Vet industry


The Royal Canin recall hit us hard. Hypoallergenic is the prescription diet we use second most (after Royal Canin’s Calorie Control). Over fifty of our clients feed it to as many as 100 of our patients. On Friday we sent out thirty-nine sets of bloodwork to Antech, almost what we’d expect to perform in a full month. We had another thirteen cats scheduled to come in for testing on Saturday. We’re performing urinalyses in house and sending out for CBCs and general chemistry profiles. I expect our bill to Royal Canin (who told us they will pay for testing of any cat that has eaten Hypoallergenic in the past six months) to be in the $8,000–$10,000 range, not including treatment costs for those cats showing signs of renal failure (so far, at least two) and not including overtime costs for our staff who have worked extra-long hours the past few days.

Royal Canin’s Handling of the Recall
Catmanager’s wife contacted our Royal Canin representative about three weeks ago to report a cat she had seen in early February with unusual urine crystals. The cat had slightly elevated BUN and creatinine (but still within normal range), had been vomiting, and was generally ADR. Fast forward several weeks and those odd crystals were popping up all over the country, now identified as melamine (Antech has a nice PDF with nine photographs). When my wife realized what she’d likely been seeing, she called our Royal Canin rep. The cat had been eating Hypoallergenic. Our rep said he was unaware of any problems but advised my wife to contact one of the company’s staff veterinarians.

Now that Royal Canin has recalled Hypoallergenic (along with a few other diets) because it contains tainted rice protein, we really wish my wife had made that second call (the birth of our first child got in the way). Had she talked with one of Royal Canin’s vets, would they still have reported “we have no confirmed cases of illness in pets” in their press release announcing the recall?

Probably yes, because a “confirmed” case is worlds away from a “suspected” case. Although I find the semantic game frustrating, it’s a small annoyance in what seems to be an otherwise forthright and responsible response—certainly Royal Canin has outperformed Hill’s in handling the recall. Unlike Hill’s, our Royal Canin rep contacted us immediately about the recall. We also didn’t have to wait for days for them to announce that they’d reimburse for testing. We were simply told that testing would be covered as long as we could show that the client had purchased a bag of recalled food within the last six months.

The response on the two companies’ Web sites is also quite different. Royal Canin’s front page is currently all about the recall. You can’t miss it. If one were unaware that Hill’s products had been recalled and visited the main page of their Web site, one would leave still unaware (unless one read the “Letter to Pet Owners” that is linked to from the main page). The page instead implies that Hill’s foods are unaffected by the recall: “Feed with Confidence.” “Wheat Gluten Free.” “Hill’s products not affected by rice protein concentrate recall.”

(We don’t use any P&G or Purina products, so I haven’t been as aware of their responses. Checking quickly, I don’t see any mention of the recall on Iams’ U.S. page. Purina addresses the recall on its main page.)

For several years now, my wife’s confidence in Hill’s products has steadily declined. For at least the past eighteen months she has refused to carry most of their maintenance diets. She finds that the Royal Canin prescription diets are generally more effective (k/d and z/d are the only Hill’s Prescription Diets we regularly use). Now, after watching them respond poorly over the last month to the pet food recall, her confidence has plumeted to new lows, and we’re seriously considering carrying only k/d and z/d.

Royal Canin, itself not free of warts (we’ve complained loudly in the past about poor communication from them), does at least seem to handle recalls well, admitting the problem in a timely manner and not shying away from their fiscal responsibility.

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Hill’s appears to have heard the loud chorus of veterinarians upset about their handling of the m/d recall and their initial refusal to offer to pay for testing of affected cats. Here’s the letter from the president of Hill’s:

Dear Colleague,

Hill’s announces Prescription Diet® m/d® Feline dry pet food medical screening payment plan

As you know, Hill’s makes all its products with an overriding commitment to the health and well being of pets. With that in mind, on March 30, we notified you of our decision in conjunction with the FDA to issue a precautionary voluntary recall of a single product, Prescription Diet® m/d® Feline dry pet food, our only product containing the wheat gluten at issue other than the earlier recalled Science Diet® Savory Cuts® pet food. A list of recalled products is available on our website, http://www.hillspet.com. This recall was done in an abundance of caution, as the FDA has not yet been able to determine a cause for any pet illness.

