Thursday, May 2, 2013

Sucks for this dog who got Herpes, check out this clinical case report


Canine Herpes Virus Case Study
By: Sarah Peloquin

History
Sadie is a 2-3 year-old Labrador mix who has been presented with her two puppies following parturition. The owners found Sadie about 2 weeks ago in their backyard; they adopted her and have been taking care of her since then. They did not know that she was pregnant, so she has not yet been to a vet. Her puppies were born 8 days ago and the owners are concerned that yesterday evening they both started going downhill. They stopped moving as much and stopped suckling. The puppies have had a green-colored diarrhea and now cry more. The owners report that Sadie is doing fine. 
Rule out list

Canine herpes virus, canine parvovirus, canine hepatitis, congenital defects

SOAP

S. Puppies seemed lethargic and unthrifty. They were reluctant to move and very vocal

O. T: 95.3, 96.0
Weights: 2.3 lb, 2.0 lb
Erythematous rashes on ventral abdomens
Enlarged lymph nodes 
Radiographs: lungs show diffuse unstructured interstitial pattern

A. All of the puppies have shown a rapid decline in health, which would point away from congenital defects. The absence of a fever rules out both hepatitis and parvovirus, since these viruses tend to cause a fever. The normal temperature would be more indicative of herpes virus, since this virus is temperature sensitive. 

P. Since canine herpes virus is the number one diagnosis, serum antibodies can be transferred to the puppies in an attempt to decrease mortality. Unfortunately, the puppies died overnight prior to this procedure. The owners approved necropsies of the puppies to further solidify the diagnosis. 

Necropsy Results
Focal areas of necrosis and hemorrhage. Petechial hemorrhages in kidney (shown), liver, lung, and spleen. Intranuclear inclusion bodies on histopathology sections. All findings are consistent with canine herpes virus. 
Tissue samples sent out to reference laboratory for PCR and in situ hybridization for further confirmation of acute neonatal viremia of canine herpes virus.
The owners turned down testing Sadie, since the puppies’ tissues were sent out for sampling.

Client Communication
The owners were told that Sadie was likely infected with canine herpes virus, and that these puppies were most likely her first litter. She was probably infected with the virus from direct contact with an infected dog during the last three weeks of her pregnancy. She then transmitted the virus via mucosal secretions to her puppies. Since these puppies were not able to control their own temperature at this point in their life and also had no antibodies to the virus, they were very susceptible to the virus replicating in their oronasal pharynx.
This virus has very high morbidity and mortality rates. There is unrewarding therapy in young puppies that have already been infected, because they usually have severe organ damage. Unfortunately, there was a very slim chance that they would have survived, and if they did, they would probably have had organ defects.
The owners were very concerned about Sadie’s health, and wanted to know if she would ever become sick. They were told that she should develop antibodies to the virus, but she will be infected for the rest of her life. Any future litters she has will inherit the maternal antibodies to the virus and will not become diseased. The owners inquired about spaying, and were told that spaying would be recommended if they were not planning on breeding Sadie later on. 
Once confirmation from lab results is available, the owners will be notified. 


Sources:
http://www.merckmanuals.com/vet/generalized_conditions/canine_herpesviral_infection/overview_of_canine_herpesviral_infection.html
“Small Animal Infectious Diseases” Theriogenology VM8374 powerpoint, Dr. Julie Cecere.

OH NO, my puppy has CHV, what should i do?



What signs do I look for in my puppies?

Severely affected puppies will display: 
  • Depression
  • Weakness, lethargy, crying
  • Soft yellow/green feces
  • Nose bleeds or small bruises on the mucus membranes
  • Lack of appetite/not suckling 
  • Painful abdomen
  • Respiratory signs or nasal discharge
  • Some puppies may show nervous system signs such as blindness or staggering



How do you treat Canine Herpes virus in puppies?

Unfortunately there is currently no specific treatment for canine Herpes virus. Once symptoms occur in newborn puppies, death usually follows 48 hours later. Treatment is currently aimed at supportive care, such as anti-diarrheal medications or force-feeding older infected puppies.  Subcutaneous fluids, oxygen, warmth, and other life –supporting measures can be done.  Antiviral medications are not recommended when treating puppies.
 Puppies less than 3 weeks that become infected have a poor outcome, however the litter should be kept warm (100 degrees) and allow the virus to run its course. A passive immunization protocol may be attempted in young puppies this passive immunization occurs when serum from an infected female is given to the infected pup in an attempt to decrease mortality. This disease can occur suddenly with little or no signs seen. Therefore, if any of the previous mentioned signs are noted in your newborn puppies, contact a veterinarian immediately. 

“I want to be a breeder, how do I protect my puppies from Canine Herpes virus?”

