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An immunology question


juliepoudrier
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So in the frenzy of treatments for mast cell cancer for Willow and losing my job in April of 2009, I managed to overlook Willow's rabies vaccine. I am a minimalist when it comes to vaccinating, but of course always follow the law when it comes to rabies vaccines.

 

In early spring thhis year, Willow became ill on her chemotherapy (liver problems) and so we stopped all treatments. At that time I discussed with my vet stopping treatments altogether and just going to palliative care (essentially treating symptoms as they arose) in order to improve her quality of life, given that she was going on 13 and so quantity of life wasn't as great an issue.

 

Last May, Willow's external tumors disappeared on their own. She had been off all cancer treatment since February. My vet, who is not an oncologist, told me that in his experience, largely with horses, if such tumors disappeared and stayed gone for six months, then they tended not to return.

 

It's now been 7 months and she still appears to be in remission. So here's my dilemma. I took the young dogs in for their rabies vaccines and checked on everyone else. They had no record of Willow having a recent rabies vaccine. I checked my records and found a note saying she was due in April 2009.

 

So I made an appointment for next week. But then I got to wondering whether it makes sense to stimulate her immune system, even if it should be a stimulation specific to the rabies virus, since mast cell cancer is a cancer of the immune system (mast cells are responsible for producing histamines, among other things, that are associated with allergic responses <--simplistic explanation). Thoughts, anyone?

 

J.

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I don't know. I thought about asking for a titer instead and will certainly ask if that's a possibility. We are having some serious rabies issues in surrounding counties, so I think I (and my vet) would have to make a very good case for accepting the titer vs. vaccinating.

 

As a side note, it used to be that if your pet was overdue for a rabies vaccine, a vet couldn't give you a 3-year certificate but instead had to issue a 1-year certificate. In NC at least, this practice has changed within the past year, and even though I'm more than a year late vaccinating (if I do it), she can still be issued a 3-year certificate.

 

J.

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If it were me, I probably would not vaccinate. Could your dog be exempted simply due to the fact that she has an immune system illness, regardless of a titre? I can't imagine that you'd be forced to vaccinate a dog regardless of it's health status, but maybe I'm just being naive.

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Julie, I googled "mast cell cancer" and "rabies vaccine" and I found a holistic D.V.M. recommending getting a titer -- here's the page where it's discussed:

 

The Nature of Animal Healing

 

I'm not that knowledgable about animal vaccines, but don't most vaccines include an adjuvant, which stimulates the immune system generally in order to increase the response to the vaccine? Also, if I remember correctly, Kris Christine, who posts here and is very active on the subject of rabies vaccine intervals, had a dog who developed a mast cell tumor at the site of a rabies vaccination, so she's probably researched the whole subject pretty extensively.

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I agree that you should go with your instincts. Minnie had all manner of autoimmune issues as she aged. Once she started having seizures I took her to a neuro specialist. The specialist advised no more vaccines (she was 9 at the time), and gave me a something in writing exempting her from futures rabies vaccs due to her health issues. But my regular vet said he couldn't agree with that recommendation. It was at that point that I did research on vaccinating schedules and learned that for the most part, according to studies, immunity remains for several years after the immune system has been stimulated and the 3 year time frame is arbitrary.

 

ETA disclaimer: subject to discussion with your vet, of course. Also, when I took her to a holostic vet, he agreed with the neuro specialist emphatically, and offered to write me an exemption as well. While my regular vet insisted on either the vaccine or titres

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I'm in a somewhat similiar situation with my nine year old dog...history of mast cell cancer, history of a granuloma (that had to be cut off) at the site of her last rabies vax, history of allergies, history of methacillin-resistant skin infections. She is due for rabies in about 6 months. My vets don't want to vaccinate her...the vaccine label says to only use in healthy dogs and we can make a strong case for her not being healthy, but rabies is endemic in our area and the little princess has killed some small critters in my backyard.

 

When the time comes, I guess that we will pull titers and go from there.

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Rabies vaccines are highy effective. I would not vaccinate her again.

 

Kipp recently tangled with a sick raccoon. State protocal says the dog need to be revaccinated if this happens. So I took him in. But my vet told me that the only reason they have to do it is because of state policy. In some online reading I did I found that pretty much if your dog has been vaccintaed more than once they are protected.

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Even if NC won't allow waivers, I'd be tempted to get a titer and flaunt the law. You might get caught or fined, but in the unlikely event your dog was ever in a bite situation you would at least have some paperwork protecting you. I'd hazard that her titer would be fine if she was vaccinated appropriately in the past.

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I won't do it. Vaccines are for Healthy animals. I assume Willow has had her vaccines on schedule all her life. The chances are about nil that she'd even contract rabies if exposed. Of course it is your issue to deal with should an exposure occur so I won't tell you not to do it. I can only say what I would/wouldn't do.

