Distemper Question: I am most impressed with your knowledge and the clear and concise manner that you provide advice. We experiencing a terrifying situation confronting our dogs. On Saturday, May 26, 2001, our dog Princess was euthanized due to Acute Distemper. Princess was rescued from the street around March 18, 2001. Our dogs first came into direct contact with her at that time. She had been exhibiting a cough and a nasal drip. After about two days with us she was placed in another home for approximately three weeks. After that period of time, she returned to our home where she resumed contact with our dogs for several more weeks until she was euthanized. For about one or two days before she was brought to the hospital on Friday, May 25, 2001, Princess exhibited a pronounced nasal discharge and her breathing was very labored. We were not overly concerned about anything being spread to our dogs because they were all "vaccinated." Moreover, we have a small two bedroom home and many other dogs, therefore, separating her effectively was difficult. We have many fears and questions. However, I will mainly ask at this time about one of our dogs, Bear, whose situation we feel is the most urgent. Background: Bear is one years old and weighs about 45 pounds. He had his complete baby series of vaccinations. He is due for his first booster in September. Unfortunately, the baby series of vaccinations may not have been effective due to the vaccines not being cooled properly during transport. We administered them ourselves, but I believe the ice packs were warm by the time they arrived. A cough was first noted on Monday, May 27, 2001. A sneeze was first noted on Wednesday, May 30th. A Titer test for Distemper was performed on Thursday, May 31st. The results on Saturday, June 2nd were positive for Distemper antibodies. For these last two weeks his symptoms had been confined to an occasional mild cough or sneeze. However, Monday, June 11, he became somewhat lethargic, so we took his temperature which was 103.6. We reported his fever to our vet who placed Bear on an antibiotic. Last night, June 12, at 10:30 PM his fever climbed to 104.6. We administered a half of a 325 mg aspirin. His temperature continued to rise. At 1:00 AM, it was 105. Although, his temperature decreased. at 4:30 AM to 103.6, it has risen again this morning to 105.4. We are great believers in boosting the immune system. Bear and our other dogs are receiving a wide variety of supplements. We are using the following vitamin regimen for our dogs: Vetri DMG Liquid - 10 drops twice a day. Vetri-Science Cell Advance 880 - As prescribed on the bottle. Vetri-Science Canine Plus multivitamins - As prescribed on bottle. Jarrow Colostrum 500 mg twice a day. 30% immunoglobulins per capsule C-Flex canine Esther-C form of calcium ascorbate - 500 mg recommended dosage on bottle is one 500 mg tablet per 20 pounds animal body weight. The Missing Link - As prescribed on the package. Anitra's Vita-Mineral Mix - As prescribed on bottle. Questions: 1) Do you feel fever is the body's natural reaction to fighting off the attack by the virus and therefore no attempt should be made at lowering it, unless it reaches a certain point? 2) Do you believe we should attempt to lower Bear's fever at this time? If so, please explain how. For example do you recommend using aspirin? 3) I have heard of the benefits of using mega doses of vitamin C given intravenously. Your comments please regarding if/when this might be an advisable protocol. 4) Do you believe Interferon could be beneficial to use? 5) Please advise a nutritional and/or other types of protocols, or advice, that you believe would be helpful. 6) Do you believe the vaccines we administered were probably a "zero" benefit due to the ice packs melting during transport? 7) What length of time is considered dangerous if Bear's fever continues? 8) What length of time is considered dangerous if there is no improvement in Bear's other symptoms? 9) What do you believe is Bear's percentage chance of survival? 10)We are attempting to separate Bear and our other dogs from each other as much as possible in order to avoid their reinfecting each other. Naturally, this is difficult with many dogs in a small home. Are there certain points, depending on a dogs symptoms, when it presents a greater chance of spreading the virus? For example: A) Would Bear be more likely to be contagious at this time because he has a fever? B) Would a dog be more likely to be contagious according to the degree and severity of its coughing, sneezing, or other discharge, or when exhibiting neurological symptoms? 9) What course of action do you recommend if a dog begins to exhibit neurological symptoms, i.e., seizures? I am not certain whether you will email me directly your response, or if I need to keep checking the web cite. Please notify me if I must check the website. A direct response would be most appreciated. Once again, thank you for the service that you provide. Answer: D- I'll try to answer your questions sort of by the numbers, but there will be some overlap. 1) I do think that fever has some benefits in fighting off infection and that a case can be made for not controlling fever based on this, unless it gets severe. We worry about temperatures over 105.5 to 106 degrees Fahrenheit and do try to control fevers when they get higher than this since the fever itself can become damaging to the patient. 