Page 278 - Problem-Based Feline Medicine

270 PART 5 CAT WITH ACUTE ILLNESS

In some cases fever is absent, and this should not be
ACUTE ANEMIA**
used to rule out bacterial infection. Septic cats without
a fever are more likely to have severe sepsis and
Classical signs
impending septic shock.
● Pale mucous membranes.
In some cats, the localizing signs of infection are not
● Acute onset of anorexia, depression and
readily detectable on physical examination. This most
physical inactivity.
often occurs when there is primary neutropenia
and secondary infection.
See main reference on page 526 for details (The
● Severe sepsis or septic shock should always be con-
Anemic Cat).
sidered in the differential diagnoses of cats with
acute depression and anorexia without more spe-
cific signs.
Clinical signs
● Other common signs of severe sepsis are bradycar-
dia, pale mucous membranes, weak pulses, polyp- The degree of depression, anorexia and dehydration cor-
nea, diffuse abdominal pain and icterus. relates with the severity and acuteness of the anemia.
Tachypnea and tachycardia may be evident.
Diagnosis Pale mucous membranes with or without splenomegaly
or icterus.
A complete blood count may reveal neutrophilia
and a left shift. Alternatively, neutropenia may be If the anemia is due to infectious causes, e.g.
present from primary bone marrow failure (e.g. Mycoplasma haemofelis (Haemobartonella felis), the
FeLV infection) or exhaustion of marrow granulo- cat may be pyrexic.
cyte reserve.
Meticulous physical examination, serum chemistries,
Diagnosis
diagnostic imaging and fine-needle aspiration will help
localize the infection (e.g. deep subcutaneous abscess, Routine hematology will confirm anemia.
pyometra, pyelonephritis, peritonitis, pyothorax, pneu-
The cause of the anemia can usually be determined by
monia).
routine work-up (see The Anemic Cat).

Differential diagnosis
Differential diagnosis
In the absence of a fever and localizing signs, all other
Pale mucous membranes due to shock.
causes of acute depression and anorexia should be con-
sidered.
Treatment
Treatment Treat the cause of anemia; transfusion. See The Anemic
Cat.
Treatment is supportive pending a diagnosis.
Systemic antibiotic therapy and local treatment of
infection if indicated (e.g. drainage of abscess). SEPARATION OR SITUATION ANXIETY**
Empirical therapy with broad-spectrum, bactericidal
Classical signs
antibiotics (e.g. cefazolin plus gentamicin, cefoxitin)
should be started at standard doses in depressed ● Withdrawal or hiding and/or anorexia.
neutropenic cats.