Vaccinations

[Karlin]

Vaccinations -- whether to give them, andf if so, how, how often and whether to give boosters -- have become a hot topic in recent years with many veterinary schools now recommending dogs only need puppy vaccinations, the first annual booster, then at MOST vaccines every THREE years. In some cases researchers believe a single initial booster will protect a dog (or cat) for life against a disease. To make things even more confusing for the pet owner, there is also clear evidence that annual vaccinations can actually weaken the immune system and in themselves, can cause serious health problems.

Although many of the leading vet schools in the US now recommend a three year vax schedule, veterinarians, kennels, pet insurance companies annd groomers generally require evidence of annual vaccinations still, leaving many pet owners in a quandary.

These are the key recommendations from two leading sources:

University of California, Davis Veterinary School (one of the world's leading vet schools): http://www.vetmed.ucdavis.edu/vmth/small_animal/internal_medicine/vaccination_protocols.cfm

The American Animal Hospital Association recommendations: http://www.aahanet.org/PublicDocuments/VaccineGuidelines06Revised.pdf



While not offering any definitive answers, this link provides an excellent overview of the evidence, the issues, the published research, the existing recommendations and the options. I strongly advise reading through this and deciding what is best yourself given your own situation.

http://www.caberfeidh.com/Revax.htm

Also this article directly addresses ALL the issues and takes toy breeds into special consideration towards the end:

http://www.cavaliersonline.com/health/vaccinenew.htm

Be aware that you will almost certainly encounter opposition from your vet to vaccinating to any other than a yearly schedule, as annual vaccinations are very much a part of an ingrained vax system still pushed by the vax companies themselves, and also, are part of the 'annual visit' regime that vets would like to maintain (it is of course a good idea to take an animal for an annual check-up; linking the visit to a 'required' vax has been a useful way of getting clients to make that annual visit). Younger vets who have been schooled following the later protocols, or holistic vets, are likely to be more supportive.

My own choice? Right now I am observing a three-year cycle for my dogs and cats. I give lepto annually to the dogs as they like to swim and risk exposure in Ireland.

On titers:

Some dog owners are big advocates of using titers to determine whether to vaccinate and write about this approach as if it is a highly reliable, well-established way of measuring immunity. They are not.

Responsible dog owners need to be aware that titers are still NOT considered an accurate way of measuring immune response and personally, I would consider them only a general indication. This is what breeder Laura Lang (Roycroft Cavaliers in Ohio, who is an advocate of minimal vaccination) says:


TITERS
Titer tests (blood tests to attempt to determine the dog's level of immunization) are also becoming more common, but are inconvenient and expensive in some areas, and remain somewhat controversial. As yet, there is no consensus on the usefulness of titers. Critics point out that there have been no studies to determine what levels actually confer protection from disease, or if there is even a correlation between antibody levels and susceptibility to disease. Some maintain that there is a difference between protection from infection, and protection from disease. Also somewhat suspect is the lack of standardization for tests determining antibody concentration.

Dr. Richard Ford, of North Carolina State University, states, "The risk lies in the fact that a single serum sample divided three times and sent to three different laboratories is quite likely to yield three different titers, and quite possibly three different interpretations. What may be deemed 'protective' by one laboratory could well be labeled 'susceptible' by another. Furthermore, it is important to note that a vaccinated dog or cat that does not have a significant concentration of antibody may, in fact, have excellent immunity. A 'negative' antibody titer does not necessarily correlate with susceptibility to infection. Likewise, the presence of antibody, even at high levels, does not guarantee immunity subsequent to exposure. (6)

At this point, the bigest role of the titer may be merely to convince boarding clinics or show committees that the animal doesn't require its annual vaccination. It is likely that titer testing will receive greater utilization in the future, but further studies are obviously needed.

You can read more in her online cavalier care manual in the 'health' section: http://roycroftcavaliers.com/manualhealth.htm

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Here are some additional links to read through so you can talk to your vet about these issues and decide what you feel is right for your cavalier:

http://www.thepetcenter.com/exa/vac.html

http://www.doglogic.com/vaccineinfo.htm#news

http://www.janineadams.com/vaccinations.htm

Dr Jean Dodds article: http://www.critterchat.net/immune.htm

Letter from Dr Dodds on vaccination legislation: http://www.malamutehealth.org/vaccination_letter.htm

[Karlin]

In the latest issue of this widely-recommended journal. You can subscribe here: http://www.whole-dog-journal.com/ and then get access to articles online as well as print; plus access to the full archive. Many people subscribe for their annual food recommendations alone. icon_thumbsup



You should decide whether your dog needs that vaccination

By Nancy Kerns

Most dog owners are responsible and understand the importance of protecting their companions from preventable disease. That’s surely what motivated the dozens of people I observed standing in a long line with their dogs and puppies at a low-cost vaccination clinic offered in a local pet supply store.

