Let’s all call it “H1N1,” OK? Or “Mexican Flu.” Because to refer to this triple human-bird-swine influenza virus by its porcine etymology does everyone a BIG disservice.
No, I’ve not been sent here by the marketers of “the other white meat” to exonerate their livestock or to coax you all into supporting their industry. In fact, it was only when my son commented on his fortuitous aversion to pork in light of the “swine flu” epidemic that I realized this pig-citing misnomer would have to be dropped.
Just think about it: Playing the catchy name game may not be so benign if people fail to recognize that eschewing pork will NOT keep them safe. (Hello!...Only LIVE pigs can pass on a virus.)
And I’m not alone in my crotchety word-choice ways. The acting director of the CDC apparently agrees with me. He’s all for dropping the current flu’s given name...in deference to the H1N1 mouthful and out of respect for the pigs, who are by all measures no more at fault here than birds or humans.
Add to this the fact that the swine are currently out of the picture, given that NONE of the infected has been determined to have had contact with pigs, and you start to wonder why anyone ever called this bug “swine flu” to begin with. So in case you’re as curious as I am, here’s an explanation:
In 1918 there was a horrible influenza pandemic, called “Spanish flu,” whose origins were likely to have been in wild birds. Because it decimated both swine and human populations, alike, somehow it came to be more popularly known as “swine flu.” This was an H1N1 strain of Influenza A akin to the one we’re seeing now, hence the current terminology.
More explaining:
The genetic material contained within this current H1N1 influenza virus is composed of human, pig and bird-specific DNA. And that’s what scares the bejeezus out of the World Health Organization. A virus that can happily crash out on the sofa of three very different kinds of homes is one that’s got lots of cozy places in which to evolve into something truly scary. That’s the biggest reason why the WHO’s raised the alert level from three to five over the past 72 hours.
Make no mistake, this is frightening stuff. When viruses find a hospitable presence in multiple species it’s a recipe for disaster. Add to that all the other unknowns––how virulent is it? is it getting more so? will it hide out over the summer and come back as something devastating in the fall?––and all our officials are more than well-justified in their cautions.
Back to the pigs:
Yes, it’s true. This virus, if it makes it back to pigs, could exterminate our pork industry. Even worse, this virus’s potentially innate ability to hide out in the swine population may mean more dangerous strains in the future. That’s why the swine vets of this world are taking serious precautions.
Though public health officials in Egypt have taken the extreme approach of culling all swine to head off a reservoir of infection, you can bet we here in the US will be taking a different tack––for now, anyway. Increased biosecurity on farms is what we’re advocating now. Which means our farm workers will be implementing even more of the basic shoe-dipping, hand-washing, immunizing and showering they’re already required to do. They’ll also be keeping a much closer eye on all the pigs.
Now back to the words:
But when it comes right down to it, our pigs are not likely to have been the source of this infection––no matter what they say about the nasty swine farms down in Mexico. They are, like us––and the birds, for that matter––every bit the victims of this virus.
That’s why it makes sense, epidemiologically speaking, to stick to the H1N1 nomenclature. Why promote fear, fuel ignorance and effectively offer a false sense of security to those who would paint our pigs in a dusky light?
While I’m all for curbing our consumption of pork and improving conditions for swine everywhere, it makes no sense to tarnish the image of the noble pig with the incendiary term, “swine flu.” Just ask those Egyptian pigs. I bet they would agree with me.
Got a Schnauzer? What made you want this breed of dog? Did “Shnauzer” come up on an Internet breed finder? Maybe you grew up with one, or your friends have one. Perhaps you just like the way they look. Their spunk. Their style.
Today’s topic is “breed perceptions.” The question, according to one study out of Australia, is whether people, at a formative age––at a time when lifelong opinions tend to be formed––might acquire misperceptions on dog breed behavior that could affect their future ability to select the right canine companion.
Here’s the abstract for the article titled, “Young adults' familiarity with, and perceptions of, common dog breeds in Australia”:
“A common reason for relinquishment of pet dogs is that their behavior is contrary to the expectations of their owner. Because behavioral predispositions within a breed are believed to be relatively predictable, to assist owner-dog matching potential owners are often advised to acquire a purebred dog. Breed information is readily available via books, breed clubs, and the internet. The extent to which this information is used by the public is unknown. The aim of this study was to explore the familiarity of young adults with a range of dog breeds and their perceptions of these breeds.”
