Haemoplasmosis in cats: European guidelines from the ABCD on prevention and management

OVERVIEW

Haemoplasmas are haemotropic bacteria that can induce anaemia in a wide range of mammalian species. Infection in cats: Mycoplasma haemofelis is the most pathogenic of the three main feline haemoplasma species known to infect cats. ' Candidatus Mycoplasma haemominutum' and ' Candidatus Mycoplasma turicensis' are less pathogenic but can result in disease in immunocompromised cats. Male, non-pedigree cats with outdoor access are more likely to be haemoplasma infected, and ' Candidatus M haemominutum' is more common in older cats. All three haemoplasma species can be carried asymptomatically. Transmission: The natural mode of transmission of haemoplasma infection is not known, but aggressive interactions and vectors are possibilities. Transmission by blood transfusion can occur and all blood donors should be screened for haemoplasma infection.

DIAGNOSIS AND TREATMENT

PCR assays are the preferred diagnostic method for haemoplasma infections. Treatment with doxycycline for 2-4 weeks is usually effective for M haemofelis-associated clinical disease (but this may not clear infection). Little information is currently available on the antibiotic responsiveness of ' Candidatus M haemominutum' and ' Candidatus M turicensis'.

Small animal disease surveillance: GI disease and salmonellosis

Presentation for gastrointestinal (GI) disease comprised 2.2 per cent of cat, 3.2 per cent of dog and 2.2 per cent of rabbit consultations between April 1, 2016 and March 31, 2017Diarrhoea and vomiting without blood were the most frequently reported GI disease clinical signs (34.4 and 38.9 per cent in cats and 42.8 and 37.3 per cent in dogs, respectively)The mean percentage of samples testing positive for Salmonella in dogs was double that in cats (0.82 per cent and 0.41 per cent, respectively) from January 1, 2011 to December 31, 2016In dogs, autumn was associated with a greater proportion of Salmonella-positive sample submissions; no clear suggestion of seasonal variation in cats was observedIn both cats and dogs, isolates belonging to Salmonella enterica group B serotypes were the most common (68.9 per cent in cats and 55.0 per cent in dogs).

Mycoplasma tullyi sp. nov., isolated from penguins of the genus Spheniscus

A mycoplasma isolated from the liver of a dead Humboldt penguin (Spheniscus humboldti) and designated strain 56A97^T, was investigated to determine its taxonomic status. Complete 16S rRNA gene sequence analysis indicated that the organism was most closely related to Mycoplasma gallisepticum and Mycoplasma imitans(99.7 and 99.9 % similarity, respectively). The average DNA-DNA hybridization values between strain 56A97^T and M. gallisepticum and M. imitans were 39.5 and 30 %, respectively and the Genome to Genome Distance Calculator gave results of 29.10 and 23.50 %, respectively. The 16S-23S rRNA intergenic spacer was 72-73 % similar to M. gallisepticum strains and 52.2 % to M. imitans. A partial sequence of rpoB was 91.1-92 % similar to M. gallisepticum strains and 84.7 % to M. imitans. Colonies possessed a typical fried-egg appearance and electron micrographs revealed the lack of a cell wall and a nearly spherical morphology, with an electron-dense tip-like structure on some flask-shaped cells. The isolate required sterol for growth, fermented glucose, adsorbed and haemolysed erythrocytes, but did not hydrolyse arginine or urea. The strain was compared serologically against 110 previously described Mycoplasma reference strains, showing that, except for M. gallisepticum, strain 56A97^T is not related to any of the previously described species, although weak cross-reactions were evident. Genomic information, serological reactions and phenotypic properties demonstrate that this organism represents a novel species of the genus Mycoplasma, for which the name Mycoplasma tullyi sp. nov. is proposed; the type strain is 56A97^T (ATCC BAA-1432^T, DSM 21909^T, NCTC 11747^T).

