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Dog Vaccinations: are they really necessary?

Tomorrow is World Veterinary Day (WVD), an annual event that highlights the role of veterinary profession around the world. This year's theme is the importance of vaccination to animal health. Over the past two hundred years, scientists have created vaccines that have prevented - and, in some cases, eradicated - diseases in humans and animals. Yet if you talk to pet owners online, the question of the need to vaccinate is one that keeps cropping up. People worry that vaccines may even be causing illnesses, and sadly, they sometimes feel that they cannot trust the advice from their vet, because the vet benefits financially from the sale of the vaccine. There is a danger here that pet owners may stop vaccinating their pets, and if they do, it's likely that they will get away with doing so for a number of years. Vaccines have caused serious illnesses to become rare, so that there may not be an immediate threat to most pets. The problem is that if people choose not to vaccinate, there will be a growing population of unprotected animals that are vulnerable to viral disease if an epidemic does occur. It's useful to compare the situation with measles in humans. Before the introduction of measles vaccination in the UK in 1968, about half a million people caught measles each year of whom about 100 died. The introduction of the MMR vaccine in 1988 led to a dramatic reduction in measles, with only two human deaths from the disease in the past twenty years. False claims in the late 1990's that MMR could cause autism led many parents to refuse to vaccinate their children. Vaccine rates dropped and there are now up to two million young people who remain unvaccinated: they are at risk of the disease. This is not just theoretical: an outbreak of measles is currently happening in Wales, with over eight hundred confirmed cases including over eighty patients being treated in hospital. The first death happened last week, when a twenty five year old man passed away. As one official said, "Measles is a serious, horrible disease. We need to get rid of it." The sad truth is that we know how to get rid of it: vaccinations, which have been proven to be safe and effective. Public health officials are now running large scale measles vaccine clinics to protect people who missed out on childhood vaccination, but there are still worries that the proportion of unvaccinated people may be so high that the current measles outbreak will spread to elsewhere in the UK, with further deaths. There have been similar false claims about dangers associated with vaccinations in the pet world, and as a result, there is a risk of the gradual development of a large unvaccinated population of pets. This would create the potential for an outbreak of one of the nasty viral diseases of pets in a similar way to the human measles situation. It is true that there is a low incidence of adverse reactions to vaccines. Like humans who feel a little under the weather after some vaccines, pets can suffer mild signs of illness as their immune system reacts to the vaccine. This is part of the same immune reaction that causes the body to produce antibodies against the virus, so it's nothing to worry about. More serious adverse reactions, such as allergic or autoimmune diseases, do happen, but they are exceptionally rare. Overall, the reported incidence of any type of problem is less than one in five thousand; the risk of a serious reaction is much lower than this. The aspect of dog vaccines that seems to worry owners most is the traditional model of "once yearly boosters". People don't understand why this is necessary, when in humans, childhood vaccines often confer lifetime immunity. Why do pets need so many vaccines? The answer to this is complicated: when vaccine regimes were first devised, back in the 1970's,  there was a high mortality rate from diseases like Parvovirus and Distemper. Duration of immunity after vaccines had not been clearly established, and the safest option was the once yearly booster. In recent years, more studies have been done, with many vaccines now promising immunity for three to five years for some diseases after the annual booster at fifteen months of age. In the face of this changing information about vaccines, the challenge for vets has been to recommend a reduced vaccine schedule while still ensuring that no vulnerable animals slip through the loop. Much as pet owners may appreciate the opportunity to go to the vet less often, if even one animal died of a preventable viral disease, vets would feel that they had failed. The veterinary profession has tackled this on a global scale, by setting up expert groups, using independent scientists to assess the evidence and to provide guidelines for the vaccination of pets. A simple set of recommendations have now been issued to vets across the world by the World Small Animal Veterinary Association, and these offer the safest approach to pet owners. You can read them for yourself online by clicking here. Vaccines are now classified as "core" and "non-core". Core vaccines include those which all animals need to receive, which means Distemper, Hepatitis and Parvovirus for dogs. Non-core vaccines are those that are required by only those animals whose geographical location, local environment or lifestyle places them at risk. Examples include Leptospirosis, Kennel Cough and Rabies, although the prevalence of rats in many parts of the UK  is so high that many people would regard Leptospirosis as a core vaccine in this country. The aim of the veterinary profession is to vaccinate every animal with core vaccines and to vaccinate at-risk individuals against non-core vaccines if they are seen to be at risk. The WSAVA guidelines also address the recommended frequency of vaccination: for the main core vaccines, after puppy shots followed by a booster at fifteen months of age, it's now regarded as safe to repeat the vaccine every three years. If dogs need to be protected against certain other illnesses- including Leptospirosis and Kennel Cough - immunological studies have demonstrated that once yearly vaccines are still needed. This can all become over-complicated for the average pet owner, which is why it's still recommended that the safest answer is a once yearly health check by your vet. The vet will review your pet's health and lifestyle, and will then only give the vaccines which are judged to be necessary. In the United Kingdom, for most dogs, the recommendation is likely to be a once yearly vaccine against Leptospirosis, with a booster against Distemper, Hepatitis and Parvovirus every three years. Other vaccines, such as Kennel Cough and Rabies, may also need to be given, depending on the dog's activities. There is plenty more to discuss on this subject, including widely-disseminated but unproven claims that over-vaccination is the cause of a wide spectrum of illnesses in the dog world. Perhaps that's a subject for another blog.
