VetInfo Digest                                          April 2007

Table of Contents:

Menu Foods Recall

Veterinary Medicine and Pet Diets

This Month's Note:

As you might imagine, much of this issue of the VetInfo Digest will be related to the recent recall of multiple brands of pet food manufactured by MenuFoods, Inc. I did not intend for this to be the topic of this month’s VetInfo and it has been a very hard topic to write about, despite all of the attention it has gotten over the last couple of weeks. There are some lessons to be learned from the recall and there is a need to discuss some of the basic philosophical issues related to feeding pets, as well. 

I have revised this newsletter every day for several days trying to get it to the point that it was up to date. That seems to be an impossible task so I’m just going to mail it today and hope that you will continue to keep up with this controversy. I can’t promise that I will keep it completely current but I have started a blog on the web site.  www.vetinfo.com/blog  It was my original intention to use the blog to summarize articles from veterinary journals that might be of interest and I hope to continue to do that in the future.

The Menu Foods Recall 

The first thing that is necessary is to discuss what we know right now. Don’t forget that this information could all change quickly as new information is released about the possible causes of this problem. 

The recall apparently occurred when reports reached Menu Foods that some pets who had been on one of the affected diets were exhibiting signs of kidney disease unexpectedly. It is surprising to me that the link to the food was made as quickly as it was because there isn’t a central reporting agency in veterinary medicine that functions automatically. This means that astute pet owners or astute veterinarians made the link to the food and reported it to the company in the absence of widely available information that the food might be a problem. If this hadn’t happened, many more pets may have died. So the first lesson to be learned from the recall is: 

Report all instances of unusual illness that you believe or your veterinarian believes may be related to food to the company that you purchased the food from.  

Corollary: This applies equally as well to home made diets. If you are feeding purchased ingredients and a problem occurs, report it! 

At the time that I am writing this it is unclear what toxin is present in the contaminated food. This confusion also brings up the possibility that there isn’t a toxin, although that does seem very unlikely at this time.

Initially during this recall it seemed likely that there was a toxin in the wheat gluten used to make canned and foil packaged foods by Menu Foods, Inc. This involved a number of pet food brands. The wheat gluten was suspected because it was the only ingredient that was from a new source at the time the foods were made. The problem was identified before it was possible to identify the specific toxin involved. While this is a huge recall it is good that a problem was identified and that the food was recalled quickly. There are some undocumented claims right now that Menu Foods received several complaints prior to acting on the recall but I believe that even if this did happen it was reasonable to consider the possibility of coincidental findings at least for the first few cases. If it turns out that there was a delay beyond the first few cases of illness or death that will be a different matter. At this time it appears that Menu Foods has acted responsibly in this recall.  

The first toxin identified was aminopterin. This is a drug that is banned in the United States and is reported to be used as a rat poison in some areas of the world. The toxic profile for aminopterin fits the syndrome seen in most of the affected pets. This toxin was identified by the New York State Department of Agriculture and Markets. The FDA has so far been unable to confirm that this is the toxin causing the problems in all of the affected pets and at this time seems to believe that it is not.  

The FDA identified melamine in some of the food associated with illness in this recall.  This is an ingredient used to make plastics. It doesn’t belong in pet food but it is not clear why it would cause kidney damage at this time. Despite this, it is now the prime suspect as the toxin as far as the FDA is concerned. Cornell University has identified melamine in several samples and has not yet confirmed finding aminopterin in any samples. The Chinese government denies that aminopterin is in the wheat gluten but has not ruled out melamine. Necropsy examination and tissue analysis of several pets who have died has failed to provide confirmation of the presence of aminopterin. Melamine has been found in the tissues and urine of affected cats.

At the present time it is hard to find information on melamine, at least in regards to toxic effects it might have in pets and any treatment options that might exist.  For this reason, most pets are being treated symptomatically for acute or chronic kidney disease.  It is possible that melamine is present but not causing the problems seen. It is also possible that is the cause of the problems and that this will constitute new information on melamine toxicity.  As happens with many disastrous situations available information changes daily and it is likely that a reliable consensus opinion about what happened may take months or years to surface.  

