I breathed a big sigh of relief on the evening of Saturday, May 5. The 138th running of the Kentucky Derby was over and the equine ambulance didn’t have to pick up any passengers, no screens were erected to shield the viewing public from tragedy, and everyone made it back to the barn safely.
 

Oh yeah, and the race … it was a good one. Lots of talented horses, a fast start and early fractions, and then the exciting come from behind win by I’ll Have Another (his name a reference to cookies, not booze, his connections claim). The winning jockey, a newcomer named Mario Gutierrez, cried with joy in his post-race interviews. It was a feel-good moment.

Unfortunately, I just don’t enjoy horse racing like I used to. In the past, I harbored dreams of having my own little breeding operation where I could watch “my” babies grow up and then play a role in their inevitable triumphs on the track. Then two thoughts brought me back to earth: 1) Unless I was willing to live in a dump and generally be more miserly than I am already, I was never going to have the cash reserves necessary for this endeavor (these days any extra money we have goes into my daughter’s college fund, where it will undoubtedly be put to much better use), and 2) I don’t think I could stand losing one of my horses to an injury sustained during a race that I entered it in.

My primary feeling when I catch the rare race on TV these days is trepidation. The horses are still spellbinding in their beauty and athleticism, but my joy in watching them run has been tempered with worry for their well-being. A study that was published in 2011 showed that thoroughbreds and quarter horses racing at three Midwestern racetracks sustained catastrophic musculoskeletal injuries (i.e., broke down and had to be euthanized) at a rate of 1.46 per 1,000 starts. To put it another way, if a typical race day included ten races with ten starters each, at each of these three tracks, 1.46 horses would die from musculoskeletal injuries sustained during racing alone every 3.3 days.

Granted, the superstars that run on the first Saturday in May have led the good life during their three short years of existence, but all that could change with even a non life-threatening injury or a string of losses. I can’t watch even the most pampered of thoroughbreds without thinking about all the horses that run on the smaller tracks around the country and the hard lives they lead and the uncertain futures that await them.

So, I’ll probably continue to catch the occasional big race on TV when my schedule permits, but as for taking a more active role in horse racing — either as a bettor or a potential breeder/owner — I’ll have to pass for now. Racing is making some strides in advancing the welfare of their equine athletes (synthetic tracks, charities and sanctuaries dedicated to retired racers, etc.), but they still have a long way to go.
 
 

Dr. Jennifer Coates
 
 
Image: Cheryl Ann Quigley / via Shutterstock

It’s spring, and in veterinary clinics across the country kittens and the animals that have been in contact with them are being diagnosed with ringworm. Okay, it’s not fair to blame kittens for every case of ringworm, but that soft and fluffy feline coat may be harboring an uninvited guest.
 

Let’s get this out of the way first — ringworm (more correctly called dermatophytosis) has nothing to do with worms. It got the name because the raised ring that is a characteristic of the infection in people, but not pets, looks a bit like a worm lodged underneath the skin. Ringworm is a type of fungal infection that most commonly affects the skin, fur and nails of cats, particularly kittens, and less frequently dogs and other species. Cats don’t just get the disease more frequently than do other animals, they also shed LARGE numbers of fungal spores when they are infected. So while the ringworm fungus can be found virtually everywhere in our environments, contact with an infected kitten or cat is often responsible for overwhelming a person or pet’s natural defenses.

The most common signs of ringworm infection in cats and dogs are hair loss, itchiness, flaky skin, and brittle or misshapen nails. It is important to note that some cats can be asymptomatic carriers, meaning that while they look perfectly normal themselves, they can be a source of infection for other individuals in the household.

Unfortunately, the symptoms of ringworm fit with just about every dermatological condition we see as veterinarians. The most commonly used diagnostic test involves plucking hairs from affected parts of the body, pushing them into a special type of growth medium, and waiting up to three weeks to see what grows. Some veterinarians will use a black light to identify which parts of the body are potentially harboring ringworm organisms (some types fluoresce), but examination by black light alone cannot definitively diagnose or rule out ringworm. In difficult cases, a skin biopsy might be necessary to reach a definitive diagnosis. Something called a toothbrush test — essentially brushing a pet’s fur with a toothbrush and then poking the bristles into a fungal growth medium — is a good way to screen potential asymptomatic carriers.

If anything, treating ringworm is even more difficult than diagnosing it. Mild to moderate cases may respond to medicated baths, lotions or dips (e.g., lime-sulfur, miconazole, chlorexidine). Shaving pets with long fur can help the medications reach the skin and reduce the number of contagious fungal spores present. In severe cases, oral anti-fungal drugs, such as griseofulvin or itraconazole, are often necessary. For large dogs when cost is a concern, ketoconazole can also be considered. Oral flea preventatives containing lufenuron may also help eliminate ringworm but should not be used alone.

Treatment generally needs to continue for several months and should not be stopped until hair is starting to regrow and fungal cultures are rechecked and found to be negative.

Because ringworm is so contagious, animals undergoing treatment need to be isolated and owners should decontaminate the parts of the home where infected critters have spent time. Vacuum floors, rugs and upholstery thoroughly, and wash everything possible in hot water and dry on a hot setting. A one part bleach to thirty parts water solution will kill the fungus on hard surfaces that can handle such treatment.

As always, wash your hands thoroughly after handling any pet, especially if it might have ringworm.
 
 

Dr. Jennifer Coates
 
 
Image: Noam Armonn / via Shutterstock
 

May 20-26 is National Dog Bite Prevention Week. Being bitten is just one of the professional hazards veterinarians face every day. In fact, I was bitten last week — very minor, couldn’t blame the dog as the whole reason I was at his house was to euthanize him because he was feeling terrible and not himself, but the episode served to remind me of how important education about dog bite prevention is.  

