Sunday, February 27, 2011

Farewell to Jack

Perhaps there is nothing more profound that our pets do for us than teach us how to die.

Joan and I got Jack from the East 92nd Street ASPCA shelter in March of 1996. We were both in corporate jobs in Manhattan and though we wanted a dog, it was out of the question with our schedules. Also our building in Brooklyn Heights had a no-pet rule, but grudgingly accepted cats. Jack was our second cat at the time, and Arthur, the cat my wife had when I met her, did not take kindly to Jack. We had to separate them for almost a month for fear that Arthur would kill the young kitten. Arthur eventually accepted Jack, but only on his own terms. Jack had to remain second. The servant. The one who licked Arthur, while Arthur never licked Jack. But Arthur was old and died after three years. Jack came into his own.

Everyone loved Jack. He was a calm cat. He had no buttons pushing which would get you scratched or bitten, at least when he was young.

Joan and I, and Jack, made great friends on 9/11 when Jack was five. I was working at home that day and Joan was at her job at a bank headquarters a block from the World Trade Center. She began walking back to Brooklyn across the bridge after the first tower came down. That was lucky because all the windows on the south side of her building were blown inward when the second tower fell. Soon after she got home, our neighbors, Chris and Rod knocked on the door.

“We don’t want to spend this day alone. Can we join you?” they asked.

“Please come in,” Joan said.

They lived on the same floor in a building on Monroe Place, Brooklyn Heights. We knew them for elevator rides, for occasional conversations on the roof deck, but only in the formality of dwellers of the same building. 9/11 made us friends and they spent many hours in our living room that day, occasionally looking west where two towers had loomed above the building across the street only hours before. Jack was there and made friends with Chris and Rod as well. Whenever they entered our various homes after that, Jack always wanted to sit as an equal, as if part of the conversation. There had to be a place for him at the same level. On a chair or a couch. The five of us visiting. It never happened with anyone else.

Then in 2006 I got Chloe and Jack’s life took a turn for the worse, the mirror image of Arthur’s reaction to Jack. Now it was Jack that hated and despised the newcomer. And I favored Chloe. I began to train her, at first just because I wanted to have an obedient dog, but soon because I wanted her to be a therapy dog. He never got as much attention after Chloe came into our lives though Joan was more balanced in her affections. Jack began to age, became grumpy, sometimes hostile. Guilt bothered me, but I had a right to have a dog, I told myself. I had grown up with dogs. I was more of a dog person than a cat person. Even though James Thurber exaggerated the gap between the two types of pet owners, there is something to it.

Our two pets achieved a separate peace. Jack was the dominant one. Chloe, four times his size, accepted Jack’s rule. We decided not to interfere, at least not too often. They had to work it out.

About a year ago we noticed that Jack was thinner. Vets in New York and Arizona tested for hypothyroidism and diabetes, the mostly likely suspects, but the results came back negative or inconclusive. Perhaps we were overreacting to the weight change? Everything else seemed reasonably healthy, he was eating well, and pretty active for cat approaching 15 years.

But he continued to lose weight and his habits began to change. We always put his food on the kitchen counter so that the dog couldn’t get to it. Twice a day. In the evening he would sit on the kitchen table and howl for additional food from anyone who passed. One of us would usually pay the toll, particularly after the weight loss began. That declined and then stopped. I looked at him one evening and knew that he had lost even more weight in just two days. “I think he’s dying,” I said to Joan.

We went to the vet the next morning. When we put him on the examination table, I saw that his right eye had a reddish brown color. It had not been there the day before. The vet was troubled by the eye as well. He had lost two pounds since his previous visit five weeks earlier.

“It’s not hypothyroidism,” the vet said. “It’s more serious.”

“How serious?” Joan asked.

“There are a number of things that could explain the symptoms, but lymphosarcoma would be up there, and feline perotinitis. Most of the possibilities are not good. Do you want blood tests?”

We did. When the vet tech brought Jack back in the room and put him on the table, Jack looked at me. Stared at me. Wouldn’t take his eyes off me. One now clearly red. One normal and green but with some puss coming out. Staring at me. Staring into my heart. Not angry, I don’t think. Perhaps sad. Afraid. Trying to reach across the barrier of species and tell me something, that he was was breaking apart, that he wanted help, but he could see from my eyes that I was powerless against what was happening to him. We were all powerless. He knew, I think, that his body was coming to an end.

“I will call you tomorrow with the results,” the vet said. Then he added something. “Brace yourselves. It seems he’s starting to shut down. It may not be long.”

We drove home. In the back of my mind I was thinking that we might have to delay our drive east in early April. We could not cross the country with a dying cat. I was thinking months, weeks at least, not days or hours. So was my wife, though neither of us expressed this aloud.

After lunch the same day I lay down on the bed to rest my eyes and put Jack beside me. He remained there for a minute, then got up, jumped off and went into the closet. Not a usual place for him, but dark, private. He began to howl. I brought him back to the bed. He went back to the closet.

