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VETT 210 Nursing Care III
Wk 9 ~ Immune System ~ Intro/Stress/Vx/Anaphylaxis
70
Veterinary Medicine
Not Applicable
11/10/2012

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Term
What is the first line of defense? Second line? Third?
Definition
First line of defense
• Is a set of barriers between the internal and external environment
Second line of defense
• involves the innate inflammatory response (including phagocytosis)
Third line of defense
• Includes the adaptive immune responses and the innate defense offered by NK cells
Term
What is the difference between self and non-self?
Definition
Non-self = foreign invaders known as antigens (e.g., microorganisms, foreign material, chemical substances)that threaten the health of an animal
Term
Mechanisms to destroy antigens include:
Definition
- Phagocytosis and destruction of foreign cells
- Lysis of foreign cell membranes
- Inactivation of pathogenic organisms or chemical substances
- Precipitation or clumping (agglutination) of cells or molecules
- An overreactive response results in an immune-mediated disease such as anaphylaxis
Term
List the 5 classes of antibodies
Definition
- IgG
- IgM
- IgA
- IgE
- IgD
Term
For each class of antibodies, list where it is found and what produces it.
Definition
- IgG – the immunoglobulin made during the first exposure to an antigen. It is also the first immunoglobulin made by newborns. Production of IgG is relatively slow, so the animal may become sick before the immune response can conquer the antigen

- IgM – the immunoglobulin that is made when the animal has been exposed to an antigen for a long time or when the animal is exposed to the antigen for the second time.


- IgA – can leave blood and enter tissue fluids. It plays an important role in preventing dzs caused by antigens that may enter the body through mucosal surfaces (e.g. intestinal tract and lungs)

- IgE – associated w/ an allergic response


- IgD – function is unknown
Term
IgG
Definition
the immunoglobulin made during the first exposure to an antigen. It is also the first immunoglobulin made by newborns. Production of IgG is relatively slow, so the animal may become sick before the immune response can conquer the antigen
Term
IgM
Definition
– the immunoglobulin that is made when the animal has been exposed to an antigen for a long time or when the animal is exposed to the antigen for the second time.
Term
IgA
Definition
can leave blood and enter tissue fluids. It plays an important role in preventing dzs caused by antigens that may enter the body through mucosal surfaces (e.g. intestinal tract and lungs)
Term
Antigen
Definition
Any substance that the immune system recognizes and that can stimulate an immune response.
Such invaders include microorganisms (commonly called germs, such
as bacteria, viruses, and fungi), parasites (such as worms), cancer cells, and even transplanted
organs and tissues
Term
Antibodies
Definition
A protein that is produced by B cells and that interacts with a specific
antigen.
Term
Briefly list the steps that occur when the body detects a pathogen.
Definition
- Recognition: To be able to destroy invaders, the immune system must first recognize them. That is, the immune system must be able to distinguish what is nonself (foreign) from what is self. The immune system can make this distinction because all cells have identification molecules on their surface. Microorganisms are recognized because the identification molecules on their surface are foreign.
-
Activation and Mobilization: White blood cells are activated when they recognize invaders. For example, when the antigen-presenting cell presents antigen fragments bound to HLA to a T cell, the T cell attaches to the fragments and is activated. B cells can be activated directly by invaders. Once activated, white blood cells ingest or kill the invader or do both. Usually, more than one type of white blood cell is needed to kill an invader. Immune cells, such as macrophages and activated T cells, release substances that attract other immune cells to the trouble spot, thus mobilizing defenses. The invader itself may release substances that attract immune cells.
-
Regulation: The immune response must be regulated to prevent extensive damage to the body.
Regulatory (suppressor) T cells help control the response by secreting cytokines (chemical
messengers of the immune system) that inhibit immune responses.

