Feline
THREE things to remember about FeLV and vaccinations: ? 1) what does the test measure (Ab or Ag)? 2) What should you do with FeLV + cats? 3) Where do you vax?
1. FeLV ELISA and IFA tests measure ANTIGEN, not antibody, so FeLV vaccination does NOT interfere with testing. 2.Vaccinate FeLV-positive cats yearly against respiratory, enteric viruses with inactivated vaccines. 3. FeLV vaccination for FeLV-negative cats has been associated with sarcomas. Vaccinate LOW on the LEFT hind.
With treatment, it is thought that the response of acute and chronic cholangiohepatitis cases is similar with about _____% of animals dying or being euthanized within ______ months and half of them having ________ survival.
50% die or are euthanized within 3 months, while to other 50% tend to have prolonged/long-term survival.
A 12-year old male neutered cat weighing 14 pounds is presented with a 2-month history of PU/PD, increased appetite, lameness, weight gain, exercise intolerance and dyspnea. Physical exam shows a systolic heart murmur with a gallop rhythm, a lateral chest radiograph shows pulmonary effusion and a large heart. T=102.0 F (38.9 C)..[N=100-103.1F, N=37.8-39.5 C] HR=110 bpm.......[N=130-140] RR=24 brpm........[N=16-40] A CBC shows PCV=48 %.............[N=24-45%], WBC=14,850/µl..[N=3800-19,500/µl] Neuts=88%............[N=35-75% ], Lymphs=4%..[N=20-55%] Monos=7%.............[N=1-4%], Eos=1%..[N=2-12%] Basos=rare............[N=rare] Blood chemistry reveals the following NA=150 mEq/L................[N=151-161 mEq/L]...K=5.1 mEq/L..[N=3.5-5.1 mEq/L] LDH=200 U/L.................[N=35-225 U/L]..........ALT=108 U/L..[N=8.3-53 U/L] Total protein=10.1 g/dl..[N=5.7-8.0 g/dl]........Bilirubin (total)=0.3 mg/dl [N=0.0-0.2 mg/dl] Alk Phos=200 U/L.........[N=3-65 U/L]..............Cholesterol=250 mg/dl..[N=95-130 mg/dl] BUN............47 mg/dL (2.6 mmol/L) ............[Normal: 10-30 mg/dl (0.55- 1.66 mmol/L)] Creatinine= 3.4 mg/dL (300.56 ?mmol/L) ..[N=0.5-1.6 mg/dL (44.2- 141.44 ?mmol/L)] Glucose.....350 mg/dl (19.4 mmol/l)...........[N=63-132 mg/dl(3.5-7.3 mmol/L)] Urinalysis U Sp. G= 1.018........[N=1.020-1.040] Glucose +++, WBC ++, RBCs +, protein +++ Which one of the following choices is the most likely diagnosis? A - Hyperthyroidism complicated by renal disease B - Hyperadrenocorticism C - Pancreatic exocrine insufficiency D - Acromegaly E - Diabetes insipidus complicated by cardiomyopathy
Answer = ACROMEGALY ***This complicated mix of diabetes mellitus , renal disease and heart failure/cardiomyopathy in an OLDER MALE cat suggests feline acromegaly. First presenting sign may be PU/PD, polyphagia of diabetes. WEIGHT GAIN in an unregulated diabetic cat STRONGLY SUGGESTS acromegaly, (but they may LOSE weight at first). May see prognathism (long mandible), lameness (esp. cats), marked vertebral spondylosis, thickened skin, large head, wide interdental spaces and a Stress leukogram (High neuts, low lymphs/Eos)
You are examining the eyes of a cat and find it has no dazzle reflex, menace response and is not visual out of one of its eyes, but it does have a palpebral reflex. Where is the lesion? CN VII CN II CN V Visual cortex
Answer = CN II *** The dazzle reflex examines CN II separate of the visual cortex (an animal with a cortical lesion will still have a dazzle reflex). Therefore the lesion is in CN II. The presence of a palpebral indicates normal function of CN V and VII.
