P e r s p e c t i n

A Newsletter fo r Cat Fanciers O n C a t s From The Cornell Feline Health Center

Spring 1983 I I

Feline Toxoplasm osis: The Disease and its

Public H ealth Significance Sandy Baldwin, D.V.M., M.S.

Though the parasitic disease toxoplasmosis In the entero-epithelial phase of is most often mentioned in connection with infection, the cat swallows the infective cats, in reality it is found in virtually organism, either from contaminated meat or all species of warm-blooded animals from sporulated oocysts previously passed throughout the world. Statistics show in feces. These oocysts then release that anywhere from 20% to 80% of all their organisms and infect the epithelial domestic animals in the United States have cells of the intestine. Following repro­ been infected at one time or another. It duction, oocysts (encysted organisms which has also been estimated that about half of are then passed in the feces) are formed. all people in this country harbor the Depending on the source of the infection, organism without showing any signs of oocysts can be detected in the cat's feces disease. The causative agent is an in 5 to 21 days. The oocysts will be intestinal protozoan, Toxoplasma gondii. passed daily for approximately 2 weeks, and there is the potential for passing Cats usually become infected in one of millions of oocysts in each bowel move­ two ways: 1) via ingestion of meat contam­ ment. After this 2-week period, oocyst inated with the parasite (either animals shedding stops, generally due to the caught in the wild or commercially pur­ development of immunity to the Toxoplasma chased meats); or 2) via ingestion of the organism by the host. sporulated oocysts (encysted organisms) after they have been passed in the feces The second, or systemic phase, occurs of another cat. There has been a recent at the same time as the intestinal stage. report of possible transplacental trans­ In this phase, organisms ingested by mission in cats. To understand the susceptible mammals (including humans) can differences in the two usual modes of localize in the intestinal epithelium or infection, the life cycle of the parasite spread rapidly throughout the body, caus­ will be discussed briefly. ing acute disease. As antibodies form, the Toxoplasma organism enters a resting Life Cycle stage and becomes encysted, that is, it becomes enclosed in a protective sac. There are essentially two phases of the This encystment is particularly apparent parasite: the entero-epithelial (intestin­ in the brain, heart, and muscles. These al) and the systemic phases. To date, tissue cysts are long-lived organisms and only the feline species has been recog­ are highly infective if the tissue is nized as a definitive host for Toxoplasma; consumed by another animal. Probably the in other words, only within the cat can major source of infection in cats is raw the organism undergo both phases; thus, meat infected with cysts; this may be from cysts are produced only in the cat and captured prey (rodents and birds) or raw serve as a source of infection for other meat fed by the owner. Cats fed homemade animals, including man. diets that include raw meats, such as Perspectives O n C a t s

liver, may easily become infected. In As mentioned already, the production of man, the main source of infection is also antibodies correlates well with cessation most likely ingestion of raw or under­ of oocyst shedding in feces. There may be cooked meat, not contact with cats. numerous reinfections, but rarely is disease manifested after the first Clinical Disease and Immunity in Cats infection, due to protective immunity. However, feline leukemia virus is known to In general, a vast majority of cats that suppress the cat's ability to form anti­ become infected with Toxoplasma gondii bodies and if a cat has this virus, the never show any signs of disease. The only possibility of severely acute toxoplasmo­ indication that infection has occurred sis or resurgence of chronic infection is might be the demonstration of oocysts on a something always considered by your routine fecal examination and perhaps a veterinarian. slight rise in antibody formation in the blood serum. Very rarely there might be Diagnosis and Treatment mucoid or bloody diarrhea if a significant portion of the intestine becomes infected. If the cat is newly infected and passing This would probably have to follow the oocysts, diagnosis is usually straight­ ingestion of a massive number of oocysts forward. The oocysts are easily seen on or cysts in infected meats. When seen, fecal examination by your veterinarian. clinical disease is often in the young, The problem occurs if the cat is examined and can be severe to fatal. after the time fecal oocyst shedding has stopped. Blood tests will tell whether or not the cat has been infected previously. If acute disease does occur, pneumonia Because antibody levels to Toxoplasma rise is the most consistent sign. Fever, slowly, however, it is possible although labored breathing (from the pneumonia), unlikely that no antibody will be detected hepatitis, upper respiratory infection, in an early infection. Once a diagnosis and muscle inflammation (including the is made, treatment is available which heart) are other reported signs. Usually these resolve, and a strong immunity (Continued on ‘page 5.) develops. In old cats, whose general immunity is not as strong, small nodules may occur in the intestine and lead to intestinal obstruction. Perspectives A Newsletter for Cat Fanciers Very rarely, chronic disease can be On C ats From The Cornell Feline Health Center seen. It is usually manifested by 1) ocular disease involving any or all parts of the eye, 2) anemia, and 3) encephal­ The ultimate purpose of the Cornell Feline Health Center is to itis. Due to the nature and duration of improve the health of cats everywhere, by developing methods to prevent or cure feline diseases, and by providing continuing educa­ chronic disease, oocysts have long ceased tion to veterinarians and cat owners. All contributions are tax- to be shed in the stool. An unusual deductible. complication occurs if, for some unknown Director: Fredric W. Scott, D.V.M., Ph.D. reason, one of the tissue cysts ruptures, Asst. Director-Puhlic Affairs: Edna H. Federer Editor: Joyce Tumbelston releasing the organism, rapidly eliciting Secretary: Sheryl A. Bronger a severe allergic response. This most Special Consultant: Leo A. Wuori, D.V.M. commonly occurs in the areas mentioned ®1983 by the Cornell Feline Health Center, Cornell University, College of Veterinary before for encystment, namely the brain, Medicine, Ithaca, NY 14853. All rights heart, and muscle. The local tissue death reserved. Permission to reprint selected portions must be obtained in writing. Cornell that occurs will produce a myriad of signs University is an equal opportunity, affirma­ which vary with the site and in the amount tive action educator and employer. of tissue destruction. 3

