Vet Surgery Healthcare Packages

[zeta1454]

I do try to keep up to date on the Forum with the latest information regarding vaccine protocols and parasite control measures as promoted by vet practices and sadly see that little has changed over many years with most vets still offering “healthcare packages” to clients at a monthly fee for products in direct contradiction to the current evidence based approach to small animal healthcare as recommended by the World Small Animal Veterinary Association and the British Small Animal Veterinary Association.

Most monthly fee based packages offered at Veterinary practices include annual vaccinations and three-monthly flea/worming pesticide treatments. Yet (other than the Leptospirosis vaccine which is of dubious value in any event) once a dog has been successfully immunised by a modified live vaccine against Distemper/ Hepatitis/ Parvovirus (DHP) it is likely to have long term if not lifetime protection against those diseases. As regards parasite pesticides (spot on treatments and tablets) these should not be used without proven need as over-use will likely lead to resistance and they become useless when really required or in the case of spot-on treatments these not only carry significant risks to the health of the dog but the environmental impact is already proving catastrophic.

The current advice from veterinary experts in the field of veterinary immunology and small animal welfare is for vets to adopt an individual, tailored approach to parasite control based on evidence of need and to titre-test dogs rather than repeat vaccination. I have quoted the following in previous posts but they are worth highlighting again.

The full document can be read on the link at the end of this post but here are some selected paragraphs as regards parasite control, from the “BVA, BSAVA and BVZS policy position on responsible use of parasiticides for cats and dogs” :

“Given the unknown but potentially severe environmental impacts, there should be a more considered approach to the use of small animal parasiticides.

The development of “spot-on” products in the 1990s made applying parasiticides to animals easier, so the use of parasiticides has grown considerably. In part this growth is also associated with comprehensive health-care packages based on routine and regular parasite control. The more recent development of parasiticides with longer duration or combination products, both spot-on and oral, has further fuelled their use.

Given the many health and welfare concerns associated with parasites, routine use of parasiticide treatments is now widespread. However, this does not come without risks, and given the importance of being able to use these products, it is advisable to take note of these concerns now and to use them responsibly, to make sure they continue to remain available and effective in the future, whilst being used in a way that minimises harm to the environment.

While modern parasiticides are more selective for invertebrates than previous ones, they do not discriminate between target and non-target invertebrates, so they are equally capable of killing bees, aquatic insects, and other species that they come into contact with. There is a widely documented fall in wild aquatic and terrestrial invertebrate populations, and clear evidence that use of pesticides from a wide variety of possible sources are contributing. Invertebrates are a vital part of ecosystems, including food webs, as well as providing ecosystem resources for pollination and pest control, so minimising the threats to these species is therefore very important in a local and global context.

Some of the most commonly used parasiticide products that are used in companion animals which are neurotoxic to other species are the pesticides fipronil and imidacloprid, either alone or in combination with other parasiticides. These products are effective because of their potent toxicity even at low dose rates towards a wide range of invertebrates, their persistence and their water solubility, These same properties also increase the environmental hazards associated with their use. Other parasiticides products are also used frequently and are likely to have similar impacts, but data for these two products is more readily available.
Imidacloprid belongs to a class of insecticides called neonicotinoids, for which the detrimental effects in the environment are well known. Fipronil is not a neonicotinoid, but acts in a similar way, also damaging an insect’s central nervous system to cause paralysis and death. In sub-lethal quantities, these chemicals have also been shown to impair an insect’s ability to navigate, harm the immune system and reduce fecundity, all of which can lead to populations declining. Imidacloprid has an LD5034 of just 3.6ng/bee and fipronil 2.5ng/bee, both more than 7,000 times more toxic than DDT, a chemical which became infamous for its environmental impacts and banned in the UK in 1984. This means that one spot on treatment for a medium sized dog contains enough pesticide to kill 60 million bees.
Neonicotinoids were once widely used in agriculture, but in response to growing evidence of the harm they were causing to insect populations, the EU banned their use on flowering crops in 2013, and eventually banned all agricultural uses on outdoor crops in 2018. A recent study found fipronil and imidacloprid in English rivers at levels exceeding their chronic toxicity limits and suggested that these pollutants were likely to be coming from household drains rather than agricultural sources. The study indicated a high environmental risk to aquatic ecosystems from the measured levels of fiproles (fipronil and some of its degradation products), and a moderate risk from the levels of imidacloprid. Similar research is needed to understand the exact source of contamination and toxicity levels of other potentially harmful pesticides used in veterinary medicines.
Furthermore, little is known about the impacts of multiple parasiticides mixing in the natural environment, making evaluating the effects on non-target organisms a major challenge to scientists. In the environment these chemicals can co-occur with other contaminants such as fertilisers, metals and other pharmaceuticals, and products containing multiple chemicals are now commonly used to treat several parasites at once. Research has shown that in aquatic organisms, neonicotinoid mixtures have combined effects that cannot be predicted by simple additivity, and that even once some chemicals degrade, they remain as toxic as the original compound.

