Regional K9 disease risks: How common is common?

The reality is… we don’t have much in the way of scientific evidence (aka publications) on the incidence of veterinary diseases (check out this earlier blog on prevalence and preventative care). There, I said it. Gasp…That means that on many of the occasions I tell dedicated dog and cat owners that things occur commonly, and it would be good to: a) test their pet for it, and b) protect their pet against it… I’m full of ‘poopie-caca’ as we say in my house…which likely isn’t a surprise (and is definitely well recognized in my house, i.e. that I am frequently full of @#$!).

This lack of evidence is true for Canada and globally. And, I’m quite aware that this dearth of literature is due to these types of studies being tough to do, i.e. requiring a number of general practice clinics to participate, organize, report and document disease appropriately (and accurately), perform data analysis and I think we won’t go into the odds of obtaining funding for a project of this type. Unfortunately, for all these reasons, veterinarians are left with making ‘guess-ti-mates’ when predicting and preparing for what diseases occur commonly.

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This need to ‘guess-ti-mate’ disease occurrence and what’s high risk (or not) is true for myriad concerns in dogs and cats and includes multiple (most) infectious diseases, e.g. canine parvovirus, leptospirosis, Lyme and other tick-borne diseases. As such, DVMs frequently end up relying on the willingness of veterinary diagnostics labs to share test results, extrapolating from the few studies performed at large veterinary centers that in most cases probably don’t accurately reflect the risks for local pets, and/or word of mouth in order to predict regional infectious disease risks.

Our collaborative research team (University of Guelph and PEI) has been working to try and address this lack of information for pets in Canada. As mentioned in earlier blogs, we’re analyzing a dataset of leptospirosis testing of dogs (Lepto results compared to human population). However, we’re also working on this from another angle in Atlantic Canada and in Ontario through the Canadian K9 Lifetime Study, to collect information that allows for further information on specific dog disease incidence and risk.

It’s too soon to submit the paper, but I will share that it’s been interesting to see the leptospirosis test results on puppies and dogs (vaccinated for lepto and not) and the serovar differences between Ontario and Atlantic Canada. I suspect (and hope) that when we expand the study later this summer into Quebec and western Canada there will be further illumination on leptospirosis and tick-borne disease in dogs nationally. Hopefully work like this will allow us to capture true disease incidence information for dogs (and their people) allowing us to best ensure the health of our pets.

Research efforts such as these occur thanks to the participation of the over 400 dog owners and their respective dedicated veterinary teams enrolled in the study to date.

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Happy early birthday Canadian K9 Lifetime Study- it’s been amazing to watch you grow! Due our successful enrollment in Ontario and Atlantic Canada we’ll be closing the study to new puppy enrollment in Ontario, Nova Scotia and Prince Edward Island on July 1, 2019. Thanks so much to all of our dedicated veterinary clinics and pet-owner participants. It’s amazing to work with a community of people who are devoted to dog health and continue to be engaged with annual reevaluations so that we can learn all about these puppies as they grow into dogs!

I’ve got the Brucella blues…and that’s no joke

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It’s easy to let infectious disease slide off the radar. Common things tend to occur commonly, and after all, this is Canada and the cold (and our political climate) keep us safe from most things, right? However, that type of thought process is true until it isn’t…and this latest news about canine brucellosis in Ontario (and now in Wisconsin: is a good example of an infectious disease cropping up while (or because) no-one was looking.

Savvy dog owners (and veterinarians) tend to think about reproductive system problems (e.g. infertility, abortion, weak puppies) in dogs with brucellosis. Although correct, part of the challenge with canine brucellosis is the bacterium’s (Brucella canis) ability to infect and spread in dogs without causing obvious signs of illness. Additionally, infected dogs (whether neutered or intact) can have other disease manifestations beyond the reproductive system. 

Unfortunately, like any number of infectious diseases, Brucella canis is zoonotic. This means that the 2 legged (i.e. humans) are at risk along with our K9 4 legged friends, and people who frequently have high levels of contact with infected dog body fluids (e.g. veterinarians, breeders, etc.) are at highest risk of disease. People with a weakened immune system (e.g., children, elderly, immunocompromised) are also at increased risk for infection. Further, brucellosis may not be on many human medical doc’s radars either. This is because it can cause variable and vague signs-plus it’s thought of as an animal thing...when it’s thought of at all.