A Message From the Director

Fredric W. Scott, D.V.M., Ph.D.

My last column contained the Cornell Feline I would like to take this opportunity to Health Center "Christmas Wish List." The thank Dr. Wuori for his valuable contributions response from our readers proved to me once to the CFHC over the past two years. It has again that cat lovers are among the most loyal, been a critical period of growth for the CFHC. devoted, and generous people I have ever known, His efforts have been vital in our reorganiza­ when it comes to the welfare of their pets. tion and expansion to help the Feline Center Two couples in particular deserve special serve the needs of both veterinary profession­ recognition for their exceptional generosity. als and the cat-owning public. Mr. and Mrs. Ellice McDonald, Jr., of Mont- chanin, Delaware, provided the funds for an CFHC Staff Reorganized incubator for critically ill cats, an isolation Dr. Wuori's retirement necessitated a restruc­ unit for raising germ-free kittens, and a turing of our office staff. Mrs. Edna Federer gradient mixer to aid the study of feline has been promoted to the position of Assistant viruses. A short time later, a large gift Director for Public Affairs. She is responsi­ (also intended for the purchase of a gradient ble for the day-to-day operations of the mixer) arrived from Don and Joan Blackburn of office, fund raising, publications, continuing San Antonio, Texas. With their permission, education, and coordinating the activities of their gift will be applied to the purchase of an external volunteer organization currently another equally important item used for study­ being formed. Her advancement from Secretary ing feline viruses. to Administrative Aide to Assistant Director As you might imagine, there was great reflects her outstanding abilities and total elation at the Feline Health Center when these dedication to the Feline Health Center and its gifts arrived. The warm-hearted response to goals. our needs truly surpassed our expectations. I Mrs. Joyce Tumbelston, Assistant Editor for cannot overstate the beneficial effect these the past two years, now assumes the duties of gifts will have on cats. Once again, I'd like Editor. A very talented individual, Joyce has to express our deepest gratitude to the done an extraordinary job with our publica­ McDonalds, the Blackburns, and each one of you tions, given the limited help and resources who sent a gift to help meet these needs. available to her. Our publications and commun­ ications with practicing veterinarians and cat Dr. Leo Wuori Retires owners are the lifeblood of the CFHC; without As of January 1, 1983, Dr. Leo A. Wuori retired them, public support for all of our activities, including scientific endeavors, would wither as Assistant Director of the Cornell Feline and die. Health Center. After 38 years in private Miss Sheryl Bronger, who started as a practice and two years with the CFHC, he has more than earned the privilege of spending some volunteer this past summer, is now serving admirably in the position of Secretary. additional time in warmer climates than Ithaca, extra time on the golf course, and doing those Our New Look things a busy veterinarian just never quite gets time to do. We all wish him well. Those of you who have been receiving our It is our good fortune that we will not be newsletter for some time will immediately losing Dr. Wuori's talents and experience notice that this issue has a new look, a new entirely. He has graciously agreed to continue logo, and a new name. We feel these changes serving as a "Special Consultant," especially make the publication much more pleasing to the as a liaison to the veterinary profession and eye. We hope you appreciate these changes, as Cornell alumni. we strive toward excellence in every way. Perspectives O n C a t s 4

It's R aining Cats and D oss

High-Rise Syndrome

Ken Marcella, B.S.

