Infectious diseases
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INFECTIOUS DISEASES. ZOONOSES & VECTOR-BORNE DISEASES. CASE #9. PATIENT PRESENTATION. PATIENT PRESENTATION. SIGNALMENT: ~6mth old neutered, male DSH

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INFECTIOUS DISEASES

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Infectious diseases

INFECTIOUS DISEASES

ZOONOSES

&

VECTOR-BORNE DISEASES


Case 9

CASE #9


Patient presentation

PATIENT PRESENTATION


Patient presentation1

PATIENT PRESENTATION

  • SIGNALMENT: ~6mth old neutered, male DSH

  • PRESENTING COMPLAINT: depression, feels “hot”, looks yellow, painful abdomen, and difficulty breathing. Cat began to act strange over the last week. Poor appetite, soft stool

  • Hx: indoor/outdoor cat, fully vaccinated, but not against FeLV and FIV, microchipped, often brings “gifts of mice” home


Patient presentation2

PATIENT PRESENTATION

  • PHYSICAL EXAM

    • Temp: 104.1, HR:220, RR:40, shallow

    • Depression

    • Labored breathing

    • Icteric mm, CRT: difficult to assess, >2sec

    • Painful on abdominal palpation

    • OS: signs of inflammation/uveitis


Patient presentation3

PATIENT PRESENTATION


Diagnostic tests

DIAGNOSTIC TESTS

  • CBC/SERUM CHEMISTRIES

    • Elevated ALT. ALP, total bilirubin

    • CBC WNL

  • FeLV/FIV Test

    • Neg/Neg

  • Thoracic radiographs

    • pneumonia

  • Paired titers

  • ELISA

  • FECAL

    • See next slide


Diagnostic tests1

DIAGNOSTIC TESTS

PNEUMONIA IS MOST COMMON IN NEONATALLY

OR TRANSPLACENTALLY INFECTED CATS


Toxoplasma oocyts

TOXOPLASMA OOCYTS

THESE OOCYTS

ARE DIFFICULT & RARE

TO FIND


Transmission life cycle

TRANSMISSION & LIFE CYCLE

  • TRANSMISSION:

    • EATING CONTAMINATED MEAT

      • Ingestion of uncooked or undercooked meat is most likely the main route of infection in both cats and humans.

    • Fecal – oral route

    • Transplacental route

  • Cats are the definitive host for Toxoplasma gondii, but several animal can serve as intermediate hosts


Transmission life cycle1

TRANSMISSION & LIFE CYCLE

CATS ONLY SHED OOCYTS

IN THE FECES FOR 1-2 WEEKS

THE OOCYTS BECOME INFECTIVE

AFTER 1-5 DAYS

TACHYZOITES ARE THE RAPIDLY

DIVIDING STAGE OF THIS PARASITE

THAT INFECTS THE TISSUES


Treatment prognosis

TREATMENT & PROGNOSIS

  • Clindamycin or Trimethoprim Sulfa for 2-3 weeks (may require 4 weeks treatment)

  • Prognosis is poor for young patients with hepatic or respiratory involvement, but good for the older cat with minimal or no signs of disease


Transmission life cycle2

TRANSMISSION & LIFE CYCLE


Client information

CLIENT INFORMATION

  • Exposure to Toxoplasma is common – 30%-60% of adult humans are seropositive

  • Humans who are immunosuppressed should avoid contact with infected cats

    • Have someone else clean the litter box

  • Avoid getting a new cat during pregnancy

  • Have antibody titers checked before getting pregnant

    • Infection during the 1st or 2nd trimester can lead to birth defects

  • Cook all meat thoroughly

  • DON’T PANIC


Case 10

CASE # 10


Patient presentation4

PATIENT PRESENTATION


Patient presentation5

PATIENT PRESENTATION

  • SIGNALMENT: 2yr old hound mix, intact male

  • PRESENTING COMPLAINT: dog is reluctant to move, has a stiff gait and seems painful, possibly ataxic, lethargic for the last week.

  • Hx: dog goes hunting with the owner about once month for the last 3 months. Dog is current on HW and flea preventive.


Patient presentation6

PATIENT PRESENTATION

  • PHYSICAL EXAM

    • Temp: 103.5, HR: 116, RR:24

    • Mild mucopurulent ocular discharge

    • Mm:pale pk, CRT: 2sec

    • Animal is somewhat painful and ataxic

    • Technician finds several ticks on the head and neck region


Patient presentation7

PATIENT PRESENTATION


Diagnostic tests2

DIAGNOSTIC TESTS

  • CBC/SERUM CHEMISTRIES

    • Anemia

    • Leukocytosis w/left shift

    • Thrombocytopenia

    • Increased liver enzymes (ALT, ALP)

    • Hypoproteinemia

  • SERUM TITERS – 4-fold increase between titers

  • TISSUE BIOPSY & FLUORESCENT STAINING


Diagnostics treatment

DIAGNOSTICS & TREATMENT

  • DIAGNOSIS: TICK-BORNE DISEASE

    • ROCKY MOUNTAIN SPOTTED FEVER – caused by Rickettsia rickettsii, a gram- obligate intracellular bacterial organism.