However, to further reinforce our commitment to both pets and the veterinary profession, Hill’s is announcing a plan to offset medical screening costs you have incurred to support your clients who have purchased Prescription Diet m/d Feline dry pet food from January 2007 to the present.

Hill’s has decided to take this action to help support so many in the profession who have already extended themselves to assist their clients during this difficult time.

The program will provide a one time payment of $100 per patient tested. This is being made available to help offset the costs of standard tests that would otherwise be borne by your client or yourself. In the case of tests previously conducted, it is up to you to reimburse your clients for out of pockets costs up to $100. This payment shall be available for all requests thru May 30, 2007.

Hill’s Pet Nutrition would like to thank each of you for your on-going support of the Prescription Diet business and encourage you to take advantage of this offer.

Sincerely yours,
Justin Skala
President, North America

Karen Padgett, DVM
Chief of the Veterinary Business Channel

Rural, large-animal veterinarians are on the decline. At least one state (Oklahoma) is considering legislation that would provide tax incentives for large-animal veterinarians. Missouri already has a Large Animal Veterinary Medicine Loan Repayment Program, which legislators are trying to expand. North Dakota is considering a similar program.

The current issue of DVM (Vol. 38, no. 3, March 2007) has a front-page story on the response of the USDA to the “rural vet crisis,” including claims that the agency “fails to take NVSMA [the National Veterinary Services Medical Act] seriously.” NVSMA, which became law in 2005, was supposed to be in place last year.

The pressure to jumpstart NVMSA stems from the profession’s migration toward small animal practice, which leaves large animal sectors scarce of DVMs and public health and food safety segments not far behind. NVMSA is an attempt to allay a crisis that, in extreme cases, forces owners to treat and euthanize their own animals in DVM-deficient rural areas and hinders bioterrorism safety when veterinarians’ disease expertise acts as a first-line defense.

Rural large-animal vets might be on the decline, but catmanager can’t find evidence of jobs going unfilled. A scan of the help wanted ads in the current JAVMA (Vol. 230, No. 7, 1 April 2007) reveals only three large animal openings and thirty-seven mixed animal openings across the United States. (The number of large- and mixed-animals jobs is dwarfed by the small animal jobs. Virginia alone has more small animal openings than there are large- and mixed-animal openings in the entire United States.) Catmanager wonders if the problem of rural and large-animal DVMs doesn’t have more to do with the poor economics of large-animal practices (at least relative to small animal practice).

Wonder what a day during calving season is like for a large animal vet? Here’s a nice story from Canada’s Leader-Post about a day spent with a large-animal rural vet. The reporter tags along as the vet delivers calves, repairs a prolapsed uterus, conducts a necropsy on a feed-lot cow, and opines about his colostrum research. [Update: Milwaukee’s Journal-Sentinel also has a profile of a large-animal vet.]

Vet student Megan Watland offers her own thoughtful analysis of the most recent turns in the pet food recall.

Cabezalana wonders what happened to his Saturday. The latest updates in the food recall played a part:

As you might imagine, this ratcheted up the general hysteria and our poor receptionist was nearly in tears trying to keep up with all the phone calls from panicked people who decided that we must have some special insider knowledge. Because we manufacture the foods ourselves in our spare time, of course.

T.J. at dogscatskidslife offers a thoughful commentary about the pet food recall. He sees problems with the anecdotal reports of pet deaths. For one, how many pets that have died had undetected illness before ingesting tainted pet food?

There are many pet owners who do not seek medical care for their pets at the first onset of their symptoms. Either they simply ignore the symptoms, believe that it is a passing malady, or just don’t pay enough attention to their pets to notice the symptoms, until they are pointed out to them by news reports, mass hysteria and fear.

(My own observations from my wife’s practice support this point, although I’d add a cat-specific reason pet owners don’t seek veterinary care soon enough: cats are experts at hiding symptoms of illness. Combine that with the difficulty of observing gradual changes in a pet you see every day, and you have a recipe for cats becoming severely ill before their owners notice. That’s why we recommend all cats be seen twice a year for physical exams—or any time owners notice a change in sleep pattern, vocalization, bad breath, grooming, weight, food and water intake, urination/defecation, or behavior.)

T.J. also makes a point that catmanager had been thinking about:

I began to think about contaminants that are probably present in all of our foods. Foods that we eat every day.

