Wednesday, October 31, 2012

Hurricane Sandy

We had a half day at work today due to the impending severity of Hurricane Sandy.

She is expected to make landfall tonight and all "weather models" predict that she will muster up winds in excess of 70 mph.

Luckily for us most of the leaves are off of the trees, making it less likely that the limbs or tree will come down.

The weathermen have been warning about Sandy for days, allowing us to be well stocked and prepared.

To prepare for the storm at home we did al o the usual stuff; put away the last pieces of summer porch furniture, the last of the potted plants, all of the last traces of the summer of 2012, and in one day went from fall to winter.

Strawberry (our pot-belied pig) had her house winterized. Closed all the windows, put her winter door flap down to keep wind,snow, and rain out, and pilled the house full of hay. She has bails of hay that line all of the walls of her house, and then enough hay to make a burrow in and essentially compost herself through the winter. that house is soo warm I am surprised she doesn't get hot flashes. She is smart enough to never venture outside unless we provide an easy outlet and ample incentive. For my husband that means he has to shovel her walkway and entice her with carbs, preferably chocolate.

Everyone here at our house is snug in their beds, safe from the wind and water outside, purring away or snoring.


Ready for flash floods.
International orange suit, with flashing light, and reflective color.


My biggest challenge has been to try to figure out a way to get the dogs to go outside to go to the bathroom.

We lost power for about an hour. It came back on and we are glued to the weather channel, and old classic movies.

No power to watch t.v. so we are left with board games.
The game 'Smart Ass' was a Christmas gift from Diedra.
Of course I smoked Joe


I know that tomorrow the winds will start to die down, the house will be standing just where it has been for the last 200 years, and the surrounding countryside will be clean, dusted, and ready for the snow to fall, and the holiday season to start.


The view from the observatory. Not much to see in the grey rain.

The limbs came down on the front gate, and the driveway floods.

Happy Halloween everyone.



And from our family to yours we wish you all a safe passage through Sandy.



Thursday, October 25, 2012

Mr. Audubon, The Turkey Vulture Capture


There are times when just a tiny bit of faith is all you have to hold onto.

It is a part of the beauty and meaning hidden in the tiny details of life.

If you forget to savor every second of life, and you get bogged down in the turmoil that mysteriously finds you even when you are just trying to keep busying staying afloat, then the days fly by and the years slip away. Seems when you need a few more minutes in the day you cannot find them, or they are stolen by the unexpected mishaps, like your car breaks down, your clients are especially needy, (and sometimes nasty), or you find that you have a turkey vulture in your barn that you thought was just loitering, but turns out has a broken wing and can't leave.
 
Yesterday was the day of a broken down car. “OK, honey I will pick you up at your co-workers tonight.”  (Minus the cost of one new fuel pump from the budget, yippee!).

And, “Why do I have to pay for a urinalysis? No one told me I had to pay for it!” The client phone conversation I had yesterday after her diabetic cat came in for lethargy. ‘Really? Did you think I was going to pay for your cat’s urinalysis?’ Was what I wanted to reply to her nasty yelling tantrum call (I didn’t, well only to you guys, not to her).

I informed my husband that we had a wild bird in need of help two days ago. He initially seemed flattered to be asked to help me save something, but when he questioned me on exactly "What kind of wild bird needed help?" and I had to confess that it was a "turkey vulture." He replied, "Oh, it’s just a buzzard, leave it alone, they stink."

"Honey, it has a broken wing, it is starving, and since when do you get to decide which species are worth saving, and which are not?"

He should know me well enough by now to know that I am going to help something regardless of whether he assists me or not. I’m not going to beg or argue with him. I’ll do it myself, get hurt, remind him it is his fault, and then coerce him into helping me. (So much faster to just say ‘OK’).

He gave up, and realized I was going to catch that big, bald, ugly bird with or without his help.

And so the plan was set;

· Get up early.

· Catch big, ugly, bald, bird. Safely.

· Send bird to be dropped off at BF Jane's practice, (with her consent and permission).

· Feel good about doing the right thing, and hope Jane doesn't ask me to take him back home for rehab care (because he is really ugly and stinky).

And so the day started with a slow wake up. There's no rush outside to capture a turkey vulture in an old uneven-footing, rusty nailed obstacle course. You need to wait for the sun to rise, so you can rodeo-capture a big stinky hissing bird.

As with every veterinary venture my husband and I partake in it is 75% preparation, 25% arguing, and 99% "he does it his way" regardless. It seems I am not an expert at anything he assists with. I promise you he has never caught a bird in his life, but ask to help you and he is Mr. Audubon.

The broken winged bird was corralled easily once I got my husband to slow his sheet-yielding terrorizing advance to a slow crawl.

In almost all cases of animal capture it is important to understand that animals have a 'flight distance'. This is the radius that as you approach they start to walk away. If you approach too fast and get too close they will run in the opposite direction. The objective of animal capture is always to be calm, careful, and not to hurt yourself or the animal you are after. This can often be dangerous as some animals will try to kill themselves in an effort to escape.

Often the biggest mistakes people make in attempting to capture an animal is that they go too fast and move too erratically.

For the turkey vulture we had to create a wide low barely detectable screen with sheets and approach slowly enough to be able to place the sheet over him without scaring him into trying to fly away, and/or further injuring himself.

We approached very slowly, (after multiple rapid approaches from self-proclaimed avian expert, who was hissed and squawked at) and eventually that vulture was at my feet and sitting still enough for me to drop the sheet on him.

The sheet was slowly and gently draped over his wings, being careful to hold the wings to their body and then wrapped around him to bundle him into a safely portable package. Into a laundry bag he went and it was loosely and firmly tied shut. Animals feel safer and will not injure themselves if they are in a dark quiet containment area.

