Archive for the ‘The Vaccination Conundrum’ Category

Veterinarians and Vaccines: A Slow Learning Curve

Sunday, March 17th, 2013

Am I feeling frustrated and disappointed? You bet I am after reading an article titled, “Vets Slowly Move to 3-Year Vaccine Protocols” in the most recent edition of Veterinary Practice News. According to the article, approximately 60 percent of veterinarians continue to over-vaccinate their adult canine and feline patients by administering “core” vaccinations annually. This in spite of the fact that, for a decade now, it has been public knowledge that these vaccines provide a minimum of three year’s worth of protection.

Current canine and feline guidelines recommend that adult dogs be vaccinated against distemper, parvovirus and adenovirus, and adult cats against panleukopenia virus, herpesvirus and calicivirus no more than once every three years. Bear in mind, these are not rules or regulations (although I wish they were) they are simply guidelines. With the exception of rabies (mandated by state governments) veterinarians can vaccinate as often as they please.

The risks of over-vaccinating

What’s the downside to your pets receiving three-year vaccines once every year? My concerns extend far beyond wasting your money. (Please pause for a moment while I step up on my soapbox!) Vaccinations are so much more than simple shots. They truly qualify as medical procedures because each and every inoculation is associated with potential risks and benefits. While adverse vaccine reactions are infrequent and most are mild, every once in awhile a vaccine reaction becomes life threatening. As with any medical procedure, it is only logical to administer a vaccination if the potential benefits outweigh the risks. Giving a three-year vaccine once a year defies this logic in that the patient is exposed to all the risk of the procedure with absolutely no potential benefit. How in the world does this make sense?!

Why some vets continue to over-vaccinate

According to the Veterinary Practice News article, there are two reasons why approximately half of veterinarians continue to over-vaccinate. First, they believe as I do in the importance of annual health visits for dogs and cats. They also believe that the lure of a vaccine is the only way to convince their clients of the need for a yearly exam, and for good reason. In 2011, the “Bayer Veterinary Care Usage Study” documented that many people continue to believe that vaccinations are the only reason to bring their overtly healthy pet in for a veterinary visit.

The second explanation provided for over-vaccinating is that veterinarians don’t want to interrupt the revenue stream derived from annual inoculations. Despicable, in my book!

A possible third explanation is that some veterinarians remain unaware of current vaccination guidelines. If so, they must be living under a rock and begs the question, why would you want such an “outdated” individual caring for your pet’s health?

What you can do

Okay, now that I’ve ranted and raved a wee bit, I invite you to join me on my soapbox! Here are some things you can do to prevent over-vaccination.

  • Stand your ground! If your vet insists on administrating core vaccinations to your adult pets every year, share a copy of current canine and feline guidelines. You may need to agree to disagree and/or find yourself a more progressive veterinarian. Remember, you are your pet’s medical advocate and you have the final say so!
  • Bring your pets in for a yearly checkup, whether or not vaccinations are due. I cannot overstate the importance of an annual physical examination for pets of all ages. It’s a no brainer that the earlier diseases are detected, the better the outcome. The annual visit also provides a time to talk with your vet about nutrition, behavioral issues, parasite control, and anything else that warrants veterinary advice. Enough people bringing their pets in for annual wellness exams may convince more veterinarians to revise their vaccine protocols in accordance with current guidelines.
  • Spread the word by sharing the information in this blog post with your pet loving friends and family members.

To learn more about vaccinations, I encourage you to read “The Vaccination Conundrum” in Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life.

How frequently are your adult pets receiving their core vaccinations?

Best wishes,

Nancy Kay, DVM

Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot and Your Dog’s Best Health.   There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot and Your Dog’s Best Health are available at www.speakingforspot.com, Amazon.com, local bookstores, and your favorite online book seller.

Resolutions for the New Year That Will Benefit You and Your Pet

Sunday, January 1st, 2012

The transition to a new calendar year may inspire you to muster the resolve to make good changes in your life. How about the lives of your pets? No time like the present to make some new year’s resolutions that will benefit both of you. Here are three suggestions:

More Face Time With Your Pets

Our furry family members are more than happy to be our exercise partners, confidantes, psychotherapists, and nonelectric heating blankets. Take advantage of such pet-facilitated services as much as possible this year!

