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Year 1/2 > Defense & Barriers 2: FeLV & FIV > Flashcards

Defense & Barriers 2: FeLV & FIV Flashcards

1
Q

4 steps for RETROVIRUSES to be propagated?

A
  1. ENTER HOST CELLS VIA RECEPTOR & TAKEN IN VIA PHAGOCYTOSIS
  2. Reverse transcriptse turns viral RNA into DNA
  3. DNA transcribed to produce MORE VIRAL RNA
  4. Virus reassembled and RELEASED OUT
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1
Q

4 risk factors for FIV/FeLV positivity?

A
  1. Adult age
  2. Outdoor access
  3. Sexually intact
  4. Clinical disease/wounds
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2
Q

FIV…
MAJOR mode of transmission?
other modes of transmission? (4)
signalment? (2)

A

MAJOR mode of transmission? = HIGH VIRAL CONCENTRATIONS in SALIVA, BITING!

other modes?
1. Transplacental
2. Parturition
3. Milk
4. Blood donation

signalment?
1. MALES MORE LIKELY THAN FEMALES to be positive
2. ~6-8 years old

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3
Q

4 main stages of FIV development?

A

(1) INFECTED CAT SHEDS VIRUS in SALIVA and transmits infection to other cats via FIGHTING

(2) ACUTE PHASE = 1-3 months
–> Time varies depending on immune response of cat
–> CATS ARE FIV+ AT THIS POINT

(3) ASYMPTOMPATIC PHASE
–> Cats can pose as a RISK FACTOR for other cats but NO CLINICAL SIGNS
–> MANY cats will not progress beyond this stage

(4) CLINICAL PHASE
–> FUNCTIONAL IMMUNODEFICIENCY may develop in some cats
–> Increases RISK OF SECONDARY INFECTIONS, IMMUNE-MEDIATED DZ, OR NEOPLASIA

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4
Q

ACUTE phase of FIV disease…
= what’s happening at this stage overall?
MAIN TARGET of this phase?
pathophysiology? (4, include WHAT RESPONSE WE’RE LOOKING FOR WHEN TESTING)
clinical signs? (start with overall, then 8 others)
prognosis?

A

= VIRAL replication is occurring in lymphoid tissues with PEAK VIREMIA at 8-12 weeks

MAIN TARGET = CD4+ T CELLS (T regulatory cells)

pathophysiology?
1. After CD4+ T cells infected, they’re ACTIVATED
2. Causes INHIBITION OF PROLIFERATION OF CD4+/CD8+ cells
3. APOPTOSIS/DECLINE in CD4+/CD8+ lymphocytes
4. Dysfunctional T cells causes STRONG HUMORAL RESPONSE, and this is what we TEST FOR WHEN LOOKING FOR FIV

clinical signs? = TRANSIENT illness that may go unnoticed
1. Lethargy
2. Fever
3. Anorexia
4. D+
5. Stomatitis
6. Weight loss
7. Lymphadenopathy
8. Neutropenia

Prognosis? = MOST CATS SURVIVE

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5
Q

ONCE A CAT HAS DEVELOPED AN ____ _____, THEY’LL HAVE FIV ____

A

ANTIBODY RESPONSE, FOREVER

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6
Q

SUBCLINICAL phase of FIV disease…
is this a latent infection? why or why not?
what 3 things happen biochemically?
RATE of progression from this phase depends on? (4)
MANY CATS…

A

latent infection?
= THIS IS NOT A LATENT INFECTION because VIRAL PRODUCTION CONTINUES

3 things?
1. SLOW DECLINE in CD4+ T cells & hyperglobulinemia from B cell HYPERACTIVATION
2. IMMUNOSUPPRESSION from ALTERED CELL FUNCTION & DYSREGULATION OF CYTOKINES
3. INFLUX of INFLAMMATORY CELLS into CNS that can cause some NEUROLOGIC signs in cats

RATE of progression depends on…
1. Viral load
2. Strain
3. Immunity in host
4. Presence of any co-infections

MANY CATS NEVER PROGRESS, JUST MONITOR FIV+ cats for GETTING SICK

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7
Q

POINT-OF-CARE ELISA for FIV…
= what is it?
screening/differentiating, specific/sensitive?
has a high chance of WHAT FALSE RESULT/why? what should be done to avoid going with false results? (2)
FALSE POSITIVES can be due to… (2)
FALSE NEGATIVES can be due to… (3)
what does POSITIVE SEROPOSITIVITY mean?

