Conference misery::feline

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Note 471.0             New Disease causing potassium loss?             3 replies
VAXWRK::SKALTSIS "Deb"                               53 lines   8-FEB-1987 15:47
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    The following appeared in the March 1987 issue of Cat Fancy in the
    LITTER BOX. It appears that dispite a balenced diet a number of
    cats have been quickly getting ill due to no potassium in their
    bodies. Has anyone heard anything about this?
    
    Deb
    
    The letter, retyped with out permission, follows the form feed.
    
    New Disease?
    ------------
    
    We own a 7-year old, orange and white domestic shorthair named Seymour.
    He has always been very healthy and is a large cat. One evening
    when he jumped up on the couch next to me, I noticed that he was
    holding his head with his  chin tucked in down toward his chest.
    It gave him the appearance of a show horse. Twentry-four hours later,
    Seymour was at Colorado State University Vetanary Hospital in critical
    condition.
    
    Although Seymour had the most severe case of what now appears to
    be a new disease, doctors at the hospital told us that they have
    recently treated several other cats with the same symptoms. The
    first noticable change is in the head position. This is followed
    by a staggering walk where the front legs appear week and stiff.
    These cats do not have a fever and give no other warning. Seymour
    was still trying to eat and drink when he could not even hold himself
    up. When we got him to the hospital, he could hardly breathe and
    his whole body seemed to be shutting down. 
    
    The treatment that saved Seymour was oxygen and an intravenous dose
    of potassium. For whatever reason, Seymour and the other cats treated
    at the hospital for the same problem seemed to have no potassium
    in their systems, although they were all on a balenced diet. My
    understanding is that potassium is converted into electrolytes within
    the system and that is what the muscles need to operate. without
    it their systems quickly shutdown and they could die.
    
    If you have had a similar experience with one of your cats, please
    write to
    		Dr. Richard LaCourtier
    		c/o Colorado State University Veterinary Teaching Hospital
    		300 West Drake Rd.
    		Fort Collins, CO 80526
    
    Dr. LaCourtier is doing research to identify what is causing the
    potassium loss in these cats. We are fortunate to have CSU so close
    to us. Had it not been for their exceptional staff, we may have
    lost Seymour.
    
    Susan Vincent
    Colorado
    

    This description of Cardiomyopathies was taken from the Cornell Book of
    Cats, 1989.
    
    "Cardiomyopathies are primary diseases that affect the heart muscle. 
    The ultimate result is an inability of the heart to compensate for
    stress, and heart failure may occur.  Inheritance, viral infections,
    autoimmune mechanisms, biochemical disorders, and diet deficiencies
    (e.g. insufficient taurine) are factors that may contribute to the
    development of cardiomyopathies."
    
    "Cardiomyopathies are subdivided into Hypertrophic, Dilated, and
    Restrictive (also known as Intermediate).  However, an increasing
    number of cats are being recognized with cardiac disease that cannot be
    classified into just these three catagories.  Middle-aged male cats and
    certain breeds seem more predisposed to cardiomyopathies."  
    
    "Generally, the observed signs of labored breathing, lameness or
    paralysis, lethargy, and ascites (accumulation of fluid in the
    abdommen) are a result of cardiac arhythmias, congestive heart failure,
    or blood clots.  In advanced stages collapse may occur.  This occurs
    when a partial or complete temporary suspension of respiration or
    circulation results from obstructed arterial blood flow."  
    
    "Diagnostic tests that may be performed by a veterinarian include
    electrocardiogram, radiography, serum chemistries, and hemogram
    (includes blood counts, packed cell volume, percent of hemoglobin). 
    These tests do not necessarily help in differentiating between the
    various types of cardiomyopathies; however, they can provide vital
    information on the funtion of other organs.  this information is
    important in determining appropriate methods of treatment.
    Sophisticated tests that can be performed at progressive small-animal
    clinics or veterinary college clinics are echocardiography and
    angiocardiography.  These tests can differentiate between various types
    of cardiomyopathy."
    
    "Treatment is directed at reducing the workload on the heart and
    improving oxygenation of blood.  Therapy regimen varies according to
    the type and severity of the cardiomyopathy.  Also, a low-sodium diet 
    can be beneficial to the patient by preventing fluid retention."
    
    
    
    

    This description of FUS was taken from the Cornell Book of Cats, 1989
    edition.
    
    "Feline urologic syndrome is a term for a wide range of problems
    associated with the lower urinary tract of both male and female cats:
    inflammation of the urinary bladder and urethra, the formation of
    urinary stones, and obstruction of the urethra (usually the male's) by
    tiny stones and plugs.  A number of factors seem to be responsible for
    the syndrome.  Therefore, it is not unusual if treatments and methods
    of prevention vary.  It is reported that up to 10 percent of the feline
    population may be afflicted with FUS.  The consequences of FUS may be
    fatal if urethral obstuction occurs, especially in male cats."
    
    Urethral obstruction in the male ("blocked cat") is a life-threatening
    emergency for which owners must be alert.  The cat keeps licking at its
    penis and going to its litter box but produces no urine or only a few
    drops (which may be bloody).  Sometimes urinary "sand" is present on
    the tip of the penis or surrounding fur.  Experienced owners may be
    able to palpate the tense, overfull urinary bladder like a large lemon
    in the posterior abdomen.  The cat must be taken to a veterinarian at
    once; a delay of only a few hours can mean death from uremic poisoning. 
    The owner must not make the common mistake of assuming that the cat is
    constipated and waste precious time plying the cat with laxatives."
    
    "Treatment for a blocked cat could include passing a catheter through
    the urethra into the bladder with the aid of a tranquilizer, sedative,
    or light anesthesia.  If that fails, urine must be withdrawn from the
    overdistended bladder by suction with a needle directly through the
    abdominal and bladder walls."
    