Preventing canine Herpes virus should start with monitoring your breeding female.  The female will carry the virus in the respiratory and reproductive tracts. Although you may not see any signs or symptoms, the female may be a “latently” infected. Signs or symptoms that may appear in infected females include vaginal pain, purulent discharge, and recurrent lesions on reproductive organs, infertility, and other symptoms. 
There is currently no vaccine in the US to protect adults and puppies from canine herpes virus. Therefore, there are many preventative measures you must consider when managing a breeding operation. If you are considering getting any new females, you must isolate them from your kennel to insure you do not see any viral signs or symptoms.  You may also want to get new introduction females tested for canine herpes virus. A very sensitive test can be run at your local veterinary office to determine if they are infected. One of the most important preventative measures you can take in protecting your litter from herpes virus is to isolate the pregnant mother during the most high-risk times. These critical times include the three weeks prior to whelping and the three weeks after whelping. Isolate the pregnant mother from other adult dogs outside of the kennel during these high-risk periods. 
Canine herpes virus survives and thrives at low temperatures. Since puppies cannot regulate their body temperature It is extremely important to keep whelping boxes warm. The virus cannot survive at body temperature, so keeping puppies warm can help prevent spread or transmission of disease. 
These preventative measures are crucial to follow in you breeding programs to ensure 



FAQ's about CHV




FAQ's about CHV

Can I catch herpes from my dog?
  • No, Canine Herpes Virus can only be transmitted between wild and domestic dogs.  People cannot be infected by dogs.
What should I do if I think my dog has CHV?
  • Contact your veterinarian immediately.
Can my dog be cured from the infection with CHV?
  • Once infected a dog never completely clears the virus but they can lead a normal life.  Read CHV prevention and treatment brochure for more information.
My dog is an adult, can it still become infected with CHV?
  • Yes, dogs can become infected at any age.

How would my dog become infected?
There are three primary ways that a dog can become infected with Canine Herpes Virus.  First, if a dog has direct contact with an infected dog and they can contract the virus.  This can include physical contact with blood or bodily fluids.  Also, the virus can live on surfaces or carried from one animal to another on a person.  Next, puppies can receive the virus from their mother while in utero through the placenta. Infections of puppies from the mother can occur before, during or after birth.   This can occur through the birth canal, from other infected littermates and from nasal secretions.  Finally, adult dogs can transmit the virus as a genital infection.  This is important if you plan on breeding your animal.
What clinical signs would I see in my breeding animal?
  • Abortions of the litter
  • Stillborn puppies or weak newborns
What clinical signs would I see if my puppies are infected at less than 3 weeks of age?
  • Constant crying
  • Breathing distress
  • Nasal discharge
  • Small red and purple spots on the body
  • Weakness, lethargy
  • Lack of suckling
Are there any other possible signs that I could look for?
  • Conjunctivitis
  • Disease of the eye
  • Respiratory distress
  • Central Nervous System signs
This dangerous virus can infect young puppies before, during or after birth.
What is the outcome if my dog is infected?
If your dog is older than 3 weeks they may have a latent infection develop.  Although they may not display clinical signs all the time it may reappear with a stressful event or pregnancy.  Although females will abort their litter that she was carrying during infection she may be able to carry litters in the future.  Unfortunately, puppies less than 1 week of age do not survive.  Death can occur very suddenly.    From 1 to 3 weeks the chances of survival increase.  Older puppies can also develop a latent infection.
How is my dog diagnosed?
If you suspect Canine Herpes Virus contact your veterinarian.  Many of the symptoms that are seen with CHV are also seen with other diseases and it is important to differentiate in order to appropriately treat your animals.
PCR is the test used by most veterinarians to diagnose CHV.  This test is very sensitive to the virus.  Your veterinarian can check your dog with a mouth or vaginal swab for a diagnosis.  If you have seen an abortion or stillborn fetus it is important for your veterinarian to perform a necropsy to determine the cause of death.  Appropriate diagnosis helps to protect littermates and any other dogs that are in contact with your animal.

A Herpe's Tale, By Jimmy Muray



                                                         A Herpe's Tale, By Jimmy Murray
                                                            NO, Not a Hobbit's Tale, A HERPES Tale!
In a land far away, there is a kingdom named Pyometra where talking dogs rule the land.  For thousands of years Pyometra was full of peace and plenty, with all breeds of dogs living together in harmony with abundant supplies of Purina and Hill’s Food available to all who were hungry.  The German Shepherds would serve in the Kings Guard with their great strength and sharp teeth.  The Labradors were firefighters, the Huskies would pull the food from the farmlands into the city, and the Boxers were engineers to keep the kingdom running smoothly.  In fact, all breeds had an important job in Pyometra, even the Chihuahuas bar tended at the popular Drunken Dog Pub&Cafe.  

