'Kennel Cough' is the
term that was commonly applied to the most prevalent upper respiratory
problem in dogs in the United States. Recently, the condition
has become known as tracheobronchitis, canine infectious tracheobronchitis,
Bordetellosis, or Bordetella. It is highly contagious in dogs.
The disease is found worldwide and will infect a very high percentage
of dogs in their lifetime.
Infectious agents involved
There are many different agents that contribute to the disease
process of tracheobronchitis. The most common are parainfluenza,
Bordetella bronchiseptica, and mycoplasma. Canine adenovirus,
reovirus, and canine herpes virus are thought to possibly contribute
to the disease. Although any one of these organisms can cause
symptoms of the disease, the majority of cases are the result
of more than one organism.
The most common viral agent is parainfluenza virus. This common
virus will cause mild symptoms lasting less than 6 days unless
there is involvement with other bacteria, as is usually the
case. Most 5-way vaccines and 'kennel cough' vaccines offer
some protection against this virus.
Bordetella bronchiseptica is the most common bacteria isolated
from this disease. Clinical signs of infections occur three
to four days after exposure, and if uncomplicated with other
agents, will last around 10 days. However, after the infection
has been resolved, the affected animal will continue to shed
the bacteria for 6 to 14 weeks and can spread the disease to
other susceptible animals during that time. Bordetella is one
of the agents protected against through the use of intranasal
'kennel cough' vaccines. Parainfluenza and Bordetella most commonly
appear together in infectious tracheobronchitis, creating a
disease that normally lasts from 14-20 days.
The most common symptom is a dry hacking cough sometimes followed
by retching. Many owners describe the cough as having a 'honking
sound.' A watery nasal discharge may also be present. With mild
cases, dogs continue to eat and be alert and active. Many times,
there is a recent history of boarding or coming in contact with
other dogs. In more severe cases, the symptoms may progress
and include lethargy, fever, inappetence, pneumonia, and in
very severe cases, even death. The majority of severe cases
occur in immunocompromised animals, or young unvaccinated puppies.
Diagnosis is usually based on the symptoms and a history of
recent exposure to other dogs. Bacterial cultures, viral isolation,
and blood work can be performed to verify individual agents
of the disease, but due to the characteristic nature of the
symptoms are not routinely performed.
There are two treatment options depending on the severity of
the disease. In the most common mild (uncomplicated) form of
the disease, antibiotics are usually not used. If the dog has
a good appetite and is alert but suffers only from a recurrent
cough, we will often let the disease run its course just as
we would with a cold in humans. Treating the mild case does
not shorten the length in which the animal will be a potential
spreader of the disease. Many times, prednisone is given to
help reduce the severity and frequency of the cough and to make
the dog more comfortable. In addition, Bronchodilators like
aminophylline or cough suppressants may also be used.
In more severe (complicated) cases where the animal is not eating,
running a fever, or showing signs of pneumonia, antibiotics
are often used. The most common ones are tetracycline or trimethoprim-sulfa.
However, many other choices are also available. Steroids or
cough suppressants are not usually recommended because of the
risk of immunosuppressive with steroids and the need to continue
to clear extra fluid or mucous in pneumonia patients. Bronchodilators
and even aerosol therapy can be used. In moderate or severe
cases, veterinary care should be instituted, as the resultant
pneumonia could become life threatening if not treated properly
Vaccination and prevention
The best prevention is to not expose your dog to other dogs,
especially young puppies. If this cannot be avoided, then proper
vaccination is the next best option. Chances are that if your
dog is regularly vaccinated with a standard 5-way or 7-way vaccine,
he is already being protected against several of the agents
causing tracheobronchitis, mainly parainfluenza and adenovirus.
However, these vaccines alone rarely provide protection against
contracting the disease, although they will help reduce the
severity of the disease if the animal becomes infected.
More commonly, for best protection, an intranasal vaccine containing
both parainfluenza and Bordetella is used. Intranasal vaccines
create localized immunity that greatly reduces the incidence
of clinical signs and illness. There are several precautions
and warnings that need to be observed pertaining to this vaccine.
Some dogs will develop mild signs similar to tracheobronchitis
when given this vaccine. Very often, the symptoms will last
for several days and the dog will recover without treatment.
Dogs that are vaccinated can also shed the virus and cause other
dogs to become mildly infected and show mild signs. This shedding
usually lasts less than 72 hours. In addition, it takes up to
4 days after vaccination for dogs to develop protection. When
you combine these facts, you will see why I strongly recommend
that a dog not be given intranasal vaccine within 72 hours of
coming into contact with other susceptible dogs. Do not give
the vaccine the day before a dog show, boarding, etc. Try to
give at least four days before contact with other dogs, and
preferably 7 days. This way you will protect your dog from becoming
infected by other dogs, and protect those dogs from becoming
infected by yours.