It seems likely at this time that the recall has been effective and that the number of cases of affected pets will drop off dramatically and hopefully stop completely within a few days to a few weeks. It is probably inevitable that someone won’t get the information and will continue to feed affected foods but it is hard to imagine a concerned pet owner who is not aware of this recall at this time. 

Good sources of information for keeping up with this recall can be found at www.avma.org and www.acvim.org.  There are many other good sites.  

At present the susceptibility to the toxin appears to go in this order: cats are most affected, followed by small dogs and then larger dogs.  

On April 2^nd, as I am continuing to add to the newsletter, there have been two additional recalls. Hills Prescription Diet m/d ™ dry food has been recalled. This is the first dry food and it is also likely to be the only one since wheat gluten isn’t a common ingredient in dry food. In this case the m/d canned food was not recalled as it does not contain wheat gluten. Delmonte has recalled several dog treats, including their Jerky treats, Gravy Train Beef Sticks and Pounce Meaty Morsels ™ brands.  The recalls from Hills, Alpo and Delmonte were voluntary recalls and there have been no toxicities from these foods as far as I know. Several Alpo canned foods, all with Prime Cuts ™ labeling, were recalled earlier this weekend. 

If you suspect that your pet was injured by these foods the contact URL for reporting the evidence to the FDA is:  http://www.fda.gov/opacom/backgrounders/complain.html. 

Once again, it is important to report any suspected poisonings. This is the only way this mystery can be resolved and doing so may save your pet’s life or someone else’s pet’s life.  

Menu Foods is a processing company that makes foods for other companies based on recipes provided by the company. The foods that are manufactured are not identical but some of the ingredients are shared among multiple foods. In this case wheat gluten was one ingredient that was in most of the foods with a gravy type flavoring or base. The large number of foods that are produced at the same plants (there were two manufacturing plants involved, one in Kansas and one in New Jersey) does represent a problem when a problem like the contamination of a food ingredient occurs.  The fact that a single company was involved in making so many brands of pet food made this problem much worse than it would have been had each individual brand been made in separate factories, at least in theory.  

If the foods had been manufactured at multiple manufacturing plants it seems less likely that such a large contamination problem could have occurred but it is not out of the question. Hills and Delmonte apparently acquired the wheat gluten separately from Menu Foods so contamination of several facilities could still have occurred. It is possible that the discovery of the problem might have been delayed if so many cases were not linked to a single source of food. However, it still seems disappointing that so many pet food companies farm out the manufacturing of their foods.

We really do live in a global economy at this time. Things that happen far away in the world can still affect us deeply. 

If you suspect that your pet has been affected by the products in this recall, or any other food products, try to keep any open cans frozen and labeled in a safe place, where the food can be turned over for evaluation if necessary.  It is very helpful in these cases if the sick cat or dog can be examined and the diet it was eating analyzed in conjunction with each other.  Keep any extra cans of the suspect food that are affected by the recall. It is very important to link the signs of illness in the pet with the food and that is best accomplished when there are food samples to test.  

When a recall occurs save any unopened cans of pet food that might be on the recall list! If your pet becomes ill having the food to analyze might save your pet’s life or might save another pet’s life.  If you have small children or if storing opened cans of food cannot be safely accomplished, throw them out. If you can save them safely, save opened cans, as well.  

Your veterinarian or his or her staff should be asking you what types of food you are feeding your pet at the time of yearly physical examinations as well as any office visit for illness. This is something that veterinarians really have to force themselves to remember to do. We have tried to remember to ask this question for several years now but I suspect that we forget, give up in frustration when pet owners don’t have a clue what food they are using or get incorrect information about half the time. Both veterinarians and pet owners need to work on this issue. Tell your vet what you feed your pet if he or she doesn’t ask.  If you are feeding a non-commercial diet tell your vet that, too. If your veterinarian doesn’t agree with your approach to feeding your pet consider finding a veterinarian who does. Chances are their overall philosophy about how veterinary medicine should be practiced will match yours better if they are supportive of whatever alternative you prefer to feeding a commercial diet.  