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Horses and money – is it really either/or?

With the new financial year, and the recent bad weather, everyone involved in and working with horses is trying to make money go a bit further. Among other issues, the cost of medicines is rising every month (many drugs have seen their manufacturers put the price up 10 or 15% in the last few months), and feed bills are rising due to poor cereal harvests. As a result, I've put together a list of "top tips" for saving money in the coming year. Firstly, 5 things to do... 1) Make sure you worm smart - which doesn't necessarily mean often! Many owners still worm religiously every 6-8 weeks; however, recent studies have shown about that 80% of the worms are in 20% of the horses. If your horse doesn't have a high worm burden, it may be a waste of money pouring expensive wormers down him every other month. In addition, the more wormers we use, the higher the risk of worm resistance - there has been recognised round- or redworm resistance to every active ingredient available in the UK, so the less we use them, the longer they'll be effective. The way I like to recommend people go forward is to use Worm Egg Counts - your vet will be able to do these, or will have a lab they send them away to. The test simply takes a faeces sample and counts the worm eggs in it, giving you a good estimate of the number of worms in the horse. Remember, this test can only be done in the warmer months (the worms don't lay eggs in the winter!), and it only tests for nematodes (round and redworms). To test for tapeworms, your vet will need to take a blood sample, but this usually only needs doing once or at most twice a year. Depending on the test results, your vet will be able to advise you on the best worming strategy, and if you've got a low burden, it may not be necessary to worm at all, as long as your pasture management (poo-picking etc) is decent. I've seen horses wormed every month come back with such low counts that we stopped worming completely and, because they weren't mixing with lots of other horses, they were still worm free a year later. That said, I've also seen horses that really do need that regular dose, so it does depend on the yard, the herd and the individual horse. 2) Consider warming up with unaffiliated competitions - and beware direct debits! Skip past this one if you're not competing - but if you are, it may be possible to affiliate part way through the season, saving money by starting with cheaper unaffiliated events. How much you save depends on your sport, and your area (down here in Devon and Cornwall, unaffiliated events are are usually perhaps half to three quarters as much as an affiliated event), but at the very least you save the up-front cost of affiliation and membership. That said, you can't decide to cancel your affiliation if you've got a Direct Debit set up to automatcally renew it (as my brother found out this year, when he accidentally rejoined BE...!) 3) Buy medicines online. This is a fairly new area, and can be controversial. However, without any doubt you can save money on prescription drugs if you buy them from a reputable online pharmacy or dispensary. If your horse needs a prescription medicine, your vet is legally obliged to give you a written prescription if you ask for it (although they will normally charge an administration fee). In general, you can get the same medicines online for about half to two thirds the price. However, its important to make sure you deal with a reputable company: as a rule of thumb, if they don't ask for a prescription, or they're not based in the UK, don't touch them. In addition, you should check to see who is in charge of dispensing the medicines at that company - if they're legit, they'll be able to tell you the name and registration number of the pharmacist or vet who is responsible. Having worked in this sector, there are four companies I've dealt with who I would consider safe and reliable to buy from (AniMed Direct, MedicAnimal, MyVetMeds and VioVet), but that doesn't mean that there aren't other good ones out there. Bear in mind as well that a few companies change their prices through the day, and also make sure that the price includes VAT - if in doubt, phone them up and ask! Although it seems like a hassle, for long-term medication (like bute or Prascend) or really expensive drugs (like Gastrogard), you can make a massive saving buying online. 4) Shop around for insurance... It may be you can get a better deal from a different company! However, before you change, make sure that your level of cover won't be affected, and remember that you are legally obliged to disclose any relevant medical history. There are a couple of very bad insurers out there, and some fantastic ones, so do your research before changing - a company with a really cheap premium but who won't pay out when needed are a false economy. The other option is to cancel your insurance, and then set aside some money each month in a separate acount to cover vets bills. Do your sums first, but if you've got several horses it can save money to do it this way, and there's no worry about exclusions or wondering if they're going to pay out. 5) Does your horse NEED all those vaccines? Tetanus is a genuine life-saver. However, not every horse needs every other vaccine. If they're not competing, not mixing with other