Page 305 - Problem-Based Feline Medicine

16 – THE CAT WITH ACUTE DEPRESSION, ANOREXIA OR DEHYDRATION 297

If intravenous access is not possible, 50% dextrose Diagnosis
(0.5–1.0 ml/kg) or corn syrup (0.25–0.5 ml/kg) PO and
The cat with unexplained acute depression should be
rubbed on the gums may be effective, but glucagon
carefully examined repetitively for neurological signs.
0.25–1.0 mg IM is superior. Glucagon must be fol-
lowed by intravenous dextrose once seizures have
stopped and intravenous access is possible. Differential diagnosis
In the absence of specific neurologic signs, all other
causes of acute depression and anorexia should be con-
CENTRAL NERVOUS SYSTEM NEOPLASIA sidered.
OR INFLAMMATION
If neurologic signs develop, poisoning should be con-
sidered.
Classical signs
● Acute depression and anorexia.
● Stupor, coma, and specific neurological Treatment
signs. Treat the underlying disease.
In the absence of a specific diagnosis, treatment should
See main reference on page 795 for details (The Cat
be supportive.
With Seizures, Circling and/or Changed Behavior), page
821 (The Cat With Stupor or Coma), page 835 (The Cat
With a Head Tilt, Vestibular Ataxia or Nystagmus), page HEPATIC ENCEPHALOPATHY
852 (The Cat With Tremor or Twitching) and page 941
(The Cat With Generalized Weakness). Classical signs
● Disorientation and ptyalism.
Clinical signs ● Intermittent central nervous system (CNS)
signs often associated with eating.
Acute meningitis, encephalitis or central nervous ● Usually in young cats (< 1 year).
system neoplasia may initially be characterized by ● Affected cats are often stunted in size.
non-specific signs such as acute onset of anorexia and
depression. See main reference on page 588 for details (The Cat
With Salivation) and page 425 (The Yellow Cat or Cat
Depression may then progress to stupor, coma, behav-
With Elevated Liver Enzymes).
ior change or other specific neurological signs. See The
Cat With Stupor or Coma, The Cat With Seizures,
Circling and/or Changed Behavior, and The Cat With a Clinical signs
Head Tilt.
Porto-systemic shunts usually cause signs in young
● Acute depression may be the only finding in a cat in
cats that are small in size. Copper-colored irises may be
the prodromal phase of clinical rabies, but fever
evident. Intermittent central nervous system signs
spikes are typical. The prodromal phase typically
including disorientation and behavioral changes, and
only lasts one to two days in cats before proceeding
occasionally seizures occur, often associated with eat-
to the furious phase (most often) or the paralytic
ing. Ptyalism may occur alone or associated with neu-
phase. Rabies is highly unlikely if there is persist-
rological signs. Occasionally urethral obstruction
ent depression and anorexia without the develop-
results from ammonium biurate uroliths. Prolonged
ment of other behavior changes or specific
post-anesthetic recovery may be reported.
neurologic signs.
● Acute depression is a consistent initial sign in Mature cats with hepatic lipidosis and cholangio-
pseudorabies (Aujesky’s disease, mad itch), but hepatitis typically have anorexia, weight loss, vomit-
typically progresses to severe pruritis, voice change ing and icterus. In severe cases, collapse, disorientation
and anisocoria with 1–2 days. and ptyalism may occur.