Reality and Rabies in Strays

Rabies is almost universally fatal once symptoms are observed, but it can be difficult to detect. In 2017 in New Jersey, there was a case in which a rabid kitten that was taken to visit a school, a hospital, and a Thanksgiving party before it was evident that it was ill. More than a dozen people were required to have the prophylactic series of rabies vaccinations.

Cats are the most commonly infected domestic animal. In 2018, 20 cats tested positive for rabies in New York state. In 2019, there were 24. Both years had only one positive dog. During 2019, 241 rabid cats were reported nationwide.

Why are cat cases so high? Outdoor cats are more likely to roam unescorted and contact wildlife than dogs. And, sadly, people often neglect rabies vaccinations for their cats, as not all states require rabies vaccination for cats. People believe that indoor cats and barn cats are safe. Not so. Barn cats interact with wildlife all the time, and indoor cats do manage to slip out at times. Plus, infected bats can get into houses.

For stray and feral cats that get picked up, rabies is a concern. Most municipalities have holds for any strays that come into their animal control or local humane societies. While the goal is to allow enough time to reunite cats with their owners, it also avoids adopting out rabid animals.

Elizabeth Berliner, DVM, DABVP, Swanson Endowed Director of Maddie’s Shelter Medicine Program and associate clinical professor at Cornell University’s College of Veterinary Medicine, says there are fallacies with that thinking: “Mandatory holds for healthy stray cats have nothing to do with mitigating rabies risks, given the long incubation period for rabies in cats (on average, two months, or longer). Preventive health programs such as trap-neuter-return (TNR) and return-to-field (RTF) get rabies vaccines into cats, which is an essential part of reducing risk to humans and providing better welfare for cats.”

More importantly, people need to be aware of signs of rabies in strays. Most cats will die within 10 days of the first signs of rabies, but those signs can vary dramatically and need to be distinguished from other neurological problems.

“Every shelter veterinarian who has been practicing for a while has likely encountered a rabid cat or kitten at some point in their career . . . The overarching lesson is how important it is that shelter intake protocols, which include the recognition of risk factors for rabies and enact isolation and handling protocols, protect staff.  Personnel handling stray animals should be given pre-exposure rabies vaccinations to mitigate risk,” says Dr. Berliner.

Rabies infections tend to have three stages in cats:

1. Prodromal. During this stage, the main sign is a change in behavior. Quiet cats may become aggressive and cats that aren’t normally friendly may become mellow. This can be hard to judge in a newly captured stray. Any bite from an infected cat can transmit rabies. The CDC warns that bites and saliva may contain infective virus even before clinical signs are noticed.
2. Excitation. This furious rabies stage is the classic rabid-animal picture. These cats tend to be aggressive. Swallowing is affected, so they will commonly drool excessively and literally foam at the mouth. Alternatively, a cat may show the dumb form at this stage, with quiet behavior and paralysis of the throat and mouth muscles. This is not common.
3. Paralytic. After a few days, the infected cats move on to this final stage where swallowing becomes impossible and paralysis sets in.

Throughout all three stages, widely dilated pupils are often noted. It’s important to realize that most stray cats and kittens have parasites, both internal and external, and possibly upper respiratory infections. The odds of a cat being rabid are not high, but any cat showing neurologic signs must be considered a rabies suspect. All strays should be isolated from other pets using solid barriers such as doors, not baby gates. A vaccinated adult should be assigned to care for them during a minimum 14-day quarantine and still follow good hygiene.

If someone is bitten, follow your state guidelines for bites by animals of unknown vaccination history. Unfortunately, that might mean euthanasia. While that may seem extreme, rabies is fatal once symptoms develop.

Rabies In Wildlife

Rabies is endemic in North America. Rabid animals are found in cities as well as rural areas. The most common species are skunks, bats, raccoons, and foxes. Except for bats,  these animals usually show signs of illness, in particular unusual behavior and abnormal movement. Wildlife that appear during unusual times for their species, such as bats out in daylight, or that move with an abnormal gait or approach humans should be treated as rabies suspects. If a wild animal attacks you or your pets, you should try to confine the animal and contact animal control. Unfortunately, but understandably, the animal usually will be killed and then examined for rabies.

You Should Know

Signs of Rabies

• Change in behavior, inappetence, hyperactivity, bad temper, hiding
• Dilated pupils, anxiety
• Sudden, unprovoked attacks
• Abnormal gait, loss of coordination
• Excessive drooling, foaming at the mouth, worsened by difficulty swallowing
• Progressive paralysis