Loobani AcademyAbstract
Canine infectious respiratory disease is called CIRD for short, which is a highly contagious disease in China,especially in the poor environment of the dogs houses and the dogs hospice. There are a number of dogs suffer from a coughing and recover quickly however,a bronchopneumonia can develop mild to severe. And CIRD is well-known considered to be a multi-factorial disease.In this case,patient perform coughing and sneezing,along with purulent secretion. As far as I am concerned,this disease is easily to be confused with the bacterial infection of respiratory for the pet owners,and it could be dangerous to the dogs especially of the young ages and the weakness. So it is important to know how to diagnose and therapy.
Key words: CIRD, diagnose, treatment, infectious.
1. Basic information
Name: LA LA
Breed: Labrador retriever dog
Sex: Female (no-castrated)
Age: 2 month old
Body weight: 5.2kg
History: no vaccination and deworming
2. Before therapy
The patient was bought from the dogs house 7 days before on Tiktok ,feeding in group in the dog house and performed normal at that time.Recently the owner found it coughing and sneezing but do nothing because of considering the changing of the environment.But 1 day before the symptoms of patient became worse and presented depressing and no appetite of food and water.According to the seller,there was a vaccination but only the first needle and no deworming history,feeding with young dogs food,and the other dogs had become similar symptoms these days.A stress, overcrowding, and increasing the length of stay in a shelter/kennel environment also helps the transmission of diseases.
3. Physical examination
This case was presented with a coughing and sneezing with yellow,purulent charge. The oral mucous membranes was pink and pale.Basic physiological of heart rate was 132 beats per mini,respiratory rate was 30 per min,temperature was 39.7℃,capillary refill time(crt)was normal(<1s).Cardiophony was no obvious abnormal while there was not clear sound in the auscultation of the chest.Bilateral ears,eyes were cleaned,and the purulent secretion was found in the nose.The surface of the skin was soft and a little dry with the membranes of the palmulas.Lymph gland palpation abnormal was not found except a mild swelling of the cervical lymph node.Inducing cough reflex testing was positive.No abnormal was found in the abdominal palpation and the bone palpation.
4. laboratory examination
4.1 Complete Blood Count(CBC)examination
Table 1 The result of the CBC examination
|
Project |
Result |
Reference Range |
|
WBC |
24.5 |
6-17×109/L |
|
RBC |
4.13 |
5.5-8.5×1012/L |
|
HGB |
9.2 |
8-15g/L |
|
HCT |
26.3 |
37-55% |
|
MCV |
63.7 |
39-55fL |
|
MCH |
22.3 |
12.5-17.5pg |
|
MCHC |
35 |
30-36g/L |
|
PLT |
284 |
300-800×109/L |
|
LYM% |
20.2 |
20-55% |
|
OTHR% |
82.7 |
60-77% |
|
EO% |
0.4 |
2-12% |
|
LYM |
1.6 |
1.5-4.8×109/L |
|
OTHR |
23.4 |
3-11.5×109/L |
|
EOS |
0.1 |
0.1-1.25×109/L |
|
RDW |
13 |
13-17% |
|
PCT |
0.18 |
0-2.9% |
|
MPV |
4.8 |
12-17fL |
|
PDW |
18.2 |
0-50% |
4.2 The result of the CRP examination
Project | Result | Reference Range |
CRP | 10 | <20mg/L |
Complete Blood Count(CBC)examination: CBC examination showed a mild anemia in patient, but it may be a normal performance in the young dogs.The HCT,HGB and MCV was normal.In the part of white blood count index,we can see the rise of the white blood cells,as well as a right shift of the white blood cell nucleus in the microscope.The numbers of the lym cells are normal in the testing,is was weird in the virus infection patient and had a possibility that consumable with the causative agent.So,as i am concerned that it may suggesting the possible existence of infection and inflammation in this report.Thrombocytopenia may be associated with neutrophilia or the operation in blood collecting.
