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

Other signs

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?