Ask The Vet Archives

Vaccination And Titers

I know we over vaccinate our pets. I’ve been taking a minimal approach with my Chinese Crested – Eva and my Toy Mexican Hairless – Mr. Reese. Both are on raw diet. Eva is a healthy girl other than “cloudy lenses” and Reese has environmental allergies spring thru fall. I am concerned and confused about titers that I recently had done for them. I had my conventional vet use the VacciCheck kit for both. My holistic vet said the kit is unreliable and though the results on the kit suggested re vaccination that I should not. I am also confused…Eva was a responsible breeder purchase and I know she had all core vaccines and Rabies at about 5 months. Reese is a rescue and we believe he had one single puppy booster, he was given Rabies at 5 months when he came to the rescue. Both have the exact same result on the VacciCheck titer – in the 1 range (below 3+ marker). I had Reese’s Rabies titer done beginning of summer knowing he was “over due” for another 1yr shot. His Rabies titer is .5 and the lab indicated he was VERY well covered. How on earth is is possible for them to have the same LOW, almost no protection result on the VacciCheck titer when Eva got full boosters and Reese (we assume) had only 1 shot? Referring to DHPP2.
The conventional vet says vaccinate again, holistic vet says no way. I’m confused, I just want what is best for my dogs.
~ Crystal

Dear Crystal,

Dr Sara ChapmanThere are many things about vaccination that are confusing. It is lovely that you are so concerned about the well being of Eva and Mr. Reese. Let me try to make the vaccine and titer situation a little clearer.

Let’s review why individuals (hosts) become ill from infectious diseases. Infectious agents (invaders) – bacteria, viruses, and other microorganisms – are around us all the time, and yet we and our animals rarely become ill. First, and most importantly, we all have natural resistance to disease because of the barrier of healthy skin and mucus membranes. Even if an invader does penetrate theses barriers, the non-specific actions of our immune system, through protective cells and factors in our blood and tissues, will inactivate most organisms. If the body fails on these levels of protection, then the invader can reproduce in the body. The body may still be able to control the invader, so that even though the invader reproduces, it may not cause disease. So, for a host to get a disease, it must be exposed to the invader, which must then get past all the defense systems of the body to invade, and even then, if the body is strong, there may not be any signs of disease. Successful invaders are those who do not seriously damage the host body they invade; successful invaders live with the body, reproduce, and go out to find other bodies in which to live. Disease can occur if the host body is too weak to control the invader, or if the invader is so strong or present in such large numbers that it overwhelms the host.

Vaccination manipulates the host’s immune system to create an immune response to an invader, without the body actually being exposed to the invader. Once our immune system has inactivated a real live invader, it often develops an ability to respond faster to that same type of invader in the future. This ability depends upon the activation of memory cells who will produce immunoglobulins (or antibodies) to recognise and help kill the invader. This is particularly effective in the case of viruses, and is why it is very rare for a dog who has survived parvo to ever get parvo again.

Vaccination exposes the body to a killed or inactivated invader to get the body to mount this immune response without the danger of creating disease. That sounds like a great idea, doesn’t it? And, in principle, it is. The problem is that if vaccines are given too frequently, the excessive immune stimulation may harm the immune system, leading to allergic reactions or immune mediated diseases. In addition, vaccines have components in them, such as mercury or aluminum, which are toxic, and the eggs or cell lines in which vaccines are grown can cause reactions or allergies when these substances are injected into us or our animals. This is why so many vets encourage people to vaccinate rationally.

Rational vaccination means that we should only consider vaccinating for diseases to which our animals are likely to be exposed, and which are capable of causing serious disease. There is no point in vaccinating against viruses such as Corona which have not been shown to actually cause disease. If a disease, such as Lyme or Lepto, can be prevented by avoiding the organism, that is a safer route. In addition, we should only use vaccines which have been proven to be safe and effective. If we choose to vaccinate, we should give the minimum number of vaccines to stimulate immunity so that we minimise side effects.

