Serologic test Antigen Time frame for positive results Comments

Table 11.1.1 Serologic tests for Brucella canis in the dog Serologic test Antigen Time frame for positive results Comments 2-ME-RCAT Cell wall 8 12 weeks after infection to 3 months after the animal is abacteremic 2-ME-TAT Cell wall 10 12 weeks after infection to 3 months after the animal is abacteremic AGID test Cell wall 12 weeks after infection to 4 months after the animal is abacteremic AGID test Cytoplasmic 12 weeks after infection to 36 months after the animal is abacteremic Cell wall Unknown (expect time to be similar to that observed with the TAT) Cytoplasmic Unknown (expect time to be similar to that observed with AGID-cytoplasmic) Very sensitive; false-positive results are common; few (1%) false-negative results are reported; easy and fast Semiquantitative; false-positive results are possible Test procedure is complex; more specific than 2-ME-RCAT Most specific serologic test but not sensitive, detects chronic cases when other tests give negative results Very specific, less sensitive than TAT, limited availability Very sensitive and specific, detects chronic infection, limited availability RCAT, card slide agglutination test; 2-ME, 2-mercaptoethanol; TAT, tube agglutination test; AGID, agar gel immunodiffusion;, enzyme-linked immunosorbent assay. Source: Adapted from Johnston SD, Root-Kustritz MV, Olson PN. Canine and Feline Theriogenology. Philadelphia, PA: W.B. Saunders; 2001.

Table 11.1.2 Methods used to diagnose Helicobacter infections Method Sensitivity Specificity Invasiveness Notes Bacterial culture Up to 90% 100% Biopsy required Sensitivity varies with laboratory expertise Rapid urease test 88 100% 88 100% Biopsy required Commercial assays available >90% 100% Biopsy required High High May use biopsy specimen, gastric juice, or dental plaque Sensitivity varies with the primers used Urea breath test >95% >95% Noninvasive May be done on blood or breath Stool antigen test >92% >92% Noninvasive Antibody 60 100% 60 100% Noninvasive Commercial assays available Modified from Flatland B. Helicobacter infection in humans and animals. The Compendium on Continuing Education for the Practicing Veterinarian 2002;24:688 696.

Table 11.1.3 Sample protocols for treatment of Helicobacter infections Protocols Drug Drug type Dose Route Frequency Notes Protocol 1 Amoxicillin Antibacterial 20 mg/kg PO q 12 h Metronidazole Antibacterial 10 20 mg/kg PO q 12 h 62.5 mg total in cats Famotidine Antisecretory 0.5 mg/kg PO q 12 h Bismuth Coating agent 6 mg/kg PO q 12 h subcitrate Protocol 2 Tetracycline Antibacterial 22 mg/kg PO q 8 h Metronidazole Antibacterial 10 20 mg/kg PO q 12 h 62.5 mg total in cats Ranitidine Antisecretory 1 2 mg/kg PO, IV q 12 h 3.5 mg/kg in cats, PO Bismuth subsalicylate Coating agent 0.5 1.0 mg/kg PO q 12 h Use with caution in cats. Protocol 3 Clarithromycin Antibacterial 7.5 10.0 mg/kg PO q 12 h Omeprazole Proton pump inhibitor 0.5 1.0 mg/kg PO q 24 h Modified from Happonen I, Linden J, Westermarck E. Effect of triple therapy on eradication of canine gastric helicobacters and gastric disease. Journal of Small Animal Practice 2000;41:1 6; Fox JG. Enteric bacterial infections. In: Infectious Diseases of the Dog and Cat, 3rd edition, ed. CE Greene, pp. 343 351. St. Louis, MO: W.B. Saunders; 2006; Lieb MS, Duncan RB. Gastric Helicobacter spp. and chronic vomiting in dogs. In: Kirk s Current Veterinary Therapy XIV, 14th edition, eds. JD Bonagura, DC Twedt, pp. 492 497. St. Louis, MO: W.B. Saunders; 2009.

Table 11.2.1 System involvement in canine cryptococcosis System involved Percent of dogs affected (%) Upper respiratory 50 Integument 10 20 Ocular involvement 20 40 CNS involvement 50 80 Source: Nelson RW, Couto CG (eds.). Small Animal Internal Medicine, 4th edition. St. Louis, MO: Elsevier Mosby; 2009.

