Tail Vaccinations. The New Protocol For Vaccinating Cats?

Vaccine induced sarcomas are a specific type of cancer caused by the injection of a vaccine. This type of cancer is highly aggressive and requires wide surgical excision to remove. The sarcomas begin as a firm mass under the skin. Based on location and behavior it is recommended that they be surgically removed and submitted for biopsy. I have seen many cats of all ages and breeds, and ages present with their parents concerned about a marble sized knot they stumbled upon while petting their cat. The mass can be painful when palpated, but for some cats it seems to to be bothersome at all. Unfortunately, even with an early diagnosis and surgical intervention most of my patients have recurrence of their cancer and succumb to the sarcoma in a matter of months. The prevalence and nature of this has influenced not only how often we vaccinate our cats but also where we vaccinate. Veterinarians started moving the placement of the vaccine from the shoulder blade area to the extremities when the American Association of Feline Practitioners recommended that vaccines be placed below the elbow or stifle. We also began using three year duration of immunity vaccines instead of annual vaccines.

Cats with sarcomas require aggressive surgical excision with wide margins. Excision for a sarcoma in the shoulder blade area, in many cases, needs to include the dorsal (top) aspect of the spinous processes of the vertebrae. This includes the skin all of the underlying muscle and the top part of the spine. For a general practitioner this surgery is beyond our comfort zone, or ability, so these patients are referred to specialists. The cost of this surgery is in many cases considerable leading many owners to decline treatment. The hope with placing vaccines low on the limb was that if, or when, a sarcoma occurred that the leg could be amputated to remove the cancer and hopefully save the cat.

For those of us who love our cats the thought of a vaccine costing our pet’s life or limb seemed too much to pay. Some clients chose not to vaccinate and others want to vaccinate even less then every three years. The cost-benefit decision was significantly altered by the fear of sarcomas.

Enter Dr. Levy of the University Of Florida College Of Veterinary Medicine. She has just released the findings from her study on feline tail vaccinations. She estimates that “1 to 10 cats out of 10,000 vaccinated against infectious diseases develop cancer at the infection site.” Dr. Levy studied 60 cats and found that using the tail as an injection site was just as effective and should a vaccine cause a sarcoma or require excision the tail is an easy structure to remove and will not disfigure or alter the cat’s ability to function normally. Dr. Levy recommends vaccinating as distally (down the tail away from the body) as possible. She also notes that cats tolerate tail vaccination as well as they do in traditional sites.

After reading Dr. Levy’s study I hesitantly  jumped on the band wagon. Cats are not the easiest patients. The traditional spot of vaccinating between the shoulder blades was chosen because their is ample skin, less chance of being bitten, and it is the place our assistants scruff to hold our patients still. Admittedly, when I first read the article I thought, "this is never going to work." There just isn't enough room to hold safely, and there isn't enough skin to tent to place a SQ shot safely. But if it can save a cat I'm going to try. So, with some trepidation I vaccinated my first cats for a local rescue during their spay/neuter clinic. These cats were waking up from anesthesia and provided a quiet, calm patient for my first vaccination attempts. (Note about vaccinating anesthetized patients..)

I will add a few first impressions. It is difficult to tent the skin in the distal tail. The traditional 22 or 23 gauge 1 inch needle is too long and a bit large to place in the distal tail. I do think that it will take me a while to get used to this protocol. The standard pulling the plunger back to make sure that we are not in a blood vessel before we inject the vaccine needs to be done faster and I in inadvertently hit bone with each attempt when trying distally. Also, if you are placing multiple vaccines it is difficult to get enough SQ space to place them. Lastly, every site I used bled. So, be prepared to hold off those bleeders, and hold the cat, and not stick yourself. Like everything else "practice will make perfect." I  hope.

I will keep you all posted as I transition to the more “lively” patients.

Dr. Levy’s study is published in The Journal of Feline Medicine and Surgery.

I posted this picture on my Wordless Wednesday blog and I received this from a reader;

"I read your blog – love it. 

I wanted to comment on your Dec 18 entry – but not on the blog.  You have a picture of a cat that you just spayed and are giving a vaccine into the tail.  I am assuming that the cat is still under anesthesia since you say:  “a nice, quiet pet to practice this on.”  My concern is that it is not advisable to vaccinate a pet when under anesthesia.  Not that I want to criticize – I just read a lot and have come across this many times – and feel that I should share this with you.  I have attached a link to an article that is posted on the rabieschallengefund.org website and is authored by Dr. Dodds and Dr. Schultz who you are probably familiar with."

Clean Run Article About Vaccines

I sincerely appreciate her reminder! We all learn together, so please never hesitate to offer your opinion, advice, or experience. It is my sincere hope that this blog is an exchange of information to help pets worldwide.

If you have any pet questions, or thoughts to help other pet lovers, please find me on Pawbly, or on Twitter @FreePetAdvice.

