Newsletter March 2014

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March 2014
Rabid –
A Wisconsin Tale
A Twist of Fate
The traditional medical teaching was that
“rabies is universally fatal once symptoms
develop.” Things have changed a lot over
the last 10 years with our understanding of
rabies. Thanks to a Wisconsin patient and
her doctor, rabies is no longer considered 100
percent fatal.
A teenager from Fond du Lac, Jeanna Giese,
made history in 2004 after she became the
first known unvaccinated survivor of clinical
rabies. She received an experimental treatment, now known as the Milwaukee protocol, involving a medically induced coma and
course of anti-viral drugs that was pioneered
at the Children’s Hospital of Wisconsin in
Milwaukee. Prior to 2004, there had been
only five documented survivors of symptomatic rabies and all had either been rabies
vaccinated prior to exposure or received postexposure prophylaxis.
Simply the act of surviving rabies is remarkable, but to have a neurologically functional
outcome is remarkable. After being released
from intensive care, Jeanna spent months in
the hospital and in a rehabilitation facility relearning how to perform basic functions like
speaking, standing and walking. She was
able to go home at the beginning of 2005 and
although some neurologic deficits still persist
they have not stopped her from achieving her
goals. In May 2011, Jeanna graduated from
Lakeland College in Sheboygan, WI with a
bachelor’s degree. One of her hobbies is sled
dog racing with her team of Siberian Huskies.
Jeanna is also an advocate for rabies education; she talks with school children about
rabies safety and the importance of vaccinating their pets and is an Ambassador for the
Global Alliance for Rabies Control.
In Wisconsin in 2004 there were ten confirmed cases of rabies. This included eight
bats, one skunk and one person, Jeanna
Giese. In Wisconsin in 2013 there were 30
confirmed rabies cases, all in bats. In a twist
of fate, one of those rabies positive bats was
submitted by Jeanna Giese. She found the
dead bat covered in bite marks in an enclosure with two of her Siberian Huskies. The
bat was submitted to the Wisconsin State
Laboratory of Hygiene which confirmed a
positive rabies test. Fortunately there was no
human contact (Jeanna collected the bat with
a shovel and bags) and her dogs were rabies
vaccinated. Her family veterinarian, Dr. Kim
Everson of St. Bernard’s Animal Medical
Center in Van Dyne, WI boosted her dogs’
rabies vaccinations and per Wisconsin state
statutes the dogs were on home quarantine
for 60 days. Jeanna’s encounter with rabies
in 2013 was much less eventful than the one
nine years ago.
The Milwaukee Protocol
In her first and most serious encounter with
rabies, Jeanna Giese was only 15 years old
when she found a bat in her Fond du Lac
church. As an animal lover, she picked it
up to carry it outside and was bitten on the
finger. The wound was cleansed but due
to a lack of awareness of any public health
concern, the bat was not submitted for rabies
testing. Jeanna was asymptomatic while the
rabies virus traveled from the bite wound up
her peripheral nerves into her central nervous
system. Thirty seven days after being bit, she
developed flu-like symptoms which rapidly
progressed.
Rabies causes encephalitis. In people this often begins with symptoms of a mild illness
(headache, muscle aches, lethargy, weakness, nausea, fever and pain or paresthesia
at site of the bite) that progressively worsens
within days with changes in mentation (anxiety, insomnia, hallucinations) and neurologic
deficits. The classic rabies symptoms of hydrophobia and hypersalivation are due to
dysphagia. The disease progresses with hyperthermia, convulsions and death often occurs due to dysautonomia. Prior to Jeanna’s
case, the most modern medicine could offer
a clinical rabies patient was palliative end of
life care with sedatives and analgesics.
In Jeanna’s case, the diagnosis of rabies was
made less than a week after the onset of her
continued on page 2
1
symptoms via exRabid
Continued from page 1 clusion of other
causes of encephalitis and with confirmatory testing by
the CDC of rabies. Antemortem testing that
is utilized for diagnosis of rabies in people includes virus-specific antibody in the CSF and
serum, nuchal skin biopsy antigen testing of
cutaneous nerves and virus isolation on salivary samples.
Dr. Rodney Willoughby, Jr. and his colleagues at the Children’s Hospital of Wisconsin in Milwaukee who were caring for Jeanna
offered either hospice care or an experimental treatment to the Giese family. The treatment was based on the hypothesis that rabies
mortality occurs not from neuronal cell death
(from viral or immune-mediated cytopathic
effects) but from temporary neurotransmission dysfunction. An excitotoxicity causes
the neurons to rapidly deplete their supplies of
nutrients leading to dysfunction. If one could
protect the brain until neutralizing antibody
levels were developed by the immune system a patient could potentially survive rabies.
