Page 394 - Problem-Based Feline Medicine

386 PART 7 SICK CAT WITH SPECIFIC SIGNS

neutro-penia are classically associated with fever. Fever
SALMONELLA SPP. (SONGBIRD FEVER)
may occur with other tumors via other mechanisms,
including antibody stimulation from tumor antigens,
Classical signs
and tissue necrosis which activates leukocytes to
release pyrogenic factors. ● Vomiting/diarrhea.
● Fever (40.0–40.6˚C [104.0–105.0˚F]).
Signs are specific to the organ system involved.
● Depression.
Lymphoma (mediastinal, GI, renal), mammary ● Anorexia.
adenocarcinoma, squamous cell carcinoma (nasal, oral)
and mast cell tumor are the most common tumors in cats. See main reference on page 719 for details (The Cat
With Signs of Acute Small Bowel Diarrhea).
Diagnosis
Hematology, biochemistry panel, radiology, ultra-
sound and/or bone marrow aspirates may be necessary Clinical signs
to provide evidence that a tumor is present, especially
Acute onset of fever and malaise are initial clinical
if it involves the hematopoietic system (leukemia) or is
signs.
located internally (splenic mast cell tumor).
Vomiting, diarrhea and abdominal pain may occur,
Identification of the tumor type is via fine-needle
however, approximately 50% do not have gastrointesti-
aspirates and/or biopsies.
nal signs.
Dehydration.
Differential diagnosis
Shock may occur if septicemia/bacteremia develops.
Organ dysfunction due to infectious or degenerative
disease process. Mortality rate approaches 10% and may be higher if
the cat is concurrently immunosuppressed.
FeLV/FIV or other immunosuppressive illness.
Benign masses (granulomas, abscesses, reactive lymph
nodes, benign tumors).
Diagnosis
Treatment Typically, the cat is an outdoor cat with a history of
hunting behavior, especially of birds.
Treatment involves surgical excision of identifiable
masses +/− regional lymph nodes, especially for mam- Complete blood count and biochemistry panel sup-
mary adenocarcinoma, nasal squamous cell carcinoma, ports infectious diarrhea or septicemia, e.g., neutrope-
splenic mast cell tumor, etc. nia with a left shift, bacterial rods in blood leukocytes
if overwhelming sepsis present, hypoglycemia,
Chemotherapy may be effective and needs to be based hypoproteinemia, pre-renal azotemia.
on tumor type, e.g., COP (cyclophosphamide, vin-
cristine, prednisolone) protocol in lymphoma cases. Blood cultures provide the best definitive diagnosis if
positive. Three separate samples over a 4–6 hour
Radiation therapy is used for local disease only, and period should be taken during febrile episodes using
response to radiation therapy is tumor dependent (e.g., aseptic techniques.
squamous cell carcinoma).
● Radiation therapy is most effective after surgical Fecal cultures may isolate Salmonella organisms,
debulking of the primary mass. The effectiveness of but because many animals are subclinical carriers,
radiation therapy may be enhanced with concurrent positive culture does not prove that the organism is
chemotherapy. the cause of the clinical signs.