{"id":192,"date":"2020-03-06T14:18:03","date_gmt":"2020-03-06T14:18:03","guid":{"rendered":"https:\/\/elliottandbulbeck.co.uk\/?page_id=192"},"modified":"2020-04-14T06:21:11","modified_gmt":"2020-04-14T06:21:11","slug":"peticide","status":"publish","type":"page","link":"https:\/\/chichester-vets.co.uk\/peticide\/","title":{"rendered":"Peticide"},"content":{"rendered":"\n

Is the Veterinary Industry, and Pet related business, participating in the systemic destruction of human and animal health as well as the environment?<\/h4>\n\n\n\n
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Dr Mark Elliott BVSc VetMFHom MRCVS MLIHM PCH DSH RSHom <\/p>\n<\/div>\n\n\n\n

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v. March 2020 <\/p>\n<\/div>\n<\/div>\n\n\n\n

Concern for\nthe environment and its destruction due to human influence has never been\ngreater. Public demand for change is forcing governments around the world to\nlook to targets and set proactive agendas like never before. People are making\nlifestyle changes to do their part even if there is direct personal cost.<\/p>\n\n\n\n

And yet,\nillogically and in what seems a wholly irresponsible way, the Veterinary\nIndustry in the UK is promoting mass application\/dosing of pesticides and worm\ntreatments for pets. There seems little to no recognition of the consequences\nfor the environment, or for the direct human and animal health concerns. <\/p>\n\n\n\n

BUGLIFE, the\ncharity dedicated to conservation of invertebrates, highlighted the fact that\nchemicals used for prevention\/treatment of ticks, fleas and other parasites of\npets are being recorded in water supplies downstream of\/associated with major\nconurbations, and that these can only be due the products Vets and Pet Stores\nare selling. These chemicals are extremely toxic to many aquatic organisms and are\npersistent in the environment for long periods of time. They called in 2016 for\nan immediate ban on the sales of these products but have been ignored (1). <\/p>\n\n\n\n

Little\nconsideration has yet been given to (or raised publicly about) the widespread\ndissemination of these chemicals through urine and defaecation to parks and\ngardens, through dander and fur to household environments, and yet these can be\nseen as significant sources of environment pollution and even the latter a risk\nto human health (in addition to exposure via direct contact with a recently\ntreated pet). <\/p>\n\n\n\n

As single\nchemical products fail, many newer Veterinary products now combine multiple\nchemicals to achieve their aims. Chronic exposure to mixtures of pesticides is\none of the major causes of the collapse (est. 50%) in the biomass of insects,\nmany of which we need to maintain the now fragile ecosytems that support human\nlife. Each and every one of us should be very concerned. (2).<\/p>\n\n\n\n

Exposure to\neven tiny doses of pesticides can have complex and unpredictable sublethal\nimpacts on insect behaviour. On top of this there can be unexpected and\nsynergistic interacts between different pesticides and other stressors such\nthat the combined effects can be much worse than one might expect from data\ncaptured by the regulatory process for pesticides. That process only focuses on\nshort term exposure of otherwise healthy individuals. As a result, even DEFRA\u2019s\nchief scientist recently admitted that it is not currently possible to predict\nthe environmental repercussions of landscape-scale use of large quantities of\nmultiple pesticides (3) to which the Veterinary use is compounded<\/p>\n\n\n\n

Prophylactic\nuse of pesticides is contrary to all of the principles of Integrated Pest\nManagement, a widely accepted approach that seeks to minimise pesticide use as\nexpressed in the EU\u2019s Sustainable Pesticides Directive (3) However, recent\nrestrictions on the use of some pesticides by the EU do not cover use when\napplied as flea treatments for dogs and cats \u2013 considering the  above it surely is time for legislating\nagainst prophylactic medications if the profession will not take a responsible\napproach to the problem <\/p>\n\n\n\n

We\nurgently need to stop ALL routine and unnecessary use of pesticides that are\nonly adding to the problem, and start to build a network where nature can\nrecover.<\/strong><\/p>\n\n\n\n

If other\ncountries can do this, and prophylactic sale\/use of these chemicals can be a\ndisciplinary offence for Vets, why have we not followed suit? <\/p>\n\n\n\n

Worse,\nsomewhat bizarrely in in the UK we have even allowed some to be available over\nthe counter in pet stores and on-line (without prescription) so use is\ncompletely unregulated, unrecorded and without any realistic control without\nre-visiting legislation<\/p>\n\n\n\n

I have previously written and published articles along these lines in the wider media and I have encountered from within the Veterinary profession attacks on my person and my integrity, as well as threats of legal action. In response I challenged representative of an organisation claiming independence of thought, yet linked to a parent organisation sponsored by the pharmaceutical giants, to produce the \u201cwealth of peer-reviewed research to support routine treatments as an essential part of prevention\u201d, that they claimed existed; unsurprisingly perhaps, none were ever forthcoming. Perhaps it was because I asked them to provide such where it could be shown there was NO commercial support\/direction to the studies, no commercial vested interest, and where all the environmental risks and consequential health challenges to \u201cin-contacts\u201d had been fully considered. (4) The role of scientists is to tell the truth, but the bearers of bad tidings do not always fare well. Historically they have been belittled, ignored or worse. So the nature and aggression of the attacks suggested something was even more seriously wrong and added weight to the argument this debate must be brought to prominence in the environmental agenda. <\/p>\n\n\n\n

\u201cAnyone who asserts his or her therapies should not be criticised should have his or her therapies questioned closest of all\u201d.<\/p>Campaign for Rational Vet Medicine, Vet Times April 2018<\/cite><\/blockquote>\n\n\n\n

There are clearly huge profits to be made from marketing of pesticides for pets to a consumer society that is easily manipulated. April sees the annual increase in articles and adverts in the Veterinary Press to get Vets on-side, and television campaigns as well as emotive articles in the mainstream media warning of death and dire consequences for pets and their human companions if we don\u2019t swamp them with these chemicals. Veterinary practice management software is set up to market these products creating text, email and postal reminders to encourage client compliance. Pet \u201cHealthcare\u201d programmes seek to bind clients into application of these chemicals, with supply paid for on easy to manage direct debit. Once hooked you become a valued client, maybe even getting discounts on other services for following the flock \u2013 all seemingly such a good deal. Software can target the non-compliant as well so there is little escape for the unwary, and Veterinary business journals even publish articles about \u201cmining\u201d clients data for gold ! (5) I don\u2019t actually believe, as individuals, the vast majority of Vets are in anyway uncaring or inconsiderate. Recent surveys have found 89% want to play a more active role in Sustainability. However, the use and marketing of these chemicals has become almost ubiquitous within Veterinary practice and sales a key part of the business model. The rise of large corporate owned chains of clinics, with shareholders, accountants, and targets for sales, as well as a weight of influence on regulators and the media, has fundamentally changed the profession and creates an environment that is difficult to confront. Such should never have been allowed to happen and it is for Veterinary practitioners to take back ownership and responsibility for pet care and respond to this crisis. <\/p>\n\n\n\n

