Feline Videos

What is the pathophysiology of an alveolar pattern>?

Fluid/cells within alveoli

Collapse

How do you know its an alveolar pattern?

Air bronchogram (tress in the fog)

What can cause an alveolar pattern?

Bronchopneumonia

Edema

Atelectasis

Hemorrhage

Masses (granulomatous or neoplasia)

Torsion

What is in the uvea?

Iris, ciliary body, choroid

What is anterior uveitis vs posterior uveitis?

Anterior involves iris and ciliary body

Posterior involved ciliary body and choroid

What are C/S anterior uveitis?

Aqueous flare, miosis, corneal edema, hypopyon, hypotension

What is aqueous flare?

Due to breakdown of blood-aqueous barrier and release of protein and or cells into the anterior chamber from iridal and ciliary vessels

Aqueous flare (anterior uveitis)

What are causes of anterior uveitis in cats?

Idiopathic, intraocular (cataracts or intraocular tumor), infectious (4Fs, T, and B), neoplastic (lymphoma)

What are the infectious causes of anterior uveitis?

FeLV, FIV, FIP, Fungal

Toxoplasma gondii

Bartonella henselae

How do you treat anterior uveitis?

Underlying cause if found

Is not, topical steroid, mydriatic like atropine if IOP is normal or low, oral steroid (only if negative for infectious disease)

Need to be careful not to cause a herpesvirus flareup

What are some sequelae to anterior uveitis?

Secondary glaucoma, synechia, cataracts, retinal detachment, blindness

What is the most common fungal infection in cats?

Cryptococcus

Cryptococcus

What does cryptococcus look like?

Dimorphic, basidiomycetous fungus, capsule, narrow-based budding and a thin cell wall

Where is cryptococcus found?

Pidgeon feces, decaying plants, hollows of some trees

What are the common sites of cryptococcus infection?

Nasal cavity

Skin

Lungs

CNS

What are c/s of a cat with cryptococcus/

Sneezing, stertor, nasal deformities, nasal discharge, epistaxis

What are CNS signs of cryptococcus?

Obtundation, hyperesthesia, tremors, seizures, vestibular signs, ataxia

How do you diagnose cryptococcus?

Histopathology

Serology with serum or CSF

How do you treat cryptococcus?

Azoles (fluconazole, itraconazole, ketoconazole)

Amphotericin B if there is disseminated or CNS involvement because it is fungalcidal

What is the main adverse effect of amphotericin B?

Renal toxicity

What causes demodex in cats?

Demodex cati and gatoi

Describe demodex in cats

Normal flora that is acquired from the mother as a neonate living in hair follicles, sebaceous glands, and stratum corneum

Where is the lifecycle of demodex in cats?

All on the host

Describe demodex cati

Infects hair follicles on head, neck, eyelids, face, and ear canals

Usually not pruritic and causes alopecia, scaling erythema, hyperpigmentation, and crusting

What usually causes Demodex cati infections?

Immune suppression from metabolic diseases or iatrogenic

Usually no juvenile vs adult onset forms but better prognosis in younger cats

What are your ddx for Demodex cat?

Anything that causes folliculitis (bacterial, fungal or demodex)

How do you diagnose Demodex cati?

Deep skin scraping

Hair pulcks in sensitive areas

How do you treat Demodex cati?

Treat underlying immune suppression and secondary infections

Not always needed, ivermectin, lyme sulfur, isoxazolines, advantage multi

Describe Demodex gatoi

Shorter than cati

Located superficially on stratum corneum

Pruritic on lateral thorax and abdomen

Contagious

How do you diagnose Demodex gatoi`?

Acetate tape preparations

Superficial skin scrapes

May be hard to find

How do you treat Demodex gatoi?

Treat all cats in the house for 6-10 weeks with lime sulfur

What is the estrous cycle in females?

Induced ovulators that are seasonally polyestrous long day breeders (January - September)

When does puberty start in cats?

4-6 months old

When is anestrus in cats?

October-December

What are options in diestrus in cats?

Pseudopregnancy for 35-40 days

Pregnant for 65 days

Describe proestrus

Period of follicular development for <2 days

Dominant hormone is rising estrogen

Rejects advances of the tom

Describe estrus

Sexual receptivity for 7-9 days with or without ovulation

Dominant hormone is estrogen

What is estrus behavior incats?

Face-rubbing, rolling, lordosis, kneading, elevation of perineum, vocalization

What is post-estrus in cats?

Interval between follicular waves if ovulation did not occur

What is diestrus in cats?

Period after ovulation influenced by presentation of a mature CL

Dominant hormone is progesterone

What is normal post-coital behavior in cats?

Aggression toward male

Rolling

Vocalization

Vulvar licking

What part on the tom helps promote ovulation?

Penile spines

How can cats get a herpesvirus infection?

Primary infection due to exposure to an infected carrier (shortly happens after parturition in kittens)

Recurrence due to stress of immunosuppression

What are the C/S of herpesvirus in kittens?

