Bacterial culture of blood from critically ill dogs and cats: 100 cases (1985-1987)

Of 100 critically ill dogs and cats, 49 (39 dogs, 10 cats) had bacteremia. Gram-negative bacilli were the most common isolates from the bloodstream of dogs with bacteremia (46%), and gram-positive cocci and anaerobic bacteria were isolated from 36% and 31% of positive cultures, respectively; 15% of positive cultures were polymicrobial. In cats, gram-negative bacilli (especially Salmonella enteritidis) and anaerobic bacteria were the most common isolates, and 30% of positive cultures were polymicrobial. Gram-positive cocci were not isolated from the blood-stream of cats. Odds ratios, adjusted for the combined effects of disease status (severe vs nonsevere), results of bacterial culture of blood result (positive vs negative), and species (dog vs cat) were calculated for mortality in animals in the study. In animals with bacteremia, severe disease increased the risk of death 11.6-fold, compared with the risk in animals with nonsevere disease. Bacteremia increased mortality 10-fold in animals with severe disease, compared with mortality in animals with severe disease without bacteremia. Animals with severe disease and bacteremia were 15.6 times more likely to die than were those with nonsevere disease and negative culture results. In animals with nonsevere disease, culture results (positive vs negative) were not related significantly to mortality. Disease status (severe vs nonsevere) in animals without bacteremia also was not significantly related to mortality. There was no significant difference in overall mortality in dogs, compared with that in cats.(ABSTRACT TRUNCATED AT 250 WORDS)     

Blood culture isolates and antimicrobial sensitivities from 427 critically ill neonatal foals

OBJECTIVE: To assist correct decision-making about antimicrobial treatment of equine neonates with septicaemia. DESIGN: Retrospective study of microbial blood culture results obtained from foals less than 7 days of age. METHODS: Microbial blood culture results from foals less than 7 days of age admitted to an intensive care unit between July 1999 and December 2004 were reviewed. Antimicrobial sensitivity was assessed by the Kirby Bauer disc diffusion method. Antimicrobials were defined as an effective first-line choice antimicrobial if greater than 70% of isolates were susceptible. Multiple drug resistance (MDR) was defined as resistance to at least three antimicrobials in different chemical classes or with different mechanisms of resistance. RESULTS: Of the 427 Thoroughbred foals included in the study, a positive blood culture was obtained in 110 foals and 124 microorganisms were isolated. Gram-positive isolates, predominantly Streptococcus/Enterococcus spp, were obtained in 41% of foals. Gram-negative isolates were predominantly of the Enterobacteriaceae family, in particular Escherichia coli. The overall antimicrobial sensitivity of the isolates was low. The Gram-positive organisms had unpredictable sensitivity patterns. MDR was recorded in 32% of isolates. In total, 81% of foals were discharged from hospital and 74.5% of foals with a positive blood culture were discharged. CONCLUSION: With the increasing prevalence of Gram-positive microorganisms and their unpredictable sensitivity patterns, blood cultures remain important in the diagnosis and treatment of equine neonatal septicaemia.     

Bacterial isolates from equine infections in western Canada (1998-2003)

All bacterial samples of equine origin submitted to the diagnostic laboratory at the Western College of Veterinary Medicine from January 1998 to December 2003 from either "in-clinic" or Field Service cases were accessed (1323 submissions). The most common bacterial isolates from specific presenting signs were identified, along with their in vitro antimicrobial susceptibility patterns. The most common site from which significant bacterial isolates were recovered was the respiratory tract, followed by wounds. Streptococcus zooepidemicus was the most common isolate from most infections, followed by Escherichia coli. Antimicrobial resistance was not common in the isolates and acquired antimicrobial resistance to multiple drugs was rare. The results are compared with previous published studies from other institutions and used to suggest appropriate antimicrobial treatments for equine infections in western Canada.     