Of course to get any community to address concerns there has first to be recognition that there is a problem, and therein lies the rub. Aside from the financial pressures on the industry, Vets have little time in their busy lives to interrogate such issues, and there are so so many articles in the Veterinary Press that influence, promote and argue for ever more use. Such articles never (and I have read many) mention the environmental, pet, or human risks from the use of these products, instead they make claims of risk, and of the scale of disasters that may happen if products are not marketed, sold and applied endlessly, that on closer interrogation are more fiction than fact. <\/p>\n\n\n\n

It is also widely acknowledged the profession is not in a healthy state as regards mental health which cannot help. There are multiple initiatives to try and address this, but are such missing a link? Vets are suffering an epidemic of suicide, and as chronic exposure to some of these pesticides can lead to depression, in an already stressful world are we adding to that risk for colleagues? We know that there are risks from some of these chemicals to sperm viability and DNA integrity, development of the unborn child, for still-births and miscarriages from chronic exposure and yet this is never once mentioned in industry led articles promoting pesticide use. In a young female dominated profession it would make sense to have that debate and apply a precautionary approach even if the research is currently thin on this.  Consider that almost every dog or cat visiting a clinic promoting regular pesticide use will potentially expose staff to that product. <\/strong>(6) Even in clinics where the use on the pet is not always known risk is there as products may have been purchased from pet supermarkets or on-line where some are freely available.<\/p>\n\n\n\n

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To add to the\ndifficulties research is almost never done to investigate harm from product use\nlong term, it is mostly only through surveillance systems and large volumes of\ndata collected after years of use that these issues are belatedly realised. <\/p>\n\n\n\n

Fortunately, some\nregulators are becoming more transparent and making such data more accessible\nwith technology. The European Medicines Agency has set up an information site\nwhere you can type in the generic name of the chemical and it will show data on\nreported issues from exposure, both human and animal (if there is any\ndifference). The link is listed below and alot of the data on Flea and Worm\nproducts is pretty scary. Consider though, when accessing that data, it is\nrecognised that only around 4% of human adverse reactions to medicines are ever\nrecorded, it\u2019s possibly even less for animal reactions, and quite likely that\nthe human reactions to veterinary products are rarely recognised and recorded.\nSo without widespread recognition and acknowledgement of problems what are the\ntrue levels? I would suggest they can only be much higher than the already\nworrying levels reported in that data.<\/p>\n\n\n\n

Humans aside,\nrecent report in the Veterinary Record has acknowledged the probability of\nenvironmental risk from topical pet ectoparasiticides. The same report noted\nastoundingly that the process of authorising these products may not have taken\nsufficient account of their possible environmental impacts and that risk\nassessment stops early on as it is assumed the products are not used in large\nvolumes! However, there are a lot of dogs, and with a high concentration of\nthese products in use, so the effects are now being seen. (6a)<\/p>\n\n\n\n

My own\nexperience of asking clients, transferring from other practices and who request\nthese products, as to whether they are aware of the side effects, the potential\nenvironmental concerns, and the actual level of need to worm, flea and\nchemicalise is that not one has ever been informed by the previous Vets. Few have\nread the information on the packaging either (potentially relied on as a get\nout clause for the vendor). Almost all are shocked, even angry, at the fact\nthey had not been fully appraised that there might even be a problem at all.\nThere was no informed consent, no understanding of the potential for problems, no\ninstruction how to mitigate risks, and no explanation of the concerns for\nanimal and human health in the process of sale -it was just what they were told\nto do.<\/p>\n\n\n\n

The RCVS\nGuide to Professional Conduct clearly states: <\/p>\n\n\n\n

4.1  The\nresponsible use of veterinary medicines for therapeutic and prophylactic\npurposes is one of the major skills of a veterinary surgeon and crucial to\nanimal welfare and the maintenance of public health.<\/p>\n\n\n\n

6.1\nVeterinary surgeons must seek to ensure the protection of public health and\nanimal health and welfare,  and must\nconsider the impact of their actions on the environment.<\/p>\n\n\n\n

Surely articles in the media designed to educate vets, and similarly adverts to the profession should be required to consider and present the potential risks from marketing of these products to clients? In my response to one attack I suffered for raising these concerns I noted to the antagonist: \u201cNot once, in any article you have written that I have read (and there are many) do you consider or reference the risk to the environment, or to the humans exposed chronically (even at low level) to these pesticides. Not once have you referred to the growing evidence of adverse reactions in pets; the many, many sick and chronically ill that result, and the many deaths thought to be due to these chemicals use\u201d. (4) The recent concerns from the FDA (7), as well as the reports from the VMD (8) provide ample evidence of this. And lets not forget the ignored public who are ever louder clamoring for consideration through forming networks and campaign groups to highlight the problems they and their pets are experiencing from use of these poisons.\u201d(see list of concerned groups) <\/p>\n\n\n\n

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I raised the challenge: \u201cWith your position and contacts in the profession you have the opportunity to contribute to ensuring a better future for us all. Will you do this, or will you continue to market excessive and injudicious use of pesticides and lead the world further towards another mass extinction? I challenge you to look deep within and decide.\u201d (4)<\/p>\n\n\n\n

I heard\nnothing more\u2026\u2026\u2026\u2026..<\/p>\n\n\n\n

And yet \u2013 that very week an article was published by the same antagonist in a business journal warning vets that client fears over use \u201cwill reduce compliance\u201d. Compliance being a word used frequently, at times in the same sentence as maximising sales. (9) Frankly the whole episode was beyond belief. <\/p>\n\n\n\n

Are there\narguments justifying Mass pesticide use on Pets?<\/strong><\/p>\n\n\n\n