Check out these statistics:   Almost 5 million people were bitten by dogs in 2011 in the United States. Nearly 1 million people (more than half of which were kids) required medical attention for these bites. The problem appears to be getting worse. The number of people who were hospitalized for dog bites increased from 5,100 to 9,500 (up 86 percent) from 1993 to 2008. Sources: American Veterinary Medical Association and Agency for Health Care Research and Quality   The most common victims of dog bites are children who are either left unattended with and/or are playing outside with a dog that is usually familiar to them. Senior citizens are the next most frequently injured group. Preventing dog bites requires work from both dog owners and the general public.   Make sure puppies are properly socialized, particularly between 4 and 16 weeks of age. Puppies should get used to being around different types of people and become familiar with all of the different situations that he or she will be faced with as an adult. Dogs need to be well trained so that they will invariably obey basic commands like "sit," "stay," and "come." Never force dogs into setting where they are likely to become fearful or nervous. Use a leash and an appropriate collar or harness to ensure you have control in public settings. Keep dogs mentally and physically healthy with proper preventive care (including rabies vaccines), exercise, and pain medications when necessary.   When approaching a dog, children and adults should use the acronym "WAIT" to remind themselves of proper doggy etiquette:   W – Wait to see if the dog looks friendly. If the dog looks afraid or angry, STOP and walk away slowly. A –  Ask the owner for permission to pet the dog. If the owner says no or there is no owner present, STOP and walk away slowly. I –   Invite the dog to come to you to sniff you. Put your hand to your side with your fingers curled in. Stand slightly sideways and dip your head down so you are not looking directly at the dog. If the dog does not come over to sniff you, STOP and do not touch him. T –  Touch the dog gently, petting him along his back while staying away from his head and tail. Source: preventthebite.org   Here’s a final recommendation. Don’t restrain your dog (or any animal for that matter) when he or she is at the veterinary clinic. I know this can be tough. Your beloved pets are nervous and you want to reassure them, but this puts you at risk for injury. Let the veterinarians and veterinary technicians be the "bad guys." Stand nearby to offer soothing words and to get your pet to focus on you, but stay out of the range of teeth, claws, hooves, beaks, etc. Protect yourself (and your veterinarian from potential liability) just in case your pet decides that’s it, I’ve had enough and lashes out at whomever is nearby.     Dr. Jennifer Coates     Image: Kuricheva Ekaterina / via Shutterstock  

My dog Apollo has inflammatory bowel disease (IBD), so unfortunately, I have experience with this condition as both an owner and veterinarian.
 

IBD is a chameleon. Its typical symptoms of vomiting, diarrhea, weight loss, and/or anorexia fit with a whole host of diseases. Couple that to the fact that IBD can only be definitively diagnosed with a biopsy of affected tissues, and I think it’s safe to say that the disease’s incidence is probably even higher than we think.

Both dogs and cats can be affected with IBD. Certain breeds of dogs appear to have a higher than average risk of developing the disease, including basenjis, soft coated wheaten terriers, German shepherd dogs, shar-peis, rottweilers, weimaraners, border collies and boxers. Some combination of altered immunity, antigenic stimulation (e.g., food allergies, bacterial overgrowth, metabolic diseases, food intolerance, parasites, etc.), environmental stress and genetics determines which pets get IBD and when symptoms first develop. IBD is typically diagnosed in middle age, but can develop in younger or older animals as well. Often a pet’s symptoms are mild and/or intermittent to begin with but progress with time.

In Apollo’s case, he developed extremely severe symptoms at about nine months of age. He was not my dog at the time, but I suspect something triggered this acute episode — perhaps a change in diet, a gastrointestinal infection … who knows. His condition remained undiagnosed for awhile, I suspect because of his age. Most vets aren’t thinking IBD in a nine month old, but when he came to me and was failing to respond to symptomatic therapy and I had ruled out GI diseases that are more typical to a dog his age, I dug a little deeper and found some references to boxers developing the disease when they are very young.

As is suggested by its name, the pathophysiology of inflammatory bowel disease centers on abnormal inflammation within the gastrointestinal tract. Normally, the GI system has multiple layers of defense against all that passes through it. When these systems break down or are ineffective to begin with, triggers that are normally kept at bay gain access to the lining of the intestines and stimulate the immune system. The result is inflammation, which serves to recruit more inflammatory cells, further increasing the "leakiness" of the intestinal wall. A vicious, self-perpetuating cycle ensues. IBD is sub-classified by the part of the GI tract affected as well as the predominant type of inflammatory cell involved. The most common form goes by the name plasmocytic lymphocytic enteritis.

Treatment takes a two-pronged approach: eliminating triggers to inflammation within the GI tract, and suppressing the immune system. Hypoallergenic diets are key. Apollo remains symptom-free without drug intervention as long as he eats only a diet made from hydrolyzed protein (i.e., proteins broken down into pieces so tiny that they evade detection by the immune system) and a single carbohydrate source. Antibiotics may be used to help control bacterial numbers in the gut, and some antibiotics like metronidazole also have an immunosuppressive effect. Corticosteroids are the most common way to reduce the immune system’s over-exuberant response, but other medications like azathioprine (dogs) or chlorambucil (cats) can be used when corticosteroids are not fully effective or cause unacceptable side effects.

Some cases of IBD respond beautifully to treatment, but unfortunately, others do not. I recently euthanized an otherwise healthy cat and dog that had both been treated appropriately and aggressively for this disease. Fingers crossed that Apollo continues to do as well as he has so far.
 
 

Dr. Jennifer Coates
 
 
Image: Anna Hoychuk / via Shutterstock
 

Part of the veterinary oath states that a veterinarian does "solemnly swear to use my scientific knowledge and skills for the benefit of society through the … promotion of public health," which is why diseases that can be transmitted from animals to people (called zoonoses or zoonotic diseases) get special attention from us. When we can effectively treat or prevent a zoonotic disease in a pet, we are protecting both animal and human health.
 

A study appearing in the journal Emerging Infectious Diseases points to a new link between a type of bacteria carried by cats and poor human health. The bacteria are Bartonella henselae, which most commonly cause bartonellosis in cats and cat scratch disease in people. Add to that list the possibility that Bartonella bacteria may also play a role in the development of some human cases of rheumatoid arthritis (RA).

The researchers tested blood samples taken from 296 human patients exhibiting symptoms consistent with RA, and 62 percent had antibodies to Bartonella bacteria, indicating they had been exposed at some point in the past. Bacterial DNA was found in 41 percent of patient samples, which is consistent with an active infection. B. henselae was one of the most prevalent but not the only species of Bartonella identified in these patients. B. vinsonii subsp. berkhoffii, which causes bartonellosis in dogs, was also found.

B. henselae bacteria are usually transmitted from infected to non-infected cats through fleas (The vector for B. vinsonii subsp. berkhoffii appears to be ticks). People often come in contact with the B. henselae when they are scratched or bitten by a cat that has the bacteria around their nails or in their mouths. Immunosuppressed people are at a higher than average risk of diseases associated with B. henselae infection. Cats may carry Bartonella henselae bacteria in and on their bodies without becoming sick themselves. If they are affected, typical symptoms include fever, enlarged lymph nodes, and/or chronic inflammation of the digestive tract.

Diagnosing a cat with bartonellosis is not always easy. Blood tests capable of identifying cats that have been exposed to the bacteria do not determine whether or not an animal’s current illness is related to Bartonella or if they can transmit disease to people. Other tests reveal the presence of an active infection, but they tend to misdiagnose cats with low-level infections as being free from disease. It is generally not recommended that healthy cats be tested for bartonellosis because of the results can be so difficult to interpret.

