Page 480 - Problem-Based Feline Medicine

472 PART 7 SICK CAT WITH SPECIFIC SIGNS

● The wound may be difficult to visualize or palpate, Abdominal ultrasonography may reveal a normal or
but palpation of the abdominal wall at the wound enlarged liver, altered hepatic echogenicity and peri-
site will usually incite a painful response. The toneal fluid.
severity of bleeding varies with the organs and
Peritoneal fluid is usually a transudate or modified
blood vessels that are injured.
transudate. Occasionally, high protein fluid typical of
Abdominal hemorrhage may occur following surgery an exudate occurs with non-suppurative cholangiohep-
or external biopsy procedures (e.g. percutaneous liver atitis.
biopsy).
Definitive diagnosis requires liver biopsy.
Regardless of the type of trauma, the signs of
abdominal hemorrhage are those of acute hypo- Differential diagnosis
volemia. Abdominal distention is unlikely.
Differential diagnoses for a cat with signs of liver
abnormalities and peritoneal fluid include hepatic neo-
Diagnosis
plasia and other chronic liver diseases, acute pancreati-
Abdominal ultrasonography will usually demonstrate tis, right heart failure, feline infectious peritonitis and
peritoneal fluid. Abdominocentesis may yield blood. toxoplasmosis.
● Following percutaneous biopsy of an abdominal
organ, tachycardia is the first sign of hemorrhage
Treatment
and this finding is more sensitive than ultrasound or
abdominocentesis to detect active bleeding. Nutritional support.
Corticosteroids for cholangiohepatitis.
HEPATIC LIPIDOSIS, NON-SUPPURATIVE
CHOLANGIOHEPATITIS AND HEPATIC Therapeutic abdominocentesis is not required.
CIRRHOSIS*
STEATITIS
Classical signs
Classical signs
● Anorexia, lethargy, weight loss, icterus.
● Depression, anorexia and reluctance to
See main reference on page 425 for details (The Yellow move.
Cat or Cat With Elevated Liver Enzymes).

Clinical signs Clinical signs
Anorexia, lethargy and weight loss. Depression, anorexia, fever and reluctance to move
because of pain.
Variable icterus, vomiting, diarrhea.
Abdominal distention may occur from fluid and
Ascites is uncommon, especially ascites sufficient to
firm abdominal fat, and the abdomen may be tense
cause abdominal distention.
because of pain.
● Ascites is reported more frequently in some case
series, which may represent distinct sub-types of Other clinical signs include fever and firm and lumpy
chronic liver diseases. subcutaneous fat with or without accompanying lymph-
adenopathy.
Hepatomegaly is common with lipidosis, but is usually
not sufficient to cause abdominal distention.
Diagnosis
Diagnosis
History of a diet high in oxidized unsaturated fats
These liver diseases may be suspected on the basic of (e.g. rancid tuna) and/or deficient in vitamin E. Rare
clinical signs and variably elevated liver enzymes. in cats fed commercial foods.