Two press releases this week report pets testing positive for SARS-CoV2: a household cat in Minnesota who was clinical for disease shortly after her owner became ill; and a pet GSD dog in NYS in a household with owners with clinical signs, one whom tested positive for SARS-CoV2. In both cases, the sick pets have made full recovery. In the case of the dog, a housemate dog also tested positive for antibodies, but never displayed signs of illness while the rest of the household was ill. Direct links to the press releases are below:
NYS Ag and Markets has issued a guidance document for veterinarians in resuming elective, non-urgent procedures in NYS. While emergency services and spay/neuter of companion animals were deemed essential during the initial PAUSE, practices are now released to perform other elective procedures as long as they are following guidelines to protect the public and clinic staff. Highlights include the following:
Communication with clients regarding new procedures and risk reduction
Patients seen by appointments only unless it is an emergency
Screening of clients and staff for COVID-19 signs or exposures
Curbside intake and discharge procedures, with limited client traffic in facilities
Adjustment of workplace hours and practices to reduce density of people
Mandatory face coverings and physical distancing practices
In order to resume business, leadership of clinics and organizations need to read and certify that they have read a detailed “master” document on various mandatory and recommended practices for all non-food agricultural related business.
In addition, the summary document specific to veterinary practice is posted below.
Guidelines from the CDC for testing animals for SARS-COV2 have been released, and include specific information addressing shelters and other group-housed populations of animals.
Here are the highlights
Routine testing of animals for SARS-COV2 is not recommended.
The decision to test an animal must be agreed upon by local, state, and/or federal public health and animal health officials.
Priority animals include those of high risk of exposure AND demonstrating significant clinical signs not attributed to other causes.
For animals in a group setting such as a shelter, testing is advised when a cluster of animals shows clinical signs of concern*.
If testing is performed, the USDA has FAQs around sample collection, transport, storage, and result reporting. Additionally, samples should be collected in duplicate so positives can be confirmed through the NVSL.
The document in its entirety can be viewed and downloaded below.
* If you are a shelter experiencing an outbreak or unusual presentation of respiratory disease in your population, please reach out to us at firstname.lastname@example.org. Our program faculty are happy to provide expert advice on diagnosis and management, and due to the generous support of Maddie’s Shelter Lab we are able to provide subsidized or no-cost testing through the AHDC.
FAQ: A friend or family member has tested positive for COVID-19 and may be hospitalized. They have asked me to care for their pet. Can I do that, and how?
Thanks for asking, and for offering to help your friend. The following advice is based on current knowledge and research and the CDC’s interim recommendations for caring for pets of COVID-19 positive owners. It is important to know the risks and decide for yourself, in conversation with your physician and your family, on whether you can perform these duties.
You likely have these options:
the pet can stay in its own home and you can care for it there (ideal for cats, small mammals primarily)
the pet may be taken to your home and cared for there
the pet may be able to go to a boarding facility
Things to consider:
SARS-CoV2 has been reported to be found present on surfaces such as metal and hard plastic for up to 3 days. The home of an infected person likely has live virus on surfaces for several days after they leave.
According to the CDC and AVMA, there is no evidence that pets act in the transmission of SARS-COV2 to people. However, the virus can live on surfaces for hours to days, and so the home of a COVID-19 patient is more likely to be of risk to you than the pet.
There have been rare reports that cats and dogs can contract SARS-COV2 through close contact with their sick owners; again, there is no evidence that they transmit it back to humans.
There is some potential that cats, if they become ill or share litterboxes, may transmit it to other cats. Again, we still believe this to be rare.
The primary goals here are to provide ongoing humane care to the pet, minimize stress to pets and humans, and minimize possible cross contamination from the infected home to your home.
Providing care for a pet in the owner’s home
Ensure that heating and cooling will remain on to provide a safe and comfortable temperature.
If at all possible, you should avoid entering the home.
For cats, simply slipping a few days’ worth of food/water/litter through the door from outside will likely be sufficient.
For dogs who are easy to handle, food and water may be slipped through the door from outside. The dog can be leashed as he comes to the door for a walk a few times a day and then placed back in the home without entering.