CRP examination: The result of the CRP was normal,this situation was not inconsistent with the CBC result which infer inflammatory.We know that the CRP is the fist inflammation index of dog,is the evidence of the acute inflammatory factor,can elevate highly in the acute injury and bacterial infection disease,so the normal number may not replace there was no inflammation in the body,it may be explained that the patient was in a chronic infection period.The result should analysis with the CBC and a following symptoms.
4.3The result of the 3 common infectious virus disease examination
Project | result | Reference Range |
Cdv | 0.22 | ＜1 Coi |
Cpv | 0.32 | ＜1 Coi |
Ccv | 9.51 | ＜1 Coi |
The result of antigen texting:Feces and secretion sample were collected to take a exam of the CDV,CPV and CCV antigen texting.We should know that this examination was convenient in the clinical but less accurate than PCR testing.So if the treatment response wasn’t accord with the doctor’s expecting,PCR may be taken for a better diagnosis.We can see that the CPV is positive in the report.
4.3 X-ray examination
Picture 1 Increased pulmonary markings in dog which infer the pneumonia – VD radiography
Picture 2 Increased pulmonary markings in the radiography in the chest – right lateral radiography
5. Diagnosis
Canine corona virus infection,Canine infectious respiratory disease
6.Treatment
(1)Prescription
①Lactated Ringer + 0.9% NaCl 1:1 (40mL/kg *24h)+ 1mL Vc, ivggt
②Cob 0.1mL, s.c
③IFN-w 250IU, s.c
④Cefotaxime sodium 250mg, s.c
⑤Doxorubicin 50mg, p.o
⑥Nebulizer therapy with 0.9% NaCl
The therapy continued for 3 day and in 4 day after the treatment,the symptoms of the patient became better,and it started to eat and drink.So stop giving liquid therapy and lessen the needle drugs.Only giving IFN and doxorubicin.Nebulizer therapy for every two days.After 7 days of the treatment,the symptoms of coughing and sneezing were less and less and rechecked the radiography of lung.We can see the abnormal area of the radiography was improved.Then the owner tooe it back home to nurse and kept on treatment of oral doxorubicin for 7days,during the days,adequate ventilation should be sure to helps reduce the spread of CIRD. The patient was recovery at last.
Picture 3 decreased pulmonary markings in dog compared with picture 1 – VD radiography
Picture 4 decreased pulmonary markings in the radiography in the chest – right lateral radiography
7. Conclusion
Introduction:Canine infectious respiratory disease was describes as an acute infection primarily impacting the upper respiratory tract which is one of the most usual causes we have seen in the respiratory disease of dogs especially in the young ages.There are a several virus and bacteria are associal with canine infectious respiratory disease.In this case,the cause of the CIRD was diagnosed as canine respiratory coronavirus.There are a possibility that more than one viral may be affected the dogs such as canine distemper virus,canine parainfluenza virus,canine adeno virus type 2,canine influenza virus,canine herpes virus, canine pneumovirus amd canine reovirus.The other type of pathogens which is also common involved in dogs is the bacterial pathogens such as Bordetella bronchiseptica,Streptococcus equi subsp andMycoplasma spp.So it is important to differentiate diagnosis by a complete examination instead of giving drug empirically.And we may note that the healthy dogs can also harbor canine infectious respiratory disease pathogens in the clinically.Those dogs in group or not giving vaccination are more easily exposed to the pathogens.Canine infectious respiratory disease is transmitted by oral and nasal contact with aerosol form the respiratory secretions.The contaminated food and environment can also affect the patients.The incubation period is 2-3days usually and in some cases it may be up to 10 days which is depending on the virulence of the pathogen.
The methods of diagnosis:In this case,we made a presumptive diagnosis of canine infectious respiratory disease according to the based clinical sings,life history and the physical examination.And taking a series of diagnostic examination in patients to confirm the result to avoid the risk that the patient did not respond to the supportive therapy and have a evidence to show to the pet owners.In some case,we can usually find the symptoms such as fever,lethargy,anorexia,coughing,snezzing,dehypration,edema conjunctiva,gagging,nasal and ocular discharge,retching,vomiting,tachypnea,trachea palpation painful,weakness and weight loss by doing physical examination.We have mentioned that several pathogens are associated with canine infectious respiratory disease,so we can not use the clinical signs alone to diagnose.
