As spring approaches, a pressing question has come to the minds of many kids: “Can the Easter bunny get COVID-19?” or “Can Easter bunny eggs spread COVID-19?

Fortunately, the answer is no. Easter bunnies are safe from this virus and kids don’t have to worry about whatever the Easter bunny leaves behind.

Based on what we know to date, “regular” rabbits aren’t very susceptible to the SARS-CoV-2 virus.  Some types of rabbits can be infected with SARS-CoV-2 experimentally, but they don’t seem to get sick and they only shed low levels of virus. So, even a regular rabbit that was infected probably poses little to no risk.  (Don’t worry kids, no one’s going to try that with the Easter bunny.)

Furthermore, as we all know, the Easter bunnies have inherent magical properties that protect them from various problems (e.g. nosy household dogs). Their elusive nature (have you actually ever seen an Easter bunny depositing its wares?) and strategic placement of gifts in empty rooms mean the Easter bunny is following our “3 Cs approach to COVID-19 control,” that is avoiding closed spaces, close contact and crowded settings. And maybe the Easter bunny wears a mask too? We’ll probably never know for sure…

Don’t be afraid of the Easter bunny.

Don’t worry about what the Easter bunny leaves behind

No, you don’t need to disinfect Easter eggs.

The biggest risk from the Easter bunny is when the family dog finds all that chocolate first (yes, I am speaking from personal experience). That has nothing to do with COVID-19.

I tweeted recently about the first report of the B.1.1.7 SARS-CoV-2 variant being found in animals, specifically in a dog and cat in Texas, which deserves some more discussion. Also a new pre-print article (i.e. non-peer-reviewed paper) was posted recently that will probably raise more concerns, so I figured I’d better write about that one too.

Texas A&M Research Uncovers First Known COVID-19 UK Variant In Animals

The B.1.1.7 variant of SARS-CoV-2, which first emerged in the UK, is becoming widespread internationally and fueling third waves of COVID-19 in the human population in multiple countries. It’s more transmissible than “regular” SARS-CoV-2 and may cause more severe disease. Fortunately most of the available vaccines still seem to be effective against it, but it’s causing a lot of damage while we’re still trying to get enough people vaccinated.

It’s clear that people commonly pass SARS-CoV-2 to their pets. As this strain (and others) become more common in people, it’s inevitable that animals (particularly the pets we live with) will be exposed too. It’s unlikely (though possible) that the strain will be significantly less infective in animals than the original strain, so we fully expect to see it spillover into pets.  I assume there have been thousands of dogs and cats unknowingly infected with this and other variants of concern (VOCs) so far, but we test very few animals in COVID-19-affcected households. So, the Texas report was an expected confirmation that pets can also be infected with this VOC. We’re testing animals here in Canada too as part of our ongoing surveillance project.

Myocarditis in naturally infected pets with the British variant of COVID-19 (preprint)

This paper, which I will emphasize again has yet to be peer reviewed, will likely cause a bit of concern, but probably unnecessarily.

The authors observed an increase in dogs and cats presented to a referral veterinary clinic in the UK with myocarditis (inflammation of the heart). The concern was that the increase occurred at the same time the B.1.1.7 variant was surging through the human population in the UK.

  • Clinical observations of abnormal patterns are important. Most often, they end up being nothing remarkable – just random changes in normal events, or coincidences. Sometimes, though, they’re an early warning that something is going on. So, they are worth investigating.

Most owners of the affected animals reported having COVID-19 themselves in the 3-6 week period preceding the animals’ illnesses.

  • Interesting. Far from definitive (especially during a pandemic when lots of people are infected), but worthy of investigation.

They collected oro-nasal and rectal swabs from six cats and one dog with myocarditis in late January / early February. They also collected blood from these pets to look for antibodies against SARS-CoV-2. Blood samples were also collected from 4 other pets (2 cats, 2 dogs) that were recovering from myocarditis. None of the animals were reported to have had any respiratory disease.

