Popular Posts

Tuesday, November 6, 2012

Pets Aren't Fruitcakes

With the holiday season fast approaching, this is a good time to write about something that bothers every veterinarian I know, which is the concept of giving a pets as presents. If you stop to think about it, you can easily figure out how this might not be a good idea, but in case you can't, I will explain.

A pet (and I'm talking mostly dogs and cats here) is an ongoing expense, and a LOT of work. When you give someone a pet, you are giving them a tremendous amount of responsibilty that they may not have asked for. Those of us who love our pets (and consider them family members) are willing to deal with the accidents on the rug, the chewed-up furniture, the need to skip happy hour so we can let the dog out, the smelly litter box, the humongous vet bills, and all of that...because WE agreed to these things when we got our pet(s).

However, if you aquire a pet involuntarily, all of these issues become yours for the next 10-15 years. Merry Christmas. As a veterinarian, and especially in my position of County Veterinarian, I have witnessed what can happen when someone gets a pet they didn't ask for. Usually it's the pet that suffers the most. These innocent animals are neglected, resented, and occasionally abandoned or abused. That's a tragic thing for a creature who mostly wants love and companionship. Sometimes, the owner tries valliantly to do right by their unwanted pet. But this can be sad too. I've had several nice folks bring their "gifts" to me for regular check-ups and illnesses, but with every visit they say, "You know, he's a nice dog - I just didn't ever want him. I feel guilty saying this but...I'll be glad when he's gone."

We animal-lovers know how special and wonderful it can be to have the companionship of a beloved pet (or pets in most cases!) But there has to be just as much commitment and devotion from the owner as there is from the animal. The decision to become a pet-owner, and what type of pet to get, is one that should take a lot of thought, and should never ever be made for someone else.

Can't decide on what to give someone? Give them a fruitcake. At least no one is hurt if that gets neglected or discarded.

Friday, October 26, 2012

You Think Your Dog Is Safe, But...

One of the large veterinary pharmaceutical companies recently conducted a survey of clients leaving veterinary clinics who had declined heartworm preventative medication for their dogs. When questioned why they had chose not to protect their dogs from heartworms, the most common responses were: 1.They didn't think it was very likely that their pet could get heartworms 2.They figured it would be cheaper to just treat the dog if it got heartworms than to pay for preventative medication. This blog is to address these misconceptions.

First off, heartworms are much more common than people believe. At our practice, the majority of our dog-owning clients give their pets at least some heartworm preventative. Unfotunately, many of these folks skip or "miss" a few months every year (even though they tell us otherwise, the data doesn't lie). Of the dogs who get no heartworm prevention or intermittant heartworm prevention, we see more than sixty new cases of heartworm infections per year at our practice alone! Here's what their hearts will look like:

Because heartworms are spread by mosquitos, ALL dogs in the midwest are at risk without prevention. The travesty of this is how easily (and relatively inexpensively) heartworm infection can be prevented. We sell heartworm prevention pills which cost from $5 a month for small dogs to $7.50 a month for large dogs. There is even a twice-yearly shot for those who hate pills! In contrast, it typically costs $500-$1,000 to safely treat a heartworm-infected dog. Plus, you don't have to subject the dog to what is shown in the photo above.

I had to tell a long-standing client this week that her 9-year old dog had heartworms. She had always purchased preventative from us, but admitted that she did occasionally skip a month when she wouldn't get around to picking up more pills. She is now racked with guilt (she cried when I gave her the news), and faces the expensive prospect of heartworm therapy. She's one of those who always thought "It can't happen to my dog."

The take-home message? Get your dog tested every year, and buy a year's worth of preventative when you do. The medication is much cheaper when purchased as a full year's supply, and you are less likely to subject your best friend to what is shown in the photo above.

Friday, September 7, 2012

Ten Rules For Getting A Pet

Ten Rules For Getting a Pet:


1.       Be sure a pet fits your present and future lifestyle before you buy one (or accept a free one).  That cute little puppy is going to grow.  That kitten may use your furniture as a scratching post if not provided with a suitable substitute.  Are you planning on moving in the near future and are uncertain whether you could take animals with you?  This is no excuse to kill a pet or turn the responsibility over to someone else.  Did you know that veterinarians are asked to euthanize more pets for behavioral reasons than for medical reasons?  This reflects a failure on the part of owners, not of pets.  Pets are demanding of your time and deserve that time when you make the conscious decision to bring one into your home. Be honest with yourself – don’t “give it a try” and see what happens.  What happens over 1800 times every hour of every day in the United States alone is that these animals are eventually killed.

