Archive for September, 2013

Dogs trained to detect human cancers using scent

Tuesday, September 24th, 2013

Dogs have been trained to use their noses to detect human cancers including lung and ovarian cancer with reliability, and one U.K. organization is training dogs to detect bladder cancer by sniffing urine samples. Dogs have a keen sense of smell thanks to their abundant olfactory cells, and since they can communicate with humans better than animals such as mice, they are useful for detecting cancers, said veterinarian Cynthia Otto, director of the Penn Vet Working Dog Center. CBS News

A dog’s sense of smell might be one of his or her best, innate abilities. And an increasing number of researchers are using that nose to help humans detect cancer.

Claire Guest of Berkshire, England runs a charity called “Medical Detection Dogs”that trains dogs how to detect cancer. One project involves teaching animals how to find out which patients have bladder cancer using only urine samples.

Guest’s connection to the project is a personal one. She was letting her dogs out one day when Daisy started jumping and nuzzling her head on Guest’s chest. She went to the doctor, and was diagnosed with breast cancer.

“Without any question I would not be as well and perhaps alive today had Daisy not drawn my attention to it,” she told CBS News’ Alphonso Marsh.

Dogs trained to detect ovarian cancer have 90 percent accuracy rate

The science of dogs sniffing out cancer is emerging. Researchers at the University of Pennsylvania’s Working Dog Center are currentlytraining three dogs how to smell ovarian cancer in different samples.

“Mice can do a better job at sniffing out things (than dogs),” Dr. Cynthia Otto, director of the Working Dog Center and associate professor of critical care at Penn Vet, previously told CBSNews.com. “But, there is an ability to communicate between a dog and a human so they can tell us what they are finding.”

Dogs are also up to the task because they have a larger number of olfactory or smell sensors than humans do, Otto explained. In addition, the area of the forebrain that processes smell information is larger than a human’s.

Additional studies of dogs detecting cancer include a 2011 German paper that showed that dogs were able to detect people with lung cancer with 71 percent accuracy, and correctly distinguish people without lung cancer in 93 percent of the cases. Another West Hills, Calif. trainer is working with researchers to teach dogs how to detect ovarian cancer using breath samples.

Scientists are also trying to come up with technology that mimics the dogs’ natural abilities. Some companies are making electronic “noses” that can pick up on these cancer smells.

Researchers are also testing a “mechanical dog” that sniff’s a patient’s breath to tell if they have cancer markers. They hope that if all tests continue to go well the tool could be used to diagnose cancer within five years.

Service dog brings aid and friendship to girl with debilitating bone disease

Tuesday, September 24th, 2013

Service Dog for AniceeTen-year-old Anicee Lamoreaux has already had 100 broken bones due to osteogenesis imperfecta, or brittle bone disease, but that’s not stifling her excitement over her new service dog, Pearl. Pearl hasn’t completed her training yet, but once she does, she’ll be the newest Lamoreaux family member, responsible for helping Anicee perform daily tasks. But more importantly, Pearl will be the friend Anicee needs. Anicee’s parents, both of whom also have osteogenesis imperfecta, are raising money to help cover the $10,000 cost for Pearl and her training. Daily Camera (Boulder, Colo.)

They’ve only known each other a few short weeks, but Anicee and Pearl are already partners in crime.

Pearl, a 14-week-old labradoodle, has a fluffy puppy-dog face anyone would love. But she is loved most of all by her 10-year-old owner, Anicee Lamoreaux, who is raising money to keep Pearl as her personal service dog.

Anicee, a fifth-grader at Birch Elementary, has osteogenesis imperfecta, also known as brittle bone disease. The condition means Anicee can break a bone simply by coughing or sneezing too hard.

Anicee uses a specialized wheelchair to get around, and Pearl will be a valuable partner who can help her open doors, help with errands and bring her medication or other essential items.

Most of all, Pearl also will be Anicee’s constant companion.

“I’ll have a buddy to spend time with,” she said, feeding treats to her pet in her living room Thursday. “I don’t have that many friends, so I’ll have a friend who will be with me every day, hour, minute.”

Anicee was adopted from Belize in 2010 by her parents, Chris Lamoreaux and Lisa Ferrerio. Both parents also have osteogenesis imperfecta and said they wanted to adopt a child who had a similar condition.

