Infectious Disease Flashcards
Bivalent leptospirosis vaccine
Tetravalent contains
Canicola and icterohaemorrhagiae
Grippotyphosa and Bratislava
Best way to diagnose leptospirosis
Rising MAT >1:1600 (likely to be positive at this level if not vaccinated)
Positive PCR urine or blood (can get false negatives)
ELISA positive - needs confirmed with rising MAT
Best test for FeLV infection
IFA for p27 antigen
ELISA good screening test but can be negative in early infection and needs to be confirmed with IFA
If both negative and highly suspicious can do PCR
Toxoplasma serology
IgG positive titre indicates exposure
IgM indicates active infection and reduces when the IgG rises
Toxoplasmosis treatment
Clindamycin 12.5-25mg/kg PO BID 4 weeks
TMS 15mg/kg PO BID
Azithromycin 5mg/kg PO BID
Best test for crenosoma vulpis
Zinc flotation
DDx skin fragility syndrome
Diabetes mellitus HAC Progesterone FIP Cholangiocarcinoma
Definitive diagnosis of FIP
Immunohistochemistry for coronavirus antigen in tissue samples (good if there are skin lesions)
Effusion analysis has good predictive value (immunoflourescence of coronavirus antigen within macrophages in effusion is diagnostic of FIP)
Ddx for hypergammaglobulinaemia
In a cat
Lymphoma Multiple myeloma/plasma cell neoplasm Chronic infection FIV FIP
Indicators of FIP on haem/biochem
A:g ratio <0.4
Glob > 35 g/l
Alpha1-acid-glycoprotein >1500
(Especially in effusions)
Anaemia non-regen
Lymphopaenia
Left shift neutrophilia
How to perform rivaltas test
One drop of fluid to 98% acetic acid solution - positive if a precipitate is formed
PPV 86%
NPV 96%
False positive rivalta test can occur with what diseases
Lymphoma
Bacterial peritonitis
Best test on CSF in cats for FIP
RT-PCR if having neurological signs (100% specificity and PPV for FIP)
Ab titre useless and CSF immunocytochemistry is sensitive/specific but too low to confirm FIP
Two main causes of tuberculosis in cats and dogs
M. Microti
M. Bovis
Is FeLV or fiv infection a consistent feature in cats with leprosy
No
Treatment of ehrlichia Canis
Doxycycline for at least 21 days for acute disease or 6-8weeks for chronic/subclinical disease
Imidocarb diproprionate if resistant to tetracyclines
Supportive: blood transfusions, glucocorticoids for immune-mediated disease
Human granulocyte colony stimulating factor, vincristine?
What is considered gold standard test for e.canis
Indirect immunoflourescent antibody titre (IFA)
Use PCR for monitoring response to tx
Should do serology and PCR to confirm
PCR is actually the most sensitive and specific test for ehrlichia
Cause of canine granulocytic ehrlichiosis
Anaplasma phagocytophilum
Transmission of anaplasma
Ixodes ricinus
Clinical signs of anaplasma phagocytophilum (canine granulocytic ehrlichiosis)
Lethargy Anorexia Seizures Reluctance to move Weakness Fever Lymphadenopathy Diarrhoea
Neck pain Splenomegaly Lymphadenopathy Lameness Subcutaneous oedema Multiorgan failure / shock
Diagnosis of anaplasma
Intracytoplasmic inclusions in neutrophils
Fourfold increase in IFA titre over 2-4 weeks
Positive PCR
Cause of canine cyclic thrombocytopaenia
Anaplasma platys
Diagnosis of A.platys
PCR
Intra-platelet inclusions (morulae)
(Serology not possible)
Feline ehrlichiosis clinical signs
Polyarthropathy
Fever
Uveitis
Best way to diagnosis feline ehrlichiosis
PCR
And intracytoplasmic monocytic inclusions
Acute manifestations of canine monocytic ehrlichiosis
Fever Anorexia Weight loss Haemorrhages Purulent Ocular/nasal discharges Dyspnoea/cough Lymphadenopathy CNS signs
Chronic manifestations of monocytic ehrlichiosis
Lymphadenopathy Weight loss Anaemia Bleeding Glomerulonephritis and renal failure Depression Weight loss
Clinicopathologic abnormalities with canine ehrlichiosis
Thrombocytopaenia Non regen anaemia Leucopaenia Pancytopaenia Monocytosis Lymphocytosis Hypoalbuminaemia Hypergammaglobulinaemia Low albumin:globulin ratio Abnormal electrophoretic pattern
Prognosis of acute ehrlichiosis
And chronic
Acute - Good
Chronic - guarded
Infectious causes of glomerulonephritis
Lymes Leishmania Ehrlichia Leptospirosis Babesia Hepatozoon canis
Diagnosis of babesiosis
Examination of a blood smear (inclusions)
Elisa
