Feline Infectious Disease Flashcards
when is infectious feline upper respiratory tract disease common?
in multi-cat environments (e.g multi-cat households/shelters)
stressed cats
what are the most prevalent causes of infectious feline upper respiratory tract disease?
feline herpes virus (FHV-1) feline calicivirus (FCV)
what are the less common causes of infectious feline upper respiratory tract disease?
chlamydia felis
Bordetella brochiseptica
secondary bacterial infections
what are the main symptoms of infectious feline upper respiratory tract disease?
watery discharge from nose and eyes with staining
inappetance
snuffly
ulcers in mouth / on tongue
what tends to cause the most severe infectious feline upper respiratory tract disease?
viral agents esp. FHV
what type of virus is FHV-1?
enveloped DNA virus
what happens to cats post FHV-1 exposure / infection?
most cats become latent lifelong carriers
where is FHV-1 carried in the cat?
trigeminal ganglion within the face
what can trigger shedding of FHV-1?
stressful event e.g. other illness, immunosuppression, new family member
when is shedding of FHV-1 triggered?
4-12 days post stressful event
how long do cats shed FHV-1 for?
~1 week
will cats show clinical signs when shedding FHV-1?
not always - may be silent shedders
how is FHV-1 spread?
close contacts
phomites
what type of virus is FC?
non-enveloped, single stranded RNA virus
how long does FC last in the cat post infection?
up to 1 month in oropharyngeal tissues
where does FC persist following infection?
oropharyngeal tissues
how long does carrier state of FC last?
most cats around a month - some may be lifelong carriers
when does shedding of FC occur following infection?
continuously - may be asymptomatic
how is FC spread?
phomite
close contact
aerosol also possible
where are infectious agents of both FHV-1 and FC found?
in respiratory secretions - oculo-nasal discharge, saliva
what cells of the naive cat are targeted by FHV-1 and FCV?
upper respiratory tract epithelial and lymphoid tissue
where else does FCV replicate?
systemic tissues
where is FCV also shed?
urine and faeces of infected cats
how long is the incubation period of FHV-1 and FCV?
2-6 days
when does viral shedding of FHV-1 and FCV occur after infection?
1 day - before the clinical signs
when are clinical signs seen after infection with FHV-1 and FCV?
2-6 days
what is the range of symptoms seen with FHV-1 and FCV?
can be very mild to severe and life threatening
what animals suffer more severely with FHV-1 and FCV?
kittens and immunocompromised patients
what can FHV-1 and FCV symptoms be exacerbated by?
secondary opportunistic infections caused by damage to tissues by initial virus
where are main symptoms of FHV-1 and FCV seen?
oral
nasal
occular
some systemic (FCV)
what are dendritic ulcers pathognomic for?
FHV-1
what oral lesions are seen with FHV-1 and FCV?
gingivostomatitis
what is gingivostomatitis?
inflammation of gingiva and oral mucosa generally
what oral lesions are seen with FCV?
lingual ulcers
where can samples be taken from to diagnose FHV-1 and FCV?
conjunctival or pharyngeal swabs (depending on area most affected)
what tests may be used to diagnose infectious feline upper respiratory tract disease?
PCR
virus isolation
culture
what test is most sensitive to FCV?
virus isolation
what cause of infectious feline upper respiratory tract disease is usually diagnosed by culture?
C.felis
B.bronchoseptica
what infectious feline upper respiratory tract disease can PCR show?
all 4: FHV-1, FCV, C.felis, B.bronchosepta
what supportive therapies are needed for treatment of infectious feline upper respiratory tract disease?
fluid therapy
nutrition
what specific medications might be needed for treatment of infectious feline upper respiratory tract disease?
antivirals
antibiotics for secondary infections
analgesia
appetite stimulants
what are the key elements of nursing care for patients with infectious feline upper respiratory tract disease?
clean face with warm, wet swab
barrier creams
occular lubricant
nebulisation to loosen secretions
why is cleaning the patients face with a warms wet swab necessary when they are suffering with cat ‘flu?
improved comfort
improved smell
what is the role of barrier creams in the patient with infectious feline upper respiratory tract disease?
prevent scald caused by discharge from nose and eyes
what should not be used on cats with cat flu?
olbas oils / human cold remedies as they are highly irritant to nasal mucosa
why should injectable meds be given to infectious feline upper respiratory tract disease patients where possible?
due to oral ulcers they may find oral handling undcomfortable
why should cats with infectious feline upper respiratory tract disease be restrained without hands under mouth/near neck?
altered head position may lead to pharyngeal obstruction which can cause difficulty breathing
what must be corrected in the first 24-48hrs of infectious feline upper respiratory tract disease treatment?
dehydration and electrolyte imbalance
what method of eating is preferred in patients with infectious feline upper respiratory tract disease?
orally
what should patients with infectious feline upper respiratory tract disease be fed?
small volume, palatable, warm foods
how often should infectious feline upper respiratory tract disease patients be fed?
