Page 280 - Problem-Based Feline Medicine

272 PART 5 CAT WITH ACUTE ILLNESS

Ventroflexion of the neck and stilted forelimb gait. Clinical signs
Severe muscle weakness may lead to respiratory mus-
Most common in cats 2–6 months of age.
cle failure (rare).
Typically, there is acute onset of depression and
Polyuria and polydipsia – this is usually due to the
anorexia. Vomiting then appears, followed by the onset
underlying disorder, but hypokalemia may impair con-
of fetid and often bloody diarrhea in 1–2 days. Cats
centrating ability (hypokalemic nephropathy).
may stand hunched-up, sometimes with the face over a
Arrythmias – increasing risk with decreasing potas- water bowl, but refuse to drink. Dehydration develops
sium level. with vomiting and diarrhea.
Diagnosis Pain is often evident on abdominal palpation, and loops
of intestine may be thickened and contain excess gas
Serum potassium level < 3.5 mmol/L. and fluid.

Ruling-out other causes of depression, weakness and Affected kittens are initially febrile, but if signs are
anorexia. severe, this progresses rapidly to hypothermia. Coma
and death usually follow in a few hours.
Differential diagnosis
Other causes of depression, weakness and anorexia
Diagnosis
related to the primary disorder.
Diagnosis is usually suspected when there are consis-
Other causes of cervical ventroflexion include thiamine
tent clinical signs in a kitten or cat with no history of
deficiency and other causes of muscle weakness
vaccination.
(including motor neuron disease and myasthenia
gravis, which do not cause anorexia). Complete blood count reveals severe neutropenia and
lymphopenia. Fecal tests for parvovirus antigen are
Treatment sometimes useful.

Potassium-rich intravenous fluids. See Diabetic
ketoacidosis in The Cat With Polyuria and Polydipsia. Differential diagnosis

Cats with mild hypokalemia (3.0–3.5 mmol/L) may be No other disease mimics classic severe panleukopenia,
treated as outpatients with potassium gluconate, 1.0–3.0 and this should be the first differential diagnosis in any
mEq/kg/day q 8 h, followed by a maintenance dose of 1.0 unvaccinated kitten presented for acute depression.
mEq/kg/day q 12 h once serum potassium has normalized.
Many other diseases mimic mild panleukopenia clini-
Prognosis cally. However, leukopenia is usually present, even in
mild cases, which supports the diagnosis.
The prognosis for correction of hypokalemia is good
and overall prognosis is determined by the underlying
disorder. Treatment
Intravenous fluids and bactericidal antibiotics (e.g.
PANLEUKOPENIA** ampicillin plus gentamicin, cefoxitin) at standard doses
are required.
Classical signs
● Acute depression, anorexia, dehydration,
and fever in kittens or unvaccinated cats. PANCREATITIS*
● Vomiting usually precedes diarrhea.
Classical signs
See main reference on page 650 for details (The Cat ● Acute depression and anorexia.
With Signs of Acute Vomiting).