Vaccine titer and Rabies Challenge Fund Update

In 1999, the  American Animal Hospital Association and American Association of Feline Practitioners Current Vaccine Guidelines (check out www.dvmvac.com) Issued guidelines indicating that there was sufficient research to support boostering vaccines every 3 years for mature dogs and cats. Newer research indicating boostering Distemper Parvo and Feline respiratory vaccines every 5 years provides adequate protection. Some vaccines like Kennel cough must be repeated each year to be effective, but most do not. Rabies vaccines by law have a 1 year or 3 year license. It has been legal to use the 3 year license rabies vaccine in South Carolina for at least 10 years, as long as it is the second rabies vaccine the pet has received in it's lifetime. There has been a Duration of immunity study for Rabies vaccines underway for 5 years, and for 1 vaccine, the results are a bit disappointing.

http://www.rabieschallengefund.org/latest/summary-of-the-rabies-challenge-fund-duration-of-immunity-study is the link to the summary of the unpublished results. What the researcher, Dr. Ron Shultz, used to determine protection against rabies is the current titer test which is used to establish if a pet has an antibody level against rabies considered to be protective, and thus safe for travel into an area with no known rabies virus. For the first vaccine, this titer level was protective for the first 3 years for all the dogs, with the titer levels dropping in the fourth and 5th years. The dogs with a protective titer in the 5th year was  less than 30%. While this is disheartening, as part of the goal of the study was to extend the duration of immunity licensing for pets, the dogs that did not have protective titer levels, were tested for immunologic memory, and most, but not all dogs did have immunologic memory. What is not known is if Immunologic memory correlates to protection against live virus. As soon as a facility is available, the animals with a low titer but immunologic memory will be exposed to live rabies virus to determine if there is a correlation. The Titer test values that are deemed protective, are an extrapolation from human values, and have not been determined via challenging animals with the virus.

So what does this mean? it means that your pet is most likely protected for at least 5 years after it’s last rabies vaccine, though it may not have a protective titer level. The live virus challenge should shed more light on how well your pet is protected.

With regards to potential vaccine side effects, we’ve been using Thuja for a few years to help ameliorate both short term and long term side effects, and While there is no way to know for sure, the reaction rate is very low in our practice. I recommend splitting the vaccines by at least 2 weeks as well, to allow the immune system to process properly, and not be overwhelmed. We know the rabies vaccine will increase thyroid autoantibodies in dogs for 3 months after being vaccinated, and there is an association with the distemper parvo vaccine and autoimmune disease. While these are concerning, the fact is that parvo virus and distemper virus are still out there, and we had the sad task of treating a puppy with parvo last week. The University of Tennessee veterinary school experienced an outbreak in their teaching hospital that started with an adult dog that had never been vaccinated. Thankfully both viruses are easliy destroyed by disinfectants, but do persist outside in the soil.  

Medicine Is Intention

I am just back from the first combined meeting of the AAVA and International Veterinary Acupuncture Society, and it was an inspiring meeting. The first series of talk by Dr. Bonnie Wright focused on how Evidence based Medicine understands the efficacy , or lack thereof, of acupuncture. There are several types of research that are given more credence or weight as to whether a particular treatment works, or doesn't work. The most valued type of research is a meta-analysis, which essentially combines the results of many studies, filtered out for specific characteristics. Randomized control trials are considered the best type of primary research, as the new treatment is often compared to a control or untreated group, or to the gold standard of treatment. the validity of studies decreases as you go down the scale to a series of case, reports, or expert opinion. Studies looking at what are called Patient centered outcomes are considered to have low value, but many in medicine are asking why we are not doing more of these studies, as the afore mentioned studies often involve looking at only one condition and treating that condition, whereas a patient that is sick may have several medical issues present, and the randomized control study may not have any bearing on a more typical patient's response to a treatment. There is growing sentiment that Evidence based medicine may not be in the best interest of the patient. EBM is often funded by a drug company looking to bring a drug to market, and so the suspicion is that the results are biased toward the drug. Dr. Wright presented a series of papers comparing placebo treatments to placebos treatments, with one paper showing astonishing results. Ted Kaptchuk is a talented human acupuncturist, and wrote The Web That Has No Weaver, a seminal book about Traditional Chinese Medicine. His more recent interests lie in studying the placebo effect, and he has authored several studies comparing placebo to placebo, sometimes with the patients knowledge, and sometimes not. In Components of placebo effect: randomised controlled trial in patients with irritable bowel syndrome BMJ 2008; 336 doi: http://dx.doi.org/10.1136/bmj.39524.439618.25 (Published 1 May 2008) BMJ 2008;336:999, There were 3 groups of patients with Irritable bowl syndrome. The first group was on a waiting list for teatment, the second group received sham acupuncture with limited practitioner contact, and the third group received sham acupuncture with and augmented warm, caring relationship with the practitioner. After 6 weeks, 28% of the participants reported an improvement on the waiting list, 44% in the limited sham acupuncture group improved, and 62% of the augmented sham acupuncture group improved. The fascinating thing, is that 61 and 62% improvement is the gold standard for drug therapy across many trials. So what does this mean? Certainly the practitioner interacting with the patient is important. Also, the practitioner telling the patient that they expect that the patient is a good candidate for acupuncture, and that it should suply quite a lot of relief, creates confidence in the patient that they will improve. What this study makes me think most about are the words of Sun Si Miao, a 7th century Chinese doctor. He said "Medicine is intention". These are words I do my best to live by every day. We generally think that there is no placebo effect in pets, but what I have seen is that as the owner grasps that there is some hope for their pet, and that the quality of life can be improved, then the pet will visibly relax in the room. I believe that if one has a trust based relationship with one's healthcare provider, then the chances of healing are markedly improved. If you do not trust your health care provider, it is tough to get well. More than half of what I do all day is talk to people and give them tools to help support their pets. as well as a sense of hope. I cannot begin to tell you how gratifying this job is, when I see pet and owner united in optimism for health.

Welcome to DrRuthRoberts.com !

Welcome!

I want to help you understand that the transformation from a sick pet to a healthier pet is your responsibility, and right if you are willing to commit to change.

Change is difficult, uncomfortable, and it takes tremendous effort. But it is so worthwhile, especially once you begin to see the results.

With each choice we make, we take ourselves down a path. As we get far enough along a particular path, the outcome may become inevitable. While some outcomes are inevitable, we can make the journey less painful.

I want to help you see how much joy our pets want us to experience. Our pets do not want to be sick, but they also do not want you to be so afraid because they are sick. 

The basis of health is a healthy lifestyle. While many people are adopting this concept, there are few clearly laid out programs for pets.

On my site you will find tools and products to help you rebuild your pet's natural vibrancy.

- Dr. Ruth Roberts