Veterinary Medicine - Infectious diseases Flashcards
(181 cards)
1
Q
What disease is caused by Erlichia Canis?
A
CME - Canine Monocytic Ehrlichiosis
2
Q
Canine Monocytic Ehrlichiosis (CME) - Blood Smear - Possible findings
A
Activated monocytes
In 5% of cases (Extremely low sensitivity) - Morulas of Ehrlichia can be found in the cytoplasm monocytes at the feathered edge
3
Q
Canine Monocytic Ehrlichiosis (CME) - Name 3 predisposed breeds and to what particular stage of the disease are they predisposed?
A
German shepherd, Husky, Malamute
4
Q
Canine Monocytic Ehrlichiosis (CME) - Which lab finding can be found across all disease stages?
A
Thrombocytopenia
5
Q
Canine Monocytic Ehrlichiosis (CME) - How long after infection are anti-platelets antibodies formed?
A
5 Days
6
Q
From what platelet count you might start seeing spontaneous bleeding due to thrombocytopenia?
A
<30,000
7
Q
Canine Monocytic Ehrlichiosis (CME) - Diagnosis - How can serology be useful in determining Ehrlichia Canis is the cause for the dogs current illness?
A
Seroconversion (4x) over a period of 2 weeks
8
Q
Ehrlichiosis - Diagnosis - In general serology is more useful for Ruling Out Ehrlichiosis (T/F)
A
True
9
Q
Canine Monocytic Ehrlichiosis (CME) - Treatment - At what stage of the disease Steroids might be useful?
A
Chronic stage
10
Q
Canine Monocytic Ehrlichiosis (CME) - What is the vector?
A
Tick - Rhipicephalus sanguineous
11
Q
Canine Monocytic Ehrlichiosis (CME) - Transmitted transovarially/transstadially?
A
Transstadial
12
Q
Canine Monocytic Ehrlichiosis (CME) - What is the target cell for Ehrlicia Canis
A
Macrophages\Monocytes
13
Q
Canine Monocytic Ehrlichiosis (CME) - How long does it take for an infected tick to transmit E.Canis to an animal after it started feeding
A
3 Hours
14
Q
Canine Monocytic Ehrlichiosis (CME) - In what season do you see the most cases of E.Canis (Acute stage)
A
Summer months
15
Q
Canine Monocytic Ehrlichiosis (CME) - Incubation period
A
1 - 3 Weeks
16
Q
Canine Monocytic Ehrlichiosis (CME) - Chronic - What are the main 2 causes of death?
A
Sepsis
Anemia
17
Q
Canine Monocytic Ehrlichiosis (CME) - Acute phase - Clinical signs
A
Lethargy
Anorexia
Fever
Lynphadenomeglay
Splenomegaly
Petechiae, ecchymoses
Melena/hematochezia, Pigmenturia, Epistaxis
Uveitis
Lameness
18
Q
Canine Monocytic Ehrlichiosis (CME) - Acute phase - Common lab findings
A
Leukocytosis/Leukocytopenia
Monocytosis
Thrombocytopenia (Mild-moderate)
Blood smear - Activated monocytes +- Morulas
19
Q
Canine Monocytic Ehrlichiosis (CME - Acute phase - Duration
A
1-4 Weeks
20
Q
Canine Monocytic Ehrlichiosis (CME - Sub-clinical phase - Duration
A
Months-years
21
Q
Canine Monocytic Ehrlichiosis (CME) - Sub-clinical phase - Common lab findings
A
General progression towards Pancytopenia: Leukopenia
Possible anemia (mild non-regenerative)
Thrombocytopenia
22
Q
Canine Monocytic Ehrlichiosis (CME) - Sub-clinical phase - Clinical signs
A
None
23
Q
Canine Monocytic Ehrlichiosis (CME) - Chronic phase - Clinical signs
A
Lethargy
Anorexia
Fever
Pale mucosal membranes
Lymphadenomeagly
Splenomegaly
Petechiae, ecchymoses, Epistaxis
GI Signs
CNS signs
Uveitis
Retinal separation
Lameness
24
Q
Canine Monocytic Ehrlichiosis (CME) - In what stage of the disease do most owners bring their dog to the vet for the first time (Acute/Sub-clinical/Chronic)
A
Chronic stage
25
Canine Monocytic Ehrlichiosis (CME) - Chronic phase - Lab findings
Pancytopenia (Anemia, Leukopenia, Thrombocytopenia)
Hypoalbuminemia
Hyperglobulinemia (Polyclonal)
Mild elevation of liver enzymes
26
Canine Monocytic Ehrlichiosis (CME) - Chronic phase - Bone marrow cytological findings
Hypocellular bone marrow
Lipid deposition replacing bone marrow
27
Canine Monocytic Ehrlichiosis (CME) - Chronic phase - What are the Immune-mediated elements of the disease?
