WHAT DO YOU NEED TO KNOW ABOUT FELINE INFECTIOUS DISEASES ?

2. WHAT DO YOU NEED TO KNOW ABOUT FELINE INFECTIOUS DISEASES? FANAN SUKSAWAT DVM, MS, PH.D

3. FELINE INFECTIOUSDISEASES Causative agents FVRFCVPCFeLVFIPFIV Chlamydophila Coronavirus Parvovirus Feline immuno-deficiency virus Feline leukemia virus Cat flu Calicivirus Herpesvirus

4. FELINE INFECTIOUS DISEASES Causative agents Chlamydophila spp. Bartonella spp. Toxoplasma gondii Cryptococcus spp.

5. Scope of this talk Characteristics of each disease Diagnosis Vaccination Potential interferon application

6. FELINE PARVOVIRAL INFECTION FELINEPANLEUKOPENIA Syn: feline distemper, feline infectious enteritis, cat fever and cat typhoid

7. FELINE PARVOVIRUS, PANLEUKOPENIAcharacteristics diarrhea DIC feline ataxia syndrome Cerebellar hypoplasia

8. Less prevalent nowadays • Widely vaccinated • Virus adjust to cats • CPV to cats..Ab crossprotect to FPV

9. diagnosis FELINE PANLEUKOPENIA • clinical signs, and the presence of leukopenia • Leukopenia (severe: 50-3000 at D4-D6, mild: 3000-7000 cells/ul) • Thrombocytopenia • confirmed by necropsy examination virus isolation identification of the virus infected tissues Serology (Ag, serum, feces, 24-48 hrs after infection) serological tests do not differentiate between infection- and vaccination-induced ab. CPV Kit

10. Vaccination * MLVin <2 m of age

12. FELINE CORONAVIRUS INFECTION Feline Infectious Peritonitis, FIP

13. More prevalent • farm raised • indoor raised • inbred

14. FIPcharacteristics • effusion • systemic serositis • fibrin on internal organ’s surface • granuloma • peritonitis

15. http://www.vetmed.wsu.edu/courses_vm546/Content_Links/DfDx/Cat%20Case%204/systemic_diseases.htmhttp://www.vetmed.wsu.edu/courses_vm546/Content_Links/DfDx/Cat%20Case%204/systemic_diseases.htm Wet FIP Dry FIP

16. Wet acute 4-8 wks, C’ fixation increases permeabilityDry chronic, months to years, CMI

17. FIPdiagnosis Good clinical skills- signs history environment Serology IS NOT THE BEST! Biopsy Immunohistochemical immunofluorescent staining of gut biopsy RT-PCR good but negative doesn’t mean FIP ruled out

18. WHY SEROLOGY IS NOT THE BEST IN FIP? • Either healthy and sickcats with disease other than FIP have FCoV antibodies • Effusive FIP cats have low titers or negative.. Ab bind to lots of viral Ag in effusion not many left to bind with Ag in the test • The presence of FCoV antibodies alone is NOT diagnostic of FIP, if the other parameters of the profile do not indicate a diagnosis of FIP

20. Rivalta’s test 1. Mix 8 ml of distilled water with one drop of 98% acetic acid 2. Carefully place one drop of the pleural or abdominal fluid on the surface + if the drop adheres to the surface and hangs like a jellyfish...85% positive predictive value for FIP - If the drop mixes with the solution and falls to the bottom…nearly 100% negative predictive value

21. Lab results • A:G of < 0.4 indicates FIP is quite likely • A:G of >0.8 rules out FIP • A:G of between 0.4-0.8 is inconclusive consider other parameters

22. Lab results modified transudate.. total protein> 35g/l ..<5000 nucleated cells effusion color:clear straw viscous froth when shaken may clot when refrigerated

23. Cytology effusive FIP generally < 3 x 109 nucleated cells/L in the effusion Neutrophils macrophages predominate Cytology of pleural effusions is useful for differentiation of thymic lymphosarcomas

24. GP level • alpha one acid glycoprotein (AGP) is an acute phase protein which has been shown to be very useful in distinguishing FIP from other clinically similar conditions • In FIP, AGP levels are usually > 1500 µg/ml) (normal range 500 µg/ml) )

25. Conclusions wet FIP • FCoV seropositive • total protein of the effusion >35g/l • A:G < 0.4 (or at least less than 0.8) • AGP >1500 µg/ml) • cytology should reveal few nucleated cells which are mainly neutrophils and macrophages • Rivalta test should be positive • Diagnosis can be confirmed by detecting FCoV in the macrophages in the effusion

