I have only seen it once before, in a lovely British short haired cat. When his biopsies were cultured we had growth of Staph aureus. He ended up having recurrence of the masses (but at a different site each time), which we removed surgically.
The mainstay of our treatment was Prednisolone and co-amoxiclav after surgical removal. After the first two surgeries new masses developed and so we continued the anti-biotics for a very long time after the third surgery (months) and when I left the practice he hadn’t had any more, but this was a few years ago now.
I would FNA the LN and if possible the gastric wall, ultrasound guided. If these were none diagnostic then consider biopsy, if the gastric changes are transmural then endoscopy might be possible and less invasive.
I would probably give a Chlorphenamine injection IM prior to FNA’s too, just in case there was a MCT component to the pathology.
So we don’t know if the pro-biotics contain any protein derivatives, so to be on the safe side try a pro biotic course first, for a couple of weeks and then if no response stop this and transition on to a hydrolysed diet trial?
I have a couple of questions about lesson two if thats ok:
-Do you have the references that support the two week diet trial rather than the long trials that we have previously done for food responsive entropathies etc?
-What are your thoughts on using metoclop CRI’s post enterectomys for ileus?
I have tried this in a couple of refractory cases a few years ago. Again using the dilution and dosing you have referenced. Anecdotally, it provided some improvement in the clinical signs, but as you say both cases were on a combination of drugs and so I thought it would be worth a try to see if it helped the clinical signs at all.
It would be interesting to have prospective, controlled trial to get some evidence to back up its use.
What were your echo findings in this case? If you had hypertrophy would you expect this to resolve with time if the underlying cause is viral?
What triggers you to run a troponin in a cat? You mention age as a reason you might run it, would you run it in any young cat that is presenting with respiratory signs or are there more specific reasons to run it?
Just me again, I coincidentally had an e-mail today about a new product for use in USMI called Caniphedrin, it looks like it’s Ephedrine Hydrochloride, which I think is the same as Enurace. I think I might have used Enurace once before in a case, but I can’t remember why (or maybe I just put through a repeat prescription for a dog that was already on it!). Would you ever use this in USMI and if so what would the clinical indications be over the use of propalin/incurin?
Also very randomly I am scanning an Australian ladradoodle on Monday that was speyed at 3 months old, it’s not presenting with urinary incontinence though luckily! I wonder if it’s from the same breeder that you used to see!
The app looks amazing with so much potential information it can give us on a case by case basis, I am keen to find a case that I can try it on, especially the radiograph analysis section!
I have the app on my phone, but have yet to find a case to use it on.
The information and data on it is pretty impressive on the app and it would be very useful to be able to predict a stone type to help avoid surgery where we can.
I did try a medical dissolution on a case last year, which sadly didn’t work (I think there were a number of factors contributing to the failure), I will try and find the case history and radiographs as there was a hint on the radiographs that dissolution might not work, but I wanted to try and give it ago as the dog was on steroids and it’s skin was horrific. I will pop a post up with the case if I find the images.
I recently was at an imaging conference which had a presentation from a medic about how imagers can make their life easier in managing uroliths and this medic put a lot of emphasis on predicting the type of urolith present and advised the use of the Minnesota hills urolith app. Ultimately with the aim of medically managing as many cases as possible. Is this something you use/would recommend?
Is it an angiostrongylus larvae? Visualisation of the parasite itself should be diagnostic I think, so I don’t think any further testing would be needed?
Licensed treatment would be advocate, but fenbendazole is also used quite frequently off-license I think. If there was a large worm burden then steroids may be indicated alongside, depending on clinical signs in response to the advocate.
It’s really interesting that the radiographs were unremarkable, maybe I should consider BAL’s more frequently 🙂
Log in to activate the form below and to access any credits you've previously purchased, or those you hold on your account as part of your membership. Members receive inclusive credits when the free trial period has ended.
