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

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  • IMPOSSIBLE?!?NOTHING IS IMPOSSIBLE! THE WORD ITSELF SAYS IM POSSIBLE.-AUDREY HEPBURN

  • CASE #4Feline Upper Respiratory Disease ComplexSee Ch. 11 pgs194,198-199

  • PATIENT PRESENTATIONSIGNALMENT: ~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 PRESENTATIONHx: no known vaccinations

    PHYSICAL EXAMPatient is QARTemp: 104.1, HR: 200, RR:40Audible upper respiratory congestiondehydratedMm: pale pk, CRT: 2 sec

  • DIAGNOSTICSDIAGNOSTICSClinical signsNasal, pharyngeal swabs to send for virus isolation to an outside lab

    DIAGNOSIS: Upper Respiratory InfectionFeline Viral Rhinotracheitis(FVR)Feline Herpesvirus-1Feline Calicivirus (FCV)80-90% of all URI is caused by 1 of these 2 viruses Chlamydophila felisBordetellaMycoplasma

  • DIAGNOSIS: Differentiating the causesSneezing is common in allUpper repiratory diseaseCorneal ulceration is associated with HerpesvirusCoughing is associatedwith Bordetella or mycoplasmaOral ulcers areassociated withcalicivirus

  • TREATMENTFLUIDSANTIBIOTICSNURSING CAREWarm, cleanForce feed, warm, foodPain meds for oral or corneal ulcersDECREASE STRESSAVOID STEROIDSANTIVIRALSIdoxuridine topical ophthalmic solution

  • PROGNOSIS & CLIENT INFORMATIONBoth FVR and FCV are highly contagiousTransmitted via fomites (hands, clothes) and aerosolization of respiratory droplets within 5 feet

    Morbidity is high, mortality is lowOral ulcers can last 7-10 days

  • PREVENTIONVACCINATIONVaccines will reduce severity and duration of clinical signs

    ISOLATION OF AFFECTED ANIMALS

  • CASE #5Feline Panleukopenia

  • PATIENT PRESENTATIONhttp://www.youtube.com/watch?v=xLlL24shW7E

  • PATIENT PRESENTATIONSIGNALMENT: 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.

  • PATIENT PRESENTATIONPHYSICAL EXAM FINDINGS103dehydratedAtaxic, unstableLethargicFecal-soiled rear-end

  • DIAGNOSTICSCBCModerate to severe panleukopenia

    Positive parvovirus snap test

    Antibody titers

    Virus isolation is difficult

    PCR for detection of viral DNA

  • TREATMENTMaintain hydration and electrolyte balance

    Force-feeding

    Broad-spectrum antibiotics

  • PREVENTION & CLIENT INFOProper 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 virusTransmission is through direct contact or contaminated environment

  • CASE #6Feline Infectious Peritonitis

  • PATIENT PRESENTATION

  • PATIENT PRESENATIONSIGNALMENT: 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

  • PATIENT PRESENTATIONHx: 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 TESTSFECAL

    ABDOMINAL RADIOGRAPHS

    CBC/SERUM CHEMISTRY

    ABDOMINOCENTESISCytology & chemical analysis of the fluid

    ANTIBODY TITERS(?)

  • DIAGNOSTIC TESTS

  • DIAGNOSTIC TESTS

  • DIAGNOSTIC TESTS

  • DIAGNOSTIC TESTS

  • DIAGNOSTIC TEST RESULTSFECAL(?)

    There is NO FIP SPECIFIC antibody titer test

    CBC/SERUM CHEMISTRYDecreased protein in the blood

    ABDOMINAL RADIOGRAPHSAscites found

    ABDOMINOCENTESISViscous, clear to yellow fluid, high protein, low cellularityRIVALTA TEST positive

  • DIAGNOSTIC TESTS: Abdominocentesis

  • RIVALTA TEST Fill a clear test tube full with distilled water, add one drop 98% acetic acid and mix (or vinegar). Carefully place one dropOf the cats effusion on the surface of the acid. If drop disappearsTest = negative If drop retains shapeTest = positive

  • DIAGNOSTICS

  • TRANSMISSION & PATHOPHYSIOLOGY

  • TRANSMISSION & PATHOPHYSIOLOGY

  • TRANSMISSION & PATHOPHYSIOLOGYFIP occurs in 2 forms: the wet or effusive form (75%) and the non-effusive or dry form.DRY FORMFeverAnorexiaDepressionWt. lossOcular lesions inflammation, hemorrhageNeurologic lesionsRarely, enlarged kidneysThis form of the disease is vague and progresses slowly these animals may live months to years

  • DRY FORMUVEITIS, RETINITIS, IRITIS

  • FIP: DRY FORMIRREGULARLY MARGINATEDKIDNEYS, POSSIBLE RENOMEGALY

  • TREATMENT & PREVENTIONSUPPORTIVE CAREThoracocentesis/abdominocentesis to make pet more comfortableDaily steroidsAntibiotics

    PREVENTIONControl of the virus shedding is keyHouse cats separatelyClean litter boxes frequentlyThe virus can last up to 4 weeks in the environment, but is killed easily by disinfectantsLower number of cats, lower stressNo proven efficacy of the Primucell FIP vaccine

  • CLIENT INFO & PROGNOSISClinical 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