“We knew how much we could offer her,” Ferrerio said. “We know exactly what it’s like to go through surgery or be talked about in school.”

Anicee’s parents also wanted her to have extra help, but the cost of service animals can be overwhelming, especially on top of other medical bills.

The family and their friends are organizing several fundraisers to help cover the estimated $10,000 annual cost to provide Pearl’s specialized training.

As a service dog, she must undergo many hours of training that will familiarize her with Anicee’s specialized care.

That’s worth it for Ferrerio, who remembers the companionship and warmth of her own service dog, Kosmo. Ferrerio had Kosmo when she was a teenager.

When Ferrerio’s longtime friend, dog trainer Ana Melara, came across Pearl, she knew the puppy would be a good fit for the family because of her low-key, gentle temperament. Melara is in charge of much of Pearl’s service dog training.

“She’s just such a sweet dog,” she said.

When Anicee met her dog for the first time, she said she couldn’t contain her excitement.

“I was jumping up and down. I could have broken the wall,” she said with a smile. “I wish I could take her for the whole day.”

Pearl isn’t a permanent resident at Anicee’s house yet, though. Melara is in charge of training the puppy in all the basics, and it could take up to two years before Anicee and her dog become permanent companions. Right now, Anicee and Pearl hang out about twice a week.

 

Help Anicee and PearlBirch Elementary School student Anicee Lamoreaux is raising money to train her service dog, Pearl.

An art silent auction, featuring art by Anicee, will be from 5 to 8 p.m. Oct. 26 at Pearl’s training center, Training with Grace, 9100 W. Sixth Ave. in Lakewood. For more information, go to facebook.comand search “Anicee and Pearl” for updates and other fundraising opportunities.

To learn more about Anicee’s fundraisers or to donate money to help train Pearl, visithttp://aniceefunds.com.

Ferrerio said the training will help make sure Pearl is the right dog for her daughter, who has experienced about 100 broken bones in her short 10 years. Anicee also has undergone three major surgeries to help strengthen her spine and legs, and she hopes to have Pearl nearby when she undergoes another surgery on her arms sometime next year.

“Pearl will be so important in Anicee’s life,” Ferrerio said. “We’ll need her to be Anicee’s arms and legs, and we need to know that Pearl won’t bolt when she sees something like a squirrel or duck — that would break Anicee’s arm.”

So far, Anicee and Pearl are already fast friends. Anicee can’t wait to introduce her dog to her fifth-grade class and take her dog on the playground.

Her dad said he’s happy Anicee is getting the opportunity. In Belize, she didn’t have the same medical opportunities or the chance to have a service dog.

“Here, she has the medical accessibility she needs,” he said.

Anicee’s grandmother, Diane Holstein, said Pearl will bridge the gap between her granddaughter and her peers. Right now, kids don’t always know how to interact with Anicee, but Pearl’s presence will give them a way to talk and ask questions, she said.

“People will see Anicee at King Soopers, the library, out in the community, and Pearl will help people get to know her,” she said

With the Angel Fund’s help, beautiful Isis thrives

Tuesday, September 24th, 2013

isisIsis, a beautiful Pharoah Hound, was not doing well last October.  “She had been down in the dumps off and on for a couple of months,” said her owner, John, a free-lance photographer who asked that his last name not be used. “She lost her appetite – and then she took a turn for the worse and stopped eating and drinking. She lost about five pounds in two weeks – about 10 percent of her body weight or something like that.  So we took her in (to Southern California Veterinary Hospital in Woodland Hills).

The veterinarian said she thought she knew what it was but wanted to run urine tests and do some blood work. The tests confirmed that it was something called Addison’s Disease. It doesn’t get better by itself and so they gave her some steroid shots and also injected some fluid in her because she was dehydrated. That basically saved her life.

“My wife wasn’t working at the time and we were just barely getting by so several hundred dollars on the dog was a lot,” John said.  But Angel Fund contributed $150 and the hospital discounted its fee.  “The money from Angel Fund was a big help – that’s for sure,” he said.

Now Isis, who is seven years old, gets a monthly shot – “every month forever, apparently, and those shots run about $70.” The dog also takes half a prednisone tablet every day as well, medication that is “pretty inexpensive,” John said.

