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FIV (feline immunodeficiency virus)
FIV (also sometimes referred to as the feline version of HIV, or “cat AIDS”) is an infectious viral disease, that weakens the immune system. This virus is species-specific, meaning it can only infect cats, humans can not be infected with FIV. In cats, it is mostly transmitted through bite wounds, as there is a high concentration of the virus in the saliva of infected cats. An infected mother cat can also pass the virus on to her kittens.
FIV is one of the most common and consequential infectious diseases of cats around the world. A cat may appear healthy for a long time, despite the infection, but will eventually suffer from immuno deficiency, making it vulnerable to secondary infections. Normally harmless bacteria, viruses, parasites and funghi can cause sever illnesses in immunodeficient cats.
When cats are first infected with FIV, they may exhibit signs such as swollen lymph nodes, fever, loss of appetite and other unspecific symptoms. Often times these symptoms can be missed or attributed to other causes. After that first phase, they typically enter an asymptomatic phase, that can last for months to multiple years. During this phase, the virus slowly replicates in the cells oft he immune system. There may be blood work anomalies. As the virus continues to spread, cats start becoming immunocompromised. That means, that is becomes more likely for secondary infections to occur. They may develop chronic or recurrent infections of the eyes, upper respiratory tract, urinary tract, gums, or skin.
FIV is diagnosed by performing blood tests by looking for specific antibodies. This process is usually done in two tests, a screening test first and then a different test for confirmation.
Unfortunately there is no definitive cure for FIV currently. For healthy cats, it is most improtant to reduce the risk of aquiring secondary infections and to prevent the spread oft he FIV Virus to other cats. For that reason FIV positive cats should be kept indoors, should be neutered/spayed and it is advised to keep them isolated from FIV negative cats. There are also special dietary recommendations to minimize the risk of food-borne bacterial and parasitic infections.
FIV positive cats should be monitored closely, weighed regularly and also be examined by a veterinarian regularly, to catch signs of secondary infections early. Treatment of secondary infections may be longer or more intense than in otherwise healthy cats.
Cats that are available for adoption should be tested for FIV (among other infectious diseases) to make sure that no FIV positive cats are introduced to a houshold occupied by uninfected cats.
Currently there is no vaccine for FIV.
FeLV (feline leukemia virus)
Feline Leukemia Virus (FeLV) is a common and significant infectious disease among cats, affecting around 2-3% of cats in Europe, with a higher prevalence in shelter and rescue cats. Infection rates are significantly higher in cats that are ill or otherwise at high risk (e.g. immunodeficient cats). However, the prevalence has decreased over the years due to effective vaccines and testing methods.
FeLV is a retrovirus, meaning it can become a permanent part of a cat’s genetic makeup, leading to persistent infection. The virus is spread through close contact among cats, including bite wounds, grooming, and sharing food and litter boxes.
After exposure to FeLV, cats can react in different ways. Some cats mount an effective immune response and eliminate the virus without showing any symptoms, while others develop either regressive or progressive infections. Regressive infections mean the virus is present but controlled by the immune system, while progressive infections lead to continuous viral replication and severe health issues. Cats with progressive FeLV face a high risk of developing fatal associated diseases, as the virus infects their bone marrow, allowing continuous viral replication. Moreover, these cats shed viral particles, posing a risk of transmission to other cats. According to studies, around 30-40% of cats exposed to FeLV may develop progressive infection, with kittens being at a significantly higher risk compared to adult cats.
Diagnosing FeLV requires multiple tests to accurately determine the infection’s status.Some blood tests detect the presence of the virus or its components, while PCR can identify if the virus has integrated into the cat’s genome.
FeLV can cause various health problems, including cancer, blood disorders, and immune deficiencies. Cats infected with FeLV may show symptoms like loss of appetite, weight loss, fever, and infections of the skin and respiratory tract. Treatment options are limited, and management typically involves addressing specific symptoms and complications.
Preventing exposure to FeLV-infected cats is crucial. Keeping cats indoors, testing new cats before introducing them into a household, and vaccination are important preventive measures. Although vaccination is not 100% effective, it can reduce the risk of infection, especially for outdoor cats or kittens.
Despite the diagnosis of FeLV being distressing, affected cats can live normal lives for extended periods. Regular monitoring and prompt veterinary care are essential for managing the disease and maintaining the cat’s quality of life.