For fish, some reptiles and small mammals, care may not need to be feed as frequently, or could be provided a long-lasting food source, reducing the frequency of care visits.
For some dogs and other pets, it may be simpler to take them home or to a boarding kennel.
If you are planning to take the animal home with you, it is recommended to wait until at least 3 days have passed with no one living in the home,if possible; most of the virus present will have died during that time. If in-home care can be continued for 14 days (through the CDC recommended period for animals to be kept separate), or until the owner is able to resume care, that is ideal.
Exposure to the virus can be mitigated by following the measures to prevent exposure.
Measures to prevent exposure
For every visit use proper PPE: wear gloves, mask, and coveralls or additional piece(s) of clothing worn over your existing clothes that can be shed and placed in a bag to be washed once you leave the home. Shoe covers or another clean pair of shoes to put on before going home is advised.
Sanitize doorknobs and other surfaces you’ll be contacting frequently with disinfectant wipes or sprays.
After you leave the home and before you leave or contact your car, sanitize any items that you are taking with you (eg leash, food container, carrier). Remove your shoe covers or change your shoes. Carefully remove all PPE and place them in large plastic bags: one to be discarded and the other to be laundered or sanitized. Alternatively, if you are returning to the home, you can leave coveralls, extra shoes, and gloves at the entry to the home. Sanitize your hands frequently by hand washing or alcohol gel, including immediately following the removal of gloves.
Though the risk from animals is negligible, it is still recommended to minimize close contact (snuggling, licking, etc.) for 14 days based on CDC recommendations to shelters.
Retrieving a pet from an owner’s home
Check with the local health departments and/or your animal control agency for specific recommendations and potentially assistance in getting the animal. If at all possible, you should avoid entering the home.
If the animal can be passed to you without contact through the use of a carrier or by securely tying the dog’s leash, this is the best means of taking the animal from someone else.
If you must enter the home follow the guidance above to prevent exposure.
Minimize time in the home and avoid contact with household items.
Once outside, sanitize the surface of pet care supplies you are taking with you (leashes, bowls, food containers, etc.) using disinfecting wipes or sprays before removing your PPE. Place washable items belonging to the pet into the bag with your washable PPE.
Caring for an exposed pet in your home
Although it is theoretically possible for the pet to be carrying some viral particles on their fur, the AVMA and CDC agree that fur is highly unlikely to be a means of spreading the virus. Furthermore, there is no evidence of transmission of SARS-CoV2 from pets to people. These overly cautious steps will further minimize any chance of cross-contamination and exposure to your household.
Studies and extremely rare natural infections suggest dogs and cats are very very low risk to humans, if any. However, out of an abundance of caution the CDC recommends separating animals from COVID-positive homes from close contact with other pets and people for 14 days from the last point of contact with an infected person.
A separate space in your home should be prepared before you bring the animal home. This should be an area that is easily disinfected and contains limited household items.
Minimize interaction with multiple family members.
Any carriers or other items that came with the animal should be thoroughly cleaned with disinfectant or run through the laundry if applicable.
It is good general practice at any time to wash your hands after contact with an animal or their food, waste, or bedding
Do not bring items (other than medications and food in a closed container) from the home with you unless you can wash them immediately (beds, blankets, toys, even the leash).
For cats, in addition to keeping them separate from other pets and people for 14 days, they should not share litterboxes with non-exposed cats during the separation period.
Advice for all pet owners — Make a plan for your pets now.
Identify a friend or family member who will care for your pet in the event you become sick or injured. Once they agree, provide them with written permission to enter your home and access to a key.
Prepare a “go-bag” for your pet so that everything they need is in one convenient location. This will give the caretaker of your pet ample time to find more of your pet’s most important supplies. The “go-bag” should include everything your pet needs for at least two weeks including:
Food in a closed and wipeable container with instructions and the specific brand indicated
Medications with instructions
Other supplies (eg DAP, litter, favorite treats, harness)
A copy of medical records including recent vaccinations and veterinary contact information.
There is no indication that community cats play a role in the spread of this human disease. Community cat caregivers should apply the same precautions as are recommended for care of pets.