    "The type of lower urinary tract disease will determine the treatment
    prescribed for a cat.  Treatment may include one or a combination of
    the following: diet, antibiotics, or urine acidification.  Feeding a
    low magnesium diet (less than 20 milligrams of magnesium per one
    hundred calories) is advisable for cats that are predisposed to
    urolithiasis or urethral obstruction.  For all cats, encouraging
    exercise and frequent urination, preventing obesity, avoiding extreme
    confinement, keeping the litter box clean and easily available, and
    always having fresh water available will assist in preventing FUS."
           

    This descriptoin of Diabetes was taken from the Cornell Book of Cats,
    1989 Edition.
    
    "The common form of diabetes that occurs in the cat is Diabetes
    Mellitus.  Diabetes Insipidus has been reported in the cat but appears
    to be extremely rare.  Diabetes Mellitus is caused by the inability of
    the body to utilize sugar in the blood because inadequate amounts of
    insulin are produced by the pancreas.  The sugar is excreted in the
    urine, causing increased volume of urination and increased thirst,
    which are the first early signs of this disease.  If the disease is
    neglected, it progresses to produce signs such as lethargy, increased
    appetite, weight loss, rear leg weakness, diarrhea, and vomiting,
    followed by loss of appetite."
    
    Diabetes Mellitus is a recognized disease entity in middle-aged and
    older cats (rarely younger than eight years), affecting both males and
    females.  Physically, most affected cats will be overweight in the
    early stages of the disease, while in those cases where treatment has
    been delayed, they will become emaciated and show muscle wasting. 
    Other physical findings include thinning or loss of the hair coat. 
    signs compatible with chronic infections, such as chronic bladder
    disease, and continuing sore and inflammed tongue and gums can also
    occur."
    
    "...diagnosis of diabetes is based on clinial signs, physical exam, lab
    tests, and the persistent presence of abnormal amounts of blood sugar
    and sugar in the urine.  Diagnosis is not based on a single elevated
    blood sugar test because stressed cats can have temporary sugar levels
    that are abnormally high.  With diabetes, urinalysis results will
    always reveal sugar in the urine, and in more advanced cases, toxic
    ketone bodies will be found.  Ketones are a by-product of the body's
    digestion of it's own tissues to produce energy when sugar cannot be
    metabolized to be used.  Presence of ketones is not a favorable sign."
    
    "Home treatment of diabetes is not easy for many owners.  The owner
    must be willing to continue giving treatment for the rest of the cats
    life.  Home care of the diabetic cat requires strict adherence to a
    predetermined time schedule with close attention to detail, vigilant
    observation, and no excuses."
    
    "Once the home treatment schedule and routine have been adjusted
    properly, everything should remain basically the same.  There must be
    no change in time schedules, dosages, diet, exercise, or testing
    procedures except by consultation with the veterinarian.  A periodic
    recheck would be indicated before a change is made."
    
    

    Here's some information about mast cell tumors, which my cat Sweetie
    and Barbara Benton's cat Murphy have had.  Moderators, could we have a
    keyword for cancer added to this note?  Thanks.
    
    The Cornell book on cats says that Mast cell tumors are the fourth most
    common kind of skin cancer in cats, and most are benign but some are
    rapidly spreading malignant ones that spread to other organs in three
    to six months.  My Sweetie's looked like a very small whitish pearly
    lump, a fraction of the size of a pencil eraser when I first noticed
    it.  The vet said it may have reached this size in just a week. 
    Eventually the lump apparently grows what appears to be a scab on top,
    and gets bigger.
    
    Hopefully the vet has removed it all, and Sweetie's first blood
    test came back clear.  His vet says he has had good luck with treating
    even advanced cases in cats with steroids, but Barbara's vet seems less
    hopeful about this.  (As a side note, the vet says steroid treatment
    does not seem to work for dogs with this problem.)  Hugs to Murphy who
    is fighting this.
    

    I have searched the Cornell Book of Cats for information on FeLV
    (Feline Leukemia Virus) and found it contains pages and pages of very
    good information.  I was looking specifically for something that would
    tells us just how contagious the disease is, how it is passed from cat
    to cat, symptoms, etc.  The following is some of what I found:
    
    "After infection of lymphatic tissues surrounding the site of initial
    virus penetration, a low-grade transient viremia (virus in the
    bloodstream) involving small numbers of infected white blood cells
    occurs within two weeks of exposure.  In this way the virus is
    transported to other regions of the body, especially systemic lymphatic
    tissue, intestinal tissue, and bone marrow.  The areas contain
    populations of rapidly dividing cells wherein FeLV replication can be
    enhanced.  Infection of white blood cell and platelet (cells involved
    in blood clotting) precursors in the bone marrow, plus the subsequent
    release of infected cells into the circulation, result in a second,
    more profound viremia (persistent viremia).  In those cats that resist
    widespread infection with FeLV, virus containment takes place in the
    early lymphatic stage of infection, after transient viremia has
    occured.  In those animals destined to become persistently viremic,
    infection proceeds to extensive involvement of the bone marrow,
    pharynx, esophagus, stomach, bladder, respiratory tract, and salivary
    glands."
    
    "All persistently viremic FeLV cats excrete infectious FeLV and
    probably do so for the rest of their lives.  Consequently, they serve
    as a source of infection for healthy, uninfected, susceptible cats with
    which they come into contact.  Cats that develop immunity experience an
    initial transient viremia lasting from one to two days and for as long
    as eight weeks, during which time they too may shed infectious FeLV."
    
    "Excretion of FeLV occurs primarily in salivary secretions, although
    virus may also be present in respiratory secretions, feces, and urine. 
    The social grooming habits of cats, licking and biting, sneezing, and
    the urban practice of sharing litter boxes and feeding bowls, probably
    represent the major modes of spread of FeLV among pet cats...Prolonged
    close contact (days to weeks) between cats is probably required for
    effective transmission of FeLV..."
    
    "...FeLV is extremely labile (chemically unstable) once outside the cat
    and is rapidly inactivated by alcohol and most common houshold
    detergents and disinfectants..."
    