Nonenteric Escherichia coli isolates from dogs: 674 cases (1990-1998)

OBJECTIVE: To determine nonenteric sites associated with Escherichia coli isolates in dogs and the antimicrobial susceptibilities of the isolates. DESIGN: Retrospective study. SAMPLE POPULATION: 17,000 canine specimens. PROCEDURE: Medical records of 17,000 canine specimens submitted for bacteriologic culture were examined and the number of isolations of E coli was determined. For these cases, records were further examined with respect to body system involvement, sex, concurrent infection with other species of bacteria, and antimicrobial susceptibility. RESULTS: 674 E coli isolates (424 from urine, 62 from the skin, 52 from the respiratory tract, 45 from the ear, 43 from the female reproductive tract, 25 from the male reproductive tract, and 23 from other organ systems) were identified. There was a significantly higher proportion of isolates from urine specimens from spayed females than from sexually intact females or males. Escherichia coli was isolated in pure culture from 65.9% of the specimens. Most E coli isolates were susceptible to norfloxacin (90%), enrofloxacin (87.5%), gentamicin (90.7%), and amikacin (85.9%). CONCLUSIONS AND CLINICAL RELEVANCE: Most nonenteric E coli infections in dogs involve the urinary tract. Amikacin, gentamicin, norfloxacin, and enrofloxacin have the highest efficacy against canine E coli isolates. For E coli isolates from dogs, in vitro susceptibility to commonly used antimicrobial agents has remained fairly stable during the past decade.     

Characterization of Clostridium difficile isolates from foals with diarrhea: 28 cases (1993-1997)

OBJECTIVE: To determine molecular characteristics of Clostridium difficile isolates from foals with diarrhea and identify clinical abnormalities in affected foals. DESIGN: Retrospective study. ANIMALS: 28 foals with C difficile-associated diarrhea. PROCEDURE: Toxigenicity, molecular fingerprinting, and antibiotic susceptibility patterns were determined. Information on signalment, clinical findings, results of clinicopathologic testing, whether antimicrobials had been administered prior to development of diarrhea, and outcome was obtained from the medical records. RESULTS: Twenty-three (82%) foals survived. Toxin A and B gene sequences were detected in isolates from 24 of 27 foals, whereas the toxin B gene alone was detected in the isolate from 1 foal. Results of an ELISA for toxin A were positive for fecal samples from only 8 of 20 (40%) foals. Ten of 23 (43%) isolates were resistant to metronidazole. Molecular fingerprinting revealed marked heterogeneity among isolates, except for the metronidazole-resistant isolates. Sixteen foals had tachypnea. Hematologic abnormalities were indicative of inflammation. Common serum biochemical abnormalities included metabolic acidosis, hyponatremia, hypocalcemia, azotemia, hypoproteinemia, hyperglycemia, and high enzyme activities. Passive transfer of maternal antibodies was adequate in all 12 foals evaluated. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that a large percentage of C difficile isolates from foals with diarrhea will have the toxin A and B gene sequences. Because of the possibility that isolates will be resistant to metronidazole, susceptibility testing is warranted. Clostridium difficile isolates from foals may have a substantial amount of molecular heterogeneity. Clinical and hematologic findings in affected foals are similar to those for foals with diarrhea caused by other pathogens.     

Radiographic patterns of periodontitis in cats: 147 cases (1998-1999)

