These days almost everyone feels like an expert on vaccines...but are you?! Do you know the "puppy shot" schedule? What about kittens? Do senior dogs, 7 yrs old and up, REALLY need vaccines EVERY year? And, what about titers, don't those count for something? Does your vet give your dog a vaccine that goes "up the nose?"
Luckily, Dr. Jen the vet and Dr. Jason know a vaccine expert! Dr. Amy Stone enters the Chat Room to talk all about "vaccine-ology" and YOUR pets! Dr. Stone is another smartypants - not only is she a veterinarian - she also has a PhD in immunology! Currently, Dr. Stone is the Primary Care and Dentistry Service Chief at the University of Florida's College of Veterinary Medicine. Find out more about Dr. Stone here: https://www.vetmed.ufl.edu/profile/stone-amy/
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vaccine, animals, immune system, dog, people, talking, veterinarian, injectable, influenza, titers, immune response, jason, vet, intranasal, parvo, pets, pet owners, stone, response, disease
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Welcome to chats with the Chatfields. This is a podcast to expand your idea of what impacts veterinarians, pet owners, and basically all animal lovers in the galaxy is humans We are your hosts. Hi, I'm
Dr. Jen the vet. And I'm Dr. Jason.
And if you have not yet subscribed to our show, why not? Head over to Chatfieldshow.com And subscribe today. And if you want to reach us and you've got a positive message that's filled with love. You can find me at Jen@Chatfieldshow.com
But for all other messages that includes the real you can reach me at Jason@Chatfieldshow.com
Okay. Jason, in the chat room.
Oh, we're going right to it. I thought you make a comment about my the real well, with the real is i guess i Everything is not
positive. Right. I was thinking that the real was sort of like a delusion that perhaps you were laboring under I wasn't sure.
We can move off of this right now.
Okay. All right. New topic. So no, I wanted to jump right into it. Because today, we have someone in the chat room that I'm very excited about. She's a very, very good friend of mine. And of course she's a smarty pants. And because she is not only a veterinarian, but also she has a PhD,
a smarty pants in the good sense of the word, right? Yeah. So yeah, I got like little kids and I use smarty pants a little bit differently, maybe? Well, that's a person who wears pants and is smart.
Yes, no. Okay. No. I would think that you would use ants in your pants more often than smarty pants around your house. But anyway, for one of them. Yeah, yes, exactly. So into the chat room. Today we have my very good friend who is a veterinarian. I as I said, with a PhD in wait for it. immunology. Don't Don't don't? Yes. And she is also currently a clinical assistant professor and clinical service chief for primary care and dentistry at the University of Florida's College of Veterinary Medicine. Yep. So yep, she needs a bucket to carry those titles.
That's alot! You just kept going.
I know. Anyway, so I can't believe she has time today. So we're gonna get right to it. Welcome into the chat room. Dr. Amy stone. Yeah, yeah. Welcome. Welcome. Welcome. So here, I am really excited, because as you know, one of my favorite things that you and I chat about all the time, is vaccines. Again, dum dum dum...
really awesome conversations.
Ominous Music would be good. Yeah, it is.
Get on the producer to get some sound effects.
I know. We'll have to drop those in later. But the production team. So yeah. So Dr. Stone, thank you so much for joining us, I know that you spend most of your days shaping the future of Veterinary Medicine at the vet school.
awesome way to put that shaping the future of Veterinary Medicine, medicine. I like that.
It's, I mean, it's what she's doing. Yeah, which is why she also stays on the cutting edge of vaccine technology protocols administration's all of it. And for me, one of the most common things that I do when I'm working in general practice is talk to people about preventive medicine, which is pretty largely focused on vaccines. And God bless the internet. There's a ton of information and misinformation. And just a lot of words out there about and also
God, God bless 2020 and a pandemic now that people are really focused on this right. Even more work better, for better for worse, I think it's great to get it all. It's cool. I'm glad they're asking questions, because you want to get the right information to them. But they are seem to be more, more not just like, Okay, Doc, do whatever, how should I do this? Should I not do this? What's the Pro? And it's a lot more questions and back and forth than it used to be?
Yeah, have you? So let's get to that. So Dr. Stone, have you noticed that like our clients, like asking more about vaccines or saying all these words or what, like, is there a difference?
So yes, and no, um, we've gotten, we haven't really got more questions than we ever have about our vaccines, like about okay, that we've been getting pretty steady stream about that since? I don't know. I'm gonna say 2010 and 2010 more there. And sweeping getting a steady stream of that. What we've been getting is people asking us about the COVID vaccines because they trust our opinion Right, right. Yeah. I sometimes over there MDS.
Yes. Which Which is interesting, right? Yeah.
I'm not sure we want to go down that road right now. We'll just call it interesting and we can move on.
It's true. It's very, very true.
Yeah, we thank you for that.
