In our backyard
A few months back I touted the joys of telecommunication - veterinary lectures via phone and computer...how happy I was not to have to catch the ferry, leave my kids, or shell out big bucks for a hotel. The universe must have been listening because in May, International Veterinary Seminars sponsored a three-day meeting on Practical Management of Common Medical Problems at the Harbor View Hotel in Edgartown. Be still, my heart. A real live veterinary conference with real live specialists in my very own backyard.
I was particularly excited because one of the speakers was Michael Lappin, D.V.M., Ph.D., a professor of Medicine at the College of Veterinary Medicine at Colorado State University, with a special interest in infectious diseases, including some of those pesky tick-borne diseases we have on the Island. In fact, Dr. C. Rogers Williams and Dr. Bridget Dunnigan from the Vineyard Veterinary Clinic in Edgartown have worked with Dr. Lappin on research published recently about Ehrlichia infection in cats. I couldn't wait to hear him speak. I wasn't disappointed. In an Oklahoma drawl that brought Forrest Gump to mind, Dr. Lappin dazzled us with his knowledge, humor, and practical down-to-earth approach.
He began with gastrointestinal infections of dogs and cats, including worms, protozoa, flagellates, bacterial, and viral diseases. How do our pets contract these diseases? Ingestion of rodents and birds is a major source, and indoor cats are not immune. "Cats are torturers and murderers," Dr. Lappin joked, flashing a slide of his own indoor kitty toying with a mouse.
I know in my practice, I always ask if there is any chance that Puss, the pampered indoor Persian, has caught any rodents. I don't want to impugn your housekeeping, but mice can sneak into the most immaculate of houses. Dr. Lappin showed us a slide of a nest of pink squirmy baby mice. "We found these in our silverware drawer," he said, unabashedly. "Your house isn't a glass biosphere." The prevalence of many GI infections is the same for indoor cats as for outdoor cats. Cockroaches or flies can transport diseases inside. Maybe Boots, the Border Collie, goes in and out, bringing in disease-carrying fleas and ticks, even if Puss never leaves the safety of her satin sofa.
Another source can be diet. Maybe you feed a raw meat. In one study of high-quality frozen raw meat pet foods marketed in the United States, 52% contained an enteric pathogen, i.e., a sick-making bug. Dr. Lappin modestly said he wasn't enough of a nutritionist to comment on the nutritional value of such diets but he did volunteer this: "It you're eating raw meat, you're more likely to be eating bacteria. I'm an infectious disease specialist. I cook my meat medium- well."
Wash your hands!
What about our risk of catching these diseases from our pets? This is especially of concern to people with compromised immune systems such as those with HIV or undergoing chemotherapy. "A healthy pet without ectoparasites is of minimal danger to human health." (Ectoparasites are critters that live on the skin like ticks, lice, and fleas.). "Happy people have better immune function," Dr. Lappin said, extolling the benefits of pet ownership and encouraging us to be sure our clients get accurate information. "Don't tell someone to get rid of their cat and then not tell them to wash hands after gardening....Hand washing is key to all infectious disease control."
Realistically, our human contacts pose a greater risk than our pets. "Think about it," he smiled. "Who am I more likely to catch an infectious disease from, my seven pets or my wife?" One scenario in which pets can pose a serious risk, especially to kids, is with intestinal parasites. The common roundworm of dogs and cats can infect small children, if they ingest fecal matter containing the microscopic eggs. The larvae can migrate into the eye, causing blindness. Dr. Lappin supported the deworming recommendations of the Compendium Animal Parasite Council. I have always thought these protocols overzealous, when looked at in terms of individual animals, but Dr. Lappin convinced me that it's really about public health. The goal is epidemiologic. We are trying to lessen the world worm burden so that no "kid's eyeball gets rotted out." To learn more, check our www.petsandparasites.com.
Next he discussed vaccination guidelines. Dr. Lappin's philosophy was simple and compelling. Vaccinate for diseases that are deadly to animals or deadly to people. "Parvo kills dogs. Rabies kills people. Panleukopenia kills cats. We want to vaccinate pets for what they need." What about vaccine reactions? As with any medical treatment, we have to decide if the risk of side effects outweighs the risk of the disease. How many animals do you help versus how many do you make sick? "There's not one thing we can do that is 100 percent safe." But in the case of these "core" vaccines, the pros clearly trump the cons. Other vaccines? "How many of you got a Yellow Fever vaccine this year?" he asked the crowd. The point again is simple. If you're going rafting on the Amazon, you might need a Yellow Fever vaccine. If you're going vacationing on the Vineyard, you probably don't.
Which brings us to Lyme disease. No Yellow Fever here, but we sure got a whole lot o' Lyme. How effective is the canine vaccine? Should every dog get it? Not if Boots lives in Dr. Lappin's home turf of Colorado, where Lyme disease is rare. But here? I'm a firm believer in the vaccine for Island dogs. Dr. Lappin concurred. "We don't know if [Lyme] vaccines help. We don't know if they hurt. We just honestly don't know," he admitted, then concluded with a shrug, " If I lived here, I would vaccinate." The routine screening of apparently healthy dogs for Lyme, and how to interpret the results, is also a source of debate. "Positive tests don't prove that you're ill. They prove that you're positive," Dr. Lappin said. What about the newest test, the IDEXX Quantitative C6 Lyme? In spite of all the literature provided by IDEXX Dr. Lappin maintains there is, as yet, insufficient scientific data to support their protocols. He did not say they were wrong, simply that they were unproven. "[IDEXX] is giving us a test that we don't know what it means."
Dang! I was hoping for a clear-cut directive about these tests. Instead, I got some really good take-home advice that I pass on to you. Testing for Lyme (and other tick-borne diseases) is important if Boots is sick. If Boots appears healthy, Lyme screening still has benefits. It can help us learn more about the prevalence and distribution of the disease. It may identify dogs with subclinical infection that may benefit from treatment. But if Boots is healthy, and money is tight, it's better to spend your shekels on Frontline or Advantix. "Don't miss flea and tick control because you're doing a bunch of tests. Tick control first, testing second, is the best use of your client's financial resources!"