26. Dry FIP Conclusions • high FCoV antibody titre • be hyperglobulinaemic and have a reduced albumin:globulin ratio • high AGP, lymphopenia, PCV < 30%, non-regenerative anemia and possibly a neutrophilia • lost weight and ocular signs such as iritis, retinal vessel cuffing, keratic precipitates, aqueous or vitreous flare

27. Vaccination • Non-core • Primucell® -type 2 attenuated virus • intranasal • >4 mold..booster 3-4 wks later and annually • can be used in FeLV cat • safe in pregnanted cats • Primucell doesn’t cause ADE

28. FELINE LEUKEMIA VIRUS (FeLV)characteristics leukemia non-regenerative anemia fadding kitten syndrome infection after birth-thymus atrophy-immunosuppression anorexia i

29. FeLVdiagnosis • Serology detect FeLV core protein p27Ag ELISA immunochromatographic assays (ICGAs) direct FA test recheck 90 days after exposure/previous test Free soluble Ag in serum and plasma, tear saliva? Ag in cytoplasm

30. In some insituations Ab can’t be detected • Abortive infection • FeLV induced malignant cell clonebut not permanently in genome and destroyed earlier • FeLV infected cells that the body can’t detected • Ab cannot be detected in B cell lymphoma but T cell lymphoma • 70-94% of cats with mesenteric lymphomacan not detected Ab • Therefore, use Ag testing forFeLV

31. FeLV status of all cats should be known • Testing and identifying positive cats is the mainstay of managing this disease • All new kittens and adult cats should be tested before introduction into any house • Kittens can be tested at any age • FeLV vaccine does not interfere with the FeLV test • ELISA test is the preferred screening test

32. Viral isolation • PCR..strain specific when retrovirus mutation but good to detect latent infection

33. Vaccination • all cats at a potential risk of exposure should be vaccinated at the age of 8 or 9 weeks and repeat at 12 weeks • Annually booster • >older than 3-4 yrs, booster 2-3 years interval • Use killed vaccine because MLV can cause disease

34. Vaccination of immunocompromised cats • The vaccination of FeLV-positive cats against FeLV is of no benefit whatsoever • FIV infection should be vaccinated against FeLV infection, but only if they are at risk • As the immune response in immunocompromised cats is decreased, more frequent boosters may be considered (in asymptomatic cats)

35. FELINE IMMUNODEFICIENCY VIRUS, FIVcharacteristics • Immunodeficiency • Stomatitis • Tumor

36. Signs at terminal stage

37. AC stage ARC stage FIV ARC stage AID stage

38. Dermatological Chronic abscesses Chronic gingivitis Chronic stomatitis Periodontitis Pustular dermatitis http://www.whitecourtvet.com/material/FIVcats.htm

39. Gastrointestinal Chronic diarrhea Weight loss Immunological Anemia Leukopenia Lymph node hypoplasia Lymph adenopathy Lymphosarcoma

40. Neurological Behavioral changes Dementia (mental deterioration) Facial twitching Peripheral neuropathies Psychomotor abnormalities Seizures

41. Ocular Cataracts Conjunctivitis Glaucoma Keratitis

42. Reproductive Spontaneous abortions and stillbirths Upper Respiratory Chronic rhinitis

43. FIVdiagnosis Serology is Mainstay Ab: ELISA, Rapid immunomigration-type assay best confirm with westernblot Using serum better than whole blood *Ab from vaccine interfere when vaccinated with different subtype *false positive.._early stage of the disease- Ab from mother-recheck 6-8 weeks after *false negative.. late stage of disease

44. FIVinterpretation of serology results • After vaccination, 2-3 weeks, Ab. detected and last for 4 years • After infection, 8, 10 weeks to 6 months to have Ab. • Mistake: Cats vaccinated with one type of virus, get infected with the other but interpreted as false positive maternal immunity • Be aware of interpretation serology results in cats younger than 6 months old,, detect at age of >6 month

45. FIVdiagnosis • FIV Antibody test • Viral isolation • PCR, false negative from strain specific • AAFP recommends testing all cats being introduced into a household to prevent exposing any existing cats to the virus

46. Misdiagnosis of FIV in uninfected cats may lead to the inappropriate euthanasia of vaccinated cats or kittens from vaccinated mother

47. Vaccination • Fel-O-Vax vaccine, killed vaccine • 5 clades of FIV virus • The virus in the vaccine is not the virus that is commonly causing FIV • Fibrosarcoma risk • For FIV cat, used killed vaccine for other disease protection http://www.newvaccinationprotocols.com/Cat%20Recommendations.htm

48. CAT FLU • Herpesvirus • Calicivirus • Reovirus • Cowpox • Bordetella bronchiseptica • Chlamydophila felis • Mycoplasma

49. CAT FLUcharacteristics Ulcer in oral cavity Sneezing conjunctivitis

50. PREDISPOSING FACTOR • Crowded environment