“Don’t let yesterday use up too much of today.” LET IT GO! “Don’t let yesterday use up too much of today.”

ZOONOSES & VECTOR-BORNE DISEASES INFECTIOUS DISEASES ZOONOSES & VECTOR-BORNE DISEASES

CASE #9 Toxoplasmosis p.168

PATIENT PRESENTATION

PATIENT PRESENTATION SIGNALMENT: ~6mth old neutered, male DSH PRESENTING COMPLAINT: depression, feels “hot”, and difficulty breathing. Cat began to act strange over the last week. Poor appetite, soft stool Hx: indoor/outdoor cat, fully vaccinated, but not against FeLV and FIV, microchipped, often brings “gifts of mice” home

PATIENT PRESENTATION PHYSICAL EXAM Temp: 104.1, HR:220, RR:40, shallow Depression Labored breathing Mm:pale CRT: 2sec Painful on abdominal palpation OS: signs of inflammation/uveitis

PATIENT PRESENTATION

DIAGNOSTIC TESTS CBC/SERUM CHEMISTRIES FeLV/FIV Test Non-specific, variable changes FeLV/FIV Test Neg/Neg Thoracic radiographs pneumonia Paired titers ELISA (although NOT A quick SNAP TEST) FECAL See next slide

DIAGNOSTIC TESTS PNEUMONIA IS MOST COMMON IN NEONATALLY OR TRANSPLACENTALLY INFECTED CATS

TOXOPLASMA OOCYTS THESE OOCYTS ARE DIFFICULT & RARE TO FIND

TRANSMISSION & LIFE CYCLE EATING CONTAMINATED MEAT Ingestion of uncooked or undercooked meat is most likely the main route of infection in both cats and humans. Fecal – oral route Transplacental route Cats are the definitive host for Toxoplasma gondii, (coccidia) but several animals can serve as intermediate hosts

TRANSMISSION & LIFE CYCLE CATS ONLY SHED OOCYTS IN THE FECES FOR 1-2 WEEKS THE OOCYTS BECOME INFECTIVE AFTER 1-5 DAYS TACHYZOITES ARE THE RAPIDLY DIVIDING STAGE OF THIS PARASITE THAT INFECTS THE TISSUES

TREATMENT & PROGNOSIS Clindamycin or Trimethoprim Sulfa for 2-3 weeks (may require 4 weeks treatment) Prognosis is poor for young patients with hepatic or respiratory involvement, but good for the older cat with minimal or no signs of disease

CLIENT INFORMATION Exposure to Toxoplasma is common – 30%- 60% of adult humans are seropositive Humans who are immunosuppressed should avoid contact with infected cats Have someone else clean the litter box Avoid getting a new cat during pregnancy Have antibody titers checked before getting pregnant Infection during the 1st or 2nd trimester can lead to birth defects Cook all meat thoroughly DON’T PANIC

“YOUR LIFE WILL FOLLOW YOUR THOUGHTS.” THINK GOOD THOUGHTS! “YOUR LIFE WILL FOLLOW YOUR THOUGHTS.”

CASE # 10 Rocky Mountain Spotted Fever p. 173

PATIENT PRESENTATION

PATIENT PRESENTATION SIGNALMENT: 2yr old hound mix, intact male PRESENTING COMPLAINT: dog is reluctant to move, has a stiff gait and seems painful, possibly ataxic, lethargic for the last week. Hx: dog goes hunting with the owner about once month for the last 3 months. Dog is current on HW and flea preventive.

PATIENT PRESENTATION PHYSICAL EXAM Temp: 103.5, HR: 116, RR:24 Mild mucopurulent ocular discharge Mm:pale pk, CRT: 2sec Animal is somewhat painful and ataxic Technician finds several ticks on the head and neck region

PATIENT PRESENTATION

DIAGNOSTIC TESTS CBC/SERUM CHEMISTRIES Anemia Thrombocytopenia SERUM TITERS TISSUE BIOPSY & FLUORESCENT STAINING History of tick exposure

DIAGNOSTICS & TREATMENT DIAGNOSIS: TICK-BORNE DISEASE ROCKY MOUNTAIN SPOTTED FEVER – caused by Rickettsia rickettsii, a gram- obligate, bacilli intracellular bacterial organism. This organism is carried in the saliva of the dermacentor tick TICKS MUST BE ATTACHED TO HOST FOR 5-20 HOURS BEFORE TRANSMITTING INFECTIOUS ORGANISM Clinical signs occur secondary to vasculitis of small blood vessels throughout the body. Other clinical signs include: edema, hemorrhage, seizures, coughing, vomiting, diarrhea, and more…

DIAGNOSIS & TREATMENT TREATMENT Doxycycline Tetracycline Antibiotics only reduce the number of organisms, the animal must have a good immune system to eliminate them.

