Fiv, Felv, Fip Small Animal Medicine Combined

Front 1

What is the agent that causes feline viral leukemia?

Back 1

A retrovirus

Front 2

What are the 2 types (agents) of feline coronavirosis?

Back 2

-feline enteric coronavirus (FECV) = enteric infection
-Feline infectious peritonitis virus (FIPV) = systemic infection = FIP

Front 3

What is the agent that causes FIV?

Back 3

RNA retrovirus: genetically diverse, mutates fast

Front 4

What is the distribution of FeLV?

Back 4

Worldwide

Front 5

How does the feline coronavirus result in systemic infection?

Back 5

FECV can infect monocytes and cause viremia and potential FIP

Front 6

What is the distribution of FIV infections?

Back 6

Worldwide distribution

Front 7

What animals have the highest seroprevalence of FeLV?

Back 7

Higher prevalence in Sick cats and cats w/ outdoor access
*Sick feral cats

Front 8

How does FIP develop?

Back 8

FECV causes viremia and then can mutate to "FIP" in the intestine of some cats

Front 9

Which cats have the highest seroprevalence of FIV infection?

Back 9

Sick outdoor cats

Front 10

What is the signalment of cats at the highest risk of being infected with FeLV?

Back 10

Outdoor male cats 1-6 years of age

Front 11

What environment is FECV common in?

Back 11

Catteries
-variable prevalence, in a particular cattery its usually high or low
-prevalence in house w/ 1 to 2 cats is 1 in 5000

Front 12

How is FIV transmitted?

Back 12

-Bites: older (>6 years), male, outdoor cats
-Milk: FIV-infected queens to kittens
-Transplacental

Front 13

What are the 2 routes of FeLV transmission?

Back 13

1) *vertical
2) saliva & nasal secretions

Front 14

Are mixed or pure bred cats at higher risk of developing FIP?

Back 14

Pure bred cats- weaker immune system

Front 15

What are the initial clinical signs seen with acute FIV?

Back 15

Low grade fever and lymphadenopathy, a retrovirus so takes a long time to develop clinical signs and initial signs probably aren't noticed

Front 16

How do cats get infected with FeLV from saliva and nasal secretions?

Back 16

Have to have prolonged contact with secretions:
-grooming (*dz of nice cats)
-same water source
-Fight

Front 17

What is the FIPV shed in?

Back 17

Feces and oronasal secretions

Front 18

What stage follows the acute phase of FIV infection?

Back 18

Acute phase is followed by a subclinical latent period

Front 19

True or false. The virus that causes FeLV does not survive in the environment.

Back 19

True

Front 20

How is FIPV transmitted?

Back 20

-Ingestion or inhalation of virus
-transplacental (Rare)

Front 21

How long does the subclinical latent period of FIV normally last? What does the duration depend on?

Back 21

Average of 7 years, depends on age when infected and viral strain

Front 22

After exposure to the FeLV virus, 30% of cats will develop _______, 30% will develop _______, and 40% will develop ________.

Back 22

30%= persistent viremia
30%=transient viremia
40%=latent or sequestered infection

Front 23

True or false. All cats that test positive for the coronavirus shed the virus.

Back 23

False, only 30% of positive cats shed the virus and less than 10% of cats get the virus

Front 24

What are the clinical syndromes (full blown infection) that develop with FIV infection (8)?

Back 24

1) Chronic small bowel diarrhea
2) Non-regenerative anemia
3) Anterior uveitis
4) Glomerulonephritis, renal failure
5) CNS signs
6) Myeloproliferative disease
7) Infections
8) Hematologic changes

Front 25

What is the usual fate of a cat that gets persistent viremia from FeLV?

Back 25

Usually die of FeLV-related diseases in 2-3 years

Front 26

What are the 2 forms of feline infectious peritonitis?

Back 26

1) Effusive
2) Non-effusive

Front 27

*Why are cats with FIV prone to infections?

Back 27

-The virus is immunosuppressive so they are much more likely to get infection, so often present with pneumonia, abscesses, UTIs, etc.

Front 28

What is the usual fate of a cat that gets transient viremia from FeLV?

Back 28

develop neutralizing antibodies--> clear infection in 4-6 weeks

Front 29

What cats develop the effusive form of FIP?