OBJECTIVE: To determine patterns of alveolar bone loss (periodontitis) and other lesions evident on full-mouth survey radiographs of cats. DESIGN: Retrospective study. ANIMALS: 147 cats. PROCEDURE: Full-mouth radiographs were evaluated for evidence and severity of alveolar bone loss, odontoclastic resorption lesions (ORL), retained roots, missing teeth, signs of endodontic disease secondary to periodontitis, and apical resorption. RESULTS: 106 (72%) cats had some degree of periodontitis, 100 (68%) were missing teeth, 98 (67%) had ORL, 78 (53%) had expansion of the buccal alveolar bone at 1 or more canine teeth, 75 (51%) had retained roots, 48 (33%) had apical resorption, and 12 (8%) had signs of endodontic disease secondary to periodontitis. Cats < 4 years old were not significantly more likely than the general population to have normal alveolar bone height. Prevalence of ORL increased with age, but cats > or =13 years old were less likely than the general population to have moderate or severe generalized periodontitis. Purebred cats were not significantly more likely to have periodontitis or ORL than mixed-breed cats. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that periodontitis is common in cats and that horizontal bone loss is the most common radiographic pattern of alveolar bone loss. Purebred cats were not more likely than mixed-breed cats to have ORL or periodontitis, but when they did have periodontitis, it was more likely to be moderate to severe. Cats with ORL were less likely than cats without ORL to have normal alveolar bone height and more likely to have severe focal vertical bone loss.     

Nasopharyngeal diseases in cats: a retrospective study of 53 cases (1991-1998)

The records of 53 cats with nasopharyngeal disease were examined. Of the cats with nasopharyngeal disease, 49% had lymphosarcoma and 28% had polyps. Clinical signs in these cats were compared to 24 cats with nasal disease alone. Cats with only nasal disease more commonly had historical nasal discharge and sneeze, whereas cats with nasopharyngeal disease more often had stertorous respiration, phonation change, and typically reported less nasal discharge or sneeze. It is important to include nasopharyngeal disease in the differential diagnosis for cats with nasal discharge, sneeze, stertor, or phonation change.     

Medical treatment of cholangiohepatitis and cholelithiasis in mature horses: 9 cases (1991-1998)

The medical approach to treatment of cholangiohepatitis and cholelithiasis in 9 horses is described. Seven horses were treated successfully and returned to normal use, with a minimum follow-up period of 12 months. Long-term antimicrobial therapy was believed to be critical in those cases that survived, with a median treatment duration of 51 days (range 17-124 days). Treatment failure was associated with severe periportal and bridging hepatic fibrosis from biopsy material obtained at admission in 2 horses, one of whom also presented with hyperammonaemic hepatic encephalopathy. Transabdominal ultrasound was used diagnostically in each case to obtain hepatic biopsy material for histopathology and bacterial culture, to evaluate hepatic size and echogenicity and to identify and monitor the dissolution of hepatoliths. Histologically, all horses had evidence of suppurative cholangiohepatitis with varying degrees of periportal and bridging fibrosis. Discrete hyperechoic calculi were identified in 4 cases, but all horses had ultrasonographic evidence of biliary obstruction with numerous dilated bile ducts. Aerobic and anaerobic cultures of liver biopsy material were negative from 7 horses, but 2 different species of Escherichia coli were obtained from one horse, and Bacteroides vulgatus and Escherichia coli were isolated from another. In all 7 horses that survived, clinical recovery was seen before normalisation of biochemical indices of hepatobiliary function including gammaglutamyl transaminopeptidase (GGT), alkaline phosphatase (AP), bile acids and serum bilirubin. Serum GGT levels were monitored extensively as a marker of hepatobiliary disease and actually increased during the initial period of clinical improvement in horses that recovered. Supportive medical therapy with i.v. fluids was also a critical part of the therapy of several cases in this report, both acutely and in the management of chronic cases that deteriorated clinically during treatment. Previous therapeutic failures may well be related to treatment periods of inadequate duration, and the authors recommend that antimicrobial therapy should be continued until GGT values are normal.     

