Vaccination is important in all animals. The FVRCP vaccine is made to protect cats from a couple of different viral pathogens. In this report discussion of the pathogens is assessed and explained. First knowledge about the form of the vaccine and the route it can be administered has to be understood before education is achieved. A modified live virus and killed virus are forms that vaccines can come in. Different types of vaccines can affect animals and should be given only by medical professionals. Feline rhinotracheitis, calici, and panleukopenia virus are all highly contagious diseases that spread quickly. It is important to know the signs and symptoms and beware in the event that your cat becomes ill.
I - INTRODUCTION
The FVRCP vaccine protects against feline viral rhinotracheitis, calicivirus, and the panleukopenia virus. The vaccine can be made in the form of a modified live virus (MLV) or killed virus (KV) (Siegal, 2004). Route and location of administration can vary with different types of vaccines. The location should follow protocol for that vaccine and should be adhered to in the case of an adverse reaction. The injectable FVRCP vaccine should be administered in the right shoulder. The vaccine can be given by subcutaneous, intramuscular, intraoculary, or by intranasal routes. The optimum time the vaccine should be given is at 8 weeks of age when the mother's antibodies from her colostrum begin to wear off (p. 343-345). If the vaccination is given between 6-9 weeks of age then two to three doses should be administered with a 3 to 4 week interval between doses until the cat reaches 12-14 weeks old (Kahn, 2005). Then administration once a year will be effective against the viruses (p.637). If the cat is less than 4 weeks old then a couple of problems can result (Siegal, 2004). Kittens less than 4 weeks of age should not be vaccinated with any MLV vaccine that includes the feline panluekopenia virus. If a MLV vaccine is given it will damage part of the kittens cerebellum located in the brain (p.345l). Symptoms such as ataxia and tremors may occur if damage is present in the cerebellum (Kahn, 2005 p.636). The earliest time a kitten can be vaccinated is at 2 weeks old (Siegal, 2004). Reasons for vaccinating a kitten so young can result from the kitten losing its mother and becoming an orphan. A kitten without a mother may not have gotten the appropriate antibodies needed in order to mount an effective immune response in the event that it is exposed to a virus. Kitten's 2-4weeks of age can get KV intranasal and intraocular vaccines that are administered by one drop in each eye or nostril. If a cat is pregnant and has an unknown history of vaccination and is around a lot of other cat's immunization may be needed to protect the kittens. It is usually not recommended to vaccinate pregnant animals but if the risk outweighs the incurrence of disease it should be done. Pregnant cats should be vaccinated with the KV form of the vaccine and can include the feline panleukopenia virus. MLV vaccines should not be given if they include the feline panluekopenia virus. They should be vaccinated in the last 2-3 weeks of pregnancy (Seigal). This allows the mother to safely pass antibodies to her offspring. Adverse reactions can occur with any immunization. Some reactions may be mild and resolve on their own while others can be life threatening. A systemic reaction may occur that can be mild or severe. In a mild case the patient may develop a fever and be lethargic which resolves in a couple of days possibly requiring medication or supportive care. In a severe systemic reaction anaphylaxis may occur with symptoms such as hives, wheezing, facial swelling, throat and mouth swelling, and difficulty breathing. Adverse effects can be apparent within 30 minutes after the vaccine is administered but it may take as long as hours or days to become evident. Vaccine induced fibrosarcomas can occur after vaccination in animals as well. Fibrosarcomas are a very invasive type of connective tissue cancer. This type of cancer does not spread very far in the body system but it penetrates very deeply in soft tissue. Therefore if this develops it is extremely hard to remove the tumor and excise it completely. Removal of the leg is sometimes necessary to eradicate the cancer completely. In some cases a lump may be seen that is benign and disappears on their own after a vaccine. In the event that anything abnormal occurs the veterinarian should be notified to assess the condition of the animal. As suggested earlier it is important to vaccinate animals in designated areas in the case that an amputation is required. Vaccinating your cat is very important in preventing disease with adverse reactions being rare (p.345-350). Being knowledgeable and paying attention to your cat may combat any problems that may arise. In the next couple of sections I will go into detail about the specific diseases that the
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FVRCP vaccine protects against and what to expect in the event that one of your pets develops one of these diseases.
