Canine Distemper Protocol
Canine Distemper Protocol
Date Written: Yann Sokchea, BSc
in lab science, MSc, DVM.
Author/Approved by:
Date Revised:
Date Implemented:
19 May 2025
Purpose: The purpose of this document
is to guide treatment and testing for distemper in dogs.
Background:
Distemper is a
viral infection that typically causes some or all of the following signs in
most cases: upper respiratory, lower respiratory, gastrointestinal, or
neurological; however, it can infect any organ system of dogs and subsequently cause a wide variety of signs (including skin lesions, urinary
tract/kidney involvement, and transplacental infection). It is commonly spread
through aerosolization of respiratory secretions, though it is also shed in
other bodily fluids. Survival in
adult dogs can be greater
than 90% with aggressive treatment, but mortality in puppies often approaches 50%
or more. It poses a challenge in shelter
settings because of the potential for extended periods of
shedding even after clinical recovery (weeks to months); during this period,
dogs are still considered contagious.
Routine vaccination is
effective and is recommended as a core vaccine for owned and shelter dogs. Despite this, however, many dogs entering
shelters are not protected; previous studies report that 57% to 62% of dogs do
not have a protective antibody titer to CDV upon entering shelters. Current shelter guidelines recommend
vaccination upon intake, and though some protection is gained rapidly
and can prevent
mortality, protective antibody
titers to prevent infection take several days.
Testing using a CDV PCR test
has the potential to be complicated due to the fact that modified live vaccines
may cause a positive PCR result, and a cut-off value is given on test results;
however, low viral counts (below the cutoff) also occur with early or late
infection. If clinical signs are present
or if dogs come from a high-risk situation, every positive
result should be treated as
real infection until proven otherwise.
Treatment:
Treatment for canine
distemper is supportive; there is no direct treatment
for the viral component of the
disease. Treatment is aimed at
controlling clinical signs and supporting the dog through the illness.
·
Mild upper respiratory signs
o
This includes any dog showing
only mild respiratory signs, including ocular discharge, nasal discharge,
sneezing, or cough, but is otherwise BAR and eating/drinking.
o
Doxycycline 10mg/kg SID x 10 days
o
Topical antibiotic medications can be used for ocular
signs (BNP, tobramycin, etc.)
·
Systemic signs
o
This includes dogs that develop
a fever either while on doxycycline or have a fever that does not respond in 24 hours
to doxycycline treatment
o
This can also include dogs with upper respiratory signs that then progresses to include gastrointestinal signs
(inappetance, vomiting, diarrhea)
o Additional treatments:
§
Subcutaneous fluids
(120ml/kg/day divided BID to TID) or IV fluids (boluses or continuous) to
maintain hydration.
§
Anti-emetics/gastrointestinal protection for patients not eating or vomiting
·
Maropitant (Cerenia) 1mg/kg PO, SQ, or IV SID
·
Ondansetron (Zofran) 0.5 - 1mg/kg
IV or SQ BID OR Dolasetron
(Anzemet) 0.5mg/kg IV or SQ SID
·
Famotidine 1mg/kg IV, SQ, or PO BID OR Omeprazole 1mg/kg PO BID OR pantoprazole 1mg/kg IV SID
·
Lower respiratory signs
o
This includes dogs with moderate
to severe tachypnea or dyspnea, likely
related to CDV pneumonia.
o
Oxygen therapy should be considered for patients
with severe lower respiratory signs (via nasal
canula or oxygen
cage); if this is not available in-house, transfer to a critical care facility or consider humane
euthanasia.
o Consider
dexamethasone SP 0.1-0.2mg/kg IM or IV (anti-inflammatory dose), particularly if heartworm positive,
followed by tapering
dose of prednisone when appetite returns.
o
Clavamox 12.5mg/kg
PO BID or ampicillin 22mg/kg SQ or IV BID to TID and Enrofloxacin 10mg/kg PO, IM, or IV for broader spectrum coverage
(for pneumonia)
o Nebulization with saline and coupage BID to TID
●
Neurological signs
○ For active
seizure activity: Diazepam
5-10mg/kg IV, intranasal, or rectally
○ For longer-acting control:
■ Phenobarbital 10-20 mg/kg IV once to effect then 2-8 mg/kg PO q 12 hrs
■
and/or levetiracetam (60mg/kg
IV bolus, then 20-30mg/kg PO or IV q8h or equivalent for BID extended release
tablets)
○
For tremors:
■
Methocarbamol 55-220mg/kg IV initially, do not exceed
330mg/kg/day; can also be used in a CRI
■ Methocarbamol 330mg/kg
PO divided BID for ongoing
control
○
Refractory and severe neurological signs causing
significant reduction in quality of life warrant
the consideration of euthanasia. Mild signs may not impact quality
of life, but they may or may not resolve with recovery – some dogs have
permanent mild neurological signs (typically tremors) but live normal lives. Mild neurological signs alone do not
warrant euthanasia.
