Why isn't it standard practice to clean the injection site?

[PepperD]

Has anyone had a dog who got Tetnus? We had a litter of Great Dane puppies about 10 years ago. When we took them to get their rabies shots, and got home, we noticed one of the females looked funny. Her brow was furrowed and she looked stiff. We called the vet, thinking she was having an allergic reaction to the shot, but he wasn't concerned; said to just keep an eye on her. By the next morning, she could barely walk, so we rushed to her the vet, where they did all sorts of tests...and determined that she had tetnus. When they gave her the "antidote" she had a reaction to it. We were going to have her put to sleep, but decided to take her to Virginia Tech...where she stayed for a week, before everything just shut down and she died.

We never discovered any wounds, to suggest that she got the tetnus from anything other than when she got her shot. We then requested that everytime one of our dogs got their shots, that they "cleaned" the skin before receiving the injection. Where they knew what we went through with the puppy, they never questioned our request. But we have since switched vets, and the new vet acts like we are being unreasonable or strange about our request. Do you think we are? I know dogs getting tetnus is rare, but it happened once to us and we don't want to take the chance. I was just wondering why it isn't standard practice to clean the injection site (like they do for humans) before giving the shot?

[k9Karen]

I've often wondered that myself, but even more in regard to when they draw blood.

I'm terribly sorry you had to go through something like that - it must have been awful. I would, however, like to express some concerns about the tetanus your puppy suffered. IMHO, it is very unlikely that your pup had tetanus due to an infection at the injection site. The illness we call tetanus is caused by in infection with the organism Clostridium tetani and takes days to develop. It is not the infection that causes the problem, but rather a toxin (poison) produced by that organism. It is virtually impossible for an infection (especially with toxin production) to occur between the time you left the vet's office and the time you got home. The only way tetanus could occur due to this vaccination is if the vial of vaccine was contaminated with Clostridium tentani and contained the tetanus toxin. I'm pretty sure all of your pups received their injections from the same vial;' so if this was from the vaccine, all of your pups would have been affected. Tetanus is unfortunately a common problem in human infants in developing countries caused by infections at the site of umbilical attachment (where the umbilical cord attached to the infant in utero - the 'belly button'). If I had to take a guess, that would be what I would suspect with your puppy. If not that, it seems more likely that this was a horrible reaction to the vaccine. Something like that is very rare, but it does happen. Again, I am so sorry for your loss and also am curious why the vets no longer clean the injection sites (they used to!).

[momPaws]

Would be interested in Davet's opinion about cleaning injection site. ..ie- if he did or if he advises it???

[PepperD]

My original vets did clean the injection site (after I started requesting it--they went thru the loss of the pup with me, so they understood), but I recently switched vets (mainly for financial reasons, but also because the practice I had been going to, started switching vets too often). It is the new office that seems to be reluctant...they will, when I request it, but I get the feeling like they are irritated by the request.

I hadn't thought about the pup getting tetnus thru the umbilical cord. Her mother had 17 pups in one litter (15 were born alive). Wouldn't some of the other pups have experienced similar infection? They were all born inside. My husband made a huge box with a sofa mattress tucked snuggly in it, that we covered with a water proof mattress cover and towels that we could wash. The birthing process was extremely tiring, but everyone came thru it well (except for the 2 that were still-born). It was a nightmare helping her nurse them all (we divided them up into 3 groups and rotated them and supplemented the feedings with goats milk).
The pup was fine until about 4-5 hours after her rabies shot (she was 4 months old and we only had 3 other pups left at that point). None of my vets had even seen a dog with tetnus... The only good thing that came out of it, was where we took her to Virginia Tech...the students there got the chance to see it and learn from it (it cost us over $1,000). I probably am being too cautious, but I don't want it to happen again...we had always thought that the tetnus toxin/virus/or whatever was on her skin and was introduced when the needle was inserted. But even without tetnus, it just doesn't make sense not to clean the site...there are so many germs on a dog...why take chances and give them another way into the body?

[davet]

OK here is davets oppinion...right or wrong just an opinion
in oreer to propery disenfect a site you have to shave the area, apply alcohol, apply betadyne and rub it in. However i used to do about 100 SPCA dogs at a shoe and just stuck and never got an abscess...the chances of having pathogenic bacteria on the skin at that spot is very very rare..I have seen three dog cases of Tetanus...one dog we spayed (in miam) and they let it run loose on the recently fertilized lawn with horse manure....a very hig tetanus carying agent...Another was hit by a train and i forget what the third one was but is is very rare to see tetanus in a dog... It has log been discussed as to give tatenat antitoxin to all injured dogs...The reactions would far be more than the one or two cases an average practioner would see in years of practiee--in a dog that is...horses are different..Another point when you injecct aa vein in the foreleg lots of people would shave the area...it has been shown that shaving leaves little tiny stubs, one of whioch can get into the lumen (hole) of the syrings and be injected into the blood stream..i never shave the dfore legv when doing heartworm testing or iv solutions...can never think of a problem......there fore in order to properly disenfect a site anywhere you would have to shave, disenfect with alcohol, betadyne etc...Most vets will wipe the area with alcohol orany solution to get the hairs to lie down...this does absolutly nothing towards killaing and pathogens in the are....I took Sassie in for shots last thursday to a friend of mine who gave on shot in the thigh flank and one in the middle of the back....he used nothing which is common practice..But if he dd donne the textbook way then he would have whavedd both areas....i can't give a scientific reason why dogs and cats and cattle etc so seldom get an injection site abscess's...most of these so called abscesss are from a body reacion to the injection material....i have never heard, nor have i ever read about tetanus given with a shot except one where the dog had been rolling around the barn and so tetanus got into it....i would find it very difficult to prove that a shotr cause it but stuff hapapens........this is rambling so ignore most of it and i haven't check it over for content or spelling as i guess you can tell

[Traci]

Subcutaneous injections rarely require prepping, as long as one starts with a new, sterile syringe/needle.

It is IV's one needs to prep, shaved, swabbed with alcohol, betadine or similar antiseptic, prior to the injection.

Blood draws should always be prepped as above.

I too question whether or not the pup actually had tetanus, and how exactly it was disgnosed/confirmed. It could also have been one of those unexplainable events with the immune system, in which it may or may not have been associated with the vaccine at all, but rather something else entirely unrelated, and possibly the vaccination worsened an underlying condition. Had the vet (or the university) suspected tetanus from the vaccine, they would have looked further into that specific lot and perhaps tested the other pups who recieved the same vaccine.

[davet]

Teraci is absolutly right on the IV routine...but then she is young and learning...give her 30 more years and she will improve.....sorry traci

[k9Karen]

17 puppies - wow!

Since the pup was 4 months old, I doubt a tetanus infection was at the umbilcus. By then, the cord should have dropped off and the site completely healed. If it hadn't, I'm sure you would have noticed it. It doesn't take a large wound to cause tetanus. Only a small amount of toxin can be deadly. If there was no wound on the pup, my next guess would be that there might have been some type of intestinal/abdominal infection. Strangulated hernia? As davet mentioned, this organism can be found in feces (as well as dirt). Did the pup have any wound, even a small one? Any chance of an intestinal obstruction?

[Traci]

Teraci is absolutly right on the IV routine...but then she is young and learning...give her 30 more years and she will improve.....sorry traci

In 30 years, I won't remember you posted this.