Saturday, December 28, 2019

The New Year, a request to share what is on your mind, and a teaser about heartworm, flea and tick preventives

The New Year is just around the corner - hard to believe! As spring quickly heads our way, and in light of the crazy (but wonderful) warm weather recently, I'm working on a post for the near future on heartworm and flea and tick preventives. Keep an eye out for that coming soon. There is a confusing array of products available intended to prevent these devastating and distressing parasites. Some market their convenience, some argue their long-lasting effectiveness, and some now carry significant FDA warnings for seizure risks. As we approach the season to make decisions about what we want to do for our dogs, I'll help you sort through the options, the risks, and the research to make informed choices. 

What's on your mind? 
While I work on that, I am interested in knowing what you would like to read about. What challenges are you facing in the health care of your dog, or what have you come across that has piqued your curiosity and you would like to know more?  What New Year's resolutions would you like to share? Comment below with your suggestions for future blog posts, or your suggestions for care. I look forward to your comments and suggestions for future topics.

More resolutions for the new year
As for the New Year, Henry posted his top 8 resolutions last year. You can revisit that here in the December, 2018 post, or find it linked on the SEVA-GRREAT website under the "Medical" tab. This year he wants to add two more:

9.  Expose your dog to new places and stimuli regularly, within the limits of the dogs tolerance.   Anyone experienced with dog training knows that taking your dog to new places is critical to their socialization and the ability to have a well trained dog who is comfortable in a variety of settings. One of my favorite places for training is Lowe's, and a trip down the doorbell aisle where you can test the different chimes is a great place for exposing the dog to different stimuli. Of course, you want to do that carefully, with a dog who is ready for that degree of stimulation, and only one or two chimes during a visit. But that is an example of the kinds of different stimuli, noises, people, etc., that can help a dog gain confidence and learn to handle all sorts of different situations. Some of our rescues will not be ready for something like that for a long time, if ever. But you can accomplish something similar by varying your walking route. Drive a few blocks away and walk in a different area, visit a park. You are out in the world every day, going to work, stores, social events, restaurants, all sorts of things. Your dog's world is the walls of your home. Variety will help the dog grow, develop important skills, and be comfortable with different stimuli. Just to emphasize again, exposure needs to be appropriate to the dog and the ability to tolerate new situations and environments. For fearful dogs, that exposure needs to be very, very positive, perhaps with high value treat rewards. But careful exposure, in a positive way, can help to build confidence in addition to fighting boredom. Henry, once incredibly fearful, loves new smells and sounds and sights and people.... even if we go to the same park, we take a different path each time. At one time he was terribly fearful, and he still is a little unsure when we go to a new place. But he has gained a lot of confidence over time and I want that to keep building for him.

10.  Consider cooking with your dog (a golden retriever's dream, right? It involves food!). There are some very simple treats that are made easily at home where you can control the ingredients. This can also be a good savings approach as made at home treats often are less expensive than "store-bought." I like knowing what goes in my food, and in his.  You can find recipes for treats many places on the internet. Many do not involve cooking at all, or not much, anyway.  One of my favorites is dehydrated sweet potato chews, or I should say Henry's favorite, a good source of fiber and a tooth-safe alternative for some chewing satisfaction. They don't last long as a chew, but it seems to satisfy the urge to chew.  There's always the stuffed kong approach, too, which involves minimal prep and maximum pleasure. An easy recipe to start:  3 ingredient pumpkin and peanut butter dog treat

So while this may not be the typical "medical" blog, we know that good nutrition, healthy food, and good socialization and stimulation are very important to the health of our dogs.  We'll be back with something more specifically veterinary in focus soon when we look at flea, tick, and heartworm preventives. Remember to let me know what you would like to see here during 2020.

Till then, Henry and I wish you all a healthy, happy, and Golden New Year!

Saturday, July 20, 2019

“Stop scratching!!” Common causes of itching and what to do about them

"Stop Scratching!" If you own a golden retriever, odds are really good you’ve said that at least a few times, as if the dog could obey this like a "Sit" or "Shake" command.  Rather than being just an irritating behavior, though, scratching is a signal that something is not right, something that could lead to much bigger problems for our dog.  Our first step is to figure out the cause so proper treatment is started and we can prevent those bigger problems. Some of the more common reasons for scratching that will be discussed here include parasites, environmental allergens, food and other sensitivities, and hot spots.

