Sunday, July 14, 2013

Saturday, July 13, 2013

Carbon Monoxide- How Dogs are Affected

  • Once man discovered fire, the issue of being poisoned by pollutants began. One of the most common (and the most fatal) is Carbon Monoxide (CO). The toxic gas is odourless, tasteless, and invisible. It is a highly toxic gas that’s the incomplete combustion of carbon-based fuels such as gasoline. Sources of carbon Monoxide are unventilated kerosene or propane heaters, gasoline engines, automobile exhaust, or fumes from carbon-based fuel heating systems. Some causes of carbon monoxide exposure include accidental enclosure of dog in garage with automobile engine turned on, poorly ventilated areas with any source of carbon monoxide (e.g., fireplace, oven, barbecue grill). Another danger to dogs is being left alone in the car while the engine is running.
  •     In an article on the PetMD website it is noted that carbon monoxide affects the ability of the blood to carry oxygen, by attaching itself to the hemoglobin (a protein) in the red blood cell. Once inhaled, CO molecules are attracted to hemoglobin several hundred more times than oxygen. CO then replaces the oxygen attached to the hemoglobin and is carried to the dog’s brain and heart thereby causing damage to the heart, lungs, and brain. The condition of low oxygen levels in the blood is known as hypoxemia.   (PetMD, ©1999-2013 ). The combination of hemoglobin and CO is called Carboxyhemoglobin. (The medical dictionary, 2007 ). In addition to binding to hemoglobin, 10% to 15% of CO attaches to other proteins, especially myoglobin within the heart. Chest pains and myocardial injury can occur with just a mild exposure to CO.  ( Quinn, et al., 2009). In a study published in the Annals of Clinical and laboratory Sciences, LR Goldbaum (et al) noted “Dogs inhaling CO (13 percent in air) for 15 minutes died within 15 minutes to 65 minutes with an average COHb (Carboxyhemoglobin) level of 65 percent”. (Goldbaum, et al., 1976 ) .  In the journal “Environmental Health Perspectives”, DG Penney wrote “Dogs were found to be more resistant to Carboxyhemoglobin than humans. (Penney, 1988). Carboxyhemoglobin can also affect the dog’s Central Nervous System whereby a dog would be too weak to walk, and may not be able to stand at all. Carbon Monoxide poisoning affects the hippocampus in the cerebral cortex causing spatial problems, along with memory loss. Some of the symptoms and behaviors (in dogs) of Carbon Monoxide poisoning are sleepiness, Lethargy, Depression, Seizures, loss of exercise stamina, and many more.
  •   If you suspect your dog may have CO poisoning, it is imperative to bring the dog to your Vet immediately. The vet will immediately start the dog on oxygen and begin diagnostic tests. A complete blood count, a biochemistry profile, a urinalysis and other applicable body fluid tests will be performed. The vet will collect blood samples for determination of carboxyhemoglobin levels. Obtaining the levels of carbon monoxide in the blood is the most useful test for putting together the initial treatment plan. Treatment will include 100% oxygen and plenty of fluids to improve the flow of blood through the body tissues to areas such as the brain. If you Vet does not have the facilities to treat your dog for carbon monoxide poisoning, you can bring your dog to the local hospital. Long-term treatment will include limiting the activity of the dog such as short walks in lieu of longer walks and running. Observation is important to watch for signs of nervous symptoms, awkward gait and movement and other abnormal behaviors. Usually once the dog is removed from the affected area, the carboxyhemoglobin levels (the dog’s blood) will begin to lower just as fast as they rose.
  • Philip K Greis


Works Cited

Quinn, D. K., McGahee, S. M. & Stern, T. A., 2009. Complications of Carbon Monoxide Poisoning: A Case Discussion and Review of the Literature. Primary Care Companion to The Journal of Clinical Psychiatry, 2(11), p. 74–79.
Goldbaum, L. R., Orellano , T. & Dergal , E., 1976 . Mechanism of the toxic action of carbon monoxide. Annals of Clinical and Labratory Sciences, VI(IV), pp. 372-376.
Penney, D., 1988. Hemodynamic response to carbon monoxide. Environmental Health prospectives, Volume 77, pp. 121-130.
PetMD, ©1999-2013 . Carbon Monoxide Poisoning in Dogs. [Online]
Available at: http://www.petmd.com/dog/conditions/respiratory/c_dg_carbon_monoxide_toxicosis#.Uc-8xqLD8zs
[Accessed 30 June 2013].
The medical dictionary, 2007 . carboxyhemoglobin. [Online]
Available at: http://medical-dictionary.thefreedictionary.com/carboxyhemoglobin
[Accessed 30 June 2013].