    "...diseases directly caused by FeLV can include lymphosarcoma, a
    number of myeloproliferative disorders, several types of anemia, the
    panleukopenialike and thymic atrophy syndromes (shrinking or wasting
    away of the thymus), at least one form of kidney disease, and certain
    reproductive disorders.  Diseases indirectly caused by FeLV include a
    myriad of conditions that develop secondary to FeLV-induced
    immunosuppression.  The prognosis for survival of persistently viremic
    cats is poor; approximately 50 percent will die within 6 months of
    infection, while over 80 percent will die within three years of
    infection."
    
    Diagnosis of FeLV can be made by two types of blood tests, IFA or
    ELISA.  "The ELISA test can detect the primary (transient) viremia
    stage, before the bone marrow has become infected...Transiently
    viremic cats characteristically test ELISA-positive and then revert to
    negative status within about 8 weeks.  It is important that a positive
    FeLV test be repeated in 8 to 12 weeks in order to determine whether
    the viremia is transient or persistent."
    
    The above information covers some of the more frequently asked
    questions about FeLV that came up in the old version of Feline.
    
    Jo
    

    The following article appeared in the CFA Alamanac, December 1991
    edition.  Credit was given their to publication of this article in the
    Tails Of The Orient, the official newsletter of the CFA club Oriental
    Shorthairs of America (OSA).
    
                     FELINE LEUKEMIA VIRUS UPDATE:
    
    			Prophylaxis and Testing
    
    			by John M. Todd, DVM
    
    At a recent seminar at the DC Academy of Veterinary Medicine,
    information was released that is of utmost importance for feline
    breeders.  The subject presented by Alfred Legendre, DVM (University of
    Tennessee College of Veterinary Medicine) pertained to the recent
    findings of Feline Leukemia virus and current vaccines available.  In
    the study presented, the three vaccines tested were
    (Synbiotics)VacSYN/FeLV, (Ft. Dodge laboratories) Fel-O-VAX Lv-K and
    (SmithKline Beecham/Norden) LEUKOCELL 2.  Although the sample sizes of
    cats in the study were relatively small, the outcome of the study was,
    in my mind, very significant.
    
    There were eleven control kittens used in this study (unvaccinated) and
    twelve kittens for each of the three vaccines under study.  All 47 cats
    were under constant exposure to positive FeLV carrier cats for a period
    of 23 weeks.  The results of the study are as follows:
    
    SEVEN of the eleven CONTROL kittens were positive by the ELISA and IFA
    test of blood.
    
    SIX of the twelve kittens vaccinated with Vac-SYN/FeLV were positive.
    
    FIVE of the twelve LEUKOCELL 2 kittens were positive.
    
    NONE of the twelve Fel-O-VAX Lv-K kittens were positive (by blood
    test).
    
    Of interest is that the virus could be isolated by bone marrow testing
    in all groups, but by the 31st week most of them had cleared by IFA
    bone marrow testing and all of these are expected to clear by the
    testing end.
    
    Also, testing of the blood for results of antibody tests post
    inoculation, which has been the standard method of detecting what was
    thought to be protective, apparently has no correlation to actual
    protection after exposure to FeLV infected cats.  This asserts the
    suggestion of "cell mediated" immunity actually being the significant
    role player for protection instead of normal antibody.  The study done
    was one of exposure, as opposed to inoculation of the virus, which much
    better relates to the normal method of exposure.  Clinical trials where
    subjects are inoculated with a virus may not be worthwhile due to the
    amount of inoculum and the infrequent "exposure" which does not occur
    in typical multi-cat households.
    
    The other significant bit of information offered by Dennis Macy, DVM
    (Colorado State University School of Veterinary Medicine) basically
    reported on testing methodology and its significance.  The "Gold
    Standard" of testing is IFA testing, but requires special equipment in
    universities and laboratories.  Other types of tests available are
    ELISA, Elisa Microwell, and Saliva/Tear testing.  The non-Microwell
    ELISA test methodology proved the best of the three types with
    significant decreased sensitivity using the Saliva/Tear test.  Positive
    test results should still be retested by IFA test in 4 to 6 weeks as a
    confirmatory test.  The highly effective in-clinic ELISA testing, and
    availability and rapid turn around of results, warrants its usefulness
    as the typical test to be used.  Negative results correlation to IFA
    negative testing are 100% in one study.  Aproximately 85% of positive
    ELISA FeLV concurs with IFA tests which are positive; but, with an
    error margin of 15%, it is worthwhile repeating positive test results
    with an IFA test.  Although IFA testing may be done immediately, the
    ELISA ttest is more sensitive at an earlier date.  Therefore, it is
    recommended that a 4 to 6 week time period elapse prior to IFA testing
    since ELISA may detect FeLV up to five weeks sooner than with the IFA
    procedure.
                                                                       
    The Fort Dodge Fel-O-VAX Lv-K vaccine, when first used, had significant
    allergic reactions (vomiting, diarrhea, respiratory distress) which
    were even worse when given concurrently with other vaccines, apparently
    due to the adjuvant used.  This reaction has been corrected due to
    moderation of the adjuvant.  I still feel that, although few reactions
    still occur, predosing with 25mg. Benadryl orally by tablet may be
    beneficial in avoiding allergic reactions (when using the Fort Dodge
    Fel-O-VAX/Lv-K).
    
    

From MUTTON::FELINE_V1.
    
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Note 4524.9                      Feline AIDS????                         9 of 14
WR2FOR::CORDESBRO_JO "set home/cat_max=infinity"     21 lines   5-APR-1991 12:04
                           -< more FIV information >-
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    Feline Aids is an immunodeficiency virus.  It attacks that immune
    system and leaves the cat open for all kinds of illnesses.  Basically,
    almost any kind of chronic health problem can be a symptom of FIV. 
    That can range from eye infections, upper respiratory infections,
    chronic skin conditions, weight loss, lethary, bladder and bowel
    problems, and any kind of problems with any of the major organs.  
    