Having been a person who's made a vaccine wasn't a marketed vaccine, but a vaccine. I tried to explain. My postdoc was disease back super early.
Okay. I know back to back the truck up for just a second chatterboxes Did you guys hear that? So not only is this woman a DVM with a PhD, she and we have her here, because we're going to talk about vaccines and the immune system, but she's actually made a vaccine.
Speaking of sound effects, right? It's like heard the record scratch, but can you spend a few seconds and tell us about that, or Yeah, primary information or what?
So we were making a vaccine to porphyromonas Ginger ballasts, which is a long way of saying a bacteria that causes periodontal disease in humans. We were taking a salmonella, so bacteria vector, and a virulent salmonella, and we were putting a portion of porphyromonas into that salmonella. So that then if you gave it as an oral vaccine that would go and present to the mucosal immune system, the facial tissue, US and animals from the world via the inside of our mouths and guts and all that good stuff. And it sees it readily because our immune systems are set up to watch for salmonella, and then would help create an appropriate immune response to porphyromonas.
Okay, so that's not unlike what one of the COVID vaccine platforms is right now. Right, the Johnson and Johnson is the ad, no viral vectored vaccine where they took a chunk of the, the COVID virus, right that codes for the spike proteins, but they put that in there, and then they inject it, immune system recognizes it, and makes defenses against the spike protein,
right. So interesting is bacteria work better for an oral you know, oral vector than viruses do. Viruses work nicely for injectable?
I just don't listen who you said we who did you just did that at your house? Or like,
garage or the basement? Tips? Aren't
you astounded by this like a vaccine? I had some stuff, I made a vaccine, whatever that's one does. But who like how did that who did that?
The researcher was Dr. Thomas Brown, and he hired me after my PhD to be the postdoc, one of the postdocs. And I worked on a lot of stuff with looking at what cytokines which is sort of immune system messages that the body produces and response to what we were doing. Also, what looked at how we were going to do a little bit with some of the sequencing and some of PCR that went along with our experiments, but it was a team of us.
Dr. Jason did I not, like preface this whole episode with the fact that she's a smarty pants?
I mean, you did, but I had no idea you ask. My good friend that I thought okay, now, I don't know how many of those exists, right. I don't know what's going on.
It is tough in the chat room. Dr. Stone, it's tough. It's
super awesome. I so you made a vaccine, you saved the world. And we interrupted you. Where were you? Where were you headed? before? We talked about that? What was the question? Oh, I forgot.
Oh, well, unfortunately, our vaccine didn't get very far out of an animal model. Having said that, I'm not sure that it couldn't have it's just the backup to do that. Yeah. Yeah. But when I explain that, I kind of get a shortened version of that, because most people don't want most of that information. When I do that, and I talk then to the clients about that, now that we can sort of see them face to face. We can't we're not going through our exam rooms yet. But we are going outside and talking to them. We're going out like that. I take my little board, and I draw on it. And they I can explain better the vaccine technology because they kind of beat me, right? Yeah,
absolutely. I thought I was gonna get it Lynn's 100% credibility, right. It's way different than if I say it even no offense, if Dr. Jen says it. Then if you say because you've actually done it, so
yeah, yeah, yeah. I mean, people
nurse it. I mean, it does. So okay, so you'd like that goes right into one of the things that I wanted to talk about because I also get this question from not well, not only from pet owners, but from technicians, from receptionists from sometimes from other veterinarians. So you were talking about a vaccine that was an oral one, right that you administered orally in the mouth, versus when you gave it like we give it through a shot in the muscle. And so in Vet Med, we have some vaccines like that. So for dogs for what we call the respiratory viruses, or respiratory complex pathogens, there are choices, right, we can do an injectable, we can do an oral or we can do the nose. And so if we just like group, those that are injected, versus those that go somewhere else, right? Totally mucosa. Lee, thank you. Then what? What's the what's the difference there? What are we finding there? Because I think that's also actually something that lends itself to COVID as well. But yeah, can like explain that local tissue effect?
Sure. So it's probably easier to explain if I talk about specific vaccines and why that works. So in dogs, we have bacteria like Bordetella, we have adenovirus, we have parainfluenza, those, those are make a nice little complex that causes cough along with a bunch of other things and sneezing and whatnot mycoplasma.
By December winner.
