I've been titre testing rather than boostering my dogs for a while now.  I've had to change vets recently, and after finally persuading them to send it off (think I must have been the first to ask for it), the vet has told me that everything is fine apart from Distemper for which the reference 'minimum' is 65 and one of my dog's samples scored 65 (bit vague, but they were unable to give me a copy this morning!).  Anyway, I realise a titre is just a snapshot of a dog's antibodies at that precise moment in time, but they've previously been way above the minimum cutoff.  Has anyone had this before?  And if so, what did you decide to do?

This is further complicated by the fact that I still haven't found a vet who will just give the single vaccines that are required, every single vet I have encountered routinely vaccinates with the whole lot, every single year. 

Thanks,

Clare

I wouldn't revaccinate with that score. There ARE antibodies, and unless your dog has been in contact with the disease, the antibodies will be low.

Ditto Lurcher girl. What part of the country are you in, perhaps someone can recommend a vet with a more current view on vaccinations?

I think I'm questioning it because I'm curious as to why their minimum is 65, rather than 0.  That suggests to me that dogs can have low levels of antibodies and not have sufficient immunity OR the margins of error within the test are such that they can't be confident that a 'score' of lower than 65 is actually indicative of any antibody at all.  I kind of think it's the latter, but should probably speak to the lab myself.... don't think my vet can handle any more new things from me!

I'm in Leeds, so if anyone can recommend somewhere that'd be great :-)

>That suggests to me that dogs can have low levels of antibodies and not have sufficient immunity

Exactly. Immunity wanes over time (hence elderly people are more vulnerable to diseases than younger people) and low levels aren't sufficient to prevent ilness.

I've just checked the interpretation guidleines... anything under 8 suggests no significant immunity, anything under 64 or lower is 'low' and they recommend a booster.  65 is borderline. 

I think if I could find a vet to just vaccinate for distemper, I'd probably do it.  I'm not going to do the whole lot though!!

CVL, due to immune system memory, it doesn't make any difference what figure these tests come back with - even if they come back with 0, it's highly likely that antibodies will be manufactured by the dog, if the dog were exposed to (say) distemper.  That is:  Dogs make antibodies in response to the dog's immune system encountering the pathogen.  If there are no pathogens in the environment, then no antibodies will be present in the test.  That doesn't mean the dog is not protected - since, were the dog to be exposed to distemper, he would manufacture the antibodies again. 

As a separate point, there have been only 2 cases of distemper seen by UK labs in the past year.  This is highly likely to be the reason why you're seeing a reduction in antibodies in your dog - the immune system is not being challenged to produce them because there is hardly any distemper now in the UK.

Personally, I wouldn't revaccinate on the basis of results for distemper or adenovirus(hepatitis) - because they are so rare.  I would only revaccinate possibly if I had a low parvo result.

If you're at all unsure, I'd advise walking your dog through really high density dog areas (urban city parks, lots of places where dogs toilet) and try re-testing again in a month or two.  Often you then get 'safe' antibody levels, because the immune system has been challenged as a result of being exposed to the pathogen.  But the dog would have been protected even if it had not been challenged.  (Although got to say, it's still unlikely the dog would be exposed to distemper - so low is the incidence of it.)

Antibody levels do not show that you need to revaccinate, they only show that you don't know whether you need to.  So I think, then, look to incidence of disease.  With only 2 cases of hepatitis and 2 cases of distemper in the past year in the UK...

> So I think, then, look to incidence of disease.  With only 2 cases of hepatitis and 2 cases of distemper in the past year in the UK...

......thanks to responsible owners vaccinating.

Thanks rabid :-)  I understand what you're saying, but these guidelines have me confused... maybe they're just making it up :-D  I suppose any diagnostic test has to have arbitrary ranges, but I thought there must be some rationale behind it.

http://www.gla.ac.uk/media/media_198533_en.pdf

I've got the paperwork now, his titre was '64', not 65 as I thought earlier. 

I'm a bit worried because I've found a kennel that will accept titre testing (on the very rare occasion my dogs may need to be kennelled), and I don't know whether they'll accept him now. 

I live just outside Leeds city centre, and high-density dog area is an understatement... I so unfortunately, I don't think that suggestion would necessarily work for us anyway - it'd be really interesting to try if we lived somewhere remote. 

