This wasn’t on my bingo card for 2023, but it looks like I need to comment on the use of Paxlovid in dogs with respiratory disease. I guess I shouldn’t be surprised, but there’s been a lot of buzz about a single report of a veterinarian using Paxlovid to treat one dog with respiratory disease – in the absence of any definitive diagnosis as to what was making the dog sick.

Some media reports are claiming Paxlovid cured the dog. Did it?

Probably not. I suspect the dog got better on its own despite Paxlovid (not because of it), but can’t say for sure. However, I can say that I don’t see any evidence that we should be using this drug in dogs, and I have a variety of concerns about its use in this manner.

Concerns about Paxlovid use in dogs (quick version)

Paxlovid is an antiviral that we know basically nothing about in dogs. We don’t have dosing or safety info in dogs, and we don’t have evidence that the respiratory disease we’re currently seeing in dogs in North America is caused by a virus that’s susceptible to Paxlovid. So, I don’t think its use is appropriate in such cases, and I suspect widespread use of Paxlovid in dogs would result in harming more dogs than it would help.

Concerns about Paxlovid use in dogs (longer version)

Using a human drug in a pet isn’t rare in veterinary medicine, and often it can be appropriate. Veterinarians often need to use drugs in an extra-label manner, since many important drugs are not licensed for use in animals. When we know how to use the drug, its safety and that it’s likely to work in an animal, this kind of extra-label use can be appropriate.

  • The less we know about things like dosing and safety in animals (which can be very different across species), the greater the risk.
  • The less we know about efficacy, the lower the value.

Treatment is typically a cost-benefit decision, based on assessing potential risks, potential unknowns and potential beneficial effects.

Paxlovid is a combination of two antiviral drugs, nirmatrelvir and ritonavir, which are both protease inhibitors, neither of which are used in dogs. The combination has been shown to be beneficial for treating COVID-19 in some types of people, in some circumstances, with the right timing. That’s based mainly on study of Paxlovid use in unvaccinated people. In Canada, it’s licensed for use in people with mild to moderate COVID-19 who are at increased risk of severe disease. It’s not meant for everyone, and it’s meant for early treatment. There are different opinions about whether it’s really of much use at this point in the pandemic, but I won’t get into that.

What do we know about Paxlovid in dogs?

Pretty much nothing. I’m not aware of any dosing or safety information.  The only thing I can find is a study that looked at Paxlovid in serum of different animal species, including dogs (i.e. they added the drug to serum in a tube, but they did not give the drug to the live animals) and did a pharmacokinetic study on just two healthy research dogs (Greenfield et al 2023). That’s a start, but the small number of dogs (2) means it still doesn’t tell us too much. The researchers reported some pretty major differences between species, including between dogs and people. They concluded that “Some species (rabbit,dog) demonstrated high plasma protein binding (PPB) that was concentration-dependent, whereas others (human, monkey, rat) did not. This can have a major impact on understanding concentration-effect relationships for both efficacy and safety endpoints. As such, it is important to consider PPB when selecting animal species for studies aimed towards understanding efficacy and safety in humans.

My take home message from that study is it can’t tell us anything about how/if we can and should use Paxlovid in dogs, and we can’t assume safety and efficacy data in people apply to dogs.

Sometimes we use the same doses in people and dogs for a specific drug, but sometimes, the doses are quite different.

Some drugs that are useful in people also work in dogs, but some drugs do not.

Some drugs that are relatively safe in humans are relatively safe in dogs, but some human drugs are highly toxic to dogs.

If we don’t know dosing and safety in a particular species, it’s really hard to consider use of a particular drug if there isn’t a huge potential upside, e.g. because we need to treat a severe disease and we have no other options, and where the drug has a strong chance of working. That’s not the case here with canine respiratory disease and Paxlovid.

Could Paxlovid work in dogs?

Paxlovid could have an impact on some viral causes of canine infectious respiratory disease complex (CIRDC), such as canine respiratory coronavirus (which is a completely different virus than SARS-CoV-2, despite the similarity in name). However, even IF Paxlovid has effects on canine respiratory coronavirus, or other relevant viruses, that may not really mean a lot clinically. It might shorten disease and/or might reduce the risk that secondary complications developing, but that would probably still be dependent on very early treatment, something that is not likely to happen in a lot of dogs when illness is still mild, particularly given the cost of Paxlovid.

Could use of Paxlovid in dogs hurt?

Absolutely. We have no idea if the drug is safe in dogs. There are various known side effects in people, and the drug interacts with a lot of other medications. If we’re going to apply a cliché, it should be “above all, do not harm” vs “it can’t hurt.” The latter is not likely true.

What about developing resistance to Paxlovid?

There’s probably very little risk of viral resistance to Paxlovid increasing due to use in dogs. The concern would mainly be about development of resistance in viruses that can affect people, since that’s where the drug is most often used and where resistance is most likely to have a significant impact. Dogs can be infected with SARS-CoV-2, but for resistance to be a risk, a dog would have to be infected with SARS-CoV-2 at the time it had respiratory disease (likely unrelated, since SARS-CoV-2 is unlikely to cause clinical respiratory disease in dogs based on what we know) AND resistance would have to develop while the dog was infected AND that resistant virus would have to be transmitted back to a person. Dogs seem to pose very limited risk for transmission of SARS-CoV-2 to humans, so it’s fair to assume that the health risks posed to humans from use of Paxlovid in dogs are very low to negligible.

However, we understand little about antivirals and antiviral resistance in animals, and the precautionary principle would have us remain pretty conservative with their use, and to only do so after a thorough risk assessment.

At this point, my assumption is that widespread use of Paxlovid in dogs would harm more dogs that it would help.

In contrast, there’s a different story about another COVID-19 drug in cats. We have some good data about the antiviral drug Remdesivir in terms of dosing, safety and efficacy for feline infectious peritonitis, which is otherwise a pretty much invariably fatal disease. This is a drug we should be using in cats, but we still can’t get (legal) access to it in North America. We’re working on that, so it will probably be the topic of a post in the near future. Good or bad news? I don’t know yet.


I’ve held off writing about this but since I’ve been answering many emails about it every day, here we go.

The questions I keep getting (as usual) are “What’s going on with this reported outbreak of respiratory disease in dogs in the US? What new disease is this?”

I’m not sure there’s a new disease here. I’m not even sure there’s a major outbreak (or any outbreak).

Various groups in different areas of the US are reporting cases of respiratory disease in dogs (which we refer to as canine infectious respiratory disease complex, or CIRDC) in dogs in various parts of the US. There’s always limited info about true numbers, and the disease description is vague and quite familiar (coughing dogs, some that get pneumonia, a few that die).