Stealing Vet Drugs



According to a statement by Stanford Hospital and Clinic website, 1 %( one percent) of the world’s human population has some form of epilepsy (Stanford Hospitals and Clinics, 2013).The percentage of dogs with epilepsy is approximately 4% (four percent) (inconclusive). (Dennis O'Brien, 2002)The statistics show that dogs are three times more likely to have some form of epilepsy than humans. In a study published in Plos One conducted at the University of Helsinki by Professor Hannes Lohi and his group, a gene region has been identified in chromosome 37 that which if homozygous (having identical alleles for a single trait), increases the risk of epilepsy by seven-fold . ( Lohi, et al., 2012) This study was conducted on Belgian Shepherds, a breed which has a high rate of epilepsy. In light of this initial data, breeders now have some basic evidence that there is genetic link to epilepsy. Basically with or without these findings, dogs should never be bred if one has any illness that can be inherited by their offspring. Dr O’Brien goes on to state that a typical canine epileptic seizure lasts about two minutes. According to the book “A Dog Owner’s Home Veterinary Handbook”, “Phenobarbital continues to be the single most effective drug for treating epilepsy in dogs.” (Eldredge, et al., 2007). Phenobarbital is a drug prescribed for human epileptic seizures as well. Phenobarbital falls into a class of drugs known as Barbiturates. According to the National Institutes of Health (US), “barbiturates are a type of depressant drug that cause relaxation and sleepiness. A barbituate overdose occurs when someone accidentally or intentionally takes more than the normal or recommended amount of this medication. This is life threatening”. (Perez & Zieve, 2012). The article further states “Barbiturate abuse is a major addiction problem for many people” “However, those who become addicts usually start by abusing medication prescribed for them or other family members.” Not only are people abusing phenobarbital for human consumption, there are studies that show veterinary medications such as phenobarbital is being abused as well. According to a 2002 article in The Journal of the American Academy of Psychiatry and the Law titled “Novel Cases: Malingering by Animal Proxy”, there are pet owners who are reporting false symptoms in an effort to obtain certain veterinary drugs. The article specifically states “In a veterinary setting, malingering takes on a different twist. Instead of misrepresenting illness in themselves, clients (pet owners) report false symptoms in their pets to veterinarians”.  (LeBourgeois III, et al., 2002) The article further states “We propose that veterinarians, like their medical counterparts, are potential targets of malingering by their clients for drugs of abuse. Because of their familiarity with this condition, psychiatrists may have a role in training veterinarians to recognize malingering on the part of their human clients. The authors of the aforementioned article have labeled this an actual behavior by humans. Five specific cases of this are documented in this report denoting five different medications; Tranxene (Benzodiazepine), Winstrol tablets (Anabolic Steroid), Levothyroxine (thyroid supplement), Hycodan (opiate), and Amitriptyline (anti-depressant). In all these cases, persons attempted to dupe a vet into writing more prescriptions, and all were denied.
              On May 1, 2013, I interviewed my friend (and my dogs’ Vet) Doctor Pasquale Meleleo DVM, owner of Pleasant Plains Animal Hospital, (Staten Island, NY). Dr Meleleo claims there is a problem of dog and cat owners attempting to obtain meds for falsely claimed ailments. He stated “Pain management meds are the most popular drug targeted by people”. He went on to discuss his policy of conducting random drug tests of his own employees. “I test for potential ketamine abuse by my staff randomly at least once a month”. Ketamine is a drug used for veterinary use as an anesthesia (with other sedatives) and for pain management. According to the U.S. Drug Enforcement Administration (DEA), Ketamine is as a street drug called “Special K”. In a released statement, the DEA states “Ketamine distorts perceptions of sight and sound and makes the user feel disconnected and not in control. A “Special K” trip is touted as better than that of LSD or PCP because its hallucinatory effects are relatively short in duration, lasting approximately 30 to 60 minutes as opposed to several hours”. (Drug Enforcement Administration, August 2011).
     On June 10, 2013, I interviewed a personal friend; Donna who owned a Chihuahua (now deceased) named Sparky which I knew suffered from seizures. After the first seizure, Donna took Sparky to a vet, Dr Theresa Cavallero. Dr Cavallero diagnosed Sparky with epilepsy. Dr Cavallero prescribed a 30 day prescription of phenobarbital BID (twice daily). According to Donna, although on the meds Sparky’s seizures were increasing in frequency. Donna called the vet and requested another prescription of phenobarbital. The vet’s office instructed Donna to bring Sparky to the office for blood test to rule out liver damage to the dog (from the phenobarbital). In addition to the blood test, Dr Cavallero must examine Sparky in order to get another prescription of phenobarbital. Donna inquired why, she was told that phenobarbital is a controlled substance and Sparky must see Dr. Cavallero. Donna didn’t have the money to pay for the additional blood work and Vet visits every 30 days; Dr Cavallero had donna sign a waiver for the meds, and she only had to bring sparky for a visit once a year. In Donna’s opinion, Dr. Cavallero ordered the monthly blood for two reasons. The blood tests were for both the liver and to ascertain whether or not Sparky was actually being given the phenobarbital.

