Page 78 - Problem-Based Feline Medicine

70 PART 2 CAT WITH LOWER RESPIRATORY TRACT OR CARDIAC SIGNS

24 h in the evening) or inhaled via a face mask Because of the restricted expansion of the lungs during
(albuterol). inspiration, negative pressure is increased in the pleural
space, resulting in rapid reaccumulation of fluid.
Steroids at anti-inflammatory doses are usually the cor-
nerstone of therapy (prednisone 1 mg/kg q 12 h for
Clinical signs
7 days then 1 mg/kg q 24 h, then reducing to the mini-
mum effective dose over 2–4 months). Dyspnea occurs which is inspiratory and expiratory.

Antibiotics are indicated when signs worsen and do not Muffled lung and heart sounds are audible ventrally as
respond to steroids. If there are many neutrophils in the a result of the pleural effusion.
BAL fluid, a preliminary course of antibiotics may be
There is rapid return of hydrothorax, even after the
indicated before steroids are used, to see if there is any
pyothorax has been successfully treated.
improvement in signs. Be careful about combined use
of enrofloxacin and theophylline, as enrofloxacin has
Diagnosis
the potential to inhibit liver metabolism of theophylline
and increase plasma concentrations. Radiography may reveal distorted poorly expanded
rounded lung lobes.
FIBROSING PLEURITIS Diagnosis is frequently only made at surgery.

Classical signs Treatment
● Dyspnea. Stripping of the fibrotic pleura from the lungs followed
● Muffled heart and lung sounds ventrally. by glucocorticoid therapy has been attempted, but is
rarely successful.

Prognosis
Pathogenesis
Prognosis is generally poor.
Fibrosing pleuritis is a rare sequence of pyothorax and
other chronic pleural effusions, especially chyothorax.
Chronic pleuritis results in restrictive fibrosis of the
pleura, which prevents the lungs expanding.

RECOMMENDED READING
Mason RA. Dyspnea, tachypnea and panting. In: Tilley LP, Smith FWK (eds) The 5 minute veterinary consult, 2nd
edition. Baltimore, Lippincott Williams & Wilkins, 2000, pp 68–69.
Turnwald GH. Dyspnea and tachypnea. In: Ettinger SJ (ed) Textbook of Veterinary Internal Medicine, 4th edition.
Philadelphia, Saunders, 1995, pp 61–64.
Ware W. Dyspnea: diagnosis and management. In: August JR (ed) Consultations in feline internal medicine.
Philadelphia, Saunders, 1991, pp 147–169.
Williams K, Malarkey D, Cohn L, Patrick D, Dye J, Toews G. Identification of spontaneous feline idiopathic pul-
monary fibrosis: morphology and ultrastructural evidence for a type II pneumocyte defect. Chest 2004; 125(6):
2278–2288.