A bird will try to fly and beat its wings against any object to try to free itself. Be gentle, be careful, and keep the wings safely tucked into their body and shield the talons and beak from any objects they can reach for, your body included.

For transport we placed the laundry sack in a cat carrier and secured it closed.

I then sent my husband to my dear friends’ clinic as she is very experienced in avian care.

I did remind him to "not open that carrier no matter what noise that bird made."

I got a call last night to update me on my birds condition. It seems he is a young (6-8 months old) and most likely he broke his wing up by the shoulder months ago. Apparently those young birds aren’t very proficient flyers so often they crash and brake bones. Because the brake is so old and has already healed it will be left alone and he will be sent to a rescue rehabilitation center. If he can’t be taught to fly and be released he will stay at the rehab facility to help educate students and the public.

I am very grateful to the highly skilled and dedicated staff at Fallston Vet in Fallston MD. And I am grateful he will be in a safe place that can take care of him and my husband for helping trap and transport our vulture.

Sunday, October 21, 2012

Mr. T.S.'s Dearly Departed

 It was a typical slammed busy booked, (OK, truth be told, I was overbooked, yet again), night.
There is some debate over how many appointments a veterinarian should optimally see in an hour. I think 20 to 30 minutes is ideal, but I typically get booked at 15 minute intervals, with walk-in emergencies on top of that, on the two nights I work. Seeing appointments every 15 minutes causes me great stress. It is too much information to try to keep straight as I run from room to room and patient to patient. It is the eternal juggling between keeping prices affordable, assisting our clients with their emergencies even though our appointments are booked, and providing a thorough examination, diagnostics, and treatment plan in a timely manner. (I have yet to find that ‘perfect’ balance, I continue to run around like a headless chicken (goodness, that is a terrible saying for a veterinarian,, umm, maybe I’ll say  “run around like a crazy person” instead?).
In the middle of the hysteria my receptionist came to corner me in the pharmacy. I sensed her still presence and I knew she needed my full attention..(Argh, getting further behind by the minute).
I looked up met her eye to eye and then she smiled.
“OK, don’t laugh, and I’m not kidding.” She said, giggling.
“OK.” I replied, begging her internally to talk faster.
“Mrs. T.S. called, she is very upset, she said her husband is on his way down here with his fish who just died and he thinks he is responsible for it, but she wants us to tell him that it wasn’t his fault, that it died from a bladder tumor and, he wants his fish to be privately cremated.” She was of course laughing by half way through the first sentence.
I, however, was not laughing because I was still trying to comprehend what she had just described.
I was mentally trying to sort through; a man is coming to the clinic with his fish?? His dead fish?? Who died from bladder cancer?? Is that possible?? Where do I find the bladder in a fish?? Oh my god, is it like a goldfish?? Is someone going to come into the front office with a fish in a baggie for me to,,umm,,,examine?? Private cremation for a fish?? There was too much odd information for me to try to process to laugh. I was just hoping that she was kidding.
I looked at her after a moment.

When she realized I wasn’t laughing she replied, “well, I told you that I wasn’t kidding.”
“As soon as Mr. T.S. gets here put him immediately in an exam room and come get me.” I could at least try to save him from the gawking clients as he stood at the front desk holding up a goldfish in a baggie.
I didn’t have any time to research ‘fish bladder tumors’ in a book, so I was going to have to wing it should that topic arise when Mr. T.S. arrived.
A few minutes later my receptionist found me again and notified me that Mr. T.S. was waiting for me in room two. I had seen him enter the waiting area, he was carrying a attaché sized folded towel in his arms. OK, nix baggie fears.
I entered the room and looked at Mr. T.S.’s tear streaked face. I was going to be further behind then I had planned, but this man needed a shoulder to lean on and I was going to switch into low/slow gear to help him.
“I know this sounds silly, I know that no one could understand this,” he whimpered and paused. “But I loved that fish, I did, he was a really special fish.”
“My wife and I have a 75 gallon tank in the living room. We went to the aquatic store and the salespeople told us that they had a fish that liked to be petted. So my wife went over to the tank, stuck her arm into the water, and he bit her. I knew right then and there that he was the fish for me.” We both smiled, and my receptionist finally got her laugh from me.
“I brought him home that day, and every day since he has followed me back and forth in his tank. And when I go over to the tank he comes to my hand and I would just pet him. He loved that. That fish knew me.”
He lay his towel on the exam table and gingerly opened it.
In the middle of his carefully folded towel lay a ten inch long purple pink bulbous domed large headed fish. It was quite beautiful and it was certainly not your average 'goldfish'. I watched closely for any signs of life, just in case he asked, but sure enough there was none. (I was relieved he didn’t ask me to check for a pulse or a heartbeat. I wouldn’t have known how to do either).
“No, Mr. T.S. I don’t think it’s silly. You loved your fish and I think he loved you to. I understand how hard it is to lose something you love.” I gave Mr. T.S. a hug. "I know the pain you feel when you lose a pet you love. I have loved and lost a rabbit, a pig, a sheep, and many dogs and cats, and no one can tell me that the love for one kind of pet is greater than another."

There was a long, slow, still few minutes as he stood next to his fish and gazed with adoration at him.
I took another deep breath. “OK, Mr. T.S. here is where I am stuck.”
He looked at me perplexed.
“I don’t know how to be any other way than honest with you, but I am concerned that I will make you more upset.” I was dreading my next few words. I couldn’t bear to further upset an already grieving man.
“Dr. I want you to be honest.” He replied. I believe he was still fearing I would mock his fish.
“Mr. T.S. I can send your fish to be cremated, and they will gladly take your payment for it, but once he is cremated there won't be any ashes to return to you.”
“Oh!” his eyes opened wide!

