Page 124 - Problem-Based Feline Medicine

116 PART 2 CAT WITH LOWER RESPIRATORY TRACT OR CARDIAC SIGNS

Clinical signs Clinical signs

Acute tachypnea/dyspnea may develop after a blunt Acute dyspnea is associated with pulmonary throm-
traumatic event. There may be signs of shock and boembolism or acute pulmonary inflammation and
other injuries related to an event such as a road traffic edema associated with worm death. Acute respira-
accident. tory distress syndrome (ARDS) and generalized res-
piratory failure is not uncommon.
Acute exacerbations of chronic diaphragmatic hernia
may occur following the development of a pleural Cats usually have an acute onset of severe dyspnea,
effusion or dilation of a herniated stomach. tachypnea and cyanosis, and may mouth breathe.

In chronic cases, signs may be restricted to exercise Dyspnea may be worsened in lateral recumbency
intolerance, or signs of gastrointestinal upset may (orthopnea) and the cat is reluctant to lie in this posi-
occur, weeks or months after the trauma. tion.

Entrapment of viscera following traumatic diaphrag- There may be splitting of the second heart sound,
matic hernia may lead to pleural effusion. Even resulting in a gallop rhythm, due to acute pulmonary
partial herniation of liver may result in significant arterial hypertension.
effusion.

Congenital peritoneo-pericardial hernias also occur
causing similar clinical signs. Diagnosis
Thoracic radiographs may show evidence of parenchy-
mal lung disease, right-sided cardiomegaly, or
enlargement of the caudal lobar arteries or may be
Diagnosis
normal.
Clinical findings of muffled lung sounds, displace-
Ultrasound examination may reveal heartworm as
ment of cardiac apex, gut sounds audible in thorax
hollow linear densities in the main pulmonary
and reduced volume of abdominal contents are
artery or right artrium, as well as pulmonary arterial
suggestive.
dilation.
Thoracic radiography may show loss of diaphrag-
Definitive diagnosis of the thromboembolism requires
matic line, abdominal contents in the thorax or pleural
angiography or pulmonary scintigraphy.
effusion.
Blood chemistries may indicate the presence of a
Thoracic ultrasound can identify the presence of
hypercoagulable condition.
abnormal contents in the thorax and loss of continuity
of the diaphragmatic line. Heartworm tests may be positive.

PULMONARY THROMBOEMBOLISM PNEUMONIA
ASSOCIATED WITH HEARTWORM
DISEASE Classical signs
● Fever.
Classical signs
● Tachypnea.
● Severe dyspnea. ● Cough.
● Tachypnea. ● Dyspnea.
● Cyanosis. ● Inappetance.

See main reference on page 104 for details (The See main reference on page 62 for details (The
Coughing Cat). Dyspneic or Tachypneic Cat).