The scary thing about vaccinations

 “Immunization saves more than three million lives worldwide each year, and it saves millions more from illness and lifelong disability.” - Human vaccines and immunotherapy.

Today, in many parts of the world, people see vaccination as common sense, especially in developing countries where people are exposed to life threatening diseases. However, as the developed world enjoys clean water and modern housing, we have seen less and less of the illnesses that have plagued humans and animals over the previous centuries. We’ve forgotten how terrifying it was when polio played Russian roulette with all the children in a village, or measles swept through urban slums, leaving death, blindness and deafness in its wake. Instead, we look at the rare cases of medicine gone wrong, such as thalidomide affecting unborn babies, and we start to distrust medical experts and big pharmaceutical companies, seeing bogie men under beds and monsters in closets. In recent years, Melbourne and Sydney have seen babies dying again, despite our clean water, modern housing and medicine, from diseases that should have been entering the history books. 

The sled dog community has no business forgetting this stuff - sled dog enthusiasts known well the story of the Nome Serum run, where sled dog team relays transported vital diphtheria serum across snow bound rural Alaska to save the children of the town of Nome. That diphtheria serum contained antibodies to fight the infection, and today it is no longer used, having been replaced by vaccines like DTaP that stimulate the body to make its own antibodies for life long protection against diphtheria, tetanus and whooping cough (pertussis). The Nome serum run is commemorated each year with the Iditarod race to Nome, the heroicism of dogs and mushers, never to be forgotten.

So, with the recent tragedy of parvovirus deaths, there has been a lot of discussion about vaccinating our puppies. Healthy discussion is obviously good - if people have genuine concerns, they need to be addressed. But when everyone is so passionate about the health of their dogs, it can be hard to stay calm and reasonable. I get burning mad when people use terminology that I think is irresponsible, like “vaccines are poisoning animals” or “vaccines are full of carcinogens”. Too many people see those statements and freak out, without looking into it fully.  And of course, when I get mad, I annoy people by saying things like “are you serious????” Not helpful.

So here is my calm(er) response. 

What is in puppy vaccines? 

One of the chemicals used in vaccines last century is a preservative called thimerosal. It has antifungal and antibacterial properties, which are excellent, and it is used in a variety of ways, including in some tattoo inks. However, it breaks down into compounds that include ethylmercury, and ethylmercury can be toxic, similar to mercury. Because of concerns about this, thimerosal was phased out of human vaccines, starting in 1999. (Adults like me, who were fully vaccinated prior to this have yet to become Mad Hatters in vast numbers, and the scientific consensus is that the concerns were unjustified.)

When this question was raised recently, a vet who was part of the FB discussion went and did some very detailed reading on animal vaccines.  

  “Having spoken with drug companies in Victoria and looking at all MSDS  for multiple vaccinations in canines I can confirm that there is NO thimerosal used in our vaccinations. It was used primarily in human multi dose vials as a preservative and given canine vaccinations are individually compounded there has never been a need for it. The only vaccination it is used it is the rabies vaccine which is not used in Australia, and currently there are thimerosal free vaccinations which can be used instead overseas.” - KC, B.VSc

Is there a risk of over-vaccinating our dogs? 

Currently puppies get their “core” vaccines at 6, 12 and 16 weeks, and many adult dogs get an annual booster.  In recent years, there has been a concern that annual boosters may lead to other health issues in animals, especially in terms of feline tumours. It is not clear yet whether this is directly related, and currently (2018) this is being reviewed. Some vets are transitioning to triennial boosters. Others are using a process called titre testing to look at the antibodies in a dog’s blood and give boosters only when the levels fall below optimum. This process is very expensive in Australia. Many vets are sticking to annual vaccinations.

  “Vets often recommend yearly vacations given 90% of vaccinations are not registered for a three yearly vaccinations and until that changes WE are legally liable. Yes the vaccinations guidelines are changing, yes vets are changing, it’s not an overnight change. Titre testing is a wonderful alternative however minimal labs in Australia are doing it. My last rural clinic had to send ours to the uk for testing.” - KC, B.VSc

Overall, we have a choice - 1) we can quarantine puppies til 16 weeks and hope that a single core vaccination is enough to protect the dog for its entire life (the trade off is restricted socialisation and very high risk of death from infectious diseases during a critical developmental and vulnerable period), 2) we can titre test dogs repeatedly from 6 weeks to find the perfect time to try a single core vaccination (very expensive) or 3) we can trust the veterinary expertise and follow their guidelines, which may change as new research clarifies the impact of annual boosters.

How Big is the risk attached to not vaccinating versus vaccinating? 

Over the last hundred odd years, we have introduced more and more vaccines to humans and animals. Hundreds of thousands of puppies are vaccinated every year. Yes, there is a risk to vaccination, just like there is a risk to crossing the road. Sometimes the immune system responds with hives or a temporary lump of lymph fluid - unpleasant but low risk, and quite rare. The risk of a bad reaction is even more minimal - there are no terrifying stories about dozens of puppies having allergic or anaphylactic reactions. It’s so rare that it’s actually hard to count such cases, despite the huge numbers of dogs now getting vaccinated every year. Vaccination carries a minimal risk. 