Immune complex formation
Auto-agglutinin formation (Comb's Positive)
Anti-platelet antibodies
Anti-nuclear antibodies
28
Canine Monocytic Ehrlichiosis (CME) - Antibodies are the main defense against CME (True/False)
False
They do more harm than good
29
Canine Monocytic Ehrlichiosis (CME) - How long does it take for thrombocytopenia to resolve after treatment has began? (Acute stage)
10-14 Days
30
Canine Monocytic Ehrlichiosis (CME) - Thrombocytopenia - 4 Mechanisms in which E.Canis can cause thrombocytopenia
Increased consumption (e.g. Vasculitis)
Sequestration in the spleen
Destruction (IMT)
Decreased production in the bone marrow (Chronic stage)
31
Canine Monocytic Ehrlichiosis (CME) - Diagnosis - Blood smear - In what percentage of cases can morulas be seen? In what section of the smear? In what stage of the disease?
4%
Feathered edge
Acute
32
Canine Monocytic Ehrlichiosis (CME) - Can CME be transmissible through blood transfusion?
Yes
33
Canine Monocytic Ehrlichiosis (CME) - Diagnosis - Best diagnostic method
Blood PCR
34
Canine Monocytic Ehrlichiosis (CME) - Treatment - Treatment of choice (Acute stage), Treatment for chronic stages, Monitoring
Doxycycline - 3-4 Weeks.
Chronic stage:
Fluids, Anti-pyretics
Anemia - Blood transfusion, Darbepoetin.
Leukpoenia - G-CSF
Broad-spectrum antibiotics (2nd infections due to leukopenia)
Immunosuppression (e.g. GC, +/- 2nd drug such as Cyclosporine).
CBC (Monitor thrombocytopenia) + PCR
35
Canine Monocytic Ehrlichiosis (CME) - Treatment - Epistaxis
Acepromazine (+/- Benzodiazepines)
Adrenaline-soaked gauze
Tranexamic acid
Yunnan Baiyao
36
Canine Monocytic Ehrlichiosis (CME) - Negative prognostic indicators
Severe anemia
Severe thrombocytopenia
Severe leukopenia
Prolonged aPTT
Hypokalemia
37
Canine Monocytic Ehrlichiosis (CME) - Prevention
Anti-tick treatment
38
Anaplasma Platys - Vector
Rhipicephalus sanguineous
39
Anaplasma Platys - Target cell of the parasite
Platelets
40
Anaplasma Platys - Hallmark clincal-pathological finding
Cyclic thrombocytopenia (every 10-14 days)
41
Anaplasma Platys - Can be transmissible through blood transfusion (T/F)
True
42
Anaplasma Platys - Treatment
Doxycycline for 3-4 weeks
43
Anaplasma Platys - Causes a more severe disease when comes with CME co-infection (T/F)
True
44
Anaplasma Phagocytophilum - Target cell of the parasite
Neutrophils
45
Anaplasma Phagocytophilum - Acute / Chronic Disease Mostly?
Acute
46
Anaplasma Phagocytophilum - Lab findings
Anemia
Thrombocytopenia (90% of cases)
Lymphopenia
Hypoalbuminemia
Hyperglobulinemia
ALP Increase
47
Anaplasma Phagocytophilum - Diagnosis - Is blood smear a sensitive tool to detect the parasite?