Let’s say we took a food product off of the shelf at our local grocery store. Any product would do, just pick one. And let’s say we sent it to a toxicology lab and tested it for every known toxin possible.

How do you think that final report would read?

I think we would be very surprised.

Indeed. I think it’s important to remember, though, that our food supply today is (in general) much safer than at any time in human history. We might hear more about food poisonings and contaminated batches of food, but, as one researcher argues, “This trend . . . is essentially an artefact, whose significance is reduced if considered in its broader historical context.”

Dr. Khuly at the Dolittler blog appears to have been inspired by the latest AVMA-PLIT newsletter (“a self-serving tool for the insurance industry”? Oh, the synicism!) to write about veterinary professional liability issues.

We vets are not used to being hauled in front of lawyers and judges to defend the way we do our jobs—not yet, anyway. Increasingly, though, we’re forced to practice medicine as if we might be in that position with each and every case.

In some ways that’s good. It makes us careful in our record-keeping, more willing to consider diagnostics before treatment, and conscientiously detailed when securing consent from our clients. In other ways, it’s kind of depressing.

And that’s because we have to practice more defensively. This finds us thinking about clients in an different way, adhering to hard-and-fast protocols with less regard to our patients’ needs, and generally driving the cost of pet healthcare through the roof.

This post from Alexander Wilkas, a Realtor with “20+ years in quality Assurance for a major consumer products company,” bothers catmanager. Mr. Wilkas

  • refers to “the corn gluten used in the recent pet food recall”;
  • makes unsupported claims about nonexistent regulation in the pet food industry. Yes, I’d like to see more or different regulation, but to call it “almost nonexistent” and imply that the human food supply is significantly more regulated is simply wrong (“The Pet food industry is subject to the same regulation as the human food industry,” the FDA’s Stephen Sundloff said at last Friday’s FDA press conference);
  • claims that “Most companies spend very little on testing, since . . . ‘it’s only pet food,'” again without offering any evidence. Has Mr. Wilkas seen the testing budgets of Menu Foods, Hill’s, Purina, Royal Canin? Is he familiar with their QC protocols? Or is he just speculating?

I hate to be in the position of defending pet food manufacturers, but as Ohio State’s Dr. Tony Buffington has pointed out: we see far fewer recalls of pet foods than we do of human foods; and unlike most human foods, the majority (if not all) of pet foods are formulated by board-certified nutritionists to meet specific nutritional requirements (whether they are successful or pressured by corporations in their formulations is another matter). Are the makers of Twinkies, Doritos, and Big Macs formulating their products to meet the nutritional needs of human beings?

Changes are needed in the pet food industry, to be sure. PetConnection has made some excellent recommendations (here and here). Congress is (I hope) finally starting to pay attention. The FDA’s Sundloff has promised that his agency is looking at ways of preventing similar problems in the future. Things can and will get better, but that doesn’t mean they are currently bankrupt, as Mr. Wilkas’s post implies.

The Blog Pound catches an interesting—and confusing—story from the Toronto Sun.

New York Times on the recent recall news.

The Washington Post weighs in too.

The AP offers a story about the possibility that cats are more susceptible to the contaminants in the recalled pet food.

We’re not the only ones having problems with recalled food.

Abaxis held a free “Wellness Testing Program” for pet owners at its Union City, CA, headquarters on Saturday. Cats and dogs that had eaten recalled foods were offered free blood tests.

From Michigan State, images from a dog that reportedly ate recalled food.

The Baltimore Sun profiles Maryland horse vet Fred Lewis, who has been practicing for over fifty years. Not that it’s felt like work to him: “‘I can’t retire because I’ve never worked a day in my life.'”

The following journal issues are now available online:

Catmanager received a letter from Hill’s (makers of Science Diet) today informing me (actually the letter wasn’t addressed to me but to “Our Valued Retail and Professional Partners”; yeah, right) about the pet food recall. Is late really better than never? This just seems insulting.

Now, to be fair, I should point out that the letter implies I would have heard earlier from Hill’s had my practice been in possession of any of the recalled products:

If you have not received notification from Hill’s, then the Savory Cuts you currently have in your possession are outside the scope of this voluntary recall.

Catmanager hopes veterinary practices that were in possession of affected Savory Cuts at least heard from Hill’s prior to last Wednesday, which is when the letter I received was dated.

