Hydrocortisone therapy in a cat with vasopressor-refractory septic shock and suspected critical illness-related corticosteroid insufficiency

Pisano, Simone R. R.; Howard, Judith; Posthaus, Horst; Kovacevic, Alan; Yozova, Ivayla D.

One day after surgery, the cat developed mild dyspnea. A thoracic ultrasound revealed minimal pleural and pericardial effusions. Echocardiography revealed mild inhomogeneity of the ventricular wall, suggestive of possible myocarditis, and minimal pericardial effusion. Pleural fluid real-time PCR for feline Corona virus was negative. Cytology revealed a septic exudate, confirmed to be hemolytic E. coli on bacterial culture. Blood cultures were negative. The pyothorax was treated with intermittent thoracocentesis followed by placement of bilateral chest drains and intermittent lavage during 4 days. Bacterial culture and sensitivity revealed that E. coli cultured from both body cavities was sensitive to marbofloxacin but E.coli cultured from the peritoneal cavity was resistant to ampicillin and rifampicin, and E.coli cultured from the pleural cavity was resistant to all penicillins and 1st-and 3rd-generation cephalosporins. Monotherapy with marbofloxacin was, therefore, continued.