Like a good vet, I spent much of Sunday reading my scientific veterinary journals. True, I love the fluff bits and typically devour these first. If cartoons were included I’d likely read these, too, before moving on to the stiff bits of scientific rigor we’re expected to consume on a regular basis if we’re to be “all that we can be,” as it were.
Though I typically read it first, this past issue of the Journal of the American Veterinary Association (JAVMA, April 1st 2008) was a tad boring, I’m afraid. No April Fool’s jokes, unless you count the following small animal medicine publication:
“Esophageal foreign body obstruction caused by a dental chew treat in 31 dogs (2000-2006).” Submitted by two internists out of Virginia-Maryland’s vet school, Virginia Tech and Oradell Animal Hospital, it details one of the worst manifestations of dental chew blockage. Namely, getting stuck in the esophagus.
The esophagus is a singular organ. As in, you’ve got only one. And it’s vital. Pets don’t do well without them—nor do we, for that matter. When things get stuck in there the symptoms can be less obvious than you’d think. Though they may vomit and salivate, some dogs just get depressed. And all those abdominal X-rays for the most obvious ones? They won’t help. You’ve got to look for this problem in the chest where the esophagus lives.
By the time some of these cases were identified (the study focuses on 31 reported cases treated from 19 different hospitals/institutions), they were pretty bad off. 25% died, despite care.
Most of the chews were lodged in the esophagus at the level of the heart base or the diaphragm, making retrieval with an endoscope hard to accomplish, apparently. Consequently, most had to be pushed into the stomach then retrieved.
Six dogs’ chests had to be opened to facilitate removal. (Ouch!) 87% had moderate or severe esophageal lesions as a result. In the dogs that survived, six ended up with strictures in their esophagi. (Not a good thing for future GI function.)
The upshot: Though the manufacturer reported sales of 300,000 dental chews for 2005, only 31 cases ended up in facilities that reported treating dogs for esophageal obstructions between 2001 and 2006. That’s pretty limited. But it’s nonetheless important for us to know. Otherwise why would the JAVMA publish this retrospective study at all?
The April Fool’s joke (I know you were wondering when I would get back to that) I believe was in failing to mention the manufacturer’s name or the name of the product that occasioned the obstructions.
Why would the paper describe the product to a T (“A chlorophyll-containing, toothbrush-shaped, injection-molded dental chew treat is manufactured for dogs.”) then fail to include the name of the damn thing? I couldn’t find it anywhere in the paper. Nowhere. Not in the references, even (though I admit to failing to source those papers myself and scour their contents, too).
Did they assume we already knew what they were talking about? If so then what’s the harm in mentioning the name of the product? Is this a scientific journal thing? Yet I can’t recall not reading the names of products in other journals—for JAVMA no ready example springs to mind, but that’s odd, isn’t it?
If the purpose of a scholarly article like this is to raise our awareness level on the morbidity and mortality associated with a product so that we can diagnose and treat it better then why limit our information to the inane description above?
If JAVMA is hoping to evade libel claims in failing to print product names, not only is it displaying a lack of courage, it’s failing in its responsibility to adequately protect the lives of animals our profession pledges to serve while doing nothing to thwart criticism of the vet industry’s coziness with pet product manufacturers.
But, then again, maybe it’s just a misguided April Fool’s joke.
OK so let's make up for the lapse: Greenies Greenies Greenies Greelies Greenies Greenies Greenies Greenies Greenies....
P.S. And, no, before you ask... I have nothing against Greenies, per se. If your dog eats treats whole it's common sense that chews like this are not for him. Moreover, Greenies has changed its formula to make it more digestible. But I'm not sure that would help in the case of an esophageal foreign body. I'll ask my surgeon consultant about this ASAP.
P.P.S. OK, the April Fool's joke is on me. My industrious vet surgeon consultant just called to inform me of the need for an errata notice here. There is a teeny superscript in the paper which refers back to a line in the references mentioning the product's name and manufacturer. Maybe I do need that Lasik after all...;-)
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I gave my dogs Greenies for years without incident, but discontinued when I read a second "web-warning". What do other readers feed for chews good for teeth??
Barbara A. Albright/New Hampshire April 8th, 2008 07:48:00 PM
My cat just loves chlorophyll-containing, toothbrush-shaped, injection-molded dental chew treats manufactured for cats.
Alex April 8th, 2008 07:50:00 PM
The safest edible chews I've found are either raw meaty bones (in a size appropriate for the dog or cat) or bully sticks - for those times you don't want your pet dragging a raw meat item around the house :-)
Both still require supervision of course... animals can break teeth or choke on bones, and although the bully sticks seem to be VERY safe -- even with my buzz-saw chewing crew they just shred off in tiny bits from the end and the stick doesn't get mushy so they can swallow it - once they've chewed it down to little piece that could be swallowed you have to pick them up.
And you have to watch the quality - get bully sticks that have been processed in the USA, without chemicals (most are just roasted). I've found good ones at e-petsboutique.com but if you do a search for "bully sticks" you'll find lots of vendors.
Barb April 8th, 2008 08:52:00 PM
To not include the name of the product seems like a serious oversight. I have written several scientific journal articles, and in the materials and methods section, indicated the manufacturer, product code, and state where it was made. This is important information for anyone who wants to replicate the study.
there is still arguement about raw bones- are they safe, dogs can still choke, vomit, get constipated / diarrhea, etc. But that said, I'm a huge fan of raw bones for my dogs, and cats. If you don't want the grossness in your house, put the pet in a crate with the bone.
