Both of my cats have medical conditions (FHV and aortic stenosis) and after the age of 2 I have stopped getting them vaccinated. They are indoors only and never come into contact with other animals. I always get a little pressure from my vet but she has been pretty supportive about my decision to eliminate one more stress on their immune systems. She is a wonderful and caring doctor who always puts the welfare of the animals before anything else.

I have been lucky in finding vets for my dog and ferrets who understand that giving multiple vaccines at the same time can be risky, and let me return in the following weeks after a complete exam to get any follow-up vaccines without paying a recheck. They are taking in by a tech who would administer the vaccine. I always called ahead to find a time when they were not busy, and took my pet in then.

After watching 3 of my ferrets going into shock and seizures after being vaccinated (all in about 20 minutes after arriving home!) I stopped vaccinating them all together. Watching those poor critters convulse was HORRIBLE! I had another ferret also react badly on another occasion, while we were still in the exam room - he ended up in an oxygen box, and had to stay over night (well, he actually went home with my vet, it turns out, and she said her husband wanted to keep him!). I don't think ferret vaccines have been researched enough to prove they really are safe for their biology. I've had ferrets for more than 12 years, and I think non-vacc is the way to go, for their health and safety.

Wow, I'm sensing a bit of hostility regarding the cost of education in some of the previous blogs. Surely everyone knows that most undergrads in any chosen field of studies are coming out of college with hefty loans to repay, regardless of the vast differences in expected/actual income.

"J" , on previous blogs we have had the human doctor post as to how questions are welcome and expected in human medical care. And it has been a grand topic of comparing the vast difference between pet & human care, including the huge malpractice insurance sum to be paid "on top" of those hefty college loans!

Well I can't help but post a comment on this one. I CAN"T STAND IT when someone comes in with a sick animal - and "By The Way, can we vaccinate him/her while she is here?" Seriously? I am sorry but that just seems like a no brainer......if there sick we are not going to ask their immune system to concentrate on something different, maybe make them more sick or have some serious reaction that they may not have otherwise had. I am of the camp anyway that I think we can determine the need for 'yearly' vaccines or alternating vaccine schedules on a case by case basis. I definitely don't think every pet needs to be vaccinated every year.

On a little bit of a side note and in reference to some of the comments made earlier.....I don't understand how people can be upset that when you come to your pets doctor you would be charged an office visit. God Forbid. This whole thing about an annual wellness exam and not having to have another exam any other time of the year or if your in for something else either before or after the time you were in for vaccines is just absurd. When I go to my doctor I would never ask whether or not I had to pay for this visit or not. I had an abscess on my leg that had to be drained and I had to go in for subsequent rechecks and I got charged for each one and you know what I ACCEPT that. I know that humans have 'insurance' but if you not up to you deductible yet you can bet your paying. I am just dying to know if you people who question your vet do the same thing to your human doctor?? You get your teeth cleaned twice a year like your supposed to and not want to pay for it the second time???

As someone stated and if it helps some of you - don't think of it as just paying for a wellness exam or physical exam....really that should be done EVERY TIME you come in for something. And at least where I am from by law I have to exam the animal if I am going to adminster a Rabies Vaccine. IMO I think that the same should hold true for other vaccines with the exception of maybe the IN Bordetella. (But that doesn't mean I would vaccinate sick ones). Your paying for the office time and yes my time and expertise. People need to remember that under all the 'cute and cuddly' this is a business and OUR livelihood.

You want to pay my 120,000 + in school loans???? I will work free....oh wait I still have a mortgage, car payment, utilites, groceries and gas......guess I still need to make some money.

I think people should remember that an office visit/exam fee from a good vet entails a thorough full body exam that can uncover an infinite number of illnesses. The vets I worked for also include nail trimming, ear hair pulling, ear cleaning, and anal gland expression at no extra charge. My family doctor charges me much more to just chat for a few minutes!