This treatment was consented to by the family
even though there were no guarantees about
what kind of quality of life a rabies survivor
would have.
The original Milwaukee protocol used on
Jeanna involved a medically induced coma
with antiviral drugs. Jeanna was on a ventilator and in a coma for six days. The sedatives
were weaned once signs of an immune response were noted. After rehabilitation, Jeanna has had a remarkable recovery; seven years
after her initial diagnosis, Dr. Willoughby
was in attendance at her college graduation.
Details of the original case can be found in publication and online in the New England Journal
of Medicine. Willoughby, RE; Tieves, KS; Hoffman, GM; Ghanayem, NS; Amlie-Lefond, CM;
Schwabe, MJ; Chusid, MJ; Rupprecht, CE (June
2005). “Survival after treatment of rabies with induction of coma” New England Journal of Medicine 352 (24): 2508–14.
The Milwaukee protocol has been used on 43
reported cases and has been modified based
on additional rabies research and clinical data.
Recommendations for symptomatic patients
include neither providing rabies immunoglobulin (as this delays rabies antibodies in
the CSF which are thought to be essential for
survival) nor rabies vaccination as this may be
detrimental to survival.
It is now known that there are common
2
complications associated with rabies such
as transient hyponatremia, arrhythmias and
diabetes insipidus which are routinely monitored for and managed. The main treatments
in the Milwaukee protocol are based on the
hypothesis that there are three main pathways
of rabies induced neuronal damage including:
excitotoxity, BH4 deficiency and cerebral vasospasm.
Ketamine is an NMDA antagonist which
has shown anti-rabies activity in animal
models. It is also thought that ketamine
can help prevent the build-up of the excitotoxin quinolinic acid through NMDA
blockade. Amantadine, besides its antiviral properties is also an NMDA antagonist.
Rabies patients also often have an acquired tetrahydrobiopterin (BH4) deficiency in their CSF. BH4 is a cofactor for the
synthesis of dopamine, norepinephrine,
serotonin and melatonin. Interestingly,
people can be born with a BH4 metabolic
deficiency. Symptoms of this rare genetic
disorder can overlap with some of the
symptoms of rabies including poor muscle tone, movement disorders, inability
to modulate body temperature, difficulty
swallowing and seizures.
Cerebral arterial spasms are thought to
be from decreased nitric oxide synthase
(NOS). BH4 is a cofactor for NOS. Cerebral arterial spasms can respond to calcium channel blockers.
The Rabies Treatment Controversy
In 2011, Precious Reynolds, an 8 year old
Californian was bitten by a cat and underwent
treatment with the Milwaukee protocol with a
positive outcome. Unfortunately Jeanna’s and
Precious’ successful outcomes are still the exception rather than the rule for clinical rabies
treatment. According to the rabies registry
through the Medical College of Wisconsin,
to date there have been 43 attempts to treat
rabies with the Milwaukee protocol with only
5 classified as survivors. Of those survivors,
limited information is available on if they are
still alive or what quality of life they have.
This poor success rate has led the scientific
community to ask why so few patients respond to treatment. One of the major presumptions of the Milwaukee protocol is that
there is not direct neuronal damage, only
neuronal dysfunction, which can be managed
until an immune response is mounted. This
presumption is controversial in the scientific
community; some researchers have found cytopathic effects in cells induced with rabies
virus. Even if the central premise of the Milwaukee protocol is questioned, we still can’t
ignore the fact that a handful of people have
now survived rabies after developing clinical
symptoms.
A determining factor may be differences in
strain of wild rabies. Three of the survivors
were bitten by bats and two by cats (which
often carry the bat strain of the virus). There
has been less success for treatment of canine
strains of the virus. Survival may increase
from being infected with a less virulent strain
of the virus.
The patient’s own immune systems may also
hold a key to surviving rabies. Two of the survivors were early immune responders which
is not typical for rabies cases. An early immune response may have begun clearing the
virus even before treatment was initiated.
There may be a unique genetic component to
survivors’ immune systems or perhaps being
bit on an extremity allows the immune system
adequate time to respond as the virus slowly
moves up peripheral nerves to the brain.
Rabies is Preventable
There is no controversy that rabies prevention
is much more effective than rabies treatment.
The World Health Organization (WHO) estimates that over 55,000 people die each year
of rabies. Death rates are especially high in
developing nations in Asia, Africa and nonurbanized areas of Latin America where
there are no preventative programs in place.
Dogs are the source of rabies in 99% of cases
world-wide so vaccination and stray animal
control are key factors in decreasing human
exposure.