“She has her good days and her bad days. One of the side effects of the shot is that right after that she gets extremely thirsty and every once in a while she can’t control her bladder. . . . And then after the first few days she’s feeling good and is really good for another three or four weeks and then she gets her next shot.  So it’s a cycle.

“The short story is that it undoubtedly saved her life and she is still a member of the family and my two kids love her.  She was a rescue and weighs 48 to 50 pounds.  She’s beautiful. She’s been nothing but a treasure. Not only is she great with my kids but she just loves kids and women in general.”

Dog’s connection with terminally ill child will never be forgotten

Monday, September 23rd, 2013

Casper and CreedCasper, a Canine Assistants therapy dog, is special to many of the sick children at Children’s Healthcare of Atlanta at Scottish Rite, but his relationship with one child there was particularly moving and meaningful. Creed, a young patient who spent half his life in the hospital, bonded with Casper in a way his family and caregivers will never forget. “I don’t think he ever saw Casper as a dog,” said the boy’s father, Jon Campbell. WXIA-TV (Atlanta)

ATLANTA, Ga. — There once was a tiny boy with an old soul whose name was Creed. His name meant ‘to believe.’

Creed had a fierce spirit, but a body that battled illness from the day he was born.

His parents speak a language they never wanted to learn — a language of pre leukemia and chromosonal issues and bone marrow transplants.

It was a language that forced Creed to spend half his life in the hospital.

“There’s nothing medically normal about that kid,” says Creed’s mom Stephanie Campbell.

It would seem a bleak existence — the opposite of what childhood should be.
But Casper, a service dog from Canine Assistants, changed all of that.

Casper was the new therapy dog at Children’s Healthcare of Atlanta at Scottish Rite. Creed was one of Casper’s first kids.
The bond was instant. Different.

Casper’s owner and handler Lisa Kinsel says the relationship between these two went way beyond the demands of the job.
There were movies and sleep overs and countless hours spent in Creed’s bed. After a lifetime of illness, a little boy had a best friend.

Creed’s father Jon says, “I don’t think he ever saw Casper as a dog.”

One day creed was near death. Casper came and got in bed with the little boy. Mom Stephanie put her son’s hand on Casper’s paw. His hand began to move. Later a nurse told the family, “That dog just saved your son.”

Creed’s health was restored but then the sickness returned. John and Stephanie could see their little boy was done fighting. Not long after creed died a new litter of puppies was born at canine assistants. They named one for Creed.

It’s an idealized image of childhood — a boy and his dog.
But the love between this boy and this dog was beyond everyone’s understanding. Creed’s parents believe the comfort and love Casper gave to Creed came from God, until the very end.

Creed’s name will live on in another creature who will one day comfort and care for someone else.
And that would make the tiny boy with the old soul very happy.

Children with autism improve communication using horses and iPads

Monday, September 23rd, 2013

New is meeting old as iPads and horses have been incorporated into a new approach to helping children with autism communicate. In the program, called Strides, the children ride horses and also learn speech and language skills using applications on their iPads. The combination has helped unlock new ways for the kids and their families to communicate, with parents reporting their first-ever two-way conversations with their children. Yahoo/Asian News International

Washington, Sept 15 (ANI): A new study has revealed that children with autism can improve their verbal communications skills with the help of horses and iPads.

Southern Tier Alternative Therapies, Inc. (STAT), together withTina Caswell, a clinical faculty member in Ithaca College’s Department of Speech-Language Pathology and Audiology, has combined equine therapy and assistive technology through an exclusive program called Strides.

The Strides program puts children on horseback and gives each family iPads equipped with speech-generating applications.

Caswell and her team of Ithaca College graduate students provide intensive, highly customized training and ongoing support. The unique therapeutic approach has helped children reach significant breakthroughs in communication, both verbally and through effective use of the device.

Caswell said that it’s the first time the children have been on horseback, the first time many of them are using iPads with speech software, and more important, the first time they’ve had any kind of access to self-expression.

She said that parents also told her that it’s the first time they’ve been able to have a two-way conversation with their kids.

The researchers found that children are doing more than requesting food and toys and for the first time, they are telling narratives and sharing feelings.

