Feline Medicine and Therapeutics PDF

1: Feline Medicine and Therapeutics toxicities in cats, such as chloramphenicol - Drugs normally metabolized by toxicity. glucu...

1: Feline Medicine and Therapeutics toxicities in cats, such as chloramphenicol - Drugs normally metabolized by toxicity. glucuronidation may either have a wide General Considerations: safety margin or be metabolized by an Special Considerations in Feline Therapeutics Metabolism Phase I alternative route in cats. For example: - Converts the parent drug to a more polar - Sulfation is well-developed in cats Drug Disposition metabolite through oxidation, reduction, or compared to dogs. - Cats and dogs share many physiological hydrolysis. - Acetylation, which is deficient in dogs, similarities. - Metabolites are often inactive, though appears to be well-developed in cats. - Dosing regimens for dogs can often be occasionally, their activity is modified rather - Other drugs displaying pharmacokinetic extrapolated to cats. than terminated. differences include succinylcholine, which is - If sufficiently polar, phase I metabolites may metabolized more slowly in cats than in However, there are important differences in drug be readily excreted by the kidney. dogs, likely due to reduced blood disposition between the two species, including: pseudocholinesterase activity. - Pharmacokinetic differences in drug Metabolism Phase II metabolism. - Involves conjugation of phase I reaction Hemoglobin - Differences in hemoglobin structure, products with natural substrates, requiring Feline hemoglobin has an increased susceptibility to receptors, and behavior, which may also energy input and resulting in compounds oxidation, leading to methemoglobinemia. This is impact drug disposition. with increased polarity that can be readily due to: excreted by the kidney. 1. Different structure of feline hemoglobin. Absorption and Distribution - Common conjugates include glucuronic acid 2. Lower concentrations or activities of - Minor differences exist between dogs and and glutathione, with other possible intracellular repair enzymes. cats in factors influencing drug distribution. conjugations including acetylation, 3. Differences in intracellular concentrations of For instance: methylation, or conjugation with sulfate or glutathione-conjugating enzymes. - Cats have a smaller blood volume per glycine groups. - Drugs affecting oxidative processes include kilogram (66–70 ml/kg body weight) - Dogs have essentially no acetylation some sulphonamides, nitrofurans, and compared to dogs (90 ml/kg). activity, while cats are deficient in sulfones. - Plasma drug concentrations may differ glucuronidation. between the species for drugs confined to Receptors the plasma compartment. Metabolism in Cats - Differences in drug receptor distribution and - Cats are often deficient in some glucuronyl affinity between dogs and cats have been Metabolism transferases (UGTs), which are important documented, with morphine being a prime - Drug metabolism occurs in the liver in two for glucuronidation. example. phases (1 & 2). - As a result, drugs excreted as glucuronide - In addition to slower biotransformation due - Most differences between dogs and cats in conjugates in other species, such as aspirin, to glucuronidation deficiency, cats exhibit drug disposition are related to phase II benzoic acid, paracetamol, morphine, and different pharmacodynamic effects of metabolism, though some evidence hexachlorophene, may have a prolonged morphine compared to dogs: suggests that deficiencies in phase I half-life in cats, increasing the risk of toxicity metabolism may contribute to certain drug due to drug accumulation.  Age-Related Differences Paracetamol (Acetaminophen) Age-related differences should always be - Paracetamol is a non-steroidal drug with considered, as pediatric and geriatric animals are analgesic and antipyretic actions, but more susceptible to adverse drug effects due to: severe toxicity can occur in cats. 1. Alterations in drug distribution. - Clinical signs of toxicity include edema of 2. Lower plasma protein levels in young and the face, cyanosis, methemoglobinemia, old animals, affecting drug metabolism. anemia, hemoglobinuria, and icterus. 3. Differences in drug elimination. - In cats, paracetamol is metabolized by Other Drug Effects glucuronidation, sulfation, and cytochrome - Xylazine and febantel induce emesis more Pathological Factors P450-mediated oxidation. However, cats readily in cats than in dogs. - Febrile states, organ dysfunction, have a limited capacity for glucuronidation, - Digitalis glycosides are less tolerated by cardiovascular and renal dysfunction leading to a higher risk of toxicity. cats due to increased sensitivity of feline affecting water balance and drug cardiac Na/K-ATPase to inhibition. distribution, and gastrointestinal disorders Therapy for Paracetamol Toxicity affecting drug absorption all impact drug - Supportive therapy and specific treatments Behavioral Differences disposition. like N-acetylcysteine, glutathione, and - The grooming behavior of cats increases - Inappetence in diseased cats is significant sulfate precursors can be effective. the likelihood of ingesting topically applied as dietary protein is an important source of - Cimetidine, a cytochrome P450 inhibitor, medications. This can be advantageous sulfate and other compounds used in phase may also be beneficial, though its use in when administering medications intended II drug metabolism in cats, making anorexic cats has not been evaluated. for ingestion, such as anthelmintic or cats more susceptible to adverse drug antibiotic paste preparations. reactions due to reduced drug metabolism. Phenytoin - However, cats are at greater risk of - An anticonvulsant with a prolonged half-life exposure to toxic topical substances like Drugs Not Recommended for Use in Cats in cats, leading to rapid accumulation and disinfectants (especially phenolics) or adverse effects like sedation, ataxia, and pesticides. Azathioprine anorexia. - Concentrated permethrin (insect repellant) - Although used to treat immune-mediated - Dermal atrophy has also been reported in a preparations can be lethal to cats if diseases in cats, serious bone marrow cat treated with phenytoin. ingested. suppression has been reported with doses used in dogs (2.2 mg/kg and 1.1 mg/kg on Propylthiouracil Other Physiological Factors Influencing Drug alternate days). - An antithyroid drug with a high incidence of Disposition - Severe, irreversible, and sometimes fatal serious side effects in cats, such