Monday, March 14, 2016

Diagnosing and treating infectious diseases in cats - an interview with Dr Steven Holloway

cat flu signs
Cats tend to hind signs of infectious disease.

Diagnosing and treating infectious diseases in feline patients can be tricky for a range of reasons. Dr Steven Holloway is a Melbourne-based veterinary specialist who knows a thing or two about infectious diseases. He has worked in Australia and the US, and became a diplomate of the American College of Veterinary Internal Medicine in Small Animal Medicine. He undertook a PhD in virology and has taught in veterinary faculties in Sydney and Melbourne. His research interests include clinical and genetic aspects of disease and the interaction between infectious diseases and the host immune response. I think it is fair to say we have mutual feelings about feline infectious peritonitis. He took some time out of his hectic day to chat to us about infectious diseases in feline patients.

Dr Steven Holloway with Alfie.
What is your day job? 

My day job is as a specialist veterinarian at Advanced Vetcare in Melbourne.  I am a registered specialist in Internal Medicine, I see a lot of cats.  Sadly many have cancer but we see a number with infectious diseases.  

What are the most common infectious diseases you see in feline patients?

The most common infectious diseases I see in cats would be chronic herpesvirus infections, cryptococcus, FIP (feline infectious peritonitis) and FIV (feline immunodeficiency virus).

What are the most severe infectious diseases you see in feline patients and why?

Feline herpesvirus is probably the most difficult one in terms of chronicity and overall morbidity.  It is under-rated in terms of impact on feline health with so many cats suffering from chronic nasal disease and eye diseases.  

Why do infectious diseases in cats often present a diagnostic challenge?

The biggest challenge is carrier status of so many of the important diseases.  This poses particular problems with diagnosis and defining if the agent is actually causing the disease you are trying to treat/diagnose.

How can veterinarians improve their approach to infectious diseases in feline patients?

The most important thing for veterinarians to know about infectious diseases relates to how to identify them as part of a differential diagnosis, In cats, think infectious disease as part of every differential.  Learn to interpret test results correctly in light of the carrier status that may exist and how to control infection once a patient with a suspected infectious disease enters your hospital.  Know the factors that make a particular infectious disease spread in the feline population, how it is transferred, carried, and eliminated from the environment.  
What improvements have you seen in the management of infectious diseases in cats in the last decade?

Diagnostics have improved greatly in the last two decades with PCR and improved cage side serology tests.  Treatment has not improved much for most of the diseases, particularly the viral ones.   I hope to live long enough to see FIP become a treatable disease [Ed: me too].   We made great progress in FeLV prevention due to improved tests and management awareness.   I think most veterinary graduates are much more aware of husbandry practices and the importance of infection control in hospitals and animal shelters/catteries.  

Where do we go from here?

I feel that we need to be aware of the growing problem with antibiotic resistance and take precautions to make sure we don't add to this in our hospitals.  I feel more research into antiviral therapies would help a lot in our practice.  In particular, new anti-coronavirus drugs might lead to a treatment for cats with FIP.  Every FIP case is a tragedy in small animal practice.  

Do you live with any cats yourself?

We have no cats at our house L  My youngest daughter is very allergic sadly.  We have Mabel the Russian Blue and Dusty our neighbour’s cat who visit each night.  Mabel in particular seem keen to get inside with my second daughter Sammy.  We call Sammy the cat whisperer cause cats seem to follow her home.  We also have our two AVC practice cats Basil and Alfie, so I get my cat fix.   Alfie in particular seems glued to my Mac keyboard!

Any advice for veterinarians and vet students about how to best treat their feline patients?

Get a nurse who is an expert cat handler! Our nurse Lauren is absolutely the best cat holder I ever met.  Cats seem to respond to vets/nurses who have good karma with them.  I always think over restraining cats is worse than no restraint at all.   Patience will pay off with feline patients.  

Thank you Dr Holloway for sharing your thoughts. Dr Holloway will be talking about immune mediated and infectious diseases, among other topics, at the Centre for Veterinary Education’s Valentine Charlton Feline Conference in July. Check out event details on Facebook here Or visit the webpage here