Veterinary associations


Catmanager saw this AVMA news item the other day: “How to submit samples, report cases related to adulterated pet food.”

The story explains that “the American Association of Veterinary Laboratory Diagnosticians, in consultation with the Food and Drug Administration, was refining a working definition” of what consitutes a “case” of food-recall-related illness. As part of their effort, the AAVLD has set up an online survey (available on the AAVLD Web site and conducted by Michigan State University and the University of Guelph on behalf of the AAVLD) to collect incidents that diagnostic laboratories or veterinarians suspect are related to the food recall.

The AAVLD will share data with the FDA and will present an analysis of the data at the October 2007 AAVLD meeting.

Catmanager was excited to hear about the AAVLD survey, but after checking it out I was somewhat confused.

First
What is the purpose of the survey? Veterinarians have already been encouraged to report incidents to the FDA, their state veterinarian, and (if they are members) to VIN. Now they need to submit to another organization? Already taxed for time, why would they contribute to AAVLD?

According to the AVMA, the primary goal of the survey

is to distinguish true cases of nephropathy unique to this recall, hopefully resulting in a set of criteria defining a true case.

Other survey objectives are to characterize the spectrum of lesions; the temporal and geographic distributions of the suspected intoxications; the species, breeds, and ages of affected animals; and when possible, the brands, lot numbers, and UPC numbers of pet food involved in the toxic exposure, and results of chemical analyses.

Catmanager interprets this to mean that the AAVLD isn’t in the business of counting cases. They aren’t trying to create an authoritative tally (that’s up to the FDA). Instead, they’re trying to figure out how one should go about counting cases. In an e-mail responding to my questions, survey coordinator Dr. Wilson Rumbeiha seemed to confirm this interpretation.

The main objective is to define a true case of pet-food-induced nephrotoxicity derived from several criteria including history of ingestion of contaminated pet foods, documentation of renal failure by chemistry assays and urinalysis, histopathologic signs consistent with pe-food-induced nephrotoxicity and chemistry tests for markers of contaminants found in food, tissues and/or urine. Everyday animals fall sick or die of acute renal faliure and so our job is to come up with criteria that decide what is in and what is out.

Second
Who should be submitting data to the survey? The survey is publicly accessible and doesn’t require registration or passwords. According to Dr. Rumbeiha, the openness of the survey “is meant to encourage participation rather than discourage.” However, some of the

information asked for in the survey is not what you would expect regular veterinarians to have. That information would be gathered at diagnostic laboratories or selfstanding commercial labs like IDEXX. Hence we expect that only terminal diagnosticians will complete the survey as primary practitioners will not have the information handy.

Looking over the survey questions, catmanager suspects primary practitioners could answer all of the questions (in fact, many of the questions about patient history will be more easily answered by the primary practitioner unless they provide extremely detailed histories to the labs) but might not be able to fully answer question 9, which asks about crystal composition. The average practitioner will need to rely on labs to confirm the presence of melamine in the pet’s food or tissues, for example.

Still, I wondered about the openness of the survey. I can without difficulty imagine pet owners attempting to complete the survey. Would the researchers screen out data submitted by laypersons? Dr. Rumbeiha indicated that they will, and he pointed to the unique animal ID (such as a case number assigned by a lab) and contact information asked by the survey. Dr. Rumbeiha and three other pathologists will contact “each and every case entered” using that contact info. Any unauthenticated cases will be discarded from the survey.

Third
Will the survey, which was released on April 4, be updated to include the foods subsequently added to the recall? Dr. Rumbeiha said no, they’ll rely on people using the spot for “other” in the list of foods. This holds open the possibility that the survey could identify new foods in need of recall, although it’s not certain whether that information would be identified soon enough to have a practical effect.

Fourth
When can we expect to see results of the survey? After one or two months, the survey will close so that the team contacting the cases, reviewing slides, and checking the data has enough time to complete their work before the fall presentation to the AAVLD. Because the AAVLD commissioned the survey, they get to decide when and how they’ll release the data to the public. Dr. Rumbeiha wasn’t sure when that might be. He also wasn’t sure when or how the data would be shared with the FDA, but he did say they wouldn’t be sharing data in real time.

Our job is to define criteria of what is a real case of pet food poisoning and what is not. . . . the real work will follow the survey where pathologists will come up with these criteria defining what is in and what is out. That requires time and good scientific review.

