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Canine Distemper Virus
Distemper
Distemper in Shih Tzu
Canine Distemper Virus
Long term problems associated with distemper
Distemper possible
Possible distemper
Distemper in vaccinated puppy
Distemper possible
also see Infectious DiseasePlease note: The most recent medical information is at the top of the page to least current at the bottom.
also see Vaccination
Question: I am most impressed with your knowledge and the clear and concise manner that
you provide advice. We experiencing a terrifying situation confronting our
dogs.On Saturday, May 26, 2001, our dog Princess was euthanized due to Acute
Distemper. Princess was rescued from the street around March 18, 2001. Our
dogs first came into direct contact with her at that time. She had been
exhibiting a cough and a nasal drip. After about two days with us she was
placed in another home for approximately three weeks. After that period of
time, she returned to our home where she resumed contact with our dogs for
several more weeks until she was euthanized.For about one or two days before she was brought to the hospital on Friday,
May 25, 2001, Princess exhibited a pronounced nasal discharge and her
breathing was very labored. We were not overly concerned about anything
being spread to our dogs because they were all "vaccinated." Moreover, we
have a small two bedroom home and many other dogs, therefore, separating her
effectively was difficult. We have many fears and questions. However, I
will mainly ask at this time about one of our dogs, Bear, whose situation we
feel is the most urgent.Background:
Bear is one years old and weighs about 45 pounds. He had his complete baby
series of vaccinations. He is due for his first booster in September.
Unfortunately, the baby series of vaccinations may not have been effective
due to the vaccines not being cooled properly during transport. We
administered them ourselves, but I believe the ice packs were warm by the
time they arrived. A cough was first noted on Monday, May 27, 2001. A
sneeze was first noted on Wednesday, May 30th. A Titer test for Distemper
was performed on Thursday, May 31st. The results on Saturday, June 2nd were
positive for Distemper antibodies. For these last two weeks his symptoms had
been confined to an occasional mild cough or sneeze. However, Monday, June
11, he became somewhat lethargic, so we took his temperature which was 103.6.
We reported his fever to our vet who placed Bear on an antibiotic. Last
night, June 12, at 10:30 PM his fever climbed to 104.6. We administered a
half of a 325 mg aspirin. His temperature continued to rise. At 1:00 AM, it
was 105. Although, his temperature decreased. at 4:30 AM to 103.6, it has
risen again this morning to 105.4.We are great believers in boosting the immune system. Bear and our other
dogs are receiving a wide variety of supplements. We are using the following
vitamin regimen for our dogs:Vetri DMG Liquid - 10 drops twice a day.
Vetri-Science Cell Advance 880 - As prescribed on the bottle.
Vetri-Science Canine Plus multivitamins - As prescribed on bottle.
Jarrow Colostrum 500 mg twice a day. 30% immunoglobulins per capsule
C-Flex canine Esther-C form of calcium ascorbate - 500 mg recommended dosage
on bottle is one 500 mg tablet per 20 pounds animal body weight.The Missing Link - As prescribed on the package.
Anitra's Vita-Mineral Mix - As prescribed on bottle.
Questions:
1) Do you feel fever is the body's natural reaction to fighting off the
attack by the virus and therefore no attempt should be made at lowering
it, unless it reaches a certain point?2) Do you believe we should attempt to lower Bear's fever at this time? If
so, please explain how. For example do you recommend using aspirin?3) I have heard of the benefits of using mega doses of vitamin C given
intravenously. Your comments please regarding if/when this might be an
advisable protocol.4) Do you believe Interferon could be beneficial to use?
5) Please advise a nutritional and/or other types of protocols, or advice,
that you believe would be helpful.6) Do you believe the vaccines we administered were probably a "zero"
benefit due to the ice packs melting during transport?7) What length of time is considered dangerous if Bear's fever continues?
8) What length of time is considered dangerous if there is no improvement in
Bear's other symptoms?9) What do you believe is Bear's percentage chance of survival?
10)We are attempting to separate Bear and our other dogs from each other as
much as possible in order to avoid their reinfecting each other.
Naturally, this is difficult with many dogs in a small home. Are there
certain points, depending on a dogs symptoms, when it presents a greater
chance of spreading the virus? For example:A) Would Bear be more likely to be contagious at this time because he
has a fever?B) Would a dog be more likely to be contagious according to the degree
and severity of its coughing, sneezing, or other discharge, or when
exhibiting neurological symptoms?9) What course of action do you recommend if a dog begins to exhibit
neurological symptoms, i.e., seizures?I am not certain whether you will email me directly your response, or if I
need to keep checking the web cite. Please notify me if I must check the
website. A direct response would be most appreciated.Once again, thank you for the service that you provide.
