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The Daily Vet by petMD

The Daily Vet is a blog featuring veterinarians from all walks of life. Every week they will tackle entertaining, interesting, and sometimes difficult topics in the world of animal medicine – all in the hopes that their unique insights and personal experiences will help you to understand your pets.

Molly’s Bill Exempts Some Dogs from Rabies Vaccination

I feel compelled to praise the California government for making vaccination an individual decision undertaken as a collaboration between pet owners and veterinarians. This is a victory for our canine companions, as circumstances exist where a vaccination can induce illness and can be a contributing cause of death.

Until Molly’s Bill (AB 258) was signed into law on October 7, 2011, Calif. Health and Safety Code, Sec. 1920 and [Los Angeles] County Code Title 10, Sec. 10.20.220 stated, "Rabies vaccinations are required for all dogs 4 months of age or older. Failure to comply may result in a citation and a court appearance. Vaccinations must be valid for the entire licensing period."

AB 258 will "exempt from the vaccination requirement a dog whose life would be endangered due to disease or other considerations that a veterinarian can verify and document if the dog received the vaccine, as determined by a licensed veterinarian on an annual basis. The bill would also require a dog that is exempt from the vaccination requirement to be confined to the premises of the owner, keeper, or harborer, and would require, if the dog is off the premises of the owner, keeper, or harborer, the dog to be on a leash not to exceed 6 feet in length and to be under the direct physical control of an adult."

Here’s some background on vaccination requirements for California pets. Rabies is the only legally required vaccination for dogs, while cats have no vaccination requirements.

So, who is Molly and what are her health concerns meriting exemption from rabies vaccination? Susan Thixton from the Truth About Pet Food reports:

"Molly is a Springer Spaniel who contracted an autoimmune disease which kills her own red blood cells. Molly contracted this disease after receiving her yearly Rabies vaccine. Understandably so, Molly's owners refuse to revaccinate Molly believing another vaccine would kill her; their veterinarian agrees. However, because California law does not allow for a rabies exemption for sick dogs and cats, Sam and Cecilia Gadd of Chino Hills, CA (Molly's folks) remain in violation of the law and Molly remains in quarantine [under house arrest]."

At the time of Thixton’s quote, AB 258 had not yet been approved.

Both Molly and my dog Cardiff have Immune Mediated Hemolytic Anemia (IMHA). The term immune mediated is more appropriate than autoimmune, as it’s an updated and more specific classification of immune system abnormalities. Immune mediated conditions can be primary or secondary. A primary disease is inherent to one’s genetics and can truly be considered autoimmune. A secondary disease is caused by a stimulus (cancer, infection, toxic or environmental exposure, vaccination, etc.).

Other immune mediated diseases include Immune Mediated Thrombocytopenia (IMTP, where blood-clotting platelets are destroyed) and Pemphigous Folieaceous (a painful form of chronic skin inflammation). Regardless of primary vs. secondary status, unnecessary immune system stimulation should be avoided for pets having these conditions.

AB 258 was up for consideration by legislative assembly in 2010, but it was not approved. California Assemblyman Curt Hagman reintroduced it for the 2011 assembly based on the efforts of the Gadd family and Western University of Health Sciences student Lisa Lippman (who is also my client).

Like the Gadds (and myself), Lippman is personally connected to AB 258‘s cause. Lippman’s beloved and now deceased dog Max suffered from Pemphigus Folieaceous and couldn’t be licensed when she moved to California to attend veterinary school. Max’s rabies vaccination was administered at a time when it was legally necessary for him to receive a booster to satisfy licensing requirements. "A vaccine would stimulate an immune system that has already gone out of control," said Lippman. "[Max] was already protected from all the previous rabies vaccines I've given him over the years. It's a sad situation. I don't want to potentially risk my dog's life for a vaccine for a disease he's already protected from."

"Rabies is a serious and lethal health threat," she added. "This (AB 258) doesn't change the law, it just provides an exemption for veterinarians to do their job."

I agree wholeheartedly with Lippman, as AB 258 promotes the best health of our pets as an individual decision between the pet caretaker and veterinarian instead of a blanket rule mandated by the state of California. Pets that have previously had an adverse response to vaccines are additional examples of when an alternative to vaccination administration should be considered.

As Cardiff’s veterinarian, I closely observe his ability to respond to rabies by performing blood tests (antibody titers) for rabies (along with distemper and parvo) at least every 12 months. Cardiff’s rabies titers have always been adequate despite not having been vaccinated since 2008 — well before his first of three IMHA episodes.

I find comfort in California’s recognition of my status as the primary decision maker regarding Cardiff’s immune system health and vaccination status.

Cardiff suffers from a post-transfusion reaction by acting lethargic and lying in an unusual location during one of his IMHA episodes.

Dr. Patrick Mahaney

Image: Cardiff on transfusion day, by Patrick Mahaney

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