1. Armillaria ostoyae (honey mushroom)

2. CANINE

5.  SIGNALMENT: 12 week old, male/neutered, mixed breed puppy  PRESENTING COMPLAINT: lethargy, ocular and nasal discharge for the past 3 days; appetite is poor; puppy had diarrhea last night and vomiting/diarrhea this morning ◦ Diet: Science diet puppy dry  Hx: puppy adopted from local shelter 2 weeks ago; has received one set of vaccinations – owner was planning to schedule booster shots in one week

6.  Hx: Puppy received his first doses of Heartworm and flea prevention 2 weeks ago at time of adoption.  Other Info: Client has 1 other dog who is 1 year old and fully vaccinated; and 2 cats who are 2 and 5 yrs old that are fully vaccinated

7.  PHYSICAL EXAM FINDINGS: ◦ Lethargy ◦ ~8% dehydrated ◦ Temp: 103.8, HR: 116, RR: 20 – lung fields sound slightly moist, and the puppy coughs a few times during the exam ◦ Mm: pink, CRT: 2.5sec ◦ Mucopurulent ocular/nasal discharge ◦ The nose looks, dry, thick, and crusty

8.  TREATMENT ◦ ANTIBIOTICS ◦ FLUIDS ◦ SYMPTOMATIC TREATMENT  Anti-emetics  Ophthalmic ointments  Cleaning ocular/nasal discharge frequently  Nutrition  Clean, dry environment; low stress  DIAGNOSTICS ◦ Blood work is drawn for a CBC, serum chemistry profile and Canine Distemper titers

9.  DIAGNOSTIC TEST RESULTS: ◦ Leukopenia ◦ Mild anemia  WORSENING OF CLINICAL SIGNS: 1 week later, the client returns. The puppy is weak and appears to have muscle twitching; muscle of the mouth appear as if the puppy is “chewing gum”; there are pustules on the abdomen, and hyperkeratotic foot pads

10. http://www.youtube.c om/watch?v=QL4S4M A2zT0 http://www.youtube.c om/watch?v=HyEFS77 rOzU *Myoclonus is almost pathognomonic for Canine Distemper

11. ENAMEL HYPOPLASIA HYPERKERATOSIS OF NOSE & FOOT PADS

12.  FURTHER DIAGNOSTICS: ◦ Blood work drawn to compare serum titers and CBC results  Leukocytosis with neutrophilia found  Viral inclusions are found in mononuclear cells of the blood smear  Post-mortem tissue sample taken from mucous membranes or epithelial cells of the urinary, respiratory, or GI tract may also display viral inclusions.  Titers have increased since last measurement

14.  Transmission of this (single-stranded, RNA, paramyxo-) virus is through aerosolization of bodily fluids, fomites  Fatality rate may be as high as 50%- 90%  Prognosis is guarded at best, esp if neurologic signs are present  Neurologic signs may be focal to general including seizures ◦ Could occur weeks to years after initial infection  Although Distemper is contagious, it is unlikely to affect the clients older, vaccinated dogs ◦ CVD does not affect cats

15.  Vaccination  Thorough cleaning – the virus is labile and can be killed with common disinfectants, and heat  Isolation of infected animals

18.  SIGNALMENT: 4yr old, female spayed, daschund,  PRESENTING COMPLAINT: dry, hacking cough; dog is still active and eating and drinking well. Coughing began about 1 week ago.  Hx: Owner began sending the dog to day care everyday while she was at work; After the puppy set of vaccines, dog was vx at 1yr and 2 yrs old. She received an injectable Bordetella vaccine 2 days before beginning daycare.

19.  Hx: ◦ Diet: Purina One ◦ Patient is current on HW and flea prevention ◦ No other significant illnesses  PHYSICAL EXAM FINDINGS: ◦ Temp: 102.1, HR: 140, RR: 36 ◦ Sneezing and occasional coughing on exam  Cough can be ellicited on tracheal palpation  Mild, clear nasal discharge ◦ Normal hydration status ◦ Mm: pk CRT: <2sec

20.  Aka Infections Tracheobronchitis  Major causes ◦ VIRUSES: Canine Adenovirus-2, Parainfluenza, Canine Distemper, Canine Influenza ◦ BACTERIA: mycoplasma, bordetella bronchiseptica, streptococcus sp. http://www.youtube.com/wa tch?v=amGKQX9zdug

21.  DIAGNOSTICS ◦ Based on physical exam, clinical signs and history ◦ Virus isolation from swabs of the pharynx, nasal passageways, trachea ◦ Thoracic rads if pneumonia suspected  TREATMENT ◦ Adequate hydration ◦ Antibiotics ◦ Antitussives  Hycodan (hydrocodone)  Butorphanol  Cough Tabs (dextromethorphan, guafenesin)  Bronchial dilators  Aminophylline  terbutaline

22.  Transmission of these organisms is by inhalation of respiratory droplets or contact with fomites  The prognosis is good with proper treatment ◦ It is a self-limiting disease ◦ May take 2-3 weeks to resolve  Vaccinate 2-3 weeks prior to expected exposure

23.  Isolate infected animals  Vaccinate appropriately  Most routine disinfectants, bleach, quarternary ammonium compounds will kill these viruses and bacteria  Proper sanitation

