1. Companion Animals in the
EU
Paula Boyden BVetMed MRCVS
Dogs Trust

2. Movement of Animals
• From 2001, pet animals have been
allowed to travel throughout the EU as
long as they had a pet passport

3. 1st January 2012
• Individual country derogations reviewed /
removed:
– NO requirement for rabies titre (blood) test to
enter UK, Ireland, Malta, Sweden
– 6 month wait prior to (re-)entry reduced to 3
weeks
– Tapeworm treatment window extended to 24-
120 hours
– NO requirement for tick treatment

4. Movement of Pets: The Future
• 998/2003
– Movement of animals before 3 months of age
– Derogation from anti-rabies vaccination
– Participating in competitions, exhibiting,
sporting or recreational events or in training for
these events

5. …..so is this a problem?

6. Rabies Control in Europe
Rabies infected countries 1998

7. Number of Cases in the EU

8. Rabies in Europe 2003

9. Rabies in Europe in 2012

11. Rabies: The Disease
• Very variable, sometimes death can be
acute and few signs seen
– Change of demeanour and behaviour
– Restless, confused, disoriented
– Altered vocalisation
– Incoordination, paralysis, salivation, ‘bone in
throat’ syndrome
– Aggression, biting, hypersexuality
– ‘Fly-snapping’, pica

12. Rabies in Humans
• Localised pain or
paraesthesia
• Change in behaviour,
anxiety, fear,
aggression
• Aerophobia
• Hydrophobia
• Paralysis, coma, death

13. Rabies PEP

14. What about rabies
vaccination?

15. Factors Affecting Vaccine Failure
• Vet Record (2004) 154, 423-426
– Factors affecting the serological response of
dogs and cats to rabies vaccination
(Mansfield, Burr et al)
• BSAVA Proceedings 2005 (Abstract)
– Do dogs vary in their response to Rabies
vaccination (Kennedy et al)

16. Factors Affecting Failure
1. Brand
2. Number of doses
used
3. Age
4. Timing of sampling
5. Breed

17. Comparison of Vaccines
(Dogs)
30
25
Vaccine A
20
15 Vaccine B
10
Vaccine C
5
0
Mean Titre IU/m L % Failed Tes ts
(<0.5IU/m L)
Significant differences (p<0.01) between each
vaccine for mean titres and % fails

18. Number of Doses Used
• Dogs: Using a primary course of 2 doses will
increase the mean titre achieved
• Cats: No significant increase in titre after 2
doses
• D/S recommends 2 doses in young, naïve
individuals

19. Age
• Adults significantly more likely to pass
than old or young
• Kennedy: 10400 dogs;
– <1yr, 1-7yrs, >7yrs
– Adults>old>young
• ?Take into account when electing number
of doses to use

20. Effect of Interval Between
Vaccination and Sampling
8
7
6
5 Mean Titre (IU/mL)
4
3
2
1
0
<30 30-59 60-89 90-119 ≥120
Compared to 30-59 day interval, significant (p<0.05)
increase in titre for 0-29 days, and highly significant
(p<0.01) decreases in titre for longer time intervals.

21. Breed
• Larger breeds appear
to have lower
response to
vaccination than small
breeds
– Burr, personal
communication
– Kennedy:
Rottweilers
Greyhounds

22. Study: Main Conclusions
• Dogs <6months old had significantly lower titres
• Ability to respond may decline with age
• Timing of sampling and number of doses had
most significant impact of titres

23. Risk of Rabies
• Number of cases across EU has declined
• No guarantee of the response to
vaccination
• Increased potential for incubating animals
to cross borders
• Number of animals travelling (legally) has
increased
• Increase in illegal movements

24. Rabies Control
“To solve the problem
of rabies would be a
blessing for
humanity” (Louis Pasteur)

25. Echinococcus multilocularis

27. Echinococcus multilocularis

28. Risk of Echinococcus granulosus
• Praziquantal will only kill tapeworms
present at the time
• Increasing the treatment window up to 5
days increases the chances of re-
infection prior to travel
• Sweden has already lost its derogation
due to Echinococcus granulous being
detected

