Parvoviroza felina, FPV,Panleucopenia felina,

1. Boli Infectioase aleBoli Infectioase ale FelineFelinelorlor
Curs anul 5Curs anul 5
010091551263

2. PanleuPanleuccopeniaopenia FelinaFelina
-- DefinitieDefinitie--
 Boala virala, sBoala virala, severeveraa,, deosebit de contagioasadeosebit de contagioasa,, aa
pisicilor tinere nevaccinate, clinic insotita depisicilor tinere nevaccinate, clinic insotita de
simptomatologiesimptomatologie gastrointestinalgastrointestinala.a.
 Cea mai importanta boala a efectivelor deCea mai importanta boala a efectivelor de
pisicipisici nnevaccinate.evaccinate.
 Rata de infectie a felinelor receptiveRata de infectie a felinelor receptive= 100%= 100%
 LeuLeuccopenia =openia = semn caracteristicsemn caracteristic
 MortalitMortalitate deate de = 25 – 90%= 25 – 90%
 Total controlTotal control numai prin vaccinarenumai prin vaccinare

3. PanleuPanleuccopeniaopenia FelinaFelina
IIstorstoricic
First described in 1800 as “cat plague”First described in 1800 as “cat plague”
THETHE most important disease of catsmost important disease of cats
50-100% incidence in animal shelters50-100% incidence in animal shelters
Mortality 25-90%Mortality 25-90%
First crude tissue origin vaccine in 1934First crude tissue origin vaccine in 1934
Causative virus isolated & identified in 1960sCausative virus isolated & identified in 1960s
Excellent vaccines developed 1968-1975Excellent vaccines developed 1968-1975
Vaccine programs centered around FPVaccine programs centered around FP

4. Feline PanleukopeniaFeline Panleukopenia
Current StatusCurrent Status
Vaccines excellentVaccines excellent – can totally control and prevent FP– can totally control and prevent FP
Incidence very lowIncidence very low
Still problem in some populationsStill problem in some populations
SheltersShelters
FarmsFarms
Free-roaming cats/feral populationsFree-roaming cats/feral populations
Cause of problemsCause of problems
Contaminated environmentContaminated environment
Improper or no vaccinationImproper or no vaccination
Canine parvovirus – some strains infect catsCanine parvovirus – some strains infect cats
Change in revaccination recommendationsChange in revaccination recommendations

5. Feline PanleukopeniaFeline Panleukopenia
SynonymsSynonyms
FPFP
FPLFPL
Feline parvovirus infectionFeline parvovirus infection
FPV infectionFPV infection
Feline “distemper”Feline “distemper”
Feline infectious enteritisFeline infectious enteritis
Cat “plague”Cat “plague”
Feline ataxiaFeline ataxia
Feline cerebellar hypoplasiaFeline cerebellar hypoplasia

6. FP ~FP ~ EtiologyEtiology
Feline Parvovirus (FPV)Feline Parvovirus (FPV)
Single serotypeSingle serotype
Cross-reacts with CPV-2 & MEVCross-reacts with CPV-2 & MEV
Canine Parvovirus-2 (CPV-2)Canine Parvovirus-2 (CPV-2)
CPV-2 - 1CPV-2 - 1stst
appeared in dogs in 1977appeared in dogs in 1977
CPV-2a - dogs in 1978; can cause FP in catsCPV-2a - dogs in 1978; can cause FP in cats
CPV-2b - dogs in 1984; can cause FP in catsCPV-2b - dogs in 1984; can cause FP in cats
CPV-2c - large cats 1997; can cause FP in catsCPV-2c - large cats 1997; can cause FP in cats

7. Characteristics of FPVCharacteristics of FPV
ParvovirusParvovirus = small, single-stranded DNA virus= small, single-stranded DNA virus
Absolute need forAbsolute need for mitotic cellmitotic cell for replicationfor replication
Produces intranuclear inclusionsProduces intranuclear inclusions
ExtremeExtreme resistanceresistance
Will survive for years at room temperatureWill survive for years at room temperature
Resistant to most disinfectantsResistant to most disinfectants
Similar to CPV-2 and MEVSimilar to CPV-2 and MEV

