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Case Series Summary: This case series describes six cases involving seven cats naturally infected with Cytauxzoon felis in Indiana, USA. Medical records were retrospectively reviewed and all available information on signalment, history, clinical and diagnostic findings, treatment, outcome and pathology was reported. Cats infected with C felis were domestic shorthairs, were aged between 2 and 9 years and all but one of the cats were male. The seven infected cats originated from five counties in southwestern Indiana. Six of seven cats were found to have acute cytauxzoonosis based on clinical signs, gross pathologic lesions, observation of C felis in tissues and/or detection of C felis DNA. One cat was identified as a subclinical survivor cat with no known clinical history of cytauxzoonosis., Relevance and Novel Information: The reported cases are the first confirmed reports of acute and chronic cytauxzoonosis in cats from Indiana and document an expansion in the range of C felis . Veterinary practitioners in Indiana should consider infection with C felis as a differential diagnosis for cats that present with fever, inappetence, lethargy, depression, dehydration, dyspnea, hemolytic crisis, anorexia or icterus. Administration of approved acaricides to cats currently offers the best protection and control against C felis infection., Competing Interests: Conflict of interestThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Cytauxzoonosis is a severe tick transmitted protozoan disease of domestic cats, caused by Cytauxzoon felis. The disease is characterized by acute onset of high fever, depression, lethargy, inappentence, anorexia, icterus, dehydration, hemolytic anemia, and alteration of immune response. The aim of our study was to further detail the immune response of domestic cats to C. felis infection by comparing the differential expression of feline immune transcriptional elements during acute and chronic cytauxzoonosis. True single molecule sequencing (tSMS) was used to analyze the whole genome of acutely and chronically infected C. felis cats, focusing on the analysis of genes involved on the immune response. Two C. felis donor cats were infested with Amblyomma americanum nymphs, which after repletion were collected and kept in humidity chambers until they molted. The resulting A. americanum were randomly selected to infest three C. felis naïve principal cats. Infection of these cats was confirmed by nested PCR of the 18S rRNA C. felis gene and clinical signs. RNA was extracted from whole blood at different time points and used for tSMS analyses, the results revealed overexpression in transcripts involved in type I interferon signaling, cellular and cytokine responses during the acute stage of infection, while cell cycle, and metabolic processes were downregulated. Genes involved in cell adhesion increased their expression in the chronic infected cats, whereas inflammatory and apoptotic related genes were downregulated. This study provided information on the host immune response to C. felis in domestic cats, demonstrating that inflammatory, apoptotic, and cell adhesion are some of the pathways altered during acute and chronic infection., Competing Interests: Declaration of Competing Interest None, (Copyright © 2023 The Author(s). Published by Elsevier GmbH.. All rights reserved.)

Background: Cytauxzoonosis is a life-threatening disease of cats, caused by the tick-borne piroplasmid hemoparasite, Cytauxzoon felis. Current experimental models for cytauxzoonosis rely on either tick transmission or direct injection of infected cat tissues. These models require researchers to directly work with infected ticks or use cats with acute cytauxzoonosis. To improve the feasibility and accessibility, there is a need to establish sharable resources among researchers. In related piroplasmid parasites, sporozoite-based inoculums are routinely produced from tick salivary glands, cryopreserved and distributed to other investigators and facilities. For these parasites, sporozoites have been the basis for vaccine development and in vitro cultivation, both of which remain lacking for C. felis research. If infectious sporozoites can be similarly isolated for C. felis, it would significantly broaden our capabilities to study this parasite. Aims of this study was to determine if C. felis sporozoites inoculums collected from the salivary glands of Amblyomma americanum ticks were capable of inducing cytauxzoonosis in naïve cats., Materials and Methods: A. americanum nymphs were acquisition-fed on a donor cat chronically infected with C. felis and allowed to molt to adults. Four groups of adult ticks (n = 50/group) were either stimulation-fed for 4 days on naïve cats or were heated at 37 °C for 4 days. After these treatments, salivary glands (SG) of each group of ticks were collected to create inoculums. Infectivity of these inoculums was then tested by subcutaneous injection into naïve cats., Results: The two naïve cats used for stimulation feeding and as controls both developed cytauxzoonosis, indicating these groups of ticks were capable of producing infectious sporozoites. Of the 2 cats that were injected with SGs from the stimulation-fed ticks, one cat developed cytauxzoonosis and C. felis infection was confirmed by both light microscopy and PCR. The other cat did not develop cytauxzoonosis and only had equivocal evidence of infection. Neither cat injected with SGs from the heated ticks developed cytauxzoonosis. One of these cats had equivocal evidence of infection and one had no evidence of infection., Conclusion: This study validates the feasibility of collecting infectious sporozoites from C. felis-infected ticks that can be used to infect naïve cats. While this model requires further optimization, it has the potential to expand resources to study C. felis and further advance research in this field., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

