Pig ear pet treats blamed for human Salmonella outbreak

Pig ear pet treats have been linked to an outbreak of multidrug-resistant Salmonella infections in 13 states, according to an investigation report released today by CDC.

Forty-five individuals in California (1), Illinois (3), Indiana (3), Iowa (12), Kansas (3), Massachusetts (2), Michigan (7), Missouri (3), New York (6), North Dakota (1), Pennsylvania (2), South Carolina (1) and Wisconsin (1) have been infected with the outbreak strain, identified as Salmonella I 4,[5],12:i:-.

Twelve outbreak victims were hospitalized.

According to CDC, epidemiological evidence points to pig ear pet treats as a likely source of the illnesses.

Of the outbreak victims interviewed, 89% reported contact with a dog before getting sick and 71% reported contact with pig ear dog treats or with dogs who were fed pig ear dog treats.

In comparison, only 61% of healthy individuals reported contact with a dog, and only 16% reported having handled dog treats such as pig ears in the week before the interview.

Pig ear pet treats obtained from bulk bins at two Michigan retailers have tested positive for a number of different Salmonella strains, according to a report from the Michigan Department of Agriculture and Rural Development (MDARD).

According to FDA, MDARD found four different strains – Salmonella London, Salmonella Typhimurium, Salmonella Newport, and Salmonella Infantis – in the pig ear samples.

FDA is working with CDC and state health partners to determine whether any human or animal cases of Salmonella illness may be linked to the strains found in the treats tested by MDARD.

Other brands of individually wrapped or bagged pig ears sold at multiple retail locations in the state tested negative for Salmonella.

Pet Supplies Plus (Livonia, MI) issued a voluntary recall after learning that MDARD found Salmonella in “…aging bulk pig ear product…” in one of the company’s stores.

The contaminated bulk pig ears were stocked in open bins in Pet Supplies Plus stores in AL, AR, CA, CO, CT, DE, FL, GA, IA, IL, IN, KS, KY, MA, MD, MI, MN, MO, NC, NE, NH, NJ, NY, OH, OK, PA, RI, SC, TN, TX, VA, WI and WV. Prepackaged pig ears are unaffected by the recall.

The company has removed bulk pig ear treats from all of its stores and has stopped shipping these treats from its distribution center.

FDA is working to identify the source of the pig ear treats, how they became contaminated, and where they were distributed.

What consumers need to know

Salmonella can cause illness in both humans and animals. People infected with Salmonella can develop diarrhea, fever and abdominal cramps. Most individuals recover without treatment. However, in some cases, the diarrhea may be so severe that hospitalization is needed.

In severe cases, without antibiotic treatment the infection may spread from the intestines into the blood stream and from there to other parts of the body.

Pets do not always display symptoms when infected with Salmonella, but signs can include vomiting, diarrhea (which may be bloody), fever, loss of appetite and/or decreased activity level. Infected pets can shed the bacteria in their feces and saliva without showing signs of being sick.

If you or a household member is suffering from symptoms of Salmonella, consult a healthcare provider.

If you believe your pet may be infected with Salmonella, consult your veterinarian.

How to alert FDA to a problem

Veterinarians who wish to have pets tested for Salmonella may do so through the Veterinary Laboratory Investigation and Response Network (Vet-LIRN Network) if the pet is from a household with a person infected with Salmonella.

FDA encourages consumers to report complaints about pet food products electronically through the Safety Reporting Portal. This information helps FDA further protect human and animal health.

574 Companion Animals Stricken with DCM. No answers yet

The US Food and Drug Administration (FDA) received a total of 524 reports of companion animals stricken with dilated cardiomyopathy (DCM) between January 1, 2014 and April 22, 2019, according to an update released by the agency today.

Some of the reports involve multiple animals in a single household. In all, DCM was reported in 560 dogs and 14 cats. Five cats and 119 dogs died.

Only seven reports were lodged with FDA during calendar years 2014-2017. The number of incidents spiked to 320 in 2018, and have continued at a steady pace this year, with 197 cases reported between January 1st and April 30th 2019.

FDA has posted a spreadsheet containing all of the individual reports it has received.

