Lung Protein Leakage in Feline Septic Shock

Schützer, Kajs-Marie; Larsson, Annhild; Risberg, Bo; Falk, Abigail

doi:10.1164/ajrccm/147.6_pt_1.1380

Cited by 20 publications

(14 citation statements)

References 25 publications

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“…26 Cats also appear uniquely sensitive to pulmonary damage secondary to SIRS and sepsis compared with dogs, as the lungs are a major source of bacterial clearance and inflammatory reaction in this species. 27,28 The patient in this report did have suspicion for pulmonary thromboemboli on CT scan, which is a reported complication of SIRS and sepsis and corroborates our suspicion of sepsis in this case. 1 This likely contributed to the instability exhibited under general anesthesia, and was considered a poor prognostic indicator.…”

Section: Discussionsupporting

confidence: 85%

Spontaneous cholecystopleural fistula leading to biliothorax and sepsis in a cat

VanDeventer

Cuq

2019

Journal of Feline Medicine and Surgery Open Reports

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Case summaryA 13-year-old spayed female domestic shorthair cat presented with pleural effusion and suspected triaditis. Intake vitals and leukocytosis were consistent with a diagnosis of systemic inflammatory response syndrome. Biochemical analysis confirmed a pleural fluid-to-serum bile ratio consistent with a diagnosis of biliothorax. Abdominal ultrasound failed to identify a definitive gall bladder but noted a hypoechoic tubular structure ventral to the liver and contacting the diaphragm. Thoracic ultrasound identified a hyperechoic structure contacting the diaphragm at the same location. Thoracoabdominal CT scan identified a fluid-dense tubular structure extending from ventral to the liver, through a diaphragmatic defect and directly communicating with the pleural space, suspected to be an abnormal gall bladder. The cat was humanely euthanized, and post-mortem analysis confirmed a cholecystopleural fistula arising from the gall bladder with multifocal abscesses, mixed inflammatory hepatic infiltrates and small-cell gastrointestinal lymphoma. Culture of the abscess isolated Parabacteroides merdae, meeting the reported feline criteria for sepsis.Relevance and novel informationTo our knowledge, spontaneous cholecystopleural fistula formation leading to biliothorax and sepsis has not been previously reported in the cat. This case highlights a novel sequela of gall bladder disease in this species, and biliothorax should be a differential diagnosis for pleural effusion in cats with evidence of cholecystitis or triaditis.

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Section: Discussionsupporting

confidence: 85%

Spontaneous cholecystopleural fistula leading to biliothorax and sepsis in a cat

VanDeventer

Cuq

2019

Journal of Feline Medicine and Surgery Open Reports

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“…SRMD was not observed in any of the 94 cats that were included in this study, and this finding is consistent with the hypothesis that the GI tract is not a ‘‘stress organ’’ in cats. Previous experimental and epidemiologic studies indicate that cats are susceptible to pulmonary injury when suffering from systemic inflammation or sepsis, and there are no previous reports suggestive of SRMD in this species. Observation of a greater number of cats in ICUs is likely to be required to determine whether SRMD occurs at lower prevalence than could be detected during this study.…”

Section: Discussionmentioning

confidence: 85%

Prevalence and risk factors for development of hemorrhagic gastro‐intestinal disease in veterinary intensive care units in the United Kingdom

Swann

Maunder

Roberts

et al. 2015

J Vet Emergen Crit Care

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Objective To determine the prevalence of hemorrhagic gastro‐intestinal (GI) disease developing in dogs and cats admitted for management of non‐GI disease in veterinary intensive care units (ICUs). Design Retrospective study of animals presented between October 2012 and July 2013. Setting Three ICUs located in veterinary teaching hospitals in the United Kingdom. Animals Dogs (n = 272) and cats (n = 94) were consecutively enrolled from 3 ICUs if they were hospitalized in the unit for at least 24 hours. Cases were excluded if they had hemorrhagic GI disease in the 48‐hour period before presentation or in the 24‐hour period after admission. Cases were also excluded if they suffered skull fracture, epistaxis, or hemoptysis, if they underwent surgical procedures of the GI or upper respiratory tracts, or if they were presented for management of GI disease. Measurements and Main Results Hemorrhagic GI disease was observed in dogs at all 3 units, but at different rates (Center 1: 10.3%, Center 2: 4.8%, Center 3: 2.2%). Hemorrhagic GI disease was not observed in cats at any of the participating centers. Construction of a multivariable logistic regression model revealed that serum albumin concentration, administration of prophylactic gastro‐protectant drugs, and institution were significantly associated with the development of hemorrhagic GI disease in dogs. Development of hemorrhagic GI disease and placement of a feeding tube were significantly associated with mortality during the period of hospitalization in dogs. Thirty‐seven (13.6%) dogs and 12 (12.8%) cats died or were euthanized while hospitalized, with a higher mortality rate (42.1%) in dogs with hemorrhagic GI disease. Conclusions Hemorrhagic GI disease does develop in dogs hospitalized for management of non‐GI disease, but this phenomenon was not observed in cats. Development of hemorrhagic GI disease appeared to have a significant impact on survival in veterinary ICUs.

