GREAT DANEUpdate - CHAGAS DISEASE Kissing Bug Parasite Found in Great Dane Puppies - Purina Pro Club
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GREAT DANE Update
A NESTLÉ PURINA PUBLICATION DEDICATED TO GREAT DANE ENTHUSIASTS VOLUME 16 | FALL 2018
CHAGAS
DISEASE
Kissing Bug Parasite Found in
Great Dane Puppies
FALL 2018
CHAGAS DISEASE
GREAT DANE PUPPIES CONTRIBUTE TO
AWARENESS As Memore Great Dane breeders
Lori Masse and her husband, Tom, of
Spring Branch, Texas, began planning
to have a litter of puppies, their
fourth litter in 20 years, they diligent-
ly researched stud dogs to find the
right one to breed to their 3-year-
old fawn bitch, “Summer” (GCH
Memore’s Sweet Little Texas Heat).
Their good friend, Aslynn Rose,
of Bastrop, Texas, a professional
handler and the co-owner of Sum-
mer, joined them as they studied
pedigrees, temperament, confor-
mation, movement, health histories,
and health clearances to find the
right stud dog. Summer already had
cleared the breed’s health tests. A
handsome 7-year-old brindle male
named “Maverick” (Multi-BISS GCH
Paxton’s Tsun of Tsunami AOM),
owned by Allison Paxton of Napa,
California, was their pick.
Summer delivered a healthy litter
of seven puppies — three males, two
Unbeknownst to breeders Tom and Lorie Masse of Spring Branch,
Texas, and Aslynn Rose of Bastrop, Texas, their bitch, “Summer”
(GCH Memore’s Sweet Little Texas Heat), was already infected with
the T. cruzi parasite that causes Chagas disease when she was
bred. All seven puppies in her litter contracted the infection in utero.
At right: “Cassie,” the first puppy to show signs of being infected,
died at age 12 weeks after suffering for a short time with advanced
heart failure, an effect of Chagas disease.
2
GREAT DANE Update
fawn and one brindle, and four
females, three fawn and one brin-
dle — in April 2017. The Maverick
X Summer litter was a dream, but
things would soon turn dramatically.
“At 12 weeks, 4 days old, ‘Cassie,’
the brindle female puppy, couldn’t
keep anything down, and she was
lethargic,” Masse says. “I thought
it was just an upset stomach when
I found some throw up beside
her. I waited about an hour and gave
her a biscuit, but she vomited it.
Then, I gave her some water, and
she couldn’t keep it down either. I
was concerned she may have eaten
something that caused a blockage.”
A trip to the veterinarian began
with a radiograph to check for a
blockage, which showed nothing
unusual. The puppy’s temperature
and bloodwork were normal, but “Reign,” a male, died suddenly from Chagas disease at 12 weeks of age with no prior
the heart rate was concerning. “The signs of illness.
veterinarian asked the technician
to bring her ‘the other stethoscope,’ After two more rounds of medi-
and I became worried something cations, Cassie’s heart stabilized.
SIGNS OF CHAGAS
wasn’t right,” says Masse. Around 7 a.m., Cassie was moved
DISEASE IN DOGS*
Cassie’s heart was beating 250 to the critical care area of the vet-
beats per minute, considerably erinary clinic.
• Diarrhea
higher than a normal resting heart “The critical care specialist thought
• Vomiting
rate of 65 to 80 beats per minute. the heart problem was likely sec-
• Lethargy or Depression
Cassie was given medications to ondary to something else, maybe
• Seizures
lower her fast-beating heart, and anaphylactic shock caused from
• Enlarged Lymph Nodes
Masse and the puppy were sent being bitten or stung or from eating
and/or Spleen
to a nearby emergency veterinary something poisonous or maybe
• Fever
hospital for urgent care. Addison’s disease,” Masse says.
• Fainting
At the emergency clinic, Cassie About when Addison’s disease was
• Cardiac signs including in-
was given oxygen and intravenous ruled out, Cassie’s heart rate again
creased heart rate, abnormal
fluids. As Cassie’s heart raced to climbed to 300 beats per minute.
heart rhythm and fluid buildup
300 beats per minute, the tech- Her bloodwork showed extremely
in the abdomen & lungs
nicians began two more doses of elevated liver enzymes. The puppy
heart medications to try to lower the went into cardiac arrest and was *If you suspect your dog may be
heartbeat and stabilize her heart. euthanized as Masse held her in her infected with T. cruzi, see your vet-
“They told me Cassie was in arms. The date, Friday, July 14, 2017, erinarian as soon as possible. Early
advanced heart failure,” Masse says. was etched in Masse’s memory. treatment for an infection has the
Then, a littermate brother, “Reign,” greatest chance of success.