as Other physiological factors that may influence drug leukopenia and thrombocytopenia have immune-mediated hemolytic anemia and disposition are similar in dogs and cats, including: been reported. thrombocytopenia. - Age - The recommended dose in cats is - No longer recommended, with methimazole - Pathology 1.5–3.125 mg per cat every 48 hours. being the drug of choice for feline - Chlorambucil is often used as an hyperthyroidism. alternative. Sodium Phosphate Enrofloxacin opioid receptors in cats and a decreased - Found in enemas used to treat constipation - A fluoroquinolone antimicrobial agent, with rate of metabolism. in humans and dogs, sodium phosphate acute retinal degeneration and potential - The recommended dose is 0.1 mg/kg enemas should not be used in cats due to blindness being species-specific toxicities subcutaneously (s.c.) or intramuscularly the risk of fatal hyperphosphatemia and reported in cats. (i.m.). other electrolyte imbalances. Furosemide (Frusemide) Organophosphates Drugs Therapeutically Useful in Cats but with - A loop diuretic, with cats being more - Widely used in the control of ectoparasites, Different Toxicity/Activity Profiles Compared to sensitive than dogs to its effects, particularly especially fleas in cats. Dogs sodium excretion. - Cats are more sensitive than dogs to the effects of organophosphates (OPs). Aspirin Griseofulvin - Toxicity: May be acute, chronic, or delayed. - Used in cats for managing osteoarthritis and - A fungistatic drug for dermatophytosis, with Chronic or delayed toxicity manifests as preventing thromboemboli. However, cats bone marrow suppression and neutropenia paresis or paralysis, which may or may not have a prolonged half-life of salicylate due being more common in cats, especially be reversible. to a deficiency in glucuronyl transferase, those with FIV. - Toxic epidermal necrolysis has been leading to prolonged hepatic clearance. reported in cats treated topically with Ketoconazole organophosphate-based flea rinses. Chloramphenicol - An antifungal drug with dose-related - A survey of the effects of flea collars in cats - A broad-spectrum antimicrobial drug with a gastrointestinal side effects in cats. revealed a high number of adverse longer elimination half-life in cats, requiring reactions, ranging from dermatitis to death. dosage adjustments. Reversible Lidocaine non-regenerative anemia is a potential side - Used to treat ventricular arrhythmias, with Tetracyclines effect. cats being more prone to seizures at - Bacteriostatic antibiotics with a broad therapeutic doses. spectrum of activity. Digoxin - In veterinary medicine, tetracyclines are - Used in the management of cardiac failure, Megestrol Acetate most frequently used for atypical bacterial with cats being more sensitive to - A synthetic progestogen with serious side diseases caused by Chlamydia (particularly digitalis-induced toxicosis. Dosage should effects in cats, including diabetes mellitus in cats), Borrelia, Rickettsia, be reduced, especially when used with and adrenal suppression. Haemobartonella, and Mycoplasma. aspirin and furosemide. - Tetracyclines are the drugs of choice for Morphine Ehrlichia canis and Rickettsia rickettsii Doxorubicin - Cats appear to be more sensitive to the infections. - Used in cancer treatment, with cats being effects of several opioid analgesics, - Adverse effects: Hepatic lipidosis, increased resistant to doxorubicin-induced particularly morphine. alanine transferase (ALT) activity, ptyalism, cardiomyopathy but susceptible to renal - Adverse effects: Inconsistent sedation and and anorexia. failure at dog doses. an increased risk of excitation due to - Cats are more susceptible than other differences in the type or concentration of species to tetracycline-induced  hepatotoxicosis due to their unique protein - Genetically engineered subunit Major Diseases with Vaccines Available for Cats metabolism and requirements. vaccines: Recently developed, such as those for feline leukemia virus, where the 1. Feline Distemper (Panleukopenia Virus) Vaccination relevant viral protein is produced in large - Symptoms include fever, vomiting, diarrhea, quantities by growth in bacteria. and seizures. It is usually fatal in young, Introduction - The use of inactivated vaccines in cats has unvaccinated kittens. - Vaccination has been successfully used for increased in recent years, partly due to the - The vaccine for this disease is one of the many years to control major infectious development of inactivated vaccines against four core vaccines recommended by diseases in cats. feline leukemia and improvements in veterinarians. - The main diseases against which cats are adjuvants. vaccinated include feline panleukopenia, - In some countries, modified live intranasal 2. Feline Herpesvirus-1 and Feline Calicivirus feline herpesvirus, and feline calicivirus vaccines are available against feline - The vaccines for these diseases can be infection. herpesvirus, feline calicivirus, and feline delivered with the same dose as the - Feline leukemia virus vaccines are also infectious peritonitis. distemper vaccine. used. - Recombinant vector vaccines: Developed - Also referred to as core vaccines, these are for use in cats, such as canarypox vectors designed to prevent two upper-respiratory Types of Vaccine incorporating either feline leukemia virus or infections in cats. - Cat vaccines generally comprise either rabies genes, offering potential advantages modified live or inactivated (killed) in safety and efficacy. 3. Rabies adjuvanted vaccines administered - Rabies infects the brain and nervous subcutaneously. Vaccination in the Philippines system. Disease-carrying mammals such as - Modified live vaccines: These have been - Kittens are prone to a number of illnesses bats or skunks can infect the cat through a attenuated or altered to eliminate or reduce and diseases, which can result from living bite. their virulence. Attenuation can be achieved with multiple pets or spending time - This disease is transmissible to humans and through serial passage in cell culture, outdoors. other mammals. genetic manipulation, or the use of a - Vaccinations are necessary to combat these naturally occurring apathogenic strain. Live contagious and potentially deadly diseases, 4. Feline Leukemia vaccines have the disadvantage of helping to build the body’s natural defense - Though not among the core vaccines, it is potentially causing disease and the risk of system and prevent the kitten from frequently recommended, especially for reversion to virulence. contracting these illnesses. outdoor cats and kittens. - Traditional killed vaccines: The whole - Vaccinations can be divided into two types: - This fatal virus can impair a cat’s immune agent is inactivated chemically. 