I took my 20 week old English Setter pup to the Vets to have a Rabies vaccination. the vet insisted he have a kennel cough vaccination also - which he then administered by injection in the same place as the rabies injection. Since then the pup has been very poorly. He was listless and obviously sore in the region of the injections. The vet administered antihistamin and painkiller injections later that day. He seemed better the next day and then went down hill the following day (yesterday). Today he could hardly lift his head from his bed and was whimpering. Again, I took him to the vet who this time kept him in, put him on a drip with fluids, antibiotics and painkillers. When my wife collected him this evening he was slightly improved and his temperature of 42 had returned to 38. My question is double-edged: surely kennel cough should be administered by spraying up the nose?, and is there any possibility that the kennel cough vaccine injected into the same site as the rabies vaccine aggravated the possible reaction to make it far worse than otherwise it might have been?

The kennel cough vaccination is squirted up the nose, not injected. Are you 100% positive (though I've no reason to doubt you) that it was a kc vaccine?

There is a nasal spray for one of the strains of kennel cough but there are many different types of kennel cough much like our upper repository viral infections and any one vaccine will not deal with all the different types there is a injectable one that is usually given with the booster jab so I would not be surprised if that is the one your pup had and he may well have already had the same thing when he had his initial set of injections. IMO a vet can't and should not insist in giving medication that you have not asked for certainly not before they have explained why.

What brand of vaccine does his vaccination card say was given?

Yes - in fact, we took 3 dogs (2 adults and the puppy) and all 3 were injected.

The pup had not had any kennel cough vaccine before - and the brand given (by injection) was Nobivac KC.

http://www.msd-animal-health.co.uk/products_public/nobivac_kc/090_product_datasheet.aspx

If you read this datasheet it tells you how it should be administered.

Many thanks for this - it is unequivocal in its statement that it should be administerd nasally. I wonder whether the combination of a wrongly injected Nobivac KC serum on top of the Rabies vaccination aggravated the reaction and caused the extraordinary collapse in my puppy?

I hope that your pup improves and that you're not being charged.  I think that if you're sure that's what's happened, then I don't think I'd let it rest within the practice.... :(

Well, not only was I charged for the dogs to be vaccinated against rabies & kennel cough - but then the pup has had antibiotics which invalidate the effect of the kennel cough and anyway all three were injected with it and that is not the correct or effective way of administering it. I am certainly going to take this further, though at present am unsure how to do so.

I would certainly make a complaint in writing to the practice manager; this is a clear case of misadministration of a vaccine, and I suspect you'd be well within your rights to reclaim the cost of all remedial treatment. Poor pup. :-(

I agree that you need to put in writing a complaint to the practice manager and owner.Just curious was this your usual vet or was it part of a large chain in say a pet supermarket?

I have only ever known of this vaccine being administered nasally

I am certainly going to take this further, though at present am unsure how to do so.

This might be useful.

http://www.rcvs.org.uk/home/

We have been registered with this vet which is part of a larger chain here in the Dover area. This, however, was the first time we had ever been seen by this particular vet who is an elderly man (no ageism here, I assure you - I am an elderly priest!). He took far longer than the usual vets, tried to manhandle our large dogs onto the inspection table - they are a Flatcoat and a Gordon Setter - no other vet has tried this, and became quite confused as to which dogs were due which vaccinations... the benefit of hindsight!

I know from my French friend, there is an injectable version of KC vaccine but here it's mostly intranasal. I think you should complain about this! No vets will inject in my dogs anything I don't approve of and certainly not two injections on the same spot at the same time :-(
Poor dog, hope he is better now!

Surely it is unnecessary for a puppy to have a rabies vaccination on top of the normal course of puppy vaccinations. This puppy has been overloaded with vaccines.

There is an injection for kennel cough in Spain too. But not used frequently in UK . Maybe as the vets in Dover and they have come across Leishmaniasis  and other  european diseases ,they have picked up on the kennel cough vaccine too .Vaccines against Bordatella are administered by spraying up the nose, whereas vaccines against viruses (eg parainfluenza virus) are given by injection.Make sure the dog doesn't get dehydrated, if need be using a syringe of water, with a little glucose in it . Dogs showing mild vaccine-induced respiratory symptoms can pass these vaccine viruses on to other dogs in the household, thereby inducing similar mild upper respiratory tract symptoms.  It certainly needs to be checked out and I hope your dog gets better.

