Every now and then, I have a caretaker ask me why their cat or dog needs a rabies vaccine when they hardly, if ever go outside. Every time I get this question, I cringe, because it is not a simple answer. The easy answer is, because it is required by state and federal law. The true, and far more complicated answer is that rabies vaccination is required, not to protect your pet, but to protect the people your pet may come into contact with.

The first thing you need to understand, is the rabies virus is 99.99% fatal in all mammals once the mammal shows clinical signs of the disease, and people are mammals too. Until an exposed animal shows clinical signs, there is no way of knowing it has rabies. The virus has a very long incubation period, which means an animal could have been bitten as long as 6 months prior to becoming sick. During that incubation period, the animal has the virus, but does not act ill. So just because an animal appears healthy, doesn't mean it doesn't have rabies. It just means that the virus hasn't made it to the animals brain.

Fortunately, we do know that it takes about 10 days for the virus to travel from the salivary glands, where it can then be transmitted to other mammals, to the brain, where it will begin to cause clinical signs of disease. That means that an animal that is still alive two weeks after biting someone could not have transmitted the virus to that victim, even if it was recently bit by a rabid animal. That is why the law requires at least a 10 day quarantine period on all animals that have bitten someone if they are not up to date on their vaccines.

Rabies is endemic in Rhode Island. Racoons, bats and feral cats are the largest carriers of the disease in the wild here, with 3 cats testing positive in the Cumberland/Lincoln area in just the last few months. Pets that are allowed to go outside unsupervised are at a high risk for contact with these animals. Cats, because they are hunters and very territorial are at a huge risk for picking up the disease, simply by interacting with stray cats in their area. Further complicating matters, many cat bites are fairly superficial and may heal without their family ever knowing they were bitten. Cats also show a more paralytic form of the disease than dogs. They tend to develop weakness and disorientation rather than aggression. These signs can be mistaken for a myriad of other far more common conditions, putting everyone interacting with that animal at risk for unknowingly being exposed to a fatal disease.

While your pet may be indoors only, sometimes the wildlife sneaks into the home. Recently we had a family that was feeding strays in their neighborhood. One of the strays made it onto a porch where one of their pet cats was then bit. The stray cat then took off. Fortunately that cat was up to date so all we had to do was treat the bite wound and booster the vaccine. Had the cat not been vaccinated, it would have had to been quarantined for up to 6 months because the biting cat was unavailable for testing, and it can take that long for the bitten cat to become ill. In another situation, a bat that found its way into a household tested positive for rabies. The cats had been playing with the dead bat, and thus were exposed. Again, these cats were vaccinated, so they only required a booster. Had they not been vaccinated, they definitely would have been quarantined for the 6 month incubation period. Whether that quarantine was done in the home, or at a state facility at the family's expense, would have been decided by the State Veterinarian and Health Department, not by us.

Just last month, this clinic had the misfortune of coming into contact with a feral cat that tested positive for rabies. Even though no one was bitten, several members of the clinic had to be given post- exposure vaccines to protect them from exposure to a potentially fatal virus. The cost for this series of 3 – 5 vaccines was between $13,000 and $15,000 per employee...a cost by the way which increases everyone's insurance costs. While the disease is 100% preventable with post-exposure vaccination, the vaccines do have side effects and can make a person feel pretty painful and ill for a few days. We tend to see patients when they are stressed, sick or injured, making the staff's risk for being bitten pretty high. While we take every precaution to avoid being bitten, it still happens. We are required by law to submit a bite incidence report to the animal control officer every time someone is bitten. If a staff member receives medical treatment for that bite wound, their physician is required by law to submit a bite incidence report to the state health department. Once those reports are submitted, the risk is assessed and the health department decides on what course of action is required. It is not up to us. They are acting to protect the health of the human patient.

