Archive for the ‘Vaccinations’ Category

A Primer on Leptospirosis

July 24, 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.

Reasonable Expectations VII: Discussion and Open-Mindedness About Your Dog’s Vaccinations

December 27, 2010

This is the seventh part of an ongoing series describing how people are developing new expectations when it comes to veterinary care for their pets. Parts one through six can be found at www.speakingforspot.com/blog

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. Gone are the days of behaving like  “Stepford wives” simply because you’ve received a vaccine reminder postcard or email. Vaccinations are no different than any other medical procedure.  They should not be administered without individualized discussion with your veterinarian and consideration of the potential risks and benefits. Please know that having such a discussion with your veterinarian is a perfectly reasonable expectation, and your input is an invaluable part of the vaccine decision-making process.

Consider the following:

• There are currently more than a dozen 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 against 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 vaccine 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:

As your dog’s savvy medical advocate, what can you do to be sure that he or she 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.  Read the chapter called “The Vaccination Conundrum” in Speaking for Spot. It provides detailed discussion about all aspects of canine vaccinations including the diseases they prevent, adverse vaccination reactions, and the topic of vaccine serology (blood testing that helps determine if your dog is truly in need of vaccine booster). The American Animal Hospital Association’s “Canine Vaccine Guidelines” is also an excellent source of information (http://secure.aahanet.org/eweb/dynamicpage.aspx?site=resources&webcode=CanineVaccineGuidelines).
2.  Talk with your veterinarian to 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.  Talk to your veterinarian about vaccine serology.  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 currently no need for a vaccine booster. Serology may make more sense than simply vaccinating at set intervals.
6.  Talk to 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.

What happens if your veterinarian declines vaccine discussion and simply wants to vaccinate based on what he or she thinks is appropriate?  Time to find yourself a new veterinarian who is progressive enough to have a working relationship with people who choose to be a stellar medical advocates for their dogs!  Is your vet willing to have open-minded discussion with you about your dog’s vaccinations?

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
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
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

August 1, 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.

Potential Dog Park Diseases

April 10, 2010

Many people enjoy taking their dogs to the dog park, and I’m commonly asked if, from a canine contagious disease point of view, the dog park is a safe place for dogs to be.  Here is the advice I give:  

1. Be sure your dog has ample immunity (vaccine protection) against distemper and parvovirus, both of which are life threatening diseases readily transmissible from dog to dog. This can be accomplished by vaccinating at appropriate intervals (more than once every three years for adult dogs is too much) or by regularly performing blood testing (vaccine serology) to ensure adequate protection. Read the chapter in Speaking for Spot called “The Vaccination Conundrum” for a complete discussion on vaccination timing, the risks and benefits of vaccinations, and vaccine serology.

2. Consider the potential risks and benefits of vaccinating your dog for Bordatella (this is often referred to as the “kennel cough” vaccine).  Kennel cough refers to treatable upper respiratory tract infections that primarily cause coughing, the kind that, left untreated, have the potential to keep you and your dog awake all night! Because kennel cough is highly contagious, some dog parks may require that dogs be vaccinated for Bordatella before participating (oy, I can only imagine the nightmare monitoring  this would be).  Unfortunately, the Bordatella vaccination is not a 100% insurance policy that your dog won’t get kennel cough because Bordatella is only one of several microorganisms capable of causing kennel cough.  Treatment for kennel cough typically consists of antibiotics and cough suppressant medication.

3. Intestinal parasites are readily transmitted between dogs, particularly in high-traffic dog park.  If you frequent the dog park, have your dog’s stool sample checked regularly for parasites.  Ask your veterinarian for his or her recommendation regarding frequency of testing as the prevalence of parasites varies from region to region.

4. Heartworm disease (long, spaghetti-like worms that set up housekeeping within the heart) is transmitted from dog to dog via mosquitoes.  Talk with your veterinarian to learn whether or not heartworm disease exists in your area.  If so, be sure your dog regularly receives heartworm preventive (whether you frequent the dog park or not).

5. Fleas are always on the lookout for their next meal, so you may find that your flea-free pooch arrives home from the dog park riddled with fleas.  Discuss options with your vet so you can choose the flea control options that you are most comfortable with.

It’s a good idea for every dog park organization to keep an updated telephone/email list in order to broadcast “contagious disease sightings,” the same way parents receive notification from their children’s school about health issues such as head lice. Bear in mind that, while contagious diseases at the dog park do exist, risks of physical injury associated with canine altercations, and risks of emotional injury associated with human altercations are far greater.  Hmm, perhaps we should begin requiring rabies vaccinations at both ends of the leash!

Best wishes to you and your four-legged family members for 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.

Way to Go, Alabama

July 3, 2009

Alabama is the last state in the union with a law requiring annual rabies vaccinations for dogs and cats.  I was delighted to learn that this is about to change – plans are in the works for the state to amend its requirements from once a year to once every three years.  Why am I so pleased about this?  If you’ve read Speaking for Spot you know that I am a proponent of vaccinations, but I am adamantly opposed to overvaccinating (giving unnecessary vaccinations and giving necessary vaccinations more frequently than necessary).  Giving a rabies vaccination once a year is definitely too much of a good thing. 

Vaccines are not without potential adverse side effects.  As with any other medical procedure, all of the risks and benefits of a particular vaccine should be weighed before a pet is inoculated.  A once a year rabies vaccination offers all the risks with no benefits (protective immunity lasts a minimum of three years).  Kudos to the Alabama state legislature for waking up from their “vaccine slumber.”  I’m delighted they’ve chosen to do what is in the best interest of our pets.

Wishing you and your four-legged family members good health, 

Dr. Nancy Kay
Specialist, American College of Veterinary Internal Medicine 

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. 

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Listen to Dr. Kay’s interview – A Veterinarian Advises “How to Speak for Spot” on NPR’s Fresh Air with Terry Gross –