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Overview of Health-Management Interaction: Small Animals

By Steven L. Marks, BVSc, MS, MRCVS, DACVIM, Clinical Professor of Emergency and Internal Medicine; Associate Dean and Director of Veterinary Medical Services, North Carolina State College of Veterinary Medicine

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Proper management to prevent and control disease has historically been a higher priority in production animal medicine than in small animal medicine. However, appropriate management is just as important for small animals, whether their environment is that of a single or multiple-pet household or a more intensive housing situation such as a kennel or cattery.

Responsible pet ownership must be emphasized to all those owning and considering owning pets. Areas of client education that should be emphasized include the following: 1) routine care and grooming, 2) preventive health care, 3) parasite control, 4) nutrition, 5) household hazards, and 6) housing requirements and environmental factors.

Routine care and grooming not only help maintain pet health but also allow identification of health problems early in the course of disease. Compared with disease in people, disease in animals is generally identified at a later stage. Close observation of pets allows for evaluation of changes in appetite, thirst, urination, defecation, ambulation, and general behavior. Any changes may suggest the need for a more thorough examination and possible intervention. Special attention should be given to hair coat, skin, ears, eyes, and teeth. Anal sac impaction and overgrowth of nails are common problems.

Preventive health care in small animals primarily involves vaccination and parasite prevention. Vaccines are available for a variety of infectious diseases in dogs, including distemper, parvovirus, hepatitis, leptospirosis, tracheobronchitis, rabies, Lyme disease, and coronavirus. Vaccines available against infectious diseases in cats include those for panleukopenia, rhinotracheitis, calicivirus, rabies, feline infectious peritonitis (FIP), and feline leukemia virus (FeLV).

Vaccination schedules vary but generally require an initial vaccination at 6–8 wk of age, followed by additional vaccinations at 3-wk intervals until the animal is 4–5 mo old. After this, most vaccines are given annually. Rabies vaccination is dictated by state law or local jurisdiction. First-time vaccination for diseases other than rabies in adult animals should include an initial vaccination followed by at least one booster.

In the past, there has been some question concerning the overvaccination or hyperimmunization of both dogs and cats. Vaccine-associated sarcomas, specifically fibrosarcoma, have been an increasing problem in cats (see Soft-tissue Sarcomas). The etiology of this tumor is not completely understood, but it appears at vaccination sites of rabies and FeLV vaccines. In dogs, there has been some correlation between vaccination and immune-mediated disorders such as immune-mediated hemolytic anemia.

Current canine vaccination guidelines, published in 2011 by the American Animal Hospital Association, identify core and noncore vaccines. Core vaccines include distemper, parvovirus, and adenovirus-2. A killed rabies vaccine is also core and is available as a 1-yr and 3-yr product. The specific vaccine schedule is 8 wk, 12 wk, and 16 wk of age. The first booster should be given no later than 1 yr after the final vaccine dose of the initial series. Subsequent boosters should be administered every 3 yr. Current feline vaccination guidelines, published in 2013 by the American Association of Feline Practitioners, suggest vaccination for panleukopenia, herpesvirus 1, calicivirus, and feline leukemia virus (FeLV). Additional vaccines may be suggested depending on risk of exposure, eg, indoor versus outdoor or cattery situations. Current recommendations for vaccination sites also follow the guidelines of the American Association for Feline Practitioners. This protocol can also be used for dogs. The guidelines suggest that cats be vaccinated in an area amenable to surgical resection, ie, distal limbs rather than torso. Vaccines for feline panleukopenia virus, feline herpesvirus 1, and feline calicivirus are administered below the right elbow. FeLV vaccines are given below the left stifle, and rabies vaccines below the right stifle. Vaccinating dogs and cats less frequently has also been suggested. A triannual vaccination protocol for vaccines other than rabies has been adopted at many institutions. It is also recommended to reserve vaccines for certain diseases such as FeLV, Lyme disease, leptospirosis, feline immunodeficiency virus, and FIP for at-risk animals.

Other preventive health care measures may include castration or ovariohysterectomy, and annual veterinary examinations. The current trend in preventive health care is to emphasize an annual examination separate from visits for vaccination. The preventive health visits allow the veterinarian to see the animal frequently and detect disease at an earlier stage.

