Dr. Hyram Kitchen

Last month marked the 29th anniversary of the still-unsolved murder of my friend Dr. Hyram Kitchen. At the time of his death, he was Dean of the University of Tennessee College of Veterinary Medicine. He was just 57 years old.

For those who are interested, here is a web page about the murder I set up years ago. I have kept it online through several hosts ever since. In addition to the information I included, there is a link at the bottom of the page to the entry about Dr. Kitchen on the Knox County (TN) Cold Case page. If anyone has any information whatsoever that might help solve the case, please contact the sheriff through that page.

Press accounts of the unsolved murder of University of Tennessee College of Veterinary Medicine Dean Hyram Kitchen

UPDATE-– April 23, 2019: That web page was getting a little long in the tooth, so I just rebuilt it.

Good Advice for Patients – and Their Doctors

Dr. Alex Lickerman, the proprietor of Happiness in this World, just put up a thoughtful, masterfully written post, When Doctors Don’t Know What’s Wrong. While it's primarily directed toward patients, I'd encourage all physicians and veterinarians to read it, too. Here's the beginning:

The first patient I ever saw as a first year resident came in with a litany of complaints, not one of which I remember today except for one: he had headaches. The reason I remember he had headaches isn’t because I spent so much time discussing them but rather the exact opposite: at the time I knew next to nothing about headaches and somehow managed to end the visit without ever addressing his at all, even though they were the primary reason he’d come to see me.

Then I rotated on a neurology service and actually learned quite a lot about headaches. Then when my patient came back to see me a few months later, I distinctly remember at that point not only being interested in his headaches but actually being excited to discuss them.

I often find myself thinking back to that experience when I’m confronted with a patient who has a complaint I can’t figure out, and I thought it would be useful to describe the various reactions doctors have in general to patients when they can’t figure out what’s wrong, why they have them, and what you can do as a patient to improve your chances in such situations of getting good care.

Not only should you read all of it, you should share it with as many people as you can – especially your doctor and your veterinarian.

Equine Massacre

The Palm Beach Post reports a shocking incident in Wellington, Florida under the overly cautious headline 14 polo horses reportedly die in Wellington before polo match. Is there any doubt whatsoever that 14 horses mysteriously became ill and died within a very short time of each other? Is there any chance that some of the horses didn't really die, but are just playing dead? Is there even some slight chance that some of these horses may be miraculously resurrected? Apparently not:

WELLINGTON — At least 14 horses died Sunday after collapsing before a polo match. Vets hooked up intravenous tubes to the sick horses and fought to help them breathe as the horses from the Lechuza Caracas team were stricken by an unknown illness, officials said.

"Some died right away. Others lasted about 45 minutes," said veterinarian Scott Swerdlin, a member of the Palm Beach Equine Clinic who was at the scene and said 14 horses died.

A bit farther down, we are told:

The horses began breathing heavily and stumbling at the Lechuza equestrian facility before they were brought to the polo club, Swerdlin said he was told.

Necropsies and blood tests will be done on the dead horses at a state-run clinic in Kissimmee. The carcasses were taken intact to the facility Sunday afternoon. Results could come as early as today.

Swerdlin wouldn't speculate on what happened to the horses. "I don't guess," he said. "I wait for evidence."

So it does appear that 14 horses were involved, and that they are indeed deceased beyond any reasonable doubt, since their "carcasses" (couldn't they have said "bodies" or "remains"?) were taken to a state laboratory for necropsy. So why, then, did the brave Palm Beach Post not come right out and tell us that in the headline? Why did it feel obligated to use the adverb "reportedly" to modify the word "died"?

So what happened? What might have caused these 14 apparently healthy polo ponies to sicken and die within 45 minutes or less? We have to read all the way down to the 10th paragraph to learn what the reporters "reportedly" found out – which then turns out to be a rehash of what some other reporters reportedly found out:

According to several sources, the horses had a reaction to a steroid derivative that may have been tainted with a cleaning solution, the Sun Sentinel reported. The shots apparently were administered by an Argentine vet not licensed in the U.S., it further reported.

