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Prevalence of common conditions and associated mortalities of dogs treated at the small animal clinic, Makerere University, Kampala, Uganda

BMC Veterinary Research volume 20, Article number: 590 (2024) Cite this article

Abstract

Background

In developing countries such as Uganda, domestic dogs suffer high burdens of infectious diseases often with high mortalities. Surveillance data on the common diseases and associated mortalities is however scanty. We thus, present results of a retrospective study of common clinical conditions and mortalities of dogs brought for treatment at the small animal clinic, Makerere University, Kampala, Uganda.

Methods

We analysed data from the case records register of the clinic from January 2021-December, 2022. Descriptive statistics were generated using the frequency functions of R (R-4.3.3 for Windows®). Records were reviewed for all 650 cases presented at the clinic except those presented for routine care services like vaccination and grooming.

Results

Up to 51% of the dogs were female, mostly (56%) under two years old. The Alsatian (30.7%) and mongrel (22.7%) were the commonest breeds. Cases were recorded as: elective surgeries (29.2%), parvovirus infection (13.9%), skin infections (09.7%), canine babesiosis (6.9%), fractures (6.0%) and neoplasms (6%); mainly transmissible venereal tumour (TVT). Some (3.4%) dogs developed post-operative complications, while 4.8% were euthanized and 12% died during treatment. Of the dogs that died, 50% were parvovirus infection cases while other conditions included babesiosis (13%), poisoning (7.8%), pyometra (7.8%) and liver dysfunction (5.1%).

Conclusion

We impute that parvovirus infection and other preventable diseases were the most frequent reasons for morbidity and mortality of especially puppies in Uganda. This points to the need for epidemiologic surveillance of dog diseases and community sensitisation for improved control of dog diseases.

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Introduction

Dogs are the most numerous and widespread domestic carnivore globally [1, 2]. They are kept for reasons including companionship (pets), hunting, sports and security [3, 4]. In communities within developing countries, dogs are believed to suffer high burden of infectious diseases, often with high mortality of puppies [4]. In these often poor communities, dogs receive limited to no veterinary care, and are often free-ranging [5, 6]. The dogs are thus, usually in poor health conditions and compromised welfare [6]. Some of the common diseases in the dog populations are actually zoonotic [7,8,9].

Besides serving as reservoirs of zoonotic infections, dogs are also play a central role in cross-transmission and maintenance of important disease of livestock and wildlife [10, 11]. For these reasons, dogs are often used as sentinels for early detection and monitoring of emerging and re-emerging infections of animal and public health importance [12, 13]. On the whole, routine dog health monitoring is important for planning interventions to ensure their improved welfare but also the detection and control of important zoonotic infections [14]. Healthy and comfortable dogs are good companions, guards or hunters [4].

Provision of quality health services require availability of regular and reliable data from health facilities and/or surveillance systems [15]. In absence of surveillance information, data from clinical sources may be useful for evidence-based case management and disease control [16,17,18]. Unfortunately, in developing countries, published data on the general health and wellbeing of dogs is scanty. This is attributed to weak surveillance and reporting systems [19,20,21]. In Uganda specifically, there is a dearth of literature on common diseases of dogs other than rabies. This study therefore, aimed at determining the prevalence of common conditions and mortality of dogs using clinical records form the case register at the Small Animal Clinic, Makerere University, Kampala, Uganda.

Materials and methods

The study facility

The Small Animal Clinic (SAC) is a teaching and referral facility located at the School of Veterinary Medicine and Animal Resources, Makerere University, Kampala. As the most established veterinary care facility, the clinic receives cases, including those referred by other practitioners within and around Kampala City, Uganda. The clinic receives on average 325 cases annually, excluding those presented for routine grooming and vaccinations.

Study design

This was a retrospective study to determine the prevalence of common disease conditions and mortality of dogs using records from the case register at the small animal clinic, Makerere University.

Sampling and data collection

From the case register at the clinic, records for all dogs presented for treatment between January 2021-December, 2022 were capture for this study in February 2023. The records captured included: biodata (age, sex, and breed), case history, physical examination, laboratory and/or imaging results, clinical diagnosis and the case treatment outcome. Haematological tests, especially complete blood count (CBC) and /or parasitology were requested and done for suspected haemoparasite infection cases [22]. Imaging by conventional radiography were performed in suspected fracture cases while grayscale ultrasonography was used to visualise intra-abdominal lesions. However, the case register did not have detailed results of the specific tests other than the clinician’s final diagnostic opinion. Also captured were the individual case clinical outcomes i.e. whether there was recovery after treatment or other outcomes including post-operative complication, recurrence of the condition, euthanasia and/or death of the dog as recorded. Euthanasia was performed by rapid intravenous injection of 5% thiopentone sodium (Thiosol Sodium®, Neon Laboratories Ltd, Mumbai, India) following informed consent by pet owners. Except for elective surgical procedures such as spay, neuter and tail docking, dogs presented for other routine care services like vaccination and grooming were not included in this study. Cases were attended to by clinicians licensed by the Uganda Veterinary Board often who were often assisted by graduate and undergraduate veterinary students on clinical rotations.

