Page 932 - Clinical Small Animal Internal Medicine

870 Section 9 Infectious Disease

little or no evidence of vaccination for FPV after 12 Prognosis
VetBooks.ir weeks of age. About two‐thirds of FPV‐infected cats will Without treatment, a cat with severe enteric disease and
present with vomiting or diarrhea (occasionally bloody),
but these signs may be absent or only transiently observed
and reported as part of the animal’s history. Anorexia, leukopenia due to FPV infection has a poor prognosis. It
is not clear just how effective good nursing care is at
lethargy, and dehydration are also common clinical signs; improving the prognosis for recovery. One study noted a
fever is a less consistent finding. Sudden death with no 51% recovery rate of ill cats with a median hospitaliza-
apparent clinical signs may result from peracute FPV tion time of seven days, with a poor prognosis associated
infection, especially in young kittens. with leukopenia (specifically due to neutropenia),
Leukopenia, due to neutropenia and/or lymphopenia, thrombocytopenia, hypoalbuminemia, and hypoka-
is present in most affected cats, but some cats are able to lemia. Age was not associated with outcome in this
maintain normal leukocyte counts or may even have leu- group of treated cats. However, a recent retrospective
kocytosis in response to secondary bacterial infections. evaluation of outcome predictors and survival time for
Anemia, hypoalbuminemia, and electrolyte imbalances FPV‐infected shelter cats determined that only about
often occur in these cats. Sepsis can lead to the develop- 20% of hospitalized cats survived to discharge, with a
ment of disseminated intravascular coagulation. median survival time of three days. In this population of
cats, animals with signs of lethargy, low body weight,
o
rectal temperature lower than 100.2 F, and leukopenia
Diagnosis during hospitalization had the poorest prognosis.
Predictors of survival included history of antiparasitic
Diagnosis of FPV infection is based on history (potential therapy, and treatment with amoxicillin‐clavulanic acid
exposure, poor vaccination history) and clinical signs, and maropitant.
including characteristic hematology changes. Confirmation
of the diagnosis can be made through detection of fecal
parvovirus antigens using point‐of‐care assays that are Prevention
marketed for detection of CPV‐2. Fecal samples or rectal
swab specimens may also be submitted for PCR analysis of As with any virus infection, prevention of exposure to
viral DNA. FPV would be the ideal method for preventing infection;
however, the sturdy nature of the viral particles and high
potential for environmental contamination decrease the
Treatment feasibility of this approach. Good sanitation practices,
strict isolation procedures, and prevention of over-
The same general principles of supportive care used for crowding are all important methods for preventing out-
managing CPV‐2‐infected dogs can be applied to FPV breaks of FPV in multicat situations.
patients (see Chapter 82). Rehydration and maintenance Vaccination of cats with commercial modified‐live or
of electrolyte and acid–base balances, and blood glucose inactivated FPV vaccines is considered to be a safe and
are of primary importance. Parenteral administration of effective method of FPV prevention, but recent studies
broad‐spectrum antimicrobial agents is also indicated to showing a high degree of interference with vaccination by
combat sepsis due to loss of integrity of the gastrointesti- maternally derived antibodies have led to a change in vac-
nal tract lining and neutropenia. Extrapolation from cination protocols. Kittens should be vaccinated begin-
canine research suggests that early reintroduction of ning at 6–8 weeks of age, continuing every 3–4 weeks
enteral nutrition as soon as vomiting is controlled may be until 16–20 weeks of age. Cats older than 16 weeks should
beneficial. Cats with severe anemia or hypoproteinemia be vaccinated twice, four weeks apart. Revaccination is at
may require blood or plasma transfusions, and intrave- one year after the primary series and then every three
nous nutrition should be considered for these cats if years. If preexisting FPV antibody titers are relatively
enteral feeding is not possible. Ancillary treatments may high, revaccination may have little or no benefit.
include immunomodulatory therapies such as passive
immunoglobulin transfer using feline serum containing
anti‐FPV antibodies and active immune stimulation with Public Health Implications
feline recombinant interferon‐omega, although one study
showed no difference in survival for cats treated with the Feline parvovirus is not infectious to humans and does
latter agent compared to controls. not pose a public health risk.