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FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie
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FeLV si FIV Boli pisici an 5 curs Diagnostic si Profilaxie

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Imunodeficienta felina si Leucemia Felina, boli infectioase ale felinelor, metodologie de diagnostic de suspiciune si confirmare, Boli infectioase anul 5 curs patologie felina, Dragos Cobzariu

Imunodeficienta felina si Leucemia Felina, boli infectioase ale felinelor, metodologie de diagnostic de suspiciune si confirmare, Boli infectioase anul 5 curs patologie felina, Dragos Cobzariu

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  • 1. Dr. Dragos Cobzariu Sef Lucrari, FMV Bucureşti e-mail: dragoscobzariu@gmail.com 2014
  • 2. Leucemia Infectioasa si Imunodeficienta Felina DR. Dragos Cobzariu DVM PhD Infectious Diseases
  • 3. FeLV si FIV Introducere Feline leukemia virus (FeLV) and feline immunodeficiency virus (FIV) are among the most common infectious diseases of cats. Risk factors for infection include male gender, adulthood, and outdoor access, whereas indoor lifestyle and sterilization are associated with reduced infection rates.2–6 The retroviral status of all cats should be known. Cats may require retrovirus testing at different times in their lives. Here are some general principles for retrovirus testing: A cat with a confirmed-positive test result should be diagnosed as having a retroviral infection– not clinical disease. Diseases in cats infected with FeLV or FIV may not necessarily be the result of the retrovirus infection. Cats infected with FeLV or FIV may live for many years. A decision for euthanasia should never be made solely on the basis of whether or not the cat is infected. No test is 100% accurate at all times under all conditions. All test results should be interpreted along with the patient’s health and prior likelihood of infection. All positives should be confirmed by another test method. While they can be life-threatening viruses, proper management can give infected cats longer, healthier lives.
  • 4. FeLV(Eng.-Ro.) Feline leukaemia virus (FeLV) is a retrovirus, which may induce depression of the immune system, anaemia and/ or lymphoma ( anemie,imunosupresie,limfom) ■ It affects cats worldwide. The prevalence of infection in Europe is low(≤5%), although it may exceed 20% in some regions from East Europe ( prevalenta 5-20% datorita lipsei de informare a proprietarului si a vaccinarii, comertului cu animale fara a cunoaste provenienta acestora, si lipsei metodelor de testare) ■ Over the past 25 years, the prevalence of FeLV infection has dropped in US (datorita actiunilor sustinute de informare- profilaxie si datorita testelor si vaccinurilor), thanks to reliable diagnostic tests and vaccines.
  • 5. ETIOLOGIE
  • 6. ETIOLOGIE
  • 7. Retrovirusurile sunt specifice fiecarei specii . Acest lucru înseamnă ca un retrovirus felin, FIV va infecta numai pisicile, un retrovirus uman, HIV va infecta numai omul. Retrovirusurile sunt alcătuite din ARN. În gazdă, ARN-ul este transcris în ADN și încorporat în ADN-ul celulelor gazdei. Retrovirusurilor sunt fragile, fiind ușor inactivate de lumina ultravioleta, caldura, detergenti, și uscare. ETIOLOGIE
  • 8. Particularitati structurale virusul FeLV  Cats with transient viremia may develop persistent bone marrow infection-Fast tests used  spleen, lymph node or small intestine Peyer’s patches and timus develop persistent infection  neutralizing antibodies clear blod viremia  Once marrow infected, remain latent infection for years ( 3-4 years)  Latent infection can be present even though serological tests are negative  blood and bone marrow are negative for virus by Imunofluorescence, ELISA or viral culture, but viral genom can be found.  FeLV defective viruses that transduce cellular oncogenes – PCR used to find them LTR GAG LTR POL oncogene
