DEAR DR. FOX: Recently, you wrote in your column, "Make the wellness exam part of the needed annual blood test for heartworm prior to resuming post-winter preventive medication; this exam should evaluate kidney and liver function, blood glucose and other essential health indicators."
I thought that there was no treatment for heartworm (at least for cats), and if that's true, then there isn't any point in testing, right? More to the point, just so I'm clear, are you saying we should take our 1-year-old indoor-only cat in for yearly blood testing? Even if she seems healthy otherwise? She's supposed to go in for another rabies shot -- something else I question, again considering she's indoor-only with no possibility of escape -- but we'll get blood work done as well if you think that's wise. -- M.K., Washington, D.C.
DEAR M.K.: You raise an important issue when it comes to the annual wellness exam protocols, which vary from region to region and veterinary clinic to clinic.
The blood test for heartworm infestation is routine for dogs, and if the test is clear, they can be put back on the seasonal preventive medication. Since cats can get heartworm disease -- especially if they get outdoors or onto a porch with defective screens where infective mosquitoes can get inside -- the blood test for such cats, and preventive medication if they do not test positive, is an advised protocol.
Ideally, have the veterinarian come to your home to do the wellness exam, and check my website (DrFoxVet.com) for what most veterinarians consider to be the optimal vaccination protocol for indoor cats. Fortunately, more veterinarians are aware that until recently, too many unwarranted vaccinations have been prescribed for cats and dogs, with attendant risks to both species, as I have documented in my column and in my book "Healing Animals & the Vision of One Health."
DEAR DR. FOX: My 2-year-old female cat is sick. I took her in for her annual checkup last Friday. The vet gave her Pfizer's nasal vaccine FRVC (no distemper). No other medication. She got her last set of vaccinations by injection in November 2013.
On Nov. 26, 2014, she was throwing up and had a fever of 104.6. She got a shot for nausea and a delayed-reaction antibiotic. She started keeping food down. Two days later, she threw up three times overnight. I took her back to her vet. Her temperature was up again. She had eaten and was keeping it down, but got another nausea shot. At the vet, she also got an X-ray, blood work and a stool check. She showed no problems on the X-ray. She had no elevated white cell count, no problems with the stool and no fleas.
Could this be a late reaction to last year's vaccines? What should I do? Her vet says he can give her a shot to bring her temperature down, but I worry because she has already received the other medications. She also has three brothers due for their annual checkups and vaccines. I don't know if I should let them get the nasal vaccine.
I am worried sick about Angel. She's a rascal, but I love her. -- M.H., St. Louis
DEAR M.H.: I am sorry to hear about your trials and tribulations following what should have been a routine wellness examination and what you and your poor cat had to go through, including costly diagnostic tests to rule out a cause other than a delayed adverse vaccine reaction.
I consider this the most probable cause. The new-generation feline vaccines that are sprayed into the cat's nose to protect against panleukopenia (feline distemper), calicivirus and rhinotracheitis (feline influenza or herpesvirus-1) certainly eliminate the possibility of an injection-site cancer developing. Feline nasal vaccine manufacturer Heska Co. also notes that unlike the nasal-spray vaccines, subcutaneous vaccines have been reported to produce a significant antibody response to kidney cells that could be a factor in causing kidney disease later in life. But this does not mean that this new generation of vaccines is safe, and your veterinarian should report your cat's post-vaccination issues without delay to the manufacturer, Pfizer, and the Food and Drug Administration. The suggested injection (probably prednisone) to bring her temperature down may be effective.
I would also ask why your cat, presumably a protected indoor-only cat, who had prior vaccinations, was given this annual booster and what was the justification for giving additional vaccinations, which could have triggered an adverse effect on your cat's immune system.
(Send all mail to email@example.com or to Dr. Michael Fox in care of Universal Uclick, 1130 Walnut St., Kansas City, MO 64106. The volume of mail received prohibits personal replies, but questions and comments of general interest will be discussed in future columns.
Visit Dr. Fox's website at DrFoxVet.com.)