Yes. Parasite can be detected in majority of cases
48
Anaplasma Phagocytophilum - Diagnosis
Blood smear, PCR
49
Anaplasma Phagocytophilum - Treatment, Prevention
Doxycycline
Tick prevention
50
Mycoplasma haemofelis - Modes of transmission
Bites
Fleas (unproven)
Blood transfusion
Intra-utero
51
Mycoplasma - Main type seen on blood smears
Mycoplasma Haemofelis
52
Mycoplasma haemofelis - Pathogenesis
Extravascular hemolysis => Strong regenerative anemia
53
Mycoplasma haemofelis - Blood smear findings
Anisocytosis
Polychromasia
Spherocytosis
Nucleated RBCs
Howell-jolly bodies.
RBCs infected with Mycoplasma can also be seen occasionally
54
Mycoplasma haemofelis - Classic signalment and concurrent pathologies to look for in infected cats
Male cats coming in contact with other cats
Co-infections causing immunosuppression (e.g. FIV, FeLV).
Abscess - A frequent finding occurring several weeks before acute disease with mycoplasma
55
Mycoplasma in cats - What types are usually associated with sub-clinical infection?
Candidatus M. hemominutum
Candidatus M. turicensis
56
Mycoplasma haemofelis - Clinical signs in acute episode
Fever
Lethargy
Anorexia
Pale mucus membranes
Splenomegaly
Lymphadenomegaly
Occasionally jaundice
Tachycardia
Tachypnea
57
Mycoplasma haemofelis - Diagnosis - Is blood smear useful for detecting the parasite? Also, in what percentage of clinical cats can Mycoplasma be detected in blood smears?
Mycoplasma (Haemofelis) can be detected in blood smears. However, bacteremia is cyclic and can disappear after 2 hours. Also, even if collected in the bacteremic phase - When collected with EDTA, after a while the parasite dissociate from the RBCs and die off - another source for false negative
50% of cases. If suspicion is high - keep taking blood samples every couple of hours
58
Mycoplasma haemofelis - Diagnosis (Gold standard)
PCR
59
Mycoplasma - Transmissible through blood transfusion?
Yes
60
Mycoplasma - Treatment
Doxycycline for 3-4 weeks
Fluoroquinolones also considered effective
GC if IMHA is suspected \ No-response to GC
Blood Transfusion if indicated
Anti-Pyretics, Fluids
61
Mycoplasma - Prognosis
Good. Clinical Improvement can be seen after 2-3 days from start of treatment. May remain a sub clinical carrier for years or for life / may experience repeat episodes.
62
Babesiosis - Modes of transmission
Tick bite
Blood Transfusion
Dog bite (B.Gibsoni)
Intrauterine (Some Spp.)
63
Babesiosis - Mechanisms of hemolysis (4)
RBC Rupture (Intravascular hemolysis)
Complement-mediated
Extravascular hemolysis
IMHA
64
Babesiosis - Breed predisposition - B.Vogeli
Greyhound
65
Babesiosis - Breed predisposition - B.Gibsoni
Pitbull
66
Babesiosis - Factors that determine severity of disease
Age (Young - more severe)
Babesia species ( B.Rossi > B.Canis > B.Vogeli)
Breeds (Greyhound, Pitbull)
Concurrent disease\Immunosuppression\Neoplasia
Splenectomy
Co-infections
67
Babesiosis - Clinical signs
Fever
Tachycardia
Tachypnea
Anorexia
Lethargy
Pale Mucus Membranes
Splenomegaly
Lymphadenomegaly
Pigmenturia
Icterus
68
Babesiosis - Common CBC findings
Regenerative anemia
Thrombocytopenia (mild-moderate)
69
Main differential for babesiosis
Primary \ Secondary IMHA
70
Babesiosis - B.Rossi - Name of specific pathology only to B.Rossi
Cerebral Babesiosis
71
Babesiosis - B.Vogeli - Mild/Moderate/Severe disease? Detectable in blood smear?
Mild-moderate
Parasitemia usually detectable
72
Babesiosis - B.Canis - Mild/Moderate/Severe disease? Detectable in blood smear?
