Emergency call for assistance from HUMAN ONCOLOGISTS

[kestrel91316]

with experience in managing methotrexate toxicity. The veterinary profession needs help addressing a massive problem with which we have no experience. Any help would be greatly appreciated.

This pertains to the current pet food recall with aminopterin exposure.

DUers in the medical field (human), please pass the word. Please keep this kicked.


AVMA:
http://www.fda.gov/ora/fed_state/dfsr_activities/fdapas.html

FDA public affairs regional offices:
http://www.fda.gov/ora/fed_state/dfsr_activities/fdapas.html

Also, please contact Paul Pion DVM at VIN. He can get the word out on any therapeutic suggestions.
http://www.vin.com/VIN.plx?P=ContactUs

On edit: I just emailed Paul to suggest he contact oncology and rheumatology associations in the human field directly.

[rubberducky]

1. Kick!

[Bridget Burke]

2. Ask the rheumatologists, too.

Methotrexate also treats rheumatoid arthritis.

[kestrel91316]

4. THANK YOU!

[Extend a Hand]

3. K&R

[crispini]

5. K&R nt

[Lone_Star_Dem]

6. K&R

And my thanks to all the wonderful veterinary professionals working together on this.

[Warpy]

7. I know the antidote in humans is leucovorin

It's a folic acid derivative, folinic acid. It's used in chemo when symptoms of toxicity from chemo become severe.

I have no idea whether it's tolerated by small animals.

It's certainly worth looking up for dosage ranges.

[kestrel91316]

8. VIN is on top of the leucovorin thing. I can't imagine there's enough

of it in the entire US to treat everybody, and it's probably hideously expensive, too. And the bigger issue is - how much time do you have after exposure to use the antidote before it becomes pointless? We have had a serious delay in proper treatment because we didn't know what it was. In human medicine, they usually know right away that the dose of chemo - oops - was too high, and they treat immediately.

The horror of this has me shaking.

[Warpy]

12. My question is why they'd put methotrexate into wheat

in the first place, unless it was meant to be seed grain. That begs the question of why that adulterated grain was then sold as a consumable product. It would be dangerous to humans, too.

I am deeply grateful that my kitty lives on kibble and likes it.

I'm wondering if a large dose of folate would help the animals almost as much. There is plenty of that around.

I can't imagine what you and other vets in the trenches are going through.

[IndyOp]

13. They are going through heartbreak I am sure - along with pet food stores...

I just dropped by my local-family-owned pet food store this morning and they are in a state of shock. They look as if the blood has drained out of their faces.

As we talked about the food issue, one of the customers announced that one of his three dogs had to be treated for kidney failure, that the dog would be fine, but that he has the emergency treatment bill to prove the sickness. I suggested that he post the information on PetConnection.com.

It seems possible to me that someone put the rat poison into an ingredient at the plant on purpose - like the Tylenol case long, long ago.

:(

[hedgehog]

16. That's the explanation right there - seed grain treated with a chemical then

sold for consumption! Go into any farm store in a few weeks and you'll see bins of seed for sweet corn. It's dyed bright pink to signal it's been treated to prevent the seed from rotting in wet soil and to warn people against using it for cattle fed. Usually there is a sign warning parents not to let their kids runs their hands though the seed as well.

[kestrel91316]

19. This was not seed grain treated with a fungicide.

The grain was treated with a rodenticide which is a banned chemo drug in the US. China has less stringent standards than us. It was Chinese wheat that they made the wheat gluten with.

[davsand]

21. Was the company buying cheap stuff for animal foods?

Is that the deal? Were they trying to save cash by purchasing this stuff?

I'd think treated grain would cost more--just because of the chemicals put on it...

Geeze. Makes me wonder: What is in my loaf of bread?


Laura

[kestrel91316]

17. They put aminopterin in the grain, as a rodenticide (bet it works great).

It's very similar to methotrexate, which is a chemo drug in the US that oncologists have experience with. Aminopterin isn't used in chemo due to the side effects.

[Warpy]

26. It's one of those last line, last ditch drugs

but that might explain why such a large quantity was sold off on the cheap, making it more economical than the usual warfarin.

China has lousy quality control on foodstuffs. There was a poisoning case there a year or so ago (as I dimly recall) involving a convenience food manufacturer using inedible, toxic dyes in his food.

They're going to have to tighten this stuff up a lot if they expect to keep selling overseas.

[Blue Gardener]

64. Its not just foodstuffs

China seems to have pretty lax quality control on everything. I work in the automotive industry, and we will soon be shipping some interior parts to China. I know their flammability standards are much less stringent than they are in the US.
I trust NOTHING that comes from China. Them selling poisoned wheat gluten does not surprise me at all. And US companies willing to buy it to save a few pennies is disgusting.

