Feline viral upper respiratory disease: why it persists! (Proceedings)
There is little argument among clinicians that feline upper respiratory disease is perhaps the most common respiratory disorder for which cats are presented. In multiple-cat households and animal shelters world-wide, transmissible feline upper respiratory disease (URD) represents the most prevalent clinical disease in the population of cats at risk. The question that must be asked is: despite widespread use of vaccines against viral (herpesvirus and calicivirus) and bacterial (Chlamydophila felis and Bordetella bronchiseptica) respiratory disease, why do these infections persist? ...and, what can be done to effectively manage these infections within households?
This question is important, but today there are answers that will help veterinarians manage the infected cat and minimize spread of infections among cats living within a closed population. This presentation addresses the most common cause of both acute and chronic upper respiratory infection in cats: feline herpesvirus-1 (cause of feline rhinotracheitis) and feline calicivirus. From diagnosis, to clinical management of infected cats, to vaccination...the critical issues surrounding this respiratory complex will be discussed.
Several infectious organisms are known to produce clinical signs of upper respiratory disease (URD) in cats. The most important, and most common, are:• Feline Herpesvirus-1 (FHV-1)
• Feline Calicivirus (FCV)
• Chlamydophila felis (formerly, Chlamydia psittaci)
• Bordetella bronchiseptica
Reports on the prevalence of individual pathogens in outbreaks of feline respiratory will vary from country to country. In the United Kingdom, for example, it has been estimated that Chlamydophila felis infections constitute up to 30% of the cases of respiratory disease in cats. In North America, it's estimated to cause fewer than 5% of cases of feline respiratory disease. Today, most authors agree that between 80% and 90% of the cases of feline viral URD are caused by one of two viral groups, either (FHV-1), cause of feline viral rhinotracheitis (FVR), or feline calicivirus (FCV). Although a number of other viruses (cat pox, FeLV and FIV) and bacteria (Haemophilus felis, Mycoplasma spp.) have been shown to be associated with clinical signs of respiratory disease in cats, their clinical importance is largely linked to either herpesvirus or calicivirus infection...and occasionally, both!
Acute Viral Respiratory Infection
The hallmark clinical sign of acute viral URD is sneezing. Initially intermittent, the frequency and severity of sneezing episodes increases over a 3 to 5 day period. Fever and a bilateral or unilateral serous nasalocular discharge typically accompany sneezing episodes. As normal respiratory bacterial flora colonize in the upper respiratory tract membranes, the serous discharge becomes mucopurulent; this represents the most common problem for which affected cats are presented to a veterinarian. Left untreated, the nares obstruct, the eyelids become adherent to each other with viscous purulent secretions, and sneezing actually stops. Oral (especially lingual) ulceration is common and may be accompanied by hypersalivation, severe dehydration, anorexia, malnutrition. Secondary bacterial infections can become life threatening (pneumonia and sepsis) therefore; empiric antimicrobial therapy is always indicated. Clinical signs are most intense during the end of the first week and the second week of infection but may persist for as long as three weeks.
In practice, a diagnosis of acute viral URD is justifiably established on the basis of history and physical signs. Seldom is it necessary to isolate the specific virus responsible for causing infection in the individual cat. Laboratory profiles are more important in monitoring patient progress during therapy than establishing a diagnosis. Although morbidity can reach 100% in multiplecat households, mortality is more common among kittens (<6 months of age) with secondary bacterial infections than in older cats. Therefore survival rates among affected cats are expected to be high presuming antibacterial, hydration, and nutritional support can be provided.
In multiplecat households the problem of acute viral URD in kittens does not stop despite successful management of individual cat infections, implementation of a comprehensive vaccination program, and a seropositive adult population. It is important to note that approximately 80% or more of cats that survive acute FCV infection will become chronic carrier cats. One-hundred percent of kittens that recover from acute FHV-1 infection are expected to become chronic carrier cats. Healthy appearing carriers maintained in the population serve as reservoirs and can spread virulent virus to susceptible kittens, as well as adult cats, through direct cattocat contact or fomite contamination.