Which vaccines should your dog receive? It is your responsibility to determine the real risks of the diseases they are supposed to defend your dog against, and weigh the potential benefits of vaccination against the potential harm.

In addition to vaccinations, the veterinary business running the clinic also offers flea and tick treatments, heartworm tests and preventive medication, and identification microchip implanting, so at the head of the line, a young man in a white coat and holding a clipboard asked each client what she wants for her pet. Dozens of times, I heard an owner say something like, “Well, we just got him, so I want to get whatever shots he needs.” It was a tense moment for me every time I heard this, since I was aware that the clinic had available for sale far more vaccines than the dogs and puppies standing in line were likely to “need.”

No universal protocol
Many dog owners are surprised to learn that there is no single, universally accepted canine vaccination schedule. Most trust their veterinarians to give their dogs whatever vaccinations the vet recommends – and many vets recommend more vaccinations than most dogs require in order to be protected from contagious disease.

This can probably only rarely be accurately attributed to opportunism on the part of the vet. Most vets use the vaccination schedules they receive with the vaccinations they buy from drug companies.

Historically, this was a sound choice. For decades after the first veterinary vaccines were developed, veterinarians and government regulators alike trusted the companies that studied, developed, and manufactured the lifesaving vaccines to recommend appropriate schedules for their use. Today, though, they are realizing their trust of the vaccine makers may have been slightly overextended for a decade or two.

You see, vaccine makers are in the business of selling vaccines. So it follows that most of them recommend that their vaccines be administered annually – despite the fact that independent studies have shown that many vaccines convey immunity from disease for many years, if not the lifetime of the dog.

In a policy statement about vaccines, the American Veterinary Medication Association (AVMA) acknowledges, “The one-year revaccination frequency recommendation found on many vaccine labels is based on historical precedent and United States Department of Agriculture regulation, not on scientific data. Even in those cases where scientific data was submitted to qualify the label claim, the data generated does not resolve the question about average or maximum duration of immunity.”

For a long time, the few experts who realized dogs may receive far more vaccines than they needed were not particularly worried. “It can’t hurt ’em!” But in the late 1980s, as medical science learned exponentially more about the immune system, proof began to turn up that repeated vaccinations could have deleterious effects on companion animals.

Today we know that adverse events may be associated with the disease antigen, the adjuvant (an agent added to increase or aid the effect of the antigen), carrier substance, preservative, or a combination of any of these. The AVMA vaccination policy statement says “Possible adverse events include failure to immunize, anaphylaxis, immunosuppression, autoimmune disorders, transient infections, and/or long-term infected carrier states.”

To their credit, when vaccines can be directly linked to specific, reproducible injuries or illnesses, the vaccine makers (and regulators) leap to study the problem, as in the case of vaccination site-associated feline sarcoma. Unfortunately, the problems experienced by dogs that many practitioners and researchers suspect may be linked to overvaccination are all over the map. Some suspect excessive vaccines are linked to the increased incidences of many diseases, including cancer, epilepsy, severe allergies, thyroiditis, autoimmune hemolytic anemia, Addison’s disease, and even behavioral problems such as aggression.

Get information
Fortunately, educated owners can do a number of things to make sure that their dogs are adequately protected against disease, without overvaccinating.

There are canine vaccines for more than two dozen diseases, with many vaccines available in combinations with others. Very few dogs are at risk for all or even most of the diseases. So the first step is to learn about the diseases the vaccines are designed to defend your dog against.

Before agreeing to any vaccination, ask your vet about the disease it prevents. What is its incidence? How is it transmitted? Is it more prevalent in some climates or parts of the country than others? Is the disease treatable, and if so, how many dogs recover? Then you can extrapolate the answers to your dog and locale.

If you learn that the disease kills many dogs who contract it, and the virus is everywhere, well, you probably authorize that vaccine, right? But if you lived in a city apartment with a Papillon who didn’t so much as visit parks, a vaccination for a tick-borne disease like Lyme is really not needed.

