1. 1 Brucella Canis Our Practice and Experience

2. 2 Agenda I. Introduction II. Clinical Signs III. Therapy IV. Conclusion

3. 3 Introduction

4. Fetus Placenta, fetal fluids,vaginal discharge after an abortion and stillbirths Normal vaginal secretions(estrus) Semen Urine, saliva, nasal and ocular secretions Feces 4 Transmission

5. The shedding of this organism can last from 60 weeks to 2 years Urinary excretion begins between 4-8weeks after infection and continues at least 3months

6. Brucella Canis enters the body by 6 Ingestion and through genital, oronasal and conjunctival mucosa Injured skin In utero Blood transfusion Contaminated syringes

7. 7 Dogs and other members of wild candis Including foxes, coyotes and raccoon (Procyonlotor)… …while Sheep, Swine and Cattle are reported to be highly resistant !!! Affected Species

8. 8 Take Into Consideration When we have Canine Brucellosis, the dog must have a contact with other infected dog!

9. 9 The prevalence of the infection Age Housing condition Geographic location

10. 10 The prevalence of the infection The infection is maintained in the breeding kennels

11. 11 Data for various countries Methods of testing Interpreting test results Whether it is done

12. 12 Low temperature The survival of this organism is longer when the temperature is low Artificial insemination

13. 13 Geographic Distribution United States (particularly the southern states) Canada Central and South America (including Mexico) European countries Tunisia Nigeria South Africa Madagascar Philippines Malaysia India Korea Japan Taiwan China

14. 14 Geographic Distribution

15. 15 Clinical Signs

16. 16 Lymphadenitis Lymphadenitis-common for infected dogs Routine clinical examination Exam of lymph nodes

17. 17 For example The dog with complaint of difficult urine retention Elevated leucocytes Enlargement of prostate Enlarged lymph nodes! Canine brucellosis in your differential diagnoses IF THE DOG HAD NO SEXUAL INTERCOURES!!!!

18. 18 Oral transmission Absolutely possible!!!

19. 19 Dog Diana 3 years old Ovarihysterectomy Doxycyclin and dehydrostreptomycin (before 3 years) Generalized polyarthritis

20. 20 Dog Murfy 4 years old Already neutered Snap test- positive Laboratory test- positive

21. 21 Oral Transmission

22. 22 Other common clinical signs Splenomegaly Lethargy Fatigue Weight loss

23. 23 Fever is uncommon!!!!!

24. 24 Clinical signs - female dogs Abortion  7-9 weeks of gestation Early embryonic deaths  2-3 weeks after infection

25. 25 Dog Birma 4 weeks after she has had a sexual contact with stray dog, Birma has thrown 2 puppies with unpleasant smelling vaginal discharge Without Vet service

26. 26 Dog Birma After 27days the dog had a lameness and decreased appetite. After detailed examination in our clinic, we found pain in all joints,generalized lymphadenitis and normal temperature - 38,5

27. 27 Other common clinical signs

28. 28 Dog Gloria 3 years old Labrador retriever has thrown at 62nd day of the gestation. The puppies were normal. But after 24hours they all died with gray-green diarrhea Snap test-positive The bitch had no clinical signs Laboratory testing-positive (outside Bulgaria)

29. 29 Male Dogs Epididymitis Scrotal edema and orchitis are common in the acute stage. Scrotal dermatitis can occur due to self- trauma(licking). Unilateral and bilateral testicular atrophy can be seen in chronical infections Prostatitis frequently reported

30. 30 Dog Aron Scrotal edema Snap test-positive The owner rejected the laboratory testing

31. 31 Dog Ratz The snap test was positive Without laboratory testing(only castration and treatment with doxycycline for 1 months)before 3 years NOW - Pyogranulomatous dermatitis at scrotal area every month

32. 32 Other Clinical Signs What is it?

33. 33 Other Clinical Signs

34. 34 Discospondylitis Discospondylitis of the thoracic and/or lumbar vertebrae can cause stiffness, lameness or back pain Polyarthritis Radiographic changes of discospondylitis may be difficult to visualize in the first weeks of infection because brucellar spondylitis is a slow process As computed tomography or magnetic resonance imaging

35. 35 Other Clinical Signs What is it?

36. 36 Uveitis Most often occurs in Infection disease(Canine Distemper, Infectious Canine Hepatitis, Leptospirosis, Canine Leishmaniasis, Canine Brucellosis) Posterior Uveitis

37. 37 Endophthalmitis Endophthalmitis - the uvea, retina, vitreous, and sometimes the lens

38. 38 Endophtalmitis Report from USA Lebetter E.C Cornell University, College of Veterinary Medicine, Department of Clinical Sciences, Ithaca, NY 14853, USA. 3 registered dogs with endophthalmitis caused by Brucella Canis in 2009.

39. 39 Other Clinical Signs What is it?

40. 40 Other Clinical Signs

41. 41 Endocarditis Is usually caused by bacteria Circulate in the blood and settle on the heart valves The bacteria colonize the heart valve(s) and cause infection and inflammation. Resulting in valvular insufficiency typically auscultated as a heart murmur.

42. All sources advise us to send blood for culture testing Brucella canis-may be we have to leave it out, due to difficulties in culture testing

43. 43 Endocarditis Frequently reported in dogs with Canine Brucellosis At necropsy of dogs diagnosed with Brucellosis, in 80% of them are found endocarditis Report from USA: 49 years old man with endocarditis caused by Brucella Canis (Center for Disease Control and Prevention Atlanta).