He moved from place to place, moaning. Joan and I began to follow him. I was now thinking days. Then I picked him up and put him on the bed again. His legs did not support him. He fell on his side. But he managed to get up and move to the floor and then to the glass door. He wanted to look outside towards the White Tank Mountains. Soon he could not walk. He would try, but only get his front legs up. Enough to look out the window. His eyes moved from me to Joan, to the mountains, then back to us, back to the mountains, those he was leaving, where he wanted to fly. Or was he just saying goodbye to the earth he had so briefly walked upon, drinking deep the last draughts of life?

I called the vet’s office just before it would close at 5. The doctor came on the phone. I explained what was happening. Should I bring him in? He was dying, the vet said. “I can tell you what may happen in the next hours.” There was no point in bringing him to the office unless we wanted Jack euthanized.

“I think he’d rather die at home.”

“He probably would,” the vet agreed.

I will always be grateful to him for not adding to the guilt. More than I could express to him or put in words here.

Jack stopped purring. We remained with him. He became comatose. His breathing became occasional gasping.

“We might not know when he goes,” Joan said.

The gasping became less frequent. It would stop so long that we would look at each other. Was he gone? Then he would gasp again. His feet were cold. His nose was cold. Everything was cold.

Finally I picked him up. Limp like a rag. Suddenly weighing nothing at all.

Jack was gone.

We called Chris and Rod, then Ruth, his favorite cat-sitter in recent years. A small but wonderful part of the world had left it, and left us.

Joan lit a Yahrzeit candle.

Saturday, February 26, 2011

Bite Patterns When Dogs Attack Children

As a therapy dog handler, I am more cautious when I visit facilities with children. Children can rush upon my dog, put their arms around her neck, punch her more than pat her, pull her hair, and other things. One autistic boy clamped his hand so tightly to her back that she was whimpering while two teachers took half a minute to unlock his grip. Fortunately, Chloe is highly trained and something of a teddy dog (see the picture on the bio of this blog), and has never bitten anyone.

Yet not all dogs react so calmly to such situations and children get bitten, particularly when pack behavior takes over in a group of dogs. A study of the unique features of fatal dog attacks of children found that just two dogs can produce extreme injuries, even decapitation. Although there are one to four million nonlethal dog bites in the United States every year, around 25 to 35 will be fatal, about half of which involve infants and young children. Dog bites of children are much more often to the head and neck region than the rest of the body, unlike police dog bite patterns that occur in suspect apprehensions (see blog of June 15, 2010). A website that regularly reports dog bite statistics is that of Beverly Hills attorney, Kenneth Phillips, just called Dog Bite Law.

In one attack described by German and Australian researchers, two pit bulls attacked a six-year-old boy on a playground, first going after the boy’s ball, then going after the boy. The boy weighted less than 50 pounds. The left jugular was severed. The facial destruction is indicated by the dark portion of the upper left drawing in the figure reproduced here. The dogs had two separate owners, both of whom were present during the attack and unable to stop it. The owner of the male dog was found guilty of manslaughter and served three and half years in prison. The owner of the female dog, also present, served 18 months for manslaughter. Case 2 resulted when a girl was playing with two German shepherds, which attacked her when she fell over. Case 3 also involved two German shepherds, but the girl was not found until she was dead. The dogs were still attacking her. Case 4 involved a three-week-old baby who was attacked by the family dog, a large male mixed breed terrier weighing around 90 pounds. The boy was decapitated. The dogs were all euthanized and generally autopsied for physical diseases without anything being found.

Attacks are usually motivated by aggression, not hunger, according to the researchers. They note that dogs usually attack the head or neck region of a child, or sometimes the abdomen and trunk, causing significant blood loss. Another study found that at least 25 different breeds were involved in 238 deaths in the U.S. over a 20-year period. Pit bulls, rottweilers, and German shepherds were more commonly involved than other breeds. Male dogs are 6.2 times more likely to bite than female dogs, chained dogs 2.8 times more than unchained, and sexually intact dogs 2.6 times more than neutered. Male dogs may be more likely to consume parts of victims, though statistics on this appear slim.

Children are at risk because they sometimes try to play with dogs, or provoke them by attempting to take away food. Provocation has been accepted by courts as a defense or in mitigation of damages. See, e.g., Enquist v. Loyas, 787 N.W.2d 220 (Minn. Ct. App. 2010) (girl trying to play with black Lab mix was bitten on eyelid and area above her eyebrow and her neck was punctured by the dog’s claws; in addition to permanent scarring, girl had to receive rabies injections; whether child provoked dog by putting her arm around it was a question for the jury; jury awarded $15,000 for past pain and suffering but failure to award damages for permanent scarring was not reversible error).