Table 11.2.2 Antifungal drugs of choice for dogs Drugs of choice for dogs Dose Comments Amphotericin B regular Amphotericin B liposomal or lipid complex Fluconazole 0.25 mg/kg IV as test dose, then 0.5 mg/kg IV up to three times a week 0.05 0.8 mg/kg SQ two to three times weekly 0.5 mg/kg IV as test dose, then 1.0 mg/kg IV three to five times a week 5 mg/kg PO q 12 24 h Can be used in combination with fluconazole, flucytosine, itraconazole, or ketoconazole. BUN or creatinine should be monitored prior to each treatment. Can be used in combination with fluconazole, flucytosine, itraconazole, or ketoconazole. BUN or creatinine should be monitored prior to each treatment. Flucytosine 50 mg/kg PO TID Can be used in combination with amphotericin B Ketoconazole 10 mg/kg PO q 12 24 h Azole antifungals have been shown to be successful as monotherapy. Itraconazole 5 mg/kg PO BID for 4 days, then 5 10 mg/kg PO q 24 h Itraconazole is the treatment of choice. Source: Plumb DC. Plumbs Veterinary Drug Handbook, 6th edition. Ames, IA: Blackwell Publishing; 2008; Nelson RW, Couto CG (eds.). Small Animal Internal Medicine, 4th edition. St. Louis, MO: Elsevier Mosby; 2009.

Table 11.2.3 Antifungal drugs of choice for cats Drugs of choice for cats Dose Comments Amphotericin B regular Amphotericin B liposomal or lipid complex 0.25 mg/kg IV every other day to three times a week 0.05 0.8 mg/kg SQ two to three times weekly 0.5 mg/kg IV as test dose, then 1.0 mg/kg IV three to five times a week Can be used in combination with fluconazole, flucytosine, itraconazole, or ketoconazole BUN or creatinine should be monitored prior to each treatment. Can be used in combination with fluconazole, flucytosine, itraconazole, or ketoconazole BUN or creatinine should be monitored prior to each treatment. Fluconazole 50 mg PO q 12 24 h Azole antifungals have been shown to be successful as monotherapy. Flucytosine 50 mg/kg PO TID Can be used in combination with amphotericin B Ketoconazole Itraconazole 10 mg/kg PO q 12 24 h 50 100 mg/cat PO once daily (may be divided into twice-daily dosing) 3 months or more Source: DC Plumb. Plumbs Veterinary Drug Handbook, 6th edition. Ames, IA: Blackwell Publishing; 2008; Nelson RW, Couto CG. Small Animal Internal Medicine, 4th edition. St. Louis, MO: Elsevier Mosby; 2009.

Table 11.2.4 Frequency of clinical signs canine blastomycosis Clinical sign Percent of dogs affected (%) Pulmonary signs 65 85 Diffuse lymphadenopathy 40 60 Cutaneous signs 30 50 Ocular involvement 20 50 Febrile 40 Lameness 25 Reproductive system involvement 5 10 Nervous system involvement <5 Source: Modified from Taboda J, Grooters AM. Systemic mycoses. In: Textbook of Veterinary Internal Medicine, 6th edition, eds. SJ Ettinger, EC Feldman, pp. 671 690. St. Louis, MO: Elsevier Saunders; 2005.

Table 11.5.1 Appropriate sample selection Sample selection for diagnosis of disease Organ system or clinical sign Sample collection in vivo Samples collected at necropsy Central nervous system a, whole blood, feces, cerebrospinal fluid Brain sections Gastrointestinal tract, whole blood, feces, vomitus Small intestine sections, mesenteric lymph nodes, intestinal contents Genitourinary tract Respiratory and ocular Skin and mucous membranes Blood dyscrasias, hematologic abnormalities, immunosuppression, whole blood, urine, urogenital swabs, vaginal mucus ; whole blood; transtracheal wash; conjunctival scrapings; nasal, ocular, and pharyngeal swabs, whole blood, scraping of lesions, vesicle fluid, whole blood, bone marrow Kidney, liver, spleen, fetal lung, and placental tissue Bronchiolar lymph nodes and selected tissue Regional lymph nodes and selected tissues Lymph nodes and selected tissues a Handle animals with neurological signs with caution due to the possibility of rabies. Source: Modified from Greene CE. Infectious Diseases of the Dog and Cat, 3rd edition, p. 3. St. Louis, MO: Elsevier Saunders; 2006.