People who are at risk are encouraged to be
vaccinated. This includes those with potential exposure due to occupation (such as veterinarians and technicians) and people who
travel or those living in rabies endemic areas.
Pre-exposure rabies vaccinations are expensive but they are less expensive than post-exposure prophylaxis. Prevention is also more
effective and economical than treatment of
clinical rabies; one doctor estimated that for
the cost of treating just one patient with the
Milwaukee protocol, 10,000 vaccines could
have been administered.
Fortunately United States laws requiring rabies vaccinations for dogs (and cats) have
limited human exposure to rabies significantly. According to the CDC, in the United
States over 90% of animal cases of rabies in
the US are from wildlife and there are now
only 2-3 cases of human rabies each year
rather than dozens.
There needs to be an ongoing crusade for
public awareness of the risks of rabies since it
is preventable and post-exposure prophylaxis
can be life-saving. As Jeanna Giese learned, it
is easier to take precautions immediately after
a possible exposure to a rabid animal than to
ignore the risk since the new saying is that rabies is still almost always a fatal illness.
If you are interested in listening to a fascinating
account on the history of rabies and treatments
over the years you can download the August 2013
Radiolab podcast “Rodney Versus Death” at
www.radiolab.org
For further information on rabies and prevention,
please visit the CDC: www. cdc.gov/rabies/ and
the World Health Organization at www.who.int/
rabies/en/
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There is also mounting evidence that people
may be able to develop natural rabies immunity. There was case in 2009 in Texas of a
teenager who encountered bats in a cave two
months before rabies symptoms developed
but did not received any prophylactic treatment as she did not think she was bit. When
symptoms developed, she tested positive for
rabies but only developed mild symptoms. She
needed no intensive care and was discharged
from the hospital two weeks later. Three years
later and over 3000 miles away from Texas,
people in the Amazon have developed natural rabies antibodies. Research published in
the 2012 Vol. 87 of The American Journal of
Tropical Medicine and Hygiene “Evidence of
Rabies Virus Exposure among Humans in the
Peruvian Amazon” shows some people living in two communities in Peru survived being exposed to rabies virus without receiving
treatment. After nearly twenty years of outbreaks of rabies from the resident vampire bat
population, 11% of those in the study tested
positive for rabies neutralizing antibodies. It
was unknown from the study if these people
were ever clinically symptomatic or not.
3
Symptoms of RBF include fever, chills, muscle aches, headache, and vomiting. A
maculopapular rash on the limbs may be noted 24-48 hours after the onset of fever
and can then be followed by polyarthritis. The incubation period is from 3-10 days.
Death in untreated cases is around 10% and is often from development of endocarditis,
myocarditis, meningitis, pneumonia or sepsis.
Fortunately Rat Bite Fever is rare in the United States and is highly treatable with
antibiotics (such as penicillins) when caught early. It is not a reportable disease.
PAST-PRESIDENT
Dr. Jessica Daul
Riverside Animal Hospital
920-336-5090
Email: [email protected]
TREASURER
Dr. Ellen Hooker
WDATCP-Division of Animal Health
715-256-0068
Email: [email protected]
EXECUTIVE DIRECTOR
Dr. Jennifer Cyborski
Fox Valley Animal Referral Center
920-931-2VMA
Email: [email protected]
BADGER DISTRICT DIRECTOR
Dr. Pete Gasper
One Medicine
920-359-1182
Email: [email protected]
FOX VALLEY DISTRICT DIRECTOR
Dr. Stephanie Slavik
Country View Animal Hospital
920-722-1518
Email: [email protected]
LAKELAND DISTRICT DIRECTOR
Dr. Melanie Goble
Mishicot Veterinary Clinic
920-755-2115
Email: [email protected]
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STERN WISC
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Contact the NEWVMA Office at:
920-931-2862 or e-mail: [email protected]
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NEWVMA Office
N3354 Meade Street
Appleton, WI 54913
PACKERLAND DISTRICT DIRECTOR
Dr. Jenny Knorr
Riverside Animal Hospital
920-336-5090
Email: [email protected]
WVMA DISTRICT REPRESENTATIVES
Dr. James Ziegler
Wolf River Veterinary Clinic
920-982-2733
Email: [email protected]
Dr. Ann Sosalla
Companion Animal Care
920-921-5199
Email: [email protected]
Contact your NEWVMA district
director directly or get in touch
with the NEWVMA Office at
[email protected] or leave a message
at 920-931-2VMA.
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Membership Announcements
& Congratulations
NEWVMA welcomes Dr. Tara Johanek
of Apple Valley Veterinary Clinic as a
new member.