At least three more horses were affected.

One 10-year-old mare was gravely ill late Sunday afternoon. She was lying in a stall under the care of the medical staff at the Lechuza facility.

"They started getting dizzy," [polo club spokesman] O'Connor said of the scene at the polo club. "They dropped down right onto the grass."

The truth, then, is not that these unfortunate horses "reportedly" died, but that they most definitely died after "reportedly" having been accidentally poisoned in a doping attempt involving an unlicensed veterinarian.

If true, this allegation reflects very poorly upon the polo club and both the Federal and Florida state regulatory agencies which are charged with enforcing our animal protection laws. For many decades, incidents such as these were routine at horse racing tracks in third-world countries, but were almost unheard of in the United States and other first-world countries. Now, it appears that an individual who may or may not be licensed to practice veterinary medicine in Argentina, but was practicing illegally here, somehow managed to bring in enough of some illegal substance to kill at least 14 horses, then administer it to them by injection without being detected.

If this episode turns out to have unfolded approximately as related in the Palm Beach Post story, its significance cannot be overstated. It would represent a major failure in the regulatory systems upon which we rely to keep everyone honest, and would constitute further evidence, if any were needed, of our degeneration into a banana republic.

The importance of definitively ascertaining not only the precise cause of the horses' death, but the exact circumstances and, above all, the identities of those responsible, cannot be overstated. Regardless of who was involved, all of the people responsible for this outrage must be exposed, tried, convicted, and punished as severely as the law will allow. In addition, we must insist that our regulatory agencies use the authority they have been granted to enforce the laws which are supposed to prevent this sort of flagrant abuse.

Stay tuned.

4/20/09 10:34 AM UPDATE: According to the AP, 7 more horses have now died, for a total of 21. This story doesn't mention the allegation that an unlicensed Argentinian veterinarian had given the affected horses some type of steroid injections just before they fell ill, but does include this additional information:

A veterinarian who was at the scene said the tests will need to determine the trigger for what he believed was heart failure among the horses.

"Well clearly, it's an intoxication, clearly there's some sort of a poison," Dr. James Belden told NBC.

Belden said it remains to be seen "whether it's something in the environment or something that the horses were exposed to." He said the routine in the horses' stable ahead of the match was absolutely normal.

4/20/09 12:56 PM UPDATE: The Palm Beach Post has an updated story: Polo veterinarian: Tainted meds, performance drugs unlikely the culprit to 21 polo horses' deaths. Here's a snippet:

The horses, all from the same team, died one by one, "almost certainly of an intoxication of some sort that they consumed," said Lechuza Caracas team veterinarian James Belden, a local vet who was among those pumping intravenous fluids into the horses, trying to save them. Belden doesn't travel with the team but thought it unlikely that the horses would be given anabolic steroids because the team competes in England, where such drugs are prohibited.

"Almost certainly they don't use anabolic steroids," Belden said.

He also said tainted medication - a concern raised late Sunday - was not a likely culprit because the horses are cared for diligently.

"I've been in practice 50 years," Belden said. "I've never seen anything like this."

There's also another story with some intriguing information about the horses' owner, Venezuelan multi-millionaire Victor Vargas, Wicked-rich owner of dead ponies has local ties:

The man has literally vanished since some of his horses laid down and died on the turf. One source at the United States Polo Association told me Vargas hopped on one of his three private jets Sunday afternoon and flew overseas.

Vargas, who also has oil interests, owns homes in the Dominican Republic and his native Venezuela, where he is considered close to President Hugo Chavez.

Looks as though there are a few rocks out there that need turning over to expose all the slugs hiding underneath. Let's hope that between them, the Feds and the Florida state authorities can come up with the cojones to do the job.

