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Dodds: Titer Tests

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11 replies to this topic

#1
Kris L. Christine

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Avoid unnecessary vaccines with titer tests (Part III) by Dr. W. Jean Dodds 10/11/12 http://drjeandoddspe...testing-animals In my last two posts, I discussed the potential side-effects (vaccinosis) of over-vaccinating our pets, and the difference between MLV (modified live) and killed vaccines. I cautioned that dogs and cats with immune-mediated diseases are especially vulnerable to vaccinosis, since over-vaccination places additional stress on their already compromised immune systems and has been linked to autoimmune disease. So, then, what is the solution to this dilemma? How can you protect your pet from over-vaccination and the risk of contracting a life-threatening disease at the same time? Fortunately, the solution is simple and affordable. Titer tests. What is a titer test?A titer test is a simple blood test that measures a dog or cat’s antibodies to vaccine viruses (or other infectious agents). For instance, your dog may be more resistant to a virus whereas your neighbor’s dog may be more prone to it. Titers accurately assess protection to the so-called “core” diseases (distemper, parvovirus, hepatitis in dogs, and panleukopenia in cats), enabling veterinarians to judge whether a booster vaccination is necessary. All animals can have serum antibody titers measured instead of receiving vaccine boosters. The only exception is rabies re-vaccination. There is currently no state that routinely accepts a titer in lieu of the rabies vaccine, which is required by law. There are commercially available vaccine titer tests for dogs that can be performed in a laboratory or also in the veterinarian’s office for faster results. Several commercial and university veterinary diagnostic labs and Hemopet offer reliable titer testing for dogs, cats and horses. What do I do if the titer shows that my pet has immunity?If your pet’s titer levels show that an adequate immune memory has been established, you do not need to create the potential for vaccinosis by introducing unnecessary antigen, adjuvant, and preservatives into his body via booster vaccines. Instead, skip the boosters and have your dog re-titered in three years. Are there downsides to titering?There is no downside to titering your pet. However, be aware that some veterinarians may be resistant to performing titer tests in lieu of vaccination. These veterinarians are misinformed and incorrectly believe that measuring an animal’s serum antibody titers is not a valid method of determining his immunity to infectious diseases, or that this testing is too costly. With all due respect to these professionals, this represents a misunderstanding of what has been called the “fallacy of titer testing,” because research has shown that once an animal’s titer stabilizes, it is likely to remain constant for many years. Properly immunized animals have sterilizing immunity (immunity that prevents further infection even when an animal is exposed) that not only prevents clinical disease but also prevents infection, and only the presence of antibody can prevent infection. As stated by the eminent expert Ronald Schultz, DVM of the University of Wisconsin in discussing the value of vaccine titer testing, “You should avoid vaccinating animals that are already protected, and titer testing can determine if adequate, effective immunity is present. It is often said that the antibody level detected is ‘only a snapshot in time.’ That’s simply not true; it is more a ‘motion picture that plays for years.’” Furthermore, protection as indicated by a positive titer result is not likely to suddenly drop off unless an animal develops a severe medical condition or has significant immune dysfunction. It’s important to understand that viral vaccines prompt an immune response that lasts much longer than the immune response elicited by contracting the actual virus. Lack of distinction between the two kinds of responses may be why some practitioners think titers can suddenly disappear. What if the titer test is negative?Interpreting titers correctly depends upon the disease in question. Some titers must reach a certain level to indicate immunity, but with the clinically important “core” diseases vaccines, the presence of any measurable antibody indicates protection. A positive titer test result is fairly straightforward, but a negative titer test result can be more difficult to interpret. This is because a negative titer is not the same thing as a zero titer, and it doesn’t necessarily mean that the animal is unprotected. A negative result usually means that the titer has failed to reach a desired threshold antibody level, but a low titer may still mean that the dog is protected upon exposure, as it doesn’t reflect tissue levels of immunity. What’s the bottom line on titers?More than a decade of experience with vaccine titer testing and published studies in refereed journals show that 92 – 98% of dogs and cats that have been properly vaccinated develop good measurable antibody titers to the infectious agent measured. In general, serum antibody titers to the “core” vaccines along with any natural exposures last a minimum of 7 – 9 years, and likely are present for life. This corresponds with what we see clinically, as the number of cases and deaths due to these diseases has decreased significantly in the vaccinated population. The bottom line is that using vaccine titer testing as a means to assess vaccine-induced protection will likely result in your pet avoiding needless and potentially harmful booster vaccinations. And that is a huge benefit for a simple blood test!

#2
GrandCynth

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This is an excellent article to print out, and share with your vet. I've come across two vets who didn't want to titer my dogs, as they were obviously uninformed on titering.Thanks for sharing this valuable info Kris! I've made all three posts, stickies.

#3
Kris L. Christine

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You're very welcome!

#4
jakksmum

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thanks for the good info

#5
Kris L. Christine

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thanks for the good info

My pleasure!

#6
porterk

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I'm sorry for being ignorant, but I must ask. My pups are apparently allergic to their vaccines. They balloon up, turn bright red, get spots and in some cases go into anaphylactic shock (even when pre-medicated). Since the vet usually gives multiple shots together, I was told that next time that they are due for vaccines that we should do titers first to see if they really need them. We are not sure what they are allergic to: the rabbies shot, the parvo, or the distempter (I think those are the ones). If in fact it's the rabbies shot, my vet said they could have a note in their file saying they can't have a rabies shot, if needed, but you're saying a titer can't determine if they need a rabies shot or not?? Or are you just saying it doesn't matter if you check because most states won't accept the titer results?

