Fever, Pyrexia, Febris

Humanity has three great foes

Fever, Famine and Fights of those the most terrible
by far is fever
William Osler
• Clinically the fever is characterized by increase in body
temperature(>2°F)
• Anorexia,depression,loss of milk production
• Pyrexia is elevation of body temperature caused by the stimulation
of the thermoregulatory center(lies within the
hypothalamus),under the influence of pyrogens circulating in
blood.
 Continued……

• Infectious agents ,inflammatory lesions, massive tissue damage

immune complexes release certain chemicals(toxins) called
• Exogenous toxins (Pyrogens)
• e.g. G-ve bacteria Lipopolysaccharides (Lipid-A)
• Ex.pyrogens in blood release certain types of low molecular
weight proteins from polymorphonuclear leucocytes, lympocytes ,
Monocytes,macrophages,vasular endothelium etc.known as
Endogenous Pyrogens/Leucocytic pyrogens
e.g. interleukin -1,tumor necrosis factor(a&b),cachectin,and interferons
These don’t cross blood brain barrier but bind to surface receptors on endothelial
cells of blood vessels close to the neurons of ‘Temperature Regulatory Center’
Hypothalamus
Continued…

Calcium channels activated

influx of calcium ions into the cells
↓
Phospholipase-A2 +cyclooxygenase
activated
↓
Arachidonic acids
e.g.PGE2(Prostaglandin E2)
↓

Neurotransmitters
↓

Raise body temp. to a new set point

Continued……..

• Conservation of heat loss by peripheral

vasoconstriction and heat production by shivering
↓
Fever
 Continued…..

Feedback mechanism of PG
↓
Stimulation of cAMP
Cyclic adenosine monophosphate derivative of AMP,intra cellular signalling
transduction

↓
control production of interleukin-1
other end. pyrogens
 Continued…….

Prolonged continued fever

↓ ↓ ↓

Increased metabolism
↓ ↓ ↓

Low feed intake+Prolonged fever

Catabolism and muscular atrophy
Wasting and general body weakness
↓ ↓ ↓

Cardiovascular failure, Early embryonic death , Abortion

Pyrexia or Fever of Unknown Origin
PUO/FUO

• Febrile conditions
• For wks/months
• Non-specific signs e.g.anorexia,wt loss,depression
etc.
• Obscured diagnosis
 Etiology
• Bacterial Diseases Haemorrhagic septicemia,black quarter ,anthrax .brucellosis,
glanders ,strangles,tetnus etc.
• Viral Diseases Rinderpest , blue tongue ,malignant catarrhal fever, bovine viral
diarrhoea, canine distemper etc.
• ParasiticDiseasesBabesiosis,toxoplasmosis,anaplasmosis,trypanosomiasis,theileri
osis,coccidiosis etc.
• Fungal Diseases Aspergillosis, mycotoxicosis etc.
• Immune mediated disordersAnaphylaxis ,drug allergies, thrombocytopenia etc.
• Septicemia and Toxemic conditions mastitis, metritis, pyelonephritis, hepatitis
etc.
• Tumors Lymphosarcoma ,squamous cell carcinoma etc.
• Plant/Animal/Chemical Poisoning castor beans, ergot poisoning,
arsenic,mercury,furazolidone,mercury,kerosien oil
• Miscellaneous trauma,burns,surgery,hemolysis,post-parturient hemoglobinuria
 Types of Fever
• Simple Fever
• Doesn’t touch to normal limit within 24hrs.
• Doesn’t exceed 2°F Enteric fever
• Remittent Fever
• Doesn’t touch to normal limit within 24hrs.
• More than 2°F Babesiosis,urinary infection ,brucellosis ,septicemia
,Bronchopneumonia
• Intermittent(Relapsing Fever)
• Brief attacks of fever for several hrs ,then afebrile condition
• Human malaria, canine distemper, neoplasm,trypanosomiasis
• Atypical/Irregular fever
• Daily fluctuation of body temp.no specific pattern Strangles, louping
ill
 Transient(Ephemeral) Fever
• Fever subsides in 24hrs. Bovine ephemeral fever
• Continous Fever
• Temperature remains elevated for longer period than simple
fever Q fever
• Periodic Fever
• Body temp.rises with an alternate afebrile periods
• Sustained Fever
• Consistent high rise in body temperature without any variation
• > 3 wks.(Fever of unknown origin)
 Hyperthermia/Heat-Stroke,Heat Prostration,Malignant
Hyperthermia

Elevation in body temp. either due to

• Excessive heat production OR
• Excessive heat absorption OR
• Deficient heat loss

It is non-infectiuos (physical)condition due to high environmental

temperature and humidity
 Etiology

• Severe muscular exertion, dehydration, electrolyte

imbalance predisposing ….hyperthermia
• At >60 percent humidity …↓ heat loss by sweating
• Exotic breeds more sensitive than indigenous breeds
• Fat, lactating, long hair coat spps more sensitive
• Damage to hypothalamus(neurological hyperthermia)
 Pathogenesis

• Heat load /heat production ↑

• Homeostatic mechanism of temp regulation fails to dissipate
heat temp. ↑
• Increase in metabolic rate
• Non-protein nitrogen contents↑in blood
• Liver glycogen↓
• Hypoglycemia
• Heart and respiration rate increases(due to high metabolism
and body temp.
• If temp 108°F…depression of nervous activity and respiratory
center…..certain death
 Clinical Findings

• Rise in body temp.(>2°F)

• Depression
• Loss od appetite
• Constipation
• Diarrhoea
• ↓ milk production
• Muscle wasting/emaciation (chronic cases)
• Clinical signs observed with various stages of fever
• Stage I (Period of increment Temp.or chill)
• Cutaneous vasoconstriction, coldness and dryness of skin
 Continued….

