2922. An eosinophilic cat has a "lungworm"?

Has the chronic coughing cat a lungworm?

This is a strange case. The much beloved old Himalayan cat has chronic coughing for the past 6 months. Yet the heart and lung sounds were normal when examined by Vet 1 earlier and myself on Jan 18, 2016. I could hear rapid breathing which could be due to this cat being unhappy at the vet.
The cat had good appetite but now had a sore throat owing to daily coughing nowadays. 

MEDICAL HISTORY.
Oct 2015. Went to Vet 1.  Occasional cough. Cough medicine did not banish the coughing.
Dec 2015. Went to Vet 1.  Coughing more often. Vet 1 wrapped cat around towel to examine the cat in a room away from the owner. Vet 1 prescribed antibiotics and steroids but the owner did not give them to the cat as there was no definitive diagnosis. Vet 1 did advise X-rays.Vet 1 noted that the heart and lungs sounds were normal.

On Jan 18, 2016, a mother and young adult daughter brought the cat to consult me. I confirmed the heart and lung sounds were normal. There was a rapid breathing rate which I attributed to the cat being unhappy with examination by any vet as he tried to claw me now and then. He did not like his head area touched. I palpated his enlarged left submandibular lymph node when the owners were distracting him, but he would not permit opening of his mouth. Was there a tumour in his painful throat?

"X-rays of the throat and lungs are needed to check for tumours or other abnormalities," I advised as simply giving antibiotics would not be useful in chronic coughing. "A blood test is needed to check for blood-borne infection and diseases of the liver and kidneys." 

The owners agreed and the results are as follows:


X-RAYS

The cat was stressed when isoflurane gas was given via the carrier and bag. As an alternative, he was given a lowest dosage of IM injection - xylazine 0.3 + ketamine 0.2 ml IM to enable a thorough physical examination of the mouth, throat and abdomen.

Reversin 0.15 Im woke up the cat in less than 15 minutes.


 
 

 

BLOOD TEST
Leucocytois with neutrophilia and thrombocytopenia suggest a septicaemia on Jan 18, 2016.
Eosinophilia suggests allergy, parasitic or tumour condition. 
No liver or kidney disorders.

COMMENTS
Close up of the X-ray appeared to show a donut-shaped object looking like a lung worm swallowed inside the left lower lung. This would account for the eosinophilia. Tumours would also cause eosinophilia. Eosinophilic granuloma is a possibility although the lesions manifest in the mouth and skin usually.

The X-ray shows a full stomach, suggesting that the cat has a good appetite. The throat was very painful due to daily coughing. Antibiotics and anti-inflammatory medication was given. Review in 10 days. May need deworming (Panacur, ivomectin or Revolution).

PHYSICAL EXAMINATION UNDER SEDATION
Tonsils are enlarged. The owner said they had been enlarged for some time. No tartar or calculus in all snow white teeth as if they were brushed daily. 

 

CONCLUSION

Follow up by tel on Jan 19, 2016. 
"The cat eats and is more active," the young lady said. "Less coughing."
"If the lung lesion is not a tumour or lungworm, we will see complete recovery in a month," I said. 

Chronic coughing of 6 months' duration and old age suggests a high probability of a pulmonary tumour.  A review is needed in 2-4 weeks' time by telephone.

   

2921. A much loved 13-year-old Sheltie has a right head tilt - vestibular disease

Jan 16, 2016

The 13-year-old Sheltie has a right head tilt, became off-balance. What is the cause and solution?
Some old dogs suffer from chronic ear infections. The infections rupture the ear drum and affect the middle ear where the organs of balance are located. Many old dogs suffer from vestibular disease.

In this Sheltie, the first vet did not resolve the loss of appetite and balance to the owner's satisfaction. The owner consulted me on Jan 2, 2016.  I anaesthesized the dog and irrigated the right ear and did a dental scaling. There was fresh blood deep inside the right ear.

Around a week later, the lady owner phoned me saying that she cleaned the pus discharging from the right ear every day.  I checked the dog's right ear on Saturday Jan 16, 2016. There were thick plugs of brownish yellow purulent exudate. These were flushed out. X-rays of the ear showed some masses at the horizontal canal area.

   

2920. Saving an old Silkie Terrier's eyeball

Jan 17, 2016

After one month of intense eye pain and rubbing, the first vet advised enucleation (removal of the eyeball) to resolve the problem. This was a deep corneal ulcer. The owner asked me for a second opinion. He was an old client but had gone to the other vet.

It was already one month and the tarsorrhaphy works very well with injuries sustained within 24 hours. He was agreeable to the surgery. Outcome was excellent. The dog did not need enucleation and has his eyeball and eyesight back. Images are shown below but not in order. There is a video at:
https://www.youtube.com/watch?v=aUEC5WmmJ-s

  

2919. Top 10 most common bird blogs

1.  10000birds.com
2. blog.aba.org
3. leesbird.com
4. birdingblogs.com

5. birdchick.com/blog.htm
6. nemesisbird.com

7. billofthebirds.blogspot.com
8. birdingisfun.com

9. urbanhawks.blogs.com
10. besgroup.org    Bird Ecology Study Group

2918. X-ray interpretation website - ear x-rays

http://www.acvr.org/node/335 used to provide case interpretations of x-rays  in 2015 but now no more.

Cat

2917. Fat deposit behind the rabbit eye's cornea? Images

Jan 16, 2016

Fatty deposit behind the cornea of a rabbit's eye?

2916. Farm Visit with intern - Caesarean section of 3-day-old Maltese pups healthy

Jan 14, 2016

I find time to visit the breeder after Caesarean section to do a follow up. For home breeders, I phone them to enquire about the dam and puppies. Much can be learned by going to the grass root level instead of being in the ivory tower all the time.

In this visit, Breeder William Goh wanted subcutaneous sutures as the ends of the sutures will not prick the suckling puppies. I did use subcuticular sutures and two horizontal mattress sutures on the Dachshund and he had no complaint. He was not happy with the simple interrupted sutures done by Dr Daniel and said it was old school and outdated as the ends pricked the puppies trying to suckle.

He has a point. I use only horizontal mattress sutures in over 100 caesarean sections in dogs and had no complaint. He did not complain about my sutures being stiff and high risk to his puppies because I use Polysorb which is a braided absorbable while Dr Daniel used Monosyn which is monofilament absorbable closer to the "nylon" in composition. What he wanted was subcuticular sutures for all his Caesarean sections. This is not necessary and I seldom use this subcuticular sutures as they may break down. I used horizontal mattress sutures with the ends on one side of the incision, unlike monofilament simple interrupted sutures with ends on both sides..    

Horizontal mattress sutures may not look good but they are not crossing the incision line and may be stronger in holding the ends of the skin together. This is my experience in over 100 C-sections.

I hope the intern Su-en going to 3rd year of Melbourne University Vet School in 2016 learnt more on this farm visit than from textbooks and lectures.