PANSYSTEMIC DISEASES

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Transcript PANSYSTEMIC DISEASES

INFECTIOUS
DISEASES
THESE DISEASES ARE COVERED PREDOMINANTLY IN CHAPTER 9 & 11
OF YOUR TEXTBOOK
Supplemental reading:
https://www.aahanet.org/PublicDocuments/Canine
VaccineGuidelines.pdf
CTVT Textbook 8th edition - pages 701-710
CASE #1
CANINE DISTEMPER
PATIENT PRESENTATION
PATIENT PRESENTATION

SIGNALMENT: 12 week old, male/neutered, mixed breed puppy

PRESENTING COMPLAINT: lethargy, ocular and nasal discharge for the
past 3 days; mild cough, appetite is poor; puppy had diarrhea last
night and vomiting/diarrhea this morning
PATIENT PRESENTATION

Hx:
 puppy

adopted from local shelter 2 weeks ago
has received one set of vaccinations
 Incompletely

vaccinated!
Other Info:
 Client
has 1 other dog who is 1 year old and fully vaccinated
 Client
has 2 cats who are 2 and 5 yrs old that are fully vaccinated
PATIENT PRESENTATION

PHYSICAL EXAM FINDINGS:
 Lethargy
 dehydrated
 Temp:
103.8, HR: 116, RR: 20 – lung fields sound slightly
moist, and the puppy coughs a few times during the
exam
 Mm:
pink, CRT: 2.5sec
 Mucopurulent
 The
ocular/nasal discharge
nose looks, dry, thick, and crusty
PATIENT PRESENTATION
HYPERKERATOSIS OF NOSE & FOOT PADS
ENAMEL HYPOPLASIA
DIAGNOSTICS & TREATMENT


DIAGNOSTIC TESTS:

CBC: to look for evidence of infection and/or anemia

Blood work to send off titers for Distemper Virus Infection
TREATMENT

ANTIBIOTICS

FLUIDS

SYMPTOMATIC TREATMENT

Anti-emetics

Ophthalmic ointments

Cleaning ocular/nasal discharge frequently

Nutrition

Clean, dry environment; low stress
DIAGNOSTICS

WORSENING OF CLINICAL SIGNS: 1 week later, the client
returns. The puppy is weak and appears to have muscle
twitching; muscles of the mouth appear as if the puppy is
“chewing gum”; there are pustules on the abdomen,
and hyperkeratotic foot pads & nose

LACK OF RESPONSE TO TREATMENT IS CHARACTERISTIC
FOR CANINE DISTEMPER VIRUS
DIAGNOSIS:
CANINE DISTEMPER VIRUS
http://www.youtube.com/w
atch?v=HyEFS77rOzU
http://www.youtube.com/
watch?v=QL4S4MA2zT0
*Myoclonus is characteristic for Canine Distemper
DIAGNOSTICS AND TREATMENT

FURTHER DIAGNOSTICS:
 Blood
work to compare serum titers and CBC results
CBC: Leukocytosis with neutrophilia found due to
secondary infection
Titers have increased since last measurement
 Flourescent
antibody(FA): Viral inclusions are found in
mononuclear cells of the blood smear
 Post-mortem
tissue sample taken from mucous membranes or
epithelial cells of the urinary, respiratory, or GI tract may also
display viral inclusions.
PROGNOSIS & CLIENT INFORMATION

Transmission of this (single-stranded RNA, enveloped,
paramyxo-) virus is through aerosolization of bodily fluids,
fomites

Fatality rate may be as high as 90%

Prognosis is guarded at best, especially if neurologic signs are
present

Neurologic signs may be focal to general including seizures
 Could

occur weeks to years after initial infection
Although Distemper is contagious, it is unlikely to affect the
clients older, vaccinated dogs
 CVD
does not affect cats
PREVENTION
 Vaccination
 Thorough
cleaning – the virus is labile and can
be killed with common disinfectants, and heat
 Isolation
of infected animals
CASE #2
Parvovirus
PATIENT PRESENTATION
PATIENT PRESENTATION

SIGNALMENT: 3mth old Rottweiler puppy, intact male

PRESENTING COMPLAINT: lethargy, poor appetite, bloody diarrhea
for 2 days; puppy has vomited twice this morning

Hx:
 Owner
old.
purchased puppy from local trader’s market at 10 weeks
 The
breeder gave the first set of vaccinations at 3 weeks old and
a booster @ 7 weeks
 Incorrect,
incomplete vaccinations
PATIENT PRESENTATION

Hx: owner already has a 6mth old, intact female
Rottweiler he got as a gift from a family member. He
purchased the new puppy as a playmate.
 The
6mth old puppy had 3 sets of vaccinations Neither puppy
has been started on heartworm or flea prevention.
PATIENT PRESENTATION
 PHYSICAL
EXAM FINDINGS:
 dehydrated
 mm:
pale, CRT: >2.5sec
 Depressed
 Rear
odor
soiled in blood-tinged diarrhea, strong, foul
 Temp:
103.5, HR: 120 RR: 24
DIAGNOSTICS