Cytauxzoonosis is a fatal tick-borne disease in domestic cats caused by infection with the apicomplexan Cytauxzoon felis. Bobcats are the natural wild-vertebrate reservoirs for C. felis, and infections are typically subclinical and chronic in this species. The present study was done to determine the prevalence and geographic distribution of C. felis infection in wild bobcats from Oklahoma and the occurrence in northwestern Texas. Tongue samples from 360 bobcats were collected from 53 counties in Oklahoma and 13 samples from three counties in Texas. For DNA extracted from each tongue sample, a probe-based droplet digital PCR assay was performed targeting the C. felis mitochondrial gene cytochrome c oxidase subunit III (cox3). Prevalence of C. felis infection was calculated for each county sampled, and data from individual counties were combined according to geographic regions and compared using chi-square tests. Overall prevalence of C. felis in bobcats from Oklahoma was 80.0% (95% confidence interval [CI], 75.6-83.8). The prevalence of infection was >90% for bobcats from central, northeastern, south-central, and southeastern regions of Oklahoma, but <68% for bobcats from northwestern and southwestern regions. Bobcats from central counties in Oklahoma were 25.693 times more likely to be infected with C. felis compared to all other bobcats sampled from the state. Higher prevalence estimates of C. felis in bobcats appeared to be in counties where known tick vectors are most common. Occurrence of C. felis in bobcats from northwestern Texas was 30.8% (95% CI, 12.4%-58.0%) based on 13 samples. Results of this study support the utilization of bobcats as sentinel animals to identify geographic areas with risk of C. felis infection to domestic cats., (© Wildlife Disease Association 2023.)

Cytauxzoonosis is a tick-borne disease of domestic cats with high mortality and narrow therapeutic window, particularly in the southcentral and southeastern United States. The causative agent is the apicomplexan protozoal parasite Cytauxzoon felis and is primarily transmitted by Amblyomma americanum, the lone star tick. Currently there is no vaccine available to prevent cytauxzoonosis and treatment is often ineffective if not initiated early enough in the course of disease. Early diagnosis and therapeutic intervention are therefore crucial for the survival of infected cats. Several methods are available for diagnosis of cytauxzoonosis, with PCR being the most sensitive. However, current PCR assays, which employ double-stranded DNA intercalating dyes to detect C. felis infection, have inherent limitations such as the potential for false positive detection of non-specific amplification products and inability to provide absolute quantification of parasite load. The objective of this study was to develop a probe-based droplet digital PCR (ddPCR) assay capable of detection and quantification of C. felis load over time and during treatment. The C. felis ddPCR assay was able to (i) reliably detect and quantify C. felis DNA in clinical blood samples from cats with acute cytauxzoonosis and (ii) monitor clinical parasite load in response to anti-protozoal treatment through absolute quantification of C. felis DNA over time. When tested on blood samples from cats with experimental C. felis infection, the assay was able to detect infection in cats as early as 24 h prior to the development of clinical signs. In addition, we demonstrate that this probe-based design can be utilized in traditional real-time PCR systems, with similar detection capabilities as compared to ddPCR. The C. felis probe-based ddPCR was also able to detect infection in samples with lower parasite loads when compared to existing nested PCR assays, although these results were not significant due to small sample size. To the author's knowledge, this is the first reported probe-based ddPCR assay to detect Cytauxzoon felis infection in domestic cats., (Copyright © 2021. Published by Elsevier B.V.)