It is worth\nlooking at some of the arguments put forward as to why in the UK dogs and cats are\nregularly doused with chemicals to try and prevent infestation with fleas,\nworms and ticks? Why are we advised to try and prevent infestations that may\nnot happen? Is there any logic and good science behind it? <\/p>\n\n\n\n

Obviously I\ntried to get some good scientific unbiased data to support the use of these\nchemicals, as noted above, but none was forthcoming (4) <\/p>\n\n\n\n

Worming<\/strong><\/p>\n\n\n\n

In the\njournal \u201cCompanion\u201d published by the British Small Animal Veterinary Association\nin December 2017 it was notable in a report from Norway that there \u201cWe don’t\nroutinely worm dogs other than pups and nursing bitches (because there is no\nneed, not because we don’t bother..)\u201d (10) Norwegian Vets are not allowed to\nsell prescription only medicines (POMs), so there is also no financial\nincentive to prescribe other than for actual need anyway. This contrasts the\nposition in the UK.<\/p>\n\n\n\n

Similarly in\nDenmark prescriptions of POMs are only allowed after a positive diagnosis of\ninfection and there is greater awareness of environmental concerns from use of\nthese products (11)<\/p>\n\n\n\n

Are our worm\nproblems so different to those countries? Of course not,they\nhave the same worms. This includes lungworm but clearly they do not see that as\na such major issue as we seem to in the UK despite similar levels of incidence,\nand certainly not worth the risk of the products without good cause.<\/p>\n\n\n\n

Part of being\na scientist is to question everything, especially when practices are based on\ntradition rather than a clear evidence base. It has become increasingly clear\nto me that in the UK regular worming of adult pets for roundworms and tapeworms\ndue to the risks to pet and human health is just not based on a sustainable or\neven an evidence-based argument. <\/p>\n\n\n\n

Worming of a\npet only treats the current infestation and after just a few days new\ninfestations can begin to establish as the eggs and infective forms of these\nparasites are pretty much endemic in the environment. When I was at University,\nlong before the advent of many of the newer chemicals, we were categorically\ntold that to worm too frequently also led to a reduced immunity in the host\nspecies and greater levels of worms and egg shedding. Within only a few weeks\nof worming infestations have often re-established and eggs are being shed into\nthe environment \u2013 this certainly happens more quickly than a month, the now commonly\nrecommended interval now by the pharmaceutical companies for the application of\ntopical pesticides and wormers. Question has to be raised therefore \u2013 are we\nactually increasing possible risk by continuing current practices of monthly\ndosing of pets?<\/p>\n\n\n\n

Lets look at\nsome of the confusion and mixed messages in the Veterinary Press:<\/p>\n\n\n\n

Quotes from\njust one article: (12)<\/p>\n\n\n\n

\u201cTo achieve\ngood worm protection, a parasite risk assessment should be considered. Indeed,\nprior<\/p>\n\n\n\n

to\nprescribing any preventive antiparasitic therapy, a full parasite risk\nassessment should be<\/p>\n\n\n\n

performed.\u201d <\/p>\n\n\n\n

\u201cDue to the\nlack of a robust scientific evidence, veterinary professionals use clinical\njudgement to figure out what works best for each pet.\u201d<\/p>\n\n\n\n

\u201cSome\nguidelines, developed by professional organisations, recommend the use of\nantiparasitics at<\/p>\n\n\n\n

a certain\nfrequency based on \u201cexpert opinion\u201d, but without substantial evidence to\nsupport such<\/p>\n\n\n\n

recommendations.\u201d<\/p>\n\n\n\n

To add to the\nconfusion:<\/p>\n\n\n\n

\u201cit is\nimportant to minimise the risk of clinical disease \u2013 especially in high-risk\ncases \u2013 treatment at a frequency close to the pre-patent period (monthly for\nconvenience) will help achieve this.\u201d<\/p>\n\n\n\n

And yet:<\/p>\n\n\n\n

\u201cNo definite\nevidence exists that resistance to commonly used anthelmintics in dogs and cats\nis an<\/p>\n\n\n\n

emerging\nproblem\u2026..However, experiences with worm species \u2013 particularly those with the\nquick spread of anthelmintic resistance (AR) in livestock \u2013 should warn\nsmall animal clinicians against the extensive use of anthelmintics for the\ncontrol of helminth infection in dogs and cats.\u201d<\/p>\n\n\n\n

So,\nlike antibiotics, if used indiscriminately and excessively resistance to\ncurrently effective pesticide medications is inevitable. <\/em><\/strong><\/p>\n\n\n\n

I\u2019m sure most\nVets in practice would acknowledge many products are fast becoming ineffective,\nand some would argue that is why combinations are appearing with ever more\nfrequency.<\/p>\n\n\n\n

It is\nacknowledged:<\/p>\n\n\n\n

\u201cThe quest\nfor optimal deworming frequency is ongoing, due to the diversity and complex\nnature of<\/p>\n\n\n\n

parasites,\nand because a solution that can fit all scenarios simply does not exist.\u201d<\/p>\n\n\n\n

So as a GP\npractitioner what to do? <\/p>\n\n\n\n

In line with\nthe very good advice in this article to first conduct a risk assessment (12), we\nadvise clients to do worm counts on faeces samples to assess actual need for\nworming. Almost all find there is no need to worm adult pets, and for some\nthere is no need even to worm younger animals. Lungworm can be checked for and\ntreated (if manufacturers claims are correct) if there.<\/p>\n\n\n\n

And if you\nare worming without infestation what does that achieve? There is now debate\nover evidence that wormers can alter the animals microbiome, some wormers can certainly\naffect bone marrow function and immunity (likely only short term \u2013 but with\nrepeated use?), levels of wormer may be higher with nothing to use them up\nmaking risk of adverse events from the product worse, and excretion into the\nenvironment is possibly higher.<\/p>\n\n\n\n

Even if there\nis some evidence of low level of parasites, it is important to realise that\nrarely do parasites have lifecycles that compromise or kill their hosts under\nnormal evolutionary conditions. We do of course create a potential problem by\nour manipulation of the environmental conditions under which we keep many animals,\nbut for pets it\u2019<\/ins>s not really that intensive. And as\nadults all species have evolved to live with a low level of infection, even\nsome argue it is important to maintain health. It is at times of reproduction\nthat parasites seek to spread to new hosts and that is why worming of\nbitches\/queens with young is still important as these are the times of\nincreased risk to life (never, ever, worm in pregnancy as these chemicals are\nteratogens). Ask yourself \u2013 if most humans have worms anyway, including\ntapeworms, why are we not wormed regularly? <\/p>\n\n\n\n

