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Sarah - Mulller and Kirk > Chapter 7 - Viral and protozoal > Flashcards

Chapter 7 - Viral and protozoal Flashcards

1
Q

By which mechanisms does FeLV cause skin disease?

A

Oncogenesis and cytosuppression

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2
Q

In FeLV associated giant cell dermatosis, on which anatomical site are lesions always found and what are the lesions?

A

Face and head +/- legs

Scaling, erosions, crusting

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3
Q

Which viral protein can be stained for on histopathology?

A

gp70

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4
Q

On histopathology, where do you see syncytial-type giant cells with FeLV?

A

In the epidermis and outer root sheath of hair follicles

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5
Q

Which virus most commonly causes poxvirus infections in cats?

A

Cowpox (Orthopoxvirus)

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6
Q

What are the reservoir hosts of cowpox virus?

A

Rodents - bank and field voles, wood mice

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7
Q

What is the primary skin lesion of cowpox?

A

Single, ulcerated nodule on the head/neck or forelimbs

Cats that hunt rodents
Concurrent viraemia (pyrexia, lethargy, anorexia)
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8
Q

How long do cowpox skin lesions take to heal?

A

4-5 weeks

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9
Q

Which disinfectant is cowpox particularly susceptible to?

A

Hypochlorite solutions

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10
Q

What type of virus is canine distemper?

A

Paramyxovirus

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11
Q

Which diseases appear clinically similar to canine distemper virus?

A

Leishmania, necrolytic migratory erythema, generic dog food disease

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12
Q

What type of inclusion body, and in which cells, are seen with canine distemper virus?

A

Cytoplasmic inclusion bodies in keratinocytes

Often numerous

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13
Q

What causes contagious viral pustular dermatitis?

A

Orf - parapoxvirus

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14
Q

Which type of virus is pseudorabies?

A

alpha-herpesvirus

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15
Q

Which species are the main reservior of infection for pseudorabies?

A

Pigs

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16
Q

What are the cutaneous signs of feline herpesvirus infection?

A

Superficial, multiple ulcers at any body site OR ulcerative and nectrosing facial dermatitis

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17
Q

Which finding on histopathology is unique to feline herpes virus infection?

A

Necrosis of epitrichal sweat glands.

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18
Q

Are papillomaviruses species specific?

A

Yes - in dogs and cats

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19
Q

Which layer of the epidermis do papillomaviruses infect?

A

The stratum basale but they need terminally differentiated keratinocytes for viral replication

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20
Q

A keratinocyte with an enlarged nucleus, irregular nuclear membrane, increased nuclear staining and perinuclear halo is called what?

A

A koliocyte

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21
Q

Which cells are important in the cell mediated immune response to canine oral papilloma virus?

A

CD4+

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22
Q

Which breeds of dog are predisposed to exophytic cutaneous papillomas?

A

Kerry Blues, Cocker spaniels

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23
Q

Which breeds of dog are predisposed to inverted cutaneous papillomas?

A

Beagles, Bernese Moutain dogs, Cocker spaniels, Great Danes, Irish setters, Kerry Blues, Whippets

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24
Q

What can canine pigmented viral plaques transform to?

A

Squamous cell carcinomas

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25
Q

What causes Rocky Mountain spotted fever?

A

Rickettsia rickettsii

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26
Q

How is Rocky Mountain spotted fever transmitted?

A

Ticks - Dermoscentor andersoni/variabilis

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27
Q

Which tick is the vector for Ehrlichia canis?

A

Rhipicephalus sanguineus

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28
Q

Skin lesions occur in what % of dogs with visceral leishmaniasis?

A

80%

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29
Q

At which body sites are the lesions of exfoliate cutaneous leishmaniasis most pronounced?

A

Head, pinnae and extremities

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30
Q

Which histopathology stain aid identification of Leishmania amastigotes?

A

Giemsa

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31
Q

What changes can be seen on histopathology in papillomavirus infected keratinocytes in feline viral plaques?

A

Nuclear shrinkage
Perinuclear clearing (koilocytosis)
Increased quantities of blue-grey foamy cytoplasm

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32
Q

Which breeds of dog are reportedly predisposed to papillomavirus associated viral plaques?

A

Pugs and Min. Schnauzers

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33
Q

What changes can be seen on histopathology of canine papillomavirus associated viral plaques?

