Respiratory infections in cats Flashcards
What are the main upper respiratory infections?
Viral - herpes, calici - main ones, especially in kittens
Bacterial - chlamydophila, bordetella, mycoplasma
Fungal - cryptococcus and aspergillus but much less common
What are the main LRT infections?
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
Outline general info on viral URTi
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
Outline FHV-1
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
Outline FHV-1 occular disease
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
Outline FHV-1 non occular syndromes
Tracheitis and pharygitis - leads to coughing
Herpetic dermatitis - v ulcerative
Chronic rhinitis possible due to osteomyelitis from secondary infection, squamous metaplasia, lymphocytic plasmacytic infiltrate
Outline calici virus
V few carriers
No latency
V few persistently infected
Rarely can get limping syndrome - due to replication within the joints, resolves after few days
Outline viral ulceration
Calicivirus much more ulcerogenci cf FHV other than in the eye
Massive mouth ulceration etc often calici virus
Which viruses are associated with stomatitis
FIV and calici
Possible association with FeLV and bartonella
Outline chlamydophila
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
How important in mycoplasma
Different studies suggest it is a primary, secondary or commensal organism
Outline bordetella
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
What is general treatment for resp infection?
Antipyretics, ABs if needed (doxy) Nutrition/ IVFT Clear secretions Nebulisations Bromhexine has no evidence, some say is useful, others not Occular tx Analgesia
What are the treatment options for FHV-1?
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
How can you treat stomatitis associated with calicivirus?
Many will just say total mouth extractions
Some recommend omega interferon given intralesionally initially and then s/c or oral
Not v popular option
How do you test for URTi?
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
How do you ix LRTi?
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
Outline vaccination of FHV and FCV
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%
outline vaccination for the bacteria
Chlamydophila and bordetella only
Non core
Doesn’t produce as solid immunity as for virus
May be useful in outbreaks
What is the importance of bartonella infections?
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
What condition is the most associated with canine bartonella?
Endocarditis
How is bartonella transmitted between cats?
Fleas
Do cats generate good immunity to bartonella?
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
What are the clinical signs in cats
Mostly mild/ non specific if any, e.g. pyrexia, reproductive failure, lymphadenopathy, may see neuro signs
How can you diagnose bartonella
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
How can you treat bartonella
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
How do humans get bartonella?
contamination of scratches or other skin abrasions with flea excrement containing B henselae.
