CASE #5

PATIENT PRESENTATION

http://www.youtube.com/watch?v=xLlL24shW 7E

PATIENT PRESENTATION

• SIGNALMENT: 4week old, intact female, DSH • PRESENTING COMPLAINTS: kitten is depressed and appears to be very thin, has blood-tinged diarrhea, occasional vomiting • Hx: client lives in an apartment complex and found this kitten outside. She thinks she know the owner, but the owner doesn’t seem to be taking care of her.

PATIENT PRESENTATION

• PHYSICAL EXAM FINDINGS – 103.9

– ~6% dehydrated – Ataxic, unstable • Infected neonate may develop cerebellar hypoplasia or retinal defects – Lethargic – Fecal-soiled rear-end

DIAGNOSTICS

• CBC – Moderate to severe panleukopenia • Positive parvo snap test • Antibody titers • Virus isolation is difficult

TREATMENT

• Maintain hydration and electrolyte balance • Force-feeding • Broad-spectrum antibiotics

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PREVENTION & CLIENT INFO

Proper vaccination is required to prevent disease • Like canine parvovirus, this virus can remain in the environment for years.

• Infected cats should be isolated as all body secretions contain the virus • Cats who survive the infection will not get re infected later in life. They acquire life-long immunity.

CASE #6

PATIENT PRESENTATION

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PATIENT PRESENATION

SIGNALMENT: 3mth old, intact female, DSH • PRESENTING COMPLAINT: kitten is sometimes lethargic and seems to be bloated. She eats, although appetite is decreased. Owner can still feel and see the backbone and pelvic bones. • Hx: owner is fostering a litter of kittens from a shelter for the past 3 weeks, until they are healthy enough for adoption. The kittens have had intermittent diarrhea over the past 2 weeks, but has resolved

PATIENT PRESENTATION

• Hx: The other 5 kittens are generally healthy – Diet: dry kitten Iams • PHYSICAL EXAM: – Distended abdomen, although BCS:2/5 – Depression – – ~6% dehydrated Mm: pale pk, CRT:2sec – Temp: 102.9. HR: 200, RR: 30

DIAGNOSTIC TESTS

• FECAL • ABDOMINAL RADIOGRAPHS • CBC/SERUM CHEMISTRY • ABDOMINOCENTESIS • ANTIBODY TITERS(?)

DIAGNOSTIC TESTS

DIAGNOSTIC TESTS

DIAGNOSTIC TESTS

DIAGNOSTIC TESTS

DIAGNOSTIC TEST RESULTS

• • • • • FECAL(?) There is NO “FIP SPECIFIC” antibody titer test CBC/SERUM CHEMISTRY – Low albumin/globulin ratio (<0.8) in the blood ABDOMINAL RADIOGRAPHS – Ascites found ABDOMINOCENTESIS – Viscous, clear to yellow fulid, high protein, low cellularity – RIVALTA TEST positive • DIAGNOSIS: FELINE INFECTIOUS PERITONITIS

DIAGNOSTIC TESTS

RIVALTA TEST

• • Fill a clear test tube ¾ full with distilled water, add one drop 98% acetic acid and mix (or vinegar).

Carefully place one drop Of the cat’s effusion on the surface of the acid.

• If drop disappears • Test = negative If drop retains shape Test = positive

DIAGNOSTICS

TRANSMISSION & PATHOPHYSIOLOGY

TRANSMISSION & PATHOPHYSIOLOGY

TRANSMISSION & PATHOPHYSIOLOGY • FIP occurs in 2 forms: the “wet” or effusive form (75%) and the non-effusive or “dry” form.

– DRY FORM • • Fever Anorexia • • Depression Wt. loss • • Ocular lesions – hyphema, iritis, retinal hemorrhage Neurologic lesions • • Rarely, enlarged kidneys This form of the disease is vague and progresses slowly –

these animals may live months to years

UVEITIS, RETINITIS, IRITIS

DRY FORM

FIP: DRY FORM

MESENTERIC LYMPHADENOPATHY IRREGULARLY MARGINATED KIDNEYS, POSSIBLE RENOMEGALY

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TREATMENT & PREVENTION

SUPPORTIVE CARE – Thoracocentesis/abdominocentesis to make pet more comfortable – Daily steroids – Antibiotics PREVENTION – Control of the virus shedding is key – House cats separately – Clean litter boxes frequently • The virus can last up to 4 weeks in the environment, but is killed easily by disinfectants – Lower number of cats – Lower stress – Vaccinate against feline coronavirus

CLIENT INFO & PROGNOSIS

• Clinical FIP is almost always a fatal disease with a mortality rate >95%. – Cats with the effusive form usually progress more quickly and often die within 2 months of initial diagnosis

CASE # 7

PATIENT PRESENTATION

PATIENT PRESENTATION

• SIGNALMENT: ~2-3yr old intact male DSH • PRESENTING COMPLAINT: cat seems to have lost weight in the last few months and seems lethargic • Hx: unknown, client feeds this stray cat who is very friendly. She brings him in out of concern for his health

