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Webinar: Curbing Disease as Intake Rises - Prevent, Fight and Win Today - 8/16/23

  • 1.  Webinar: Curbing Disease as Intake Rises - Prevent, Fight and Win Today - 8/16/23

    Posted 07-28-2023 11:22 AM

    How to Keep Infectious Disease at Bay at Your Shelter

    a dog and a cat are on their hind legs, there is a QR code to the recording and handouts on Maddie's University


    From animal care attendants to RVTs and beyond, everyone in the shelter has the power to have a big impact on animal health. Does it seem like animals keep getting sick no matter what you do, especially right now with intake numbers climbing in many shelters? Does URI have to be status quo for summer? Is parvo inevitable? Have you wondered what else you can do to get ahead of these vicious cycles? This webinar is for you!

    This 90-minute webinar was recorded on Wednesday, August 16, 2023.

    You can access the resources and handouts on Maddie's University via this link: https://tinyurl.com/CurbDiseaseHome 
    The recording will be available to watch starting Thursday 8/17/23 at the same link. 

    The on-demand has been approved for 1 hour of continuing education credit through The AAWA and NACA and in jurisdictions that recognize RACE approval by RACE.  After watching the on-demand video and taking the short quiz, you can receive your CE certificate at that same link.

    UC Davis Koret Shelter Medicine Program veterinarians Dr. Aziz and Dr. Stuntebeck will arm you with the information you need to squash the most concerning infectious diseases in your shelter. Whether you're providing daily care for animals or reviewing care and intake protocols, you'll learn practical steps to relieve the strain on animals and team members. Come prepared to UNLEARN unhelpful myths and walk away with tools and techniques that will lead to healthier animals, less stress for you, and make your job of serving the pets and people in your community easier.

    If you have any questions, you can post them on this discussion thread or at learniverse@sheltermedportal.com.

    About the speakers

    Chumkee Aziz, DVM, Outreach Veterinarian, UC Davis Koret Shelter Medicine Program

    portrait of Dr Aziz with little dog


    Dr. Aziz grew up in Houston, Texas within a strong Bangladeshi-American community. Pet ownership and veterinary medicine were uncommon concepts growing up within her culture and it wasn't until later in life that she was exposed to veterinary specialty medicine and eventually shelter medicine. Dr. Aziz found that shelter medicine encompassed everything she was interested in within veterinary medicine – supporting communities, championing the human-animal bond, upholding animal welfare and wellbeing, and supporting shelter colleagues and veterinary students. After completing her shelter medicine residency training with UC-Davis KSMP, Dr. Aziz worked with Austin Humane Society, the ASPCA and eventually rejoined the KSMP team in 2022 as an outreach veterinarian. Through her various positions, Dr. Aziz has been able to work with shelters across the country on mitigating infectious disease outbreaks, operating within their capacity for care, and implementing programs to keep pets with their families.

    Dr. Aziz volunteered with the Association of Shelter Veterinarians' (ASV) board from 2016-2022. Her time with ASV meant a lot to her because it gave her the chance to support colleagues in their efforts to care for animals and families across the country. Dr. Aziz also served on the authorship task force for the updating of AAHA's Canine Vaccine Guidelines and ASV's Guidelines for Standards of Care in Animal Shelters. Currently, Dr. Aziz supports shelter medicine's specialty college, ABVP; volunteers with her Houston-based Street Dog Coalition chapter; and serves on Texas VMA's shelter medicine committee, leading their student mentorship program.

    Becky Stuntebeck, DVM, Facility Design Veterinarian, UC Davis Koret Shelter Medicine Program

    portrait

    Becky joined the KSMP team as a Facility Design Veterinarian in April 2022. She obtained her DVM degree at the University of Wisconsin-Madison School of Veterinary Medicine in 2013. She completed a shelter medicine internship at Dane County Humane Society via the KSMP team in 2014 and a shelter medicine residency with the UW Shelter Medicine Program in 2018, achieving board certification through the American Board of Veterinary Practitioners that Fall.

    Becky has also worked as a shelter veterinarian at two private shelters in Wisconsin. In addition to facility design her interests include proactive population management and infectious disease prevention in shelters, as well as building relationships with folks across the sheltering field.

