April 2, 2006

THROUGH your weekend newspaper I should be grateful for the space to clarify the following for our clients, many of whom have been calling us asking so many questions, and very worried about the press releases concerning heartworm in dogs. It is difficult to do them justice and get on with our work at the same time.The Hanover Veterinary Hospital is not a member of the BVA (Bermuda Veterinary Association), which only represents the interests (and views) of Endsmeet and Ettrick animal hospitals, and possibly also the Department of Environment protection. Depending on the topic.

Sporadic, rare cases are nothing new in Bermuda. When I first returned home in the summer of 1981 to do a locum for Dr. James (founder of Ettrick), having no experience of this parasite, I was mortified by the sudden death of a boarding dog. So was the owner, staying at the Hamilton Princess at the time when I had to break the news to her!

A post-mortem showed the pulmonary artery and larger lung arteries crammed with the long adult worms. Discussion with my senior colleagues on the island at that time put me more at ease, as they were able to confirm that this did crop up from time to time in animals imported from various heartworm enzootic regions — usually the US. Indeed this dog was one of a household pair, which originated from Florida.

The next three cases I saw originated from the Base covering the decade from the mid-1980s to '90s, while the USNAS was still here. The dog-owning personnel on Base were not subject to import and export controls as Bermuda residents were — an obvious break in bio-security at many levels.

As training in Europe dictated, I brought these and other concerns to the attention of the Department of Agriculture, both in writing and during one of our meetings of veterinary practitioners and the Director. I recall the subsequent institution of a one-off, high-level meeting, involving local veterinary surgeons and two USNAS officers. We discussed various problems, many stemming from the fact they provided an occasional veterinary service to the Base — a USN veterinary officer.

Because I lived in the East End, during the rest of the time when he was not on Base, I had to deal with many sick animals, whose case histories I did not know, and had little hope of obtaining. The most important issue was the gaping hole in trying to control enzootic diseases, so back then we frequently tested for heartworm, even though it was a tedious procedure.

Somewhere around that time, one of the practices had also picked up a dirofilaria case in a local dog, which reportedly had not left the island. Our practice had not seen a single case in the last decade, and for this reason perhaps had stopped doing the more frequent checks of the previous decade. The newer antigen / antibody test is, however, available to our clients at a cost of $45.

Three weeks ago, we diagnosed heartworm in a dog originating last year from the SPCA, which showed severe, acute right-sided heart failure and the canal syndrome. We cannot trace whether this dog travelled. Every dog we have tested since then has been negative.

I have discussed this issue with David Kendall, entomologist in the Department of Environmental Health. He has been a wonderfully rich source of information about the habits of possible vector mosquitoes (culicidae), and in summary proposed the possibility of very localised micro-environmental conditions.

As I understand him, these micro-environmental conditions may favour the possible transfer of fillariae from a dog infected with adult worms to the obligatory mosquito host/vector in which an essential maturing process follows before vector transfer to a new canine host. We need to collect female culex mosquitoes and look for the presence of dirofilaria L3 larvae. If there are any willing university students looking for a project, please contact David Kendall directly, or call us.

When reviewing the sporadic pattern of the incidence of this disease in Bermuda, and taking into account the complexity of the life-cycle, including this maturing period in a mosquito above a certain temperature, Bermuda does not appear to be able to provide all the conditions this disease requires to become entrenched.

Seventy different species are capable of supporting the maturation to L3 infective larvae, but apparently, members of the culicidae family are the 'preferred' vectors. Dr. Kendall is a wealth of information on culex and its habits in Bermuda.

Literature on the subject states: "Once heartworm is introduced into an area, its transmission is virtually assured."

However, I keep asking myself the same question. If the ecological factors were highly contusive for its development as an enzootic disease in Bermuda, would heartworm not have already taken a firm hold on the island? I think so.

We used to have many stray dogs until the early 1980s and there were gaping holes in our bio-security and USNAS transport of personnel and animals was completely exempt from local regulations, unless personnel used civilian air transport, which was rare. Perhaps our evening temperatures are not hot enough consistently enough in the summer (yet). Perhaps mosquito control is more effective here. Perhaps the earlier preference (in the days before the PBT) for a crossbred that had thick hair protected many dogs from successful transmission.

These days many clients are already using topical or internal biological products, which are effective in blocking any transfer of infective larvae from a culex mosquito. These are the available prescription pharmaceuticals: Advocate (Bayer), Heartgard Merial and ProgramPlus Novartis. Simply bringing your dog indoors is one less risk factor.

Nonetheless, we should, however, be requiring a higher level of vigilance from the Department of Environmental Protection. The public should know, for instance, that the practice of ear cropping was (is still?) was made available to the breeders pursuing this mutilation of their puppies via an exceptional export licence to the US. The Department has allowed, and quite probably still allows the administrative circumvention of regulations relating to (re) import of canines into Bermuda. (I was instructed in a very heated and adamant manner by the relevant Government official — he felt it was an issue of 'personal choice'. I presume he meant on behalf of the 'owner' that is naturally not the poor pups.)

The sort of breeds involved in this purely cosmetic and cruel practice are thin-skinned, short—haired animals such as Dobermans, miniature Pinschers; the very animals most susceptible to multiple successful bites from mosquitoes containing the infective L3 larvae. Where are these ear-cropping clinics located? Yes, heartworm regions of the US.

If we cannot expect our civil servants to do things for the right moral reasons, can we not at least expect them do behave in the broader interest of the environment we all share?

DR. A M. WARE—CIETERS, M.R.C.V.S.

Turn it down, pleaseMarch 24, 2006

I AM a status Bermudian of some 35 years' residence here in Bermuda, originating in the UK, a retired pharmacist. I live within the vicinity of Whitney Institute, a school which appears to be quite well regarded in the local community.Today, the school mentioned above is holding its sports day; at least I was awakened this morning by sounds identifiable as a PA system for such an event but being operated at a volume more suitable to the PA system of a warship. It was at least three or four times the necessary volume for such a purpose.

Having put up with this intrusion for maybe half an hour I called the police (fool that I am!) and reported the facts to a police officer (at least, I hope he was an officer!) who apparently spoke only rudimentary English, keeping the details as short as would allow some precision.

He assured me that something would be done but some two hours later the noise from the east was unabated (maybe even increased in volume) so I called back only to be told that I was the 'only one who had complained' and offering to switch me to the police inspector to whom I had spoken earlier.

I agreed to the transfer but the inspector (if that was indeed the person with whom I spoke) there was no satisfaction to be found with him, even to the suggestion that many retired people live in the area and they deserve some peace and quiet.

I am sending this letter to you because I have heard discussion around bars and similar places of assembly, indicating that many people in the community feel that the current membership of the police force have little concern for the aspects of police work which are generally thought of as essential to the public interest.

AB