A

= antibody tests!!!

screening/differentiating, specific/sensitive?
SCREENING & HIGHLY SENSITIVE

high chance of…
1. because of LOWER OVERALL PREVALENCE OF DISEASE, HIGHER CHANCE OF FALSE POSITIVE!
2. CONFIRMATORY TESTING IS RECOMMENDED IN ALL CATS THAT TEST POSITIVE VIA..
–> Different antibody test (ELISA or Western blot)
–> PCR

FALSE POSITIVES in ELISA could be due to…
1. PREVIOUS VACCINATION OUTSIDE US, FIV not vaccinated for in US
2. If a YOUNG CAT still has circulating maternal antibody

FALSE NEGATIVES in ELISA could be due to…
1. EARLY INFECTION, can take up to 60 days to develop antibodies
2. IN KITTENS, ALWAYS REPEAT TESTS IN 2 MOS
3. TERMINAL DISEASE CAUSES IMPAIRED ANTIBODY PRODUCTION

POSITIVE SEROPOSITIVITY = DIAGNOSTIC FOR PERSISTENT, LIFELONG INFECTION

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8
Q

PCR testing for FIV…
what does it detect? (2)
why is PCR NEVER USED ALONE?
when is PCR most helpful?
one practical application?

A

what does it detect?
1. VIRAL RNA
2. or PROVIRAL DNA

why is PCR never used alone?
= PCR has LOW SENSITIVITY due to LOW VIRAL LOADS IN MOST CATS

most helpful?
= in TERMINAL DISEASE when UNABLE TO PRODUCE ANTIBODY to be detected via ELISA

practical application?
= Done for SCREENING BLOOD DONOR CATS

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9
Q

MANAGEMENT & PREVENTION of FIV…
management by VET? (what is it mainly considered, then 3 other points)
preventative measures? (7)
PROGNOSIS?

A

Managed as a CHRONIC DISEASE..
1. Semi-annual exams
2. Yearly b/w for detection of comorbidities
3. NOT A DEATH SENTENCE, try to keep healthy in other ways!

prevention?
1. VIRUS HIGHLY SUSCEPTIBLE TO DISINFECTION, so good hygiene helps!
2. BLOOD DONORS SHOULD TEST NEGATIVE FOR ANTIBODY & PCR
3. STILL VACCINATE FIV+ CATS AGAINST OTHER DISEASES
4. NEUTERING to reduce roaming behavior
5. INDOOR housing
6. No hunting/raw diets
7. House AWAY FROM OTHER CATS/NO NEW CATS to AVOID FIGHTING/TRANSMISSION

GOOD PROGNOSIS!!

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10
Q

FeLV is MORE ____ than FIV, but can have ____ or _____ _____

A

FeLV is MORE PATHOGENIC than FIV but can have LATENT or ABORTIVE infections

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11
Q

STAGES of FeLV disease?
6 main steps, 2nd and 4th have TWO POSSIBLE OPTIONS

A

(1) INFECTED cat sheds virus WITHIN 30 days of infection and SPREADS IT via SALIVA (grooming, shared foodbowls) to an uninfected, naive cat

(2) Two options…
1. ABORTIVE = cat is able to ELIMINATE VIRUS & NO EVIDENCE OF EXPOSURE LEFT due to LOW VIRAL DOSE and STRONG ANTIBODY RESPONSE
2. PROVIRAL INTEGRATION = the virus REPLICATES in LYMPHOID tissue of OROPHARYNX

(3) INITIAL viremia
= VIRALLY-INFECTED LYMPHOCYTES & MONOCYTES will enter the CIRCULATION and are distributed to other ORGANS in the body