    Outside of work she enjoys petting kittens, getting outside, and reading. She lives in Wisconsin with her husband, daughter, 3 aging cats, and 1 rowdy puppy.

     


    #Conferences,WorkshopsandWebcasts
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    alison gibson
    Senior Media Specialist
    Maddie's Fund
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  • 2.  RE: Webinar: Curbing Disease as Intake Rises - Prevent, Fight and Win Today - 8/16/23

    Posted 08-16-2023 01:06 PM

    Hi, there! Thank you to everyone who joined us today! The recording will be available by Friday, 8/18. 

    I mentioned I would address questions around the new parvo monoclonal antibody treatment but I didn't get to it during the live chat, so I've written up some comments about it below from insights I've gathered from folks who've started using it:

    • Effectiveness: In an experimental challenge study, the treatment was given to exposed dogs early on and it was effective in shortening recovery time and decreasing severity of signs. Regardless, supportive care was still needed for affected dogs. I don't believe there is data on whether it can shorten viral shedding periods. 
      • In this experimental study, the treatment was given to dogs challenged with parvo at a time when the dogs were lethargic but not yet vomiting. The implication  here means that shelters would need to keep a close eye on catching signs of disease in animals as early as possible if they wanted to use this treatment and have it be maximally effective. Also, it could be helpful to give to dogs with known exposure to parvo who are not yet sick  (like in the case of an outbreak). 
    • Direct cost: Relatively high. It's $200 for 1mL vial. You have to purchase the vials in packs of 6 in a carton which is $1200. It's unknown what the mark-up might look like in private practice.
    • Dose: The dose is about 1mL for every 11lbs, so an 11lb dog needs 1mL, 22lb dog needs 2mL and so on. The cost of treating an 11lb would be $200 because you just need to give a single dose. 
      • Even though the cost is high, it MAY be worth it since it could significantly reduce days of care. 
    • Handling: The vials must be frozen and it's uncertain if a partially used vial can be refrigerated or frozen and used later; however, the shelf life seems to be 2 years.
    • Minimum age to treat: The treatment was tested in 8 week old puppies but was noted to be tolerated in 6 wk old pups.
    • It seems that some folks have started getting shipments of the product from Elanco, so hopefully we'll start getting updates about its usefulness. The treatment has  conditional licensing only currently. 



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    Chumkee Aziz, DVM, DABVP (Shelter Medicine Practice)
    Outreach Veterinarian
    UC Davis
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  • 3.  RE: Webinar: Curbing Disease as Intake Rises - Prevent, Fight and Win Today - 8/16/23

    Posted 08-17-2023 10:05 AM

    Webinar Question: Why can't we test puppies who are healthy with parvo SNAP?



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    MIRANDA WILL
    Koret Shelter Medicine Program- UC Davis
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  • 4.  RE: Webinar: Curbing Disease as Intake Rises - Prevent, Fight and Win Today - 8/16/23

    Posted 08-17-2023 11:08 AM

    This is a very important question! The reason we don't recommend testing puppies who appear healthy without known exposure to parvo is simply because the test is imperfect (as are all diagnostic tests).  The test is highly specific but far less sensitive. What this means is that it's very unlikely to be positive in a sample from an animal not infected with parvo, but less reliable to be positive in a sample from an animal that is truly infected. 

    Assuming the animal you're looking at appears healthy and does not have known exposure, interpreting the test becomes really tricky. If the test is positive, this could potentially be due to recent vaccination, or to a true infection. If the test is negative, this suggests the animal isn't shedding parvo but because of the lower sensitivity false negatives are more of a risk for this test. 

    So what we recommend is to focus on looking at and monitoring individual animals and their health over time, and using testing judiciously when indicated by clinical suspicion- is there  a reason to suspect this animal might be shedding parvo?

    You can find some additional info about diagnostic testing for parvo here: Parvovirus diagnostic testing

    And here's some info about daily health/behavior monitoring: Daily monitoring of health and behavior



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    BeckyStuntebeckUCD Koret Shelter Medicine ProgramVeterinarian
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  • 5.  RE: Webinar: Curbing Disease as Intake Rises - Prevent, Fight and Win Today - 8/16/23

    Posted 08-17-2023 10:07 AM

    Webinar Question: We currently only have single-sided housing; we'd like to get double-compartment housing, but what can we do in the interim with this limitation?