2.       Be sure you can be a responsible pet owner.  Although everyone considers themselves to be responsible, the facts say otherwise.  Do you believe cats should always be able to roam outdoors?  Wrong!  Do you think it is a pity not to have at least one litter from your current pet before it is neutered?  Wrong!  Is it all right to let your dog out without a leash because it always listens to you?  Wrong!  Pets need our attention, our protection, and our concern.  They are not disposable items when they misbehave, get older, or outlive their entertainment value.

3.       Be sure you can afford a pet before you get one.  Pets have needs and it is short-sighted to think that the purchase price is the last expense other than food.  Pets need routine health care, vaccinations, spay/neutering, dentistry, training and licensing.  Most would agree however that a pet gives much more than it could ever cost.  Should economic constraints arise, there are many public service organizations that will see that you can have your pet neutered at low or no cost.  Failure to take advantage of these programs is a reflection of irresponsibility, not poverty.

4.       Never buy a pet on impulse.  Most puppy/kitten “mills” thrive on this behavior.  Do you want to rescue that poor puppy from that enclosure?  Can’t stand to see those kittens kept in that unclean cage?  Your intentions may be honorable, but you are directly contributing to more of these animals being produced and sold that way.  If you want to break the chain of events that makes this happen, don’t buy a pet from these outlets and caution others against it too.

5.       If you do not need a pet for show purposes, consider adopting an animal that needs a home.  Breed rescue organizations do their best to place animals in good homes and they will be familiar with the breed and be able to tell if they have a suitable pet for you.  If you don’t want a purebred, visit the local shelters.  Not all shelters are created equal.  Only deal with ones that have the best interests of the animals at he4art.  Responsible shelters will want to make sure that the animals are going to an appropriate home, that you understand about vaccinations and health care and that you agree to have the animal neutered if it has not yet been done.

6.       If you do want a show-quality pet or think you may want to breed it someday, deal only with a reputable breeder.  Reputable breeders will undoubtedly be affiliated with the appropriate breed clubs, have health care information available for several generations of their animals, and if applicable, have had these animals screened for genetic problems.  Call the breed clubs and ask for information and a list of breeders they might recommend in your area.  Many good breeders spend more time scrutinizing you before they trust you with one of their animals than you’ll spend assessing them.  A good rule is not to buy any purebred where you can’t see at least one of the parents and have access to the medical history and performance record of both.

7.       If you intend to buy a purebred animal, check with your veterinarian as to the potential hereditary problems in that breed and ask if they can be determined before purchase.  Breeders that are truly interested in the breed will be happy to discuss these concerns with you, and, if possible, will provide proof of being “clear” or can give a guarantee.  The same cannot be said of indiscriminate breeders and many pet shops.  What is their policy if your new pet does have a hereditary defect?  An exchange-only policy is common for pet-sale outlets but they know that once an animal has been welcomed into a family, most people can’t return it.  These problems can also happen to reputable breeders occasionally and how they are handled is a mark of just how responsible they are.  Always enquire before you buy.  Caveat emptor – Let the buyer beware!

8.       Be reasonable when it comes to purchase price.  You can buy a pet with “papers” for $25 or $2500.  Either could be disasters.  Ask yourself what your money is paying for.  Has there been excellent prenatal care for the mother and proper health care for the puppies/kittens or are you paying for freight and cage space for an animal shipped in from a distant location?  Were the parents champions (documented), did they hold titles in obedience, and are the “clear” of heritable disorders?  Are the animals kept in clean hygienic quarters and have they been well-socialized?  Is the breeder/seller accredited in responsible health care (e.g. Project TEACH)?  These are much more important questions than does it have papers, or how much does it cost?  Support those breeders that care enough to do the job right and expect to pay more.

9.       Immediately after acquiring a new pet, make an appointment with your veterinarian and bring along all information you have about its previous health care.  It is also wise to bring a stool sample since parasites such as worms are not unusual but will require proper diagnosis and treatment.  Puppies and kittens need a series of vaccinations when young and then regular boosters annually.  And, make sure you have your new pet neutered or spayed as soon as your veterinarian recommends.  Do not wait for the first “heat” or for a first litter.  Did you know that you can significantly diminish the risk of mammary tumors in bitches by spaying them before their first heat?  Neutered males are also at reduced risk of experiencing prostate problems later in life.

