Unfortunately, the choice of rabies vaccine for cats isn't that easy ... at least for now.
For cats there are two types of rabies vaccines: 1. Killed Virus (also called "inactivated") 2. Recombinant
The problem that comes up with feline vaccines is that some cats develop a very aggressive type of cancer at the vaccination site ... called a fibrosarcoma. They have been called more specifically "Vaccine Associated Sarcomas" (VAS) but the experts seem to be changing the terminology to "Feline Injection Site Sarcoma" (FISS) since they "can" develop after other types of injections as well.
Research has shown that the problem revolves around how the cat's immune system responds to chronic inflammation. What happens is that a mutation occurs to the "p53 gene". The p53 gene is a tumor suppressor gene. When it mutates, it allows tumor growth, i.e. a fibrosarcoma (and occasionally other types of cancer).
The two elements required for a VAS/FISS to develop are: 1. inflammation (particularly chronic inflammation) 2. a genetic predisposition that results in a mutation to the p53 gene in the inflammation
How does this effect vaccination choice?
Killed Virus (inactivated) vaccines are made using a dead virus (e.g. dead rabies). But the immune system knows that something dead is not a threat. So, in order to get the immune system to respond, they MUST use a chemical additive, often aluminum, called an "adjuvant". The whole purpose of an adjuvant is to hold the vaccine at the vaccination site and create INFLAMMATION ... and studies have shown that it is a chronic inflammation that can last months (and likely years).
The other option for rabies vaccines for cats (not for dogs) is the recombinant rabies vaccine (designated as "rRabies"). A recombinant vaccine is made by taking ONLY the small piece of DNA (not the entire virus ... so rabies is not present in the vaccine) that is needed to produce a protein that triggers the immune system to develop antibodies that will protect the cat from rabies. Injecting just that piece of DNA won't work ... so the DNA is inserted (i.e. "recombined" ... hence "recombinant" vaccines) with a carrier virus (known as a "vector"). For the feline rRabies vaccine, the small piece of rabies DNA is inserted into the Canarypox vaccine (vector). Canarypox is a bird virus and cannot reproduce in mammals, so there is no danger of giving a cat "canarypox" disease. But when it tries to replicate, the canarypox breaks apart and delivers that piece of rabies DNA which produces immunity to rabies. It is a very good vaccine that gives very good protection.
What is important, is that the recombinant rabies vaccine does NOT contain any adjuvant and produces very little inflammation that only lasts a couple days.
A recently published statistical study by Dr Phil Kass of UC Davis (who is highly respected) concluded that cats given a recombinant vaccine have a significantly lesser risk of developing a VAS than cats given a Killed Virus rabies vaccine.
Okay, back to the issue of using a 3 year rabies vaccine. ALL licensed 3-year rabies vaccines are ADJUVANTED Killed Virus vaccines ... which increase the risk of a VAS.
The recombinant rabies vaccine is only licensed for 1 year (must be boostered annually) but has NO ADJUVANT and reduces the risk of a VAS.
So here is the dilemma ... vaccinate only every 3 years but use an adjuvanted KV vaccine that increases the risk of an aggressive and lethal cancer.
Or, use a recombinant vaccine that must be boostered every year, but reduces the risk of cancer.
Every vet school in the US and the majority of vaccine experts choose to use only non-adjuvanted vaccines (i.e. they only use the rRabies).
The frustrating thing is that there is a new study in Europe by Merial (which makes the only rRabies vaccine) that shows it protects for at least 3 years ... but it is only licensed in the US for 1 year. Thus the dilemma.
I'm not a vet, so can't say what the cause may be. However, what you describe sounds like a known reaction in some dogs (more commonly in small breed dogs under 25 lbs) after vaccination ... particularly with rabies vaccines (anecdotally, more often with the old Fort Dodge, now owned by Boehringer Ingelheim, RabVac-3 vaccine).
Dr Richard Ford, now emeritus at North Carolina State vet school who is an expert in infectious diseases and vaccines/vaccination protocols ... and a co-author of the 2011 AAHA Canine Vaccination Guidelines (and, a friend of mine) has a personal website on vaccinations. He has a page on "hot topics" in which he talks briefly about "single and multifocal skin lesions characterized as ischemic vasculitis" as a vaccine reaction. The one thing that doesn't sound usual is that you said it happened almost immediately after vaccination. Dr Ford comments that it usually occurs 1 to 3 months after vaccination. So, what you are seeing may be something else.
