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Companion Animals in the EU
Paula Boyden BVetMed MRCVS
Dogs Trust
Movement of Animals
• From 2001, pet animals have been allowed to travel throughout the EU as long as they had a pet passport
1st January 2012
• Individual country derogations reviewed / removed:– NO requirement for rabies titre (blood) test to
enter UK, Ireland, Malta, Sweden– 6 month wait prior to (re-)entry reduced to 3
weeks– Tapeworm treatment window extended to 24-
120 hours– NO requirement for tick treatment
Movement of Pets: The Future
• 998/2003 – Movement of animals before 3 months of age– Derogation from anti-rabies vaccination– Participating in competitions, exhibiting,
sporting or recreational events or in training for these events
…..so is this a problem?
Rabies Control in Europe
Rabies infected countries 1998
Number of Cases in the EU
Rabies in Europe 2003
Rabies in Europe in 2012
Rabies: The Disease
• Very variable, sometimes death can be acute and few signs seen– Change of demeanour and behaviour– Restless, confused, disoriented– Altered vocalisation – Incoordination, paralysis, salivation, ‘bone in
throat’ syndrome– Aggression, biting, hypersexuality– ‘Fly-snapping’, pica
Rabies in Humans
• Localised pain or paraesthesia
• Change in behaviour, anxiety, fear, aggression
• Aerophobia• Hydrophobia• Paralysis, coma, death
Rabies PEP
What about rabies vaccination?
Factors Affecting Vaccine Failure
• Vet Record (2004) 154, 423-426– Factors affecting the serological response of
dogs and cats to rabies vaccination (Mansfield, Burr et al)
• BSAVA Proceedings 2005 (Abstract)– Do dogs vary in their response to Rabies
vaccination (Kennedy et al)
Factors Affecting Failure
1. Brand
2. Number of doses used
3. Age
4. Timing of sampling
5. Breed
Comparison of Vaccines (Dogs)
0
5
10
15
20
25
30
Mean Titre IU/mL % Failed Tests(<0.5IU/mL)
Vaccine A
Vaccine B
Vaccine C
Significant differences (p<0.01) between each vaccine for mean titres and % fails
Number of Doses Used
• Dogs: Using a primary course of 2 doses will increase the mean titre achieved
• Cats: No significant increase in titre after 2 doses
• D/S recommends 2 doses in young, naïve individuals
Age
• Adults significantly more likely to pass than old or young
• Kennedy: 10400 dogs;– <1yr, 1-7yrs, >7yrs– Adults>old>young
• ?Take into account when electing number of doses to use
Effect of Interval Between Vaccination and Sampling
Compared to 30-59 day interval, significant (p<0.05) increase in titre for 0-29 days, and highly significant (p<0.01) decreases in titre for longer time intervals.
012345678
<30 30-59 60-89 90-119 ≥120
Mean Titre (IU/mL)
Breed
• Larger breeds appear to have lower response to vaccination than small breeds– Burr, personal
communication– Kennedy:
Rottweilers
Greyhounds
Study: Main Conclusions
• Dogs <6months old had significantly lower titres
• Ability to respond may decline with age
• Timing of sampling and number of doses had most significant impact of titres
Risk of Rabies
• Number of cases across EU has declined• No guarantee of the response to
vaccination• Increased potential for incubating animals
to cross borders• Number of animals travelling (legally) has
increased• Increase in illegal movements
Rabies Control
“To solve the problem of rabies would be a blessing for humanity” (Louis Pasteur)
Echinococcus multilocularis
Echinococcus multilocularis
Risk of Echinococcus granulosus
• Praziquantal will only kill tapeworms present at the time
• Increasing the treatment window up to 5 days increases the chances of re-infection prior to travel
• Sweden has already lost its derogation due to Echinococcus granulous being detected
Limitations of PETS
• PETS is in place to protect human health• Animal health is not a primary
consideration• No vaccine is 100% effective• Complying with PETS will not ensure a
pet remains healthy if it travels to another country
Diseases associated with Travelling Pets
• Leishmania (Sandfly)• Babesia (Tick)• Ehrlichia (Tick)• Dirofilaria (Mosquito)
Introductions
Travelling diseases
• Increasing over last few years• Previously unknown diseases introduced• PETS travel scheme• Relaxing of travel rules
Plan
1. Leishmania
2. Babesia
3. Ehrlichia
4. Dirofilaria
5. Case study – leishmania
6. Case study – ehrlichia
7. Conclusions
1. Leishmania
Leishmania• Protozoon• Up to 40% of dogs in endemic
areas• 12 million people in 88
countries• Transmitted by sandflies
Where is it found?
Leishmania infection
• Highly immune dogs clear infection (20-40%)• Some breeds (eg Ibizan hounds) appear to
have higher resistance• Once infection is established, it cannot be
cured
Clinical infection
• Very variable!• Vague illness• May be a long gap between being
infected and becoming ill
Skin signs of infection
Testing – what are we looking for?