Treating bartonellosis in cats is also difficult. The antibiotic azithromycin is the drug of choice, but it often fails to completely clear the infection. Cats with symptoms that are thought to be linked to Bartonella bacteria often improve with antibiotics but commonly relapse after treatment is stopped.

The link between Bartonella infections in cats (and potentially dogs) and rheumatoid arthritis in people is still tenuous, but certainly points to a need for more research into these harmful bacteria.
 
 

Dr. Jennifer Coates
 
 
Image: Arman Zhenikeyev / via Shutterstock
 

The recall of pet foods manufactured at a Diamond Pet Foods plant in Gaston, S.C. just keeps getting bigger and bigger. Initially, Diamond Pet Foods recalled only particular batches of its Naturals Lamb Meal & Rice dry dog food. This occurred on April 6, when the company stated that the action was simply a "precautionary measure."  On April 26 certain lots of Chicken Soup for the Pet Lover’s Soul Adult Light Formula dry dog food were recalled. On April 30, Diamond Puppy Formula dry food was added to the list.
 

And as of today (May 7, 2012), the recall associated with the plant in South Carolina has been expanded to include all of the following:
 

Chicken Soup for the Pet Lover’s Soul
Country Value
Diamond
Diamond Naturals
Premium Edge
Professional
4Health
Taste of the Wild
Apex
Kirkland Signature
Kirkland Signature Nature’s Domain
Canidae
Natural Balance’s Sweet Potato and Venison, Sweet Potato and Bison, Vegetarian, and Lamb Meal and Brown Rice dog foods
Wellness Large Breed Puppy, 15 lb. and 30lb. bags and 5 oz. sample

 
For an up-to-date list of recalled products, including affected production codes, visit petMD's recall page. You can also visit the websites of Diamond, Natural Balance, Wellness or any of the other affected pet food manufacturers.

All of these products have been recalled because of contamination or potential contamination with Salmonella bacteria. The Centers for Disease Control (CDC) reports that 14 people have been sickened due to contact with either contaminated food or with the dogs that have consumed the food. Five people have been hospitalized but none have died.

No reports of canine illness have come forth at this point, possibly because cases are simply being treated as nonspecific gastroenteritis. I wouldn’t be surprised if we start hearing of dogs being affected as word of the recall spreads, however.

Problems with the Diamond manufacturing plant were first identified when the Michigan Department of Agriculture and Rural Development detected Salmonella in an unopened bag of Naturals Lamb Meal & Rice dry dog food, which had been collected as part of a routine surveillance program. Public health investigators then identified recent human cases of salmonellosis caused by bacteria that were indistinguishable from those isolated from Diamond’s food. According to the CDC, "Seven of 10 (70%) ill persons interviewed reported contact with a dog in the week before becoming ill. Of 5 ill persons who could recall the type of dog food with which they had contact, 4 (80%) identified dry dog food produced by Diamond Pet Foods."

If you have recalled food in your home, seal it in a plastic bag and put it in a secured garbage can for disposal. Thoroughly clean all utensils, bowls, etc., that may have come in contact with the food, wash your hands thoroughly, and switch to a non-recalled brand of dog food or cat food immediately. If any people or pets in your household develop gastrointestinal symptoms (e.g., vomiting, diarrhea, loss of appetite, fever or abdominal pain), contact your doctor or veterinarian ASAP and be sure to mention your potential exposure to Salmonella bacteria.

Stay tuned — the pet food recall situation seems to be changing rapidly.
 
 
 
Dr. Jennifer Coates
 
 
Image: Chris Smith Ronnie Shumate / via Flickr
 

Did you hear the reports concerning a case of bovine spongiform encephalopathy (otherwise known as BSE or mad cow disease) in a dairy cow in California a couple of weeks ago?
 

Thankfully, it doesn’t look like this incident is indicative of a looming outbreak like the one seen in Great Britain in the 1980s and 90s, which led to the deaths of around 150 people from Creutzfeldt-Jacob disease and the slaughter of 3.7 million cattle. But I hope it does bring attention to the current state of food safety in this country.

First a bit of background. BSE is a disease of adult cattle that usually develops a while after they eat food that is contaminated with a type of protein called a prion. Prions are odd and scary little buggers. They are abnormally folded proteins that typically infect the tissues of an animal’s nervous system, causing proteins there to deform in a similar manner. The accumulation of all these abnormal proteins leads to disease. In this case, officials are saying that the cow in question developed spontaneous BSE — meaning that ingestion of contaminated feeds was not to blame but that the prions originated within the cow herself. This certainly can happen, but it’s a pretty rare occurrence. As they say, "investigations are continuing."

Folks associated with the meat industry are trying to put a good spin on this case, touting it as an example of how well the surveillance system and control measures that are in place work. Really? If this is one of those rare cases of spontaneous BSE, finding it before the cow was rendered and used as fertilizer or feed for other animals was simply a case of good luck. (She was not headed into the human food chain because she was a "downer" — generally defined as a cow that is unable to rise and stand on her own.)

Currently, only 40,000 cows are tested out of the 34 million that are slaughtered in the United States each year. Let me do some quick math here:
 
40,000 / 34,000,000 x 100 = 0.1%
 
Anybody care to bet that we’re missing some cases when we only test one-tenth of one percent of cattle going through processing facilities? Compare that to the situation in Europe and Japan where all cattle over a certain age (20-30 months depending on the location) are tested.

Now don’t get me wrong. I don’t think that BSE is a major danger to human health in this country. I’m simply using this case to illustrate how lax our food safety regulations are in general. For example, the federal government banned the feeding of cows to cows in 1997 because of worries about BSE, but chickens still routinely eat foods of bovine origin, and then the chicken litter (e.g., excrement, feathers, spilled food, etc.) is fed back to cows. Once you get over the "ick" factor of this practice, it becomes evident that this is a potential path for prions to reenter the food chain of cows.

I’m not a big fan of industrial agriculture, but even if you are a supporter I think we could agree that we can do better than this.
 
 

Dr. Jennifer Coates
 
 
Image: Dudarev Mikhail / via Shutterstock
 

Some veterinarians thrive on the thrill of being faced with new situations every day — me, not so much. Don’t get me wrong, I enjoy challenging cases, but I like to feel that I’m entering the fray with some level of competence. I suspect that most owners don’t want their pet to be the first case of its kind that their veterinarians have ever seen. This is a special concern for the owners of non-traditional pets or livestock, basically anything other than dogs, cats, horses, and cattle.
 

One of the dirty little secrets about veterinary school — strike that, all professional schools — is that there simply isn’t time to teach everything you need to know. The schools focus on the most pressing information (e.g., common diseases in common species), and if you have a special interest outside of these areas, it’s up to you to seek out the information and training.

So how can you ensure that you pick out a vet that has at least some familiarity with your species-of-choice?

