impossible?!? “nothing is impossible! the word itself says “i’m possible.” -audrey hepburn

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


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


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.


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 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


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 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

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

impossible?!? “nothing is impossible! the word itself says “i’m possible.” -audrey hepburn

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