Maybe Dr. Khuly can post on vaccine reactions at some point?

Elizabeth: I would make this decision after speaking to the internist I work in partnership with on these cases. Mostly they wouldn't be vaccinated but it depends on the pet's specific risk profile (puppy park, boarding, geographic area, etc.).

Dr. Patty: What is your opinion on vaccinating dogs with Primary/Typical Addison's disease who are stable? There are a lot of opinions on it out there and I was just curious as to yours.

Thanks for the response. I've been lucky as my cats have never had a reaction to a vaccination, but I would never vaccinate with active symptoms. As mentioned I think there is a risk for the herpes, so from that perspective do vaccinate.

Jenny: Like plenty of vets, I won't vaccinate a minimal-risk patient (indoor cat who truly never has the opportunity to get out, for example) if they have a disease that leaves them chronically immunocompromised (as in an IBD case) but that's a decision you make with your vet in a one-on-one setting. Lots of factors come into this decision-making process.

I began minimallyvaccinating Agadore, my standard, at age 3. He had reactions both the previous years after vaccinating him. He was listless, and within three weeks of vaccinating, had horrible ear infections. He also had bad reactions to his heartworm meds. Thankfully he does well on Heartguard.

My vets won't vaccinate sick pets. When I rescued an emaciated, wormy, mangy pitbull, they said he had to get better before they could do anything....and after about 2 months of groceries they vaccinated him, then a few weeks later neutered him.


I am amazed that people ASSUME vaccines are 100% safe. OR for that matter, any procedure or medicine. I may be a nerd, and I probably am, but I research everything that goes into or onto my pets.

Tomcat1: I am reminded of the hours of phone calls and visits with a particular attorney, who felt very, very badly about Pocket's case, including the inhumane methods utilized for euthanasia (he was privy to that long before my experience), never charging a dime. I felt so bad about his time, we went to lunch, my treat. So there are professionals not wrapped up on money---he didn't take the case, though!

Shannon: I am surprised that you weren't offered a brief courtesy tour of the facilty by a knowledgable representative (if not the vet himself), to ask a few simple questions. The 10 yr. old Yorkie with health issues is certainly in need of a good advocate!

As far as a brief recheck, prior to vaccine , I have no qualms with that---although lately I have heard about some pretty steep markup/prices for the vaccine itself!

I actually posted a link to this on our Feline IBD forum...Very good point. The one thing, though, at the bottom....."Getting a steroid shot? Good luck with that rabies shot. " While I would never vaccinate my two pancreatitis/IBD cats while they have active symptoms...I do vaccinate them when they are on steroids...they need steroids to keep them from being sick.

One of them has been on prednisoloone for just over 3 years and would be dead without it. The other started prednsolone (every other day) in January after being very sick...he just had his rabies updated in June (6 months late) but is very healthy now. I don't really care so much about the rabies shot...it is just to comply....But I do find the intranasal FVRCP to be very important. One of my cats gets what we think is mild herpes, particularly anytime he gets run down. So far neither of the other two cats has ever had a virus...and I'm thinking the vaccination must help keep the symptoms mild for the other. If I were to say not to vaccinate when they are on steroids, they may never get a vaccination.

Is that what you meant to say in your closing comment?

Thanks!

I might print out this blog and send a copy to all the vets in my area. They all still recommend yearly vaccinations. They all routinely give rabies shots when they spay/neuter. They all routinely give vaccinations when an animal comes in for an acute problem, especially if past due or just close to being due (next few months). I've been looking for a vet to perform dentals for my parent's elderly Yorkies and found one with great protocols. Most of his surgeries are twice the cost of everyone in town because he insists on monitoring during the procedure, etc. However, his receptionist states that any animal that comes in must receive vaccinations if they are due (yearly). The vet won’t call me back so I can’t directly ask him if he is willing to make exceptions about the yearly vaccinations (such as a 10 year old Yorkie with seizures and seasonal allergies). So now I either accept subpar protocols or I can pay the $45 office fee just to meet with the vet and discuss the vaccination issue with him (but I can’t let them take the animal out of my sight or they might try to sneak in some vaccinations). I’d like to talk with the vet because I think his intentions are appropriate and his protocols are just out of date.