But now things are different.  Henry Rottweiler VIII is King of Pyometra and is a cruel tyrant who has brought famine to the kingdom and unfairly persecutes anyone who speaks out against him.  The German Shepherds have turned all the other dogs into slaves while Henry and his wife Catherine live in luxury.  After 4 months of marriage, Catherine has announced to Henry and the rest of Pyometra that she is pregnant and due for puppies very soon.  While all the breeds despise the royal family due to their forced life of servitude without pay, the entire kingdom still throws her a huge puppy shower, as is custom to do for the royal family’s first litter.  Hundreds of gifts are brought including bones, collars, kong toys and leashes.  For the first time since Henry VIII has become king, there is an excitement stirring through the air as the dogs believe the litter may soften his heart and cause him to treat Pyometra’s citizens with more respect.

The day has finally come and Queen Catherine is in labor for over fourteen hours giving birth to five boys and three girls.  Within 48 hours after birth, it becomes evident that something is wrong...very wrong.  The puppies are all very lethargic with none of them suckling from the Queen’s royal nipples.    Some of them have diarrhea and others have a red erythematous rash on their skin.  The enslaved Dr. Dachshund veterinarian is rushed to the scene to figure out what is wrong, but unfortunately all the puppies are dead on arrival.  As the Queen cries in great sadness, the veterinarian collects the dead puppies and brings them to his lab for necropsy to try and solve the problem.  The King does not cry, but instead becomes furious and accuses Catherine of killing his five Royal Canine sons (he doesn’t really care about the three girls as they can’t become his successor).  Henry tells his German Shepherd guards that Catherine has poisoned the puppies and orders her to be put to death. The guards drag Catherine to the middle of a busy street in Pyometra and publicly execute her via barbiturates for all of the kingdom to see.

In the veterinary lab of Dogdex, the veterinarian begins his diagnostic necropsy on the puppies.  After opening up the body wall of one of the dogs, he notices that all of the major lymph nodes are significantly enlarged and filled with blood.  The lungs and kidneys had serious necrosis and hemorrhage.  The vet continued to necropsy the rest of the puppies and noticed similar findings in all of the dogs, but also found some necrosis to the adrenal glands and liver in some of Henry’s offspring.  The vet took samples from the lungs and kidneys for looking at them under his light microscope.  Under magnification, the tissues showed single, basophilic intranuclear inclusion bodies in the necrotic lesions.  The vet submitted these tissues for virus isolation by cell culture and subsequent identification by PCR testing because he suspected that these lesions were caused by Canine Herpes Virus.   

 Dr. Dachshund reports to Henry VIII and tells him the puppies died from Canine Herpes Virus.  Henry hears from the veterinarian that Catherine had been an asymptomatic carrier that had come into contact with the virus in the last three weeks of her pregnancy and passed the virus to her pups shortly after birth.    Despite hearing  this knowledge, Henry is still a cruel and naive ruler and believes that the veterinarian is in on the conspiracy to kill his children.  So, he does as all cruel tyrants would do and had Dr. Dachshund executed the next morning.  

Three months later, Henry re-marries a new dog named Anne-Bonelyn.  Two months after the wedding Anne becomes pregnant and in sixty five days after that, gives birth.  Everything seems fine until again, just like with Catherine, the puppies become very sick.  None of them are suckling and there is green diarrhea all over the pen.  All of the puppies die by the age of five days, except for one who is clinging on by the faintest of hopes.  Henry VIII wastes no time and has him taken to the best veterinarian in the kingdom (2nd best until Dr. Dachshund was executed).  The vet closely monitors the male puppy, named Harry, and feeds it a milk replacer and an experimental dose of the antiviral drug Vidarabine.  As Harry is making a recovery against all odds, King Henry VIII is busy being the evil dog that he is and has Anne-Bonelyn executed for killing his litter.  If it had not become evident to you that Henry is just a very, very bad dog who does not listen to anyone, then hopefully by now you can see that this is the case.  

It is considered a miracle that Harry makes a full recovery and grows up to be a relatively healthy dog.  However, Harry does have some permanent liver and lymphoid tissue damage that was not fully repaired after the severe viral infection that causes him to be sick and depressed from time to time.  Harry is living with Henry VIII as his only son and Henry is content never to remarry since he does have one son to succeed him now.  Harry has a completely different idea, which has been molded from the rumors and whispers he has heard about how cruel his father is by suppressing all the dogs of Pyometra and killing two of his wives.  Harry fixes all of this by collecting Rabies infected raccoons from the woods and placing five of them into Henry’s bed chamber one night.  All of the raccoons manage to bite Henry in his sleep before the guards are able to exterminate the raccoons.  Pyometra’s medical capabilities are not able to cure rabies once a dog has become infected, so Henry VIII is isolated and dies a painful death.  Harry succeeds as king, but instead of ruling he steps down from power and creates a democracy where all the dogs can vote for laws and politicians.  The cruelty has ended and Pyometra quickly returns to a prosperous land with equality to all.


RESOURCES



  1. Merck Veterinary Manual http://www.merckmanuals.com/vet/generalized_conditions/canine_herpesviral_infection/overview_of_canine_herpesviral_infection.html