At the moment, the heightened awareness of K9 brucellosis in Canada and the USA appears to be in:

1) dogs associated with commercial breeding facilities in parts of Ontario- and groups who obtain dogs from them, e.g. shelters, breeders in other parts of Canada, etc., and

2) dogs imported from South Korea that are currently being tested and quarantined- or being notified to be tested quarantined...the latter being a herculean task.

Other concerns surrounding brucellosis in dogs are that it’s near impossible to treat and cure-and it’s a challenge to diagnose. Typically, veterinarians begin with one test and if positive additional testing is required to ensure that a positive is a ‘true positive’, meaning that the dog is definitively infected. This is fairly critical because in certain scenarios (e.g. kennels, shelters) dogs who are positive tend to be euthanized due to risk of spread, inability to effectively (or practically) quarantine, public health recommendations, and cost concerns.

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For dog-owners (or soon-to-be dog owners), awareness of risks associated with dog importation (particularly from high risk regions) and ensuring your dog breeder is screening for brucellosis are important things to bone up on-and proactively ask about. Infectious diseases can (and do) occur globally, and they should always rank on the ‘DAMN-IT’ list of considered diagnoses for those of us accountable for human and animal health.

Ultimately, awareness and education are what’s needed to reduce risk and further spread of this pathogen…and until that (& additional ID and quarantine of currently infected dogs) happens… we’ll all be howling the B.canis blues.

 

Infection Control

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Infection Control for Dummies (i.e. Me, Myself, and I)

There are any number of things in life I suspect we all know are important, in part because they are necessary. However, the idea of spending time on some of these things (much less learning, teaching or being accountable for them), frequently bores us to tears. I freely admit that I feel this way about infection control.

After applying a simplified (‘dumbed down’) definition for infection control, i.e. ‘How to slow or stop bad (or disease causing-contributing) bugs from affecting a group of patients and caregivers, e.g. hospital staff and clients’… I think most of us would agree that infection control is critically important, needed and should be upheld & supported. However, I confess that the topic area makes me want to slink unobserved out of any room in which it’s being discussed or lectured. After all, I got into vet med to save lives…and that type of heroic action warrants much more time allotment than learning what disinfectant can kill parvo, right? Ahhh…crap (literally!). Imagine my dismay when I slowly, (reluctantly), began to recognize that there was a direct relationship between savin’ lives and infection control (see def’n above).

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This awareness and newfound incentive to ‘take my ‘infection-control (IC)’ medicine’ led me to a number of resources on the topic. One of the latest of these is from AAHA: Their 2018, Infection control, prevention and biosecurity guidelines . These resources were developed to assist veterinarians, personnel and dedicated pet-owners in the reduction and outright stomping out of disease (and infection risks) associated with vet clinics. It’s EPIC that these latest guidelines come with a practical resource section for the entire practice, e.g. identifying high-risk patients for the front-end staff, an outline of action items and accountabilities for the hospital, tables of disinfectants (see ‘ya later parvo poopie!), and a biosecurity tracker to measure veterinary and vet practice infection control prevention incorporation and ongoing success.

Pet-owners were also included in the IC equation, and can help by initiating and considering ways to keep their beloved babies (and in some cases themselves and their 2 legged family) healthy.

The videos on AAHA resource page should keep any millennial happy, and I strongly suspect my students will enjoy using them to keep me on track also. Particularly the clip on ‘Top 5 ways to decrease hospital acquired infections’. In fact, I can almost hear, “Why didn’t you wait for the appropriate contact time before wiping that surface down?” Or even worse…’Ummm, I’m pretty sure you missed a spot with your attempt at hand hygiene’. Along these lines, while I doubt the typical vet would claim to be a fashion plate (it not being a high glamour gig) …I 100% agree that we should all be able to don and doff our PPE (personal protective equipe) properly, particularly if the motivating outcome is safer pets- vs. the front page of InStyle or Canadian Living.

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Infection control is everyone’s job, and while interest and value can be inconsistently (or not at all) applied to simple tenets, i.e. wash your hands, these are basic things that can have the highest impact on health- for our pets and us. And that’s well worth all of us (including a self-admitted infection control dummy like myself) spending time on.

 

The risks of importing (and traveling with) pets

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We live on an island, and sometimes life on PEI can bring various ‘Alice in Wonderland’ quirks. This past week quite a few folks traveled to the island, and probably more travelers would have reached PEI, if not for the ‘predictably unpredictable’ November weather that resulted in flight delay and bridge closure. A number of travelers brought their pets with them during their visit to PEI (i.e. once the bridge opened), and it made me ponder (not for the 1st time), the infectious disease risks associated with animal importation. Although these risks are highest from imported animals lacking a known medical history (e.g. strays, rescue animals, etc.), particularly those who come from countries with known infectious disease, these risks are still present (albeit on a reduced scale) with any type of animal importation, including owned pets.