  • 9. EPIDEMIOLOGIE ■ Transmission of infection occurs through viral shedding (saliva, faeces,nasal secretions, milk) by FeLV infected cats.(transmiterea virusurilor se realizeaza prin secretii, excretii, lapte, bolurile de apa si mancare custile de transport, litierele venite in contact cu pisicile infectate. Transmission between cats occurs mainly through friendly contacts(mutual grooming), but also through biting. (transmiterea se poate face doar prin contact, muscatura, zgarietura) ■ In large groups of cats: ( distributia viremiei)  30-40% will develop persistent viraemia,  30-40% show transient viraemia and  20-30% seroconvert; a minority(IgM IgG)  (~5%) shows antigenaemia in the absence of viraemia ■ In viraemic queens, pregnancy usually results in embryonic death, stillbirth or viraemic, ‘fading’ kittens(mortalitate embrionara, pisoi neviabili) ■ Young kittens are especially susceptible to FeLV infection. With age, cats become increasingly resistant( receptivitatea maxima o au pisoii mici in primele saptamani de viata)
  • 10. Clinic – suspicionam FeLV? ■ Most common(frecvent) signs of persistent FeLV viraemia are:  Anemia(mainly non-regenerative) Anemie  Imunosupresion (predisposition to other infections) Imunosupresie  Limfoma(thymic, alimentary, multicentric or atypical)Limfom Most persistently viraemic cats die within two to three years ■ Less common(atipic):  Immune-mediated disease (haemolytic anaemia, glomerulonephritis, polyarthritis) Boli autoimune  Chronic enteritis (crypt necrosis) Enterite cronice  Reproductive disorders (foetal resorption, abortion, neonatal death and fading kittens) Probleme Reproductive  Peripheral neuropathies (anisocoria, mydriasis, Horner’s syndrome, abnormal vocalisation, hyperesthesia, paresis, paralysis) Neuropatii SN periferic
  • 11. Patogeneza si Diagnostic Replication in tonsils Replication in draining lymph node Bone marrow Thymus Peyer’s patches Protective Immune Response Inadequate Immune Response Recovery Latency Viremia ELISA + Fast Tests ELISA + IFA + PCR on Bone Marrow Infection by oral route Infection by bite envelope (ENV) nucleocapsid p27 (GAG) genome (2 copies) RNA dep. DNA pol (POL) p15e gp70 http://www.youtube.com/watch?feature=player_detailpage&v=B0AxdX4n_gI http://www.youtube.com/watch?v=B0AxdX4n_gI
  • 12. DIAGNOSTICUL FeLV Soluble-antigen tests are preferred for initial screening. These include:  Immunochromatographic FAST tests:  Agrolabo FeLV IC  Agrolabo FeLV/FIV IC  ELISA:  Agrolabo FeLV ELISA Ab Anti GP70  Agrolabo FeLV ELISA antigenic While screening tests detect the presence of free antigen in the circulating blood, the IFA tests for the presence of antigen within infected white blood cells and platelets.
  • 13. Managmentul FeLV ■ Supportive therapy (including fluid therapy if required) and good nursing care ■ Secondary infections should be treated promptly ■ Feline interferon omega may reduce clinical signs and extend the survival time ■ AZT (azidothymidine) may be used, but side effects may occur ■ Blood transfusions may prolong survival (Agrolabo RapidVet-H feline) ■ Asymptomatic FeLV + cats may live many years and end up dying of an unrelated cause ■ FeLV + cats need special care to avoid infections ■ FeLV infected cats should remain indoors and receive a regular clinical check-up (every 6 months) (Carantina) ■ Corticosteroids, other immune-suppressive or bone marrow-suppressive drugs should be avoided (Atentie! Imunosupresori – corticosteroizi) ■ The virus does not survive for long outside the host and is readily destroyed by disinfectants, soap, heating and drying (Rezista putin in mediu) ■ However, the virus may survive in faeces; it remains viable if kept moist at room temperature
  • 14. Imunoprofilaxia ■ All cats of uncertain FeLV status should be tested prior to vaccination (Se recomanda testarea tuturor pisicilor inainte de vaccinare, folosind testele rapide ) ■ All healthy cats with a potential risk of exposure (outdoor access, FeLV endemic area) should be vaccinated against FeLV ■ Kittens should be vaccinated at 8 to 9 weeks of age, with a second vaccination at 12 weeks, followed by a booster one year later (Vaccinarea se face la varsta de 8-9 saptamani, cu rapel la 12 saptamani, apoi la un an) ■ Inactivated vaccines are recommended
  • 15. Concluzii 1.All cats of uncertain FeLV status should be tested prior to vaccination! La achizitionarea unei pisici solicitati testarea ei cu: Teste rapide-Imunofluorescenta-PCR pentru ai stabili statusul: - Libera de FeLV -Viremica -Provirus integrat 2. Most persistently viraemic cats die within 3 to 4 years!
