Senior Care

& Vaccines
Companion Animal
Initiative of Tennessee
Updates In Vaccine Technology
And Senior Pet Issues
 Dr. Kristi Lively, DVM,
DABVP Canine and
Feline Specialty
 Village Veterinary
Clinic & Laser Center
 Farragut, TN 37922
 865-966-8900
 Advances in
Vaccine Technology
 Controversy has surrounded vaccine
technology for the last 40 years
 Do vaccines protect pets for more than
1 year?
 Tradition doesn’t make it right
 USDA approved 3 year vaccine for
Distemper, Adenovirus (Hepatitis) and
Parvo virus is on the market- this changes
everything
 Vaccine History
 Annual vaccine protocols started in the
1950’s when the first canine distemper
vaccines were developed
 By 1961 annual vaccinations were being
questioned but the research didn’t exist to
test the need
 Annual vaccination was born because it
was cheap to do and the science didn’t
exist to explain if this was right or wrong
 History Continued
 In 1998 discussions began regarding the
link of vaccinations to cancer in cats
 Feline vaccine guidelines and technology
were revised
 Suddenly vaccinology and protocols were
under scrutiny
 History Continued
 1998 a canine group published 3 year
vaccine protocols
 Many veterinary schools started adopting
these protocols
 In 2002 AVMA updates guidelines to allow
for extended use protocols
 In 2003 AAHA published Canine Vaccine
protocols vaccinating for Distemper,
Parvo, and Adeno every 3 years
 Into the Future
 Now we have scientific recommendations from
our leading veterinary organizations, but we still
did not have an approved product with a 3 year
duration label
 Vets were using the 1 year products in an off
label manner by giving them every 3 years
 We were betting that the older vaccines did
what we hoped they did
 Has the immunity been proven?
 What’s my liability?
 Challenge Studies
 Challenge studies are the ONLY way to
truly prove the duration of effect of a
vaccine
 Titers are more anecdotal
 Challenge study: vaccinate, wait 3 years
challenge with the virus
 These are expensive studies to perform
 Many companies not willing to invest
 Challenge Study
 In 2005 Intervet completed a 3 year challenge
study for Distemper, Adenovirus and Parvovirus
 20 Beagles in each group
 Each dog was exposed directly to the virus and
monitored for clinical signs or shedding of the
virus
 Excellent results
 This is the ONLY company to get USDA 3 year
labeling
 Challenge Studies
Fort Dodge:
 They do NOT have a USDA 3 year label
 They used 7 dogs
 1 in 7 was shedding Parvo in its stool
 3 in 7 had clinical signs
 I consider this unacceptable- so we had to
wait
 Protocol
 Continuum Distemper/Adenovirus and
Parvovirus combination
 Parainfluenza and Bordetella are annual in
a nose drop
 Rabies according to county law (3 yr in
Knox Cty)
 Corona no longer considered a core
vaccine
 Lepto for at risk dogs only
 Puppies
 2 shot series of the
Continuum DAP, with
at least 1 booster
being after 12 weeks
of age
 DAP not due again for
3 years
 Puppies
 Rabies at 16 weeks,
at 1 year, and then
every 3 years
 Bordetella/
Parainfluenza annually
 Others after risk
assessment
 What This Means To You
 Find a vet who is using the new Intervet
product
 Ask your vet why they aren’t using this
product
 Find a vet open to extended duration
protocols, and tailoring the protocol to
your pet’s individual needs
 Expense is actually less over 3 years
 What This Means To Your Pet
 Safer- fewer side effects
 Less painful for the pet
 Its not “just about the shots”
 Redefining the reason for the annual visit
 Vaccines save lives, absolutely…
but they are not the most
important part of the visit
Questions Regarding
Vaccine Protocols
 Considerations
For The Senior Pet
 Goals for Senior Patients
 Enhance the Human-Animal Bond
 Early detection of disease in the
apparently healthy pet
 Individualized medical care
 Outline common senior conditions
 Prevent of delay morbidity/mortality
 Principles of assessing and managing pain
 What is a Senior?
 Varies for breed and size
 In people, 54-60 years of age
 Dogs and cats: about
7 years of age
 Considered a senior
when in the last 25%
of the predicted life
span for that breed
 Approach To Apparently
Healthy Senior