10.   If you’re truly interested in pets and their welfare, take time to understand the issues and why so many pets are destroyed each year.  Give a home to a pet in need.  Don’t accept a pet that doesn’t fit your lifestyle.  Don’t buy a pet as a whim.  Don’t support irresponsible pet sales.  Don’t become a backyard breeder or buy a pet from one.  Make sure that your pets have been neutered.   And, if you know somebody who doesn’t know better, tell them, or give them a copy of this.

Wednesday, July 18, 2012

Pet Rescue Groups - Heros To Me

I was invited to speak last night to the Metro-East Petlover Coalition (MEPC) meeting. The MEPC is  a gathering of personnel from area humane groups and animal control departments.  I'm embarrased to say that prior to my invitation, I was unaware of this group's existence, but it was thrilling to know that these folks have such a desire to improve animal rescue and welfare that they gather once a month to listen to speakers and exchange ideas about how to improve their effectiveness. It got me thinking about the people who do animal rescue, and how highly I regard them. So I wanted to share some of that with you.

In my career as a veterinarian in private practice, as well as my job at Rabies Control, I have worked with or volunteered for several dozen humane organizations. In most of these organizations, the "workforce" is composed primarily of volunteers and minimally-compensated employees. A lot of these workers have regular jobs, just like the rest of us. They have bills to pay, and mouths to feed at home. In spite of that, they spend many hours every week, using the family vehicle to transport dogs and cats from animal control facilities (or just about anywhere where they have been abandoned) to rescue shelters, adoption events, vet clinics, and/or foster homes. Trust me, the animals are often dirty, stinky, agitated, and VOCAL. These folks are volunteering to clean cages, litter boxes, kennels, floors, and walls. They volunteer to spend their weekends at adoption events and fundraisers. They are usually doing the most un-glamorous jobs you can imagine.

But amazingly, these folks will tell you that the best part of their week is when they're doing these dirty jobs for the pets they've pledged to rescue. As an animal-lover, I can tell you that these people are heros to me, and the community in general. They promote responsible pet ownership, help reduce euthanasia rates, and campaign for better treatment of animals. Yes, there are some nutjobs in the ranks, but even they usually have good intentions and are dedicated to the animals. They're sometimes just a little self-righteous, or just simply misguided.

I am honored to be able to work with these heros. I've said it before, but I truly believe that the privilege I have of practicing veterinary medicine is accompanied by a responsibility to help homeless pets in the community. My role is easy when compared to the efforts of my many friends in animal rescue and relief. God bless you.

Tuesday, April 24, 2012

When The End Comes

Unfortunately, one of the most critically-important things veterinary teams do is end the lives of suffering pets. I guess it goes without saying that we all hate that part of our jobs. Ironically, it often creates a lasting bond between us and the family who is losing their pet. I think this is because there is sincere grief and empathy on our part for the passing of one of God's valued creatures. People appreciate that we are grieving right along with them, and this helps to affirm that losing a pet can be incredibly painful. Our society is much more accepting of the bond between pets and people than it used to be. Still, some of us are ashamed to let others know just how much we love our furry family members. I have had people tell me that their human family members ridicule them for the love and attention they give and get from their dogs or cats. The decision to euthanize one's pet is often surrounded by guilt. We can feel like we're "killing" a family member. Most people want their veterinarian to tell them how to know when "it's time." Unfortunately, there is no black-and-white criteria for making this decision, and this makes the decision even more difficult. Most of us hope in vain that our pet will simply pass in their sleep. I usually tell people that "it's time" when the pet has suffering that can't be relieved, or the pet is causing significant quality of life issues for the owner which can't be alleviated. The pet's suffering is usually in the form of pain (old dogs with end-stage arthritis, cancer, or back disease), but can also be caused by a variety of medical symptoms (dimentia, wasting, seizures, respiratory compromise, etc...) The client may have significantly-compromised quality of life if a pet can no longer control their bladder or bowels, or a large pet that can't move without assistance, or a serious medical condition which is beyond the financial means of the owner. The knowledge that euthanasia is truly painless gives me comfort. As far as the pet is concerned, it is just another trip to the vet - they do not have the same anticipation (and anxiety) as the owner, who knows what's going to happen. So the mental anguish that we feel is blessedly absent for the patient, which along with the painlessness of the procedure makes it much better for the pet than the owner. When we built our new facility, we made a room especially for euthanasias. It has a comfortable couch, a rug, soft lighting, and window treatments. The fact is, these things are mostly for the benefit of the family. As a veterinarian, I envy the fact that we can painlessly end the suffering of patients who are beyond medical hope. Animals give us their best for the duration of their lives. They ask very little in return. Like all of us, they reach a point where quality of life is irreversibly compromised. Why should they continue to suffer when we can offer them something better?

