Canine influenza is a respiratory virus that can be transmitted between dogs. The Los Angeles Public Health Veterinarians suspect that between July and October, 2021, there were over 1,000 cases, the largest outbreak ever in LA County. In this episode, Dr. Durocher-Babek, veterinary internal medicine specialist, talks about canine influenza. She provides prevention tips to help keep your pet safe, using many of the same methods being used for SARS-CoV2, such as vaccination, disinfecting surfaces, and isolating when an animal might be ill.
Welcome, Dr. Lawren Durocher-Babek
[00:01:05] Dr. Lancellotti: Welcome, everyone, to today’s episode of Your Vet Wants You To Know. Today, we’re going to be talking about canine influenza. This is something that is particularly interesting to me, as a Los Angeles resident, because we’ve been having an outbreak of this disease here in our pet population. With me today, I have Veterinary Internal Medicine Specialist, Dr. Lawren Durocher-Babek. She joined us on the Leptospirosis episode (since we were having an outbreak of that, in Los Angeles, as well) and she’s back to talk about canine influenza. Welcome back, Dr. Durocher-Babek.
[00:01:39] Dr. Durocher-Babek: Thank you for having me.
[00:01:41] Dr. Lancellotti: For those people who have not listened to the leptospirosis episode, can you tell those listeners a little bit about who you are, what your training is, and where you’re practicing right now?
[00:01:52] Dr. Durocher-Babek: I am a small animal internal medicine specialist, and I’m currently working and living in Hong Kong, but I did all of my training in North America. I did my veterinary school at University of Georgia (go Dogs!), my internship at University of Guelph (Ontario), and my residency at Ohio State University, which I finished in 2007. Since then, I was practicing in large specialty referral hospitals in North Carolina, as well as a few in New Jersey. We moved to Hong Kong from New Jersey in 2018, and I’ve been practicing in a large referral hospital here for a few years. I actually remember when canine influenza was a brand new disease in Chicago in 2015, and all of us were kind of freaking out about it and trying to figure out what our next step was going to be, and how to best manage all of these outbreaks (while thinking that the sky was falling). Yet, things got under control relatively quickly in that outbreak.
The early days of canine influenza outbreaks
[00:02:49] Dr. Lancellotti: Yeah. I remember, at that time, I was in my internship and reading all the reports coming out of Chicago, thinking the same thing. So, I think this is a great episode for us to talk about, because we are seeing a little bit of an outbreak here in Los Angeles. I think having some more information for pet owners to be familiar with what’s going on, and giving them the tools to have that conversation with their family veterinarian about what their pet needs, is really helpful for them. Are there any particular cases that come to mind when you think of canine influenza?
[00:03:24] Dr. Durocher-Babek: I actually haven’t seen a large number of cases of canine influenza. I’ve seen a few here and there. We never had the huge outbreaks in other cities that we had in Chicago. Even though I know you’re having an outbreak right now in California, it hasn’t quite reached the level of what it reached in Chicago. That’s mostly because we have vaccination. But I do remember one of my patients named Sylvie. She came in the very early days of canine influenza, when this was all brand new to us. We weren’t sure how to test for it and weren’t sure what it meant for all of us. She had signs of respiratory disease, like most of the dogs. She had this cough that just wouldn’t go away. She just seemed dull and lethargic. Usually when we have a dog like that, we would start thinking about kennel cough or some unnamed respiratory disease. But because we’d had the outbreak recently, we decided to test for canine influenza. Low and behold, she was positive. Luckily, she had a pretty mild case. Somehow, the rest of the dogs in our household never got sick, but we instituted really strict quarantine measures right away. When she was in our isolation ward, we were gowning and gloving and using all the personal protective equipment that we had in the hospital to try to keep it from spreading to anybody else. Luckily, it didn’t. We kept her in the hospital quite a long time- probably longer than we would now, just because it was a newer disease and we didn’t know the best way of treating it. But she did really well and has never looked back since.
[00:04:53] Dr. Lancellotti: And you said, “luckily it didn’t spread throughout the hospital,” but I want you to give yourself and your staff some credit for the hard work that went into making sure the disease was isolated, because it does take a fair amount of thought, intention, and protocols to be able to keep infectious diseases from spreading. So, the fact that there was not an outbreak within the hospital is a testament to your team’s ability to be able to control an infectious disease like that. So, well done!
[00:05:22] Dr. Durocher-Babek: Thank you. You’re absolutely right about that. And I think one of the best things we did in veterinary medicine was when we heard about the outbreaks happening, we all started to think about what we would do if it came to our hospital. We all had certain plans in place, that we could institute, if this spread throughout the whole country. And I think having that preparation, ahead of time, really helped us deal with it.
