Sunday, May 18, 2014   http://bostonherald.com/entertainment/lifestyle/2014/05/diagnosing_rabies_cases_early_essential_to_health
By:
Dr. John De Jong

 
Dear reader,


Once in a while I address an interesting case or subject that needs attention instead of my typical column answering your questions. Today, I’m writing about a case of rabies I saw this week. Rabies is often overlooked as a diagnosis because of its relative infrequency, yet it is a serious public health issue and a fatal disease.


Approximately 17 days before I saw the kitten in question, the owner found it at a relative’s farm in Pennsylvania. The kitten was very young and lived under the chicken coop with its mother and three littermates. Its siblings had all been killed by some wildlife, and this kitten sustained several wounds around its hind end and near the left eye. The kitten was transported to our area and seen by two other veterinarians who administered and prescribed antibiotics. The kitten was about 6 weeks old at the time.


The kitten did reasonably well until two nights before I saw the patient, when it started to exhibit neurological signs, including shaking and falling over which worsened over the next 36 hours. When I saw the kitten, it could not stand up and kept falling over on its side. The wounds in the hind end were healing, as was the one near the right eye, yet it had a fever of 106.


Call it a sixth sense, but given the history and the rapid progression of clinical signs, I suspected possible rabies. Rabies in cats can show up in two ways. After a brief day or so of early signs, the cat either becomes aggressive in the furious form or gets weak and uncoordinated leading to paralysis (known as the paralytic form). Rabies is an RNA virus that is transmitted by saliva in affected animals, most often raccoons, bats, foxes and skunks. When saliva of an infected animal gets into another animal, the virus spreads to the nerves and the central nervous system, eventually affecting the grey matter in the brain. This can take several days or weeks. It is also FATAL.


Due to my suspicions and after consulting with the proper state authorities, the owner euthanized the kitten and I removed the head from the body to submit the brain for testing at the state laboratory. This is the only way to test for and verify rabies. Rapid turnaround allows for proper public health precautions. In the case of this kitten that had been bottle fed by several individuals, including one who was scratched, all of these people had to undergo rabies shots at the hospital.


The take-home message is that bite wounds of unknown origin must always be taken seriously, including proper reporting and need for quarantines. Rabies should always be considered as a differential in certain cases, and protecting animals and humans is a responsibility, among many others, that veterinarians have.