Top 20 Feline Conditions Part 1

For my own personal use only:
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mother cat and kittens
  • This list of the top 20 feline conditions is the purrfect preparation for boards success!
  1. Feline leukemia virus (FeLV)
    FeLV-associated lymphosarcoma in the mesentery at the ileocolic junction
    • Classic case:
      • Kitten or young adult, free-roaming, usually male
      • "Ain't Doin' Right" (ADR)
      • +/- Abdominal or thoracic masses
    • Dx:
      • CBC: Leukopenia, neutropenia
      • Radiography: Thorax and abdomen for FeLV-associated lymphosarcoma
      • Screen: Serum ELISA
      • Confirmation: IFA
    • Tx:
      • Supportive: Antibiotics, nutritional support, fluids
      • Stress-free environment
      • Separate from FeLV-negative cats
    • Pearls:
      • Prognosis: Fair to poor
      • Transmission: Saliva exchange
      • Vaccinate kittens against FeLV; continue vaccinations if high risk
      • IFA-positive cats persistently infected for life

  2. Feline immunodeficiency virus (FIV)
    FIV-positive, FeLV-negative ELISA test
    • Classic case:

      • Mature cat, usually intact male, lives outdoors, previous bite wounds
      • Gingivitis, stomatitis
      • ADR, fever, anorexia, lethargy
    • Dx:
      • CBC: Anemia, leukopenia (esp. neutropenia), thrombocytopenia
      • Screen: Serum ELISA (false positive if vaccinated)
      • Confirmation: Western blot (false positive if vaccinated)
    • Tx:
      • Supportive: Antibiotics, fluids, nutritional support
      • Dental care
    • Pearls:
      • Prognosis: Good to excellent, most do well for years
      • Some cats develop AIDS-like disease with profound neutropenia
      • Test before FIV vaccination

  3. Feline hyperthyroidism
    • Classic case:
      • Middle-aged or older cat
      • Weight loss with increased appetite
      • Vomiting, diarrhea
      • Murmur, tachycardia, arrhythmia
      • "Yowling" at night
      • Palpable thyroid nodules
      • Thyroid gland (6)
    • Dx:
      • Screen: Total T4 (TT4) – may be high-normal with concurrent disease (euthyroid sick syndrome)
      • Thyroid scintigraphy
      • Echocardiogram and blood pressure
    • Tx:
      • Iodine 131 (I-131)
        • Gold standard
        • Most cases cured with ONE dose
      • Anti-thyroid medication (methimazole, felimazole, tapazole)
        • Controls, but does not cure, many side effects
      • Thyroidectomy: Risk of accidental parathyroid removal and life-threatening hypocalcemia
      • Diet: Iodine restriction
    • Pearls:
      • Prognosis: Fair to excellent
      • Adenomatous hyperplasia most common, neoplasia uncommon
      • Less common presentation is "apathetic hyperthyroid": Anorexia, lethargy, etc.
    • Click here to see a thyroid nodule in a cat from the Merck Vet Manual

  4. Hepatic lipidosis
    Nutritional support with an esophageal feeding tube is often necessary to treat hepatic lipidosis
    • Classic case:
      • Obese cat with several-day history of anorexia
      • Weight loss, jaundice
      • Ptyalism when hepatic encephalopathy (HE) present
    • Dx:
      • Serum biochemistry: ALP higher than ALT, total bilirubin increased, normal GGT (helps differentiate from other hepatobiliary diseases)
      • Coagulopathies
      • Abdominal ultrasound
      • Liver fine-needle aspirate (FNA) or biopsy
    • Tx:
      • Nutritional support is key
        • Esophagostomy tube
        • High-quality, high-protein diet (unless HE present)
      • Avoid glucocorticoids
      • If HE: Lactulose retention enemas
    • Pearls:
      • Prognosis: Fair to excellent
      • Treat hyporexic and anorexic cats promptly and aggressively

  5. Chronic renal disease
    Subcutaneous fluids administered at home to a cat with chronic renal disease
    • Classic case:

      • Senior or geriatric cat
      • Polyuria and polydipsia
      • Weight loss, vomiting
      • Lethargy, hyporexia/anorexia
      • Small, lumpy, bumpy kidneys
    • Dx:
      • Azotemia and hyperphosphatemia
      • +/- Hypokalemia and anemia
      • Dilute or isosthenuric urine
      • High blood pressure
      • Urine protein:creatinine ratio > 0.4
      • Abdominal ultrasonography
    • Tx:
      • Supportive care: Appetite stimulants, anti-emetics, H2-blockers, fluids, K+ supplements, anti-hypertensive medication, phosphorus binders
      • Nutrition: Renal prescription diets
    • Pearls:
      • Prognosis: Poor to good, depending on severity and concurrent illnesses

Images courtesy of Stephanb (queen with litter), Dr. Uwe Gille (mesenteric lymphosarcoma, subcutaneous fluids), Kalumet (FIV/FeLV ELISA), Anatomy of the Cat (thyroid anatomy), AGarren (cat with feeding tube), and Art man (cat nose).

Feline