Answer: D-
I'll try to answer your questions sort of by the numbers, but there will be
some overlap.1) I do think that fever has some benefits in fighting off infection and
that a case can be made for not controlling fever based on this, unless it
gets severe. We worry about temperatures over 105.5 to 106 degrees
Fahrenheit and do try to control fevers when they get higher than this
since the fever itself can become damaging to the patient.2) I probably wouldn't do anything for a 105.4 degree temperature unless it
persisted at this level for more than 24 hours. Then I probably would try
aspirin to reduce the fever. There is not a clear right or wrong answer
for when to control fevers in this range, though.3) Megadoses of Vitamin C were proposed as a treatment for canine distemper
and sort of in the tail end of being in vogue when I graduated from
veterinary school in 1979. At that time, there seemed to be enough
scientific evidence to say that the therapy was not effective. It is
unlikely to be harmful in a dog that is past the growth stage in age, though.4) Dogs with distemper produce interferon and other immune modulating
compounds (cytokines) while ill. I do not know if supplementing these would
be beneficial and I could not find any information on whether this had been
tried, or not. You would have to consider this to be an experimental
treatment. Interferon has been used for other diseases in dogs without
apparent side effects at low dosages, so it seems like it would be
reasonably safe to try this if you wanted to (one study, Gilger 1999, was
on keratoconjunctivitis sicca, using interferon alpha at 20 to 40U per day,
orally. This might at least make Bear's eyes more comfortable).5) To the best of my knowledge, there are no known medications, nutritional
supplements or other therapies that have proven to be successful in
treating canine distemper virus consistently. Using a good quality food,
perhaps supplementing with a multi-vitamin and using other therapies that
are not likely to be harmful, such as the ones you asked about, all seem
reasonable. Antibiotics are justified, I think, because secondary
infections seem very common in puppies with distemper. In addition,
anything that increases patient comfort, like humidifying the air the pup
is breathing, decongestants, seizure control medications (if seizures
occur), etc. are all worth considering.6) Vaccines are supposed to be able to survive about a 4 to 5 day period
without refrigeration as part of their approval process, I think. It is
always hard to be certain what happens to vaccines after they leave the
manufacturer, which is a good reason to use suppliers you believe to be
ethical and to try to be careful about taking care of vaccines
yourself. There is probably no way to be certain of the vaccines
effectiveness in retrospect but it is good that the other dogs are not
showing signs.The most common cause of vaccine failure is residual maternal immunity that
prevents successful vaccination. This is a problem when puppies are
vaccinated at less than twelve weeks of age and is the reason that series
of vaccinations are given to puppies. If Bear was given one of the
vaccinations when he was over twelve weeks of age and if modified live
vaccines were used (most are this type), it would be unusual for the
vaccine not to work unless it was defective. If he was not vaccinated after
twelve weeks of age, there is a chance that maternal immunity prevented the
vaccine from working.7) I have not seen a chart that describes any sort of risk vs. duration for
fevers of any temperature in dogs. We try to bring fevers down when they
persist for more than 48 to 72 hours but that is just an established
practice, not something that we have the references to prove is necessary
to do.8) Dogs with distemper can experience worsening of the disease, especially
neurologic problems from it, for years after the initial illness seems to
have passed. Unfortunately, for this particular disease, there is not a
time when danger of a neurologic complication such as seizure activity can
be discounted.9) There is no real way to predict survivability for an individual dog
affected by distemper. Some puppies with really severe initial signs
experience only mild neurologic problems while other puppies with mild
initial disease have severe seizure disorders or blindness later. Overall,
my best estimate of long term survival with what I consider to be
reasonably good quality of life is probably about 50% to 60% of affected
puppies.10) Shedding of the virus usually stops after the acute phase of the
illness (after upper respiratory and gastrointestinal signs have cleared
up) but there are reports of some puppies shedding the virus for two to
three months, so it is best to consider an infected dog to be a potential
shedder of the virus for three months and to keep them isolated from other
dogs for this period of time. I do not know if the rate of viral shedding
relates to clinical signs at all but it would be best just to assume that
the virus could be shed for some time.11) If seizure activity does occur it may be beneficial to administer
dexamethasone (a corticosteroid) one time at the onset of seizure activity,
since there is inflammatory encephalitis at this time in most patients. I
am not sure if the long term value of this has really been established,
though. Other than this, treatment of any seizure activity using
phenobarbital or other anticonvulsants is the only thing that I know of to
do. Many dogs have a period when seizure activity is intense and then
seizures become less of a problem over time and we have several patients
who have not needed seizure control after the first year or so of use.There is a chance that Bear's disease is not distemper, but the signs do
seem to support this diagnosis.Mike Richards, DVM
7/2/2001
Question: Dear Dr. Richards,
Many thanks for being accessible on the web.
I and my wife bought my pet, Ding Dong, from a local pet shop in Hong Kong
on 29.10.2000. He is a Shih Tzu puppy. We took him to a vet for checkup
after we got him. The vet told us that he had coughing, which may be kennel
cough. He prescribed a course of doxycycline. The course seemed deteriorated
a bit. So he changed to another antibiotic (? Augmentin).Ding Dong have apparently improved in the following week but deteriorated
again since last week. He had diarrhoea with blood and mucus. He vomited
twice and he had a high fever (up to 39.6 C). A pustular lesion was noted on
the abdominal wall which ruptured spontaneous a few days ago. Since last
Sunday, he has developed seizure for a few times. He also got a bad
pneumonia. My vet has set a ivi drip for him and given antibiotic and Vit
B12 for him. Concerning the bowel motion, he had no more diarrhoea in the
last 2 days but resumed to diarrhoea with blood and mucus again. Fever still
persist.My vet asked me and my wife to be psychologically prepared for the death of
Ding Dong,May I ask:
1. Is there any clue that Ding Dong may have a chance of recovery?
2. What can we do in order to optimize his chance of recovery?
3. How long should we wait before we can have a clearer prognosis?Thanks again.
Regards, Ben
Answer: Ben-
It does sound like you are describing the symptoms of a puppy infected with
distemper virus. This disease causes gastrointestinal signs, respiratory
disease and neurologic disease (tremors and seizures -- usually after the
other signs start to disappear).With treatment some puppies survive distemper and some do not. The
percentage of puppies that live or die depends on the quality of the care
they receive (which seems good for your puppy) and the virulence of the
strain of the virus that they are infected with. There is no good way to
determine in an individual puppy how virulent the strain of distemper they
have is. Some puppies who do not seem to have severe disease die and some
puppies have serious clinical signs but live through them. We will usually
try very hard to save puppies since this is the case. We sometimes regret
this effort when the puppies do not make it, because we feel badly that
they suffered in our care, but we can not easily give up due to the puppies
that do live. You should be aware of the possibility of seizures or other
neurologic signs as a long term complication. It is sometimes necessary to
provide for long term seizure control even after all other symptoms have
disappeared.The shorter answers: 1) there is hope for recovery but it may take a long
time and it is not a sure thing, by any means 2) All that can be done is
to control the symptoms of the disorder until a puppy lives or dies and to
provide as much mental encouragement as possible in the form of gentle
care, holding the puppy, encouraging eating and things like that 3) I am an
optimist to the end and I have a hard time ever giving up on these puppies
but sometimes it becomes clear that a puppy has really given up or the
neurologic signs are so severe that it really looks hard on the puppy. At
these times we consider euthanasia.I hope that things are improving for Ding Dong. Your vet was wise to tell
you to be prepared to accept that he might die while still providing care
that should help him to live, if it is possible for him to do that. It
would be unfair to you not to tell you that death was a strong possibility.
It is not necessarily inevitable, though.I hope that this helps. Please feel free to ask for clarification if I
didn't explain part of this clearly enough.Mike Richards, DVM
12/10/2000
For many years canine distemper virus was the most feared of the viral diseases affecting dogs. Parvovirus may have surpassed it in this regard but it is still a deadly virus that kills dogs and other members of the canine family. It is also infective to ferrets, mink, weasels and their kin among the Mustelidae family as well as raccoons, pandas and other members of the Procyonidae family. Recently it is believed to be the culprit in the death of a number of African lions. Canine distemper virus is an RNA virus from the morbillivirus family. In humans, measles is caused by a member of this virus family. Distemper virus is more likely to affect puppies than older dogs. This is probably due immunity acquired through vaccination or exposure to the virus naturally, leading to immunity. It can affect dogs of any age, though. It causes very variable clinical signs which makes ruling it out in a young sick dog a difficult process. In some dogs a transient fever, perhaps accompanied by a lack of appetite or mild depression may be the only signs of onset of distemper. Other dogs are affected by a systemic illness with nasal and ocular discharges, coughing, fever, depression, lack of appetite, vomiting and diarrhea. It is not uncommon for dogs to have some but not all signs associated with this disease. Since the inapparent infections often go undiagnosed and the severe infections often are present in dogs who die from distemper virus the mortality rate of canine distemper was always thought to be very high. Over time, it was recognized that a number of dogs were surviving the initial infection only to develop neurologic signs from one to a few weeks after infection. Seizures, behavioral changes, walking in circles and other ambulatory problems commonly develop. Many dogs who develop neurologic signs develop rhythmic motions or "tics". These are known as chorea. Sometimes affected dogs appear to be chewing gum due to the steady contractions of the muscles of the head. Dogs that survive both the initial infection and subsequent neurologic disease may go on to develop retinal damage, corneal discoloration or extreme hardness of the skin of the nose or foot pads. Infection with the distemper virus can be hard to diagnose with certainty. It is not uncommon for puppies with suggestive clinical signs to have a recent vaccination for the virus. This makes it hard to judge infection by antibody titers in many instances. There is a latent period from the time the virus enters a dog's body until clinical signs appear of approximately 10 to 14 days which means that puppies already infected may be vaccinated before clinical signs appear. The vaccination is not likely to be effective in preventing the disease when it is given after infection occurs. Sometimes the virus can be identified in infected tissues using immunofluorescent techniques. This works in the white blood cells several days after infection and in conjunctival (the pink part of the eye area) swabs up to 21 days after infection. Inclusion cysts may be seen in conjunctival swabs as well. General blood chemistry and blood cell count values are usually pretty uninformative when distemper is present. Cerebrospinal fluid (CSF) taps may indicate antibodies to distemper virus and increased protein. X-rays may show signs of pneumonia that are typical for viral infection but not definite for distemper virus alone. In many instances the course of the disease finally provides the diagnosis as initial signs of a generalized illness change to neurologic signs over time. At present there is no specific treatment to kill the distemper virus. General supportive care and control of neurologic signs such as seizures may result in a reasonable recovery from this infection. This may be a long term project, though. Prevention of infection is the best way to deal with canine distemper. Adequate vaccination of puppies is necessary. Veterinarians tend to begin vaccinations for this disease at approximately 6 weeks of age and continue until 12 or even 16 weeks of age at 3 to 4 week intervals. The vaccine is repeated due to interference with vaccination from antibodies passed to puppies in the mother's milk. These antibodies prevent the vaccine from working in about 75% of puppies at six weeks of age, about 25% of puppies at nine weeks of age and only a very few puppies at twelve weeks of age. The first vaccination is therefore an attempt to treat the 25% of puppies who are susceptible and the follow-up vaccinations are given to eventually provide protection to almost all puppies who receive vaccination. Some strains of distemper vaccine provide nearly lifelong immunity after the initial series and one-year booster while other strains provide a shorter duration of immunity. Some puppies develop signs of canine distemper following vaccination even though they do not appear to have the disease. In these puppies encephalitis occurs. This can be fatal, although most puppies probably recover. Canine distemper virus is shed in all body secretions from infected animals. Dogs may spread the virus for several weeks during the illness and subsequent recovery period. The virus is not especially stable in the environment, probably lasting no more than a few weeks. It is susceptible to disinfectants, especially the quaternary ammonium compounds such as Roccal (TM). The incidence of canine distemper infections is much lower than in the past. Good vaccination practices are almost certainly a big part of the reduction in cases of distemper. It is still present all over the world and continued vigilance on the part of veterinarians and dog owners is necessary to prevent a resurgence of this deadly illness.