Nasal and ocular signs of discharge, mucoid ocular discharge, hyperemia, chemosis, symblepharon

What are signs of herpesvirus in adult cats?

Ocular signs mostly of hyperemia, chemosis, dendritic corneal ulcers, seromucoid to mucoid discharge, chronic interstitial keratitis

How do you diagnose feline herpesvirus/

Viral detection via virus isolation, IFA, or PCR

Detection of antibodies

How do you treat feline herpes virus?

Topical antivirals like idoxuridine, cidofovir, vidarabine, trifludirine or oral antivirals like famciclovir

Topical antibiotics to prevent secondary infections

Nutritional supplementation with L-lysine to reduce viral replciation

What antiviral is toxic to cats?

Valacyclovir

What is a sequelae to feline herpesvirus/

Symblepharon

Chronic keratitis

Corneal sequestrum

Eosinophilic keratitis

KCSq

Where should you give feline vaccines/

Distal rear limbs due to injection site sarcomas

What is the 1,2,3 rule for injection site sarcomas?

Biopsy any lumb continuing to grow after 1 month

Biopsy any mass greater than 2cm

Biopsy any mass present after 3 months post vaccination

How do you diagnose an injection site sarcoma?

CBC/chem/UA, thoracic rads, abdominal ultrasound

Biopsy/histopathology

CT/MRI prior to surgery

How do you treat an injection site sarcoma?

Surgery: 5cm margins and 2 fascial deeps

Radiation therapy and doxorubicin too

What are the risk factors for lymphoma?

FeLV

Immune suppression

Environmental factors

Genetics in Siamese and oriental breeds

Chronic inflammation (IBD and GI lymphoma)

Diet

What is the most common form of lymphoma in cats?

Gastrointestinal (small cell, lymphocytic, or low grade) that can present similar to IBD

Can also be large cell, lymphoblastic, or high grade form with a worse prognosis

How do you treat GI lymphoma small cell, lymphocytic, low grade in cats?

Prednisone and chlorambucil and it usually responds well to treatments

How do you treat large, cell, lymphoblastic or high grade lymphoma in cats?

Chemotherapy with CHOP and COP

Prognosis is 6-8 months with chemo

Describe mediastinal lymphoma

Thymus and sternal lymph nodes

Clinical signs are respiratory distress and pleural effusion

Often FeLV positive in young cats

Describe nodal lymphoma in cats

High grade or low grade, but less common with multiple lymph nodes at head and neck

Describe hodkins like lymphoma

Single or regional nodes at head and neck that is treated with surgery

Describe renal lymphoma in cats

Cause for renal failure, often bilateral, commonly metastasizes to the CNS

Describe nasal lymphoma in cats

Presents for sneezing, epistaxis, nasal discharge, and facial deformity

How do you diagnose lymphoma in cats?

Aspiration or biopsy

FELV and FIV tests

Staging

Bone marrow aspirate

What are the components of CHOP or L-CHOP?

L-asparaginase

Cyclophosphamide

Hydroxydaunorubicin

Oncovin

Prednisone

What is the prognosis of lymphoma in cats?

Very greatly. Not bad if low grade but less than a high if high grade

Best prognostic indicator is determined on response to therapy

What is the key difference in prognosis of lymphoma in cats vs dogs?

T vs B cell is not prognostic in cats

Describe the pancreatic duct in cats

Fuses with common bile duct and opens on the major papilla

What do acinar cells in the pancreas do?

Synthesize and store digestive enzymes

What are the parts of Islets of langerhans?

Alpha cells: produce glucagon

Beta cells: insulin

Delta cells: somatostatin

F cells: Pancreatic polypeptide

What does trypsin and chymotrypsin do?

Split whole and partially digested proteins into smaller peptides but not individual amino acids

What does carboxypolypeptidase do?

Cleaves individual amino acids

What does eastase do?

Digests elastin fibers that partially hold meats together

What digests carbs?

Pancreatic amylase then brush border enzymes digests them into glucose

What digests fats?

Pancreatic lipase

Cholesterol esterase

Phospholipase A2

Where are pancreatic enzymes activated?

Small intestine by enterokinase activating trypsinogen to trypsin which activates the rest

What can cause pancreatitis in cats?

Hyperlipoproteinemia or triglyceridemia

Drugs

Hypercalcemia

Cholinesterase inhibitors or cholinergic agonists

Scorpion venom

What is the triaditis in cats?

Pancreatitis

Cholangitis

IBD

How do you diagnose pancreatits in cats?

Pancreatic biopsy is gold standard

AUS: can show hypoechoic region with an enlarged and hyperechoic pancreas

Amylase and lipase are not specific for pancreatitis in cats

cPLI is a good screening test then a specific cPL or fPL is good

How do you treat pancreatitis?

Remove any inciting causes

Nutritional support with high calorie diets in cats with enteral feeding once no longer vomiting

Buprenorphine for pain control, antiemetics, gastroprotectants if esophagitis or GI ulcers are present, cobalamin supplementation