Acute respiratory distress syndrome and septic shock in a cat with disseminated toxoplasmosis

Abstract

The clinical and necropsy findings presented here are consistent with ARDS secondary to disseminated toxoplasmosis in a cat. This is the first detailed report of ARDS in a cat. Toxoplasma titer testing and antimicrobial prophylaxis should be considered in cats prior to immunosuppressive treatment with cyclosporine.

Clinical Toxoplasmosis in Dogs and Cats: An Update

“…Pneumonia is the main sign of generalized toxoplasmosis (25), and acute respiratory distress syndrome and septic shock may occur (26). Ocular toxoplasmosis has been observed in cats without poly-systemic clinical signs of disease, and anterior or posterior uveitis, iritis, iridocyclitis, or chorioretinitis.…”

“…It has been reported in the literature that skin nodules worsened after treatment with corticosteroids in two cats (41, 66), and three cases of generalized toxoplasmosis with pneumonia in cats were observed after cyclosporine (5, 67) and prednisolone (68) treatments. In another case, disseminated toxoplasmosis involving acute respiratory distress syndrome and septic shock occurred in a cat (26) after the use of cyclosporine for eosinophilic dermatitis treatment. Several dogs developed cutaneous toxoplasmosis after treatment with prednisone and cyclosporine against immune-mediated thrombocytopenia and immune-mediated hemolytic anemia (14, 16, 17, 69).…”

Update on feline toxoplasmosis

“…A more recent experimental study indicated that cyclosporine therapy (at a dose of 7.5 mg/kg orally once daily) did not reactivate quiescent T gondii infection in healthy cats (Lappin and others 2014). However, there have been a number of case reports linking cyclosporine therapy to toxoplasmosis reactivation, which has been fatal in some cases (Bernsteen and others 1999, Beatty and Barrs 2003, Barrs and others 2006, Evans and others 2017). Therefore, as stated above, T gondii and retrovirus serology is advisable before prescribing cyclosporine or other immunosuppressive therapies.…”

Immunsuppressive Therapie bei Hunden und Katzen. Eigenschaften von Wirkstoffen und ihre Anwendung bei verschiedenen immunvermittelten Erkrankungen

“…Opportunistische Infektionen gehören ebenfalls zu den Nebenwirkungen von Ciclosporin (11,13,32,57,58,60,62,65,87,113). Bei 32 Katzen, die mit Ciclosporin behandelt wurden, ließ sich jedoch kein bakterieller Harnwegsinfekt nachweisen (61).…”

“…Auch in einer Studie an Hunden mit immunvermittelter Polyarthritis, die entweder mit Prednisolon (1 mg/kg zweimal täglich) oder Ciclosporin (5 mg/kg zweimal täglich) behandelt wurden, traten nur in der Ciclosporingruppe opportunistische Infektionen (Demodex, Erysipelothrix) auf (87). Fallberichte (13,32,58) und eine experimentelle Studie an 30 Kat-zen (57) machten auf das Risiko von disseminierten Toxoplasmeninfektionen bei Katzen unter Ciclosporin-Therapie aufmerksam. Auch bei Hunden wurden in Einzelfällen unter Ciclosporintherapie eine disseminierte Toxoplasmose und Neosporose beschrieben (60,62,113).…”