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VETM 522 > Infectious (Feline Viruses) > Flashcards

Infectious (Feline Viruses) Flashcards

1
Q

You notice pleural effusion, tap it and find a protein rich transudate, what are your top differentials?

A

Pyothorax, Chylthorax, FIP, CHF (more of like water)

but pyo and chylo are more exudate

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2
Q

How do we best diagnose FIP in practice?

A

Rivalta test, Coronavirus PCR on effusion fluid, FIP virus isolation

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3
Q

What kind of virus is FeLV?

A

Gamma retrovirus = oncornavirus subfamily, it has a single RNA strand with protein core that has a specific antigen called P27.

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4
Q

How is FeLV transmitted?

A

Given through grooming or also fighting. Mainly via the saliva

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5
Q

FeLV given to _____ (friends or enemies); FIV given to______

A

Friends; enemies (L for LOVE). This means that FeLV is transmitted via social behaviours, mainly saliva, and FIV transmission is mainly via bite and fight wounds.

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6
Q

Is vertical transmission possible for FeLV?

A

Yes

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7
Q

What’s the typical signalement and history with FeLv cats?

A

Young kittens < 4 months old, adopted from a rescue and wasn’t tested, then exposed to naïve cats at home through grooming behaviours or biting. Could also mainly be male cats and outdoor cats, but ends up having abscesses and bite wounds visible

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8
Q

What percentage of cats will have an effective immune response to FeLV?

A

40% have an effective immune response

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9
Q

What is an ineffective immune resopnse to FeLV exposure?

A

Cat gets virus, we don’t know it is infected, if the immune system continues to be ineffective the animal will be viremic. During this transient viremia, you might get subtle cues of infection and fever. 30% of the cats will end up in the progressive infection stage where they shed virus and have a lot of disease. < often ones you see in clinics

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10
Q

What does it mean that 10-30% of cats are in the regressive infection state?

A

They are subject to stress or immunosuppression and the virus that was dormant in wakes up, but they don’t shed the virus and have a low incidence of disease (but still have the virus)

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11
Q

What is an abortive cat?

A

They are negative on all tests for FeLV, their immune system was able to eliminate the virus (40% of all cats) and they have a lifelong protection to FeLV

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12
Q

What is a regressive infection in cats related to FeLV?

A

The virus is in a regressive form (10-30% of cats) which means they will usually test negative on ELISA and IFA, but positive on proviral PCR tests. They do not shed, and have low disease incidence but have the virus circulating int hem

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13
Q

What is a progressive infection?

A

Persistent viremia affecting 30% of all cats, and shows up as positive on all tests

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14
Q

Both ______ (abortive, progressive, regressive) and ______ start from an ineffective immune response

A

progressive and regressive

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15
Q

How long can transient viremia last?

A

6-8 weeks

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16
Q

T/F: the shorter the viremia lasts, the more chances the cat can eliminate the virus

A

TRUE: this is why we retest after 8 weeks

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17
Q

During the transient viremia stage, is the cat infectious and shedding?

A

yes

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18
Q

Where does the virus FeLv replicate and how do you diagnose it?

A

Lymphoid tissue everywhere and GI. Can do a ELISA (shows positive), proviral PCR or IFA (shows up as negative)

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19
Q

In the viremic state, the virus replicates and the cat can be a healthy carrier, regressive, or progressive, describe what these mean

A

A healthy carrier is that it has no clinical signs but the virus replicates in it and it sheds transiently (rare), virus can sometimes become regressive which means inactive and will reactivate if immunosuppressed or under stress , progressive is bad because these are the sick cats we see in clinic that are shedding and not doing good. During viremia the cat is infectious and shedding.

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20
Q

Is the cat seen as sick in the regressive state? What would diagnostic tests show?

A

The cats rarely develop diseases in this state, it has enough of an immune response to keep the virus at bay most of the time. FeLV proviral DNA is integrated into the cat’s genome without any BM involvement. ELISA is negative, IFA is negative but proviral PCR is positive (not shedding and not infectious). It can revert to progressive state with stress as time goes on

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21
Q

How does the cat look in the progressive state and what do diagnostic tests say?

A

Cats are often sick, the virus goes to BM and in multiple organs. There is shedding and the cat is infectious. ELISA and IFA are positive, so is proviral PCR

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22
Q

What manifestations will we see with FeLV that may make the cat look really sick?

A

Infections (coinfections), anemias, lymphoma, leukpenia/thrombocytopenia, Leukemia

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23
Q

What clinical signs wll we see in most cases of FeLV?