Keeping track of the type of food fed should be a regular part of health records for pets! 

A number of clients have asked me over the last week or so if the recall means it would just be better to feed a home made diet to their pets.  If  it was not obvious before, it is obvious now that there are risks associated with feeding commercial diets. These risks are not necessarily alleviated by feeding a home made diet, though. If you think back a few months you should be able to remember recalls of spinach, lettuce, ground turkey, ground beef and possibly other food ingredients that I can’t recall. In addition, Menu Foods has said that they purchased the human grade wheat gluten for their manufacturing process. If this is true then it is possible that human cases of toxicity may eventually show up.  If the pattern of decreased susceptibility to poisoning with increased size follows the same pattern in humans it seems likely that the effect on people would be small compared to cats and small dogs.  

Some of my clients will inevitably change to feeding home made diets due to the recall. There are just going to be some people who aren’t going to be able to reconcile themselves to the small risk that the commercial diets represent.  It is similar to plane crashes. Despite a recent plane crash, traveling by air continues to be safe in comparison to other methods of travel but some people are unable to trust airplanes again after every big accident involving aircraft. This same type of reasoning will prevent some of my clients from utilizing commercial dog or cat foods for some time.  

If you do decide to make your own dog food, try to ensure that you are feeding a balanced diet. If you are willing to stick to small number of recipes you can get advice and customized supplements to balance your diets from balanceit.com (Balance It). If you want to be very cautious you can get a customized diet that has been analyzed using very sophisticated dietary software from petdiets.com.  Be aware that PetDiets is somewhat expensive due to the expense of software licensing and paying a board certified veterinary nutritionist and that some people have complained that follow up questions at a later date about the diets have gone unanswered.

Diet and Veterinary Medicine 

I know that my opinion on this issue is somewhat out of line with the mainstream opinion in veterinary medicine but I think that if you elect to feed your dog a diet that is composed of leftovers from your own meals or even a self designed varied diet it is likely that you will come close to meeting their dietary needs, as long as you are coming close to meeting your own. While dogs are not identical to humans in their dietary needs they are very close. The thousands of years that dogs and humans have lived together might have something to do with that closeness. I don’t actually encourage my clients to do this but I have kept track over the years of some of my clients who do it anyway and most of their dogs seem to do OK. Obesity is rampant in pets whose owners feed them in this manner, though. Something about the urge to share food seems to predispose these folks to overfeed their pets, as well.  I don’t think that many people can really manage to feed their cats a well balanced diet that meets the cat’s needs. Cats are obligate carnivores, making it much harder to balance their diets without professional help.  

There are several other dietary approaches, including trying to feed breed specific diets, trying to feed “natural” diets ( like feeding mice to cats),  raw food diets, vegetarian diets and others that don’t come to mind right off.  When you get to this point in dietary discussions there is a certain amount of near religious feeling about the diets. I don’t try to argue too much with folks who believe that one of these types of diets is necessary because it just isn’t possible to have a reasoned discussion. For the most part these diets are only slightly more of a risk than feeding commercial diets. I may think that any additional risk is unnecessary but that doesn’t mean that I am correct.  

There is one argument that I really detest that people make for most of these diets, though. This argument is that there was a time when pets were fed the diet, or fed themselves the diet being promoted. This is followed by a claim that if you go back far enough in their ancestry they were healthier, lived longer and were generally better off, due to diet. I have done way to much work with wildlife to believe these arguments. Nature has one goal for wild species; to live long enough to reproduce. Nature has no other goal. Wild animals almost always have drastically shorter life spans than domesticated animals of the same or similar species. Most of the wild canine species have average life spans of five to six years or less. Feral cats are reported to have life expectancies of two to three years, overall. Sure some individuals do live longer but they are the exception. There is no evidence that wild animals eating their natural diets are any healthier than domestic pets fed commercial diets and there is a lot of evidence to suggest that the wild species are actually less healthy, especially when looking at expected life spans. Nature is cruel. If you don’t think so, watch the Planet Earth series on the Discovery Channel this month. It is beautifully filmed and it depicts many of the struggles that nature inflicts on its inhabitants.  

