pansystemic diseases

VT121 Pansystemic Diseases Study Notes

Terminology

  • Pansystemic: A disease that affects all body systems.
  • FeLV (Feline Leukemia Virus)
  • FIV (Feline Immunodeficiency Virus)
  • FIP (Feline Infectious Peritonitis)
  • Panleukopenia: A decrease of all types of white blood cells (WBCs) in blood.
  • Retrovirus: An RNA virus that integrates a DNA copy of its genome into the host cell for replication.
  • Parvovirus: A small, species-specific virus capable of self-replication.
  • Erythropoietin: A hormone produced by the kidneys that stimulates red blood cell (RBC) production in the bone marrow.

Pansystemic Diseases Covered in This Lesson

  • Feline Leukemia Virus (FeLV)
  • Feline Immunodeficiency Virus (FIV)
  • Feline Infectious Peritonitis (FIP)
  • Feline Panleukopenia
  • Toxoplasmosis
  • Canine Distemper Virus
  • Canine Parvovirus
  • Rickettsial infections
  • Rabies

Feline Leukemia Virus (FeLV)

  • Characteristics:
    • FeLV is a retrovirus that destroys white blood cells (WBCs) and affects the immune system.
    • It is unstable in the environment.
    • It spreads vertically (from queen to kitten) and horizontally (from cat to cat).
    • Transmission occurs through body fluids such as grooming, bite wounds, and feces.
    • Most severe effects observed in young animals.
Possible Outcomes of Infection
  • Rapid-onset death: Common in neonates and young cats.
  • Bone-marrow suppression and anemia: May lead to death related to secondary infections.
  • Virus-induced lymphoma.
  • Recovery: Some cats can clear the virus or remain positive without succumbing to the disease.
Clinical Signs
  • Variable based on affected organs:
    • Weight loss
    • Fever
    • Chronic infections (e.g., stomatitis, gingivitis, upper respiratory infections)
    • Gastrointestinal signs, especially intestinal lymphoma.
Diagnosis
  • Point-of-care testing: ELISA, SNAP, Witness tests.
    • Transiently affected cats may clear the virus.
  • Real-time PCR: Testing at diagnostic labs.
  • CBC results: Show bone marrow suppression, such as anemia or leukopenia.
  • Biopsy: Histopathology for lymphoma diagnosis.
Treatment
  • No cure available.
  • Chemotherapy for lymphoma.
  • For bone marrow suppression:
    • Blood transfusions
    • Erythropoietin
    • Granulocyte-stimulating factor
  • Antibiotics: For secondary infections.
  • Antiviral and immunomodulatory medications: Optional.
  • Nursing care: Important for patient management.
Preventing Transmission/Infection
  • Vaccination: Core vaccine, recommended for all cats.
  • Prevention of exposure: Keep positive cats indoors, separate from others.
  • Good hygiene: Wash bowls, bedding, housing, and hands between patients.
  • Routine testing: For all new cats, high-risk, or sick cats.

Feline Immunodeficiency Virus (FIV)

  • Characteristics:
    • FIV is a retrovirus also known as Feline Acquired Immunodeficiency Syndrome (AIDS).
    • Predominantly affects adult outdoor male cats.
    • Transmission primarily through saliva (bite wounds) and from queen to kittens via placenta and milk.
    • Also transmitted through blood transfusions.
Possible Outcomes of Infection
  • Impairment of the immune system: Results from destruction of T-cells, leading to severe illnesses.
  • Bone-marrow suppression: May lead to leukemia and related anemia.
  • Normal life: Some infected animals live healthy, normal lives.
Diagnosis
  • Point-of-care testing: ELISA, SNAP, Witness tests (be mindful of maternal antibodies).
  • Real-time PCR test: For definitive diagnosis.
  • CBC results: May show bone marrow suppression.
Managing the Disease
  • No cure available.
  • If bone marrow suppression occurs:
    • Blood transfusions
    • Erythropoietin
    • Granulocyte-stimulating factor
  • Antibiotics: For secondary infections.
  • Possible use of antiviral and immunomodulatory medications.
Preventing Transmission/Infection
  • Keep FIV positive cats indoors: Prevents exposure to healthy cats.
  • Spay/neuter: Reduces wandering and fighting behavior.
  • Vaccine: No longer available due to limited protection, risk of sarcomas, and potential for false positives.

