Veterinary Dictionary - |
Pleura The membrane that covers the LUNGS and lines the chest cavity. The Pl |
Gram's Stain A diagnostic test performed at a laboratory which allows identification of two groups of bacteria, gram-negative and gram-positive, by identifying differences in their cell-wall structure. Finding the type of bacteria involved in disease is valuable in determining treatment. i.e. some specific antibiotics treat specific bacteria better than others. |
- Home Care Food & Water, Medication - Mid - Long Term Care x-rays and prognosis |
Pyothorax in Cats |
This article is written from my own experiences with Nikki. When I was looking for information on the condition, I found very little, in fact many search engines would only produce links which discussed pyothorax in humans, although there were many articles on the related conditions of chylothorax and hemathorax. Although your vet(s) will be doing everything in their power for your cat and may be very good at explaining procedures and outcomes, if you're like me you'll want to do a little investigatng of your own. This article outlines Nikki's progress and links to other resources specifically on pyothorax in cats. |
Pyothorax is a condition in which the thorax, the lung cavity, fills with infected fluids (pus). This is not only dangerous in itself, any large scale infection is, but takes up space normally used by the lungs. Eventually the lungs deflate and collapse. This may occur to one or both lungs at varying degrees. |
Causes are many and varied. In Nikki's case no cause was ever established. Initially establishing, or eliminating, the cause of the pyothorax takes high priority. If your cat is infected with Feline LeukoVirus, FIP or cat AIDs then the prognosis is much more serious. Tests for these must be done immediately, although treatment for the pyothorax can also begin while some of the test results are being returned from the lab. |
One of the biggest problems with cats in general is recognising when they are genuinely ill. This may sound rather strange but unlike dogs, cats tend to become quiet when seriously ill. Worse, if your cat is normally sluggish, a finicky eater and\or naturally thin then symptoms such as missing meals or rarely moving will not be all that obvious. |
Here are some signs to watch for, but remember that most are fairly generic and could mean anything from your cat has a cold, is stiff from a recent fight or has somethng more serious. I've made a few notes beside some of them to relate them to Nikki's symptoms. If in doubt visit the vet. |
What is Pyothorax? |
- Home Care Food & Water, Medication - Mid - Long Term Care x-rays and prognosis |
Symptoms |
Unwillingness to move - this may even mean that your cat soils in the house, however no matter how sick, this will still be abhorrent to your cat, so it may make it to a dark corner or cupboard (i.e. you may not see this immediately) |
Loss of appetite - this may be hard to spot in a fussy eater, however if you try to handfeed a favourite morsel your cat may appear to have problems swallowing or chewing. |
Smelling \ Bad Breath - If your cat has other symptoms, get close enough to have a sniff. If your cat has very bad breath, or worse smells generally of infection get it to the vet's straight away. |
Strange Upright Position - this is a big giveaway that there is something seriously wrong in your cat's chest. Because of the fluid in it's lungs your cat will be very uncomfortable lying on its side or back. This means that the only way that it can rest is to lie with it's legs underneath it. While this is a natural position for your cat some of the time, you will notice that this is the only position that it will rest in and that it seems to constantly fidget as if uncomfortable. |
Rattling, Gurgling,Wheezing, Rapid Shallow breathing - You may think that these are going to be the first signs of trouble, but remember that this is an infection which is in the thorax, around the lungs, not in the lungs initially. And your cat will not be moving very much so these symptoms will only appear when it is under stress. i.e. either when the lungs are already seriously hampered or when you take your cat to the vet and it's stress levels are increased by the car journey. |
Treatment will consist of 3 phases; Emergency, Home care and Long term monitoring. Emergency Phase Getting your cat to the vet as quickly as possible will greatly enhance its chance of survival. After diagnosing pyothorax, your cat will be put into hospital. Hospitalisation will last somewhere between 3 and 7 days. During this phase your vet will be draining as much fluid as possible from the infected area. This may be by syringe or by inserting a catheter. |
Treatment |
Food and Water You may also have to force feed and\or syringe water into your pet at some stage, particularly during the initial stages when your pet is still very ill. |
Home Care This is perhaps the most important stage of treatment for long term recovery and may be the hardest for you as an owner. Home medication will last for at least 8 weeks. Your cat's lungs will still be partly deflated. There will still be infection present in the chest cavity (both dependent upon how quickly your cat was diagnosed and treated, of course) During this period you will need to return to your vet's for further monitoring. Your vet will be taking further x-rays to compare current lung condition to previous x-rays. |
Medication If you are very lucky, it will involve a single anti-biotic several times a day and they won't be too hideous tasting. If not, you may have to do a lot of experimenting and receive a lot of scars. More likely you will have several medications during the initial stages of home care. This may include steroids, diuretics, apetite enhancers, as well as anti-biotics. |
Long Term Monitoring Once you've finished with the medication, you're still not out of the woods. You may be going back to your vet for between 6 months and a year for checkups and x-rays dependent upon how your cat is doing. During this period the x-rays will be monitoring how much lung capacity your cat has and comparing to the last set of x-rays. Your cat still doesn't have it's lungs back yet! Nikki still had a shadow on the back of one lung, either from scar tissue or a pocket of fluid at her 3 month x-ray, it's not possible to tell. She was fighting fit and had been off medication for some time. At this point it was thought that she would probably always have one lung slightly smaller than another and this was probably scar tissue. Right up until this time it was a possibility that she may have to undergo an operation to remove the problem lung entirely, however her outward good health kept her from the operating table. It was not until a further checkup 6 months later, almost a full year from the initial diagnosis, that she was completely clear (much to all our surprise, the shadow had disappeared completey!). You're also going to have to keep an eye on your cat until you get that 'all clear' for anything that looks like a relapse or even a cold that could reinfect the damaged lung or thorax areas. The good news is that once you've gone for 9mths - 1year with good results an no relapses, this isn't a recurring disease and your cat's health regime will be just like any other's. |
