Page 364 - Problem-Based Feline Medicine

356 PART 6 CAT WITH WEIGHT LOSS OR CHRONIC ILLNESS

– Symptomatic or asymptomatic urinary tract ● Thoracic radiography may show cardiomegaly, vas-
infections are frequently present in diabetes cular congestion and possibly pleural effusion or
mellitus. pulmonary edema.
● Echocardiographic examination is usually
required to make a definitive diagnosis of the
CARDIAC CACHEXIA
type of cardiac disease.
Classical signs
● Decreased appetite and weight loss. CHRONIC BACTERIAL RHINITIS AND
● Lethargy. SINUSITIS
● Signs relating to cardiac disease –
tachycardia, cardiac murmurs and Classical signs
arrhythmias.
● Chronic sneezing and snuffling.
● Dyspnea if pleural effusion or pulmonary
● Chronic, persistent or intermittent,
edema present.
mucopurulent nasal discharge.
● Stertorous respiration.
See main references on page 124 for details (The Cat
With Abnormal Heart Sounds and/or an Enlarged Heart).
See main references on page 21 for details (The Cat
With Signs of Chronic Nasal Disease).
Clinical signs

Inappetence and weight loss may occur, associated with Clinical signs
cardiac disease.
Usually there is a history of chronic upper respiratory
● The remaining clinical signs will vary with the nature
tract disease following an acute episode of signs.
of the cardiac disease, although cardiac cachexia
● Typically there is serous to mucopurulent, unilat-
usually only occurs in cats with cardiac disease suf-
eral or bilateral oculonasal discharge, often associ-
ficient to cause failure.
ated with sneezing.
● Generally it is seen in cats with chronic, severe
– Signs may be persistent or intermittent, but are
right-sided congestive cardiac failure.
usually gradually progressive.
Lethargy and exercise intolerance are present. – Rarely epistaxis may be noted, but this is more
frequently associated with neoplasia.
Dyspnea due to the presence of pleural effusion or pul-
● Stertorous respiration may be audible.
monary edema may be present.
If chronic and severe, in rare cases, bone destruction
Rarely ascites may be present.
may lead to nasal distortion.
Physical examination may reveal poor peripheral
Inappetence, which is often associated with inability to
pulses or evidence of venous congestion (jugular dis-
smell food, and weight loss may occur.
tention and pulses, hepatojugular reflux).
Systemic signs such as depression and anorexia are
Cardiac auscultation may reveal tachycardia, arrhyth-
often associated with intermittent exacerbation of
mias or cardiac murmurs.
disease.
Diagnosis
Diagnosis
Diagnosis is based on documenting the presence of
Appropriate clinical signs and a history of previous
severe cardiac disease in a cat with weight loss.
acute upper respiratory tract disease are supportive
Evidence of cardiac disease may be provided by tho- of the diagnosis, however a full investigation is
racic radiography, electrocardiography, measurement required to exclude other causes of nasal discharge
of systemic blood pressure and echocardiography. including neoplasia and fungal disease.