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A colleague of mine spends a good deal of time trying to eradicate the incursion of canine influenza into our fair country Canada- and he’s been remarkably successful at this (https://www.wormsandgermsblog.com). However, every time I see an update on canine flu, I heave a deep sigh (hope someone buys that guy a beer!) and wish that the practise of importing higher-risk animals from other countries was something that either, a) didn’t happen, or b) if considered absolutely necessary, was thoughtfully considered (& vetted) prior to doing so. Since, these types of canine influenza outbreaks (or the risk of them occurring) seem largely avoidable with a bit of rational planning, i.e. imported (or adopted) dogs from countries with known flu (e.g. Asia, or portions of the U.S.A with known risk), should be isolated from other dogs for 28 days, until the risk of disease (and disease spread) has passed. 

Over the past number of years, I’ve done consults for or seen patients in Canada that are ill with diseases including leishmaniosis, coccidioidomycosis, hepatozoonosis and trypanosomiasis. These diseases may sound like the poem of the Jabberwocky, but they are in actuality infectious concerns that can affect dogs (and sometimes humans) from places outside of Canada. However, when dogs travel (with their humans) or are imported from other countries, these infectious concerns (just like with canine influenza) may ride along (or cross bridges) also.

As such, I’d gently suggest that any animal importation should be done with a degree of thoughtful consideration (i.e. risk assessment on a sliding scale), in order to minimize adverse impacts on the entire animal community (local, regional and national). Probably this is a tough ask, but as we approach the holiday season (and no…black Friday isn’t a holiday), perhaps it’s a request that’s in keeping with a sense of community, accountability and what is ‘looking a lot like Christmas’ in many parts of Canada?

 

 

Winter is Coming! (Could Leptospirosis be coming, too?)

Winter is coming (& canine leptospirosis may be more likely) … In B.C. and other parts of Canada.

On September 14th, I posted a draft map (http://www.canadian-k9.com/puppy-tales-blog/) provided by our collaborative research team (Universities of Guelph and PEI) on Canadian canine lepto test positive incidence.

This past week, an article quoting a veterinarian in Sooke, British Columbia was released, warning dog owners about a local sick dog that had been diagnosed with leptospirosis and encouraging vaccination to prevent more sick dogs (https://www.goldstreamgazette.com/news/veterinarian-warns-dog-owners-of-leptospirosis-in-greater-victoria/)

Test results (like those on our map) don’t equate with clinical disease in all instances, and that’s important to keep in mind. However, based on our preliminary assessment of the Canadian lepto test results, it’s also not too surprising (to me) that dogs in BC are at risk of (and are it seems) being diagnosed with leptospirosis. How many dogs are being diagnosed or are sick is quite another topic, since lepto: 1) isn’t always on dog owners’ (or veterinarians’) radar, and as such may be missed by not being considered or tested for, and 2) the lepto vaccine isn’t considered a ‘core’ vaccine in the traditional sense, and thus not used when perhaps it may be beneficial (https://www.aaha.org/guidelines/canine_vaccination_guidelines/practice_vaccination.aspx).

Lepto has been worrying me (hence the blogging), and there are few things I hate more than disease in dogs that I consider largely preventable through awareness and vaccination. The end result of that concern is that we’ll be expanding the Canadian K9 Lifetime Study in early 2019 to try and sort out a few more canine welfare troubles…or make a solid attempt on it.

Ongoing we’ll include Leptospira spp. serovar testing on puppies (and as they grow up-dogs) and also be expanding new puppy enrollment into Western Canada. We appreciate the support of those in the Canadian Veterinary Community who have helped us enroll such amazing puppies and pet-owners. We simply cannot do our work to raise awareness and help protect dogs without this- and it is our hope that you will continue to help us achieve these expanded Canadian K9 goals.

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Cough, gag, hack, snort…STOP (CIRD-C spread)

Dogs who cough are a common concern for pet-owners and veterinarians. Just like in people, coughing, sneezing and hacking are frequently (but not always) associated with an infection of the lungs, trachea (windpipe), nose and/or eyes. Unfortunately (and again just like in people), it’s not possible to know just by looking or listening what type of infection (bacterial, viral, etc.) is causing the clinical signs (symptoms in people). In dogs, the myriad possible infectious causes of coughing, snorting and hacking (aka canine infectious respiratory disease complex-CIRD-C) makes things challenging. This can impact veterinarians knowing what to do to help patients feel better, AND how to prevent other dogs from becoming sick if they are in contact with those who are coughing or hacking, or in contact with those animals who are carrying bacteria or viruses without showing clinical signs (canine carriers) but are still able to pass on disease.

