TB in cats fed Natural Instinct - please make your cat clients aware

RE: TB in cats fed Natural Instinct - please make your cat clients aware

Evelyn Barbour-Hill — Wed, 29 May 2019 16:07:33 GMT

[quote user="Andreas Ege"]Does evaluation of dental pockets allow to judge dental/ periodontal disease?[/quote]

Yes.

It's of considerable significance.

There's some trouble in interpreting minor changes though. For instance, 1mm or even 0.5mm improvement can be significant in man, but not, in my opinion, in the dog.

RE: TB in cats fed Natural Instinct - please make your cat clients aware

Andreas Ege — Wed, 29 May 2019 08:57:22 GMT

Thanks for the dental clarifications.

Does evaluation of dental pockets allow to judge dental/ periodontal disease? If I remember right the first paper did look into that as well and found quite some improvements. If not I guess I have to re-think my opinion.

RE: TB in cats fed Natural Instinct - please make your cat clients aware

Evelyn Barbour-Hill — Mon, 27 May 2019 23:41:04 GMT

[quote user="Rob Davis"]

[quote user="Andreas Ege"]And while I'm not a dentist if I understood dentistry right, plaque and tartar come before periodontal disease. [/quote]

As Lucy has said, plaque certainly is the precursor to periodontal disease rather than calculus. It is important to note, however, that it is subgingival plaque which is the cause, NOT supragingival, and it is unlikely that bones etc have much effect beneath the gingival margin. As the Australian study quoted above shows, cleaner crowns does not necessarily equate to reduced levels of periodontal disease.

[/quote]

Wot Rob said.

And to be a little more exact, it's the thickening and maturation of subgingival plaque which originates periodontal disease. Calculus formation is of wonderful irrelevance in the pathology.

RE: TB in cats fed Natural Instinct - please make your cat clients aware

Rob Davis — Mon, 27 May 2019 10:03:26 GMT

[quote user="Andreas Ege"]And while I'm not a dentist if I understood dentistry right, plaque and tartar come before periodontal disease. [/quote]

RE: TB in cats fed Natural Instinct - please make your cat clients aware

Lucy Fleming — Mon, 27 May 2019 09:56:32 GMT

It kind of makes sense to me - bone isn't yielding enough to get to the gum margin, cartilage/ "gristle" more so but still quite a rubbery rather than abrasive texture - kind of like those rubber-bristled finger brushes? Tendon/ ligament/ connective tissue might "shred" enough to get to the gumline but will be dependent on chewing behaviour, I would have thought?

RE: TB in cats fed Natural Instinct - please make your cat clients aware

Virginia Campbell — Mon, 27 May 2019 09:42:39 GMT

measurement of gingival recession, periodontal pocketing, alveolar bone loss etc, as well as tooth loss demonstrated that there was no difference in the occurrence of periodontal disease. The teeth looked cleaner, but weren't necessarily healthier.

Interesting!!

RE: TB in cats fed Natural Instinct - please make your cat clients aware

Lucy Fleming — Mon, 27 May 2019 08:56:05 GMT

[quote user="Andreas Ege"]And while I'm not a dentist if I understood dentistry right, plaque and tartar come before periodontal disease.[/quote]

Plaque yes, but not necessarily calculus (or rather, periodontal disease can certainly exist in the absence of calculus). I could only read the second study in full, which like you mentioned was a much smaller than the first, but it only mentioned reduction in calculus score - essentially the action of the bones was breaking away pieces of established calculus. This doesn't (necessarily) equate to good dental hygiene (in the same way that cracking some thick calculus off a carnassial in consult doesn't equate to "a dental")

Admittedly, cats are not equivalent to dogs in this situation, given their propensity towards a few unique conditions like tooth resorption, but a 1998 study published in Australia demonstrated that feral cats (essentially eating a "raw" diet of rodents, small lizards etc) had lower calculus scores than cats fed a commercial diet. However, measurement of gingival recession, periodontal pocketing, alveolar bone loss etc, as well as tooth loss demonstrated that there was no difference in the occurrence of periodontal disease. The teeth looked cleaner, but weren't necessarily healthier.

Clarke and Cameron, "Relationship between diet, dental calculus and periodontal disease in domestic and feral cats in Australia" Australian Veterinary Journal, 76, 10 pp690-693, Oct 1998

RE: TB in cats fed Natural Instinct - please make your cat clients aware

Andreas Ege — Mon, 27 May 2019 00:28:47 GMT

[quote user="Niall Taylor"]

Not very convincing as evidence if you'll forgive me. Also there are far safer ways of improving dental hygiene which don't involve the risk of serious and antibiotic resistant pathogens - raw-hide chews, chew toys, tooth-brushing and so on.[/quote]

Nothing to forgive. Scientific evidence is open to interpretation. I do find the evidence especially of the first studie rather convincing. Definitely more evidence than the evidence of the risks of feeding raw bones maybe with the exception of pathogens. While he first study didn't particularly look into pathogens they didn't notice any problems with loads of dogs over a long time and you'd expect risk for the animals should have shown if it's relevant. The second certainly was too small and too short to notice that.