Wednesday, February 15, 2012

Crap For Service From A So-Called Professional

This is going to be more of a "rant" than a blog. So, sorry, but here goes...

My daughter went to her dermatologist this morning. She has some sort of allergic/unknown skin problem which she's been seeing him about. Skin testing was done, and this was a recheck of the test results.

Well, she called me while I was at lunch to tell me about the "appointment." Her appointment time was 10:30, and she was finally called in by the nurse at noon. The nurse made small talk by asking, "How are you doing today?" My daughter informed her that she was going to be late for work due to having to wait so long for the doctor. The nurse told her to tell the doctor about this, because he should be aware of her frustration.

The doctor came in, informed her that she was allergic to rubber, told her to avoid rubber, and said, "Is there anything else?" To which my daughter replied by informing him of her hour-and-a-half wait. Without so much as looking at her, he said,"Well then, I better get my ass in gear," and walked out of the room.

So after two months of suffering with a miserable skin condition, multiple visits to this "specialist," and $120 in co-pays, she is kept waiting for an hour and a half to be told to stay away from rubber. No recheck, no follow-up, no apology or explanation.

Probably the number-one complaint we get from our clients at Horseshoe Lake Animal Hospital is how long they sometimes have to wait to see the vet. It's not unusual for someone to be kept waiting 10-20 minutes. On rare occasions, we have had clients wait for up to an hour to be seen. This is usually because of one or more emergency visits coming in to our hospital. No matter what the reason, we HATE to keep people waiting. We spend a lot of time problem-solving it. Two years ago, we lengthened our scheduled appointment times, so we would be less likely to fall behind (it worked!) We have trained our staff to offer something to clients who are kept waiting (soda, nail trim, even gift certificates if they've had to wait a really long time.) And the first thing I always do when I know someone has had to wait to see me is apologize. Then I make sure they get my full attention for the visit.

Now I doubt there are a lot of dermatological emergencies to make this guy run 1 1/2 hours behind, so I don't know what his excuse is, but to act like wasting anyone's time is a trivial matter is inexcusable to me. Likewise, I consider it shoddy medicine to make a diagnosis with no accompanying explanation or follow-up plan. An animal doctor who behaved this way at my practice would find himself looking elsewhere for employment.

Okay, I'm done. Thanks for reading. Your comments would be welcome.

Friday, February 3, 2012

Ear Infections Make Pet Owners Angry!

It is 2:45 on a Friday, and I have already seen five dogs with ear infections today. If practice makes perfect, I could be a "Doggie ENT" (ear nose & throat specialist) by the end of the month. Some of these dogs have been suffering with on-again off-again ear problems for months to years.

A lot of people don't understand how or why their dogs keep getting these infections. They may blame the groomer "for getting water in my dog's ears," or the previous veterinarian "for not treating the infection properly in the first place."
I heard that one twice already today in cases where I was consulted for a second opinion.

The truth is, the majority of recurring ear infections in dogs are due to underlying allergies. The allergy causes the ears to become inflamed, the inflammation compromises the defense mechanisms in the ear, and the infection sets in. The allergies are usually to some food protein (70% are due to beef or dairy ingredients), or environmental allergens (dust, molds, pollen, etc...) The infection can be treated appropriately by the veterinarian, but another infection occurs later, because the allergy is still there.

A common complaint by our clients is our insistence on seeing their pet every time he gets another infection: "Doc, it looks just like it did last time. I don't need you to tell me what it is. Just give me more of the medicine I got last time." Here's why we don't like to do that: Inflamed/itchy/red/greasy/sore/swollen/etc... ears look pretty much the same regardless of whether the culprit is yeast, Staph, another bacteria called Pseudomonas, or just the allergy. Each of these situations should be treated differently. Indiscrimminant use of antibiotic and/or antifungal preparations are less likely to be effective, but more importantly can lead to resistant organisms - the kind that are killing people in human hospitals (Google "MRSA" if you don't know what I'm talking about.) So, yes, even though the ear looks the same to you, it may be a completely different organism (or no organism at all) causing the trouble.