Michael Richards, DVM
Long term problems that are associated with distemper - Akita
Question: We got our female Akita named Sadie from the local kill shelter late last
November. Several days after coming home she came down with distemper.
After several hospital stays, weeks of home nursing and six weeks of stress
she recovered and seems to have been fine since. Our vet at the time (she
has since left that practice) indicated the virus is always present just
dormant. There was also a chance it would go active and neurological later,
but always within a year. Is this your understanding of distemper also? The
other thing we have been wondering is whether there would be possible other
long-term effects. The only unusual thing we have noticed is that she seems
to lose her appetite every few weeks. She'll then go maybe 3-4 days without
much interest in food, eating less than half what we usually give her. The
appetite then returns to normal. She is a sorta finicky eater compared to
most dogs I've known, but during these periods of concern she really won't
eat much of anything. Any thoughts about the appetite problems or other
long-term distemper issues would be appreciated.
Answer: Maureen-
There are several long term problems that are associated with distemper
virus infection. Some dogs develop seizures, which can be lifelong and
often require medical management, after infection with distemper virus.
Seizures may not occur for several years after apparent recovery from
distemper, although usually they occur sooner than that. Some dogs develop
tear deficiency as a result of infection with distemper virus and it may be
necessary to treat this on a chronic basis, as well. Changes in the foot
pads in which a hard crust forms on the edges of the pads occurs after
distemper virus in some patients (hard pad) and these crusts may also form
on the dog's nose. Sometimes there is damage to the retina
(chorioretininitis) that leaves visible scarring long term but usually does
not result in blindness.I have not associated appetite disturbances with previous distemper virus
infection but the virus does cause gastrointestinal disorders in its acute
stage, so it seems possible that it might cause some problems long term. If
this does occur, I didn't find any reference to it while researching this
question, though. I think that this behavior (variable appetite) is not
that unusual in Akitas, based on the ones that we see. If there is any
vomiting, diarrhea, or visible discomfort associated with the loss of
appetite it would still be a good idea to check for problems like
inflammatory bowel disease (IBD), chronic pancreatitis, pancreatic
insufficiency, liver disease and other systemic diseases, even though there
is a good chance nothing will be found.Seizures are the major long term complication with distemper virus
infections based on the patients in our practice. Once in a while we have
difficulty controlling seizures in patients who have had distemper but I
think we have always finally managed it if the owners hung in there with us.Good luck with this. Hopefully you won't see any long term problems. That
does happen sometimes.Mike Richards, DVM
10/14/2000
Question: Dr. Richards,
My fiancée and I adopted a four month old German Shepherd mix named Juneau last Tuesday. When
we picked him up, we were told that he was starting to come down with kennel cough, and we were
given Clavomox to prevent an infection. He was coughing quite a bit and had thick discharge from his
nose and eyes. Over the next two days, he became increasingly lethargic and began throwing up. He
ate nothing at all and was drinking very little. On Thursday night, we took him to our vet to have him
checked out. Our vet thought that he probably had parvo or maybe distemper. He kept Juneau for
tests, which later confirmed that Juneau does have parvo. Juneau stayed in the hospital until
Saturday afternoon, at which point he took a turn for the better and was eating and drinking on his
own. Since Saturday, we have noticed a slight decline in his energy level, but he is still eating and
drinking fairly well and is not throwing up. He still has discharge from his nose and eyes, but it seems
to be clearer. We began to worry again Sunday when he woke up crying in the middle of the night at
the top of his lungs. We were able to calm him down after a minute or two, and he went right back to
sleep. But he did the same thing about five times that night, just about every hour or so. We tried to
give him food and water, but he didn't seem to want anything. It sounded like he was really in pain.