One of the first things to do if you see your dog scratching is to inspect that area closely.  Look for redness, hair loss, any sores or oozing, or parasites in the area. Look closely for ticks, fleas, or “flea dirt,” the tiny black specks of excrement left behind by fleas. A flea comb can be really helpful in determining if your dog has these awful parasites hitching a ride. Check the head and neck closely as these are prime areas for parasites since they have good access to a canine head poking around under bushes or in tall grass. Feet and legs are good access points also, especially if your dog is walking through tall grass or on trails.  Fleas like to hide in deep fur, so around the ears, armpits, and tail area are good spots for them. Every dog that goes outside should be checked thoroughly at least once each day for ticks and other parasites. It's a good time to feel for lumps and bumps while you're at it. If you find a tick, be sure to remove it properly to minimize disease transmission.

Check out this video for a description of proper tick removal:

Here’s a good link and video about how to use a flea comb to find and remove fleas:

Scratching around the head also can be an early sign of ear infection, so take a good look under the ear flap. Redness or heat in that area, a foul odor, or an ear flap with tiny specks of brown (typical of yeast infections) or that otherwise looks dirty may indicate an infection is building so a trip to the vet is in order. 

Another common cause of scratching is natural environmental allergens. Pollens and molds are abundant in much of Virginia.  These can be problems for both humans and canines. Some people may notice that when they start sneezing or feel the pressure of sinus congestion their dogs start scratching, too.  That may be a sign that environmental allergens are on the rise and a notice to be on the lookout for sensitivities in your dog. Dogs can have issues with pollens just from walking across grass, and rolling in it may bring instant pleasure but an itchy night later. Feet are particularly vulnerable due to contact with grass pollens (and chemical residue on many lawns which, despite advertisements to the contrary, can still be transferred to the dog long after application). In such cases, something as simple as a good foot wash for the dog (and shoe removal for the humans) before going into the house can work well to remove those irritants and limit the amount that enters the house.  A dog who likes to roll in the grass might benefit from a soothing rinse to remove irritants from the fur.  My current dog had no problems with itching before moving to Virginia (thank you, humidity and pollens!). Foot rinses during pollen season and HEPA air filters inside the house have made life much better for both of us. His bedding also gets washed weekly with mild, all natural, unscented detergent.  

Bathing - A complete bath may be needed but optimal schedule varies for each dog. Obviously baths are needed more often for a dog who swims and gets fur full of sand, one who frolics in mud, and dogs like one of mine who loved nothing better than rolling in dead alewives on the shores of Lake Michigan (if you’ve been to Lake Michigan, you know what I’m talking about).  Baths can be beneficial to remove irritants and restore a dog to a huggable condition, but they also can be detrimental if they dry out the skin, strip it of essential oils, or if the dog is not dried properly afterwards. The need for baths varies, but in general no more often than once each week and use only a mild solution made specifically for dogs. Many with skin sensitivities benefit from conditioning hypoallergenic or neutral shampoos which can be soothing as well as cleansing. Before bathing, a good brushing to remove loose fur and undercoat will make the bath more effective and avoid trapping of moisture against the skin by that cottony undercoat. Be sure to dry the dog thoroughly afterwards with a clean towel. If you use a dryer, use only low heat and keep the dryer a distance from the dog to avoid burns or excessive drying of the skin.

Dull, dry, flaky skin can be a cause of itching. If your dog fits this description, a quality fish, krill, or green lipped mussel based oil supplement can provide significant relief from dry, itchy skin. Fish oils are known to carry a lot of impurities, however, so processing and quality control are important. Look for products tested for purity by a third party lab and who make those results public.  With rare exception, most dogs benefit from fish oil/Omega 3s, not just those with skin problems. There is extensive research supporting their anti-inflammatory effects as well as benefits to nerve transmission and heart muscle health in both humans and dogs. The difference in skin condition can be remarkable as well and generally shows up fairly quickly if this is going to make a difference in skin and coat health.

Other causes for itching should be considered if the dog has chronic problems regardless of weather conditions or seasonal variations.  Food sensitivities or household products could be irritants for the dog, so there are other avenues to explore if problems with itching persist throughout the year. A discussion with your vet can help identify possible sources, but some easy things to consider in advance of that visit are possible irritants around the house such as cleaning materials or laundry detergents. Minimizing use of chemicals with which the dog may have contact, including scented laundry detergents or cleaning agents used on flooring, can be very helpful to the sensitive dog. A change in diet may be worth considering, especially if your dog has year round skin problems and is on a diet based on proteins often associated with sensitivities.

