Are veterinarians prepared to deal with ongoing COVID angst?

Fear of zoonosis can be tricky to address, especially for people living with anxiety

COVID anxiety spares no one. Can pets get sick and die from it? Can they give it to their people? Can we infect them? Surrounded by all of this angst, can we practicing veterinarians survive the tension? PHOTO COURTESY UNDEFINED UNDEFINED / ISTOCK / GETTY IMAGES PLUSCOVID anxiety spares no one. Can pets get sick and die from it? Can they give it to their people? Can we infect them? Surrounded by all of this angst, can we practicing veterinarians survive the tension?

So much of our time is spent answering questions, sometimes the same questions, worded just a little differently, from the same nervous clients. We have some reliable research to share, but their fears can consume our time and run us more ragged than we already are. Facts can help.

The SARS-CoV-2 virus, the organism responsible for the human pandemic, has been investigated in cats and dogs. Here is what we know—so far.

Getting to the source

A recent paper titled, “Natural SARS-C0V-2 infections, including virus isolation, among serially tested cats and dogs in households with confirmed human COVID-19 in Texas USA,” by Sarah Hamer and colleagues, conducted a longitudinal study of pets living with at least one SARS-CoV-2 infected human. Researchers found, “47.1 percent of 17 cats and 15.3 percent of 59 dogs from 25.6 percent of 39 households were positive for SARS-CoV-2 via RT-PCR and genome sequencing or neutralizing antibodies. Virus was isolated from one cat. The majority (82.4 percent) of infected pets were asymptomatic.” The authors concluded that, “Despite recovery of live SARS-CoV-2 from one feline respiratory sample, this study provides no evidence that companion animals play a role in spreading the virus to humans or to other animals.”

I contacted the lead author of this paper. Dr. Hamer explained, “One great finding in our research so far is that most of the dogs/cats that test positive either are asymptomatic, or have had only mild symptoms as reported by owners (e.g., few days of lethargy or some sneezing). We’ve been fortunate to re-sample positive animals over time in our study. All cases have resolved their infections without veterinary intervention.”

That last sentence has been helpful to me when talking to clients. I explain that, so far, there is no evidence suggesting we should worry about sharing affection with our pets. I add that I will continue reviewing new information as it becomes available. Pet lovers, most of them anyway, love research. They hang on every word.

Another study, titled, “SARS-CoV-2 infection, disease and transmission in domestic cats” by Gaudreault, et al, determined that experimentally exposed cats became only transiently infected. They did not show the virus in their blood, but it was detected “in nasal, oropharyngeal and rectal swabs, and bronchoalveolar lavage fluid as well as various tissues.” These cats developed antibodies, but in this study none of them showed symptoms. In other words, had they not been tested, nobody would have suspected anything.

So, pets can get COVID from people and it’s possible for them to get sick, but so far none are known to have died from it and they haven’t infected any humans. Still, talk of illness and death can ratchet up the stress of a struggling pet lover. Emotions can be brittle; people are vulnerable right now. Empathy and kindness are our best communication tools, but logic still has its place.

Talking to clients

Veterinary pathologists, like all scientists, understand new information will continue to sharpen our understanding of how COVID behaves in animals. Current thinking is dogs are very unlikely to have any involvement; likewise, while cat-to-human transmission is theoretically possible, the risk is essentially nonexistent.

Snuggles and close contact don’t have to stop with beloved pets. Let clients know they have little concern when it comes to pets and humans transferring the COVID virus to each other. Such fears led to needless deaths during the 1918 pandemic. Photo courtesy Xsandra / E+ / Getty Images
Snuggles and close contact don’t have to stop with beloved pets. Let clients know they have little concern when it comes to pets and humans transferring the COVID virus to each other. Such fears led to needless deaths during the 1918 pandemic.
Photo courtesy Xsandra / E+ / Getty Images

Only a small fraction of our clients are equipped with significant medical knowledge. When they call us in normal times, they want their pets to feel better. With COVID in the air they also want to control their “heebie jeebies” about their own wellbeing. And, of course, they want definitive answers to questions like, “Can my cat get COVID?” “Can he die from it?” “Can she give it to my family?” It’s a yes or no question, doc.

