20 Linear foreign body in a cat
Initial presentation
Signalment: 9-month-old neutered male domestic shorthaired cat body weight 3.3 kg
Case history
The cat had been vomiting for 5 days. The vomitus initially had contained food and then contained primarily liquid. The cat was not eating and had reportedly lost weight. There had been no diarrhoea, although he had not passed faeces for 2 days.
He had been given his vaccinations as a kitten and had last been de-wormed 4 months previous to presentation. He had not been given any treatments for ectoparasites. His usual diet was canned cat food, plus cooked ham, chicken and tuna.
Previous treatment had included intravenous fluids, maropitant, clavulanate-potentiated amoxicillin and ranitidine. After this treatment, he had initially vomited less and was brighter. A feline pancreatic lipase immunoreactivity test for pancreatopathy had been negative. He then vomited a large amount of greenish bile-stained fluid several times and became lethargic and was referred to a specialist centre.
Clinical tip on histaminergic H2 blockers
Ranitidine, unlike cimetidine, has a gastrointestinal promotility effect by inhibiting acetylcholinesterase inhibitors and is used in some cases for this effect. It also is reported to produce fewer adverse drug interactions, have less systemic toxicity and greater potency than cimetidine. Cimetidine is the only H2 blocker which inhibits the P450 enzymes in the liver, causing the metabolism of other drugs to be decreased. Cimetidine induced leukopaenias and thrombocytopaenia have also been reported.
Clinical tip on maropitant use in cats
While maropitant is not approved in cats (at the time of writing), studies have shown that at 1.0 mg/kg it is highly effective in preventing motion-induced emesis in cats. These studies indicate that the NK-1 receptor antagonist maropitant is well tolerated, safe and has excellent anti-emetic properties in cats.
Physical examination
On physical examination the cat was quiet but alert. He was in slightly thin body condition (body condition score 4/9) and appeared well hydrated. His mucous membranes were pink and his capillary refill time was less than 2 seconds. Thoracic auscultation revealed a heart rate of 185 beats per minute with matched pulses. Heart and lung sounds and percussion and compression of the thorax were unremarkable. The cat appeared to be uncomfortable on abdominal palpation. His respiratory rate was normal at 32 breaths per minute. Rectal temperature was 38.9° C.
Problem list and discussion of problems
The cat’s primary problem was vomiting; the decreased appetite, weight loss and abdominal discomfort were thought to be related to the vomiting.
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