    It is a good idea to have any and all new cats tested for FIV now.  In
    a lot of vet offices, the test can be performed at the same time that
    the Felv test is done.  That means only having to draw one sample of
    blood for both tests.
    
    Currently, the cats that have the greatest risk for FIV infection are 
    outdoor, or feral, whole male cats.  These cats are most likely to get
    into territorial battles.  Any cat that goes outdoors though is at
    risk.  
    
    Glad that James T. is coming home.  BTW, would love to know how you
    settled on that name. :^)
    
    Jo

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Note 302.109                     IN THE NEWS...                       109 of 109
MSE1::SUTTON "He roams the seas in freedom..."      137 lines  15-MAR-1994 08:17
                    -< NEJM Article on Cat Scratch Disease >-
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    re: 302.58
    
    Having recently been given a tentative diagnosis for this malady, I
    did some digging and came up with the article referred to in the above
    note. It is reprinted here in its' entirety without permission:
    
    
    
                             Cat Scratch Disease

                   From Feline Affection to Human Infection


       Although cat scratch disease was first recognized more than 60 years
    ago, only in the past few years has real progress been made in
    identifying the microbes that cause this disorder. The diagnosis of cat
    scratch disease has relied on several criteria: a compatible clinical
    picture, usually with unilateral regional lymphadenitis; a history of
    contact with a cat, often followed by the formation of a papule at the
    site of primary inoculation; the exclusion of other identifiable
    causes, especially mycobacterial; the presence in a lymph-node biopsy
    specimen of multiple microabscesses or granulomas;  and a positive
    response to a noncommercial skin test prepared from lymph-node
    aspirates from patients known to have the disease. The disease is
    characterized by malaise, low-grade fever, and lymphadenopathy. In most
    cases, the disease resolves spontaneously within a couple of months.
    Occasionally, there are severe complications, such as encephalitis,
    follicular conjunctivitis, and neuroretinitis.
       A decade ago, pleomorphic organisms were visualized in lymph-node
    biopsy specimens prepared with the Warthin-Starry silver stain. In
    1988, English and associates cultivated a bacillus in cell-free mediums
    from the lymph nodes of 10 of 19 patients with cat scratch disease. This
    motile, gram-negative rod was subsequently named 'Afipia felis' in
    honor of the Armed Forces Institute of Pathology (AFIP), where much of
    the initial work was performed. In 1991, six afipia species were
    cultured in selective mediums from a broad range of clinical specimens,
    including lymph-node tissure, lymph-node aspirate, bone, sputum,
    pleural fluid, and bone marrow. The next year, afipia species were
    isolated from 10 clinical specimens with the use of a tissue-culture
    technique.
       The picture looked relatively clear until conflicting information
    began to emerge that suggested that 'Rochalimaea henselae' was a more
    common cause of cat scratch disease. Like 'A.felis', 'R.henselae' is a
    member of the alpha-2 subgroup of the class Proteobacteria, and it has
    a similar appearance when treated with the Warthin-Starry stain.
    'R.henselae' belongs to the order Rickettsiales, however, and is not
    closely related to 'A.felis'. Rochalimaea species, including
    'R.quintana' as well as 'R.henselae', have been implicated as the cause
    of bacillary angiomatosis, a disorder characterized by the
    proliferation of small blood vessels in the skin and visceral organs,
    which occurs primarily in adults with the acquired immunodeficiency
    syndrome. But recently 'R.henselae' has been identified in specimens
    from patients with cat scratch disease as well.
       Dolan et al. cultured 'R.henselae' from lymph-node tissue obtained
    from two immunocompetent adults with cat scratch disease and typical
    regional adenitis. Both patients had had contact with cats, and one had
    an elevated titer for antibody to 'R.henselae'. Using an indirect
    fluorescent-antibody assay for 'R.henselae', Regnery and coworkers
    found markedly elevated titers in serum from 36 of 41 patients (88
    percent) with suspected cat scratch disease, as compared with 3 of 107
    healthy controls (3 percent). Finally, five preparations of cat scratch
    disease skin-test antigen tested by methods based on the polymerase
    chain reaction were positive for rochalimaea species but negative for
    afipia species.
       The report by Zangwill and associates in this issue of the 'Journal'
    contributes to our understanding of the epidemiology of cat scratch
    disease and its microbial causes. This retrospective survey of
    physicians in Connecticut identified 60 patients in whom cat scratch
    disease had been diagnosed during a 13-month period. The disease was
    defined very broadly, as unexplained lymphadenopathy in a person who
    owned a cat or kitten. The interactions between 56 of these patients
    and their cats were then compared with those between age-matched
    controls and their cats. The patients with cat scratch disease were
    more likely to have been scratched, bitten, or licked on the face by a
    kitten and to have had at least one kitten with fleas.
       Serum samples from 45 patients were evaluated with a 'R.henselae'-
    based indirect fluorescent-antibody test. Identical testing was
    performed on 112 comparison samples previously obtained for testing for
    measles or varicella antibody in an unrelated group of controls of
    roughly similar age. Of 45 patients tested, 38 (84 percent) had
    elevated titers (GTE 1:64) in one serum sample, as compared with only 4
    of the 112 comparison samples (4 percent). Paired acute-phase and
    convalescent-phase serum samples from four patients were tested: one
    patient had a fourfold rise in titer, but the other three patients had
    high titers in both samples. Samples from 39 of 48 cats (81 percent) in
    patients' households were positive for antibodies to 'R.henselae'
    according to testing with fluorescein-labeled anti-cat IgG, as compared
    with 11 of 29 samples (38 percent) from control cats.
       The clinical features of cat scratch disease as defined by Zangwill
    et al. differ greatly from those reported previously. Symptoms and
    signs other than lymphadenopathy, for example, occurred in 82 percent
    of their 60 patients, as compared with just over half of 1502 patients
    in an earlier study. In contrast, only 25 percent of the patients in
    the current study reported a primary skin lesion at the scratch site,
    as compared with over 60 percent of the patients in the larger series.
    These clinical discrepancies can probably be attributed to the looser
    case definition used by Zangwill et al. The absence of strict
    diagnostic criteria for cat scratch disease is especially problematic
    when patients have atypical presentations, such as encephalopathy.
    Until recently, a clinical suspicion of cat scratch disease in such
    patients could be confirmed only with the help of skin-test and biopsy
    results. Serologic and microbiologic testing for the disorder should
    soon become more readily available and thus permit a more precise
    clinical definition of the spectrum of the illness. Given the broad
    definition of disease in the current study, the serologic findings are
    all the more remarkable. The clinical manifestations of infection may
    be much more diverse than is now recognized.
       A high proportion (17 percent) of the patients in the study by
    Zangwill et al. were hospitalized, and nearly half (43 percent) were
    adults - features that also differ from those of previous reports but
    that most likely reflect differences in the methods of case
    ascertainment. Five of the seven patients with negative titers for
    'R.henselae', however, were adults. Family physicians and internists
    should be alert, nevertheless, to consider the possibility of cat
    scratch disease in cat-owning adults with chronic lymphadenopathy.
    There are now more than 60 million cats in this country, and this
    population is growing. The incidence of cat scratch disease and its
    associated morbidity can be expected to increase. Will cat lovers
    modify their behavior to minimize this risk? Can we devise a feasible
    version of universal precautions for playing with one's cat? Other
    strategies will doubtless be needed.
       Additional microbiologic and serologic studies should help to
    clarify the roles of 'R.henselae', 'A.felis', and perhaps other
    microbes in causing cat scratch disease. The mechanism of transmission
    is another important area for further research, with the intriguing
    suggestion from this study and one earlier study that fleas or ticks on
    cats may be involved. Wider availability of appropriate serologic tests
    should reduce the need for skin testing and for lymph-node biopsy.
    Further identification of the causative agent or agents can improve the
    selection of antimicrobial agents, but placebo-controlled trials are
    much needed. The new information about the causation of cat scratch
    disease may also make feasible the development of a vaccine (or
    vaccines) for cats or humans.