  • 16. 3.Anaemia in a cat with persistent FeLV infection 4.Alimentary lymphoma associated with FeLV-clinical enteric sindrom
  • 17. 6.Primary visible signs of an FeLV infected cat  chronic stomatitis  gingivitis  non-healing skin lesions  respiratory infections Haemobartonella felis  skin Ringworms-Microsporum, Tricophiton (Agrolabo - Dermakit) 5.Thymic lymphoma filling thethorax of an FeLV infected cat
  • 18. Prezentare de caz Stinky Stinky's chronic problems Stinky, a 4 year old neutered male, was presented to the clinic in August 1992. He had been depressed and anorexic and for the previous two days he had diarrhea with lots of mucous. Owner had noticed a wound on the right side of his abdomen. We examine Stinky and find: Depressed, T= 39.5o, Pulse =144, yellow mucous membranes. Wound on right lateral abdomen with palpable firm tract going ventrally. Oral cavity- large red plaque with small white plaques under tongue - some ocular discharge - 8% dehydrated. When placing IV catheter cat went into cardiac arrest - revived with external cardiac massage. Positive pressure ventilation, IV epinephrine, bicarbonate, dexamethasone - later given mannitol IV. CBC: Neutropenia with left shift and 2+ toxic change. PCV 0.24 - non regenerative SADB (small animal data-base): bilirubin 40. 2+ icteric serum UA (urinalysis): strong positive for bilirubin +2 blood 1+ bilirubin crystllauria SG 1.068. Stinky's rescords show: Stinky had a long history of chronic infections and problems that are summarized below: Normal until 1990, except: Chronic non-parasitic otitis externa overweight - 8kg, Began losing weight in mid-1990. Developed suspicious number of abscesses and infected scratches after skirmishes with other cats workup shows :whitish grey plaques bilaterally in ear-canal - biopsies non-diagnostic no radiographic evidence of otitis media... otitis resolved after antibiotic treatment
  • 19. Stinky's rescords show: Spring 1991: Hair coat shows marked thinning, presumably pruritic as cat is constantly grooming. Skin and hair samples show evidence of dermatophytosis Culture on dermatophyte medium – Dermakit- heavy growth of Trichophyton equinum and another obscure dermatophyte that is not normally pathogenic treated with oral ketoconazole –resolved in 2 weeks, hair coat improved. Fall 1991: Upper respiratory tract problems but no etiological agent could be identified Spring 1991: Alopecia and pruritus returned. URT problems still there. alopecia treated with oral vitamin E You decide to see if Stinky's chronic problems are related to FeLV infection. • What should you do? • What samples do you need to take? • What does the tests determine? • What do the results mean? Stinky's test show that he is FeLV ELISA-FastKit: positive, FeLV PCR: positive What is you opinion?!
  • 20. Prezentare caz Emily-4luni Emily was a 4 month old female Siamese. She was apparently healthy until the previous day when she was caught under the leg of a recliner chair. She has had difficulty breathing since then. A physical examination showed that Emily had trouble breathing - Inspirational effort, marked pleural effusion present. Her chest showed more than normal resistance to compression. Radiological findings: There is a medium to large volume of pleural fluid with associated lung collapse. The mediastinum is abnormally dense. The heart is difficult to assess. Progress exam. No.1 - There is an increased volume of pleural fluid with further lung collapse Progress exam No 2 - Again there is an increase in pleural fluid indicating active fluid formation or hemorrhage, as the case may be. Reassessment of the abdomen indicates an almost certain cranial mediastinal mass as seen in the dorsoventral view. Radiologist's note: This latter diagnosis, although unsuspected in the context of the proposed trauma, was confirmed on the basis of the palpable mass in the mediastinum. the reason for the rapid fluid formation is uncertain. Possibly, trauma might cause hemorrhage in a mass or a mass may erode regional vasculature to produce such blood tinged fluid as it is removed from this cat's thorax on repeated occasions.
