Vaccination: To Titer or not to Titer?

Keymaster

Mary,
Gosh I am sorry, this is terribly confusing to many owners and it doesn’t seem straightforward and understandable. Let me see if I can explain this in a way that is understandable. I may have to say quite a lot to do that.

When we got Chance in the late 90’s the breeder told me that once we had given him his puppy series of vaccinations and his rabies shot that we should no longer give him yearly vaccinations. She recommended that we titer him thereafter. This was revolutionary for that time. Up until then, not only did everyone vaccinate every year, but the only people who titered dogs for proof of vaccination, for the most part, were breeders who titered puppies to make sure their first series of shots had taken. Sometimes the first series does not “take” in a puppy and that is a risk for the whole litter.

In my simple understanding I thought this meant that every year we go in and check Chance’s blood for antibodies and that would prove that he was ok and didn’t need to be re-boostered. I will explain this better in a minute.

The first problem was that the vet in town refused to titer him. I had so little understanding at that time, I was simply confused. Isn’t this better I thought? But eventually someone recommended another vet clinic to me and I asked them if they would titer. They said they could, but it wasn’t requested very often, they used Cornell labs, would this be ok? Hmm, why is this so complicated?

But I did titer him every year after that. He was also a registered therapy dog and they would not accept titers, but insisted on yearly vaccinations. He, however, had severe allergies and was under treatment for them by getting allergy shots. The vet signed paperwork every year for TDI that exempted him from the re-boosters. TDI said they would allow this as long as we re-boostered any low titers.

Ahh, slippery territory. What would happen if I re-boostered him? And in fact, for some strange reason his parvo would come back low every year. So I dutifully re-boostered that. That was a bad thing I did. I later found out from Dr. Dodds that this was one of those particularly dangerous vaccinations that can lead to serious health issues. I will never know for sure, but it is possible that the last parvo booster he was given in late 2006 was one of the reasons he went on a few months later to develop bone marrow failure. Yes, bone marrow failure is a possible outcome of contracting parvo. However, vets would tell you that a dog cannot “get” parvo from the vaccination and that is true! So what are the mechanisms involved? I research this all the time, still looking for answers.

It was a huge learning curve for me. But around that same time I joined Tick-L, an email list for discussing all things tick disease in dogs. The owner is a an older gentleman who has extensive scientific biological training. He explained titers to me in a way that I understood.

The immune system is really pretty straightforward and incredibly “intelligent.” You expose it to some kind of foreign thing and it remembers it FOREVER. If it considers that thing a threat it makes up a warning signal to let the body know that if it is ever exposed to it again, it should fight it the same way it did the first time.

Vaccines utilize this “memory” method to help our bodies recognize a bad foreign “thing” and learn to fight it off, but without actually giving you the disease itself. Vaccine manufacture is a complicated process and I won’t go into that here, but not all vaccines work in exactly the same way. The basic difference you need to know is that most veterinary vaccines are either “killed” or “modified live.” (And modified live are not used very often anymore.) Here is the first page I found when searching that explains this if you want to read it.
http://www.canismajor.com/dog/vaccine.html

Some vaccinations take a series of boosters to be effective over time and some vaccinations can be considered “life time.” Any of the first puppy series are generally killed and that is why you must return a second time for the second series. But once you have “set” that memory, these are considered life time by those who truly understand vaccinations (like Dr. Dodds).

Other vaccinations like kennel cough must be frequently re-boostered because they lose their effectiveness. Leptospirosis vaccinations, which also need re-boostering, are only partially effective against a set number of strains. You may have different strains in your area that are not in the vaccination. Your dog could be exposed and get Lepto despite being vaccinated! I know of dogs that have received the Lyme vaccination and came down with symptoms of Lyme disease.

So in my case I don’t give Kennel Cough, Lepto or Lyme vaccinations, but I do make sure that I protect my dogs from those diseases. I avoid situations where they could get exposed to Kennel Cough and Lepto and I protect them fastidiously from getting bitten by ticks.

Here is the important take away. The deadly diseases that may kill a dog, and they are those vaccinations that you give to your puppy, generally provide lifetime “memory”. Once your dog is exposed to the vaccination and develops antibodies their immune system develops a life time memory of that.

So why are titers so confusing? It should be really easy, titer your dog and you know they are protected against distemper, right?

Titers really only tell us that there is “MEMORY.” They cannot tell us HOW WELL THE IMMUNE SYSTEM CAN RESPOND IF EXPOSED TO A DISEASE.”

If a dog is ill, they still have memory, but they they may not be able to mount a defense to the disease properly. So there is the difference, the titer may say “yes” but the dog’s (or cat’s) immune system cannot respond and they may express the disease after exposure.

So that is why titers are very rarely accepted by any authority as PROOF of immunity. This especially comes into play with Rabies. This is the one canine disease that can not only kill the dog (since exposure means illness, means death) but the dog can also pass on the rabies disease to the humans in his life and that will kill the human too. Human health departments around the world know this and they have stringent rules about vaccinating dogs for rabies because dogs are the vector for rabies to humans. They are not concerned about your dog’s health, they are only concerned that humans be protected from exposure to rabies!

