Page 758 - Problem-Based Feline Medicine

750 PART 9 CAT WITH SIGNS OF GASTROINTESTINAL TRACT DISEASE

FIV is most prevalent in middle-aged, male cats that Diagnosis
live outdoors or are allowed to roam, and are prone to
A history of persistent lethargy, weight loss or
fighting.
anorexia in an older cat, especially a Siamese, should
raise suspicions of chronic GI disease and the need for
Diagnosis further evaluation.
The history and physical examination findings are Abdominal palpation may reveal a thickened region
often suggestive of chronic immunodeficiency disease. of bowel or a firm mass.
Hemogram and serum chemistry abnormalities are not A routine hemogram and chemistry profile is often
specific, but lymphopenia is a common finding. unremarkable or has non-specific abnormalities
associated with chronic disease, such as mild non-
Diagnosis is made by determining the presence of FIV
regenerative anemia, hypoproteinemia, or elevated liver
antibody on a commercially available ELISA test, as
enzyme concentrations.
long as the cat has not been previously vaccinated with
the FIV vaccine. Imaging studies such as contrast radiography or
ultrasound examinations are useful in identifying and
A western blot analysis or PCR test can be used to con-
localizing the lesion. Ultrasound can also be used to
firm the presence of the virus.
obtain a fine-needle aspirate of the mass or regional
In cases where FIV is confirmed, a further search for lymph nodes. A thoracic radiograph to check for
other infectious or parasitic causes (Cryptosporidia, metastasis is also indicated.
Toxoplasma, Giardia, Campylobacter, Salmonella,
Ultimately, the definitive diagnosis is by histopatho-
etc.) should be pursued because concurrent infections
logic examination of the tissue obtained either by
with other agents are common with FIV.
endoscopic or surgical biopsies.
INTESTINAL ADENOCARCINOMA Surgical exploratory is often the best approach for
both obtaining tissue for diagnosis, as well as allowing
for surgical removal of the affected tissue. In addition,
Classical signs
biopsies of regional lymph nodes can also be obtained.
● Weight loss, anorexia and vague signs of
malaise. CAMPYLOBACTERIOSIS
● Vomiting is the more common than
diarrhea. Classical signs
● Most common in older, Siamese cats.
● Abdominal distention, colicky abdominal
pain, and diarrhea are most common.
See main reference on page 677 for details.
● Kittens are generally in poor body
Clinical signs condition, or have other concurrent
infections.
The most common clinical signs are anorexia,
weight loss and vague signs of malaise. See main reference on page 726 for details.
Vomiting is more common than diarrhea because of
the tendency of the tumor to produce an annular, Clinical signs
obstructive lesion in the distal small intestine, however,
Campylobacter was isolated from 21% of cats with
diarrhea is not unusual. In general, the GI signs occur
diarrhea and 4% of healthy cats in one study. Other
late in the course of the disease.
studies with and without diarrhea have reported isola-
Abdominal pain may also occur, especially in cats tion rates varying from 0–50%.
with metastatic disease.
In cats, clinical signs of campylobacteriosis are
The disease is most common in older, Siamese cats. uncommon, as most infections are asymptomatic in the