Follow all safety and physical distancing guidelines in the course of caring for cats as in all activities.
Only one person should be present to care for the cats at a time.
Practice hand hygiene before and after caring for cats.
Follow recommendations for wearing masks when in public places.
Persons who are sick or under medical care or quarantine for COVID-19 should stay at home and avoid close contact with cats; if possible, another caregiver should provide care for cats until recovered.
If TNR activities are occurring, practices should follow social distancing guidelines (within clinic, during transport, and during collection and release).
Community cats should remain in their community and not be relocated or intermixed with new groups at this time except as necessary for animal or public safety (e.g., cat has been admitted to a shelter and cannot be returned to the location of origin due to an exigent risk).
When seeking medical care, all precautions should be made as for pet animals. For example, if cats are displaying signs of respiratory illness (nasal discharge, sneezing, ocular discharge, etc.) or are known to have been exposed to a COVID-19 positive caregiver within the last 14 days, the veterinary clinic should be called and informed prior to arrival.
New information about COVID-19 continues to be released daily. Faculty of the Maddie’s Shelter Medicine Program have continued to update protocols and information sheets for shelters based on new information. Download below for the most recent updates to the general shelter protocol for handling animals from COVID-19 positive homes. Remote consultations on this and other topics welcome at email@example.com.
The Million Cat Challenge and Maddie’s Fund is at it again — bringing portals to every shelter to provide humane, double-sided enclosures for cats. With shelter inventories at record lows, now is the time to get portals installed, and shelters can apply to receive the portals they need FOR FREE!
Photos and instructions from https://www.sheltermedicine.com/library/resources/?r=cat-portals-order-information-and-instruction-for-installation
Application for Portalmania 2020 can be found here
This opportunity is being generously funded by SHOR-LINE, the Banfield Foundation, the Joanie Bernard Foundation, Team Shelter USA, and Virox Technologies.
A commercial laboratory has announced that SARS-CoV2 testing is available to the public through veterinarians. It is important to note the recommendations for when to test are similar to those we discussed in our previous post about the testing recommendations from the NYS State Veterinarian and summarized nicely in this flow chart from the AVMA.
Some commercial labs are performing testing for SARS-CoV2 on all samples submitted for canine and feline respiratory or GI PCR as a means of surveillance. Veterinarians submitting samples should be aware that any non-negative result for SARS-CoV2 will be sent for confirmation; confirmation is needed because the prevalence of SARS-CoV2 in animals is so low, the chance of a false positive result is high. A positive result in an animal on the confirmatory tests would be reported to the state veterinarian and the World Organization for Animal Health (OIE).
Before submitting test samples, veterinarians should clarify with their state veterinarian what the response to a positive test might be, especially for an animal in a shelter. Likewise, veterinarians should clarify with their laboratories whether they are adding on SARS-CoV2 testing even if not specifically requested.
What’s important to take from this new information is the same message we have been saying all along:
Infected owners are a risk for infecting their cats and cats need to be protected like other family members when a family member is ill.
Widespread testing of healthy cats is not recommended.
And there is no evidence that pets play a role in the transmission of SARS-CoV2 to people.
You may have heard some shelter medicine experts and the Alliance for Contraception in Cats and Dogs (ACC&D) promoting the use of a birth control medication called megestrol acetate (MA) to slow the tide of the kitten flood sure to come this spring if we can’t spay outdoor cats.
Low doses have been used with success to temporarily suppress estrus in community cat colonies, but little scientific evidence exists for efficacy and safety
Side effects could be an issue, so consultation with a veterinarian is required before prescribing, and care should be taken when handling the medication and dosing it to cats
The medication for cat doses is only available through a compounding pharmacy and it is not FDA approved in cats
If other litter prevention techniques won’t work for you (separating males and females, for instance), do your homework first, then share your data with ACC&D
The nitty gritty:
MA is a potent synthetic progestin hormone that has actually been used for many years in many species. Two early studies on its effects in cats were published in 1977. Unfortunately, there hasn’t been much in the way of actual controlled clinical research on this medication since then. At the high doses originally studied (0.5mg/kg daily), many serious side effects were reported. These included pyometra, mammary cancers and mammary enlargement (males and females), diabetes (maybe reversible), adrenal gland dysfunction (maybe reversible), uterine disease (reversible), and finally, birth defects, dystocia and failure to produce milk in pregnant cats. MA can also be dangerous to the people administering it, since it can be absorbed through the skin, so gloves must be worn by people handling and administering this medication.