“Oh!” he said again. “Fish have no bones! There won't be anything left of him for me to keep!” His tone changed from grief to resolve.
“Yes.” I meekly replied. Somewhat baffled by his sudden transformation.
He re-wrapped his fish quickly and adeptly.
“Ok, I’ll take him home and bury him. Thanks Dr. Magnifico. I’ll be OK.” And out the door he went.
He was off in one direction, and I was off to find my place in the evenings appointments.

 (As a foot note; I am not sure if Mr. T.S. had a name for his fish? I do, however, recall that this was a "special" kind (breed?) of fish. When I get the answers to these I will add them.)

Wednesday, October 3, 2012

Raw Pet Foods, The AVMA's policy

I have written several articles on raw foods. I wanted to provide a more scientific paper.

Please let me know what you think.

Raw Pet Foods and the AVMA's Policy (FAQ)


In August 2012, the AVMA House of Delegates approved a new policy on raw or undercooked animal-source protein in dog and cat diets. Below are answers to the questions we’ve received about this issue.
Q: What is the AVMA’s policy on raw diets?
A: The Raw or Undercooked Animal-Source Protein in Dog and Cat Diets policy, approved by the AVMA House of Delegates in August 2012, is available on our website..
Q: Does the AVMA policy apply to all raw food fed to pets, or only a certain type?
A: It only addresses raw or undercooked animal-source protein, which includes meat or products from chickens (including eggs), turkeys, cows, pigs, sheep, fish, deer, buffalo, or other animal sources. It also includes raw, unpasteurized eggs and milk. And more specifically, it addresses the need for eliminating pathogens from these diets if they are to be fed to pets.
Q: How did the AVMA policy come about?
A: The Delta Society (now Pet Partners) contacted our Animal Welfare Division and inquired as to whether or not the AVMA had a policy addressing raw feeding, primarily due to concerns about therapy animals being fed raw diets. At the time, we did not have a policy on the subject. Pet Partners did not request that AVMA develop a policy, and did not suggest a specific policy. The Animal Welfare Division staff contacted the AVMA Council on Public Health and Regulatory Veterinary Medicine (CPHRVM) and notified them of the inquiry. The CPHRVM discussed the matter and felt that the AVMA should have a science-based policy addressing the public health risks of raw food.
For a list of the scientific literature the CPHRVM reviewed when developing this policy, see the reference list.
Q: Do other veterinary or public health groups have policies or statements about raw diets for pets?
A: Yes. The U.S. Food and Drug Administration Center for Veterinary Medicine (FDA-CVM) makes the following statement on its website:
FDA does not believe raw meat foods for animals are consistent with the goal of protecting the public from significant health risks, particularly when such products are brought into the home and/or used to feed domestic pets; however, we understand that some people prefer to feed these types of diets to their pets.

The U.S. Centers for Disease Control and Prevention (CDC) make the following statement on their website:
Raw diets, especially raw meat diets, are not recommended because of the risk for salmonellosis and other infections that can affect pets and their owners.
In addition, the CDC provided the following statement to the AVMA when the policy was being considered:
CDC recommends against feeding raw food to dogs and cats because of the risk of illness to the pet as well as to people living in the household. Do not feed your pet a raw diet. Here is why:
• Raw diets consist of foods such as meat, poultry, milk, and eggs that have not been cooked or treated to remove harmful germs.
• These food items can carry harmful bacteria including Salmonella and Campylobacter.
The American College of Veterinary Nutritionists (ACVN), in a FAQ document on its website, makes the following statement:
Raw diets, both home-prepared and commercial, have become more popular. Advocates of raw diets claim benefits ranging from improved longevity to superior oral or general health and even disease resolution (especially gastrointestinal disease). Often the benefits of providing natural enzymes and other substances that may be altered or destroyed by cooking are also cited. However, proof for these purported benefits is currently restricted to testimonials, and no published peer-reviewed studies exist to support claims made by raw diet advocates. No studies have examined differences in animals fed raw animal products to those fed any other type of diet (kibble, canned, or home cooked) with the exception of looking at the effects on digestibility. Typically raw meats (but not other uncooked foods like grains or starches) are slightly more digestible than cooked meat.
There are risks and concerns associated with the feeding of raw diets. One of these is the risk of nutritional imbalances, which is a reality for both home-prepared and commercial raw meat diets. Another important risk is related to bacterial or parasitic contamination. Of course, food poisoning is also a major concern for people, and the public health aspects of feeding raw foods to pets cannot be overlooked. Safe and proper handling of raw foods is crucial for reducing the risk, but safety cannot be guaranteed. At this time, the vast majority of purported benefits of feeding raw foods remain unproven, while the risks and consequences have been documented. It is best to discuss the choice of feeding raw foods with your veterinarian so that an informed decision can be made with regard to your pet’s diet.
The American Animal Hospital Association (AAHA) approved a policy in August 2012 that discourages feeding raw meat to pets. The National Association of State Public Health Veterinarians (NASPHV) and American Association of Feline Practitioners (AAFP) both endorsed the AAHA statement. The policy was developed independently of the AVMA’s position, but was shared with AVMA prior to posting on the website.