(4) Two options…
1. REGRESSIVE = viral replication is CONTROLLED prior to or shortly after BONE MARROW INFECTION due to partially effective IMMUNE RESPONSE
–> Has LOW RISK of FeLV-related disease, most have NO CLINICAL SIGNS
2. INFECTION OF BONE MARROW PROGENITOR CELLS

(5) SECONDARY viremia with infection of epithelial cells associated with viral shedding

(6) PROGRESSIVE infection
–> Persistent viremia and high risk of FeLV-related disease due to SYSTEMIC VIRAL REPLICATION
–> WORST-CASE SCENARIO

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12
Q

cats with REGRESSIVE FeLV infections have an increased risk of WHAT & why?

A

increased risk of FeLV-associated MALIGNANCIES from VIRAL DNA present in HOST ONCOGENES

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13
Q

in ABORTIVE FeLV infections, the virus is confined prior to WHAT?

A

prior to PROVIRAL INTEGRATION

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14
Q

FOCAL FeLV infection…
AKA “name?”
commonality?
what is it?

A

AKA “Discordant”

RARE

= immune system keeps virus replication sequestered to ONLY SOME TISSUES & NOT BLOOD OR BONE MARROW

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15
Q

in PROGRESSIVE FeLV infection…
involvement of WHAT is established?

the virus DETROYS cells faster than…

A

involvement of BONE MARROW is established

the virus DESTROYS CELLS faster than the IMMUNE SYSTEM CAN SUPPRESS REPLICATION

16
Q

PCR FeLV results if…
EXPOSED to FeLV?
what UNIQUE result would we expect in REGRESSIVE infections?

A

EXPOSED to FeLV? = NEGATIVE

REGRESSIVE?
–> due to virus being INTEGRATED, PROVIRAL PCR WILL COME UP SLIGHTLY POSITIVE, but won’t stay this way because NOT ACTIVELY REPLICATING

17
Q

FeLV PROGRESSIVE infection…
at higher risk for WHAT kind of infection? 7 examples?
prevalence of these kinds of infections vs. normal cats?

A

higher risk of WHAT KIND of infection?
1. Bacterial URI
2. UTI
3. Hemoplasma
4. FIP
5. Stomatitis
6. Cryptococcus
7. Toxoplasma

Prevalence of opportunistic infections is not higher than non-infected cats, but is MORE SEVERE & REFRACTORY TO TREATMENT

18
Q

cats with PROGRESSIVE FeLV are most likely to get WHAT KIND OF NEOPLASIA? (2)

A
  1. LYMPHOID NEOPLASIA
  2. T CELL LYMPHOMA is most common
19
Q

MYELODYSPLASIA…
commonality? (2)
= what is it?
can arise from WHAT kind of infection?

A

commonality?
1. NOT VERY COMMON overall
2. but CAN be found in FeLV+ cats

what is it?
1. ANEMIA or MULTIPLE CYTOPENIAS
2. NORMAL to HYPERCELLULAR BONE MARROW
3. INEFFECTIVE HEMATOPOIESIS
4. LESS THAN 30% BLASTS IN BONE MARROW

Could arise from LATENT FeLV INFECTION

20
Q

ELISA antigen detection testing for FeLV…
= what is it detecting?
what sample types can we use? (3)
if we see ANTIGENEMIA, what does that indicate?
what kind of FALSE result is possible/when + what should we do?
what we need for CONFIRMATORY diagnosis?

A

ELISA = detects SOLUBLE ANTIGEN IN THE BLOOD

sample types?
1. anticoagulated whole blood
2. plasma
3. serum

ANTIGENEMIA = VIREMIA (in most cats)

FALSE results?
1. FALSE NEGATIVES COMMON WITHIN FIRST MONTH
2 recommended RE-TEST in 30-60 DAYS AFTER!

CONFIRMATORY diagnosis?
–> SINGLE POSITIVE RESULTS NEED A SECOND TEST FOR CONFIRMATION!!

