I just spent $400 for an ultrasound on my rescue Shepherd mix, whom we’ve had for five of his six years. Last year, we had baseline lab tests run and discovered that he had slightly elevated liver enzymes. This year, when the tests were rerun, they showed higher enzyme levels and mild chronic liver and renal failure.

The vet and I narrowed the cause down to one culprit: the chicken jerky treats we fed him every day. Although the treats are labeled “Made in America,” they are actually made in China and lab-tested in America. The vet said to immediately stop giving him these treats; he also said they’ve seen a large increase in medical issues (up to and including death) due to these made-in-China treats.

I would like stores to stop carrying all food products made in China, although I know this isn’t possible. But at the very least, because companies seem to hide the place of manufacture in very small print, warnings should be printed on packages that explain the risks of feeding these treats to our pets.

Had we not had a wellness-panel run, our beloved dog would have succumbed to liver and renal failure. I now wonder if the same product didn’t contribute to the deaths of our last two rescue dogs.

We humans are terrific at measuring and recordkeeping— we even know the length of Noah’s ark, in cubits (300) no less. Technology abets this trait, as computers dutifully crunch our numbers, ad, well, infinitum. As a species, however, we are not so good at appraising information to extract its meaning. Confronted with new data, we tend to overemphasize and generalize, often less than critically.

On that cautionary note, what are we dog people to make of a new University of California, Davis, study that examines relationships between early, late or no spay/neuter and several health conditions in Golden Retrievers? How do we apply its conclusions to the animals in our care?

The Davis docs found increased risk of several cancers, hip dysplasia and cranial cruciate ligament tears among sterilized Goldens; the incidence varied according to the sex and age-at-neuter of their subjects. As such, their findings add to a growing library of veterinary literature on the spay/neuter subject. However, the authors are careful to limit their conclusions, as should we.

First, the findings are breed-specific. Goldens, a highly inbred line, were chosen in part because of their susceptibility to cancers and joint issues. The gene pool was further limited by a study sample of dogs (759, to be precise) seen at the UC Davis clinic, in northern California.

Second, we need to remind ourselves that risk is not destiny, and that correlation is not causation. The study notes that the risk of one type of canine cancer quadrupled in late-neutered females, but also reveals that its incidence grew from 1.6 to 7.4 percent— meaning that about 93 percent of the subjects did not contract the disease.

The authors also indicate that they did not specifically consider obesity, another known factor in dysplasia and cancers. Neutered dogs do tend to be heavier, but we can manage that risk by controlling food intake and quality. We also need to recognize that other studies have noted countervailing positive health effects, as spay/neuter reduces or eliminates rates of other common diseases, such as mammary cancers and uterine infections.

Third, context is crucial. These data feed into the universe of things that are harmful to canines. We know, for example, that nationwide, some 50 percent of the animals in shelters don’t survive the experience. To the extent that intact canines contribute litters to the shelter population, that risk dwarfs exposure to accidents or disease. Shelter “save” rates are improving in many places, but we remain far from a no-kill equilibrium. Job One for canine partisans (including the veterinary community) remains the imperative to reduce that carnage.

After sheltering, risk-of-death varies widely by age and breed. A comprehensive University of Georgia study of vet-reported deaths (“Mortality in North American Dogs from 1984 to 2004,” published in 2011) identifies infections, trauma and birth defects as primary culprits in young dogs, with tumor-related diseases at various breed-specific rates, distantly followed by trauma and infections, which dominate the tally for the late-in-lifespan.

Finally, there are the behavioral and other risk implications of fertility, including management of ardent males and bitches in heat.

The Davis study is a significant contribution to our understanding of the unintended consequences of fertility management in a useful and popular breed. Reproductive organs contribute hormones for many reasons—it would be surprising if their removal were completely trivial. Alternatives to traditional spay/neuter do exist, but they are rarely performed. Injectable sterilizers and contraceptives are coming on the market (they, of course, will carry their own measurable side effects).