Dr Ford says that the vasculitis reaction to vaccines can occur at the injection site ... or the ear tips (which sounds like your experience), eyelids, nasal planum, tail, footpads, and occasionally the trunk.
He has a photo on his website of the necrotic vasculitis on the ear tips. You might want to take a look and see if it is similar to what your dog has. Here is a link: http://www.dvmvac.com/HotTopic.shtml#skin
He created the page in 2008, so it is a bit dated now ... but as of then, he said that most dematologists were recommending against treating with corticosteroids (e.g. prednisone) because they might promote coagulation ... which is a problem with vasculitis. He does recommend Pentoxyphylline as your vet also prescribed. Some also prescribe an antibiotic and/or vitamin E, and, if there is a lot of pain, then an analgesic like buprenorphine.
I'm just sharing that from Dr Ford's website ... as something to discuss with your vet and dermatologist. You might ask whether or not it is needed to continue the steroids. You can also have your dermatologist consult with Dr Ford if he thinks it might be a vaccine reaction. I can give you his email address if needed. If the problem is vaccine reaction, that might suggest that it isn't a food allergy reaction.
Since this occurred so quickly after vaccination, it may not be the problem at all since Dr Ford mentions it as more of a delayed reaction (1-3 months after vaccination). On the other hand, it might be wise ... if you used the RabVac-3 ... to use a different brand at the next booster. Also, particularly with small breed dogs, it is now recommended to avoid giving too many vaccines at the same office visit. Generally, it is best to give just the core vaccines, DA2P (Distemper, Adenovirus-2, Parvovirus) and if needed by law, Rabies. If any non-core vaccines are recommended (e.g. Lyme, Lepto, Canine Influenza, Bordetella, Parainfluenza), then they should be given at another office visit with a MINIMUM of 2 WEEKS between vaccination appointments. Studies have shown that the more vaccines given at the same time, particularly to small breed dogs, increases the risk of vaccine reactions. Vaccines save many dogs from disease, but they are biological products and need to be given carefully.
Cats still have the instinct to hide signs of illness or weakness, so when they do show symptoms, it is generally good to try to learn the cause. But many symptoms can indicate anything from something very mild and benign to something very serious. So, it isn't possible to know without further testing ... though some things are likely more probable than others.
I doubt her cat was tested for rabies since the only way to confirm (or deny) rabies is to euthanize the cat and cut its head off to examine the brain. But perhaps the vet simply indicated that she didn't see the typical symptoms of rabies. Hopefully, the cat is up-to-date with its rabies vaccinations and hasn't been exposed to potentially rabid wildlife. So, it is probably very low on the list of possibilities.
Frequently, the test for FeLV (feline leukemia) is combined with the test for FIV (feline immunodeficiency virus), so that may be what was also negative. FIV is sometimes called feline AIDS, though it isn't AIDS, but is in the same class of viruses (retroviruses) as HIV.
You didn't give much information about the cat. How old is she? There are a number of diseases, mostly common in middle-age and older cats, that cause an increase in thirst and also increased urination. If the cat is overweight, then diabetes is a possibility. Older cats are very prone to hyperthyroidism (which usually causes increased hunger, along with weight loss) ... or, perhaps more likely, Chronic Kidney Disease (CKD) which causes increased drinking and peeing.
All of those diseases (diabetes, hyperthyroidism, CKD) can be diagnosed with a simple blood test ... though, particularly for CKD, a urinalysis (urine test) should be done at the same time.
I'm not a vet, but I would think that having at least a standard blood panel done would be a good idea to see how various organs are functioning. If it is an older cat, then a geriatric panel is wise, which may add a few items.
You don't say how the cat is eating. Is she eating well or eating less (or not at all). A common sign of nausea is licking their lips, which might be seen as flicking her tongue out. CKD can cause excess stomach acid that results in nausea, so that might be a possibility. But MANY things can cause nausea. The symptoms can be treated ... e.g. with an antiemitic (anti-vomiting) drug like Cerenia or Ondansetron ... or an antacid like Pepcid AC (but don't give any medication without being directed to by a vet!).
However, it's probably more important to try to learn the cause of the nausea ... or, if the tongue flicking is caused by something else. I would think the vet would also want to check her teeth to make sure she doesn't have dental problems causing pain ... or make sure there isn't some type of foreign body (e.g. string wrapped around the back of her tongue, etc). I assume the vet has already checked for most of that.