A

Papillary thickening of the epidermis
Hyperkeratosis
Hypermelanosis throughout the epidermis and superficial dermis
Large keratohyaline granules

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34
Q

Which are the oncogenic proteins of papillomavirus?

A

E5, E6 and E7

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35
Q

Pustular dermatitis at the site of a surgical wound following ovariectomy has been reported in 2 cats associated with which virus?

A

Calicivirus

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36
Q

What are the clinical (cutaneous and systemic) signs of FCV-associated virulent systemic disease?

A
  • Subcutaneous oedema of the face and limbs and variable levels of ulceration of the skin, particularly on the pinnae, footpads, and nares
  • Fever, anorexia, jaundice
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37
Q

Name two FeLV associated cutaneous syndromes

A

Cutaneous horn

FeLV-associated giant cell dermatosis

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38
Q

Which type of papillomavirus is responsible for feline sarcoids?

A

BPV-14

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39
Q

What type of virus is a papillomavirus?

A

Papillomaviruses are non-enveloped, double-stranded DNA viruses.

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40
Q

What skin lesions have been reported in cats with FIP?

A

Papules/nodules
Pitting edema
Skin fragility

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41
Q

Which genus of sandflies are vectors for Leishmania?

A

Phlebotomus (Europe) and Lutzomyia

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42
Q

Which Leishmania species is reportedly most likely associated with visceral leishmaniasis in cats?

A

L. infantum (as in people)

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43
Q

What are the most common cutaneous clinical signs of leishmaniasis in cats?

A
  • Nodules 72.7%
  • Ulcers or crusts 36.4%
  • Alopecia 9.1%
  • Scaling 7.6%
    The majority of animals showed only one dermatological sign (75.7%)
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44
Q

Which areas of the body are most commonly affected in cats with leishmaniasis?

A

Head 90.9% (nose 60.6%, ears 42.4% and eyelids 16.7% most commonly)
Legs 30.3%

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45
Q

In leishmaniasis, which toll-like receptor induces production of reactive oxygen species and reduces parasite growth when it binds parasite ligands?

A

TLR-4

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46
Q

What are the most common clinical signs of leishmaniasis in ferrets?

A

Enlargement of peripheral lymph nodes and skin lesions such as papular and/or ulcerative dermatitis

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47
Q

Domperidone is a dopamine D2 receptor antagonist that can potentiate the immune response through modulating the effect of what?

A

Prolactin

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48
Q

When treating leishmaniasis, increasing the production of prolactin induces a boost of T CD4+ lymphocytes, in addition to the release of cytokines such as?

A

IL-2 and IL-12, IFN-γ and TNF-α

Producing an activation of NK cells and macrophages, followed by a decrease of CD4+ Th2 cytokines and TNF-β.

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49
Q

Which canine papillomavirus is most commonly associated with pigmented viral plaques?

A

CPV4

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50
Q

Has diarrhoea been reported as the only clinical manifestation of leishmaniasis in cats?

A

Yes - very rarely

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51
Q

A canine papilloma virus-like particle vaccine is made using which part of the papilloma virus?

A

L1

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52
Q

What are the six syndromes of canine papillomavirus infection?

A
  1. Oral papillomas
  2. Venereal papillomas
  3. Exophytic cutaneous papillomas
  4. Cutaneous inverted papillomas
  5. Footpad papillomas
  6. Pigmented viral plaques
    Cutaneous horn also reported with CPV-1!
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53
Q

Gould et al. (2021); what was the median age of onset of canine footpad papillomas?

A

4 years

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54
Q

Gould et al. (2021); were canine footpad papillomas most common on haired skin of the digits or footpads?

A

Haired skin

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55
Q

Gould et al. (2021); most canine footpad papillomas resolved how many weeks after biopsy?

A

3 weeks

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56
Q

What are these lesions?

A

Inverted papilloma (raised erythematous nodules with a central keratinised core)

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57
Q

How do papilloma viruses invade skin and cause disease?

