|Presentation to:|| Staff
Faculty of Veterinary Science
Palmerston North, New Zealand
9 September, 1993
|Summary||Politics and Economics||Periodontal Consequence||Cybernetic Hypothesis of Periodonal Disease in Mammallian Carnivores|
|Introduction||Environmental Impact||Foul Mouth AIDS - A Dietary Disease||Beneficial Consequences of the Veterinary SNAFU|
|The Name||Veterinary Science||Plasma Cell Pododermatitis of Cats||Conclusion|
|Psychology||Periodontal Disease||The Inabilty of the Clinical Diagnostic Pathway||Suggested Further Reading|
'My affiliation with the pet food industry commenced on July 1, 1993 when I became part-time consultant to Friskies Pet Care.....If I did not believe that good quality commercial pet foods had advanced the health of companion animals enormously in the past decades I would not have accepted this consultancy'.It is my belief that the profession's political mismanagement and acquiescence is matched by a naive scientific methodology.
'We have followed the reductionist paradigm to absurdity; such that we are all specialists in a specialist world knowing more and more about less and less until we know everything about nothing. Narcissists every one, we are dazzled by our own 'brilliance' and ultimately blinded by the so-called 'science' which appears to open up the innermost secrets of the natural world. We worship at the holy shrines of 'scientific' excellence. We honour and serve the high priests, each one having an awe-inspiring grasp of some demanding inaccessible truths concerning the orthodox wisdom. But en masse we suffered one immense fatal flaw: bereft of humility we forgot the subject, we lost the plot.Our way out of the mire is via a holistic assessment. Alas, our communication methods depend upon compartmentalisation of the topic into bite-sized chunks. It is with deference, that I ask you the reader, to reassemble the whole in order to create and recreate the infinite interconnectivity of the component parts.
Never is this more so than in the area of small animal dietetics. Boffins in innumerable labs separated by great distance and time work on hypotheses, generate theories and derive 'unquestioned fact'. The measurers and recorders produce miles of tables confirming their point of view on esoteric topics and readily justify the vast array of assumptions they care to make on all other parameters known and unknown.'
'In stomach contents of 530 dingoes (Canis familiaris dingo) in south-east Australia, 89.3% of feed, by occurrence, was large and medium-sized marsupials (Wallabia, Macropus, Pseudocherirus and Trichosurus). Of 26 dingoes with sheep or cattle remains in the stomach, 11 had eaten it as carrion, judging from the presence of maggots, and 5 of those had obtained it from carcasses used as bait for the traps. There was 4% of feral pig, 0.3% of horse and 7.8% of rabbit which are all regarded as pests. There were 26 species of prey altogether. Of the 25 other species caught in the traps, over 20 were protected wildlife.'Whitehouse commenting on the populations of dingoes in Western Australia remarked that they appeared to be opportunistic feeders preferring wild animals to domestic stock even though they were equally available. Where rabbits occurred they were a large part of the diet and it was thought that dingo numbers varied with the rabbit population. (Whitehouse, 1977)
|Friskies R Go-Cat R|
|Whole Grain Cereals:||Corn and wheat|
|Cereal By-product:||Derived from soya bean and corn.|
|Chicken and Chicken By-products|
|Beef, Liver and Meat By-products:||Derived from Beef and/or mutton|
|Fish and Fish By-products:||Derived from sardines, pilchards and tuna|
|Vitamins:||A, D3, E, B12, Thiamine, Riboflavin, Pyridoxine, Niacin, Calcium, D-Pantothenate, Folic Acid, Choline Chloride and Biotin.|
|Minerals:||Calcium Carbonate, Ferrous Sulphate, Manganese Sulphate, Cupric Oxide, Zinc Sulphate, Cobalt Carbonate, Phosphoric Acid, Potassium Iodide, Sodium Chloride, Calcium Chloride and Dicalcium Phosphate.|
|Others:||Yeast, Potassium Sorbate, Dextrose Monohydrate, Amino Acids (Taurine, Glycine), Antioxidants and Food Colours.|
|Pal Meaty Bites|
|Whole grain cereal, meat and meat by-products derived from beef, mutton, chicken Cereal by-products. Iodised salt, vegetable oil, vitamins and minerals, food colouring, preservatives and anti oxidants.|
|a.||Arguments must be predicated on false assumptions which a rigorous application of deductive logic transmits to the bottom line producing a false conclusion.|
|An example being that:|
|Processed food may be considered to be the same as, or as good as, the natural diet. If all other things are equal then : Conclusion - the perfect state of health will prevail.|
|b.||Either inadvertent or intentional sloppy application of the rules of logic enable true premises to give rise to false conclusions.|
|Eg.||Animals need specific chemicals, there are specific chemicals in processed food: Conclusion - therefore animals obtain their specific chemicals.|
Where this is due to ignorance, education may help. If it can be shown that misinformation is presented with intent to deceive then regulatory/legal action will be required. This was the course of action required in respect of the 'infant milk formula' saga. At least the name of the powder implies that it is an artificial substitute formula but nonetheless the effect in third world countries was, and is, a disgrace as the following abstract from 'The Greening of Medicine' will portray.