What dog doesn’t crave attention from their favorite human? Teach your best friend some new tricks. Begin working on that long overdue grooming. Get your pup out for more exercise (lose the sedentary human behavior at the dog park). Don’t let the winter weather be a deterrent. Go shopping for some canine winter apparel and gift yourself with Dr. Phil Zeltzman’s book, Walk a Hound, Lose a Pound to glean some inspiration!

What about our kitties? Well you know how it is- cats tend to like things on their terms. However, even the most curmudgeonly of cats will benefit from a feather toy tempting them to expend some energy and some affectionate scratches under the chin. The challenge is to spend more quality time with your kitties while convincing them that the activity is of their choosing.

Fewer Vaccinations

Your adult pet’s good health requires inoculation with core vaccinations no more than once every three years. The term “core” is reserved for those vaccines, such as distemper, that are recommended for every adult animal. Overvaccinating (vaccinating more than once every three years) exposes your best little buddy to needless risk (yes, there is some risk associated with every vaccination). Besides, why spend your hard earned money on something that is completely unnecessary?

If your veterinarian has remained on the “once a year bandwagon” and the thought of convincing him or her otherwise gives you a case of the willies, I encourage you to read the chapter called, “Discussion About Your Dog’s Vaccinations” in Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet. Kathie please make this a live link to the Amazon page The information found there will provide you with all the inspiration you need to broach the vaccination conversation with your vet. (For those of you who are cat fanciers, please know that my hope is to create the feline version of this book within the year. In the meantime, know that the basic principles provided in Your Dog’s Best Health apply to kitty care as well.)

Recruit a Professional to Help With Your Pet’s Behavioral Issues

Would you love to be able to leave your dog home alone for more than ten minutes without the house being destroyed? Would you be ecstatic if your precious puss quit spraying your walls with his version of graffiti? Would you relish the idea of taking your dog for a walk without having to ice your shoulder afterwards? There is no time like the present to tackle such behavioral issues. I encourage you to get the professional help you need so that you and your pet can fully enjoy cohabitating. Chronic behavior issues tend to gradually result in more and more isolation for the pet until most of their waking hours are spent within a crate, a single room of the house, or the backyard. Such isolation begets even more negative adaptive behaviors, and the end result may be relinquishment to a shelter or rescue organization; worse yet, euthanasia.

Please know that if your dog or cat has a significant behavioral issue, you are certainly not alone. Also know that the sooner the issue is dealt with, the happier the outcome will be for both you and your pet. Hiring a pro to help you work out a behavior bugaboo will be one of the best investments you make this year!

When choosing a trainer or behaviorist, check in with your veterinarian for a recommendation. Additionally, check out the websites below. You’ll find lots of information about how to choose the right person to help you with the issue at hand. These sites also have “locators” to help you find a professional in your area.

Association of Pet Dog Trainers

Certification Council for Professional Dog Trainers

International Association of Animal Behavior Consultants

Animal Behavior Society

American College of Veterinary Behaviorists

Have you made any “pet resolutions” this year? Does your pet have a behavioral issue that is affecting the quality of your life? Have you successfully dealt with a significant behavioral issue in the past? Please share what you know so that others may offer advice and/or benefit from what you have learned.

Best wishes for a happy new year,

Nancy Kay, DVM

Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, and your favorite online book seller.

A Primer on Leptospirosis

Sunday, July 24th, 2011

Of all the vaccination questions I receive, the most common one is from folks questioning whether or not to vaccinate their dogs for Leptospirosis.  And I am so pleased they are asking- I love when people recognize that simply handing their dog over for “the works” in response to a vaccination reminder card (or these days, perhaps an email reminder) simply doesn’t make sense.