Resolution: Resolution involves confining the invader and eliminating it from the body. After the
invader is eliminated, most white blood cells self-destruct and are ingested. Those that are
spared are called memory cells. The body retains memory cells, which are part of acquired
immunity, to remember specific invaders and respond more vigorously to them at the next
encounter.
Term
Where are macrophages found?
Definition
- Develop from a type of WBC called monocytes after monocytes move from the bloodstream to the tissues
- Stay in the tissues
- Ingest bacteria, foreign cells, and damaged and dead cells
- (the process of a cell ingesting a microorganism, another cell, or cell fragments is called phagocytosis, and cells that ingest are called phagocytes)
Term
Where are monocytes found?
Definition
- Monocytes move from the bloodstream to the tissues when infxn occurs
- Over a period of about 8 hrs, monocytes enlarge greatly and produce granules within themselves, becoming macrophages
- Granules are filled with enzymes and other substances that help kill and digest bacteria and other foreign cells
Term
Complement System
Definition
- The complement system consists of more than 30 proteins that act in a sequence: One protein activates another and so on.
- This sequence is called the complement cascade.
Complement proteins have many functions in acquired immunity as well as innate:
- Killing bacteria directly
- Helping destroy bacteria by attaching to them and thus making the bacteria easier for neutrophils and macrophages to identify and ingest
- Attracting macrophages and neutrophils to a trouble spot
- Causing bacteria to clump together
- Neutralizing viruses
- Helping immune cells remember specific invaders
- Promoting antibody formation
- Enhancing the effectiveness of antibodies
- Helping the body eliminate immune complexes, which consist of an antibody attached to a foreign substance (antigen), and dead cells
Term
Innate Immunity
Definition
Innate (natural) immunity is so named because it is present at birth and does not have to be learned through exposure to an invader. It thus provides an immediate response to foreign cells.
However, its components treat all foreign substances in much the same way. They recognize only
a limited number of identifying substances (antigens) on foreign cells, although these antigens are present on many different cells. Innate immunity has no memory of the encounters and does not provide any lasting protection against future infection.
Term
The white blood cells involved in innate immunity are:
Definition
Monocytes (which develop into macrophages)
Neutrophils
Eosinophils
Basophils
Natural killer cells
Each type has a different function. The complement system and cytokines also participate in
innate immunity.
Term
Neutrophils
Definition
- the most common type of white blood cell in the bloodstream,
- are among the first immune cells to defend against infection.
- They ingest bacteria and other foreign cells.
- contain granules that release enzymes to help kill and digest these cells.
- circulate in the bloodstream and must be signaled to leave the bloodstream and enter tissues. The signal often comes from the bacteria themselves, from complement proteins, or from damaged tissue, all of which produce substances that attract neutrophils to a trouble spot. (The process of attracting cells is called chemotaxis.)
- also release substances the produce fibers in the surrounding tissue. These fibers may trap bacteria, thus keeping them from spreading and making them easier to destroy
Term
Eosinophils
Definition
- can ingest bacteria but also target foreign cells that are too large to ingest.
- contain granules that release enzymes and other toxic substances when foreign cells are encountered. These substances make holes in the target cell's membranes.
- circulate in the bloodstream.
- However, they are less active against bacteria than are neutrophils and macrophages.
- Their main function may be to attach to and thus help immobilize and kill parasites.
- help destroy cancer cells.
- They also produce chemicals involved in inflammation and allergic reactions (such as asthma).
- People with allergies, parasitic infections, or asthma often have more eosinophils in the bloodstream than people without these disorders.
Term
Basophils
Definition
- do not ingest foreign cells.
- contain granules filled with histamine, a substance involved in allergic reactions.
- When basophils encounter allergens (antigens that cause allergic reactions), they release histamine.
- Histamine increases blood flow to damaged tissues.
- Basophils also produce substances that attract neutrophils and eosinophils to a trouble spot.
Term
Natural Killer Cells
Definition
- called “natural” killers because they are ready to kill as soon as they are formed.
- Natural killer cells attach to foreign cells and release enzymes and other substances that damage the outer membranes of the foreign cells.
- Natural killer cells kill certain microorganisms, cancer cells, and cells infected by viruses. Thus, natural killer cells are important in the initial defense against viral infections.
- natural killer cells produce cytokines that regulate some of the functions of T cells, B cells, and macrophages.
Term
Dendritic Cells
Definition
- reside in the skin, lymph nodes, and tissues throughout the body.
- Most dendritic cells ingest and break antigens into fragments (called antigen processing), enabling helper T cells to recognize the antigen. Dendritic cells present antigen fragments to T cells in the lymph nodes.
- Another type of dendritic cell, the follicular dendritic cell, presents unprocessed (intact) antigen that has been linked with antibody (antibody-antigen complex) to B cells.
- After T and B cells are presented with the antigen, they become activated.
Term
Cytokines
Definition
- Cytokines are the messengers of the immune system.
- White blood cells and certain other cells ofthe immune system produce cytokines when an antigen is detected.
- There are many different cytokines, which affect different parts of the immune system.
- Some stimulate activity. They stimulate certain white blood cells to become more effective killers and to attract other white blood cells to a trouble spot.
- Other cytokines inhibit activity, helping end an immune response.
- Some cytokines, called interferons, interfere with the reproduction (replication) of viruses.
- Cytokines also participate in specific immunity.
Term
Acquired (adaptive or specific) immunity
Definition
- not present at birth. It is learned.
- As a person's immune system encounters foreign substances (antigens), the components of acquired immunity learn the best way to attack each antigen and begin to develop a memory for that antigen.
- Acquired immunity is also called specific immunity because it tailors its attack to a specific antigen previously encountered.
- Its hallmarks are its ability to learn, adapt, and remember.
- Acquired immunity takes time to develop after initial exposure to a new antigen. However, because a memory is formed, subsequent responses to a previously encountered antigen are more effective and more rapid than those generated by innate immunity.
- Lymphocytes are the type of white blood cell responsible for acquired immunity.
- Typically, an acquired immune response begins when antibodies, produced by B cells (B lymphocytes), encounter antigen.
- Dendritic cells, cytokines, and the complement system (which enhances the effectiveness of antibodies) are also involved.
Term
T – Cells
Definition
T cells are produced in the thymus. There, they learn how to distinguish self from
nonself. Only the T cells that ignore self antigen molecules are allowed to mature and leave the
thymus. Without this training process, T cells could attack the body's cells and tissues.
Mature T cells are stored in secondary lymphoid organs (lymph nodes, spleen, tonsils, appendix,
and Peyer's patches in the small intestine). These cells circulate in the bloodstream and the
lymphatic system. After they first encounter a foreign or abnormal cell, they are activated and
search for those particular cells.
- Killer (cytotoxic T cells
- Helper T cells
- Suppressor (regulatory) T cells