"The gradual reinstatement of breast feeding like that of natural birth has resulted from a few pioneering individuals, the rise of consumer organisations and the gradual change in society's perception so that, although 'breast is best' is now more widely accepted, the vested interests in controlling the economics of the product ensure that the battle continues. Nowhere is this more clearly seen than in the baby food industry and Third World nutritional needs. A public outcry and a series of lawsuits against Nestle's widespread promotion of artificial feeding in Third World countries led to the establishment of a WHO/UNICEF code on the marketing of breast milk substitutes. In summary this code suggests that the following good practice should be observed. WHO/UNICEF Code
The code was officially authorised by the Australian Trades Practices Commission Ruling, Sept, 1992.
It is because the issue of breast feeding versus bottle involves such large profits that the medical and social factors have been marginalised by the economic and political ones."
- No advertising of breast milk substitutes
- No free samples to mothers.
- No promotion of products through health care facilities.
- No company mother craft nurses to advise mothers.
- No gifts or personal samples to health workers.
- No words or pictures idealising artificial feeding, including pictures of infants, on the labels of the products.
- Information to health workers should be scientific and factual.
- All information on artificial feeding, including the labels, should explain the benefits of breast-feeding and the costs and hazards associated with artificial feeding.
- Unsuitable products, such as sweetened condensed milk, should not be promoted for babies.
'According to Chris Argyris, all organisations are prone to this because it flows from a natural human response that we practice from the time we leave the cradle. This is the response we have to particular problems, problems that we see as personally threatening. What we do, with increasing skill as we mature, is develop ways of by-passing the problem, then of covering up the by-pass and then covering up the cover-up......as a result, instead of being cleared up, the original flaw not only goes on festering, but its very existence becomes taboo - undiscussible, and so irremediable.'
Max Walsh, Sydney Morning Herald, 20 June, 1993
'What I recommend is that dogs should be fed a nutritionally sound diet which would be the easiest way to go is with tinned food such as Pal, Whiskas and any of the better known commercial brands. But they need dental exercise and so on that they should have hard dog biscuits or eat bones regularly two to three times a week. But it's a very simplistic approach to say that if you give a dog just a natural diet of bones he's never going to have teeth problems. That's a fairytale.'Dr H Southwood, President of the Sydney Metropolitan Practitioners Branch of the AVA speaks with admiration of the pet food industry in the March, 1993 edition of the AVA News, Letters Page:
Dr Stephen Coles (President, Australian Veterinary Dental Society) Radio National, Daybreak 14/9/1992
'First, it is my belief that the widespread availability and use of commercial rations has generally contributed to a longer and healthier life of pets........ Second, to my knowledge Tom has no post-graduate qualifications or specialist qualification in animal nutrition nor does he have any valid scientific data to back his assertions. This position contrasts strikingly with the major players in the pet food industry........ Finally, I congratulate the pet food industry on their patience and tolerance in the face of this attack. I have no vested interest in this matter yet my patience is exhausted.'Without the least show of conscience, should the poor unfortunate animal demonstrate signs of obesity, diarrhoea, kidney disease etc, then another can of pulverised offal is prescribed. Just as '100% complete and balanced' but manufactured to a different prescription formula by the same manufacturer, especially for your pet's requirements. (I speak of the 'can to counteract the can' but my solicitor prefers the 'con to counteract the con'.) The net result of this complicity is a woeful absence of protection from the highly ingenious, resourceful pet food producers.
'It is important to emphasise that the calculations made in the formulation of a diet make a number of arbitrary assumptions and the potential for significant error is high.'The headline in 'The Veterinarian', August, 1993 screamed the recurring truth; RESEARCHER CONTRADICTS ESTABLISHED DIET PRACTICE. Professor David Kronfeld:
(Vet Business, 1993 2:1)
'concluded that the low protein diets often recommended for healthy geriatric dogs and dogs with chronic renal failure were more harmful than diets with moderate protein content'.Advertising of an outrageous nature. If one adopts an intelligent approach to the claims one detects not mere 'puffery' but outright distortion. That the government and consumer watchdogs allow this exploitation of the public probably traces back to the veterinary (expert) endorsement of the products.
(JSAP, 1993; 34:211)
'The confusion, even blindness, by researchers and regulatory agencies (however well intentioned) is apparent in the following incredible contradiction by authors with DVM, PhD and specialty board certification in veterinary internal medicine and nutrition credentials: "These protocols (The authors are discussing AAFCO studies) were designed to assure that pet foods would not be harmful to the animal and would support the proposed life stage. These protocols were not designed to examine nutritional relationships to long-term health or disease prevention." (G F Collings, et al, Veterinary Forum Oct, 1992, p34)" In other words a food could cause disease and destroy long term health yet at the same time "not be harmful" and be "100% complete"! So after a pet has been fed the "proven" food for a period of time equal to the duration of an AAFCO study (26 weeks), all bets are off. The "100% complete and balanced" food may then be literally poisoning the animal with the blessings of the entire academic, professional, scientific, governmental and industrial pet food establishment.'When viewed at a national level, the annual cost to Australians of processed pet foods exceeds $600 million and the cost of veterinary pet care in excess of $400 million. (AVA News, Aug, 1993) The net result of political and economic mismanagement is that the community and its animals suffer. As in other areas, it is the poor who are disproportionately affected. Natural foods cost much less than the processed and natural food-fed animals suffer less disease. It is alarmingly common that clients present sick animals at our practice having paid huge sums for commercial food. Frequently the animals are suffering a variety of signs attributable to incorrect feeding for which the owner cannot afford the diagnostic and therapeutic work. Alas they are doubly victims with the alternatives being: allowing the animal to suffer, euthanasia of the pet or seeking charity.
