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Posts in Category: Medical Issues

Disabled Woman Turns to Angel Fund for Help With Dog’s Heart Problem

In 2004, Galina Coleman slipped and fell at work not far from where she lived in Petaluma.  She had five surgeries for the injuries she suffered.  In the wake of that personal catastrophy and disillusioned with her marriage, she got a divorced and moved to Southern California.

Today, estranged from her former husband and two sons, she lives in Aliso Viejo and struggles to pay her bills. She was declared totally disabled in 2006 and lives on a Social Security disability check.

“I’m just really struggling,” she said.  “I’m in affordable housing.  My rent is $1,398 a month, which is ‘very affordable’ here. However, for me it’s just really, really difficult.  I’ve tried to get jobs but it just hasn’t worked out for me.  I have two senior dogs and a senior cat and I know they’re basically at the end of their lives.”

Late last November, her struggles came into clear perspective when Abby, her nearly 14-year-old Dachshund, appeared to be having a digestive issue.  “When I took her to a veterinarian, the doctor discovered a heart murmur. She thought it was pretty serious and prescribed medication for Abby after doing an x-ray,” Galina said.

Later, she took the dog to Dr. Lynn Sanchez, a veterinarian she said she likes and trusts at Garden Grove Dog and Cat Hospital.  Dr. Sanchez recommended an electrocardiogram to get a clearer idea what Abby’s problem was.  But Galina could not handle the cost.  She applied for an Angel Fund grant and was awarded $451, a sum that was matched by the hospital.

Abby got the electrocardiogram in late December – and with it some good news: the murmur was not as bad as originally suspected.  “Dr. Sanchez said that everything looked pretty good and prescribed three medications,” Galina said.  A week later, when she took Abby back for a recheck, two of the medications were discontinued.  “One of them was really hard on her kidneys,” she said, “so I was really glad to get rid of it.”

After another recheck early in January, the dog is continuing to take Vetmedin.  “She’s not in heart failure but has some damage to a mitral valve,” Galina said.

When Galina divorced, she took her animals with her.  “I have tried to help them on a piecemeal basis,” she said. “I’ve had to rely on charity.  They’ve all been in pretty good health but now they are at the point where that’s starting to change [because of their ages].”

Augie, Abby’s brother, is two years younger at 12.  Aurora, her cat, also is 12.  Galina believes that Augie will need a dental treatment soon.

“I’ve been given the blessing of having these animals – they are just truly a blessing for me.  I am their steward and I need to make sure they get whatever is needed to take care of them. I have to do that.

“Had I not been able to do this [echocardiogram], I would either have been giving Abby way too much medication or no medication at all.  It wouldn’t have been good either way.  it was going to be detrimental to her health one way or the other.”

Galina is grateful to Angel Fund.  “They really helped me out,” she said.  “It is a wonderful thing to help people because things can be so expensive.  I think it’s a really great thing for veterinarians to give back.  I admire them for doing that.  I think that’s what we’re all here for – to give back.”

She is thinking about moving with her animals to a place – perhaps New Mexico – where her disability check would go further.  She is 58 years old.

“I have ignored a lot of my life for these dogs.  But, in return, they’ve provided me with something,” she said.  That something is love and support.

A Kiss Changes Everything

Animal Health Foundation’s Caring Creatures Pet Partners Team Jane Horsfield and Kiss are celebrated in Pet Companion Magazine!

From  Pet Companion Magazine  http://digital.petcompanionmag.com/publication/?m=40178&i=651393&p=38    “Reprinted with permission from Pet Companion Magazine, Spring 2020.”

Just like the rock band for which she’s named, the black-and-white­masked Kiss never gives up, even when people might count her out.

Like KISS, whose members have been rocking for 4 7 years, she keeps coming back, stronger each time, just when you think she’s thrown in the towel. KISS the band is traveling the world throughout 2020 on their The End is Near tour-this time, they say, they’re really going to retire. We’ll believe it when we see it.

Kiss the border collie, however, has no plans to throw in any towel or slow down, and certainly not to retire. This rock star therapy dog/athlete has a can-do attitude that won’t quit, and all the curve balls she’s been thrown so far haven’t taken her down. She’s tough as nails, and yet sweet as the pink swipe of a gentle doggie smooch. She’s one special dog who has defied unthinkable odds to not just survive but also stay at the top of her game.

And what game is that? Well, for starters, she used to give other dogs a run for their money in flyball, agility, dock diving, nosework, and Frisbee catching. But being a top athlete wasn’t where Kiss found her calling. It turns out her best talents emerged during her 11-year career (so far) as a therapy dog-part of the Animal Health Foundation, an affiliate of Pet Partners. Kiss visits hospital patients, helps elementary school children learn to love reading, and appears at many public service events benefiting various causes for pets and children, including her local Rotary Club’s fundraising efforts to raise awareness of skin cancer. Since 2013, she has served as a crisis response dog, sent on deployments where she has helped people affected by disasters or other crises cope with their losses. But her best trick yet? Beating her own cancer, a soft-cell sarcoma on her front left leg, and now living with a complex disease called immune-mediated hemolytic anemia (IMHA). This 13-year-old takes it on the chin, but she never takes it lying down. Despite a grim diagnosis and multiple complications, Kiss is making steady progress and will soon be back visiting her local hospitals and elementary schools, putting smiles on the many faces she loves.

Kiss was six months old when she was given to Jane Horsfield and Dan Balza of Fountain Valley, California, by a fellow flyball enthusiast. Horsfield and Balza previously owned several dogs involved in the sport-which, heartbreakingly, they had lost to various forms of cancer. A lover of border collies, Horsfield was all in for taking Kiss home. However, she and Balza had recently discussed how their household was definitely at its maximum dog capacity. Grudgingly, Balza agreed to take a look at a photo of the striking black and white little furball. It wasn’t long before Kiss became part of the family.

Horsfield describes young Kiss as “one wild little banshee.” She recalls, “She barked, she chased, she screamed … and she ate everything in sight. She chewed clothes, glasses, furniture, walls (not kidding!), and the oak baseboard. I’d get home from work and, with drywall hanging from her mouth, she’d look at me with those big, brown, loving eyes. Who could be mad? Eventually, the bad behavior faded, and a wonderful ‘teenaged’ doggy emerged.”

At that time, Horsfield was doing pet therapy work with another of her beloved athletic dogs, who was 11 and nearing retirement age. All of her dogs do dog sports, but therapy work-that’s a raised bar that Horsfield says only a few dogs can reach. Because Kiss was proving to be a loving and sensitive dog, she began to train her. At just 2 years old, Kiss passed her Pet Partner evaluation, and with that opened
a new chapter in her life. Although her primary job was now therapy work, Kiss still enjoyed participating in dog sports in her spare time.

In 2017, Kiss’s image was featured on a surfboard that was part of a fundraiser by the Huntington Beach Rotary Club. Local artists were paired with local surfboard shapers, and 22 surfboards were decorated and auctioned off, with the money donated to local hospitals benefiting skin cancer research, prevention, and care. At the unveiling of her surfboard, a participant visiting with Kiss felt a swelling on her front left leg and alerted Horsfield to it. It turned out to be a soft-tissue sarcoma, and Kiss was referred to a specialty hospital.

Having lost four previous dogs to cancer, Horsfield and Balza were devastated, fearing the worst. But after 18 months of treatment, including 6 months of rehabilitation, Kiss was declared free of cancer and cleared to go back to work.

Horsfield got word of a grant from the Petco Foundation and Blue Buffalo that was available to therapy dogs with cancer. The foundation donated $3,000 to help cover some of the costs ofKiss’s treatment, and Petco Foundation and Blue Buffalo shared Kiss’s story on their websites for the 2018 Pet Cancer Awareness campaign. The two companies have invested more than $15 million into pet cancer research since the campaign began in 2010. Asked to participate again in 2019, Kiss’s face was featured on ads in People magazine, on Petco’s Pet Cancer Awareness website, on posters in nearly every Petco store, and even on a reuseable tote bag, a gift for donating $10 to the campaign in any Petco store nationwide.