Jitterbug Decides

I, like I am sure many of you, feel that I have always had a sort of magnetic attraction to animals. I, in my own modesty, feel as if it is mutual, of course. In retrospect I now understand that they aren’t really attracted to me, moreover, I am always looking out for them. I drive down the road scanning the horizon for deer, groundhogs, and yes, to be perfectly honest, even toads in the road during the summer. I take every opportunity that presents itself to me to try to save every apparently injured, or in need, homeless animal. Its borderline compulsion and I am working on it. At least that’s the mantra I provide my husband.

Jitterbug, is one of the cats that found his way to my house. I live in an old stone farm house in York Co, Pa, where everything is considered “living in the country”. Seems like the cats like it out here. I have 2 cats a year show up. You can almost set your clock by it. I think I know where the source is, but in the country cats are sort of a kin to mice. They are part of the landscape and most people let them just try to keep each others populations in check. I will admit I am not of this school of thought. A cat is a domesticated species. Mankind bred them, and they don’t exist in the wild. They were a species developed by us, and thus I see them as our responsibility. This means that when a cat shows up at my house it is fed, vaccinated, and spayed or neutered. 

Jitterbug was about 6 months old when he started stealing food off of my cats back porch. I saw a little tiger-tabby darting on and off to eat as much as he could as fast as he could for about 2 weeks before I made any attempts to talk to him. My cats were split down the middle by his arrival. Half cared to the point of hissing, yelling, screaming and then attacking, and half had naps to catch up on. I always knew when he arrived. Fearing he would begin to retaliate the hostility I decided it was probably best to try to make friends, see if I could find his “real home”, and then send him back there. Inside we all know he left because the pickin’s were easier at my house. After another two weeks I set a have a heart cat trap for him and within 30 minutes he was caught.

For the first time in a month I could see him in his entirety. He was a beautiful white and black tabby with big green eyes, and he was petrified. I put the cage with him still in it in the garage so he would stay warm and dry. I put a towel over his cage, because every animal feels safer in a dark quiet small box. And I said goodnight.

The next morning he took a ride with me to the clinic. The first thing we always do with a found pet is scan for a microchip. Every pet at my clinic is offered a microchip for free. We provide them for free because we know firsthand how many pets it saves. Did you know that less than 13% of pets find their way home if they get lost? He didn’t have a microchip, it wasn’t a big surprise. He was young unneutered, full of fleas, and not tame. I called every local authority to report him as found, placed him in quarantine, and gave him a FeLV/FIV test. He was clear of both of these deadly infections and he was placed away from all of the other pets for his two week quarantine period. I also started his vaccines, gave him a flea and tick preventative and a formal introduction. Two quiet weeks passed. No one called for him and he didn’t ask for anyone either. He hated being caged, refused to interact in any way shape or form, and his solitary confinement period was ended by his last set of vaccines, a neuter, a microchip and a name. I tried to put him into the general cat population here at the hospital but he still refused to interact in any way. He would lash out at anyone trying to befriend him and I knew his misery was only being matched by the danger he was presenting to the staff

It was at that point that I had to make a decision. There aren’t many options for an unfriendly wild cat. I had to decide whether I would euthanize him or bring him back to my house and release him. I fundamentally was apposed to euthanizing a healthy animal. It wsnt his fault no one ever took the time to give him any time or attention. There is a key period of time that a kitten can be socialized. If you can start touching and socializing and exposing a kitten to human beings before about 3 weeks old they will make a great housecat. The later you wait to do it after that the less likely your chances of success will be. After about 6 months a wild cat stays pretty close to a wild cat. This is part of the reason I love cats. They are their own individual. These no wooing a cat. You have to be determined, patient, and lucky. Dogs, well, dogs are just easier to win over. I like a challenge of a cat, and the pay off of being patient and kind. You earn a cat’s affection, you can buy a dogs.  (ok, I really, really, do love dogs, I just identify with cats). So of course, without telling my husband I took Jitterbug home. I let him free by the back porch hoping he would remember these once familiar surroundings and not run away from fear or resentment. The second I opened the trap he ran like a refugee for freedom. I really wasn’t sure I would ever see him again. The next night there were the familiar cat calls from the back porch. He was back. I was happy to see him.

It has been about a year since then. He now spends every night on the bed next to me and Jekyll and he waits for me everyday I come home from work. I would love to have him inside full time, for his safety, but he is always right by the house, and always comes when I call him, so I will continue to be patient until the day the winter starts to wrap its frigid fingers around us, then he will move in for the winter. He is usually in my arms upside down purring away, 0r playing with the puppies in the front yard.  I may indentify with the cats better, but he thinks he is a dog.

For more information on FeLV or FIV please see the attached link below:

www.petmd.com/cat/conditions/infectious-parasitic/c_ct_feline_leukemia

www.petmd.com/cat/.../c_ct_feline_immunodeficiency_virus_infection

A New Lease on Life, Kiki's Story. Nasopharyngeal Polyps in Felines.

He arrived as they all do; in a small cat carrier. He was hidden from view in a dark enclosed plastic box. Designed to be light weight, these carriers are like a little treasure chest to a veterinarian. You really never know what you are going to find inside. Sometimes the smell gives you a big hint, but I’ll get to that later.