Q: What influence did the pet food industry have on the AVMA’s policy?
A: None. Neither commercial nor raw diet manufacturers were contacted during development of this policy because it was based on public health risk, and not on nutritional comparisons, health benefits, or economic factors. None of the pet food companies were aware that a policy was being developed.
Q: What is your response to allegations that the AVMA is “in the pockets” of the pet food industry?
A: These allegations are false. We are a science-based organization, and this policy is based on scientific research. Veterinarians are pet owners too. We love our animals and have the experience and training to make educated decisions about what to feed our own pets. Veterinarians choose and recommend diets based on what is best for the animal – e.g., it is medically appropriate and nutritionally balanced to meet that pet’s need. Many veterinarians feed commercial diets, and veterinarians are free to make their own choices when it comes to feeding their pets.
Contrary to the internet rumors that have been propagated, none of our Executive Board or House of Delegates members are employed by pet food companies. AVMA Convention Sponsorship provides financial support for programs and activities that are designed to enhance the attendees’ overall experience through unique educational programs, networking events and entertainment options. AVMA Convention Sponsorship provides visibility and engagement with attendees for the sponsor, as well as an opportunity to support important educational initiatives. AVMA Convention attendees are invited to attend and participate in sponsored events without any obligation to promote, purchase or sell the sponsor’s product or services.
The development of AVMA policy is independent of sponsorship. This is critically important to us because we are expected to be objective, science-based experts on animal health and welfare topics. Sponsorship is necessary to allow us to provide experiences for our members, but we do not allow sponsorships or sponsors to drive AVMA policy.
Veterinarians are independent thinkers, and are free to promote and sell the products they feel will serve their patients’ and clients’ needs. We encourage you to have an open discussion with your veterinarian about your pet’s nutritional needs, and work with them to find the optimal diet for your pet.
Q: Why does the policy only address raw protein diets, and not other foods?
A: The Council on Public Health and Regulatory Veterinary Medicine (CPHRVM) felt that the science supported a policy that specifically addressed the public health risks associated with raw/undercooked animal-source protein that hasn’t been adequately treated to remove pathogens. At a future meeting, the CPHRVM will discuss the pet food recalls and the hazards associated with commercial pet foods to see if a policy is needed. If the CPHRVM or another council or committee determines that other policies addressing pet foods are indicated, they will be developed separately.
Note that with this policy we aren’t encouraging commercial diets, we’re encouraging “commercially prepared or home-cooked food” (as stated in the policy). As long as it isn’t raw or undercooked and doesn’t contain pathogens, we’re not concerned with what it is or where it came from. Regardless of what you feed your pet, the diet should be free of pathogens that can sicken you, your pet and your family. Just like you, we also want pets’ diets to be nutritionally balanced. We support the FDA’s efforts to ensure that pet foods and treats of all types are safe and healthy for pets.
Q: What are raw diets?
A: Raw diets usually contain some or all of the following: muscle meat from animals (often still on the bone); bones (whole or ground); organ meats (e.g., liver, kidney); raw eggs; raw vegetables and/or fruit; and possibly some dairy products, such as unpasteurized yogurt or milk. As the name implies, the food is not cooked prior to feeding.
Q: What are the benefits of raw diets, and how do they compare with commercially processed kibble diets?
A: There are many anecdotal reports of benefits associated with feeding raw food – including easier weight management; reduced dental disease; healthier coat and skin; elimination of allergies; improved overall health and immunity; and more – but there is no scientific evidence to support these claims. Raw food advocates also contend that the diet more closely resembles what dogs’ and cats’ ancestors ate, but this does not account for the evolutionary, biological and dietary changes that have accompanied domestication to produce the pet dogs and cats that currently share our lives. According to the Pet Food Institute raw pet foods comprise approximately less than 1% of the pet food market.
Commercially processed canned or kibble foods are formulated to meet dogs’ and cats’ nutritional needs for proteins, fats, carbohydrates, vitamins and minerals. They are convenient, cost less than raw or homemade diets, and are readily available in most grocery stores, pet stores and “big box” stores. These pet foods comprise the majority of the pet food market. Commercial foods are nutritionally balanced and they undergo a process of quality control/ inspection that is meant to catch any contaminants or pathogens before they affect pets or people.
At this time, there are no scientific studies comparing the health benefits of raw and commercially prepared foods. The decision to feed one diet or another is a personal decision made by the pet owner.
Q: What are the risks of raw diets, and how do they compare with commercially processed kibble diets?
A: It’s common knowledge that raw meat is likely to be contaminated with bacteria; it’s not sterile by any means. Even USDA-inspected, “human grade” meat is not free of bacterial contamination. Some of the commonly-known pathogens that can be present in meat include Salmonella, E. coli, and Campylobacter. Other pathogens that may contaminate raw meat include Toxoplasma gondii (the parasite that causes toxoplasmosis), Cryptosporidium, Echinococcus, Clostridium, Neospora and Sarcocystis.1-4 The same applies to raw meat fed to pets. If the raw food isn’t adequately treated to eliminate pathogens, you could be feeding your pet potentially harmful pathogens that could cause illness in your pets and/or your family.
The biggest difference is that raw meat is cooked (which kills the bacteria) before it is fed to your family, but the meat is not cooked prior to being fed to a raw-fed pet. When you feed meat to your family, precautions should be taken to store, handle and prepare the meat in order to prevent foodborne illness. Therefore, your family’s risk of infection with these bacteria is low when the appropriate precautions are taken, but the risk of your pet being exposed to and infected with the bacteria is higher because the food isn’t cooked to kill the bacteria.
Scientific studies have confirmed that pets fed raw diets contaminated with Salmonella can become Salmonella carriers; this means that they don’t develop any illness, but the Salmonella bacteria are shed in the pet’s feces (stool) and can contaminate the environment and potentially infect people with the bacteria. For example:
  • Salmonella has caused illness in dogs fed raw diets.5
  • Salmonella has been found in the stool of sled dogs and racing greyhounds fed raw diets.6-8
  • An outbreak of Salmonella associated with raw feeding caused illness in 27 puppies from 8 litters at a Greyhound breeding facility. Ten of the affected puppies (37%) died. Salmonella was cultured from the raw diet and the environment. Salmonella was cultured from 57 of 61 (93%) stool samples.9
  • Salmonella organisms were isolated from 8 of 10 samples (80%) of homemade raw diets. The bacteria were also found in the stool of 3 of 10 dogs fed homemade raw diets, but in none that were fed commercial diets. While 3/10 may seem like a low number, actual number infected may be significantly higher. It is well known that Salmonella is shed intermittently, therefore others may have been infected but not shedding at the time the stool samples were tested.10
  • Five of 7 dogs shed Salmonella after consuming a raw diet, and the type of Salmonella was identical to that cultured from the raw food. Healthy dogs became infected with Salmonella after a single meal.11
  • Salmonella was recovered from the stool of 6 of 42 dogs (14.3%) fed raw meat, versus 0 of 49 dogs that were not on raw meat diets.12
  • Salmonella cultured from the gut and lungs of two cats that died from salmonellosis was identical to the Salmonella cultured from the raw diet they were fed.13
In a 1999 study,14 indoor-only cats fed raw meat in addition to a home-cooked or commercial diet were significantly more likely (19.1% vs. 2.2%) to be positive for antibodies to Toxoplasma gondii (indicating exposure and infection); outdoor cats fed raw meat were almost twice as likely to test positive for antibodies to T. gondii (30.3% vs 18.4%) than those fed only home-cooked or commercial diets. Another study in 2008 determined that cats fed raw or undercooked viscera (organs) or meat were more than twice as likely (53.5% vs 22.9%) to be antibody-positive for T. gondii.15
In addition, some raw diets may not be nutritionally balanced for pets. This can result in deficiencies or imbalances, particularly of vitamins and minerals, that can be harmful.16 This can be particularly problematic in puppies and kittens, because calcium/phosphorus imbalances can lead to bone deformities and growth problems. If you choose to feed raw foods, consult with a veterinarian or veterinary nutritionist to develop a diet that meets your pet’s nutritional needs. The high protein levels in raw meat-based diets can be harmful to pets with liver or kidney disease.
Bones or bone fragments in some raw diets can result in intestinal obstruction or perforation, gastroenteritis and fractured teeth.16
Salmonella has been cultured from raw diets in several studies,16-18 underscoring the need to adequately treat the diets to eliminate pathogens. In contrast, commercially prepared diets – kibble or canned – are considered adulterated and unfit for consumption if they test positive for bacteria.