The keys to effective management of reoccurring ear infections are good follow-up by the veterinarian, a cooperative pet owner, management of the underlying allergies, but most of all, great communication between the pet owner and the doctor.

Monday, January 30, 2012

Influenza Update

Here is an article from a service we subscribe to, confirming the fact that the recent hype over the Canine Influenza epidemic, was hugely overstated:

January 23, 2012
By: Edie Lau
For The VIN News Service

A look at dog-flu diagnoses documented by major veterinary laboratories suggests that the reality was less dramatic and more nuanced. Some veterinarians believe aggressive marketing of dog-flu vaccines was behind the hype.

The New York City metropolitan area did have a bona fide outbreak and continues to experience documented illness, according to information from Cornell University Animal Health Diagnostic Center, Idexx Reference Laboratories, and Antech Diagnostics, the veterinary diagnostic laboratories most likely to test samples from suspected canine influenza cases around the country.

Idexx detected a spike in activity in Texas and California, as well. However, those spikes occurred between August and October, said Dr. Christian Leutenegger, head of molecular diagnostics for Idexx. He said the outbreaks appeared to be short-lived. By the time news accounts circulated in late December, things had calmed down in those regions.

Reports also named Colorado and Massachusetts among the regions with confirmed cases but government officials in those states told the VIN News Service that the occurrences did not constitute outbreaks.

Dog flu is considered enzootic, or generally present, in Colorado. Massachusetts received reports of two cases of canine influenza in 2011, but they happened two months apart — one in October and one in December — and therefore appear to be unrelated, said Michael Cahill, director of the Massachusetts Division of Animal Health.

“When there’s no epidemiological link between the two cases you can’t call it an outbreak,” Cahill said.

Some veterinarians suspect that vigorous marketing of canine influenza vaccine plays a part in confusing perceptions of disease prevalence.

“It seems to be getting harder to (determine) when a disease is real and when it is being ‘pushed’ by vaccine or drug manufacturers these days,” commented Dr. Margaret Mason, a practitioner in Carpenteria, Calif. Mason posted her thoughts on the Veterinary Information Network (VIN), an online community for the profession.

A number of Mason’s colleagues have expressed similar sentiments on VIN. Several related anecdotes about and experiences with Merck Animal Health, maker of one of two canine influenza vaccines on the market, pressing boarding kennels and shelters to require or administer the vaccine routinely.

Merck confirmed that it markets the vaccine through “education of boarding facility operators, kennels, pet owners and veterinarians about the disease state and about steps they can take to encourage prevention.” Told that some practitioners are concerned about overzealous marketing, a company media-relations official had no comment.

Dr. Cynda Crawford, a veterinarian at the University of Florida (UF) who led the research team that first identified the canine influenza virus in 2004, said that regardless of Merck’s role in calling attention to the disease, documented infections are occurring. She said the company is making worthwhile contributions to scientific understanding of the disease.

“It’s an accepted practice for different pharmaceutical companies to market their wares. I view their interest in canine influenza as a valuable asset to the veterinary community," she said. "Merck Animal Health has taken an active role in tracking canine influenza in an effort to provide updates on where it is occurring. In addition, their tracking provides opportunities to acquire field isolates for analysis to determine whether the virus is mutating in a way to affect diagnostic test accuracy (and) vaccine efficacy."

Crawford, along with colleagues at UF, Cornell University and the U.S. Centers for Disease Control and Prevention (CDC), share intellectual rights to the virus; Merck has licensed the right to use the virus to make a vaccine. However, Crawford noted, she and the others do not receive compensation from vaccine sales.

A mutated form of the equine influenza virus, the H3N8 canine flu virus has been found to affect dogs in much the same way that flu viruses typically affect people and horses: causing a runny nose, cough and fever but usually able to be shaken off with rest and time. But in some dogs, regardless of age and health status, Crawford said, the flu may progress to pneumonia. "There is no way to predict which ones will" be stricken with more severe illness, she said.

Dog flu isn't known to transmit to humans, just as dogs don’t usually catch flu from people — an exception being the dreaded H1N1 influenza virus that has sickened humans, livestock, zoo inhabitants and house pets alike.

