INFECTIOUS DISEASES

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INFECTIOUS DISEASES

• These diseases are covered predominantly in
  chapter 9 11 of your textbook

Supplemental reading https//www.aahanet.org/Pu
blicDocuments/CanineVaccineGuidelines.pdf CTVT
Textbook 8th edition - pages 701-710
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CASE 1CANINE DISTEMPER
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PATIENT PRESENTATION
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PATIENT PRESENTATION

• SIGNALMENT 12 week old, male/neutered, mixed
  breed puppy
• PRESENTING COMPLAINT lethargy, ocular and nasal
  discharge for the past 3 days mild cough,
  appetite is poor puppy had diarrhea last night
  and vomiting/diarrhea this morning

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PATIENT PRESENTATION

• Hx
• puppy adopted from local shelter 2 weeks ago
• has received one set of vaccinations
• Incompletely vaccinated!
• Other Info
• Client has 1 other dog who is 1 year old and
  fully vaccinated
• Client has 2 cats who are 2 and 5 yrs old that
  are fully vaccinated

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PATIENT PRESENTATION

• PHYSICAL EXAM FINDINGS
• Lethargy
• 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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PATIENT PRESENTATION
ENAMEL HYPOPLASIA
HYPERKERATOSIS OF NOSE FOOT PADS
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DIAGNOSTICS TREATMENT

• DIAGNOSTIC TESTS
• CBC to look for evidence of infection and/or
  anemia
• Blood work to send off titers for Distemper Virus
  Infection
• TREATMENT
• ANTIBIOTICS
• FLUIDS
• SYMPTOMATIC TREATMENT
• Anti-emetics
• Ophthalmic ointments
• Cleaning ocular/nasal discharge frequently
• Nutrition
• Clean, dry environment low stress

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DIAGNOSTICS

• WORSENING OF CLINICAL SIGNS 1 week later, the
  client returns. The puppy is weak and appears to
  have muscle twitching muscles of the mouth
  appear as if the puppy is chewing gum there
  are pustules on the abdomen, and hyperkeratotic
  foot pads nose
• LACK OF RESPONSE TO TREATMENT IS CHARACTERISTIC
  FOR CANINE DISTEMPER VIRUS

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DIAGNOSISCANINE DISTEMPER VIRUS
http//www.youtube.com/watch?vHyEFS77rOzU
http//www.youtube.com/watch?vQL4S4MA2zT0
Myoclonus is characteristic for Canine Distemper
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DIAGNOSTICS AND TREATMENT

• FURTHER DIAGNOSTICS
• Blood work to compare serum titers and CBC
  results
• CBC Leukocytosis with neutrophilia found due to
  secondary infection
• Titers have increased since last measurement
• Flourescent antibody(FA) 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.

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PROGNOSIS CLIENT INFORMATION

• Transmission of this (single-stranded RNA,
  enveloped, paramyxo-) virus is through
  aerosolization of bodily fluids, fomites
• Fatality rate may be as high as 90
• Prognosis is guarded at best, especially 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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PREVENTION

• Vaccination
• Thorough cleaning the virus is labile and can
  be killed with common disinfectants, and heat
• Isolation of infected animals

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CASE 2Parvovirus
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PATIENT PRESENTATION
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PATIENT PRESENTATION

• SIGNALMENT 3mth old Rottweiler puppy, intact
  male
• PRESENTING COMPLAINT lethargy, poor appetite,
  bloody diarrhea for 2 days puppy has vomited
  twice this morning
• Hx
• Owner purchased puppy from local traders market
  at 10 weeks old.
• The breeder gave the first set of vaccinations at
  3 weeks old and a booster _at_ 7 weeks
• Incorrect, incomplete vaccinations

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PATIENT PRESENTATION

• 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
  Neither puppy has been started on heartworm or
  flea prevention.