A

No c/s (30%), weight loss (63%), fever (42%). Keep an eye on the oral inflammatory diseases as they have a highe chance of a seropositive test than healthy cats

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24
Q

What blood changes will we see on hematology? (RBC and WBC and platelets)

A

Regenerative anemia (from immune mediated hemolysis, mycoplasma coinfection, blood loss from thrombocytopenia), non-regenerative anemia (myelosuppression (virus in progressive state in BM), myeloproliferative disease, chronic inflammatory disease), Leukocyte changes (neutropenia, lymphopenia), platelet abnormalities (thrombocytopenia, thrombocytosis)

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25
Q

Cat with FeLV likely comes in with immune diseases, what are some examples?

A

Immune mediated hemolytic anemia, thrombocytopenia, polyarthritis, uveitis, glomerulonephritis (with immune complex deposition)

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26
Q

In non-regenerative anemia, we may see pancytopenia, which replaces the proteins with…..

A

Adipose tissue, making it have a poor response to treatments

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27
Q

How do neoplasias arise from FeLV? MOA

A

There is insertion of the FeLV proviral DNA into the genome near cellular oncogenes. Cats will have a 60 fold increased risk for developing lymphoma (23% of FeLV cats develop neoplasias and 95% of those are lymphomas)

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28
Q

What are types of malignant neoplasias that are developed from FeLV?

A

Lymphoma*, leukemia, fibrosarcoma, osteochondroma, olfactory neuroblastoma

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29
Q

What types of lymphomas are most common in FeLV cats?

A

Mediastinal/thymic, multicentric, alimentary, visceral (mainly mediastinal and multicentric)

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30
Q

Which cats should we test for FeLV and FIV?

A

Any sick cat (immune suppressed, oral inflammation, etc.), priod to adoption, exposed to FeLV/FIV, outdoor urban cats, unknown FeLV status, those living with positive cats

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31
Q

What tests are available to test for FeLV and FIV

A

ELISA antigen snap test, IFA, PCR.

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32
Q

How does the ELISA antigen test work?

A

done on plasma or serum (can do tears or saliva), looks to measure soluble p27 antigens created by the virus. If positive, cat has FeLV (100% sensitive) but it could actually clear the virus

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33
Q

T/F: maternal antibodies intere with ELISA antigen testing

A

False: maternal antibodies do not interfere with this test

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34
Q

If you test a suspected FeLV cat with ELISA and it shows up as positive, what do you do?

A

Don’t euthanize it, restest in 6-8 weeks and they might end up negative cause the animal clears the virus (40% have this chance), if they are positive twice then they probably have it. You could check the positives with IFA ( not common anymore), which checks for the progressive state in bone marrow.

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35
Q

If the ELISA test is FeLV negative and cat is less than 12 weeks old… do we trust it?

A

If the cat is <12 weeks old, the test sensitivity decreases, if the exposure was <30 days the virus could be in a pre-viremic phase. You need to do a retest to make sure it is truly negative.

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36
Q

Using the ELISA SNAP test measuring soluble p27 gag protein in plasma, serum, whole blood, saliva, tears… which samples cause a false positive and negative?

A

False positive with whole blood, false negative with saliva and tears

37
Q

How long does it take for the viral load to reach a level testable by the ELISA snap test?

A

30 days of viral exposure

38
Q

What does IFA test for?

A

it’s a specific test that detects the p27 gag protein in the bone marrow after virus replication

39
Q

Describe what the abortive cat, transient viremia, regressive infection and progressive infected cat would show on ELISA

A

Abortive cat = negative on all tests, Transient viremic cat = positive ELISA and proviral PCR, Regressive infection cat = negative IFA, usually negative ELISA, positive proviral PCR, progressive infection cat = positive on evertything. Also with a viremic healthy carrier it will show as positive ELISA, IFA and proviral PCR

40
Q

How do we care for a FeLV+ healthy cat?

A

Keep indoors only, neuter it, PE and CBC twice yearly, perioperative antibiotics for surgeries and dentals, avoid raw food, vaccinate with core killed vaccines.

41
Q

How do we care for a FEeLV+ sick cat?

A
  • Treat the concurren diseases since it’s getting enias, it will get sick from opportunistic infections,
  • blood transfusions,
  • erythropoietin, darbepoietin (stimulate BM RBC production),
  • Filgrastim (Neupogen) helps with neutropenia but $$$$ (tells BM to do its job and raise WBC count),
  • Chemotherapy (for confirmed lymphoma) but it suppresses immune system
42
Q

What drugs can we use to help treat FeLV + sick cats?

