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Objective: To identify risk factors associated with development of pyothorax in cats, assess survival rates for cats that are treated, determine prognostic indicators, and determine recurrence rates., Design: Retrospective study., Animals: 80 cats with pyothorax and 212 control cats., Procedure: History; month of evaluation; physical examination findings; results of hematologic, serum biochemical, and retrovirus testing; radiographic findings; outcome; recurrence rate; and necropsy findings were recorded. For control cats, age, sex, breed, indoor versus outdoor status, vaccination history, and single- versus multi-cat household status were recorded., Results: Cats from multi-cat households were 3.8 times as likely (95% confidence interval, 1.9 to 8.2) to develop pyothorax, compared with cats from single-cat households. Indoor or outdoor status was not a risk factor. Cats with pyothorax were significantly younger (mean, 3.83 +/- 3.43 years) than controls (mean, 5.62 +/- 5.27 years). Nonsurvivors had significantly lower heart rates than survivors. Hypersalivation was significantly more common in nonsurvivors (11/39; 26.8%) than survivors (1/39; 3%). Overall, 48.8% (39/80) of cats survived. When cats that were euthanatized without treatment were excluded from analyses, the survival rate was 66.1% (39/59). Pyothorax recurred in 1 of 17 cats for which follow-up information was obtained., Conclusions and Clinical Relevance: Cats with pyothorax that received treatment had a fair to good prognosis, with low recurrence rates in survivors. Hypersalivation and low heart rate were associated with worse clinical outcome. Cats with pyothorax were likely to come from multi-cat households.

Objective: To document the clinical, clinicopathologic, and pathologic findings in cats with severe sepsis, identify abnormalities unique to this species, and identify criteria that could be used antemortem to diagnose the systemic inflammatory response syndrome in cats., Design: Retrospective study., Animals: 29 cats confirmed to have severe sepsis at necropsy., Procedure: Pertinent history, physical examination findings, and results of hematologic and biochemical testing were extracted from medical records., Results: Clinical diagnoses included pyothorax, septic peritonitis, bacteremia secondary to gastrointestinal tract disease, pneumonia, endocarditis, pyelonephritis, osteomyelitis, pyometra, and bite wounds. Physical examination findings included lethargy, pale mucous membranes, poor pulse quality, tachypnea, hypo- or hyperthermia, signs of diffuse pain on abdominal palpation, bradycardia, and icterus. Clinicopathologic abnormalities included anemia, thrombocytopenia, band neutrophilia, hypoalbuminemia, low serum alkaline phosphatase activity, and hyperbilirubinemia. Necropsy findings included multi-organ necrosis or inflammation with intralesional bacteria., Conclusions and Clinical Relevance: Results suggest that severe sepsis in cats is characterized by lethargy, pale mucous membranes, signs of diffuse abdominal pain, tachypnea, bradycardia, weak pulses, anemia, hypoalbuminemia, hypothermia, and icterus. Recognition of this combination of clinical findings should facilitate the diagnosis of severe sepsis in cats.

A 3-year-old mixed-breed dog was evaluated for lethargy, weakness, anorexia, and vomiting. The dog was dehydrated, hyponatremic, hypochloremic, and hypoglycemic. Results of an ACTH stimulation test indicated hypoadrenocorticism. Treatment to restore cardiovascular stability and serum electrolyte balance caused serum sodium concentration to increase by 32 mEq/L within 48 hours, and the dog developed severe neurologic signs that persisted for approximately 3 weeks. Magnetic resonance imaging revealed cerebrocortical lesions on day 6 and more severe lesions, including diffuse atrophy of the cerebral hemispheres, at 23 weeks after initial evaluation; however, the dog recovered complete neurologic function. Serum sodium concentration should be monitored during treatment for hypoadrenal crisis to avoid rapid increases that can cause CNS damage.