Small Ani. Medicine- Feline viral dzs 2

untimely's version from 2015-10-03 22:24

Feline Infectious Peritonitis (FIP)

Question Answer
what is the causative agent of FIP?Feline corona virus associated syndrome--> but it's not just a coronavirus (Coronaviridae) that causes this problem. It's a MUTATED WITHIN THE BODY corona virus
how common are Coronaviridae infections? how do they affect cats?MOST CATS are infected with coronavirus, which results in various GI signs
what age is usually affected by FIP?very interesting- bimodal age distribution meaning that cats UNDER 2y and then cats OVER 10y are more likely to develop this problem
what are the 4 possible outcomes of a feline coronoa (FeCoV) infection?(1) develop resistance (2) transient infection (3) persistant infection (carrier) (4) FIP (this is only in 1-3% of the cases)
who has higher risk for FIP?Purebreds more at risk, esp: Abyssianian, Bengal, Birman, Himalayans, Rag dolls and Rex cats
is FIP more common in single pet houses or multi pet houses? and why?Most common to come from multi cat homes/catteries/shelters (Exposure to feces and stress)
what are the two kinds of FIP?Dry vs. effusive(aka wet) although they think it is Probably more of a continuum. They also think Wet vs. dry might be associated with the number of vessels affected by the Pyogranulomatous vasculitis(not peritonitis!)
what's up with the "peritonitis" of the FIP?It's actually NOT peritonitis. It is Pyogranulomatous vasculitis which causes blood vessel damage--> effusions collect in the abdomen
how is Effusive FIP charaterized?Usually Ascites or thoracic effusion (or both) Image is a classic example of an effusive cat
what are the common clinical signs of a cat with effusive FIP?Weight loss, dyspnea, tachypnea, muffled heart sounds, pale mm, abdominal masses (adhesions or LN)
If you are palpating an effusive cat's abdomen and you feel masses, what are they most likely?adhesions or LNs
which manifestation is the acute manifestation? Chronic?Acute: effusive. Chronic: noneffusive (dry)
what are the clinical signs like for non-effusive (dry) FIP?Vague CS! Mild pyrexia, weight loss, dullness, decreased appetite, +/-icterus. Intraocular signs common. Neurologic signs in up to 33% of cats. Intestinal and cutaneous signs possible.
which form usually kills kittens?Noneffusive(Dry) FIP is the 2ndmost common cause of death in weaned kittens (causes Stunted growth, GI and respiratory signs)
What kind of EYE signs do you see? (and is it the dry or wet form?)(dry form) Iritis--(brown or other color change), aqueous flare, keratic precipitates, hyphema
what are neurological signs like in FIP cats?Any manifestation—depends on the pyogranulomas. Neuro signs=poorer prog
What is this problem? iritis
what is this problem? keratic precipitates
what is this problem? cloudy vitreous and cuffed retinal vessels
what do the effusions from the wet form usually look like?yellow straw colored fluid (looks a little cloudy to me)
how do you dx/test for FIP?there is NO specific test. But If you do a coronoa fecal RT PRC and can prove the cat has never been infected with coronavirus, you can prove the cat DOESNT have FIP (bc FIP if a mutated corona virus). But, if you get a POSITIVE coronoavirus result, you cannot confirn that it is FIP, only that the cat has been infected with corona. The GOLD STANDARD for dx is Necropsy with histopathology
gold standard dx for FIP?necropsy :(
what does the abdomen look like in the effusive form? non-effusive form?EFFUSIVE: abdomen full of yellowish fluid. NON-EFFUSIVE: tiny little bumps all over the abdomen (these are the pyogranulomas) (can be on GI, kidneys, liver, whatever)
explain how they try to use effusion analysis to dx FIP (what is the charateristics which would hint to FIP?)The fluid in the abdomen would be a Modified transudate, with a HIGH PROTEIN COUNT >3.5 g/dL. (Serum A/G ratio < 0.45 with a high protein effusate very consistent with FIP)
Serum A/G ratio (albumin/globulin) which would make FIP unlikely? which would make it likely?UNLIKELY FIP: Serum A/G ratio > 0.8. LIKELY FIP: Serum A/G ratio < 0.45 AND a high protein effusate
what's an IFA test? what are we looking for with it?IFA (Immunofluorescence Antibody Assay) is a test looking for Ab's to the corona virus-- remember that a positive doesnt prove FIP, only proves that the cat had corona. A negative can rule out FIP
what cells can you look for in the effusate which might hint towards FIP?usually effusate is very LOW in macrophages. But in FIP they can be if the effusate looks like FIP effusate (high protein >3.5g/dL, serum albumin/globulin ratio <0.45) AND there are high macrophages, it is most likely FIP. However, low macrophages doesnt mean NOT FIP (bc this can be normal)
what is the Rivalta test?add a drop of acetic acid to 5 ml water. Then add a drop of effusate- if the drop dissapates, the result is neg. If the drop of effusate retains shape/stays attached to the surface, or floats slowly, it is positive. but this is just testing the protein levels of the effusate, not actually telling you about the FIP
what does bloodwork look like for FIP?Lymphopenia, +/-non reganemia
how do globulin levels look with FIP?Serum gamma-globulin increase
what would a CSF analysis look like with FIP? what should you know about performing this?risky to test and can inc viscosity. you would see higher protein and pleocytosis (inc cell count, often WBCs)
how useful is PCR for dx FIP?very difficult to see any diff between corona and FIP- don't really know what the PCR results mean. In order to know what they mean, Check the laboratory to see if the PCR is validated….(the problem is, the only way to validate the PCR would be with known neg and known positive...and the gold standard for the known positive is...via necropsy)
how might you use knowledge of location of the corona virus to determine if it might be FIP?corona lives in the if corona DNA in a macrophage, the virus has left the gut and is in different places (shouldn't be in the blood either)
what do you usually do to treat FIP? explaining reasoning behind drugs chosen (3) (1) Disease is caused by the cats inflammatory immune response, so prednisolone can help with this. However, this causes non-selective immunosuppression which can lead to 2* infections (so caution with concurrent dzs!) (2) Polyprenyl immunostimulant (?) might be helpful for DRY FORM ONLY. (3) interferon-omega has been tried in very limited studies
5 main things you can do to help prevent FIP?(1) reduce fecal contamination of environment (2) do not have excessive amounts of cats (3) Ab/virus testing (4) isolation and early weaning (5) vx with primucell