      Various media outlets have reported about break-ins at Veterinary clinics all over the US. 10/23/2006, Noblesville, Ind; police were investigating a rash of break-ins of veterinary clinics. Police believe the thieves may have been targeting the drug Ketamine. (spencer, 2001)  March 29, 2010 Marlette, MI, An investigation into the theft of drugs during a recent break-in at a Marlette veterinary clinic has resulted in the apprehension of three male subjects. Two vials of ketamine were found on the suspects (BARRINGER, 2010). In my research, I have found many stories on the subject as drug enforcement agencies in the US and Europe start cracking down on medical providers freely writing prescriptions for abused drugs, addicted person will start looookinking elsewhere to obtain prescriptions to feed their addictions. Staff at veterinary clinics must be educated in order to recognise when somebody is looking for drugs for themselves while using their pets as excuses.

Philip K Greis

Works Cited

Lohi, H. et al., 2012. Identification of a Novel Idiopathic Epilepsy Locus in Belgian Shepherd Dogs. PLOS ONE, 7(3).
BARRINGER, C., 2010. Drugs stolen during break-in at vet clinic. The Banner, 29 March, p. 1.
Dennis O'Brien, D. P., 2002. Understanding Your Pet's Epilepsy. [Online]
Available at: http://www.canine-epilepsy.net/basics/basics_index.html
[Accessed 15 June 2013].
Drug Enforcement Administration, August 2011. KETAMINE, s.l.: Drug & Chemical Evaluation Section.
Eldredge, D. M., Carlson, L. D., Carlson, D. G. & Giffin, J. M., 2007. Epilepsy. In: B. Adelman, ed. Dog Owner’s Home VETERINARY Handbook. Hoboken, New Jersey: Wiley Publishing, pp. 369-370.
LeBourgeois III, H. W. M., Foreman, T. A. M. & Thompson Jr., J. W. M., 2002. Novel Cases: Malingering by Animal Proxy. [Online]
Available at: http://www.jaapl.org/content/30/4/520.full.pdf
[Accessed 17 June 2013].
Perez, E. M. & Zieve, D. M., 2012. Barbiturate intoxication and overdose. [Online]
Available at: http://www.nlm.nih.gov/medlineplus/ency/article/000951.htm
[Accessed 16 June 2013].
spencer, T. R. 6. N., 2001. Vet Clinics Targeted In Rash Of Break-Ins. Noblesville, Ind: s.n.
Stanford Hospitals and Clinics, 2013. Epidemiology (the numbers) of Epilepsy. [Online]
Available at: http://stanfordhospital.org/clinicsmedServices/COE/neuro/epilepsy/patientEducation/causes.html
[Accessed 15 june 2013].