I'm not totally comfortable with the idea of my dog being 'safe' (if not immune), just because it's so rare ... presumably it's so rare because dogs have been immunised against it for many years now.  It's interesting though, I wonder if there will ever be proposals to stop the routine vaccinations for Distemper and Hepatitis?  Presumably there must be a point at which vaccinating makes no difference to the number of cases, perhaps like the smallpox vaccine for humans (although I suppose if people are willing to pay, it's less likely to be phased out).  I'm not totally against the prospect of vaccination, I just can't stand that every vet I've encountered, does the full vaccine complement, every year, without question.

ooops, typed that before seeing yours stooge - wasn't just being a copycat!

> must be a point at which vaccinating makes no difference to the number of cases, perhaps like the smallpox vaccine for humans (although I suppose if people are willing to pay, it's less likely to be phased out). 

Smallpox has been totally wiped out thanks to a worldwide vaccination programme.  I doubt that will ever happen with canine disease as there will always be people who do not vaccinate their animals.  If only :)

> presumably it's so rare because dogs have been immunised against it for many years now

I'll probably get this wrong :) but dogs being brought into this country from abroad don't have to have had any vaccinations against distemper etc, do they ?? (apart from rabies) so it could be brought into the country - it's not disappeared worldwide ??

Daisy, it is still present in this country so it matters not whether it is brought in.

> it is still present in this country so it matters not whether it is brought in.

Agreed - I was trying to reply to CVL's remark about smallpox - ie smallpox has been wiped out worldwide, hence there is no need to vaccinate any more

I guess I was just wondering what were the criteria that had to be met before smallpox vaccination stopped (a certain number of years without new infection maybe?).... it was just a throwaway comment because I wondered if there'd ever, possibly, be a situation like that with canine infectious desease.

Well in the US there haven't been any recorded cases of distemper for 10 YEARS... 

I think all these decisions have to be made on a cost-benefit analysis, and for me the risk of vaccination reactions and the unnecessary risk of having to give the whole wham of vaccinations again (rather than just distemper), coupled with how rare distemper is, and how memory cells work - would make me not want to give it.  But everyone has to make their own call on these issues.

I stopped vaccinating annually after I noticed that my eldest dog always became ill after vaccinations and it would roll on from one thing to another.  Last time it was eczsema, giardia, pancreatitis (potentially from the ABs to stop the giardia)...  So for me, it'll just be puppy shots and 1 yr booster from now on.  I won't even titre test - for the very reason you're seeing now - that the titre test often comes back falsely requiring boosters. 

Oh, and the reason for that (falsely requiring boosters) is because we have no way of measuring the immune system's 'memory' and capacity to manufacture antibodies.  All we can assess is whether or not there are antibodies present.  If we know there are antibodies, then we're fine.  If there aren't - then we may be fine (probably), or we may not (unlikely). 

But there are many of us who don't titre test and who only give puppy shots and 1st yr jabs - and I've never heard of any dog contracting parvo, hepatitis or distemper, despite not being titre tested.

>I wondered if there'd ever, possibly, be a situation like that with canine infectious desease.

Not until all dogs, foxes, wolves, coyotes worldwide etc are vaccinated for several years.

> coupled with how rare distemper is

but that is only the case because so many other people vaccinate their dogs. 

There is that arguement that the diseases aren't there because of good vaccination protocols but really to make that point we'd need to know how many domestic dogs in the uk actually are vaccinated annually or at least in accordance with the vaccine manufacturers recommendations (note that most vaccines are required every 3 yrs NOT annually). I strongly suspect that it is not a majority. Does anyone have any stats on this? They would be highly speculative.
While there is a role for vaccination in control of infectious disease, I think it is over used - rather like the over use of antibiotics and fanatic cleaning and sterilising. It is interesting how vets seem to differ widely in their recommendations. I have used several vets in london - never have I had annual vacs recommended, always 3 year programmes, and my current vet offers vacs but doesn't promote them saying that the risks of disease are so low.

> I think it is over used - rather like the over use of antibiotics and fanatic cleaning and sterilising.

Very different.  They didn't "overuse" the smallpox vaccine and one day the "overuse" of the polio vaccine may wipe that one off this earth too. :)

I live in a city with several vet surgeries, and they all recommend annual vaccinations, of everything - full boosters.  I used to use a mobile vet who would come to our house to give the dogs the Nobivac jabs, so they didn't need to have everything every year - as their regular vet wanted to give.  I am totally shocked at the number of vets still recommending giving a full vaccination for everything, every year - despite the recent shift to 3 yearly jabs for core diseases.