As a pet owner, I've learned that we can often sense when there is a problem that is bothering our cats. If your co-owner is still concerned about the tongue flicking, then I would recommend further testing to find out the cause. She might want a second opinion from another vet ... or, if finances aren't a problem, an Internal Medicine or Feline specialist might be helpful. But a simple blood test may solve the problem. Hyperthyroidism and Diabetes are usually fairly easy to manage ... and with supportive care (e.g. increased fluids) many cats live for years with CKD.
I'm really sorry that I didn't see your post four days ago. I was actually at a vet conference specifically to hear and spend some time with one of the top experts in vaccines/vaccinations for dogs and cats (Dr Richard Ford of NC State Univ). Dr Ford is a co-author of the AAHA Canine Vaccination Guidelines (just updated last year) which has become a Standard of Care for vets to follow (though it is not a "protocol", just guidance for vets to develop a protocol). I would have liked to have asked him about your dog(s)'s reaction.
I'm not a vet and have no formal training. Dr Ford has become my mentor and I try to learn from listening to talks at vet conferences and share, as accurately as I can, what the experts are teaching vets.
There are no definitive scientific studies that show a direct connection between IMHA (immune mediated hemalytic anemia) and vaccines. But most of the experts have seen an increase of IMHA in general after vaccinating some dogs. Like many things, it may be that there is something in the genetic make up of an individual dog that causes an abnormal response to vaccines. I don't think the problem is "just" the vaccine because thousands (millions) of dogs are vaccinated with no problems and vaccines have certainly saved the lives of millions of dogs by preventing potentially lethal disease.
I've heard another expert, Dr Ron Schultz (Univ of Wisc, who is a PhD in immunology and has spent his career researching vaccines for dogs and cats) ... say that he doesn't feel that vaccines "cause" IMHA ... but that they may be one "trigger" for it in some dogs. It is known that IMHA can be triggered by several things, including some types of drugs and medications, and I think other disease or health issues. So, vaccines are not the only trigger for IMHA in a genetically susceptible dog.
That said ... and even though a direct link between vaccinations and IMHA has not been proven ... no matter what the initial cause of IMHA, all the experts have said that they would not give additional vaccinations to a dog that had developed IMHA and recovered from it (of course, Rabies law has to be followed, but some states give vets waiver authority for Rabies).
What I don't know since I'm not a vet, is if the neurological issues your dog developed 3 weeks later is also related to the IMHA episode or vaccines. I don't recall hearing that suggested, but I don't have the medical knowledge to know. You may want to see a specialist to make sure it isn't a separate problem that needs treating. If you can't afford a specialist, you might want a second opinion from another vet. But without a definitive diagnosis, it is not possible to predict whether or not your dog will recover on his own.
I wouldn't avoid a vet solely because of a bad vaccine reaction. Sometimes they can't be avoided. But another issue is what and how many vaccines were given at the same time? Lepto is a "non-core" vaccine and a Killed bacterial vaccine that is known to be very reactive. It is recommended that for small dogs, multiple vaccinations at the same office visit be avoided. Rather, give the core vaccines and then a MINIMUM of two weeks later, give a non-core vaccine like Lepto or Lyme. And, if giving a Killed vaccine at the same time as a Modified Live (the core vaccines) ... the two should be given at separate locations (that drain to different lymph nodes). That is new advice from the 2011 Vaccination Guidelines.
I'm sorry you & your dogs have gone through this. Vaccines help many dogs, but it is a biological product that some do not handle well. I don't know if the neurological problem is related or not and without testing you probably won't know. I hope it works out.
I'm sorry to hear about your kitty. You need to get her to a vet NOW! If she has no use of her back legs and her back feet are cold, she may not be getting any blood circulation to her legs. A common cause of that is from a blood clot that originates in the heart and gets lodged in the artery where it splits to go down each leg (sometimes called a "saddle thrombosis"). It can be very painful to the cat and can indicated heart disease (frequently a disease called "HCM" for Hypertrophic Cardiomyopathy) which causes a thickening of the left ventricle of the heart. It would require an ultrasound of the heart to diagnose but a vet can listen for a heart murmur which is often (but not always) present. Your vet can also check for a pulse in the back legs to see if she is getting any blood circulation to them.
If it is a blood clot that is causing the paralysis, there are a couple medications a vet can try to help dissolve it. And a vet can also give her pain medication which is very important.
I'm not a vet and there may also be other causes. Most cats with arthritis have pain walking but still get around and don't drag their back legs. It might be a spinal problem ... but I'm mostly concerned over your comment that her paw pads are cold. She REALLY needs immediate vet care. This could be an emergency situation.
