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Nomographs Guide Individualized Vaccination Schedules for Puppies

The concept of nomographs has been around for over 50 years, but due to diagnostic testing limitations and access, the practice of requesting nomographs stalled – until recently.

A nomograph is not a test in and of itself, but rather the practical application of a test with several steps, as well as consideration of possible health and lifestyle limitations (variables). Simply put, a nomograph analysis can provide a breeder with an estimated time to vaccinate a litter against canine distemper virus and canine parvovirus.

Before we go through a simplified version of the nomograph process, we need a refresher course on the birthing process of female dogs. Within 36 hours of giving birth, maternal antibodies are transferred to a puppy when he receives colostrum milk from his mother. After that, even though the breast milk contains many antibodies as well as wholesome nutrients, these antibodies can no longer cross the neonatal intestinal mucosal lining.

The maternal antibodies have a half-life that decreases approximately every 9-12 days until the puppy is no longer protected against the disease. For instance, let’s say a puppy’s maternally-derived antibody (MDA) level is 1,000 on day 1. On day 10, it would be 500. On day 20, the antibody level would be 250. On day 30, the level would be 125…and so on. (Note: These are just arbitrary, easy-to-deduce example numbers and are not to be used to estimate when to give your puppy a vaccination.)

Maternal antibodies are important and, depending on their strength, will overpower and neutralize vaccines as well as any natural virus exposure. Basically, vaccinating too early renders the vaccine essentially useless. So, veterinarians, breeders, and new puppy caregivers have to find the perfect time to vaccinate to ensure the vaccine is effective and that the puppy is still protected from these deadly infectious diseases.

Note: This same MDA and nomograph diagnostic process applies to kittens for their serious infectious diseases like that caused by feline panleukopenia virus (a parvovirus of cats).

The nomograph analysis steps into the process to provide individual results. Let’s go through a simplified version of the nomograph.

Step 1. Either two weeks before or two weeks after a female dog gives birth, a blood sample is collected. The blood sample is sent to a veterinary reference laboratory like Hemopet’s Hemolife Diagnostic Laboratory,. This also could be the diagnostic laboratories of university veterinary schools like those at University of Wisconsin-Madison, Michigan State University, Cornell University, Auburn University, and others including commercial labs such as Antech Diagnostics and Idexx.

Step 2. The laboratory runs an antibody titer test for canine distemper and parvovirus.

Step 3. Based on the results, the laboratory will provide a nomograph analysis that conservatively estimates the optimal time to vaccinate a litter against distemper and parvovirus.

Based on a peer-reviewed study published in 2020 (Larson et al.), the researchers compared litters that had a nomograph analysis to those that did not. Turns out, 95.7% of the nomograph group was protected against distemper and 90.5% was protected against parvovirus, whereas only 85.5% of the non-nomograph group was protected against distemper and 81.7% against parvovirus. The data used included date of birth and vaccination history of commercial canine vaccinations for puppies less than one year of age and was compared to more than 5,000 adult dogs with known vaccination histories.

One of the limitations with this nomograph analysis approach is the assumption of 100% percent transfer of MDA. According to the study authors, “Rather than an evaluation of protection for a litter, nomograph analysis of breeding dam antibody level is intended to be a conservative estimate of duration of maternal antibody interference with modified- live viral vaccines. Reported percent transfer estimates of 60 – 70% was confirmed by our laboratory (data not shown). However, because we had transfer rates up to 100% in some excellent colostrum-producing dams, nomograph is calculated based on conservative assumption of 100% transfer from dam to litter.”

Regardless, we found this study to offer a good baseline for further research. It would be interesting to have a large scale nomograph study that compares two litters from the same female dog or, even better, from the same biological parents. Within that, the study can run nomographs 2 weeks before estimated births, measure antibodies in the actual colostrum, and ask about variables that might affect the antibody level outcome of one litter to the next. For instance, was milk replacer used? (Milk replacer closes the gut so maternal antibodies cannot be absorbed.) Was fresh-frozen plasma (FFP) given? Cesarean section or natural birth?

