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IMPOSSIBLE?!?“NOTHING IS IMPOSSIBLE! THE WORD ITSELF SAYS “I’M POSSIBLE.”
-AUDREY HEPBURN
CASE #4Feline 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 is QAR Temp: 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 allUpper repiratory disease Corneal ulceration is associated with Herpesvirus
Coughing is associatedwith Bordetella or mycoplasma
Oral ulcers areassociated withcalicivirus
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 #5Feline
Panleukopenia
PATIENT PRESENTATION
http://www.youtube.com/watch?v=xLlL24shW7E
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 FINDINGS103°dehydratedAtaxic, unstableLethargicFecal-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 #6Feline 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:2/5Depression dehydratedMm: pale pk, CRT:2secTemp: 102.9. HR: 200, RR: 30
DIAGNOSTIC TESTS FECAL
ABDOMINAL RADIOGRAPHS
CBC/SERUM CHEMISTRY
ABDOMINOCENTESISCytology & 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 Decreased protein in the blood
ABDOMINAL RADIOGRAPHS 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 lesions
Rarely, enlarged kidneys
This 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 MARGINATEDKIDNEYS, 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
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