Rabies Free at 23
June 9, 2021 8:37 PM   Subscribe

My cat is so old, the vet is refusing to vaccinate her. Is this ok?

My cat just hit 20 years old this month and she is "surprisingly" healthy according to the vet, in that she is still alive, eats, has good energy, and is pretty spry (can jump about 8 feet high). But she has kidney problems, thyroid problems, and is losing weight FAST.

Because of her age and related health issues, the vet declined to give her annual vaccines last year. Now the vet won't vaccinate my cat for rabies. That was alarming to me because though she is indoors 90% of the time these days, she still slips out periodically and we have small children in our house.

I googled it and the internet appears to be surprisingly conflicted about rabies vaccinations for cats. My city/county/state doesn't require it for cats of any age and the online materials I read suggested that it wasn't necessary for older cats.

I thought rabies vaccines for cats were an absolute must. Am I wrong about the need for rabies vaccines for cats - particularly older cats? Is there any more official information I can turn to?
posted by Toddles to Pets & Animals (14 answers total)
Good job on getting to 20 years with your kitty. You are taking excellent care of her. So, the thing is, at her age, the risks of another vaccination outweigh the benefits, especially if she's already been vaccinated many times.

It would be different if the cat has never been vaccinated. But if the cat has had regular rabies vaccines on schedule for all of her life, there's an excellent chance that she has good enough immunity. Studies on rabies immunity demonstrate multiyear immunity in most cases.

Why then do we vaccine on a schedule? Because it's the pragmatic thing to do. Given the choice between a $400 test for an antibody titer and a $35 vaccine booster, it makes sense to default to the vaccine booster. In this case, if you would sleep better knowing she has good immunity, there's always the option to ask to do a rabies antibody titer. Please give her some scritches behind the ears for me!
posted by dum spiro spero at 9:11 PM on June 9 [20 favorites]

I understand better now, after re-reading and seeing the part about small children.

Here's a script that will work with almost any vet : "I understand the risks, but you need to know that I take zero chances with my children. I am happy to sign any kind of waiver, and I accept that she might develop serious or fatal reactions. I've put a lot of thought into this, and I have decided that I want to vaccinate my cat."
posted by dum spiro spero at 9:21 PM on June 9 [3 favorites]

I use to work with a vet who only vaccinated his animals every few years because the vaccine generally lasts longer than a year, but goverment regs want it every year. Depending on where you live, there might not even be any rabies cases in the wild AT ALL. Rabies is awful and pretty much 100 percent deadly in humans, which is why there is all of this push around it, and the public health messaging about it is very very clear. In terms of risk through: for example, there hasn't been a reported case of human rabies in IL since 1954.That link also breaks down cases in different animal types, there has been one case in a cat since 2008. Your area may have a bigger or smaller risk than mine though.
posted by AlexiaSky at 9:27 PM on June 9 [6 favorites]

Here's an authoritative reference article if you like that sort of thing. There is a good discussion under the heading of "Creating an Individualized, Lifestyle-Based Vaccination Plan".
posted by dum spiro spero at 9:32 PM on June 9

Ugh I just realized the information I posted only reports through 2018, but the point still stands.
posted by AlexiaSky at 9:33 PM on June 9

In Poland, vets have been recommending that vaccine every other year for cats for at least ten years now, unless you're travelling abroad.
posted by I claim sanctuary at 11:45 PM on June 9 [1 favorite]

When a cat of mine developed an autoimmune condition, the vet recommended no further vaccinations for him, including rabies. She felt that in his case the risk/benefit ratio to his health made vaccination a bad idea, and that as an indoor cat, his existing antibodies from years of shots would be enough. Which is just to say that there are cases where rabies shots aren’t critical given other circumstances.

I wouldn’t sweat this in your shoes. I’d focus more energy on keeping the cat indoors.
posted by Stacey at 4:17 AM on June 10 [3 favorites]

Anecdote: We recently lost our 20-year-old kitty. We had gotten her rabies vaccine maybe 2 weeks before she passed. We were planning to board her in the next few months (for a week or so) while traveling, and the boarding vets wouldn't do so without the rabies vaccine. She was an indoor-only cat, got all her regular vaccines, etc.
posted by Ms Vegetable at 5:23 AM on June 10 [1 favorite]

I know dogs and cats are not the same, but my 17-year-old dog just had a vet appointment, and the vet recommended not doing his regular blood work and the whole spate of vaccines due to his "lifestyle." Basically he's at the age where he's gotten a LOT less active, and therefore the risk/benefit ratio of the stress it takes to vaccinate him isn't worth it.