OK, so I admit it. I didn’t read the whole journal article. I’m a little cash poor at the moment so I decided to dispense with the $12 worth of science. Instead, I thought I’d offer you my personal take on this subject, leaving it up to you to determine whether my assessments strike a chord.
It seems to me that prospective pet owners acquire dog breed information––increasingly––through media sources unrelated to expert recommendations or prevailing wisdom. For example: based on TV sources, a smart, well-behaved Jack Russell (like Eddie on reruns of Frazier), is likely to engender JRT-affinity among those who seek a small but feisty apartment dog.
Unfortunately, as most of us here know, Eddie is an aberration. Few pet owners are terrier-worthy. And fewer Jacks do well in urbanity relative to those who live the rural life dogs like this were bred for.
Chihuahuas, Yorkies, Maltese and other teacup varietals (the celebrity pooches-of-pocketbook choice) now appeal not only to those with a predilection for one on one companionship in closed settings, but to young, first-time dog owners who would expose their dogs to all humanity––despite their well-known health and temperamental peculiarities (the dogs not the humans).
My goal is not to disparage any of these breeds. Plenty of exceptions exist in which certain breeds of dogs work our well for owners despite their obvious incongruities (especially when an owner is responsible, aware and willing to apply training).
Nope. No breed-bashing in this post. (That's not the point, at least.) I’m simply pointing out the questionability of how many humans arrive at pet choice decisions––decisions that have implications for 10-15 years of their lives, decisions that too often prove disastrous in ways that lead to owner-pet break-ups or worse...the shelter.
As veterinarians, we’re sometimes asked to recommend a breed for our client’s families. And we love doing this. It tends to mean these clients are doing their homework, ruling out breeds that absolutely will not fit their family’s style and abilities. More often, however, they walk in the door with the worst possible breed for their 1) aged parents who live with them, 2) their toddlers, 3) their travel schedules, 4) their activity level or 5) their personalities.
The mismatch usually works out somehow, but not without some sacrifice––either through major pet owner involvement or (more commonly) through pet marginalization. It’s not typical for my clients to give their pets away outright, but it does happen. Instead, my clients tend to opt for the yard. Or the college-aged kid’s dog ends up at mom’s house. In other words, the pet pays the price.
That’s why studies like this one are necessary. Alerting owners of possible breed incompatibilities before they happen is crucial. But it’s not going to happen if children and young adults acquire their awareness of and interest in specific dog breeds through our popular culture. Not when you consider the steaming pile of dog-doo our kids are chronically exposed to ostensibly by way of teaching them to value canine life.
The Obama administration is working hard on solutions to the high cost, spotty availability and inefficiencies of our current medical system. As if the economic crisis, foreign policy nightmares and energy issues weren’t enough, taking on the US’s human healthcare insufficiencies as well will take an act of God to surmount.
No matter, we have to start somewhere, right? Some proposals have already been floated. The ones I’ve looked at? They all seem to include the adoption of computerized medical records. And it’s about time.
For decades now, the concept of computerizing medical records has been out there. For the past ten or so years, the technology has been readily available to most any physician. Indeed, veterinarians have been working these programs for almost as long as they’ve been available.
Yet the bulk of healthcare practitioners continue to eschew them based primarily on privacy concerns. Never mind that we’re willing to play with our money online––shopping, banking and even gambling with it. Never mind that encryption technology feels far safer to us than entering any human hospital with no records in tow.
That’s why the resistance to computerized medical records seems incredible to me. I just don’t get it.
Back to the animals:
Despite the veterinary profession’s acceptance of so-called “paperless” medical records systems, it’s by no means a universal phenomenon. The vast majority of us still labor, pen on paper, without them. Though new hospitals are happy to start afresh with nary a thought as to reaching for a writing tool, the rest of us are transitioning very slowly to the concept of no physical records.
What will we do if the power goes out? We’re not big hospitals with generators, right? And if the phone lines go down, too? Where’s all our stuff now? Where are the backups? In the event of a hurricane? Who’ll fish us out of the paperless abyss? And what if I can’t type? I mean...zero typing skills.
These are all valid concerns, more so for small hospitals and clinics than for big, human hospitals. Many hospitals feel they can’t justify the extra cost (mostly involved in the labor required to transition to a new system). Then there’s the issue of older practitioners who haven’t even heard of Twitter, much less do the understand the value of computerizing anything.What the heck do you do with that contingent?
