Vet to Vet: Real-World Solutions to Save More Pets – Dr. Julie Levy TAIL VACCINATION IN CATS BALANCING DISEASE PROTECTION AND CANCER TREATMENT WHAT VACCINATION SITE IS USED MOST COMMONLY IN YOUR SHELTER? A. Between the 33% 33% 33% shoulders B. In the legs C. All over All over In the legs Between the shoulders No More Homeless Pets National Conference October 10-13, 2013 1 Vet to Vet: Real-World Solutions to Save More Pets – Dr. Julie Levy Feline injection site sarcoma • FISS develops in 1-10 per 10,000 cats vaccinated • 8,000-10,000 cases annually • High post-operative local recurrence rate and mortality • Best outcomes with radical and disfiguring surgery • 5-cm margins • 2 tissue planes deep Bladder à Photos courtesy of Dr. Nick Bacon Currently recommended vaccination sites Are these sites the best for cats and surgeons? No More Homeless Pets National Conference October 10-13, 2013 2 Vet to Vet: Real-World Solutions to Save More Pets – Dr. Julie Levy First step: Ask the experts • Online survey via radiation, surgical, and medical oncology listservs • Asked about preferred sites for feline vaccination considering only the issue of potential surgical treatment of injection-site sarcoma, not other issues such as ease of administration • Respondents: • 45 medical oncology • 37 surgical oncology • 12 radiation oncology “This is an excellent site to vaccinate a cat” No More Homeless Pets National Conference October 10-13, 2013 3 Vet to Vet: Real-World Solutions to Save More Pets – Dr. Julie Levy “What are your top 3 recommended sites for vaccination in cats?” Spontaneous utterance from a survey respondent . "Tail, Tail, Tail! I've been vaccinating my cats in their tails for years and, while I understand the initial hesitancy for practitioners to consider vaccinating in the tail of cats, it is definitely worthwhile from a surgical treatment and potential for cure perspective." No More Homeless Pets National Conference October 10-13, 2013 4 Vet to Vet: Real-World Solutions to Save More Pets – Dr. Julie Levy Is tail vaccination a viable alternative? Second step: Ask the cats 1. Will cats even allow injections in the tail? • Enrolled 60 socialized adult cats admitted to Operation Catnip for spay/ neuter • Each cat was examined, identified with microchip, had blood collected for serology • Randomized every other cat to receive vaccine injections either in the hind limbs or in the distal tail • Injected each cat twice (separate FVRCP and rabies vaccines) • Compared cat reactions to injections using a 6-point scale 2. Will cats have an adequate immune response to vaccination in the tail? • Compare serological responses to feline panleukopenia virus vaccine and rabies vaccine in tail vs. hind limbs • Blood collected prior to vaccinated and at recheck 1-2 months later • Antibody titers performed for FPV and rabies No More Homeless Pets National Conference October 10-13, 2013 5 Vet to Vet: Real-World Solutions to Save More Pets – Dr. Julie Levy Cats examined and blood collected Photographed and microchipped for follow-up No More Homeless Pets National Conference October 10-13, 2013 6 Vet to Vet: Real-World Solutions to Save More Pets – Dr. Julie Levy Cats randomly assigned to traditional site (below the stifle) . or the new site (distal tail) No More Homeless Pets National Conference October 10-13, 2013 7 Vet to Vet: Real-World Solutions to Save More Pets – Dr. Julie Levy Reaction to tail injection Vaccination acceptance scores 60 cats = 120 vaccine injections Tail injection accepted more often than hind limb injection Vaccine acceptanc e 87% No More Homeless Pets National Conference October 10-13, 2013 8 Vet to Vet: Real-World Solutions to Save More Pets – Dr. Julie Levy Serological responses 100% response to FPV All but 1 response to rabies Conclusions • Experts tasked with treatment of injection- site sarcomas are interested in tail vaccination • Cat tolerance and serological responses are excellent for both tail and hind limb injections • The tail is a practical alternative vaccination site No More Homeless Pets National Conference October 10-13, 2013 9 Vet to Vet: Real-World Solutions to Save More Pets – Dr. Julie Levy WOULD YOU TRY TO VACCINATE CATS IN THE TAIL? A. Yes – I can do it! 33% 33% 33% B. No way – people would laugh at me C. No way – cats would hate me Yes – I can do it! No way – people wouldNo way ... – cats would hat... No More Homeless Pets National Conference October 10-13, 2013 10 .