Transcript CASE #4 Feline Upper Respiratory Disease Complex See Ch

IMPOSSIBLE?!?
“NOTHING IS IMPOSSIBLE! THE WORD ITSELF SAYS “I’M
POSSIBLE.”
-AUDREY HEPBURN
CASE #4
Feline Upper
Respiratory Disease
Complex
See Ch. 11 pgs194,198-199
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
PATIENT PRESENTATION

Hx: no known vaccinations

PHYSICAL EXAM
 Patient
 Temp:
is QAR
104.1, HR: 200, RR:40
 Audible
upper respiratory congestion
 dehydrated
 Mm:
pale pk, CRT: 2 sec
DIAGNOSTICS


DIAGNOSTICS

Clinical signs

Nasal, pharyngeal swabs to send for virus isolation to an outside lab
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
Chlamydophila felis

Bordetella

Mycoplasma
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
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
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
PREVENTION

VACCINATION
 Vaccines

will reduce severity and duration of clinical signs
ISOLATION OF AFFECTED ANIMALS
CASE #5
Feline
Panleukopenia
PATIENT PRESENTATION
http://www.youtube.com/watch?v=xLlL24sh
W7E
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.
PATIENT PRESENTATION

PHYSICAL EXAM FINDINGS
 103°
 dehydrated
 Ataxic,
unstable
 Lethargic
 Fecal-soiled
rear-end
DIAGNOSTICS

CBC
 Moderate
to severe panleukopenia

Positive parvovirus snap test

Antibody titers

Virus isolation is difficult

PCR for detection of viral DNA
TREATMENT
 Maintain
hydration and electrolyte balance
 Force-feeding
 Broad-spectrum
antibiotics
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

Transmission is through direct contact or contaminated
environment
CASE #6
Feline Infectious
Peritonitis
PATIENT PRESENTATION
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
PATIENT PRESENTATION
 Hx:
The other 5 kittens are generally healthy
 PHYSICAL
EXAM:
 Distended
abdomen, BCS:2/5
 Depression

dehydrated
 Mm:
pale pk, CRT:2sec
 Temp:
102.9. HR: 200, RR: 30
DIAGNOSTIC TESTS

FECAL

ABDOMINAL RADIOGRAPHS

CBC/SERUM CHEMISTRY

ABDOMINOCENTESIS
 Cytology

& chemical analysis of the fluid
ANTIBODY TITERS(?)
DIAGNOSTIC TESTS
DIAGNOSTIC TESTS
DIAGNOSTIC TESTS
DIAGNOSTIC TESTS
DIAGNOSTIC TEST RESULTS

FECAL(?)

There is NO “FIP SPECIFIC” antibody titer test

CBC/SERUM CHEMISTRY


ABDOMINAL RADIOGRAPHS


Decreased protein in the blood
Ascites found
ABDOMINOCENTESIS

Viscous, clear to yellow fluid, high protein, low cellularity

RIVALTA TEST positive
DIAGNOSTIC TESTS:
Abdominocentesis
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
DIAGNOSTICS
TRANSMISSION &
PATHOPHYSIOLOGY
TRANSMISSION &
PATHOPHYSIOLOGY
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
 Rarely,
 This
lesions
enlarged kidneys
form of the disease is vague and progresses slowly – these animals may
live months to years
DRY FORM
UVEITIS, RETINITIS, IRITIS
FIP: DRY FORM
IRREGULARLY MARGINATED
KIDNEYS, POSSIBLE RENOMEGALY
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

No proven efficacy of the Primucell FIP vaccine
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