“We were hoping she would make
it through the night.” died the next day, on Saturday,
She left the puppy at the emer- July 15, 2017, when he awoke from
gency clinic for the night. Early the a nap while snuggling on the chest
next morning, at 3 a.m., when they of his new owner. It came suddenly,
took the puppy out to go bathroom, with no prior signs of being ill.
the fast heartbeats returned, again Necropsies were ordered for both
going up to 300 beats per minute. puppies to learn the cause of their
3
FALL 2018
deaths. It would take a few days to puppies can contract the disease
get the results. from an infected dam. When this
happens, puppies may even die in
CHAGAS CAN BE FATAL utero or as neonates. Dogs also
Trying to figure out what was can become infected if they eat
going on was challenging. “Aslynn the bug or its feces on the ground
asked me to check with the veter- or from licking their paws or coat.
inarians for Chagas disease, which On Monday, July 17, after Cassie
is carried by kissing bugs,” Masse and Reign died, Masse took Summer
says. “She remembered seeing and the four surviving puppies, “Zoe,”
kissing bugs during one of the “Rhythm,” “Storm,” and “Aspen,”
visits to see the puppies at our who lived at her house to the
house and recalled from breeding veterinarian to have an indirect
Doberman Pinschers (Whiskey fluorescent antibody (IFA) blood
Mac Dobermans) that Chagas can test for Chagas disease. A few days
mimic the heart disease dilated later, the results came back show-
cardiomyopathy.” ing that Summer, Zoe and Rhythm
Bingo! tested positive for infection with the
Chagas disease, also called Trypanosoma cruzi parasite that
American trypanosomiasis, is a causes Chagas disease. Storm and
potentially deadly disease that is Aspen were clear of the infection.
spread to animals and people by When testing the dogs for Chagas,
the feces of insects called triato- the veterinarian detected an irregular
mines, or kissing bugs. Unborn heartbeat, or arrhythmia, in Zoe, and
an accelerated heart rate of around
250 beats per minute in Rhythm.
“We thought we would probably
lose Rhythm quickly,” Masse says.
“I took her and the others home.
We hoped that Rhythm would live
through the night.”
However, it was Zoe, a beautiful
fawn female, who died next, on
Wednesday, July 19, 2017, at 13 weeks,
3 days old. “Zoe was treated for the
irregular heartbeat for a couple of
days, and then the heart became
accelerated like Cassie’s had done,”
Masse says. “She died in my arms.”
Meanwhile, the necropsy reports
on Cassie and Reign came back,
tagging them as having had Chagas
disease.
Mostly found in the poor rural
areas of Latin American, where
Chagas is endemic, kissing bugs
also are in the U.S., particularly
the Southern states. It is estimated
that as many as five to 13 million
dogs in the U.S. are infected with
T. cruzi, though it is challenging
“Zoe” experienced arrhythmia, or irregular heartbeats, for a short period before dying to pinpoint the number because
of Chagas disease at 13 weeks old. many cases are likely undiagnosed
4
GREAT DANE Update
or misdiagnosed. Not all kissing tocol that had successfully cured
bugs are infected with T. cruzi, other dogs with Chagas disease.
though it is believed that 60 per- Even before the blood test results
cent of the seven species found came back, he suggested to begin
in Texas carry the infection. Summer and Rhythm on the treat-
Chagas disease in dogs can cause ment due to their clinical signs.
severe heart disease, including Working with a Venezuelan
cardiac rhythm abnormalities, research scientist, Alberto E. Paniz-
congestive heart failure and sudden Mondolfi, MD, PhD, of the Institute
death. The cardiac signs often for Scientific Research in Caracas,
resemble dilated cardiomyopathy Dr. Madigan formulated the treat-
and even look similar on an echo- ment for dogs after a drug therapy KISSING BUG CITIZEN
cardiogram. Bloat may occur due Dr. Paniz-Mondolfi had used to cure SCIENCE PROGRAM
to reduced cardiac function resulting a Venezuelan man with Chagas
in an inability to properly pump disease. The therapy combines a At Texas A&M University, researchers
want to learn more about the distri-
blood through the body. Other daily dose of itraconazole, an anti- bution and behavior of kissing bugs
conditions that can result from fungal medicine that is given (triatomine bugs). Since the study
Chagas include megaesophagus, according to a dog’s weight, and began in 2013, more than 5,000
an enlarged esophagus reducing amiodarone, an antiarrhythmic heart bugs have been submitted for the
the movement of food and liquid drug. Due to potential ill effects research that aims to characterize
the transmission of Chagas disease
to the stomach, and megacolon, a from the medications, a dog’s liver
and determine the risk factors for
dilated colon making it difficult to enzymes and heartrate must be exposure in animals and humans.