'Science has taken over from religion and it has become a rather corrupt church, It's in its mediaeval theological phase.'This is the more so in the veterinary sphere where much energy is directed to technological manipulation of a few flawed scientific concepts.
'The ideal level of protein intake for dogs is still a matter of debate amongst nutritionists, veterinarians and breeders, with recommendations varying two- to three-fold. Perhaps the best way to investigate this further is by the use of purified diets, but this brings an added challenge because they do not usually reflect the normal diet. Relating these basic studies to practical feeding of the dog represents a key issue for veterinarians and nutritionists to resolve.'Two volumes summarise the blunders of the processed pet food industry and its army of blinkered stooges. These are 'The Nutrient Requirements of Dogs' (1985) and 'The Nutrient Requirements of Cats' (1986) where the following absurd statements can be found.
'Cats /dogs require specific nutrients not specific foodstuffs'.So deeply uncritical is the profession that, for example, the British Small Animal Veterinary Association, Journal of Small Animal Practice gives over one complete edition annually to the publication of papers presented at the Waltham Symposium on pet foods. The editorial committee of that journal is so hoodwinked that they even allow employees of Walthams to write the guest editorial.
'Hazewinkel et al (J Nutr 121:S99-S106) in a study of growing Great Dane puppies with varying calcium and phosphorus levels, concluded that the dogs are unable to protect themselves against chronic excessive calcium intake regardless of the ratio of calcium to phosphorus. A balanced Ca:P ratio does not offer protection from a high level of calcium in the diet. Many pet foods in Australia, even some especially formulated for puppies, contain higher levels than this new recommended maximum for calcium of 2.5% (according to their own guaranteed analysis). Check these for yourself and see!'Quality of the chemicals is important as evidenced by :
(NutriPet News, 1993)
'The conclusion that cats fed a single commercial food exclusively were at greater risk for developing taurine deficiency and dilated cardiomyopathy than cats fed a variety of foods is not unexpected. This and other examples of diet-induced disease should serve as a warning to veterinarians who prescribe or endorse the feeding of one food exclusively to any animals, especially for maintenance.'Frequency of providing the chemicals clearly affects obesity and under nourishment and possibly other aspects of a healthful existence.
(Pion, P D et al, 1992)
'I have a friend who feeds genuine whole chicken to his racing huskies. Stools in his yard sprout feathers like pre-avian reptiles.'Evolutionary theory of natural selection is now sufficiently well accepted. The understanding being that adaptation occurs at the margin. In the case of carnivores they have adapted to, and now depend upon, their tough chewy food for survival.
'Several studies have shown that the form of the diet is much more important in controlling plaque build-up and gingival inflammation than is the nutritional content of the diet in dogs. At least over the short medium term, gross changes in carbohydrate and protein content have no effect on rate of plaque build-up. A diet grossly deficient in calcium leads to secondary nutritional hyperparathyroidism and demineralisation of periodontal bone but does not cause more rapid periodontal tissue breakdown. The 'rubber jaw' syndrome of secondary (nutritional or renal), hyperparathyroidism is a periodontosis that does not affect connective and epithelial tissues unless the soft bone permits mobility of teeth that is mechanically harmful.'Periodontal disease is actually a continuing process rather than individual stages, but may be divided up for ease of comprehension.
|Healthy||Sharp gingival margin, shrimp colour, normal stippling and no odour.|
|Grade I||Marginal gingivitis. The leading edge of the gingiva appears inflamed. Odour is usually present.|
|Grade II||Moderate gingivitis. Inflammation of gingiva with the addition of edema causing margins to swell and begin to roll.|
|Grade III||Severe gingivitis. Increased edema, red to purple margin with rolling occurring. Beginning pocket formation beyond normal 1 to 3mm depth. No loss of attachment at this point.|
|Grade IV||Moderate periodontitis. Severe inflammation, deep pocket formation, beginning bone loss with epithelial attachment loss and a slight increase in mobility.|
|Grade V||Severe periodontitis. Advanced epithelial attachment loss, advanced bone loss, tooth mobility and tooth loss.|
'Paradontal disease is always associated with an alteration in the physical or chemical character of the diet of the animal - in other words with a departure from natural diet and conditions.'Borthwick in his study for the pet food industry states:
'It would appear that the veterinary surgeon/patient approach to reducing periodontal disease in dogs and cats is largely ineffective and that people have come to accept that periodontal disease is inevitable.'Higgins in his capacity as advisor to the pet food industry states:
'It is ironic that preventative dentistry towards the end of the twentieth century is based on what dogs and cats found in nature thousands of years ago.'Colyer makes the obvious point that prepared foods increase the contamination of the oral cavity by sticking to the teeth and gums. Milk and tablescraps are equally subject to this error of commission. It is equivalent to the worsening spiral created by a house cleaner who removes no dirt and leaves a trail of muddy footprints.
