Page 123 - Problem-Based Feline Medicine

8 – THE CYANOTIC CAT 115

Wheezing and crackling with moist gurgling sounds See main reference on page 56 for details (The
can be heard on auscultation. Dyspneic or Tachypneic Cat) and page 676 for details
of treatment.
Thoracic radiographs may show a bronchial or a
mixed bronchial/interstitial or alveolar pulmonary pat-
tern throughout the entire lung field.
Clinical signs
In the acute phase there may be hyperinflation of the
Dyspnea and tachypnea are often associated with a
lungs and flattening of the diaphragm. Occasionally
pleural effusion.
collapse of the right middle lung lobe may be seen.
Regurgitation may occur due to compression of the
Bronchoalveolar lavage fluid usually shows an inflam-
esophagus by the mass.
matory response which is usually eosinophilic but may
be neutrophilic in nature. Cyanosis may result from compression of the medi-
astinal vessels.
Differential diagnosis Reduced compressibility of the cranial mediastinal
Lungworm and lung fluke infestation are diagnosed thorax may be evident because of a space-occupying
with fecal Baermann exams. mass.
Heartworm disease is often associated with vomiting,
and sometimes basophilia. On radiographs, dilated and Diagnosis
blunted pulmonary arteries, which are most promi-
nent in the caudal pulmonary arteries, particularly the Thoracic radiography shows a space-occu-
right side, may be seen. Lung changes vary from pying lesion causing widening of the cranial
patchy pulmonary infiltrates to severe alveolar den- mediastinum. A pleural effusion is frequently present.
sities, and sometimes are difficult to differentiate from Cytologic evaluation of pleural fluid is useful as it
those of feline bronchopulmonary disease/ asthma. often contains lymphoblastic cells.

Fine-needle aspiration of the mass under ultrasound
Treatment
guidance will yield a sample for histopathologic exam-
Acute respiratory distress requires a rapid-acting ination.
corticosteroid such as methylprednisolone sodium
Test cat for FeLV as approximately 60% of cats with
succinate given intravenously at a dose of 30–50
mediastinal lymphosarcoma are FeLV-positive in
mg/kg, oxygen and terbutaline at a dose of 0.01
USA. This may be lower in countries where FeLV is
mg/kg IM or SQ q 4 h.
rare.
Long-term management involves eliminating potential
Test for FIV as this virus is also associated with
allergens and intermittent anti-inflammatory and bron-
increased rates of lymphosarcoma.
chodilator therapy.
CRANIAL MEDIASTINAL
LYMPHOSARCOMA** DIAPHRAGMATIC HERNIA (CONGENITAL
ANOMALY OR TRAUMATIC)*
Classical signs
Classical signs
● Dyspnea.
● Tachypnea. ● Dyspnea.
● Regurgitation. ● Tachypnea.
● Pleural effusion.
● Non-compressible cranial thorax. See main reference on page 58 for details (The
Dyspneic or Tachypneic Cat).