Yeah, so having an intra nasal vaccine for that really does mimic the way that the backs body actually gets infected most of the, from those things, therefore, the mechanisms that we have set up and the immune system to respond, do much better when it comes from the way that our body responds to it to begin with. So it's faster. In some cases, depending on what agent we're talking about, and what vaccine may be more robust or better than response that you're going to get from an injectable, depending on the type of injectable vaccine. Sure. We also have it in cats, we have the Khaleesi herpes in the Peenya complex that is offered as an intranasal. And for that two of those components work very well, because that's the way they mostly get infected. And that's the way mostly the immune response is activated to them. So okay, well, that way. Okay. So
so for those diseases that are respiratory, right, so they're the creature becomes infected with stuff going up their nose, they breathe it in, or they look, or they stick it, yeah, stick it up their nose or whatever. It if it's possible, it's, it's often best to administer the vaccine that same way, right? Because it stimulates that, that local tissue immunity, but
you can also use a modified live version of it. And so then it really does give the body is sort of a natural infection, if
you will. Right. Okay, interesting. Okay, so does that mean that an injectable version of that because like for Bordetella. For dogs, I knew there's an injectable version? Does that mean that that doesn't work at all, because also the vaccine is injectable,
right. And the Parvo vaccine is injectable in the panleukopenia vaccine is injectable. And they all really, really well. But those, it has more things have to do with whether the antibody response is the response we totally want to rely on or the whole immune response is the smart response we want to rely on. Okay. And it also has to do with whether you can give it live or not.
Okay. Okay. So it's a lot of choice.
Yeah, great point for each antibody versus the whole thing,
all or nothing. That's, that's a simplification, but without going in without getting my board out and drawing.
Maybe we want you to I don't know, like, I want to see a whiteboard today. Right? Always living with a simple life. But no, no, no.
It's, um, you know, like, so if you get if you inject the Bordetella, it's a killed vaccine, right. So with that, you have to wait two weeks to get for about two weeks to get another one booster it and then it's a little bit of time after that. And that time is a little bit debatable, but I would probably say five to seven days, where you get good immune response. Yes, you're going to have some immune response after the first vaccine, you're going to want immune response immediately after the second vaccine, but it to get what you're gonna get the quality of what you're gonna get about 72 hours. After you do the intranasal you have much longer. So if I'm going to put a dog into a situation that I'm going to expose them, I would rather than have something faster,
right? Going to work, you know, point A nose. Yep, right.
Good point. But if I'm going to give a cat, a panleukopenia vaccine is going to work much better, because it's got more to do with a whole immune response when you get it objectively. If I'm going to do that, I want them to have it by injection, not for nasal, because the response is a modified live vaccine, going to be fast, around five to seven days, you're gonna get a great response. And it's going to act like an infection as well. Infection if you will, and they're gonna get a nice robust immune response to the immune response.
It matters, it does matter, it does matter. And I'm glad to hear you say that, because I think a lot of times when I'm talking with pet owners, and I say, you know, here's what we're gonna do today, you know, I'm gonna, I'm gonna boost this vaccine, or I'm gonna administer this and for the first time, and then we're going to boost it. And I'm going to do this one, is it as an injection, and I'm going to do this one up the nose. And this, they, you know, I think a lot of times, pet owners are there, they are hesitant to ask a question about that. And so if I just see any flicker of interest in asking a question, I stop and say, Do you have a question? Because I think it's important for pet owners don't understand that. Because they're the ones who actually are in control of the exposure, right? Because wherever you take your pet, that's where they can be exposed. And so I think it's important for pet owners to understand as much as they can about how each of these different vaccine that routes work and why your veterinarian is selecting the ones they are. And, you know, if you have a choice, maybe you want to weigh in on the choice of how they're going to administer it. So yeah. Okay, so, um, so we're gonna take a quick break, and then, you know, Dr. Stone dropped some serious terms in there, talking about this. So she talked about modified live, and she talked about killed, vaccines and stuff. So we're gonna, we're gonna get into that a little bit more. And then we're going to talk about antibody titers and over vaccination, is that a thing? Alright, so hang with us. We will catch you guys on the other side of this break. With all the fuss happening in the pet food industry, why not invest in something to help guard against digestive health arrangements in your pet? Full buckets probiotics are formulated by veterinarians to support your pets normal digestive health, your pets gut microbiome is integral to their immune system performance. Why not add full buckets daily dog or daily cat probiotic powder to your pets daily routine? to curate, protect, maintain and strengthen your pets microbiome. Visit full bucket health.com today to check out all of their veterinary strength supplements. Okay, back in the chat room with Dr. Amy stone, throwing down some real knowledge all about the immune system and how we stimulate it with vaccines and how you should stimulate it with vaccines. Right. So Dr. Stone before the break, you mentioned, killed vaccines modified live vaccines were like what tell us like what's what's the difference? And who cares?
Yeah, what she means if you would, I don't think Dr. Jason understood that. Can you sound a little easier for him? I will try. Oh, great. Good day. Good. All right. I'm ready ears open.
So when you have what's called a modified live vaccine, that vaccine is the the either the material the vector, the agent that you're going to have a response to. So if it's December, it's distemper, but it's been made. So it's been made so that the immune system can see it and respond, but it's not going to cause symptoms and make the animals sick. Okay. So and those vaccines that we have that do that, so, distemper, Parvo, adenovirus, panleukopenia, Khaleesi, herpes, all those are really good vaccines because they mimic a really, really natural response. Okay, with the intranasal vaccines we just talked about, they don't usually last quite as long because the the natural immunity to those things doesn't last as long. Okay, but they do last a long time. They killed vaccine, and there are a lot of vaccines. We don't can't make any other way.
