Core Vaccines and In-house Antibody Titer Testing

In the news recently, the debate about vaccinations for children was at the forefront during the measles outbreak. There has been a similar debate going on in the veterinary community about vaccines for pets. Clients are electing not to vaccinate their pets or are inquiring about why they should, and if they really need to vaccinate their pets every 3 years? What is the appropriate and recommended protocol? Are we currently over-vaccinating?

chihuahua and syringe

In 2011, the American Animal Hospital Association (AAHA) recommended that ALL of the core vaccines go to a 3-year protocol while also stating that “among healthy dogs, all commercially available (core) vaccines are expected to induce a sustained protective immune response lasting at least 5 years.”  Many clients and professionals will still argue that an every 3-year protocol is still over-vaccinating and in fact most adult animals will have lifelong immunity without the need for repeated vaccination. Should we go to a 5 year or longer protocol for the DHPP and FVRCP vaccines?

The issue is that the immune system of every pet is different. How can we be sure our pet patients are protected? How can both sides of the argument be satisfied? One solution on the forefront is antibody titer testing. In lieu of a vaccination, a small blood sample can be taken and a “titer” test can be performed. This titer test will essentially say if this pet still has enough circulating antibody against a particular disease (canine parvo, distemper, etc.) In the past this has been very expensive to perform and samples had to be sent to an outside lab with results taking several days to come back. Now in-house testing kits are available to veterinary clinics and results in as few as 20 minutes.

Antibody Testing Kits For Veterinary Clinics 

Guide to Vaccine Antibody Testing

For owners who have concerns about routine vaccination,  a vaccine titer is a reasonable recommendation, and it may be that in the future this becomes a standard of care. Now that in-house fast titer testing is becoming available, it makes it more cost effective for clinics and for clients.

Lastly, one size does not fit all. The vaccine needs for our pet patients should be assessed yearly and the vaccination protocol should be modified as needed based on that pet’s risk, lifestyle, age, health, medical conditions, and travel as concurs with the recommendations of the AAHA task force.

AAHA Vaccination Guidelines

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National Wildlife Week as a Veterinary Technician

This is National Wildlife Week!
Most of us working in practice don’t get to work much with wildlife or exotic animals. What is it like to be a vet tech in a wildlife or zoo job?
Did you know that veterinary technicians can specialize? VetTech Specialists 
One of the areas can be zoo medicine or wildlife.
Kemp's Ridley sea turtle having surgery

Kemp’s Ridley sea turtle having surgery

Wildlife veterinary technicians perform many duties. These may include:
  • Assisting with exams or surgeries
  • Helping to capture or tranquilize animals for handling
  • Helping to transport animals if needed
  • Drawing blood, taking x-rays, and assisting with procedures
  • Helping with breeding programs
  • Assisting with husbandry issues
  • Administering vaccinations or medications
  • Assisting with rehabilitation or sick or injured animals
 Are you interested in learning more or trying something new? There are several opportunities coming up this summer! Consider volunteering for your local wildlife rehabilitation center or refuge, as almost all areas have one. Or, consider applying for a wildlife or a zoo internship/externship either here in the U.S. or abroad!
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Case Study Quiz: Hypertension and Neurologic Presentation

A 10-year old Golden Retriever presents with a history of unsteady gait. The owner reports she is walking like she is drunk and she has vomited a few times. You are taking a history in the room and notice her tilting her head to the left. Upon closer look at her face you see that her eyes are moving side to side rapidly. The veterinarian asks you to perform a blood pressure. The blood pressure is 200/120 mmHg. Answer the quiz questions, then scroll to the bottom for the answer explanations.

headtiltgolden

1) What medication may help to treat hypertension (high blood pressure) in this dog?

a) Benazepril
b) Prednisone
c) Phenobarbital
d) Furosemide

2) The condition from which this dog is suffering is also known as which of the following?

a) Vasculitis
b) Vestibular syndrome
c) Disseminated Intravascular Coagulation (DIC)
d) Syncope