The risk of not vaccinating is very high. Bacteria can become antibiotic resistant. Viruses cannot be treated with antibiotics. Diseases are often deadly - parvovirus is estimated at a 75% chance of fatality in puppies and 50% in adult dogs.  Vaccination protects our animals and children from these things by giving their own immune systems the amazing ability to fight them off naturally.

Overall, to me, the scary thing about vaccination is just that people don’t do it.

Czar and the mystery lump

Thankyou to everyone that’s wished us luck and to everyone that I’ve made poke and prod at Czar and talk about lumps and bumps and vets and bills in the last few weeks - the short version of this is that Czar is ok.  

The long version is that for a few weeks now, Czar has been crying out in pain at random intervals. Anyone who has met Czar has probably heard his voice, which is quite... um, distinctive... and loud... yes, very loud. Huskies come in two varieties - ridiculously stoic (Ishka and Bolo almost never yelped or whimpered ever, no matter what) and total wimps (Czar and Frankie are definitely the latter). We haven’t been able to pin down the cause - he’s had a good appetite, no diarrhea or vomiting, no heat or swelling anywhere, no obvious injuries, little consistency about where he is or what he’s doing when he yelps. We did find one little lump, about 2.5cm long, on his right flank.

It is a strange lump, not rounded or raised, but elongated and flat, slightly pointed at each end. I took Czar to the local vet and they couldn’t find anything else wrong either. They inserted a needle into the lump area and drew out some fluid. No blood or pus, just clear lymph fluid. The vet was hopeful but microscopic examination showed no cells in the fluid, nothing to indicate what the lump might be. 

Regardless, said the vet, it probably should come out. I asked for a quote, wincing at the idea of spending several hundred dollars on veterinary surgery. When I got the quote, it was three times higher than I expected, with a top estimate of $1200. Much as I’d like to say that money is no object when it comes to the health of our family, human or canine, you can’t spend money you don’t have. My maternity leave finishes soon and things will be (financially) better then, but lately every penny has been pinched til it squeaks.  I rang around and asked other local vets to quote on the surgery, but the price was the same.

I spoke to a few friends at the SHCV Cup Race weekend and everyone that touched the lump said “oh that’s really weird, but I guess it has to come out” Our consensus was that the lump was possibly a thorn or grass seed, and that it was going to cause problems sooner or later. One friend suggested a veterinary hospital in south eastern Melbourne as being remarkably affordable. I looked them up and not only are they affordable, but they are transparent and up front about their prices, removing the difficulty of asking the awkward question, brilliant!

I rang them the next day and got an appointment. The second vet agreed that the lump seemed more like a foreign body, but pointed out that not only was there no sign of infection, there was also no sign of entry or the kind of “track” that a thorn, seed or spine might make as it worked it’s way in. Based on the surface location, small size, clear margins of the lump, he was happy to quote a much cheaper rate for a quick and easy surgery. We booked it in for the following week.

Today, I locked Frankie on the deck, Kit in the yard (worried that otherwise poor Frankie would be tormented by Kit’s attempts to play) and packed Czar in the car. I dropped Wee Monster at childcare and then Czar at the vet. I signed the consent form, including my contact details for the day. Lil Bunyip and I said goodbye Czar-zar and headed off.

 * * *

When the phone rang, my heart sank. What was wrong? Fortunately, nothing.

The vet that was ringing was a different person to the one we’d seen the week before.

”I’ve been reviewing the case notes and I’ve looked at the lump and I’m not sure he needs the surgery.” 

We discussed the case history and I realised that I might have inadvertently biased the vets by drawing their attention to the mystery lump. The lump wasn’t inflamed or infected. The real reason we were there was actually the random yelping. I described how Czar had started yelping when he was randomly lying around - the vet thought the yelping might have been related to gastrointestinal pain, and asked about changes to diet. I admitted that we’d been giving bones much more frequently since Kit arrived, trying to keep Kit entertained. The vet suggested that Czar’s random yelping sounded more like colic or griping than anything else.

The vet also had a much more plausible theory on the lump than anyone else. He asked about Czar’s previous surgical history and suggested that the lump could be a drain tube section from a previous surgery. 

“Dogs chew them off and leave little segments in the wound. My heeler had retained drain tube that kept getting infected, we’d treat with antibiotics and it’d come back. This feels the same, but it’s not infected, so I’m not sure it’s worth going through with the surgery.” 

One of the reasons we’d been so quick to assume the lump was a grass seed (apart from its shape) was the fact that Czar had had one before. That was some 7-10 years ago, before I met J, so I wasn’t sure on the details, but I knew we had photos of Czar wearing a “cone of shame” to stop him chewing at his wound. If the mystery lump was that old, that would explain why there was no entry track. 

The vet’s recommendation was to take Czar home, put him back on his old food, no extras, for six to eight weeks, and monitor for signs of pain. He felt that there was no need to remove the lump unless it became infected or swollen. After some reflection and discussion, J and I agreed. I brought Czar home.

The fact that the vet didn’t just go ahead and do the surgery that we’d agreed to was a sign of great integrity. Sometimes it feels like vets are either just trying to make money, or they’re insensitive to dog owners’ financial stresses. We are so grateful to these guys for refusing to act like a  factory line, and for taking the time to review and discuss. Putting Czar through unnecessary surgery is not a great idea. Hopefully his mystery lump stays a mystery, and we never have to go digging around.