Isolation

Question 1

Why do we have isolation protocols? (4)

Answer 1

1. Patient may be contagious to other animals
2. May be contagious to people
3. May be dangerous to humans
   - Radiation Tx
   - Chemo
4. Patent may need to be protected from hazards of facility (immunosuppression)

Question 2

What are universal precautions for isolation patients? (5)

Answer 2

1. Limit the number of staff allowed that come in contact with the infected animal
2. Practice good personal hygiene after all contact with a sick animal and contaminated surfaces
3. Use gown & gloves of any contact with the sick animal or contaminated
   - Items in iso do not leave iso
   - Items are patient specific
4. Contain & dispose of contaminated waste properly
   - Double bag!!
5. Enforce cleaning & disinfecting procedures for contaminated environmental surfaces

Question 3

Describe each level of isolation:
1. Green
2. Yellow
3. Orange
4. Red
5. Purple

Answer 3

1. No special precautions aside from normal animal husbandry & good personal hygiene
2. When condition of patient warrants segregation from other animals
3. Patients who are highly contagious to animals of any species but not the staff or general public
4. Most severe level
5. Conditions hazardous to people, but not necessarily a concern for other animals

Question 4

Isolation level Green (3)

Answer 4

1. No special precautions aside from normal animal husbandry & good personal hygiene
2. A typical hospital would operate in the green condition most of the time
3. Used to denote isolation space has been properly cleaned and disinfected after use and is now ready for the next patient.

Question 5

Isolation level Yellow (2)

Answer 5

1. When condition of patient warrants segregation from other animals, especially of the same species
2. Condition is not considered contagious to the staff or general public
   - Kennel cough
   - Feline URI
   - Fe Leuk

Question 6

Isolation level Orange (2)

Answer 6

1. Patients who are highly contagious to animals of any species but not the staff or general public.
2. Diseases such as these include Scrapie and Foot & Mouth disease (FMD)

Question 7

Isolation level Red (2)

Answer 7

1. Most severe level
2. Condition is not only contagious but zoonotic
   - Rabies
   - Lepto
   - Salmonella
   - Dermatophytes

Question 8

Isolation level Purple (2)

Answer 8

1. Conditions hazardous to people, but not necessarily a concern for other animals.
2. This typically includes chemo patients, radiation therapy, etc

Question 9

What does isolation communication entail? (3)

Answer 9

1. Use of special signs or label that alert staff of the condition.
2. Everyone should know what the signs and posters mean!! Helpful to poster describing each.
3. Place poster w description throughout practice, esp in entrances to patient wards

Question 10

Facts about chemical agents (6)

Answer 10

1. Most don’t work on organic debris (bleach)
2. Hard water may inactivate
3. Fresh solution made every few days
4. Sufficient contact time to work
5. Do not mix products
6. Do not apply directly to patient, use with care on equipment

Question 11

Parvosol and bleach need ___min contact time to kill parvo!

Answer 11

10 minutes

Question 12

Isolation procedures (8) (name 4/8)

Answer 12

1. Procedures should be utilized even for SUSPECTED cases! Such as URI, parvo, distemper, ringworm, salmonella, lepto, etc.
2. Separate room with separate air exchange
3. One-way flow traffic through hospital
4. Bleach in - Bleach out foot bath
5. All items into Iso until stay in unit (or discarded)
6. Dogs do not step on any surface people or animals will walk through
7. Staff caring for isolated animals must wear gowns & gloves at all times in unit and they stay IN UNIT. Minimal staff allowed.
8. Separate supplies for each animal in iso unit

Question 13

Canine Parvo Pathogenesis
1. Incubation period
2. Transmission
3. Once in bloodstream… (2)

Answer 13

1. 3-8 days, with shedding of the virus beginning on the 3rd day, before the appearance of clinical signs.
   - VOMITING 1ST SIGN
2. Thru direct contact with infected feces or indirectly thru fecal-contam fomites. May shed up to 3w follow infection & survive up to 9mo in contam area.
3. Once in bloodstream, virus will seek out rapidly dividing cells such as: bone marrow cells, lymphopoietic cells, & intestinal epithelium leading to viremia & further replication & lysis of these host cells.
   - Depletion of lymphocytes & compromised GI system may lead to bacteremia by normal gut flora, which can be FATAL

Question 14

Parvo signs & symptoms (4)

Answer 14

1. Initial signs:
   - Depression, Fever, Anorexia, Vomiting, & severe Diarrhea. Feces may be yellow-ish gray due to the presence of mucus or contain blood from hemorrhagic enteritis.
2. Dehydration is also common due to rapid loss of fluids thru vomiting & diarrhea. Some may experience both in projectile until death (48-72hrs following obvi signs)
3. Overlapping symptoms with parasite infections, stress colitis, or last meal disagreeable have led to accidental misdiagnosis.
4. Be sure to use correct diagnostic procedures to prevent misdiagnosis’s!!

