Clinical course, diagnostic findings and necropsy diagnosis in dyspneic cats with primary pulmonary parenchymal disease: 15 cats (1996–2002)

Abstract

Objective: Correlate the necropsy diagnosis with the history, diagnostic findings, and clinical course of dyspneic cats with primary lung parenchymal disease. Design: Retrospective study. Setting: Matthew J. Ryan Veterinary Hospital of the University of Pennsylvania. Animals: Client-owned cats over 6 months of age hospitalized in the Intensive Care Unit (ICU) with a primary problem of respiratory distress that had pulmonary parenchymal disease on thoracic radiographs, and a complete necropsy. Interventions: None. Measurements and main results: Cats included were assigned into 2 groups based on the pulmonary histopathology: inflammatory (n 5 8) and neoplastic (n 5 7) disease. No statistical difference was found between the groups with regard to age, body weight, clinical signs, duration of clinical signs, physical examination findings, thoracic radiography, duration of hospitalization, treatment, and outcome. Cats with neoplasia had a statistically higher mean total white blood cell count (26.60 k/mL AE 10.41) than those with inflammatory lung disease (11.59 k/mL AE 4.49; P 5 0.026). Cats with bacterial or viral pulmonary disease had a significantly shorter median duration of illness (5 days, range 1-7 days) than all other cats (30 days, range 7-365 days; P 5 0.0042). Ultrasound guided pulmonary fine-needle aspiration (FNA) provided an accurate diagnosis in 5/5 cases. Conclusions: Forty-seven percent of cats with pulmonary parenchymal disease had neoplasia. The clinical diagnosis was difficult to obtain ante-mortem; lung FNA appeared to be the most helpful diagnostic tool in these cases. (J Vet Emerg Crit Care 2005; 15(1): 38-47)

Evaluation of respiratory parameters at presentation as clinical indicators of the respiratory localization in dogs and cats with respiratory distress

“…Only few and inconsistent associations between specific breathing types and localizations or diseases are described in the literature and many of them are only based on clinical impressions 1,12,26 . Our study confirms some of these associations but also shows significant differences to some commonly used, clinically relevant associations.…”

“…Auscultation findings in trauma patients were significantly associated with radiographic signs of lung contusions 19 . Pulmonary parenchyma localization has been described with clinical signs of open mouth or paradoxical respiration, 7 increased RR, 48,49 rapid shallow breathing, 49 mixed dyspnea, 29,39 or unspecified respiratory distress 26,50,51 . In our study, dogs with pulmonary parenchymal disease in combination with another localization showed a mixed type of dyspnea; this was no longer significant when dogs with isolated parenchymal diseases were evaluated.…”

“…The anatomic localization of lung parenchyma includes many different disease processes such as bleeding, inflammation, infection, and neoplasia 24–26,45 . Thoracic radiographs often show an infiltrative pattern localizing the problem to the pulmonary parenchyma, but often do not provide a specific diagnosis 46,47 .…”

Acute bronchointerstitial pneumonia in two indoor cats exposed to the H1N1 influenza virus

“…Tracheal wash samples allow for both cytologic evaluation and microbial culture and sensitivity . There is some evidence that fine‐needle aspirate of the lung may have better yield than endotracheal wash in cats with unexplained pulmonary parenchymal disease . Viral testing, fungal titers, fecal examination, and serology for heartworm disease and toxoplasmosis may be considered on a case‐by‐case basis .…”

“…20 There is some evidence that fine-needle aspirate of the lung may have better yield than endotracheal wash in cats with unexplained pulmonary parenchymal disease. 41 Viral testing, fungal titers, fecal examination, and serology for heartworm disease and toxoplasmosis may be considered on a caseby-case basis. 40 The authors suggest viral testing include feline herpes virus, calicivirus, H1N1 influenza, feline leukemia virus, and feline immunodeficiency virus.…”