3 yo F/S Siamese mix, lives in the cat room at a rescue with many other cats. Unknown history.
Anorexia and vomiting (bile) for 3 days, dehydrated, fever 104.3 yesterday, none today (had Convenia last night).
High bili 3.6, normal liver enzymes, high Glob, normal Alb, high SMDA 22, low BUN/Creat, low HCT 31, low Na, normal K.
U/a pending, suspect pyelonephritis, hyperechoic foci in the medulla of both kidneys, decreased cortico-medullar junction, normal size (4cm), dark/cloudy urine.
Liver, GB, CBD, pancreas WNL.
3 yo F/S Siamese mix, lives in the cat room at a rescue with many other cats. Unknown history.
Anorexia and vomiting (bile) for 3 days, dehydrated, fever 104.3 yesterday, none today (had Convenia last night).
High bili 3.6, normal liver enzymes, high Glob, normal Alb, high SMDA 22, low BUN/Creat, low HCT 31, low Na, normal K.
U/a pending, suspect pyelonephritis, hyperechoic foci in the medulla of both kidneys, decreased cortico-medullar junction, normal size (4cm), dark/cloudy urine.
Liver, GB, CBD, pancreas WNL.
Thickened guts (mild), Reactive LN 5-6mm, near the guts and both kidneys: IBD vs FIP vs lymphoma.
Rec Corona serology, supportive care, FNA LN next. I am concerned about dry form FIP given the hx.
Question: Large adrenals (5-6mm wide). Is that just a normal variant? I thought adrenals in cats were under 4.5mm. She weighs 9.4#, BSC 5.5/9.
Thanks!
Julie
Comments
Most likley disease-related
Most likley disease-related hyperplasia as would expect hypokalamia with Cohn’s syndrome. Signs are suspicious for FIP. Consider running serum protein electophoresis..
Thank you Dr. Lobetti! You
Thank you Dr. Lobetti! You recommend the protein electrophoresis instead of Corona serology?
Her HCT dropped a little too, and with the fever and fleas, I was wondering about Mycoplasma too.
Julie
Positive serology merely
Positive serology merely means exposure to a Corona virus, with FIP would expect a broad based hypergammaglobulinemia. Hemoplasma also possible.
Thank you for your
Thank you for your input.
Julie
With the high bili and
With the high bili and anemia i would think hemolytic or salmonella as with liver disease the bilirubin should be accopanied by SAP (especially in cats with SAP short half life) and usually ALT as well is up if the bili is hepatic in origin.
Thank you Eric! Salmonella is
Thank you Eric! Salmonella is def possible. She had “strawberry milkshake” diarrhea on the first day. It resolved with Convenia, which was given before the u/s.
Julie
regarding the adrenals, even
regarding the adrenals, even though some studies have discounted the fact that it measurable change occurs, the stress adrenal swelling in cats i think is real perhaps more in the hypoechoic parenchyma more so than actual measurable enlargement. I see it when systemically stressed as th eadrenals jump on the probe like they did here.
Wow, it is good to know that
Wow, it is good to know that stressed cat adrenals do that. They really jumped at me, and I didn’t know how to fit that with the clinical picture. I always look for the cherry tomatoes, but these were obvious. Thanks!
Julie