Patterns of antimicrobial agent prescription in a sentinel population of canine and feline veterinary practices in the United Kingdom

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Antimicrobial agent prescription was monitored in a large UK population of cats and dogs over a 2 year period (2014–2016).

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Systemic antimicrobial agents were prescribed more frequently to cats; topical prescription was more frequent in dogs.

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A temporal reduction (2014–2016) in antimicrobial agent prescription was observed in both cats and dogs in this population.

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Premises which prescribed antimicrobial agents commonly to cats generally also prescribed commonly to dogs.

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The most frequently prescribed antibiotics were cefovecin in cats and clavulanic acid potentiated amoxicillin in dogs.

Antimicrobial resistance is an increasingly important global health threat and the use of antimicrobial agents is a key risk factor in its development. This study describes antimicrobial agent prescription (AAP) patterns over a 2 year period using electronic health records (EHRs) from booked consultations in a network of 457 sentinel veterinary premises in the United Kingdom. A semi-automated classification methodology was used to map practitioner defined product codes in 918,333 EHRs from 413,870 dogs and 352,730 EHRs from 200,541 cats, including 289,789 AAPs. AAP as a proportion of total booked consultations was more frequent in dogs (18.8%, 95% confidence interval, CI, 18.2–19.4) than cats (17.5%, 95% CI 16.9–18.1). Prescription of topical antimicrobial agents was more frequent in dogs (7.4%, 95% CI 7.2–7.7) than cats (3.2%, 95% CI 3.1–3.3), whilst prescription of systemic antimicrobial agents was more frequent in cats (14.8%, 95% CI 14.2–15.4) than dogs (12.2%, 95% CI 11.7–12.7). A decreasing temporal pattern was identified for prescription of systemic antimicrobial agents in dogs and cats. Premises which prescribed antimicrobial agents frequently for dogs also prescribed frequently for cats. AAP was most frequent during pruritus consultations in dogs and trauma consultations in cats. Clavulanic acid potentiated amoxicillin was the most frequently prescribed antimicrobial agent in dogs (28.6% of prescriptions, 95% CI 27.4–29.8), whereas cefovecin, a third generation cephalosporin, was the most frequently prescribed antimicrobial agent in cats (36.2%, 95% CI 33.9–38.5). This study demonstrated patterns in AAP over time and for different conditions in a population of companion animals in the United Kingdom.

Anaplasma, Ehrlichia and Rickettsia species infections in cats: European guidelines from the ABCD on prevention and management

OVERVIEW

Anaplasma species, Ehrlichia species and Rickettsia species are vector-borne pathogens infecting a wide variety of mammals, but causing disease in very few of them. Infection in cats: Anaplasma phagocytophilum is the most important feline pathogen among these rickettsial organisms, and coinfections are possible. Little information is available on the pathogenesis of these agents in cats. Clinical signs are usually reported soon after tick infestation. They are mostly non-specific, consisting of fever, anorexia and lethargy. Joint pain may occur. Infection in humans: Some rickettsial species ( A phagocytophilum, Ehrlichia chaffeensis, Ehrlichia ewingii, Rickettsia conorii, Rickettsia rickettsii, Rickettsia felis, Rickettsia typhi and Candidatus Neoehrlichia mikurensis) are of zoonotic concern. Direct contact with cat saliva should be avoided because of potential contamination by R felis. Infected cats are 'sentinels' of the presence of rickettsial pathogens in ticks and fleas in a given geographical area, and they signal a risk for people exposed to vectors.

Small animal disease surveillance: respiratory disease

Presentation for respiratory disease comprised 1.7 per cent, 2.3 per cent and 2.5 per cent of canine, feline and rabbit consultations, respectively, between January 2014 and December 2015. Coughing was the most frequent respiratory sign reported in dogs (71.1 per cent of consultations); in cats it was sneezing (42.6 per cent). Mean percentage of samples testing positive for feline calicivirus (FCV) was 30.1 per cent in 2014 and 27.9 per cent in 2015. January was the month with the highest percentage of FCV-positive samples in both 2014 and 2015.

