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Pneumonia in a cat: how to recognize and treat them [medicine wet Piotr Smentek

Pneumonia in a cat

Pets, who live in close contact with their owners, are usually closely monitored by them, which of course allows you to quickly spot any deviations in behavior or emerging disease symptoms.

In other words, an attentive cat owner will very quickly notice that his pupil, with whom he has excellent contact, behaves differently than usual, which often will rightly arouse anxiety and will cause him to go to the nearest veterinary clinic to answer the question whether everything is okay.

Companion animals, just like small children, will not tell us that they are feeling unwell and that something is wrong with them, but only with their changed behavior they will manifest a worse disposition or a developing disease state.

I think it may be correct to say that the vast majority of cat diseases accompanying us, especially those that are infectious and infectious, begin with very harmless-looking symptoms.

It is these small, very subtle changes in behavior, greater drowsiness, avoidance of movement, less physical activity, faster breathing or not taking food or water that can indicate the onset of more than one serious illness.

Not all illnesses, even those that are life-threatening, must be associated with great pain, which manifests itself in avoiding touching the animal or picking up on the hands. Many inflammatory conditions or other pathologies inside the body at the very beginning do not have to give very specific disease symptoms, which increase only over time during the course of the disease.

Inflammatory processes are sometimes not visible with the naked eye and clinical symptoms result from impairment of the functioning of given organs or organs, and they reveal themselves after some time.

Let us use it as a practical example of what he writes about pneumonia that is, a pathology related to the vital organ, without which we are not able to function or live efficiently even for a short time.

So what do we need to know about this common and ill-known respiratory pathology??

  • When we talk about pneumonia?
  • Causes of pneumonia in cats
  • Symptoms of pneumonia in a cat
  • Diagnostics of cat pneumonia
  • Treatment of cat pneumonia
    • Supportive treatment

When we talk about pneumonia?

Lung (in Latin. pulmo) is a paired gas exchange organ in vertebrates for gas exchange, popularly known as respiration. In embryonic development, they develop from the germinal layer of the entoderm.

The lungs are located in the chest and have a follicular structure. Generally speaking:

they consist of numerous bubbles and blood vessels and are used for gas exchange.

It can be carried out thanks to the muscles between the ribs and the diaphragm, which, while contracting, create negative pressure in them and suck air into the lungs.

The structure of the lungs is species specific, but they generally consist of lobes. In the left lung, there is a cranial and caudal lobe, and in the right, cranial, caudal, middle and additional. The right lung is larger than the left lung by a ratio of 4: 3.

The lungs are surrounded by the pulmonary pleura and fill most of the chest.

As we all know, the main task of the lungs is gas exchange, i.e. oxygen absorption, and the excretion of carbon dioxide outside, i.e. breathing.

Without this process, which we do not always think about, it would not be possible for the body to function.

Hence, the cessation of breathing very quickly ends with the death of the entire system.

Inflammation or other diseases developing in the lungs, due to their key role, will have an impact on the functioning of the entire body and significantly worsen the overall well-being.

Bacterial infections can affect all parts of the respiratory system, including the respiratory tract, alveoli and interstitial tissue.

Bacterial inflammation of the lung tissue in cats may not give special clinical symptoms, but also take a severe form, often posing a direct threat to the cat's life, therefore they should never be underestimated.

In the pathogenesis of bacterial inflammation of the lungs, we must remember that bacteria entering the lungs are phagocytosed by alveolar macrophages and neutrophils, which protects the body against the development of inflammation.

It can develop when there is adhesion, i.e. the attachment of bacteria to the receptors of the alveolar mucosa.

A malfunctioning ciliary system, which cleans the lung tissue, also favors the development of infection.

Under normal conditions, this mucus moves as a result of the movement of the cilia towards the larynx from where it is swallowed or exfoliated.

Hence, proper mucus composition and cilia movement are essential in ensuring immunity and preventing disease development.

Pneumonia is therefore a pathological condition involving the alveoli of the lungs called pneumonia in Latin (bronchopneumonia).

Causes of pneumonia in cats

Causes of pneumonia in cats

Inflammation in the lung tissue is caused by a wide variety of infectious agents.

It should come as no surprise that these are bacteria, viruses, fungi, protozoa, rickettsiae and some parasites.

These diverse pathogens can enter the lower respiratory tract through inhalation of air, pharyngeal aerosols, foreign bodies and esophagus, through penetration from adjacent tissues, or through the bloodstream from an infection outside the system. respiratory.

Every healthy cat organism to some extent is able to cope with a certain number of pathogens living in a given organ, engaging its own cleaning mechanisms, i.e. its immune system.

