Page 484 - Problem-Based Feline Medicine

476 PART 7 SICK CAT WITH SPECIFIC SIGNS

tion) and specific etiologies (e.g. feline infectious in a dog, so testing for this organism should be consid-
peritonitis, virulent systemic feline calicivirus infec- ered.
tion, toxoplasmosis, acetaminophen and diazepam
toxicosis).
HEPATIC ABSCESS
Clinical signs are due to the specific cause and to acute
liver injury, which may range from subclinical to ful- Classical signs
minant hepatic failure with hepatic encephalopathy.
● Lethargy, anorexia, and weight loss.
Necrotic liver tissue may spontaneously hemorrhage
resulting in peritoneal fluid and acute anemia.
Clinical signs
Non-specific signs are most common.
Diagnosis
In a case series about a quarter of cats had a fever and
Liver biopsy will demonstrate necrosis.
about a third were hypothermic. One third of cats had
Abdominal ultrasonography will confirm the presence abdominal pain.
of peritoneal fluid. Abdominocentesis will confirm that
the fluid is blood.
Diagnosis
Rare disorder.
PELIOSIS HEPATIS
Variable neutrophilia, anemia, hypoalbuminemia,
Classical signs hyperbilirubinemia and elevation in liver enzymes.

● Spontaneous abdominal hemorrhage. Ultrasound may demonstrate hypoechoic or mixed
hypoechoic/hyperechoic lesions in the liver and
abdominal effusion.
Clinical signs
Abdominal fluid cytology usually reveals degenerate
Variable clinical signs include: neutrophils and bacteria. Degenerate neutrophils with-
● Spontaneous abdominal hemorrhage from irregu- out bacteria and hemorrhagic effusion have also been
lar blood-filled cystic spaces, which may result in seen.
pale mucous membranes, collapse or abdominal
Culture of hepatic lesions.
distention.
● Signs of liver disease, including hepatomegaly or
jaundice. Telangiectasia is often present. PERI-RENAL PSEUDOCYSTS
● Weight loss, dyspnea.
Classical signs
Diagnosis ● Abdominal distention.
● Polyuria and polydipsia.
Abdominal radiographs may reveal hepatomegaly or
● Inappetence and weight loss.
loss of abdominal detail.
Abdominal ultrasound examination will reveal hypo-
Clinical signs
echoic regions in liver ± peritoneal fluid.
Abdominal distention occurs due to the formation of
Fine-needle aspiration of liver lesions should yield
unilateral or bilateral fluid-filled sacs. The sacs lack an
blood. Abdominocentesis may yield blood.
epithelial lining and contain either a transudate of
Histology of liver biopsy will confirm the diagnosis. serum, urine, or uncommonly, blood.
Peliosis hepatis may be caused by Bartonella henselae About 75% of cats have concurrent chronic renal fail-
infection in humans, and the two have been associated ure, but cause and effect are not known.