Hot spots – a phrase that strikes fear in many golden retriever owners.  Hot spots, also known as  “moist dermatitis,” arise quickly, spread rapidly, can be challenging to heal, and make your dog miserable. Since they often require a cone to restrict the dog’s access to the spot, we definitely want to do what we can to minimize occurrence and speed healing. Hot spots are preventable in many instances. Common causes include wet fur from swimming or bathing without proper drying; skin irritation from parasites; dermatitis from contact with various irritants including pollens or household products; and improper skin and fur hygiene, with matted fur provoking the dog to lick and chew and also trapping moisture and bacteria. High humidity such as we see in much of Virginia creates a double-whammy with these other conditions leading to an optimal environment for hot spots. It is important that we prevent these dreaded skin problems as much as possible, intervene quickly, and be diligent to put healing on a fast track.  

Hot spots arise when scratching and itching problems are not addressed promptly and the dog damages the skin leaving an open wound. This wound leads to more scratching and licking and chewing (keeping things moist) and in no time at all can be a significant size and also infected. Hot spots generally are associated with bacterial infections, so they need proper treatment and avoidance of scratching to heal. Hot spots appear as defined areas of redness. They are moist and often oozing with drainage that that collects in the surrounding fur. They itch terribly which makes it very hard for the dog to leave that site alone and which, of course, contributes to rapid enlargement. These wounds often have a secondary bacterial infection, so treatment by a vet is recommended.  There are a number of over the counter preparations and instructions on the internet for home remedies, but contents vary and some could be additional irritants or even toxic (such as some essential oil remedies I've seen). These could make the wound worse or at least they may be ineffective and delay healing. The usual veterinary treatment is to shave around the area so the wound is open to air, and then a prescribed process for cleansing with an antiseptic solution. Following cleansing, usually there is application of an antibiotic preparation. This antibiotic preparation may be combined with something to help manage the itching.  While it might be possible to manage these at home, especially with experience, the rapid spread and slow healing make it worth a trip to the vet to get treatment going before things get even harder to heal. Typical healing time is 10 days or more depending on the size and depth of the wound. It is important to keep the dog from injuring this area further while the spot heals, thus a cone or restrictive collar may be needed.  

Scratching is an important way for our dogs to tell us something is bothering them. We want to provide close inspection to see if we can determine the cause and also so we can report to the vet as much detail as possible. Early detection of parasites, good management of skin condition and hygiene, healthy diet, and limiting environmental irritants can do a great deal to keep your dog happy and itch-free. Dogs who have frequent problems may benefit from a variety of products to manage recurrences if needed and avoid complications of too much scratching. Many causes of itching can be managed very well at home as noted above.  For recurring problems that do not respond to such intervention, talk with your vet to determine what is going on with your dog and the best management approach. Diligence and early intervention, and consultation with your vet, are key to keeping your dog as itch free as possible and avoid bigger skin problems.

Sunday, March 17, 2019

Pet Poison Awareness Week: Risks, Prevention, and Response

March 17 - 23, 2019, is designated as Pet Poison Awareness Week.  This potential danger for our dogs should be on our minds every day, but having a designated week reminds us to strengthen our awareness of this important aspect of the care of our companions.  It is a good time also to make sure we are doing all we can to keep our pups safe from poisoning and that we know what to do in the event of suspected poison ingestion.

Signs of possible poisoning: One of the most frightening experiences we can have with the animals in our care is to find our companion acting ill and we have no idea what could have happened. Poisoning often needs to be a consideration but can be challenging because the signs vary depending on the poison and how recently it was ingested. In general, you might see any of the following in a case of poisoning:

GI signs such as vomiting, diarrhea, black or tarry stool, excessive salivation or drooling, nausea or loss of appetite, excessive thirst, or really bad breath; signs of internal bleeding such as coughing of blood, vomiting blood, pale gums, rapid heart rate, weakness or lethargy, loss of consciousness or collapse.  Some of these signs are indicators of potential kidney or liver failure. 

Signs of poisoning often are very subtle at first and then become more obvious. There might be a little tiredness, easy to dismiss as just due to a day of fun activity. Then more lethargy, or maybe a little vomiting, then more vomiting. Or something is "just not right" but it doesn't seem like any big deal, until it gets more "not right." Early intervention is critical if you have any reason to think your dog may have ingested a dangerous substance. 