The current Rabies Challenge research study being run by Dr. Dodds and Dr. Shultz is attempting to determine if the rabies vaccination provides “memory” for 7 years. The results would hopefully mean that a dog would only need to be vaccinated every 7 years not every 3.

But the reality is that both my dogs (and maybe even any puppy I might get in the next few years) will be long gone before this study is done, challenges are made to this by more studies, the results are released and health departments around the US (and world) accept and put into practice this change. It took many years for the “yearly” recommended veterinary vaccine booster protocols to be changed to every three years. The leaders for this change were veterinary universities. But, in fact, some localities still insist on yearly boosters and don’t honor the standard compendium recommendations. When it comes to rabies, the local authorities usually rule by how they handle the emergency, not by what laws are on the books. They may, and actually have, killed a dog on the spot that was suspected of having rabies just to protect human health.

So Mary, for you as a cat owner, you have similar but different considerations. First, you must identify those diseases that will result in serious illness and death in cats and are considered active in your area. If you refine it this way, it should be a relatively short list. Then you must decide if you actually provided this immunity to them at some point in their life. Using a titer test for those diseases is perfect. If you see “any” level of titer (as Dr. Dodds reminds me) then you can be sure that there is “memory.” In my case, I don’t have to, but I do repeat this test about every three years for each of my dogs. I do this mostly to make my vet feel better, not to reassure me that my dogs are protected.

Secondly, you and your vet should determine if there is an opportunity for your cat to be exposed to these diseases. In my area, our county is an active rabies area. I would never risk them being exposed to rabies without having a current vaccination. Am I worried about distemper etc? Not really, but I do have a healthy respect for how deadly this disease is. It just doesn’t exist in my area due to “Herd Immunity.” This is immunity in the general population due to most of that population being protected by vaccination.

Then you and your vet determine the overall health of your cat. Have they had previous illnesses (esp autoimmune) or seem to have a sensitive constitution? I am more cautious about Cassie because she is older but not because she has ever had illness.

Then you must look at the reactions that cats have in general to vaccinations. I know that they have a much higher rate of cancer related vaccinosis at the site of vaccine injections, far higher than dogs. Is this for certain vaccinations or is it all of them? What does your vet know about this and what do they recommend?

So, use titers as a tool, but don’t rely on the results too heavily. If your cat is perfectly healthy, then the titer is telling you that they are protected and will probably have the ability to summon the immune system response they need if they are exposed. If your cat is not healthy then you need to think about how to protect them that doesn’t involve another vaccination if possible. There is nothing wrong with making a dog or cat a “house pet” to avoid exposure. Modify their lifestyle for their health.

Try to partner with your vet to find an in-between ground that isn’t totally tipped in favor of heavy vaccination but doesn’t totally avoid them either. Some vets will welcome this, other vets will find any challenge to their authority offensive. If this were me, I would just step away and find someone who can partner with me. And that is exactly what I did with Chance in 1998!

I hope this lengthy response helped?
my best
patrice

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Patrice

Keymaster

Lynda,
I feel your angst. I worried a great deal with Chance as the following spring after he recovered he was due for a rabies booster. I did spend about 2 months researching what I would do.

The most important issue with rabies vaccinations are the legal implications. After two months I began to understand first that most dogs probably are protected (by vaccination) against contracting rabies longer than the three year period allowed by most laws.

In fact, I did have Dr. Dodds titer him. The test results I received were certainly quite odd. Come to find out there is no canine titer standards of acceptable titer values. That is yet to be determined. The titer values that they use are human and that was established mostly because veterinary professionals etc must be current on their rabies vaccination. So his test results showed that he had an acceptable titer value for rabies according to the human titer values.

But to NYS law, this means nothing. The laws regarding rabies are very complex and that is why it took me a long time to gather the information and then sift through it to understand all aspects.

Rabies is essentially a human health issue. The law and the health departments only care about protecting humans from contracting rabies because is is a deadly disease. It would be wildly expensive and dangerous to give all humans rabies vaccinations so instead the law requires that the vector of rabies, dogs, be vaccinated. It puts the expense on the owners and puts the risk of the side effects to the dogs.

Each country, each division such as state and county etc, each locality such as village or town, each version of health department and each veterinary clinic have laws or regulations that govern a dog’s rabies status. To know what applies to YOU, you must research where you live.

Honestly your best protection against having your dog taken from you because of a violation of a rabies law is to know every law and regulation where YOU live. Avoiding knowledge in this area is very dangerous for your pet. Thinking that “my dog” won’t be exposed and can’t possibly get rabies can land any owner in trouble.

Why? Because most laws and regulations revolve around 2 things. Contact with wild animals and biting a human. Unless your dog is completely house bound, there is always a risk, even if it is slight, of one of those things happening.

Once Chance recovered I wanted him to go back to a normal life. And that included going on long walks in the woods, being on sidewalks in town and being petted by people.

