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

3. ZOONOSES & VECTOR-BORNE DISEASES
INFECTIOUS DISEASES
ZOONOSES
&
VECTOR-BORNE DISEASES

4. CASE #9 Toxoplasmosis
Chapter 9

5. What is Toxoplasmosis? Caused by Toxoplasma gondii
Intracellular coccidian parasite
Cats – Definitive host
Other warm-blooded animals/humans serve as intermediate host
Definitive host: Supports adult and sexually reproductive stage.
Intermediate: supports the immature or nonreproductive.
TOXOPLASMA GONDII NEEDS THE CAT TO COMPLETE LIFE CYCLE.

6. 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, but several animals can serve as intermediate hosts
Transmission is by 3 routes
Intermediate: supports the immature or nonreproductive (secondary host)
Definitive host: Supports adult and sexually reproductive stage (primary host)

7. 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
Sporulation: The process by which immature (noninfective) coccidian oocysts develop into the mature, infective form (TACHYZOITES: infective form)
ONLY CATS WILL SHED INFECTIVE FORM
In cats the two tissues mainly involved are lungs and eyes.
Dogs: Gastrointestinal, neurologic, and respiratory system (rare in dogs though)

8. Clinical signs: Depends on organs involved Anorexia**** Lethargy***
Fever***
Wt loss***
Diarrhea/vomiting
Icterus
Respiratory disease/labored breathing
Lameness
Pancreatic disease
Anterior uveitis
Glaucoma
CNS disease
Sudden death
Liver issues

9. PATIENT PRESENTATION
Inflammation of the middle layer of the eye (uvea)

10. DIAGNOSTIC TESTS CBC/SERUM CHEMISTRIES Non-specific, variable changes
FeLV/FIV Test
Neg/Neg
Thoracic radiographs
Pneumonia/lesions
Paired titers( IgG, IgM, and antigen- containing immune complex)
ELISA (although NOT A quick SNAP TEST)
FECAL
See next slide
IgG: the presence of IgG antibody generally indicates past exposure and immunity (so had infection and has fought off infection)
IgM:  Detection of IgM indicates acute or primary infection (active infection)
IgG & IgM: These are a type of antibody
SNAP test: takes 2.5 hours

11. TOXOPLASMA OOCYTS THESE OOCYTS ARE DIFFICULT & RARE TO FIND
Fecal examinations for oocysts are usually unrewarding since they are shed for only a short period of time

12. DIAGNOSTIC TESTS PNEUMONIA IS MOST COMMON IN NEONATES
PNEUMONIA: inflammation of air sacs
Can be passed to kittens in utero
PNEUMONIA IS MOST COMMON IN NEONATES

13. 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
The most effective drug is clindamycin and it must be given for two to three weeks
Healthy cats do not always show signs

14. 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
Seropositive: giving a positive result in a test of blood serum
1st & 2nd due to the development stage

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

16. CASE # 10 Rocky Mountain Spotted Fever

17. What is Rocky mountain spotted fever?
Tick born disease
caused by Rickettsia rickettsii, a gram- obligate, bacilli intracellular bacterial organism.
Usually occurs in early spring and summer.
gram- obligate, bacilli intracellular bacterial organism: have the ability to only grow and replicate inside other cells

18. Rickettsia rickettsii:
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
Vasculitis: Inflammation of blood vessels. Each tick has to be attached for a different amount of time.
American dog tick

19. dermacentor tick
American dog tick

20. PATIENT PRESENTATION

21. PATIENT PRESENTATION

22. Clinical signs: Fever Anorexia Depression
Mucopurulent ocular discharge
Tachypnea
Muscle pain
Wt. loss
Scrotal edema
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…
Mucopurulent: fluid containing mucus
Edema: swelling
Hemorrhage: an escape of blood from a ruptured blood vessel
* These signs are vague and may mimic other infectious diseases

23. DIAGNOSTIC TESTS CBC/SERUM CHEMISTRIES Anemia Thrombocytopenia
Increased ALT/ALP
SERUM TITERS
TISSUE BIOPSY & FLUORESCENT STAINING
History of tick exposure
Thrombocytopenia: Low levels of thrombocyte/ clotting issues.
Serum titers: blood tests that measure whether or not the patient is immune to the disease
Tissue biopsy: look for bacteria in the tissue

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

25. 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
Myalgia: muscle pain. Incubation: exposure and infection. Takes 7 days to see signs.

26. CASE #11 Ehrlichiosis

27. What is Ehrlichiosis? Tick-born disease
CANINE MONOCYTIC EHRLICHIOSIS, caused by Ehrlichia canis transmitted by the tick Rhipicephalus sanguineus (brown dog tick)
Southeastern and southwestern region. Gained attention in Vietnam in military working dogs.
After infection, E. canis causes acute, subclinical, and chronic stages of the disease.