It has long been a common saying that what great heights and survive. Some of the goes up must come down. In today's rapid­ stories recorded at the Henry Bergh ly expanding urban centers, going up are Memorial Hospital of the American Society more and more super high-rise apartment for the Prevention of Cruelty to Animals buildings and coming down are more and in New York City read like entries in The more cats. They are falling from heights Guinness Book of World Records. Cats have so frequently that a new feline trauma survived falls of up to 18 stories onto a syndrome has been identified: High-Rise hard surface (concrete, asphalt, dirt or Syndrome (HRS). car roof), 20 stories onto shrubbery, and 28 stories onto a canopy or awning. These Apartment dwellers often have cats or figures are not considered to be exaggera­ small dogs for pets because space limita­ tions and it is quite possible that there tions and apartment rules forbid larger have been longer, higher, more spectacular pets. Many of these cats live totally falls...and a cat that lived to meow about indoor existences, their only contact with i t . the outside world consisting of sleeping on a patio or watching pigeons from a Cats have a very efficient righting windowsill. Over the last few years an mechanism and usually fall in an upright increasing number of these cats have lost position with their legs extended and head their balance, slipped, or dozed off and down. Thus there is some truth to the fallen from their apartment windows. saying that cats always land on their feet. But when the fall is 20 stories High-Rise Syndrome is understandably down onto blacktop, even landing on one's seen most frequently in big cities and in feet has certain consequences. Because of warm climates. There is an increase in the way in which cats fall and land, a cases seen during the summer and fall. In specific triad of injuries has been air conditioned buildings, incidents of observed. HRS have been related to a window or screen being left open or an air condi­ The three main injuries seen are tioning unit being replaced or cleaned. epistaxis (bleeding from the nose), a Most owners doubt, at first, that their split in the hard palate (the bone and pets have actually fallen and report tissue region separating the nasal cavity instead that someone has left the apart­ from the throat), and pneumothorax (air in ment door open and the cat has run out the chest, outside the lungs). When a cat into the street where some type of trauma hits the ground its legs break the fall, (e.g., traffic accident) has occurred. In but the lower jaw impacts on the upper the cases where owners have actually seen jaw, splitting the hard palate, with their pets fall, some report that the cat resultant bleeding from the nose. Broken was sleeping in the sun one minute, and canine teeth also result from the chin then just rolled off the railing, or that hitting the ground, and the lower jaw may the cat was stalking some birds, leaped, possibly be fractured. The force of missed and fell. impact on the legs can cause fractures of one or both rear legs or of smaller bones It is known that cats can fall from in the front legs. The chest often hits 5

the ground, forcing free gas out of the Toxoplasmosis (Cont. from page 2.) lungs into the chest, which makes breath­ ing difficult. precludes replication of the Toxoplasma organism. With proper precautions, treat­ Now that HRS has been recognized and ment is usually very straightforward. its major associated injuries have been identified, cats which suffer long falls Public Health have an increased chance of survival because veterinarians know what problems In adult humans, toxoplasmosis is usually to look for and how to treat them. The a mild disease resembling the flu, with a first step should be a quick, nonstressful slight fever, fatigue, swollen glands in physical exam with primary emphasis on the the neck and armpits, rashes, headache, presence or absence of pneumothorax. If and sore throat. It has been misdiagnosed such a condition is found, the veterinar­ as mononucleosis upon occasion. Acute ian can then place a tube into the chest cases may occur very infrequently, with to remove the trapped air and allow the damage to the central nervous system, lungs to expand more fully. The tube can blindness, heart attacks, and death. be left in place and air drawn off period­ ically if needed. This type of traumatic The main reason for public concern pneumothorax usually resolves itself in about toxoplasmosis is the serious time as the cat stabilizes and heals the consequence of infection in pregnant tears in its lung tissue. Once the cat is women. The organisms have been shown to breathing easier, a more detailed exam can cross the placenta and infect the develop­ be done to evaluate any fractures which ing child, resulting in an estimated 3,000 can then be radiographed (X-rayed) and congenitally-infected infants per year. repaired in a routine manner. It is The most common defects are blindness and important for the veterinarian to check brain cysts; however, stillbirths and the hard palate in HRS cases because miscarriages also occur. fractures in this region may go undetected for some time unless extra effort is made As mentioned, approximately 50% of the in looking for them. Once found, these people in the United States harbor the fractures can generally be repaired parasite without exhibiting any disease. without complications. Twenty-five to 45% of women of child-bear­ ing age (20-39 years of age) fall into S till, High-Rise Syndrome is an urban this category and are immune to reinfec­ problem, one that is more difficult to tion. These women, should they be exposed prevent than it would seem. Take extra to the parasite during pregnancy, will not care when leaving your pet out on a patio deliver infected babies. or near an open window. Use screens wherever possible. Providing a short The major problem arises in women who protective barrier along outside railings have no previous exposure to toxoplasmo­ or ledges might well save your pet from a sis, who become infected either at the painful fall. Even so, as long as cities time of, or shortly after, conception. continue to grow upward, high-rise injur­ One third to 1/8 of the babies born of ies will continue to be a threat. It is these newly infected women will be deliv­ hoped that by owner education, the number ered with congenital toxoplasmosis. These of falling cats can be decreased. children can have many severe neurological problems, including blindness. It is also possible that they may show no signs what­ Ken Marcella, a fourth-year veterinary soever. student at Cornell, plans to enter mixed practice after graduation in May. If a woman becomes infected late in Perspectives O n C a t s 6