Salmonella
infections have certainly been associated with commercially prepared kibble diets, but there have been no studies to determine the relative risks associated with raw vs. kibble diets. Keep in mind that raw pet foods account for about 1% of the total pet food market, which makes accurate risk comparisons difficult.
Q: Have cases of human illness been associated with raw food diets?
A: To date, there have been no reports of human illness associated with raw food diets. This doesn’t necessarily mean that they don’t occur; it could mean that illnesses have occurred but the link to the pet’s raw diet wasn’t made. In addition, if the pet is eating the same food the humans are eating (but raw instead of cooked), tracing the origin back to the pet’s raw food could be very difficult.
Keep in mind, too, that most cases of foodborne illness are never reported because they are usually mild and untreated. However, if someone from a high-risk group (very young, old, and/or immunocompromised) is exposed, the resulting illness is more severe and could even be fatal.
Q: Have cases of human illness been associated with commercially processed kibble diets?
A: Yes, there have been cases of human salmonellosis associated with commercially prepared diets.
  • From 2006-2008, there was a multistate outbreak of Salmonella enterica serotype Schwarzengrund infections in humans. A total of 79 cases from 21 states were reported. The source of infection was identified as dry dog food produced at a manufacturing plant in Pennsylvania. This investigation was the first to identify contaminated dry dog food as a source of human Salmonella infections
  • In spring 2012, an outbreak of Salmonella Infantis was traced to a Diamond Foods production facility in Gaston, SC. A total of 49 individuals (47 individuals in 20 states and two individuals in Canada) were infected with the outbreak strain. Seventeen brands representing >30,000 tons of dry dog and cat food produced at the facility were recalled as a result of the outbreak.

There have also been human illnesses associated with “natural” animal by-product pet treats, such as pig ears and dehydrated/dried beef and fish.
  • In 1999, contaminated pig ear pet treats were confirmed as the source of an outbreak of human S. Infantis in several provinces in Canada.19
  • In 2002, contaminated pet treats imported from Texas were associated with human S. Newport infections in Calgary, Alberta.20
  • In 2004-2005, contact with Salmonella-contaminated pet treats of beef and seafood origin resulted in nine culture-confirmed human Salmonella Thompson infections in western Canada and the state of Washington. This was the first outbreak associated with pet treats in the United States.

Q: Why haven’t raw foods been recalled due to Salmonella or other bacteria?
A: Bacteria are expected to be present in raw meat, so the presence of Salmonella or other bacteria in raw diets does not trigger the same regulatory process that applies to commercially made canned or kibble pet foods.
That said, we are aware of a recall of raw food. In May 2011, Primal Pet Foods recalled their Feline Chicken & Salmon formula due to contamination with Salmonella.
Q: Why have processed diets been recalled due to Salmonella or other bacteria?
A: With the exceptions of the recalls associated with the 2006-2008 and 2012 outbreaks, all other Salmonella-related recalls of commercially produced pet foods were associated with the detection of Salmonella on routine surveillance testing of products. In the majority of these recalls, no pet or human illnesses were reported.
Unlike with raw pet foods, the detection of Salmonella or other bacteria in a commercially processed pet food triggers a cascade of events at the state and federal level that lead to a voluntary recall by the pet food manufacturer. The pet food is considered adulterated and not fit for distribution or sale.
In October 2011, the FDA issued a Nationwide Assignment to Collect and Analyze Samples of Pet Foods, Pet Treats, and Supplements for Pets from Interstate Commerce in the United States for Salmonella. The objectives of the assignment are to 1) determine the prevalence of Salmonella in samples collected from a limited number of pet foods, pet treats, and supplements for pets; 2) determine the serotype, genetic fingerprint, and antimicrobial susceptibilities of each Salmonella found in samples collected from pet foods, pet treats, and supplements for pets under this assignment; 3) ensure that Salmonella-contaminated pet foods, pet treats, and supplements for pets are removed from interstate commerce; and, 4) collect investigational samples for research purposes and for providing surveillance information on microbes other than Salmonella in pet foods, pet treats, and supplements for pets.