Not every microbial entry into the respiratory system is automatically associated with the development of the disease because its occurrence depends on the interaction of the current pathogens, their virulence and the immune status of the cat's organism itself.

It is certainly worth knowing the factors that predispose to the development of pneumonia.

These are:

  • Previous respiratory tract infections caused by viruses, fungi,
  • difficult swallowing,
  • vomiting,
  • downpouring of food content,
  • dementia and coma,
  • certain metabolic disorders (e.g. uremia, ketoacidosis, less often hyperadrenocorticism),
  • surgical procedures,
  • chest injuries,
  • immunosuppressive therapy,
  • cancers,
  • immune system incompetence
  • some anatomical disorders.

Pneumonia in cats eludes the framework of simple diseases, although it may seem so.

This is due to, among others, the not always clinical course of pneumonia and the lack of changes in the radiological image and laboratory blood tests.

In other words, sick cats do not have to manifest it in a clinical form, i.e. have serious symptoms.

For many cat owners it may seem at least strange and incomprehensible, because they often compare both diseases occurring in humans and cats by analogy.

In numerous cases confirmed as causative agents, the following bacteria were present:

  • Streptococcus spp,
  • Pasteurella multocida,
  • Fusobacterium spp,
  • Escherichia coli,
  • Bacillus spp.,
  • Pseudomonas aeruginosa,
  • Enterobacter spp,
  • Bordetella bronchiseptica,
  • Streptococcus beta hemolytic,
  • Yersinia pestis,
  • Klebsiella pneumoniae.

On the other hand, fungal infections are caused by pathogens:

  • Blastomyces,
  • Histoplasma,
  • Aspergillus,
  • Cryptococcus.

They are generally both Gram positive and Gram negative bacteria and anaerobes.

Protozoa can also be the causative agents of pneumonia in cats, an excellent example of which is Toxoplasma gondii or viruses - feline rhinotracheitis virus.

An infestation of the Aelurostrongylus (A. abstrusus). This nematode can cause bronchopneumonia.

Also other viral diseases relatively common in cats, such as feline leukemia or viral immunodeficiency, predispose cats to inflammation of the lung tissue.

Bacterial pulmonary inflammation may be a consequence of surgical procedures and related intubation or aspiration of food content during recovery from anesthesia, which we must always remember.

Pneumonia can also be of a mixed nature, involving anaerobic and aerobic bacteria, which is especially true in aspiration pneumonia.

A separate group of factors are those in the case of aspiration pneumonia.

Well, the risk of this serious disease increases in lying animals, subjected to general anesthesia, endotracheal intubation, artificially fed through a nasogastric tube, and in weakened animals, with paralysis of the esophagus or with impaired muscle conduction.

These are animals that show impaired swallowing, which is associated with a greater risk of ingestion into the respiratory tract.

Bacteria can enter the lungs with air from the microflora in the mouth and throat, as well as with chyme or aspirated foreign bodies.

They can also travel to the lungs from a primary site outside the respiratory system (through the bloodstream).

We should also remember about periodontal diseases and tartar, from which bacteria are constantly released predispose to the development of lung inflammation as a result of their aspiration.

So we see how many causative factors cause and predispose to lung inflammation.

Symptoms of pneumonia in a cat

Symptoms of pneumonia in a cat

As we have already said, pneumonia in a cat is one of the diseases that do not have to give specific clinical symptoms and confirmation in the diagnostic tests performed, which certainly does not make it easier for a doctor who wants to make a diagnosis.

So while in dogs a moist cough with discharge of secretions, variable fever and accompanying shortness of breath or mucopurulent discharge and other general symptoms (e.g. dejection, apathy, anorexia) often occur in cats, we do not have to face these non-specific clinical symptoms.

According to experts, cough occurs in only a few percent of sick cats.

Cats suffer from pneumonia, often without showing it clinically, which should not confuse us.

The most common symptoms are rapid breathing and associated shortness of breath with discharge from the nose.

Such symptoms also often appear in other diseases of the respiratory system.

General symptoms such as apathy, fever, lethargy or lack of appetite do not have to appear.

Helminth pneumonia may cause symptoms of cat coughing and emaciation, but they occur when the infection is significantly intensified. It can also occur:

  • chronic cough,
  • apnea,
  • sneezing,
  • dyspnoea,
  • discharge from the nose and conjunctival sac,
  • apathy.

Therefore, we should be very careful in the case of pneumonia and always suspect it secondary to other infections of the respiratory system or other organs.

The listed symptoms are not very specific, therefore, even if they occur, it is difficult to make an accurate diagnosis on their basis.

We may suspect aspiration pneumonia in patients recently hospitalized, undergoing general anesthesia due to procedures performed with vomiting or drenching food.