What is Canine Influenza?
[00:05:43] Dr. Lancellotti: Absolutely. Preparation is so important. And even though it may not be spreading around the entire country, I think pet owners (no matter where they’re listening) can get some information from this episode, and be prepared if something like this does come to their region. Here in Southern California, our public health department has recently issued warnings about influenza infections in pets. I’d love for you to tell us a little bit about what exactly canine influenza is, and how might an animal get exposed to this disease?
[00:06:13] Dr. Durocher-Babek: Canine influenza is caused by the influenza virus (we’ve all heard about the flu virus- we get vaccinated for it every year). There are two types of influenza viruses that we have seen infect dogs and cause issues- H3N8 and H3N2. These names are very confusing and kind of difficult to remember which one is which, because it all has to do with the proteins on the outside of the virus. The H3N8 virus was first found in the early 2000s in racing greyhounds, and it was spread from horses. But since it spread from horses into dogs, it’s now canine specific- which means dogs can spread it from dog to dog. H3N2 was a form associated with a big outbreak in Chicago and most of the outbreaks since then. We believe that one started in birds, then spread to dogs, and is now dog specific as well. It is believed that the H3N2 started in Southeast Asia and then spread to other countries, possibly from saving dogs from the meat trade. Neither of these viruses have been known to infect humans (which is obviously good), but both are now considered endemic, which means that it’s always going to be in a canine population and we’re going to have periodic outbreaks, now and again. The viruses are spread from dog to dog, the same way most respiratory viruses are spread- through respiratory droplets that are released when you’re coughing or sneezing. It can be found on most surfaces, but it’s really easily cleaned up. By using bleach or other cleaning products, you can kill the virus. We do think that cats can get H3N2, but very rarely, and they don’t usually get sick. Dogs get exposed to this disease just like you would expect- a lot of dogs in a small place, like a shelter or a hospital or a kennel show. They’re going to spread the disease from one to another.
[00:08:03] Dr. Lancellotti: You talked a little bit about cleaning. So, all of the cleaning that we’ve been doing, trying to manage our exposure to COVID, it’s something that we can do to help protect our dogs as well.
[00:08:14] Dr. Durocher-Babek: Absolutely. In fact, there are so many similarities between this and SARS-CoV-2, that a lot of the precautions that we’re taking for SARS-CoV-2 are also precautions that we’re taking for canine influenza, and of course, influenza in humans as well.
Does my pet have dog flu?
[00:08:31] Dr. Lancellotti: So if a dog does potentially come in contact with and contracts this particular virus, what signs might a pet owner notice if the animal’s starting to become ill? Give us some red flags that the pet owner might watch for.
[00:08:47] Dr. Durocher-Babek: It’s hard to say red flags because these respiratory diseases can all look like each other. But what you’re going to notice is that these dogs are going to have a cough. It might sound like a kennel cough. It also might just be a soft, moist cough that just seems to happen all the time. They can have runny noses or eyes, seem a little bit lethargic, or they may not be eating as well. And that’s the majority of cases, which are relatively very mild. The very severe form of canine influenza is very quick-acting. What happens is that they develop a very quickly progressive pneumonia and a high fever, and some of those dogs may actually start coughing up blood. So the important thing to remember is there’s not one sign that says, “Aha, my dog has canine influenza.” It might look like so many other things. If you’re worried about your dog at all, just check with your veterinarian. It’s never wrong to give them a call or to bring your dog in to get checked out.
[00:09:44] Dr. Lancellotti: Yeah. Coughing could be a sign of just a wide variety of different disease processes, from infectious to something wrong with the animal’s heart to something wrong with the animal’s trachea. There’s just so many things that can cause them to cough.
What tests are recommended for canine influenza?
Dr. Lancellotti: So if an animal does develop the signs and does start coughing, and it’s living in an area where influenza may have been reported (such as Southern California), what tests might a veterinarian recommend and why?