Background: Successful Cytauxzoon felis transmission studies have occurred using Amblyomma americanum adults acquisition-fed as nymphs on an experimentally infected domestic cat or Dermacentor variabilis adults fed as nymphs on a splenectomized bobcat. Here, we evaluated A. americanum and D. variabilis nymphs acquisition-fed as larvae on a C. felis-infected carrier domestic cat for competence to transmit the protozoan parasite as nymphs to naïve, healthy domestic cats., Methods: Amblyomma americanum and D. variabilis larvae were applied to a chronically infected, parasitemic C. felis donor cat (Felis catus) and allowed to feed to repletion. Engorged larvae were collected and held through ecdysis. Three cats were each infested with 66 A. americanum or 66 D. variabilis emerged nymphs. Cytauxzoon felis infections in principal cats were determined by clinical signs and detection of circulating parasite by blood smear and PCR evaluation., Results: Clinical signs of cytauxzoonosis were observed in cats infested with A. americanum nymphs beginning 12-15 days post-infestation (dpi). The same cats were PCR positive on 12-14 dpi; piroplasms were evident in blood smears at 16 dpi, and macrophage schizonts were observed in stained spleen impression smears in two animals at necropsy. Cats infested with acquisition-fed D. variabilis nymphs remained clinically normal and did not develop detectable parasitemia over the course of the study as determined by blood smear and PCR., Conclusions: Cytauxzoon felis was successfully transmitted to domestic cats by A. americanum nymphs acquisition-fed as larvae on the donor cat. However, we were not able to transmit C. felis to healthy domestic cats with D. variabilis nymphs that were simultaneously acquisition-fed on the same donor cat. Results from this study suggest that larval and nymphal A. americanum likely play important roles in natural transmission cycles of C. felis.

Objectives The objectives of the present study were to determine the duration of infestation by Amblyomma americanum necessary for transmission of Cytauxzoon felis to domestic cats and to determine if ingestion of C felis-infected A americanum by cats is a route of transmission. Methods Forty-nine cats were assigned to one of seven groups, with seven cats per group. Cats were infested with A americanum adults, acquisition fed as nymphs on a cytauxzoonosis survivor cat, for 12 h (group 1), 18 h (group 2), 24 h (group 3), 36 h (group 4), 48 h (group 5) and to repletion (group 7; control). Cats in group 6 were fed C felis-infected ticks. Thumb counts were performed at the end of the duration of infestation for groups 1-5 and at 48 h for the control group. For group 6, 50 live C felis-infected adult A americanum were mixed with food and fed to each of the cats. Transmission of C felis was determined by examining blood of cats by DNA extraction followed by PCR. Results Of 50 ticks placed on each cat (groups 1-5 and 7), the arithmetic mean attachment ± SEM ranged from 46.9 ± 1.9 in group 3 to 49.3 ± 0.3 in group 1. In group 6, the average number ± SEM of ticks ingested was 46.5 ± 2.3. One cat in group 5 that had been infested for 48 h became infected with C felis. None of the cats in group 6 (ingestion) became infected with C felis. Six of 7 (85.7%) cats in group 7, the control group, became infected with C felis. Conclusions and relevance Our results indicate that transmission of C felis to domestic cats can happen as quickly as >36 h but ⩽48 h of exposure to A americanum infected with C felis and that ingestion of C felis-infected A americanum is not a likely route of transmission.

Background: Infection with Cytauxzoon felis in domestic cats can cause fever, lethargy, depression, inappetence, icterus, and often death. With a high mortality rate, cytauxzoonosis was historically considered a fatal disease. Within the last 15 years, cats with or without treatment have been recognized as chronically infected survivors of C. felis infection. Our objective was to determine the prevalence of C. felis in healthy domestic cats from Arkansas, Missouri, and Oklahoma., Methods: Infection with C. felis was determined using DNA extracted from anticoagulated whole blood and PCR amplification using C. felis-specific primers. Chi-square, Fisher's exact tests, and odds ratios were used to compare proportions of cats infected with C. felis., Results: Blood samples were collected from 902 healthy domestic cats between October 2008 and April 2012. DNA from Cytauxzoon felis was detected in 56 of 902 (6.2%; 95% confidence interval, 4.7-7.9) samples. The highest prevalence of C. felis infection (15.5%; 10.3-21.7) was observed in cats from Arkansas, followed by cats from Missouri (12.9%; 6.1-24.0), and cats from Oklahoma (3.4%; 2.2-5.1). Cats sampled in Arkansas and Missouri were 5.1 and 4.2, respectively, times more likely to be chronically infected with C. felis than cats from Oklahoma., Conclusions: Infection with C. felis is common in domestic cats through Arkansas, Missouri, and Oklahoma. The high prevalence of C. felis reported herein suggests that infected domestic cats are likely reservoirs of infection for naive felines. The high prevalence of C. felis substantiates the importance for the use of approved acaricides on cats to prevent cytauxzoonosis.