pregnancy, she will most likely not sis due to other immunodeficient diseases transmit disease to her child. is possible.

Guidelines for Prevention 5. To completely protect cats, it is necessary to prevent hunting of animals or To prevent contracting toxoplasmosis, birds and to feed commercially prepared several guidelines can be offered: foods, avoiding raw or undercooked meats.

1. First, cook all meats to a minimum 6. Good personal hygiene after any internal temperature of 151° F. This is animal contact is important. Care should the only definite way to k ill the organism especially be taken with stray animals. in meat. Freezing for prolonged periods reportedly will k ill the organisms, but 7. Pregnant women in particular should dependence on freezing as a method of wear rubber gloves while gardening, espe­ prevention is, at best, very foolhardy due cially in areas frequented by cats, and to variations in temperature and duration. the skin should be washed thoroughly after A specialnote of caution should be gardening. Food grown in home gardens directed to hunters, particularly those should be washed thoroughly prior to being who field dress game. Washing hands and eaten fresh. Oocysts may be present in utensils after dressing is an obvious soil for a year or more. precaution. This should also be done after handling meat and preparing non-game 8. To prevent infection in young me a t s . children, sandboxes should be covered whenever not in use. 2. Cats should be tested for the presence of antibodies, especially if 9. Always check with your physician testing can be done prior to the owner's for further guidelines, precautions, and pregnancy. If there is a significant recommendat ions. titer or a rise in titer, then immunity is probably effective and organisms will not It is hoped that this article will aid likely be shed. If the titer is negative, in an understanding of toxoplasmosis and the cat is a potential candidate for the role of cats and infected meats in disease and production of oocysts. human infection. It is also hoped that, because of this information, fewer cats 3. Litter boxes should be emptied of will be euthanized due to ignorance of the feces daily. Toxoplasma oocysts do not disease processes. By following simple become infective until one to 5 days after precautions to prevent exposure, by iden­ being passed in the feces, and they can tifying susceptible women with the use of survive for long periods. The use of dry antibody tests, and by the rational inter­ cat litter is also indicated since oocysts pretation of serum titers, much of the mature slower if the area is dry. If the fear of Toxoplasma gondii infection can be litter is changed daily and is disposed of abated. properly prior to maturation of the sporu- lating oocysts, no infection can occur. Also, the addition of boiling water to the Charles A. "Sandy" Baldwin earned his litter pan daily as a means of steriliza­ D.V.M. in 1973 and his M.S. in 1982, both tion is also an excellent method of k ill­ at Cornell. He is currently at work on ing the organism. his Ph.D. in Veterinary Virology, special­ izing in intestinal diseases of cats. 4. Pregnant women should not clean the litter box, perhaps even if the cat pos­ sesses antibodies and is not shedding the organism, since recurrence of toxoplasmo­ 7

