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Environmental and Group Health Risk Factors for Feline Upper Respiratory Disease Complex in Animal Shelters Carrie Jenkins, Stephanie Byers, Claudia J Baldwin, DVM, MS, College of Veterinary Medicine, Iowa State University. Sandra Newbury, DVM, Kate F Hurley, DVM, MPVM, Koret Shelter Medicine Program, University of California, Davis. Abstract Introduction Feline Upper Respiratory Disease Complex (FURDC) is a common and infectious multi-factorial disease syndrome that is either enzootic or epizootic in many animal shelters. Previous research on multiple cat environments has focused primarily on stress and welfare.3,5,7 Shelter conditions are often crowded, with varying levels of sanitation and stress, creating a perfect environment for inoculation, amplification, and recrudescence of infectious disease. Most cats present apparently healthy. Previous studies evaluating infectious disease transmission confirmed that disease transmission in shelters and shelter-like environments is rapid and efficient.6 Production models have demonstrated that specific management practices and environmental conditions on farms are significantly correlated to disease and decreased production in identifiable patterns.4 Many farms can quantify the relationship between expenses to reduce disease and the corresponding production benefit. Equivalent tools for shelters and other multiple cat populations would be invaluable. In this study, FURDC incidence and severity in two Iowa Animal Shelters was used as a marker for evaluating shelter health management practices. The purpose of this pilot study, done in conjunction with studies by Dr. Kate Hurley, Director of the Koret Shelter Medicine Program, and Dr. Sandra Newbury, National Shelter Medicine Extension Veterinarian, University of California, Davis, was to evaluate relationships between selected environmental risk factors and the occurrence of FURDC in animal shelters using tools borrowed from production medicine models. Image 2. Mucopurulent nasal discharge on a cotton ball from a cat at Shelter A. Image 1. Kittens at Shelter B. Oneway Analysis of Average # Cage Moves vs. Shelter 12 11 10 9 8 7 6 5 4 3 2 1 0 A* B Shelter # Cage Moves Question: Do management practices and environmental factors impact the development of Feline Upper Respiratory Disease Complex (FURDC) in shelters? Hypothesis: Environmental factors and management decisions within a shelter are risk factors for the development of clinical signs of respiratory disease. Objectives: 1) To apply modern methods for evaluating animal health used in the livestock industry to cats in shelter environments. 2) To assess relationships between environmental factors in animal shelters and feline group health using FURDC as a model. FURDC incidence and severity will be used as a marker for evaluating shelter health management practices. 3) To evaluate and compare viral, bacterial, and bacteria-like pathogens infecting groups of shelter cats during enzootic and epizootic episodes of disease. Results: The two shelters studied had very different management practices and incidence of disease. Some environmental factors were significantly different between the two shelters. Both commonly had mixed Staphlyococcus and Streptococcus spp. isolated from the shelter environment but some bacteriological findings were unique to each shelter. Patterns of oropharyngeal and conjunctival bacterial growth from cats at each shelter were different as well. Mycoplasma spp. bacteriology and real time PCR, virology, and further statistical analysis are pending. Conclusions: Both shelters had some unique environmental and management challenges. Incidence of disease was markedly different between shelters Careful review of management practices, including sanitation, disinfection, and population control, is warranted. When all bacteriology and virology tests are completed, a more complete picture of pathogen presence in each shelter will be available, and strategies to decrease incidence of FURDC can be developed. Results and Discussion Room Adoption Variables Shelter A Shelter B Population Density 1.10 1.03 Temperature (°C)* 24.6 22.5 Relative Humidity (%) 69.2 65.9 0.35 1.24 Temperature (°C)* 24.5 22.5 Relative Humidity (%) 69.5 71.5 Population Density* 0.41 0.84 Temperature (°C)* 24.2 22.6 Relative Humidity (%) 65.5 66.8 Stray Holding Population Density* Isolation Table 3. Average values for environmental variables in each room of the shelters. Population density is the number of cats divided by the room volume, in this case presented as a single value, which is the number of cats per 100 cubic feet. * Values differed significantly (p < .0001). Figure 