Back 29

Cats with partial cell-mediated immunity (non-effusive form occurs in cats with a better immune response)

Front 30

*What hematologic changes are commonly associated with FIV?

Back 30

-Pancytopenia (Neutropenic, nonregenerative anemia, thrombocytopenia)
-Myelodysplasia or leukemia (some cell lines may be increased)
-polyclonal gammopathy (chronic inflammation)

Front 31

Why is it important to retest FeLV seropositive cats in 4-6 weeks?

Back 31

Because if they have a good immune system they will just get transient viremia and the virus will be eliminated in 4-6 weeks and be negative on the retest

Front 32

What is the effusive form of FIP?

Back 32

Immune complex vasculitis ---> leaks protein rich fluid resulting in exudate in abdomen and sometimes the thoracic cavity

Front 33

A cat presents to you that has an abscess and glomerulonephritis and you suspect that it has FIV. Is serology a good test to use? Why or why not?

Back 33

Yes, because it takes months to years to develop clinical signs of infection, so by this time the cat will have antibodies

Front 34

How does a latent or sequestered FeLV infection develop?

Back 34

The provirus is inserted into the cat's genome, but no viremia develops-very few will develop problems

Front 35

What can be done to help treat the effusive form of FIP?

Back 35

Immunosuppression because vasculitis is immune mediated

Front 36

How long does seroconversion take in cats infected with FIV?

Back 36

2-4 weeks, very few never convert

Front 37

Where can the FeLV virus be found in cats with the latent or sequestered infection?

Back 37

Bone marrow, spleen, liver

Front 38

What is the non-effusive form of FIP?

Back 38

Pyogranulomatous or granulomatous lesions in eyes, brain, kidney and liver

Front 39

How long do maternal antibodies to FIV infection last?

Back 39

14 weeks

Front 40

What are the 3 non-specific signs that develop in a cat with FeLV?

Back 40

1) Anorexia
2) Lethargy
3) Weight loss

Front 41

What is a differential for bilateral nephromegaly?

Back 41

Non-effusive form of FIP

Front 42

A kitten comes into your office and tests positive for FIV, but it is only 10 weeks old and you know that maternal antibodies can last up to 14 weeks. When should you retest the kitten?

Back 42

Retest at 8-12 months of age

Front 43

What are the abnormalities that develop from FeLV being associated with specific organ systems? (6)

Back 43

1) Vomiting & diarrhea
2) Icterus
-IMHA or liver failure
3) Rhinitis & pneumonia
4) Glomerulonephritis
5) Ocular signs
6) Neurologic abnormalities

Front 44

What is a differential for bicavitary effusion?

Back 44

Effusive form of FIP

Front 45

What does a positive FIV serology test mean?

Back 45

-Documents a persistent infection
-Does not mean that clinical signs are due to FIV

Front 46

What lab abnormalities will you see in a cat with FeLV?

Back 46

Hematologic changes:
-nonregenerative anemia (increased MCV w/o reticulocytes)
-Thrombocytopenia, neutropenia, lymphopenia (bone marrow suppression, immune mediated destruction)
-Myelodysplasia or leukemia
-proteinuria

Front 47

What is one of the most common signs of FIP in young cats?

Back 47

Jaundice

Front 48

What is the routine screening test for FIV?

Back 48

ELISA (serology)

Front 49

What are 4 examples of secondary infections that can develop in FeLV positive cats?

Back 49

1) Calicivirus
2) Haemoplasma
3) Toxoplasmosis
4) Bacterial infections

Front 50

What are the clinical signs of FIP (in general)?

Back 50

-Fever, weight loss
-jaundice
-chorioretinitis or iridocyclitis
-Multifocal CNS signs
-Nephromegaly or small kidneys
-splenomegaly

Front 51

Why should you really retest a healthy indoor cat that tests positive for FIV with an ELISA? What test should you use to confirm the diagnosis?

Back 51

-Can get false positives because prevalence drives the number of positives and an indoor cat has about 50% chance of getting a false positiveIf get a positive test can perform a western blot to confirm the diagnosis

Front 52

What are 2 types of neoplasia commonly seen in FeLV positive cats?

