICT
* Negative test does not completely rule out
* If get positive + negative IFA → make sure to repeat test in 3 months to see if they have neutralized it (still cannot rule out without IFA)
Supportive
* CBC - leukopenia, neutropenia
* Rads - look for FeLV-associated lymphosarcoma
Treatment
* Reduce stress
* Support with Abx, nutrition, fluids
* Keep + and - cats separate
* Fair to poor prognosis
Any ADR cat, cat of unknown status should be tested!
Easily disinfected
Prevent with vaccination - booster more often if high risk - left rear distal leg
feline
Feline immunodeficiency virus (FIV)
MC sig? Path/transmission? CS? Dx? Tx? Prognosis?
Signalment
* Very unlikely in kittens due to maternal antibody protection
* MC in mature outdoor male cats (fighting)
Transmission/Pathology
Spread via saliva, bites → replicates in lymphoid and salivary tissues → spreads to mononuclear cells → slow decline in CD4+ cells → immune system failure (usually when 10-15 years old)
Clinical signs
* Gingivitis, stomatitis
* ADR, fever, lethargy, diarrhea
Diagnosis
Confirmatory: Western blot test
Screening: serum ELISA (snap)
Both above have false positive with vaccination = test before vaccinating
Supportive CBC - pancytopenia
* Some cats can develop an AIDS-like syndrome with severe neutropenia
Treatment
* Supportive = abx, fluids, nutrition
* Good dental care
Prognosis good-excellent, most do well for years
Easy to disinfect
feline
hyperthyroidism
MC signlament? path? CS? Dx? Tx? Prognosis?
Signalment:MC middle-aged to older cats
Pathology
* MC due to adenomatous hyperplasia of thyroid
* Rarely due to functional thyroid carcinoma
Clinical signs
* Polyphagia+ Weight loss
* Hyperactivity
* Heart murmur (HCM), tachycardia, arrhythmias
* hypERtension
* Vomiting/diarrhea
* Unkempt hair coat
* Thyroid nodule (“slip”), heart murmur
* Uncommonly could be anorexic or lethargic = apathetic hyperthyroid
Diagnosis
* Serum total T4 MC - can be high-normal if euthyroid sick syndrome
* Free T4 most sensitive and used for borderline cases
* Thyroid scintigraphy
* Should take BP (often hypertensive) and do an ECG
* CBC often unremarkable, may have increased liver enzymes and erythrocytosis
Treatment
I-131 = gold standard, most only need one dose to cure
Medical = Methimazole for rest of life
* Requires monitoring bloodwork
* Side-effects (never use again): severe facial pruritus/excoriations → try other therapies - MC seen in first 3mo of therapy
Limit dietary iodine (Hills Y/D)
Thyroidectomy - risks
* damage or removal of parathyroid → hypOcalcemia
* Damage sympathetic trunk → Horners
* Damage recurrent laryngeal nerve → laryngeal paralysis damage recurrent
* Iatrogenic hypothyroidism
Tx any hypertension!
Prognosis fair to excellent
warn owners → treatment can unmask renal disease – should keep an eye on kidney values
feline
hepatic lipidosis
Sig? CS? Path/causes?Dx? Tx? Prognosis?
MC in older, obese cats with recent stress
Clinical signs
* sudden icterus, anorexia, dehydration, weight loss
* +/- ptyalism if hepatic encephalopathy present
Pathology/Causes
Anorexia → mobilization of excessive fat stored to liver
Causes of anorexia?
* IBD, neoplasia, cholangiohepatitis, neoplasia, pancreatitis
Diagnosis
* Chem = ALP»_space; ALT, +/- elevated GGT (if cholangitis a problem leading to anorexia)
* Coags - may be prolonged
* AUS - hypERechoic liver
* FNA or liver biopsy - lipid droplets
* Only do if coags normal or if gave vitamin K to combat
* Rads - enlarged liver
Treatment
FEED by NG tube, E-tube, G-tube - high quality, high protein
* Not high protein if hepatic encephalopathy
Lactulose enema if hepatic encephalopathy
Prognosis fair-excellent; full recovery can take 2-4 months
Always has an underlying issue!
feline
chronic kidney disease
sig? CS? Dx? Tx?
