I had a spinal injury a few years ago and the surgeon warned me of permanent nerve damage causing incontinence being a potential consequence if it got worse. It's called "cauda equina syndrome", I did a quick search and it looks like it occurs in dogs too. Essentially you lose all nerve feeling on your bowel, hence not knowing when you need to go. I'm not sure what the solution is (if any) but it could be a clue.
13 States with Medical Exemptions
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There are 13 states with rabies medical exemption clauses, they are as follows:
ALABAMA Alabama Code Alabama Code Title 3 Section 7A-2 http://alisondb.legislature.state.al.us/acas/ACASLogin.asp effective August 1, 2009
(1) Notwithstanding the other provisions of this chapter, the State Board of Health by rule may establish procedures and qualifications for an exemption from the requirement for a vaccination for an animal if a rabies vaccination would be injurious to the animal's health.
(2) An animal exempted under subdivision (1) shall be considered unvaccinated by the State Board of Health in the event of the animal's exposure to a confirmed or suspected rabid animal.COLORADO http://www.cdphe.state.co.us/dc/zoonosis/rabies/rules%20and%20regs%206%20ccr%201009_1.pdf
A veterinarian licensed in Colorado may issue a written waiver as provided in this section exempting an animal from a rabies vaccination order if the veterinarian, in his or her professional opinion, determines the rabies inoculation is contraindicated due to the animal's medical condition. The terms "waiver" and "exemption" as used in this section are interchangeable. A veterinarian may issue a waiver if:
1. The animal to be exempted has a medical condition defined as "a disease, illness, or other pathological state" for which, in the opinion of the exempting veterinarian, a rabies inoculation is contraindicated;
2. A valid veterinary-client-patient relationship, as definied under C.R.S. Section 12-64-103 (15.5), has been established between the veterinarian, owner and animal to be exempted from rabies inoculation;
3. The veterinarian completes and signs the veterinary section of the Exemption from Rabies Vaccination form provided by the department.
4. The animal owner signs the informed consent section of the Exemption from Rabies Vaccination form;
5. The veterinarian maintains the signed exemption as part of the animal's medical record and provides a copy to the owner;
6. The exemption issued is limited to the anticipated duration of the animal's medical condition that precludes inoculation; and
7. The veterinarian provides a copy of the exemption form to the department, the local health department or animal control agency when requested.
C. A waiver may not exceed a period of three years from the date of issuance. If the medical condition persists beyond a three year period and, in the professional opinion of a veterinarian licensed in the State of Colorado the exemption continues to be appropriate, a new waiver may be issued.
D. Upon receiving a complaint regarding the validity of a rabies inoculation exemption, the executive direction or his/her designee(s) may review Exemption from Rabies Vaccination forms and examine the veterinary records pertaining to the medical condition to determine if the medical condition legitimately contraindicates rabies inoculation. If appropriate, the executive director or his/her designee(s) may refer the case to the State Board of Veterinary Medicine.CONNECTICUT http://cga.ct.gov/2007/pub/Chap435.htm#Sec22-338.htm
(b) The State Veterinarian or the Commissioner of Agriculture, or the commissioner's designee, may grant an exemption from vaccination against rabies for a dog or cat if a licensed veterinarian has examined such animal and determined that a rabies vaccination would endanger the animal's life due to disease or other medical considerations. Such exemption may be granted for an individual animal only after the veterinarian has consulted with the State Veterinarian, the Commissioner of Agriculture, or the commissioner's designee, and completed and submitted to the department an application for exemption from rabies vaccination on a form approved by the Department of Agriculture. After approval of such exemption, the department shall issue a rabies vaccination exemption certificate, copies of which shall be provided to the veterinarian, the owner of the dog or cat exempted from rabies vaccination and the animal control officer of the municipality in which the owner of the dog or cat resides. Certification that a dog or cat is exempt from rabies vaccination shall be valid for one year, after which time the animal shall be vaccinated against rabies or the application for exemption shall be renewed.
Any veterinarian aggrieved by a denial of a request for an exemption from rabies vaccination by the State Veterinarian, the Commissioner of Agriculture or the commissioner's designee may appeal such denial as provided in the Uniform Administrative Procedure Act, sections 4-166 to 4-189, inclusive.(2) A dog, cat, or ferret is exempt from vaccination against rabies if a licensed veterinarian has examined the animal and has certified in writing that at the time vaccination would endanger the animal's health because of its age, infirmity, disability, illness, or other medical considerations. An exempt animal must be vaccinated against rabies as soon as its health permits.
