Parvoviral myocarditis in puppies

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  • If the bitch is infected at the time of birth it will take up to 15 days to produce adequate antibodies in colostrum (JK)
  • McGavin 376-380
  • Enterocyte turnover increases up to 3 weeks old (Neonatal pigs is 7-10 days, and at 3 weeks old its 2-3 days) McGavin p342
  • Parvoviral myocarditis in puppies

    1. 1. Parvoviral myocarditis in a litter of puppies Brian Caserto Anatomic Pathology Resident Kansas State Universtiy Manhattan, KS
    2. 2. History <ul><li>Nine out of 11 puppies in a litter died over a 4 week period </li></ul><ul><ul><li>Born at a shelter to a bitch with no known vaccination history </li></ul></ul><ul><li>All had dyspnea leading to respiratory distress and death </li></ul><ul><li>Deaths occurred at 1 week, 4 weeks, 5 weeks and 6 weeks of age. </li></ul><ul><li>Four 4-6 week old pups were submitted for evaluation </li></ul>
    3. 3. Gross Lesions <ul><li>Lungs </li></ul><ul><ul><li>Multifocal edema and congestion (Pups # 1, and 3) </li></ul></ul><ul><ul><li>Severe diffuse congestion and edema in Pup #4 </li></ul></ul><ul><ul><li>No gross lesions (Pup #2) </li></ul></ul><ul><li>Heart </li></ul><ul><ul><li>Pale myocardium with red streaking (Pup #4) </li></ul></ul><ul><ul><li>No lesions in Pups 1, 2, and 3 </li></ul></ul>
    4. 4. Pup #4
    5. 5. Pup #4
    6. 6. Histologic Lesions <ul><li>All hearts examined histologically had similar lesions (Pups #2-4) </li></ul><ul><li>Myocarditis </li></ul><ul><ul><li>Lymphoplasmacytic, histiocytic </li></ul></ul><ul><li>Cardiomyocyte degeneration and necrosis </li></ul><ul><li>Basophilic to amphophilic intranuclear inclusions </li></ul>
    7. 11. Histologic lesions cont… <ul><li>Pulmonary edema and congestion (Pups # 1-4) </li></ul><ul><ul><li>Heart failure </li></ul></ul>
    8. 12. Immunohistochemistry <ul><li>Positive for Canine Parvovirus-2 (Pups #2- 3) </li></ul><ul><ul><li>Throughout the heart the nuclei and sometimes cytoplasm stained strongly positive </li></ul></ul>
    9. 14. Other diagnostic tests <ul><li>Virus Isolation </li></ul><ul><ul><li>Negative (All 4 pups) </li></ul></ul><ul><li>Aerobic culture </li></ul><ul><ul><li>Slight to moderate growth of Streptococcus sp, alpha hemolytic (kidney Pup #1, Lung Pup #4) </li></ul></ul>
    10. 15. Canine Parvovirus <ul><li>CPV-2 </li></ul><ul><ul><li>1978 </li></ul></ul><ul><ul><li>Arose from Feline Panleukopenia-like virus in wild foxes 1 </li></ul></ul><ul><ul><li>CPV-2 rapidly mutated to CPV-2a and CPV-2b, and since 2001 CPV-2c 1,10 </li></ul></ul><ul><li>CPV-1 </li></ul><ul><ul><li>CPV-2 is antigenically/ serologically/ genomically distinct from CPV-1 (minute virus of canines) 1 </li></ul></ul>
    11. 16. CPV-2 Susceptibility <ul><li>Pups born to naïve bitches (no antibodies) </li></ul><ul><li>Failure to receive adequate colostrum </li></ul><ul><li>Postweaning period (declining maternal antibodies) 3,5,7,9 </li></ul><ul><li>Virus enters the cell via the transferrin receptor and virion replication is dependent on host cell nucleoprotein synthesis prior to mitosis 1 </li></ul>
    12. 17. CVP-2 Disease syndromes <ul><li>2 weeks old </li></ul><ul><ul><li>generalized disease with focal necrosis of liver, kidney, heart, vessel, bone marrow, intestine 3 </li></ul></ul><ul><li>3-8 weeks old </li></ul><ul><ul><li>myocarditis- dogs that survive may die later due to myocardial scarring- up to 5 months later 3,5,7 </li></ul></ul><ul><li>8 weeks and older </li></ul><ul><ul><li>necrotizing enteritis with crypt necrosis 1,2,3,4,6 </li></ul></ul>