Sadly, between the time she was declared cancer free and the start of the 2019 Pet Cancer Awareness campaign in May 2019, Kiss was diagnosed with immune-mediated hemolytic anemia, or IMHA. “It’s a horrible, not-so-common disease where the immune system goes haywire and starts destroying its own red blood cells,” explains Horsfield. “She liter­ally was fine on Saturday, then on Sunday morning she didn’t want to eat her break­fast.” While that symptom didn’t seem particularly alarming, Horsfield discovered discoloration in Kiss’s mouth and imme­diately took her to a veterinary specialist. From there, her condition went downhill fast, but thankfully Kiss’s condition today has been mostly stabilized through medica­tion. But not before she suffered an intes­tinal blockage that required emergency sur­gery and a severe bout of pneumonia. The road has been long, and it’s been rough. But Kiss is not a quitter. She fights on.

And Horsfield, who “researches absolutely everything” but was too terrified to even look up this disease at first, is fighting along with her. Every day, she’s learning and, more importantly, educating others about IMHA. It’s a complicated disease with no “one-size-fits-all” treatment-veterinarians must try protocol after protocol to find one that strikes the right balance for Kiss. “This story is far from over, and she has not been ‘cured.’ Knowledge is everything when treating this disease,” Horsfield points out. She says if she’d waited a day to take Kiss to the vet or not gone straight to a specialist, Kiss likely would have died, according to her doctors. “Dog owners need to be aware of what IMHA is and know the warning signs” she cautions. “IMHA packs quite a punch, and Kiss’s life has taken a drastic side road.” Younger dogs who make it through this disease are generally more able to get back to normal, says Horsfield. “Kiss got this ugly disease at 12. She’s not a young dog, but she was in great shape before this hit, which is probably why she’s been able to fight it. I am just grateful to still have her with me 12 months after diagnosis.”

While Horsfield admits that Kiss probably won’t be competing in flyball or dock diving anytime soon, she still enjoys her nosework and catching the occasional ball or Frisbee. A pivotal moment in her recovery was when she was finally able to take a swim once again in the family’s backyard pool with her pack, the other family dogs. She’s also back to visiting hospital patients, and will head back to school for the elementary reading program very soon. In December, when a student from Rim of the World High School in Lake Arrowhead was tragically murdered, Kiss was there to lend support. In January, she helped deploying military service men and women and their families prepare for the year ahead.

With all she’s been through, you might expect Kiss to just bask in the sun and take life easy for the rest of her days. But that’s not who she is. That little banshee who barked her head off, ate everything in sight, and chewed her way through puppyhood (and the drywall) isn’t resting on her laurels or her haunches. She’s forging ahead, mending hearts and spreading joy and kisses along the way. Because, sometimes, a kiss changes everything.

Immune-Mediated Hemolytic Anemia
By Julie Stegeman, DVM 

Immune-mediated hemo­lytic anemia (IMHA) is an autoimmune condition wherein the patient’s immune system attacks their own red blood cells as if they were a foreign invader. IMHA is more common in dogs than in cats, and it is an almost daily occurrence in the caseload of a referral hospital because of the need for inpatient support­ive care and often the need for blood transfusion. It is most often seen in middle-aged dogs and in young cats, and some breeds are more at risk ( cocker spaniels, miniature schnauzers, miniature dachshunds, etc). IMHA represents a loss of immune system “tolerance of self.” Our immune system has checks and balances built in, but when there is a disturbance in that balance, a red blood cell can “look” like a virus to an immune system cell. It then be­comes a target for destruction, leading to severe anemia and death if left untreated.

Symptoms ofIMHA initially can be vague. Lethargy, poor appetite, even a fever may be seen. Pet owners might notice a red or orange discoloration to the pet’s urine, or they might notice pale gums. The gums and skin might even appear yellow (“jaundiced”) due to buildup of bilirubin, which is a byproduct ofred blood cell destruction. Orange stool is also commonly seen. These symptoms lead to taking the pet in to their veter­inarian. Blood tests will show anemia and may or may not show elevated bilirubin levels, elevated white blood cells, low platelets, or elevated liver or kidney values. If the platelet count is low, the pet may have autoimmune destruction of their platelets as well-this is called Evan’s syndrome.”

It is recommended to screen for a variety of immune system triggers in an IMHA patient, such as various tick-borne illnesses, viral infections, other infectious diseases, and cancer. Other triggers can include a variety of medications and even (rarely) vaccinations. If there is an underlying triggering con­dition, the immune destruction will continue until the trigger is eliminated. This is especially important because treatment for IMHA requires immune suppressive medications, and if there is an infectious disease present, the immune suppres­sant medications will allow the triggering infectious disease to overcome the patient. It is very important to provide a full medical and travel history to the attending veterinarian, so that these issues can be discovered right away. Various blood tests, chest radiographs, and abdomi­nal ultrasounds are usually per­formed to screen for underlying conditions, depending on the patient and their exact history.

If no inciting cause is identi­fied, then immune suppressive treatment is begun. The corner­stone of immune suppressive treatment is glucocorticoid (ste­roid) treatment, most commonly in the form ofprednisone or as injectable dexamethasone. High doses of steroids are required at first, because the immune reac­tions in IMHA are very intense, and progression is rapid if left unchecked. It can take several days to start to see the benefits of the immune suppressive treatments. In some patients, if the immune system is attacking red blood cells at the level of the bone marrow ( where they are being produced), it can take 4 to 6 weeks for stabilization of the red cell levels to occur. Until the red cell level ( often determined with a Packed Cell Volume [PCV]) stabilizes and starts to increase, blood trans­fusions are often necessary. Transfusions help “buy time” until the steroids can control the situation. Unfortunately, the transfused red blood cells are often destroyed as quickly as the pet’s own red blood cells, so repeated transfusion may be needed.

In addition to steroids and transfusions, sometimes other treatments are used. Intrave­nous gamma globulin treatment (IVIgG) is an expensive but often effective way to shorten a hospital stay. This treatment binds to auto-antibodies and keeps them from attacking the red blood cells. It also may reduce antibody production by the patient’s body. It helps “win the battle” but is not proven to improve long-term outcomes. Plasmapheresis is another treatment available at a few referral hospitals in the nation, with a similar end result as IVIgG. Other immune suppressive medications such as cyclosporine, mycophenolate, azathioprine, or leflunomide, often started in conjunction with prednisone, take longer for full effect and are most helpful to reduce how much prednisone is given over the long run.

Patients with IMHA have a high risk for development of abnormal blood clots, and pulmonary embolism is actually one of the leading causes of death in these pets. Therefore, it is common to prescribe blood thinners such as aspirin, clopi­dogrel (Plavix), and/or heparin. A blood thinner is often given as long as the prednisone is given.

Because anemia affects the entire body, gastrointestinal support is often needed, in the form of antacids, anti-nausea medications, and coating agents.

Survival ofIMHA is, un­fortunately, not 100 percent. Estimates vary, but the author’s experience is that approxi­mately 75-percent survival is expected. Not all pets respond completely to treatment. Others succumb to pulmonary embo­lism. Rarely, they develop sec­ondary opportunistic infections, such as fungal infections, due to chronic immune suppressive therapy.

Close monitoring is critical after the patient is discharged from the hospital. A patient may need to be rechecked a couple of times a week at first, gradual­ly reducing to once every 2 to 3 weeks. The medications are ta­pered over time, and usually by 4 to 6 months after diagnosis, the pet is either off medication entirely or is on the minimum dose of medication required to maintain a normal red blood cell level. Relapses can occur, as can other immune-mediated diseases.

In summary, IMHA is a life-threatening but treatable disease, which most but not all patients survive. A thorough evaluation of the patient is needed initially, and most re­quire hospitalization to survive the initial part of the illness. Long term, the pet owner will need to work closely with their veterinarian to adjust medica­tions and watch for relapses.