It is certainly possible to demonstrate immunity by exposing an animal to a disease organism and seeing if it becomes ill (this is called challenge testing), but most people are reluctant to do this with their beloved pets. The only simple indicator of immunity to disease is via titer testing; this measures the antibodies circulating in the blood to combat a particular disease. According to Dr. Schultz’s work (see for references) any titer to Distemper or Parvo indicates a response, and that titer will persist for the life of the individual in most cases. Titers may drop in older dogs who have not had further exposure to either disease or vaccination, but these individuals should still have memory cells and tissue immunity to lead to protection if they were to encounter the disease organism.

Ideally, to demonstrate response to a vaccine, animals should be titer tested at least two weeks after the completion of the series of vaccinations. Some animals do not respond to vaccines by showing protective titers. Some of these animals require another vaccination to develop titers, others will never show protective titers. This does not necessarily mean that these animals are susceptible to this disease. A very small number of animals are incapable of mounting any effective immune response to a disease (non-responders), others just don’t develop circulating blood antibodies. Immunity is not just due to blood antibodies, it also relies on tissue immunity and antibodies secreted on tissue surfaces. That is why we say that blood titers are an indicator of response to a disease organism. An animal with a high titer can also still get a disease, as no vaccination is 100% effective.

So, Crystal, what does that mean for your two little dogs who were vaccinated as pups, yet apparently now have no measurable titer for Distemper and Parvo? (Rabies vaccination is a separate concern. Rabies vaccination is mandated by state law, and I refer you to the Rabies Challenge Fund website for more information about duration of immunity of the current Rabies vaccines.) The VacciCheck titers are ELISA tests and compare favourably for both specificity and sensitivity to the IFA tests sent out to labs, according to Dr. Jean Dodds; I personally asked her as we are thinking of using the VacciCheck in our hospital. If you have ever had titer tests done on your little dogs which showed antibodies to Distemper and Parvo, that indicated that they responded to the vaccine, and they most likely still have memory cells and would mount an immune response. If you never had titer tests done, the issue is not as clear. It is likely that your dogs had blood titers which have dipped, and they are still probably immune through their memory cells. It is also possible that they were non-responders who will always be susceptible regardless of vaccination status, but this situation is quite rare.

Both of your vets are counseling you according to the way they view disease. Your conventional vet feels that the possible risks of disease outweigh the risks of vaccination; your holistic vet sees things the other way, and is likely also weighing in the fact that elderly and toy breed dogs are more likely to have adverse reactions to vaccines. You need to ask yourself what the right choice is for you. Are your dogs likely to encounter Distemper or Parvo? Are you able to keep your friends in excellent health to maintain a healthy immune system? In the end, the choice is yours alone. I hope this information has been helpful.

S.F. Chapman DVM, MRCVS, VetMFHom

Bile Vomiting, Intolerance, Food Allergies

We currently have 4 adult shih tzus ranging in age from 3 years to 12 years of age. They frequently vomit up stomach acid, the yellow, foul-smelling liquid. It is generally during the night or early morning when they have empty stomachs. We feed (or try to feed) them several small meals a day and a late night snack to get them through the night. Most days they aren’t hungry very early (before 9 a.m.), then they end up vomiting. It happens to any or all of them several times a week. They all eat dry dog food, (previously California Natural Lamb and Rice, until the last recall, now it is Natural Balance Limited Ingredient) mixed with filtered water. Usually we add a small amount of fresh vegetables or a cooked egg to their food. It is so very frustrating and exhausting to try to get them to eat so they won’t vomit. Would it be a good idea to add yogurt or something else to try and keep the stomach acid from upsetting their tummies? Any help would be so greatly appreciated!!
~ Rose

Hi Rose,

Dr Jeff FeinmanAh, the old common (but not normal) early morning bile vomiting syndrome. There are lots of possible causes for your pups to be doing this, but my first suspicion is that they don’t like or do well with their dry food diet. It is possibly an intolerance to one or more of the ingredients or even a food allergy. Therefore, the first thing I would do in this situation since all four are effected by this problem is to stop feeding dry food. Although many dogs can do well with this processed food, some can not tolerate it. Personally, I try not to feed any brand of kibble to my own dog (she eats a variety of raw foods) and advise my clients too do the same.

