Commercially Available Enzyme-Linked Immunosorbent Assay and Polymerase Chain Reaction Tests for Detection of Feline Immunodeficiency Virus Infection

BACKGROUND

Feline immunodeficiency virus (FIV) infection is an important cause of disease of cats worldwide. Initial screening is commonly performed by commercially available point-of-care (POC) ELISA tests. Confirmatory testing for positive POC test results is recommended. Polymerase chain reaction (PCR) tests for FIV are commonly used additional testing methods; however, reported measures of diagnostic accuracy vary widely between PCR tests, making interpretation of results difficult.

HYPOTHESIS/OBJECTIVE

There is very good agreement between results of a commercially available PCR test and a POC ELISA test for FIV for specimens collected from owned and shelter-housed cats.

ANIMALS

Blood samples from 168 cats from 2 adoption guarantee shelters, an FIV Sanctuary, and 64 private homes were used.

METHODS

This was a prospective study. Whole blood samples were collected in K₂ -EDTA, divided, and submitted for PCR and ELISA testing. Follow-up whole blood samples were collected in lithium heparin from cats with discordant results and submitted for virus isolation (VI).

RESULTS

There was very good agreement between ELISA and PCR (kappa 0.87; P < .001; 95% CI 0.79, 0.95). Of 168 cats, eleven had discordant ELISA/PCR results: 7 ELISA+/PCR- and 4 ELISA-/PCR+. Using VI as a reference standard, there were 4 false-positive PCR results, 5 false-positive ELISA results, and 1 false-negative PCR result (1 cat lost to follow-up).

CONCLUSIONS AND CLINICAL IMPORTANCE

While there was good agreement between the POC ELISA and PCR tests, the discordant results highlight the importance of cautious interpretation of test results and the necessity of confirmatory testing.

Signalment changes in canine leptospirosis between 1970 and 2009

BACKGROUND

Previous studies have identified large breed, male, outdoor dogs of herding or working groups to be at increased risk for Leptospira infection. Exposure risk factors may change over time, altering the signalment of dogs most commonly diagnosed with leptospirosis.

OBJECTIVES

The objectives of this study were to evaluate possible signalment changes by decade in canine leptospirosis cases diagnosed at university veterinary hospitals in the United States and Canada using reports to the Veterinary Medical DataBase (VMDB) over a 40-year period (1970-2009).

ANIMALS

One thousand and ninety-one dogs with leptospirosis diagnosed among 1,659,146 hospital visits.

METHODS

Hospital prevalence of leptospirosis by decade was determined by age, sex, weight, and breed groups. Multivariable logistic regression models were created to evaluate the association between variables and the odds of disease for each decade.

RESULTS

Veterinary Medical DataBase hospital prevalence of leptospirosis in dogs, after a marked decrease in the 1970s and low rates in the 1980s, began increasing in the 1990s. Hospital prevalence significantly increased in dogs between 2 and 9.9 years of age (P < .05) and in male dogs (P < .05) in each decade since the 1980s. Among weight groups in the most recent decade (2000-2009), dogs weighing <15 pounds had the greatest odds of being diagnosed with leptospirosis (P = .003).

CONCLUSIONS AND CLINICAL IMPORTANCE

Hospital prevalence rates by age, weight, sex, and breed groups differed by decade. These changes may reflect changes in exposure risk, Leptospira vaccination practices for dogs, or both.

Prevalence, risk factors, and genetic diversity of Bartonella henselae infections in pet cats in four regions of the United States

Blood was collected from a convenience sample of 271 pet cats aged 3 months to 2 years (mean age, 8 months, median and mode, 6 months) between May 1997 and September 1998 in four areas of the United States (southern California, Florida, metropolitan Chicago, and metropolitan Washington, D.C.). Sixty-five (24%) cats had Bartonella henselae bacteremia, and 138 (51%) cats were seropositive for B. henselae. Regional prevalences for bacteremia and seropositivity were highest in Florida (33% and 67%, respectively) and California (28% and 62%, respectively) and lowest in the Washington, D.C. (12% and 28%, respectively) and Chicago (6% and 12%, respectively) areas. No cats bacteremic with B. clarridgeiae were found. The 16S rRNA type was determined for 49 B. henselae isolates. Fourteen of 49 cats (28.6%) were infected with 16S rRNA type I, 32 (65.3%) with 16S rRNA type II, and three (6.1%) were coinfected with 16S rRNA types I and II. Flea infestation was a significant risk factor for B. henselae bacteremia (odds ratio = 2.82, 95% confidence interval, 1.1 to 7.3). Cats >or=13 months old were significantly less likely to be bacteremic than cats <or=6 months old (odds ratio = 0.18, 95% confidence interval, 0.05 to 0.61). Flea infestation, adoption from a shelter or as a stray cat, hunting, and being from Florida or California were significant risk factors for B. henselae seropositivity. DNA fingerprint was significantly associated with region (P = 0.03) and indoor/outdoor status of cats (P = 0.03).

