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Wednesday, March 6, 2013

Rabies!!!

Post vaccination - Farley has shown no signs of being foot sore!!!!!!! A little stiff in the hind for her trimming 2 days post vaccination but that's it! I'm really hoping that I've found a protocol that works for keeping her comfortable working barefoot and allows me to protect her from infection with vaccination. So far tetanus toxiod + west nile (innovator) = no problem. The next test will be a rabies vaccine, and a EHV/EEE/WEE/rhino combo (which I'm not sure Ill be able to get without the toxoid). I liked vaccinating in the thigh - I felt like she was less sore for a shorter period of time.

You may have noticed a change on the blog - I have now enabled comment moderation. It was either that or turn on the funky word verification, or not allowing anonymous commenting, both of which I felt like would be substantial hinderance to people who read and comment on my blog. The amount of spam comments on my blog has risen astronomically in the last month for some reason, and not just on the older posts. The last straw for me was when spam started showing up on a post that I had just posted within 24 hours. I usually get to my moderated comments within a couple of hours of someone submitting, so please don't let it stop you from voicing your opinion! I will not be editing who I allow to comment and who I won't - everyone who isn't a russion porno spammer will be approved. :)

In a turn-your-stomach-perhaps-not-read-this-paragraph-if-you-are-especially-squeamish sort of way I have another proof that 2 years is a wonderful number in dog years. Today at school Tess had diarrhea all over her kennel. Last year when this occured I came back to a pitiful, disgusting puppy, who in addition to smearing diarrhea over all surfaces had also tried to clean up by eating it - and then vomiting it back up. And then continued to vomit for several more hours the most disgusting fluid imaginable. Today, the situation was much the same except.....NO VOMITING AND NO ATTEMPT AT ORAL CLEAN UP. Instead she was standing in her kennel, drooling (a sign of nausea) while waiting to be rescued (and rescue her I did!). I do believe she learned an important lesson a year ago. Diarrhea in the the crate sucks, but any attempt to clean it up will only result in further misery.

So at present, I have one urine incontinent dog (the german shepherd), a diarrhea dog (Tess), and all I'm missing is a bit of vomit. Which, considering how close I was to that this morning to losing it, I think I have that covered.

As a friend pointed out, I have 2 outside dogs right now. I confirmed, while pointing out that my 2 "outside dogs" can't actually be out together or the German will eat the Brittany. Which would add yet another animal problem that I do NOT NEED. So I'm missing yet another afternoon of school since Tess isn't stable enough to put back into her crate. GREAT!!!!!!

I'd rather have 4 footed furry problems than 4-hoofed problems if I'm being completely honest.......

The one lecture I did manage to make so far this week was on rabies.

Most of the time I would be excited to bring you such an exciting, interesting, zoonotic vetmed topic, but if you are looking for the details of the disease in this post, I'm sorry to dissapoint. I will point you towards youtube and the internet. The disease is just awful (second only to tetanus in my childhood fears) and it's impossible for me to write a post for you guys without really getting into the subject and I just can't. The pictures and videos I saw in lecture today was bad enough. Every picture of dog reminded me of Tess and in all the human pictures you were looking at dead people. They weren't clinically dead yet, but it was just a matter of time. Instead I wanted to share with you some epidemiolgical facts about the disease and some other miscellaneous pieces of information I picked up in lecture that I thought were interesting, or I had wrong. My apologies to my non-CA readers - most of the stats I have here are from CA - however you should be able to look up these sorts of things for your state/locality, and hopefully function as a starting point for questions if you want to do some further research.

