Corine Boucraut-Baralon

Feline Herpesvirus Infection: ABCD Guidelines on Prevention and Management:

Overview Feline viral rhinotracheitis, caused by feline herpesvirus (FHV), is an upper respiratory tract disease that is often associated with feline calicivirus and bacteria. In most cats, FHV remains latent after recovery, and they become lifelong virus carriers. Stress or corticosteroid treatment may lead to virus reactivation and shedding in oronasal and conjunctival secretions. Infection Sick cats shed FHV in oral, nasal and conjunctival secretions; shedding may last for 3 weeks. Infection requires direct contact with a shedding cat. Disease signs Feline herpesvirus infections cause acute rhinitis and conjunctivitis, usually accompanied by fever, depression and anorexia. Affected cats may also develop typical ulcerative, dendritic keratitis. Diagnosis Samples consist of conjunctival, corneal or oropharyngeal swabs, corneal scrapings or biopsies. It is not recommended that cats recently vaccinated with a modified-live virus vaccine are sampled. Positive PCR results should be interpreted with caution, as they may be produced by low-level shedding or viral latency. Disease management ‘Tender loving care’ from the owner, supportive therapy and good nursing are essential. Anorexic cats should be fed blended, highly palatable food - warmed up if required. Mucolytic drugs (eg, bromhexine) or nebulisation with saline may offer relief. Broad-spectrum antibiotics should be given to prevent secondary bacterial infections. Topical antiviral drugs may be used for the treatment of acute FHV ocular disease. The virus is labile and susceptible to most disinfectants, antiseptics and detergents.

Feline immunodeficiency. ABCD guidelines on prevention and management.

Overview Feline immunodeficiency virus (FIV) is a retrovirus closely related to human immunodeficiency virus. Most felids are susceptible to FIV, but humans are not. Feline immunodeficiency virus is endemic in domestic cat populations worldwide. The virus loses infectivity quickly outside the host and is susceptible to all disinfectants. Infection Feline immunodeficiency virus is transmitted via bites. The risk of transmission is low in households with socially well-adapted cats. Transmission from mother to kittens may occur, especially if the queen is undergoing an acute infection. Cats with FIV are persistently infected in spite of their ability to mount antibody and cell-mediated immune responses. Disease signs Infected cats generally remain free of clinical signs for several years, and some cats never develop disease, depending on the infecting isolate. Most clinical signs are the consequence of immunodeficiency and secondary infection. Typical manifestations are chronic gingivostomatitis, chronic rhinitis, lymphadenopathy, weight loss and immune-mediated glomerulonephritis. Diagnosis Positive in-practice ELISA results obtained in a low-prevalence or low-risk population should always be confirmed by a laboratory. Western blot is the ‘gold standard’ laboratory test for FIV serology. PCR-based assays vary in performance. Disease management Cats should never be euthanased solely on the basis of an FIV-positive test result. Cats infected with FIV may live as long as uninfected cats, with appropriate management. Asymptomatic FIV-infected cats should be neutered to avoid fighting and virus transmission. Infected cats should receive regular veterinary health checks. They can be housed in the same ward as other patients, but should be kept in individual cages.

Feline Infectious Peritonitis ABCD Guidelines on Prevention and Management

Overview Feline Coronavirus infection is ubiquitous in domestic cats, and is particularly common where conditions are crowded. While most FCoV-infected cats are healthy or display only a mild enteritis, some go on to develop feline infectious peritonitis, a disease that is especially common in young cats and multi-cat environments. Up to 12% of FCoV-infected cats may succumb to FIP, with stress predisposing to the development of disease. Disease signs The ‘wet’ or effusive form, characterised by polyserositis (abdominal and/or thoracic effusion) and vasculitis, and the ‘dry’ or non-effusive form (pyogranulomatous lesions in organs) reflect clinical extremes of a continuum. The clinical picture of FIP is highly variable, depending on the distribution of the vasculitis and pyogranulomatous lesions. Fever refractory to antibiotics, lethargy, anorexia and weight loss are common non-specific signs. Ascites is the most obvious manifestation of the effusive form. Diagnosis The aetiological diagnosis of FIP ante-mortem may be difficult, if not impossible. The background of the cat, its history, the clinical signs, laboratory changes, antibody titres and effusion analysis should all be used to help in decisionmaking about further diagnostic procedures. At the time of writing, there is no non-invasive confirmatory test available for cats without effusion. Disease management In most cases FIP is fatal. Supportive treatment is aimed at suppressing the inflammatory and detrimental immune response. However, there are no controlled studies to prove any beneficial effect of corticosteroids.

