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| PRACTICE TO PRACTICE
NOT JUST THE CLINIC KENNEL The virus was spreading like wildfire. Another dog that had boarded with the original two infected dogs had returned to a kennel with more than 75 dogs. The kennel called to say that some of their dogs were coughing. I had to be the one to tell them we sus- pected there was an outbreak of CIV and that we had not been vaccinating dogs prior to admission to our facility. My husband and I went to the kennel to suit up and
start checking every dog for clinical signs and fever. The kennel is made up of five wards, about 50 to 100 feet apart. We started with the least symptomatic ward and worked our way through each one. We walked through bleach baths, changed our gloves between dogs, and changed our protective gear between wards. We tested random dogs that had fevers or were
coughing from each ward with nasopharyngeal swabs and blood samples to send to the laboratory.
AND THE OUTBREAK CONTINUES Back at the clinic, all coughing dogs were seen in the parking lot with foot covers, plastic gowns, and gloves to prevent us from becoming fomites. Several dogs that were seen for an ear flush or examination the same day the two infected dogs came into the clinic returned to us with coughs. We collected samples and sent them to IDEXX
Laboratories and University of Cornell, where serol- ogy was performed on the blood and PCR on the naso- pharyngeal swabs. The titers were high enough on the serology tests to confirm CIV without needing to submit a second sample.
HOW TO "CLEAN" THE CLINIC CIV can be killed with dilute bleach and dies in the envi- ronment in about 48 hours. The first step in bringing the outbreak under control was to close the boarding facility and only see criti- cally ill patients for 48 hours. During
this time, the
entire staff, includ- ing myself, suited up and started ble a c h i ng every sur- face.
Canine Influenza Overview CIV is an emerging infectious disease that has been confirmed in dogs across 38 states and the District of Columbia.1
is rising and virtually every naïve dog exposed to the virus will become infected.2
It's prevalence This
highly contagious disease is rapidly spread by a combination of aerosols, droplets, and direct contact with respiratory secretions or contaminated fomites.2,3
Diagnosis Clinical signs of CIV are usually seen 5 days after infection.4
See Clinical Signs of Canine
Influenza Virus for a list of signs. However, CIV cannot be distinguished from other causes of acute respiratory disease based on clinical signs alone.5,6
flu-antigen enzyme-linked immunosorbent assay (ELISA), serology, PCR, and virus isolation. Accurate results are affected by timing of sample collection with regard to the phase of disease; therefore, use of more than one diagnostic approach may be needed to determine etiology rapidly and accurately.2
Treatment Because there is no specific treatment for CIV, the focus of management is providing supportive care while the infection runs its course.2
Diagnostic testing options include
infection may be present, which indicates the use of antibiotics.2,5,7
In some cases, a secondary bacterial In dogs with severe illness,
critical care, such as IV fluids and supplemental oxygen, may be needed. At this time, treatment with antiviral agents is not recommended for dogs.2,7
Prevention Effective vaccination is the best prevention against viral disease.8
Vaccines are available
for CIV, including Nobivac Canine Flu H3N8 (merck.com) and Vanguard CIV (Pfizer.com). The vaccines protect dogs against CIV infection by: r 4JHOJGJDBOUMZ EFDSFBTJOH DMJOJDBM TJHOT r 3FEVDJOH WJSBM TIFEEJOH r 3FEVDJOH $*7 JOEVDFE MVOH DPOTPMJEBUJPO The initial CIV vaccine is given in two doses,
two (Nobivac Canine Flu H3N8) and three (Vanguard CIV) weeks apart; annual vaccination with one dose is then recommended. For additional information on canine influenza,
visit the following links: r doginfluenza.com r cdc.gov/flu/canine r avma.org/public_health/influenza/ canine_guideslines.asp
r vetmed.wsu.edu/depts_waddl/dx/ K9Influenza.aspx
70 Today's Veterinary Practice January/February 2012