Panleukopenia...
Don’t let a fuzzy little Typhoid Mary sneak through your doors!
By Keri Weyenberg, Fourth-Year Veterinary Extern at Dane County Humane Society
A good Samaritan drops off a 10-week-old stray kitten at your shelter. It has diarrhea staining around his hind end and vomits once on initial exam, what is your initial impression? Intestinal parasites? gastroenteritis? What about panleukopenia?
Panleukopenia is a parvovirus with a multitude of pseudonyms: feline distemper, feline parvo, cat fever, infectious enteritis and, my favorite, cat typhoid. But whatever you choose to call it, Panleukopenia is a swift and deadly disease and can cause mass mortality in a shelter environment. It’s usually passed by fecal-oral transmission and does not require direct contact among cats to be passed. If there is a concurrent URI, the virus may also be present in respiratory secretions. It can also be passed from mother to their kittens through the placenta. Without proper disinfection it can remain infective in the environment for years.
It’s native to every region throughout the US, and can be found in almost every corner of the globe. It is most prevalent in places with high concentrations of cats, like barns, rural areas and shelters. Feline panleukopenia season peaks in later summer and early in the height of kitten season.
The virus has a preference for any rapidly dividing cells such as the intestinal tract and bone marrow, with foul diarrhea and dramatically reduced white blood cells counts as the consequence. Cerebellar brain tissue can be affected in fetal kittens if the mother is infected (or vaccinated with a modified live vaccine during her pregnancy), causing characteristic ataxia, hypermetric gait and intention tremors.
With the virus remaining active in the environment, just imagine how much viral spread could occur in just a week in your shelter. With the morbidity and mortality rates of nearly 100% in susceptible animals, early identification and isolation of potentially affected cats is critical.
Risk Factors
The population most vulnerable to panleukopenia is unvaccinated kittens, but it can strike any unvaccinated cat. Kittens age 2-6 months are the most susceptible as maternal immunity starts to wane. That same maternal protection may have also interfered with any vaccinations those young cats have received prior, leaving them susceptible to infection.
Cats to be most concerned about:
Sudden death of any cat should be a major red flag
Panleukopenia is a parvovirus with a multitude of pseudonyms: feline distemper, feline parvo, cat fever, infectious enteritis and, my favorite, cat typhoid. But whatever you choose to call it, Panleukopenia is a swift and deadly disease and can cause mass mortality in a shelter environment. It’s usually passed by fecal-oral transmission and does not require direct contact among cats to be passed. If there is a concurrent URI, the virus may also be present in respiratory secretions. It can also be passed from mother to their kittens through the placenta. Without proper disinfection it can remain infective in the environment for years.
It’s native to every region throughout the US, and can be found in almost every corner of the globe. It is most prevalent in places with high concentrations of cats, like barns, rural areas and shelters. Feline panleukopenia season peaks in later summer and early in the height of kitten season.
The virus has a preference for any rapidly dividing cells such as the intestinal tract and bone marrow, with foul diarrhea and dramatically reduced white blood cells counts as the consequence. Cerebellar brain tissue can be affected in fetal kittens if the mother is infected (or vaccinated with a modified live vaccine during her pregnancy), causing characteristic ataxia, hypermetric gait and intention tremors.
With the virus remaining active in the environment, just imagine how much viral spread could occur in just a week in your shelter. With the morbidity and mortality rates of nearly 100% in susceptible animals, early identification and isolation of potentially affected cats is critical.
Risk Factors
The population most vulnerable to panleukopenia is unvaccinated kittens, but it can strike any unvaccinated cat. Kittens age 2-6 months are the most susceptible as maternal immunity starts to wane. That same maternal protection may have also interfered with any vaccinations those young cats have received prior, leaving them susceptible to infection.
Cats to be most concerned about:
- Any kitten 2-5 months of age
- Any kitten that may not have received colostrum (queen’s first milk)
- Any unvaccinated/ under vaccinated cat
- Cats with a recent onset of vomiting, diarrhea, lethargy, anorexia
Sudden death of any cat should be a major red flag
Clinical signs
The signs can be in any combination with differing degrees of severity, but vomiting and diarrhea are the classic symptoms.
Differentials
Any disease that can cause severe diarrhea, vomiting and sudden death should also be considered. Just don’t keep a potentially infectious kitten with the general population while you figure it out.
The signs can be in any combination with differing degrees of severity, but vomiting and diarrhea are the classic symptoms.
- Vomiting
- Diarrhea-usually liquid, malodorous. May be bloody.
- Decreased white blood cell
- Concurrent bacterial infection (ex. otitis, ulcers, etc.)
- Dehydration: sunken eyes, skin tent, dry mucus membranes
- Pain on abdominal palpation
- Sudden death
Differentials
Any disease that can cause severe diarrhea, vomiting and sudden death should also be considered. Just don’t keep a potentially infectious kitten with the general population while you figure it out.
- Bacterial: Salmonellosis, C. perfringens, Campylobacter
- Viral: calicivirus, toxoplasmosis, FeLV
- Parasites: Toxoplasmosis, Severe intestinal parasites
- Toxins- especially in cases of acute death
- Foreign body ingestion
- Intussusception
Diagnostics
The diagnosis of panleukopenia should be made based on the full clinical picture, rather than any one diagnostic test.
