Veterinary Vertex
Veterinary Vertex is a weekly podcast that takes you behind the scenes of the clinical and research discoveries published in the Journal of the American Veterinary Medical Association (JAVMA) and the American Journal of Veterinary Research (AJVR). Tune in to learn about cutting-edge veterinary research and gain in-depth insights you won’t find anywhere else. Come away with knowledge you can put to use in your own practice – along with a healthy dose of inspiration to remind you what you love about veterinary medicine.
Veterinary Vertex
Companion Animals and H5N1: What Vets and Owners Should Know
A spike in feline H5N1 cases has many of us asking the same question: how did bird flu end up in our living rooms? We sit down with author and clinician Dr. Jane Sykes to map the path from migratory birds to household pets, spotlighting the two biggest drivers of risk for cats—predation on infected wildlife and contaminated raw diets. The conversation is candid, practical, and rooted in current data, with clear guidance for veterinarians and pet owners who want to reduce danger without fear or hype.
We break down the clinical pattern that should trigger suspicion: a rapidly worsening illness with fever, lower respiratory signs, neurologic changes like ataxia or seizures, hypersalivation, and even sudden vision loss. Jane shares a step-by-step plan for what to do next: preserve the suspect diet for testing, notify local public health partners, and coordinate diagnostics through NAHLN labs with NVSL confirmation. We also unpack why household cases typically arise from common exposure rather than cat-to-cat spread, and why ending raw feeding across the home is the first and most effective intervention. The oseltamivir question comes up too; Jane weighs the risks, pharmacologic unknowns, and stewardship concerns around antivirals in cats.
Listeners get concise takeaways: cooked diets are safer, indoor life or secure catios cut exposure, and detailed dietary histories matter more than ever because many raw products look like pasteurized foods. We touch on the evolving clade 2.3.4.4b, the possibility of reassortment in cats, and why dogs appear more resistant yet still susceptible to infection. Jane points to the research we still need—serology to find silent infections, better food-chain surveillance, and communication tools that help us talk about diet without blame. Subscribe, share with a colleague or pet-loving friend, and leave a quick review to help more people find evidence-based guidance on companion animal health.
JAVMA article: https://doi.org/10.2460/javma.25.06.0388
Washington Post article: https://wapo.st/49isM8M
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SPEAKER_02:Welcome to Veterinary Vertex, the Avium Made Journal's podcast, where we delve into behind-the-scenes look with manuscript authors. I'm editor-in-chief Lisa Fortier, joined by Associate Editor Sarah Wright. Hi everyone, and thanks for tuning in. Today in this episode, we're discussing companion animals in H5N1, which is highly pathogenic avian influenza, also known as bird flu, with author Jane. Hey Jane, I know you're super busy and on clinics and such an awesome author. Thanks again for being here with us.
SPEAKER_03:Oh, thanks for the opportunity to contribute again.
SPEAKER_01:So, Jane, before we dive into your manuscripts, can you paint a picture of the current situation? Many veterinarians have heard about H5N1 and wildlife and large animals, but what's happening right now in terms of epidemiology?
SPEAKER_03:Yeah, thanks. Like the incredible thing about H5N1 avian influenza is that since it emerged in Europe in late 2020, the situation has really been changing on an almost weekly basis. It makes it hard to keep up. This year alone, there's been nearly 70 infections that have been documented in domestic cats by the USDA. And since the virus appeared in the US at the end of 2021, there's been around 200 cat cases in the United States. There was a lull in domestic poultry and mammalian cases in the summer and early fall this year. But since then we've seen infections and deaths rise again in association with avian migration patterns. So the bottom line for companion animals is that we're continuing to see plenty of cases in wild birds as well as mammals like house mice. So cats remain at risk of infection from predation. And because the feeding of raw food diets to pets by owners continues to be very popular, cats remain at risk of infection from both raw milk and commercial raw food diets. So the cats that died this year from San Francisco and Los Angeles had been fed a contaminated raw food chicken diet, which was actually contaminated with a genotype B313. And that genotype disappeared in late 2024. The diet had a cell bide diet, amazingly, of September 2026. So the virus can survive long periods of time in raw food diets that are stored frozen or under refrigeration. So that risk continues to be very high.
SPEAKER_02:That's really fascinating. And not only disease, but lacking some micronutrients. Really, really important information for the public as well as our veterinary colleagues. Jane, what motivated you to examine H5N1 and companion animals?
SPEAKER_03:Yeah, so that's a great question. My interest in this disease began actually when I started taking media calls about cat cases in California. And I also received many requests to talk to veterinarians and cat owners about the disease and requests to help develop infection control protocols in our hospital. And I had had experiences before this in terms of COVID-19 in dogs and cats and educating the public and veterinarians about that disease. And I realized that there was a real opportunity to do some proactive education on the topic. The rise in infections associated with raw food diets and the increasing popularity of raw food diets also made me very concerned. And I noticed that there seemed to be some misinformation circulating about the susceptibility of dogs to H5N1 infection. So I developed a presentation for the California Veterinary Medical Association, which involved a really extensive review of the literature so that I could present very accurate information. And as a good review article of infections in cats was actually lacking in the literature, it seemed a really logical next step to publish one to increase awareness about the problem.
