Medical Treatment on a Shoestring Budget
CONTAINING HIGHLY
CONTAGIOUS DISEASES
LIKE PANLEUKOPENIA
AND CALICIVIRUS
Ellen Je...
 Basics
 Calicivirus
 Panleukopenia
CONTAINING CONTAGION
 Detection
 What to look for
 What is it?
 What does it look like?
 Isolation
 How is it spread?
 What kills it?
 ...
 What to look for
 Groups of animals with the same symptoms
 The usual suspects
 parvo, distemper, panleukopenia, ring...
 How is it spread?
 Aerosol
 Saliva
 Fecal matter
 Fomites
 What kills it?
 How do I treat it?
 Location?
ISOLATION
 What is the quarantine period?
 When is it safe for affected animals to be re-introduced to the
general public?
RE-INTR...
 All of a sudden, we had several adult cats in cattery not
eating and with fevers
 They all had ulcers…
THE HUNGER STRIK...
 What is it?
 Similar to feline herpes virus,
but hardier in the environment
 Usually causes relatively benign
URI in k...
 How is it spread?
 Nasal
 Oral
 Conjunctival
 **Fomites
 What kills it?
 Lasts days to weeks or more dried on surf...
 Who goes?
 Affected
 Exposed (ideally separately)
 Scrub in/out procedure
 Designated staff
 Scrubs
 Footbath/foot...
 Antibiotics
 Doxycycline
 Amoxicillin
 Pain
 Sucralfate
 +/- buprenex
 Fever: dipyrone
 Nutrition
TREATMENT
 What is the quarantine
period?
 Sometimes there isn’t enough
research to know
 Make an educated guess
 When is it saf...
RE-INTRODUCTION
 Everyone will panic
 Make a plan, assess, then
continue to change it
 Find the silver linings
 Survival rate
 Knowin...
 “Feline Distemper”
 Actually a parvovirus
 Acts similar to Canine
parvovirus- infects small
intestine
 Spreads easily...
Very hard to identify
because not cut and
dry like in dogs
Usually
vomit/diarrhea
Testing is inconclusive
 False posit...
1. The Community.
1. Most kittens live
outside
2. Ubiquitous virus
3. Least likely continual
source of outbreak
1. But pro...
City Facility
On intake kittens
are:
weighed,
held
photographed
Entered into
computers
sometimes
fed/treated before...
 APA! Medical Clinic.
 All incoming kittens
are:
 tested and held
 given wellness
 handled by the technicians
 treat...
 APA! Nursery is especially
vulnerable to disease spread
due to:
 the proximity of kittens,
 the invasive handling to f...
Foster homes.
 risk is smaller
 Smaller population
 Less stress
5/5
Believable Positive:
unvaccinated or not-
recently-vaccinated cat
signs of illness
Exposed within
previous 5 days
Not...
 A reliably positive-tested
cat can have no vomiting,
no diarrhea, and even be
eating.
 Or she can be very sick with
cop...
Vaccines
 FVRCP vaccine is
extremely effective for
prevention
 If given to kittens younger
than 4 weeks of age, it
will...
Test as soon as you see signs that are not
normal for diet changes
 but only when appropriate
Keep sick kittens isolate...
ALL IN AND ALL OUT MODEL
1. Test and kill
symptomatic cats
2. Kill all cats in
same room in case
of exposure
 Empty cages and
clean
3. Resume norm...
The same way but no
killing
1. Identify the problem
2. Isolate and treat the
problem
3. Don’t add to the
problem
Yes, it i...
 Test:
 Figure out who has it
 Who has been exposed in last 5 days
to everyone who tested positive?
 Questions:
 Wher...
Create a “parvo ward” just
like in dogs
 No unauthorized
access/locked
 All directly exposed
(sharing same cage) and
pos...
X 3 days or until all symptoms
are gone
Subcutaneousy:
 Baytril sq once a day in fluids
 Ampicillin/polyflex or
Cefazoli...
Create a Quarantine Area
(can be current exposed
area)
 Clean everything
 Dedicated staff
 Put all susceptible cats
tha...
All incoming cats
and kittens go to
CLEAN place with
new supplies and
dedicated staff
No cross over with
quarantine area...
The virus is just like
Canine
 removal of all organic
debris (feces, vomit)
 Cleaning with detergent
 disinfection wit...
Who to test- is it just
diet change?
When to isolate
negative-tested
kittens?
 All neonatal kittens get
diarrhea due to...