4-6x a day
when should uneaten food be removed from a cats kennel?
after 20-30 mins as may increase nausea and stress levels
what drugs may be used to aid nutrition?
anti-emetics and appetite stimulants
how may severe flu cases need to be fed?
tube feeding - meds can also be given this way
what antiviral drugs are used to treat recurrent or severe FHV-1?
Famciclovir
what is the effect of Famciclovir?
clinical improvement and reduced shedding of virus
what antiviral drugs are used in FHV-1 cats with conjunctivitis?
Lysine
how does lysine work?
antagonises arginine which is needed for FHV-1 replication
what is the role of Lysine?
improves conjunctivitis in FHV-1 cats
reduces FHV-1 shedding
what is the role of recombinant feline interferon gamma?
significantly improves refractory stomatitis in FCV infected cats
when should secondary bacterial infections be suspected alongside infectious feline upper respiratory tract disease?
if thick, mucopurulent discharges present
what tests should be performed if secondary bacterial infection alongside infectious feline upper respiratory tract disease suspected?
culture and sensitivity
what antibiotic is the best for both C.felis and B.bronchiseptica?
doxycycline
what is the alternative antibiotic that can be given if Doxycycline is contraindicated?
Amoxycillin clavulanate
what are the issues with Doxycycline as an antibiotic?
not ideal with anorexic patients and there is risk of oesophageal stricture if drug remains in the oesophagus for a prolonged period
what other medication may be given to patients with infectious feline upper respiratory tract disease?
analgesia
mucolytics
what type of analgesia is most commonly used for infectious feline upper respiratory tract disease patients?
opioids
why may NSAIDs not be a suitable analgesic for infectious feline upper respiratory tract disease patients?
if corneal ulceration is present NSAIDs may suppress the helpful inflammatory response
what are mucolytics?
substances which break down mucous
when can mucolytics only be used?
if animal is unable to clear mucous themselves as will make runnier mucous worse
give an example of a mucolytic
bromhexine
how can the environment that a cat with infectious feline upper respiratory tract disease has been in be managed?
thorough cleaning
disinfection of fomites
cages
how long does FHV-1 survive for?
18 hours at room temperature
how can FHV-1 be inactivated?
by most disinfectants and drying
how long does FCV survive in the environment?
up to 1 month / longer in dry conditions
what cleaning agents can be used to kill FCV?
bleach
accelerated hydrogen peroxide
what disinfectant agents are FCV resistant to?
QAC
which animals should be placed in isolation facilities?
clinically affected patients
suspected carriers
when should infectious patients be handled?
last
what sort of nursing is required for infectious feline upper respiratory tract disease patients?
barrier nursing
what should be done about infectious feline upper respiratory tract disease patients if isolation facilities are not available?
barrier nursing
house respiratory cats at one end of ward
sneeze barriers
if cages are facing each other there should be 2m between
disinfect cage at end of stay and leave empty for 2 days
what is the role of FHV-1/FCV vaccines?
reduces incidence and severity ofdisease
what do FHV-1 and FCV vaccines form part of?
CORE vaccines
what immunity is gained from FHV-1 and FCV vaccination?
local humoral (IgA) and cell mediated immunity
how long does maternally derived FHV-1 and FCV immunity last?
6-16 weeks
what are the 2 types of FHV-1 / FCV vaccines available?
attenuated live or inactivated
what type of FHV-1/FCV vaccine be used wherever possible?
attenuated live
when can inactivated FHV-1/FCV vaccines be used?
immunosuppressed and pregnat cats
when can kittens be vaccinated against FHV-1/FCV?