A

Zidovudine (AZT) = first HIV drug, blocks retroviral resverse transcriptase. Human interferon-alpha < studies show it does nothing, feline interferon omega helps stimulate immune system but isn’t available in NA and is effective for secondary infections

43
Q

What’s the most important factor to stopping FeLV outbreaks?

A

Vaccination, do a test prior to vaccination if you’re sus…, it’s a killed vaccine so we don’t know how effective it is. It won’t avoid viremia, but it won’t be as severe if the cat gets it. FeLV is not a core recommended vaccine, so vaccinate the at risk cats.

44
Q

Will vaccination cause a positive FeLV test result?

A

Since it’s an antigen test, it won’t be positive on the test

45
Q

What must you ask the owner about if you’re suspecting FeLV?

A

Ask about retrovirus status and if doubtful test and retest

46
Q

So your cat comes in, it’s ELISA: is FeLV+ and IFA is FeLV+, what treatments we giving to start?

A

Dexamethasone and L-asparaginase (chemotherapy drugs)

47
Q

What kind of virus is Feline immunodeficiency virus?

A

Lentivirus

48
Q

How is FIV transmitted?

A

FIV is for ENEMIES: it exists in salivary epithelium, saliva, lymphocytes, plasma and serum. You transmit it via biting and fighting mainly. Vertical transmission is possible

49
Q

Can you get rid of FIV?

A

Nope, there’s no immune system to remove it and if you get it, it spreads to every inch of the body. You can’t clear this one at all

50
Q

What is the pathogenesis of FIV influenced by?

A

Age of cat at time of infection : younger cats will get sick faster, medium age cats get sick slower.

51
Q

What’s the hallmark of FIV pathogenesis?

A

progressive disruption of normal immune function

52
Q

Describe the pathogenesis of FIV

A

You get viral particles that are cleared by tissues rich in macrophages, it targets the lymphoid organs and replicates then messes up the immune system and disrupts cytokine productions. Eventually you get progressive immune dysfunction.

53
Q

T/F: FIV ELISA tests for antigens, same as FeLV

A

False: it’s an antibody test (not antigen test), but same ELISA

54
Q

Can FIV affect the CNS of these cats?

A

Yes it manifests as neurologic signs

55
Q

What happens after viremia levels hit a peak in the cat?

A

Circulating virus levels will decrease to low levels after the peak because the host mounts an ineffective immune response to FIV. Antibodies are produced against the FIV proteins, at this time cats enter a clinically asymptomatic period of variable duration (prone to opportunistic infections or wasting). At this level, plasma levels of virus and viral RNA can increase again during terminal phase of infection.

56
Q

What manifestations come with FIV?

A

Lymphadenopathy, Uveitis, conjunctivitis, Dermatitis, Stomatitis (30%), abscesses, URI, chronic kidney disease, neoplasia

57
Q

What clinical signs will we see with FIV?

A

Fever (36%), , neuro signs, weight loss/emaciation (51%), diarrhea

58
Q

What’s a common finding with FIV?

A

Stomatitis is a common finding with gingivitis, chronic, ulceroproliferative, mucosa invaded by plasma cells, lymphocytes, inflammatory cells, we don’t know why it happens

59
Q

What will we see on CBC with an FIV cat?

A

Neutropenia, lymphopenia, anemia, thrombocytopenia

60
Q

What will we see on FIV chem panel?

A

Azotemia (from FIV associated CKD: sometimes FIV leads to chronic kidney disease faster and we think it’s due to immune complexes in the kidney tubules), hyperglobulinemia

61
Q

How does the ELISA snap test work for FIV?

A

You test it on the serum, it detects FIV-specific antibodies. But if you vaccinate the cat, it interferes with this and causes false positive in acute phases and end stages.

62
Q

Do maternal antibodies interfere with the FIV antibody test?

A

yes

63
Q

How important is age to diagnosis of FIV?

A

< 6 months, likely maternal antibodies if seeing a positive on ELISA and retest it when animal is > 6 months. If you get positive on a cat that is > 6 months, use a western blot or PCR and if it is negative then retest in 60 days and if positive then it is infected

64
Q

What do I do with my cat who tested negative for FIV but it was in contact with positive FIV cats?

A

Retest in 60 days after exposure to allow for time for seroconversion

65
Q

What are some organs and tissues that FIV will infect?

A

LN, thymus, intestinal tract, liver, bone marrow, kidney, CNS, lung, skeletal muscle

66
Q

What is the prevalence of Neoplasia development after FIV infection?