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    MIRANDA WILL
    Koret Shelter Medicine Program- UC Davis
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  • 6.  RE: Webinar: Curbing Disease as Intake Rises - Prevent, Fight and Win Today - 8/16/23

    Posted 08-17-2023 11:18 AM

    Great question. We're so glad to hear that you are exploring ways to provide double compartment housing at your shelter. It is a HUGE game changer! 

    Until that time, there are definitely ways you can make sure the housing you do have available is optimized. These recommendations apply to housing for both cats and dogs! 

    • Provide furnishings that allow an animal the choice to hide/conceal itself if desired
    • Put up partial visual barriers on the cage/kennel doors. Again, by making it a partial barrier we preserve choice (choice is important for alleviating stress and promoting coping!). You can hang solid panels on the outside or use fabric or special "curtailments"  to create these visual barriers. 
    • Maximize the distance between food/water, toileting area, and resting area. It may not be far, but space these areas out as much as possible!
    • Elevate food/water bowls off of the floor by mounting bowl holders on to the kennel doors. 
    • Provide elevated spaces so that animals can choose to hide beneath, or perch/rest above. This can be achieved with elevated cat beds, bunk beds for dogs, cardboard boxes, etc. These can be purchased/donated or you can diy them yourself!


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    BeckyStuntebeckUCD Koret Shelter Medicine ProgramVeterinarian
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  • 7.  RE: Webinar: Curbing Disease as Intake Rises - Prevent, Fight and Win Today - 8/16/23

    Posted 08-17-2023 10:08 AM

    Webinar Question - In regards to vaccination upon intake - What if the animal had vaccinations the day or two prior? Could that compromise their immunity? 



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    MIRANDA WILL
    Koret Shelter Medicine Program- UC Davis
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  • 8.  RE: Webinar: Curbing Disease as Intake Rises - Prevent, Fight and Win Today - 8/16/23

    Posted 08-17-2023 11:36 AM

    Webinar Question - In regards to vaccination upon intake - What if the animal had vaccinations the day or two prior? Could that compromise their immunity? 

    Immunologically speaking, receiving two vaccines for the same antigen less than 14 days apart could compromise the immune response and therefore effective vaccination.  I specifically say this for the same antigen because if different vaccines are given (e.g. parvo vaccine followed by rabies vaccine 2 days later) this is not a problem. 

    However, practically speaking, it's incredibly unlikely that an animal will present to your shelter for admission so soon after vaccination. Now, if an owned animal is being surrendered and the guardian updated the pet's vaccinations just before surrender (and have the medical records to show it) you probably don't need to revaccinate at intake- that can count as an intake vaccination!

    For those animals you don't have medical history for, I would err on the side of vaccinating ASAP upon admission. Here are the reasons why

    -- adult animals that have EVER been vaccinated for parvo and distemper after they reached 20 weeks of age may be immune to these pathogens more or less for life; giving them any number of repeat vaccines for these viruses whether every 2 weeks or every 2 days is unlikely to do anything- no good, but also no harm.  If an adult hasn't been vaccinated after reaching 20 weeks of age (or ever) , we want to get the vaccine protection on board ASAP as shelters are a high risk for disease exposure. 

    -- vaccines in puppies/kittens are complicated (see the handout we shared during the live webinar here). Because we cannot predict when any given pup will mount an immune response to a vaccination, we recommend vaccinating them as often as possible (every 2 weeks) to minimize the amount of time when they would be susceptible to vaccine preventable diseases. Vaccines given before a pup/kitten can respond are pointless (as in the adult animal example above).  But what are the odds that a puppy (or kitten) presenting to your shelter for admission was vaccinated less than 2 weeks ago, and that the vaccine was given at the time when the animal's immune was ready to respond to the vaccine?  Pretty low. The odds of disease exposure at your shelter are much higher, so in assessing the risks of either choice I would err on the side of vaccinating. 

    Hope this helps!



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    BeckyStuntebeckUCD Koret Shelter Medicine ProgramVeterinarian
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  • 9.  RE: Webinar: Curbing Disease as Intake Rises - Prevent, Fight and Win Today - 8/16/23

    Posted 08-17-2023 10:08 AM

    Webinar Question - Sorry if you already covered this, but how long can we assume dogs are shedding parvo after they are asymptomatic?



