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