The Rip Van Wrinkler, XX, Issue 4, November 2016

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SOME HEALTH & SCIENCE NEWS

A SURVEY OF CANINE IMMUNITY TO, AND VACCINES FOR, NEWER FLU VIRUSES

DR. JEAN DODDS' PET HEALTH RESOURCE BLOG

The 1918 influenza pandemic infected an estimated 500 million people worldwide and killed potentially 20 million people. In the United States, approximately 675,000 deaths were attributed to this particular virus, which originated in Europe and was carried throughout the world by troops returning home after World War I. It is important to remember that medical science was emerging and missteps were taken. For instance, influenza was not a reportable disease to public health officials at the time, medical doctors were scarce due to the war, doctors often thought it was the common cold, and some thought it was a bacteria causing the symptoms. But, I am not stating this to scare you into running out and getting vaccinated. The 1918 flu was hyper-virulent and mutated several times. Plus, we now have preventive and other measures in place, know more about healthy lifestyles and have a better healthcare system.

In 2008, a groundbreaking study was released about the 1918 pandemic. Eric Altschuler and a team of researchers gathered 32 survivors who were born before 1915. 94% of them (30 people) had produced antibodies that neutralized the 1918 flu virus. The scientists went further and found out that the gene sequence that encoded these antibodies had accumulated many mutations, which suggests that the cells had made further adaptations to similar viruses after 1918. This means they would more than likely not become ill if the 1918 virus cropped up again.

This study proved that naturally generated immunity can be lifelong in humans. At this time, we do not know if dogs have the same lifelong memory cell response to the two newer canine flu viruses, H3N2 and H3N8, because no long-term studies have been conducted at this point in time. I presume dogs would have lifelong immunity to influenza if it is naturally generated.

Researchers and scholars agree that naturally generated immunity is better than vaccine-induced immunity. In regards to influenza, vaccinated immunity is believed to last 2-3 years in humans. Now, let’s pretend that virus XYZ circulated in 2005 and reappeared in 2010. We have three healthy people in their 30’s: one person vaccinated in 2005 and 2010; one person never vaccinated; and, another vaccinated in 2005 but not in 2010. The person that was vaccinated both times will probably not become ill. The person never vaccinated will either become mildly ill or not ill at all since the body recognizes the virus. The person, who was only vaccinated in 2005, will more than likely become sicker than the other two since the body did not learn what to combat by natural exposure to the virus.

Why would the person never vaccinated possibly become just mildly ill? Influenza viruses need to change and mutate to survive. When the vaccine producers predicted that virus XYZ would be circulating again, they were able to adjust it for these potential changes.

As the Centers for Disease Control adroitly points out about flu vaccines, “Antibody elicited by vaccination is generally strain-specific, such that antibody against one influenza virus type or subtype confers limited or no protection against another type or subtype, nor does it confer protection against antigenic variants of the same virus that arise by antigenic drift.” In layman’s terms, influenza vaccines are very specific to the type (Influenza A), subtype (H3N2 and H3N8), and variances of viruses within those categories.

Herein lies the problem with companion animal influenza vaccines: they are generally not adapted for mutations after initial development.

In 2012, Pfizer Animal Health released a study it funded of its H3N8 vaccine which was isolated from dogs in Iowa in 2005. The researchers found that the Iowa vaccine was effective against more recent strains isolated from other parts of the country. However, the researchers noted, “The greatest amount of divergence correlated with the more recent isolates.“ Would the H3N8 vaccine still be efficacious in 2016 and beyond? We do not know. We would need to continually complete studies such as this annually.

These days, the headlines are focused on H3N2, which is the latest flu virus to be identified in dogs in the United States. It was isolated in Chicago, and the vaccine was fast-tracked through the United States Department of Agriculture. To date, there has been one challenge study that has proven that the H3N2 vaccine is efficacious. Then again, we do not know if it would prevent your companion dog from catching this strain of flu or not – no matter where he lives – because we do not know how fast the virus is changing or mutating. So, we do not know if the vaccine developed from Chicago dogs would be effective for the more recent outbreak in Atlanta.