So, check with your diagnostic lab to see whether they’re submitting reports to the AAVLD survey. If they’re not, consider submitting them yourself. (Pet owners, please save yourself and the researchers conducting the survey some time and don’t try to submit data yourself. You might, however, want to check that your veterinarian is aware of survey—many veterinarians aren’t members of AAVLD, and the AVMA news story announcing the survey won’t be published in print until the May 1 issue of JAVMA.)

As Pet Connection noted last week, this survey could serve as a model for a future reporting mechanism. One thing that struck catmanager was how simple setting up the survey appeared to be. It’s hosted at SurveyMonkey.com, which is one of many online survey companies that make it surprisingly easy—and inexpensive—to create your own survey. Of course, someone has to review the data (which presumes people have taken the time to submit data), and as Dr. Rumbeiha noted in his e-mail to me, the real work doesn’t start until the data are all in.

Still, from a technological standpoint, setting up a national adverse-events database for veterinary medicine should be doable with existing, commericially available software. Finding money for the real work of reviewing all the data is where the political will is needed.

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The American College of Veterinary Nutrition released a statement on the food recall (thanks to Pet Food Blog).

The statement expresses condolence to pet parents whose pets have been “adversely affected by the recent pet food contamination incident.” (Incident is an interesting term to use for an ongoing problem.)

It argues that the “ever-changing news about the pet food recall” and its media portrayal

has created confusion and panic . . . and allowed for wild speculation about the safety and wholesomeness of commercial pet foods in general and mistrust of both the industry and government oversight of the industry.

It notes the college’s confidence that everything possible is being done to “identify the source of contamination and isolate pet foods affected by the contamination” and further notes that this process takes time.

It makes the sensible comment that “Contrary to the assertions of some, it simply is not in the best interest of companies to want to sell potentially unsafe product.”

It urges caution among those inclined to start feeding their pets home-prepared foods.

Overall the statement is, as the Pet Food Blog notes, a “voice of reason.”

My wife spoke with an AP reporter yesterday about the food recall. One question the reporter asked was whether the state veterinarians had asked local veterinarians to send in data on pets affected by the recall. Oregon’s state veterinarian has been collecting data in his state and released numbers earlier this week.

The reporter’s question got catmanager wondering about how the state veterinarians and state veterinary medical associations had responded to the pet food recall.

What I discovered was disappointing and might go a long way toward explaining why it’s been so hard to get official numbers: almost none of the states seem to want to collect the information (or if they do, they’re making it darned difficult to find out how and to whom to report data). I know Gina and the crew at Pet Connection have proposed a national, centralized system to which veterinarians could submit morbidity and mortality data during crises like the current one. This is a wonderful, long-overdue idea, and I urge pet owners to press the idea on their congressmen and -women. I also urge them to agitate at the state level. I see no reason why the states cannot develop their own reporting structures (perhaps in conjunction with the federal government). Doing so will allow local information to be disseminated more quickly (rather than waiting for the federal government to disaggregate data from around the country, states could release their own data) and will give states the information needed to more effectively manage crises like the present one. If you’re concerned about how the pet food recall has been handled, don’t forget to work for change at the local level as well as the national.

Before jumping into the results of my canvassing, some caveats:

  • Catmanager is not a member of any of the state veterinary medical associations. So I was unable to access the members-only sections of their Web sites. Sites that had no publicly available information about the recall might still have information that is only available to the members.
  • Also, although I have not heard reports of this happening, it is possible that some (or even all) state VMAs have contacted their members via e-mail, fax, or phone to alert them about the recall.
  • In most states the state veterinarian is a position within the department of agriculture. Not all states have Web pages specifically for the office of state veterinarian. I’ve done my best to identify the appropriate Web sites for all the state veterinarians, but I might have missed some and thus missed information about the recall on their Web site.
  • Furthermore, in many cases the state veterinarian’s primary responsibility is for food animals. Because of this, some might have deemed the pet food recall to be outside their purview and thus have made a conscious decision not to post information about it.