A 10-year-old male neutered domestic short hair cat presents for progressive vomiting of 3 weeks duration. On physical exam, you palpate a firm mass in the abdomen. Ultrasound of the abdomen reveals a 3cm irregular mass in the jejunum with effacement of the normal intestinal layering. There are also multiple mildly prominent mesenteric lymph nodes around the mass. What is the next best step? Tru cut biopsy of the mass Fine needle aspirate of the mass Endoscopy with biopsies Recommend chemotherapy Exploratory surgery of the abdomen with mass resection
Answer = FNA The cat most likely has some form of neoplasia. The most common forms of intestinal cancer in cats are lymphoma (large and small cell), carcinoma or adenocarcinoma, and mast cell tumor. A fine needle aspirate is often an effective way to obtain a diagnosis in the least invasive way possible. A Tru cut biopsy of an intestinal mass carries too much risk for potential perforation of the intestines causing peritonitis. Exploratory laparotomy may be indicated if the fine needle aspirate is non-diagnostic or inconclusive, but if lymphoma is diagnosed, surgery is not typically recommended unless the cat has an intestinal obstruction. If lymphoma is diagnosed, chemotherapy would be the indicated form of treatment.
FIP spreads by what route? Where does it replicate? Fecal-oral transmission Mucous membranes Aerosol transmission Respiratory secretions
Answer = Fecal-oral, Macrophages
What NSAID should only be used on a limited/short-term basis in cats?
Answer = Meloxicam
A 6-month old cat presents for having ptyalism and for being underweight. On physical examination, you note a bright copper color to the cat's iris bilaterally. What is this suggestive of? Hemolytic anemia Toxoplasmosis Portal systemic shunt Polycystic kidney disease
Answer = PSS ***Ptyalism is a sign commonly seen with PSS in cats but not dogs, and the copper-colored iris is a striking and almost pathognomonic finding in conjunction with other clinical findings. Hemolytic anemia could cause icterus but not the change in iris color.
A 4-year old male Himalayan cat presents to your clinic for swelling over the neck. The owner reports that the cat is indoor/outdoor and has a history of getting into fights with other cats in the neighborhood. You sedate the cat and surgically explore the wound, draining 15mls of purulent fluid. After thoroughly flushing the wound, which of the following measures is most important? Give an injection of penicillin G intramuscularly Prescribe a 7 day course of meloxicam Prescribe a 10 day course of clindamycin Place a penrose drain for 4 days Prescribe a 7 day course of amoxicillin
Answer = Penrose drain Because most cat bite abscesses are predominated by ANAEROBES, the most important measure you take to promote healing is to prevent the wound from closing back up, allowing continued drainage and preventing an anaerobic environment from being re-established. Penrose drains are typically left in place for 3-5 days days and are then removed depending on how productive the wound is. Although many veterinarians prescribe antibiotics to cats after draining abscesses, this is believed to be UNNECESSARY for most cases.
What is the drug of choice for a Chlamydophila felis infection? Tetracyclines Aminoglycosides Fluoroquinolones Penicillins Macrolides
Answer = Tetracyclines ***Tetracyclines are the drugs of choice, specifically doxycycline. Doxycycline is less likely to cause permanent discoloration of the teeth as compared to other tetracyclines. - Doxycycline will also be effective against Bordetella and Mycoplasma.
A 1-year-old female indoor cat from Florida was presented for an after-hours emergency examination. Approximately, 72 hours after spending the night locked out on the family's screened-in porch, the cat developed acute severe facial pruritus and was presented for the lesions shown in the image below. Similar lesions were seen on the ear tips and paws; only thinly haired areas with dark hair were affected. The cat was otherwise healthy. Skin scrapings were negative. Impression smears of the nose revealed inflammatory exudates comprised of approximately 75% eosinophils and lesser numbers of neutrophils, lymphocytes, and mast cells. Which of the following is the best diagnostic or treatment plan? Confine the cat indoors for 5-7 days Intradermal skin testing for allergens Bacterial culture of lesions Dietary trial with novel protein source Institute aggressive flea control
Answer = confine cat indoors The history, onset, clinical appearance, as well as the cytologic and histologic findings are most consistent with INSECT BITE HYPERSENSITIVITY. There are other reasonable but less likely differentials including pemphigus foliaceus, food allergy or atopy, and dermatophytosis.