1. Core vaccines: Recommended for system and cause certain types of cancer. - Subunit killed vaccines: Only certain parts all cats. of the agent are incorporated into the 2. Non-core vaccines: Administered 5. Cat Flu vaccine after disassembling it. Both depending on individual risk. - Caused by various pathogens, including traditional and subunit killed vaccines - Most vaccines are delivered through feline herpesvirus (FHV) and feline contain adjuvants to increase injection, but some can be administered calicivirus, cat flu affects the eyes, mouth, immunogenicity. nasally. and airways.  Vaccination Schedules - Rabies vaccines are typically a single dose Vaccine Factors - Most data sheets recommend primary given between 12 and 16 weeks, with - The bacterium or virus strain used in the vaccination for kittens, followed by annual revaccinations typically beginning after the vaccine may be incompletely attenuated or boosters. This regimen maximizes individual cat’s first year. inactivated. protection. - Unvaccinated adult cats or kittens older - However, concerns have been raised, than 16 weeks should ideally receive their Vaccine Error particularly with the increasing use of shots in 2 doses, 3 or 4 weeks apart. - Any vaccine site masses that persist for inactivated adjuvanted vaccines in cats and greater than 3 months following vaccination, the possible association with Vaccination of Kittens are greater than 2 cm in diameter, or are vaccine-associated sarcomas. - In some situations, earlier vaccination increasing in size 1 month after vaccination - Some authorities in the USA have schedules may be appropriate, such as in should be biopsied and, if malignant, designated certain vaccines as ‘core,’ cases of high disease risk or where kittens surgically excised. requiring: are deprived of colostrum. - Advanced diagnostic imaging to identify the 1. Primary vaccination as indicated by - However, vaccines are generally not full extent of the tumor is suggested before the manufacturer. licensed for use in younger animals, so care extensive surgical excision. 2. Revaccination 1 year later. should be taken in making a risk–benefit - If the mass is confirmed as a sarcoma, 3. Boosters every 3 years. assessment for the animal’s safety and radiotherapy and possibly chemotherapy - Core vaccines are designated based on the efficacy, and informed consent from the may also have some beneficial effects. severity of the infection (e.g., feline owner should be obtained. panleukopenia) or the high prevalence and - An alternative strategy to boost kitten Recommendations to Help Identify Causes, Aid transmissibility of the disease (e.g., feline maternal derived antibodies (MDA) is to Treatment, and Reduce the Prevalence of herpesvirus and feline calicivirus). vaccinate queens before breeding (or during Vaccine-Associated Sarcomas - In countries where rabies is endemic and pregnancy, if indicated on the data sheet). poses a significant zoonotic risk, rabies 1. Vaccines containing rabies antigen should vaccines are mandatory and considered Adverse Reactions be administered as distally as possible in core vaccines. - Include both recognized side effects, which the right rear limb. - Other vaccines are designated as ‘non-core’ are expected, and unexpected reactions. 2. Vaccines containing feline leukemia virus and should only be used following a - Some adverse reactions may be difficult to antigen should be administered as distally risk/benefit assessment. relate to vaccination, particularly if they as possible in the left rear limb. occur infrequently or long after vaccination. 3. Vaccines containing any other antigens Vaccination Schedule in the Philippines - Adverse reactions may be due to several except rabies or feline leukemia virus - Kitten vaccines should ideally be factors, including operator error, vaccine should be administered on the right administered when they are 6 to 8 weeks factors, and host factors. shoulder, avoiding the midline or old, with different vaccines (or doses of the interscapular space. same vaccine) given at intervals of 3 or 4 Operator Error 4. Vaccines should be given subcutaneously weeks until they are about 16 weeks old. - Vaccines may be administered incorrectly, rather than intramuscularly. - The timing of certain vaccines may vary such as using the wrong vaccine or route of 5. A core/non-core approach to vaccination depending on the particular vaccine. administration. with a risk–benefit analysis should be used.  6. Alternative vaccination routes, such as NOTES NOTES intranasal, should be used if possible. 7. Ensure medical records are kept of the date, site of injection, type, serial number, and manufacturer of the vaccine. 8. Report any adverse reactions to the appropriate authorities. Host Factors - Normal Biological Variation: Not all animals may respond fully to vaccines due to natural differences in biological responses. - Maternal Antibody Interference: In young kittens, maternal-derived antibodies (MDA) may interfere with the vaccine's effectiveness. - Immuno-suppression or Intercurrent Disease: A cat suffering from immune system suppression or concurrent diseases may not respond adequately to the vaccine's antigenic stimulation. - Overwhelming Infection: In some cases, a severe infection may occur, potentially worsened by poor husbandry conditions such as overcrowding or stress. - Carrier Status: The cat may already be a carrier of the disease, showing persistent or recurrent symptoms, which can complicate the vaccine's effectiveness. - Infection with Different Organisms: The animal might be infected with different pathogens than those included in the vaccine. For instance, respiratory diseases can have multifactorial etiologies, making it harder for the vaccine to provide complete protection.  