Preventative Health Care for Small Animals

Historically, veterinary examinations focused on vaccinations and parasite control; now, however, the focus has broadened to overall wellness, including medical, nutritional, and behavioral health. Examinations by a veterinarian are generally recommended every few weeks for puppies and kittens until they are ~20 weeks old, then at least once a year for dogs and cats. More frequent examinations may be recommended for older animals or those with chronic disease. These examinations have the purpose of health surveillance and wellness planning, which includes appropriate vaccination and parasite control, nutrition counseling, behavioral wellness assessment, and reproductive counseling. End-of-life care is also a focus now, as the human-animal bond becomes ever more important in the pet-owning population.

Vaccines are available for a variety of infectious diseases in dogs, including distemper, parvovirus, hepatitis, leptospirosis, tracheobronchitis, rabies, and Lyme disease. Vaccines available against infectious diseases in cats include those for panleukopenia, rhinotracheitis, calicivirus, rabies, and feline leukemia virus.

Vaccination schedules vary, but generally they are guided by the Recommendations for Core and Noncore Canine Vaccines and the 2020 AAHA/AAFP Feline Vaccination Guidelines. Both sites have lifestyle calculators to aid in creating individualized protocols for patients.

Historically, there was some concern about overvaccination or hyperimmunization of both dogs and cats. Vaccine-associated soft-tissue sarcomas, specifically fibrosarcomas, have been an increasing problem in cats. The etiology of these tumors is not completely understood. They appear at vaccine injection sites; non-viral vaccine components have been implicated. In dogs, there has been some correlation between vaccination and immune-mediated disorders such as immune-mediated hemolytic anemia. The guidelines for dog and cat vaccinations mentioned above recommend a triennial vaccination protocol for adult dogs and cats, and that protocol has been adopted by many veterinary practices. In addition, the guidelines suggest vaccinating cats in an area of the body amenable to surgical resection—ie, distal limbs rather than the torso.

The current canine vaccination guidelines identify core and noncore vaccines. Core vaccines include rabies, distemper, parvovirus, and adenovirus-2. A killed rabies vaccine is available as 1-year and 3-year products. The age of the initial rabies vaccination is dictated by state law or local jurisdiction, as is the frequency of rabies boosters. The distemper, parvovirus, and adenovirus-2 vaccines are available as a combination vaccine. For puppies > 16 weeks old, the vaccine is administered generally at 6–8 weeks, then every 2–4 weeks until they are > 16–20 weeks old. The first booster should be administered no later than 1 year after the final vaccine dose of the initial series. Subsequent boosters should be administered at intervals of ≥ 3 years.

Additional canine vaccines, such as those against Bordetella bronchiseptica, Leptospira, Borrelia burgdorferi, and canine influenza, are considered noncore and are administered according to assessment of the patient’s lifestyle and risk for these diseases. A coronavirus vaccine is also available; however, it is no longer recommended.

Current feline vaccination guidelines also identify core and noncore vaccines. The vaccines against feline panleukopenia (FPV), feline herpesvirus 1 (FHV-1), and feline calicivirus (FCV) are core; new in the current update, the vaccines against rabies and feline leukemia virus (FeLV) are now also considered core. The FPV-FCV-FHV-1 vaccination schedule for kittens starts at 6–8 weeks old, then every 3–4 weeks up to 16–20 weeks old, then again at 6 months old, then every 3 years. The FeLV vaccine is administered at 8–12 weeks, then a booster in 3–4 weeks, and then yearly for high-risk patients and every 2–3 years for patients with less risk.

 Additional feline vaccines (against Chlamydia and Bordetella) may be suggested, depending on the animal's risk of exposure—eg, multicat situations. The feline infectious peritonitis vaccine is no longer recommended. 

Preventive health care measures may include castration or ovariohysterectomy. Historically, it was common to spay and neuter dogs and cats at 4–6 months old in the battle against pet overpopulation. That recommendation now varies for large-breed dogs because some studies have suggested there may be longterm health benefits in waiting to spay and neuter dogs until after they have passed through puberty.1

Parasite control continues to be important. The primary endoparasites of small animals include GI parasites such as roundworms, whipworms, and tapeworms. Heartworm disease, an important clinical entity in both dogs and cats, is preventable with prophylactic treatment. Although a treatment is currently available for heartworm disease in dogs, no safe or acceptable treatment is available for cats. The American Heartworm Society provides treatment guidelines for canine and feline heartworm disease. The primary ectoparasites include fleas, ticks, and mites. Both oral and topical products are available for flea control in dogs and cats.

Another important aspect of parasite control includes the prevention of zoonotic diseases such as visceral larva migrans and toxoplasmosis. Bartonella infection may also be an important vector-borne disease affecting humans.

Nutrition is an important and often overlooked aspect of pet ownership. The explosion in the number of diets on the market with persuasive marketing claims increases the need for nutritional counseling by the veterinary team. Recommended pet foods have been formulated on the basis of extensive research and development. A potential link between grain-free diets and dilated cardiomyopathy in dogs has been identified and is being investigated.1

Helping pet owners monitor their pet’s body condition score to keep the animal lean can add years to the life of the pet because overfeeding and oversupplementation may lead to numerous problems. For specialized health needs, specialty diets are available (both over-the-counter and prescription diets) for young, growing, and geriatric pets, as well as for specific disease processes. (Also see Nutrition: Small Animals.)

Water quality should not be overlooked, especially in rural areas and in kennels and catteries. An unlimited supply of fresh water should be available.

Behavioral wellness is increasingly important for the well-being of pets and the human-animal bond. Cats and dogs are affected more by behavior problems than by any other condition. Integrating screening for behavior problems with other health surveillance can be critical to prevention and early intervention. Managing patients in the veterinary environment with attention to both the emotional well-being and the physical well-being of the patients can enhance the bond between pet owners and their pets. Helping owners choose professionals for their pets' veterinary care, training, grooming, and boarding or pet-sitting needs can enhance the behavioral and overall wellness of the pets. See Choosing a Pet Professional Team.

End-of-life care is one of the most difficult and painful experiences that pet owners will face. Sudden death is possible but uncommon. Often, pet owners witness a slow decline of their beloved dog, cat, or other pet. During this period, support from the veterinary professional team is critical to the continued quality of life of the pet. Quality-of-life scales have been developed to assist pet owners in knowing when euthanasia is warranted. It is a great responsibility to make a decision for euthanasia—a decision that should be supported with great empathy from the veterinary professional team. Euthanasia can provide a peaceful, painless death. In cases of animals that are fearful or aggressive, care should be used to select protocols that minimize that fear or aggression. A patient that becomes distressed during euthanasia can leave a heartbreaking impression on an owner that can last for years, even a lifetime.