Dr. Douglas Brum
Complete blood count. The CBC is useful in diagnosing panleukopenia infection, since it evaluates and counts the white blood cells. In the initial stages of the disease a leukopenia develops, with total white blood cell counts usually between 50 and 3000 cells per microliter. Care should be taken when evaluating the white count, however, since after the leukopenia develops, the white blood cell numbers may rebound within 24 to 48 hours. The CBC also evaluates the red cell line; some cats may lose significant amounts of blood through the bowel and become anemic.
An unvaccinated kitten between 3 and 5 months of age that presents with signs of vomiting and diarrhea is suggestive of panleukopenia infection. Many of these kittens are very ill, and have high fevers (104-107 degrees F).
Biochemistry profile. The results of a biochemistry profile can provide critical information. A decrease in blood glucose may be seen in septic animals. The serum electrolytes (sodium, potassium, and chloride) are often abnormal due to gastrointestinal losses. Liver and kidney function may also be abnormal in septic animals.
Stool analysis. Analysis of a stool sample is always advised to rule out overwhelming gastrointestinal parasitic infections, such as roundworms, hookworms and coccidian.
Fecal ELISA testing can detect parvovirus in feces or intestinal contents.
Fecal cultures can be taken for campylobacter and salmonella infections. If these diseases are suspected, the cultures are highly recommended, since they are potentially zoonotic diseases (diseases that can be spread from animals to people).
Feline leukemia virus (FeLV) and feline immunodeficiency virus (FIV) testing is advised for all seriously ill cats. These viruses cause immunosuppression, and can predispose the cat to other illnesses.
Abdominal radiographs are recommended to check for evidence of foreign material in the intestine or for potential intussusceptions. The radiographic findings in cats with panleukopenia generally consist of fluid-filled loops of bowel.
There is no specific treatment for the panleukopenia virus. Therapy is aimed at providing supportive care and for treating the secondary bacterial infection. The virus causes a number of potentially life threatening changes, including damage to the intestinal lining, a marked decrease in the number of white blood cells (thereby decreasing the body's ability to fight infection by decreasing the white blood cells), and severe dehydration or shock due to the marked fluid loss. Treatment is aimed at addressing each of these problems, therefore allowing time for the body to recover and mount an immune response against the virus. If a cat is strong enough when this response is produced, he generally will survive.
Intravenous fluids given to maintain hydration and tissue perfusion. Cats with panleukopenia infection may lose large amounts of fluid through vomiting and diarrhea. Oral supplementation is not adequate; it is critical to replace lost fluids aggressively to prevent or to treat shock. If needed, intravenous fluids may contain supplemental glucose (sugar) and electrolytes, as significant electrolyte losses are common with severe vomiting and diarrhea.
Intravenous antibiotics are given to prevent or treat septicemia; the antibiotics should be broad spectrum to cover for a wide range of potential bacterial infections.
Food and water should be withheld from the vomiting cat, since anything that is taken in orally may promote continued vomiting. After there has been no vomiting for about 24 hours, water, and then food, is gradually re-introduced. A good quality, bland, highly digestible diet is used initially.
Antiemetic drugs are often given to cats with persistent vomiting. These allow for increased comfort and a shorter period of time before food can be started. Common antiemetics used include metoclopramide (Reglan) and chlorpromazine (Thorazine).
Intravenous nutritional support (parenteral nutrition) can be used to provide nutrition and calories to compromised animals that are unable to eat. This is especially important in septic animals, or in patients undergoing prolonged hospitalization. Intravenous feeding provides the calories and protein needed to give an animal a better chance of overcoming sepsis and severe debilitation.
If there has been a significant amount of blood lost through the bowel, a blood transfusion may be needed.
Recombinant human granulocyte colony stimulating factor (G-CSF) is a glycoprotein that stimulates the bone marrow to produce white blood cells. It is occasionally useful if the white blood cell count is not rebounding and remains low. It is not always effective, but it produces rapid results when it does work. G-CSF is not readily available at most veterinary hospitals.