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Lymphoreticular > Feline Infectious Dz 1 (Garden) > Flashcards

Feline Infectious Dz 1 (Garden) Flashcards

1
Q

Family of FeLV ?

A
  • Retroviridae (family)
  • Oncovirinae (subfam)
  • Gammaretrovirus (genus)
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2
Q

Where does FeLV replicate and what are its effets?

A
  • replicates in many tissues

- non-cytopathic

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3
Q

Describe the type of retrovirus FeLV is. What does it contain?

A
  • labile, enveloped, ssRNA (~100nm)

- reverse transcriptase: ssRNA to dsDNA (provirus) integrated into host DNA

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4
Q

What are the 3 possible ‘fates’ of a FeLV infected cell?

A
  • destruction infected cell by immune response
  • infection +- virus production
  • transformation to neoplastic cell
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5
Q

What 3 major protein groups are in FeLV?

A
  • gag
  • pol
  • env
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6
Q

What is the basis of most diagnostic tests?

A
  • core protein p27 gag protein
  • produced within infected cells
  • circulates in plasma/excreted tears and saliva
    > ELISA/immunochromatographic testing
  • anti-p27 Ab not effective viral neutralisation
  • envelope masks presence of core protein in intact virion
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7
Q

What envelope proteins are present on FeLV virus? What do they do?

A

> p15E (spike) -> immunosuppression
gp70 9knob) -> defines viral subgroup and induces antiVNAbs
- Ab subgroup specific (immunity to reinfection)
- target for vax production

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8
Q

Prevalence of FeLV in UK?

A
  • 1-2% in healthy cats
  • 20% symptomatic cats
    > decreasing since mid-1980s (testing and vax)
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9
Q

Outline pathogenesis of FeLV

A

see lecture for flow diagram
- oral/nasal exposure
- replicaition in oropharyngeal lymphoid tissue
> effective immune response
- virus cleared, p27 negative, latent virus in BM, lymphoid tissue (integrated non-replicating)
- haematopoetic malignancy and myelosuppression
- p27 negative
> ineffective immune response
- viraemia (lymph and monocytes)
- replication: marrow, lymphoid cells
- transient viraemia/persistent viraemia
- p27 positive
-> healthy carrier/immunosuppression/myelosuppression/malignancy/stress, immunosuppression GCs
> can interchange between transient viraemia and latent virus and persistnet viraemia

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10
Q

What are the 4 forms of disease pathogenesis with FeLV?

A
  • abortive (virus cleared)
  • regressive (transient viraemia -> latent virus in BM/lymphoid tissue)
  • progressive (replication -> persistent viraemia)
  • focal/atypical (persistent viraemia -> malignancy/myelosuppression/immunosuppression/stress GCs)
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11
Q

How is FeLV shed? SOurce of infection?

A 
> source of infection: PI cats
> virus shed in 
- saliva
- nasal secretion 
- feaces
- urine
- milk 
> short survival outside body (fews hrs)
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12
Q

How is FeLV transmitted?

A 
> intimate prolonged contact 
- sharing food/water, mutual grooming 
> beonates
- in utero/nursing 
> blood transfusion
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13
Q

Risk factors for transmission of FeLV?

A

HOME STUDY

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14
Q

Result of infection with FeLV?

A
  • persistnet viraemia
  • transient viraemia
  • latent infection
  • localised infection
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15
Q

Clinical signs of FeLV?

A
  • many asymptomatic
  • varied and non-specific clinical signs
  • depends on organ system +- 2* dz
    eg. inappetence, weigh loss, wasting
  • pooor coat
  • lymphadenopathy
  • persistent fever
  • pale mm
  • ocular dz, gingivitis, stomatitis
  • infections (skin, bladder, URT)
  • persisnt D+
    = seizures, behavioural change, neuro
  • queens: abortion
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16
Q

Pathophysiology of 2* dz associated with FeLV?

A

> immunosuppression (most common manifestation of virus)
depletion/interference w/ function of lymphocytes +- neutrophils
susceptible to co-infection
- common for FeLV+ cats to have concurrent infection (opportunistic pathogens)

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17
Q

Pathophsiology of haematological disorders associated with FeLV?

A

> BM suppression d/t vira linfection of haematopoeitic stem cells and stromal cells
- anaemia (non-regenerative in pure red cell aplasia/ aplastic anaemia pancytopenia/ regenerative ~10% inIMHA/mycoplasma spp.)
- thrombocytopenia
- granulocytopaenia
Myelodysplasia -> myelodysplastic syndrome
Leukaemia (all cell lines affected)

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18
Q

How is lymphoma related to FeLV?