The German and Australian team, in their 2007 paper, recommend the following steps in the autopsy evaluation of a fatal dog attack:

Description of the events leading up to the attack
Description of the attack
Description of attempted resuscitative measures
Characteristics of the dog (age, sex, breed, desexed or not, tethered or free ranging)
History of the dog’s behavior
History of the dog and victim’s interaction

Crime Scene
Evaluation/examination of the scene, with photographic documentation
of the position of the victim and likely site of the attack

Age, sex, medical and psychological history
Weight and height
External examination with collection of trace evidence (eg, dog hair)
Photographic and diagrammatic documentation of wounds
Internal examination documenting lethal and nonlethal injuries
Samples for toxicology

Involvement of a veterinary pathologist if possible
Details of the breed of dog and previous aggressive actions (as above)
External examination for identifying features (eg, collar, tattoos)
External examination for scars or injuries to indicate possible
involvement in organized dog fighting or maltreatment
Collection of external trace evidence (e.g., victim’s blood, clothing fibers)
Examination of oral cavity
Internal examination for (i) stomach/intestinal contents; (ii) underlying diseases/conditions
Samples for toxicology

A study by six scientists from Kyushu University and other institutions in Japan was able to identify which Dachshund, of three in the household at the time, was responsible for killing a baby. There were extensive wounds to the baby's head and face. The scientists used DNA analysis to identify the offending dog.

Sources: Tsokos, M., Byard, R.W., and Puschel, K. (2007). Extensive and Mutilating Craniofacial Trauma Involving Defleshing and Decapitation: Unusual Features of Fatal Dog Attacks in the Young. The American Journal of Forensic Medicine and Pathology, 28(2), 131-136; Sacks, J.J., Sinclair, L., Gilchrist, J., et al. (2000). Breeds of Dogs Involved in Fatal Human Attacks in the United States Between 1979 and 1998. Journal of the American Veterinary Medical Association, 217, 836–840; Gershman, K.A., Sacks, J.J., and Wright, J.C. (1994). Which Dogs Bit? A Case-control Study of Risk Factors. Pediatrics, 93, 913–917; Avner, J.R. and Baker, M.D. (1991). Dog Bites in Urban Children. Pediatrics, 88, 55–57 (finding 94% of pit bill attacks to be unprovoked compared with 46% overall); Shields, L.B.E., Bernstein, M.L., Hunsaker, J.C., and Stewart, D.M. (2009). Dog Bite-Related Fatalities: A 15-Year Review of Kentucky Medical Examiner Cases. American Journal of Forensic Medical Pathology, 30, 223-230 (see particularly Figure 4, showing comparison of dentition of suspect dog to wounds on the victim); Aldko Tsuji, Atsushi Ishiko, Hirohisa Kimura, Masanobu Nurimoto, Keiko Kudo, and Noriaki Ikeda (2008). Unusual Death of a Baby: A Dog Attack and Confirmation Using Human and Canine STRs. International Journal of Legal Medicine, 122(1), 59-62; Albert Y. Chu, Mary G. Ripple, Carol H. Allan, Jon R. Thogmartin, and David R. Fowler (2006). Fatal Dog Maulings Associated with Infant Swings.  Journal of Forensic Sciences, 51(2), 403-406 (analyzing three fatal dog mauling of infants left in mobile swings; in all cases the attacking dog was a family pet).

Additional Notes
. A paper in the Journal of Forensic Sciences by Colard et al., analyzing post-mortem mutilations by domestic dogs, found the following:

"Through 41 cases, 10 at the forensic institute in Lille (France) and 31 at the New York City Office of Cheif Medical Examiner (USA), plus 22 cases from the literature, specific locations and patterns of postmortem scavenging lesions are proposed.  These lesions are mainly distributed in three locations: the face, especially the nose and the mount (73.1%), the neck (43.1%), and the arm (shoulder/upper limb (29.2%), hand (26.8%)."  

Colard, T., Delannoy, Y., Naji, S. Gosset, D., Hartnet, K., and Becart, A. (2015).  Specific Patterns of Canine Scavenging in Indoor Settings.  Journal of Forensic Sciences, 60(2), 495-500.

In a 2012 South Carolina case, a boy was found dead in a neighbor's yard, surrounded by at least three dogs. The owner was convicted of involuntary manslaughter. On appeal, the defendant claimed that seven photographs that were introduced into evidence were unduly prejudicial. The photos were taken of the boy's body by a forensic pathologist before the autopsy. The photos showed that "the dogs ate a significant portion of the boy's flesh," something that was otherwise established by the testimony of the pathologist, who had stated:

"There were extensive traumatic injuries consisting of loss of skin and soft tissue in a tearing fashion about the face, the ears, the eyes, the neck, the chest. There was loss of skin and soft tissue with exposure of the bones of both shoulders. Essentially, the humeral bone in the upper arm, both right and left, was exposed from the shoulder to the elbow."

The pathologist also testified to "loss of skin to the face to include the nose, the ears, and all soft tissues around the lips with exposure of the mandible, which is the lower jaw, teeth, and the underlying bony part of the skull.... The ears and nose were completely eaten away."

The appellate court concluded that the photos added little to the jury's ability to understand the pathologist's testimony, and that there probative value was minimal. The court said that the "danger of unfair prejudice of the admitted photos is extreme," and reversed and remanded for a new trial. South Carolina v. Collins, 2012 WL 469719 (Ct. App. 2012)

Saturday, February 19, 2011

Agency Ineptitude and Congressional Inaction Leave Many Puppy Mills Poorly Regulated or Not Regulated At All

Video of Animal Rights Discussion: At an appearance at the Ford Hall Forum, I discussed some difficult issues regarding animal rights. 