Innovative therapy puts Blaine, WA dog’s cancer into remission

The Northern Light Community Newspaper, Bellingham, WA
Blaine dog Wiley with his veterinary team at Bellingham Veterinary. From l., Brittany Grant, Sebastian Grant, Dr. Kevin Steele, Sharon Pozzi and Dr. Edmund Sullivan.
Blaine dog Wiley with his veterinary team at Bellingham, WA Veterinary. From l., Brittany Grant, Sebastian Grant, Dr. Kevin Steele, Sharon Pozzi and Dr. Edmund Sullivan.
  • by Jami Makan

When Jackie Craig got her dog Wiley from a ranch when he was eight weeks old, she expected him to have a long, healthy life. That’s because he’s a Blue Heeler, a type of Australian Cattle Dog known for its long, healthy lifespan and lack of predisposed conditions. Wiley quickly became a beloved figure at The Hair Shop on Martin Street in Blaine where Craig works. “He’s the barbershop dog,” she said. “Everybody knows him.”

So it came as a shock when Wiley, at the age of seven and a half, was diagnosed with lymphoma in August last year. Craig first noticed that Wiley was gaining weight and would start coughing when he drank. She took him in for an appointment at Bellingham Veterinary, where Dr. Edmund Sullivan performed blood work and diagnosed Wiley with B-cell lymphoma, a type of blood cancer. It is also known in people as non-Hodgkin’s lymphoma. “It turns out the lymph nodes in his neck were extremely enlarged,” Craig said. “He was in very sorry shape, and they said he would’ve died within two weeks.”

Although she didn’t have pet insurance – “My biggest mistake,” Craig said – she decided to pay for chemotherapy for Wiley. “I did not think he was going to make it,” she said. “I just wanted to prolong his life. It was agonizing trying to decide whether to put my dog to sleep.”

At first, Dr. Sullivan performed chemotherapy on Wiley once a week. Unfortunately, it wasn’t working well. “Wiley had a very poor response to standard chemotherapy,” said Dr. Sullivan. “On the standard therapy, he didn’t get into any kind of remission at all. He quickly would relapse.”

That’s when Dr. Sullivan decided to try a new approach being developed around the country. Through a separate Bellingham company named Aurelius Biotherapeutics, of which his wife Dr. Theresa Westfall is the CEO, Dr. Sullivan has been working for years in conjunction with the Fred Hutchinson Cancer Research Center in Seattle, as an off-campus research partner. “We have developed therapies for dogs as patients through that relationship,” said Dr. Sullivan. One of those therapies is known as adoptive T-cell therapy. It is a therapy that is also used on some human patients, and Dr. Sullivan decided to try it on Wiley.

“Basically, it is a method where we first take blood out of the dog,” explained Dr. Kevin Steele, Dr. Sullivan’s Blaine-based lab researcher. “We take anti-tumor T-cells away from the influence of the tumor. The T-cells, the anti-cancer cells, they are in culture now. We give them dead tumor to attack. They expand and get very anti-tumor. All of this is happening in culture. Then we inject them back into the dog.”

Dr. Steele said that adoptive T-cell therapy is typically used in conjunction with standard chemotherapy. First, the chemotherapy kills off rapidly dividing tumor cells, and then the T-cells, after being “jazzed up” in the laboratory, are injected to “hunt down” any surviving cancer cells. The first time Dr. Steele and Dr. Sullivan tried the technique was in 2016, and since then, they have treated about a hundred dogs together. They have conditional USDA approval to provide the treatment, and they are currently working on overcoming additional levels of regulatory hurdles to expand their facility.

“With standard therapy, we don’t have any cures,” said Dr. Sullivan. “So none of them survive. This immunotherapy, meanwhile, has resulted in a fair percentage of dogs living for long periods of time, and some of them being cured,” which he defines as being cancer-free for longer than two years after a diagnosis. Some dogs he has treated have gone as long as four and a half years (and counting) without relapsing. “We believe there’s something to this.”

The experimental treatment was performed at no cost to Craig. The doctors grew T-cells for Wiley and then gave him an additional dose of standard therapy followed by two infusions of the T-cells. Wiley went into remission and has gone without additional chemotherapy for several months now. “Just last week, we did an analysis and he was free of disease – there was no detectable disease,” said Dr. Sullivan. “We will generate another batch of T-cells for him to see if we can extend his remission even longer. There’s a chance he may be cured – we don’t know that until he’s gone two years since his diagnosis – but we’re already six months in. We’re a quarter of the way there.”

During the entire process, Craig said that Wiley’s suffering was minimal, and that he didn’t lose hair. “Now he’s got the puppy bounce,” said Craig. “He was pretty sick when he was going through chemo. I could only get him to eat steak. Now he’s eating completely normal and he’s right back to his old self, playing with other dogs.”

Craig is extremely grateful to Dr. Steele and Dr. Sullivan, who will continue to monitor Wiley’s condition. “Kevin is an angel,” she said. “And Dr. Sullivan, he sits on the floor and talks to the animals. He loves the animals. His entire staff is just very compassionate.”

Craig said that with so many dogs getting cancer, these treatments have come a long way and are worth it. “It gives other people with dogs hope,” she said.

Pancreatitis in Dogs

Date Published: 01/02/2006
Date Reviewed/Revised: 05/07/2019

The Normal Pancreas and What it Does

We eat food, chew it up into a slurry, and swallow it. It travels down the esophagus to the stomach where it is ground up further and enzymes are added to begin the break-down of dietary nutrients (digestion). When the food particles are small enough, they are propelled into the small intestine for further digestive treatment and ultimately nutrient absorption. The upper part of the small intestine (the duodenum) is for further digestion/break down of nutrients while the lower parts of the small intestine are for absorption of the digested nutrients.

Normal Pancreas

Graphic by MarVistaVet

The pancreas is a pale pink glandular organ that nestles cozily just under the stomach and along the duodenum. As a glandular organ, the pancreas is all about secretion and it has two main jobs: the first job is to secrete digestive enzymes to help us break down the nutrients we eat, the second job is to secrete insulin and glucagon (to regulate how we use the nutrients we eat). It’s the first job (the digestive enzyme part) that concerns us in pancreatitis.

Canine Pancreas

Graphic by VIN

Pancreatitis is Inflammation of the Pancreas

In pancreatitis, inflammation disrupts the normal integrity of the pancreas. Digestive enzymes are normally stored safely as inactive forms within pancreatic granules so that they are harmless. In pancreatitis they are prematurely activated and released internally, digesting the body itself. The result can be a metabolic catastrophe. The living tissue becomes further inflamed and the tissue damage quickly involves the adjacent liver. Toxins released from this rampage of tissue destruction are liberated into the circulation and can cause a body-wide inflammatory response.  If the pancreas is affected so as to disrupt its ability to produce insulin, diabetes mellitus can result; this can be either temporary or permanent.

Specific Pancreatitis Disasters

  • A syndrome called Weber-Christian syndrome results, in which fats throughout the body are destroyed with painful and disastrous results.
  • Pancreatitis is one of the chief risk factors for the development of what is called disseminated intravascular coagulation or DIC, which is basically a massive uncoupling of normal blood clotting and clot dissolving mechanisms. This leads to abnormal simultaneous bleeding and clotting of blood throughout the body.
  • Pancreatic encephalopathy (brain damage) can occur if the fats protecting the central nervous system become digested.
    Inflammed Pancreas

    A swollen, inflamed pancreas with areas of hemorrhage. Graphic by MarVistaVet

The good news is that most commonly the inflammation is confined to the area of the liver and pancreas, but even with this limitation pancreatitis can be painful and life-threatening.

Pancreatitis can be acute or chronic, mild or severe.

What Causes Pancreatitis

In most cases we never find out what causes it, but we do know some events that can cause pancreatitis.

