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
1. Hoppe, J.E.; Frey, P.: Evaluation of six commercial tests and the germ-tube test for presumptive identification of Candida albicans. Eur. J. Clin. Microbiol. Infect. Dis. 18(3):188-191; 1999.
2. Gerding, P.A. Jr. et al.: Ocular and disseminated candidiasis in an immunosuppressed cat. JAVMA 204(10):1635-1638; 1994.
3. Leibovitz, E. et al.: Disseminated fungal infections in children infected with human immunodeficiency virus. Pediatr. Infect. Dis. J. 10(12):888-894; 1991.
4. Saunders, W.B.; Tobias, K.M.: Pneumoperitoneum in dogs and cats: 39 cases (1983-2002). JAVMA 223(4):462-468; 2003.
5. Mahaffey, M.B.; Barber, D.L.: The peritoneal space. Textbook of Veterinary Diagnostic Radiology, 3rd Ed. (D.E. Thrall, ed.). W.B. Saunders, Philadelphia, Pa., 1998; pp 441-457.
6. Edwards, N.J. et al.: Radiographic diagnosis spontaneous pneumoperitoneum in a cat. Vet. Radiol. Ultrasound 35(6):428-429; 1994.
7. Lykken, J.D. et al.: Pneumoperitoneum secondary to a perforated gastric ulcer in a cat. JAVMA 222(12):1713-1716; 2003.
8. Mellanby, R.J. et al.: Spontaneous pneumoperitoneum in two cats. J. Small Anim. Pract. 43(12):543-546; 2002.
9. Yoho, K.S. et al.: What is your diagnosis? Pneumoperitoneum. JAVMA 222(5):585-586; 2003.
10. Hinton, L.E. et al.: Spontaneous gastroduodenal perforation in 16 dogs and seven cats (1982-1999). JAAHA 38(2):176-187; 2002.
11. Chen, K.Y. et al.: Pulmonary fungal infection: Emphasis on microbiological spectra, patient outcome, and prognostic factors.
Chest 120(1):177-184; 2001.
12. Matuschak, G.M.; Lechner, A.J.: The yeast to hyphal transition following hematogenous candidiasis induces shock and organ
injury independent of circulating tumor necrosis factor-alpha. Crit. Care Med. 25(1):111-120; 1997.
13. Greene, C.E.; Chandler, F.W.: Candidiasis, torulopsosis, and rhodotorulosis. Infectious Diseases of the Dog and Cat, 2nd Ed. (C.E. Greene, ed.). W.B. Saunders, Philadelphia, Pa., 1998; pp 414-417.
14. Altamura, M. et al.: Immune responses to fungal infections and therapeutic implications. Curr. Drug Targets Immune Endocr. Metab. Disord. 1(3):189-197; 2001.
15. Lorenzini, R.; DeBernardis, F.: Antemortem diagnosis of an apparent case of feline candidiasis. Mycopathologia 93(1):13-14; 1986.