Risks to Human health of worms in Pets?<\/strong><\/p>\n\n\n\n

So if worming\nalmost certainly fails to completely prevent, should we really be concerned\nover human risk from worms? <\/p>\n\n\n\n

Looking at a\ncouple of examples:<\/p>\n\n\n\n

Toxacara<\/strong><\/p>\n\n\n\n

With the\ncommon roundworm \u2013 Toxocara \u2013 there is a known risk of 3 forms of disease. Of\nparticular concern is ocular toxacariasis where the larva migrates into the eye\nof small children It can cause blindness along with some other associated\nconditions such as epilepsy. So obviously serious if the child is unlucky\nenough to be affected. However, a very large study in Ireland failed to\nconclusively show that infection was linked to dog and\/or cat ownership, not\nleast because laboratory results showed a high seropositive rate (31%) of\nchildren to exposure to the parasite, but only at worst 12 cases per 100,000 of\neye problems relating to the worm. What did seem linked was geophagia (earth\neating) and there was a suggestion that climatic conditions that supported the\nsurvival of the infective larval stage may have an impact on the higher level of\ncases in Ireland than other areas. (13)<\/p>\n\n\n\n

Whatever, it\nis clear, for all the worming of Cats and Dogs done there is no demonstrable\ndecrease in human risk of this disease.  It\nis even reported there are 34 million Toxacara eggs released per square\nkilometre per day (14), and yet it is at times described in the veterinary\nliterature as the most common zoonosis to pass from dogs and cats to humans. Whilst\nexposure levels are clearly high, also clear is the very low risk of consequent\ndisease from Toxocara. Compare this to Toxoplasma (a protozoan) transmission from\nCats which is some 10 times more commonly reported as actually causing eye\nproblems, as well as risking the unborn child (15) And yet we don’t\npreventatively treat for that at all \u2013 personal hygiene is the way forward\nthere. Hygiene is arguably the way forward for Toxacara too as the eggs only\nbecome infective in the external environment and contaminated\nfood\/pica\/infected water sources are the main routes to human infection.<\/p>\n\n\n\n

Echinococcus\nmultilocularis<\/strong><\/p>\n\n\n\n

In Europe and\nother countries (fortunately not the UK at the moment) there is a serious\ndisease caused by a Tapeworm called Echinococcus multilocularis. It is not that\nlong ago I sat in a committee meeting where the Human health risks of\nEchinococcus multilocularis entry into the UK through imported pets was raised.\nHuman deaths occur in Europe, including in children, from this tapeworm. With\nan asymptomatic incubation period of 5-15 years before clinical signs are\ntriggered treatment is not always successful even if diagnosed.  In dogs it causes no symptoms. Some have\nconcerns (myself included) the Pets Passport scheme rules are not stringent\nenough to prevent this crossing onto our shores, and that scheme arguably has\nmade the illegal import of dogs into the UK more prevalent. Considering in the\nUK our pets live in our houses and sleep in our beds, it would be devastating\nif this parasite ever got over here. In dogs that travel there would certainly be\na legitimate argument for more and targeted worming on return to the UK. Some\nwould say why travel a dog and put it at risk at all ? We certainly need more\naction on illegal imports and our loose borders before we have a mass panic\nwhen the first child dies and dogs are abandoned on the streets.<\/p>\n\n\n\n

However, at\nthis time it is not here and so for now not an argument for chemical use unless\nthe dog travels.<\/p>\n\n\n\n

Lungworm:\nAngiostrongylus vasorum<\/strong><\/p>\n\n\n\n

On the\nsurface this appears to be a special case, with reports of it spreading\nthroughout the UK, or at least the reports have increased and are recorded\ncumulatively as the marketing has raised awareness. However, the very marketing\nthat seeks to strike fear into our hearts that our beloved pets will die a\nterrible death also contains the information to calm those fears \u2013or does it?\n(16) It is stated that one product effectively resolves infections after just\ntwo doses 32 days apart. Do I believe that? No, I don’t at all as nothing is\nthat perfect, the treatment group was small, and reports are coming in of\nfailures in preventative programmes from discussions with laboratories. That\nsaid my experience is that it works mostly, and I would prescribe it more\nfrequently to an infected case as it seems illogical to treat at greater\nintervals than the pre-patent period of the worm and expect 100% efficacy\nanyway. It doesn’t happen that way in other species, so I don’t see why it\nwould in dogs. <\/p>\n\n\n\n

At least the\nnumber of deaths is not huge. Around 6-8 every quarter if reports are to be\nbelieved (there may be other cases missed diagnostically, or just not\nreported). From that figure one has to suspect clinically asymptomatic\ninfection is more likely and the Danish approach already discussed is more\nlogical as a way forward. Compare that to the estimated number of Road Traffic\nAccidents involving dogs in the UK, at around 100,000pa – clearly investment in\ntraining and a collar might be a better focus for marketing campaigns targeting\nresponsible dog ownership. <\/p>\n\n\n\n

The main\nsource of spread is the urban fox. Data shows infection rates of foxes at\naround 18% (50% in the south east) (16). Keen Springwatch fans will recall the\ncoughing fox that was chased out of it territory in Brighton and travelled\nmiles and miles before disappearing off the radar, presumably spreading\ninfection along its path. Its perhaps not politically correct to blame the fox,\nbut in my opinion the movement of pets around the country is not enough to\nexplain the spread of a condition. <\/p>\n\n\n\n

Interestingly\nthe Kennel Clubs website explains \u201cNot every snail or slug carries the\ndisease and lungworm’s geographical limitations means infection is currently\nrelatively uncommon, but it does rear its head from time to time\u201d. There is debate in the Vet\nprofession over the dramatic advertising (16) overstating risk as well and it\nis reported that \u201cmonthly treatment has been questioned by some clinicians who\nconsider monthly lungworm preventives unnecessary \u2013 especially when the\nevidence for risk of infection is minimal.\u201d (12)<\/p>\n\n\n\n

Logic says do\nnot encourage urban foxes into your garden if you have a dog, and if there has\nbeen case locally consider how best you protect your pet. In my opinion the\nbest route to take is to monitor your pet for infection and keep the products\nthat are effective, effective, so they are there when you need them the most. <\/strong><\/p>\n\n\n\n

