Hey! You! Yes – you. You know that feeling when you get in a hot car after it’s been sitting, baking in the sweltering sun all day? That cloying, sweaty, Corinthian-leather-sticking-to-the-back-of-your-thighs, tight in the chest, oh-when-will-the-A/C-kick-in feeling? Well, add in a heavy fur coat and the inability to sweat and that’s your dog in a hot car.Dogs die in hot cars – it’s even the name of a band (pretty catchy tunes, too). But beyond the funny band names, the reality of the situation is no laughing matter. I don’t want to dwell on the morbid reality of just what goes on inside the car when a dog is stuck in there on a hot day, so instead I’ll provide this list of alternate things you can do inside a hot car: • Bake a pizza • Soft-boil an egg • Defrost some fish filets for making lutefisk • Science experiment: Magically turn ice into flowing liquid water! (Take that, Nova!) • Produce certain kinds of eastern European cheeses. Any of those would be better, ethically and pet-ownershipically speaking, than leaving your dog to suffer in the confines of a hot car. Your dog is better than lutefisk! And lutefisk is delicious, trust me.What does a dog look like in a hot car? Miserable is what. It looks like a miserable, sad, melting dog. And they’re not just uncomfortable – after just a few minutes, uncomfortable slides over into wretched agony which then runs right the heck into blood-boiling deadly. And dogs don’t sweat to get rid of body heat – they can’t sweat. Mother Nature let the summer intern design the whole canine HVAC system. Instead they pant to try and dissipate the extra heat. But since they are locked in with no ventilation, they only make more heat by trying to pant. After a bit, they give up on panting and just sort of droop like an over-boiled noodle. And after that…well, you get the picture. Just how long it takes to go from happy tail-waggity pup to one who is peeing on heavenly fire hydrants depends on the size of the dog and the heat and humidity of the day, but it is safe to say that in just a few minutes, you can go from new-car smell to hot car hell. So the first way to prevent this sad turn of events is to leave the pooch (or cat, or capybara or whatever) at home and ask Aunt Gladys to watch over them while you run to the store for more Mogen David (L’chaim!) or rutabaga to go with the lutefisk (Uff da!). In all the cases that I have ever treated ? and I have treated many, many, many, too many cases of heat stroke ? the situation was entirely preventable. The guilt and shame felt by those owners were immense, and they could have saved themselves a whole world of heartache (not to mention keeping a whole buncha dogs here on earth where they belong) if only they had stopped and thought for a sec about the dangers of heat stroke in a hot car, or made some alternate pooch plans. Is it still even a thing? Sad to say, but – yes. Dogs are left in hot cars every day. The only way to prevent it is to raise awareness, as we here at VetzInsight are trying to do. Plus we are pushing lutefisk as a nutritious snack for Norwegians and non-Norwegians alike – this PSA has been brought to you by a generous grant from the North American Lutefisk Isn’t as Gross and Slimy as You’ve Been Led to Believe Council®. If you do see a dog in a hot car, first try and (calmly, gently) find the owner and see if they will get the dog out. Go to the store that they are likely in and ask the management to make an announcement over the PA. Alternatively, you could hop the counter at Customer Service, grab the mic and start screaming “Will the troglodyte who locked their dog in a hot car please go get them out before I find you and go all Pompeii on your buttocks?” Either is an effective strategy, just one is more fun. The NA Lutefisk IAGASAYBLTB Council® frowns on property destruction, so smashing a car window with a brick and busting out the dog all on your lonesome is a step best reserved for desperate cases and those with adequate legal counsel. Calling for help from the police is always a good idea when you see a dog in a hot car; let them deal with the troglodytes and window-smashing bricks. Wouldn’t that leave you with more time to go soak your whitefish in lye?When you get the dog out of the scalding car, what do you do? Job #1 is to get them cooled down, and cold water is the best way to do it. Soak them, put a fan on them, and get them in the shade. Minus the lye, it is similar to preparing whitefish for lutefisk. If they can drink (meaning, no vomiting and they are able to hold their head up) then drinking cool water will help. If they can’t get up, have trouble breathing or just seem droopy and melty, stop making lutefisk and get them to a veterinary emergency hospital posthaste! (Which means ‘now’ only sooner.) The faster they are cooled off and the sooner they get medical attention, the better their chances are for recovery. You could also use their erstwhile instrument of destruction – the car – to save the day. Crank the A/C, and drive them to a vet hospital! It has a sort of beautiful ironic symmetry to it (kind of like the palindromic Finnish word saippuakalasalakauppias, which means “lutefisk smuggler.” I did not make that up!) Your course of action is now as clear as an unmuddied lake or a Norwegian fjord: • Don’t leave your dog in a cool car on a hot day as the car will become hot. Remember: time passes and the earth rotates and the day warms up! • Don’t leave your dog in a hot car • Help out those unfortunates who do by busting out the dog • Aid their inept owners by encouraging them to hit themselves in the forehead with a big hammer • Go home and enjoy some refreshing, cold lutefisk! You don’t have to be a saippuakalasalakauppias to love it anymore – anyone can! (Just don’t share it with your dogs – they’ll think it’s totally gross.)

The High Points • Cats are carnivores and were never meant to eat high-carbohydrate diets • Commercial diet – especially dry diets – are too high in carbohydrates • Cats eating dry food are chronically dehydrated, and do not drink enough water to properly re-hydrate themselves • Dry diets are not that helpful in preventing dental disease • Experts are beginning to warn against feeding cats dry diets • If your cat is addicted to dry food or is picky, it is important to make changes carefully; don’t let your cat stop eating in protest Q. Dry food is best, right? A. Dry pet food is a dehydrated and processed mix of grains, meats, and added vitamins and minerals. Dry foods are typically 30-60% carbohydrate in composition. What isn’t well known among cat owners is that a requirement for carbohydrates has never been proven in cats (in contrast to dogs and people). Cats are carnivores, and in the wild eat nothing but meaty little rodents, bugs, birds and lizards. Our domesticated cats, on the other hand, are fed mixtures of meat and grain that produce a balanced diet over the long term. Many believe that those grains, aside from providing artificial balance, may be contributing to problems in the long run. Q. Look, my cat is doing well on dry food. Why should I change? A. Cats descend from desert animals that depended on their food to provide needed water. Their kidneys are adapted to this desert environment to conserve water and concentrate the wastes into the urine. When cats don’t get enough water from food or additional water intake, some feel that cats spend much of their lives chronically dehydrated, which is not good for those kidneys or the rest of the body. One common problem that seems to respond to more water in the food is the frustrating FUS, now called FLUTD () or interstitial cystitis. Most doctors recommend feeding only canned food to these cats to increase water going into the body and out through the bladder. Could this be a signal that cats don’t do well on dry food? Also, many people tend to leave dry food out all the time, leaving their cats to free feed. As convenient as it may be, this is a potentially harmful practice for the cat! Most cats given food all the time eat more than they should, and this practice is behind a growing epidemic of obese cats. And no, it doesn’t usually work to give them weight loss food free choice! In addition, free feeding these high-carbohydrate meals has been suggested to contribute to the rising incidence of insulin resistance and diabetes in cats (Rand, 1998). Since this is a chronic, potentially dangerous problem that sometimes requires insulin injections for the rest of the cat’s life, this is a major concern. Finally, many people have difficulty medicating their cats, and are forced to mix it in food. It’s much easier to mix medicine in canned food than in dry food. Cats who are addicted to dry food and won’t eat any canned food (a common problem) are a special challenge to medicate! Q. I was always told to leave food out all the time. Doesn’t this decrease urine pH and prevent lower urinary tract disease? A. It is true that eating small meals often lowers urinary pH. And cats are born to hunt constantly, catching little protein meals throughout the day. Remember, though, that dry food is not a meat protein like a lizard or mouse, and since it contains large amounts of carbohydrates (and often less fat) than real prey, we are essentially turning our cats into grazers.Worse, hunting cats are expending mental and physical activity between kills, and must work hard for those meals. The only exercise our dry food grazers are often getting is a jump off the couch! Q. OK, but what about my cat’s teeth? Isn’t canned food bad for