Sepsis in Cats
Sepsis in cats can be challenging to recognize, Sepsis is defined as a systemic inflammatory response syndrome a secondary to an infectious process, Septic shock is a progression of this inflammatory response resulting in cardiovascular dysfunction caused by an overwhelming infection in the body results in severe inflammation untreated it results in severe sepsis which can cause multi organ failure.
There has been numerous studies documented an inappropriately low heart rate in cats with severe systemic illness and sepsis this response to critical illness appears to be unique to the feline species cats should be evaluated for the presence of hypoglycemia too much insulin which may cause blood sugar level to drop too low manifestation of sepsis , this phase rarely seen in cats. Instead cats often present with pale mucous membranes prolonged any of the fine branching blood vessels that form a network between the arterioles and venules which is a tube that has an internal diameter of hair like thinness resulting in poor to absent pulses.
Septic cat is frequently hypothermic with temperature often below 99 degrees F and occasionally too low to register on conventional digital thermometers. The systemic effects of this severe hypothermia are widespread including compromise of cardiovascular, respiratory, central nervo anus system and the flow of blood within the organs and tissues of the body. Rewarming of these cats is initially done by administering warm intravenous fluids after an initial bolus, external warming should be instituted.
In a seriously ill cat could result in underlying organ dysfunction with the lungs are often considered the shock organ in cats. As such, septic cats may be particularly susceptible to fluid overload, and pulmonary edema and pleural effusion are common. This pulmonary compromise occurs because of increased vascular permeability, sepsis-induced myocardial dysfunction, and decreased colloid oncotic pressure due to hypoalbuminemia. That differs from dogs, in which the liver and gastrointestinal tract are the primary shock organs.
In some cases, the source of infection is readily apparent, such as severe bite wounds, penetrating trauma or infected wounds, some cats with severe sepsis may show clinical signs of diffuse abdominal pain. Potential sources of infection in cats include pneumonia, pyothorax, septic peritonitis, septic pancreatitis, pyelonephritis, bacteremia secondary to severe gastrointestinal disease, pyometra, hepatic abscesses, endocarditis, or meningitis. Initial diagnostics in these cases generally consist of a complete blood count, serum biochemistry profile, urinalysis and culture, thoracic and abdominal radiographs, and abdominal ultrasound. Additional diagnostics may include blood cultures, endotracheal wash and culture, echocardiography, CSF tap or diagnostic peritoneal lavage.
Septic cats are often fluid depleted the shock bolus in cats is 50-60 ml/kg of crystalloids or 5ml/kg of colloids, however, care mut be taken when administering fluids and overload pulmonary edema and pleural effusion are common in these patients.
In cats that remain hypotensive despite adequate volume replacement and normothermia, exogenous catecholamine therapy may be necessary. Supplemental oxygen is often necessary in these cats. In addition, the administration of red blood cells to an anaemic patient will improve the oxygen carrying capacity of the blood and therefore improve oxygen delivery. In addition, replacement of coagulation factors with plasma therapy minimizes further blood loss and provides colloidal support. Red blood cell transfusions should be considered in any septic cat with a PCV < 20, and plasma should be administered in cats with prolonged coagulation times.
Appropriate antibiotic therapy is an integral part of the treatment of septic cats. Culture and sensitivity should be used to identify effective antibiotics whenever possible. Broad spectrum antibiotics should be instituted pending sensitivity results
Pain management is also important in these cats, and appropriate use of analgesics is an essential part of appropriate management of the septic cat. Untreated pain in these cats leads to depression, inappetence or anorexia decreased mobility and an increase in stress hormones.
Depending on the case, analgesia can be maintained with either local nerve blocks, epidural analgesia, or parenteral analgesics. Nonsteroidal anti-inflammatory drugs carry a high risk of renal damage and should be avoided. Constant-rate infusions of analgesics may be helpful to maintain adequate pain control.
In cat septic some of the factors could also be age, concurrent conditions, sex some breeds or families, individual genetic variations or polymorphisms appear to further contribute to disease susceptibility.
The goal when treating septic cats is the same as when treating any other critically ill patient: Maximize perfusion and oxygen delivery to the tissues. Cardiac output is calculated as heart rate x stroke volume. Stroke volume can be improved by maximizing preload with fluid administration. The shock bolus in cats is 50 to 60 ml/kg of crystalloid fluids or 5 ml/kg of colloids given intravenously. Start with small crystalloid boluses of 10 to 20 ml/kg given to effect (normalization of blood pressure or central venous pressure).
Supplemental oxygen is often necessary in septic cats. Increased inspired oxygen can improve oxygen saturation (SpO2) as well as the partial pressure of oxygen in the blood (PaO2), thereby improving oxygen delivery to the tissues. As discussed previously, fluid overload and pulmonary edema are common in septic cats. Inflammatory lung disease (acute respiratory distress syndrome) and pneumonia can also contribute to hypoxia and decreased oxygen delivery. In most cats, treatment in an oxygen cage or oxygen administration by mask is sufficient, but in severe cases, positive pressure ventilation may be necessary.
Septic cats are often anemic and may have a coagulopathy. Administering red blood cells to an anemic patient improves the oxygen-carrying capacity of the blood and, thus, improves oxygen delivery to tissues. In addition, replacing coagulation factors by administering plasma minimizes further blood loss and provides colloidal support. Consider a red blood cell transfusion in any septic cat with clinical signs of decreased oxygen delivery (tachypnea, tachycardia or bradycardia, pale gums) and with a packed cell volume < 20. Administer plasma to cats with prolonged coagulation times. Cats with type B blood have autoantibodies to type A blood,25 so blood typing is essential before any blood transfusion. Cats that have been previously transfused should also only be transfused with blood to which they have been crossmatched.
Herb Treatment Good for Cats with Sepsis must be treated quickly as risk from death is high. Mixture: Rosehips, Echinacea, Garlic, Burdock and Red CLover, as well as Bach Flowers Rescue Remedy and Walnut. The mix quickly removes the bacteria and inflammation while strengthening the natural ability to heal.