He did get his rabies, but she only did it due to the legal requirement. I don't know if it's regional, or if it's a dog v. cat thing, but the rabies vaccine he gets is good for 3 years. And she was confident that any of the other vaccines given annually weren't a big deal because we kept on his regular schedule for so long that he likely is still immune (per the titer explanation given above.)

I would push for more information from your vet if you are still concerned, or maybe a second opinion if it's that important to you.
posted by pixiecrinkle at 6:11 AM on June 10

Hi there, I'm a vaccine developer who has worked with veterinary and human rabies vaccines. Part of the issue at hand is that the veterinary rabies vaccine that has a federally-mandated (in the US) requirement for a stated duration of immunity (DOI) along with pretty strident national, state and local laws that require up-to-date proof of current vaccination status (or a waiver).

That might not sound like much, but it does set up a situation in which we--as in, the field of immunology at large--are pretty sure we're giving animals like your cat vaccinations that they probably/possibly don't need. If the manufacturer of a rabies vaccine has done the DOI studies to prove that their vaccine confers, let's say, 2 years of immunity, they then have a product that must be purchased every two years. Doesn't a 2 year DOI mean that the vaccine is only effective for two years? Not at all--it just means that the company did a DOI study for two years.

Well, why wouldn't that company do a longer DOI study? There's the obvious marketing rationale--you sell more doses of the same product if it has a shorter stated DOI--but DOI studies are just plain awful. To carry out a 7 year DOI study of the feline rabies virus, for instance, a lab buys a big group of cats. Half get the vaccine, half don't. Then those cats live in that lab for 7 years. At the end of those 7 years, all of those cats are injected with live rabies virus. For the DOI test to be valid, a set percentage of the vaccinated cats must survive, and a set number of the unvaccinated cates must develop rabies and die (i.e. statistically all of them).

So, understandably, companies aren't rushing out to do these long-term DOI studies. (As an aside, there is one DOI study that's been conducted pretty recently using beagles for a canine rabies vaccine, but the lab that ran the study is... well they're not good, they're not communicative, etc., and that has set such a bad precedent for the entire drawn-out, expensive, brutal process that I can't imagine it inspired hope for other rabies vaccine makers that a long-term DOI study could be done well.)

That brings us to today. We're pretty sure these modern veterinary rabies vaccines confer immunity for longer than the amount of time stated in the DOI documentation. We know how to prove it, but it's distasteful and expensive. Meanwhile we keep giving vaccine doses, which means that the likelihood that any given animal will experience a serious side effect of simply have a major medical problem emerge sometime after one of these routine vaccinations goes up over time. This leads to camps emerging, just like we've seen with the pandemic: you get flat out antivax camps, you get groups that think the vaccine is poison, you get fanatical insistence on abiding strictly by the letter of the law, and no one wins.

I think it's fair to have a deeper conversation about this with your vet. Will your vet talk you through their risk assessment (i.e. are you in an area with limited wildlife reservoirs for the rabies virus, or where wildlife vaccination programs are in effect?)? Will your vet document a veterinary waiver so that you have paperwork on hand to attest to it? Are there steps you can take to further reduce your cats risk of becoming a rabies vector? And so on.
posted by late afternoon dreaming hotel at 6:45 AM on June 10 [44 favorites]

Late Afternoon Dreaming Hotel, why can't you do trials like Human Trials, where you track a large group of test and control "in the wild" and measure differing rates between the two groups?
posted by bbqturtle at 7:28 AM on June 10

In some states rabies is much less common, so much so that in Oregon some vets don't give the rabies vaccine to indoor only cats. We had less than 10 cases of rabies last year reported and it was all in bats, but your state might have a much higher frequency. Consider whether your state's rabies rate is high enough to warrant giving the vaccine for the 10% of the time your cat will be outside.
posted by fiercekitten at 8:44 AM on June 10

bbqturtle, the shortest answer possible is that science treats animals very, very poorly. In the US, there's no legal mandate for even considering animals' pain and suffering in scientific procedures. Even in the EU, where there is a directive that establishes a mandate to replace the use of animal tests wherever possible, this lethal challenge test approach to vaccine testing is still considered the gold standard for efficacy. And so, everywhere, this DOI rule stands.

It's very, very hard to change (human and veterinary) drug tests that have been ensconced in national laws. In the US, for example, if it ends up in the CFR, you're looking at needing a legislative action to change the rules, contemporary science be damned. And when your legislative body works as smoothly as it does in the US... you're stuck with 75 year old science.
posted by late afternoon dreaming hotel at 12:13 PM on June 10 [1 favorite]

The Animal Welfare Act of 1966 regulates the treatment of animals in research, exhibition, transport, and by dealers.

Every institution thereby has an Institutional Animal Care and Use Committee to oversee animal treatment, including consideration of painful treatment, under their purview.
posted by Dashy at 1:56 PM on June 10

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