Just a few years ago, we veterinarian's termed any dog that came to us with a "cold", as having "kennel cough". We now know that it is a much more complex disease than that. Today we realize there are a host of different bacteria and viruses that can all cause similar symptoms in the dog. By using the new term: "Canine Infectious Respiratory Disease Complex" (CIRDC), we can better discuss with our clients the importance of treating it and, very importantly, preventing it in the first place.

The list of 10 different organisms known to cause CIRDC include: Bordetella, Streptococcus zooepidemicus, Mycoplasma, parainfluenza, adenovirus type 2, canine influenza, distemper, coronavirus, pneumovirus, and most recently described, canine herpesvirus. This list will likely grow in the future. While the organism causing a particular outbreak of respiratory disease in dogs may vary by geographic region, the primary cause of CIRDC and what we used to call "kennel cough" remains the bacteria Bordetella.

When a dog is brought to us showing signs of CIRDC, it is important for Dr. Meisner and I to inform our clients that any one or a number of these organisms may be the cause of their pets' illness. This being said, just putting such a patient on antibiotics for 10 or 14 days may not rapidly resolve the problem. As in people with a cold, it may take quite a few weeks for the dogs natural immunity to clear the infection on its' own, especially if it is viral. In addition, a "secondary infection", where bacteria may be involved, is often seen, and thus it may be worthwhile at least trying an antibiotic to see if it helps.

You may ask yourself if your dog is at risk for contracting CIRDC? Risk is present for most house pets, when lack of or inappropriate vaccination, and contact with other dogs occur. Dogs who go to groomers, doggie daycare, dog parks (such as the one at Knox Park here in East Aurora), walks and social encounters with other dogs, pet stores, and yes, even veterinary clinics, are at higher risk than the general population. In years past, most of the dogs presented with respiratory infections were from shelters, pet stores, or kennels. In recent years, more and more dogs go to doggie day care, pet stores, and dog parks. These are now the dogs presented to us with CIRDC most frequently.

The presenting symptoms vary widely, and in part, dictate how we will proceed with a particular case. If I am presented with a young seemingly healthy dog, that is eating and otherwise acting normally, does not have a fever, and just a mild cough, I usually just start it on an antibiotic and a cough suppressant medication. A staff member or I will phone in a few days to learn how our patient is doing. As long as they are responding satisfactorily, we advise continuing the medication until it is finished. If on the other hand, the presenting patient has a high fever, a nasal or ocular discharge, and we hear congestion in the lungs, we will recommend some blood tests, and likely take chest radiographs (x-rays) as well. If we feel it is warranted, we may also recommend a test for canine influenza (CIV.....covered in a previous blog), cytology of any discharge, and perhaps even a culture to try and identify what is causing the infection. Also very important, we educate the client to keep their pet away from other dogs until it has been asymptomatic for at least a week.

In terms of prevention, the best thing a person can do is to keep their dog away from other dogs showing symptoms of CIRCD, such as coughing, having a nasal discharge, or otherwise acting ill. Since so many of our patients are at least on occasion, placed in a situation where there is a possibility of exposure to one of the organisms known to cause this disease, we recommend vaccination. For decades now, all puppies and adult dogs have been immunized against distemper, parainfluenza, and adenovirus type 2. It has been known since the 1970’s that adenovirus type 2 cross protects against infectious canine hepatitis. For this reason, all dogs have traditionally received this important protection. More recently, vaccines that protect dogs from Bordetella have become widely used as well.

About 10 or 15 years ago, it was clearly demonstrated that immunity against some of the organisms we vaccinated dogs for lasted longer than what had been the traditional annual vaccination. In particular, canine distemper, adenovirus type 2, and parvovirus (DAP vaccine). The protection against Bordetella however, only lasts 9 - 14 months at best. For this reason, it is recommended as an annual booster.

Originally, the Bordetella vaccine was administered under the skin, just as other vaccines are. It was then discovered, that if administered intranasally (like some human influenza vaccines are), a better level of immunity could be provided. Even more recently, an oral vaccine came to market, that does a wonderful job protecting our canine patients against this infection, and was much easier for us to administer in most dogs. Many of our canine patients had received this type if vaccine over the past few years.

It gets even more complicated then this!! Once we veterinarians went to a triennial (every 3 year) DAP vaccine, we stopped vaccinating our adult canine patients for parainfluenza. As luck would have it, once veterinarians stopped vaccinating, the disease began to show up in sporadic outbreaks across the country. Dr. Meisner and I attended a continuing education meeting in September of 2015, where one of the world's foremost experts on infectious diseases and vaccination was the speaker. He recommended we again change our vaccination protocol. That is why you may notice we no longer are administering the oral bordetella vaccine, but an intranasal one that protects against bordetella and parainfluenza. Unlike the triennial DAP, this one is recommended to be administered on an annual basis.

So now you have learned it is not just "kennel cough" that may be affecting a particular coughing dog, but a much more complex one termed CIRDC! As always, we are happy to answer any questions you may have regarding anything mentioned in this blog. We are also happy to discuss your particular dog, and how vaccination may help prevent infection with at least the primary organisms causing CIRDC.

Thanks for "listening".....

Dr. Keem