Unlike canine distemper and parvovirus- infectious bad guys that are ubiquitous in the environment and against which all dogs should receive vaccine protection- not all dogs come into contact with Leptospirosis.  Exposure is truly dependent on where you and your dog live and his or her extracurricular activities- in medical jargon this is referred to as “biolifestyle”.  Leptospirosis organisms are bacteria that thrive in warmer, wetter climates.  Wild animals (particularly deer and rodents) and some domesticated animals (cows, sheep, pigs) can be Leptospirosis carriers. Although infected, they manage to maintain good health while shedding Leptospirosis organisms in their urine.  Dogs can develop the disease by coming into contact with the infected urine or urine contaminated soil, water, food, or bedding.  So, if your dog’s biolifestyle includes roaming on rural property or drinking from creeks, streams, lakes, or rivers the potential for exposure to Leptospirosis is far greater than if your pup is a couch potato and your yard is devoid of trespassing wildlife.

Not all dogs become sick when exposed to Leptospirosis, but for those that do, the results can be devastating.  Symptoms associated with kidney failure (lethargy, vomiting, diarrhea, loss of appetite) are most common.  The liver and lungs are also targets for this disease.  Your veterinarian will suspect Leptospirosis based on the history your provide, abnormal kidney and/or liver enzymes on blood testing, and specific blood and/or urine testing for Leptospirosis.

Successful treatment ideally consists of aggressive round the clock intravenous fluids and antibiotics. If the kidneys become so inflamed that urine production diminishes, temporary dialysis may be recommended.  Infected dogs should be housed in an isolation ward to protect other hospitalized patients and personnel are advised to wear protective garb (gloves, gown, goggles) as Leptospirosis is considered a zoonotic disease (humans can become infected via contact with infected urine). Yes, such therapy is expensive- far more costly than the price of a vaccination- and in spite of everyone’s best efforts, some dogs do succumb to Leptospirosis.

The Leptospirosis vaccine provides adequate protection for one year and, in theory, the risk of adverse reactions is no different than reported with other vaccinations.  However, some vets feel strongly that the Lepto vaccine is more likely to produce transient “post-vaccine blues” than are other vaccinations.

Is the Leptospirosis vaccination appropriate for your dog?  Talk to your vet to find out whether or not the disease has been reported in your neck of the woods.  Next consider your doggie’s biolifestyle.  Does your pup live in a pristinely kept environment or does he go camping and hiking with you? If your pup lives in an environment with no standing water or exposure to wildlife, the risks of vaccinating clearly outweigh the benefits.  If you and your best buddy love to hike and camp together, vaccinating may be a no-brainer.  As I routinely advise whenever discussing vaccines: Administration of vaccinations is no different than any other medical procedure- they should not be administered without individualized discussion and consideration of the potential risks and benefits.

Have you considered vaccinating your dog for Leptospirosis?  If so, whereabouts do you live and how did you (will you) decide whether to say “yea or nay” to the vaccine?

Best wishes for good health,

Nancy Kay, DVM
Diplomate, American College of Veterinary Internal Medicine
Author of  Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, and your favorite online book seller.

Trends in Veterinary Medicine

Sunday, June 26th, 2011

Just as human docs are seeing more patients with diabetes, so too are veterinarians.  A first-of-its-kind study conducted by Banfield Pet Hospital (a corporation with more than 770 veterinary hospitals) documents rises in the incidence of diabetes, dental disease, flea infestations, ear infections, and intestinal parasites.  Banfield collected their data from a whopping 2.1 million dogs and 450,000 cats seen during 2010, and then released it as a document called “State of Pet Health 2011 Report.” The entirety of this report is available via the Banfield website.

 

Here are some highlights from this study:

-Dental disease was the most common medical condition reported. In fact, 78 percent of dogs and 68 percent of cats over three years of age had some form of dental disease.  The top five dog breeds most likely to develop periodontal disease included the Toy Poodle, Yorkshire Terrier, Maltese, Pomeranian, and Shetland Sheepdog (it’s a given that small breed dogs have a higher incidence of dental disease than medium and large breed dogs).

-Otitis externa (infection or inflammation of the external ear canal) was the second most common disease, found in 15.8 percent of dogs and 7.4 percent of cats.

-There has been a 32 percent increase in canine diabetes and a 16 percent increase in feline diabetes compared to data collected in 2006.

-Obesity ranked in the top five diagnoses for dogs and in the top three diagnoses for cats.  This may, in part, explain why the prevalence of diabetes is increasing.