FIP (feline infectious peritonitis)
Feline Infectious Peritonitis (FIP) is a usually fatal viral disease in cats caused by certain strains of the feline coronavirus (FCoV). Most strains of FCoV are found in the gastrointestinal tract and are termed feline enteric coronavirus (FeCV), typically causing mild or no symptoms. However, approximately 10% of cats infected with FeCV undergo mutations, resulting in the development of the FIP virus (FIPV). FIPV infects white blood cells and spreads throughout the body, triggering an intense inflammatory response that leads to the development of FIP.
FIP can manifest in two main forms: wet (effusive) and dry (non-effusive), with transition forms also possible. Cats infected with FIPV initially display nonspecific signs such as fever, loss of appetite, weight loss, and depression. Additionally, FIP can present as ocular or neurological, affecting the eyes and brain, respectively.
Wet FIP typically involves fluid accumulation in body cavities, leading to symptoms such as abdominal swelling and breathing difficulties. In wet FIP, symptoms may include weight loss, fever, jaundice, severe anemia, and lethargy. On the other hand, dry FIP is characterized by inflammation of internal organs, leading to localized masses in various organs and tissues. Neurological FIP can cause a range of symptoms, including weakness, stumbling, tremors, abnormal eye movements, seizures, urinary or fecal incontinence, and dementia.
Diagnosing FIP can be challenging due to its nonspecific clinical signs. Despite the lack of a definitive test, presumptive diagnosis is often made based on clinical signs and high coronavirus titers. Other blood test results, and characteristic changes in cerebrospinal fluid can help differentiate it from other diseases. The rapid response to treatment with the nucleoside analogue GS-441524 (the predominant Remdesivir metabolite, often referred to as just “GS44”) can also serve as a diagnostic indicator.
Getting treatment is oftentimes difficult, since the drug is not approved in most countries, despite numerous clinical trials attesting to it’s effectiveness and safety Exceptions to this are Australia, the UK and the Netherlands, where oral tablets became legally available. It is a criminal offence for a veterinarian to import GS-441524. Veterinarians who do so risk losing their license to practice.
Treatment for FIP typically involves a minimum of 12 weeks or 84 days of daily subcutaneous injections or oral medication. Before discontinuing treatment, blood work should be checked to ensure its effectiveness. Each vial of injectables costs between $65 to $120, depending on the brand and concentration of the medication. The daily dose is determined by the cat’s weight and the type of FIP they have. Cats with neurological FIP are the most difficult to treat and often require an even higher dosage.
Both the oral medication and the injections should be given every 24 hours at approximately the same time each day for at least 12 weeks. Supportive care, including fluid therapy and drainage of accumulated fluids, is also recommended in some cases.
Preventing FIP involves minimizing exposure to FeCV, which is challenging due to its ubiquitous nature. Vaccination against FIP is available but its effectiveness is questionable. Management strategies such as maintaining clean litter boxes and reducing stress in multi-cat households can help prevent FeCV transmission.
Recent research has provided new insights into the pathogenesis of FIP and potential treatment options, offering hope for improved outcomes for affected cats in the future. However, diagnosing and managing FIP remains complex, requiring further research and development of effective diagnostic tools and treatments.
Panleukopenia (feline distemper)
Feline panleukopenia, also known as feline distemper, is a highly contagious and potentially fatal disease in cats caused by the feline panleukopenia virus (FPV). It primarily affects kittens and unvaccinated cats, particularly those living on the street or in environments such as pet shops or shelters. FPV targets rapidly dividing cells in various body tissues, including those in the lymph nodes, bone marrow, and intestines. FPV significantly reduces white blood cells, weakening the body’s ability to fight infection.
Transmission occurs through contact with infected bodily fluids or contaminated objects like bedding and toys. The virsu can persist for up to 1 year and be transported long distances. Cats who survived infection can continue to shed the virus for as long as 6 weeks after recovery. Cats infected with FPV may exhibit symptoms such as diarrhea, vomiting, fever, lethargy, dehydration and loss of appetite. Infected cats have a higher likelyhood of developing additional infections. Especially kittens are at higher risk of severe illness and death. Surviving kittens infected before or shortly after birth may suffer brain damage, causing incoordination and tremors when moving, seizures, or blindness.