Congratulations
to
the
following
veterinarians who have earned the 10 Year
Membership Award:
Dr. Jill Duch, Globe University Appleton
Dr. Mark Pipkorn, St. Anna Veterinary
Clinic
The following veterinarians have
been awarded the 25 Year Membership
Certificate:
Dr. Kelly Peters, Countryside Veterinary
Service
Dr. Scott Ruetten, DePere Veterinary
Services
Life Membership, which is an honor
awarded to NEWVMA members of
good standing 65 years and older, has
been bestowed upon the following
veterinarians:
Dr. John Fountain, Manawa-Marion
Veterinary Clinic
Dr. Allen Lande
Dr. Dennis Nyren, We Care Animal
Hospital
Dr. Gretchen Schmidt, Animal Eye
Clinic
VETERINAR
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It is advised that people in contact with rats practice good hygiene including washing
hands after handling and not eating or drinking around rodents. Anyone with suspicious
symptoms should see their physician and alert them to ownership/exposure to rodents
so appropriate testing and treatment can be sought. Since S. moniliformis is part
of the natural respiratory flora of rodents, routine testing or treatment of rodents by
veterinarians is not advised.
PRESIDENT-ELECT
Dr. Ruth Hanson
Oak View Veterinary Hospital
920-468-6936
Email: [email protected]
The NEWVMA Board is here to
serve you, but we can only be as helpful as the feedback we get from our
members. If you have an idea for a
continuing education topic or a speaker you’d like to hear, let us know. If
there is a fun activity or locale you
think would make for an interesting
NEWVMA social next year, send us
a line. If there is a serious local or
state issue that affects you professionally and you would like NEWVMA
and the WVMA to become involved,
please share your thoughts and concerns.
STERN WISC
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TH
Rat-bite Fever RBF is caused primarily by Streptobacillus moniliformis, a gram-negative
bacillus. S. minus has been associated with RBF cases in Asia. Both of these bacteria are
part of the normal respiratory flora of rats (and can also be found in other rodents such
as mice and gerbils) and can be transmitted to people via bites or scratches. Cases have
also been reported to occur from simply handling an infected rodent without any bites or
scratches or ingesting contaminated food and drink. Person-to-person transmission has
not been reported.
PRESIDENT
Dr. Ron Biese
Kaukauna Veterinary Clinic
920-766-1237
Email: [email protected]
Contact Us
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Around half a million households in America have a rat
or mouse as a pet. Rat fanciers praise rats as affordable
pets that are sociable, intelligent animals with distinct
personalities. Recently rat ownership has been in the
news in a negative light with reports of a family suing
Petco for the death of their ten-year old son from ratbite fever.
2014 NEWVMA BOARD
of DIRECTORS
N
IO
Rat-Bite Fever
Correction
The January 2014 NEWVMA Newsletter should have read on page 6 “Thank
you to Dr. Frank Shearer for his ongoing support of the NEWVMA Scholarship
Fund. He has made another contribution as a Silver Level Donor. His ongoing
support helps NEWVMA support deserving veterinary students.”
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for Published Articles
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patient that would make a great case
summary? Do you have a humorous
veterinary anecdote to tell? Is there
a timely public health issue, medical
advance or veterinary-related humaninterest story that would be worth
sharing with others?
NEWVMA will pay $50 for each fulllength (minimum one page including
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5
Refresh Your Memory –
Reportable Infectious Diseases in Wisconsin
There are a list of reportable diseases that
veterinarians who work with those species
in Wisconsin should be knowledgeable
about. The diseases are legally reportable
to the Department of Agriculture, Trade
and Consumer Protection (DATCP) for
the protection of the public, monitoring of
animal health, eradication programs and/or
for the safety of agriculture in the state.
Suspected or confirmed cases are legally
required to be reported. Per state law if the
WVDL or the State Lab of Hygiene tests a
sample that is positive for a reportable disease
they will make the report to the DATCP; in
that case the referring veterinarian is not
also required to do so.