Veterinary associations dedicated to particular types of animals are good places to start. Examples for exotic pets include The Association of Avian Veterinarians, The Association of Reptile and Amphibian Veterinarians, and The Association of Exotic Mammal Veterinarian. Each of these associations’ websites contains a link to a listing of their member veterinarians that is searchable by location.

If you are looking for a veterinarian who has extensively studied and been tested on their knowledge about a particular type of animal, the American Board of Veterinary Practitioners (ABVP) is a good resource. ABVP diplomates are "veterinarians who have demonstrated expertise in the broad range of clinical subjects relevant to their practice and who display the ability to communicate medical observations and data in an organized, appropriate manner."

ABVP is accredited to offer board-certification in clinical practice for the following practice categories:
 

Avian Practice
Equine Practice
Beef Cattle Practice
Feline Practice
Canine/Feline Practice
Exotic Companion Mammal Practice
Food Animal Practice
Dairy Practice
Reptile and Amphibian Practice
Swine Health Management

 
The ABVP website includes a searchable directory that makes finding an expert near (or relatively near) you easy.

As odd as it may sound, your "regular" veterinarian is also a great way to find nearby specialists, as are local clubs and societies formed by owners of unusual pets. Most vets are more than happy to refer cases that fall outside of their comfort range, so feel free to ask, "Do you know of any good sugar glider vets in the area?" If the doctor replies, "I can take care of that for you," ask to see his or her credentials and/or references from clients. Anyone who’s put off by such a request doesn’t deserve your business.
 
 
 
Dr. Jennifer Coates
 
 
Image: Eric Isselée / via Shutterstock
 

We received some great questions in response to the two posts on heartworm disease that appeared last week. Today, I’ll do my best to answer them.
 

Several people wanted more information about the regional prevalence of heartworms and other parasites. I don’t have the space to address that directly here, but I can point you toward an excellent resource – the Parasite Prevalence Maps that have been put together by the Companion Animal Parasite Council (CAPC).

When you go to the site, you can navigate your way to multiple categories: tick borne disease agents including Lyme disease, ehrlichiosis, and anaplasmosis; intestinal parasites including roundworms, hookworms and whipworms; and heartworms. CAPC provides maps for both dogs and cats, but unfortunately the feline data is a little sparse at this point.

On each map, you can narrow your focus to individual states and even down to the county level; it’s pretty cool. Keep in mind that the raw numbers do NOT represent the total number of positive cases in the area, only the number of positive tests reported to CAPC by three organizations: IDEXX Laboratories, ANTECH Diagnostics, and Banfield Pet Hospitals. CAPC estimates that the data represents less than 30% of the number of positive cases in each geographic region. That said, the information provided is a good representation of the parasite activity in the area.

On the national level, the CAPC maps for dogs reveal:
 

 
As I said, the data for cats is not complete, but CAPC does report that one out of twenty cats tested for roundworms was positive.

Other reader questions to the heartworm posts included:
 
Are there any dangers associated with changing the type of preventative utilized? Can there be any danger of residual medication from the previous dose mixing with a different brand?

No, it is perfectly safe to switch from one brand of heartworm prevention to another. Give the first dose of the new product when you would have given the next scheduled dose of the old.
 
 
What about older, sick, immune-compromised (etc.)cats?

This would have to be dealt with on a case-by-case basis with regards to the illness involved, its severity, and the risk that a cat could contract heartworms.
 
"The biggest problem we have today is still the number of dogs and cats that are not on prevention or are not on 12 doses all year round. Talk to your veterinarian about what the best product is for your pet. That will depend on a series of factors, including the spectrum of the product."

If HW is transmitted mostly from infected mosquitoes that get the disease from wildlife and farm animals and it is not as prevalent in the companion canine population, how does this comment hold any water?

I’m not sure I understand this question. A large reservoir of heartworm positive dogs, coyotes, fox, etc. exists from which mosquitoes can pick up infective heartworm larvae and transmit them to pets. I think Dr. von Simson’s point was that at the population level, our biggest problem is still the number of pets that do not receive adequate heartworm prevention and not drug resistance in the parasites themselves.
 
 
My question, what is the lifespan of the heartworm?

Five to seven years when a dog does not receive treatment is typical. With regards to the "slow kill" method you referenced, I can’t do better than the reply offered by descendingdaphne:
 
Straight from the American Heartworm Association's treatment guidelines:

Slow-kill methods using continuous monthly administration of prophylactic doses of any macrocyclic lactone are NOT RECOMMENDED. While effective in reducing the life span of juvenile and adult heartworms, it appears that the older the worms are when first exposed to macrocyclic lactones, the longer it takes for them to die. The adulticidal effect of macrocyclic lactones may take more than two years of continuous administration before adult heartworms are eliminated completely, and rigid exercise restriction would still be required for the entire treatment period. Throughout this period, the infection would persist and pathology would continue to worsen. Another potential concern in using macrocyclic lactones long-term in heartworm positive dogs as stand-alone therapy is the potential for selection of resistant sub-populations of heartworms.
 

 
 
Dr. Jennifer Coates
 
 
Image: Eric Isselée / via Shutterstock
 

The Carlsbad, New Mexico area just suffered through one of the worst rabies outbreaks in the state’s recent history. Over a three month period from the end of 2011 to the beginning of 2012, 32 dogs, 1 cat and 10 sheep had to be euthanized because they had been exposed to a rapid fox. During that December, January, and February tests also showed that 22 skunks in the area were infected with rabies.
 

What makes this outbreak especially painful is that almost all of the euthanasias could have been prevented if only the pets and livestock had been up-to-date on their rabies vaccines. In addition, twelve people in the Carlsbad area had to go through post-exposure prophylaxis even though no one was directly exposed to rabid wildlife. In one example, an unvaccinated dog came down with rabies and the entire family — all eight people — needed to get expensive, post-exposure prophylaxis according to Dr. Paul Ettestad, New Mexico’s state public health veterinarian.

I just don’t get it. Why do so many people fail to protect their pets and themselves from such a deadly disease when safe and effective rabies vaccines are so readily available? I understand when people can’t spend large amounts of money on a pet when the budget is tight, but that’s no excuse when it comes to rabies vaccines. They are dirt cheap. In fact, with a little research owners can oftentimes get them for free. Here in Colorado, 73 veterinary clinics just took part in a campaign providing complimentary wellness exams and rabies vaccinations to over 1,047 pets. Similar events can be found all across the country.

The only dogs or cats that I don’t recommend receive rabies vaccinations on the schedule dictated by local regulations are those that have had a documented anaphylactic reaction (i.e., a life-threatening allergic reaction) to a previous rabies vaccination and those that are so sick that the risk of vaccination outweighs the benefits. In these cases, veterinarians usually need to fill out a form or write a letter to the appropriate regulatory agency explaining why they have declined to vaccinate.

