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Senior Care & Vaccines

Learn about the advances in vaccine technology and senior pet care, including the controversy surrounding vaccine protocols, the history of annual vaccinations, challenge studies, and the protocol for senior pets. Find out how these updates can benefit your pet's health and well-being.

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Senior Care & Vaccines

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  1. Senior Care& Vaccines Companion Animal Initiative of Tennessee

  2. Updates In Vaccine TechnologyAnd Senior Pet Issues • Dr. Kristi Lively, DVM, DABVP Canine and Feline Specialty • Village Veterinary Clinic & Laser Center • Farragut, TN 37922 • 865-966-8900

  3. Advances in Vaccine Technology • Controversy has surrounded vaccine technology for the last 40 years • Do vaccines protect pets for more than 1 year? • Tradition doesn’t make it right • USDA approved 3 year vaccine for Distemper, Adenovirus (Hepatitis) and Parvo virus is on the market- this changes everything

  4. Vaccine History • Annual vaccine protocols started in the 1950’s when the first canine distemper vaccines were developed • By 1961 annual vaccinations were being questioned but the research didn’t exist to test the need • Annual vaccination was born because it was cheap to do and the science didn’t exist to explain if this was right or wrong

  5. History Continued • In 1998 discussions began regarding the link of vaccinations to cancer in cats • Feline vaccine guidelines and technology were revised • Suddenly vaccinology and protocols were under scrutiny

  6. History Continued • 1998 a canine group published 3 year vaccine protocols • Many veterinary schools started adopting these protocols • In 2002 AVMA updates guidelines to allow for extended use protocols • In 2003 AAHA published Canine Vaccine protocols vaccinating for Distemper, Parvo, and Adeno every 3 years

  7. Into the Future • Now we have scientific recommendations from our leading veterinary organizations, but we still did not have an approved product with a 3 year duration label • Vets were using the 1 year products in an off label manner by giving them every 3 years • We were betting that the older vaccines did what we hoped they did • Has the immunity been proven? • What’s my liability?

  8. Challenge Studies • Challenge studies are the ONLY way to truly prove the duration of effect of a vaccine • Titers are more anecdotal • Challenge study: vaccinate, wait 3 years challenge with the virus • These are expensive studies to perform • Many companies not willing to invest

  9. Challenge Study • In 2005 Intervet completed a 3 year challenge study for Distemper, Adenovirus and Parvovirus • 20 Beagles in each group • Each dog was exposed directly to the virus and monitored for clinical signs or shedding of the virus • Excellent results • This is the ONLY company to get USDA 3 year labeling

  10. Challenge Studies Fort Dodge: • They do NOT have a USDA 3 year label • They used 7 dogs • 1 in 7 was shedding Parvo in its stool • 3 in 7 had clinical signs • I consider this unacceptable- so we had to wait

  11. Protocol • Continuum Distemper/Adenovirus and Parvovirus combination • Parainfluenza and Bordetella are annual in a nose drop • Rabies according to county law (3 yr in Knox Cty) • Corona no longer considered a core vaccine • Lepto for at risk dogs only

  12. Puppies • 2 shot series of the Continuum DAP, with at least 1 booster being after 12 weeks of age • DAP not due again for 3 years

  13. Puppies • Rabies at 16 weeks, at 1 year, and then every 3 years • Bordetella/ Parainfluenza annually • Others after risk assessment

  14. What This Means To You • Find a vet who is using the new Intervet product • Ask your vet why they aren’t using this product • Find a vet open to extended duration protocols, and tailoring the protocol to your pet’s individual needs • Expense is actually less over 3 years

  15. What This Means To Your Pet • Safer- fewer side effects • Less painful for the pet • Its not “just about the shots” • Redefining the reason for the annual visit • Vaccines save lives, absolutely…but they are not the most important part of the visit

  16. Questions RegardingVaccine Protocols

  17. Considerations For The Senior Pet

  18. Goals for Senior Patients • Enhance the Human-Animal Bond • Early detection of disease in the apparently healthy pet • Individualized medical care • Outline common senior conditions • Prevent of delay morbidity/mortality • Principles of assessing and managing pain

  19. What is a Senior? • Varies for breed and size • In people, 54-60 years of age • Dogs and cats: about7 years of age • Considered a senior when in the last 25% of the predicted life span for that breed

  20. Approach To Apparently Healthy Senior • Detect sub-clinical abnormalities and proactively intervene • Thorough history • Nose to tail physical exam

