Lifestyle Vaccinations

Educating pet owners on the risks of specific lifestyle-related diseases

Animals can be vaccinated against a wide variety of diseases, and the vaccinations are crucial in preventing disease. It’s important for veterinary practices to educate pet owners about the need for vaccinations and reinforce the fact that vaccines don’t cause disease. Rather, the cells of the immune system are stimulated to develop antibodies against the portion of the pathogen that is antigenic. Thus, when the animal is again exposed to the pathogen, it will not become infected because it has been immunized.

When discussing immunity, there are two ways that an animal can acquire the immunity needed: passively and actively. Passive immunity happens when the animal acquires preformed antibodies to a variety of pathogens. This occurs naturally, when maternal antibodies cross the placenta into the fetus or when neonates nurse and ingest the dam’s colostrum. Passive immunity can also occur artificially, with antibodies administered exogenously. When an animal develops its own antibodies to pathogens, this is known as active immunity. Active immunity also occurs naturally, through infection or exposure to the pathogen, or artificially through vaccination. Both artificially acquired passive and artificially acquired active immunity can exist for the same disease.

According to the AAHA Canine Vaccination Guidelines (Guidelines)^1,2, vaccinations are designated as either core or non-core. Core vaccinations are those immunizations that are recommended for every dog. Non-core vaccinations are those that are recommended for dogs at risk for contacting a specific disease depending on that dog’s age, lifestyle, and location.

Noncore vaccinations, also referred to as lifestyle vaccinations, do not mean they are not important. In fact, their importance cannot be underplayed and must be communicated effectively to pet owners.

Veterinarians often agree which canine vaccines fall into core and lifestyle categories in addition to when they should be administered. However, the AAHA Canine Vaccination Guidelines suggest the vaccination protocol should always be individualized based on the patient’s risk factors. They should also offer a range of recommendations to aid veterinary healthcare teams in making logical decisions on vaccine selection for their individual patients.^1,2

Lifestyle vaccines can be critical in the prevention of a number of canine diseases. The veterinary healthcare team, specifically veterinary nurses, play a crucial role by:

• Collecting a thorough patient history to assess risk factors, thus aiding the veterinarian in recommending specific lifestyle vaccines.
• Educating the pet owner on the importance of lifestyle vaccines.

Canine infectious respiratory disease complex

Canine infectious respiratory disease complex (CIRDC) is considered one of the most prevalent and common infectious respiratory diseases in dogs. Several viruses and bacteria are implicated in its etiology, such as:³

• Canine Parainfluenza Virus (CPiV)
• Bordetella bronchiseptica

One of the most common viral pathogens associated with CIRDC is Canine Parainfluenza Virus (CPiV).⁴ CPiV can cause mild illness. However, if the patient is co-infected with CPiV and Bordetella bronchiseptica (or potentially another respiratory virus), an extended, potentially severe clinical course may result. Often, the primary bacterial pathogen of CIRDC is Bordetella bronchiseptica.³

Primary pathogens are those pathogens that can cause disease when they gain entry into the body by stressing
the host’s immune system. This allows other microorganisms within and/or outside of the dog’s body
to grow in number, causing problems of their own. Typically, these would not cause illness but due to the increased load of pathogens on the dog’s immune system, disease results. These pathogens are known as secondary or opportunistic pathogens.

The veterinary team should be familiar with the following signs associated with CIRDC in dogs:⁴

Respiratory 

• Cough (hacking, dry, or moist). Cough can oftentimes be produced by palpating the trachea.
• A soft moist cough
• Nasal/ocular discharge
• Sneezing

 

Systemic

• Inappetence
• Fever
• Lethargy

Educating clients regarding how CIRDC is transmitted is of utmost importance. Owners should be educated that direct transmission can occur when their dog comes into contact with infected dogs or with the aerosolized droplets from an infected dog (e.g., sneezing, coughing). Indirect transmission of CIRDC occurs when the dog encounters fomites.³ Fomites can include dog bowls, toys, and even the clothes and shoes of individuals with infected dogs.

Veterinary team members have referred to CPiV and Bordetella bronchiseptica as “infectious tracheobronchitis” and “kennel cough” for years. However, canine infectious respiratory disease complex is being used to replace these terms as they convey false implications. Kennel cough is a misleading term because it falsely implies that only kenneled dogs are at risk. Likewise, infectious tracheobronchitis is an inaccurate term because it falsely implies that pathogens only affect the airways. This is not the case as these pathogens can also infect the pulmonary parenchyma.