Sometimes T cells—for reasons that are not completely understood—do not distinguish self from
nonself. This malfunction can result in an autoimmune disorder, in which the body attacks its own
tissues
Term
List the 3 types of T-cells, where they are formed, where they are located, and the functions of each
Definition
Killer (cytotoxic) T cells –
- attach to particular foreign or abnormal (for example infected) cells because they have encountered them before.
- Killer T cells may kill these cells by making holes in their cell membrane and injecting enzymes into the cells or by binding with certain sites on their surface called death receptors.
- This binding triggers reactions within the foreign or abnormal cell that lead to death.

Helper T cells
- help other immune cells.
- Some helper T cells help B cells produce antibodies against foreign antigens.
- Others help activate killer T cells to kill foreign or abnormal cells or help activate macrophages enabling them to ingest foreign or abnormal cells more efficiently.

Suppressor (regulatory) T cells
- produce substances that help end the immune response or sometimes prevent certain harmful responses from occurring.
Term
9. What effects does aging have on immune system functioning? 1. What effects does aging have on immune system functioning?
Definition
As people age, the immune system becomes less effective in the following ways:
- The immune system becomes less able to distinguish self from nonself (that is, antigens). As a result, autoimmune disorders become more common.
- Macrophages (which ingest antigens) destroy bacteria, cancer cells, and other antigens more slowly. This slowdown may be one reason that cancer is more common among older people.
- T cells (which remember antigens they have previously encountered) respond less quickly to the antigens.
- There are fewer white blood cells capable of responding to new antigens. Thus, when older people encounter a new antigen, the body is less able to remember and defend against it.
- Older people have smaller amounts of complement proteins and do not produce as many
- The amount of antibody produced in response to an antigen is less, and the antibodies are less able to attach to the antigen.
- These changes may partly explain why pneumonia, influenza, infectious endocarditis, and tetanus are more common among older people and result in death more often.
- These changes may also partly explain why vaccines are less effective in older people.

