scientific fun fact
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Scientific Fun Fact. Armillaria ostoyae (honey mushroom). PANSYTEMIC DISEASES. CANINE. CASE #1. PATIENT PRESENTATION. PATIENT PRESENTATION. SIGNALMENT: 12 week old, male/neutered, mixed breed puppy - PowerPoint PPT PresentationTRANSCRIPT
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Armillaria ostoyae (honey mushroom)
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CANINE
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SIGNALMENT: 12 week old, male/neutered, mixed breed puppy
PRESENTING COMPLAINT: lethargy, ocular and nasal discharge for the past 3 days; appetite is poor; puppy had diarrhea last night and vomiting/diarrhea this morning◦ Diet: Science diet puppy dry
Hx: puppy adopted from local shelter 2 weeks ago; has received one set of vaccinations – owner was planning to schedule booster shots in one week
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Hx: Puppy received his first doses of Heartworm and flea prevention 2 weeks ago at time of adoption.
Other Info: Client has 1 other dog who is 1 year old and fully vaccinated; and 2 cats who are 2 and 5 yrs old that are fully vaccinated
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PHYSICAL EXAM FINDINGS:◦ Lethargy◦ ~8% 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 ocular/nasal discharge◦ The nose looks, dry, thick, and crusty
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TREATMENT◦ ANTIBIOTICS◦ FLUIDS◦ SYMPTOMATIC TREATMENT
Anti-emetics Ophthalmic ointments Cleaning ocular/nasal discharge frequently Nutrition Clean, dry environment; low stress
DIAGNOSTICS◦ Blood work is drawn for a CBC, serum chemistry
profile and Canine Distemper titers
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DIAGNOSTIC TEST RESULTS:◦ Leukopenia◦ Mild anemia
WORSENING OF CLINICAL SIGNS: 1 week later, the client returns. The puppy is weak and appears to have muscle twitching; muscle of the mouth appear as if the puppy is “chewing gum”; there are pustules on the abdomen, and hyperkeratotic foot pads
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http://www.youtube.com/watch?v=QL4S4MA2zT0
http://www.youtube.com/watch?v=HyEFS77rOzU
*Myoclonus is almost pathognomonic for Canine Distemper
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ENAMEL HYPOPLASIA
HYPERKERATOSIS OF NOSE & FOOT PADS
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FURTHER DIAGNOSTICS:◦ Blood work drawn to compare serum titers and
CBC results Leukocytosis with neutrophilia found 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.
Titers have increased since last measurement
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Transmission of this (single-stranded, RNA, paramyxo-) virus is through aerosolization of bodily fluids, fomites
Fatality rate may be as high as 50%- 90% Prognosis is guarded at best, esp 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
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Vaccination Thorough cleaning – the virus is labile and
can be killed with common disinfectants, and heat
Isolation of infected animals
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SIGNALMENT: 4yr old, female spayed, daschund,
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 2 days before beginning daycare.
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Hx: ◦ Diet: Purina One◦ Patient is current on HW and flea prevention◦ No other significant illnesses
PHYSICAL EXAM FINDINGS:◦ Temp: 102.1, HR: 140, RR: 36◦ Sneezing and occasional coughing on exam
Cough can be ellicited on tracheal palpation Mild, clear nasal discharge
◦ Normal hydration status◦ Mm: pk CRT: <2sec
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Aka Infections Tracheobronchitis Major causes
◦ VIRUSES: Canine Adenovirus-2, Parainfluenza, Canine Distemper, Canine Influenza
◦ BACTERIA: mycoplasma, bordetella bronchiseptica, streptococcus sp.