AntibodyDog has fought infection
Body’s response to diseaseIncludes Speed Leish K
Leishmania itselfIncludes looking at blood/ bone marrow under microscope and PCR test
When to test
• Easier to diagnose when dogs are ill – Both antibody and parasite levels are higher
• If available, use PCR tests – most sensitive
Treatment• Generally remission NOT
cure• Allopurinol (Zyloric)• Meglumine antimonate
(Glucantime)• Amphotericin B (Fungizone)• Treatment can be toxic,
especially when combined with damage from leishmania
Preventing leishmania
• Insect repellent (eg Scalibor collar)• Keep inside between dusk and dawn
Leishmania vaccine
• Must test first• 3 injections, 3 weeks
apart• Dogs over 6 months
Plan
1. Leishmania
2. Babesia
3. Ehrlichia
4. Dirofilaria
5. Case study – leishmania
6. Case study – ehrlichia
7. Conclusions
Babesia
• Like leishmania, a protozoon• Lives inside the red blood
cells• AKA piroplasmosis
Signs of babesia
• Anaemia• Bleeding problems• Red urine• Sudden collapse
Treatment of babesia
• Drugs similar to leishmania- Imidocarb- Iminazine- Atovaquone- Azithromycin
Plan
1. Leishmania
2. Babesia
3. Ehrlichia
4. Dirofilaria
5. Case study – leishmania
6. Case study – ehrlichia
7. Conclusions
• Bacteria• Live inside white blood cells
(macrophages)
Ehrichia
Signs of ehrlichia
• Acute (8-20 days after infection)– Vague depression, fever, weight loss, poor
appetite– Enlarged lymph nodes, nosebleeds, bleeding
into skin
• If diagnosed and treated in acute phase, often recover
• Otherwise progress to chronic infection
Chronic ehrlichia infection
• As for acute, but more severe– Emaciation– Swelling of hindlegs and scrotum– Pale gums– Eye problems– Neurological problems
Treatment of ehrlichia
• Doxycycline for at least 2-3 weeks• May relapse• Infection with both ehrlichia and babesia
may occur
Prevention of babesia and ehrlichia
• Good parasite control• Scalibor, Frontline, Advantix
Babesia only:-• Vaccine (does not completely prevent
infection)
Plan
1. Leishmania
2. Babesia
3. Ehrlichia
4. Dirofilaria
5. Case study – leishmania
6. Case study – ehrlichia
7. Conclusions
Heartworm (dirofilaria immitis)
• A type of roundworm• Spread by mosquitos• Worms lodge in the
arteries of the lungs• Dogs and cats
Signs of infection
• Depends on how bad the infection is• May be sudden onset but more often
gradual• Coughing• Trouble breathing• Unable to exercise• Weight loss• Fainting• Sudden death
Treatment of heartworm
• Regular worming (not all wormers!)
• Macrolides – Ivermectin, Moxidectin,
Selamectin)
• Reactions can occur on worming
• Surgical removal of worms from heart
Plan
1. Leishmania
2. Babesia
3. Ehrlichia
4. Dirofilaria
5. Case study – leishmania
6. Case study – ehrlichia
7. Conclusions
Should we worry?
• Animal health and welfare• Owner awareness• Vet awareness • Treatment availability• Stress and expense for new owner
Conclusions
• Travelling diseases a serious problem• May be different in non endemic country eg UK• Export of infection best avoided where possible• Test before import (and 6 months after if leish
endemic)
Acknowledgements
• Centre for Evidence-based Veterinary Medicine
• Rachel Dean and Gemma Clark• Dogs Trust• ICAWC• Thank you!
Websites which pictures have been ‘borrowed’ from
http://www.parasitologie.univ-montp1.fr/english_vers/en_leish2.htmhttp://globalhealthvet.com/2010/10/05/working-in-morocco-recurring-leishmaniasis-in-a-canine-patient/http://www.who.int/leishmaniasis/surveillance/slides_manual/en/index5.htmlhttp://www.bestvetstore.com/leishmaniasis-in-dogs/http://www.flickr.com/photos/19187511@N00/2478336427/http://silvercoastangelicdogs.wordpress.com/2012/04/05/canine-leishmaniasis-vaccine-now-available-in-portugal/http://www.pepisdogrefuge.com/news.htmlhttp://www.noahs-arks.net/RESCUE/SAM.html
Adoption Across Borders
The Law: EU and listed non-EU
• Microchip• Vaccinate against rabies• Wait for 3 weeks• Travel• If travelling to UK, Ireland, Malta, Finland:
treat against tapeworm Echinococcus granulosus 24-120 hours before travel
Listed Non-EU Countries
Belarus Liechtenstein Russian Federation
Bosnia Herzegovina
Monaco Switzerland
Croatia Norway Vatican
Unlisted Countries
• Microchip• Vaccinate• Blood sample after 30 days• Wait 3 months from date of successful
blood sample• Travel• Tapeworm
Further Considerations
• What infectious diseases are prevelent across Europe?– CPV / CDV / CAV– Leptospirosis– FPL / FeLV / Cat ‘flu
• What about further afield?– WSAVA guidelines
Further Considerations
• What infectious diseases are prevalent in the country of origin?
• Are there appropriate tests available?
• Are these diseases endemic in the destination country?– Naïve population– Should we risk introducing the disease into this?
Further Considerations?
• What infectious diseases are prevalent in the destination country?
• Is there a vaccine available?
• Vaccinate before travel?
Leishmaniasis
• Sandfly transmitted• Prevalent around the Med basin• Zoonotic • PCR test available
– Before travel– 6 months later
• Can manage but not cure
Other Diseases
• Dirofilaria (Heartworm) – Regular treatment required to prevent clinical
disease
• Babesia
• Ehrlichia
In Practice
• Comply with rules regarding movement of animals
• Test for diseases prevalent in the country of origin but absent at destination
• Prevention against diseases prevalent in the destination country
But this costs money- what happens if I don’t?