Respiratory Tract Disease Complex in Cats
Sushant Sadotra, PhD/Diagnostic specialist Feline respiratory disease (FRD) syndrome or feline upper respiratory tract disease complex is a common infection in cats caused mainly by Feline Herpesvirus (FHV-1), Feline Calicivirus (FCV), Chlamydophila felis, Mycoplasma spp., and Bordetella bronchiseptica. About 90% of all upper respiratory infections are caused by FHV-1 and FCV. Common Symptoms: · Sneezing · Nasal congestion · Conjunctivitis (inflammation of the membranes lining the eyelids) · Discharge from the nose or eyes (clear, purulent, or cloudy containing pus). · Difficulty breathing · Ulcers in the mouth Less specific symptom · Less appetite · Lethargy · Fever · Enlarged lymph nodes · Blepharospasm (squinting) Sources of infection: · Susceptible cats can get an infection by contagious particles in saliva or secretions from the nose or eyes shredded by an infected cat. · Most cases are associated with direct contact · Natural transmissions can also occur via aerosol droplets. Stress may also cause a secondary course of illness. Real-Time PCR for Diagnosis: A definitive diagnosis is based on clinical signs and laboratory testing for the isolation and identification of the infection. The Polymerase chain reaction (PCR) test is one of the sensitive tests and most reliable for detecting the presence of infectious agents. PCR detects the genomic material of the pathogen and determines its presence in the host. It is often more sensitive and specific than other available tests. However, false negative results are still expected. In the case of patients with latent herpes infections where the FHV-1 is found in the trigeminal ganglion can give negative PCR results. In the case of Chlamydophila, 2-3 days of antibiotic treatment for patients can also have negative PCR results. Samples of ocular, nasal, or caudal pharyngeal secretions for PCR assay are best for the diagnosis and identification of causative agents. Sample collection tips: · Ocular: Moisten with tears/exudate well or firmly swab both of the conjunctival sacs with a sterile swab. · Clinical lesions: Prefer to swab from the nasal and pharyngeal areas. After sample collection, place the swab into the preservation buffer and mix thoroughly. If not for immediately use, please keep the mixture at 4°C (no more than 3 days) until nucleic acid extraction.
Feline Herpesvirus Infection- Diagnosis
Trinh Mai Nguyen Tang Feline herpesvirus-1 (FHV-1) is a feline respiratory infection virus also known as feline viral rhinotracheitis (FVR) [1]. The Herpes virus was first isolated by scientists Crandell and Maurer in 1958 in cats with respiratory infections [2]. This virus has a prominent genome with large double stranded DNA, belonging to the family Herpesviridae [3]. This virus is characterized by cat-to-cat transmission with an exposure rate of up to 97% [4]. Herpes virus can be inactivated at 37oC around 3 hours or at 56oC in 5 mins. Meanwhile, the virus can remains infective in the enviroment approximately 5 months and a month at 25oC [5]. Once a cat is infected with the herpes virus, it is incredibly difficult to completely treat it since the virus can enter a dormant state and continue to survive in the cat for the remainder of its life [6]. Cats are not infectious during this latent period, but if they are sick or going through a stressful period, the virus may be reactivate. If this occurs, the cat will once more get the infection and may represent symptoms [7]. Herpes viruses can be latent in the ganglion, attach to sensory nerves and reach nerve cells, persist in the nucleus of infected nerve cells and do not replicate, leading to the process of detecting this virus becomes difficult [7-8]. As reported by Ngoc.N.T and her colleagues, herpes virus can infect cats of any age, however, kittens are more susceptible [9]. Specifically, the prevalence of virus infection in cats younger than 6 months old, 6-12 months old and over 12 months old were 52.17%, 33.33% and 19.05%, respectively [9]. Although previous reports have demonstrate that gender has no effect on the incidence of herpes virus infection [7-8], but Henzel et al. (2002) found that isolates from female cats are substantially taller than isolates from male cats [10]. Clinical Symptoms Herpes virus enters the cat’s body by contact with infected