Page 1478 - Small Animal Internal Medicine, 6th Edition

1450 PART XIV Infectious Diseases

with the name of the infectious disease suspected. The outer Examination tables, countertops, floors, canister lids, and
surface of the bag should be disinfected before leaving the water taps should be saturated with disinfectant for 10
VetBooks.ir isolation area. minutes. Surfaces should be blotted with paper towels
until dry, and the soiled towels should be placed in a trash
Disposable materials should be placed in plastic bags in
the isolation area. The external surfaces of the bags should
with paper towels, blotted, and placed in trash recepta-
be sprayed with a disinfectant before being removed from receptacle. Urine or feces on the floor should be contained
the isolation area. After attending to the patient, contami- cles. The soiled area of the floor should be mopped with
nated equipment and surfaces should be cleaned and disin- disinfectant.
fected, and contaminated outer garments and shoe covers Disinfectants are relatively effective for viral and bacterial
should be removed. Hands should be washed after discard- agents but require high concentrations and long contact
ing the contaminated outerwear. Dishes and litter pans times to kill parasite eggs, cysts, and oocysts. Cleanliness is
should be cleansed thoroughly with detergent before return- the key to lessening hospital-borne infection with these
ing them to the central supply area of the hospital. Optimally, agents; detergent or steam cleaning inactivates most of these
materials such as outerwear and equipment to be returned agents. Litter pans and dishes should be thoroughly cleaned
to the central supply area should be placed in plastic bags with detergent and scalding water.
and sprayed with a disinfectant before transport. Procedures
requiring general hospital facilities such as surgery and radi-
ology should be postponed to the end of the day, if possible, BIOSECURITY PROCEDURES
and the contaminated areas disinfected before use with other FOR CLIENTS
animals. Animals should be discharged by the shortest path
to the parking lot possible. Housing animals indoors in a human environment to
Some animals with infectious diseases can be maintained prevent exposure to other animals, fomites, or vectors is the
in the general hospital boarding or treatment areas with optimal way to prevent infectious diseases. However, some
special management techniques. For example, cats positive infectious agents can be carried into the home environment
for the feline leukemia virus (FeLV) or feline immunodefi- with the owners, by other pets that are allowed outdoors,
ciency virus (FIV) should not be placed in the isolation area, by vectors, or by paratenic or transfer hosts. Although most
if possible, to avoid exposing them to other infectious agents. infections occur in both immunocompromised and immu-
Because neither of these two viruses is transmitted by aero- nocompetent animals, clinical disease is often more severe
solization, cats with these infectious diseases can be housed in immunocompromised animals. Puppies, kittens, old or
in close proximity to other cats. The cages should be labeled debilitated animals, animals with immunosuppressive dis-
appropriately, and the infected cats should not be caged next eases (e.g., hyperadrenocorticism, diabetes mellitus, cancer),
to or above seronegative cats. In addition, no direct contact animals with concurrent infections, and animals treated
or sharing of litter boxes or food bowls should occur between with glucocorticoids or cytotoxic agents are examples of
infected and naïve cats. immunocompromised patients. Avoiding exposure to infec-
tious agents in this group is particularly important because
BASIC DISINFECTION PROTOCOLS of the potential for increased susceptibility to disease. These
To lessen the spread of potential infectious agents, hospital- animals may also be less likely to have appropriate responses
ized animals should never be moved from cage to cage. The to immunization. Kennels, veterinary hospitals, dog parks,
key to effective disinfection is cleanliness. Cage papers and dog and cat shows, and shelters have an increased likelihood
litter boxes soiled by feces, urine, blood, exudates, or respira- for infectious agent contact because of the concentration of
tory secretions should be removed and placed in trash recep- potentially infected animals and should be avoided when
tacles. Bulk fecal material should also be placed in trash possible. Areas such as parks are common sources of infec-
receptacles. tious agents that survive for long periods in the environ-
Many infectious agents are resistant to disinfectants or ment; parvoviruses and enteric parasites like Giardia spp. are
require prolonged contact time to be inactivated (Greene, classic examples (Hascall et al., 2016). Owners should avoid
2012). Contaminated surfaces, including the cage or run bringing new animals with unknown histories into a home
floors, walls, ceiling, door, and door latch, should be wetted environment with other pets until the new animal is evalu-
thoroughly with a disinfectant that is then blotted with clean ated by a veterinarian for infectious disease risk. If people are
paper towels or mops. Surfaces should be in contact with in contact with animals outside the home environment, they
the disinfectant for 10 to 15 minutes if possible, particularly should wash their hands before contact with their own pet.
if known infectious agents are present. Soiled paper towels The owner should consult the veterinarian concerning vac-
should be placed in trash receptacles. If infectious disease cination protocols and other preventive medical procedures
is suspected, the trash bags should be sealed, the surface most indicated for each individual patient. Of most impor-
of the bag sprayed with a disinfectant, and the trash bags tance are flea control (Bartonella spp., Rickettsia felis); tick
discarded. control (Borrelia burgdorferi, rickettsial agents); Dirofilaria
Contaminated surfaces in examination rooms should imitis prevention; and strategic deworming for roundworms
be cleaned to remove hair, blood, feces, and exudates. and hookworms.