Pulmonary lobectomy in the management of pneumonia in five cats

Lower respiratory tract infections in cats: reaching beyond empirical therapy

PRACTICAL RELEVANCE

Lower respiratory tract infections (LRTIs) in cats can be due to bacteria, parasites, fungi and viruses. This review details the practical investigation of these infections and highlights specific therapy where possible. The aim is to avoid the all-too-frequent temptation in practice to treat cats with lower respiratory tract signs empirically for feline bronchial disease (FBD)/asthma. This is potentially hazardous as immunosuppressive therapy for FBD/asthma could exacerbate disease due to a LRTI. Empirical treatment of suspected LRTI is also difficult to recommend given the wide range of potential pathogens.

CLINICAL CHALLENGES

Making a clinical ante-mortem diagnosis of LRTI in a cat can be challenging. Consistent historical, clinical, haematological and radiographic abnormalities are often lacking and findings may be non-specific. Astute clinical acumen, thorough investigation and high quality laboratory analysis are usually required for a diagnosis. Bronchoalveolar lavage, if feasible, and tests for lungworm should be routine in cats with lower respiratory tract signs. Lung fine needle aspiration may be useful in cases of diffuse or nodular pulmonary disease. Histopathology is rarely employed in ante-mortem investigations.

EVIDENCE BASE

The authors have reviewed a substantial body of literature to provide information on many of the reported bacterial, parasitic, fungal and viral pathogens, including some that occur in Asia. Attention has been given to specific therapy for each pathogen, with evidence-based comments when there is a deviation from routine recommendations.

Clinicopathologic and radiographic features and etiologic agents in cats with histologically confirmed infectious pneumonia: 39 cases (1991-2000)

OBJECTIVE

To determine clinicopathologic and radiographic features and etiologic agents in cats that died as a result of infectious pneumonia.

DESIGN

Retrospective study.

ANIMALS

39 cats.

PROCEDURE

Medical records of cats in which infectious pneumonia was confirmed by histologic examination of necropsy specimens were reviewed. Signalment, clinical signs, and results of a CBC, viral serologic tests, and thoracic radiography were evaluated. Infectious agents were classified as bacterial, viral, fungal, protozoal, or parasitic. Histologic features (severity, duration, anatomic location, and distribution) were analyzed.

RESULTS

Clinical signs referable to the respiratory tract were not detected in 14 of 39 (36%) cats, and results of a CBC (4/18 cats) and radiography (3/13) were unremarkable. Sixteen of 39 (41%) cats lacked clinical signs of systemic illness. Etiologic agents identified included bacteria (n = 21), viruses (11), fungi (6), protozoa (2), and parasites (1). Cats with clinical signs related to the respiratory tract (19/24 [79%] cats) were more likely to have severe histologic changes than cats without signs related to the respiratory system (6/14). Twenty-nine of 38 (76%) cats had histologic evidence of systemic disease, whereas the remaining cats had lesions limited to the respiratory tract.

CONCLUSIONS AND CLINICAL RELEVANCE

Infectious pneumonia is uncommon in cats. Cats with infectious pneumonia may lack clinical signs and have unremarkable results for a CBC and thoracic radiography, yet frequently have systemic infections. Therefore, clinicians should maintain an index of suspicion for pneumonia and evaluate the respiratory tract when infection is detected in other organ systems.

Recurrence of Spontaneous Lung Lobe Torsion in a Pug

Lung lobe torsion (LLT) results from a displacement and twisting of a lung lobe around its bronchovascular pedicle. This relatively rare disorder affects dogs, cats, and humans. Etiologies include primary (i.e., spontaneous) and secondary torsion due to thoracic trauma, pleural space disease, thoracic surgery, pulmonary parenchyma disease, and diaphragmatic hernia repair. Although both spontaneous and secondary torsion have been described in small-breed dogs, a spontaneous LLT followed by recurrence of a spontaneous LLT >2 years later has not been documented. This article describes the presentation, diagnosis, management, and outcome of a pug with recurrent spontaneous LLT.