If the veterinary team discovers the pet’s lifestyle puts the pet at greater risk of CIRDC, the veterinarian will recommend vaccination for Bordetella bronchisepticaand CPiV dependent upon the pet’s history.

Remember the importance of educating pet owners. The pet owner should be educated that the goal of vaccinating against CIRDC is to vaccinate against the primary pathogens that can increase disease, especially in the case of secondary infections.

By vaccinating against the primary pathogens, the dog’s own immune system is able fight off milder, self-limiting infections. Parenteral and mucosal vaccines are available to fight against the principal pathogens of CIRDC, Bordetella bronchiseptica and canine parainfluenza.

When vaccinating puppies 16 weeks of age or younger, AAHA Canine Vaccination Guidelines for oral Bordetella Bronchiseptica recommend a single dose into the buccal pouch for initial vaccination.^1,2 The vaccine can be given to puppies as early as 8 weeks of age to induce local (mucosal) immunity. Dogs older than 16 weeks of age, the recommendation is to administer a single dose into the buccal pouch for the initial vaccination. Where the risk of exposure is sustained and revaccination is recommended, give a single dose 1 year following the last dose administered and then annually.

Leptospirosis

Leptospirosis in dogs is an infectious disease caused by bacteria in the genus Leptospira. Leptospirosis is caused by the spirochete Leptospira and is a zoonotic disease that affects both humans and animals. Once infected, mammals can serve as one of two hosts: reservoir hosts, or incidental hosts. Reservoir hosts can harbor persistent infection with a specific serovar without severe signs of disease. Dogs are reservoir hosts only to the serovar L. canicola.⁵

Leptospirosis is a multi-systemic disease that impacts several different organ systems. Clinicopathologic signs are usually the result of end-organ damage and can end in death. Diagnosis can be very difficult since clinical signs are often varied and nonspecific; some dogs may not show any signs at all.⁶

Veterinary team members should look for the following signs in potential leptospirosis cases: polyuria and polydipsia, abdominal pain, fever, vomiting, lethargy, and anorexia. Also, some dogs may not present with any signs or symptoms. Once infected, leptospires live in the renal tubules of reservoir hosts and are excreted in the urine.⁵ Direct transmission occurs between two host animals in close contact through bites, placental and venereal transfer, or ingestion of infected tissue, or urine. More common, however, is indirect transmission with contaminated water being the most common means of spread. It is important for veterinary teams to educate owners that Leptospirosis can survive several months in mild, damp environments. Lakes, streams, rivers, puddles and soil are common areas where transmission can occur.⁵

The pet owner should be informed that minimizing risk of exposure is key to preventing leptospirosis in dogs. Pet owners should limit their pet’s contact with wildlife and sources of contaminated water. To minimize exposure to wildlife, owners should remove the pet’s food, water bowls, compost, and garbage to reduce attracting wildlife reservoir hosts. Additionally, for those owners that like to hike, the dog should not be allowed to roam freely while on hikes or on property that is frequented by reservoir hosts.

Pet owners should also be educated about minimizing the risk from standing water by removing sources of pooling or stagnant water in their yard and by deterring the dog from wading, swimming in, or drinking from standing water.

Puppies 16 weeks of age or younger are recommended by the Guidelines to have two doses, 2 to 4 weeks apart, for the initial vaccine series.  The vaccine can be given to puppies as early as 8 to 9 weeks of age. If the healthcare team is giving the initial vaccine series in dogs older than 16 weeks of age, the recommendation is two doses, 2 to 4 weeks apart. To booster the immunization, a single dose 1 year following completion of the initial 2 doses, then annually thereafter is recommended.

Lyme disease

Lyme disease is caused by infection with the bacterium Borrelia burgdorferi. According to the Companion Animal Parasite Council (CAPC), the highest prevalence for canine Lyme disease is in the Northeast, upper Midwest, and the Pacific Coast of the United States.⁷ However, Lyme disease is spreading and is being reported in areas outside of recognized endemic regions. It is important for healthcare teams to remember that canine cases have been reported in all 50 states. In 2018 according to CAPC, 1 in 18 dogs tested positive for antibodies against B. burgdorferi in the U.S.⁷

On the East Coast of the United States, the main vector of the disease is the Black-legged tick (Ixodes scapularis) and on the West Coast, the main vector is the Western black-legged tick (Ixodes pacificus).

