Today's Veterinary Practice

SEP-OCT 2016

Today's Veterinary Practice provides comprehensive information to keep every small animal practitioner up to date on companion animal medicine and surgery as well as practice building and management.

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Today's Ve T erinary Prac T ice | s eptember/ o ctober 2016 | tvpjournal.com TH e ye LL o W ca T: dia G nos T ic & TH era P e UT ic s T ra T e G ies Peer r eviewed 42 found in tropical environments, such as Florida, the Caribbean, and Hawaii, where land snails, lizards, and toads are the hosts. Infection is usually subclinical, although cats may present with nonspecific signs (Table 1). DIAGNOSTIC APPROACH TO AN ICTERIC CAT As with any diagnostic approach, the clinical evaluation of an icteric cat begins with signalment, history, and physical examination. Signalment The list of differentials for hyperbilirubinemia (Table 1) include breed-specific entries (eg, Abyssinian) and diseases that occur in certain age groups (eg, feline infectious peritonitis [FIP]). For many differentials the patient history is similar. History & Clinical Signs Anorexia is a key component in the presentation of cats with hepatic lipidosis and appears to be an early clinical manifestation of anemia in cats. l ethargy Table 2. Hyperbilirubinemia in Cats: Differential Diagnoses, Diagnostics, & Hyperbilirubinemia in Cats: Differential Diagnoses, Diagnostics, & t reatment D i FF erenti AL D i A gn OS e S D i A gn OS ti CS tre A t M ent OP ti O n S Pre H e P ati C Hy P erbi L irubinemia Mycoplasma species 23 Complete blood count (CBC) Blood smear Serum biochemical profile Polymerase chain reaction (PCR) Doxycycline, 5 mg/kg PO Q 12 H for 14 d Pradofloxacin, 5 mg/kg PO Q 24 H for 14 d Enrofloxacin, 5 mg/kg PO Q 24 H for 14 d Cytauxzoon felis 24 s CBC Blood smear PCR Atovaquone, 15 mg/kg PO Q 8 H Azithromycin, 10 mg/kg PO Q 24 H Feline infectious peritonitis Babesia species CBC Blood smear PCR FIP: Supportive care Polyprenyl Immunostimulant (sassandsass.com) Pentoxifylline, 10 mg/kg PO Q 12 H Prednisolone, 2–4 mg/kg PO Q 24 H Babesiosis: Imidocarb diproprionate, 2.5 mg/kg IM Doxycycline, 10 mg/kg/day PO for 21 d Feline leukemia virus Feline immunodeficiency virus FeLV: p27 antigen test FIV: Antibody test Blood transfusion Supportive care Antiviral treatment Medical therapy: • Prednisolone, 2.2 mg/kg Q 12 H • Cyclosporine, 5 mg/kg Q 24 H • Chlorambucil, 2 mg/cat Q 3 days • Mycophenolate mofetil, 10 mg/kg Q 12 H i mmune-mediated hemolytic anemia 8,25 (primary, excluding identifiable causes) Saline agglutination Coombs' test In one report: 8 Anemia was severe, with median packed cell volume of 12% Prednisolone, 2.2 mg/kg PO Q 12 H Mycophenolate mofetil, 10 mg/kg Q 12 H e rythrocyte PK deficiency 26 Genetic testing Breeding practices Supportive care Ursodeoxycholic acid, 5−15 mg/kg Q 24 H i ncreased erythrocyte osmotic fragility 27 n eonatal isoerythrolysis 28 Appropriate blood typing prior to breeding Supportive care Cardiovascular support t ransfusion reaction 29 Pretesting donors Blood-typing Crossmatching Supportive care Cardiovascular support h ypophosphatemia 30,31 Electrolyte monitoring Supportive care Treatment of underlying conditions Microangiopathic hemolytic anemia 32 CBC with platelets Clotting times Intensive monitoring Cardiovascular support Treatment of underlying conditions Drugs, toxins, envenomation, oxidative stress Various toxin assays Blood smear Remove exposure Reduce remaining burden (eg, emesis) Support of target organs Support of target organs Plasmapharesis

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