8. FPV Intranuclear InclusionsFPV Intranuclear Inclusions
~ Cell Culture ~~ Cell Culture ~

9. HostsHosts
FelidaeFelidae
Domestic cat = primary hostDomestic cat = primary host
Non-domestic felids – all believed to be susceptibleNon-domestic felids – all believed to be susceptible
CanidaeCanidae
Outbreaks in dogs in EuropeOutbreaks in dogs in Europe
Artic foxArtic fox
ProcyonidaeProcyonidae
RaccoonRaccoon
CoatimundiCoatimundi
MustelidaeMustelidae
Mink – MEV, subclinical FPV infectionMink – MEV, subclinical FPV infection
Others? – skunks, otters, weasels, badgersOthers? – skunks, otters, weasels, badgers

10. EpidemiologyEpidemiology
Distribution - worldwideDistribution - worldwide
IncidenceIncidence
High in unvaccinated populationsHigh in unvaccinated populations
Low in properly vaccinated catsLow in properly vaccinated cats
SeasonSeason
Summer & Fall – susceptible kittensSummer & Fall – susceptible kittens
Can occur throughout yearCan occur throughout year
AgeAge
Kittens 2-4 months old most susceptibleKittens 2-4 months old most susceptible
Any age may be susceptibleAny age may be susceptible
Sex predilection - noneSex predilection - none

11. Transmission of FPVTransmission of FPV
Direct contactDirect contact
Contaminated environment & fomitesContaminated environment & fomites
Cages, floor, food dishes, water bowls, beddingCages, floor, food dishes, water bowls, bedding
Contaminated hands, clothing, and feet of peopleContaminated hands, clothing, and feet of people
In uteroIn utero infection – if queen has acute infectioninfection – if queen has acute infection
Carrier cats? – possible, but not commonCarrier cats? – possible, but not common

12. Pathogenesis of FPV InfectionPathogenesis of FPV Infection
Virus requires aVirus requires a mitotic cellmitotic cell for replication. All clinicalfor replication. All clinical
signs result from cytolysis of mitotic cellssigns result from cytolysis of mitotic cells
Intestinal cryptsIntestinal crypts
Vomiting & diarrheaVomiting & diarrhea
DehydrationDehydration
22ndnd
bacterial infectionsbacterial infections
Lymphopoietic cellsLymphopoietic cells
PanleukopeniaPanleukopenia
Granulocyts & Purkinje cells of cerebellum (neonate)Granulocyts & Purkinje cells of cerebellum (neonate)
Cerebellar hypoplasiaCerebellar hypoplasia
Retina (neonate)Retina (neonate)
Retinal dysplasiaRetinal dysplasia

13. Feline PanleukopeniaFeline Panleukopenia
Forms of DiseaseForms of Disease
Peracute FPPeracute FP
Acute FP = typicalAcute FP = typical
Mild FPMild FP
Subclinical infectionSubclinical infection
““Chronic” FPChronic” FP
In uteroIn utero infectioninfection

14. Feline PanleukopeniaFeline Panleukopenia
Peracute FPPeracute FP
Very acute onsetVery acute onset
Cat may just disappear, found deadCat may just disappear, found dead
Subnormal temperature, 94-98 F.Subnormal temperature, 94-98 F.
Severe leukopeniaSevere leukopenia
Severe depressionSevere depression
Owner may believe cat was poisonedOwner may believe cat was poisoned
Almost always fatal within 12 hoursAlmost always fatal within 12 hours

15. Feline PanleukopeniaFeline Panleukopenia
Acute or Typical FPAcute or Typical FP
FeverFever
Mild to moderateMild to moderate
May have subnormal temp.May have subnormal temp.
DDepression - may be severeepression - may be severe
Classic attitude or postureClassic attitude or posture
Vomiting andVomiting and DDiarrheaiarrhea
DDehydration - usually severeehydration - usually severe
Complete anorexiaComplete anorexia
DDeatheath

16. Feline PanleukopeniaFeline Panleukopenia
Mild FPMild FP
Slight anorexiaSlight anorexia
Slight feverSlight fever
Some depressionSome depression
Leukopenia - only consistent findingLeukopenia - only consistent finding
Perhaps mild gastroenteritisPerhaps mild gastroenteritis
Will recover without treatmentWill recover without treatment

17. Feline PanleukopeniaFeline Panleukopenia
Subclinical InfectionSubclinical Infection
More common inMore common in older catsolder cats
Cat appears clinically normalCat appears clinically normal
Slight feverSlight fever
Slight leukopeniaSlight leukopenia
Viremic and shedding virusViremic and shedding virus
Develops excellent immune responseDevelops excellent immune response