Table 11.5.2 Sample collection and processing techniques Sample collection and processing Test Sample Collection and processing Culture bacterial and fungal Body fluids; tissue; fine needle aspirates; nail clippings; feces; transtracheal wash; conjunctival scrapings; nasal, ocular and pharyngeal swabs Collect aseptically to prevent contamination. Use appropriate swab and suitable transport medium Cytology or body fluids Collect fresh; do not fix or freeze. Make impressions on clean, dry microscope slide and air dry. Fix in alcohol. Direct fluorescent antibody (FA) impressions Fix in Michel s fixative for antibody testing by direct FA Make impressions on clean, dry microscope slide and air dry. Fix in acetone. Electron microscopy Collect aseptically to prevent contamination. Cut into 1 2 mm sections. Fix in 2 4% glutaraldehyde (at 10 volume) for 24 h at 20 C Enzyme-linked immunosorbent assay () for antigen Whole blood, tissue biopsy, feces, swabs Collect aseptically to prevent contamination. Store at 10 C to prevent inactivation. Do not freeze or fix. Collect aseptically to prevent contamination. Cut into 5-mm sections and fix in 10% buffered formalin (at 10 volume) Collect aseptically to prevent contamination. Cut into 5-mm sections and fix in 10% buffered formalin (at 10 volume) Nucleic acid-based testing Whole blood, tissue biopsy, feces, swabs Collect aseptically to prevent contamination. Store at 10 C to prevent inactivation. Do not freeze or fix. Organism isolation Whole blood, tissue biopsy, feces, swabs Collect aseptically to prevent contamination. Store at 10 C to prevent inactivation. Do not freeze or fix. Serology Cerebrospinal fluid, serum, synovial fluid Collect aseptically to prevent contamination. Handle gently to prevent hemolysis. Centrifuge and pipette serum into clean, sterile tube. Paired samples (10 14 days preferred) Modified from Greene CE. Infectious Diseases of the Dog and Cat, 3rd edition, p. 4. St. Louis, MO: Elsevier Saunders; 2006.

Table 11.5.3 Veterinary diagnostic laboratories Antech Diagnostics Many regional locations Idexx Laboratories Many regional locations Mira Vista Diagnostics Indianapolis, IN American Association of Veterinary Laboratory Diagnosticians 800-745-4725 800-872-1001 http://www.antechdiagnostics.com 800-444-4210 888-433-9987 http://www.idexx.com 866-647-2847 http://www.miravistalabs.com See http://www.aavld.org for a current listing of accredited laboratories by state Note: See the Appendix for a complete listing of accredited laboratories by state.