It’s important to recognize the limitations of the study: one breed, one gene pool, defined conditions and their rank among all the calamities that can befall our best friends. The study itself notes that spay/neuter is uncommon in Europe, which would appear to open up a range of comparative research possibilities and fertility management options.

We should add the Davis work to the burgeoning database. But until a lot more measurements have been taken from which broader conclusions may be drawn, the best advice is not general to all dogs, but individualized: choose your canine companions carefully and love and support them well, and completely. And recognize that we can’t measure or control for everything, yet—or ever.

We’re barely halfway into the year and already, there have been a flurry of pet food recalls. The sheer number of brands has been surprising, as have the names of the brands involved; we’ve seen recalls from some of the industry’s most respected companies. How and what we feed our dogs (and ourselves, for that matter) is such a fundamental issue that we’ve decided to do a series of articles on pet food safety, starting with a report on a few of the most recent recalls. We examine the reasons behind them, lessons learned and what we might expect in the future.

Until very recently, all recalls have been voluntary (a confusing term that can lead consumers to believe that a recall is optional), triggered for a variety of reasons: mislabeling, misbranding, the inclusion of potential allergens or adulterants, or contamination with a pathogen such as one of the varieties of salmonella. And some products are recalled simply because they were produced at the same factory during the same timeframe as the affected food.

So far, no pet food recall has been as widespread as the one in 2007, which involved the Menu melamine scandal. If Hurricane Katrina taught policymakers the importance of the human/ pet bond, the ’07 Menu Foods recall did the same for the focus on the safety of the food that we feed our pets. As William Hubbard, a former FDA official, notes, “I do think that this pet food thing has shown people … that something needs to be fixed. If this is not a wake-up call, then people are so asleep, they are catatonic.”

It took a while for Congress to fully awaken, but in 2010, the Food and Drug Administration (FDA) was given more power with the passage and then signing into law by President Obama of the Food Safety Modernization Act (FSMA). The act marks the most sweeping food-safety reform since the Great Depression.

This new act will soon be putting broader issues into the spotlight. For the first time, the FDA will be empowered to more aggressively regulate and enforce preventive measures. Recalls will no longer just be voluntary, but rather, can be mandatory. In our opinion, given this new regulatory power and the plethora of places from which pet food manufacturers source their ingredients, the number of recalls will surely rise. Closer attention and accountability are good for consumers and the animals we feed, and definitely something we need to be informed about.

RECALL CLASS OF 2013
Six years ago, in 2007, veterinarians began seeing a surprising number of companion animals—primarily dogs—with kidney problems; in September of that year, the American Veterinary Medical Association alerted the FDA that they had had reports of a Fanconi syndrome–like disease that appeared to be associated with the consumption of chicken jerky treats made in China. As a result, the FDA issued its first cautionary warning—not a recall—for those treats. In early January 2013, after the FDA had spent years investigating whether or not jerky treats from China were harming (and killing) pets, these treats were finally voluntarily recalled.

We have the New York State Department of Agriculture and Markets to thank for finding what might be the contributing factor: the department identified antibiotic residues not approved for poultry in the U.S. in the treats. This spurred Del Monte, the makers of Milo’s Kitchen Chicken Jerky Treats, and Nestle Purina, manufacturers of Waggin’ Train and Canyon Creek Ranch dog treats, as well as others, to finally initiate a nationwide removal of these products from store shelves.

Though the FDA continued to claim that “there is no evidence that raises health concerns, and that these results are highly unlikely to be related to the reports of illnesses,” the findings were enough to convince the slow-moving food industry that they needed to get the products out of circulation. The FDA, which still considers this to be an open investigation, notes that they “welcome additional information about New York’s testing methodology …” To date, the treats are thought to have contributed to the deaths of roughly 500 dogs and nine cats. If New York’s state inspectors had not found the illegal antibiotic residue, those treats would still be available. Chalk one up for the state team!

