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“A creative man is motivated by the desire to achieve, not by the desire

to beat others.”-Ayn Rand

PANSYTEMIC DISEASES

These diseases are covered predominantly in chapter 9 of your textbook

CASE #1

PATIENT PRESENTATION

• SIGNALMENT: 12 week old, male/neutered, mixed breed puppy

• PRESENTING COMPLAINT: lethargy, ocular and nasal discharge for the past 3 days; mild cough, appetite is poor; puppy had diarrhea last night and vomiting/diarrhea this morning– Diet: Science diet puppy dry

• Hx: puppy adopted from local shelter 2 weeks ago; has received one set of vaccinations – owner was planning to schedule booster shots in one week

PATIENT PRESENTATION

• Hx: Puppy received his first doses of Heartworm and flea prevention 2 weeks ago at time of adoption.

• Other Info: Client has 1 other dog who is 1 year old and fully vaccinated; and 2 cats who are 2 and 5 yrs old that are fully vaccinated

PATIENT PRESENTATION

• PHYSICAL EXAM FINDINGS:– Lethargy– ~8% dehydrated– Temp: 103.8, HR: 116, RR: 20 – lung fields sound

slightly moist, and the puppy coughs a few times during the exam

– Mm: pink, CRT: 2.5sec– Mucopurulent ocular/nasal discharge– The nose looks, dry, thick, and crusty

PATIENT PRESENTATION

PATIENT PRESENTATION

ENAMEL HYPOPLASIA

HYPERKERATOSIS OF NOSE & FOOT PADS

• DIAGNOSTIC TEST RESULTS:CBC shows:– Leukopenia –early in the disease– Mild anemia

• WORSENING OF CLINICAL SIGNS: 1 week later, the client returns. The puppy is weak and appears to have muscle twitching; muscle of the mouth appear as if the puppy is “chewing gum”; there are pustules on the abdomen, and hyperkeratotic foot pads

DIAGNOSTICS AND TREATMENT

• TREATMENT– ANTIBIOTICS– FLUIDS– SYMPTOMATIC TREATMENT• Anti-emetics• Ophthalmic ointments• Cleaning ocular/nasal discharge frequently• Nutrition• Clean, dry environment; low stress

• DIAGNOSTICS– Blood work is drawn for a CBC, serum chemistry

profile and Canine Distemper titers

DIAGNOSTICS AND TREATMENT

DIAGNOSIS:CANINE DISTEMPER VIRUS

http://www.youtube.com/watch?v=QL4S4MA2zT0

http://www.youtube.com/watch?v=HyEFS77rOzU

*Myoclonus is characteristic for Canine Distemper

• FURTHER DIAGNOSTICS:– Blood work drawn to compare paired serum titers and CBC

results; Flourescent antibody(FA)• CBC: Leukocytosis with neutrophilia found due to

secondary infection

• FA: Viral inclusions are found in mononuclear cells of the blood smear– Post-mortem tissue sample taken from mucous membranes

or epithelial cells of the urinary, respiratory, or GI tract may also display viral inclusions.

• Titers have increased since last measurement

DIAGNOSTICS AND TREATMENT

• Transmission of this (single-stranded, RNA, paramyxo-) virus is through aerosolization of bodily fluids, fomites

• Fatality rate may be as high as 90%• Prognosis is guarded at best, especially if neurologic signs are

present• Neurologic signs may be focal to general including seizures

– Could occur weeks to years after initial infection

• Although Distemper is contagious, it is unlikely to affect the clients older, vaccinated dogs– CVD does not affect cats

PROGNOSIS & CLIENT INFORMATION

• Vaccination• Thorough cleaning – the virus is labile and can

be killed with common disinfectants, and heat• Isolation of infected animals

PREVENTION

CASE #2

PATIENT PRESENTATION

• SIGNALMENT: 4yr old, female spayed, daschund

• PRESENTING COMPLAINT: dry, hacking cough; dog is still active and eating and drinking well. Coughing began about 1 week ago.

• Hx: Owner began sending the dog to day care everyday while she was at work; After the puppy set of vaccines, dog was vx at 1yr and 2 yrs old. She received an injectable Bordetella vaccine 1 day before beginning daycare.

PATIENT PRESENTATION

• Hx: – Diet: Purina One– Patient is current on HW and flea prevention– No other significant illnesses– HW negative

• PHYSICAL EXAM FINDINGS:– Temp: 102.1, HR: 140, RR: 36– Sneezing and occasional coughing on exam

• Cough can be ellicited on tracheal palpation• Mild, clear nasal discharge

– Normal hydration status– Mm: pk CRT: <2sec

PATIENT PRESENTATION

• Aka Infections Tracheobronchitis• Major causes– VIRUSES: Canine Adenovirus-2, Parainfluenza,

Canine herpesvirus, Canine Influenza, canine distemper virus

– BACTERIA: mycoplasma, bordetella bronchiseptica, streptococcus sp.