    Children's Medical Center of the Univer-	  Andrew M. Margileth, M.D.
     sity of Virginia, Charlottesville, VA 22903    Gregory F. Hayden, M.D.
    

    Crossposted by Moderator
    
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Note 754.34                Lady Di/fatal disease - FIP                  34 of 34
DELNI::FALLON                                       110 lines  17-NOV-1994 10:32
                     -< Please overlook the typos! thanks >-
--------------------------------------------------------------------------------
    I am gonna give it a go, although it may have to come in parts! 
    Re-written from November 1994 CFA Almanac.
    
    The Robert H. Winn Foundation & The University of California, Daves
    Center for Companion Animal Health
    International FIP/FECV Workshop
    _________________________________________________________________
    
    The Program, Participants, Future Direction by Joan Miller
    
    	The Robert H. Winn Foundation and the Center for Companion Animal
    Health (CCAH) co-sponsored and presented the 1st International Feline
    Infectious Peritonitus (FIP) and Enteric Coranavirus  (FECV) Workshop
    at the University of California, Davis, School of Veterinary Medicine
    on August 12-14, 1994.
    
    	Truly an international event, the workshop brought together
    veterinary scientists from all over the world.  Several of the
    presenters included new and important information on projects still
    underway and not yet published.  Many of the leading veterinary and
    industry scientists had never before met face to face to interact on
    the sugject of FIP.  The atmosphere was exciting.  A balance of
    learning, exchange of theories and creative brainstorming brought forth
    new information and helped to develop some direction for future
    scientific studies on FIP control in catteries and other multicat
    environments.
    	In addition to the 27 research participants from The Netherlands,
    jScotland, Switzerland, England, France, Germany, Australia and the
    United States there were four invited veterinarian practitioners who
    offered practical questions and information durng the sessions.  Four
    invited breeders with experience and knowledge of FIP also provided the
    cat fancy perspective and asked challenging questions of the
    scientists.  Several observers were present to assist in the
    dissemination of all the information which wsa generated by this
    workshop.  The complete proceddgings will be published in FELINE
    PRACTICE magazine with reprints available to veterinarians and cat
    fanciers.
    	Everyone was impressed with the overall organization, pecise
    programming, videotaping and excellant quality of all the
    presentations.  Complex scientific theories and research information
    were absorbed and informally analysed during the pleasant social
    gatherings on the campus.  Co-chairs, Dr. Niels Pedersen, Director of
    CCAH, and Janet Wolf, representing the Winn Foundation, coordinated all
    aspects of this precedent setting event.  Without their efforts adn
    those of the Winn Foundation Board members, The Cat Fancier's
    Association (CFA) staff and Sharon Anglin, CCAH manager, the high
    standard set by this workshop would not have been possible.  Generous
    support from many cat clubs, companies and individual donors made the
    worshop a reality. Major contributors  were the Winn Foundaton, CCAH,
    CFA, Marsha Ammons, Garden State CAt Club, Greater Lancaster Feline
    FAnciers, Hunt Country Cat Club, Ralsont Purina, SmithKline Beecham,
    Solvay and Virbac France.  The majority of the funds were donated by
    individual cat fanciers and clubs including contributins from the sale
    of special FIP buttons throughtout the United States.
    	One of the primary goals of the weekend was to give those in the
    veterinary biologics industry and research community a knowledge of the
    impact that FIP has on breeders of pedigreed cats.  A breeder survey
    was developed by the Winn Foundation and randomly distributed to
    breeders who register cats with CFA.  The epidemiology of FIP based on
    the breeder survey was presented along with the management problems of
    the disease from a breeder viewpoint.  The scientific program began
    with the background of feline coronavirus infections and the risk of
    FIP in cats naturally exposed to to feline coronavirus.  Topics
    included a review of relationship theories of FIP and other coronavirus
    infections, the genetic structure, diagnostics and current use of
    serology, prevention by vaccinations, control of feline coronavius
    infections by various methods and the state of knowledge of treatment. 
    Breakaway workgroups concentrated on recommendations for managmente in
    catteries and vaccination as a means of control in catteries.  These
    recommendations, when fully outlined and published with the procedings,
    will begin the process of education breeders and their veterinarians on
    ways to deal with FIP.  They will help focus future scientific work so
    that protection of cats in the multicat environment is emphasized in
    research projects.
    	The worshop made it apparent that several new directions are needed
    inresearch, diagnostics and vaccination.  Further analysis of the
    information from the breeder epidemiology survey and follow up
    questions would be valuable.  Determining the co-factors involved in
    susceptibility to and transmission of feline Corona viruses and 
    devolping testing methods which will be both sensitive and specific are
    needed.  The point was strongly made that the current tests for
    coronavius indicate exposure to a coronavius and NOT FIP virus infection. 
    And ther is no evidence that a cat with a high coronavius titer is an
    FIP carrier.  Participants agreed they would like to be able to predict
    carrier status in a cat and to know why some cats are totally immune to
    FIP challenges.  The need to refine and establish other reliable means
    of diagnosis, in addition to serology tests, was recognized.  More work
    must be done to dtermine the strains and esposure dose of virus in
    field conditions.  Several recommendations were directed  toward
    optimum use of the currently marketed vaccine and the future direction
    of vaccination trials and development.  Kittens are at hightest risk
    between six and eight weeks of age; therefore, protecting these kittens
    until they are more immunocompetent (16 weeks and older) seems to be
    the most critical cattery management and prevention challenge.  Ways in
    which to specifically modify cattery environments need to be explored. 
    Cattery decisions on control versus eradication of the feline
    coronavirus may be different for individual breeders and situations. 
    One of the most important ways in which breeders can contribute to the
    control of FIP is to de-stigmatize the disease and to communicate
    openness.  The workshop was a start in this approach and it gave real
    hope to everyone present that, with the help of the research groups,
    the biologics companies and veterinarians, the devastating impact of
    FIP can eventually be alleviated.  The Winn Foundation id dedicated to
    furthering this objective.
    
