C09988696 / invoice 10000

CAT - Lump check
GVH

1. When the problem started  (2 days ago)
2. The current diagnosis (Lymphadenitis likely secondary to cat fight accident)
3. Treatment (Amoxyclav 20mg/kg BID for 10 days and recheck if not responding)



2 days ago the animal
the animal is an indoor cat and dose not have access to outdoor
there are 2 cats at home
small scratch next to the L eye at prior to the lump, L Submandibular LN is swollen, about 
The lump feels softer 

Phoned Anna to report BT results - alb/ glob ratio normal - unlikely to be FIP

AST, ALP raised - in line with growing cat, 
lymphocytes mild raise - likely excitement in young cat

generally unremarkable!

Other ways to investigate FIP as discussed include FeCoV testing (nonspecific - so many cats exposed & clear it without converting to FIP); ultrasonography.

I think low suspicioun of FIP as he seemed clinically well - any concerns we can recheck and prob next step would be detailed abdo US

n/a - CAT - o wants FIP test
swollen belly, fever. Offered earlier appt, o wants friday pm appt. Hx requested from Kippax ald - leave xtended

No history from Kippax - visited on Wednesday
Recently adopted from rescue. There was FIP among the other cats. No symptoms in Nero or the other cat. Nero went to Kippax for conjunctivitis OS - chlorsig dispensed - he had an elevated temp and was given meloxicam. Kippax vet also felt belly enlarged and wanted to consider FIP as a diagnosis.
Eating well - kibble, and Felix sachet.
No V or D - drinking normal. Normal demeanour. Playful.
Has had worming and vaccines (2 doses).
has had flea and tick tx.

Exam.
Very BAR - trying to explore room, lively
Pink moist membranes - some gingivities around molars as adult teeth erupt; upper deciduous canines present.
peripheral LNs palpate normally
Abdomen does feel soft, no free fluid immediately discernable, no pain, rectum contains solid poo.
Normal mentation - PLRs appropriate, L eye slightly more 'blinky' - NAD seen in eyes.
NAD thorax ausc - HR approx 160, lung fields sounds normal
Temp up a bit but I feel acceptable for energetic young kitten.

Opportunistic abdo scan - no free fluid seen (portable US scanner). (Just a quick look)

Plan.
Discuss difficulty in diagnosing FIP in general - CoV titre non diagnostic; blood proteins may raise supcioin, clinical signs and lesions vary; antiviral treatment trial is possible and likely optimal for sick cats with index of suspicion.

Nero is clinically well so suggest start with bloods (esp protains and ratio) - if suspcious would advise full abdo ultrasound to rule out with more confidence any ascites/ granulomatous lesions .