And people can be funny sometimes. They will get all excited about petting one of my dogs and then suddenly encounter a wet Schnauzer beard. Oh! Your dog bit me! Well, no, they didn’t get bitten, they just experienced “dog.” But if they report that, then my dog must be held accountable (and so do I). What is the first thing they do? They may take my dog away from me to be held in quarantine up to at least 10 days but can be as long as 6 months depending on the dog’s vaccination status. They need to know immediately if my dog transmitted rabies to the human so they can protect that person from contracting the disease by beginning the rabies inoculation. That would be the 10 days. They routinely give a booster shot.

Where I live, it is routine to see wild animals in back yards, all around Western NYS. People have been attacked by rabid foxes in their own driveway in a suburb! So it is likely that a rabid animal could be in my back yard. My dogs could go attack it. This is another area where the law is very clear, my dogs must be immediately examined and given a booster. If I foolishly run out and grab my dog immediately, then I have exposed myself unknowingly to rabies in the saliva on my dog.

So, no I don’t want to see Dora exposed to the rabies vaccination, but I also would like to see you protect her from legal action that would involve removing her from you. Crossing state or country lines is often a no-no with a dog that is not currently vaccinated. Some countries will not allow a dog, even vaccinated, to just pop off the plane and start trotting around the country!

In the end I had Chance vaccinated. By this time the rabies booster was no longer modified live, but killed and he had no issues at all. I felt comfortable that he was protected and safe to be “at large” in the community. This is the language that is used when discussing a dog’s rabies status. Currently vaccinated dogs can be “at large” in the community. However, I still took precautions about exposure to wild animals and I never took him back to the nursing home for visits. He did private home visits.

So find out what your laws and regulations are in your area and then research carefully all aspects of traveling to France. That would also include airlines if you plan on flying. If you must go through borders, you can bet they are going to want to see all of Dora’s vaccination records. When we travel to Canada, the border folks actually spend more time examining the dog’s records than they do our own passports.

And, by the way, I have done some research on canines and ebola. It’s a well known fact that there are many dogs wandering around in the areas where ebola is rampant and it is not beyond belief that some of these dogs ate carnage in those areas. About 10 years ago a study was done on some of these dogs and found that some dogs did carry the disease, though symptom free, and the conclusion was that they could be carriers and pass it to humans. That is something to keep in mind when traveling considering the current hysteria. Mainland France is not experiencing outbreak, only certain French territories.
my best
patrice
patrice

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admin

Keymaster

Hi Vally, Patrice and Lynda.

Thank you so much for your very useful advice and information. Patrice – what you said completely makes sense and now that I have read that, I can see what the AAFP are saying about titers not being reliable – it says that they cannot predict the extent of protection or susceptibility, which is exactly what you’ve said but in terms I understand! So, now I feel more confident that as Mable appears to be quite healthy, a titer would be a good idea as per Dr Dodds recommendations. The only issue is that they have told me they cannot titer for FeLV, although I may research this a little further and see if I can find somewhere that does. Crazy and paranoid? Certainly. I have an inkling (though could be wrong) that the FeLV is the “nasty” when it comes to vaccine site sarcoma, although of course it’s a terrible disease itself. Aaargh!

Lynda – you are so right in saying that many vets say there is no evidence about vaccination and the link with IMHA. They may be right, but I am highly suspicious. I don’t blame my vets or the vaccine companies for what happened to Molly, but I will always be mindful of it now. I think we all will, right? It sounds like you and I are in a similar position. I have been worried that her vaccines are about a week overdue, but I certainly won’t be rushed into it. The vet I spoke to on the phone was quite sensible and said that yes, she thinks we do over-vaccinate, but in the vast majority of cases this is safe to do and therefore the vaccine companies don’t invest in trials to assess the frequency required. The last vet we saw was great and as Patrice said, I felt she was willing to partner with me. She was happy to titer, to vaccinate separately etc. Part of me would like to rely on herd immunity since most people do vaccinate their cats, but this doesn’t feel like a safe or responsible option and I’d not forgive myself if she ended up with something horrid. The reality is that Mable is probably far more likely to contract an infectious disease than come down with IMHA, as she’s never shown signs of an immune problem, but I can’t get over the fact she is Molly’s littermate and so I feel I have to be particularly cautious, though I think I would with any animal now.

Rabies is frankly terrifying and we are very fortunate that we don’t have it here. It just makes me think of that scene from “To Kill A Mockingbird”. I agree with Patrice that I’m sure the laws are so tight due to the risk to human health, which is so sad. I live in hope that one day, the human race will learn that it isn’t all about us and we need to learn to love and respect our fellow animals.

Vally and Patrice – thank you so much for the links you have sent. They are really helpful and I will have a good read through. I’m determined that I WILL be informed when I make this decision!

Again, so sorry for a rambling post. It’s 3.30 am (!) but it is so helpful to be able to mull it over with people who truly understand.

Much love to all,

Mary and Sleepycat x

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