Fleas and\nTapeworm<\/strong><\/p>\n\n\n\n

In the UK it\nis said that children can accidentally ingest a flea infected with the larval\nstage of the Tapeworm, Dipylidum caninum. Infection can lead to diarrhoea and\npruritis but is rarely serious in actuality \u2013 the stress of seeing tapeworm\nsegments in a child\u2019s stool or nappy is probably the main concern rather than\nit being a significant issue for human health. So not really an argument for\nrepeatedly chemically exposing everyone in reality.<\/p>\n\n\n\n

What about\nTicks?<\/strong><\/p>\n\n\n\n

Clearly there\nis growing concern over zoonotic diseases transmitted by Ticks, with Lymes\nDisease being the most commonly recognised problem. But the dog itself is not\ngoing to give its owner the Lymes Disease \u2013 that will only happen if the owner\nis bitten by an infected Tick, and there are plenty of precautions that can\nsensibly put in place to manage ourselves.<\/p>\n\n\n\n

Yes the dog\nis at risk itself, but there needs to be a logical approach to decrease risk by\napplication of the least level of insecticide at an appropriate time that will\nkill the tick without it needing to bite the animal to get a lethal dose.\nSpot-on or oral chemicals that rely on systemic (throughout the whole body)\ndissemination of the active ingredient with risk of attendant side effects, and\nwhich rely on the tick biting, are not logical. There are now very effective\ncollars with less systemic and environmental risk, and which kill without the\nneed to bite, that can be used in affected regions.<\/p>\n\n\n\n

So clearly\nthe Human Risk, whilst not nil, is negligible and quite arguably resolved in the\nmain by good personal hygiene. Education of pet owners I would argue would go a\nlot further towards reducing risk to human health than selling chemical\nproducts.<\/strong><\/p>\n\n\n\n

What are the Side effects of these\nchemicals? What are their impacts on the environment?<\/strong><\/p>\n\n\n\n

There are now\nso many chemicals on the market that it would be difficult in one article to\nassess and present them all even if they were all known about and even\npublished. Side effects that can affect the animal, associated animals\n(including humans) and worryingly also the environment are rarely researched as\nlong term issues, published or even reported. And researching a negative result\ntakes years and massive population cohorts to determine.<\/p>\n\n\n\n

To confound\ninvestigations, the trend now (as some chemicals seem to fail alone), is to\ncombine products in one \u201ccure all\u201d product. This makes it even harder as clear\ninferences regarding individual toxicity of each chemical cannot be easily\nmade.<\/p>\n\n\n\n

Add to that\nthe UK reporting system of reporting adverse reactions is reliant on voluntary\nengagement, and when various surveys in the human field with such systems suggest\nthat as high as 96% of problems are never reported at all what hope have we if\nwe rely on that ? (17)<\/p>\n\n\n\n

So we have to\nlook at data sheets from manufacturers, and reports from other industries, for the\nacute reactions; and what few long term mammalian and human studies there are\nfor more information. <\/p>\n\n\n\n

Imidacloprid  <\/strong><\/p>\n\n\n\n

Perhaps the\nmost commonly used insecticide in spot-on preparations in pets is Imidacloprid<\/strong> \u2013 a Neonicotinoid. <\/strong><\/p>\n\n\n\n

Neonicotinoids are classified by the United States\nEnvironmental Protection Agency as both toxicity class II and class III agents\nand are labeled with the signal word \u201cWarning\u201d or \u201cCaution.\u201d Because the\nneonicotinoids block a specific neuron pathway that is more abundant in insects\nthan warm-blooded animals, these insecticides are presented as more selectively\ntoxic to insects than mammals (18). Note the words \u2013 more abundant \u2013 not\ntherefore not present\u2026. <\/p>\n\n\n\n

The most available toxicity data of the neonicotinoids\nis with imidacloprid. This data indicates that it is less toxic when absorbed\nby the skin or when inhaled compared to ingestion. It causes minor eye\nreddening from contact, but is non-irritating to the skin. Signs of toxicity in\nrats include lethargy, respiratory disturbances, decreased movement, staggering\ngait, occasional trembling, and spasms. (18) There are no accounts of human\npoisoning, but signs and symptoms of poisoning would be expected to be those\nsimilar for other mammals and indeed are what is seen in pets<\/p>\n\n\n\n

Those are acute symptoms, but there are general population studies in humans reporting associations between chronic exposure and adverse developmental or neurological outcomes, including tetralogy of fallot (a developmental heart condition), anencephaply, autism spectral disorder, memory loss and tremors (19). Accepted these were limited and weak data, but enough to raise concerns and a call for more research. Other mammalian studies have raised concerns over high dose exposure leading to degenerative changes in the testes, thymus, bone marrow and pancreas. Cardiovascular and hematological effects have been observed. Longer term low dose exposure has been associated with effects on the liver thyroid and weight loss. In rabbits studies have raised concerns over reproductive toxicity, developmental retardation and neurobehavioural deficits.(20) If we think of the problems we are seeing in general practice today, there has to be concern that some of the problems we see are a consequence of acute and chronic exposure (including of Vets to animals that have had these applied) (6) The emerging science suggesting neonic pesticides pose a health risk to people, coupled with environmental contamination of waterways and food, raises an alarm beyond the already significant risk to invertebrate life. Remember always absence of evidence is not evidence of absence \u2013 it is better in my opinion to adopt a precautionary approach than to find out later one could have avoided the avoidable. (21) <\/p>\n\n\n\n

The Birds and the Bees<\/strong><\/p>\n\n\n\n

Bees.<\/strong><\/p>\n\n\n\n

Perhaps much more importantly than the impact on our Pets, and us, is the fact that to members of the genus Apis, the honey bees, imidacloprid is one of the most toxic chemicals ever created as an insecticide. <\/strong><\/em>Several studies have found that sub-lethal levels of imidacloprid increase honey bee susceptibility to the pathogen Nosema. Research has found that bees consuming the pesticide suffered an 85% loss in the number of queens their hives produced, and a doubling of the number of bees who failed to return from food foraging trips.(22) <\/p>\n\n\n\n