If you have a suspected or confirmed
reportable disease, during business hours
(7:45 a.m.-4:30 p.m. weekdays), contact one
of the following (do not leave a message,
please make sure you speak directly with the
contact person):
•
Wisconsin Division of Animal Health
608-224-4872
•
U.S. Department of Agriculture
Veterinary Services 608-662-0600
•
A district veterinarian
For diseases (suspected or confirmed)
that must be reported within 24 hours
the following numbers are to be used
to report a veterinary emergency and
only during non-business hours:
•
•
•
Wisconsin Emergency Management
duty officer 1-800-943-0003
Wisconsin State Veterinarian 262740-0574
USDA Veterinary Service Area
Veterinarian in Charge 608-3346811
Diseases to be Reported within One Day
Foot and mouth disease
Bluetongue
Vesicular conditions including vesicular
stomatitis
Equine encephalomyelitis (Eastern and
Western)
Swine vesicular disease
African horse sickness
Rinderpest
African swine fever
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Peste des petits ruminants
Classical swine fever
Contagious bovine pleuropneumonia
Avian influenza
Lumpy skin disease
Viscerotropic velogenic Newcastle disease
Rift Valley fever
Sheep pox and goat pox
Pseudorabies (Aujesky’s disease)
Brucellosis
Rabies
Tuberculosis
Pullorum disease
Mycoplasma meleagridis
Chronic wasting disease
Any disease that is a foreign or exotic
disease to Wisconsin
Diseases to be Reported within 10 Days
Multiple species diseases
Anthrax
Echinococcosis/hydatidosis
Heartwater
Leptospirosis
New world screwworm (Cochliomyia
hominivorax)
Old world screwworm (Chrysomya
bezziana)
Paratuberculosis also known as Johne’s
Disease
Q Fever
Fish diseases
Channel catfish virus
Enteric septicemia of catfish
Epizootic hematopoietic necrosis
Infectious hematopoietic necrosis
Largemouth bass virus
Mycobacteriosis infection
Oncorhynchus masou virus disease
Proliferative kidney disease
Spring viremia of carp
Streptococcus iniae
Viral hemorrhagic septicemia
Whirling disease (Myxobolus cerebralis)
White sturgeon iridovirus
Sheep and goat diseases
Caprine and ovine brucellosis (excluding
B. ovis)
Caprine arthritis/encephalitis
Contagious agalactia
Contagious caprine pleuropneumonia
Enzootic abortion of ewes (ovine
chlamydiosis)
Maedi-visna
Nairobi sheep disease
Ovine epididymitis (Brucella ovis)
Ovine pulmonary adenomatosis
Salmonellosis (S. abortusovis)
Scrapie
Division of Animal Health
Ve t e r i n a r i a n S t a f f
Wisconsin Department
of Agriculture, Trade &
Consumer Protection
7/25 /20 12
Contacts for Central Office:
Dr. Bourie, supervisor
Melissa Mace, Bureau Dir
DATCP - Reception
USDA - Reception
Swine diseases
Atrophic rhinitis of swine
Enterovirus encephalomyelitis
Porcine cysticercosis
Porcine reproductive and respiratory
syndrome
Transmissible gastroenteritis
Trichinellosis
(608) 224-4886
(608) 224-4883
(608) 224-4872
(608) 662-0600
Bayfield
Douglas
Ashland
Iron
Vilas
Bee diseases
Acariosis of bees
American foulbrood
European foulbrood
Nosemosis of bees
Varroosis
Washburn
Burnett
Sawyer
Florence
Tom Varty - USDA
(715) 933-1202 cell
Polk
Lagomorph diseases
Myxomatosis
Rabbit hemorrhagic disease
Oneida
Price
Rusk
Barron
Forest
Timothy DeVeau - USDA
(715) 536-4534
(715) 432-2152 cell
Lincoln
Taylor
Marinette
Langlade
Chippewa
Saint Croix
Cattle diseases
Bovine anaplasmosis
Bovine babesiosis
Bovine spongiform encephalopathy
Bovine cysticercosis
Bovine genital campylobacteriosis
Infectious bovine rhinotracheitis/infectious
pustular vulvovaginitis
Dermatophilosis
Enzootic bovine leukosis
Hemorrhagic septicemia
Malignant catarrhal fever
Theileriosis
Trichomonosis
Trypanosomosis (tsetse-borne)
Door
Marathon
Ellen Hooker - DATCP
(715) 256-0068
(608) 516-9131 cell
Shawano
Pierce
Clark
Eau Claire
Pepin
Kewaunee
Portage
Wood
Buffalo
Waupaca
Brown
Outagamie
Jackson
Trempealeau
Libby Balzer - DATCP
(608) 269-0604
(608) 516-9128 cell
Waushara
Manitowoc
Calumet
Winnebago
Lake
Winnebago
Monroe
La Crosse
Juneau
Dick Bertz - USDA
(608) 444-3546 cell
Adams
Marquette
Fond du Lac
Green Lake
Sheboygan
Vernon
Columbia
Sauk
Richland
Dodge
Washington
Ozaukee
Crawford
Equine diseases
Contagious equine metritis
Dourine
Epizootic lymphangitis
Equine infectious anemia
Equine influenza
Equine piroplasmosis
Equine herpes virus
Equine viral arteritis
continued on page 8
Oconto
Menominee
Dunn
Erika Doescher- DATCP
(608) 516-9127 cell
Dane
Jefferson
Iowa
Waukesha
Grant
Racine
Lafayette
Green
Rock
Walworth
Dennis Foelker - DATCP
(920) 261-5584
(608) 225-5490 cell
Milwaukee
Shelby Molina - DATCP
(262) 473-3757
(608) 516-9125 cell
Kenosha
Kim Kessenich - USDA
(608) 444-5047 cell
I:\Library\MAPS\AH_Vets_Map.pdf
7
Pet Jerky Treat Investigation Update
Fowl pox
Fowl typhoid
Marek’s disease
Infectious bursal disease
(Gumboro disease)
Diseases
Continued from page 6
Glanders
Horse mange
Horse pox
Japanese encephalitis
Surra (Trypanosoma evansi)
Venezuelan equine
encephalomyelitis
Avian diseases
Avian infectious bronchitis
Avian infectious
encephalomyelitis
Avian infectious laryngotracheitis
Avian mycoplasmosis (M.