3) Which cranial nerve is likely involved in this process?

a) cranial nerve III (oculomotor)
b) cranial nerve VII (facial)
c) cranial nerve VIII (vestibulocochlear)
d) cranial nerve V (trigeminal)

4) Which endocrine disease is often associated with hypertension?

a) Cushing’s disease
b) Addison’s disease
c) Diabetes mellitus
d) Hypothyroidism

5) The eyes moving side to side rapidly is also known as:

a) Vertigo
b) Nystagmus
c) Postural thrust
d) Bupthalmous

Answers: This dog is exhibiting symptoms of vestibular syndrome, which has many possible causes. Because this dog has a very high blood pressure (should be less than 150 systolic in a nervous dog), the likely cause is a vascular accident (a stroke type of event).

Hypertension can be sometimes be associated with Cushing’s syndrome in dogs, and with hyperthyroidism in cats. Hypertension in dogs may be treated with benazepril and/or amlodipine. Amlodipine is the treatment of choice for cats.

Vestibular syndrome is a results of the inflammation or disturbance of cranial nerve VIII (8), the vestibulocochlear nerve which helps with sound in the ear and with equilibrium (balance). Dogs that have vestibular syndrome are often  nauseated and have a history of vomiting. The eyes moving back and forth or side to side is also known as a nystagmus.

For further information on vestibular disease, hypertension, and cranial nerves, please visit our other blog pages on these important topics:

Vestibular Disease Review

The Dangers of Hypertension

Review on Cranial Nerves

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Rabies Exposure Guidelines: New Study from JAVMA

It isn’t all that uncommon. A client has a dog that has been bitten or exposed to a rabies “suspect.” Whether it be a fox, a skunk, coyote, or bat, any wild animal could be a potential hazard for transmitting rabies to our domesticated pets.

State law is very strict regarding pets and exposure to rabies. There was a story in October 2014 that raised some controversy over this issue. A 10-year old Schnauzer was bit by a rabid skunk. The dog’s rabies vaccine had only expired 10 days prior to the attack. The options were to euthanize the dog, or quarantine for 3 months in a kennel with then another 3 months of strict home confinement. The owner was devastated but ultimately chose euthanasia.

For currently vaccinated pets exposed to rabies, they must receive a rabies booster immediately and then be under home confinement for 45 days.

As we know, there is a very high chance that even if the rabies vaccine has lapsed, the animal likely still has immunity. This is why this case is so heartbreaking.

A new JAVMA study, published for January 15, 2015 looks at a Comparison of anamnestic responses to rabies vaccination in dogs and cats with current and out-of-date vaccination status.

Full Abstract Here

Findings in this study “supported immediate booster vaccination followed by observation for 45 days of dogs and cats with an out-of-date vaccination status that are exposed to rabies, as is the current practice for dogs and cats with current vaccination status.” 

This is important information to keep in mind for pets that have been vaccinated and exposed to rabies, even if their vaccine has recently expired. While state law will still be in effect, this can provide some additional information to pet owners who find themselves in this predicament.

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Free Sample Questions for VTNE Study via VetTechPrep.com

Please enjoy a few sample questions to help you prepare for the Veterinary Technician National Examination! VetTechPrep.com is the most comprehensive resource you will find on preparation for the VTNE exam. The site covers the categories you will find on the exam, and also includes PowerPages, which are condensed notes on important board review topics.