So, we went back to the vet yesterday. Our vet again thought that it might still be distemper, and his
behavior the night before could have been due to seizures. Juneau was not dehydrated and was
otherwise fine, so we were able to take him home (he is still on antibiotics). Since then, he hasn't had
another crying episode and yesterday he slept the whole night without any problems. I don't know
what to expect now. I was wondering if you could give me a little more information on distemper and
what I should look for in Juneau. I thought once that I saw his front paw twitch, but I also know that I
have been watching and studying his every move. I would also like to know how long, if he does have
distemper, before it will be obvious. The waiting to know if he will make it or not is so hard!Thanks for your help,
-TAnswer: T-
Distemper is not very common anymore, so it is tough to put it at the top of the list of differential
diagnoses when a puppy comes in with signs that might be attributable to it. Distemper causes fevers
and drops in white blood cell counts in the initial stages of the infection but the fever may go
unnoticed and the changes in white blood cell counts are only noticed if blood is examined for some
reason at this time. Early in distemper affected puppies often have respiratory disease with mucous
drainage from the nostrils and often the eyes, as well. Affected puppies appear to be lethargic or
depressed. They often refuse to eat and sometimes exhibit other gastrointestinal signs, such as
diarrhea or vomiting. As time goes on, they may recover from the respiratory and gastrointestinal
signs and then develop neurological signs, including a chorea, which is a tic (rhythmic motion) of the
muscles that usually affects the face but can affect other areas of the body. Seizures are a common
neurologic complication of distemper infection. An unusual form of seizure that affects primarily the
muscles of the head occurs with distemper and produces a syndrome that looks like the dog is
chewing gum frantically. Generalized seizures, with loss of conciousness, involuntary muscle
movements, urination and/or defecation are also a common problem, though.Distemper is hard to diagnose. Titers for distemper would be useful except that most of the puppies
I see with the disease have been vaccinated, usually within a couple of weeks of the disease. It takes
about 10 to 14 days for distemper vaccine to provide much protection, so puppies that are exposed
at the time they are vaccinated develop the disease. I see this most commonly in dogs coming from
animal shelters, who are exposed and vaccinated at the same time but it could occur in any puppy.
Conjunctival swabs examined by a pathologist will sometimes provide a diagnosis and blood smears
can also sometimes show viral inclusion bodies, too. If cerebrospinal fluid is tested it sometimes
provides enough information to make a diagnosis, as well (increased white blood cells, increased
protein and positive immunofluorescent antibody (IFA) titer). X-rays of the chest may show an
interstitial density pattern suggestive of viral pneumonia. Abnormal growth (hyperkeratosis) of the
foot pads or nose tissue is suggestive of distemper infection and is a late sign of the disease.
Unfortunately, a post-mortem exam with tissue samples examined by a pathologist is sometimes the
only way to confirm this diagnosis.It may seem odd that veterinarians have a hard time distinguishing parvovirus from distemper but it
makes sense to me. Parvovirus normally causes low white blood cell counts, depression, diarrhea
(often reddish brown but can have other appearances) and it occurs most commonly in puppies,
which is also the most likely age group for distemper. Add those similarities to the fact that
parvovirus is probably the most common serious viral illness affecting puppies and there are times
when it is hard to decide which is going on. This is even further complicated by the fact that
parvovirus test kits will sometimes give a positive reading for some time after vaccinations for
parvovirus and the situation becomes even more confusing.We used to think of distemper as being nearly always fatal if clinical signs appeared. It is still a
disease that many dogs die from but many recover, too. Dogs that live through the initial infection
may require long term seizure control medications, though.As time goes on, if you need more information on this situation, please feel free to send additional
questions.Mike Richards, DVM
8/7/2000
Question: Please help...
My husband and I purchased a Golden Retriever puppy from
a local pet store in Florida. Bailey was 10 weeks old when we bought her
on February 20, 2000.She was already vaccinated for canine distemper, hepatitis,
parainfluenza, leptospirosis, canine parvo, canine coronavirus vaccine and she received
athelbon and panacure for roundworm and hookworm.We took her to a vet for a check up (There is a "lemon law" in Florida,
indicating this must be done within 4 days of purchase) on February 23.
Our vet (who is also the vet for the pet store) put her on Amoxitab due to
some bacteria in her stool and 3/4 of a heartworm pill (Filibartis) per day.On February 27 we had to bring her to the animal emergency room because
she stopped eating, drinking, was very lethargic, and had a green discharge
from both of her eyes. The vet at the ER gave her shots of fluid because she
was dehydrated (not an IV). She wrote in the record that she found "few
Giardia cysts & Bunny-Yeast (incidental in bunnies)" in Bailey's stool. She told
me she didn't know the clinical term for what she called the "Bunny Yeast".
She took Bailey off of the Amoxitab as she had a rash on her belly and
ears, and put her on Chloromphenicol, Flagyl, Baby Asprin (she had a fever of
103.8), and a strong scented food called CNM. Bailey would eat the CNM.
As much as we would give her she would take without the slightest
hesitation.Bailey was significantly worse On February 28 (at this point she still
had all of her initial symptoms (except the eating part) plus she was
drooling profusely from her mouth and would not take her mediation) I brought
Bailey to her normal vet and he kept her there for treatment. At that point she
still had a fever of 104 and she was sneezing also.As of February 29 Bailey's white cell count was 20,000. Since then it
has decreased but still is not normal.Today is March 3 and Bailey is still at her vets. Initially he diagnosed
her with pneumonia but he could not tell me what caused the pneumonia. I
did all of the research I could on pneumonia in dogs/pups and I could not
find anything on just pneumonia. It is always pseudomonas or parvo or
some other illness which leads into the Pneumonia. Our vet has not diagnosed
any other illness. I have asked him twice to do a culture and sensitivity
test and he has not done it yet. When I asked him why he said it is because
she is already on the best medications and that there is no where to go from
here. I have also asked him to check her for Parvo (she started vomiting
up her food at night on 3/2) and he said he would if she kept vomiting. I
don't know if I am just being impatient, but I feel if she keeps vomiting
then by the time it is diagnosed, it could be too late.One fact you should know is that since he is also the pet store's vet, he
is billing them directly (it is in our contract for the pet store to pay for
any sickness within 14 days of purchase). When I asked for the Parvo
test he said "its a $50.00 test, she might not have Parvo." I have told him
several times that the $$ is not an issue. If the pet store will not pay
for part or any of his services, we will gladly pay him and take it up
with the pet store ourselves. We didn't even ask him to bill the pet store.
