1. IMPOSSIBLE?!?
“NOTHING IS IMPOSSIBLE! THE WORD ITSELF SAYS “I’M POSSIBLE.”
-Audrey HEpburn

2. CASE #4 Feline Upper Respiratory Disease Complex Chapter 11

3. Feline upper respiratory disease complex
Upper respiratory infection caused by one or more bacterial infections.
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
A respiratory infections caused by one or more bacteria. Most are caused by Feline viral rhinotracheitis or Feline calicivirus.
Bacteria: Chlamydophila felis, Bordetella, and mycoplasma are others but it less likely.
Chlamydophila felis(Bacteria that cause inflammation of feline conjunctiva, rhinitis and respiratory problems)

4. Feline Viral Rhinotracheitis(Feline Herpesvirus):
(FVR)
Highly contagious upper respiratory disease in cats
Severe in kittens
Occurs year round in vaccinated and unvaccinated cats (Worse in unvaccinated)
Worse in unvaccinated because they have no protection.

5. Feline Viral Rhinotracheitis(Feline Herpesvirus):
Transmission: Aerosolized(sneezing) or direct contact(Queens can pass to kittens during grooming)
Virus not active in environment(18-24hrs)
Cats shed virus for 3 weeks
Fomites(dishes, clothing, bedding and toys)
That’s good that it isn’t in the environment for too long. You would still want to disinfect fomites. Especially important in hospital settings. You wouldn’t want to put another cat in a kennel where a cat had an upper respiratory issue, even if it was in isolation.
Transmission: In contact with nasal discharge.

6. Feline Viral Rhinotracheitis(FVR) Clinical signs:
Acute onset of sneezing
Fever
Conjunctivitis (purulent rhinitis)
Depression
Anorexia
Ulcerated nasal planum (dorsal part of the nose)
Excessive salivation
Abortion in pregnant queens
Corneal ulcers
Purulent rhinitis: runny nose with colored discharge

7. Diagnosis of FVR: Clinical signs
Nasal, pharyngeal swabs to send for virus isolation to an outside lab
Mainly clinical signs
Isolation test takes a while to come back

8. Feline Calicivirus(FCV):
Acute, highly contagious upper respiratory tract disease in cats
Ulcerative stomatitis seen with FCV, not with FVR
Resistant to disinfectants(remains in environment for several days)
This disease is transmitted through direct contact/Contaminated environment.

9. Feline Calicivirus(FCV):
More severe in kittens 2-6mths
Transmission through direct contact with
infected cat/nasal droplets
Clinical signs usually last 5-7 days
This disease is transmitted through direct contact/nasal droplets

10. Feline Calicivirus(FCV) Clinical signs:
Fever
Serous ocular/nasal discharge
Mild Conjunctivitis
Oral ulcers with increased salivation
Pneumonia
Acute arthritis in kittens(limping kitten syndrome)
Diarrhea
Dehydration
Serous: associated with allergies.

11. Diagnosis of FCV:
Clinical signs
Viral isolation

12. DIAGNOSIS: Differentiating the causes
Sneezing is common in all
Upper repiratory disease
Corneal ulceration is associated with Herpesvirus
Feline rhinotracheitis: corneal ulcers.
Feline Calicivirus: Ulcerative stomatitis.
If the upper respiratory issue has caused a cough:
Bordetella or mycoplasma bacteria. You see sneezing with all of them. Know the differences between them.
Oral ulcers are
associated with
calicivirus
Coughing is associated
with Bordetella or
mycoplasma

13. 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
Steroids will weaken immune system.

14. PROGNOSIS & CLIENT INFORMATION
Both FVR and FCV are highly contagious
Transmitted via fomites (hands, clothes) and aerosolization of respiratory droplets within 5 feet
Morbidity is high(Illness), Mortality is low(death)
Oral ulcers can last 7-10 days
They can both be contracted through direct contact or coming in contact with another cat sneezing. FVR does not last as long in the environment though. Again it is a umbrella concept with these complexes.
With FCV they aren’t usually sneezing, while they are with FVR. That’s why with FCV is more through direct contact.