DIAGNOSIS: CANINE RESPIRATORY DISEASE COMPLEX

http://www.youtube.com/watch?v=amGKQX9zdug

• DIAGNOSTICS– Based on physical exam, clinical signs and history

– Virus isolation from swabs of the pharynx, nasal passageways, trachea

– Thoracic rads if pneumonia suspected

DIAGNOSTICS & TREATMENT

• TREATMENT– Adequate hydration– Antibiotics– Antitussives• Hycodan (hydrocodone)• Butorphanol• Cough Tabs (dextromethorphan, guafenesin)• Bronchial dilators

– Aminophylline– terbutaline

DIAGNOSTICS & TREATMENT

• Transmission of these organisms is by inhalation of respiratory droplets or contact with fomites

• The prognosis is good with proper treatment– It is a self-limiting disease– May take 2-3 weeks to resolve

• Vaccinate 2-3 weeks prior to expected exposure when using the injectable vaccine– If using the intranasal vaccine 2-3 days prior to exposure is

recommended

PROGNOSIS & CLIENT INFORMATION

• Isolate infected animals• Vaccinate appropriately• Most routine disinfectants, bleach,

quarternary ammonium compounds will kill these viruses and bacteria

• Proper sanitation

PREVENTION

CASE #3

PATIENT PRESENTATION

• SIGNALMENT: 3mth old Rottweiler puppy, intact male

• PRESENTING COMPLAINT: lethargy, poor appetite, bloody diarrhea for 2 days; puppy has vomited twice this morning

• Hx: Owner purchased puppy from local trader’s market at 10 weeks old. The breeder gave the first set of vaccinations at 3 weeks old and a booster @ 7 weeks

PATIENT PRESENTATION

• Hx: owner already has a 6mth old, intact female Rottweiler he got as a gift from a family member. He purchased the new puppy as a playmate.– The 6mth old puppy had 3 sets of vaccinations

given by the family member.– Neither puppy has been started on heartworm or

flea prevention.– Diet: Blue Buffalo

PATIENT PRESENTATION

• PHYSICAL EXAM FINDINGS:– ~8% dehydrated• Mm:pale, CRT: >2.5sec

– Depressed– Rear soiled in blood-tinged diarrhea, strong, foul

odor– Temp: 103.5, HR: 120 RR: 24

PATIENT PRESENTATION

• Fecal• Parvo ELISA (snap test)– Detects viral antigen

• CBC/Serum Chemistries– Marked lymphopenia, neutropenia, increased PCV– Hypoglycemia, hypokalemia

• Parvo titers– High titers (1:10,000)

DIAGNOSTICS

PARVO ELISA

PATHOGENESIS

• TRANSMISSION: fecal-oral route– Virus has affinity for rapidly dividing cells such as

intestinal epithelium & bone marrow; severe cases affect the myocardium (esp in utero)• Affect on bone marrow lymphopenia,

neutropenia WBCs may be <2000

– Possible sequelae: septicemia, intussusception

• ISOLATE INFECTED ANIMALS• HOSPITALIZATION– IV fluids w/added electrolytes, added dextrose– ANTIBIOTICS– ANTI-EMETICS

• Reglan• Maropitant (cerenia)• Ondansetron

– NSAIDs– +/- Plasma transfusion for hypoproteinemia– +/-ANTIVIRAL

• Tamiflu

TREATMENT

• PROGNOSIS: generally good with aggressive and early treatment; 80%-90% success– Concurrent infections and GI parasites can worsen

prognosis

PROGNOSIS

• VACCINATION– Keep puppies isolated until they have firm immunity,

usually about 18-22 weeks of age– Vaccinate at 6-8 weeks then q3-4 weeks until 16

weeks of age

• CLIENT INFO– In this case, the 1st 2 vaccines are not valid– Client should isolate the new puppy from the older

one– Treatment is expensive– The virus is resistant in the environment and may

survive for years. A 1:30 solution of bleach is effective.

PREVENTION & CLIENT INFORMATION

CASE #4

• SIGNALMENT: ~6 week old intact, male kitten, DSH

• PRESENTING COMPLAINT: mucopurulent ocular/nasal discharge, congestion, head shaking, sneezing, inappetance – has gotten progressively worse in the last week

• Hx: owner has been feeding a family of stray cats outside her home. Several of the kittens look like this. This is the only kitten she could catch

PATIENT PRESENTATION

• Hx: no known vaccinations, no flea or HW prevention– Diet: owner feeds canned Whiskas

• PHYSICAL EXAM– Patient is QAR– Temp: 104.1, HR: 200, RR:40– Audible upper respiratory congestion– ~6-8% dehydrated– Mm: pale pk, CRT: 2 sec

PATIENT PRESENTATION

• DIAGNOSTICS– Clinical signs– Nasal, pharyngeal swabs

• DIAGNOSIS:– Feline Viral Rhinotracheitis(FVR)

• Feline Herpesvirus-1– Feline Calicivirus (FCV)

• 80-90% of all URI is cause by 1 of these 2 viruses

Chlamydophila felis– Bordetella– Mycoplasma

DIAGNOSTICS

DIAGNOSIS

• FLUIDS• ANTIBIOTICS• NURSING CARE– Warm, clean– Force feed, warm, food– Pain meds for oral or corneal ulcers

• DECREASE STRESS• AVOID STEROID• ANTIVIRAL– Idoxuridine

TREATMENT

• Both FVR and FCV are highly contagious– Transmitted via fomites (hands, clothes) and

aerolsolization of respiratory droplets withing 5 feet

• Morbidity is high, mortality is low– Oral ulcers can last 7-10 days

PROGNOSIS & CLIENT INFORMATION

• VACCINATION– Vaccines will reduce severity and duration of

clinical signs

• Isolate infected animals

PREVENTION