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Questions for Dr. Shawn - Vaccines, Titers, Blood Testing

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"Dear Dr. Shawn:
"Does my pet really need vaccines every year?"

Answer:
”According to veterinary vaccination and immunology experts, veterinarians should make judicious use of vaccinations. Doctors should recognize that each patient has a unique level of risk of exposure to infectious diseases and that risk levels even for the same patient can vary from year to year. This means that varying types and levels of protection are therefore needed, and that doctors should avoid using the same vaccination protocol for all pets.

Additionally, the vaccines currently on the market are so good that immunity from most of them can last many years, making annual vaccination an obsolete practice for most pets. Each patient should be evaluated individually and vaccinated if needed. Blood titer testing, a simple and inexpensive test which measures a pet’s individual antibodies against infectious diseases, is an easy way to determine if and when pets actually need vaccinations.”


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"Dear Dr. Shawn:
"What do you currently recommend regarding vaccination of pets? I prefer not to give my dog and cat all those shots every year. One of my email groups said that vaccine recommendations have recently changed anyway, so annual shots might not even be needed. What do you think? I’m more than a little confused."

Answer:
”Excellent question. We now know that vaccines are not needed by most pets each year. Immunity from immunizations last more than 12 months, and in my practice many pets have immunity that lasts several years. I agree that annual shots should become a thing of the past, but certainly annual exams and diagnostic blood testing is essential in order to diagnose and treat diseases early before they become serious.

In my practice, I use a blood antibody test called a titer test to help me determine which vaccines a pet might require. This is a simple and inexpensive approach, but is not used by many doctors. A recent survey by the American Animal Hospital Association revealed that only 10% of doctors surveyed use vaccine titers in their practices. This is quite disappointing, but also encourages me to the extent that more doctors are starting to investigate a holistic approach to immunizations.

There is never any guarantee of protection, whether we use titers or immunize the pet. What is known is that unless the titer is low or non-existent, giving an extra vaccine to an adequately immunized pet is of no value, a waste of money, and possibly harmful. Vaccines are currently being investigated for links to a whole host of serious diseases, including thyroid disease, autoimmune disease, and cancers in pets. The less we immunize the pets the better for their health!

Finally, keep in mind that if the titer is low, I recommend trying to only immunize against the specific disease indicated by the low titer, rather than giving your pet a vaccine that contains everything. Finally, never vaccinate a sick pet. When needed, vaccines are only meant to be given to healthy pets.”


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"Dear Dr. Shawn:
"My husband and I have an 11 year old collie, Buddy. We have been taking him in once a year for shots. I know you’ve talked about other things that can be done such as blood testing. How often do you recommend doing this for a dog Buddy’s age?"

Answer:
”In general, I think most younger pets do well with an annual visit. For pets 5 years of age and older, I prefer seeing them at least twice a year. As pets age, the incidence of chronic degenerative diseases like heart disease, arthritis, cognitive disorder, kidney disease, thyroid disease, diabetes, and cancer greatly increase. Seeing the pet, and running tests including blood and urine testing, and X-rays and an EKG (when needed) allow us to detect diseases BEFORE pets like Buddy actually show any illness. Early diagnosis increases the likelihood of a cure or at least a successful treatment, and usually decreases medical bills. I would also suggest that you stop vaccinating Buddy and instead consider using blood titer testing to determine if and when he needs any more “shots.” Due to his age, my guess is that he will probably never need another vaccine. Finally, keep in mind that an important part of disease prevention includes regular, usually annual, dental cleanings to remove infectious tartar from the mouth. Even older pets like Buddy can be safely anesthetized and benefit from dental cleanings.”


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"Dear Dr. Shawn:
"You’ve mentioned using blood tests to see if we need to vaccinate our dog and cat. When we asked our veterinarian about this, he said that our pets would have to be vaccinated if we needed to use his facility for boarding them. Since we board them several times a year, we’re in a bind as we really hate to do the vaccines if the pets don’t’ need them. What do you suggest we do about this?"

Answer:
"I’m always amazed when a new client tells me that her prior veterinarian is opposed to using blood antibody testing (titer testing) to determine if vaccines are needed. Veterinarians and medical doctors use titer testing all the time in trying to diagnose diseases. Tests such as heartworm testing, feline leukemia and AIDS testing, FIP testing, tick disease testing, and even testing for infectious diseases like leptospirosis involve testing blood levels for antigens or antibodies. Vaccine manufacturers use titer testing when evaluating their products. If doctors can use titer testing in their practices for all of these reasons, why can’t they use titer testing in their practices to determine if their patients need vaccinations (even medical doctors do this!)

Some doctors are now using a 3-year vaccination protocol, giving pets vaccines every 3 years rather than annually. Interestingly, this recommendation (with which I disagree) came about as a result of titer testing!

Sadly, there’s not much you can do in your situation. Here are your choices. Still use your veterinarian for your pet’s medical needs but find another boarding facility which will recognize titer testing. Second, consider having a pet sitter watch your pet so that boarding is not even needed. Finally, you may consider switching to another veterinarian who will board your pet relying on titers. In my practice, pets are boarded if they are current on vaccinations or titer testing. Using the titer approach allows us to only use vaccines when needed. This individualized, holistic approach is best for the pet, as we only do what is necessary for the pet’s health. Since some vaccines can produce immunity that lasts longer than 12 months, annual vaccination is not needed for most pets."


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"Dear Dr. Shawn:
"My cat has had reactions to multiple vaccinations in the past. Should I have her vaccinated again? I don’t want to risk her life, but I just got her reminder card in the mail. What should I do?"

