Pet Vaccines 104 - How Often Should You Vaccinate?

Try these links for previous articles in the series on canine vaccines, feline vaccines, and how vaccines work.

You've probably had many vaccines yourself - vaccines for measles, mumps, hepatitis, tetanus and more. And if you're like me, you're likely hard pressed to remember what you've had and when... but you probably remember several sore arms spaced throughout life. Every vaccine varies in effectiveness and duration, meaning sometimes you need a vaccine once (measels), annually (flu), or every several years (tetanus). This article will attempt to demystify some of the when of vaccines for your dog and cat.

The Vaccine Schedule
For those who just wandered by looking for the recommended vaccine schedule without a burning need for the why behind those recommendations, let's get it out of the way:

• Puppies 
• Distemper, Hepatits, Parvovirus (DAP): every 3-4 weeks, from 6-16 weeks old
• Rabies: once at 12-16 weeks
• Bordetella (optional, but recommended for puppies): intranasal once at first vaccine appointment
• Leptospirosis (optional, recommended in most areas): at 12 and 16 weeks
• Kittens
• Herpes, Calicivirus, Panleukopenia (FVRCP): every 3-4 weeks, from 6-16 weeks old
• Rabies: once at 12-16 weeks
• Feline Leukemia (FeLV) (optional, recommended for kittens): at 8 and 12 weeks
• Adult Dogs & Cats with initial and regular vaccination history
• DAP or FVRCP: every three years
• Rabies: every three years (some states/municipalities require annual vaccination, however)
• Bordetella and leptospirosis (dogs), FeLV (cats): Annual if indicated

Why Are Puppies and Kittens Different?

Right after birth some "magic" happens inside mom and her kids - and by magic, I mean really complicated physiological changes. These allow antibodies (proteins that help prevent infection) from the mother to exuded in her milk, and for a brief period the pups or kittens can absorb these antibodies through the gut and into the bloodstream. These maternal antibodies hang around for the first six weeks or so and protect them from common diseases - that's why we generally wait until after six weeks to begin vaccinations.

Eventually those maternal antibodies start to break down, however, leaving the kids increasingly susceptible to disease. So, we start vaccinating them to teach their own  immune system how to protect itself. There's a hitch, though: the remaining maternal antibodies interfere with those vaccines and prevent the pet from developing a full immune response until they are gone. Somewhere around 12-14 weeks the maternal antibodies should have entirely disappeared, and that's why we booster most vaccines every 3-4 weeks until then - each vaccine gives the immune system a boost that keeps the pet safe, but that boost doesn't "stick" until mom's antibodies get out of the way. It's also why we don't give rabies vaccines until after 12 weeks.

Why Do Some Vaccines Need A Second "Booster?"
Some vaccines are more effective at stimulating the immune system than others; for example, a single dose of rabies will typically provide immunity for at least a year. Others, like leptospirosis, pack less of a punch; for those the first shot "warms up" the immune system so it's ready to mount a full response when boosted 3-4 weeks later. The reasons for this mostly have to do with the type of vaccine in question (see the previous article) and are beyond the scope of this article - trust your vet to sort this out for you, or ask them for the details when you've had six or more cups of coffee.

Wait, I Thought Fluffy Needed Shots Every Year?
How long is a vaccine good for? It's an easy enough question to answer - if you're willing to spend the money and time to vaccinate a bunch of animals, then maintain them in a controlled environment monitoring their immune response. The vaccine companies did this, of course, but generally just for a year. So, we knew the vaccines were good for at least that long but really didn't know when immunity started to fade, and thus when a booster vaccine was really necessary. At the time, recommending annual boosters made perfect sense as the safest thing for pets.

We now know, however, that most of the "core" vaccines generally provide good immunity for three years or longer, and most of us have changed our recommendations to reflect that. So, why so some veterinarians still hang on to the old annual recommendations? Maybe you're tempted to think it's about money - that vets see yearly dollar signs associated with yearly vaccines. That couldn't be further from the truth - after all, if money was our focus we'd all have become human physicians instead, doing essentially the same work on a different animal for three times the income. No, the reason many vets still recommend annual vaccinations is because it's a reliable way to get you to bring your pet to the clinic for the most important part of the annual visit - the physical exam.

This bladder stone - which basically filled the entire
bladder - was discovered on "routine" physical exam.
The owners had no idea the dog was having urinary issues.

It's no secret most people associate going to the vet with "getting muffy's shots," not "getting a physical." And yeah, you likely don't take yourself in for a physical yearly, either. The trouble is you know when your tooth hurts, when you've been nauseous for a month, or when your knees are starting to feel sore in the morning. You can get in the car and head to the doc as needed, or at least tell someone what's wrong and ask for a ride. Our pets don't have that luxury. Sure, sometimes it's obvious Muffy isn't feeling well - but ask yourself, do your friends and family notice every time you're not feeling well? And how long does it take them if they do notice. I couldn't tell you how often I find problems a pets' people had no idea about - everything from bum knees and ear infections, to bladder stones and broken teeth. Regular physical exams are hands-down the most essential service your vet offers, and while I don't agree with recommending vaccination more frequently than necessary to get pets in the door for that exam, I certainly understand why some vets still do it.

