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Your Singapore, the Tropical Garden City
K. Borgeat1
1Langford Vets- University of Bristol, Cardiology, Bristol, United Kingdom
A Practical Approach to Cats with Respiratory Distress
The cat presenting with respiratory distress poses unique challenges. Not only do clinical signs often appear to occur suddenly, creating an emotional situation for owners, but the cat is often in an unstable condition where decompensation can occur because
of the stress associated with handling and procedures. Intensive care and support are vital, but the number and frequency of procedures must be minimised in order
to promote patient stability. The clinician must maintain
a logical and calm approach, by formulating a list of differential diagnoses that is revised on an ongoing basis as diagnostic test results are revealed.
Presenting signs, initial stabilisation and historical findings
Most cats with respiratory distress present acutely,
often at an inconvenient time and with little notice. We recommend that the patient is provided with supportive oxygen therapy as soon as they are known to have respiratory distress. As a result, history taking is often curtailed early on, but this can be resumed once initial stabilisation is under way. Whilst the clinician is working with the cat, a third party (possibly a veterinary nurse) should obtain a signed consent form for stabilisation and initial procedures, including thoracocentesis.
It is imperative that the dyspnoeic cat is handled minimally, in a quiet and calm environment, with adequate oxygen provision. Intravenous access
or blood work is often contraindicated early in the timeline of case management. Sedation should be considered if the patient is distressed. Pharmaceuticals that dramatically alter systemic vascular resistance or promote bronchoconstriction should be avoided. The authors typically use butorphanol (0.2-0.4mg/kg IM, SC or IV if access is present), and avoid using medetomidine or ketamine because of their profound effects on systemic vascular resistance.
Observation of respiratory pattern is a very useful way of narrowing the list of possible differential diagnoses in cats with respiratory distress (Table 1). It can be performed whilst the cat is in a carrier, whilst they are receiving oxygen, and without any patient restraint which may contribute to stress. It is worth noting that a paradoxical pattern represents non-specific respiratory fatigue, although it is common in patients with pleural
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7. Penetration of laser light at 808nm and 980nm in bovine tissue samples. Hudson DE, Hudson DO, Wininger JM, Richardson BD. Photomed Laser Surg 31:163-168, 2013.
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9. Low-level laser therapy enhances wound healing in diabetic rats: A com- parison of different lasers. Al-Watban FA, Zhang XY, Andres BL. Photomed Laser Surg 25:72-77, 2007.
10. Effect of low level laser therapy on inflammation reactions during wound healing: Comparison with meloxicam. Viegas VN, Abreu ME, Viezzer C, et al. Photomed Laser Surg 25:467-473, 2007.

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