Salmonella in Pets and Humans

May 17, 2012

On April 6, 2012, the United States Food and Drug Administration announced a voluntary recall of Diamond Naturals Lamb Meal and Rice dry dog food. Since the initial recall, several other brands of food manufactured in a South Carolina plant have been voluntarily recalled for possible Salmonella contamination. Voluntary recalls of pet food are not uncommon, but this recall is unusual. Illness in humans, not dogs, prompted the recall.

Outbreak investigation

Scientists at the Centers for Disease Control checked the genetic fingerprint of the Salmonella found in the dog food against a national database of foodborne infections and found people infected with an identical bacterium. Because the Salmonella isolated from the dog food and the people is a rare type, the humans were interviewed to determine if there was a common source of infection. These interviews revealed many of the infected people had been exposed to dogs and the brand of dog food included in the initial recall. Subsequent recalls have all involved food manufactured in the same facility.

Why did people get sick?

This medical mystery seemed backwards to me. I could understand if my dog and I both got sick from some food I slipped her at the table, but I would suspect hardly any of us grab a handful of tan nuggets from our dog’s bowl as a quick snack.

So to help me understand, I called my sister, Mary Hohenhaus, MD, FACP, who is also a board certified internist (but for people) with Brigham and Women’s Physicians Organization in Boston.

The other Dr. Hohenhaus says:

Salmonella bacteria are a leading cause of infectious gastroenteritis in humans – more than a million cases in the U.S. each year. Symptoms include diarrhea, cramping, and fever starting anywhere from 12 to 72 hours after exposure.

Catching Salmonella is easy only if the bacteria can find their way into your mouth. I use a scoop to measure out dry food for my cat, but I could just as easily grab a handful of kibble for Sam’s bowl – and if the next thing I did was grab a handful of grapes for my breakfast, I could be in trouble.

Food and water contaminated with animal feces are a common source of Salmonella infection. Outbreaks have been associated with meat, eggs, dairy products, and fresh produce, as well as processed foods. Pet birds and reptiles can carry Salmonella without appearing ill. Feces from infected humans are another source.

Many infections are mild and don’t come to medical attention. Most people get better within a week just with extra fluids and rest. Children, the elderly, and people whose immune systems don’t work well are more likely to have severe cases of Salmonella, where the bacteria enter the bloodstream. These people need intravenous fluids, antibiotics and close monitoring in a hospital.

This current outbreak is a good reminder that Salmonella can show up in some surprising and unexpected places. It also reminds us that contaminated foods look, smell, and taste perfectly normal. The best protection against Salmonella and many other infections is common sense: keep your hands clean (and out of your mouth) and practice food safety.

When should you wash? After using the toilet, before preparing food, and any time your hands are visibly soiled are a must. Don’t forget to wash after playing with pets, not just after poop-scooping. A pocket-sized bottle of hand sanitizer is a great addition to your daily walk with Fido.

In the kitchen, wash utensils and work surfaces thoroughly after handling raw meat and eggs and before preparing produce – especially important if fruits and vegetables will be served raw. Thoroughly cook meat and eggs, and be sure to serve hot foods hot and cold foods cold. For more information click here.

This Dr. Hohenhaus is worried about dogs

Although the Salmonella cases making the news are human, dogs can also contract Salmonella after eating tainted food. Veterinarians in New York City are required to report certain diseases to the Department of Health and Mental Hygiene just like physicians are. We report zoonotic diseases, diseases transmitted between animal and humans, which include: Salmonellosis, tuberculosis, Rocky Mountain spotted fever, and leptospirosis.

I contacted one of my colleagues at the New York City Department of Health and Mental Hygiene, Dr. Sally Slavinski, Assistant Director Zoonotic, Influenza and Vector-borne Disease Unit, and she says no canine cases associated with this recall have been reported to the DHMH. I do have veterinary colleagues out of state who have seen a smattering of dogs they believe contracted Salmonellosis from the recalled foods.

Prevention in pets

For tips on preventing foodborne infections in your pets, click here.