QUESTIONS?
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Panleukopenia and calicivirus

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Presented at the American Pets Alive No-Kill Conference 2014.

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Panleukopenia and calicivirus

  1. 1. Medical Treatment on a Shoestring Budget CONTAINING HIGHLY CONTAGIOUS DISEASES LIKE PANLEUKOPENIA AND CALICIVIRUS Ellen Jefferson, DVM Executive Director Kristen Kjellberg, DVM Veterinarian
  2. 2.  Basics  Calicivirus  Panleukopenia CONTAINING CONTAGION
  3. 3.  Detection  What to look for  What is it?  What does it look like?  Isolation  How is it spread?  What kills it?  How do I treat it?  Re-introduction BASICS
  4. 4.  What to look for  Groups of animals with the same symptoms  The usual suspects  parvo, distemper, panleukopenia, ringworm  Things you are always on the lookout for  The unusual suspects  Canine influenza, virulent strain calicivirus, etc.  Can be harder to detect  What is it?  Virus?  Bacteria?  Fungus? DETECTION
  5. 5.  How is it spread?  Aerosol  Saliva  Fecal matter  Fomites  What kills it?  How do I treat it?  Location? ISOLATION
  6. 6.  What is the quarantine period?  When is it safe for affected animals to be re-introduced to the general public? RE-INTRODUCTION
  7. 7.  All of a sudden, we had several adult cats in cattery not eating and with fevers  They all had ulcers… THE HUNGER STRIKE KITTIES
  8. 8.  What is it?  Similar to feline herpes virus, but hardier in the environment  Usually causes relatively benign URI in kittens  Can mutate to different strains like the flu  What does it look like?  Typical calici: fever, mouth ulcers, URI  Virulent calici: vaccinated adults severely affected, skin lesions, limping VIRULENT CALICIVIRUS
  9. 9.  How is it spread?  Nasal  Oral  Conjunctival  **Fomites  What kills it?  Lasts days to weeks or more dried on surfaces, longer in cold wet conditions  First, remove organic debris  Then bleach:water 1:30 ISOLATION
  10. 10.  Who goes?  Affected  Exposed (ideally separately)  Scrub in/out procedure  Designated staff  Scrubs  Footbath/foot covers  Keep pens, litterboxes, spray bottles within the ward  Wash hands between patients!  We eventually considered all exposed  Closed cattery  Utilized offsite and foster homes ISOLATION
  11. 11.  Antibiotics  Doxycycline  Amoxicillin  Pain  Sucralfate  +/- buprenex  Fever: dipyrone  Nutrition TREATMENT
  12. 12.  What is the quarantine period?  Sometimes there isn’t enough research to know  Make an educated guess  When is it safe for affected animals to be re-introduced to the general public?  Couldn’t afford to test them all like parvo or panleuk  Have a plan for if you make the wrong decision  Educate adopters RE-INTRODUCTION Voodoo and Venus, post-calici!
  13. 13. RE-INTRODUCTION
  14. 14.  Everyone will panic  Make a plan, assess, then continue to change it  Find the silver linings  Survival rate  Knowing that it can’t go on forever  You’ll be amazed at what you can do when killing isn’t an option WHAT WE LEARNED
  15. 15.  “Feline Distemper”  Actually a parvovirus  Acts similar to Canine parvovirus- infects small intestine  Spreads easily in animal shelters  Causes vomiting and/or diarrhea and/or anorexia  Generally runs its course in 3-7 days  Lives in environment for 6-12 months PANLEUKOPENIA- WHAT IS IT?
  16. 16. Very hard to identify because not cut and dry like in dogs Usually vomit/diarrhea Testing is inconclusive  False positive tests occur within 10 days of vaccination  False negatives can occur if early in the disease WHAT DOES IT LOOK LIKE?
