Cats are not small dogs

Correct answer: B. They have limited glucuronide conjugation (UGT1A6 deficiency)

In felids the UGT1A6 gene is non-functional, so glucuronidation capacity is very limited. Drugs normally cleared this way, such as paracetamol, salicylates and some NSAIDs, accumulate or are diverted into toxic pathways. Choose drugs licensed for cats, follow feline doses and intervals, and never extrapolate from dog or human doses.

Correct answer: C. Methaemoglobinaemia and Heinz body haemolysis; N-acetylcysteine

In cats, paracetamol toxicity is dominated by oxidative damage to red blood cells: methaemoglobinaemia (brown mucous membranes, cyanosis, tachypnoea), Heinz body anaemia and facial and paw oedema; liver damage is less prominent than in dogs. N-acetylcysteine replenishes glutathione and is the antidote; give oxygen and supportive care, and some protocols add ascorbic acid. A single tablet can be fatal.

Correct answer: D. Control tremors and seizures (e.g. methocarbamol, benzodiazepines), bathe with lukewarm water and mild detergent once stable, and manage body temperature

Permethrin keeps sodium channels in nerve cells open for longer, and cats metabolise it poorly. Signs are tremors, twitching, hyperaesthesia, seizures and hyperthermia. Treatment is supportive: control tremors (methocarbamol is commonly used) and seizures, decontaminate with lukewarm water and washing-up liquid once the cat is stable, and correct body temperature; intravenous lipid emulsion has also been reported to help. Atropine is not an antidote. With prompt treatment the prognosis is usually good.

Correct answer: A. Clopidogrel

In the FAT CAT trial (Hogan et al., 2015), cats that had survived an arterial thromboembolism went longer without recurrence on clopidogrel than on aspirin. The ACVIM consensus on feline cardiomyopathies recommends clopidogrel for cats at increased risk, such as those with marked left atrial enlargement, and another drug may be added in high-risk cats. NSAIDs have no role here.

Correct answer: B. Stabilisation: treat hyperkalaemia (calcium gluconate to protect the heart, insulin with dextrose), start IV fluids, then relieve the obstruction under sedation

Severe hyperkalaemia with bradycardia is life-threatening. Calcium gluconate protects the myocardium within minutes but does not lower potassium; insulin with dextrose moves potassium into cells. Start IV fluids: a balanced isotonic crystalloid is appropriate despite its small potassium content. Decompressive cystocentesis may be used while you prepare to catheterise. Catheterise under sedation or anaesthesia once the cat is more stable, and monitor potassium, glucose and the ECG.

Correct answer: A. Early enteral nutrition, usually through a feeding tube, with fluid and electrolyte support

Hepatic lipidosis develops when a cat, often an overweight one, stops eating and mobilises fat faster than the liver can process it. Recovery depends on reliable calorie intake: an oesophagostomy tube is commonly used, feeding is increased gradually over several days, and potassium, phosphate and thiamine are monitored and supplemented because of the risk of refeeding syndrome. Treat the cause of the anorexia as well. Appetite stimulants alone rarely provide enough calories.

Correct answer: C. Hyperthyroidism raises GFR and can mask chronic kidney disease, which may appear once the cat is euthyroid

Thyroid hormone increases cardiac output and glomerular filtration, and muscle loss lowers creatinine further, so CKD can be hidden in a hyperthyroid cat. Once the cat is euthyroid, GFR falls and azotaemia may appear. A trial of reversible medical treatment (e.g. methimazole) before radioiodine or surgery shows how the kidneys cope; recheck creatinine, SDMA, urine specific gravity and T4 after a few weeks. Avoid iatrogenic hypothyroidism, which worsens azotaemia.

Correct answer: B. Urine protein:creatinine ratio (UPC) and systolic blood pressure

IRIS substages feline CKD by proteinuria and blood pressure. In cats a UPC below 0.2 is non-proteinuric, 0.2–0.4 borderline and above 0.4 proteinuric. Systolic pressure below 140 mmHg is normotensive, 140–159 prehypertensive, 160–179 hypertensive and 180 or more severely hypertensive, which puts the eyes, brain, heart and kidneys at risk. Both substages guide treatment and prognosis, so measure them in every cat with CKD.

Correct answer: D. Minimal, gentle restraint, examining it in the bottom half of its carrier or under a towel, and considering pre-visit medication such as gabapentin

The guidelines advise against scruffing and forceful restraint: they increase fear and the risk of injury and make the next visit harder. Use a quiet, separate area, let the cat stay in the bottom of its carrier or under a towel, move slowly and use the least restraint that works. For cats with known fear, pre-visit medication such as gabapentin given at home reduces stress. If needed, stop and reschedule.

Correct answer: C. Serum fructosamine, together with glucosuria in a urine sample collected calmly at home

Stress can push a cat's blood glucose above the renal threshold and sometimes cause transient glucosuria. Fructosamine reflects the average glucose over roughly the previous 1–3 weeks and is not raised by acute stress. Persistent hyperglycaemia with glucosuria, a raised fructosamine and compatible signs (polyuria, polydipsia, weight loss) support diabetes. A urine sample collected at home, away from clinic stress, also helps.