Cats with pleural effusion represent common emergencies in small animal practice. The aim of this prospective study was to investigate the diagnostic ability of a point-of-care ELISA (POC-ELISA) for the measurement of N-terminal pro B-type natriuretic peptide (NT-proBNP) to differentiate cardiac from non-cardiac disease in cats with pleural effusion. The sample material for use of this rapid test was either plasma or diluted pleural effusion. Twenty cats with moderate to severe pleural effusion were prospectively recruited. The cats were grouped into two groups, with or without congestive heart failure (CHF; N-CHF), after complete work-up. Blood and effusion were collected in EDTA tubes. Plasma and pleural effusion supernatants were transferred into stabilizer tubes and frozen. POC-ELISA for NT-proBNP was performed with plasma and diluted effusion (1:1). Quantitative NT-proBNP measurement was performed in plasma and diluted and undiluted effusions. Six cats were assigned to the CHF group. Of the 14 cats in the N-CHF group, 6 had concurrent cardiac abnormalities that were not responsible for the effusion. For the detection of CHF, the test displayed respective sensitivities and specificities of 100% and 79% in plasma and 100% and 86% in diluted pleural fluid. Receiver operating characteristic (ROC) analysis for quantitative NT-proBNP measurement of plasma and diluted and undiluted pleural effusions displayed areas under the curve of 0.98, sensitivities of 100% and specificities of 86%. The optimum cut-off was calculated at 399 pmol/l in plasma and 229 pmol/l in the diluted effusion and 467 pmol/l in the undiluted effusion. POC-ELISA for NT-proBNP in both plasma and diluted pleural effusion was suitable to differentiate cardiac from non-cardiac causes of feline pleural effusion. According to our results, use of pleural effusion is feasible, but dilution of the effusion before measurement seems to improve specificity.

Induction of a hypocoagulable state is imperative in the treatment of feline arterial thromboembolism. Publications in human medicine report the use of enoxaparin intravenously in selected cases. The aim of our retrospective study was to report the regain of perfusion, short-term outcome, and complications of cats treated with a novel intravenous enoxaparin protocol (1 mg/kg bolus injection followed by 3 mg/kg/day continuous infusion) combined with oral clopidogrel administration. The secondary aim was to report the monitoring of enoxaparin with anti-Xa activity. There were 36 cats included. The probability of reaching limb reperfusion was significantly (p = 0.0148) higher with anti-Xa activity within or above the target range compared to results below the target range (19/21, 90% versus 11/20, 55%). The complications observed were acute kidney injury (15/36, 42%), hemorrhage (2/36, 6%), and neurological signs (6/36, 17%). The most common causes of death/euthanasia were cardiac instability, acute kidney injury, neurological abnormalities, and limb necrosis. The hospital discharge rate was 83% (10/12) for single limb and 29% (7/24) for dual limb thrombosis; the difference was significant (p = 0.0039). The median hospitalization time for the survivors was 119.5 (95–480) h. Our study supports the use of intravenous continuous rate infusion of enoxaparin in combination with oral clopidogrel for cats with aortic thromboembolism. We report similar discharge rates and lower hemorrhage rates than previously reported with thrombolytic treatment.

First-line therapy for cats with pyothorax consists of intravenous antibiotics, drainage of the septic pleural effusion and closed-chest lavage. Large-bore thoracostomy tubes are traditionally used for drainage, but case series indicate a comparable efficacy using small-bore tubes. In this retrospective study, we describe a new technique of sheath-guided small-bore (6 F) thoracostomy tubes in cats with pyothorax and evaluate their efficacy and complications. Additionally, we compare outcomes between two treatment groups. Placement and use of the small-bore thoracostomy tubes described here has a low complication rate of 4% (3/67 tubes), and 53% (24/45) of the cats could be treated with thoracostomy tubes and closed-chest lavage according to the protocol. The success rate is reduced by 18% (8/45) due to deaths caused mainly by sepsis, 16% (7/45) due to structural diseases requiring surgery and a further 14% (6/43) due to lavage failures that could only be cured after additive therapy (thoracotomy or fibrinolysis). The long-term prognosis was very good, with a survival rate one year after discharge of 94% (30/32). We detected no effect on survival by early placement of bilateral thoracostomy tubes or closed-chest lavage with a heparinised solution. In conclusion, therapy of pyothorax with small-bore thoracostomy tubes is as successful as therapy with large- or medium-bore tubes.

Vergiftungen können zu lebensbedrohlichen Notfällen führen. Neben der allgemeinen Stabilisation des Patienten sollte eine Therapie eine schnellstmögliche Toxinelimination bewirken. Zunächst wird versucht, durch allgemeine Dekontaminationsmaßnahmen (gastrointestinal, dermal, okulär) die Giftaufnahme so gering wie möglich zu halten. Eine genauere Eingrenzung des Toxins bzw. seiner Eigenschaften kann bei der Auswahl spezifischerer Behandlungsansätze, wie beispielsweise Dialyse oder Gabe eines Antidots, Hilfestellung leisten. Die Therapie mit Lipidemulsionen zur raschen Elimination lipophiler Substanzen aus dem Körper hat in den letzten Jahren zunehmend an Bedeutung gewonnen. Sie kann das Allgemeinbefinden des Patienten schnell verbessern und ist mit wenig Nebenwirkungen verbunden.