Risk Assessment for Cat Vaccination

"Veterinarians should still limit vaccination to those needed on the basis of individual risk assessment and should limit the number of concurrently administered vaccinations. Results of the present study indicated risk factors for VAAEs in cats and may help veterinarians individualize vaccine protocols for cats, but further studies are needed to evaluate other vaccines or vaccine types. Results of those studies should be interpreted in light of their clinical relevance and statistical validity and thereafter appropriately incorporated into published guidelines. Although the findings of this study can be used in communication with clients regarding risk of adverse events after vaccination, the low rate and mild nature of most VAEEs in cats should not be a deterrent to the routine use of vaccination for the prevention of important infectious diseases."(George E. Moore, et al. JAVMA "Adverse events after vaccine administration" Vol. 231 #1 July 1, 2007, pp. 94-100)

Are Distemper Shots Safe?

Since there have been no controlled studies, there can be no definitive answer to this issue. Because distemper comes under a combined viral booster, it is even more problematic. There is a persistent strain in the literature from 1990 on, however, and that points to the entire sensitizing mechanism of inflammatory response ... leading to oncogenesis--or the productive of a malignant neoplasm (new cells that are cancerous). Of course, rabies and leukemia have occupied most of the mass media--and the professional literature in part because these hideous cancers were unknown (or at least unremarked upon) until adjuvanted killed rabies and leukemia in the 1980s. Because rabies had been live (without ill effects) and because leukemia was a new vaccine (and was given annually), there is little sense of whether it is the adjuvant (pure and simple) or whether it was the combination--and therefore, over-vaccination that led to the disaster.

It should be mentioned that every oncologist that I have met with, spoken to, corresponded with has agreed that each generation of cats seems more prone to VAS because of hypersensitivity. There obviously needs to be real genetic and immunological work to answer these questions.

For a commonsense warning/advice re: inoculations: see Dr Mike's www.vetinfo4cats.com ... under vaccinations. Most of us are so old that we remember the deadly consequences of distemper ... but we never had cats dying of VAS from distemper shots. Check out the likely risk age for distemper and leukemia. I have lived on this site ...for a few years ... but regrettably, I went to each entry as things happened. How I wish I had reviewed his wise counsel re: vaccinations.

I do think that combination shots, repeated inoculations increase the risk ... This would seem to be borne out by the literature ... over time.

Do Vets Know What They're Doing?

What are we to make of professional journals noting "if tumor recurs, make certain second surgery is done by a qualified surgeon." What are we to make of folks performing make-or-break treatments when they are utterly unqualified? What allows them to practice in this way?

I would think the joy of being an independent practitioner would be the chance to always put the bar higher ... always expect more from yourself ... always keep up. The flood of gratitude that washes upon vets when much loved pets are saved ... isn't that enough of an incentive?

I wouldn't have thought that I could possibly be more horrified than I was. But these 8 months of working through the literature has undone me. To have gone in Jan 07 to our specialists of 20 years (absolutely wonderful then ... but they obviously have felt no need to keep up) with Natty ... complaint: every night after falling asleep he awakens with a sharp cry and gnaws at his right flank. Answer (after a $600 workup): Behavioral ... sometimes cats just go wiggy. When I asked the oncological team, shortly after his surgery, whether any of them thought that was the beginning of his cellular changes ... each vehemently agreed. Though I do not believe that there was any intervention possible at that point, I wish that I had been believed that something dreadfully was wrong with Natty.

Grading Tumors

Best article I have found appears (online) in Veterinary Pathology: "Feline Vaccine-Associated Fibrosarcoma: Morphologic Distinctions" [SS Couto, SM Griffey, PC Duarte, and BR Madewell]

"Tumors were graded based on cellular differentiation, presence and extension of necrosis within the neoplasm, and mitotic rate. All sarcomas were scored 1-3 for overall differentiation (1=tumor cells closely resembled the mature differentiated type; 2=tumors that had a defined histological phenotype; and 3=poorly differentiated tumors), mitotic rates (1=1-0 mitotic figures per 10 400x fields; 2=10-19 figures per ten 400x fields; 3= 20 or more figure per ten 400x fields), and necrosis (1=no necrosis; 2=necrosis of <50% 3=" necrosis">50% of the total area). Final scores of 3-4 were designated Grade I; scores of 5-6 were designated grade II; and scores 7-9 were designated Grade III."

Additionally, presence of "spindle cells" and "multinucleated giant cells" confirm chemically induced neoplasm or cancer.
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The article is quite detailed, has extensive references and illustrations. For those who are dealing with Grade III, it offers a means to visualize neovascularization, cavitation, necrosis.

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Reviewing the literature of 10 professional journals over the last 20 yrs, I have discovered increasing agreement re: the 12-18 signatures of VAS.

A final note: Last November's University of Pennsylvania vet newsletter begins a section on vaccination with "Though not uncommon, VAS..." Hmmm, that which is not uncommon is common ... I guess this represents progress from the earlier "statistically improbable," "rare," "unlikely" of earlier articles.

New Article

Article of interest: Vet Med Today
"Special Report: Summary of adverse event reports for veterinary biologic products received by the USDA from 1999 through 2006" JAVMA, 229/7: Octover 1, 2006. 1100-1101.

Distinguishes between "drugs" (province of FDA) and "biologics" (i.e., vaccinations ... province of Dept of Agriculture)

. Discusses failure to report issues in part due to the voluntary basis of reporting. Notes that clients are often primary reporters ... though imprecise and anecdotal.

For starters: Center for Veterinary Biologics (Dept of Agriculture): 1-800-752-6255 ... may also access web site or FAX.