Feline Infectious Peritonitis (FIP)

  • Characteristics:
    • FIP is a mutated form of the feline coronavirus (FECV or FCoV).
    • FCoV is common; approximately 90% of cats test positive.
    • Mutation causes the virus to leave the intestinal tract and infiltrate the body.
    • Only a small percentage of cats with FCoV develop FIP.
    • An individual cat's mutation is necessary for FIP transmission.
Possible Outcomes of Infection
  • Wet Form: Severe vasculitis leading to fluid buildup in cavities (e.g., respiratory distress from effusion).
  • Dry Form: Granulomas and inflammation with neurological or ocular symptoms (e.g., seizures, uveitis).
  • Dormant Infections: Cats may have FIP without showing symptoms until stressed or ill.
Diagnosis
  • Wet Form:
    • Diagnosis is often through exclusion of other diseases.
    • PCR testing: Conducted on effusion samples.
    • Rivalta test: 91-98% sensitivity, 66-80% specificity for diagnosis.
  • Bloodwork: Abnormalities such as elevated neutrophils, low lymphocytes, elevated globulin.
    • An Albumin:Globulin ratio of
  • Histopathology: Biopsy of lymph nodes and internal organs showing vasculitis and necrotic lesions.
Treatment
  • A recently developed antiviral drug, GS-441524, has cured FIP in over half the cases.
  • Steroids: To reduce inflammation.
  • Nursing Care: Critical for supportive management.
Prevention
  • With FCoV widespread, prevention of infection is challenging.
  • Breeding: Only breed cats tested negative for FCoV.
  • Vaccine: Current vaccine is not recommended due to clinical ineffectiveness.

Feline Panleukopenia

  • Characteristics:
    • Caused by feline parvovirus, leading to high morbidity and mortality.
    • Kittens are particularly susceptible, with the virus attacking rapidly dividing cells in the bone marrow and GI tract.
  • Transmission: Via feces, urine, and blood, and can persist in the environment for years.
Possible Outcomes of Infection
  • Sudden death: Especially in kittens.
  • Clinical signs: Vomiting, diarrhea, fever, lethargy, anemia, leukopenia, thrombocytopenia.
    • Pregnant cats may have kittens with cerebellar hypoplasia.
  • Recovery: More likely in well-vaccinated adult cats.
Diagnosis
  • Point-of-care testing: SNAP/Witness tests for canine parvovirus.
  • Clinical signs: Fever, vomiting, diarrhea, lethargy, anorexia.
  • Bloodwork: CBC reflects panleukopenia, thrombocytopenia, and anemia.
Treatment
  • Supportive care: Crystalloid and colloidal fluids, broad-spectrum antibiotics for secondary infections, anti-nausea medication, and pain control.
  • Hygiene and isolation: Critical for preventing further exposure.
Prevention
  • Vaccination: Recommended for kittens, breeding queens, and adult cats.
  • Isolate infected animals and maintain good hygiene/disinfection practices.
  • Euthanasia: May be necessary for seriously ill animals due to high mortality rate.

Toxoplasmosis

  • Characteristics:
    • A protozoal disease affecting cats of all ages, with cats as the definite host.
    • Cats shed oocysts only after their first infection.
    • Infection usually through raw meat or infected prey.
Possible Outcomes of Infection
  • Affects multiple organ systems: Respiratory, pancreas, muscle, liver, eyes, intestines, and neurological.
  • Silent Infections: Not all cats show clinical signs.
  • Dormant Infections: Organism lays dormant; reactivation possible under stress or illness, without re-shedding.
Diagnosis
  • Fecal testing: Identifying oocysts can be unreliable.
  • Antibody titers: Testing on serum, Cerebrospinal fluid (CSF), or aqueous humor.
  • Histological findings: Bradyzoites in tissues like brain, muscle, and eye or tachyzoites in affected fluids or tissues.
  • Bloodwork: Signs of inflammation, anemia, and chemistry abnormalities may be present.
Treatment
  • Antibiotics: Clindamycin, trimethoprim-sulfonamide, or azithromycin.
  • Supportive care: Fluid and electrolyte balance, seizure control, anti-inflammatory therapy for uveitis, and pain control for any systemic effects.
Prevention of Infections
  • Do not allow hunting or feeding raw foods to cats.
  • Preventing Human Infections: Maintain daily litter box hygiene, wash hands, ensure vegetables are clean, cook food thoroughly, and avoid unpasteurized milk.

Canine Distemper Virus (CDV)

  • Characteristics:
    • A deadly disease affecting many carnivorous animals.
Transmission
  • Spread through bodily fluids (urine, feces, vomit) and respiratory secretions.
  • Fomite spread is common.
Possible Outcomes of Infection
  • Often fatal in puppies and immune-compromised adult dogs.
  • Full-blown Disease: Symptoms include vomiting, diarrhea, fever, pneumonia, death, skin infections, hyperkeratosis on paws and nose, and neurological signs.
  • Recovery can lead to persistent neurologic issues.
Diagnosis
  • Clinical signs: Observational diagnosis based on symptoms.
  • WBC inclusions: Identifiable in blood tests.
  • PCR test or IFA testing: To confirm infection result.
  • Coupled IgM and IgG titers can assist but are challenging to interpret.
Treatment
  • Supportive care: Address fluid and electrolyte imbalances and provide nutrition.
  • Antibiotics: For managing secondary infections.
  • Euthanasia: May be necessary for untreated cases.
Prevention
  • Vaccinate: At appropriate ages and intervals.
  • Maintain excellent hygiene to prevent fomite transmission.
  • Treat affected dogs in isolation to prevent outbreaks.