Urine Dribbling: Plugging the Leaking Dog

December 14, 2011

Willa came to The AMC today. Her owner was worried she might have diabetes because the dog bed was smelly and soaked with urine the last couple of mornings. Dogs with diabetes (and cats too!) will drink and urinate excessively, often having accidents in the house. When I questioned Willa’s owner, the “accidents” only happened when the dog was sleeping and there was no increase in water consumption or urinations. A quick test of the urine the owner brought with her dog determined diabetes was not the problem.

Causes of Urine Dribbling
Simple and complex disorders can lead to urination abnormalities in dogs. Infections, bladder stones and hormone problems are common causes of urine leakage and can readily be identified with routine blood tests, analysis of urine and x-rays. The x-ray to the right shows a dog with four large stones in its bladder. In some cases, a special diet will dissolve bladder stones. In this case, surgical removal of the stones resolved the urine dribbling.

In Willa’s case, testing showed no urinary tract infection, no stones and no blood test abnormalities. Because she is an older spayed female dog, I thought she might have “urethral incompetence.” Large breed, older, spayed female dogs are at risk for developing this condition, which may be related to a lack of estrogen in spayed female dogs and occasionally neutered males.

Treatments for Urine Dribbling
Commonly it is treated with medications including drugs to tighten the urethra (known as α-blockers), such as phenylpropanolamine, ephedrine or pseudoephedrine, or with estrogen replacement therapy using diethylstilbestrol. Recently, the Food and Drug Administration approved estriol for use in dogs.

If your dog resists taking medications, specialists at The Animal Medical Center can inject collagen into the urethral wall using special noninvasive endoscopic equipment to help narrow the urethral lumen and prevent urine dribbling. For refractory cases, AMC specialists also use a hydraulic urethral occluder.

Willa quickly responded to treatment with estrogen and once again has a dry bed in the morning. With all these options available to plug the leak, no dog should have to suffer with a stinky, wet bed.

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This may also be found in the “Tales from the Pet Clinic” blog on WebMD.com.

For over a century, The Animal Medical Center has been a national leader in animal health care, known for its expertise, innovation and success in providing routine, specialty and emergency medical care for companion animals. Thanks in part to the enduring generosity of donors, The AMC is also known for its outstanding teaching, research and compassionate community funds. Please help us to continue these efforts. Send your contribution to: The Animal Medical Center, 510 East 62nd Street, New York, NY 10065. For more information, visit www.amcny.org. To make an appointment, please call 212.838.7053.


The Danger of Xylitol to Your Dog and Ferret

September 26, 2011

My regular trip to the grocery store this week brought a health risk for dogs and ferrets to the forefront of my mind.

As I was standing in the checkout line, I noticed a number of hard candies and mints with xylitol on the label. Xylitol may help keep us slim and protect our teeth, but it is deadly for our dogs and ferrets. The Animal Medical Center’s Emergency Service has seen several dogs suffering from xylitol-induced illness. The danger is serious enough to have caused the FDA to issue a warning to pet owners because xylitol poisoning is on the rise.

Xylitol is an organic compound and a naturally occurring sugar alcohol used as a low calorie sweetener. Chewing gum and candies are commonly sweetened with xylitol. Recipes abound on the Internet for home baked treats using the sweetner as an ingredient. Medical products such as throat lozenges, cough syrup, children’s multivitamins, toothpaste and mouthwash contain xylitol because it helps prevent tooth decay.

When a dog or ferret consumes xylitol, blood sugar drops dangerously low (hypoglycemia) and can result in seizures. Even if the hypoglycemia is reversed with administration of intravenous sugar (glucose), there is still the potential for development of liver failure and death.

If your dog inadvertently ingests one of the many xylitol-containing foods, medications or any other potentially toxic substance, go to an animal emergency room immediately as the drop in blood sugar occurs very quickly. Take the package, bag or box containing the xylitol product with you. The information on the package will help when your veterinarian contacts one of the animal poison control services included in the links below. These services are open 24 hours a day to advise pet owners and veterinarians on optimal management for pet poisonings.

For more information on other foods toxic to pets, visit:

Fur the Love of Pets: Kitchen Catastrophies

ASPCA: Poison Control

MSPCA Angell Poision Control Hotline

Pet Poison Helpline

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This may also be found in the “Tales from the Pet Clinic” blog on WebMD.com.