A
  1. Microtrauma allows the PV to gain access to the basal cells.
  2. Expression of E1 and E2 genes allows the virus to make a small number of copies of itself which then infect surrounding basal cells - persistent infection.
  3. Replication is only possible when a basal cell terminally differentiates
  4. Suprabasally, the expression of the E6 and E7 proteins interferes with cell regulation by preventing the terminally differentiation ensuring the nucleus is retained, and forcing the epithelial cells to divide and make copies of the PV
  5. As the infected cells near the surface of the epithelium, the L1 and L2 proteins are expressed allowing the virion to be assembled.
  6. Cells slough and degenerate releasing the viral particles into the environment
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58
Q

Most oral papillomas in dogs will spontaneous resolve in __ months

A

3

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59
Q

IHC detects which papilloma virus antigen?

A

L1 (capsid protein)

Can also be used to detect increased p16 protein

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60
Q

Which feline papilloma virus is found in the oral cavity and what lesions does it cause?

A

FcaPV 1

Appear to be restricted to the ventral surface of the tongue - clusters of exophytic lesions

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61
Q

Which feline papilloma virus is most common?

A

FcaPV 2 - majority are asymptomatic (most common PV in BISC)

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62
Q

What are the histopathological findings with FcaPV 2 infection?

A
  1. Expansion of the cytoplasm with either non-staining material or with wispy, granular or amorphous blue-grey material
  2. Unlike FcaPV types 1 and 3, FcaPV2 does not result in the development of any intracytoplasmic bodies.
  3. Koliocytes
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63
Q

Which breeds of cats are predisposed to BISC?

A

Sphynx and Devon Rex

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64
Q

What are the histopath findings in BISC?

A
  • Mild to moderate epidermal hyperplasia within the deeper layers of the epidermis
  • No marked expansion of the stratum spinosum as in a viral papilloma
  • Cells within the epidermis become disorganised and progress to intraepithelial neoplasia (do not breach BM)
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65
Q

Which protein is increased in papilloma-induced neoplasias?

A

Increased p16 due to the consistent PV-induced degradation of the retinoblastoma protein (pRb)

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66
Q

Are feline oral SCC PV induced?

A

No - no evidence to support an association

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67
Q

Do feline sarcoids typically require close contact with cattle

A

Yes - BPV14

68
Q

Which canine papilloma viruses may be associated with SCC?

A

CPV 9, 15 and 16

CPV 1 isolated from oral SCC

69
Q

What are squamous papillomas?

A

Papillomas lacking the typical cytopathic effects seen with papilloma virus (viral aetiology has not been confirmed):

  • dysplasia
  • cytoplasmic vacuolation
  • koilocytosis
  • hypergranulosis (giant granules in SG)
  • intranuclear inclusions
  • blue-grey cytoplasm
70
Q

Which canine papilloma virus is associated with oral papillomas?

A

CPV 1

71
Q

Endophytic papillomas in dogs are most often associated with which papilloma virus?

A

CPV 2

72
Q

What type of papillomatosis is this?

A

Footpad, exophytic

73
Q

Canine papilloma, what are the arrows pointing at?

A

Intranuclear inclusion bodies

74
Q

Which diseases are reportedly associated with papilloma virus in cats?

A
  1. Viral plaque/BISC
  2. Cutaneous SCC
  3. Basal cell carcinoma
  4. Oral papilloma
  5. Feline sarcoid
75
Q

What are the clinical signs of viral plauqes/BISC in cats?

A
  • Aged 8 and 14 years
  • Face, head and neck most common
  • Lesions are often multiple and pigmented
  • Can develop within pigmented or non-pigmented, haired or non-haired skin
  • Viral plaques < 1 cm in diameter, slightly raised, hairless lesions covered in a thin crust
  • BISCs larger and typically markedly raised ulcerated lesions covered by a significant serocellular crust or a thick layer of keratin
76
Q

What type of papillomatosis is this?

A

BISC

77
Q

Which treatments have been reported for canine papillomas?

A
  1. L1 virus like particle vaccine
  2. Surgery/cryosurgery/CO2 laser ablation
  3. Imiquimod
  4. IFN-alpha
  5. Azithromycin
  6. Tigilanol tiglate gel
  7. Systemic retinoids
78
Q

Which feline papilloma viruses have been associated with BISC?

A

FcaPV 2 (most common), 3, 4 and 5

79
Q

Describe the papilloma virus induced keratinocyte changes in this image

A

Enlarged keratinocytes with increased amounts of blue, fibrillary material

Cells with shrunken nuclei surrounded by a clear halo (koliocytes) - arrows

80
Q

What type of papilloma is this?

A

Inverted/endophytic

81
Q

Which canine papilloma viruses are most commonly associated with cutaneous papillomas?