With caveats out of the way, onward to the data! As of 27 March,

  • 24 state VMAs plus the Puerto Rico VMA provided (publicly accessible) information about the recall on their Web sites.
  • Of these, 16 included only links to other sites (typically the AVMA, Menu Foods, and the FDA); and 8 included at least some original content, such as a summary of the recall or a press release generated by the VMA.
  • In catmanager’s opinion, the Georgia and Oregon VMAs have done the best job of providing information to the public.
  • 15 of the 50 state veterinarian Web sites (including Web sites of departments that comprise state veterinarians’s offices) provide publicly available information about the recall.
  • 1 (Connecticut) addresses the need for the state veterinarian to work closely with the state VMA during the crisis
  • Only 3 (4 if you count Connecticut) discuss what the state is doing to respond to the crisis (in each case: spot checking retailers to make sure they’ve pulled the recalled pet food; in the case of Georgia: also conducting lab testing of the recalled food)
  • 1 state (Vermont) asks veterinarians to report deaths and illnesses that they suspect are related to recalled food. (We know that Oregon has been collecting this data, but I couldn’t find on the Oregon state Web site where they invite veterinarians to submit data.

The data
The table that follows lists all fifty states, the District of Columbia, and Puerto Rico. From the left, the columns indicate state; whether I found publicly available information about the recall on the state VMA’s Web site; any comments I wanted to make about the state VMA’s Web site; whether I found information about the recall on the state veterinarian’s Web site (or the department or agency to which the state veterinarian’s office belongs); and any comments I wanted to make about the state vet’s Web site. To check out the state VMA Web sites, go here. To check out the state veterinarian Web sites, go here.

State VMA mentions recall Notes State vet mentions recall Notes
Ala. no   no  
Ak. ? no Web site no  
Ariz. yes links to information elsewhere no  
Ark. no   no  
Cal. yes links to information elsewhere, plus a client information sheet created by the CVMA and a fact sheet for veterinarians supplied by Iams no  
Col. yes links to information elsewhere no  
Conn. yes links to AVMA advice to pet owners yes press release urging pet owners to check their pets’ food and the Dept of Ag to work closely w/CVMA to ensure the public is getting “accurate information” about the recall
Del. no   no  
D.C. no   ?  
Fl. yes press release and links to information elsewhere no  
Geo. yes information for pet owners on main page; FAQ for pet owners; information for member veterinarians (not publicly accessible); one of the better responses yes a couple of hard-to-find press releases: one notes the state lab will be testing samples and inspectors will be checking that retailers comply with the recall
Hi. no   no  
Idaho no   no  
Ill. no yes Update, 3/28: Now recommends AVMA main page for info. no  
Ind. yes links to information elsewhere no  
Iowa yes information for pet owners (from AVMA); information for member veterinarians (not publicly accessible) no  
Kan. yes information from AVMA no  
Ken. yes links to AVMA no  
La. yes three press releases in .doc format yes press release on main Dept. of Ag and Forestry site
Maine no   no  
Md. yes mostly information for pet owners (from AVMA) no  
Mass. yes links to information elsewhere yes link to PDF
Mich. yes several documents in .doc format; links to information elsewhere no  
Minn. yes “Information about Dog Food Recall” (which links to the original FDA press release) no  
Miss. unknown no Web site no  
Mo. yes links to AVMA no  
Mt. no   no  
Neb. yes brief description on Web site; links to information elsewhere no  
Nev. no   no  
N.H. no   no  
N.J. yes links to FAQ in .doc format (same as La.) yes reprints FDA’s original news release
N.M. no   no  
N.Y. no no publicly available information; possibly information available for members only yes press release announcing discovery of toxin (seems to be the only mention)
N.C. no   yes on main Dept. of Ag page
N.D. no   no  
Ohio no   yes on main Dept. of Ag page (link to Menu Foods)
Okla. yes links to information elsewhere no  
Ore. yes plenty of information, most on the site; one of the best yes link to FDA’s original press release
Penn. no yes Update, 3/28: Now has page dedicated to recall information, including alerts sent to PVMA members and links to information elsewhere. One of the better state VMA responses. yes press release and links to information elsewhere
P.R. yes links to Menu Foods ? no Web site
R.I. yes links to AVMA press releases; site mentions only the Iams and Eukanuba recall yes press release (notes officials will be spot checking retail outlets for compliance with recall); links to FDA, Menu
S.C. yes links to information elsewhere (link to VIN actually goes to the Veterinary News Network) no  
S.D. no   no  
Tenn. no   no  
Texas yes links to AVMA and Menu Foods no  
Utah no   no  
Vt. no   yes press releases on main Agency of Ag page; one asks vets to report deaths and notes inspectors have been checking retailers for compliance with the recall
Va. no   no  
Wash. yes press release; links to information elsewhere yes overview (written for pet owners) and links to information elsewhere
W.V. no   yes press release on main Dept of Ag page
Wisc. no information might be available in members-only section yes info on main Dept. of Ag page with more info here, including links and advice for pet owners, vets, and retailers [This is the most informative state vet site I found.]
Wy. no   no  

Pet Connection has now received reports of over 1,000 pets presumed to have been killed by eating tainted food. Their latest post is here.