2: Feline Vaccination Program All cases of rabies in cats result from lymphadenopathy, and sometimes coughing spillover from the reservoir species, as there and bronchopneumonia. Terms is no feline-specific variant of the rabies - Vaccination: The administration of an virus. - Giardiasis: An intestinal infection caused antigen (vaccine) to stimulate a protective by the protozoan parasite Giardia. immune response against an infectious - Feline Leukemia Virus: One of the most agent. This term is synonymous with common infectious diseases in cats. The Vaccine Administration immunization. virus commonly causes anemia or Injection: - Antigen: Any foreign substance that can lymphoma, but because it suppresses the - Vaccines are mostly administered through bind to specific lymphocyte receptors and immune system, it can predispose cats to injection. induce an immune response. deadly infections. - Needles must be clean and sterilized. - Vaccine: A suspension of living or - The injection site must be disinfected. inactivated organisms used as an antigen to - Feline Immunodeficiency Virus (FIV): Intranasal Administration: confer immunity. Attacks the immune system, leaving cats - Used against many pathogens of the - Immunity: The state of resistance to an vulnerable to many other infections. respiratory and gastrointestinal tracts. infection. Although infected cats may appear normal - Requires the generation of a mucosal for years, they eventually suffer from cellular or humoral immune response, which Common Feline Diseases and Terms immune deficiency, allowing normally varies by agent. - Feline Herpesvirus-1: A highly contagious harmless bacteria, viruses, protozoa, and virus that primarily causes upper respiratory fungi to cause severe illnesses. Vaccination Schedules tract infections in cats, with symptoms such Initial Series and Boosters: as rhinitis, sneezing, and conjunctivitis. In - Feline Infectious Peritonitis (FIP): An - Most vaccines require an initial series to some cases, it may lead to chronic signs. immune-mediated disease triggered by initiate protective immunity, followed by infection with feline coronavirus, which is revaccination (booster shots) at intervals to - Feline Calicivirus: Another key pathogen common in cats and transmitted via the ensure that immunity remains at an causing upper respiratory disease, notable oral-fecal route between felids. adequate level. for causing oral ulcerations. Some strains - Revaccination schedules depend on the may induce febrile lameness or subclinical - Chlamydia felis: A bacterial pathogen that duration of effective protection, which is infection and are also associated with predominantly causes conjunctivitis and has influenced by the specific antigen content, chronic gingivitis or stomatitis. also been associated with upper respiratory whether the vaccine consists of living or tract diseases. dead organisms, and its route of - Feline Panleukopenia: A highly infectious administration. disease with often high mortality, caused by - Bordetella bronchiseptica: An aerobic, feline parvovirus. Clinical signs include Gram-negative coccobacillus recognized as Frequency of Administration: lethargy, anorexia, vomiting, diarrhea, and a respiratory pathogen of several animal - Poor vaccines may require frequent fever. species. It causes upper respiratory tract administration, possibly every 6 months, to diseases with symptoms such as sneezing, maintain an acceptable level of immunity. - Rabies: A zoonotic disease caused by oculonasal discharge, submandibular - Modern vaccines usually produce Lyssavirus, commonly transmitted by bites. long-lasting protection, with revaccination  typically required every 3 years or in some NOTES cases, immunity may persist for a lifetime. Special Considerations - Age - Breed - Pre Existing Illness or Infection - Alterations of Immune Status Cat Vaccines 1. Rabies Vaccine: - Administered at 12-16 weeks of age. - Given annually or once every 3 years, depending on the type of vaccine. 2. FVRCP Vaccine: - A 3-in-1 vaccine for cats, preventing feline rhinotracheitis virus, calicivirus, and feline panleukopenia virus. 3. 4-in-1 Vaccine (FVRCCP): - Developed to combat four diseases, this vaccine protects against rhinotracheitis, calicivirus, panleukopenia, and chlamydia. Vaccination Side Effects (Mild) - Pain or swelling at the injection site. - Mild fever. - Decreased appetite. - Lethargy. More Serious Cat Vaccine Reactions: - Serious reactions are rare but can be part of an anaphylactic reaction, which is potentially life-threatening. - Symptoms include vomiting or diarrhea, facial swelling, hives, collapse, difficulty breathing, severe lethargy, and lumps at the injection site.  3: Feline Panleukopenia - Canine parvoviruses (CPV) type 2, which - Acute Cases: Show fever (104–107°F), cause canine parvoviral enteritis. depression, and anorexia. Vomiting usually Introduction - CPV strains (CPV-2a, -2b, and -2c) have develops 1-2 days after the onset of fever. - Feline panleukopenia is a highly contagious, been shown to cause a panleukopenia-like Diarrhea may or may not be present. often fatal, viral disease of cats that is seen illness in domestic cats and larger felids. - Subacute Cases: Display signs between worldwide. Kittens are affected most acute and chronic. severely. Feline panleukopenia is now Transmission - Subclinical Cases: Without clinical diagnosed infrequently by veterinarians, - Direct contact or from a contaminated manifestations. Detectable by presumably as a consequence of environment (feces, urine, saliva, licking, clinicopathological tests but not by a clinical widespread vaccine use. sneezing, or biting). examination. - Secretions and excretions. Other Names: - Fomites. Other Signs: - Feline Infectious Enteritis - Fleas and humans act as mechanical - The panleukopenia virus attacks and - Feline Parvoviral Enteritis vectors for this disease. destroys WBCs. - Feline Distemper - An infected cat often lowers its head over - Feline Ataxia Cats of all ages are susceptible to infection, the water bowl, thirsty but unable to drink. - Cat Plague especially: - Dehydration, lethargy, endotoxemia, - Free-roaming cats. bacteremia, cerebellar disease, and retinal Etiology - Kittens under 1 year old (mortality is highest defects. - Family: Parvoviridae – DNA virus family; in young kittens under 5 months old). - After an incubation period of 2–7 days, fever closely related antigenically to the Canine (40°–41.7°C), depression, and anorexia. parvovirus (CPV) type 2 and mink enteritis Pathogenesis - Vomiting usually develops 1–2 days after virus. - FPV enters through the oropharynx and the onset of fever. - Subfamily: Parvovirinae replicates in regional lymphoid tissues. - Extreme dehydration. - Genus: Protoparvovirus - FPV infects and destroys actively dividing - Terminal cases are hypothermic and may - Species: Feline panleukopenia virus cells in the bone marrow, lymphoid tissues, develop septic shock and disseminated All are now designated as members of the species intestinal epithelium, and—in very young intravascular coagulation. Carnivore protoparvovirus 1. They replicate in the animals—the cerebellum, cerebrum, retina, nucleus and form intranuclear inclusion bodies. and optic nerve. Physical Examination: - This is often a fatal disease. - Depression, dehydration, and sometimes Feline Panleukopenia Virus (FPV): - In pregnant queens, the virus may spread abdominal pain. - A non-enveloped, ssDNA virus that has transplacentally, causing embryonic - In cases of cerebellar hypoplasia, ataxia, established tropism for cells undergoing resorption, fetal mummification, abortion, or and tremors with normal mentation are mitosis in the tissue of the neonatal brain, stillbirth. seen. bone marrow, and intestinal lymphoid tissue. Clinical Signs Diagnosis - Peracute Cases: May die suddenly with - Clinical signs. Closely Related To: little or no warning. - Neutropenia is a more consistent finding - Mink enteritis virus than lymphopenia.  - Confirmed using an in-office - Whole blood transfusion to improve - The most effective means of prevention is immunochromatographic test kit intended pancytopenia. by preventing exposure to infected cats by for detection of fecal CPV antigen. keeping them indoors. - PCR test (polymerase chain reaction). Prevention - Yearly boosters should be given. - Raising antibody titer. - Kittens should be vaccinated between 8 and 10 weeks of age, then again after 12 to 14 Differential Diagnoses: weeks. 1. Salmonellosis. - Disinfection of food bowls, bedding, and 2. Infections with feline leukemia virus (FeLV). utensils is crucial as the virus can live on 3. Feline immunodeficiency virus (FIV). human clothing and shoes (fomites). A thorough disinfection of the entire premises Treatment and Prevention is necessary after an outbreak of feline - Fluid Therapy and Supportive Nursing Care panleukopenia in a home shared by cats. in the isolation unit. - The only disinfectant presently - B vitamins should be added to the infusion, acknowledged is a dilute bleach solution together with 5% glucose if hypoglycemia is (1:9 ratio, one part bleach to nine parts suspected or proven. water). - Whole blood is preferable for the occasional - Vaccination is critical, as even lions, tigers, cat that is severely anemic. minks, and raccoons are susceptible. - Parenteral, broad-spectrum antibiotic - Vaccinate kittens at 9, 12, and 16 weeks therapy is indicated; however, nephrotoxic old, and then again one year later. drugs (e.g., gentamicin, amikacin) should be - Inactivated and modified-live virus vaccines avoided until dehydration has been that provide solid, long-lasting immunity are corrected. available for prevention of feline - Antiemetic therapy (e.g., metoclopramide, panleukopenia. Live vaccines should not be ondansetron, maropitant) may provide some given to cats that are pregnant, relief and allow earlier enteral feeding of immunosuppressed, or sick, or to kittens soft, easily digested food. under 4 weeks old. - Recombinant feline interferon omega. - The virus can live in the environment for many years, so keeping all pet supplies Recommended Treatments: clean is essential. - Feline panleukopenia requires aggressive treatment if the cat is to survive, as this Client Education disease can kill cats in less than 24 hours. - Cats that survive the infection acquire - Vigorous fluid therapy. lifelong immunity. - Supportive nursing care in an isolated unit. - It is possible for kittens to receive immunity - Antibiotics to prevent or correct infection. from their mother through the transfer of - Medications to stop vomiting. antibodies.  4: Feline Leukemia Infections of wild free-ranging felids are rare and Age-Dependent Disease often associated with interactions with feral - FeLV is considered an age-dependent Feline Leukemia Virus (FeLV) domestic cats. Susceptible species include: disease: - Feline leukemia virus (FeLV) remains one of - Pallas’ cats (Otocolobus manul) - Young kittens are at higher risk of the most important infectious diseases of - Puma subspecies (e.g., the Florida progressive infection and more rapid cats globally. It manifests primarily through: Panther, Puma concolor coryi) disease progression. - Profound anemia - European wildcats (Felis silvestris) - Adults display some degree of age - Malignancies - Iberian lynx (Lynx pardinus) resistance. - Immunosuppression - Far-eastern leopards (Panthera pardus - However, transmission can occur at any orientalis) age. FeLV infects domestic cats and other species of - Far-eastern wildcats (Prionailurus - Factors affecting the clinical course of the Felidae. bengalensis euptilurus) disease are complex and incompletely - Sand cats (Felis margarita) understood. Etiology/Causative Agent - FeLV is a retrovirus in the family It is believed that ocelots (Leopardus pardalis), Clinical Features Oncovirinae. oncillas (L. tigrinus), and guignas (L. guigna) can - Exogenous Gammaretrovirus (enveloped, be infected but resist the development of clinical single-stranded RNA) enzootic to domestic disease. cats. - There are four FeLV subgroups of clinical Transmission importance. Almost all naturally infected - Persistently infected, healthy cats serve as cats are originally infected by: reservoirs of FeLV for both vertical and - FeLV-A: The original, archetypical horizontal viral transmission. form of the virus. - Horizontal transmission: Oronasal contact - FeLV-B: Increases the frequency of with infectious saliva or urine, direct contact, neoplastic diseases. mutual grooming, and shared litter trays and - FeLV-C: Strongly associated with food dishes. the development of erythroid - Vertical transmission: Occurs in utero or hypoplasia and consequent severe through nursing. anemia. - Tears and feces may contain the virus but - FeLV-T: Has the propensity to infect are not considered clinically significant in and destroy T lymphocytes, leading disease transmission or diagnostic Four Main Presentations of FeLV Infection: to lymphoid depletion and detection. 1. Feline lymphosarcoma immunodeficiency. - Infection through bite wounds is possible. 2. Feline myeloproliferative diseases and - The virus targets monocytes and anemia Epidemiology lymphocytes within oral or pharyngeal 3. Immunopathologic disease associated with Hosts: lymphoid tissues, which then migrate and FeLV infection - Domestic cats (Felis catus) transport the virus to peripheral tissues. 4. Feline fibrosarcoma Disorders Caused by FeLV - PCR is sensitive and typically regarded as a - Tenofovir 1. Anemia: Non-regenerative and confirmatory test. - Gemcitabine normochromic. - IFA may be used but is prone to false - Decitabine 2. Neoplasia: Lymphoma. positives. 