Mild-severe
Parasitemia doesn't usually correlate with severity
73
Babesiosis - B.Rossi - Mild/Moderate/Severe disease?
Severe
74
Babesiosis - B.Vulpes - Main host
Fox (Can be transmitted to dogs)
75
Babesiosis - Diagnosis (Gold standard)
Blood PCR
76
Babesiosis - Treatment - Large spp.
Imidocarb (Imizol) - 2 treatments14 days apart
77
Babesiosis - Treatment - Small spp. (3 treatment modalities)
1) Atovaquone + Azithromycin
2) Clindamycin
3) Clindamycin + Imidocarb + Diminazine Aceturate (for Atovaquone resistant strains)
78
Babesiosis - Supportive Treatment
Fluids
Blood Transfusion
Vitamins & Iron
*Steroids (controversial)
79
Hepatozoonosis - Modes of transmission
Swallowing an infected tick
Intrauterine
80
Hepatozoonosis - Transmissible In blood transfusion?
False
81
Hepatozoonosis - Hepatozoon Canis - Vector
Rhipicephalus Sanguineous
82
Hepatozoonosis - Hepatozoon Canis - Usually mild disease (True/False)
True
83
Hepatozoonosis - Hepatozoon Canis - What percentage of cases have a high amount of parasitemia? What cells are Affected?
15% (8%-100% of Neutrophils infected)
Neutrophils and monocytes
84
Hepatozoonosis - Hepatozoon Canis - Clinical signs in cases of severe disease
Cachexia
Fever
Splenomegaly
Lymphadenomegaly
Pale mucus membrane
85
Hepatozoonosis - Hepatozoon Canis - Treatment? How effective is the treatment
Imidocarb (Imizol)
Decrease in parasitic load but will always remain in the bloodstream
86
Hepatozoonosis - Hepatozoon Americanum - Clinical signs
Muscle Pain
Muscle Atrophy
Fever
Mucopurulent conjunctivitis
Lameness
Weight Loss
87
Hepatozoonosis - Hepatozoon Americanum - Modes of Transmission
Swallowing in infected tick
Perdition of an infected animal
88
Hepatozoonosis - Hepatozoon Americanum - Whats the severity of Parasitemia usually seen
Low (present in <1% of neutrophils)
89
Hepatozoonosis - Hepatozoon Americanum - Lab findings / Imaging
Severe leukocytosis (20k-200k neutrophils)
Hyperglobulinemia
Increased ALP
X-Ray - Periosteal reactions
90
Hepatozoonosis - Hepatozoon Americanum - Diagnosis
PCR
Muscle biopsy
91
Hepatozoonosis - Hepatozoon Americanum - Treatment and Prognosis
TMS + Permethrin + Clindamycin (Not really effective)
If remission is achieved - Decoquinqate (Coccidiostat)
Prognosis: Grave
92
Hepatozoonosis - Hepatozoon Felis - Target tissue
Muscle
93
Hepatozoonosis - Hepatozoon Felis - Common concurrent diseases
FIV, FeLV
94
Hepatozoonosis - Hepatozoon Felis - Mild/Severe disease?
Mild
95
Can Babesia be transferred through bites?
Yes - B.Gibsoni (Pitbulls)
96
Splenectomy predisposes dogs to what infective disease?
Babesiosis
97
What diagnostic tool can differentiate between the different large Babesia species?
PCR
98
Leishmaniasis - Name some known species of leishmania
L.Infantum
L.Major
L.Tropica
99
Leishmaniasis - Name the specie that commonly causes disease in dogs
L.Infantum
100
Leishmaniasis - If owners ask if their pet is posing a threat to other people - What would you tell them?
Usually the risk of zoonosis is very low. However, immunosuppressed people and infants are at greater risk
101
Leishmaniasis - What formLife stage can be found in the blood? and in what cell?