6-8 weeks
how does the initial course of FHV-1/FCV vaccines work?
from 6-8 weeks
every 3-4 weeks
until at least 16 weeks
when should cats be re-vaccinated for FHV-1/FCV?
every 1-3 years after
when should queens also be vaccinated against FHV-1/FCV?
prior to mating
how can FHV-1/FCV be prevented?
minimise stress
avoid overcrowding
quarantine new additions to multi-cat households for 3-4 weeks
don’t breed from clinically infected queens
consider early weaning (although could be detrimental) if outbreak
how can FHV-1/FCV be prevented in catteries?
house cats individually unless from same household at home
impermeable sneeze barrier
over 4ft apart
what are the signs of highly virulent calicivirus?
upper respiratory disease (as for FCV)
cutaneous signs - especially head and limbs
what are the cutaneous signs of highly virulent calicivirus?
ulceration
crusting
alopecia
oedema
what severe signs may a cat with highly virulent calicivirus exhibit?
sever respiratory signs - pulmonary oedema and pleural effusion
hepatic and pancreatic involvement - icterus, vomiting and diarrhoea
marked pyrexia, anorexia, lethargy and weight loss
what can highly virulent calicivirus result in?
peracute death (sudden)
what type of bacteria is Chlamydia felis?
obligate intracellular bacteria
what are the 2 forms of Chlamydia felis?
elementary body (EB) - infectious form reticulate body (RB) - non infectious form
how are C.felis bacteria elementary bodies transmitted?
via direct contact, fomites and aerosols
how long doe C.felis survive in the environment?
a few days
what disinfectants is C.felis susceptible to?
most disinfectants
what happens to EB C.felis when it attaches to host epithelial cells?
internalised into inclusion and morphs into RB
what does RB C.felis do?
replicates in host cells, matures to EB and is released from cells
what is the incubation period of C.felis?
2-5 days
what is the key sign of C.felis?
severe conjunctivitis
what cats are typically infected by C.felis?
young cats (<1 year) from multi cat households
what are the main clinical presentations of C.felis?
feline conjunctivitis (acute/chronic/recurrent) upper respiratory signs corneal ulceration (rare)
how is C.felis diagnosed?
PCR from conjunctival swabs
how is C.felis treated?
oral doxycycline for 4 weeks
at least 2 weeks after clinical resolution
in cattery all in contact cats should be treated
is a vaccine for C.felis available?
yes - non core
what type of bacteria is B.bronchiseptica?
aerobic, gram negative, cocco bacilli
where may B.bronchiseptica be found?
clinically healthy dogs and cats as well as those with respiratory disease
where is B.bronchiseptica most prevalent?
high density populations e.g. boarding kennels/catteries
how long does B.bronchiseptica persist in the environment?
~10 days
what disinfectants are B.bronchiseptica susceptible to?
most
how is B.bronchiseptica passed on?
airborne
fomites
infected water sources
what is the incubation period of B.bronchiseptica?
2-10 dasy
hwo does B.bronchiseptica lead to secondary infections?
respiratory colonisation leads to inflammation and so increased mucus production. This impairs host defences and so increases susceptibility to secondary infections
how does B.bronchiseptica infection most commonly present?
upper respiratory tract and large airway disease
what are kittens with B.bronchiseptica susceptible to?
pneumonia
what are the signs of B.bronchiseptica?
sneezing
mucoid/mucopurulent nasal discharge
harsh cough
how is B.bronchiseptica diagnosed?
use of brochoalveolar lavage fluid
culture and sensitivity
PCR
how can B.bronchiseptica be treated?
doxycycline 1-4 weeks
is there a vaccine for B.bronchiseptica?
yes - intranasal (non core)
what type of viruses are FIV and FeLV?
enveloped RNA
what are retroviruses?
viruses with RNA which is reverse transcribed within the host to produce proviral DNA
how well do FIV and FeLV survive outside the host?
poor survival - rapidly desiccated, inactivated by disinfectants
how does a cell become persistently infected with FIV and FeLV?
virus fuses with host cell membrane
viral reverse transcriptase enzyme converts RNA to proviral DNA
provirus integrated into host genome leading to persistent infection
what viral enzyme converts RNA to proviral DNA?
reverse transciptase
what part of the FIV and FeLV genome encodes core viral proteins?
gag
what is an example of a gag gene in FIV?
p24
what part of the FIV and FeLV genome encodes enzymes (including reverse transcriptase)?
pol
what part of the FIV and FeLV genome encodes envolope glycoproteins?
env
what is an example of a gag gene in FeLV?
p27
what is an example of a env gene in FIV?
gp40
what is an example of a env gene in FeLV?
gp70
what is FIV similar to?