Relationship between Doppler blood pressure and survival or response to treatment in critically ill cats: 83 cases (2003-2004)

OBJECTIVE: To evaluate the relationship between Doppler blood pressure (DBP) and survival or response to treatment in critically ill cats. DESIGN: Retrospective case series. ANIMALS: 83 cats. PROCEDURES: Medical records from cats admitted to the intensive care unit with at least 2 recorded DBP measurements were included in the study. Hypotension was defined as 1 or more DBP measurements d 90 mm Hg. Change in blood pressure, survival to hospital discharge, heart rate, rectal temperature, PCV, plasma pH, serum ionized calcium concentration, disease process, body weight, age, duration of hospitalization, and catecholamine treatment were also evaluated. RESULTS: 39 cats were included in the hypotensive group, and 44 were consistently normotensive. Overall survival rate was 53% (44/83), with a significantly higher mortality rate in the hypotensive group (64% vs 32%). Among other variables, only low rectal temperature and low PCV were significantly associated with hypotension. Hypotensive cats with an increase in blood pressure of >or=20 mm Hg during hospitalization were more likely to survive to discharge (mortality rate, 69% vs 17%). CONCLUSIONS AND CLINICAL RELEVANCE: Hypotensive cats had increased mortality rate with lower rectal temperatures and lower PCV, compared with normotensive critically ill cats. The implications of these findings with regard to treatment remain to be elucidated, but addressing these abnormalities may be appropriate.     

Evaluation of use of human albumin in critically ill dogs: 73 cases (2003-2006)

OBJECTIVES: To evaluate the use of human albumin in critically ill dogs. Design-Retrospective case series. ANIMALS: 73 client-owned hospitalized dogs. PROCEDURES: Medical records of dogs that received human albumin were reviewed to assess effects of the use of human albumin on serum albumin concentration, colloid osmotic pressure, and total protein concentration; determine the relationships between these variables and outcome; and assess its safety. Data for signalment, diagnoses, physiologic variables, dosage, amount of crystalloid fluid administered prior to human albumin administration, complications, and outcome were reviewed. Additionally, pre- and postadministration values for serum albumin, colloid osmotic pressure, and total protein were recorded. RESULTS: Administration of human albumin resulted in significant changes in serum albumin, colloid osmotic pressure, and total protein. The serum albumin, total protein, degree of improvement in serum albumin, colloid osmotic pressure, and dosage of human albumin were significantly greater in survivors. Seventeen of 73 (23%) dogs had at least 1 complication that could be potentially associated with the administration of human albumin that occurred during or immediately following administration of human albumin. Three of 73 (4%) dogs had severe delayed complications. CONCLUSIONS AND CLINICAL RELEVANCE: Administration of human albumin significantly increased serum albumin, and total protein concentrations and colloid osmotic pressure, especially in survivors. Because of the high mortality rate of the study population and other confounding factors, it was uncertain whether complications were associated with the underlying disease or with human albumin administration. Acute and delayed complications may have been under-recognized.     

Causes of caprine abortion: diagnostic assessment of 211 cases (1991-1998).

In an 8-year period, 1991-1998, 217 accessions of caprine abortions were submitted to the California Veterinary Diagnostic Laboratory System. Of these 217 submissions, 211 were suitable for examination in this study (6 had insufficient data). Infectious agents as the cause of abortions were found in 37% of the cases: bacterial agents were identified in 30.5%, viral agents in 2%, fungal agents in 0.5%, and protozoal agents in 4% of the cases submitted. The most common causes of abortions were Chlamydia psittaci and Coxiella burnetii infection, which accounted for 23% of all goat abortions. Mineral deficiencies were observed in 4%, fetal anomalies accounted for 3%, and leukoencephalomalacia of the brain (probable oxygen deprivation) accounted for 3% of the submissions. No diagnosis was made in 112 of the 211 submissions (53%). No lesions were noted in 104 of the submissions (49%). The other 8 submissions (4%) had histologic lesions suggestive of a bacterial agent; however, no infectious agents were identified in these cases.     

