CHAPTER 23. Preventive Medicine
Valerie A. Chadwick
VACCINATIONS
I. Vaccinations are an important part of preventative medical practices, thus providing animals with optimum health care
A. Vaccination itself is a potent medical procedure associated with known benefits and risks. Knowledge of these benefits and risks is necessary to implement an effective individualized vaccination protocol
B. Considerations of exposure, susceptibility, severity of disease, efficacy and safety of the vaccine, potential public health concerns, and owner’s preferences are appropriate
II. Vaccinations have contributed greatly to the well-being of our companion animals. The number of patients with infectious disease has decreased appreciably since the first vaccines were available
III. Recommendations for vaccines had been considered a routine part of animal care
A. Differences in risk exposure to infectious diseases, age and health of the patient, and potential side effects make it difficult to recommend one protocol for all dogs or cats
B. An annual wellness examination should be recommended even if the vaccinations are not being given in a particular year for the overall continued health of the animal
IV. Puppies under 16 weeks of age represent the most susceptible age group
A. They experience the highest rates and most severe cases of disease and therefore the principal target population for vaccination
B. Because of maternal antibody influences, a series of periodically spaced vaccinations is indicated in young dogs
V. Feline vaccination protocols
A. The American Association of Feline Practitioners and Academy of Feline Medicine created an advisory panel in 1997 to develop guidelines for vaccination of cats. These guidelines were adopted by the Vaccine-Associated Feline Sarcoma Task Force for administration of vaccines
B. Vaccines containing antigens limited to Rhinotracheitis-Calicivirus-Chlamydia-Panleukopenia (RCCP) are administered subcutaneously on the right shoulder
C. A vaccine containing rabies virus antigen (plus any other antigen) is administered on the right hindlimb as distally as possible
D. Vaccines containing feline leukemia (with or without any other antigen except rabies) are administered on the left hindlimb as distally as possible
VI. Core vs. noncore vaccination
A. Core vaccines are defined as vaccines appropriate to protect most animals against diseases that pose a risk of severe disease due to virulent, highly infectious pathogens, as well as being highly distributed
B. Noncore vaccinations target diseases of minimal risk in the geographic region or lifestyle of the pet and protect against diseases that are less severe threats to infected animals. Noncore vaccines should be considered on an individual basis
C. Core vaccines
1. Canine: Core vaccines considered for dogs are distemper, parvovirus, adenovirus-2, and rabies
2. Feline: Vaccines against panleukopenia, rhinotracheitis, and calicivirus should be considered core vaccines for cats. Vaccines against feline leukemia virus should be considered a core vaccine if the cat spends time outdoors or has interaction with outside cats
D. Noncore vaccines
1. Canine: Noncore vaccines considered for the dog are parainfluenza, Bordetella, coronavirus, Lyme disease, and Giardia. Leptospirosis may be considered either core or noncore, depending on the area of the country the dog is living in and exposure risk
2. Feline: Noncore vaccines to consider for the cat are chlamydiosis, feline infectious peritonitis, Microsporum canis, bordetellosis, giardia, and feline immunodeficiency virus (FIV)
VII. Veterinarians should provide their clients with adequate information regarding vaccine choices so owners can make an informed decision regarding vaccinations for their animals. Currently a signed consent for administered vaccines is not required, but this may change with time (Table 23-1)
| MLV, Modified live virus. | |||||||||
| Canine Vaccine | Initial Puppy Vaccination | Initial Adult Dog Vaccination | Revaccination | Comments | |||||
|---|---|---|---|---|---|---|---|---|---|
| Canine distemper virus (MLV) | Administer 6-8 wk of age, then every 3-4 wk until 12-14 wk old | Two doses 3-4 wk apart | One year booster at 15 mo then revaccination once every 3 yr considered protective | Core | |||||