Start with a bland diet and see if this helps the vomiting. Low fat cottage cheese or boiled white meat chicken plus mushy rice is one of my that works well. Mushy rice is rice cooked well enough so that there are no whole grains left. Like baby rice cereal. Alternatively, you can “blenderize” cooked rice that you already have made by adding it and a little water or organic chicken broth into the blender. Do not use minute rice.

If there is no further vomiting within the period that you would otherwise have had a few episodes then start adding one fresh food every few days. Eggs are a great place to start. Alternatively, you can also just select a new, higher quality food and gradually start mixing it in. Ideally, this would be a fresh food. Try at least to use a freeze-dried, air dried, dehydrated or even wet food. I you use fresh ingredients, by adding one at a time, you will get a better idea about what they can tolerate. I’d also be wary of adding back veggies too soon. Vegetables are often not well digested by dogs. Especially raw chunks of veggies. Best to either not use them at all, or use steamed, grated or juiced veggies if you want to add the phytonutrients found in vegetables.

If however there isn’t improvement after 1-2 weeks on the bland diet, you may want to further investigate the etiology for the vomiting. Especially in your older dogs. There are many potential metabolic imbalances that may manifest with vomiting. At the same time as your vet’s diagnostic investigation, you can try some other lifestyle alterations that may help. Oral aloe vera juice, slippery elm, marshmallow extract, deglycyrrizinated licorice, among others, are all wonderful natural ways to soothe and protect the gastrointestinal system. Pro Bi is a fermented probiotic with aloe vera + other natural ingredients and is one such supplement that can often help.

Homeopathic remedies are my preferred method for dealing with dogs who vomit. Many of the thousands of remedies can cause symptoms like this. They therefore can also cure the symptom according to the “like cures likes law of homeopathy. However, it is frequently other aspects of your pet’s individuality that guide the veterinary homeopath to homeopathic remedies that are most similar to your dogs’ specific internal imbalance. For example dogs who get extra clingy and prefer to lie near open windows may need Pulsatilla to help their vomiting. If a dog is uncharacteristically restless and craving frequent drinks of water, Arsenicum album may prove useful. In contrast to Puls, if your vomiting dog isolates more than usual, especially if there is lots or retching and/or abdominal noises then Nux vomica could prove useful, etc.

Most important is to not consider this vomiting normal. If it becomes more frequent, or if there are other changes like lethargy, refusing food, weight loss, etc. it is critical to have get a veterinary physical examination.

Best of luck resolving the vomiting.

Dr. Jeff

Homeopathy For Pancreatitis

My 9 year old lurcher is prone to bouts of pancreatitis if he gets even a little too much fat in his diet. He vomits, but does not have diarrhea typically. Is this something that homeopathy could help make him less susceptible to? Would it likely be treated constitutionally or more acutely when he is having a flare up?

Also, homeopathy does help him when he is very ill with this, but I am afraid to give him anything orally when his fever is high and he is doing poorly that may exacerbate the problem. Even a sip of water will spike his fever and cause him to feel more pain. Can remedies be given some other way? Or would just one pellet placed along his gum not be likely to cause a problem? Would a few drops of a liquid remedy be ok?

He does receive supportive care when this happens with iv fluids, pain medications when it is at its worst and anti-emetics, but I’d like to know if homeopathy can maybe prevent this from happening and/or lessen the severity. Thank you for any insight.

~ Nancy

Dear Nancy

Jennifer RamelmeierI have treated many successful cases of pancreatitis homeopathically and have found that while it is good to treat in the acute stages, it is paramount that you follow up with constitutional prescribing by a certified veterinary homeopath. I have also found that homeopathy works amazingly quick on the acute stages of pancreatitis and I often do not need supportive care(but it would not hurt to get intravenous fluids in a severe case). As far as homeopathic remedies causing vomiting, you should be able to put 1-5 pellets directly on the gums without eliciting a gag reflex. Also make sure that an abdominal ultrasound has been preformed on your Lurcher to make sure that you rule out a pancreatic abcess or tumor.

Yours in health

Dr Jennifer Ramelmeier DVM, CVH

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