\"\"<\/figure><\/div>\n\n\n\n

In May 2012, researchers at the University of San\nDiego released a study showing that honey bees treated with a small dose of\nimidacloprid, comparable to what they would receive in nectar and formerly\nconsidered a safe amount, became “picky eaters,” refusing nectars of\nlower sweetness and preferring to feed only on sweeter nectar. It was also\nfound that bees exposed to imidacloprid performed the “waggle dance,”\nthe movements that bees use to inform hive mates of the location of foraging\nplants, at a lower rate. (23)<\/p>\n\n\n\n

This information becomes even more worrying when it is\nreported that in a survey of Honey\u2019s from around the world 75% contained\nneonicotinoid insecticides (3) There is just so much data now available on the\ndamage to bees by are we just ignoring the unnoticed apocalypse and making it\nworse by use of these chemicals in the Veterinary industry on an industrial\nscale?<\/p>\n\n\n\n

What about other insects? <\/strong><\/p>\n\n\n\n

It\u2019s worth looking at birds that feed on insects for\nNatures own assessment of the scale of the concern;  the figures are horrifying. Populations of the\nGrey Partridge have declined 92% since 1967, Nightingales by 93%, Cuckoos by\n77% and Spotted Flycatchers by 93% (3) Insect decline is a massive problem and\nwe must do all we can to halt it. <\/p>\n\n\n\n


\n<\/sup>Researchers from the Canadian Forest Service showed\nthat imidacloprid used on trees at realistic field concentrations decreases\nleaf litter breakdown owing to adverse sublethal effects on non-target\nterrestrial invertebrates. (24)
\n
\nAphids have<\/a> been found to lead to altered behavior, such as wandering and eventual\nstarvation. Very low concentrations also reduced nymph viability.<\/a>(23)<\/p>\n\n\n\n

In January 2013, the European Food Safety Authority stated\nthat neonicotinoids pose an unacceptably high risk to bees, and that the\nindustry-sponsored science upon which regulatory agencies’ claims of safety\nhave relied might be flawed,<\/a> (23) The arguments of vested interests will go on and on\nas ever, no doubt until extinction is inevitable and governments then act.
\n
\n<\/p>\n\n\n\n

The Birds<\/strong><\/p>\n\n\n\n

Imidacloprid has also been found to be highly toxic to four bird species: Japanese quail, house sparrow, canary, and pigeon (23) Worryingly the pervasiveness of these chemicals is illustrated by a recent study in Switzerland which found Neonicotinoids in the feathers of 100% of House Sparrows tested ! (25)
The European Food Safety Authority also has stated that imidacloprid poses a potential high acute risk for herbivorous and <\/a>insectivorous birds and <\/a>granivorous mammals.<\/a> While at the same time chronic risk has not been well established. (23). Why are governments not completely banning these chemicals?

At imidacloprid concentrations of more than 20 nanograms per litre, bird populations tended to decline by 3.5 per cent on average annually. And this is not related to any other land use factor (26). Yet more reports show birds exposed to these chemicals become disorientated, lose their sense of direction, become unable to migrate. <\/p>\n\n\n\n

\"\"<\/figure><\/div>\n\n\n\n

Earthworms<\/strong><\/p>\n\n\n\n

Such an important organism, and yet a significant body of research suggests that earthworms suffer reductions in their ability to reproduce as well as changes to their burrowing behavior. (20) Consider the impact therefore of dogs in parks and gardens urinating the defecating onto the soil and the persistence of the chemical in the environment. <\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

As already noted Imidacloprid is highly toxic on an acute basis to aquatic <\/a>invertebrates<\/a> so it was especially worrying that the 2016 report by\nBUGLIFE on Neonicotinoid Insecticides in British Freshwaters (1) specifically\nimplicated veterinary topical applications and flea collars as the most likely\nsource of pollution with Imidacloprid in some catchment areas. Neonicotinoids\nare persistent, stable and long lasting in the environment. They recommended a\nthorough review of the use of ectoparasite treatments and their use should\nimmediately be suspended in the UK . They have clearly been ignored !<\/p>\n\n\n\n

Why do the\ndata sheets that come with spot-on products containing imidacloprid not\nroutinely carry the warning that the chemical should not be allowed to enter water\ncourses as it has harmful effects on aquatic organisms? Quite arguably for\nthese and oral products too, the pet should not be allowed to urinate or\ndefecate anywhere where environmental contamination might result (so pretty\nmuch everywhere) and waste disposed of responsibly. This is in my opinion a\ntravesty as harm is being done now.<\/p>\n\n\n\n

Imidacloprid\nis just one of the many treatments marketed for regular use in the UK on pets.\nControversies over this and other products are growing, with websites and\nsocial media sites are now picking up on concerns and gathering huge amounts of\ndata on cases (see further reading). So why is more action not being taken in\nthe UK to highlight and reduce the use of these products to a situation similar\nto that mentioned in Norway and Denmark?<\/p>\n\n\n\n

And when will\nthe use of regular treatments when there is no need produce resistance to the\nchemicals anyway in the fleas, worms and ticks? Whilst it is claimed there is\nno evidence yet (12) Speaking to one laboratory recently they are now seeing\ncases of Lungworm not responding to treatments so problems may well be already\nhappening as a result of the madness of commercial marketing and promotion for prophylactic\nuse.<\/p>\n\n\n\n

So many\ndifferent Products<\/strong><\/p>\n\n\n\n

There are so\nmany different products now being marketed for use on Pets. Many of these\nindividually not only risk and impact on our environment, but some combinations\n(and combining is the trend) are only now being found to be worse than the\nindividual products alone ! (3) The marketing authorisations of many system\ninsecticides worldwide has generally failed to assess the individual and joint\necological risks resulting from widespread and simultaneous use of multiple\nproducts with multiple formulations and multiple modes of action. Nor has it\nconsidered the impact of the multiple uses in multiple industries, of which the\nVet component is but a player in the build-up of cumulative toxicity. (27)<\/p>\n\n\n\n

Many of the\nVeterinary used products are chemicals now found in all environmental media\nincluding soil and water. Persistence can be long in these, worse in plants\nthat take them up into their tissues (27) with the disaster moving up the food\nchain to us humans. Cumulative toxicity effects long term have not been studied<\/p>\n\n\n\n

There are\nmany gaps in knowledge of the eventual fate of many of these chemicals, but\nwith DDT hanging around still some 50 years or so since last used sure common\nsense tells us to stop poisoning the planet and ourselves.
\n
\nSo how do we go forward logically and sensibly?<\/strong><\/p>\n\n\n\n