Diagnosis involves examination, general blood tests and specific testing for presence of the virus. Treatment focuses on supportive care to manage symptoms, including fluid therapy and nutritional support. Chances for recovery depend on a variety of factors, like age, general health status, the severity of their illness, and how quickly they receive veterinary attention. Generally, the earlier a cat receives care, the better the chance of a good outcome.
Prevention is crucial, with vaccination being the primary method. Vaccination protocols typically involve a series of doses for kittens and periodic boosters for adult cats. Additional preventive measures include minimizing contact with infected cats, practicing good hygiene, and disinfecting potentially contaminated surfaces.
Overall, early vaccination and proactive preventive measures play key roles in safeguarding cats against feline panleukopenia and reducing its spread within feline populations.
Toxoplasmosis
Toxoplasmosis is a disease caused by the parasite Toxoplasma gondii. It is one of the most common parasitic diseases and and infects many differenc species, including pets and humans. Toxoplasmosis occurs worldwide and is widespread in cats.
Cats play a crucial role in the parasite’s life cycle, but typically show no clinical signs of the disease. However, immunocompromised cats, particularly kittens and those with feline leukemia virus (FeLV) or feline immunodeficiency virus (FIV), are more susceptible to toxoplasmosis.
The disease can manifest with symptoms such as fever, loss of appetite, lethargy, respiratory issues, jaundice, eye inflammation, neurological abnormalities, seizures, and urinary or fecal incontinence, depending on the location oft he parasite in the body. Diagnosis often relies on a cat’s medical history, clinical signs, and blood tests measuring antibodies to the parasite.
Treatment typically involves antibiotics, sometimes combined with steroids to reduce inflammation. The prognosis varies depending on factors like the affected organs, timing of treatment, and initial response to therapy. The prognosis for cats with toxoplasmosis affecting the liver or lungs is usually poor. The earlier treatment is started, the better the chance of recovery. This is why treatment should be started as soon as possible, if Toxoplasmosis is suspected in a cat. If there is no clinical improvement after a few days of treatment, a different cause for the symptoms has to be considered, and further diagnostic investigations may be necessary to determine an alternative diagnosis and appropriate treatment plan.
Preventing toxoplasmosis involves minimizing exposure to infective oocysts by feeding cats cooked food, preventing access to uncooked meat and potential hosts like rodents. For pets, it also includes maintaining good hygiene practices such as regular litter box cleaning. Obviously, this is not possible for stray cats. Because pregnant women and immunocompromised individuals are at higher risk, it is very important to take preventive measures such as proper food handling and hand hygiene. However there is no need to avoid cats altogether.
Pneumonia
Pneumonia in cats can result from various causes. Common triggers include bacterial, viral, or fungal infections, as well as aspiration of foreign material or invasion by parasites. Cats of any age can develop pneumonia, but it’s more commonly seen in kittens, senior cats, or those with underlying health issues (as are often present in stray cats).
Symptoms of pneumonia in cats may include difficulty breathing, coughing, abnormal respiratory sounds, fever, nasal discharge, and loss of appetite. Severe cases may present with rapid breathing, coughing up mucus or blood, bluish discoloration of the mouth, lethargy, and weight loss. Fungal pneumonia may additionally manifest with eye or skin problems and limping.
While contagious forms of pneumonia can spread not only to other cats, but also to other animals, such as dogs or small animals. To contain the spread, it is essential to isolate the sick cat and maintain good hygiene practices to prevent transmission. Treatment typically involves veterinary care, including hospitalization for monitoring, oxygen therapy, intravenous fluids, and medication such as antibiotics or antifungals. Prognosis is generally favorable with appropriate treatment, though complications may arise, particularly in cases of aspiration pneumonia or in cats with compromised immune systems. Recovery depends on factors like the underlying cause and the cat’s overall health and age.
Upper respiratory infections
Respiratory infections are prevalent among cats, particularly in densely populated environments like shelters, colonies and breeding catteries. They can be caused by various pathogens including viruses, bacteria, fungi, and protozoa, and can severely affect feline health. While vaccines have reduced the severity of respiratory diseases, they haven’t eradicated the highly contagious pathogens responsible.
These infections can affect both the upper and lower respiratory tracts. Clinical signs of these infections include sneezing, coughing, nasal discharge, ocular discharge, lethargy, ulcers in the mouth, inappetence, fever and difficulty breathing.