4/20/09 1:24 PM UPDATE: The Orlando Sentinel has another relevant story, Kissimmee vet will try to determine what killed polo horses:

KISSIMMEE - Terry McElroy, a spokesman with the Florida Department of Agriculture, Division of Animal Industry, confirmed the number of dead horses as at least 21. Of those, 10 to 15 have been sent to the division's main laboratory in Kissimmee. The others might be sent to a similar facility at the University of Florida in Gainesville, McElroy said.

"Animals died en masse and we need to know why," McElroy said. "The Kissimmee facility is the leading lab in the state, and one of the top ones in the nation for this type of investigation. That's why they went there."

McElroy said the entire necropsy process might take up to a week. It is very much like an autopsy: the body is dissected and fluid and tissue samples are collected.

"It might take the better part of the week or even longer because of toxicology reports," McElroy said.

4/20/09 4:42 PM UPDATE: And now the law is involved: Palm Beach County Sheriff's Office now investigating death of horses in Wellington.

In the meantime, the Florida Department of Agriculture and the U.S. Polo Association have launched investigations into the deaths, as has the Palm Beach County Sheriff's Department.

"As we find out more, we'll talk to more people, but right now we don't anticipate this being anything other than these animals accidentally ingested something or were accidentally poisoned," said Capt. Greg Richter, the commander of the Wellington district.

Wouldn't it be better if Capt. Richter, like Dr. Swerdlin, waited for the evidence to come in before jumping to the conclusion that this was all a terrible accident?

4/20/09 6:36 PM UPDATE: Sissy Willis was kind enough to draw my attention to this new article in the South Florida Sun-Sentinel, PBSO and state investigations launched in deaths of 21 horses in Wellington. The most significant bit of information I got from it is contained in the accompanying video. In it, a veterinarian correctly points out that the clinical signs exhibited by the horses which died are completely consistent with monensin poisoning.

Monensin, sold by the Elanco division of Eli Lilly and Company under the trade name Rumensin, is a special-purpose antibiotic used in ruminants and poultry as a feed efficiency improver and coccidiostat. It has long been known to be deadly poisonous to horses, and should never be mixed into any feed to which they might have access. While anything is possible, in my opinion, it would be highly unlikely that anyone would be so careless as to accidentally feed monensin-containing feed to high-value horses such as these. If monensin should turn out to be the causative agent of these horses' deaths, I would hope that the law enforcement personnel working on the case will thoroughly investigate the possibility that it was mixed into the horses' feed deliberately.

Another consideration is the matter of exposure. Generally, all of the horses in a barn are fed the same feed, with only the quantity being tailored to the individual horse. Therefore, if monensin had been introduced into the feed, normally all of the horses which consumed it would have been affected.

At this time, it is vitally important for everyone involved to keep an open mind and avoid jumping to conclusions which may turn out to be wrong. While we all want to know exactly what happened and who was to blame, we need to be patient and give the veterinary pathologists time to perform their detailed and painstaking examinations.

The time for recriminations is not yet at hand.

4/21/09 2:14 PM UPDATE: Here's the latest – first from the Sun-Sentinel:
State officials hope to finish examinations of dead horses by tomorrow

WELLINGTON - State officials today said they hope to finish necropsies on all 21 polo horses that died in Wellington by tomorrow. But so far, the deaths remain a mystery.

Terance McElroy, spokesman for the Florida Department of Agriculture and Consumer Services, said the physical examinations should be finished by Wednesday morning at the latest.

"But then we will begin toxicology tests," McElroy said.

As for the examinations that have taken place, McElroy said: "No conclusions [have been] drawn so far."

The state and Palm Beach County Sheriff's Office opened parallel investigations into the horses' deaths and are waiting for blood and tissue test results along with an analysis of everything the horses came in contact with that could have been toxic.

"There is no indication at this time of any criminality, any criminal intent, foul play," Sheriff's Office Capt. Greg Richter said today. "There's every indication these horses ingested or were injected with something that caused them to pass away."

The bodies of the horses arrived Monday at the University of Florida's College of Veterinary Medicine in Gainesville and a state laboratory in Kissimmee so scientists could examine them for answers. State officials quickly ruled out infectious diseases.