DOMESTIC PRODUCTS TAKE A HIT
Over the past few years, consumers have learned to look for “Made in the U.S.” to guide their food purchases. So it was a surprise when a U.S. manufacturer of jerky and other “animal-parts” treats like bully sticks and pig ears issued a large-scale recall. This time, salmonella —a group of bacteria responsible for most cases of human food poisoning— was the culprit. Again, inspectors from a state department of agriculture, this time in Denver, Colo., were responsible for identifying the problem. In September 2012, during a routine check of the Kasel Associated Industries processing plant, inspectors found evidence of salmonella contamination. The firm issued three recall notices that year, one in September and two in October.

In February of this year, Kasel had the dubious distinction of being the first pet food manufacturer to possibly face a first-ever FDA/FSMA mandatory recall notice, a threat based on inspections by an FDA team that found a number of infractions: “All of the finished pet treat product samples and 48 out of 87 environmental samples collected during the inspection tested positive for salmonella. More than 10 different species of salmonella were found in the firm’s products and manufacturing facility, indicating multiple sources of contamination.” The jerky treats were sold through a number of big-box retailers, including Target, Petco, Sam’s Club and Costco.

Other jerky products made in Kasel’s Denver plant were drawn into the recall as well. Bixbi, an up-and-coming independent brand from Boulder, had batches of their products swept up, and Nutri-Vet, a more established brand, was also named, although it was noted that none of these products had tested positive for bacteria. (I contacted the owners of Bixbi and Kasel, who responded to my questions; I also placed numerous calls to Nutri-Vet, who didn’t reply.)

Treats aren’t the only products in which salmonella has been found, however. Natura, a premium holistic brand now owned by Procter & Gamble, had its first recall experience this year after one of their dry-food products tested positive for salmonella by Michigan inspectors. When I spoke in late March to Jason Taylor, a P&G spokesperson, he said the company was still in the process of trying to recreate the production situation at the time the contamination happened; they were, however, sure that it had occurred during a post-extrusion step. “We have an extrusion [cooking] process that is scientifically proven to kill pathogens … So it probably happened either at the dryer or packaging line.” According to Taylor, the company has a complex manufacturing process in place to ensure that their products are contamination- free. Their microbial-mitigation process, which has more than 100 steps, addresses each step the food goes through, from raw material through packaging.

Taylor said that the company was fairly confident that the problem was limited to products manufactured during the two-week period beginning December 17, 2012, and ending January 2, 2013. Since then, we learned that they extended the recall for products manufactured up through March 24, 2013— making this a larger-scale recall.

RAW FOOD PRODUCTS UNDER THE MICROSCOPE
Pet-food safety advocates wondered if the FDA was exerting more muscle on domestic manufacturers to make up for their foot-dragging on Chinese jerky. Then the recalls moved into the raw-food realm. The first, also in February, involved Honest Kitchen’s recall of limited lots of Verve®, Zeal® and Thrive® products. Honest Kitchen has a transparent, consumer-friendly approach to their food sourcing, and in their recall notice, founder and CEO Lucy Postins noted that “the Company is taking this action after learning that one of its raw ingredients suppliers has recalled a batch of human-grade parsley that may contain salmonella.” The parsley— which had come with a certificate of analysis from the supplier attesting that it was pathogen-free—had been used in the production of five lots of finished products.

While most of Honest Kitchen’s rawfood sources are in North America, they also get some produce from Europe and exotic fruits from Asia. Surprisingly, they get their parsley from Egypt. Yearround availability of organic and/or human-grade ingredients at a reasonable price is one of the challenges faced by smaller food manufacturers like Honest Kitchen, and is the reason for this wide-ranging sourcing.

Since this incident, Honest Kitchen has switched to another parsley supplier (also in Egypt) and added a new step to their processing of dried herbs and leafy greens, treating them with a gentle steam sterilization to protect against microbial pathogens.

More raw food companies were hit with recalls in March, when the Minnesota State Department of Agriculture found salmonella, first in Steve’s Real Food Turducken patties, and a week later in a two-pound tube of Bravo! Chicken Blend raw frozen food diet the agency had purchased from a local pet store.* I talked with veterinarian Heidi Kassenborg, director of Dairy and Food Inspections for Minnesota, to get a better idea about her state’s pathogen inspection process.

