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Chlamydiosis 157

• CT can also be used to evaluate for CLM Chronic Treatment Prevention
when MRI is not available; imaging modality Surgical decompression (foramen magnum Breeders should be advised to access online
VetBooks.ir information about brain and spinal cord medically refractory cases. ing and MRI screening (www.veterinary- Diseases and Disorders
is limited in its ability to obtain detailed
resources for current guidelines on breed-
decompression) may be necessary in severe or
neurologist.co.uk/Syringomyelia/).
parenchyma.
Possible Complications
• Brainstem auditory evoked response (BAER)
can be performed to evaluate hearing. • Adverse effects of long-term glucocorticoid Technician Tips
Hearing pathways can become adversely administration • CLM is a heritable disease that is associated
affected in CLM. • Medical complications: continued neurologic with high morbidity.
decline despite therapy; neurologic signs can • Neurologic signs usually consist of cervical
TREATMENT become refractory to continued medical pain and discomfort. Care should be taken
therapy during physical restraint because some of
Treatment Overview • Surgical complications: intraoperative death, these patients are sensitive to normal touch.
The therapeutic goal is to halt disease progres- postoperative worsening of neurologic status
sion and achieve improvement or resolution of or continued neurologic decline, and/or Client Education
clinical signs of neurologic dysfunction. This can possible need for re-operation at surgical • SM is a potential slowly progressive sequela
be achieved using conservative medical therapy site due to formation of excessive fibrous of CLM. It is thought to be due to an
or surgical intervention. Surgical intervention tissue alteration in CSF flow dynamics, structural
has been typically reserved for young patients compression/obstruction, or a combination
that are severely affected and older patients that Recommended Monitoring of both.
have failed medical management. Postoperative in hospital monitoring for 3-5 • It has been proposed that surgical interven-
days. tion may be necessary to achieve resolution
Acute General Treatment of SM, although more scientific research is
• Most respond favorably to glucocorticoid PROGNOSIS & OUTCOME needed to confirm this.
therapy (prednisone 0.5 mg/kg PO q 12h, • To date, there has not been a documented
then taper). • Most patients improve with medical therapy, surgical technique that has consistently led
• Decrease CSF production: omeprazole but clinical signs often do not resolve. Some to resolution of SM. Veterinary specialists
(0.5-1.5 mg/kg PO q 12-24h). Acetazol- patients will have disease progression despite can offer their recommendations based on
amide and methazolamide can be used as medical therapy. scientific research, experience, and expertise.
adjunct therapy for short periods. • Surgical therapy has been reported to have
• Analgesia an 81% success rate, but recurrence of SUGGESTED READING
○ For acute or chronic pain: tramadol clinical signs can necessitate repeat surgery Marino DJ, et al: Chiari-like malformation and
4-10 mg/kg PO q 8-12h or codeine in 8%-47% of cases. syringomyelia: a handbook for veterinary profes-
0.5-2 mg/kg PO q 8-12h sionals, The Canine Chiari Institute (website).
○ For scratching or chronic pain: gabapentin PEARLS & CONSIDERATIONS http://caninechiariinstitute.org/index.php/doctor
10-20 mg/kg PO q 8-12h. In refractory -center/dvm-guide-chiari/.
cases, amantadine 3-5 mg/kg PO q 24h Comments AUTHOR: Joshua Gehrke, DVM, DACVIM
and/or pregabalin 2-4 mg/kg PO q 8-12h MRI findings do not correlate with patient EDITOR: Karen R. Muñana, DVM, MS, DACVIM
can be administered. clinical signs. Patients can have significant MRI
• Patients that respond poorly to conserva- findings with minimal neurologic deficits and
tive medical therapy may require surgical vice versa.
intervention.

Chlamydiosis Client Education
Sheet

Epidemiology RISK FACTORS
BASIC INFORMATION
SPECIES, AGE, SEX Primarily young age; multi-cat households;
Definition C. felis has been positively correlated with higher incidence in stray/outside cats
A bacterial infection associated with acute, conjunctivitis and upper respiratory tract disease
chronic, or recurrent conjunctivitis and in cats of either sex. The prevalence of C. felis CONTAGION AND ZOONOSIS
occasionally signs of mild upper respiratory ranges from 10%-30% in cats with clinical • Highly contagious and spread by direct
infection such as sneezing and nasal discharge. signs. Most cats with C. felis are < 5 years of contact with ocular discharge or respira-
The primary pathogen implicated is Chlamydia age, but it is common for affected cats to be tory tract secretions, by aerosol, or through
felis (formerly Chlamydia psittaci and Chla- < 1 year old. contact with fomites
mydophila felis). Non-C. felis infections have been reported: • Zoonosis is rare but reported for C. felis
• Chlamydia pneumoniae: cats >2 years with a confirmed case of conjunctivitis in an
Synonym • Neochlamydia hartmannellae: 30% in cats immunocompromised human; other reports
Feline pneumonitis (outdated) <1 year and 54% in cats > 10 years likely related to a cross-reaction between C.

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