MC in older cats
Clinical signs
* PU/PD, weight loss
* hypOrexia, vomiting
* lethargy
* palpable small lumpy kidneys
Diagnosis
* CBC: anemia
* Chem: hyperphosphatemia, azotemia, hypokalemia
* SDMA: increased
* BP: increased
* USG: hyposthenuria or isosthenuria (<1.020), possible proteinuria
* UP:UC > 0.4
* AUS - lumpy bumpy kidneys
* Gas: metabolic acidosis
Treatment
Supportive
* phosphate binders
* Ca-channel blockers
* H2 blockers
* K supplements
* Anti-hypertensive agents
Nutrition: restricted dietary protein
Increase fluid intake
feline
vaccine-associated fibrosarcoma
CS/et? Dx? Tx? Prognosis?
Clinical signs/etiology
* May appear up to 3y post-vaccine
* MC associated with rabies (RH) and FeLV (LH)
* Incisional biopsy w/ histopath
Diagnosis
* Incisional biopsy w/ histopath
* Stage w/ TXR, CBC, Chem, CT, MRI - mets MC to lung
Treatment
* Radiation followed by resection w/ wide margins and 1 fascial plane deep at referral center +/- adjuvant chemo
Prognosis 2mo-1y depending on surgical success
why we now recommend…
* Rabies - distal RH
* FeLV - distal LH
* Others - distal RH
feline
Panleukopenia
aka? Path/CS? Dx? Tx? Prognosis?
**“Kitty parvo” **
Path/CS
* Damages rapidly dividing tissues (bone marrow, GI)
* Dehydration, depression, fever
* Hypothermia
* v/d
* Thickened intestinal loops
* If infected in utero → cerebellar hypOplasia → intention tremors, wide-based stance
Diagnosis
Canine Parvovirus fecal test if 24-48h post-infection
* False positive up to 2 weeks post vaccine
CBC - profound leukopenia, thrombocytopenia
Hypoalbuminemia
Treatment
* Fluids
* +/- plasma, blood
* Parenteral B complex to prevent thiamine deficiency
* Abx for gram- (ampicillin)
* Tx for vomiting - antiemetics
Degree of cytopenia dictates prognosis
Bleach to disinfect,
Vaccine is effective for prevention (FVRCP)
feline
Toxoplasmosis
host? Path/CS? Dx? Tx? Issues?
Toxoplasma Gondii
* Protozoa, cat is definitive host
* Rodents and birds are intermediate host
* eat exposed rodent or insect with bradyzoites encysted in tissue
* Oocytes shed in feces, take 1-5 days to sporulate
Clinical signs
CS only usually seen in younger or immunocompromised cat
* fever, uveitis, chorioretinitis, neurologic signs, mucoid diarrhea, icterus, muscle pain
Diagnosis
Paired IgM or IgG titers - 4x increase 2-4w apart
* Single positive IgG = exposure
* IgM > 1:64 = active infection
Fecal
Treatment
Clindamycin for 2w beyond CS resolution
Zoonotic
* Only recently infected cats shed oocysts for 1-2 weeks, usually only happens once in a lifetime (unless become immunocompromised)
* Can cause chorioretinitis and mental retardation of baby if pregnant woman infected for first time in life
* Prevention: scoop litter daily (takes 24+ hours to sporulate), pregnant or immunocompromised should not handle litter box
feline
Feline lower urinary tract disease (FLUTD)
MC sig? CS? Tx? Prevention?
MC overweight male cats
Clinical signs
* Straining to urinate, large bladder
* May be hypOthermic, comatose, or have bradycardia
Diagnosis
* UA - hematuria, pyuria, crystalluria
* Chem- azotemia, hypERkalemia
* Rads
* ECG - bradycardia, tall T waves
Treatment
Initial:
* Retrograde urohydropulsion (avoid cystocentesis)
* Tx bradycardia w/ 10% calcium gluconate (cardioprotective)
Continued
* U-cath with closed collection
* IVF
Refractory, repeat offenders
* Perineal urethrostomy
Prevention - weight management, canned diet for extra moisture
Somewhat likely to recur
Watch out for post-obstruction hyPerkalemia (bradycardia, arrhythmias) and hypOcalcemia (tetany, seizures)
feline
Diabetes mellitus
Sig? CS? Dx? Tx? Poor regulation causes?