| Canine distemper virus (rCDV) | Administer 6-8 wk of age, then every 3-4 wk until 12-14 wk old | Two doses 3-4 wk apart | One year booster at 15 mo, then revaccination once every 3 yr considered protective | Core | |||||
| Distemper-measles virus | One dose only between 4-12 wk old | Not indicated animals over 12 wk | Not indicated animals over 12 wk | Noncore | |||||
| Canine adenovirus-1 | Not recommended. Significant risk of hepatitis blue- eye. CAV-2 cross protect against CAV-1 | ||||||||
| Canine adenovirus-2 (MLV) | Administer 6-8 wk of age, then every 3-4 wk until 12-14 wk old | Two doses 3-4 wk apart | One year booster at 15 mo, then revaccination once every 3 yr considered protective | Core | |||||
| Canine adenovirus-2 (killed) | Not recommended. CAV-2 (MLV) more effective | ||||||||
| Canine parvovirus (MLV) | Administer 6-8 wk of age, then every 3-4 wk until 12-14 wk old | Two doses 3-4 wk apart | 1- yr booster at 15 mo, then revaccination once every 3 yr considered protective | Core | |||||
| Canine parvovirus (killed) | Not recommended. This vaccine susceptible to maternal antibodies | ||||||||
| Canine parainfluenza virus (MLV) | Administer 6-8 wk of age, then every 3-4 wk until 12-14 wk old | One dose | One year booster at 15 mo, then revaccination once every 3 yr is considered protective | Noncore | |||||
| Leptospira interrogans (canicola, icterohaemorrhagiae) (killed bacterin) | Administer 12 wk of age, then booster at 14-16 wk of age | Two doses 2-4 wk apart | Annual update | Core, noncore | |||||
| Leptospira interrogans (canicola, icterohaemorrhagiae, pomona, grippotyphosa) (killed bacterin) | Administer 12 wk of age, then booster at 14-16 wk of age | Two doses 2-4 wk apart | Annual update | Core, noncore | |||||
| *Bordetella bronchiseptica (killed) – parenteral | Administer 6-8 wk of age, then one dose 4 wk later | Two doses 2-4 wk apart | Annual update | Noncore. Administer 1 wk before exposure | |||||
| Bordetella bronchiseptica (live avirulent bacteria), parainfluenza (MLV) – intranasal | Administer single dose (may give as early as 3 wk of age) | One dose | Annual update | Noncore | |||||
| Bordetella bronchiseptica (cell wall antigen extract) – parenteral | Administer 8 wk of age, then repeat at 12 wk of age | Two doses 4 wk apart | Annual update | Noncore. Administer 1 wk before exposure | |||||
| Canine coronavirus (killed and MLV) | Not recommended. Clinical disease rarely occurs, typically self-limiting | ||||||||
| Rabies 1 yr (killed) | Administer as early as 12 wk of age | One dose | Annual update | Core. State, local or provincial laws apply | |||||
| Rabies 3 yr (killed) | Administer as early as 12 wk of age | One dose | Revaccination 1 yr following initial vaccine, booster vaccines administered every 3 yr | Core. State, local or provincial laws apply | |||||
| *Borrelia burgdorferi (killed whole bacterin) | Administer 9-12 wk of age, then booster with second dose 2-4 wk later | Two doses 2-4 wk apart | Annual update | Noncore | |||||
| *Borrelia burgdorferi (recombinant-outer surface protein A) | Administer 9-12 wk of age, then booster with second dose 2-4 wk later | Two doses 2-4 wk apart | Annual update | Noncore | |||||
| Giardia lamblia (killed) | Administer 8 wk of age, repeat in 2-4 wk | Two doses 2-4 wk apart | Annual update | Not recommended. Does not prevent infection | |||||
| Feline Vaccine | Initial Kitty Vaccination | Initial Adult Cat Vaccination | Revaccination | Comments | |||||
| Panleukopenia (MLV, killed), parenteral | Administer 6-8 wk of age, then every 3-4 wk until 12 wk old | Two doses 3-4 wk apart | 1-yr booster after primary vaccines, then revaccination once every 3 yr considered protective | Core. MLV not for pregnant queens or kittens less than 4 wk of age | |||||
| Panleukopenia (MLV), intranasal | Administer 6-8 wk of age, then every 3-4 wk until 12 wk old | One dose | 1-yr booster after primary vaccines, then revaccination once every 3 yr considered protective | Core. Not for pregnant queens | |||||