To my way of thinking, computerized medical records are better medicine for a huge host of reasons. They allow for all organ systems to be checked off as within normal limits, aberrant or “not examined.” Diseases can be tracked. All chronic and previous medical issues are flagged. All drug or vaccine reactions are prominently noted.
Not only are these systems safer, they mean better medicine because the information of the Internet is more readily accessed, some programs offer diagnostic software, and most offer easily printed cautions, complete drug labels, drug interaction warnings, recommendations, home care instructions and informative articles for pet owner education.
All these features, plus accessibility of records to specialists and emergency hospitals and the potential for cost-cutting due to duplication of work (which is what makes them so attractive in human health), it's invaluable. What’s not to like?
Do I work in a paperless office? Heck no. (Dammit!) But I lobby for it regularly. Can I complain? Not really...especially now that I’m finally getting my digital X-rays. Picking my battles, as Obama seems to have done, is working out for me. Now let’s see if I can manage to get my new hospital. the paperless system will doubtless follow. Wish me luck.
Topical pet pesticides. You may know them as Frontline, Advantage, Advantix and Promeris, among others. Perhaps you also use Adams brand flea and tick shampoo and occasionally defer to a Sergeant’s supermarket brand spot-on flea and tick killer when your veterinarian is closed (or when you’re tight on money, as so many of us currently are).
In case US pet owners didn’t know this, our FDA (Food and Drug Administration) is NOT in charge of these products. Ultimately, the EPA (Environmental Protection Agency) is.
That’s because flea and tick products are usually not applied inside an animal––they go ON your pet, instead. And because they’re intended to kill things ON your pet, just as pesticides sprayed on the fields go ON the crops to kill bugs ON them...it’s in the EPA’s purview to regulate these products.
Despite the fact that you and I know that anything that goes ON any animal with a porous membrane for protection (i.e., skin) will end up IN him, pet flea and tick manufacturers have long understood that when it comes to animals, life is easier if you’re dealing with the EPA instead of the FDA.
That’s because the EPA doesn’t require the same stringent standards for safety and efficacy the FDA does. It’s less expensive, then, to produce these products. It’s a quicker process, this approval to market.
In many ways that’s good. It means more products get the chance to reach vet hospital and supermarket shelves more quickly––and at a lower price. The problem comes in only when it’s time to...
1-ensure the product works as effectively as it says it does, and
2-ensure that pets aren’t harmed by them.
Recently, the EPA seems to have come to the realization that some of these products don’t the agency’s standards for #2 (i.e., safety). Last week (April 17th) it published an advisory titled, “Increased Scrutiny of Flea and Tick Control Products for Pets.” The advisory listed 7 products that accounted for 80% of 44,000 adverse effects reported in 2008. Here’s most of it:
“Due to a recent sharp increase in the number of incidents being reported from the use of spot-on pesticide products for flea and tick control for pets, the Environmental Protection Agency (EPA) is intensifying its evaluation of whether further restrictions on the use of these products are necessary to better protect pets.
Incidents with flea and tick products can involve the use of spot-on treatments, sprays, collars and shampoos. However, the majority of the potential incidents reported to EPA are related to flea and tick treatments with EPA-registered spot-on products. Spot-on products are generally sold in tubes or vials and are applied to one or more localized areas on the body of the pet, such as in between the shoulders or in a stripe along the back...
...Adverse reactions reported from the spot-on products range from mild effects such as skin irritation to more serious effects such as seizures and in some cases death. Over 44,000 potential incidents associated with registered spot-on products were reported to EPA in 2008. Pesticide registrants are required by law to submit information to EPA on adverse effects resulting from the use of any registered pesticide. The seven products in the table below represent about 80% of that total.”
So now...drum roll please...here are the seven products:
That’s right. They’re no longer on the site. A few days late to this party, I was unable to catch the breaking news in time. Because the EPA is clearly under pressure by these products’ manufacturers to contain the data until they’ve had time to circle the wagons, who knows when we’ll know which products to inform our clients to avoid––for now, anyway.
(One thing I do know, courtesy of a Hartz veterinarian, is that the Hartz brand is not represented among the products listed.)
Regardless of WHY these products are responsible for 80% of 44,000 complaints, do we not deserve access to the information as quickly as possible? At 44,000 a year, that’s 120 patients per day. Another week without these stats? Another opportunity for 844 patients to succumb to adverse reactions.