II - FELINE VIRAL RHINOTRACHEITIS
Feline viral rhinotracheitis is also known as "snuffles" or feline herpes virus - 1 (Rand, 2006). The virus causes an acute upper respiratory tract infection that also develops in the conjunctiva and cornea. Lesions develop on cooler mucosal epithelial surfaces of the body that include the nasopharynx, conjunctiva, and the turbinate's. After infection with the virus necrosis of epithelial tissue begins within 24-48 hours. It takes two to six days before clinical signs become present. Often time's secondary bacterial infections occur on viral lesions turning clear nasal discharge into thick non clear mucus. The turbinate bones located in the nasal cavity can become destructed by the virus. The eye may be infected by the virus and cause corneal necrosis and possible corneal rupture that may result in loss of the eye. Other viruses or disease may be present at the same time during infection with feline viral rhinotracheitis. Infections that can be concurrent may include; the calicivirus, Chlamydophila, Mycoplasma or Bordetella and can alter symptoms (p.7).
Clinical signs: The first sign to emerge is usually uncontrollable sneezing spasms (Rand, 2006). Then in a non specified order extreme conjunctivitis with tearing and light sensitivity along with swelling of the conjunctiva occurs. Severe discharge from the eyes and nose that is initially clear in nature then becomes pus like. After awhile the discharge from the eyes and nose becomes crusty and can result in sealing of the eyes or nasal passage obstruction. The cat may be unwilling to eat and have a lack of appetence. A fever is not uncommon along with depression and dehydration. Inflammation of the trachea and bronchi may cause coughing and difficulty breathing and occasionally cause pneumonia in small kittens. If the cornea is involved with symptoms it usually takes about 1-2 weeks after infection to emerge. Corneal cloudiness may be present due to swelling and inflammation which can lead to branching or large ulcers in the eye. If a pregnant queen becomes infected possible fetal absorption, abortion, or kittens born infected immediately or shortly after birth may result. Kittens born with the virus may have signs like continuous crying, difficulty breathing, sneezing and discharge from the nose. Symptoms can be worse in kittens when the mothers passed antibody levels begin to dissipate. Over crowded environments and infection with other diseases such as FeLV and FIV can exaggerate signs in kittens as well. Signs of the disease usually only last about two weeks but the discharge from the nose and sinuses may persist longer. On rare occasions ulcers of the skin may appear on the face, trunk, and footpads. Generally the lesions are worse on the face and may be itchy. Inflammation of the mouth is sometimes seen with the latent form of the disease (p.7-8).
Diagnosis: The diagnosis is mostly made off of clinical signs (Rand, 2006). A couple of tests are available for diagnoses that are usually not used. The reason the tests are not used is that it rarely changes the treatment for any upper respiratory condition. An area were these tests can be used is in a cattery in which a population of cats is sick despite vaccination. The tests therefore enable to find the exact cause of why the cats are sick if not responding to treatment. Tests available include florescent antibody staining of scrapings from the conjunctiva or nasal mucosal epithelium or of a biopsy. Antibody titers and virus isolation or polymerase chain reaction diagnostics can also be used. Under the microscope evaluating skin lesions if present may show epidermal cells that have basophilic intranuclear inclusion bodies (p.8).
Treatment: To avoid contamination of the hospital patients may be treated as an outpatient (Rand, 2006). If the cat needs fluids or oxygen they may need to stay at the hospital. If the discharge from the eyes and nose is a pus color broad spectrum antibiotics should be administered. The antibiotics of choice are amoxicillin, cephalosporin, doxycycline, or trimethaprim-sulfadiazine for secondary bacterial infections. If dehydration is present subcutaneous or intravenous fluids may be required to correct hydration status. Dehydration is common because of the loss of bodily fluids and the lack of eating and drinking from not being able to smell. Discharge from the nose along with crusting may inhibit the cat's ability to get enough oxygen. A vaporizer or nebulizer can be used to help the patient to breathe easier. Owners who do not have these machines can put their cat in a steamy bathroom as an alternative treatment. The cat's nose should be wiped and rid of all crusts at least three times a day. Vaseline can be applied to the cat's nose to prevent tissue irritation from occurring because of the wiping. Intranasal decongestants can be used but cats generally don't like them. Decongestants like phenylephrine, neosynephrine or oxymethazolen one drop in each nostril can be given but only for a couple of days. Oral decongestants can be used but does not taste well to cats and causes severe salivation. A couple examples of oral decongestants are ephedrine or pseudoephedrine that can be used in the treatment of feline viral rhinotracheitits. Discharge from the eyes must be cleaned at least three times a day. An ophthalmic antibiotic may need to be administered such as tetracycline or tobramycin. If herpetic inflammation of the cornea is present antiviral eye drops may be of good use. L-lysine can be given to cats with the virus it works by competing with arginine an enzyme that is needed for the replication of the virus. L- lysine also decreases physical signs of the disease and lessens the shedding of the virus. Nutritional support may be necessary to encourage the sick patient to eat. Appetite stimulants such as diazepam, oxazepam, or cyproheptadiene may be placed in the cat's food. Multivitamins may be given that include vitamin A, B, C, and especially thiamine. Force feeding the cat may occur if they refuse to eat on their own. Heating the food up may entice the cat to eat on its own smelly foods like sardines or tuna can help to increase palatability. If the cat will not eat for the duration of three days in a row a feeding tube may need to be placed. The feline viral rhinotracheitis likes to be in cooler temperatures so warming a patient with a heating pad or incubator may help in the treatment of the disease (p.8-9).