First Aid: A M atter Life and Health

Joyce Tumbelston

Imagine for a moment: a few examples. You're sitting quietly in your living room, Of course it is not pleasant to dwell on reading. Suddenly you hear a loud screech of these possibilities, but they should be given brakes. You run to the window in time to see some thought by every conscientious cat owner. a car speed off. Your precious Tinkerbell You may never face a "life or death" emergency lies on the pavement, crumpled and in shock. with your cat, but you may indeed have to cope What do you do? with situations of some peril. The swiftness and appropriateness of your reaction can Or: It's time for Fluffy's dinner, but certainly affect Fluffy is nowhere to be found. The next morn­ your cat's recovery, for better or worse. ing you find out why. There he is, huddled on the back porch, a miserable sight. Cruel This article begins a new series that will wounds and once-beautiful fur now matted with appear regularly in "Perspectives on Cats" to blood reveal that he has been in a battle. help you deal effectively with all kinds of What do you do? situations requiring first aid. We hope, over Numerous hazards threaten the pet cat, even time, to help you gain a good understanding of the housebound cat. Many an indoor cat has your cat's physiology, as well as how to suffered a broken bone by getting caught in a recognize when it needs first aid, successful doorway, has been poisoned by eating certain ways to handle your cat when it is frightened house plants, or has gotten an electric shock and in pain, and what measures you can take to by chewing on an appliance cord, just to give comfort and care for the animal until it can

H aving a Cat Show? A C FH C Award of Distinction is

Better Than a Trophy

How many times have you wished you could do more to support feline health, only to be limited by your own budget? Here's a way for cat club members to join together and make a , v H elm * - r significant contribution to the important work of the Cornell Feline Health Center. Simply award the prestigious Cornell Feline Health Center Awards of Distinction instead of ,A6jarb of JSistinrtton trophies or rosettes at your next cat show, and (Ehi* ib to rrrtifg that donate to the Center the amount you would have Hci}ienct> tiff honor of tt|e atearb of spent on prizes.

at % Recipients will be honored to display these handsome certificates, which are all the more

. . , 19 , .... . meaningful because of what they stand for: a ®|i» furtipr rrrtifir* rtjxt In lint at trepfyy, funk* t)«u* been bonatrb solid commitment to the advancement of feline la tbf Cornell Jftlinr Stralll) Cnttrr to improve tljr t|>xltt) snb tortl-bring of coto rorrytobrre. medicine, to benefit cats everywhere. When planning your next cat show, request Airrrtor/Corn*!! JWin* MrolH) Cenlrr these certificates in advance from the Cornell J Feline Health Center. Let it be known that your club is doing something important to make a better world for cats. Perspectives O n C a t s 8

be treated by a veterinarian, if that is should only be attempted by a veterinarian, needed. and how to provide follow-up care prescribed by the veterinarian. Perhaps the most important quality needed for successful first aid is self control. The Remember, only a trained, experienced ability to remain calm in an emergency or a veterinarian should perform surgery or complex threatening situation is primary. Precious medical procedures on your cat. Resist the moments can be lost if you panic. Not only temptation to do more than you are qualified that, but your fear will be sensed by the cat, to do. An important part of responsible first and the cat may react violently. Unless you aid training is knowing your own limitations are able to take charge of the situation with and knowing when to place your cat in the confidence, transmitting your authority to capable hands of an expert. both the animal and any onlookers, chaos may There are many helpful things you can do result. This is one of the reasons it is so for a suffering cat. In the next several important to prepare a first aid strategy long issues of "Perspectives on Cats," we will before you need to actually use it, even to provide specific steps you can take in coping the point of visualizing what you would do in not only with the situations described at the specific situations. By training your mind beginning of this article but with other this way, chances are greater that you will common feline health hazards as well. react efficiently when called upon to face an emergency. (If a situation arises and you are unsure what to do, or if you think you may do Feline H ealth Sem inar more harm than good, leave the animal and contact your veterinarian immediately.) Mark your calendar now and plan to attend the third annual Feline Health Seminar, Besides the proper mental attitude and June 23, 24, and 25. A multitude of preparation, the other essential factors for topics will be covered by experts in each first aid involve skills that can be learned field, and continuing education credits by anyone who has an interest and will take will be awarded to attendees. For more the time to learn. You must know how to information about courses and registra­ determine the extent of injury, how to provide tion, contact Edna H. Federer, Cornell immediate relief (if possible), how to treat Feline Health Center, Cornell University, shock, how to prevent the cat from injuring College of Veterinary Medicine, Ithaca, itself further by trying to move or escape, New York 14853. how to control bleeding, what treatments

Cornell Feline Health Center Cornell University College of Veterinary Medicine Ithaca, New York 14853