If you have been following along with the previous two articles you will have chosen your preferred vet and excitedly taken delivery of a new family member. Now is the time to kick off down the right track and provide this new friend with a healthy start in life. If you haven’t done so already now is also the time to decide about pet insurance.
When we look at the broad areas that constitute early health care, we can define them as socialisation, nutrition and dental care, vaccination, internal and external parasite control and de-sexing. Within some of these areas differing opinions exist so, again, it will be of value to be well informed. Of course, you could say that having done your homework and chosen the “best vet” that you are going to leave all the decisions to them, and will follow their directions to the letter: After all that is their job isn’t it? Yes, but understanding the reasoning behind those decisions, especially when faced by people with other opinions and points of view, should leave you in a position of knowledge rather than just confused. Quite a lot to discuss. So much in fact that this is part one only, with parts two and three of the article to follow in the coming months.
Vaccination is a topic that never seems far from the headlines and is definitely one where people hold polarising divergent views. Broadly speaking what follows is in line with the recommendations of the World Small Animal Veterinary Association’s (WSAVA) Vaccine Guidelines Group (VGG). Comprising a panel of experts in the field the group’s recommendations apply worldwide and can be downloaded here:
One of the main points of contention and owner confusion for the vaccination of puppies and kittens is how many vaccinations are required and at what age is the primary vaccination course completed? Before we can answer these questions however we need to know what we are going to be vaccinating against and what type of vaccine we are going to use.
Vaccines are essentially only of two types – infectious, alternatively called modified live or attenuated (MLVs); or non-infectious, so called killed or inactivated vaccines. MLVs are the closest thing to infecting the patient with a disease without them actually falling ill. They generally produce a superior immune response and that immune response persists for longer than when a killed vaccine is used. The superior response means the animal is better protected when, or if, it is exposed to the naturally occurring disease and the persistence of the immune response, the greater the duration of action (DOI), reduces the number of vaccinations an animal will require over its lifetime. A win win situation. Killed vaccines are often combined with immunostimulatory compounds (adjuvants), to increase their effectiveness, yet they still often fall short of the MLVs. Adjuvants themselves have been implicated in adverse injection reactions and whilst the exact interplay of the vaccine components in relation to adverse events is not fully understood, at the time of writing, it is generally accepted that MLVs are the preferred choice. Research into adjuvants and adjuvanted vaccines is ongoing and for some diseases killed vaccines are the only available option.
Regarding what we should be vaccinating against we need to make the distinction between so called “core” and “non-core” vaccines. The VGG consider core vaccines to be those that all dogs and cats should receive. Non-core vaccines are those that should only be used in geographical regions where the vaccinatable disease is prevalent and the individual is considered at risk. The core vaccines for dogs protect against canine distemper virus, canine adenovirus and canine parvovirus: For cats, feline parvovirus (panleukopenia), feline calicivirus and feline herpesvirus.
Locally non-core vaccines for dogs are parainfluenza virus, bordetella bronchiseptica, leptospira and coronavirus and for cats chlamydia, feline leukaemia virus and feline immunodeficiency virus.
I administer three primary vaccinations of a core MLV given at 6-8 weeks, 10-12 weeks and 16 weeks of age or later regardless of whether we are dealing with a puppy or kitten. For puppies I additionally perform vaccination against canine infectious tracheobronchitis (BbPi), more commonly known as kennel cough. A single dose of an intranasal MLV BbPi vaccine administered beyond 4 weeks of age is licensed though I currently use a killed vaccine given at 12 and 16 weeks of age.
The alternative point of view is that only the 6-8 week and 10-12 week vaccinations are required, this latter approach being called an early finish protocol. The contentious point revolves around maternally derived antibodies (MDA). As the name describes MDA originate from the mother and transfer to her offspring where they provide some protection against disease whilst the puppies’ or kittens’ own immune systems develop further. MDA has been shown to both persist until 16 weeks of age and interfere with the body’s ability to respond to vaccination: Hence the VGG position, that a 16 week or later vaccination is necessary. Vaccine manufacturers have, in trials, shown that individuals with good levels of MDA, experimentally challenged with the disease after receiving an early finish vaccine course, do not develop illness. This has allowed the manufacturers to obtain licenses for their vaccines for use in the real-world population that specify the early finish protocol. Confident in the efficacy of their vaccines the manufacturers support these claims by offering to pay for the treatment of any individual that succumbs to disease when vaccinated accordingly. To complicate matters further, vaccines are often licensed for both early and 16-week finish protocols; placing the onus on the vet to make the best decision for the individual situation.