CLIENT INFORMATION Blood from infectious patients and from the tick can be infectious Client should watch for signs of myalgia, headache, fever, or abdominal pain Keep pets out of heavily infested tick areas and remove ticks quickly. Add tick prevention to the pet’s health regimen. Incubation period is ~7days

CASE #11 Ehrlichiosis pp. 174-175

PATIENT PRESENTATION

PATIENT PRESENTATION

PATIENT PRESENTATION SIGNALMENT: 2yr old mixed breed, castrated male PRESENTING COMPLAINT: lethargy, labored breathing, swollen neck, and swollen rt rear leg for about a week that seemed to resolve. About 6 weeks later developed bleeding from the nose, dyspnea, weakness, and “red spots” on the skin Hx: outdoor dog, vaccinations current, on HW and flea preventive.

PATIENT PRESENTATION PHYSICAL EXAM Temp: 103.8, HR: 120, RR: 28 Mild epistaxis Petechial hemorrhages Edema of the extremities Ticks found in the coat

DIAGNOSTIC TESTS CBC/SERUM CHEMISTRY Blood smear Observe morula in 25% have pancytopenia Anemia Thrombocytopenia Blood smear Observe morula in mononuclear cells

DIAGNOSIS DIAGNOSIS: TICK-BORNE DISEASE CANINE MONOCYTIC EHRLICHIOSIS, caused by Ehrlichia canis transmitted by the tick Rhipicephalus sanguineus (brown dog tick) After infection, E. canis causes acute, subclinical, and chronic stages of the disease ACUTE: lasts 2-4 weeks Organisms multiplies in mononuclear cells Mononuclear cells carry the organism to other organs including the lungs, kidneys, and meninges. Vasculitis develops SUBCLINICAL PHASE Few clinical signs if any CHRONIC PHASE Bone marrow suppression Bleeding tendencies

DIAGNOSIS: another Ehrlichial disease to consider CANINE GRANULOCYTIC EHRLICHIOSIS caused by Ehrlichia ewingii or Ehrlichia equi Clinical signs associated with Ehrlichia ewingii infection: Fever Lethargy Lameness Muscle stiffness CBC: Thrombocytopenia Blood smear: morulae found in neutrophils Transmitted by the Amblyomma americanum (lone star) tick

DIAGNOSIS: another Ehrlichial disease to consider CANINE GRANULOCYTIC EHRLICHIOSIS caused by Ehrlichia ewingii or Ehrlichia equi Clinical signs of Ehrlichia equi infection: Fever Debilitating lethargy Anorexia CBC: thrombocytopenia Serum chemistries: Increased ALP Transmitted by the Ixodes dammini (deer tick or black-legged tick)

DIAGNOSIS

DIAGNOSTIC TESTS

TREATMENT & CLIENT INFO ANTIBIOTICS Doxycycline Tetracycline +/- blood transfusions CLIENT INFO: Ticks can be a threat to pets and humans Owners should avoid exposure to the blood of the tick The prognosis is good – Improvement often seen within 48 hours Check pets frequently for ticks and remove them when found.

CASE #12 Lyme Disease p.175-176

PATIENT PRESENTATION

PATIENT PRESENTATION SIGNALMENT: 3yr old castrated male, English Setter Hx: Moved from the northeast about 3 weeks ago. Prior to moving, owner pulled off a few ticks . Some of the areas have a red rash. In the last few days, the dogs is showing some lameness in the rear legs

PATIENT PRESENTATION PHYSICAL EXAM Temp:103.5, HR: 100, RR: 24 Lethargic Swollen lymph nodes Wt. bearing lameness on the rt. Rear limb that seems to come and go.

