The team at NorthStar VETS is doing innovative and amazing things every day as they work to advance the level of care available to your pet. This series of posts highlights cool cases at NorthStar VETS and the types of things done to save pets and improve their quality of life. These are cases using innovative and cutting-edge medical techniques, and/or stories of pets beating the odds. This is the story of Abby, a patient of our Surgery team.

About Abby
Abby is an 8 year old Samoyed who initially presented to NorthStar VETS for 5 days of coughing and an episode of falling where she was suspected to hurt her wrist. She was taken in through the Emergency service, who did not find any significant abnormalities with her forelimb. They did notice, however, that her breathing was somewhat labored. Radiographs of her chest were taken which showed a large volume of free air within the thoracic cavity (“collapsed lung.”) (Fig 1). Pneumothorax is a very serious problem that can result in death if not treated appropriately.

Abby’s Condition
In order to allow Abby’s lungs to expand appropriately, the emergency doctors performed a thoracocentesis, a procedure in which a small needle is inserted through the chest wall to remove the trapped air. She tolerated the procedure well, but then built up more air rapidly. The recommended course of action at that point was a CT scan to look for any areas of the lung that might be damaged, allowing the air Abby was breathing to collect within her chest cavity. There are several possible reasons why a lung lobe might leak air. Diseases in which the lung tissue is unhealthy (and thus “leaky”) such as cancer or severe pneumonias/abscesses are one cause. Trauma can also damage lung tissue and cause air leakage. Another possibility is the formation of a bulla or bleb, which can then rupture and leak air.

Lung bullae or blebs (Fig 2) are areas of the lung where air collects under the lung tissue covering (viscera) or within small areas of the lung itself. These areas are more delicate than normal lung tissue, and can rupture, leading to a massive volume of air collecting in the thorax. Certain breeds are more predisposed to developing pulmonary bullae or blebs, such as Arctic breeds (Huskies, Samoyeds, etc.) There is usually no known cause of these areas forming.

Abby’s Treatment
Occasionally, lungs that are leaking can seal over on their own if the air is removed, making more aggressive intervention unnecessary. However, if the air is quickly leaking and collecting, surgery may be needed to stop the leak. Abby’s air was collecting very fast, and her initial chest radiographs did not show any definitive cause for the problem. A CT scan was performed under general anesthesia. On Abby’s CT, there was no evidence of cancer or pneumonia. There were no definitive blebs or bullae, but a few areas that appeared slightly abnormal. Abby’s owner and the surgeons discussed options, which included waiting to see if her lungs would seal over on her own as there were no definitive lesions, or exploratory surgery of her chest. Abby’s owner and the surgeon elected to do exploratory surgery of Abby’s chest, which required a median sternotomy (in which a surgical saw is used to section the bones in the middle of the chest, giving us access of the entire chest.) It was found that Abby had three abnormal areas of blebs/bullae, one of which was actively leaking air (see video below). All three areas were resected with the Ligasure, a vessel-sealing instrument that is useful also for sealing lung tissue on the periphery. After removal of all three areas, the air leakage had stopped. A temporary chest tube was placed to remove any fluid that collected postoperatively. Abby’s chest was repaired with surgical wires, and she recovered well in the ICU.

How Things Went for Abby
The day after surgery, Abby was up, walking, and eating. She was breathing very well and her chest tube was removed. Abby was discharged to the care of her owner 2 days postoperatively and continued to do well at home. Abby came back in for her suture removal two weeks later, and was completely back to normal at home.

Learn more about the Surgery service at NorthStar VETS

Kelly Kraus, VMD, DACVS
Dr. Kraus is originally from Connecticut. She obtained a Bachelor of Science degree from Loyola University in Baltimore, Maryland in 2003 before moving to Philadelphia, where she did molecular genetics research for two years at the University of Pennsylvania. Dr. Kraus then completed veterinary school at the University of Pennsylvania in 2009. After graduating, she completed a rotating internship at Oradell Animal Hospital in Paramus, NJ. She then moved to Texas to complete a one-year internship in surgery at Gulf Coast Veterinary Specialists. She was fortunate to then move back to New Jersey for a three-year residency in surgery at Red Bank Veterinary Hospital, which she completed in 2014.

She is excited to be part of the surgery team at NorthStar VETS. Her special surgical interests include, but are not limited to, wound management and reconstructive surgery, surgical oncology, cardiothoracic surgery, and hepatobiliary surgery. Dr. Kraus also enjoys management of orthopedic conditions. She is trained in the tibial plateau leveling osteotomy (TPLO) for cranial cruciate ligament disease. Outside of work, Dr. Kraus enjoys spending time with her family, cooking, traveling, and helping her local SPCA.