21
Q

IFA test for FeLV…
= what does it detect?
comparison to ELISA? is it used ALONE?
what does it mean if it’s POSITIVE?
in what situation is it best to use?

A

IFA = detects ANTIGEN IN CIRCULATING CELLS

is LESS SENSITIVE than ELISA, so not used as a standalone SCREENING TEST

POSITIVE = BONE MARROW INFECTION –> PROGRESSIVE FeLV INFECTION

Good for FeLV negative cats with clinical signs that suggest FeLV-related disease

22
Q

PCR test for FeLV…
= is this a screening test?
when are the TWO situations it’s most commonly performed?
if PCR positive for PRO-VIRAL DNA…
if PCR positive for VIRAL RNA…

A

= NOT a screening test for FeLV INFECTION

ONLY performed when…
1. screening BLOOD DONORS & TESTING FOR REGRESSIVE INFECTION
2. Helps determine when FeLV syspected as CAUSE OF NEOPLASIA but still has ANTIGEN NEGATIVE RESULTS

PCR positive for PRO-VIRAL DNA = NON-PRODUCTIVE viral infection where pro-virus has been INTEGRATED but NOT REPLICATING

PCR positive for VIRAL RNA (RT-PCR) = PRODUCTIVE viral infection

23
Q

PRECAUTIONS/RECOMMENDATIONS for cats with FeLV?

word bank:
gloves
isolation
multiple cats
vaccines
environment

A
  1. Use GLOVES when handling
  2. CLEAN anything the cat has touched
  3. ISOLATED
  4. If one cat is positive, TEST THE OTHER
  5. VACCINATE CATS
  6. Make sure ENVIRONMENT IS CLEAN/low stress bc IMMUNOCOMPROMISED
24
Q

VACCINES for FeLV…
what does it help prevent/MIGHT help prevent? (2)
risk/what we should do to reduce it?
testing after giving vax?

A

prevention…
1. Helps PREVENT PROGRESSIVE INFECTION
2. MIGHT help prevent REGRESSIVE infection

risk?
–> Has slight risk for INJECTION SITE SARCOMA, so give AS DISTAL AS POSSIBLE IN L PELVIC LIMB

VACCINE WILL NOT INTERFERE WITH FeLV TESTING!! Can still test without risk of positive result

25
Q

PROGNOSIS (2) & PREVENTION (3) of FeLV?

A

Prognosis?
1. PROGRESSIVE infection = LIMITED LIFESPAN, usually within 5 years if infected young
2. can LIVE LONGER if infected as adult

Prevention?
1. CLIENT EDUCATION & APPROPRIATE AT-HOME MANAGEMENT in MULTI-CAT HOUSEHOLDS
2. Testing in ACCORDANCE with AAFP guidelines
3. Know the status of ALL your patients

26
Q

FeLV & anemia
what kind of anemia do we usually see?
size of RBCs? & why?

A

anemia type?
–> Often see NON-REGENERATIVE, SEVERE ANEMIA (less than 15%)

size of RBCs? = MACROCYTOSIS
–> Macrocytosis because VIRUS INTERFERES WITH HEME TRANSPORTER PROTEIN so HEME TOXICOSIS = LARGE SIZE

27
Q

is there a BEST TEST for FIV and FeLV?

A

FIV = ALL THE SAME EFFICACY

FeLV = SNAP TEST has best SENSITIVITY & SPECIFICITY

28
Q

AAFP recommendations for FIV/FeLV testing (6)

A
  1. If NEW CAT ENTERING HOUSE, TEST and then RE-TEST 60 DAYS LATER with LIMITED EXPOSURE TO OTHER CATS DURING THIS TIME
  2. Test ALL CATS AFTER AN EXPOSURE and AGAIN IN 60 DAYS
  3. If a cat is SICK, ALWAYS should be tested REGARDLESS of PRIOR RESULTS
  4. Make sure to TEST CAT BEFORE FeLV VACCINATION!
  5. For AT-RISK cats (such as outdoor), ANNUAL RE-TESTING!
  6. ALWAYS CONFIRM POSITIVE TEST

Year 1/2 (139 decks)

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