  • Dogs shed the virus in their saliva a few days prior to developing clinical signs. This is why the 10 day incubation period (for animals with a current vaccination history) is used - if after 10 days the animal is healthy, than if it does have rabies it was not shedding virus in the saliva the 10 days prior when it bit. It isnt that the animal doesn't necessarily have the disease (the incubation is 7days to over 6 years with an average of 4-6 weeks), but that it didn't TRANSMIT the disease at the time of the bite. Surviving the incubation period is not synomonous with not having the disease, but it does mean that rabies wasn't transmitted in that dog bite 10 days earlier.
  • Rabies can look like anything, especially in the first "prodromal phase". One of the biggest ways that people are exposed to rabies is through cattle - the cow might look like it's choking or that there is an obstruction in the air way and so a person puts their hands in the cow's throat/mouth to look for a foreign object. Rabies can be "furious" or "paralytic". In some species one form is more common than the other. Cows are often paralytic (especially with the bat form). Horses tend to present with the more aggressive (furious form). Dogs can be either, but seem especially driven to bite and roam with the disease - thus making very good carriers and transmitters!!!! Cats hide and die. Human exposure occurs most commonly in cats when a good samaritan finds a sick cat hiding somewhere and tries to help it.
  • Not every species presents with the classic "hydrophobia" symptom. Humans do, dogs do not. Aerophobia occurs in dogs. Remember that rabies can look like ANYTHING! In cows it can look like ketosis, milk fever, listeriosis, botulism etc.
  • Recovery from rabies is very very very rare. That's why it makes the news. We are talking about known survivors in the single digits. 2 years ago we were on survivor number 8. For some reason survivors tend to me female and either children or teenagers.
  • Vectors in the US by prevalence shown in class are: skunk/raccoon, bat, dog/fox, other. However, in CA wildlifethe main reservoirs are the skunk and bat. Skunks used to be number 1, but have declined over the years to a very low level on par with the third major CA vector, the fox. The bat numbers have remained at an intermediate level and are currently number 1.
  • 92% of rabies cases in the US are wild animals.
  • Dogs used to exceed cats in number of rabies cases, but right now cats exceed dogs. Cats are less likely to be vaccinated and tend to be allowed more freedom. Total cases are declining (this bullet point refers to CA stats). Cats are the most common rabid domestic animal
  • Let's talk about vampire bats. Especially because I said that bats were a major vector in CA. I am NOT referring to vampire bats!!!!!! They only exist in Mexico and S. America.
  • Since 2002, 33 cases of human rabies in the US. 24 of those were acquired in the US. 21/24 cases were associated with bat strains. Since 2000, 8/36 national cases were reported in CA residents. Lucky California.....
  • There IS a possibility for transmission to occur with non-bite exposure. This is RARE!!!!.
  • In addition to the obvious "seek medical attention" if you are bit by something, wash with SOAP and water. SOAP not alcohol was specifically said in lecture.

 

Highlights of the CA Rabies Control program
  • Epidemiologic surveillance - passive. It's possible to sign up for alerts in your area. Karen provided a GREAT link that is a website devoted to horse and people relavant outbreaks of westnile, rabies etc. and I signed up for email alerts when new cases are found in my area. So far most of the cases are bats, with a cat or two thrown in.
  • K-9 mandatory immunization. Must be with a CA approved vaccine (killed vaccine) under the direct or indirect supervision of a DVM. Although not required, strongly recommend vaccination of cats, ferrets and livestock (I find it funny that even though ferrets are illegal here, at least from a disease control point of view, the government is realistic enough to know that they are here and conceding at least having them vaccinated so they don't contribute to a public health risk). In the rest of the US, vaccination laws differ - some require vaccination for dogs AND cats, others let local districts decide. CA is a 3 year booster state. Others are 1 year or 2 year booster states. I didn't know there was this much variation throughout the country on this. Note that wild animal species (including wolf hyprids) and other animal species not specifically listed above are NOT considered as vaccinated, even with a vaccination history and thus if they are exposed there is NO ISOLATION period and euthanasia is law (although there is an evaluation on case by case basis stipulation in there - probably if a zoo etc. gets exposed). Titers cannot substitute for vaccination - there is no excemptions for the mandaory canine rabies vaccine. That being said, apparently there is some legislation out there right now to try and put an exemption in. An interesting difference between CA and the rest of the US is that vaccination is given to dogs 4 months and older, while in the rest of the country it's 3 months and older.
  • Stray animal control
  • Human rabies prophylaxis
  • Animal quarrantines. If an animal bites, it undergoes a 10 day isolation period. If signs develop the animal is euthanized and tested. If healthy at end of 10 days, no rabis was transmitted at time of bite. If animal is exposed: 30 d. isolation (CA) or 45 d. isolation (rest of US) if vaccinated (and immediate revaccination). 6 month isolation if no current vaccination (and immediate vaccination). Immediate vaccination = within 48 hours. As mentioned before, there is no isolation period for non-dog/cat/ferret/livestock species regardless of vaccination history. I'm not sure if this applies to just the exposure isolation, or in case of a bite or both.
  • Commuity education.

