What’s in your dog? Screening tests.

I have had a busy week and,  as always, one patient with a history of vomiting. Since that is a common complaint the challenge is to determine which ones are emergencies and which will pass. In further consultation with the owner, the invariable question arises,  “Is anything missing?" This patient, bright and alert, incidentally ate a golf glove approximately a month ago. So here are the lateral films. Do you see anything in the stomach.

Well, we did not know either since there is so much food in there. Yet I knew the white/ metal objects were not normal! Sooo, we gave an injection of apomorphine to induce vomiting and this is what we found. Surprise!!!! 

This is the golf glove consumed a month ago.  Just as I do not often know what an animal eats, I often do not know the genetic makeup of a patient, their allergic tendencies, and thus, their health risks.

What is out there for basic breed/genetic testing of Animals?

Royal Canin (yes, the food manufacturer) has a Genetic Health Analysis that reviews basic risks and breed background. I recently ran this on my own dog, Taco Belle and received these results. 

I am looking for more specific breed associated diseases. Is there a link?

Yes, I would look at the following sites. 

   http://www.offa.org/dna_alltest_b.html

https://www.vetstream.com/canis/corporate/html/Inheriteddiseases/Genetictestsforhereditarydiseases.htm

WHAT’S OUT THERE FOR CAT TESTING?

https://www.vgl.ucdavis.edu/services/cat/

What do veterinarians use for more specific genetic testing?

The Metabolic Genetic Disease Laboratory at the University of Pennsylvania 

http://research.vet.upenn.edu/penngen

Similarly Cornell's Comparative Coagulation Laboratory offers functional testing for many bleeding disorders 

http://ahdc.vet.cornell.edu/  

 Comparative Neuromuscular Laboratory in San Diego for neurological 

http://vetneuromuscular.ucsd.edu/

What are some of the laboratories that have skeptical results?

 Here is a pet store “off the shelf’ allergy test based on hair samples and saliva swabs collected from a 6 month old dog.  Scientifically, positive results of food allergy blood testing do not correlate with clinical food allergy in dogs. Note the disclaimer and allergy to white wine among other questionable results. 

With the known inaccuracy of food allergy blood testing in companion animals, it makes more sense to spend the pet owner’s time and funds on the prescription or home cooked hypoallergenic diet trial which is both diagnostic and potentially therapeutic. I wish we could call these tests "predatory health misinformation," sort of like predatory lending.

WHAT IS THE PROBLEM WITH VETERINARY vs HUMAN LABORATORIES?

Many upscale “veterinary laboratories” are not well regulated and thus are accountable to no one. I would be skeptical of any lab that is providing animal testing with no scientific VALIDATION of the results (from reputable sources). Testimonials alone are not evidence based medicine. Clearly the obvious question is, "where is the science and does it make sense?"

Betsy Sigmon DVM, Diplomate ABVP Canine & Feline 

Creature Comforts Animal Hospital PLLC

Cary, NC

My thanks for photos to Terry Seaks sharing Puffball the cat  and Tammy Butler sharing her Rescue Dog January staring at statue with the blog followers. Memphis Woodall is a repeat performance from last week now wearing antlers. 

Reefer Madness: the 2014 Marijuana Update

As a teenager in Cary, I distinctly remember being shown the cult film, Reefer Madness (1936), in Health Class as a deterrent to trying marijuana. The film had a distinct scare factor at the time. As time passed, it morphed into more silliness than fact. To drive the point home, a sample of artificial marijuana was produced and lit to discourage use by my classmates. I am not sure it helped. During the session, while the teacher was distracted one classmate, Curtis, began hanging out the window (2 stories up). Then he sneaked out the door, went down the stairs, and proceeded to lie on the ground below the window. Then classmates yelled, “Curtis just fell out the window," of course he didn’t, but the teacher was not in on the joke.

 The movie was on my mind at a recent lecture by Dr. Dawn Boothe from Auburn University into new points into the science of medical marijuana. As several states have decriminalized recreational use, there has been a huge upswing in dogs ingesting recreational forms. The focus of this blog is the medical application of the more that 480 unique compounds it contains. 