I certainly agree about tooth brushing. Don't know that many people that manage the discipline, including me wife, though. Some raw-hide chews suffer the same risks as raw feeding, same as pig's ears and other similar treats. Just not as much in the focus.

[quote]Raw feeding is a lifestyle choice, pure and simple, none of the supposed health benefits stand up to scrutiny

[/quote]

Agree. Having pets is a lifestyle choice as well, though. For the second part I do disagree in the case of bones and I think ignoring or disregarding those two papers is cherry picking.
If you'd argue the risk of (potentially zoonotic) diseases does outweigh the benefits, I could go along and would only argue that that's the owners choice if they are honestly advised about risks and benefits.

As I said before, I don't think I can advocate raw feeding in general anymore, as long as there isn't more compelling evidence about any potential benefits. But to be honest, without the raw feeding movement I think hardly anybody would have looked into any research in this regard. The quality of research has certainly improved a lot in the last 10 years or so. When I started having an interest in raw food it was, in one word, crap.

Unfortunately, almost all the research with some money to back it up, concentrates on infection. For potential benefits, as far as I'm aware there was one series of papers looking into feeding cats raw that came to the conclusion it can work as well as other AAFCO compliant feeds without noting any major benefits, one study where I never could find more than an interims report (makes one wonder why) and one awfully flawed "study" by Honey's, a raw food manufacturer that also produced a couple of awfully bad booklets.

Possibly the raw food manufacturers will do some research off their own. I would prefer more independant research, though, and not just on raw feeding but all nutritional topics. After all, it's been proven that research tends to support the interests of the research investors, across pretty much all fields of science.
And excuse my cynisism, but established food research has very little interest to prove that alternatives to established commercial diets have any benefits over them, but a lot to prove it's less good.

I'll hardly convince any raw feeders to change what they're doing. So I try my best to inform them about risks and then work on a way to make it as safe as possible. But if I just tell them, how much crap it is what they are doing, they'll only stop talking to me about it. Has been done for long enough and doesn't help anybody.

Doesn't help, that a lot of practices sell traditional commercial diets and a lot of clients think they are biased because they make money from it.

I even had one practice that refused to refer a client to a nutrionist to calculate a home made liver diet for a dog that's been on home made food for years (not raw). Their argument: what they are selling is the best choice for this case. I barely believed the client, but they actually wrote it in their clinical notes. Do I need to mention the client changed vets?

RE: TB in cats fed Natural Instinct - please make your cat clients aware

Andreas Ege — Sun, 26 May 2019 23:39:27 GMT

[quote user="Lucy Fleming"]I'd be more interested to hear about periodontal disease and tooth loss than calculus scores.[/quote]

It's about prevention, not treatment...

I'd assume laboratory beagles probably have healthier teeth/ better dental care than the average pet dog. And while I'm not a dentist if I understood dentistry right, plaque and tartar come before periodontal disease.

I certainly would not recommend any hard chews, whether bones or other kinds, with already damaged teeth.

RE: TB in cats fed Natural Instinct - please make your cat clients aware

Niall Taylor — Sun, 26 May 2019 16:52:44 GMT

[quote user="Andreas Ege"]Control of dental calculus in experimental beagles, Brown & Park, 1967

Haven't got a link and the actual paper is awfully difficult to find but I got a copy at home, likely as a pdf but would need to check that. They've used a fairly big number of dogs.

Raw beef bones as chewing items to reduce dental calculus in Beagle dogs, Marx et al, 2016

https://onlinelibrary.wiley.com/doi/abs/10.1111/avj.12394

Very similar study with results so similar if I remember right that one might wonder... Only used 8 dogs unfortunately, but a lot of veterinary and nutritional studies don't have much more. Different bones used in the studies. No control groups, if I remember right. Been a while that I read them.[/quote]

Raw feeding is a lifestyle choice, pure and simple, none of the supposed health benefits stand up to scrutiny.

Niall

RE: TB in cats fed Natural Instinct - please make your cat clients aware

Julian Earl — Sun, 26 May 2019 10:57:26 GMT

It may be relatively few cases at the moment, but otherwise, should we really be surprised by this? I would be very surprised here in Lincolnshire, but in areas with enzootic TB in the cattle and wildlife population ?

Just a thought...

