Page 444 - Problem-Based Feline Medicine

436 PART 7 SICK CAT WITH SPECIFIC SIGNS

Correct hydration deficits with intravenous fluids. Fluid Persistent hyperglycemia observed on 2–3 occasions at
choices are based on the presence of ascites and elec- least 3 hours apart over 24 hours.
trolyte status.
Urinalysis shows glucosuria, +/− ketonuria, +/− pro-
Use low-salt diets, cage rest and diuretics for control of teinuria and +/− bacteriuria.
ascites.
Liver biochemical parameters (ALT, ALP) are mildly to
Antibiotics are indicated in patients with suppurative moderately increased.
inflammation, fever and/or leukocytosis.
Use anti-inflammatory (e.g., prednisone, azathioprine) NON-HEMATOPOIETIC LIVER TUMORS
drugs to reduce mononuclear cellular infiltrates. (BILIARY CYST ADENOMA,
HEPATOCELLULAR CARCINOMA)
Anti-fibrotic agents, such as colchicine, D-penicillamine,
may reduce hepatic fibrosis.
Classical signs
Actigal may cause choleresis and promote a more bene-
● Most cats are > 10 years old.
ficial bile acid milieu.
● More common in DSH.
Reduce free radical damage to hepatocytes by adminis- ● Hepatomegaly +/- mass lesion is often
tration of S-adenosyl. palpable.

Prognosis Pathogenesis

The prognosis in most animals with cirrhosis is poor. Most (60%) of cats have benign tumors.
Bile duct tumors may progress from benign to malig-
nant lesions.
DIABETES MELLITUS
● Benign lesions are usually focal and cystic; malig-
nant tumors often involve multiple lobes.
Classical signs
Hepatomegaly is associated with extensive infiltrative
● Polyuria and polydipsia.
disease.
● Increased appetite.
● Weight loss with palpable hepatomegaly. Metastasis is common with bile duct carcinomas.

Clinical signs
Clinical signs
Generally seen in geriatric cats (> 10 years old).
Polyuria/polydipsia (PU/PD) are common.
More common in DSH than in Siamese.
Increased to ravenous appetite, although terminally it
may be decreased. Anorexia, lethargy and weakness are seen.
Weight loss with or without hepatomegaly. Hepatomegaly +/− mass lesion is often palpable.

Jaundice is an uncommon complication of diabetes. It
is more commonly associated with sulfonylurea (e.g., Diagnosis
glipizide) therapy. Approximately 20% of cats on sul-
Variable elevation in hepatic biochemical parameters.
fonylurea therapy develop increased liver enzymes and
In general, relative increases in ALP versus ALT activ-
a small percentage become jaundiced.
ity are observed. However, dramatic increases in either
liver enzyme may not be present even with moderately
Diagnosis sized tumors.
Suggested by salient clinical signs (PU/PD, alterations Abdominal imaging (survey radiographs, sonography)
in appetite, weight loss). confirms hepatomegaly or mass.