---

The information presented on this web site is not intended to take the place of your family veterinarian’s advice and is not intended to diagnose, treat, cure or prevent any disease. Discuss this information with your own veterinarian to determine what is right for your pet. All information is intended for your general knowledge only and is not a substitute for medical advice or treatment for specific medical conditions. We can not and do not give you medical advice via this blog. The information contained in this online site and emails is presented in summary form only and intended to provide broad understanding and knowledge. The information should not be considered complete and should not be used in place of a visit, call, consultation or advice of your veterinarian. We do not recommend the self-management of your pet’s health problems.

1. FDA Alerts Pet Owners About Potential Pentobarbital Contamination in Canned Dog Food Manufactured by The J.M. Smucker Company, Including Certain Gravy Train, Kibbles ‘N Bits, Ol’ Roy, and Skippy Products

---

2. Raws for Paws of Minneapolis, MN is recalling approximately 4,000 pounds of its 5 lb. and 1 lb. chubs of Ground Turkey Pet Food because they have the potential to be contaminated with Salmonella. Salmonella can affect animals eating the product and there is risk to humans from handling contaminated products, especially if they have not thoroughly washed their hands after having contact with the products or any surfaces exposed to these products.

Healthy people infected with Salmonella should monitor themselves for some or all of the following symptoms: nausea, vomiting, diarrhea or bloody diarrhea, abdominal cramping and fever. Rarely, Salmonella can result in more serious ailments, including arterial infections, endocarditis, arthritis, muscle pain, eye irritation, and urinary tract symptoms. Consumers exhibiting these signs after having contact with this product should contact their healthcare providers.

Pets with Salmonella infections may be lethargic and have diarrhea or bloody diarrhea, fever, and vomiting. Some pets will have only decreased appetite, fever and abdominal pain. Infected but otherwise healthy pets can be carriers and infect other animals or humans. If your pet has consumed the recalled product and has these symptoms, please contact your veterinarian.

The recalled Ground Turkey Pet Food was distributed throughout Minnesota, Wisconsin, and Iowa directly to consumers and through online mail orders.

The recalled product is packaged into 1-pound and 5-pound sealed plastic tubes, also known as chubs. The chubs are packaged into regular Turkey Pet Food cases and Pet Food Combo Pack cases, which contain a variety of pet food products. The products in question have case codes of 9900008, 9900009, 9900014, and 9900015. The manufacture date of Turkey Pet Food cases is 10/12/2017, and the manufacture dates of Combo Pack cases are between 10/12/2017 and 2/2/2018.

Two illnesses have been reported to date in connection with this problem.

The potential for contamination was noted after testing by the Minnesota Department of Agriculture (MDA) revealed the presence of Salmonella in some packages of Turkey Pet Food.

Production of the product has been suspended while MDA and the company continue their investigation as to the source of the problem.

Consumers who have purchased Turkey Pet Food should discontinue the use of the product and contact Raws for Paws to determine if their product is subject to this recall and more information about disposal or return instructions. Consumers with questions may contact the company at 612-465-0372.

---

3. The FDA is alerting pet owners to a history of four recalls of and multiple complaints associated with Darwin’s Natural and ZooLogics pet foods, manufactured by Arrow Reliance Inc., dba Darwin’s Natural Pet Products, over the period from October 17, 2016 to February 10, 2018. In each instance, the company recalled these products after being alerted to positive findings of Salmonella and/or Listeria monocytogenes in samples of their raw pet food products.

In its most recent recall, on February 10, 2018, Arrow Reliance/Darwin’s Natural recalled ZooLogics Duck with Vegetable Meals for Dogs (Lot #41957) and ZooLogics Chicken with Vegetable Meals for Dogs (Lot #41567) because the products may be contaminated with Salmonella and therefore have the potential to cause salmonellosis in humans and animals. The company states that it only sells its products online through direct-to-consumer sales.

The FDA has investigated six complaints of illness and death in animals that have eaten the recalled products.

Arrow Reliance/Darwin’s Natural has notified its customers directly of the recalls, but has so far not issued any public notification announcing this or any of the previous recalls.

This issue is of particular public health importance because Salmonella can make both people and animals sick.

As part of an ongoing investigation into complaints associated with products manufactured by Arrow Reliance/Darwin’s Natural of Tukwila, WA, the FDA has confirmed that new samples of Darwin’s Natural Pet Products raw pet foods have tested positive for Salmonella. These raw pet foods include ZooLogics Duck with Vegetable Meals for Dogs Lot #41957 and ZooLogics Chicken with Vegetable Meals for Dogs Lot #41567.

