The Cutting Edge Veterinary Podcast

STUDENTS: Natalia Feschuk, Mackenzie Forsythe and Taylor Huber

FACULTY MENTORS: Drs. Serge Chalhoub and Søren Boysen

Initial evaluation of a cat in respiratory distress involves oxygen supplementation, anxiolytics, and a minimally invasive physical exam to reduce patient stress and avoid respiratory decompensation. If the cat tolerates an initial triage physical exam, a thoracic point of care ultrasound (POCUS) can be initiated, which has been shown to be more sensitive and specific in diagnosing lung diseases compared to auscultation and aids in diagnoses alongside radiographs. When visualizing the thorax via ultrasound, the “bat sign”, “glide sign”, and “curtain sign” can normally be identified. On POCUS, pulmonary edema appears as excessive B lines (> 3 B lines at more than 2 locations). Pleural effusion appears as irregularly shaped anechoic areas between the thoracic wall and lungs, with no glide sign. Atrial enlargement identification relies on a subjective assessment of the size of the left atrium in comparison to the aorta (a ratio of >2:1 is very abnormal). It’s important to identify these abnormalities to rule out other diseases and arrive at a diagnosis of exclusion for feline asthma. Feline asthma appears as minimal or absent B lines on POCUS, with no atrial enlargement, and can be acutely treated by dexamethasone and bronchodilators such as theophylline (IV/IM) or albuterol (inhaled).