It’s not fun to feel ill or see those we care for get sick, and the first reaction as devoted parents of pet patients is to seek relief. This typically means heading into the veterinary clinic for diagnosis and therapy. Unfortunately, seeking aid in this way can endanger other dogs through spread of infection, i.e. dog nose to dog nose contact or cough droplets inhaled in a shared air space like a veterinary clinic lobby, treatment room, or ICU. When people (the big and little versions) are sick with a respiratory infection, most clinics will have you check in and wait at a different location from everyone else or put on a mask.  Why wouldn’t we want the same level of precaution (and protection) for our pets? …granted the mask thingie is less easily done with animals, i.e. not practical aside from trying it for fun with your dog at home and please send me pictures if you do. 

The very best thing to do when your dog suddenly (acutely) begins coughing, hacking or snorting is to contact your veterinary clinic to let them know what you are worried about BEFORE walking into the clinic with your dog. This type of ‘STOP, CALL (email or text if you prefer) and then PROCEED’ strategy with patients who have an acute onset of cough or nasal discharge can reduce spread of illness to other dogs who may happen to be in the veterinary clinic. In fact, your veterinary clinic may ask that you remain in your car with your dog and then come out to you to do an exam and ask questions to gather more information. This isn’t because they don’t like you (or your dog) it’s because they are responsible for all the other dogs who come to the clinic to be seen for various ailments- and the last thing anyone wants is to inadvertently spread an infectious disease from one dog to another causing an outbreak of something like canine flu (influenza virus) or another CIRD-C illness (outbreak links below).

So…if you’re worried about a brand-new cough or nasal drip in your dog, please CALL your veterinary clinic to alert them, relay your concerns and ask how they want you to proceed…but please STOP the instinct to hustle your dog into the clinic before doing so. Similarly, veterinary clinics appreciate your input and mentioning that you’re worried your dog’s cough may be infectious can help them remember to take steps to help your dog- and all the other K9 cuties they care for.

 Recent outbreaks of CIRD-C:

Canine Influenza, Ontario, Canada 2018:

https://www.wormsandgermsblog.com/2018/01/articles/animals/dogs/canine-influenza-ontario/

Respiratory disease outbreak in a Canadian veterinary hospital associated with canine parainfluenza virus infection: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3524821/

Spread of Canine Influenza A (H3N2) Virus, United States.

https://wwwnc.cdc.gov/eid/article/23/12/17-0246_article

 

Autumn is coming (& lepto may be more likely)...in Canada.

Autumn is coming (& lepto may be more likely)...in Canada.

Autumn is coming (& lepto may be more likely)…in Canada.

Here in Canada we don’t have much in the way of current publications on K9 lepto hot spots. However, due to the veterinary grapevine, willingness of diagnostics labs to share results and word of mouth, many of us are sadly aware that near the Halifax (and surrounding Nova Scotia) area leptospirosis established itself with a vengeance last fall. Portions of southern Ontario were hit pretty hard with K9 cases as well…and for both regions new cases were being diagnosed well into December 2017. That’s unusual since we don’t tend to think of lepto as a bug that does particularly well in colder climes (i.e. how we traditionally think of the Canadian winter), but times ‘they are a changin’ and at the risk of using 2 song choruses at one go, we (veterinarians) may need to ‘change, change, change’ our thinking on what vaccines are indicated for our specific geographic risk regions. 

 These days, if you live in (or plan to travel to) eastern or Atlantic Canada (and potentially coastal B.C) with your dog, leptospirosis vaccination (i.e. containing the 4 K9 lepto serovars I mentioned in the prior blog (http://www.canadian-k9.com/puppy-tales-blog/) is something you’ll want to consider in order to protect dogs year-round. Particularly as we slide into fall and hope to avoid further outbreaks of severe canine illness. 

 On that note and to help raise awareness, here’s a draft map provided by Scott Weese and our collaborative research team (Universities of Guelph and PEI) on Canadian canine lepto test positive incidence (PCR, ELISA). Data source from December 2008 to May 2018, provided courtesy of IDEXX Laboratories.