SPEAKER_02:If you're in the exam room with a patient, what are the key clinical features that might raise suspicion of H5N1?
SPEAKER_03:Yeah, so the really important thing about this disease is history. So it's really about history, history, history for risk factors. So being fed raw food, raw milk, a cat with exposure to dairy cattle, domestic poultry, whether it be direct or indirect, for example, exposure to dairy farm workers, and also getting a history about any predation, whether it's indoor or outdoor type access to wildlife, and whether other cats in the household have been ill with similar signs. So it's about having a high index of suspicion for the disease, because still it's a relatively rare disease in cats. So having it in your mind when examining a sick cat, especially a cat that has acute illness and severe illness with signs of fever, lower respiratory signs, neurologic signs, which are really common in cats, and many cats are actually hypersalivating as well. Some cats have been blind as well due to ocular involvement, like carioetinitis. So I think it's so important that we ask questions about diet, especially raw food diets. And some raw food diets can actually look quite like processed pasteurized diets. And so you really have to check the label, ask the owner the brand, and do a search for the brand online and check to see whether or not it could be raw, because it can be sometimes very difficult to tell.
SPEAKER_01:So let's say clinician suspects H5N1. What are the next steps diagnostically?
SPEAKER_03:Yeah, so I would say first of all, um try to get as as much information on any raw food diets fed as possible. Uh, get the owner to keep the diet, bring it in so it can be um tested. Um notify local public health officials. And then really, there's a lot of different samples that can be tested. Uh, urine can be tested for the virus, blood or saliva discharges uh can be positive. And then you are usually going to be contacting a regional National Animal Health Laboratory Network laboratory, um, and that laboratory um will verify non-negative results, uh, and then they'll be um confirmed through the National Veterinary Services Laboratories. But a local public health official can help with navigation of uh all of that diagnostic testing.
SPEAKER_02:I find Jane, when I ask people if they're feeding a raw diet, they get the clients get pretty defensive. Do you have any uh smooth ways to ask or what what diet are you feeding? Is it raw? They uh the one people that I speak to, not all, but many are it it's frozen, it's fine, it's pasteurized, it's fine. And you're like, like you said, it's confusing. Do you have any tidbits, uh pearls of wisdom for veterinarians how to ask that question?
SPEAKER_03:Yeah, I mean, I think trying to make it a routine thing and say, you know, we always collect a dietary history and what diet is your animal being fed, and um really get into the details with that. Do they know brand? Um, or can when they get home, can they check the brand? I think it's just a very important part of a um a normal history taking process for a sick dog or cat. Um, and so trying to sort of normalize that and be very matter-of-fact about it without um being judgmental is the first step because um oftentimes it is really difficult to tell. I would say that most clients are not aware of the risks of raw food diets and are quite uh horrified when they learn that they can be sources of different um infections like salmonella and listeria and H5N1. Um, so many people um are willing to change because they just don't know what the risks are. Um, and I think just the fact that now you can go into pet stores and the shelves are packed with different types of packaged raw food diets. I mean, it's really, it's never really been like this in the past. It's uh reached an amazing peak. I recently went into a pet food store in Shreveport in Louisiana, and the entire store, which was a big store, was devoted to um raw food or freeze-dried diets. And um, like I was just so impressed of the range and number of different diets that were available. So I think many animal owners just think it's the right thing to do and they they're not aware of the risks. Uh, and I think that it's really important that veterinarians do educate um owners about the risks of uh infections like H5N1 and tell them stories about uh animals that have died. But people, you know, some people can be very hardcore and very resistant to change. Um, but I think legally uh we also need to document that we've had that conversation with them because if we don't have the conversation with them and then their pet gets uh a serious infection like H5N1 influenza, then we could be um legally at risk if they're not aware of that.
SPEAKER_02:Yeah, great, great words of wisdom. Thank you. And sticking with the household, when a positive case is identified in a companion animal, what does that mean for the rest of the household?
SPEAKER_03:Yeah, so fortunately there's a low risk of cat-to-human transmission that really hasn't been documented. However, cats can shed the virus when they're infected, um, and potentially there could be uh spread of infection to other cats in the household. So I think that potential exists, although when multiple animals in a household have been affected, it's usually because of common exposure, for example, to the same um raw food diet. Um, but there is that potential for transmission. Um, there was um an uh anecdotal um uh um benefit potentially of treating a cat, cat with oscultamavir in order to um to cure that cat of uh influenza virus infection, but we don't really know what the pharmacokinetics of oscillatamavir um are in cats, and we also don't um know whether or not there could be any adverse effects of using that drug in cats. So I think we always have to be very careful about using human antiviral drugs in cats or any uh human drugs in cats, as they tend to metabolize drugs quite differently to other species. And so there is the potential for toxicity. Also, osultamilvir or tamiflu is a drug that has been reserved for human infections. Um, and so there is some concern about using that drug indiscriminately without really knowing whether or not influenza is the problem. So treatment is a little bit controversial, but there is the potential for transmission to other cats. I think the biggest thing is to like stop feeding any raw food diets to other pets in the household and watching other pets for any clinical signs uh in association with the unaffected cat.