MC overweight middle-older aged altered cats
Clinical signs
* PU/PD/PP+weight loss
* Potential plantigrade stance w/ hocks low to the ground (diabetic neuropathy)
Diagnosis
* BG - fasting hyperglycemia
* UA (DDx from stress hyperglycemia)
* Fructosamine - can help DDx stress hyperglycemia
Screening
* UA/culture - often get UTIs, and any infection can make them more insulin resistant
* +/- liver enzyme, cholestrol elevation
Treatment
Insulin
* Glargine or PZI BID
* Bovine insulin closest to feline but no FDA approved ones
Diet = very low CHO
* May even send into remission for awhile on its own!
+/- oral hypoglycemics such as Glizipide - variable efficacy
Poorly regulated? Check for acromegaly or Cushing’s → Skin Fragility!
feline
Feline infectious peritonitis (FIP
et/pathology/transmission/sig? CS? Dx? Tx? Prognosis?
Etiology/pathology/transmission
* MC occurs in young and/or immunocompromised cats
* Develops from mutated FECV (feline enteric coronavirus)
* Majority of cat population will be exposed at some point, unknown why the enteric coronavirus sometimes mutates to FIP
* Can become latent and reactivate with stress
* Transmission of FECV (not FIP) = fecal-oral, direct contact, inhalation
Clinical signs/pathology
* Unmutated form = GI upset
* Wet/Effusive form: fever, weight loss, GI symptoms, dyspnea, pleural effusion, ascites
* Dry form - hepatopathy, splenomegaly, renal failure, uveitis
Immunocompromisation (failure of cell-mediated immunity) - often get both forms concurrently
* Ag-Ab complex deposition in venous endothelium → pyogranulomatous vasculitis
* Wet form: complement formation → pleural effusion, peritoneal effusion due to leakage of protein and fibrin-rich fluid
* Dry form: partial immune response → slow virus replication with granuloma formation in GI, liver, lymph nodes, eyes, kidneys, CNS
* HypOalbuminemia, HypERglobulinemia
Diagnosis
CSF- elevated protein, mononuclear pleocytosis
Effusive
* Fluid analysis - straw-colored, viscous, with high protein/globulins, positive Rivalta test (drop retains shape in acetic acid solution)
* Rads- pleural effusion
Dry
* Gold standard = biopsy of granuloma for histopath - perivascular pyogranulomatous inflammation
Treatment
* Limited, supportive - fluids, thoracocentesis, appetite stimulants
* Prednisolone
Prognosis overall poor
Vaccination = FVRCP
* Be aware kittens can still get infected when antibodies wane
* Prevention = hygiene
- Titers (serology) very hard to interpret since most have been exposed already and also vaccines - basically useless
- Fecal PCR cannot distinguish coronavirus vs mutated FIP
feline
Mammary adenocarcinoma
Sig? CS? Dx? Tx? Prognosis? Prevention?
cats that have had heat cycles before
Clinical signs
* Enlarged mammary gland or nodules near mammary glands (MC in cranial glands)
Diagnosis
* Excisional biopsy (FNA can be misleading)
* TXR - often met to lung/lnn
Treatment
* unilateral mastectomy + regional lnn removal + chemotherapy to slow metastasis
Prognosis poor - almost always metastatic
* <2cm = >3y
* >3cm = 4-6mo
Prevention = spay before first estrus
feline
Squamous cell carcinoma
CS/causes/Sig? Dx? Tx? Prognosis
- Malignant keratinocytes
Clinical signs, causes, signalment
Cutaneous - associated with chronic sun exposure
* small, proliferative/ ulcerative lesions on head
* MC in white-haired cats
* Rarely - digits – if this is the case, check thoracic rads because it is often secondary to a primary lung tumor!
Oral
* Lesions on tongue, gingiva, under tongue
* MC in older cats
Diagnosis
* Wedge or excisional biopsy
* TXR especially if on digit because often secondary to primary pulmonary SCC
Treatment
Cutaneous
* Surgical excision
* Cryosurgery
* Strontium radiation
Oral
* NSAIDs
* Good Luck Charlie :(
Oral has POOR prognosis - MST 3-4 mo
MC oral tumor of cats
feline
Lymphosarcoma
Etiology? CS? Dx? Tx? Prognosis?
