Exam 1 - Zoonoses in the Home Flashcards
One of your favorite clients and her 4-year-old daughter, Mrs. Murphy and Molly, come into your clinic with Mr. Mugs, a 5-year-old basset hound. Just last week you saw Mr. Mugs “brother” and pal, an 18-month-year -old male neuter domestic short-haired cat for routine vaccinations. Today, Mr. Mugs has several circular patches of hair missing over forehead, shoulder and back. Come to think of it, Molly has a 1 cm circular lesion with a red ring around it smack in the middle of her forehead. While you are NOT legally allowed to diagnose Molly, you suspect that Mr. Mugs and Molly both suffer from the same infection.
What immediate “cageside” test can you do to potentially confirm your suspicions?
wood’s lamp
What are the limitations of the wood’s lamp for checking for ringworm?
not all spots fluoresce - only 50% of microsporum canis fluoresce & trichophyton won’t at all
Mrs. Murphy tells you that it seemed like everything had been going right at their house and then they
adopted a young rat 1 week ago from the local pet store. Now this has happened. She takes out her cell phone and shows both pictures and a short video of the rat; it appears to have no visible lesions.
How likely are the two occurrences (adoption and this infection) related? How could you tell? What test would tell you?
unlikely to be related but not impossible
look at it under a microscope - check for spores/hyphae
What other concerns do you have regarding the pets within the Murphy household?
asymptomatic carriers - cats & possibly rat
Do you have any recommendations for additional diagnostics and treatments which you wish to discuss with Mrs. Murphy?
tooth brush thing on cat for DTM or PCR, treat all animals in the house, & decon procedures in the house (vacuum & clean carpets/bedding)
also tell them to contact their doctor
On a busy Monday, a 4-year-old MN border collie presents at your clinic with classic ADR (“ain’t doin’ right”) history and clinical signs: lethargy, anorexia, vomiting, abdominal pain. The owner also complains that when in the house at night, the dog “needs to go out more”. The border collie is a working dog on a small picturesque hobby farm with sheep, cattle, and chickens. The farm even has a pond that provides the cattle with a place to drink and cool off from the Texas heat.
You run an in-house CBC, Chem, UA. Lab results reveal renal azotemia and a slightly elevated ALP (just outside reference interval). The USG is 1.010. You send off the urine for culture to rule out pyelonephritis and on the off-chance this is leptospirosis you request a Leptospira PCR 2. You start supportive care. On Tuesday, repeat Chem reveals increasing liver values. On Wednesday, the PCR results come back. The dog is positive for Leptospira interrogans. Often, by the time a diagnosis of Leptospira is confirmed, many people have been in contact with the patient and their bodily fluids.
Why is leptospirosis so hard to suspect in canine patients?
vague signs & all animals are different
initially looks like renal problems!
When you think back, a lot of your office staff, RVTs, and your associate DVM all handled either the dog or its urine sample. What do you do now? What should you advise your hospital staff to do?
tell them to speak to human doctors & advocate for themselves for their confirmed exposure
What cleanup procedures in the hospital should you perform?
1:1 bleach solution for surfaces & floor
not terribly stable outside - killed by UV light
block off parts of yard where the patient was
What hospital policies could you introduce to help prevent the clinic personnel from another exposure to Leptospira in the future?
gloves always, limited staff interaction (no immunocompromised or pregnant women), good hand washing, decrease movement of patient through out the hospital
How should clients handle these patients if they cannot afford inpatient care?
biosecurity & PPE!!!!
don’t contaminate environment - especially the yard
what are the risks to the family of the lepto dog?
subclinical infection
most severe - hepatic & renal failure (weil’s disease) or lepto-pulmonary hemorrhage syndrome (1 week post recovery from initial febrile illness accompanied by myalgia, headache, chills, & conjunctivitis
The family wants to know: where did their dog acquire the lepto infection? What do you tell them?
some water source contaminated by an infected animal - unlikely to tell them the exact cause
Mr. Jones brings his 12-year old beagle, Ranger, to you. You diagnose Ranger with kennel cough. Because the dog is older, you order a culture. The results come back as you might expect: a dual infection of Bordetella bronchiseptica and Pasteurella spp.
When you ask about all the human and non-human members of the household, the owners tell you the house comprises of:
● Two adults (ages 48 and 52) and two children (ages 15 and 17)
● The dog (Ranger) currently in your exam room
● A 4-year-old pet rabbit
● A 2-year-old pet guinea pig
most likely - guinea pig (bordetella - pneumonia, sepsis, & death)
most likely - rabbit (pasteurella - abscess formation)
what is the risk of concern for adults in regards to their chance of serious disease or death?
pasteurella - low
what is the risk of concern for children in regards to their chance of serious disease or death?
pasteurella - low