  • Backwash (reflux) of duodenal contents into the pancreatic duct. The pancreas has numerous safety mechanisms to prevent self-digestion. One mechanism is storing the enzymes it creates in an inactive form. They are harmless until they are mixed with activating enzymes. The strongest activating enzymes are made by duodenal cells which means that the digestive enzymes do not actually activate until they are out of the pancreas and mixing with food in the duodenum. If duodenal fluids backwash up the pancreatic duct and into the pancreas, enzymes are prematurely activated and pancreatitis resuls. This is apparently the most common pancreatitis mechanism in humans, though it is not very common in veterinary patients.
  • Concurrent hormonal imbalance predisposes a dog to pancreatitis. Such conditions include: Diabetes mellitus, hypothyroidism, and hypercalcemia. The first two conditions are associated with altered fat metabolism, which predisposes to pancreatitis, and the latter condition involves elevated blood calcium that activates stored digestive enzymes.
  • Use of certain drugs can predispose to pancreatitis (sulfa-containing antibiotics such as trimethoprim sulfa, chemotherapy agents such as azathioprine or L-asparaginase, and the anti-seizure medication potassium bromide). Exposure to organophosphate insecticides has also been implicated as a cause of pancreatitis. Exposure to steroid hormones have traditionally been thought to be involved as a potential cause of pancreatitis but this appears not to be true.
  • Trauma to the pancreas that occurs from a car accident or even surgical manipulation can cause inflammation and thus pancreatitis.
  • A tumor in the pancreas can lead to inflammation in the adjacent pancreatic tissue.
  • A sudden high fat meal is the classic cause of canine pancreatitis. The sudden stimulation to release enzymes to digest fat seems to be involved.
  • Obesity has been found to be a risk factor because of the altered fat metabolism that goes along with it.
  • Miniature Schnauzers are predisposed to pancreatitis as they commonly have altered fat metabolism.

Signs of Pancreatitis

The classical signs in dogs are appetite loss, vomiting, diarrhea, painful abdomen, and fever or any combination thereof.

Making the Diagnosis

Lipase and Amylase Levels (no longer considered reliable)

A reliable blood test has been lacking for this disease until recently. Traditionally, blood levels of amylase and lipase (two pancreatic digestive enzymes) have been used. When their levels are especially high, it’s reasonable sign that these enzymes have leaked out of the pancreas, and the patient has pancreatitis, but these tests are not as sensitive or specific as we would prefer. Amylase and lipase can elevate dramatically with corticosteroid use, with intestinal perforation, kidney disease, or even dehydration. Some experts advocate measuring lipase and amylase on fluid from the belly rather than on blood but this has not been fully investigated and is somewhat invasive.

Pancreatic Lipase Immunoreactivity

A newer test called the PLI, or pancreatic lipase immunoreactivity, test has come to be important. As mentioned, lipase is one of the pancreatic digestive enzymes and only small traces are normally in the circulation. These levels jump dramatically in pancreatitis, which allows for the diagnosis to be confirmed with a non-invasive and relatively inexpensive test. The PLI test is different from the regular lipase level because the PLI test measures only lipase of pancreatic origin and thus is more specific. The problem is that technology needed to run this test is unique and the test can only been run in certain facilities on certain days. Results are not necessarily available rapidly enough to help a sick patient.

The PLI, or pancreatic lipase immunoreactivity, test has come to be important. Photo courtesy of National Institutes of Mental Health, Department of Health and Human Services

Spec CPL and DGGR Lipase Assay

More recently a new test called the SPEC cPL (specific canine pancreatic lipase) test has become available. This test is a newer generation immunological test for canine pancreatic lipase and can be run overnight by a reference lab. This test is able to detect 83 percent of pancreatitis cases (the test is 83 percent sensitive) and excludes other possible diseases in 98 percent of cases (i.e. the test is 98 percent specific for pancreatitis). The CPL test has been adapted into an in-house test kit and can be run in approximately 30 minutes. Some kits provide a numeric value while others are simply positive or negative depending on whether the CPL level surpasses the normal level. These kits have made diagnosis of pancreatitis much more rapid and convenient.

A similar lipase assay called the DGGR Lipase Assay (Precision PSL® test). This test can be run at a reference laboratory with results obtained usually overnight; there is no in-hospital test kit.

The diagnosis of pancreatitis is not made solely on the basis of a lab test. These tests are not used to screen patients that are not sick; the entire clinical picture of a given patient is considered in making this or any other diagnosis.

Imaging

Dr. Jon Perlis of DVMSound performs an ultrasound exam on a dog. Photo by MarVistaVet

Radiographs can show a widening of the angle of the duodenum against the stomach, which indicates a swelling of the pancreas. Most veterinary hospitals have the ability to take radiographs but this type of imaging is not very sensitive in detecting pancreatitis and only is able to find 24 percent of cases.

Ultrasound, on the other hand, detects 68 percent of cases and provides the opportunity to image other organs and even easily collect fluid from the belly. Since pancreatitis can be accompanied by a tumor near the pancreas, ultrasound provides the opportunity to catch such complicating factors.

In some cases, surgical exploration is the only way to make the correct diagnosis.

Treatment

The most important feature of treatment is aggressively rehydrating the patient with intravenous fluids as this restores the circulation to the pancreas and supports the natural healing mechanisms of the body.  This means that the best route to recovery involves hospitalization. Fluids are continued until the patient is able to reliably drink and hold down adequate fluid intake, a process that commonly takes the better part of a week. Pain and nausea medication are needed to keep the patient comfortable, restore interest in food, and prevent further dehydration.

Plasma transfusion is somewhat controversial in treating pancreatitis. On one hand, plasma replenishes some of the natural blood proteins that are consumed by circulating digestive enzymes and would seem to make sense. In humans with pancreatitis, however, no benefit has been shown with plasma transfusion. Whether or not the protection afforded by plasma is real or theoretical is still being worked out. Higher mortality has been associated with patients receiving plasma but this may be because they were sicker than patients who did not receive plasma to begin with.

Drawing by Dr. Wendy Brooks

In the past, nutritional support was delayed in pancreatitis patients as it was felt that stimulating the pancreas to secrete enzymes would encourage the on-going inflammation, but this theory has been re-thought. Currently, earlier return to feeding has been found to be beneficial to the GI tract’s ability to resume function. If nausea control through medication does not give the patient a reasonable appetite, assisted-feeding is started using a fat-restricted diet. Return of food interest and resolution of vomiting/diarrhea generally means the patient is ready for return to the home setting. Low-fat diets are crucial to managing pancreatitis and their use should be continued for several weeks before attempting return to regular dog food. Some dogs can never return to regular dog food and require prescription low fat foods indefinitely.

How Much Fat is Okay?

There are several ultra-low fat diets made for pancreatitis patients and your veterinarian will likely be sending your dog home with one of them. Remember that pancreatitis is a diet-sensitive disease so it is important not to feed unsanctioned foods or you risk a recurrence. If your dog will not eat one of the commercial therapeutic diets, you will either need to home cook or find another diet that is appropriately low in fat (less than 7 percent fat on a dry matter basis). In order to determine the fat content of a pet food, some calculation is needed to take into consideration how much moisture is in the food.

The Guaranteed Analysis on the bag or can of food will have two values that we are interested in: the % moisture and the % crude fat. To determine the % fat in the food, you must first determine the % dry matter of the food. This is done by subtracting the moisture content from 100. For example, if the moisture content is 15%, the dry matter is 85%. If the moisture content is 75%, the dry matter is 25% and so on.

Next, take the % crude fat from the label and divide the % crude fat by the % dry matter. For example, if the moisture content is 76%, this means the dry matter is 24%. If the crude fat content is 4%, the true fat content is 4 divided by 24 which =0.16 (16%). Such a food would be way too high in fat for a dog with pancreatitis. You want the number to be 0.07 (7%) or less. Simply reading the fat content off the label does not take into account the moisture content of the food and will not tell you what you need to know. If this is too much math, the staff at your vet’s hospital can help you out.

When in doubt, canned chicken, fat-free cottage cheese and/or boiled white rice will work in a pinch.

Beware of Diabetes Mellitus

When the inflammation subsides in the pancreas, some scarring is inevitable. When 80% of the pancreas is damaged to an extent that insulin cannot be produced, diabetes mellitus results. This may or may not be permanent depending on the capacity for the pancreas’ tissue to recover.