18. Feline PanleukopeniaFeline Panleukopenia
“Chronic” FP“Chronic” FP
Presents with “panleukopenia-like” syndromePresents with “panleukopenia-like” syndrome
Chronic leukopeniaChronic leukopenia
Chronic enteritisChronic enteritis
Chronic wastingChronic wasting
Histopathology - enteric lesions like FPHistopathology - enteric lesions like FP
Usually this isUsually this is feline leukemiafeline leukemia, not FP, not FP

19. Feline PanleukopeniaFeline Panleukopenia
“In utero” Infection“In utero” Infection
Usually with subclinical infection of Ab(-) queenUsually with subclinical infection of Ab(-) queen
One or more fetuses may be destroyedOne or more fetuses may be destroyed
AbortionAbortion
Fetal resorptionFetal resorption
Mummified fetusMummified fetus
Stillbirth, or “fading” newborn kittenStillbirth, or “fading” newborn kitten
Congenital birth defectsCongenital birth defects
Cerebellar hypoplasia with ataxiaCerebellar hypoplasia with ataxia
Retinal dysplasiaRetinal dysplasia
HydrocephalusHydrocephalus

20. FP ~FP ~ DiagnosisDiagnosis
HistoryHistory
Clinical signsClinical signs
Laboratory findingsLaboratory findings
Total leukocyte countTotal leukocyte count
Viral isolation/FPV antigen detectionViral isolation/FPV antigen detection
Serological findingsSerological findings
Postmortem findingsPostmortem findings
Gross pathological changesGross pathological changes
Histopathological changesHistopathological changes

21. FP ~FP ~ Diagnosis - HistoryDiagnosis - History
Unvaccinated cat?Unvaccinated cat?
Vaccinated under 14-16 weeks of age?Vaccinated under 14-16 weeks of age?
Recent exposure?Recent exposure?
Adoption shelter?Adoption shelter?
Farm or feral cat?Farm or feral cat?

22. FP Diagnosis ~FP Diagnosis ~ Clinical SignsClinical Signs
Sudden onsetSudden onset
Fever, lethargy, depressionFever, lethargy, depression
Classic attitude or postureClassic attitude or posture
head down, shoulders elevated, tucked positionhead down, shoulders elevated, tucked position
hang head over food/water dishhang head over food/water dish
Diarrhea and vomitingDiarrhea and vomiting
Severe dehydrationSevere dehydration
Complete anorexiaComplete anorexia
Abdominal palpationAbdominal palpation
edematous, turgid bowelsedematous, turgid bowels
pain?pain?

23. FP – Classic AttitudeFP – Classic Attitude

24. FP Diagnosis ~FP Diagnosis ~ Laboratory FindingsLaboratory Findings
PanleukopeniaPanleukopenia
4-8,000 cells/dl = mild or subclinical infection4-8,000 cells/dl = mild or subclinical infection
2-4,000 cells/dl = acute infection2-4,000 cells/dl = acute infection
<2,000 cells/dl = acute or peracute infection<2,000 cells/dl = acute or peracute infection
Viral isolation/detectionViral isolation/detection
Positive canine parvovirus SNAP testPositive canine parvovirus SNAP test – feces– feces
Isolation from feces, ileum/jejunum, thymus, spleenIsolation from feces, ileum/jejunum, thymus, spleen
PCRPCR
Immunofluorescence (IFA) - ileumImmunofluorescence (IFA) - ileum
Electron microscopy - identify viral particles in fecesElectron microscopy - identify viral particles in feces
Serum antibody titersSerum antibody titers
4-fold increase in paired serum samples4-fold increase in paired serum samples

25. Feline PanleukopeniaFeline Panleukopenia
Leukocyte Count vs. Clinical DiseaseLeukocyte Count vs. Clinical Disease
Clinical DiseaseClinical Disease
0
1,000
2,000
3,000
4,000
5,000
6,000
7,000
8,000
9,000
10,000
Normal Mild Acute
High
Low

26. Feline PanleukopeniaFeline Panleukopenia
Diagnosis - Viral DetectionDiagnosis - Viral Detection
 Detect FPV or antigen in fecesDetect FPV or antigen in feces
 Canine parvovirus SNAP testCanine parvovirus SNAP test
 Electron microscopy for viral particlesElectron microscopy for viral particles
 Viral isolation in cell culturesViral isolation in cell cultures
 Ileum, spleen, thymus, rectal swabIleum, spleen, thymus, rectal swab
 IFA on tissuesIFA on tissues
 Small intestine - ileum, jejunumSmall intestine - ileum, jejunum
 PCRPCR

