1. INFECTIOUS DISEASES THESE DISEASES ARE COVERED PREDOMINANTLY IN CHAPTER 9 & 11 OF YOUR TEXTBOOK Supplemental reading: https://www.aahanet.org/PublicDocuments/Canine VaccineGuidelines.pdf CTVT Textbook 8 th edition - pages 701-710

2. CASE #1 CANINE DISTEMPER

3. PATIENT PRESENTATION

4.  SIGNALMENT: 12 week old, male/neutered, mixed breed puppy  PRESENTING COMPLAINT: lethargy, ocular and nasal discharge for the past 3 days; mild cough, appetite is poor; puppy had diarrhea last night and vomiting/diarrhea this morning

5. PATIENT PRESENTATION  Hx:  puppy adopted from local shelter 2 weeks ago  has received one set of vaccinations  Incompletely vaccinated!  Other Info:  Client has 1 other dog who is 1 year old and fully vaccinated  Client has 2 cats who are 2 and 5 yrs old that are fully vaccinated

6. PATIENT PRESENTATION  PHYSICAL EXAM FINDINGS:  Lethargy  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

7. PATIENT PRESENTATION ENAMEL HYPOPLASIAHYPERKERATOSIS OF NOSE & FOOT PADS

8. DIAGNOSTICS & TREATMENT  DIAGNOSTIC TESTS:  CBC: to look for evidence of infection and/or anemia  Blood work to send off titers for Distemper Virus Infection  TREATMENT  ANTIBIOTICS  FLUIDS  SYMPTOMATIC TREATMENT  Anti-emetics  Ophthalmic ointments  Cleaning ocular/nasal discharge frequently  Nutrition  Clean, dry environment; low stress

9. DIAGNOSTICS  WORSENING OF CLINICAL SIGNS: 1 week later, the client returns. The puppy is weak and appears to have muscle twitching; muscles of the mouth appear as if the puppy is “chewing gum”; there are pustules on the abdomen, and hyperkeratotic foot pads & nose  LACK OF RESPONSE TO TREATMENT IS CHARACTERISTIC FOR CANINE DISTEMPER VIRUS

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

11. DIAGNOSTICS AND TREATMENT  FURTHER DIAGNOSTICS:  Blood work to compare serum titers and CBC results  CBC: Leukocytosis with neutrophilia found due to secondary infection  Titers have increased since last measurement  Flourescent antibody(FA): 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.

12. PROGNOSIS & CLIENT INFORMATION  Transmission of this (single-stranded RNA, enveloped, paramyxo-) virus is through aerosolization of bodily fluids, fomites  Fatality rate may be as high as 90%  Prognosis is guarded at best, especially 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 Parvovirus

16. PATIENT PRESENTATION

17.  SIGNALMENT: 3mth old Rottweiler puppy, intact male  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  Incorrect, incomplete vaccinations

18. 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 Neither puppy has been started on heartworm or flea prevention.

19. PATIENT PRESENTATION  PHYSICAL EXAM FINDINGS:  dehydrated  mm: pale, CRT: >2.5sec  Depressed  Rear soiled in blood-tinged diarrhea, strong, foul odor  Temp: 103.5, HR: 120 RR: 24

20. DIAGNOSTICS  Fecal  Check for concurrent intestinal parasitism  Parvo ELISA (snap test)  Detects viral antigen  CBC/Serum Chemistries  Marked lymphopenia, neutropenia, increased PCV  Parvovirus titers  High titers (1:10,000) in positive animals

21. PARVO ELISA

23. 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

24. TREATMENT  ISOLATE INFECTED ANIMALS  HOSPITALIZATION  IV fluids w/added electrolytes, added dextrose  ANTIBIOTICS  ANTI-EMETICS  Reglan (metoclopramide)  Cerenia (maropitant)  Zofran (ondansetron)  NSAIDs – possibly for fever, but could complicate bleeding  +/- Plasma transfusion for hypoproteinemia  +/- ANTIVIRAL  Tamiflu

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

26. 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 1 st 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.

27. DON’T WORRY, BE HAPPY “ WORRYING DOES NOT DECREASE THE STRUGGLES OF TOMORROWY, BUT IT DOES DECREASE THE STRENGTH OF TODAY. -MARY ENGELBRELT

28. CASE #3 Canine Respiratory Disease Complex (Kennel Cough, Infectious Tracheobronchitis) see ch.11 pgs193-194

29. PATIENT PRESENTATION

30.  SIGNALMENT: 4yr old, female spayed, dachshund  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 1 day before beginning daycare.

31. PATIENT PRESENTATION  Hx:  Patient is current on HW and flea prevention  HW neg.  No other significant illnesses  PHYSICAL EXAM FINDINGS:  Temp: 102.1, HR: 140, RR: 36  Sneezing and occasional coughing on exam  Cough can be elicited on tracheal palpation  Mild, clear nasal discharge  Normal hydration status  mm: pk. CRT: <2sec

32. DIAGNOSIS: CANINE RESPIRATORY DISEASE COMPLEX  Aka Infectious Tracheobronchitis  Major causes  VIRUSES: Canine Adenovirus-2, Parainfluenza, Canine herpesvirus, Canine Influenza, canine distemper virus  BACTERIA: mycoplasma, bordetella bronchiseptica, streptococcus sp. http://www.youtube.com/wa tch?v=amGKQX9zdug

33. DIAGNOSTICS & TREATMENT  DIAGNOSTICS  Based on physical exam, clinical signs and history  Virus isolation from swabs of the pharynx, nasal passageways, trachea can help determine which virus and/or bacteria is the cause  Thoracic rads if pneumonia suspected

34. DIAGNOSTICS & TREATMENT  TREATMENT  Adequate hydration  Antibiotics  Antitussives (cough suppressants)  Hycodan (hydrocodone)  Butorphanol  Cough Tabs (dextromethorphan, guaifenesin)  Bronchial dilators  Aminophylline  terbutaline

35. 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  Injectable Bordetella vaccine requires 2 doses at least 2 weeks apart, then another 7-10 days for protective immunity  If using the intranasal vaccine, 2-3 days prior to exposure is recommended

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

37. NOTE: CANINE HEPATITIS  CANINE HEPATITIS  Caused by Canine Adenovirus-1 (CAV-1)  The vaccine for CAV-2 (a respiratory virus) will cross-protect against canine hepatitis.  Hepatitis is uncommon due to thorough vaccination programs.  The disease causes hepatic necrosis in affected dogs  Treatment is supportive