Today, most veterinarians discuss vaccines in terms of “core” versus “non-core” products. Core vaccines are those that can protect your dog from the diseases that are widely distributed in your part of the country, virulent, and highly infectious. Think of them as the vaccines with the highest benefit to risk ratio. Non-core vaccines are those that are intended for a minority of dogs in special circumstances. They may target diseases that are of limited risk in your area, or those that present only a low-level threat to your dog’s health.

“Core” vaccines
These are the vaccines for diseases that most experts agree puppies and dogs should be protected against – diseases that are highly contagious and potentially fatal.

Ronald D. Schultz, PhD, is department chairperson and a professor at the School of Veterinary Medicine, University of Wisconsin in Madison. He’s also one of the country’s leading experts on veterinary vaccines, having performed research for or with literally every veterinary vaccine company in the U.S. We’ll use Dr. Schultz’s list of “core” vaccines for dogs:

• Canine parvovirus type 2 (CPV-2)
• Canine distemper virus (CDV)
• Canine adenovirus type 2 (CAV-2)
• Rabies virus (RV)

For what people commonly refer to as “puppy shots,” many veterinarians use a combination vaccine that contains antigens for distemper, hepatitis, leptospirosis, parainfluenza, and parvo (referred to by its initials, DHLPP). If you are concerned about overvaccination, ask your veterinarian if she can vaccinate your puppy against just parvo, distemper, and adenovirus (the rabies vaccine is usually given separately later, after the puppy is 16 weeks old). A vet can purchase and use individual vaccines, but she may have to buy them in bulk, and won’t be happy about it if you are the only one in her practice who wants them.

Most experts agree that puppies should be vaccinated against distemper, parvo, and adenovirus, not before six weeks, and at least once after the age of 12 weeks; the rabies vaccine is given after 16 weeks. About two weeks after the last vaccination with distemper, parvo, and adenovirus, ask for a vaccine titer test to confirm your puppy has been successfully immunized (see “Titer Tests: A Terrific Tool” sidebar).

“Non-core” vaccines
Then there are the non-core vaccines. Some (including Dr. Schultz) refer to all the other vaccines that are available as non-core, suggesting that these be given only to dogs that need them, and only as often as needed. For these vaccines, the ratio of benefits to drawbacks is less weighted toward the benefits – at least for most dogs.

A good example is leptospirosis. The duration of the immunity typically conveyed by the lepto vaccine is generally less than one year, so to convey optimal protection from this disease, it must be given at least twice a year, every year. Also, the vaccine used must contain all four strains of the disease that are currently available to vaccine makers, because the strains do not provide cross-protection. Lepto poses a very minimal risk in many regions of the U.S. And where it is more common, there have been recent reports of new strains emerging, for which there are no vaccines yet.

All of this suggests that administering the vaccine would benefit only those dogs living in an area with a current, high rate of infection – and only if they are properly vaccinated at frequent intervals with all the available strains.

“Not recommended” vaccines
Some experts classify some vaccines in a third category of “not recommended.” These would include any vaccine for which they perceive to be no realistic benefit.

For example, there is now a vaccine against giardia, which is a protozoan intestinal organism that dogs may be exposed to when drinking out of ponds or streams. Many veterinarians feel that despite the marketing efforts behind the vaccine, giardiasis poses little risk to most dogs.

Many experts also doubt the usefulness of the coronavirus vaccine. According to Dr. Schultz, “To date, no one can demonstrate a benefit for coronavirus vaccine.”

Other vaccination tips
When they learn that overvaccination may be harmful to their dogs, many people ask, “Why would my veterinarian suggest doing something that could hurt my dog?” The fact is, information about the potential risks of overvaccination is fairly new. Veterinary colleges, the AVMA, and the American Animal Hospital Association (AAHA) have changed their suggested vaccination schedules in only the past few years.

A few final vaccination tips:

• Use vaccine titer tests to determine whether your dog is adequately immunized against the core diseases. (For more detailed information, see “Taking the Titer Test,” WDJ December 2002).

• Don’t rely on low-cost clinics for your dog’s vaccinations. These clinics exist to sell vaccines, not to provide full care or detailed advice. They cannot provide the full hands-on exam that your dog should receive at least once a year, and may not take the time to determine whether a vaccination is contraindicated for your dog. Instead, establish a relationship with a veterinarian who will take the time to examine your dog, ask about his health history, answer questions about the benefits and risks of various vaccines, and recommend an individualized vaccination protocol for your dog that takes your dog’s health, his lifestyle, and his environment into account.

