Grain Free Diets High in Legumes Associated With Cardiomyopathy in Golden Retrievers

Given the marketing push behind grain free diets, I feel urgency to share the following information.  Veterinary Cardiologist, Dr. Joshua Stern, has noticed a a disturbing trend in dogs. Golden Retrievers are developing acquired dilated cardiomyopathy, (DCM) caused by lack of an amino acid called taurine. The other form of dilated cardiomyopathy is called inherited or familial DCM.  It is a common cause of heart failure in large breed dogs including boxers, dobermans and great Danes.

According to Dr. Janet Olson, “Taurine is an amino acid that is found in high concentrations in heart and muscle. Among its many functions, it aids in normal contractile function. Evidence shows that taurine helps mediate calcium channel transports and modulates calcium sensitivity of the myofibrils.”

Taurine deficiency causing cardiomyopathy in cats was a huge problem in the late 80’s. Cats are obligate carnivores who cannot make taurine from other amino acids. They must consume it in their diet. After commercial diets were supplemented with taurine, the incidence of DCM decreased dramatically. The problem was rarely seen in dogs because dogs can synthesize taurine from two other amino acids, methionine and cysteine.

Unfortunately, DCM is now being seen in dogs on grain free diets. Dr. Stern noticed an increased incidence of acquired DCM in Golden Retrievers on grain free diets that  contain high levels of legumes. Merriam-Webster defines legumes as the fruit or seed of leguminous plants (peas or beans) used for food.  Examples include peas, alfalfa, beans and peanuts.

Dogs who have been fed or are currently on a grain free diet should be tested for taurine levels. A simple blood sample is all that is required. If the level of taurine is below normal limits, veterinary cardiologist, Dr. Janet Olson, recommends chest films. If the heart is enlarged, then more diagnostics are needed to to access cardiac function.

Clinical signs of DCM including coughing, exercise intolerance and an increased respiratory rate. Unlike heart disease caused by leaky valves, patients with  DCM usually don’t have heart murmurs. That is why Dr. Olson recommends chest films to access heart size.

Treatment begins with changing the diet to one without legumes. In dogs with low blood levels of taurine, supplementation may be needed. Dogs suffering from clinical signs of heart failure may require oxygen therapy as well as diuretics to reduce fluid build-up and other heart specific medications. If acquired DCM is caught early, the heart damage can be reversed with taurine supplementation. Unfortunately, even with aggressive therapy and supplementation, dogs with severe cardiac dysfunction may succumb to this disease. My colleague told me about a family with two dogs that developed acquired DCM. Both had been fed grain free diets since they were pups. Even with aggressive therapy, one of the dogs died. He was only three years old!

In my own practice, I am seeing a large number of owners relying on the advice they receive from the (let’s be honest – untrained ) clerk at the pet store rather than their veterinarian. The marketing campaigns touting grain free diets make things even worse. When grain is taken out of dog food, it is replaced with fat or a carbohydrate with an even higher glycemic index. Because of this, I am seeing more diabetes and pancreatitis in dogs. I am also seeing more urinary tract infections and crystals in dogs on grain free diets.  Now I have to look for acquired DCM as well. While I’m making a small fortune fixing the medical problems caused by grain free diets, it breaks my heart to see these animals suffer needlessly.  If your veterinarian suggests a specific diet, especially a prescription diet, please heed their advice. Don’t fall for a slick marketing campaign based on the human grain free craze. Your dog’s health is depending upon it.



-Olson, Janet. Taurine Deficiency Induced Dilated Cardiomyopathy in Golden Retrivers. Memo, Veterinary Cardiology Specialists.

‘S. zooepidemicus’ Infects Dogs at Maricopa County Animal Shelter

On January 21, 2018, Mary Martin, Director at Maricopa Animal Care Centers (MCACC), announced that Streptococcus equi subspecies zooepidemicus was found at their east valley shelter located at 2630 W. Rio Salado Parkway in Mesa, AZ. S. epidemicus is a serious bacterial disease that effects horses, dogs, cats and immune compromised people in rare circumstances. As of yet, there are no confirmed cases of human infection after direct contact with infected dogs. Most of the human cases occurred after consuming unpasteurized dairy products from infected cows or working with infected horses. Infected people developed pharyngitis, glomerulonephritis, meningitis and pneumonia.