For over a century, The Animal Medical Center has been a national leader in animal health care, known for its expertise, innovation and success in providing routine, specialty and emergency medical care for companion animals. Thanks in part to the enduring generosity of donors, The AMC is also known for its outstanding teaching, research and compassionate community funds. Please help us to continue these efforts. Send your contribution to: The Animal Medical Center, 510 East 62nd Street, New York, NY 10065. For more information, visit www.amcny.org. To make an appointment, please call 212.838.7053.


Traditional Chinese Medicine and Cancer Therapy for Your Pet

March 3, 2011

My inspiration for today’s blog post comes from two wonderful patients of The Animal Medical Center, Baby and Basil, who benefited from both traditional Chinese medicine and Western chemotherapy during the management of their cancer and inspired me to research the topic further.

Basil/Photo: Dr. Steven Chiros

Traditional Chinese medicine is an alternative medical system different from our more familiar Western medical system. Traditional Chinese medicine is based in the Taoist religion and encompasses acupuncture, herbal therapy, mind-body therapy and Chinese massage, Tui-na. Although these treatment modalities have been used to treat diseases for five millennia, their use is not widespread in the Western world.

Despite this, there are people in the West seeking traditional Chinese medicine for themselves and requesting the same for their pets.

Some traditional Chinese therapies have been used in pets. Acupuncture is one of them. According to the Leukemia and Lymphoma Society, acupuncture has been shown to be safe in human cancer patients and may help to ameliorate treatment associated nausea.

The AMC’s acupuncturist, Steven Chiros, DVM, CVA used acupuncture to help decrease Basil’s nausea, improve her appetite and increase her energy. The photo of Basil shows an acupuncture treatment in progress. In addition to acupuncture, Basil received two Chinese herbal formulas. Basil’s owner reported a significant improvement from the two therapies. Based on its safety in humans with cancer and experience with acupuncture in my patients, I do not hesitate to have my patients see AMC’s acupuncture specialist.

Baby/Photo: Leo Weinberger

Baby was a cat with intestinal cancer whose Chinese medicine practitioner referred him to The AMC for treatment with Western medicine chemotherapy in addition to the traditional Chinese therapies. Baby received an herbal antioxoidant, coenzyme Q and other herbal therapies as well as well as traditional chemotherapy. The use of Chinese herbal therapies in cancer patients is not as straightforward as the use of acupuncture.

Herbal therapies must be carefully selected in pets on chemotherapy. Strong evidence exists indicating St. John’s wort (Hypericum perforata) extract decreases blood levels of various anticancer agents in human cancer patients and this herb should not be used in conjunction with chemotherapy. Other herbs, such as ginko, may decrease the ability of the blood to clot, resulting in excessive hemorrhage during surgery.

Investigation of natural compounds active against cancer is currently an area of enormous interest. Between 1981 and 2002, 62% of cancer drugs approved by the FDA were of natural origin. Today, the National Cancer Institute Office of Cancer Complementary and Alternative Medicine is funding studies on tumeric (Curcuma longa), a spice commonly used in African and Asian cultures, often as a component of curry powder, and in traditional Chinese medicine.

In the November issue of the American Journal of Veterinary Research, a laboratory study showed the carotenoid lycopene slowed growth and killed canine bone tumor cells grown in cell cultures. Even more promising was the fact that lycopene did not interfere with chemotherapy drug effects on the tumor cells. These are hopeful findings, not yet ready to be translated to use in clinical patients.

Right now, what is critical to treatment success is an open dialogue between your veterinarian and your traditional Chinese medicine practitioner. Be sure to tell them you are giving your pet herbs or they are undergoing chemotherapy.

This blog may also be found in the “Tales from the Pet Clinic” blog from WebMD.

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For over a century, The Animal Medical Center has been a national leader in animal health care, known for its expertise, innovation and success in providing routine, specialty and emergency medical care for companion animals. Thanks in part to the enduring generosity of donors, The AMC is also known for its outstanding teaching, research and compassionate community funds. Please help us to continue these efforts. Send your contribution to: The Animal Medical Center, 510 East 62nd Street, New York, NY 10065. For more information, visit www.amcny.org. To make an appointment, please call 212.838.7053.