them? A. Scientific evidence does say that cats eating canned food have worse teeth than cats eating dry food; however, if dry food were all that effective, we would not be seeing the large number of dental diets recently introduced to the market. Saying that dry cat food is great at preventing dental disease is like claiming that people could eat pretzels to maintain dental health! Teeth need proper nutrition (good quality diets increase all-around health and decrease susceptibility to gum disease), exercise (dental toys or safe meaty bones act like dental floss), and preventive treatment (brushing, where possible). Q. Well, maybe so, but I can’t get my cat to eat anything new! A. Well, this is a problem. Cats easily become addicted to certain types of foods. Like people who become addicted to cigarettes or drugs, this isn’t always good for them. A cat willing to eat only one kind of food will be much more difficult to support nutritionally when sick and we are forced to feed them something different! In addition, recent findings by some feline veterinarians suggest that this feeding practice – offering only one kind of food for years on end – actually contributes to the development of food allergies in cats (or inflammatory bowel disease, which is often synonymous). We recommend that all cats have a rotating diet, changing food types and food brands at least 2 to 4 times yearly. Cats are sometimes willing to go along with you on this, but if not, don’t force the issue by starving the cat. Cats who don’t eat are susceptible to a serious disease called fatty liver syndrome (hepatic lipidosis), which is a potentially fatal liver condition. If your cat is resistant to change, gradually try this technique: If free feeding, slowly but surely reduce the availability of the food so that the cat is finishing what’s offered during two mealtimes during the day. In other words, if food is usually available 24 hours daily, make it available for 4 hours in the morning and 4 hours at night, then 2 hours in the morning and 2 at night, and finally for only – 1 hour each time. Make sure to call your cat to meals so your cat doesn�t miss the opportunity to learn that a meal is available during set times of the day. Once you have turned your free feeder into a meal feeder, start mixing the new food into the old food. If your cat isn’t interested, stop mixing the new food in and return to the old food. Cut the amount of old food by 1/2 for ONLY 1 day. Your cat should become fairly hungry by the second day. This is when a cat is motivated to try the new taste, and you can once again begin mixing in the new food, very little at first and gradually increasing the amount. If your cat does not eat the new mixture then, try cutting the amount of food offered for 3 to 5 days, then add some of the new food. Remember that the object is to increase your cat’s motivation to try something new without starving him or her – just inducing a mild feeling of hunger. DON’T let your cat lose weight, and don’t push the issue too hard – some cats would rather get sick than switch. It’s best to work with your veterinarian’s scale during this process. Advantages The advantages to changing your cat’s eating habits are many-fold. By switching from free feeding dry food to meal feeding using canned with some dry, you can more easily control the amount and kind of food your cat gets. Cats fed this way are usually not as addicted to a single type of food, and rotating the diet will become much less stressful. And by rotating the diet, you will learn what foods your cat looks and feels best on. If your cat refuses to switch easily using the technique above, go ahead and give in, but keep thinking about how your next cat will be fed!

Author: Marie Haynes Publish Date: 4/13/2012 12:35:31 PM Editor’s note: There’s a common public perception that veterinary care is overpriced and that many veterinarians get rich at the expense of pets and their owners. Dr. Marie Haynes addresses that concern through a sympathetic, humorous and informative account from her experience as a companion-animal practitioner in Ottawa, Ontario. She wrote the following essay two months ago after a frustrating day in which she and her staff faced limited treatment options for an injured animal owing to the owner’s financial straits. The article, which she posted on her blog, went viral via Facebook. At last count, it had garnered more than 15,000 “likes” and 800 comments. The VIN News Service is reprinting the essay with Dr. Haynes’ permission. Sometimes I hate my job. Well, that’s not true. I almost always love my job. But what I hate is that everything I do costs people money. Multiple times per day, I am helping people make decisions for their pets based on how much they can afford. “All vets think about is money!” “You don’t care about my pet, all you care about is getting rich!” “Why does it cost so much to clean my pet’s teeth? My own dentist is cheaper!” Unfortunately, these are remarks that I hear on a regular basis. And I feel for you guys! It can be expensive to keep a pet healthy these days. I thought I would write this article to explain some of the facts about the financial side of veterinary medicine. A veterinary hospital is a business Doesn’t that sound heartless? But it’s true … a vet clinic is a business and needs to make money. Just like any other business we have bills to pay (and often these bills are huge). We pay rent, electricity and gas bills. And we pay large bills to buy and maintain equipment. An X-ray machine costs anywhere from $30,000 to $90,000. An ultrasound is going to cost about the same. And there is a lot of other equipment that needs to be purchased and maintained: dental equipment (most veterinarians have similar equipment to what a human dentist has), equipment to run laboratory tests, surgical instruments and on and on. We also have salaries to pay. The staff at veterinary clinics are, in my opinion, usually severely underpaid for the quality of work that they do. A veterinary technician is an extremely skilled individual, able to place a catheter, draw blood, do a dental cleaning, counsel clients and multitask animal care all day long. According to Payscale.com , a technician generally gets paid between $9 and $18 per hour. It’s a crummy wage for someone with so many skills. Most technicians have gone to school for three years and carry some student debt. Compare this to a registered (human) nurse who gets paid between $20 to $36 dollars per hour. Why are techs paid so poorly? It’s because we’d have to raise our prices in order to afford to pay them more. What about the veterinarian’s salary? I have a confession to make. I drive a BMW. There you go. Is this why vet bills are so expensive? To pad the pockets of greedy veterinarians? Well, here’s the rest of the story. My husband is a successful real estate agent. His recent business successes and hard work have paid for my car. Prior to this, for the last 10 years I have driven a 2002 Honda Civic. Now, there’s nothing wrong with a Civic … it’s a great car. But my point is that a veterinarian’s salary is not one that allows you to live in luxury. Veterinarians on average have spent seven years of their lives in college/university doing intensive study. According to the Journal of the American Veterinary Medical Association, the average veterinarian graduates with a debt of a whopping $142,613! And, according to Payscale.com , a veterinarian generally makes between $45,000 and $106,000 depending on experience. Let’s compare this with a few other professions: Family physician: $75,000 – $204,000Pharmacist: $50,000 – $130,000Dentist: $61,000 – $201,000Ophthalmologist: $93,000 – $304,000General surgeon: $65,000 – $368,000 A veterinarian does all of the things that the professions above do, but usually gets paid much less. Many vets work 10- to 12-hour days, and some are on call throughout the night. We get scratched and bitten on a regular basis. A good amount of our day involves intensive grief counseling of clients. This is not a “cushy” job. It’s hard work! Explaining the charges for a vet bill I thought I’d explain the way that some things are charged for. I’ll occasionally hear people talking about their vet, saying things like, “I was in there for 20 minutes and paid $200! I’m in the wrong profession! Here is an example scenario: John brings his golden retriever, Andy to see me, Dr. Marie, because he has a problem with his ears. I have a good look at Andy from nose to tail and notice that the ears are red, inflamed and full of debris. The skin between the toes is a little red, as well, and there is saliva staining, which shows me that he has been licking at his feet. (This is likely a sign of allergies). Otherwise, he looks good. I put a swab in each ear and hand them off to my technician. We have a good discussion about underlying allergies and what kind of things we can do in the future if things are getting worse. (I decide not to do allergy testing or special hypoallergenic food now because I don’t want John’s bill to be outrageous. We’ll consider those things in the future.) We talk about the type of things that cause infection and what we could do to prevent further ones. Ten minutes later, my technician tells me that the ears have yeast and cocci (bacteria). She takes Andy to the back to thoroughly clean his ears. We send him home with some medication to put in the ears twice a day and instructions to come back and see me in a few weeks. Here are the costs for the visit, along with an explanation: Office visit: $68.00 What you’re paying for: The most important part of the office visit is the time and expertise of the veterinarian. In that 20-minute time period, the vet will examine the pet, make a diagnosis and share valuable information with you. I have had clients say things like, “ I knew there was an ear infection! I didn’t need you to tell me that. I just needed medication.” But it’s the vet’s experience that tells us how long we need to treat for, what medication is best, whether or not there are ear mites, whether we need to treat one ear or both, whether there is possibly a resistant type of bacteria present, whether the ear drum is intact (because if not, then regular ear medications could be dangerous) and whether there is an underlying problem such as allergies or a thyroid condition. This charge also covers the time that I take to make notes in your file. Did you know that almost everything that is discussed and done in your office visit is documented? This is often one of the most time consuming parts of the visit for the veterinarian. Cytology: $31.00 What you’re paying for: This is a lab test where we take the debris from the ear, put it on a slide, stain it and look at it under the microscope. Some clients will say, “Just give me the medicine that worked last time. I don’t need a test.” But this test tells me a lot. It usually tells me which medicine is best. It also tells me the severity. If I see a mild amount of bacteria I may just treat for 10 days. If I see lots, I could treat for 3 weeks. If I see rod bacteria, then I’m suspicious I’m dealing with a nasty Pseudomonas infection and I know that I should be doing additional tests such as culturing the ear to find out exactly what the bacteria is and what medication is going to work. At the recheck exam I do a cytology again and it tells me how well our treatment worked and whether we need to keep going. If we stop too soon then the infection will come back again. Spending a little money now and dealing with the problem properly can save you hundreds of dollars in the long run. Ear cleaning: $28.00 What you’re paying for: The expertise of the technician. Cleaning an infected, inflamed ear takes skill and expertise. If the ear is not properly cleaned, then the medicine is not going to work as well. If you don’t know what you are doing, then you can damage the ear drum, which is a horrible thing. Medication: $38.00 What you’re paying for: The bulk of this charge is due to the cost of the medication. There is a markup on the cost, because (gasp) we are a business and yes, we do make some money off of medication. There is also a dispensing fee. This is another thing that people will gripe at. “Why charge me to put pills or cream in a bottle and slap a label on it?” The dispensing fee also covers the explanation on how to use the drug and answering questions that you have about it. Taxes: In my area, the taxes on this bill would be $21.45. Total: $186.45 What happens when clients can’t pay? This is the part of my job I hate the most. I think every new veterinary graduate goes through a phase where you want to just pay for the bill for anyone who can’t afford it so that no animal has to go without help. It truly sucks when an animal needs care but the owner is not able (or not willing) to pay for that care. So, whose responsibility is it to make sure that that animal gets help? Let’s take the above scenario. Let’s say the client comes in with a $50 bill in his pocket and says, “Doc, I love my dog so much and I’ll do anything for him but all I have is $50. I know you love animals and don’t want him to suffer, so please help.” What am I to do? On one hand, I could look at the situation like this: “Well, what does this actually cost me? The office visit and tests really only cost me time. So, if I just charged for the medication, this dog could have some relief.” But, how is that fair to the next person who comes in with a dog with an ear infection? What if I give an inappropriate medication (because I didn’t do tests on the ear)? If the dog doesn’t improve, is it then my fault? And what happens the next time this dog has a problem? Do I always give this owner a huge discount? What happens when he tells his friends that I gave him a huge discount? I’m sure there will be others who want the same treatment! Here’s another, much more difficult, scenario: Need life-saving surgery — but can’t afford it! Susan comes in with her beloved Chihuahua, Peppy. Susan could not afford to spay Peppy and although she tried hard to keep her away from other dogs, a big dog jumped the fence in her yard and bred Peppy. Now, she is pregnant, in labor and struggling. Susan comes in crying. She and I both know that Peppy’s going to need a C-Section in order to survive. She has $100 to pay me today. And she promises to pay me $100 per month until the bill is paid off. A C-Section can cost anywhere from $800 to $2,500 or even more if there are complications. Often, extra staff needs to be brought in and the costs to the clinic are significant. What do I do? What would you do if you were the vet? Unfortunately, history tells me that if I set up a payment plan, I will not receive any of that money. Susan has good intentions, but good intentions don’t pay bills. In 13 years of practice, I have unfortunately been in this situation many, many times. In the past, when I have made arrangements for clients like this, it has been extremely rare that we have received the full payment for the bill. In most cases, we may get one or two payments. We end up spending money on collection agencies to try and get the rest of that payment back but usually it gets written off as bad debt. So, whose responsibility is it to help the animals in a situation like this? Do I do the surgery, knowing that I will likely not get paid, simply because the dog needs it? (Keep in mind that a situation like this can happen several times per week in a veterinary hospital. Where do we draw the line?) Do I send the dog away and tell her to come back when she has the money? Can you see why I hate this part of my job? What can be done? There are options for people who are in a difficult situation like this. These options are not always what the client wants to hear, but we have to set some limits. The first thing I do is give the client the option of using Medicard or Care Credit. These are financing agencies that will give you a loan to help you pay a veterinary bill. I hear the cries now: “I don’t want to pay interest!” “I have bad credit … I won’t get approved.” If a client’s credit rating is not good enough to be approved for one of these loans, then I ask the client to find a family member or friend who would be willing to lend them the money. Sometimes this is a solution. But what happens when you have bad credit and no family or friends at all to help? If this is the case, then why should the veterinarian pay for your pet’s treatment? If your children are hungry and you can’t afford groceries, is it the responsibility of the grocery store to pay for their food? Organizations Sometimes, we can draw on charity help in situations like this. In Ontario, where I practice, we have something called the Farley Foundation. This organization will give us up to $500 per year to help pay the veterinary bill of someone who has a documented disability. Five hundred dollars is not a lot, but it can help. I get to use this once a year. It’s often tough to choose which client gets the help. Before my mom succumbed to cancer in 2001, she went to the veterinary hospital where I had worked in high school and asked if she could set up a fund to help people who had trouble paying their vet bills. (She did this because when I was growing up, we struggled to pay our veterinary bills. She didn’t want others to be in that situation.) When she died, instead of asking people to donate to the cancer society, she asked for donations to the fund in her name at the animal hospital. This helped many animals and, to this day, people still contribute to this fund in order to help more pets. But, again, this can go only so far. I have compiled a list of similar charities that help as much as they can. You can find this list here: organizations that help with veterinary bills. If you know of other organizations that do this, then leave me a comment and I will add them to the list. Humane societies and the SPCA If an animal is suffering and needs care, in many areas an option is to take them to the local humane society or SPCA. In the case of the dog needing a C-Section this is likely what I would have suggested. Many times the humane society or SPCA will take in the pet and do whatever medical care is necessary. The unfortunate thing is that in many cases, you will need to sign the pet over to the care of the shelter and you may not get them back. Conclusion Oh, how I wish that I could do my job and not care about how much things cost! For those of you reading this, I would highly advise that you look into getting pet insurance to cover you in case you find yourself in a financial bind. Or, if you are an organized person, put some money aside each month in an account for your pet. I sympathize with you on how expensive veterinary bills are. It would be so wonderful, as a vet, to be able to practice and make decisions for animals based on what they need rather than what their owners can afford (or are willing to pay). I do all I can to work with my clients’ budgets and to do the best for their pets. But, sometimes we do face difficult situations!