Now if it is generally accepted that maternal immunity persists to sixteen weeks of age and can interfere with vaccination, what was the driving force behind the development of the early finish protocol? In a word socialisation. The early socialisation of puppies and kittens, their exposure to the wider environment and their early life experiences go a long way to producing a well-balanced individual. The ease with which animals learn about appropriate social interaction, both with people and other animals; and their ability to accept new surroundings and new situations diminishes as they pass through fourteen weeks of age. Puppy school and kitten kindy classes are often structured to accept enrolments from animals that have had the 6-8 week and 10-12 week vaccinations to maximise the time spent in class under the fourteen-week threshold and make full use of the early learning advantage. This makes perfect sense but does not preclude giving a sixteen-week vaccination.
Talking more about socialisation one factor that I believe cannot go overlooked is the age at which puppies and kittens are being removed from the litter parent dynamic. As a strong, stable, family unit provides the environment that allows the development of our children to become confident integrated members of society, so the same principles apply to our pets. Separating animals as young as six to eight weeks of age from their parents and initial environment is, I believe detrimental to development of good mental health and resilience for when the time comes to be rehomed. I appreciate that everyone wants to experience the early childhood of their new pet, the “cute and cuddly phase”; but I would urge you not to think about bringing your newest family member home until at least ten weeks and preferably twelve weeks of age. Of course, this requires a breeder that is on board with keeping the litter together for a longer period and this leads to both increased costs and work for them. These costs will in turn be reflected in a higher initial purchase price, which may make them seem uncompetitive or expensive when compared to other breeders. Understandably then, breeders are often keen to rehome individuals at the earliest opportunity, often before those individuals can cope with this very drastic change; increasing the likelihood of separation anxiety, fear aggression and phobias. Once again this highlights the importance of carefully selecting the breeder when acquiring a new pet. As with all decisions where cost is a factor make sure that you are comparing fairly and clarify what you are really being offered for your money.
If you are still with me at this point you may well be able to provide your own answer to one of the most commonly asked questions I hear: Is it safe to take my new pet to the park after the second vaccination? If you said there is no one answer – congratulations, you have truly understood the complexity of the issue. Following the early finish protocol? A few days after the second vaccination and you’re good to go. Following the sixteen-week finish protocol? Best wait until a few days after the last vaccination. This is where talking with your vet about the prevalence of disease in your local area is important. If prevalence is high, then waiting that bit longer and going with the sixteen-week finish seems prudent. With a low prevalence of disease then the risk taken during early park visits is reduced. Identify the risk, weigh the advantages to those risks and make an informed choice. As with puppy school, even if you do choose to go out beyond the home boundary early, remember this does not limit you to the early finish protocol.
After all this science lets finish part 1 with an easier topic. Insurance. Not being financial advisers’ veterinarians are limited to providing basic information only. If insurance is something you are considering, make a choice early, before the occurrence of disease that will then be excluded for life as pre-existing. You also need to make the best choice first time around, as swapping to a different insurance policy down the track will not provide coverage for conditions for which your pet has already been treated. This can lead to you feeling trapped with your chosen provider who are free to amend your policy and increase premiums at their discretion. Accident only cover will be limiting in the conditions for which you can claim, accident and illness giving much broader coverage. The highest levels of cover may provide a small yearly discretionary spend that you can use towards your service of choice – vaccination, de-sexing, parasite prevention. Be aware though that insurance is not there to cover your routine costs just as your car insurance doesn’t cover for servicing or new tyres. Dentistry is classified as routine care and is not covered, though as the insurance market develops it is possible we will begin to see policies that offer some form of dental coverage. Expect to pay more for this level of protection. Premiums will increase as your pet ages and the percentage pay-out, often quoted as up to eighty percent, will decrease over the same timeframe. This occurs even if the claimed condition was first diagnosed before the age at which a pay-out reduction is implemented. As of May 2019, Choice Magazine had reviewed eighty-six different policies and refused to recommend any, awarding a less than coveted Schonky award to the industry.
If you are well organised and can resist the temptation of dipping into available funds a bank account that you pay into regularly can be a viable alternative. Less beneficial if your pet develops a chronic or serious condition early in life, but for those individuals who are generally healthy this may well provide enough funds to cover the inevitable treatments as your pet ages.
The take home message remains the same. Do your research thoroughly, consider the options available and make an informed choice.
Next time we will be discussing another heavily debated topic desexing.