These changes in immune function may contribute to the greater susceptibility of older people to
some infections and cancers.
Term
Basic Y structure of Antibodies
Definition
An antibody molecule is shaped like a Y. It has 2 parts

- Variable Part: this part varies from antibody to antibody, depending on which antigen the antibody targets. The antigen attaches to the variable part. The variable part is the top half of the V part of the Y. The antigen binding sites are the very top of the V
- Constant part: the part can be one of 5 structures, which determines the antibody’s class – IgM, IgG, IgA, IgE, or IgD. This part is the same w/in each class. The contant part is the I part of the Y.
Term
pathogen
Definition
A bacterium, virus, or other microorganism that can cause disease.
Term
chemotaxis
Definition
Chemotaxis is the phenomenon whereby somatic cells, bacteria, and other single-cell or multicellular organisms direct their movements according to certain chemicals in their environment. This is important for bacteria to find food (for example, glucose) by swimming towards the highest concentration of food molecules, or to flee from poisons (for example, phenol). In multicellular organisms, chemotaxis is critical to early development (e.g. movement of sperm towards the egg during fertilization) and subsequent phases of development (e.g. migration of neurons or lymphocytes) as well as in normal function. In addition, it has been recognized that mechanisms that allow chemotaxis in animals can be subverted during cancer metastasis
Term
phagocytosis
Definition
the cellular process of engulfing solid particles by the cell membrane to form an internal phagosome by phagocytes and protists
Term
histamine
Definition
an organic nitrogen compound involved in local immune responses as well as regulating physiological function in the gut and acting as a neurotransmitter.[2] Histamine triggers the inflammatory response. As part of an immune response to foreign pathogens, histamine is produced by basophils and by mast cells found in nearby connective tissues. Histamine increases the permeability of the capillaries to white blood cells and some proteins, to allow them to engage pathogens in the infected tissues
Term
Pyrogens
Definition
A substance, typically produced by a bacterium, that produces fever when introduced or released into the blood
Term
Pyrexia
Definition
Raised body temp, fever
Term
Plasma cells
Definition
also called plasma B cells, plasmocytes, and effector B cells, are white blood cells which secrete large volumes of antibodies
Term
purulent
Definition
Consisting of, containing, or discharging pus
Term
4. Define innate immunity and list another name for this.
Definition
- innate immunity (non-specific, present from birth, does not depend on exposure to any particular antigens)