[Warpy]

68. I know, their quality control is nonexistant

to the point that if something sorta looks like it's been assembled OK, it's shipped.

I looked for a foot pump to inflate my bicycle tires. The only ones I could find were all cheesy little things, all made in China, different colors and labels but basically the same item. I have owned several, and all have failed within a couple of months of purchase.

I now own an electric pump.

Corporate pigs don't seem to care that they're importing and selling crap, even if it's unsafe crap. They just budget for the few "cranks" who sue them over it. It's cheaper than paying Americans to produce quality products.

[Morgana LaFey]

50. This would've been helpful in your OP

you can usually persuade people to get involved better if you tell them why. Sorry to nitpick, but it's true nonetheless.

[kestrel91316]

18. The thinking is that it's TOO LATE to derive any benefit from using

folate.................too much time has elapsed between exposure and correct diagnosis.

[Warpy]

23. Damn! Damn! Damn! Damn!

However, you're still likely to see new cases from people who don't watch the news and haven't heard of the recall. Maybe they can still be helped by folate.

In the meantime, this is going to get much uglier. It could as well have been people's kids along with their cats and dogs.

[eppur_se_muova]

25. Unfortunately, seed grain has been mixed into the human food chain before.

http://www.fda.gov/fdac/reprints/mercury.html

Studies of the poisoning incident in Iraq have provided limited data about what effects low levels of methyl mercury exposures to the fetus have on the infant. One possible effect, for example, is lateness in walking. In the fall and winter of 1971-72, wheat seed intended for planting--and which had therefore been treated with an alkyl mercury fungicide--was mistakenly used to prepare bread; more than 6,500 Iraqis were hospitalized with neurological symptoms and 459 died. The vast majority of the mothers experienced exposures that resulted in hair levels greater then the lowest levels associated with effects in adults. But there was no clear evidence that the fetus was more sensitive that the adult to methyl mercury.

http://en.wikipedia.org/wiki/Ergot

The mass poisoning which took place in the French town of Pont-St. Esprit in 1951 has been widely presented in the lay and scientific press as an example of ergotism. While the poisoning was traced to bread, ergotism was not the cause of the syndrome, which was due to a toxic mercury compound used to disinfect grain to be planted as seed. Some sacks of grain treated with the fungicide were inadvertently ground into flour and baked into bread. Albert Hofmann arrived at this conclusion after visiting Pont-St. Esprit, and analyzing samples of the bread (which contained no ergot alkaloids) and autopsy samples of four of the victims who succumbed (Hofmann 1980; Hofmann 1991). On the other hand, Swedish toxicologist Bo Holmstedt insists the poisoning was in fact due to ergotism (Holmstedt 1978)...<1>

[yardwork]

29. I remember the 1971-72 incident. How ironic that it occurred in Iraq

The grain had been provided for seed, but the people were hungry that winter and they ground it up into bread. It shows how LONG we've been torturing the people in the middle east.

And this rat poison in the food supply. It's heartbreaking.

[eppur_se_muova]

30. IIRC, the grain was dyed bright red (maybe pink) to mark it as dangerous.

I remember immediately thinking of pistachios (which used to be dyed red) and wondering how effective that was.

Limited literacy is always a factor to worry about. Even the old skull and crossbones isn't adequate warning sometimes. Don't know if that played any role here.

[yardwork]

32. That's right - it was dyed but the warnings were in English

The people couldn't read the warnings, and they thought that the bright pink dye was pretty. They made loafs of bright pink bread for their starving children.

[roseBudd]

39. China is notorious for contamination and mislabeling of herbal supplements, why would food be

any different. Allopathic ACVIM vets are having to constantly fight to be listened to when a client has a propensity to value the advice of a homeopathic or naturopathic dvm.

I am on a Feline Heart Yahoo group and one woman's cat almost died from homeopathic digitalis for HCM. This was an asymptomatic cat, not a cat in heart failure. The woman began listening to her ACVIM vet and was thrilled at how well her cat responded to the non-natural "oh the horror" pharamceutical beta-blocker atenolol.

[Clark2008]

9. Kick

:kick:

[deminks]

10. OBGYN's might help - methotrexate used to treat ectopics. nt

what on earth happened? I just got here.

[kestrel91316]

11. Thank you! They found aminopterin, a human chemo drug, used

as rat poison in China, in the pet food.

[kestrel91316]

14. Let's please keep this kicked for now. The presser is coming up.

That may really help ger the word out.

