Page 697 - Problem-Based Feline Medicine

31 – THE CAT WITH SIGNS OF CHRONIC VOMITING 689

because they all may cause vomiting in the absence of Diagnosis
other signs of disease.
History and physical examination findings will be
suggestive of congestive heart failure, especially if the
Treatment cat has a murmur, gallop rhythm or other signs refer-
able to primary heart disease.
Surgical removal of the foreign body is required if it
is not able to be retrieved and removed via an endo- Hematology and serum biochemical profile data
scopic procedure. may reveal mild, non-specific changes, such as ane-
mia of chronic disease, prerenal azotemia, elevations in
liver enzyme activities secondary to congestion, and
CONGESTIVE HEART FAILURE* changes in electrolytes and proteins consistent with
dehydration. If myositis is a differential for the cause of
Classical signs heart failure, elevated creatine kinase values may be
useful additional information.
● Coughing or dyspnea.
● Lethargy. Imaging studies are necessary to make a definitive
● Anorexia. diagnosis. In particular, thoracic radiographs will be
● Exercise intolerance. helpful in assessing cardiac size and pulmonary
● Weight loss. involvement (edema vs. pleural effusion, etc.).
Cardiac ultrasound examination is the best diagnos-
See main reference on page 124 for details (The Cat tic test for evaluating cardiac muscle function, size and
With Abnormal Heart Sounds and/or an Enlarged Heart). presence of valvular or other defects.
Electrocardiography may also be useful to detect or
Clinical signs document any arrhythmias.

Classical signs of congestive heart failure include dys-
pnea, coughing, cyanosis, pale mucous membranes,
poor pulse quality, inappetence, exercise intolerance/ SYSTEMIC NEOPLASIA*(GENERALIZED
weakness and lethargy. Cats are usually presented with LYMPHOMA, SYSTEMIC MASTOCYTOSIS)
acute dyspnea and cyanosis.
Classical signs
The signs may be quite variable depending on the
cause of heart failure. Valvular disease is often associ- ● Weight loss.
ated with an audible murmur, while heart muscle ● Lethargy or depression.
diseases often are associated with tachycardia, gallop ● Anorexia.
rhythm and weak pulses. ● Enlarged spleen or liver, lymph nodes or
bone marrow involvement.
Other signs that may be observed in cats with heart
failure include collapse, vomiting, weight loss, limb
paresis/paralysis due to thromboembolic disease, and
Clinical signs
rarely, abdominal distention.
The most common clinical finding is marked
Other cats may develop pleural effusion that increases
hepatomegaly or splenomegaly along with enlarged
respiratory effort but is not associated with coughing or
lymph nodes (mesenteric).
increased lung sounds (decreased or absent lung sounds
are present). Other common signs are vomiting and anorexia.
Vomiting episodes are typically chronic, but infre- In some cases, peritoneal effusion will be present,
quent and more commonly associated with heart mus- which along with the hepatomegaly or splenomegaly
cle disease (myopathy) rather than valvular disease. will be observed as profound abdominal enlargement.