Feline Herpes Virus (FHV-1) and Feline Calicivirus (FCV) are two common viruses causing respiratory issues, with symptoms ranging from mild to severe. Diagnosis typically involves recognizing clinical signs and conducting diagnostic tests like PCR.
Treatment for respiratory infections often includes supportive care, such as ensuring proper nutrition and hydration, alongside specific therapies like antiviral drugs or antibiotics to control secondary bacterial infections. However, the prognosis varies depending on the severity of the infection and the overall health of the cat. Prevention primarily involves vaccination, although it’s not always 100% effective in preventing infection but helps in reducing the severity of the disease.
While Feline Herpes Virus (FHV) and Feline Calicivirus (FCV are responsible for the vast majority of cases, other respiratory infections in cats include Feline Chlamydiosis, fungal infections (such as Cryptococcus neoformans), and bacterial infections like Bordetella bronchiseptica. These infections have their specific clinical signs, diagnostic methods, treatments, and preventive measures. Overall, early detection, appropriate treatment, and preventive measures are crucial in managing respiratory infections in cats. Affected cats may become carriers of the virus, shedding it intermittently, and posing a risk to other cats. Prevention strategies include vaccination against FHV and FCV, as well as other measures.
Dental disease
Dental disease is a prevalent health concern for stray and pet cats. It affects up to 90% of cats over four years old. The three most common conditions are gingivitis, periodontitis, and tooth resorption, all of which can lead to significant discomfort and pain. If left untreated, these conditions can lead to severe pain, hindering the cat’s ability to eat, and can result in starvation.
Gingivitis is characterized by inflamed gums due to plaque buildup, which can progress to periodontitis if left untreated. Tooth resorption involves the breakdown of tooth structure, leading to tooth loss.
Gingivitis typically manifests as red, swollen, and painful gums, often accompanied by bleeding and bad breath. Preventive measures include regular tooth brushing with cat-specific products and addressing underlying systemic diseases. Treatment may involve scaling, antibiotics, immunosuppressive drugs, and tooth extraction if necessary.
Periodontitis results from untreated gingivitis and is characterized by weakened tooth attachment tissues, potentially leading to loose teeth and tooth loss.
Diagnosis involves probing the gums and X-rays. Treatment aims to remove plaque and mineral buildup, with tooth extraction in severe cases.
Tooth resorption, the most common cause of tooth loss in cats, presents as pinkish defects at the gum line and can be extremely painful. Treatment involves pain management, lesion monitoring, and tooth extraction if necessary.
Overall, preventive dental care, including regular check-ups and proper oral hygiene, is essential in maintaining a cat’s dental health and ensuring their overall well-being.
Feline Herpes Virus
Feline Herpes Virus (FHV) infections are common in cats, often resulting in acute upper respiratory infections (URI) characterized by symptoms like conjunctivitis, nasal and ocular discharge, sneezing, lethargy, and fever. These infections are highly contagious and typically last for several weeks, during which virus shedding occurs. Cats that have been infected become lifelong carriers, who may experience occasional recurrences of clinical signs and shed the virus again, especially during periods of stress or immunosuppression.
Chronic FHV infection can lead to more severe ocular complications such as keratitis, characterized by the development of multiple small corneal ulcers, known as dendritic keratitis. Rarely, FHV may also cause dermatitis, resulting in skin inflammation and ulceration, primarily around the nose and mouth.
Diagnosis of FHV infection is primarily based on clinical signs, but specific tests such as PCR can confirm the presence of the virus in ocular or oral swabs. Treatment typically involves supportive care with antibiotics to address secondary bacterial infections. In severe cases, hospitalization for intravenous fluid therapy and nutritional support may be necessary. Antiviral drugs like Famciclovir can be effective, particularly in managing severe acute infections. Topical antiviral therapy may also be used for ocular manifestations.
Prevention through vaccination is crucial, starting with two or three injections in kittens beginning at around 8 weeks of age, with boosters at one year and then every 1–3 years thereafter. While vaccination doesn’t necessarily prevent infection, it significantly reduces the severity of clinical disease. Strict hygiene practices, isolation of infected cats, and disinfection measures are important, especially in multi-cat households or colonies, to prevent the spread of FHV.