In 2018, the ASPCA poison control center responded to 213,773 cases of potential animal poisoning.  Keep in mind those are just the cases for which someone called the ASPCA poison center. Undoubtedly many more were not caught in time or were dealt with in some other way, such as an emergency trip to the vet. Fortunately, there is a lot we can do to minimize the risk to our dogs and to help them in the event of suspected poisoning.

Common toxins in the home and yard: The ASPCA lists the following as the top animal toxins for which they received calls in 2018 (they have a top 10 list, but there is some overlap so I've condensed it for easy reading):
  • Medications, both over the counter and prescription products. This category includes vitamins and supplements. In some cases, this could be the result of someone trying a human remedy on a dog. In other cases, improperly secured medications were ingested by the dog. All products intended for human consumption, whether prescription or not, need to be stored securely and out of reach of pets, and not used on dogs without the guidance of a veterinarian.
  • Foods, chocolate, and artificial sweeteners. This includes a wide variety of items but xylitol, grapes, raisins, onion, and garlic were the top poisons in this group.  If you own any "sugar free" foods or candies, keep them far away from your dog. Many contain the highly toxic ingredient xylitol. Others may contain sweeteners known to cause diarrhea. Other foods to keep securely away from your dog include anything with caffeine or alcohol, macadamia nuts, and chives which are in the onion and garlic family.  Chocolate is extremely toxic with often fatal results, especially for dark or baker's chocolate.  Unfortunately, many dogs are drawn to this deadly item. The ASPCA center received approximately 60 calls per day about chocolate ingestion.
  • Veterinary products. This includes medications administered improperly or poisoning due to labels not being read correctly or not following directions of the prescribing veterinarian.
  • Household items. The typical house is loaded with highly toxic items. Look under your kitchen or bathroom sink to see the array of potentially deadly products stored there. Paint and glue, oils, antifreeze, cleaning products, even some health and beauty items such as lotions, soaps, and cosmetics can be toxic to a curious canine. Some essential oils also are highly toxic to dogs. Remember that whatever you use to clean the floor will end up on your dogs paws or fur, providing a mechanism for possible ingestion. 
  • Rodenticides and insecticides. The same thing that makes those baits appealing to rodents makes them appealing to our dogs. Keep in mind that a dog consuming a dead mouse is ingesting not just the rodent but whatever that rodent has eaten. If the rodent was killed by rodenticide, your dog has just consumed rodenticide also. Bug sprays, repellents, and ant baits are common insecticides your dog could contact.  Our dogs make contact with the floor constantly, so exposure is not just through obvious traps or baits but may also come from contact with residue that is licked off the paws or fur.
  • Plants.  It is possible to love houseplants, gardening, and also dogs. Some even like to help with the digging chores. But we do need to choose plants with care.  There are many available that are safe for pets, but some of the most popular ones are highly toxic. A bored dog can easily destroy that beautiful hyacinth and end up with a trip to the ER assuming you catch it in time. Is your dog inclined to chew on a fallen or low hanging branch? Consider your yard plants also as many of those are highly toxic as well.  The ASPCA has a comprehensive guide for house and outdoor plants that is a must read for any dog owner. When I moved into my current house, there were some beautiful azaleas and rhododendron in the back yard. Not any more. I did find a spot in the front for them, fortunately, outside the fence. Way outside the fence where my dog never goes. The deer are very happy I did that. But that points out just how the definition of "poisonous" varies by species. The deer eat them readily, and other bovidea species such as sheep and goats would do just fine, but my dog could end up in cardiac failure or neurologic crisis if he ate them. My dogs also have had an amazing ability to find poison mushrooms and toads, so I spend a lot of time in the summer doing yard patrol to remove such hazards. 
  • Lawn and Garden products. Fertilizers, bone meal, compost, mulch, treated hardwoods, and herbicides all can be highly toxic to your dog. But they told you the lawn was safe for your dog after the weed and feed application dried, you say? Short answer, no it is not. The label saying it is safe after it dries is based on specific testing.  Numerous studies have shown that residue can be transferred from grass to a dog's paws long after a liquid product has dried or a granular product has been watered into the soil or rained on. That residue will be on the grass, then on your dog's paws and fur, and then in your house.  Usually that amount of exposure does not cause immediate poisoning, but long term risks remain. Herbicides and fertilizer products themselves, however, could cause a more rapid poisoning. Some wood mulch, like some lumber prepared for outdoor use, is treated with toxic chemicals and can be poisonous if ingested.  Many dogs are very attracted to Cocoa mulch, sometimes called cocoa bean mulch, which is a byproduct of chocolate production. Cocoa mulch has the same components that make chocolate toxic and can be very dangerous if ingested.      