I don’t consider healthy old age or indoor only status a good reason to skip rabies vaccination even though I often recommend against vaccinating for other diseases under these circumstances. Why? Because if one of these pets is ever exposed to an animal that is known or suspected to have rabies or it ever bites someone, it’s lack of current vaccination is going to spell big trouble.

Many owners have heard of the ten day quarantine that is typically mandatory after a pet has bitten someone, but the situation is even more serious when a pet is exposed to a potentially rabid animal. Dogs and cats that are current on their rabies vaccines generally receive a booster vaccine and are quarantined for 45 days or so (this can often be done at home). However, if your pet does not have a current rabies vaccine, euthanasia is the most likely outcome. If you do not permit this, a strict quarantine of six months or longer will imposed, most likely at your expense.

Are your pets current on their rabies vaccinations? If not, what’s your excuse?
 
 
 
Dr. Jennifer Coates
 
 
Image: Matthew Niemi / via Flickr
 

I have no doubt that dogs dream. I’ve caught every one of my pooches "running" and "barking" in their sleep at one time or another, but what exactly are they dreaming about? Most of the time, it appears to be something good — chasing bunnies, I frequently call it. But every now and then, one of them appeared to be distressed. The yips change in pitch and frequency and all of a sudden it looks and sounds like they’re running from something rather than after it. I’ve even heard stories of dogs that seem to have very disturbing dreams after having been rescued from less than ideal situations — the canine equivalent of PTSD, perhaps.
 

I’ve often had clients bring up their dog’s "weird" behavior while sleeping during an examination. Many are worried that their pets are experiencing seizures. When they describe what is going on and I answer that it sounds like a typical doggy-dream, some are shocked at the notion that dogs could dream, which invariably leads to a discussion about what the dogs could possibly be dreaming about.

I can’t imagine how we could ever have a definitive answer to that, but I’d love to know the canine equivalent to the "I was halfway through X, Y, or Z when I realized I was naked" dream, or my personal favorite (even though I’ve been out of school for 13 years), "What do you mean the final exam is TODAY!"

And what about cats? I can’t say I’ve witnessed any activity while my cats have been sleeping that is obviously associated with a particular dream activity — the occasional twitch as they pounce on a mouse, perhaps — but I’d still bet they dream. Isn’t it just like cats to be more mysterious than dogs even in sleep?

Horses are more like dogs than cats when dreaming. When mine have lain down and fallen into those brief periods of deep sleep that they enjoy, their ears will start flicking and their legs start moving; sometimes the whole body gets into the act. Looks to me like they’re enjoying a good run.

What are your thoughts? Have you ever watched your pet dream and been able to put together a convincing narrative as to what might be going on inside his or her head?
 
 
 
Dr. Jennifer Coates
 
 
Image: Martin D. Vonka  / via Shutterstock
 

I talked yesterday about compassion fatigue, which often develops when caregivers focus primarily on others while ignoring their own needs. Sometimes, however, a caregiver’s negative emotions are a direct result of the words or actions of others.
 

I have found that stress seems to bring out the best or the worst in people. I am constantly amazed at how gracious and kind the great majority of my clients are when we are making end-of-life decisions regarding their pets. Of course, I’ve met a few bears too, but they are the exception that proves the rule.

I recently ran across a story about an especially egregious account of malice directed at a medical doctor. You can listen to the whole story at Colorado Matters, but here is an excerpt:
 

It was one of the darkest days of Daniel Matlock’s medical career. Dr. Matlock specializes in older patients and end-of-life care. He’d been summoned to the case of a woman who experienced a massive stroke. The woman had spelled out her wishes in an advance directive and she did not want any form of life support. Matlock saw the woman was getting intravenous hydration and asked that it be removed. That was when another doctor essentially accused him of murder. Turns out, this isn’t unusual. A recent report in the Journal of Palliative Care finds that one in four doctors who work with patients at the end-of-life have experienced accusations like these. Dr. Matlock, who’s a geriatrician at the University of Colorado, started blogging about his experience. It was picked up by the New York Times.

 

I’ve never had an owner or another veterinarian accuse me of "murder" when I’ve discussed palliative care, or even the euthanasia, of one of my patients, but I commonly come across very different points of view about what is appropriate treatment. I’ve dealt with a few clients who are morally opposed to the euthanasia of animals and in those cases we’ve developed a plan for hospice care that helps the animal die as peacefully as possible. Other people are adamant in their desire to prevent suffering and will request euthanasia at the first sign that a pet’s quality of life is starting to decline. Most owners fall somewhere in the middle, wanting to maximize the good times and minimize the bad. I work with each client on their own terms, always trying to be the animal’s advocate and remembering that there usually is more than one right way to handle a difficult situation.

The New York Times recently ran a group of editorials called One Sick Dog, One Steep Bill. In her commentary, Dr. Louise Murray, vice president of the ASPCA’s Bergh Memorial Animal Hospital in New York City stated:
 

In situations in which euthanasia would once have been the only option, pet owners may now need to make tough decisions about the best course of action for their pets and themselves … I reassure them that for an animal that is lucky enough to be a beloved pet, there are no wrong answers as long as the focus remains on minimizing suffering. In a world in which too many dogs and cats find themselves homeless, an animal in a loving home has already won the lottery. Beyond that, the choices become personal to each individual or family, and are not for others to judge.

 

Amen.
 
 
 
Dr. Jennifer Coates
 
 
Image: We all get old by kgantz / Flickr
 

I had an insanely busy week awhile back. All the normal (and a little extra) stuff, plus a business trip took me away from the practice I work for, so I had to make up some hours on a Saturday I’d normally be spending with my family. My energy was already on low ebb, and then I saw the full appointment schedule — sigh. To top it off, I was returning client calls like a madwoman in between cases. After one appointment my phone showed that I had missed seven calls. I felt like I was drowning.

And there was that one particularly odd message that I had to deal with. The clinic’s receptionist called me on Friday to let me know that a client I had worked with a year ago wanted to meet up with me at some point over the weekend; Jeff, I’ll call him. Jeff and I played phone tag throughout the day, and to be honest, when I finally got home from work the last thing I wanted to do was head out again to meet him. Ingracious, I know, but frankly I was burnt out.