In the broad field of biology there is much that is possible, but highly improbable. Scientific conclusions should always be taken in context. We can explain our current knowledge is not based on proof; rather, on the weight of the evidence—which, of course, can change. The layman doesn’t want to hear we lack rock-solid proof. But if they trust us to be patient with their concerns and straight with our answers, we have a shot at helping them feel better.

Working with distraught people is hard. Whether or not we bargained for it when we applied to veterinary school, it is part of what we do. But rather than dreading these conversations, we can see them as opportunities to help others with their stress. That sounds grand, but I didn’t just fall off the turnip truck. I have been at this a while and I’ve been caught flat-footed as much as anyone.

After delivering a thoughtful explanation of a complex medical challenge to clients I have occasionally been asked, “Are you sure?” I doubt any of us enjoys that question. You can answer, “No, we are not sure” but that frank answer never instills confidence. Trust me; I have made that blunder.

As one veterinary pathologist pointed out, we should be more concerned about catching this nasty disease from the infected human who may have shared it with a pet, rather than from the pet itself. Depending on the situation, I might explain the precautions I take with my own pets (I enjoy them with abandon) but with people outside my immediate household—I’m playing it safe. We veterinarians are trusted medical professionals who understand transmission of airborne viruses. Our clients look to us as an example. I wear a mask, avoid indoor gatherings, and maintain at least six-foot distances. My own pets? They don’t worry me at all.

This whole COVID debacle is rife with challenges. There is nothing new about confusion and disinformation. Mass hysteria during the influenza epidemic of 1918 was heavily influenced by rumors that spread like wildfire. Even without social media as an accelerant, many anxious families succumbed to the unsupported notion that dogs could be carriers. Beloved dogs were relinquished and euthanized in hopes of sparing human lives. Pets played no part in that crisis. No one has to distance themselves from their cats or dogs during this one either.

They call the practice of medicine an art. Well, I guess so. Fears of zoonosis can be tricky to address, especially for people living with anxiety. The empathy we extend to them also benefits their pets. Gently saying, “I understand how you feel” gives us a lift, too. Brief comments of support for clients and coworkers reduces our drift toward burnout.

We do not have to do it all. The Centers for Disease Control  and Prevention (CDC) has great resources for pet owners who want every scrap of information they can find, including that “Tests for COVID-19 in animals are available for most types of pets, but testing is only recommended for animals with COVID-19 symptoms and have been exposed to a person with COVID-19.” There is a whole lot more. I suggest adding the below links to your hospital’s website.

For pet owners: https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/pets.html

If a pet tests positive: https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/positive-pet.html

And for managing risks in our facilities: https://www.cdc.gov/coronavirus/2019-ncov/community/veterinarians.html

The worry factor

This epidemic has been really taxing. People are affected differently. People who carry tension, fear, worry, and express impatience in their tone of voice need the best we can give. Even more than the facts of COVID research, they crave reassurance.

We can teach our staff good listening skills just by practicing them. They will hear us repeat a person’s question back to be sure we understand their concerns. They will follow our lead when we use simple language in a calm tone. Those around us will feel better as we end these conversations with, “Stay safe.”

Don’t forget to sit back—every chance you get—to indulge in a few deep stomach breaths to oxygenate your brain. You have just improved the wellbeing of a real human. The pets in that home won’t miss the healthy shifts in their person’s body signaling and demeanor. We do important work. We are reliable. Let’s take good care of ourselves so we can do this again tomorrow.

Jeff Nichol, DVM, did his undergraduate studies and graduated from veterinary school at Michigan State University. He has been a veterinary hospital owner and has practiced general and behavior medicine throughout most of his career. Dr. Nichol completed his residency in behavior medicine through the American College of Veterinary Behaviorists in 2015. His current practice, located in Albuquerque, New Mexico, is now limited to the diagnosis and treatment of behavior disorders of pets. Medical comorbidities are a common feature in his case load.

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