Many have observed that while salmonella is the most prevalent foodborne pathogen, few dogs actually become ill from it, and I asked her why the FDA and her agency have such a strong concern about its presence in pet food. She explained that they are charged with finding adulterants in food, and “in food items, salmonella is considered to be an adulterant.” As for the USDA’s salmonella-tolerance level for raw poultry (now at 7.5 percent, down from 20 percent in 1996), she confirmed that “in raw food, like poultry and beef, it is not considered to be an adulterant.” Basically, there is no tolerance for adulterants in finished food items, and even raw diet is considered a “food item.”

Kassenborg explained the high concern about pet food, saying that since pet food is handled by humans, they are exposed to any pathogens that may be in it; these pathogens can also be excreted in the pet’s stool. Given that salmonella can cause serious and sometimes fatal infections in young children, the frail or elderly, and those with weakened immune systems, this is indeed a compelling reason for concern.

She went on to say that there would be increased surveillance now that raw diet has tested positive for pathogens. “Once things are found in one food type, they start looking at it and testing more. We have an obligation to find out if it is a widespread problem. And if so, is there a way to produce it better without it becoming contaminated?”

Doug Lueders, supervisor of Minnesota’s Commercial Feed Regulatory Program and the person responsible for its product-sampling plan, concurs. “If we have a category that has had few [contaminants] or none, we may switch our emphasis to one where we have had a problem. I think we will raise the percentage [of resources] that we have devoted to raw in the past; that, however, will be at the expense of something else.”

Resource allocation is a real issue. Other states have registered positive hits on items like jerky and kibble, so even though there might not be direct interstate coordination of efforts, Lueders says, since “Michigan found salmonella in one brand of pet food, it probably doesn’t serve much practical purpose for us to look at the same brand ourselves. There is an old adage that says an absence of evidence is not evidence of absence, so we wouldn’t continue to test the same pet food for salmonella in hopes of finding more salmonella, or hoping to find that it is clean …”

THE PRICE OF SAFETY
What impact does this have on consumers and the pet food industry— in particular, the raw-diet industry? For an answer to that question, I turned to Melinda Miller, president of North American Raw Petfood Association (NARPA), a trade organization. She acknowledges that positive findings— which she says are likely to increase once the FSMA legislation is fully implemented—have an impact on NARPA members; she also notes that the leading raw-diet manufacturers subject their processes to more vigilance and testing than occurs in any other pet-food sector.

Prior to processing a food in their facilities, suppliers must certify that the food is pathogen-free. Throughout the manufacturing process, pathogens are tested for and eradicated. A few NARPA members use what is known as highpressure processing or high-pressure pasteurization (HPP), which disrupts a pathogen’s cell walls. Miller says that this very expensive system is considered by the general food industry to be stateof- the-art in controlling pathogens.

Companies like Bravo! also batchtest and follow a test-and-hold system, meaning that finished products are not shipped from their plants until negative pathogen reports are in hand. A Bravo! spokesperson described the company’s process: “Most established companies in raw diet own their own facilities. We [at Bravo] come out of the meat business and our facility is a USDA facility for human food, so we have standards we have to keep up. We have a USDA inspector who checks the plant daily to make sure that [things are] being done by the books [and] we have a HACCP [Hazard Analysis Critical Control Points] plan in place. What consumers should be looking for are companies who use ‘test and release’ and batch testing, and have HACCP plans.” He also noted that the company’s website will soon have a function that will allow consumers to enter an item number and “best used by” date and receive test results for E. coli, Listeria and salmonella.

This type of high-level testing increases the cost of the final product; as Miller observes, “you can’t add a whole level of pathogen controls and not have a resulting increase in cost to consumers.”

THE BOTTOM LINE
No business undertakes a recall lightly — it’s the last thing any food manufacturer wants to do. Not only are recalls costly, they have the potential to harm a brand’s image.

But while smaller brands can be devastated by such events, companies who have worked hard and long to develop a loyal customer base can, most likely, recover from them, as can internationally distributed brands such as Natura.