    13. 18. Cardiac Disease <ul><li>Puppies born to naïve bitches died with signs of respiratory distress 8 </li></ul><ul><ul><li>Gross lesions can include pale mottling of myocardium and moderate to severe pulmonary edema and congestion 5,7 </li></ul></ul><ul><li>The disease was produced experimentally in puppies 5 </li></ul><ul><ul><li>Myocardial degeneration </li></ul></ul><ul><ul><li>Lymphoplasmacytic interstitial infiltrates </li></ul></ul><ul><ul><li>Healing by fibrosis </li></ul></ul><ul><li>Enteric disease was produced using virus from the cardiac disease 7 </li></ul><ul><ul><li>4-7 week old pups were inoculated and developed the enteric disease with typical lesions. </li></ul></ul>
    14. 19. Diagnostics <ul><li>Histopath </li></ul><ul><ul><li>Basophilic to amphophilic intranuclear inclusions in cardiac myocytes </li></ul></ul><ul><ul><li>Lymphocytic and histiocytic inflammation </li></ul></ul><ul><ul><li>Myofiber degeneration </li></ul></ul><ul><li>IHC </li></ul><ul><li>FA </li></ul><ul><li>PCR </li></ul><ul><ul><li>CPV-2a,b,c </li></ul></ul>
    15. 20. Summary <ul><li>All 4 pups had clinical signs of heart failure </li></ul><ul><li>3 of 4 pups had gross lesions consistent with heart failure </li></ul><ul><li>Pup 4 had gross lesions in the heart </li></ul><ul><li>All 3 hearts that we examined had histologic lesions typical of Parvoviral infection </li></ul><ul><li>Immunohistochemistry confirmed the presence of the virus in hearts of 2 pups </li></ul><ul><li>No other significant infectious agents were identified in the heart or lungs </li></ul>
    16. 21. References <ul><li>1. Brown, CC, Baker, DC, Barker, IK: Alimentary system. In: Pathology of Domestic Animals, ed Maxie, MG, 5th ed, Vol 2, p. 177, Saunders (Elsevier), Philadelphia, Pennsylvania, 2007. </li></ul><ul><li>2. Decaro, N., Cirone F.,  Desario, C.,   Elia, G. , Lorusso , E. , Colaianni, M. L.,   Martella, V. and  Buonavoglia, C. Severe parvovirus in a 12-year-old dog that had been repeatedly vaccinated. The Veterinary Record 164:593-595 (2009). </li></ul><ul><li>3. Gelberg, H: Alimentary system. In: Pathologic Basis of Veterinary Disease, eds. McGavin, DM, Zachary, JF, 4th ed., pp. 378-379. Mosby (Elsevier), St Louis, Missouri 2007. </li></ul><ul><li>4. Meunier, PC, Cooper, BJ, Appel, Lanieu, ME, Slauson, DO. Pathogenesis of canine parvovirus enteritis: sequential virus distribution and passive immunization studies. Veterinary Pathology, Vol 22, Issue 6 617-624, 1985. </li></ul><ul><li>5. Meunier, PC, Cooper, BJ, Appel, MJ, Slauson, DO. Experimental viral myocarditis: parvoviral infection of neonatal pups. Veterinary Pathology, Vol 21, Issue 5 509-515, 1984. </li></ul><ul><li>6. Nelson, DT, Eustis, SL, McAdaragh, JP, and Stotz, I.: Lesions of spontaneous canine viral enteritis. Veterinary Pathology, Vol 16, Issue 6 680-686, 1979. </li></ul><ul><li>7. Robinson, WF, Huxtable, CR, Pass, DA. Canine parvoviral myocarditis: a morphologic description of the natural disease. Veterinary Pathology, Vol 17, Issue 3 282-293, 1980. </li></ul><ul><li>8. Robinson, WF, Wilcox, GE, Flower, RL. Canine parvoviral disease: experimental reproduction of the enteric form with a parvovirus isolated from a case of myocarditis. Veterinary Pathology, Vol 17, Issue 5 589-599, 1980. </li></ul><ul><li>Meunier, PC, Cooper, BJ, Appel, MJ, Slauson, DO. Experimental viral myocarditis: parvoviral infection of neonatal pups. Veterinary Pathology, Vol 21, Issue 5 509-515, 1984. </li></ul><ul><li>9. Spibey, N., Greenwood, N. M., Sutton, D., Chalmers, W. S. & Tarpey, I. Canine parvovirus type 2 vaccine protects against virulent challenge with type 2c virus. Veterinary Microbiology 128,48 -55, 2008. </li></ul><ul><li>10. Vieira, M. J., Silva, E., Oliveira, J., Vieira, A. L., Decaro, N., Desario, C., Muller, A., Carvalheira, J., Bbuonovoglia, C. & Thompson, G. Canine parvovirus 2c infection in central Portugal.  Journal of Veterinary Diagnostic Investigation 20, 488-491, 2008. </li></ul>
    17. 22. Acknowledgements <ul><li>Photomicrographs courtesy of Gordon Andrews </li></ul><ul><li>Kansas State Veterinary Diagnostic Lab (KSVDL) </li></ul>

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