Plague (Feline)

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Feline plague is caused by an infection with the bacteria Yersinia pestis. The bacterium is very contagious and is zoonotic, which means it can be transmitted to humans. Wild rodents are the primary carriers of disease. It is spread by fleas that have bitten rodents, direct contact with infected animals, and nasal discharge cats that have the respiratory (pneumonic) form. There are three clinical forms of this disease- the bubonic, septicemic, and pneumonic forms. The bubonic form causes enlargement and infection of the lymph nodes especially around the head. The septicemic form can cause collapse and sudden death, and the pneumonic form causes difficulty breathing, nasal discharge, and other respiratory signs.

Common name: Bubonic plague, black Death
Scientific name: Yersina pestis, Yersiniosis

Diagnosis

Signalment Cats are the most susceptible species, while most dogs are resistant to the infection. Cats that go outside are more at risk due to their increased exposure to wild rodents and the rodent's fleas. There is no age, breed, or gender predilection.

Incidence/prevalence
There is no known incidence or prevalence.

Geographic distribution
Feline plague is endemic (native to the area) in the western and southwestern United States. It is usually seen in cooler, semi-arid climates. It is most prevalent in Colorado, Arizona, New Mexico, and California. It is usually seen in the warmer months between March and October. Plague is also present in South America, the Middle East, Africa, and Asia.

Clinical signs (primary, most to least frequent, scientific term, synonyms)
High fever, lymphadenopathy (enlarged lymph nodes), abscessed (infected), draining lymph nodes, collapse, shock (associated with sepsis), pneumonia, sudden death.

Clinical signs (secondary, most to least frequent, scientific term, synonyms)
Anorexia, lethargy, depression, dehydration, difficulty breathing, nasal discharge.

Cause (scientific, common term)
Infection with Yersinia pestis.

Organ systems affected (most to least affected)
Lymph nodes, lungs, liver, spleen.

Diagnostic tests
Diagnosis is made on history, physical exam and clinical suspicion, complete blood count, thoracic radiographs, gram stain of infected, draining material, immunofluorescent antibody on tissue samples or aspirates, PCR (polymerase chain reaction), serology.

**The state veterinarian should be notified of all suspected cases of plague**

Differential Diagnosis
Bite wound abscess, systemic bacterial infection, lymphoma, tularemia, feline panleukopenia.

Overview

Feline plague is caused by an infection with the bacteria Yersinia pestis. The bacterium is very contagious and can be spread to humans. Dogs are generally resistant to infection. Wild rodents in the western and southwestern United States are the primary carriers of this disease in this country. It is most prevalent in Colorado, Arizona, New Mexico, and California. Most cases occur in the summer months, but can also be seen in the spring and fall. Cats are most at risk when they go outdoors and are exposed to wild rodents. It is spread by fleas that have bitten rodents, direct contact with infected animals, ingestion of rodents infected with the bacteria, and can be airborne in respiratory secretions from infected cats. Clinical signs usually develop within 24-48 hours of exposure. There are three clinical forms of this disease- the bubonic, septicemic, and pneumonic (respiratory) forms. The bubonic form causes a high fever, and swelling with possible drainage of the lymph nodes especially around the head. The septicemic form can cause collapse and sudden death, and the pneumonic form causes difficulty breathing, nasal discharge, coughing and other respiratory signs. The bubonic form is the most common form seen in cats. All forms can be associated with a fever, decreased appetite, and lethargy. Often, the first signs owners will see are decreased appetite, lethargy, coughing, and swollen lymph nodes.

Treatment

Home Care
In areas were feline plague is present, any cat that is exhibiting signs of pneumonia, or has swollen lymph nodes should be immediately taken to a veterinarian due to the possibility of human exposure, and the rapid course of this disease. There is no appropriate homecare for cases of feline plague.

Professional Care
If the clinical suspicion for feline plague is high, antibiotic therapy should be started immediately as the disease progresses quickly. Affected animals should be hospitalized and isolated due to the contagious nature of the disease. Gowns, gloves and masks should be used when handling any animal presumed to be infected. Lymph node abscesses can be drained and flushed. Chest x-rays should be taken of all animals suspected of having the pneumonic form of plague to evaluate for signs of pneumonia. Oxygen supplementation may be necessary if the animal is having difficulty breathing. The state veterinarian or the public health department should be contacted regarding any case of suspected plague.

Action
Any humans exposed to an animal with suspected plague should seek immediate medical attention from a physician. Cats should be kept indoors in areas where plague is endemic, and flea control should be used regularly.

Outcome
Mortality in affected cats is around 50%. The prognosis is better with aggressive early treatment, especially with the bubonic form. Cats with the septicemic or pneumonic form of plague have a poorer prognosis than those with the bubonic form.

References/Additional Readings
Macy, Dennis. Plague. In: Greene, Craig, 3rd edition. Infectious Diseases of the Dog and Cat. St.Louis: Elsevier, Inc., 2006; 439-446.

Iowa State University, Institute for International Cooperation in Animal Biologics, Center for Food Security and Public Health, College of Veterinary Medicine. Plague., Aug.3, 2005. http://www.cfsph.iastate.edu/DiseaseInfo.

Taylor, Kathryn. Plague. In: Cote, Etienne, 1st edition. Clinical Veterinary Advisor Dogs and Cats. St. Louis: Mosby, Inc., 2007.853-854.

Nelson, Richard and C. Guillermo Couto. Polysystemic Bacterial Disease, Feline Plague. Small Animal Internal Medicine, 2nd edition. Mosby, Inc., 1998. 1273-1275.

Author
Tracie Romsland, DVM

Editor
Sharon Gwaltney-Brant DVM, PhD
DABVT, DABT

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