Each child participating in the program is given an iPad to be used as a speech-generating device. Participants and their parents are then trained by the Strides team and the Ithaca College students and faculty to continuously update new communication opportunities on their devices. (ANI)

Diabetes alert dog brings comfort, relief to boy and his family

Monday, September 23rd, 2013

Diabetic Alert DogsKermit, a 2-year-old service dog trained to detect fluctuations in human blood sugar levels, helps 9-year-old Kiernan Sullivan monitor his type 1 diabetes, giving Kiernan’s parents some extra relief. Uncontrolled blood sugar levels can lead to problems such as neuropathy, limb loss and even blindness, so specially trained dogs, along with tools such as glucose monitors that help keep blood sugar levels within the normal range, can improve the quality of diabetes patients’ lives, said physician Andrew Ahmann. The Oregonian (Portland)

When 9-year-old Kiernan Sullivan started school this month, he attends each class in the company of his new best friend – a 2-year-old service dog named Kermit.

“It’s fun but hard,” Kiernan says of his new charge. “You have to feed him, take him out to bathroom and take him out for walks.”

Kiernan has Type 1 diabetes, which usually affects children and young adults and accounts for about 5 percent of all diabetes cases. It occurs when the body does not produce insulin, a hormone needed to convert starches, sugars and other food into energy.

Kiernan, who was diagnosed when he was six, experienced a grand mal seizure in November. The experience was scary, but his parents thought they could manage Kiernan’s disease with careful meal planning and regular insulin shots.

Then one Saturday morning in March, Kiernan’s mom, Michelle Sullivan, awoke to a horrifying scene.

Her husband, Stuart, had left early that morning to go grocery shopping so the family could do something together. He kissed her goodbye and closed the bedroom door so she could sleep in a bit.

She awoke to her husband’s terrified screams as he came home to find their son lying unconscious on the kitchen floor. Kiernan had wandered into the kitchen to find some sugary food to bolster his blood sugar but found only sugar-free licorice. Bright red licorice was still smeared on his face when his parents found him.

The Sullivans realized they needed help. Thanks to the help of a staff member at Kiernan’s school, City View Charter School in Hillsboro, they found out about Dogs Assisting Diabetics.

About Dogs Assisting Diabetics

The Forest Grove-based nonprofit was founded by dog trainer Kristin Tarnowski and Darlene LaRose Cain, a former national chair for the American Diabetes Association.

Since the organization launched in 2009, Tarnowski has trained more than 35 dogs to be service-alert dogs.

The dogs initially came from breeders, but Tarnowski recently started her own breeding program with registered Labrador retrievers so she can start training them as puppies.

(Kermit came from the Guide Dogs for the Blind breeding program but failed his final test).

The training process can take at least six months to one year.

To train the dogs, Tarnowski places a swab of sweat collected from a diabetic person whose glucose levels are high or low and puts it in a sealed vial.

When the dog approaches the vial and reacts to it, she rewards them with treats and affection.

“We’re getting the dog to think of it as a game and have fun of it,” Tarnowski says. “The dog gets excited and wants to keep looking for it.”

The dogs can smell a metabolic change that takes place when someone’s blood sugar changes, although researchers still aren’t sure exactly what the dogs detect.

The dogs cost $15,000 and are in high demand. Each year, Dogs Assisting Diabetics receives about 200 requests from people all over the world.

Priority goes to people who have a high medical need for the dog, such as those whose blood-sugar levels are high enough to require dialysis.

How it works

When Kiernan’s blood sugar levels veer away from normal levels – below 80 or above 180 milligrams per deciliter – Kermit alerts him in one of three ways.

The dog will paw at the boy’s leg or chew on an orange strip on his leash called a “brain cell.”

Kermit continues to alert until Kiernan acknowledges him with a treat. Then he can check his blood-sugar levels and treat them accordingly.

Because Kiernan’s blood sugar levels fluctuate so frequently, the family decided against a Continuous Glucose Monitor that alerts during changes in glucose levels, Michelle Sullivan says.

The monitor’s frequent sensors can become a nuisance for someone like Kiernan, who can drop from a normal blood sugar level down to 50 mg/dL after walking just a few blocks.

Properly trained service dogs can offer great value to people with diabetes, says Dr. Andrew Ahmann, director of the Harold Schnitzer Diabetes Health Center at Oregon Health & Science University.

“I have no doubt that they can alert individuals who have low blood sugar at a time when the person themselves does not recognize the problem,” he says.

Since Kermit alerts Kiernan as soon as his blood sugar changes, he’ll know to check the levels sooner. He has less risk of reaching the dangerous highs or lows that can send him into a seizure.