"Because of the very rapid onset of sickness and death, state officials suspect these deaths were a result of an adverse drug reaction or toxicity," McElroy said Monday, in a written statement.

Dr. John Harvey, assistant dean of the University of Florida College of Veterinary Medicine, said a necropsy is much like an autopsy: The body is checked for visible trauma, and fluid and tissue samples are collected after a preparation process that takes two to three days.

"The suspicion here is toxins because of how sudden these animals died," Harvey said. "But since we don't know what we're looking for, there are literally thousands of things we can test for. It could be like looking for a needle in a haystack."

The Palm Beach Post has this:
UF animal pathologists will examine remains of all 15 polo ponies taken there

GAINESVILLE — A team of University Florida animal pathologists and technicians is working as quickly as possible to determine the exact cause of death for the 21 polo ponies from Wellington.

At UF's College of Veterinary Medicine, four pathologists and three technicians are examining blood and tissue samples from the remains of the 15 horses they received Monday.

"As soon as the horses got here, we started processing them," Sarah Carey, spokeswoman for the college of veterinary medicine, said today. "But it's not like we have a huge, huge facility. This is a stress for us as well."

Preliminary results could be available by the end of this week, said Dr. John Harvey, executive associate dean of the College of Veterinary Medicine.

Initially, pathologists were going to examine only the eight horses that were insured. But Carey said that the UF school was asked to test all 15 horses - "possibly because of the sensitive nature of this case, and the fact that it is under investigation," she added.

As of this morning, necropsies had been performed on the eight insured horses, with the seven others scheduled next.

The bodies of the other six horses from the Lechuza Caracas team are being examined at the Florida Animal Diagnostic Lab in Kissimmee. Agriculture Department spokesman Mark Fagan said the two sites are communicating regularly on the exams.

"We are trying to expedite this (process) to get something conclusive as quickly as possible," Fagan said from Kissimmee. "It's hard to say it's going to be a week, or two weeks, but it's going to be done as quickly as we can."

Arrival at a definitive diagnosis may well depend upon the completion of the toxicology tests. If so, this may take a while.

4/22/09 5:58 PM UPDATE: Here's the latest from the Palm Beach Post:
State investigators: Dead Wellington polo horses had hemorrhaging lungs:

With the necropsies on the 21 horses that died in Wellington on Sunday nearly complete, the Florida Department of Agriculture confirmed today that the horses suffered from hemorrhaging of the lungs.

"The thing that is consistent with all the horses is hemorrhaging and pulmonary edema," said Mark Fagan, spokesman for the agricultural department. "That's consistent through all the necropsies so far, and we certainly expect that with the remaining few necropsies."

Fagan said that an official cause of death wouldn't be released until the toxicology reports are completed - those results aren't expected until the end of the week, at the earliest.

Fagan said that investigators are following a report in the La Nacion newspaper of Buenos Aires where a captain of the Lechuza Caracas polo team said the horses were injected with a vitamin supplement called Biodyl that is not approved for use in the United States, Fagan said.

Pulmonary edema and pulmonary hemorrhage in all 21 horses – sure sounds like it'll turn out to be some sort of a mass poisoning. Now, they'll determine what substance or mixture of substances was involved. Once that's been established, it will be a matter of good old-fashioned detective work to ascertain with legal certainty how it got into the horses, and who was responsible.

I'd be extremely surprised if the death of all these horses turns out to have a natural cause. It's a virtual certainty that one or more humans was involved. The investigators will have to figure out who did this, then whether it was some sort of terrible accident – or intentional and malicious.

Let's be patient while the veterinary pathologists complete their necropsies and forensic analyses. It sh ouldn't be too much longer.

4/23/09 2:53 AM UPDATE: The Palm Beach Post is now reporting FDA: Supplement, allegedly injected into Wellington polo horses that died, illegal in U.S..

The 21 polo ponies that died in Wellington were all injected before Sunday's match with a government-banned vitamin supplement designed to fight off exhaustion, and polo team members believe a tainted dose caused their deaths, the team's captain said.