A

CPV-1, 2, 6 and 7

82
Q

Have papilloma viruses been isolated from corns in Greyhounds?

A

Yes - CPV 12 and 16 from two dogs

Balara et al. (2009) found no PV association with corns in 18 Greyhounds!

83
Q

Azithromycin may speed resolution of oral and cutaneous papillomas in dogs within what time frame?

A

10-15 days of treatment

84
Q

Antibodies are produced against which part of the papilloma virus?

A

L1

85
Q

Which TLR is important for double-stranded DNA viruses like papilloma virus?

A

TLR 9

86
Q

Which herpes virus is associated with ulcerative facial dermatitis in cats and what is it’s structure?

A

FHV-1

Double-stranded DNA virus

87
Q

Where are skin lesions seen with FHV-1 infection?

A

Lesions are most common on the dorsal and lateral muzzle and periorbital area, but have also been reported on the extremities. Rarely reported on the pinna.

88
Q

How pruritic is FHV-1 infection?

A

Variable - moderate to absent

89
Q

Name three differentials for FHV-1 associated ulerative facial dermatitis

A
  • Mosquito bite hypersensitivity
  • Cutaneous adverse food reaction/FASS
  • EGC
  • Cowpox
  • SCC
  • PF
  • Bacterial infections
90
Q

What are the histopath findings in FHV-1 infection?

A
  1. Full-thickness epidermal necrosis, often extending to adnexal structures and dermis.
  2. Variably severe eosinophilic and neutrophilic infiltrate
  3. Lightly basophilic intranuclear inclusion bodies with chromatin margination in intact epithelial cells adjacent to the necrotic areas (keratinocytes, follicular keratinocytes and sebocytes)

Predominant infiltration of mast cells and plasma cells has been reported.

91
Q

Why is IHC preferable to PCR for FHV-1 detection on histopath?

A

IHC identifies a protein from the nuclear envelope regarded as indicative of viral transcription and assembly, implicating FHV-1 in the pathogenesis of the lesions

92
Q

What is the structure of calicivirus?

A

Unenveloped, single-stranded RNA virus

93
Q

What are the clinical signs of calicivirus infection?

A

Oral/nasal vesicles and ulcers, depression, pyrexia, sneezing and conjunctivitis.

Severe haemorrhagic and highly virulent type - facial and paw oedema, pyrexia, diarrhoea, ulcers on the lips, pinnae, nose, periocular skin and distal limbs.

94
Q

What is the classical cutaneous manifestation of canine distemper?

A

Hard-pad; nasal and footpad hyperkeratosis (usually accompanied by systemic signs)
- the footpads are much harder to the touch than the degree of hyperkeratosis would suggest

95
Q

Feline sarcoma virus is associated with which tumours?

A

Multicentric fibrosarcoma
Liposarcoma
Uveal melanoma

96
Q

Why do feline sarcoma virus +ve cats also test positive for FeLV?

A

The FeSV virus is a true hybrid virus, resulting from the combination of FeLV pro-viral particles with parts of the infected cat genome, specifically proto-oncogenes

97
Q

At what age are cats typically infected with feline sarcoma virus and what is the prognosis?

A

Young - extremely poor

98
Q

Apart from FeLV-associated giant cell dermatosis, which other skin disease is it associated with in cats?

A

Cutaneous horn

99
Q

What unusual manifestation of cowpox virus has been reported in cats?

A
  • Lameness and skin lesions affecting hindlimbs consisting of severe oedematous, hyperaemic swellings often with plaque-like lesions or erosions.
  • Large areas of focal dermal necrosis (eschars) and/or extensive erythema and oedema
100
Q

Which drugs can be used to treat feline herpes virus infection?

A
  1. Famciclovir, L-lysine (controversial efficacy), acyclovir, gancyclovir, cidofovir
  2. Human IFN-a
  3. Recombinant fel IFN-ω
  4. Imiquimod?
101
Q

What role do IFN-gamma and TNF-alpha have in the immune response to Leishmania?

A

They recruit and activate macrophages to kill Leishmania through phagocytosis and release of radical oxygen species

102
Q

What % of feline leishmaniasis cases were coinfected with FIV or FeLV?

A

FIV 12.1%

FeLV 9.1%

103
Q

Do most cases of feline leishmaniasis present with skin lesions?

