Cat Scratch Disease and Heartworm Disease

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tsbatiste
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251331
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Cat Scratch Disease and Heartworm Disease
Updated:
2013-12-09 18:48:45
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Canine Feline Final
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  1. Bartonellosis - changes in what we think
    • No longer thought to be self limiting
    • Now found to infect cats and is therefore now considered zoonotic

    Bartonella henselae considered primary but Bartonella vinsonii is now more commonly fount in the US
  2. Primary transmission of Bartonellosis
    • inoculation of flea feces through a bite or scratch.
    • - flea feces in nail beds
    • - flea feces in saliva
  3. What percentage of cats carry bartonellosis at some time during their lives?
    14-70%
  4. Feline bartonellosis symptoms
    lymphadenopathy, pyrexia, anterior uveitis
  5. When do symptoms appear in human bartonellosis?
    3-20 days
  6. What is the percentage of skin rashes seen in human bartonellosis?
    25-90%
  7. What are the characteristics of the rash in human bartonellosis?
    • small pustules at the sight of injury
    • progresses to enlarged lymph nodes 1-2 wks later
  8. Name 3 conditions that can happen in 5-16% of human bartonellosis patients that are immunosuppressed.
    brain inflammation, heart inflammation and nerve involvement
  9. Feline bartonellosis incubation
    2-16 days after exposure
  10. What is the primary means to diagnose feline bartonellosis?
    • 1) PCR
    • 2) serology
  11. What must the titer be to be considered positive for Bartonellosis?
    IgG 1:128
  12. What is the primary treatment of Bartonellosis?
    Clindamycin or Doxycycline
  13. Which products are know to block transmission of Bartonella from flea to flea?
    Moxidectin 1% and Imidacloprid (Advantage Multi - Topical - Bayer)
  14. What was the old name for Bartonellosis?
    Blood poisoning
  15. The first person to coin the phrase "cat scratch fever" in reference to pyrexia of Bartonellosis was:
    Ted Nuget
  16. Length of time Bartonella can live in flea feces.
    3-9 days
  17. Where is bartonella cultured on the cat?
    • 1) blood
    • 2) skin
    • 3) claw bed
    • 4) gingiva
  18. What percentage of Ctenocephalides felis carry bartonella bacteria?
    40%
  19. 3 most common mosquito species in US homes
    • Culex
    • Anopheles
    • Aedes

    serve as the intermediate host for Dirofilaria immitis
  20. Heartworm disease etiology
    Dirofilaria immitis
  21. What is the average number of heartworms in a regular infection?
    14
  22. What is the average number of adult heartworms in a Caval Syndrome patient?
    75-100
  23. Diagnosis of Dirofilaria infection by blood sampling:
    • 1) direct smear - 64% acc.
    • 2) modified knots method - 84% acc.
    • 3) micropore filtration method (difil millipore) - 84% acc.
    • 4) microhematocrit tube - least acc.
    • 5) occult test - most acc.
  24. Diagnosis of Dirofilaria infection by History:
    loss of stamina, coughing
  25. Diagnosis of Dirofilaria infection by radiology:
    "Inverted D"
  26. Diagnosis of Dirofilaria infection by echocardiology:
    "equals" sign of adult
  27. This heartworm occult test requires at least 3 adult females
    antigen test
  28. What type of substance is the antigen produced by female adult heartworms?
    Glycoprotein
  29. This heartworm occult test only shows an possible exposure to and can be skewed by intestinal parasite infection.
    antibody
  30. What percentage of dogs with adult heartworms test negative for microfilaria?
    50%
  31. What is the percentage of dogs with microfilaria but no adults?
    2-5%
  32. Life span of adult heartworms
    5-7 years
  33. Life span of microfilaria
    1.5-2 years
  34. What are the typical dimension of a normal canine heart?
    5 ribs in length and should sit just off the sternum
  35. What company is developing a test for stage 4 dirofilaria larva?
    Merck
  36. Dirofilaria immitis life cycle
    • S1 (microfilaria) & S5 (adult) – dog 1
    • S1 in mosquito molts to infective S3 - 1 to 4 weeks depending on temp
    • S3 enters dog 2 & molts to S4 in 1 to 2 weeks
    • S4 stays in the subcutaneous area for 100days
    • S4 moves to pulmonary artery, molts to premature S5a, and remains there S5a for 80 days.
    • After 80 days premature S5a will mature to S5 and begin mating and produce S1
  37. Temperature and time for S1 to S3 molting in mosquito
    • 30 degrees C - 8 days
    • 26 degrees C - 12 days
    • 22 degrees C - 17 days
    • 18 degrees C - 29 days
    • 12 degrees C - death
  38. What is the reason why the average Dirofilaria infection is 14?
    Immune recognition- even with repeated inoculation of heartworms from the mosquitos, less heartworms survive due to protein recognition and antibody production
  39. Definitive host for Dirofilaria immitis
    dog - 75 to 80% of S5a will mature to S5
  40. Non-definitive hosts for Dirofilaria immitis
    • Cats - very high mortality of S5a when molting to S5
    • Ferret - far less mortality than cats of S5a when molting to S5
  41. Newest name for dirofilaria infection
    3 month disease - because it takes 80 day for S5a to mature to S5 so cardiac system is affected 3 months before actual diagnosis
  42. The level of heartworm disease is characterized by the animal with mild clinical signs or is asymptomatic
    Class 1
  43. This level of heartworm disease is characterized by moderate clinical signs and radiographic anomalies.
    Class 2
  44. This level of heartworm disease is characterized by severe clinical signs and radiographic anomalies - R sided CHF
    Class 3
  45. What is usually attributed to left sided CHF?
    Mitral Valve Insufficiency
  46. This level of heartworm disease is the most severe and often associated with caval syndrome.
    Class 4
  47. What class(es) of heartworm disease does an animal have to make it a poor surgical candidate?
    Class 3 and 4
  48. What does a CBC look like with heartworm disease?
    • Eosinophila and Basophila - most common
    • Neutrophilic Leukocytosis - mostly seen with pulmonary thromboembolisms.
    • Thromocytopenia - arterial/lung disease
  49. Why do we see hemoglobinuria with heartworm disease?
    Dirofilaria immitis microfilaria are the same width of RBCs.  If microfilaria punch holes in the nephron, the RBCs will also leak out into the urine
  50. Filaribits
    type:
    non-proprietary name:
    route of administration:
    manufacturer:
    stage(s) killed:
    • prevention
    • diethycarbamazine citrate (DEC)
    • oral
    • Pfizer
    • 1st true prevention of S3 to S4
    • Note: will cause a reaction with microfilaria
  51. Heartgard
    type:
    non-proprietary name:
    route of adminstration:
    stage(s) killed:
    manufacturer:
    • prevention and microfilaricide - an Avermectin
    • Ivermectin (Plus has Pyrante pamoate)
    • oral
    • S3/S4
    • Merial
    • Note: not approved by FDA as microfilaricide but is is the D.O.C.
  52. Ivomec
    type:
    non-proprietary name:
    route of administration:
    stage(s) killed:
    manufacturer:
    • off label microfilaricide (cattle strength) D.O.C. - an Avermectin
    • Ivermectin 1%
    • oral
    • S3/S4
    • Merck
    • Note: if given to K9: 0.25ml/40# orally
  53. Sentinel
    type:
    non-proprietary name:
    route of administration:
    stage(s) killed
    manufacturer:
    • macrocyclic prevention
    • Milbemycin oxime and Lufenuron
    • oral tablet
    • S3/S4, flea ovitrol (fleas must bite, egg does not hatch d/t damaged chitin)
    • Novartis
    • Note: will cause a reaction with microfilaria
  54. Revolution
    type:
    non-proprietary name:
    route of administration:
    stage(s) killed:
    manufacturer:
    • prevention and microfilaricide - an Avermectin
    • Selamectin
    • Topical spot-on
    • S3/S4, fleas, ticks, feline ascarids/hookworms, Otodectes cyanotis, Sarcoptes scabiei, Notoedres cati
    • Pfizer
    • Note: 1st FDA approved hw prevention
  55. Advantage Multi
    type:
    non-proprietary name:
    route of administration:
    stage(s) killed:
    manufacturer:
    • prevention
    • Moxidectin (avermectin) & Imidacloprid
    • Topical spot-on
    • S3/S4, off-label demodectic mange
    • Bayer
    • Note: called Advocate in Europe and approved for demodectic mange
  56. What are the three preventative that will cause a reaction with microfilaria?
    • Diethylcarbamazine citrate
    • Milbemycin oxime
    • Dichlorvos(Task - ogranophosphate)
  57. ProHeart
    type:
    non-proprietary name
    route of administration:
    stage(s) killed:
    manufacturer:
    • 6 month preventative
    • Moxidectin - an Avermectin
    • injectable
    • S3/S4
    • Pfizer
    • Note: developed by Steelmeadows in TX
  58. Dizan
    type:
    non-proprietary name:
    route of administration:
    manufacturer:
    • microfilaricide
    • Dithiazine Iodide
    • oral