Back 52

1) **Lymphoma
-alimentary, multicentric, mediastinal, renal
-Lymphoma in young cats= very suggestive of FeLV
2) Leukemia

Front 53

What are 3 signs of the EFFUSIVE form of FIP?

Back 53

1) Muffled heart sounds
2) Abdominal distention
3) Dyspnea

Front 54

When is RT-PCR a good diagnostic tool for FIV?

Back 54

Can distinguish maternal antibodies and antibodies from a vaccine from a real infection

Front 55

**What hematologic change is very suggestive of FeLV?

Back 55

***If have macrocytosis and don't have anemia bc FeLV causes change in maturation of RBCs (causes maturation arrest of erythroid line in the bone marrow)
-other differential= hyperthyroidism

Front 56

What are 3 abnormalities that will be found on blood work of a cat with FIP?

Back 56

1) Chronic inflammation-->
-nonregenerative anemia
-hyperproteinemia***
2) increased liver enzymes
3) Renal failure

Front 57

What are the 3 components/ options for treating FIV?

Back 57

1) Always treat the secondary disease (antibiotics for bacterial infections, high doses & longer periods)
2) Alpha-interpheron (parenteral is better)
3) Zidovudine (AZT) -for acute infections

Front 58

What is the purpose of giving AZT for acute FIV infections?

Back 58

Improves neuro signs, improves stomatitis

Front 59

When do you get a positive ELISA in FeLV positive cats?

Back 59

Prior to bone marrow infection
-earlier stages
-retest 4-6 weeks to confirm not transient viremia

Front 60

What do you expect to find on electrophoresis of a cat with FIP?

Back 60

Polyclonal gammopathy
Increased alpha2 and gamma

Front 61

What are the side effects of AZT? What parameter should be monitored?

Back 61

May cause anemia, stop if PCV <20%

Front 62

What does a positive IFA for FeLV mean?

Back 62

Get positive after bone marrow infection so if IFA positive: then >90% are viremic for life and are contagious
-+=viremic, -=transient

Front 63

You perform an abdominoscentesis of a cat with the effusive form of FIP. Describe the protein content of the fluid.

Back 63

Nonseptic pyogranulomatous exudate:
-Protein concentration 3.5 -12 g/dL

Front 64

How can you prevent your cat from getting infected with FIV? (3)

Back 64

1) House cat indoor (avoid fighting)
2) Test new cats before introducing in an FIV-negative cattery
3) Vaccines

Front 65

What does it mean if an animal has a positive ELISA and negative IFA in an FeLV infected cat?

Back 65

Early in the disease or self-limiting infection
-probably not contagious
-may progress to persistent viremia
OR false + ELISA or false - IFA

Front 66

How do you know that FIP is unlikely according to the albumin content?

Back 66

Albumin-to-globulin ratio >0.8 OR
Albumin > 48% of total protein

Front 67

What should you do when a kitten is born to an FIV positive dam?

Back 67

-Kittens should not be allowed to nurse
-Test at 14 weeks and if cat is (-) can sell, if + retest

Front 68

What is your next step if a cat has a positive FeLV ELISA and negative IFA?

Back 68

Isolate and retest in 4-6 weeks

Front 69

How can you tell if FIP is likely according to the total protein?

Back 69

-Total protein > 3.5 and globulin > 50% of total protein OR
-gamma globulin > 32% of total protein concentration

Front 70

How good of protection does the FIV vaccine offer?

Back 70

Inactivated whole virus vaccine, 60-80% efficacy, mutates too quickly and vaccine covers A e D and most common form of virus is B.

Front 71

Is a cat that is FeLV positive then becomes negative contagious? Do you ever have to worry about becoming viremic?

Back 71

-Latent or localized infection so not likely to be contagious, but infected queens may transmit to kittens (placenta, parturition, or milk)
-May become viremic with steroids or extreme stress

Front 72

Why is serology that uses detection of FIP antibodies using serology of little benefit?

Back 72

It is a coronavirus test and is not standardized

Front 73

What can you do for cats with non-regenerative anemia due to FIV?

Back 73

Do respond to EPO< but if someone already tried the rhGM-CSF then it increases viremia

Front 74

What are the components/options to treating FeLV?