 

Dr. Schultz & Dr. Dodds are working on a Duration of Immunity study (DOI) right now-the Rabies Challenge Fund is trying to show 5 & then 7 year DOI for Rabies vaccines. The problem with titers is that there are no real guides to say what is a good titer and so states can make their own decision.

 

Do you now what NC laws are? Do they allow for an exception if sick pets? How much time does Willow spend outside now? Unattended? Will that decrease now that it is winter? You should assess the risk of exposure- what are the carrier animals in your area- fox? raccoon? bats?

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The point of the titer would be to have some "proof" (however admissible it might be) that she is fully immunized even without an up-to-date vaccination certificate. We do walk on this property, and although they've encountered just one raccoon (which treed itself) in the three-plus years I've lived here, I'd rather have something to back me up should such an encounter take place, since there have been numerous incidences of rabid animals in this area. My hope would be that if she encountered a rabid animal I would have a leg to stand on with regard to quarantining her at home.

 

J.

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Based on Willow's age and medical history, I agree with trying to get an exemption from the rabies vaccine. From my readings on this forum, I think that the ability to get exemptions can vary state by state - hopefully NC offers that option. (IMO, state policy often does not reflect current scientific knowledge.)

 

Unless necessary for the exemption, I wouldn't get a titer done unless you are curious. On one hand, I would not revaccinate for rabies. As another poster pointed out, due to Willow's age and your management of her activities, her exposure may be very insignificant - even though the incidence of rabies cases in wildlife may be high in your area. On the other hand, if an exposure did occur, I think the only way to protect Willow would be if she had a current rabies vaccination. I do not believe a titer would be enough. I may be wrong, but in cases with serious consequences, public health officials can have wide-ranging and destructive powers (think of hoof-and-mouth in England).

 

This is a hard decision. If I was in this situation, I would really be torn between not vaccinating (since there is a strong possibility of collateral damage) and vaccinating (to protect my dog from seizure if an exposure did occur - even though it is highly unlikely). I didn't vaccinate my cat for rabies the last 6 years of his life. I took that risk, but heck, he was 100% an indoor cat and was 14-15 years old when I thought that he was having some negative reactions to vaccines. He lived to be 20 years old. My vet cautioned me that indoor cats MIGHT still get rabies if they were to catch a bat or mouse inside the house. Yeah, OK. I will risk a bat getting into my house. And a mouse is so small that if it were attacked by a rabid animal, it probably would not survive the attack. So a mouse vector for rabies is a very low risk.

 

FWIW, as an immunology graduate student, I used the rabies virus as a model virus system. Because I focused on the cellular and molecular levels, I do not claim to be an expert at the clinical level - but merely knowledgeable.

 

Jovi

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From a pragmatic angle, there are two basic reasons for following the legal schedule for rabies vaccination.

 


  •  
  • First, to protect people/animals who might be bitten by a dog who can't be proved *not* to have rabies.
     
  • Second, to protect the dog (in case the dog is bitten by an active rabies carrier, or in case the dog bites a human and they require legal "proof" of non-infection).

 

(I don't think the order is important. If so my own warped personal preference might be to put the dog's protection first... but I suspect protecting humans and their property is what actually drives the legal engine on this issue.)

 

Regarding the first case, from what you've said, it seems unlikely that Willow will ever bite anyone, much less anyone who would press the issue of a current rabies vaccination. I'd think not biting humans would remove the single greatest threat of action from the authorities on the vaccination front. (Unless you have a very proactive animal control/licensing department? Or difficult neighbors whose complaints force you to ensure you're in full, current compliance? Which is always, alas, quite possible.)

 

Regarding the second case... if Willow should be bitten by a possible rabies carrier (which also seems unlikely due to your good care and management) could she not be treated then, on an as-needed basis? Unvaccinated humans can be treated successfully within a specific window of time. It seems sensible that as long as it's caught quickly they ought to be able to give preventative treatment to dogs. Particularly when it's likely the dog already carries some protection from a documented history of prior vaccination. That would mean not running the risk of re-vaccination *unless* you had serious cause.

 

I'd pass on the rabies update myself, if at all possible. The rabies vaccination seems to be quite long-lasting and also one which causes a significant number of strong reactions. I wouldn't mess with Willow's miracle. :-)

 

Just my few cents. I'm not a vet or scientist but at one point I followed the issue fairly closely from a layman's perspective. I have one dog (an Australian Cattle Dog) who crashed at 3 months old, very probably from excessive vaccination. (Idiopathic auto immune mediated thrombocytopenia, which is the technical way of saying his immune system was destroying all his platelets and it was impossible to diagnose the specific cause.) I haven't gone all the way to the "never vaccinate" end of the spectrum, but I've definitely become more conservative and respectful of what a compromised immune system can do.

 

Good luck whatever you decide.

