6.Death Is A Bitch

We hypothesised that the outbreak could be due to two rabid dogs in Kasumpti locality in the city. We tested the hypothesis by trawling questionnaire on exposures including asking the affected patients if they have seen such dogs before. We could draw conclusions that both the black bitch and brown dog were residing in Kasumpti area and were stray kept as pets in the locality. Black bitch, that suddenly became furious, was having four pups of two and a half month old and ate all of them alive and attacked the household child nearby and then furiously attacked the passersby. The brown dog involved was probably bitten by black bitch on the nape of the neck as described by the residents. The history of movement of these rabid dogs was also reported by the patients from one area to another after they became rabid. The black bitch moved in and around Kasumpti locality area but the brown dog moved from Kasumpti area to Vikasnagar and then to Devnagar which are located at a distance of about 2 Km.

6.Death Is a Bitch

A huge outcry was in the media as the dogs were on biting spree in a VIP locality of the city. The higher authorities pressed into service the dog squad of MC Shimla working for Animal Birth Control (ABC) and after great difficulty cornered the suspected rabid dogs, black and brown and captured them for observation at Animal Birth Control Centre (ABC) near Tutikandi on April 8, 2015. The black rabid bitch was furious and died due to clinical symptoms of furious rabies after 3 days of isolation as confirmed by the observing veterinarian. The brown dog was lethargic and was given anti-rabies injections till 28th day while it started showing paralytic symptom and had left feeding few days before it died. The brain of the brown dog was extracted and sent to CRI lab at Kasauli for confirmation of rabies as it was not appearing to be rabid. CRI Lab confirmed the dog to be Rabid (FAT Positive) as conveyed by their written report dated May 12, 2015.

For the last 15 years no outbreak like situation has been reported in Shimla municipality. While investigating the source of rabies in the dogs in Shimla Municipality, we initially theorized that, may be nearest forest may be the reason of the black bitch becoming rabid and infecting the brown dog but later intensive interviews with the residents of Kasumpti area of the Shimla MC clarified that both the black bitch and brown dog were domesticated strays (Unvaccinated) and suddenly turned to be rabid. We are surprised with the similarity in the pattern of lactating bitches becoming rabid after 1 - 3 months of litter birth (Whelping) in the last 9 years. If we take a pattern of people becoming rabid after bite/scratch of rabid bitches/pups below three months, it clearly show that may be low immunity of bitches after litter birth activates the latent rabies virus in their brains as 22.8% of the healthy dogs/bitches brought for slaughter in Nigeria [13] are found to be carrying rabies virus. The prevalence of rabies antigen in the saliva and brains of apparently healthy dogs sold for human consumption in Nigeria, is also in agreement with that of earlier work [14] which established that apparently healthy dogs excrete rabies virus in their saliva for long period of time without showing clinical signs. The new rabies virus strain found in Israel, V7, can both serve as reservoir in Dogs and dogs can transmit rabies as well [15] . We tested the brains samples of six animals in Shimla municipality and to our surprise all stray dogs, a pup and some wild animals were found to be positive for rabies virus [16] though none of them appeared to have died due to rabies. This underlines the endemicity of rabies virus in domestic as well wildlife in and around Shimla Municipality. Apart from a carrier status in dogs, some studies [17] have reported that rabies is maintained in one district in the Serengeti region of Tanzania with apparently healthy dog density > 5/km2 as ours is the similar case having dog density more than 5 dogs/Km2 in the Shimla Municipality.

In 2006, a domesticated stray bitch had litter and one of the pup brought home for rearing had a scratch on the hand of 56 yrs male in Sangrah area of Sirmaur district (200 KM) and the person died after three months of clinically confirmed rabies at local hospital. In 2011, we investigated [18] death due to rabies in a village in Solan district (70 Km) where the two patients who died were bitten by a month old pup born to a bitch that died soon after birth of the pups, pup died soon after. In 2012, a lady from village Punjgain (60 KM) was referred to IG Medical College and died after three days after a two month old healthy looking stray pup had bitten her on leg. In the year 2014, one young lady tourist in Manali (300 KM) was bitten by a healthy looking pup of 2 months old and died after a month in Delhi as she was given the vaccine but not the rabies immunoglobulins, RIGs. Again in 2014, a 11 years old male child of Sirmaur district (150 KM) was bitten by a pup of 2 and a half month and died after a month later due to rabies. In Shimla municipality we tested the brain sample of 2.5 month old pup that was reported dead near the forest and it was found to be positive for FAT.

