Titers... Discuss!

[BatterseaBrindl]

Some friends and I have been having a discussion on them....

None of us has ever done it....we just blindly get our hounds vaccinated.

However, one gal asked her Vet and the Vet really tried to talk her out of it

 

Who does these before vaccinating their hounds?

 

How often?

What is the cost?

 

At what age do you just say "NO" to vaccinating your dog?

 

 

[Charlies_Dad]

Nancy, We have done this for all our pups. Peanut our Rat Terrier who is 16+yrs has been tested as well as Angie our Pug who will be 12. Both tested positive and have not had vaccinations for 3-4 yrs. They were expensive though if I recollect, approx $200 each but I could be wrong.

Edited January 31, 2015 by Charlies_Dad

[Blaidd49]

The DHPP titre was around $100 I think. We vaccinate at one year (after puppy shots) then titre at three years and every two or three years thereafter vaccinationg only if necessary based on titer results. We do Rabies vaccinations every three years as we cross the border a lot.

[Hawthorn]

I told my vets when I registered with them that I didn't do annual vaccinations and that I would be titering instead, so there was never any discussion about it. Personally I think it's outrageous that a vet would try to talk anyone out of it - on what grounds I wonder? Vaccines are not harmless and no dog should be having one unless it's absolutely necessary IMO.

 

There's now a VacciCheck blood test kit that vets can stock to do the titer test inexpensively in-house, though mine were always sent away to a lab. This link shows the vets in Canada who stock VacciCheck, but there are only two, and they are both in the same place so not sure how helpful it is: http://www.petwelfarealliance.org/vaccicheck-vets.html

[tbhounds]

Tittering does not prove immunity. This is why many veterinarians are still recommending vaccinations, however, many clinicians are vaccinating at longer intervals. Also, cost comes into play-honestly it's less expensive to vaccinate--that is a factor that comes into play with some owners.

[Batmom]

Wouldn't bother. As tbhounds notes, titers aren't terribly meaningful. Vaccines are lifesavers and unfortunately blamed for many illnesses that have nothing to do with the vaccine; weird, that. After an appropriate puppy/young adult series, we do 3-year rotation for most things (except the things like lepto that need to be annual).

[Hawthorn]

Excerpt from:

http://drjeandoddspethealthresource.tumblr.com/post/33393350071/vaccines-titer-testing-animals

 

Are there downsides to titering?
There is no downside to titering your pet. However, be aware that some veterinarians may be resistant to performing titer tests in lieu of vaccination. These veterinarians are misinformed and incorrectly believe that measuring an animal’s serum antibody titers is not a valid method of determining his immunity to infectious diseases, or that this testing is too costly.

With all due respect to these professionals, this represents a misunderstanding of what has been called the “fallacy of titer testing,” because research has shown that once an animal’s titer stabilizes, it is likely to remain constant for many years. Properly immunized animals have sterilizing immunity (immunity that prevents further infection even when an animal is exposed) that not only prevents clinical disease but also prevents infection, and only the presence of antibody can prevent infection.

As stated by the eminent expert Ronald Schultz, DVM of the University of Wisconsin in discussing the value of vaccine titer testing, “You should avoid vaccinating animals that are already protected, and titer testing can determine if adequate, effective immunity is present. It is often said that the antibody level detected is ‘only a snapshot in time.’ That’s simply not true; it is more a ‘motion picture that plays for years.’”

Furthermore, protection as indicated by a positive titer result is not likely to suddenly drop off unless an animal develops a severe medical condition or has significant immune dysfunction. It’s important to understand that viral vaccines prompt an immune response that lasts much longer than the immune response elicited by contracting the actual virus. Lack of distinction between the two kinds of responses may be why some practitioners think titers can suddenly disappear.

[Batmom]

Dr. Dodds' work is not backed up by science.

 

Titers for various diseases in dogs are *being* studied, but that science -- knowing what the titers mean -- is way behind where it is in people for things like measles.

[tbhounds]

This topic is like juggling a hot potato. I have be to agree with Batmom regarding Dr Dodds. Does it hurt to run a titer-only in the wallet-doesn't prove immunity.

