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Old May 19th, 2007, 09:01 PM
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Vaccinations senior dog - Answered by Dr. Lee

I took our 11 year old dog, Rusty, to the vet today for her yearly check-up and discovered that a new vet was filling in for the long weekend. We absolutely love our regular vet but this one seemed nice enough so I figured all would be okay. I made it clear to the vet right away that I wasn't interested in having Rusty vaccinated because of her age. She had a 3 year rabies show in December 2005 but hasn't received any regular vaccines since December 2004. I've done my research and feel that a dog her age should be vaccinated every three years tops (if at all). Unfortunately, the vet didn't respect my wishes and kept going on about how she should at least be vaccinated for parvo because older dogs are at higher risk for parvo (which is the opposite of what I've read), especially if they go to dog parks regularly (which Rusty does) and she made me feel so guilty that I reluctantly agreed to let her vaccinate Rusty for parvo ONLY. Rusty had to have a suspicious lump deep in her neck aspirated so she was taken to the back of the clinic. The vet brought her back a few minutes later and said "we gave her her parvo vaccine while she was back there, which is a 4-in-1 vaccine that also includes distemper, parainfluenza and hepatitis." I honestly couldn't believe what I was hearing. I said, "I thought she was being vaccinated for parvo only?" and she said "parvo isn't given alone but in combination with other vaccines." At no point did she explain this to me when I agreed to have her vaccinated for parvo only.

I was so shocked and upset that I didn't know what else to say and I left the clinic on the verge of tears. I feel like I've failed my old girl by agreeing to allow her to be vaccinated at all. :sad: I'm so angry with myself for not raising hell with the vet for giving Rusty vaccinations I did not agree to and putting her health at risk in the process. I wish I had refused to pay for anything but the examination, aspiration and the cost of a single parvo vaccine.

Am I being totally unreasonable here?
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Old May 19th, 2007, 09:09 PM
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WOW - you have every reason to be upset and angry! I'd be upset too.. You might consider telling your regular vet about this incident - hopefully to prevent it happening again to someone else!
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Old May 19th, 2007, 09:19 PM
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No, I don't think you are being unreasonable at all. The prevailing thought amongst the more progressive vet community is that older dogs don't need any further vaccinations, beyond what may be required by law (rabies). A similar thing happened to me a couple of years ago, when I had to use a walk-in clinic to get a rabies vaccination for a trip to the U.S. (our regular vet was fully booked, and this was last-minute). I only realized after I left that they had also vaccinated (via a second syringe) for distemper/parvo etc. I wasn't paying too much attention when they were vaccinating him, and hadn't really processed the fact that they had used 2 needles.

According to Dr. Jean Dodds, however, vaccinating senior dogs seems to be troublesome only if the dog is experiencing geriatric-type disorders, or has a problem with the immune system. I would think that if your dog is fairly robust, healthwise, that she will not suffer any ill effects. If she is still frolicking at the dog park, it sounds like she is doing well.
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Old May 19th, 2007, 09:21 PM
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Thanks, Jan. It's comforting to know that I'm not overreacting here. I've felt sick about it all day and the more I think about it the more angry I become.

I most certainly plan to call my regular vet on Monday and tell her how furious I am about what happened. The thought of this vet doing the same thing to another dog or cat makes me physically ill. :sad:
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Old May 19th, 2007, 09:26 PM
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You're a paying customer, the vet should have done what was asked from you. You should defenetly tell your regular vet. Is Rusty feeling alright tonight ?
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Old May 19th, 2007, 09:33 PM
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I'm so sorry to hear that the same thing happened to you, satchelp.

Those are exactly the guidelines I read while researching vaccinations earlier this week. I read that some vets believe every 3 years is adequate (particularly in younger animals) but that older dogs have usually built up enough immunity to last them a lifetime.

Thankfully, Rusty doesn't have any major health problems for a dog of her age. She does have arthritis in her hips and knees (though she's doing quite well on daily glucosamine and aspirin) and she was diagnosed with and surgically treated for an autoimmune eye condition (KCS) during her first year of life. The eye condition does make me worry that she's immunocompromised to some extent.
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Old May 19th, 2007, 09:47 PM
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I totally agree, Frenchy. Why she would do something so sneaky behind my back after I expressed my concern about vaccination is truly beyond my understanding.