The USDA Inspector General’s 2010 Report on USDA inspections of large-scale dog dealers found that some large breeders were circumventing the Animal Welfare Act by selling animals over the internet. Inspections of large-scale dealers are conducted by the Animal and Plant Health Inspection Service’s (APHIS) Animal Care unit which, despite finding a high level of repeat violations, often took no action at all. APHIS was found by the Inspector General to have “continued to assess minimal penalties that did not deter violators.” APHIS auditors may have gotten too close to some of those they audit in that they “(1) inconsistently counted violations; (2) applied ‘good faith’ reductions without merit; (3) allowed a ‘no history of violations’ reduction when the violators had a prior history; and (4) arbitrarily changed the gravity of some violations and the business size.”

Congress passed the Laboratory Animal Welfare Act, PL 89-544, in 1966, which was amended and renamed the Animal Welfare Act in 1970 (PL 91-579). Additional amendments were passed in 1976, 1985, 1990, 2002, and 2008, and the Inspector General’s 2010 Report resulted in additional legislative proposals. The Act is enforced by the Animal Care unit of APHIS, which has 99 inspectors, a budget of $21 million, and conducts over 15,000 inspections per year. Inspectors of the Animal Care unit use the Dealer Inspection Guide. The Animal Care unit can take remedial action against a violator by assessing a fine, suspending or revoking a license, or pursuing penalties. Under 7 U.S.C. 2149 , violators can be subject to civil and criminal penalties, with the possibility of imprisonment of up to one year. Employees of the USDA’s APHIS Animal Care Unit may also notify state and local officials of violations, who may pursue animal cruelty charges, even at the felony level, against violators.

That the system is not working can be demonstrated from figures in the Inspector General’s 2010 report. During a three-year period (2006-2008), the Animal Care unit inspected 8,289 licensed dealers and found that 5,261 violated the Animal Welfare Act. On re-inspection, 2,416 of 4,240 violators were found to have repeatedly violated the Act. The Inspector General found virtually no enforcement actions for first-time violators, no action taken against more than half of repeat violators, application of lenient options even when guidelines recommended more serious enforcement actions, and failure to confiscate animals that were suffering and even dying. This culture of administrative leniency and ineptitude apparently began with the rose-tinted beliefs of administrators in the Animal Care unit that educating dealers would lead to long-term compliance. The agency provided seminars, but attendance was not required of dealers.

The Inspector General's Report has pictures of dogs that turns one stomach, yet where little or no action was taken by APHIS. The pictures of the tick-infested dogs here were taken at a facility in Oklahoma that had 96 dogs, many of which were infested by ticks. The inspector had reported the dogs might be anemic but cited the ticks as an indirect violation (i.e., not affecting the animal’s health). When a staff member of the Inspector General approached the dog it did not move. The Animal Control unit could not explain why no enforcement action was taken. When the Inspector General’s staff requested treatment records regarding tick-infested dogs to see if they had subsequently received appropriate care, the assigned inspector said that she could not require the records from the dealer because the Animal Care unit “cannot enforce policy” and the regulations do not require breeders to keep records. The Inspector General acknowledged that treatment records are not mentioned in the Animal Welfare Act or regulations, but that adequate veterinary care is required, which in turn means that records should be kept. The Inspector General found a consistent lack of documentation by the Animal Care unit. The third picture was taken at the facility of another breeder, who admitted the dog had been in this condition for seven days. The dog had to be euthanized.

The Inspector General recommended that APHIS change its Dealer Inspection Guide to allow immediate confiscation. APHIS agreed with the intent of this recommendation, but believed that its current guidance provided such authority. Yet the part of the Dealer Inspection Guide dealing with Confiscation Procedures still provides criteria that require notification of the dealer and a chance to rectify a condition. APHIS appears to be an highly industry-friendly enforcement agency.

As with so many other businesses, the internet has provided a way for puppy mills to avoid regulation. This occurs because the Animal Welfare Act excludes retail pet stores from the definition of “dealer” (7 U.S.C. 2132(f), 9 CFR 1.1). Internet sales are made directly to customers and, therefore, qualify as retail pet stores. The Inspector General made a strong argument that internet sellers should not be subject to the retail pet store exception, and noted that internet sellers are becoming quite large, with one breeder in Iowa having over 140 breeding dogs. Since such breeders are not inspected, the complaints come not from inspections but from consumers who receive sick dogs. The Inspector General recommended that APHIS seek legislative authority to regulate such dealers, which led to the proposal of the Puppy Uniform Protection and Safety Act.