PATIENT PRESENTATION

DIAGNOSTIC TESTS Radiographs ELISA TEST SYNOVIAL FLUID ANALYSIS Would be normal ELISA TEST Lyme Positive SYNOVIAL FLUID ANALYSIS Increased nucleated cells

LYME DISEASE LYME DISEASE is caused by the spirochete Borrelia Burgdorferi, passed by an Ixodes tick (black-legged ticks or deer ticks) The tick must be attached to the host for more than 48 hours Other clinical signs: Fever Anorexia Lymphadenopathy Chronic flare-ups Myocardial abnormalities Nephritis, esp in Labs

LYME DISEASE TREATMENT & CLIENT INFO ANTIBIOTICS Doxycycline is the treatment of choice for Borreliosis Treatment may not completely eliminate the organism and some animals may remain permanently infected. CLIENT INFO Vaccination is effective, unless dog has already been exposed. Animal infection should alert owners to the possibility of human infection from ticks in the area. Use a tick preventive regularly

CASE #13 Rabies p.169

PATIENT PRESENTATION

PATIENT PRESENTATION SIGNALMENT: 4 yr old, neutered male mixed breed. HISTORY: owner saw dog playing with remains of a dead bat out in the back yard yesterday. The owner brings the dead bat into the clinic in a box and wants to know what to do. The dog is current on all vaccinations including rabies. He is on HW and flea prevention.

RABIES EXPOSURE CASES The bat should be sent to a laboratory for analysis and rabies testing This requires a sample of brain tissue that has NOT been frozen. There is no antemortem test available The dogs should be examined and handled carefully. He should be quarantined until the results from the bat are known.

RABIES VIRUS INFORMATION Rabies virus is spread through the saliva of an infected animal Bite, open wound, or mucous membranes High Risk Animal Bite (bats, coyotes, foxes, raccoons, skunks) Low risk animals( opossums, armadillos, rodents, moles, rabbits) It travels up the nerve endings at the site of infection until it reaches the brain where it multiplies. It then enters the salivary glands where it can be transmitted through saliva. This may take 3-8 weeks

RABIES VIRUS INFORMATION RABIES IS CHARACTERIZED BY 3 STAGES: PRODROMAL STAGE – people are greatest risk during this phase. It is associated with behavior changes EXCITATIVE/FURIOUS STAGE- Infected animals may attack inanimate objects or appear hyperreactive. Some animals may appear “dumb” PARALYTIC STAGE - characterized by ascending paralysis of the hind limbs which may progress to respiratory paralysis and death. Death will occur between 2 and 10 days from the onset of clinical signs

RABIES VIRUS INFORMATION CLINICAL SIGNS: Behavioral changes Difficulty swallowing Voice changes CNS signs (seizures, ataxia) hypersalivation

RABIES INFORMATION CLIENT INFO: Never handle wild animals that appear tame or friendly Leave wild life in the wild Wear glove when examining a pet’s oral cavity, esp if rabies is suspected Promote vaccination against rabies If your pet bites someone, it must be quarantined for 10 days to observe for signs of clinical rabies Vaccinated animals exposed to a rabid animal should be revaccinated and observed for 90 days.

CASE #14 LEPTOSPIROSIS On pgs. 48-49

PATIENT PRESENTATION

PATIENT PRESENTATION SIGNALMENT: 2 yr old, neutered male, Shepherd mix Hx: Dog goes with his owner camping and hunting twice a month. Dog is current on DHPP vaccination, Rabies, HW & Flea prevention. Presenting complaint: dog is lethargic, vomiting, and seems very thirsty.

PATIENT PRESENTATION PHYSICAL EXAM FINDINGS: DIAGNOSTIC TESTS: ~8% dehydrated Temp: 103.9, HR: 100, RR:36 Mm: icteric, CRT:2.5 sec DIAGNOSTIC TESTS: CBC: leukocytosis, thrombocytopenia SERUM CHEMISTRIES: increased kidney and liver enzymes

PATIENT PRESENTATION FURTHER DIAGNOSTICS: Vet suspects an infectious disease causing acute renal and liver failure such as leptospirosis. FURTHER DIAGNOSTICS: URINALYSIS: low urine specific gravity Increase in serum titers Fluorescent antibody PCR

LEPTOSPIROSIS TREATMENT Hospitalization IV Fluid therapy Antibiotics: Penicillin, Doxycycine Antibiotics Leptospirosis is caused by the bacteria Leptospira interrogans, a spirochete bacteria There are many serovars of this organism: Canicola Icterohemorrhagica Pomona Grippotyphosa bratislavia

LEPTOSPIROSIS The natural hosts of Leptospirosis are skunks, raccoons, opossums, & pigs. Infection occurs through mucosal contact (even through aerosolization) with water or soil contaminated with urine from infected animals

LEPTOSPIROSIS CLIENT INFO Animals with Leptospirosis are contagious to humans and other animals Diagnosis and treatment are expensive Vaccination is best for prevention of clinical disease, but infected animals can still shed the organisms in the urine. Current vaccines do not protect against all serovars