Page 301 - Problem-Based Feline Medicine

16 – THE CAT WITH ACUTE DEPRESSION, ANOREXIA OR DEHYDRATION 293

cats have urinary tract infection at the time of admis- Clinical signs
sion (culture urine).
Cats of any age may be affected, but 70% of cats are
less than 2 years of age.
NEOPLASIA*
Toxoplasmosis may affect any organ system resulting
in a wide variety of clinical signs. Uveitis, pneumonia,
Classical signs
hepatitis and encephalitis are the most common syn-
● Usually chronic depression, anorexia and dromes. Most cats with systemic toxoplasmosis have a
weight loss. fever.
● Occasionally acute signs.
Lethargy, anorexia and fever are early signs.
Clinical signs Uveitis or other forms of intraocular inflammation are
present in about 80% of cases.
Neoplasia typically causes chronic signs, but depend-
Dyspnea is present in the majority of cats, and associ-
ing on location and growth rate, a tumor may cause
ated with increased respiratory sounds over the chest.
acute signs, which may include acute depression,
anorexia, and dehydration. Abdominal signs may occur associated with hepatitis
or pancreatitis and include abdominal pain on palpa-
Diagnosis tion, infrequent vomiting, and enlarged mesenteric
lymph nodes.
Routine history-taking, physical examination, and
Neurologic signs are more common in older cats.
diagnostic work-up is required to identify specific
signs and localize organ involvement. Definitive diag-
nosis requires biopsy. Diagnosis
Acute systemic toxoplasmosis typically affects kittens,
Differential diagnosis or immunosuppressed cats, which usually have a his-
tory of chronic disease.
Other causes of acute depression and anorexia.
Confirmation is by measuring serum IgM antibodies
Treatment or demonstrating rising serum IgG antibodies.
The organism occasionally may be seen in airway wash
Surgery, radiation therapy, chemotherapy and other
cytology of cats with pneumonia.
treatment modalities may be indicated, depending upon
the neoplasm.
Differential diagnosis
NUTRITIONAL SUPPORT Rule out other diseases causing acute lethargy,
anorexia and fever, which in the cat are usually infec-
tious causes. Physical examination will often identify
TOXOPLASMOSIS*
localizing signs, which can be pursued diagnostically.
Classical signs
● Fever, anorexia and depression. Treatment
● Uveitis, dyspnea, icterus, or neurologic
Clindamycin at standard doses (10–12 mg/kg orally q
signs.
12 h for 4 weeks).
See main reference on page 432 for details (The Yellow Other drugs with potential efficacy include trimethoprim-
Cat or Cat With Elevated Liver Enzymes), page 375 sulfas, doxycycline, minocycline, azithromycin and clar-
(The Pyrexic Cat). ithromycin.