Feline Calicivirus
Feline Calicivirus (FCV) is a highly contagious virus responsible for causing acute upper respiratory infections (URIs), commonly referred to as cat flu, in cats worldwide. Together with feline herpesvirus (FHV), FCV accounts for the majority of URIs in cats. FCV spreads easily between cats through direct contact with saliva, ocular or nasal secretions, inhalation of sneeze droplets, and sharing of food bowls and litter trays. It can also survive in the environment for up to a month, contributing to its widespread transmission. FCV exhibits significant genetic variability, resulting in various strains with differing pathogenicity levels.
Once exposed, cats undergo an incubation period of 2-6 days before developing clinical signs, which typically last 14-21 days. Infected cats shed the virus for at least 2-3 weeks. Some cats may become carriers, shedding the virus intermittently for months to years. Up to 50% of cats that have recovered from FCV infection become carriers.
Clinical signs of FCV infection include typical URI symptoms such as sneezing, nasal congestion, conjunctivitis, and discharge from the nose or eyes. Additionally, cats may develop painful ulcers in the mouth, throat, and nose, or sudden lameness in joints. Limping syndrome associated with FCV infection, particularly in young kittens, is a common manifestation. Although usually self-limiting, severe cases may require anti-inflammatory medication and veterinary attention. Since there are numerous other potential causes of lameness, veterinary consultation is necessary, especially for persistent or severe cases.
One specific strain of feline calicivirus causes severe generalized disease. The initial symptoms involve the eyes, nose, and mouth, but the infected cat quickly develops a high fever, severe immune depression, edema of the legs and/or face, jaundice, and symptoms of multiple organ disease. This strain is highly pathogenic, and the death rate for virulent systemic FCV (vsFCV) is reportedly up to 67%.
Diagnosis of FCV infection is usually based on clinical signs, but specific tests such as PCR can confirm the presence of the virus in swab samples. Treatment involves symptomatic care with eye medications, antibiotics to prevent secondary bacterial infections, and anti-inflammatory drugs for lameness. Environmental humidification and supportive care can also help alleviate symptoms. Vaccination is crucial for all cats, starting with two or three injections in kittens at around 8 weeks of age, followed by boosters every 1-3 years. While vaccination doesn’t prevent infection, it will help reduce the severity of disease and shorten the length of the illness if a cat is exposed.
Parasites
Fleas
Fleas, particularly the Ctenocephalides felis felis species, are a significant issue for cats and their owners due to their small size and ability to cause discomfort and transmit diseases (e.g. tapeworm). These parasites thrive in warm, moist environments, finding the dense, furry coat of a cat an ideal habitat. Flea infestations lead to relentless itching, potential skin wounds, and infections in cats, while also posing health risks to humans and other animals due to the transmission of various infectious agents.
The life cycle of a flea spans about a month, during which they undergo a complete metamorphosis from egg to larva to pupa to adult. Under optimal conditions, a single mating female flea can produce thousands of new adult fleas within a couple of months. All cats are susceptible to flea infestations, and the consequences can be severe, especially for kittens, which may suffer from anemia due to blood loss caused by flea feeding.
Detecting fleas on cats can be challenging due to their grooming habits, but fleas and flea dirt can be detected by using a flea comb.
Addressing flea infestations requires both treating the cat and eliminating fleas from the environment. A common “makeshift treatment” used is dawn dishshoap (or other perfume free dish soap), however this will not get rid of flea eggs, larvae and puppae making it quite ineffective at treating fleas, while at the same time removing healthy oils from the cats skin and fur. Various products, including powders, topical treatments, and oral medications, are available to eradicate fleas from cats. However, these products should be used under the guidance of a veterinarian to ensure safety and effectiveness. Additionally, comprehensive flea control involves thorough cleaning of the home and outdoor areas to prevent reinfestation from wildlife.
Overall, vigilant and consistent flea control measures, combined with regular veterinary guidance, are essential for keeping cats free from fleas and minimizing the associated health risks for both pets and humans.
Ticks
Ticks pose a significant health risk to cats, particularly during warmer months when they are more active. These blood-feeding parasites can transmit various infectious agents, leading to serious illnesses requiring prompt veterinary attention. Unlike fleas, ticks attach to their hosts to feed on blood during their nymph and adult stages, introducing infectious pathogens into the cat’s bloodstream.