Canine babesiosis and tick activity monitored using companion animal electronic health records in the UK

Recent publications highlighting autochthonous Babesia canis infection in dogs from Essex that have not travelled outside the UK are a powerful reminder of the potential for pathogen emergence in new populations. Here the authors use electronic health data collected from two diagnostic laboratories and a network of 392 veterinary premises to describe canine Babesia cases and levels of Babesia concern from January 2015 to March 2016, and the activity of ticks during December 2015–March 2016. In most areas of the UK, Babesia diagnosis in this population was rare and sporadic. In addition, there was a clear focus of Babesia cases in the affected area in Essex. Until February 2016, analysis of health records indicated only sporadic interest in Babesia largely in animals coming from overseas. Following media coverage in March 2016, there was a spike in owner concern that was geographically dispersed beyond the at-risk area. Tick activity (identified as ticks being removed from animals in veterinary consultations) was consistent but low during the period preceding the infections (<5 ticks/10,000 consultations), but increased in March. This highlights the use of electronic health data to describe rapidly evolving risk and concern that follows the emergence of a pathogen.

European molecular epidemiology and strain diversity of feline calicivirus

Feline calicivirus (FCV) causes a variable syndrome of upper respiratory tract disease, mouth ulcers and lameness. A convenience-based prospective sample of oropharyngeal swabs (n=426) was obtained from five countries (France, Germany, Greece, Portugal and the UK). The prevalence of FCV by virus isolation was 22.2 per cent. Multivariable analysis found that animals presenting with lymphoplasmacytic gingivitis stomatitis complex were more likely to test positive for FCV infection. Furthermore, vaccinated cats up to 48 months of age were significantly less likely to be infected with FCV than unvaccinated animals of similar ages. Phylogenetic analysis based on consensus sequences for the immunodominant region of the capsid gene from 72 FCV isolates identified 46 strains. Thirteen of the 14 strains with more than one sequence were restricted to individual regions or sites in individual countries; the exception was a strain present in two sites close to each other in France. Four strains were present in more than one household. Five colonies, four of which were rescue shelters, had multiple strains within them. Polymerase sequence suggested possible rare recombination events. These locally, nationally and internationally diverse FCV populations maintain a continuous challenge to the control of FCV infection and disease.

Lungworm disease in cats: ABCD guidelines on prevention and management

OVERVIEW

Cardiopulmonary nematodes are emerging parasites of cats in Europe. A number of helminth parasites may be involved. The most prevalent lungworm in domestic cats is Aelurostrongylus abstrusus. Oslerus rostratus and Troglostrongylus species are found mainly in wild cats. The trichurid Capillaria aerophila has a low host specificity and is not uncommon in cats. Additionally the lung flukes Paragonimus species are reported in many species outside of Europe, including cats.

CLINICAL SIGNS

Lungworm infections may be asymptomatic, or cause mild to severe respiratory signs, dependent on the worm species and burden; mixed infections are observed. Kittens can be vertically infected and may develop a more severe disease. Affected cats show a productive cough, mucopurulent nasal discharge, tachypnoea, dyspnoea and, in severe cases, respiratory failure and death.

MANAGEMENT

Early diagnosis and treatment greatly improves the prognosis. First-stage larvae can be easily detected in fresh faecal samples; the Baermann migration method is the enrichment technique of choice, but takes 24 h. Lungworm larvae can be found in tracheal swabs and bronchoalveolar lavage fluid, but with less sensitivity than in faeces. Molecular methods have been developed that exhibit high specificity and sensitivity, and allow diagnosis in the prepatent phase. Treatment options include fenbendazole paste, milbemycin oxime/praziquantel and various spot-on formulations. Severe cases should receive prompt medical care in an intensive care unit.

PREVENTION

Avoiding predation is at present the only preventive measure for pulmonary worms with indirect life cycles.