Diatomaceous Earth for Pest Prevention

October 4, 2010

In the past month, The Animal Medical Center has received several inquiries about the use of diatomaceous earth (DE) as a flea preventative. I knew DE was used in swimming pool and fish tank filters, in cat litter and in laboratory studies but I hadn’t heard of using it against fleas. I found some interesting information to share with you.

Diatomaceous earth is composed of the fossilized silica skeletons of a unicellular organism known as a diatom. Diatomaceous earth crumbles easily and has the texture of pumice. Many websites recommending natural and organic medications suggest a host of medical uses for DE. Although DE is GRAS (Generally Recognized as Safe) by the FDA and some forms of DE are considered food grade, there are no FDA approved DE compounds for the treatment of diseases or for parasite control.  

Food and Drug Administration approval of a medication assures the consumer and the prescribing veterinarian that the product meets certain safety and efficacy standards.  In the case of flea and tick preventative medications, FDA approval means the medications are tested for safety in both dogs and cats if the medication is approved for use in both species. The manufacturer also has to prove to the FDA that the medication works against the parasite(s) the label says it kills or prevents. Without FDA approval, I don’t have enough information on the dosage, efficacy or safety of a medication to know how much to give, if the product works, or if it will hurt my patient.

Pet owners wishing to avoid chemical flea control don’t have very effective options. Keeping the pet inside and away from other animals will decrease exposure, but in apartment buildings the little critters can travel between apartments in the hallway carpet. Daily vacuuming of your apartment and disposing of the bag will help to decrease the numbers of fleas and eggs in the environment. Finally, using a flea comb daily will decrease fleas and eggs on your pet.
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For nearly a century, The Animal Medical Center has been a national leader in animal health care, known for its expertise, innovation and success in providing routine, specialty and emergency medical care for companion animals. Thanks in part to the enduring generosity of donors, The AMC is also known for its outstanding teaching, research and compassionate community funds. Please help us to continue these efforts. Send your contribution to: The Animal Medical Center, 510 East 62nd Street, New York, NY 10065. For more information, visit www.amcny.org. To make an appointment, please call 212.838.7053.


Pet Food Recalls

June 10, 2010

Yesterday, the Iams Company voluntarily recalled Iams ProActive Health canned cat and kitten food – all varieties of 3 oz & 5.5 oz cans (date on the bottom of the can is 09/2011 to 06/2012). The Iams Company quality assurance team identified a deficiency of vitamin B1, also called thiamine, in this line of cat food. Cats can easily become thiamine deficient. If your cat is eating any of the recalled foods and appears sick in any way, please see your veterinarian immediately. Thiamine deficiency can easily be treated if recognized early. For more information, visit the Iams website.

The Food and Drug Administration (FDA) regulates pet food. Regulations indicate pet food should be sanitary, safe for consumption and truthfully labeled. Unlike FDA approved medications for your pet, food does not have to undergo a pre-market approval process. The FDA regulates pet food labels in two ways. First, pet food must be correctly identified: what’s in it, who makes it, where is it made. Second, the FDA reviews specific health claims of pet food such as “promotes urinary tract health” or “prevents dental tartar.”

A recall can be one of three different types. The most common is a voluntary recall, and this recall is just that type. During a voluntary recall, the manufacturer realizes the food or medication is in some way unsafe and issues a recall. Distributors are alerted to remove unsold product from stores. As a service to consumers, a press release is posted on the FDA website. Less commonly, the FDA can request a recall if their investigation identifies a safety issue with a food or medication. And finally, the FDA has statutory power to mandate a recall.

Pets and humans share a common environment, food and often the same diseases. A human food recall could affect our pets if they were sharing our hamburger that gets recalled. A pet food recall can directly affect us as well. Recalled food can be risky for those handling the food, not just those eating it. For example, pet foods are at risk for being contaminated by a bacterium called Salmonella. Pets eating the food can get sick, and humans who prepare the food for their pet without properly washing their hands after handling the contaminated food could contract Salmonellosis too. Since humans are not eating this food, this particular recall is of consequence only to our cats. The recalled cat food poses no safety issues for the humans in the family.

