Feline dysautonomia

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Sections available in full article Introduction, Presenting signs, Geographic incidence, Age predisposition, Breed predisposition, Pathogenesis, Etiology, Pathophysiology, Timecourse (incubation, duration), Epidemiology (population dynamics), Diagnosis, Presenting problems, Client history, Clinical signs, Diagnostic investigation, Confirmation of diagnosis, Gross autopsy findings, Histopathology findings, Differential diagnosis, Treatment, Initial symptomatic treatment, Monitoring, Sequelae, Prognosis, Expected response to treatment, Reasons for treatment failure, Sources, Publications, Vetstream contributor(s),
Contributors Dr Agnes Delauche DVM MRCVS DACVIM DECVN AdvCertCIM
Dr Rosanna Marsella DVM DipACVD
Synonyms Key-Gaskell syndrome

Introduction

  • Disease first recognized in 1981 and appeared to have largely died out, although recently a few cases reported.
  • Cause : remains unknown.
  • Signs : regurgitation, constipation, third eyelid protrusion.
  • Diagnosis : clinical signs.
  • Treatment : symptomatic only.
  • Prognosis : guarded although some animals appear to make a full recovery.

Diagnosis

Clinical signs

  • Dry mucous membranes (oral, nasal, dry eye).
  • Protrusion of third eyelid  Key-Gaskell syndrome: dysautonomia  .
  • Dilated pupils  Key-Gaskell syndrome: dysautonomia - Burmese kitten  .
  • Pupillary reflexes reduced.
  • Dehydration.
  • Bradycardia (<120/min).
  • Palpable bladder distension and/or constipation.
  • Reduced anal tone.
  • Proprioceptive deficits.

Diagnosis

Differential diagnosis

  • Other causes of regurgitation  Regurgitation  .
  • Other causes of megaesophagus  Megaesophagus  .
  • Esophageal stricture  Esophagus: stricture  .
  • Other esophageal disease  Esophagus: disease  :
    • Foreign body  Esophagus: foreign body  .
    • Diverticulum.
    • Neoplasia.

Sequelae

Prognosis

  • Very guarded.
  • A few cases make a full recovery and some recover with residual neurological deficits.
  • Many cases die as a result of complications of the disease.

Expected response to treatment

  • Reducing severity of clinical signs:
    • Improved urination/defecation.
    • Reduced frequency of regurgitation.
    • Improving demeanor and appetite.

Reasons for treatment failure

  • Development of complications, eg aspiration pneumonia.
  • Inadequate supportive care.
  • Many cases will die whatever treatment and nursing care is given.

Sources

Publications

Refereed papers

  • Recent references fromPubMed.
  • Kidder A C, Johannes C, O'Brien D P, Harkin K R & Schermerhorn T (2008)Feline dysautonomia in the Midwestern United States: a retrospective study of nine cases.J Feline Med Surg10, 130-136PubMed.
  • Nunn F, Cave T A, Knottenbelt C & Poxton I R (2004)Association between Key-Gaskell syndrome and infection by Clostridium botulinum type C/D.Vet Rec.155(4), 111-115.
  • Cave TA, Knottenbelt C, Mellor DJ, Nunn F, Nart P & Reid SW (2003)Outbreak of dysautonomia (Key-Gaskell syndrome) in a closed colony of pet cats.Vet Rec.153(13), 387-392.PubMed
  • Symonds H Wet al(1995)A cluster of cases of feline dysautonomia (Key-Gaskell syndrome) in a closed colony of cats.Vet Rec136(14), 353-355.
  • Bjerkas Eet al(1994)Feline dysautonomia in Norway.Vet Rec135(19), 463.
  • Levy J Ket al(1994)Decreased urinary catecholamines in a cat with dysautonomia.JAVMA205(6), 842-844.
  • Nash A Set al(1994)Feline dysautonomia in group-housed cats.Vet Rec134(7), 175-176.
  • Patterson C J (1994)Suspected cases of feline dysautonomia.Vet Rec134(5), 123-124.
  • Sharp N J (1990)Feline dysautonomia.Semin Vet Med Surg (Small Anim)5(1), 67-71.
  • Edney A Tet al(1988)Feline dysautonomia around the world.Vet Rec123(17), 451-452.
  • Pollin M Met al(1987)Feline dysautonomia: an ultrastructural study of neurones in the XII nucleus.Acta Neuropathol (Berl)73(3), 275-280.
  • Griffiths I Ret al(1985)Feline dysautonomia (the Key-Gaskell syndrome): an ultrastructural study of autonomic ganglia and nerves.Neuropathol Appl Neurobiol11(1), 17-29.
  • Sharp N J H, Nash A S & Griffiths I R (1984)Feline dysautonomia (the Key-Gaskell syndrome): a clinical and pathological study of forty cases.JSAP25, 599-615.
  • Nashet al(1982)The Key-Gaskell syndrome an autonomic polygangliopathy.Vet Rec111, 307.

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