We performed heartworm antibody and antigen testing in this cat because of the radiographic evidence of respiratory disease.
A diagnosis of feline heartworm disease requires multiple testing modalities for accurate diagnosis. A positive antibody test
result correlates with exposure to D. immitis, and a positive antigen test result correlates with infection. Ideally, the positive antigen test result in this case would
have been followed with an echocardiographic examination, which reportedly detects heartworms in cats with a sensitivity of
78%,25 but further workup was precluded by the need for emergency surgery. We attributed the murmur in this cat to chronic anemia
since no cardiac abnormalities were noted on necropsy.
In complicated cases such as this, not only is it imperative to address immediate problems, but it is equally important to
methodically evaluate every aspect of the case to appropriately manage each problem. Although the cat in this report was presented
for the obvious problem of abdominal distention and it had a gastric perforation, the disseminated candidiasis and severe
underlying respiratory disease were life-threatening comorbidities that played an important role in patient management and
eventual outcome.
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