The issue is, that largely describes the every day status quo when it comes to CIRDC. This syndrome is endemic in dogs and has a variety of known causes (e.g. canine parainfluenza virus, Bordetella bronchiseptica, canine respiratory coronavirus, canine pneumovirus, canine influenza virus, Streptococcus zooepidemicus… roughly in that order of occurrence, and maybe the enigmatic Mycoplasma as well). There are also presumably a range of other viruses involved that have been present for a long time but that we don’t diagnose.

We see CIRDC all the time, anywhere there are dogs. There’s a background level of disease that usually flies under the radar, alongside periodic clusters of cases. I get lots of emails every week asking whether there’s more or more severe CIRDC activity at the moment, but I’ve been getting those reports for years, from across North America. To me, that reflects the fact that CIRDC is always circulating, but we notice it more at certain times than others, either because of local clusters or, increasingly, local increases in awareness, often due to media coverage. Media and social media can drive outbreak concerns. They can be great to get the word out and help sort out issues, but often, they lead to false alarms.

  • For example, we might have 100 dogs with CIRDC every week in Guelph (a complete guess since we have no way to track this). Usually, only a few people hear about it. The dogs typically get better and life goes on. However, if someone starts talking about it on social media, we might hear about 50 of those 100 cases. All of a sudden, we have an “outbreak of a disease affecting dozens of dogs” when in reality, we might just have our normal background level of disease that people are actually noticing.

The same thing can happen on a larger scale. There are thousands of coughing dogs in the US every day, since there are millions of dogs. Once people start talking about it, some of these go from “Oh, my dog is coughing. I guess he picked up something at the park. Whatever.” to “OMG, my dog has this new disease that’s sweeping the nation, I need to tell someone!” With the first approach, no one but the owner usually knows or cares. Once we hit the panic button, many owners start to tell everyone about it.

We don’t have any idea if the current stories reflect:

  • A multistate outbreak caused by some new bacterium/virus
  • A multistate outbreak caused by our usual suspects, for some reason
  • Unconnected sporadic local outbreaks caused by usual suspects
  • A slight increase in baseline disease
  • Our normal disease activity with an outbreak of media attention.

I suspect it’s one of the last two. My perception is that we have been seeing a bit more CIRDC activity over the past couple of years, and that we are now seeing a somewhat greater incidence of severe cases. However, with more cases, we see more severe disease, so those are linked. Also, with the explosion of breeds like French bulldogs that are much more likely to have severe outcomes from any respiratory disease (since a large percentage of them have been bred to have completely dysfunction respiratory tracts), increases in deaths could be linked to dog factors, not disease factors.

I never outright discount reports of something potentially new, and we continue to try (futilely so far) to get a better handle on what’s happening with regard to CIRDC activity in different areas. It’s tough, since there’s no effective surveillance system, the voluntary reporting that we’ve tried tends not to get much buy-in (understandably knowing veterinary clinics are swamped by other priorities), testing of sick dogs is expensive and rarely impacts how we care for an individual animal (great for surveillance but harder to justify the cost to an individual owner), and we have little to no funding to do much with companion animal infectious diseases at all.

My guess is this is simply an outbreak of media attention piggybacked on a somewhat increased rate of CIRDC cases that we’ve seen over the past year.

I might be wrong, which is why we’re still trying to collect more data, but I don’t currently see a reason for extra concern.

If you’re worried about canine respiratory disease:

  • Limit your dog’s contacts, especially transient contacts with dogs of unknown health status
  • Keep your dog away from sick dogs
  • If your dog is sick, keep it away from other dogs
  • Talk to your veterinarian about vaccination against canine parainfluenza virus (CPIV) and Bordetella bronchiseptica (plus canine influenza, but influenza is much more sporadic (especially in Canada) and vaccine availability is still an issue).

And, at risk of a flurry of emails, I’ll add… consider health when choosing a dog. That doesn’t mean no Frenchies, but get one that looks like they used to – one with a nose, not the current popular version of the breed.

For the past year or more, we’ve been trying to track infectious upper respiratory tract disease (officially known as “canine infectious respiratory disease complex (CIRDC)” but more commonly called “kennel cough”). It’s a tough thing to do since testing is limited, the disease is always present to some degree in the dog population, and there’s no formal reporting system. Enquiries about CIRDC in different areas seem to fill my inbox in waves, but that’s probably more related to reporting (especially social media rumours) vs actual frequency of illness. This week’s been busy so far  with a dozen or so emails asking about things like “new” respiratory diseases, or specific things like canine influenza (and it’s only Monday…).

We’re still not sure what’s going on. It does seem like there’s increased CIRDC activity over a lot of North America right now, and it’s been going on to some degree for quite a while. When we think about increases in respiratory disease reports, there are a few  potential causes (as I have mentioned many times before):

Increased disease caused by the usual suspects

  • This is my main guess at this point for what’s currently going on. Common things occur commonly, and that’s particularly true for the variety of bacteria and viruses that cause CIRDC in dogs.
  • A few potential reasons for the increased disease from these pathogens can be postulated. One is there’s more dogs mixing with each other now as people start to increase activity and get together post-lockdowns, and as people prioritize safer outdoor activities (often with their dogs). Combine that with a surge in new dogs and potentially decreased vaccination (due in part to overloaded veterinary clinics and access difficulties from earlier restrictions), and it’s easy to see how we might have more disease.
  • Another potential dynamic is increased use of oral “kennel cough” vaccines, as they are easier to administer to some dogs compared to intranasal vaccines. The problem is oral vaccines only protect against one cause of CIRDC (Bordetella bronchiseptica) while intranasal vaccines protect against Bordetella and canine parainfluenza virus (CPIV). That’s important because CPIV is the most commonly diagnosed cause of CIRDC in many areas.

Increased disease caused by a new pathogen

  • We’re always on the lookout for something new, but nothing is apparent yet. With a new virus, we’d be more likely to see widespread transmission in exposed groups, since no dogs would have any immunity. We’re not really seeing that. The cases being reported are more sporadic, as we’d expect with our typical causes of CIRDC. However, we can’t rule out a new pathogen completely, and there are undoubtedly various causes of CIRDC (mainly viral) that we simply haven’t identified yet.  I don’t think it’s the explanation for the current situation, though.

Increased reporting of disease

  • This is probably part of what we’re seeing. There’s more social media use these days so word spreads quickly. One voice can be amplified disproportionately and unsubstantiated claims can be disseminated easily. Further, it feeds on itself. When there’s more buzz about sick dogs, more people that otherwise wouldn’t have said anything chime in. So, we probably hear about a greater percentage of sick dogs simply because people are talking about them when they otherwise wouldn’t have.
  • Also, as more people are at home with their dogs, we probably hear more about the typical mild cases of CIRDC, because owners pay more attention when the dog is coughing beside them all day.

What about SARS-CoV-2?

  • SARS-CoV-2 is very unlikely to be playing a role. We can never say never, since the COVID-19 pandemic is a dynamic situation and we don’t know much about recent variants in animals. However, what we know so far is that infection of dogs and cats with SARS-CoV-2 is quite common, but disease is uncommon in cats and rare in dogs.