Overuse of parasiticide products can lead to resistance developing in the target parasites, which if not checked could have a serious impact on animal welfare.
As part of their responsible prescribing measures, veterinary professionals should avoid blanket treatment and instead risk assess use of parasiticides for individual animals. This should take into account animal, human and environmental health risks, in addition to knowledge of the individual’s lifestyle or environment and the results of routine examination to look for parasites eg faecal examinations for worms.
Recommendation 18: Veterinary schools should increase awareness amongst future vets of responsible use and applying tailored, as opposed to blanket, treatments of parasiticides
Recommendation 19: Veterinary businesses should not have blanket treatment policies in place, instead empowering individual vets to have those conversations with their clients.

Regularly checking for fleas, ticks, and those mites which are visible to the naked eye, will increase the chances of spotting these early, helping to provide treatment when it is needed. This may help to reduce the need for parasiticide treatment, especially during the winter when prevalence of some parasites is likely to be lower.

An increased use of testing by veterinary practices, such as faecal egg counts, could help to identify the presence of endoparasites, meaning only those pets with confirmed presence of parasites may need to be treated. This approach is used widely in the farm and equine sectors due to resistance issues. There is also evidence of a growing demand for testing before treatment within small animal medicine, for example a number of clients now opt for an antibody titre test before deciding whether to have booster vaccinations for their animals……. Lessons could be learnt from other countries which routinely undertake faecal sampling for small animals

Wherever possible, veterinary professionals should use targeted and specific treatments rather than combination or broad-spectrum products, unless they assess there is a need to treat for multiple types of parasite, or have evidence that a broad-spectrum product poses a lower environmental risk.”

From: https://www.bva.co.uk/media/4352/bva-bs ... d-dogs.pdf

Although I have previously posted topics on the WSAVA guidelines, here are a few selected quotes regarding vaccination which are still being frequently overlooked (?) by vets when they advise their clients:

“Vaccines should not be given needlessly. Core vaccines should not be given any more frequently than every three years after the 6- or 12-month booster injection following the puppy/kitten series, because the duration of immunity (DOI) is many years and may be up to the lifetime of the pet

Dogs that have responded to vaccination with MLV core vaccines maintain a solid immunity (immunological memory) for many years in the absence of any repeat vaccination (Bohm et al. 2004, Mouzin et al. 2004, Schultz 2006, Mitchell et al. 2012)

An adult dog that had received a complete course of core vaccinations as a puppy, including a 26 or 52 week booster, but that may not have been vaccinated regularly as an adult, requires only a single dose of MLV core vaccine to boost immunity (Mouzin et al. 2004, Mitchell et al. 2012) [EB1].

Similarly, an adopted adult dog (or puppy over 16 weeks of age) of unknown vaccination history requires only a single dose of MLV core vaccine to engender a protective immune response. Many vaccine datasheets will advise in these circumstances that the dog requires two vaccinations (as for a puppy), but this practice is unjustified and contrary to fundamental immunological principles [EB4].

However, the principles of ‘evidence- based veterinary medicine’ suggest that testing for antibody status (for either puppies or adult dogs) should be better practice than simply administering a vaccine booster on the basis that this would be ‘safe and cost less.’

DOI after vaccination with MLV vaccines is 9 years or longer, based on challenge and serological studies (Schultz et al. 2010).

Leptospira vaccines provide relatively short-term immunity. Also, some Leptospira products prevent clinical disease, but fail to protect against infection and shedding of the bacteria, especially when infection occurs more than 6 months after vaccination. Persistence of antibody after vaccination will often be only for a few months and immunological memory for protective immunity is relatively short (e.g. 1 year).

One dose of a MLV canine core vaccine (CDV, CPV-2 CAV-2) or MLV FPV vaccine should provide long term immunity when given to animals at or after 16 weeks of age. Every puppy and kitten 16 weeks of age or older should receive at least one dose of MLV core vaccines.

The presence of antibody (no matter what the titre) indicates protective immunity and immunological memory is present in that animal. Giving more frequent vaccines to animals in an attempt to increase antibody titre is a pointless exercise. It is impossible to create ‘greater immunity’ by attempting to increase an antibody titre.

Vaccines should not be given needlessly, as they may cause adverse reactions. Vaccines are medical products that should be tailored to the needs of the individual animal.”

From : https://wsava.org/wp-content/uploads/20 ... s-2015.pdf

[Dawnspell]

I got sucked into the healthcare package when we got Barney. First time dog owner I didnt know any better and just thought the vet knows best and had basically been told you need to give all these chemicals to keep your dog healthy.

The vets of course arent going to educate owners into not having the treatments when it takes away their income.