Acute Collapse in Cats
Dr. Etienne Cote
If your cat is still collapsed when it is brought to the veterinarian, tests will be done immediately and hospitalization with continuous monitoring may be recommended, particularly if the situation is perceived as life threatening. A complete medical history and a thorough physical examination. Particular attention should be paid to auscultation of the heart (listening with a stethoscope). The arterial blood pressure should be measured. Added examinations should include palpation (feeling) the abdomen, assessing the neurologic status of your cat.
Your veterinarian will determine the underlying problem and the immediate threat it poses to your cat. Alternatively, if your cat's condition improves spontaneously, and your cat seems well when you reach the veterinary hospital, tests will be performed. These will be aimed to determine the cause of the problem in order to assess the risk of future collapse and to see whether medication is warranted.
As mentioned in "Causes", numerous diseases can lead to acute collapse. Therefore, your veterinarian may perform one or more of the following tests:
Routine blood tests. Abnormalities in blood test results can pinpoint certain causes of collapse (such as anemia or hypoglycemia). Blood tests can also help evaluate the state of many internal organs.
Specialized blood tests. These may be recommended including screens for leukemia or immunosuppressive viruses as well as other blood studies.
Radiographs. X-rays of the thorax and the abdomen (the chest and belly) may be advised. X-rays generally show the outlines of internal organs, which helps determine their size, shape, and position. Fluid accumulation or bleeding may be evident if moderate to severe.
X-rays of the back and limbs. If a spinal problem or a leg problem is suspected on physical examination, X-rays are the best way to evaluate the bones. Often these X-rays need to be taken with the animal under general anesthesia or heavy sedation.
Electrocardiogram (ECG or EKG). If a cardiac problem is suspected, the rhythm of the heartbeat is analyzed with an ECG recording. This can be as simple as a routine EKG or more advanced such as an ambulatory EKG that your pet wears while at home. These specialized electrocardiograms are sometimes called Holter monitors and Event Recorders.
Ultrasound of the abdomen or of the heart. While X-rays show the outlines of organs, ultrasound makes it possible to see inside the individual organs. Therefore, X-rays and ultrasound examinations are often complementary. Ultrasound is frequently performed by a specialist, which may require referral to a specialty veterinary hospital.
Neurologic evaluation. If a disease of the brain, spinal cord, or nerves is suspected, a consultation with a neurologist may be recommended.
If a spinal problem or brain problem is suspected, additional procedures may be recommended. Examples include a myelogram (X-rays of the spine taken with a special dye injection, to better evaluate the spinal cord), a CT scan ("CAT" scan), or an MRI scan. Sometimes a neurologist will recommend specialized tests of the nerves and muscles called an electromyogram (EMG).
Additional, tests may be recommended from the results of any of the tests listed above. For example, a cat with spinal cord lymphoma (a type of cancer) may have the same type of cancer cells in the bone marrow. A bone marrow aspiration is much easier and safer to perform than a biopsy of spinal cord tissue.
Therefore, the initial tests may find the cause of collapse outright, or may direct the veterinarian to pursue other causes of collapse.
At the time of initial collapse, it is best to go immediately to the nearest veterinarian rather than spend time on "life-saving" measures. Inappropriate cardiopulmonary resuscitation (CPR), for example, can be ineffective and cause internal organ damage if done improperly.
The most beneficial treatment for acute collapse is the elimination of its cause. Finding the cause can be complicated and time-consuming, because so many potential explanations are possible. Therefore, treatments often are general ("supportive") at first and then become more specific as new information is obtained from test results.
The following are examples of treatments the veterinarian may provide.
Immediate reversal of the problem if possible. Examples include removing an object that is obstructing airflow in the throat or giving an antidote if poisoning was known to have occurred.
Intravenous fluids ("IV's"). These fluids may rehydrate, provide nutrition and bring the blood pressure back towards normal if collapse was associated with low blood pressure.
Surgery. Many of the causes of acute collapse involve abnormal tissue that should be removed. Examples include tumors in the abdomen that cause internal bleeding, and intervertebral disk problems that cause stiffness or paralysis of the legs. If and when to perform surgery requires a careful decision that is based on weighing the risk of general anesthesia against the risk of delaying surgery.
Intravenous drugs. A number of emergency drugs can be given intravenously, including drugs to control blood pressure (dopamine, phenylephrine), regulate the heartbeat (antiarrhythmics), reduce inflammation (corticosteroids), stimulate respiration in an emergency (doxapram), and so on. Naturally, the exact drug selection depends on the underlying problem.
Blood transfusion. If a severe anemia or a loss of blood (injury, internal hemorrhage, etc.) is the cause of collapse, then giving whole blood, blood components or blood substitutes may be lifesaving. Many veterinary hospitals do not have a blood bank on-site and a blood transfusion may require transfer to a specialty veterinary hospital.