Data handling and statistical analysis

Individual case records as captured in the clinic register were entered into an Excel spreadsheet and cleaned off any entry errors. These were exported to R programming software for further analysis (R-4.3.3 for Windows®). Descriptive statistics on the data were generated using the frequency functions of the R programme. Pearson’s Chi-square distribution was used to make bivariate comparisons to show plausible associations between variables; especially clinical diagnosis (disease condition) and the sex, age, breed of the dog. This was also applied to assess association between the variables including clinical diagnoses and the treatment outcomes i.e. recovery, death and or euthanasia. Conveniently, the dogs were categorised into age groups including: puppies (0-6months), juveniles (7-12months), adults (13-24months) and old (above 24 months). Statistical comparisons with P-values ≤ 0.05 were considered significant.

Results

Demographic characteristics of dogs

Records for a total of 650 dogs were obtained from the case register at the clinic over the study period (January 2021 to December 2022). Demographic characteristics of the dogs treated at clinic are as summarized in Fig. 1. By sex, 51% of the dogs were female, a greater percentage (56%) of which were below two years old (Fig. 2). The Alsatian (30.71%) and mongrel (22.69%) were the commonest (53%) dog breeds presented for treatment. As presented in Fig. 2, male and female dogs were evenly distributed across age groups (X2 = 1.04, p > 0.05).

Fig. 1
figure 1

Demography of dogs treated at the Small Animal Clinic, Makerere University

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Fig. 2
figure 2

Age and sex distribution of dogs at the Small Animal Clinic, Makerere University

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Common clinical cases at the small animal clinic, Makerere University

From the register, the case distribution at the clinic is as summarized in Table 1: Elective surgery (spay, neuter and tail docking) constituted most (29.23%) of the cases followed by: parvo-virus infection (13.85%), dermatitis (9.69%), babesiosis (6.92%), fractures (6.0%) and neoplasms (5.69%), mainly transmissible venereal tumour (TVT). Figure 3 summarises the distribution of the common clinical cases by age categories of dogs. In sumary, puppies were presented mainly for treatment of othopedic conditions i.e. fractures/dislocations (5%) and parvovirosis (45%). Juvenile dogs meanwhile were mainly treated against babesiosis (15%) but also orthopedic conditions (22%). Adult dogs were presented for dermatistis (10%) and also orthopedioc conditions (12.7%), while older dogs were mainly presented for wounds/trauma (10.5%) and neoplsams (12%).

Table 1 Clinical cases attended at the small animal clinic, Makerere University
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Fig. 3
figure 3

Distribution of the dogs presented for treatment by age category

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Common clinical manifestations and outcomes in dogs

As presented in Table 2, of the 650 cases attended to at the clinic in the study period, 88% recovered on treatment while 12% died or were euthanized. Up to 97% of the cases that died or were euthanized showed multiple clinical signs. The most observed clinical signs included diarrhoea (15%), vomiting (15%), fever (8%), lameness (7%), inappetence (4%) and jaundice (4%). Of the animals that died during the course of treatment, 51% were reported with signs of vomiting and/or diarrhoea, while 15% had fever, 7% had jaundice and 5% had inappetence. Generally, dogs reported with vomiting and /or diarrhoea (40%), fever (22%) and jaundice (20%) died during treatment. Death was reported mainly in puppies under 6 months old (56%) but also dogs above 75 months old (35%) as summarized in the density plot (Fig. 4).

Table 2 Common clinical manifestations and outcomes in dogs
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Fig. 4
figure 4

Density plot of clinical outcomes for dogs treated the clinic

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Common disease conditions and clinical outcomes at the small animal clinic, Makerere

Table 3 is a summary of specific disease conditions and associated clinical outcomes following treatments at the Clinic. Up to 79.17% of the cases recovered after treatment. Some (3.4%) however, developed post-surgical complications. Of these, 64% were dogs that underwent elective surgical procedures. Of the cases recorded as recurrent, 63% were due to dermatitis, mainly demodectic mange and fungal infections.

