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Concerned about over-vaccination??


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A few weeks ago we were having a discussion here about over-vaccination. I commented that I was afraid to approach my vet about it, because I thought she'd just tell me I was losing my mind.

 

Well, yesterday on a whim I asked the vet-techs what our Vet's views on it was. Guess what they said to my surprise?? For anyone who ever asks, she recommends giving the dogs titres as opposed to yearly vacc's. However, almost no-one ever asks.

 

So, June goes in for her yearly in two weeks, and we're going to do rabies and bordatella, and then titre for the rest! I'm so relieved - as I was afraid I'd have a fight on my hands. Yippee! As a side note, the titres weren't as expensive as I expected - $80 total for all of them. So, while it will be a tad more expensive than the actual vaccinations, I think it will be well worth the $$ to avoid over vaccinating!

 

Thank you Julie and AK Dog Doc for the encouragement!

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Laura,

 

I spoke with our new vet here in Arkansas on Saturday about the same thing. We are moving out of city limits next month and here in Arkansas they require annual rabies, etc, where in SO Cal rabies was every three years to be licensed.

 

Having an epi dog with one kidney, I hate the thought of pumping all that stuff into her if she doesn't need it. The vet has AGREED! And we will titre both dogs on their next annual.

 

She did recommend annual bordatella because up where we are moving many people let their dogs roam (drives me crazy). But the rest including rabies she will test first.

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Well, glad that worked out well! As a BTW, Bordatella vaccine appears to only give a duration of immuninty of about 9 to 12 months, so yearly vaccination for dogs with exposure risk is a good idea. I'm not sure if the shorter duration of immunity is because Bordatella vaccine is a bacterin (a vaccine directed against bacteria rather than viruses) or if it's some other reason.

 

FWIW, I would LOVE it if my clients showed up asking me for titers. (Hey... how come YOU guys aren't my clients? What do you MEAN you don't want to commute to AK for your vet visits?) :rolleyes:

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What do you MEAN you don't want to commute to AK for your vet visits?
Silly us! We'll be right over - get the wine out while you're at it. :rolleyes:

 

Good for you too Cheri! I can certainly understand your concern. I'm just beginning to learn about this whole subject. Where ya movin to?

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AK Dog Doc,

While I have been known to travel 3+ hours to visit a favorite vet, I think traveling to Alaska is a bit above and beyond the call of duty, though maybe if Laura wants to get a road trip up (and if you're offering wine), then perhaps summer would be a good time to visit?

 

Alternatively, we could get together and fly *you* down here to sunny NC--we can also supply wine (sorry, not home made) and even sheep so you can work your dogs! :rolleyes:

 

J.

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Snerk! :D:D Thanks for the kind words, and as a general thing, for most people summer is not just a good time to visit AK, it's the BEST time to visit AK (for some people, the ONLY time to visit, as the dark and cold are for some mysterious reason deterrents for some folks. Can't figure why. :rolleyes: )

 

Now, if I were to fly south, what I'd REALLY be excited about (apart from meeting y'all and your dogs in person, naturally!) would be your excellent training advice. Once we've thoroughly humiliated me in the stock pens, :D we can collapse and rest the rest of the righteous and sheep-manure-covered, saluting our victories (assuming I had any!) with whatever comes to hand (and I could be persuaded to bring a few bottles in my carry-on.... Speaking of which I just started a new batch which I think will be extra-fabuloso and I'm kind of excited about it.) Sadly I'm down to a narrow variety of selections lately, so perhaps we should wait til my cellar is re-stocked... currently on hand I have only a red zin, a pinotage, one port and one sherry. Oh, and two reserve bottles of Eileen's favorite Buddy-wine (another sherry), so if I were to show up there we'd have to make sure she could stop by. That sounds like a lot, but the port and the sherry(s) are bottled in splits, so that's really not so much.

 

Back to the vaccine thing...