SPEAKER_01:Yeah, what you just said there remind me of something I learned in vet school, which is cats are not small dogs. They are their cats are not small dogs. Yes. Yep. So Jeannie shared so much important information with us today. And I really want to boil it down now to some of the really important takeaways for our listeners. So, first we'll start with the veterinarian's perspective. What are the key take-home messages from your manuscript that you hope veterinarians will remember?
SPEAKER_03:Yeah, so for veterinarians, um, strains of H5N1 that have been circulating um since uh late 2020 belong to this clade called H5N12344B, which is a particularly concerning clade because of its ability to infect both birds and mammals and reassort very rapidly. And several different genotypes of that virus have emerged that might have differing pathogenic potential for animals as well as humans. And most infections in cats are preventable by feeding cooked diets and keeping cats indoors. When cats develop illness, it usually progresses rapidly and it usually includes neurologic signs. So the cat with upper respiratory tract disease that we see every day is not a cat that you should be worried about H5N1 influenza in. Cats also have the potential to act as a reassortment vessel for avian influenza viruses. Um, and so you know there is concern for public health should such an event occur and uh lead to a virus that's more pathogenic for people. Dogs seem to be resistant to disease, although they can be infected. Um, and this virus is not going away. Um, it remains an ongoing concern because we're continuing to see these reassortment events and spread as a result of bird migration.
SPEAKER_02:And how about key takeaways for the client or the pet owner? You said keep the cat inside, don't feed raw diets. What else would you wisdom would you impart on our clients and pet owners?
SPEAKER_03:Yeah, so um definitely don't feed raw food diets or raw milk. And it's really our responsibility as veterinarians to educate um clients about this and keep cats indoors, or if they need to have some outdoor exposure, think about building a catio. Um there are some really creative patios out there. And in fact, in in Oregon every year, they have uh catio tours. So um very creative catio ideas. Um, you can find a lot of them online as well. So I talk to animal owners about that. Um, and also um things like rodent control within households, um, because there have been many detections of H5N1 in in house mice, for example. And I think really the most difficult thing is what you've alluded to already, is that there are some owners that really believe that raw food diets are better. So maybe having a handout for clients on the um pros and cons and what's known about raw food diets. Um, and I recently published a column in my Washington Post Ask of that series on raw food diets. I think that's just kind of a really nice column that um can be useful for clients in terms of education about those diets and the risk of those diets.
SPEAKER_01:Yeah, Jane, we're happy to link to that article too in our show notes as well for anyone that wants more information about that.
SPEAKER_03:That would be fantastic.
SPEAKER_01:So, Jane, what research directions are you most excited about?
SPEAKER_03:Yeah, I mean, I think we still don't have a very good understanding of the epidemiology of this disease in in companion animals. There's a lot to learn, um, just as there was a lot to learn about COVID, and we're still learning about um SARS-CoV-2 infections in dogs and cats, and the epidemiology of those infections in dogs and cats. And I suspect with future studies uh we'll find that what we're seeing in terms of these deaths are just the tip of the iceberg. And there's probably a lot of both dogs and cats that get infected that we don't know about. So there's probably a lot of evidence of subclinical infections. And I think we're going to be learning about that in the future. Um, so seeing how this disease changes in the future will be very interesting, and also getting a better understanding about the the um the incidence of infections in in dogs and cats.
SPEAKER_02:Yeah, thanks so much, Jane. I know this is a uh very timely, continues to be a very timely topic. Um I want to ask a couple fun questions. If you could instantly communicate with any one species, which would you pick and what would be the first thing you'd ask them?
SPEAKER_03:Um, yeah. So I think my dog, um Bodie, I have a black lab called Bodhi, who's um quite kind of an odd dog. I would really like to know if he likes to go on road trips or not, or if he's more of a homebody. Sometimes difficult to tell.
SPEAKER_02:Fair. Yeah, the things that we were doing to like bring them along, and they're probably like, just leave me alone.
SPEAKER_03:I just want to stay at home.
SPEAKER_02:On the professional side, is there a gadget or veterinary gadget or tool that you wish existed but doesn't yet?
SPEAKER_03:Yeah, I I actually wish that we had um a way of cleaning out Aspergillus fungal plaques from dog noses quickly. Um, so I wish we had a quick way of diagnosing that disease that's easy, and a way of being able to clean out all of those fungal plaques efficiently and quickly. It takes us hours sometimes, um, and we really don't have a good gadget for doing that yet.
SPEAKER_01:Well, Jane, thank you so much for being here today, for joining us. We always appreciate whenever we have you on the podcast, and also we love reading your articles too.
SPEAKER_03:Thank you so much for the opportunity to comment.
SPEAKER_01:And for our listeners and viewers, you can read Jane's article in JAFMA. I'm Sarah Wright here at Lisa Fortier. Be sure to tune in next week for another episode of Veterinary Vertex. And don't forget to leave us a rating and review on Apple Podcasts or wherever you listen.
