Page 527 - Problem-Based Feline Medicine

23 – THE BLEEDING CAT 519

Diagnosis CUTANEOUS ASTHENIA (EHLERS–DANLOS

See The Cat With Depression, Anorexia or SYNDROME)
Dehydration (page 273).
Classical signs
Hemostatic testing may reveal evidence of DIC (e.g.
thrombocytopenia, prolongation of clotting times), evi- ● Excessive wounding since birth.
dence of vitamin K deficiency (prolonged PT and ● Subcutaneous hematomas or seromas.
PIVKA time), and/or evidence of other hemostatic dis-
orders associated with concurrent liver disease (see
Liver disease, above). Clinical signs

Signs are present from birth, but may worsen with age.
Differential diagnosis
Skin is hyperextensive and wounds easily with minor
See The Cat With Depression, Anorexia or
trauma, and may feel softer. Scars from previous
Dehydration (page 275). Pancreatitis is difficult to
wounds may be present. Signs result from abnormal
definitively diagnose without biopsy. Many diseases in
collagen synthesis, and will vary in degree with the spe-
the cat cause non-specific signs and sub-clinical hemo-
cific genetic defect.
static defects. Systematic elimination of diseases by
● The chief complaint may be bleeding from the
work-up helps narrow the list of differential diagnoses.
skin, but bleeding is appropriate for the wound.
● Bleeding into the skin without a wound (petechia-
Treatment tion, ecchymoses) is not characteristic of the dis-
eases described to date in cats.
See The Cat With Depression, Anorexia or
● Subcutaneous hematomas and seromas may
Dehydration (page 277).
occur because blood and lymphatic vessels are
If there is clinical bleeding, treat with vitamin K as for fragile or are injured when the skin stretches.
liver diseases and transfusions as for DIC.
Concurrent signs include joint laxity, lens luxation
and cataracts.
Reported in domestic shorthaired, domestic longhaired,
STRANGULATION
Himalayan and Burmese cats.
Classical signs
● Scleral hemorrhage.
Diagnosis
Clinical signs are highly suggestive.
Clinical signs
Skin extensibility index (SEI) > 19%. SEI = height of
Non-fatal strangulation may result in scleral edema and fold/body length × 100, where, with the cat standing, a
hemorrhage, and neurologic signs. Pulmonary edema fold of lumbosacral skin is pulled upwards and the
has also been seen in dogs. height from the top of the spine to the top of the fold is
measured, and body length is measured from the occipi-
tal crest to the base of the tail.
Diagnosis
Skin biopsy for histopathology and/or electron
History is diagnostic. Usually the collar or leash is
microscopy of skin to document collagen abnormali-
caught in a tree.
ties, special biochemical analyses, and measurement of
Skin lesions around neck. tensile strength.
Hemostatic testing is normal. Hemostatic testing is normal.