A specific type of burn-out called compassion fatigue is a real problem for veterinarians and other caregivers. According to the Compassion Fatigue Awareness Project:
 

Caring too much can hurt. When caregivers focus on others without practicing self-care, destructive behaviors can surface. Apathy, isolation, bottled up emotions and substance abuse head a long list of symptoms associated with the secondary traumatic stress disorder now labeled: Compassion Fatigue

Studies confirm that caregivers play host to a high level of compassion fatigue. Day in, day out, workers struggle to function in care giving environments that constantly present heart wrenching, emotional challenges. Affecting positive change in society, a mission so vital to those passionate about caring for others, is perceived as elusive, if not impossible. This painful reality, coupled with first-hand knowledge of society's flagrant disregard for the safety and well being of the feeble and frail, takes its toll on everyone from full time employees to part time volunteers. Eventually, negative attitudes prevail.

Compassion Fatigue symptoms are normal displays of chronic stress resulting from the care giving work we choose to do. Leading traumatologist Eric Gentry suggests that people who are attracted to care giving often enter the field already compassion fatigued. A strong identification with helpless, suffering, or traumatized people or animals is possibly the motive. It is common for such people to hail from a tradition of what Gentry labels: other-directed care giving. Simply put, these are people who were taught at an early age to care for the needs of others before caring for their own needs. Authentic, ongoing self-care practices are absent from their lives.

 
Now on the Saturday that I’m talking about, I was simply tired, stressed and grumpy, not suffering from compassion fatigue. I’ve dealt with short bouts of this debilitating condition, however, which is one of the reasons I only work part-time in end-of-life care.

Turns out that meeting up with Jeff was exactly the medicine I needed to banish my feelings of overwork and underappreciation. He and his family simply wanted to say "thank you" in the form of a bouquet of flowers, a note, and a beautiful picture, in gratitude for my help in taking care of their beloved dog at the end of its life.

I tell this story so you don’t underestimate the power that showing gratitude for a caregiver’s work can have. I left this brief get-together feeling reenergized and ready to take on whatever was headed my way … after a Sunday off, that is.
 
 

Dr. Jennifer Coates
 
 
Image: Nomad_Soul / via Shutterstock
 

Yesterday, I talked with Dr. Cristiano von Simson, Director of Veterinary Technical Services of Bayer HealthCare LLC, Animal Health Division, about how heartworm preventives work and a bit about the unique aspects of the heartworm disease in cats. Today, we’ll tackle the subject of drug resistance as it applies to heartworm disease.  Full disclosure: Bayer makes Advantage Multi, a product to which Dr. von Simson refers.
 

Dr. Coates: What do you have to say about the reports primarily coming from the southeastern United States about heartworm infection becoming more prevalent in dogs that by all reports have been on monthly, year round preventives?

Dr. von Simson: Years ago, the FDA announced that they were getting more reports about a lack of efficacy in heartworm prevention products. We also heard directly from veterinary practitioners in central and southern states that in addition to those cases where they didn’t think dogs had received all their preventive doses at the right time, which is unfortunately very common, they were also seeing cases where they were very confident that owners had given all the doses correctly and they believed that the product had really failed to prevent heartworm disease.

There have been some researchers working on this as well. Dr. Byron Blagburn is the one who really took the lead. He went there, collected some samples, took them to his lab, and did some in vitro assays and clinical studies on heartworms and the lack of efficacy of preventives. Dr. Dan Snyder did some work on that too, and so did researchers from the University of Georgia. So, there is a lot of information out there. I think the best summary that is available is in the American Heartworm Society’s new canine guidelines that have just been revised.

What they are saying, and I’ll paraphrase here, is that in some areas, certain isolates of heartworm show some resistance to preventive products. In clinical studies where dogs are infected with one strain of heartworm called MP3 that was isolated in Georgia, several different preventive products were challenged by Dr. Blagburn and only one was able to prevent 100 percent of heartworm cases, and that was Advantage Multi. The other monthly products that were tested had seven out of eight dogs in their groups develop heartworms in that trial. Some other studies by Dr. Snyder corroborated that evidence of failure.

So this is sort of a new area. We thought we knew everything about heartworms, but there’s a lot of new evidence and we’re still trying to understand the mechanisms of resistance and why we’re seeing heartworms now and where those resistant isolates are.

Dr. Coates: How do you recommend that owners use this information?

Dr. von Simson: The biggest problem we have today is still the number of dogs and cats that are not on prevention or are not on 12 doses all year round. Talk to your veterinarian about what the best product is for your pet. That will depend on a series of factors, including the spectrum of the product. The Companion Animal Parasite Council (CAPC) recommends broad spectrum products that will kill heartworms and intestinal parasites (including whipworms). So the veterinarian and owner should discuss the best parasite prevention protocol, including the topic of resistant strains of heartworms, and choose a product that will give peace of mind.
 
*
 
Do you have any questions for Dr. von Simson? He has graciously offered his time to provide answers; so ask away and I’ll pass on the ones that get the most "likes".
 
 
 
Dr. Jennifer Coates
 
 
Image: Dog portrait 2 by Tambako The Jaguar / via Flickr
 

Did spring arrive early where you live? It sure did here in Colorado (my last ski trip of the year involved almost as much mud as it did snow). An unusually warm spring could certainly mean that we are in for one heck of a mosquito season, spelling trouble on the heartworm front.
 

I wrote a post a few months back about the mounting evidence that some mosquito populations are developing resistance to widely used heartworm prevention medications. A combination of larger than normal numbers of mosquitoes potentially carrying drug-resistant heartworm larvae would be very worrisome, to say the least. That’s why I thought I’d share with you parts of a conversation I recently had with Cristiano von Simson, DVM, MBA. Dr. Simson is the Director of Veterinary Technical Services of Bayer HealthCare LLC, Animal Health Division.

Full disclosure: Bayer makes Advantage Multi, a product you will see referenced in the second half of this post that will be available tomorrow. Today, we’ll focus on background information about heartworm disease in dogs and cats.

Dr. Coates: Could you talk a little about how heartworm preventives work and how the term "prevention" is a bit of a misnomer?

Dr. von Simson: That’s a very good point. We call them heartworm prevention products, and that is correct if you are thinking of heartworm disease. They do prevent adult worms from invading the heart and blood vessels in the lungs, but they don’t prevent mosquitoes from infesting the dog with immature heartworms on a regular basis. When these products are given once a month, they kill the baby heartworms before they can grow into the adults that cause all the damage in the heart and blood vessels.  That is why we need to give these products on a monthly basis, on the same day of the month, all year long, because you never know when a pet might get exposed to mosquitoes and be infected again.

Dr. Coates: What are some of the unique aspects of heartworm disease in cats?

Dr. von Simson: In cats, the disease is slightly different than it is in dogs. Cats can get the adult worms in their heart and blood vessels in the lungs. The fact that cats are generally smaller than dogs, and their hearts and vessels are too, means that a smaller burden of worms will cause significant clinical disease in cats. But cats also have a very unique inflammatory reaction to many things, including worms in general. This inflammation causes Heartworm Associated Respiratory Disease (HARD), with symptoms like coughing, difficulty breathing, and exercise intolerance, which can be hard to appreciate in cats.

