Page 800 - Problem-Based Feline Medicine

792 PART 9 CAT WITH SIGNS OF GASTROINTESTINAL TRACT DISEASE

not have overt accompanying clinical signs on Treatment
physical examination, such as idiopathic megacolon,
The perineal area should be clipped and cleaned.
acute or chronic colitis, and litterbox dissatisfaction.
Wounds and/or abscesses should be debrided and
This is done by taking a thorough drug and litterbox
flushed with saline or an aqueous iodine solution.
history.
Feces should be kept soft by the use of laxatives
and/or dietary fiber supplements until healing has
Treatment occurred. See page 785 (Constipation (including idio-
pathic megacolon)).
The condition resolves once the causative drug is
Oral antibiotics, such as doxycycline (5 mg/kg q 12 h
withdrawn.
8 days) should be prescribed.

PERINEAL INFLAMMATION/INFECTION DYSAUTONOMIA

Classical signs Classical signs
● History of pain or sensitivity in the perianal ● Mostly young adult cats (< 3 years of age).
region or evidence of perianal wound or ● Acute onset of depression and anorexia
abscess. over 48 h.
● Signs of constipation. ● Constellation of signs including
regurgitation, constipation, mydriasis and
dry eyes.
Clinical signs ● ± Protrusion of the third eyelids,
bradycardia and dysuria.
Cats are presented with a history of pain or sensitivity
in the hindquarters, and sometimes a reluctance to sit or
an unusual sitting posture. On inspection of the per- Pathogenesis
ineum, there may be hair loss and/or matting, and
Dysautonomia is an idiopathic condition character-
wounds or abscessation. Sometimes, an abscess is asso-
ized by widespread degeneration of the autonomic
ciated with one of the anal sacs.
ganglia.
Signs or history of constipation are present because
The condition was originally reported in the UK and
pain associated with defecation promotes fecal
Europe, but is rarely recognized at this time. There are
retention.
rare reports of affected cats in the USA. While some of
these cats were imported from the UK, a small number
were bred in USA.
Diagnosis
Recent evidence suggests that Clostridium botulinum
The condition is self-evident, but in some cats, heavy
type C neurotoxin may be involved. The toxin was
sedation or general anesthesia may be required to
detected in the feces or ileum contents in affected cats,
thoroughly inspect the area.
and also in their dry food, but not in healthy control
cats. Fourteen weeks after the outbreak, IgA antibodies
to the toxin and organism were significantly higher in
Differential diagnosis
the feces of affected cats compared to unaffected cats.
Perineal inflammation or infection should be differenti-
Both sympathetic and parasympathetic nervous sys-
ated from other conditions causing matting of the
tems are affected.
perineal hair, such as chronic diarrhea or conditions
causing poor grooming. This is done by performing The predominance of gastrointestinal signs relates to
a thorough physical examination including the per- failure of parasympathetic stimulation of esophageal,
ineal region. gastric and colonic motility.