#7
GrandCynth

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There is no state in the US, that currently accepts a titer test, in lieu of a rabies vaccination, which is mandated by law. I live in CA, and we are fortunate to allow medical waivers for dogs that have medical conditions that could be worsened by a rabies vaccine. My Ruby, is one such dog. Yearly, I must bring a letter written by my vet, to our city, to renew her license. I would think if you want to be safe, titer your dogs for the core vaccines, and get the written waiver your vet has offered for the rabies, since how can you possibly know which one/s caused such life threatening reactions?

#8
porterk

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Yes, that's exactly what my vet suggests and I plan to do. Sounds like your saying waivers are acceptable, that's what my vet said, too.

#9
Kris L. Christine

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[quote name='porterk;786942]I'm sorry for being ignorant' date=' but I must ask. My pups are apparently allergic to their vaccines. They balloon up, turn bright red, get spots and in some cases go into anaphylactic shock (even when pre-medicated). Since the vet usually gives multiple shots together, I was told that next time that they are due for vaccines that we should do titers first to see if they really need them. We are not sure what they are allergic to: the rabbies shot, the parvo, or the distempter (I think those are the ones). If in fact it's the rabbies shot, my vet said they could have a note in their file saying they can't have a rabies shot, if needed, but you're saying a titer can't determine if they need a rabies shot or not?? Or are you just saying it doesn't matter if you check because most states won't accept the titer results?[/QUOTE'] Absolutely, do the titers, ask for a note for their files & request a medical waiver from your vet the next time their rabies shot is due. Sometimes even states without medical exemption clauses in their rabies laws will accept a waiver. When my dogs were ill & had waivers, I had them titered in case they bit someone. States will not accept titers in lieu of rabies vaccination, but a current titer can make a difference if your dog runs into trouble.Having multiple vaccinations at the same time is not recommended, especially for small breeds of dogs (see below). Combination Vaccines, Multiple Shots--on Page 16 of the 2003 American Animal Hospital Associaton's Canine Vaccine Guidelines http://www.leerburg....cial_report.htm under Immunological Factors Determining Vaccine Safety, it states that: "Although increasing the number of components in a vaccine may be more convenient for the practitioner or owner, the likelihood for adverse effects may increase. Also, interference can occur among the components. Care must be taken not to administer a product containing too many vaccines simultaneously if adverse events are to be avoided and optimal immune responses are sought. "The quotes in red below are from the attached scientific report covering adverse events within 3 days of vaccination in dogs over the course of 2 years. Reports of dogs having vaccinal adverse reactions within the same time frame were not included if heartworm medication had been administered along with the vaccines. This study did not include adverse reactions such as development of fibrosarcomas and/or other conditions which take longer than 3 days to develop.Moore, George E. et als., Adverse events diagnosed within three days of Vaccine Administration in Dogs, Journal of the American Veterinary Medical Association, Vol 227, No. 7, October 1, 2005 Results—4,678 adverse events (38.2/10,000 dogs vaccinated) were associated with administration of 3,439,576 doses of vaccine to 1,226,159 dogs. The VAAE rate decreased significantly as body weight increased. Risk was 27% to 38% greater for neutered versus sexually intact dogs and 35% to 64% greater for dogs approximately 1 to 3 years old versus 2 to 9 months old. The risk of a VAAE significantly increased as the number of vaccine doses administered per office visit increased; each additional vaccine significantly increased risk of an adverse event by 27% in dogs ≤ 10 kg (22 lb) and 12% in dogs > 10 kg. The risk of a VAAE significantly increased as the number of vaccines administered per office visit increased (P for trend < 0.001).In all dogs, each additional vaccine administered per office visit increased the rate of a VAAE by 24.2%; the rate increase was significantly (P <0.001) greater in dogs that weighed 0 to 10.0 kg, compared with dogs that weighed 0.1 to 45.0 kg (27.3% vs 11.5%, respectively; Figure 4). The 3 dogs with recorded deaths each had received ≥ 4 vaccines at their last office visit.The risk of a VAAE in this study population was inversely related to a dog’s weight.The risk of allergic reaction has been reported to increase after the third or fourth injection of a vaccine (ie, a booster response).

#10
RICKYSmomma

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Another option when your dog could be allergic to any or all of the vaccinations is to do the vaccines separately and one at a time with a few weeks in between. The clinic I work at does this quite frequently where we do the distemper/parvo and then two weeks later the rabies as its quite a lot on their systems to do them all together. But i am PRO titre testing as well and we do that with Ricky

#11
jakksmum

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my little chihuahua always had the shots two weeks apart , and still puffed up like a shar pei....and the vet we went to at the time [ this was 5 years ago ] never even told us that she probaly did not need them every year and never mentioned titers , either. I still feel so guilty for trusting that vet. I think their only motivation was money...they didn't care what happened to the pets at all !

#12
GrandCynth

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Don't be so hard on yourself....it's amazing how many vets would still like owners to believe their animals need to be vaccinated annually, AND continue to give multi vaccines at the same time, even to very small dogs. And if you bring up the subject of titering....be prepared to hold your ground, or find another vet who will follow out your wishes. It's a HUGE pet peeve of mine! I am not anti vaccinations, but I am for responsible/educated vaccinations.




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