    • This organism is carried in the saliva of the tick

    • Clinical signs occur secondary to vasculitis of small blood vessels throughout the body. Other clinical signs include: edema, hemorrhage, seizures, coughing, vomiting, diarrhea, and more…


Dermacentor variabilis

DERMACENTOR VARIABILIS

TICKS MUST BE ATTACHED TO HOST FOR 5-20

HOURS BEFORE TRANSMITTING INFECTIOUS ORGANISM


Dermacentor andersoni

DERMACENTOR ANDERSONI


Diagnosis treatment

DIAGNOSIS & TREATMENT

  • TREATMENT

    • Doxycycline

    • Tetracycline

    • Antibiotics only reduce the number of organisms, the animal must have a good immune system to eliminate them.


Client information1

CLIENT INFORMATION

  • Blood from infectious patients and from the tick can be infectious

  • Client should watch for signs of myalgia, headache, fever, or abdominal pain

  • Keep pets out of heavily infested tick areas and remove ticks quickly. Add tick prevention to the pet’s health regimen.

  • Incubation period is ~7days


Case 11

CASE #11


Patient presentation8

PATIENT PRESENTATION


Patient presentation9

PATIENT PRESENTATION


Patient presentation10

PATIENT PRESENTATION

  • SIGNALMENT: 2yr old mixed breed, castrated male

  • PRESENTING COMPLAINT: lethargy, labored breathing, swollen neck, and swollen rt rear leg for about a week that seemed to resolve. About 6 weeks later developed bleeding from the nose, dyspnea, weakness, and “red spots” on the skin

  • Hx: outdoor dog, vaccinations current, on HW and flea preventive.


Patient presentation11

PATIENT PRESENTATION

  • PHYSICAL EXAM

    • Temp: 103.8, HR: 120, RR: 28

    • Mild epistaxis

    • Petechial hemorrhages

    • Edema of the extremities

    • Ticks found in the coat


Diagnostic tests3

DIAGNOSTIC TESTS

  • CBC/SERUM CHEMISTRY

    • 25% have pancytopenia

    • Anemia

    • Thrombocytopenia

    • Hyperglobulinemia

  • Blood smear

  • Observe morula in

    mononuclear cells

  • IFA


Diagnosis

DIAGNOSIS

  • DIAGNOSIS: TICK-BORNE DISEASE

    • CANINE MONOCYTIC EHRLICHIOSIS, caused by Ehrlichia canis transmitted by the tick Rhipicephalus sanguineus

    • After infection, E. canis causes acute, subclinical, and chronic stages of the disease

    • ACUTE: lasts 2-4 weeks

      • Organisms multiplies in mononuclear cells

      • Mononuclear cells carry the organism to other organs including the lungs, kidneys, and meninges.

      • Vasculitis develops

    • SUBCLINICAL PHASE

      • Few clinical signs if any

    • CHRONIC PHASE

      • Bone marrow suppression

      • Bleeding tendencies


Rhipicephalus sanguineus

RHIPICEPHALUS SANGUINEUS


Diagnosis another ehrlichial disease to consider

DIAGNOSIS: another Ehrlichial disease to consider

  • CANINE GRANULOCYTIC EHRLICHIOSIS caused by Ehrlichiaewingii or Ehrlichiaequi

  • Clinical signs associated with Ehrlichiaewingiiinfection:

    • Fever

    • Lethargy

    • Lameness

    • Muscle stiffness

    • CBC: Thrombocytopenia

    • Blood smear: morulae found in neutrophils

    • Transmitted by the Amblyommaamericanumtick


Diagnosis another ehrlichial disease to consider1

DIAGNOSIS: another Ehrlichial disease to consider

  • CANINE GRANULOCYTIC EHRLICHIOSIS caused by Ehrlichiaewingii or Ehrlichiaequi

  • Clinical signs of Ehrlichiaequiinfection:

    • Fever

    • Debilitating lethargy

    • Anorexia

    • CBC: thrombocytopenia

    • Serum chemistries: Increased ALP

    • Transmitted by the Ixodesdammini tick


Diagnosis1

DIAGNOSIS


Diagnostic tests4

DIAGNOSTIC TESTS


Treatment client info

TREATMENT & CLIENT INFO

  • ANTIBIOTICS

    • Doxycycline

    • Tetracycline

    • +/- blood transfusions

  • CLIENT INFO:

    • Ticks can be a threat to pets and humans

      • Owners should avoid exposure to the blood of the tick

    • The prognosis is good – Improvement often seen within 48 hours

    • Check pets frequently for ticks and remove them when found.