Scroll down to the very bottom for the correct answers and explanations. For access to the full database of study materials, visit www.VetTechPrep.com

POP QUIZ:

Question1: Bacteria differ from animal cells in which of the following ways?

a)      They lack ribonucleic acid

b)      They lack cell walls

c)      They are unable to metabolize glucose

d)     They lack a true membrane-bound nucleus
 

Question 2: A cigar-shaped mite that is seen on a skin scraping from a dog with severe generalized skin lesions is probably what type of mite?

demodex

a)      Sarcoptes

b)      Cnemidocoptes

c)      Otodectes

d)     Demodex

e)      Notoedres

Question 3: A patient under anesthesia is hypoventilating and the end-tidal CO2 is rising. The doctor instructs you to give the patient a breath. The pressure on the manometer to which you ventilate the patient is:

a)      20 cm H2O

b)      5 cm H2O

c)      40 cm H2O

d)     60 cm H2O

Question 4: In a pregnant mare, “red bag” delivery implies what situation?

a)   Delivery of a premature foal

b)  Rupture of the amniotic sac

c) Rupture of the chorioallantois

d) Premature placental separation

Question 5: What type of estrous cycle does the cow have?

a)      Estrus every 6 months

b)      Polyestrous in the fall

c)      Non-seasonal polyestrous

d)     Induced ovulation when bred

Question 6: How many upper incisors does a goat have?

a)      Six

b)      Four

c)      Zero

d)     One

e)      Two

ANSWERS AND EXPLANATIONS TO QUESTIONS:

Question 1: Correct answer: D

Bacteria are referred to as prokaryotes because they lack a true membrane-bound nucleus. Animals, as well as all multi-cellular organisms, are known as eukaryotes since they have a membrane-bound nucleus. Bacteria do have ribonucleic acids, and several antibiotics target transcription of mRNA. Bacteria are able to metabolize glucose. The type of cell wall that a bacterium has helps us differentiate whether it is a Gram-positive or Gram-negative organism.

Question 2: Correct answer: D

Demodex is the cigar-shaped mite. The other mites are much rounder. The generalized skin lesions are not specific for Demodex as they can also be seen with Sarcoptes.

Question 3: Correct answer: A

When inflating the lungs, the pressure should reach but not exceed 20 cm H2O.
Question 4: Correct answer: D

Red bag is the layman’s term for premature separation of the chorioallantois from the placenta and is a medical emergency. The chorioallantois interfaces with the mare’s endometrium and is the interface that transfers oxygen to the fetus. Under normal circumstances, the fetus breaks through the chorioallantois at the cervical star, and the fetus and amniotic sac are delivered first. In a red bag delivery, the entire fetal-placental unit is being delivered all at once and thus can cut off the oxygen supply to the fetus prior to birth; this can result in death of the fetus if parturition is not facilitated immediately.

Question 5: Correct answer: C

Cows have non-seasonal polyestrous cycles. This means that they have estrus cycles year round. Average estrus is 21 days and lasts for 18 to 24 hours, but heat stress can shorten this window. Estrus is the time of “standing heat” when the cow will stand to be mounted by the bull. Sheep are polyestrous in the fall. Cats are induced ovulators.

Question 6: Correct answer: C

Goats have no upper front teeth (incisors); their upper front mouth is one big gumline. In the back on their mouth they do have both upper and lower teeth. Goats are born with teeth which are replaced by permanent teeth as they age.
The dental formula for permanent teeth in the goat is:
2 ( I 0/3 C 0/1 P 3/3 M 3/3) = 32

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Ebola Virus and Animals

As animal lovers, I think all of us that read about Spanish Ebola patient Teresa Romero‘s dog “Excalibur” being euthanized as a precaution from exposure to Ebola were disheartened. In the veterinary community, our pets are our family members. This disease has caused a lot of fear. I know we were all relieved that they decided to quarantine the U.S. Ebola patient Nina Pham’s dog Bentley for monitoring instead of euthanizing him as a precaution, and were happy to hear he is now safe at home.

Ebola virus, Photo CDC Cynthia Goldsmith

Ebola virus, Photo CDC Cynthia Goldsmith

There is not a confirmed source for Ebola currently, but is thought to be found in fruit bat populations. Humans initially may contract the disease by coming into contact with an infected animal (bat or primate) or infected fruit or meat (bushmeat), and then human to human transmission occurs via bodily fluids or fomites with infected fluid. Those caring for Ebola patients or in close contact are at highest risk.