The puppy had his usual vaccinations at 8 & 10 weeks. He is now 20 weeks and we took him to have a rabies vaccination, because we want to take him to France. It was at the Vet's insistance that we had the kennel cough which I thought would be nasally applied, but was in fact another injection.

Has anyone any information regarding the second part of my question, namely, if the Nobivac Kennel Cough vaccine could, combined with the Rabies vaccine, produce this extreme reaction that the rabies vaccine on its own would not. Any vets or scientists out there?

I have my dogs vaccinated agains rabies and KC with the intranasal vaccine at the same time and never had a problem. But they have always been administrated correctly.

It's a live vaccine, and is not commonly used where I live, so my vet was very sceptical about using it and contacted the manufacturer when I asked for it to be administered to my dogs (he felt that with the dogs struggling and most of the liquid ending up spilled would not provide the dogs immunity, and was advised by the manufacturer that a small drop getting inside the nasal passages was enough to be effective).

If it was my puppy I would be contacting the manufacturer, they probably have data regarding it being injected instead of properly administered.

You first port of call should be the practice head vet to find out exactly what was given, how and why.  I may be a simple case of misunderstanding or misrecording.
Regarding your question about combining vaccines, if you feel your vet cannot answer this with assurance, you would be best putting your question to MSD customer support as you can never be truly sure of the value of advise given on an internet forum, good though this one is :)

Just as a side note to the situation with your vet, you can give Thuja (homeopathic rememdy) after injections to help with any unwanted side effects.  The same can be given to babies after their jabs too.

Should there ever be an adverse reaction to a drug or treatment or a 'suspect' or 'possible' adverse reaction, this should be reported to the Veterinary Medicines Directorate forthwith, on a yellow form (MLA252a), by visiting www.vmd.gov.uk.

Thank you all for your comments and advice. I contacted MSD Customer Support asking them about the situation - they were very quick to respond AND my veterinary pracice had contacted them by phone as soon as I had referred the situation to the practice Clinical Director. MSD said that Nobivac KC is only licenced for intra nasal use;inadvertant administration subcutaneously can lead to local oedema and swelling at the injection site; swelling of the regional lymph nodes; fever and depression. They recommend that the puppy be treated with antibiotics and anti-inflammatories (he is currently being so treated), and to keep an eye on the other dogs. Nobivac KC is not licenced for use with Nobivac Rabies as there have not been any compatability trials.

So the error appears to be squarely with the veterinary practice.  Has the Clinical Director indicated yet what they propose to do in recompense?  A fulsome appology and no charge for treatment at the very least I would say.

> Should there ever be an adverse reaction to a drug or treatment or a 'suspect' or 'possible' adverse reaction, this should be reported to the Veterinary Medicines Directorate forthwith, on a yellow form (MLA252a), by visiting www.vmd.gov.uk.

I don't think that would be applicable where there has been an error in administering the drug.

Definitely indicative to contact Royal College of Veterinary Surgeons then. :(

I will keep my powder dry until I have heard from the Clinical Director.

Personally I would be aiming for and expect all treatment costs to be refunded - including the rabies vaccine.  As it's not licensed to be given with the KC it may not have worked so I'd either want a titre test (paid by the vet clinic as it's their mistake that makes the test necessary) to prove it worked or another rabies jab.  I would expect to only be out of pocket by one rabies jab at the end of it all, and even then that may be considered to be a gesture of good will for distress and inconvenience.

I hope your dog feels better soon.

And this is one reason why I stopped being a vet nurse!! Where was the nurse on the consult? A good nurse would not have allowed that to happen.

KC goes up the nose and the pup should not have had 2 vaccines together as anti body levels need monitoring and 2 at once could cause false reading, highly unlikely but must be ruled out.

Straight to RCVS for a huge complaint, clear cut case of a vet not paying attention and forgetting how to administer a vaccine!! So basic,shouldn't be a vet. Could you smell alcohol at all? I've known that to happen, especially after lunch. Follow it up don't let someone else's dog possibly die due to this numpty.

I agree.  This isn't about revenge, compensation etc.  A Vet who could make such fundamental mistakes shouldn't be practicing.  It's about protecting another dog being subjected to such incompetence.
Ex-Veterinary Nurse here too. :(

> A good nurse would not have allowed that to happen

Nurses are just as capable of human error :)
Any second professional in the room might have spotted the error but any of us are capable of a blind moment when busy or stressed.
Personally, I would take it from how the practice deals with it before firing off all guns.