Usually we think of poisoning as the result of accidental exposure, but it can occur with intentional exposure as well. Some dogs have had toxic reactions to flea and tick products which, even when used as directed on the label, can have serious side effects. Each dog is an individual when it comes to sensitivity and reaction. 

This is by no means a complete list. But I hope that a look at the array of products listed, with special consideration to all the additional hazards that seem to come with lawn and garden season every year, will heighten awareness of the dangers our dogs (and we humans, too) face on an everyday basis. Be mindful of the hazards that exist, know what to do if you find your dog has ingested something it shouldn't, and keep the poison control center number handy just in case.

More information: One of the best resources for more information:

Here you can find details about all sorts of toxic substances your dog might encounter as well as a guide for selecting safe plants for your house and yard. The guide covers dogs, cats, and other animals since toxicity is not the same for all species.

What to do if you suspect poisoning: If you have a case of suspected poisoning, quick action is critical.  First, if you can, try to identify the potential toxin. If you know what your dog consumed, grab the container to stop further ingestion and so you can tell a poison control expert about the product. Next, call a pet specific poison control helpline. There are several, and most do charge for the service. Charges may be waived for dogs registered with certain microchip services. AKC Reunite microchips are associated with a free poison control helpline but the service must be activated in advance through the AKC reunite website. Another well known source for poisoning-related information is the ASPCA Poison Control Center (888-426-4435).  Know where your nearest 24 hour veterinary emergency center is also. While you are thinking of it, put this number and the number of your Vet ER in your phone. Think of it as insurance, something you really need to have but hope you'll never use. Do not try to treat the poisoning until you receive professional advice about the product ingested. Depending on the poison, it may be appropriate to induce vomiting, but vomiting can cause additional harm in some cases. Always get the advice of a poison control specialist first. Keep a fresh bottle of 3% hydrogen peroxide available, along with a measuring spoon and syringe or measuring dropper, in the event you are directed to use this to induce vomiting. Keep it sealed, and replace it before the expiration date. Fortunately, hydrogen peroxide is inexpensive, but it is worth a fortune if you have an emergency and need to use it to induce vomiting.

Hopefully you will never need it, but here's a video on how to induce vomiting using hydrogen peroxide. There is some good information here about when not to induce vomiting, also.  Be sure to contact a vet or poison helpline first.

How to induce vomiting in a dog (and when not to)

In the near future I will provide a blog post about natural alternatives for some common household products including my favorite recipe for a non-toxic flea and tick repellent that really works.

Stay safe out there!

Friday, January 25, 2019

Titers or vaccinations? (Or, is your dog really “due” for vaccinations?)

Be forewarned, this is a long entry, but I want you to have sufficient information to be an informed partner in decision making with your vet about what is best for your dog.  While I hope you will take the time to read this so you understand the current recommendations, I have provided a summary at the end of this post.  Spoiler alert: I have been getting titers rather than repeated core vaccines for my goldens for more than 20 years, which is as long as I’ve been able to find veterinarians who were willing to do that. I was living in Wisconsin early in this time frame and, with one of the best veterinary immunologists in the country not too far away, I may have had earlier access than many to titer testing as an option.  Still, I had to make a lot of calls to find a vet who shared my viewpoint. OK, now I’ve given away the ending to some extent, but there are many angles to this topic, so please keep reading.  Health care decisions about your dog need to be based on informed discussions, not quick sound bites that came from the internet.  

How immunity and vaccines work. Let’s start with a very simplistic overview of how vaccines work (my immunologist colleagues will cringe, but they’ll get over it).  Vaccines are created with actual disease-causing bacteria or viruses that have been altered so that they do not cause the disease with which they are associated. Vaccines come in a variety of forms; you may have heard the terms “killed virus,” or “modified live virus,” both of which describe the way a disease-causing organism in a vaccine is altered so it does not make your dog ill.  When a vaccination is given, one of the things that happens is the lymphatic system produces antibodies to fight off the invading organism in the vaccine.  The antibodies remain in the body for a time, sometimes a very long time, and are primed to attack that virus or bacterium should it be encountered in the future.  There are a number of complex and interacting mechanisms that are involved in the immune response and different types of immunity, but antibodies generally are the first line of defense and the one involved with the titer testing we will be discussing.  So I’ll leave it at that. 

