Page 733 - Problem-Based Feline Medicine

32 – THE CAT WITH SIGNS OF ACUTE SMALL BOWEL DIARRHEA 725

Classical signs—Cont’d nine aminotransferase and alkaline phosphatase
enzymes. Other abnormalities may include elevations
● Arsenic toxicity eventually results in in bilirubin, bile acid values and decreases in albumin
hepatic and renal failure presenting as (in end stage hepatic failure).
depression, anorexia, vomiting and
diarrhea, along with oliguria or anuria, or Nephrotoxicity associated with arsenic poisoning is
icterus and ascites. also associated with isosthenuria, azotemia and even-
tually oliguria/anuria.
See main reference on pages 596, 659 for details.
FELINE LEUKEMIA VIRUS
Clinical signs
Classical signs
There are two major categories of clinical signs with
lead poisoning: (1) gastrointestinal signs, which ● Clinical signs are incredibly variable and
occur early in the course of the disease, and (2) cen- depend on which organ(s) are affected.
tral nervous system signs, which are manifest late in ● Weight loss, inappetence.
the disease. ● Occasionally vomiting or chronic diarrhea.
● Diarrhea is rarely observed as an acute
GI tract signs occur early with lead toxicity and may
onset.
include vomiting, diarrhea, salivation, inappetence
● Anemia may be observed.
and lethargy.
Chronic signs of lead toxicity involve the central nerv- See main reference on page 540 for details.
ous system, and include seizures, tremors and ataxia.
Arsenic causes GI signs early, but is hepatotoxic and Clinical signs
nephrotoxic, resulting in depression, anorexia, vomit-
Inappetence, weight loss, and lethargy are typical
ing and diarrhea along with oliguria or anuria, or
non-specific signs.
icterus and ascites.
The clinical signs observed in cats infected with feline
Lead is commonly found in older paints, while
leukemia virus will be quite variable and depend
arsenic is primarily obtained from snail baits.
upon which body system(s) is affected.
Neoplasia, immunosuppression and bone marrow
Diagnosis
disease (especially of the red cell series causing ane-
Historical information of exposure to heavy metals is mia) are the most common clinical manifestations of
a very important means of getting the diagnosis, how- the disease.
ever, such information is not always known.
Generalized lymphosarcoma is a manifestation of
The hemogram and serum chemistry profile will be FeLV in cats, and involvement of liver and mesen-
unremarkable when the cat presents with signs of gas- teric lymph nodes results in gastrointestinal tract
trointestinal disturbance. signs, such as vomiting, anorexia, chronic diarrhea and
weight loss. While the diarrhea is generally chronic in
The most common hematologic abnormality asssoci-
nature, the owner may perceive that it is acute in onset.
ated with lead poisoning is basophilic stippling of
Occasionally, the diarrhea occurs in cats with a good to
red cells, which occurs in 30% of cats with lead expos-
increased appetite.
ure, and the presence of nucleated red blood cells
(also 30%). However, these tests are not pathogno-
monic for lead poisoning. Diagnosis
Heavy metals also cause hepatocellular necrosis, Any ill cat should be tested for infection with feline
which will be evidenced by elevations in serum ala- leukemia virus, due to its many clinical manifestations