Question 15

Parvo Diagnosis (3)

Answer 15

1. Extensive history based upon clinical signs
2. Positive fecal ELISA result to confirm
3. Newest diagnostic tools (PCR, electron microscopy)

Question 16

T/F: ELISA is the least effective tool for diagnosing Parvo

Answer 16

False!
Most effective tool for parvo Dx! However, it can be sensitive by some factors such as recent vaccination or onset of clinical signs and may lead to false pos/neg

Question 17

Prevention of Parvo (4)

Answer 17

1. Vaccinate pups at 8w & every 3-4w until 16w old
2. At risk breeds vax q. 4w until 6mo then annually
   - Rott, dober, pitties
3. Pups shouldn’t go to public spaces until vax complete
4. Pos animals should be quarantined
   - Will be contagious for 6w
   - Yard contagious for 3-6mo (min)

Question 18

Parvo control & prevention
1. Decontamination
2. Isolation

Answer 18

1. Absolute disinfectant is BLEACh at 1:30 dilution.
   - Use on hands, clothing, food/water bowls, toys, anything pup may come into contact with or reg contact
2. Infected animals must be isolated from healthy animals to prevent the spread of the virus.
   - High risk places: Dog shows, field trials, boarding, public spaces for dogs

Question 19

Feline Panleukopenia “Feline Distemper”
1. Etiology
2. Pathophysiology
3. Transmission (2)

Answer 19

1. Parvo virus (related to k9 parvo)
2. Virus attacks neonatal brain tissue, bone marrow, & GALT
3. Transmission:
   - Direct: Bite wounds, grooming
   - Indirect: Envir may be contam for years

Question 20

Feline Panleukopenia
1. Clinical Signs (5)
2. Treatment (3)
3. Prevention

Answer 20

1. Signs
   - Fever
   - Vomiting/diarrhea
   - Panleukopenia
   - Abortions
   - Cerebellar gait in surviving neonates
2. Aggressive supportive care
   - IVF
   - AntiB
   - Tx symptoms
3. Vax all kittens at 8, 12, & 16w of age

Question 21

T/F: Feline panleukopenia patients must be quarantined since it is a highly contagious disease

Answer 21

True!
This is an often FATAL disease and all body secretions contain the virus

Question 22

Canine Distempter
1. Etiology
2. Pathophysiology (4)
3. Transmission (3)

Answer 22

1. Paramyxovirus that is highly contagious but easily decontaminated
2. Pathophys:
   - Leukopenia
   - Vomiting/diarrhea
   - Enamel Dysplasia
   - Neuro signs
3. Transmission:
   - Aerosol (common in humane societies)
   - Fecal/urine-oral
   - Transplacental

Question 23

Canine Distemper
1. Treatment
2. Prevention (2)

Answer 23

1. Supportive care!
2. Prevention:
   - Vax as per other pup protocols
   - Quarantine all suspected animals

Question 24

Rabies
1. Incubation period
2. Three stages of clinical signs (3)

Answer 24

1. 3-8 weeks depending on species & site of viral entry
2. Stages
   - Prodromal: Changes in behavior, inappropriate for species
   - Furious: Hyperreactive, “Dumb” stuporous
   - Paralytic: Ascending paralysis & death

Question 25

Rabies How to decrease zoonotic risk (6)

Answer 25

1. Assume any animal with neuro signs, bite wounds, or unknown vax status may be a carrier 2. Wear gloves when working with these Pts 3. Quarantine procedures 4. Get vax if working with wildlife or zoo animals 5. If bitten by unknown vax status, report to Public Health 6. Brain examination of a fresh, not frozen, sample is only recognized definitive test for rabies in a biting animal.