Medical Nursing Week 7

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Gia_bella
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176887
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Medical Nursing Week 7
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2012-10-23 13:48:27
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Medical Nursing Week
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Infectious disease
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  1. Infectious Disease
    Infectious Canine Tracheobronchitis
    Any contagious respiratory disease that is manifested by coughing and is not caused by canine distemper.
  2. Infectious Disease
    Infectious Canine Tracheobronchitis
    Etiology
    • Canine adenovirus (CAV-2) and Parainfluenza virus (PIV)
    •        weakens the airway
    • Bordetella bronchiseptica- Bacteria
    •      takes advantage after weakened by virus
    • Klebsiella, E. coli, Pasteurella cause secondary pneumonia
    • Incubation period is 5-10 days
  3. Infectious Disease
    Infectious Canine Tracheobronchitis
    Clinical Signs
    • Coughing
    • Ocular and nasal discharge
    • Retching or gagging
    •     Vomiting white foam
    • Anorexia and fever
    • Pneumonia
    • Many times are still active and eating
  4. Infectious Disease
    Infectious Canine Tracheobronchitis
    Diagnosis
    • Based on clinical exam and history of exposure
    •    cough on tracheal palpation
    • Blood profile
    • Radiographs
    •    normal
    •    collapsing trachea-from all the coughing
    •    pneumonia
    •          Interstitial to alveolar pattern
    • Tracheal wash
    • Canine Respiratory Panel (PCR) test for RNA/DNA
    •  
  5. Infectious Disease
    Infectious Canine Tracheobronchitis
    Treatment
    • Antibiotics for 14-21 days
    •    clavamox
    •    cephalexin
    •    baytril
    • Antitussives
    •     Hycodan or Tussigon- cough suppresents
    •            0.22mg/kg Po Bid
    •     Butorphanol
    •           0.05-0.1mg/kg PO BID
    • Fluid support and nutrition if severe
  6. Infectious Disease
    Infectious Canine Tracheobronchitis
    Prevention
    • Vaccination
    •      Bordetella
  7. Infectious Disease 
    Canine Distemper- viral, neurological, respiratory
    Etiology
    • CDV is caused by a Morbillivirus (related to measles)
    • That is highly contagious to dogs and all canine species
    •     Ferrets, coyotes, etc.
    • CDV is inactivated by heat and sunlight
    • Transmission
    •    shed in all body secreations, especially respiration
    •    aerosol
    • Effects young puppies 3-6 months of age
    • New puppies can be introduced into environment infected with CDV after 1 month period
    • Incubation is 1-3 weeks
  8. Infectious Disease
    Canine Distemper
    Clinical Signs
    • Fever
    • Conjunctivitis and rhinitis
    •     mucopurulent nasal discharge
    • Coughing, vomiting and diarrhea
    • Anorexia and emaciation
    • Neurological signs (1-3) weeks
    •    seizures
    •    ataxia
    •    rhythmic motor movement (Myoclonus) video
    •    chorioretinitis
    •    hyperkeratosis (thickening) of foot pads
    •     hypoplasia (tooth enamel deficit)
  9. Infectious Disease
    Canine Distemper
    Diagnosis
    • History
    •    unvaccinated puppies
    • Clinical signs
    • Blood profile
    •    lymphopenia
    • Radiographs
    •   pneumonia
    • Immunological tests
    •    Fluorescent antibody test
    •        tissue or conjunctival scrape
    •    Serology
    •       tests for antibody IgG and IgM
    •        IgM indicates acute infection
    •        False negatives
    • Canine Distemper PCR (polymerase chain reaction) test is most accurate.  Pharyngeal (pharynx)or conjuctival (eye) swipe
  10. Infectious Disease
    Canine Distemper
    Treatment
    • Supportive Care
    • Antibiotics
    • Fluid Therapy
    • Anticonvulsants
    • Long Term prognosis poor
    • Dogs that get over or live through canine distemper may have myoclonal twitching for life
    • Phenobarbitol-barbituate anti-convulsing
  11. Infectious Disease
    Canine Distemper
    Prevention
    Vaccination-MLV Modified Live Virus
  12. Infectious Disease
    Infectious Canine Hepatitis- Midwest and East Coast
    Etiology
    • ICH is a multisystemic adenovirus (CAV-1) that infects the liver of dogs and foxes.