29. Limitations of PETS
• PETS is in place to protect human health
• Animal health is not a primary
consideration
• No vaccine is 100% effective
• Complying with PETS will not ensure a
pet remains healthy if it travels to another
country

30. Diseases associated with
Travelling Pets
• Leishmania (Sandfly)
• Babesia (Tick)
• Ehrlichia (Tick)
• Dirofilaria (Mosquito)

31. Introductions

32. Travelling diseases
• Increasing over last few years
• Previously unknown diseases introduced
• PETS travel scheme
• Relaxing of travel rules

33. Plan
1. Leishmania
2. Babesia
3. Ehrlichia
4. Dirofilaria
5. Case study –
leishmania
6. Case study – ehrlichia
7. Conclusions

34. 1. Leishmania

35. Leishmania
• Protozoon
• Up to 40% of dogs in endemic
areas
• 12 million people in 88
countries
• Transmitted by sandflies

36. Where is it found?

38. Leishmania infection
• Highly immune dogs clear infection (20-40%)
• Some breeds (eg Ibizan hounds) appear to
have higher resistance
• Once infection is established, it cannot be
cured

39. Clinical infection
• Very variable!
• Vague illness
• May be a long gap between being
infected and becoming ill

40. Skin signs of infection

41. Other signs

42. Testing – what are we
looking for?
Leishmania itself Antibody
Includes looking at blood/ Dog has fought infection
bone marrow under Body’s response to disease
microscope and PCR test
Includes Speed Leish K

43. When to test
• Easier to diagnose when dogs are ill
– Both antibody and parasite levels are higher
• If available, use PCR tests – most
sensitive

44. Treatment
• Generally remission NOT
cure
• Allopurinol (Zyloric)
• Meglumine antimonate
(Glucantime)
• Amphotericin B (Fungizone)
• Treatment can be toxic,
especially when combined
with damage from leishmania

45. Preventing leishmania
• Insect repellent (eg Scalibor collar)
• Keep inside between dusk and dawn

46. Leishmania vaccine
• Must test first
• 3 injections, 3 weeks
apart
• Dogs over 6 months

47. Plan
1. Leishmania
2. Babesia
3. Ehrlichia
4. Dirofilaria
5. Case study –
leishmania
6. Case study – ehrlichia
7. Conclusions

48. Babesia
• Like leishmania, a protozoon
• Lives inside the red blood
cells
• AKA piroplasmosis

49. Signs of babesia
• Anaemia
• Bleeding problems
• Red urine
• Sudden collapse

50. Treatment of babesia
• Drugs similar to leishmania
- Imidocarb
- Iminazine
- Atovaquone
- Azithromycin

51. Plan
1. Leishmania
2. Babesia
3. Ehrlichia
4. Dirofilaria
5. Case study –
leishmania
6. Case study – ehrlichia
7. Conclusions

52. Ehrichia
• Bacteria
• Live inside white blood cells
(macrophages)

53. Signs of ehrlichia
• Acute (8-20 days after infection)
– Vague depression, fever, weight loss, poor
appetite
– Enlarged lymph nodes, nosebleeds, bleeding
into skin
• If diagnosed and treated in acute phase,
often recover
• Otherwise progress to chronic infection

54. Chronic ehrlichia infection
• As for acute, but more severe
– Emaciation
– Swelling of hindlegs and scrotum
– Pale gums
– Eye problems
– Neurological problems

55. Treatment of ehrlichia
• Doxycycline for at least 2-3 weeks
• May relapse
• Infection with both ehrlichia and babesia
may occur

56. Prevention of babesia and
ehrlichia
• Good parasite control
• Scalibor, Frontline, Advantix
Babesia only:-
• Vaccine (does not completely prevent
infection)