Author: Edie Lau; Bill EnfieldPublish Date: 2/10/2012 1:33:22 PM Three young pet birds died one after the other within five months. The girl who owned them landed in the hospital soon after with a mysterious malady. Her family wondered: Might the birds hold a clue to the girl’s illness? It was a natural question, their veterinarian, Dr. J.C. Burcham, said: “Three birds died, now the girl is sick, they all shared the same room. What’s wrong?” The trouble is, no one knew what ailed the birds. Each died abruptly not long after undergoing a wellness exam that revealed no problem. A necropsy of the third bird failed to identify a cause of death. When their owner, a young teenager in Kansas, ended up in the hospital with septic shock, her father phoned the veterinarian to ask whether she thought the girl’s illness might be connected to the birds’ deaths. Burcham racked her brain, fretted over what to do, then put the question to colleagues on the Veterinary Information Network (VIN), an online community for the profession. “Should I call the state vet, even though I have no diagnostic results indicative of a human health concern?” she asked. One of the veterinarians who responded was Dr. Radford Davis, an associate professor of public health at Iowa State University’s College of Veterinary Medicine and an authority in diseases that can transmit to people from animals. His answer was no. “Guessing about a zoonosis is really just an academic exercise unless the physicians work to diagnose the human patient,” he said. Davis’s stance was consistent with answers he’s given over the years to similar inquiries. A VIN consultant on zoonoses and public health, Davis estimates that such questions pop up weekly on the organization’s message boards. In Burcham’s case, the series of bird deaths and their owner’s illness raised a logical question, but many times, veterinarians are asked to test apparently healthy animals — even if the human patient doesn’t have a definitive diagnosis. “That’s really jumping the gun,” Davis said. “We don’t even know the exact disease in the person, let alone whether the (animal) could have transmitted it. Those kinds of questions really put the vet in a predicament.” To help veterinarians respond to general requests for testing, Davis recently posted a commentary on VIN elaborating on his belief that, in many instances, testing should be discouraged. “Testing of healthy animals for zoonoses is not indicated in most instances unless there is a high potential for the animal to infect others or in outbreak situations where a source is sought,” he wrote. “Some diseases in humans and animal populations are reportable at the state and national level (as well as international level), which also might require the testing of healthy animals to identify the source. Testing requires time, money, effort, and results may not correlate to risk of pathogen transmission or risk to human health. Depending on the type of testing done, testing may identify other zoonotic pathogens, which then creates problems in addressing their true risk to human health. False positive and false negative results can occur with some testing, and shedding of pathogens is often intermittent, so samples might be negative at any given point. Also, it should be noted that tests results from the animal will not change the course of treatment in the human. “When testing an animal, the veterinarian should ask herself/himself: What will I do if the test is positive? What will I do if it is negative? What is the cost … in terms of money, time, effort, actionable answers, emotion and health to all involved? Is the quest more academic, or is there a real need to test and find a source? If the animal is negative, where will the physician and/or veterinarian turn to next to find the source? … “A positive test in a healthy animal might mean euthanasia for that animal, or repeat cycles of testing and treatment, despite a low risk for future transmission. The animal may no longer be shedding, yet have evidence of past infection. A negative test might not truly be negative, giving a false impression of risk and a false sense of safety to owners. A false positive test result can lead to unnecessary outcomes: more testing, a greater financial input by owners, unnecessary treatments (creation of antibiotic resistance), and perhaps rehoming or euthanasia of the animal. “Most zoonoses acquired directly from animals can be avoided by such measures as washing hands for 20 seconds after animal contact, washing hands after handling pet foods, avoiding contact with the animal’s nose and anal regions, keeping the animal in good health, good husbandry practices, wearing gloves when contacting feces/litter, preventing pets from hunting/scavenging, regular fecal exams and regular veterinary visits…” Perspectives differ Davis’s stance against liberal testing is appreciated but not fully shared by experts on the human medical side. For instance, Dr. Cheryl Scott, an RN and DVM who heads the Calvin Schwabe One Health Project at the University of California, Davis, School of Veterinary Medicine, finds value in testing for “academic” reasons in some cases. “If you don’t look, you’re not going to know,” Scott said. “You’re just going to keep these blinders on.” As a general example of when looking and testing were productive, Scott pointed to the discovery that Lyme disease lurks in Northern California. Spread by ticks, Lyme disease was first identified in the Northeast, where it is most prevalent. “Years ago when I first got out in practice, we never looked for tick-borne diseases,” Scott recalled. “When I started looking for things in my practice in Solano County (in California), sure enough, I started finding Lyme disease everywhere. Nobody thought it was out here. Well, it’s out here … and it’s causing problems. It’s making dogs sick and it’s making people sick.” Likewise, Dr. Carol Glaser, an MD and DVM in the California Department of Health Services, said she agrees with almost all of Davis’s comments, with some caveats. “I don’t think it’s a simple yes or no (whether to test),” Glaser said. “It’s going to be highly dependent on which disease is being considered, how sick the human patient is, is it more than one patient, what type of animal is involved and the health status of the animal.” Underscoring the need to examine seemingly unrelated events in animal and human health, Glaser pointed to the baffling set of circumstances in New York City that led to the discovery in 1999 of West Nile virus in the United States. “There were dead birds on the lawn, people sick and zoo animals sick,” she recounted. “Nobody knew they were aligned. We didn’t even know West Nile virus was here. Having data from veterinary groups helped the people who deal with human medicine put it all together.” In her role as chief of the encephalitis and special investigation section of the communicable disease emergency response branch in California’s Department of Health Services, Glaser said she has at times gone to great lengths to sleuth the source of a disease. One such case occurred last May. An 8-year-old girl contracted rabies, and no one knew how. Her family owned a horse that died five months earlier, presumably of colonic torsion. We actually had the horse dug up and tested,” Glaser said. Unfortunately, the “brain tissue was not ideal for testing,” according to an account in the U.S. Center for Disease Control’s Morbidity and Mortality Weekly Report, and the source of infection remained unknown. Remarkably, the girl survived. While public health threats such as rabies call for aggressive action, Glaser said, other diseases don’t warrant the same level of response. “Say you have a child with diarrhea and the dog also has diarrhea,” Glaser said. “You might know it’s Salmonella in the child; should you explore the dog? In those circumstances, I’d say probably not, for a number of reasons. Even if … the dog had been the source, by the time you do the testing, the organism may be gone, so you’ve wasted the money and time. (And) if it’s positive, how do you know the kid got it from the dog? Maybe both ate (contaminated) chicken.” But sometimes testing that’s not medically or scientifically necessary could be useful in educating patients or their families, said Dr. Larry Pickering, a professor of pediatrics at Emory University School of Medicine and a senior advisor to the director of the CDC’s National Center for Immunization and Respiratory Diseases. For example, if a 6-month-old baby on a formula-only diet, living in a home with a turtle, came down with Salmonella sepsis, Pickering said, chances are that the baby contracted the pathogen from the turtle. Some doctors might forgo testing, figuring by inference that the turtle is to blame. But Pickering said he would opt to test the turtle, if only to help the baby’s parents