1. Companion Animal Initiative of Tennessee
Senior Care & Vaccines
Companion Animal Initiative of Tennessee

2. Updates In Vaccine Technology And Senior Pet Issues
Dr. Kristi Lively, DVM, DABVP Canine and Feline Specialty
Village Veterinary Clinic & Laser Center
Farragut, TN 37922

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
CDC does not accept serologic titers in people

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 Regarding Vaccine 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, years of age
Dogs and cats: about 7 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 a Thorough 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 the Physical Exam
Observation before handling
Weight changes
Ocular exam
Lymph nodes
Thyroid enlargement
Abdominal palpation
Orthopedic and nervous systems
Auscultation
Rectal palpation

24. Minimum Laboratory Data 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 The Unhealthy 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 Regarding Senior Care?

43. For more information, please contact CAIT www. vet. utk
For more information, please contact CAIT