Edited January 31, 2015 by tbhounds

[Guest Lillypad]

Thanks Hawthorn, I had heard about VacciCheck thanks for the links. You are so (and all your animals as well) fortunate to live on an island where rabies vaccine is not required. Wish that were the case here in North America. Rabies vaccine is law, there are not many ways around it.

Edited January 31, 2015 by Lillypad

[philospher77]

Just read a fascinating discussion of this. Which has left me even more confused, and I am waiting to see if there is a response to my comment. The issue appears to be that high titers will, at least for some diseases, be evidence that there is immunity. However, for other diseases, it is still possible to become ill, even with high titers. And the flip side is true: some dogs with low titers will be immune to diseases, while others won't. So this vet is saying that they aren't that useful for predicting who is immune and who isn't, so he suggests vaccinating at 5-year intervals.

 

Ok. So, my question to the vet on which I am awaiting a response is, since apparently titer values don't correlate to protection levels, and the only way to truly tell if the dog is immune is to try and infect it and see what happens... why should I trust a 5 year vaccine schedule, or a 3 year one, or a one year one? Since the entire point of vaccines is to boost the number of antibodies, it seems like the same issues hold. If you titer, at least you have some idea of what the antibody levels are. If I just blindly vaccinate, I could be vaccinating a dog that has a high number of antibodies, or a low number. I just don't know. And I have no way of knowing if the dog is protected between the vaccination time points.

[PrairieProf]

I titer, though it's pricey. And one year Beth did come in with low levels on one or more of the measures so we boostered. So I would never not titer annually. My vet doesn't promote it but has no objection at all.

[cleptogrey]

my vet too doesn't promote them. i have discussed this with him, pros and cons. he will if you ask, but in his 45 years of practice he's seeing the highest amounts of preventable diseases(especially lepto). yes, this is a very hot potato....what ever WE decide is right for our hounds or even children is right for us and our family. now do we talk about the rise in measles and whooping cough in humans, a very preventable disease?inoculations is such a hot topic these days

[Hubcitypam]

We do 3 year protocol after puppy/ first adult shots and stop everything but rabies at the 9-10 year old range. No titers. My vet does this with his own dogs.

[JJNg]

Some vets, including specialists and infectious disease experts, don't feel that titers are useful because they don't necessarily correlate with protective immunity. A high titer is *probably* protective, but it's not a guarantee. To determine whether a certain titer level is protective, challenge studies would need to be done to expose vaccinated individuals with various titers to see which antibody levels truly prevent disease.

Low or zero titers also don't mean an individual is not protected. Even if there are no detectable antibodies, memory cells and cell-mediated immunity can adequately protect that individual from disease.

There are convincing challenge studies that show DHPP vaccination is protective for at least 3 years, and may even be lifelong. That's what the current AAHA guidelines for a 3-year interval are based on. Risks of vaccines are actually very low, and there's no evidence to show they cause the majority of the problems people blame on vaccines these days. So without definitive proof that protection is consistently lifelong for all dogs, many vets follow the AAHA recommendation to vaccinate every 3 years.

For clients who are very concerned about vaccine side effects, I recommend completing the puppy series, then boostering a year later. I'm ok with not vaccinating for DHPP again after that as long as the client understands the potential risks. Rabies vaccination needs to follow state regulations. For the majority of other healthy patients, I recommend 3-year DHPP boosters. I stop giving DHPP after 12-13 years old. Other non-core vaccines like Bordetella, Lepto, Lyme, etc are tailored to the individual patient's lifestyle and potential for exposure.

If a client insists on running titers, I would do it, but I would advise them that they are unreliable, not correlated with protection, and IMO, not worth spending the money. If vets are as money hungry as so many people seem to think and the media portrays, why would we try to talk people out of running a $100-200 test to give a $15-25 vaccine instead, or not vaccinate at all?

[Hawthorn]

The updated WSAVA summary guidelines (2013) say:

 

"The WSAVA states that we should vaccinate against the core diseases no more

frequently than every three years. This is often taken to mean that we should

vaccinate every three years – but this is not the case. If the dog is already immune

to these three core diseases, re-vaccinating will not add any extra immunity."