Sometimes more than one injection of the vaccine is needed to generate sufficient antibody response.  This is the case with “puppy shots” and also the reason that follow-up or “booster” injections sometimes are recommended after the initial injections.   Some animals do not respond completely to the vaccine and develop weak or limited immunity, though this is uncommon.    

How long is my dog immune after a vaccination? For many vaccines, immunity may develop that can last for several years or, in many cases, much longer.  The type of original vaccine as well as the animal’s response will affect the duration of immunity (DOI).  For some, it may last only about one year, which is why the Bordetella vaccine and a few others are recommended for annual revaccination. 

Dr. Ronald Schulz of the University of Wisconsin (Madison) School of Veterinary Medicine, one of the leading researchers in the area of veterinary vaccines and an author on the recent guidelines created by the American Animal Hospital Association (AAHA) and the World Small Animal Veterinary Association (WSAVA), has done extensive research on the duration of immunity achieved with initial core vaccines.  His research, going as far back as the 1970s and using the best techniques for studies of this type, has demonstrated repeatedly that the core vaccines provide immunity on average for 7 years or longer and, in some cases, immunity from initial vaccination may last for the life of the dog.

Core vaccines are the ones considered to be critical to the health of the dog and are recommended for all dogs. They include only the following at present:
  • Modified Live Virus (MLV) or recombinant Canine Distemper
  • MLV Parvovirus
  • MLV Adenovirus-2
  • MLV Parainfluenza Virus
  • Rabies

Adenovirus is related to canine hepatitis, so you may know the combination vaccine as the DAPP or DHPP (distemper, hepatitis, parvovirus, and parainfluenza). All other vaccines are considered Noncore, or to be given only if individual circumstances warrant based on a balanced consideration of risk and benefit. Risk includes how likely the dog is to encounter the disease organism based on environment or behavior, the risk to the dog if it contracts the disease, and whether the protective effects of the vaccine warrant the risk of the vaccine administration. Risk assessment might also include whether the disease can be avoided in other ways, for example, through minimizing exposure or using other means of prevention. 

In 2003, with evidence increasingly showing that the prevailing standard for yearly re-vaccination was not necessary, the major veterinary and animal hospital associations revised their guidelines to recommend a 3 year interval for re-vaccination.  The 3-year interval was a compromise position based on a number of considerations, not based on evidence that immune status lasted only 3 years. Since that time, the recommendation has evolved so that the guidelines now read that the interval between vaccination administrations should be a minimum of 3 years, in other words, as a general principle, a dog should not be vaccinated with core vaccines any more often than every three years.  As stated in the current guidelines of the World Small Animal Veterinary Association, “above all, it must be remembered that even a 3-year license is a minimum DOI [duration of immunity] for core vaccines and for most core vaccines the true DOI is likely to be considerably longer, if not lifelong, for the majority of vaccine recipients.”

What to do when your dog is “due” for vaccination (after initial vaccination series is complete)?  Immunity does not fall off precipitously on the vaccination “due” date. In addition, there is all that evidence that shows that for many vaccinations immunity lasts much longer than three years, often for the life of the dog. That leaves us with several options: assume the dog continues to have satisfactory immunity and do not obtain additional vaccinations (might be ok, but we have no way of knowing so there is risk to your dog with this option), booster the vaccinations just to be sure (might ensure immunity but there are risks to your dog of unnecessary vaccinations), or do serum titers that provide a measure of current immunity (evidence supports this as best practice).  Re-vaccination, if not needed, is of no benefit to the dog; a dog with sufficient immunity does not become more immune, so it is at minimum a waste of money and may be harmful because of possible negative effects of vaccination.  An adverse response to vaccine can occur with an array of symptoms and severity that ranges from mild to life threatening. While this is relatively uncommon, it does occur. Animals that are immunocompromised or have other health problems may be more likely to experience adverse reactions and this response also is more common in certain breeds and smaller dogs.  There is some evidence that the risk of adverse effects might increase with repeated vaccinations.  Vaccines trigger a complex immune response and the outcome of this repeated triggering of the immune system may have detrimental health effects ranging from short term lethargy to serious autoimmune disorders. There is a need for more research in this area although both research and anecdotal reports show that there is at minimum some risk associated with vaccines. 