Table 11.5.4 Laboratory testing for infectious disease Laboratory testing for infectious disease Infectious agent Type of organism Test methodology Sample Anaplasmosis Rickettsial Cytology Blood smears, bone marrow smears Protein electrophoresis Whole blood Aspergillosis Fungal Agar gel immunodiffusion Complement fixation Culture Blastomycosis Fungal Agar gel immunodiffusion Culture Cytology Complement fixation or exudates Blood or serum or fluid aspirates or fluid aspirates Babesiosis Protozoal Complement fixation Cytology, body fluids biopsy Blood smear Whole blood, ticks Botulism Bacterial Toxin analysis Blood, serum, feces, intestinal contents Brucellosis Bacterial Agar gel immunodiffusion Culture Slide agglutination test Tube agglutination test Blood, tissue, feces, testicles, placenta, semen, genital swab Blood, tissue, feces, testicles, placenta, semen, genital swab Campylobacter Bacterial Culture Gastric biopsy, feces Histological Intestine, colon, lymph node, lung, spleen Gastric biopsy, feces Candidiasis Fungal Culture Blood or tissue Canine bartonellosis Bacterial Culture Blood Canine calici Viral Oropharyngeal swab, fecal swab, trachea, lung, kidney, intestine Canine corona Canine corona Canine distemper Canine distemper Canine herpes infection Canine herpes Blood Viral Electron microscopy Immunoprecipitation test Viral Intestine Intestine Intestine Intestine Viral Blood, buffy coat smear, conjunctival scraping, CSF, transtracheal wash, blood, urine, CSF, CSF Viral, conjunctival smear Viral Nasal swab, vaginal swab Immunoprecipitation test Nasal swab, vaginal swab Viral Brain, lymph node, liver, adrenal, kidney, spleen, lung Puppy/fetus tissue Lung, liver, kidney, CNS Canine influenza Viral Nasal swab, tissue Canine papilloma Canine parainfluenza Hemagglutination inhibition Viral Electron microscopy Nasal swab, tissue Nasal swab, tissue Viral Respiratory wash or tissue Hemagglutination inhibition or CSF Transtracheal wash, oropharyngeal swab, CSF Canine parvo Viral, feces Canine rota Canine rota Chlamydial infection Clostridium perfringens Electron microscopy Hemagglutination Hemagglutination inhibition Viral Latex agglutination, intestinal mucosa, intestinal mucosa, intestinal mucosa, feces, feces Viral Electron microscopy Intestine Intestine Bacterial Complement fixation Culture Nasal and ocular swabs Nasal and ocular swabs, serum Conjunctival or tissue smear, serum Blood or tissue Bacterial Culture or intestine Latex agglutination Reverse passive latex agglutination Coccidiosis Protozoal Oocyst flotation Coccidioidomycosis Fungal Agar gel immunodiffusion Complement fixation Culture Cytology or intestine or intestine or intestine or intestine Fluid aspirate, tissue Cryptococcosis Fungal Culture Fluid aspirate or tissue Cytology Latex agglutination Fluid aspirate smear or tissue or CSF Cryptosporidiosis Protozoal Oocyst floatation, CSF or intestine Cytauxzoonosis Protozoal Cytology Blood smear, bone marrow Ehrlichiosis Rickettsial Cytology Blood smears, bone marrow smears Protein electrophoresis Whole blood Feline bartonellosis Bacterial Culture Blood Feline calici Feline calici Feline foamy (syncytium-forming) Feline immunodeficiency Feline infectious peritonitis Feline infectious peritonitis Feline leukemia Feline leukemia Feline Lyme borreliosis Feline Lyme borreliosis Feline panleukopenia Feline panleukopenia Feline papilloma Feline rota Feline rota Blood Viral Electron microscopy Oropharyngeal swab, intestinal