Tracheostomy in cats: 23 cases (1998-2006)

Tracheostomies can be used to provide a patent airway in animals with upper airway obstruction but have been reported to be more difficult to manage in cats than in other animals. The purpose of this study is to retrospectively describe the indications, complications and outcome of cats undergoing tracheostomy. Twenty-three cats underwent tracheostomy for laryngeal mass (n=13), trauma (n=5) and upper airway swelling (n=5). Major and minor complications were recorded in 10 and 17 cats, respectively. Seventeen cats were discharged to home, four cats were euthanased and two cats died in hospital. Complications with stoma healing were reported in one cat. Of seven cats discharged with a permanent tracheostomy, one cat is alive and six cats survived at home for between 2 and 281 days. Although complications are common, temporary tracheostomies can be beneficial for conditions in which the underlying cause can be treated. Despite risk of occlusion, permanent tracheostomies can be effective palliative procedures for cats with severe upper airway disease.     

Eclampsia in dogs: 31 cases (1995-1998)

OBJECTIVE: To compare clinical characteristics and laboratory findings of dogs with eclampsia with those of dogs without eclampsia. DESIGN: Retrospective study. ANIMALS: 31 dogs with eclampsia (affected) and 31 with dystocia (controls). PROCEDURE: Information on signalment, type of diet, reproductive history, litter size, time from whelping to eclampsia, body weight, clinical signs, results of physical examination and hematologic and biochemical analyses, response to calcium supplementation, and recurrence was obtained from the medical records of all dogs with eclampsia evaluated between 1995 and 1998 and compared with information from medical records of 31 of 102 dogs with dystocia evaluated during the same period. RESULTS: Dogs with eclampsia weighed less, had a smaller body weight-to-litter size ratio, higher rectal temperature and heart and respiratory rates, and lower plasma total solids concentration than control dogs. Ionized calcium concentration was < or = 0.8 mmol/L for all but 1 of the affected dogs; median concentration for the affected dogs was significantly less than that for control dogs. Six (19%) dogs did not manifest typical clinical signs associated with eclampsia. Twelve (39%) dogs with eclampsia had previous litters; none had a history of eclampsia. Affected dogs were discharged from the hospital within hours after admission, but 3 dogs returned 1 to 3 weeks later because of recurrence of eclampsia. CONCLUSIONS AND CLINICAL RELEVANCE: Eclampsia develops primarily in small-breed dogs with large litters. Plasma ionized calcium concentrations > 0.8 mmol/L in dogs with clinical signs typical of hypocalcemia may indicate that other causes of clinical signs should be considered. In addition, some dogs with eclampsia may have low ionized calcium concentrations and not manifest typical clinical signs.     

Zinc intoxication in dogs: 19 cases (1991-2003)

OBJECTIVE: To determine physical examination findings, clinicopathologic changes, and prognosis in dogs with zinc toxicosis. DESIGN: Retrospective case series. ANIMALS: 19 dogs with zinc toxicosis. PROCEDURES: Medical records from 1991 through 2003 were searched for animals with a diagnosis of zinc toxicosis. Information concerning signalment, body weight, historical findings, initial owner complaints, physical examination findings, clinicopathologic findings, blood zinc concentrations, source of zinc, treatments given, duration of hospital stay, and outcome was collected. RESULTS: Records of 19 dogs with zinc toxicosis were reviewed.The most common historical findings were vomiting (n = 14) and pigmenturia (12). The most common clinicopathologic findings were anemia (n = 19) and hyperbilirubinemia (12). Median age was 1.3 years, and median weight was 5.6 kg (12.3 lb). The prognosis was favorable, with 17 dogs surviving after a median hospital stay of 2 days. CONCLUSIONS AND CLINICAL RELEVANCE: Hemolytic anemia as a result of zinc toxicosis appeared to affect young small-breed dogs more frequently than older large-breed dogs. The prognosis with treatment is good, and most affected dogs had a short hospital stay.     

Umbilical cord remnant infections in foals: 16 cases (1975-1985)

Infection of the umbilical cord remnants was diagnosed in 16 foals. The infection was found in the urachus alone in 3 foals, the umbilical arteries in 2 foals, the urachus and umbilical arteries in 3 foals, the urachus and umbilical vein in 2 foals, and the urachus, umbilical vein, and umbilical arteries in 2 foals. The specific location of the infection was not determined in 4 foals. Eleven foals developed an acquired patent urachus between 4 and 16 days of age. Seven foals had one or more joints infected. All foals with umbilical cord remnant infections were treated with orally, intramuscularly, or intravenously administered antibiotics and 9 foals had the umbilical cord remnants excised. Nine foals survived, 6 of which had had excision of the infected remnants. Only 2 foals with joint infections survived.     