Margaret April 8th, 2008 09:32:00 PM
A dental diet like Hill's T/D is good for the teeth if you or your pet doesn't care for chews, rawhides, etc...I give individual kibbles as treats.
anna April 9th, 2008 02:06:00 AM
Most holistic pet supply shops will sell (refrigerated) raw bones/knuckles for dogs to chew. These are also good for teeth, as well as being healthy dietary supplements. Marrow and meaty bits are all attached, and the dogs love them!
Pai April 9th, 2008 02:20:00 AM
Oh man.....I started giving Lottie Greenies again when they changed the formulas (if you put one in a cup of water, it will dissolve). She takes FOREVER to eat one (the "teenie" mind you) and often times carries it around hiding it and then re-hiding it before she eats it. She only gets one about once a week (we brush ehr teeth every night), but I'm thinking they may need to go altogether and she is already prone to gagging on just about everything.
Barb, what brand of Bullies do you get? I get mine from a pet boutique in town, but everything is displayed in glass jars, there's no "brand name".
Creature of Habit April 9th, 2008 08:46:00 AM
I think raw meaty bones are great. But I still wouldn't assume they're any more safe than a Greenie. Knowing your pet's chewing style and making sure it doesn't vary is key to knowing whether any of these methods is safe at all. T/D I like a lot, though. I've never heard of one getting "stuck." ;-)
Dr. Patty Khuly April 9th, 2008 08:52:00 AM
I don't give my dogs greenies, rawhides or pig ears for the reasons that you mention. It's easier to load up a appropiate sized Kong with peanut butter or treats and let them have at it.
Stacy April 9th, 2008 09:28:00 AM
If I read that paper, and missed the subscript, I would just assume that not all of the cases in the study were verified to be the specific product from the manufacturer. There are now similar items on the market. Plus, you never know what exactly is going to be in a medical record. Maybe some of the cases were a little vague on the brand.
Or maybe somewhere a scientific journal is getting sued for using the trademark name for some reason.
Otherwise, I don't know why you would use a citation to a reference to point out what you were studying in the paper. That's just being annoying.
Compcat April 9th, 2008 11:16:00 AM
Barbara, to answer your question we stick with edible raw meaty bones (note the phrase *meaty*... bare bones don't do much... and also note *edible*... soup bones and weight-baring bones are not offered around here), and bully sticks. For bully stick brands, I usually go with Red Barn... they are the least smelly bully stick I've found (seems they dry them vertically instead of horizontally), and they don't douse them in chemicals or bleach like some other companies do. Both dogs teeth have increased dramatically (I mean really dramatically... I was skeptical at first!) since changing 3/4 of their diet to raw, which is a double whammy because the teeth-cleaners double as their actual meal. I prefer using that over them ingesting anything with a lot of teeth-cleaning chemicals in it, but that's just me... if there's a non or low-chemical alternative to something with a similar end result I just tend to go that route, for both my dogs and myself personally. I guess kind of like using diluted vinegar and water to clean instead of drenching every surface in Clorox. I've never used Greenies so I really have no input on them either way but a few people I know who used to offer them regularly seem to have stopped since they heard of the deaths. However there is *nothing* in this world that is 100% safe and we are kidding ourselves if we think that everything we throw in our shopping cart should have no risks whatsoever - my dog could also rip up a play ball and choke and die on a piece... supervision is pretty much the key, I feel....
Carissa April 9th, 2008 01:08:00 PM
Carissa~ thanks for the Red barn tip!
Creature of Habit April 10th, 2008 08:47:00 AM
When I was an ICU tech working at a University Teaching Hospital in 2006 I saw a BIG breed of dog (a really really great dog too) with a horrific case of septic abdomen due to post intestinal resection and anastamosis for foreign body removal..and yep, lo and behold greenie clumps!! They had to go in on her 3 times I think and she died the 3rd time on the table....but for me never again will I feed my dogs greenies even if they are new and improved nowadays..... and yes, I do know it was more likely the complications of surgery that probably killed her and not the greenies but still as the pet owner how would you feel?? Possibly outraged that you yourself ultimately your own dog something that ended up killing it... still too sad for me as a previous LVT, current vet student and pet owner...i say no thanks and check out the many other dental products there are that are approved.. http://www.vohc.org/accepted_products.htm
just my 2 cents on greenies =)
Splenomegaly April 10th, 2008 07:01:00 PM
Addendum: Edit to insert---> Possibly outraged that you yourself ultimately FED your own dog something that ended up killing it
Splenomegaly April 10th, 2008 07:06:00 PM
Splenomegaly: Horrible experience--it would put me off Greenies forever, too. But how many other dental treats could theoretically occasion the same imtestinal horrors? Greenies are SO much more popular than all the others combined that it seems altogether too likely that these green creatures (obvious in the intestines unlike some of the others) are over-represented in the literature and pop culture sources. And Greenies are approved, too. The vet dental association sanctioned their use. I just think we should be careful in warning that ANY dental chew can do this...and a rawhide..and a toy...and...
Dr. Patty Khuly April 12th, 2008 09:37:00 AM
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