[davsand]

15. Kicking FOR the cats (and dogs!)

We love our kitty, Chaucer. He's family.

Here's to the vets our there fighting to help the affected animals!


:kick:



Laura

[piesRsquare]

52. Don't forget the Techs...

:-)

piesRsquare <--Vet Tech

[OnceUponTimeOnTheNet]

20. recommended.

[TZ]

22. kicking

for my wonderful fuzzy children, aka kitties. Thank you Kestrel!!:yourock:

[merh]

24. Kick

:kick:

& recommended

[Holly_Hobby]

27. Please warn people about chronic effects vs. acute

Pets can have chronic poisoning that isn't so easily seen.

[kestrel91316]

31. We just don't know enough to speculate about this aspect yet.......

[Maraya1969]

67. I keep wondering if my dog was exposed a while ago because he is not sick

now but he is 14 so he has slowed down. He does seem a little more tired and we don't take as long walks as we did in December when I got him.

He is such a picky eater and I can't remember if I ever gave him any of those products. I know I gave him some Pedigree wet food. I was giving him that food in a roll when this whole thing broke. (Now I'm cooking hamburger meat and mixing it with oatmeal and I even get him hamburgers and chicken burgers from Burger King because I am afraid of pet stores right now.

Forget about the dry food. He refuses to eat it.

It also just occurred to me that my friend's dog died from kidney failure about 2 months ago. They didn't know what caused it then.

[Eurobabe]

28. K & R for ALL furkids!!

What a tragedy. :cry:

[Tsiyu]

33. Another kick

Perhaps now when some are asked, "who will grow your food?" they won't laugh off the question.

Let's hope this is a very isolated situation and not a sign of complete decline in food safety. Under the current less-government-protecting-you-from-thieves-more-government-listening-to-your-phone-calls style of federal administration, I can't see any reason for TPTB to allocate any more resources for inspections and such.

Has the White House had anything to say about it all?


Here's hoping you get some help.

:kick:

[AzDar]

34. Kick...n/t

[Nikki Stone1]

35. dfjilag;uepri [bviv'gks,V'

(Meow.)

[ArbustoBuster]

37. Kicking, too

[piesRsquare]

55. That photo is so great!

I love it!

Miao! :-)

[Nikki Stone1]

36. kljl;iyivo;ig;n

(Meow)

[kestrel91316]

38. ``````````` 11111111111111 ````````````1`11111111111

That's all mine can manage.......

[Nikki Stone1]

40. LoL!!!!!!!!!!!!!!!!!

.....

[libnnc]

45. lkorfrfthgtk,gk,tlfgvhyrdtgkl

She wants an explanation!




kick :kick:

[Nikki Stone1]

48. vnju8u)))))ld; kafldkflkdlaklkdfs; kldfls;k

djmsadk/jaso'k,mcmk'dlkoduifndk;aui
dsnja'judkmfodkldfmdounrm0e9jv
k,lkdjskajfsa'
al

[piesRsquare]

41. Hey Kestrel

I just called a friend of mine who is a (human) pharmacologist, who apparently knows A LOT about methotrexate toxicity. I sent him your original post (links and all) and he will be contacting everyone mentioned with what he knows.

Note to all readers: Pass the word on to pharmacologists as well

On Edit: My cats say "Miao"! :-)

[kestrel91316]

53. Thanks!

[roseBudd]

42. From PubMed: The difficulty in handling poisonings associated with Chinese

Vet Hum Toxicol. 1997 Apr;39(2):106-14. Links
The difficulty in handling poisonings associated with Chinese traditional medicine: a poison control center experience for 1991-1993.

The purpose of this prospective case series was to outline the characteristics of Chinese traditional medicine poisonings and develop essential information for poison prevention and management. All phone inquiries made to the Poison Center related to Chinese traditional medicines from January 1, 1991 to December 31, 1993 were included. Standardized questionnaires were used to capture relevant information. Among the 318 phone inquiries about Chinese traditional medicines, 273 cases were classified as poisonings; and 22 mortalities occurred (6.9%). All of the poisonings occurred because of suicide attempts, accidents, or erroneous or improper use or processing. In our study, 47% of the potential toxic effects of Chinese traditional medicines were either unknown or could not be found in the literature. There existed undefinable uncertainty in attributing the clinical effects to the exposures to Chinese traditional medicines. We recommend that the strategy in handling Chinese traditional medicine poisonings to decrease mortality should be comprised of confirmation of the generic name of the substances and the specific part of the plant used, awareness of improper processing methods, maintenance of records on a broad review of systems and laboratory data, identification of active principles and potential interactions among the individual active agents; verification of histopathologic effects of the toxins; development of information on toxicodynamics and toxicokinetics; intensive supportive care for poisoned patients, and investigation of potential antidotes. There are several regulatory options available to health authorities to control the unrestricted use of these potentially toxic medicines and to help safeguard the public.