I don’t believe that most of these pet food companies and manufacturers acted recklessly. But after a recall, it shouldn’t be business as usual. Measures need to be taken to identify where the contamination came into the system, and pathogen controls need to be improved. Changes need to be made—for some businesses, that may mean switching manufacturers, raw-material suppliers, warehouses or distributors, or even instructing pet stores on proper handling and storage techniques for their products.

It’s also critically important that they pay attention to how customers are notified (and receive compensation or refunds). For example, I commend Honest Kitchen for quickly alerting its customers via email, social media and website notices. Retaining the trust of customers requires companies to be transparent, forthcoming and ready to make production and sourcing modifications, as they and a few other companies have done.

Realistically speaking, it’s unlikely that the food system can be made 100 percent safe. Nonetheless, we need to know we can trust that those who make the food we feed our companion animals are held to the same standards as those who supply the food we eat ourselves.

Over the years, we’ve become well aware of the concept of food sourcing. In addition to knowing exactly what goes into the food we feed our dogs and cats, we also need to know where it comes from. How the finished products are processed, packaged and distributed is also vitally important. As P&G’s Taylor observed, pathogen elimination is challenging when working with large quantities of raw meat and poultry.

Do some food processors take shortcuts to save money? For some, that might be the case, as evidenced by the huge 2012 recall involving a Diamond co-processing plant in Gaston, S.C. , which ultimately affected 17 brands representing more than 30,000 tons of dry dog and cat food. Because a rare strain of Salmonella infantis was found in some product samples, all brands, ranging from high-end Wellness to Costco’s brand, Kirkland, were recalled. According to the Centers for Disease Control and Prevention, at least 49 people in 20 states and two in Canada who came in contact with pet food made at this facility are confirmed to have been affected. When the FDA inspected the plant, they found numerous problems with the contamination-containment processes, including the use of cardboard and duct tape on some of the equipment. How they got away with this—how they managed to fly under the radar of the companies for which they were making food—is anyone’s guess.

Yet another problem that cries out for better monitoring involves actually getting recalled products off store shelves. A reporter for a Colorado television station found bags of the tainted Chinese jerky in stores such as Safeway, K-Mart and Albertsons almost a month after it had been recalled. I learned about this from attorney Jennifer Reba Edwards of the Animal Law Center in Wheat Ridge, Colo. As Edwards points out, “The bigger problem is [that] once recalled, the products are still getting to the end user. Retailers are not pulling the products from the shelf and you can buy them online; that is almost a bigger problem than the recall itself—preventing it [from] being available to the end user.” Who is responsible for this step? Who should be held accountable? This is definitely a problem to track and one that consumers need to be aware of.

Within the dog community, the issue of salmonella is controversial; some question its potential to harm dogs. However, I don’t believe this is debatable. There are too many instances in which people have been damaged by cross-contamination or mishandling in the home of food intended for pets. The FDA considers it to be an adulterant in both human and animal foods, as well they should. More to the point, as Jennifer Edwards says, “I’m pregnant; I would really be upset if I were to be exposed to salmonella. It goes beyond protecting our animals—we have to protect our people as well.”

If ever there was a reason to look at the big picture, this is it. We have only one food supply, and it should be safe for both humans and animals. This is, and ought to be, the standard that foodsafety regulators, the food industry and we—the consumers—need to meet.

*A Bravo! company spokesperson told me that the product that tested positive had been tested by a third-party inspector before leaving the plant and had a negative-contamination finding. In an unusual step, the FDA allowed that point to be included in their recall statement.

As our pets age, you may begin to notice subtle changes in their movement, such as having a little difficulty going up or down the stairs, or seemingly slow to rise from a comfortable laying position.  These can be early signs of arthritis, and early intervention is critical to slowing progression of the disease.  I am currently experiencing this “slow down” with my 11 year old Dobie, and I thought it would be good to share some suggestions that you, too, can consider if you have a pet that is living with some degree of arthritis.

