Kennel cough and vets

An article from NBCMontana.com describes a kennel cough outbreak in dogs in Bozeman, Montana. It's a pretty basic article that outlines a rather typical presentation of kennel cough (now largely referred to as canine infectious respiratory disease complex - a respiratory infection that can be caused by a range of viruses, bacteria and Mycoplasma).

As part of the story, they state that if you have a sick dog, the "best course of action is to call your local veterinarian and get medication." I realize it's a quick statement, perhaps tossed in without much consideration, but there are some important issues to consider.

Should someone call a veterinarian and get medication, or should a veterinarian actually see the dog?

  • Sometimes dogs just need to be given time and rest. Viruses are often the cause of this condition, and it just takes time for the infection to resolve (just like person with a cold virus). If that's the case, a little over-the-phone veterinary advice might be fine. If drugs are needed, then the dog needs to go to a veterinarian. Affected dogs might need something to control cough, which need to be given by prescription, and occasionally antibiotics are needed, but in either case a veterinarian needs to see the dog first. If the dog is sick enough that it needs additional treatment above and beyond this, then of course it needs to be seen by a veterinarian.

Are there any problems with a dog like this going to the veterinarian?

  • Here's where the ball often gets dropped. The last thing we want to see is someone walking through the from door with a hacking, biohazardous dog who goes nose-to-nose with other dogs in the waiting room, breathes on half of the surfaces in the room, sits there for ten minutes while waiting for the appointment, and gets handled by every staff member before they realize the dog might be infectious. A situation like that can turn a veterinary clinic into a source of infection for many other dogs, and help an outbreak spread.

A very basic but well coordinated approach can greatly reduce the risk of dogs infecting other dogs in the clinic. These would include:

  • Not taking a biohazardous dog into the waiting room. The owner can call from the car upon arrival or come in without the dog to let the clinic know they're there.
  • The dog can be admitted directly into isolation or an exam room, thereby avoiding contact with other animals in the waiting room or elsewhere in the clinic.
  • Veterinarians and techs that are going to work with the dog can know in advance and come in prepared, wearing appropriate protective outerwear (e.g. gloves and a labcoat or gown that they use for only that appointment) to prevent contamination of their clothing or body.

Very easy to do. Probably very effective too, but often not done.

What not to do in a vet's office

TheNorthwestern.com has an interesting article about "10 things not to do with pets in a vet's waiting room." They're all good points, and I've put an infectious disease/infection control spin on them below:

1. Don’t fail to contain your cats. Even if your cat is the sweetest thing on record, some other animals may not agree. The last thing we want is to see in our lobbies is an altercation in which one animal dies. Cat carriers are cheap and widely available. Use them.

2. Don’t give dogs free reign.  Don’t use retractable leashes!

  • You wouldn't (hopefully) go into an emergency room and lick the face of the person puking in the corner or the kid hacking up a lung. Your pet's not as discriminating. Some pets are at the vet because they are sick. You don't want your pet to get what some other pet has. Also, not all dogs and cats are social, especially in a strange environment. You don't want to change your vaccination appointment to a "vaccinate and stitch up the big wound on my dog's face" appointment.

3. Don’t bring in animals you cannot personally control.

  • As above. Lack of control equals increased risk to other animals, your animal, and potentially other people.

4. Don’t do the puppy park meet-and-greet thing. The vet’s is not the dog park. It’s a strange environment in which pets don’t always act the way you expect them to. Moreover, in a veterinary hospital the onus is on the doctor’s staff to keep your dogs safe. Please keep all pets apart. After all, no matter how well you know your pet, can you honestly say you know someone else’s?

  • Same as above. More mixing and more contact equals a greater risk of disease transmission. That's acceptable in many situations where the risk of coming into contact with an infectious animal is low, but the odds are higher in a place where sick animals congregate.

6. Give the cell phone rest. In a place as potentially anxiety provoking as the vet hospital, cell phones can be a hazard. Even if you don’t feel the anxiety, your pet certainly does. She deserves the comfort of your undivided attention for her safety and her stress level.

  • Not really an infectious disease issue but it's annoying.

7. Don’t walk a dog into a packed waiting room. If the lobby is crammed wall to wall with pets, don’t chance it. Ask someone to let the receptionist know you’re waiting outside. Or use your cell phone for something really useful for once.

  • Good point. I'd take that a step further. Don't take a potentially infectious pet into a waiting room, packed or not. If you have an animal that might have an infectious disease (e.g. diarrhea, sudden onset of coughing and/or sneezing) it would be ideal to call when you arrive so they can take your pet right back to an exam room or isolation for examination. That way, if your pet is infectious, you won't expose other animals. We're trying to get more clinics to be proactive about doing this, and hopefully your clinic would mention it, but if they don't, feel free to bring it up yourself.

8. Don’t fail to tell the receptionist ahead of time if your pet is severely anxious or aggressive. All hospitals appreciate the warning when you make your appointment. It gives us a chance to offer you back-door alternatives or other concessions to your pet’s unique behavior issues.

  • Good point. "If your pet is severely anxious, aggressive or might have an infectious disease" would be better.

9. Don’t bring small children unless you can’t help it. A busy animal hospital is tough on small kids. They’re not old enough to benefit enough from the educational experience relative to their risk of getting hurt.

  • Sometimes you have to, but if you can avoid it, that's preferred. Vet clinics can be busy. There are a lot of animals around and it may be hard for a child to resist reaching out for another animal. I haven't seen any data on bites and scratches in waiting rooms, but they certainly occur. As well, if you are distracted by your child, you may not be able to tell your vet all the relevant information or ask all the questions you have.

10. Don’t be rude. Courtesy is king. Kill them with kindness. I shouldn’t have to offer so many versions of the same cliche, but the fact that they all exist is fine testament to their utility.

  • Again, not necessarily an infectious disease concern, but really being polite and considerate to those around you applies to just about any situation, and generally makes everyone feel better and makes things go smoother.