Feline Leukaemia: ABCD Guidelines on Prevention and Management

Overview Feline leukaemia virus (FeLV) is a retrovirus that may induce depression of the immune system, anaemia and/or lymphoma. Over the past 25 years, the prevalence of FeLV infection has decreased considerably, thanks both to reliable tests for the identification of viraemic carriers and to effective vaccines. Infection Transmission between cats occurs mainly through friendly contacts, but also through biting. In large groups of non-vaccinated cats, around 30–40% will develop persistent viraemia, 30–40% show transient viraemia and 20–30% seroconvert. Young kittens are especially susceptible to FeLV infection. Disease signs The most common signs of persistent FeLV viraemia are immune suppression, anaemia and lymphoma. Less common signs are immune-mediated disease, chronic enteritis, reproductive disorders and peripheral neuropathies. Most persistently viraemic cats die within 2–3 years. Diagnosis In low-prevalence areas there may be a risk of false-positive results; a doubtful positive test result in a healthy cat should therefore be confirmed, preferably by PCR for provirus. Asymptomatic FeLV-positive cats should be retested. Disease management Supportive therapy and good nursing care are required. Secondary infections should be treated promptly. Cats infected with FeLV should remain indoors. Vaccination against common pathogens should be maintained. Inactivated vaccines are recommended. The virus does not survive for long outside the host.

Feline panleukopenia. ABCD guidelines on prevention and management

Overview Feline panleukopenia virus (FPV) infects all felids as well as raccoons, mink and foxes. This pathogen may survive in the environment for several months and is highly resistant to some disinfectants. Infection Transmission occurs via the faecal-oral route. Indirect contact is the most common route of infection, and FPV may be carried by fomites (shoes, clothing), which means indoor cats are also at risk. Intrauterine virus transmission and infection of neonates can occur. Disease signs Cats of all ages may be affected by FPV, but kittens are most susceptible. Mortality rates are high - over 90% in kittens. Signs of disease include diarrhoea, lymphopenia and neutropenia, followed by thrombocytopenia and anaemia, immunosuppression (transient in adult cats), cerebellar ataxia (in kittens only) and abortion. Diagnosis Feline panleukopenia virus antigen is detected in faeces using commercially available test kits. Specialised laboratories carry out PCR testing on whole blood or faeces. Serological tests are not recommended, as they do not distinguish between infection and vaccination. Disease management Supportive therapy and good nursing significantly decrease mortality rates. In cases of enteritis, parenteral administration of a broad-spectrum antibiotic is recommended. Disinfectants containing sodium hypochlorite (bleach), peracetic acid, formaldehyde or sodium hydroxide are effective.

Bordetella Bronchiseptica Infection in Cats: ABCD Guidelines on Prevention and Management:

OverviewBordetella bronchiseptica is a Gram-negative bacterium that colonises the respiratory tract of mammals and is considered to be a primary pathogen of domestic cats. It is sensible to consider B bronchiseptica as a rare cause of zoonotic infections. The bacterium is susceptible to common disinfectants. Infection The bacterium is shed in oral and nasal secretions of infected cats. Dogs with respiratory disease are an infection risk for cats. The microorganism colonises the ciliated epithelium of the respiratory tract of the host, establishing chronic infections. Disease signs A wide range of respiratory signs has been associated with B bronchiseptica infection, from a mild illness with fever, coughing, sneezing, ocular discharge and lymphadenopathy to severe pneumonia with dyspnoea, cyanosis and death. Diagnosis Bacterial culture and PCR lack sensitivity. Samples for isolation can be obtained from the oropharynx (swabs) or via transtracheal wash/bronchoalveolar lavage. Disease management Antibacterial therapy is indicated, even if the signs are mild. Where sensitivity data are unavailable, tetracyclines are recommended. Doxycycline is the antimicrobial of choice. Cats with severe B bronchiseptica infection require supportive therapy and intensive nursing care.

Bartonella Species Infection in Cats ABCD guidelines on prevention and management

Overview: Over 22 Bartonella species have been described in mammals, and Bartonella henselae is most common worldwide. Cats are the main reservoir for this bacterium. B henselae is the causative agent of cat scratch disease in man, a self-limiting regional lymphadenopathy, but also of other potentially fatal disorders in immunocompromised people. Infection: B henselae is naturally transmitted among cats by the flea Ctenocephalides felis felis, or by flea faeces. A cat scratch is the common mode of transmission of the organism to other animals, including humans. Blood transfusion also represents a risk. Disease signs: Most cats naturally infected by B henselae do not show clinical signs but cardiac (endocarditis, myocarditis) or ocular (uveitis) signs may be found in sporadic cases. B vinsonii subspecies berkhoffii infection has reportedly caused lameness in a cat affected by recurrent osteomyelitis and polyarthritis. Diagnosis: Isolation of the bacterium is the gold standard, but because of the high prevalence of infection in healthy cats in endemic areas, a positive culture (or polymerase chain reaction) is not confirmatory. Other compatible diagnoses must be ruled out and response to therapy gives a definitive diagnosis. Serology (IFAT or ELISA) is more useful for exclusion of the infection because of the low positive predictive value (39–46%) compared with the good negative predictive value (87–97%). Laboratory testing is required for blood donors. Disease management: Treatment is recommended in the rare cases where Bartonella actually causes disease.