A review of surveillance testing of samples collected from pet foods and pet treats demonstrated a significant reduction in Salmonella from 12.4% (2002) to 6.1% (2009). Salmonella prevalence in pet foods declined from 13.0% (2002) to 9.8% (2009).21 These results certainly indicate progress, but additional progress is desired to eliminate pathogens in all pet food products.
Q: If animals fed raw diets can shed Salmonella in their stool, why haven’t there been reports of human illness associated with raw pet diets?
A: Knowing that these pets can shed Salmonella in their stool, there’s no denying the risk of infection if the food isn’t adequately treated to eliminate pathogens. Individual cases of human illness are difficult to identify and trace back. Since salmonellosis is typically a foodborne illness and often does not require medical attention, physicians will most likely attribute the illness to the most recent foodborne outbreak. Therefore, they may not think to inquire about exposure to raw pet food or pets fed raw diets when initially investigating individual cases of illness, and the connection is missed. Furthermore, reports of human illness associated with anything, be it pet turtles or peanut butter, are only reported if they occur as part of an outbreak so that government authorities can trace the illness back to its source. With the exception of commercially produced raw diets, there is not a single consistent product to trace the illness back to in the event of an outbreak. Another compounding factor is that pet owners feeding raw may be taking additional precautions when handling the raw food, reducing their personal risk of illness (but that doesn’t reduce the risk to others due to the shedding of bacteria in their pet’s stool or other environmental contamination) .
It’s also possible that the pet owners have developed some degree of immunity to infection with the bacteria; the potential for owners of raw-fed pets to be carriers of Salmonella has not, to our knowledge, been investigated.
Q: Are there certain groups of people or pets that are more prone to the risks of infection associated with any type of food?
A: Young children, elderly people, and immunocompromised individuals (chemotherapy, immune disease, etc.) are at higher risk of infection and illness if exposed to bacteria.

One of the important concerns that drove the development of this policy is the concern that therapy animals fed raw diets and taken into hospitals, nursing homes or other healthcare facilities could serve as sources of infection to patients whose immune system may already be compromised by illness.
Pets that are more prone to risks of infection include those with cancer; pets receiving chemotherapy or other immunosuppressive therapies; very old or very young pets; and those with immune diseases.
Q: Are raw pet food diets subject to different regulations than commercially processed kibble diets?
A: Raw pet foods are produced with little to no regulatory oversight by the state or federal governments. The FDA publishes Guidance for Industry on the Manufacture and Labeling of Raw Meat Foods for Companion and Captive Noncompanion Carnivores and Omnivores, but the guidance is voluntary and not legally enforceable by the FDA.
This guidance recommends that raw food producers adhere to many of the same regulations which processed food manufacturers are legally required to follow. We commend those raw food manufacturers who voluntarily adhere to these guidelines and have put controls in place to ensure that their products are free of pathogens. Commercially processed foods are subject to a number of state and federal regulations, including the federal Food, Drug and Cosmetic Act, which charges the FDA with ensuring that human and animal foods are safe and properly labeled. For more information on the FDA’s regulation of pet foods, visit their site. The FDA also incorporates the Nutrition Labeling and Education Act in 1990, which regulates the permission of health claims on human food, into its regulation of pet foods.

State regulatory offices also play a vital role in regulating commercial pet food. The 2012 Diamond Foods-origin recall originated when the Michigan Department of Agriculture and Rural Development reported detecting Salmonella from an intact package of Diamond Naturals Lamb and Rice Formula for Adult Dogs, collected during regular retail surveillance.
Q: Why are you warning people of the risks of raw pet food diets, when there have been confirmed cases of human illness from commercially processed kibble diets?
A: This policy isn’t a comparison of pet foods. Neither is it a condemnation of raw foods – it is a caution against feeding raw foods that aren’t adequately treated to eliminate pathogens. It was developed in response to a recognized risk associated with raw foods and the scientific support that pets fed raw diets are at risk of becoming Salmonella carriers and could potentially infect people, particularly those that are most susceptible to infection (the very young, very old, and immunocompromised).
Note that with this policy we aren’t encouraging commercial diets, we’re encouraging “commercially prepared or home-cooked food” (as stated in the policy). What’s important is that the food isn’t raw or undercooked and doesn’t contain pathogens, Regardless of what you feed your pet, the diet should be free of pathogens that can sicken you, your pet and your family. Just like you, we also want pets’ diets to be nutritionally balanced. We support the FDA’s efforts to ensure that pet foods and treats of all types are safe and healthy for pets.
Please also be aware that we have made efforts to communicate the risks associated with commercially produced dry food and treats. We have a FAQ document about Salmonella and dry pet foods and treats, and our AVMARecallWatch Twitter feed is dedicated to notifying followers about pet food and product recalls.
Q: Are there raw foods that would be acceptable under the AVMA policy?
A: The primary concern we have about raw animal-source proteins is the bacterial contamination issue. Cooking, pasteurization, irradiation or other methods that successfully eliminate pathogens would render the food products safer and minimize the public health risk and be acceptable.
Q: Is the AVMA developing, or going to develop, additional policies that address the health risks of pet foods in general?
A: AVMA policy is developed by volunteer AVMA members serving on councils, committees or other entities. Therefore, it is up to those groups to determine the need for and develop new policies. The CPHRVM will discuss the possible development of a policy addressing the public health risks associated with pet foods and treats.

