Page 277 - Problem-Based Feline Medicine

16 – THE CAT WITH ACUTE DEPRESSION, ANOREXIA OR DEHYDRATION 269

Ulcers and foreign material in the oral cavity are usu-
ACUTE INTRANASAL, ORAL
OR PHARYNGEAL INFLAMMATION ally obvious, except for those under the tongue.
Anesthesia is often required for thorough evaluation of
the tongue and oropharynx.
Classical signs
● Partial or complete anorexia and Differential diagnosis
depression.
Other causes of acute depression need to be ruled out.
● Sneezing, nasal discharge.
● Stertor. Treatment
● Halitosis, ptyalism.
Foreign material should be removed by extraction or
See main reference on page 5 for details (The Cat With lavage.
Acute Sneezing or Nasal Discharge), page 32 (The Cat
Antibiotics (e.g. ampicillin or amoxicillin at standard
With Stridor).
doses) are indicated when secondary bacterial infection
is evident with viral, foreign body, corrosive or uremic
Clinical signs ulceration.

Cats with foreign material (e.g. kitty litter, plant mate-
rial) in the nose or nasopharynx may be acutely depressed BACTERIAL SEPSIS**
and refuse to eat. Typically there is an acute onset of
sneezing or serous nasal discharge. Foreign material in the Classical signs
nasopharynx may result in stertorous respiration.
● Acute anorexia and depression.
Cats with acute viral rhinitis may also be depressed ● Fever and localizing signs of infection.
and anorexic, but these cats usually have a fever. ● Hypothermia and bradycardia with severe
Anosmia may contribute to anorexia; so may concur- sepsis.
rent oral inflammation with calicivirus infection.
Conjunctivitis may be present. See main reference on page 112 for details (The Fading
Kitten and Neonate).
Cats with oral and oropharyngeal foreign bodies
(e.g. needle) will be acutely depressed and refuse to eat.
More specific signs include halitosis, ptyalism, unusual Clinical signs
jaw motions, gagging, pawing at the mouth and ster-
Cats with a bacterial infection usually have a fever and
torous respiration.
localizing signs of infection, in addition to depression
Oral ulcers, acute anorexia and salivation may occur and anorexia.
following exposure to a corrosive substance. ● Sepsis is defined as presence of a systemic inflam-
matory response syndrome (SIRS) due to a dissem-
Uremic ulceration contributes to anorexia in cats with
inated bacterial infection. Signs of SIRS include
renal failure.
high fever or hypothermia; tachycardia or bradycar-
dia; polypnea; and moderate to marked neutrophilia,
neutropenia or left shift.
Diagnosis
● Severe sepsis is defined as sepsis accompanied by
Acute viral rhinitis is usually diagnosed on the basis organ dysfunction, hypoperfusion or hypotension.
of clinical findings. ● Septic shock is defined as severe sepsis with
hypotension that is refractory to adequate fluid
Foreign material may be evident adhered to the external
resuscitation.
nares. The nasal cavity may be examined for foreign mate-
rial by means of an otoscope, rigid endoscope or radi- Febrile responses may be blunted in older cats, and
ographically. The nasopharynx may be examined under the severity of infection may be underestimated based
anesthesia with a dental mirror or flexible endoscope. on the magnitude of the fever.