A

It’s a higher risk than for a retrovirus negative cat, but it’s less than FeLV. Still an increased risk and lymphoma is again the neoplasia we most often see

67
Q

What are some treatments for FIV?

A

Antivirals (AZT improves stomatitis along with antibiotics), complete dental extractions (for cases with stomatitis), human interferon alpha or omega (not available and we don’t know if it’s effective)

68
Q

What are some management strategies for FIV?

A

Keep cat indoors, reduce stress, regular physical exams, vaccinate for other infectious diseases since you can’t vaccinate for FIV in north america (not available), isolate infected cats from healthy ones

69
Q

Which has a better prognosis, FIV or FeLV?

A

FIV > FeLV, but both diseases cause immune dysfunctions and can lead to higher rates of cancer, but FeLV is worse

70
Q

What is FIP?

A

Feline infectious peritonitis is an immune mediated disease caused by a mutation of feline coronavirus (FCoV)

71
Q

Is coronavirus commensal or not?

A

Coronavirus is commensal in GI of cats, transmitted by feco-oral routes, it’s super prevalent and replicates in the enterocytes. Causes few clinical signs initially some diarrhea, maybe fever, decreased appetite then disappears. It is when the 5% mutate and develop ability to leave gut that it becomes a problem

72
Q

Why is the “infectious” part of FIP misleading?

A

It isn’t contagious, but you can have at least 50% of cats with this

73
Q

The mutation of FIP coronavirus allows it to….

A

replicate in macrophages and leave the organs that house poop.

74
Q

What are 3 possibilities that can occur if FIP mutates in the cat enterocytes?

A
  1. Body can clear it via cell-mediated responses (not super common), Dry form = granulomatous lesions form with immune complexes, wet form (most common) = vasculitis, effusion in pleural or abdominal space
75
Q

What might a cat come in with if it has FIP?

A

Fever, uveitis, abdominal distension, dyspnea, tachypnea, muffled hear sounds, weight loss, anorexia, icterus, enlarged LN, neuro signs, irregular organs.

76
Q

What’s the typical signalement of FIP?

A

Young cats (3 months - 3 years), old cats (> 13 years), male intact cats and purebreds. Rule of 3 = 3 months, 3 years, 13 years

77
Q

How are we looking for on CBC to say it could be FIP?

A

Lymphopenia, non regenerative anemia, thrombocytopenia < all match FeLV and FIV but still test

78
Q

What might we see on chemistry panel if it’s FIP?

A

Hyperglobulinemia!! (50% effusive form, 70% dry form), mainly gamma globulins. Hyperproteinemia, albumin/globuin ratio < 0.8 (very suggestive of it), hyperbilirubinemia

79
Q

T/F: sometimes we will see proteinuria on urinalysis

A

TRUE

80
Q

What are we looking for on imaging for FIP?

A

effusion to sample and granulomas for the dry form

81
Q

Which type of protein goes up while the other one stays?

A

Globulins go way up during hyperglobunemia, albumins go down due to negative acute phase. Body says there are too many proteins cause of the lower albumin but it can’t change the globulins.

82
Q

Explain the Rivalta’s test to diagnose FIP

A

simple, inexpensive, only good for wet form. If drop floats = modified transudate (super high protein rich) = positive

83
Q

What is the fecal coronavirus antibodies test?

A

PCR test, but problem is that all cats have coronavirus, it’s not super helpful

84
Q

How do you analyse the effusion of FIP?

A

high protein count > 3.5 g/dL, low cellularity (<5000 nucleated cells/ml) (protein rich transudate most common but can also be exudate). May see a pyogranulomatous effusion (yellow, pus like fluid that’s really viscous = FIP)

85
Q

How does the RT-PCR on abdominal or thoracic effusion work?

A

You can only submit this for the wet form, coronavirus shouldn’t be in monocytes and macrophages and definitely not in effusion. False negatives possible. 100% reported positive predictive value.

86
Q

What does IHC staining do for FIP diagnosis?

A

FCOV antigens are in the macrophages so this can detect that

87
Q

What’s the treatment for FIP?

A

no specific treatment, very poor prognosis (death in a few days). Nucleoside analogues (Remdesivir, GS-441524 and has a great imrpovement rate. Relapse is common, but is currently not legally available in Canada

88
Q

How do you prevent FIP?

A

Hard, most cats have enteric coronavirus. Wait 3 months before adopting if previous FIP. It’s hard to prevent transmission if you already have a positive cat at home.

VETM 522 (11 decks)

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