MANAGEMENT OF



OPERATIONAL PROTOCOL:

MANAGEMENT OF

FELINE UPPER RESPIRATORY DISEASE

EITIOLOGY

Feline Upper Respiratory Disease can be caused by any one or combination of the following infectious agents: feline herpesvirus (FHV-I); feline calicivirus (FCV); chlamydophila; Bordetella; and Mycoplasma. FHV-I is the most common with 50% – 70% of all adult cats having antibodies to the virus. In addition to upper respiratory signs FHV-I may produce conjunctivitis and/or corneal ulcers.

DISEASE TRANSMISSION

Pathogens responsible for URI are highly contagious and transmitted by both aerosol (sneezing) and fomites (hands, clothing, food/litter containers etc). Staff and volunteers working with URI cats must: wear protective outer clothing (coveralls, smocks) that are put on and taken off in the Isolation room and laundered at least daily; not work in any other cat areas that day or if necessary to do so, then finish working the regular areas before entering the Isolation. There can be no back-and-forth traffic between these areas. The Isolation must be physically separated from the regular areas with intervening doors being kept shut and the direction of ventilation flow coming from the “clean” areas into Isolation then exhausted out of the building. Not adhering to these basic rules of disease control will jeopardize the lives of healthy cats.

ISOLATION

There must be a zero tolerance for sneezing cats in adoption and stray areas.

Any cat showing one or more of the following signs should immediately be placed in the Isolation Room:

1. Clear or colored discharge form the eyes and/or nose

2. Sneezing

3. Ulcers on nose, lips or tongue

Prior to the above signs, a cat sitting quietly in its cage with piloerection (raised hair) possibly “sore” looking eyes and often having a reduced appetite should be suspected of incubating URI. These cats are contagious and should be appropriately handled.

It is important that Isolations rooms lend themselves to cleaning, not contain shelter supplies and be kept well ventilated (ideally 12 complete air changes per hour) and not overcrowded.

When cleaning cat cages, cats must not be allowed to wander on the floor but be confined either in a clean wire cage or remain in their own cage. The causative organisms of URI are usually killed by routine disinfection (e.g. A-33), use of bleach or other chlorine-based disinfectants is not necessary on a daily basis but either that or steam-cleaning is recommended on a monthly or as-can-do schedule.

Cats remain in the Isolation until discharges and sneezing have stopped. These cats may then be transferred to the Post-URD Adoption (PURDA) room. This room contains only cats that have recovered from clinical signs of URI and they must never be placed back into regular adoption areas.

TREATMENT

Level I – Cat exhibiting: watery, clear discharge from eyes/nose; sneezing; eat/drink OK.

Treatment – monitor hydration and appetite; feed wet as well as dry food; watch for progression of signs.

Assessment: mild viral URI without secondary bacterial involvement.

Level II – signs as per Level I and in addition any one or a combination of: fever; severe lethargy; inappetance; dehydration.

Treatment - in addition to Level I: S/C fluids for dehydration; to reduce fever and promote eating use tolfenamic acid (Tolfedine) given either orally or by sub-cutaneous injection @ 4.0 mg/kg once daily day for 3 treatments.

Assessment: severe primary viral infection.

Level III – Yellow or green eye/nasal discharge with or without any of the Level I/II signs.

Treatment – treat Level I/II signs as indicated. In addition: at least twice daily use a moistened swab to remove ocular/nasal discharges; for infected eyes use an antibiotic ophthalmic ointment not containing steroids, three times daily: start cat on oral antibiotics.

Assessment: viral with secondary bacterial infection. Antibiotics are now indicated.

Past culture and sensitivity results indicate the following as best choice oral antibiotics:

• Clavamox suspension: 11 - 22 mg/kg or standard adult cat dose of 62.5 mg Q12H (twice daily)

• Chloramphenicol susp: 50 mg/kg Q12H

• Doxycycline suspension: 5 mg/kg Q12H (this is the antibiotic of choice for all three primary bacterial causes - Chlamydophila; Boretella; Mycoplasma). Use with caution in kittens.