High exposure rates (75%) have been seen in areas where Lyme disease is more pervasive; however, clinical signs may only display in 5-10% of the patients. White-tailed deer play an important role in the spread of black-legged ticks as the ticks are carried on the deer. Therefore, as the deer population increases due to re-forestation, reduced hunting, and fewer predators, veterinary teams and pet owners in every state must stay vigilant.

Lyme disease is difficult to detect, and unfortunately the signs associated with Lyme disease mimic other illnesses.

Veterinary teams typically observe the following signs in dogs presenting with Lyme disease:⁸

• Arthritis-like pain
• Shifting leg lameness
• Anorexia
• Swollen lymph nodes

As the Lyme spirochete infects tissues throughout the body, potentially more serious signs may manifest, including; Lyme nephritis, myocarditis-induced cardiac arrhythmia, and neurologic disease. Borrelia damages cells as it reproduces. The dog’s antibodies against the bacteria interact with the synovial fluid in the joints as well as nerve, liver, and cardiac and skeletal muscle tissues, activating immune-mediated disease.⁸

Ticks can be found in forests, mainly in moist leaf litter, or in leafy green vegetation. The seasonality of transmission of Lyme disease in dogs is longer than in humans. Adult Ixodes scapularis feed from October through April, presenting infection risk almost 5 months longer than humans experience.

The veterinary team is responsible for educating pet owners about mitigating risk factors for Lyme disease in dogs and should include the following:

Tick checks and environmental management

• Avoid having the dog walk/hike in forests or grassy areas
• Educate owners on the need to keep their lawns short and quickly remove piles of moist vegetation (leaves, cut grass, etc.) to avoid attracting ticks
• Owners should examine their dog for ticks daily
• Tick checks and environmental management

Encourage and educate the need for tick preventives

• Use an approved monthly tick product 12 months of the year.

Vaccination

• Recommend vaccination against Lyme disease
• Educate owners that dogs have not been known to clear the bacteria — it is a life-long disease.
• Educate owners that Lyme disease causes serious and lasting illness in both humans and pets which is difficult to identify and treat once established. Therefore, prevention is a far more desirable option.

Puppies 16 weeks of age or younger are recommended by the Guidelines to have two doses, 2 to 4 weeks apart for the initial vaccine series.^1,2 The vaccine can be given to puppies as early as 8 to 9 weeks of age. If the healthcare team is giving the initial vaccine series in dogs older than 16 weeks of age, the recommendation is two doses, 2 to 4 weeks apart. To booster the immunization, a single dose 1 year following completion of the initial 2 doses, then annually thereafter is recommended.

Calculating the need

Not all dogs need every vaccine, according to AAHA. Veterinarians will ask pet owners questions about their dog’s lifestyle, environment, and travel to help tailor the vaccination plan. AAHA offers a Lifestyle-Based Vaccine Calculator that uses factors such as whether the dog visits dog parks, groomers, competes in dog shows, swims in freshwater lakes, or lives on converted farmland to help the pet owner and veterinarian develop a dog’s individualized vaccination plan.

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1. Ford R, Larson LJ, McClure KD, et al. 2017 AAHA Canine Vaccination Guidelines. Trends Magazine. October 2017. Pp. 26-35.

2. AAHA’s Canine Vaccination Guidelines. Available at: aaha.org/pet_owner/aaha_guidelines/aahas_canine_vaccination_guidelines.aspx. Accessed April 14, 2019.

3. Ford RB. Canine infectious respiratory disease. In: Greene CE, ed. Infectious Diseases of the Dog and Cat. 4th ed. St. Louis, MO: Saunders. 2012:55-67.

4. Canine Parainfluenza. Merck Animal Health. Available at: merck-animal-health-usa.com/dp/7. Accessed April 14, 2019.

5. Goldstein RE. Canine Leptospirosis. Vet Clin Small Animal. 2010;40:1091-1101.

6. Green CE, Sykes JE, Moore GE, Goldstein RE, Schultz RD. Leptospirosis, In: Infectious Diseases of the Dog and Cat. 4th ed. Philadelphia:
WB Saunders Co. 2012;431-446

7. Yabsley MJ. Elevated risk of heartworm disease and lyme disease continues in 2018. Companion Animal Parasite Council website. capcvet.org/articles/elevated-risk-of-heartworm-disease-and-lyme-disease-continues-in-2018. Accessed April 15, 2019.

8. Greene CE, Straubinger RK: Borreliosis, in Greene CE (Ed): Infectious Diseases of the Dog and Cat, 3rd ed. St Louis, Saunders Elsevier. 2006;
pp 417-435.