The AVMA has posted data collected by New York’s Animal Medical Center, which reviewed all blood chemistries performed at AMC between 17 and 20 March. Of the chemistries performed during this period (on animals seen for all reasons, not just because of recall-related concerns), 5 percent “have been determined to have food-related acute renal failure.” AMC also describes the symptoms they have been seeing:

All pets had at least one clinical sign of acute renal failure: 75% had anorexia, 50% had polyuria and polydipsia, 50% had vomiting and 50% lethargy. The course of the disease before presentation to AMC ranged from 1 to 60 days. Mean creatinine was 7 mg/dl with a range of 2.1-14.8 mg/dl. Mean BUN was 110 mg/dl with a range of 33-210 mg/dl. Three pets were diagnosed on an out-patient basis. Nine animals were hospitalized of which 3 (2 dogs, 1 cat) died or were euthanized despite treatment. Six were discharged from the hospital. Four of these were discharged with persistent azotemia. Our follow-up time is short and the long-term prognosis is unknown.

The information in this release should be of considerable use to veterinarians across the country.

NPR’s Talk of the Nation included a segment on Thursday that touched on the pet food recall. Host Neal Conan introduced the food recall as a “scare,” as if the situation was all under control. (He was called on it in the program’s blog.) Catmanager wasn’t too impressed with guest Steve Dale. When asked by a caller if anything was going to be done for owners who lost pets, he said yes and mentioned the Yahoo class action lawsuit group and then started talking about how polycystic kidney disease was a genetic disease and totally unrelated to acute kidney failure. Okay. What did that have to do with anything? Catmanager wishes NPR had asked a veterinarian to be on the show. Dale did make a good point about the dithering between Menu Foods and the FDA over who should be keeping the “official” database of complaints. Without naming any particular Web sites, Dale criticized those that had “sprung up” and were trying to collect information too. In his post on the NPR blog he writes that “Sadly, some of the information out there has been sensationalized.”

In a post warning that the news will get worse, the Pet Industry Weekly blog makes an excellent point regarding a story in the San Francisco Chronicle that said the FDA is not asking veterinarians to report suspected cases of recall-related deaths:

This is a mistake. In the lightly regulated industry of pet food manufacturing, official documentation of the toll of this pet disaster will help craft the regulations and legislation that will inevitably follow. The last pet disaster – hurricane Katrina – resulted in new federal and state laws incorporating pets into disaster planning.

Torontovet speculates on the possibility of aspergillus being the contaminant in the Menu Foods recall.

Here’s a video of a 36-year-old cat, or so the owner claims. Catmanager has his doubts, though.

Another cat attack in the news: A Florida man was attacked by a stray cat on Tuesday while working in his yard. The cat tested positive for rabies.

The latest issue of Journal of Veterinary Medicine Series A (Vol. 54, Issue 3, April 2007) is now available online.

A new veterinary association is being founded to “to serve the discipline of aquatic veterinary medicine in enhancing aquatic animal health and welfare, public health, and seafood safety in support of the veterinary profession, aquatic animal industries and other stakeholders.” Veterinarians interested in becoming charter members of the Aquatic Veterinary Association are invited here.

The AVMA is now offering brochures to help prospective pet owners through the pet-selection process. The two new brochures (one on cats, one on dogs) are part of the AVMA’s “What you should know about” brochure series. AVMA members can download the brochures at the AVMA Web site.

In the past week I’ve added several pages of links that I hope will be useful. Please let me know if you notice any omissions or errors!

  • International Veterinary Associations lists associations outside of the United States, as well as those based in the United States whose names include the word International.
  • National Veterianry Associations lists associations based in the United States (except for those that choose to call themselves “International”).
  • State Veterinary Associations lists all fifty state veterinary medical associations, plus the ones for the District of Columbia and Puerto Rico.
  • Veterianry Technician Associations lists international, national, state, and local associations for vet techs and veterinary nurses.
  • Veterinary Blogs lists all the veterinary blogs catmanager has been able to track down. The list includes blogs by veterinarians, by veterinary students, by veterinary support staff, by others in the veterinary industry, as well as a handful of miscellaneous blogs that might be of interest to those in the veterinary profession.

Catmanager is still working on a list of local veterinary associations (i.e., those that serve cities, counties). If you know of any, please contact me!