    Phew!!!  I will add the rest of the article another day!  To come:
    Overview and prelimanary recommendations, Possible strategies for
    control of coronavirus transmission/ prelimary recommendations.
    
    Karen 

    Crossposted by Moderator
    
               <<< MISERY::APPLE$:[NOTES$LIBRARY]FELINE.NOTE;1 >>>
           -< Meower Power - Where Differing Opinions are Respected >-
================================================================================
Note 754.35                Lady Di/fatal disease - FIP                  35 of 35
DELNI::FALLON                                        51 lines  21-NOV-1994 14:02
                        -< FIP TESTS   (more to come) >-
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    Overview and Preliminary Recommendations
    
    (Recommendations will be refined and clarified when included with the
    final published workshop prodeedings.)
    
    by: Hilary Helmrich
    
    	FIP is a disease which is caused by feline infectious peritonitus
    virus (FIPV).  Other members of this same group of viruses are termed
    feline enteric corona viruses (FECV).  These viruses appear to be
    relatively harmless and mainly affect the gastro-intestinal tract. 
    However, FIPV can cause serious, even deadly, disease in cats.  There
    are several theories on the relationship between FIPV and FECV, but the
    most likely explanation is that FIPV is a simple variant of FECV.
    	There are two forms of FIP disease that result from this viral
    infection, the "wet form" and the "dry form".  The wet form is the most
    common form of FIP and is characterized by fluid in the peritoneum or
    chest.  The dry (solid) form can affect the eyes, the brain, and other
    organs and has little or no fluid build-up.
    	FIP is found mainly where large groups of cats are housed together;
    shelters, catteries rescue facilities and large multicat households. 
    In households with only one cat FIP occurs at a rate of about 1:5000. 
    In multiple cat situations the disease occurs in up to 4-5% of the cats
    (and rarely as an epidemic).
    	For many years breeders have had FIP strike their households
    without warning and, although scientists have worked very hard to find
    answers to questions about transmission, protection and treatment of
    the virus, the answers to many questions have eluded them.  One of
    themain objectives of the International FIP?FECV Workshop was t assess
    current knowledge and find new direction and recommendations for
    control of FIP.
    	
    		FIP Tests
    	There has been much discussion over the last few years about the
    meaning of FIP tests and FIP titers.  The scientists agreed that
    although the current serology test are an indicator of exposure to
    coronavirus infections in general, they are not a good indicator of the
    presence of FIP disease.  Some scientists are currently working with
    new technology which may result in the more sensitive testing method
    known as polymerase chain reaction (PCR).  These tests are experimental
    and expensive and it is no yet clear that they are better indicators
    than the current tests.
    	One of the most important discussions about FIP testing was made by
    one of the presenters who had studied catteries in England.  She stated
    that more cats were "euthenized" on the basis of blood test results
    than were euthenized because they were sick.  In other words, on the
    basis of test results alone, cats were being euthanized when it was not
    really known whether the cat had the disease.  The researcher reminded
    the veterinarians that this is a serious mistake.  Coronavirus titers
    are an indicator of EXPOSURE to either harmless or harmful types of
    coronaviuses and are not a definitive diagnosis of disease.