IFA
PCR - most sensitive
Dogs from endemic areas may be seropositive so should do PCR (if always been in the UK a positive antibody titre would likely be diagnostic)
Treatment of babesiosis
Imidocarb diproprionate once then repeated in 14days
Dimenazene
Once
Phenamidine
Once and repeat in 24hrs
Trypan blue once
Steroids?? May reduce response of immune system if IMHA is involved but could worsen signs
Prognosis of acute and chronic babesiosis
Acute - good
Chronic - guarded
Acute manifestation of babesiosis
Fever Anorexia Lymphadenopathy Splenomegaly Weakness Pallor Haemolytic anaemia (may be immune mediated) Splenomegaly Thrombocytopaenia Disproportionately high urea Mixed acid base disorders
Chronic manifestations of babesia
Intermittent fever
Variable appetite
Marked loss of weight
Regenerative anaemia
Can process to multi organ failure :
Acute renal failure, hepatopathy and icterus, cerebral pathology, acute respiratory distress syndrome
Clinical signs of acute lymes disease
Fever Inappetance Lethargy Lymphadenomegaly Polyarthropathy (lanes, stiffness)
Clinical signs of chronic lymes
Recurrent intermittent non erosive arthritis 2 or more joints involved Erythema Glomerulonephritis Myocarditis Neurological signs
Treatment of lymes
Doxycycline Penicillin like antibiotics Tetracycline NSAID Ceftriaxone IV if chronic
Lymes prognosis
Acute - good usually improves in two weeks
Chronic - guarded
Hepatozoon canis clinical signs
Fever Lethargy Pallor Mucopurulent ocular discharge Anorexia Vomiting Bloody diarrhoea Myalgia (temporal muscle atrophy) Myosotis Myocarditis Posterior paresis Tetraparesis SC oedema Hind limb oedema Lumbar pain Pneumonia Hepatitis Splenitis Glomerulonephritis
Clinicopathologic abnormalities with hepatozoon canis
Neutrophilia Increased ALP Hypoalbuminaemia Hypoproteinaemia Hypoglycaemia Mild non regen anaemia
Diagnosis of h.canis
Inclusions within neutrophils on blood smear
Serology - Elisa (most sensitive method)
Muscle biopsy
Treatment of hepatozoon canis
TMPS
+/-
Clindamycin
Pyrimethamine
Decoquinate (anti coccidial) use for years
Imidocarb (unsure about this one not enough studies)
How long for bone marrow to react to haemolysis
3-5 days
Vaccinations against infectious disease for dogs
Babesiosis vaccine
Lymes vaccine
Leishmania vaccine
Prevention of leishmaniasis in endemic areas
Keep dogs in at dawn and dusk
Deltamethrin impregnated collars
Treatment of leishmaniasis
Megline antiomoniate daily s/c for 3-6 weeks
Allopurinol twice weekly orally (can be continued)
Miltefosine
Clinical signs of leishmaniasis
Pyrexia Lymphadenopathy Cutaneous crusting/alopecia Renal disease Onychogryphosis Conjunctivitis/uveitis secondary glaucoma Vasculitis (poly arthritis) Thrombocytopaenia and bleeding Non-regen anaemia DIC
See hyperglogulinaemia and hyperalbuminaemia on bloods
What is caval syndrome
The concomitant presence of right sided congestive heart failure and intravascular haemolysis
Diagnosis of dirofilaria immitis
Visualisation of larvae in blood smear or using modified knots test
Antigen Elisa (may get false neg if low worn burdens)
Serology (only really useful for ruling out infection as may have been previously exposed and treated)
PCR - good but not widely available
May see worms in pulmonary artery/ r ventricle on echo
Eosinophilia +/- worms on BAL
Treatment of dirofilaria immitis
Melarsomine dihydrochloride
Physical removal of worms via jugular
Eliminate microfilariae 4-6 weeks after adulticide therapy (using ivermectin or milbemycin oxime) can give prednisolone alongside this
In cats only supportive tx as usually clear infection themselves and high risk of thromboembolism with adulticide tx (steroids, oxygen etc)
What test should be used to confirm a positive FIV in house Elisa
IFA
(PCR not great given low levels of circulating antigen)
Could do western blot but time consuming and expensive
Virus isolation is the gold standard but not commonly available
Diagnosis of leishmania
Presence of amastigotes in tissue samples or LN aspirates
Serology May be negative early in course of disease when PCR is positive and then the titre will rise and PCR May be negative so best to use both tests together