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PATIENT PRESENTATION

• PHYSICAL EXAM FINDINGS
• dehydrated
• mm pale, CRT gt2.5sec
• Depressed
• Rear soiled in blood-tinged diarrhea, strong,
  foul odor
• Temp 103.5, HR 120 RR 24

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DIAGNOSTICS

• Fecal
• Check for concurrent intestinal parasitism
• Parvo ELISA (snap test)
• Detects viral antigen
• CBC/Serum Chemistries
• Marked lymphopenia, neutropenia, increased PCV
• Parvovirus titers
• High titers (110,000) in positive animals

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PARVO ELISA
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PATHOGENESIS

• 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 lt2000
• Possible sequelae septicemia, intussusception

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TREATMENT

• ISOLATE INFECTED ANIMALS
• HOSPITALIZATION
• IV fluids w/added electrolytes, added dextrose
• ANTIBIOTICS
• ANTI-EMETICS
• Reglan (metoclopramide)
• Cerenia (maropitant)
• Zofran (ondansetron)
• NSAIDs possibly for fever, but could complicate
  bleeding
• /- Plasma transfusion for hypoproteinemia
• /-ANTIVIRAL
• Tamiflu

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PROGNOSIS

• PROGNOSIS generally good with aggressive and
  early treatment 80-90 success
• Concurrent infections and GI parasites can worsen
  prognosis

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PREVENTION CLIENT INFORMATION

• 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 130 solution of bleach is
  effective.

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DONT WORRY, BE HAPPY ?

• WORRYING DOES NOT DECREASE THE STRUGGLES OF
  TOMORROWY, BUT IT DOES DECREASE THE STRENGTH OF
  TODAY.
• -Mary Engelbrelt

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CASE 3Canine Respiratory Disease
Complex(Kennel Cough, Infectious
Tracheobronchitis)see ch.11 pgs193-194
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PATIENT PRESENTATION
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PATIENT PRESENTATION

• SIGNALMENT 4yr old, female spayed, dachshund
• 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 1 day before beginning daycare.

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PATIENT PRESENTATION

• Hx
• Patient is current on HW and flea prevention
• HW neg.
• No other significant illnesses
• PHYSICAL EXAM FINDINGS
• Temp 102.1, HR 140, RR 36
• Sneezing and occasional coughing on exam
• Cough can be elicited on tracheal palpation
• Mild, clear nasal discharge
• Normal hydration status
• mm pk. CRT lt2sec

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DIAGNOSIS CANINE RESPIRATORY DISEASE COMPLEX

• Aka Infectious Tracheobronchitis
• Major causes
• VIRUSES Canine Adenovirus-2, Parainfluenza,
  Canine herpesvirus, Canine Influenza, canine
  distemper virus
• BACTERIA mycoplasma, bordetella bronchiseptica,
  streptococcus sp.

http//www.youtube.com/watch?vamGKQX9zdug
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DIAGNOSTICS TREATMENT

• DIAGNOSTICS
• Based on physical exam, clinical signs and
  history
• Virus isolation from swabs of the pharynx, nasal
  passageways, trachea can help determine which
  virus and/or bacteria is the cause
• Thoracic rads if pneumonia suspected

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DIAGNOSTICS TREATMENT

• TREATMENT
• Adequate hydration
• Antibiotics
• Antitussives (cough suppressants)
• Hycodan (hydrocodone)
• Butorphanol
• Cough Tabs (dextromethorphan, guaifenesin)
• Bronchial dilators
• Aminophylline
• terbutaline

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PROGNOSIS CLIENT INFORMATION

• 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
• Injectable Bordetella vaccine requires 2 doses at
  least 2 weeks apart, then another 7-10 days for
  protective immunity
• If using the intranasal vaccine, 2-3 days prior
  to exposure is recommended

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PREVENTION

• Isolate infected animals
• Vaccinate appropriately
• Most routine disinfectants, bleach, quarternary
  ammonium compounds will kill these viruses and
  bacteria
• Proper sanitation

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NOTE CANINE HEPATITIS

• CANINE HEPATITIS
• Caused by Canine Adenovirus-1 (CAV-1)
• The vaccine for CAV-2 (a respiratory virus) will
  cross-protect against canine hepatitis.
• Hepatitis is uncommon due to thorough vaccination
  programs.
• The disease causes hepatic necrosis in affected
  dogs
• Treatment is supportive