Record your pet’s life in a diary

Pet Connection by Dr. Marty Becker, Kim Campbell Thornton and Mikkel Becker

A Life in Words

Pet Connection
By Kim Campbell Thornton

Andrews McMeel Syndication

When you find a diary, are you tempted to read it? Do you keep a diary yourself, under lock and key? Diaries feature in some of the world’s most famous literature, social history, fiction and children’s books: Anne Frank’s “The Diary of a Young Girl.” The diary of Samuel Pepys. “Bridget Jones’s Diary.” “Harriet the Spy.” “Harry Potter and the Chamber of Secrets.”

Diaries bring history to life, store secrets, record lives. They can make for fascinating reading. But they can also make for fascinating writing, especially if they focus on your best friend: your dog, cat, bird or other pet. It’s not just in Nancy Drew mysteries that a diary is filled with clues.

Susannah Charleson is a K-9 search and rescue handler and author of “Where the Lost Dogs Go: A Story of Love, Search, and the Power of Reunion.” She spoke last month at the K-9 Sport Scent Work Conference in Palm Springs, California. While her topic was the importance of logs for search and rescue handlers, she also touched on how keeping a log can make a difference in the health, confidence and success of any dog-human team — including the partnership between people and their companion dogs. And there’s no reason to leave out cats, birds, rabbits, horses or other pets. Anyone can benefit from tracing the story of their relationship with an animal.

“I think for pet owners it’s invaluable,” she says. “If you’re doing any kind of training, even just to be a good companion animal, it’s all coming fast — the dog is new, the training is new, how the dog views the world versus how we view the world is completely different.”

When you keep a diary and document the changes you see in your pet and yourself, you are capturing the journey of your developing friendship, as well as making observations that can help you solve behavior problems and identify health issues before they become serious.

Bringing a record to your veterinarian or behaviorist of when a behavior began and how frequently it occurs can be the first step in solving a problem.

Some owners track daily blood sugar curves and insulin doses for diabetic pets, delivery of medication, occurrence of seizures, and pets’ eating habits or weight.

People who participate in dog sports log trials and practice sessions to track their progress.

“Log entries allow you to start seeing a pattern and learning about your dog,” Charleson says. “They assist in self-evaluation. You’ve got all these beautiful signals that can tell you where your strengths and weaknesses are and find areas where you can improve, where your dog can improve and where you can improve together.”

Keeping track of a pet’s life can be done with a paper journal, on computer apps or social media, or on a calendar. I have a pile of calendars that I can’t bear to throw away because they record so many of the events of my dogs’ lives. Supplement diaries with photos and videos.

At the end of a pet’s life, a diary is a way to look back at the journey you and your pet have shared. The memories can help to heal grief and establish a foundation for the next partnership.

“When a career or life ends, logs trace the journey that you and a dog have shared,” Charleson says. “Logs tell a story. They trace the arc of our understanding and our ability as separate entities and together. They’re a history of the earliest days that we might forget. Write it all down. You’ll have a wealth of information to learn from, and at the end of a life, those words may save you.”

Q&A

Do kittens need

socialization?

Q: Do kittens have the same type of socialization period as puppies?

A: They do, but it starts even earlier and doesn’t last as long. My colleague Nicholas Dodman, a veterinary behaviorist and emeritus professor at Cummings School of Veterinary Medicine at Tufts University, says the social period in kittens is between weeks 2 and 7.

During those early weeks, kittens soak up knowledge of everything around them, that clever kitty brain making new neural connections daily to generate learning and behavior. Kittens who see, hear, smell and experience many different people, animals, sights and sounds during this sensitive period grow up to be sociable, smart and curious.

Young kittens need to have many different positive experiences with children, friendly dogs and cats, people of all ages and appearances, common household sounds such as vacuum cleaners and blenders, car rides, being transported comfortably and safely in a carrier, and visiting the veterinarian. In an ideal world, they haven’t had any bad experiences with those things, and they don’t have preconceived ideas about what to expect from such experiences.

Limiting fear during this impressionable time is also important to a kitten’s development. A normal amount of fear is valuable because it helps kittens to avoid things that might hurt them, but protecting them from aversive experiences can help them to have more fulfilling lives as adult cats because they are more calm in the face of new experiences.

When young kittens encounter these things in a positive way during the socialization period, their brains store the good memories and help the kittens develop resiliency if they later have negative experiences with, say, dogs or scary noises. The neural connections their brains make during this period is how they become well-rounded, adaptable cats.

You can learn more about feline development at FearFreeHappyHomes.com. — Dr. Marty Becker

Do you have a pet question? Send it to askpetconnection@gmail.com or visit Facebook.com/DrMartyBecker.

This South Bay veterinarian is leading the pack to provide hospice care for cats and dogs who are terminally ill

From The Beach Reporter  By Melissa Heckscher   Feb 5, 2020

So when emergency vets recommended hospitalizing the 12-year-old dog to give her, maybe, a few extra weeks in her six-year battle against cancer, Russell knew what needed to be done:

“I just looked at them and said, ‘I’m taking her home,” she said. “We sat in the chair until about midnight, then I put her in the bed and laid there holding her until 4:30 in the morning.”

Cricket died the next day with the help of in-home euthanasia.

“She was tired,” Russell said. “She had gone through a lot.”

But she wasn’t alone. For the past six years, Cricket has had the help of veterinary oncologist Alice Villalobos, a Torrance-based veterinarian who specializes in palliative and end-of-life hospice care for dogs and cats.

For Cricket, palliative care meant treating the cancer—the dog underwent four surgeries and four chemotherapy sessions for her recurrent tumors—and getting a slew of supplements and medications to keep the champion agility dog active and comfortable.

Hospice care meant preparing Russell for the days when nature would take its inevitable course—and guiding her about how to recognize her dog was “ready to cross the rainbow bridge.”

“In human medicine, physicians don’t generally refer to hospice until patients are about three days before death,” said Villalobos, who in January received the Shomer Ethics Award from the Society of Veterinary Medical Ethics for her contributions to both cancer and palliative care for pets.

“When we use the word ‘hospice,’ we want to make sure people know that we are going to support the pet and provide comfort care whenever they get the diagnosis of a life-limiting disease,” said the Hermosa Beach resident.

While palliative care is a growing niche in the world of pet care, it isn’t all that different for dogs and cats than it is for humans. The goal is to make patients comfortable so they can live out their days in peace, even in spite of incurable conditions. The only difference for pets is the added option of euthanasia when suffering becomes intolerable.

“Many times people say, ‘Let nature take its course,’” said Villalobos, who has been called the”Mother of Veterinary Hospice” by the SVME.  “And then I’m contacted to help with that end-of-life decision. People want to know, ‘When is the right time to put my pet down?’”

To aid in this decision-making, Villalobos developed a Quality of Life Scale to help people determine if their pet has “acceptable life quality to continue with pet hospice.” Her guidelines have been shared and used by veterinarians and pet-owners worldwide.

“In the old days some doctors would just recommend euthanasia right away,” Villalobos said. “People would take a limping dog into the vet and they would come home without a dog. [Doctors] would choose to do euthanasia upon diagnosis.”

Veterinarians, she said, would often give patients two options when presented with a seriously sick pet: Euthanize the pet or opt for surgery, the latter of which is expensive and may not necessarily extend the animal’s life significantly.

“I’m trying to give people a third option—and that is hospice,” Villalobos said. “Hospice embraces the whole beginning right up to the end. It allows people time to grieve and gives me time to counsel the family members.”

For Ari Dane of Playa del Rey, Villalobos helped his 17-year-old chihuahua, Roxy, stay comfortable despite a trio of grim diagnoses including a chest tumor, heart problems and kidney disease.

“(Roxy) keeps bouncing back and she’s still here,” said Dane, who sees Villalobos about every six weeks. “She will perk up around mealtime, but most of the time she sleeps. It’s fading time.”