Answer:
"As I recently wrote in this column, I’m not a big fan of doing things to pets (or people) that don’t need to be done. While I have absolutely no problem with vaccines per se, (when they are used correctly,) I have a big problem with vaccinating pets that don’t need to be vaccinated. Current research shows that most dogs and cats do NOT need vaccines every year for every possible disease they might encounter. The immune system of pets is such that, with the great vaccines we have available, most can mount an immune response and be protected against infections for many years. The problem we have is not knowing what YOUR pet needs each year. The only inexpensive, reliable, easy-to-use test we have is a serum antibody (titer) test.

In my practice, use of this test allows me to tell each owner what shots, if any, her pet needs this year. While not perfect, it is the best alternative I can use to avoid unnecessary vaccinations. For pets such as yours, titer testing is a perfect alternative to repeated vaccinations. If your cat needs vaccines based upon titer testing, the fewest necessary vaccines should be given at a time to minimize any chance of reaction. Alternatively, the use of antihistamines or even low doses of prednisone could be given prior to vaccination if her past reactions have been severe. In my opinion though, if she’s had severe reactions in the past it would probably be best to never vaccinate her again, as vaccine reactions can be fatal.

For most pets, however, vaccines can be safely administered when needed. Various supplements can be used before and after immunization in an attempt to minimize reactions and boost the immune response to the vaccination."


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"Dear Dr. Shawn:
"I was curious how important you feel about vaccines to provide protection against diseases such as rabies and parvo virus infections. I hate to vaccinate if it¹s not life-threatening to my dog, who¹s only 5 pounds. And I¹ve heard the rabies vaccine is good for three years, even though most vets recommend dogs get it every year. What are your thoughts?"

Answer:
”Excellent question. In my handout on natural health care one of my basic steps is to minimize vaccines. All of the current research on the topic proves that most pets do NOT need vaccines every year. The current recommendations by many experts, including all of the veterinary schools in the US, is to vaccinate pets every 3 years with only those vaccines that each pet needs. In other words, based upon your pet’s needs your doctor is supposed to work with you and make recommendations for your pet, which may be different from what another pet requires.

I should point out that these recommendations are from CONVENTIONAL veterinarians, not holistic doctors. Therefore, every veterinarian should, at least, be following these guidelines and not immunizing pets on an annual basis.

Holistic doctors like myself go even further to prevent the unnecessary use of vaccines in pets. Most of us like to do a titer test in place of vaccines. A titer test is a simple, inexpensive test that tells us your pet’s antibody status. If the titer test comes back normal, your pet would not receive any benefit from a vaccine, might be harmed by it, and therefore would not receive the shot. If the titer is low, a vaccine might be needed IF your pet is young and healthy.

For example, if your pet is due for a parvo vaccine, I would draw blood and do a parvo virus titer test instead. If it comes back in the normal range, there would be no reason to do the vaccine as your pet is protected against parvo virus and would not need additional vaccination.

For rabies, you must follow state laws. Most allow vaccination every 3 years. You should keep in mind that if your doctor does it every year, the 1 year and 3 year vaccines are the same, only the label is different. Therefore I recommend finding a doctor that will administer the vaccine only every 3 years. There is currently a study underway to show that immunity to the rabies vaccine actually lasts 5-10 years or longer, so hopefully we can reduce the need to administer that vaccine as well.

Some veterinarians may tell you that they “don’t believe in titers” or that they “cost too much.” That’s interesting, since every veterinarian does blood testing that involves titers (such as the annual heartworm test, FIP test, and tests for tick-borne disorders.) As for cost, we charge $55 for all the vaccine titers each dog or cat requires.

Since unnecessary vaccines do not help the pet, and there is always a risk of side effects anytime we administer a medication, I agree with you in wanting to minimize immunizations for your pet.”


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"Dear Dr. Shawn:
"I’ve read on a website that most of the veterinary schools have adopted a new vaccination protocol. Supposedly, the schools are using vaccines every 3 years instead of every year. What do you think of this new protocol?"

Answer:
”I’ve also heard that the veterinary schools are reviewing and changing their vaccination protocols, although I can’t say for sure what each school is doing. The shift in our vaccine regimens has come about as a result of various studies over the last few years that show immunity from many vaccines last longer than 12 months (most vaccines are labeled to be administered every 12 months.) As a result, it just doesn’t make sense to vaccinate most pets every year with all of the “recommended” vaccines. Additionally, several committees convened to review vaccination protocols have determined that most pets do not need all of the vaccines that have been previously recommended.

Instead, these various groups of experts have recommended we think of vaccines in 2 groups: core vaccines required by most pets, and non-core vaccines that may be needed in certain circumstances in some pets. However, it should be noted that the experts do not recommend every doctor start vaccinating pets every 3 years. The conclusion of the experts is that each doctor must determine what is needed by each individual pet based upon a number of factors, including age of the pet, lifestyle of the pet, and prevalence of the various diseases in the area.

While I am glad that some veterinarians are decreasing the number and frequency of vaccinations, I don’t like the generic recommendation for vaccines every 3 years. Why not? Because every pet is different. Some may need vaccines every 3 years, some pets may need vaccines every 5 years, and still others may never need another vaccination.

In my practice, I prefer to draw blood for vaccine antibody (titer) testing. This allows me to determine what each individual pet needs, rather than generically vaccinate all pets every 3 years. While not perfect, titer testing is inexpensive (we charge $45 for a complete set) and helps me fine-tune my recommendations for pet care. Finally, current recommendations are that pets receive at the very least an annual checkup and a twice yearly checkup for many pets (especially those 7 years of age an older.) This is so important as early detection of disease allows early intervention. I see too many pets who don’t get these checkups who are severely ill (many are terminal as the disease is discovered too late.) However, even many terminal pets can benefit from holistic therapy.

When possible, early detection and treatment with holistic therapies can help many pets live longer, healthier lives.”

 

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