  • 3 animals (2 cats and 1 dog) were positive on PCR for SARS-CoV-2 on rectal swabs, with a low viral load. All oro-nasal swabs were negative. The PCR test that was used indicated that the B.1.1.7 variant was present, although the test performance isn’t described.
  • Antibodies against SARS-CoV-2 were not detected in these 3 pets. That makes the results a challenge to interpret. Were the PCR results false positives, or were the serology results false negatives? It doesn’t seem like they followed up with later antibody testing of PCR-positive animals. That would help determine if they were antibody negative initially simply because they had not yet produced enough detectable antibodies (as that can take some time).
  • Three other animals (2 cats and 1 dog) had antibodies against the virus. Those animals were either PCR-negative (1) or PCR was not done (2).  If the serological test used was good (no information was provided on test performance or quality control), then I’d assume the PCR-negative, serology-positive animals had been infected at some point in the past.  PCR is only positive for a short period of time when the animal is actively infected and shedding virus, but antibodies can stick around for a long time after the infection is gone.

What does this tell us?

  • That some human-to-pet transmission of SARS-CoV-2 likely occurred (but we already know this happens).
  • The B.1.1.7 variant was involved (ditto).

Overall, 6/11 animals had some degree of evidence of exposure to SARS-CoV-2. That seems like a fairly high proportion, but it’s not far off the numbers we’re seeing with our work and work from other groups in healthy animals from COVID-19-positive households. So this does not provide any evidence of a link between SARS-CoV-2 infection in pets and myocarditis. Nonetheless, I wouldn’t dismiss it, and we should look into it more.

The authors’ statement that “the discovery of B.1.1.7 infected cats and dogs highlights more than ever the risk that companion animals may potentially play a significant role in SARS-CoV-2 outbreak dynamics than previously appreciated” has no substance. This study just showed that animals can be infected. It does not indicate anything about pets’ role in outbreak dynamics or anything else. We don’t want to ignore the potential that cats, in particular, could transmit the virus. However, their conclusion is unsupported and unlikely to be true.

I’m fully on board with their last statement, though: “Therefore, there is an urgent need to greatly accelerate and strengthen the investigations and surveillance of animal infections by highly-transmissible variants such as British B.1.1.7, South-African B1.351 and Brazilian P.1 variants as part of the global response to the ongoing multi-species COVID-19 pandemic.”

We partnered with the Canadian Academy of Veterinary Dermatology to update our MRSP fact sheets for pet owners, including a new look, and a French translation!  Access them using the links below, or on the Worms & Germs Resources – Pets page.

What is methicillin-resistant Staphylococcus pseudintermedius? (English)

Qu’est-ce que le Staphylococcus pseudintermedius résistant à la méthicilline? (Français)

Here’s a pot pourri of reports of staphylococcal infections in humans linked to dogs. Specifically, they’re infections caused by Staphylococcus pseudintermedius, a common dog-adapted species of Staphylococcus. (If you get freaked out reading these, make sure you read the end of the post so you also get the context.)

A 41-year-old man with a history of skin disease and receiving parenteral nutrition (i.e. being fed intravenously) presented with fever, and developed a recurrent infection of the access port of his indwelling intravenous catheter. Staph pseudintermedius was isolated from him and his dog. They recommended he get rid of his dog.

  • It doesn’t sound like they recommended any other infection control measures, and the person did not get rid of the dog initially. He later did, after being hospitalized from the infection.
  • It’s impossible to say, but I suspect there were other (better) ways to reduce the risk of transmission in the household rather than have the patient get rid of his pet, especially if the dog was an important part of his life.

A hemodialysis patient with an indwelling intravenous catheter developed a S. pseudintermedius infection.

  • The authors stated, “Catheter care education should include information about pet exposure and the possibility of zoonotic infections.” I can’t access (aka I’m too cheap to spend the $37 access fee for) the full paper, so I couldn’t see what details were provided.

Infection of an implanted port catheter system by methicillin-resistant S. pseudintermedius (MRSP). MRSP is basically the dog version of methicillin-resistant Staphylococcus aureus (MRSA).

  • The MRSP strain was a type that’s commonly found in dogs internationally.
  • The person was a dog owner, but they didn’t investigate the pet dog and they don’t say anything about infection control measures in the paper.

A 56-year-old woman with rheumatoid arthritis, osteoporosis and common variable immunodeficiency developed a S. pseudintermedius infection of bone and soft tissue after surgery to repair a broken arm.

  • The same bacterial strain was subsequently also isolated from the patient’s pet dog.
  • No high-risk behaviours (e.g. dog licking face or broken skin, dog sleeping in the bed) were reported.
  • The patient had another dog that had a septic tooth and was being treated with an antibiotic, but it died before they were able to get samples. There’s no more discussion of that, but I wonder whether she was the one giving the dog oral medications and had exposure to the dog’s saliva that way. It’s possible the sick dog harboured the same bacterium as its housemate… maybe even more likely, since antibiotic treatment is a risk factor for MRSP in dogs. That’s all highly theoretical, obviously.

