Page 69 - Problem-Based Feline Medicine

5 – THE DYSPNEIC OR TACHYPNEIC CAT 61

● Often, there is extensive local invasion by the neo- heartworms on ultrasound. Occasionally peripheral
plasm, and the recurrence rate after radiotherapy basophilia is evident (see Feline heartworm page 104,
and/or surgery is high. The Coughing Cat).
Nasal lymphoma responds well to standard Lungworm infection with Capillaria aerophilia is
chemotherapy for lymphoma, with remission times of diagnosed by finding eggs in the stools or lung wash,
16 months reported. and with Aelurostrongylus abstrussus, by finding lar-
vae in the lung wash or fecal Baermann.
Pharyngeal and tracheal masses and nasopharyngeal
polyps are best treated with surgical resection. Lung flukes (Paragonimus kellicotti) produce opercu-
lated eggs in the stool.
PARASITIC DISEASE Toxoplasmosis rarely produces clinical disease in cats.
Mixed fluffy interstitial and alveolar patterns are
Classical signs typically evident on radiographs. Tachyzoites may be
recovered in the lung wash.
● Coughing.
● Reduced physical activity and reluctance to Differential diagnosis
play.
● Mild to severe dyspnea. Other forms of pneumonia, including bacterial, viral, fun-
● Weight loss, poor coat, inappetance. gal, inflammatory and neoplasia, need to be considered if
● Sudden marked respiratory distress (feline no larvae or ova are found in the stool or lungwash.
heartworm).
Treatment
See main reference on page 104 for details (The Cough- Feline heartworm disease therapy is usually sympto-
ing Cat). matic, as adulticide therapy is associated with a high
mortality rate (see Feline heartworm disease, page 105,
The Coughing Cat).
Clinical signs
Lungworm – Capillaria aerophilia and Aeluro-
Heartworm (Dirafilaria immitis), lungworm (Aeluro-
strongylus abstrussus – fenbendazole (50 mg/kg PO q
strongylus abstrusus, Capillaria aerophilia), lung
24 h for 3 days) or ivermectin (400 μg/kg PO, SQ).
flukes (Paragonomus kellicoti), migrating nematodes
(Toxocara cati) and toxoplasmosis all may cause respi- Lung flukes – Paragonimus kellicotti, fenbendazole
ratory signs. (50 mg/kg PO q 24 h for 3 days), or praziquantel
(25 mg/kg PO q 8 h for 2 days).
Coughing may be present and is typically harsh, pro-
ductive and paroxysmal. Toxoplasmosis – clindamycin, 12.5 mg/kg PO q 12 h,
potentiated sulfa (trimethoprim or ormetoprim) or
Mild to marked dyspnea and reduced activity may be
azithromycin.
observed, depending on the severity of the lung disease.
Weight loss, poor coat and ill-thrift may be evident. MYOPATHY/NEUROPATHY
Vomiting is a common sign with feline heartworm dis-
ease. Sudden death or sudden extreme respiratory distress Classical signs
and generalized respiratory failure occur in approxi-
● Dyspnea characterized by weakened chest
mately 30% of symptomatic cats with heartworm disease.
excursions.
● Weakened gait, ventroflexion of the head.
Diagnosis ● Regurgitation may lead to aspiration
pneumonia.
Feline heartworm disease is suggested by a positive
heartworm antibody test, radiographic changes of See main reference on page 941 for details (The Cat
dilated and blunted pulmonary arteries and evidence of With Generalized Weakness).