CASE #4 Feline Upper Respiratory Disease Complex See Ch. 11 pgs194,198-199

1. CASE #4Feline Upper Respiratory Disease ComplexSee Ch. 11 pgs194,198-199

3. PATIENT PRESENTATION • SIGNALMENT: ~8 week old intact, male kitten, DSH • PRESENTING COMPLAINT: mucopurulent ocular/nasal discharge, congestion, head shaking, sneezing, inappetance – has gotten progressively worse in the last week • Hx: owner has been feeding a family of stray cats outside her home. Several of the kittens look like this. This is the only kitten she could catch

4. PATIENT PRESENTATION • Hx: no known vaccinations, no flea or HW prevention • Diet: owner feeds canned Whiskas • PHYSICAL EXAM • Patient is QAR • Temp: 104.1, HR: 200, RR:40 • Audible upper respiratory congestion • ~6-8% dehydrated • Mm: pale pk, CRT: 2 sec

5. DIAGNOSTICS • DIAGNOSTICS • Clinical signs • Nasal, pharyngeal swabs to send for virus isolation • DIAGNOSIS: Upper Respiratory Infection • Feline Viral Rhinotracheitis(FVR) • Feline Herpesvirus-1 • Feline Calicivirus (FCV) • 80-90% of all URI is caused by 1 of these 2 viruses Chlamydophilafelis • Bordetella • Mycoplasma

6. DIAGNOSIS: Differentiating the causes Sneezing is common in all Upper repiratory disease Corneal ulceration is associated with Herpesvirus Oral ulcers are associated with calicivirus Coughing is associated with Bordetella or mycoplasma

7. TREATMENT • FLUIDS • ANTIBIOTICS • NURSING CARE • Warm, clean • Force feed, warm, food • Pain meds for oral or corneal ulcers • DECREASE STRESS • AVOID STEROIDS • ANTIVIRALS • Idoxuridine topical ophthalmic solution

8. PROGNOSIS & CLIENT INFORMATION • Both FVR and FCV are highly contagious • Transmitted via fomites (hands, clothes) and aerosolization of respiratory droplets within 5 feet • Morbidity is high, mortality is low • Oral ulcers can last 7-10 days

9. PREVENTION • VACCINATION • Vaccines will reduce severity and duration of clinical signs • ISOLATION OF AFFECTED ANIMALS

10. CASE #5Feline Panleukopenia

11. PATIENT PRESENTATION http://www.youtube.com/watch?v=xLlL24shW7E

12. PATIENT PRESENTATION • SIGNALMENT: 6week 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.

13. 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

14. DIAGNOSTICS • CBC • Moderate to severe panleukopenia • Positive parvovirus snap test • Antibody titers • Virus isolation is difficult • PCR for detection of viral DNA

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

16. 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 acquire life-long immunity.

17. CASE #6Feline Infectious Peritonitis

18. PATIENT PRESENTATION

19. 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 seems to be resolved

20. 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

21. DIAGNOSTIC TESTS • FECAL • ABDOMINAL RADIOGRAPHS • CBC/SERUM CHEMISTRY • ABDOMINOCENTESIS • ANTIBODY TITERS(?)

22. DIAGNOSTIC TESTS

23. DIAGNOSTIC TESTS

24. DIAGNOSTIC TESTS

25. DIAGNOSTIC TESTS

26. DIAGNOSTIC TEST RESULTS • FECAL(?) • There is NO “FIP SPECIFIC” antibody titer test • CBC/SERUM CHEMISTRY • Low albumin/globulin ratio (<0.8) in the blood – all the albumin has leaked into the chest and/or abdomen • ABDOMINAL RADIOGRAPHS • Ascites found • ABDOMINOCENTESIS • Viscous, clear to yellow fluid, high protein, low cellularity • RIVALTA TEST positive • DIAGNOSIS: FELINE INFECTIOUS PERITONITIS

27. DIAGNOSTIC TESTS

28. 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

29. DIAGNOSTICS

30. TRANSMISSION & PATHOPHYSIOLOGY

31. TRANSMISSION & PATHOPHYSIOLOGY

32. 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 – inflammation, hemorrhage • Neurologic lesions • Rarely, enlarged kidneys • This form of the disease is vague and progresses slowly – these animals may live months to years

33. DRY FORM UVEITIS, RETINITIS, IRITIS

34. FIP: DRY FORM IRREGULARLY MARGINATED KIDNEYS, POSSIBLE RENOMEGALY

35. 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

36. 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