Objective: To characterize the clinical characteristics, electrolyte changes, acid-base changes, and renal parameters in a consecutive population of cats with urethral obstruction. Design: Retrospective clinical study. Setting: University Veterinary Teaching Hospital. Animals: Two hundred and twenty-three male cats that presented consecutively with urethral obstruction between 1997 and 1999. Interventions: None. Measurements and main results: The medical records of 223 cats with urethral obstruction were reviewed for signalment, previous medical history, indoor/outdoor status, body weight, clinical signs, physical examination findings, renal function tests (blood urea nitrogen and creatinine), and blood gas and electrolyte analysis. The majority of cats were relatively stable without serious metabolic derangements. Only 12% (24/199) of cats had severe hyperkalemia (48.0 mmol/L). Hyperkalemia did not occur in isolation; the majority of these cats had concurrent acidemia and low ionized calcium concentrations. Potassium was significantly inversely correlated with pH, bicarbonate, pCO 2 , sodium, chloride, and ionized calcium, but positively correlated with blood urea nitrogen and creatinine. Ionized calcium was positively correlated with pH and bicarbonate. Of the animals with a potassium concentration greater than 8.0 mmol/L, 75% (18/24) had an ionized calcium concentration of less than 1.0 mmol/L. Seventy-nine percent (19/24) of cats with a potassium concentration greater than 8.0 mmol/L had a blood pHo7.20. Similarly, 74% (23/31) of cats with a pHo7.20 had an ionized calcium concentration o1.00 mmol/L. Conclusions: The majority of cats with urethral obstruction presented with mild electrolyte and blood gas changes and were relatively stable, although 12% of cats had multiple, life-threatening metabolic derangements. Of 219 cats in this study, 205 (93.6%), where it could be determined, survived to discharge from the hospital, supporting the fact that most cats with urethral obstruction survive the acute episode with emergency treatment. (J Vet Emerg Crit Care 2003; 13(4): 227-233)
Results suggest that the survival rate for cats requiring PPV may be lower than reported survival rates for dogs. Death was attributable to progressive respiratory failure, non-responsive hypotension, kidney failure, or neurologic impairment.
Objective: To evaluate selected historical and physical parameters as predictors of hyperkalemia in male cats with urethral obstruction. Design: Retrospective study. Setting: Veterinary teaching hospital. Animals: Two hundred and twenty-three male cats. Interventions: None. Measurements and main results: The metabolic derangements of 223 male cats that presented with urethral obstruction from 1997 through 1999 were reported in a companion article. Approximately 12% of the cats had multiple, life-threatening metabolic derangements. In the present study, historical and physical parameters were evaluated as predictors of hyperkalemia (K 1 ! 8.0 mmol/L) in cats with urethral obstruction. The 4 historical parameters significantly associated with hyperkalemia were: first time obstruction, outdoor status, anorexia, or vomiting. The 5 physical parameters significantly associated with hyperkalemia were: rectal temperature, heart rate, respiratory rate, pulse quality, and the presence of arrhythmia. Of the physical parameters, a rectal temperature below 95-96.61F (35-35.91C) or a heart rate below 120 b.p.m. were the most accurate predictors. When used in combination (i.e., evidence of bradycardia and hypothermia), the specificity for hyperkalemia was 98-100%. Conclusions: Rectal temperature and heart rate were the best parameters for predicting hyperkalemia in this population.(
A 2-year-old female spayed domestic shorthair cat was examined because of lethargy, inappetance, vocalization, and abnormal aggressive behavior of 1 day's duration. The cat had been groomed the previous day with a d-limonene-based insecticidal shampoo. Skin lesions consisted of coalescing erythematous patches. Despite supportive care, the cat's condition deteriorated. Dermatohistopathologic changes included multifocal areas of acute coagulative epidermal necrosis. The dermis was infiltrated by a dense population of bacilli. d-Limonene toxicosis has been rarely described in dogs and cats. Toxic effects such as hypersalivation, ataxia, shivering, hypothermia, scrotal irritation, hypotension, and erythema multiforme major have been reported. Treatment for septicemia and disseminated intravascular coagulation, along with intensive supportive care, may be necessary.
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