A

Yes in > 50% of cases

104
Q

Cytology diagnosed feline leishmaniasis in what % of cases?

A

94% (FNA or impression)

105
Q

In feline leishmaniasis, histology was diagnostic for the presence of Leishmania amastigotes in what % of cases?

A

62% (without IHC/PCR)

106
Q

Which treatments were most often used to treat feline leishmaniasis?

A

Allopurinol for at least 6 months +/- meglumine antimoniate for 30 days
Surgery

107
Q

What is the suggested approach to diagnose leishmaniasis in cats presenting with alopecia/scaling?

A
  1. Wood’s lamp, trichography, skin scrapings, fungal culture
  2. Biopsy for histopathology
  3. IHC/qPCR if amastigotes are not visible
108
Q

What should be monitored in cats receiving allopurinol?

A

Urinalysis and kidney ultrasound

Reversible skin reactions have also been reported

109
Q

Are infected cats capable of transmitting L. infantum to sandflies?

A

Yes

110
Q

Do you see spontaneous remission in cats with leishmaniasis?

A

Yes

111
Q

In dogs leishmaniosis is a chronic and progressive disease which affects all tissues and organs, which organs are typically affected in cats?

A
  • Spleen, liver, lymph nodes, bone marrow, kidney, eyes, skin and mucous membranes
  • Skin > ocular and oral > others
112
Q

What is the most common biochemical finding in cats with leishmaniasis?

A

Hypergammaglobulinaemia

Proteinuria and non-regenerative anaemia are less common findings in cats

113
Q

What is the IFAT cut off for leishmaniasis in dogs and cats?

A

1:80

114
Q

_________ impregnated collars are the only pyrethroid formulation licensed for use in cats that has been demonstrated to reduce the incidence of L. infantum in cats

A

Flumethrin

115
Q

How frequently should quantitative serology be performed when monitoring dogs and cats after treatment for leishmaniasis?

A

Every 3-6 months

116
Q

What does this image show?

A

Leishmania infantum amastigotes in a macrophage

117
Q

Which non-vector routes of transmission of Leishmania have been reported in dogs?

A
  1. Sexual
  2. Vertical
  3. Blood transfusion
118
Q

What are the cutaneous signs of leishmaniasis in dogs?

A
  1. Non-pruritic exfoliative dermatitis with or without alopecia
  2. Erosive-ulcerative dermatitis or stomatitis
  3. Nodular dermatitis
  4. Papular dermatitis (eg sites of sand fly bites)
  5. Pustular dermatitis (rare - possible drug reaction/PF?)
  6. Onychogryphosis
  7. Vasculitis
  8. Nasal and digital hyperkeratosis
  9. Nasal and oral depigmentation
  10. Mucosal proliferations on the penis, tongue, nose and orally
119
Q

What are the general signs of leishmaniasis in dogs?

A
  1. Generalized lymphadenomegaly
  2. Weight loss
  3. Decreased or increased appetite
  4. Lethargy
  5. Mucous membranes pallor
  6. Splenomegaly
  7. Polyuria and polydipsia
  8. Fever
  9. Vomiting and diarrhoea
120
Q

What are the ocular signs of leishmaniasis in dogs?

A
  1. Blepharitis (exfoliative, ulcerative or nodular) and conjunctivitis (nodular)
  2. Keratoconjunctivitis, either common or sicca
  3. Anterior uveitis
  4. Endophtalmitis
121
Q

What biochemical changes are seen with leishmaniasis in dogs?

A
  1. Hyperproteinemia
  2. Hyperglobulinemia (polyclonal beta and/or gammaglobulinemia)
  3. Hypoalbuminemia
  4. Decreased albumin/globulin ratio
  5. Renal azotemia
  6. Elevated liver enzyme activities
  7. Proteinuria
122
Q

What samples and techniques should be used for Leishmania PCR?

A

First choice: bone marrow, lymph node, spleen, skin or conjunctival swabs.
The sensitivity of the PCR assay is lower when performed on blood, buffy coat and urine.

Most sensitive technique: real-time/quantitative PCR.

123
Q

How long do you treat dogs with allopurinol for leishmaniasis?

A

6-12 months

10mg/kg

124
Q

Which drugs should allopurinol be used in combination with to treat canine leishmaniasis?