S. epidemicus is a bacterium often found in the respiratory tract of horses and ruminants including goats and cows. When given the opportunity, it will invade other species. In dogs, it usually causes hemorrhagic pneumonia. Although MCACC has not declared this an outbreak, previous outbreaks at other facilities throughout the U.S. have been associated with crowded, kennel-like situations. At this time 30 dogs are showing clinical signs of illness in the Arizona facility.

Clinical signs of S. epidemicus  in dogs include:

  1. Coughing, sometimes bringing up a bloody material
  2. Nasal Discharge, sometimes bloody
  3. Anorexia
  4. Fever
  5. Bloody Urine
  6. Vomiting
  7. Labored Breathing
  8. Death

S. epidemicus is diagnosed by either culturing the bacteria or with a PCR test performed on samples taken from infected tissues. The advantage with PCR is a much faster turn around time as well as better accuracy. The advantage with culture is that antibiotic sensitivity can be performed to determine the best antibiotic for treatment. Early diagnosis and treatment with antibiotics is the key to saving effected dogs. Unfortunately, doxycycline resistance is starting to occur with S. epidemicus.

To prevent further infections, MCASS has shut down all playgroups and non-mandated services at the east location. They have held press conferences to warn local veterinarians about the disease. They are also adopting out animals for free in order to get them out of the shelter before contracting this disease. This last action step is surprising to many including me for fear of spreading the disease to dogs outside the shelter. According to the New York City Department of Health and Mental Hygiene, ‘Streptococcus equi subspecies zooepidemicus is an extremely rare pathogen in dogs and typically limited to shelter settings. Unpublished observations suggest transmission of Streptococcus equi subspecies zooepidemicus from shelter dogs to other dogs following adoption is unlikely.’

Although I understand their decision is based on the above information, I still worry that this action may end up spreading the disease. I am especially worried about animals and people with compromised immune systems including chemotherapy patients and valley fever patients. Therefore, I recommend isolating newly adopted pets from this shelter from all other animals for a least 2 weeks. Do not bring your existing pets to this shelter. Clean all equipment including bowls, leashes and combs between animals. Last, wash hands well and change clothes after visiting the shelter.  In other words, I would not adopt pets from there right now and strongly feel the facility should be quarantined until the incubation period has passed.

For a more detailed discussion of this horrible disease, watch Dr. Cynda Crawford’s presentation at the UF Maddie’s Shelter Medicine Conference 2011 on Streptococcus zooepidemicus. 


-Slavinski, Sally. “2009 Veterinary Alert#1: Streptococcus equi subspecies zooepidemicus Identified in Shelter Dogs.” NYC Health:  NEW YORK CITY DEPARTMENT OF HEALTH AND MENTAL HYGIENE, 1.12.2008.

-Tanabe, Morgan. “More than 30 dogs showing symptoms of ‘Strep Zoo’ at Maricopa County animal shleter.” ABC15news,com, posted 1.21.18.





FDA Issues Warning for Dog Bone Treats

The Food and Drug Administration has issued a warning for dog bone treats. From November 1, 2010 to September 12, 2017, many dogs have fallen ill after eating commercially produced dog bone treats. Unfortunately, 15 dogs died. According to their report, the treats are marketed under the names, “Ham Bones, Pork Femur Bones, Rib Bones and Smokey Knuckle Bones.” Some are smoked or baked with additional chemicals added for flavor.

According to the FDA, the clinical signs reported are:

  • Gastrointestinal obstruction (blockage requiring surgical removal)
  • Vomiting
  • Choking
  • Diarrhea
  • Damage to the mouth
  • Bleeding from the anus
  • Death

As a veterinarian, I do not recommend bones of any kind. Beside the problems listed above, I see a lot of tooth fractures from bones. The large upper premolar is often fractured when the dog chews the bone. This results in a painful infection along the roots that causes a swelling under the eye. Removal of the tooth is the only way to end the pain.

More information on the FDA warning can be found at:

Trump Placed Hold on Decision to Allow Elephant Trophy Imports But Still Allows Lion Trophy Imports

It is with great dismay that I read of the Trump administration’s decision to allow importation of lion and elephant trophies. Lions and elephants are classified as ‘threatened’ which means they are likely to become endangered (become extinct in all or part of their normal habitat) soon. The ban was put in place in 2014 because the populations of endangered and threatened species in Zimbabwe and Zambia are dropping due to poaching, game hunts and loss of habitat. Zimbabwe is where the beloved Cecil the lion was killed. He was lured out of a national park for a so-called “game hunter”, Walter Palmer, to kill. These countries also allow ‘lion hunting’ which means shooting confined lions who are acclimated to humans. This is not hunting as the animals do not have any chance of escape.

