Armillaria ostoyae (honey mushroom)

CANINE

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

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

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

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

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

http://www.youtube.com/watch?v=QL4S4MA2zT0

http://www.youtube.com/watch?v=HyEFS77rOzU

*Myoclonus is almost pathognomonic for Canine Distemper

ENAMEL HYPOPLASIA

HYPERKERATOSIS OF NOSE & FOOT PADS

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

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

Vaccination Thorough cleaning – the virus is labile and

can be killed with common disinfectants, and heat

Isolation of infected animals

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.

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

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

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

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

Isolate infected animals Vaccinate appropriately Most routine disinfectants, bleach,

quarternary ammonium compounds will kill these viruses and bacteria

Proper sanitation

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

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

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

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)

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

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

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

prognosis

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.

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

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

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

FLUIDS ANTIBIOTICS NURSING CARE

◦ Warm, clean◦ Force feed, warm, food◦ Pain meds for oral or corneal ulcers

DECREASE STRESS AVOID STEROID ANTIVIRAL

◦ Idoxuridine

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

VACCINATION◦ Vaccines will reduce severity and duration of

clinical signs

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

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.

PHYSICAL EXAM FINDINGS◦ 103.9◦ ~6% dehydrated◦ Ataxic, unstable◦ Lethargic◦ Fecal-soiled rear-end

CBC◦ Moderate to severe panleukopenia

Positive parvo snap test Antibody titers Virus isolation

Maintain hydration and electrolyte balance Force-feeding Broad-spectrum antibiotics

Proper vaccination Cats who survive the infection will not get

re-infected later in life. They acquire life-long immunity.