[roseBudd]

43. Toxic heavy metals and undeclared drugs in Asian herbal medicines

Toxic heavy metals and undeclared drugs in Asian herbal medicines.Ernst E.
Dept of Complementary Medicine, School of Sport and Health Sciences, University of Exeter, UK. [e-mail]

Asian herbal medicines are currently used by large sections of the population. Because they are not regulated as medicines and are freely available to everyone, serious safety concerns might be associated with these herbal medicines. In this article, evidence suggesting that some Asian herbal medicines contain toxic heavy metals or undeclared prescription drugs is reviewed. In particular, Indian and Chinese preparations have been implicated. Although adulteration with drugs is by definition fraudulent, the inclusion of heavy metals could be either intentional for alleged medicinal purposes or accidental. Evidence from various countries implies that toxic heavy metals and undeclared prescription drugs in Asian herbal medicines might constitute a serious health problem. However, the majority of the data is anecdotal and insufficient to define prevalence figures. Ways ought to be found to maximize consumer safety.

[roseBudd]

44. here is an avenue, looks like hospitals have been concerned about methotrexate exposure to personnel

Exposure of oncologic nurses to methotrexate in the treatment of osteosarcoma.
Authors:

Mader RM

Rizovski B

Steger GG

Wachter A

Kotz R

Rainer H

Author Address: Department of Internal Medicine I, Division of Oncology, University of Vienna, Austria.


Source: Arch Environ Health. 1996 Jul-Aug; 51(4):310-4.


Abstract:

Methotrexate is a therapeutic agent used widely for osteosarcoma. We used an extremely sensitive high-performance liquid-chromatography assay to evaluate 112 urine samples obtained from 28 hospital employees during high-dose therapy with methotrexate and during routine care of patients. The highest cumulative urinary excretion was observed when methotrexate infusions were handled in a workbench from which a portion of filtered air was emitted into the room. Remarkable urine contaminations were identified for personnel, including 1 administrative employee who had "stood by" for 2 h in the room where infusions were prepared. Lower methotrexate concentrations were detected in the urine of nurses whose exclusive function was to care for patients. The urine burden in oncologic nurses decreased after a central pharmacy unit was installed. Methotrexate was excreted in the sweat of patients who were under high-dose therapy, and its elimination half-life was 11.1 h (mean maximal concentration = 1.7 micrograms/ml

[TZ]

46. another kick for you..

mew, squeak, claw, claw, boom, my children aren't allowed in computer room because they find computer wires tasty but I thought I would let you guys in on what I listen to while posting.:silly:

[redacted]

47. kestrel, cycling buddy is an oncology charge nurse at a big private hospital here in

the San Francisco area; one of us will put a call in to her over dinnertime tonight.

[kestrel91316]

54. Thanks!

[Pierogi_Pincher]

49. K&R/ thank you for your sticking-to-it-tive-ness! n/t

[druidity33]

51. kick...

[Vox Acerbus]

56. Kicking

Because this fellow is pissed about all the animals hurt due to this criminal negligence.

[Nikki Stone1]

57. fdjkas;u9wpcm830-qcx[d

sfdglsdf;,l mvigitrjnmagjldss

(Meow)

[blondie58]

58. thanks so much, Kestrel

my two furpuppies and my seven furkitties appreciate it. I am so grateful that we had none of those brands in our pantry.

These are scary, scary times. I grieve for all of the innocents.

[Erika]

59. I love my animals but can we show the same passion for our military?

See www.icasualties.org Our military is suffering also.

[blondie58]

65. Erika - I don't think that is the case

I think that we all feel deeply for our soldiers and the injustices that are heaped upon them, both over there and upon their return.

However, this entire story is unbelievable. Who knew that our pets food was made in Canada and that they bought their wheat gluten from China? And the saddest part was that the owners unknowingly poisoned their own pets.

These stories need to be exposed and investigated as they may not just stop with the pet food. What if a company bought something from a company that used similar products that they fed to their child?

Knowledge is power.

[stimbox]

69. Boycott

Boycott all of the brands, wet or dry, that were named in this disaster.
Hit them where they live.

[Gelliebeans]

60. A K&R for kestral

[ninkasi]

61. K&R

Anything that can be done, I hope will be done...

[intaglio]

62. Kick and Rec

[Kurovski]

63. Kick.(nt)

[WiseButAngrySara]

66. Kick! ....n/t

[bananas]

70. kick. nt