Under Villalobos’ direction, Dane adds more than 15 different medicines and supplements to Roxy’s food every day, all of which are meant to treat the tiny dog’s myriad health issues. It’s a tedious, expensive process, but one that Dane wouldn’t give up.

“It’s a sad thing to watch her decline, but that’s the price of admission,” he said. “Roxy has been a part of the family for 17 and a half years. I wouldn’t want her to be treated any differently.”

Pets As family

In a society where people consider pets part of the family—and where half of all dogs that reach the age of 10 will be diagnosed with cancer, according to the American Veterinary Medical Association—it only makes sense that palliative care would become a part of the deal.

As of 2020, there were more than 800 members in the International Association for Animal Hospice & Palliative Care (IAAHPC), an organization dedicated to developing guidelines for comfort-oriented care to pets as they approach the end of life. The organization was founded in 2009.

“Veterinarians have been offering some measure of comfort care for animals as long as they have been caring for them, but the shift has come with families embracing pets as members of the family,” said IAAHPC President Tyler Carmack, a Virginia-based veterinarian. “They now wish their pets to have the same level of compassionate care at end of life as our human family members.”

Carmack said many providers and pet-owners shy away from discussing hospice and palliative care until their pets are already very sick. She hopes this will change as people become more aware of their options.

“As we open the communication about caring for pets as they enter their end-of-life stage, we allow more and more families to make the best possible decision for their pet and their family,” Carmack said.

Costs of care

Of course, caring for sick and dying pets isn’t cheap.

According to the Veterinary Cancer Society, cancer care costs for dogs ranges between $150 and $600 per dose of chemotherapy and between $1,000 and $6,000 for radiation. Pet insurance can help pay some of these costs, but many companies have a cap on annual or per-illness expenses.

On top of that, in-home euthanasia, the option most palliative care specialists prefer, costs about $250.

For many pet-owners, it’s a price that must be paid.

“You get them as a pup and you know that you’re probably going to outlive them,” Russell said. “It’s part of the package.”

For more information about Dr. Alice Villalobos and to get information on palliative care for pets, visit www.pawspice.com. Villalobos operates out of Harbor Animal Hospital. She plans to move her services to Redwood Animal Hospital in Redondo Beach in the coming months.

Contact Lisa Jacobs lisa.jacobs@TBRnews.com or follow her on Twitter @lisaannjacobs.

Breaking: Taurine might not be behind heart disease from kibble

From Dogs Naturally Magazine

By:  –

They alerted pet owners about the potential for heart disease in dogs on certain diets … diets that may be deficient in taurine.

Everyone panicked … but was this panic warranted?

The Tale Of Taurine

Taurine is an amino acid found mainly in meat. Unlike other amino acids, which are used mainly to build proteins, taurine is a loner. It has many special functions, including:

  • It’s a component of bile, which breaks down dietary fat.
  • It’s vital for the proper function of muscles (especially the heart), eyes, brain, and the immune system.
  • It has beneficial antioxidant and anti-inflammatory properties.

Dogs manufacture their own taurine from the sulfur-containing amino acids methionine and cysteine.  But, with advancing age, taurine production decreases.

The first inkling about taurine’s importance came in the 1980s. Researchers at UC Davis discovered that taurine deficiency was impacting cats. Thousands of cats were going blind. Some were even dying from a heart condition called dilated cardiomyopathy (DCM).

This happened because pet food companies were making ingredient substitutions. They substituted more and more plant proteins, such as soybeans or corn gluten meal, in place of real meat.

The trouble is … soybeans and corn are poor sources of sulfur-containing amino acids. They also contain zero taurine.

Unlike dogs, cats (and ferrets) must consume taurine in the diet and cannot produce their own.

So the manufacturers started supplementing all cat foods with taurine. The epidemic then faded away (although DCM can still occur, unrelated to diet). Pet food makers saw no reason to add taurine to dog foods, so they chose not to incur the added expense.

However, DCM is common in dogs, especially large breeds. And there is such a thing as taurine-deficiency DCM in dogs; it was discovered in the 1990s.

Spaniels, Golden Retrievers, Newfoundlands … and a handful of other breeds … appear to be genetically predisposed to DCM. It’s also recognized that big dogs produce taurine more slowly than small dogs. This increases their risk of DCM.

[Related: NEWS: FDA Reports Some Dog Foods May Cause Heart Disease]

What The Research Has To Say

Recent research suggests that diet is a factor in less than 20 to 30 percent of dogs with DCM. Some (but not all) of these dogs will improve with taurine supplementation. And that raises even more questions about it!

For one thing, taurine may not even be the real culprit. Taurine production relies on adequate methionine and cysteine in the diet. So the problem may be a deficiency of those amino acids, rather than a lack of taurine itself.

The microbiome may also play a major role in taurine deficiency. This turned out to be the primary factor in cats.  The taurine from bile is reabsorbed in the colon … but bacteria can “steal” taurine and prevent this crucial recycling.

Processing may also play a significant role in dogs as well as cats. This has not, to date, been considered or investigated.

Grain-Free And “Boutique” Foods

The FDA reported a link between DCM and “grain-free” dog foods with large amounts of:

  • Potatoes
  • Legumes
  • Exotic proteins

One expert called these “BEG” (Boutique, Exotic and Grain-Free) diets.

The increase in reported taurine-DCM cases caught the FDA’s attention. Not because it was a new concern … but because the dogs weren’t breeds previously known to develop taurine-deficiency DCM. 

These included:

  • Labrador Retrievers
  • Whippets
  • Miniature Schnauzers
  • Shih Tzu
  • A Bulldog and an unspecified number of mixed-breed dogs (and 7 cats).

The FDA said, “potatoes or multiple legumes such as peas, lentils, other pulses (seeds of legumes), and their protein, starch, and fiber,” were the main ingredients of the food in several cases of DCM reported to the agency.

In practical terms, this means that a pet food containing related ingredients … such as “peas, potatoes, pea starch, pea protein, potato protein” could be problematic. This is a common label trick known as “splitting.”

Listing ingredient fractions separately helps a small amount of meat rise to the top … as the ingredients are listed by weight. But, in reality, if they totaled all the plant products, they’d outweigh the meat. This means the food is primarily plant-based.

If the meat is itself is low in taurine, as it is in …

  • Beef
  • Venison
  • Lamb
  • Rabbit
  • Kangaroo

…  that exacerbates the problem in diets with these ingredients.

Interestingly, most vegetarian and vegan dog foods already contain added taurine and carnitine. Evidently, this issue was not hard to anticipate in low- or zero-meat diets.

Manufacturers whose products have been implicated quickly retuned to add supplemental taurine to their foods … but even that may not be enough to correct the problem.

The link between canine DCM and diet is not restricted to exotic meats, potatoes or legumes. Current and past research notes that any of these ingredients may be correlated with DCM:

Animal Products

  • Bison
  • Duck
  • Lamb
  • Kangaroo
  • Salmon
  • Venison

Plant Products

  • Barley
  • Beet pulp*
  • Chickpeas
  • Fava beans
  • Lentils
  • Peas
  • Potatoes
  • Rice/rice bran**
  • Sweet potatoes
  • Tapioca

* While it was not named by FDA in this situation … beet pulp is known to decrease taurine status in dogs under some conditions. 

** Previous studies found taurine deficiency from eating diets containing rice or rice bran. 

[Related: The Truth About Grain-Free Dog Foods And DCM]

Consider All Factors

It’s important to remember that correlation does not equal causation. Just because taurine is a common factor in a bunch of dogs with DCM … it does not mean that taurine deficiency is the sole cause.

Taurine may just be an innocent bystander! Moreover, this list is counter-intuitive, because salmon and duck are high in taurine. Therefore, processing, bioavailability or other factors are also playing a role. 

For example, taurine from fish is diminished by heat processing; the loss is about 30 percent.

The FDA claims … food made by small “boutique” manufacturers is more likely to be problematic.