What about canine influenza?

  • Canine flu certainly can cause large outbreaks of respiratory disease in dogs. It spreads quickly because of limited immunity in the dog population. There has been some canine flu activity in a couple places in the US in the past few months, but these seem to have burned out (or at least burned down) relatively quickly.
  • There have been social media reports of canine flu outbreaks in Ontario. As far as I know, that’s false. Canine flu is reportable in Ontario, and no such reports have been received from any lab. We haven’t seen canine flu in Ontario since we eradicated it in 2018. I’m always on the lookout for it, but I’m most concerned about flu when there’s an outbreak that has a very high attack rate, including dogs that have had intranasal kennel cough vaccine. We’re still looking but I doubt canine flu is playing a role currently.

What can people who are worried about their dogs do?

  • Reduce contacts with large numbers of unknown dogs. Just like with other respiratory pathogens, the more contacts, the greater the risk of encountering someone that’s infectious.
  • Reduce contact with sick dogs. This can be harder but it’s common sense: if a dog looks sick (e.g. coughing, runny nose, runny eyes), keep your dog away from it.
  • Keep sick dogs at home. (Duh… but you’d be surprised.)
  • Avoid things like communal water bowls in parks that are shared by multiple dogs.
  • Get your dog vaccinated (ideally intranasally) against kennel cough if it tends to encounter other dogs regularly. My dog doesn’t get this routinely since we live in the country and he has a very limited number of other dogs with which he interacts. If I was in town and/or going to dog parks or other places where he’d mix with lots of dogs of unknown status, I’d vaccinate him (especially as he’s getting older now).
  • Consider testing your dog if your dog gets sick. Testing is useful to help figure out what’s going on and maybe to help control things. However, it rarely tells us something that influences care for the individual dog (since we don’t have specific treatments). So, the cost of testing is (understandably) hard to justify for some.

We’re also still tracking cases so people with sick dogs can provide information by filling out our quick survey here:

When we talk about vaccines of dogs*, we tend to split them into “core” and “non-core” vaccines.

(*The same applies to cats. I use dogs by default for posts like this, which sometimes gets me an earful, but I’m not actually ignoring cats.)

Core vaccines are those that every animal should get (e.g. rabies vaccine in areas where rabies exists, canine parvovirus in areas where dogs exist). Non-core vaccines are those that aren’t required by every dog, or that are less convincingly needed in every case.

Non-core vaccines are also often referred to as “lifestyle vaccines,” because the nature of the dog’s (or cat’s) lifestyle can put the animal at more or less risk of exposure to a disease, which affects the relative need for vaccination. Respiratory diseases are a great example. All dogs are at some degree of risk, but the risk is much higher in dogs whose lifestyles create more dog-dog contact (e.g. going to daycare, boarding, off-leash dog parks). That’s a good way to think about how to prioritize vaccination for an individual dog, but it misses a big part of the disease prevention equation.

When I’m assessing the need for vaccination in a pet, I think about two main things:

  1. Risk of exposure. The lifestyle aspect covers this.
  2. Risk of serious disease. This often gets ignored.

Some dogs are at higher risk of severe disease or death from respiratory infections. I’d put senior dogs, brachycephalics (i.e. flat-faced breeds), pregnant dogs, dogs with pre-existing heart or lung disease and dogs with compromised immune systems on that list. I’m more motivated to protect them because the implications of infection are higher, even if their risk of exposure may be fairly low.

Take my two dogs as an example (again):

Ozzie is 1.5 years old and healthy. If he gets a respiratory infection, most likely he’ll have transient disease and, while it will be annoying (for him and us) and I’d like to prevent it, odds are quite low he’ll suffer any serious consequences.

In contrast, Merlin is an 11 year old dog with chronic lymphoid leukemia who’s been getting chemotherapy for about 2 years. He’s doing really well, but he has a significant chronic disease and he’s old. If he gets a respiratory infection he’s at much greater risk of dying than Ozzie.

If we look at lifestyle of these two dogs, they’re similar, since they do everything together. The exception is in the summer when we go to a cottage for 2 weeks. Since 2 weeks with Ozzie at a cottage isn’t much of a vacation for us or Merlin, he went to a local day care for part of the time. (An exhausted Ozzie is a good Ozzie, and he often came home close to comatose, which was perfect.) So Ozzie has a major additional lifestyle risk factor, therefore he’ll get a respiratory vaccine again this summer (both because of the risk and because the day care requires it).

Merlin doesn’t have that same direct exposure risk, but he has some added risk through being exposed to Ozzie. Should he get a respiratory vaccine? If we just look at his lifestyle, we’d say no, he’s pretty low risk for exposure. However, his higher risk for severe disease increases my motivation to vaccinate him, and he’ll likely get a respiratory vaccine this summer at the same time Ozzie does.

Lifestyle is definitely important to consider, but we need to make sure we don’t just focus on the dog’s lifestyle and consider the dog (or cat) as a whole.

As awareness of canine infectious respiratory disease complex (CIRDC, formerly known as “kennel cough”) has spiked recently, there are more discussions happening about respiratory vaccines in dogs. A large number of different bacteria and viruses play a role in CIRDC. We can vaccinate against a few of them including parainfluenza virus (the most commonly diagnosed contributor to CIRDC), the bacterium Bordetella bronchiseptica (typically number 2 or 3 on the list of diagnosed contributors), canine adenovirus (pretty uncommon) and canine influenza (very sporadic).

We also have different ways to vaccinate dogs, specifically use of injectable versus mucosal (oral or intranasal) vaccines.

  • Injectable vaccines tend to induce a better systemic antibody responses. Mucosal vaccines provide a better local immune response at the mucosal surface. For respiratory infections, the local immune response is probably the most effective. There’s reasonable evidence that mucosal vaccines are superior to injectable vaccines for Bordetella. We don’t have good data for parainfluenza, but I’d assume the same applies. (We only have injectable influenza vaccines for dogs.)
  • Mucosal vaccines are modified live organisms – versions of Bordetella and parainfluenza that are still alive (i.e. functional) but have been attenuated so that while they can elicit an immune response, there is negligible risk of causing disease in the animal. We never say a modified live vaccine (MLV) is 100% guaranteed not to cause disease, but the risk is really low, and the protection is really good, so overall they’re beneficial for vaccination in “normal” animals. However, we tend to avoid MLVs in immunocompromised animals because low virulence organisms might be more likely to cause disease in an individual with a compromised immune system.

That’s the dog side. But, we have to remember that each dog is attached to one or more people too. When we vaccinate a dog with a mucosal vaccine, it sheds the modified bacterium/virus for a while, and might have a large load of the vaccine strain in their nose or mouth right after the initial administration.