 

Liz S in South Central PA

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Here is the NC Rabies Manual This one's dated 2007 so it may not be the most recent but it looks like NC is pretty strict about vaccine schedules and they specifically mention that titers will not be considered in cases of exposure- it even explains why.

 

To Liz S- unfortunately there is no post exposure treatment for pets if the pet is not currently vaccinated for rabies. If you check out the link above on pg 13 there is a pretty scary flow chart that shows "Management of Dogs and Cats Exposed to a Potentially Rabid Animal" In NC it appears that exposure is defined as a bite to or from any one of a list of animals (raccoon, fox, bat, skunk, bobcat, etc...). If a bite occurs and the animal is not recovered then it is assumed rabid. The scary part of the flow chart is the end where it states that the government gets to decide whether your pet is quarantined for 6 months or euthanized.

 

The thought of losing control of the fate of my dogs is really scary to me. I know I said I won't vaccinate a sick dog but when I read this stuff it makes me want to lock them inside & never let them out!

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I faced this situation with Sara when her liver cancer was stable. My vet, Sara's oncologist, and I all discussed it and both vets recommended against vaccinating her. Yes, it was a violation of the law and had she bitten someone, I likely wouldn't have any defense against immediate euthanesia. But she was 15, had never bitten anyone, showed no propensity towards biting anyone, was not boarded in kennels or taken to a groomer, no longer romped in fields around wildlife, etc. and I chose to take the chance. It is the same decision I have made over the years for older cats - my vet is not a big proponent of vaccinating cats older than 15.

 

Regardless of which decision you make, I hope Willow's healthy state continues for a long time to come.

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  • 2 weeks later...

I found your post about tumors/rabies shots very interesting. I own a male border collie(Chance) who is now 11 1/2. He has had small fatty tumors for years. Just one year ago I brought him in for his rabies vaccine.(I really didn't want to) Within 2 months a growth started to appear on his upper front leg - towards the body. It was a wide growth that covered the entire inside upper leg - not thick at the time. My vet said he would not be able to operate because of location and the way the tumor had grown. The only option would be to go to a specialist who might be able to do a removal and skin graft. The tumor has now grown very large..but Chance keeps on plugging along doing his running and swimming and enjoying life ...I always wonder if the rabies shot "triggered" this tumor.

 

So in the frenzy of treatments for mast cell cancer for Willow and losing my job in April of 2009, I managed to overlook Willow's rabies vaccine. I am a minimalist when it comes to vaccinating, but of course always follow the law when it comes to rabies vaccines.

 

In early spring thhis year, Willow became ill on her chemotherapy (liver problems) and so we stopped all treatments. At that time I discussed with my vet stopping treatments altogether and just going to palliative care (essentially treating symptoms as they arose) in order to improve her quality of life, given that she was going on 13 and so quantity of life wasn't as great an issue.

 

Last May, Willow's external tumors disappeared on their own. She had been off all cancer treatment since February. My vet, who is not an oncologist, told me that in his experience, largely with horses, if such tumors disappeared and stayed gone for six months, then they tended not to return.

 

It's now been 7 months and she still appears to be in remission. So here's my dilemma. I took the young dogs in for their rabies vaccines and checked on everyone else. They had no record of Willow having a recent rabies vaccine. I checked my records and found a note saying she was due in April 2009.

 

So I made an appointment for next week. But then I got to wondering whether it makes sense to stimulate her immune system, even if it should be a stimulation specific to the rabies virus, since mast cell cancer is a cancer of the immune system (mast cells are responsible for producing histamines, among other things, that are associated with allergic responses <--simplistic explanation). Thoughts, anyone?

 

J.

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I can tell you that when I discussed this with my vet, he said that common wisdom is that vaccines are specifically targeted enough that they shouldn't trigger an overall immune response that, at least in my dog's case--an immune system cancer, would result in "reawakening" a cancer in remission. But he also said it was a very good question (meaning that I wouldn't be wrong to choose not to vaccinate), but of course because of the legal issues involved with rabies vaccines, he couldn't recommend not vaccinating.

 

If you look in the literature, there is evidence--especially in cats--of injection site tumors that are a direct result of the injection of a vaccine. Have you had the tumor biopsied to see what it is?

 

J.

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It's a hard question.

 

We do chemo at the vet clinic where I work and it is the vet's recommendation that these dogs never receive further vaccines. She writes letters explaining that vaccinating would not be in their best interest and that they are not healthy enough to receive them.

 

But if push came to shove, those letters probably wouldn't be enough to halt the seizure of a dog in a rabies case.

 

Personally, I wouldn't vaccinate, but my dogs are town dogs and not really at risk of exposure. They've also been well vaccinated for rabies in the past.

 

I understand the reason for rabies laws and the concern for public safety, but I wish that the law were flexible enough to allow for the well-being of dogs in this situation.

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