and fecal swab, oropharyngeal swab, intestinal and fecal swab Oropharyngeal swab, intestinal and fecal swab Viral Trachea, lung, kidney, intestine Viral Titer Trachea, lung, kidney, intestine Viral, whole blood Immunoblot Indirect fluorescent antibody Viral Protein electrophoresis, whole blood, whole blood Whole blood, bone marrow, lymphoid tissue Viral, CSF, lymphoid tissue, effusion fluid Viral or whole blood Rapid immunomigration Blood smear, buffy coat or bone marrow smear Lymphoid tissue or bone marrow Blood or serum Blood or serum Viral Blood or tissue or bone marrow Bacterial Immunoblot Lymphoid tissue or bone marrow Bacterial Body fluid, blood, tissue Viral, serum Electron microscopy Hemagglutination inhibition Viral Electron microscopy Viral Skin biopsy Viral Latex agglutination Skin biopsy Skin biopsy Viral Electron microscopy Intestine Intestine Giardia Protozoal Fecal flotation Fecal smears Helicobacter Bacterial Culture Gastric biopsy, feces Histological Intestine, colon, lymph node, lung, spleen Gastric biopsy, feces Hemobartonella Parasite Cytology Blood smear Blood smear, whole blood Hepatozoonosis Protozoal Cytology Blood smear Infectious canine hepatitis Infectious canine hepatitis Viral Complement fixation Hemagglutination inhibition Muscle biopsy, tissues Liver tissue Blood, urine, liver Oropharyngeal swab, urine, feces Viral Cytology Liver tissue Spleen, liver, brain Liver tissue Leishmaniasis Protozoal Cytology Lymph node aspirate Western blot or dried blood spots Blood, tissue Leptospirosis Bacterial Culture, urine Canine Lyme borreliosis Canine Lyme borreliosis Latex agglutination Microscopic agglutination or body fluids Kidney, placenta, urine, fetal fluid Bacterial Immunoblot Kidney or urine Bacterial Mycobacteriosis Bacterial Culture Exudates or tissue Mycoplasmal infection Parasite Culture Nasal swab, transtracheal wash or swab Neorickettsiosis Rickettsial Cytology Blood smears, bone marrow smears Protein electrophoresis Whole blood Neosporosis Protozoal Indirect fluorescent antibody biopsy Nocordiosis Bacterial Culture Pleural, pericardial nor peritoneal fluid Plague Bacterial Culture Blood, swab, fluid, tissue Hemagglutination Blood, swab, fluid, tissue Body fluids or tissue Pneumocystosis Fungal Cytology Lung aspirates, sputum Rabies Vaccination titers Rabies Rhinotracheitis Rhinotracheitis Rocky Mountain spotted fever Viral viral neutralization Rapid fluorescent focus inhibition test Lung aspirates, sputum CSF Viral Brain Brain Brain Viral, whole blood Electron microscopy, whole blood, whole blood, respiratory wash, feces, oropharyngeal swabs, conjunctival smears, CSF, whole blood, body fluids, whole blood Viral Trachea, lung, kidney, intestine Rickettsial Latex agglutination Trachea, lung, kidney, intestine Salmonellosis Bacterial Culture, fecal swab, blood, intestinal lymph node Intestine, colon, lung, lymph node, spleen Intestine, colon, lung, lymph node, spleen Sporotrichosis Bacterial Culture Lymphatic exudate Cytology Toxoplasmosis Protozoal Complement fixation Hemagglutination Indirect fluorescent antibody Oocyst flotation Lymphatic exudate biopsy biopsy Trichomoniasis Protozoal Fecal flotation Fecal smears or body fluids Trypanosomiasis Protozoal Cytology Blood smear Tularemia Bacterial Culture Exudate or swab Microagglutination Swab or exudate Source: Modified from Greene CE, et al. Infectious Diseases of the Dog and Cat, 3rd edition, p. 4, St. Louis, MO: Elsevier Saunders; 2006.