• Do take your dog to your veterinarian at least once a year. A thorough annual (or better yet, semiannual) health examination and annual titer test is the best way to find problems early, before they are difficult and costly to treat. Your veterinarian can also help you develop a sound preventive health program to keep your dog vital to the very end of a long, happy life.

• Vaccinations are contraindicated for dogs who are not healthy. Do not vaccinate dogs who suffer from chronic or acute health problems, running a high temperature, or who have a history of vaccine reactions. This sounds simple, but many times people go to the vet for an injury, say, an abscess or to remove an embedded foxtail, and the vet notices the dog is “overdue” for vaccinations. The dog is currently battling a local infection! Do not have him vaccinated at that time.

• Don’t vaccinate elderly dogs. If your dog has been vaccinated many times in his younger years, he is probably as well immunized against disease as he will ever be. Plus, his exposure to disease decreases as he ages and travels and exercises less.

[Karlin]

From Newsday, this ran at the start of April. Something to consider when deciding on a vax schedule for your cavalier.

Link -- http://www.newsday.com/news/columnists/ny-adcova4687741apr03,0,3536936,print.column


Annual vaccinations may harm your pet

Inoculating your dog annually sometimes can do more harm than good. Experts say it's best to customize a program for your pet.

Denise Flaim
Animal House


April 3, 2006

In her popular agility classes, Marcy Pratt of Lido Beach teaches dog owners to zoom their corgis through tunnels and sail their Australian shepherds over jumps.

But as she chatted with the handlers on the sidelines, she realized there was another area they needed help navigating.

"I found that most of them had their dogs vaccinated for everything, every year," Pratt says, even though the trend in veterinary medicine has been to tailor vaccine programs to a dog's lifestyle and risk. "And I had a couple of students whose dogs had had adverse reactions, including one that almost died."

The clarion call among veterinarians in recent years has been a movement away from reflexive annual "shots" and toward a more individualized approach: In its 2002 vaccine report for dogs and cats, the American Veterinary Medical Association rejected the idea of "one-size-fits-all" protocols, suggested that unnecessary overstimulation of the immune system might incur health risks, and divided vaccines into "core" and "non-core" categories.

A year later, the American Animal Hospital Association went a step further: In its landmark Canine Vaccination Guidelines, it added a third category - not recommended at all - and gave suggested intervals of vaccination for each vaccine. Earlier this year, the association published an update of the guidelines, adding some new information about specific vaccines and the vaccination needs of shelter dogs.

The original 2003 guidelines were "largely driven by the veterinary profession understanding that the way we have always done things may not be the way they will continue to be done," says veterinarian Michael P. Andrews of Riverside, Calif., the association's president. The fact that the 2003 protocols did not result in any obvious disease outbreaks reinforces the guidelines' message that "less is better," he says.

But as far as Pratt could tell from her students' stories, practice hasn't caught up with theory. So she organized a seminar by veterinary immunologist Ron Schultz of the University of Wisconsin School of Veterinary in Madison, arguably the expert's expert in the field of canine epidemiology. Since the 1970s, Schultz has conducted trials for manufacturers to determine duration of immunity, and he was on the task force that updated the association's guidelines. Seventy-five people attended the March 18 lecture in a church gym in Syosset; Pratt says a couple of local vets bought tickets, but she didn't see any in the audience.

Guidelines vs. habits

Schultz says that while some vets have kept up with changing times, old habits die hard. "We have a lot of work yet to change the attitudes of most vets in practice. We are trying to get them away from the annual thing and get them to understand that immunity doesn't stop on the precise day" that the vaccine expires.

The association's guidelines identify four vaccines as "core," or critical for every puppy to receive: distemper, parvovirus, adenovirus-2 and rabies. For the first three, the guidelines recommend a puppy series, a one-year booster and then revaccination no more frequently than every three years, if not less often. (There is no such flexibility with rabies, which, by New York State law, must be administered every three years.)

The remaining vaccines in the marketplace are either not recommended, or are considered "non-core," meaning that a dog's individual situation might require them. A pooch who lives in an area where leptospirosis is endemic - including parts of Long Island - might be a candidate for that short-lived vaccine; ditto for one owned by globe-hoppers who spends time at a boarding facility where bordetella (kennel cough) is a constant possibility.

Schultz says some vets resist this nuanced approach to vaccination because of habit and economics. Urging a client to come in for annual shots is more compelling than a postcard cheerily announcing that it's "wellness exam" time.

"There's no evidence that a one-year requirement improves compliance with vaccination," Schultz adds. "At one point, it was thought if we make people vaccinate every year, we're going to vaccinate more dogs. What it turned out to be was that we were having the same dogs revaccinated annually."