horses much and aren't on a big yard, its worth talking to your vet about flu vaccine, and if they're not breeding stock either, herpes vaccine probably isn't worth it. 6) If you have any health concerns about your horse - phone your vet! Most practice do not charge for a phonecall, and your vet will be able to advise you as to whether you need a visit, and if there's any treatment or first aid you can give. Beware of consulting "Dr Google" - its an easy way to scare yourself, because for some reason, Google always lists the most serious and rare diseases first. If you do want to check out your horse's symptoms online before calling your vet, I'd advise you to use the VetHelpDirect Symptom Checker - but talking to your vet is likely to be even more reliable! I once had a client call to arrange a visit for us to "sew up her mare after foaling". We thought that she meant the mare had torn a bit, but it turned out that she thought the foal was going to come bursting out of the mare's side like a alien parasite, and she was delighted when we were able to tell her that she didn't need to spend the £50 for an evening visit as long as the foaling went well... So, thats your things to do, now five things to watch out for: 1) DON'T skimp on Preventative Health. Tetanus vaccination is a genuine life-saver, and regular, routine dental care will save money in the long run. I once had to spend five hours basically repairing an 11 year old stallion's mouth because he'd never had any teeth rasped and the hooks had overgrown so much that one day he couldn't open his mouth enough to chew. For the previous six months the owners had been pouring expensive concentrates into this pony to try and get the weight back on, but it was due to his inability to chew properly. If they'd kept up to date with routine dental care, it would have saved them a lot of money, effort and time! 2) Be cautious with cheap paraprofessionals. There are a lot of horse dentists, chiropracters, massagers, physios and assorted back people out there. Many of them are very good, some aren't, and a few are downright dangerous. However, it isn't immediately obvious which is which... There are a couple of things to bear in mind when you're calling someone out. Firstly, it is a criminal offence for anyone who isn't a vet to diagnose a medical problem in a horse (with limited exceptions in the case of farriers dealing with a hoof problem, and BAEDT qualified dentists dealing with dental overgrowths). This means that your insurance policy will be invalidated if they make a diagnosis and act on it; it also means that in law you have no comeback if something goes wrong. In addition, if you allow anyone except a vet to prescribe or dispense a prescription only medicine to your horse (e.g. a dentist giving sedatives), you're both breaking the law. Remember too, even qualified physios technically need a referral from your vet before they're permitted to work on your horse. Secondly, it isn't necessarily a money saving technique to call in a paraprofessional. I remember seeing one client who had spent nearly a thousand pounds on physios, back people, chiropracters and alternative therapists, all of whom had given her a different diagnosis of her poorly performing pony. When my colleague was called out, she realised immediately that the horse was lame, and dug out an abscess from her nearside hind hoof. The horse was right as rain two days later - all for the princely sum of £48 plus a packet of animalintex. Thats not to say there isn't a place for paraprofessionals - BAEDT dentists, farriers, qualified physios and some other practtioners can be great to work with and bring a horse right again, but it needs to be a team exercise, as we all bring our different skills and expertise to the case. 3) DON'T buy ultra-cheap feed and fodder. Cheap, poor quality hay and haylage are never a good place to save money - if you're lucky, you're horse will need to eat more to maintain condition, and if you're unlucky, they'll suffer lung and sinus problems from spores, and possibly even listeria infection from bad haylage. 4) Be cautious about chopping and changing vets - many people use one vet for vaccines and another for out-of-hours and emergencies, or stud work. Sometimes this can save you money, but it can also lead to problems - a client of mine (who also used two other local vets) nearly lost one of her broodmares to a bad reaction to penicillin. It turned out that one of the vets had noted that the horse had reacted once before, but because they didn't know she was using the other practices, they didn't know to tell us. Fortunately in this case the mare survived, but it just goes to highlight the necessity for good communication. If you are going to use more than one practice, make sure that everyone knows who's involved and who's doing what, so that we can share notes if needed. Better still, make up your mind who you want to treat your horses, so they can provide continuity of care. Keeping horses is, by its very nature, expensive. However, with care and forethought, you can make the money stretch a bit further, even as the prices are going up.
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Ask a vet online- “My 9 year old GSD has a black disk like cataract in one eye. Can it be removed safely. Would this be expensive to remove? Is this usually done by my vet or a specialist eye vet?”