    		Cattery Management
    	FIP occurs more frequently in environments in which multiple cats
    are kept indoors and is usually seen in younger kittens and cats in the
    age range of 12 weeks to 3 years.  Outward clinical signs of FIP
    disease include failure to thrive and stunted growth (in kittens),
    persistant spiking fevers and eventually weight loss and more specific
    signs such as fluid in the abdoment, cloudy eyes, neurologic signs etc.
    	Common laboratory abnormalities include raised levels of protein
    (especially the globulins), increased plasma fibrinogen, increased
    white blood cells and neutrophils and decreased lymphocytes.  The
    coronavirus titer is usually greater than 1:100 but in rare
    circumstances may be very low or even negative.
    	The more of these individual abnormalities that are present the
    more likely it will be that the cat has FIP.  No single abnormality,
    including antibody levels, is diagnostic by itself.
    
    		Cattery Management
    	Recommendations for cattery managment to minimize FIP and enteric
    coronavirus infections were developed at the end of the workshop.  The
    FIP virus and the FECV are passed from cat to cat by the fecal-oral
    route.  Litter boxes that are shared are the major source of infection. 
    Because nearby food and water dishes can become contaminated by feces
    they may provide other means for transmission.  Contaminated litter can
    also be carried on the fur and serve as a source of the virus for other
    cats.  One researcher reported that his group had found that these
    viruses had lived for several weeks at room temperatures in dried
    feces.
    	
    		Preliminary recommendations for controlling the spread
    ofthese viruses in a cattery include:
    	1.  Scoop daily and change litter in litter boxes frequently. 
    Clean and disinfect litter boxes when changing litter.  Most common
    household disinfectants used in catteries, as well as bleach or
    cyclohexadine (Nolvasan) will kill these viruses effectively.
    	2.  If using the "scoopable" litter, remove solid materials daily
    and fully change the box weekly.  Disinfect at the time of changing.
    	3.  Keep the tracking of material from the litter box toa minimum
    and sweep or clean-up spilled litter.  This will minimize the spread of
    fecal material from the litter box area.  The area around the litter
    box must be easily cleaned and disinfected (a hard washable surface).
    	4.  Try to keep cats in small stable groups (4 cats); that is,
    minimize the swithcing of cats from group to group so that an infection
    in one cat does not have the opportunity to be transferred to many
    cats.
    	5.  Keep cats themselves clean.  Clip hair around anal opening in
    lonhairs so that feces do not get stuck in the coat and get tracked to
    other areas of the cattery.
    	6.  When introducing a new cat or kitten into the household isolate
    the new arrival for 4 to 6 weeks.
    
    		Prelimanry recommendations for isolation and early weaning
    include:
    (Note - refer to the followng section, by Dr. Niels Pedersen, for more
    details on weaning strategies.)
    
    	1.  Isolate the mother in a room by herself before the litter is
    born (preferably 1-2 weeks prior to birth).  Disinfect litter box, food
    and water bowls prior to the mother being introduced.  (Soaking ina a
    1:32 dilution of household bleach for 15 minutes is an effective
    disinfectant.  Be sure to rinse everything thoroughly before use.)
    	2.  Keep the litter box, food and water bowls dedicted to that
    room.
    	3.  Have an easily cleanable nesting box available for the mother. 
    Remember that the nesting box will need to be cleanedn and disinfected
    as well.
    	4.  Create a stress-free environment for the mother and kittens. 
    This will ensure that stress will not allow the mother's immune system
    to be suppressed.
    	5.  When visiting or taking care of the mother and kittens try t
    minimixe the contact that the mother would have with the remainder of
    the cats in the house.
    	6. Wash your hands prior to entering and when leaving the mother's
    room.
    	7.  Do not bring the remains of food, dirty litter, or litter dust
    into the room on your clothing or shoes.  An apron and sandals worn
    only in that room may prevent the spread of germs to the susceptible
    kittens.
    	8.  Decide on a strategy of early weaning or isolation with late
    weaning, as discussed in the following section.  If the mother is to
    stay with the kittens and be allowed to freely nurse, keep the mother
    and kittens isolated for 16 weeks following their birth.  If the mother
    is to be removed from the kittens (when they are 4-6 weeks old) do not
    reintroduce her into the room until the kittens are gone.
    	9.  Keep the kittens separated from all other cats until they reach
    16 weeks of age.  This will minimize the risk of virus transmission
    during the period of life when they are most susceptible to disease.
    
    		Vaccination
    	Recently a vaccine has been marketed for FIP and at least one more
    is under development.  The veterinarian practitioners and breeders were
    very interested and had many questions concerning vaccine use.
    
    	Preliminary recommendations for the use of the vaccine include:
    	1.  Vaccination of normal household pet cats is probably not
    necessary.  The incidience of FIP is very low in such cats and
    vaccination is not cost effective.
    	2.  Vaccination is probably not necessary in cattery situations
    wher no cases of FIP have been documented.  Continue to use good
    cattery management and isolation to minimize transmission of possible
    coronavirus infection.
    	3.  In catteries wehre FIP cases have been documented.
    		a) There is no evidence that the vaccine alone will greatly
    reduce the pattern of infection or disease when used as currently
    recommended, i.e. two doses started at 16 weeks of age.  Most cattery
    kittens are already exposed to coronaviruses before they reacj an age
    at which they can properly respond to the vaccine.
    		b) The vaccine has been shown to protect against FIP if the
    kitten is at least 16 weeks of age at the time of vaccination and has
    had no previous coronavirus exposure.  Earlier vaccination is not as
    effective and the inhibiting effects of maternal or acquired antibodies
    on vaccination have not yet been determined.
    		c) If isolation of kittens has been maintained until they
    are 16 weeks old, and the kittens have no evidence of virus infection,
    the vaccine is safe to use and has shown evidence that it reduces the
    subsequent incidence of FIPV infection and the severity of the disease.
    