In an instructional video, Dr. Laurie Larson of the University of Wisconsin team discusses some of the additional variables that can affect a puppy’s MDA levels.

#1. The mother is not good at making colostrum. #2. The puppy does not absorb colostrum well. #3. The mother has no interest in the litter and will not nurse.

Thus, because of these variables, the nomograph analysis – as Dr. Larson points out – is an estimate but can provide more accuracy on a case-by-case basis.

Additionally, are you wondering about the reason and benefit of giving FFP to newborn pups?

Sometimes a puppy is weak or orphaned, did not receive enough colostrum, or might have the “fading puppy syndrome”. In this instance, we can replace the colostrum with FFP either by injection or orally in the first 36 hours of life. The FFP then provides a source of globulins (plasma protein antibodies) to protect the puppy against common viruses and other microbes, and to supply important nutrients.

Rescues and shelters frequently have abandoned mothers whose vaccination histories are unknown. Additionally, pregnant and nursing dogs should not be given any vaccines as these could harm her health and the health of her fetuses and newborn litter. So, these organizations would particularly benefit from having a few tubes of FFP on hand.

Plasma treatment for orphaned puppies or for those receiving only minimal colostrum after birth should be given three times in the first 24 – 48 hours of life: 1st at birth; 2nd in 12 hours; and, 3rd time in 12 hours after the 2nd. Treatment for healthy newborns may be repeated at 5 to 14 days of age and then again at 3 to 4 weeks of age. For sick newborns, more frequent transfusions of FFP may be necessary. These transfusions are usually given intraperitoneally (IP), but they can also be given orally in the first 24-36 hours of life. FFP is salty, so it should be followed with a little drop of honey (not raw honey for newborns) or syrup on the tongue. When puppies are two days of age or older, the route of administration must be IP (or IV or subcutaneously) and not oral, as the antibodies in plasma will no longer be absorbed through the gastrointestinal tract.

Hemopet offers 12 mL tubes of FFP that are the ideal size to treat fading puppy syndrome or orphaned pups. To order FFP from Hemopet, please call (714) 891-2022 ext. 1. Hemopet offers a 10% discount to rescues and shelters.

References

“CAVIDS Titer Testing.” Nomograph and Puppy Follow-up Video (30:42 Minutes) | CAVIDS Titer Testing, University of Wisconsin-Madison Veterinary School of Medicine, https://www.vetmed.wisc.edu/lab/cavids/nomograph-and-puppy-follow-up-explainer-video-30-minutes/.

Dodds, W. Jean. “Puppy and Kitten Vaccinations: Timing Is Critical.” Jean Dodds’ Pet Health Resource, Tumblr, 5 Mar. 2014, https://drjeandoddspethealthresource.tumblr.com/post/78666367482/maternal-antibodies-vaccines#.YtgQfXbMLIV.

Dodds, W. Jean. “Treating ‘Fading Puppy Syndrome’ or Orphaned Pups with Fresh-Frozen Plasma.” Jean Dodds’ Pet Health Resource, Tumblr, 7 Aug. 2016, https://drjeandoddspethealthresource.tumblr.com/post/148593018041/treating-fading-puppy-syndrome-or-orphaned-pups#.YtgWLnbMLIV.

Larson, Laurie, et al. “Canine Nomograph Evaluation Improves Puppy Immunization.” Clinical Theriogenology, vol. 12, no. 3, Sept. 2020, pp. 215–221, https://www.vetmed.wisc.edu/lab/wp-content/uploads/sites/12/2020/11/Larson-Clinical-Theriogenolgy-Official-Journal-of-Society-for-Theriogenology-Volume-12-Number-3-September-2020-215-221.pdf.

Mila, Hanna, et al. “Immunoglobulin G Concentration in Canine Colostrum: Evaluation and Variability.” Journal of Reproductive Immunology, vol. 112, Nov. 2015, pp. 24–28., https://doi.org/10.1016/j.jri.2015.06.001, https://www.sciencedirect.com/science/article/pii/S0165037815000923.

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