Mechanical ventilation in foals with botulism: 9 cases (1989-2002)

"Shaker foal" disease, toxicoinfectious botulism of foals, was 1st described as a clinical entity in 1967. The reported mortality rate was 90%, with death occurring within 24-72 hours of the onset of the characteristic clinical signs. The mortality rate decreased when equine-origin botulism antitoxin became available; however, a certain percentage of foals continued to die of respiratory failure. Mechanical ventilation is an important part of the treatment of infant botulism and is essential to the survival of many affected infants. We report a retrospective study of 9 foals with toxicoinfectious botulism where early mechanical ventilation was employed as part of the treatment. Foals receiving mechanical ventilation were progressively acidemic and had increased PaCO2 tensions before mechanical ventilation. These arterial blood gas abnormalities were ameliorated with mechanical ventilation. One foal was euthanized for economic reasons; survival in treated foals was 87.5%. Mechanical ventilation of foals with botulism and respiratory failure appears to be an effective therapy.     

Periparturient hemorrhage in mares: 73 cases (1998-2005)

OBJECTIVE: To determine signalment, physical examination and clinicopathologic abnormalities, outcome, and subsequent fertility of mares with periparturient hemorrhage (PPH) and identify factors associated with outcome (ie, survival vs death). DESIGN: Retrospective case series. ANIMALS: 73 mares. PROCEDURES: Medical records were reviewed for information on age, breed, initial complaint, physical examination and clinicopathologic abnormalities, treatment, outcome, and subsequent fertility. RESULTS: Median age was 14.0 years (range, 5 to 24 years), and median number of foals produced prior to the diagnosis of PPH was 8 (range, 1 to 16). Ten (14%) mares had prepartum hemorrhage and 63 (86%) had postpartum hemorrhage. Treatment was aimed at restoring cardiovascular volume, enhancing coagulation, controlling pain, and reducing the effects of endotoxemia. Sixty-one (84%) mares survived and 12 (16%) died or were euthanized. Common complications included fever, leukopenia, retained fetal membranes, increased digital pulses, thrombophlebitis, and cardiac arrhythmias. Of the 53 surviving mares for which subsequent breeding information was available, 26 (49%) produced 1 or more foals after recovering from PPH. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that PPH can develop in mares of any age and parity. Treatment was associated with a good prognosis for survival and a reasonable prognosis for future fertility.     

Retinal detachment in horses: 40 cases (1998-2005)

OBJECTIVE: To determine clinical features, ophthalmic examination findings, etiology, treatment, and outcome of horses diagnosed with retinal detachment (RD). ANIMALS STUDIED: Forty horses, presented to the North Carolina State University and The Ohio State University Veterinary Teaching Hospitals from 1998 to 2005 that were diagnosed with RD. PROCEDURE(S): Horses with documented RD, confirmed either on ophthalmic examination or by ultrasonography, and with a complete medical record were included. Information retrieved from the medical records included signalment, presenting complaint, duration of clinical signs, ophthalmologic examination findings, diagnostics performed, identified cause of the retinal detachment, treatment given, and outcome. RESULTS: Forty horses (46 eyes) were diagnosed with RD. Mean +/- SD duration of clinical signs of ocular disease was 10.5 +/- 14.7 months. Thirty-four horses presented with unilateral involvement, 6 with bilateral, 14 with partial and 32 with complete RD. Ultrasonography was used to make the diagnosis in 26 eyes, while RD was diagnosed on routine ocular examination in 20 eyes. Bullous RD was the only type of RD observed, although small vitreal traction bands were considered secondary to the underlying inflammation or trauma. RD caused by equine recurrent uveitis (ERU) was diagnosed in 27 of 40 (67.5%) horses. Trauma-induced RD involved 10 of the 40 horses (25%). Presenting problems included known ERU (n = 16), acute or progressive vision loss (n = 9), known ocular trauma (n = 6), cataract (n = 6), and a cloudy cornea (n = 3). No horses regained vision after RD despite therapy. Many eyes were enucleated or eviscerated, or the horses were euthanized. Seven eyes with complete RD were noted to be unchanged and comfortable with medical therapy. CONCLUSIONS: The visual prognosis of RD in horses is grave; however, horses with nontraumatic RD (most commonly ERU) may be able to maintain a comfortable but blind globe with anti-inflammatory medical therapy.     

