bi curs an5 panleucopenia felina
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PanleuPanleuccopeniaopenia Felina Felina- - DefinitieDefinitie--
Boala virala, sBoala virala, severeveraa, , deosebit de deosebit de contagioasacontagioasa, , a pisicilor tinere nevaccinate, a pisicilor tinere nevaccinate, clinic insotita de simptomatologie clinic insotita de simptomatologie gastrointestinalgastrointestinala.a.
Cea mai importanta boala a efectivelor de Cea mai importanta boala a efectivelor de pisici pisici nnevaccinate.evaccinate.
Rata de infectie a felinelor receptiveRata de infectie a felinelor receptive= 100%= 100% LeuLeuccopenia = openia = semn caracteristicsemn caracteristic MortalitMortalitate deate de = 25 – 90% = 25 – 90% Total control Total control numai prin vaccinarenumai prin vaccinare
PanleuPanleuccopeniaopenia Felina Felina IIstorstoricic
First described in 1800 as “cat First described in 1800 as “cat plague”plague”THETHE most important disease of most important disease of catscats
50-100% incidence in animal shelters50-100% incidence in animal sheltersMortality 25-90%Mortality 25-90%
First crude tissue origin vaccine in First crude tissue origin vaccine in 19341934Causative virus isolated & Causative virus isolated & identified in 1960sidentified in 1960sExcellent vaccines developed Excellent vaccines developed 1968-19751968-1975Vaccine programs centered Vaccine programs centered around FParound FP
Feline PanleukopeniaFeline PanleukopeniaCurrent StatusCurrent Status
Vaccines excellent Vaccines excellent – can totally control – can totally control and prevent FPand prevent FPIncidence very lowIncidence very lowStill problem in some populationsStill problem in some populations
SheltersSheltersFarmsFarmsFree-roaming cats/feral populationsFree-roaming cats/feral populations
Cause of problemsCause of problemsContaminated environmentContaminated environmentImproper or no vaccinationImproper or no vaccination
Canine parvovirus – some strains infect Canine parvovirus – some strains infect catscatsChange in revaccination Change in revaccination recommendationsrecommendations
Feline PanleukopeniaFeline PanleukopeniaSynonymsSynonyms
FPFPFPLFPLFeline parvovirus infectionFeline parvovirus infectionFPV infectionFPV infectionFeline “distemper”Feline “distemper”Feline infectious enteritisFeline infectious enteritisCat “plague”Cat “plague”Feline ataxiaFeline ataxiaFeline cerebellar hypoplasiaFeline cerebellar hypoplasia
FP ~ FP ~ EtiologyEtiology
Feline Parvovirus (FPV)Feline Parvovirus (FPV)Single serotypeSingle serotypeCross-reacts with CPV-2 & MEVCross-reacts with CPV-2 & MEV
Canine Parvovirus-2 (CPV-2)Canine Parvovirus-2 (CPV-2)CPV-2 - 1CPV-2 - 1stst appeared in dogs in 1977 appeared in dogs in 1977CPV-2a - dogs in 1978; can cause FP CPV-2a - dogs in 1978; can cause FP in catsin catsCPV-2b - dogs in 1984; can cause FP CPV-2b - dogs in 1984; can cause FP in catsin catsCPV-2c - large cats 1997; can cause CPV-2c - large cats 1997; can cause FP in catsFP in cats
Characteristics of FPVCharacteristics of FPV
ParvovirusParvovirus = small, single-stranded = small, single-stranded DNA virusDNA virusAbsolute need for Absolute need for mitotic cell mitotic cell for for replicationreplicationProduces intranuclear inclusionsProduces intranuclear inclusionsExtreme Extreme resistanceresistance
