Page 667 - Problem-Based Feline Medicine

30 – THE CAT WITH SIGNS OF ACUTE VOMITING 659

Clinical signs Some cats with only central nervous system disease
will have a normal physical examination, with only
Clinical signs associated with xylazine administration
neurologic deficits or abnormalities found with careful
are either associated with the sedation effects (which
assessment.
also include some profound cardiovascular effects such
as bradycardia and hypotension) or vomiting.
Diagnosis
Diagnosis Hematology and serum biochemistry profiles help
define systemic or infectious causes (e.g. viral, bacte-
Vomiting is such a common side effect following
rial or fungal causes).
administration of xylazine that the drug is used fre-
quently to induce vomiting. Radiographs of cervical, thoracic and lumbar spine are
used to rule out diskospondylitis or evidence of neo-
Treatment plasia.
There is no need to treat vomiting associated with Cerebrospinal spinal fluid analysis (cytology and
xylazine administration since it is self-limiting. culture) may be essential for the diagnosis, but caution
should be exercised during CSF collection due to pos-
sible elevated intracranial pressure which could cause
ENCEPHALITIS/MENINGITIS
tentorial herniation.
Classical signs Imaging studies (MRI and CT scanning) are impor-
tant means of lesion localization and identification, but
● Neurologic signs predominate and depend
are not universally available.
on the location.
● Ataxia, dementia, nerve deficits, or cervical
ARSENIC POISONING
pain may be evident.
● Vomiting is often associated secondary to
Classical signs
the systemic illness (fungal, bacterial,
protozoal or viral) that is causing the ● Vomiting, diarrhea, anorexia and
disease. depression occur early.
● Arsenic toxicity eventually results in
See main reference on pages 829, 859 for details (The hepatic and renal failure (depression,
Cat With Seizures, Circling and/or Changed Behavior anorexia, vomiting and diarrhea along with
and The Cat With Tremor or Twitching). oliguria or anuria, or icterus and ascites.

Clinical signs Pathogenesis

Neurologic signs predominate and depend on the Arsenic may be present in herbicides, insecticides,
location in the brain that is affected. If the rostral fossa wood preservatives and treatments used for blood par-
is affected, seizures, circling, pacing, personality asites (including heartworm).
change, and decreased responsiveness are common. If
Cats appear to be more commonly poisoned than dogs,
the caudal fossa is affected, depression, head tilt, facial
possibly due to consumption of prey or insects killed by
paralysis, incoordination and other brainstem abnor-
the toxin.
malities are noted.
Toxicity may be acute, resulting in immediate and life-
Vomiting is uncommon, but is often associated with
threatening illness, or chronic, and more insidious.
the presence of systemic illness (fungal, bacterial, pro-
tozoal or viral) that has also affected the CNS.
Clinical signs
Other clinical signs, such as fever, depression, weak-
ness, hypotension or shock may be observed with cats Acute arsenic toxicity is associated with vomiting,
that are systemically ill. diarrhea or hematochezia, abdominal pain, weakness