understand the hazards of keeping such a pet. “Some parents want evidence,” he said. Cats and toxoplasmosis: a conundrum In some situations, Glaser said testing is “absolutely not warranted.” For instance? To allay concerns about toxoplasmosis. As most women who’ve ever been pregnant know, cats may shed the parasite Toxoplasma gondii in their feces. Healthy people may pick up and harbor the parasite with no problem, but a first-time exposure in a pregnant woman potentially is devastating to her fetus. However, Glaser said, infected cats typically shed the parasite for only a short period — one to two weeks — and never again. Chances are much greater that a person will become infected by eating unwashed contaminated vegetables or undercooked meat, she said. In fact, the CDC calls toxoplasmosis “the leading cause of death attributed to foodborne illness in the United States.” While cats play an important role in the spread of the parasite — they are its only known definitive host — targeting the household pet is not justified, Glaser and others say. Yet women widely believe that keeping a cat while pregnant is a significant risk. Dr. Michele Gaspar, a feline specialist in Chicago, said she once worked at a large animal shelter in which she saw “sobbing women bringing in their cats to give up” because of their fear of toxoplasmosis. Pickering explained the thinking of physicians who advise pregnant patients not to keep cats: “If you get rid of the cat, you won’t get any diseases from the cat; that’s 100 percent,” he said. “If you don’t get rid of the cat, make sure it’s immunized, make sure it’s dewormed, get rid of its fleas,” he said, naming precautions that generally keep cats healthy, “and don’t clean the litter box.” Pickering added: “If the obstetrician says ‘get rid of the cat,’ I’d support him or her. If you’ve seen a baby die of a disease that may have been acquired from a cat, that changes how you approach it.” He acknowledged, at the same time, that cats may contribute to an expectant woman’s well-being. He personally witnessed this. “When my wife was pregnant with our baby, she had to be down (in bed) for three months. The cat was a lifesaver. It was with her all the time,” Pickering remembered. “I think with the appropriate precautions, things can be handled well,” Pickering concluded. “We don’t want to go too far to the left or the right.” Better communication needed On one point veterinarians and physicians firmly are in agreement: they should talk to each other more. “If there’s (a) question that (a) pet might be a source of infection to somebody who’s under medical care and the client is talking to the vet about this, then the vet could say, ‘If you give me permission, I’d be happy to talk to your doctor,’ ” Davis suggested. Davis said he recommends this to colleagues all the time, but doesn’t believe such consultations happen frequently. “We (veterinarians and MDs) don’t really communicate too well,” he said. Pickering agreed. The problem isn’t lack of desire, he said, but lack of time. “It’s another step in another process and we have so many steps and so many processes (already),” he said. Whether in concert with physicians or not, veterinarians are playing a more prominent part in human health. The expanding role for small-animal veterinarians, in particular, in protecting public health was the topic of a 2007 commentary in the Journal of the American Veterinary Medicine Association. The authors, Drs. James S. Wohl and Kenneth F. Nusbaum, stated that small-animal veterinarians have assumed the job of primary educators “in the risks of emerging diseases such as West Nile virus infection and avian influenza for pets and pet owners; and the risks of animal contact for immunocompromised people.” They noted that “many Americans have more contact with their veterinarian than with their physicians.” Gaspar agreed. “Fact of the matter is that veterinarians are really at the forefront of public health,” she said. “We are not only the doctor for the pet; we have a role in the health of the family.” Epilogue In the case of the three dead birds and sick teenager in Kansas, the mystery has remained unsolved, although the girl reportedly has recovered. “It was all so weird that you wanted there to be an explanation for it,” said Burcham, the veterinarian who had seen the two cockatiels and one green cheek conure. “The three birds dying back-to-back seemed like a red flag for something but … it’s a reminder that just because there are animals dying doesn’t mean that is why the human is sick.”

Author: Tony Johnson, DVM, DACVECC Publish Date: 8/4/2014 10:06:32 AM I have a cat. Since I’m a veterinarian, that probably doesn’t come as a big surprise to many. But I have a…radioactive cat! That’s right – I have a dyed-in-the-wool, glowing green, isotope-emitting, half-life-y radioactive cat. And I paid actual money to make him that way. Lemme ‘splain. Crispy, the isotope-y cat of the hour, has had a rough life. He is currently about 15, but at the tender age of 2 or 3, some antisociopathic troglodytic knuckle-dragger with a can of lighter fluid and the will to use it set him aflame (and then was promptly captured and ground down into a fine powder, which I sprinkle on my oatmeal daily…I mean incarcerated. That other part was just a dream of mine.) Anyway, he was set on fire, but recovered and other than a scarry head that would make Freddy Krueger envious, he’s more or less normal. Normal until a few months ago, when my wife, the smarter and better looking of our little world of two, noticed that the litter boxes were filling up with extra bonus pee and the water dish was getting as dry as a really dry thing (sometimes analogies fail me). To a veterinarian, drinking too much water and forming too many piss biscuits in the litter box leads us to a short and fairly unhappy list of diseases: diabetes, kidney failure, liver failure, some adrenal gland disorders, hyperthyroidism and a smattering of lesser diseases. So we were a might alarmed, and after a round of Rock-Paper-Scissors to see who would haul him in for blood work (I won), she took him in and we discovered that he was hyperthyroid. Given the baddies on that list, hyperthyroidism isn’t all that bad. We were secretly hoping for it to be a phenomenon known as “psychogenic polydipsia,” which is just medicalese for “he’s drinking more water than he should because he likes to,” but as far as diseases go, hyperthyroidism is pretty mild. Except for the radiation, which I will get to in a bit. When your thyroid gland decides to go all whoopsy and hyper, it’s like the accelerator pedal on your metabolism is pressed to the floor. No one really knows what causes it. It’s like one morning, it just wakes up, downs three venti lattes and says “I’m working overtime today!” and starts churning out abnormally high levels of thyroid hormone, the substance that regulates how fast you burn energy. The cause is elusive, and everything from space rays to preservatives in pet food has been blamed, but the reality is in most cases it just does this spontaneously. Most cats with hyperthyroidism lose weight, eat ravenously and drink and pee too much. Crispy, ever the iconoclast, only did the last bit with the water, the peeing and such, but we caught it early and his levels were only mildly high.Years ago, one of the few options for therapy was to have a madman with a scalpel go in and cut the darn hyperactive thing out. The problem is that the thyroid glands sit right atop some important nerves, and, like a game of Operation, has wee little secondary glands within it that get upset when these tiny giblets (creatively known as parathyroid glands) are yanked along with the thyroid gland. There is also a medication called methimazole that is every bit as hard to administer as it is to pronounce. Luckily for Crispy, treatment has advanced of late.The current treatment of choice is radioactive iodine, also known by t.he less scary and cuddlier moniker I131. Iodine is taken up by the thyroid and forms a core portion of the thyroid hormone molecule. When you attach a little radioactive bit to some regular old iodine, it becomes a thyroid smart bomb and detonates right inside the thyroid, destroying the overactive gland. If it is dosed just right, it leaves enough normal gland to still provide some thyroid function. It’s not unheard of for cats (and humans, too – this treatment is used in people with hyperthyroidism) to swing from hyperthyroid to hypothyroid and need thyroid supplements, but the ideal end result is destruction of the excess tissue only. Once we had a diagnosis, we signed Crispy up for treatment at a nearby clinic. The actual nuts and bolts aspect of the treatment is ridiculously simple: wearing lead-lined gloves and in a special room, a technician trained in the ways of nuclear medicine injects the stuff