Will survive for years at room Will survive for years at room temperaturetemperatureResistant to most disinfectantsResistant to most disinfectants
Similar to CPV-2 and MEVSimilar to CPV-2 and MEV
HostsHosts
FelidaeFelidaeDomestic cat = primary hostDomestic cat = primary hostNon-domestic felids – all believed to be Non-domestic felids – all believed to be susceptiblesusceptible
CanidaeCanidaeOutbreaks in dogs in EuropeOutbreaks in dogs in EuropeArtic foxArtic fox
ProcyonidaeProcyonidaeRaccoonRaccoonCoatimundiCoatimundi
MustelidaeMustelidaeMink – MEV, subclinical FPV infectionMink – MEV, subclinical FPV infectionOthers? – skunks, otters, weasels, badgersOthers? – skunks, otters, weasels, badgers
EpidemiologyEpidemiology
Distribution - worldwideDistribution - worldwideIncidenceIncidence
High in unvaccinated populationsHigh in unvaccinated populationsLow in properly vaccinated catsLow in properly vaccinated cats
Season Season Summer & Fall – susceptible kittensSummer & Fall – susceptible kittensCan occur throughout yearCan occur throughout year
AgeAgeKittens 2-4 months old most susceptibleKittens 2-4 months old most susceptibleAny age may be susceptibleAny age may be susceptible
Sex predilection - noneSex predilection - none
Transmission of FPVTransmission of FPV
Direct contactDirect contactContaminated environment & fomitesContaminated environment & fomites
Cages, floor, food dishes, water bowls, Cages, floor, food dishes, water bowls, beddingbedding
Contaminated hands, clothing, and feet Contaminated hands, clothing, and feet of peopleof peopleIn uteroIn utero infection – if queen has acute infection – if queen has acute infectioninfectionCarrier cats? – possible, but not Carrier cats? – possible, but not commoncommon
Pathogenesis of FPV Pathogenesis of FPV InfectionInfection
Virus requires a Virus requires a mitotic cellmitotic cell for for replication. All clinical signs result from replication. All clinical signs result from cytolysis of mitotic cellscytolysis of mitotic cells
Intestinal cryptsIntestinal cryptsVomiting & diarrheaVomiting & diarrheaDehydrationDehydration22ndnd bacterial infections bacterial infections
Lymphopoietic cellsLymphopoietic cellsPanleukopeniaPanleukopenia
Granulocyts & Purkinje cells of cerebellum Granulocyts & Purkinje cells of cerebellum (neonate)(neonate)
Cerebellar hypoplasiaCerebellar hypoplasiaRetina (neonate)Retina (neonate)
Retinal dysplasiaRetinal dysplasia
Feline PanleukopeniaFeline PanleukopeniaForms of DiseaseForms of Disease
Peracute FPPeracute FPAcute FP = typicalAcute FP = typicalMild FPMild FPSubclinical infectionSubclinical infection““Chronic” FPChronic” FPIn uteroIn utero infection infection
Feline PanleukopeniaFeline PanleukopeniaPeracute FPPeracute FP
Very acute onsetVery acute onsetCat may just disappear, found Cat may just disappear, found deaddeadSubnormal temperature, 94-98 F.Subnormal temperature, 94-98 F.Severe leukopeniaSevere leukopeniaSevere depressionSevere depressionOwner may believe cat was Owner may believe cat was poisonedpoisonedAlmost always fatal within 12 Almost always fatal within 12 hourshours
Feline PanleukopeniaFeline PanleukopeniaAcute or Typical FPAcute or Typical FP
FeverFeverMild to moderateMild to moderateMay have subnormal temp.May have subnormal temp.