ZOONOTIC RISK

C aerophila has zoonotic potential, causing severe pulmonary disease in humans. Some Paragonimus species are also of zoonotic concern.

Streptococcal infections in cats: ABCD guidelines on prevention and management

OVERVIEW

Streptococcus canis is most prevalent in cats, but recently S equi subsp zooepidemicus has been recognised as an emerging feline pathogen.

S CANIS INFECTION

S canis is considered part of the commensal mucosal microflora of the oral cavity, upper respiratory tract, genital organs and perianal region in cats. The prevalence of infection is higher in cats housed in groups; and, for example, there may be a high rate of vaginal carriage in young queens in breeding catteries. A wide spectrum of clinical disease is seen, encompassing neonatal septicaemia, upper respiratory tract disease, abscesses, pneumonia, osteomyelitis, polyarthritis, urogenital infections, septicaemia, sinusitis and meningitis.

S EQUI SUBSP ZOOEPIDEMICUS INFECTION

S equi subsp zooepidemicus is found in a wide range of species including cats. It was traditionally assumed that this bacterium played no role in disease of cats, but it is now considered a cause of respiratory disease with bronchopneumonia and pneumonia, as well as meningoencephalitis, often with a fatal course. Close confinement of cats, such as in shelters, appears to be a major risk factor. As horses are common carriers of this bacterium, contact with horses is a potential source of infection. Additionally, the possibility of indirect transmission needs to be considered.

DIAGNOSIS

Streptococci can be detected by conventional culture techniques from swabs, bronchoalveolar lavage fluid or organ samples. Also real-time PCR can be used, and is more sensitive than culture.

TREATMENT

In suspected cases, treatment with broad-spectrum antibiotics should be initiated as soon as possible and, if appropriate, adapted to the results of culture and sensitivity tests.

West Nile virus infection in cats: ABCD guidelines on prevention and management

OVERVIEW

West Nile virus (WNV) is a zoonotic mosquito-borne virus with a broad host range that infects mainly birds and mosquitos, but also mammals (including humans), reptiles, amphibians and ticks. It is maintained in a bird-mosquito-bird transmission cycle. The most important vectors are bird-feeding mosquitos of the Culex genus; maintenance and amplification mainly involve passerine birds. WNV can cause disease in humans, horses and several species of birds following infection of the central nervous system.

INFECTION IN CATS

Cats can also be infected through mosquito bites, and by eating infected small mammals and probably also birds. Although seroprevalence in cats can be high in endemic areas, clinical disease and mortality are rarely reported. If a cat is suspected of clinical signs due to an acute WNV infection, symptomatic treatment is indicated.

Blood transfusion in cats: ABCD guidelines for minimising risks of infectious iatrogenic complications

OVERVIEW

The availability of blood components has increased the number of indications for transfusing cats, and fresh whole blood is readily accessible to clinicians because it can be taken from in-house donor cats or 'volunteer' feline blood donors. A certain amount of risk remains to the recipient cat, as immediate or delayed adverse reactions can occur during or after transfusion, related to immunemediated mechanisms. This article, however, focuses on adverse events caused by infectious agents, which may originate either from contamination of blood following incorrect collection, storage or transfusion, or from transfusion of contaminated blood obtained from an infected donor.

PREVENTION OF BLOOD CONTAMINATION

In cats, blood cannot be collected through a closed system and, therefore, collection of donor blood requires a multi-step manipulation of syringes and other devices. It is crucial that each step of the procedure is performed under the strictest aseptic conditions and that bacterial contamination of blood bags is prevented, as bacterial endotoxins can cause an immediate febrile reaction or even fatal shock in the recipient cat.

PREVENTION OF DISEASE TRANSMISSION

With a view to preventing transmission of blood-borne infectious diseases, the American College of Veterinary Internal Medicine has adopted basic criteria for selecting pathogens to be tested for in donor pets. The worldwide core screening panel for donor cats includes feline leukaemia virus, feline immunodeficiency virus, Bartonella species and feline haemoplasma. The list should be adapted to the local epidemiological situation concerning other vector-borne feline infections. The most practical, rapid and inexpensive measure to reduce transfusion risk is to check the risk profile of donor cats on the basis of a written questionnaire. Blood transfusion can never, however, be considered entirely safe.

