On November 10, 2016, the Arizona Veterinary Medical Association issued the following alert: “Leptospirosis Outbreak in Dogs in Maricopa County. The report stated, “At least 20 laboratory positive dogs have been reported since the beginning of the year.”
Isolated problem? Definitely not. Consider this report from Chicago: “Leptospirosis is threatening dogs in the Chicagoland area.”
An AVMA article stated that: “Common risk factors for leptospirosis in dogs include exposure to or drinking from rivers, lakes or streams; roaming on rural properties (because of exposure to potentially infected wildlife, farm animals, or water sources); exposure to wild animal or farm animal species, even if in the backyard; and contact with rodents or other dogs.”
And, “Dogs can become infected and develop leptospirosis if their mucous membranes (or skin with any wound, such as a cut or scrape) come into contact with infected urine, urine-contaminated soil, water, food or bedding; through a bite from an infected animal; by eating infected tissues or carcasses; and rarely, through breeding. It can also be passed through the placenta from the mother dog to the puppies.”
Hmmm. Considering your sales territory…
Is it possible that these leptospirosis risk factors are present in your part of the country?
We’re thinking yes, it’s possible. And it’s worth discussing risks, vaccinations, and management with the clinics you visit, so you can help them help patients avoid infection.
“The biggest issue with Lepto vaccination is still a reluctance to vaccinate,” said Eileen Ball, DVM, veterinary medical lead/biologicals and infectious diseases, Zoetis. “This is often due to concerns about safety, a belief that lepto is not present in the area, or the dog is not at risk of infection.”
So what can you do to overcome these barriers? We have suggestions from Dr. Ball and also Madeleine Stahl, DVM, sssociate director, scientific marketing affairs, Merck Animal Health.
We asked them the following questions about addressing leptospirosis risk in the practice — and how you can help.
What is the biggest issue when it comes to managing leptospirosis?
Dr. Ball: Lepto is often called the great pretender as dogs can initially present with varied symptoms that might initially look like other diseases or conditions. This can hinder a timely diagnosis and, in some instances, it might make the difference between life and death.
Traditionally the thought was that large breed, male hunting dogs were the highest lepto risk group. It has been demonstrated that this isn’t necessarily the case.
Many different mammalian species can transmit Leptospira bacteria in their urine. Rodents are often infected and also tend to live in and around residential areas. This puts many, many more dogs at risk than traditionally might have been expected.
Finally, not only does leptospirosis occur in dogs — it is actually the #1 zoonotic disease in the world. Awareness of both the disease itself as well as opportunities for prevention at both the clinic and pet parent levels are key take home messages.
Dr. Stahl: In the past, it was presumed that only large breed outdoor or working dogs were at risk for leptospirosis, but studies have now shown that even small breed dogs are at risk today.
Urbanization and encroachment on wildlife reservoirs are thought to play a role in the increased incidence in dogs. Since reservoir hosts such as rats can spread the disease through urinary shedding, dogs in urban environments are at risk for leptospirosis. Rodents can shed leptospires throughout their lifespan without clinical manifestations.
In addition, the rise in cases could be due to increased disease recognition and diagnostic testing or also a reflection of a reduction in leptospirosis vaccination in small breed dogs due to the concern of vaccine adverse reactions.
Furthermore, some clinics are still using 2-way (2-serovar) Leptospira vaccines when there is more comprehensive protection available with the 4-way (4-serovar) Leptospira vaccines.
(Dr. Ball also mentioned the latest vaccines: “Today’s 4-serovar vaccines are very different from the 2-serovar vaccines of the past from a smoothness and reactivity perspective,” she said.)
Are there updated lepto prevention and treatment solutions, protocols, and recommendations that DSRs can bring to the clinic?
Dr. Stahl: “One of the easiest prevention recommendations is to switch to a 4-way Leptospira bacterin for the broadest protection currently available. Also, recommend diagnostic testing — the more veterinarians test for canine leptospirosis, the more they may find in their area. Early clinical signs can be vague, such as anorexia and lethargy. Recognition of leptospirosis is important not only for animal health but also human health, as it is one of the most prevalent zoonotic diseases worldwide. Have a protocol in place for the hospital and staff members in the event a potential leptospirosis case is presented to the clinic.
Dr. Ball: Helping to promote awareness of the risks of leptospirosis is paramount. It is important to have an understanding that risk of leptospirosis is not as simple as knowing if the disease has previously been diagnosed in the area. Unfortunately, this is a common myth. Climate changes, such as increased rainfall or flooding, increases in rodent or wildlife populations and failure to test potential cases, are all reasons why historical data alone isn’t enough to determine risk and apply to vaccination protocols.”
Why should practices take another looks at leptospirosis management?
Dr. Ball: When leptospirosis vaccination is promoted at the clinic level as a core vaccine for dogs, clinicians can rest assured that they are helping to prevent a potentially deadly disease. This can translate to a progressive image for the practice as well as increased revenue.
Dr. Stahl: The cost of vaccination and minor risk of adverse effects outweigh the cost of therapy and risk of death by leptospirosis.
Is there anything new regarding leptospirosis prevention efficacy?
Dr. Ball: Today’s 4 serovar leptospira vaccines are an efficacious and safe option for helping to prevent this deadly disease. “
Dr. Stahl: Four-serovar Leptospira vaccines have been commercially available since 2001, and 2-serovar vaccines are not recommended in current guidelines, yet there are still many patients only receiving protection against two Leptospira serovars.
While some veterinarians may be hesitant to switch to a 4-way bacterin due to the concern of vaccine-associated adverse events, newer bacterins have undergone further refinement and are much smoother today. In addition to providing broader serovar protection with 4-way bacterins, some have been specifically tested and are labeled for prevention of urinary shedding of Leptospira by infected dogs. Prevention of shedding is one of the key objectives of vaccinating dogs against a zoonotic disease such as leptospirosis.
What’s a great way for distributor reps to open the leptospirosis conversation with veterinarians?
Dr. Ball: It is best to begin by gaining an understanding of the clinic’s current perspective on vaccination to help prevent leptospirosis, as well as past experience.
Dr. Stahl: Some questions a distributor sales representative can ask include:
- Which of the zoonotic canine diseases pose the greatest concern for you and your canine patients?
- How do you approach zoonotic disease and awareness with your clients?
- Did you know that the Centers for Disease Control and Prevention (CDC) recommends pet owners visit their veterinarian to have their pets vaccinated against leptospirosis?
- What factors are important to you when choosing a Leptospira vaccine?
- What concerns do you have regarding Leptospira shedding?
- What protocols do you have in place to protect your clinic staff from Leptospira exposure?
Do you know of any Lepto educational resources for clinic and client education?
Dr. Stahl: Distributor sales reps can refer veterinarians to reputable, informative websites, such as the Centers for Disease Control (CDC) website for leptospirosis. This website features one-page fact sheets in English or Spanish that could be posted in the clinic waiting area to help increase awareness of this zoonotic disease. Distributor sales reps can also utilize pet owner brochures from vaccine manufacturers to help educate pet owners on leptospirosis and ways to help prevent this important disease.
Many thanks to Dr. Ball and Dr. Stahl for their insights on leptospirosis. You can count on Zoetis, Merck Animal Health, and other manufacturers to support your efforts on disease prevention in the practice.