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    MIRANDA WILL
    Koret Shelter Medicine Program- UC Davis
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  • 10.  RE: Webinar: Curbing Disease as Intake Rises - Prevent, Fight and Win Today - 8/16/23

    Posted 08-17-2023 11:44 AM

    Webinar Question - how long can we assume dogs are shedding parvo after they are asymptomatic?

    In general, most dogs and cats infected with parvo virus will cease shedding virus in 10-14 days after infection (they may still appear ill at this time). However, rarely some animals have been documented to shed parvo for 6 months or more after infection. Some ways that you could limit the risk of a recovered dog or cat (recovered means no more diarrhea or other signs of illness related to parvo) posing a risk to the population include

    • Running a parvo fecal antigen test (e.g. IDEXX SNAP) after clinical signs have resolved. If the test is negative you can't be certain the animal is no longer shedding, but in contrast, if the test remains positive, it is a good indicator that the risk is probably low at this time.
    • Bathing recovered animals prior to moving them out of isolation. You do not need any special anti-viral shampoo (please NEVER apply disinfectant to a living animal!!) as the aim is to remove fecal contamination of the coat that could be harboring parvo virus previously shed. 
    • Handle the animals as if they could be a risk to new intakes or other juveniles. Remove gloves after handling and/or wash hands thoroughly, do not allow to have direct contact with potentially susceptible animals, etc. 
    • Get them out of the shelter ASAP via shelter or adoption!



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    BeckyStuntebeckUCD Koret Shelter Medicine ProgramVeterinarian
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  • 11.  RE: Webinar: Curbing Disease as Intake Rises - Prevent, Fight and Win Today - 8/16/23

    Posted 08-17-2023 10:09 AM

    Webinar Question - Do you recommend the recombinant or modified live distemper vaccine?



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    MIRANDA WILL
    Koret Shelter Medicine Program- UC Davis
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  • 12.  RE: Webinar: Curbing Disease as Intake Rises - Prevent, Fight and Win Today - 8/16/23

    Posted 08-17-2023 11:50 AM

    RE: Webinar Question - Do you recommend the recombinant or modified live distemper vaccine?

    Thank you for asking this question. In general, the modified live virus (MLV) distemper vaccine is recommended in shelters because it seems to have a faster onset of protection compared to the recombinant distemper vaccine. We've also worked with shelters that switched from an MLV to recombinant distemper vaccine and starting experiencing distemper outbreaks. 
    One side note - some manufacturers' DAPP vaccines have recombinant distemper but MLV parvovirus in them, so double check what type of vaccine your shelter is using. If possible, consider switching to a vaccine that contains both MLV distemper and MLV parvo. 



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    Chumkee Aziz, DVM, DABVP (Shelter Medicine Practice)
    Outreach Veterinarian
    UC Davis
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  • 13.  RE: Webinar: Curbing Disease as Intake Rises - Prevent, Fight and Win Today - 8/16/23

    This message was posted by a user wishing to remain anonymous
    Posted 08-17-2023 11:29 AM
    This message was posted by a user wishing to remain anonymous

    Webinar question-- I heard about a new distemper-parvo vaccine from Nobivac that is better for parvo; is that accurate?




  • 14.  RE: Webinar: Curbing Disease as Intake Rises - Prevent, Fight and Win Today - 8/16/23

    Posted 08-17-2023 12:54 PM

    RE:  I heard about a new distemper-parvo vaccine from Nobivac that is better for parvo; is that accurate?

    Thanks for submitting this question. There is a newer vaccine from Merck Nobivac called the DP Plus (here is info about it from the UK where it was first launched: https://www.msd-animal-health.ie/nobivac-dp-plus-vet/ ). There are claims that this vaccine can overcome parvo maternal antibodies faster than other vaccines can, so in theory this vaccine can become effective and protective in very young animals.  We don't have published independent studies on this yet, so we can't make any strong recommendations either way. One other note is that this vaccine is more costly than the typical DHPP vaccine (last time I checked it's about an extra $1/dog/vaccine). 



