Page 796 - Problem-Based Feline Medicine

788 PART 9 CAT WITH SIGNS OF GASTROINTESTINAL TRACT DISEASE

passage of fecal material to the rectum. The increased Treatment
fecal volume that occurs over the extended time in the
Treatment of dehydration is by administration of fluid
colon, and fecal dryness, worsen the condition.
therapy to correct hydration, electrolyte and acid–base
The differential diagnosis of dehydration depends on status.
the primary cause. Hypokalemia may be caused by
Potassium deficits can be corrected by oral and/or IV
any condition which causes reduced intake from
supplementation, depending on the severity of the
anorexia, or increased losses via the urinary or gas-
problem. Fluid therapy may initially worsen
trointestinal tract. Conditions commonly associated
hypokalemia because of expansion of blood volume and
with increased loss of potassium include chronic
+
diuresis, so it may be beneficial to supply oral K con-
renal failure, and any causes of vomiting and/or
currently. Oral potassium should ideally be supplied
diarrhea.
as gluconate or citrate, as KCl may worsen concurrent
metabolic acidosis. Please refer to the main reference
Clinical signs
+
for correction of K deficits in dehydration on page 557.
Depending on the severity of dehydration, signs
Maintainence fluid rates are 70 ml/kg/day. Fluid
progress from subtle loss of skin tenting to dry
deficits and ongoing losses should be estimated and
mucous membranes and sunken eyeballs. There are
added to maintenance rates so that the deficit can be cor-
signs of shock in advanced cases.
rected over the first 12–24 hours. Please refer to the main
Hypokalemic cats are weak, and may show a reluc- reference for treatment of dehydration on page 558.
tance to jump or climb stairs, ventroflexion of the
head and poor limb tone. Prognosis
Reduced, absent or painful defecation may be pres- The prognosis for constipation from dehydration and
ent, and tenesmus is frequently noted. hypokalemia depends on the primary cause of the
problem.
Feces are hard, dry and may or may not be covered in
mucus.
PELVIC FRACTURES*
Systemic signs including lethargy, anorexia, weight
loss and vomiting may be present, depending on the
Classical signs
underlying cause.
● Inability to walk and severe pain on
Diagnosis palpation of the pelvic area in a cat with
a recent history of trauma.
Clinical signs of loss of skin elasticity and tacky ● Dry hard feces and straining to defecate in
mucous membranes, accompanied by elevations in
a cat with evidence of healed pelvic
PCV and total protein are indicative of dehydration,
fractures.
together with evidence of constipation (hard, dry
feces and tenesmus).
Clinical signs
Serum potassium concentration is low, determined
by in-house or laboratory analysis. Cats with recent pelvic fractures may be able to sit up,
but are rarely able to walk normally. Attempts at
Differential diagnosis abdominal and especially pelvic palpation elicit a pain
response. When the tuber ischii are palpated from
Severe constipation or megacolon can result in behind, there may be asymmetric movement in an
depression, anorexia and dehydration. Constipation anteroposterior direction. Attempts to defecate may be
resulting from dehydration and hypokalemia is more absent.
likely when an underlying disease with the potential to
Cats with old healed pelvic fractures may have asym-
cause dehydration and hypokalemia is detected, and the
metry on pelvic palpation, and differences in length of
constipation or megacolon is not severe.