Like any lifestyle change, one of the most important things to do first is to ensure that there are no other causes for the changes you are seeing in your pet. An intermittent and subtle slow down can be caused by many things, such as a low thyroid level or even a slowly bleeding tumor on the spleen. X-rays, a urine sample and blood work are important to ensure the overall health of your pet before starting any treatment plan.   

Today, there are a number of effective pain medications that are available to our pets, and a multi-modal approach to pain management is the best way to go.  By using pain medications that address various pain pathways, you get more complete and synergistic pain management while actually using lower doses of medications.  A cornerstone of arthritis management is a non-steroidal anti inflammatory, or NSAID. This provides excellent pain management in the early stages of arthritis, and then as the disease progresses, additional “layers” of pain management can be “added on.” These medications include such options as gabapentin, tramadol, and amantadine, with each one working to enhance the other.

Adequan is another medication that has been used in pets with degenerative joint disease or traumatic events such as a torn cruciate ligament. It works to help slow down the rate of decay of cartilage as well as stimulate new collagen and hyaluronic acid, a lubricant in joints. This is an injectable product that can be taught to be given at home underneath the skin and is initially given twice weekly for three to four weeks and then, once monthly. By the fifth or sixth injection, most pet parents usually see a more comfortable and agile pet.

Supplements such as glucosamine, chondroitin and omega-3 fish oils are good additions to managing arthritis changes. These supplements provide your pet's joints with building materials to help rebuild their cartilage and decrease the inflammation in the joints. Supplements are not an overnight fix, and they generally take at least six weeks before improvements can be seen. Products can be purchased over-the-counter and do not need to be labeled specifically for pets.  However, not all nutrapharmaceutical products are FDA regulated, and there is quite a bit of discussion with regards to bioavailability between various brands; this is a case where cheaper is not always better and I would recommend purchasing only high quality and trusted brands.  Your veterinarian can make recommendations for you. The standard dose for glucosamine/chondroitin is approximately 10 mg per pound of body weight once a day, for which you can round up or down to make tablet division or multiplying easiest.  For example, a 20-pound dog could take half of a 500 mg tablet daily (250 mg), even though its “recommended” dose is 200 mg. Also, when you are considering fish oil, you want to be sure to base it on the omega-3 concentration of EPA. The dose is 20 mg EPA for every pound of body weight once daily, and for example, our 20-pound dog would need 400 mg EPA daily.

Another area of extreme importance is your pet’s body weight.  I have to admit, I am a little guilty of letting this area slip and my boy and I recently went through a five-pound weight reduction program (I couldn’t let him “suffer” alone). How can you tell if your pet is a little too chubby? You should be able to easily feel your pet's ribs and backbone beneath the skin; if you cannot, then your pet may be overweight. Excessive weight is an added burden for already compromised joints, and you may be amazed how much better your dog will feel simply by shedding a few pounds. I can already see a difference in the way Bauer prances around.

Continued activity is also important—the old adage, “if you don’t use it, you lose it,” holds true for our pets, too. Working to keep up your pet’s muscle mass through activity can help provide stability and flexibility to joints.  Low-impact exercise is best, such as long walks and swimming, and both are highly encouraged.  

There are also newer concepts of arthritis management. One such treatment is known as Stem Cell Therapy. This is a procedure in which adult stem cells are injected into the arthritic joints, or into damaged ligaments and tendons, to aid in healing and repair. While continued studies are still needed, there are many reports of pets responding well and this therapy holds promise.  Joint replacement is a surgical therapy and has been proven to be very successful. As an example, 95% of canine patients with hip replacement can return to normal function. There has also been the development of dedicated rehabilitation centers for pets, which are becoming more widely available as the demand for options grows. Trained professionals can offer additional treatments such as hydrotherapy, acupuncture, chiropractic, massage, physical therapy, cold laser therapy, and pulsed signal therapy. Complementary treatments can offer your pet a complete approach to management of its arthritis, and many of these singular modalities, such as acupuncture, are often offered by veterinarians in general practice. These newer approaches to arthritis management are areas that I can discuss in greater detail in another blog, if there is any interest.  Let me know!