The AVMA, CDC and FDA recommend precautions be taken when feeding any type of pet food or treat.
Q: If I choose to feed raw food to my pet, what precautions should I take to protect my family?
A: First, be aware of the risks and know that despite your best efforts to clean the surfaces and environment, your pet’s stool could remain a potential source of infection. Always practice good food hygiene and sanitation.
  • If avoiding commercial foods is your goal, consider cooking the raw food before feeding it to your pet.
  • If purchasing commercial raw diets, select products that have been adequately treated to eliminate pathogens.
  • Do not purchase the product if the container is damaged.
  • Keep the product frozen until ready to use, and promptly refrigerate or discard any leftovers.
  • Keep the raw meat intended for your pet(s) separate from that intended for your family, to avoid any cross-contamination. Do not handle raw meat intended for your pet in the same area(s) or use the same utensils or equipment used for preparing food for your family.
  • Never allow cooked foods to come into contact with raw meat unless they are subsequently cooked at temperatures that will kill bacteria.
  • Wash vegetables and fruit prior to feeding.
  • Wash your hands thoroughly after handling raw food.
  • Regularly sanitize pet dishes, surfaces, cutting boards and utensils.
  • Rigorously control insects and other pests that may be attracted to the raw meat and could spread contamination.

Q: How would I know if my pet becomes infected with Salmonella from its food?
A: There are many sources of Salmonella. Because the organism can persist in the environment for weeks, even after thorough cleaning, the exact source of your animal’s illness (if it is the food) may be long gone. Animals with salmonellosis may show some or all of the following signs:
  • Lethargy
  • Decreased appetite
  • Fever
  • Vomiting
  • Excess salivation (in cats)
  • Diarrhea (may contain blood or mucus)

Also be aware that pets may be infected with Salmonella but may not appear to be sick. Salmonella bacteria can be shed in your pet’s stool for 4 to 6 weeks, and possibly longer, after infection. If you suspect your pet is ill, contact your veterinarian.
If your pet is infected with Salmonella and is shedding the bacteria in their stool, it’s also possible for people to become infected by contact with their infected pet’s fur, mouth, or feet – as well as anything that can come in contact with your pet’s stool. You can find Salmonella essentially anywhere the animal has been. Salmonella can survive for weeks or even years given the right environmental conditions (temperature, pH, humidity).
Q: How would I know if my pet is a Salmonella carrier?
A: Salmonella is usually detected by culturing your pet’s stool, but it can be difficult to detect because they don’t consistently shed the bacteria in their stool. They intermittently shed the bacteria, but are more likely to do so when stressed. It has been widely reported that infected dogs can shed Salmonella in their stool for 6 or more weeks.4 Several stool samples may be necessary to find the bacteria.
Q: If my pet is identified as a Salmonella carrier, what do I do?
A: Consult with your veterinarian regarding your pet’s health and the possible treatment of your pet. If it’s confirmed that your pet is a Salmonella carrier, take extra precautions to protect yourself and your family.
References:
1. Savani G, Dunsmore J, Robertson I. A survey of Western Australian dogs for Sarcocystis spp and other intestinal parasites. Aust Vet J 1993;70:275–276. 46.
2. Laarman J, Tadros W. Coccidiosis of man, dog and cat resulting from the ingestion of Sarcocystis in insufficiently cooked beef, pork or mutton—a brief review. Trop Geograph Med 1975;27:226.
3. LeJune JT, Hancock DD. Public health concerns associated with feeding raw meat diets to dogs. J Am Vet Med Assoc 2001;219:1222–1225.
4. Finley R, Reid-Smith R, Weese JS. Human health implications of Salmonella-contaminated natural pet treats and raw pet food. Food Safety 2006: 42: 686-691.
5. Caraway CT, Scott AE, Roberts NC, Hauser GH. Salmonellosis in sentry dogs. J Am Vet Med Assoc 1959; 135; 599-602.
6. Chengappa MM, Staats J, Oberst RD, et al. Prevalence of Salmonella in raw meat used in diets of racing greyhounds. J Vet Diagn Invest 1993; 5; 372-7.
7. Stone GG, Chengappa MM, Oberst RD, et al. Application of polymerase chain reaction for the correlation of Salmonella serovars recovered from greyhound feces with their diet. J Vet Diagn Invest 1993; 5; 378-85.
8. Cantor GH, Nelson S Jr, Vanek JA, et al. Salmonella shedding in racing sled dogs. J Vet Diagn Invest 1997; 9; 447-8.
9. Morley PS, Strohmeyer RA; Tankson JD et al. Evaluation of the association between feeding raw meat and Salmonella enteritica infections at a Greyhound breeding facility. J Amer Vet Med Assoc 2006; 228: 1524-1532.
10. Joffe DJ, Schlesinger DP. Preliminary assessment of the risk of Salmonella infection in dogs fed raw chicken diets. Can Vet J 2002; 43: 441-442.
11. Finley RL. Salmonella in commercially available pig ear treats and raw food diets: prevalence survey and caning feeding trial (MSc. thesis). Guelph, Ontario: University of Guelph, 2004.
12. Lenz J, Joffe D, Kauffman M et al. Perceptions, practices and consequences associated with foodborne pathogens and the feeding of raw meat to dogs. Can Vet J 2009; 50: 637-643.
13. Stiver SL, Frazier KS, Mauel MJ, Styer El. Septicemic salmonellosis in two cats fed a raw-meat diet. J Am Anim Hosp Assoc 2003; 39: 538-42.
14. Lucas SRR, Hagiwara MK, Loureiro VS et al. Toxoplasma gondii in Brazilian domestic outpatient cats. Rev. Inst. Med. trop. S. Paulo 1999; Available at http://www.scielo.br/scielo.php?pid=S0036-46651999000400003&script=sci_arttext.
15. Lopes AP, Cardoso L, Rodrigues M. Serological survey of Toxoplasma gondii in domestic cats from northeastern Portugal. Vet Parasit 2008; 155: 184-9.
16. Freeman LM, Michel KE. Evaluation of raw food diets for dogs. J Am Vet Med Assoc 2001;218:705–709.
17. Weese SJ, Rousseau J, Arroyo L. Bacteriological evaluation of commercial canine and feline raw diets. Can Vet J 2005;46:513–516
18. Strohmeyer R, Morley PS, Hyatt DR et al. Evaluation of bacterial and protozoal contamination of commercially available raw meat diets for dogs. J Am Vet Med Assoc 2006; 228: 537-542.
19. Clark C, Cunningham J, Ahmed R, et al. Characterization of Salmonella associated with pig ear dog treats in Canada. J Clin Microbiol 2001;39:3962--8.
20. Pitout JDD, Reisbig MD, Mulvey M, et al. Association between handling of pet treats and infection with Salmonella enterica serotype Newport expressing the AmpC ß-Lactamase, CMY-2. J Clin Microbiol 2003;39:538--42.
21. Li X, Bethune LA, Jia Y et al. Surveillance of Salmonella Prevalence in Animal Feeds and Characterization of the Salmonella Isolates by Serotyping and Antimicrobial Susceptibility. Foodborne Pathog Dis 2012l 9:692-8.