Yes, but we need to make a distinction between puppy/childhood vaccinations and intermittent boosters rather than annual vaccinations as is advocated for dogs. I doubt anyone is suggesting we do not give pups their first jabs, just that they do not need vaccination every year thereafter until they die.

But how often do you get your polio vaccine Stooge?

> just that they do not need vaccination every year thereafter until they die.

Certain vaccinations are required every year.

> But how often do you get your polio vaccine Stooge?

I'd have a vaccine when ever it was advised and they all vary. 
I had the polio vaccine as a child (not saying when that was :)), again in 1991 and again in 2001. 
I think this is getting a bit muddled between the issue of whether vaccines are given frequently enough to an individual and whether they are being given widespread enough in a population to bring about the extinction of a disease which was the issue brought up here.

I think the original issue was how many circulating antibodies for a given pathogen are necessary to give immunity to an individual.

As you say, some vaccinations need boosters, others do not. As I am sure you know Dr Jean Dodds has written about the potential harm of over vaccination, this is not the same as no vaccination.

I would prefer more vets to be prepared to do titres and offer individual vaccinations, but clearly the costs and complexities are an obstacle. There is also a reasonable fear, as you infer, that some people may simply stop vaccinating altogether, whether because of costs, or misunderstanding that although some conditions do not require annual vaccinations that puppy vaccinations are still a requirement for all.

> As I am sure you know Dr Jean Dodds has written about the potential harm of over vaccination

She has but other studies have shown very little if any harm. 

Although many of those studies are funded by the companies that make the vaccines and pharmaceutical companies are not as pure as the driven snow in their motives, some have been known to hide data to protect their lucrative position in the market. However, one can argue for vested interests on all sides so probably nothing to gain there. Surely the best evidence is the level of antibodies in the individual's system- that way vaccination protocols can be tailored to give the optimal level of protection.

> Surely the best evidence is the level of antibodies in the individual's system

Unless they appear low and then we hear the comments that they prove nothing :)

Regardless of that, even if it did give you the best evidence, by the time you have thrown in the risks of venepuncture and the possibility that vaccination will be required anyway it does not stack up for me.

I suppose, at least if people are testing, and responding to the advise from the result, the population is better protected than by those that just don't bother.

But isn't it true that a titre test is just looking at immunity from one angle. Also, one individual may demonstrate immunity with a lower level of antibodies than another. It is not straightforward or measureable unfortunately. Wouldn't it be great if we had a test to examine the memory cells of the immune system. But we don't and that is why there are vaccination protocols. However little we do know, understanding has improved greatly in recent years, and the current advice from manufacturers on when a distemper booster is required is 3 yrs (this is minimum, some animals demonstrate lifetime immunity). So if my dog were still showing antibodies to distemper 3yrs post vac, and there were very low risks of coming into contact with distemper, I would not give another booster.

shivj,

you are correct it is not straightforward and I think that is why many vets are reluctant to go the titres route. Should a pet contract something nasty after titres indicate high enough antibodies then guess who will get sued. Stooge is also correct that because the majority do still vaccinate it is hard to really test the efficacy of titre testing as a good enough measure as to whether an animal is protected or not.

>I think that is why many vets are reluctant to go the titres route. Should a pet contract something nasty after titres indicate high enough antibodies then guess who will get sued.

If the vet is following the recommendation of the laboratory offering their opinion then surely the lab would be taking responsibility and would be culpable.  I doubt very much this is why vets do not offer titre testing routinely, I suspect it is more because they are perfectly satisfied that the protocols are fit for purpose.

It is the vet that has the animal's medical and vaccination history- the lab will deliver information on the blood test. The final decision on vaccination schedule is between the vet and the dog owner.

Should anyone wish to wade through the following it will become apparent that this subject is very much under debate.

http://www.vmd.defra.gov.uk/pdf/vaccines_VMDpositionpaper.pdf (see final part)

http://users.on.net/~peter.hart/Submission_re_RCVS_draft_code_of_professional_conduct.pdf

Which final part?  This bit?