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    Chumkee Aziz, DVM, DABVP (Shelter Medicine Practice)
    Outreach Veterinarian
    UC Davis
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  • 15.  RE: Webinar: Curbing Disease as Intake Rises - Prevent, Fight and Win Today - 8/16/23

    Posted 08-17-2023 12:05 PM

    Webinar question -- Parvo Puppies - we have limited foster home available so what is the best course of action in the shelter?

    Apologies if we are misinterpreting, but we think you are asking what to do with sick pups who have parvo when you don't have the option to place them in foster care for treatment. 

    It is possible and at times may be preferable to keep an animal with parvo in the shelter for treatment. However, this decision should not be taken lightly, as you need to carefully weigh the risk of spread to other animals in the population if you keep the sick pet in the shelter. In particular if it appears that the sick pups (or kittens) were exposed to parvo after shelter admission (i.e. they came in healthy/uninfected and  were exposed in the shelter) that may be where you want to focus your energy; until you prevent new cases from arising due to shelter exposure you aren't serving anyone very well.  Really ask yourself- does your team have the capacity, knowledge and skills prevent exposure from this pup to others in the population? Even if you successfully isolate this animal without spread to other animals, in doing so what will be lost in terms of capacity to care for the other animals already in and arriving to the shelter? 

    There are some ways that you can reduce the chances of spreading diseases between animals in your population.  Avoiding crowding and co-mingling of unrelated animals, vaccination at intake (and revaccinating juveniles every 2 weeks), providing double compartment housing, minimizing length of stay in care, and having good sanitation protocols are all key factors in minimizing disease transmission in the shelter. You can read more here

    PS Someone asked in the live webinar about what to do if a foster home becomes contaminated with parvo and I wanted to share this resource in case others were interested. 



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    BeckyStuntebeckUCD Koret Shelter Medicine ProgramVeterinarian
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  • 16.  RE: Webinar: Curbing Disease as Intake Rises - Prevent, Fight and Win Today - 8/16/23

    Posted 08-17-2023 12:29 PM

    Webinar question--  How to recognize Panleukopenia sooner? Making the decision to euthanize a panleuk kitten is difficult. Any words of advice?

    There are two main operational practices that will help to optimize recognizing a kitten (or puppy, though I'll only say kitten from here on out) may be ill from panleukopenia (feline parvovirus).  The first is having trained staff perform a brief intake exam soon after admission, generally when intake vaccinations are given. Staff do not need to be a veterinary technician or veterinarian- other staff can be trained to identify normal vs abnormal findings on an exam. From there there needs to be system for prompt reporting of concerns (panleukopenia suspicion or other) and initiating assessment by a tech or veterinarian.  Staff can be provided with a list of conditions that should be urgently addressed to help limit handling and contamination from a potentially infectious animals. 

    The second practice is performing daily health and behavior monitoring. Carestaff see and interact with animals regularly and are well positioned to notice when an animal's health or behavior changes. The same system used to report concerns at intake can be used to initiate assessment by a tech or veterinarian. 

    Recognize that you cannot effectively implement or maintain intake examinations and daily monitoring if your team is overstretched, so the other key aspect of recognizing sick animals sooner (kittens with panleuk or other cases) is to be continuously stiving to operate within your agencies capacity for care. Crowding, random co-mingling, poor housing, lack of behavioral care/enrichment are all risk factors for missing early signs of illness in sick animals. 

    With regard to the question about the difficulty deciding to euthanize a kitten with panleukopenia, I hear you. When euthanasia will or will not be appropriate for any given case is going to vary between seasons, between agencies, and many other factors. When I have been faced with this very difficult decision I tend to focus on two questions. 

    1) If I choose to continue treating this kitten,  what risks am I creating for other animals in the population? Can we effectively isolate this animal and prevent spread within the population? What will the team not be able to do if their time is taken up helping to care for this kitten, and how will that affect both the team and the other animals in the population?

    2) What is this kitten's quality of life (QOL)? If currently poor,  am I likely to be able to improve it (and improve it rapidly) with the treatment/housing/care options that are within my means?  If the kitten's QOL declines, what will I do? What changes am I looking for to decide euthanasia is definitely appropriate?  If QOL is currently poor and I am uncertain that treatment will be effective, if the kitten is  suffering, how do I justify not euthanizing? 

