Page 957 - Problem-Based Feline Medicine

44 – THE CAT WITH GENERALIZED WEAKNESS 949

Treatment Diagnosis

Twice daily insulin therapy is usually required to A presumptive diagnosis is based on appropriate clini-
achieve good glycemic control. See page 237 (The Cat cal signs and is supported by finding small puncture
With Polyuria and Polydipsia). wounds.

Treatment of the hyperglycemia may result in improve- Serum CK is often elevated.
ment of sciatic nerve function if substantial peripheral
Electrodiagnostic studies may reveal decreased or
nerve damage has not occurred prior to diagnosis and
absent motor unit potentials with electrical stimula-
therapy.
tion.

ENVENOMATION BY SNAKES FOUND Differential diagnosis
IN THE USA**
Other toxic neuropathies and myopathies may present
Classical signs with similar clinical signs.
● Clinical signs are usually rapid in onset
(within 24 hours of envenomation).
● Progressive lower motor neuron (flaccid) Treatment
paralysis. General supportive care is important including keep-
● Death is usually the result of respiratory
ing the cat in a warm, comfortable environment and
muscle paralysis. managing hydration status.

In the small number of cats reported with Coral snake
Pathogenesis envenomation, recovery rates have been good, usually
within 2–5 days.
Coral snake envenomation is most often seen in the
southeastern US. If respiratory paralysis results, mechanical ventilation
may be required.
Envenomation from Coral snakes results in a blockage
of transmission at the neuromuscular junction. Antivenom is available for Coral snake envenomation,
however, it may not neutralize all toxin present, and is
The exact mechanism of action of the toxin is not com- relatively expensive.
pletely defined.
Aspiration pneumonia may be a complicating factor
that will require standard treatment for aspiration
Clinical signs pneumonia.
Signs usually are seen within 2–4 hours following
envenomation, but may be delayed for several hours.
Prognosis
Cats present with a rapidly progressive lower motor
Cats reported with Coral snake envenomation have had
neuron (flaccid) paralysis.
a reasonably good prognosis for recovery.
Rectal body temperatures may be slightly decreased.
Respiratory paralysis may result in death unless respi-
Cranial nerve dysfunction (decreased palpebral rator support is available.
reflexes) may result.
Aspiration pneumonia may complicate the clinical
Respiratory paralysis can occur and result in death. signs.
Physical examination may reveal small puncture wounds Spontaneous recovery in instances with mild clinical
or the presence of small amounts of blood on the fur. signs is possible.