Cat with lethargy and vomiting diagnosed with septic splenitis

Abstract

A 3.5-year-old female neutered Abyssinian cat was referred for investigation of a 2-week history of lethargy and intermittent vomiting, with recent development of diarrhoea, hyporexia, pyrexia, abdominal pain, moderate anaemia, hyperglobulinaemia and a palpably enlarged spleen. Abdominal ultrasound revealed a nodular spleen, and cytology identified septic splenitis (cocci were seen within neutrophils following fine needle aspiration). After 72 h of intravenous amoxicillin and clavulanic acid (20 mg/kg, per os, every 8 h), lack of clinical improvement prompted exploratory laparotomy and splenectomy. Histopathology was compatible with a suppurative to pyogranulomatous splenitis and identified intralesional bacteria. Bacterial culture of abdominal effusion and splenic biopsies grew Staphylococcus pseudintermedius resistant to benzylpenicillin. After surgery, the cat was treated with a 4-week course of the fluoroquinolone pradofloxacin (5 mg/kg, per os, every 24 h) and made a complete recovery. Septic splenitis is an uncommon diagnosis in the veterinary literature, being limited to eight splenic abscesses in cats, rare reports in dogs and a case of splenic foreign body in a cat and a heifer. To the authors' knowledge, this is the first description of the successful management of septic splenitis in a cat not secondary to a foreign body. This case highlights that splenectomy should be considered the treatment of choice in the absence of response to antibiotic treatment and that antibiotic choice should be guided by antibiotic susceptibility results.