Like rabies. Like,
oh, I was gonna say,
or, you know, modified live rabies.
I know, I know, but you know what, okay, so for everybody listening, you are correct within your brain right now is, oh my gosh, if it's modified live, isn't there a chance it could actually cause the disease? Yes, yes. Now for the ones who did it did with rabies, but the ones that are on the market now, right we have tons and tons and tons and tons and tons and tons and tons of data. So you're not going to give your your dog distemper because we're using it. I mean, we're talking millions and millions and millions and millions and millions and millions more doses have been administered. So do not like they're there. You can see there's no risk, but there's no risk. Okay? All right, but not have that not have that. But the difference is like with rabies, they actually when they were using modified live rabies vaccine they gave some animals rabies with so we don't do that's a problem. That's a small problem. The same thing with the influenza, right? The Up the nose modified live influenza and humans that they were using and kids, they actually they stopped that it turned out that wasn't a
good plan. For perspective. I'm gonna put you guys on this. But how long ago was this? Was this last year? Oh, yes. This Yes.
For the rabies. The rabies was like in the late 70s. Maybe? Or was it?
50 years ago? Right? Right. No, that sounds like, okay, just just making sure. It's not like we just did that in the in the 10,000 10s. Right. So,
but now the modified live influenza that was being given to people that was in the last 10 years, I think they were giving it and the idea behind it was it only went did people who had a very, very competent immune system who were unlikely to develop severe disease. That's kids. However, if you know anything about me, and you're getting ready right now, for my admiration for influenza, to show through the fact that influenza can mutate at will. This just made this a bad plan. Just this a bad plan. So so we decided to stop that. Right. So, okay, so now instead what we use is
killed, right killed. And so if and I wanted to back up just one second, because I've been under the impression that if you give your dog an intranasal Bordetella, that they'll never have any symptoms. And that's not true. They may have some sneezing here, and there, they may have a little bit of coughing, but I assure you, it is nothing like them having actual disease. And a few little symptoms are far better than huge
hacking cough for eight weeks.
Right? So but I didn't want to make that clear. Especially when you're giving something that's alive via the mucosal route, you put some posts, and all signs are possible that that mimic the ones that the real disease causes. Yes. So but when we have to rely on kill, like influenza, rabies, leptospirosis, you end up needing to basically take the way we used to do it, and the way some vaccines still are made is you take a whole agent, a whole virus, a whole bacteria, and you kill it. And then you add a bunch of stuff to it to make the immune system see it, because if it's killed, the immune system is gonna be like mad, that's trash. But if you add some things to it, then it the immune system, once you inject it will see it, and everybody will come and join the party and develop that risk response we're hoping for, right? So again, primarily a antibody type response, primarily, not solely, but primarily response. And so that's why it takes a booster then memory. So the immune system has a memory, and it's got to see something twice in order to truly remember
it. Right? Not, not six times, but twice. No. For me,
just to write really good, worse.
Okay, so, so that's a couple that so I but I think that's an important distinction to make, especially these days when we're talking about, there's vaccines that are being talked about all over the place. And we haven't even mentioned kind of the Star Trek level platforms for vaccine manufacturing production, right, like the replicon. Thing, the messenger RNA, the mRNA platform we're talking about, those are different. But again, though, minute technology, right, recombinant technology, right. But again, for everyone listening, those are not modified live, they're not live. So there is no risk of development of the disease itself. And so what all this means is that you did not get the flu from your flu shot friends. And your your dog didn't get distemper from Parvo, or, right now. If the immune system gets stimulated, then what does that look like? Because that's, that's what we're trying to do. Right?
This is something I've found that COVID vaccines have helped us with. have now gotten some vaccines that made us not feel so awesome. Next day,
or the next three days, or whatever,
depending on funded, and so it's now more understandable. And so for years when I get my flu vaccine, I don't feel good for about two days. Oh, feel terrible, but I'll feel good and fever met. So it didn't surprise me when I got it, that I had a fever and didn't feel great. Our animals, our pets feel the same way. Most of them don't take themselves nearly as seriously as we do. And blow right through that.
There's so much tougher than as I liked. are like kids are just super tough.
They don't have to hold a job. I'm gonna put it in a box and forget about that. Right? Move on. Yeah, so if they do that, then you won't know. But yes, probably prefer that their lives go in a certain way that they plan. And so they'll go, you know, hide under the bed for 48 hours or whatever. And yes, it freaks pet parents out. I'm the first one to say it. My dog gets any sort of pain, any sort of ill. And I listened to the show, and I know that cosets mom is very, very, very attached to her. Yes, I would wager that Greyhound and I are also very, very, very attached. Yeah. So I mean, she yells, and I'm like, what?