I think Roxanne started to hit on a big point here. When your pet is in for an illness exam, that is not the time to discuss vaccination protocols, dewormings, etc, unless it is within the context of the illness (fecal exams for diarrhea as an example). Also, in all honesty, your veterinarian is likely spending MORE time with you during that illness exam and some practices will actually charge you a higher exam fee because of that.

Some practices, as has been mentioned, do charge reduced recheck fees and some will even forego them all together. But, what happens when your pet is in for vomiting and the veterinarian advises a recheck in 2 weeks. The owner shows up for the recheck (which is at a reduced rate), vomiting is now resolved and the owner says "hey doc, can you check out the limp on his right rear foot?" Now we have an entirely new problem, yet the owner is not truly paying for a "full" exam. I watched many clients "learn" how to work our "no charge on rechecks until the problem is solved" system during my tenure in practice.

I think what all clients should remember is that the office call (exam fee, whatever) is the charge for the veterinarian's time and expertise. If a veterinarian continually gave away rechecks or charged less than appropriate for their time, their business would suffer and ultimately close. How many times can you call your attorney without being charged for a phone consult? Have you ever seen a veterinarian charge for speaking to a client on the phone? Probably not, I hope!! :-)

I think for poor folks like gennifer who feel that they are being "screwed" by an exam fee either aren't getting the right value for their money (clinic's fault) or perhaps they don't have a full understanding of what all is involved in a simple "checkup".

Good discussion!!

I don't vaccinate sick pets. If the pet has a health problem serious enough to warrant postponement of vaccines, then the pet should be re-evaluated professionally by a vet to be sure the problem is resolved sufficiently to allow for safe vaccination. This is where a subsequent exam charge comes in. If it is brief, then it costs less (at my clinic anyway) than a full exam. I am sorry this bugs some folks but we need to be paid for our time, expertise and facilities. When a vet gives away something somewhere, you pay for it somewhere else through increased fees on another service/product or cutting corners somewhere to trim expenses. There is no free lunch folks. I wish I made as much money as people think I do.

Ooops - "above the minimum"....not "about".

Great post Dr. Patty.

I get very anxious around vaccines, and I would not vaccinate during a surgery or illness period. But I'm also not 100% clear on how vaccines work and am reluctant to administer anything about the bare minimum, as many of them work differently. Whole Dog Journal has a great article this month on Vaccines, how they work and the research being done on proper protocols (Dr. Ron Schultz and Dr. Jean Dodd). It really "broke it down" and cleared a lot of things up for me. It also affirmed that my Vet and I are on the same page (minimal but appropriate). ;)

Last year we were visiting with some old friends in another state. I asked the husband, a veterinarian, his views on vaccinations. I minimally vac. my dogs and wanted to know what schedule he used. He used the yearly, full vaccination schedule. When I questioned the need for yearly vaccinations, he said he considered vaccinations safe and said you could give them every day of the year with no problems. Needless to say I was upset with his lack of concern. I am glad we do not live close, as I would never consider taking my dogs to this vet!

My vet also allows us to go in just for vaccines--skipping the check up if it isn't necesary (assuming the animal has been checked recently). We just have the vaccination done by a tech.

My dogs have had teeth cleaning done when other procedures have been done--at the vet's recommendation. The idea was that the dog was already under anesthetic so the risk was reduced. Seems like a good idea to me!

Roxanne: I think it depends on the overall health of the animal and the severity of the periodontal disease. I'm all for a scaling and polish of healthy but tartar-coated teeth during most simple mass removals, for example. A bladder surgery? Maybe not.