RE: TB in cats fed Natural Instinct - please make your cat clients aware

Lucy Fleming — Sat, 25 May 2019 09:05:30 GMT

[quote user="Andreas Ege"]Control of dental calculus in experimental beagles, Brown & Park, 1967[/quote][quote user="Andreas Ege"]Raw beef bones as chewing items to reduce dental calculus in Beagle dogs, Marx et al, 2016[/quote]

I'd be more interested to hear about periodontal disease and tooth loss than calculus scores.

RE: TB in cats fed Natural Instinct - please make your cat clients aware

Andreas Ege — Fri, 24 May 2019 18:09:54 GMT

[quote user="Rob Davis"]

[quote user="Andreas Ege"]There's a couple of good studies on laboratory beagles confirming a huge positive impact on dental health with no problems reported.[/quote]

Do you have a link to these studies?

[/quote]

Control of dental calculus in experimental beagles, Brown & Park, 1967

Haven't got a link and the actual paper is awfully difficult to find but I got a copy at home, likely as a pdf but would need to check that. They've used a fairly big number of dogs.

Raw beef bones as chewing items to reduce dental calculus in Beagle dogs, Marx et al, 2016

https://onlinelibrary.wiley.com/doi/abs/10.1111/avj.12394

RE: TB in cats fed Natural Instinct - please make your cat clients aware

Bob Russell — Fri, 24 May 2019 17:36:04 GMT

The manufacturers statement regarding TB is not exactly open and honest IMO. The suggestion that wild rodents or infected humans might be the source of the infection glosses over the fact that these cats were indoor and did not have access to rodents. Two owners may be receiving treatment but the others are not therefore unlikely to be the source.

The raw food companies also gloss over the fact that APLA and FSA inspections are there to protect human health and limit the risk of infection spreading to economically important animal species. It also should ensure the health status of exports.

Nothing they do is going to ensure that raw meat is 'safe' to eat raw!

Not sure where we stand with Foot & Mouth disease prevention should there be another outbreak in the UK.

RE: TB in cats fed Natural Instinct - please make your cat clients aware

Rob Davis — Fri, 24 May 2019 17:17:45 GMT

[quote user="Andreas Ege"]There's a couple of good studies on laboratory beagles confirming a huge positive impact on dental health with no problems reported.[/quote]

Do you have a link to these studies?

RE: TB in cats fed Natural Instinct - please make your cat clients aware

Andreas Ege — Fri, 24 May 2019 15:57:03 GMT

[quote user="Iain Richards"]A further thought, how natural is it for cats to eat deer?[/quote]

About as natural as lamb and beef. ;-)

My cat only ever got chicken or rabbit, though I guess one could source mice, rats or chicks from the reptile/ raptor market.

In regards to risks of raw feeding I agree (sadly ;-) ) that it's difficult defending recommending it. I do still think, from a purely nutritional perspective, it is probably better. But I also think the advantages, if they really do exist, are possibly too small to outweigh the risk. I've not been too bothered whether it's raw or cooked for quite a while now after initially being all in favour of raw. I'm more interested in the low carb - high prot aspect, especially in cats, though good studies comparing that long term to moderate to high carb diets are lacking, unfortunately.

Only exception I'd still make is feeding raw bones to dogs. There's a couple of good studies on laboratory beagles confirming a huge positive impact on dental health with no problems reported. IMO this is good enough evidence to balance it against potential risks.

Not to mention the behavioural aspect... ;-)

RE: TB in cats fed Natural Instinct - please make your cat clients aware

Bob Russell — Fri, 24 May 2019 15:13:46 GMT

All the inspection in the world is not going to remove bacterial risk.

Meat inspected by the MHS is designed to minimise the risk of human infection and contamination but there is an assumption that the final product will be cooked.

Having been an OVS many years ago nothing in the world would persuade me that feeding raw meat to a pet is worth the risk!

http://www.thedeerinitiative.co.uk/uploads/guides/119.pdf

States less than 1% of deer have TB rising to 15%in local clusters.

Anyone out there willing to take a gamble by eating a bit of raw venison?

RE: TB in cats fed Natural Instinct - please make your cat clients aware

Iain Richards — Fri, 24 May 2019 14:33:21 GMT

Thanks for that Andreas. The breakdown seems to be that the game handling establishment that supplied NI did not inspect the offal that went into the product. Intestines are normally left in the field but the pluck often comes back. If there is no pluck with the carcase, then the "hunter declaration" is the inspection. If the pluck is with it, then this needs inspecting by an OV or MI.

I'm speculating that a anscessed LN has been minced, thus spreading bacteria throughout the batch.

A further thought, how natural is it for cats to eat deer?

