Page 1477 - Small Animal Internal Medicine, 6th Edition

CHAPTER 93 Prevention of Infectious Diseases 1449

BOX 93.1 with sneezing or coughing (Lappin et al., 2017). The index
of suspicion for infectious diseases is increased for dogs or
VetBooks.ir General Hospital Biosecurity Guidelines cats with acute disease and fever, particularly if the animal
is from a crowded environment such as a breeding facility,
• Wash hands before and after each patient contact.
• Wear gloves when handling patients when zoonotic boarding facility, or shelter.
Front desk personnel should indicate clearly on the hos-
diseases are on the list of differential diagnoses. pital record that gastrointestinal signs, respiratory signs,
• Minimize contact with hospital materials (instruments,
records, door handles, etc.) while hands or gloves are or ectoparasites are present. If the presenting complaint
contaminated. is known before admission into the hospital, an optimal
• Always wear an outer garment, such as a smock or method would be to meet the client in the parking area to
scrub shirt, when handling patients. determine the infectious disease risk before the pet enters
• Change outer garments when soiled by feces, the hospital. If an infectious gastrointestinal or respiratory
secretions, or exudates. disease is suspected, the animal should be transported (i.e.,
• Clean and disinfect equipment (stethoscopes, not allowed to walk on the premises) to an examination
thermometers, bandage scissors, etc.) after each use room or the isolation facility. If a patient with acute gastro-
with animals likely to have an infectious disease. intestinal or respiratory disease or ectoparasites is presented
• Examination tables, cages, and runs should be directly to the reception desk, the receptionist should contact
cleaned and disinfected after each use. the receiving clinician, technician, or student immediately
• Litter boxes and dishes should be cleaned and
disinfected after each use. and coordinate placement of the animal in an examination
• Place animals with suspected infectious diseases into room to minimize hospital contamination. Animals with
an examination room or an isolation area immediately suspected infectious diseases should be treated as outpa-
on admission into the hospital. tients if possible. If hospitalization is required, the animal
• Treat animals with suspected infectious diseases as should be transported to the appropriate housing area by
outpatients if possible. the shortest route possible, preferably with a gurney to
• Procedures that use general hospital facilities, such as lessen hospital contamination. The gurney and any hos-
surgery and radiology, should be postponed until the pital materials in contact with potentially contaminated
end of the day if possible. employees (including examination tables and doorknobs)
• Do not consume fluids or drink in areas where patient should be immediately cleaned and disinfected as previously
care is provided. mentioned.

HOSPITALIZED PATIENTS
If possible, all animals with suspected infectious diseases,
they should be changed immediately after contamination such as Salmonella spp., Campylobacter spp., parvovirus
with feces, secretions, or exudates. Equipment such as infection, canine infectious respiratory disease complex
stethoscopes, pen lights, thermometers, bandage scissors, (CIRDC), acute feline upper respiratory disease syndrome,
lead ropes, percussion hammers, and clipper blades are sus- rabies, or plague, should be housed in an isolated area of the
pected to serve as fomites and should be cleaned and disin- hospital. The number of staff members entering the isola-
fected after each use with animals likely to have a transmissible tion area should be kept to a minimum. On entry into the
infectious disease (Haun et al., 2016). Disposable thermom- isolation area, outerwear should be left outside, and surgical
eter covers or thermometers should be used. booties or other disposable shoe covers should be placed
To avoid zoonotic transfer of infectious diseases, food or over the shoes. Alternatively, a foot bath filled with disinfec-
drink should not be consumed in areas where animal care is tant should be placed by the exit and used when leaving the
provided. All areas where animals are examined or treated area. The room should be entered, and a disposable gown
should be cleaned and disinfected immediately after use, (or smock designated for the patient) and latex gloves should
irrespective of infectious disease status of the individual be put on. A surgical mask should be worn when attend-
animal. ing dogs or cats with suspected plague or tularemia, and
extreme care should be taken to avoid being bitten. Separate
PATIENT EVALUATION equipment and disinfectant supplies should be used in the
Prevention of infectious diseases starts with the front desk isolation area.
personnel. Staff should be trained to recognize the present- All biologic materials submitted to clinical pathology
ing complaints for the infectious agents in the geographic laboratories or diagnostic laboratories from animals with
area of the hospital. Animals with gastrointestinal signs, suspected or proven infectious diseases should be clearly
respiratory signs, or ectoparasites are the most likely to be marked as such. Fecal material should be placed in a plastic,
contagious. Infectious gastrointestinal disease should be sus- screw-capped cup with a tongue depressor or while the cli-
pected in all dogs and cats with small- or large-bowel diar- nician is wearing gloves. Place the cup in a clean area and
rhea whether the syndrome is acute or chronic. Infectious place the lid on with a clean, gloved hand. Remove the used
respiratory disease should be suspected in all dogs and cats gloves and place the cup in a second bag clearly marked