    • CAV-1 is highly contagious from urine, feces, and saliva
    • Similar to CAV-2 (Tracheobronchitis)
  13. Infectious Disease
    Infectious Canine Hepatitis- Midwest and East Coast
    Clinical Signs
    • Fever
    • Vomiting and diarrhea
    • Petechiations (clotting issues)
    • Icterus
    • Lymphadenopathy
    • 'blue eye' anterior uveitis
    •   can occur after vaccine
    • Blue eye is a side effect of CAV-1
  14. Infectious Disease
    Infectious Canine Hepatitis- Midwest and East Coast
    Diagnosis
    • Blood Profile
    •    high liver enzymes
    •    icterus and leukopenia
    • Serology
    •    rarely performed
  15. Infectious Disease
    Infectious Canine Hepatitis- Midwest and East Coast
    Treatment
    • Supportive care
    • Antibiotics
    • Poor prognosis if acute and guarded if chronic
  16. Infectious Disease
    Infectious Canine Hepatitis- Midwest and East Coast
    Prevention
    • Vaccination
    •    CAV-1 and CAV-2
    • Feeding tube with any kind of liver damage
  17. Infectious Disease 
    Canine Parvovirus- survives in environment for 3-4 months
    Etiology
    • Virus of Parvoviridae
    • Disease caused by canine parvovirus type 2 (CPV-2)
    • That causes severe gastroenteritis
    • CPV-1 causes clinical disease in puppies, 3 weeks of age
    • Transmission
    •     feces, saliva, vomit, and environment (Fomite)
    •     parvovirus lives in the environment for long periods (60-90 days)
    • Effects young puppies 6-20 weeks old
    • Suseptible breeds include rotweillers, dobermans, pit bull
    • CPV-1 is more mild thand CPV-2
  18. Infectious Disease
    Canine Parvovirus
    Clinical signs
    • Anorexia and fevrile
    • Bloody vomiting and bloody diarrhea
    • Dehydration and shock
    • May cause myocarditis (infection of the heart muscle) and death in puppies
  19. Infectious Disease
    Canine Parvovirus
    Diagnosis
    • History
    •   unvaccinated young dogs- multiple puppies in household
    • Blood Profile
    •   leukopenia
    • Fecal ELISA test
    •    most common used
    •    false negatives
    • Serology
    •    4 times increase of IgG or IgM to note information
    • SNAP test
  20. Infectious Diseases
    Canine Parvovirus
    Treatment
    • Anitibiotics
    • Antiemetics
    • Fluid support
    • Plasma Trasnfusions- for wors cases
    •     Critical patients
    • Endoserum- Salonella typhimurium toxoid
    •     Endotoxin
    • Prognosis- good, as long as u get them hospitalized
  21. Infectious Diseases
    Canine Parvovirus
    Prevention
    • Vaccination
    •    killed CPV-2
    •        short immunity
    • MLV
  22. Infectious Diseases
    Canine Coronavirus
    Etiology
    • Coronavirus that causes gastroenteritis
    • Shed in feces
    •    fecal oral transmission
    • Effects all ages
    • Similar clinical signs to parvovirus
  23. Infectious Diseases
    Canine Coronavirus
    Clinical signs
    • Vomiting and diarrhea
    • Fever
    • Dehydration
  24. Infectious Diseases
    Canine Coronavirus
    Diagnosis
    • Physical exam and history
    • No specific test
    •     diagnose by rule out other diseases
  25. Infectious Diseases
    Canine Coronavirus
    Treatment
    Similar to parvovirus
  26. Infectious Diseases
    Canine Coronavirus
    Prevention
    • Vaccination
    •    killed
    •    MLV
    • Prognosis is better than Parvovirus
  27. Infectious Diseases
    Heartworm disease- infects blood
    Etiology
    • Dirofilaria immitis
    •      Parasite
    • Transmitted by mosquito bits
    • Microfilaria
    •     Larval form that may circulate for up to 2 years
    •     Larval form must first deveopl in mosquito
    • Adult heartworm causes clinical disease
    •     migration to arteries takes 5-6 months
  28. Infectious Diseases 