pass feces normally. monitored every few weeks to be For information about how to safely
Many infected dogs don’t show sure the drugs are being safely collect and submit a kissing bug for
clinical signs; however, asymptomat- absorbed and metabolized. the study, click here.
ic carriers can pass on the disease In 2007, Dr. Madigan treated a
to their offspring. “This explains 1 1/2-year-old male Pointer mix from
why Summer had a completely the local humane society with
normal echocardiogram not even severe arrhythmia and a heart rate
six months before whelping the of more than 220 beats per minute.
litter,” Masse says. The dog eventually died, which
Dogs may show signs within troubled Dr. Madigan. He ordered
weeks of an infection, the acute a necropsy, which indicated the
form of the disease, or months to dog had severe heart disease. PHOTO: GABRIEL HAMER
years later, a chronic infection. Dogs “I was so frustrated,” Dr. Madigan
under 1 year old typically develop recalls. “I didn’t know why we were
acute disease; older dogs are more not able to help this dog.”
likely to have chronic disease. Dr. Madigan sent tissue samples to
“I cannot begin to explain the Texas A&M University. After several
devastation and hopelessness we rounds of testing, they found the
were feeling,” Masse says. T. cruzi parasite in the dog’s heart
As good fortune would have it, tissue, indicating Chagas disease.
the Masses’ veterinarian learned Four months later, Dr. Madigan
about a local veterinarian who had had a second patient with Chagas,
been working with Chagas disease a 180-pound Irish Wolfhound. He
patients for 10 years. Their veteri- discovered Dr. Paniz-Mondolfi while
narian reached out to Roy Madigan, researching treatments for Chagas
DVM, of The Animal Hospital of disease and wanted to see if the
Smithson Valley in Spring Branch, treatment he used on the Vene-
Texas, for advice. zuelan man could be adapted to
Dr. Madigan offered a silver lining help the dog.
to losing three puppies in five days: The Irish Wolfhound survived and
an experimental treatment pro- became the first dog to be cured of
5
FALL 2018
Chagas disease. The collaboration to help reduce the inflammation
led to testing the treatment on and secondary scar tissue forma-
many affected dogs. Among their tion caused by the parasite.”
findings, the amount of itracon- A scientific paper, titled “Success-
TIPS ON REDUCING azole needed to be higher than ful Treatment of Canine Chagas’
KISSING BUGS the dosage used to treat fungal Disease Using Combination Treat-
infections, and treatment needed ment of Amiodarone and Itracon-
• Limit outdoor lighting, particularly to continue for 12 months in dogs azole,” describing the treatment in
around a dog kennel, as kissing bugs
with chronic cases. dogs with Chagas disease will be
are attracted to outdoor lights
• Bring dogs indoors at night or move “The success rate was almost published in 2019 in the Journal
them to a secure, well-sealed 100 percent,” Dr. Madigan says. of the American Veterinary Med-
environment. If you have outdoor “We had a sample size of 105 dogs, ical Association. The drug com-
kennels, consider protective screens of which 100 percent of those that bination that Dr. Madigan and Dr.
• Examine pet bedding for signs of
completed the 12-month protocol Paniz-Mondolfi have adapted for
the bugs
• Keep your yard free of woodpiles were cleared of the infection. Not dogs will be sold as Vidarone once
and brushy areas, as these are a only were they cured, much of the it is approved by the Food and
breeding ground for the insects heart damage due to inflammation Drug Administration.
• Seal cracks and crevices around repaired itself and cardiac func- “We hope that Vidarone will
windows, walls, doors, roofs, and tion improved.” provide a more affordable alter-
attics
However, scar tissue caused by the native to current options,” says
• Begin a pest control plan to combat
kissing bugs, though the effec- disease cannot be repaired. “This Dr. Madigan.
tiveness of spraying is limited due is why starting treatment as soon Meanwhile, Summer and Rhythm,
to the large migration pattern of as possible is important, especially the fourth Great Dane puppy with
kissing bugs in dogs showing cardiac signs,” Dr. Chagas, continued on the treatment
Madigan says. “This also is why we protocol. “They both did pretty well
first treat patients with a nonsteroi- on the medications,” Masse says.
dal ant-inflammatory medication “Occasionally, they were lethargic
and didn’t have much appetite or
would vomit. Rhythm was putting
up a good fight.”