tears, nose, saliva, or items, and then multiplies rapidly in the epithelium of the nose, nasopharynx, and conjunctival mucosa leading to primary infection [11]. In cats infected with FHV-1, signs of sadness, moodiness, lethargy, sneezing, fever, and discharge from the eyes and nose have been noted (figure 1-A), a process that is frequently extended 2-4 days or longer, depending on the immunological system of the cat [11]. Secondary infection occurred after the fourth day of incubation, with symptoms of infection in the throat, bronchi, and bronchioles, and the nasal and conjunctival epithelium necrosing [12]. Conjunctivitis is a common herpes virus symptom, indicated by congestive and exudative symptoms that develop over many days to purulent discharge (figure 1-B) [13]. Gaskell and Dawson (1988) found lung infection or bronchitis in cats, with kittens dying from pneumonia at a greater incidence than adult cats [11,14]. Some other atypical symptoms such as mouth and skin ulcers, dermatitis or neurological signs are rarely seen [7]. Furthermore, the mean white blood cell (WBC) count of cats infected with FHV-1 (17.77 ± 0.70 x103/μl) was slightly increased compared with that of normal cats (4.6-12.8 x 103/μl) [9], in which neutrophils, eosinophils and monocytes all showed signs of slight increase compared. Secondary infections of the eyes, upper respiratory tract, and necrotic ulcers of the mouth can all cause high white blood cell counts [11]. Table 1 displays the white blood cell count. Table 1. Hematological results of cats was infected with FHV-1 [9]. Targets Unit Reference ± SE Red blood cells ´ 106/μl 7-10,7 10,20 ± 0,64 Hemoglobin content g/dl 11,3-15,5 13,47 ± 0,54 RBC mass % 33-45 38,78 ± 1,41 Average volume of red blood cells fl 41-49 45,16 ± 0,75 Average amount of hemoglobin in red blood cells pg 14-17 15,57 ± 0,24 Platelet count ´ 103/μl 180-680 362,50 ± 30,82 WBC count ´ 103/μl 4,6-12,8 17,77 ± 0,70 Lymphocytes ´ 103/μl 1,05-6,00 4,50 ± 0,36 Mono leukocytes ´ 103/μl 0,05-0,68 0,96 ± 0,13 Neutrophils polymorphonuclear leukocytes ´ 103/μl 2,32-10,01 11,47 ± 0,45 Eosinophils ´ 103/μl 0,1-0,6 0,78 ± 0,08 Basophils ´ 103/μl 0-0,14 0,07 ± 0,01 Laboratory Diagnosis In the laboratory, there are many different methods used to determine FHV. Common approaches include PCR, virus isolation in cell culture, and indirect fluorescent antibody staining of tissue samples for viral antibody detection [8,16]. PCR FHV is one of the most common causes of upper respiratory tract illness in cats. Infected cats would show upper respiratory signs. Co-infection of FHV with other pathogens makes the clinical signs more severe, particularly feline calicivirus, Chlamydophila felis, Bordetella pneumoniaseptica, Mycoplasma species, Staphylococcus spp., or Escherichia coli [6]. When a cat is suspected of having a viral infection, a swab can be used to collect nasal, ocular, oropharyngeal secretions, corneal debris, aqueous humor, corneal samples, blood, or biopsies. By amplifying viral DNA, tPCR can detect genetic material of FHV in specimen. However, if the cat is not in the infectious phase, no virus particles will be shed, rendering the PCR test ineffective [19-20]. ELISA method – detecting IgG antibodies The enzyme-linked immunosorbent test (ELISA) is used to determine IgG antibodies against FHV or FHV-1 utilizing serum, aqueous humor, and cerebrospinal fluid samples [15]. This approach, however, cannot discriminate between diseased and vaccinated cats. Due to the extended latent period of FHV, the cat’s body will generate antibodies to combat it [8]. These neutralizing antibodies manifest 20-30 days after the first infection. As a result, the presence of antibodies in the serum signals a prior infection but does not always correspond with clinical signs [8]. Immunofluorescent antibody assay Another approach for detecting FHV is immunofluorescence antibody (IFA) testing on corneal or conjunctival smears or biopsiengs. Through an antigen-antibody response, this assay may identify viral proteins produced in cells. However, this approach is thought to be less sensitive than viral isolation or PCR [16]. Virus isolation This is a traditional method that can detect viruses through isolation of conjunctival debris, nose, oropharynx, or postmortem lung samples from infected cats [8]. This traditional method can detect