15. Review: FVR FVR: Herpes virus Worse in unvaccinated cats
Corneal ulcers (last 7-10 days)
Can be killed by disinfectant
Does not remain in environment for long
Aerosolized(sneezing)

16. Review: FCV FCV: Ulcerative stomatitis
Remains in the environment for long period of time
Resistant to most disinfectants
Direct contact with infected cat
Or contact with nasal droplets.
Can be killed with bleach.
Again you don’t usually see sneezing so they have to come in direct contact with infected cats nasal discharge.

17. Review: FVR and FCV Both FVR and FCV are highly contagious
Diagnosis: Virus isolation
Morbidity is high(Illness), Mortality is low(death)

18. CASE #5 Feline Panleukopenia
Chapter 9

19. Feline Panleukopenia(Feline Distemper):
DNA virus (caused by family Parvoviridae-closely related canine parvovirus)- NOT THE SAME THOUGH
Affects young unvaccinated cats or animals
Causes destruction of cells in neonatal brain, bone marrow, lymphoid tissue and intestinal lymphoid tissue
Incubation 4-5 days
Signs: peracute, acute, subacute, or subclinical
Peracute: very fast, Acute: happens quickly, Subacute: Recent, Subclinical: no signs.
Know that is also called Feline parvovirus

20. Clinical signs: Feline panleukopenia(Feline Distemper)
Fever
Depression
Vomiting
Fetid diarrhea(Smells bad, can have blood in stool as well)
Dehydration
Anorexia
Fetal death (Spontaneous abortion, or reabsorption in the pregnant queens)
Ataxic/unstable
Cerebellar or retinal defects in neonates

21. Diagnosis of Feline Panleukopenia:
CBC(Moderate to severe leukopenia)
Positive PARVO snap test
Panleuk=PARVO: because closely related to parvo virus. Leukopenia: low WBC (all).

22. PATIENT PRESENTATION

23. Prognosis will depend on the underlying condition.
Cerebellar hypoplasia: Cerebellum is smaller due to cell destruction in the brain.
Prognosis will depend on the underlying condition.
Cats can have cerebellar hypoplasia: cerebellum is not normal size, its smaller. Due to cell destruction in the brain. They can still live life, but they will just have neurologic defects for the rest of their life.
The cerebellar hypoplasia will not cause them to die.

24. TREATMENT Maintain hydration and electrolyte balance Force-feeding
Broad-spectrum antibiotics
As mentioned before, I do not care for force feeding, I prefer to use nasogastric tubes.

25. 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 is through direct contact or contaminated environment

26. Review: Feline panleukopenia
Feline distemper
DNA virus
Young unvaccinated animals
CBC: Moderate to sever leukopenia
PARVO SNAP TEST
Cerebellar defects/ataxia
Direct contact/Environment
Lives in environment for years

27. FVRCP Vaccine broken down:
FVR: Feline viral rhinotracheitis(Feline Herpes)
C: Calicivirus
P: Panleukopenia(Feline Distemper)
Kittens receive the vaccine starting at 6-8 weeks of age
Boosted every 3-4 weeks until 16 weeks of age
This is a core vaccine for cats
Feline vaccines (DOVE 7 minutes)
Administering vaccines (DOVE 3 minutes)

28. CASE #6 Feline Infectious Peritonitis
Chapter 9

29. Feline Infectious Peritonitis(FIP):
Primary disease of multicat households
Does not occur without exposure to Feline coronavirus
Feline enteric coronavirus(FECV)- Cats shed virus intermittently
Contagious through feces, urine, and saliva
FECV-mutates to FIP within some infected cats
Two forms: Wet(Effusive) and dry form(Non-effusive)
8% to 90% of cats have antibodies for feline corona virus and shed the virus intermittently. It is believed that Feline coronavirus actually mutates into FIP. Corona virus is a disease that is very unknown. We don’t know how the cats get corona or why.
Certain strains of Corona virus will actually cause FIP. FECV will cause diarrhea.

