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===Clinical Signs===
 
===Clinical Signs===
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Canine distemper is characterised by a biphasic fever, with the first peak 3-6 days post-infection and the second peak several days later and intermittently thereafter. The second peak of pyrexia is usually associated with the onset of other clinical signs. These initially include conjested conjunctiva and nasal mucosa leading to serous ocular and nasal discharges that become mucopurulent. The animal is depressed and anorexic, and vomiting, diarrhoea and pneumonia commonly follow. These gastrointestinal and respiratory signs are often complicated by secondary bacterial infections. Lesions may occur on the retina and optic neuritis can develop. Some strains of CDV cause hyperkeratosis of the footpads and the nose, and retinal lesions and optic neuritis can occur. In neonates, hypoplasia of the tooth enamal is common following infection, causing "distemper rings". Pustular dermatitis may also be seen on the abdomen of infected puppies.
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Canine distemper is characterised by a biphasic fever, with the first peak 3-6 days post-infection and the second peak several days later and intermittently thereafter. The second peak of pyrexia is usually associated with the onset of other clinical signs. These initially include conjested conjunctiva and nasal mucosa leading to serous ocular and nasal discharges that become mucopurulent. The animal is depressed and anorexic, and vomiting, diarrhoea and pneumonia commonly follow. These gastrointestinal and respiratory signs are often complicated by secondary bacterial infections. Lesions may occur on the retina and optic neuritis can develop. Some strains of CDV cause hyperkeratosis of the footpads and the nose, and retinal lesions and optic neuritis can occur. In neonates, hypoplasia of the tooth enamal is common following infection, causing "distemper rings". Pustular dermatitis may also be seen on the abdomen of infected puppies.  
    
Many, but not all, infected dogs develop CNS signs after systemic disease but this is dependent on the strain of the virus. Either the white matter or the grey matter may be affected. Grey matter disease affects the cerebral coretx, brainstem and spinal cord, and may give a non-suppurative meningitis, seizures, stupor, hysteria or ataxia. Dogs with grey matter disease may die within 2-3 weeks, recover, or alterntatively progress to white matter disease. In this, mutlifocal lesions mean that the signs are variable: cerebellovestibular signs are common, as well as spinal cord paresis, ataxia and occasionaly myoclonus. Once white matter disease has developed, some dogs die with a non-inflammatory, demyelinating disease 4-5 weeks after intial systemic infection. Other animals may recover with minimal injury to the CNS but may still suffer neuromuscular tics or "chewing gum" seizures.
 
Many, but not all, infected dogs develop CNS signs after systemic disease but this is dependent on the strain of the virus. Either the white matter or the grey matter may be affected. Grey matter disease affects the cerebral coretx, brainstem and spinal cord, and may give a non-suppurative meningitis, seizures, stupor, hysteria or ataxia. Dogs with grey matter disease may die within 2-3 weeks, recover, or alterntatively progress to white matter disease. In this, mutlifocal lesions mean that the signs are variable: cerebellovestibular signs are common, as well as spinal cord paresis, ataxia and occasionaly myoclonus. Once white matter disease has developed, some dogs die with a non-inflammatory, demyelinating disease 4-5 weeks after intial systemic infection. Other animals may recover with minimal injury to the CNS but may still suffer neuromuscular tics or "chewing gum" seizures.
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Dogs that recover from acute canine distemper infection may develop "old dog encephalitis" years later. This is a result of persistent infection and manifests with several episodes of neurological abnormalities over weeks to months, before the dog ultimately dies.
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Although canine distemper is often fatal, in some cases an increased production of virus-neutralising antibodies promotes the recovery of the animal. However, CDV can persist in the uvea, CNS, lymphoid organs and footpads despite elimination from most organs and the blood. This can result in "old dog encephalitis" in dogs that recovered from acute canine distemper years previously. In this, several neurological episodes occur over weeks to months, and end in the death of the dog.
 
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5.2. Clinical manifestations
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According to clinical features a catarrhal and nervous
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form or a combination of both, also termed acute systemic
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form, and a chronic nervous manifestation can be distinguished.
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In addition, various unusual manifestations,
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including old dog encephalitis and hard pad disease are
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recognized (Krakowka et al., 1985; Baumga¨ rtner, 1993;
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Moritz et al., 1998, 2000, 2003). At the acute stage, virus is
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found in every secretion and excretion of the body. This
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phase is accompanied by various dramatic clinical signs
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including onset of a cutaneous rash, serous nasal and ocular
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discharge, conjunctivitis and anorexia, followed by gastrointestinal
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and respiratory signs, which are often complicated
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by secondary bacterial infections and neurological
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disturbances (Krakowka et al., 1985). Nervous signs are
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diverse and progressive (Parker, 1978; Greene and Appel,
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1998) and include myoclonus, nystagmus, ataxia, postural
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reaction deficits and tetraparesis or plegia (Koutinas et al.,
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2002; Vandevelde and Zurbriggen, 2005; Amude et al.,
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2007).
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In some cases, an improved immune response especially
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an increased production of virus-specific neutralizing
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antibodies can promote the recovery of the animal.
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However, despite elimination of the virus from several
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organs and the peripheral blood, CDV can persist in certain
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tissues including uvea, CNS, lymphoid organs and footpads
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(Appel, 1970, 1987; Zurbriggen et al., 1995a,b; Greene and
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Appel, 1998; Gro¨ne et al., 2003a; Schobesberger et al.,
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2005). Moreover, some infected animals display a delayed
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progression of the disease and a moderate immune
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response with subtle early clinical signs. Later, as a
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consequence of viral persistence in the CNS, overt CNS
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disturbances can be observed resulting in the nervous form
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of canine distemper. Dogs with nervous signs usually die,
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but some recover, and may display lifelong residual signs
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such as a persistent myoclonus.
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    * Clinical specimens: Conjunctival scrapings, blood (buffy coat) smears, lung, urinary bladder, stomach, and brain.
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    * A laboratory diagnosis may not be feasible. A presumptive diagnosis is frequently made on the basis of clinical signs in a young unvaccinated dog. Nonetheless, the vaccinated status does not assure protection since many cases of distemper have been reported in well vaccinated dogs.
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    * A reliable way to diagnose canine distemper is the demonstration of viral infected cells by immunofluorescence. Examination of conjunctival scrapings and blood smears is useful during early stages of the illness, but false negative results are likely to occur as the disease progresses. Tests are accurate when performed on appropriate necropsy tissues.
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    * Microscopic lesions of demyelination in the cerebellum and characteristic inclusion bodies in various tissues are diagnostically significant. The inclusions are primarily intranuclear in the brain and intracytoplasmic in other tissues.
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    * The prognosis is poor for dogs with CNS involvement.
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*Can contribute to [[Canine Infectious Tracheobronchitis|Infectious Canine Tracheitis]]
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*May be involved in [[Pancreatitis, Chronic Interstitial|chronic interstitial pancreatitis]]
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*May cause [[Bones Developmental - Pathology#Retention of elongated primary trabeculae|growth retardation lattice]]
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*May also trigger latent [[Toxoplasma|Toxoplasmosis]] due to suppressing effect on lymphoid tissue
      
===Laboratory Tests===
 
===Laboratory Tests===
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