The ecological distribution of Cytauxzoon felis, an often-fatal tick-borne apicomplexan that infects domestic cats, has not been evaluated or identified despite its continued emergence. Infection of C. felis is characterized by lethargy, icterus, fever, anorexia, anemia, and death. The natural vertebrate reservoir of C. felis is the bobcat (Lynx rufus). To determine the possible distribution of C. felis in three states where infection is common (Oklahoma, Missouri, and Arkansas), two separate approaches to ecological niche modeling were implemented. First, a model relating several different climatic layers to geographic locations where cases of C. felis infection were confirmed in domestic cats was developed to predict the possible distribution of the parasite. The second model incorporated occurrences of bobcats with environmental layers and land cover suitable for tick vectors to identify areas of overlap where C. felis transmission was likely. Results of both models indicated a high probability of C. felis from central Oklahoma to south-central Missouri. However, other predicted areas of C. felis occurrence varied between the two modeling approaches. Modeling the vertebrate reservoir and the tick vector predicted a broader possible distribution compared to modeling cases of C. felis infection in domestic cats. Our results suggest that C. felis is likely to extend beyond areas predicted by case modeling due to the presence of both the vector and reservoir., (Copyright © 2012 Elsevier B.V. All rights reserved.)

The order Piroplasmida consists of several genera of tick-borne parasites that infect mammals, and to a lesser extent birds, and are therefore of medical and economic importance. Despite their importance, considerable confusion exists concerning the relationship among piroplasmid species, specifically concerning the number of genera and the intergeneric relationships. To examine evolutionary relationships among piroplasmids, we conducted phylogenetic analyses of 192 18S rDNA sequences from the genera Theileria, Babesia and Cytauxzoon. Our analyses revealed eight clades potentially representing distinct genera, and we distinguish the Duncani Group and Microti Group as genetically distinct groups of species requiring detailed analysis of morphology and life-history to allow formal generic description. The piroplasmid phylogeny revealed considerable host diversity and limited host specificity, suggesting piroplasmids have undergone frequent host switches during their evolution. Our analyses provide the first reported evolutionary timescale for piroplasmids independent of the assumption of parasite-host cospeciation, which is invalid for piroplasmids. Evolutionary rate analyses revealed considerable substitution rate heterogeneity, which we attribute to host switching and diversification. Finally, we call for a comprehensive phylogenetic, morphological and life-history analysis for these medically relevant taxa to resolve relationships and understand host specificity., (Copyright © 2012 Australian Society for Parasitology Inc. Published by Elsevier Ltd. All rights reserved.)

Amblyomma americanum was confirmed as a competent vector in the transmission of Cytauxzoon felis to domestic cats. Infection with C. felis was produced and replicated in four domestic felines by the bite of A. americanum adults that were acquisition fed as nymphs on a domestic cat that survived cytauxzoonosis. Numerous attempts to transmit C. felis with Dermacentor variabilis at the same time were not successful. All cats upon which infected A. americanum were transmission fed exhibited disease typical of cytauxzoonosis, and the eitiologic agent's presence was confirmed. Clinical signs including fever, inappetence, depression, and lethargy were observed beginning 13 d postinfestation. Pale mucus membranes, splenomegaly, icterus, and dyspnea were also observed during the course of the disease. Rectal temperatures of the C. felis-infected principal cats fluctuated from high to subnormal before returning to the normal range. Clinical signs of cytauxzoonsis improved by 24 d postinfestation in all but one cat, with survivors remaining parasitemic and subclinically infected with C. felis. Unengorged A. americanum and D. variabilis were collected from wild habitats to determine the minimum infection rate of C. felis in ticks from an enzootic area. Infection of C. felis was found only in wild-collected A. americanum. The minimum infection rate of C. felis in A. americanum was 0.5% (one of 178) in males, 0.8% (three of 393) in nymphs, and 1.5% (three of 197) in females. We found no wild-collected D. variabilis infected with C. felis. Our results confirm that A. americanum is a primary vector of C. felis.

