Patient Story: Biscuit

By April 21, 2021 Our Patients

Sometimes in medicine, human or veterinary, we don’t get the clear-cut answers we’re looking for. We see a problem and we want to know what caused it and what will make it go away. Biscuit’s story is a good example of those times when we don’t have all the answers so we do the best we can and hope for the best results.

“Biscuit” is a 7-month-old, intact female, domestic shorthair cat. She initially came in because she’d been lethargic for just under 12 hours. During this time, she didn’t want to eat or drink and wasn’t playing with the other cats in the home like she normally does. Her owner was concerned that she may have eaten a poisonous plant or that she could have intestinal parasites.

She came to us quiet, alert, and responsive, weighing in at 4.5lbs. Her heart rate was fast (mild tachyarrhythmia), she was mildly dehydrated, and her fever was 106.9*F. The normal temperature range for a cart is 100.5*F – 102.5*F, so this was a good indication that something wasn’t right. All her other physical exam findings were within normal limits, so this is what we call a “fever of unknown origin.”

When dealing with a fever as high as this with no apparent cause, it’s recommended to run bloodwork or even a slide differential. Due to the acute nature, or sudden onset of symptoms, we were leaning towards a viral infection such as Feline Immunodeficiency Virus, Feline Leukemia Virus, and Feline Coronavirus, which can lead to Feline Infectious Peritonitis. So here’s a little background info on what these viruses entail:

Feline Immunodeficiency Virus (FIV) is a retrovirus that attacks the immune system and delays the immune response to other diseases and bacteria. Transmission of this is usually via close contact and salivary sharing/wound contamination or via the Queen to kitten. It can make treatment of common things like upper respiratory syndrome a bit more arduous and ongoing. We can test for the antigens via a simple blood test that is highly efficacious starting approximately 60 days after contact. Experimental treatment with antiviral drugs is ongoing, but most cats with this disease can live normal lives with regular exams and blood work.

Feline Leukemia Virus (FeLV) is a “fighter’s” virus and is usually transmitted via scratches and bites and other types of social contact. There are several subgroups of this virus and once a cat reaches about two years of age, it may be able to fight this virus off on its own. There are also several stages of this viral infection. This virus can alter the body’s ability to fight off infection and may predispose cats to develop a type of cancer called leukemia or lymphoma by altering the cell lines within the bone marrow. We can test for this with a simple blood test that is highly accurate after about 4-8 weeks post-exposure.

Feline Infectious Peritonitis is a disease based on the immune system of the cat fighting off a normal pathogen called Coronavirus. This can lead to uveitis, fluid build-up in the chest or abdomen, and very high non-responsive fevers. This has historically been a fatal disease but recently has been shown to be able to be put in remission with antiviral medications and steroids. It is unsure how long remission lasts at this point.

Another possible and more likely cause in this kitten’s case is an upper respiratory syndrome. There is a multitude of viruses and bacteria that contribute to this syndrome including herpes virus, parainfluenza, calicivirus, mycoplasma, and Bordetella just to name a few. Each may be treated differently and ultimately depends on the kitten/cat’s immune system and supportive care on our end as pet parents. The upper respiratory syndrome sufferers can present with fever, lethargy, anorexia, sneezing, watery or red eyes, and corneal or oral ulcerations are some common clinical signs. There is a PCR (polymerase chain reaction) test we can use to determine which aspect we are dealing with.

During this kitten’s visit, we performed a feline triple test which tested for heartworm disease, feline leukemia, and FIV.  The test came back negative for all three.  This does not eliminate these 2 viruses from being a cause as an indoor/outdoor cat may not develop antibodies for another few weeks to months.  It is recommended to retest the kitten in a few months to ensure she is in fact negative for these viruses.  We also performed a slide differential which showed “toxic” neutrophils with Barr bodies present. This means that the primary white blood cell used for infection and inflammation has been fighting something.

Due to the sudden nature of the pet’s clinical signs, we elected to pursue symptomatic care with antibiotics for potential bacterial infection, a steroid injection to boost the immune system and bring down the fever, and subcutaneous fluids (fluids under the skin) to combat dehydration.

Within 24 hours Biscuit was eating and playing as though nothing had happened. A month later, she’s still doing great! She came in to be spayed recently, which means that the doctor believes she’s healthy enough to go under anesthesia, but she did some routine bloodwork first.

Anytime we have an animal come in for a surgery or any procedure where they go under anesthesia we always perform a complete blood count (CBC) and a chemistry panel (Chem Panel). The CBC tests all the cells that make up your pet’s blood: red blood cells, white blood cells, and platelets. The chemistry panel checks the function of all the major organs.

When Dr. Mundahl ran her bloodwork, it showed that her white blood cells were elevated which is indicative of long-term infection. She didn’t see anything else that would cause her to forego the surgery, so she got started.

During the procedure, she discovered the cause of her fever and elevation in her white blood cells – it was a pyometra. A pyometra is a dangerous infection that can develop in the uterus of female dogs and cats if they don’t get pregnant and aren’t spayed. We normally recommend a spay (ovariohysterectomy) to be done on a dog or cat around 6 months. That is typically before they have their first heat cycle. It’s not usual at all for a 7-month-old cat to have this kind of life-threatening infection, but as we can see, it’s not impossible.

So Biscuit was spayed, the pyometra removed and she was given another round of antibiotics. She’ll come back to see us next week for her suture removal so we can monitor her healing. As for now, Mom says she’s doing great!

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