Pulmonary Edema in Cats
Introduction
Urgent conditions in animals require special attention and self-control from the veterinarian. Often, identifying the critical moment means looking closely at barely noticeable signs. This is the case with pulmonary edema in cats. The condition can develop rapidly, threatening the animal's life. A pet can be lost within a few days or even hours.
Solomon, a 14-year-old Canadian Sphynx cat, was admitted to the clinic with dyspnea and thoracoabdominal breathing. The owners reported a decrease in activity and appetite over the past 5-7 days. On the day of presentation, when they returned home from work in the evening, they found the pet lying on the floor on his side, with his neck stretched forward. Solomon was breathing with his mouth open, his mucous membranes and tongue were pale, and he felt cooler than usual to the touch. Without wasting time, the owners took him to the veterinary clinic. After a brief examination, the therapist referred the patient to the intensive care unit with a diagnosis of respiratory distress syndrome.
Pulmonary edema is a condition in which the amount of fluid in the pulmonary interstitial exceeds the normal level. It is characterized by the accumulation of extravascular fluid in the lungs due to an increase in the difference between hydrostatic and colloid osmotic pressures in the pulmonary capillaries.
This is the official definition. Behind these academic words lies a wave of emotions, the need to make rapid decisions, mobilize all available knowledge, and coordinate actions clearly according to their importance and urgency.
Cats are special patients. They are highly susceptible to the harmful effects of stress, and their main stress target organ is the lungs. That is why a cat may respond to stress with pulmonary edema, a dangerous condition that often develops rapidly and, in most cases, is fatal without treatment.
This is not a disease in itself, but a process that develops against the background of infectious or non-infectious conditions.
Fluid accumulation in the alveoli of the lungs can occur for various reasons, which are divided into two main groups: cardiogenic and non-cardiogenic.
Cardiogenic causes refer to heart diseases, which may be congenital or acquired. Various destructive processes in the heart and blood vessels disrupt the movement of blood and lymph through the pulmonary capillaries, leading to fluid stagnation and subsequent filling of the lungs with fluid. Pulmonary edema may be caused by hypertension, pulmonary thromboembolism, cardiosclerosis, aortic heart disease, and other disorders.
Non-cardiogenic causes of pulmonary edema include various systemic disorders, inflammation, infectious and non-infectious diseases, trauma, allergies, tumors, poisoning by toxic fumes, burns of the respiratory tract, and even electric shock.
Although some owners believe that obesity can trigger pulmonary edema, in reality excess weight only worsens the overall condition but does not cause edema.
Solomon's body temperature was 36.9 °C, his reflexes were depressed, his respiratory rate exceeded 200 breaths per minute, the femoral pulse was not palpable, and auscultation revealed grade 4/6 holosystolic heart murmurs and pleural friction rub. Solomon was given a sedative (Gapentin) and placed in a warm oxygen cage. After 30 minutes, the cat was breathing more effectively, and his temperature had risen to 37.8 °C. This made it possible to perform radiographic examination in three projections and place an intravenous catheter. Initial diagnostics revealed massive pulmonary edema. Resuscitation measures were continued.
MAIN SYMPTOMS
In the early stage of pulmonary edema, only a change in the pet's behavior is noticeable: the animal becomes lethargic, restless, and prefers to lie down.
Later, one or more of the following symptoms may appear:
- hoarse breathing, crackles on lung auscultation
- dyspnea, thoracoabdominal breathing
- the mucous membranes become bluish or pale
- nasal discharge of mucus
- tachycardia, though sometimes bradycardia
- hypothermia
- weak pulse
- cough with expectoration of mucus, sometimes with blood.
The animals are very frightened, may breathe with their mouths open, which is not typical for cats, and assume forced postures to make breathing easier and improve its quality.
DIAGNOSIS
The diagnosis of any disease should begin with a general clinical examination. However, when pulmonary edema is suspected, great care and gentleness are required. During the examination and diagnostic procedures, the patient should not be disturbed, and the position that is most comfortable for the cat should not be changed.
To establish a definitive diagnosis, thoracic radiography should be performed in three projections: two lateral and one ventrodorsal. Ultrasound according to the T-FAST and Vet BLUE protocols may also be needed, and CT may be required in some cases. A complete blood count and blood chemistry profile will help rule out sepsis, anemia, and liver or kidney failure.
TREATMENT APPROACH AND PROGNOSIS
In the treatment of pulmonary edema, there are basic measures that are mandatory regardless of the cause of the edema. Ideally, they should be carried out actively and at the same time, because all of them are equally important. These include supplemental oxygen, diuretics, and sedatives. Successful patient management also requires intravenous access, ideally two IV lines.
As a diuretic, the product of choice is Furosenit-Vet. In pulmonary edema, it is prescribed at a dose of 1-4 mg/kg body weight. If the patient becomes relatively stable after injections, Furosenit-Vet Solutab tablets can be used for further management.
Supplemental oxygen therapy can be provided in any suitable format; the main point is not to cause stress in the sick cat.
As a sedative, it is convenient to use Gapentin. This product acts gently and reliably, and its broad range of uses makes it easy to work with in practice.
The prognosis in pulmonary edema depends on the underlying cause, the timeliness of treatment, and how promptly care is provided.
Two injections of Furosenit-Vet at a dose of 2 mg/kg, given 4 hours apart, along with warming, oxygen therapy, and reduction of anxiety, had a positive effect on Solomon. He drank water and ate a little wet food. Heart ultrasound revealed hypertrophic cardiomyopathy (HCM) in a decompensated stage. A systematic approach to therapy and diagnostics made it possible to stabilize the patient and later achieve a comfortable quality of life.
There are contraindications. Please read the instructions.