Rhythm hung on for three months
before dying on Sept. 21, 2017, at
age 5 months and 6 days. When
she passed away, her liver weighed
14 pounds, taking up her entire
abdominal cavity, an effect of fluid
accumulation due to congestive
heart failure caused by Chagas
disease. She left behind her dam
and three littermates: Storm,
Aspen and “Cairo,” who lived with
his family in Arizona.
Although Storm and Aspen orig-
inally tested clear for Chagas, one
month later they tested positive.
Cairo was tested, and he, too, was
positive for T. cruzi infection.
By now, the Masses and Rose had
spent several thousand dollars treat-
ing their Great Dane dam Summer
“Rhythm,” a female, was treated with an experimental drug therapy and fought hard and her puppies. Originally, they
before dying of Chagas disease at age 5 months. When she died, her liver weighed
14 pounds, the effect of fluid accumulation due to congestive heart failure caused by thought Storm and Aspen would
T. cruzi infection. need the 60-day drug therapy for
6
GREAT DANE Update
WHERE TO FIND KISSING BUGS IN THE U.S.
MAP COURTESY OF RACHEL CURTIS-ROBLES
Triatomine insects, more commonly known as kissing
bugs, are found worldwide, but those that carry the
parasite T. cruzi that causes Chagas disease are only
found in the Americas, particularly in poor, rural areas
of Latin America. Thus, Chagas disease is sometimes
referred to as American trypanosomiasis.
Named for their habit of biting humans around the
mouth or eyes, kissing bugs have been recognized in
Triatomine insects, or kissing bugs, can be found throughout
the U.S. since the mid-1800s. Eleven species of the the United States in a broad geographical area that runs from
nocturnal, blood-sucking insects have been identified south of Oregon to south of Pennsylvania. The insects also are
in Hawaii.
in the U.S., with Southern states, notably Texas, New
Mexico and Arizona, having a higher prevalence. transmitted to animals and people via the feces of
Carlos Chagas, a Brazilian physician and bacte- an infected kissing bug. The ancestor of T. cruzi is
riologist, discovered the T. cruzi pathogen in 1909. believed to have been introduced to South America
The zoonotic infectious disease named for him is from bats 7 to 10 million years ago.
acute cases, but they had the chron- to have their blood checked for
ic form and would need one year liver toxicity and their hearts mon-
of medications. Cairo, too, needed itored for cardiac disease, but also
one year of medications, and they PCR (polymerase-chain reaction)
paid for his treatment. They worried blood tests are used to detect the
that soon they would not be able parasite’s DNA. PCR testing is
to afford the medications or the more effective than antibody
blood and heart tests monitoring blood tests to check the effective-
their condition. ness of treatment because anti-
“They were all doing well and bodies stay in a dog’s system long
were happy,” Masse says. “They after the parasite is cleared.
were active and playful and had Reflecting on the experience,
a good chance of being cured.” Masse says, “This has forever
They shared information about changed our lives. We have added
their ordeal with Chagas disease testing for Chagas disease to our
with the local Great Dane club. A pre-breeding checks, and we plan
good friend organized a fundrais- to periodically test all our dogs.
er auction on their behalf despite It was an unbelievable heartache
Masse’s protests. An educational to have perfectly healthy, thriving,
component helped to teach others beautiful puppies from birth to 13
about Chagas disease and the weeks of age die suddenly with no
importance of testing dogs. clinical signs. We hope our expe-
“More than 200 items were rience will help educate others
donated plus cash gifts came in,” about Chagas disease.” n
Masse says. “Our dog community
pulled together to support us in a
way I had never seen. We can never Purina appreciates the support of
repay the generosity of everyone. the Great Dane Club of America,
We are so blessed to be part of particularly Neil O’Sullivan, PhD,
such a wonderful community.” chair of the GDCA Health and
Research Committee, in helping
Now, a year later, over $20,000
to identify this topic for the Purina
has been spent caring for the dogs,
Pro Plan Great Dane Update.
Masse says. She not only continues
7
FALL 2018
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