Table 3 Disease conditions and clinical outcomes in dogs at SAC, Makerere University
Full size table

A total of 31 dogs (4.8%) were euthanized, and of these 55% were recorded to have had liver dysfunction while 29% were neoplastic conditions. Up to 12% of the cases died during treatment, majority (50%) of which were parvo virus infection cases. Other deaths were associated with babesiosis (13%), poisoning (7.8%), pyometra (7.8%) and liver dysfunction (5.1%).

Discussion

Common clinical cases at the clinic

More young dogs (puppies and juveniles) than older ones, mainly Alsatian or mongrel breed were presented for treatment. Previous dog demographic studies reported similar results [23,24,25]. In developing countries, the burden of infectious diseases and hence, mortalities is highest amongst puppies and juvenile dogs [4, 25]. Therefore, developing expertise in veterinary neonatology and paediatrics should be emphasised amongst practitioners in Uganda.

In the current study, most dogs were presented for elective surgery, especially spay and neuter surgeries. Elective sterilization of pets is the commonest procedure in general veterinary practice [26, 27]. Unlike in human reproductive health, operative surgery is the most applied method for pet birth control [26]. Clinical practices should be adequately equipped to offer safe and effective spay neuter surgeries as a major veterinary service to communities in and around Kampala.

Besides spay/neuter procedures, elective tail docking (amputation) was routinely perfumed in puppies. Tail docking is a controversial subject in veterinary practice but is still routinely performed on certain breeds, especially the Rottweiler, Doberman and the South African Boerboel [28]. It is a common practice in Africa due to an increasing influx of traditionally docked breeds [28]. Unfortunately, docking is often done without due considerations for management of post-operative pain and asepsis [28, 29]. Elective tail docking is thus, banned in many European countries [30]. Therefore, concerned authorities should consider evaluating the effects of docking on pet welfare and institute policy advice on this otherwise widespread practice accordingly.

Of the infectious conditions, parvo virus infection was the commonest amongst dogs brought for treatment. Indeed, parvovirusis is today one of the most important pathogens of the wild, feral and domestic canine populations [31,32,33]. This study has demonstrated that parvo virus infection is today a major dog health problem in Uganda. There is thus, a need to emphasise timely vaccination of puppies against the virus.

Dermatitis was the other common infectious condition in dogs presented for treatment. In small animal practice, skin conditions constitute at least 20% of cases seen, some of which are zoonotic [34,35,36,37]. Client education on associated public health risks is thus, essential. Another infectious disease seen in dogs across age groups was babesiosis. Indeed, canine babesiosis is a common infection in many parts of Africa [38, 39]. It is therefore, advisable that clinicians in this region should always include bebesiosis in differential diagnosis of febrile conditions of dogs. Equally, veterinary practitioners should always encourage pet owners to keep dogs free of tick infestation.

Fractures and tumours, especially transmissible venereal tumour (TVT) were the common non-infectious conditions recorded. Studies elsewhere have reported much lower prevalence of fractures in dogs presented for treatment [40, 41]. The clinic at Makerere is relatively well equipped referral facility that receive complicated cases, including fractures for specialised case management. Oncology and orthopaedics are advanced surgical specialty not often offered in general practices, thus referral to better equipped facilities [42, 43]. Implicitly, orthopaedic clinical service needs to be further developed and promoted through improved training and equipment provision by veterinary authorities in Uganda.

Common symptoms and the clinical outcomes in dogs

Diarrhoea, vomiting, fever, lameness, loss of appetite and jaundice were the common symptoms in dogs brought for treatment. Most of these are signs of systemic infectious conditions [44]. Vomiting, anorexia (inappetence) and diarrhoea in dogs are common signs of gastroenteritis [44, 45]. The major causes of gastroenteritis include helminthosis (parasitic gastroenteritis) and infections especially with parvovirus, rotavirus and sometimes campylobacter [45, 46]. From these symptoms, it is evident that infection, especially gastroenteritis is the leading cause of morbidity of dogs attending the small animal clinic, Makerere University, Kampala. Infection control through routine prophylactic measures including vaccination and deworming could significantly improve pet health and general welfare in Uganda.

Most dogs that died exhibited diarrhoea, vomiting, fever and jaundice. Gastrointestinal symptoms (vomiting, inappetence etc.) and fever increase the risk of severe illness or even death in patients [47,48,49]. Indeed, vomiting, appetite loss, fever and dehydration which could lead to shock are clinically used as predictors of disease severity or even mortality [47]. These findings could thus, be useful in development of standard critical care practice guidelines for pets and other animals in Uganda.

Up to 12% of dogs, especially puppies died during treatment at the clinic. Actually, puppy deaths are common in kennels and small animal practices [50]. Puppies often die within 12 weeks of birth, especially from gastroenteritis [4, 51, 52]. Improved management of individual litters through better hygiene and prophylactic measures could greatly minimize mortality of puppies.