Feline Respiratory Disease

Question Answer
what kind of environment is feline resp dz more likely to be a problem in?Multi-cat households, shelters, catteries
resp dz transmitted through what secretions?Ocular, nasal, conjuctivaland oral secretions (there are acute and carrier states)
what are the 4 main causative agents of felaine resp dz?Feline herpesvirus, Feline calicivirus, Bordetella, Chlamydophilafelis....dont forget OTHER ORGANISMS can also cause this, though
what kinda virus is involved in the feline herpes virus responsible for the feline resp dz?FHV-1 alpha herpesvirus
what is bordetalla?Aerobic gram neg bacteria, can be 1* or 2* disease in feline resp dz
what is a more consistant finding caused by Chlamydophila felis which will indicate it's probably this bacteria that's the prob?Conjunctivitis more consistent
how common is FHV-1? why is it this way?MOST cats have this- and if they get it, they keep it-- Virtually all cats infected become latently infected carriers! Reactivation is common!
what are two common things which can cause a reactivation of FHV-1 infection?Stress and glucocorticoids
If there is intermittant shedding of FHV-1, for about how long are they infective?~3wk
hallmark look of a herpes cat?irritated eyes and serous nasal discharge
what are the clinical signs of a FHV-1 infxn?Depression, sneezing, inappetence, pyrexia----> serous ocular and nasal discharge. There is CONJUNCTIVITIS With serous to mucopurulent ocular and nasal discharge. **caution: can have 2* ocular dz!!
aside from resp dz, what other thing are you worried about with FHV-1?SECONDARY OCULAR DZ! (such as ulcerative keratitis)
how often does FHV-1 become a systemic disease?Rarely can progress to systemic disease...however, immunocompromised cats and then kittens are both at higher risk
how long does a FHV-1 outbreak usually last?10-20d
what is important to know about FCV (feline calicivirus)?More virulent strain exists US and UK which has High mortality. It is called FCV –VSD (Virulent systemic disease)
which is more likely to cause systemic dz in immunocompetant adult cats: FHV-1 or FCV?FHV-1 rarely causes systemic dz. Feline calicivirus has highly virulent strains which have high mortality (FCV-VSD=feline calicivirus virulent systemic dz)
FHV-1 vs FCV: which get eye stuff? which get mouth ulcers?HERPES=eyes. CALICI=mouth
clinical signs of calicivirus?More variable, but Pyrexia, oral ulceration*, resp and conjunctival signs
which resp dz do you NOT want around your cat with gingival stomatits?feline calicivirus
explain the relationship between FCV and gingival stomatitiscats with FCV can get the gingivostoma complex (concurrently) and if you combine them theyre worse
how do you dx both FHV-1 AND FCV?go by Clinical signs and also Oropharyngeal or conjunctival swabs for virus isolation or PCR*
do you want to use abx with FVH1 and FCV infections?YES, if there is or is risk for secondary bacterial infections
what is an over-the-counter med you can give to a cat suffering from FHV-1 or FCV that might help?lysine (cant hurt, might help, might help dec # of outbreaks)
non-drug tx for FHV1 and FCV include..(1) Good nursing home care: Aromatic warmed food to encourange them to eat (usually they wont if they can't smell anything) (Blended if necessary). (2) Hospitalization if necessary: Fluids +/-feeding tubes
****what are the core feline vx?? (which arent core? which arent recc? )(1) Parvovirus (Panleukopenia) (2) Herpesvirus-1 & Calicivirus (3) rabies [LEUKEMIA is given if there are risk factors to merit it- FIV should not be given as it doesnt help and just confounds the test]