3. Immunosuppression: Predisposes cats to Prevention and Control bacterial, fungal, protozoal, and viral Serological Tests: Environmental Control: infections. - Point-of-care ELISA screening kits for - FeLV virus is unstable in the environment 4. Immune-Mediated Diseases: Systemic FeLV’s viral capsid protein gp27. and is susceptible to all common detergents vasculitis, glomerulonephritis, polyarthritis, - Can detect gp37 in blood 1 month and disinfectants. and other immune disorders. post-exposure, but the test may need to be - In a hospital or boarding setting, infected 5. Reproductive Problems: Fetal death, repeated to ensure antigenemia was not cats may be kept in the general population resorption, and placental involution may missed. as long as they are housed in separate occur in the middle trimester of pregnancy. - May get discordant test results pending cages. 6. Enteritis variability in response to infection, time - Medical and surgical equipment 7. Neurologic Dysfunction since exposure, etc.; in these cases, contaminated with body fluids, even when 8. Stomatitis: Chronic ulcerative proliferative retesting is indicated. dried, can be fomites for infection. gingivostomatitis. - Thorough cleaning and sterilization of Differential Diagnoses equipment, strict attention to washing Diagnosis 1. Feline immunodeficiency virus (FIV) contaminated hands, and avoiding reuse 1. ELISA (Enzyme-Linked Immunosorbent 2. Feline infectious peritonitis (FIP) and sharing of single-use and consumable Assay) 3. Feline panleukopenia virus supplies between patients are critical 2. PCR (Polymerase Chain Reaction) 4. Hemoparasite infection (e.g., Mycoplasma practices to prevent iatrogenic transmission. 3. IFA (Immunofluorescence Assay) haemofelis) 5. Toxoplasmosis Medical Prophylaxis: Laboratory Diagnosis 6. Cataracts, glaucoma, retinal detachment - Vaccination may not be protective against Samples for Isolation of Agent: 7. Glomerulonephritis infection but may lessen the severity and - Lymphoid tissue 8. Non-viral lymphosarcoma progression of the disease. - Salivary gland 9. Non-viral fibrosarcoma - Inactivated, subunit, and recombinant - Intestinal tract 10. Multiple myeloma, myelophthisis vaccines (+/- adjuvant) are available for domestic cats and are effective for at least 1 Serological Tests: Treatment year following administration. - Whole blood In vitro studies using antiretroviral drugs have - Saliva yielded cautiously promising results suggesting Wild Felids: - Bone marrow virus-suppressing activity of FDA-approved drugs - It is unclear whether current FeLV used to treat HIV and other myelodysplastic vaccines—which utilize the gp27 Procedures syndromes against FeLV virus. subunit—are effective in wild free-ranging Identification of the Agent: felids. However, gp70 subunit vaccines - Virus isolation is possible but not often List of Antiviral Drugs: designed for domestic cats are successful in performed outside a research setting. - Raltegravir  increasing antibody titers in cheetahs, NOTES NOTES tigers, and servals. - Do not vaccinate already infected cats. - Identification and removal of infected cats in at-risk populations. - Do not allow neonates in captive facilities to nurse from infected mothers. - Avoid sharing communal food/water in captive facilities. Zoonotic Risks - Some strains of FeLV can be experimentally grown in human tissue cultures, leading to concerns about the potential for transmission to people. - Studies addressing this concern have shown no evidence that any zoonotic risk exists, and there are no known cases of zoonotic transmission. Potential Impacts of Disease Agent Beyond Clinical Illness Risks to Public Health - FeLV is not believed to be a health risk to humans. - FeLV is a potential threat to biodiversity and the health of wild free-ranging felid populations. Risks to Agriculture - There are currently no identified risks to the agricultural industry.  5: Feline Calicivirus (FCV) - Indirect Transmission: Indirect - Laboratory Diagnosis: Commercial labs transmission via infectious discharges and detect the presence of FCV in two ways: Etiology fomites is also possible. - Growing the virus in cells in a petri - Feline Calicivirus (FCV) is a highly - Virus Shedding: Lab tests have detected dish. contagious viral disease that causes mild to the virus in urine, feces, and blood. Cats - Reverse Transcriptase PCR severe respiratory infection and oral disease typically shed the virus for about two to (RT-PCR) to detect a segment of in cats. three weeks after infection, but some cats genetic material specific to - It is especially common in shelters and become long-term carriers. calicivirus. breeding colonies, often infecting young - Both tests are equally effective, though cats. Clinical Signs RT-PCR may be more common in some - Most cats recover completely after a - Incubation Period (I.P.): 3 to 4 days. areas. calicivirus infection, but rare strains can be - FCV replicates in epithelial cells of the especially deadly. upper respiratory tract, conjunctiva, tongue, Treatment - FCV and Feline Herpesvirus-1 (FHV-1) and in pneumocytes in the pulmonary Primary Therapeutics: account for about 80% of all feline upper alveoli. - Antibiotics: respiratory infections (URIs). Common Symptoms: - Mild to moderate disease: - FCV belongs to the family Caliciviridae, and - Sneezing amoxicillin (12.5 mg/kg q12h PO) or is a small, non-enveloped, single-stranded - Fever amoxicillin-clavulanic acid (15 RNA virus. - Nasal discharge mg/kg q12h PO). - Members of the Caliciviridae family infect a - Oral ulceration - Severe disease: azithromycin (10 wide range of vertebrate animals, including - Hypersalivation mg/kg q24h PO for 10 days) or rabbits, livestock, reptiles, birds, and - Anorexia (due to fever, oral ulceration, or clavulanic acid/amoxicillin plus a amphibians. nasal congestion) fluoroquinolone for outpatients. - Several strains of FCV circulate in domestic Duration of Symptoms: For Cats Resisting Oral Medications: and wild cats. - Symptoms can persist from five to 10 days - Cefovecin injection (8 mg/kg q24h SC) in mild cases and up to six weeks in more - Amoxicillin (12.5 mg/kg q12h SC) or Transmission severe ones. ampicillin (10-20 mg/kg q12h SC) plus - Direct Contact: FCV is primarily Complicating Infections: enrofloxacin (2 mg/kg q12h SC) for transmitted through direct contact between - Chlamydia felis and Mycoplasma felis can hospitalized patients. cats, involving oral and nasal secretions, also cause respiratory disease and may Hydration: IV fluids. nasal mucus, and eye discharge of infected complicate FCV infections. Nutritional Support: Orogastric or nasoesophageal cats. tubes. - Aerosol Droplets: The virus can also Diagnosis spread through aerosol droplets when cats - Primary Diagnosis: Based on history and Secondary Therapeutics: sneeze. clinical signs. - Ophthalmic Antibiotics - Routes of Infection: Infection occurs via - Secondary Diagnosis: - Nasal Decongestants: Use vaporizers and the nasal, oral, and conjunctival routes. - Polymerase Chain Reaction (PCR) saline nose drops to help clear nasal - Viral Isolation passages; oxymetazoline hydrochloride.  - NSAIDs: Non-steroidal anti-inflammatory NOTES NOTES drugs can lower fever and reduce mouth pain. Prevention - Vaccination: The Calicivax™ vaccine against feline calicivirus is the best way to prevent this condition. - Kittens should receive a vaccine every three to four weeks starting at six to eight weeks of age, with the final booster given after 16 weeks of age. - Quarantine: If multiple cats are present and one or more are being treated for FCV, quarantine the infected animals. - Clean food and water bowls, litter boxes, and other items that may be contaminated with the virus. - A dilute bleach solution (½ cup of bleach per gallon of water) is effective at killing the virus. - Cleaning solutions containing phenol, like Lysol, are also effective but should not be used around cats as they cause irritation and are toxic. Zoonotic Risks - The virus poses no threat to humans.  6: Feline Infectious Peritonitis (FIP) - Advanced Signs: unresponsive to antibiotics, leukopenia, and - Consistent lethargy and fever. non-regenerative anemia. Feline Infectious Peritonitis (FIP) - Progressive appetite suppression - Effusive Form: - FIP is a viral disease of cats, commonly and weight loss. - High suspicion with the same lab fatal, particularly affecting young cats from - Effusive Form: Abdominal distention due to findings plus yellow-tinged, mucous, shelters and catteries. FIPV occurs in two ascites or dyspnea due to pleural effusion. inflammatory ascites or pleural serotypes: - Ocular Signs: Uveitis (most common), iris effusion. - Type I: More likely to cause FIP. color change. - Immunohistochemical examination of cells - Type II - CNS Signs: Posterior paresis, in the fluid positive for viral antigens is incoordination, hyperesthesia, seizures, confirmatory. Etiology nerve palsies, convulsions, hydrocephalus, - High levels of FIPV RNA detected with - FIP is caused by FIPV, a virulent biotype of dementia, personality changes, nystagmus, real-time PCR. feline coronavirus (FCoV). The non-virulent head tilt, and circling. - Histopathology is confirmatory when form is the feline enteric coronavirus - Respiratory/GI Signs: Sneezing, watery pyogranulomas are revealed in a cat with (FECV), commonly found in healthy cat eyes, nasal discharge, and mild appropriate clinical, hematological, and populations worldwide. FECV can mutate gastrointestinal symptoms like diarrhea. serological findings. into FIPV, often involving a loss of the 3c gene, leading to a change in cell tropism Two Forms of FIP Secondary Diagnostics: from the apical bowel epithelium to 1. Wet (Effusive) Form: Non-granulomatous, - Aqueous Humor: Increased proteins and macrophages. Cats infected with FECV most common; involves visceral serosa, leukocytes. typically produce antibodies within 7-10 omentum, or pleural surfaces, characterized - Cerebrospinal Fluid: Increased proteins days. by fluid accumulation in body cavities like (>200 mg/dL) and leukocytes (>100 the abdomen and chest, leading to cells/uL, predominantly neutrophils). Transmission distension and difficulty breathing. - FCoV Antibody Tests: Titers >1:1600 are - FIP is believed to be transmitted via the 2. Dry (Non-effusive) Form: Granulomatous usually found in cats with FIP. fecal-oral route. Cats shed the virus in their or parenchymatous; involves abdominal - Rivalta's Test: Used to detect exudates in feces, and close contact with infected feces organs with less fluid accumulation and body cavities; a positive result indicates the can lead to transmission. more inflammation and tissue damage presence of proteins and inflammatory within organs like the liver, kidneys, and markers, consistent with effusive FIP. Clinical Features nervous system. - Incubation Period: Unknown in natural Rivalta’s Test infections; subclinical disease may persist Diagnosis - Rivalta’s test is a simple, inexpensive for months or years before overt disease Primary Diagnostics: diagnostic tool used to detect the presence onset. In experimental conditions, the - High suspicion in young cats from catteries of exudates, which are abnormal fluids with effusive form appears in 2 weeks, and the or shelters with the following signs: a high protein content, in body cavities. It is non-effusive form in several weeks. presence of uveitis or CNS signs, elevated often used in veterinary medicine to assist - Early Signs: Progressive lethargy, serum proteins, increased serum globulins, in diagnosing conditions like feline infectious intermittent fever, poor appetite, and weight decreased serum albumins, fever peritonitis (FIP). loss.  - If a cat has FIP, it might exhibit a positive - Breeding cats, especially those that have NOTES Rivalta’s test result due to the nature of the produced FIP kittens, should be carefully fluids that accumulate in the body cavities selected. during the effusive (wet) form of FIP. In this - Closed populations may see a decrease in form of the disease, fluid buildup occurs in FIP over about 3 years. the abdominal or thoracic cavities. This - Strict isolation of queens and their kittens, fluid, known as exudate, has a high protein with weaning at 4 to 6 weeks of age and content and a specific composition that continued isolation until 16 weeks. causes it to react positively to Rivalta’s test. - Quarantine measures: Separate quarters, - To perform Rivalta’s test, a few drops of separate litter, food, and water pans, acetic acid (vinegar) are added to a sample separate air space, and of the fluid collected from the body cavity. If change-in/change-out protective clothing. the fluid forms a jelly-like precipitate or - Reduce fecal-oral transmission by curdles, the test is considered positive, managing litter boxes and litter indicating the presence of proteins and replacement. inflammatory markers in the fluid, which is common in conditions like FIP. If the drop Prognosis disappears and the solution remains clear, - FIPV Prognosis: Grave. Euthanasia is often the Rivalta’s test is considered negative. recommended when the diagnosis is confirmed. Treatment - Primary Therapeutics: No treatment has Zoonotic Risks been consistently effective in curing FIP. - FIP poses no health risk to humans. No Management focuses on symptom relief, evidence of zoonotic transmission exists. supportive care, and addressing secondary infections. - Secondary Therapeutics: Investigational drug Polyprenyl Immunostimulant™ has shown some efficacy in controlling non-effusive FIP for up to 2 years in continuously treated cats. Prevention Proper management can significantly reduce FIP incidence: - Avoid overcrowding, longer shelter stays, and other kittenhood diseases (e.g., panleukopenia, viral respiratory disease).  