That means people can be exposed to the vaccine strains as well. Generally, that’s not a big deal, and it’s really only a potential issue for Bordetella (because canine parainfluenza and canine adenovirus of any form don’t infect people). I get asked about this a lot, by both veterinarians and pet owners, and I write a similar post to this one every few years, but each time we have a bit more data.

Why is there concern about human exposure to Bordetella in canine vaccines?

  • Bordetella bronchiseptica can cause infections in people. They are rare, but they occur. So, if the “normal” Bordetella bronchiseptica can cause disease in people, we have to think about whether the vaccine strains can cause disease too.
  • The answer is “yes,” with a big “but” (actually, a series of “buts”).

Yes, there have been a couple of reports of human infections with canine vaccine-strain Bordetella, some of which are more convincing that others.

A recent report (Kraai et al. 2023) described vaccine-strain Bordetella bronchiseptica infection in a 43-year-old woman who was taking immunosuppressive medication.

  • She developed bronchitis with malaise and a mild fever two weeks after her dog had received an intranasal vaccine.
  • Bordetella bronchiseptica was isolated from her sputum. When it’s gene sequence was assessed, it was consistent with the vaccine strain.
  • She had mild disease and responded to antimicrobial treatment.

Clearly there is some risk with human exposure, that’s certain. Some groups have said to avoid MLVs in animals living with immunocompromised people. But let’s thing about that critically for a moment. All vaccination decisions require consideration of the costs (risks) versus benefits:

  • The risk to humans from canine vaccines is really low. Millions of doses of mucosal vaccines are given to dogs every year, yet human infections are still extremely rare.
  • Disease that has been reported in people who do get sick is mild.
  • Mucosal vaccination is superior to parenteral vaccination, and prevention of disease in dogs can also reduce the risk of exposure to the “wild type” (non-attenuated) strains of Bordetella in humans.

Broad “don’t use modified live vaccines in animals owned by high risk people” statements overlook a few big-picture issues:

  • The big one is the vaccine strain is much less likely to cause disease than the circulating (non-attenuated, disease causing) strains. A person is much more likely to be infected with the Bordetella from a naturally infected dog than from a vaccinated dog, so I’d rather prevent the dog from getting infected by vaccinating with the most effective method available.
  • Natural Bordetella infection (unlike vaccination) also tends to make the dog cough, which increases human exposure to any number of bugs in the dog’s respiratory tract.
  • If that dog needs treatment with antimicrobials, we run the risk of the person being exposed to antimicrobial resistant bacteria, some of which can pose additional risks to people.
  • Antimicrobials also increase the risk of the dog developing diarrhea, which can greatly increase human exposure to disease-causing bacteria in feces (especially if the dog poops on the floor).

Some more food for thought:

If I have a dog that was recently vaccinated with a mucosal vaccine, and I was asked to rank the top 5 zoonotic pathogens that are in the dog, vaccine-strain Bordetella wouldn’t even crack that list. There’s a mix of potentially disease-causing bacteria in every dog, all the time. Getting tunnel vision about one in particular, especially one that’s really quite low risk, is not helpful.

What about killed, injectable Bordetella vaccines?

Injectable killed Bordetella vaccines (which contain no live organisms, as the name suggested) do work, they just don’t work as well. If there’s significant concern from the owner, or some other unusual circumstance that makes use of a mucosal vaccine undesirable, then by all means, use an injectable vaccine. I’d consider that to be a rare situation.

Also bear in mind that killed “kennel cough” vaccines are just for Bordetella. They don’t include anything for parainfluenza virus, the most common cause of CIRDC. Parainfluenza is part of common combination “core” vaccines (e.g. DA2PP), but those vaccines don’t do a great job of protecting against paraflu. So, while an injectable Bordetella vaccine removes the risk of exposure to vaccine-strain Bordetella, it offers less protection against Bordetella and none against paraflu, so we have greater risk of disease in the dog overall, and the implications described above that come with it.

Let’s be clear: There’s never a zero risk situation when it comes to exposure to infectious bugs (from vaccination or pet ownership in general). We have to consider the risks and benefits in every situation.

But, almost always, for high risk households, I support vaccination whenever the dog’s lifestyle and risk factors indicate that Bordetella vaccination is warranted. I’d stick with mucosal vaccines for respiratory diseases whenever possible, since they provide much better protection and we can easily mitigate the very low risk from the vaccine. Those mitigation measures include:

  • Keeping the owner outside of the exam room when the dog is vaccinated.
  • Wiping the dog’s nose/mouth after vaccination to remove any major external contamination.
  • Recommending that the owner avoid direct contact with the dog’s oral and nasal secretions. That’s particularly important for the first 24 hours after vaccination, but it’s something I’d recommend for a high risk owner to always avoid.
  • Being diligent about routine hygiene practices (e.g. handwashing), especially after contact with the dog’s face (again, something that’s actually always important for a high risk owner).

Photo credit: Dr. Kate Armstrong (from Weese & Evason, Infectious Diseases of the Dog and Cat, A Color Handbook)

This may be my last update on this topic in the short term (unless things change, of course).

The good news:

The bad news:

  • Well, it’s not really bad news, but we still don’t know what actually happened. That’s far from surprising, because with waxing and waning endemic disease conditions like CIRDC, we rarely have a clear picture of what happened and why.
  • Everything for me continues to point to a gradual increase in the rate of infectious respiratory disease in dogs over the past couple of years, with the usual intermittent local and regional peaks and valleys. This year’s issues were probably somewhat higher peaks overlaid on a higher baseline, making the issue more obvious and drawing more attention.

What was the cause of the increased cases of CIRDC?

I’m sticking to “the usual suspects, doing their usual thing, just at higher rates.” There’s been a lot of investigation looking for new pathogens and, as far as I know, nothing convincing has come to light. Given the number and quality of the research groups that have been looking, it’s pretty convincing that we don’t have a specific new pathogen that’s caused an outbreak of disease in dogs across North America.

What do we do now?

As with any outbreak, we try to learn some things from the experience:

1. Surveillance

This situation was a reminder that we don’t have a good surveillance system in place for CIRDC (or most other companion animal diseases). There’s no easy fix for that, especially with no money, so we need to continue to try to leverage the information that is available to better understand disease patterns. We need to do that on an ongoing basis, not just when there’s concern about increased cases, because when we’re concerned about an outbreak, we need to know the normal rates of disease to put things into context.

2. Vaccination

While we only have vaccines for a few of the important causes of CIRDC (Bordatella, parainfluenza, influenza), they are good vaccines, and we need to optimize their use in dogs that have a reasonable risk of exposure and/or a higher risk for severe disease.

3. Thinking about severe disease

The risk of severe disease in some dogs during outbreaks doesn’t get as much attention as it should; hopefully we’re changing that. In most dogs, CIRDC is a short term, self-limiting problem that’s fairly mild, just like upper respiratory infections in people. However, some dogs get really sick, and some even die. We can’t predict every dog that will have a severe outcome, but we know that there are groups that are at higher risk, particularly older dogs, dogs with pre-existing heart or lung disease, and brachycephalic dogs (i.e. flat-faced breeds). We need to think about minimizing exposure and maximizing vaccine coverage in these groups.

