PHC 1 - Canine cough complex

Question 1

What is the canine cough complex?
What is it also known as?

Answer 1

Common, acute, highly contagious cause of upper respiratory (eyes, nasal, mouth/naso pharyngeal) tract signs in dogs.

Also known as: Infectious tracheobronchitis, kennel cough, canine cough

Question 2

Why is the canine cough a complex?

Answer 2

Referred to as a complex because it is a multi-agent infection

Question 3

Which dogs does it mostly occur in?

Answer 3

• Can occur in all ages of dogs, puppies are prone to more severe clinical disease.
  
  • No real breed predilection although brachycephalic breeds may be more susceptible to clinical disease (due to conformation of nasal/naso-pharyngeal passages).

Question 4

How is it transmitted?

Answer 4

Transmitted via “social” (nose to nose, mouth to mouth contact). Sneezing, coughing, barking - via direct contact and via aerosolised droplets.

Question 5

What are the agents of CIRDC?

Answer 5

• Bordetella bronchiseptica
  
  • Canine parainfluenza virus (CPIV)
  • Canine adenovirus 2 (CAD-2)
  • Canine Influenza virus (CIV), H3N2, H3N8
  • Canine herpesvirus
  • Mycoplasma spp.
  • Streptococcus spp.
    These are opportunists making things worse

Question 6

What are the clinical signs of B. Bronchiseptica, CPIV, CAD-2

Answer 6

Acute onset, non productive hacking cough
Something stuck in throat

- Not a 'goose honk' sound cough - dynamic airway disease However this is possible with narrowing of trachea 

- Often inducible cough, or a spontaneous cough 
- Worse with exercise and activity 

Nasal or ocular discharge

Submandibular lymphadenopathy

Mild pyrexia

Question 7

How does mild vs severe cases differ?

Answer 7

Mild - moderate lethargy
Mild - moderate decrease in appetite
Severe cases - progress to pneumonia –> harsh lung sounds, pyrexia, dyspnea, cyanosis

Question 8

What are the clinical signs of CIV: H3N2, H3N8

Answer 8

• Subclinical form: Minimal/absent clinical signs
  
  • Mild upper respiratory tract form: Pyrexia, cough, nasal discharge, sneezing, anorexia, lethargy
  • Severe form: Mild (above) + life threatening pneumonia possibly leading to death

Question 9

What is the difference of clinical signs between B. Bronchiseptica, CPIV, CAD-2 VS CIV: H3N2, H3N8

Answer 9

May be clinically distinguishable or clinical suspicion increases when - cough persisting for up to 21 days, pyrexia, mucopurulent nasal discharge, lethargy, inappetence

Question 10

What are the risk factors for CIRDC?

Answer 10

• Boarding facilities, doggy daycares, grooming facilities, dog parks, dog shows, dog sporting events, behaviour and training classes, puppy classes, breeding facilities, pet stores
  
  • Taking a sick dog to the park
  • Taking a dog diagnosed with CIRDC to socialize with other dogs
  • Drinking from communal water bowls at parks, cafes, restaurants
  • Fomites transmission for CIV possible, E.g., humans who contact infected dogs –> on hands and clothes (also caution for other CIRDC pathogens)
  • Stress from other disease processes… places individual dog at higher risk
  • Socialising a group of unvaccinated dogs.

Question 11

What are the incubation times and shedding intervals?

Answer 11

• B. Bronchiseptica, CPIV, and CAV-2: pathogens can be shed before dogs show clinical signs. Once with clinical signs shedding typically lasts 7-10 days, therefore typically contagious for 7-10 days.
  
  • CIV: Incubation time is 1-5 days after exposure.. Peak shedding occurs 2-4 days after infection and often BEFORE clinical signs are obvious. Clinical signs can last 2-4 weeks, dogs are typically considered contagious for up to 4 weeks.

Question 12

What is the treatment for B. Bronchiseptica + CPIV +CD-2

Answer 12

• In uncomplicated cases: cough will typically be self-limiting in 7-10 days
  
  • Cough control/ suppression/ symptomatic relief: anti-tussive treatment when needed (butorphanol). Contraindicated if cough is productive in nature.
  • Swap out collar/lead for a harness instead: decreased pressure around the trachea.
  • Ensure eating and hydrated, offer soft foods.
  • Antibiotic treatment is generally NOT required unless you suspect pneumonia, lower respiratory tract infection, severe secondary bacterial infection.
  • Consider antibiotics if fever, lethargy, inappetence is present with mucopurulent discharge

Question 13

How to prevent disease spread?

Answer 13

Keep infected/symptomatic dog away from other dogs, limit dogs activity if possible –> which will reduce the trigger for coughing.
- At home treatment is enough
- Clean down surfaces in exam room, mop floors, clean any exposed walls with Viraclean, allow room to airdry completely/don’t use that room to next patients.
Wash hands, change scrub top, wipe down your stethoscope, wipe down your shoes if possible

Question 14

How do you treat CIV - H3N2, H3N8

Answer 14

• In mild, uncomplicated forms: supportive care as previous slide
  
  • Cough should be self limiting and uncomplicated/otherwise well dogs but can last for 2-4 weeks.
  • Nebulisation can help: Helps moisten and warm passages/airways to allow dislodgement of mucopurulent discharge
  • Game changer when severe form involving lower respiratory tract clinical signs
    Hospitalization, oxygen therapy, IV fluids, radiographs, treat and secondary bacterial disease, isolate from other dogs while in hospital.

Question 15

What advise would you give a client about CIRDC?

Answer 15

• Keep dog home if sick - especially if diagnosed with CIRDC
  
  • Keep yourself and your dog away from any sick looking dogs
  • Your dog can still develop symptoms of ‘kennel cough’ even if vaccinated but symptoms will be less than if not vaccinated
  • Even if your dog is vaccinated, and has mild symptoms, keep your dog at home
  • Yearly vaccination after dog has had previous coughing symptoms
    Do let boarders/kennels know if your dog comes home with a cough