Chlamydophila felis infection. ABCD guidelines on prevention and management.

OverviewChlamydophila felis is a Gram-negative bacterium and its primary target is the conjunctiva. The bacterium does not survive outside the host. Infection Transmission requires close contact between cats; ocular secretions are probably the most important body fluid for infection. Most cases occur in cats under 1 year of age. Chlamydophila felis is the infectious organism most frequently associated with conjunctivitis. Disease signs Unilateral ocular disease generally progresses to become bilateral. There can be intense conjunctivitis with extreme hyperaemia of the nictitating membrane, blepharospasm and ocular discomfort. Transient fever, inappetence and weight loss may occur shortly after infection, although most cats remain well and continue to eat. Diagnosis PCR techniques are now preferred for diagnosing C felis infection. Ocular swabs are generally used. In unvaccinated cats, antibody detection can be used to indicate infection. Disease management Tetracyclines are generally regarded as the antibiotics of choice. Doxycycline has the advantage of requiring only single daily administration and is given at a dose of 10 mg/kg orally. Vaccination should be considered if there is a history of confirmed chlamydial disease in a shelter. Single housing and routine hygiene measures should suffice to avoid cross-infection. Cats maintained together for longer terms should be vaccinated regularly. In breeding catteries where C felis infection is endemic, the first step should be to treat all cats with doxycycline for at least 4 weeks. Once clinical signs have been controlled, the cats should be vaccinated.

Leishmaniosis in cats: ABCD guidelines on prevention and management

Overview: Leishmania infection is less known in cats than in dogs and humans; felids were traditionally considered a resistant species, and canids as the main reservoir. Only sporadic cases of feline disease have been reported worldwide, mainly caused by L infantum. Epidemiological investigations have confirmed, however, that feline infections are not rare and that disease occurrence might be underestimated in endemic areas. Infection: Cats are infected by the same Leishmania species that infect dogs and humans in tropical and subtropical areas worldwide. Sand fly vectors take blood meals from cats and are competent vectors for L infantum, as shown experimentally. Disease signs: Skin lesions (ulcerative, crusty, nodular or scaly dermatitis) are the most frequent clinical manifestations and sometimes the only findings on physical examination. Lymph node enlargement, weight loss, ocular involvement (nodular blepharitis, uveitis, panophthalmitis), decreased appetite, chronic gingivostomatitis and lethargy are the most frequent non-cutaneous findings, alone or in combination. Diagnosis: Direct confirmation can be obtained by cytology, histology, isolation or polymerase chain reaction (PCR) on samples of skin, lymph nodes, blood or any affected tissue. Serology using a validated immunofluorescence test, ELISA, direct agglutination or Western blot has been used to assess infection frequencies. Disease management: Little information is available about treatment with follow-up reports. Long-term administration of allopurinol (10–20 mg/kg q12h or q24h) is usually clinical effective. Vaccines are licensed for dogs only.

Dermatophytosis in cats: ABCD guidelines on prevention and management.

Overview: Dermatophytosis, usually caused by Microsporum canis, is the most common fungal infection in cats worldwide, and one of the most important infectious skin diseases in this species. Many adult cats are asymptomatic carriers. Severe clinical signs are seen mostly in kittens or immunosuppressed adults. Poor hygiene is a predisposing factor, and the disease may be endemic in shelters or catteries. Humans may be easily infected and develop a similar skin disease. Infection: Infectious arthrospores produced by dermatophytes may survive in the environment for about a year. They are transmitted through contact with sick cats or healthy carriers, but also on dust particles, brushes, clothes and other fomites. Disease signs: Circular alopecia, desquamation and sometimes an erythematous margin around central healing (‘ringworm’) are typical. In many cats this is a self-limiting disease with hair loss and scaling only. In immunosuppressed animals, the outcome may be a multifocal or generalised skin disease. Diagnosis: Wood’s lamp examination and microscopic detection of arthrospores on hairs are simple methods to confirm M canis infection, but their sensitivity is relatively low. The gold standard for detection is culture on Sabouraud agar of hairs and scales collected from new lesions. Disease management: In shelters and catteries eradication is difficult. Essential is a combination of systemic and topical treatments, maintained for several weeks. For systemic therapy itraconazole is the drug of choice, terbinafine an alternative. Recommended topical treatment is repeated body rinse with an enilconazole solution or miconazole with or without chlorhexidine. In catteries/shelters medication must be accompanied by intensive decontamination of the environment. Vaccination: Few efficacy studies on anti-M canis vaccines (prophylactic or therapeutic) for cats have been published, and a safe and efficient vaccine is not available.