Page 392 - Problem-Based Feline Medicine

384 PART 7 SICK CAT WITH SPECIFIC SIGNS

Transmission to cats is either via ingestion of infected interpreted carefully, as high titers can persist for up to
rodents or a fleabite from infected fleas. one year after infection.
Rapid multiplication of organism causes tissue damage Chest radiographs may reveal patchy, nodular lesions if
and necrosis. The host immune response contributes to the pneumonic form is present.
pathology.
Be aware that the risk of exposing other staff mem-
Three forms of the plague exist: bubonic (local infec- bers to the disease should be weighed against the
tion), bacteremic/septicemic and pneumonic. benefit of the diagnostic test.
Bacteremia occurs in many cases, resulting in the
septicemic or pneumonic form of plague. Differential diagnosis

Endemic regions of the world include the western Reactive lymph nodes from a percutaneous abscess
USA, South America, Africa, Asia, eastern Europe. or tooth-root abscess.
● Aspirates of cat bite abscesses contain a mixed bac-
Clinical signs terial population compared to Y. pestis, which is
homogeneous.
History of hunting rodents, especially in known
endemic areas. Neoplasia, although it is less common in the US for cats
with lymphoma to have peripheral lymphadenopathy.
Current flea infestation is evident.
Respiratory signs may be due to other upper respiratory
Acute onset of fever, anorexia, depression over a infections (calicivirus, herpesvirus, Chlamydophila)
period of 2–6 days. The clinical course may last 6–20 or lower respiratory disease (parenchymal lung disease,
days. pleural disease).
Submandibular or cervical swelling associated with Other diseases which cause high fever (tularemia,
lymph nodes (can be unilateral or bilateral). The toxoplasmosis, FIP, etc.).
inflamed, swollen lymph node is referred to as a bubo.
Subcutaneous abscessation may occur and appear Treatment
similar to a cat bite abscess.
Absolute caution must be practiced in all suspect
In the pneumonic form (~10% of cases), upper and plague cases. Cautionary measures include gloves,
lower respiratory signs may be present, including sneez- mask, isolation of animal and limited exposure to other
ing, nasal discharge, coughing, dyspnea/tachypnea. staff members.

Doxycycline/tetracycline: (1) Doxycycline at 5 mg/kg
Diagnosis
q 12 hours PO for 14–21 days or (2) tetracycline 25
Initially, microscopic examination of a lymph node mg/kg q 8 hours PO.
aspirate, especially a markedly swollen lymph node ● Begin treatment immediately after samples for
(bubo) should reveal a homogeneous population of diagnosis have been collected.
bipolar-staining coccobacilli. ● Doxycycline is preferred as tetracycline has been
● Blood should be examined in cats with the bac- associated with relapse.
teremic/septicemic form.
Consider aminoglycosides or enrofloxacin (5 mg/kg
Fluorescent antibody testing of sample provides a IM q 8 hours) for the first 3 days to avoid placing
definitive diagnosis. hands into the cat’s mouth (see Transmission section
below).
Culture of organism should be performed by a quali-
fied laboratory only.
Prognosis
A four-fold rise in antibody titers (taken 10–14 days
apart) is suggestive of plague. These results must be Prognosis for bubonic plague is fair to good.