Page 731 - Problem-Based Feline Medicine

32 – THE CAT WITH SIGNS OF ACUTE SMALL BOWEL DIARRHEA 723

(feces contains the largest amount of virus). However, Secondary upper respiratory tract infections may
fomites are an important aspect of transmission occur, especially calici- or herpesvirus infections.
because of the prolonged survival of the virus in the
environment. Diagnosis
Feline panleukopenia can be inactivated by bleach The history (acute onset of depression and vomit-
and formaldehyde, but is resistant to other common ing), signalment (cat less than 1 year of age) and
disinfectants. physical examination findings (fluid- and gas-filled
intestines) are all suggestive of the disease.

The milder forms of the disease that occur in adult cats
Clinical signs can be difficult to differentiate from many other gas-
trointestinal diseases.
The majority of cases of clinical panleukopenia are
observed in kittens or young cats under 1 year age. The most consistent hematologic abnormality is pan-
leukopenia, with leukocyte counts typically ranging
Clinical signs vary from mild to very severe.
between 500 and 3000 cell/μl. Because the disease is so
Anorexia, depression and extreme lethargy are very acute, serum biochemistry values are usually within
common clinical signs in the early stages. normal limits. Hypoglycemia and elevated liver enzyme
concentrations may be detected in cats with endotoxemia.
Vomiting usually occurs but varies in severity and is
associated with dehydration. There is no licensed ELISA test kit for the feline par-
vovirus, however, the canine test kit will detect the
Diarrhea occurs 24–48 hours after the onset of
feline parvovirus in feces as well. False-positive and
depression, and may be mild or marked with severe
false-negative test results can occur.
blood-streaked or hemorrhagic diarrhea.
● False-positive test results can occur following
In the peracute form, death may occur before diarrhea recent vaccination with a modified live panleukope-
develops. nia vaccine, and false-negative results occur if the
● The cat often sits sternally with its head down kitten is tested before shedding starts, if there is
(flexed). low virus burden or late in the course when
● Abdominal palpation may reveal evidence of pain, shedding becomes more intermittent.
enlarged abdominal (mesenteric) lymph nodes and
Serologic testing is still an important diagnostic test
increased gas or fluid in the intestines.
for feline panleukopenia, but it requires paired sam-
The cat may or may not be febrile, but may become ples (acute and convalescent) that show a rise in titer
febrile if there is sepsis. In the late stages of fatal dis- to be definitive. Serology is usually only indicated in
ease, the cat will almost always become hypothermic. a multi-cat facility so appropriate preventative vacci-
Hypothermia indicates a grave prognosis. nation programs can be implemented.
Kittens affected in late gestation, or in the first 9 Other tests that can be performed include virus isola-
days after birth, are often ataxic, hypermetric, dys- tion on feces or tissues and electron microscopy for
metric, incoordinated and have a base-wide stance detection of virus particles in the feces.
when they begin to walk at 2–3 weeks of age.
Other neurologic abnormalities include seizures, Differential diagnosis
behavioral changes and retinal degeneration.
In its severe form, which is typically present in kittens,
Prenatally infected kittens may be stillborn or die as few diseases mimic feline panleukopenia.
fading kittens in the first few days of life.
Milder clinical forms of the disease in adult cats must
Many susceptible cats will be infected, but have sub- be differentiated from all other infectious causes of
clinical or mild GI signs associated with depression gastrointestinal disease (e.g. campylobacterosis, giar-
and anorexia for 1–3 days. diasis, etc.).