Table 11.5.5 Chemical agent Chemical agents by category Concentration Presence of organic material Alcohols Aldehydes Halogens Oxidizing agents 50 95% Ethanol, isopropyl Glutaraldehyde 1 : 30 (sodium hypochlorite bleach) Iodine Iodophor (betadine) 1 10% (1 : 9) 5 20% Hydrogen peroxide Peracetic acid Ineffective Some effect Ineffective May be reduced May be reduced Some effect Phenolics Pine-Sol (5% solution) Effective Quaternary ammonium Roccal D-256 Benzalkonium chloride Not effective against nonenveloped es Biguanides Chlorhexidine (0.78%) Ineffective Source: Greene CE (ed.). Infectious Diseases of the Dog and Cat, 3rd edition, St. Louis, MO: Saunders Elsevier; 2006.

Table 11.5.6 Common microorganisms in veterinary medicine and their modes of transmission, survivability, and recommended disinfectants Microorganism Mode of transmission Environmental temperature Time of survival Disinfecting agent Contact time to disinfect Feline rhinotracheitis Aerosol 4 C/39.2 F 154 days Heat a 56 C/132.8 F 4 5 min 25 C/77 F 33 days 70% Alcohol 37 C/98.6 F 3 h Sodium hypochlorite b 100% Iodine Phenol 0.5% Quat c Glutaraldehyde 0.78% Big d Canine herpes Direct contact 4 C/39.2 F 48 h Heat-56 C/132.8 F 4 5 min Canine distemper Fomites 37 C/98.6 F 48 h Aerosol 65 C/ 85 F 7 years Heat 60 C/140 F 30 min Body fluids 4 C/39.2 F 7 8 weeks 120 min Transplacental 25 C/77 F 3 h 0.2% Quats 30 min Canine parvo Fecal/oral 25 C/77 F Very stable in the environment Feline panleukopenia Infectious canine hepatitis Fecal/oral Very stable in the environment 3 months or more 3 months or more Heat 56 C/132.8 F Sodium hypochlorite 15 min 15 min 0.05% Phenol Rapid Sodium hypochlorite Glutaraldehyde 0.78% Big Fecal/oral 4 C/39.2 F 2 months Heat- 60 C/140 F 30 min Feline calici Aerosol 7 C 20 C/ 44.6 F 68 F Canine and feline rota 25 C/77 F 14 days Ultraviolet 120 min 37 C/98.6 F 6 h 24 h Sodium hypochlorite 100% Iodine Phenol 10 days Heat 50 C/122 F 30 min Phenol (at 50%) Sodium hypochlorite Glutaraldehyde Fecal/oral 24 C/75.2 F 2 days Heat 60 C/140 F 30 min 37 C/98.6 F 19 h 70% Alcohol 25 min 56 min Chlamydia Aerosol 0 C/32 F 24 h Heat 60 C/140 F 15 min Ocular discharge 25 C/77 F 7 days 0.5% Quats Mycoplasma Aerosol 28 C/82.4 F 21 days Heat 55 C/131 F 15 min Gram + staphylococci Direct contact Aerosol 4 C/39.2 F Several months 1% Phenol <5 min Heat 60 C/140 F <5 min 30 min 1% Phenol 15 min Brucella Direct contact 25 C/77 F 3 months Heat 60 C/140 F 15 min Salmonella Fecal/oral 25 C/77 F 12 14 weeks Clostridium spores Leptospira Direct contact Urine Very resistant in the environment 1% Phenol 15 min Heat 60 C/140 F Heat 120 C/248 F 20 min 5% Phenol 10 12 h 0 25 C/32 77 F Heat 50 C/122 F Toxoplasma cysts Fecal/oral 4 C/39.2 F 68 days Heat 56 C/132.8 F 10 15 min Isospora Fecal/oral 25 C/77 F 24 h Heat 50 C/122 F 4 h Canine influenza H3N8 Canine infectious Tracheobronchitis Iodine Freeze Aerosol Surfaces 48 h Sodium hypochlorite Fomites Clothing 24 h Quats Aerosol Fomites Hands 12 h 28 C/82.4 F 21 days Heat 55 C/131 F 15 min 1% Phenol <5 min <5 min 0.78% Big Influenza H1N1 Aerosol Paper/cloth 8 12 h Sodium hypochlorite Methicillin-resistant Staphylococcus aureus Methicillin-resistant Staphylococcus intermedius Fomites Surfaces Wet areas 24 48 h Up to 72 h Direct contact 4 C/39.2 F Several months Direct contact 4 C/39.2 F Several months Quats Heat 60 C/140 F 30 min 1% Phenol 15 min Sodium hypochlorite Quats Heat 60 C/140 F 15 min 15 min 30 min 1% Phenol 15 min Sodium hypochlorite Quats 15 min 15 min a Heat dry or steam. b Sodium hypochlorite household bleach. c Quats quaternary ammoniums. d Big biguanides.

Table 11.5.7 Precaution Recommended standard precautions Action Individual Hand hygiene Personal protective equipment Personal health Frequent hand washing or use of alcohol based gels; use gloves appropriately Gowns, lab coats, eye protection, masks appropriately utilized Current personal immunizations; stay home when ill, seek prompt medical attention Employer Safety committee Ill worker policy Food and beverage Provide ongoing training, monitor for compliance of policies Enforce ill worker policy, send ill employees home Prevent ingestion, limit food and beverages to appropriate areas Animals Isolation procedures Restraint Both in hospital and in isolation protocols in place Proper restraint techniques and appropriate use of anesthesia/ sedatives to prevent bites/scratches Client education Vaccination Flea and tick control Internal parasites Current on all core and recommended vaccines Educate and recommend Check fecal samples q 6 months, recommend year-round preventatives if appropriate Facilities Clean and disinfect Isolation decontamination All patient contact items daily and as needed Exam rooms, hospital and isolation areas, barriers and procedures Modified from Ehnert K. Zoonotic disease problems. In: Textbook of Veterinary Internal Medicine, eds. SJ Ettinger, EC Feldman, Table 222-2. Saunders Elsevier; 2010.