Complete Blood count:The changes of CBC testing are nonspecific in many times,but it can show us the situation in the body. We can see a stress leukogram or infection leukogram,with neutrophillia,lymphopenia and eoxinopenia in the testing usually.If the patient occur pneumonia,a left shift or marked leukocytosis can be found and it is a complicating factor in the disease.
Thoracic Radiography:Thoracic radiography examination are usually used in the patients of respiratory symptoms.Although it is unremarkable in some patients with uncomplicated canine infectious respiratory disease,this examination has a advantage of convenience and perceptual intuition.
ELISA of the antigen testing: antigen testings are one of the most commonly used tests and convenience methods for the viral detection in China.We can get the result in 30 minute and make a diagnosis quickly.But the False-negative and false-positive can occur with many reasons like improper sample collection and the quality of the viral testing kit.
Ploymerase Chain Reaction(PCR)assay:PCR assays are the one of the most commonly used tests methods especially in central hospital,which are a accurate and reliable methods.But it has some disadvantages like too long to get the result and it can be impacted by the improper sample collection.
What is the treatment for CRID ? There are no specific anti-viral therapy for canine infectious respiratory disease if the affected pathogen is CcV.The principle of the treatment consists of supportive therapy according to the clinical sings to maintain the resistance to the infection .Antibiotic drugs are suggested to be used if there are sings and symptoms of secondary bacterial infection.Liquid therapy may be needed in the weakness dogs which do not eat and drink.Nebulizer therapy is a good choice to relieve the patients from injury of respiratory by the acute coughing.In most cases of CIRD whose signs are typically mild,antibiotic therapy may not be required in most times because they are self-limiting and can resolve spontaneously within 10 days.Hence,if the disease is due to viral infections,and the patients present secondary bacterial infection such as fever,lethargy,loss of appetite,along with a purulent nasal or ocular discharge, antibiotics are used although they are ineffective for the underlying cause.Doxorubicin is considered to be a good drug for a first choice to use because of its efficacy to against the common pathogens like Mycoplasma spp. And B.bronchiseptica,and has a good effect in respiratory tract.If lungs are involved in the infection, other broad-spectrum antibiotics like cefotaxime sodium may be needed.In ideally situation,we should select antibiotic drugs by the bacterial culture, but it is not reality in clinical therapy of sever patient.In some reports,the supportive therapy of prednisone may be considered as an anti-inflammatory drug to use to help relieve coughing.However,if the the level of the glucocorticoids are inhibited, there is a risk of infection. Besides,anti-tussives drugs like hydrocodone ,butorphanol and codeine may be used to reduce the frequency and intensity of coughing, however,coughing is also a protecting mechanism to increase clearance of respiratory pathogens for the patients,the suppressants of coughing can reduce this effects.So in this case, the anti-tussive s drugs should not be used in the patient because of the secondary bacterial infections.On the other hand,nebulization therapy is a good choice for solving the problem of excessive respiratory secretions.6-10mL 0.9% sterile NaCl liquid are beneficial.And the patient is suggested to be nebulized over 20 minutes q 12-24hrs.
Monitoring and Prognosis: In clinical ,most patients which is diagnosis as CIRD with mild symptoms can be treated and monitored as out patients and no need to stay in the hospital. Those that develop complicating factors such as this case which is pneumonia are require more intense monitoring and therapy.Vaccination is key to prevent the disease of infectious respiratory and can relief the symptoms although the vaccinated dogs still can be infected.In my experience,the prognosis is good in this king of patients and the clinical sings and symptoms are typically mild and self-limiting.But in the dogs which are not vaccinated,young ages or immunity suppressive,are at a higher risk for more severe symptoms and death rate. In this case,the therapy continues 14 day, and the symptoms are controlled.
