Purdue Vet Med Problems

The Heart of the Matter

In mid-July, the U.S. Food and Drug Administration (FDA) released an alert to veterinarians and pet owners regarding reports of increased incidence of a heart disease called canine dilated cardiomyopathy (DCM). This disorder is characterized by weakening of the heart muscle, which leads to a decreased ability of the heart to pump, and if untreated, to cardiac failure. The reported cases occurred in breeds that are not considered to be genetically predisposed to this disorder.

Further, a significant number of the dogs were found to have reduced levels of circulating taurine in their blood and have responded positively to taurine supplementation. It is speculated that these cases are related to the consumption of foods that negatively affect taurine status, leading to taurine-deficiency DCM. Foods containing high levels of peas, lentils, other legume seeds, or potatoes were identified by the FDA as potential risk factors. These ingredients are found commonly in foods that are formulated and promoted as “grain-free.”

As these things go, there followed a lot of hype and a fair bit of hysteria in response. Let us avoid this type of reaction and instead look at the evidence – what do we currently know about the role of diet and taurine in the development of DCM in dogs and how is it that “grain-free” foods have been recently targeted as a possible dietary cause?

A lot of the ‘cheap’ flea products have active ingredients which have been around for 10+ years and so are no longer subject to copyright. Problem is once those meds have been in the market for 10+ years, they may not be all that effective.

Often they’re cheap and nasty medication to start with, and pharmaceutical companies often copyright the transport medium too, the other compounds in there that distribute the insecticide across/around the skin. You can have different products with the same active, but one will cause chemical burns and one will not.

Case in point, I saw a bunch of dogs for chemical burns over their shoulders one year because some enterprising idiot decided to buy imidacloprid used to spray on crops and put it on dogs, because it was significantly cheaper. There’s a reason.

Something at the supermarket does not have to have proven itself to the same degree that a product for same at a vet clinic needs to. If you buy a product at the supermarket that doesn’t work, are you going to complain to the supermarket? If you buy a product at a vet clinic that doesn’t work, you most certainly will be complaining to the vet!

Pharmaceutical companies don’t set their prices just based on what it costs to produce a product. They price it based on what they think the consumers will pay. That’s why products that do the same thing are all around the same price point. 

It’s an unfortunate result of for-profit businesses doing all the research, but the main driving force setting a price for a product is what they think people will pay. I am not permitted to give details, but there are market research surveys offered to vets on a semi-regular basis which ask questions like “What do you think a reasonable price is for a product which does X, Y and Z?”

Case in point, cerenia tablets are the only non-sedating tablet for car sickness in dogs. When they were first released, they were eight times more expensive than they are now. Nobody bought them, so the price mysteriously dropped.

Reconcile was a brand of beef-flavoured prozac for dogs, at more than double the price of human brand prozac from the chemist. Nobody bought it, they stopped making it.

As a vet I don’t determine these prices by the way. We can determine the in-clinic markup, but not the wholesale price. And products like flea treatments which are non-prescription and widely advertised often have a recommended retail price we’re encouraged to follow.

1. Give human medication to your pet

2. Make that passive aggressive comment “With all the money I have spent here, I should: have my name on the building/have a whole wing dedicated to me/buy you a new car/have just gotten a new dog/etc”

3. Discuss a lot of concerns and do nothing to address them because it costs money to do diagnostics 

4. Make them call your spouse after spending 20 mins on the phone with you explaining your pet’s illness, recommended diagnostics, potential outcomes to explain the same thing to them

5. Call at the last minute to refill your pet’s important meds and then get mad when it is not ready for you at that second

6. Show up at the front desk to handle something that could easily be done over the phone

7. Use the statement; “Can’t you just give them some medication to fix it” when you refuse all diagnostics and “it” is a vague symptom with 20 differentials 

8. Text/message/post on Facebook asking about your pet at any time of day, but especially at 8:30 at night on a Friday

9. Call 1 hour after dropping them off for a surgical procedure asking if they are ready to go home

10. Treating their technicians, receptionists, assistants like crap 

11. Stop medications or change dosages without asking

12. Call asking for a same day appointment for vaccines because you are dropping your pet off at the boarders this afternoon for a week long vacation and getting mad when they cannot be squeezed in

13. Not making your pet wear an e-collar after their abdominal surgery and getting angry when they must be placed under general anesthesia again to fix an incision dehiscence

14. Having a very fear-aggressive puppy and getting offended when behavior training and puppy classes are strongly recommended

15. Laughing when the dog tries to bite 

16. Using the statement: “He started scratching at his ears/having goopy eyes/licking at his skin about a month ago”

“One tablet twice a day is not the same as giving two tablets once a day.”

“Feed your dog cooked chicken and cooked rice. The chicken should have no skin, no fat, no butter, no seasoning and should not be K.F.C.”

“I do not believe you have no room in your car to take this A5 sheet of specific home care instructions with you.”

“It is not recommended to breed these cats together because they are brother and sister.”

“Even if your dog looks fine, if it just ate rat poison it needs to come to the clinic right now.”

“No, you probably can’t throw the tablets into your cat’s bowl of food and expect her to just eat it.”

AAFP (the American Association of Feline Practitioners) has constructed and released a guideline, first of its kind, to feline anesthesia. This was inspired by the uniqueness of cats and their specific physiology and size. According to their records, cats have a higher mortality rate under anesthesia compared to dogs.

Their physiology makes them more prone to complications during surgery,…