You might be thinking to yourself, “Dr. Dodds, so you don’t think I should have my companion pets vaccinated?” As I always say, it depends on the pervasiveness, region, and the level of potential fatality of a disease. Please refer to the minimal vaccination protocol for my recommendations. In regards to influenza, you probably should allow nature to run its course since the symptoms are generally mild and the fatality rate is extremely low. Your pet will more than likely develop natural immunity that will help protect against further adaptations to similar viruses. If your pet was diagnosed with pneumonia in the past, then discuss whether the flu vaccine should be given in this case with your veterinarian and always take preventative measures.

W. Jean Dodds, DVM
Hemopet / NutriScan
11561 Salinaz Avenue
Garden Grove, CA 92843

References

Cureton, David K, et al. "An Inactivated H3N2 Canine Influenza Virus (CIV) Vaccine Aids in the Prevention of Clinical Disease and Virus Shedding in Dogs Challenged with Virulent H3N2 CIV.” The International Journal of Applied Research in Veterinary Medicine 14.2 (2016): 128-134. JARVM.com. Web. 2 Oct. 2016. http://www.jarvm.com/articles/Vol14Iss2/Vol14%20Iss2Cureton.pdf.

“The Great Pandemic: The United States in 1918-1919.” Flu.gov. U.S. Department of Health and Human Services, n.d. Web. 02 Oct. 2016. http://www.flu.gov/pandemic/history/1918/index.html.

Grohskopf, Lisa A., MD, et al. “Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices – United States, 2013–2014.” Centers for Disease Control and Prevention, 20 Sept. 2013. Web. 02 Oct. 2016. http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6207a1.htm.

Ledford, Heidi. “Remembrance of Viruses past." Nature.com. Nature International Weekly Journal of Science, 18 Aug. 2008. Web. 02 Oct. 2016. http://www.nature.com/news/2008/080818/full/news.2008.1045.html.

Oien, Nancee, BS, MS, et al. "Cross-Reactivity to Field Isolates of Canine Influenza by a Killed Canine Influenza Virus (H3N8, Iowa05) Vaccine." The International Journal of Applied Research in Veterinary Medicine 10.1 (2012): 14-18. Print. http://www.jarvm.com/articles/Vol10Iss1/Salmon1.pdf

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     Lab of Auditory Neurophysiology

     Dept. Biomedical Engineering

     Johns Hopkins School of Medicine

     Baltimore, MD    

Certain therapeutic agents can cause functional impairment and cellular degeneration of the eighth cranial nerve and inner ear.  These drugs are said to be “ototoxic” (or, toxic to the ear/hearing).  The effects may be reversible (as with aspirin, antimalarial drugs, and loop diuretics like lasix) or irreversible (as with the aminoglycosides).

The aminoglycosides are a class of broad-spectrum antibiotics that can produce a profound and irreversible sensorineural hearing loss (SNHL).

Aminoglycoside antibiotics include (generic names):

·       amikacin

·       streptomycin

·       neomycin

·       gentamicin

·       ribostamycin

·       kanamycin

·       tobramycin

·       netilmicin

·       dihydrostreptomycin

The general summary of ototoxic action is that first the outer hair cells of the basal turn in the cochlea are affected, followed by the other two rows of outer hair cells and inner hair cells.  SNHL mostly affects high frequency hearing (so your dog may adjust and still be able to understand YOUR speech (human speech consists of many frequencies, including portions in the low frequency end) but may not react at all to a dog whistle. 

With increased level of toxicity and/or particular sensitivity of individual animals may also produce “vestibulotoxicity,” or toxicity to the vestibular (balance) system.  Symptoms include, but are not limited to, dizziness and loss of balance, nausea/vomiting (especially upon moving head), and nystagmus (involuntary eye movements which look “shifty”).  To demonstrate an explanation of nystagmus, imagine spinning round and round and then stopping and trying to focus on an object straight ahead.  You can actually DO this and may have see your kids do it!- your eyes still look like they are trying to track in the direction that you were spinning.

Aminoglycoside otoxicity/vestibulotoxicity is cumulative and permanent; many symptoms have not reached their full potential until after therapy is stopped (expect that if a dog starts to exhibit problems and therapy is stopped that it may get worse over the next two to three days because some of the drug is still circulating in the system and has not yet reached the hearing & balance systems). 

Major risk factors for toxicity include:

·       therapy lasting for more than 7 days

·       elevated serum levels

·       noise exposure (loud and/or long time course)

·       prior use of aminoglycosides

·       high dose (equal to or greater than 25mg/kg/day)

·       young age (avoid using in neonates completely!)

·       perforated ear drum (for aminoglycoside-containing ear drops)   

To be safe, do not use aminoglycoside-containing eardrops at all and never use any form in young animals (especially neonates).  Aminoglycoside use for topical applications and in the eyes is fairly safe because the actual amount of the antibiotic is so small that it has little or no consequence to the dog.  Be very wary of systemic (injectable or oral) use, though, watching the dose and length of therapy carefully.  These antibiotics are very good if used properly and, in some cases as a last resort in bad infections, there is a time to give in and go against the guidelines discussed above.  If it is an absolute last resort drug, no others will work (always have your vet send out cultures for antibiotic sensitivity tests!!), you must go with systemic treatment.  I’ve only personally run into one infection that required systemic gentamicin, as the bacteria was rapidly mutating and forming resistance to every antibiotic we tried.  In most cases there are many choices for therapy that are just as effective and safer.

Always keep your meds out of your pet's reach. 

I know this goes without saying but imagine having some topical cream with one of these antibiotics in it - the Basenji decides it will make good dental floss-  and then you may run into serious problems.

A lot of people take for granted what may be in those topical creams. Read your triple antibiotic ointment tube’s contents.  What’s that it has? Neomycin.

K9 FLU VACCINE - W. Jean Dodds, DVM

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From Dr. Jean Dodds' Pet Health Resource Blog - 10 July 2016

Nosodes Instead of Vaccines?

Homeopathic nosodes are often touted as alternatives to conventional vaccines. In fact, I often suggest the homeopathic nosode remedies, Lyssin, along with Thuja, to help blunt the effects of potential and actual adverse vaccine reactions. However, I do not recommend nosodes to prevent or treat infectious diseases. They do not generate measurable humoral immunity; the B-cell response we want to protect against infectious diseases. After long term use, some antibody may appear because the companion pet is exposed to the native virus, bacterium or parasite and mounts an immune response.

This is generally the point at which the nosode debate turns from objective to emotional. I empathize if you are concerned about adverse vaccine reactions, have had a companion dog or cat fall ill or even die from the adverse effects of vaccines. As we need to keep this conversation objective; I will review the few canine nosode studies that have been conducted.

Before I move forward, I want to clearly state that I promote a minimal vaccine protocol based on the infectious potential and severity rate of the disease, the effectiveness of the vaccine, the documented regional incidence and prevalence, and the duration of immunity. Also, the general principles discussed here apply to cats and other companion animal species, like horses.

History

The history of smallpox gives us perspective on nosodes and vaccines. The concept of immunity has been around since approximately 430 BC when survivors of smallpox cared for the afflicted. Around the 10th century AD, the Chinese reported taking smallpox pus from infected individuals, drying it and inserting it up the nose of those who never had the disease. Indians would take pox laden blankets and wrap children in them.

The practice of inoculation (aka variolation) is believed to have started regionally around the globe before the 17th century. Inoculation is a derivative of the Latin word, inoculare, meaning “to graft”. Now we use the term more generally, but it originally was the subcutaneous instillation of fresh pus from one infected individual and transferred to another through a cut in the skin. During the 18th century, inoculation was gaining popularity throughout Europe and the American Colonies, and was statistically proven to be effective by Cotton Mather and Zabdiel Boylston, but was still met with skepticism.

The first accounts that cowpox provided cross-immunity to smallpox surfaced during the mid-18th century. Benjamin Jesty, a dairy farmer, applied the philosophy in 1774 to his family by purposefully inoculating them with cowpox.

It is unknown if Edward Jenner was aware of Jesty, but he had heard the comments about the cross-immunity of cowpox. Jenner was a scientist and probably more of a showman. In 1796, Jenner inoculated (still by grafting the skin) a boy with cowpox and renamed it “vaccination” (cowpox is “vaccinia” in Latin). In essence, he popularized the practice.

Concurrently, German Samuel Hahnemann, the father of homeopathy, advanced the concept of nosodes, which are highly dilute biological preparations from an element of a disease or from diseased tissue and used to prevent disease.

The Difference Between Vaccines and Nosodes

Vaccines and nosodes sound the same because they both are derived from diseases but fundamental differences exist.

Preparation

Vaccines are prepared in three steps:
1. An antigen is generated and grown. An antigen is a foreign or toxic substance that induces the immune system to produce antibodies against it.
2. The antigen is isolated from the cells used to create it.
3. The antigen is then mixed with adjuvants, stabilizers and preservatives. Adjuvants increase the immune response of the antigen; stabilizers increase the vaccine’s storage life; and preservatives preserve and also allow for the use of multi-dose vials.

Homeopathic nosodes are prepared in a totally different way to commercial vaccines. Their preparation does not include antigen, but involves serial dilutions of biological material usually by incremental factors of 100. The theory behind their development invokes transfer of the memory message of the vital force or energy from the infectious agent or other material to a diluent having polar identity. This diluent will not be capable of accepting the vital energy message unless it is shaken in a particular manner, termed succussion. The higher the dilution of fluid that is succussed, the more potent will be the nosode product. This dilution must exceed Avogadro’s number (moles) in order to assure that there are no longer any infectious particles in the resultant nosode. Thus, nosodes are safe but may not equate with protection against the intended infectious disease. In other words, they generally do no harm but may not work.

Administration

Vaccines are administered either by injection (shot) into muscle and subcutaneous tissue, orally or intranasally. They have also been used in bait to help immunize wildlife. A variety of vaccination protocols for dogs and cats exist; and national and international veterinary policy guidelines are available for immunizing dogs, cats and horses. My canine protocol calls for a distemper and parvovirus vaccine at 9-10 weeks of age and again at 14-16 weeks. Then measuring serum antibody titers for those two viruses a year later, and then every three years, or more often, if desired. I prefer to wait until a minimum of 20 weeks to give rabies and thereafter as specified by law. Other vaccines such as those for canine adenovirus-2 (hepatitis; cross-protects against infectious canine hepatitis), Bordetella, canine influenza, and canine coronavirus, are generally not essential, as they either immunize against diseases that rarely occur, or the diseases are mild and the vaccines are not fully protective anyway. For leptospirosis, and Lyme disease, which are zoonoses (can infect humans and other species), the need for vaccines depends upon the specific strain seen clinically (leptospirosis), and regional and situational circumstances. Please remember that misinformation, along with fear of exposure and infection should not be the primary determinant here, as any vaccine can elicit an adverse reaction!

Nosodes are given orally. My colleague, Dr. Charles Loops, states that nosodes can be started as early as start at six weeks of age. The dosing interval is every two weeks, then three weeks and monthly. Generally, the nosodes can be stopped at 6 months of age.

Studies

The question that arises about nosodes is whether they actually immunize animals or humans. As we’re not talking about vaccines here, the terms immunization and protection from infectious disease are not really applicable. While, the individual given nosodes may remain healthy in the face of normal environmental/community exposures, this is not proof that the approach works. Only when individuals given nosodes, rather than conventional vaccinations, become ill with the infectious disease addressed by the nosode does one have evidence of nosode failure.

On a positive note, there is a large body of anecdotal evidence from veterinarians, allied health professionals, and the public at large – who use homeopathic nosodes against various infectious disease agents – indicating that their animals have kept healthy. These are not animals that are secluded and would be unlikely to be exposed to infectious diseases. Nevertheless, these reports do not scientifically prove that the nosode worked. Regardless, this is why I advocate a minimal vaccination protocol: to balance protection against deadly diseases yet preserve the integrity of the immune system.

My friend and holistic veterinary colleague, Dr. Susan Wynn, has researched the topic of homeopathy extensively. Her goals are to prove objectively when homeopathy is effective and then have the therapy gain acceptance within the mainstream medical world. She wants fundamentally to change the perception with positive action for the betterment of humans and animals.

In fact, with my encouragement, Dr. Wynn performed a controlled nosode study in the late 1990’s with Dr. Ronald Schultz. Her 1998 Journal of American Veterinary Association article discussed this and two other nosode trials.

Kennel Cough

Possibly the most referenced nosode study was conducted in 1985 by Christopher Day, a veterinary homeopath. He had found out about a kennel cough outbreak at a dog boarding facility in the United Kingdom.

214 – Sample size
62 dogs injected with Enduracell 7. According to the primary source dated May 9, 1990, by Ministry of Agriculture Fisheries and Food, in The London Gazette, the Enduracell 7 vaccine covered distemper, parvovirus, adenovirus-2 (hepatitis), parainfluenza and leptospirosis. Smith-Kline was the manufacturer at the time.
2 dogs given Intrac (Bordetella only) nasally.
150 dogs not vaccinated.
All dogs were given 30c of nosode and then administered the nosode twice per day for 3 days.
92.5% – Kennel cough incidence prior to nosodes
44.3% – Kennel cough incidence after nosode protocol started (significant decrease)
51 – Previously vaccinated developed mild symptoms
1 – Unvaccinated dog developed mild symptoms

Yes; this study would make one undeniably think that the kennel cough nosode was effective and more effective than the vaccine. However, here are my thoughts:

No control group. A control group is a basic, standard protocol with any research study whether homeopathic or conventional.
How was the vaccination history question posed? Was there a timeline or history requested? If no timeline was given or full history requested, the unvaccinated dogs might have been vaccinated years prior [although admittedly, kennel cough vaccines have a relatively short duration of immunity]. We also have no clue when the vaccinated dogs were individually injected.
We do not know the ages of the dogs.
We do not know their antibody levels to the disease prior to and after nosode exposure.

Kennel cough equivocates to the common cold so the symptoms are mild and rarely develop into pneumonia. Most importantly, true kennel cough demands two factors: a bacterium like Bordetella and a virus to produce symptoms. Let’s discount the two dogs only vaccinated with Bordetella. Regarding canine parainfluenza, we rarely hear it causing clinical disease in unvaccinated dogs, so I have not considered the parainfluenza vaccines necessary. With respect to canine influenza and the recent outbreak around Chicago, the current vaccine (H3N8 strain) did not adequately protect against the recent entry into North America of the Asian strain (H3N2). But, new canine vaccines are already available against this H3N2 strain. The clinical difference seen in the early stages of kennel cough and canine influenza is that the former rarely develops a fever and pneumonia, whereas the latter typically exhibits a fever that can lead to pneumonia.

In general, vaccines against the core antigen of a virus usually cross-protect against any mutants that evolve, as it’s the envelope that mutates – canine parvovirus is a classical example as the current parvovirus 2b vaccines still fully protect against both strains 2 b and virulent 2c.

Further, it is widely recognized that the injectable kennel cough vaccines do not provide complete protection against the viruses and bacteria in this complex. Note that the intranasal and oral Bordetella vaccines induce the release of interferon, an immune e protective protein that inhibits viral replication, and thus protects against the other upper respiratory canine viruses. Injectable Bordetella vaccines do not release interferon.

Distemper

Stray dogs – admitted to a municipal shelter – were given a canine distemper nosode to help prevent the spread of the disease. They remained in the shelter for eight days. After the fifth day, they were observed for clinical signs of distemper. The incidence of disease decreased from 11.67% to 4.36%. Again, no control group was used. Additionally, the immune history of these dogs was unknown.

Parvovirus

Dr. Wynn and Dr. Ronald Schultz (University of Wisconsin; Principal Investigator of the Rabies Challenge Fund) performed the only controlled, albeit small, parvovirus nosode study.

13 – Sample size
5 – Unvaccinated control group; not given nosodes
1 – Contact-control dog for the nosode-treatment group
7 – Unvaccinated and given nosodes. Parvovirus nosodes given orally and in ascending potencies in a manner recommended by veterinary homeopaths.
Control and experimental groups exposed to the 2a and 2b strains of canine parvovirus. The dose (1 X tissue culture infectious doses) was less than or equal to the viral challenge a dog would be expected to encounter in a parvovirus contaminated environment.
Results: 5 out of 7 nosode treated dogs passed away; 5 out of 6 control dogs passed away.
Study findings: Parvovirus nosode failed to provide adequate protection from infection or disease.

Dr. Wynn states it most eloquently, “Until well designed studies are completed and thousands of pet owners make a concerted effort to help with potential retrospective studies, nosodes remain an unknown quantity, and I do not recommend using them as a sole strategy for disease prevention.”

On a final note, whenever an alternative approach to conventional medicine is used, the client must be informed that it is an alternative, perhaps unproven modality, and that both oral and written informed consent should be obtained from the client to use any form of alternative, holistic or homeopathic therapy, including the use of nosodes. In the case of rabies vaccine, however, conventional vaccination is required by law and must be followed by all licensed veterinarians. Please remember that all vaccines, included those for rabies are stated on the label to be given to healthy dogs. he only exception to this requirement might be applicable on a case-by-case basis with appropriate justification for exemption or deferral from rabies booster vaccination. In these cases, rabies serum antibody titers are usually performed in order to document an acceptable level of protection in the event of exposure to rabies virus.

W. Jean Dodds, DVM
Hemopet / NutriScan
11561 Salinaz Avenue
Garden Grove, CA 92843

References

Becker, Karen, DVM. “The ABCs of Homeopathic Nosodes." Healthy Pets. Mercola.com, 22 May 2016. Web. 10 July 2016. http://healthypets.mercola.com/sites/healthypets/archive/2016/05/22/homeopathic-nosodes.aspx.

Burns, Katie. " To Titer or to Revaccinate." To Titer or to Revaccinate. American Veterinary Medical Association, 15 June 2016. Web. 10 July 2016. https://www.avma.org/News/JAVMANews/Pages/160701a.aspx.

Day, Christopher. "Canine Tracheobronchitis (Kennel Cough).” (2007): n. pag. Web. http://www.alternativevet.org/Clinical%20Trial%20-%20Dogs%20K-C%20WS009-07.pdf.

Dodds, W. Jean, DVM. “Myths About Thyroid Disorders, Vaccines in Pets.” Veterinary Practice News, 23 June 2016. Web. 10 July 2016. http://www.veterinarypracticenews.com/myths-about-thyroid-disorders-vaccines-in-pets/.

Gross, Cary P., MD, and Kent A. Septkowitz, MD. “The Myth of the Medical Breakthrough: Smallpox, Vaccination, and Jenner Reconsidered.” International Journal of Infectious Diseases 3.1 (1998): 54-60. Web. http://www.ijidonline.com/article/S1201-9712(98)90096-0/pdf.

Rieder, Michael J., and Joan L. Robinson. “‘Nosodes’ Are No Substitute for Vaccines." Paediatrics & Child Health 20.4 (2015): 219-20. May 2015. Web. 10 July 2016. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4443832/.

"Veterinary Product Licences Granted Under Part II of the Medicines Acts 1968 And 1971." The London Gazette; 9 Mar. 1990. Web. 10 July 2016. https://www.thegazette.co.uk/London/issue/52133/page/8879/data.pdf

Wynn, Susan G., DVM. "Animal Studies of Homeopathy." Journal of the American Veterinary Medical Association 212.5 (1998): 719-24. Print.

Wynn, Susan G., DVM. "Vaccination Decisions.” Louise’s Pet Connection, n.d. Web. 10 July 2016. http://louisespetconnection.com/Articles/VacinationDecisions.html

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