Updates on Current Respiratory Disease Concerns

I am monitoring a number of veterinary medical and news sources for any changes in information regarding the current respiratory disease that is in the news. On 11/30, I watched a webinar presented by two highly regarded infectious disease veterinary specialists. Here is a recap of that and what seems to be the current status of understanding regarding the recent round of respiratory problems.  These are individuals who experience a daily deluge of questions and are in the thick of the situation, so to speak, so have a good handle on the bigger picture with this round of Canine Infectious Respiratory Disease Complex (CIRDC).

1. Data: There are many, many questions about what is going on at this time. Meaningful data are essentially absent as there is not a useful, comprehensive database for disease tracking of conditions like this. One source of information is insurance claims data indicating how many claims have been submitted for certain conditions. People with dogs with respiratory illnesses are encouraged to have samples submitted so additional testing can be done to help answer the many questions around this condition.

2. Organism: There has been some interesting DNA sequencing from ill dogs showing organisms similar to mycobacterium, a well known genus of a number of bacterial diseases including pneumonia, and some sequencing that looks like a relatively new viral organism. But neither is definitively linked to current respiratory disease. Work is ongoing to identify possible causative organisms which will help a lot with devising effective treatment plans. 

3. Outcomes: There is a higher incidence of fatalities, but that could be due to more cases. More sick dogs naturally means more fatalities. Without good data, it is not clear if healthy dogs are succumbing or only high risk dogs. There are some anecdotal reports on the web and in the general news media of healthy dogs becoming seriously ill, but again not enough data to make meaningful connections. Cornell University confirms that this particular outbreak is associated with a longer course of illness and more severe outcomes for some dogs and does not respond to the usual treatment for other CIRDC illnesses. Many dogs do recover without problem, though it seems to take a bit longer in this current situation.  It is not known just what leads to different outcomes in different cases. Add this to the list of questions at present. 

4. Incidence: Claims data from Trupanion does show an increase in claims for respiratory conditions. Without a sound tracking system, claims data can be a somewhat useful indicator of cases. There are a lot of limitations to that, but there are limitations with all tracking systems due to reporting mechanisms. Claims are up as much as 70% in some areas. As of the end of October, Trupanion shows a 5.41% increase in the number of claims in Virginia.  Some of this may be due to higher awareness and more people seeking care for symptomatic dogs more quickly than they might have in the past. Another unknown. Regardless, 70% is a sizeable increase, so there is something going on. 

5. Vaccination status: This could be a factor. It is possible that people are more selective about vaccinations, perhaps foregoing some vaccinations altogether, or focusing only on the core vaccines. That would leave many dogs without Bordetella or parainfluenza vaccination, possibly opening a window for more infection and greater spread. This was one of many "hypotheses" presented by these specialists. Again, we don't know.

6. What to do: In spite of all the unknowns, they advised the standard caution for respiratory diseases, which are -- Keep vaccinations up to date, particularly Bordetella and parainfluenza. Influenza vaccine may be important as well depending on local data. That vaccine is not always available. Avoid contact with dogs of unknown health and vaccination status. Keep symptomatic dogs away from other dogs including in the same household. Good hygiene/sanitation around the house. They emphasized there is no need for panic, but also a need to be wise.  

More specific guidelines have been developed for dog-related businesses such as grooming shops, day care, and boarding facilities, etc. So while the "don't panic" message is clear from many sources, there is good reason to be diligent and cautious. 

I will continue to monitor credible sources of information and will update this blog entry when there is new information to share. Feel free to bookmark this page and check periodically for updates.

It's Always Respiratory Disease Season

Those of us on the human end of the leash are well aware of the variety of contagious respiratory viruses that seem to be ready to pounce on us as we innocently go about our daily lives. Unfortunately, our dogs are subject to their own array of respiratory illnesses. While many respiratory conditions might be considered seasonal or isolated to specific circumstances, it is now wise to be on the lookout and in protective mode throughout the year. Recent outbreaks of canine influenza across the United States serve as a good reminder of the need to raise our caution levels a bit more.  

Most dog owners are familiar with “kennel cough.” There are a number of different organisms that can cause a cough and respiratory condition including an array of bacteria and viruses. Because of the complexity of these infections this condition sometimes is referred to as Canine Infectious Respiratory Disease Complex (CIRDC).  One of the more common causative agents is Bordetella bronchiseptica and there is a specific vaccine available for that particular organism. Because other organisms can be responsible, the Bordetella vaccine does not offer complete protection, although it does offer a considerable decrease in the likelihood of infection with this agent. Other vaccinations are available for additional protection, particularly parainfluenza and adenovirus.  Distemper also has a respiratory component and is one of the recommended core vaccines but is significantly distinct from what we usually think of as “kennel cough.” 