Every vet has learned to peek inside the box before you open the door or even dare to stick your hand in. There are sometimes ferocious little lions hidden beneath a puff of orange fluff.

This is Kiki's story. Kiki is a part of the over 700 cats living in the Animal Rescue Farm just along the Pa-Md border, in a little town called New Freedom, Pa. They are the most devoted bunch of amazing, inspiring, compassionate people I have ever met.

To begin, Kiki is a boy. I know it’s confusing. I can’t really explain why, but that’s a lot of cats they have to manage so some of those cats get some pretty funky, or down right mis-appropriated, names. We have learned to just accept them and go with it. But he is whom he is, Kiki. He sat in his little plastic cat carrier box, hidden quietly in the back. I opened the door. He didn’t lift his head, he didn’t move, he didn’t care about me, or where he was, nor did his internal survival drive tell him to even care about pretty much anything anymore. I could see and hear his rattle and crackle of the all to common ailment of rescue cats “chronic upper respiratory disesase”. How many of these rescues cats do I see? A LOT! You put too many of anything together, and you know what you get? A lot of flu. Send your kids back to school and then grab the tissues, because you’ll need them soon. He had yellow-green snot just caking his nose. Some of it had dried leaving a crust but more was coming down the chute, like a slow flow of yellow-green lava. He could barely breathe, and when you can barely breathe you barely move. I lifted his lifeless thin black body out of the carrier. He didn’t fight, or protest, or struggle even a little. I weighed him. 5 pounds, (that’s at least 2 pounds less then he should have weighed). When you only weigh 5 pounds, those 2 pounds really count. That’s 40% of your weight, OMG almost half! We quickly made up a treatment a very basic treatment plan for him. The good ole basic stand-by treatment plan, fluids, food, and antibiotics. Feed him any damned thing he wanted, try to make it as smelly as possible. When you have a whole nasal cavity full of snot it takes a smelly-smelly morsel to convince you to open your mouth and eat.

We also started him on the antibiotic I call “the big guns”. “The big guns” are the expensive guns. Funny how life always works that way? I was going to hit him hard and keep him on them for at least a month. I was going to make sure that the previous attempts that the rescue had made were either not the strong enough meds, or they weren’t used long enough. I was covering my bases and stacking the deck. We put him in a cage with my treatment plan in place and I moved onto the next little plastic chest of mysterious disease. I didn’t really need 12 years of college for this guy, I thought to myself and I moved onto the next carrier in line.

Over the next few weeks we cleaned more slung snot from the walls, the doors, and the ceiling than anyone could imagine a 5 pound creature could produce. He sneezed, spit, and re-painted our walls. In case any of you are ever thinking of working at a vets office, and need to start at the bottom, (aka kennel), be prepared to not only pick up poop, scoop litter, but oh, yes, scrape snot off of walls is also in the job description. After 4 weeks of “the big guns” he still looked puny and miserable. So I called the rescue director and confessed that my hopes had fallen far short for poor Kiki. I asked if I could put him under general anesthesia, look in the mouth, flush the nose, take head x-rays, pretty much make any stab in the dark that was listed in the text book under ”chronic upper respiratory disease” from my old vet school days. I heard the pause in her voice, (that little jab of falling short of expectations, I get used to it, sigh), and a reluctant “ok”.

The next day, I said hello to Kiki, said a little quiet prayer, crossed my fingers and put him under general anesthesia. His head x-rays showed the damage to the very fine bony turbinates, years of snot eating your nasal passages, but no tumor, score 1 for Kiki. We flushed his nasal passages, until the snot ran a clear saline, and I thought “aahh, now maybe you will be able to breathe, well, at least for a little while”. And then we looked behind his soft palate. This is the area where the hard bony roof of your mouth transitions to the soft part then heads down into your larynx. And there it was an enormous irregular cluster of grape like tissue the size of your thumb. I was never so happy to see such a hideous structure. The veterinary treatment for a big wad of tissue growing in the back of your throat? grab, yank, and pull. And, oh yeah, hope it doesn’t grow back. It was the center stage curiosity of every staff member in the building. We were all happy to see the culprit.

Kiki woke up without any complications and since then he has put on 4 pounds and become the most extraverted, playful, and rambunctious kitty you have ever seen. He decides when you are done playing, when it is time to start playing, and he will slap you if you walk away without his permission. He has become one of our resident cats. And he reminds me everyday why I do what I do.

Here are a few video's of our JVC cats having their polyps removed; 

Here is more information on Nasopharyngeal Polyps. 

Kiki is one of the many reminders of why we work so hard on even the most difficult and chronic cases. Kiki was adopted by one of the vets of the clinic and has a family who sees him as the perfect soul he always was.

If you have a pet with this condition and would like to learn more about it (or any other pet related condition) please ask the amazing people at Pawbly.com. It is free for everyone to use. 

If you would like to learn more about us at Jarrettsville Vet Center please find us here at our website, or like our Facebook page.

I am also on YouTube and Twitter @FreePetAdvice.

If you would like more information on this topic; Nasopharyngeal polyps, then please follow the link below:

www.petmd.com/dog/conditions/respiratory/c_dg_nasal_polyps