[00:10:14] Dr. Durocher-Babek: The first thing your vet is going to want to do is just a really good physical examination. Then, depending on how bad the cough is, they may recommend chest x-rays to rule out pneumonia. Sometimes, that’s all that they do. Then, they’d just simply recommend treating, at that point, for the most likely cause. However, if we know that there’s an outbreak, we’re probably going to want to test for canine influenza. And there’s a few different ways of testing. The early test, which you can do within 5 days of clinical signs, consists of a nasal and pharyngeal swab that is submitted for PCR for influenza. I know. This sounds very familiar. They also may collect some blood to hold aside for antibody testing, for comparison later. If the infection is not active, meaning it didn’t just happen, the PCR may be falsely negative. So if you collect some blood, you’re going to be looking for antibodies, to see if the dog has actually been exposed to canine influenza. But if you have antibodies, you may have just been exposed. It doesn’t mean you’re actively sick. So a lot of people will take one sample now (the first time that they see your dog), and then they’ll take a sample about 10 – 20 days later, to see if those antibody levels are rising or falling. If the antibody levels are changing, that means that your dog has probably actively infected.
[00:11:31] Dr. Lancellotti: Whereas, if the antibody levels stay the same, it just means that (at some point in time) the animal has been exposed to influenza, but that may not be the reason why the animal’s coughing currently.
[00:11:42] Dr. Durocher-Babek: That’s exactly right. And of course, as the disease progresses, if your dog doesn’t continue to get better, then your vet is probably going to want to reassess. They may recommend some blood work to check to make sure there’s nothing else underlying all of this. They may recommend repeat chest x-rays to see if any changes have occurred in the lungs, themselves, which could account for the cough.
How is dog flu treated?
[00:12:03] Dr. Lancellotti: So once the infection has been confirmed, what treatments might a veterinarian recommend for animals that have canine influenza?
[00:12:12] Dr. Durocher-Babek: There’s no specific treatment for canine influenza. It’s a virus. It’s not going to be killed by antibiotics. For the mild self-limiting form, usually no treatment is necessary. These dogs continue to improve over time. But if they’re coughing a lot or not eating, your vet may recommend cough medicine, mostly to help them sleep. We want these guys to cough up the mucus and the stuff that may get into their lungs, but we don’t want them to cough so much that they can’t sleep, because they don’t get better if they don’t rest.
[00:12:43] Dr. Lancellotti: I can absolutely sympathize with that because my daughter’s had some preschool crud recently. Not COVID! But the stuff you bring home when you’re four and five years old and around other kids that age- and even when you don’t have it, it’s still a rough night for everybody in the household.
[00:12:59] Dr. Durocher-Babek: It really is. And you’ll never get better if your body isn’t given that time to rest. A lot of the things that we talk about for canine influenza are the same things we talk about for human influenza. Get plenty of rest, drink plenty of liquids, and take care of yourself. Give yourself time to recover. Of course, for dogs, we can’t make them drink orange juice, nor make them drink more than they want to. Sometimes, we do give them fluids under the skin or change their dog food from dry to canned- ways of getting them to get more moisture into their body. For the more severe forms, we do recommend hospitalization with oxygen and IV fluids. We also treat with antibiotics for the secondary bacterial infections. Again, the antibiotics are not treating the flu. They’re treating the secondary problems from the flu.
[00:13:50] Dr. Lancellotti: Right. Because sometimes the flu can make them so sick that their lungs can’t protect themselves from normal bacteria, which usually wouldn’t cause a problem.
[00:13:59] Dr. Durocher-Babek: That’s exactly right. I can’t emphasize that enough. I get so many people coming in who just want an antibiotic to make everything better. The problem is- it might help, but we have to realize why we’re doing the antibiotics, so that we use them in a way that we don’t promote antibiotic resistance.
[00:14:17] Dr. Lancellotti: Yeah, absolutely. Being in dermatology and seeing so many skin infections, I am a big proponent of anti-microbial stewardship and trying to use antibiotics only when I absolutely have to.
How can I prevent canine influenza?
Dr. Lancellotti: I want to talk a little bit about prevention. We’ve talked about how to recognize, test for, and treat it, but how do we prevent it from even happening in the first place? What are some steps that pet owners can take to protect their pets from even becoming infected? Tell me a little bit about the influenza vaccine, because I’m actually taking all three of my dogs to go get their vaccines, tomorrow, with our family veterinarian, so that we can make sure that they are protected against the outbreak that’s going around.
[00:14:59] Dr. Durocher-Babek: That’s such a good idea to do that. And it’s funny- the more I think about these canine influenza outbreaks, the more I see the similarities with our SARS-CoV-2 that we’re dealing with. Prevention for canine influenza is pretty much the same as for SARS-CoV-2. Vaccinate and isolate. If you have a dog who is sick, keep them away from other dogs. If you have a healthy dog who might be in any way exposed to canine influenza, get them vaccinated. There are two different types of vaccines, both cover the different strains. There’s an H3N2 vaccine, an H3N8 vaccine, and then one vaccine that has both of the strains in one. These dogs will need to be given 2 shots, given about 2-4 weeks apart, and they’re not going to really be considered immune until about 2 weeks after the last shot. So that means if you’re planning on boarding your dog, or if you hear about an outbreak, it’s better to get them vaccinated early, so that they have some immunity within the next month or so. You should talk to your vet to see which vaccine is recommended for your dog, but the bivalent vaccine would easily cover all of the strains. And once started, it is recommended that your dog get yearly boosters.