A 
Meglumine antimoniate (4-6 weeks)
Miltefosine (28 days)
125
Q

Which products have proven efficacy for repelling sand flies in dogs and when should they be started?

A
  1. Permethrin spot-on may provide a repellent (anti-feeding) activity for 3-4 weeks (at least 48 hours before exposure)
  2. Deltamethrin-impregnated collars: duration of efficacy is up to 12 months.
  3. Flumethrin-containing collar,: duration of up to 8 months.
    All the collars should be applied at least 1-2 weeks before exposure
126
Q

Which dogs can be vaccinated against Leishmania?

A

Healthy, quantitatively seronegative dogs of 6 months of age or older

127
Q

The vaccine for Leishmania available in Europe is based on which protein and what is its efficacy?

A

Q-protein

72%

128
Q

Does vaccination against Leishmania affect Ab IFAT/ELISA testing?

IFAT = immunofluorescence antibody test

A

No

129
Q

Is there a seasonal variation in anti-Leishmania Ab in dogs?

A

Yes - associated with sand fly seasonality
- 44% of clinically healthy seropositive dogs became seronegative in the non-transmission season (this could be due to cell-mediated immune response!)

130
Q

What is the sensitivity and specificity of the IFAT for the diagnosis of canine leishmaniasis?

A

Sens: 96%
Spec: 98%

131
Q

Which type of immune response is associated with resistance to Leishmania?

A

A robust Th1 immune response:
- production of pro-inflammatory cytokines e.g. IFN-γ and TNF-α which limit infection by increasing the leishmanicidal activity of macrophages.

132
Q

Which type of immune response is associated with susceptibility to Leishmania?

A

Th2 cells, regulatory T-cells and regulatory B cells:

  • cytokines released by Th2 cells e.g. IL-4 and IL-13 and the activity of Tregs and regulatory B cells via IL-10, downregulates the protective Th1 immune response
  • promotes “inappropriate” humoral immune responses
  • induces the formation of circulating immune complexes (Leishmania antigen, IgG and complement protein C3)
133
Q

In dogs with leishmaniasis, do circulating immune complex levels correlate with disease severity?

A

Yes

134
Q

How does L. infantum counteract the killing effects of reactive oxygen species and promote parasite growth within marcophages?

A

By producing antioxidants such as superoxide dismutase

135
Q

Is T cell exhaustion a factor in clinical disease with Leishmania?

A

Yes

136
Q

Do wild animals pose a significant risk of infection with Leishmania to people?

A

In most cases there is no close contact between wild animals and humans or pets and, as sand flies do not travel long distances, significant transmission is unlikely.

137
Q

What are the criteria for reservoir hosts e.g. for Leishmania?

A
  1. The reservoir must be abundant and long-lived
  2. An intense host-vector (sand fly) contact is necessary
  3. Parasite (Leishmania) prevalence in the reservoir host should be higher than 20 %
  4. The infection should be non-pathogenic and long enough
  5. The parasite should be available in the blood or skin
138
Q

Do acute phase proteins correlate with disease severity in dogs with leishmaniasis?

A

Yes - Dogs in the more advanced stages of Leishvet and CWLG classifications had significant increases in serum ferritin and C-reactive protein (CRP) and decrease in Paraoxonase1 (PON1).

139
Q

Which is the most successful preventative strategy for canine leishmaniasis?

A
  1. Repellents

2. Domperidone may provide additional protection (low numbers in Fernadez et al.)

140
Q

Did vaccination result in a significantly lower incidence of leishmaniasis compared to not applying any measure?

A

No - incidence of 10.1% with vaccination vs. 12.5% with no intervention

141
Q

What are the sero-prevalence and PCR-prevalence of Leishmania in cats in Italy?

A

Sero-prevalence (24 %) and PCR prevalence (21 %)

142
Q

Does treatment of leishmaniasis lead to parasitological cure?

A

Very difficult - usually only clinical remission

143
Q

What are the four stages of clinical leishmaniasis?

A
  1. Mild: Negative to low positive Leishmania titer, mild skin disease, lymphadenopathy, normal labwork: Prognosis good.
  2. Moderate: Moderate skin disease, lymphadenopathy, weight loss, fever, anemia, hyperglobulinemia Low to high Leishmania antibody titer, hypoalbuminemia, no to mild proteinuria with no azotemia. Prognosis good to guarded.
  3. Severe: Medium to high Leishmania antibody titer, Stage I and II signs + renal disease. Prognosis guarded to poor.
  4. Very severe: Medium to high Leishmania antibody titer, Stage III signs + pulmonary thromboembolic disease and/or nephrotic syndrome/end stage renal disease with marked proteinuria. Prognosis poor.
144
Q

How do you treat the four stages of clinical leishmaniasis in dogs?