Over time, that careful monitoring can help bring three-month blood sugar averages, called A1Cs, closer to normal range.

“That’s adding time to their life,” Tarnowski says. “High blood sugars contribute to blindness, limb loss or neuropathy.”

According to one study, one in 20 children will die in their sleep from low blood sugar levels.

Yet Ahmann cautions that little research is available that proves the dogs’ effectiveness in preventing severe hypoglycemia or in improving overall glucose control.

The dogs should never replace the use of blood sugar testing meters that provide accurate readings, he says.

“I don’t think the use of diabetic assistance dogs is a replacement for continue glucose monitoring or intermittent glucose monitoring,” Ahmann says, “but the dogs do provide another layer of security that is very important to kids and their families.”

For Kiernan’s mom, that furry security blanket is priceless.

“I know that Kermit isn’t 100 percent, but he’s at least given me an extra level, just an extra step of assurance,” she says. “I hope that Kiernan doesn’t have another seizure, but Kermit is just an extra layer of protection.”

If you want to help: The Sullivan family is struggling to pay for Kermit, who costs $15,000. So far, the family has paid $5,000 and is on a payment plan for the remaining amount.

The family has established a fundraising page on Youcaring.com called “Help Kiernan Bring Kermit home” that allows people to donate to his cause.

You can also donate to Dogs Assisting Diabetics at dogsassistingdiabetics.com.

Bentley, the world’s largest therapy dog

Monday, September 23rd, 2013

Bentley the Great Dane

 After a nine year old family member developed cancer 3 years ago, he wanted our huge Great Dane, Bentley, to visit him in the hospital.  Because of hospital rules, Bentley had to first become a therapy dog to be able to visit children in the hospital.  Bentley not only became a therapy dog, he became the World’s Largest Therapy Dog and also has the Guinness World Record for longest tail ever on a dog.  He missed being the world’s tallest dog and the longest dog by less than 1/2 inch each.  Sponsored by PetSmart and Organix dog food, Bentley has been going to children’s hospitals all over the United States raising money and awareness for canine and pediatric cancer research.  In 2012, Bentley raised $25,000 for canine cancer research and $25,000 for pediatric cancer research.  He now has a children’s book coming out on Kickstarter.com and a portion of the proceeds from the book sales are used to fund free books being given to the hospitals that Bentley visits.
Bentley’s a terrible showoff and when in public, he works the room shamelessly getting petted and rubbed.  Thanks for your support.  Patrick Malcom  

 

 

Survey helps owners make objective decisions about cancer care

Monday, September 23rd, 2013

The Pet Quality of Life Survey is designed to help owners by providing objective criteria they can use to decide if treating cancer is the right choice. Veterinarian Maria Iliopoulou developed the survey for dog owners but has plans to revise it so cat owners can use it too. Business Insider (9/19)

More than 73 million U.S. households own a pet and altogether they spend $53 billion per year to care for them.

 

More than half of that budget goes toward medical treatment, with money spent on supplies and OTC medications rising by more than 7% in 2012.

But where do you draw the line between keeping Fido healthy and compromising your finances to give him a few more months of playtime?

“It’s a very difficult situation [for both patients and veterinarians],” said Dr. Kristen Frank, an internist with the American Society for the Prevention of Cruelty to Animals.  “I’ve had pet owners who don’t necessarily have $15,000 to spend to treat a terminal illness, but they’ve done it anyway through borrowing money or credit cards.”

Emergency treatments can range from $1,500 to $4,000 for dogs, according to Frank, with cancer treatment sometimes costing twice as much or more.

Sometimes, the decision to forego medical care has more to do with the emotional cost of watching a beloved pet go than the potential financial burden.

“Recently I saw a woman who specifically said that her other cat passed way from cancer and she did everything including chemo and she said she did not want to go through that again,” Frank said.

Unlike hospitals for humans, vets don’t typically have the same flexibility to work with pet owners who can’t afford treatments. Pet insurance can be handy, but it often comes with maximum coverage limits, steep deductibles, and pre-existing conditions clauses.

“Payment plans are also hard to come by,” Frank said. “The financial aspect of veterinary care is toughest thing our people have to deal with on a daily basis …We all wish we could provide free care but unfortunately it’s just not possible.”

