infectious diseases n.
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INFECTIOUS DISEASES

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INFECTIOUS DISEASES

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  1. INFECTIOUS DISEASES ZOONOSES & VECTOR-BORNE DISEASES

  2. CASE #9

  3. PATIENT PRESENTATION

  4. PATIENT PRESENTATION • 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

  5. PATIENT PRESENTATION • 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

  6. PATIENT PRESENTATION

  7. DIAGNOSTIC TESTS • 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

  8. DIAGNOSTIC TESTS PNEUMONIA IS MOST COMMON IN NEONATALLY OR TRANSPLACENTALLY INFECTED CATS

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

  10. TRANSMISSION & LIFE CYCLE • 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

  11. 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

  12. 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

  13. TRANSMISSION & LIFE CYCLE

  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

  15. CASE # 10

  16. PATIENT PRESENTATION

  17. PATIENT PRESENTATION • 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.

  18. PATIENT PRESENTATION • 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

  19. PATIENT PRESENTATION

  20. DIAGNOSTIC TESTS • 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

  21. DIAGNOSTICS & TREATMENT • 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…

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

  23. DERMACENTOR ANDERSONI

  24. DIAGNOSIS & TREATMENT • 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

  26. CASE #11

  27. PATIENT PRESENTATION

  28. PATIENT PRESENTATION

  29. PATIENT PRESENTATION • 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.

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

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

  32. DIAGNOSIS • 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

  33. RHIPICEPHALUS SANGUINEUS

  34. DIAGNOSIS: another Ehrlichial disease to consider • CANINE GRANULOCYTIC EHRLICHIOSIS caused by Ehrlichiaewingii or Ehrlichiaequi • Clinical signs associated with Ehrlichiaewingiiinfection: • Fever • Lethargy • Lameness • Muscle stiffness • CBC: Thrombocytopenia • Blood smear: morulae found in neutrophils • Transmitted by the Amblyommaamericanumtick

  35. DIAGNOSIS: another Ehrlichial disease to consider • CANINE GRANULOCYTIC EHRLICHIOSIS caused by Ehrlichiaewingii or Ehrlichiaequi • Clinical signs of Ehrlichiaequiinfection: • Fever • Debilitating lethargy • Anorexia • CBC: thrombocytopenia • Serum chemistries: Increased ALP • Transmitted by the Ixodesdammini tick

  36. DIAGNOSIS

  37. DIAGNOSTIC TESTS

  38. TREATMENT & CLIENT INFO • ANTIBIOTICS • Doxycycline • Tetracycline • +/- blood transfusions • 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.

  39. CASE #12

  40. PATIENT PRESENTATION

  41. PATIENT PRESENTATION • 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

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

  43. PATIENT PRESENTATION

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

  45. PATIENT PRESENTATION

  46. LYME DISEASE • 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

  47. LYME DISEASE TREATMENT & CLIENT INFO • ANTIBIOTICS • Doxycycline is the treatment of choice for Borreliosis • Treatment may not completely eliminate the organism and some animals may remain permanently infected. • 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

  48. CASE #13

  49. PATIENT PRESENTATION

  50. PATIENT PRESENTATION • SIGNALMENT: 4 yr old, neutered male mixed breed. • 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.