A 39-year-old woman receiving peritoneal dialysis developed septic peritonitis (i.e. infection of the abdominal cavity) with (you guessed it) S. pseudintermedius.

  • Peritoneal dialysis (PD) uses an indwelling catheter that goes from the skin into the abdomen.  Infections are the main complication associated with these devices.
  • The patient had a dog that slept in her bed, having close contact with the dialysis catheter.
  • While vague, the authors did address basic infection control issues: “No recurrent infections have been noted since admission with better hygiene and some distance with the pet dog.” and “Furthermore, PD training and ongoing education programs are needed for pet owners to help decrease the risk of PD-associated bacterial peritonitis. “
  • That’s what I want to see – awareness and education, not ignoring the issue or knee-jerk recommendations to get rid of the pet.

The main take-home message from all this: Relax, and wash your hands.

Is S. pseudintermedius a bigger threat now than in it was years ago?

  • No. It’s not likely any more able to infect people than it could in the past. Most dogs harbour the bacterium on their skin and/or in their mouth, nose and intestinal tract. Millions of people are exposed it every day. Yet, infections are very rare. It’s something to be aware of but we shouldn’t over-react.

But there are many more reports of human disease caused by S. pseudintermedius. Are zoonotic infections increasing?

  • Probably not. I suspect it’s a function of better identification of the bacterium by human diagnostic laboratories (they could have misdiagnosed it as a common human staph in the past), and proliferation of journals that will publish single case reports. I’d wager it’s more of an increase in publications than an increase in disease.

Is MRSP from dogs a bigger threat now?

  • Sure, because it’s much more common in dogs than it used to be.
  • However, MRSP is no more likely to spread to people than susceptible S. pseudintermedius, it’s just harder to kill when we have to treat it. It’s an important bug but human infections seems to be rare.
  • We can’t ignore MRSP, but it likely doesn’t crack the top 10 list of things I’m concerned about your average dog and cat transmitting to a person.

So, what should we do?

Staphylococcus pseudintermedius is a bug that’s found in and on most dogs. Most of the time, it doesn’t do anything to us when we encounter it. We have barriers like our skin and immune system to fight off such foreign invaders. When those barriers are compromised, the risk of infection goes up. Preventing infections comes down to very basic precautions like:

  • Hand washing
  • Limiting contact with saliva, nasal secretions and feces.
  • Keeping open wounds or invasive devices (like catheters) away from animals, and in particular, their secretions. (For me, here’s where there’s a difference between sleeping in the bed and sleeping on the bed. I’m ok with an animal sleeping on the bed if there’s no direct contact with the person. If it’s sleeping under the covers with someone, that creates ample, longterm contact for transmission of pathogens.)
  • Good, prompt wound care after any bite or scratch.

One last thing that often gets forgotten: People should make sure their physician knows they have contact with animals, and physicians should ask about animal contact. Most of the time it’s not relevant, but it only takes a few seconds and can provide important information in certain cases.

More information about MRSP can be found on the Worms & Germs Resources – Pets page.

Ontario Animal Health Network Veterinary PodcastsThe companion animal Ontario Animal Health Network has produced a series of mini-podcasts on COVID-19 precautions in veterinary clinics, featuring none other than Dr. Scott Weese.  Each mini-podcast features a quick 3-5 minute “lighting round” on common questions and topics – bite-sized bits for busy practitioners and clinic staff who may only have a few minutes to spare these days.  Current topics include:

  • Avoid the 3 Cs: Crowding, close contact, confined spaces
  • Rethinking clinic spaces: The end of the waiting room and more
  • Masks and the trouble with bubbles
  • Patients and procedures that warrant extra precautions
  • Don’t panic! Talking to clients about SARS-CoV-2 risk to and from pets
  • Staying safe with the swiss cheese approach
  • What’s on your face? The why, when and what of masks and face shields

If you have a COVID-19 related question about which you’d like to hear a podcast or mini-podcast, you can email OAHN at oahn@uoguelph.ca.  Also check out the OAHN COVID-19 resources page for veterinarians. Stay safe!

