1. CASE #8

2. PATIENT PRESENTATION

3. SIGNALMENT: ~4-5yr old, intact, male, DMH PRESENTING COMPLAINT: inappetant, hypersalivation, lethargy 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, but nothing serious. PATIENT PRESENTATION

4. 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 PATIENT PRESENTATION

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

6. CBC – Anemia, lymphopenia ELISA positive – THIS IS AN ANTIBODY TEST, not antigen – there will be interference by maternal antibodies and vaccination! – Test result may be supported by other lab tests such as IFA, Western blot, & PCR DIAGNOSTIC TEST RESULTS

7. 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. TRANSMISSION

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

9. 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 pos cats indoors Keep FIV pos cats free of stress and concurrent disease CLIENT INFO & PROGNOSIS

10. CASE #9

11. PATIENT PRESENTATION

12. SIGNALMENT: ~6mth old neutered, male DSH PRESENTING COMPLAINT: depression, feels “hot”, looks yellow, painful abdomen, 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

13. PHYSICAL EXAM – Temp: 104.1, HR:220, RR:40, shallow – Depression – Labored breathing – Icteric mm, CRT: difficult to assess, >2sec – Painful on abdominal palpation – OS: signs of inflammation/uveitis PATIENT PRESENTATION

15. CBC/SERUM CHEMISTRIES – Elevated ALT. ALP, total bilirubin – CBC WNL FeLV/FIV Test – Neg/Neg Thoracic radiographs – pneumonia Paired titers ELISA FECAL – See next slide DIAGNOSTIC TESTS

16. PNEUMONIA IS MOST COMMON IN NEONATALLY NEONATALLY OR TRANSPLACENTALLY INFECTED CATS

17. TOXOPLASMA OOCYTS THESE OOCYTS ARE DIFFICULT & RARE TO FIND

18. TRANSMISSION: – 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 animal can serve as intermediate hosts TRANSMISSION & LIFE CYCLE

19. 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

20. 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 TREATMENT & PROGNOSIS

21. TRANSMISSION & LIFE CYCLE

22. 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 1 st or 2 nd trimester can lead to birth defects Cook all meat thoroughly DON’T PANIC CLIENT INFORMATION

23. CASE # 10

24. PATIENT PRESENTATION

25. 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

26. 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

28. CBC/SERUM CHEMISTRIES – Anemia – Leukocytosis w/left shift – Thrombocytopenia – Increased liver enzymes (ALT, ALP) – Hypoproteinemia SERUM TITERS – 4-fold increase between titers TISSUE BIOPSY & FLUORESCENT STAINING DIAGNOSTIC TESTS

29. DIAGNOSIS: TICK-BORNE DISEASE – ROCKY MOUNTAIN SPOTTED FEVER – caused by Rickettsia rickettsii, a gram- obligate intracellular bacterial organism. – This organism is carried in the saliva of the tick – 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… DIAGNOSTICS & TREATMENT

30. DERMACENTOR VARIABILIS TICKS MUST BE ATTACHED TO HOST FOR 5-20 HOURS BEFORE TRANSMITTING INFECTIOUS ORGANISM

31. DERMACENTOR ANDERSONI

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

33. 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 CLIENT INFORMATION

34. CASE #11

35. PATIENT PRESENTATION

37. 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

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

39. CBC/SERUM CHEMISTRY – 25% have pancytopenia – Anemia – Thrombocytopenia – Hyperglobulinemia Blood smear Observe morula in mononuclear cells IFA DIAGNOSTIC TESTS

40. DIAGNOSIS: TICK-BORNE DISEASE – CANINE MONOCYTIC EHRLICHIOSIS, caused by Ehrlichia canis transmitted by the tick Rhipicephalus sanguineus – 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

41. RHIPICEPHALUS SANGUINEUS

42. ANTIBIOTICS – Doxycycline – Tetracycline – +/- blood transfusions TREATMENT

43. CASE #12

44. PATIENT PRESENTATION

45. 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

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

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

49. PATIENT PRESENTATION

50. LYME DISEASE is caused by the spirochete Borrelia Burgodorferi, passed by an Ixodes tick – 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

51. ANTIBIOTICS – Doxycycline – Anti-inflammatory drugs for pain NSAIDs OR Steroids – VACCINATION For animals in endemic areas, northeast U.S. CLIENT INFO Infected animals may have relapses even after treatment because the antibiotic does not completely eliminate the organism Use tick prevention TREATMENT & PREVENTION