    Heartworm Disease
    Clinical Signs
    • Cardiopulmonary disease
    •     Right sided heart failure
    •     Pulmonary hypertension
    • Caughing
    • Respiratory distress
    • Lethargy and fatigue
    • Syncope
    • Weight loss and anorexia
    • Ascited- right sided heart failure
  29. Infectious Diseases
    Heartworm Disease
    Diagnosis
    • Clinical signs and exposure history
    • Knott's test
    •    direct blood smear for mircofilaria
    • Serology (Heartworm Antigen)
    •    ELISA
    •    IFA
    • Radiographs
    •    Right sided heart failure
    •    Pulmonary edema
    •   Ascites
  30. Infectious Diseases
    Heartworm Disease
    Treatment
    • *Thiacetarsamide (caparsolate)
    •    risks acute death from thromboemboli
    •   Hepatotoxic and nephrotoxic
    • Melarsomine (Immiticide)
    •    Risks thromboemboli
    •    Less hepatotoxic and nephrotoxic
    •    Safer and less treatment
  31. Infectious Diseases
    Heartworm Disease
    Prevention
    • Heartworm preventative
    •    Ivermectin (heartguard)
    •        Monthly dose
    •   Milbemycin (Interceptor)
    •       Monthly dose
    •   Diethylcarbamazine (Filarabits)
    •        Daily
    • No Vaccine
  32. Infectious Diseases
    Lyme Disease
    Etiology
    • Borrelia burgdorferi
    •      Spirochete bacteria
    • Transmitted by ticks
    • Long incubation period 2-5 months after exposure
  33. Infectious Diseases
    Lyme Disease
    Clinical Signs
    • Fever and lethargy
    • Anorexia
    • Lameness and joint pain
    • Lymphadenopathy
  34. Infectious Diseases
    Lyme Disease
    Diagnosis
    • History to exposure and clinical signs
    • Serology
    •    ELISA
    •    IFA
    •    PCR- testing for DNA
  35. Infectious Diseases
    Lyme Disease
    Treatment
    • Tetracycline antibiotics
    • Prevention
    •   Vaccination- killed
  36. Infectious Diseases
    Feline Panleukopenia
    Etiology
    • Feline panleukopenia s called feline distemper
    • Characterized by gastroenteritis and leukopenia
    • FPV is a parvovirus
    • Cause disease in cats, ferrets and raccoons
    • Transmission
    •   Saliva, secretions, and feces
    • Highest incidence is in kittens 3-5 months age
  37. Infectious Diseases
    Feline Panleukopenia
    Clinical Signs
    • Fever and anorexia
    • Vomiting and diarrhea
    • Lymphadenopathy
    • Leukopenia
    • Kittens infected in utero have cerebellar hypoplasia
  38. Infectious Diseases
    Feline Panleukopenia
    Diagnosis
    • Young age 3-5 months w GI signs
    • Clinical signs
    • Hematology
    •    Leukopenia
    • Serology
    •   not used in clincal practice
  39. Infectious Diseases
    Feline Panleukopenia
    Treatment
    • Fluid therapy
    • Antibiotics
    • Antiemetics
    • Prognosis- guarded 50/50
  40. Infectious Diseases
    Feline Panleukopenia
    Prevention
    Vaccination
  41. Infectious Diseases
    Feline Coronavirus (FIP)
    Etiology
    • 1. Feline coronavirus infection is a highly contagious and fatal disease of cats with two forms : Effusive and Nonerosive
    • 2. Feline Enteric coronavirus cross reacts in lab test with FIP virus (FECV)
    • 3. Transmission
    •   mother to kitten in utero
    •  urine or fecal oral
    •      inhalation and ingestion
    • may have long latent period- goes dorment
    • do not bring new cat into household for >60 days
    • 4. 2 forms of the disease
    •       a. Effusive (wet) form is characterized by yellow Peritoneal and /or abdomenal pleural effusion (vasculitis)
    •       b. Noneffussive (dry) is characterized by localized Pyogranulamatous lesions with no peritoneal or pleural effusion
    • 5. Causes vasculitis and immune complexes
  42. Terminology
    Retina
    choroid
    Chorioretinitis
    Uveitis
    hyphema
