THINGS THAT MAKE YOU GO HMMM….. “IS IT GOOD IF A VACUUM REALLY SUCKS?”

CASE # 7 Feline Leukemia

PATIENT PRESENTATION

 SIGNALMENT: ~2-3yr old intact male DSH  PRESENTING COMPLAINT: cat seems to have lost weight in the last few months and seems lethargic  Hx: unknown, client feeds this stray cat who is very friendly.

PATIENT PRESENTATION  PHYSICAL EXAM  BCS: 2/5  Temp:103.1, HR: 160, RR: 30  Enlarged mandibular lymph nodes and popliteal lymph nodes (see pic below)  Firm, mid-abdominal mass palpated Enlarged popliteal lymph node Lbah.com

DIAGNOSTIC TESTS  CBC/SERUM CHEMISTRIES  ABDOMINAL RADIOGRAPHS  FeLV/FIV Test  All cats that go outdoors or come from unknown backgrounds should be tested for FeLV and FIV when first examined by a veterinarian

DIAGNOSTIC TESTS  CBC  Nonregenerative anemia  Leukopenia – this virus can affect the bone marrow resulting in feline panleukopenia-like syndrome  FeLV ELISA  positive

DIAGNOSTIC TESTS TUMOR OF THE THYMUS – WOULD OCCUR IN A YOUNG ANIMAL INFECTED WITH FeLV

DIAGNOSTIC TESTS

TRANSMISSION & PATHOPHYSIOLOGY  Feline Leukemia is a retrovirus and is associated with both neoplastic and non- neoplastic disease  Lymphoma is the most common neoplastic disease – tumors can occur in the thymus, GI tract, or lymph nodes throughout the body  Other clinical signs  Secondary infections  Wt. loss  Anorexia  Neurologic signs  Spontaneous abortion

TRANSMISSION & PATHOPHYSIOLOGY  TRANSMISSION:  The most likely route of infection is through continued intimate contact such as grooming, sharing food and water bowls (virus shed in saliva, urine, tears, blood) – this is horizontal transmission  The virus can also be transmitted to neonates in utero and through the milk of infected queens – this is vertical transmission

TRANSMISSION & PATHOPHYSIOLOGY  POSSIBLE OUTCOMES OF FeLV INFECTION  1. REGRESSIVE INFECTION - Cat may mount an immune response, clear the virus, and become resistant to future infection  2. PROGRESSIVE INFECTION - some cats fail to mount an effective immune response, become persistently viremic, but with no clinical signs  3. Active infection – with clinical signs  Outcome depends on:  Age, immunocompetence, concurrent disease, viral strain, dose, duration of exposure

TREATMENT  NO CURE for FeLV  IMMUNOMODULATING DRUGS (none have proven efficacy in cats with FeLV)  Human interferon-α – interferes with viral replication; given orally  Acemannan – known to have antiviral, immunostimulant, and antineoplastic properties; given intraperitoneally (IP)  Proprionibacterium acnes – killed form of this bacteria can be given to stimulate the immune system to fight disease  ANTIVIRAL DRUGS -*can be toxic to bone marrow in cats  AZT – antiretroviral  ANTIBIOTICS  POSSIBLE CHEMOTHERAPY

CLIENT INFO & PROGNOSIS  FeLV positive cats should be retested 3-4 months after initial test  FeLV cats should be isolated from all other cats  FeLV cats should be kept indoors  FeLV cats should have reduced stress and regular vaccination and veterinary check-ups  Life expectancy is approximately 2 years after diagnosis

CASE #8 Feline Immundeficiency Virus

PATIENT PRESENTATION

 SIGNALMENT: ~4-5yr old, intact, male, DMH  PRESENTING COMPLAINT: inappetant, hypersalivation, lethargy. Cat has had recurrent bouts of skin infections and respiratory disease for several years.  Hx: indoor/outdoor cat, has not had vaccinations in over 3 years. Cat has had a few fights with other neighborhood cats over the years.

PATIENT PRESENTATION  PHYSICAL EXAM:  Gingivitis, stomatitis  Wt. loss  Temp: 103.5, HR: 200, RR:36  Mm: pale, CRT: 2sec  Other clinical signs may include:  Gingivitis, stomatitis  Chronic fever  Vomiting  Diarrhea  Chronic URI  cachexia  Chronic, unresponsive skin/ear infections

DIAGNOSTIC TESTS  CBC/SERUM CHEMISTRIES  FeLV/FIV ELISA  All unvaccinated outdoor cats should be tested for these diseases as they are contagious and without cure

DIAGNOSTIC TEST RESULTS  CBC  Anemia, lymphopenia  ELISA positive  THIS IS AN ANTIBODY TEST, not antigen – there will be interference by maternal antibodies and vaccination!

TRANSMISSION  TRANSMISSION  Most infections are acquired through horizontal transmission among adult male, sexually intact cats  Fight and bite wounds appear to be the major route of transmission.  It is possible to transmit the virus vertically to neonatal kittens, but the virus is not easily transmitted this way.

TREATMENT  SEE FELINE LEUKEMIA VIRUS  DENTAL SURGERY  Whole mouth extraction of teeth may be necessary in cats with chronic stomatitis and gingivitis

CLIENT INFO & PROGNOSIS  Although FIV is morphologically and biochemically similar to HIV, it poses no threat to humans  Infected cats may survive for prolonged periods before experiencing advanced stages of the disease  Some may be asymptomatic for 10+ yrs  Keep FIV+ cats indoors  Keep FIV+ cats free of stress and concurrent disease