But how does a pet owner decide whether to pay for treatment or let their pet go?

There is no one-size-fit-all answer, but a Michigan State University research may have found a simple way to help pet owners through such difficult times.

“Pets are like surrogate children,” said Maria Iliopoulou. “In some cases, when a human bond evolves, it makes the decision more difficult.”

Iliopoulou, who owns a small menagerie of pets herself, set out in 2009 to create a “Quality of Life Survey for Canine Cancer Patients” that dog owners can use to look at medical treatment with an unbiased eye.

Before each visit, Iliopoulou suggests dog owners complete the survey, which asks basic questions to help them track major quality of life indicators for canines — play behavior, signs of illness, and overall happiness.

“What we were trying to do with the research was to isolate the emotions to help people make the best decisions for their pet and for themselves,” she said. “It helps the owner to pay attention to specific observable changes and transfer this info to the veterinarian.”

So far, the survey is applicable only to dogs, but Iliopoulou plans on continuing her research in order to create similar tools for a range of animals, like cats, birds, etc.

CLICK HERE to view the survey.

Katrina lessons keep Colo. flood victims and pets together

Monday, September 23rd, 2013

Colorado FloodPets have been routinely evacuated from flood areas in Colorado, despite life-threatening conditions for the rescuers, because officials there made a conscious decision to save pets and people, adopting the motto “No pets left behind,” according to a National Guard spokesman. Lessons learned from Hurricane Katrina led rescuers to include pets in their evacuation plans, and temporary shelters have been ready with pet essentials including water bowls and kenneling capabilities. The Seattle Times/The Associated Press

By JERI CLAUSING   Associated Press

Some helicopters rescuing people after massive flooding in Colorado carried more dogs, cats and fish than people. Rescuers using zip lines to evacuate people over raging rivers also risked their lives to make sure the four-legged members of families were safe.

In contrast to stories of people forced to leave their pets when New Orleans was swamped by Hurricane Katrina, the motto during one of the largest evacuations in Colorado history was “No pets left behind,” said Skye Robinson, a spokesman for the National Guard air search and rescue operations during Colorado’s floods. That’s because including pets in the rescue effort helped convince even reluctant residents to leave their homes. Officials also had more than enough space for the animals and even carried animal crates with them.

More than 800 pets have been ferried to safety with their owners via helicopter, the National Guard said. Hundreds more were rescued by ground crews. Livestock, like horses and cattle, were left behind, but a monkey was among those saved.

Once safely on dry ground, Red Cross shelters had water bowls, on-site dog kennels and all the necessary supplies to ensure already stressed evacuees wouldn’t be separated from their pets.

“We kind of learned after Katrina, when people wouldn’t evacuate because of their pets,” said Kathy Conner, a worker at a shelter at a YMCA in Boulder.

Evacuees Jerry Grove and Dorothy Scott-Grove said they never would have abandoned their vacation cabin in Estes Park without their two golden retrievers. But they didn’t have to make that hard choice. Firefighters carried the two large dogs to safety on the same zip line used to rescue the retired Ohio couple.

“They put them in a harness and one of the firefighters hooked himself to them and brought them across,” Dorothy Scott-Grove said. “We will not be separated.”

Once out, the Red Cross found the couple a pet-friendly hotel where the dogs the next day “were resting comfortably on our king-sized bed,” she said.

In a state where dog passengers are as common as humans in cars, Lisa Pedersen, CEO of the Humane Society of Boulder Valley, said taking care of pets has become a central part of disaster planning.

It appears to be working. One week after floods and mudslides forced the local evacuation of more than 3,000 people, Pederson said the Boulder area shelter had just 72 pet evacuees – all but two of which were delivered by their owners for temporary shelter after they were forced from their homes.

“It just makes sense that you bring the pets along. They are part of the family,” Robinson said. “You wouldn’t leave a family behind because they had kids.”

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Follow Jeri Clausing on twitter (at)jericlausing

From the AVMA about canine circovirus

Monday, September 23rd, 2013

Canine circovirus infections have been documented in dogs with vomiting and diarrhea. The distribution of the virus in the U.S. is not yet known, but dogs infected with circovirus have been reported in California and circovirus may be associated with recent illness and death of dogs in Ohio.

CLICK HERE to see the FAQ from the American Veterinary Medical Association