Rusty has been mostly sleeping (and snoring up a storm ) since we returned from the vet late this afternoon. She eagerly gobbled up her dinner this evening. I'm definitely keeping an eye on her for any adverse reactions.
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Old May 19th, 2007, 11:43 PM
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How completely arrogant of the vet to do that! I'd be pissed to no end. I would for sure let the regular vet know this one overstepped their bounds.
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Old May 20th, 2007, 09:29 AM
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Quote:
Originally Posted by celticfox View Post
Rusty has been mostly sleeping (and snoring up a storm ) since we returned from the vet late this afternoon. She eagerly gobbled up her dinner this evening. I'm definitely keeping an eye on her for any adverse reactions.
I'm sure she will sleep it off. Good girl Rusty !
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Old May 20th, 2007, 12:15 PM
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wow. i would have been super pi$$ed too!!! that is unnacceptable and i would say a little unethical. totally tell your vet when she gets back.
hope Rusty is feeling fine and happy today!
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Old May 21st, 2007, 07:06 PM
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Ontario vets are a total PITA about vaccines, most totally reject the US studies

I have been battling with my vet about with 2 seniors and an immune comprised dog

Sorry about your incident
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Old June 23rd, 2007, 01:32 AM
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indoor cat vaccines

You sure have me thinking about things. Excellent site--sure glad I joined. By the way, I have 2 cats that are never let outside except on the porch. I had both given "full" sets of vaccines including feline leukemia, just in case. They are microchipped and neutered/spayed. The male born to a feral mother, the female was semi-feral rescue but still hides from visitors. Linus literally screams and hisses when taken to the vet before anything is done while still in his cage. I can only guess what Muffin will do. Are the initial vaccines enough for them if they are not permitted to roam throughout the neighborhood? They are only 2 and 1 years old now. One or both will have to be sedated prior to routine office visits, most likely. Thanks.
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Old June 24th, 2007, 03:14 AM
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No, the initial shots really aren't enough protection, even for indoor cats.

I believe that rabies can be given every 3 years now, but that will probably depend on where you live and what your vet recommends. I believe everything else should still be done annually. Also, your cats really would have needed booster shots in addition to those initial shots, or you'll have to start the process all over again.

Even though your cats don't go outside, you could actually bring viruses into the house that they could contract. Viruses like panleukopenia can actually live on objects and can be transferred on clothes and shoes. So if you came into contact with an infected animal, you could unknowingly spread that potentially fatal disease to your house cats.
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Old June 24th, 2007, 09:16 AM
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Quote:
Originally Posted by Barbaraann View Post
You sure have me thinking about things. Excellent site--sure glad I joined. By the way, I have 2 cats that are never let outside except on the porch. I had both given "full" sets of vaccines including feline leukemia, just in case. They are microchipped and neutered/spayed. The male born to a feral mother, the female was semi-feral rescue but still hides from visitors. Linus literally screams and hisses when taken to the vet before anything is done while still in his cage. I can only guess what Muffin will do. Are the initial vaccines enough for them if they are not permitted to roam throughout the neighborhood? They are only 2 and 1 years old now. One or both will have to be sedated prior to routine office visits, most likely. Thanks.
My indoor cat is 7 and hasn't had any shots since he was 2. He hasn't been sick a day in his life. I don't have many friends with cats and I do not go around attempting to pick up strays. Rabies is not a problem where I live and I don't make it a habit of inviting wild animals into my home.

Sorry, but the more I read about vaccines - the more I believe that I am right in NOT vaccinating my indoor only cat.
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Old June 24th, 2007, 01:15 PM
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I would be very upset,and probably switch vets.

I havent found that OntarioGreys,but if I did,I would switch vets.Vaccination decisions are our decisions.It is not for the vet to decide.
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Old June 24th, 2007, 04:35 PM
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No over-reaction there. I'd be mad as heck.

My dogs are still young so it hasn't become an issue yet for us... However, I usually run into a lot of trouble here regarding the vaccination schedule. Our previous vet with our previous dog insisted on FULL annual vaccinations. I was younger then -- and really too scared to put up much of a fight... But each time I would go in for the (required) annual rabies shot and tell him I was only there for rabies... And when we'd leave I'd be informed that he had the full course of shots. After eight years of this I was finally able to get out of the clinic that year with only a rabies shot --- by dressing in rags and telling the staff and vet repeatedly and upfront that I could not afford anything but the rabies shot.
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Old June 24th, 2007, 05:43 PM
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Maybe the trick is to demand titer tests to see if the animal still has antibodies, in which case the immune response is still functioning and further vaccines are not needed. Of course, there's the cost.
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Old June 24th, 2007, 10:01 PM
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Quote:
Originally Posted by glitterless View Post
No, the initial shots really aren't enough protection, even for indoor cats.

I believe that rabies can be given every 3 years now, but that will probably depend on where you live and what your vet recommends. I believe everything else should still be done annually. Also, your cats really would have needed booster shots in addition to those initial shots, or you'll have to start the process all over again.