Isolation and Management:
·
Dogs with any respiratory signs should be isolated from general population.
·
PPE in the isolation area consists of: gloves, gown or coveralls
(coveralls preferred), shoe
covers.
·
PPE should be changed in between individual patients or litters
housed together to prevent spread of other illness.
·
Dogs in isolation should be cared for by either
separate staff or last in the order of animals
cared for separate
staff is not possible
to prevent spread
of distemper to the healthy population.
·
During recovery, distemper dogs may be housed
with fully vaccinated (at least two vaccines
including one as an adult dog within
the last 3 years), otherwise
healthy adult dogs (over one
year of age, no immunocompromising conditions or medications, no significant
chronic health issues). See Canine
Distemper Virus for Fosters document.
Exposure and Quarantine
·
Dogs that are exposed to a distemper positive dog should be
evaluated and handled based on risk.
·
Puppies (< 6 months of age) are considered high risk, regardless of vaccine status.
·
Adult, healthy dogs are considered fully vaccinated and low risk if:
o
Dogs recently entering
a shelter are older than 6 months
and have received an intake
vaccine AND a booster vaccine two weeks (or more) after the initial vaccine.
o
Dogs have been in a home or at the sanctuary for
an extended period and are considered current
on their DHPP vaccine through a booster within the last year (or
within the last 3 years for 3 year labeled vaccines).
o
Low risk dogs that have been exposed
should be monitored for any clinical signs but do not need to be quarantined.
·
Antibody titer testing
may be used at the discretion of the veterinarian for adult dogs only.
o
If greater than a week since exposure, titer
testing cannot distinguish between antibodies induced due to active infection and vaccine-induced (or induced from prior exposure).
o
Paired antibody and PCR testing may be used to
eliminate the need for quarantine in exposed, adult dogs. A protective titer and
concurrent negative PCR test may
replace quarantine.
o
Antibody titer testing
does not yield predictable results
in puppies due to inability to
distinguish between transient maternal antibodies and long-lasting vaccine-inducted antibody protection.
·
High risk dogs that have been exposed
to a positive dog should
be quarantined for 14 days after the exposure.
o
If at any point, they develop clinical
signs consistent with distemper, they should be tested at
that time.
o
If no clinical
signs develop, at the end of 14 days, they should be tested (CDV only PCR test).
o If negative, they may be cleared from
quarantine.
o
If positive, move to isolation and follow the serial testing
protocol outlined above.
References:
American Animal
Hospital Association. (2017).
Vaccination Recommendations – Shelter-
Housed Dogs. Retrieved from https://www.aaha.org/guidelines/canine_vaccination_guidelines/shelter_vaccination.aspx
Association of
Shelter Veterinarians. (2010). Guidelines for standards of care for animal
shelters. Retrieved from https://www.sheltervet.org/assets/docs/shelter-standards-oct2011-
wforward.pdf
Crawford, C. 2014.
Everything Shelters Need to Know About Canine Distemper. https://www.maddiesfund.org/everything-shelters-need-to-know-about-canine-distemper.htm
Crawford, C. 2017. Personal
communication. Unpublished data on distemper
shedding in shelter dogs.
Edinboro, C. H., Ward, M. P.,
& Glickman, L. T. (2004). A placebo-controlled trial of two intranasal vaccines
to prevent tracheobronchitis (kennel cough) in dogs entering
a humane shelter. Preventive Veterinary Medicine,62,
89-99. doi:10.1016/j.prevetmed.2005.03.001
Greene, C. E. (2012).
Canine Distemper. In Infectious
diseases of the dog and cat(pp. 25-41). St. Louis, MO: Saunders Elsevier.
Larson, L. J., & Schultz, R. D. (2006).
Effect of vaccination with recombinant canine
distemper virus vaccine immediately before exposure under shelter-like
conditions. Veterinary Therapeutics,7(2),
113-118.
Lechner, E. S.,
Crawford, P. C., Levy, J. K., Edinboro, C. H., Dubovi, E. J., & Caligiuri,
R. (2010). Prevalence of protective antibody
titers for canine
distemper virus and canine parvovirus in dogs entering a Florida
animal shelter. Journal of the American
Veterinary Medical Association,236(12), 1317-1321.
doi:10.2460/javma.236.12.1317
Leutenegger, C.,
Crawford, C., Levy, J., & Estrada, M. (2011). Canine Distemper Virus
Quantification by Real-time PCR Allows to Differentiate Vaccine
Virus Interference and Wild-
type Infection. ACVIM Forum 2011.
Litster, A., Nichols, J., & Volpe,
A. (2012). Prevalence of positive antibody
test results for canine
parvovirus (CPV) and canine distemper virus (CDV) and response to modified live
vaccination against CPV and CDV in dogs entering animal shelters. Veterinary Microbiology,157(1-2), 86-
90. doi:10.1016/j.vetmic.2011.12.030
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