We also need to get people thinking about function over appearance in dogs they are breeding and buying. There is currently a disturbingly high number of anatomically disastrous dogs out there, because people have bred reasonably-functional brachycephalic breeds into extremely flat-faced dysfunctional dogs that have myriad respiratory issues, even without infectious diseases to complicate the situation (see the pictures below). As the French bulldog has shot to the top of the list of the most common breeds in the US, we’re going to see more dogs die from respiratory disease. Not all Frenchies are a mess, but there are enough of them that we see infectious and non-infectious complications in them all the time.

The recent situation with CIRDC also might get people thinking more about their dogs’ social networks and risks, and how to minimize those while having limited impacts on important or enjoyable aspects of dog ownership. We’ll be doing some work on dog social networks later this year, so stay tuned.

Image from: https://pedigreedogsexposed.blogspot.com/2017/08/the-frenchies-that-win-by-nose.html


There’s still not really a lot to report with the current canine infectious respiratory disease situation in North America, which is probably good news. As ever, we’re largely flying blind because we have no coordinated surveillance for canine infectious respiratory disease, so we’re try to figure out as much as we can through a variety of sources.

Current status:

The hype is dying down. We’re seeing a far fewer reports of disease in dogs, and I’m getting fewer calls from veterinarians. The question is whether that’s because there’s less disease, or because people have gotten bored with reporting or have simply adapted to the current situation. The news cycle is pretty short, as are attention spans, so in the absence of fairly dramatic changes, social media and traditional media usually move on fairly quickly. My somewhat educated guess is that we still have an elevated baseline level of canine infectious respiratory disease complex (CIRDC)(which has been gradually increasing over the last couple of years), and some local outbreaks (as we always have), and decreasing rates of CIRDC in places that reported higher numbers this past fall. Those are all things we expect with the normal waxing and waning of endemic disease.

Where is this disease present?

CIRDC is everywhere, as always.

I get a bit annoyed seeing reports about “the disease” being present or absent in a particular area or those that try to give it a new name like “atypical CIRDC.” Canine infectious respiratory disease has been around as long as dogs have been around. Various respiratory viruses and bacteria are circulating in the dog population all the time, everywhere. When people ask “is it here?!” they’re really referring to an increase in CIRDC (or an increase in awareness of it), not introduction of some specific pathogen. Maps showing where the disease “is” cause confusion, and they’re purely made up.

Increased rates of disease absolutely occur in different areas at different time. When that happens, sometimes it’s missed, sometimes it’s high profile. Almost invariably, rates come down again after a few weeks, as things revert to normal.

Is there a new “mystery virus” causing disease in dogs?

Many good laboratories are doing deep sequencing to look for any new pathogens. The longer we go without anyone reporting something potentially relevant, the less likely it is that something new is involved. It’s possible that (but would be really disappointing if) a laboratory has found something they’re not reporting, but given the number of laboratories that are working on this, if there was a widespread new virus, I’m pretty sure we’d know by now.

My theory is still that the increase in CIRDC is being caused by our regular respiratory pathogens (e.g. canine parainfluenza virus, Bordetella bronchiseptica, canine respiratory coronavirus, canine pneumovirus, Mycoplasma) doing their regular things, just at higher levels in some areas.

What about that weird Mycoplasma-like bug from the laboratory in New Hampshire?

Not much new has been reported on this finding either. It’s good that they’re still working on it, but we’re not hearing similar reports from other laboratories, so it’s probably not a key player. If this bug is a cause of disease in dogs, I’d guess it’s something that’s been a cause of disease all along, but we just didn’t know about it, versus it being a new organism that’s emerged and is spreading in the dog population.

Do our “kennel cough” vaccines still work?

Yes (and no). We have good mucosal (i.e. intranasal, oral) vaccines for some respiratory pathogens in dogs that work quite well. The problem is that they don’t work against all causes of canine infectious respiratory disease. We have vaccines that will cover one or more of Bordetella, canine parainfluenza virus and adenovirus; while they don’t protect against other pathogens, protection against those three is important (especially the first two).

We also have a vaccine against canine H3N2 influenza virus. It’s been in short supply because of production issues over the past couple of years. Canine flu is a sporadic (but locally dramatic) cause of disease in dogs in the US. Like any flu vaccine, the canine flu vaccines are moderately effective and best for prevention of severe disease (versus prevention of infection), and are lower on my priority list for the average dog.

What do we do now?

  • Dog owners should relax. Think about your dog’s exposure risk and susceptibility to severe disease, and make some modifications to their routine if indicated. Talk to your veterinarian about respiratory disease vaccines. And did I mention relax?
  • As for me – Wait. Watch. Continue to collect as much data as we can. Continue to try to walk the fine line between increasing peoples’ awareness of CIRDC and avoiding paranoia/panic.

Why don’t we have a good canine disease surveillance system?

Money, specifically lack thereof. That’s not the whole issue but it’s a lot of it. The broader issues include:

  • Animal disease control and regulation has historically been developed for food animals. Animal health is usually under the purview of agriculture or food safety agencies. So, there is often little or no mandate to cover companion animals, and less expertise. There are often inadequate resources to cover core mandates with livestock species, let alone something peripheral like dogs. It’s not that these groups aren’t interested, it’s mainly that they don’t have the time, staffing or mandate to do much.
  • Limited veterinary infectious disease expertise. The veterinary infectious disease world is pretty small. There aren’t many of us and we have a finite degree of bandwidth.
  • Testing for CIRDC is scattered amongst various private, academic and government laboratories. Those system aren’t currently able to communicate effectively, and there are often various barriers to data sharing.  For effective surveillance, we need a coordinated, real-time system with integration of data across these sources. That’s probably a long way away.
  • There’s very little funding for companion animal infectious diseases, both for surveillance systems and targeted research. I think we get a lot of bang-for-buck with the limited money that flows to the area, but it’s really hard to get any money to investigate things like this. That means we don’t get the data we need and we don’t train more experts in the area.
  • Detailed study of disease situations like this requires collaboration with primary care veterinary clinics. That’s really tough because of the workload that they currently have – they’re swamped. Adding more work (usually unfunded) isn’t something for which most clinics are up, at least on a long-term basis. We can get little targeted studies done with some clinics, but it’s hard to do the broad work that’s needed with financial and IT support to make it viable over time.  

Am I optimistic or pessimistic for where we’ll be with CIRDC heading into 2024?

I’m fairly optimistic. I’ve felt this situation was overblown from the start, with some real disease issues over-amplified by media and social media. I’m not dismissing the real impacts in some areas and on some dogs, but I’ve never been convinced that we have a massive, broad outbreak. There have been real impacts, real concerns, as well as excessive fear, and there’s been a lot of good work done trying to sort this out. Increasing awareness about CIRDC in dogs and disease prevention is always good. As we head into 2024, hopefully we’ll see a continued die-down in reports of (and actual) disease, and improvements in infection prevention.


