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.

This first story has been all over the Internet, so apologies if you’ve seen it elsewhere. A cat in England has taken to riding the bus each morning. It’s a brief ride (one stop only) that takes the feline suspiciously close to a fish-and-chip shop. One blogger argues that only an escaped lab cat could navigate public transit, a feline Mrs. Frisby as it were. Catmanager thinks the blogger doesn’t know enough cats.

A story from earlier in year tells of Tama, a cat appointed honorary stationmaster of a Japanese railway station. Although the original news story doesn’t seem to be available, a photo and some text from the original article are preserved at this blog.

From one of catmanager’s favorite feline Web sites, Purr-n-Fur, a profile of the resident cats of the Ft. Smith, AK, Trolley Museum. Purr-n-Fur also has several stories of cats taking nonpublic means of transportation such as airship, military vessel, methanol tanker, and spaceship.

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.”

Dr. Dan at The Happy Healthy Horse catches an amusing AP story about an RUI: riding under the influence.

Another horse doc, Dr. Alan Weldon, shares his recent experience working on a zebra and elephant at the Jacksonville Zoo.

Tasmiya compares the respect physicians get with the attitudes veterinarians sometimes face.

Patients waiting for their G.P. can often wait for over an hour and nobody complains. It’s just expected that they will have to wait. If vets are running 15 minutes behind, we must apologise profusely and placate many an angry client. I know everyone has busy lives and things to do and nobody wants to sit around for longer than they absolutely have to but sometimes we will have an emergency or urgent case to attend to and so normal vaccinations and ear cleans will have to wait.

As Tasmiya acknowledges, most people understand this—but the ones who don’t sure can make for an interesting day. Actually, I think it’s a credit to the profession that most veterinarians are so conscious of their clients’ time. Just one more way the veterinary community rises above our human medicine counterparts!

A (human) surgeon comments on the environmental impact of surgery. Not pretty. All but One Species, who found this interesting post, notes that the reality in vet med isn’t much different. Catmanager concurs.

Forbes has a great commentary on the response of pet food manufacturers to the recall crisis (thanks PetConnection!).

The home pages of Hill’s Pet Nutrition, Del Monte Foods and Nestlé Purina PetCare offered links to press releases that sound like the product of a chemist, a lawyer and a publicist huddled around a conference table.

From the article’s list of recommendations:

Third, stop being defensive. Simply reassuring people your other products are safe isn’t very reassuring. After all, a few weeks ago, you were de facto assuring that all your products were safe. Do you trust the guy who says “just trust me” right after he messed up? Probably not. To regain consumers’ trust, pet food brands have to give consumers reasons to trust that their food is safe.

Dr. Zwingenberger offers another installment of her Journal Club and answers more questions about peritoneal detail.

Dr. Khuly thinks pet food companies have left veterinarians out to dry. She speculates on the impact the food recall might have on veterinary professional liability.

Lyme disease on the rise in Vermont.

World Veterinary Day is April 28. The AVMA has a press release.

The USDA has extended for another six months its BSE-testing contract with the University of Washington College of Veterinary Medicine. UW’s is the only BSE testing program in the Pacific Northwest.

An update from the New York Times on the 2005 fake veterinarian case. (You remember, the case in which Fred the cat went undercover to bust a Brooklyn man practicing veterinary medicine without a license. Sadly, Fred was later killed in a traffic accident.)

For the seventh straight year Cornell’s College of Veterinary Medicine has been ranked the top vet school in the country by U.S. News and World Report.

“Fat Cat Goes Wild”: another cat attack in the news.

Serbia is trying to give the veterinary and food production sectors of its economy a boost.

Veterinarians strike (briefly) in Cyprus.

The EU announced plans to form an emergency veterinary team similar to the AVMA’s VMATs.

News flash! Pet food scare over! So said a Florida veterinarian last week. The head of the AVMA says food is safe.

With spring upon us, veterinarians might once again be asked to operate on that sweetest of avian critters, Peepsis mallowis. Need a refresher? Catmanager recommends this excellent article on Peep surgery from the venerable Peep Research Organization. The article makes clear that operations on this species, while carrying their own special set of complications, are not necessarily restricted to the avian specialist. From the “Introduction”:

One of the great mysteries of the Peep species is that these creatures are always born as conjoined quintuplets. Some scientists have theorized that this arrangement, much like pack behavior in other species, serves as a natural protection against predators. . . .

Nevertheless, as Peeps integrate into modern society, there is no ethical reason they should be denied the benefits of individualism.

In addition to describing the surgery itself, the article offers tips on patient prep, anesthetic protocols, how to handle emergencies, and advanced reconstructive surgical technique. Enjoy!

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