A

Stage 1: Treat with allopurinol +/− miltefosine or meglumine.
Stage 2: Treat with allopurinol + meglumine antimoniate (treatment of choice) or miltefosine
Stage 3: Treat with allopurinol + meglumine antimoniate (treatment of choice) or miltefosine
Stage 4: Treat palliatively with allopurinol alone and follow IRIS guidelines for renal failure treatment, euthanasia based on quality of life.

145
Q

In canine babesiosis, skin lesions are rare and include oedema, ecchymosis, ulceration and necrosis. What type pathology causes these lesions?

A

Subjacent leukocytoclastic vasculitis with or without vascular necrosis

146
Q

In canine babesiosis, where can cutaneous lesions be found?

A

Pinnae, axillae, groin, limbs or scrotum

147
Q

What are the cutaneous clinical signs of canine neosporosis?

A

Widespread draining nodules or rapidly spreading ulcerative dermatitis of the eyelids, neck, thorax and perineum have been reported.

148
Q

On histopathology, where can Neospora tachyzoites be found?

A

Within keratinocytes, macrophages, neutrophils and rarely endothelial cells

149
Q

How do you differentiate Neospora from Toxoplasma on histopathology?

A

IHC, ultrastructural or PCR studies

150
Q

What are the cutaneous signs of toxoplasmosis in dogs and cats?

A

Occasionally causes ulcerative skin lesions in dogs and cats. Lymphadenopathy is common

151
Q

What are the histopath findings of cutaneous toxoplasmosis?

A

Pyogranulomatous or necrotizing dermatitis and vasculitis with Toxoplasma organisms

152
Q

How do you treat toxoplasmosis?

A

Clindamycin 10mg/kg PO TID × 4 weeks

153
Q

What are the cutaneous signs of ehrlichiosis?

A

Skin lesions in dogs can include petechiae/ecchymoses due to thrombocytopenia, and rarely crusting on the dorsal muzzle or a pruritic papulocrustous dermatitis. Lymphadenopathy is common.

154
Q

How do you diagnose ehrlichiosis?

A

Ehrlichia serology: IgG>1 : 80 (15days post infection).

Ehrlichia PCR

155
Q

How do you treat ehrlichiosis?

A

Doxycycline 10mg/kg/day × 3–4weeks

Tetracycline 22–30mg/kg PO or IV TID × 3–4weeks.

156
Q

What cutaneous signs can be seen with FIV infection?

A
  • Chronic abscesses
  • Increased risk of infections
  • Generalised papulocrusting eruption with alopecia and scaling (not pruritic - interface dermatitis)
  • A severe form of mucinous degenerative mural folliculitis
157
Q

Which form of Leishmania is transmitted by sand fly vectors?

A

Proamastigote (flagellate)

158
Q

Leishmaniasis is seen in what age of dog?

A

2-4 years and >7 years (associated with underlying disease)

159
Q

Which breeds of dog are more often affected by leishmaniasis?

A

Rottweiler, GSD, Boxer

160
Q

Which breed of dog is resistant to leishmaniasis?

A

Ibizan Hound

161
Q

What is the incubation time of Leishmania?

A

4 months to 7 years

162
Q

What % of dogs in endemic areas are seropositive for Leishmania?

A

Up to 40%

163
Q

Which cytokines are associated with a Th2 immune response to Leishmania?

A

IL4, IL5, IL6 and IL10

164
Q

Which cytokines are associated with a cell mediated response to Leishmania?

A

IFN gamma, TNF alpha IL2 and IL12

165
Q

What % of dogs with leishmaniasis show symmetrical alopecia and dry exfoliation?

A

60%

166
Q

Why don’t you find amastigotes easily in areas of ulceration or vasculitis due to Leishmania?

A

Vasculitis is the result of circulating immune complexes and not direct presence of Leishmania

167
Q

Which non-invasive test can detect early positivity in leishmaniasis?

A

Conjunctival swabs

Sarah - Mulller and Kirk (14 decks)

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