Tracheal rupture in cats: 16 cases (1983-1998)

OBJECTIVE: To determine causes of tracheal rupture in cats and the mechanism of injury. DESIGN: A retrospective study was conducted to identify cats with tracheal rupture. A second study was conducted to establish mechanism of injury, and a third study was conducted to determine volume of air needed to obtain an airtight seal when inflating the cuff of an endotracheal tube in a cat. ANIMALS: 16 cats with clinical signs of tracheal rupture, 10 cat cadavers, and 20 clinically normal cats that were undergoing anesthesia. PROCEDURES: Details were extracted from medical records of 16 cats with tracheal rupture (9 treated surgically and 7 treated conservatively). For the cadaver study, the trachea of each cat cadaver was intubated and observed during overinflation of the endotracheal tube cuff. For clinically normal cats, volume of air needed to obtain an airtight seal for the endotracheal tube was recorded. RESULTS: Most ruptures were associated with cats anesthetized for dental procedures. Clinical signs associated with tracheal rupture included subcutaneous emphysema, coughing, gagging, dyspnea, anorexia, and fever. Tracheoscopy was the method of choice for documenting tracheal rupture. Surgical and conservative management were successfully used, unless the injury extended to the carina. In the cadaver study, overinflation of the endotracheal tube cuff with > 6 ml of air resulted in tracheal rupture in 7 of 10 cadavers. For clinically normal cats, the volume of air (mean +/- SD) needed to obtain an airtight seal was 1.6 +/- 0.7 ml. CLINICAL IMPLICATIONS: Overinflation of an endotracheal tube cuff may result in tracheal rupture in cats.     

Severe sepsis in cats: 29 cases (1986-1998)

OBJECTIVE: To document the clinical, clinicopathologic, and pathologic findings in cats with severe sepsis, identify abnormalities unique to this species, and identify criteria that could be used antemortem to diagnose the systemic inflammatory response syndrome in cats. DESIGN: Retrospective study. ANIMALS: 29 cats confirmed to have severe sepsis at necropsy. PROCEDURE: Pertinent history, physical examination findings, and results of hematologic and biochemical testing were extracted from medical records. RESULTS: Clinical diagnoses included pyothorax, septic peritonitis, bacteremia secondary to gastrointestinal tract disease, pneumonia, endocarditis, pyelonephritis, osteomyelitis, pyometra, and bite wounds. Physical examination findings included lethargy, pale mucous membranes, poor pulse quality, tachypnea, hypo- or hyperthermia, signs of diffuse pain on abdominal palpation, bradycardia, and icterus. Clinicopathologic abnormalities included anemia, thrombocytopenia, band neutrophilia, hypoalbuminemia, low serum alkaline phosphatase activity, and hyperbilirubinemia. Necropsy findings included multi-organ necrosis or inflammation with intralesional bacteria. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that severe sepsis in cats is characterized by lethargy, pale mucous membranes, signs of diffuse abdominal pain, tachypnea, bradycardia, weak pulses, anemia, hypoalbuminemia, hypothermia, and icterus. Recognition of this combination of clinical findings should facilitate the diagnosis of severe sepsis in cats.