    Note: FDA approved
  59. Which 2 drugs were considered both a microfilaricide and an adulticide?
    • Levamisole
    • Fenthion(Talodex) - organophosphate
  60. Caparsolate
    type:
    non-proprietary name:
    manufacturer:
    route of administration:
    • hw adulticide
    • Thiacetarsamide sodium
    • Rhone Merieux
    • MUST be injected into the vein or else will eat all the way down to the bone
  61. Immiticide
    type:
    non-proprietary name:
    manufacturer:
    route of administration
    • hw adulticide
    • Melarsomine dihydrochloride
    • Merial
    • 1 IM injection to lumbar. 30 days repeat with 2 IM injections 24 hours apart
  62. What 2 drugs reduce pulmonary arterial lesions during adult heartworm treatment?
    • Baby aspirin
    • Heparin
  63. This is the only way to dilate pulmonary arteries in emergencies and severe cases of heartworm adult treatments.
    Oxygen
  64. Typical routine for Dirofilaria treatment
    • Diagnosis via antigen/antibody at office visit
    • Schedule Laboratory tests
    • Initiate microfilaricide treatment or prevention
    • Adult treatment with Immiticide
    • Check for microfilaria and treat if positive
    • Recheck antigen/antibody 4 months after treatment
  65. The name given to a clot that blocks a small artery in the lungs
    Pulmonary thrombus or embolism
  66. PVR
    Pulmonary Vascular Resistance - the more adults the dog has the more exercise will increase this effect
  67. 4 post adult heartworm treatment complicatons:
    • 1) dyspnea and severe coughing
    • 2)lung injury - absorption of dead adults by lung macrophages
    • 3) Pulmonary thromboembolism
    • 4) Disseminated Intravascular Coagulation
  68. When is right sided congestive heart failure seen after infection by adult heartworms?
    10-17 months
  69. When is a rise in blood pressure seen after infection by adult heartworms?
    9  months
  70. This is the specific lung that is severely affected by infective heartworm stage and dead adults
    Caudal lung lobes
  71. This is the time it takes to kill the adult heartworm post treatment.
    21-28 days
  72. This is the time it takes for complete removal of adults from the lungs.
    Up to 6 months
  73. The first sign of shock in surgery is:
    the bp drops below 79 systolic
  74. Immiticide is contraindicated in what class of heartworm infection
    Class 4 - will cause acute cardiovascular collapse and shock

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