Monday, October 1, 2012

What Possesses Them To Eat....?

I am definitely guilty of having favorites. I cannot help it. I am too attached to my job and even more so (like by a degree of a hundred) to some of my patients.

Levi is one of them, without a doubt.
When he has a problem his parents can call me about it. It doesn’t matter what it it or at what time it happens. I am one phone call away, and I worry for him as much as they do.
Today, (of course it was an already too busy Monday), the clinic phone rang. It was Levi’s mom to say that he had just eaten almost 200 gauze squares. I didn’t even wait to pick up the phone to hear the explanation I just told the receptionist to tell them to come in right away.
Hasn’t everyone heard about the human patients who complain of chronic stomach pains months to years after they have had abdominal surgery? And after months to years of complaining of nondescript ghost abdominal pains find out that someone left a gauze square behind in their belly which is not adhered into a big ball of intestinal mess that has to be surgically dissected out?
As I waited for Levi to arrive I thought to myself how impossible it would probably be for close to 200 gauze squares to make it through the g.i. tract without clumping up together and plugging up his entire internal plumbing system. He had to come in right now and I had to hope that he would vomit them all up.
Levi, bouncing, dancing, wagging, happy 80 pounds of joy, arrived a few minutes later. His mom was drug behind him obviously worried about him and fittingly-so pondering what would possess him to eat a whole package of gauze. As soon as she saw me she said, “his dad left a little while ago. I knew when he saw his suitcase and pillow depart the front door with his dad that Levi would be upset. I was only out of the room for a moment and in that time he had wedged himself between the couch and the love seat and the gauze package was gone. I had just gotten a whole sleeve of gauze and tape from my doctor because my toe is infected. I had just gotten the tape out of his mouth and then the gauze disappeared. I am pretty sure that my other dog didn’t get any.”
All I could do was laugh. And thank the heaven above that Levi found these wonderful people who love him unconditionally no matter how much trouble he gets himself into.
As  Levi’s mom sat in the reception area I gave him a quick exam. As I did she told the person sitting next to her the whole sad tale again. All she could do was cover her mouth and laugh.
“Are you going to take an x-ray to see how many are in there?” she asked me.
“We always do a post-op count to make sure that we haven’t left any in a patient at my hospital.”
I could tell by her demeanor and her question that she was a nurse.
“No,” I replied, “it was gauze for her foot and they don’t put the radiopaque marker on bandaging material, just OR gauze.”
“Oh, yeah,” she replied.
“Well are you going to take him to endoscopy for removal?”
“Umm, well, this is veterinary medicine, and endoscopy requires anesthesia, and expensive endoscopy equipment, so no, we aren’t. Levi’s gauze is coming out the way it went in. the old-fashioned, cheap method of vomiting.”
I asked Levi’s mom if she could stay with us for a while while we tried to get Levi to puke up the goods. She said yes, so off we went to the treatment/surgery area.
In the treatment area I went over the plan with the staff. After each recount of Levi’s story there was laughter. 200 gauze pads, is tragic, and laughable. That’s our life in the clinic, usually a bit of both tragedy and comedy. If you can’t laugh about it you will burn out. So laugh, its good medicine.
We lined the floor with puppy pads, and started to deliver the first 60 ml dose of hydrogen peroxide.



Within ten minutes we had a pile of white gauze.


The techs counted out 86 on the first vomit pile.


Ten minutes later he got 92 more mls of peroxide, and within 10 minutes had another pile of gauze.


“Oh, Levi, buddy I empathize,” as another pile of gauze was delivered to the puppy pad on the floor, “I’ve been there.”


“Me, too,” his mom said, “food poisoning,” she added.
“Tequila,” I replied.
The third and final hydrogen peroxide dose produced only 16 gauze in a foamy pile of fluid, (the sure sign that the stomach is empty and the gauze was all out of his belly.


I reminded his mom to not let him eat for at least 3 hours, and sent her on her way with a fresh supply of veterinary gauze and tape. (Had I had any gauze with radiopaque markers I would have sent them.)
I don’t think I will ever understand the reasoning for eating gauze, but Levi is has been known to eat socks, and his parents are masters at Levi-proofing their home.


I’ll call and check on him tomorrow. I am sure they will call if they need me tonight. Some dogs sure don’t make it easy. But as Levi’s mom put it, “I know he’s bad, but he’s a really cute bad. And we love him.”
Levi left with an empty stomach and a long sad face. I think he will forgive us, and I hope I see his happy bouncy face again soon,,,just for a “hello” of course.