Well, yeah, so any, any drastic change of behavior is gonna bother anyone? Or whatever. Of course, it doesn't matter if it's a vaccine or anything. So.
But I think that's also what's appropriate that people should remember that. There's some incredible technology that goes into that little syringe, right, that we're going to give this injection with. And if we are if, if it's doing its job, and stimulating the immune system, then it's quite likely and so you know, when when you feel a little crappy after that shot that you got at the doctor, you should say, Yes, immune system work in
something cool. At least my body saw it. Yeah.
Right. And so and so you could feel that way. And sometimes that's why if you call like if you call your veterinarian the next day, and you say, hey, you know what, my dog doesn't feel that great. And I know, we just gave him a whole passel of shots yesterday, what can I do, they may have, you can pick up some nonsteroidals, like, basically, the doggy equivalent of some ibuprofen, don't give your dog ibuprofen, or something like this, just to help them with aches and pains. But if that lasts longer than that, 24 And really, they should start to feel better at 48 hours. But if it persists, you need to take your dog and have him be seen, or your cat, if your cat is still hiding, haul them out from under the bed taken to be seen or have the vet come to your home. So because we'd want to make sure that you're seeking care and not just dismissing it. Yeah. But then that kind of gets us into one of the things that I think a lot of not only pet owners, but veterinarians are a little bit afraid of which is adverse events. Right, don't don't go home. Because we I have talked about it all the time. Right. And I know you do two primary practice. You know, people talking about how these horror stories of how I just took my dog in for their vaccinations, and they're dead. Or I just took them in for vaccinations and their heads swelled up like a basketball, you know, or now I spent two grand at the emergency clinic because they started barfing their guts out or all these things. Yeah. And so what is that about? Like?
Yeah, so I would say a preponderance of the vaccines that we give, don't do any of that. Because we people don't really take into consideration. I just look at the town I live in, and the number of veterinarians that are here and I live in a medium sized town. And if I look at the number of veterinarians that gave vaccines this morning, just this morning, at least 10 tend to have practices that gave vaccines this morning, and that's just count small. Then the large animal veterinarians, it also gave some dog and cat vaccines and then the five or six vaccine clinics that happened this morning. Oh, right. culture that gave some vaccines this morning, there's probably only about one or two of those animals and all of those animals, that means that any sort of truly adverse reaction, the swelling of their head, hives, bomb, and all those kinds of things. There's it it's so very small, the amount of animals that have any sort of reaction. And the problem is is we don't know if they're going to have a reaction until they have it. And so you know, it is it is good idea to take every vaccine you give seriously. I mean, I tell my students, it's just as important as picking an animal to surgery. We need to be careful, you need to watch you need to make sure that this animal is at risk. They're going to have it like You heard of getting sick from this disease. So they really need this vaccine, and that you're going to monitor them and take care of them once they have that vaccine.
But But I also think it's what's, you know, our brains immediately jump to those horrific ones, right? Like Jason if I say to you, vaccine allergic reaction, like what pops in your head?
Honestly, yeah. The My child,
were okay. Well, there's that.
Okay. Because he had one right. But it was, it was it's a little it's a little scary. So you know, I learned that he was it was a vaccinate animals I go through I know all about vaccines. I think I'm super smart about vaccines. And then sure enough, you know, he got his normal round of vaccines. And then 20 minutes later, he was, you know, passed out or whatever. And it's a little, it's a little scary. I knew what's happening. It wasn't like totally freaked out. I mean, I was, but I won't tell anybody. But, but yeah, so that's what comes to mind. So so the immediate reaction really is what? What is good, right? Because it's usually still there or whatever. But this is why they say wait 15 minutes before you go anywhere. I I did not. And all my knowledge, jetted out of there saying everything's fine, right? I shouldn't it
well, he had had those vaccines before, right. And so you you, and I guess that's part of it, too. So when when clients ask her or when your veterinarian tells you, yeah, I mean, it's possible because anything is always possible. But it's unlikely because your dog is five years old. And they've had the routine vaccines, as they should, you know, three or more vaccination rounds when they were puppies, or kittens, and then annually thereafter or every second or third year thereafter, and they haven't had any problem. So it becomes less and less likely that they're going to react, but we can't predict. And so you know, we don't, the good thing is, you're right, like I like for me for seeing the reactions is so uncommon anymore. And when we talk about it, we don't mean just the ones where they're barfing, like you say, or they're having hives, or they're their faces swelling up and geo edema, that technical term, we also have to include in that because the data includes it soreness at the injection site, for the first 24 hours. Perceived lethargy, or you know, malaise, they just want to lay around for that day, etc.