[00:16:13] Dr. Lancellotti: Yeah, I think that’s great. Even though my dogs aren’t going to boarding and they don’t hang out at a lot of dog parks, they still live in an area where we come across a fair amount of dogs just walking around our neighborhood. To have them very easily protected against something that is spread pretty easily gives me a little peace of mind- knowing that’s one less thing that I have to worry about when managing their health.
[00:16:39] Dr. Durocher-Babek: Absolutely. We talk a lot about the dogs who are at risk, but really any dog is at risk. If they’re on a walk and they encounter a dog who’s coughing, they could pick up the virus from them. So it’s very unusual for us to say a dog would absolutely have no exposure to canine influenza, especially during an outbreak.
What should I do if my dog had canine influenza?
[00:16:56] Dr. Lancellotti: How about for those dogs who have been sick? Are there things that pet owners should know about how to avoid spreading it to other dogs that may be in their neighborhood?
[00:17:07] Dr. Durocher-Babek: Absolutely. The best thing that those people can do is to keep their dog isolated. Do not bring them to the doggy parks. Don’t bring them to the groomers. If you’re going to bring them to the vet, give the vet a call ahead of time, so that the vet can be prepared to bring them right into their isolation ward, rather than leaving them in the waiting room with a bunch of other dogs who could pick up the influenza virus. The other thing that you want to remember is that these dogs can be shedding the virus for up to a month. So, even if your dog has fully recovered, if they still have a cough, I would still keep them at home. Err on the side of caution. If you have other dogs in the household, try to keep the dog who is coughing separated from your other dogs, and just make sure to clean your surfaces really well. Treat them like you would treat a person who has had SARS-CoV-2. You want to keep them isolated until you’re sure that they’re not spreading any more germs.
[00:17:59] Dr. Lancellotti: Yeah, that’s great. I think that’s excellent advice for keeping everybody who’s around that animal as healthy as possible.
What is important to remember about canine influenza?
Dr. Lancellotti: What are some big takeaway points that you want pet owners to remember about canine influenza? What’s important for them to understand?
[00:18:15] Dr. Durocher-Babek: The important thing to remember is that if you’re worried about your dog, if they’re showing signs of respiratory disease, it’s always best to consult with your family vet. They’re going to know about any outbreaks in the region, what to test for, and they’re going to give you advice about how to treat your dog. The other thing that I highly recommend for any sick animal is isolation. If your dog is sick, don’t bring them out on walks during the busiest part of the day, when you’re going to see 10 of their doggy friends. Keep them at home. Keep them on short walks- only like early in the morning or late in the evening, when you know that they’re not going to expose other dogs to whatever illness that they have. Try to avoid dog parks, dog shows, boarding- things like that- during times of large outbreaks. Social distancing for your dog is a really good idea, at this point. You don’t want to be that person whose dog sets off a chain reaction that affects hundreds of dogs. The other thing to remember about canine influenza is while most dogs do recover without any issues, there are dogs with chronic health issues (like cancer or chronic bronchitis) who may really suffer from this. And vaccination is a really good way to prevent this disease from happening.
[00:19:27] Dr. Lancellotti: Excellent. These are all really helpful tips for pet owners to talk to their family veterinarian about, to figure out the best plans of prevention and treatment for their pets. I’m so happy that you came on to talk about canine influenza today. Thank you so much.
[00:19:43] Dr. Durocher-Babek: Thank you for having me.
More Resources from Dr. Lawren Durocher-Babek
[00:19:45] Dr. Lancellotti: I want to bring up your website because you also have a lot of really good resources regarding a variety of different internal medicine diseases. Can you tell our pet owners a little bit about what they might find if they go and visit you at drlawrenvet.com?
[00:20:04] Dr. Durocher-Babek: Yeah, absolutely. On the website, we have basically everything that I would be talking to my patients’ families about. We have information on inflammatory bowel disease, cancer, chronic kidney disease, heat stroke, and tick fever is a really big one here in Hong Kong. I put together this website as a way of having more information for our pet families, because I really believe that we need to work together as a team (the veterinarian and the patient’s family) to make sure that our patients have a really good quality long life.