 

And

 

"The WSAVA supports the use of titre testing. This is where a small sample of blood

is taken from the dog and checked for the presence of circulating antibodies. The

presence of circulating antibodies indicates that the dog is immune, and

revaccination (with core vaccines) is not required. You may decide to titre test before

giving the 12 month booster, as this may show that boosting is unnecessary. New

in-practice titre-testing kits are now available which will allow your veterinarian to do

a titre test very quickly, without sending the blood sample to a laboratory."

 

And

 

"It is important to give as few vaccines as possible, whilst also ensuring that dogs are

protected from life-threatening viral and bacterial diseases. The WSAVA seeks to

reduce the number of vaccines given as there is always a risk of adverse reactions

with any vaccination. The risk of adverse reaction is considered small and the

WSAVA asserts that the benefit of protecting your pet from life-threatening infections

far outweighs the risk of adverse reaction – although any reaction to a vaccine that

is not needed is unacceptable. The WSAVA has listed the types of reactions in its

vaccine guidelines (which you can see on the link given above). They range from

mild (such as fever, loss of appetite), through to severe (such as epilepsy, arthritis,

autoimmune haemolytic anaemia, and allergic reactions). The most severe adverse

effects can be life-threatening."

 

This is the link to the full document:

http://www.wsava.org/sites/default/files/New%20Puppy%20Owner%20Vaccination%20Guidelines%20Updated%20July%2029%202013.pdf

 

It's a complex subject for sure, and there's plenty of information available to intelligent owners who want to educate themselves. This will of course include listening to their own vet's opinion, but I hope that no-one will allow themselves to be dissuaded from doing titers if they have done their homework and believe that this is best for their dog.

 

 

 

 

[PrairieProf]

Interesting. Another issue.... if I titer I can use the titer results date to certify my dog as current on vaccines. If one just switched to every three years, say, what do you do when "proof of current vaccination" is required?

[Hubcitypam]

At the boarding/daycare where I worked titers were not acceptable in lieu of vaccination records. YMMV.

Some (rather backward thinking IMO) vets here still insist on yearly DHPP and rabies. While it might have been a total fluke my first greyhound died of Autoimmune Hemolytic Anemia in 2000 at the age of four shortly after her shots so I've been kind of gun shy on overdoing shots. That was exactly when Dr. Bob Rogers in Houston (considered a quack by many) started a huge push for three year shot protocol.

[JJNg]

Interesting. Another issue.... if I titer I can use the titer results date to certify my dog as current on vaccines. If one just switched to every three years, say, what do you do when "proof of current vaccination" is required?

 

I'm not aware of any facilities (vets, boarding kennels, daycares, groomers, etc) here that accept titers as proof of vaccination. If your vet gives a 3-year vaccine, your paperwork would show that it's due in 3 years, so they're current until that due date.

[PrairieProf]

They give one year vaccines. There's no such thing as a "three year vaccine" except rabies, is there?

 

My proof of vaccines is a receipt/sheet that says when they're due next. They update that after the titer.

 

Of course the boarding and grooming I use is AT my vet where everyone totally knows us, so I don't have to show proof often. But I know I've used their printout with the dates.

Edited February 2, 2015 by PrairieProf

[JJNg]

Whether the paperwork for a DHPP vaccine is issued as a 1-year or 3-year is completely up to the vet. Many vets are now going to 3-year DHPP vaccinations with that being indicated on the vaccine reminder due dates. I believe there's 1 brand of DHPP vaccine that actually has a 3-year label, but all the manufacturers will back up their product for 3 years given the newer research and AAHA guidelines.

[PrairieProf]

That's interesting...I will talk to my vet about this.

[Batmom]

Nobody who requires proof here ever minds the 3 year cycle.

[Hubcitypam]

It really does depend on the vet. Here's an example of right now here in Dallas -

My vet does 3 year protocol for DHPP and rabies on adult dogs with vaccination history.
The shot clinic I took Barkley to says the rabies is good for 3 years (at my insistence and state law with proof of prior vaccinations) but according to them DHPP is only good for a year.

The vet where my neighbors take their boxer insists that DHPP and rabies are only good for one year.

[Guest Lillypad]

Thanks everyone for your input. It does seem to be a complicated issue. A special thank you to Dr. Ng for clarifying what a titer can and can not do; this is more than my vet did for me when I asked about titering recently.