Time trends and risk factors for diabetes mellitus in dogs: analysis of veterinary medical data base records (1970-1999)

The objectives of the study were to identify recent trends in the prevalence of diabetes mellitus (DM) in dogs and to identify host risk factors. Veterinary Medical Data Base (VMDB) electronic records of 6860 dogs with a diagnosis of DM (VMDB code 870178500) between 1970 and 1999 were evaluated to determine time trends. Records of 6707 dogs with DM and 6707 frequency matched dogs with any diagnosis other than DM from the same teaching hospitals in the same year, selected as controls, were evaluated for risk factor analysis. The prevalence of DM in dogs presented to veterinary teaching hospitals increased from 19 cases per 10,000 admissions per year in 1970 to 64 cases per 10,000 in 1999, while the case-fatality rate decreased from 37% to 5%. The hospital prevalence of DM was consistently greater over time in older compared with younger dogs with the highest prevalence occurring in dogs 10-15 years of age. Dogs weighing <22.7 kg had a significantly (P<0.001) greater risk of DM compared with heavier dogs. Female dogs had an increased risk of DM compared with males (P<0.001).

Extracellular Bartonella henselae and artifactual intraerythrocytic pseudoinclusions in experimentally infected cats

Blood, spleen and liver of specific pathogen-free (SPF) cats and SPF cats experimentally infected with Bartonella henselae were examined. Using immunohistochemical labeling, no intracellular B. henselae were observed in tissues of any cats, but extracellular B. henselae were detected in tissues of infected cats. Pseudoinclusions were detected in erythrocytes of all cats using electron microscopy.

Immune response of neonatal specific pathogen-free cats to experimental infection with Bartonella henselae

The purpose of this study was to determine whether neonatal cats develop and maintain a persistent bacteremia for longer than do adult cats with a normal mature immune system, and whether neonatal cats are susceptible to infection with Bartonella henselae by oral inoculation. Neonatal specific pathogen-free (SPF) cats were inoculated with B. henselae intradermally (n = 4) or orally (n = 5) or with 0.9% NaCl (n = 2). Blood was collected periodically through 16 weeks post-inoculation (PI) for serology, bacteriology and complete blood count. Cats inoculated orally or intradermally at 3-5 days of age were bacteremic through 12-16 weeks PI, similar to what is documented for adult cats inoculated intradermally or intravenously. One cat inoculated at age 2 weeks was bacteremic through 10 weeks PI; the other was not bacteremic. Intradermally inoculated neonatal cats produced serum IgG antibodies to B. henselae but orally inoculated neonatal cats did not. Infected cats with and without serum IgG antibodies to B. henselae became blood-culture negative simultaneously, suggesting that IgG is not required to clear bacteremia.

Evidence of reproductive failure and lack of perinatal transmission of Bartonella henselae in experimentally infected cats

Five female specific pathogen-free (SPF) cats inoculated intradermally with B. henselae and bacteremic for 4 weeks, and one cat inoculated with 0.9% NaCl, were bred with uninfected SPF male cats. The uninfected female became pregnant with one breeding, while three infected cats became pregnant 1-12 weeks later, after repeated breedings. Two infected females either did not become pregnant or maintain pregnancies despite repeated breedings. Infected cats produced anti-B. henselae IgM and IgG antibodies. Fetuses and kittens of infected cats were not infected and did not produce anti-B. henselae antibodies. Male cats bred with infected females did not become infected or seroconvert. Maternal anti-B. henselae IgG antibodies detected in sera of kittens 2 weeks post-partum were no longer detectable 10 weeks post-partum. These findings suggest that B. henselae causes reproductive failure in female cats, but is not transmitted transplacentally, in colostrum or milk, or venereally. Infected cats immunosuppressed with methylprednisolone acetate after their kittens were weaned had no detectable bacteria in tissues, suggesting that they were no longer infected.