57. Plan
1. Leishmania
2. Babesia
3. Ehrlichia
4. Dirofilaria
5. Case study –
leishmania
6. Case study – ehrlichia
7. Conclusions

58. Heartworm (dirofilaria
immitis)
• A type of roundworm
• Spread by mosquitos
• Worms lodge in the
arteries of the lungs
• Dogs and cats

59. Signs of infection
• Depends on how bad the infection is
• May be sudden onset but more often
gradual
• Coughing
• Trouble breathing
• Unable to exercise
• Weight loss
• Fainting
• Sudden death

60. Treatment of heartworm
• Regular worming (not all
wormers!)
• Macrolides
– Ivermectin, Moxidectin,
Selamectin)
• Reactions can occur on
worming
• Surgical removal of
worms from heart

61. Plan
1. Leishmania
2. Babesia
3. Ehrlichia
4. Dirofilaria
5. Case study –
leishmania
6. Case study – ehrlichia
7. Conclusions

62. Should we worry?
• Animal health and welfare
• Owner awareness
• Vet awareness
• Treatment availability
• Stress and expense for new owner

63. Conclusions
• Travelling diseases a serious problem
• May be different in non endemic country eg UK
• Export of infection best avoided where possible
• Test before import (and 6 months after if leish
endemic)

64. Acknowledgements
• Centre for Evidence-based Veterinary
Medicine
• Rachel Dean and Gemma Clark
• Dogs Trust
• ICAWC
• Thank you!

65. Websites which pictures have
been ‘borrowed’ from
http://www.parasitologie.univ-
montp1.fr/english_vers/en_leish2.htm
http://globalhealthvet.com/2010/10/05/working-in-morocco-
recurring-leishmaniasis-in-a-canine-patient/
http://www.who.int/leishmaniasis/surveillance/slides_manua
l/en/index5.html
http://www.bestvetstore.com/leishmaniasis-in-dogs/
http://www.flickr.com/photos/19187511@N00/2478336427/
http://silvercoastangelicdogs.wordpress.com/2012/04/05/ca
nine-leishmaniasis-vaccine-now-available-in-portugal/
http://www.pepisdogrefuge.com/news.html
http://www.noahs-arks.net/RESCUE/SAM.html

66. Adoption Across Borders

67. The Law: EU and listed non-EU
• Microchip
• Vaccinate against rabies
• Wait for 3 weeks
• Travel
• If travelling to UK, Ireland, Malta, Finland:
treat against tapeworm Echinococcus
granulosus 24-120 hours before travel

68. Listed Non-EU Countries
Belarus Liechtenstein Russian
Federation
Bosnia Monaco Switzerland
Herzegovina
Croatia Norway Vatican

69. Unlisted Countries
• Microchip
• Vaccinate
• Blood sample after 30 days
• Wait 3 months from date of successful
blood sample
• Travel
• Tapeworm

70. Further Considerations
• What infectious diseases are prevelent
across Europe?
– CPV / CDV / CAV
– Leptospirosis
– FPL / FeLV / Cat ‘flu
• What about further afield?
– WSAVA guidelines

71. Further Considerations
• What infectious diseases are prevalent in the
country of origin?
• Are there appropriate tests available?
• Are these diseases endemic in the destination
country?
– Naïve population
– Should we risk introducing the disease into this?

72. Further Considerations?
• What infectious diseases are prevalent in
the destination country?
• Is there a vaccine available?
• Vaccinate before travel?

73. Leishmaniasis
• Sandfly transmitted
• Prevalent around the Med basin
• Zoonotic
• PCR test available
– Before travel
– 6 months later
• Can manage but not cure

74. Other Diseases
• Dirofilaria (Heartworm)
– Regular treatment required to prevent clinical
disease
• Babesia
• Ehrlichia

75. In Practice
• Comply with rules regarding movement of
animals
• Test for diseases prevalent in the country
of origin but absent at destination
• Prevention against diseases prevalent in
the destination country

76. But this costs money
- what happens if I don’t?