gallisepticum)
Avian tuberculosis
Duck virus enteritis
Duck virus hepatitis
Fowl cholera
Ornithosis (psittacosis)
Paramyxovirus infections of
poultry other than Newcastle
disease
Salmonellosis
Infectious laryngotracheitis
Chicken jerky treats originating from China have been causing pets to become ill. The
FDA first put out a warning to pet owners in 2007 and has recalled certain brands, but
jerky products are still being sold and illnesses are still being reported. The FDA has
had over 3,000 reports of pet illness that may be related to jerky treats; this includes
more than 3,600 dogs, 10 cats and includes more than 580 deaths. Testing is also being
extended beyond chicken jerky to include duck, dried fruit, sweet potato and yam jerky
treats.
Mollusc diseases
Haplosporidiosis (H. nelsoni or
H. costale)
Bonamiosis
Marteiliosis
Mikrocytosis (Mikrocytos
mackini)
Perkinsosis
The FDA is working with laboratories across the country to investigate causes but
thus far testing for contaminants in jerky pet treats has not revealed a cause for the
illnesses. The following have been ruled out with negative testing: Salmonella, metals
and elements such as arsenic, cadmium and lead, markers of irradiation level (such
as acyclobutanones), pesticides, antibiotics (including both approved and unapproved
sulfanomides and tetracyclines), mold and mycotoxins, rodenticides, nephrotoxins (such
as aristolochic acid, maleic acid, paraquat, ethylene glycol, diethylene glycol, toxic
hydrocarbons, melamine, and related triazines) and endotoxins.
Diseases of other animal
species
Leishmaniasis
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8
Pet owners should watch for signs that may occur within hours to days of ingestion
including anorexia, lethargy, vomiting, diarrhea and polyuria/polydipsia. Severely
affected cases are often diagnosed with pancreatitis, gastrointestinal bleeding and
kidney failure including Fanconi-like Syndrome which can cause glucosuria, proteinuria,
electrolyte abnormalities and metabolic acidosis. Fanconi-like Syndrome is an acquired
disease most commonly caused by renal tubular toxicity. Fanconi Syndrome is a rare
inherited disorder seen most commonly in Basenjis.
Pet owners and veterinarians can report cases to the FDA either through their local FDA
Consumer Complaint Coordinator or electronically through the FDA safety reporting
portal online. Any packaging and samples of the treats should be held in case the FDA
asks for submission for testing. The FDA states that although they do “not necessarily
respond to every individual complaint submitted, each report becomes part of the body
of knowledge that helps to inform FDA on the situation or incident.”
What you can do to
prevent issues:
■ Alert your clients to the possible
dangers of jerky treats. A client
warning can be shared from
the NEWVMA Facebook page,
downloaded from www.newvma.org
or you can contact [email protected]
for a Microsoft Publisher document
you can customize with your own
business logo to hand out to clients.
What you should do if
you suspect a case:
■ Perform routine blood work and
urinalysis for diagnosis. Urinalysis
should be performed even if only GI
symptoms are noted.
■ Record the product information
including lot number.
■ Submit an official report (see
reporting information above).
■ Save additional samples for possible
submission including: the treats, a
frozen sample (10 mL if possible) of
urine (if within 24 hours of ingestion)
and frozen necropsy tissues.
Since it has been difficult for the FDA to determine if jerky treats or other diseases are
the cause of illness/death in reported cases, the Veterinary Information Network (VIN)
and veterinary pathologists are helping with the investigation. If a veterinarian has a
suspected case (where signs occur within four days of ingestion of a jerky treat) he or she
may complete a survey on VIN. Veterinarians who are not members of VIN may call
toll-free (800) 700-4636 to obtain a temporary login and password to access the survey.