This vaccine is not without its problems. It is a very effective
vaccine, but it must be used carefully and is generally only
recommended for dogs that are at high risk. If your dog is not
shown, boarded, or comes into contact with stray dogs, your
dog is considered low risk.
In kennels where tracheobronchitis is a problem, strict hygiene
with thorough cleaning and disinfection of cages and food and
water containers is essential. In addition, kennels that are
indoors should have good ventilation with an air turnover rate
of at least 12 times an hour. Agents causing tracheobronchitis
can be transmitted on hands and clothing as well as through
the air, so infected animals must be isolated and handlers should
wear gloves and use proper hand washing to help prevent spread.
Vaccination of all animals, especially puppies is indicated
in problem kennels. After initial vaccination as puppies, a
yearly booster is recommended. However, some dogs that are at
very high risk are vaccinated every six months.
Human health risk
Until recently, infectious tracheobronchitis was considered
to not be a human health risk. Recently however, research indicates
that Bordetella bronchiseptica may cause disease in some humans,
primarily those with compromised immune systems. In normal,
healthy adults there does not appear to be a risk factor, but
young children and immunocompromised individuals should take
precautions against coming into contact with animals that have
symptoms of tracheobronchitis.
'Kennel Cough,' now more commonly referred to as 'infectious
tracheobronchitis' is a widespread disease caused by several
different viruses and bacteria. It is usually a self-limiting
disease and most animals do not require treatment. Intranasal
vaccines are effective, but due to some possible side effects,
are recommended for animals that are at higher risk. Infectious
tracheobronchitis is a disease of dogs and wild canids, it does
not appear to be a risk to healthy humans or cats.
References and Further Reading
Ettinger, S. Textbook of Veterinary Internal Medicine. W,B.
Saunders Co. Philadelphia, PA; 1989.
Foster, R.; Smith, M. What's the Diagnosis. Macmillan. New York,
Greene, C. Infectious Diseases of the Dog and Cat. W.b. Saunders
Co. Philadelphia, PA; 1998.
INFECTIOUS TRACHEOBRONCHITIS (Kennel Cough)
Kennel cough is a contagious respiratory disease characterized by a cough lasting up to several weeks. The syndrome is caused by bacterial and viral
micro-organisms, and is found mainly in large populations with dogs of various origins. It is also found in isolated animals, for example, after a dog show. The main bacterium responsible is Bordetella bronchiseptica, which often appears at the same time as a viral infection. The dog's general health is not affected. After an incubation period of about three days, the dog begins to cough and a purulent nasal discharge appears. Different viruses may cause the various symptoms. Canine parainfluenza virus may provoke a slight inflammation of the nasopharyngeal region and a cough lasting a few days. This virus is highly contagious and can be transmitted to nearby dogs. Finally, various Mycoplasma may increase the effects of other
micro-organisms, although they alone do not cause symptoms.
The most common clinical symptom of kennel cough, tracheobronchitis, is uncomplicated. It causes a severe cough that is dry, harsh,
non-productive, and persistent. The symptoms may disappear in less than a week or last several weeks in more serious forms of the illness. Associated symptoms are inflammation of the conjunctiva, sinuses, tonsils, and pharynx. Usually, the dog's overall health is not affected.
More rarely, in dogs with diminished immune response, a more serious form of the illness develops, leading to pneumonia and affecting general health (producing exhaustion, anorexia, and fever). This form develops slowly over several weeks.
Diagnosis is easier within a population than on a single animal. Kennel cough is usually suspected if a cough corresponding to the previous description is observed. Laboratory analysis of a sample of the nasal secretions can confirm which viruses or bacteria are responsible, thus indicating which treatment will be most effective. For isolated cases, other possible causes of the same symptoms should be investigated before concluding that the disease is kennel cough.
The value of laboratory analysis in implementing treatment is limited. The only effective medical treatment is an
aerosolised antibiotic. If treatment is administered less than forty-eight hours after the appearance of the first symptoms, injection of serum specific for the principal pathogens may be effective. To make the dog more comfortable, antitussives are also given. The risk of kennel cough can be reduced by taking proper sanitary measures. The facility's layout is important in this regard: an outside area and an area with a constant temperature should be available to the dogs. The facility should be easy to disinfect. A quarantine period allows the facility's operator to determine a dog's state of health before introducing it into a group, and vaccinations can be administered. A number of vaccines exist, although their effectiveness varies.