Even though your cats don't go outside, you could actually bring viruses into the house that they could contract. Viruses like panleukopenia can actually live on objects and can be transferred on clothes and shoes. So if you came into contact with an infected animal, you could unknowingly spread that potentially fatal disease to your house cats.
Although you may believe that annual vaccinations are necessary, many do not... In fact, more and more vets are recommending not to vaccinate annually.

I believe that it is important to do solid research before making a decision that could have serious implications for our pets.

The thing that is troubling me right now is that I will have to board my pet next year for a couple of weeks and I would rather not have him vaccinated to do so. I may need to call around and see if I can find a place that will accept titer testing in lieu of vaccinations.
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Old June 25th, 2007, 03:30 AM
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I thought I would throw in a veterinarians point of view...

When I became a hospital owner, the retiring vet told me that I would give up my minimalistic vaccine protocols and start vaccinating for as many things as i could. Actually now that I am an owner, who can set all of my hospitals protocols, my vaccine protocols HAVE changed (about every 6 months or so, i re-evaluate them due to the ongoing research and new information) and I am vaccinating even less than before! (he thought I was minimalistic then! he should see me now!)

Celtic Fox: I think you are well justified in being upset. Regardless of vaccine views - you did not ask for vaccines that were given after you had been explicit with what you wanted. I think you should inform your regular veterinarian. I know as a hospital director - I would want to know; however I hear better with calm discussion than with yelling

I would like to offer some explinations for perhaps this common vaccine view of veterinarians since this is such a hot topic and address some myths.

I can't explain why he/she gave the additional vaccines, but I think an attempt to deceive is unlikely. Unfortunately it may be that it wasn't seen as a big deal. But you are right; it is a big deal.

Why do vets give so many vaccines? In school we are told to, out of school the vaccine companies bombard us with reasons to use their vaccines, clients walk in for the service, we get so used to giving them that we worry less about the reactions than with many other medications, and because, and this is important, many lawyers urge us to. There is currently over a $30'000.00 law suit against a vet because his adult dog got leptospirosis and didn't get a leptospirosis vaccine (vet didn't forget to give it, it wasn't his policy - it is a controversial vaccine and many feel the risks outweighed the benefits and that the benefits may be minimal either way). Now I know many vets that didn't give it before, that now vaccinate every dog with it. Finally i think the most important reason that we give so many vaccines is that few other procedures in medicine (human or animal) have saved so many lives. I think of polio in humans and parvo in dogs as prime examples. Most every parvo dog I see is a young, never vaccinated puppy.

Should we be giving so many vaccines? No... and yes.

Why no?
As many of the members will tell you, there is increasing evidence that many vaccines last much longer than one year. Some studies at Texas A&M have shown pets to have good protection up to seven years. There is much evidence that they may last a life time after the initial puppy/kitten set. Furthermore there is reason to believe that older dogs, especially ill dogs, may not respond to the vaccines. Remember all the tests on vaccine response done to make a new vaccine are performed on healthy young dogs (usually beagles). So age, breed variation - not to mention any other health concerns, nutrition etc... are not taken into account. Then of course there are the pets that have serious, sometimes life threatening reactions to them.

So why don't all vets just give initial puppy sets and thats it? or go every 7 years? Well believe it or not, even with the many tests - the specialists are not in agreement. I know two AVMA presidents who give all vaccines other than rabies every year. Then you have Dr Dodds (mention above - a good source) who has a very differnent view. The reason for the controversy? While many people think it is monetary - the vets I associate with have many other concerns. Law suits are high on the list; Unfortunately - force of habit is common (This is the one that gets me upset). Most importantly (the number one reason for me) is we don't want to let down the pets. One of the problems is that much of the evidence with regard to vaccine length is due to titers. Titers are great - I recommend them often; however for study with vaccine, challenge tests are needed and the challenge tests which have been done are great starts but not to the thoroughness needed to sway many of the immunologists. Why haven't these tests been done? This is where the money comes in ---- the vaccine companies do not want this done. Heaven forbid we use less of their product. There isn't enough specialist agreement to make any standard recommendations that are accepted nation/worldwide. AAHA is the closest resource that has made an official stand (and many vets disagree here as well). Here is the site to dog AAHA protocols (you can go from there to cats): http://www.aahanet.org/About_aaha/Ab..._Canine06.html

So in a nutshell as time goes on and continued testing and information is revealed and more vets become progressive and god willing the lawyers let us help pets (if any of you are lawyers, please don't take this personally - I have three lawyers in my family who I love and are ethical, but the law suits have done both bad and good in health care) --- I think we will see less and less vaccines. At least in adult pets with the basic four in one....