| Rhinotracheitis virus (MLV), parenteral, intranasal | Administer 6-8 wk of age, then every 3-4 wk until 12 wk old | One dose | One year booster after primary vaccines, then revaccination once every 3 yr considered protective | Core. Not for pregnant queens | |||||
| Rhinotracheitis virus (killed), parenteral | Administer 8-10 wk of age, repeat in 3-4 wk | Two doses 3-4 wk apart | One year booster after primary vaccines, then revaccination once every 3 yr considered protective | Core | |||||
| Calicivirus (MLV, killed) | Administer 6-8 wk of age, then every 3-4 wk until 12 wk old | Two doses 3-4 wk apart | One year booster after primary vaccines, then revaccination once every 3 yr considered protective | Core. MLV not for pregnant queens | |||||
| Calicivirus (MLV), intranasal | Administer 6-8 wk of age, then every 3-4 wk until 12 wk old | One dose | One year booster after primary vaccines, then revaccination once every 3 yr considered protective | Core. MLV not for pregnant queens | |||||
| Rabies 1 yr (killed), parenteral | Administer as early as 12 wk of age | One dose | Annual update | Core | |||||
| Rabies (recombinant), parenteral | Administer as early as 8 wk of age | One dose | Annual update | Core | |||||
| Rabies 3-yr (killed), parenteral | Administer as early as 12 wk of age | One dose | Revaccination one year following initial vaccine, booster vaccines administered every 3 yr | Core. State, local or provincial laws apply | |||||
| Leukemia virus (live canarypox vector), parenteral | Administer at 9 wk of age, repeat in 3 wk | Two doses 3 wk apart | Annual update | Core, noncore | |||||
| Leukemia virus (killed), parenteral | Administer 8-10 wk of age, repeat in 3-4 wk | Two doses 3-4 wk apart | Annual update | Core, noncore | |||||
| Chlamydia psittaci (MLV, killed), parenteral | Administer 6-8 wk of age, then every 3-4 wk until 12 wk old | Two doses 3-4 wk apart | Annual update | Noncore | |||||
| Feline infectious peritonitis (MLV), intranasal | Not approved for cats less than 16 wk | Two doses 3-4 wk apart to cats 16 wk of age or older | Annual update | Not recommended. Efficacy of vaccine controversial | |||||
| Microsporum canis (killed), parenteral | Not approved for cats less than 16 wk | First dose subcutaneously 16 wk or greater, second dose 12-16 days afterwards, third dose 26-30 days after second dose | Not stipulated | Not recommended | |||||
| Bordetella bronchiseptica (MLV), intranasal | One dose to cats 4 wk or older | One dose | Not stipulated | Not recommended. Primarily problem of very young kittens | |||||
| Giardia lamblia (killed), parenteral | Administer 8 wk of age, repeat in 3-4 wk | Two doses 3-4 wk apart | Annual update | Not recommended. Same limitations as those listed for canine giardiasis | |||||
| Feline immunodeficiency virus (killed), parenteral | Administer 8 wk of age, then every 2-3 wk for an additional 2 doses | Three doses 2-3 wk apart | Annual update | Not recommended. Vaccination of FIV (-) cats renders current available serologic tests positive | |||||
HEARTWORM AND FLEA PREVENTATIVES
I. Heartworm preventatives (Table 23-2)
| *These products help control infections with these parasites. | |||||||||
| Product (Age Approved for Use) | Heartworm | Fleas | Ticks | Round- worms* | Hook- worms* | Whip- worms* | Ear Mites | Sarcoptes | Mosquitoes |
|---|---|---|---|---|---|---|---|---|---|
| Canine Filaribits | x | ||||||||
| Canine Filaribits Plus | x | x | x | x | |||||
| Canine Heartgard (6 wk) | x | ||||||||
| Canine Heartgard Plus (6 wk) | x | x | x | ||||||
| Canine Interceptor (4 wk) | x | x | x | x | |||||
| Canine Sentinel (4 wk) | x | x | x | x | x | ||||
| Canine Revolution (6 wk) | x | x | x | x | x | ||||
| Canine Iverheart (6 wk) | x | x | x | ||||||
| Canine Tri-Heart Plus(6 wk) | x | x | x | ||||||
| Heartgard for Cats (6 wk) | x | x | |||||||
| Feline Interceptor (6 wk) | x | x | x | ||||||
| Feline Revolution (8 wk) | x | x | x | x | x | x | |||
| Canine Frontline Top Spot (10 wk) | x | x | |||||||
| Feline Frontline Top Spot (8 wk) | x | x | |||||||
| Canine, Feline Frontline Plus (8 wk) | x | x | |||||||
| Advantage (7 wk dog, 8 wk cat) | x | ||||||||
| Canine Advantix | x | x | x | ||||||
| Program (4 wk dog, 6 wk cat) | x | ||||||||
| Capstar (4 wk) | x | ||||||||
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