Podcast
Questions and Answers
Which of the following is true regarding the abortive classification of infection?
Which of the following is true regarding the abortive classification of infection?
In the regressive/latent classification, what is typically true about the Anti-FeLV antibodies?
In the regressive/latent classification, what is typically true about the Anti-FeLV antibodies?
For the progressive infection classification, which of the following statements is accurate?
For the progressive infection classification, which of the following statements is accurate?
Which of the following is a potential diagnostic differential for feline hypercalcemia?
Which of the following is a potential diagnostic differential for feline hypercalcemia?
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In the updated problem list, which symptom is most directly associated with FeLV Snap positivity?
In the updated problem list, which symptom is most directly associated with FeLV Snap positivity?
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What is the chief complaint for Ceefer, the cat?
What is the chief complaint for Ceefer, the cat?
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What type of oral examination findings were observed in Ceefer?
What type of oral examination findings were observed in Ceefer?
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During the physical examination, which of the following vital signs indicated a possible health issue?
During the physical examination, which of the following vital signs indicated a possible health issue?
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What lifestyle detail was noted regarding Ceefer?
What lifestyle detail was noted regarding Ceefer?
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Which symptom suggests that Ceefer may be experiencing dehydration?
Which symptom suggests that Ceefer may be experiencing dehydration?
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What was a significant finding during the abdominal palpation of Ceefer?
What was a significant finding during the abdominal palpation of Ceefer?
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Which of the following conditions is included in the differential diagnosis for Ceefer?
Which of the following conditions is included in the differential diagnosis for Ceefer?
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What type of diagnostic tests should be considered for Ceefer's evaluation?
What type of diagnostic tests should be considered for Ceefer's evaluation?
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Which patient samples are acceptable for conducting an FeLV test?
Which patient samples are acceptable for conducting an FeLV test?
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What is the primary function of the snap test?
What is the primary function of the snap test?
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What does a positive FeLV snap test indicate?
What does a positive FeLV snap test indicate?
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Which classification of FeLV infection indicates that the cat is contagious during transient viremia?
Which classification of FeLV infection indicates that the cat is contagious during transient viremia?
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What is the prognosis for cats with progressive FeLV infection?
What is the prognosis for cats with progressive FeLV infection?
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Which of the following is a possible reason for discordant test results, such as an ELISA snap positive but IFA negative?
Which of the following is a possible reason for discordant test results, such as an ELISA snap positive but IFA negative?
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What is a key characteristic of abortive FeLV infection?
What is a key characteristic of abortive FeLV infection?
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What should be done if a patient tests positive for FeLV but appears healthy?
What should be done if a patient tests positive for FeLV but appears healthy?
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What diagnostic tests are used to differentiate neoplasia from infection in this clinical scenario?
What diagnostic tests are used to differentiate neoplasia from infection in this clinical scenario?
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What percentage of cats with progressive FeLV infections develop lymphoid malignancies such as lymphoma?
What percentage of cats with progressive FeLV infections develop lymphoid malignancies such as lymphoma?
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Which of the following cellular genes is commonly observed with viral insertion in feline lymphoma?
Which of the following cellular genes is commonly observed with viral insertion in feline lymphoma?
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What condition is characterized by increased band neutrophils and monocytosis in the updated problem list?
What condition is characterized by increased band neutrophils and monocytosis in the updated problem list?
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Which of the following best describes the role of FeLV in cancer development?
Which of the following best describes the role of FeLV in cancer development?
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Which systemic cancer treatment approach is generally applied?
Which systemic cancer treatment approach is generally applied?
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How has the percentage of cats with lymphoma that were FeLV positive changed from before the 1980s to 2003?
How has the percentage of cats with lymphoma that were FeLV positive changed from before the 1980s to 2003?
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What is a common clinical presentation associated with FeLV positive cats at risk for lymphoma?
What is a common clinical presentation associated with FeLV positive cats at risk for lymphoma?
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Study Notes
Ceefer Case Presentation
- Ceefer is a Domestic Shorthair (DSH) cat, female, spayed, and a young adult.
- Chief complaints include decreased appetite, weight loss, and decreased activity level.
- Ceefer was found as a stray about 6 months prior to the presentation.
- Ceefer has 5 other cats, 2 indoor/outdoor dogs, and 4 horses as pets.
- Ceefer was vaccinated about 3 months ago for panleukopenia, calicivirus, herpes-1, and rabies.