Dr. Khuly, This topic can never be over-stated or repeated too often. The majority of pet-owners still do not fully understand the concept of vaccines and immunity or how powerful the immune system is. Most do not even translate this into human care. A good friend of mine recently lost her healthy grandson 10 hours after multiple vaccine injections---heartbreaking to say the least.

I do believe in vaccine protocol, it is the life-long repetition that I am not in favor of.

In my mind, any old exam isn't an "annual exam," but clearly the practice we go to thinks otherwise. I asked once when my dogs were due for their wellness exam, and the staff seemed confused since both dogs had come in for some little things recently. Then, when I brought Lilly in for a full blood workup and exam to look for any illnesses that might have caused the shift in her behavior, the receptionist seemed shocked that I didn't want to do vaccines at that point ... due later this year.

We also space out the vaccinations since Lilly doesn't do well, if they're all given at once. BUT, our vet hosts vaccination nights, where you only pay for the injection, not an office visit. So, after the first one, which includes her wellness exam, then I just pay for the shots that are spaced out every few weeks. Then, again, we ONLY vaccinate every 3 years, so it's not a frequent issue.

While I'm commenting, I'll add that the other somewhat scary combination thing is doing a dental while the dog is in having some other procedure done. Isn't it true that dentals get all kinds of ick cruising around, not something you want done when a pet is already compromised? Especially since Ginko (my big dog) had bilateral TPLO surgery both knees at age 3 ... metal plates and dental bacteria don't mix ... I believe.

My two cats spent their kittenhood in an overcrowded, epidemic-ridden shelter, and got sick repeatedly there. The shelter gave them their vaccines on a strict schedule, whether they were sick at the time or not. I adopted them at the age of 6 months; it took another 6 months before they reached full health and vigor. Now they're doing great. Their only lingering health problem is itchy allergies to inhaled allergens, especially during pollen season (April-August). I often wonder whether their being vaccinated while sick contributed to their over-reactive allergic immune systems. I guess I'll never know.

I wish that's how they did it here. I worked for my vet for a few months in reception and the biggest complaint I got was the office visit fee. Maybe I should move to Florida...I have enough animals to justify it...lol

Kristie: Most vets have a lower recheck fee (we charge $25 instead of $45). And some of us charge no visit for things like anal gland expression or a follow-up shot or deworming. In many cases I'll split up vaccines so they don't have to be administered on the same day. In these cases we charge nothing extra--no visit, just pop on in and get the shot. Same for Bordetella pre-kenneling, for example. Some vets do try to make things fair for you.

My vet, and many others that I know of, charge an office visit fee every time you setp into their office UNLESS it's for suture removal. This ranges anywhere from $45-75, depending on whether a vet tech can administer a vaccine (intranasal bordatella) or if the vet has to do it (any kind of "look-see").

Not only that...but if I take both of my dogs at the same time I get charged two office visits, despite the fact that we are only taking up one 15 minute time slot.

People want to do right by their pets but can't or don't want to shell out $50 just to walk in the door.

Good point. Our annual visit comes with the visit and the bloodwork/fecal check and vaccines (if needed) as a package to encourage a complete kind of care and so that "wellness" issues take center stage.

Lots of vets do it this way because when a pet is sick you don't really get the kind of well-visit information needed for optimum prevention/maintenance of your pet. We can and often do provide this kind of info during sick visits but I find that most owners aren't in a frame of mind to internalize it at this time.

Having said that, asking you to come back in a couple of weeks for the full shebang is cost effective--you get the recheck built into the well visit. I hope that explains our side of things somewhat.

i know one of the reasons that i make that request despite knowing its not a good idea is that all the vets i've ever gone to will charge me again for a "checkup" when i return for vaccines. i've never been able to go to a vet and not get "screwed" on this "checkup" fee. it's not like my animals have not have their annual already either. or even their followup. it's really obnoxious. i'm hoping that i just have not found a good vet yet and that they don't all charge a "checkup" fee for vaccines.