It’s Time For A Veterinary “High Five” For a “Low .5”

By Dr. Marty Becker

“Pump Up The Volume” is the only single by one-hit-wonder British band MARRS. Released in 1987, the tune is very popular with music samplers, who reuse existing recordings to produce new works. I certainly adhered to this philosophy during my teenage and college years, pumping up the volume on 8-track players, then cassette tapes, trying reel-to-reel tapes for a time before moving to CDs and now mostly digital music via providers like Spotify, Pandora, or iTunes. What I got from pumping up the volume are some great memories with friends who shared music tastes, some pretty incredible college stories (luckily there were no phone cameras back then), and severe hearing loss. Now I’m 64 years old, have practiced veterinary medicine for 40 years, and am preaching the advantages of dramatically reducing the volume of both music (for my adult children and eight-year-old granddaughter) and for vaccines.

Studies show that the number-one thing people fear about medical care is needles. Doesn’t really matter if it’s a needle used for vaccination, blood draw, or catheter placement, these tiny tubes cause people to skip flu vaccines, postpone diagnostic tests, and run from or pass out during catheter placement. And people pass on the fear, anxiety, and stress (FAS) to their pets whom they consider family.

Besides the prick of the needle, the other thing that causes discomfort is the volume of the vaccine itself. I know that I, like about 80 percent of the veterinary healthcare professionals I’ve polled during meetings, watch the needle go in. That part doesn’t bother me. What does cause some pain and/or FAS is when the volume of the vaccine makes room for itself in the soft tissues of my arm. And pet owners assume that their pet will also respond negatively to the volume.

Whether you’re following some of the vaccination guidelines that recommend giving vaccines below the elbow or knee—both of which have very little SQ space—or you’re still giving under the skin (where pet owners have NO idea there is a lot of SQ space) on the dorsum of the pet, volume matters to the pet owner and to the pet.

I’ve actually tried this experiment in the exam room a few dozen times. (NOTE: I don’t just play a vet on TV; I still practice at North Idaho Animal Hospital in Sandpoint, Idaho.) I’ve mixed up an equivalent volume of fluid to represent single-agent vaccines from typical 1 ml vaccine lines in one 5 cc syringe, and then used a multivalent vaccine from Elanco’s ULTRA ½ ml vaccine line in another 5 cc syringe, and showed the two options to pet owners asking, “If you knew the protection was the same for both vaccines, which one would you chose for your pet?” Being honest, I didn’t get 100 percent of the pet owners to pick the reduced volume, as one new client, a thirty-something gentleman, said he wanted the syringe with three times the volume for his cat. To my quizzical expression of “Really?” he responded with a smile, “My cat has kidney disease and I have to give her SQ fluids from time to time, so I thought this might help.”

So unless you want to rehydrate a pet, I strongly recommend you explore the value of giving multivalent vaccines with the lowest possible volume of fluid for less pain and more comfort. Decreased FAS for the pet and increased client satisfaction never hurts.

This article was reviewed/edited by board-certified veterinary behaviorist Dr. Kenneth Martin and/or veterinary technician specialist in behavior Debbie Martin, LVT.

This article is brought to you in collaboration with our friends at Elanco, whose ULTRA™ line of vaccines—ULTRA Duramune®ULTRA™ Fel-O-Vax®, and ULTRA™ Hybrid—help give veterinary professionals another tool in creating Fear Free veterinary visits.