There needs\nto a common-sense proportionate risk-based assessment of the need for control\nof parasites in pets in the UK. <\/p>\n\n\n\n

Even if the\nrisk described for the individual pet is perhaps low, the cumulative effect of\nuse cannot be denied \u2013 and why accept risk anyway, especially at this time of\ngrowing environmental crisis, and when the current mode of use is illogical\nanyway?<\/p>\n\n\n\n

 All products must be on Veterinary prescription\nonly, not available over the counter in pet stores and on-line. Use must only\nbe for confirmed infestation causing a health concern. <\/p>\n\n\n\n

Vets must be\nresponsible and face action if they breach prescribing rules. Corporations that\nnow dominate the ownership of practices should be subject to sanctions if they\nforce marketing of these products onto their veterinary employees.<\/p>\n\n\n\n

Clearly other\ncountries are leading the way and regard the environmental impacts as more\nimportant than occasional infection in pets. Treatment is not prevented, it\njust must be with correct diagnosis and investigation and the response be\nproportionate to the risks. This is no different than the initiatives in\nantibiotic reduction that are widely recognised as responsible, even if there\nare individual casualties from time to time. <\/p>\n\n\n\n

Consumers in\ngeneral and the pet-owning public in particular need to be more mindful and\nquestioning rather than trusting what they are told by manufacturers and those\nwith a vested interest in selling products. Vets need to take the lead and\neducate the public to only use these products when absolutely necessary and\nonly after diagnosis and only in the correct amounts to resolve a problem\nefficiently and effectively with appropriate disposal of any contaminated waste\nand fluids (stools, urine, waste from shampooing).<\/p>\n\n\n\n

If applying any topical insecticide keep the pet away from children and pregnant women until it can be absolutely guaranteed that it is safe for them to be in contact.<\/p>\n\n\n\n

<\/div>\n\n\n\n

Our practice recommendation is<\/strong><\/p>\n\n\n\n

Firstly\nbefore putting chemicals on your pet ask yourself – would you willingly apply\npesticides and other chemicals to your children on a monthly basis? If not then\nwhy are you doing this to your pets? And consider the low-level exposure of\nhumans as a result a potential route for harm. In particular consider the risks\nfor children and pregnant women. Consider the risks for the environment from\nusing that product, dispose of faeces responsibly and avoid contamination of\nwaterways, ponds and lakes from urine and pets swimming.<\/p>\n\n\n\n

Then consider<\/strong><\/p>\n\n\n\n

  1. For ALL Worms only to worm adults based on confirmed need. Send regular faeces samples to a laboratory for monitoring (2-4 times annually). Treat only for species identified as a concern, and at levels indicating a concern. In all cases where worms are found in quantity investigate for concurrent disease that might have an impact on the immune system. <\/li>
  2. Worm Cats and Dogs once they have given birth, and worm puppies and kittens through the at-risk period. <\/li>
  3. Never worm in pregnancy due the teratogenic risks.<\/li>
  4. In Tick areas where they are known to carry disease risk use effective collars that act both as insecticide and repellent. Take these off on walks if the dog is going into water and avoid the dog coming into contact with children while wearing these collars<\/li>
  5. For Fleas and other ectoparasites, treat on first sign of infestation with an effective product until the problem is resolved, then stop. If there are long term problems use an effective collar during the spring\/summer months, but take these off on walks if the dog is going into water. Address the pets environment.<\/li><\/ol>\n\n\n\n

    In line with a growing number of colleagues, my stance that logical use, only as needed, is a more balanced, considered and responsible one is one that I will continue to advance in my practice and to anyone that seeks my advice. To do otherwise would be to participate in condemnation of the planet and the future of humanity to Suicide by Pestcide, <\/strong>or PETICIDE<\/strong> as I like to call it.. <\/p>\n\n\n\n

    \n
    \n

    Dr Mark Elliott BVSc VetMFHom MRCVS MLIHM PCH DSH RSHom <\/p>\n<\/div>\n\n\n\n

    \n

    March 2020<\/p>\n<\/div>\n<\/div>\n\n\n\n

    \"\"<\/a><\/figure><\/div>\n\n\n\n
    <\/div>\n\n\n\n

    Note: When\ntime I intend adding annexes looking at specific chemicals and their risks to\npet and human health through 2020. In the meantime readers can access some\nsurveillance data (albeit such that relies on recognition of link and actually\nreporting it) at European Medicines Agency \u2013 Public access to the reported side\neffects of Veterinary Medicines. https:\/\/www.ema.europa.eu\/en\/news\/public-access-suspected-side-effect-reports-veterinary-medicines<\/a><\/p>\n\n\n\n

    And there is\nstill hope: Steve Garland, entomologist and Chair of the Wildlife Trusts\npolicy setting body for England said: \u201cI really believe that the catastrophic\ndecline of insects can be reversed by drastically reducing the use of chemicals\nin the environment and creating strong Nature Recovery Networks to give them\nspace to live and thrive in safety.\u201d(3).<\/p>\n\n\n\n

    References:\n<\/strong><\/p>\n\n\n\n

    1.\nNeonicotinoid Insecticides in British Freshwaters: 2016 Water Framwrok\nDirective Watch List Monitoring Results and Recommendations. Shardlow M (2017)\nBuglife \u2013 The Invertebrate Conservation Trust, Peterborough, UK. Available\non-line<\/strong><\/p>\n\n\n\n

    2.\nWidespread losses of pollinating insects in Britain. GD Powney et al. Nature\nCommunications (2019) 10:1018 <\/strong>https:\/\/doi.org\/10.1038\/s41467-019-08974-9<\/strong><\/a><\/strong><\/p>\n\n\n\n

    3. Insect\nDeclines and why they matter. Prof D Goulson. Sussex Wildlife Trusts \u2013\nSomerset. Essential reading and contains many peer reviewed research\nreferences.<\/strong><\/p>\n\n\n\n

    4.\nPersonal communications 2019<\/strong><\/p>\n\n\n\n

    5. Data\nalchemy: discover why your top 20 per cent of clients are pure gold. E Ward\nVeterinary Business Journal. May 2016<\/strong><\/p>\n\n\n\n