All in the localized small swelling, a local
swelling, which which happens with almost every vaccination, because they go sub q, right, they go into a potential space people. So you can feel that little knot where we put that one cc of a vaccine, and so and we poked him with a needle. So hello, it hurts. And so I think that, bearing all of that in mind, and then still recognizing that what was that the recent metadata that was published the overall vaccine adverse reaction rate, including all of those things with like, 0.38%,
something almost impossible to even
fathom, right. And it was over 3 million doses, the number of doses is humongous, right? That they that they looked at, and then included everything, right, including lepto. So friends, if you're listening, get your dog vaccinated for lepto for heaven's sakes. So notic please do that. It's so nice. And I know you have an incredible story about that, that she will tell on another episode of the podcast friends, and it's incredible. Okay, so yes, it is. Dr. Stone saving lives. So we, we talked about adverse reaction. And that's where we get into people worrying about too many vaccines on the same day, and worrying about, but my Pomeranian is only two and a half pounds. I don't want him to get oh, all of that vaccine on the same day, or doesn't really need half the dose, et cetera. And so what is your How do you talk about that with with folks?
So, what I usually tell people about small dogs is that, you know, how when a big dog comes in, they are just, they think they're mighty, and they're gonna go and knock those kinds of things. Well, their immune system is pretty much the same. Their immune system is quite gracious and response quite well and a whole ml of vaccines not gonna hurt them. So with their inner
Napoleon Napoleonic syndrome,
my sort of compare it to that. The other thing I tell them is if they're going to have a reaction, one drop of a vaccine, like a peanut allergy is going to cause that reaction. So it doesn't matter if I give half a mil or a whole mil, it's going to have the same effect if there's going to be a true reaction.
portion is inevitably Okay, that's great, Doc. But what about giving Are for for vaccines. There are five vaccines given me okay, but do we have to give them all? Yeah, yes. I was just asking what? I was asking
that. Well, we don't have to give them all today. Okay, not too. Okay. We can wait two weeks and give some more.
Is there an advantage? Is there an advantage to giving them all on the same day? It just, I mean, besides, like, it's efficient for me. Is there? Is it? Does it make a difference to my dog? Or my cat?
I don't think so. I mean, other than the cat might be stressed by coming back to the vet twice? Well, yeah.
Yeah. Is there a disadvantage? Yeah, the opposite question.
Yeah, the opposite. Is
there a disadvantage the same day? Okay.
Yeah, is there a disadvantage to doing it all the same day. So it's just whatever you feel like, it's whatever you
feel like, It's my only caveat to that, Oh, get ready, here comes
your Shut up. Okay, I'm about to lay some knowledge.
When I have, and this is based on some, some clinical data, on data that people have just looked at the immune response separate from what the animals doing clinically, but dogs that are going to be less than 20 pounds, so a puppy that's going to yes, they're all less than 20 pounds at some point. But like, grown up, if they're going to be less than 20 pounds, I can, as long as the owner is on board with not exposing them to everything under the sun, I try to move some of those vaccines to after I've given the rabies vaccine at 16 weeks, because I have to I can give less protein, so less things that tend to set animals up for a vaccine reaction. And little dogs, let's face it tend to be the ones that have more vaccine reactions over time. And if when they're young, and their immune system is doing its thing, I cannot set it up to be primed to have a reaction later, I'm going to do that. So I don't necessarily charge the owner for another visit. Have them come in make sure the animals not ill that kind of thing, give the vaccine vaccine, but I try to spread that out a little bit. I make sure they've had their distemper, Parvo combination, at the right intervals for there being a puppy, I make sure that they've had their rabies, and probably at least one other like there. Were in for intranasal Bordetella. Ever at the beginning, those have all happened, but I might save lepto, mine flew to later, or one of them in that series, and then wait till a little bit later to do the others. Okay.
Risk. And so you know, here in the chat room, we do we love diversity of opinion. And it doesn't mean anyone's a bad person. Right? So let's hear this. Because only only because so for me when I'm looking at that. There. So there there is. There's data, right regarding safety and efficacy, because it's on the label. So they tell us these things, right, in order to get the labels. So they say it's safe in you know, puppies and kittens of this age or or more. And that metadata study when they looked at the 3 million didn't find any correlation between size. Right, but I will tell you this, and they looked at all the different kinds. I will tell you this, that for me, I think that this a lot of the smaller breed dogs, they do tend to get the little sub q lump that seems to persist a little bit longer. Eventually, it resolves right over a couple of months. But they seem to get that which of course would classify as an adverse event. It's not what we typically think of like I said, but I do find that. And I do also take a deep breath before I I administer vaccines to the little two pound Pomeranian, but but I do it because this really smart person that I know Dr. Amy stone told me once that I should we should either, as you describe wait two weeks and at least two weeks in between each different vaccine we're going to give or we should give them on the same day. Yep. All at once. Because they can work synergistically, right? Because if you're trying if your goal is to stimulate the immune system, let's man let's stimulate. Right, right. And so yeah, so I do worry about that because I also worry about owners really recognizing the risk of exposure because puppies are so cute and they're so excited to have them. So I that makes me worry a lot.