Diagnostics of cat pneumonia

Diagnosis

The diagnosis of such an important pathology as pneumonia in cats seems simple only on the surface.

As I wrote before, they do not have to manifest inflammation clinically and the results of blood laboratory tests or chest radiographs may remain normal and correct.

The blood test shows leukocytosis and leukopenia (increase in the number of white blood cells and their reduction in relation to the norm) as well as neutrophilia.

In the radiographic image of the chest, we can sometimes observe pulmonary infiltrates of a broncho-parenchymal or bronchoalveolar nature.

Therefore, the best method of diagnosis is to obtain an aspirate, i.e. washings from the lower respiratory tract, and then to perform a culture and cytological examination.

As you can guess, these methods are not routinely used in every veterinary practice. We can use one of several methods of collecting material for testing.

Tracheal aspiration is a safe, relatively simple and well-tolerated method.

Animals are unable to cough up mucus that does not reach the oropharynx.

Tracheal aspirations allow obtaining material for cytological examination from the trachea, bronchi and lungs.

The method, in a nutshell, consists in puncturing the trachea and administering a sterile physiological solution there, and then aspirating it together with the cells present in the trachea.

The greatest amount of valuable aspirate is obtained when the animal is coughing.

Although it is a relatively simple method, its implementation is always associated with some risk and possible complications, which include:

  • injection site infections,
  • heart arrhythmia,
  • tracheal damage,
  • swelling under the skin,
  • haemorrhage inside the trachea.

The material should therefore be collected by a person with appropriate experience in this field.

Intra-tracheal lavage can only be performed under general anesthesia using barbiturates.

It is necessary to intubate the cat and administer about 5 ml of sterile physiological fluid through the catheter inserted into the tube, and then quickly aspirate it.

This method does not injure the trachea, requires a minimal amount of equipment and is technically easy to carry out.

Another possible technique of collecting the material for examination is the bronchoalveolar lavage, which can be performed with the help of an endoscope.

Bronchial alveolar lavage can also be performed using a bronchoscope.

Such examination allows to visualize the respiratory tract and obtain material for examination with the use of a special brush.

A limitation is the required general anesthesia, which is associated with some risk in patients with pneumonia.

We insert the bronchial speculum through the endotracheal tube.

Endoscopy of the trachea and bronchi offers many advantages in terms of diagnosis, as it allows for a better diagnosis of purulent pneumonia.

Samples taken with it are more accurate because they come from the lower part of the respiratory system.

Sometimes it is also possible to perform a more invasive test such as fine needle aspiration lung biopsy. It allows you to collect material from the lungs and perform cytology and bacterial culture.

The material collected using various methods is subjected to cytological and bacteriological examination.

The collected cells should be stained and evaluated by an experienced pathologist after placing them on a slide. Bacterial culture most often finds gram negative microorganisms, and mycoplasmas or anaerobic bacteria are much less common.

The most invasive method of examination, and therefore rarely used, is a lung biopsy consisting in surgical removal of a lung tissue section, which is then subjected to routine diagnostic techniques (cytology, bacterial culture).

So we can see that the diagnosis of pneumonia in a cat is not always simple and sometimes requires the use of more complicated diagnostic methods, unavailable in every veterinary clinic.

Treatment of cat pneumonia

The basis for the treatment of inflammation of the lower respiratory tract in cats is skillfully performed antibiotic therapy, which should last longer and be more intense compared to inflammation of the upper respiratory tract.

Therefore, we use antibiotics administered generally parenterally and orally because their penetration into the lung tissue is greater than aerosols and administered topically.

The most optimal and reasonable approach seems to be the prior identification of the pathogen, which significantly improves the effectiveness of treatment and may shorten its duration.

Such identification requires, as we remember, performing a bacteriological culture from the material collected from the bronchial lavage or tracheal puncture.

In field practice, however, it is an uncommon test.

I would like to warn you against throat swab, which is not the best diagnostic test for pneumonia. First of all, the obtained results, the growth of bacteria is not reliable and does not represent the pathogens present in the lower respiratory tract (bacteria in bronchi and alveoli are often different).

Treatment of pneumonia is therefore empirical and based on the experience of the treating physician.

As we know, bacterial pneumonia is mainly a dog problem, and in cats it occurs less frequently.

Bacterial pneumonia may be mild or even asymptomatic.

Then we can implement treatment based on monotherapy, i.e. administration of one antibiotic, which is considered by many to be a safe form of treatment.

The best solution is to administer fluoroquinolones, doxycycline or one of the beta lactam antibiotics.