Bordatella IS kennel cough, but there are a variety of "kennel coughs" which can have a variety of different causative agents. By convention when we say "kennel cough" we mean a bacterial infection caused by Bordatella bronchiseptica . Can be nasty and hard to clear up, but usually will respond to antibiotics.

 

"Running titers" (simplified, for the sake of ease of explanation) means to do a blood test and see what level of immunity the dog has toward any specific pathogen. The titer is the level of antibody. So, if you want to see if your dog is immune to rabies, you do a rabies titer and see if the amount of antibody present would be considered protective. This picture is complicated by the fact that there is what is called humoral immunity - antibodies - and what is called cellular immunity, another (very important) branch of the immune system... but this could get pretty intricate, so I'll stop there.

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Originally posted by AK dog doc:

...This picture is complicated by the fact that there is what is called humoral immunity - antibodies - and what is called cellular immunity, another (very important) branch of the immune system... but this could get pretty intricate, so I'll stop there.

If you don't mind, could you give me some links on this bit? I've titered my dogs this year, they have acceptable levels of whatever is tested, but the vet did explain that there is another component to the whole titering thing.

 

Also, Vancouver is much closer than North Carolina, so if you are heading south, come here! We have a few places to work sheep, and Finn can play with Wicked the wonder tongue! (hmm, that just sounds wrong :eek: )

 

Thanks!

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Originally posted by AK dog doc:

... You just want the basics, yes?

Yes please! The part that flummoxes me the most is the delineation between what titre tests indicate as appropriate levels of anitbodies in the dog, versus the other mechanisms of the immune system that protect the dog.

 

I've tried reading articles on the Internet but this topic seems to engender as much passion and wackiness as the raw food debate.

 

Thanks!

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Okay, if it's just that you want to know what the defenses are, I'll outline that. (As best as I can off the top of my head).

 

There are three lines to disease resistance: nonspecific defenses, the cellular defenses and the humoral defenses. The nonspecific defenses are partly comprised of things like mucus and cilia in the airways, the acid mantle and the keratinzed surface of the skin, etc. They provide pysical barriers or mechanisms to prevent pathogens from getting into the body in the first place and are not specific to any given agent, but just a general defense against all comers. Some of the cells of the immune system proper are also non-specific, but are part of the "internal" defenses - what needs to come into play after the pathogen has entered the body.

 

The specific defenses are part of the immune system. The immune system has multiple types of cells at its command. There are neutrophils (which are non-specific, as in not addressed against any agent in partcular), eosinophils (which are involved in parasite responses and allergies), monocytes and macrophages (also non-specifc, but important in presenting antigens to the "specific" arms) and lymphocytes, which are the specific, directed-against-particular-agent cells. The lymphocytes are divided into two main groups, the B cells and the T cells (of which there are mulitple types, to be mentioned later). B cells produce antibodies, of which there are five classes: M,D, G, E and A (in that order on the genome) - and there are subsets of each class, although that's probably more detail than you need. On first seeing an antigen, a B cell is generally presented with it by a macrophage (+/- a helper-T cell). A B cell which can respond to that antigen will then begin to replicate (clone) itself (clonal expansion) and produce antibodies against the antigen it was presented. At first it makes IgM, which is a big, slow, 5-pronged antibody. This may be adequate if you don't see the pathogen again. However, if the pathogen reappears (as occurs when you boost a vaccine), the clone changes over to (usually) IgG (this is called class-switching). IgG is a small, fast, highly agressive antibody which is much more efficient in fighting the pathogen. Generally the clone also expands itself again to handle the threat, and each of the daughter cells is also making antibodies like mad. In effect you've let the immune system know this is an important threat and it should take it seriously. Once the threat is gone, however, the cells gradulally down-regulate and die out... mostly. :rolleyes:

 

Just to make things more fun, there are memory cells. They are why you don't get chicken pox and mumps every year. These are cells that develop out of the expanded clone and hang around for years (sometimes the lifetime of the animal, or nearly that long; sometimes a lot less long). If there is a memory cell hanging around, and the pathogen turns up again, it immediately switches on the clone again and the immune system gears up to kill the pathogen before it causes disease. (BTW, the reason your lymph nodes swell up and get tender when you're sick is that they're crammed with busy little immune cells all replicating and communicating and working like crazy to keep you from being killed by something about a billionth of your size.)