Juan Martin Nero, captain of the Lechuza Caracas polo team, told the Argentine newspaper La Nación that all of the horses received injections of Biodyl before getting sick and dying.

"We don't have any doubts about the origin of the problem," Nero said. "There were five horses that weren't given the vitamin and they are the only ones that are fine."

Biodyl, a French-made supplement, is banned by the federal Food and Drug Administration, and its sale or use in the United States is generally illegal, an FDA spokeswoman said.

But veterinarians say the supplement is usually harmless and would have been unlikely to kill the horses unless it had been somehow contaminated.

This information is interesting, but leaves us no closer to a definitive answer. Despite the polo team captain's certainty, investigators are going to rely upon the results of laboratory tests to reach their conclusions.

4/23/09 3:21 PM UPDATE: According to the Palm Beach Post, Pharmacy admits it incorrectly mixed supplement linked to deaths of 21 Wellington polo ponies.

WELLINGTON — The head of an Ocala-based pharmacy today admitted that it incorrectly mixed a medication that was given to 21 horses that mysteriously collapsed and died last weekend.

Jennifer Beckett, chief operations officer for Franck's Pharmacy, said an internal investigation revealed that the strength of an ingredient in the medication was flawed. In a written statement, she did not name the medication or the ingredient involved.

"We will cooperate fully with the authorities as they continue their investigations," she wrote. "Because of the ongoing investigations, we cannot discuss further details about this matter at this time."

The news came as the politically-connected Venezuelan multi-millionaire who owns the 21 horses indicated that he suspects his team's own veterinarian may have played a role in the deaths of some of the polo ponies, according to a letter from a Philadelphia lawyer.

In a letter to polo team veterinarian Dr. James Belden, an attorney representing an insurance company says its investigation revealed that a generic compounded version of Biodyl was administered to 12 ponies prior to their deaths before a match at the International Polo Club Palm Beach on Sunday. It is unclear why the letter references only 12; 21 horses are believed to have received the supplement.

Attorney William Gericke wrote that Belden ordered the compound from Franck's Pharmacy in Tallahassee.

The Sun-Sentinel has a similar report including a few more details, Ocala pharmacy says it incorrectly prepared medication for 21 polo horses that died:

WELLINGTON - University scientists think they have identified the chemical that likely killed 21 polo horses in Wellington, but are withholding the information until it can be reviewed by the state.

"We believe the likely chemical responsible has been tentatively identified, but pending review by the state veterinarian and state law enforcement, we cannot comment any further at this time," said Sarah Carey, spokeswoman for the University of Florida's College of Veterinary Medicine in Gainesville.

She did not know when the results would be released.

That accompanies news today that an Ocala pharmacy has taken responsibility for botching a vitamin compound given to the horses just hours before they died.

If a compounding pharmacy's mixing error is indeed the proximate cause of what happened, the lawyers are going to have a field day.

Veterinarians commonly use various drugs for "off-label" purposes. This practice is necessary because it's economically unfeasible for pharmaceutical manufacturers to pay for all of the testing which would be necessary in order to get each drug approved by the FDA for every conceivable purpose. Therefore, we are permitted to use any licensed drug we can legally obtain for any legitimate medical purpose on non-food-producing animals.

When we use drugs for off-label purposes, we don't have the legal cover of a multi-billion dollar pharmaceutical company backing us up. Quite the contrary, in fact – when we do this, we are on our own; we assume full responsibility for the consequences of our actions. Therefore, it's wise to:

• be absolutely certain that according to our best medical knowledge, we are using an appropriate drug at the correct dosage;
• take every precaution to avoid known drug incompatibilities;
• use our best judgment to decide whether to do it ourselves or entrust the compounding job to a trusted licensed pharmacist experienced in dealing with veterinary prescriptions;
• make sure that the client is fully informed at every step of the way, specifically informed about the risks involved in using an off-label drug upon his animal – and that he signs a release form to that effect

It will be interesting to find out whether the veterinarian responsible for ordering the compounded mixture from the pharmacy had explained the risks to the owner of the horses and gotten him to sign a release. If not – he'd better have some super heavy duty malpractice insurance, because the chances are pretty good that he'll be needing it.