Amastigote
Macrophages\Monocytes
102
Leishmaniasis - Vector
Phlebotomus fly
103
Leishmaniasis - Modes of transmission
Fly bite
Syringes
Blood transfusion
Intrauterine
104
Leishmaniasis - Possible clinical signs
Splenomegaly
Lymphadenomegaly
Dermal changes
Weight loss
Ocular Disease (e.g. Uveitis, Keratitis, Conjunctivitis, Blepharitis, KCS)
Onychogryposis
Epistaxis
Hyperkeratosis of the nasal planum and foot pads
Signs of kidney failure (e.g. Oliguria, anuria, Vomiting)
105
Leishmaniasis - Possible lab findings
Anemia (Usually mild non-regenerative)
Thrombocytopenia (Mild)
Elevation of liver enzymes
Hyperglobulinemia (Polyclonal gammopathy)
Hypoalbuminemia (NaPP, PLN)
Azotemia (CKD)
Proteinuria (PLN)
106
Leishmaniasis - Possible dermal findings
Exfoliative dermatitis with alopecia
Ulcerative dermatitis
Nodular dermatitis (Boxers)
Mucocutaneous dermatitis
Papular dermatitis
107
Leishmaniasis - What is the effect on the kidneys? Explain the basic pathophysiology and how to approach it diagnostically?
Deposition of immune-mediated complexes causing glomerulonephritis and eventually CKD
Urinalysis - check for proteinuria. If positive => Proceed with checking UPC (Urine protein creatinine ratio)
108
Leishmaniasis - What is the cause of death in the majority of cases?
Kidney failure (Glomerulonephritis leading to tubulointerstitial lesions and CKD)
109
Leishmaniasis - Possible & most common ocular findings (5)
Anterior uveitis
Conjunctivitis
Keratoconjunctivitis
Periocular alopecia
Blepharitis
110
Leishmaniasis - What percent of cases present with epistaxis? What are the possible mechanisms?
<10% of cases of Leishmaniasis
-Ulcerative lesions
-Anti-platelet antibodies
-Thrombocytopathy
-Hyperviscosity syndrome (Hyperglobulinemia)
111
Leishmaniasis - What percentages of cases present with thrombocytopenia
30-50% of cases
112
Leishmaniasis - Diagnosis
History and clinical signs
CBC (Anemia, Thrombocytopenia)
Panel (Hyperglobulinemia, Azotemia)
UA (Proteinuria, UPC)
1) Serology (88-100% Sensitivity in clinical dogs. Only 30-60% in dogs without clinical signs
2) Cytology - Amastigotes (Skin\Lymph nodes\Spleen\Bone marrow\Conjunctiva)
3) PCR (Not from blood! from Spleen\LN\BM )
113
Leishmaniasis - What tissues to sample for PCR?
Lymph nodes
Spleen
Bone marrow
NOT BLOOD URINE!
114
What are "Mott cell"" with "Russel bodies"? In what diseases can you find it?
Plasma cell with vacuoles ocontaining Immunoglobulins
Any disease that produces large amount of immunoglobulins, classically infectious diseases such as Leishmaniasis and neoplasia such as Lymphoma
115
Leishmaniosis - Treatment options
Allopurinol
Meglumine Antimoniate
Miltefosine
Best - Combination of Allopurinol + Meglumine \ Allopurinol + Miltefosine.
*When treating with Allopurinol - best to switch to a low purine diet to avoid formation of xanthine uroliths (e.g. Hill's u/d)
116
Leishmaniasis - When is it okay to stop treatment
All 3 conditions must be met:
1) Cessation of clinical signs
2) Normalization of CBC\Panel\UA
3) Normalization of Leishmania antibody titer (Monitored with quantitative serology)
117
Leishmaniasis - What is the main side effect of Allopurinol?
Xanthinuria (usually after years of therapy)
118
Leishmaniasis - When can you expect to start seeing clinical improvement after starting treatment? And when can you start seeing significant improvement?