- 3 components to innate immunity
1. genetically controlled factor (species, strain of animal, age, sex)
2. external defense mechanisms (barriers such as skin, digestive tract, resp tract, urogenital tract
3. inflammatory response (histamine release, chemotaxis, bactericidal proteins release)
Term
What are the 2 types of immunity?
Definition
- innate immunity (non-specific, present from birth, does not depend on exposure to any particular antigens)
- acquired immunity (specific, develops during life as a result of exposure to particular antigens that have managed to by-pass the innate mechanisms)
Term
List the external defense mechanisms. Why are these important?
Definition
rovide an effective barrier against entry by non-pathogenic and pathogenic organisms, providing they remain intact and the animal is healthy
Skin
- Impermeable barrier which can only be breached by injury, boting insects, sx equipment and hypodermic needles
- Sebaceous glands in the skin secrete sebum which acts as a source of nutrition for commensal bacteria living in the skin. Create an acid pH which deters growth of pathogenic bacteria on the skin surface
- Sweat from sweat glands contains lysozymes which have an antibacterial action
Digestive tract
- lined w/ mucus membrane which secretes sticky mucus to which particles adhere and these are either swallowed or spat out
- saliva contains lysozymes with antibacterial action
- pH of the stomach is acid. This will destroy any organisms that enter the stomach
- proteolytic enzymes are secreted by gastric glands in the stomach wall. They act on protein w/in the antigens and digest them
Resp tract
- lined w/ ciliated mm. Particles collect in the mucus and are then swept up the trachea towards the larynx and pharynx by the cilia
- the cough reflex is initiated by particles stuck in the area of the pharynx and larynx which are coughed out or swallowed
Urogenital tract
- lined by mm
- pH of the vagina is acid which destroys pathogens
- urethra is regularly flushed by urine which removes any organisms in the tract
Term
What are the benefits of fever (raised body temperature)?
Definition
- Higher temp slows bacterial growth, bacteria prefer to grow at around 38 C
- Stimulates liver cells to take iron out of the blood into storage in the liver. Reduced levels of iron in the blood slow down bacterial growth and increase the rate of recovery.
Term
Define “acquired immunity and list another name for this.
Definition
- acquired immunity (specific, develops during life as a result of exposure to particular antigens that have managed to by-pass the innate mechanisms)
Term
List the 2 types of acquired immunity.
Definition
2 types – usually develop in parallel
1. humoral immunity – antibody production by B cells
2. cell-mediated immunity – T cells develop the ability to destroy specific antigens
Term
What occurs with humoral immunity?
Definition
Production of specific antibodies or immunoglobulins by B cells in the lymph nodes, spleen and bone marrow
Term
How is an animal protected against infectious diseases?
Definition
If an animal is exposed to a dz the B cells forms antibodies against it. If the animal encounters the antigen again (secondary response), these cells are capable of producing the specific antibody very quickly and the antigen is overcome. The animal is described as being immune
Term
The antibody response can be detected by measuring levels of antibodies in the blood and is divided into:
Definition
- primary response – antibodies are produced w/in 7 – 10 days. Levels are relatively low, slowly reach a peak and fall as antigen-antibody rxns mop them up.
- Secondary response – antibodies are produced w/in 12 – 24 hrs. levels are 10 – 50 x higher and remain high for several months. Subsequent exposure to the antigen will boost levels still higher
Term
Describe Active and Passive immunization
Definition
An animal may be protected against infectious dzs in 2 ways:
- active immunization – antibodies are formed by the susceptible animal and protection is lifelong.
- Passive immunization – performed antibodies are taken from an immune animal and given to the susceptible animal. Protection is transient.
Term
active immunization
Definition
antibodies are formed by the susceptible animal and protection is lifelong.
Term
Passive immunization
Definition
performed antibodies are taken from an immune animal and given to the susceptible animal. Protection is transient.
Term
Describe Maternal Immunization
Definition
Maternal immunization – neonatal animals are protected from infectious dzs during the first few weeks of life by antibodies that are derived from the dam. This is natural passive immunity.
Term
How are the antibodies transferred in Maternal Immunization?
Definition
Antibodies are transferred in 2 ways
- via the placenta – antibodies in the maternal circulation enter the fetus through the placenta and umbilical cord. This only accounts for about 5% of the total maternal antibodies.
- In the colostrums – this is the first milk secreted by the dam after parturition. It contains 95% of the total maternal antibodies and is therefore essential for neonatal protection
Term
What is colostrum and why is it important?
Definition
- the 1st milk secreted by the dam after parturition
- rich in antibodies to any antigen with which the dam has been in contact
- includes antibodies to dzs in the dam’s immediate environment
- moving the young to a new environment after birth will expose them to different pathogens to which they have no maternal immunity
- ensuring dam recently vx before breeding will increase the levels of antibodies
- booster may be given during preg provided live vx are avoided, which may harm the developing fetuses
Term
Why is it critical that neonates receive colostrums within the first 24 hours of life?
Definition
Antibodies, ingested in the colostrums, pass undigested through the lining of the small intestine for 24 – 48 hrs post-partum. After this, the lining of the intesting “closes” and the antibodies are digested along with all other proteins. This makes them useless in overcoming antigens so it is essential that neonates receive colostrums w/in the first 24 hrs of life
Term
Why are vaccinations given to young animals every 3-4 weeks until they are at least 12-16 weeks of age?
Definition
- at 8 – 9 weeks the maternal antibodies have fallen to levels that no longer interfere with vaccination
Term
What is a vaccine?
Definition
Vaccine – contains an antigen in a harmless form so that it loses its virulence (ability to cause dz) but is able to stimulate the production of specific antibodies against it
- if the vx animal is challenged by the natural dz, a secondary response is produced and antibody levels rise to fight the antigen, preventing the onset of clinical signs
- antibodies resulting from vx are specific to the antigen, although some pathogens are so closely related that immunity to one will protect against infxn by another, e.g, canine adenovirus (CAV-2), one of the causes of kennel cough, will also protect against CAV-1, the causal organism for infectious canine hepatitis
Term
Describe the “primary response” and “secondary response”.
Definition
- primary response – antibodies are produced w/in 7 – 10 days. Levels are relatively low, slowly reach a peak and fall as antigen-antibody rxns mop them up.
- Secondary response – antibodies are produced w/in 12 – 24 hrs. levels are 10 – 50 x higher and remain high for several months. Subsequent exposure to the antigen will boost levels still higher
Term
List the 7 types of vaccines
Definition
- live and attenuated
- killed
- Adjuvenated
- Toxoid
- genetically engineered
- sub-unit
- autogenous vx
Term
- live and attenuated
Definition
antigen is live but the virulence of the antigen is reduced or lost. Live vx undergo limited replication when injected, which may cause a mild infxn, and there is a very slight risk of the antigen regaining its virulence and causing dz. For this reason, they should never be given to preg females as they may affect the developing fetuses. Live vx stimulate a good level of immunity, require fewer boosters and are less likely to initiate an allergic rxn
Term
- killed
Definition
the antigen is allowed to replicate in the lab and is then killed by the use of heat, uv or chemicals such as formaldehyde. The dead antigen is quickly removed by phagocytosis, so levels of antibodies must be raised by repeated doses. Killed vx are safe to use in preg animals.
Term
- Adjuvenated
Definition
– the addition of an insoluble adjuvant enhances the immune response elicited by a killed antigen. Use of an adjuvant means that only one dose of vx has to be used, the disadvantage is that they are associated with systemic rxns and aluminum in particular has been recently linked w/ fibrosarcoma in cats
Term
- Toxoid
Definition
the most common use of a toxioid in vet practice is tetanus toxoid. Toxoid or heat-killed toxoid is given, the body responds by producing antitoxins.
Term
- genetically engineered
Definition
the genetic makeup of the pathogen is altered so it stimulates the formation of antibodies but cannot cause dz
Term
- sub-unit
Definition
pathogen is fragmented to release the part that stimulates the formation of antibodies which is used in the vx, leaving out the parts responsible for causing dz. Feline leukemia vx is a sub-unit vx based on the protein coat of the virus
Term
- autogenous vx
Definition
derived from pathogenic bacteria or viruses taken from the individual animal. This is injected into the animal to form antibodies against the pathogen. It is used particularly in cases of intractable staphylococcal skin infxns.
Term
What are the advantages and disadvantages of “modified live“ vaccines (=attenuated)?
Definition
Advantages
- Live vx stimulate a good level of immunity
- require fewer boosters
- are less likely to initiate an allergic rxn