Labels aren't guidelines

Another problem is byzantine labeling and clever marketing on the part of vaccine manufacturers.

"The label means nothing," Schultz says simply, noting that vaccines licensed for one year and three years are often the same product. "The label has an arbitrary and capricious annual revaccination requirement, and it takes an act of Congress to take it off" - literally. Schultz says the Department of Agriculture has applied to remove the language, a legislative process that he estimates will take seven years.

While many veterinary colleges have moved toward vaccine protocols of every three years for core vaccines that are "modified live viruses," or MLV, such a parvo, distemper and adenovirus, others suggest that immunity lasts far longer - Schultz among them. "Duration of immunity is whatever is determined by the studies, and those studies show that duration of immunity is seven to nine years, which is a lifetime."

Too much, too soon

Veterinary immunologist Jean Dodds of Santa Monica, Calif., another popular lecturer on the vaccine topic, stresses that overvaccination can overwhelm the immune systems of dogs, in particular certain purebreds that are genetically predisposed to adverse reactions. (In a recent study by veterinarian George Moore of Purdue University in West Lafayette, Ind., dachshunds, pugs, Boston terriers, miniature pinschers and Chihuahuas showed the highest rate of adverse effects to vaccines.)

"The recently weaned young puppy or kitten entering a new environment is at greater risk here, as its relatively immature immune system can be temporarily or more permanently harmed," says Dodds. "Consequences in later life may be the increased susceptibility to chronic debilitating diseases."

Dodds adds that because vaccine labels themselves state that vaccines should only be given to healthy animals, owners should not vaccinate chronically ill animals, adding that they can even apply to their state for a waiver of the rabies vaccine requirement if their vet writes a letter documenting the animal's frail health.

For owners who worry about their dogs' immunity lapsing, Dodds recommends titers, or blood tests that can measure antibody levels.

But being progressive while the rest of the world inches to catch up can be frustrating. Karen Tragesser, 50, of Lynbrook, takes her 8-year-old golden retriever, Dillon, to Pratt's classes. She says her vet has "never been one to push vaccination," and Dillon gets a booster only every three years. With a new puppy on the horizon, and Dillon getting on in years, Tragesser is thinking of titering for "core" diseases such as distemper, parvo and adenovirus.

"If you want to do activities with your dog, you need proof of current vaccination," including the above trio, Tragesser says. The group that certifies Dillon as a therapy dog will not accept titers as proof that he is adequately protected, and so she will have to choose between doing what she feels is best for him health-wise - and letting him make visits to hospitals and nursing homes.

As for Pratt, she's left with the acronym that Schultz used to open his lecture. "He said every dog needs TLV - training, love and vaccination," she says.

The key is that only the middle one needs to be unlimited.

To read the American Animal Hospital Association's complete 2006 Canine Vaccination Guidelines, go to www.aah anet.org.

LESS IS MORE FOR CATS, TOO

When it comes to progressive attitudes about vaccination, cats were way out ahead.

"We were the first out with vaccination guidelines in 1997-98," says veterinarian James Richards of the Cornell Feline Health Center in Ithaca, N.Y., and past president of the American Association of Feline Practitioners.

One of the motivators was the incidence of injection-site sarcomas in cats. "Even though it's a rare event" - Richards puts the "best estimate" at one to three out of every 10,000 vaccinated cats developing cancer at the vaccination site - "it's a very serious one. "

As with dogs, reflexively vaccinating felines was the order of the day until 15 or so years ago. "Back when I started as a vet, we had vaccines for three or four infectious cat diseases, and we didn't think a whole lot about how often they needed to be given," he says. "At this moment, we have vaccines for 10, in various combinations. "

Richards urges cat owners to think about vaccines as a double-edged sword: necessary medical procedures that also have their risks and downsides. "Vaccination is an elective medical procedure that's going to be individual for each critter instead of a knee-jerk sort of thing. Becoming informed yourself is very important. "

To that end, he encourages cat owners to discuss vaccination with their vet - and if their vet is unresponsive to their questions, to find someone who does respond. A good starting point for discussion is the current association guidelines, available at www.aafponline.org - for now, at least. Richards is convening an international panel of feline specialists to revisit the guidelines, a process he hopes to complete by summer.

While he doesn't know precisely what the update will say, he can guess the tune: "The key is using the right vaccines absolutely only as often as we need," he concludes. "Most assuredly, less is more."

- Denise Flaim
Copyright 2006 Newsday Inc.