Also to be fair, I should acknowledge that the Science Diet recall was precautionary. Hill’s did the right thing by withdrawing food that was manufactured at the same plant as the rest of the recalled foods even though neither they nor Menu had received reports of illnesses in cats eating Savory Cuts. What remains unclear is whether Hill’s supplied their own ingredients to Menu Foods or relied on that company to procure ingredients. On VIN/VSPN one person has reported a conversation with a Hill’s rep in which the rep said that Hill’s supplied its own ingredients. Catmanager hasn’t seen that claim verified, however. In fact, several posts on VIN/VSPN by a Hill’s official seem to carefully avoid the issue. Catmanager suspects that if Hill’s were supplying its own ingredients it would be taking great pains to advertise that fact.

So why do I feel it’s insulting to receive a letter from Hill’s nine days after the recall was announced? (Aside from the fact that it’s nine days after the recall was announced.) The letter concludes by noting that we might be asked by consumers about the safety of the Savory Cuts products. Why couldn’t Hill’s acknowledge that many consumers are greatly concerned about with this question? That, in fact, the question is actually more along the lines of “Are any Science Diet products safe to feed my pets?” Then the letter asks us to believe

that those products that remain in the marketplace have been manufactured with the hightest quality ingredients and production protocols to “help enrich and lengthen the special relationship between people and their pets.”

I really want to believe this statement. And I have NO evidence to the contrary. But given what I’ve learned about Hill’s in the past week, I’d like more than bland assurances.

Specific questions I’d like answered:

  • Why didn’t Hill’s notify us sooner?
  • Even if Hill’s knew my clinic didn’t have any affected products, what about my clients? How were we supposed to notify them?
  • Why was the Hill’s notification letter signed by the vice president of sales? (A letter from their head veterinarian, vice president of quality control, or the president of the company would have carried more weight. A letter from sales just implies that their primary concern is $.)
  • When did Hill’s know about the recall?
  • What is the basis for Hill’s claim that their nonrecalled Savory Cuts products are safe?
  • Does Hill’s supply their own ingredients to Menu Foods or rely on Menu Foods to supply them? If the latter, how does Hill’s ensure quality control? (Are they inside Menu’s factories? Do they supervise the cleaning of equipment prior to manufacture of Hill’s products? Do they test and monitor the raw ingredients?)
  • How can we believe that their foods are made with the highest quality ingredients? (Just because they say so isn’t going to cut it.)
  • Why were we told that Hill’s doesn’t farm out their production?
  • Why is Hill’s making diets that place marketing concerns (cuts and gravy foods are apparently highly popular with customers) before the health of cats and dogs (again, why is wheat, a well-known allergen, in these and other foods made by Hill’s)?

A woman in Chicago has filed suit against Menu Foods, the AP reports. According to the report the woman “took the 9-year-old cat to its first-ever veterinarian visit the day of the recall” (emphasis added).

A story in the Pittsburgh Post-Gazette reports on a telephone news conference FDA officials held yesterday with reporters. The conference clarified a few matters:

  • Fourteen confirmed deaths (one dog, thirteen cats) led to the recall, including nine from Menu “tasting trials.” The dog and four cats were companion animals (i.e., pets).
  • “The test animals that died were involved in quarterly taste tests routinely done by Menu. The animals were not intentionally given tainted food, as earlier FDA reports had indicated.”
  • The FDA believes the tainted food came only from Menu’s Kansas plant. (Menu also has a plant in New Jersey.)

Also, while Menu still believes wheat gluten is the problem ingredient, “officials are looking at other products and ingredients, including substances that are known to be toxic to the kidneys of dogs and cats.” Catmanager wonders what the writer means by “other products.”

New Jersey’s Star-Ledger runs a story on Menu’s (mis)handling of the PR aspect of the recall and quotes several communications experts who say Menu blew it. “‘You’ve got 60 to 120 minutes,’ . . . because bloggers and Internet chat rooms will start buzzing about the problem.” (Seems about right. I mentioned the story in my Friday news roundup about two hours after if broke and about forty minutes after I found it on the Veterinary Technician’s Journal blog.)

In an unrelated event, a class-action lawsuit was filed in Canada against Royal Canin over pet deaths alleged to have been caused by last year’s vitamin D–related food recall. Reports of the suit all note that it is unrelated to the Menu Foods recall.

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