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NoKill Conference 2013

Shelter Medicine for Non-Vets Session II Disease Treatment for Shelters
Michael R. Moyer, V.M.D. NoKitten Consulting Bridgewater Veterinary Hospital, Inc. Pethealth Consultant info@nokitten.com

Overview of Diseases Considered
Canine Parvovirus (GI) Feline Panleukopenia (GI) Canine Respiratory Disease Complex (URI) Feline Respiratory Diseases (URI) Dermatophytosis Eye, limb, skin trauma

Canine Parvovirus
• • • •
Closely related to Feline Panleukopenia Virus Affects dogs, wolves, coyotes, foxes, big cats, bears Some current stains can infect domestic cats** Fecal-oral transmission (remember puppies are covered in poop!) • Infected animals can shed virus for 2 weeks, even if not showing any clinical signs • Can persist in environment for up to 5 months • Affects cells of GI tract, bone marrow, growing cardiac muscle, and lymphoid tissue

Canine Parvovirus: Risk Profile
• • • • •
Naive (unvaccinated) dogs Young dogs, less than 6 months of age Usually 6 weeks – 20 weeks most severe disease No gender predilection Seasonal: July-Sept 3x > than Nov-June

Canine Parvovirus: Contagious!

Canine Parvovirus: Signs/Symptoms .

sometimes bloody) .Canine Parvovirus: Symptoms • • • • • • Lethargy Anorexia Vomiting Fever Dehydration Abdominal pain Diarrhea occurs 12-48 hours later a lot of it! (watery.

virus isolation .Canine Parvovirus: Diagnosis • Fecal Snap Test: detects Parvo antigens • Can detect as long as patient is shedding virus. later neutropenia • May not appear until after patient is showing clinical signs • PCR. even if clinical signs have resolved • Can have false positive results if vaccinated within the last week • CBC: leukopenia • Early lymphopenia.

observe for symptoms. high titer means lower risk. no titer means high risk Not-exposed: Keep in location.Canine Parvovirus: Risk Assessment Symptomatic: Test/treat in isolation** Exposed: Isolate/observe--can do titers against parvo. can adopt but urge vigilance with adoptors .

Canine Parvovirus: Treatment The mainstay is symptomatic. supportive care • Fluids: to replace fluids lost in diarrhea and vomit • IV ideal. oral or subQ possible depending on severity of illness • Balanced crystalloid +/. Maropitant OK only if >16 wks old .colloid • Antibiotics: to prevent sepsis • Ampicillin is a good choice! • Antiemetics • Ondansetron good.

encourage to eat! • Oral nutrition keeps intestine healthier • Consider GI protectants--sucralfate .Canine Parvovirus: Treatment • Nutrition – once vomiting controlled.

but continue vaccination series for other viruses . you'll recall). Immune to parvo.Canine Parvovirus: Recovered Dogs Recovered dogs/puppies are okay for adoption after a two week period. but should be bathed before returning to the shelter (covered in poop.

you will have occasional breaks with this disease in your foster network . Because kitten foster is increasing.Feline Panleukopenia Virtually identical to Canine Parvovirus. but more acute deaths seen in kittens (often with no prelude signs).

. any plurality of kitten will be covered in poop! Fecal oral and "hair borne" disease with cats.Feline Panleukopenia: Spread As with puppies.

Feline Panleukopenia: Symptoms • • • • • • • • Lethargy Anorexia Vomiting Fever Dehydration Abdominal pain Diarrhea Acute death .

Feline Panleukopenia: Diagnosis Symptoms in high risk cats/kittens Fecal antibodies (Idexx Parvo kits) Necropsy showing segmental enteritis PCR .

Feline Panleukopenia: Treatment Fluid support--can be very challenging in very young kittens Antibiotics to defend against sepsis Serum from vaccinated cat in exposed. naive kittens may be helpful .

Feline Panleukopenia: Recovered Cats Can be adopted after 2 week period Bath before return to shelter Immune to panleukopenia. but continue vaccination series for other viruses .

Canine Respiratory Disease CIRD Constellation of agents Route of Infection Incubation Periods "rolling infection" Role of Vaccination Diagnostics Treatments .

Canine Respiratory Disease Primary Causative Agents: Canine Distemper Canine Influenza Canine Respiratory Corona Virus Canine Adenovirus Canine Herpes Virus Canine Parainfluenza Virus Bordetella bronchiseptica Mycoplasma Streptococcus zooepidemicus .

Canine Respiratory Disease Route of Infection: Aerosol. Fomite .

Canine Respiratory Disease Incubation Period Short: Canine Influenza 1 day Medium: Bordetella 2-4 days Long: Distemper 7-21 days .