[00:20:39] Dr. Lancellotti: Absolutely. And I do think education is a huge component of having pet owners understand what’s going on with their pet, so that they can be an active part of their pet’s health care and make decisions for their pet with their family veterinarian or any specialists that they decide to work with. A lot of family veterinarians are comfortable managing pets with influenza, but the link to find a veterinary internal medicine specialist like Dr. Durocher-Babek will be posted on the Your Vet Wants You To Know website, if you would like to consult with a specialist. I’ll also have links to Dr. Durocher-Babek’s website and Instagram, so that you can look into the resources that she mentioned, if there’s something else that your pet is dealing with. If you are in Southern California and you are in the midst of this outbreak with me, you can join the Facebook group and tell me about what you’ve been dealing with as far as canine influenza. If you’re in another part of the country or part of the world, and your pet has experienced canine influenza, or you just want to share your experience with other pet owners, I would encourage you to join the Facebook group, Your Vet Wants You To Know, and tell us about what’s going on.
Scratching the Itch
[00:21:53] Dr. Lancellotti: I always like to end the show with a segment called Scratching The Itch. This is a short segment that highlights something- whether it’s a human interest story, a product, or a website- basically, anything that provides relief or just makes you feel good. Hence, scratching the itch. Dr. Durocher-Babek, do you have something that scratches the itch for our listeners, today?
[00:22:15] Dr. Durocher-Babek: Well, one of the things I actually wanted to talk about is books. Books are a very important part of our family life. I have two kids- a son who’s seven and a daughter who’s five- and like everybody, we’ve been affected by the SARS-CoV-2 outbreak and the pandemic. And we’ve been separated from our family in the states for the last two years. I think the last time we went home was October 2019, which gets harder and harder, the longer this drags on- just like it does for everybody. While it’s been really hard to be away from home, one of the things that has made it much easier is technology. Every night we have my mother (the kids’ grandmother) read them a bedtime story via FaceTime. It works out perfectly because our nighttime is her early morning time, so every night they get a story read by “Grammy.” This allows them to stay close to my mother, for her to see them growing up, listening to their stories from the day, and really maintain those good close family relations. So using FaceTime to get through the pandemic is invaluable. While I hate that we’re going through the pandemic, I’m so glad that we have technology right now, which allows my kids to see their grandparents.
[00:23:30] Dr. Lancellotti: That must be a really nice thing for your kids to look forward to throughout the day- they’re going to have this bedtime story with your mom- and a really great way for her to start her day, every single day.
[00:23:42] Dr. Durocher-Babek: It is. They all love it. They all look forward to that time. And I get a little bit of a break during bedtime which, as we all know, is just about the worst part of the day.
[00:23:53] Dr. Lancellotti: Amen, sister!
[00:23:56] Dr. Durocher-Babek: It works out really well. And on top of that, one of the best things I think we ever did was for both of our kids’ first Christmases, we had each of our family members record a storybook. So these are their recorded books- I think they’re available from hallmark, but also from some other places as well- where somebody will read a storybook and it records it as you turn the pages. And that has just become one of our most treasured possessions, especially as some of our family members have passed away or have gotten older. It really helps us to maintain those ties where we can hear their voices whenever we want, so I highly recommend that for new babies as well.
[00:24:37] Dr. Lancellotti: Oh, I really like that. That’s a nice thing to have. I’ll have to talk to my parents and my in-laws about that, as Christmas is around the corner. I think that would be something that my kids (who are now 5 and 1.5) would really like. I love that. Thanks for sharing that.
[00:24:52] Dr. Durocher-Babek: Of course. And thank you so much for giving me the opportunity to come on this podcast again. I really enjoy it.
[00:24:58] Dr. Lancellotti: Absolutely. I am so excited that you wanted to share that with pet owners and I would love to have you back again, to talk some more about all the different topics that you are knowledgeable about.
[00:25:09] Dr. Durocher-Babek: Thank you so much.
[00:25:12] Dr. Lancellotti: And for everyone listening, I look forward to your next visit with your Your Vet Wants You To Know.
- Los Angeles County H3N2 Outbreak Information: http://publichealth.lacounty.gov/vet/influenzacanineh3n2.htm
- American Veterinary Medical Association information on Canine Influenza: https://www.avma.org/resources-tools/animal-health-and-welfare/canine-influenza
- CDC Information on Canine Influenza: https://www.cdc.gov/flu/other/canine-flu/index.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fflu%2Fcanineflu%2Findex.htm
- DogFlu – Information on vaccinations and outbreaks map: https://www.dogflu.com