Cytauxzoonosis in cats: ABCD guidelines on prevention and management

OVERVIEW

Cytauxzoon species are apicomplexan haemoparasites, which may cause severe disease in domestic cats, as well as lions and tigers. For many years, cytauxzoonosis in domestic cats was only reported in North and South America, but in recent years the infection has also been seen in Europe (Spain, France and Italy).

INFECTION

Cytauxzoon felis is the main species; it occurs as numerous different strains or genotypes and is transmitted via ticks. Therefore, the disease shows a seasonal incidence from spring to early autumn and affects primarily cats with outdoor access in areas where tick vectors are prevalent. Domestic cats may experience subclinical infection and may also act as reservoirs.

CLINICAL SIGNS

Cytauxzoonosis caused by C felis in the USA is an acute or peracute severe febrile disease with non-specific signs. Haemolytic anaemia occurs frequently; in some cats neurological signs may occur in late stages. The Cytauxzoon species identified in Europe differ from C felis that causes disease in the USA and are probably less virulent. The majority of infected cats have been healthy; in some cases anaemia was found, but disease as it occurs in the USA has not been reported to date.

DIAGNOSIS

Diagnosis is usually obtained by Cytauxzoon detection in blood smears and/or fine-needle aspirates from the liver, spleen and lymph nodes. PCR assays are able to detect low levels of parasitaemia and may be used for confirmation.

TREATMENT

Currently a combination of the antiprotozoal drugs atovaquone and azithromycin is the treatment of choice. Concurrent supportive and critical care treatment is extremely important to improve the prognosis. Cats that survive the infection may become chronic carriers for life.

PREVENTION

Cats with outdoor access in endemic areas should receive effective tick treatment.

Hepatozoonosis in cats: ABCD guidelines on prevention and management

OVERVIEW

Hepatozoonosis of domestic cats has been reported in several countries, mainly as a subclinical infection.

DISEASE AGENT

Infection has been described mostly in areas where canine infection is present and, in recent years, Hepatozoon felis has been identified as a distinct species by molecular techniques. The vector for feline hepatozoonosis remains unknown and the pathogenesis has not been elucidated.

INFECTION IN CATS

Feline hepatozoonosis is mainly a subclinical infection and few cases have been reported with clinical signs. The diagnosis of hepatozoonosis in cats can be made by observation of parasite gamonts in blood smears, parasite meronts in muscles by histopathology, and detection of parasite DNA in blood and tissue by PCR.

DISEASE MANAGEMENT

The treatment of choice is not known, but single cases have been treated with doxycycline or oxytetracycline and primaquine. Although the mode of transmission and the type of vector is not known, preventive treatment against blood-sucking vectors (fleas and ticks) is advised.

Something old, something new: Update of the 2009 and 2013 ABCD guidelines on prevention and management of feline infectious diseases

OVERVIEW

The ABCD has published 34 guidelines in two Special Issues of the Journal of Feline Medicine and Surgery (JFMS): the first in July 2009 (Volume 11, Issue 7, pages 527-620) and the second in July 2013 (Volume 15, Issue 7, pages 528-652). The present article contains updates and new information on 18 of these (17 disease guidelines and one special article 'Prevention of infectious diseases in cat shelters'). For detailed information, readers are referred to the guidelines published in the above-mentioned JFMS Special Issues.

Feline injection-site sarcoma: ABCD guidelines on prevention and management

OVERVIEW

In cats, the most serious of adverse effects following vaccination is the occurrence of invasive sarcomas (mostly fibrosarcomas): so-called 'feline injection-site sarcomas' (FISSs). These develop at sites of previous vaccination or injection. They have characteristics that are distinct from those of fibrosarcomas in other areas and behave more aggressively. The rate of metastasis ranges from 10-28%.