BY THE NUMBERS

The ten breeds appearing most often in these reports include: Golden Retriever (95), Mixed (62), Labrador Retriever (47), Great Dane (25), Pit Bull (23), German Shepherd (19), Doberman Pinscher (15), Australian Shepherd (13), Unknown (13) and Boxer (11).

DCM is recognized as a genetic condition in some large or giant breed dogs, including the Doberman Pinscher, the Great Dane, and the Irish Wolfhound, manifesting mainly in male dogs in middle to older age. DCM also is associated with taurine deficiency in Cocker Spaniels.

In contrast, cases of DCM reported to FDA have involved a wide range of dog breeds of all sizes and ages, from 0.4 – 17 years in dogs and 7 – 13 years in cats. More than one half of the cases (58.7% of dogs and 62.5% of cats) involve males.

The vast majority of affected pets (452 of the 524 reports) were fed a dry food diet exclusively. The rest of the animals were fed a diet that included one or more of dry, raw, semi-moist or wet foods.

More than 90% of the dry dog foods were grain-free. Ninety-three percent of the formulations contained peas and/or lentils. Forty-two percent contained potatoes or sweet potatoes.

The most common animal source proteins were chicken, lamb and fish. Some foods contained exotic meats, such as kangaroo or bison. No one animal protein source predominated in the illness reports.

Dry food brands named most frequently in DCM cases were Acana (67), Zignature (64), Taste of the Wild (53), 4Health (32), Earthborn Holistic (32), Blue Buffalo (31), Nature’s Domain (29), Fromm (24), Merrick (16), California Natural (15), Natural Balance (15), Orijen (12), Nature’s Variety (11), NutriSource (10), Nutro (10) and Rachael Ray Nutrish (10).

THE FDA INVESTIGATION

FDA’s Veterinary Laboratory Investigation and Response Network (Vet-LIRN) has analyzed multiple products for minerals and metals (calcium, magnesium, phosphorus, iron, cobalt, copper, zinc, selenium, iodine) and amino acids including taurine, cysteine, and methionine. No abnormalities were found.

A comparative test of grain-free and grain-containing products for levels of protein, fat, moisture, crude fiber, total dietary fiber, soluble fiber, insoluble fiber, total starch, resistant starch, cystine, methionine and taurine revealed that both types of products contained similar levels of all of these components on a dry matter basis (ie., after removing all moisture content).

Additional tests are in progress

Vet-LIRN has interviewed 95 owners of affected pets, in order to document a complete dietary history and to explore any other possible contributing factors, including environmental factors.

FDA has received results of 19 gross necropsies from dogs with suspected heart disease, and Vet-LIRN is processing tissues from the necropsies for review by a board-certified veterinary pathologist.

Vet-LIRN is collaborating with Chesapeake Veterinary Cardiology Associates (CVCA) to collect medical records, owner interviews, and diagnostic samples from pets diagnosed with DCM. CVCA will be following the medical progress of these pets, including regular collection of diagnostic samples and follow-up echocardiogram. Vet-LIRN is collecting food associated with the pets included in this study for lab analysis.

UNANSWERED QUESTIONS

Why have cases of DCM spiked in recent years? What has changed?
Why are grain-free products so strongly associated with DCM, even though there is little apparent difference in the levels of minerals, amino acids, protein levels, etc. between grain-free and grain-containing products?
Acana (67 DCM reports) and Orijen (12 DCM reports) are both manufactured by the same company. Why is there such a large difference in the number of associated cases between these two brands?
Is there any correlation between brand popularity and number of DCM case reports? Would it be useful to compare the report frequency to the market share of each product?

WHAT CAN PET OWNERS AND VETERINARIANS DO?

FDA encourages pet owners and veterinarians to submit reports on any food-associated pet illness. Details for submitting this info can be found on the FDA page “How to Report a Pet Food Complaint.”
Pet owners should contact a veterinarian as soon as possible if their dog is showing possible signs of DCM or other heart conditions, including decreased energy, cough, difficulty breathing and episodes of collapse.
Veterinarians are urged to report well-documented cases of DCM in dogs suspected of having a link to diet by using the electronic Safety Reporting Portal or calling their state’s FDA Consumer Complaint Coordinators. FDA especially welcomes detailed reports, including information about feeding history, medical records, and diagnostic testing.