30. Clinical signs: Feline Infectious Peritonitis
Wet form:
Ascites, pleural effusion(Distended abdomen)
Anorexia
Depression
Weight loss
Dehydration
May or may not have fever
Ascites: Fluid in peritoneal cavity (Abdominal) Pleural effusion: pleural cavity (Chest).
You see wet form more often than dry form.

31. Clinical signs: Feline Infectious Peritonitis
Dry Form:
Fever(FUO)
Anorexia
Depression
Weight loss
Ocular lesions
Neurologic signs
Enlarged kidneys(Uncommon)
This form of the disease is vague and progresses slowly
these animals may live months to years

32. PATIENT PRESENTATION
You can see the distended abdomen. Is it intestinal parasites or FIP? Could be the wet form of FIP.

33. DIAGNOSTIC TESTS FECAL ABDOMINAL RADIOGRAPHS CBC/SERUM CHEMISTRY
ABDOMINOCENTESIS
Cytology & chemical analysis of the fluid
Fecal: to rule out intestinal parasites. Rads to look for ascites. Abdominocentesis: to take a sample of the fluid in the abdomen.
ABDOMINOCENTESIS: will be yellow due to protein built up
CBC/serum: Decreased protein in the blood

34. DIAGNOSTIC TESTS
This is what it should look like. You can make out the organs.

35. DIAGNOSTIC TESTS
This view you can’t.

36. DIAGNOSTIC TEST RESULTS
There is NO “FIP SPECIFIC” antibody titer test
CBC/SERUM CHEMISTRY
Decreased protein in the blood
ABDOMINAL RADIOGRAPHS
Ascites found
ABDOMINOCENTESIS :Viscous, clear to yellow fluid, high protein, low cellularity
Rivalta Test
Rivalta test has been used in Europe for a long time; Some DVMs here do it as well, but is not listed as an official diagnostic.
Elisa snap test: detect the presence of coronavirus antibodies in a cat, but these tests cannot differentiate between the various strains of feline coronavirus. A positive result means only that the cat has had a prior exposure to coronavirus, but not necessarily one that causes FIP.

37. DIAGNOSTIC TESTS: Abdominocentesis

38. DIAGNOSTICS
Ascites: fluid in the abdomen.

39. Pleural Effusion
Fluid that builds up between the lungs and chest

40. TRANSMISSION & PATHOPHYSIOLOGY
They won’t always have diarrhea, but with feline enteric coronavirus would most likely cause diarrhea.

41. TRANSMISSION & PATHOPHYSIOLOGY
This theory of mutation is changing as of 2014; nothing is certain at this point;

42. Feline corona virus FIP

43. TREATMENT SUPPORTIVE CARE
Thoracocentesis/abdominocentesis to make pet more comfortable
Daily steroids
Antibiotics
Steroids can help slow the disease process.
Thoracocentesis video (DOVE 4 minutes)
Treatment is mainly aimed at controlling the immune response triggered by the infection with the feline coronavirus/ Steroids help stop the immune response, thus decreasing clinical signs. This will not cure the patient though.

44. 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
Don’t house another cat with FIP. That is the bets way to prevent the virus from shedding.

45. 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
Effusive is the wet form: Cats with distend abdomens.

46. Review: FIP Multicat household
Has to be exposed to Corona virus – mutates to FIP
Sheds through feces, urine, or saliva
Two forms: Wet and dry
Wet: Ascites and pleural effusion
Distended abdomen
Last 4 weeks in environment (killed by most disinfectants)
Mortality rate is 95%
Ascites (abdomen), pleural effusion (chest).