Disadvantages
- Live vx undergo limited replication when injected which may cause a mild infxn
- very slight risk of the antigen regaining its virulence and causing dz.
- For this reason, they should never be given to preg females as they may affect the developing fetuses
Term
What are the advantages and disadvantages of killed vaccines?
Definition
- Disadvantage - The dead antigen is quickly removed by phagocytosis, so levels of antibodies must be raised by repeated doses.
- Advantage - Killed vx are safe to use in preg animals.
Term
What are the advantages and disadvantages of using an adjuvant in vaccines?
Definition
Advantage - The use of an adjuvant means that only one dose of vaccine has to be used.

Disadvantage – they are associated with systemic rxns and aluminum in particular has been recently linked with fibrosarcomata in cats
Term
What is an adjuvant and why is it used?
Definition
An insoluble adjuvant enhances the immune response elicited by a killed antigen. Common adjuvants incl oil and aluminum hydroxide which form a depot and slow down the release and removal of the killed antigen. The antigen leaks out of the granulomatous rxn to the adjuvant and may remain for several wks. Without the adjuvant it may remain for only a few days. The use of an adjuvant means that only one dose of vaccine has to be used. Disadvantage – they are associated with systemic rxns and aluminum in particular has been recently linked with fibrosarcomata in cats
Term
15. Give examples of each of the types of vaccines
Definition
live and attenuated - Rabies, kennel cough, lepto, Lyme, giardia
- killed - kennel cough, lepto, Lyme, giardia
- Adjuvenated -
- Toxoid – tetanus toxoid
- genetically engineered
- sub-unit - Feline leukemia vx is a sub-unit vx based on the protein coat of the virus
- autogenous vx - used particularly in cases of intractable staphylococcal skin infxns
Term
16. How long is a vaccine effective once it has been reconstituted and how should it be handled?
Definition
Must be stored in the fridge and used w/in a few hrs
Term
17. What are the 3 most common routes for vaccine administration and name a vaccine administered by each route?
Definition
- SQ - DA2PP
- Intranasal - Bordetella
- Oral – lungworm in cattle
Term
What are some of the common post-vaccinal signs seen in dogs and cats?
Definition
- slight lethargy a few hrs afterwards
- loss of appetite and depression within 24 – 48 hrs
- small swelling at the inj site
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