It depends on where they are in the schedule. We recommend puppies get a booster vaccine three weeks later, especially if it's a leptospirosis vaccine and they've only had it the one time. If they have missed it, if it's been over that three-week or four-week mark, it's going to be most ideal to give them an additional booster three weeks afterward.

Titers are for dogs with owners who do not wish to have them vaccinated, as perhaps they have had an adverse reaction to a vaccine before. The owner may choose to do that instead of relying on the medications that we give them beforehand to do their job. Sometimes we don't want to trust that. Titers can be a way to test your dog's blood and determine if they have a good immune response with that vaccine that we had previously given them or if the levels are a little too low and they need to get a booster.

So it certainly can be, especially if your dog has never had any problems with vaccines before. So we always like to make sure that your dog has tolerated vaccines well in the past. Still, as far as things go, especially if your dog is fairly good size, we usually don't see any problems giving multiple vaccines, but we don't like to overdo it either. So if your dog's small or has had a problem with vaccines in the past, we will tend to split those up.

There can be variations in the puppy and dog vaccine schedules. As I said, the puppies will be getting that every three weeks, and then they are good for a year after that last booster. And then dogs sometimes will be able to go every three years, depending on the types of vaccines they need. We’ve come to find that some of them last a little bit longer, but as far as your puppies go, you need to make sure you're doing that every three weeks.

We usually will start puppy vaccines around six to eight weeks old. And then they're going to be getting vaccines about every three weeks until they've had four total. And then, as far as dogs go, their first set of vaccines is usually going to be about a year after they've gotten their last set of their puppy boosters. So about a year and four months old or so is whenever we anticipate that. And then from there, it's usually every one to three years based on what vaccines your dog is getting.

We can usually see some GI issues—vomiting, diarrhea, inappetence, things like that—that tell you that your dog has an upset stomach. If left untreated, especially in smaller dogs with hookworms, we can see what's called hookworm anemia. And that is something that can end up being fatal, so you always want to make sure that if your dog does have diarrhea or you see worms, you're getting to your vet pretty quickly.

Worms inside your dog can last for quite some time, especially without showing any symptoms. They can live for several weeks to months because they continue to reproduce.