MAINE http://www.maine.gov/sos/cec/rules/10/144/144c260.doc
A. A letter of exemption from vaccination may be submitted for licensure, if a medical reason exists that precludes the vaccination of the dog. Qualifying letters must be in the form of a written statement, signed by a licensed veterinarian, that includes a description of the dog, and the medical reason that precludes vaccination. If the medical reason is temporary, the letter shall indicate a time of expiration of the exemption.
B. A dog exempted under the provisions of paragraph 5 A, above, shall be considered unvaccinated, for the purposes of 10-144 C.M.R. Ch.251, Section 7(B)(1), (Rules Governing Rabies Management) in the case of said dog?s exposure to a confirmed or suspect rabid animal.MASSACHUSETTS http://www.mass.gov/legis/laws/mgl/140-145b.htm
In order for a dog or cat to be accepted at an animal hospital, veterinarian's office or boarding facility an owner or keeper of such animal shall show proof of current vaccination against rabies; provided however, that if a dog or cat has not been so vaccinated or such owner or keeper fails to show such proof the animal shall be vaccinated against rabies prior to being discharged if the animal's medical condition permits.
NEW HAMPSHIRE http://www.gencourt.state.nh.us/rsa/html/xl/436/436-100.htm
II. A rabies immunization exemption may be issued, where illness or a veterinary medical condition warrants, by the local rabies control authority upon the written recommendation of a veterinarian licensed under RSA 332-B. The recommendation shall also be signed by an American College of Veterinary Internal Medicine diplomate and the state veterinarian. The exempted animal shall be maintained in strict rabies isolation, under conditions that are at the discretion of the local rabies control authority, until such time as the medical condition has been resolved and the animal can be immunized against rabies. Exempted animals shall not be allowed outdoors without being on a leash and shall be under the direct physical control of an adult owner at all times. In addition, when the animal is outdoors, it shall be muzzled in a manner approved by the local rabies control authority.
Source. 1985, 72:1. 1992, 250:3. 1995, 202:4, eff. June 12, 1995. 2007, 79:1, eff. Jan. 1, 2008.NEW JERSEY http://www.state.nj.us/health/animalwelfare/law.shtml
The State Department of Health shall promulgate regulations providing for the recognized duration of immunity, interval of inoculation, certificate of vaccination, certificate of exemption, and such other matters related to this act.
Medical exemption form http://www.state.nj.us/health/cd/ravacpolicy.doc
NEW YORK http://www.health.state.ny.us/diseases/communicable/zoonoses/rabies/docs/pet_owners_fact_sheet.pdf Exemptions The vaccination requirements hall not apply to any dog, cat, domesticated ferret if …. a licensed veterinarian has determined that the vaccination will adversely affect the animal's health....
NY Medical exemption form http://www.agmkt.state.ny.us/AI/vetpage/Rabies%20Exempt%20Form.pdf
OREGON http://arcweb.sos.state.or.us/rules/OARs_300/OAR_333/333_019.html
(1) Except where specifically exempt, all dogs at least three months old shall be immunized against rabies by the age of six months.
(3) To be considered immunized against rabies, dogs and cats must be vaccinated according to guidelines published by the U.S. Centers for Disease Control and Prevention in the Compendium of animal rabies prevention and control, 2005 MMWR 2005; 54 (No. RR-3).VERMONT http://healthvermont.gov/prevent/rabies/documents/RabiesControlManual_vaccination.pdf
2.C.4.D. Rabies vaccination must be administered to domestic pets and wolf/hybrids prior to the age of 4 months unless in the judgment of the veterinarian the animal's medical condition would prevent the development of adequate immunity to rabies. Animals so exempted must be inoculated against rabies as soon as their medical condition permits.
VIRGINIA http://leg1.state.va.us/cgi-bin/legp504.exe?101+ful+CHAP0182 ? 3.2-6521. (enacted March 29, 2010)
D. The Board of Health shall, by regulation, provide an exemption to the requirements of subsection A if an animal suffers from an underlying medical condition that is likely to result in a life-threatening condition in response to vaccination and such exemption would not risk public health and safety. For the purposes of ? 3.2-6522, such exemption shall mean that the animal is considered not currently vaccinated for rabies. For the purposes of ?? 3.2-5902, 3.2-6526, and 3.2-6527, such exemption shall be considered in place of a current certificate of vaccination.
WISCONSIN http://www.legis.state.wi.us/statutes/Stat0095.pdf
(d) A city, village, or town may exempt the owner of a dog from the requirement to have the dog vaccinated against rabies for ayear based on a letter from a veterinarian stating that vaccination
is inadvisable because of a reaction to a previous vaccination, a physical condition, or a regimen of therapy that the dog is undergoing. The city, village, or town shall require the owner to providea new letter for each year in which the owner seeks an exemption under this paragraph.