 Detect sub-clinical abnormalities and

proactively intervene

 Thorough history

 Nose to tail physical exam

 Approach Continued
 Client education

 Preventive care

 Minimum data base

 Establish a baseline assessment for future

comparison (PE/Xrays/BW/UA)
 Elements of a
Thorough History
Questions extend beyond the owner’s presenting
concern
 Risk factor analysis
 Quality of life
 Specific behavior questions
 Medications and supplements
 Water intake
 Housebreaking
 Ambulation
 Elements of the
Physical Exam
 Observation before handling
 Weight changes
 Ocular exam
 Lymph nodes
 Thyroid enlargement
 Abdominal palpation
 Orthopedic and nervous systems
 Auscultation
 Rectal palpation
 Minimum Laboratory
Data Base
AAHA recommends every 6 months:
 Complete blood count
 Urinalysis
 Fecal
 Chemistry 27
 HWT
 Labwork Continued
 Urine protein/creatinine ratio
 Thyroid
 Schirmer tear test
 Blood pressure
 Intraocular pressures
 Imaging studies
 Preventive Care
 Recommendations prior to or at the onset
of disease to prevent/slow the effects of
disease
 Start senior wellness plans at middle-age
to establish baselines
 AAHA recommends bloodwork annually
during middle-age
 Client Education
 Semi-annual exams
 Increased attention to oral health,
prophylaxis and home care
 Nutrition and supplements- digestibility,
calories, new developments
 Weight and parasite control
 Maintaining mobility- exercise or therapy
 Client Education
 Vaccination as appropriate
 Mental health/enrichment- cognitive
decline, social interaction
 Environmental conditions- accommodation
of disabilities, indoors/outdoors
 Potential reproductive disease in un-
neutered pets: pyometra/testicular,
mammary and prostatic neoplasia
 Approach To The
Unhealthy Senior Pet
 Common clinical conditions
 Evaluation of the patient
 Client communication
 Choosing appropriate treatments
 Monitoring
 Pain management
 Nutrition
Common Clinical Conditions
 Weight changes
 Orthopedic conditions- arthritis
 GI disease- IBD, dental disease, liver
 Endocrine disorders- Cushing’s,
Hypothyroidism, Diabetes Mellitus
Common Clinical Conditions
Neurologic /behavior:
 Disorientation
 House soiling
 Anxiety
 Aimless activity, sleep-wake cycle
alteration
 Fecal or urinary incontinence
 Spinal disease/ seizures
Common Clinical Conditions
 Sensory: KCS, cataracts, retinal disease,
deafness
 Urogenital: renal disease, UTI’s, stones,
uterine or prostatic disease
 Cardiac: murmurs, endocarditis, dilation
 Anemia
 Skin: tumors, otitis
 Respiratory: laryngeal/ tracheal collapse/
saccules
Exam Of The Sick Senior Pet
 Still nose to tail, but pay particular
attention to clinical changes or signs of
pain
 Maybe required more often than every 6
months depending upon condition
 Include blood work, blood pressures as
appropriate for the condition or
medications
 Client Communication
 Veterinarian should recommend what is
best for the pet and the client choose
what is best for both of them
 Discuss your follow-up plan and required
monitoring
 Get diagnosis and information in writing
 Copies of blood work
 Client Communication
 Discuss prognosis
 Discuss side-effects of treatments
 Discuss time commitment
 Discuss quality of life issues
 Pain management
 Choosing Appropriate
Treatments
 Don’t overuse/indiscriminate
use of antibiotics
 Avoid drugs that alter
mentation or impair mobility
(sedatives)
 NSAIDs (Rimadyl, Deramaxx,
Previcox) -
Must monitor blood work, other
meds
 Long Term Monitoring
 Vet and client share the responsibility of
complying with long term monitoring
 Drug monitoring (therapeutic levels)
 Specific tests according to disease state
 Formal hospital call back system is crucial
to successful case management
 Consider referral to specialist as needed
 Pain Management
 Treatment options vary depending upon the
type of pain (acute vs chronic)
 Opiods are not as appropriate for chronic
pain alone
 Supplements (Cosequin,
Adequan, Fatty acids)
 Physical therapy and
massage
 Pain Management Cont
 Acupuncture
 Weight management
 Environmental modification
 Frequent communication between vet and
owner
 Discuss side effects, monitoring,
combinations
 Nutrition
 The unhealthy senior pet will have unique nutritional needs

 Prescription diets

 Weight control
 Caloric intake (decreased
or increased)
 Conclusion
 The goal is to identify underlying disease
before it is clinical
 Start treatment and monitoring plans
proactively, not reactively
 Ensure the best quality of life for the
senior patient and for the senior pet
owner
 Communication and follow-up are key
Questions Regarding
Senior Care?
For more information,
please contact CAIT
www.vet.utk.edu/cait
cait@utk.edu
865-755-2276