Feline enteropathogens and molecular diagnostics: benefits, limitations and clinical applications

Abstract

Practical relevanceFeline enteric disease is a commonly encountered presentation in clinical practice. Interpretation of the clinical relevance of enteropathogens is often misunderstood and can lead to inappropriate case management or overtreatment.Clinical challengesThe approaches to enteric disease, and the enteropathogens responsible, have proven to be an ever-emerging and challenging area within feline medicine. There are often many difficulties regarding diagnosis, interpretation of results and indications to treat. It is important to understand the aetiopathogenesis of disease, population predispositions and the principles underlying diagnostic testing, including its benefits and limitations, to appropriately manage these cases in clinical practice. Diagnostic testing and treatment should be carried out in a targeted manner only where indicated to do so.Evidence baseThis review provides extensive summaries of the most pertinent feline enteropathogens and diagnostic methods available, as well as their limitations, with a particular focus on molecular testing. The authors have provided their substantiated opinion on how best to approach these cases.Global importanceAn enhanced understanding of feline enteric disease is required not only for improved management of these veterinary patients but also particularly relates to the critical topic of antibiotic stewardship and judicious use of antibiotics, which form the mainstay of treatment for many enteropathogens, but are often used inappropriately in healthy cats testing positive for organisms that are not implicated in enteric disease.AudienceThe target audience for this review encompasses general and specialist practitioners, alongside researchers within this field.

Keywords: Enteropathogens; PCR; intestinal disease; molecular diagnostics; molecular testing.

Figure 1

An example of large intestinal diarrhoea in a cat. Courtesy of Arianna Baldini

Figure 2

An example of mixed (large and small intestinal) diarrhoea in a cat. Courtesy of Danielle Roussel

Figure 3

The principle of polymerase chain reaction (PCR), including the denaturation, annealing, elongation and amplification stages