-The incidence of flea infestation has increased 16 percent in dogs and 12 percent in cats; rather surprising given the fact that flea control products have been steadily evolving.

-One of the top three diseases found in dogs examined in Banfield hospitals located within the Southern United States was heartworm disease (detected in 6.7 percent of dogs examined).

-Cats in 2010 more frequently test positive for roundworms, hookworms and whipworms (all intestinal parasites) compared to cats evaluated in 2006. Canine hookworms and whipworms have also increased during this same time period.

-Small breed dogs are gaining in popularity.  Chihuahuas represented a whopping 8 percent of Banfield’s patient population.  This represents a 116 percent increase when comparing data between 2000 and 2010.  Labrador Retrievers remained the most common dog breed among Banfield patients, but their numbers decreased by 20 percent between 2000 and 2010.

-The number of feline vet clinic visits is declining.  In 2006 Banfield veterinarians examined 5.3 dogs for every feline visit.  The current ratio is 6.6 dogs for every one kitty.

Dr. Jeffrey Klausner is the chief medical officer for Banfield.  He expresses concern about the rise in some of the preventable diseases mentioned above and he states, “I just can’t help but wonder if there is a correlation between the increase and prevalence of these diseases and the decreasing visits to veterinarians.”

The stated purpose of the Banfield study is to help the veterinary profession gain a better understanding of the state of pet health in the United States, especially in light of many recent reports indicating a decline in veterinary visits.  Dr. Klausner hopes that the Banfield analysis will help veterinarians develop strategies to improve patient care.  The decline in vet clinic visits may correlate with the relatively newer knowledge that core vaccinations (rabies, distemper, parvovirus) need not be given annually.  It appears that some folks view vaccines to be the primary reason for vet clinic visits and ignore the importance of an annual physical examination. Several studies are currently underway to try to understand why feline veterinary clinic visits have declined so dramatically.

Kudos to Banfield Pet Hospital for orchestrating this monumental study.  What a great way to give back to the profession.  The Banfield data underscores the importance of annual visits to the vet (whether or not vaccinations are due) and discussion of preventive health care.  When did you and your pet last visit your vet for an annual physical examination?  Did you discuss dental disease, flea control, or weight management for your pet?

Best wishes for good health,

Nancy Kay, DVM
Diplomate, American College of Veterinary Internal Medicine
Author of  Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, and your favorite online book seller.

Vaccinations for Your Dog: A Complex Issue

Sunday, August 1st, 2010

During my last year of veterinary school, I recall how scary it was when a new canine virus—parvovirus—seemed to appear out of nowhere.  Highly contagious, it spread like wildfire throughout the United States, causing severe illness and often death. It was a downright frightening time for veterinarians and the clients they served. Fortunately, an effective vaccine was rapidly developed, and this horrible new virus was downgraded from a rampant deadly infection to a preventable disease. Thank goodness for vaccines! They provide a remarkable means of preventive health care for dogs. 

As invaluable as vaccinations are for protecting canine health, determining which vaccines are appropriate and how frequently they should be administered are no longer simple decisions. In my book, vaccinations are no different than any other medical procedure.  They should not be administered without individualized discussion and consideration of the potential risks and benefits. Gone are the days of behaving like a “Stepford wife” when it comes to your dog’s vaccinations — it’s no longer necessarily in his best interest to vaccinate simply because a reminder postcard has arrived in the mailbox.

Consider the following: 

• There are currently 14 canine vaccinations to choose from! Back in the days when I was just a pup there were only five, and decision-making regarding vaccine selection for an individual dog was far less complicated.

• Over the past decade we’ve learned that, for some vaccines, the duration of protection is far longer than previously recognized.  In the past we vaccinated for the core diseases (distemper, parvovirus, and rabies) annually.  We now know that these vaccinations, when given to adult dogs, provide protection for a minimum of three years and, in some cases protection is life-long.

• The duration and degree of immune protection triggered by a vaccine is variable, not only based on manufacturer, but from dog to dog as well.

