IMPOSSIBLE?!?

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IMPOSSIBLE?!?

• NOTHING IS IMPOSSIBLE! THE WORD ITSELF SAYS IM
  POSSIBLE.
• -Audrey HEpburn

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CASE 4Feline Upper Respiratory Disease
ComplexSee Ch. 11 pgs194,198-199
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(No Transcript)
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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

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PATIENT PRESENTATION

• Hx no known vaccinations
• PHYSICAL EXAM
• Patient is QAR
• Temp 104.1, HR 200, RR40
• Audible upper respiratory congestion
• dehydrated
• Mm pale pk, CRT 2 sec

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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

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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
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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

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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

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PREVENTION

• VACCINATION
• Vaccines will reduce severity and duration of
  clinical signs
• ISOLATION OF AFFECTED ANIMALS

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CASE 5Feline Panleukopenia
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PATIENT PRESENTATION
http//www.youtube.com/watch?vxLlL24shW7E
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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.

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PATIENT PRESENTATION

• PHYSICAL EXAM FINDINGS
• 103
• dehydrated
• Ataxic, unstable
• Lethargic
• Fecal-soiled rear-end

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DIAGNOSTICS

• CBC
• Moderate to severe panleukopenia
• Positive parvovirus snap test
• Antibody titers
• Virus isolation is difficult
• PCR for detection of viral DNA

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TREATMENT

• Maintain hydration and electrolyte balance
• Force-feeding
• Broad-spectrum antibiotics

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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

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CASE 6Feline Infectious Peritonitis
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PATIENT PRESENTATION
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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

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PATIENT PRESENTATION

• Hx The other 5 kittens are generally healthy
• PHYSICAL EXAM
• Distended abdomen, BCS2/5
• Depression
• dehydrated
• Mm pale pk, CRT2sec
• Temp 102.9. HR 200, RR 30

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DIAGNOSTIC TESTS

• FECAL
• ABDOMINAL RADIOGRAPHS
• CBC/SERUM CHEMISTRY
• ABDOMINOCENTESIS
• Cytology chemical analysis of the fluid
• ANTIBODY TITERS(?)

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DIAGNOSTIC TESTS
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DIAGNOSTIC TESTS
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DIAGNOSTIC TESTS
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DIAGNOSTIC TESTS
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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

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DIAGNOSTIC TESTS Abdominocentesis
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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 cats effusion on the surface of the
  acid.
• If drop disappears
• Test negative
• If drop retains shape
• Test positive

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DIAGNOSTICS
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TRANSMISSION PATHOPHYSIOLOGY
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TRANSMISSION PATHOPHYSIOLOGY
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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

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DRY FORM
UVEITIS, RETINITIS, IRITIS
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FIP DRY FORM
IRREGULARLY MARGINATED KIDNEYS, POSSIBLE
RENOMEGALY
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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

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CLIENT INFO PROGNOSIS

• Clinical FIP is almost always a fatal disease
  with a mortality rate gt95.
• Cats with the effusive form usually progress more
  quickly and often die within 2 months of initial
  diagnosis