‘Serengeti Elephants’ taken by Kristen Nelson

The argument made by the hunting industry is that big game hunting brings money to the local communities. According to Richard Leakey of Kenya Wildlife Service, the amount of money generated by killing wildlife is minuscule compared to the millions generated by tourists coming for ecotourism. I was fortunate to go on safari in Tanzania this year. Seeing the animals living in their native habitats was amazing. Based on the number of tourists I saw on safari, I sincerely believe what Mr. Leakey is reporting. The animals are worth far more alive than dead.

On Friday, President Trump said he would halt the import of elephant “trophies” pending his personal review. Unfortunately, he did not halt the importation of lion “trophies”. The Trump family appears to be divided on this issue. Although President Trump has expressed disgust over game hunting, two of his sons have gone on big game hunts in Africa. Lara Trump, the president’s daughter-in-law, has been campaigning for several important animal issues including providing therapy dogs for veterans, saving wild horses and burros from slaughter and tighter regulation of puppy mills. Hopefully, she will take up this issue as well.

‘Ngorongoro Crater Lions’ taken by Kristen Nelson

If you care about the ethical treatment of animals and helping Zimbabwe and Zambia care for their greatest natural resource, please express your opinion to the White House, US Fish & Wildlife Service and our Interior Department. Please join me in asking President Trump to please keep the ban in place on importation of elephant and lion “trophies”. Keeping these magnificent animals alive is the right thing to do.


– Eilperin, J & Gearan, A. ‘Trump face public and private pressure to halt elephant hunting trophy imports.’ WASHINGTON POST, 11/18/17, 6:12PM




A Tribute to Fozzie the Scottsdale Crisis Response Dog

Fozzie, the Scottsdale Crisis Response Dog died last month. This golden retriever responded to all kinds of crimes providing comfort to people suffering from psychological trauma. From homicides to school shootings and everything in between, Fozzie was there ready to help. His big brown eyes and wagging tail were simply irresistible!

Photo: Jim Vail

Animal-assisted therapy came about after studies showed that spending time with animals decrease blood pressure, heart rate, cholesterol and triglyceride levels in humans. According to his bio, Fozzie was the first full-time crisis response dog in America. He was trained by Paws With A Cause and donated to the Scottsdale Police Department where he worked for ten years. Service dogs are also being used in airports, courtrooms, schools, libraries, hospitals and with our military to reduce stress.

Hanna and Topaz help Fozzie celebrate his first anniversary with dog-friendly cupcakes. Photo: Jim Vail

Fozzie will be greatly missed by many citizens and officers of the Scottsdale Police Department. He lived life to the fullest bringing his own special furry love to all he met. Rest in peace Fozzie.

Fozzie with volunteer, Jim Vail


-Friedmann, E. et al, Social Interaction & Blood Pressure:  Influence of Animal Companions. J of Nervous and Mental Disease 17 (8): 461-465.

-Morse, Samantha. ‘Scottsdale POlice bid farewell to beloved 10-year veteran, Fozzie’, SCOTTSDALE INDEPENDENT, November 2017.

-Seigel J.M., Stressful Life Events and Use of Physician Services Among the Elderly:  The Moderating Role of Pet Ownership. J. Person Soc Psych 1990; 1081-1086.

-Serpell, J.A. Evidence for long term effects of pet ownership on human health, Pets, Benefits and Practice, Waltham Symposium 20, April 19, 1990.


Halloween Dangers for Dogs & Cats

Halloween is a fun holiday for people of all ages to dress up, trick or treat and maybe scare a friend or two. But the noises, decorations and costumes can frighten our pets. Here’s a few tips for keeping cats and dogs safe during Halloween:

  1. Pet costumes – Make sure pet costumes do not contain dyes or paints that are toxic if ingested. Costumes should fit the pet comfortably, allowing them to walk and lie down. Check around the neck and legs for elastic bands that may cut of circulation or make it difficult to breathe. Never use rubber bands! Also, make sure your pet can’t chew off and swallow their costume. Cats love to eat costume jewelry and ribbons while dogs favor the fake skeletons.
  2. Costumes – Pets often find costumes scary. People they know suddenly become monsters when wearing a costume with a mask over their face. A normally social pet may bite. As Dr. Kathleen Shaw wrote in her article, Halloween can be Spooky for Pets, “Remember, you are responsible for controlling your pet and insuring that he doesn’t bite any guests.”
  3. Decorations – Halloween decorations can be scary as well as dangerous for pets. Fake skeletons may be too realistic for some dogs to resist. Many cats find the fake cobwebs enticing. Eating these items may obstruct the animal’s gastrointestinal system leading to expensive surgery to remove the decorations.
  4. Jack-o-lanterns – Keep all pets away from jack-o-lanterns. Pets, especially cats, are drawn to the flickering light inside. After Halloween, I see many pets with singed whiskers. The battery operated candles don’t cause fires but are highly toxic if ingested. I saw a lab who suffered greatly after eating a pumpkin with a battery operated light inside.
  5. Electric cords – Keep pets away from cords to prevent electrocution.
  6. Accidental escape – The loud noises, scary costumes and open doors for trick-or-treaters lead to many lost pets during Halloween. I recommend letting your pet sit this holiday out with some treats in the back bedroom away from all the action. Play music to distract from unusual noises. Bring all animals indoors. Even when pets are in secure outdoor enclosures, there is a greater risk of theft with all the people coming and going. Please take extra care with black dogs and cats. Over my career, I have seen horrible animal abuse associated with this holiday – particularly with animals whose fur is black.
  7. Candy – Candy possesses a variety of dangers for pets. First, there is the danger of chocolate toxicity from having too many fun bars. Second, foil wrappers and lollipop sticks may causes intestinal obstruction. Third, many candies contain the artificial sweetener xylitol that causes life-threatening drops in blood sugar. One stick of sugar-free gum can kill.

With a little planning, Halloween can be fun for the entire family. Please follow these tips to make sure everyone has a good time. Happy Halloween!



Shaw, Kathleen. ‘Halloween can be Spooky for Pets’, Veterinary Partners,, 2013.

Campylobactor Infections After Contact With Puppies

A multi-state outbreak of Campylobacter has occurred in people associated with puppies from Petland as well as private breeders. According to the Centers for Disease Control and Prevention, “a total of 55 people with laboratory-confirmed infections or symptoms consistent with Campylobacter infection who live in Florida, Kansas, Maryland, Missouri, New Hampshire, New York, Ohio, Pennsylvania, Tennessee, Utah, Wisconsin and Wyoming have been linked to this outbreak.” The organism is spread through the fecal-oral route which means a person ingests feces from an infected dog. Clinical signs in dogs include vomiting, diarrhea and fever. Some dogs may be asymptomatic carriers which means they shed the organism without having any signs of illness. Humans often have severe stomach cramps in addition to fever, vomiting and diarrhea. Symptoms usually last 5-7 days.

Unfortunately, this strain of Campylobacter is resistant to many antibiotics commonly prescribed for this disease including tetracycline, azithromycin, ciprofloxacin, clindamycin and erythromycin. This makes it a dangerous bacteria for all dogs and people, most especially those with compromised or immature immune systems.

The Arizona Veterinary Medical Association, of which I am a member, encourages people to take the following precautions:

  • “Wash hands thoroughly with soap and warm water after each encounter with the dog, their food, or waste.
  • Pick up and dispose of pet waste immediately, and disinfect the area, especially in areas where children might play.
  • Thoroughly clean areas occupied by sick pets and keep them isolated from other pets in the house.
  • Don’t let pets lick areas around owner’s mouth, face, or areas with broken skin.”
  • In addition, seek medical attention immediately for all sick dogs and/or humans with gastro-intestinal disease.


-‘Multistate Outbreak of Multidrug-Resistant Campylobacter Infections Linked to Contact with Pet Store Puppies’, Outbreak Advisory, Centers for Disease Control and Prevention, posted Oct. 3, 2017.

-‘Zoonotic Disease Health Advisory: Multistate Outbreak of Human Campylobacter Infections Linked to Pet Store Puppies’ Arizona Veterinary News, AZVMA, October 2017.


National Veterinary Technicians Week begins October 15th.

Happy Veterinary Technicians Week!

October 15th through the 21st is National Veterinary Technicians Week, a time to celebrate the hard-working men and women who take care of our beloved pets. Veterinary technicians require training in a variety of areas in order to do their jobs. Here’s are partial list of all the things they do:

  • Radiology – Take dental and whole body X-rays
  • Surgical Assistance – Set up the operating room, help the veterinarians during surgery and clean-up after surgery is done
  • Anesthesia – Monitor patients during surgery
  • Record Keeping – Controlled substances, medical notes, etc.
  • Laboratory – Collect and process samples
  • Client Education – Help people care for their pets
  • Maintain & Sterilize Equipment
  • Assist Veterinarians – Restrain animals for exams, blood draws and treatments
  • Administer Treatments – Give injections, clean wounds and a variety of other things
  • Phlebotomy – Draw blood for testing and place intravenous catheters for treatments
  • Comfort Patients – This is the most important job of a veterinary technician. When pets come into the hospital, they are often frightened. Veterinary technicians provide a soothing voice and soft touch to reassure the scared patient. Many pets will pick one of the technicians as their substitute ‘mom or dad’. I know it is surprising, but dogs and cats rarely pick the veterinarian for this role!