• Sweating absent,decreased respiration rate, muscle shivering

,piloerection ,curling and gathering ↑ heart rate and core body
temp.,↓ urine output
• Stage II Period of constant Temp. /Fastigium
At this stage body temp. remains constant but at a higher set point
so heat production and loss remain constant
. Stage III Period of Decrement Temp. or Defervescence
At this stage vasodilation, sweating muscle flaccidity, polyuria
and decrease in body temp. than of stage I
 Clinical Signs (Hyperthermia)

• Sudden rise in body temp.107-108°F

• Increased heart and respiration rate
• Dyspnea,absence of sweating
• Increase in thirst
• General depression, during months of high environmental
temperature and humidity indicative of HEAT STOKE
• Complications
• Early embryonic death
• Abortion
• DIC…..liver kidney dysfunction,mycardial necrosisIn
untreated animals convulsions, collapse, coma ….death
 Clinical Pathology

• CBC
• Leukopenia then leukocytosis with or without shift to left
• ↑ serum protein(Fibrinigen)
• For etiology diagnosis
• Blood culture(bacteria)
• Blood smears(hemoparasites)
• Serum liver enzymes(liver function)
• Abdominocentesis(evaluation of peritoneal fluid)
• Serology for viral infections
• Renal and liver dysfunction (In hyperthermia)
 Necropsy Findings

• Vasodilation
• Rapid rigor mortis
• Early putrefaction of carcass
• Partial clotting of blood (Hyperthermia)
• Microscopic necropsy lesion in kidneys liver
(Hyperthermia)
 Treatment

• Specific Treatment
• Antibacterial,antiprotozoal ,antifungal drugs
• Specific anti toxins/hyperimmune serum Anti FMD serum,anti
enterotoxemia serum etc.
• Symptomatic Treatment
• Antipyretics,Adrenocortical hormones and diuretics
↓
By blocking PG synthesis
Examples Sod.Salicylate 30-50 mg/kg LA/SA PO
100 mg/kg horse IV
• Acetyl salicylic acid (Aspirin) 100 mg /cat 500 mg/dog PO
• Phenyl butazone 10-20 mg/kg SA Horses 4-8 mg/kg PO
• 2-4 mg/kg IV
• Oxyphenyl butazone(Dipyrone) 20-30 ml/LA IV IM
• It has longer antipyretic effect than salicylates
• NB: high temp…..cold water or ice packs
• Adrenocortical hormones collapse /shock
• Dexamethasone 0.5…upto 6mg mg tab, PO ,(2m/ml g-
10mg/ml IM, IV).etc.
• Prednisolone cattle 4-8 ml IV,Horses IV 6-10 ml, SA 0.1-3ml
IM SC
• Diuretics
• Lowering body temp.
• Removal of body toxins
• Example: Fursemide (Lasix) 4-8mg/kg IV IM
• Fever mixture
• Soda salicylate 30gm Ammonium Chloride 20gm Magnesium
sulphate 200gm Water QS(quantity sufficient) to drench
• Chiretta …..Antipyretic effect
• Supportive Treatment
• Multi-vitamins, minerals ,palatable diet
• Treatment of Complications
• Anemia, dehydration ,anorexia etc.
 Treatment Hyperthermia

• Cold water application ……. 1-2°F↓ temp.

• Cold water enema…↓ body temp.
• Fluid therapy …..5% Dextrose or NS 0.85%...... ↓ body temp.
and dehydration
• Cold drinking water with salt
• Well ventilated shelter
• Antipyretics
• Antibiotics…for secondary bacterial
infections,tranquilizers…Acepromazine etc.
• For prevention….exercise…hard work….grazing avoided in
hot sunny days
 Hypothermia

• Lowering of body temp. than normal

• Excessive heat loss
• Insufficient heat production
• In cold ,wet and windy weather,if animal cannt regulate its body temp.by
metabolic activity,muscle tone and peripheral vasoconstriction
Etiology
Decreased muscular activity…winter season
Emaciation ..malnutrition
Metabolic conditions hypoglycemia,hypocalcemia,electrolyte
imbalance,acidosis
Damage to thermoregulatory system
Diseases causing hypoxia,coma ,collapse
Profused watery diarrhoea
Anaesthsia
 Clinical Findings

• Sub-normal body temp.

• Cold skin and extremities
• Weak shallow breathing
• Low cardiac output hypoxemia..reflexes decrease…death
(In hyperthermia)
Hypothermia following hyperthermia or any other fatal disease is
a bad prognosis
Treatment
Preheated room or shed
Prewarmed Dextrose solution 10 25 50 percent IV
• In hypoxia oxygen therapy

• Rectal enemata with luke-warm water

• Use of corticosteroids