In the current Ebola outbreak in West Africa, animals have not been found to be a factor in ongoing transmission. According to the Centers for Disease Control, the USDA, and the AVMA, pets are not considered to be at a significant risk for Ebola in the United States. This is probably because currently it is still considered low-risk for humans in the U.S. as well, so would be even lower risk for pets. But even in West Africa where Ebola is found, there are no current reports of dogs or cats actually becoming ill from Ebola. That being said, the above organizations are continuing to work to gather more information about Ebola and animals for veterinarians and the public.

There was a study written regarding the outbreak of Ebola in Gabon in 2001-2002. Over 400 dogs were screened for Ebola antibodies (many dogs were thought to have eaten infected dead animals because in this country dogs are scavengers), and approximately 25% of the dogs had detectable Ebola virus- IgG. This shows that these dogs were exposed to the virus. However, none of these dogs were symptomatic. Therein seems to lie the concern then about dogs harboring and transmitting the virus, even if they are asymptomatic. But, the dogs with positive antibodies against the virus tested negative for the disease. So the question is, when they are initially exposed, how long could they be shedding virus if at all? Currently only a few animal species (primates and humans) have demonstrated the ability to actually spread the Ebola virus.

As a vet tech, if you were to be encountered with the rare situation that an owner believed their dog to have Ebola, the best thing to do would be to notify the veterinarian immediately. The veterinarian should take a thorough history, acquire personal protective equipment, quarantine the dog, and contact the CDC and state veterinarian.

Please visit www.avma.org/ebola which includes information for veterinarians and a FAQ section for clients. There is also a link to the CDC page regarding Ebola and pets. You may also listen to this podcast by Dr. Ron DeHaven, the VP and CEO of the American Veterinary Medical Association regarding Ebola and Pets.

 

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Leptospirosis Review

October is Leptospirosis awareness month. Take a moment to review some facts about this zoonotic disease.

What is Leptospirosis? It is a disease caused by a spiral shaped Leptospira bacteria that can infect wildlife, domestic pets, and humans.  Many wildlife are carriers of the bacteria and do not have any clinical symptoms of the disease.

How is it transmitted? The bacteria are passed in the urine to water sources where they can live and reproduce. They can survive for a long time in water (especially stagnant water, ponds, or lakes) and wet soil. Animals become infected by drinking or swimming in water that is contaminated by the bacteria. It can enter the bloodstream through the mucous membranes or through a wound or cut.

Can it be prevented? Vaccinating dogs and livestock for leptospirosis is an important part of prevention, especially in areas where the disease is prevalent. Avoid stagnant water. Practice good hygiene and wash hands frequently- especially if there is contact that may have any urine on it.

What are the symptoms? The symptoms can resemble those of the flu virus. Fever, decreased appetite, vomiting, diarrhea, dehydration, weakness, and lethargy are some symptoms. Some dogs may have jaundice if the liver is severely affected. Bloodwork of a leptospirosis infected dog often has increased kidney and liver values. If a dog is suspected of having leptospirosis, make sure technicians handling the dog and the dog’s urine contaminated bedding, etc. wear gloves and protective clothing. The time between exposure and development of disease is usually 5 to 14 days, but can be as short as a few days or as long as 30 days or more. Cats seem to have some natural resistance and infection is rare in this species.

How is Leptospirosis treated? Treatment for leptospirosis involves supportive therapies including IV fluid diuresis and antibiotics. Leptospirosis is often treated with a combination of antibiotics including amoxicillin and doxycycline. The disease can be fatal, and the best chance for a good outcome is early diagnosis and treatment.

For more information about this disease, please visit www.leptospirosis.org and http://www.cdc.gov/leptospirosis/

 

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Review on Eye Testing

Veterinary technicians commonly perform or assist with ophthalmic examinations. This blog is a review on common eye tests and normal values.