Spoiler alert: there’s not a lot new to say about the ongoing situation with canine infectious respiratory disease in North America. Most of this I’ve said before. Talk seems to be dying down in a lot of areas, but whether that’s because there are fewer cases or people are just getting bored of talking about it is unclear. It’s probably a combination of both. Based on some data I posted last week and talking to people on the ground in different regions, it seems like most areas that have had a (real or perceived) increase in canine infectious respiratory disease complex (CIRDC) cases are returning back to baseline. Presumably, there are some other areas where disease is ramping up, as usual. However, there are still a few questions worth bearing in mind at this stage:

Is this really an outbreak?

I’d say it’s not so much an “outbreak” as a gradual increase in the incidence of CIRDC over the past couple of years, with typical periodic spikes of disease superimposed over top of it. We have fairly clear evidence of more cases in some areas, usually following the typical outbreak pattern where cases go up, then return back to baseline levels. We also have areas where there’s really nothing too different happening.

Is there a “mystery virus” causing the increase in cases?
This is commonly reported in news headlines, but there’s no evidence of that. There’s a lot of viromics work underway, where they sequence any and all viral bits present in a sample to look for anything new. Since nothing has been found (or at least reported) thus far, it’s becoming less and less likely that there’s a new virus causing any substantial number of cases. I’d also expect a bit of a different disease pattern with a new, highly transmissible virus. More time and more testing will provide more details but at this point, I don’t think we have a reasonable suspicion of a new pathogen.

What about that strange little bacterium reported by the lab in New Hampshire?

This bug needs to be investigated more, but it’s not looking like a leading candidate at this point. It hasn’t been found to be a potential important cause of respiratory disease elsewhere (although I’ve only heard of one place that’s said they’ve looked and failed to find it). We need to learn more about this bacterium, but I’d guess that it’s either just part of the normal bacterial microbiota in dogs or it’s a potential cause of disease that’s been around for a long time, we just didn’t know (and therefore didn’t test for it). I doubt it’s a new bug that’s just recently emerged and spread in dogs in North America.

Are the reported cases of CIRCD more severe?

I don’t think so. Concerns about severe disease in dogs are probably more of a media effect. With typical CIRDC, we expect a small percentage of dogs to get pneumonia, and an even smaller percentage to have serious disease and die. That’s always been the case. When the number of dogs with CIRDC goes up, the number of dogs with severe disease will go up proportionately. So, we’d expect to see more cases of severe disease when we have an more cases during outbreaks, not because the disease itself is more severe, but simply because there’s more overall illness. If we have 100 dogs with CIRDC, we’d expect maybe 1-2 severe cases. If we have 1000 dogs with CIRDC, our severe case numbers jump to 10-20, even if the disease itself is no different.

What about treating dogs with CIRDC with Paxlovid?

Ugh. Horrible headline writing has driven requests to use this drug in dogs with CIRDC.

Please don’t.

We have inadequate dosing data and little understanding of safety for Paxlovid in dogs, and no evidence that its use is necessary (or effective) in any of these cases

What about treating dogs with CIRDC with chloramphenicol?

UGH X2. Chloramphenicol is an antibiotic. It’s a great drug, but (as for all antimicrobials) should only be used when it’s really needed. This drug has fairly important animal and human health risks (even just handling the drug), so we should not be using it routinely; however, if I have a multidrug-resistant bacterial infection in an animal, and chloramphenicol appears to be the best option to treat it, I’ll use it. Standard treatments still apply for routine cases of CIRDC. If we start using Paxlovid and chloramphenicol routinely (be it out of fear, panic or just the desire to do “something”), I have little doubt that we’ll harm more dogs than we’ll help.

Is “kennel cough” vaccination in dogs worthwhile?

Yes. We have good vaccines against canine parainfluenza virus and Bordetella bronchiseptica, two important causes of respiratory disease in dogs. Protection is much better with “mucosal” vaccines that are given directly into the nose or mouth, so that’s the kind we want to use routinely for these pathogens. The vaccines won’t protect against all types of infectious respiratory disease, but reducing the risk of some major ones is still very helpful. Intranasal and oral vaccines are given once, then re-dosed annually. There’s currently nothing indicating we should re-vaccinate dogs more frequently than this.

Are some dogs at increased risk of infection with respiratory pathogens?

Risk of infection depends heavily on risk of (and amount of) exposure. Dogs that encounter a lot of other dogs, especially transient groups of dogs of unknown health status, are at increased risk of pathogen exposure. The more dogs encountered, the closer and more prolonged the contact, and the less certain the health status of the dogs involved, the greater the risk.

Reducing the overall number of dog contacts, particularly contacts with groups of dogs of unknown health status (e.g. random groups of dogs at an off-leash park, versus a small consistent group of known dogs at a day care or play group) is an important control measure.

Are some dogs at increased risk of severe respiratory disease?

Generally yes. We know there are some dogs that have a greater risk of severe respiratory disease or death if they get infected, so we want to be extra cautious with them, including avoiding exposure, vaccination and getting them to a veterinarian sooner if the dog gets sick. High-risk dogs include older dogs, very young puppies, dogs with pre-existing heart or lung disease, dogs with compromised immune systems, and brachycephalic breeds (i.e. flat-faced breeds like bulldogs).

Why might CIRDC rates be increasing?

It’s just a guess, but we could have a pandemic-associated confluence of factors that have led to more dogs with greater susceptibility to respiratory infection.

Changes in how we have interacted over the past few years, and how often dogs go to kennels or daycare (which is often the trigger for getting a kennel cough vaccine) could plausibly have reduced overall vaccination coverage in the dog population. Also, if fewer dogs were exposed to respiratory viruses over the past few years, there may be more dogs that are susceptible to them now. I try to stay away from the “immunity debt” discussion, since that’s more political than scientific, and it’s triggering for some people (my inbox is a testament to that). Nonetheless it’s quite logical that less immune protection from less vaccination and less infection over the past couple years could mean more susceptible dogs. It’s not “debt,” it’s just deferred exposure.

From a severe disease standpoint, changes in the popularity of different dog types could be playing a role too. The French bulldog, a higher risk breed, is now the most popular dog in the US. That’s plausibly going to increase the number of cases of severe disease just based on numbers.

What should the average dog owner do?

  • Breathe. This is not a doggie plague sweeping across the nation.
  • Consider your dog’s risk of exposure and whether you can do things to reduce it, while not being unnecessarily disruptive to life in general (e.g. if your dog needs to go to day care for you to work, send your dog to day care).
  • Consider your dog’s risk of severe disease when deciding whether to change your behaviours and how much to change.
  • Talk to your veterinarian about respiratory disease vaccines.