  21. Approach Continued • Client education • Preventive care • Minimum data base • Establish a baseline assessment for future comparison (PE/Xrays/BW/UA)

  22. Elements of aThorough History Questions extend beyond the owner’s presenting concern • Risk factor analysis • Quality of life • Specific behavior questions • Medications and supplements • Water intake • Housebreaking • Ambulation

  23. Elements of thePhysical Exam • Observation before handling • Weight changes • Ocular exam • Lymph nodes • Thyroid enlargement • Abdominal palpation • Orthopedic and nervous systems • Auscultation • Rectal palpation

  24. Minimum LaboratoryData Base AAHA recommends every 6 months: • Complete blood count • Urinalysis • Fecal • Chemistry 27 • HWT

  25. Labwork Continued • Urine protein/creatinine ratio • Thyroid • Schirmer tear test • Blood pressure • Intraocular pressures • Imaging studies

  26. Preventive Care • Recommendations prior to or at the onset of disease to prevent/slow the effects of disease • Start senior wellness plans at middle-age to establish baselines • AAHA recommends bloodwork annually during middle-age

  27. Client Education • Semi-annual exams • Increased attention to oral health, prophylaxis and home care • Nutrition and supplements- digestibility, calories, new developments • Weight and parasite control • Maintaining mobility- exercise or therapy

  28. Client Education • Vaccination as appropriate • Mental health/enrichment- cognitive decline, social interaction • Environmental conditions- accommodation of disabilities, indoors/outdoors • Potential reproductive disease in un-neutered pets: pyometra/testicular, mammary and prostatic neoplasia

  29. Approach To TheUnhealthy Senior Pet • Common clinical conditions • Evaluation of the patient • Client communication • Choosing appropriate treatments • Monitoring • Pain management • Nutrition

  30. Common Clinical Conditions • Weight changes • Orthopedic conditions- arthritis • GI disease- IBD, dental disease, liver • Endocrine disorders- Cushing’s, Hypothyroidism, Diabetes Mellitus

  31. Common Clinical Conditions Neurologic /behavior: • Disorientation • House soiling • Anxiety • Aimless activity, sleep-wake cycle alteration • Fecal or urinary incontinence • Spinal disease/ seizures

  32. Common Clinical Conditions • Sensory: KCS, cataracts, retinal disease, deafness • Urogenital: renal disease, UTI’s, stones, uterine or prostatic disease • Cardiac: murmurs, endocarditis, dilation • Anemia • Skin: tumors, otitis • Respiratory: laryngeal/ tracheal collapse/ saccules

  33. Exam Of The Sick Senior Pet • Still nose to tail, but pay particular attention to clinical changes or signs of pain • Maybe required more often than every 6 months depending upon condition • Include blood work, blood pressures as appropriate for the condition or medications

  34. Client Communication • Veterinarian should recommend what is best for the pet and the client choose what is best for both of them • Discuss your follow-up plan and required monitoring • Get diagnosis and information in writing • Copies of blood work

  35. Client Communication • Discuss prognosis • Discuss side-effects of treatments • Discuss time commitment • Discuss quality of life issues • Pain management

  36. Choosing Appropriate Treatments • Don’t overuse/indiscriminate use of antibiotics • Avoid drugs that alter mentation or impair mobility (sedatives) • NSAIDs (Rimadyl, Deramaxx, Previcox) - Must monitor blood work, other meds

  37. Long Term Monitoring • Vet and client share the responsibility of complying with long term monitoring • Drug monitoring (therapeutic levels) • Specific tests according to disease state • Formal hospital call back system is crucial to successful case management • Consider referral to specialist as needed

  38. Pain Management • Treatment options vary depending upon the type of pain (acute vs chronic) • Opiods are not as appropriate for chronic pain alone • Supplements (Cosequin, Adequan, Fatty acids) • Physical therapy and massage

  39. Pain Management Cont • Acupuncture • Weight management • Environmental modification • Frequent communication between vet and owner • Discuss side effects, monitoring, combinations

  40. Nutrition • The unhealthy senior pet will have unique nutritional needs • Prescription diets • Weight control • Caloric intake (decreased or increased)

  41. Conclusion • The goal is to identify underlying disease before it is clinical • Start treatment and monitoring plans proactively, not reactively • Ensure the best quality of life for the senior patient and for the senior pet owner • Communication and follow-up are key

  42. Questions RegardingSenior Care?

  43. For more information, please contact CAITwww.vet.utk.edu/caitcait@utk.edu865-755-2276

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