AN EDITORIAL NOTE

I have sometimes read complaints from pet owners and at least one blogger that FDA doesn’t care about pet food safety, or about the health of companion animals.

The agency has spent significant resources and manpower on this investigation for more than a year, and is continuing its efforts to find the root cause for the spike in DCM in dogs. This is a complex, difficult, and wide-reaching investigation with no guarantee of success.

In my opinion, FDA’s commitment to solving the DCM riddle bears witness to its dedication to pet health.

FDA reveals name of Hill’s vitamin D premix supplier

DSM Nutritional Products Inc. (DSM) was the supplier of vitamin D premix to Hill’s Pet Nutrition.

DSM is an international corporation that is “…a world leading supplier of vitamins, carotenoids and other nutritional solutions…”, according to the company’s website. Its US headquarters are in Parsippany, New Jersey.

According to the FDA Weekly Enforcement Report released this morning (June 19, 2019), DSM was notified by Hill’s Pet Nutrition (Hill’s) that a dog had become ill after consuming Hills Prescription Diet W/D canned dog food, manufactured using the DSM vitamin premix.

On January 30, 2019, DSM initiated a recall of 2217 Canned Canine PMX Product Code: NP15268025, net weight: 25 Kg per package, package type: Woven polyethylene bag.

The recall encompassed two production lots – 9100058130 and 9100058131 – comprising a total of 2500 Kg (~2.75 tons) of premix.

The premix was produced on August 18, 2018.

DSM notified Hill’s of the recall by telephone. There were no other consignees, and no public recall notice was released.

Hill’s first notified FDA about potentially toxic levels of vitamin D in its canned dog foods on January 31, 2019 and initiated a recall of 25 products manufactured during the months of September 2018 through December 2018.

On March 20, 2019, Hill’s expanded the initial recall to include additional products and lot codes. A second expansion was announced on May 20, 2019.

The recalled products were distributed in the USA and around the world.

FDA initiated an inspection of Hill’s manufacturing facility in February 2019. According to the inspection report, Hill’s blamed a manufacturing error by its premix supplier (DSM) for the toxic levels of vitamin D in its canned dog foods.

Although the Hill’s written procedures called for testing of vitamin D levels in the premix, the company was unable to provide any evidence to FDA inspectors that those tests had been carried out.

Subsequent tests conducted on a retained sample of the premix revealed a level of vitamin D that was roughly 30 times the target range for this ingredient.

As of February 11, 2019, Hill’s acknowledged having received 85 consumer complaints reporting pet deaths.

More than 20 civil lawsuits have been filed against Hill’s Pet Nutrition by grieving pet owners.

FDA offers the following information regarding vitamin D toxicity to pet owners and veterinarians.

If your pet is having symptoms of vitamin D toxicity, contact a veterinarian immediately. Provide a full diet history to your veterinarian. You may find it helpful to take a picture of the pet food label, including the lot number.
Don’t feed the recalled products to your pets or any other animal. Contact the company listed on the package for further instructions or throw the products away in a way that children, pets and wildlife cannot access them.
Consumers can report suspected illness to the FDA electronically through the Safety Reporting Portal or by calling your state’s FDA Consumer Complaint Coordinators. It’s most helpful if you can work with your veterinarian to submit your pet’s medical records as part of your report. For an explanation of the information and level of detail that would be helpful to include in a complaint to the FDA, please see How to Report a Pet Food Complaint.
The FDA encourages veterinarians treating vitamin D toxicity to ask their clients for a diet history. We also welcome case reports, especially those confirmed through diagnostics. You can submit these reports electronically through the Safety Reporting Portal or by calling your state’s FDA Consumer Complaint Coordinators. For an explanation of the information and level of detail that would be helpful to include in a complaint to the FDA, please see How to Report a Pet Food Complaint.
Veterinarians should also be aware that vitamin D toxicity may present as hypercalcemia, similar to dogs that have consumed rodenticide. In these cases, FDA suggests that veterinarians confirm diet history to verify whether the dog has been eating any of the recalled products.

For a comprehensive list of Hill’s Pet Nutrition canned pet foods recalled due to excessive Vitamin D, please visit Hill’s Pet Nutrition recalls: Country-by-country breakdown on eFoodAlert