The latest recall was triggered by a complaint of an adult dog that had recurring diarrhea over a nine-month period. The dog tested positive for Salmonella from initial testing by the veterinarian and by follow-up testing by the FDA’s Veterinary Laboratory Investigation and Response Network (Vet-LIRN). The Darwin’s Natural raw pet food that the dog had been fed was also positive for Salmonella.

Arrow Reliance/Darwin’s Natural is aware of the dog’s illness and the positive results and initiated a recall on February 10, 2018 by directly notifying its customers via email. The firm has not issued a public recall notice.

Since October 2016, Arrow Reliance/Darwin’s Natural has initiated four recalls and had six reported complaints (some referring to more than one animal) associated with their raw pet food products, including the death of one kitten from a severe systemic Salmonella infection. The Salmonella isolated from the kitten was analyzed using whole genome sequencing and found to be indistinguishable from the Salmonella isolated from a closed package from the same lot of Darwin’s Natural cat food that the kitten ate.

In addition to reports of illnesses associated with Salmonella contamination in the products, the FDA is aware of complaints of at least three animals who were reportedly injured by bone shards in the Darwin’s Natural raw pet food products.

Since 2016, Arrow Reliance/Darwin’s Natural has recalled the following raw pet food products:

Darwin’s Natural Selections Duck with Organic Vegetables Meals for dogs, due to Salmonella Lot #40487, manufacture date 9/29/17, in 2 lb. flexible film packages, recalled on 12/04/17 Darwin’s Natural Selections Chicken with Organic Vegetables Meals for Dogs, due to Salmonella and Listeria Monocytogenes Lot #40727, manufacture date 9/26/17, in 2 lb. flexible film packages, recalled on 12/04/17 Darwin’s Natural Selections Turkey with Organic Vegetables Meals for Dogs, due to Salmonella Lot #39937, manufacture date 8/24/17 and Lot #40507, manufacture date 9/20/17, in 2 lb. flexible film packages, recalled on 12/04/17 Darwin’s Natural Selections Frozen Duck Meals for Cats, due to potential contamination with Salmonella Lot #38277, manufacture date 6/1/17, in 2 lb. flexible film packages, recalled on 09/08/17 Darwin’s Natural Selections Frozen Raw Beef with Organic Vegetables Meals for Dogs, due Listeria Monocytogenes Lot #3146070, manufacture date 7/21/16, in 2 lb. flexible film packages, recalled on 10/17/16 Darwin’s Natural Selections Frozen Raw Turkey with Organic Vegetables Meals for Dogs, due to Listeria Monocytogenes Lot #3142070, manufacture date 7/20/16, in 2 lb. flexible film packages, recalled on 10/17/16 ZooLogics Frozen Raw Turkey with Vegetable Meals for Dogs, due to Listeria monocytogenes Lot #3155070, manufacture date 7/25/16, in 2 lb. flexible film packages, recalled on 10/17/16

The recalled lot codes and the manufacturing dates are printed directly on the flexible film packages.

Arrow Reliance/Darwin’s Natural initiated each recall of the product lots by notifying customers directly via email. The company states that the raw pet foods are only sold online through direct-to-consumer sales. This contaminated raw pet food is of particular public health importance because of the potential hazard to both human and animal health. Pets can get sick from Salmonella, but may also be carriers of the bacteria and can infect humans. Pets do not have to be apparently ill to be able to pass Salmonella onto their human companions.

Raw pet food is more likely than other types of pet food to contain Salmonella and Listeria monocytogenes. Pet owners who choose to feed raw pet food should be aware of the risks associated with these products. The FDA has a zero-tolerance policy for Salmonella or other pathogenic bacteria in all pet food, meaning the agency will take action, as appropriate, against any pet food found to be contaminated with the harmful bacteria.

What are the Symptoms of Salmonella Infection (Salmonellosis)?

People infected with Salmonella can develop diarrhea, fever and abdominal cramps. The illness usually lasts 4 to 7 days, and most people recover without treatment.

Pets do not always display symptoms when infected with Salmonella, but signs can include vomiting, diarrhea (which may be bloody), fever, loss of appetite and/or decreased activity level. Pets can pass Salmonella to humans without showing any signs of the illness themselves.

How Soon After Exposure do Salmonellosis Symptoms Appear?

Most people infected with Salmonella develop diarrhea, fever, and abdominal cramps 6 to 72 hours after infection.

Although not all pets display symptoms when infected, those who do may have symptoms within 72 hours of infection. Pets do not need to display symptoms to be able to pass Salmonella onto their human companions. Once Salmonella gets established in the pet’s gastrointestinal tract, the animal can shed the bacteria when it has a bowel movement, and the contamination will continue to spread.