As long as I have been in practice there have been folks who are chasing the holy grail of nutrition – a diet that produces perfect health, forever. There have been hundreds of suggested diets and the proponents of most of them were very strident in their insistence that they had found the answer at last. Despite the efforts of these people and the efforts of nutritional researchers on an ongoing basis, there really is not much that is known with absolute certainty about nutrition.  

As much as nutrients are studied it is hard to say much more about their effects in a living organism other than what happens if the minimum requirements for a specific nutrient are not met. We know what the minimum required levels of essential nutrients are, or we are at least very close to knowing these. In some cases we know the maximum quantities of a nutrient that can be ingested safely. We know many of the compounds that are toxic to pets when given in sufficient quantities. Other than these three things we do not know a great deal about the nutritional effects of individual nutrients or supplements when thinking about their effect on a pet over a lifetime.

If you think that this isn’t so, think about the information that you have seen regarding nutrients and humans.  Can anyone who is getting more than the absolute minimum say with certainty whether they are getting just enough Vitamin C, too much Vitamin C or too little Vitamin C based on scientifically valid studies?  There are studies that validate any of these points of view for almost any level of Vitamin C intake that is greater than normal.  There are studies that support the use of glucosamine to treat arthritis and studies that do not show a beneficial effect. There are studies that support high fat, high protein diets and studies that support low fat, high fiber diets. Which is better for you? It is very likely that one or the other of these diets would be a better choice. Often, though, the only way to know for a particular individual is to try the diet to see if it meets that individual’s needs.

As much as nutrition and diet are debated, the bottom line is that there are very few well documented facts about nutrition and the effects of changes in nutrient intake on health in people or pets over long periods of time.  There are lots of well documented facts about how nutrients behave in microscopic systems, how they are absorbed or other facets of nutrient behavior but most of this information can’t be readily integrated into a complete view of nutrient needs because it is extremely difficult to study the real life effects in a whole organism. One of the basic tenets of scientific analysis is to change one aspect of a system only and then to see the effect on the whole system. It is nearly impossible to do this with nutrient intake for the life of a pet, or even for significant time periods in the life of a pet. Often all that can be done is to theorize that a measurable change at the microscopic level will translate into a positive change at the macroscopic level. Unfortunately, there is lots of evidence that refutes these sorts of assumptions as they were made in the past. I don’t think we are a lot better at making them today.

The lack of scientific knowledge about nutrients is used by many people with theories about benefits from specific nutrients to justify using anecdotal data (testimonials) to prop up their claims rather than using well designed scientific studies. Testimonials are simply unreliable as supporting evidence, even when they come from well meaning or otherwise well informed people. When they are all that is available to consider as evidence it is difficult not to give them some weight when trying to make decisions, though.  People seem to be naturally inclined to try to see cause and effect relationships in their lives and testimonial evidence is compelling because the person giving the evidence usually truly believes in the effect or is convincing in their not so sincere support. Believing in something doesn’t make it true, though. Over the years since the scientific method was established it is abundantly clear that humans overemphasize cause and effect and miss more subtle linkages between events. For this reason, testimonials and case reports are given very low credence in evidence based medicine.

One of the major criticisms leveled against physicians and veterinarians is that their training teaches them to fight disease after it has occurred rather than attempting to prevent it. I do not know enough about human medical training to comment on whether that is true for physicians but it is not true for veterinarians. In veterinary medicine prevention of illness has always been a major goal. This is especially true for large animal medicine but almost all of the currently practicing veterinarians were exposed to herd health management courses because veterinarians are usually taught both large animal and small animal courses throughout their training.  Prevention of illness is critical in large animal medicine because it is less expensive to prevent illness in a herd of animals than to treat illness, in almost all cases. This is most true for illness related to nutrition and infectious disease but efforts are made to prevent inherited conditions, dangers from toxins and even injuries. While it is also true that it is cheaper to ignore some illnesses than to treat or prevent them and that this practice is followed to save money in some cases, overall the need to prevent illness has been strong in veterinary medicine for a very long time. Using good dietary information when it is available has always been a strong point in veterinary medicine.