Experimental infection of young specific pathogen-free cats with Bartonella henselae

Eighteen 12-week-old specific pathogen-free cats, blood culture- and serum antibody-negative for Bartonella henselae, were randomly allocated to groups and were intravenously inoculated with 10(10) (group 1), 10(8) (group 2), or 10(6) (group 3) B. henselae or with saline (group 4) or were not inoculated (group 5). Cats were humanely killed at 2, 4, 8, 16, and 32 weeks after inoculation. All B. henselae-inoculated cats were bacteremic by 2 weeks after infection. Bacteremia persisted until 32 weeks after infection in 1 cat. Cats in groups 1 and 2 had fever (>39.7 degrees C) and partial anorexia by 2 weeks after infection that lasted 2-7 days. All infected cats had Bartonella-specific IgM and IgG serum antibodies and lymphocyte blastogenic responses. Histopathologic lesions were observed in multiple organs of infected cats through 8 weeks after infection. Cats were readily infected with B. henselae by intravenous inoculation, developed histopathologic lesions that apparently resolved, and developed B and T lymphocyte responses to infection.

Use of the urine cortisol: creatinine ratio to monitor treatment response in dogs with pituitary-dependent hyperadrenocorticism

OBJECTIVE

To determine the usefulness of measuring urine cortisol:creatinine ratio (UCCR) as a means of monitoring response to mitotane treatment in dogs with pituitary-dependent hyperadrenocorticism (PDH).

DESIGN

Case series.

ANIMALS

51 clinically normal dogs and 21 dogs with PDH.

PROCEDURE

The reference range for the UCCR was determined by measuring the ratio in 51 clinically normal dogs. The usefulness of measuring UCCR in evaluating response of 21 dogs with PDH to treatment with mitotane was evaluated by comparing ACTH-stimulated blood cortisol concentrations with UCCR at the end of the induction phase of treatment (13 dogs) and during the maintenance phase of treatment (21).

RESULTS

UCCR was not useful for identifying dogs with inadequate adrenal reserves at the end of the induction phase of treatment or during the maintenance phase. The UCCR was useful for identifying dogs in which control of cortisol secretion was not adequate.

CLINICAL IMPLICATIONS

UCCR should not be used for evaluation of dogs during the induction phase of treatment, because the potential consequences of not identifying dogs with inadequate adrenal reserves are great. The UCCR may be useful as an adjunct means of monitoring treatment response during the maintenance phase of treatment. However, the ACTH stimulation test remains a necessary component when monitoring response to treatment in dogs with PDH receiving mitotane.

Diagnosis of canine hyperadrenocorticism

Diagnosis of canine hyperadrenocorticism can only be made when a suspicion of the disorder persists after completion of a thorough history and physical examination. The first diagnostic testing steps include a complete blood count, serum biochemical tests, and urinalysis with urine culture. Radiography or ultrasonography may also be necessary, depending on physical findings. Screening tests are next applied to support or exclude the clinical diagnosis of hyperadrenocorticism. After the diagnosis has been made, discrimination tests are applied to determine whether the cause is pituitary or adrenal. The limitations of screening tests, particularly in the presence of nonadrenal diseases, cannot be overemphasized. We recommend that neither screening tests nor discrimination tests for hyperadrenocorticism be used in dogs with concurrent nonadrenal disease.

Response to high-dose radioactive iodine administration in cats with thyroid carcinoma that had previously undergone surgery

Seven cats with thyroid carcinomas that had previously undergone surgical removal of neoplastic tissue were treated with 30 mCi of radioactive iodine (131I). Six of the cats had clinical signs of hyperthyroidism; 1 did not. There were no complications associated with 131I treatment, and clinical signs resolved in all cats. Technetium scans of 4 cats made after treatment did not have evidence of isotope uptake. In the remaining 3 cats, small areas of isotope uptake, the intensity of which was equal to or less than the intensity of uptake in the salivary glands, were seen. All 7 cats became hypothyroid after treatment; 4 required L-thyroxine supplementation. One cat was alive 33 months after treatment. The other 6 cats were euthanatized because of unrelated diseases 10 to 41 months after treatment.

Primary hypoparathyroidism in a cat

Primary hypoparathyroidism caused by lymphocytic parathyroiditis was diagnosed in a cat. Other causes of hypocalcemia (ethylene glycol toxicosis, phosphate enema administration, pancreatitis, renal insufficiency, and malabsorption) were ruled out on the basis of history, clinicopathologic data, and lack of supportive clinical signs, which in this cat included inappetence and tetanic muscle spasms. The diagnosis was confirmed by histologic examination of a surgically excised thyroparathyroid lobe that comprised lack of recognizable parathyroid tissue and a lymphocytic plasmacytic infiltrate adjacent to the cranial pole. A treatment regimen similar to that for iatrogenic postthyroidectomy hypoparathyroidism was successful in controlling clinical signs of the disease.