2) I probably wouldn't do anything for a 105.4 degree temperature unless it persisted at this level for more than 24 hours. Then I probably would try aspirin to reduce the fever. There is not a clear right or wrong answer for when to control fevers in this range, though. 3) Megadoses of Vitamin C were proposed as a treatment for canine distemper and sort of in the tail end of being in vogue when I graduated from veterinary school in 1979. At that time, there seemed to be enough scientific evidence to say that the therapy was not effective. It is unlikely to be harmful in a dog that is past the growth stage in age, though. 4) Dogs with distemper produce interferon and other immune modulating compounds (cytokines) while ill. I do not know if supplementing these would be beneficial and I could not find any information on whether this had been tried, or not. You would have to consider this to be an experimental treatment. Interferon has been used for other diseases in dogs without apparent side effects at low dosages, so it seems like it would be reasonably safe to try this if you wanted to (one study, Gilger 1999, was on keratoconjunctivitis sicca, using interferon alpha at 20 to 40U per day, orally. This might at least make Bear's eyes more comfortable). 5) To the best of my knowledge, there are no known medications, nutritional supplements or other therapies that have proven to be successful in treating canine distemper virus consistently. Using a good quality food, perhaps supplementing with a multi-vitamin and using other therapies that are not likely to be harmful, such as the ones you asked about, all seem reasonable. Antibiotics are justified, I think, because secondary infections seem very common in puppies with distemper. In addition, anything that increases patient comfort, like humidifying the air the pup is breathing, decongestants, seizure control medications (if seizures occur), etc. are all worth considering. 6) Vaccines are supposed to be able to survive about a 4 to 5 day period without refrigeration as part of their approval process, I think. It is always hard to be certain what happens to vaccines after they leave the manufacturer, which is a good reason to use suppliers you believe to be ethical and to try to be careful about taking care of vaccines yourself. There is probably no way to be certain of the vaccines effectiveness in retrospect but it is good that the other dogs are not showing signs. The most common cause of vaccine failure is residual maternal immunity that prevents successful vaccination. This is a problem when puppies are vaccinated at less than twelve weeks of age and is the reason that series of vaccinations are given to puppies. If Bear was given one of the vaccinations when he was over twelve weeks of age and if modified live vaccines were used (most are this type), it would be unusual for the vaccine not to work unless it was defective. If he was not vaccinated after twelve weeks of age, there is a chance that maternal immunity prevented the vaccine from working. 7) I have not seen a chart that describes any sort of risk vs. duration for fevers of any temperature in dogs. We try to bring fevers down when they persist for more than 48 to 72 hours but that is just an established practice, not something that we have the references to prove is necessary to do. 8) Dogs with distemper can experience worsening of the disease, especially neurologic problems from it, for years after the initial illness seems to have passed. Unfortunately, for this particular disease, there is not a time when danger of a neurologic complication such as seizure activity can be discounted. 9) There is no real way to predict survivability for an individual dog affected by distemper. Some puppies with really severe initial signs experience only mild neurologic problems while other puppies with mild initial disease have severe seizure disorders or blindness later. Overall, my best estimate of long term survival with what I consider to be reasonably good quality of life is probably about 50% to 60% of affected puppies. 10) Shedding of the virus usually stops after the acute phase of the illness (after upper respiratory and gastrointestinal signs have cleared up) but there are reports of some puppies shedding the virus for two to three months, so it is best to consider an infected dog to be a potential shedder of the virus for three months and to keep them isolated from other dogs for this period of time. I do not know if the rate of viral shedding relates to clinical signs at all but it would be best just to assume that the virus could be shed for some time. 11) If seizure activity does occur it may be beneficial to administer dexamethasone (a corticosteroid) one time at the onset of seizure activity, since there is inflammatory encephalitis at this time in most patients. I am not sure if the long term value of this has really been established, though. Other than this, treatment of any seizure activity using phenobarbital or other anticonvulsants is the only thing that I know of to do. Many dogs have a period when seizure activity is intense and then seizures become less of a problem over time and we have several patients who have not needed seizure control after the first year or so of use. There is a chance that Bear's disease is not distemper, but the signs do seem to support this diagnosis.