The cat in the image below presents for lethargy, depression, and weakness. The cat can't seem to lift his head (as seen in this image). You recommend running a chemistry panel on the cat. What potential finding explains can explain the findings? High urea nitrogen Low calcium High glucose Low phosphorus Low potassium
Answer = low potassium Explanation The cat in the image is exhibiting cervical ventroflexion, which is a general sign of weakness. The most common cause for this presentation is hypokalemia (low potassium), which can be caused by a variety of reasons (such as chronic renal failure). This weakness can also be caused by a number of different problems other than low potassium, including myasthenia gravis; polymyopathies caused by toxoplasmosis, immune-mediated disease, or hyperadrenocorticism; and neuropathies caused by organophosphate poisoning, thiamine deficiency, or botulism.
An 8-year old female spayed Siamese cat shown in the picture below presents for a right-sided head tilt and a horizontal nystagmus with the fast phase to the left. On physical exam, the cat has the described head tilt and nystagmus. She is circling to the right and her mentation is normal. What is your next step? Otic exam Computed tomography (CT) of the head Magnetic resonance imaging (MRI) of the head Radiographs of the head Complete blood count and chemistry panel
Answer = otic exam WOULDN'T WANT TO MISS AN EASY DX AND THEN GO AND SPEND $2,000 OF SOMEONE'S MONEY ON A CT/MRI ***Any dog or cat that presents with vestibular signs such a head tilt, nystagmus, and circling should have an otic exam as part of its physical exam. Vestibular disease can be central or peripheral in origin. Although, advanced imaging such as a MRI or CT scan of the head is often recommended for vestibular disease to better characterize the brain and inner ear, an otic exam is the least invasive way to evaluate the patient and should be the next step, even prior to running blood work. Also, it is important to CHECK BLOOD PRESSURE in an animal presenting with vestibular disease. Hypertension and vascular accident can be an important cause to rule out.
Feline leukemia (FeLV) status has been shown to affect many aspects of disease progression and treatment of lymphoma. FeLV seropositive cats with lymphoma are similar to FeLV seronegative cats with lymphoma in which one of the following aspects? A - Remission rates B - Treatment response C - Survival time D - Prevalence of gastrointestinal lymphoma E - Prevalence of mediastinal lymphoma
B - Treatment response Feline leukemia virus seropositive and seronegative cats share similar response rates to initial treatment with chemotherapy for lymphoma. Lymphoma remission rates are higher and survival times are shorter for cats with FeLV compared with FeLV negative cats. Most U.S. cats with mediastinal, multicentric, or spinal forms of lymphoma are FeLV-positive.
Congenital shit: mucopolysaccharidosis is? myotonia congenita is?
Cats born with mucopolysaccharidosis (usually Siamese cats) have an enzyme deficiency that results in problems with the joints and/or bones. Cats born with myotonia congenita (very rare) have muscle stiffness and may be heavily muscled with little body fat.
In addition to lethargy, anorexia, fever, conjunctivitis, sneezing, nasal discharge, oral ulceration, what Cx is considered pathognomonic for feline calicivirus?
Dendritic ulcers
An adopted adult cat from a shelter with an unknown vaccination history tests positive for feline leukemia virus (FeLV) infection by IFA. What should the owner be told? A - Possible transient FeLV infection B - Need an ELISA test in 12 weeks to confirm diagnosis C - Cat may be vaccinated for FeLV D - Need a Western blot test to confirm diagnosis E - Strong chance of lifelong FeLV infection
E - Strong chance of lifelong FeLV infection ****IMPORTANT THING is IFA, NOT ELISA*** 97% of cats positive for feline leukemia virus (FeLV) by IFA remain persistently infected and viremic for life. The FeLV ELISA is more seNsitive than the IFA (fewer false Negs, so trust a NEG test more), so it is a better general screening test with which to start. The FeLV IFA is more sPecific than the ELISA, (fewer false Pos, so trust a POS test more) so it is a better confirmatory test for any cats with a positive FeLV ELISA. Click here for a diagram.
What is the biological behavior of mammary gland tumors in cats?