Apparently that is part of his agreement with them.He took an x-ray and said that her lungs aren't nearly as bad as he
thought they would be due to how sick she is. Since she has been at the vets,
she has stopped eating completely. They are force feeding her. Now the vet
tells me that her kidneys and liver have been affected (the #'s in both
are up) either by the medication or the bacteria which got her sick in the
first place. Do you have any idea what could be causing her sickness?Dr. Mike, this is our first pet. We have only had her 1 week and we have
a 5 year old son. We love her so much and we feel so helpless. I can't
seem to get a straight answer. I keep asking the vets if they think she will
be okay and the only thing I hear is that she is not out of the woods yet,
they aren't expecting a bad outcome, but anything can happen. I would like an
honest opinion on how bad this sounds because it does sound bad to me.
I'm so afraid that she is going to die. She is only a puppy and I don't know
how much of this she can take.I have been in contact with the pet store's corporate office. I asked
for the name of the breeders that they got Bailey from. They would not give
it to me. I told them I wanted to find out if any other pups were sick that
were in her litter and they told me they would call the breeder and would
only give that info to the vet not to me. They weren't the slightest bit
concerned with what she had or with the other puppies she was in contact
with at their pet store. I am completely taken back by this. How can
people be so unconcerned?I want to get this info for several reasons. I have told several people
of our experience with this pet store and guess what...several people have
now told me of their horror stories from this pet store. Even a person at
the vets office has told me that they get a lot of very very sick puppies in
from the same pet store. It just sounds odd to me (and by the way, they
charge an arm and a leg for their pups/kittens). I would like to write
letters to the Better Business Bureau, AKA and anyone else that will
listen.
I don't want other people to go through this.Thank you for any help you have to offer.
Cathy
Answer: Cathy-
I think that you should probably consider moving Bailey to a different
veterinary hospital. You will probably end up paying the bills there (but
I'm not sure of this). Despite this, I think you need to get a second
opinion at this point.The fever, white blood cell count, nasal discharge and pneumonia that
seems bad clinically but doesn't look too bad on X-rays are all supportive of a
diagnosis of distemper. If there was an increase in overall white count
but a decrease in lymphocyte count, that would be even a little more
supportive of distemper. Unfortunately, puppies who are sold in pet stores are often
very stressed and they are mixed together with many other puppies,
including some with diseases they have not been exposed to. In addition,
there is a possibility of several other illnesses and it may be helpful to
continue to pursue a diagnosis. Distemper can sometimes cause very
characteristic inclusion bodies in cells that can be obtained by swabbing
the conjunctivae (pink portion of the eyes) or identified on blood
smears. Serologic testing (looking for distemper titers) doesn't work
very well in recently vaccinated puppies, unfortunately. Sometimes there are
changes in the retina of the eye that can be seen on an ophthalmic exam
that are associated with distemper. Central spinal fluid taps have some
changes typical for distemper, as well. Later, if neurologic signs develop
that will also help to identify distemper, if it is present. We send our
X-rays to a radiologist for review when we think that distemper might be
present, because that can be helpful, too.Being vaccinated against distemper does not provide a guarantee that the
disease is not present.Giardia is common in puppies and does not normally produce disease of this
magnitude. I don't know what the ER vet was referring to as "bunny yeast",
unfortunately.There are several causes of pneumonia. There is a chance of a bacterial
pneumonia (Bordetella, Pseudomonas, E. coli, Streptococcus, Staphylococcus
and other types of bacteria can all cause pneumonia). Fungal pneumonia
occurs and is more common in some areas of the country than in others.
Since you really have no idea where this puppy is from, these have to be
considered even though they would be unusual in this age range.This might not be distemper but I think that it would be a good idea to
try to rule it out. If this does turn out to be distemper the prognosis is
grave but with good supportive care puppies can survive the initial
problems and neurologic disorders, such as seizures, that can occur later.Writing to the Better Business Bureau and the AKC are good ideas. I would
also recommend checking to see if there is a Consumer Protection Agency in
your state that might respond to this type of problem, too.Sometimes people are reluctant to remove a pet from a veterinary hospital
in order to get a second opinion but you shouldn't be. There are
definitely times when this is justified and when there is a serious
illness that your vet can't identify that is one of those times.Mike Richards, DVM
3/8/2000
Continued
Question: I appreciate your quick response. I researched distemper on the internet.
I found an article and read it (I didn't realize until I was finished with
it that the article was yours). Bailey looked like she was chewing gum the
day I brought her to the vet. I thought it was just from the drool. Her
mouth kept opening and closing opening and closing. She was very lethargic,
but suddenly she would get up, walk in brisk circles and just collapse back
down and sleep. I had no idea what she was doing.Are dogs with distemper dangerous to their owners?
Thank you so much for being available on the internet. I think it is a
great idea and I am telling my friends and family about you hoping that they
will also subscribe.Thanks.