Clinical signs
* Progressive weight loss, vomiting, diffusely thickened intestines, lymphadenopathy
Diagnosis
GI
* AUS - diffusely thickened SI, enlarged lnn
* FNA or ex-lap for biopsy
Cutaneous
* Cytology - mostly large lymphocytes/ lymphoblasts (much bigger than neutrophils)
Treatment
* chlorambucil (oral alkylating agent chemo) or doxorubicin, prednisolone
Causes
* Associated with FeLV except Gi form
* FIV cats more likely to develop
Low-grade prognosis = 6mo-1y
Gastrointestinal
* slowly progressive and MC low grade
Cutaneous
* Malignant T cells
feline
Feline viral rhinotracheitis
et? CS? Dx? Tx?
Feline herpesvirus 1 = often become carriers
Clinical signs
* Mild respiratory signs
* Rhinitis, clear nasal discharge
* +/- conjunctivitis
Diagnosis
* Presumptive - account for 90% of URIs in cats
* Can do PCR
* Symptomatic, supportive
Treatment
* Early - oral antivirals
* antibiotic if secondary infection (clindamycin, clavamox, doxycycline), sucralfate
FVRCP vaccine can reduce severity (as prevention)
feline
Calicivirus
CS? Dx? Tx?
Clinical signs
CS of “typical” calicivirus
* upper respiratory, oral ulcerations, stomatitis, gingivitis, ptyalism +/- conjunctival chemosis
CS of VS-FCV (viral systemic calicivirus)
* severe upper respiratory, ulcerative/edematous lesions on skin of head and limbs, cutaneous edema, +/- jaundice
* Jaundice due to hepatic necrosis or pancreatitis
* May lead to thromboembolism and coagulopathy caused by DIC (petechiae, ecchymoses, epistaxis, hematochezia)
Diagnosis
* Presumptive - account for 90% of URIs in cats
* Can do PCR
Treatment
* Symptomatic, supportive
* Early - oral antivirals
* antibiotic if secondary infection (clindamycin, clavamox, doxycycline), sucralfate
FVRCP vaccine to reduce severity (as prevention
feline
chlamydiosis
et? CS? Dx? Tx?
Chlamydophila felis
Clinical signs: Severe chemosis, conjunctivitis +/- nasal discharge, sneezing, etc.
Diagnosis: Conjunctival scraping or swab -inclusion bodies
Treatment:doxycycline
feline
acetaminophen toxicity
Path/CS? Dx? Tx?
Pathology/CS
* Oxidative damage to Hg in RBCs because cats have decreased glucuronyl transferase (usually conjugates acetaminophen to glucuronic acid for excretion in other animals) → methemoglobinemia, methemoglobinuria, possible hepatic necrosis
* Can die!! (1-2d post-ingestion) due to oxidative damage - a single tablet can be enough!!
* Dyspnea, facial/paw edema, lethargy, vomiting, comatose
Diagnosis
* Blood smear → heinz body hemolytic anemia (methemoglobinemia)
* elevated metHg on EDTA blood
Treatment
* Emesis - alpha-2
* Charcoal? (careful, risk of aspiration in cats especially)
* IV N-acetylcysteine (increases availability/synthesis of glutathione = antidote)
* SAMe (S-adenosylmethionine) - hepatoprotectant PO
* Cimetidine (inhibit p450 in liver = decrease toxic metabolites)
* Ascorbic acid (binds toxic metabolites)
* O2 support
10 mg/kg toxic dose
feline
Ethylene glycol toxicity
CS? Dx? Tx?
CS:Ataxia, stupor, depression, PU/PD
Dx: EG test kit (before charcoal)
Treatment
* <60min: emesis, activated charcoal
* IVF w/ bicarb
* <3h: 4-MP IV (much higher dose than for dogs!)
* >3h: IV ethanol in fluids
feline
Pyrethrin/Pyrethroid toxicity
Path/CS? Dx? Tx? Prognosis?
Clinical signs/pathology
* Prolong Na conductance in Na channels → repetitive nerve firing
* Cats have a reduced capacity for glucuronidation (needed for excretion)
* hypersalivation, ear twitching, tremors, seizures, general CNS signs
Diagnosis
* Hx of using OTC or dog flea control
Treatment
* Bath
* Methocarbamol to control seizures/tremors +/- propofol, midazolam
Prognosis guarded-poor depending on dose and quick tx
No longer toxic once dry
feline
eosinophilic granuloma complex
causes? CS? Dx? Tx?