  • 21. Necropsy report Gross necropsy: Ventral mediastinal area contains a nodular, grey- white mass-- approximately 3 X 3 X 6 cm in size. Both right and left lung lobes appear atelectatic and there is a 2 cm tear in the posterior mediastinum. A single sub lumbar lymph node is visibly enlarged. Histopathology Sections of mediastinal mass contain a uniform population of lymphoblast like cells. These cells have roughly circular nuclei, some have prominent nucleoli and most have minimal cytoplasm that has ill defined margins. There are scattered foci of necrotic cells and hemorrhage. Similar cells have replaced the sub lumbar lymph node that was sectioned and are also present in sinusoids and portal areas of the liver. Immunohistochemistry A section of the liver shows cells that stain with anti GAG antibody as well as antibody against CD3. • How would you interpret the results of the immunohistochemistry? • Was the tumor induced by a feline retrovirus? • How did a young 4 month old kitten develop rapidly growing retrovirus induced tumor?
  • 22. Feline immunodeficiency virus- FIV First isolated in 1986, (FIV) is a retrovirus-lentivirus closely related to HIV. Most felids are susceptible to FIV, but humans are not. ■ FIV is endemic in domestic cat populations worldwide (4 subtypes A and B are most common in Europe) ■ Seroprevalence of FIV varies greatly between regions ■ Sick adult cats, male cats and free-roaming cats are most likelyto be infected ■ FIV loses infectivity quickly outside the host and is susceptible to all disinfectants including common soap
  • 23. Infectia cu FIV ■ Most FIV infections are acquired by bites (fights, mating) from persistently infected cats. The risk of transmission is low in households with “socially well- adapted cats” (Transmiterea – frecvent prin muscaturi) ■ Transmission from mother to kittens may occur, especially if the queen is undergoing an acute infection (Transmiterea de la mama la pui  frecvente infectii acute) ■ FIV infected cats are persistently infected in spite of their ability to mount antibody and cell-mediated immune responses
  • 24. Patogeneza infectiei cu FIV Bite (virus shed in saliva) Virus infects B-cells, T-cells and macrophages B-cell proliferation (Swollen Lymph nodes) Reversed CD4:CD8 ratios Immunodeficiency (Opportunistic infections, B-cell Lymphomas) Variable time Inapparent in most cats
  • 25. Clinic – suspicionam FIV? Infection has a long latent or ‘asymptomatic’ phase. Infected cats generally remain free of clinical signs for several years, and some cats never develop disease. (Perioada de latenta – lunga. Semnele clinice pot lipsi ani de zile sau pe tot timpul vietii) Clinical signs are not caused by FIV, but are the consequence of immunodeficiency(CD4+/CD8+ decreased ratio) ■ Typical manifestations are:  Acute phase  May last a few days to few weeks (cateva zile  cateva saptamani)  Fever and malaise may go unnoticed (febra)  Acute enteritis (diarrhea), stomatitis, dermatitis, conjunctivitis, respiratory tract disease (enterite, stomatite, dermatite, conjunctivite, inflamatii ale tractusului respirator)  Generalized lymph node enlargement common (marirea in volum a limfonodurilor)
  • 26. Clinic – suspicionam FIV?  Asymptomatic phase Follows acute phase Appear clinically healthy May last for years Use to say would become ill within 5 years Now know that many FIV + cats can live “normal lives” for much longer FIV is not a death sentence
  • 27. Clinic – suspicionam FIV?  Terminal phase - No good predictor of when this phase will occur - Characterized by opportunistic infections, neoplasia or other syndromes such as wasting (infectii oportuniste, neoplasm)  bacterial, fungal, and protozoal (Toxoplasmosis, Ringworms) infections common  treatment is directed at the secondary condition - Chronic gingivostomatitis (stomatita cronica) - Lymphadenopathy (limfadenopatie) - Renal failure associated with immune-mediated glomerulonephritis (glomerulonefrita autoimuna) - Chronic rhinitis and - weight loss (rinita cronica, pierdere in greutate)
  • 28. Examenele de laborator paraclinice-suspiciune?  None are specific for FIV but Acute phase  Neutropenia, lymphopenia Resolves as progresses to asymptomatic phase  CBC and chem panel normal during asymptomatic phase Clinically ill cats may have  anemia, neutropenia, lymphopenia (seen in 1/3 – 1/2 of cats), thrombocytopenia  Cytopenias may reflect secondary disease or may be suppression of bone marrow precursors by the FIV infection