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Prognosis: Cats generally do not die from feline viral rhinotracheitis fatalities are more common in young kittens (Rand, 2006). Some cats that recover can have chronic bacterial rhinitis and sinusitis. When this occurs it usually is the result from damage the virus caused in the epithelial lining and turbinate bones of the nose. Chronic tearing may occur if the tear ducts were scarred during infection. Rarely chronic inflammation of the cornea and ulcers that don't want to heal can persist after the infection has passed. It is estimated that up to 80% of cats who became infected are now in a carrier state of disease that can last for years. Cats in the carrier state can become infective and shed the disease when stressful conditions arise. Stressful situations such as moving to a new house, overcrowding, the addition of a new pet, and glucocorticoid administration could instigate re occurrence of the disease (p.9).
Transmission: Feline viral rhinotracheitis is a highly contagious disease that spreads very quickly in areas where cats reside (Rand, 2006). It is said that 100% of unvaccinated cats will eventually become infected with the virus if not immunized. Young kittens usually between 5 and 8 weeks are most likely to become infected. Infections occur when a cat has direct contact with a cat infected by the disease. Spread of the disease can be thru fomites and it is extremely important to clean and disinfect all items that come in contact with the virus. Food bowls, unwashed hands, and contaminated kennels can serve as reservoirs of infection. Transmission of the disease can be by airborne means and can travel as far as 4feet. The virus is shed through ocular, nasal and oral secretions and can be shed for up to 3weeks after infection. In the hospital setting the disease has high potential to spread due to the high numbers of carrier cats. Stressed carrier cats can then become infective and then facilitate the spread of disease. Kittens born to carrier queens may develop the virus thru vertical transmission when the queen becomes infective 4-6 weeks after parturition. The kitten's antibodies at that time are becoming decreased and raise the potential for infection. On a good note the virus cannot live for long periods away from its host and is only stable in the environment for 24 hours. Most common disinfectants can kill the virus (p.9-11).
III - FELINE CALICI VIRUS
The feline calicivirus multiplies in epithelial cells of the upper respiratory tract, tongue, and conjunctiva and in lung cells of the alveoli (Rand, 2006). There are many different strains of the virus that cause different signs and symptoms. Most of the strains that are prevalent in the environment have low mortality rates. Although, some strains can be severe in its disease causing capabilities and may cause pneumonia or death. One strain has the potential to cause a symptom called "limping kitten syndrome". The feline calicivirus - Ari strain is very deadly and should be taken seriously (p.11).
Clinical signs: Can vary some are not so bad while others are very severe (Rand, 2006). The strain of the virus and the health status of the cat are critical of what the outcome might be. Early in the disease signs can be vague looking like the typical sick cat. Symptoms like lethargy, anorexia, and fever may be present. Unlike the feline viral rhinotracheitis discharge from the nose and eyes is very mild if even present. Sneezing is also not a major symptom but may occur. In 70% of cats oral ulcers are a big sign that the calicivirus may be present. The ulcers may be small or large and can be located on the front side of the tongue and on the sides. Ulcers can develop on the footpads as well. A common nickname for the virus is "paw and mouth disease". Due to ulcers in the mouth the cat may have excessive salivation. Viral pneumonia and Sudden death may occur with certain strains of the virus. Joints may become swollen due to viral arthritis which results in the animal not wanting to move. Viral arthritis is what causes the "limping kitten syndrome". In California a very bad and rare strain of the disease was reported named feline calicivirus-Ari. In 50% of the cats a high fever, facial and paw swelling, eye and nose discharge, conjunctivitis, and ulcers and inflammation of the mouth was experienced. In 30-40% of the cats hemorrhage from the nose was reported. Yellowing of the skin was prevalent in 20% of the cats with the rare Ari strain. 30-50% of the cats infected with the Ari strain resulted in fatalities. Other symptoms include pneumonia, pleural effusion, pancreatitis and abdominal effusion (p.11-12).