In this case, the pharmacy has already admitted fault, so assuming that the laboratory test results confirm that their compound caused the deaths of the horses, they will have to share in the liability. As the saying goes, IANAL (I Am Not A Lawyer), but it was always my understanding that whenever I was using off-label drugs, anything that might have gone wrong was upon my head; the buck stopped with me. In this case, the team veterinarian allegedly prescribed the mixture, ordered it to be compounded by Franck's Pharmacy, and either administered it personally or supervised its administration. So it's unlikely that he'll be able to transfer the entire responsibility for the deaths of the 21 horses to the compounding pharmacist.

At least, thankfully, it is beginning to appear as though the deaths of these horses were not caused by a deliberate act.

4/24/09 2:51 PM UPDATE: Both the Palm Beach Post and Sun-Sentinel have some new information today.

From the Palm Beach Post comes High selenium in supplement mix could be to blame in death of 21 Wellington polo ponies

WELLINGTON- — Did too much selenium kill 21 polo ponies on Sunday?

As the polo world waits for test results to be released by state investigators, speculation has focused sharply on the naturally occurring chemical element.

Before dying Sunday and early Monday, the Lechuza Caracas team's horses were injected with a generic lab-made version of a banned French vitamin supplement that contained sodium selenite, a selenium-based salt.

Citing anonymous sources, the Argentine newspaper La Nacion reported today that the horses' lab-made supplements included 5 milligrams per milliliter of sodium selenite instead of the prescribed 0.5 milligrams.

Then there's this from the Sun-Sentinel: Ocala pharmacy says it incorrectly prepared medication for 21 polo horses that died

WELLINGTON - Five days after 21 polo horses mysteriously died in Wellington, university scientists Thursday singled out a chemical they think killed the ponies.

They just weren't ready to reveal it quite yet.

Still, clues have come together as an Ocala-based pharmacy acknowledged it incorrectly mixed a vitamin compound given to the horses just hours before they died -- a compound the Lechuza Caracas polo team says an unidentified Florida veterinarian requested.

The U.S. Food and Drug Administration says the compound is of questionable legality and attorneys say there could be costly consequences for its use.

Citing anonymous sources, La Nacion newspaper of Argentina, reported today that the formula given to the horses contained ten times the correct amount of selenium. The newspaper reported that 0.5 mg/ml was prescribed but the compound actually contained 5 mg/ml.

Conceding that definitive conclusions are still a bit premature, it is nevertheless becoming more apparent that these horses died because of a pharmacists's medication mixup. It looks as though the person who mixed the ingredients made a decimal error resulting in a formulation containing 10 times the prescribed dose of selenium.

This type of error is unfortunately all too common in both human and veterinary medicine. For example, in a widely publicized incident, actor Dennis Quaid's twin babies were inadvertently given a huge overdose of the anti-clotting medicine heparin – in Cedars-Sinai, one of the most respected hospitals in the country. Even at the finest institutions, human carelessness can still occur. People in a hurry don't always stop to read a label, but far too often grab a vial from a certain spot on the shelf, quickly noting the color and, perhaps, the drug name on the label, but not the concentration of the active ingredient. Thus, an infant can accidentally receive an adult dose of heparin one thousand times greater than the correct dose ordered by the neonatologist.

Similarly, a pharmacist in a hurry can slip a decimal point when calculating the quantity of sodium selenite to add to a medication he is compounding in order to fill a veterinarian's prescription. If neither he nor a second person catches the error, 21 horses can die agonizing deaths as a result.

