Visiting Vet: Selene

What caused the young cat’s mysterious respiratory symptoms?

—Takashi Hososhima

Over the weekend, the family noticed something was wrong with their 1-year-old cat, Selene. On Saturday, she vomited, and was shaking her hind legs oddly. Then she disappeared. Selene is an indoor cat who never ventures outside, but she was nowhere to be seen. Sunday they found her hiding under the couch, unusual behavior for this normally outgoing and affectionate kitty. Monday morning, they dislodged her from beneath the furniture and brought her to see me.

“Well, she’s purring,” I commented, taking her from the carrier. “But it’s a different-sounding purr,” her dad replied. He was right. Selene was making bubbling, gurgly sounds as she breathed. Like a kid with a stuffy, runny nose … but her nose looked dry and clear. She also made a strange rattling noise in her throat. Her temperature was a tad above normal, but minor elevations like this may occur just from the stress of the car ride. Ausculting her heart and lungs with my stethoscope, all I could hear was constant snorting and snuffling. I had my assistant put her finger over Selene’s nostrils for a few seconds to stop the noises so I could assess her heart. It sounded fine. No murmurs, no arrhythmia.

Upper respiratory infections are a common cause of stuffy noses in young cats. These can involve a variety of diseases, including feline herpesvirus, calicivirus, and chlamydia. But these infections typically produce other symptoms, like red, watery eyes, nasal discharge, sneezing, and fever. Selene didn’t fit the picture. Tularemia is another disease that can cause significant respiratory symptoms, with ulcers in the mouth or throat, swollen glands, and labored breathing. Cats contract it via tick exposure or by hunting rabbits. Stay-at-home Selene had neither of these risk factors. Other inflammatory diseases of the nasal passages are more common in elderly cats, and tend to be slow, chronic illnesses with visible nasal discharge, and feline asthma usually presents with dry, wheezy breathing and, occasionally, coughing … not gurgling.

“I’ve never seen anything exactly like this before,” I said. Pondering Selene’s condition, I thought of Athena, a cat seen many years ago. Like Selene, Athena had experienced a sudden onset of odd respiratory signs. Her distress was so severe we actually anesthetized her while we ran diagnostics and tried treatments. Radiographs revealed lung congestion, but no obvious cause. Every time we tried to wake her from anesthesia, her distress returned, and a decision was finally made for euthanasia. The owner gave permission for a necropsy. I opened the trachea, following it down the neck and into the chest, where it forks into two bronchi. Continuing to explore the airways as they traveled into the lungs, I saw something small and black peeking out. What was that? I cut further. A leg. A furry leg. Grabbing it with forceps, I extracted an entire wolf spider. Athena must have tried to eat the spider and inadvertently inhaled it. Without having a specialist to scope her airways, there was no way we could have known this, or treated it, but it was still heartbreaking.

Could Selene have inhaled a foreign object, like that spider? She wasn’t as distressed as Athena had been. The congestion seemed more in her nose or throat. I then thought of the cat Rhapso. It must have been 30 years ago. Rhapso first presented with a weird swallowing and gaggy respiration, as if her throat was sore. That resolved with antibiotics, but several weeks later, Rhapso developed a slight limp. I couldn’t find anything wrong. The limp resolved, but then an abscess appeared just behind her shoulder blade. I lanced the abscess and gave more antibiotics. It got better, but then recurred. Agggh! Determined to finally figure out what was going on, I started exploring deep in the draining shoulder wound. Look! There! A small black dot. Reaching in with a hemostat, I grabbed the black dot and pulled. A thread. I pulled harder. A long thread … attached to the needle that Rhapso had swallowed. The needle had perforated her esophagus, migrated through her neck, down her body, eventually emerging behind her shoulder blade. Had I taken radiographs, I would have diagnosed this on day one.

“Let’s take x-rays,” I suggested to Selene’s owners. Radiographs revealed changes suggestive of inflammation in her lungs, but no visible foreign body. We started antibiotics and sent her home. The next morning, Mom called, worried. Selene was no better, and now breathing with her mouth open, often a sign of respiratory distress. I had them come right back. Selene’s fever was higher, but her breathing actually seemed mildly improved. I was relieved, but still mystified. As a strictly indoor cat, she was not exposed to the dangers and diseases outdoor cats experience. My gut kept saying “spider, needle.” I grilled the owner. What could Selene have put in her mouth? Pins? Needles? Any construction in the house? Sawdust, chemicals, fiberglass insulation?

Fiberglass insulation. When I was a kid, our living room curtains were material made from spun fiberglass. Every time I helped my mother take them down to wash, I got an awful rash on my arms, like a million invisible glass shards. Selene was licking her hind legs, but I hadn’t paid much attention to that, being too focused on her breathing. Looking now, I saw it. A rash, just like my teenage arms. Could she have gotten into fiberglass insulation? Licked it? Inhaled it?

Her owner instantly confirmed the diagnosis, remembering that recently Selene had found some insulation in the basement. They had actually seen her carrying a chunk in her mouth. Fiberglass insulation causes local irritation on the skin, but if ingested or inhaled, it can actually be life-threatening. We added corticosteroids to Selene’s protocol to reduce the inflammation, instructed the owners to eliminate any possible further exposure to insulation, and hoped for the best. Within two days, Selene was markedly better, and in a week, completely back to normal. We’re so glad that at least this time, curiosity didn’t kill the cat.