1 Month
3 Months
119
Leishmaniasis - Prevention
Anti-fly collars
Vaccinations if available
120
Leishmaniasis - Recommended monitoring
Every month for 6 months - Physical exam
Every 3 months - CBC + Creatinine + UPC
Every 6 months - Serology + Full panel
121
Leishmaniasis - Prognosis - Stage 1 (Clinical findings, Lab findings, Overall prognosis)
Solitary lymph node enlargement
Papular dermatitis
No abnormal clinical-pathological findings on blood tests
Prognosis: Good
122
Leishmaniasis - Prognosis - Stage 2 (Clinical findings, Lab findings, Overall prognosis)
Generalized lymphadenopathy
Cutaneous disease
Onychogryposis
Epistaxis
Loss of Appetite & Weight loss
Mild non-regenerative anemia
Thrombocytopenia
Hyperglobulinemia
Hypoalbuminemia
Substage-a) Creatinine <1.4 , UPC < 0.5 (Normal )
Substage-b) Creatinine <1.4 (Normal) ,UPC = 0.5-1 (Mild proteinuria)
Prognosis: Good to guarded
123
Leishmaniasis - Prognosis - Stage 3 (Clinical findings, Lab findings, Overall prognosis)
Stage 2 signs plus immune-mediated complex pathologies:
Vasculitis
Uveitis
Glomerulonephritis
Stage 2 findings plus CKD: UPC = 1-5 Creatinine 1.4-2 mg\dL (CKD Stage 2)
Prognosis: Guarded to poor
124
Leishmaniasis - Prognosis - Stage 4 (Clinical findings, Lab findings, Overall prognosis)
Stage 3 plus:
PTE
Nephrotic syndrome
End stage kidney disease
Stage 3 Plus: Creatinine 2.1-5 (CKD Stage 3) or >5 mg\dL (CKD Stage 4) UPC >5 (Nephrotic syndrome)
Prognosis: Poor
125
Leishmaniasis - What level of Thrombocytopenia do we Expect?
Mild
126
Leishmaniasis - What type of dermal changes do Boxers usually have? What other animals tend to get them?
Nodular dermatitis
Cats
127
FeLV - Modes of transmission
Orally (Saliva)
Intra-uterine
Blood transfusion
128
FeLV - Where does the virus multiply?
Bone marrow
Respiratory epithelium
Salivary glands
129
FeLV - What is the sub-type that is passed from cat to cat
FeLV A
130
FeLV - What are the more pathogenic types?
FeLV B, FeLV C
131
FeLV - When are cats most susceptible to catching the virus? (Young/Old)
Young
Risk of infection goes down as the cat ages
132
FeLV - Pathophysiology
Cat eats viral matter => Enters oropharyngeal lymphatic tissues (Tonsils) => Can abort here and be rid of the virus ("Abortive Infection").
If not: Primary viremia => Reaches bone marrow => Can be suppressed here ("Regressive Infection") and be eliminated, or go into latency => Stress \ Immunosuppression => Secondary (Persistent) viremia: Virus migrates to: Lymph nodes, Salivary glands and respiratory epithelium => Cat becomes FeLV positive & secretion in saliva & clinical signs begin
133
FeLV - Can a persistently infected queen pass the virus to her litter?
Yes
134
FeLV - Clinical signssyndromes
Fever
Lethargy
Anorexia
Lymphadenomegaly
Diarrhea, Vomiting
Neoplasia: Lymphoma - Mostly - T-cell (60x higher risk than normal cats)
Leukemia
Bone marrow suppression: Anemia, Granulocytopenia and\or Lymphopenia, Thrombocytopenia (Pancytopenia)
Secondary infections (e.g. Mycoplasma, Toxoplasmosis)
Myoproliferative disorders
Myriad of syndrome: Nephrotic syndrome, Urinary incontinence, Uveitis, CNS signs, infertility and abortions.
135
FeLV - Diagnosis - What type of test is it and what does it search for specifically in the virus?
Serology (IFA ELISA)
FeLV antigen - Core antigen p27
136
FeLV - If a cat turns out positive in the Test - what is your next step, when and why?
Test again after 2-3 months - to see if the viremia is transient or persistent (Primary vs. secondary). If positive for the second time - persistent viremia and clinical signs are imminent
137
FeLV - Treatment
Neoplasia - Chemotherapy
Bone marrow suppression - Darbepoetin \ G-CSF \ Steroids
Treat 2nd infections and keep cat indoors
138
FeLV - Whats the difference between cats with lymphoma who also have FeLV and ones that only have Lymphoma?