In the last year or so, outbreaks of canine influenza have led to serious illnesses and the closure of a number of shelters and other facilities for dogs in order to control the spread of this dangerous disease.  Several of these have been in the mid-Atlantic area including D.C., Virginia, and North Carolina. Canine influenza is viral in origin with two specific subtypes of the Canine Influenza virus being responsible for outbreaks in the US so far.  Canine influenza gained considerable attention in 2004 when a number of racing greyhounds were affected. The causative agent for that outbreak was identified as Canine H3N8 influenza virus which is thought to have originated in horses. In 2015 another subtype (H3N2) was found in association with some severe cases during an outbreak in Chicago.  The H3N2 strain also has been found in cats who were presumed to have been infected by transmission from dogs. 

Illnesses associated with CIRDC are highly contagious. Similar to how respiratory disease spread among humans, dogs can spread infection before there are obvious signs of illness. This makes it much more difficult to control and, for us trying to keep our dogs safe, also to avoid exposure. In most cases an infected dog will show signs of illness, particularly an obvious cough. In addition to the cough, other signs that are easy to observe in other animals are noisy or labored breathing and nasal or eye discharge. Infection is spread through the close contact including sharing toys or water bowls, close play, or any close contact that enables a dog to inhale or ingest droplets from the cough or sneeze or saliva of an infected dog. A dog who is showing any signs of respiratory disease should be kept apart from other dogs. For the most part, we humans are safe from these particular pathogens. Only one of the causative organisms, Bordetella, is known to spread to humans but that is very rare and more of a concern for people with compromised immune status.

A hallmark sign of CIRDC is the sudden onset of coughing. It is common for the cough to have a loud honking sound, although this is not essential for diagnosis. Nasal and eye discharge may be present as well. The cough and other symptoms tend to appear suddenly, often within 2-3 days of exposure. Kennel cough can be self-limiting provided the lungs are not involved; similar to our cold viruses, the dog might recover on its own within about 10 days or so.  Canine influenza has the potential to be more serious with dogs in poor health otherwise or those very young or very senior being at greater risk. Since the owner cannot tell what organism has infected the dog or if the lungs are involved, it is best to have a veterinary examination to determine an appropriate plan for each dog.  The veterinarian will be interested not only in the examination of the dog but the dog's recent activities which gives a clue to possible exposure.

Any upper respiratory condition (the pathway that carries air prior to reaching the actual lungs) can progress to a more severe state if the lungs become involved (pneumonia). As with most illnesses, this is a greater risk for debilitated animals. The dog may seem distressed and uncomfortable from coughing and some symptomatic relief can ease the process for the dog and concerned owner as well.  Typically a cough suppressant is prescribed which can help the dog be more comfortable. Occasionally antibiotics are prescribed if there is suspected or bacterial infection or concern or developing a secondary infection beyond the initial cause. Antibiotics are not effective against viruses and should be used judiciously. In addition to these measures, supportive care can help the dog be more comfortable and make good progress through the disease. Supportive care includes ensuring adequate rest and maintaining good nutrition and drinking plenty of water.

CIRDC, including kennel cough and influenza, are ongoing concerns for our dogs. The dedicated caretaker or pet parent should be aware of the widespread nature of these diseases and the potential for outbreaks and take steps to protect dogs from becoming ill.  An important starting point is to ensure the dog is up to date with core vaccines (or titers) which offer some protection against several of the causative agents. Discuss with your veterinarian your dog’s lifestyle, including potential for exposure and risks associated with respiratory illness, to determine if any additional vaccinations are appropriate.  Stay alert to any news about outbreaks in your area or locations where you may travel with your dog. Minimize exposure to other dogs during times of high disease activity. This is especially relevant for dogs of unknown history such as at a public dog park. It may be safer for your dog to visit a dog play group or day care where someone supervising the dogs is likely to notice a cough or other signs of illness. Check what vaccinations are required for a dog to attend that facility. Consider your own dog’s health and risk profile to determine best ways for exercise and socialization. Of course, a healthy dog is better able to recover from any illness, so good nutrition, weight management, and exercise are beneficial for any dog.  If your dog does develop a cough, contact your veterinarian for an appointment. Be sure to tell the office personnel that your dog is coughing.  They will have specific directions for how you can bring your dog for examination while minimizing exposing other animals to a respiratory illness. Keeping your dog fit and healthy and taking just a few precautions can help you and your dog enjoy activities without interruption from a respiratory infection.