A
  • FeLV+ cats 60x ^ Risk lymphoma
  • expect to develop in 25% FeLV cats within 2y dx
  • some cats with lymphoma test FeLV - but have virus in the tumours
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19
Q

What lymphoma is most commonly seen with FeLV?

A
  • medastinal (thymic)

- multicentric

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20
Q

What is FOCMA?

A
  • Feline oncornavirus cell membrane antigen
  • present on membrane of maligant cells, absent on all other cells even if infected with FeLV
  • anti FOCMA abs + complement lyse tumour cells -> immune surveillance against tumour developnenet - protective
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21
Q

How is FeLV associated with immune-mediated dz?

A
  • Overactive/dysregulated response to virus

- eg. IMHA, glomerulonephritis, uveitis (immune complex deposition in iris and ciliary body), polyarthritis

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22
Q

How is FelV associated with reproductive dz?

A
  • Infertility: fetal death and resorption in middle trimester
  • abortion less common
  • transmission FeLV transplacentally +- colostrum, both viraemic and latently infected queens may give birth to PI infected kittens
  • > FADING KITTEN SYNDROM
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23
Q

How is FelV associated with skeletal abnormalities?

A

> Osteochondromatosis
- benign proliferatie dz of bone: multiple cartilagenous exostoses of flat bones
chronic progressive PA
- young cats: fibrous ankylosing arthritits and periostitis
- older cats: progressive lymphoplasmacytic synovitis, joint instability and deformity

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24
Q

How is FelV associated with neurological dz?

A
  • Neuropathies infrequent and need to r/o CNS lymphoma
  • clinical signs: anisocoria, urinary incontinence, vague pain, spinal hyperaesthesia, posterior paresis
  • acute demyelinating myelopathies also seen in infected cats
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25
Q

IS dx of FeLV / FIV basis for PTS?

A

No!

+ test only confirms retroviral infection not clinical dz

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26
Q

Dxx tests to detect FeLV?

A 
> Immunoassay 
- ELISA/immunochromatic lateral flow devices
-p27 ag screening tests
> IFA 
- p27 in lecocytes and platelets after marrow infection
- not widely available
> PCR
- detects nucleic acid sequences 
- qPCR supersede IFA 
> viral culture
- gold standard 
- rarely done 
> Ab tests 
- not for dx but VNA canbe sueful
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27
Q

What does a + test for FeLV indicate?

A 
> Antigen test
- transient/persistnet viraemia
- d/t low prevalence of FeLV consider repeating (ideally using different test) 
> IFA
- BM infection or persistent viraemia
- not seen with transient viraemia
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28
Q

What does a - test for FeLV indicate?

A
  • unexposed
  • eliminated infection
  • early infection (retest @9-12w)
  • latent/localised infection
  • false negative rare, test relable
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29
Q

See lecture for table on location of FeLV and p26 detectino in various tests?

A

serum ELISA
* IFA
* Tears/saliva
> oropharynx - - -
> 1 viraemia + - -
> lymphoid tissue + - -
> BM + -/+ -
> marriow virameia + + -
> epithelial tissue + + +

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30
Q

What does + Ag test but - IFA/viral isolation indicate? How should this be dealt with clinically?

A

(discordant results)
- early infection (virus not replicating)
- recovery
- false + (v prevalence)
- detection of incomplete virus
- localised infection w/ ag released but not virus
- ^ sensitivity Ag test
> isolate from other cats, repeat bloods in 4w
- if neg for ag and virus, likely free (repeat 8w to check)
- if still discordant, recheck 8w too

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31
Q

What should a + screening test be followed up with?

A
  • confirmatory test (IFA, qPCR, viral isolation)
32
Q

Tx FeLV in cats?

A 
> systemically well 
- preventative healthcare
- nutiriton and control of 2* infections (GI parasites, fleas, vx) 
- neuter
- confine indoors
> sicks
- supportive care
- tx 2* dz
- confine indoors
33
Q

What shoudl theoretically be checked before vax for FeLV?

A 
> test FeLV status 
- not point vax if already + 
> assess risk of exposure
- outdoor/lives w/ cats of unknown FeLV status
> risks 
- efficacy? 
- ISS
34
Q

What type of virus is FIV? How many subtypes are there?

A
  • family retroviridae, genus Lentivirus
  • RNA virus (reverse transcriptase)
  • 5 subtrypes
35
Q

What dz is FIV similar to in humans? Is it transmissable to humans?

A

HIV not transmissable to humans

36
Q

Prevalence of FIV?

A
  • varies country UK ~5% US ~2%
  • sick cats ~17%
  • most common free-roaming aggressive males
  • infection least common indoor cats
37
Q

How is FIV transmitted?