    • Retina- light-sensitive tissue lining the inner surface of the eye
    • Choroid- choroid coat, is the vascular layer of the eye, containing connective tissue, and lying between the retina and the sclera
    • Chorioretinitis- inflammation of the choroid and retina
    • Uveitis- swelling and irritation of the uvea
    • hyphema- blood in front of the eye
  43. Infectious Diseases
    Feline Coronavirus (FIP)
    Clinical Signs
    • General signs
    •    May be sudden or over monthhs
    •    Anorexia, weight loss, dehydration
    •    Febrile
    •    vomiting, and diarrhea
    • Effusive form
    •   yellow sticky ascited
    •   Tachypnea or dyspnea
    • Noneffusive form
    •    Form and weight loss
    •    Signs specific of organ disease
    •             Kidney, lymph nodes and liver
    •             CNS- Seizures
    •             Ocular lesions
    •                 chorioretinitis (inflammation of the choroid and retina)
    •                 Uveitis and hyphema
    •                 retinal hemorrhage
  44. Infectious Diseases
    Feline Coronavirus (FIP)
    Diagnosis
    • 1. History
    •    cats with history FIP
    •    Nonvascular cats
    • 2. Characteristics clinical signs
    •    Ascites
    • 3. Blood profile
    •        T.P >7.8g/dl
    •        High globulins - Antibiotics
    • 4. Serological testing 50% accurate
    •       Not accurate
    •       Negative test does not rule out FIP
    •       Titer >1:1600 clinical signs determines FIP
    • 5. Fluid analysis- abdominal fluid
    •     High cellularity and WBC
    • 6. Polymerase Chain Reaction (PCR)
    •    Detects low levels of viral RNA in tissue and body fluids
    • Basis is that FIP is found in tissue, while FECV is found only in feces
    • 7. Necropsy tissue
  45. Infectious Diseases
    Feline Coronavirus (FIP)
    Treatment
    • Theres is no curative therapy
    • Treatment is supportive
    •    Fluids
    •    Antibiotics and corticoseroids
    •    Chemotherapy
    •        Cytoxan
  46. Infectious Diseases
    Feline Coronavirus (FIP)
    Prognosis
    • Poor
    • survival is 5-7 weeks once the onset of clinical signs
  47. Infectious Diseases
    Feline Coronavirus (FIP)
    Prevention
    • Vaccination (intranasal)
    •     Does not prevent infection, only reduces clinical symptoms
    •     50% successful at best
    •    Vaccinated cats will have 1:100 FIP titer
  48. Infectious Diseases
    Feline Leukemia Virus (FELV)
    Etiology
    • FELV is a retrovirus that replicates in bone marrow, salivary glands and respiratory epithelium
    • Can be latent infection
    • Transmission
    •    Transmitted directly by ingestion in saliva
    •    Transplacental
  49. Infectious Diseases
    Feline Leukemia Virus (FELV)
    Clinical Signs
    • Immunosuppression
    •    Anemia
    • Anorexia
    • Vomiting and diarrhea
    • Neoplasia
    • Blood profile
    •    Anemia
    •   Glomerulonephritis
    • Radiographs
    •    Neoplasia
    • Serology
    •    ELISA_ Antigen- testing for virus
    •        Most sensitive
    •        False negative
    •       IN house CITE test
    • Indirect fluorescent antibody test (IFA)
    •     Definitive test
    • Seroconversion after 3 negative test 30 days apart
  50. Infectious Diseases
    Feline Leukemia Virus (FELV)
    Treatment
    • Symptomatic- no cure
    • Blood transfussion
    • Prognosis poor
    •    Live <2 years after clinical signs
  51. Infectious Diseases
    Feline Leukemia Virus (FELV)
    Prevention
    • Vaccination (killed vaccine)
    •    75% effective
  52. Infectious Diseases
    Feline Immunodeficiency Virus (FIV)
    Etiology
    • Lentivirus (retrovirus) that causes similar disease as AIDS
    • complex in People
    • Transmission
    •    Through bite wounds
    •         Saliva