PATHOGENESIS

The pathogenesis of these sarcomas is not yet definitively explained. However, chronic inflammatory reactions are considered the trigger for subsequent malignant transformation. Injections of long-acting drugs (such as glucocorticoids, and others) have been associated with sarcoma formation. Adjuvanted vaccines induce intense local inflammation and seem therefore to be particularly linked to the development of FISS. The risk is lower for modified-live and recombinant vaccines, but no vaccine is risk-free.

TREATMENT AND PREVENTION

Aggressive, radical excision is required to avoid tumour recurrence. The prognosis improves if additional radiotherapy and/or immunotherapy (such as recombinant feline IL-2) are used. For prevention, administration of any irritating substance should be avoided. Vaccination should be performed as often as necessary, but as infrequently as possible. Non-adjuvanted, modified-live or recombinant vaccines should be selected in preference to adjuvanted vaccines. Injections should be given at sites at which surgery would likely lead to a complete cure; the interscapular region should generally be avoided. Post-vaccination monitoring should be performed.

Borna disease virus infection in cats: ABCD guidelines on prevention and management

OVERVIEW

Borna disease virus (BDV) has a broad host range, affecting primarily horses and sheep, but also cattle, ostriches, cats and dogs. In cats, BDV may cause a non-suppurative meningoencephalomyelitis ('staggering disease').

INFECTION

The mode of transmission is not completely elucidated. Direct and indirect virus transmission is postulated, but BDV is not readily transmitted between cats. Vectors such as ticks may play a role and shrews have been identified as a potential reservoir host. Access to forested areas has been reported to be an important risk factor for staggering disease.

DISEASE SIGNS

It is postulated that BDV may infect nerve endings in the oropharynx and spread via olfactory nerve cells to the central nervous system. A strong T-cell response may contribute to the development of clinical disease. Affected cats develop gait disturbances, ataxia, pain in the lower back and behavioural changes.

DIAGNOSIS

For diagnostic purposes, detection of viral RNA by reverse transcription PCR in samples collected from cats with clinical signs of Borna disease can be considered diagnostic. Serology is of little value; cats without signs of Borna disease may be seropositive and yet not every cat with BDV infection has detectable levels of antibodies.

HUMAN INFECTION

A hypothesis that BDV infection may be involved in the development of selected neurological disorders in man could not be confirmed. A research group within the German Robert Koch Institute studied the potential health threat of BDV to humans and concluded that BDV was not involved in the aetiology of human psychiatric diseases.

Matrix vaccination guidelines: 2015 ABCD recommendations for indoor/outdoor cats, rescue shelter cats and breeding catteries

OVERVIEW

In 2013, the ABCD published 'Matrix vaccination guidelines: ABCD recommendations for indoor/outdoor cats, rescue shelter cats and breeding catteries' in a Special Issue of the Journal of Feline Medicine and Surgery (Volume 15, Issue 7, pages 540-544). The ABCD's vaccination recommendations were presented in tabulated form, taking into account that there is no universal vaccination protocol for all cats. To support the veterinarian's decision making, recommendations for four lifestyles were made: for cats with outdoors access, cats kept solely indoors, rescue shelter cats and cats in breeding catteries. This update article follows the same approach, offering current and, where relevant, expanded recommendations.

Disinfectant choices in veterinary practices, shelters and households: ABCD guidelines on safe and effective disinfection for feline environments

OVERVIEW

Regardless of whether a pathogen is viral, bacterial, parasitic, fungal or an emerging unknown, the mainstay of infectious disease control is hygiene, and the cornerstone of good hygiene is effective disinfection.