DDepression - may be severeepression - may be severeClassic attitude or postureClassic attitude or posture
Vomiting and Vomiting and DDiarrheaiarrheaDDehydration - usually severeehydration - usually severeComplete anorexiaComplete anorexiaDDeatheath
Feline PanleukopeniaFeline PanleukopeniaMild FPMild FP
Slight anorexiaSlight anorexiaSlight feverSlight feverSome depressionSome depressionLeukopenia - only consistent Leukopenia - only consistent findingfindingPerhaps mild gastroenteritisPerhaps mild gastroenteritisWill recover without treatmentWill recover without treatment
Feline PanleukopeniaFeline PanleukopeniaSubclinical InfectionSubclinical Infection
More common in More common in older catsolder catsCat appears clinically normalCat appears clinically normalSlight feverSlight feverSlight leukopeniaSlight leukopeniaViremic and shedding virusViremic and shedding virusDevelops excellent immune Develops excellent immune responseresponse
Feline PanleukopeniaFeline Panleukopenia“Chronic” FP“Chronic” FP
Presents with “panleukopenia-Presents with “panleukopenia-like” syndromelike” syndromeChronic leukopeniaChronic leukopeniaChronic enteritisChronic enteritisChronic wastingChronic wastingHistopathology - enteric lesions Histopathology - enteric lesions like FPlike FPUsually this is Usually this is feline leukemiafeline leukemia, not , not FPFP
Feline PanleukopeniaFeline Panleukopenia“In utero” Infection“In utero” Infection
Usually with subclinical infection of Usually with subclinical infection of Ab(-) queenAb(-) queenOne or more fetuses may be One or more fetuses may be destroyeddestroyed
AbortionAbortionFetal resorptionFetal resorptionMummified fetusMummified fetusStillbirth, or “fading” newborn kittenStillbirth, or “fading” newborn kitten
Congenital birth defectsCongenital birth defectsCerebellar hypoplasia with ataxiaCerebellar hypoplasia with ataxiaRetinal dysplasiaRetinal dysplasiaHydrocephalusHydrocephalus
FP ~ FP ~ DiagnosisDiagnosis
HistoryHistoryClinical signsClinical signsLaboratory findingsLaboratory findings
Total leukocyte countTotal leukocyte countViral isolation/FPV antigen Viral isolation/FPV antigen detectiondetectionSerological findingsSerological findings
Postmortem findingsPostmortem findingsGross pathological changesGross pathological changesHistopathological changesHistopathological changes
FP ~ FP ~ Diagnosis - HistoryDiagnosis - History
Unvaccinated cat?Unvaccinated cat?Vaccinated under 14-16 weeks of Vaccinated under 14-16 weeks of age?age?Recent exposure?Recent exposure?Adoption shelter?Adoption shelter?Farm or feral cat?Farm or feral cat?
FP Diagnosis ~FP Diagnosis ~ Clinical Clinical SignsSigns
Sudden onsetSudden onsetFever, lethargy, depressionFever, lethargy, depressionClassic attitude or postureClassic attitude or posture
head down, shoulders elevated, tucked head down, shoulders elevated, tucked positionpositionhang head over food/water dishhang head over food/water dish
Diarrhea and vomitingDiarrhea and vomitingSevere dehydrationSevere dehydrationComplete anorexiaComplete anorexiaAbdominal palpationAbdominal palpation
edematous, turgid bowelsedematous, turgid bowelspain?pain?
FP Diagnosis ~FP Diagnosis ~ Laboratory Laboratory FindingsFindings
PanleukopeniaPanleukopenia4-8,000 cells/dl = mild or subclinical 4-8,000 cells/dl = mild or subclinical infectioninfection2-4,000 cells/dl = acute infection2-4,000 cells/dl = acute infection<2,000 cells/dl = acute or peracute infection<2,000 cells/dl = acute or peracute infection
Viral isolation/detectionViral isolation/detectionPositive canine parvovirus SNAP testPositive canine parvovirus SNAP test – feces – fecesIsolation from feces, ileum/jejunum, thymus, Isolation from feces, ileum/jejunum, thymus, spleenspleenPCRPCRImmunofluorescence (IFA) - ileumImmunofluorescence (IFA) - ileumElectron microscopy - identify viral particles Electron microscopy - identify viral particles in fecesin feces