While hospitalised your cat will also have frequent (daily) x-rays to check on progress. Until the results of the gram's stain have been received (several days) your cat will be receiving multiple doses of a range of antibiotics, re-hydrating fluids, vitamins and proteins (since it probably won't eat). Antiseptics and antibiotics may be flushed into the chest during the drainage period. This procedure, known as lavage, will help flush out the infection and apply antibiotics as closely as possible to the source of the infection. Don't think that this is going to be an inexpensive exercise. |
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In the end Nikki and I came to an understanding about pill taking and it was simply part of her daily routine, but over the course of her illness and relapse we had many battles over medication and I had to try many different methods, including binding her in a towel to imobilise her while trying to get medication down her throat. This is not ideal, it is stressful for the cat and you!. But remember, the choice is between doing something unpleasant and making sure that your cat survives! You must make sure that the medication get's in regularly, in the proper dosage. BTW, always ask your vet for more medication than you need, retrieving pills from under the refrigerator is not easy! ;-) |
Which method is used will depend partly on the experience of your vet and partly on your cat. It is recommended that initial drainage last 5 days and, if possible, use of the catheter will give best results since it is constantly draining. However there are also drawbacks to this procedure, some cats will not cope well with a catheter without putting themselves under greater stress or doing themselves some further damage. Your vet will be able to monitor and assess what's best for your cat. |
Fluids drained during this time may be in the range of 1-200mls or more. Nikki, a small cat, had around 120ml drained from one side by syringe, during a relapse. The fluids themselves will also change during the course of the disease. Initially Nikki's drainage was a whitish, creamy liquid (pus) however when she had her relapse a month later the fluid was bloody. This is quite distrubing as an owner, you associate blood with bad news, but is quite normal for this illness. It only takes a small amount of blood to stain the fluids being drained, some may be coming from the puncture wound of the syringe or clots formed during the healing process. |
Try not to take to heart some of the remarks your vet makes during treatment. It's dreadful to hear things like "worst case I've seen" or "poor chance of survival". This may depend more on your vet's exposure to the illness and previous successes, and sometimes they just don't realise how devasting such remarks can be. When you have a chance, discuss how many cases they've had and ask about any additional information you've found in your search. |
Water is particularly important and you must make sure that you know how to tell if your cat is becoming dehydrated. Lift a large pinch of fur away from the body (along the back of the neck is a good place to test) and see how long it takes to pop back into place. Try this on a healthy cat and the fur should spring back into place almost immediately. A dehydrated animal will have lustreless fur which is very slow to drop back into place. |
If you are concerned that your cat is becoming dehydrated, see your vet, it may require hospitalisation or you may be able to continue homecare provided your vet can provide water subcutaneously. This is where water is inserted under the skin using a syringe. It looks really strange but will give your pet the fluids he\she desperately needs and the cat doesn't really seem to mind. This method is often preferable to being on a drip which can be very stressful for a partially healthy cat. (The really sick ones don't have enough strength to care) |
If you can, get your cat into a routine of taking tablets and then receiving something nice afterwards. If this sort of bribery works, life will be a lot easier. Your local pet store may be able to help with pill poppers (plastic implements that make it easier to put a pill into the back of your cat's throat) and you can get plastic syringes (without the needle of course) of various sizes for sloppy food and water for a few cents from your local chemist (pharmacist). You may have to try several things before getting into a rhythm that your cat is comfortable with. The least stressful you can make it, the more likely you are to succeed. |
For example: Nikki was prescribed; Baytril, Prednil, Prednisone, Vibravet, Stromogyl, Frusid and eventually Clavulox (as well as a couple of others that I can't remember the names of) at various times, in various combinations during the 3 months of her home medication. BTW if your cat is prescribed Stromogyl ask for an alternative - the pills are huge and taste disgustingly bitter! Poor Nikki foamed at the mouth when she had to take these for a short period after a visit to an emergency vet during her relapse. |
Terminology |
When you are dealing with the life threatening illness of a dearly loved pet, you often don't stop to ask all the questions you want to. This is a brief guide to help you understand some of the terms that your vet will use. Each term will have my layman's explaination, followed by a link to a full, more technical article, if required. |
Gram's Stain A diagnostic test performed at a laboratory which allows identification of two groups of bacteria, gram-negative and gram-positive, by identifying differences in their cell-wall structure. Finding the type of bacteria involved in disease is valuable in determining treatment. i.e. some specific antibiotics treat specific bacteria better than others. |
Pleura The membrane that covers the LUNGS and lines the chest cavity. The Pl |
Veterinary Dictionary - |