27. PanleukopeniaPanleukopenia
Serological AssaysSerological Assays
 Virus neutralization (VN) assayVirus neutralization (VN) assay
= serum neutralization (SN) assay= serum neutralization (SN) assay
 ELISAELISA
 Paired serum samples:Paired serum samples:
 2 weeks apart for diagnosis2 weeks apart for diagnosis
 4-fold rise in titer4-fold rise in titer
 Single serum sample to check immunity:Single serum sample to check immunity:
 Titer = 1:10 or higher if >16 weeks oldTiter = 1:10 or higher if >16 weeks old

28. Feline Panleukopenia DiagnosisFeline Panleukopenia Diagnosis
Gross Pathologic FindingsGross Pathologic Findings
Rough hair coatRough hair coat
Gaunt and dehydratedGaunt and dehydrated
Evidence of diarrhea and vomitingEvidence of diarrhea and vomiting
Gross pathological changes may be mildGross pathological changes may be mild
Thick, edematous walls of small intestineThick, edematous walls of small intestine
Hyperemia, petechial or ecchymoticHyperemia, petechial or ecchymotic
hemorrhages - jejunum & ileumhemorrhages - jejunum & ileum
Small thymus in young kittensSmall thymus in young kittens

29. Small Intestine of Cat with FPSmall Intestine of Cat with FP

30. Small Intestine of Cat with FPSmall Intestine of Cat with FP

31. Lesions in Neonatal KittensLesions in Neonatal Kittens
with Feline Panleukopeniawith Feline Panleukopenia
Thymic atrophyThymic atrophy
Retinal dysplasiaRetinal dysplasia
Cerebellar hypoplasiaCerebellar hypoplasia

32. Feline Panleukopenia DiagnosisFeline Panleukopenia Diagnosis
Histopathologic FindingsHistopathologic Findings
Ileum & jejunumIleum & jejunum
Dilated crypts with loss of epitheliumDilated crypts with loss of epithelium
Short, blunted, fused villiShort, blunted, fused villi
Pathognomonic lesionPathognomonic lesion
Lack of inflammatory cellsLack of inflammatory cells
Intranuclear inclusions early in diseaseIntranuclear inclusions early in disease

34. Jejunum - NormalJejunum - Normal

36. Panleukopenia ~Panleukopenia ~ TreatmentTreatment
Supportive careSupportive care until immune responseuntil immune response
FPV antiserum?FPV antiserum?
Fluid and electrolyte replacementFluid and electrolyte replacement
– Indwelling IV catheterIndwelling IV catheter
– Lactated Ringers with potassiumLactated Ringers with potassium
– 5% dextrose in electrolyte replacer5% dextrose in electrolyte replacer
– 60-100 ml/kg/hr60-100 ml/kg/hr
No antivirals against parvovirusNo antivirals against parvovirus
GI therapyGI therapy
Antibiotics parenterallyAntibiotics parenterally
DietDiet

37. FP - Vaccines Available
MLV vaccines
•Injectable vaccines
•Intranasal vaccines
Inactivated vaccines
•Injectable non-adjuvanted
•Injectable adjuvanted
Recombinant FP vaccines - experimental
FP vaccines are often in combination
JAVMA 229(9):1405-1441, 2006

38. Feline VaccineFeline Vaccine
RecommendationsRecommendations
Standard ConditionsStandard Conditions
FPV/FHV/FCVFPV/FHV/FCV
First vaccineFirst vaccine 8 - 10 weeks8 - 10 weeks
Second vaccineSecond vaccine 12 - 14 weeks12 - 14 weeks
First booster vaccineFirst booster vaccine 1 year later1 year later
Booster vaccinesBooster vaccines every 3 yearsevery 3 years

39. 2006 AAFP Vaccine Advisory Panel Report
- Feline Panleukopenia -
Initial series of vaccinations
– 6-16 weeks of age
– 2+ doses 3-4 weeks apart
Revaccinate one year later – single dose
Then revaccinate no more frequently than every 3 yrs.
Serious adverse reactions to FPV vaccines are rare
CPV-2 can infect cats - FPV vaccines protect
JAVMA 229(9):1405-1441, 2006