I was at the vet tonight and queried whether there was an injectable version available and was told no.  If only a little bit of vaccine is required to get up the dogs nose would it be possible for me as an owner to give the vaccine myself to the dog at the vets?  My boy is a pest and needs muzzled in the vets so the chances of getting a vet anywhere near his nose is going to be nigh on impossible.

>Where was the nurse on the consult?

Doing vet nurse 'stuff' elsewhere, I expect. I've certainly never known a vet nurse to be in the room during a consult, at any practice I've attended either as client or staff. for routine vaccinations. If bloods etc were needed then yes, but not otherwise.

I agree jeangenie I rarley see avet nurse when havinga consult neither would I expect there to be one generally. Sound like op is taking good advice and not reacting too quickly. Only hope the pup is ok 

There is no rule to say that vaccines have to be administered by either a vet or a vet nurse.

I enquired with my new vet (he was recommended through a friend who has used him for several years and is very approachable) as to whether I could buy my own vaccines and administer as I have done this in the past when working for other people. he answered simply that this would be possible with a prescription from the vet and just said to be careful which ones you buy as some are better than others. Please don't shout me down if this information is incorrect as I am only passing on what I was told and believe to be true!

Good for you with staying calm and not going in all guns blazing. Please update as to how the pup gets on, hope he is okay.

Jo

How odd , we were always in with our vet , taking notes , which then were downloaded afterwards so we had hard copy . We assisted in holding an animal if required, cleaned down the tables , laid out instruments ,checked and got required injections ready , got vaccines out the fridge ready, counted out antibiotics etc ready for the labels to go on ... He always asked if clients minded us doing routine vaccines etc

I am happy to say that the twice daily antibiotics and daily anti-inflammatory suspension seem to be doing the trick with the pup. He is much more lively and his oedemic lump is gradually decreasing in size. The clinical director of the practice has asked to have a meeting with me today and I will see what transpires from that. She is a very personable and good (I think) vet, who has cared for our dogs over the course of the past 4 years and has always shown herself to be thoroughly professional whilst maintaining a rather jolly approach. If only she had been in the clinic last Friday...

Sensible approach speaking to the Clinical Director before taking any further action.

I am happy to say that my meeting with the Clinical Director of the practice was wholly satisfactory. She admitted that it had been their mistake: the elderly vet who had administered the KC subcutaneously had only just moved over from Australia, having spent his entire veterinary life there. In Australia the KC vaccinations can be administered by injection and he had assumed (and she made the point that he should have checked) that this was the case here in Britain. He was very sorry and she was most apologetic and, of course, reimbursed all monies spent in bringing my pup back to good health after their mistake. She also undertook to take blood tests to determine whether the rabies had 'worked'. The only thing is that said elderly Aussie vet has been injecting KC for the last month - I am apparently the first to complain and for whom there were repercussions for my dog.

Hi Setter Rev

Thanks for raising this topic - and keeping us updated.  It's a useful reminder that it pays to know how such things are administered so that we can spot an error if it occurs.  I do try to research  before I go to the vet but of course that isn't always possible.  I'm so glad you had a good outcome from your meeting and that your pup is recovering nicely :)

Although a bit worrying if the vet is still practising.  In addition to the vaccination error, the OP mentioned 'manhandling' dogs onto the table & the vet appearing confused. 

I agree JG and I think it also helps if the client is able to control the dog and help for example holding the dog if the vet needs to examine of administer anything that needs the dog to be still. If the client cannot do that then a bet nurse would be asked to go and help.

As for taking notes the my vet has a computer in the room and up dates whilst we are in there or straight after we leave the room so no need for somebody to take notes.

Glad the situation has been resolved and the pup doesn't have any lasting effects from the mistake.

Oh poor puppy, I'm so glad he is on the mend. Glad that the practice have apologised and refunded - and that they will be making sure this vet does things properly from now on. Hopefully no long term harm done. It was a useful topic for me too, I had my puppy's 2nd jab yesterday, they recommended not doing the KC vaccine at the same time, which I wouldn't have let them anyway, but as she will be shown I do want it done in a month or so, and will be making sure that they do a nasal one. 2 of the vets at my practice are very good and the 3rd is a bit of a numpty and I wouldn't trust her for more than the basics, and avoid seeing her if possible!

Time he retired.

At our practices it was pretty standard to have a nurse in on the majortiy of consults especially if the dog was getting upset. Easiest all round if dog is in and out before getting too upset.

AS for being a foreign vet, worked at plenty of practices where all vets virtually have english as a second language. They know about different vaccine courses and meds available. Poor excuse but glad you were refunded and hopefully he won't be doing it again.