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“…Cats are particularly prone to this potential complication of resuscitative therapy, 2,48,49 which has been attributed to their smaller blood volume per kilogram of body weight, 2,48 the inadvertent use of the canine-derived shock fluid doses, 48 anemia of chronic disease, 2,50 occult cardiac disease, 2,51,52 and the role of the lung as the shock organ in cats. 2,53 Bolus IV fluid therapy has been associated with the development of pulmonary edema in a population of cats with urethral obstruction as well. 54 Although the median volume of resuscitative fluids administered in that report (18.8 [55][56][57][58][59] Additionally, the site of DBP recording varied throughout the cases in this study and is thus associated with a margin of error pertaining to different measurement sites.…”

Section: Discussionmentioning

confidence: 99%

“…Monitoring the progression of fluid resuscitation is of a particular interest to feline emergency medicine practitioners due to the potential risk of hypervolemia and pulmonary edema. Cats are particularly prone to this potential complication of resuscitative therapy, 2,48,49 which has been attributed to their smaller blood volume per kilogram of body weight, 2,48 the inadvertent use of the canine‐derived shock fluid doses, 48 anemia of chronic disease, 2,50 occult cardiac disease, 2,51,52 and the role of the lung as the shock organ in cats 2,53 . Bolus IV fluid therapy has been associated with the development of pulmonary edema in a population of cats with urethral obstruction as well 54 .…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of intravenous fluid resuscitation in hypotensive cats: 82 cases (2012–2019)

Chalifoux

Hess

Silverstein

2021

J Vet Emergen Crit Care

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Objective: To evaluate the effectiveness of intravenous fluid resuscitation in hypotensive cats in an emergency room setting. Secondary objectives were to investigate changes in heart rate (HR) and body temperature (BT) in response to fluid resuscitation, and the association of these changes with patient survival.Design: Retrospective study.Setting: University teaching hospital. Animals: Eighty-two cats with confirmed hypotension. Interventions: None.Measurements and main results: Medical records from 2012 to 2019 were searched for cats that had documented systemic arterial hypotension (blood pressure measured using a Doppler ultrasonic flow probe [DBP] < 90 mm Hg) on presentation to the emergency room. Data collected included patient characteristics and DBP, HR, and BT before and after fluid resuscitation, type and volume of fluids administered, and outcome. The median DBP before and after resuscitative fluid therapy in all cats was 65 mm Hg (range, 20-85 mm Hg) and 80 mm Hg (range, 20-128 mm Hg), respectively (P < 0.001). However, only 30 cats (37%) were classified as responders to fluid resuscitation (DBP ≥ 90 mm Hg following bolus therapy). The mean HR and median BT before resuscitative fluid therapy was 159/min and 36.7 • C. Following fluid resuscitation, where measured, the mean HR and median BT was 154/min (P = 1.00) and 35.9 • C (P = 1.00). No significant differences in HR and BT were identified between responders and non-responders. Cats had a low survival rate of 7%. All survivors (n = 5) were initially bradycardic (HR < 160/min), compared to only 45% of non-survivors (P = 0.4). Conclusions:Bolus fluid resuscitation effectively increases blood pressure in hypotensive cats; however, it does not result in normalization of blood pressure, HR, or BT in the majority of cases.

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Lung Protein Leakage in Feline Septic Shock

Cited by 20 publications

References 25 publications

Spontaneous cholecystopleural fistula leading to biliothorax and sepsis in a cat

Spontaneous cholecystopleural fistula leading to biliothorax and sepsis in a cat

Prevalence and risk factors for development of hemorrhagic gastro‐intestinal disease in veterinary intensive care units in the United Kingdom

Effectiveness of intravenous fluid resuscitation in hypotensive cats: 82 cases (2012–2019)

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