Back 74

1) Always treat the secondary disease!!!
-antibiotics for bacterial infections
-high doses for longer periods
2) AZT
3) Alpha-interpheron
-takes 4-6 weeks for immunotherapy to start working
4) Chemotherapy for FeLV-associated neoplasms

Front 75

What are 4 things that a positive FIP antibody test NOT tell you?

Back 75

1) Doesn't diagnose FIP
2) Doesn't protect against the disease
3) Doesn't predict if cal will develop FIP
4) Doesn't identify cats that are shedding the virus

Front 76

How can you diagnose a sequestered (latent) FeLV infection?

Back 76

Bone marrow biopsy

Front 77

What are 3 reasons that cats with FIP can be serologically negative?

Back 77

1) Rapid progressive disease
2) Immune complex formation
3) Severe immunosuppression

Front 78

How do you treat IMHA related to FeLV?

Back 78

immunosuppression

Front 79

How do you make a presumptive diagnosis of the effusive form of FIP?

Back 79

Clinical signs + effusion characteristics

Front 80

How do you treat haemoplasmosis that develops secondary to FeLV?

Back 80

Doxycycline usually effective

Front 81

What type of FIP does a cat have if it has FIP but does not have antibodies against the coronavirus (negative serology)?

Back 81

Means the cat has the effusive form because the cat has such a horrible immune system that it has no antibodies

Front 82

What are 6 ways to prevent FeLV infection?

Back 82

1) House cats indoor
-keep FeLV positive isolated
2) Avoid sharing of litter boxes and water bowls
3) Test new cats before introducing in an FeLV- negative cattery
4) Test and separate seropositive cats
5) Flea control
-prevent transmission of mycoplasma haemofelis and bartonella henselae
6) Vaccines

Front 83

How can you come up with a presumptive diagnosis of the non-effusive form of FIP?

Back 83

Clinical signs + hyperglobulinemia + serum antibody titer > 160 + Lymphopenia = PPV 88%

Front 84

When is the Non-core FeLV vaccine recommended?

Back 84

-Kittens
-cats w/ sustained risk (give annual boosters)

Front 85

Describe the negative predictive value for a negative serology on a cat being tested for the non-effusive form of FIP.

Back 85

High negative predictive value because cats with the non-effusive form have a good immune system so if the cat doesn't have antibodies to the coronavirus you can pretty much rule out non-effusive FIP

Front 86

A cat is diagnosed FeLV positive, what can you do to help maintain the health of this cat? (4)

Back 86

1) PE every 6 mo (CBC)
2) Intensive diagnosis if sick
3) Aggressive therapy if infected
4) Routine vaccination (core vaccine-attenuated FPV)

Front 87

How can you definitely diagnose non-effusive FIP that causes neurological signs?

Back 87

Find antibodies to the coronavirus in the CSF

Front 88

In general, how can a definitive diagnosis of FIP be reached?

Back 88

-Histopathology
-very high positive predictive value (in the effusion)- use FA in macs or RT-PCR

Front 89

What are 4 options/components of FIP therapy?

Back 89

1) Supportive therapy
2) alpha interpheron
-may improve effusive form, temporary relief at best
3) Immune suppression
-prenisone + cyclophosphamide or chlorambucil
4) Antibodies for secondary infection

Front 90

What are 2 general ways to prevent FIP?

Back 90

1) Avoid exposure
2) Vaccine

Front 91

How do kittens most commonly contract the coronavirus that causes FIP after the maternal antibodies wane?

Back 91

From other cats (not mother)

Front 92

How long do maternal antibodies to FIP last?

Back 92

4-6 weeks

Front 93

What should you do when you have kittens born into a colony with FIP seropositive cats?

Back 93

-House kittens with mother and litter mates until sold
-Test for antibodies at 10 weeks of age
-Only sell if negative

Front 94

What type of vaccine is available for FIP? How does it work?

Back 94

Mutant strain of coronavirus - induces mucosal immune response
-effective in some cats

Front 95

What are the downfalls of the FIP vaccine? What cats should receive vaccine?

Back 95

-antibodies cannot be differentiated from other coronavirus antibodies
-only recommended in seronegative cats with high risk of exposure
-Generally NOT recommended