Eighty to 90% of mammary gland tumors in cats are considered malignant and the majority of them will metastasize.
What are the 3 main etiologies behind feline cholangiohepatitis?
Feline cholangiohepatitis is more common than the canine form and has three main etiologies. 1. Acute neutrophilic (suppurative) 2. Chronic (lymphoplasmacytic or mixed) 3. Lymphocytic (nonsuppurative)
In regards to FIP, which of the following tests have the highest Negative Predictive Value (NPV) and PPV, respectively? 1)Immunofluorescence staining for coronavirus in macrophages in effusion fluid 2) Coronavirus antibody detection in effusion fluid 3) Reverse-transcriptase polymerase chain reaction (RT-PCR) for coronaviral RNA in serum 4) Rivalta's test
Highest NPV = Rivalta's test (NPV > 90%) Highest PPV = Immunofluorescence staining for coronavirus in macrophages in effusion fluid (PPV = 100%)
what are the three big chemistry values that you look for in cats with hepatic lipidosis? and what if any change would you expect to see?
Increased ALP/ALT with a NORMA GGT
A 3-year old female spayed indoor/outdoor domestic short hair presents for congestion and swelling over the bridge of the nose. The swelling over the nose is firm and seems to be subcutaneous. There is also mild enlargement of the mandibular lymph nodes. You perform cytology from a fine needle aspirate of the swelling over the nose and see narrow, budding, thin-walled yeasts surrounded by clear capsules (see picture). You also detected a lesion in the retina on fundic examination. Which of the following treatments would be indicated? Doxycycline Lufenuron Trimethoprim sulfa Amoxicillin-clavulanic acid Itraconazole
Itraconazole Based on the description of the cytology and clinical symptoms of this cat, the most likely diagnosis is Cryptococcus neoformans. This is a fungal disease that occurs when the organism is inhaled and is disseminated to skin, eyes, CNS, lungs, or other areas. The upper respiratory tract is most often involved and symptoms can include nasal discharge, sneezing, swelling over the nose, and regional lymphadenopathy. If the CNS is involved, seizures can also occur. The disease has been thought to be transmitted most often through infected pigeon droppings. Itraconazole or fluconazole are the anti-fungals of choice for this disease.
What are the main side effects of the following medications? 1. Methimazole (Tapazole) 2. Enrofloxacin (Baytril) 3. Metoclopramide (Reglan) 4. Metronidazole (Flagyl)
Methimazole (Tapazole), can cause intense facial pruritus as a side effect. Enrofloxacin (Baytril) cause blindness in some cats (at doses typically higher than 5mg/kg daily can and should be used with caution) Metoclopramide (Reglan) can cause head bobbing as a side effect, but this is extremely rare and mostly occurs in dogs. Metronidazole (Flagyl) given at high doses can cause neurologic symptoms including nystagmus, ataxia, dilated pupils or even seizures.
A cat presents with a nonspecific history of slightly decreased appetite, lethargy, and odd behavior. A leukogram shows the following values: WBC 18,630 cells/ul (5,400-23,600/ul) band neutrophils 100 cells/uL (0-300/ul) segmented neutrophils 16,432 cells/uL (1,600-15,600/ul) lymphocytes 1587 cells/uL (1,000-7,400/ul) monocytes 352 cells/uL (0-700/ul) eosinophils 154 cells/uL (0-230/ul) basophils 5 cells/uL (0-300/ul) What is your interpretation of the leukogram? Physiologic leukogram Left shift Your Answer Degenerative left shift Infection Normal
Physiologic leukogram A "physiologic leukogram" is from an epinephrine-mediated excitation response and is commonly seen in cats who get excited upon entering a veterinary clinic. You can see the classic mild neutrophilia along with normal to increased lymphocytes and no monocytosis. Although there are bands present in the blood work this is a normal amount according to reference levels provided, and is thereby not considered a left shift.