The lead in drafting the Puppy Act was taken in the House of Representatives by Sam Farr of California and in the Senate by Dick Durbin of Illinois. The proposed legislation would require USDA licensing of “high volume retail breeders,” which are breeders who have “an ownership in or custody of one or more breeding female dogs” and sell, via the internet, telephone, or newspaper, “more than 50 of the offspring of such breeding female dogs for use as pets in any 1-year period.” (S.3424 and H.R. 5434) The Senate bill acquired 19 cosponsors and was referred to the agriculture committee. The House bill gathered 150 cosponsors but also went into committee limbo. No legislative developments are listed for the bills after June 2010, nor does the Thomas government website list any legislation with "puppy" as having been introduced in the current Congress. This is unfortunate, given that the legislation is simple, straightforward, and could be easily implemented (that is, assuming that the Animal Care unit decides to do its job). reported on January 21, 2011, that eBay, which had initially declined to allow puppy mills access to its services, has been allowing classified ads from puppy mill operators. Efforts to increase state enforcement, such as in Ohio have also languished. State puppy mill legislative efforts have unfortunately been impeded by some politicians, though voters in Missouri recently approved a ballot initiative requiring necessary veterinary care despite such opposition. The fact that such a measure passed in a state with a significant dog breeding industry, some of which is opposed to regulation, indicates that voters believe that someone in government should be watching puppy mills and taking action where necessary.

Although the USDA has promised that the Animal Care unit will mend its ways, federal legislation appears to be necessary to deal with the expanding internet trade, and the ability of internet sellers to operate outside of the regulatory structure, such as it is. Once more, human foolishness means that animals suffer.

Sources. U.S. Department of Agriculture, Office of Inspector General, Animal and Plant Health Inspection Service: Animal Care Program: Inspections of Problematic Dealers, Audit Report 33002-4-SF (May 2010). A 2005 audit had also looked at APHIS. USDA, OIG, APHIS Animal Care Program Inspection and Enforcement Activities, Audit Report 33002-3-SF (September 2005) (concluding that APHIS did not aggressively pursue enforcement actions against research facilities for violations of Animal Welfare Act requirements and tended to assess minimal monetary penalties, generally offering a 75% discount on fines that violators considered a normal cost of business rather than a deterrent); Doris Day Animal League v. Veneman, 315 F.3d 297, 354 U.S.App.D.C. 216 (D.C. Cir. 2003) (attempt by animal rights group to force USDA to expand Animal Welfare Act regulations to include breeders who sold dogs from their residences succeeded at district court level but failed in federal appellate court; circuit court noted that Act does not define "retail pet store"; D.C. Circuit held that USDA had issued a permissible regulation under the Act).

Addendum. The anti-puppy mill legislation has been reintroduced by Senator Durbin (S.707) and Representative Gerlach (H.R. 835). Both bills are in committee. With anti-regulatory sympathies in Congress high, they are likely to remain there. 

Monday, February 14, 2011

Malinois May Detect Prostate Cancer Better Than Standard Lab Test

Dogs have been trained to detect bladder, lung, and breast cancers (see blogs of July 9, 2009, and July 11, 2010). Now a study published in European Urology adds prostate cancer to the list.

Prostate-specific antigen (PSA) blood testing remains the most widely used tool for detecting prostate cancer, which strikes about 200,000 men per year in the U.S. Research continues to look for volatile organic compounds in urine as alternative biomarkers. A team at the Tenon Hospital in Paris, France, trained a Belgian Malinois owned by the French Army that, prior to being trained to sniff urine, was destined for explosives detection training.

The dog was trained to discriminate between urine from individuals with prostate cancer and urine from controls. A clicker method was used, with a ball as a reward for alerting to a cancer urine. The dog’s alert was to sit before a target odor. Passive alerts are preferred for explosives detection work and the trainer taught such an alert here. The dog trained and worked in the experiments for almost three years, from October 2007 to June 2010. The training phase alone was 16 months and involved repeated exercises in which the dog chose between one cancer sample and one control sample.

Urine samples were obtained from 108 male Caucasian patients, all of whom underwent biopsies, but only 66 samples were used in the double-blind phase of the experiment. The figure shows the sort of six-station scent lineup that was used in the double-blind phase. The handler did not know the location of the cancer sample until after the dog had alerted. Of the 66 samples in that phase, 33 were cancerous, and 33 were controls. In 33 runs, the dog sat in front of the cancer sample, but in three the dog sat before a control. Although these were classified as false positives, the three urine providers underwent new testing and one was found to have prostate cancer. The researchers also noted that some patients with negative biopsies may nevertheless have prostate cancer, meaning that the other two false alerts might also not have been truly false.

The researchers acknowledged that this was a costly and long study and that it is “difficult to conceive of an extended use of this test in clinical practice.” Mary Elizabeth Thurston noted 15 years ago that cancer sniffers might be used in poor countries, but until dogs can be available to doctors without borders, this may remain a fantasy.

Cornu, J.-N., Cancel-Tassin, G., Ondet, V., Girardet, C., and Cussenot, O. (2011). Olfactory Detection of Prostate Cancer by Dogs Sniffing Urine: A Step Forward in Early Diagnosis. European Urology, 59, 197-201. Thurston, M.E. (1996). The Lost History of the Canine Race, 6. Species other than dogs may be more economical for medical detection work. See Poling, A. Weetjens, B.J., Cox, C., Mgode, G., Jubitana, M., Kazwala, R. Mfinauga, G.S., and Huis, D. (2010). Using Giant African Pouched Rats to Detect Tuberculosis in Human Sputum Samples: 2009 Findings. American Journal of Tropical Medicine and Hygiene, 83(6), 1308-1310. For a summary of cancer sniffing research, see Ensminger, Service and Therapy Dogs in American Society, 112-115.