1. Comparison of cage moves between shelters. The green line is the mean, and the blue lines are the standard deviation. * Values differed significantly (p < .0001). References # Cats in Study Period Shelter A Shelter B Total 64 87 Methods Adopted 27 8 Personnel at two Iowa Animal Shelters were interviewed and shadowed to document management practices. Husbandry was evaluated for stress reduction and potential for fomite transmission of disease. Housing factors were evaluated for comfort and ability to express natural behaviors. Daily shelter visits were done for 28 consecutive days at a set time in reference to cleaning and feeding. Clinical signs of FURDC and duration of disease were recorded for each cat. Population density was calculated in each cat room. Cage moves for each cat were recorded and evaluated. Temperature and relative humidity were evaluated daily, along with decibel levels. Cats from each shelter showing clinical signs of respiratory disease were physically examined for presence of ocular, nasal and oral lesions, and a severity score—based on clinical signs and symptoms—was recorded. Standardized treatment was then provided based on the severity score. Sponges and swabs were used to sample the environment for Mycoplasma spp., Chlamydophila spp. and Bordetella bronchiseptica. Conjunctival and oropharyngeal swab samples were collected from 6 cats from shelter A and 5 cats from shelter B with clinical signs of respiratory disease. Contributing pathogens for FURDC were evaluated for bacteria at the ISU Veterinary Diagnostic Laboratory. At a later date, samples were collected from different cats at the shelters for viral studies at the University of California, Davis. Data was analyzed using the JMP 6.0.0 statistical package. A standard t-test was used to determine significant differences in several variables between the two shelters. Further statistical analysis is pending. Returned to Owner 2 2 Fostered 1 0 Died 0 2 Euthanized 1 29 Table 1. Comparison of cat numbers between shelters. FURDC Shelter A Shelter B Total Incidents 27 11 Repeat Incidents 4 1 URI Severity (Avg Score)* 1.07 0.55 Ocular Severity (Avg Score) 0.85 0.82 Duration (Avg Days) 7.85 6.67 Table 2. Comparison of FURDC incidence and severity between shelters. * Values differed significantly (p = .0080). 1. Bannasch MJ, Foley JE. Epidemiologic evaluation of multiple respiratory pathogens in cats in animal shelters. J Feline Med Surg. Apr 2005;7(2):109-119. 2. Binns SH, Dawson S, Speakman AJ, Gaskell CJ, Hart CA, Morgan KL, Gaskell RM. Prevalence and risk factors for feline Bordetella bronchiseptica infection. Vet Rec. May 22 1999;144(21):575-580. 3. Carlstead K, Brown JL, Strawn W. Behavioral and physiologic correlates of stress in laboratory cats. Appl Anim Behav Sci. 1993;38:143-158. 4. Lago A, McGuirk SM, Bennett TB, Cook NB, Nordlund KV. Calf respiratory disease and pen microenvironments in naturally ventilated calf barns in winter. J Dairy Sci. Oct 2006;89(10):4014-4025. 5. McCobb EC, Patronek GJ, Marder A, Dinnage JD, Stone MS. Assessment of stress levels among cats in four animal shelters. JAVMAJournal of the American Veterinary Medical Association. Feb 15 2005;226(4):548-555. 6. Pederson NC, Sato R, Foley JE, Poland AM. Common virus infections in cats, before and after being placed in shelters, with emphasis on feline enteric coronavirus. J Feline Med Surg. 2004;6(2):83-88. 7. Rochlitz I, Podberscek AL, Broom DM. Welfare of cats in a quarantine cattery. Vet Rec. Jul 11 1998;143(2):35-39. Acknowledgements Special thanks to the participating shelters, Joann Kinyon, Jennifer Corbin, Dianne Ritz, and Deb Moses. Supported by The Maddie’s Fund®, The Pet Rescue Foundation Veterinary Summer Scholar Research Program, The College of Veterinary Medicine, Iowa State University Some management practices were similar between shelters but others were very different. Shelter space devoted to cats was similar between the two shelters. Cage size varied within the shelters, and not all cages had resting perches. Cats were not always able to stretch out to rest, and placement of food, water, and litter pans was closer than ideal. Cleaning and disinfecting agents and practices also varied between shelters. Both shelters used a practice of cleaning with cat in residence, although Shelter A would at times move cats into a common room during cleaning. Figure 1 compares the mean number of cage moves per cat during the period of study, with a significantly greater number of moves in Shelter A (p < .0001). Movement of cats in the shelter environment is necessary at times to clean soiled cages, but devising a way to avoid placing cats in a common use area, where pathogens can be