'You do not need a post graduate degree in nutrition to evaluate the effects of raw bones on a dogs dentition - in fact, it appears that the qualification would be a serious disadvantage!'Failure to perceive severe bacterial/toxic consequences is not restricted to vets. In a recent survey of renal transplant units it was found that 4 out of 22 did not schedule dentistry prior to renal transplantation. In conclusion the researchers state:
(Control and Therapy No 3406, 1993)
'A more striking disagreement was what was considered a dental focus of infection since, infection is one of the major complications in renal transplant patients, agreement in this area is of the utmost importance for the standardisation of future protocols. In order to reach agreement and improve protocols greater collaboration will be necessary between dentists and the surgical team.'DeStefano et al writing in the British Medical Journal, March, 1993 showed a weak correlation between severe periodontal disease and heart disease. They found a stronger correlation between severe periodontal disease and total mortality. Unfortunately they did not put the question as to whether slight periodontal disease could be a sufficient trigger of systemic disease.
(Yamalik et al, 1993)
'Theory for the genesis of certain chronic degenerative diseases of the aged dog and proposes a toxic sequence of events.'Gary Beard speaking in July, 1991 said:
(Vet Scope International, 1992)
"The haematogenous spread of bacteria, originating in dental calculi and embolised by manipulation of the gingival capillaries during dental procedures and even mastication, have been documented in man and other animals. This spread of bacteria, or anachoresis, to other organ systems can result in peritonitis, glomerulonephritis and endocarditis." "Veterinarians have long suspected, and research supports, the fact that periodontal disease can become systemic and can predispose the animal to problems such as right side heart failure, hepatic compromise, renal failure and bone marrow depression. This anachoretic effect can have drastic repercussions on the overall health of the pet and represents one of the greatest challenges facing small animal practitioners today."Our subjective assessment of the situation is that most of the degenerative diseases treated in modern veterinary hospitals in fact derive from the processed pet foods/ periodontal disease nexus.
This paper has now been expanded into a survey of the first eight dentistry cases presented at our clinic with a low white cell count and low RBC.
Raw Meaty Bones Promote Health Control and Therapy No. 3323
The raw versus processed food debate became obstipated. A stand-off occurred across the philosophical and scientific divide with little new material being exchanged and certainly no movement of personnel between the camps.
The methodological incompatibility of the two factions were as the inhabitants of Lilliput to those of Brobdingnag.
With the emergence of some recent information, the latter day Gulliver can catch a glimpse of the rich new areas of inquiry waiting to be explored.
The Zubrycki silky terriers represent just such a case. From November '85 to August '91, Tuffy and Blossom were presented at the surgery on numerous occasions. Often with vexatious non-specific illness/lethargy/dermatitis.
A recurrent complaint was that Tuffy had attacks of the 'scurries'. Variously determined to be hyperventilation or bouts of mad anxiety. Several theories and treatments were proposed by ourselves but to no avail.
On 6/8/91, at time of annual vaccination, it was determined we should be entirely resolute in our dealings. The owners were persuaded to adopt a thorough approach to flea control, and the dogs were booked in for radical dentistry. Previously our advice to give an occasional raw bone had been overlooked. Now we insisted that a raw meaty bone should be a staple of the diet.The WCC of 12/8/91 were:Several times, in the intervening weeks, I met Mrs. Zubrycki in the street. Each time she remarked on the lack of 'scurrying' attacks, much improved skin, vitality and breath. On 17/6/92 she was persuaded to bring the dogs back for follow up and blood test. The results are reprinted below.
Tuffy Blossom Normals Tot.WBC 5.1 5.2 6.0-14.0 Differential WCC (absolutes) Neut. 3.4 4.0 4.1-9.4 Lymph 1.5 0.8 0.9-3.6 Mono. 0.1 0.2 0.2-1.0 Eos. 0.2 0.3 0.1-1.2Some gingivitis and tartar accumulation was evident where opposing teeth had been removed, but otherwise the mouth was healthy.
Tuffy Blossom Normals Tot.WBC 8.5 8.2 6.0-14.0 Neut. 4.8 5.9 4.1-9.4 Lymph 2.7 1.7 0.9-3.6 Mono. 0.4 0.4 0.2-1.0 Eos. 0.5 0.2 0.1-1.2
Comment A number of explanations could be postulated to explain the findings. My rude hunch is that just like the millions of other process food fed dogs, the sequence of events is as follows.
Traumatic gingivitis of teething and plaque-induced gingivitis of normal living becomes exacerbated by calcification of plaque. All of the former remaining unchecked by nature's cleaning, polishing, washing action at feeding sessions.
During the canine evolutionary phase there would have been no pressure to cope with chronic mouth lesions.
The modern dog protected from heat, cold, starvation and predation has to withstand the affront of a mouthful of gram negative bacteria and toxins.
Ill-equipped for the task, the bone marrow suffers toxic suppression and a concomitant bacteraemia compounds the problem. The whole noxious mess occasionally punctuated by dramatic demonstrable disease entities, (septic arthritis, endocardiosis, nephritis). More usually characterised by suboptimal health of an insidious nature running parallel with the aging process and confused with the same.