CHALLENGES AND CURRENT CHOICES

Certain pathogens present a challenge to kill effectively: parvovirus, protozoal oocysts, mycobacteria, bacterial spores and prions resist most disinfectants but can be eliminated through heat, especially steam, which will kill protozoal oocysts. Heat is the safest and most effective disinfectant, but cannot be universally applied. Temperatures in washing machines and dishwashers should be at least 60 °C to eliminate pathogenic spores and resistant viruses. Enveloped viruses are susceptible to most disinfectants; of the non-enveloped viruses, parvovirus is recognised as being the most difficult to eradicate. Sodium hypochlorite is recommended for many applications: cleaning of floors, laundry, food preparation surfaces and utensils. Skin scrubs and rubs containing alcohols are more effective than those containing chlorhexidine, and less subject to contamination.

DISINFECTANTS TO AVOID

Deficiency of the enzyme UDP-glucuronosyl transferase renders the cat susceptible to the toxic effects of phenol-based disinfectants (including many essential oils), so these should be avoided in feline environments. Quaternary ammonium compounds (eg, benzalkonium chloride) are also probably best avoided.

THE FUTURE

Veterinary disinfection approaches in the future may include use of ultraviolet radiation and, increasingly, silver.

Surveillance of diarrhoea in small animal practice through the Small Animal Veterinary Surveillance Network (SAVSNET)

Using the Small Animal Veterinary Surveillance Network (SAVSNET), a national small animal disease-surveillance scheme, information on gastrointestinal disease was collected for a total of 76 days between 10 May 2010 and 8 August 2011 from 16,223 consultations (including data from 9115 individual dogs and 3462 individual cats) from 42 premises belonging to 19 UK veterinary practices. During that period, 7% of dogs and 3% of cats presented with diarrhoea. Adult dogs had a higher proportional morbidity of diarrhoea (PMD) than adult cats (P <0.001). This difference was not observed in animals <1 year old. Younger animals in both species had higher PMDs than adult animals (P < 0.001). Neutering was associated with reduced PMD in young male dogs. In adult dogs, miniature Schnauzers had the highest PMD. Most animals with diarrhoea (51%) presented having been ill for 2-4 days, but a history of vomiting or haemorrhagic diarrhoea was associated with a shorter time to presentation. The most common treatments employed were dietary modification (66% of dogs; 63% of cats) and antibacterials (63% of dogs; 49% of cats). There was variability in PMD between different practices. The SAVNET methodology facilitates rapid collection of cross-sectional data regarding diarrhoea, a recognised sentinel for infectious disease, and characterises data that could benchmark clinical practice and support the development of evidence-based medicine.

Bartonella species infection in cats: ABCD guidelines on prevention and management

OVERVIEW

Over 22 Bartonella species have been described in mammals, and Bartonella henselae is most common worldwide. Cats are the main reservoir for this bacterium. B henselae is the causative agent of cat scratch disease in man, a self-limiting regional lymphadenopathy, but also of other potentially fatal disorders in immunocompromised people.

INFECTION

B henselae is naturally transmitted among cats by the flea Ctenocephalides felis felis, or by flea faeces. A cat scratch is the common mode of transmission of the organism to other animals, including humans. Blood transfusion also represents a risk.

DISEASE SIGNS

Most cats naturally infected by B henselae do not show clinical signs but cardiac (endocarditis, myocarditis) or ocular (uveitis) signs may be found in sporadic cases. B vinsonii subspecies berkhoffii infection has reportedly caused lameness in a cat affected by recurrent osteomyelitis and polyarthritis.

DIAGNOSIS

Isolation of the bacterium is the gold standard, but because of the high prevalence of infection in healthy cats in endemic areas, a positive culture (or polymerase chain reaction) is not confirmatory. Other compatible diagnoses must be ruled out and response to therapy gives a definitive diagnosis. Serology (IFAT or ELISA) is more useful for exclusion of the infection because of the low positive predictive value (39-46%) compared with the good negative predictive value (87-97%). Laboratory testing is required for blood donors.

DISEASE MANAGEMENT

Treatment is recommended in the rare cases where Bartonella actually causes disease.