Feline Parvovirus/Panleukopeniavirus (FPV)

Question Answer
how do most parvovirus infections occur?Most infections occur via fomitesexposed to feces
how labile is the parvovirus? How easy is it to get rid of it?can survive One year at room temp!! However, it is inactivated by bleach :D
at what age are cats usually affected by parvo?Virtually all susceptible cats infected within 1 year of life. (most infections are subclinical)
can materially derived Abs (MDAs) protect kittens from parvo?kittens with MDA usually protected for 3 months
how common is it for a cat to get parvo?75% unvaccinated cats ab+ by 1 year of age- but usually the infections are subclinical
things that can be up cats noses?tumors polyps cryptococcus
which tissues does feline parvo like to attack?likes RAPIDLY DIVIDING TISSUES like the GI, *bone marrow, lymphoid tissue (as well as CNS in pre-and early neonates) [cardiomyopathy?]
If you think the cat might have parvo, but there are all these other signs that don't add up, what do you think is going on?comorbidities with parvo are common! can often confuse you. To top it off, comorbidities make both the FPV AND the comorbidity symptoms worse
CQ: if you see a snotty, goopy cat, which in-house test would you want to do FIRST, and why? if common dz that happens in kittens, CBC will tell you WBC and RBC-- they get panleukopenia bc bone marrow being attacked, so can see with a CBC that WBC is being attacked
how does FPV affect the CNS?****CEREBRELLAR HYPOPLASIA occurs in cats who were infected at a time when their CNS was rapidly dividing (so, usually dam infected when pregnant, or infected very soon after birth). Can also see optic nerve, retinal abnormalities, hydrocephalus
cardinal sign of cerebellar hypoplasia?intention tremors and proprioceptive ataxia
when do you expect to see that clinical signs of parvo will be worse?if unvx
at what age are there the most morbidities?Highest morbidity 3-5 months
how deadly is feline parvo? usually the dz is Acute self limiting...HOWEVER, can cause rapid death within 12 hours (DIC)
how can parvo cause rapid death?DIC
what is the unique feel of abdominal palpation of a cat with parvo?"ropy" intestines
what are the clinical signs of parvo?Fever depression and anorexia, Vomiting and extreme dehydration, Abdominal pain ("Ropy" intestines)
what clinical signs will you see in QUEENS with parvo which were Infected or vaccinated during pregnancy?Infertility or abortions w/o any other clinical signs
2 ways to presumptively dx parvo?(1) Clinical Signs and leukopenia: Neutropenia, lymphopenia +/-thrombocytopenia (can rebound after 24-48hrs) (2) Chem non specific: pre-renal azotemia
which tests are helpful for parvo dx?Cytology for inclusion bodies, PCR and VI (virus isolation), Necropsy and histopathology.
is there a snap for feline parvo? are there false positives?you can use the CANINE PARVO SNAP test!! Can also detect vaccinations~2 weeks post vaccination
what kinda fluids do you want to provide for parvo kitty?fluids+KCl
do you want to feed parvo kitty?NPO!!! The virus is in the GI cells, you don't want to feed the virus (but if it's a tiny baby you are going to have to feed them a little)
should you use anti-emetics in a parvo kitty?YES- if you know that it's parvo and not sthing else
what meds can you give to try to help parvo kitty's GI?GI protectants, B-vitamins
can you use interferon omega in cats?worked in dogs-- not sure if works in cats
do you want to give abx? Why? if so, which kinds?YES-- virus attack GI--> GI weakened--> BACTERIAL TRANSLOCATION. You'd want a BROAD spectrum abx like A penicillin and metro/clinda
****what are the core feline vx?? (which arent core? which arent recc? )(1) Parvovirus (Panleukopenia) (2) Herpesvirus-1 & Calicivirus (3) rabies [LEUKEMIA is given if there are risk factors to merit it- FIV should not be given as it doesnt help and just confounds the test]