Not all animals had RCC's performed as initial investigation was for WBC changes. The animals were not objectively assessed for dehydration. Tess Abson had complete laboratory profile and heartworm, microfillaria and serology testing. She was noticeably dehydrated and thus would provide erroneously high base readings at first presentation. She subsequently gained 20% in weight with a presumed corresponding increase in total circulating erythrocytes. Accordingly adjustment should be made for her minus 3% RCC change in value.Changes in RCC varied from minus 3% to 46% increase. Average 28%. WBC counts varied from 37 to 150 % increase. Average 78%. Neutrophil counts varied from 0 to 170% increase. Average 77% Lymphocyte counts varied from 8 to 136% increase. Average 72%By completing dental extractions/scaling prior to the change of diet could only serve to accelerate improvement of those severely affected. It is acknowledged that diet alone can bring about improvements in oral hygiene and thereby health. 'This test confirms the feasibility of preventing the accumulation of dental calculus in experimental beagle dogs by regular feeding of oxtails'. (Brown and Park, 1968) 'Her dental hygiene and lack of dragon breath is a joy to behold. She enjoys her six kilometre walk everyday on her tiny little legs and has a new zest for life.' (Consultant, obstetrician and gynaecologist commenting on dietary change for elderly terrier).
Results of owner observations were arguably more valuable than the scientific parameters. Owners living in close association with their pets are able to make value judgments which mostly depend on behavioural changes.Eg. "Didn't know X was sick". "Like a kitten again". "Stopped the strange behaviour pattern". "Could not sleep was up all night, now sleeps soundly."These subjective assessments add support for the 'Cybernetic Hypothesis' which predicts that dogs and cats which do not receive the 'wash, scrub and polish' of natural feeding will suffer a foul mouth and severe health consequences.
Four cases were initially presented for annual vaccinations. These were perceived as 'normal' by their owners. The figures are tabulated here.
RCC(x10^12/L) WBC(x10^9/L) Before dentistry After dentistry Before dentistry After dentistry Case 1 6.00 7.10 5.10 8.50 Case 2 5.60 7.40 5.20 8.20 Case 3 5.27 7.68 4.90 7.80 Case 4 6.03 8.83 5.70 8.00 Average 5.72 7.75 5.22 8.10
The average RCC increase was 35% and the average WCC increase was 55%.
Sources of Error
That every animal tested showed such a dramatic improvement in blood values and general health is remarkable given that a number of interactive factors would be expected to create errors.
a. Elderly patients addicted to processed foods are not good candidates for diet change. Owner compliance was often in question. b. Once established periodontal disease can be expected to persist albeit at a reduced level, even after extensive dental work. c. If the observed changes in blood parameters and health were triggered by chronic periodontal disease the withdrawal of the stimulus would not necessarily result in abatement of the clinical condition. d. Other preexisting pathology could be expected to exert an influence on blood values and perceived health status.
The reference range referred to by ourselves originated from Macquarie Vetnostics in Sydney. Dr B Duff states: 'Our reference ranges were derived from approximately 100 animals presenting at Sydney general practices in 1986. Veterinarians submitted blood according to a recommended protocol. The animals were selected as being 'clinically normal' as opposed to animals specifically raised for the purpose of biomedical research.' No comment could be made on the diet and oral health of the survey sample.
Veterinary Pathology Services' Dr Bill Vernau states: 'Our reference range was derived from 40 dogs and 40 cats between 1989 and 1991. These animals were accessed via veterinary clinics. They had to be 'healthy' animals more than one year of age presented for vaccinations etc.' Dr Vernau could not comment on diet and dental status but the animals were supposedly 'healthy' and did not require dental 'prophylaxis'.
Comparable ranges published in Kirk's "Current Veterinary Therapy No. 11" derived from the University of Guelph between 1989 to 1991. 'There was a mix of mongrels and pure-breds. All were vaccinated against distemper and hepatitis and treated for parasites. They were fed a balanced commercial diet (Hills Science Diet, wet and dry). Dogs were held in a preconditioning unit four to six weeks prior to testing. All dogs were healthy and Dr Lumsden states that, 'none had periodontal disease'. Cats had a similar protocol, age ranges six to twenty-four months.'
MVS VPS GUELPH Dogs Cats Dogs Cats Dogs Cats RCC (x1012/L) 5.00-8.00 5.50-10.0 5.5-8.5 5.5-10.0 5.6-8.5 5-10 WBC (x109/L) 6.0-14.0 6-16 6.0-17.0 5.5-19.0 6.1-17.4 5.5-15.4 Neut. (x109/L) 4.1-9.4 3.8-10.1 4.0-12.0 2.0-13.0 3.9-12.0 2.5-12.5 Lymph (x109/L) 0.9-3.6 1.6-7.0 0.9-5.0 0.9-7.0 0.8-3.6 1.5-7 Mono (x109/L) 0.2-1.0 0.1-0.6 0.1-0.6 0.1-0.4 0.1-1.8 0.0-0.85 Eos. (x109/L) 0.1-1.2 0.2-1.4 0.1-0.5 0.1-0.8 0.0-1.9 0.0-0.75
We did have concerns and pathologists are the first to admit the fallibility of single tests and the interpretations arising. When a patient (Tess Abson) shows a blood profile within the reference range although 20% underweight and chronically ill one must question the validity of the reference range. When the patient subsequently glows with relative health (for a twelve year old with a mammary carcinoma, cardiopathy, hepatopathy and no teeth in the upper jaw) but the pathologist comments on several perceived problems, then we have serious cause for alarm.