A good eye exam begins with a thorough history and appreciating a patient’s signalment (age, male/female/spay/neuter status, breed). Some particular breeds may be predisposed to certain ocular diseases. Taking a good history may help the veterinarian make a proper diagnosis and treatment plan.

Eye tests should be performed in a certain order. The proper order for the most common ocular tests are Schirmer Tear Test (STT), Fluoroscein stain, and Intraocular pressures (IOP).

1)   Schirmer Tear Test- The STT tests for dry eye or kerratoconjunctivitis sicca (KCS). This is a decrease in tear production. A small piece of paper made for this test is inserted under the lower eyelid and held in place for 60 seconds. Normal tear production should be greater than 15 mm in 60 seconds. Most normal dogs will produce more tears than this but this is a guideline to follow.

036

039

2)   Fluoroscein stain- This is a yellow dye which is applied to each eye to look for a corneal abrasion or ulcer. The abrasion or ulcer is seen when highlighting the stained eye with a fluorescent blue light.

034

035

3)   Intraocular pressure (IOP) – This is the test for glaucoma. Glaucoma is increased pressures in the eyes. The pressure in the eyes is tested using a device called a tonometer (the most commonly used one is the TonoPen). A drop of proparacaine is applied to each eye to numb the surface of the eye. The tonometer is gently touched to the surface of the eye and a proper or good reading should be with less than 5% error. Normal values are less than 20 mmHg (typical normal range 10-20 mmHg). Again, this is only a basic guideline and should be interpreted based on the rest of the exam and clinical signs. A low pressure may be due to uveitis (inflammation). It is important to note: DO NOT put any pressure around the neck region while holding the pet for IOP. This can falsely elevate the readings.

032

033

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Rodenticide Toxicity

Anticoagulant rodenticide, otherwise most commonly known as “rat bait” poisoning, is a serious and potentially fatal toxicity that requires treatment. Coumarins such as warfarin and brodifacoum are the most commonly known examples. D-Con is a common rodenticide that pets ingest in the home in cases of toxicity.

Anticoagulant rodenticide is a vitamin K1 antagonist. Vitamin K is required for synthesis of clotting factors II, VII, IX, and X (2, 7, 9, and 10). Factor VII has the shortest half-life of these and will be depleted first.

Prothrombin time (PT) measures the extrinsic clotting system which contains factor VII and it becomes prolonged first.  Therefore, PT measurement is helpful in determining clotting status in a pet that may have been exposed to anticoagulant rodenticide. Platelet counts in these animals are usually normal. Any time there is a history of potential exposure or an animal is showing evidence of bleeding, coagulation should be checked.

Pets that have been exposed to anticoagulant rodenticide are at risk for bleeding. They may bleed spontaneously or if they receive an injury could bleed due to their inability to clot. They can bleed from anywhere and symptoms may include melena, epistaxis, bleeding from gums, blood in urine or vomit, lameness or joint swelling, etc. Clinical signs may be seen initially  within 4 to 6 days after ingestion.

If an animal is known to have recently ingested this toxin (within the last 8 hours), induction of emesis (vomiting) is recommended, followed by activated charcoal to prevent further absorption of the toxin, and supplemental Vitamin K 1 (phytonadione). It is given daily for 3 to 4 weeks. Vomit of this type of toxin is very commonly a green/blue color.

rodentvomit

 

Animals that are actively bleeding will need supportive care which may include IV fluid therapy and blood products to provide clotting factors in addition to the Vitamin K1 supplementation.

 

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Updates to VetTechPrep

We recently changed our program to reflect the new changes in the VTNE blueprint! The new categories you will find are:

Pharmacology, Surgical Nursing, Dentistry, Laboratory, Animal Care and Nursing, Diagnostic Imaging, Anesthesia, Critical Care, and Analgesia.

Take a quick 3 minute tour to see if VetTechPrep is right for you! http://www.vettechprep.com/tour.jsp

 

 

 

 

 

 

 

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