You also mention that she is an "older" cat ... so, if she hasn't had a complete checkup recently, she should have one ... with a senior blood test that, among other things, will check her kidney function and thyroid function. Hyperthyroidism (high thyroid) is also common in older cats and can usually be controlled easily with medication. Uncontrolled Hyperthyroidism can also lead to the same type of heart thickening (and blood clots) as HCM ... but if the thickening is caused by the hyperthyroidism, once that is controlled, the heart will usually improve and return to near normal.
The short answer is that there is very little chance that you might bring FeLV home to your cats.
I'm not a vet but my "hobby" is listening to talks given at vet CE conferences by some of the top veterinary experts and researchers. I've been blessed to become friends with Dr Richard Ford (emeritus at NC State) who is one of the top Infectious Disease and vaccinology experts.
Here is one quote from the 2006 AAFP Feline Vaccination Guidelines' section on FeLV about transmission:
"The virus is extremely labile; thus, exposure to virus persisting in the environment, on fomites, or in aerosolized secretions is not an efficient means of viral transmission."
So, it is saying that FeLV is unstable in the environment and transmission on clothing, hands, etc is not common.
More is said in one of the big vet reference works: "Infectious Diseases of the Dog and Cat" (4th ed just published last Dec, so it is quite current) by Dr Craig Greene, et al. It states that FeLV is very susceptible to disinfectants, soaps, heating and drying and is easily inactivated in the environment within minutes. Therefore even in a household where a cat had or died of FeLV, there is no need for a waiting period to introduce another cat. Even in veterinary hospitals and boarding facilities, all that is needed is to keep cats separated (to avoid direct contact) and to disinfect cages and do routine hand washing between handling cats.
Here are two direct quotes from Dr Greene's book:
"The viral envelope is lipid-soluable and susceptible to disinfectants, soaps, heating, and drying. FeLV is readily inactivated in the environment within minutes. Therefore, close contact among cats is usually required for spread of infection, and indirect transmission (e.g., via feces-contaminated humans) is hardly possible."
"Because of the viral lability, a waiting period is not needed before introducing a new cat into a household after removal of an infected cat. FeLV is not a hazard in a veterinary hospital or boarding kennel as long as cats are housed in separate cages and routine cage disinfection and hand washing are performed between handling cats."
Something else to keep in mind is that KITTENS (particularly those under 4 months of age) are VERY susceptible to FeLV infection (hence the Vaccination Guidelines recommends all kittens be vaccinated for FeLV). However, ADULTS over 8 months of age (i.e. when their immune system has matured) have a natural resistance to FeLV so that it is difficult for an adult cat to become infected ... not impossible, but not easy.
A retroviral researcher at NC State has described it by saying that on a scale of 1-10, where 10 is most susceptible ... kittens are a 10 if exposed to FeLV, while adults are a 1.5. They are not completely immune and can be infected if they have sustained contact, but otherwise healthy adults are very resistant and hard to infect ... even if never vaccinated.
So, if your cats at home are adults over 8 months of age ... there is very little (almost no) risk of your transmitting FeLV to them as long as you wash your hands after playing with the FeLV kitten.
By the way, if you should ever decide to vaccinate your cats for FeLV (which is not needed if they are indoor only cats) be sure to ONLY use the Recombinant FeLV vaccine (Merial Purevax). It is the only FeLV vaccine that is not adjuvanted (adjuvant increases the risk of a vaccine associated sarcoma) AND it gives a very robust "cell mediated immunity" which is beneficial for FeLV which is an intracellular infection.
Forgive my ignorance, what is "A.R."? I thought I was familiar with all the canine vaccines but can't figure out which one you are talking about. I'm not a vet but have listened to many talks on vaccinology given at veterinary continuing education conferences by some of the top experts and researchers. I've become friends with Dr Richard Ford of NC State (emeritus) who is an infectious disease and vaccinology expert and a co-author of the AAHA Canine Vaccination Guidelines which were just updated last September.
The Core vaccines include: Distemper, Adenovirus-2, Parvovirus-2 and Rabies. Is the "A" you mention for Adenovirus-2? It is usually given as a combination vaccine with Distemper and Parvo.
Not classified: Crotalus atrox (because it has a conditional licensure) and the Canine Melanoma vaccine (because it is used to TREAT melanoma, not prevent it)
Besides Adenovirus-2, the only vaccine that starts with an "A" is Crotalus atrox (against the venum of the Western Diamondback rattlesnake).