 

The arm that is usually referred to as "cellular immunity" (even though these are ALL cells we've been talking about) is the T cell line. Those are killer T, helper T, Natural Killer (NK) and other sets and subsets of T cells (the immune system is unbelievably complex, if you hadn't gathered - and we haven't even talked about the variable and hypervariable regions of the genome, or any of the subcellular mechanisms, or chemical communications between cells, or immune system modifiers, or interleukins or interferons or cytokines, or...!) :D Back to the T cells. T cells also have specificity to given agents, but act by directly killing the agent rather than producing an antibody which exits the cell and then kills the agent. When T cells kill, they also release the "dead" in processed form to help stimulate the other parts of the immune system, as well as relseasing chemical mesengers which call up more cells (of various kinds). T cells may attack the viral agent directly, or attack the cells that are infected by the virus. This seems counter-intuitive at first (since it means your immune system is killing your own cells) but since viruses replicate by hijacking the cell's production machinery and forcing the cell to make new viruses for release, this disrupts the virus's means of replicating. The cell dies before it can make a lot of new virus which would then go out and infect more cells, so killing the infected cell saves a huge bunch of uninfected cells.

 

The controversy about titering is probably mainly about the thought that we're testing antibody levels and not cellular immunity. (Or at least so I assume, as I have not visited the sites where the controversy apparently rages.) It is true that cellular immunity is important to immunity in general. However, it is ALSO true that humoral immunity is important to immunity in general, and in some ways could be viewed as the "front line" defense (since you always have some circulating antibodies in your system.) Naturally these will eventually fade into lower and lower quantities if there's no "reminder" to your immune system that some pathogen is a Bad Actor that needs to be watched out for. At that point you may be "falling back on" your cellular immunity - which might be more than adequate for the job, but it could be viewed as one step back from the front line, so it may allow a little more invasion before you see the threat and gear up. Also, bear in mind that sometimes memory cells DO die out or are otherwise lost (as in splenectomy, which removes a significant number of white cells from the body), and then where are you? It's rare, but we do occasinally see people who (for instance) get measles or chicken pox more than once in a lifetime. Presumably this is because the memory clone died out and so the immune system "forgot" it should be watching out for that. So, unless you can survey every last white cell in the body and be sure that you still have adequate numbers of B and T cells that remember the pathogen of interest, how do you decide if there's adequate protection? Titers. Until something better comes along, that's where we go to find out.

 

There's a lot of stuff we could go over about immunity against bacteria VS. viruses and how other systems may affect immune system function and so on, but that's the basics. Does that address the question(s) you had? If not I'll try to locate some links for you (but it was easier just to expound a little out of my own head for the basics, since I had that info "on hand" already!) :D

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So, AKDogDoc, do you recommend annual vaccinations or titering as the best alternative? I didn't titer this year but I didn't vaccinate for anything but rabies, after doing all the puppy shots and revaccinating at 1 1/2 and 2 1/2 years of age.

 

It sounds from your posts that titering may not be all it's cracked up to be. If so, would you go with annual revaccinations (and rabies at whatever is required by a person's state) or with titering, and then vaccinating if sufficient immunity levels are not indicated?