RE: TB in cats fed Natural Instinct - please make your cat clients aware

Andreas Ege — Fri, 24 May 2019 11:46:17 GMT

[quote user="Iain Richards"]This is something I am following up (chair of NW BRitish Der Soc). Possibilities - criminal selling of known infected carcass; selling uninspected pluck; untrained person selling venison or, this is the uncomfortabe one, vension (meat) contains a lot more M bovis than we thought.[/quote]

They got some information about Tb on their webpage now, though it's not exactly obvious: https://www.naturalinstinct.com/venison

They claim:

"8. Where does Natural Instincts source it’s meat from?

The Venison is sourced in Britain. It is human grade and ethically sourced from a reputable supplier. The supplier is also approved by DEFRA. The supplier has informed Natural Instinct that it can assure full traceability of all venison materials provided to Natural Instinct down to the species and sex of the individual animal, the day and where it was killed.
We have been informed by our supplier that all venison is inspected at the Game Handling Plant by the Meat Hygiene Inspector who passes the meat. The Meat Hygiene Inspector is not an employee of the supplier, but is employed by the Meat Hygiene Services who are part of DEFRA. At the time of kill, the stalker also has to tag the carcass which confirms the stalker has inspected. All carcasses had been tagged and they have full traceability of all the deer kill used in our products."

RE: TB in cats fed Natural Instinct - please make your cat clients aware

Thomas Johnson — Tue, 21 May 2019 09:01:18 GMT

[quote user="Anthony Dennison"]

[quote user="Peter Faulkner"]Does treating TB involve injecting gold or something? I just wonder how you could structure a fee to end up with this figure of £7000 ? [/quote]

Repeated CTs, biopsies, ZN staining, repeat PCRs, multi-drug therapy (long term as well) plus a referral consult fee if referred for treatment.

I imaging there was quite a thorough work up prior to the diagnosis of TB as well when it was low on the differential list for an indoor cat so there would have been that cost plus the TB specific work.

[/quote]

My current TB case cost around £2,000 to get to a diagnosis. Treatment is going to be about £100 a month for 6 months. As discussed it had ultrasound and xrays, but not CT scan. It also had the advantage that I had read Danielle Gunn-Moore's latter in the Veterinary Record last year so I had TB on my differential list and after ruling out the more common differentials I took a tissue biopsy for mycobacterial culture. I also imaging that cost would vary depending on how unwell the cat was, the cat I am treating was very unwell initially, but shortly after taking the biopsy she was clinically much better, so we could wait for the results without having to spend a lot of money on supportive treatment.

RE: TB in cats fed Natural Instinct - please make your cat clients aware

Peter Faulkner — Mon, 20 May 2019 21:51:56 GMT

[quote user="Anthony Dennison"]

[quote user="Peter Faulkner"]Does treating TB involve injecting gold or something? I just wonder how you could structure a fee to end up with this figure of £7000 ? [/quote]

Repeated CTs, biopsies, ZN staining, repeat PCRs, multi-drug therapy (long term as well) plus a referral consult fee if referred for treatment.

[/quote]

Yes, if you factor in referral for further investigations I could see how that would quickly add up to a tidy sum.

RE: TB in cats fed Natural Instinct - please make your cat clients aware

Beats — Mon, 20 May 2019 19:37:23 GMT

[quote user="Anthony Dennison"]And a full post-mortem with histo and culture of probably every organ.[/quote]

I tend to send suspect cats to the local government lab and they have to-date post-mortemed them at no charge, presumably as part of their bovine TB surveillance. They do mycobacterial culture as well (though not really clinically useful as get a report back about 6 months later). Been a couple of years, so policies may have changed.

RE: TB in cats fed Natural Instinct - please make your cat clients aware

Anthony Dennison — Mon, 20 May 2019 17:58:37 GMT

And a full post-mortem with histo and culture of probably every organ.

RE: TB in cats fed Natural Instinct - please make your cat clients aware

Anthony Dennison — Mon, 20 May 2019 17:58:11 GMT

[quote user="Peter Faulkner"]Does treating TB involve injecting gold or something? I just wonder how you could structure a fee to end up with this figure of £7000 ? [/quote]

Repeated CTs, biopsies, ZN staining, repeat PCRs, multi-drug therapy (long term as well) plus a referral consult fee if referred for treatment.

RE: TB in cats fed Natural Instinct - please make your cat clients aware

Peter Faulkner — Mon, 20 May 2019 17:24:30 GMT

The Times article is here:

https://www.thetimes.co.uk/article/posh-natural-pet-food-recalled-as-cats-and-their-owners-develop-bovine-tuberculosis-t90zcjskt?shareToken=d8280c14e3f979aba7531f91c87337ea

They say two people have been infected, but there are no other details.

As with most newspaper articles, the vet fee is exactly £7000. I presume this has been rounded up? I'm not moaning, just a bit fearful I maybe missing out here.

Does treating TB involve injecting gold or something? I just wonder how you could structure a fee to end up with this figure of £7000 ? :)