FELINE MEDICINE EXAM
Primary Survey
Aim to rapidly, and without the aid of diagnostics, assess the major body systems of the
animal.
RESPIRATORY -> Aim to ID hypoxaemia and hypoventilation. Obvious signs include
open-mouth breathing, paradoxical abdominal effort, cyanosis, or increased RR and
effort. For the purpose of a primary survey, check for apnoea, stridor/stertor, resp
distress, cyanosis, and abnormal lung sounds
CVS -> Assessment of the CVS is subjectively evaluating the cardiac output. Check
shock parameters.
NEURO -> Assess mentation, assess for evidence of head or spinal trauma, and
assess for seizures or tremors. In any abnormal patient, a complete neuro exam should
later be performed
MM colour and meaning
PALLOR -> vasoconstrictive shock, anaemia
INJECTED -> Vasodilation, most common in sepsis, but also seen in anaphylaxis and
hyperthermia
CYANOSIS -> Sever hypoxaemia
ICTERIS -> Seen secondary to the breakdown of RBC or liver disease
BROWN -> Methaemoglobinaemia
Pulse Quality Meaning
Pulse quality assessed pulse pressure variation (difference between systolic and
diastolic). When pulses are thready or reduced, then pulse pressure waveform is
narrow, which is indicative of reduced stroke volume. Bounding pulses are noted in
vasodilation and sepsis, but are less common in cats
Levels of Mentation
NORMAL (BAR,QAR)
OBTUNDED - Patient responds to the environment, but responses are sluggish and
slow
STUPOR - Patient does not respond to the environment, but does respond to noxious
stimuli (e.g. loud noise, pain)
COMA - Patient responds to no stimuli
SpO2 of 95% is equivalent to a PaO2 of?
80mmHh - Which is hypoxaemic
SpO2 of 90% is equivalent to a PaO2 of?
60mmHg - Severe hypoxaemia
Accurate SPO2 measurements impacted by
Hypothermia
Pigmented MM
Hypovolaemia
Movement
Patient Demeanour
How is haematocrit calculated?
, Mean Corpuscular Volume x RBC count / 10
Can be falsely increased with storage of blood (due to increased MCV) or decreased
with cell destruction in haemolysis
Neutrophil half life in cats
10-15 hours
Stress Leukogram
Due to endogenous or exogenous corticosteroids
LEMoN
Lymphopaenia
Eosinopaenia (or philia in cats)
Monocytosis
Mature Neutrophilia
Physiologic Leukocytosis
Due to adrenaline, resulting in mature neutrophila and lymphocytosis
Very common in cats
Inflammatory Leukogram
eosinopaenia Bone marrow response to increased demand, leading to a release in the
storage pool of band cells and seen as neutrophilia with left shift and toxic change
Also monocytosis, lymphopaenia, and possible
Lymphopaenia DDx
Stress
Acute Infection
Chylous Effusion
Immunodeficiency
Lymphocytolysis due to viral infection
Lymphocytosis DDx
Physiologic response to adrenaline
Leukaemia
Chronic Inflammation
Various Infections
Expected Compensatory Changes in Primary Acid Base Disorders
2 Common Mechanisms of Metabolic Acidosis
1. Loss of Bicarbonate
- Leads to Cl ion increase
- AG is normal
2. Gain of Acid
- Excess H+ in system, which combines with HCO3- leading to reduced bicarb
- Anion that accompanied the hydrogen ion will accumulate, maintaining
electroneutrality, and increasing the AG
Anion Gap Calculation
(Na + K) - (Cl + HCO3)
Type A Hyperlactataemia
Due to inadequate Oxygen Delivery
Primary Survey
Aim to rapidly, and without the aid of diagnostics, assess the major body systems of the
animal.
RESPIRATORY -> Aim to ID hypoxaemia and hypoventilation. Obvious signs include
open-mouth breathing, paradoxical abdominal effort, cyanosis, or increased RR and
effort. For the purpose of a primary survey, check for apnoea, stridor/stertor, resp
distress, cyanosis, and abnormal lung sounds
CVS -> Assessment of the CVS is subjectively evaluating the cardiac output. Check
shock parameters.
NEURO -> Assess mentation, assess for evidence of head or spinal trauma, and
assess for seizures or tremors. In any abnormal patient, a complete neuro exam should
later be performed
MM colour and meaning
PALLOR -> vasoconstrictive shock, anaemia
INJECTED -> Vasodilation, most common in sepsis, but also seen in anaphylaxis and
hyperthermia
CYANOSIS -> Sever hypoxaemia
ICTERIS -> Seen secondary to the breakdown of RBC or liver disease
BROWN -> Methaemoglobinaemia
Pulse Quality Meaning
Pulse quality assessed pulse pressure variation (difference between systolic and
diastolic). When pulses are thready or reduced, then pulse pressure waveform is
narrow, which is indicative of reduced stroke volume. Bounding pulses are noted in
vasodilation and sepsis, but are less common in cats
Levels of Mentation
NORMAL (BAR,QAR)
OBTUNDED - Patient responds to the environment, but responses are sluggish and
slow
STUPOR - Patient does not respond to the environment, but does respond to noxious
stimuli (e.g. loud noise, pain)
COMA - Patient responds to no stimuli
SpO2 of 95% is equivalent to a PaO2 of?
80mmHh - Which is hypoxaemic
SpO2 of 90% is equivalent to a PaO2 of?
60mmHg - Severe hypoxaemia
Accurate SPO2 measurements impacted by
Hypothermia
Pigmented MM
Hypovolaemia
Movement
Patient Demeanour
How is haematocrit calculated?
, Mean Corpuscular Volume x RBC count / 10
Can be falsely increased with storage of blood (due to increased MCV) or decreased
with cell destruction in haemolysis
Neutrophil half life in cats
10-15 hours
Stress Leukogram
Due to endogenous or exogenous corticosteroids
LEMoN
Lymphopaenia
Eosinopaenia (or philia in cats)
Monocytosis
Mature Neutrophilia
Physiologic Leukocytosis
Due to adrenaline, resulting in mature neutrophila and lymphocytosis
Very common in cats
Inflammatory Leukogram
eosinopaenia Bone marrow response to increased demand, leading to a release in the
storage pool of band cells and seen as neutrophilia with left shift and toxic change
Also monocytosis, lymphopaenia, and possible
Lymphopaenia DDx
Stress
Acute Infection
Chylous Effusion
Immunodeficiency
Lymphocytolysis due to viral infection
Lymphocytosis DDx
Physiologic response to adrenaline
Leukaemia
Chronic Inflammation
Various Infections
Expected Compensatory Changes in Primary Acid Base Disorders
2 Common Mechanisms of Metabolic Acidosis
1. Loss of Bicarbonate
- Leads to Cl ion increase
- AG is normal
2. Gain of Acid
- Excess H+ in system, which combines with HCO3- leading to reduced bicarb
- Anion that accompanied the hydrogen ion will accumulate, maintaining
electroneutrality, and increasing the AG
Anion Gap Calculation
(Na + K) - (Cl + HCO3)
Type A Hyperlactataemia
Due to inadequate Oxygen Delivery