This French study was brought to my attention by Dr. John Wong, CEO of Moraga Biotech. John, a former roommate of mine at Berkeley and among the most brilliant people I've ever known, is doing some of the most interesting biotechnology research in the world and came across the paper in his daily scouring of international research developments.

Wednesday, February 9, 2011

Sleeping with Our Best Friend Carries Risks of Rare but Deadly Diseases

The percentage of pet owners in the U.S. is increasing (more than 60% of households), as is the percentage who let their dogs and cats sleep on their beds. More than half of dog owners consider their dogs to be members of their family, and approximately 56% let their dogs sleep in their beds. The smaller the dog, the more likely it will sleep with its master. Women are more likely than men to let dogs into the bed. These trends are not confined to the U.S. and have been reported, for instance, in England, the Netherlands, and France.

A professor at the University of California at Davis and an official of the California Department of Public Health in Sacramento searched PubMed for peer-reviewed publications that “clearly documented human exposure to zoonotic diseases by sleeping with, sharing a bed with, kissing, or being licked by pets," i.e., dogs and cats. They found records of 12 separate diseases (13 if bites were included). The diseases were:

1. Plague. Dogs and cats facilitate transfer of infected fleas into the home but, unlike cats, dogs rarely show clinical signs of the disease.
2. Chagas disease (Trypanosoma cruzi). Reported in Argentina; infection rates were significantly higher when infected dogs shared sleeping areas with humans. This disease is a tropical parasitic disease that can lead to life-threatening heart and digestive disorder, brain toxicity, and skin disorders.
3. Cat-scratch disease (Bartonella henselae). This has at least once been reported as coming from a dog licking the handler’s face.
4. Pasteurellosis (Pasteurella multocida or Pasteurella stomatis). One case arose from a cat stealing a baby’s pacifier and using it as a toy before it was returned to the baby. A man got an infection after a hip replacement. The man’s dog slept against the affected leg both before and after the operation. Numerous cases describe a dog or cat licking the person contracting the disease. The disease can lead to edema, vomiting, headache, and diarrhea, with serious complications including septic arthritis and osteitis.
5. Capnocytophaga canimorsus septicemia. A 60 year old patient with chronic eczema died of septic shock and renal failure, probably because his dog used to lick his legs. The disease causes fulminant sepsis and disseminated intravascular coagulation.
6. Staphylococcosis (Staphylococcus intermedius). This bacterium rarely causes human infection, but it has been found in dogs licking a patient after surgery.
7. MRSA infection (methicillin-resistant Staphylococcus aureus). A 48 year old man and his wife had recurrent MRSA infections, which did not stop until the MRSA was eradicated from the dog’s nose.
8. Rabies. Rabies remains a problem in Southeast Asia and sometimes affects travelers, particularly those who allow themselves to be licked by dogs. It is perhaps not widely known that a bite is not the only means of transmitting rabies from a dog to a human.
9. Roundworms (Toxocara canis). The bacterium may be found on a dog’s hair.
10. Giardiasis (Giardia). This is sometimes called "beaver fever" in humans and is a diarrheal infection of the small intestine.
11. Cryptosporidiosis. This is a protozoan parasite that leads to diarrhea, but can be fatal in individuals with compromised immune systems, such as AIDS patients.
12. Cheyletiellosis. Cheyletiella are a genus of mites that live on the skin of dogs, cats, and humans. The mite causes dermatitis, sometimes called walking dandruff.

The authors acknowledge that zoonotic infections acquired by sleeping with a pet are rare, and often involve sleeping with individuals after surgery or who have open sores. The authors also note the bite danger from letting a dog sleep with an infant. Of 109 dog-bite related deaths from 1989 to 1994, 57% were of children under ten years old and 11 were of a sleeping infant.

Administrators of hospitals and other health providers with therapy dog programs should be aware of this report, and should probably confine the visits of therapy dogs to wards and areas where there are no patients who would be vulnerable from contact with a dog. Therapy dog organizations have rigorous requirements regarding dog hygiene, and the risk is small, but an administrator has to consider even remote liabilities.

I must concede that I and my wife sleep with our dog. Our cat is older and doesn’t usually like sharing space with the rest of the family, but for years he slept on or near my wife’s head. Will this study make me change this? No, I’m afraid not, but perhaps if I have surgery or get an open wound of some kind—perhaps—I’ll consider a change of household policy (for myself at least, that being the limit of my authority in the family unit).

Chomel, B.B. and Sun, B. (February 2011). Zoonoses in the Bedroom. Emerging Infectious Diseases 17(2), 167-172. See also Enoch D.A., Karas, J.A., Slater, J.D., Emery M.M., Kearns, A.M., and Farrington, M. (2005), MRSA carriage in a pet therapy dog, Journal of Hospital Infection 60, 186-188; Ensminger, J. (2010), Service and Therapy Dogs in American Society, 191-2.

