(photo credit: http://www.laceyinthecity.com)
Many dog owners recognize distemper as a common vaccine we administer to dogs. The reality is that distemper is most commonly administered as one part of the 4 in one core vaccine (some vets do a 5 in one or even a 6 in one, which I do not agree with – something I will clarify in a later post), known as the DHPP. Since Distemper is represented as the “D,” the first letter in the DHPP vaccine, we commonly just call the DHPP vaccine, distemper.
This is a case in point of my previous assertion in the first post of my preventative health care series that we have failed in our profession in the communication of the details and importance of preventative health care. Many pet owners do not even know what distemper is; only that it is a bad canine disease that we vaccinate for. On one humorous occasion a few years ago, we had a client call asking if we had given his dog the “distemperament” vaccine, as it does not seem to be working, because his dog was acting very ornery in spite of the vaccine. We all got a good laugh at the fact that this gentleman had the impression that the distemper vaccine was prevention for bad temperament instead of prevention against a deadly disease. Instead of laughing, however, we should have realized back then as we are now, that the fact that that man did not understand what the distemper vaccine was our fault, not his…and it really was not funny.
Canine distemper is caused by a virus that’s closest relative in human infectious disease is measles. What makes distemper unique, is that rather than get efficiently cleared by the canine host’s immune system, it actually uses the immune system to effectively spread throughout the body. Under normal circumstances, large white blood cells called macrophages engulf viral or bacterial invaders and enzymatically destroy them. In the case of distemper virus, the virus is coated in a fatty envelope that protects it from the enzymatic destruction, instead using the macrophage as an effective transportation vehicle to infect the rest of the body.
Distemper is highly contagious to other dogs through what is called the fecal/oral route. It is either inhaled or licked when a dog is near the fresh feces, the mucus secretions, or inhaling the cough vapors of an infected dog. Before the advent of an effective vaccine, distemper was known to wipe out the canines of entire towns and cities. With the advent and mass production of effective vaccines, the incidence of canine distemper has decreased considerably, but outbreaks are still occasionally reported. Puppies and old dogs are the highest risk for disease.
Once infected, the patient starts to show an increase in mucus secretions from the nose and often develops a cough by about day 6. At this point, the virus has gone beyond the mouth and upper respiratory system and reached the stomach, spleen, small intestine, and liver. After this time, if the virus effectively continues to evade the immune system, the sensitive cells of the linings of tissues, including, the brain, gastrointestinal system, and lungs will begin to show significant disease manifesting by days 10-14. Signs include:
– Seizure, the most common presentation of which is called a “chewing gum fit,” due to rapid biting action and tremors of the mouth.
– Coughing and labored breathing from pneumonia.
– Diarrhea, sometimes with blood in it.
Treatment is mostly supportive and includes: IV fluids, antibiotics to fight secondary bacterial infections, blood transfusion if blood loss in the stool is significant and/or bone marrow suppression by the virus leads to low red blood cell production, anti-nausea and GI protective agents, nebulization to help clear the lungs, and anti-convulsant therapy to control seizures. The mortality rate is 50% even with aggressive therapy.
Luckily, there is a vaccine that effectively prevents canine distemper. As previously mentioned, it is administered within the 4 in 1 combination vaccine called the DHPP. The protocol that I follow is puppies having this vaccine administered at 6, 9, and 12 weeks of age, then boostered one year later. Following the one year booster, the vaccine can then effectively be backed off to once every 3 year administration.
One year of a dog’s or a cat’s life is equivalent to 5-7 years of a person’s life. Consider all of things that could go wrong with humans within a 5-7 year period, combined with the fact that our pet’s cannot articulate how they are feeling and instinctively hide signs of pain or illness; it should be clear how important yearly examination are, even for young pets.
Just this month alone, the majority of procedures I performed were the result of disease that I found on incidentally physical examination in a yearly visit, including:
– 6 dentistry procedures where I found painful and health compromising stages of periodontal disease.
– 1 echocardiogram (heart ultrasound) because I heard a high intensity heart murmur with my stethoscope during the yearly examination of a 4 year old King Charles Cavalier Spaniel. Because we discovered the murmur was the result of heart valve defect, we now have him on a dietary and medical a lifestyle regimen that will extend his life and stave off heart failure.
– 1 class 4 laser therapy induction in a case of degenerative joint disease in the elbow discovered on routine yearly examination of a 9 year old Bichon. I first noticed that something was odd about his gait as he entered the room, then palpated thickness and popping in the elbow. The aforementioned laser therapy and joint chew regimen that I subsequently recommended for him is already improving his quality of life, and will help to keep him in less pain long term, while optimizing the longevity of that leg.
The mother of all incidental findings I detected on routine yearly visits in the month of October, however, was on a 10 year old pit bull, whose owner’s had not observed anything wrong with their dog leading up to the visit. On routine abdominal palpation that is part of the yearly physical examination, I palpated an enlarged spleen, which I confirmed with abdominal x-rays. One week later, I performed an abdominal exploratory surgical to remove the spleen, as x-rays revealed that the dog had developed a dangerous vascular accident within the spleen called a splenic hematoma. This condition is a silent killer, as splenic hematomas do not typically show outward signs. They rupture unbeknownst to the owner, and the dog goes to sleep one day, never to wake up as they bleed to death internally. In this dog’s case, the hematoma was so large that this would likely have happened within 30-60 days.
Instead, because of the owners’ commitment to having the yearly preventative health care visit, she came in 2 days ago for suture removal, fully recovered from surgery with a new lease on life and crisis averted. The owners were so moved by what had transpired that they plan to tell as many pet owners whose ear they can bend their story, and shout from the roof tops about how important preventative pet well visits are.
Bear in mind, that I only listed procedures that came about as the result of incidental findings on physical examinations this past month. Other ailments I discovered and initiated treatment for included KCS (dry eye), ear infections, fleas, ticks, skin infections, inflammatory airway disease, and hypertension to name a few. Had I not seen these pets as well, they would still be living with the painful and health compromising consequences of these diseases. I started this preventative pet health care series with the yearly examination because it is the single most important aspect of the preventative veterinary care visit.
Dr. Roger Welton is the President of Maybeck Animal Hospital in West Melbourne, FL, Chief Editor of the Veterinary Advice and Information Website, Web-DVM, and founder/CEO of Dr. Roger’s Holistic Veterinary Care.