Someone (I’ll call her Ann) wrote me last week asking: Is there any recent info I can pass along to my Vet – he says titres are not reliable and he will not do them.
Yikes. He-will-not-do-them? Titer testing — a simple blood draw to test immunity to a disease — is an absolutely safe procedure. You can test titers (antibody) levels to determine if an animal (or human) already has immunity to particular diseases and doesn’t need “boosters.” The most commonly tested titers are for parvovirus and distemper, the two most important diseases, and also rabies in certain instances. Don’t waste your money on anything else.
Even if Ann’s vet thinks titer testing is unreliable and a waste of time and money, it is her money and her responsibility to keep her dog healthy. Not his. His job, in this instance, is to draw blood and offer advice if asked. After testing, it is up to Ann to determine the weight to give to the results. She can then allow her vet to vaccinate if he wants. Or not.
Incidentally, Ann could have any vet or vet tech draw blood. She could send the blood sample to a lab (like my favorite, hemopet.org). They’ll perform the test and an expert will interpret the results. From that point on, she can solicit her vet’s input. Or not.
Although most enlightened veterinarians will happily test titers, too many, like Ann’s vet, refuse to test or will belittle results. Others avoid confrontation by charging astronomical rates. A parvovirus/distemper titer test should cost around $50-60; a rabies titer (not for export) should cost around $100. Add to this, around $25 for a blood draw; some tests in some locations may also require a shipping expense. If your vet is charging much more than that, he/she is just trying to discourage (and/or take advantage of) you.
The answer is, not really. Titer testing need not be done every year, nor even every three years. Many experts do it once, to make sure that puppy vaccinations “took,” then never again. Contrast that with giving vaccines again and again. More importantly, you won’t have to pay anything to treat an adverse reaction which could cost hundreds or thousands of dollars, or even more./
Distinguished veterinarian Michael J. Day, BSc BVMS (Hons), PhD, DiplECVP, wrote in the proceedings book at the 39th World Small Animal Veterinary Association Congress: “Although the tests may cost more than simply revaccinating the dog, they are an important tool in the annual health check and are greatly appreciated by owners who understand the benefit of not automatically revaccinating an adult dog where this might not be required.”
Many veterinary clinics now offer quick, inexpensive in-house titer tests. Dr. Day is in favor of in-clinic testing as is Ron Schultz, PhD. (Dr. Shultz is the world-renowned scientist on whose research the American Veterinary Medical Association recommendations, the American Animal Hospital Association Canine Vaccination Guidelines and the World Small Animal Veterinary Association Guidelines are based.)
VacciCheck, one in-clinic kit, checks protection from CDV, CAV and CPV. TiterCHEK by Zoetis measures protection against canine distemper and parvovirus. Both are ELISA-based systems well validated against the ‘gold standard’ VN and HAI tests. Read more about the opinions of Drs. Day and Schultz on the Vaccichek site.
Isn’t forgoing shots dangerous?
Some veterinarians don’t understand that testing is safer than vaccinating. World-renowned vaccine and hematology expert W. Jean Dodds, DVM, has written: “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.”
How to convince your vet to start testing titers
It’s often easier to find someone who already believes as you do than it is to attempt to change a mind cast in concrete. This is especially true when dealing with a vet, like Ann’s, who has a vested interest in continuing to give injections, or who denies that vaccines can cause bad reactions. Such a vet is probably behind the times, or lacking in education, in other ways as well.
Of course, sometimes finding a new vet is not practical. Maybe your vet is the only one within miles, or is charming or is married to your baby brother. To bring this vet (or Ann’s) kicking and screaming into the 21st Century, you’ll need information from unimpeachable sources. I wrote an article called Titer Testing: A Crash Course for a lay audience. (If you’d like to know more about when, how and how often to test, check it out.) I got the impression, however, that it might not seem scientific enough for Ann’s purposes. Bummer.
So here are some suggestions.
1. If you suspect your vet doesn’t understand testing or trust test results, have him/her read the roundtable discussion of noted experts, moderated by Dr. Shultz, talking about titer testing. Other veterinarians at the table (who are also Internal Medicine diplomates) are Richard B. Ford, Jory Olsen and Fred Scott. Starting on page six, they discuss titer testing at length and how to interpret results.
2. If you are confrontation averse, try saying something like: “Bailey felt horrible after his last shots. Let’s do the titer test today and I’ll come back soon to discuss vaccinating. I just want to see the test results first.” If the vet still pressures you to vaccinate, try: “I know you don’t believe in titer testing, and I appreciate your advice. I’ll have someone else draw the blood and send it in. We can talk when I have the results.” Smile politely.
3. Gently expose any hypocrisy. Vets are vaccinated against rabies in vet school. Thereafter, they have their own titers measured periodically to determine when they should revaccinate. The US Center for Disease Control says: “A rabies antibody titer is essentially an estimation of an immune response against rabies virus (either through exposure or vaccination)…. Typically, rabies virus neutralizing antibody tests [titer tests], such as the rapid fluorescent focus inhibition test, are used to monitor antibody levels in persons that may have an occupational risk of rabies virus exposure (e.g. veterinarians, rabies virus laboratory workers, etc.).
Does your vet have his/her own titers tested? If titer testing is good enough to protect your vet from a fatal disease, isn’t it good enough to protect your dog? If your vet believes vaccines are completely safe, why don’t vets just vaccinate themselves every several years? (I don’t know any who do.)
4. Send your vet this video by Ron Schultz, PhD. On this same webpage, there’s an excellent four-part video series in which Karen Becker, DVM, interviews Dr. Schultz.
5. Titers prove immunity for exporting pets abroad and to Hawaii. In addition, standards for parvovirus and distemper are widely accepted worldwide. Prestigious institutions like Kansas State University Rabies Laboratory do rabies titer testing. (Currently, vets use the titer standard for humans for dogs.) Drs. Schultz and Dodds, principals of the RabiesChallengeFund, are working to prove a rabies titer standard for dogs. The University of Wisconsin at Madison is donating their facility for the research. Ask your vet why these institutions, and countless others, would recommend titer testing if it is bad science?
6. If titer testing is good enough for scientists and researchers, why isn’t it good enough for your vet? Titer testing (also called serology) is used during vaccine testing and in immunity studies. A study published 1-15-15 in the Journal of the American Veterinary Medical Association uses rabies titers to measure immunity acquired from revaccination of dogs suspected to have been exposed to rabies. The report explores the effectiveness of giving a rabies vaccine to a dog or cat that has been exposed to rabies — even if the dog is over-due for their “booster.” It’s called “Comparison of anamnestic responses to rabies vaccination in dogs and cats with current and out-of-date vaccination status.” A great study — but the title needs work. 🙂
Would any of this information convince Ann’s vet (or yours) to reconsider his position on testing? I hope it does. The health of her dog, and yours, may be at stake.
Jan Rasmusen is the national award-winning author of Scared Poopless: The Straight Scoop on Dog Care (winning Best Health Book and Best Pet Health Book). Scared Poopless has been updated and expanded for a 611-page e-book with 260 color photos – an Amazon Bestseller! Read it on tablets, computers or smartphones with the free Kindle app. All proceeds benefit dog causes. Check out our two other websites dedicated to dog health:truth4pets.org and dogs4dogs.com.
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