Feline plague

Clinical features
Bubonic, septicemic, and pneumonic plague develop in infected humans and cats; clinical disease is extremely rare in dogs. Bubonic plague is the most common form of the disease in cats, but individual cats can show clinical signs of all three syndromes. Most infected cats are housed outdoors and have a history of hunting. Anorexia, depression, cervical swelling, dyspnea and cough are common presenting complaints; fever is detected in most infected cats. Unilateral or bilateral enlarged tonsils, mandibular lymph nodes, and anterior cervical lymph nodes are detected in approximately 50% of infected cats. Cats with pneumonic plague commonly have respiratory difficulty and may cough.

Hematologic and serum biochemical abnormalities reflect bacteremia and are not specific for Y. pestis infection. Neutrophilic leukocytosis, left shift and lymphopenia, hypoalbuminemia, hyperglycemia, hypochloremia, hyperbilirubinemia, azotemia, hypokalemia, and increased activities of alkaline phosphatase and alkaline transaminase are common. Pneumonic plague causes increased alveolar and diffuse interstitial densities on thoracic radiographs. Cytologic examination of lymph node aspirates reveals lymphoid hyperplasia, neutrophilic infiltrates and bipolar rods.

Cytologic demonstration of bipolar rods on examination of lymph node aspirates, exudates from draining abscesses, or airway washings combined with a history of potential exposure, the presence of rodent fleas, and appropriate clinical signs lead to a presumptive diagnosis of feline plague. Since some cats survive infection and antibodies can be detected in serum for at least 300 days, detection of antibodies alone may indicate only exposure, not clinical infection. However, demonstration of a fourfold increase in antibody titer is consistent with recent infection. Definitive diagnosis is made by culture or fluorescent antibody demonstration of Y.pestis in smears of the tonsillar region, lymph node aspirates, exudates from draining abscesses, airway washings, or blood.

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