transmitted, would be ideal. Use of hand washing or a hand sanitizer in between handling of every cat may also reduce transmission of pathogens. Re-evaluation of cage moves would seem to be indicated, as this practice may contribute to increased stress and induction of infection or recrudescence of infectious agents responsible for FURDC. Table 1 shows the number of cats in each shelter during the 28 day study period. Shelter A took in fewer cats, had an adoption rate of 42% and a 2% euthanasia rate. Shelter B had an adoption rate of 9% and a rate of euthanasia of 33%. The average length of stay, determined using the subset of cats released during the study, was 36.7 and 19.2 days for Shelter A and Shelter B, respectively. This was statistically significant (p = .0174).The longest length of stay for Shelter A was 132 days, and for Shelter B was 161 days. There was also a difference in the amount of space for cat housing, with Shelter B having 21% less cubic feet than Shelter A. Image 1 is typical of shelters during the summer months when large numbers of litters present to shelters. During the 28 days of the study, there were often more kittens than adult cats in one of the shelters. Control of population is necessary to avoid overcrowding, which leads to stress and increased numbers and volume of pathogens. Health of the population is then compromised. Limiting intake, increasing adoption, shortening the length of stay, and euthanasia rather than treatment of cats with FURDC to avoid overcrowding, are all ways to maintain population health. At the onset of the study, Shelter A had 14 cats symptomatic from FURDC whereas Shelter B had 3. Table 2 shows data over the 28 days of study. Shelter A had a greater incidence and greater repeat incidence of FURDC. The average severity score was statistically significant, with severity scoring higher at Shelter A (p = .0080). Image 2 displays mucopurulent nasal discharge typical of FURDC with a bacterial component. During this study, shelter cats with FURDC were treated based on clinical scoring and the treatment was standardized. Health within Shelter A improved over the course of the study. Table 3 displays population density, temperature, and relative humidity in the cat rooms at both shelters during the course of study. Population density (# of cats/100 cubic feet) was significantly lower in 2 of 3 rooms at Shelter A compared to Shelter B (p < .0001). The temperature in all cat rooms in Shelter A was significantly greater than that of Shelter B (p < .0001). Noise level data were not included in the table, but were not significantly different between the shelters and ranged from 36.6-76.9 dBA. The temperatures in Shelter A were at the upper end of the recommended range for shelters (20-23.9 °C), but this is more of an animal comfort issue than disease issue. Of the 35 environmental samples, 14 had no bacterial growth. Bacteria were harvested from 21 environmental samples, including mixed Staphylococcus and Streptococcus spp., Chryseobacterium harvested from a cat perch and a chair in one room at Shelter A, Pseudomonas spp. from several locations at Shelter B (some species of which can cause bacterial pneumonia), and Aspergillus fumigatus, which is common in the natural environment but can be potentially pathogenic in immunocompromised animals. Of the 21 conjunctival and oropharyngeal swabs from cats, 9 had no growth. Bacteria were harvested from 12 swabs, including mixed Staphylococcus and Streptococcus spp., Pasteurella multocida from 1 cat from each shelter, Arcanobacterium pyogenes from three cats at Shelter B, and Bordetella bronchiseptica from two cats at Shelter A. P. multocida is part of the normal flora in the nasal, gingival, and tonsillar regions of many cats but can cause bacterial bronchopneumonia in animals with relative immuno-incompetence. A. pyogenes is commonly found in abscesses, although no abscesses were noted while swabbing. A certain amount of Bordetella bronchiseptica is to be expected in a shelter environment, particularly if cats are housed near dogs due to cross-species transmission. If protected and kept moist, the bacterium can survive in the environment for weeks. In a British study, 11% of 740 cats sampled were shedding B. bronchiseptica, while 18% of our 11 cats sampled cultured positive from throat swabs.2 When checked at a later date, both cats had been adopted and neither were showing any symptoms. Mycoplasma spp. bacteriology and real time PCR and virology results are pending. We plan to provide observations and recommendations for both shelters. Each shelter has individual challenges, and with a careful review and modification of management practices these issues can be addressed.