Fecal


Parvo ELISA (snap test)


Detects viral antigen
CBC/Serum Chemistries


Check for concurrent intestinal parasitism
Marked lymphopenia, neutropenia, increased PCV
Parvovirus titers

High titers (1:10,000) in positive animals
PARVO ELISA
PATHOGENESIS

TRANSMISSION: fecal-oral route
 Virus
has affinity for rapidly dividing cells such as intestinal epithelium
& bone marrow; severe cases affect the myocardium (esp in utero)
 Affect
 Possible
on bone marrow
lymphopenia, neutropenia WBCs may be <2000
sequelae: septicemia, intussusception
TREATMENT

ISOLATE INFECTED ANIMALS

HOSPITALIZATION

IV fluids w/added electrolytes, added dextrose

ANTIBIOTICS

ANTI-EMETICS

Reglan (metoclopramide)

Cerenia (maropitant)

Zofran (ondansetron)

NSAIDs – possibly for fever, but could complicate bleeding

+/- Plasma transfusion for hypoproteinemia

+/-ANTIVIRAL

Tamiflu
PROGNOSIS
 PROGNOSIS:
generally good with aggressive
and early treatment; 80%-90% success
 Concurrent
infections and GI parasites can
worsen prognosis
PREVENTION & CLIENT
INFORMATION


VACCINATION

Keep puppies isolated until they have firm immunity, usually about 18-22
weeks of age

Vaccinate at 6-8 weeks then q3-4 weeks until 16 weeks of age
CLIENT INFO

In this case, the 1st 2 vaccines are not valid

Client should isolate the new puppy from the older one

Treatment is expensive

The virus is resistant in the environment and may survive for years. A 1:30
solution of bleach is effective.
DON’T WORRY, BE
HAPPY 
“WORRYING
DOES NOT DECREASE THE STRUGGLES OF
TOMORROWY, BUT IT DOES DECREASE THE STRENGTH OF
TODAY.
-MARY ENGELBRELT
CASE #3
Canine Respiratory
Disease Complex
(Kennel Cough, Infectious Tracheobronchitis)
see ch.11 pgs193-194
PATIENT PRESENTATION
PATIENT PRESENTATION

SIGNALMENT: 4yr old, female spayed, dachshund

PRESENTING COMPLAINT: dry, hacking cough; dog is still active and
eating and drinking well. Coughing began about 1 week ago.

Hx:
 Owner
began sending the dog to day care everyday while she was
at work

After the puppy set of vaccines, dog was vx at 1yr and 2 yrs old. She
received an injectable Bordetella vaccine 1 day before beginning
daycare.
PATIENT PRESENTATION

Hx:
 Patient
 HW
 No

is current on HW and flea prevention
neg.
other significant illnesses
PHYSICAL EXAM FINDINGS:

Temp: 102.1, HR: 140, RR: 36

Sneezing and occasional coughing on exam

Cough can be elicited on tracheal palpation

Mild, clear nasal discharge

Normal hydration status

mm: pk. CRT: <2sec
DIAGNOSIS:
CANINE RESPIRATORY DISEASE COMPLEX

Aka Infectious Tracheobronchitis

Major causes
 VIRUSES:
Canine Adenovirus-2, Parainfluenza, Canine
herpesvirus, Canine Influenza, canine distemper virus
 BACTERIA:
mycoplasma, bordetella bronchiseptica,
streptococcus sp.
http://www.youtube.com/wa
tch?v=amGKQX9zdug
DIAGNOSTICS & TREATMENT

DIAGNOSTICS
 Based
on physical exam, clinical signs and history
 Virus
isolation from swabs of the pharynx, nasal passageways,
trachea can help determine which virus and/or bacteria is
the cause
 Thoracic
rads if pneumonia suspected
DIAGNOSTICS & TREATMENT
 TREATMENT
 Adequate
hydration
 Antibiotics
 Antitussives
 Hycodan
(cough suppressants)
(hydrocodone)
 Butorphanol
 Cough
Tabs (dextromethorphan, guaifenesin)
 Bronchial
dilators
 Aminophylline
 terbutaline
PROGNOSIS & CLIENT
INFORMATION

Transmission of these organisms is by inhalation of respiratory droplets
or contact with fomites

The prognosis is good with proper treatment


It is a self-limiting disease

May take 2-3 weeks to resolve
Injectable Bordetella vaccine requires 2 doses at least 2 weeks apart,
then another 7-10 days for protective immunity

If using the intranasal vaccine, 2-3 days prior to exposure is recommended
PREVENTION
 Isolate
infected animals
 Vaccinate
appropriately
 Most
routine disinfectants, bleach, quarternary
ammonium compounds will kill these viruses and
bacteria
 Proper
sanitation
NOTE: CANINE HEPATITIS

CANINE HEPATITIS
 Caused
by Canine Adenovirus-1 (CAV-1)
 The
vaccine for CAV-2 (a respiratory virus) will cross-protect
against canine hepatitis.
 Hepatitis
 The
is uncommon due to thorough vaccination programs.
disease causes hepatic necrosis in affected dogs
 Treatment
is supportive