 

Rabies IS relevant to horse owners. If a horse gets rabies, there tends to be lots of humans exposed as compared to a dog or cat case. I've never lived anywhere that I would be comfortable not vaccinating for rabies, but that's also because I've tended to live in rural areas of CA. My cats ARE vaccinated because when a rabies outbreak occurs and they start rounding up the cats in the area, I don't want my outdoor kitties to be included. The rabies vaccine is effective and assuming you can pay for the isolation in the event of exposure or bite, gives your animal a fighting chance if something happens. You as an owner gets very little say over the outcome if the vet determines that your animal most likely has rabies. I also never ever ever want one of my animals to be one of those in the pictures I saw. There is no hope. Zero. Zilch. I was traumatized enough by the thought of rabies (I believe my mother was one of those people who believed in using real life things to scare her children silly) that I'm SO GLAD I've never made an effort to research rabies in pictures and video before now (although I did read a medical history book on the subject a few months ago). For me one of the big differences about considering this disease and vaccination for it compared to the other lethal diseases that I could consider vaccination for is it's high zoonotic potential. Find out whether it's endemic in your area, and talk to your vet about whether it might be a good idea for your herd.

 

8 comments:

  1. My horse vet says that he has never seen rabies in his practice here in coastal California, nor has he heard of it in this area in the last few years. He says it was relatively common in the midwest, where he practiced previously, particularly in wild animals. I once saw what I am sure was a rabid raccoon, in Michigan. It was staggering about in a dazed way at dusk along a trail and showed no fear of people. We called the sheriffs, who shot it.

    My horses have all been vaccinated for rabies in the past, but they are older and I don't vaccinate them every year any more--with my vet's whole-hearted agreement. Older horses who have been vaccinated a lot are more prone to getting seriously ill after vaccinations. I think the risk of serious vaccination reactions is greater than the risk that their titer levels are not good enough. And again, my vet agrees.

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  2. Laura, did you see my vaccine post a few days back? I think we are on the same page mostly when it comes to vaccinating. Especially in the older horse. I definitely think rabies is one of those that is on a case by case basis with a convetsation with a vet. Definitely not equal risk everywhere in every management situation, which is true of all the vaccines, with the possible exception of tetanus. It's all risk benefit and definitely changes over time as the horse has a "stronger" vaccination history for a particular vaccine.

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  3. We vaccinate for rabies yearly; rabies IS present in the Cascades which are literally in my back yard (across the street is a foothill that rises 1100 feet in 1/4 mile from my house).

    We stay away from strange-acting critters and we vaccinate EVERYTHING!

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  4. I had this discussion again with my vet this year. Interestingly my vet (who also breeds sport horse Arabians) has had a line of his Arabs that are super rabies vaccine reactive. (I'm sure he has tried different things). He said he had to weigh what he recommends for clients with what to do himself for the health of his horses.

    These vaccine topics have been very interesting! Great also to see what other do and what works/doesn't work for them.

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    1. That's what has been interesting for me when I think about this subject - no longer am I going to be able to say "this is what I'm doing for me and my horses" because I think it's very important for me to be consistent between what I do and what I'm telling my clients to do. It's going to be tricky because unless you practice what is recommeded by the various organizations and "offical recommendations" you are potentially opening yourself up to lawsuits and the loss of liscencing. That being said, I don't think I've ever been burned by ultimately doing and recommending what I think is correct so that's how I'll practice medicine. But it's still food for thought and an interesting situation.

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    2. I think the most imporatant thing is to consider each client/patient as an individual and consider the risk/benefit in each situation rather than applying a blanket recommendation to all. It's more work to practice medicine that way and actually requires me to assess my client as much as the animal, but in the end I think it will be worth it.

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  5. This post is awesome btw. I remember thinking about rabies as a child. Mom really did a number on us with those stories. I was always fascinated thinking about crazed animals with frothing mouths running around trying to bite ppl and infect them. Somewhat less than accurate I know now lol

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  6. fascinating post, i'm also a product of rabies paranoia from my parents. surely i'd give a vaccine if i were still at home in the PNW. however in 2008 the world org for animal health declared germany rabies-free. i believe that means the risk is so low, vaccination is not necessary.

    there are little signs in our neighborhood that read "tollwut bezirk" (rabies area) but i've been told they're legacy signs. then i found wild-boar medication packets in my field because the rangers medicate the boars in a feeding station next to my pasture. but my vet said no worries, there is no risk to horses. however, my cat vet always gives me the guilt trip - you must vaccinate against rabies, even when i ask him if in his career he'd ever experienced a case. i don't understand why things would be different for a cat than a horse, if the main carriers here are fox and boar.

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