44. 44 Osteomyelitis We have not any surgery on this bone before, it would be good to include Canine Brucellosis in our diagnoses Many vets (especially by my observation in Bulgaria) are interested in Surgery

45. 45 Pyogranulomatous dermatitits Granuloma lesions has also been reported in infected dogs,but a direct causal relationship was not established.

46. 46 Many of the dogs positive for Brucella Canis do not show any clinical signs! Canine Brucellosis have a great variety of clinical signs and it make certainly difficult to diagnose this disease and skip it in our practice! Attention

47. 47 Diagnosis Clinical signs Epidemiology Hematologic and biochemical values  either unaltered or nonspecific in canine brucellosis Urine  Urinalysis is usually within reference limits despite the variable presence of bacteriuria. Semen abnormalities  5-8 weeks after infection( oligospermia and aspermia)

48. Rapid tests (snap tests) They can only deny the disease and can not confirm the diagnosis

49. 49 Diagnosis RSAT-rapid slide agglutination test Tube agglutination test (МЕ-ТАТ) AGID ELISA PCR

50. 50 Important! In contrast to other Brucella species (B. abortus, B. melitensis, B. suis) which grow in smooth colonies, B. Canis naturally forms rough phase (mucoid) colonies in culture. Serologic tests that use suspensions of smooth phase Brucellae are useless in diagnosing B.canis infections.

51. 51 Therapy Our Practice

52. All dogs presently or previously in direct contact with the implicated animal should be evaluated for infection None of treatment is 100% successful Dogs should not be treat with a single antibacterial regimen, combination therapy should be used.

53. 53 Kennels Kennels must be quarantined when a diagnosis is suspected. The treatment of kennel dogs is to be avoided.

54. 54 Recommended Drugs * in combination with therapy for Canine Brucellosis DrugsDose(mg/k g) RouteInterval (hours) Duration (weeks) Mynocyclin or Doxycycline 25PO244 12.5PO124 -ocular infection15PO124 Tetracycline30PO124 Streptomycin20IM242(1-4) -ocular infection20IM244(3-7) Gentamycin5IM,SC242(1-4) enrofloxacin5PO12-244 -ocular infection10PO248

55. 55 Additional Drugs * used only with ocular infection DrugsDose(mg/kg)RouteInterval(hours ) Duration(wee ks) Rifampine7.5PO24 Prednisolone acetate(1%) 1dropIn eye6-8

56. 56 The treatment There is the report of Faculty of Veterinary Science, University of Buenos Aires, Argentina- ‘Use enrofloxacin in the treatment of Canine Brucellosis in a dog kennel” Dr. Magdalena Wanke

57. 57 Dr.Magdalena Wanke Quote from her letter: “….. use it with streptomycin, I´m convinced that it´s better. (if streptomycin is still available in the Balkan Peninsula, we have each time more difficulties in getting it). Here we have more and more brucellosis. Moreover, we also have human cases. It seems that we have a new strain more patogenic for humans. Breeders are not ethical, and frequently they refuse to castrate/spay seropositive dogs, and frequently they "make gifts" to novel breeders... "I´m not interested in breeding this bitch any more, would you like to have her?", and this way brucellosis is spreading from kennel to kennel. Other treat dogs and breed them and frequently puppies if they survive are infected. It´s getting a real problem here!”

58. 58 The treatment Baytril 5mg/kg per day -30days Streptomycine 20mg/kg first 7 days and last 7 days After 1 month again!!!

59. 59 Prevention Risk level SituationRecommended test 1Mating or insemination, no suspicion of B. canis and no reproductive disturbances Blood sample for antibody analysis 2Mating or insemination with dog with previous reproductive disturbances, import of dogs without reproductive disturbances. Serology: 2 samples 4-6 weeks apart 3Import of or mating/insemination with dogs with previous reproductive disturbances, infection with B. canis suspected. Serology, 2 samples 4-6 weeks apart, blood culture and culture or PCR from semen or vagina 4Import of or mating/insemination with dog from kennel with endemic infection of B. canis Dissuaded from mating or import

60. 60 Research I am currently working on developing statistical data by sending a questionnaire to most of the veterinary clinics in Bulgaria, Macedonia, Serbia, Slovenia,Romania and Croatia. Currently, the observed response rate is very low, but nevertheless, any of the information that has been received was of great significance to the project. on Canine Brucellosis on Balkan Peninsula

61. 61 Brucella Canis and public health All commercially available human serologic assays in the United States utilize smooth phase Brucella species as their antigen substrates, and therefore do not detect antibodies against the rough phase B.canis The CDC does not currently perform serologic testing for B.canis

62. 62 Important! In contrast to other Brucella species (B. abortus, B. melitensis, B. suis) which grow in smooth colonies, B. Canis naturally forms rough phase (mucoid) colonies in culture. Serologic tests that use suspensions of smooth phase Brucellae are useless in diagnosing B.canis infections.

63. 63 Conclusion Based on Our Practice It should be clear from the above discussion that the true public health significance of human B. Canis infections is still unknown, and will remain so unless deliberate attempts are made to address the issue.

64. 64 Thank You, For your attention!