Ron Hines DVM PhD 11/27/07

This disease has become quite rare in house cats and cateries in the United States due to the large percentage of cats vaccinated with very effective vaccines. I have not seen a case in years. In the past, it was also called Feline Distemper or Yellow Vomit Disease. It is, however, still common in animal shelters and pet sanctuaries.

Feline panleukopenia is a highly infectious viral disease of cats. It attacks susceptible cats of all ages. It is often fatal. The disease is not related to the virus of distemper of dogs nor does it infect people. It is a close cousin of the parvovirus of dogs and is, itself, a parvovirus.

We see this disease in country cats more than city cats. This is because rural cats are less likely to receive their vaccinations and more likely to live in groups. It is also more common in the summer months when cats are out and about. Because of stress and inter-cat mingling, we often see the disease in animal shelters and pounds.

Synonyms for Panleukopenia
A disease as ubiquitous as panleukopenia, occurring throughout the world, has developed many names. Among them are: Cat Plague, Feline Distemper, Feline Infectious Enteritis, Feline Infectious Gastroenteritis, Show Fever, Feline Parvovirus, “Panleuk”, Feline Agranulocytosis, Psuedomembranous Enteritis, Maladie Due Jeune Chat, Feline Typhus, Feline Typhoid, and Feline Colibacillosis.

How Panleukopenia Is Transmitted
The panleukopenia virus belongs to a group that is quite stable in the environment. The virus is present in large amounts in the feces and saliva of infected cats so contaminated objects most commonly spread the disease - often for very long periods of time. Other transmission occurs through cat-to-cat contact. Pregnant cats transmit the disease to kittens while they are still in their uterus. Early in pregnancy this result in abortion or still births. When it occurs later in pregnancy, the kittens are born with severe neurological deficits. These kittens arrive uncoordinated due to a defect in brain maturation called cerebella hypoplasia. Tremors of the head and blindness due to retinal degeneration in these kittens are common. These kittens walk stiffly - similar to a windup toy. Despite their disabilities and possible blindness, these kittens have normal intelligence and can adapt and lead long lives.

Symptoms Of Panleukopenia
The symptoms of panleukopenia can be very mild or quite serious. The lethal action of the panleukopenia virus is its attack and destruction of the defensive white cells of the blood. No other disease causes the extent of white blood cell loss, as does panleukopenia. The virus attacks all tissues that grow rapidly. Thus, in severe cases, the lining of the digestive system, the bone marrow, lymphatic tissue and developing brains of kittens are all destroyed to some degree. Intestinal tract damage results in the drooling, vomiting and diarrhea seen with this disease.

White cells called neutrophils are responsible for protecting cats against bacterial disease. Without them cats becomes very susceptible to secondary bacterial infections. The first sign that the cat is ill is often a sudden lack or appetite and listlessness. Symptoms begin so suddenly that owners may suspect their cat has been poisoned. This is followed in 3-4 days by undulating high fevers, vomiting, diarrhea and dehydration. Vomiting and diarrhea quickly deplete the cat’s body of water. Their skin assumes a clay-like consistency and does not spring back as it should when pinched. Erosions in the lining of the small intestine may cause the diarrhea to be bloody. These cats often assume a typical dejected “hound dog” stance over their water or food bowl where they remain for long periods. Some cats die within a few days. Others linger on but die during the next ten days. Cats may have several fever spikes during which their temperature reaches 106F. Cats whose body temperature drops to less than 100 degrees Fahrenheit do not survive. These terminal cats are semi-comatose and may exhibit convulsions. Cats that survive the first week of infection will often recover over the following month.

Diagnosing The Disease
The symptoms of panleukopenia are quite distinctive and diagnosis is not difficult. Depressed kittens and young cats with fever, diarrhea and vomiting which, on examination, have a low white blood cell count are all suspects for this disease.

Poisons, feline leukemia, feline aids and Salmonellosis can produce symptoms that mimic this disease but it is rare for any of them to produce so low a white cell number. White blood cell numbers begin to decline 2-3 days after infection. By the end of the first week it can be hard to find any white blood cells or leukocytes in blood films examined under the microscope. The term “pan” means all and leukopenia means lack of white cells – hence the name of the disease. The worse the leukopenia, the graver the prognosis.

Palpation of the tummies of these cats reveal a painful abdomen, thickened, turgid small intestine and enlarged mesenteric lymph nodes. Some cats show an abnormally low number of blood platelets due to bone marrow suppression. Blood platelets are cells involved in blood clotting so clotting time can be lengthened. Panleukopenia virus isolation is a tedious and expensive procedure so it is rarely attempted.

If the diagnosis is in doubt, the SNAP parvovirus test designed for dogs will usually detect the panleukopenia virus as well. If the cat was recently vaccinated for panleukopenia, the test can give a false positive. The virus can also be detected using a PCR test (polymerase chain reaction) or by rising antibody titre.

Treating The Disease
When this disease attacks kittens the chances of their survival is very poor. As cats get older, their chances of recovery increase if the cat is given broad-spectrum antibiotics and replacement fluids early during the course of the infection. Cats older than four months have a much better chance of recovery than younger kittens.
Because no virus are susceptible to antibiotics, we need to keep the cat alive long enough for its own immune system to rid it of the virus. Adding white blood cells from a healthy cat through transfusion can help us gain time. Medications that lessen vomission and diarrhea are also helpful as are vitamin B,C and A injections.
Good nursing care and isolation are quite important. Sick cats require warmth and frequent cleaning. Some can take bland liquid nourishment without vomiting while others must be fed intravenously or subcutaneously. Frequent petting and attention given to sick cats seems to improve their will to fight the disease and recover. The virus is very tough and stable and can survive in the environment for years if conditions are cool and dark. Recovering cats shed the virus in their feces and urine for up to six weeks. The best cleaning compound to use in the cat infirmary is a 1:20 solution of common household bleach to which a small amount of dishwashing detergent has been added. Cats that are fortunate enough to recover usually suffer no permanent damage. They are immune for life and require no further vaccination. The virus is shed by recuperating cats for up to 6 weeks after recovery.

Preventing Infection
All cats – even lions and tigers – are susceptible to panleukopenia. Raccoons and mink are also susceptible. Cats that recover from a natural case of panleukopenia remain immune for the rest of their life. Since more than half the cases of this disease are too mild to notice, many adult cats are already immune without vaccination. Kittens produced by these immune cats are protected by their mother’s passive immunity until they are two to three months of age. Vaccination against panleukopenia is very safe and effective. Injectable and intra-nasal vaccines are available. I generally vaccinate kittens at 9, 12 and 16 weeks of age and again one year later. From then on, vaccination every 3-4 years is sufficient. Most vaccines marketed today are living, attenuated (weakened) virus. Multiple vaccinations help insure that passive immunity does not block the action of the vaccine. Pregnant cats and kittens younger than 4 weeks of age should not receive live virus vaccines. Live virus vaccines can damage the cerebellum of kittens. Yet, it may be advantageous to vaccinate these cats in a humane society or kennel setting. If so, they should be vaccinated with killed virus vaccines only. We now know that vaccinations will, on rare occasions, cause cancer in cats. An alternative to revaccination is to test the cat's blood for protective antibodies and only revaccinate if they drop too low.

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