Obtaining a complete medical history and performing a thorough physical examination
are necessary in order to create an appropriate diagnostic plan for the panting patient. A complete blood count (CBC) evaluates for the presence of infection, inflammation, anemia or polycythemia (high red blood cell count) associated with some diseases that cause panting.
A biochemical profile helps rule out metabolic causes of panting. It can assess the kidney, liver, electrolytes, total protein and blood sugar status. All of these parameters are important to establish in the patient with panting.
A urinalysis helps evaluate the kidneys and hydration status of the patient.
Thoracic radiographs evaluate for the presence of fluid, air or masses in the chest cavity. It also assesses for the presence of metastasis (spread of tumor), pneumonia, edema (fluid in the lungs) and helps evaluate the heart, esophagus and trachea.
Abdominal X-rays evaluate the abdominal organs, presence of a foreign body or tumor, and may help evaluate for other disorders that may relate to pain.
An arterial blood gas should be obtained as it may help formulate an appropriate treatment plan, and help identify an underlying cause.
An echocardiogram (ultrasound of the heart) should be considered in those cases where heart disease is suspected. It is a safe test that usually necessitates the involvement of a specialist.
An abdominal ultrasound evaluates the size, shape and texture of abdominal organs and helps assess for the presence of tumors, fluid or potential inflammatory disorders that may cause pain and in turn, panting. This procedure is relatively safe, but may necessitate a mild sedative. It is often recommended that a specialist perform the procedure.
Endocrine testing to include an ACTH stimulation test and a thyroid profile may be recommended to rule out hyperadrenocorticism (Cushing's disease) and hypothyroidism, respectively. They are blood tests that can usually be performed at your local veterinary hospital. Both Cushing's disease and hypothyroidism are endocrine disorders that are commonly seen in veterinary medicine, and can be associated with panting.
Heartworm testing is recommended in endemic areas.
A thyroid level (T4) should be performed in all cats six years of age or older.
Your veterinarian may recommend additional tests to insure optimal medical care. These are selected on a case-by-case basis.
A coagulation (clotting) profile should be considered when blood in the lungs or chest cavity is thought to be the cause of panting.
Thoracocentesis (withdrawing fluid or air from the chest cavity) should be considered as both a diagnostic and therapeutic tool in the panting patient.
Transtracheal wash/bronchoalveolar lavage should be considered when certain respiratory disorders are suspected in the patient. Both procedures assess cells/fluid/tissue from the lower respiratory tract for the presence of tumor, inflammation or infection. These are relatively benign procedures that may be performed at your local hospital, although in some cases it may be performed at a specialty facility.
Bronchoscopy, or evaluation of the inside of the trachea and bronchi with a scope, is recommended in selected cases. The procedure necessitates general anesthesia, and usually requires a specialist. It helps visualize the inside of the bronchi directly, and may be a tremendous benefit in certain cases. It is usually best to have the procedure performed by a specialist.
Pulmonary scintigraphy (injection of a radioactive substance) may be helpful in trying to identify pulmonary thromboembolic disease.
Computed tomography (CT scan) or magnetic resonance imaging (MRI) may be indicated if central nervous system disease is suspected. These procedures necessitate transport to a specialty facility and general anesthesia and are generally quite costly.
An acetylcholine receptor antibody titer (ARAT) may be recommended if myasthenia gravis is suspected. Generally, concurrent signs of illness, such as weakness, regurgitation and possibly pneumonia are usually seen.