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Well, your choices are vaccinate yearly, titer or go with an educated guess (which is essentiually what AAHA guidelines are... they base this guess on some very good research, but IRL no one knows what the immune status of a given dog really is unless it's tested in THAT individual. The guidelines are what one would EXPECT the dog's immunity to be, based on the research evidence - but that evidence was taken from *other dogs*, not the one in front of you. Does that make sense? I don't feel like I'm explaining that very well). I'd prefer titering to guessing, TBH. I didn't mean to give the impression that titers are not a good idea or 'not all they're cracked up to be'. The point I was trying to make is that titers don't tell you EVERYTHING about the individual status of immunity - they certainly tell you SOMETHING about it, and something very important. It just isn't all there is to know, but there currently isn't any good way to GET everything there is to know, at least not in a practical clinical setting. You could do challenges, for instance, where the animal is deliberately exposed to the causative agent, and see if the animal resists it or not; that would be the definitive way to see if the animal is immune, but realistically, that's not going to happen - and it carries some significant risks as an approach, anyway.

 

Every animal is individual in its resitance to disease. The human example that a lot of people may be familiar with is plague. There is a gene which confers resitance to it. If you have one copy, you get sick, but recover. If you have two copies, you con't get sick. If you have no copies you get sick and die (unless modern medicine intervenes.) The individual's genetics determine how well they withstand the disease. The same is, in a general way, true for memory cells.... some animals will "remember" the pathogen longer and better than others. The same individual animal may remember parvo really well, but not be so good at remembering distemper, for instance. This is why titers are nice to have - it lets you know what THAT animal remembers. It doesn't maybe tell you EVERYTHING it remembers, but it tells you something. It's like if someone asks you, "Do you remember in 1992 we went to Lake Tahoe?" and you might go "Nope!" and your sister goes, "Yup!" Well, that's sort of the "titer" of memorability of the Tahoe trip. Your sister's titer says she remembers it and no further testing or prompting is required. Your titer says you DON'T remember it. Now, maybe you DO remember it, but just not based on the question asked. If they then say, "Do you remember learning to water ski?" then you might go, "Yeah, was THAT what you meant by the Tahoe trip? Of course I remember it, how could anyone forget a thing like that?" That would be sort of like your cellular memory of the trip (which, remember, we don't currently have a practical way of testing in-clinic). If you don't remember that, maybe it's time for someone to get out the video tape to remind you about it, or perhaps take you back to Tahoe to trigger your memory, which would be like the booster shot, or slap a pair of skis on your feet and throw you off the dock. That's sort of doing the challenge - exposing you to the situation and seeing if you really DO remember how to ski, or if you need to learn all over again. In rare cases, you've forgotten how to water ski altogether, and have to start again from scratch.

 

So, to recap, I'd prefer titers to guessing, and also (TBH) to doing annual vaccines willy-nilly for most of the viruses. As stated earlier, Bordatella probably needs annual boosting, and Leptospira may need more than a three-year as well. Probably in most dogs just going by the guidelines is going to be adequate, but you can't REALLY know unless you test.

 

I don't at all mind going over the virus-vs-bacteria thing, but it's a gorgeous day here (40 degrees and sunny, and I'm starting to see glimpses of mud through the inches of ice in my back yard! yay! Sheesh. That sounds pathetic, being so thrilled about mud, but there you are. Springtime in AK.) I want to go spend some time outside with el doggos, maybe try to rake some of the frozen poo out of the melting ice (man... you really gotta have spring fever bad if THAT sounds like fun.) :rolleyes: Plus my eyes are going crossed and sting-y from staring at the screen too much. So with your indulgence, I'll do that later.

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Originally posted by AK dog doc:

...Does that address the question(s) you had? If not I'll try to locate some links for you (but it was easier just to expound a little out of my own head for the basics, since I had that info "on hand" already!) :rolleyes:

Absolutely, and thanks so much for taking the time to write all of that! I will have my mom (the chemist) have a look through so that she can explain it to me (the non-chemist).

 

Thanks again!

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I'm sure no one wants to hear this, but I'm posting it anyway.

 

My lab Lucie, who is 7 years old, became extremely ill two years ago about two weeks after she had her yearly shots. When I realized something was wrong with Lucie, it was the weekend so I called the Emergency Clinic. I explained that she wasn't acting right and I wanted to bring her in. After a little arguing I brought her in and they did blood work and we were sent home. By the time we got home, the Clinic had called back and said I needed to bring Lucie back as soon as possible, she was extremely sick.

