A challenging case: An emaciated cat with abdominal distention
This outdoor cat's severely distended abdomen and weight loss were the most obvious manifestations of numerous internal problems.
Sep 01, 2004
Four months later, the cat had been presented to the referring veterinarian because of constant vocalization and severe abdominal distention. The owners had noticed that the cat had become increasingly lethargic and anorectic and was vomiting. The results of a complete blood count and serum chemistry profile had been similar to those before except for a further increase in the total white blood cell count. At both visits to the referring veterinarian, the results of enzyme-linked immunosorbent assays (ELISAs) had been negative for feline leukemia virus (FeLV) antigen and feline immunodeficiency virus (FIV) antibody. The cat was subsequently referred to The University of Tennessee's College of Veterinary Medicine for evaluation of severe abdominal distention.
Initial physical examination and diagnostic procedures
Abnormal complete blood count results included a nonregenerative, hypochromic anemia; leukocytosis; neutrophilia with a mild left shift; and lymphopenia (Table 1). Serum chemistry profile abnormalities included an elevated blood urea nitrogen concentration, hypoalbuminemia, hyperglobulinemia, hyperbilirubinemia, mild hyponatremia, and elevated aspartate transaminase activity (Table 1). A urine sample was not obtained at initial presentation because of the cat's tympanic abdomen and suspected pneumoperitoneum. The results of FeLV and FIV ELISAs were negative. The result of an ELISA for Dirofilaria immitis antibody was negative, and the result of an ELISA for D. immitis antigen was weakly positive. An IgM antibody titer for Toxoplasma gondii was less than 1:512 (greater than or equal to 512 is suspect), and the IgG antibody titer was 1:8,192 (greater than or equal to 32 is considered positive). A Western blot to detect antibody to Bartonella henselae, Bartonella clarridgeiae, and Bartonella koehlerae measured +3 (immunoblot grade = +1 to +4), indicating strong reactivity and possible infection.