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217.e2 Coronaviral Enteritis

Coronaviral Enteritis
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• Infection and loss of mature epithelial cells
BASIC INFORMATION
on the small intestinal villus tips leads to TREATMENT
Definition malabsorptive diarrhea. Treatment Overview
Self-limited disease causing mild diarrhea. Feline • Viral shedding starts 3-14 days after The disease is usually self-limited, but sup-
coronavirus can mutate to the more virulent infection and can continue for weeks to portive therapy is used as needed.
feline infectious peritonitis (FIP) virus (p. 327). months.
• Spontaneous recovery often occurs in 6-10 Acute General Treatment
Synonyms days, but clinical disease can be prolonged • Dehydration, electrolyte and acid-base
Canine enteric coronavirus (CECoV or CCV), if co-infections are present. disturbances are treated with parenteral fluid
feline enteric coronavirus (FECoV or FECV) • Sporadic cases of pantropic (viral infection therapy and specific electrolyte supplementa-
of multiple organs) coronavirus infection tion as needed.
Epidemiology causing severe multisystemic signs have been • Antibiotics are not indicated unless bacterial
SPECIES, AGE, SEX described in dogs. translocation or secondary bacterial infection
• Dogs: neonatal puppies from seronegative • Cats only: 5%-10% are resistant, 70% have is suspected.
dams are more severely affected, but naïve transient infection, and 13% remain carriers. • Nursing care: it is important that affected
dogs of any breed or sex are susceptible to 1%-3% develop FIP. patients eat or receive adequate nutrition. If
infection. the patient is not eating, assisted feedings or
• Cats of any age or sex are susceptible to DIAGNOSIS a feeding tube should be considered. Keep
infection, but kittens are more likely to patients warm and clean.
exhibit clinical signs. Diagnostic Overview
Enteric coronavirus can be difficult to differ- Possible Complications
RISK FACTORS entiate from other causes of enteritis. Enteric Enteric coronavirus infection can be concurrent
Most prevalent in crowded housing such coronavirus can be detected in otherwise healthy with other enteric infections such as canine
as shelters, kennels, catteries, and multi-cat animals, making it difficult to prove as the parvovirus, canine adenovirus 1, canine dis-
households. cause of clinical disease. Confirmatory testing is temper virus, or feline panleukopenia virus
usually not necessary since the disease is often and result in decreased survival. Concurrent
CONTAGION AND ZOONOSIS self-limited. Diagnostic tests are aimed at ruling infection with Clostridium perfringens, Campy-
Coronavirus is highly contagious and spread out other/concurrent diseases. lobacter spp, Helicobacter spp, and Salmonella
by fecal-oral transmission. The virus remains spp may increase the severity of clinical
infectious for 2-3 days at room temperature Differential Diagnosis disease.
but longer at colder temperatures. • GI infections: viral (canine parvovirus, feline
panleukopenia virus), bacterial (Salmonella PROGNOSIS & OUTCOME
Clinical Presentation spp, Campylobacter spp), parasitic or pro-
DISEASE FORMS/SUBTYPES tozoal (Tritrichomonas foetus, coccidiosis) Prognosis is good for dogs and cats unless
Dogs: infections (p. 257) concurrent infections are present or if FECoV
• Adults: usually subclinical infection • Dietary intolerance or indiscretion or a rapid leads to FIP.
• Puppies: usually mild gastrointestinal (GI) change in diet
disease, although some may have severe • Intussusception PEARLS & CONSIDERATIONS
clinical signs • Intestinal foreign body
Cats: Comments
• Adults: subclinical infection Initial Database • Healthy dogs and cats can shed coronavirus.
• Kittens: mild to severe GI disease • CBC, serum biochemistry and urinalysis: • Few cats with FECoV actually progress to
• FIP nonspecific findings, but neutropenia would FIP.
be unexpected with enteric infections; elec-
HISTORY, CHIEF COMPLAINT trolyte abnormalities and hypoglycemia can Prevention
• Diarrhea, potentially with hematochezia be seen if severe vomiting/diarrhea A vaccine against canine enteric coronavirus
• Vomiting • Fecal flotation and polymerase chain reaction can be used in dogs at high risk for exposure,
• Anorexia/hyporexia (PCR) for Giardia, T. foetus but it is not considered a core vaccine.
• Parvovirus testing in puppies and kittens
PHYSICAL EXAM FINDINGS Technician Tips
• Malodorous, often orange diarrhea that Advanced or Confirmatory Testing Coronavirus is deactivated by cleaning with
uncommonly contains blood Dog: common disinfectants, but bleach is preferred.
• Lethargy • Electron microscopy of fresh feces; potential Good hygiene should be practiced when
• Mesenteric lymphadenomegaly for false-negatives handling dogs or cats with acute diarrhea of
• Dehydration • Fecal reverse transcription PCR (RT-PCR) unknown cause.
• Ocular and nasal discharge • Serology: positive serum titers only confirm
• Examination may be unremarkable exposure and not active disease Client Education
• Virus isolation: not recommended Reducing stress and overcrowding in shelters
Etiology and Pathophysiology Cat: and catteries and meticulous litter box hygiene
• Large, single-stranded enveloped RNA virus • Serology (IFA, ELISA): only one-third of may help reduce FECoV infections in these
(family Coronaviridea) seropositive cats are infected with FECoV settings.
• Transmission by fecal-oral route with an • Fecal RT-PCR: a negative result makes
incubation period of 1-4 days FECoV unlikely

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