As for protecting dogs against the H3N8 flu bug, the American Animal Hospital Association’s latest Canine Vaccination Guidelines list the canine influenza virus (CIV) vaccine as a “noncore” immunization, to be used only when conditions warrant.

“The CIV may be recommended (noncore) in selected shelters located within endemic communities or in shelters that transport dogs to or from communities considered to be endemic for canine influenza,” the guidelines state.

They continue: “This is a killed vaccine that requires two doses be given at least two weeks apart. Immunity is expected one week after the second dose. Therefore, even in shelters located within endemic communities, the benefit of this vaccine will be limited if exposure cannot be prevented before onset of protection or in dogs unlikely to stay long enough to receive the full series of vaccines.”

Both vaccines on the market require a booster after the initial shot to stimulate the immune response. The manufacturers recommend annual vaccination thereafter.

Veterinary infectious disease experts generally advise vaccinating dogs that travel regularly to venues where dogs congregate, such as shows and racetracks, as well as dogs in regions with a documented outbreak.

Some veterinarians also advise vaccinating dogs before they’re boarded and dogs that frequent dog parks. However, other practitioners consider that unnecessary.

A-Animal Clinic in Fort Worth, Texas, began in mid-November to require that all dogs left at the facility — whether for boarding, day camp, grooming or medical procedures — be vaccinated against canine influenza virus.

Practice Manager Newley Spikes said he and his wife, Dr. Karen Spikes, established the policy after receiving information from Merck about confirmed flu cases in their region.

He said the vaccine vendors “pounded us with the information. We’re one of the largest boarding facilities (in the area); we hold 150 dogs. They’ve been after us for about 24 months or so that we need to get on board with CIV. They continue to bring it to our attention if there are cases anywhere.”

Spikes, who co-owns the clinic with his wife, said the vaccine requirement makes good business sense. “In August 2007,” he recalled, “we had something go through our kennel, an upper-respiratory (infection) — drippy eyes, green stuff out of the nose and cough that was persistent. We treated hundreds of dogs. It cost us, net giveaway, the cost of drugs, something like $10,000. If they get sick here ... if they get hurt here, we take care of it without charging.”

Spikes said he doesn’t consider Merck’s vigorous marketing inappropriate. “Frankly, they aren’t pushing it hard enough, if you ask me,” he said. “... We are in business here, and our business is animal care. ... If there’s a (method of) prevention that’s easy and safe and economical to the client that could keep an outbreak from taking place in a facility such as ours, we should be on it.”

Spikes said the clinic charges $19.85 for the first shot and the same for the booster. “Our clientele has been nothing but receptive,” he reported.

Although it takes a week following the booster for the vaccine to confer immunity, Spikes said his facility’s requirement is met as long as the dog receives one shot. That shot may be administered immediately before the dog is admitted.

He acknowledged that requiring only one shot upon admittance doesn’t actually protect the dog, but said that to demand dogs be fully immunized before check-in is impractical. “In a business situation, perfection isn’t an option,” Spikes said.

The goal, he said, is to get patients and boarders protected over time. Spikes estimated that more than 1,000 of the facility’s canine patients and visitors have completed the two-shot series.

The Merck canine influenza virus vaccine, dubbed Nobivac Canine Flu H3N8 — developed by Intervet/Schering-Plough Animal Health, which is now owned by Merck — was available for the first time in 2009 under a conditional license from the U.S. Department of Agriculture. A full license was granted the following year.

A second canine influenza virus vaccine made by Pfizer Animal Health, called Vanguard CIV, went on the market last February. Dr. Oliver Knesl, marketing manager for companion animal biologicals at Pfizer, told the VIN News Service that his company’s marketing efforts focus on educating practitioners about how the virus works in tandem with other pathogens that cause respiratory disease in dogs.

“It can be a primary pathogen and cause disease on its own, but it’s very much (also) a participant along with some of the more traditional canine respiratory pathogens (such as) Bordetella bronchiseptica, canine adenovirus type 2 and parainfluenza,” Knesl said.

Dr. Edward Dubovi, director of the virology laboratory at the Cornell University Animal Health Diagnostic Center, agreed that tracing the cause of respiratory disease in dogs has become complicated.

"The issue of pathogens involved in 'kennel cough' is now very complex," Dubovi said, referring to a syndrome formally known as canine infectious respiratory disease or acute respiratory disease of canines.