Unfortunately, the only way to test an animal for the rabies virus, is to take tissue samples from its brain. There are NO BLOOD tests that will screen for the virus because it does not travel via blood, it travels via nerve. If a person is bitten by an unvaccinated animal, or exposed to an unvaccinated animal showing signs consistent with rabies, we must err on the side of caution and either quarantine the animal for ten days, or euthanize it and test it's brain. If the Animal Control Officer decides an animal needs to be quarantined to protect an exposed person, that quarantine may be done at a state facility, and that expense is covered by the pet's family. If the animal control officer says an animal must be tested because the suspicion rate is high, then the animal must be euthanized and tested, regardless of our emotional response to the situation. Again, the virus is deadly once clinical signs begin, and the only way to prevent clinical signs is to vaccinate the person as soon as possible after their exposure. Bites to the face or head will require immediate vaccination or testing, bites to the extremities allow more time for the quarantine process. If an animal dies after biting someone, and is thus unavailable for quarantine, it will need to be tested.

Rabies is becoming a more frequent problem in cats in Rhode Island. Any cat can be a potential carrier. Rabies can be transmitted through saliva easily, from an animal not currently showing clinical signs. Rabies is fatal once clinical signs present, but completely preventable with post – exposure vaccines when needed. Vaccination is very expensive, and has side effects, so the health care system will opt to test an available animal that bites someone to be certain they are positive before unnecessarily vaccinating someone who has been exposed. State law requires all cats and dogs to be vaccinated for rabies, regardless of their lifestyle, for this reason.

In the past, we have relied on our client's ethics, and trusted them when they have told us their pet is up to date. Because many of our client's use our facility only for emergency or urgent care, we have not required proof of rabies vaccination in the past, we have simply treated on good faith. The increased incidence of rabies in the cat population has forced us to change some policies to protect our staff.

• All patient's we see for annual physical exams and vaccination, will now need to be vaccinated for Rabies, regardless of life style. To protect cats from potential vaccine related cancer's, we have switched to a safer rabies vaccine for cats.

• If your pet is vaccinated elsewhere, we will either need a copy of the rabies certificate, or confirmation from the veterinary clinic that the vaccine is up to date.

• Patient's we see for urgent care or emergency appointments, will be asked for proof of rabies vaccination during their follow up care. Either we will call your regular veterinarian for confirmation, or ask that you provide a rabies certificate as proof of vaccination. If we can not verify vaccination, we may ask that your pet be vaccinated once it has recovered in order for us to follow up with its care.

• We will not admit patients into the clinic for elective procedures or work-ups without proof of rabies vaccination. We will vaccinate an animal that is overdue if they are healthy enough to receive the vaccination.

• We will not be able to do technician appointments for patient's without proof of rabies vaccination.

• The Imrab Rabies vaccine costs $18. The Purevax vaccine that has a reduced risk of cancer in cats is $28.

• There are annual rabies clinics offered by the state, and several low cost vaccine clinic's in the area that provide rabies vaccination.

Please understand that we are enacting these policies to protect our staff as well as your pet, and to comply with state law. With everything we try to do, we make sure the benefits outweigh the risks of what we are doing. In this case, given the fatality of the disease, the increase in its incidence, and the low risk and cost of prevention versus treating exposure, we feel very strongly that all patients of the CCVC family, should be vaccinated. We are not insisting that you vaccinate your pet here, we are insisting that your pet be vaccinated if you want us to provide anything other than emergency or urgent care.

For a list of Rabies Clinic's offered by the Rhode Island Veterinary Association, please visit their website.... http://www.rivma.org/owners/rabies-clinics and the Rhode Island SPCA website athttp://rispca.com/pet-resources/almost-free-rabies-clinic/

For more information about rabies in Rhode Island, please visit the state health department's website at

http://www.health.ri.gov/diseases/rabies/

If you would like to find out your pet's vaccination status, or have questions about the cost of examination and vaccination, please feel free to email us at our website's contact page athttp://www.ccvcri.com/contact_us. The website also has information on why we believe it is important to have your pet examined by a veterinarian at least once a year.http://www.ccvcri.com/wellness_care

If you would like to discuss the risks versus benefits of vaccinating your pet, you can do so at your' pet's annual exam, or schedule a consultation with one of our veterinarians any time.

For more information about disorders discussed in this article...please visit the following sites.

The American Association of Food Officers

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Hypertrophic Osteodystrophy

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Feline Diabetes