However, in one set of 18 cases, 15 were from foods with “boutique” brand labels … but those brands are owned and produced by some of the world’s biggest pet food manufacturers …

  • Purina
  • Mars
  • Champion

It appears that the size of the pet food company is largely irrelevant. And now the FDA has done irreparable damage to small brands’ reputations … with its premature and inaccurate assessment.

DCM occurs in all kinds of dogs eating all kinds of foods …

  • Foods with a simple ingredient list
  • Food with a very complex ingredient list
  • Homemade diets
  • Commercial raw foods.

And while the FDA listed ingredients that have at some point been associated with DCM in dogs … they seem to only be concerned with potatoes and legumes.

It’s very important to note this: Not all dogs with DCM … and not all dogs with very low blood levels of taurine … respond to taurine supplementation. 

Many dogs with DCM have perfectly normal taurine levels. A few dogs with low taurine levels can develop DCM …  but so can dogs who are eating high-taurine foods.

This implies that taurine itself isn’t the problem (at least in those cases). It could be a lack of methionine, cysteine or any number of completely different factor(s).

One study on taurine in dogs concluded, “there was no clear relationship between low (whole blood taurine) and presence of DCM.”

The Bottom Line

Grain-free dog foods have been safely fed to hundreds of thousands, if not millions, of dogs for many years. The relationship to DCM is far from clear.

The FDA is not recommending a diet change for any dog, as their investigation is ongoing.

The link between diet and DCM is much more complicated than blaming a few ingredients. It’s clear that we need to consider genetics and diet ingredients combined.

Or perhaps the food’s overall content of …

  • Methionine
  • Cysteine
  • L-carnitine
  • Taurine

… And other factors like processing are at the root of DCM in these cases.

But at this point, no one – the FDA or anyone else … has any idea which factors are actually problematic. Nor do they know in what amounts or combinations.

Unfortunately, many veterinarians are now recommending grain-based foods … even though there haven’t been all that many cases.

And the chance of a dog developing taurine-related DCM  is extremely small.

Grain-based foods have their own (significant) set of problems including:

  • Pesticide residues
  • Genetically modified organisms (GMOs)
  • Toxic byproducts of processing
  • Mycotoxins from mold

They also tend to use less expensive, poorer quality animal proteins. You’ll see ingredients like poultry by-products, meat meal and bone meal.

So, what should you do?

Ideally, feed your dog a fresh diet that’s high in animal protein. But at the very least, make sure the food you’re feeding has more meat proteins than plant substitutes.

Don’t forget, you can call the manufacturer and ask questions if you’re uncertain! 

Symptoms Of DCM In Dogs

Symptoms of DCM in dogs include:

  • Tiring easily
  • Excessive panting
  • Coughing
  • Weakness
  • Ataxia (being unsteady on the feet)

If you have any concerns about your dog or the food you’re feeding, talk with your vet about testing. Your veterinarian can submit blood and plasma samples to UC Davis for analysis.

However, as expected, their laboratory has been overwhelmed since the FDA’s announcement. So it could take weeks to get your dog’s results.

Keep Yourself Up To Date

The best place for up-to-date information on brands can be found on Facebook, in the Taurine DCM group.

While there is a great deal of speculation and misinformation in the posted comments … you’ll find a few helpful items. They have a current chart of cases, including breeds, as well as specific brand names. You’ll find these in their Files Section. 

It’s way too early to hit the panic button, but it’s certainly good to be aware of this ongoing issue.

The Invisible Emotional Burden of Caring for a Sick Pet

from: https://www.thecut.com/2017/10/the-invisible-emotional-burden-of-caring-for-a-sick-pet.html
Earlier this year, kindergarten teacher Jessica Wiles, 35, found herself faced with a choice: her boyfriend or her dog, Mia. The problem had been brewing for some time: Two years into Wiles’s relationship, Mia was diagnosed with Cushing syndrome, an endocrine disorder that can cause lethargy, weakness, and frequent infections. Wiles began staying home more often to take care of her; as time wore on, she says, her boyfriend became frustrated, accusing her of neglecting him to be with her dog. This past June, he reached a breaking point: “He actually ended the relationship because he said the dog took precedence over him,” Wiles says. “He didn’t understand that it’s not just a piece of property. They are living, breathing things.”

When Wiles told other people about her situation, she says, she was often met with bafflement and scorn rather than sympathy, and questions about why she didn’t just put Mia down. But Cushing, while chronic, is manageable. “I have a problem deciding to kill my dog just because of health issues. I don’t understand the mind-set of, ‘She’s got a health problem, we’re going to put her down,’” Wiles says. “If the dog was suffering, it would be one thing, but she is still interested in life.”

There’s no question, though, that caring for her has made Wiles’s own life more difficult — emotionally, socially, financially. It’s well known that people caring for ill relatives can suffer from caregiver burden, negatively impacting the health and well-being of the caregiver, but the toll of taking care of a sick pet is often minimized or overlooked. According to a new study, that’s a mistake.

“I wouldn’t equate pet caregiving with human, and certainly don’t want to minimize what family caregivers go through,” said lead author Mary Beth Spitznagel, a clinical neuropsychologist at Kent State University, but “we are seeing similar patterns in terms of a greater level of burden, higher level of stress, depressive symptoms, and a lower quality of life.”

Spitznagel, who had previously worked with caregivers of relatives with dementia, says she got the idea for the study while caring for her dog Allo, who had recently been diagnosed with bladder cancer. “It was a daily challenge trying to fix the problems that sprang up.
And that was kind of when I realized the similarity,” she says. “When we see a burdened caregiver, oftentimes the burden is kind of the constant problem solving, because new problems are always emerging when you are caring for someone who is sick.”

Compared to participants with healthy pets, study subjects caring for chronic or terminally ill animals scored higher on scales of depression, anxiety and lower on well-being, and a psychometric test called the Zarit Burden Interview used to measure burden in human caregivers (the study authors adapted the test by replacing the word “relative” with “pet”). In itself, the finding that people with sick pets feel more of a burden isn’t surprising — but the intensity of that burden was. “It’s meeting this threshold for what we would consider to be concerning if someone were in a human caregiving relationship,” Spitznagel says.

In humans, a score of 20 or higher on the Zarit — which contains items related to feeling strained about your pet, having your social life suffer, and financial stress — indicates “significant burden.” Caregivers of sick pets scored 25.42 on average, compared to 13.96 for owners of healthy pets.

A few caveats: Participants in the current study were almost exclusively educated, wealthy, white women, with an average age of 48. The skewed sampling is likely a limitation — but “at the same time, this might be exactly who the population is,” Spitznagel says. After all, caregiving in humans typically falls to women, and veterinary care, which typically comes out of pocket, is unaffordable to many. Beyond replicating the results in a more diverse group, Spitznahel adds, the next step in her research would be to investigate the “ramifications of burden and the impact on the pet.”

Pet owners go into more detail, describing serious negative impacts to their finances, mental and physical health, social and employment status, and relationships. Wiles, who works two side jobs to help pay for vet treatments, says she has become physically ill from the stress of caring for Mia, compounded by the fact that she now helps her mother care for her grandmother as well.

Emotionally, caring for Mia and caring for her grandmother didn’t feel very different, Wiles says. “The biggest difference is with my grandma there was someone to relieve me,” Wiles said. “Other family members would come and help, but when it’s a dog people aren’t willing to do that.”

“I felt really trapped, ” said Petra Lee, 40, who at one point last year was caring for blind dog, a dog with allergies, an epileptic dog, and a cat with cancer. “I’ve lost a lot of sleep. There was a point where I was really stressed out just having to function with all this and I was having to take a lot of time off of work. I had a hard time making food for myself.” Lee’s caregiving also caused fights with her ex-girlfriend, she says, although overall her ex was very helpful.

But “the biggest thing for me,” Lee says, “is financial.” She felt a lot of guilt last year when she had to balance caring for her cat against her other animals, and also encountered a lot of people who question her choices. “I think I have a lot of privilege, I can afford it,” Lee explains. “I don’t make a lot of money, but I have pretty good salary. And I don’t have children and my dogs are my life.”