General practitioner awareness of periodontal disease scarcely existed in 1986 when Macquarie Vetnostics Services obtained their results. Things have not progressed greatly since that time. One must be suspicious of the oral hygiene claims for the sample populations used by Veterinary Pathology Services and the University of Guelph. Dr Lumsden's comment that the laboratory animals did not have periodontal disease is at variance with: 'Dr Dan Carey of the Iams Corporation maintained that animals on canned food would require six monthly prophylactics. Dr Jo Wills, Scientific Affairs Manager - Waltham, expressed as a point of pride that their research animals received six monthly prophylactics to resolve/control dental health problems.' (Lonsdale, 1992 - Unpublished)
The conclusion must be drawn that reference ranges have been established utilising periodontal disease-affected animals. It is therefore likely that the reference ranges are too wide. At the low end chronic disease affected animals suffering Acquired Immune Deficiency are designated as 'within normal limits'.
This survey did not look at animals through all stages of life and periodontal disease, however basic pathological principles tell us that during inflammatory phases of the disease the cellular counts could rise and accordingly falsely extend the reference range upwards.
Similar remarks appear to apply for erythrocyte counts. Although within the laboratory reference range four of the six animals tested appeared to have suffered relative anaemia in conjunction with their periodontal disease.
The summation of these effects is that: artificial diets and periodontal disease have been factored into the 'normal' reference ranges.
Part of paper (submitted for publication, Lonsdale, 1993)
FELINE EOSINOPHILIC GRANULOMA DISEASE COMPLEX
'Feline Eosinophilic Granuloma Disease Complex. Control and Therapy Nol 3271
The severity of the lip and tongue lesions in Ming Hobbs the 7 year old de-sexed female cat cause me to reproduce the Anapath histology report in full.
Lip: The biopsy shows a large ulcer in the skin covered by a thick necrotic crust containing numerous large colonies of bacterial cocci. There are heavy infiltrates of eosinophils throughout the granulating ulcer bed and underlying dermis.
Tongue: The large yellow nodule is an area of reactive lymphoid follicle formation, interspersed with mixed inflammatory cell infiltrates including numerous eosinophils, mast cells and plasma cells. The smaller lesions show areas of granulating ulceration with extensive eosinophilic inflammation and superficial necrosis and bacterial infection.
Final Anatomic Diagnosis
- Multifocal severe ulcerative eosinophilic dermatitis and glossitis with superficial bacterial infection.
- Focal moderate lymphoid hyperplasia with interspersed eosinophilic inflammation, tongue.
The lesions on the lip and tongue are consistent with eosinophilic granulomas, each with significant secondary superficial bacterial infection. One of the nodules in the jar labelled "tongue" was an area of lymphoid hyperplasia, probably in response to the chronic inflammation and infection in the mouth. Many cats with eosinophilic granuloma-type lesions have underlying hypersensitivity problems (food allergy, atopy etc.)
The treatment on 28.04.92:
The above was the first of a series. In the mild cases we now dispense with the usual Megestrol Acetate and corticosteroids and treat with dental and dietary change alone. Rather than see these signs as part of a single disease, we consider it to be part of a larger immune system disease complex of which milary dermatitis, FLUTD, lymphocytic histiocytic enteritis, plasma cell pododermatitis etc are examples. Deposition of any or all of the following are the main histological findings: Eosinophils, histiocytes, lymphocytes, neutrophils, monocytes and plasma cells.
The diet was changed to include a raw chicken wing or ox tail or similar every day. At 28.05.92 Ming is thoroughly enjoying the new diet and the mouth lesions are totally healed.
- Debridement of tongue
- Dental overhaul
- Long acting penicillin, Dexamethasone I.M.
- 10 mg Depopred intra-lip lesion
- 5 mg Megestrol Acetate every 2nd day for 2 weeks
Never before have I insisted on a total dietary change nor have I seen such a rapid recovery. It will take me years to accumulate a series of such cases. If other practitioners try this approach we can quickly determine if there is a diet, periodontal disease, eosinophilic granuloma nexus.'
'Plasma Cell Pododermatitis of Cats Control and Therapy No. 3270
The extensive feeding of processed food and the equally extensive prevalence of periodontal disease has come under scrutiny. Recently I have dealt with two cases of an obscure nature. The absence of raw bones, or presence of periodontal disease seems to be implicated somewhere in the pathogenesis.
Muller, Kirk and Scott state that "The cause of Plasma Cell Pododermatitis is unknown. Hyper gammaglobulinaemia, lymphocytosis and the histopathologic findings suggest an immunologic basis. The therapy of choice is not clear".