CathyAnswer: Cathy-
There is some concern among physicians that multiple sclerosis (MS) in
humans may be linked in some way to canine distemper virus infection that
occurs in humans. To the best of my knowledge this connection has not been
proven but there are research studies that seem to support the connection
and research studies that seem to refute it. There does not seem to be a
higher than normal incidence of multiple sclerosis among veterinarians (at
least not something I have noticed), which might be expected if exposure to
canine distemper is an initiating factor in MS. Distemper virus is pretty
similar to the human measles virus and this may be a complicating factor in
some of the studies.This is the only risk that I am aware of to humans and the risk appears
to be very small, if it exists.Mike Richards, DVM
3/8/2000
Q: Dr. Mike,
We have just subscribed to your VetInfo Digest and we have some questions.
Our puppy had to be put to sleep last Saturday after she was diganosed with
canine distemper. By the time the vet decided what she had she was past
helping. This broke our hearts, and we do not understand how it happened.
She was a purebread Cocker Spaniel, with all her shots, from a reputable
breeder. The breeder is as puzzled as we are. Why did her vaccincations
not work?We want to get a new puppy but we are very concerned about distemper being
out of the house. How long should we wait before we get a another puppy?Also, we have been doing some reading on the internet about vaccinations vs.
nosodes (homeopathic treatments). There seems to be a groups of vets out
there who do not believe in vacinations. What do you think about this?
Should we give our new puppy more vaccinations to keep her extra safe.
Could our puppy have gotten distemper from her vaccine? Is the distemper virus
killed or alive? We are scared and frustrated. Our vet was very nice but
he was helpless to stop this virus in her. If you could answer these questions
we would be so grateful.Thank you very much,
Shirleen and Andy
A: Dear Shirleen and Andy-
I am very sorry to hear about your puppy. There are several possibilities
concerning the diagnosis and potential reasons for a puppy to develop
distemper even after vaccination. There are probably more possibilities
than I will think of covering, so don't hesitate to ask additional questions.The first question is over the time that you should wait before getting
another puppy. It is generally agreed among the veterinary texts that
distemper virus is relatively easy to kill. It is susceptible to dilute
chlorox antiseptic (about a 1:30 dilution) and cleaning what you can with
this will help. It lives about 2 weeks in the environment so waiting three
weeks it is a good margin of safety.I think that there are some veterinarians who do not believe in
vaccinations. I think that they are a very small minority. A somewhat
larger group of veterinarians is beginning to believe that we may be
administering vaccinations more frequently than is necessary but this group
usually firmly believes that puppies should be vaccinated appropriately.
This is a current controversy in veterinary medicine and vaccine
recommendations are likely to change over the next few years but it is too
early to predict exactly how. I think it is safe to say that
recommendations for the initial puppy series of vaccinations will stay
roughly the same, though.I believe very strongly that nosodes are worthless in protecting against
disease. Nosodes are made by diluting traditional vaccinations (or in some
cases, the actual disease causing virus) to extreme dilutions. This is a
corruption of the theory of homeopathy and strict homeopaths tend not to
believe in nosodes, either, based on reading traffic on the alternative
medicine message boards of the Veterinary Information Network.Vaccinations fail for a number of reasons. Overall, in a couple of studies
the percentage of dogs who had confirmed distemper that had adequate
vaccination histories was about 7%. This doesn't mean the vaccines fail 7%
of the time because ONLY dogs with confirmed distemper were included in the
studies. But it does show that there are at least occasional failures.Vaccines must be properly handled during manufacture, shipping, storage and
use in order to work. There have been vaccine failures related to problems
in each of the above steps. Vaccine batches do not have to be individually
tested to be sure they work so if a batch is produced that doesn't have
enough viral particles or that gets overheated or something it might not
get caught. If the vaccine is delayed in shipping or sits on a runway in
105 degree temperatures until the ice packs all melt, that could cause
problems. If the clinic refrigerator fails to keep the temperature low
enough there can be problems. I have twice encountered dog breeders who
just kept the vaccine on a shelf instead of refrigerated -- they had never
noticed that it had to be refrigerated. The vaccines have to mixed properly
and administered properly, too. There can be failures in technique even
when people are trying hard to do the right thing. We refuse vaccine with
melted ice packs, we keep a thermometer in our refrigerator and we try hard
to make sure that we do in fact get the right vaccine in the right pet and
that the injection is properly administered but I would be surprised if at
least once or twice we haven't failed in some step.Sometimes the vaccine is properly manufactured, properly shipped, properly
stored and properly administered and still doesn't work. This can also
happen for a number of reasons.If a puppy is exposed to the virus at shortly before or at approximately
the same time as the vaccine, the vaccine will fail. The virus is simply
better at causing disease than the vaccine is at preventing it, unless the
vaccine is given enough in advance of exposure to properly stimulate the
immune system. In a few instances, puppies given the combination
distemper/parvovirus/etc. vaccinations at less than five weeks of age have
developed vaccine related distemper. There have also been a couple of times
in the past when specific vaccines have been shown to cause distemper or
distemper-like disease in a small percentage of puppies. At the current
time there is no vaccine on the market with a history of this, that I know
of, though.Some puppies simply don't have adequate immune function. It doesn't matter
how many times they are vaccinated, they simply can't produce an immune
response. This has been considered to be a rare problem in the past but as