In some cases, veterinarians may also be asked to submit: samples of suspect jerky
(provided the package lot number is available), frozen tissue samples from necropsies
and urine from active cases when samples are collected within 24 hours of jerky treat
ingestion.
More than a pet to her.
More than a sample to us.
Locations in: Marshfield, WI; Milwaukee, WI; Madison, WI; Cleveland, OH; Akron, OH
1000 North Oak Avenue
Marshfield, WI 54449
www.marshfieldlabs.org
9
In Memoriam — Dr. Quintin Metzig
Dr. Quintin C. Metzig passed away on March 2, 2014. He was born on April 4, 1917, on his family’s homestead in Zittau,
Wisconsin. His industrious German family farmed, hunted, trapped, fished, and gardened, making full use of the land.
Quintin received his primary education in a one-room church school where the academic calendar revolved around planting and
harvesting. His father frequently took him to school in a horse-drawn sleigh in winter. As a teenager, he boarded with a local
family during the week so that he could attend Oshkosh High School. The day Prohibition was repealed, 16-year-old Quintin
celebrated at John Brown’s, an Oshkosh bar that would later be renamed Oblio’s.
As a student at the University of Wisconsin, he came home from Madison one Christmas, trapped 200 muskrats, and sold the pelts
for $400- the total cost of his freshman year. He went on to Michigan State University, where he earned his degree in veterinary
medicine and a number-one academic ranking.
While working in the cafeteria at Michigan State his senior year, he met Jeanne Mosson of Ionia, Michigan, a junior studying
home economics. By spring term, they were going on two dates a day. The two were married the day Jeanne graduated, in 1946.
Quintin and Jeanne made their home in Oshkosh, where they had six children and worked diligently to raise their family and
build Quintin’s veterinary practice- the only one in Winnebago County at a time when the county comprised more than 2,000
farmers. The bulk of Quintin’s work was with large farm animals, primarily cows. He was named Wisconsin Veterinarian of the
Year in 1958 and became a well-known figure among local farmers in his 45 years as a veterinarian.
Quintin was a devoted tree farmer who, over the course of his life, oversaw the planting of approximately 100,000 seedlings,
many of which stand tall today. He was also a prolific grower of shiitake mushrooms, which he and Jeanne studied while traveling
in Japan, one of many countries they visited together.
In addition to travel, farming, and being a veterinarian, Quintin enjoyed driving his tractor, eating brick cheese and licorice, and
going to lunch with his ROMEO (Really Old Men Eating Out) group every Wednesday.
Quintin was involved in numerous charitable endeavors including being the major donor which helped found the NEWVMA
Scholarship Fund which has awarded over $10,000 to third year University of Wisconsin veterinary students since it was started
in 1997. In Dr. Metzig’s memory, NEWVMA will be donating $100 to the NEWVMA Scholarship Fund.
Limited Seats Still Available
for Dentistry CE
NEWVMA has invited Animal Health
International to the Fox Valley area to provide
veterinarians and technicians up to 16 hours
of CE credit with lectures and hands on
laboratories under the guidance of two board
certified veterinary dentistry specialist, Dr.
Brooke Niemiec and Dr. Dale Kressin.
On Saturday and Sunday, April 12th and 13th,
2014 there will be lectures on oral pathology,
periodontal disease and therapy, dental
radiology and interpretation, dental extractions
and veterinary dentistry marketing. The wet
labs will include hands on dental radiology,
prophylaxis, extractions, bonded sealants,
clindoral and regional anesthesia.
The technician wet lab is full. There are still
a limited number of seats available for the
veterinarian wet lab as well as the lectures
for both veterinarians and technicians. To
register (or if you would like to be placed on
the waiting list) contact Tom Knutson at
[email protected]
or 970-347-3217. A registration link for this
program is available at www.newvma.org
In Memoriam —
Dr. James Walsdorf
James A. “Doc” Walsdorf, 86, formerly of St. Anna, passed away last year, March
10, 2013. He was born October 24, 1926, in St. Anna, son of the late Dr. I.A.
& Johanna (Wollner) Walsdorf. Doc attended St. Ann Catholic School and was
a 1945 graduate of Kiel High School. After finishing his undergraduate studies
he attended Kansas State University and was a 1956 graduate of The College of
Veterinarian Medicine.
In June of 1956, Doc began his career as a large animal veterinarian at the St.