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Diagnosis: Clinical signs are usually all that is needed in diagnosis of the calicivirus (Rand, 2006). Like the rhinotracheitis virus only in certain situations is a definitive diagnosis needed. A couple of laboratory tests that can be conducted consist of; rising antibody titers or on a polymerase chain reaction or through viral isolation. The Ari strain can be identified by cultures taken from blood, ocular or nasal secretions, spleen or the lungs (p.12).
Treatment: Like the rhinotracheitis virus treatment for the calici virus is similar (Rand, 2006). Supportive therapy is essential for a good recovery. Hydration must be maintained and fluids should be instituted where ever necessary. A vaporizer or nebulizer can be used to help the patient breathe better and prevent the nasal passages from drying out. In the case that a secondary infection occurs antibiotic therapy may be needed. If discharge is present on the patient it must be cleared away periodically throughout the day. If the patient is having problems breathing oxygen may need to be given. Pain medicine such as buprenex can be supplemented if the cat is uncomfortable due to oral ulcers. There is not a specific antiviral drug that can be administered against the calici virus that works (p.12).
Prognosis: Cats usually after 5-7 days have no symptoms after an infection Rand, 2006). In the rare case death may result due to a bad strain of the virus. In carriers of the disease inflammation of the mouth and chronic gingivitis is sometimes seen. Mild conjunctivitis or ulceration of the cornea may be a problem after clinical signs of the disease have passed (p.12).
Transmission: The calicivirus is very contagious and moves through cat colonies at great speed (Rand, 2006). Kittens that are not vaccinated between the ages of 2-6 months are most susceptible to catching the disease. The first symptoms of the virus do not occur until three days after infection. It takes 2-4 days for incubation of the virus. The virus can be spread by fomite transmission. It is extremely important to clean litter pans, food bowls, and kennels of an infected cat. Hands of people along with shoes and clothing can also facilitate the spread of disease. The calici virus is more resilient than the rhinotracheitis virus and can live in the environment for up to 8-10 days. Cats spread the virus through nasal and oral secretions. Some cats can become carriers of the disease and may have the virus for years. Carrier cats do shed the virus continuously in the carrier state mainly from secretions from the tonsils. The virus is very indestructible and the environment needs to be cleaned with a 1:32 dilution of bleach to be effective (p.12-13).
IV - FELINE PANLEUKOPENIA VIRUS
Feline panleukopenia virus is also known as cat distemper and is a parvovirus (Rand, 2006). The virus can only replicate in rapidly dividing cells in order for survival. Rapidly dividing cells are mostly located in the lymphoid tissue, bone marrow, and intestinal mucosal crypts. Pregnant cats can pass the virus transplacentally to their offspring or after birth. If kittens become infected by their mother it will result in an infection of the cerebellum, cerebrum, retina, and optic nerves. Infection of these parts of the body will show symptoms like seizures, changes in behavior, dysfunction of the cerebellum, and degeneration of the retina. When the mucosal crypts of the intestine are damaged it results in less surface area for nutritional absorption. Without absorption capabilities in the intestine the ending result equals a patient with diarrhea. Kittens that are infected with the virus can pick up secondary bacterial infections caused by bad microflora resulting in endotoxiema. The gram negative bacteria responsible for the endotoxeima are a very common cause of death in young kittens who have the virus. Pregnant queens that become infected early in gestation can cause fetal death, abortion, and fetal mummification. If infection occurs late in pregnancy the kittens are usually born with neurological dysfunction as stated earlier in the paragraph (p.722-724). The panleukopenia virus is highly contagious and can live in the environment for more than a year (Kahn, 2005). The virus can travel by fomites on shoes, clothing, and objects. Cats that recover from the disease can still shed the virus in their feces for up to 6 weeks. One way to kill the virus in the environment is with the use of a 6% solution of beach and allowing it to sit for at least 10 minutes at room temp (p.635-637). Formaldehyde can also be effective in killing the virus (Rand, 2006 p.723).