Lymphoma + FeLV - Very short remission (25 days) << Lymphoma Only (~500 days)
139
FeLV - Prevention and protocol
Vaccination: 2 Doses after 2 months old, then another one after a year, then booster every 2 years
140
FeLV - Can serology testing distinguish between the virus and the vaccine?
Yes
141
FIV - Classic signalment
Male cats older than 5 years
Outside cats > indoor cats
142
FIV - Modes of transmission
Biting
Saliva
Milk
143
FIV - Where is the majority of the virus concentrated in the body?
Salivary glands
144
FIV - Pathophysiology
Primary infection and proliferation in local lymph nodes inside of T-cells
2-4 Weeks later => Primary viremia (antibodies are created). No significant clinical signs at this point.
Asymptomatic period (years) - Virus can be isolated and CBC abnormalities might be detected
Disease eruption - Generalized lymphadenomegaly, Fever, Leukopenia
145
FIV - Cells in which the virus proliferates
T-Cells - CD4 (Mainly)
CD8
Megakaryocytes
Bone marrow cells
Macrophages
146
FIV - What is the cause for clinical signs
Immuno-compromise and secondary infections
147
FIV - Name the 5 stages of the disease
Acute stage
Asymptomatic stage
Persistent generalized lymphadenomegaly
AIDS Related complex
AIDS
148
FIV - Acute stage - Duration
4-5 Weeks
149
FIV - Acute Stage - Clinical signs\Lab findings
Fever
Depression
Lymphadenopathy
Diarrhea
Possible leukopenia
150
FIV - Asymptomatic stage - What mainly happens at this stage that progresses the disease towards its next stage?
Decrease in CD4 cells
151
FIV - Persistent generalized lymphadenopathy - Clinical signs\Lab findings
Weight loss
Lymphadenopathy
Anemia, Leukopenia
152
FIV - AIDS-related complex stage - Clinical signs\pathologies
Possible behavioral changes
Neoplasia - mainly Lymphosarcoma
Secondary infections (GI, Dermal, Respiratory, Mouth, Urinary tract, Eye, Kidney)
Anemia, Leukopenia
153
FIV - AIDS Stage - Clinical signs\ Lab findings
Severe weight loss
50% of cases - Gingivitis
Secondary infections
CNS Signs
Anemia, Leukopenia
154
FIV - Most common Clinical sign in cats diagnosed with the disease
Gingivitis (50% of cases)
155
FIV - When to suspect? (5 Categories/Examples)
Chronic recurrent disease - Not responsive to treatment
Appearance of diseases that usually occur due to immunosuppression\In association with FIV - Toxoplasmosis, Mycoplasma, Hepatozoon Felis
Opportunistic infections : Gingivitis, Skin, Ears, Eyes
Neoplasia (B-cell Lymphoma)
Persistent leukopenia / Anemia
156
FIV - When to suspect? (Lab findings)
Persistent anemia
Persistent leukopenia
Hyperglobulinemia
157
FIV - When to suspect - Diseases that are associated with FIV
Mycoplasma
Toxoplasma
Hepatozoon
158
FIV - What is the neoplasia associated with FIV?
B-cell Lymphoma
159
FIV - Lymphoma - How more likely do cats develop Lymphoma when infected with FIV? In younger or older cats?
5x More likely
Younger cats with FIV develop Lymphoma more frequently
160
FIV - Diagnosis
Serology - detection of antibodies created 4-5 weeks after infection
161
FIV - Diagnosis - How? When? (Why then?)
Serology
>4 Months old (before that - might be false positive because of passive protection from the queen)
In general: If suspicion is high and serology comes back negative - might be false negative - Test again 2-3 months later (might be the acute stage and antibodies have not yet formed).
162
FIV - Diagnosis - End stage disease isn't always positive on serology (T/F)
True
Due to severe immunosuppression and decreased production of antibodies
163
FIV - Treatment
Antibiotics\Anti-fungal for secondary infections
Steroids to decrease chronic inflammation effects (bad long-term)
Iron, Vitamins
Blood Transfusion (anemia)
164
FIV - Prognosis
In the asymptomatic stage: Great. Cat can remain healthy for many years
When AIDS develops - Poor.