  • 29. DIAGNOSTICUL FIV FIV produces a persistent, life-long infection, so detection of antibodies in peripheral blood has been judged sufficient for routine diagnostic screening (screening epidemiologic) if the cat has not been previously vaccinated against FIV and has not acquired FIV antibodies in colostrum.21, 22 ELISA and other immunochromatographic tests are the preferred screening tests:  Agrolabo FIV ELISA antibody  Agrolabo FIV IC  Agrolabo FeLV/FIV IC  Confirmation of positive screening tests should include a different method or at least an antibody test from a different manufacturer.23, 24,22
  • 30. DIAGNOSTICUL FIV ■ Vaccination of cats against FIV induces anti-FIV antibodies . These antibodies persist for at least one year and can be transferred in colostrum to kittens. ■“Discriminant ELISA” was reported by Dr. Levy and co-workers from the University of Florida, can differentiate between antibodies produced after FIV vaccination and antibodies produced after FIV infection. ■ While polymerase chain reaction (PCR) assays may help distinguish cats infected with FIV from cats vaccinated against FIV, one study found marked variability in diagnostic accuracy among commercial laboratories. ■ Positive in-practice ELISA test results obtained in a low-prevalence or low-risk population should always be confirmed by a laboratory ■ Western blot or IFA are the ‘gold standard’ laboratory test for FIV serology ■ PCR-based assays (for proviral DNA) are variable in performance and may even be inferior to serological tests
  • 31. Diagnostic-rezultate fals pozitive!  Want to confirm diagnosis with IFA –CYF or Western Immunoblot antibody testing in asymptomatic cats  IFA same accuracy of ELISA but may decrease technical error by sending to lab  Western blot considered “gold standard” for confirming a positive  Kittens from FIV infected queens may test seropositive due to persisting maternal antibodies, and should be retested at 16 weeks of age. Exceptionally, kittens may remain seropositive until 6 months of age
  • 32. Diagnostic-rezultate fals negative!  False negatives occur due to:  Anergic stage of disease (terminal phase)  Early infection and lack of seroconversion  Lack of seroconversion due to immunosuppression or seroconversion occurs later in disease (up to 6 months reported)  *Most cats seroconvert within 2-4 weeks post-exposure but may take up to 8 weeks
  • 33. Managmentul Bolii ■ Cats should never be euthanised only on the basis of an FIV positive test result, cats may live as long as uninfected cats. ■ Neutering is recommended to reduce aggression and decrease biting incidents ■ FIV infected cats should receive regular (6 monthly) veterinary health checks including routine biochemistry, haematology and weight monitoring ■ Prompt and accurate diagnosis of any secondary illness is essential ■ FIV infected cats can be housed in the same ward as other patients, but should be kept in individual cages separate from cats with contagious conditions ■ In rescue shelters, cats should be housed individually to avoid crossinfection (at the very least, FIV positive cats should be segregated)
  • 34. Managmentul Bolii ■ Feline interferon omega may reduce clinical signs and extend the survival time (interferon) ■ AZT (azidothymidine) may be used, but side effects may occur ■ Surgery is well-tolerated by asymptomatic FIV infected cats, but perioperative antibiotic treatment should be used in all cases (obligatoriu – antibiotic post-operator) ■ Care must be taken to avoid iatrogenic virus transmission (e.g. by thorough decontamination of surgical instruments that have been used on seropositive cats) ■ Avoid use of Griseofulvin for dermatophyte infections (increased susceptibility to neutropenia)
  • 35. Vaccinarea ■ In Europe at present there is no FIV vaccine commercially available ■ Vaccination against routine pathogens can be considered for healthy seropositive cats but is not recommended for sick, FIV infected cats ■ Fel-O-Vax® FIV (Fort Dodge)  new vaccine available on the market  minimal side effects  Efficacy quoted to be 82% but heavily disputed  Protects against Subtype A and D of FIV  Subtype B FIV probably more common  Vaccine titer and infectious titer not distinguishable on ELISA or Western blot testing and will make diagnosis of the disease very difficult !!