28. Clinical signs: 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
Multiplies in cells of the spleen and liver as well
mononuclear cell are any peripheral blood cell having a round nucleus (monocytes)
Vasculitis: inflammation of blood vessels

29. Clinical signs continued:
SUBCLINICAL PHASE 6-9weeks after infection
Few clinical signs if any
CHRONIC PHASE
Bone marrow suppression
Bleeding tendencies (Thrombocytopenia)
Bone marrow suppression results in thrombocytopenia, non-regenerative anemia, and pancytopenia (decrease in red cells, white cells, and platelets)

30. PATIENT PRESENTATION
Vasculitis can cause leg and face swelling.

31. PATIENT PRESENTATION
Epistaxis. MM will be a pale pink due to nongenerative anemia.

32. DIAGNOSTIC TESTS CBC/SERUM CHEMISTRY 25% have pancytopenia Anemia
Thrombocytopenia
Blood smear
Observe morula in
mononuclear cells
Pancytopenia: LOW RBC,WBC, and Platelets. Morula: results from fertilized ovum. Hints Ehrlichia positive.

33. ANOTHER EHRLICHIOSIS:
There are two forms of canine granulocytic ehrlichiosis
Caused by these two bacteria:
Ehrlichia ewingi
Ehrlichia equi

34. EHRLICHIOSIS:
CANINE GRANULOCYTIC EHRLICHIOSIS caused by Ehrlichia ewingii
Transmitted by the Amblyomma americanum (lone star) tick

35. Amblyomma americanum Lone Star Tick Not seasonal
Looks like a star on the back of the tick.

36. Clinical signs associated with Ehrlichia ewingii infection: Fever
Lethargy
Lameness
Muscle stiffness
CBC: Thrombocytopenia
Blood smear: morula found in neutrophils
Dogs with ewingii: Polyarthritis(5 or more joints) and inflammatory joint disease.
Morula: results from fertilized ovum

37. DIAGNOSIS
Morula: results from fertilized ovum

38. EHRLICHIOSIS:
CANINE GRANULOCYTIC EHRLICHIOSIS caused by Ehrlichia equi
Transmitted by the Ixodes dammini/scapularis (deer tick or black-legged tick)

39. Ixodes dammini Deer tick or black-legged tick Seasonal
Think of deer season. You can’t hunt all the time.

40. Clinical signs of Ehrlichia equi infection: Fever (acute onset)
Debilitating lethargy
Anorexia
CBC: thrombocytopenia
Serum chemistries: Increased ALP
Debilitating lethargy: the patient becomes very weak

41. TREATMENT ANTIBIOTICS Doxycycline Tetracycline +/- blood transfusions
Plasma transfusion if needed.

42. 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.

43. Review: Ehrlichiosis ***Thrombocytopenia
Canine monocytic ehrlichiosis (Ehrlichia canis)
Brown dog tick
Acute/subacute/chronic
Pancytopenia
Canine Granulocytic ehrlichiosis (Ehrlichia ewingii)
Lone star tick
Polyarthritis/inflammatory joint disease
Canine Granulocytic ehrlichiosis (Ehrlichia equi)
Deer tick or black-legged tick
***Thrombocytopenia
They all cause bleeding tendencies (thrombocytopenia)

44. CASE #12 Lyme Disease

45. What is Lyme disease? Lyme Borreliosis
caused by the spirochete Borrelia Burgdorferi, passed by an Ixodes tick
(black-legged ticks or deer ticks)
Spirochete: spiral bacteria
So just like Ehrlichiosis Equi, Lyme disease is passed by the black-legged or deer tick. World wide disease: Seen more in northeastern states.

46. spirochete Borrelia Burgdorferi
The tick must be attached to the host for more than 48 hours
Signs may take months after the tick bite

47. Clinical signs: Fever Anorexia Lethargy Lymphadenopathy
Episodes of lameness
Myocardial abnormalities(Not always)
Rash around tick bite
Nephritis(Labrador retrievers)
Chronic flare-ups
Signs may be vague and nonspecific: making diagnosis difficult. Animals out in high infested tick areas are at greater risk.
Lymphadenopathy: inflammation of lymph nodes/enlarged
Myocardial abnormalities: abnormal electrical signals between the heart chambers
Nephritis: signs such as painful urination, cloudy urination, abdominal pain

48. PATIENT PRESENTATION
You can see lameness in this pick.

49. DIAGNOSTIC TESTS Radiographs Would be normal ELISA TEST
Lyme Positive (antibody titers)
SYNOVIAL FLUID ANALYSIS
Increased nucleated cells
Radiographs normal, limping would be due to pain not any bone or tissue issues/Vaccine can cause issues with test
nucleated cells: lymphocytes/monocytes, increased will indicate polyarthritis (painful in 5 or more joints)

50. DIAGNOSTIC TESTS ELISA SNAP TEST
Anaplasma phagocytophilum : bacteria that causes anaplasmosis (fever, chills, muscle aches)- another tick born disease

51. LYME DISEASE TREATMENT
ANTIBIOTICS
Doxycycline is the treatment of choice for Borreliosis
Treatment may not completely eliminate the organism and some animals may remain permanently infected.
If permanently infected, just treat clinical signs. Goal is to make patient comfortable. Patient might not have many signs and then have flare ups.