A
  • bite wounds (virus in saliva)
  • less commonly:
  • vertical (transplacental/mmilk)
  • sexual (rare)
  • sharing food bowl (v low risk)
38
Q

5 phases of FIV infection?

A
  • acute
  • asymptomatic carrier
  • persistent generalised ymphadenopathy
  • terminal (AIDs-related complex/AIDS)
39
Q

Outline the acute phase of FIV

A
  • dd-ww
  • transient mild illness (signs ^ in ounger cats but still may not be noticed)
  • lethargy, D+, lymphadenopathy can persist for months, +- fever
  • early replication in lymphoid tissue (eg. thymus) and salivary glands
  • then spread to mononuclear cells non-lymphoid (lung, GIT, kidney)
  • +- neutropenia, lymphopenia
40
Q

How long can a cat be an asymptomatic carrier on FIV?

A

up to 10y

41
Q

How do asymptomatic carriers appear?

A
  • immune compromised but appear healthy
  • low level circulating virus after host immune response (seroconversion)
  • CBC normal
  • CD4:CD8 T cell ration decreased (inverted)
42
Q

How many FIV cats will reach the “AIDS” stage?

A

10%

43
Q

Survival time for AIDS cats?

A
  • ww/mm
44
Q

What is seen in AIDS stage of FIV?

A
  • opportunistic infection (herpes virus, calicivirus, toxoplasma, crytpsporidium , candida, mycobacterium, demodex)
  • neuro dz
  • neoplasia
  • CBC: leucopenia, anaemia, CD4: CD8 ratio inverted
45
Q

Most common clinical syndomes assoc w/ FIV?

A
  • stomatits
  • neoplasia (risk 5x cf. FIV- for lymphoma and SCC)
  • ocular inflam (uveitis and chorioretinitis)
  • anaemia and leucopenia
  • opportunistic infection
  • renal insufficiency
46
Q

How can FIV be dx?

A 
> CBC
- neutropenia and anaemia
- thrombocytopenia
- co-infection w/mycoplasla haemofelis -> HA 
> biochem 
- NAD +- polyclonal gammopathy
> FIV specific tests (See later)
47
Q

What FIV speecific tests are there?

A
  • AB tests
  • core/envelope proteins
  • most cats develop abs within 60d
  • interference= vax, MDA
    > IFA
  • FIV infected cells fixed to slide, test sample applied, fluoro 2nd Ab applid
    > western blot
  • confiromatoy test for + ELISA
    > PCR
  • commercially available
    > viral isolation
  • only research
48
Q

What does a positive FIV test indicate?

A
  • PI

- FIV infected queens: test kittens >6mo (MDA) if tested

49
Q

What does a negative FIV test indicate?

A
  • not infected
  • infected but Abs not detected
  • test error (retest if suspicious)
  • no ab respone mounted (immunosuppression)
  • warly infection (8-12w post infect no Ab made yet, retest q60d if needed )
50
Q

What action should be taken if contact with a knwon FIV+ cat has been had?

A
  • cats tests -ve, retest min 120d after initial exposure to confirm
  • retest if result doesnt match suspicion
  • PCR helpful if suspect
    > interfecrence: MDA, immunosuppression, detection before ab production (1-3w v 2-4mo)
51
Q

Tx FIV?

A

> supportive
- Abx for anaerobes
- cautious use of steroids w/ Abx (stomatitis, gingivitis)
- lactoferrin poss in stomatitis
antiviral tx
- zidovudine (AZT)
- nucleoside analogue, blocks RT of retroviruses
- inhibits new infection but not replicatio nin already infected cells
- v plasma viral load, improves CD4+ T cell count and stomatitis
- generally well tolerated, monitor for Heniz body HA (propylene glycol) and non-regen anaemia (myelotox)
- AZT-resistant mutants can develop within6mo
- lipid-zidovudin conjugate (fozivudine tidoxil) encouraging?

52
Q

How can FIV infection be prevented?

A
  • prevent exposure
  • virus killed by disinfectants or within hrs in environment
  • low risk transmission by social contact
  • DO NOT BREED FIV+ QUEENS (or hand rear kittnes)
  • vax in USA
53
Q

What are the subgroups of FeLV

A 
A 
- present in almost all FeLV infected cats
- only group transmitted between cats
- basis for production other subgroups
- least pathogenic
B 
- recombination of A with endogenous FeLV proviral sequences 
C
- arises from mutation of subgroup A
- non-regenerative anaemia
54
Q

Risk factos for FeLV?