26.  SIGNALMENT: 3mth old Rottweiler puppy, intact male ◦ *Dobermans & Rottweilers are over-represented  PRESENTING COMPLAINT: lethargy, poor appetite, bloody diarrhea for 2 days; puppy has vomited twice this morning  Hx: Owner purchased puppy from local trader’s market at 10 weeks old. The breeder gave the first set of vaccinations at 3 weeks old and a booster @ 7 weeks

27.  Hx: owner already has a 6mth old, intact female Rottweiler he got as a gift from a family member. He purchased the new puppy as a playmate. ◦ The 6mth old puppy had 3 sets of vaccinations given by the family member. ◦ Neither puppy has been started on heartworm or flea prevention. ◦ Diet: Blue Buffalo

28.  PHYSICAL EXAM FINDINGS: ◦ ~8% dehydrated  Mm:pale, CRT: >2.5sec ◦ Depressed ◦ Rear soiled in blood-tinged diarrhea, strong, foul odor ◦ Temp: 103.5, HR: 120 RR: 24

29.  Fecal  Parvo ELISA (snap test) ◦ Detects viral antigen  CBC/Serum Chemistries ◦ Marked lymphopenia, neutropenia, increased PCV ◦ Hypoglycemia, hypokalemia  Parvo titers ◦ High titers (1:10,000)

32.  TRANSMISSION: fecal-oral route ◦ Virus has affinity for rapidly dividing cells such as intestinal epithelium & bone marrow; severe cases affect the myocardium (esp in utero)  Affect on bone marrow lymphopenia, neutropenia WBCs may be <2000 ◦ Possible sequelae: septicemia, intussusception

33.  ISOLATE INFECTED ANIMALS  HOSPITALIZATION ◦ IV fluids w/added electrolytes, added dextrose ◦ ANTIBIOTICS ◦ ANTI-EMETICS  Reglan  Maropitant (cerenia)  Ondansetron ◦ NSAIDs ◦ +/- Plasma transfusion for hypoproteinemia ◦ +/-ANTIVIRAL  Tamiflu

34.  PROGNOSIS: generally good with aggressive and early treatment; 80%-90% success ◦ Concurrent infections and GI parasites can worsen prognosis

35.  VACCINATION ◦ Keep puppies isolated until they have firm immunity, usually about 18-22 weeks of age ◦ Vaccinate at 6-8 weeks then q3-4 weeks until 16 weeks of age  CLIENT INFO ◦ In this case, the 1 st 2 vaccines are not valid ◦ Client should isolate the new puppy from the older one ◦ Treatment is expensive ◦ The virus is resistant in the environment and may survive for years. A 1:30 solution of bleach is effective.

38.  SIGNALMENT: ~6 week old intact, male kitten, DSH  PRESENTING COMPLAINT: mucopurulent ocular/nasal discharge, congestion, head shaking, sneezing, inappetance – has gotten progressively worse in the last week  Hx: owner has been feeding a family of stray cats outside her home. Several of the kittens look like this. This is the only kitten she could catch

39.  Hx: no known vaccinations, no flea or HW prevention ◦ Diet: owner feeds canned Whiskas  PHYSICAL EXAM ◦ Patient is QAR ◦ Temp: 104.1, HR: 200, RR:40 ◦ Audible upper respiratory congestion ◦ ~6-8% dehydrated ◦ Mm: pale pk, CRT: 2 sec

40.  DIAGNOSTICS ◦ Clinical signs ◦ Nasal, pharyngeal swabs  DIAGNOSIS: ◦ Feline Viral Rhinotracheitis(FVR)  Feline Herpesvirus-1 ◦ Feline Calicivirus (FCV)  80-90% of all URI is cause by 1 of these 2 viruses Chlamydophila felis ◦ Bordetella ◦ Mycoplasma

42.  FLUIDS  ANTIBIOTICS  NURSING CARE ◦ Warm, clean ◦ Force feed, warm, food ◦ Pain meds for oral or corneal ulcers  DECREASE STRESS  AVOID STEROID  ANTIVIRAL ◦ Idoxuridine

43.  Both FVR and FCV are highly contagious ◦ Transmitted via fomites (hands, clothes) and aerolsolization of respiratory droplets withing 5 feet  Morbidity is high, mortality is low ◦ Oral ulcers can last 7-10 days

44.  VACCINATION ◦ Vaccines will reduce severity and duration of clinical signs

46. http://www.youtube.com/watch?v=xLlL24sh W7E

47.  SIGNALMENT: 4week old, intact female, DSH  PRESENTING COMPLAINTS: kitten is depressed and appears to be very thin, has blood- tinged diarrhea, occasional vomiting  Hx: Owner lives in an apartment complex and found this kitten outside. She thinks she know the mom, but the mom doesn’t seem to be taking care of her.

48.  PHYSICAL EXAM FINDINGS ◦ 103.9 ◦ ~6% dehydrated ◦ Ataxic, unstable ◦ Lethargic ◦ Fecal-soiled rear-end

49.  CBC ◦ Moderate to severe panleukopenia  Positive parvo snap test  Antibody titers  Virus isolation

50.  Maintain hydration and electrolyte balance  Force-feeding  Broad-spectrum antibiotics

51.  Proper vaccination  Cats who survive the infection will not get re- infected later in life. They acquire life-long immunity.