http://www.youtube.com/watch?v=amGKQX9zdug
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DIAGNOSTICS◦ Based on physical exam, clinical signs and history◦ Virus isolation from swabs of the pharynx, nasal
passageways, trachea◦ Thoracic rads if pneumonia suspected
TREATMENT◦ Adequate hydration◦ Antibiotics◦ Antitussives
Hycodan (hydrocodone) Butorphanol Cough Tabs (dextromethorphan, guafenesin) Bronchial dilators
Aminophylline terbutaline
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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
Vaccinate 2-3 weeks prior to expected exposure
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Isolate infected animals Vaccinate appropriately Most routine disinfectants, bleach,
quarternary ammonium compounds will kill these viruses and bacteria
Proper sanitation
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SIGNALMENT: 3mth old Rottweiler puppy, intact male◦ *Dobermans & Rottweilers are over-represented
PRESENTING COMPLAINT: lethargy, poor appetite, bloody diarrhea for 2 days; puppy has vomited twice this morning
Hx: Owner purchased puppy from local trader’s market at 10 weeks old. The breeder gave the first set of vaccinations at 3 weeks old and a booster @ 7 weeks
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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
given by the family member.◦ Neither puppy has been started on heartworm or
flea prevention.◦ Diet: Blue Buffalo
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PHYSICAL EXAM FINDINGS:◦ ~8% dehydrated
Mm:pale, CRT: >2.5sec◦ Depressed◦ Rear soiled in blood-tinged diarrhea, strong, foul
odor◦ Temp: 103.5, HR: 120 RR: 24
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Fecal Parvo ELISA (snap test)
◦ Detects viral antigen CBC/Serum Chemistries
◦ Marked lymphopenia, neutropenia, increased PCV◦ Hypoglycemia, hypokalemia
Parvo titers◦ High titers (1:10,000)
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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 on bone marrow lymphopenia,
neutropenia WBCs may be <2000
◦ Possible sequelae: septicemia, intussusception
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ISOLATE INFECTED ANIMALS HOSPITALIZATION
◦ IV fluids w/added electrolytes, added dextrose◦ ANTIBIOTICS◦ ANTI-EMETICS
Reglan Maropitant (cerenia) Ondansetron
◦ NSAIDs◦ +/- Plasma transfusion for hypoproteinemia◦ +/-ANTIVIRAL
Tamiflu
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PROGNOSIS: generally good with aggressive and early treatment; 80%-90% success◦ Concurrent infections and GI parasites can worsen
prognosis
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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.
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SIGNALMENT: ~6 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
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Hx: no known vaccinations, no flea or HW prevention◦ Diet: owner feeds canned Whiskas
PHYSICAL EXAM◦ Patient is QAR◦ Temp: 104.1, HR: 200, RR:40◦ Audible upper respiratory congestion◦ ~6-8% dehydrated◦ Mm: pale pk, CRT: 2 sec
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DIAGNOSTICS◦ Clinical signs◦ Nasal, pharyngeal swabs
DIAGNOSIS:◦ Feline Viral
Rhinotracheitis(FVR) Feline Herpesvirus-1
◦ Feline Calicivirus (FCV) 80-90% of all URI is cause by 1 of
these 2 viruses
Chlamydophila felis◦ Bordetella◦ Mycoplasma
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FLUIDS ANTIBIOTICS NURSING CARE
◦ Warm, clean◦ Force feed, warm, food◦ Pain meds for oral or corneal ulcers
DECREASE STRESS AVOID STEROID ANTIVIRAL
◦ Idoxuridine
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Both FVR and FCV are highly contagious◦ Transmitted via fomites (hands, clothes) and
aerolsolization of respiratory droplets withing 5 feet
Morbidity is high, mortality is low◦ Oral ulcers can last 7-10 days
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VACCINATION◦ Vaccines will reduce severity and duration of
clinical signs
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http://www.youtube.com/watch?v=xLlL24shW7E
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SIGNALMENT: 4week old, intact female, DSH
PRESENTING COMPLAINTS: kitten is depressed and appears to be very thin, has blood-tinged diarrhea, occasional vomiting
Hx: Owner lives in an apartment complex and found this kitten outside. She thinks she know the mom, but the mom doesn’t seem to be taking care of her.
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PHYSICAL EXAM FINDINGS◦ 103.9◦ ~6% dehydrated◦ Ataxic, unstable◦ Lethargic◦ Fecal-soiled rear-end
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CBC◦ Moderate to severe panleukopenia
Positive parvo snap test Antibody titers Virus isolation
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Maintain hydration and electrolyte balance Force-feeding Broad-spectrum antibiotics
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Proper vaccination Cats who survive the infection will not get
re-infected later in life. They acquire life-long immunity.