NAVLE Feline Internal Medicine 5 — Questions and Answers
Question 1: A cat with pleural effusion undergoes thoracocentesis. Analysis reveals chylous effusion (triglycerides > serum). What is the most common underlying cause in cats?
- Thoracic duct lymphoma
- Congestive heart failure
- Idiopathic chylothorax (Correct answer)
- Diaphragmatic hernia
Correct answer: Idiopathic chylothorax
Idiopathic chylothorax is the most common cause in cats when lymphoma and cardiac disease have been excluded, though thoracic duct abnormalities are suspected.
Question 2: A 4-year-old indoor cat develops acute epistaxis and retinal hemorrhages. Blood pressure is 225/160 mmHg. Which primary disease is most commonly responsible for severe hypertension in cats under 7 years of age?
- Hyperthyroidism
- Chronic kidney disease
- Primary hyperaldosteronism (Correct answer)
- Pheochromocytoma
Correct answer: Primary hyperaldosteronism
Primary hyperaldosteronism is an important cause of severe hypertension in younger cats and should be investigated when CKD and hyperthyroidism are absent.
Question 3: Feline lower urinary tract disease (FLUTD) in a young male cat is most commonly attributable to which condition?
- Bacterial urinary tract infection
- Urolithiasis (struvite or oxalate)
- Idiopathic feline interstitial cystitis (FIC) (Correct answer)
- Urethral neoplasia
Correct answer: Idiopathic feline interstitial cystitis (FIC)
Idiopathic feline interstitial cystitis (FIC) accounts for approximately 55–65% of FLUTD cases in young cats, and bacterial UTI is rare in cats under 10 years.
Question 4: A cat with suspected exocrine pancreatic insufficiency (EPI) should have which test performed to confirm the diagnosis?
- Serum amylase
- Serum lipase
- Feline trypsin-like immunoreactivity (fTLI) (Correct answer)
- Fecal fat staining
Correct answer: Feline trypsin-like immunoreactivity (fTLI)
Feline TLI (fTLI) below 8 µg/L confirms EPI in cats by measuring pancreatic exocrine secretion capacity; EPI is rare in cats but fTLI is the diagnostic gold standard.
Question 5: Which antiviral drug has been shown to induce remission of FIP caused by FCoV mutation (FIPV) in clinical trials and is now widely used off-label?
- Interferon-omega
- GS-441524 (nucleoside analog) (Correct answer)
- Ribavirin
- Famciclovir
Correct answer: GS-441524 (nucleoside analog)
GS-441524, an adenosine nucleoside analog, inhibits FCoV replication and has shown >85% sustained remission rates in cats with wet and dry FIP in clinical studies.
Question 6: A cat with hepatic lipidosis secondary to anorexia requires nutritional support. What is the preferred route of alimentation?
- Total parenteral nutrition via jugular catheter
- Nasogastric tube feeding
- Esophagostomy tube feeding (Correct answer)
- Voluntary oral high-protein diet
Correct answer: Esophagostomy tube feeding
Esophagostomy tube placement is the preferred long-term enteral feeding route for hepatic lipidosis as it allows owner-administered home feeding, is well tolerated, and provides adequate caloric delivery.
Question 7: A Siamese cat presents with recurrent upper respiratory signs, chronic nasal discharge, and sneezing since kittenhood. Rhinoscopy reveals mucosal proliferation and turbinate destruction. Which diagnosis is most likely?
- Aspergillus rhinosinusitis
- Chronic rhinosinusitis secondary to herpesvirus-1 (FHV-1) (Correct answer)
- Nasal lymphoma
- Cryptococcus neoformans rhinitis
Correct answer: Chronic rhinosinusitis secondary to herpesvirus-1 (FHV-1)
Chronic rhinosinusitis with turbinate destruction in young cats with a history of repeated upper respiratory infections is most commonly a sequela of early FHV-1 infection causing permanent mucosal damage.
NAVLE Feline Internal Medicine 5
A cat with pleural effusion undergoes thoracocentesis.
Analysis reveals chylous effusion (triglycerides > serum).
What is the most common underlying cause in cats?