I’m always on the lookout for good-looking, easy-access resources to help communicate (and to help others communicate) messages around safe and responsible pet ownership, which is how this blog got its start!  I also don’t like re-inventing the wheel when I don’t have to, and I appreciate that many organizations have people with vastly better design and layout skills than my own ;)

During the COVID-19 pandemic, the concern around the risks of SARS-CoV-2 both to and from pets (and trying to figure out exactly what those risks are) has certainly highlighted some of the basic infection control measures we recommend around pets (especially dogs, cats and ferrets), like hand hygiene.  There has also been a huge surge in puppy and kitten adoptions, which means lots of new pet owners out there who may benefit from some extra guidance and a few quick tips.

The US Centers for Disease Control (CDC)’s Healthy Pets, Healthy People website has come a long way over the years, and now has some really nice content that can be readily shared with pet owners (including prospective pet owners), linked to websites, and even shared on social media.  A few items that are worth checking out include:

Lyme disease vaccine is a non-core vaccine, meaning it’s not needed for all dogs in all areas. It’s an effective vaccine, and I’d consider it a reasonable vaccine to give to dogs in (or visiting) higher risk areas, especially when there might be owner compliance issues with tick preventive medication. Available tick preventatives are very good, but sometimes people forget to give them on time, so vaccination is a good backup plan for those situations and in areas where the risk of exposure is particularly high.

Lyme disease vaccines are a bit unusual, in that they are primarily aimed at vaccinating the tick, not the dog (strange as that sounds). They usually target two proteins on Borrelia burgdorferi , the bacterium that causes Lyme disease. One of those is outer surface protein A (OspA), which is “expressed” on the  surface of the bacterium when it’s inside the tick. After the tick has attached to a host (like a dog) for a while, the bacterium changes to make itself more adept at infecting animals. That results in a change in the outer surface protein from OspA to OspC.

Lyme disease vaccines contain OspA, which induces the dog’s immune system to produce antibodies against that protein. When a tick starts to feed, it ingests the antibodies in the dog’s blood, which attack the bacterium before it’s ready to migrate to the dog.

Lyme disease vaccines can also contain OspC, to target the bacterium in the tick as it starts to produce that protein, and provide backup protection if the bacterium happens to evade the OspA antibodies and makes it into the body.

With typical vaccines, if an individual is exposed to the bacterium/virus for which they’ve been “primed” by the vaccine, they then get an immune response boost to generate even more antibodies. However, that doesn’t really apply to Lyme disease.  Since the dog’s antibodies flow into the tick, there’s no extra immune boost because the bacterium isn’t yet in the dog’s body (so the dog’s immune system doesn’t get exposed directly). Decreased antibody levels in the dog therefore more directly correspond with decreased protection. There will be some booster effect with exposure to OspC if the bacterium makes its way into the dog, but ideally we’d like to stop the process before it gets that far.

Lyme disease vaccines are given as an initial series of 2 doses, 2-4 weeks apart, and then an annual booster. But,  there’s concern that immunity from Lyme disease vaccines doesn’t last as long as others, so there’s less leeway for overdue dogs. It’s been recommended to re-start the 2 dose series from scratch if the dog is overdue for it’s yearly booster by more than 1 month. That’s pretty conservative, but it’s fair to assume that this vaccine’s long-term protective effect could be less predictable and solid than leptospirosis vaccines (where we accept up to 3 month delay).

Based on that, when it comes to Lyme disease vaccines, if a dog gets its:

First dose, but is late for the 2-4 week booster

  • Restart the whole series (i.e. 2 doses 2-4 weeks apart, then yearly)
  • We don’t have good guidance on what constitutes “late” or “overdue” here.  The American Animal Hospital Association vaccination guidance says within 6 weeks of the first dose is still okay, and that’s reasonable. It’s quite possible that the dog would respond well to a later booster, but we don’t have confidence in that.

First dose, 2-4 week booster, and then a yearly booster not more than 1 month late

  • Continue with the single annual boosters

First dose, 2-4 week booster, but is more than 1 month late for the yearly booster

  • Restart the whole series (i.e. 2 doses 2-4 weeks apart, then yearly)

As I mentioned above, tick prevention is still key, particularly for unvaccinated or inadequately vaccinated dogs. If vaccination has lapsed, it’s even more important to avoid ticks, do tick checks and use a good tick preventive medication (on schedule).

