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Feline panleukopenia disease management

A cat showing clinical signs of feline panleukopenia, substantiated by laboratory evidence should be kept in isolation. Supportive therapy and good nursing care significantly decreases mortality caused by FPV. Restoration of fluid and electrolyte and of the acid-base balance preferably by intravenous drip is most important in symptomatic treatment.
As the gut barrier often is destroyed in FPV-infected cats, intestinal bacteria may invade the blood stream. Bacteriaemia may ensue, facilitated by the existing neutropenia, leading to sepsis in these immunocompromised patients. Prevention of sepsis is essential, and a broadspectrum antibiotic with a proven efficacy against gram-negative and anaerobic bacteria is recommended. Examples are amoxicillin/clavulanic acid or piperacillin in combination with aminoglycosides, fluoroquinolones, cephalosporins or piperacillin/tazobactam. The potential side effects of these drugs should be taken into consideration. Antibiotics should be administered parenterally (preferentially intravenously).
Oral intake of water and food should only be restricted if vomiting persists and feeding should be continued as long as possible, and restart as soon as possible. Beneficial effects of early enteral nutrition have been reported in canine parvovirosis (Mohr et al., 2003). A highly digestible diet is preferred, but if the cat does not accept it, any diet is better than no food intake at all. If vomiting persists, anti-emetics should be considered. Vitamin supplements, particularly of the B vitamin complex can be given to prevent development of thiamine deficiency, which occurs infrequently.
Cats that develop hypoproteinaemia may require plasma or whole blood transfusions to restore oncotic pressure. Plasma transfusion in combination with heparin may control disseminated intravascular coagulation (DIC), as it supplements anti-thrombin III and other important plasma proteins. In cats that are anorexic or show severe vomiting and/or diarrhoea, or in patients with persisting hypoproteinaemia, full or partial parenteral nutrition is required, preferably via a central venous catheter in the jugular vein (Hartmann and Hein, 2002).
Anti-FPV serum can be used to prevent infection of susceptible animals following exposure. The therapeutic efficacy of immune serum has been demonstrated in dogs (Meunier et al., 1985; Macintire et al., 1994), and similar beneficial effects may be expected in cats.
Feline recombinant Interferon-omega is effective in the treatment of parvoviral enteritis in dogs (Minagawa et al., 1999; Martin et al., 2002; de Mari et al., 2003) and also inhibits replication of FPV in cell culture (Mochizuki et al., 1994). So far no data are available on the efficacy of this cytokine in FPV-infected cats, but it is expected to perform well in the homologous host.
Due to the extreme physicochemical stability of FPV, contaminated cages, litter trays, food dishes, water bowls, shoes and clothing can play an important role in transmission, and attention to hygiene is of utmost importance. The virus is resistant to many common disinfectants, but can be inactivated by products that contain peracetic acid, formaldehyde, sodium hypochlorite, or sodium hydroxide (Köhler 2006). Sodium hypochlorite (household bleach, 1:30 dilution) can be used on smooth hard surfaces like litter trays that tolerate this disinfectant, while formaldehyde gas can be used for room disinfection. Susceptible kittens and unvaccinated older animals should not be in contact with other cats until they are properly immunized. Once a disease outbreak occurs, passive immunization can be used to protect susceptible cats (young kittens with an incomplete vaccination history, colostrum-deprived kittens or unvaccinated cats). Anti-FPV serum can be given subcutaneously or intraperitoneally and may protect for 2-4 weeks (Greene and Addie, 2005). If a commercial product of equine origin is used, repeated administration is not recommended as this may lead to anaphylactic reactions (Hartmann and Hein, 2002). Since the administered immunoglobulins will bind to parvoviral epitopes, these animals should not be vaccinated within the first three weeks after passive immunisation.