in the scruff of the neck, lovingly tosses him in a lead-lined cage for three days and the I131 does all the rest. He gets to cool his heels (literally) for a little 72-hour radiation vacation and then gets to come home, as long as the Geiger counter agrees that he’s no longer (all that) radioactive. When we picked him up after all was said and done, he shrugged his shoulders and said “Meh” when we asked him how his stay was. Most of the radiation was gone from his body by the time he was picked up, but the discharge instructions still offer some vaguely ominous warnings against overly close cuddling for 2 weeks, and some instructions for handling the selfsame piss biscuits that started this whole episode; most of the radiation is eliminated through urine and feces, while some just evaporates into the cosmos. We set him up with a little Chernobyl-esque dacha in the basement for his two weeks, and bought the special litter required for safe handling of his nuclear waste. All went well, but as I scooped the odd, flushable waste, a couple of scenarios started to form in my mind. The litter was made of wheat (somehow) and formed these gooey, pancake-like clumps that allegedly could be flushed down the commode. First, I pictured the residual radiation getting into the local water supply and leading to a horde of sentient fish from nearby streams with opposable fins walking up my driveway and ringing the doorbell, wanting to have a word with me about my environmental sensibilities. Once I convinced myself that this was unlikely to happen, as the local lakes are devoid of fish, I became concerned that “flushable” might be a relative term and that I was filling up the bowl with too much at one time. In my mind, a scene like the one from Fantasia where sorcerer Mickey overfills legions of (sentient, opposable) buckets from the enchanted well started to take shape. One scoop too many, one flush of the flush-knob (does that thing have a name?) and a wheaty brown mess started to overflow the bowl with alarming, nuclear speed. I pictured myself doing all the desperate things you do when a toilet overflows – the mad scramble for towels, old T-shirts, anything that would soak up the mess, the rapid-fire removal of the toilet top to press the little floaty bar thing to stop the bowl from filling more, the cramped and uncomfortable grab for the knobby bit that allows water to flow into the reservoir thing that is stopped by the floaty bar thing…. In that moment, I realized that I don’t know many of the names for toilet parts. Next, I pictured the inevitable call to the water damage restoration company:“Hello, Psychogenic Polydipsia Water Damage Restoration Company “Hi there. My toilet just overflowed and I need a plumber and someone to come out and deal with the water damage.”“Certainly, sir. We can help you with that. There is a surcharge if this is soiled water, due to the contamination hazard. Was the toilet full at the time?” (Up to this point, this is a nearly verbatim representation of an actual conversation I had once when a toilet overflowed. After this point, it’s all wheels turning in my tortured brain.)“Well, yes. It had cat poop and pee in it.”“Ah, I see. Animal waste carries an extra sur-surcharge, due to the contamination hazard.”“Ummm, OK. I need to get to this cleaned up, so I guess I’ll have to pay it. There is one more thing, though.”“What’s that, sir?”“The waste is…radioactive.”*click* Luckily for me, my family and all the nearby sentient, opposably-finned fish, the toilet did not overflow, the restoration company did not need to be summoned and all the peepee pancakes swirled merrily down the tubes without incident. It was all a dream. A fevered, radioactive, Three-Mile-Island dream. Crispy is just about done with his 2-week period of home isolation, and we can let him rejoin the family fairly soon. All in all, it was worth it, and certainly better than a lifetime of bitter pills or surgery. If only I can get the specter of those sentient fish and the overflowing, radioactive toilet out of my mind, I think life will return to normal for all of us. Now, I just need to get the manual and learn the names for some toilet parts.

Author: Rhea Morgan Publish Date: 5/15/2014 3:18:00 PM Pannus, also known as chronic superficial keratitis, is an eye disease that can result in blindness if it is not treated. Pannus is a lifelong problem that can typically be managed but not cured. Pannus is more common and more severe at high altitudes and in areas with severe air pollution. It is widely believed to be an immune-mediated condition, possibly as a response to exposure to ultraviolet light or other irritants. Genetic factors may be involved in the German shepherd dog (GSD) and GSD-mix dogs. A variation of pannus can affect the third eyelid, and is called nictitans plasmacytic conjunctivitis or plasmoma. Corneal pannus and plasmoma can occur together or alone. Pannus occurs most frequently in GSD and GSD-mix dogs, but it occurs sporadically in the greyhound, Rottweiler, Belgian shepherd, Belgian Tervuren, and several other breeds.Dogs 4 to 7 years of age are at highest risk for developing pannus. In German shepherds, the younger the dog is at diagnosis, the more severe and unresponsive the condition tends to be. Pannus tends to be milder and more responsive to treatment if the age of onset is after 5 to 6 years and if the affected patient lives at a low altitude.Both eyes are affected although one may look worse than the other. The cornea is the clear outer covering of the eye that attaches to the white sclera of the eye. Usually a pinkish film starts at the outer aspect of the cornea and conjunctiva and spreads towards the center of the eye. As the film spreads across the cornea, it becomes opaque. As time goes by, the cornea becomes dark or pigmented. An eye examination can diagnose pannus. Treatment Depending on the severity of the disease at diagnosis, aggressive treatment may be started to halt the progress and once the disease is under control, then therapy can be tapered to less frequent applications. In the beginning, eye drops and/or ointments must be given several times a day. Generally, a corticosteroid product is started initially. In severe cases or cases of plasmoma, cyclosporine or tacrolimus may be added to the steroid. When the dog is blind or near blind from the disease, subconjunctival injection of corticosteroids can be done at the onset of therapy in order to speed up response to the medications. The goal is to halt the progression of the disease and achieve remission. Flare ups are common and can occur at various seasons/times of the year. Periodic eye exams (3 to 4 times per year) are done to watch for signs of flare ups, so the treatments can be modified before the pannus becomes severe. Not every veterinarian is comfortable treating pannus. Discuss with your veterinarian whether referral to a veterinary ophthalmologist would be best for you and your pet. Prognosis Most dogs with mild to moderate pannus or that live at low altitudes respond well to topical medications. All dogs with pannus must be monitored carefully for flare ups, however. Dogs that live or work (such as military dogs in Afghanistan) at high altitudes can be much harder to treat. Cases that are not responding as expected or are poorly responsive to therapy should be referred to a veterinary ophthalmologist for further evaluation and to determine if other options should be considered.

In late February, Dr. Baird flew to Guatemala with a World Vets veterinary team to provide much needed care for animals in the highland area. World Vets is a US based non-profit group that provides aid for animals throughout the world. This veterinary team went to the Lake Atitlan area for a pilot project to provide a large scale sterilization campaign. “Roaming” dogs are often a problem in this area as they travel in packs and are quite territorial. Our mission goal was to assist local efforts in humanely controlling the “roaming” dog population as well as contribute to the public health and safety of the communities around the lake. The mission was a great success and many dogs and cats were spayed, neutered, dewormed, vaccinated and treated for fleas and ticks. Surgery was performed in Santa Catarina and a nearby community, San Pedro. Below are photos taken from this mission. Dr. Baird hopes to have the opportunity to join World Vets for projects in the future as well. http://www.worldvets.org/ If you are interested in learning more about World Vetsor to donate or volunteer for a mission, please see their website at  http://www.worldvets.org . Videos –  These videos were filmed and produced by one the participants, Dr. James Ransom, a volunteer veterinarian from San Diego. The first is a teaser with a collection of shots followed by three separate videos of our time in Guatemala.