- Case 1
- 07.91 Toby, 4 year old de-sexed male. Clinical findings pododermatitis, and as with any 4 y.o. cat on processed food, moderate to severe periodontal disease. Treatment consisted of dental overhaul, post op. course of amoxycillin. A raw chicken wing to 1111111be included in diet daily. Histopathology confirmed the diagnosis.
- Case 2
- 01.92 Alf, 7 year old de-sexed male. Findings and treatment same as for Toby. Histopath not performed. In both cases the ulceration healed in about 7 days. The pads have remained soft but otherwise there has been no relapse up to the time of writing.
The beauty of these cases is that with a change of diet the condition was reversible. Such an expedient is not available to us in a host of end stage auto immune conditions, nephritis, cardiomyopathy etc.
- Nevertheless, I believe it is diet and diet-induced periodontal disease which is the trigger. Assuming this to be so, then we are under a dual obligation.
We are pursuing this research and our findings to date suggest that cats with severe periodontal disease will have a variable range and population of inflammatory cells in their foot pads.
- To advise and continue to remind our clients of the need for daily raw bones before irreversible disease sets in.
- Conduct controlled studies to elucidate the precise mechanisms.'
'Osborne and others (1992) hypothesise that matrix - crystalline plugs obstructing the urethra are formed because of the coincidence of urinary tract inflammation and crystalluria. As the causes of inflammation in these patients are unknown, 76.2% of cases of FLUTD in the series of Osborne and others (1989) can be said to have had unknown aetiology' .In the limited number of cases biopsied by us the cellular infiltrates in bladder and urethra have been similar to our random foot pad samples. It would seem that cats with diet-induced periodontal disease are prone to the deposition of inflammatory cells in numerous tissues including the bladder and urethra. If this proves to be the case then 76.2% of cases in the Osborne et al series (1989) could possibly be attributed to this source.
'Subjective assessment can be just as important and by its nature is accepted with less stigma and finality, than is a hard figure, which is often given more authenticity and authority than is deserved'.
(Atwell R, 1992)
|Question/Test||Observation||Orthodox Vet Attitude||High Index of Suspicion View|
|Presenting Signs and Owner Observations|
|Tell me your problems||Sleeps a lot||Older dogs frequently do||Animals with chronic periodontal disease frequently do|
|Restless sleeper - howls a lot||Ditto||Ditto|
|Seems a bit stiff||Ditto||Ditto|
|Seems bad tempered||Many cats are||Cats with periodontal disease and 'neck' lesions suffer much pain|
|What diet do you feed?||Commercial 'complete' and 'balanced' food||Excellent||That's a worry|
|Do you offer bones?||Large ox bones once a week||Good||That's a worry|
|Is your animal listless and slow?||Yes||Usual||That's a worry|
|Cursory examination of mouth||Nothing noticed due to poor patient cooperation||All is probably OK||Visual observation yields partial information only|
|Sniff the breath||Rancid||This test is not performed||That's usual, highly significant and likely to respond to dietary change|
|Skin/coat condition||Poor||That's usual||That's usual and likely to respond to dietary change|
|Thermometer||Temperature normal||That's OK||Thermometer seldom yields useful information in chronic disease|
|Stethoscope||Unremarkable||That's OK||Cardiac and pulmonary signs undetectable until too late to reverse|
|Haematology||Within reference range||That's OK||Reference range misleading|
|Biochemistry||Within reference range||That's OK||Frequently within the range until too late to effect change|
|General Anaesthetic Examination|
|a) Oral||Apparently normal||That's OK||Periodontal disease is insidiuous and hard to detect. Probing, tooth movements, gum shape - highly unreliable|
|b) Other||Apparently normal||That's OK||Conscious animals do not relate how they feel. Anaesthetised animals reveal even less.|
|a) Oral||Unremarkable||That's OK||Highly unreliable|
|b) Whole body||Unremarkable||That's OK||Collagen and other periodontal-induced diseases do not show up|
|c) Whole body||Heart, liver, kidney abnormalities detected||Needs treatment||Probable over-diagnose the problems. Constnat toxaemia form mouth likley chief problem|
|None made||Leave as is||Change diet + ? scale teeth|
|Suspect bacterial disease||Antibiotic treatment trial||Antibiotic treatment trial + change of diet + ? scale teeth|
|Suspect immune problems||Steroid treatment trial||Steroid treatment trial + change of diet + ? scale teeth|
|Standard for age of animal||Will have recurrent problems||Will likely not see the patient for several years|
'That processed foods are unsuitable for lifetime feeding of pet animals is beyond doubt. Both the chemical and physical aspects are damaging with, I believe, the emphasis residing on the physical.
As a theoretician impressed by the delicate cybernetic balance of nature there seems to be the workings of an invisible hand here. A small effort enables the formulation of the cybernetic hypothesis of periodontal disease.
Periodontal disease is the subtle dependable disease which modulates the effects of starvation in wild carnivore population dynamics.
An Hypothetical Example
- A 'feedback loop' ensures daily chewing of raw meaty bones sanitises the oral cavity of the successful carnivore.
- Failure of the 'feedback loop' facilitates multiplication of pathogenic bacteria within plaque and development of periodontal disease.
- Incremental losses of carnivores and herbivores are thereby facilitated.