PATIENT PRESENTATION

• PHYSICAL EXAM – BCS: 2/5 – Temp:103.1, HR: 160, RR: 30 – Enlarged mandibular lymph nodes and popliteal lymph nodes (see pic below) – Firm, mid-abdominal mass palpated Enlarged popliteal lymph node Lbah.com

DIAGNOSTIC TESTS

• • • CBC/SERUM CHEMISTRIES ABDOMINAL RADIOGRAPHS FeLV/FIV Test – All cats that go outdoors or come from unknown backgrounds should be tested for FeLV and FIV when first examined by a veterinarian

DIAGNOSTIC TESTS

TUMOR OF THE THYMUS – WOULD OCCUR IN A YOUNG ANIMAL INFECTED

DIAGNOSTIC TESTS

DIAGNOSTIC TESTS

DIAGNOSTIC TESTS

• CBC – Nonregenerative anemia – Leukopenia – this virus can affect the bone marrow resulting in feline panleukopenia-like syndrome – These patients are at a higher risk for contracting Hemobartonellosis (feline infectious anemia) • FeLV ELISA – positive

TRANSMISSION & PATHOPHYSIOLOGY • • • Feline Leukemia is a retrovirus and is associated with both neoplastic and nonneoplastic disease Lymphoma is the most common neoplastic disease – tumors can occur in the thymus, GI tract, or lymph nodes throughout the body Other clinical signs – Secondary infections – Wt. loss – Anorexia – Neurologic signs – Spontaneous abortion

TRANSMISSION & PATHOPHYSIOLOGY • TRANSMISSION: – The most likely route of infection is through continued intimate contact such as grooming, sharing food and water bowls (virus shed in saliva, urine, tears) – this is horizontal transmission – The virus can also be transmitted to neonates in utero and through the milk of infected queens – this is vertical transmission

• TRANSMISSION & PATHOPHYSIOLOGY POSSIBLE OUTCOMES OF FeLV INFECTION – 1. Cat may mount an immune response, clear the virus, and become resistant to future infection – 2. some cats fail to mount an effective immune response, become persistently viremic, and succumb to FeLV-associated diseases • – 3. the virus is cleared from the plasma or serum but persists in a latent form in the bone marrow or lymphatic tissue. Outcome depends on: – Age, immunocompetence, concurrent disease, viral strain, dose, duration of exposure

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TREATMENT

NO CURE for FeLV IMMUNOMODULATING DRUGS – Human interferon-α – interferes with viral replication – Acemannan – from the aloe vera plant is known to have antiviral, immunostimulant, and antineoplastic properties – Proprionibacterium acnes – killed form of this bacteria can be given to stimulate the immune system to fight disease ANTIVIRAL DRUGS -*can be toxic to bone marrow in cats – AZT – antiretroviral ANTIBIOTICS POSSIBLE CHEMOTHERAPY

CLIENT INFO & PROGNOSIS

• • • • • FeLV positive cats should be retested 3-4 months after initial test FeLV cats should be isolated from all other cats FeLV cats should be kept indoors FeLV cats should have reduced stress and regular vaccination and veterinary check-ups Life expectancy is approximately 2 years after diagnosis

CASE #8

PATIENT PRESENTATION

PATIENT PRESENTATION

• SIGNALMENT: ~4-5yr old, intact, male, DMH • PRESENTING COMPLAINT: inappetant, hypersalivation, lethargy • Hx: indoor/outdoor cat, has not had vaccinations in over 3 years. Cat has had a few fights with other neighborhood cats over the years, but nothing serious.

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PATIENT PRESENTATION

PHYSICAL EXAM: – Gingivitis, stomatitis – Wt. loss – Temp: 103.5, HR: 200, RR:36 – Mm: pale , CRT: 2sec • Other clinical signs may include: –

Gingivitis, stomatitis

– Chronic fever – Vomiting – Diarrhea – Chronic URI – cachexia –

Chronic, unresponsive skin/ear infections

DIAGNOSTIC TESTS

• • CBC/SERUM CHEMISTRIES FeLV/FIV ELISA – All unvaccinated outdoor cats should be tested for these diseases as they are contagious and without cure

DIAGNOSTIC TEST RESULTS

• • CBC – Anemia, lymphopenia ELISA positive – THIS IS AN ANTIBODY TEST, not antigen – there will be interference by maternal antibodies and vaccination!

– Test result may be supported by other lab tests such as IFA, Western blot, & PCR

TRANSMISSION

• TRANSMISSION – Most infections are acquired through horizontal transmission among adult male, sexually intact cats – Fight and bite wounds appear to be the major route of transmission. – It is possible to transmit the virus vertically to neonatal kittens, but the virus is not easily transmitted this way.

TREATMENT

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SEE FELINE LEUKEMIA VIRUS

• DENTAL SURGERY – Whole mouth extraction of teeth may be necessary in cats with chronic stomatitis and gingivitis

CLIENT INFO & PROGNOSIS

• • • • Although FIV is morphologically and biochemically similar to HIV, it poses no threat to humans Infected cats may survive for prolonged periods before experiencing advanced stages of the disease – Some may be asymptomatic for 10+ yrs Keep FIV pos cats indoors Keep FIV pos cats free of stress and concurrent disease