Clinical signs: Most cases of feline panleukopenia are seen in young kittens or cats that are less than 1 year old (Rand, 2006). Symptoms can vary greatly and some may be mild while others are very severe. Early in the disease common symptoms that are seen include; not eating, depression, and over pronounced lethargy. Vomiting can occur but how bad it is can be associated with the degree of dehydration. When depression becomes a physical sign in 24-48 hours following the symptom diarrhea will present itself. The diarrhea can be extreme and have blood involved which may be hemorrhagic in its presentation. In the peracute form of the virus death may occur before diarrhea is a sign or symptom. The cat may lay sternal on the ground with its head down and flexed. On abdominal palpitation the intestines may have increased fluid or gas and pain may be noted. Also the abdominal mesenteric lymph node may enlarged and easy to feel. The cat may have a fever present and may be an indication of an infection in the blood. In the late stages of fatal disease hypothermia is often seen and the prognosis is not very good. Kittens born after infection late in utero or shortly after birth have symptoms listed above. A base wide stance when they begin to walk at 2-3weeks of age is a characteristic sign of the disease. Cats can become infected with panleukopenia and be subclinical and only show mild GI signs, anorexia, and depression. The subclinical form of the disease only lasts for about 1-3 days. Like with other conditions secondary infections are a major complication of disease. Secondary upper respiratory conditions like feline viral rhinotracheitis and the calicivirus is a potential problem when panleukopenia is present (p.723).
Diagnosis: Diagnosis is usually made by signalment, history, and physical exam findings (Rand, 2006). The signalment is a young cat less than 1 year old. The history may include an onset of depression and vomiting. The physical exam findings may reveal a painful abdomen that is fluid and gas filled. If the mild form panleukopenia occurs in older cats it may be hard to tell the difference between the virus and other GI diseases. Evaluation of the blood may reveal low white blood cell counts 500-3000/ul. Most of the time since the disease occurs very suddenly blood chemistry values are normal but changes will be evident in time. Liver enzyme values may be elevated and blood glucose values may be decreased in cats with endotoxemia. Currently there is not an ELISA test kit for the detection of feline panleukopenia. The ELISA test kit for canine parvo can be used in the detection of feline panleukopenia in feces. The potential for false positives and false negatives may be a problem while searching for the virus. A false positive can happen if a cat was recently vaccinated with the MLV panleukopenia vaccine. A false negative might happen if the cat is not currently shedding the virus due to being in late stages of the disease. A low virus burden may give a false negative as well. Testing serum titers from blood is another method of detecting the disease. This method is not used as much and is only recommended in cattery type situations for vaccine programs. The virus can be detected on feces or tissues using an electron microscope (p.723)
Treatment: Treatment needs to be aggressive and consists of supportive methods (Rand, 2006). Loss of fluids due to diarrhea will institute the need for fluid therapy. The maintenance daily dose of fluids is 40-60ml/kg/day. Potassium chloride may be added to the bag when needed to correct electrolyte imbalances. Combating secondary bacterial infections is important in the healing process. If secondary bacterial infections are present the immune system will have a harder time fighting off the virus. Antibiotics that can be administered consist of ampicillin 10-20mg/kg every 8 hours, cephalexin 20-30mg/kg every 8 hours, or enrofloxacin at 5mg/kg every 24 hours. If the need to control vomiting is present metocloprimide or prochlorperazine can be used as an antiemetic. Kittens that have anemia, low blood pressure, or low packed cell volume may require a plasma or blood transfusion. Proper nutrition is important force feeding foods that have been blenderized may be necessary. Tube feeding by the orogastric or nasogastric method is an option in making sure nutrition is received. Enteral supplements may be needed concurrently when tube feeding is implemented. The most important nutrients that a panleukopenia patient needs is amino acids and glucose. Treatment is generally supportive and is based off of the signs that are presented. Neurological signs that can occur during infection currently do not have a treatment available (p.724).
Prognosis: Kittens and young cats that have severe symptoms of panleukopenia have a guarded to grave prognosis (Rand, 2006). Other kittens that were infected before they reached 10 days old and recovered may have lifelong neurological problems. Cats older than 1 year that survived an infection will have lifelong protection against the virus (p.724).
V - CONCLUSION
In conclusion all of the diseases mentioned above are very serious and can be fatal. I cannot express the importance of vaccination. A simple vaccine that costs about 15 dollars can save you a lot of money by protecting your animal from illness. Prevention is always the best route when trying to save money. It is our duty to care for our animals as they cannot care for themselves. Vaccines may have risks but generally adverse reactions are rare. The FVRCP vaccine should be given to all healthy cats. Many times people do not keep their cats up to date on vaccines. People often have excuses as to why they do not routinely bring their cat to the veterinarian. The rabies vaccine is legally required in Ohio. I do not like it when a cat comes to the clinics that are not vaccinated for rabies. The cat puts everyone at the hospital at risk and may transmit rabies to employees. Please vaccinate your animals.