staging.vettimes.com

Author: Kele Harris

  • Delaying investigations can sometimes be beneficial

    Clock
    Time sometimes IS on your side…

    I was called out around 11pm recently to a case of acute onset dyspnoea in a seven-year-old Siamese cat (yes, we do our own out-of-hours work – how weird is that?)

    Even with my ageing ears, I felt I could hear a crackling over the lung fields and a cardiac arrhythmia. Its mucous membrane colour was a poor grey and it had a body temperature of 35.9°C.

    Obviously, the cat’s owners were very keen to know exactly what was wrong, but I really felt any attempts at handling and investigation would tip it into crisis.

    Following a good 20mg IM dose of furosemide, some oxygen supplementation and warmth, by the following morning we had a different, happy cat.

    My colleague (who is a whizz with an ultrasound) confirmed the cat, Hugo, had hypertrophic cardiomyopathy and was in congestive heart failure, but was doing well with treatment.

    I cannot help but reflect that, in my early days, I might well have rushed to investigations in the middle of the night – perhaps with a very different outcome.

  • The value of skin biopsies

    Image: Andy Duram, source: Veterinary Times
    Image: Andy Durham / Source: Veterinary Times

    Do you have a puzzling dermatological case? Is it not responding the way you expect? I’d suggest a skin biopsy…

    I recently came across a puzzling case in a nine-year-old cocker spaniel called Olli, which presented with a persistent Pseudomonas otitis. This resolved with appropriate antibiotic therapy based on sensitivity results, but erythema and ulceration of the medial aspect of the pinna remained. The otitis then relapsed.

    No response to the food trial was evident and thyroid function was normal, so I suggested a skin biopsy, imagining the results would confirm my suspicion of idiopathic seborrhoea of the cocker spaniel.

    To my surprise, however, this was not the case.

    Histopathology reported interface dermatitis with apoptosis, suggesting it as immune-mediated or possibly drug associated. We are now starting Olli on some immunosuppressive therapy.

  • Consider low vitamin B12 levels in cats with suspected IBD

    B12 injection
    The most effective method of vitamin B12 supplementation is by injection.

    Cats with inflammatory bowel disease (IBD) may have concurrent low vitamin B12 levels (Tams, 2014).

    A case recently presented with a history of chronic intermittent vomiting, inappetence and mild weight loss. Routine biochemistry, haematology, fPL (feline pancreas-specific lipase) and faecal analysis did not reveal any abnormalities, but having recently acquired the cat, the owners were reluctant for any invasive procedures.

    Trial therapy with antibiotics, a short course of steroids and a novel protein diet produced some response. Trial therapy with weekly vitamin B12 injections for six weeks, then twice weekly for three months, produced a beneficial response.

    The cat has a good appetite, has gained weight and has not vomited for the past month (compared to twice a week prior to therapy). Tams recommends monthly ongoing vitamin B12 therapy.

    Reference: Tams T R (2014). Inflammatory bowel disease and lymphoma in cats, Proceedings of the North American Veterinary Conference, Gainsville, Florida: 1,492-1,501.