  17. 17. 1. The Community. 1. Most kittens live outside 2. Ubiquitous virus 3. Least likely continual source of outbreak 1. But probably first source 5 PLACES OUR KITTENS COULD HAVE GOTTEN PANLEUKOPENIA
  18. 18. City Facility On intake kittens are: weighed, held photographed Entered into computers sometimes fed/treated before pick up. 2/5 PLACES
  19. 19.  APA! Medical Clinic.  All incoming kittens are:  tested and held  given wellness  handled by the technicians  treated on the exam table  Medicine bottles  the technicians' clothes/hair,  the cabinet knobs,  often overlooked areas to sanitize appropriately 3/5
  20. 20.  APA! Nursery is especially vulnerable to disease spread due to:  the proximity of kittens,  the invasive handling to feed and care  huge number of different people involved,  the cross use of medicine bottles for dispensing,  the time kittens spend there, and the use of small gauge (and thus difficult to sanitize) enclosures.  Remember: all of these kittens would have been dead if they did not go to the Nursery  Weigh risk vs. benefit 4/5
  21. 21. Foster homes.  risk is smaller  Smaller population  Less stress 5/5
  22. 22. Believable Positive: unvaccinated or not- recently-vaccinated cat signs of illness Exposed within previous 5 days Not longer WHEN CAN YOU TRUST A TEST?
  23. 23.  A reliably positive-tested cat can have no vomiting, no diarrhea, and even be eating.  Or she can be very sick with copious diarrhea and vomiting.  A negative-tested can have copious diarrhea and vomiting and be unresponsive to antibiotics (kills secondary bacteria, not virus) with what we assume to be Panleukopenia.  Test every 12 hours x 2 more tests INCONCLUSIVE SIGNS
  24. 24. Vaccines  FVRCP vaccine is extremely effective for prevention  If given to kittens younger than 4 weeks of age, it will give it to them  Must be given as soon as 4 weeks of age if in an outbreak = 1 lb  Repeat every 2 weeks while in shelter PREVENTION
  25. 25. Test as soon as you see signs that are not normal for diet changes  but only when appropriate Keep sick kittens isolated from healthy kittens All In and All Out Areas: Keep smaller all inclusive areas for each group of “naïve” cats Remove positive cats and exposed cats asap Develop alert system to identify kittens who lose weight or are not gaining PREVENTION (CONTD)
  26. 26. ALL IN AND ALL OUT MODEL
  27. 27. 1. Test and kill symptomatic cats 2. Kill all cats in same room in case of exposure  Empty cages and clean 3. Resume normal operations TRADITIONAL METHOD OF HANDLING AN OUTBREAK
  28. 28. The same way but no killing 1. Identify the problem 2. Isolate and treat the problem 3. Don’t add to the problem Yes, it is harder. NO KILL WAY TO HANDLE OUTBREAK
  29. 29.  Test:  Figure out who has it  Who has been exposed in last 5 days to everyone who tested positive?  Questions:  Where was the positive cat housed when symptoms began?  Which people were handling it?  What supplies from those places are shared with other cat spaces?  Were there any other cats in same area that are no longer there when cat first showed symptoms?  Watch these closely and limit handling  Where are they now?  Who, of those that might have been exposed, is symptomatic even a little?  Test those and start questions all over. STEP 1: IDENTIFY THE PROBLEM
  30. 30. Create a “parvo ward” just like in dogs  No unauthorized access/locked  All directly exposed (sharing same cage) and positive cats go to ward immediately  Deep clean after removal of animal  Dedicated supplies, clothing, and team  Keep until tests negative  Discharge with bath back to adoption/foster ISOLATE AND TREAT THE PROBLEM
  31. 31. X 3 days or until all symptoms are gone Subcutaneousy:  Baytril sq once a day in fluids  Ampicillin/polyflex or Cefazolin two-three times per day  Cerenia once or twice a day  Force feeding! Every 4 hours until eating  SQ Fluids: Iv fluids are very hard to give to tiny kittens  we found we could save them with constant feeding and sq fluids/meds APA TREATMENT
  32. 32. Create a Quarantine Area (can be current exposed area)  Clean everything  Dedicated staff  Put all susceptible cats that were exposed to same people and stuff here for 5 days  No public access  If no symptoms after 5 days, ok to move out to adoption  Consider bath ISOLATE AND WATCH THE PROBLEM
  33. 33. All incoming cats and kittens go to CLEAN place with new supplies and dedicated staff No cross over with quarantine area DON’T ADD TO THE PROBLEM
  34. 34. The virus is just like Canine  removal of all organic debris (feces, vomit)  Cleaning with detergent  disinfection with a parvocidal cleaner (used appropriately)  Extreme temperatures (steam) and roccal will not kill the virus Throw everything you can away CLEANING UP
  35. 35. Who to test- is it just diet change? When to isolate negative-tested kittens?  All neonatal kittens get diarrhea due to diet change, and the difference between that and Panleukopenia can be difficult to determine CHALLENGES
  36. 36. QUESTIONS?

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