Parasite control continues to be important. The primary endoparasites include GI parasites such as roundworms, whipworms, and tapeworms (see Gastrointestinal Parasites of Small Animals, et seq). Heartworm disease (see Heartworm Disease), an important clinical entity in both dogs and cats, is preventable with prophylactic therapy. Although a treatment is currently available for heartworm disease in dogs, no safe or acceptable treatment is available for cats. The American Heartworm Association provides treatment guidelines for canine and feline heartworm disease. The primary ectoparasites include fleas, ticks, and mites. Both oral and topical products are available for flea control in dogs and cats. Another important aspect of parasite control includes prevention of zoonotic diseases such as visceral larva migrans and toxoplasmosis. Bartonella may also be an important vector-borne disease affecting people.

Nutrition is an important and often overlooked aspect of pet ownership. Most pet foods on the market have been formulated based on significant research and development. Specialty diets are available (both over-the-counter and from veterinarians, including prescription diets) for young, growing, and geriatric pets, as well as for specific disease processes. Overfeeding and oversupplementation may lead to numerous problems, and feeding of table scraps should be kept to a minimum. (See also Nutrition: Small Animals.)

Water quality should not be overlooked, especially in rural areas and in kennels and catteries. Fresh water should be available ad lib.

Household hazards provide a variety of dangers to dogs and cats. Potential hazards include electrical cords, lead-based paint, cleaning supplies, antifreeze (see Ethylene Glycol Toxicity), houseplants (see Houseplants and Ornamentals), insecticides (see Insecticide and Acaricide (Organic) Toxicity), prescription drugs (see Toxicities from Prescription Drugs), illicit and abused drugs (see Toxicities from Illicit and Abused Drugs), alcoholic beverages, chocolate (see Chocolate), artificial sweeteners (xylitol, see Xylitol), sewing needles, fish hooks, and many others. (Also see Household Hazards.) Elements of house design, such as steep stairs, slippery floors, open windows, etc, may also be hazardous.

Housing requirements and environmental factors are an important consideration for pets. For companion animals sharing an owner’s home, concerns are generally limited. However, outdoor housing must provide cover from direct sunlight, shelter from excessive wind and extreme temperatures, adequate ventilation, and an adequate supply of fresh water. These factors are critical in kennels and catteries. Drainage must be appropriate for proper sanitation, and surfaces must be suitable for cleaning and disinfection. Hazardous environmental conditions can result in hyperthermia, sunburn, dehydration, hypothermia, or frostbite. Housing must also be safe and keep pets away from dangers such as other animals, motor vehicles, and malicious mischief. If animals are restrained by a leash or a chain, care should be taken that self-trauma cannot be inflicted. Some municipalities have introduced chain laws to prevent this type of injury.

Miscellaneous considerations include obedience training, which may help reduce aggressive interactions with other animals and people.

Traveling with pets is another important consideration. If crossing state lines, a health certificate should be issued. When international travel is planned, owners should be advised to become familiar with the appropriate health, quarantine, agriculture, and customs requirements. Transport of animals by airlines is under the jurisdiction of the specific airline company, but a veterinarian should be consulted and a health certificate issued. Animals should not be allowed to ride unrestrained in motor vehicles and should never be allowed to ride in the back of open vehicles such as pick-up trucks. Motion sickness (see Motion Sickness) and anxiety are common problems in dogs and cats when traveling. The phenothiazine tranquilizer acepromazine may be beneficial in this situation, and antihistamine therapy such as diphenhydramine may be useful. Maropitant citrate is also approved for treatment of motion sickness.

The potential disease-management interaction between pets and owners is important in prevention of zoonotic diseases, especially when pets are owned by immunocompromised people. Pet owners with human immunodeficiency virus or those being treated with chemotherapy or other immunosuppressive agents can safely own animals but should consult both their veterinarian and physician. Most animal-associated infections, including those due to Toxoplasma gondii, Cryptosporidium, Salmonella, and Campylobacter, appear to be acquired by immunosuppressed individuals from sources other than exposure to animals. The possible exception may be Bartonella or cat scratch disease. Because the risk of zoonotic transmission is low, animals pose minimal risk to immunocompromised people if basic precautions are followed. Precautions include avoiding the cleaning of litter boxes or using gloves when doing so, avoiding dog feces, avoiding young or unhealthy pets in favor of healthy or adult pets, having sick animals evaluated by a veterinarian, not allowing cats to hunt, not feeding pets undercooked meat, and preventing coprophagy or access to garbage.