7: Feline Immunodeficiency Virus Infection - Lymph node enlargement - If a cat reaches this phase, they become - Salivation immunocompromised and are susceptible to Feline Immunodeficiency Virus (FIV) - Weight loss secondary disease. - FIV is a virus found in domestic and wild - Abscesses - This usually occurs years after initial cats that attacks the immune system. - Decrease in appetite infection. - FIV leads to increased susceptibility to - Diarrhea - Symptoms related to secondary infections infections and other diseases. - Abortions or stillbirths are evident. - It can affect other parts of the body, - Chronic or recurrent infections (respiratory, including the gums, mouth, digestive tract, skin, bladder, eye) Terminal Phase urinary tract, and skin. - Conjunctivitis and uveitis - Once a cat reaches the terminal phase, the - Commonly referred to as "feline AIDS." - Weakness prognosis is approximately two to three - Seizures months. Etiology - Behavior changes - Signs include weight loss, persistent - FIV is a member of the Lentivirus genus, - Lymphoma or leukemia diarrhea, gingivitis or stomatitis, chronic belonging to the Retroviridae family. respiratory disease, lymphadenopathy, and - Six subtypes (A to F) have been well Stages/Phases of FIV in Cats chronic skin disease. characterized. Acute Phase - Oral or dental disease is common in the late - Subtypes A and B are the most common, - Signs are nonspecific and last several days stages of FIV. while subtypes C and F are less frequent in to weeks. - In some cats, the oral mucosa is ulcerated the United States and Canada. - Symptoms include fever, lethargy, and necrotic. depression, gastrointestinal dysfunction - Many cats present with neoplastic Transmission (stomatitis, enteritis), respiratory tract disorders, lymphoma, or various leukemias. - Biting: The most common way FIV spreads disease, and peripheral lymphadenopathy. among cats. The saliva of an FIV-positive - In some cats, the acute phase goes Diagnosis cat contains the virus, which can spread undetected. Primary Diagnostics through bite wounds. 1. Clinical Signs: Chronic disease states, - High-Risk Cats: Aggressive male cats that Asymptomatic or Latent Phase gingivitis or stomatitis, and minor infections are allowed to roam freely are most - This stage/phase can last for many years in (e.g., upper respiratory) that do not respond frequently infected. Cats that roam some cats. well to treatment. outdoors, male cats, and older cats are - As an asymptomatic carrier, the cat is free 2. Antibody Tests: Commercially available more likely to become infected. of clinical disease. ELISA test kits detect antibodies against - Vertical Transmission: From mother cat to - In later stages, signs reflect opportunistic major viral proteins (FIV-specific her kittens (though this is very rare). This infections, neoplasia, neurologic antibodies). Western Blot and can occur during pregnancy, birth, or dysfunction, or a general wasting syndrome. immunofluorescent antibody (IFA) tests are nursing. recommended for confirming positive ELISA Feline Acquired Immunodeficiency Syndrome tests. Clinical Signs (Feline AIDS) 3. PCR Assay: One commercial veterinary lab - Fever (IDEXX Laboratories, Westbrook, ME) offers - Lethargy a PCR test for FIV. It should be used as a  confirmatory test in cats that test antibody Advanced Treatment NOTES positive. It is reported to have 100% - Treatment with nucleoside analogues that sensitivity and 80% specificity. inhibit reverse transcriptase, such as AZT (Zidovudine) and PMEA (Adefovir), may Secondary Diagnostics reduce clinical signs but can induce anemia. 1. Complete Blood Count (CBC): Hematologic - Bicyclams bind to the FIV co-receptor abnormalities are nonspecific. Leukopenia, molecule CXCR4, thereby inhibiting viral neutropenia, and lymphopenia are common replication. Treatment with the bicyclam in the acute stage and reappear in the AMD3100 leads to a significant decrease in terminal stage along with nonregenerative proviral load in cats naturally infected with anemia. Neutrophilia or thrombocytopenia FIV and may be a useful therapy, but this are occasionally reported. treatment should not be combined. 2. Biochemical Profile: Hypergammaglobulinemia (increased Prevention and Control protein and globulins) is common. Azotemia The best way to prevent FIV in cats is to prevent may be seen, although the role of FIV in exposure by: causing renal disease is not yet clear. - Keeping your cat indoors - Spaying or neutering your cat Treatment - Keeping your cat separated from - There is no cure for FIV in cats. FIV-positive cats - Treatment options can help FIV-positive - Avoiding stress cats live a healthy life. - A whole inactivated virus vaccine has been - The mainstay of FIV treatment in cats available commercially in the USA since includes treating and preventing secondary 2002 and in Australia and New Zealand infections or diseases. since 2004. However, in Europe, it is not - Immunosuppressive drugs and steroids recommended since antibodies induced should be avoided. interfere with the serological diagnosis of - Some antiviral medications have been infection. shown to help FIV-positive cats with seizures or stomatitis, but they have not Prognosis been shown to prolong a cat’s lifespan or - The prognosis of FIV is variable and reduce the infection rate or severity. dependent upon the clinical stage at - Keeping an FIV-positive cat healthy includes diagnosis. routine parasite control, feeding a complete - Up to 50% of cats remain asymptomatic for and balanced diet, and visiting the 4 to 6 years following infection, and veterinarian every six months for routine approximately 20% will die during this time. exams and bloodwork. Zoonotic Risks - FIV poses no apparent public health risk.