This is probably the vaccine about which I get the most questions when it comes to delays. Leptospirosis (aka lepto) is a regionally important and potentially life-threatening infection of dogs (and people) caused by serovars of the Leptospira bacterium. It’s generally considered a non-core vaccine, meaning it’s not needed for all dogs in all areas. However, it’s probably best considered a regionally core vaccine. If leptospirosis occurs where a dog lives or anywhere it to which that dog might travel, I consider this an essential vaccine. This disease is pretty widespread internationally, so that includes a lot of dogs.

Lepto vaccines are killed vaccines, meaning they contain bits of the dead bacterium. Killed vaccines can be effective, but typically require multiple doses given within a specific interval to maximize immunity. For lepto, we typically start with two doses of vaccine 2-4 weeks apart, and then yearly boosters. We need that initial 2-4 week booster to make sure there’s a good immune response (unlike the modified live virus (MLV) core vaccines I mentioned in Part 1). If that 2-4 week booster is missed, we can’t assume there’s much protection or ability to respond to a future single booster shot. Also, yearly booster shots are needed for lepto to maintain immunity, unlike the core vaccines that can often be given every 3 years after the initial series.

Considering all that, if a dog is late for it’s first booster or annual shot, the default is to restart the entire series. The World Small Animal Veterinary Association vaccination guidance gives some leeway for the annual booster, indicating that re-dosing within 15 months (not the labelled 12) is likely okay. Personally, I suspect we can go longer, since the vaccines are good and immune systems usually aren’t dumb. However, the farther we go off-label, the less confidence we have. While many (or maybe most) dogs are probably protected well after a year and will still respond to a single booster, as a veterinarian, I can’t tell an owner with much confidence that that’s the case. So, the default is to go back to the start so we can be sure.

Based on that, when it comes to lepto vaccines, if a dog gets its:

First dose, but is late for the 2-4 week booster

  • Restart the whole series (i.e. 2 doses 2-4 weeks apart, then yearly)

First dose, 2-4 week booster, and then a yearly booster not more than 3 months late

  • Continue with the single annual boosters

First dose, 2-4 week booster, but is more than 3 months late for the yearly booster

  • Restart the whole series (i.e. 2 doses 2-4 weeks apart, then yearly)

What if someone doesn’t want to restart the series (due to cost, logistics, not keen on vaccines, etc.)?

Odds are reasonable the dog will still respond to a single late booster, but confidence in the immunity this will generate drops the later the booster gets. There’s no way to say exactly what the risk is, so not going back to repeat that 2-4 week primary series means the owner has to accept some degree of uncertainly regarding how well protected their pet will be. Additionally, manufacturers tend to stand by their products, but they’re not likely to offer any support if a dog gets lepto when the recommended vaccine schedule isn’t followed. Those are all things that need to be discussed and considered.

I’d prioritize dogs for lepto vaccination in this order:

1a) Starting initial lepto series

1b) 2-4 week booster for dogs that received the first dose

2) Yearly booster for dogs approaching the end of the 3 month extension window

3) Yearly booster for dogs not yet near the 3 month extension window

More information about leptospirosis can be found on the Worms & Germs Resources – Pets page.

In some ways, the approach to rabies vaccine is easy. In other ways, it’s complicated. To some degree, the medicine is easy, but other considerations (like regulatory requirements) cloud the picture.

The medicine:

Rabies vaccines are highly effective. A single initial dose provides at least 1 year of protection. The first dose is supposed to be given at 12 or 16 weeks (depending on the jurisdiction – rabies vaccines in Canada are labelled for use in dogs and cats 12 weeks of age and older), with a booster one year later. Getting that first shot is critical, so the animal is protected as soon as possible against this deadly – and zoonotic – disease.

After that, we can use 1 yr or 3 yr vaccines.

  • For a 1-year vaccine product, if the animal is overdue, we’d just give another dose as soon as possible, but the yearly cycle does not change.
  • For a 3-year vaccine product, after the initial dose and the first 1-year booster, the animal can safely go 3 years between boosters.  However, if the 1-year booster is missed, then we’d have to restart that primary series to stick to the manufacturer’s instructions, meaning the late booster would only be considered good for a year. Then we’d go to every 3 years after the next dose a year later. If the animal misses any of its 3-year boosters, the same would apply, i.e it would need a booster a year later to get back on the 3-year schedule.
  • Note: As of March 2019, there is only one 1-year rabies vaccine product for cats still available in Canada, and none for dogs; all other rabies vaccines for dogs and cats in Canada are 3-year products.