Euthanasia was performed mainly in adult dogs diagnosed with liver dysfunction or neoplasms. Pet owners usually request for euthanasia for dogs presented with old-age associated neoplasms [53,54,55]. This is different from the current study where liver dysfunction was the leading indication for euthanasia. The leading cause of liver failure in dogs is aflatoxin poisoning [56, 57]. Over 80% of commercial feeds in Kampala have aflatoxin levels beyond recommended limits [58]. There is thus, a compelling need for a good strategy to monitor and control aflatoxin contamination in animal food and feeds.

Death was most common (70%) in dogs (puppies) clinically diagnosed with parvo virus infection. Canine parvovirus enteritis (CPE) has become an important problem to dog population worldwide. Fatality can be as high as 90% for untreated cases [59]. The disease is widespread and endemic across Africa with reported sero-prevalence of 80–90% [60]. In Uganda however, there is still a dearth of literature on epidemiology and the clinical impact of canine parvovirus enteritis. Like earlier stated, our findings however has demonstrated that canine parvovirus enteritis is highly prevalent in Uganda and that, it is a major cause morbidity and mortality in puppies. Thus, there is a need for sensitisation of veterinarians and dog owners on the status and importance of vaccination against this disease.

Conclusion

We conclude that, morbidity and mortality was highest amongst younger dogs (below two years) than the older ones; and that infection, especially by parvovirus was the leading cause of death of puppies brought for treatment at the Clinic. Of the dogs euthanized, liver dysfunction from suspected aflatoxicosis was the primary reason. These findings point to the need for sensitisation to improve pet care in amongst the dog keepers, with the aim to increase uptake of prophylactic measures, especially vaccination amongst pet owners in Uganda.

Limitations of the study

The study was based purely on secondary data retrospectively extracted from the case register at the small animal clinic, Makerere University. The case register did not have detailed results of the specific tests other than the clinician’s final diagnostic opinion. Being secondary data from existing records, the authors were not able to retrospectively obtain ethical review by the Institutional Animal Care and Use Committee (IACUC). This is because publication of this information was not earlier anticipated.

Data availability

Raw data extracted from the case register of the Small Animal Clinic, Makerere University for the purpose of this study are available from the corresponding author on reasonable request.

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Acknowledgements

We acknowledge and thank management of the School of Veterinary Medicine and Animal Resources, Makerere University for allowing us access to and extraction of data from the case record register of the Small Animal Clinic.

Funding

This study did not receive any grant from any funding agency. Article Processing Charges (APC) was waived (0%) as is applicable to Uganda.

Author information

Authors and Affiliations

  1. Department of Veterinary Pharmacy, Clinical and Comparative Medicine, Makerere University, Kampala, Uganda

    James Okwee-Acai, Benard Agwai & Patrick Mawadri

  2. Department of Biosecurity, Ecosystems and Veterinary Public Health, Makerere University, Kampala, Uganda

    Christine Kesiime, Methodius Tubihemukama & Joseph Kungu

  3. School of Statistics and Planning, Makerere University, Kampala, Uganda

    Benard Odur

Authors
  1. James Okwee-Acai
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  2. Benard Agwai
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  3. Patrick Mawadri
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  4. Christine Kesiime
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  5. Methodius Tubihemukama
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  6. Joseph Kungu
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  7. Benard Odur
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Contributions

O.A conceived the study and wrote the main manuscript. B.A, P.M and J.K designed and wrote the methods. C.K, M.T and B.O captured and cleaned the data, conducted analysis and produced the figures used in this manuscript. All authors reviewed the manuscriot.

Corresponding author

Correspondence to James Okwee-Acai.

Ethics declarations

Ethical approval and consent to participate

Data was retrieved from an archived source i.e. a case record book of the Small Animal Clinic, a teaching facility at Makerere University in Kampala, Uganda. All the authors are members of the faculty at Makerere University. Clinicians within the clinic are all registered/licensed to practice by the Uganda Veterinary Board. The dogs were therefore handled in accordance with the ethical standards prescribed in the veterinary practitioners’ code of conduct, Uganda. Operative procedures were performed following informed consent of pet owners who signed on the clinic’s standard consent forms.

Consent for publication

This is not applicable.

Competing interests

The authors declare no competing interests.

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Okwee-Acai, J., Agwai, B., Mawadri, P. et al. Prevalence of common conditions and associated mortalities of dogs treated at the small animal clinic, Makerere University, Kampala, Uganda. BMC Vet Res 20, 590 (2024). https://doi.org/10.1186/s12917-024-04432-x

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BMC Veterinary Research

ISSN: 1746-6148

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