The titer option.  Fortunately, we do not have to rely on guess work or just hoping for the best to protect our dogs. Research has shown repeatedly that antibody titers are a good measure of immune status following the initial core vaccination series.  (Initial titers sometimes are done after that series to ensure that the dog responded appropriately to the vaccines as there are a small number of dogs who are “non-responders”). The AAHA guidelines note that “a ‘positive’ antibody test result [for the core vaccines] generally does correlate well with protective (sterile) immunity in dogs. This applies to not only laboratory-based testing procedures (quantitative testing) but to in-clinic point-of-care (qualitative testing) antibody kits as well."  One deterrent to titer testing had been the fact that it was more expensive, especially with samples sent to a laboratory for testing. As more people have sought titer testing in lieu of repeated vaccinations, and more veterinarians are receptive to this approach, prices have come down and new options are available, including the tests that veterinarians can perform in their own clinics. 

The WSAVA guidelines describe titer testing as the better practice compared to repeat vaccination:  “The [Vaccination Guidelines Group] recognizes that at present such serological testing might be relatively expensive. However, the principles of ‘evidence based veterinary medicine’ suggest that testing for antibody status (for either puppies or adult dogs) should be better practice than simply administering a vaccine booster on the basis that this would be ‘safe and cost less’.” Titers currently are available for all of the core vaccines. Titers should be monitored regularly to determine when revaccination might be indicated. Most people who use titers to monitor immune status repeat these with the yearly exam. The best interval can be determined by your veterinarian in discussion with you about your dog’s lifestyle and it also will vary depending on the specific vaccine administered previously to your dog. 

The rabies vaccination exception.  Unfortunately, we are faced with one exception to this decision making process due to the legal requirement for rabies vaccination. Rabies titers are available but few, if any, localities have changed their laws to match best practice for rabies vaccination.  Some local governments have a process to apply for an exception with exceptions being considered if the dig is debilitated or otherwise compromised such that the vaccination is likely to be harmful to the dog. These exceptions require approval by a local health officer and may be difficult to obtain.  Rules vary by locality.  In the event of a bite incident, the dog who is not up to date with rabies vaccination, even if only a few days past the due date, could face dire consequences, a risk that is greater than the risk of contracting rabies if the vaccination becomes past due.  So the rabies vaccine is needed when local laws dictate to protect the dog from legal ramifications if not the disease itself.  At least the rabies vaccination schedule has been changed to a 3 year interval, and the particular vaccine is of less burden on the immune system than some other vaccine types.  Further effort to extend that timeline or to gain acceptance for rabies titers will help alleviate this burden on our dogs.  

Summary – Current best practice

The current best practices regarding vaccines and your dog, supported by decades of quality evidence and as expressed in the guidelines of the American Animal Hospital Association and the World Small Animal Veterinary Association, support the following:

1.  Ensure baseline immunity through proper administration of core vaccine initial series.  For puppies, this involves administration, on the proper schedule, of the recommended “puppy shots” and booster. For adult dogs with unknown vaccine history, there are a couple of different options depending on what is known and the veterinarian’s approach. 

2. If finances allow, conduct a titer test to determine responsiveness to the initial vaccines. A blood sample taken about 4 weeks after the last vaccines in the series can be analyzed to determine that the dog is showing the desired immune response. The incidence of non-responders is quite low, so this is not essential, but if you want to be really certain that immunity has been established, this option is available. This may be particularly useful if the plan is to do titers in the future.

3. Avoid unnecessary vaccinations, including re-vaccination and non-core vaccines that are not indicated by your dog's individual situation. Consider carefully with regard to the dog’s lifestyle and risk whether any of the noncore vaccines are needed.  Balance the benefits of protection against the risk of the disease, both in terms of the risk of your dog contracting the disease and also the seriousness of the disease if your dog becomes ill.   

4. Perform serologic (titer) testing at intervals to determine maintenance of immunity. Revaccinate only when titers indicate booster is necessary (generally before it falls into the negative range) or if changes in the dog’s risk status warrant.  

5. If titers are not an option, then minimize vaccination by at least having your dog vaccinated no more frequently than necessary and with only the vaccines appropriate for your dog. Discuss with your vet the best management approach for your dog based on the dog’s lifestyle.

Wishing you and your dog the best of health!  

Links for more reading are provided below.  I welcome your questions and comments.