Case 12

CASE #12


Patient presentation12

PATIENT PRESENTATION


Patient presentation13

PATIENT PRESENTATION

  • SIGNALMENT: 3yr old castrated male, English Setter

  • Hx: Moved from the northeast about 3 weeks ago. Prior to moving, owner pulled off a few ticks . Some of the areas have a red rash. In the last few days, the dogs is showing some lameness in the rear legs


Patient presentation14

PATIENT PRESENTATION

  • PHYSICAL EXAM

    • Temp:103.5, HR: 100, RR: 24

    • Lethargic

    • Swollen lymph nodes

    • Wt. bearing lameness on the rt. Rear limb that seems to come and go.


Patient presentation15

PATIENT PRESENTATION


Diagnostic tests5

DIAGNOSTIC TESTS

  • Radiographs

    • Would be normal

  • ELISA TEST

    • Lyme Positive

  • SYNOVIAL FLUID ANALYSIS

    • Increased nucleated cells


Patient presentation16

PATIENT PRESENTATION


Lyme disease

LYME DISEASE

  • LYME DISEASE is caused by the spirochete Borrelia Burgodorferi, passed by an Ixodes tick

    • The tick must be attached to the host for more than 48 hours

  • Other clinical signs:

    • Fever

    • Anorexia

    • Lymphadenopathy

    • Chronic flare-ups

    • Myocardial abnormalities

    • Nephritis, esp in Labs


Lyme disease treatment client info

LYME DISEASE TREATMENT & CLIENT INFO

  • ANTIBIOTICS

    • Doxycycline is the treatment of choice for Borreliosis

      • Treatment may not completely eliminate the organism and some animals may remain permanently infected.

  • CLIENT INFO

    • Vaccination is effective, unless dog has already been exposed.

    • Animal infection should alert owners to the possibility of human infection from ticks in the area.

    • Use a tick preventive regularly


Case 13

CASE #13


Patient presentation17

PATIENT PRESENTATION


Patient presentation18

PATIENT PRESENTATION

  • SIGNALMENT: 4 yr old, neutered male mixed breed.

  • HISTORY: owner saw dog playing with remains of a dead bat out in the back yard yesterday. The owner brings the dead bat into the clinic in a box and wants to know what to do.

    • The dog is current on all vaccinations including rabies. He is on HW and flea prevention.


Rabies exposure cases

RABIES EXPOSURE CASES

  • The bat should be sent to a laboratory for analysis and rabies testing

    • This requires a sample of brain tissue that has NOT been frozen.

    • There is no antemortem test available

  • The dogs should be examined and handled carefully. He should be quarantined until the results from the bat are known.


Rabies virus information

RABIES VIRUS INFORMATION

  • Rabies virus is spread through the saliva of an infected animal

    • Bite, open wound, or mucous membranes

  • It travels up the nerve endings at the site of infection until it reaches the brain where it multiplies. It then enters the salivary glands where it can be transmitted through saliva.

    • This may take 3-8 weeks


Rabies virus information1

RABIES VIRUS INFORMATION

  • RABIES IS CHARACTERIZED BY 3 STAGES:

    • PRODROMAL STAGE – people are greatest risk during this phase. It is associated with behavior changes

    • EXCITATIVE/FURIOUS STAGE- Infected animals may attack inanimate objects or appear hyperreactive. Some animals may appear “dumb”

    • PARALYTIC STAGE - characterized by ascending paralysis of the hind limbs which may progress to respiratory paralysis and death.

    • Death will occur between 2 and 10 days from the onset of clinical signs


Rabies virus information2

RABIES VIRUS INFORMATION

  • CLINICAL SIGNS:

    • Behavioral changes

    • Difficulty swallowing

    • Voice changes

    • CNS signs (seizures, ataxia)

    • hypersalivation


Rabies information

RABIES INFORMATION

  • CLIENT INFO:

    • Never handle wild animals that appear tame or friendly

      • Leave wild life in the wild

    • Wear glove when examining a pet’s oral cavity, esp if rabies is suspected

    • Promote vaccination against rabies

    • If your pet bites someone, it must be quarantined for 10 days to observe for signs of clinical rabies

    • Vaccinated animals exposed to a rabid animal should be revaccinated and observed for 90 days.


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