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Animals In Print
The On-Line Newsletter

From  28 March 2001 Issue:

CANINE STREPTOCOCCAL TOXIC SHOCK SYNDROME

New more invasive strains of streptococci have recently appeared, resulting in frightening new diseases in both humans and dogs. Both humans and dogs can develop streptococcal toxic shock syndrome, with the rapid development of symptoms of shock, high fever (104 to 107 degrees Fahrenheit), cough, abnormalities of coagulation and rapid death. In humans, the mortality rate is estimated at between 60-80%. In dogs, it may be even higher as the course of the disease is so rapid that a dog may be killed in as little as 1 to 4 hours from development of the first symptoms, so that some dogs are simply found dead in their runs, houses or yards. It’s entirely possible to leave a healthy dog in the morning and find it dead when you come home from work. Necropsy, if done, frequently fails to reveal the cause of death in dogs found dead, further skewing the statistics.

Treatment of acute CSTSS is often unsuccessful. One veterinarian in Canada has noted a 50% mortality rate, which seems to be unusually successful. Those dogs who survive have been treated with IV antibiotics to which streptococci are susceptible, particularly Penicillin G and Clindomycin. Clindomycin seems to be particularly useful in acute cases because it halts the metabolism of the streptococci, stopping the cascade of toxins responsible for the high fever, shock and Disseminated Intravascular Coagulation (DIC).

Dogs can be infected by canine strains of streptococci and sometimes by human strains. A dog handler with pharyngitis (sore throat) was thought to be the source of infection in a Greyhound kennel epidemic in Florida, and a human strain was isolated from an infected dog in Canada. There are certainly human “carriers” of streptococci, and according to Brad Fenwick, D.V.M. of Kansas State University Veterinary School, there are also canine carriers of virulent streptococci who never show a symptom.

The portal of entry in dogs usually seems to be the throat and lungs. The reproductive tract of females in season is an open invitation to bacteria as well. ( Note:Spay and neuter your companion animal) Oddly, streptococcal skin infections in dogs don’t seem to be a problem although this is a frequent site of entry in humans. This could be because canine skin is better protected by the fur, because canine skin is simply more resistant to infection, or because minor wounds or cellulitis are overlooked because of being covered by fur.

The severe symptoms typical of CSTSS seem to result when the bacteria invade the bloodstream, producing septicemia and toxemia, with a cascade of toxins. In humans, the invasion follows the pattern of classical “blood poisoning” from streptococcal cellulitis or septicemia from “strep throat,” except for being much more toxic and much quicker. In humans, the disease is about as contagious as bacterial meningitis, and antibiotic prevention is recommended for both diseases.

RISK FACTORS

Important risk factors in the transmission of CSTSS seem to be:

Crowded conditions, especially inside and in the fall and winter months.

Hygiene factors, including sharing food and water bowls. Humans may transmit the infection by examining/handling multiple dogs sequentially without washing their hands. Equipment should be kept clean and/or not shared by multiple dogs.

Close physical contact: Although “social sniffing” and running with an infected but asymptomatic dog is reasonably safe, jaw-wrestling and play-fighting is not. Sharing a run with an infected dog is an important risk factor, as well as water-bowls, bedding, etc. Crate-swapping and sharing is high risk. Dogs kenneled in adjacent runs are not at high risk. Dogs licking the face of a human with a “strep throat” or cellulitis or of a child with impetigo are definitely at risk.

Stress factors, such as traveling long distances, confinement, exposure to stressful situations, estrus, etc. may reduce a dog’s resistance to disease

WHAT YOU CAN DO TO PROTECT YOUR DOG

Avoid exposing your dog as much as possible to the high-risk conditions above. If you find that one of the dogs to which your dogs was significantly exposed develops an illness with shock, collapse and high fever, consult your veterinarian about antibiotics. Remember, this is an infectious disease, like chicken pox, and if your dog develops CSTSS it’s not a reflection on your kennel, cleanliness or management. You wouldn’t be reluctant to admit that you yourself had strep throat, after all. If you don’t have a rectal thermometer, get one.

Know the location of the nearest 24-hour emergency veterinary clinic as well as your veterinarian, and memorize the phone numbers.

Print out this post or the information in websites and carry a copy in your car or van.

Watch your dog or dogs carefully, and check them frequently. Remember, if your dog does develop CSTSS there is no time to waste, so make as many preparations as possible in advance.

If you or your veterinarian have further questions, or if you think your dog may have (or may have had) CSTSS, please call:

Brad Fenwick, D.V.M.
Kansas State University Veterinary School
phone: (785) 532-5650
e-mail: fenwick@vet.ksu.edu 

Dr. Fenwick would like information on ANY dog who may have or have had CSTSS, surviving or not. There is grant money available for laboratory tests and necropsies. Contact Dr. Fenwick to find out if you are eligible, exactly what information , cultures and tissue samples he needs and where to send it. Dr. Fenwick is interested in speaking to owners and veterinarians of any dog who may have or have had CSTSS.

Kathi Anderson
shamrocksibs@earthlink.net 

Lyda Long, M.D.
ndnmd@ionet.net

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