• Other than for rabies (state mandated), vaccination protocols are anything but standardized. There are no set rules veterinarians must follow when determining which vaccines to give and how often they are administered. Unfortunately, some vets continue to vaccinate for distemper and parvovirus annually even though we know that these adult vaccines provide protection for a minimum of three years.  Some vets give multiple inoculations at once, others administer just one at a time.

• Increasingly clear-cut documentation shows that vaccines have the potential to cause many side effects.  While vaccine reactions/complications are still considered to be infrequent, they can be life threatening. 

What you can do:

So, as your dog’s savvy and courageous medical advocate, what can you do to be sure that he is neither under or overvaccinated? Here are some guidelines for making wise vaccine choices for your best buddy: 

1.  Educate yourself about available canine vaccinations and the diseases they are capable of preventing (in some cases treating the disease, should it arise, might be preferable to the risks and expense associated with vaccination). Learn about duration of vaccine protection and potential side effects.  Talk with a trusted veterinarian and read the chapter called “The Vaccination Conundrum” in Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life. It provides detailed discussion about all aspects of canine vaccinations including the diseases they prevent, adverse vaccination reactions, and vaccine serology (blood testing that helps determine if your dog is truly in need of another vaccine). The American Animal Hospital Association’s “Canine Vaccine Guidelines” is also an excellent source of information.

2.  Figure out which diseases your dog has potential exposure to.  A miniature poodle who rarely leaves his Manhattan penthouse likely has no exposure to Lyme disease (spread by ticks); however a Lab that goes camping and duck hunting may have significant exposure.

3.  Alert your veterinarian to any symptoms or medical issues your dog is experiencing.  It is almost always best to avoid vaccinating a sick dog — better to let his immune system concentrate on getting rid of a current illness rather than creating a vaccine “distraction.” If your dog has a history of autoimmune (immune-mediated) disease, it may be advisable to alter his vaccine protocol or even forego ongoing vaccinations — be sure to discuss this with your vet.

4.  Let your vet know if your dog has had vaccine side effects in the past. If the reaction was quite serious, she may recommend that you forego future vaccinations, necessitating an official letter to your local government agency excusing your pup from rabies• related requirements.

5.  Consider vaccine serology for your dog.  This involves testing a blood sample from your dog to determine if adequate vaccine protection still exists (remember, vaccine protection for the core diseases lasts a minimum of three years).  While such testing isn’t perfect, in general if the blood test indicates active and adequate protection, there is no need to vaccinate. Serology may make more sense than simply vaccinating at set intervals.

6.  Ask your veterinarian about the potential side effects of proposed vaccinations, what you should be watching for, and whether or not there are any restrictions for your dog in the days immediately following vaccination. 

Vaccine Clinics

I will tell you right up front that I am not a fan of vaccine clinics -  a “factory line” approach to vaccinating dogs.  Their only redeeming quality seems to be their low cost that makes it possible for some dogs to be vaccinated that otherwise wouldn’t be.  Know that, if you choose to use a vaccination clinic you may be sacrificing quality of care for your dog in the following ways: 

• You may not receive adequate counseling about which vaccinations are appropriate for your dog based on his age and lifestyle.

• Serologic testing will not be an option.

• A thorough physical examination will not be performed prior to vaccination administration.  Abnormalities such as a fever, irregular heart rhythm, or abdominal mass will go unnoticed.  Not only might the vaccination do more harm than good in a dog that is sick, but a golden window of opportunity for early disease detection and treatment will be missed.

• Records pertaining to prior adverse vaccination reactions may not be available.

• The vaccination clinic veterinarian may not be available to tend to your dog should he experience an adverse reaction, especially one that occurs hours to days later.

Have you had difficulty figuring out which vaccines your dog really needs and how often they should be administered?  If so, please share your story with me.

Now, here’s wishing you and your four-legged best friend abundant good health!

Nancy Kay, DVM
Diplomate, American College of Veterinary Internal Medicine
Recipient, American Animal Hospital Association 2009 Animal Welfare and Humane Ethics Award
Recipient, 2009 Dog Writers Association of America Award for Best Blog
Recipient, 2009 Eukanuba Canine Health Award
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life

Website: http://www.speakingforspot.com
Become a Fan of Speaking for Spot on Facebook    

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, or your favorite online book seller.