Note that several vaccines - leptospirosis, feline leukemia, bordetella, and lyme to name a few - don't last as long and really do need annual boosters. And for any vaccine, I always recommend a booster at one year the first time a pet receives it, regardless of the potential duration. Better safe than sorry (or stuck in the ICU with parvo). Our final article will cover adverse vaccine reactions; these are understandably a major concern of many folks, but fortunately are fairly rare.

Quick Tips For Low-Stress Vet Visits

Imagine your mother dropped by this morning with a very large box; without words or explanation she unceremoniously forced you into it, then tossed you in the car and took off. Eventually the car stops and she lugs you into the doctor's office (she's stronger than she looks, that mother of yours). She doesn't seem to understand your repeated questions, so you still have no idea what's going on or why you're here. However, several others seem to be in similar situations. Some are in boxes like you, others are tied to ropes - there's one person who won't stop shouting nonsense, another urinating on a chair leg, and one guy who won't stop trying to lick everyone in the face. Eventually you're taken into another room, dumped out of the box and onto your keister, then poked and prodded for no apparent reason by some strange woman in a white coat. They finish off with a couple of unexpected shots in the rump, then good ol' mom shoves you back in the box and drives you home.

Yeah, I guess that might be a little stressful. 

A little food cajoles most cats...

For some pets there may be no such thing as a "stress-free" vet visit, but we can reduce that stress to manageable levels. It's also important to note that animals deal with stress differently, just like people - some may growl or cower, but acting overly submissive or affectionate can be less-obvious signs too. Today's article covers several simple things you can do to make veterinary visits easier on your furry housemate's nerves (and in turn, your own).

Setting Expectations
Animals are bright, fast learners. If that cat carrier, leash, or car ride always culminates in getting poked in the butt by a stranger, it won't take them long to start freaking out at the first sign trouble is on it's way. I have one diabetic patient whose owner tells me Tiny's fine in the car if they turn left out of the driveway - but turning right always means the vet, and blood draws, and one instantly ticked-off Tiny. Fortunately, pets make positive associations just as easily, so you can undo most of this stress with a little effort.

....and the odd dog. This one
is more odd than most.

• Get in the habit of setting the cat carrier out once or twice a week with a treat or toy in it. They'll be eager to get in the next time you need to use it for travel.
• Likewise, take your dog on fun leash walks around the neighborhood regularly if you don't already.
• Once they are good with the paraphernalia, start taking your dog or cat on short car trips. Bring a food reward or two to make it fun - some fast food places like Sonic keep dog treats at the drive-thru so you can both get a little positive reinforcement.
• Placing a familiar-smelling item like a blanket in the car or carrier also helps pets relax.
• Drop by the vet clinic occasionally with Muffy, just to say hello or check their weight. Bring a favorite reward and ask a staff member to offer it.

On a related note, I highly recommend the pet carriers with snap-on tops. It's so much less stressful on everyone to just pop the top off, instead of prying Muffy out only to force her back in afterwards.

There's Stress In Numbers
Stress is additive and contagious. It's tempting to try getting all the pets in at once, and make it a family-fun event, but....Take two hyperactive kids, one mother shouting for them to calm down, then add in your incessantly barking Beagle-buddy to boot, and even the calmest Shih Tzu in the world is going to be on edge.

• Making veterinary visits an adults-only, single pet endeavor can really go a long way toward lowering the stress levels for everyone - you included. Plus, you get a lot more for your money when you can focus on asking questions and listening to the staff's recommendations without extra kids, furry or otherwise, vying for your attention. 
• If your significant other likes to argue or won't let you get a word in edgewise, get them a sitter too (my wife says her spouse is like that...). 
• On the other hand, if you are stressed out - which is okay, and often understandable - your pet will sense that and follow suit. It's always okay to ask to wait outside during the exam, and sometimes it really is less stressful for everyone.

The same strategies can be applied when choosing a vet or setting an appointment:

• Some clinics have started providing separate waiting areas for cats and exotics, since a room full of barking dogs is pretty much guaranteed to stress them out. 
• If you're flexible, asking for an appointment at a slower time of day is a good move too.
• Lastly, the discount walk-in shot clinic is almost guaranteed to have a waiting room full of chaos; that's one of many arguments for paying a little more to see the doctor down the street.

Better Living Through Chemistry
Of course, there are a few pets out there who just aren't going to adapt well to the clinic, car, or carrier no matter what you try. For those guys, there are varying levels of "chemical intervention" we can try to help them out.

What, you don't recognize Benadryl?

• Mild Anxiety: Pheromone sprays or collars like Feliway and D.A.P. may be helpful. They're also useful initially in conjunction with the above techniques to take the edge off.
• Moderate Anxiety: Ask your vet about trying Benadryl. It often provides some sedation and is quite safe for most animals at the proper dose - again, ask your vet.
• Severe Anxiety: There are several sedatives and anxiolytics that can be life-savers for dogs that truly need them; all have the potential for significant side-effects and require a prescription, however, so a good chat with your vet is in order. Furthermore, pets who need this level of intervention for a trip to the vet likely have other behavior issues that need addressed.

Lastly, but probably most important - if the stress of veterinary visits is truly tough on you and your pet, consider making an appointment solely to discuss this issue and come up with a plan of attack. You can even consider a consultation without your pet, if need be. Fortunately, though, most dogs and cats can learn to manage a trip to the vet with a just a bit of work and forethought on your part. I'm really not that bad. Plus, I have treats.