Additional Note. In Capell v. North Carolina Division of Vocational Rehabilitation Services, 2011 WL 3501894 (W.D.N.C. 2011), a federal court in North Carolina dismissed a number of claims raised by a patient who wanted to have his sugar gliders present in his in-patient recovery room. Sugar gliders are a species of possum. The court found that the sugar gliders were not service animals under the ADA regulations, citing 28 CFR 35.104 and 36.104, which limit the service animal definition to dogs (there was, understandably, no mention of guide horses). The court noted the hospital's "concern for the health and safety of Plaintiff as well as other hospital patients, and the risk of post-surgical infection from animals," describing this as a "non-discriminatory rationale for the denial." The court did not discuss whether this rationale could be applied to limit the presence of a dog in a hospital.

Sunday, February 6, 2011

Once Majestic Companions to Kings and Queens, Greyhounds Spend Their Lives in an Institutionalized Hell in Seven States

This week there was international outrage on the news that as many as 100 sled dogs had been slaughtered after they were no longer needed for entertainment at the 2010 Winter Olympics in Vancouver. The New York Times reported that the killing of the dogs was not itself illegal, but the fact that there was undue suffering might result in a prosecution under cruelty statutes. This should be prosecuted, but the U.S. cannot point fingers at Canada. Greyhounds have long been exterminated at the end of their racing lives, and it continues to happen in seven states.

The Oxford English Dictionary traces the word greyhound to Old English, citing usage as early as 1000 AD, with parallels to Norse and Teutonic words. George Jesse, in his history of the British dog, argues that the earliest form was most likely grehund, meaning great or noble hound. Jesse rejects the argument that the prefix gre- might imply a Grecian origin. The OED cites Edward Topsell (The historie of foure-footed beastes) who called the Gray-hound a Grecian Dog in 1607, but also quotes William Blane (Cynegetica, or essays on sporting) who concluded that ancient Greek writers on hunting did not know the dog. Jesse describes the greyhound as “beautifully majestic, gentle, graceful, surpassingly swift, and courageous,” and “the most superb of the canine race.”

Greyhounds received better care than other dogs at the time. In the reign of Edward II (1284-1327), the king’s huntsmen received one penny per day for each greyhound, but only a half-penny for other dogs. Greyhounds were not exclusively the dogs of nobles and kings. Chaucer (c. 1343 – 1400) says of his Monk that “Greihoundes he hadde as swift as foul of flight”—as fast as birds. Canterbury Tales, Prologue. Shakespeare knew them “swift as breathed Stags, ay, faster than the Roe.” Taming of the Shrew, Introduction.

Henry VIII (1491-1547) got tired of those he allowed at court bringing greyhounds and other dogs with them and forbade it “except it be by the King’s or Queen’s commandement. But the said greyhounds and dogs to be kept in kennel and other meete places out of court as is convenient.” Anne Boleyn may not have agreed with her husband’s banning of the dogs. She gave the Cardinal du Bellai “a complete hunting suit, including a hat, bow arrow, and a greyhound.” Jesse writes that the queen herself shot and hunted, but despite his love of dogs, Jesse acknowledges the ban on dogs at court was probably an “advancement of refinement.” The makers of The Tudors should have had more dogs in the early court scenes.

The first plate above is from the Thierbuch of Konrad Gessner (1516-1565). Aldrovanus also included drawings of several types of greyhounds in his natural history, using Latin terms, Canis venaticus (large game hunting dog) and Canis leporarius (hare dog, to be distinguished from Canis luporarios, wolf dog).

The nobility of the greyhound was not restricted to England and is reflected in Giovanni Benedetto Castiglione’s painting, Noah’s Sacrifice after the Deluge, now in the Los Angeles County Museum of Art. The painting dates from about 1650 and shows two greyhounds running while Noah prepares his offering of a calf. The lead dog, the male, looks back at the female whose body is partially obstructed by a pack horse. Noah, being a noble of his time, would have chosen the noblest breed of dog to preserve on the most famous cruise ever taken.

Greyhound racing in the United States has led to abuses so horrible I am ashamed to belong to the species that inflicts them. Greyhound litters are culled to eliminate dogs that show little promise of winning at the track. Addie Patricia Asay, in a heart-wrenching article published in the Stetson Law Review in 2003, noticed discrepancies between litter size and registration numbers and estimated that at that time upwards of 10,000 puppies were killed each year to cull the litters of dogs whose legs are too short or who don’t take to running quickly. Around 20,000 dogs were killed in 1999 after their careers were over and no one wanted them. The greyhound adoption movement has brought this figure down, as has the decline in states that permit dog racing, but the number of dogs killed at the end of their racing lives probably remains above 3,000. An official of Grey2K USA advises me that the racing industry is only quasi-public and many tracks do not release any figures on the number of dogs that are now being put down. Owners of racing dogs sometimes avoid killing them by donating them for medical experimentation.

Perhaps the largest single abuse involved a racetrack security guard in Alabama, who was investigated in 2002 for killing more than 3,000 greyhounds over several years. Autopsies showed that many were not shot in the head, but in the neck and other areas where they would have suffered before they died.