Thought to be due to hypersensitivity
Clinical signs
Indolent/rodent ulcer
* upper lip
Granuloma
* mouth/body
* Thighs, oral cavity
* Collagenolytic
Plaques
* Raised lesion on thighs, abdomen
* May be pruritic (only one)
Diagnosis
* Try to ID any underlying allergies
* Biopsy
Treatment
* Corticosteroids or cyclosporine
* Radiotherapy, laser therapy, surgical excision
* If <1y will often spontaneously regress over 3-5mo
* Tx any underlying allergies (food, environmental, etc.)
feline
Hypertrophic cardiomyopathy
sig? CS/Path? Dx? Tx? Prognosis?
MC young-middle aged at diagnosis
* Maine coons, ragdolls predisposed to juvenile dz
CS/Pathology
* Often asymptomatic
* If CHF → tachypnea, dyspnea, open-mouth breathing, death
* If aortic thromboembolism due to stasis in LA → cyanotic nail beds, pulse loss, paraplegia
* left parasternal systolic murmur or gallop
* Big problem = impaired diastolic filling
Diagnosis
* echo/rads = left ventricular hypertrophy, dilated left atrium, pulmonary edema, pulmonary effusion
* BNP elevated
Treatment
Acute
* O2
* thoracocentesis
* furosemide
* nitroglycerin
Chronic Management = decrease HR to improve diastolic filling with..
* β-blockers (-olols)
* Ca-channel blockers (diltiazem)
* +/- K supplementation if hypokalemic
Consider if severe or in HF
* antithrombotics (aspirin, clopidogrel)
* diuretics (furosemide)
* ACE inhibitors (enalapril)
Poor prognosis
feline
ear mites
et? CS? Dx? Tx?
*Otodectes cynotis
Clinical signs
* Ear pruritus, pinnal excoriations
* red-brown ceruminous discharge
* pinnal-pedal reflex (scratch with back leg when rub ear)
Diagnosis
* Otoscopy - live mites, inflammation
* Cytology in mineral oil - mites, eggs, +/- secondary bacteria
Treatment
* Clean the ears
* Topical milbemycin or ivermectin + systemic selamectin or ivermectin
* Treat all small animals in home - very contagious
feline
Dermatophytosis
path/et? CS? Dx? Tx?
Ringworm
* MC affects immunocompromised or young
* MC Microsporum canis
* Spread through contact
* 1-3 week incubation
* Others = M. gypsum (from soil), Trichophyton mentagrophytes (from rodents)
Clinical signs
* Classic lesion = circular region of alopecia with a ring of edema - MC on face, ears, feet, tail
* Can also look like other things - papules, crusts, chin acne
* Dermal microtrauma must be present for clinical infection to occur
Diagnosis
* DTM culture - determines infectivity, very sensitive, diagnostic confirmation; positive = light-colored fuzzy growth followed by red color change.
* Can do cytology on the growth to ID using scotch tape
* Woods lamp - apple green hair fluorescence in most cases of M. canis - most useful for a screening tool - does not determine infectivity
* Trichogram (pluck hairs) - Fungal hyphae grow along hair shaft and form a thick layer of infectious arthrospores - hairs are swollen, irregular, fuzzy outline - take suspicious hairs on oil or KOH slide
* PCR - most useful forruling out ringworm; fast turnaround (3-5d) but not good for monitoring
Treatment
* Topical therapy -
* lyme sulfur dips, azole shampoos
* Topical most important to reduce infectious risk - lime sulfur = 100% sporicidal
* Use 2x/week
Systemic therapy - oral antifungals needed because often have more lesions you can’t see
* Itraconazole or terbinafine
* Monitor for anorexia, vomiting, depression, increased ALT
Weekly DTM cultures to monitor response to all treatments
* Can stop Tx with 2 consecutive negative cultures
May self-resolve over months
Need to tx environment - mechanical removal + disinfection - bleach or rescue/accel
Tx 5-6 weeks typical minimum
Best = topical + systemic + environmental
