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746 Panleukopenia, Feline

• Unlike canine parvovirus type 2 (CPV2), TREATMENT • Routine vaccination has profoundly
feline parvovirus has no role in endomyocar- Treatment Overview decreased the incidence of disease. Disease
VetBooks.ir cardial fibrosis (LVEF), clinically known as Comprehensive supportive care is required the environment and birth of susceptible
ditis (EMC) and left ventricular endomyo-
is maintained due to persistence of FPV in
for acute enteritis. There is no treatment for
endomyocardial restrictive cardiomyopathy
animals in unvaccinated populations.
in cats.
the neurologic form, but clinical signs are not
progressive. Prevention
DIAGNOSIS • Modified live vaccines (MLVs) are preferred
Acute General Treatment because they provide rapid and effective
Diagnostic Overview • IV crystalloid fluids to correct dehydration/ immunity.
Diagnosis is typically based on history, signal- hypovolemia, provide maintenance needs, ○ Vaccinate after 8 weeks of age to avoid
ment, clinical signs, and initial laboratory find- and address ongoing losses inactivation by maternal antibodies
ings. Severe gastroenteritis with neutropenia in ○ Address electrolyte abnormalities (e.g., (maternal antibodies can persist up to
a young kitten strongly suggests the diagnosis. hypokalemia). 12 weeks in some kittens) and then
Diagnosis of the cerebellar form is largely • Broad-spectrum antibiotics (e.g., ampicillin ± approximately 3 and 6 weeks after first
clinical. sulbactam 20-30 mg/kg IV q 8h) to combat vaccination.
secondary bacterial infections. ○ Kittens from high-exposure environments
Differential Diagnosis • Antiemetic (e.g., ondansetron 0.5 mg/kg IV (e.g., shelters, feral colonies) may benefit
• Gastroenteritis q 12-24h, maropitant 1 mg/kg SQ q 24h, or from an additional booster between 16
○ Foreign body metoclopramide 0.2-0.4 mg/kg SQ q 8h (or and 20 weeks.
○ Other bacterial or viral infection (coro- 0.01-0.09 mg/kg/hr as an IV constant-rate ○ Initial vaccination may provide lifelong
navirus, Salmonella spp, Clostridium spp) infusion) immunity, but triennial revaccination is
○ Toxin ingestion recommended.
○ Other causes of vomiting (p. 1293) and Nutrition/Diet • MLV is contraindicated in pregnant queens
diarrhea (p. 1213) • If vomiting is controlled, consider tube or kittens < 4 weeks old.
• Leukopenia feeding (p. 1107). Trickle feeding of a liquid • A negative titer in adult cats does not indicate
○ Feline leukemia virus (FeLV) infection diet through a nasogastric tube may improve lack of protection against the disease.
○ Salmonellosis gut healing and hasten return to appetite. • Distal tail is considered an acceptable site for
○ Sepsis • Appetite stimulant (for adult-sized cats, vaccination. It is well tolerated and produces
cyproheptadine 2 mg/kg/CAT PO q 12h similar serologic responses to vaccination in
Initial Database or mirtazapine 3.75 mg PO q 72h; dosing the distal limb 1-2 months after vaccination.
• CBC: mild anemia unless severe gastro- for small kitten may be difficult). Appetite
intestinal (GI) bleeding; leukopenia and stimulants are not often successful if the Technician Tips
especially neutropenia are typical but normal animal is still nauseous/ill. • Because the virus is easily spread by fomites
leukogram does not rule out FPV infection; • See tips for coax feeding (p. 1199). (e.g., towels, bowls, shoes) and persists up
thrombocytopenia due to bone marrow • Vitamin B 12 0.25 mg/CAT IM or SQ once to 1 year, strict isolation and disinfection
suppression or disseminated intravascular protocols are essential (e.g., disposable gowns,
coagulation (DIC) Recommended Monitoring booties, gloves). Monitoring equipment such
• Serum biochemistry: often unremarkable; • Vital parameters (heart and respiratory rate, as stethoscope and thermometers cannot
prerenal azotemia and increases in alanine temperature, body weight, capillary refill leave the isolation area.
aminotransferase/bilirubin possible time) monitored closely during severe illness • Disinfection of the environment or fomites
• Retroviral testing: FeLV and feline immu- • Rebound leukocytosis (24-48 hours) is requires 1 : 32 diluted sodium hypochlorite
nodeficiency virus (FIV) expected; if leukopenia persists, rule out (bleach), formaldehyde gas, and glutaralde-
• Fecal exam: rule out parasites other causes (e.g., bacterial sepsis, retrovirus). hyde, as for parvovirus in puppies.
• Coagulation panel: occasionally, evidence of
DIC PROGNOSIS & OUTCOME Client Education
• Abdominal radiographs: rule out foreign Breeders should vaccinate any new cat before
body obstruction • Guarded (short term) for acute gastroenteri- introduction to cattery.
tis, but complete recovery common
Advanced or Confirmatory Testing • Guarded to good for kittens with cerebellar SUGGESTED READING
• Canine parvovirus fecal ELISA test kits can hypoplasia, depending on ability to com- Greene CR: Feline parvovirus intentions. In Greene
reliably detect FPV antigen. False-positive pensate for deficits; neurologic signs are not CE, editor: Infectious disease of the dog and cat,
results can occur up to 3 weeks after (modi- treatable but are nonprogressive. ed 4, St. Louis, 2012, Elsevier. pp 80-90.
fied live) vaccination. • Grave to poor for kittens with forebrain signs
• Confirmatory tests for FPV enteritis include (rare) AUTHOR: Harmeet Aulakh, BVSc & AH, MVSc,
DACVIM
serologic titer (paired samples), immunofluo- EDITOR: Joseph Taboada, DVM, DACVIM
rescence antibody testing, polymerase chain PEARLS & CONSIDERATIONS
reaction (PCR) assay, and virus isolation.
• For the cerebellar form, history and neuro- Comments
logic exam revealing stable cerebellar signs • Kittens cannot simultaneously have both
in a young cat can be assumed to be due to neurologic signs and signs of enteritis from
in utero or perinatal FPV infection. panleukopenia because neurologic signs occur
• Although unnecessary, advanced brain from in utero infection of the queen.
imaging (e.g., MRI) can confirm cerebellar
hypoplasia.

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