Canine Parvovirus (CPV)

  • Characteristics:
    • A highly contagious and deadly virus in dogs.
Transmission
  • Spread through fecal-oral route: diarrhea, vomit, contaminated environments or fomites.
  • Can survive in the environment for years.
Possible Outcomes of Infection
  • Most severe in young, poorly vaccinated puppies.
  • Symptoms: Anorexia, vomiting, diarrhea, destruction of intestinal lining, bone marrow suppression, leukopenia, and anemia.
  • Recovery is possible with appropriate care.
Diagnosis
  • Point-of-care ELISA test: SNAP/Witness tests are common, yet may yield false negatives.
  • PCR test: Can confirm suspected cases when tests show negative results.
  • Clinical signs: Noteworthy for diagnosis in young, under-vaccinated puppies.
  • CBC results: Lymphopenia and neutropenia are common findings.
Treatment
  • IV fluids: Crystalloids +/− colloids for hydration and nutrient replenishment.
  • Antibiotics: To prevent sepsis.
  • Anti-nausea medication and pain control.
  • Nursing care: Essential, including proper hygiene to avoid re-infection, and thermoregulation.
Prevention
  • Vaccination: Optimal practices suggest following manufacturer recommendations, usually ceasing at 14-16 weeks.
  • Safe environments: Keeping puppies in low-risk areas until fully vaccinated.
  • Excellent disinfection practices, employing diluted bleach solutions and specific disinfectants.

Rickettsial Diseases

  • Overview:
    • Bacterial infections transmitted through tick bites, prevalence varies geographically.
    • History of travel to tick-infested areas is critical in diagnosis.
Transmission
  • Rocky Mountain Spotted Fever (RMSF): Spread by Dermacentor ticks.
  • Ehrlichiosis: Spread by Rhipicephalus sanguineus and Dermacentor virabilis.
  • Anaplasmosis and Lyme Disease: Spread through Ixodes ticks. Borrelia burgdorferi is the causative agent for Lyme Disease.
Possible Outcomes of Infection
  • Subclinical infections: No overt symptoms.
  • Clinical infections: RMSF and Ehrlichiosis lead to vasculitis and systemic issues; may present rashes and affect major organs.
  • Chronic infections: Risk of re-infection persists; prior exposure does not confer immunity.
Diagnosis
  • Based on clinical signs and tick exposure history.
  • Finding morulae in white blood cells via buffy coat smear.
  • Point-of-care SNAP testing for antibodies.
  • Titer testing and PCR testing for definitive diagnosis.
  • CBC and chemistry results: Variable depending on affected organs.
Treatment
  • Immediately remove all ticks from the patient.
  • Tetracyclines: Doxycycline is the most commonly prescribed.
  • Anti-inflammatories: NSAIDs or steroids, but not concurrently.
  • Supportive care: As needed based on symptoms.
Prevention
  • Avoid tick-infested areas, rapidly remove ticks.
  • Consistent use of tick preventatives: Simparica, Bravecto, Advantage, and Seresto collars.

Rabies

  • Characteristics:
    • A highly contagious virus affecting all mammals, including humans.
Transmission
  • Contracted mainly through contact with saliva or CNS tissues;
  • Common wildlife carriers include skunks, raccoons, foxes, and bats, alongside domestic animals like dogs and cats.
Possible Outcomes of Infection
  • Nothing: If proper post-exposure prophylaxis (PEP) is administered (only applies to humans).
  • In vaccinated pets following rabies exposure:
    • Risk of symptoms is minimal, includes behaviors like aggression or unusual friendliness.
  • Clinical Symptoms: Hydrophobia, paralysis, and eventual death; survival post-symptom onset is very rare.
Diagnosis
  • Required examination of brain tissue via a qualified laboratory.
  • Must refrigerate samples without freezing;
  • Typically, entire heads or bodies are submitted for proper diagnosis using direct fluorescent antibody testing.
Human Treatment
  • Post-exposure prophylaxis (PEP): Immediate washing of the bite area for 15 minutes.
  • Need for rabies antibodies infusion followed by a series of rabies vaccinations.
Animal Treatment
  • Generally, there is no effective treatment for rabies.
  • Euthanasia of suspected rabies cases is advised; vaccinated pets exposed to rabid animals should receive booster vaccines.
Prevention
  • Vaccination: Vital for domestic species and vector wildlife.
  • Continued vaccination is important for humans who frequently handle susceptible animals.
  • Air drops of flavored rabies vaccines are conducted in wildlife areas with endemic rabies.
Quarantine Guidelines
  • Quarantine specifics vary regionally. Major points include:
    • 10-day: for pets that have bitten a person.
    • 45-day: for vaccinated animals exposed to rabid animals.
    • 6-month: for unvaccinated pets that encounter rabid creatures, may result in euthanasia.
  • All determinations are made by local animal control authorities.