Jessie, a 2-year-old 65-lb (29.5-kg) spayed crossbreed dog, is presented for lethargy and anorexia of 2-days’ duration and hemoptysis of <24-hours’ duration.
History
Jessie lives in rural Colorado and is allowed to roam unattended outdoors, where she occasionally finds and mouths small dead wildlife. Flea, tick, and heartworm preventives are not regularly administered. There is no history of travel.
Physical Examination
On physical examination, Jessie is weak, lethargic, and mildly dehydrated (5%). Her temperature is 103.9°F (39.9°C). Respiratory rate is 40 breaths per minute, heart rate is 110 bpm, and BCS is 5/9.
Auscultation reveals harsh lung sounds over all fields, with increased respiratory effort and a cough. Small streaks of fresh blood mixed with saliva are present along the mucocutaneous edge of the mouth and just under the upper lip on the left side. Left cervical and bilateral mandibular lymphadenomegaly is present. Flea dirt and 2 live fleas are noted in the inguinal area.
How would you diagnose and treat this patient?
Diagnosis
Left cervical lymph node aspirate and Gram stain results showed gram-negative bipolar coccobacilli consistent with Yersinia pestis infection. Thoracic radiographs revealed a bronchial pattern and changes consistent with pneumonic plague, which is a high-risk concern for human infection transmitted via droplets. After the state public health department was contacted, a blood sample, lymph node aspirate, and oropharyngeal swab were submitted for aerobic culture. Samples from the oropharyngeal region grew Y pestis.
Treatment & Outcome
Jessie was placed in isolation and treated with IV fluids, gentamicin, and supportive care; however, her condition deteriorated rapidly, and she was euthanized. The state public health department contacted her owners and all veterinary personnel involved. Prophylactic antibiotics were prescribed (via individuals’ physicians) to those exposed to Jessie.