Anna Veterinarian Clinic, which his father founded in 1921 . He continued his
practice until his retirement in 1987. Doc was an active and lifetime member of
many veterinarians associations, including NEWVMA, and was recognized by
the WVMA for his 50 years of service to his profession. He took great pride in the
work he did, especially helping many young veterinarians get started by offering
his home and clinic while they completed their internship.
On August 17, 1957, he was united in marriage to Ruth Bradley at St. Peters
Catholic Church in Oshkosh. Doc was a member of St. Ann Catholic Church, St.
Anna. He was a proud supporter and active member of many organizations in the
community, including, New Holstein St. Vincent DePaul, Knights of Columbus
and the St. Anna Sportsmen Club. He was a 50 year, charter member of the East
Shore Lions Club holding many offices throughout the years. Doc served as
Bank Director to Marytown Bank and later M&I Bank. He also enjoyed his time
volunteering as a Meals on Wheels driver and doing patient transportation. He
was a founding member of the Men’s Breakfast Club at Calumet Homestead and
served on the CPES School Board for many years. He was also a 56 year member
of the Night Crawlers Card Club.
A Gift of a Lifetime
Oral Histories
in Veterinary Medicine
by Fred J. Born, DVM
We all know of an associate, colleague,
mentor or friend that is a veterinarian
who is in their 70s, 80s or even in
their 90’s. A recent survey conducted
by the American Veterinary Medical
History Society revealed that this age
group had experienced the greatest
change in one generation in the history of our profession. It is suggested,
if anyone would be interested in conducting an interview of a veterinarian who would be willing to share his
professional story, it would be a gift of
a lifetime. What a great gift-- a transcribed, written record of that interview to accompany the spoken word
for this veterinarian and his/her family to cherish for generations to come.
Next year the WVMA will be celebrating their 100th Anniversary
1915 – 2015. It will be an exciting
year, reviewing the great history of
the WVMA and featuring some of the
outstanding WVMA members in our
local communities and including our
own leaders on the state and the national scene.
Anyone who would be interested in
this very rewarding experience need
only download the interview guide
and some examples of oral histories in
veterinary medicine. To do this, just
email: Dr. Fred J. Born fjborn@att.
net and request the complete information.
In his early days he coached his daughter’s softball teams, loved tailgating and
watching Packers and Brewers games. He found great comfort and relaxation
at the family cottage on Wilkes Lake and at the cabin in northern WI. In his
retirement, he also enjoyed his many travels with Ruth. Doc loved his time spent
golfing, bowling, sturgeon fishing, and deer hunting, especially bow hunting.
Above all else, doc most enjoyed the time he spent with his family, especially his
wife , children and grandchildren.
In Dr. Walsdorf’s memory, NEWVMA will be donating $100 to the NEWVMA
Scholarship Fund.
10
11
Tired of Winter?
Upcoming Events and
Continuing Education
Opportunities
MARCH
Friday March 28
Clarifide Genomic Technology –
Key Learnings and Applications of a
Game Changing Technology
4 CE hours*
10 am, Liberty Hall, Kimberly, WI
RSVP to Cheryl Marti at 608-206-0635
or [email protected]
APRIL
Looking forward to spending time outside
in the sunshine and fresh air?
Then join us for the NEWVMA Spring Social
on June 14th!
Save the Date! NEWVMA is hosting our Spring Social on Saturday, June 14th at the
Galloway House & Village in Fond du Lac, WI. There will be activities and food available
from 11 am to 3 pm as your family strolls the grounds, including guided tours of the
Veterinary Museum. The Fred J. Born Veterinary Office is one of only 28 veterinary
Saturday and Sunday April 12-13
Small Animal Dental Lecture and Wet Lab
for Veterinarians and Technicians
Appleton, WI
Earn up to 16 CE hours.
Registration Details Inside!
historical museums in the country. It includes hundreds of items of veterinary historical
MAY
shop with working equipment and many more century-old structures to take you back
The rest of the Galloway House & Village grounds are also available for you to explore.
They include: the famous 30-room Galloway Victorian mansion, a school house, a print
100 years.
Proceeds from the NEWVMA Spring Social will benefit maintenance and upkeep for
the Veterinary Museum at the Galloway House & Village. Help support a good cause
and enjoy the company of your fellow veterinary professionals--stay tuned for details!
Northeastern Wis. Veterinary Medical Association
N3354 Meade St.
Appleton, WI 54913
Tuesday May 20
Veterinary Medicine in the 21st Century:
Strategies for Success Now
and in the Future
6 CE hours*
Appleton, WI
Registration Details Inside!
*CE credits provided by NEWVMA
significance from old surgical texts and diagrams to antique diplomas and tools.