165
Which has the better MST - FIV or FeLV?
FIV - Can live a full life if asymptomatic stage persists
FeLV - 50% mortality 2 years after diagnosis. 80% mortality after 3 years
166
FIV - Prevention
Mainly keep FIV-positive cats away from uninfected ones
167
FIV - Prevention - FIVFeLV viruses can remain in the environment for weeks/months (T/F)
False
Only for a few days and after that its safe to bring in healthy cats.
168
FIV - Prevention - Vaccination is an important part in prevention (T/F)
False
Not reliable enough (as opposed to FeLV vaccine)
169
Leptospirosis - Common cause of disease in dogs and cats (T/F)
False
Causes disease in dogs but not in cats (But cats can serve as a reservoir)
170
Leptospirosis - Main mode of infection
Through wounds in the skin and mucosal surfaces that come into contact with polluted water
171
Leptospirosis - Associated pathologies and organs affected
Acute kidney injury (Damage to the tubular epithelium)
Hepatitis (Can be severe and acute)
Uveitis (Caused by immune complexes)
Coagulopathies (Vasculitis and thrombocytopenia)
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Leptospirosis - L. icterohaemorrhagiae - Main pathologies (2)
Icterus
Mild liver lesions
173
Leptospirosis - L. grippothyphosa - Main pathology
Chronic active hepatitis
174
Leptospirosis - Clinical signs
Fever
Lethargy
Anorexia
Vomiting
Oliguria, Anuria (AKI)
Pu\Pd
Icterus
Abdominal pain
Muscle pain
Uveitis
Less common: Bleeding disorders ,(Melena\Hematochezia\Pigmenturia\Epistaxis\Petechiae & ecchymosis)
Cough, Dyspnea (Pulmonary bleeding)
175
Leptospirosis - Can remain Chronic\Sub-clinical. From what organ does the bacteria keep being spread?
Kidney
Spread via the urine.
176
Leptospirosis - When to suspect?
AKI
Hepatitis
Uveitis
Fever of unknown origin
177
Leptospirosis - Lab findings
CBC:
Leukopenia / Leukocytosis
Anemia (Inflammation/Bleeding)
Thrombocytopenia (Mild-moderate).
Panel:
Elevation of liver enzymes (ALT, ALP)
Hyperbilirubinemia
Hypoalbuminemia (NaPP, Vasculitis, Bleeding)
Azotemia
Hyperphosphatemia
Hypocalcemia
Hyperkalemia (AKI)
Hyponatremia, Hypokalemia, Hypochloridemia (Vomiting)
Urinalysis: Isosthrnuria, Bilirubinuria, Proteinuria, Glucosuria, Hematuria, Cylindruria, Pyuria
PT/aPTT - Prolonged
178
Leptospirosis - Diagnosis (Main methods)
Serology - Microscopic agglutination test (MAT) - May yield false negative in the acute phase of the disease. 2nd test for seroconversion 7-14 days later may be necessary
PCR (Blood/Urine) - Must be done before antibiotic treatment or would result in false negative
*In the first week of disease - Blood is the prime choice because of high concentration of the bacteria in the blood. After the first week - Urine should be tested instead.
179
Leptospirosis - Treatment
Isolate from other dogs!
Antibiotics: Ampicillin (for acute disease)
Doxycycline for 14 days (to clear the bacteria from the kidneys and prevent carrier-state)
Treat AKI (Fluids, Diuretics, Treat hyperkalemia, hypertension, acidosis, Dialysis if indicated)
Anti-oxidants (Hepatitis)
Plasma (DIC)
Oxygen (if indicated in cases of pulmonary hemorrhage)
180
Leptospirosis - Prevention
Vaccine
First - 8 Weeks
Booster 2-4 weeks later
Then yearly shot
181
Leptospirosis - Vaccine - what type is it? Protection period? Protects against all serovar?
Bacterin
12-18 Months
No