Serum antibody titers Serum antibody titers 4-fold increase in paired serum samples4-fold increase in paired serum samples
Feline PanleukopeniaFeline PanleukopeniaLeukocyte Count vs. Clinical Leukocyte Count vs. Clinical
DiseaseDisease
Clinical DiseaseClinical Disease
01,0002,0003,0004,0005,0006,0007,0008,0009,000
10,000
Normal Mild Acute
High
Low
Feline PanleukopeniaFeline PanleukopeniaDiagnosis - Viral Diagnosis - Viral
DetectionDetection
Detect FPV or antigen in fecesDetect FPV or antigen in feces Canine parvovirus SNAP testCanine parvovirus SNAP test Electron microscopy for viral particlesElectron microscopy for viral particles
Viral isolation in cell culturesViral isolation in cell cultures Ileum, spleen, thymus, rectal swabIleum, spleen, thymus, rectal swab
IFA on tissues IFA on tissues Small intestine - ileum, jejunumSmall intestine - ileum, jejunum
PCRPCR
PanleukopeniaPanleukopeniaSerological AssaysSerological Assays
Virus neutralization (VN) assay Virus neutralization (VN) assay = serum neutralization (SN) assay= serum neutralization (SN) assay
ELISAELISA Paired serum samples:Paired serum samples:
2 weeks apart for diagnosis2 weeks apart for diagnosis 4-fold rise in titer4-fold rise in titer
Single serum sample to check Single serum sample to check immunity:immunity: Titer = 1:10 or higher if >16 weeks oldTiter = 1:10 or higher if >16 weeks old
Feline Panleukopenia Feline Panleukopenia DiagnosisDiagnosis
Gross Pathologic FindingsGross Pathologic FindingsRough hair coatRough hair coatGaunt and dehydratedGaunt and dehydratedEvidence of diarrhea and Evidence of diarrhea and vomitingvomitingGross pathological changes may Gross pathological changes may be mildbe mildThick, edematous walls of small Thick, edematous walls of small intestineintestineHyperemia, petechial or Hyperemia, petechial or ecchymotic ecchymotic hemorrhages - hemorrhages - jejunum & ileumjejunum & ileumSmall thymus in young kittensSmall thymus in young kittens
Lesions in Neonatal Kittens Lesions in Neonatal Kittens with Feline Panleukopeniawith Feline Panleukopenia
Thymic atrophyThymic atrophy Retinal dysplasiaRetinal dysplasia Cerebellar hypoplasiaCerebellar hypoplasia
Feline Panleukopenia DiagnosisFeline Panleukopenia DiagnosisHistopathologic FindingsHistopathologic Findings
Ileum & jejunumIleum & jejunumDilated crypts with loss of epithelium Dilated crypts with loss of epithelium Short, blunted, fused villiShort, blunted, fused villiPathognomonic lesionPathognomonic lesion
Lack of inflammatory cellsLack of inflammatory cellsIntranuclear inclusions early in Intranuclear inclusions early in diseasedisease
Panleukopenia ~ Panleukopenia ~ TreatmentTreatment
Supportive care Supportive care until immune responseuntil immune response FPV antiserum?FPV antiserum? Fluid and electrolyte replacementFluid and electrolyte replacement– Indwelling IV catheterIndwelling IV catheter
– Lactated Ringers with potassiumLactated Ringers with potassium
– 5% dextrose in electrolyte replacer5% dextrose in electrolyte replacer
– 60-100 ml/kg/hr60-100 ml/kg/hr
No antivirals against parvovirusNo antivirals against parvovirus GI therapyGI therapy Antibiotics parenterallyAntibiotics parenterally DietDiet
FP - Vaccines Available MLV vaccines
• Injectable vaccines• Intranasal vaccines
Inactivated vaccines• Injectable non-adjuvanted• Injectable adjuvanted
Recombinant FP vaccines - experimental
FP vaccines are often in combination JAVMA 229(9):1405-1441, 2006
Feline Vaccine Feline Vaccine RecommendationsRecommendations
Standard ConditionsStandard ConditionsFPV/FHV/FCVFPV/FHV/FCV
First vaccine First vaccine 8 - 10 weeks 8 - 10 weeks Second vaccineSecond vaccine 12 - 14 weeks12 - 14 weeks First booster vaccineFirst booster vaccine 1 year later 1 year later Booster vaccines Booster vaccines every 3 yearsevery 3 years