    POSSIBLE STRATEGIES FOR CONTROL OF CORONAVIRUS TRANSIMSSION PRELIMINARY
    RECOMMENDATIONS  by Niels C. Pedersen, DVM, PhD
    
    	One of the most effective means to break the cycle of feline
    coronavirus transimission within a cattery is to isolate a single queen
    with her litter from all other cats in the cattery for the first 16
    weeks. 1  The isolation area for a queen and her kittens must be
    separated sufficiently lfrom the main cattery, and managed in such a
    way, as to eliminate any chances for cat-to-cat contact and fecal
    contamination.
    	There are two possible strategies for this control program: 1)
    isolation and early weaning, and 2) isolation with late or natural
    weaning.  Early weaning requieres that the queen be removed from the
    isolation room when the kittens are 4-6 weeks of age.  Late weaning
    allows the queen to stay with the kittens until they are 16 weeks of
    age; weaning is allowed to occur naturally.  The choice of approach
    depends on whether or not the queen is likely to be shedding virus
    during the nursing period.  Evidence suggests that most queens within a
    cattery are not shedding coronaviruses at any given point in time,
    especially if they have an immunofluorescence-based (or equivalent)
    coronavirus antibody titer of 1:100 or less.  Of course, the antibody
    titer must be determined in a reliable manner by a reputable diagnostic
    laboratory.
    
    	EARLY WEANING should be considered in instances where you are
    suspicious that the queens might be shedding coronavirus.  The
    rationale for early weaning in such a circumstance is the following: 
    Kittens born to a virus shedding queen would be protected from
    infection by maternal immunity for at least the first 4-6 weeks of
    life.  If the queen can be removed from the kittens before they become
    susceptible to the virus, then infection can be prevented.
    
    ISOLATION WITH LATE WEANING may be preferable to early weaning in
    situations where the queens are thought not to be shedding coronavirus
    because ther is less physical and emotional stress on the kittens and
    the queen.  Whether early or late weaning procedures are used, all of
    the kittens should be tested for coronavirus antibodies at 16 weeks of
    age.  If they are negative, no exposure to coronavirus occurred during
    the period from birth to testing.  If the entire litter tests positive,
    then the litter was obviously exposed to coronavirus during the
    isolation period.  This exposure may be from an infected mother or an
    indadequate isolation procedure (which allowed virus contaminated
    material to enter the area from outside).  Serotesting of 16 week old
    kittens reaised in isolation would be the best measure of the success
    of the program.
    	Which is the most effective, early or late weaning isolation
    strategies?  Early weaning may be somewhat mre effective than late
    weaning, because it also takes into account the small proportion of
    queens that might be shedding the virus during lactation.  However, the
    disadvantages of early weaning such as difficulty in weaning success
    and behavioral problems with kittens may outweigh this advantage for
    some catteries.  More importantly, it must be remembered that it is not
    the early or late weaning that is most important, but isolation from
    other cats.  If a queen and its litter cannot be completely isolated
    from other cats and from fecal derived exposure, neither early nor late
    weaning attempts will be successful.
    	There is some evidence that vaccination may be effective in
    decreasing the incidence of FIP if administered to seronegative cats
    that are at least 16 weeks of age. 1 Therefore, vaccination may be used
    as an adjunct to the above isolation and early or late weaning
    procedures in reducing the incidence of FIP in cats exposed to
    coronavirus after 4 months of age.  Vaccination will not decrease the
    expected incidence of FIP in cats that have already been exposed to
    feline coronaviruses before they reach the recommended vaccination
    age.*
    
    1) Sixteen weeks of age was not arbitrarily selected, but rather is
    when the immune system of the kitten is reaching adult levels of
    competence.  As a result, kittens vaccinated for FIP before 16 weeks of
    age do not respond nearly as well as older kittens.  This may also
    explain why very young kittens are much more likely to develop FIP when
    exposed to feline coronaviruses and is another reson whey feline
    coronavirus exposure should be delayed as long as possible.  If
    exposure can be delayed until the kittens are 16 weeks of age or older,
    they will be much less likely to develop FIP as a consequence.
    
    
    That's it folks!!!  I hope you can find this to be of some value.
    Karen

    
    Thanks Karen,
    
    That was a lot of good information, and a lot of typing!
    
    Feline Thankful for good friends and healthy Kitties, Happy
    Thanksgiving Everyone!
    
    Sue & Furry Crew!

    
    
    I have a approximetly seventeen (17) year old domestic short hair cat,
    that just tested positive on the 4th. of March for Feline Leukemia. The
    other two (2) cats in the house have tested negative and have been FeLV
    injection.
    
    My knowledge is that my veterinarian has made me aware of a new drug
    that was published in Veterinary Forum in November 1993. The drugs name
    is "Immuno Regulin" (Immunomodulator), which in the round table discussion
     from the article shows some real promise. She has tried it with only
    a few felines, and it did add to their quality of life and longevity.
    The cost are between $12-$15 per injection and the whole treatment
    costing approximately $140.00 depending on the Vet., and if the
    infected animal needs more treatment.
    
    Does anyone have any experience with this treatment method, or know of
    anyone that has?
    
    
                                      Regards,
                                      Frank
     

    Frank.
    
    I have no knowledge of this new drug, but since I do have one
    positive Feline Leukemia kitty at home, I'd be real interested
    in any knowledge you do gain.
    
    As far as quality of life and longevity for Feline Positive kitties...
    some can live a very healthy long life without any drugs.   I base
    my opinions on the Pat Brody Shelter for Cats Feline Leukemia house,
    Tigger is about 6 years old and has lived three years with the
    disease and has never been sick at all.   We also have Hobo who
    is now 18 years old and has lived with the disease for well over
    10 years.  Of course we have had some Feline Positive kitties which
    have passed away at young ages from the disease.
    
    So far...we have known that my Ziggy tested positive almost one year
    ago and his last blood test showed the white blood count has not
    got worse.
    
    Good luck with your kitty..and please share any knowledge about this
    new drug.
    
    Sandy

    I have heard of immunoregulin and have seen it for sale in some
    of the catalogs I get.  It is supposed to boost the immune system.
    I know of one person who has used it, but not for help with
    felv.  It was originally designed for larger animals.  I think
    the description said it was for horses and dogs.
    Karen