I will tell you that the number of clients that I Have that really are concerned about vaccines that we spread them out is not very many. But this is not the vaccine way I would do it if I worked in a place where I was worried that the animal might not come back, or I was worried that the person won't listen to my recommendation that they don't go hunting all over the country. Those kinds of things, take it in a episode by episode basis.
But I think that's interesting that you tailor it like you tailor it for that owner. Because I think, yeah, I think that's really the the kind of the ideal right for vaccine protocols.
And that's not it's not I'm not talking about vaccinating animals in a shelter. I'm not talking about vaccinating animals in a vaccine Clinic. My way of thinking about that, vaccinate them, vaccinate and vaccinate them. Yeah. Protected.
At the place you work, I won't mention, do you charge more for your bespoke vaccine protocol there your tailor probably vaccine because she said she doesn't just want to use the word bespoke y'all didn't even know.
I don't know. Fine. Yeah. And but I think that's also key as well, because a lot of clients worry about, like, every time I bring him back to have to pay an exam fee or not. So you kind of lay all of this out, probably from the jump. Right? You say like, Okay, we're gonna early on. Yeah, we're gonna do it this way, then here's what you're in for. And you have to commit to it. Right. I think I think that's interesting. Wonderful. Yeah. Well, if
you're worried about compliance, right, the big trick is to charge them before you give it right. Make them pay for and there's no I'm not kidding. And then they come back true, because then they'll come back
percent, and they'll come back the reasons I like wellness plans for really young animals, but then
they do come back. Yeah, yeah. Because because it's already paid for. So we may as well go back and get it. And so
a couple things happen. They learned that getting their nails trimmed sometimes isn't the worst thing in the world, right? Yeah. That Tech's have cookies in their pocket? They, you know, they learn they learn things like that. Yeah. That sort of seem to make life a little easier later on.
They definitely do. Both owners into pets. I bet makes Yeah. Hey,
yes. Okay, so the final like big topic, I think. And I haven't had many people asked about this, but I think maybe you do actually in your practice there Dr. Stone getting measuring antibody titers instead of getting a vaccine. So do you have many people come in and ask for that?
Say many I have, but not many
about this more than you used to? Definitely not even with I would have been, I would have thought that given all this discussion about other vaccines for other humans, you would have some of that, right? Because they kind of equate it's weird.
People will sit there and tell me they don't get vaccines for themselves. But please put the rabies vaccine in my dog. I mean, it is interesting, weirdest thing. And I'm not the only person like I've talked to right now also be married to have that. And Ted some of the same experience. Yeah. Well, I have that with
the flu shot. Right. Like,
hold on. Didn't they tell you in vet school don't marry event like, yeah.
Jason did the same thing. Jason did the same thing. But yeah, so with the canine with the canine influenza shot, we see the same thing, right? Because people will be like, I don't know why don't get a flu shot, but give my dog the flu shot and I'm like, people get your flu shot. You know,
come on. Absolutely.
So are we Yeah, go ahead. Yeah, people
come in and ask for titers. I've even taken one of the slides that I made for one of my talks that has, we will totally do titers for your animal for these things. Because I'm titers for diseases to which a titer matters Parvo, distemper panleukopenia and cats, I'm not going to do titers for the other things that don't matter in terms of whether or not I'm going to make a choice to read vaccinate or not. So if I get an animal that comes in and I do a tighter and great tighter to Parvo grape tighter to December, sure, we don't have to vaccinate this year, you spent a lot more money you had to spend if I was going to just give the vaccine, but I'll take your money, that's fine. And if if,
okay, so, let's say that they had good titers and you gave the vaccine anyway. Okay, what's the risk there? If they don't if they don't have a history of adverse reactions, you know, they're clearly not allergic, etc. Oh, they don't die from over vaccination. Don't
die, no. Die. And the funny part is, if you a person says so my animal doesn't have a title So they must not be protected. So we should vaccinate them. I can't say that, because we can't measure the cell mediated immune response. So I don't know if they're protected. Right, don't cut or they might be.
Right. And I think we're hearing that a lot with COVID. People are talking about, well, what does a titer mean? Well, it means that if you have a titer, great, you have some protection. Theoretically, if you don't have a titer, it means you don't have a titer. Right. It doesn't correlate necessarily with with protection or not a
percent with protection. And so we know again, for those viruses, we know that a good titer does mean protection, we have done enough research, right, say this level, protect that part of the immune response gotcha there that party members aren't going to take care of it. Yeah. When we don't we don't know what that means.
