IMPOSSIBLE NOTHING IS IMPOSSIBLE THE WORD ITSELF SAYS
IMPOSSIBLE? !? “NOTHING IS IMPOSSIBLE! THE WORD ITSELF SAYS “I’M POSSIBLE. ” -AUDREY HEPBURN
CASE #4 Feline Upper Respiratory Disease Complex See Ch. 11 pgs 194, 198 -199
PATIENT PRESENTATION SIGNALMENT: ~8 week old intact, male kitten, DSH PRESENTING COMPLAINT: mucopurulent ocular/nasal discharge, congestion, head shaking, sneezing, inappetance – has gotten progressively worse in the last week Hx: owner has been feeding a family of stray cats outside her home. Several of the kittens look like this. This is the only kitten she could catch
PATIENT PRESENTATION Hx: no known vaccinations PHYSICAL Patient Temp: EXAM is QAR 104. 1, HR: 200, RR: 40 Audible upper respiratory congestion dehydrated Mm: pale pk, CRT: 2 sec
DIAGNOSTICS Clinical signs Nasal, pharyngeal swabs to send for virus isolation to an outside lab DIAGNOSIS: Upper Respiratory Infection Feline Viral Rhinotracheitis(FVR) Feline Herpesvirus-1 Feline Calicivirus (FCV) 80 -90% of all URI is caused by 1 of these 2 viruses Chlamydophila felis Bordetella Mycoplasma
DIAGNOSIS: Differentiating the causes Sneezing is common in all Upper repiratory disease Corneal ulceration is associated with Herpesvirus Oral ulcers are associated with calicivirus Coughing is associated with Bordetella or mycoplasma
TREATMENT FLUIDS ANTIBIOTICS NURSING CARE Warm, clean Force feed, warm, food Pain meds for oral or corneal ulcers DECREASE STRESS AVOID STEROIDS ANTIVIRALS Idoxuridine topical ophthalmic solution
PROGNOSIS & CLIENT INFORMATION Both FVR and FCV are highly contagious Transmitted via fomites (hands, clothes) and aerosolization of respiratory droplets within 5 feet Morbidity Oral is high, mortality is low ulcers can last 7 -10 days
PREVENTION VACCINATION Vaccines will reduce severity and duration of clinical signs ISOLATION OF AFFECTED ANIMALS
CASE #5 Feline Panleukopenia
PATIENT PRESENTATION http: //www. youtube. com/watch? v=x. Ll. L 24 sh W 7 E
PATIENT PRESENTATION SIGNALMENT: 6 week old, intact female, DSH PRESENTING COMPLAINTS: kitten is depressed and appears to be very thin, has blood-tinged diarrhea, occasional vomiting Hx: client lives in an apartment complex and found this kitten outside.
PATIENT PRESENTATION PHYSICAL EXAM FINDINGS 103° dehydrated Ataxic, unstable Lethargic Fecal-soiled rear-end
DIAGNOSTICS CBC Moderate Positive to severe panleukopenia parvovirus snap test Antibody titers Virus isolation is difficult PCR for detection of viral DNA
TREATMENT Maintain hydration and electrolyte balance Force-feeding Broad-spectrum antibiotics
PREVENTION & CLIENT INFO Proper vaccination is required to prevent disease Like canine parvovirus, this virus can remain in the environment for years. Infected cats should be isolated as all body secretions contain the virus Transmission environment is through direct contact or contaminated
CASE #6 Feline Infectious Peritonitis
PATIENT PRESENTATION
PATIENT PRESENATION SIGNALMENT: 3 mth old, intact female, DSH PRESENTING COMPLAINT: kitten is sometimes lethargic and seems to be bloated. She eats, although appetite is decreased. Owner can still feel and see the backbone and pelvic bones. Hx: owner is fostering a litter of kittens from a shelter for the past 3 weeks, until they are healthy enough for adoption. The kittens have had intermittent diarrhea over the past 2 weeks, but seems to be resolved
PATIENT PRESENTATION Hx: The other 5 kittens are generally healthy PHYSICAL Distended EXAM: abdomen, BCS: 2/5 Depression dehydrated Mm: pale pk, CRT: 2 sec Temp: 102. 9. HR: 200, RR: 30
DIAGNOSTIC TESTS FECAL ABDOMINAL RADIOGRAPHS CBC/SERUM CHEMISTRY ABDOMINOCENTESIS Cytology & chemical analysis of the fluid ANTIBODY TITERS(? )
DIAGNOSTIC TESTS
DIAGNOSTIC TESTS
DIAGNOSTIC TESTS
DIAGNOSTIC TESTS
DIAGNOSTIC TEST RESULTS FECAL(? ) There is NO “FIP SPECIFIC” antibody titer test CBC/SERUM CHEMISTRY ABDOMINAL RADIOGRAPHS Decreased protein in the blood Ascites found ABDOMINOCENTESIS Viscous, clear to yellow fluid, high protein, low cellularity RIVALTA TEST positive
DIAGNOSTIC TESTS: Abdominocentesis
RIVALTA TEST Fill a clear test tube ¾ full with distilled water, add one drop 98% acetic acid and mix (or vinegar). Carefully place one drop Of the cat’s effusion on the surface of the acid. If drop disappears Test = negative If drop retains shape Test = positive
DIAGNOSTICS
TRANSMISSION & PATHOPHYSIOLOGY
TRANSMISSION & PATHOPHYSIOLOGY
TRANSMISSION & PATHOPHYSIOLOGY FIP occurs in 2 forms: the “wet” or effusive form (75%) and the non-effusive or “dry” form. DRY FORM Fever Anorexia Depression Wt. loss Ocular lesions – inflammation, hemorrhage Neurologic Rarely, This lesions enlarged kidneys form of the disease is vague and progresses slowly – these animals may live months to years
DRY FORM UVEITIS, RETINITIS, IRITIS
FIP: DRY FORM IRREGULARLY MARGINATED KIDNEYS, POSSIBLE RENOMEGALY
TREATMENT & PREVENTION SUPPORTIVE CARE Thoracocentesis/abdominocentesis to make pet more comfortable Daily steroids Antibiotics PREVENTION Control of the virus shedding is key House cats separately Clean litter boxes frequently The virus can last up to 4 weeks in the environment, but is killed easily by disinfectants Lower number of cats, lower stress No proven efficacy of the Primucell FIP vaccine
CLIENT INFO & PROGNOSIS Clinical FIP is almost always a fatal disease with a mortality rate >95%. Cats with the effusive form usually progress more quickly and often die within 2 months of initial diagnosis
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