While there are over 800 species of ticks worldwide, only a few are associated with significant feline diseases. Lyme disease, although more common in other hosts, can affect cats and lead to severe joint damage, cardiac issues, kidney failure, and neurological dysfunction if left untreated. Fortunately this is extremely rare, as cats are generally resistant to the bacteria causing lyme disease.
Other tick-borne illnesses such as hemobartonellosis (which is relatviely common), cytauxzoonosis, and tularemia pose greater threats to feline health. Hemobartonellosis causes severe life-threatening anemia, while cytauxzoonosis and tularemia can lead to symptoms like fever, lethargy, and difficulty breathing. Especially the latter two diseases are often deadly. Early detection and treatment are crucial for managing tick-borne diseases effectively.
Preventing tick infestations in cats involves using topical medications or tick collars, but these should only be used under veterinary guidance due to potential sensitivity to the chemicals they contain. Regularly inspecting a cat’s coat for ticks and promptly removing any found ticks with forceps or tweezers is essential. Disposing of ticks safely and taking precautions to avoid direct contact with them are also important to prevent disease transmission to humans.
While finding a tick on your cat can be concerning, it’s essential to remain calm as most ticks do not carry diseases, and tick-borne illnesses in cats are relatively rare. However, vigilance and proper tick prevention measures are crucial for ensuring the health and well-being of cats in areas where ticks are prevalent.
Heartworm
Heartworm disease presents a significant health risk to cats, particularly during hot and humid weather when mosquito activity peaks. This potentially life-threatening condition is caused by the parasitic worm Dirofilaria immitis, transmitted through mosquito bites. Once infected, heartworm larvae migrate and develop within a cat’s body, primarily affecting the lungs and pulmonary arteries.
Although heartworm disease is commonly associated with dogs, it can also have severe consequences for cats. The inflammatory response triggered by immature and dying worms leads to pulmonary artery damage and respiratory complications, collectively known as heartworm associated respiratory disease (HARD). Symptoms of heartworm infection in cats may include vomiting, diarrhea, difficulty breathing, coughing, lethargy, and weight loss. These symptoms can start around 60 to 100 days after initial infection. The worms can grow to be more than 30cm long.
Diagnosing feline heartworm disease typically involves various tests, including bloodwork, chest X-rays, and antibody detection assays. Unfortunately, there is no approved drug for heartworm therapy and cats and the drug used to treat it in dogs is not safe for cats. This means that prevention is the only effective means against heartworm. If a cat is infected, the condition may be fatal. Management strategies focus on supportive care, such as oxygen therapy, fluid administration, and medications to alleviate symptoms.
Preventive measures such as Year-round administration of medications like selamectin, milbemycin, or ivermectin is recommended for all cats, especially those residing in mosquito-prone areas. Consultation with a veterinarian is essential to determine the most suitable preventive approach for individual cats.
Ringworm
Ringworm, or feline dermatophytosis, is a common fungal skin infection affecting cats worldwide. Despite its name, it has no connection to worms and is caused by microscopic fungi known as dermatophytes. These fungi thrive by consuming keratin, a protein found in hair and nails, and can cause dermatitis in infected animals.
Clinical signs of ringworm in cats include circular areas of hair loss, broken hair, scaling skin, color changes, inflammation, excessive grooming, and dandruff. If left untreated, ringworm can persist for months, leading to increased risk of skin wounds and secondary infections. Additionally, it is zoonotic, meaning it can be transmitted from cats to humans.
Diagnosis involves excluding other skin conditions and may include using a Wood’s lamp to detect the yellowish-green fluorescence of infected hairs, followed by microscopic examination for fungal spores.
Treatment typically involves topical antifungal medications applied to affected areas and systemic medication in severe cases. Full-body rinses or dips may be used for extensive infections. Complete cure may take several weeks to months of consistent treatment.
Sources:
https://www.saveacat.org/uploads/4/8/4/1/48413975/ch_11.pdf
https://ccah.vetmed.ucdavis.edu/cats/resources/general-feline-infectious-peritonitis-resources
https://www.anicura.nl/behandelingen/kat/fip-behandeling/
https://laboklin.com/en/update-on-feline-infectious-peritonitis-fip/
https://www.msdvetmanual.com/generalized-conditions
https://risiusfamilyvet.com/fleas-201-the-dish-soap-myth/
https://www.medpets.de/herzwurm-bei-hund-und-katze-dirofilaria-immitis