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Bartonellosis (Cat-scratch Disease)

By: Dr. Arnold Plotnick

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Diagnosis In-depth

Cats rarely show signs of illness related to bartonellosis, and therefore are rarely tested for the disease. Testing is more likely to be performed on people suspected of the disease, although the same tests are applicable to cats.

  • Blood culture. Culture of the blood for Bartonella organisms may be performed on humans as part of the evaluation of suspected cases of CSD. It may also be performed on cats suspected of harboring the organism. Blood culture can be difficult and prolonged.

  • Serology. Serologic tests detect antibodies to Bartonella and imply exposure or infection with the organism.

  • Polymerase chain reaction. This test is currently limited to special institutes and research laboratories, although it promises to be the most specific test for bartonellosis, and can distinguish between all of the Bartonella species.

  • Complete blood count (CBC) is often normal in most cats. A mild anemia may be present in some cats.

  • Serum biochemical profile is normal in most cats.

  • Urinalysis is normal in most cats.

  • Feline leukemia virus testing (FeLV) may be recommended to determine if coinfection exists or this disease is a cause for the underlying symptoms.

  • Feline Immunodeficiency Virus Testing (FIV) may be recommended to determine if coinfection exists or this disease is a cause for the underlying symptoms.

    Therapy In-depth

    Treatment in Cats

  • Antibiotics. For cats that are symptomatic, antibiotics are recommended. The most commonly used antibiotic is Azithromycin (Zithromax®) although tetracycline, Erythromycin, Rifampin (Rifadin®, Rimactane®), Doxycycline (Vibramycin®) or a combination of these antibiotics has been used effectively in cats. Treatment for 4 to 5 weeks is often recommended. There is no known treatment that clears infection in cats.

  • Supportive care including intravenous fluids and drugs to control vomiting may be needed.

    Treatment in Humans

    Treatment of Bartonella-related disease in people depends on the severity of the disease and the immune status of the patient. Cat-scratch disease is usually self-limiting and will resolve on its own in weeks or months.

  • Antibiotics. If a secondary bacterial infection is present, or if the patient is immunocompromised, antibiotic therapy is prescribed. Treatment is for 4 to 8 weeks in people with competent immune systems, and is extended to 8 to 12 weeks in people who are immunosuppressed. HIV positive people may require treatment for many months, and sometimes for life.

    Follow-up

    Optimal treatment for your pet requires a combination of home and professional veterinary care. Follow-up can be critical, especially if your pet does not rapidly improve. Administer all prescribed medications as directed. Alert your veterinarian if you are experiencing problems treating your pet. Preventative flea and tick control is recommended. For more information read , flea and tick control programs

    Because of the uncertain effectiveness of these antibiotics, it is recommended that affected pets have cultures performed at two to four week intervals to determine drug effectiveness. Cultures should also be taken three weeks after discontinuation of antibiotics.

    Because domesticated cats are a major source of the bacteria, common sense and good hygiene should be practiced, such as washing hands after handling pets. Scratches or bites should be cleaned thoroughly, and cats should never be allowed to lick a person's open wounds.

    Cat-scratch Disease is uncommon. Most people will never develop illness due to Bartonella henselae, and people with competent immune systems do not need to follow special precautions with their pets.

    Although routine blood cultures and serologic testing is not widely available, it should be considered for pet cats whose owners are immunocompromised. Currently, the veterinary schools at the University of Georgia, Louisiana State University, Purdue University, North Carolina State University and Texas A & M University offer some method of diagnostic testing for cats. If a cat tests negative for Bartonella antibodies, it is unlikely to have the organism in the bloodstream, and may be a good criterion for choosing a pet for an immunocompromised person. Flea control may be the most important factor in reducing cat-to-cat and cat-to-human transmission, and is highly recommended for all pet cats.

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