Dr. Dave’s Note:
While this is NOT a commonly seen disease, EARLY diagnosis and treatment are CRITICAL to a successful outcome. For additional information, contact your local veterinarian. Dogs exhibiting fever, weight loss, loss of appetite, vomiting or diarrhea should be immediately evaluated by your veterinarian. I suggest you bring along a copy of this public information release.
Dogs that develop this disease are reported to be healthy prior to being found very sick only a few hours later.
Typically the dogs are found in lateral recumbence, either being too weak to move or experiencing rigidity or mild convulsions. Rapid, uncontrolled muscle fasciculations are often noted. A consistent and important finding is a very high temperature (105 degrees Fo.).
As the disease progresses, a deep, non-productive cough typical of pulmonary edema develops. Rapidly, spontaneous hemorrhaging typical of disseminated intravascular coagulation develops which is associated with coughing up blood, bleeding from the nose, severe bruising of the skin, and in some cases, blood diarrhea.
Shock therapy alone is not able to save these dogs. Dogs treated in the beginning stages of the condition with injectable antibiotics (clindamycin or penicillin-G) are more likely to recover.
It is important to distinguish the disease from Kennel Cough which also causes coughing but which only rarely causes high fevers and severe systemic illness. Prompt evaluation by a veterinarian is required to make a timely diagnosis.
Streptococci are a family of gram-positive bacteria which cause either localized or systemic infections in humans and animals (particularly dogs). While some strains rarely cause disease and are often considered to be commensal inhabitants of the skin and mucosal surfaces (oral, nasal, intestinal), other strains are capable of causing life-threatening primary infections.
Approximately 10 years ago, Streptococci emerged as the cause of a previously unrecognized disease in humans. The clinical disease became known as Streptococcal Toxic Shock Syndrome (STSS) because it closely mimics the better known "Toxic Shock" in women caused by toxin producing strains of Staphylococci. Rapid, unexpected onset, high fever, hypotension and shock are prominent characteristics of STSS in humans.
At approximately the same time, a number of unusual cases of necrotizing fasciitis caused by Streptococci were reported in humans. This syndrome relates to a very aggressive and rapidly advancing infection of subcutaneous tissue which is associated with extensive tissue destruction and high mortality rates. The lay press referred to the organism as "flesh eating bacteria" which, while not appealing, is nevertheless descriptive of the clinical disease.
In 1996, Miller and Prescott reported on a series of seven dogs from southern Ontario that had severe systemic disease and shock associated with infection with ß-hemolytic Streptococci (Group G). (ed. note: JAVMA, Vol. 209, No. 8, Oct. 15, 1996). In four of these dogs, the infection was associated with necrotizing fasciitis. As a result of surgical debridement, supportive medical care and treatment with antibiotics, all of these dogs survived.
In contrast, all three of the dogs with STTS without necrotizing fasciitis died or were euthanized with 48 hours. The lungs were considered the primary site of infections in two of these dogs as their clinical signs were related to respiratory distress and shock.
Similar disease outbreaks have been reported by Garnett et al. (1982) in a group of research dogs; in captive coyotes by Gates and Green (1979); and in racing Greyhounds in 1981 by Sundberg et al. More recently, outbreaks of fatal STSS have occurred in racing Greyhounds in 1992 and again in January/February of 1999. Additional cases have recently been reported in other breeds of dogs.
The Department of Diagnostic Medicine/Pathobiology
College of Veterinary Medicine
Kansas State University
Manhattan, KS 66506-5606
We hope that you will find this information helpful in your quest for better pet care. If you have any questions or comments, please call your veterinarian's office, or feel free to e-mail us.
David E. Hammett, DVM
and the Staff of All Creatures Veterinary Clinic, PC