52. 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

53. CASE #13 Rabies

54. What is Rabies?
Viral-induced neurologic disease of warm blooded animals
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)

55. So what happens?
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

56. Clinical signs: Behavior changes Difficulty swallowing Hypersalivation
Hind-limb ataxia
Depression/stupor
* Three stages of Rabies
The clinical signs look similar to other diseases.

57. RABIES IS CHARACTERIZED BY 3 STAGES 1 & 2:
PRODROMAL STAGE – people are at 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”
Prodromal because it is unexpected. Remember rabies could take 3-8 weeks for them to start showing signs.
Prodromal stage: example a wild animal becomes nice or a nocturnal animal comes out during the day.

58. Stage 3:
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
All stages could happen within 1 week.

60. PATIENT PRESENTATION

61. PATIENT PRESENTATION
SIGNALMENT: 4 yr old, neutered male German Shepherd.
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.

62. RABIES EXPOSURE CASES
The bat should be sent to a laboratory for analysis and rabies testing
This requires a sample of brain tissue
There is no antemortem test available
The dog should be examined and handled carefully. He should be quarantined until the results from the bat are known.
Sample is placed in fridge not freezer. To send off the head needs to be double bagged (cadaver bag). It is then placed in a box or bucket and covered. You can place ice packs around the head to keep it cold on the way to the facility to be tested. You can use dry ice for cases that have to be shipped further.

63. 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.
10 days if you pet bites someone. If exposure to a rabid animal, your pet will have to be quarantined and revaccinated. 90 days because remember 3-8 weeks to show signs.

64. Rabies vaccine: October 8th, 2020: Third vaccine(3 year)
Dogs and cats can have first vaccine at 12weeks of age
Then once a year after that
If Patient has had two consistent vaccines(meaning not a late vaccine, 1yr later, they can get a 3 year the following year)
Example:
0ctober 8th, 2018: First vaccine
October 8th, 2019: Second vaccine(1 year)
October 8th, 2020: Third vaccine(3 year)
This also depends on if they see the same vet. Some will not give a 3 year of they have never seen the pet before.

65. CASE #14
LEPTOSPIROSIS

66. What is Leptospirosis?
Bacterial disease that affects humans and animals
Bacteria Leptospira interrogans, a spirochete bacteria
The natural hosts of Leptospirosis are skunks, raccoons, opossums, & pigs.
They do not have to come in contact with the infected animal. There are a couple different strands as well.

67. Infection occurs through mucosal contact with water or soil contaminated with urine from infected animals
There are many serovars of this organism:
Canicola
Icterohemorrhagica
Pomona
Grippotyphosa
Bratislavia

68. Clinical signs:
Fever
Sore muscles
Stiffness in muscles, legs, stiff gait
Shivering
Weakness
Depression
Lack of appetite
Icteric (Liver failure)
Increased thirst and urination, may be indicative of chronic renal (kidney) failure, progressing to inability to urinate
Can lead to acute kidney and liver failure if not treated
Typically, acute renal failure with or without liver issues. These patients are hospitalized and placed in isolation. You wear PPE because they will urinated a lot due to fluid therapy.

69. Don’t trust standing water
PATIENT PRESENTATION
Don’t trust standing water

70. Diagnostics: TREATMENT URINALYSIS: low urine specific gravity
Increase in serum titers
Fluorescent antibody
PCR
MAG test (Microscopic agglutination test)
TREATMENT
Hospitalization
IV Fluid therapy
Antibiotics: Penicillin, Doxycycline
Antibiotics
PCR (Polymerase chain reaction) identifies early phase, but not currently available.
Microscopic agglutination test has been widely used as the reference test for antibody detection. MAG is performed by incubating patient serum with various serovars of leptospirosis
Serum titers: blood tests that measure whether or not the patient is immune to the disease
Fluorescent antibody: fluorescent dye is added to tissue and combines with a specific antibody

71. 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
Vaccine can be in combination with DHPP
Vaccine is not a required vaccine, but SHOULD be
In house disposal of lepto urine (DOVE)
Isolation urine (DOVE)