we get better and better at understanding the immune system it is becoming
apparent that there are probably more puppies and kittens with immune
system deficiencies than we knew of in the past.Concurrent diseases, extreme stress, inadequate nutrition and a number of
other factors can interfere with immunity for short periods of time. If the
puppy is vaccinated during one of these time periods it may not respond
properly to the vaccine. In some instances there will not be obvious signs
of distress to help in determining that a particular puppy may be at risk
for these problems.The most confusing reason for puppies not to respond to vaccinations is
maternal immunity. Puppies that nurse in the first few hours of life get a
bunch of antibodies that are directly absorbed, along with the milk. These
antibodies are transferred from the mother to the puppy in order to protect
the puppy against diseases until the time when its immune system is fully
functional and it can produce its own antibodies. Unfortunately, the
maternal antibodies also destroy vaccine viruses -- so a puppy that has
strong maternal antibodies won't respond to a vaccination. This is the
reason that we give a series of vaccinations to puppies. It is hard to
determine in any individual puppy how much colustrum and maternal
antibodies it received. At six weeks of age, for distemper, about 25% of
puppies are susceptible to the virus and can be vaccinated. It is about 50
to 70% of puppies at nine weeks and approximately 100% at 12 weeks (100% of
puppies who can be vaccinated). If the entire series of vaccinations is not
given, a puppy may not be protected if it encounters the virus at 12 weeks
or older. There is also a short period of time when the virus simply is
stronger than the vaccine --- so a puppy getting vaccinated at three week
intervals may be exposed to the distemper virus during a time period when
it just doesn't have enough protection for the vaccine to work.Some people think that the solution to the "window of opportunity" for the
virus -- the time when it will cause disease even if a puppy has been
vaccinated --- is simply to vaccinate more frequently. The flaw in this
logic is that there are studies that demonstrate that vaccines for the same
virus administered closer to two weeks apart may interfere with each other
-- and lead to DECREASED immune response. Plus, no matter how frequently
vaccines are given there is a short time period when the puppy is not
protected. We choose a three week interval for vaccinations at our
practice, starting at six weeks, just because it seems like a reasonably
practical interval.We are currently using a recombinant vaccination that gives the benefits of
modified live vaccine (better immune response) while not using whole canine
distemper virus. So far, it seems to be working for us. In theory it should
eliminate the potential for distemper associated with vaccination. Most
(possibly all) of the vaccines on the market currently are modified live
vaccines. While killed vaccines seem like they may be safer, the experience
with cats and killed vaccines leading to increases in vaccine reactions
makes that questionable.The last possibility is that the puppy did not have distemper. Distemper is
hard to diagnose in a live patient (although sometimes it is possible to
get nearly certain test results). Without a necropsy (autopsy) exam, the
diagnosis may be a guess. If a necropsy was done and tissues examined by a
pathologist the diagnosis is a little more certain but most pathologists
are only willing to say that distemper was the most likely problem. Immune
system deficiencies can look a lot like distemper and some other disorders
can mimic it as well.There is no really good therapy for distemper. Affected puppies may live
with good supportive care but they die despite very good care, too. It is a
heartbreaking disease to treat due to this.So far, in twenty years of practice, I can't remember a case in which an
owner had a puppy we were convinced died of distemper and then got a second
puppy that developed it if they waited at least a few weeks before getting
another puppy.I hope this information helps. If I have missed a concern you have or you
need further clarification, let us know.Mike Richards, DVM
4/6/99
Q: Our family member, Jake (an alapso-apso-poo mix), who is 5 years old next month; has come down with Distemper. I took him to the vet for a cough about 4 weeks ago; the doc gave him a three injections and two prescriptions in which we gave Jake as instructed; but, even as the cough subsided, he started wheezing and breathing hard, his eyes had a lot of sleep and his nose became dry. So this trip to the doc diagnosed Distemper per say the CBC results. Now injecting Dexamethazone (3cc)ea. 24-hr. 2 days later, Chorea form set in his back leg and Doc gave him primidone(250mg); now Jake is totally bed-ridden; can't stand on his legs, pupils are wide; panting, erratic breathing, drinks pints of water at a time, last temp. 102.6; still alert-what more can be done? I will not give up-we love him very much. the doc said we'll be going a period of a month before he's out of the woods- What changes and in what order will Jake be going thru? Convulsions? Seizures? what do we do when it happens? What are the results of such extremes; and if he survives what (if any) sufferings will Jake be laidened with? Is there a sign of hope that he'll be okay (or is there a sign that we need to let him go?) My wife; will be totally lost without Jake. But then again, she doesn't want to see him suffer or in pain living this out. Please help-and thank you for being accessible on the web.
A: I really think that there are times when a second opinion is a almost always a good idea, even when the diagnosis and treatment seem proper for a given situation. When a dog is so ill that euthanasia is a consideration, this is one of those times. The symptoms certainly suggest distemper as a possible problem. It is treated mostly in a symptomatic manner -- medications are given to treat whatever effects occur, since it is not possible to give a medication to kill the virus at this time. It may be very beneficial to helping you decide how to handle the situation to get someone else who can examine your dog to give you a second opinion. I think it is better to try to get an opinion from an internal medicine specialist if possible in these cases -- they are the most likely to be current on the absolute latest treatment options. I wish I could do more than just suggest seeking a second opinion -- but I can't.
Mike Richards, DVM
Last edited 10/24/05
