Rolfe said:
But there's no way that will become optional, 1 in 10,000 cats getting a fatal disease is better than one single human getting rabies in anybody's book
I was thinking about the non-identification of uncommon to rare problems in veterinary medicine recently and it's actually quite an interesting conundrum- for anyone who isn't interested pass by to the next anti-anti-vax rant!
I was faced with a litter of mastiff puppies, one of whom started to show obvious neurological signs. It looked like a cerebellar ataxia. I searched MedLine and sure enough such a condition has been reported in two papers in this breed, and is thought to be inherited as an autosomal recessive. Now this breeder had never seen it and nor had any in her immediate circle of acquaintance. Maybe it's rare. The I did the sums. Say 1 in 50 dogs carry the defective gene. A bad litter would turn up only once every 2500 matings (assuming random combinations, which is not true in practice). No breeder or group of breeders is ever going to know about that number of matings to even know about one defective litter, yet at 1 in 50, the gene could hardly be called 'rare'.
But, what does rare mean? Cystic fibrosis is a 'common' genetic defect in people and there are thousands of sufferers in each country. But the populations of our countries are tens of millions, the individual risk in 1 in several thousand (actually the gene is 1 in 20 of us and the incidence is 1 in 2500 of live births, which must mean that a lot don't make it to term I suppose).
The practical upshot of this is that we need to be careful about definitions of 'common' and 'rare'. This common genetic disorder is probably outside the circle of acquaintance of everyone taking part in this thread. A GP could go many years without having a mother in his care deliver a CF child. But, we live in societies with organised healthcare systems where there is a central bureaucracy counting things so we know they exist. So, the telescope gets turned round and instead of seeing the tiny per capita risk we see the thousands of sufferers. Having defined them as a group, resources can then be applied in an organised manner to investigate both the disease and its treatment.
In contrast, in the veterinary world, it is much harder for even a 'common' genetic disease to get itself discovered. If, once in my life, I see an odd thing happen in one breed I may well shrug it off as unexplained or inexplicable and move on to the next solvable problem. Thus, there is less opportunity for the '1 in several thousand' disease ever to come to light.
On the other hand, we deal a lot of the time with purebred animals derived from tiny gene pools, so we are up to our ears in genetic diseases but this means that they are 'common' in a way utterly unlike CF, by 1 or 2 orders of magnitude.
For us, the CF-level disease probably occasionally gets written up as an individual journal report that sits unregarded on library shelves and because there is no central bureaucracy (or large scale science establishment or Big Pharma) to pursue these things we have no way of telling whether such a case reports is the result, literally, of 1 in a million mutational freak or is the tip of a small iceberg (icecube?) like CF in man.
The relevance to this thread is that is pretty impressive that so much effort is being put into the feline sarcoma problem, but the jury really is out as to whether a 1 in 10,000 risk of sarcoma should change our whole attitude to vaccination. I've never seen a case and probably never will. I have seen animals killed by the diseases we vaccinate against. However, unlike our superstitious anti-vax colleagues I will await a systematic review rather than using my anecdotes as definitive proof. Conversely, I must accept that there are other 1 in 10,000 risks that no one has bothered to report, but really should we worry about them, or at least worry to the degree that we talk of ceasing vaccination against deadly disease to avoid that risk?
Dealing with probability in an irresponsible way is one of the greatest limitations of the unscientific mind. I will admit, though, that knowing how to do the arithmetic doesn't necessarily win out over the emotional response to risk. I vaccinate my animals without a second thought. I vaccinated my kids with a little worry courtesy of Wakefield. I hate flying and basically don't do it! The difference is that I acknowledge my irrational emotive responses for what they are, I don't turn them into a philosophy.
p.s. The puppy spontaneously recovered. My breeder client has now heard from others that they get 'wobbly' puppies from time to time and since most of them get better they don't ever see a vet, so I suspect this may be a largish icecube in that uncommon breed