    6. Human\nBiomonitoring for Europe. Scoping document contract no 733032. Pesticides pg 20<\/strong><\/p>\n\n\n\n

    6a. Are\nspot-ons damaging the environment? Loeb J. 2018 Vet Record pg 490<\/strong><\/p>\n\n\n\n

    7. Animal\nDrug Safety Communication: FDA Alerts Pet Owners and Veterinarians About\nPotential for Neurologic Adverse Events Associated with Certain Flea and Tick\nProducts <\/strong>https:\/\/www.fda.gov\/animal-veterinary\/cvm-updates\/animal-drug-safety-communication-fda-alerts-pet-owners-and-veterinarians-about-potential-neurologic<\/strong><\/a><\/strong><\/p>\n\n\n\n

    8.\nVeterinary Pharmacovigilance in the United Kingdom Annual Reviews (available\nonline) European Medicines Agency \u2013 Veterinary Pharmacovigilance bulletins\n(available online) <\/strong><\/p>\n\n\n\n

    9.\nReference not listed due to my being bored with threats by the author of legal\naction<\/strong><\/p>\n\n\n\n

    10. <\/strong>Norway and the UK: Compare and contrast. Companion Dec 2017 Pg 19<\/strong><\/p>\n\n\n\n

    11. Personal Communication referencing\nDanish Code of Conduct for Vets <\/strong><\/p>\n\n\n\n

    12. Endoparasites: innovations and\nadvice to give owners. Vet Times. June 19, 2017. Hany Elsheikha<\/strong><\/p>\n\n\n\n

    13. <\/strong>Ocular Toxocariasis in Schoolchildren. Good B. et al CID 2004:39 (15\nJuly) 173-178<\/strong><\/p>\n\n\n\n

    14. Data in marketing literature for\nMilbemax wormer from Elanco <\/strong><\/p>\n\n\n\n

    15. Zoonotic parasitic infections\ncontracted from dogs and cats: How frequent are they? Schantz P DVM360 01-03-07\n<\/strong><\/p>\n\n\n\n

    16. Data in marketing literature for\nAdvocate from Bayer <\/strong><\/p>\n\n\n\n

    17. Drug Safety: Side effects and\nmistakes, or adverse reactions and deadly errors? Carleton BC and Smith MA\nBCMJ, 48, 7 Sept 2006 329-333 <\/strong><\/p>\n\n\n\n

    18. Pesticide Toxicuty Profile:\nNeonicotinoid Pesticides. Fishel MM University of California<\/strong><\/p>\n\n\n\n

    19. Effects of Neonicotinoid Pesticide\nExposure on Human health: A Systematic Review. Cimino A et al. Environmental\nHealth Perspectives July 2016 <\/strong><\/p>\n\n\n\n

    20. Imidacloprid: Human health and\nEcological Risk assessment \u2013 Corrected Final Report \u2013 Thistle H. 2016 USDA\nForest Service Report<\/strong><\/p>\n\n\n\n

    21. Late lessons from early warnings: science, precaution, innovation. The\nEuropean Environment Agency doi:10.2800\/70069<\/strong><\/p>\n\n\n\n

    22. Neonicotinoid Pesticide Reduces\nBumble Bee Colony Growth and Queen Production”. Whitehorn, P. R.;\nO’Connor, S.; Wackers, F. L.; Goulson, D. (2012).Science<\/em>. 336 0036-8075. <\/strong><\/p>\n\n\n\n

    23. Wikipedia: Imidacloprid \u2013\napologies, I don’t usually reference Wikipedia, but there is some good summary\ndata here<\/strong><\/p>\n\n\n\n

    24. Kreutzweiser, DP.; Thompson, DG.;\nScarr, TA. (May 2009). “Imidacloprid in leaves from systemically <\/strong><\/p>\n\n\n\n

    treated trees may inhibit litter\nbreakdown by non-target invertebrates”. doi:10.1126\/science.1215025. ISSN<\/strong><\/p>\n\n\n\n

    25. A large scale survey of House Sparrows feathers reveals ubiquitous\nprescence of Neonicotinoids in farmland. Humman-Guilleminot, S et al. Science\nof the total Environment (2019) 660: 1091-1097<\/strong><\/p>\n\n\n\n

    26. Declines in insectivorous birds\nare associated with high neonicotinoid concentrations. Nature<\/em>. 511 (7509): 341\u20133.\ndoi:10.1038\/nature13531. PMID 25030173. <\/strong><\/p>\n\n\n\n

    27. Conclusions of the Worldwide\nIntegrated Assessment on the risks of neonicotinoids and fipronil to\nbiodiversity and ecosystem functioning. Van der Sluijs JP Environ Sci Pollut\nRes DOI 10.1007\/s11356- 014-3229-5 <\/strong><\/p>\n\n\n\n

    Further\nReading and information <\/strong><\/p>\n\n\n\n

    For regular wormcounts to see if your\npet has an infestation go to www.wormcount.com (note I have no financial\nassociation with this laboratory) <\/strong><\/p>\n\n\n\n

    1. The Royal College of Veterinary Surgeons<\/strong><\/li><\/ol>\n\n\n\n

      The RCVS has\ncommitted to an evidence-based approach to Veterinary medicine. As such I call\nupon it to act now and tackle this issue, as other countries and regulators\nclearly are, and stop the mass prescription and supply of these chemicals\nwithout a clear and unequivocal need, to protect the environment, the welfare\nof animals, their human carers and veterinary professionals. <\/p>\n\n\n\n

      From its RCVS\nKnowledge website:<\/p>\n\n\n\n

      The\ncommitment to evidence-based veterinary medicine:<\/em><\/p>\n\n\n\n

      Evidence-based\nveterinary medicine is key to the delivery of modern veterinary medicine.<\/em><\/p>\n\n\n\n

      It means\nveterinary surgeons and veterinary nurses making clinical decisions according
      \nto their professional judgement, based on the best available evidence at the\ntime and what
      \nis right for the individual animal and owner. When rigorous research underpins\nmedical
      \ndecisions, adverse events can be minimised and patient outcomes can be\nimproved.<\/em><\/p>\n\n\n\n

      We believe\nevidence-based veterinary medicine reinforces the sound scientific principles
      \nof the profession and strengthens the commitment to put animal health and\nwelfare
      \nat the forefront of all we do.<\/em><\/p>\n\n\n\n

      The RCVS\nneeds to act to avoid accusations of regulatory dereliction and corporate\ncapture NOW.<\/p>\n\n\n\n