So even if an owner does not recognize the symptoms, the cat is experiencing significant problems. That is why it is important to get your cat checked at least once a year for heartworms. Owners also need to understand that we cannot use the medication that kills adult heartworms in dogs on cats, meaning it’s even more important to prevent the disease in cats.
 
*
 
Tomorrow: Dr. von Simson talks about resistance to heartworm preventives.
 
 
 
Dr. Jennifer Coates
 
 
Image: “Unknown Cat” Portrait by Danny Coen / via Flickr

I’ve got a pet peeve involving the dog park: humping. My problem isn’t with the dogs that engage in the behavior (let’s call it "mounting" from now on to appease the censors); it’s with the owners’ reaction to it. Invariably, the owner of the mountee and/or mounter runs over in embarrassment, pulls the dogs apart, and spends a good part of their remaining time at the park yelling at the "offenders" to stop. Sounds like fun for everyone involved, eh?
 

My dog Apollo is both a humper and a humpee (sorry, mounter and mountee), and that is a good thing. Why? Because it indicates that his behavior among the other dogs is very normal. Therefore, I feel no need to intervene, which means I’ve been the recipient of numerous "will you do something about your dog" glares, which I generally ignore.

So what’s the deal with mounting? Like most behaviors, dogs do it for several different reasons. Yes, it can be sexual even in spayed and neutered pets, but this the exception rather than the rule. Another common explanation is that one dog mounts another to assert his or her dominance. That also can be true, but in these cases it is simply a form of communication between the dogs. As long as neither dog is upset by the interaction, why should we care if this is how they choose to figure out who is "top dog" in the ever changing pack structure at the park? Once the relationships are ironed out, everybody can play in accordance to the new canine rules.

Mounting behavior may also simply be a form of play. When you think about it, most play is some derivative of a normal adult behavior. Stalking, chasing, wrestling, gnawing on each other … that’s all predator-prey type stuff. If the dogs are running around having a good time and first one mounts the other and then vice-versa, there’s a good chance that they’re just messing with each other. You don’t have to worry that the generally more submissive dog is actually challenging the more dominant dog’s status and that sparks will fly.

Dogs may also mount each other because they are anxious or just fired up, both of which are common states of mind at the dog park. Mounting can be an outlet for a dog’s excitement if he or she is uncertain about the best way to join the fray. I’ve also seen it when the rough-housing starts to get out of hand. Think of it as a doggy-enforced time-out that lets everybody pause and take it down a notch.

My rule of thumb is that if the dogs involved seem relaxed and happy with whatever behavior they’re engaged in and it doesn’t pose a risk of injury, let 'em play. Isn’t the dog park a place where dogs should be allowed to be dogs for a while, instead of conforming to human rules of what constitutes acceptable public behavior?
 
 
 
Dr. Jennifer Coates
 
 
Image: Nemo Humping Dexter by mattbatt0 / via Flickr
 

Whenever I talk to owners about the death of a pet, I always bring up the topic of grieving and mourning as it applies to other animals in the household. Yes, pets do grieve. We are witnessing it in our own house right now.
 

As I mentioned a few weeks back, I recently had to euthanize one of our two cats. (Thank you for all the kind remarks you sent in response to that post.) Keelor’s death made us a one cat household, and Vicky has been affected by the change. She and our dog Apollo have a good relationship (she tolerates him licking her head, he lets her sleep in his dog bed), but it’s obvious that she misses Keelor.

She is a lot needier than normal. She has always wanted to be petted when we’re trying to read the paper and drink some coffee, but her demands have been taken to new levels recently. (Someone needs to study how a seven pound cat can generate so much power behind a head butt.) She is also yowling — a lot — in the wee hours of the morning. She is a sleep-all-day kind of girl, and I think she misses having a comrade to prowl the house with at night.

In hindsight, most of these new behaviors actually started while Keelor was very sick and intensified after his passing. This is not unusual. I think animals understand a lot more than we give them credit for, especially when it comes to end-of-life issues. After all, death is a natural part of life and I think it’s reasonable to assume that social animals (yes, cats are social, at least to a degree!) have the ability to comprehend the basics behind serious illness and death.

My five-year-old daughter was concerned that Vicky’s changed behavior indicated that she was sick, just like Keelor. That’s not unreasonable since many of the symptoms of grieving in pets — withdrawal or clinginess, lack of appetite, altered sleep patterns, litter box issues, vocalization, even vomiting and diarrhea — certainly can be associated with illness, which is why I always recommend a check-up if a surviving pet’s symptoms are especially severe.

I gave Vicky a physical and she checked out just fine, which in addition to the fact that in every other way she’s seems perfectly normal, convinced me that "all" that is wrong is the loss of her companion of over 13 years.

In 1996, the American Society for the Prevention of Cruelty to Animals (ASPCA) conducted a study looking into mourning behaviors in dogs. It found that 66 percent of dogs exhibited four or more behavioral changes after the loss of another pet in the household. For example:
 

36 percent ate less than normal, 11 percent stopped eating altogether
About 63 percent vocalized more than normal or became quieter
Many changed where and how much they slept
More than half became more affectionate and clingy

 
In general, it took affected pets between two weeks and six months to return to their normal behavior patterns. It looks like Vicky is right on track. She’s certainly not her old self yet, but she only woke me up once last night, so at least we’re heading in the right direction.
 
 
 
Dr. Jennifer Coates
 
 
Image: Depressed cat by Jacquelyn / via Flickr
 

Is your pet fat? Yes … No … Are you sure?
 

A recent study into owners’ abilities to determine whether or not their pets are at an ideal weight showed that just about 44 percent of people misidentified their dog’s body condition. The researchers only looked at dog owners, but I suspect the finding would be similar for cat owners, too. This is a big deal because it’s difficult to deal with a problem when people don’t recognize that one exists in the first place.

Not surprisingly, owners most commonly thought that their dogs were thinner than they actually were — but the opposite was also true. Owners of excessively skinny dogs ranked their pet’s body condition closer to the ideal than was true. Oddly, men were almost twice as likely to underestimate their dogs’ body condition in comparison to women. Anyone got an explanation for that?

I’ve dealt with owner misperceptions about body weight all too often as a veterinarian. It happens most frequently with new clients and patients. When I’ve been seeing an adult animal for a while and every time he or she steps on the scale the numbers are a bit (or more than a bit) higher, the reality of the situation is hard to ignore. But with a new client I might say something along the lines of, "Let’s see here, Gizmo weighed in today at 46 pounds. I think his ideal weight is closer to 40. Can we go over some options for weight loss together?"

Sometimes, I’ll get a sheepish grin or a reply like, "I thought he was just big-boned," which indicates to me that the owner already suspected the problem but just didn’t want to deal with it or didn’t think it was a significant issue.