HOW LONG HAS MARIJUANA BEEN AROUND?

It has been part of recreational, religious, and medical activities for a variety of cultures for over 5000 years. Interestingly, marijuana was one of the more commonly prescribed medications in the USA until it was declared illegal in the 1930’s.  Due to its control of pain, many states have passed laws that allowed medical use in people. There is little to no research of benefits in pets.  Marijuana is still illegal on the federal level.

HOW DOES ONE KNOW Street POT’s STRENGTH? 

You do not know as it can vary depending on how much of what plant part is contained, the quantity consumed, sex, age, grown indoors vs outdoors, when harvested, and how it is dried/stored. 

WHAT ARE THE PHYSIOLOGICAL EFFECTS OF MARIJUANA?

Problems with memory and learning, red eyes, distorted perception, difficulty thinking and problem solving, incoordination, increased heart rate, and panic attacks. The tolerance varies between people, and withdrawal leads to nervousness, restlessness, anxiety, and insomnia. Concerns in teenage use include lower IQ’s and depression. 

WHAT ARE THE TOUTED BENEFITS/MEDICAL TREATMENTS OF MEDICAL MARIJUANA?

THC, the most active component, is a muscle relaxant, ant-inflammatory, anti-depressant, increases appetite, and stimulant. Other components (CBD, CBC, and CBG) are touted for treatment of behavioral, sleep disorders, protection of the nervous system, ant-anxiety (think valium-like), bone healing, nausea, glaucoma, diabetes, suppression of the immune system, malaria, and pain control.

Memphis , proudly owned by Jon & Jane Woodall

There is NO DATA to support this broad appeal in pets and limited in people. The smoke/lung cancer risks of inhaled forms are not widely discussed.  Marijuana is still illegal on the federal level.

ARE THERE legal, PRESCRIPTION FORMS OF MARIJUANA AVAILABLE AT HUMAN PHARMACIES? If so, what are its benefits compared to the marijuana dispensary? 

Yes, Marinol (dronabinol) is a synthetic THC prescription medication form of marijuana that has been out for 30 years.  The benefits are that  this is a narrow spectrum compound versus smoking marijuana, which contains a wide variety “buffet line” of chemical components. Marinol is used to treat nausea, vomiting, and stimulate appetite, all of which are side effects of chemotherapy, when other treatments are unsuccessful. Cost on the goodRx site in Cary, NC average about $10 per tablet. 

Epidiolex (a version of marihuana lacking THC) is used for seizures with other measures have failed. 

ARE MOST MEDICAL MARIJUAHUA DISPENSORIES PRESCRIBING MEDICAL MARIHUAHA UNDER THE ADVICE OF A BOARDED SPECIALIST (FOR EXAMPLE ASTHMA)?

No, it appears most prescriptions are from doctors that are general practitioners, and security of those prescriptions was lax due to the lack of money and coordination with the Federal government. Yet, the costs are higher to consumers to obtain medical marihuana from dispensaries (government taxes) rather than traditional pharmacies. 

STAY TUNED AS MARIJUANA STUDIES ARE BEING CONTEMPLATED FOR PAIN CONTROL IN PETS. 

As a side note, from the nutritional talks and lots of options after the scare from the melamine and the wheat gluten scare around 2007, what happened to the Food and Drug czar in China? Well in China, Zheng Xiaoyu: China Ex-Food and Drug Safety Chief WAS Sentenced to Death. http://www.mindfully.org/Industry/2007/Zheng-Xiaoyu-China29may07.htm

Dakota, owned by Dave Bubb

Sigmon DVM, Diplomate ABVP canine & feline

Creature Comforts Animal Hospital

Cary, NC

Myths about Food Allergies

Having experienced an extreme gastric overload over the Thanksgiving holiday, gluttony and talking about food is the furthest thing from anything we would want to discuss. It is very common for clients to come in with statements that they THINK I want to hear, such as “I'm feeding grain free, raw, gluten free, or corn-free are among several that are mentioned. As a follow-up to previous blogs, I thought I would put these in 10 myths with comments.