In situations like the ongoing concern with canine infectious respiratory disease complex (CIRDC) in the US, where we don’t have any semblance of a surveillance program, we can sometimes try to piece together the picture using different data sets and observations; insurance claims can be a valuable part of this. At our webinar on canine respiratory illness earlier this week, we were able to present some preliminary data based on pet insurance claims through Trupanion. The data are biased, since insured dogs are only a small subset of the whole dog population, but they can still be informative (especially when we don’t have much else on which to go).

The full video of the webinar, along with some other resources, is available on the Trupanion website, but I’ll give a snapshot of the of the data we presented. We’re working on more and hopefully will be able to piece together a more complete story with more data over time.

Here are few interesting slides from the webinar:

This graph shows respiratory disease claims from January 2021 to October 2023:

  • We’ve had a gradual but pretty impressive increase in respiratory disease claims over the past 2 years. Note that these data are adjusted for changes in insurance patterns, such as increasing numbers of dogs with insurance policies. This fits with my general observation from this time period that we’ve been seeing more disease, but not a sudden dramatic boom.
  • We see general ups and downs.
  • We’re at a high point now, consistent with recent concerns.

The map below is important. It shows states and provinces where there’s been an increase in respiratory disease claims year-over-year from August to October in 2022 vs 2023:

  • High rates of claims were/are present in some areas where there’s been a lot of buzz.
  • Some impressive increases have been seen in areas where we’ve had less buzz. I always get questions from Ontario veterinarians asking if we’re seeing more CIRDC cases, but I’d say it’s not much more lately than anytime over the past few years. Most often, I get asked “is that thing that’s going on in the US going to hit us here?” I think this map shows that we can’t just focus on media/social media reports to tell us what’s happening, because they can over-amplify issues and at the same time, some things might fly under the media radar.
  • Claim rates haven’t changed in most areas, though. We’re not seeing something sweeping North America, we’re seeing patchy disease. That fits with my current guess as to what’s really going on (see details below).

Oregon’s an interesting state to look at as an example. This graph shows canine respiratory-related claims in Oregon from 2021-2023, which demonstrates a typical epidemic curve with a nice increase followed by a corresponding decrease in 2023:

  • There was clearly something going on earlier this year. It didn’t seem to get much attention until it was already on the downswing, though. Talking to a few different people in Oregon, the perception seems to be that things have died down over the past month or two, and that’s consistent with the data from this graph.

This graph compares canine respiratory disease claims in California and Oregon for the last few years:

  • California has had an increase in respiratory disease claim rates too, but the pattern looks different. While Oregon had a big peak and then a return to the increasing baseline, California has had a gradual but sustained (and impressive) increase over time, eventually reaching about the same rate as Oregon overall.
  • Does California have more of a well-distributed higher rate of disease? Or, since California is a big state, have we had rotating outbreaks in different areas that end up looking like a steady increase? We’ll need to do a deeper dive on the data to figure that out. The graph shows that something’s going on in California too, but maybe in a different manner than in Oregon.

Let’s jump to some Canadian content. Here’s the graph of canine respiratory disease claims in Quebec from 2021-2023:

  • This one surprised me. I’ve been getting questions about CIRDC cases in Quebec but nothing that stood out as unusual. (Maybe there’s more in the French-language media than I’ve been seeing.)
  • The total number of claims is still relatively small, so we have to be careful not to overreact, but that’s a pretty big percentage increase.
  • The time frame is also different from the Oregon peak. There’s always a bit of a lag with insurance report data, so we can’t say whether this has hit its peak in Quebec yet, or if it’s still increasing or if it’s already on its way down.
  • Regardless, the pattern fits with something that’s been going on recently and is possibly ongoing. We’ll have to see how the numbers trend over the next few weeks.

When it comes to other factors that might increase insurance claims, we have to consider the influence of recent media attention. If a dog had mild respiratory disease (e.g. cough, runny eyes but eating well and otherwise pretty healthy), it might not normally be taken to a veterinarian. However, if the owner is freaked out because of all the news coverage about CIRDC, they’re more likely to take that dog to a veterinarian now versus in previous years. Those cases then end up in an insurance dataset like this (or in a testing dataset from a laboratory) because of owner factors, not dog or disease factors. One way to help tease this out is to look atmore expensive claims, or claims that involve things that would only be done on sicker dogs (eg. oxygen therapy). Our preliminary look at those data showed similar but more blunted trends in terms of increases in some areas, gradual increases over time overall, and no change in most regions. So, the increases we’re seeing in overall claims are probably pretty reflective of true changes, though likely with some fear-driven (vs disease-driven) increases.

Other things we need to consider are what types of dogs seem to be over-represented, beyond regional effects. Preliminarily, claims involving brachycephalics (squish-nosed breeds) seem to be significantly more common, which isn’t overly surprising as these dogs may have less tolerance of any form of respiratory disease. More to come on that.

What’s driving severe disease is also really important. Mild respiratory disease isn’t ideal, but we’re more worried about pneumonia and severe illness that can make dogs really sick, result in high veterinary bills, and kill a small percentage of dogs. Brachycephalics, senior dogs and dogs with pre-existing heart or lung disease are probably at higher risk for severe disease, but we need to look at the data more to confirm that.

Where does this take us?

As we get more data, look at disease patterns over time and locations, and talk to more people about what they are seeing, I’m increasingly convinced that this is a situation of the usual suspects (our normal CIRDC pathogens) doing their usual thing (mild disease in most dogs with a small subset that get pneumonia and a small subset that get really sick), but at a higher rate. I think the rate has been increasing for a while, which makes the normal ups that we see with waxing and waning disease more obvious. I think it’s clear that we’ve had true increases in disease in some areas, but not all, and that clusters are following the typical course of “what goes up, comes down.” Media attention is amplifying the concern, so that we’re hearing more about a lot of things we wouldn’t normally, but there’s a true disease underpinning to those reports.

Why? What is driving the increase in disease rates?

The “why” is unclear, since we still don’t really know the “what” well. When I think about what drives increased disease, I focus on dog factors and bug factors. We have various logical reasons why this increase could be driven largely by dog factors. For example, in the past few years, we’ve seen:

  • More dogs
  • Disrupted veterinary care (less vaccination)
  • Changes in human activities (e.g. more remote work, maybe leading to fewer dogs at day care and therefore less kennel cough vaccination)
  • Other changes in human activities that alter how dogs interact
  • Changes in the types of canine respiratory disease vaccines we use
  • Earlier pandemic restrictions reducing the normal level of exposure to kennel cough pathogens and vaccination

The net result would be an increase in dogs with less immunity from vaccination or previous infection.