A 5-year old male neutered cat presents with a 2 month history of coughing. He has also vomited several times per week for the last month. His heartworm antibody test is positive and echocardiogram confirms presence of Dirofilaria immitis. Which of the following treatments may be recommended? Meloxicam daily for 6 months Doxycycline liquid for 2 weeks Prednisolone and Heartgard Immiticide (Melarsomine) Milbemycin oxime
Pred + HG Heartworm adulticidal drugs can be LIFE-THREATENING in cats and immiticide is CONTRAINDICATED in this species. Heartgard can be used as a slow kill for adult heartworms. The most common complication concerning heartworms in general is an embolism to the LUNG and sudden death associated with respiratory failure.
A 2-year old indoor-outdoor female spayed domestic short hair cat presents to you for inappetance and vomiting. The cat vomits and the contents include several 3 cm long nematodes with spine-covered heads. You are able to identify the worms as Gnathostoma. Which of the following is true about these worms? - The parasite does not cause disease in humans - The parasite is typically found in dry, dusty environments - The life cycle involves a rodent intermediate host - Proper disposal of feces eliminates the threat of transmission to other animals - The life cycle involves a flea intermediate host
Proper disposal of feces eliminates the threat of transmission to other animals ***Eggs passed in the feces are not infectious unless first ingested by copepods so proper disposal of feces prevents transmission to other animals. The life cycle of Gnathostoma involves a small copepod intermediate host (similar to Dracunculus worms). Copepods are small crustaceans that are found in freshwater habitats (i.e. ponds). Adult worms live in the mucosa of the stomach and cause gastritis. They can also create nodules in the stomach which can ulcerate and lead to severe peritonitis. Human cases of gnathostoma usually occur from ingestion of undercooked fish or other animals and can cause gastritis or peritonitis. Larva may undergo cutaneous or neural migration (rare). Control is typically achieved by preventing cats from hunting in areas where the parasite is found. It is thought that albendazole is effective against gnathostomiasis.
what behavior is reduced most by castration? Next two most reduced?
Roaming > inter-male aggression > urine marking
What is the classic lesion seen with feline infectious peritonitis? Cellular degeneration Negri bodies No classic lesion observed Pyogranulomatous vasculitis Vascular cuffing
The correct answer is pyogranulomatous vasculitis. Good job if you picked it. Pyogranulomatous vasculitis will occur due to the deposition of antigen-antibody complexes in the venular endothelium. Complement-mediated inflammation results in pleural and peritoneal effusion (wet form) and partial cell-mediated immune response results in slow viral replication with granuloma formation (dry form). Negri bodies may be seen with rabies. Cellular degeneration and vascular cuffing are seen with many disease processes.
An 8-week old Abyssinian cat recently obtained from a cattery presents to you for an examination and the owner reports that the cat has had diarrhea. On fecal float, you coccidia (isospora). What should you treat the cat with? What are the other drugs listed used for? Metronidazole (Flagyl) Praziquantel (Droncit) Sulfadimethoxine (Albon) Pyrantel (Strongid) Amoxicillin and clavulanate (Clavamox) Selamectin (Revolution)
Treatment for coccidia is usually with sulfonamides such as SULFADIMETHOXINE or TMS. For the other drugs listed: Droncit- Primarily for cestodes (tapeworms) Revolution- For fleas, heartworms, hookworms, roundworms, and ear mites Strongid- Primarily for roundworms and hookworms Clavamox- A broad spectrum antibacterial Metronidazole- Primarily for anaerobes, also used for giardia
What is the classical lesion in cats with FIP?
With FIP, the classical lesion is pyogranulomatous vasculitis due to antigen-antibody complexes depositing in the venular endothelium, which results in pleural and peritoneal effusion. ***In greater than 50% of cats with the wet form of FIP, there will be hyperproteinemia. In greater than 70% of cats with the dry form of FIP there is hyperproteinemia.
This 11-year-old spayed female cat is presented with generalized weakness and unable to lift her head. The owners have noticed her at the water bowl more often and she seems to be urinating more in the last month. Which blood chemistry test would be most likely to diagnose cause of her weakness? A - Sodium B - Potassium C - Chloride D - Calcium E - Bicarbonate
the correct answer is B. Potassium Potassium. This is a classic presentation of a cat with hypokalemic myopathy which is often due to potassium loss from renal disease. Other causes of generalized weakness and neck ventroflexion include polymyositis, organophosphate toxicity, myasthenia gravis.