1. FOOD ALLERGY IS COMMON AMONG DOGS.
Confirmed cases of food allergy are actually pretty rare; only about 5 % to 10% of dogs with an allergy have a confirmed reaction to food.



2. DOGS ARE ALLERGIC TO CORN AND OTHER GRAINS.
Contrary to current marketing campaigns by many pet food companies, true corn and grain allergies in dogs are rare. Most allergies are to meat protein. In dogs, beef is the most common food allergen, while in cats it is fish. Surprisingly to some pet owners, many dogs on a grain-free diet still have symptoms of food allergy.



3. MY DOG HAS A GLUTEN ALLERGY leading to skin lesions.
Although gluten is a protein, it has not been documented to cause skin disease in dogs. The report in Irish Setters having GI issues related to wheat gluten is flawed in that the dogs in the study were genetically related.





4. MY DOG IS TOO OLD TO DEVELOP A FOOD ALLERGY.
Your dog can develop an allergy at any age, and the deciding factor is usually exposure in addition to a genetic predisposition.



5. IT CAN’T BE FOOD ALLERGIES BECAUSE MY DOG DOES NOT HAVE DIARRHEA.
Most canine food allergies manifest as recurrent skin diseases (eg. itching, skin lesions) and recurrent ear infections. Food allergies leading to diarrhea are a less common form.



6. MY DOG HAS HAD THE SAME DIET FOR YEARS SO FOOD ALLERGIES, NO WAY!
A food allergy takes time to develop. Even though the diet has not changed, the immune system response to food proteins may change. Sometimes, manufacturers change the formula slightly, without notification, which can trigger a new, unexpected allergic response.



7. I SWITCHED FROM ONE PROTEIN SOURCE TO ANOTHER AND MY PET IS STILL ITCHING, SO IT CAN’T BE FOOD ALLERGIES, RIGHT?
Often a pet owner may switch food brands but not the protein source. NOTE That MANY over the counter diets may contain ingredients that are not on their dietary labels.4 Elimination food trial of at least 10 to 12 weeks duration, with a prescription veterinary hypoallergenic diet still remain the best option for diagnosis of food allergies.

8. I DID THE FOOD TRIAL AS SUGGESTED AND MY DOG IS STILL SCRATCHING SO I NEED TO PROCEED TO ALLERGY TESTING, CORRECT?
Before allergy testing, skin infections (bacterial, fungus) and parasites (eg. fleas, mange mites) must be addressed for the food trial to succeed. In addition, it is so easy to sabotage a food trial. Was a snack provided containing a different protein? Give pills with a Pill Pocket or cheese? Give flavored medications? Did the dog get into the trash? Remember that some dogs will have environmental and seasonal allergies as well concurrent with food allergies..

9. I HEARD THAT RAW FOODS ARE BEST FOR ALLERGY DOGS.
If the raw diet consists of a raw version of the protein trigger, then the diet will still cause problems for the dogs.

10. CAN I AVOID FOOD ALLERGIES BY CHANGING THE DIET FREQUENTLY?
There is no evidence that changing diets frequently will prevent a dog from developing allergy signs. In fact, it limits the future diet trial options due to prior exposure.


The below is my family gathering for Thanksgiving. My thanks to Bradley Brodbeck for posing for my pet photo.

Betsy Sigmon DVM, Diplomate ABVP canine and Feline
Creature Comforts Animal Hospital
Cary, NC

Sources for this article: 

1) Rosenthal, M. DVM, DACVD. 2013. Sleuth out allergy problems/ 10 allergy myths. Trends Magazine. May 2013 

2) Brooks W.C. DVM, DACVD. 2013. Food Allergy Myths. The pet Nutrition corner. VIN.2013

3) Moriello, K.A. DVM. DACVD. 2009. Food Allergy: How to achieve a successful food trial. NAVC Conference.

4) Tater K. DVM, MPH, DACVD. 2013. Real or not real: Top dermatology myths debunked. VIN Rounds. January 2013.