Page 422 - Problem-Based Feline Medicine

414 PART 7 SICK CAT WITH SPECIFIC SIGNS

Pending a diagnosis, or if owner refuses a work-up, if FeLV/FIV status has not been reported in most cases,
the cat is febrile or has localizing signs of infection, but cats have not had signs of such infections.
consider empirical antibiotic treatment. Acceptable
choices include amoxicillin 10–20 mg/kg PO bid,
Clinical signs
amoxicillin-clavulanate 62.5 mg (combined dose) PO
bid, doxycycline 5 mg/kg PO bid, enrofloxacin 5 mg/kg Unilateral cervical, or unilateral and bilateral
PO once daily, orbifloxacin 2.5–7.5 mg/kg once daily, inguinal masses.
and marbofloxacin 2.5–5.0 mg/kg once daily, for
Mass has been painless on palpation in 2/3 of cases.
2 weeks. Cats receiving fluoroquinolones should be
monitored for visual disturbances. No sex predilection; the majority of cases have been
reported in cats 3–8 years of age.
Do not treat for lymphoma unless lymph node his-
tology is unequivocal or there is evidence of lym- Cervical mass may cause dyspnea from tracheal com-
phoma at another site. pression.
● Waiting to treat is probably not harmful.
No other clinical signs.
● An indolent lymphoma is unlikely to respond to
aggressive chemotherapy.

Do not treat with corticosteroids. Diagnosis
● Corticosteroids may allow an infectious process to
Histology of excised lymph node reveals capillary vaso-
worsen that may otherwise resolve spontaneously.
proliferation, lymphoid atrophy and preservation of
● Corticosteroids may induce lymphoma cell resist-
architecture.
ance to other anticancer drugs.
Prognosis Differential diagnosis

Dependent on cause of lymphadenopathy. Differential diagnoses for superficial masses include
benign and malignant solid tumors of skin, subcuta-
In the two case series, lymphadenopathy resolved
neous tissue, and muscle; epidermal cyst, granuloma,
within 4 months in 60% of cats with follow-up in the
abscess, hematoma, and scar tissue; typical and atypi-
first study, and all cats with follow-up in the second
cal lymph node hyperplasia, lymphoma, metastatic
study.
lymphadenopathy, and lymphadenitis.
Additional diagnoses for cervical masses include
PLEXIFORM VASCULARIZATION OF LYMPH
NODES enlarged thyroid or parathyroid gland, and salivary
mucocele.
Classical signs Additional diagnoses for inguinal masses include
prominent inguinal fat pads.
● Unilateral cervical mass.
● Unilateral or bilateral inguinal mass(es). Differentiation is based on biopsy for cytology, his-
tology and culture.
Pathogenesis Presence of other clinical signs, laboratory findings,
radiographs and ultrasound examination of the mass
A single case series and individual cases have been
may help narrow the list of differential diagnoses prior
reported.
to biopsy, and in some cases exclude biopsy (e.g.
Pathogenesis is not known. hyperthyroidism).
● An ischemic pathogenesis has been postulated,
but cats have not been evaluated with respect to
Treatment
thromboembolic disease nor have other throm-
boembolic events been identified. Surgical excision of the affected node(s).