2006 AAFP Vaccine Advisory Panel Report- Feline Panleukopenia -2006 AAFP Vaccine Advisory Panel Report- Feline Panleukopenia -
Initial series of vaccinations
– 6-16 weeks of age
– 2+ doses 3-4 weeks apart Revaccinate one year later – single dose Then revaccinate no more frequently than every 3 yrs. Serious adverse reactions to FPV vaccines are rare CPV-2 can infect cats - FPV vaccines protect
JAVMA 229(9):1405-1441, 2006
LONG-TERM IMMUNITY IN LONG-TERM IMMUNITY IN CATS VACCINATED WITH CATS VACCINATED WITH
AN INACTIVATED AN INACTIVATED TRIVALENT VACCINETRIVALENT VACCINE
Fred W. Scott, DVM, PhDFred W. Scott, DVM, PhD
Cordell M. Geissinger, BSCordell M. Geissinger, BS
Cornell Feline Health CenterCornell Feline Health Center
Feline Practice 25(4):12-19 (1997)Feline Practice 25(4):12-19 (1997)
AJVR AJVR 6060:652-658 (1999):652-658 (1999)
Duration of Immunity StudyDuration of Immunity StudyInactivated FHV-FCV-FPV VaccineInactivated FHV-FCV-FPV Vaccine
15 SPF kittens 15 SPF kittens Vaccinated 2x @ 8 & 11 wks of ageVaccinated 2x @ 8 & 11 wks of age No booster vaccines givenNo booster vaccines given
Placed in SPF breeding colonyPlaced in SPF breeding colony Offspring added to increase colony Offspring added to increase colony
No vaccine given to new catsNo vaccine given to new cats Original cats bled for serum on entryOriginal cats bled for serum on entry All cats bled at 3 years, then yearlyAll cats bled at 3 years, then yearly VN titers of serum run - FHV, FCV, FPVVN titers of serum run - FHV, FCV, FPV
The CatsThe Cats- After 7.5 Years -- After 7.5 Years -
9 vaccinates remained in colony9 vaccinates remained in colony– raised multiple littersraised multiple litters
8 unvaccinated contact controls 8 unvaccinated contact controls – raised multiple littersraised multiple litters
Mean VN Titer
FPV (Y1) FCV (Y2)
FHV (Y2)
Year after Vaccination1/6 3 4 5 6 7
01000200030004000500060007000
020406080100120140160
Scott & Geissinger, AJVR, 60:652-8 (1999)
Relative Efficacy of an Relative Efficacy of an Inactivated Triple VaccineInactivated Triple Vaccine7.5 Years after Vaccination7.5 Years after Vaccination
Feline parvovirusFeline parvovirus 100%100% Feline herpesvirusFeline herpesvirus 52% 52% Feline calicivirusFeline calicivirus 63% 63%
Duration of Immunity StudyDuration of Immunity StudyFPV ConclusionsFPV Conclusions
2 doses of inactivated, adjuvanted FPV 2 doses of inactivated, adjuvanted FPV vaccine provide solid immunity for at vaccine provide solid immunity for at least 7 yearsleast 7 years
1 cat still had solid protective Ab titer 14 1 cat still had solid protective Ab titer 14 years after vaccinationyears after vaccination
FPV - FPV - Disinfectants/Antiseptics Disinfectants/Antiseptics
Alcohols - ethyl, 70% isopropyl Phenolics - hexachlorophene, lysol Surfaces-active compounds - Quats,
amphoterics Biquanides - chlorhexidine Halogens - chlorine (hypochlorite), iodines Aldehydes - formaldehyde, glutaraldehyde Ethylene oxide
Inactivate FPVInactivate FPV
Not Inactivate Not Inactivate FPVFPV
Panleukopenia ~ Panleukopenia ~ ManagementManagement
Very important in shelters & pet storesVery important in shelters & pet stores Vaccinate newly arrived cats immediatelyVaccinate newly arrived cats immediately– MLV vaccineMLV vaccine
Place newly vaccinated cats in isolated, Place newly vaccinated cats in isolated, disinfected cages away from other catsdisinfected cages away from other cats
Use proper disinfectantsUse proper disinfectants– Household bleach (Clorox) 1:32Household bleach (Clorox) 1:32
– Cages, food and water dishes, floors, beddingCages, food and water dishes, floors, bedding
Prevent spread of virus by personnelPrevent spread of virus by personnel– Hands and clothingHands and clothing
– shoesshoes
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