    Again, each of us who have been in positions to make euthanasia decisions has to develop our own ways to engage with those choices, but I hope that in sharing some of my thoughts it might provide some help to others. 



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    BeckyStuntebeckUCD Koret Shelter Medicine ProgramVeterinarian
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  • 17.  RE: Webinar: Curbing Disease as Intake Rises - Prevent, Fight and Win Today - 8/16/23

    Posted 08-17-2023 12:38 PM

    Webinar question-- How to deal with the risk of E. cuniculi in shelter rabbits while rehoming them? 

     Great and very tricky question. Here is some of what we currently know about E. cuniculi (it's not a ton!):

    E. cuniculi is more or less ubiquitous- many domesticated rabbits have positive titers, meaning they have been exposed to it-  and there's not much to do other once it's in a population other than manage individuals with clinical signs (neuro, kidney, ocular).

    Rabbits who are coming from large group situations may be more at risk of exposure, but unfortunately exposure does not equate with persistent infection, nor is it an indication of which rabbits will become ill from it.  If you have rabbits coming from a high-risk situation (large groups, poor husbandry, known exposure, etc) some ways that you can prevent ongoing transmission include:

    1. spay/prevent unwanted breeding (mothers can pass the infection on to their fetuses)

    2. Do not co-mingle rabbits who didn't come in together (the organism is transmitted by contact with urine)

    3. Good sanitation/biosecurity practices

    4.  There are diagnostic testing strategies that can be used to determine which rabbits may be infected with or exposed to E. cuniculi, and you should talk to your veterinarian if you want to consider this approach. However, these tests are imperfect, time-intensive, and expensive, and it may not ultimately make sense to pursue this routinely for rabbits at your shelter. 


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    BeckyStuntebeckUCD Koret Shelter Medicine ProgramVeterinarian
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  • 18.  RE: Webinar: Curbing Disease as Intake Rises - Prevent, Fight and Win Today - 8/16/23

    Posted 08-17-2023 12:52 PM

    Webinar question-- Canine pneumovirus. How long do you think the shedding period is for dogs, and when does shedding occur in the course of infection? Specifically, does shedding occur early  on in clinical disease, possibly even before a dog is symptomatic? 

    Canine pneumovirus has been a hot topic in the animal shelter world lately, with sporadic outbreaks being detected primarily in shelters in Florida and a few other places. That being said, this virus' bark is probably worse than it's bite most of the time. 

    Though it's a new virus to many of us, it's not a new virus to the dog world. It has been around for quite awhile!  It's not like COVID-19 or H3N2 Canine Influenza, which emerged recently, and caused problems precisely because there were so many naive hosts available to infect. (Naive in the sense that these viruses were never "seen" before by our immune systems; collectively, across populations, there was no herd immunity).

    Pneumovirus is just one of many of pathogens we tend to lump together under the umbrella "Kennel Cough" or "Canine Infectious Respiratory Disease Complex" (CIRDC). It generally causes mild (or in many cases no!!) clinical signs, and all of the normal operational practices we recommend in shelters to limit disease spread within the population will effectively limit pneumovirus. However, with regard to pneumovirus there appears to be something at play that's making it flare up as an outbreak in some shelter populations. Crowding, random co-mingling, poor housing, lack of ventilation, and lack of robust health and behavioral care are all factors that will promote spread of pneumovirus (or any infectious pathogen)  and more severe clinical signs in infected individuals. 

    UF is the hub of all things pneumovirus, and these handouts will provide you with more info about pneumovirus and other agents that cause canine kennel cough, including viral shedding timing and duration.

    https://sheltermedicine.vetmed.ufl.edu/files/2017/01/Canine-respiratory-infections-in-shelters.2018.pdf

    https://sheltermedicine.vetmed.ufl.edu/2021/03/17/giving-animal-shelters-a-break-from-pneumovirus/

    This blog post about canine pneumovirus from Scott Weese is also fantastic: 

    https://www.wormsandgermsblog.com/2022/03/articles/animals/dogs/canine-pneumovirus-in-an-animal-shelter/#:~:text=Dogs%20often%20develop%20antibodies%20to,risk%20of%20infection%20goes%20up



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    BeckyStuntebeckUCD Koret Shelter Medicine ProgramVeterinarian
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