Of course, excess weight is a HUGE health concern for pets. It has been linked to shorter life spans, cancer, arthritis, cruciate ligament ruptures, skin problems, heart disease, type 2 diabetes and hepatic lipidosis in cats, and Cushing’s disease in dogs. Owners shouldn’t shoulder 100 percent of the blame for the pet obesity epidemic, though. Veterinarians generally don’t do a great job hammering home just how dangerous the extra weight can be. It’s an awkward conversation to initiate, particularly if the pet’s owner is overweight also.

Whatever the reason for not dealing with the issue, owners who have a sneaking suspicion that their pets could stand to lose some weight are usually receptive to starting a dialogue about how we should address it. On the other hand, I know I’m in for a loooong and oftentimes unfruitful discussion when an owner reacts with shock (sometimes combined with outrage) after I’ve brought up the topic of weight loss. At least I now know that many of these people honestly think their pets are skinnier than they are.

One of the best ways to objectively analyze your pet’s body shape is to compare it to a standardized chart of canine or feline body condition scores. Take a look. They’re easy to use and might just help you avoid an unpleasant surprise the next time you visit your veterinarian.
 
 

Dr. Jennifer Coates
 
 
Image: Steve Collender / via Shutterstock
 

At the beginning of April, MSNBC reported that Food and Drug Administration (FDA) inspectors have traveled to China to inspect plants that make the chicken jerky treats that we’ve been talking a lot about over the last few months. According to the article:
 


Staffers for Sen. Sherrod Brown, D-Ohio, and Rep. Dennis Kucinich, D-Ohio, confirmed Wednesday that Food and Drug Administration officials were conducting the inspections.

"Based on our ongoing discussions with the FDA, we are expecting important new information soon," Vic Edgerton, a spokesman for Kucinich said in an email to msnbc.com.

It’s not clear exactly how many inspectors are involved or which plants the officials will visit as they attempt to solve the mystery behind at least 600 reports of illnesses including abrupt kidney failure after dogs have been fed chicken jerky treats made in China.

FDA officials declined to comment on the inspections.

 
Fingers crossed that this trip will be the key that unlocks the mystery behind this tragic and ongoing problem.

Now for some good news…

A veterinary clinic here in Northern Colorado has been named the Accredited Practice of the Year for 2012 by the American Animal Hospital Association (AAHA). In other words, it’s the best of the best.

To earn accreditation from AAHA, veterinary practices have to follow rigorous guidelines regarding more than 900 standards, in categories such as:
 

anesthesia
client services
contagious diseases
continuing education
dentistry
diagnostic imaging
emergency and critical care
facilities
housekeeping/maintenance
human resources
laboratory services
leadership
being eco-friendly
medical records
pain management
all aspects of patient care
pharmacy services
referral standards
safety
surgery

 
AAHA accredited practices are inspected every two to four years to make sure they continue to maintain their high-standards. Only about 15 percent of veterinary practices have achieved AAHA accreditation.

Being named the Accredited Practice of the Year was a huge achievement for the Wellington Veterinary Clinic. What I like best about this story is that Wellington, CO is a small town — population around 5,000 or so. Just goes to show that top-notch veterinary care isn’t limited to big cities; good vets can be found anywhere.

I have heard nothing but rave reviews regarding the veterinarians and staff of the Wellington Veterinary Clinic from the clients and patients I have in common with them. Most recently, I was visiting a rural area about 20 miles or so from Wellington, performing an in-home euthanasia for a dog that had extreme hind-end weakness and difficulty walking. I commented to the owner on how good her dog looked — at a healthy weight, well-groomed, etc. — despite her problems, and she mentioned that one of the clinic’s staff-members had been traveling to her house regularly to trim the dog’s nails, since it was so difficult for her to get the dog into the clinic and she wasn’t able to do it herself. Talk about going above and beyond the call of duty.

I hope all of you are lucky enough to have a clinic like this one close to your home.
 
 
 
Dr. Jennifer Coates
 
 
Image: Monika Wisniewska / via Shutterstock
 

A couple of weeks ago "Barnyard Punch" asked some excellent questions about non-core vaccines in dogs. Canine noncore vaccines are those that will benefit some dogs but not others, and the decision about who should get them and who shouldn’t is based on such things as age, lifestyle, geographical location and other health concerns. Here are Barnyard Punch’s questions.
 

 
Do I need lepto? How effective is it?

Lepto is shorthand for the bacteria Leptospira interrogans. Dogs typically become infected with lepto when they come in contact with urine containing the bacteria or water that is contaminated with such urine. The source of infection is often wildlife and/or rats, and the bacteria gain entrance to the body through mucous membranes or breaks in the skin. Lepto infections can range from mild to severe. In the worst case scenario they lead to kidney failure, liver failure, lung disease, and/or bleeding disorders. Aggressive treatment saves many dogs, but the infection can still be deadly and may be transmitted to people.

A big problem with lepto is that we know of over 200 varieties of the bacteria, called serovars, in nature, and we currently have access to vaccines that contain, at most, four of them. So while vaccination can prevent disease from these four serovars (there may be some cross protection with others), owners should never consider their dogs completely protected against lepto. Older vaccines may have been responsible for more than their fare share of vaccine reactions, but that does not appear to be the case with the newer, safer products that are available.

When I practiced in a lepto-endemic area, I recommended vaccination for dogs at high risk (e.g., those that had regular access to ponds, wild lands and the like) but not for those that lived in a more confined environment. Local veterinarians and veterinary referral institutions are good sources of information about the disease’s incidence in your area, but in general, warm areas that receive a good amount of rain are lepto hotspots.
 
Is kennel cough every 12 months OK, or is every six months necessary?

By "kennel cough" I assume you mean Bordetella bronchiseptica, one of the microbes that can cause this condition in dogs. My answer is, "It depends."

Protective immunity from Bordetella vaccines does not last very long. It typically starts to wane somewhere in that 6-12 month range. So, if you give the vaccine every twelve months, the protection will not be as good at the end of the year in comparison to that achieved at the beginning of the year. For dogs at average risk of infection, I consider once yearly vaccination to be sufficient. However, when I have a patient that has a lot of contact with other dogs (e.g., show dogs, heavy boarders, etc.), I generally recommend vaccinating every six months.
 
How about corona?

This one’s easy. In all but the rarest of circumstances, vaccinating puppies, and certainly adult dogs, against coronavirus is not called for. In the latest canine vaccination guidelines put together by the American Animal Hospital Association, canine coronavirus vaccines aren’t even considered to be noncore; they are "not recommended" at all.
 
 

 
Dr. Jennifer Coates
 
 
Image: Poppography / via Shutterstock