Here are some suggestions to protect yourself and your pet against food-borne illnesses. Always wash your hands thoroughly after handling any food, especially raw meat. Wash your pet’s food and water bowls daily in hot, soapy water to remove any microorganisms. If your pet’s food smells strange or looks different than it usually does, discard it. Proper storage will protect food against spoiling. Opened wet food should be refrigerated and dry food should be stored in a tightly closed container at less than 80oF to preserve freshness. And finally, always save the label from the food you are feeding as a resource in case the food your pet is eating undergoes a recall.

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For nearly a century, The Animal Medical Center has been a national leader in animal health care, known for its expertise, innovation and success in providing routine, specialty and emergency medical care for companion animals. Thanks in part to the enduring generosity of donors, The AMC is also known for its outstanding teaching, research and compassionate community funds. Please help us to continue these efforts. Send your contribution to: The Animal Medical Center, 510 East 62nd Street, New York, NY 10065. For more information, visit www.amcny.org. To make an appointment, please call 212.838.7053.


Big News in Cancer Treatment for Dogs!

July 21, 2009

Palladia

Just last month, veterinary oncology had a first and as a board certified veterinary oncologist, this news just made my day. Until now, all chemotherapy agents administered to dogs were human drugs adapted for use by veterinarians. In June, the Food and Drug Administration’s Center for Veterinary Medicine approved the use of Palladia® (toceranib phosphate) which was specifically developed for use in dogs and has safety and efficacy data from canine studies backing its use. Palladia is licensed for the treatment of recurrent mast cell tumors.

mast-cell-tumorVeterinary oncologists have effective therapies for some dogs with mast cell tumors.  These treatments include surgery, human chemotherapy agents and radiation therapy.  But not all dogs have tumors amenable to surgical removal, not all tumors are in a location where radiation therapy can be safely administered and currently available chemotherapy agents do not cure every dog. So the first drug specifically developed for canine mast cell tumors is big news. 

Mast cell tumors are one of the most common skin tumors in dogs and are one of the most important cancers veterinary oncologists treat. Some dogs are unlucky enough to have multiple mast cell tumors or a mast cell tumor that keeps coming back in the same location. So a drug to help manage this common tumor is big news, redux.

Palladia belongs to a class of drugs known as tyrosine kinase inhibitors. The presence of abnormal tyrosine kinases in tumors results in the proliferation of tumor cells and the growth of new blood vessels to the tumor. These blood vessels provide nutrients to the growing tumor. Inhibition of tyrosine kinases by drugs like Pallada (or for humans, Gleevec®, another tyrosine kinase inhibitor) stops both cell proliferation and new blood vessel growth. Without nutrients and without cell proliferation the tumor shrinks. More big news.

Pfizer Animal Health is working with veterinary specialists to help them use Palladia effectively and safely. It is currently available from board certified veterinary specialists in oncology, internal medicine and dermatology. To find the specialist nearest you go to http://www.acvim.org/ for oncologists and internists and at http://www.acvd.org/ for dermatologists. Pricing for Palladia has not yet been announced.

Click here to download an information sheet about Palladia from The AMC.

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The Oncology Team at The Animal Medical Center

At The Animal Medical Center, specialists certified by the American College of Veterinary Internal Medicine in the sub-specialty of Oncology and the American College of Veterinary Radiology in the sub-specialty of Radiation Oncology provide dedicated care for pets with cancer Monday through Saturday.  We take a team approach to cancer care, collaborating with specialists in the fields of diagnostic imaging, pathology, surgery and internal medicine to create a customized plan for the care of your pets .

You can reach The AMC Oncology staff by email or phone:

• Ann Hohenhaus, DVM, DACVIM (Oncology, Small Animal Internal Medicine)    
(212) 329-8612, Ann.Hohenhaus@amcny.org   
• Nicole Leibman, DVM, DACVIM (Oncology)
(212) 329-8696, Nicole.Leibman@amcny.org   
• John Farrelly, DVM, DACVR (Radiation Oncology), DACVIM (Oncology)
(212) 329-8794, John.Farrelly@amcny.org  
• Andrea Flory, DVM, DACVIM (Oncology)
(212) 329-8687, Andrea.Flory@amcny.org


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