Respiratory infections in cats

Question 1

What are the main upper respiratory infections?

Answer 1

Viral - herpes, calici - main ones, especially in kittens
Bacterial - chlamydophila, bordetella, mycoplasma
Fungal - cryptococcus and aspergillus but much less common

Question 2

What are the main LRT infections?

Answer 2

Same as for URT
Viral only really in immunocompromised patients (e.g. failure of MDA, cattery etc)
Pastuerella another bacterial one
Mycobacteria - mostly in cats that hunt
Fungal v rare in the UK

Question 3

Outline general info on viral URTi

Answer 3

More common in young animals
More common in unvaccninated cats
Spread by direct contact/ fomites/ sneezing through oral/ nasal/ conjunctival routes
Presentation of each are largely similar with some classic features of each

Question 4

Outline FHV-1

Answer 4

Ubiquitous in cat population
80-100% of cats that are infected become latently infected
Virus resides i the trigeminal ganglia, optic nerves and olfactory bulbs
Reactivation possible following stress e.g. birth, steroid use, cat shows, other illness

Question 5

Outline FHV-1 occular disease

Answer 5

Can see ulcers, sequestrum, symblepharon in kittens, uveitis
Dendritic ulcers are pathognomonic but rare, mosstly see normal ulcers. Best to use rose bengal stain as fluoro may not show them
Dramatic chemosis often associated with FHV or chlamydophila

Question 6

Outline FHV-1 non occular syndromes

Answer 6

Tracheitis and pharygitis - leads to coughing
Herpetic dermatitis - v ulcerative
Chronic rhinitis possible due to osteomyelitis from secondary infection, squamous metaplasia, lymphocytic plasmacytic infiltrate

Question 7

Outline calici virus

Answer 7

V few carriers
No latency
V few persistently infected
Rarely can get limping syndrome - due to replication within the joints, resolves after few days

Question 8

Outline viral ulceration

Answer 8

Calicivirus much more ulcerogenci cf FHV other than in the eye
Massive mouth ulceration etc often calici virus

Question 9

Which viruses are associated with stomatitis

Answer 9

FIV and calici

Possible association with FeLV and bartonella

Question 10

Outline chlamydophila

Answer 10

More occular disease than respiratory
often see conjunctivitis/ chemosis either uni or bilaterally
Assymptomatic carriage v common - making control heard, need to test/ treat all in contact cats

Question 11

How important in mycoplasma

Answer 11

Different studies suggest it is a primary, secondary or commensal organism

Question 12

Outline bordetella

Answer 12

Mostly URT in cats
Can extend to LRT - tracheitis and pneumonia
Can be severe and fatal in kittens
A good reason not to put isolation dogs in cat ward

Question 13

What is general treatment for resp infection?

Answer 13

Antipyretics, ABs if needed (doxy)
Nutrition/ IVFT
Clear secretions
Nebulisations
Bromhexine has no evidence, some say is useful, others not
Occular tx
Analgesia

Question 14

What are the treatment options for FHV-1?

Answer 14

L-lyseine - decreases occular shedding, no clinical benefit but may be of use in a colony setting to decrease spread
Famciclovir - can see excellent results in a subset of cats, v expensive
Topical occular antivirals - v frequent admin needed for the most available ones. This can be stressful and help prevent the cat from improving
Interferon - human alpha shown to decrease the severity of diease
Polyprenyl immunostimulant - found to lower disease scores in kittens, needs to be imported, best efficacy when innoculated so hard to give strong recommendation

Question 15

How can you treat stomatitis associated with calicivirus?

Answer 15

Many will just say total mouth extractions
Some recommend omega interferon given intralesionally initially and then s/c or oral
Not v popular option

Question 16

How do you test for URTi?

Answer 16

Swabs from the most affected area, for PCR or virus isolation
Avoid large areas of dc
PCR is very sensitive and may pick up viruses not part of the problem
Virus isolation will only pick up the important bits

PCR for FHV can be -ve when it is the problem! Still give famciclovir as a trial if you think this is the issue

Question 17

How do you ix LRTi?

Answer 17

BAL and rads
Need cytology and bacterial culture
Ensure PCR done for mycoplasma and lungworm

Consider PCR done for bordetella, FHV, FCV, mycobacteria if rest of results may be suggestive

Question 18

Outline vaccination of FHV and FCV

Answer 18

Aimed at reducing severity and chance of latency, will not fully protect
Doesn’t fully stop shedding
Kittens often infected prior to vax
FHV has one straing, FCV has many, vax only protects against 50%

Question 19

outline vaccination for the bacteria

Answer 19

Chlamydophila and bordetella only
Non core
Doesn’t produce as solid immunity as for virus
May be useful in outbreaks

Question 20

What is the importance of bartonella infections?

Answer 20

Bartonella infections are common in domestic cats (up to 75 per cent to 90 per cent of cats in some populations are infected with Bartonella henselae), and cats are considered the primary mammalian reservoir and vector for transmission of zoonotic B henselae (cat scratch disease) and Bartonella clarridgeiae infections

Question 21

What condition is the most associated with canine bartonella?

Answer 21

Endocarditis

Question 22

How is bartonella transmitted between cats?

Answer 22

Fleas

Question 23

Do cats generate good immunity to bartonella?

Answer 23

Cats generate robust antibody and cell‐mediated immune responses to Bartonella infections, yet bacteraemia with B henselae and B clarridgeiae is commonly chronic and relapsing. Relapsing B henselae bacteraemia lasting up to two years has been reported in naturally infected cats

Question 24

What are the clinical signs in cats

Answer 24

Mostly mild/ non specific if any, e.g. pyrexia, reproductive failure, lymphadenopathy, may see neuro signs

Question 25

How can you diagnose bartonella

Answer 25

Positive blood culture is best, but this is not very sensitive, and multiple samples may need to be taken.. It can take up to 6 weeks for samples to grow
Serological testing has very poor sensitivity
PCR has similar use as blood culture but you can get results faster

All may be affected by recent antibiotic administration

Question 26

How can you treat bartonella

Answer 26

Documenting clearance of Bartonella infections through antibiotic treatment is problematic due to the relapsing nature of the bacteraemia of infected cats. No regimen of antibiotic treatment has proven effective for definitively eliminating Bartonella infections in cats in published controlled studies
infected cats treated with doxycycline or enrofloxacin became culture‐negative initially, but long‐term follow‐up detected recurrent bacteraemia in some cats. It has been suggested that higher doses of doxycycline given for a longer time may be more effective. Antibiotics tested in some studies (erythromycin, amoxicillin, amoxicillin‐clavulanate, tetracycline) rapidly decreased the level of bacteraemia in infected cats.
Doxycyline likely the best initial choice, likely at least for 4-6 weeks

Question 27

How do humans get bartonella?

Answer 27

contamination of scratches or other skin abrasions with flea excrement containing B henselae.