A
  • male

- young

55
Q

What does persistent viraemia with FeLV result in?

A
  • persistnet viramia -> FelV assoc dz within 3-5y
  • no VNA
  • neoplasia and non-neoplasia dz
56
Q

How long can a transient viraemia last? What is seen concurrently with a transient viraemia ? FeLV

A
  • 3 months

- usually high titres VNA

57
Q

What is latent FeLV infection? What proprotionof FeLV Infected cats will become latent carriers?

A
  • persists in some tissues but no replication so undetected
  • hard to dx (needs BM culture/PCR)
  • 30%
58
Q

How can latent FeLV infection progress?

A
  • remain latently infected
  • develop persistnet viraemia (stress/illness/steroids)
  • some eliminate virus within 30m exposure
59
Q

Is localised FeLV infection common? What tissues can it localise to? How may this be seen?

A
  • uncomon
  • mammary glands, bladder, eyes
  • may give discordant test results (positive ag test, negative other)
60
Q

What 2* infections are commonly seen with FeLV?

A
  • chronic bacteria
  • calicivirus
  • cryptococus neoformans
  • dermatophytosis
  • FIP
  • mycoplasma haemofelis
  • toxoplasma gondii
61
Q

What does the outcome of FeLV infection depend on

A
  • age
  • viral factor
  • immune status (concurent dz, vax, GCs)
62
Q

What may cause false negatives and positives of FeLV IFA test?

A 
> false - 
- neutropenia
- thrombocytopenia
> false + 
- smears too thick 
- inexperienced personnel
63
Q

Most sesnsitive test for FeLV?

A

PCR

64
Q

Why are Ab tests not usefeul for dx FeLV?

A
  • ^ rate exposure to FeLV in environment
  • vax
  • MDA in colostrum
65
Q

What can be tested for to indicate a ‘protected’ cat?

A
  • VNAs
  • indicates exposed to and eliminated virus
  • useful to decide if test - cat can live with test+
66
Q

When are antivirals helpful for FeLV? eg?

A
  • zidovudine (AZT reverse transcriptsse inhibitor)

- no use once infected

67
Q

Is there much data to support use of immunotherapies for FelV? egs?

A 
No
- acemannan
- proprionibacterium acnes
- PIND-ORF
- recombinant human interferon 
> all ineffective
- staph protein A poss effective
- lactoferrin poss effective stomatitis
- feine recomb IFN *Only vet lic product* improves survival
68
Q

How can FeLV spread be minimised in practice?

A
  • standard hygeine

- blood transfusions be careful

69
Q

What FeLV vax are available?

A 
>  5 types lic UK 
- whole inactivated virus
- inactivated gp70 and FOCMAs 
- recominant envelope protein
- live canrypox recomb vax with gag, env and protease proteins 
> all excpet canarypox contain adjuvant
70
Q

How many FIV cats present at lymphadenopathy stage? How long can this last? What is seen?

A

1/3
+ vague clinical signs (anorexia, weight loss, PUO)
- 6mo - several years
- CBC: +- leucopenia, anaemia, CD4+:CD8+ T cell ratio inverted

71
Q

What is the comerically available test for FIV?

A
  • Ab against core/env proteins
72
Q

How many FIV+ cats present at AIDS-related complex stge? How long can this last? What is seen?

A

1/2

  • 2* bacterial infections (oral cavity, GIT, URI, skin)
  • neuro signs/neoplasia less common
  • 6m-2y
  • CBC: anaemia, leucopenia/lecuocytosis, CD4:CD8 T cell ratio inverted
73
Q

Tx FIV

A
  • Immunomodulators?
  • restore imune fucntion
  • IL2 some effectivity
  • evening primrose oil
  • recombinant human/feline IFN no evidence
  • poss contraindications of non-spec stimulants (in peoplecan activate latent HIV in infected lymphocytes and macrophages)
74
Q

Challenges with vax for FIV?

A
  • error prone RT enzymes ^ mutation rate so ^ escape from immune surveillance
  • viruses take advantage of Ab production: paradoxical enhancement of viral replication and disease expression
75
Q

Is FIV vax available?

A
  • only in US
  • inactivated virus with adjuvant -> strong cellular and humoral immunity but ? efficacy in field
  • ^ susceptibility to infection post-vac so separate FIV- and + for several weeks post-infection
76
Q

Perventative healthcare for FIV+ cats?

A 
> keep indoors
- minmise contact with other dz carrying cats (eg. FeLV) 
- prevent spread
> routine health mesasures (cf. FeLV) 
- vax use killed vax
- flea control
- prevent hunting and eating raw meat

Lymphoreticular (31 decks)

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