Canine Respiratory Disease "Rolling Infection" in a kennel population .

.Canine Respiratory Disease Role of Vaccination: Crucial protective barrier for community. for foster/rescue cohabitant dogs. for limiting extent of spread in shelter dog population. All dogs should be vaccinated on intake for Distemper combination and Bordetella.

Culture/sensitivity for bacterial infections to guide empirical vaccination choices.Canine Respiratory Disease Diagnostics Important in populations to appreciate the variety and shift in causative agents over time. .

Antibiotics for Bordetella or secondary bacterial infections.Canine Respiratory Disease Treatment Most of the viral diseases require only general supportive care and appropriate isolation/segregation to halt spread. Antitussives not particularly helpful in most cases. .

Feline Respiratory Disease URI Constellation of agents Route of Infection: New vs. Recrudescent Role of Stress Incubation Periods Role of Vaccination Diagnostics Treatments .

Feline Respiratory Disease URI Constellation of Agents Feline Rhinotracheitis Virus Feline Calici Virus Feline Bordetella bronchiseptica Mycoplasma Chlamydophila Streptococcus zooepidemicus? .

Feline Respiratory Disease Route of Infection Fomite Direct Contact Hair Borne (special sort of fomite) .

spread to other cats depends on housing/movement/cleaning/disinfection protocols in shelter.Feline Respiratory Disease New Infection vs. Once shedding again. . Recrudescent Infection It is likely that many of the cats breaking with symptoms are recrudescent herpes or calici cats.

Feline Respiratory Disease Role of Stress Lack of hiding spaces Inability to stretch. assume normal cat postures Noise stress Smell stress Vibration stress Dog stress Handling/cleaning stress Group Housing stress (!) .

Feline Respiratory Disease Incubation period: 2-6 days Recovered herpes cats remain infected for life 8 % of house cats and 25% or more of cats in multi-cat households/catteries are chronic carriers/shedders of calici virus .

Feline Respiratory Disease Vaccination does not produce sterile immunity. but it is not an effective way to vaccinate against panleukopenia. Topical nasal vaccination may produce better immunity against respiratory agents. . but lessens the severity of disease.

Feline Respiratory Disease Diagnostics Respiratory panels for feline URI agents are commercially available and will be helpful to understand the range of pathogens in your shelter and cat community .

ophthalmic ointments (I especially like erythromycin for cat eyes) Antibiotics for secondary infections There is no benefit to L-lysine in the treatment of shelter cats . "de-crusting". including fluids.Feline Respiratory Disease Treatment General supportive care. humidification.

Dermatophytosis Intake Screening/Segregation Test all Wood's Lamp Fungal Culture and Microscopic ID Test high risk Kittens Hoarding cats Cats with lesions Long-haired cats .

Dermatophytosis .

Dermatophytosis Environmental containment Reduce clutter Sporicidal disinfection Mechanical cleaning Treatment of Positive Cats Systemic Topical with Lyme Sulfur Dip Treat until two consecutive negative weekly fungal cultures .

Dermatophytosis Itraconazole suspension Dosed variously: 5-10 mg/kg daily for 21 days or 2 consecutive negative cultures 5 mg/kg daily "pulsed": one week on. 3 "pulses" of drug . one week off.

. Limb. Skin Trauma Editorial Comments: We no longer teach practical. common sense care at veterinary teaching hospitals.Eye. Don’t be surprised when recent grads want to refer every fracture for plating or every eye problem to the ophthalmologist.

too) • Behavioral assessment/screening for placement (dogs) • Realistic assessment of appropriate • • repair/correction/treatment Impact of condition on adoptability Budgeting for immediate and follow up care (dollars. Limb. foster. space. Skin Trauma Overarching treatment goals should include: • Pain management (eyes hurt. other human resources) .Eye.

proptosed eyes.Eye. perforating ulcers. corneal perforations. lid abnormalities. lid tumors. glaucoma . Limb. Skin Trauma Eyes Cats: severe conjunctivitis. cherry eye. congenetally deformed/small eyes Dogs: entropion.

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joint fusion likely. or severe DJD . Limb. but after care is best done in foster (or educated adoptive home) rather than shelter environment Some fractures--especially those through a joint--cannot be returned to normal function. Skin Trauma Limb Trauma Long bone fractures can be repaired.Eye.

Eye. Limb. Skin Trauma .

Eye. Skin Trauma . Limb.

Skin Trauma . Limb.Eye.

Limb. . pins/cerclage wire. Skin Trauma Though we teach vet students exclusively referral level fracture repair. many long bone fractures can be managed with external splinting/casting.Eye. or external fixation.

Skin Trauma .Eye. Limb.

Questions? Thank You! .