What are the Complications of Salmonellosis?

In some people, the diarrhea may be so severe that they need to be hospitalized. In these patients, the Salmonella infection may spread from the intestines to the blood stream and then to other body sites and can cause death unless the person is treated promptly with antibiotics.

Who is at Risk of Salmonellosis?

Young children are particularly at risk for salmonellosis if they handle or ingest contaminated pet food or unwashed bowls used to feed the pet food. Very young children may also be exposed by crawling on or otherwise touching contaminated surfaces and put their hands or other objects in their mouth (without handwashing), or have oral contact with an animal that has consumed contaminated pet food, or with that animal’s feces. Once Salmonella gets established in the pet’s gastrointestinal tract, the animal can shed the bacteria when it has a bowel movement, and the contamination will continue to spread.

Others at increased risk of serious infection are the elderly, pregnant women, and people with weakened immune systems.

As with humans, dogs and cats who are very young, very old, or have health conditions are particularly at risk for developing salmonellosis.

What are the Symptoms of Listeria Monocytogenes Infection (Listeriosis)?

Gastrointestinal symptoms including diarrhea, fever, and muscle aches are symptoms of infection with Listeria monocytogenes.

Listeriosis is not common in pets, and when infected, typical symptoms include diarrhea and vomiting. Pets can pass Listeria monocytogenes to humans without showing any signs of the illness themselves.

How Soon After Exposure do Listeriosis Symptoms Appear?

Gastroenteritis caused by Listeria monocytogenes has a relatively short incubation period, from a few hours to 2 or 3 days. The severe, invasive form of the illness can have a very long incubation period, estimated to vary from 3 days to 3 months.

Although not all pets display symptoms when infected, those who do may have symptoms within a matter of a few hours, but possibly weeks after infection. Pets do not need to display symptoms to be able to pass Listeria monocytogenes onto their human companions. Once Listeria monocytogenes gets established in the pet’s gastrointestinal tract, the animal can shed the bacteria when it has a bowel movement, and the contamination will continue to spread.

What are the Complications of Listeriosis?

Listeriosis can be fatal, especially in certain high-risk groups. In addition, when Listeria monocytogenes infects a woman during pregnancy, it can cause miscarriage, stillbirth, premature labor, and serious illness or death in newborns.

In severe cases of listeriosis in pets, symptoms include fever, muscular and respiratory signs, abortion, and death.

Who is at Risk of Listeriosis?

High-risk groups include the elderly, people with weakened immune systems and certain chronic medical conditions (such as cancer), and pregnant women.

Very young children are at risk if exposed to Listeria monocytogenes by crawling on or otherwise touching contaminated surfaces and put their hands or other objects in their mouth (without handwashing), or have oral contact with an animal that has consumed contaminated pet food, or with that animal’s feces. Once Listeria monocytogenes gets established in the pet’s gastrointestinal tract, the animal can shed the bacteria when it has a bowel movement, and the contamination will continue to spread.

Others at increased risk of serious infection are the elderly, pregnant women, and people with weakened immune systems.

As with humans, dogs and cats who are very young, very old, or have health conditions are at an increased risk for developing listeriosis.

What Do Consumers Need To Do?

Consumers should not feed their pets recalled lots of raw pet food manufactured by Arrow Reliance Inc. Consumers who purchased this raw pet food should throw it away. People who think they might have become ill or their pets may be ill from exposure to contaminated raw pet food should talk to their health care providers or veterinarians.

Consumers who had this product in their homes should clean their refrigerator and clean and disinfect all bowls, utensils, food prep surfaces, pet bedding, toys, floors, and any other surfaces that the food or pet may have had contact with. Because animals can shed the bacteria when they have bowel movements, it’s particularly important to clean up the animal’s feces in yards or parks where people or other animals may become exposed.

Pet owners who opt to feed their pets a raw diet should consult FDA’s Tips to Prevent Foodborne Illness from Raw Pet Food.

People who think they might have become ill due to exposure to contaminated raw pet food or the feces of pets that have eaten contaminated raw pet food should talk to their health care providers.

Contact your health care provider if you have diarrhea that lasts for more than three days, or is accompanied by high fever, blood in the stool, or so much vomiting that you cannot keep liquids down and you pass very little urine.

People who think their pets have become ill after consuming contaminated raw pet food should contact their veterinarians. Veterinarians who wish to have dogs tested for Salmonella may do so through the Vet-LIRN Network if the pet is from a household with a person infected with Salmonella.

The FDA encourages consumers to report complaints about this and other pet food products electronically through the Safety Reporting Portal or by calling their state’s FDA Consumer Complaint Coordinators.