40. FP MLV Vaccine-Induced StillbirthsFP MLV Vaccine-Induced Stillbirths

41. FPV Maternal Antibody in KittensFPV Maternal Antibody in Kittens

43. LONG-TERM IMMUNITY INLONG-TERM IMMUNITY IN
CATS VACCINATED WITHCATS VACCINATED WITH
AN INACTIVATEDAN INACTIVATED
TRIVALENT VACCINETRIVALENT VACCINE
Fred W. Scott, DVM, PhDFred W. Scott, DVM, PhD
Cordell M. Geissinger, BSCordell M. Geissinger, BS
Cornell Feline Health CenterCornell Feline Health Center
Feline Practice 25(4):12-19 (1997)Feline Practice 25(4):12-19 (1997)
AJVRAJVR 6060:652-658 (1999):652-658 (1999)

44. Duration of Immunity StudyDuration of Immunity Study
Inactivated FHV-FCV-FPV VaccineInactivated FHV-FCV-FPV Vaccine
 15 SPF kittens15 SPF kittens
 Vaccinated 2x @ 8 & 11 wks of ageVaccinated 2x @ 8 & 11 wks of age
 No booster vaccines givenNo booster vaccines given
 Placed in SPF breeding colonyPlaced in SPF breeding colony
 Offspring added to increase colonyOffspring added to increase colony
 No vaccine given to new catsNo vaccine given to new cats
 Original cats bled for serum on entryOriginal cats bled for serum on entry
 All cats bled at 3 years, then yearlyAll cats bled at 3 years, then yearly
 VN titers of serum run - FHV, FCV, FPVVN titers of serum run - FHV, FCV, FPV

45. The CatsThe Cats
- After 7.5 Years -- After 7.5 Years -
9 vaccinates remained in colony9 vaccinates remained in colony
– raised multiple littersraised multiple litters
8 unvaccinated contact controls8 unvaccinated contact controls
– raised multiple littersraised multiple litters

46. Mean VN Titer
FPV (Y1) FCV (Y2)
FHV (Y2)
Year after Vaccination
1/6 3 4 5 6 7
0
1000
2000
3000
4000
5000
6000
7000
0
20
40
60
80
100
120
140
160
Scott & Geissinger, AJVR, 60:652-8 (1999)

47. Relative Efficacy of anRelative Efficacy of an
Inactivated Triple VaccineInactivated Triple Vaccine
7.5 Years after Vaccination7.5 Years after Vaccination
Feline parvovirusFeline parvovirus 100%100%
Feline herpesvirusFeline herpesvirus 52%52%
Feline calicivirusFeline calicivirus 63%63%

48. Duration of Immunity StudyDuration of Immunity Study
FPV ConclusionsFPV Conclusions
2 doses of inactivated, adjuvanted FPV2 doses of inactivated, adjuvanted FPV
vaccine provide solid immunity for atvaccine provide solid immunity for at
least 7 yearsleast 7 years
1 cat still had solid protective Ab titer 141 cat still had solid protective Ab titer 14
years after vaccinationyears after vaccination

50. FPV -FPV - Disinfectants/AntisepticsDisinfectants/Antiseptics
Alcohols - ethyl, 70% isopropyl
Phenolics - hexachlorophene, lysol
Surfaces-active compounds - Quats, amphoterics
Biquanides - chlorhexidine
Halogens - chlorine (hypochlorite), iodines
Aldehydes - formaldehyde, glutaraldehyde
Ethylene oxide
Inactivate FPVInactivate FPV
Not Inactivate FPVNot Inactivate FPV

51. Panleukopenia ~Panleukopenia ~ ManagementManagement
Very important in shelters & pet storesVery important in shelters & pet stores
Vaccinate newly arrived cats immediatelyVaccinate newly arrived cats immediately
– MLV vaccineMLV vaccine
Place newly vaccinated cats in isolated,Place newly vaccinated cats in isolated,
disinfected cages away from other catsdisinfected cages away from other cats
Use proper disinfectantsUse proper disinfectants
– Household bleach (Clorox) 1:32Household bleach (Clorox) 1:32
– Cages, food and water dishes, floors, beddingCages, food and water dishes, floors, bedding
Prevent spread of virus by personnelPrevent spread of virus by personnel
– Hands and clothingHands and clothing
– shoesshoes

52. BuddiesBuddies