  • 36. Concluzii 1.FIV positive cats (like this one) may live as long as uninfected cats 2.Chronic infections may arise due to FIV Infection 3. Cats should never be euthanised on the basis of an FIV positive test alone
  • 37. 4.Chronic infections may arise due to FIV Infection gingivitis, stomatitis, otic infections 5.Weight loss and haemorrhagic enteritis in an FIV positive cat
  • 38. FeLV Algoritmul de Diagnostic  All positive results should be confirmed, especially asymptomatic and low-risk cats. Re-test immediately with IFA/ELISA  Negative screening test results are highly reliable. However, if results are negative but recent infection cannot be ruled out, testing should be repeated a minimum of 30 days after the last potential exposure (Supraveghere epidemiologica – 3 testari la un interval de 30 de zile efectuate pe un numar cat mai mare de animlae – preferabil toate animalele din efectiv)  Discordant results may be due to the stage of infection, the variability of host responses or technical problems with testing. It is not usually possible to determine the true FeLV infection status of cats with persistently discordant test results.  Antigen Test  Negative results for either FeLV or FIV are much more reliable because of the low prevalence of infection in most cat populations.  No test is 100% accurate all the time, under all conditions. In cat populations with a low prevalence, for example less than 0.5%, more than half of the cats that test positive are likely to be uninfected.26
  • 39. FIV Algoritmul de Diagnostic  Cats vaccinated with a whole-virus vaccine will test antibody-positive. Re-test with another antibody test.  Negative screening test results are highly reliable. However, if results are negative but recent infection cannot be ruled out, testing should be repeated a minimum of 60 days after the last potential exposure. (Necesitatea repetarii testului dupa 60 de zile)  Antibody Test  If positive after kitten reaches 6 months old, consider FIV-infected and continue appropriate management program. (Anticorpii maternali persista in organism maximum 6 luni de zile)  May also consider utilizing alternative test methods such as culture or PCR where available.  If negative at any interval, consider free of infection and begin wellness program.  Kittens may be tested for FeLV and FIV at any age. Most kittens test negative, indicating no infection. Antibody tests for FIV can detect antibodies passed in colostrum from an infected or vaccinated mother, which can be mistaken for infection in the kitten.  FeLV vaccinations will NOT induce positive test results.  FIV vaccinations WILL induce positive test results.
  • 40. Managmentul Cazurilor Pozitive Sanatoase Clinic  Examinations should be performed at least twice a year and at each visit:  Update medical history. Monitor for any signs of weight loss.  Perform a thorough physical exam; pay close attention to lymph nodes, eyes and oral cavity.  Perform a complete blood count, biochemical analysis, urinalysis, and fecal examination at least once a year. FeLV cats may need a complete blood count twice a year.  Spay or neuter intact cats. Control internal and external parasites.  Vaccinate as lifestyle indicates. Most retrovirus-infected cats mount adequate immune responses when vaccinated, and there is no need to modify standard vaccination intervals.28  There is controversy about the use of inactivated versus modified-live vaccines. Current recommendations are to use inactivated vaccine products due to the theoretical risk of a modified-live product regaining its pathogenicity in cats with compromised immune systems.  Infected queens should not be bred and should be spayed if their condition is sufficiently stable to permit them to undergo surgery.
  • 41. Managmentul Cazurilor Pozitive Clinic manifeste  Prompt and accurate diagnosis is essential to allow early therapeutic intervention and a successful treatment outcome. Therefore, intensive diagnostic testing should proceed early in the course of illness for infected cats.  Many cats infected with FeLV or FIV respond as well as their uninfected counterparts to appropriate medications and treatment strategies,although a longer or more aggressive course of treatment may be needed.  Few attempts have been made to evaluate anti-viral drugs, immunomodulators, or alternative therapies in large controlled studies of naturally infected cats. To date, no treatment has been shown to reverse well-established retrovirus infection in cats.  Clients with a healthy or ill retrovirus positive cat may be frightened by the initial diagnosis.  It is important to alleviate these fears when appropriate and offer encouraging advice on the proper care and management of the cat.