Other antibiotics:

• Enrofloxacin (Baytril) tabs: 5 mg/kg Q24H (once daily). Not to be given to kittens

• Azithromycin (Zithromax): 5 mg/kg once daily for 4 days. If clinical signs persist then continue every other day for one week. This antibiotic should be reserved for suspected Mycoplasma or unresponsive secondary bacterial invaders.

• Cepha-group antibiotics (e.g. Cepha-Drops™, cephalexin, Novo-lexin™): seldom effective against URD bacterial disease; however a good choice when used at recommended dose for Bordetella.

Use of Enrofloxacin and Azithromycin should be reserved for severe bacterial disease unresponsive to other antibiotics.

The selection of “best choice” antibiotics should be rotated monthly. That is to say, for example, in January all NEW Level III cases will be started on Clavamox; in February all new cases will be started on Chloramphenicol; and in March on Doxy; in April the cycle repeats itself. Cases not responding to the “flavour of the month” will be switched to another choice.

If ocular infections do not respond within 5 days then it is usually best to change e.g. polymixin/neomycin combinations to chloramphenicol or to tetracycline ophthalmic ointments.

Level IV - yellow/green eye discharge without other URI signs. Eye infection may be unilateral.

Assessment: most likely Chlamydophila or Mycoplasma. A differential possibility would be FHV-1 ocular lesion due to chronic infection.

Treatment – tetracycline containing eye ointment and if infection is persistent and oral doxycycline.

– If unresponsive or if corneal ulcer present consult a veterinarian.

– Duration of treatment – 3 weeks

Level V – Cats:

• Not responsive to 2 weeks of treatment.

• Relapsing after successful treatment

• Showing signs additional to and not consistent with URI, such as vomiting, diarrhea, wasting, jaundice.

Treatment – with these cats consideration must be given to the possibility of them having other concomitant diseases such as Panleukopenia, Feline Leukemia, Feline Aids.

A timely decision to seek veterinary assistance or to euthanize needs to be made.

POST-TREATMENT CONSIDERATIONS

Cats that have clinically recovered commonly continue to shed URI virus for three week or more. This means that these cats coming back into adoption areas are sources of infection. Also of concern is the carrier state that develops in most recovered cats and that can frequently result in disease relapse. Ideally recovered cats would be placed and maintained in a separate adoption area reserved strictly for them. Potential adopters would view these cats after viewing the regular adoption area and for that day be restricted from going back into the regular adoption room.

EUTHANASIA DECISIONS

Regardless of any other factors, sneezing cats must immediately be removed from areas sheltering apparently healthy cats. This holds true even if Isolation is full and there are no immediately available foster homes.

The decision for euthanasia is always dependent upon available resources. When there is no more room in Isolation nor fostering there is an immediate need to make a euthanasia decision from among the group of URI sick cats. The decision will be based on future adoptability, severity of disease, response to treatment, the probability of other concomitant disease and any other factors the Branch Manager considers pertinent.

FOSTERING URI CATS AND KITTENS

– Done properly, this is an excellent strategy for reducing and controlling URI in the shelter.

– Only competent, knowledgeable and capable fosterers are selected.

– Only mild cases of URD are fostered.

– Fosterers have ready access to shelter and veterinary support

– “Healthy” cats are not fostered in the same home until a 4 week lapse from the last URD cat.

– Fostering healthy shelter kittens should take precedence over all URD fostering.

TRANSFER TO APPROVED RESCUE GROUPS

– Cats and kittens with active URI can be privately transferred (i.e. not by regular BC SPCA transfer vehicles) to approved cat rescue groups that have an URI isolation room.

– Within 24 hours of transport each cat/kitten must be examined by a licensed veterinarian and deemed fit for travel.

– Rescue groups accepting these cats must be aware of and willing to accept the risks and costs that may be associated with the care of these sick cats.

Version: BCSPCA/Ops Proto URI Management 080208

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