All these happenings point to the fact that may be stray bitches, that are mostly unimunised, are prone to becoming rabid as their latent rabies virus gets activated in circumstances of lowered immunity during pregnancy due to prolonged exposure to elevated progesterone concentrations [19] , their malnourished status and they being usually carrying worm infestation and all these contribute to lowering the natural immunity. Field observations support the view that stress reduces resistance to infections. This seems to be logical in the presence of higher than normal adrenocortical activity. Physiological stress such as birth causes immunosuppression in fetus and dam (mother) after parturition which leads to periparturent rise in worm infestation [20] . Immunocompromised dogs (Having demodicosis worm infestation) can become rabid has been demonstrated in a study [21] by Deborah J. Briggs et al. Similar immunosupression has been reported in other animals/mammals e.g. the pasteurella organisms remain as commensals in the terminal broncheols and alveoli of cattle, buffalo etc. The organisms cannot invade the lung due to pulmonary defence mechanism (Gills et al, 1974). But due to stress in animals the organisms assume the virulent role and thereby bring about changes in lung and lung is unable to clear the pathogens [22] (Thomson et al., 1975). In a recent report communicated by ProMed Mail [23] a six month old dog suddenly got rabid in French Guiana in August 2015 and the origin of infection could not be traced out. More so, the habit of these bitches to lick the pups causes the pups to become rabid as well and lowered pup immunity as described above may also be contributing to their becoming rabid.

While we were working on hypothesis of rabid dogs getting the infection from nearby forest about 8 - 10 KM away but on the follow up of the patients, they reported that both the dog and bitch used to stay in the compound

of their colony since the bitch was pregnant and there was no history of the bitch moving for away to forests neither any outside dog which was seen near them as both of them were very furious. This led us to think of other reasons causing rabies in the bitch, as for the past 9 years we had observed bitches becoming rabid after litter birth that led pups becoming rabid thereafter. Since the carrier state for rabies virus in bitches/dogs is known and a state of immunosuppression after litter birth is also known, therefore there is a possibility of latent rabies virus in carrier bitches getting activated due to immunosuppression after litter birth and we hypothesize it as one of the probable causes. We need to do further studies to ascertain this phenomenon before coming to a definite conclusion and suspect such a possibility in case a dam suddenly becomes rabid among a pack of stray dogs in rabies endemic countries like India. Sahar Abd El Rahman et al. point out that confirmed diagnosis of rabies infection of buffaloes without a history of dog biting gives an announcement about other sources for rabies occurrence in animals [24] .

An inmate who exercised with Dr. Martin MacNeill during the Utah doctor's stint in federal prison testified today at the doctor's murder trial that the physician called his dead wife \"a bitch\" and said no one could prove he killed her.

The main advantages of spaying are preventing pregnancy, preventing infection of the uterus (pyometra), preventing ovarian or uterine cancer and reducing the likelihood of mammary (breast) cancer, all of which can be life-threatening. It also prevents the inconvenience of having a bitch in season with unwanted attention from male dogs.

There is no medical reason to let a bitch have one litter before spay. In fact, some of the benefits like protection against mammary tumours, are lost if the operation is delayed. Unless an owner is committed to having a litter, with all the work and expense that can be involved, and the bitch is also suitable in temperament and free of any hereditary problems, then breeding should not be considered.

It is not a good idea to spay when a bitch is in season or about to come into season, because the blood vessels supplying the uterus and ovaries are all larger and this will increase the risks of surgery. The other time we try to avoid is the 8 weeks after a season, when a bitch may suffer from a hormonal imbalance called a false pregnancy. 041b061a72