Has the EPA learned nothing from its cousins at the FDA? In case you haven’t caught the connection, let me direct you to Exhibit A: the pet food recall of 2007. In this now-historic debacle, pet food manufacturers failed to reveal the role of their foods in the deaths of many thousands of pets.
Despite their exoneration with respect to the source of the toxin, the pet food industry’s denials and obfuscations, aided and abetted by the FDA, undercut the reputations of all involved when it became clear that preserving the affected brands’ integrity was more important than protecting our pets.
Will the same shameful history be repeated again today? Let’s hope not. Contact the EPA and let them know how important this information is to our pets. Sure, we want the EPA to be 100% certain that the information it provides us is accurate. But these deliberations should take place in the light of day, not behind the veil of corporate protectionism, and not if it means more pets will experience the ill effects of products and brands whose regulators cave to their demands at the expense of animal health.
Wanna know what I spend my time doing...day after day? It’s pretty simple really. The hard part’s the talking, explaining, teaching, cajoling, reasoning, recruiting, empathizing, etc. The rest? It’s mostly a breeze.
That’s because veterinary patients tend to observe the 80/20 rule. 80% of our “problem” cases are routine. The remaining 20? Complex cases with complex solutions. Bloats, diabetics, Addisonians, Cushingoids, liver shunts, FIP, heartworms, etc.
That’s not to say our routine cases aren’t potentially complex. In fact, they typically are when you get down to the nitty-gritty of the underlying process. But they’re so common that the accepted steps to follow as we unravel their solutions are relatively obvious for the experienced.
Because I was recently asked by a reporter to discuss the most common pet problems I see, I got a little curious about the actual stats behind my daily work. The results surprised me, since I had no idea how much time and energy I’d been dedicating to my patients’ individual disease processes.
For your consideration (and edification), here are my stats for the past month (a relatively normal one as far as I can tell):
#1: Allergic skin disease
The biggest surprise was the amount of time I dedicate daily to skin disease. While allergies are huge here in South Florida, year-round, I was shocked to discover that almost a full 25% of my [non-well pet] appointments are dedicated, exclusively, to the evaluation of allergic skin disease.
Forget spays and neuters and other basics––their volume pales in comparison to the itchy pets among us. Flea allergies, food allergies, inhalant allergies, etc. are my bread and butter, it would seem.
#2: Other skin disease
Add the allergic pets to the other [not necessarily allergic] skin cases I see and you might start to wonder why I didn’t specialize in dermatology: Demodectic mange, anal gland abscesses, ear infections (though, strictly speaking, most are allergic in nature, too), non-specific hair loss, sarcoptic mange, ear mites, fur mites, ringworm, etc.
#3: Gastroenteritis
Diarrhea, with or without vomiting as an additional symptom, is the next most common cause for pet visits to our place. Extra soft stools, runny or bloody stuff is wickedly widespread. And, in case you’re wondering, Mondays are the day for these. Barbecue, anyone?
#4: Urinary tract disease
Cats made up the bulk of my urinary tract issues with their lower urinary tract diseases (blocked boys) and idiopathic cystitis (ouchy bladders), but leaky dogs and chronic renal failure (in both dogs and cats) were significantly represented, as well.
#5: Dental disease
It was a little tough to quantify this one only because so many of my patients in for something else get flagged for dental issues, too. In many cases they don’t make appointments until after it’s too late, but my busy “routine dentistry” schedule proves there’s still a hefty interest in prevention.
#6: ADR (“ain’t doing right”)
This is a harder one to claim as “routine” because a significant percentage of the time my ADR cases turn into something more sinister than simple sniffles and common kennel cough.
#7: Limping
Limping cats and dogs is definitely routine. “Can’t get up” is another variation. But most of the time, it’s a simple sprain or strain. Next up in frequency? The dreaded osteoarthritis.
#8: Lumps and bumps
So many tumors...so little time.
#9: Bites
Limping cats usually fall into this category, as do all those cat bite abscesses I see. Evidence of inter-dog and predatory aggression also makes its way. Interesting how most of my pet bite patients are repeat offenders. you’d think it would eventually make sense to keep the cat inside, right?
#10: Simple Trauma
Lots of simple traumas here in Miami, where every day of the year is another opportunity for going out and getting hurt––just a little. Fractured claws, small lacerations, fence wounds and bleeding tails are everywhere. And let’s not even begin to factor in the “hit-by-cars” and “fell-off-the-roofs.”
***
Think that’s enough solid work to make a reporter happy?