    •     Not known to be by contact
    •     Rare transplacental infection
  53. Infectious Diseases
    Feline Immunodeficiency Virus (FIV)
    Clinical Signs
    • Fever
    • Lymphadenopathy
    • Chronic stomatitis and gingivitis- bacteria
    • Chronic conjunctivitis and rhinitis
    •    URI
    • Chronic uveitis (swelling and irritation of the uvea)
    • Immunosuppression infection
  54. Infectious Disease
    Feline Immunodeciency Virus
    Diagnosis
    • Blood panel
    •   Leukopenia and anemia
    • Serology
    •      ELISA
    •          In house test
    •     Western blot test
    •     PCR
  55. Infectious Disease
    Feline Immunodeciency Virus
    Treatment
    • Symptomatic
    •      Control secondary infections
    • Azidothymide (AZT)
    •      5mg/kg PO or SQ BID
    • Alpha interferon
  56. Infectious Disease
    Feline Immunodeciency Virus
    Prevention
    No vaccine
  57. Infectious Disease
    Haemobartonella (Feline Infectious Anemia)
    Felis- Mycoplasma Hemofelis
    Etiology
    • Haemobartonella Felis
    •       Rickettsial disease- bacteria
    • Transmitted by arthropod bites
    • Causes hemolytic anemia
  58. Infectious Disease
    Haemobartonella (Feline Infectious Anemia)
    Felis- Mycoplasma Hemofelis
    Clinical Signs
    • Anorexia and depression
    • Weakness and fever
    • Anemia
    • Pale mucous membranes
    • Dyspnea
    • Splenomegaly
  59. Infectious Disease
    Haemobartonella (Feline Infectious Anemia)
    Felis- Mycoplasma Hemofelis
    Diagnosis
    • Blood Profile
    •    Anemia
    •     Icterus
    •    Hyperbilirubinemia
    • Detection of parasite on blood smear exam
  60. Infectious Disease
    Haemobartonella (Feline Infectious Anemia)
    Felis- Mycoplasma Hemofelis
    Treatment
    • Tetracycline antibiotics
    •      Doxycycline
    • Supportive care
    •     Blood Transfusion
  61. Infectious Disease
    Rabies
    Etiology
    • Rabies is a acute viral encephalitis characterized by altered behavior, aggressiveness, paralysis and death
    • Rhabdovirus which is slow progression
    • Transmission
    •       Spread through saliva from bite wounds
    •       Virus migrates up neerve roots
    • Rabies problem in wildlife
    •        Fox, skunk, raccoon, bobcat, coyote, and bat
    • Species susceptibility
    •        High- fox, racoons, bats, skunk
    •        Medium- Primates, dogs, cats, and cattle
    •       Low - Birds, rabbits, rodents, horses, opossums
    • Incubation period ranges from 3 weeks to >6 months
  62. Infectious Disease
    Rabies
    Clinical Signs
    • 1. Prodromal stage
    •      Last 2-3 days
    •      Behavior change
    •     Snapping at imaginary objects
    •     Restlessness
    •     Vocalization
    •     Mydriasis- dilated pupils
    • 2. Furious stage
    •     1-7 days
    •      Increased response to stimuli
    •     Photophobia
    •           Fear of light
    •    Aggression
    •    Muscular incoordination to seizures
    • 3. Paralytic (dumb) Stage
    •         2-10 days after clinical signs
    •         Dysphagia- can't swallow
    •         Salivation
    •         Jaw Drop
    •         Paralysis of head to neck and whole body
    •         Coma
    •         Death
  63. Infectious Disease
    Rabies
    Diagnosis
    • History and clinical signs
    • Nogood antemortem test
    •     Intracellular inclusion bodies
    •               Negri bodies
    •              CNS tissue (Brain)
    •   Direct immunofluorescence
    •            Postmortem
    •           CNS tissue
    •           Hippocampus
  64. Infectious Disease
    Rabies
    Treatment
    • None
    • Always Fatal
  65. Infectious Disease
    Rabies
    Prevention
    • Vaccination
    •      Killed
  66. Pg 114 and 115

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