Page 115 - Problem-Based Feline Medicine

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7 – THE COUGHING CAT 107

Migrating nematodes – Toxocara spp., pyrantel
PLEURAL/MEDIASTINAL MASSES
pamoate (20 mg/kg PO, repeat 7–10 days).
Classical signs
● Dyspnea, orthopnea, tachypnea or rarely,
CARDIOMYOPATHY
(DILATED CARDIOMYOPATHY (DCM), coughing.
HYPERTROPHIC (HCM), INTERMEDIATE ● Muffled heart and lung sounds from
(ICM) OR RESTRICTIVE (RCM)) pleural effusion.

Classical signs See main reference on page 85 for details (The Cat
With Hydrothorax).
● Dyspnea.
● Gallop rhythm, murmur or arrhythmia.
● Coughing is an uncommon presenting sign Clinical signs
in the cat.
Mediastinal lymphoma, thymomas, and mesothe-
See main reference on page 54 for details (The lioma cause pleural effusion or extraluminal compres-
Dyspneic of Tachypneic Cat). sion to the trachea.
Extraluminal compression of the trachea can cause
dyspnea and coughing.
Clinical signs
Other signs that may be present include orthopnea
Coughing is very uncommon in cats, even in
(recumbent dyspnea), tachypnea, minimal airflow with
advanced congestive failure.
increased chest excursions, or muffled heart and lung
Dyspnea is common with CHF and pulmonary edema, sounds from a mass or effusion.
and signs vary from mild exercise intolerance (lethargy,
weakness, reluctance to move or play) to severe, open-
mouth breathing with cyanosis. Treatment
Abnormal heart sounds (murmurs, gallops, arrhyth- Lymphoma is best handled with standard chemotherapy
mias) are often present. protocols. See page 676 for details.
Surgical excision is the treatment of choice for thy-
Treatment moma, and may be curative.
Oxygen therapy (O chamber or tents work well), Mesothelioma is an infiltrative disease that cannot be
2
furosemide (1–2 mg/kg IV or IM), sedation if frantic readily resected. Although there are few reports in the
(morphine 0.1 mg/kg IM prn, or butorphanol 0.2–0.4 literature of effective chemotherapy, local infusion of
mg/kg IM q 4–6 h prn), and emergency thoracocentesis if carboplatin may be helpful. Prognosis is grave with
hydrothorax is present. See page 84 for treatment details. or without doxirubicin intravenously.