HIV
is FIV zoonotic?
no
do all cats with FIV develop AIDS?
not all
what is the survival rate of cats with FIV?
comparable to those without FIV
how does the pathogenicity of FeLV compare to FIV?
more pathogenic
what does the increased pathogenicity of FeLV mean?
more direct association with clinical disease than FIV
what clinical disease does FeLV lead to?
bone marrow disorders
haematopoietic neoplasia
immunosuppression
how is FIV transmitted?
bite wounds (high conc. in saliva)
infected blood products
some vertical transmission (~1/3 of kittens born to an infected mother)
how is FeLV transmitted?
allogrooming - prolongued oronasal salivary exposure
fomites
vertical transmission effective
infected blood products
what is the signalment of FIV?
fighters
outdoor access
older
male
what is the global seroprevalence of FIV?
1-12% (lower end in pets, higher in feral)
what is the signalment of FeLV?
close contact cats
outdoor access
median age ~3
entire
what is the global seroprevalence of FeLV?
1-6%
what has caused a decline in global seroprevalence of FeLV?
vaccination (in core program)
what is the effect of age on FeLV infection?
infection as an adult is less likely to lead to disease than in a younger cat (age related immunity)
what is clinical course of FIV comparable to?
HIV / AIDS
how long does FIV infection last?
lifelong as virus is integrated into host genome
what is commonly seen in cats with FIV?
prolonged (years) asymptomatic phase
what happens in the acute pahse of FIV infection?
virus replicates in local lymphoid tissue and leads to transient lymphadenopathy (large firm lymph nodes)
when does peak viraemia of FIV occur?
8-12 weeks post infection
what are the signs of peak viraemia of FIV?
transient illness - lethargy, pyrexia, inappetance, GI signs, weight loss
is illness around peak FIV viraemia often noticed by owners?
no - often undiagnosed at this stage
following acute FIV infection what can happen?
asymptomatic phase which lasts lifetime
asymptomatic phase which then leads clinical / terminal phase
what cells are particularly targeted by FIV?
CD4 T cells
what is the effect of FIV infection attacking CD4 T cells?
impaired response to infectious agents
what is often seen in the terminal phase of FIV?
chronic gingivostomatitis opportunistic infections neurological disease neoplasia myelosupression
when will viral load of FIV begin to climb after the initial peak load around 8-12 weeks post infection?
when CD4 t cell number become so low that the immune system can no longer suppress the virus
what happens to viral load following acute phase of FIV?
immune system will suppress virus for a while
what are the clinical signs of FIV?
predisposition to secondary infection
neoplasia
occular lesions
anaemia
what cats are commonly screened for FIV (and FeLV)?
sick cats
what do FIV screening tests detect?
antibodies against FIV
what does a positive result on an FIV test indicate?
FIV infection (based on 2 key assumptions)
what are the 2 key assumptions that a positive FIV result is based on?
no history of vaccination
cat is older than 6 months
why will vaccination history affect FIV test results?
vaccine will induce antibodies and these will be detected by the test
why will the age of a kitten affect the result of an FIV test?
kittens may acquire maternal antibodies through colostrum
how should a positive FIV result be confirmed?
by using a test from a different manufacturer or a different test type (especially when screening a well cat)
when is FIV more likely to be the cause of a current illness in the cat?
if immuno-incompetancy or lymphoma is a feature of the current disease
what may cause false negative FIV test results?
in early disease
in terminal disease
kittens with rapidly progressive disease
why may a FIV test give a false negative in early disease?
takes up to 8 weeks for antibodies to be detectable
why may a FIV test give a false negative in terminal disease?
antibody production may be impaired at this stage
why may a FIV test give a false negative in kittens?
may have large viral burden with minimal antibody response
what should you do if suspicious of a false negative FIV test?
re-check 2 months later use PCR (blood) to check for DNA
when should cats be tested for FIV outside of sickness?
known exposure to FIV+ cat before rehoming to muti-cat household blood donor screening before FIV vaccine seropositve kittens <6 months old
what should seropositve kittens <6 months old be retested?
> 6 months
what is the outcome if a FIV seropositve kitten <6 months old becomes negative when retested?
FIV negative result - positive was due to maternal antibodies
what are the clinical signs of initial FeLV infection?
nonspecific clinical signs (inappetance, pyrexia, lethargy)
how is FeLV shed during the infection period?
salivary shedding mainly along with urinary and faecal
what are the 3 possible outcomes of FeLV infections?
abortive infection
regressive infection
progressive infection