Blue gums are the most noticeable symptom of cyanosis. Cyanosis is the blue or purple discoloration of mucous membranes or skin caused by poor oxygenation.
• Any initial onset of cyanosis is an emergency
• Cyanosis in cats can result from a number of underlying conditions including: congenital heart disease, respiratory disease, exposure to toxins, hypothermia, blood clots, shock, or the application of a tourniquet
• Diagnostic testing includes physical examination, arterial blood gas measurement, other blood tests, and diagnostic imaging
• Cats with dangerously low oxygen levels are often stabilized with supplemental oxygen immediately upon presentation
• Treatment and prognosis depend on the underlying cause
Cyanosis is an emergency, immediate medical attention may be crucial in saving the animal's life.
There are two types of cyanosis:
Central cyanosis affects all the animal's tissues. It is caused by the decrease of oxygenated blood throughout the body as a result of heart or lung problems.
Peripheral cyanosis is localized, and the discoloration affects only one specific part of the body.
Differentiating between central and peripheral cyanosis is not always easy, and either condition indicates a need for emergency care.
Cyanosis is caused by poor oxygenation. A number of underlying conditions and risk factors can lead to cyanosis, including:
• Hypothermia • Blood clots • Application of a tourniquet • Congenital heart diseases • Ventricular or atrial septal defect
• Heart failure • Anaphylaxis • Pneumothorax • Pyothorax • Hemothorax • Chylothorax • Aspiration pneumonia
• Airway obstruction (choking) • Respiratory muscle failure (e.g. tick paralysis, spinal cord injury)
• Narcotic overdose • Lung blood clot (pulmonary thromboembolism) • Lung infections• Lung cancer
• Pulmonary fibrosis
Several chemicals can restrict a cat’s hemoglobin from correctly delivering oxygen to the body. These chemicals include:
• Nitrates (found in soil and water, or food additives) • Acetaminophen • Methylene blue• Some topical anesthetics
Short-nosed (brachycephalic) breeds (e.g. Persian, Himalayan, Shorthair, Burmese) are more likely to develop cyanosis. Blue gums are often accompanied by panting. Unlike dogs, panting in cats is a symptom of severe distress and medical attention is warranted.
A cat presenting with severe cyanosis may require supplemental oxygen before diagnostic testing can begin.
Once stabilized, a cat presenting with cyanosis usually undergoes the following diagnostics:
• Arterial blood gas test (ABG): the ABG test involves obtaining a sample of arterial blood while the animal is receiving oxygen supplementation
• Diagnostic imaging • Pulse oximetry • Blood tests
Treatment of cyanosis is dependent on the underlying cause.
Blue gums are unique and self evident, but cyanosis may be confused with pale or gray gums in the early moments of development of the symptom.
Symptoms that are commonly seen in association with cyanosis:
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