Presentation at 3rd GRF One Health Summit 2015 Session Implementing Animal Based Therapies in the Health Care Setting: A Team Approach

1. Management of Pet
Ownership in a High-
Risk Bone Marrow
Transplant Population
Jessica H. Gray, MS, RN, CPN,
BMTCN
October 6, 2015

2. High-Risk Populations
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1. Patients with recent autologous stem cell transplantation
2. Patients post allogeneic stem cell or bone marrow transplantation
and still on immunosuppression
3. Patients undergoing myleoablative chemotherapy
4. Patients with immune system failure (aplastic anemia, SCIDS)

3. Previous state of pet ownership for post-bone
marrow transplant (BMT) patients
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1. Lack of consolidated information regarding safe pet ownership for
post-bone marrow transplant patients.
2. A lack of knowledge regarding safe human-animal interaction caused
many healthcare providers to tell patients to board their pets or to
find alternate homes for their pets.
3. Boarding the pet or finding an alternate home increased patient’s
financial burdens and caused stress during an already stressful
medical crisis.
4. Patients who chose to keep their pets did not benefit from education
regarding safe human-animal interaction.

4. Intervention
October 6, 2015Safe Pet Ownership 4
1. A large, evidence-based research project was performed. The
literature review included over 25 current, peer-reviewed journal
articles and practice guidelines.
2. Findings and proposed recommendations were shared and
discussed with veterinarians from the Virginia-Maryland College of
Veterinary Medicine.
3. Recommendations were shared with the Bone Marrow Transplant
Program healthcare team for discussion and feedback.
4. Recommendations were adopted and guidelines implemented by the
pediatric and adult bone marrow transplant program.
5. Staff training materials and patient education materials were
developed and implemented for use.

5. Guidelines for Safe Pet
Ownership in Post-Bone
Marrow Transplant Patients
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6. What animals are safe to keep after transplant?
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1. Most animals can be kept after transplant, if proper safety guidelines
are met
2. Birds, chicks, ducklings, non-human primates and exotic animals are
not safe and are not permitted in the home where the patient will be
staying.
3. Patients are advised to not adopt any new pets during their
immediate post-transplant period.
4. These guidelines apply only after the patient has been discharged
from the hospital. Current research does not support in-hospital
human-animal interaction in this patient population.

7. Guidelines for dog and cat owners
October 6, 2015Safe Pet Ownership 7
1. Puppies and kittens under the age of 9 months carry more viruses
that could be transmitted and should not be kept in the home.
2. Regular veterinary care is essential. Pets must be up to date on their
immunizations.
3. Sick animals, or animals with diarrhea must be isolated and taken to
the vet promptly.
4. Dogs and cats must have monthly, preventative flea, tick and
heartworm medication.
5. No raw diets, no unpasteurized diary products

8. Guidelines for dog and cat owners
October 6, 2015Safe Pet Ownership 8
1. Patients must not handle food, water or excrement.
2. Animals must not be allowed to hunt, scavenge, eat garbage, other
animals, animal feces, drink stagnant water or water from the toilet.
3. Pets must not have contact with stray animals.
4. Pets should not lick the patient’s face or wounds.
5. Patients should wash hands with soap and water after petting the
animal.
6. The animal’s nails should be kept trimmed.
7. Any bite or scratch should be reported to the physician.
8. Pets should be spayed/neutered.

9. Specific guidelines for dogs and cats
October 6, 2015Safe Pet Ownership 9
Dog Specific Guidelines
1. Veterinarians should vaccinate
against Bordetella with the
injectable vaccine, not the
intra-nasal vaccine.
2. Patients should ask their vet to
vaccinate against
Leptospiriosis using a non-
shedding vaccine such as
Merial Recombitek 4 Lepto.
Cat Specific Guidelines
1. Cats must be indoor-only.
2. Someone other than the
patient must clean the litter box
daily.
3. The litter box must be kept
away from food preparation
areas.
4. Cats must be FeLV (feline
leukemia virus) and FIV (feline
immunodeficiency virus
negative.

10. Reptiles, rodents and fish
October 6, 2015Safe Pet Ownership 10
Reptiles and Rodents
1. May be kept in the home, but
no contact with the patient.
2. Must stay in the cage at all
times.
3. Patients may not clean the
cage or handle food/water.
Fish
1. Patients must not feed the fish
or handle the fish food.
2. Someone other than the
patient must clean the tank.
3. Patients must not have contact
with the fish or water.

11. An Interdisciplinary approach to patient education
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1. Patient education starts with the pre-transplant coordinators and
physicians during the new patient consult.
2. Inpatient nurses reinforce safe pet ownership during the inpatient
stay and before discharge.
3. Clinic nurses reinforce teaching during the patient’s clinic visits and
monitor for any pet-related complications.
4. Family and friends caring for the patients after transplant are taught
about safe pet ownership and their responsibilities during the
caregiver class.

12. Conclusion
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1. Much research has been done that shows
the therapeutic benefit of pet ownership.
2. Current evidence suggests that pet
ownership in post-BMT patients can be safe
with a few important guidelines in place.
3. Guidelines are for current pets in the family.
Patients should not actively seek adopting
or buying a new pet in the immediate post-
transplant period.

13. References
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Diseases, 13, 719-725.
Anemuller, W., Baumgartner, S., & Brasch, J. (2008). Atypical Microsporum canis variant in an immunosuppressed child. Journal of the German Society of Dematology, 6, 473-475.
Bonatti, H., Mendez, J., Guerrero, I., Krishana, M., Ananda-Michel, J., Yao, J., . . . Alvarez, S. (2006). Disseminated Bartonella infection following liver transplantation. Transplant International, 19, 683-687.
Buyck, H. C., Holliman, R., Else, J., O'Regan, L., Willis, F., Grubnic, S., . . . Chakrabarti, S. (2008). An unusual cause of acute abdomen following allogeneic transplantation: a zoonotic disease revisited. Bone
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14. References
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