If by the "R" you mean Rabies ... you have to follow your local legal requirements. If you do not booster according to local laws, your dog would be considered unvaccinated. If it then bit someone, it would either be quarantined (I think anywhere from a few weeks to a few months), or, if there is an immediate need to know the Rabies status, the dog could be killed to check for Rabies. When giving Rabies vaccines, you must go by the duration of immunity that is on the label of the vaccine you use ... either 1-year or 3-years.
For the other vaccines, the duration of immunity and booster intervals generally depend on whether the vaccine is "infectious" (including Modified Live and Vectored Recombinant vaccines) or "non-infectious (Killed Virus/inactivated).
All the Core vaccines (Distemper, Adenovirus-2, Parvovirus) are Modified Live Virus (MLV) vaccines with the addition of one Recombinant (R) Distemper vaccine.
All Rabies vaccines for dogs are Killed Virus (KV).
After all that ... the general recommendations of the 2011 AAHA Canine Vaccination Guidelines, is that when the initial vaccination is given to a dog over 4 months of age (16 weeks):
MLV & Recombinant: One initial dose is all that is needed (though many vets still prefer to give two initial doses). For the Core vaccines, boosters are recommended every "3 or more" years. For any Intranasal vaccines, after the initial single dose, boosters should be given annually (e.g., Bordetella, Parainfluenza)
Killed/Inactivated: TWO initial doses are needed (e.g. Lyme, Lepto, Canine Influenza). The second dose MUST be given 2-4 weeks after the initial dose. If the second dose isn't given, the dog may not be immunized. The exception is Rabies for which a single initial dose is sufficient ... however, an initial Rabies booster MUST be given within 1 year after the initial dose (even if the initial dose was with a 3-yr Rabies vaccine), then future boosters are given according to the vaccine label (1yr or 3yrs).
I'm not sure what vaccine you mean by the "A.R." vaccine. If you mean Rabies, then you are taking a significant risk by not giving boosters, both in terms of protecting your dog, and also putting the dog's life at risk if he/she bites someone. For the other vaccines, there is no legal danger but if you do not booster as recommended, then your dog may not be protected from disease.
The first thing I would do is to call your vet and let her/him know. You vet may want to give some fluids if she is getting dehydrated.
It may be that she needs a different antibiotic. While most cats have no problems with Clavamox ... it can cause vomiting and nausea in some. My own cat was one of them. Twice we tried Clavamox with her and she had major vomiting and obviously felt very sick. Just taking her off of the Clavamox and using a different antibiotic took care of the problem.
But a vet can check her and see if there may be other causes of the vomiting as well. I would recommend talking to your vet ASAP since dehydration and other possible issues could become serious quickly.
Good luck. I hope it is just a matter of changing her antibiotic.
I don't want to be an alarmist ... and since Dr Weigner didn't mention it, it must be a very remote possibility ... but what makes me very nervous is the possibility that the cat might have Rabies.
You mention that this is an outdoor cat and you don't know whether or not it is owned. So, the possibility exists that the cat may not have been vaccinated for Rabies. I don't know where you live nor if you are in an area where there is Rabies in the wildlife. I do know that for many years, in N America each year there have been more cases of Rabies reported in cats than in dogs ... since most dogs are vaccinated but many cats are not (and cats are natural hunters and likely to come into contact with local wildlife).
I'm sure the possibility must be remote but Rabies is nearly universally fatal once you develop symptoms, so not something you want to wait out. But there are post-exposure vaccinations for humans that are protective.
Maybe it isn't necessary ... but I would suggest that you might want to ask around the neighborhood and see if you can find the cat's owner and whether or not he has been vaccinated. If you can't find the owner, it would be helpful to see if you can trap the cat (I think the SPCA or a rescue group may have humane traps that they use for "trap-neuter-return" programs). And then put the cat in quarantine to make sure it doesn't have Rabies (I think it is a couple weeks, but your vet would know legal requirements in the area).
I'm not a vet or doctor or anything ... so, perhaps my concern is not important. But it makes me nervous when someone gets bitten by a feral or unknown outdoor cat. I'm sure that with your Rheumatoid Arthritis, you don't want to go through the post-exposure Rabies vaccinations unless necessary. But maybe you might want to, at least, talk to a local vet to see if you are in an area where there is Rabies in some of the wildlife.
I'm sure that Dr Weigner was thinking about the problem many people have when bitten by a cat ... because cats have natural bacteria in their mouths that can cause severe infection in humans when bitten. So, people need to watch for redness and soreness, etc after a bite and get treated quickly if it occurs. But it sounds like you are okay in terms of infection. But I'm still nervous about a bite from an outdoor cat with unknown Rabies vaccination history. So, I just felt a need to mention it.