Species : Canine
Breed : X German Shepherd
Sex : Female Spayed
Age : 4 years
Weight : 21.4 kg
Name : “Bella”
“Bella” was adopted from a rescue society operating in a rural area of Alberta, Canada, where the general dog population is poorly vaccinated. She presented with a fever (39.5 degrees Celsius), a chronic (3 weeks) non-responsive pneumonia, a muco-purulent conjunctivitis and nasal discharge. Over the previous 3 days she had developed chorea (neurological muscular twitching) of the facial muscles and hind legs. A presumptive diagnosis of “Canine Distemper Virus” (CDV) was made.
The owner requested a treatment protocol which she had found on the internet by a “Dr Sear’s” which involved the intra-thecal (into the spinal canal) injection of Newcastle Disease (NCD)vaccine. This is a chicken disease which is related to the distemper paramyxo virus as well as the human measles vaccine.
On Dec 16, 2009, “Bella” was anesthetized (Hydromorphone 0.15ml intravenously followed by Ketamine 1ml and Valium 1ml intravenously and then Isoflurane maintenance at 2%) and surgically prepped for a cisterna magna Cerebro-Spinal Fluid (CSF) tap. CSF fluid was collected for laboratory analysis, and 0.5ml of reconstituted NCD vaccine was injected into the spinal fluid. “Bella” was then allowed to wake up from anesthetic. This was uneventful with no signs of discomfort, twitching or seizuring.
At this time 1ml of NCD reconstituted vaccine was administered intravenously.
The same day “Bella” was discharged with the following medications:
1) Phenobarbital 30mg – 1 tablet 2 x daily to be given if required for twitching or seizures
2) Doxycycline 100mg – 1 tablet 2 x daily for 2 weeks for the secondary infection of pneumonia.
3) Antibiotic eye drops for the conjunctivitis
Samples of the CSF were submitted to the laboratory (IDEXX) for a Distemper Virus Real PCR. Results came back POSITIVE for CDV. This is a DNA test which becomes positive only if viral organism is detected, and thus proves the cause of the clinical signs of this patient as Canine Distemper Virus.
Following this treatment, “Bella” made a steady recovery. She experienced some minor muscle twitching and petit-mal seizures in the 1st month post treatment. These were expected and were well controlled with the Phenobarbital. Following the first month she no longer required Phenobarbital and recovered to full health, with minor muscle twitches only evident while she was resting or asleep.
This dog was positively diagnosed by CSF tap to have distemper virus in her spinal fluid. Extensive veterinary experience with neurologic or cerebral distemper patients is that they progressively become worse, with euthanasia or death ensuing. Very few survive the neurologic episode, and those that do have significant chorea, facial and limb muscle twitching forever. The fact that “Bella” made an almost complete recovery is therefore both significant and noteworthy.
The use of the intravenously administered New Castle Disease vaccine in this case differed from Dr Sear’s recommendation. According to his protocol, he would use “distemper serum” made by inoculating a healthy dog with NCD vaccine and then harvesting the serum after 24 hours. As we never had any “serum” on hand, I decided to use NCD vaccine as an intravenous immuno-stimulant in addition to the intra-thecal NCD vaccine injection.
The rapid recovery from the chronic pneumonia and the recovery from the neurologic form of distemper following this treatment supports our approach as a viable alternative.
Note to Reader:
Prior to “Bella’s” treatment we were presented with two puppies with neurological (cerebral) distemper, from the same above rescue group. These puppies went to the USA for the above described treatment as at that time no Canadian veterinarian could be found to deliver the requested treatment. One puppy was already significantly advanced with distemper and did not survive, but the other puppy not only did well, but continues to be a perfectly happy, healthy and normal dog. I would have no hesitation to repeat this treatment protocol for any owner willing to go forward with this approach. We know that there is an almost 100% mortality rate without this treatment. I would also try to get the treatment done as immediately as possible after diagnosis, so that we can strive for the best results from the treatment.
Dr Mark Rubensohn
Bridlewood Veterinary Clinic
Calgary, Alberta Canada