Feline

Question 1

What are the possible presentations of a cat with HCM?

Answer 1

1) Any age, M more severe
2) Compensated–only CS is heart murmur
3) CHF (tachypnea, dyspnea, wt. loss, anorexia)
4) Aortic thromboembolism

Question 2

List 4 differentials for secondary HCM

Answer 2

1) Systemic hypertension
2) Hyperthyroidism
3) Subaortic stenosis
4) Acromegaly

Question 3

What 2 breeds of cat are genetically predisposed to HCM?

Answer 3

Maine coon, Ragdoll; autosomal dominant (MyBPC mutation)

Question 4

What are 3 key treatments for chronic feline HCM?

Answer 4

Diuretics (furosemide), diet (low Na, palatable), dilator (enalapril, atenolol, diltiazam/amlodipine)

Question 5

What are 4 signs of aortic thromboembolism in the cat?

Answer 5

Pain, paralysis, pallor, pulselessness

Question 6

List 4 findings on an echocardiogram diagnostic of HCM

Answer 6

1) Concentric L. ventricular hypertrophy
2) > 6mm septum or L. ventricular free wall
3) Papillary hypertrophy
4) L. atrial enlargement

Question 7

List 4 radiographic findings suggestive of HCM

Answer 7

DV: valentine heart, L atrial bulge (1-3 o’clock), elongated heart
Lateral: elevated trachea, round heart silhouette

Question 8

What is a typical presentation of a cat with feline infectious peritonitis?

Answer 8

Young cats (6mo-2yrs), males, multi-cat environment;
CS: ascites, malaise, dyspnea, weak, effusion fluid, lack of other dz dx

Question 9

What are 5 tests for FIP and their positive results?

Answer 9

1) Glob/alb–hyperglobulinemia w/ low alb/glob ratio (0.9)
2) Effusion analysis–nonseptic exudate (high protein, low cells)
3) FcoV serology–titers > 1:16000 suggestive if FIP CS present (+ ONLY indicates exposure)
4) CSF analysis–high protein (>20mg/dL, >5 cells/mcL, mononuclear pleocytosis w/ neuts
5) Alpha1 acid glycoprotein–plasma or effusion >1500ug/dL suggests FIP

Question 10

What is the definitive diagnostic test for FIP?

Answer 10

Biopsy with immunohistochemistry (pyogranulomatous inflammation w/ vasculitis, virus particles in macrophages)

Question 11

Name 4 husbandry and hygienic measures that a shelter can take to prevent/control FIP

Answer 11

1) Separate sero(-) from sero(+)
2) Breed only sero(-) cats
3) Remove kittens from queens at 5-6wks
4) Add only sero(-) cats to population

Question 12

What is the Rivalta screening test for? What are positive results?

Answer 12

FIP; Positive = drop of effusion maintains shape and sinks slowly

Question 13

What is the pathophysiologic mechanism by which FIP is thought to develop in cats?

Answer 13

FIP virus replicates w/in macrophages and regional LN; virus travels systemically w/in macrophages

Question 14

What is the most common cause of feline lower urinary tract disease?

Answer 14

Cystitis followed by urolithiasis

Question 15

List 5 clinical signs of FLUTD

Answer 15

1) Strain often +/- vocalization
2) Small amounts of urine
3) Drops of bloody urine
4) In/out of urine pan
5) Obstruction

Question 16

What are 4 management recommendations for an indoor cat with obstructed FLUTD?

Answer 16

1) Environmental enrichment
2) Feeding–inc. H2O content
3) Litter–1 box per cat, clean daily
4) Encourage water drinking (multiple bowls, fresh water)

Question 17

What key message should be communicated to the owner of a cat with FLUTD?

Answer 17

Recurrence is common, risk of obstruction increases with multiple episodes

Question 18

What is the test of choice to confirm a preemptive diagnosis of feline hyperthyroidism?

Answer 18

Serum total thyroxine (TT4)–95% cats is diagnostic; if normal but CS are present, run Free T4 via equilibrium dialysis

Question 19

What are the treatment options for feline hyperthyroidism?

Answer 19

1) Radioactive iodine–tx of choice, pot. curative
2) Methimazole (Tapazole)
3) Thyroidectomy–risk of hypoparathyroidism
4) Hills y/d diet (controversial)

Question 20

What are 4 common concurrent problems with feline hyperthyroidism?

Answer 20

1) Cardiac–HCM, CHF, systolic murmur, arrhythmias
2) Systemic hypertension–systolic BP > 180
3) Renal failure–often masked by hyperthyroidism
4) Hypokalemia–neck ventroflexion, weakness

Question 21

What might be seen on an abdominal ultrasound in a cat with pancreatitis?

Answer 21

Enlarged, hypoechoic pancreas and prominent bile duct

Question 22

What is the typical presentation of a cat with pancreatitis?

Answer 22

VAGUE;
>50% show lethargy, anorexia, dehydration; 25-50% show wt. loss, hypothermia, vomiting, icterus; <25% show fever, abdominal pain, dyspnea

Question 23

What is triaditis?

Answer 23

Pancreatitis + inflammatory bowel disease + cholangitis

Question 24

What test should be performed in addition to abdominal ultrasound for suspected feline pancreatitis?

Answer 24

Serum feline pancreatic lipase immunoreactivity (Spec fPL); test of choice–high sensitivity and specificity

Question 25

What is the treatment of choice for acute feline pancreatitis?

Answer 25

IV fluids and supportive care (analgesia, anti-emetics, good nutrition)

Question 26

What is the treatment of choice for chronic feline pancreatitis?

Answer 26

Glucocorticoid trial Rx, empirically treat with praziquantel (poss. liver flukes)

Question 27

Which medication is contraindicated in the treatment of feline pancreatitis? Why?

Answer 27

Metoclopramide--decreases pancreatic perfusion

Question 28

A cat with suspected pancreatitis has a normal result on its fTLI test. What is your interpretation?

Answer 28

Normal results do not rule out pancreatitis--accurate if HIGH value

Question 29

What is the most appropriate test to perform for a presumed diagnosis of injection site sarcoma?

Answer 29

Incisional biopsy

Question 30

What are injection site sarcomas associated with?

Answer 30

Inactivated (killed) vaccines--adjuvant (rabies, FeLV); other injections, multiple injections at one site