For bug factors, I think about the possibility of:

  • A new pathogen
  • An existing pathogen that’s changed

We don’t currently have any clear evidence of either of these bug factors. The story about a previously unknown small bacterium that has been found by the New Hampshire veterinary diagnostic laboratory is still worth investigating, but at this point it’s not clear that it’s driving anything. If this bug turns out to be a pathogen in dogs, most likely it will be a “new to us pathogen” versus a “new pathogen” scenario. By that, I mean that it’s more likely that it’s a longstanding cause of disease that we’ve never diagnosed before, versus a new bug that’s recently emerged and is starting to spread. The current disease patterns don’t really fit with emergence of a new highly transmissible pathogen.

I’m open to new evidence and other opinions, but at this point, if I had to make a somewhat informed guess, I’d go with the assumption that we have patchy but significant increases in disease in some areas across parts of North America, but driven by our normal bacterial and viral causes.

We also have to avoid over-interpreting the insurance claim data, since it’s just one piece of the puzzle, albeit a potentially important one. Everyone always wants definitive answers “now,” but that’s not how outbreaks or outbreak investigations go (especially outbreaks in dogs where we have almost no funding for formal surveillance or analysis of any kind).


There’s a lot of concern about respiratory disease in dogs at the moment, so it’s a opportunity time to revisit some routine preventive measures that we really should be using all the time (but unfortunately sometimes fall by the wayside). This post focuses on precautions for dog groomers, but really it applies to a broad range of places where dogs go.

Infection control is typically pretty straightforward and boring (which is why it often gets neglected). There’s nothing really fancy and it’s mostly pretty low tech – mainly a matter of using some good general practices and a solid dose of common sense.

With canine infectious respiratory disease complex (CIRDC), the main transmission concerns are from direct contact between dogs, contact with oral/nasal secretions (e.g. shared bowls, licking the same spot soon after another dog) and respiratory aerosols (from coughing, sneezing, heavy panting etc.). There is always a risk of disease transmission at dog grooming facilities, regardless of whether there’s an outbreak going on in the area or not. Various diseases are always circulating in the dog population, and sometimes we can’t tell when an animal is infectious to others, so we apply routine infection control practices in all situations, and increase those when we identify increased risk.

Some routine, every day infection control practices include:

  • Communication so owners know not to bring sick dogs to the groomer. If clients are being called or emailed with appointment reminders, add a statement about cancelling if the dog is sick. (Sound familiar? Lots of what we did for people during the pandemic can also be applied for control of disease transmission in dogs).
  • Business practices that don’t encourage owners to bring sick dogs (e.g. no charge if someone cancels at the last minute because their dog is sick. Yes, a policy like that can be abused, but we don’t want incentives for people to bring in a sick dog).
  • A housing setup that keeps dogs separated. At a minimum, we want no (or very limited) direct contact between dogs.
  • Good ventilation, such as having an in-room HEPA filter or two, especially in dog housing areas.
  • Routine use of personal protective equipment. Ideally, groomers should wear something over their street clothes that’s easy to change if it gets contaminated. If street clothing or scrubs are the only layer they’re wearing, it’s important to have a change of clothes handy. However, it’s easier and better to immediately take off a lab coat, smock or gown than it is to go go somewhere to change clothes completely.
  • Hand hygiene, such as washing hands or using a hand sanitizer between animals.
  • Cleaning and disinfection of areas and shared equipment between animals. Any routine disinfectant should work against typical canine respiratory pathogens, but I always like to use as good a disinfectant as possible. If you can get it, I’d use an accelerated hydrogen peroxide (AHP) product.

Routine stuff is, well, routine. It’s not rocket science (and pretty boring in the end) but it’s the core of good infection control. However, we also need to have a plan for higher risk situations. Ideally, this plan is written out and communicated to everyone in the facility before a situation happens, so it can be implemented by everyone without delay or confusion. Human factors are usually the biggest problem when we see infection control breakdowns.

How to respond to a dog with respiratory disease at a grooming facility

Even with good use of routine practices, it’s possible for a sick dog to get in once in a while. Sometimes people don’t realize or don’t care that their dog may be infectious, and it’s not always obvious as they walk in the door. There are generally two main scenarios:

1. Sick dog is identified as it arrives

 This one’s easy. Ask the owner to take the dog home right away. If there’s a need to discuss anything, ideally the dog should be removed from the facility and the discussion is done by phone. Otherwise, the discussion could take place outside, or inside after the owner puts the dog in a vehicle (if it’s safe to do so). While this is happening, attention should be paid to any other dogs in the vicinity, to keep them away from the sick dog.

There’s not a lot to do with the airspace by the time this happens. Aerosol transmission is the main concern here, and that’s only for a short period of time and over short distances. The risk of something wafting around the building in the air for a long time is low. The pandemic taught us the importance of good ventilation and air filtering, so it would be ideal if there was already a well-ventilated space and a HEPA filter running to further reduce the risk.

Any personnel that had direct contact with the dog before it was removed should change their outerwear and wash their hands.

The general environment is probably fairly low risk but it’s not zero, especially surfaces the dog may have licked, nosed or coughed/sneezed on. Disinfecting those surfaces ASAP would be wise. Having a spray bottle with disinfectant handy is good for many things, and would help speed up the process here too.

If the owner wants to reschedule, we don’t have a good handle on how long to wait, since we won’t likely have a diagnosis for the dog. Waiting a month would be ideal. It’s not a guarantee that the dog won’t still be shedding something, but we’re trying to balance protection and practicality. At a minimum, I’d want to wait two weeks before the dog comes back.

2. Sick dog is identified after being dropped off and the owner leaves

This creates challenges since “get the dog out ASAP” may not be an option. Owners should be contacted to pick up the dog as soon as possible. While waiting, the dog should be kept in an area away from other dogs. Ideally, every facility should have an area to isolate high risk dogs. It doesn’t need to be an isolation unit like in a veterinary clinic, but there needs to be a plan for housing dogs with respiratory disease, diarrhea or other things that get flagged as a concern after drop off. This could be a separate room, or even a well-ventilated storage room or closet, that can hold a crate. The idea is to get as much physical separation between the sick dog and other dogs as possible.

When we can’t physically isolate the dog, we try to contain it as much as possible and use procedures to reduce cross-contamination risks:

  • Keep the dog as far away from others as possible.
  • Position the dog such that there’s limited airflow toward other dogs (e.g. if there’s a window or fan blowing, make sure the high risk dog isn’t upwind).
  • If there are banks of cages, keep the sick dog on the bottom.
  • Put a blanket or something similar over the cage front to reduce aerosol spread.
  • Avoid handling the dog as much as possible. If you have to handle it, either put on single use (disposable or direct to laundry) outerwear like a gown and use gloves. Wash your hands after removing gloves when you’re done.
  • When the dog leaves, disinfect any items in the cage (e.g. bowls), launder any blankets/towels and disinfect the cage.

It’s all pretty basic, but basic is effective if done right.

I’ll write more about where we stand with the ongoing CIRDC situation, but it is a good reminder that we should be upping our routine infection control game.