Page 106 - Problem-Based Feline Medicine

98 PART 2 CAT WITH LOWER RESPIRATORY TRACT OR CARDIAC SIGNS

BORDETELLA* GRASS AWNS/FOREIGN BODIES

Classical signs Classical signs
● Pyrexia. ● Sneezing with nasal foreign bodies, and
● Sneezing and nasal discharge. coughing with pharyngeal and
● Mandibular lymphadenopathy. tracheobronchial foreign bodies.
● Coughing. ● Inspiratory/expiratory dyspnea, depending
● Dyspnea, cyanosis, pneumonia. on location.

See main reference on page 14 for details (The Cat
Pathogenesis
With Acute Sneezing or Nasal Discharge).
Foreign bodies may be inhaled directly into the rostral
nasal cavity or tracheobronchial tree, or may be regur-
Clinical signs gitated into the caudal nasopharynx. Common solid
foreign bodies include grass, seeds, hairballs, twigs and
Signs are most likely to occur in cats from multi-cat occasionally stones, while particulate foreign bodies
environments, especially rescue or shelter catteries include coal dust (UK) and metal dust from road grime
where calicivirus and herpesvirus are also a problem. (Australia).
Typically there is an acute onset of pyrexia, sneezing Occasionally, penetrating foreign bodies, such as pro-
and nasal discharge. jectiles (pellets) or a broken tooth from an opponent
during a cat fight, can lodge in the nasal cavity or air-
Mandibular lymphadenopathy may be palpable.
way.
Coughing may be spontaneous, or only evident on tra-
Tracheobronchial foreign bodies may be caused by
cheal pressure; generally, coughing is not as pro-
aspiration of vomited or regurgitated ingesta.
nounced as in dogs.
Dyspnea, cyanosis, crackles and wheezes may be aus-
cultated over lung fields in some cats. Death from Clinical signs
pneumonia may occur, especially in young kittens less
Acute onset of sneezing and nasal discharge are com-
than 8 weeks old.
mon signs of nasal foreign bodies, although coughing
may be the predominant sign with post-nasal drainage
into the pharynx. These cats may be in sudden and
Treatment severe distress attempting to dislodge the foreign body.
Pawing at the face and mouth is commonly observed.
Oxytetracycline, doxycycline or enrofloxacin.
Coughing and signs of fixed obstruction – meaning
Montelukast (Singulaire, 0.25–1 mg/kg SID) is a
there is airflow limitation during both inspiratory and
leukotriene receptor blocker. Although the cat has
expiratory due to constant partial obstruction of the air-
insufficient leukotriene receptors for cysteinyl
way – may be seen with tracheobronchial foreign bod-
leukotrienes to cause bronchoconstriction, anecdotal
ies. The coughing is often harsh, and may be elicited
evidence suggests that montelukast may reduce sneez-
with tracheal palpation.
ing and nasal discharge associated with Bordetella.
This effect may be mediated through blockage of
Diagnosis
leukotriene-mediated attraction of inflammatory cells
such as eosinophils and neutrophils and their subse- Tracheal foreign bodies may be seen radiographically.
quent release of inflammatory cytokines and other Tracheobronchoscopy can be both diagnostic and ther-
chemicals. apeutic. Rigid tracheoscopy allows for larger retrieval