Thank you for dedicating your lives to helping animals. To my technicians, I am so grateful for all three of you.  Veterinary technicians are the best!

Leptospirosis Risk Increased in Flooded Areas of Texas and Florida

Health officials in Texas and Florida are warning people to avoid standing water. The obvious dangers include poisonous snakes, toxins, alligators and downed electrical lines. The less obvious reasons include infectious diseases like leptospirosis. Leptospirosis is a disease carried by rats and rodents. The infective form called a spirochete is transmitted through the urine or tissues of infected animals. Dogs and humans are infected after drinking contaminated water or touching contaminated soil and then transferring the spirochete to food. The flooding from hurricane Harvey and Irma have spread the organism throughout the hard hit areas of Texas and Florida.

Symptoms in dogs include lethargy, vomiting, diarrhea, anorexia and extreme abdominal pain. The abdominal pain results from inflammation of the liver and kidneys. Even with treatment, some animals will die. The survivors often sustain damage to the kidneys and liver that require lifelong treatment. Symptoms in people include vomiting, fever and diarrhea. As with dogs and other animals, leptospirosis may cause severe liver and kidney damage that can be fatal.

Prevention is the key to preventing leptospirosis. There is a vaccination available for this disease in dogs. Initially, the dog is given two doses two to three weeks apart then annually. In addition to vaccination, avoid contact with the spirochete by limiting your pet’s contact with wildlife,  no swimming in ponds or rivers and keep them away from sick animals. For humans, follow the guidelines listed for dogs as well as practice good hygiene. Wear gloves when cleaning up after your dog, disinfect any items that come into contact with urine and wash your hands thoroughly.

More information on leptospirosis can be found at             as well as

Plague Found In New Mexico and Arizona

Another outbreak of plague has been found in New Mexico and Arizona. From January to July 2017, New Mexico has three confirmed cases of Yersinia pestis.  This bacteria causes plague in humans. Arizona prairie dogs in Cocinino county near Williams, Arizona suddenly started dying this summer. Testing revealed Y. pestis bacterium caused their deaths. Now, fleas in Navajo county have tested positive as well. Plague often occurs in the desert southwest states from May through October.

People develop plague after being bitten by a flea infected with Y. pestis within 2 to 6 days. If the bacterium is inhaled, the onset of clinical signs is only 1 to 3 days. Unlike people, cats contract the plague after eating infected rodents. Clinical signs in animals and people include swollen lymph nodes, fever and general malaise. Plague has three different syndromes in humans and cats.  Dogs are naturally resistant to the plague. Bubonic plague is the first stage that occurs when the bacterium settles into the lymph nodes of the head and neck. With time, the glands may rupture and drain a bloody material. Pneumoic plague occurs when the bacterium spreads from the lymph nodes to the lungs. Septicemic plague occurs when the bacterium enters the bloodstream and spreads throughout the body. This form is rare in cats.

Intensive treatment with antibiotics and fluids must be started early to prevent death. Infected patients, animals as well as humans, are quarantined to prevent infecting others. Because of the extremely poor prognosis and rapid progression of the disease, treatment is often started before an actual diagnosis is confirmed. If plague is suspected, start treatment.

Avoiding the bacterium is the key to prevention. Keep cats indoors to prevent exposure to rodents. For the benefit of humans and cats who live with dogs, routinely use flea control products on the dogs. Clear out rodent habitats around homes. Humans should wear gloves when handling wild animals. Most human deaths are in either hunters who were bitten while handling their prey or veterinary professionals who were exposed when treating a sick cat.  This happens to vets and staff because draining buboes on the head and neck look similar to cat fight abscesses. More information can be found at the Centers for Disease Control.


-Hafner, John. ‘Plague in Arizona: fleas found carrying the infectious disease.’ USA TODAY Network, Published 8/16/17.

-Morrison, Wallace. ‘Plague’. Balckwell’s Five-Minute Veterinary Consult, Canine and Feline, 5th edition, Wiley-Blackwell Publishers