Leptospirosis is a bacterial infection resulting from contact with infected wildlife, urine from infected dogs or contaminated water or food. Twenty and thirty years ago, this was primarily a rural disease and often associated with cattle. Unfortunately, the two strains (or serovars) that used to cause most of the Leptospirosis in pet dogs have been surpassed by two additional strains which are now causing the majority of disease in dogs. Furthermore, these two new strains (serovars) seem to be flourishing in suburban and urban environments and are increasing in prevalence nationwide. Pinellas, Pasco & Hillsborough counties have joined the ranks of Florida counties with confirmed cases of Leptospirosis in pet dogs. A vaccine to help protect against these four pathogenic strains is finally available from a reputable vaccine manufacturer (Pfizer). Two additional strains or serovars are currently being studied to determine if they are also contributing to the recent increases in cases of Leptospirosis in pet dogs. Most dogs in populated areas become infected from drinking contaminated water or coming in contact with contaminated urine. This water (puddles, ponds, outdoor water bowls, creeks) may become contaminated by infected carriers such as raccoons, opossums, citrus rats and other rodents. The Leptospira bacteria can live in the water for months. Leptospira bacteria infect the kidneys and liver, causing fever, anorexia, depression and generalized pain initially. Diagnosis is complicated by the fact that the early signs of Leptospirosis are vague and nonspecific. Most animals will progress to acute kidney failure and mortality rates in untreated, unvaccinated dogs may vary from 10% to 75%, depending on the serovar involved. Vaccination will not only help prevent the disease, but will also reduce the symptoms and prevent shedding of the bacteria should a breakthrough occur. Two vaccinations are given 3 weeks apart and then followed by an annual booster. Leptospirosis is also contagious to humans (although uncommon) and this further adds to our concern with this reemerging disease. It is also a potentially life threatening disease in humans, again primarily by causing kidney damage. The mortality rate in humans with the kidney and liver form is about 10%. There currently is no vaccination for humans. Given the current increase in prevalence of the emerging strains of Leptospira bacteria, we are recommending this vaccine for all our canine patients over the age of 10-11 weeks.

This Spay & Neuter project was on San Andres Island, Columbia in 2012. This was another World Vets project to provide medical and surgical care to dogs & cats whose owners have limited access to veterinary care. All services provided by World Vets are free to the community. To learn more about World Vets and the work that they do, just click on their name above.

UPDATED: JUNE 5, 2017 Canine Influenza update: There have been over 12 cases of canine influenza diagnosed as the H3N2 strain by the University of Florida. All the diagnosed pets attended dog shows in Perry, Georgia on May 19-21 and/or Deland, Florida the following weekend or were in contact with dogs that attended those two dog shows. To date, this has not spread beyond this population of show dogs. While vaccinations are now available for this strain, it does require a series of two vaccinations 2 to 4 weeks apart and the vaccinated dogs are unlikely to have a protective level of immunity for at least 4-6 weeks. Given the limited population affected thus far and the delay in acquiring protective immunity from vaccination, we are not yet recommending vaccination for our normal non-showing pet population. Show dog owners are being advised to keep their pets at home for at least four weeks to decrease the risk of spreading the virus. Asymptomatic dogs can still be contagious if they have been exposed. We will update this information here and on Facebook should the situation change appreciably. -Dr Baird Please see this link for information from the University of Florida with more information. What you need to know…… The canine influenza virus first appeared in 2004 & 2005 in several Florida racing greyhound track facilities. Research since this suggests this virus mutated from the equine influenza virus. Influenza antibodies, however, have been found in samples from the 1990’s, suggesting a milder form likely predates this one. There is no evidence to suggest this virus can be transmitted to humans. In the years since it first appeared, the feared deadly epidemic never occurred. We did have a scare in Chicago and in Atlanta in 2015 with many cases of influenza, which thankfully was far milder and had less impact than the original strain that was so dangerous at the dog tracks in the previous decade. Interestingly, these 2015 outbreaks were of a different strain, H3N2, so likely more mutation has occurred, or it is a completely different origin, perhaps Asia. To the best of our knowledge, the Canine Influenza Vaccine originally developed for the H3N8 strain, is not effective in preventing this new strain, H3N2. Crowded housing facilitates the spread of the virus from dog to dog, as is typical of most contagious respiratory diseases, so the best prevention is to reduce exposure to other dogs during an outbreak such as occurred in Chicago. Of those dogs exposed to the virus, it is estimated 20-50% will show no visible evidence of disease. Evidence suggests that perhaps 50% of infected dogs develop antibodies without ever showing any clinical disease at all. The remainder will have symptoms typical of infectious respiratory disease including cough, fever, decreased appetite and lethargy. Approximately 1% of infected dogs will develop serious complications as a result of canine influenza, most typically secondary bacterial pneumonia. These patients do require intensive treatment, preferably early in the course of the disease. In 2009, a Canine Influenza vaccine was released. The vaccine carries a conditional license by the FDA, indicating that efficacy has not yet been proven although safety studies have been performed in over 700 dogs. The vaccine is intended as an aid in the control of disease associated with Canine Influenza virus infection. Although the vaccine is not expected to prevent infection altogether, efficacy trials have shown that the vaccination may significantly reduce the severity and duration of clinical illness, including the incidence and severity of damage to the lungs. In addition, the vaccine reduces the amount of virus shed and shortens the shedding interval; therefore, vaccinated dogs that become infected develop less severe illness and are less likely to spread the virus to other dogs. Locally, there have been no reports from our specialty hospitals of any Canine Influenza cases in Hillsborough, Pinellas or Pasco counties. Given the frequency with which pets travel, this certainly could change in the future. At this time, we heartily recommend vaccination only for dogs traveling to areas with known risk of Canine Influenza, particularly if this travel will include exposure at dog shows, boarding or grooming facilities. Since the influenza virus is only causing problems in certain regions within certain states, it is advisable to check with veterinarians in that specific area prior to travel to determine if there is a known risk locally. The initial dose of vaccine requires a booster 2 to 4 weeks after the first dose is given, and the second dose should be given at least 7 days prior to the dog entering the at-risk situation (boarding kennel, dog show, etc.) , so the vaccine series should be started at least 4 weeks prior to travel. Links for Canine Influenza …. www.veterinarypartner.com/Content.plxwww.cdc.gov/flu/canine/http://www.veterinarypartner.com/Content.plx?P=A&A=3610https://veterinarypracticenews.com/?s=canine+influenza

From The American Veterinary Medical Association Updated June 11, 2020 SUMMARY AND CURRENT RECOMMENDATIONS Despite the number of global cases of COVID-19 surpassing the 7 million mark as of June 8, 2020, we are aware of only a handful of pets and captive or farmed wild animals globally that have tested positive for SARS-CoV-2. In all cases, the source of the infection for pets was presumed to be one or more persons with confirmed or suspected COVID-19. At this point in time, there is also no evidence that domestic animals, including pets and livestock, play a significant role in spreading SARS-CoV-2 to people. Therefore, the AVMA maintains its current recommendations regarding SARS-CoV-2 and animals. These recommendations, which are supported by guidance from the  US Centers for Disease Control and Prevention (CDC)  and  World Organization for Animal Health (OIE) , are that: Animal owners without symptoms of COVID-19 should continue to practice good hygiene during interactions with animals. This includes washing hands before and after such interactions and when handling animal food, waste, or supplies. Do not let pets interact with people or other animals outside the household. Keep cats indoors, when possible, to prevent them from interacting with other animals or people. Walk dogs on a leash, maintaining at least 6 feet from other people and animals. Avoid dog parks or public places where a large number of people and dogs gather. Until more is known about the virus, those ill with COVID-19 should restrict contact with pets and other animals, just as you would restrict your contact with other people. Have another member of your household or business take care of feeding and otherwise caring for any animals, including pets.  If you have a service animal or you must care for your animals, including pets, then wear a cloth face covering; don’t share food, kiss, or hug them, and wash your hands before and after any contact with them. At this point in time, there is no evidence to suggest that domestic animals, including pets and livestock, that may be incidentally infected by humans play a substantive role in the spread of COVID-19. Routine testing of animals for SARS-CoV-2 is NOT recommended. Veterinarians are strongly encouraged to rule out other, more common causes of illness in animals before considering  testing for SARS-CoV-2. Human outbreaks are driven by person-to-person transmission and, based on the limited information available to date, the risk of animals spreading COVID-19 to people is considered to be low. Accordingly, we see no reason to remove pets from homes even if COVID-19 has been identified in members of the household, unless there is risk that the pet itself is not able to be cared for appropriately. During this pandemic emergency, animals and people each need the support of the other and veterinarians are there to support the good health of both.