>The working group concluded in 2002 that vaccination plays a very valuable role in the prevention and control of the major 30 infections in dogs and cats and, although, adverse reactions occasionally occur, the

>risk/benefit analysis strongly supports their continued use. The VMD is not aware of

>any new developments that would affect the previous conclusions of the Working

>Group.

:)
Sorry I don't know who Elizabeth Hart is or who has given her this mandate to act as Advocate.

No, this bit :)
Summary
1. The VMD recognises the continuing interest within the veterinary and general pet
owning community on the frequency of vaccination and the level of protection afforded
by vaccines for companion animals. There is increasing scientific evidence that
modified live vaccines (MLVs) for the core-diseases as defined in the WSAVA
Guidelines, canine distemper (CDV), canine parvovirus (CPV) and canine adenovirus
(CAV) may provide a longer duration of immunity than currently indicated on the SPCs
of authorised products. The VMD will continue to work within a regulatory and
scientific framework to ensure that re-vaccination intervals are supported by robust
data.
2. For the majority of UK authorised dog vaccines the re-vaccination interval for the core
vaccines canine distemper (CDV), canine parvovirus (CPV) and canine adenovirus
(CAV) is at least every three years. These authorised re-vaccination schedules are in
accord with the WSAVA Guidelines which state "not more often than every three
years".
3. The VMD sees no conflict between the APVMA position and that of the UK and other
EU regulatory Agencies. The APVMA recognises that in most cases core vaccines
need not be administered any more frequently than triennially and that even less
frequent vaccination may be considered appropriate. For most UK MLV vaccines for
dogs, authorised re-vaccination intervals are at least three years.
4. The duration of immunity of some vaccines is relatively short, with re-vaccination
schedules of one year or even less. Annual vaccination with some vaccines may,
therefore, be required where a particular animal is at risk of infection. For
leptospirosis, a serious endemic disease in dogs and a zoonosis, annual vaccination
may be recommended by most veterinary surgeons to ensure an adequate level of
protection is maintained. Leptospirosis has a number of wildlife reservoirs and is a
particular risk to animals and humans exposed to water contaminated with rat urine.
5. The VMD will continue to seek to develop incentives to promote submission of
scientific data to support extended DOIs for core-canine vaccines where this is ethical
and proportionate to animal health and welfare. The VMD recognises the financial,
logistical and ethical constraints for conducting long-term laboratory studies in small
groups of animals to substantiate DOI claims. The VMD will actively promote the
recognition of published scientific data to support the revision of vaccination
schedules where appropriate.
6. Within the current EU Regulatory framework, each veterinary vaccine is treated as a
unique biological product with specific characteristics that determine the profile for
safety and efficacy. Each new application for authorisation must be accompanied by
an extensive data package containing specific information relating to quality, safety
and efficacy for the specific product.
7. The VMD recognises and supports the concerns of the pet owning community and
their desire to understand the potential risks to their pets from unnecessary
vaccination. In response to these concerns, the Veterinary Products Committee
(VPC) established an independent working group on feline and canine vaccination.
The full report is available on the VPC's website
http://www.vpc.gov.uk/Working/feline.html . The working group concluded in 2002
that vaccination plays a very valuable role in the prevention and control of the major
30
infections in dogs and cats and, although, adverse reactions occasionally occur, the
risk/benefit analysis strongly supports their continued use. The VMD is not aware of
any new developments that would affect the previous conclusions of the Working
Group.
8. It is acknowledged that Pharmacovigilance has a number of limitations that will not
adequately address all the issues of adverse events. More information is needed on
the prevalence of canine diseases in the UK to enable veterinary surgeons and their
clients to make meaningful benefit/risk assessments on whether to vaccinate an
individual animal or not.
9. A veterinary surgeon is empowered to make a clinical benefit/risk judgement based on the
local reports of infection and taking account of the age, health, home environment, travel
plans and lifestyle for each individual animal presented for vaccination and discuss
recommended vaccine schedules with the owner. Thus the decision to vaccinate the
individual patient and the frequency thereof is a matter for the veterinary surgeon and his
client to discuss. It is not an issue where the VMD should intervene.
10. The VMD will seek to work with BSAVA to provide additional guidance on the
authorisation process and the application of the "cascade" to ensure puppies and
older dogs receive the most appropriate vaccination schedule for their particular
circumstances. This will help to base the decision on whether to vaccinate on an
informed benefit/risk discussion between the veterinary surgeon and the owner.
Ultimately it is the pet owner who makes the decision to vaccinate.
11. The VMD does not regulate the vaccination requirements laid down by animal
boarding establishments. Local Authorities issue licences to proprietors of boarding
kennels and catteries under the provisions of the Animal Boarding Establishment Act
1963. Published guidance and model licence conditions have been developed to
ensure animal health and welfare. The VMD has no authority or responsibility for the
legal and regulatory requirements for boarding establishments.
Veterinary Medicines Directorate
March 2010