 

This is what I was told...the vaccines that she received did what they were supposed to do but they also began killing her red blood cells, which was making her sick.

 

I'll leave out everything that we have been through over the last two years, at this point I'm happy that she is still alive and a happy dog. She continues to take medication everyday and will for the rest of her life. The cost of her illness has been greater than $12,000. The company that produced the vaccine offered me $500 to help with her medical expences.

 

She was trained to be a therapy dog and I was in my last year of graduate school for social work. I had planned on she and I working together with children. She can't work anymore and she doesn't understand why. She still has the greatest personality and is one of the most lovable dogs, it breaks my heart that she isn't able to share that love with children.

 

Liz

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Okay, on the virus VS bacteria thing...

 

As a by-and-large thing, viruses stimulate a response by the specific arms of the immune system while bacteria tend to stimulate more of a reaction from the non-specific defenses. This is part of why you can have chronic bacterial infections that are difficult to clear, and also why you can have repeat infections from the exact same bacterial strains over and over again. Viruses, as a general rule, usually stimulate a longer-term resistance and one that is specific to *that virus*. When you get a cold every year, that's a NEW cold virus each time, because the virus has mutated or a new one has come along. You CAN also have chronic viral infections, but these are usually the kind of virus that splices itself into the host genome and remains hidden inside the cell most of the time (as in herpes), or else the kind which destoys the immune system that is intended to destroy IT, via invasion of the immune cells themselves (as in FeLV or HIV).

 

Liz, I'm sorry you had such a horrible and life-threatening event with your dog, and I'm very glad she's still with you. We do see vaccine reactions from time to time, though those are FAR more rare than the morbidity and mortality that we see from distemper, parvo, hepatitis, leptospira, etc, for which we vaccinate. It sounds as if Lucy had auto-immune or immune-mediated hemolytic anemia (AIHA or IMHA)? If so, I have to point out (in the interest of medical clarity) that this disease happens sometimes, whether or not the dog has been recently vaccinated. A vaccine MIGHT be a contributor to such an event (and it certainly might have been in Lucy's case, though I'd be curious to know how that was proven, or if it was more of a speculation); but it could also be coincedental. I've treated a number of these dogs (and owned one myself), and none of them had been recently vaccinated. Also, in the case of my own dog (and at least some of the others), she was vaccinated again later (repeatedly) and never had a repeat episode of IMHA, which means that vaccine can have had nothing to do with it. Unfortunately, IMHA carries about a 60% mortality rate; other immune-mediated diseases vary in terms of their morbidity and mortality. As a BTW, there IS a breed predisposition to immune system disorders (Cockers, Lhasas and Labs for IMHA, for instance), but any breed or mix can have them (mine was a schnauzer-poodle mix). The immune system, elegant and complex and beautifully intricate as it is, is not a perfect system. Errors do sometimes occur, and may be short-term or choronic. The immune system is MEANT to be lethal (besides patrolling against pathogenic invaders, it also patrols for malignant and other abnormal "self" cells and dsetroys them before they become a malignant growth). Mechanisms are in place that prevent it from going after normal "self" cells and molecules, but sometimes that goes a bit haywire. To me it's a miracle that that doesn't happen more often. In a sense we all live in in the middle of a munitions site. As long as everything goes as planned, everyone stays safe and invaders are repelled and tunrcoats are destroyed before they wipe out the home base. If something goes wrong - like for instance, ordinance blows up - it may damage important parts of the home base, or trigger a chain reaction that might destroy the whole thing unless it's somehow reined in. At any rate, I hope Lucy continues well in your excellent care.

 

So, if I haven't answered the questions about the immune system adequately (or if my explanations are muddy), let me know. Immuno was (if you can't tell) one of my very fave subjects in both undergrad and vet school, so I'm not TOO sad to "have" to discuss it. :rolleyes:

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