Yeah, it's kind of like PCR. If we have a positive PCR, then we know that the genetic material for the for whatever we were looking for whatever virus is present, if we have a negative PCR we know we have PCR, we don't know that you're not infected. And kind of from the same perspective, if you have a positive PCR, we don't know that you're infected, we just know that genetic material is present. Right? Yeah. So I
think here's my thing about titers and talking to people about vaccines. That's our job. Oh, yeah, of course, I hear a lot of a lot of people. I'm not doing my YouTube, but I'm hearing the vet school a lot, because I teach students and people say, you know, I, in the scientific community, we sort of take vaccines, not necessarily for granted, but we take for granted that they work and we take for granted that they are good, and all those things, but I try to put myself in the position of of our clients. Right? What if I was, you know, a electrical engineer or a plumber? Or, you know, some other profession? Yeah, I may be plenty smart. But this may be confusing as all heck. And so we have to, you know, if they want to have a tighter than explain to him why that okay, yep, I used to get oh, no, we don't need titers. But now I'm like, Sure, let's talk about it. And if we get into discussion, and you still want that tighter, let's do it.
Right, because and that's But isn't that the role of the veterinarian is to absolutely to share what we know, based on all of our training and knowledge, make a recommendation, and then move forward as part of the animal care team, of which the owner is the leader. Right, like they're the ones making the decisions. But I also think that human physicians, they don't give a lot of vaccines anymore, right? Like, I mean, they just don't because there's these blanket
nutritions do, but that's it. Yeah,
I was I was gonna say I talked about I'm at the doctor every other month for vaccines, but I guess it's just pediatricians and I've never, you know, it's been there. But
they're also sort of sort of presumed, right, because they're sort of compulsory for kids going to school and stuff. And so you don't always talk a lot about it. And so I find myself having to talk with them about the as, as you mentioned, Dr. Stone like COVID vaccine, flu vaccine, all these vaccines because frankly, we do a lot of vaccinating
That's right. It's more not universal in there for sure.
Yeah. Yeah. And I love when owners are interested in
that live low they put their noses and faces and everything Oh my gosh, because it yet I mean, they don't they Yes, we can tell them know when they know what that means not to do that. But that's a different communication strategy with each other and with people and so yes, no, doing the whole social distancing and doing things like that Not gonna work as well in dogs and cats. So we know that.
Yeah, yeah, we do. We do. And I'm so thankful every day for coset that we have so many vaccines for so many horrible and life threatening diseases for her. I don't worry much anymore for her because she's she's vaccinated now. When she goes reading through puddles, I feel like she's auditioning to become the next poster dog for lepto infection. But you know, she's she's vaccinated, and then she gets the bath. And what else am I going to do? I gotta let her be the farm fresh Frenchie.
One and living in Florida. Yes. Oh my dog doing freshwater of any kind because of leftover or an alligator
or an alligator campaign against the alligators.
Against the alligator your Greyhound as a bit of a little bit better chance than that little snack called cozy.
I swear to God, greyhounds are just burrows they think oh, I'm gonna win this. Oh, yeah. Yeah, did you?
You're gonna snap your legs honey, you're a greyhound
isn't here, right?
Oh, no, I love it. I love it. Well, this is been a fantastic conversation all about the immune system and how we like to stimulate it with vaccines. Dr. Stone, is there any one thing that you wish that pet lovers knew? And frequently don't? Or that you find yourself saying over and over that you'd like to share with the chatterboxes?
I think I was I was trying to sort of consider what I would say to that question. And I think that's changed over the years. Because now what I would say is, really, really listen to your veterinarian. Because your veterinarian is going to be the source of what vaccines your animal needs, based on what you tell us. And so we need you need to be honest with us about animal does in a day. And and as I get older, I forget things. So I write stuff down that my animal does in a day. You know, if you think you might retire this year, and you might like to do agility with your dog, I need to know now, right? Or you need to bring your dog back before you
do that, right. That's a good point. Risks are going to change
and their vaccine liens are going to change based on what you put them at risk four. Right. So that needs to be a constant team decision. Yeah, and I can't know what I don't know. If you don't tell me.
That's true. But you know what, everybody out there who's heading back to work and you got yourself a quarantine puppy, and you're gonna put that puppy in doggy daycare, or you're gonna board them in a kennel on weekends, because you're headed back out for regular life. Hey, tell your veterinarian because their risk profile might shift. It might not. But it might not. But it might. Great point. Great point. Dr. Jason. Anything else you want to ask smarty pants?
No, no, no, I don't have to ask again. I'm full up on knowledge as always on the podcast. I can't take in any more full knowledge. So thank you very much for edifying me. Like the usage of the word I don't know.
On the show is just amazing, isn't it?
Dr. Jason invested in a thesaurus before we launched this ship. No, I'm just kidding. He didn't You didn't
know I already had one.
Okay, I'm not no. On that note. Thank you so much, Dr. Stone for joining us. And talking all about immunology. We'd love it. We're gonna have your back. Okay, yeah. Well lock the door door. Oh my gosh, everybody. Yes. Okay, so that's like a little teaser for it. So I think that's all we have today for everybody. I'm Dr. Jenn the vet. And I'm Dr. Jason. And she's Dr. Amy stone. We'll catch you guys on the next episode.
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