More recently, some veterinarians and community cat caretakers have advocated for using low doses of MA, anywhere from 0.625mg/kg weekly to 0.1-0.2mg/kg weekly as a stop-gap before spay/neuter in community cat management. We have some evidence of side effects for use at intermediate doses, because MA is used in other countries to treat other feline endocrine conditions (MA attaches to glucocorticoid receptors just like prednisone), and mammary enlargement and adrenal dysfunction are still problematic. In Europe, an antidote medication is available if these effects are seen- but this isn’t available in the US. Anecdotal reports of using extra low doses in colonies of feral cats report fewer side effects and fewer kittens, but there is limited to no scientific research data on efficacy or safety at those doses to guide us.
MA should not be used in male cats or in pregnant cats for the reasons mentioned above, kittens under 4 months old due endometrial disease, or cats with other endocrine disorders. MA does not prevent lactation in queens already nursing, but we don’t know about its concentration in milk. So that leaves us with healthy, non-pregnant, >5-month-old female cats. In order to confirm whether use is appropriate, Romagnoli et al in 2015 recommended the following: detailed history, clinical exam, abdominal and mammary palpation, and a vaginal swab with cytology. A quick abdominal ultrasound would also be ideal.
So should shelter veterinarians be using this medication? Here are the risk factors we would like you to consider.
Is the cat likely to become pregnant?
Can you not mitigate the risk some other way?
Remove all males from household, don’t allow cat out, rehome or re-foster, etc
Have you already examined the cat and/or would examining the cat be possible without compromising owner, staff or foster parent social distancing?
In some cases, for example, an outdoor cat for whom pregnancy is extremely likely, a telehealth prescription might be appropriate, depending on VPCR requirements in your state.
Can the cat be safely medicated (in food, liquid in syringe, or capsule) by an informed and prepared caretaker (wearing gloves)?
Do you have a plan in place for side effect management?
Some of these side effects, even at very low doses, can be fatal.
Is the shelter management and/or pet owner okay with using an experimental drug not approved by the FDA for this particular species/usage?
Are you willing to collect data about dosing/side effects/success for the good of science?
If the answer to all of the questions above is YES, then a trial run of low-dose MA may be right for this cat. To procure the drug, you will need to call your local compounding pharmacy, (Dr. Julie Levy recommends 0.625mg/kg weekly, so 2.5mg/ml liquid) and order MA either as “office stock” to your shelter if owned by the shelter, or as an individual prescription that can be shipped directly to the owner. The 20mg FDA approved canine MA tablet (OvaBan™) does not dissolve in liquid and should not be used to self-compound. For in heat cats, double your dose and give daily for 3 days before switching to a weekly schedule. Not recommended for treating longer than 30 weeks.
Finally, if you do decide to test this medication out for a few months, please share the results of your treatment trial. Contact the ACC&D to let them know how things are going.
Houdeshell, JW, Hennessey, PW. Megestrol acetate for control of estrus in the cat. Vet Med Small Anim Clin 1977; 72: 1013–1017
Oen, EO. The oral administration of megestrol acetate to postpone oestrus in cats.
Nordisk veterinaermedicin 1977: 29 (6)
Romagnoli S. Progestins to control feline reproduction: Historical abuse of high doses and potentially safe use of low doses. J Feline Med Surg. 2015;17(9):743-752. doi:10.1177/1098612X15594987
Many shelters have successfully evacuated their animals into community homes during this pandemic; now it’s time to keep them there. The work of the animal shelter should have at its very core foster care management, now done remotely: you likely need to be devoting increased staff and services to this population. How to get your people and your systems up to speed? Here is the best online training we found for shelter staff, kitten fosters, and dog fosters to create a sustainable and best practice approach to using foster homes as your new shelter.
Get organized! Training for shelter staff about foster program management: