Rabies Vaccination
Transcription
Rabies Vaccination
Rabies Vaccination Important Things You Need to Know by Jan Rasmusen The U.S. Department of Agriculture (USDA) receives more adverse-reaction reports for the rabies vaccine than for any other vaccine for pets. Although the vaccine is required by law, there’s a lot you can do to make vaccinating safer. Who pays to treat an adverse reaction? You do! In this report, you’ll learn ways to vaccinate more safely. Note: This report is for information purposes only and is not intended to be offering legal or veterinary advice. Subjects covered here include: Adverse reactions Where the vaccine should be injected What to do if your dog has a vaccine reaction How dogs contract rabies What you need to know about the law How rabies laws are made Fighting requirements to overvaccinate Understanding which vaccine is required is important How to vaccinate more safely Selecting a safer vaccine Rabies titer testing Giving multiple vaccines at once Rabies vaccination exemptions Adverse reactions Reactions may occur immediately after vaccination – or perhaps as long as a decade later. Most reactions are mild and resolve quickly, but some are serious and cause longterm illness and even death. Here’s a list of well-known reactions. They are not the only possible reactions. Reactions happening immediately or within several days Soreness or pain Injection-site redness, pain and/or swelling Fever Lethargy Vomiting Facial swelling Circulatory shock Loss of consciousness Death Reactions within days, weeks, months or even years of vaccination Fibrosarcoma (tumor) at the injection site Seizures and epilepsy Allergies Muscle weakness, especially lack of hind end coordination Chronic digestive disorders Skin diseases like Ischemic Dermatopathy / Cutaneous vasculitis Autoimmune diseases affecting the thyroid, joints, blood, eyes, skin, kidney, liver, bowel and central nervous system Behavioral problems including aggression, destructive behaviors, separation anxiety and odd obsessive behaviors (like tail chasing and paw licking). Where the vaccine should be injected Make sure your veterinarian injects the rabies vaccine in your dog’s right rear leg. Watch your vet do it. Do not allow vaccination at the scruff of the neck or anywhere else. Why? This is in part to determine where the rabies vaccine was injected should a fibrosarcoma develop. You won’t like the other reason: Experts say that if a cancer does develop, the hip and leg can be amputated. The back and shoulders cannot. Note: Cats develop injection-site tumors more often than dogs, so the injection-site selection is doubly important. Vaccinate on the right hip, leg or tail. When vaccinating cats, think rabies right; leukemia left. (Learn more about vaccinating cats at truth4pets.org.) If an injection-site lump or swelling develops, take photos and measure its size. Report the reaction to the vaccinating veterinarian immediately and make sure it’s listed in your dog’s file. If the lump/swelling does NOT disappear shortly afterwards -- certainly within a month -- or gets larger and changes shape or texture, see your veterinarian. Take action, as well, if your dog loses hair over the vaccination site or develops unexplained sores anywhere on the head or body. What to do if your dog has a vaccine reaction EMERGENCY: If your dog is breathing heavily, his face is swelling and his eyes are watering, or if he’s vomiting, has hives or is having a seizure or collapsing, your dog is showing symptoms of a potentially life-threatening allergic reaction. CALL YOUR VET IMMEDIATELY and head for your vet’s office or an emergency facility while, preferably, someone else drives. Please plan ahead about where you will go if an emergency does occur. Add phone numbers to your cell phone and note directions to the nearest 24-hour clinic. If your dog was healthy before vaccination, but exhibits a new health or behavioral problem after vaccination, suspect that a reaction may be involved. Promptly report any symptom, no matter how mild, to the vaccinating veterinarian, the USDA and the drug manufacturer. Do not expect your veterinarian to report a reaction; they rarely do. Our webpage, “Reporting Vaccine Reactions,” will show you how. Make sure your vet records the reaction and all details in your dog’s file. And get a copy of the file. You may need it in the future. Warning: Your vet cannot properly treat a reaction if he/she doesn’t realize it is one. Unless the reaction was immediate, and sometimes even then, your veterinarian will likely assure you that the vaccine is safe and couldn’t have caused the problem. This happens even when the reaction is clearly listed as a known adverse reaction on the “package insert” accompanying the product. It’s likely that the veterinarian has not read this insert recently. If you suspect a reaction, ask to see the insert. If the vet doesn’t present it, call the drug manufacturer. I have been unable to find inserts online although one is available for a human rabies vaccine. A Self-Fulfilling Prophecy Vaccine makers tell veterinarians that adverse reactions are mild and rare. Vet schools, which may receive funding from vaccine makers, teach students that reactions are mild and rare. Students are not taught to expect or recognize reactions, nor are they taught how to treat non-allergic reactions As a result, few reactions are recognized and considerably fewer (about 1%) are ever reported. Because few are recognized and reported, reactions must be mild and rare. If your vet insists that your dog is NOT experiencing a reaction, that the symptoms are a coincidence, read Why Veterinarians Don’t Recognize Vaccine Reactions and stand your ground. Trust your gut. No one knows your dog better than you do. Determining how you should treat the reaction is a complex subject that could fill its own book. In the case of an immediate allergic reaction, most veterinarians will give an antihistamine and maybe a corticosteroid. The veterinarian may also throw in a nonsteroidal anti-inflammatory (NSAID) and/or an antibiotic. But giving antibiotics unnecessarily, or giving the wrong antibiotic, can contribute to antibiotic resistance. Holistic veterinarians are generally more experienced in recognizing and treating reactions. They often take over treatment when conventional medicine has failed and have a wide range of remedies. Remedies to help avoid a reaction Veterinarians trained in homeopathy can give remedies before and after vaccination to help ward off an adverse reaction. Integrative veterinarian Margo Roman, DVM, told us: I give 200C Lyssin after the vaccine while the dog is still in the clinic. For a vaccine reaction -- which I rarely get -- I would use the homeopathic remedies Thuja and possibly Arsenicum (if the dog is wheezing) or Carbo veg (if short of breath). I would not choose a NSAID but might possibly use a dose of Dexamethasone (an anti-inflammatory corticosteroid) or Benadryl. I give only one vaccine at a time and only give it to a healthy animal. I’m sometimes contacted to treat reactions after a week, month or three months and those take more work. Sadly, this is a huge part of my practice. Tamara Hebbler, DVM, uses one dose of the remedy Ledum 30C before vaccinating. Afterward, she gives Thuja 30C and Lyssin, dosing once daily for three days. (She also uses a proprietary remedy. You can do a short, inexpensive telephone consult with her before or after vaccinating.) Note: Conventional vets are unlikely to carry Lyssin (aka Lyssinum or Hydrophobinum). Holistic vets trained in homeopathy will likely have it, as does naturalrearing.com and a few other online stores. Naturalrearing recommends that Thuja be given along with Lyssin for rabies vaccination detox and will tell you how to use it. Remedies are no guarantee of protection against vaccine reactions, but often help. Ledum and Thuja (aka Thuya) are available for under $10 at most health food stores and online. Prices I have seen for Lyssin currently range from $21 to $30. Read What to Do When Your Dog Has a Vaccine Reaction for more information. Sadly, there is no National Vaccine Injury Compensation Program for pets as there is for human victims. Occasionally, if a problem is likely linked to a vaccine, the vaccine manufacturer will reimburse at least some of the vet bills. (They will typically deny any causality/culpability and may insist on your silence in return.) Sometimes they’ll pay for a biopsy or other test to verify that the condition was caused by the vaccine. At the very least, the manufacturer is expected to report the reaction to the USDA. What about filing a lawsuit? Vaccine manufacturers are sheltered from liability thanks to the U.S. Congress. If your veterinarian was negligent in some way, you may have a cause of action against him/her. Consult an attorney or consider an action in Small Claims Court. As long as dogs are considered property, you won’t receive a large award, although you may recoup direct expenses if the veterinarian is judged to be at fault. Expect frustration, emotional stress and expense. (Read about Jena Gonzalez’s ordeal when she sued her veterinarian after her cat developed a rabies vaccine injection-site tumor. http://www.vetnegligence-vaccines.com) Brave plaintiffs like Jena may at least encourage negligent veterinarians to be more careful in the future. Read Liability Related to Vaccination to learn more. How dogs contract rabies Rabies is NOT an airborne disease. It’s almost always contracted through a bite from a rabid wild animal. Read more this at http://www.cdc.gov/rabies/exposure/ “… the number of human deaths in the United States attributed to rabies has declined from 100 or more each year to an average of 2 or 3 each year.” http://www.cdc.gov/rabies/location/usa/surveillance/human_rabies.html According to the CDC: “Wild animals accounted for 92% of reported cases of rabies in 2010. Raccoons continued to be the most frequently reported rabid wildlife species (36.5% of all animal cases during 2010), followed by skunks (23.5%), bats (23.2%), foxes (7.0%), and other wild animals, including rodents and lagomorphs [rabbits, hares and pikas](1.8%). “Domestic species accounted for 8% of all rabid animals reported in the United States in 2010. The number of reported rabid domestic animals decreased among all domestic species except cats.... The number of rabies cases reported in cats is routinely 3-4 times that of rabies reported in cattle or dogs.” http://www.cdc.gov/rabies/location/usa/surveillance/domestic_animals.html What you need to know about the law The rabies vaccine, the only vaccine required by law, may be mandated differently from state to state. There is no national rabies law and some county or city laws may differ from state laws. Individual state laws are posted at dogs4dogs.com/rabies-laws or check with your local county animal control. If your area’s laws have changed recently, your veterinarian may or may not be aware of what’s currently required. Important: There is no two-year vaccine. Two sequential vaccines must be given initially for the vaccine to be effective (and legal). Every state requires initial vaccination with the “oneyear” vaccine. For puppies, this is required at three to six months of age as determined by each state. A year later, and every three years thereafter, the “three-year” vaccine is required. If your city or county ordinance requires vaccination more often than required by the state three-year law, lawmakers could be deemed to be practicing veterinary medicine without a license. Contact your state veterinary board and urge them to take action. Sadly, some state veterinary board members have intentionally vaccinated more often than necessary and have refused to stop and to take action until they were forced to! (More on this below.) Find regulations for flying between states or other countries here. How rabies laws are made "Laws are like sausages, it is better not to see them being made." -- Otto von Bismarck (1815-1898), famous Prussian statesman. Rabies laws are generally not made by experts in immunology or rabies vaccination. They’re made by state legislators, very few of whom have medical training. Legislators are assisted by state veterinary officials who likely aren’t vaccination or rabies virus experts. (Knowing how to inject a vaccine is not the same as having expertise in vaccinology or virology.) State public health officers, who may also assist in making laws, have expertise in human, not animal, health. To be fair, most laws are based on good intentions. Unfortunately, a law or proposed change may sound like a great idea yet still be bad science. Laws may be pushed through because of irrational fears about rabies or for financial or political gain. A recent change in California rabies law is a perfect example. The proposed change (to vaccinate puppies at three months of age instead of four) was strongly opposed by California veterinarian, W. Jean Dodds, DVM, an internationally acclaimed rabies vaccine and immune system expert. I joined her, as did the American Holistic Veterinary Medical Association, veterinarian Karen Becker, Kris Christine (co-founder of the nonprofit Rabies Challenge Fund), numerous California dog welfare organizations and countless concerned individuals. We fought the proposed change on the grounds that early vaccination would endanger both human and puppy health. Sadly, because the change sounded good, and understanding the science was problematic, the legislation passed unanimously. In the end, we were able to convince legislators to allow, rather than require, the proposed change. Unfortunately, we doubt that the public, or even most veterinarians, will be aware of -- or understand the importance of -- the distinction. Adding insult to injury, some of the Assemblymembers nicknamed the legislation “Cujo’s Law” after Stephen King’s famous fictional rabid dog. See the video of the legislators enjoying the process on the Assembly floor at Rabies Lawmaking: Not the Scientific Process You Might Envision. So are you stuck with your state law? Maybe. Maybe not. Changing and modifying rabies laws isn’t easy, but can be done. We failed with “Cujo’s Law,” but several years earlier, California citizens convinced legislators to pass Molly’s Law, a medical exemption for dogs with health problems. Join the mailing list at the Rabies Challenge Fund to receive alerts about pending rabies vaccination legislation. Some exciting news is expected soon. Fighting requirements to over-vaccinate Some localities and some veterinarians require rabies vaccination more often than medically or legally necessary. Why? Some veterinarians are unaware of recently changed laws. Others are afraid clients won’t come in on a timely basis. Sadly, more frequent vaccination also increases revenue from county or city licensing fees. Veterinary revenue increases as well from more frequent clinic visits and the accompanying sales of services or products. Vaccinating more often than every three years with the “three-year” vaccine is not more protective and may cause an adverse reaction. Vaccine manufacturers guarantee to the USDA that “three-year” vaccines are protective for three years. All U.S. state laws mandate revaccination at three years. Vaccinating more often than legally or medically required without informing clients of the law, the vaccine’s guaranteed duration of immunity and the potential health risks is unethical. It’s a violation of the legal doctrine of informed consent and is likely “overservicing” or even consumer fraud. Unfortunately, failure to inform and get consent happens every day in all medical professions. Not long ago, a number of veterinarians in Minnesota purposely recorded two-year expiration dates on proof-of-vaccination certificates without informing clients that the vaccines were guaranteed for three years. A local group of concerned dog lovers took action and, with the help of experts like Dr. Ron Schultz, eventually got the problem rectified and the offending veterinarians were sanctioned. It wasn’t easy. (I’m told a similar problem still exists in a neighboring state.) Note: I’ve written detailed information in the new e-book version of my book detailing ways to help convince your dog’s caregivers (vets, groomers, day care providers, etc.) to require only necessary vaccines. Learn more at the bottom of this report. Knowing which vaccine is required is important What’s the difference between the one-year vaccine and three-year vaccine? Worldrenowned vaccination scientist Ron Schultz, PhD, has performed numerous studies that have been the basis for vaccination guidelines for AAHA (American Animal Hospital Association), the WSAVA (World Small Animal Veterinary Association) and AVMA (American Veterinary Medical Association). He says: “There is no benefit from annual rabies vaccination and most one year rabies products are similar or identical to the 3year products with regard to duration of immunity and effectiveness.” He confirmed this in our vaccination DVD. The main difference between one- and three-year rabies vaccines is the length of testing they undergo. Testing ends at one year for the one-year vaccine and at three years for the three-year drug. How long these vaccines might potentially last is currently not proven. And manufacturers have no incentive to find out. The one-year vaccine is not safer. In fact, it is likely less safe because it has to be given more often. The nonprofit RabiesChallengeFund study is your dog’s best hope of avoiding unnecessary rabies vaccination thanks to Fund founders Kris Christine and Dr. Dodds. With principal investigation led by Dr. Schultz, they have been working tirelessly and without financial gain, using USDA protocols to prove that the rabies vaccine gives protection for five, and then seven years, instead of the current three. This study is funded entirely by dog lovers. The five- and six-year results are due soon. In the meantime, here’s what you need to know about the uses of the two vaccines. If your veterinarian uses the one-year vaccine when the three-year vaccine is legally required, your dog will have to be revaccinated one year later, rather than three. Veterinarians, being human, lose records and make errors. It’s up to you to determine that the vaccine is really due and that the correct vaccine is used. Politely ask the vet to check the vaccine label BEFORE vaccinating. Afterward, ask for a copy of the license paperwork and veterinary notes. Make sure they are correct. Put the copies in a safe place -- and in your car(s). Paperwork, not reality, rules. A licensed veterinarian must give the inoculation and provide you with accurate paperwork. Otherwise, your dog will require revaccination. Do not give the vaccine yourself. If you can’t prove the initial one-year vaccine was followed by the three-year vaccine a year later, or if a three-year vaccine wasn’t followed by another within three years, you may be required to restart the series by giving both vaccines again. If you are even one day late with the vaccine, and your dog bites someone, your local health department or animal control will have power over your dog’s fate. They can mandate in-house, or in-shelter, quarantine or even euthanasia -depending on the situation and where you live. Proof of strong rabies antibody titers is not presently a legal substitute for vaccination paperwork but may influence local officials. More about this in an upcoming section. One more thing. Vaccines can’t tell time. Protection doesn’t magically disappear when the guarantee period runs out. Only the legal protection does. How to vaccinate more safely “The only safe vaccine is one that is never used” -- Dr. James R. Shannon, former Director of the U.S. National Institute of Health. Unfortunately, most of us have little choice other than to vaccinate. Here are some tips for avoiding adverse reactions: If possible, give the rabies vaccine three or more weeks away from any other vaccine, wormer, heartworm med, flea med, etc. Failure to do so will greatly increase the likelihood of a vaccine reaction and/or vaccine failure. Do not vaccinate a pregnant animal. If possible, have a veterinarian trained in holistic medicine or homeopathy give the vaccine. Find a referral list here. Vaccinate early in the morning and early in the week, and don’t leave the area for at least an hour. Reactions occurring when your veterinarian’s office is closed, or too far away, can prove disastrous -- even fatal. If possible, do not leave your dog alone after vaccination for at least the rest of the day. Watch for reactions for at least the next 48 to 72 hours. Report any vaccine reaction to your veterinarian immediately. Make sure all details are recorded in your dog’s file. You will need an official record if you want to apply for an exemption to rabies vaccination in the future. If your veterinarian doesn’t agree that the symptoms are a reaction, consider finding another vet while the symptoms are still evident. Avoid public “shot clinics.” If your dog has an adverse reaction, you’ll have limited options and will probably have to go to an expensive emergency clinic for treatment. And if you want to apply for an exemption to vaccination next time around, you won’t have a vet who knows your dog to apply for it. (More about this upcoming.) If you do go to a clinic, insist that the veterinarian give your dog a brief health exam before vaccinating. Alert the vet to any health problems your dog has. If your dog had a previous vaccine reaction, and it’s documented, you may be able to get an exemption. If your dog had a hypersensitivity (allergic) reaction, the World Small Animal Veterinary Medical Association (WSAVA) says: “The use of antihistamines pre-revaccination is acceptable and does not interfere with the vaccinal immune response.” It is, however, no guarantee of safety. Avoidance is much safer. If you are forced to vaccinate, use a brand different from the one that caused the reaction if at all possible. Different brands may contain different ingredients. Rabies titer testing A titer test (pronounced like TIGHTer) is a simple blood test assessing antibodies to a virus found in the blood. For travel to certain locales outside of the 48 contiguous U.S. states, titer results are required to prove that rabies vaccination actually caused an immune response at a legally acceptable level. If your dog has been granted a medical exemption from rabies vaccination (more about this upcoming), you may want to test titers to prove your dog is protected in case he/she bites someone. If you fear your dog might be exposed to a rabid wild animal, you might also want to test titers to make sure your dog is protected. Simply vaccinating does not guarantee 100% protection. Several knowledgeable veterinarians have told me that To get a FAVN rabies antibody to be licensed by the USDA, a rabies vaccine has test, which is required for export needs only protect 88% of the dogs challenged to certain locales, specimens must (exposed to) a live rabies virus. go to the KSU Rabies Laboratory. A Although we have heard that a few locales licensed veterinarian must draw accept titer test results in lieu of rabies the blood and send it off for vaccination, the great majority does not testing with the special completed (although they should). We hope that USDA form. rabies titer standards for dogs will be established soon through the work of the nonprofit Rabies Challenge Fund study. There is currently no legal USDA titer standard for dogs. The titer standard for humans is used for import/export. A rabies titer test is more expensive than other titer tests. I have my dogs’ titer testing done at the nonprofit lab run by Dr. Dodds: hemopet.org. She has the federallyapproved Rabies Diagnostic Laboratory at Kansas State University run the test and then interprets the results. Interpretation by an expert is extremely important. Giving multiple vaccines at once Because the initial rabies vaccine is given puppies around the time that the final “puppy shots” are given (around four months), the rabies vaccine may be given with other vaccines. Don’t do this if you can avoid it, even if it means a confrontation with your vet and/or another trip back to the clinic. A landmark Purdue veterinary school study of 1.5 million dogs (published in the 2005 AVMA Journal and widely cited) demonstrated a significant increase in adverse vaccines when multiple vaccines are given in one visit. This is especially true for, but not limited to, small- and medium-sized dogs. Find a short video and article on the subject here. Some breeds are more affected than others. If multiple vaccines are given during one clinic visit to any size dog, and a reaction occurs, there is no way to know which vaccine caused the reaction and should be avoided in the future. This also makes it more difficult to get an exemption to rabies vaccination. A dog can react badly to one vaccine but not another. Selecting a safer vaccine The rabies vaccine is made from an inactivated “killed” virus because a “modified-live virus” would be dangerous; a live virus could cause the disease it is meant to prevent. To be effective, a killed virus must be boosted with “adjuvants.” Thimerosol (mercury), aluminum and other substances may be used, but the exact adjuvants in veterinary vaccines are trade secrets. Surprisingly, ingredients are not secret for vaccines made for humans. We recently asked Dr. Dodds which rabies vaccines she recommends. For cats, she recommends Merial PUREVAX Feline Rabies. For dogs, she recommends the Merial IMRAB TF 1- or 3-year. But remember, all vaccines have the potential of causing serious adverse reactions in any dog, any time. What does “TF” mean? It stands for thimerosal free; that is, it is free of mercury. Mercury is used as a preservative in vaccines, and is known to produce the syndrome called “ASIA” -- Autoimmune/inflammatory Syndrome Induced by Adjuvants. Many experts believe mercury, a highly toxic heavy metal, to be a dangerous ingredient. Note: Today, the IMRAB TF rabies vaccines appear to be the only ones without thimerosol and are more costly as a result. (A search for other brands netted no results.) Unfortunately, most veterinarians carry only one brand of vaccine and it’s probably not the one that is thimerosal free. In larger practices, some of the veterinarians may even dislike the brand they carry but are powerless to make changes. Vaccines are often selected by price and/or because the practice owner, or the buyer, like it and/or because one manufacturer’s rep does a better selling job than another. Because safety records are not readily available, and because adverse reactions are rarely reported, veterinarians can’t easily compare the safety of vaccines. Most veterinarians will not order the brand you want unless you offer to pay for a whole package (typically 25 doses) -- and probably not even then. In numerous states, rabies vaccines are not offered for sale. Remember: To satisfy legal requirements, only veterinarians may give the rabies vaccine. Call around and find a veterinarian who already uses the brand you want. This veterinarian may, as a bonus, be more enlightened and more concerned about vaccine safety. Find a list of holistic veterinarians here. They may be more likely than conventional vets to carry a safer brand. Rabies vaccine exemptions According to all vaccine manufacturers’ labels, only healthy dogs should be vaccinated. If your dog has a documented history of health problems, or serious reactions to this or another vaccine, and your dog’s lifestyle makes him unlikely to contract rabies, you may be able to get a special exemption or postponement from your local licensing board. Vaccinating an unhealthy animal may prove disastrous, or even deadly. (Consult your veterinarian or local animal control for exemption requirements; exemption availability varies from locale to locale. These dogs generally have to be kept on-leash under an adult’s control.) Willingness to request an exemption varies from vet to vet. (You can’t request one yourself.) The vet who gave the vaccine causing the reaction is the one most likely to be willing to apply for an exemption, but may not if he/she doesn’t “believe” in vaccine reactions. (Yet another reason to find a really good veterinarian before you need one.) See Does Your State Permit Rabies Vaccination Medical Exemptions? for more details. Note: In 2012, American Veterinary Medical Association (AVMA) recommended that dogs with health problems receive exemptions: AVMA Passes a Rabies Vaccination Waiver Recommendation. If your state doesn’t allow exemptions, change the law. Action taken by one person whose unhealthy dog would be endangered by vaccination, backed by a supportive veterinarian, is how exemption laws are changed. My heartfelt thanks goes to Dr. Jean Dodds for reviewing the information in this report. ******* Jan Rasmusen conceived and hosted the Safer Pet Vaccination Benefit Seminar offering veterinarians continuing education credits and raising more than $50,000 to study rabies vaccine immunity. She is the national award-winning author of Scared Poopless: The Straight Scoop on Dog Care (winning Best Health Book and Best Pet Health Book). In 2004, Jan’s dog Jiggy (far left) was diagnosed with autoimmune liver disease. She eventually linked his illness to the rabies vaccine. Jan has three websites dedicated to dog health: truth4pets.org, truth4dogs.com, dogs4dogs.com. Scared Poopless is now an updated and expanded e-book – an Amazon Bestseller! Scared Poopless is recommended by the Journal of the American Holistic Veterinary Medical Association, Animal Wellness Magazine and countless veterinarians. The new e-book has 611 pages and 260+ wonderful color photos in 20 information-packed chapters all told from the perspective of an opinionated dog. The vaccination chapter alone has more than twice the content of the original book. Read the first 10% FREE at Amazon.com. All proceeds benefit dog causes. Download the free Kindle reading app to read the book on most computers, tablets and smartphones. DISCLAIMER This report is for information purposes only. If your pet is ill, on medication or is pregnant or nursing, consult your veterinarian to determine if anything suggested here is contraindicated. The author expressly disclaims any liability, loss, damage or injury caused by reliance on this information. Consult a qualified veterinarian or animal health professional for more information.