  • 42. LIMITAREA TRANSMITERII FeLV-FIV In the veterinary Practice Retroviruses are unstable outside their host animals and can be quickly inactivated by detergents and routine disinfectants.13–17 Simple precautions and routine cleaning procedures will prevent transmission of these agents in veterinary hospitals. As a guide: All infected patients should be housed in individual cages and not in isolation/contagious wards where they may be exposed to infectious agents. Staff should wash their hands between patients and after cleaning cages. Because FeLV and FIV can be transmitted in blood transfusions, donors should be tested prior to donating. A real-time PCR test for FeLV is also recommended for blood donors as proviral elements in seronegative cats with regressive FeLV infection may cause infection in transfusion recipients. Dental and surgical instruments, endotracheal tubes and other items potentially contaminated with body fluids should be thoroughly cleaned and sterilized between uses. Fluid lines, multi-dose medication containers and food can become contaminated with body fluids (especially blood or saliva) and should not be shared among patients.
  • 43. LIMITAREA TRANSMITERII FeLV-FIV Limiting transmission – At home Confine – Infected cats should be confined indoors so they do not pose a risk of infection to other cats and so they are protected against infectious hazards in the environment. Isolate – The best method of preventing spread to other cats in the household is to isolate the infected cat from interacting with its housemates. Isolation to a separate room is recommended, but a simple screen or chain-link barrier is adequate. Generally, FIV transmission is low in households with stable social structures where housemates do not fight, but FeLV can still be transmitted via friendly interactions. Don’t Introduce – If separation is not possible, no new cats should be introduced in the household to reduce the risk of territorial aggression. If owners choose not to separate retrovirus-infected housemates from their other cats, the uninfected cats should be consideredfor vaccination. Vaccinated cats should be isolated from infected cats for at least two months after the vaccine series is completed.
  • 44. LIMITAREA TRANSMITERII FeLV-FIV Prevention of FeLV and FIV transmission in Shelters and Catteries Control recommendations:  As for pet cats, it is ideal for all cats in shelters and catteries to be tested for FeLV and FIV.  Testing at admission is optional for singly-housed cats in shelters, but all cats in breeding catteries should be tested. Testing is highly recommended for group-housed cats. If not performed prior to adoption, testing should be recommended to the new owner before exposure to other cats.  Testing should be repeated 60 days after the initial test and annually for cats kept in long-term group housing.  Each cat should be individually tested. Testing representative kittens in a litter or colony and extrapolating results to other cats in the group is unreliable. Procedures such as pooling multiple samples for use in a single test reduce test sensitivity and should not be performed.  Both foster families and adopters should have their own resident cats tested prior to fostering or adopting a new cat.  FeLV vaccination is optional for singly housed cats. Cats should test negative prior to vaccination. FeLV vaccination is highly recommended for all cats housed in groups and for both foster cats and permanent residents in foster homes.  In catteries that follow testing guidelines and maintain retrovirus-negative status, vaccination against FeLV and FIV is not necessary.  Vaccination is not 100% effective and should never be used in place of a test and segregate program.  In contrast to the case for feline panleukopenia, herpesvirus and calicivirus vaccines, the value of a single FeLV vaccine for feral cats has not been determined. Therefore, FeLV vaccination is not recommended for feral cat trap-neuter-return programs if program resources are needed for higher priorities.  FIV vaccination is not recommended for use in shelters or feral cats.  Strict adherence to universal precautions is required to prevent iatrogenic transmission of retroviruses in the shelter environment via contaminated equipment and secretions.
  • 45. “You don’t have to consider it a death sentence. First of all, you’d do well to have the animal retested after about three months, since the original test may have yielded a false positive. Secondly, some FeLV-infected cats develop an effective immune response, which controls the viral infection and results in a transient viremia instead of a persistent viremia. In these cats, subsequent FeLV tests will show that the cat no longer has virus in its blood. Finally, while there is no complete cure for FeLV or FIV infection, newer treatments and supportive care can often result in several years of relatively good health.” Epilog!
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  • 47. Va Multumesc !

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