Cytauxzoon felis is a tick-transmitted protozoan parasite of domestic and wild felids in the south-central and southeastern United States. Infection of domestic cats (Felis domesticus) with C. felis is typically acute and characterized by fever, anorexia, listlessness, anemia, icterus and usually death within 19-21 days. To determine the temporal occurrence and environmental risk factors associated with infection of C. felis in domestic cats from Oklahoma, information in the electronic medical records from the Oklahoma Animal Disease Diagnostic Laboratory (OADDL) and Boren Veterinary Medical Teaching Hospital (BVMTH) was retrospectively searched. A total of 232 cytauxzoonosis cases from 1995 to 2006 from OADDL (n=180) and 1998 to 2006 from BVMTH (n=52) were combined and analyzed. The number of cytauxzoonosis cases remained relatively consistent from year to year. Diagnosis of C. felis infection in domestic cats followed a bimodal pattern with a peak in the number of cases in April, May, and June followed by a second smaller peak in August and September. The majority (n=72; 31.0%) of cytauxzoonosis cases were diagnosed in May. No cases of C. felis infection were diagnosed in December and only a few (n=10; 4.3%) cases were observed from November through March during the 12-year period. In cases for which the client's address was available, geographic coordinates were assigned and landscape characteristics were quantified within a 100-m radius of each cytauxzoonosis case location. Of cytauxzoonosis cases (n=41) with a known client address, a majority (n=28; 68.3%) occurred in low density residential areas and more cases (n=8; 19.5%) were found in urban edge habitat than expected at random. Locations of diagnosed cytauxzoonosis cases were significantly associated with more wooded (31.8+/-4.03%) cover and closer (55.5+/-18.45m) proximity to natural or unmanaged areas than randomly selected control sites. Practicing and diagnostic veterinarians can expect to see a distinct temporal pattern in cases of cytauxzoonosis and more cases can be expected in domestic cats living in close proximity to environments that support tick vectors and bobcats.

DNA was extracted and the 18S ribosomal RNA gene was amplified and sequenced from the blood of 2 Pallas' cats (Otocolobus manul) infected with small intraerythrocytic piroplasms. Sequences of the parasite were found to be identical with that of a previously reported Cytauxzoon-like piroplasm from a Pallas' cat. Phylogenetic analyses of the parasite DNA sequences obtained from the 3 Pallas' cats to other piroplasms revealed a sister group relationship to C. felis. The mean corrected percent sequence divergence between the Pallas' cat parasite and C. felis was 1.490%, which is greater than that for most other piroplasms in which species status has been accepted. On the basis of the sequence variation, we propose to name the Pallas' cat parasite C. manul. Phylogenetic analyses of C. manul also revealed a close relationship with the Spanish Cytauxzoon-like isolate because they exhibited only 0.389% sequence divergence, yet these sequences exhibit a mean of 1.690% sequence divergence from the New World isolate of C. felis. Our phylogenetic analyses also revealed several taxonomic problems that have impeded the development of a classification that accurately reflects evolutionary history of piroplasms. As currently arranged, Babesia and Theileria are paraphyletic taxa and are in need of reorganization.

During the quarantine examination of four Pallas's cats (Otocolobus manul) imported from Mongolia in October and December 2000, intraerythrocytic piroplasms were detected on Wright-Giemsa stained blood films that were morphologically indistinguishable from other small piroplasms of felids. Further characterization of this unknown organism via polymerase chain reaction amplification, sequencing of a portion of the 18S nuclear small subunit rRNA gene, and comparisons with orthologous sequences from other piroplasms, revealed similarity to Cytauxzoon felis. This is the first report of naturally occurring erythroparasitemia in Pallas's cats and the first documented case of naturally occurring piroplasm infections in a free-ranging felid from Mongolia.