So why did I mention that there may still be a lot of vaccinating. While there is much evidence that the distemper and parvo vaccine last a long time; there is considerable evidence that many vaccines against bacteria and toxins do NOT last very long. There is some new evidence that the leptospirosis vaccine may not last a complete year. I just attended a lecture that recommended four in one and rabies every 3 years and leptospirosis every 6 months if the pet was in a risk environment. (AAHA current protocols state yearly but the lecturer quoted this and stated there was evidence to the contrary - where do we make the decision? Who do we believe?)

So which vaccines does your pet need and how often? Leptospirosis? Giardia? FIV? Corona? Rattlesnake? Lyme? FIP? Now each of the vaccines I just mentioned have their own set of controversies - Lepto: is the vaccine working against the serovars that we see clinically? Is it worth the risk of reaction? Giardia? The vaccine doesn't stop infection but may lead to less shedding and signs? So is it worth it? FIV? Pets test false positive but only protect at 86% - so 14% may be actually infected if exposed and we wouldn't know. Corona? Generally no one likes it however if a puppy gets both parvo and corona infection together - death rates rise. And the list goes on....

Does it end here? Nope. Now there is different brands and qualities of vaccine. There are a couple of rabies vaccines that I would never use in a pet. Also there is recombinant vaccine technology out there. This is important for FeLV - this vaccine has been linked with causing a very deadly form of cancer. The recombinant vaccine (given by needless injection through military technology to deliver the vaccine in a jet of air and uses only a fourth of the amount that a regular vaccine would) has so far never been seen to cause cancer. Feline recombinant rabies also has the same claim although does not need the air injection device but a standard needle. Also recombinant is great for distemper, parvo vaccine - it causes less reactions and better response - currently it is the only vaccine that should be used on Weimaraner puppies EVER. It also doesn't cause immune suppression like some other vaccines do.

How many people have I lost so far??? Unfortunately I feel that this topic becomes so confusing that it can be just easier for some vets to give the vaccine to the pet and move on. This is a mistake though.

At my hospitals we have standard protocols for lifestyles as well as a waiver that starts out with the sentence, "Currently there is much controversy with regard to vaccines" and ends by asking them if they have questions. I firmly believe that some pets need annual vaccines to help guard their lives. I also firmly believe that some pets after their initial set of vaccines should never be vaccinated again. Do I sell clients more additional vaccines or sell them less than they were expecting when they walked through the door? Absolutely, I have more people we change their pets vaccine plan for LESS than expected.

Earlier in the thread there was a comment that it should be the clients choice of vaccines and not the doctors. Let me revise that a bit if I may. It should be the INFORMED client's choice. That is, I believe that our duty as veterinarians is to educate the clients about their options and what may be needed (or NOT needed) based upon their pet's lifestyle and health status. Once the client has been informed and feels comfortable - then the choice should be made. If the veterinarian is doing his/her job right - the pet will have only the vaccines that it needs for its health and life style and the client should feel happy and comfortable with the decision. My business has less than 10% revenue based on vaccines. When I give a vaccine, it is because to the best of my knowledge with the available data, it is the best for the pet. I feel that every time I don't sell a vaccine I make money - because I have something better than money in hand - I have client trust, their return to me when they need and often their referrals. The trust and the knowledge of doing what is right is worth more than money...


I am sorry if this is long winded and does not get anyone angry but I have seen this topic come up and I have these questions from my clients all the time so I thought it might be useful.
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Old June 25th, 2007, 08:35 PM
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Dr. Lee,

I would like to thank you for a very well thought out and easy to read post regarding your views on vaccines.

I really appreciate your taking the time for us.
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Old June 26th, 2007, 02:36 AM
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Wow, great post Dr. Lee, it is great to see a vet perspective .

I don't think that lawsuits are nearly as much of an issue in Canada as we don't have the same "damages" awards that the US seems to have to deal with. It is sad that it is such a factor :sad: .
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Old June 27th, 2007, 01:26 AM
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Excellent post, Dr. Lee! Thank you!

And if I may put in my -worth here, let me relate our recent discussion with our vet about vaccinations and the money factor. We recently adopted a new dog, supposedly vaccinated for leptospirosis (a necessity in our area), parvo, and distemper. However, the less-than-conscientious former owner of this dog did not supply the rescuer any paperwork backing this up.

Since we lack trust in the guy who had Brier, we asked the vet about running titers to see if Brier had sufficient (or any) immunity for these diseases. The vet at first suggested just revaccination. Why? Because it would save us money! He thought that with 7 dogs, our bills might be looking mighty "impressive" lately, and the vaccinations cost less than the titers. We still went with the titers (although our bills have, indeed, been looking mighty "impressive" he he), but it was nice to know that they were concerned about our cost rather than the clinic's bottom line.

In the end, I do believe that the client should be offered the information they need to make a choice. And once it's made, I believe the client should also then take the responsibility for having made that choice. I'm still shaking my head about that law suit...
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