Question from David Keown My 9 year old GSD has a black disk like cataract in one eye. Can it be removed safely and what's the prognosis for a good recovery. Would this be expensive to remove? Is this usually done by my vet or a specialist eye vet? Thanks. Answer from Shanika Williams MRCVS online vet Hi David, thank you for your question about the black disc in your GSD's eye (German shepherd dog). Firstly I will describe what a cataract is; I do not think that your dog has a cataract but an iris cyst. A cataract is an area of discolouration in the lens of the eye, the lens sits in the middle of the eye and is usually colourless and clear, it sits just behind the iris (coloured part of the eye). Usually a cataract can only be seen without the use of specialist equipment if it is very large or the lens has dropped out of its correct position and has fallen into the front chamber of the eye. So what is the black disc? The black disc that you are describing in your GSD's eye is most likely to be an iris cyst. Iris cysts are fluid filled black discs of varying size that bud off from another part of the eye. They vary in size (usually few millimetres in diameter) and can move around or are fixed in position; they are usually found at the front bottom half of the eye. I have personal experience of this condition as our family GSD had several mobile iris cysts. Does my pet need any treatment? Iris cysts rarely cause a problem to your pet; they are not painful and rarely have any impact of your pet’s vision so we tend not to treat them. It is however important to distinguish an iris cyst from an iris melanoma (benign cancerous growth). Iris melanoma is a condition where there is a slow growing area of black visible within the front chamber of your pet’s eye. Iris melanoma can lead to cataracts, glaucoma (increased pressure in your pet’s eye) and pain. If iris melanoma is suspected then it might be advised that your pet’s eye is removed. Most pets cope incredibly well after removal of an eye, it is considered to be better not to have an eye than to have one that is diseased and causing a lot of pain. So I would advise that your dog is examined by your own vet and then if required a veterinary ophthalmologist (eye specialist), if it is an iris cyst then your pets prognosis is excellent. If however iris melanoma is suspected then after the correct treatment which may involve eye removal then again the prognosis is good. I hope that this answer has helped you and your dog. Shanika Winters MRCVS (online vet)
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Ask a vet online – “My dog is drinking a lot, and seems to be starving to the point of raiding my Shopping bag. She has Arthrities and her back end seems to be wobbly.”

Question from Gurnos Tenants Residents My dog is 14 and is drinking a lot, and seems to be starving to the point of raiding my Shopping bag, something she has never done before. She has Arthrities and sometimes her back end seems to be wobbly. Answer from Shanika Winters MRCVS online vet Thank you for your interesting question which has four parts, I will discuss one at a time. Your dog is drinking a lot. The first thing to do when you have noticed that your pet is drinking more is to work out the actual amount of water being drunk. This is most easily done by measuring out how much water you put into the water bowl, also how much is left each time you change the water. It is best to work out how much your pet is drinking over a few days as this will give an average amount per day taking into account differences on each day. We usually consider a dog to be drinking too much if water intake is more than 100ml/kg/day that would work out as around 2L for a 20kg dog (a medium sized dog). So when you discuss your pet’s water intake with your vet they will want to know the amount your pet drinks a day, its weight and if there have been any changes to your pet’s diet. Dry food diets tend to lead to pets drinking more water than wet food (tins or pouches). Your vet will also want to know if your pet is passing urine as normal or if this has changed in amount or frequency, often it is helpful to collect a sample of urine in a clean container and take this to your vet for analysis. Increased drinking is called polydipsia (PD) and can be an indication many conditions including kidney disease, infection, hormone imbalances and diabetes. It is really important to discuss any other symptoms your pet is showing with your vet so that the most appropriate urine and blood tests can be performed to find out the cause of your pets PD. Your dog is raiding your shopping bags. When a pet has an increased hunger we call this polyphagia (PP). It is normal for dogs to eat more food when their energy needs go up e.g. when the weather is cold, if they are more active than usual or during the later stages of pregnancy or lactation (milk production). So provided there is no obvious reason for your pet to be eating more this is definitely something worth discussing with your vet. Ideally if your pet is weighed regularly and records have been kept of this any changes will help to make a diagnosis as to what is causing your pets PP. Some of the conditions mentioned for PD can also lead to PP. Arthritis and a wobbly back end. Arthritis is a degenerative condition of the joints which is very common in pets as they get older. There is increasing damage to the joints which can lead to difficulty standing and walking as well as pain. Your vet will diagnose arthritis based on the signs your pet is showing such as difficulty getting up and walking, wasting away of muscles, physical examination plus or minus x-rays. Often the joints feel stiff and your pet will object to their joints being moved through a normal range of movements. The hips, elbows and back are common sites for arthritis and may well lead to the wobbly back end that you describe your dog as having. There are other causes for a wobbly back end such as spinal disease other than arthritis, general weakness and poor circulation. After discussing the points you have raised as regards your dog I think it would be advisable for you to take your dog for a full examination by your vet, please take as much of the extra information you can to help a diagnosis to be made so that your pet can receive the best treatment possible. A few simple blood tests and or x-rays will help your vet to work out how best to treat your pet, we do not like to just assume that changes are due to a pet ageing. Where possible we want to provide the best quality of life for all animals. I hope that this answer has been helpful to you and that your dog soon returns to a good quality of life. Shanika Winters MRCVS (online vet)
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