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Scientific Fun Fact

Scientific Fun Fact. Armillaria ostoyae (honey mushroom). PANSYTEMIC DISEASES. CANINE. CASE #1. PATIENT PRESENTATION. PATIENT PRESENTATION. SIGNALMENT: 12 week old, male/neutered, mixed breed puppy

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Scientific Fun Fact

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  1. Scientific Fun Fact Armillaria ostoyae (honey mushroom)

  2. PANSYTEMIC DISEASES CANINE

  3. CASE #1

  4. PATIENT PRESENTATION

  5. PATIENT PRESENTATION • SIGNALMENT: 12 week old, male/neutered, mixed breed puppy • PRESENTING COMPLAINT: lethargy, ocular and nasal discharge for the past 3 days; 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

  6. 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

  7. 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

  8. 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

  9. DIAGNOSTICS AND TREATMENT • DIAGNOSTIC TEST RESULTS: • Leukopenia • 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

  10. DIAGNOSIS:CANINE DISTEMPER VIRUS http://www.youtube.com/watch?v=HyEFS77rOzU http://www.youtube.com/watch?v=QL4S4MA2zT0 *Myoclonus is almost pathognomonic for Canine Distemper

  11. PATIENT PRESENTATION HYPERKERATOSIS OF NOSE & FOOT PADS ENAMEL HYPOPLASIA

  12. DIAGNOSTICS AND TREATMENT • FURTHER DIAGNOSTICS: • Blood work drawn to compare serum titers and CBC results • Leukocytosis with neutrophilia found • 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

  13. PROGNOSIS & CLIENT INFORMATION • Transmission of this (single-stranded, RNA, paramyxo-) virus is through aerosolization of bodily fluids, fomites • Fatality rate may be as high as 50%- 90% • Prognosis is guarded at best, esp 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

  14. PREVENTION • Vaccination • Thorough cleaning – the virus is labile and can be killed with common disinfectants, and heat • Isolation of infected animals

  15. CASE #2

  16. PATIENT PRESENTATION

  17. 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 2 days before beginning daycare.

  18. PATIENT PRESENTATION • Hx: • Diet: Purina One • Patient is current on HW and flea prevention • No other significant illnesses • 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

  19. DIAGNOSIS: CANINE RESPIRATORY DISEASE COMPLEX • Aka Infections Tracheobronchitis • Major causes • VIRUSES: Canine Adenovirus-2, Parainfluenza, Canine Distemper, Canine Influenza • BACTERIA: mycoplasma, bordetella bronchiseptica, streptococcus sp. http://www.youtube.com/watch?v=amGKQX9zdug

  20. DIAGNOSTICS & TREATMENT • DIAGNOSTICS • Based on physical exam, clinical signs and history • Virus isolation from swabs of the pharynx, nasal passageways, trachea • Thoracic rads if pneumonia suspected • TREATMENT • Adequate hydration • Antibiotics • Antitussives • Hycodan (hydrocodone) • Butorphanol • Cough Tabs (dextromethorphan, guafenesin) • Bronchial dilators • Aminophylline • terbutaline

  21. PROGNOSIS & CLIENT INFORMATION • 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

  22. PREVENTION • Isolate infected animals • Vaccinate appropriately • Most routine disinfectants, bleach, quarternary ammonium compounds will kill these viruses and bacteria • Proper sanitation

  23. CASE #3

  24. PATIENT PRESENTATION

  25. PATIENT PRESENTATION • SIGNALMENT: 3mth old Rottweiler puppy, intact male • *Dobermans & Rottweilers are over-represented • 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

  26. 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

  27. 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

  28. DIAGNOSTICS • 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)

  29. PARVO ELISA

  30. 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

  31. TREATMENT • 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

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

  33. PREVENTION & CLIENT INFORMATION • 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.

  34. CASE #4

  35. PATIENT PRESENTATION • 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

  36. 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

  37. DIAGNOSTICS • 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

  38. DIAGNOSIS

  39. TREATMENT • FLUIDS • ANTIBIOTICS • NURSING CARE • Warm, clean • Force feed, warm, food • Pain meds for oral or corneal ulcers • DECREASE STRESS • AVOID STEROID • ANTIVIRAL • Idoxuridine

  40. PROGNOSIS & CLIENT INFORMATION • 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

  41. PREVENTION • VACCINATION • Vaccines will reduce severity and duration of clinical signs

  42. CASE #5

  43. PATIENT PRESENTATION http://www.youtube.com/watch?v=xLlL24shW7E

  44. PATIENT PRESENTATION • SIGNALMENT: 4week old, intact female, DSH • PRESENTING COMPLAINTS: kitten is depressed and appears to be very thin, has blood-tinged diarrhea, occasional vomiting • Hx: Owner lives in an apartment complex and found this kitten outside. She thinks she know the mom, but the mom doesn’t seem to be taking care of her.

  45. PATIENT PRESENTATION • PHYSICAL EXAM FINDINGS • 103.9 • ~6% dehydrated • Ataxic, unstable • Lethargic • Fecal-soiled rear-end

  46. DIAGNOSTICS • CBC • Moderate to severe panleukopenia • Positive parvo snap test • Antibody titers • Virus isolation

  47. TREATMENT • Maintain hydration and electrolyte balance • Force-feeding • Broad-spectrum antibiotics

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