>For the majority of UK authorised dog vaccines the re-vaccination interval for the core vaccines canine distemper (CDV), canine parvovirus (CPV) and canine adenovirus (CAV) is at least every three years.
>The duration of immunity of some vaccines is relatively short, with re-vaccination schedules of one year or even less. Annual vaccination with some vaccines may, therefore, be required where a particular animal is at risk of infection. For leptospirosis, a serious endemic disease in dogs and a zoonosis, annual vaccination may be recommended by most veterinary surgeons to ensure an adequate level of protection is maintained.

So just what the majority of vets seem to be doing: annual lepto vaccination with DHP every three years. :-)

Well the only concrete bit I can see there is the quote I pulled out.

> So just what the majority of vets seem to be doing: annual lepto vaccination with DHP every three years.

Exactly.  I'm not sure there is any debate in this document at all.

I have had letters telling me the dogs will need to start a full course of vaccination as their boosters are not up to date, which they say is if they go longer than 18 months (this is a practise I only used for puppy vaccinations).

A friend in another part of the country gets the same.

For dogs that have previously been fully vaccinated there is no justification for a course of core vaccination, and ditto for any dog over 18 weeks who has a fully mature immune system.

A booster is a boosteer is a booster, no matter the interval.

Stooge,

I'm sure you'll have noted the little difference between WSAVA guidelines for core vaccines as stating vaccination every three years as conservative and the most you'd want to do it and our own which are up to three years. WSAVA indicate three years to be the minimum interval with a suggestion that in some if not many dogs, immunity may extend beyond that. You'll be aware that newly revised USA and Canadian guidelines are now talking 5-7 years for core vaccines. I really don't think it is the open and shut case you suggest.

> with a suggestion that in some if not many dogs, immunity may extend beyond that.

Well quite.  The protocol has to protect the majority of dogs.
I am never sure who WSAVA are.

Stooge, it is all in the links. I think it is useful to be across some of the evidence on this, as it stands at the moment, you quoted the last working party report which was 2002, so arguably a little out of date. The USA report is much more recent (2011).  I also think Jean Dodds research is worth a read too, she is much less contentious than she was.

>> For the majority of UK authorised dog vaccines the re-vaccination interval for the core vaccines canine distemper (CDV), canine parvovirus (CPV) and canine adenovirus (CAV) is at least every three years.
>> The duration of immunity of some vaccines is relatively short, with re-vaccination schedules of one year or even less. Annual vaccination with some vaccines may, therefore, be required where a particular animal is at risk of infection. For leptospirosis, a serious endemic disease in dogs and a zoonosis, annual vaccination may be recommended by most veterinary surgeons to ensure an adequate level of protection is maintained.
> So just what the majority of vets seem to be doing: annual lepto vaccination with DHP every three years. :-)

Then why oh why can't I find a vet that offers this!??  I'm pretty happy with those guidelines (I am not against appropriate vaccination by any means), but I don't know if the majority of vets are complying with these.

I haven't known one use a different protocol for several years - and I have friends who use many vet practices in the area.

And of course all you have to do is tell them what you want - you as the customer have the final say and they can't do anything you don't agree to.

> you quoted the last working party report which was 2002, so arguably a little out of date.

I took the quote from your document! :)

Stooge, my only point is that the evidence is not clear and there are differing views between scientists and vets and yes, the particular couple of sentences from the whole document that you chose to quote is from a working party report in 2002..., more recent reports offer a different perspective, references to some of those can be found in the other link.

> I am never sure who WSAVA are

THE WORLD SMALL ANIMAL VETERINARY ASSOCIATION (WSAVA)

Anybody know of any vets in North Manchester/Oldham Area that do the 3 yr Protocol ??? All the ones I have telephoned do the annual and none do the Lepto seperately, they said it was not worth buying a batch of the seperate vaccine in just for one client.