Treatment
Once infected the treatment is supportive care. Treatment should only be attempted if the shelter has the ability to isolate the cat, prevent cross contamination and provide high level supportive care for at least 5-7 days. Cats can continue to shed the virus (and pose a risk to your population) for up to three weeks or more after resolution of clinical signs, so plan on having long term recovery housing in isolation. Euthanasia of infected cats may be the more humane choice if appropriate treatment and isolation cannot be provided.
Prevention
Preventing an outbreak starts at intake. Incoming cats need a complete examination and vaccinations, including a modified-live FVRCP. Any felines displaying clinical signs such as vomiting or diarrhea should be put into isolation for observation until panleukopenia can be ruled out.
Vaccination starts to reduce a cat’s risk of infection within days of receiving it, with the modified live vaccination working the fastest within 1-2 days with full immunity in 5-7 days. The killed vaccine can take 1-2 weeks and is thus not recommended for shelters. Since maternal immunity can play a large role in kittens not being protected, kittens should be vaccinated starting at four weeks of age and every two weeks until four months. The schedule doesn’t need to be so frequent if they will be kept in a foster setting.
Daily health monitoring of the in-house cat population should help any cases that develop following intake, helping the chances of recovery for the ill cat and preventing spread among the population. Suspected cats should be isolated until a diagnosis can be confirmed.
If a panleukopenia case is suspected, all areas that were potentially exposed to that animal should be thoroughly cleaned and disinfected. Parvovirus is notoriously hardy and can survive for months to years in the environment. Effective disinfectants include bleach solution (4 ounces of 5% bleach mixed with one gallon water), accelerated hydrogen peroxide products and potassium peroxymonosulfate (Virkon® or Trifectant®). Iodophors, quarternary ammonium compounds, alcohol, chloroforms, iodines and phenols are ineffective against parvo. Don’t forget for disinfectants to work, all visibly soiled area must be cleaned first and the disinfecting agent must be allowed to sit on the surface for the recommended amount of time.
Parvovirus is a swift and brutal disease that can decimate a shelter population, but with the proper detection, prevention and cleaning techniques, your shelter may escape its wrath. The next time you are faced with kitten diarrhea, run your fecals, try a bland diet, but don’t forget about a more sinister possibility.
The diagnosis of panleukopenia should be made based on the full clinical picture, rather than any one diagnostic test.
- Positive Canine Parvovirus SNAP tests: while not labeled for use in cats, it can detect the antigen in feces. It’s not perfect for diagnosing all positive cats, so if the test is negative, but the symptoms are highly suspicious, don’t rule out panleukopenia based on the test alone.
- Clinical signs (see above)
- Decreased white blood cell count
- The lower the WBC the less chance for a good outcome.
Treatment
Once infected the treatment is supportive care. Treatment should only be attempted if the shelter has the ability to isolate the cat, prevent cross contamination and provide high level supportive care for at least 5-7 days. Cats can continue to shed the virus (and pose a risk to your population) for up to three weeks or more after resolution of clinical signs, so plan on having long term recovery housing in isolation. Euthanasia of infected cats may be the more humane choice if appropriate treatment and isolation cannot be provided.
Prevention
Preventing an outbreak starts at intake. Incoming cats need a complete examination and vaccinations, including a modified-live FVRCP. Any felines displaying clinical signs such as vomiting or diarrhea should be put into isolation for observation until panleukopenia can be ruled out.
Vaccination starts to reduce a cat’s risk of infection within days of receiving it, with the modified live vaccination working the fastest within 1-2 days with full immunity in 5-7 days. The killed vaccine can take 1-2 weeks and is thus not recommended for shelters. Since maternal immunity can play a large role in kittens not being protected, kittens should be vaccinated starting at four weeks of age and every two weeks until four months. The schedule doesn’t need to be so frequent if they will be kept in a foster setting.
Daily health monitoring of the in-house cat population should help any cases that develop following intake, helping the chances of recovery for the ill cat and preventing spread among the population. Suspected cats should be isolated until a diagnosis can be confirmed.
If a panleukopenia case is suspected, all areas that were potentially exposed to that animal should be thoroughly cleaned and disinfected. Parvovirus is notoriously hardy and can survive for months to years in the environment. Effective disinfectants include bleach solution (4 ounces of 5% bleach mixed with one gallon water), accelerated hydrogen peroxide products and potassium peroxymonosulfate (Virkon® or Trifectant®). Iodophors, quarternary ammonium compounds, alcohol, chloroforms, iodines and phenols are ineffective against parvo. Don’t forget for disinfectants to work, all visibly soiled area must be cleaned first and the disinfecting agent must be allowed to sit on the surface for the recommended amount of time.
Parvovirus is a swift and brutal disease that can decimate a shelter population, but with the proper detection, prevention and cleaning techniques, your shelter may escape its wrath. The next time you are faced with kitten diarrhea, run your fecals, try a bland diet, but don’t forget about a more sinister possibility.