“We have our good days, our bad days, and our horrible days,” says Ana Sakuta, 37, whose dog, Roxy, became paralyzed a few years ago. Surgery fixed the problem — Roxy recovered and things went back to normal for a while. But soon, new issues emerged: Roxy stopped eating, became lethargic, and wouldn’t take her medicine.

At that point, Sakuta, who has been the main caregiver for the dogs, brought up euthanasia to her husband, which caused a fight — an added stressor she didn’t need. “It’s really rough. I’m crying, calling the vet all the time,” Sakuta says. “You try to talk to somebody about it and they don’t understand.” Sakuta has asked others in her family for help looking after Roxy, she says, but people tell her they don’t feel comfortable watching the dog due to the amount of work involved.

Although Spitznagel’s is the first study to formally document pet caregiver burden, veterinary social workers have long been aware of the issue. Susan Cohen, a support group facilitator at the ASPCA, estimates she has counseled thousands of pet owners over the years.
The most common issues she hears are “constant vigilance, isolation, and guilt,” she says, and the never-ending problem solving also take a toll: “They’re trying to decide all the time whether the pet is getting worse or getting better, and they often don’t have anyone to talk to about it,” she explains.

“I am so pleased that that study was done,” Cohen adds, noting that she’s tried to get vets to recognize caregiver burden and set up systems to address it. A few large veterinary practices have counselors on staff and offer support groups, but the practice isn’t widespread, and she often gets pushback about the lack of research.

In the meantime, Cohen works with pet owners to ease the decision-making load as much as possible, helping them establish boundaries and a treatment plan early on. Most people say that they will care for their pet so long as they have the means. “I want to figure out what their limits are,” Cohen says, which often involves naming a dollar amount or cap. Whether it’s money or quality of life, it’s helpful for pet owners to be able to answer one simple, and painful, question: “What are you trading it for?”

The New No-Grain Ingredient Coming to Your Pet Food Aisle

Analysis by Dr. Karen Shaw Becker

Story at-a-glance

  • Despite growing concerns about the connection between grain-free formulas containing pulse crops and dilated cardiomyopathy (DCM) in dogs, the processed pet food industry continues to talk up the use of fava beans in grain-free pet food
  • In addition to the DCM connection, there are many other reasons pulse crops such as fava beans don’t belong in dog and cat food, e.g., they contain substances pets’ bodies can’t digest, that also interfere with mineral absorption

Despite the much-publicized suspected link between grain-free diets high in legumes and diet-related dilated cardiomyopathy in dogs, the processed pet food industry remains very committed to searching out biologically inappropriate pulse crops for potential use in dog and cat food.

A recent favorite is fava beans (also called faba and broad beans), which “may be the next new grain-free ingredient in the pet food aisle,” according to a recent article in a pet food industry publication.1 Last year the same publication promoted a 2017 study that suggests fava beans are an “effective ingredient for use in a commercial dog diet.”2

“It appears fava beans were well tolerated at all levels tested and only influenced digestibility at higher levels,” reported study co-author Greg Aldrich, PhD. “The dehulled fava beans in our study processed well in extrusion. They would be a solid contributor as an ingredient choice in modern pet foods.”3

This study is typical of pet food industry scientific research designed to see how much of a biologically inappropriate ingredient pets can ingest before it interferes with their digestion in an immediately measurable way. The dogs in the study didn’t develop noticeable digestive issues until they were subjected to higher levels of fava beans.

This is a considered a win by the industry, because they now have yet another inexpensive, plentiful, plant-based (i.e., biologically inappropriate) ingredient they can use to inflate the protein percentage in their formulas, and also potentially use to replace meat protein in vegetarian or vegan pet foods.

Why Pulse Crops Don’t Belong in Pet Food

Pulse crops, also called pulses or legumes, are plants with a pod. “Pulse” is the term used to identify the edible seeds of legumes, and is derived from the Latin word puls, meaning thick soup. The Food and Agriculture Organization of the United Nations (FAO)4 recognizes 11 primary pulses:5

Dry beans (kidney, lima, azuki, mung, black gram, scarlet runner, ricebean, moth, and tepary) Lentil
Dry broad beans (fava, horse, broad, field) Bambara groundnut
Dry peas (garden, protein) Vetch
Chickpea Lupins
Dry cowpea Minor pulses (lablab, jack, winged, velvet, and yam beans)
Pigeon pea

Because they are high in fiber, folate, iron (when eaten with a source of vitamin C), and complex carbohydrates, and are also low in fat, pulse crops are considered nutritious for humans by some nutritionists, and not by others. Some experts advise keeping legume intake minimal for the same reason I recommend avoiding feeding these foods to pets — the presence of phytates and lectins that are naturally found in legumes.

Phytates are substances that carnivores can’t break down because they lack phytase, the enzyme necessary to process phytic acid. Phytates bind minerals (including zinc, iron, calcium and magnesium), leeching them out of your pet’s body. Lectins are sticky proteins that when consumed in large quantities may contribute to gastrointestinal (GI) disturbances and leaky gut.

Pet food producers and their ingredient suppliers are aware that many pet parents tend to believe foods that are healthy for humans are also healthy for dogs and cats. In fact, they use pet owners’ lack of knowledge about pet food ingredients to create and market biologically inappropriate diets. For example, one of the marketing approaches used to promote pet foods containing bean meal is weight loss.

The nutrient profile in beans may benefit some humans and other omnivores and herbivores, but carnivores thrive on animal — not plant — protein, and they don’t benefit physiologically from starch or high levels of dietary fiber. Cats are true carnivores and dogs are facultative carnivores, not omnivores or herbivores, but that pesky little fact certainly hasn’t diminished the pet food industry’s love affair with ingredients nature didn’t design dogs and cats to eat.

Most Pet Food Research is Conducted for the Benefit of Pet Food Companies, Not Dogs and Cats

Also good news for pet food producers is that fava beans “processed well in extrusion.” Extrusion, as we know, is a manufacturing method that has been used by the pet food industry for decades. About 95% of dry pet diets are produced using the extrusion process.

Batches of raw ingredients are mixed, sheared and heated under high pressure, forced through a spiral shaped screw and then through the die of the extruder machine. Extrudate is the result — a ribbon-like product that is then knife-cut and dried.

The high temperature used in extrusion (nearly 400°F) and the short time frame to process (under 5 minutes) creates continuous chemical and physical alterations to the ingredient mixture. This not only changes the molecular activity of the food, but also potentially contributes to a heavier carcinogenic load and profound levels of advanced glycation end products (AGEs). So, to review, the pet food industry’s takeaways from the study are:

  • Fava beans hold up well in the extrusion process
  • Fava beans in moderate amounts can be tolerated by dogs
  • Fava beans can be used to boost the protein percentages (misleadingly, in my opinion) in pet food formulas

Honestly, the simple fact that an ingredient such as fava beans must be tested in pets to see how much they can tolerate before they become ill is all the proof anyone should need that they didn’t evolve to eat that ingredient. Therefore, the intent and result of this study is 100% for the benefit of big pet food, and 0% for the benefit of the dogs and cats who will at some point be fed processed diets containing fava beans.

Legumes and Grain-Free Pet Food

As I mentioned earlier, there’s also cause for concern now that a link has been established between grain-free dog food containing legumes and a growing number of cases of the heart disease dilated cardiomyopathy (DCM) in dogs. Of the DCM cases the FDA reviewed for its report published in June, 91% of the diets were grain-free and 93% contained peas and/or lentils.

It’s important to note that while legumes are being singled out as a potential problematic ingredient, no definitive test results have been released. However, grain-free kibble is often much higher in both whole carbohydrates and purified starches (e.g., pea starch, potato starch and tapioca starch) than grain-based dry dog food.

The higher the starch level in any pet food, the less protein is included (hence my suggestion to avoid both grains and other sources of unnecessary starch in all pet food). You can find my most recent update on the grain-free kibble/DCM issue, including feeding recommendations, here.