Grey2K USA brought to my attention Arizona House Bill 2536. If enacted, this Bill would not ban dog racing in Arizona, but would allow Tucson Greyhound Park to end live racing and show races on screens from other states. There is an active initiative to ban dog racing in Iowa.

Alabama, Arizona, Arkansas, Florida, Iowa, Texas and West Virginia remain the only states still allowing pari-mutuel dog racing. Apparently cheap bookies and marginally reformed dog fighters still have a lot of influence in a few places.

Thanks to Beesnest McCLain for permission to reprint the photograph of Il Grechetto's Noah's Sacrifice after the Deluge.

Supplemental Note. An effort has begun to amend British Columbia anti-cruelty laws to deal with situations such as the slaughter of the sled dogs.

Tuesday, February 1, 2011

Abu Ghraib Dog Handler Court-Martialed: Rogue or Scapegoat?

Michael J. Smith was a military working dog hander at the Abu Ghraib Central Confinement Facility in Iraq. MWDs were used at Abu Ghraib primarily as a show of force to deter detainees from attempting to escape or riot. Smith participated in the interrogation of Ashraf Abdullah Al-Juhayshi, believed to be connected to al-Qaeda, in late December 2003 or early January 2004. Colonel Thomas M. Pappas, then commander of the 205th Military Intelligence Brigade in Iraq testified that he had authorized the use of MWDs in interrogations in December 2003.

During the interrogation, Smith allowed his unmuzzled MWD, a Belgian Malinois named Marco, to bark in the Al-Juhayshi’s face and to pull a sandbag off the man’s head with its teeth. In January 2004, Smith also brought the dog to the cell of two juvenile detainees who screamed in fear. Smith later said, “My buddy and I are having a contest to see if we can get [them] to shit themselves because we already had some piss themselves.”

The prosecution had to establish beyond a reasonable doubt that Smith was not obeying orders. RCM [Rules for Courts-Martial] 916 provides that it “is a defense to any offense that the accused was acting pursuant to orders unless the accused knew the orders to be unlawful or a person of ordinary sense and understanding would have known the orders to be unlawful.” Orders are presumed to be lawful. There was evidence that Smith received an order to aid in the interrogation by having his dog present. Steve Stefanowicz, a civilian contractor and interrogator, wrote in his notes that MWDs were being used in interrogations with the approval of Colonel Pappas and Chief Petty Officer Rivas. Stefanowicz was not a witness at the trial but has been sued in a civil action regarding Abu Ghraib interrogations.

Colonel Pappas testified that he had approved the use of dogs in interrogating three other “high-value” detainees, but there was other evidence that participants in the interrogation of Al-Juhayshi thought there had been official approval to have the dog present. There was no evidence that Smith had been given an order to remove the dog’s muzzle or have it touch Al-Juhayshi.

Lieutenant General Ricardo Sanchez, who later wrote a book about his experiences with the Bush administration, said that his express approval would have been necessary to use MWDs for interrogations. Sanchez was aware that MWDs could “exploit Arab fear of dogs while maintaining security during interrogations,” but there was no evidence that Colonel Pappas sought or received such approval from Sanchez for the interrogation of Al-Juhayshi. Pappas testified that he originally thought he could approve use of MWDs but then realized he was wrong. He acknowledged that subsequent requests to use MWDs in interrogations never reached Sanchez.

Military policy on MWDs is that they are to remain muzzled and under control of their handlers when near prisoners. The U.S. Court of Appeals for the Armed Forces determined that even if Smith had authority to have a dog at the interrogation, there could have been no lawful order to use the dog as he did. Nevertheless, Smith argued that the dog’s barking was “in earshot of MP guards, who did not respond, indicating that they were fully aware” of what he was doing. The court determined that even if MPs did not react, this did not prove that an order had been issued to use Marco as Smith did.

The commander in charge of Navy dog teams at Abu Ghraib testified that standard operating procedure was to use MWDs to “reduce escape attempts, encourage detainee compliance, and improve the effectiveness of compound searches and inspections.” Handlers were instructed to yell “stop” prior to the release of an MWD. The assumption of such a command is that the dogs are to be used to apprehend escapees.

Smith was convicted by general court-martial for maltreating prisoners and conspiracy to maltreat prisoners. Specifications alleging indecent acts and dereliction of duty were dismissed. U.S. v. Smith, 68 M.J. 316 (C.A.A.F. 2010). Colonel Pappas was later relieved of his command. News reports suggested that others should have been held accountable as well as Smith. Internal investigations may have glossed over abuses by military contractors. Other cases have mentioned the use of unmuzzled dogs during interrogations at Abu Ghraib. See CACI Premier Technology, Inc. v. Rhodes, 536 F.3d 280 (4th Cir. 2008). Tactics used at Abu Ghraib were approved earlier for Guantanamo by Defense Secretary Donald Rumsfeld, according to the Washington Post.

MWD handlers must know the limits of their activities under military law and should be aware that, even if they are encouraged to exceed those limits, they will be hung out to dry when a military prosecutor gets involved. There was a good deal of evidence that Smith was guilty as charged and convicted, but I am by no means convinced that he was a rogue.