That’s all pretty straightforward and by-the-book (or label, in this case).

The challenge is what constitutes “late.” Strict interpretation of the label would be that even a single day overdue would require the primary series to be repeated. Many would consider that overkill since rabies vaccines are so highly effective. However, there’s not much appetite for guessing when it comes to rabies. Once an animal is more than a couple of months overdue, it’s harder to say that the booster should count as a 3-year dose, since we’re deviating ever more from the label recommendations. So, prudence would dictate we go back to the start. If there’s concern that the provincial/state/regional authorities (especially border authorities) would use a strict interpretation and consider any lapse an indication that the vaccination series had to be restarted, then it’s safer to be more conservative and do that in your practice as well. More on that below).

From a rabies protection standpoint, I don’t worry about late vaccines (within reason) since rabies vaccines are so good, especially in an animal that has received multiple doses over the course of its life.

The “other considerations”:

What makes rabies vaccination delays complicated is most often regulatory/public health rules and interpretations thereof. In many areas, rabies vaccination is required by law; for example, in Ontario, all dogs, cats and ferrets over 12 weeks of age are legally required to be kept up-to-date on rabies vaccination, regardless of whether they have indoor or outdoor lifestyle.  I doubt there would be a fine applied in most cases for reasonable delays in vaccinating a pet due to COVID-19 restrictions over the last year (but each jurisdiction is its own…). However, the bigger issue is the response to a potential rabies exposure in such an overdue animal. When an dog or cat is exposed to a rabid (tested) or potentially rabid (untested suspicious) animal, the response depends on the pet’s rabies vaccination status. That response varies a bit by region; some default directly to the guidelines in the NASPHV Rabies Compendium, some adapt those guidelines, and others are… well, a bit unpredictable.

In Ontario, the response could range from simple observation with no strict confinement (e.g. a fully vaccinated pet that gets a booster within 7 days of the encounter) to a strict 6 month confinement (e.g. an unvaccinated pet that does not get a rabies vaccine within 7 days of the encounter). Animals with a history of lapsed vaccination are dealt with on a case-by-case basis, with things such as the time since the last dose and the number of lifetime doses being considered (among other factors). The pet could ultimately be treated as fully vaccinated or unvaccinated, depending on the details, and that can be the difference between life-and-death, as euthanasia is sometimes elected by owners in lieu of having to strictly quarantine the pet.

Understanding how your region addresses overdue vaccination is useful, to determine how strict you need to be about getting animals in for their boosters. If they’re not flexible and consider an animal’s vaccination status to be lapsed the minute they pass the 1- or 3-year mark, then we need to make sure we’re prioritizing rabies vaccinations so there are no gaps.

As an example, here’s the situation in my household:

  • My dog, Merlin, has had multiple doses of rabies vaccine and is probably effectively protected for life. Him being overdue is probably low risk, but I wouldn’t want to let it go very far. I’d booster him when feasible but not stress about it, and would keep him on the 3-year cycle. If he’s not too far overdue, I’d have a strong case to consider him completely protected if he tangles with a rabies suspect.
  • My cat, Milo, is less than a year old and has had a single dose or rabies vaccine. He’s higher priority to get boostered. If I miss the 1-year booster by much, I’d have to consider re-starting the primary series again, which means I’d give him a dose, and then another in 1 year, before switching to every three years. (That’s a picture of him… he doesn’t look very stressed about it).
  • The outdoor cats (Rumple and Alice)  have received multiple doses or rabies vaccine over their lifetimes. They’re like Merlin, but higher priority for boosters since they likely have a greater risk of exposure to rabid animals.

The take home messages on rabies vaccination delays:

  • Don’t let rabies vaccination lapse, if possible.
  • I’d prioritize pets for rabies vaccination in this order
    • Animals that may have been exposed to rabies in the last 7 days because of an encounter with a suspicious animal that couldn’t be tested for rabies (or that was tested and was confirmed to be rabid.  This is a medical urgency.
    • Animals that have never been vaccinated for rabies (or unknown if they’ve ever been vaccinated). They need a dose ASAP to make sure they’re protected and won’t have to risk a long confinement period if they’re exposed to rabies.
    • Animals that have only had one dose of rabies vaccine in their lifetime.
    • Animals that are significantly overdue for their rabies booster (more than a couple of months).
    • Other pets that are due for a rabies booster (if there’s really a need to prioritize further, focus on dogs/cats that go outside unsupervised).