Canine infectious respiratory disease has always been somewhat complicated but has suddenly become significantly more complex as we see apparent “outbreaks” of respiratory infection that seem much more severe than our usual pattern. CIRD, as we recognize it, can result from multiple organisms, and occasionally more than one is present during any particular episode of illness. The list at the end of this article shows all of the known organisms that have been associated with CIRD but the ones that we see most commonly when we test with PCR are Mycoplasma cynos, Bordetella bronchiseptica, and Canine Influenza (two strains). To add further confusion, some common infectious organisms can often be detected in perfectly healthy dogs, and this has been verified in multiple studies of well animals in various locations. These infectious agents remain active and many dogs who present with typical upper respiratory symptoms will be suffering from one or more of these pathogens. In a normal, healthy dog, the majority will recover relatively easily and often with no involved treatment. CIRD, previously known as “kennel cough complex,” typically affects dogs of all ages and typically presents with a dry, hacking cough. However, despite this nasty-sounding cough, the pet remains active and alert and often continues to eat fairly normally. The cough may worsen with activities like barking, exercising, or being excited. Some of these dogs may require treatment for the cough or coinfections. It is advisable to isolate them, as they will likely be contagious for a few weeks depending on the specific organism(s). It is important to note that a small percentage of dogs may become seriously ill, especially those who are very young, old or have a weak immune system. What we are seeing since midsummer in Oregon is a vastly different patient profile. There are 3 common presentations: typical symptoms of upper respiratory infection with a prominent cough, but the cough does not resolve and becomes chronic (weeks to a few months) with little or no response to antibiotics upper respiratory symptoms that progress to bronchitis or bronchopneumonia which, while not life-threatening, remain chronic and poorly responsive to antibiotics and may persist for weeks to a few months an acute syndrome in which the hallmark is rapidly progressive pneumonia that is also poorly responsive to antibiotics. In the acute syndrome, the patients can become desperately ill in just 24 to 36 hours after the initial cough. Clearly, the dogs that are presenting in these 3 categories are very different from what we are accustomed to in our patients with CIRD.  There are scattered reports of similar respiratory outbreaks prior to Oregon, possibly as long as a year ago, and a few different geographic locations have been reported. Multiple laboratories are at work trying to isolate the organism or organisms that may be the cause of this new outbreak. Early information from the New Hampshire veterinary diagnostic lab suggests this may be a very tiny bacterium that does not culture readily and is being identified via DNA sequencing. It has not been isolated sufficiently even to permit characterization of the bacterium. As expected with any newly recognized organism, there is no test to determine its presence nor a clear treatment protocol that is consistently successful. Some dogs that have been quite sick over the last 3 to 6 months have tested positive for more traditional agents such as Canine Influenza virus, and Mycoplasma cynos. As noted earlier, dogs can be completely asymptomatic and healthy and still carry some of these respiratory organisms, which will trigger a positive PCR test. Multiple studies have determined that normal healthy dogs are often colonized with one or more of these infectious species that are known to cause respiratory disease in susceptible pets. Given how early we are in this process, accurate testing will not become available in the near future and immunizations to protect our pets from this organism will take even longer. Since respiratory organisms often work in concert, it is imperative that we prevent infection with our known respiratory agents as much as possible. Influenza vaccines for dogs, like humans, are designed to reduce the severity of the disease but will not necessarily prevent infection 100%. We do know that the presence of canine parainfluenza virus can significantly increase the severity of infection with other agents as it causes damage to the lung tissue directly. We can, and should, vaccinate our susceptible population to try to reduce the risk of Bordetella bronchiseptica, canine parainfluenza virus, and canine influenza viruses. Combined with the new infectious agent, any of these would undoubtedly worsen the outcome. The veterinary labs that are attempting to research this organism are requesting that samples be provided directly from the veterinary hospitals prior to the initiation of any medications as they may reduce the ability to culture this suspected bacterium. Given that some dogs are becoming severely ill very quickly, it is also recommended to have these animals examined very early in an attempt to intervene before the pneumonia becomes severe. PCR testing is still recommended as many dogs that are presenting with canine cough and respiratory symptoms actually still have one of the better-known organisms that cause respiratory disease. PCR testing is most accurate early in the disease. Delays can cause false negative results. Co-infection will still be a concern if the PCR is positive and the dog is severely ill or presenting with one of the three syndromes associated with this new infection. Canine respiratory outbreaks tend to wax and wane and pop up in different locations from time to time. There are often isolated but significant outbreaks of respiratory disease in relatively small geographic areas that then move to another area, causing a different outbreak. This has been happening for years but without the severity of the outcomes seen in this current small population, who are affected much more gravely than expected historically. In summary, if indeed there is a new organism causing these outbreaks, isolation of this new organism may prove difficult, and the ability to test for it specifically is probably long in the future. Dogs presenting with respiratory symptoms should be examined and treated as early as possible during the disease. PCR testing done early can still be informative and should be performed. Since co-infection may worsen the prognosis, it is recommended to ensure all dogs are current on their Canine Parainfluenza, Bordetella bronchiseptica, and canine influenza immunizations. The assumption is this organism is probably airborne but may also be carried from dog to dog by fomites which includes potentially grooming tools, leashes, collars, and probably direct human contact. When possible, avoid areas where unfamiliar dogs tend to congregate, such as dog shows, canine sporting events, dog parks, doggie daycare, boarding and grooming facilities. These are areas where you are most likely to encounter dogs of unknown health and immunization status. Dogs you know personally, their health, immunization status and recent travel or exposures, are often relatively low risk by comparison. Watch the local news for any indication that the infection has reached your local area. While it may not always be practical to isolate your pet from all other dogs, attempt to reduce direct contact with unfamiliar dogs and sanitize your own hands carefully after touching any other dogs.  If your pet is sick with a cough, please call your veterinary hospital before arriving and they will advise you on protocol to help prevent exposure to the other pets in the facility.  If your dog has been ill with respiratory symptoms, the current recommendation is a minimum of 3-4 weeks isolation from other dogs. It is likely that we will gain much more information in the coming months, but concrete answers may require patience if this truly is a new organism not previously isolated and described. The current list of known canine respiratory pathogens: Viral pathogens include  canine distemper  (CDV),  parainfluenza  (CPIV), adenovirus type 2 (CAV-2),  influenza  (CIV, two strains),  herpesvirus  (CHV-1), respiratory coronavirus (CRCoV), pantropic coronavirus, reovirus, and pneumovirus (CnPnV). Other emerging viral pathogens associated with CIRD are canine  bocavirus , hepacivirus, and picornavirus. Bacterial pathogens include  Bordetella bronchiseptica ,  Mycoplasma  spp., and  Streptococcus equi  subsp.  zooepidemicus .   For more information on this rapidly changing situation: https://www.avma.org/news/oregon-dealing-respiratory-illness-incidents-dogs https://www.today.com/health/mystery-dog-illness-2023-rcna125553 https://www.wormsandgermsblog.com/?s=respiratory+dogs https://colsa.unh.edu/new-hampshire-veterinary-diagnostic-laboratory/canine-respiratory-outbreak https://www.facebook.com/groups/338634178658223/media www.K9illness.trupanion.com