- Ceefer's retroviral status is unknown/never tested.
- Ceefer is an indoor/outdoor cat.
- Ceefer weighs 4.8kg.
Further History
- Ceefer has had decreased appetite for a month, gradually worsening.
- No history of diarrhea.
- She does sometimes go outside.
- No increased drinking or urinating, no decrease.
- Occasional sneezing previously.
- No vomiting.
- Currently, she consumes Fancy Feast dry, some wet food.
Physical Examination
- Demeanor: Quiet, alert, and responsive.
- Heart rate: 180. No murmur or arrhythmia.
- Respiratory rate: 28. Increased bronchovesicular sounds.
- Temperature: 101.2°F. Normal stool on thermometer,
- Oral Exam: Mucous membranes pale pink and tacky; CRT 2-3 seconds. Gingiva erythematous, with multiple oral ulcers.
- Abdominal Palpation: Comfortably responsive, not nauseous. Both kidneys felt irregular on palpation, but appeared normal to slightly enlarged in size.
Problem List
- Decreased appetite
- Weight loss
- Lethargy
- Mild dehydration (tachy MM, longer CRT)
- Oral ulcers/stomatitis
- Abnormal lung sounds
- Irregular kidneys
Differential Diagnosis
- Degenerative
- Anomalous
- Metabolic
- Neoplasia
- Inflammatory/infections/immune-mediated
- Trauma/toxin
- Vascular
- Infectious
- Congenital
- Autoimmune
- Toxin/trauma
- Endocrine/metabolic
Diagnostic Tests
- CBC
- Chemistry profile (Chem)
- Urinalysis
- FeLV testing
- FIV testing
Hematology Results
- Some hematology values are elevated, potentially indicating underlying issues like anemia or infection.
- Review specific values for details.
Chemistry Results
- Some chemistry values are elevated, potentially indicating kidney dysfunction or dehydration.
- Review specific values for details.
- Potasium is high, indicating a possible issue.
Urinalysis Results
- Clear urine is observed with a normal specific gravity.
- Normal protein, Glucose, and Ketones, but bilirubin is elevated, which could indicate a problem with the liver.
FeLV/FIV Snap Test Results
- Review specific results for details, looking for positive or negative indicators.
Patient Sample Type
- Whole blood, Serum, or Plasma are used for the FeLV test.
Snap Test
- The snap test is an ELISA for antigen.
- It determines the presence of soluble p27 viral antigen.
Confirming Positive Snap Results
- Confirm positive results with an IFA (immunofluorescent assay).
- The IFA detects FeLV antigen within leukocytes.
Alternative Option for a Routine Wellness Exam
- Retest in 3 months if the results are part of a routine wellness exam and the patient is otherwise healthy.
Consequences of FeLV Infection
- Abortive: Viral replication ends due to effective immune response, does not cause significant problems.
- Regressive/Latent: Early after exposure, may become undetectable, then potentially reactivate.
- Progressive: Persistent infection causing severe problems over time.
How to Explain Discordant Results
- Early signs of infection, lab errors, or cleared disease
Updated Problem List (updated after diagnosis)
- Decreased appetite
- Weight loss
- Lethargy
- Dehydration
- Oral ulcers
- Abnormal lung sounds
- Irregular kidneys
- Left caudal lung lobe mass
- Bilateral renal masses
- Left shift (increased band neutrophils)
- Monocytosis
- Hyperglobulinemia
- Hypercalcemia
- FeLV-positive
Updated Differential Diagnosis
- Neoplasia (lymphoma, carcinoma)
- Infection (pneumonia, renal abscesses)
Cytology Smear Evaluation
- Kidney sample analysis showing lymphocytes, possibly a high-grade lymphoma, and inflammation.
Treatment/Prognosis
- Chemotherapy (CHOP protocol) may provide the best chance for successful remission.
- FeLV positive status might decrease the duration and success of the therapy.
Patient Outcome
- Ceefer is undergoing chemotherapy and responding well.
Questions/Further Investigation
- Additional questions may be needed, specific to the diagnosis.
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Description
This quiz explores the case of Ceefer, a young adult Domestic Shorthair cat presenting with decreased appetite, weight loss, and activity level changes. We delve into her medical history, vaccinations, and current health status to analyze potential health issues. Perfect for veterinary students and animal care professionals.
