Toxoplasmosis
Definition
Toxoplasmosis in cats occurs with ocular sign only or with other generalized involvement of the liver, lung and meninges. Ocular sign may not be accompanied by systemic sign and are more common in cats than dogs.
Etiology
Toxoplasmosis is an infection caused by the obligate intracellular coccidian parasite, toxoplasma gondii. Toxoplasma gondii that infects nearly all mammals, Felidae the definitive hosts, all other warm-blooded animals are intermediate hosts.
Pathophysiology
Oral ingestion of tissue cysts or oocysts result spread of toxoplasma organism to extraintestinal organs via the bloods or lymph. Focal necrosis of the heart, eye, and brain result due to proliferation of toxoplasma gondii.
Clinical presentation/signs General Comments
The uveitis in cats is frequently documentas multiple foci of renitis or retinochoroiditis with varying degrees of anterior uveitis. In dogs, chorioretinitis, optic neuritis and less frequenly, anterior uveitis and inflamation of extraocular muscles are present.
Differential Diagnosis
Cats
·Intraocular disease (anterior uveitis): Feline infectious peritonitis (FIP), Feline Leukemia Virus (FeLV), Feline Immunodeficiency Virus (FIV), immune mediated, trauma, lens induced, corneal ulceration with reflex uveitis
·Dyspnea (respiratory signs): asthma, cardiogenic, pneumonia (bacterial, fungal, parasitic), neoplasia, heartworm disease, pleural disease (effusions), diaphragmatic hernia, chest wall injury
·Neurologic (causes of meningoencephalitis), viral: (Feline infectious peritonitis (FIP), rabies, pseudorabies), fungal (cryptococcosis, Blastomycosis, Histoplasmosis), parasitic (cuterebriasis, coenurosis, aberrant heartworm migration), bacterial: idiopathic disease (feline polioencephalomyelitis)
Dogs
·Often associated with other immunosuppressive diseases.
·Neurologic: usually in very young dogs, differentiate from Neospora caninum (both produce CNS and neuromuscular disease)
·Consider other conditions causing multifocal signs, infectious or inflammatory toxicity and metabolic disease.
Diagnosis
The presumptive diagnosis of toxoplasmosis can be made in cats with sign uveitis and a positive serum titer, although ocular toxoplasmosis in cats is not association of IgM antibodies and toxoplasma antigens have been developed for diagnosis of toxoplasmosis. Fecal examination for toxoplasma oocyst can be useful to detemine if the cat is shedding and is potentially infectius for the animals or humans.
Treatment
·Usually outpatient
·Inpatient, severe disease; patient cannot maintain adequate nutrition or hydration.
·Confine, patients with neurologic signs
Medications
Drugs of choice
·Clindamycin: 25-50 mg/kg PO or IM daily, divided into two doses, for at least 2 weeks after clinical signs clear
·1% prednisone drops, every 8 hours for 2 weeks for uveitis; use concurrently
Alternative Drugs
·Sulfadiazine (30 mg/kg PO q12h) in combination with pyrimethamine (0.5 mg/kg PO q12h) for 2 weeks; can cause depression, anemia, leukopenia, and thrombocytopenia, especially in cats.
·Folinic acid (5 mg/day) or brewer's yeast (100 mg/kg/day), correct bone marrow suppression caused by sulfadiazine/pyrimethamine therapy
Management/Prevention
Cats
·Diet: prevent ingestion of raw meat, bones, viscera, or unpasteurized milk (especially goat's milk); or mechanical vectors (flies, cockroaches); feed only well-cooked meat.
·Behavior: prevent free roaming to hunt prey (birds, rodents) or to enter buildings where food-producing animals are housed.
( source vet-zone)
Etiology
Toxoplasmosis is an infection caused by the obligate intracellular coccidian parasite, toxoplasma gondii. Toxoplasma gondii that infects nearly all mammals, Felidae the definitive hosts, all other warm-blooded animals are intermediate hosts.
Pathophysiology
Oral ingestion of tissue cysts or oocysts result spread of toxoplasma organism to extraintestinal organs via the bloods or lymph. Focal necrosis of the heart, eye, and brain result due to proliferation of toxoplasma gondii.
Clinical presentation/signs General Comments
The uveitis in cats is frequently documentas multiple foci of renitis or retinochoroiditis with varying degrees of anterior uveitis. In dogs, chorioretinitis, optic neuritis and less frequenly, anterior uveitis and inflamation of extraocular muscles are present.
Differential Diagnosis
Cats
·Intraocular disease (anterior uveitis): Feline infectious peritonitis (FIP), Feline Leukemia Virus (FeLV), Feline Immunodeficiency Virus (FIV), immune mediated, trauma, lens induced, corneal ulceration with reflex uveitis
·Dyspnea (respiratory signs): asthma, cardiogenic, pneumonia (bacterial, fungal, parasitic), neoplasia, heartworm disease, pleural disease (effusions), diaphragmatic hernia, chest wall injury
·Neurologic (causes of meningoencephalitis), viral: (Feline infectious peritonitis (FIP), rabies, pseudorabies), fungal (cryptococcosis, Blastomycosis, Histoplasmosis), parasitic (cuterebriasis, coenurosis, aberrant heartworm migration), bacterial: idiopathic disease (feline polioencephalomyelitis)
Dogs
·Often associated with other immunosuppressive diseases.
·Neurologic: usually in very young dogs, differentiate from Neospora caninum (both produce CNS and neuromuscular disease)
·Consider other conditions causing multifocal signs, infectious or inflammatory toxicity and metabolic disease.
Diagnosis
The presumptive diagnosis of toxoplasmosis can be made in cats with sign uveitis and a positive serum titer, although ocular toxoplasmosis in cats is not association of IgM antibodies and toxoplasma antigens have been developed for diagnosis of toxoplasmosis. Fecal examination for toxoplasma oocyst can be useful to detemine if the cat is shedding and is potentially infectius for the animals or humans.
Treatment
·Usually outpatient
·Inpatient, severe disease; patient cannot maintain adequate nutrition or hydration.
·Confine, patients with neurologic signs
Medications
Drugs of choice
·Clindamycin: 25-50 mg/kg PO or IM daily, divided into two doses, for at least 2 weeks after clinical signs clear
·1% prednisone drops, every 8 hours for 2 weeks for uveitis; use concurrently
Alternative Drugs
·Sulfadiazine (30 mg/kg PO q12h) in combination with pyrimethamine (0.5 mg/kg PO q12h) for 2 weeks; can cause depression, anemia, leukopenia, and thrombocytopenia, especially in cats.
·Folinic acid (5 mg/day) or brewer's yeast (100 mg/kg/day), correct bone marrow suppression caused by sulfadiazine/pyrimethamine therapy
Management/Prevention
Cats
·Diet: prevent ingestion of raw meat, bones, viscera, or unpasteurized milk (especially goat's milk); or mechanical vectors (flies, cockroaches); feed only well-cooked meat.
·Behavior: prevent free roaming to hunt prey (birds, rodents) or to enter buildings where food-producing animals are housed.
( source vet-zone)
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