Perhaps a stronger argument can be made that all forms of training tend to produce biases in the trainees and that veterinary medicine is no exception. Veterinarians are biased towards certain schools of thought, in general. Vaccination is seen as a good thing, feeding proper amounts of a diet that meets AAFCO (American Association of Feed Control Officials) standards is another. When some of the data generated in studies has contradicted these findings there has been resistance to change exhibited by the profession. This is most clearly demonstrated by the continuing resistance among veterinary practitioners to increasing the interval between booster vaccinations in adult pets. The evidence now strongly supports longer intervals than the traditional “yearly” vaccination schedules but many veterinary practices have resisted making this change. These obvious biases feed the suspicion that generally accepted practices are not always best. Over time, though, most veterinarians do accept well documented changes and this will be true if it becomes evident that major changes in our approach to diet are necessary.

Another major criticism of physicians and veterinarians is that they receive very little training in nutrition. Again I can’t comment much on the situation in human medicine. In veterinary medicine this criticism is warranted when looking at the veterinary school curriculums. In the past many veterinarians were graduates of animal science programs that included a great deal of nutritional information, or at least studied these curriculums before getting into veterinary school if they entered prior to obtaining an undergraduate degree. Sometime around the early 1970s this tendency changed. Veterinary classes had a much more varied background and it became less likely that a veterinary student had studied animal science rather than English, engineering, general biology or some other field prior to getting into veterinary school. One of the major reasons for this was the shift of emphasis from large animal production medicine to small animal medicine among veterinary school graduates. Today, less than 15% of graduates go into large animal medicine and many of these graduates do not come from animal science undergraduate programs. With this in mind the lack of nutritional training has become a more legitimate issue.

Veterinarians who are not taught nutrition in veterinary school may be more susceptible to marketing from pet food manufacturers.  The easiest choice for them to make may be to choose one or two manufacturers who they trust, for whatever reason, and to back their products. In many instances veterinarians also sell these products. This does present a conflict of interest.  There is a tendency to be less critical of products that are part of the profit margin that allows a veterinarian to purchase a home, pay for their children’s education and provide for their families in other ways. You have a right to be suspicious of claims that your veterinarian sells the best food for your pet. This suspicion may have to be tempered somewhat when dealing with very specific problems, such as chronic kidney disease, but even in that kind of situation it is reasonable to discuss alternatives to the diet your veterinarian advocates. Just be sure to listen to the reasons why a particular diet might be best given your pet’s health problems.

It is also true that most of the people advocating dietary programs other than commercial pet foods, or advocating new philosophies in commercial pet food, such as organic diets, breed related diets, raw diets or vegetarian diets are even less likely to have formal nutritional training than veterinarians. Recognizing that veterinarians have limitations as nutritional experts shouldn’t imply that everyone else with an opinion about nutrition is better trained or doesn’t have a bias of their own related to their economic success.

Pets don’t live in theoretical worlds. They have real owners, who have real differences in their motivations for owning pets and their willingness to provide for their pets. One of the reasons that pet foods were developed in the first place was convenience. It was important to come up with a diet that was easy to use, met the pet’s nutritional needs and didn’t take excessive amounts of a pet owner’s time to prepare.  Veterinarians quickly realized that a standardized diet designed to meet the pet’s minimum nutritional needs was likely to result in a pet population with less nutritional disease than scrap feeding. The overall success of this approach is hard to argue. There may be differences over which approach is best for one individual pet and its individual circumstances, but overall, pet foods have improved the chances for most pets of having a well balanced diet. As a result, the overall health of pets is better than it was thirty years ago. This is as long as I can attest to but I suspect that it is better than it was fifty years ago, a hundred years ago or five hundred years ago, as well.

Contact Information:

We have had problems with our email over the last few months. If you need to contact Dr. Richards try mervet@vetinfo.com first. If that doesn’t work try mervet@inna.net.  If neither of these addresses will work for you or if you do not receive a reply within a couple of days, contact Michal at vetinfo@vetinfo.com. Sometimes when I am out of town for a while I will post that on the subscriber web site, so checking this prior to writing Michal would be a good idea.

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