- The populations of herbivores, carnivores and bacteria are maintained in dynamic equilibrium.
Now let's consider the hypothetical case of a pack of wolves and a flock of sheep within a finite environment. The sole crude determinant of success of the wolves or the sheep is starvation. If sheep numbers increase they eat out the herbage and proceed to die. At the same time the wolf numbers increase at a great rate to achieve maximum concentration just as the sheep are dying of starvation . The wolves die of starvation. The violent fluctuations suit neither the environment, the sheep nor the wolves. Now introduce periodontal disease and wolf sensitivity to starvation increases several fold. On day one ten wolves dine on sheep. On day two nine wolves dine on sheep and the tenth wolf goes hungry. On day three our hungry wolf has to contend with three additional problems.a. Nine contented, well-fed wolves.The unequal struggle begins as his 'appointed part in keeping down numbers' is made redundant. The pathogens benefit. Their numbers sharply increase by day fourteen. The sheep gain since only nine wolves now give chase.
b. His own twenty-four hour starvation
c. Increased plaque accumulation.
It is inconceivable that the stench would not communicate powerful signals to other wolves and prey alike. Wolf number ten, aware of his condition, would probably prefer to remove himself from contention and slink away to die. Each wolf in turn will occupy the number ten position and an abbreviated period of dying is highly desirable.
Periodontal Disease Allows Immense Flexibility of Control.
If she-wolf finds hunting easy then she will return chewy food to the litter on a daily basis. It could be anticipated that wolf cubs cutting their teeth are highly vulnerable to the periodontal disease organisms. However, if sheep numbers are high then more cubs need to be reared in order to perform their regulatory role.
The next phase of increased sensitivity to periodontal disease is the four to six month age range. Periodontal disease organisms can surge in numbers in the inflamed mouth of the cub whose secondary dentition is erupting. If sheep numbers are extremely high even the blundering efforts of the adolescent wolf will be rewarded with adequate food supplies. Consequently the gums will be massaged, the periodontal disease kept at bay and the wolf will mature to become an effective killer of sheep.
Bacteria, particularly anaerobes, were the earliest inhabitants of the planet. Their evolving interest is on a par with the interests of wolves. The vigorous chewing on raw bones render the mouth of the carnivore an inhospitable place, except for the enamel sulcus of upper, pre-molar four. It is usual to find a bead of calculus immune from the abrasive forces and containing a full complement of plaque bacteria lodged in this sulcus. It is easy to understand that once the feeding function of the host declines the complete colony of plaque organisms can readily colonise the gingival sulcus.
The sheep in our example benefit from a balance of wolf and bacteria numbers.
- All bacteria and no wolves leads to over multiplication of sheep, mass starvation and population destruction.
- All wolves and no bacteria leads to intense predation pressure and population destruction.
We can see the supreme efficacy of the negative/positive feedback loop. Nature has struck the perfect balance ensuring that the wolf's very strength carries with it its inherent weakness.
Paradoxically it is the susceptibility to periodontal disease of the individual carnivore which confers a survival advantage on the species. The carnivore susceptibility to periodontal disease as opposed to the omnivore and herbivore can be explained thus - in the extreme, herbivores (e.g. sheep), can all be at the brink of death by starvation and then, with the next shower of rain, their feeding fortunes recover. No particular advantages would accrue to the flock which reduced its numbers dramatically at the onset of a drought.
Human omnivores appear to withstand a level of periodontal disease more readily than carnivores. As a cooperative species even periodontal disease affected individuals could be of benefit to the survivability of the group.
Conventional wisdom has it that the immune system is necessary to protect the host. This is a simple, linear 'cause and effect' concept that takes little account of degree or time within the holistic framework. The 'Cybernetic Hypothesis of Periodontal Disease' allows a range of options depending on degree and time. This can be summarised as two functions thus
Symbiogenesis, the mutual evolutionary adaptation of species, is gaining in scientific significance. (Sir Crispin Tickell, ABC Radio National Science Show, 28 August, 1993) I am prepared to venture an opinion that we can expect similar developments in veterinary science.
It is important to note that this graduated response facilitates the shaping of populations. ie the animal which employs the immune system least will be the best adapted to its environmental niche and therefore have the greatest breeding potential.'
- In a short time, and with minor challenge, the immune system will provide a minor degree of protection sufficient to protect the host genes and therefore the gene pool.
- As either the time frame or the degree of challenge increases the immune system will provide a major response. This major response will serve to expedite the demise of the host genes. The concomitant of this being that the host gene pool (the critical issue) will be protected.
(Part of paper submitted for publication, Tom Lonsdale 1992)
'Truth emerges more readily from error than from confusion'If Bacon is right then the giant insidious error of processed pet foods should give rise to some major insights. Redoing the work that has passed for 'science' should occupy researchers for a considerable time and elucidation of some of the pathways prove interesting. Practitioners should be kept busy correcting the wrongs of previous advice until firm preventative protocols are in place.
'If you are not part of the answer, you are part of the problem.'There can be no doubt that there are people in authority, and those who have built their careers, teaching the processed pet foods mythology. That individual careers and future exam results may depend on the bias of authority figures requires careful negotiation.