"Prior to 2003, all one talked about was Bordetella and canine parainfluenza virus with some mention of canine adenovirus and mycoplasma," he said. "Since 2003, we have at least four new viruses in respiratory cases in dogs, two of which are the most common viral infections in dogs: canine respiratory coronavirus and canine pneumovirus. Dogs in group housing are often infected with multiple agents such that it is difficult to determine if one is more important than the other."

Crawford at UF concurred. She said she has tested hundreds of dogs in respiratory disease outbreaks and found co-infections to be "very common."

The relatively short history of canine influenza virus makes it all the more challenging for practitioners to sort out the facts, since researchers still are learning how the virus behaves. For example, unlike human flu, canine influenza does not follow a season. That’s another confounding factor in tracking its spread.

“Where canine influenza virus appears, in what community, is totally unpredictable and sporadic,” Crawford observed.

Furthermore, no single agency or institution tracks the virus. In veterinary medicine, there is no equivalent of the CDC.

According to Merck, the virus has caused illness in 38 states. That information is gleaned from five disparate sources.

Idexx and Cornell offer their respective data on canine influenza virus test results with the caution that the information isn’t comprehensive. Said Idexx’s Leutenegger: “Even though we receive large numbers of samples, it is difficult to determine prevalence due to the low number of cases submitted in a particular geographic area.”

Of the three laboratories believed to evaluate the majority of samples from suspected canine influenza cases, Idexx had the most varied information on positive results in 2011.

Dr. David Lewis, director of consultation services at Antech Diagnostics and a consultant on VIN, said his lab has seen no unusual flu activity outside of the New York City area in the past six months.

Dubovi at Cornell reported seeing an uptick in positive results from greater New York City as well as cases from a single kennel in San Antonio, Texas.

Leutenegger said Idexx noticed spikes in California; New York City and environs; and Texas, all occurring in August, September and October, as follows:

• California, eight cases. Five in the Los Angeles area, three in the Sacramento area.

• New York region, 10 cases. Three were in New York City, three on Long Island, and one each near Poughkeepsie, N.Y., Middletown, N.Y., Hartford, Conn., and Delaware.

• Texas, 10 cases. Five were in San Antonio, five in Dallas/Fort Worth.

Leutenegger said clusters of cases occurring in a relatively short period within a particular geographic region stand out because positive results on canine influenza tests typically pop up in more scattered fashion. For example, last July, Idexx detected five positive samples. Two were from Connecticut, one from Arizona, one from North Carolina and one from Texas.

Because canine influenza virus prevalence is not very high overall, Leutenegger said, attention-getting peaks can form easily from a relatively small number of cases.

Wednesday, January 4, 2012

Canine Influenza - And Why We Don't Vaccinate For It

Happy New Year! Canine Influenza ("CI") has been in the news a lot lately. Maybe this is because it's been a pretty mild year for human influenza, and the press needs something to write about, or maybe because the manufacturer of the new Canine Influenza vaccine has been out beating the bushes. Either way, we've been getting a lot of calls about it.

The CI virus was first identified only a few years ago, and is thought to be a variation of the Equine influenza virus. Initially, it appeared to be extremely virulent, causing severe symptoms or death in infected dogs. It is now considered much less harmful in most dogs (greyhounds seem to be the exception) than originally thought.

Symptoms of CI in dogs are similar to those suffered by people with the flu. Coughing and respiratory congestion are most often seen. Patients may run a low-grade fever, and have lethargy or inappetence. Pneumonia and secondary bacterial infections are rare but serious complications of CI. The disease is remarkably similar to a much more common infection of dogs called "kennel cough."

CI is difficult to definitively diagnose. Titer tests are available, but the disease has usually run its course and the dog is no longer contagious by the time results become available. Most veterinarians suspect CI in dogs who live in areas where the virus is known to be present, who have appropriate symptoms, and who are adequately immunized against kennel cough.

Treatment is mostly symptomatic and supportive. Hydration is very important, and antibiotics may be prescribed to treat or prevent secondary bacterial infections. Sometimes cough suppressants are used to make the dog more comfortable. Severe cases may require hospitalization.

As mentioned earlier, there is a vaccine for CI. Currently, we only recommend the vaccine for dogs who live in locations where CI outbreaks have occurred, and who will be exposed to other dogs (boarding kennels, grooming salons, pet "superstores"). There have not been any known outbreaks in our geographic locale, so we do not currently recommend the vaccine for our patients.