Thus, fluoroquinolones (e.g. enrofloxacin, marbofloxacin) with a strong killing effect covering the etiological factors of pneumonia and perfectly penetrating the respiratory mucus and alveoli, are probably the most commonly used in the treatment of bacterial conditions.

In addition, they accumulate in macrophages, which increases their penetration into inflamed areas.

At the initial stage of treatment, they should be administered parenterally and then orally, which is undoubtedly a great advantage from the owner's point of view.

Medicines from this group, although they have great advantages, are not free from certain disadvantages that we must remember.

Well, they should not be used in growing animals because they can damage the state's cartilage irreversibly.

We do not give them to cats up to 8 months of age, i.e. during the period of intensive growth.

They can also cause diarrhea, vomiting, disturbances in the sense of taste, which can lead to anorexia, which in cats is of particular importance.

They should be carefully dosed in animals with symptoms of epilepsy because they may aggravate its symptoms and cause the appearance of insomnia, impaired coordination of movements or muscle tremors.

In cats, enrofloxacin may cause the degeneration of the retina leading to permanent blindness.

This symptom especially occurs in older cats with liver and kidney disease that have received the drug intravenously. Hence, in such animals, avoid intravenous administration of the drug in high doses exceeding 5 mg / kg m. c.

We dose fluoroquinolones in cats as follows:

  • enrofloxacin 2.5-5 mg / kg m.c. once a day orally, subcutaneously or intramuscularly.

Examples of preparations containing enrofloxacin:

  • Baytril, Enrobioflox, Enroxil and others,
  • marbofloxacin 2.5-5 mg / kg m.c. orally once daily for 21 days, exemplary Marbocyl formulation,
  • orbifloxacin in Orbax Flavor - dosage cat 7.5 mg / kg m. c. once a day.

Beta lactam antibiotics used to treat inflammation of the lungs in cats are mainly amoxicillin and amoxicillin with clavulanic acid.

They have a bactericidal effect by inhibiting the synthesis of the bacterial cell wall.

They can be administered orally or parenterally.

They can be administered with food, which does not reduce their absorption and reduces the possibility of side effects.

As side effects they can cause:

  • skin changes,
  • hypersensitivity states,
  • fever with enlarged lymph nodes,
  • anaphylactic reactions.

When administered orally, they can lead to:

  • vomiting,
  • nausea,
  • diarrhea,
  • anorexia, which is quite typical gastrointestinal symptoms
  • after administration of high doses for superinfections of the large intestines.

They can also raise liver enzymes.

We have a huge number of preparations containing these antibiotics on the market.

As an example, let's use Clavaseptin, Clavubactin, Synergal, Synulox, containing amoxicillin with clavulanic acid (dosage in a cat 12.5-25 mg / kg m.c. orally or subcutaneously every 8-12 hours for 7-14 days.

In the treatment of severe pneumonia, a therapy based on several antibiotics is necessary, in other words combined therapy.

Then we use amoxicillin with clavulanic acid (15-25 mg / kg m. c. Twice a day), and enrofloxacin at a dose of 5 mg / kg m.c. once a day by subcutaneous or intramuscular injection.

Supportive treatment

Treatment of pulmonary inflammation involves not only skilfully selected antibiotic therapy, but also extremely important supportive treatment.

It consists in irrigating the patient.

Normal secretion from the respiratory tract consists of 90% of water, hence dehydration impairs the self-cleaning process.

Irrigation of the respiratory tract can be achieved through the use of a nebulizer and aerosol therapy. We can use a physiological solution as a rehydration fluid.

We can also increase expectoration by patting the chest.

Supportive care also includes administering oxygen.

This is of particular importance in animals with dyspnoea.

Oxygen should be moistened so as not to dry out the respiratory tract.

We pass it through a special mask or put the cat in an oxygen cage.

In bacterial pneumonia, it is contraindicated to administer drugs that inhibit the cough reflex, diuretics or antihistamines, which impair the removal of secretions from the respiratory tract.

As we can see, the treatment of lung inflammation in cats is not always easy to diagnose and the therapeutic management itself, and it does not always end with recovery.

Summary

Inflammation in the lungs of cats is not easy to recognize and treat.

Some of them may be asymptomatic, which further delays the correct diagnosis and the implementation of effective therapy.

Often, doctors resign from performing additional tests, which are extremely important in the diagnosis of the disease.

All of this works to the detriment of sick cats.

Fortunately, pneumonia occurs less frequently in them than in dogs, and the implemented therapy turns out to be effective in many cases.

Pneumonia, although still a serious disease, does not automatically mean the death sentence for the animal.

However, it requires careful observation of the cat and not ignoring even non-specific clinical symptoms that occur with this disease.

Each pathology detected early gives a better chance of a permanent cure, which I wish to every cat.

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