Selenium is pretty unforgiving stuff. It's a trace mineral which is essential in minute amounts in the diets of both humans and animals. Yet, in somewhat larger amounts, it becomes a deadly poison. That in itself is not unusual – many elements, such as zinc and copper, are essential in tiny doses but toxic in large amounts. The unique thing about selenium, though, is that the difference between the essential amount and the toxic amount (expressed mathematically as the therapeutic index) is very small.

Then the case would seem to be pretty cut-and-dried, no? The pharmacist made a careless mistake causing the deaths of 21 beautiful horses; therefore he's responsible. But it's not quite that simple. In this case, the pharmacist was filling a veterinarian's prescription which might well not have been legal – which, at the very least, falls into that "gray area" mentioned in the news accounts.

Prescription compounding can be an invaluable tool. It can be useful to provide an otherwise unavailable medication for a specific patient with a problem which cannot be adequately managed with the licensed drugs already on the market. It is also very handy when the commercially available dosage forms are unusable or impractical for administration to an animal. However, it appears that in this case, compounding was being used to get around the law by formulating a medication which is not licensed for use in the United States. Furthermore, it was not for the purpose of treating any medical condition, but instead for the far more nebulous purpose of injecting healthy performance horses, analogous to human professional athletes, with a vitamin/electrolyte mixture.

In this case, it would seem that the apportionment of blame between the prescribing veterinarian and the compounding pharmacist will be a task calling for the wisdom of Solomon.

Eight Belles

First of all, I need to explain that while I am a veterinarian, I am no expert on race horses. During the first 17 years of my career, up until 1987, I worked on horses regularly, but never on a race horse. My only direct exposure to them was as a student at veterinary school 40 years ago.

Nevertheless, I have enough of an understanding of the situation to have some definite ideas about what went wrong, and why we see these horrific racehorse tragedies so frequently.

Horses, like all vertebrate animals, have physeal plates – growth plates – in their bones. While the horse's bones are growing, those growth plates are composed of cartilage, and thus represent weak spots in the bone. Once the horse's bones have reached their maximum length, those growth plates ossify, or turn into solid bone. From then on, the growth plate area is just as strong as the surrounding bone.

Horses' bones continue to grow, although at a decreased rate, until the horse is nearly 5 years old. Yet, we race these horses competitively as 2-year-olds, and begin to train them intensively months earlier. Why, then, should we be surprised when some of these horses break their legs in such spectacular fashion?

Keep in mind, too, that by tradition, the Thoroughbred industry clings to a quaint custom for calculating the age of racehorses. Regardless of when in a given year a horse is born, its birthday is considered to be January 1st of that year. Most foals are dropped between February and May, so a so-called "yearling" on January 1st of the following year may well be only 8 months old in real time.

In truth, the problem is far more severe than most racing fans know. The industry's deep, dark secret is that they are racing these colts and fillies much too young. Everyone involved knows it, yet they never say it publicly.

Once in a great while, someone publishes an article laying out the unvarnished truth about this uncomfortable subject. One such appeared in the British scientific press about 15 years ago, "Early casualties of a sporting life: Thoroughbred racehorses are pampered aristocrats of the equine world. But many have their careers cut short by injuries that some say are caused by pushing them too hard too soon" by John Bonner (New Scientist, 20 March 1993).

Let's look at a few choice quotes:

Lameness is the single biggest factor preventing young racehorses from running. Some vets argue that injuries to leg bones and tendons are the result of pushing animals too hard and too soon – before they are physically mature. The racing industry accepts that pitting two-year-olds against one another is risky, but regards it as economically essential, especially when racing is in the grip of recession.

A bit later,

Horses have a natural lifespan of more than 20 years and do not stop growing until they are around five. In a two-year-old horse new bone is still being laid down in the epiphyses or growth plates near the ends of the bones. New bone is made up of cartilage-like material which gradually hardens as it is permeated by calcium and phosphorus. In the bones of the leg, these growth areas have to support the animal's weight and their softness makes them particularly vulnerable to injury.

Once in a while, experts speak frankly:

Some vets argue that two years is too young an age to race horses. They maintain that the rigours of training contribute to lameness. 'I would say that they are raced too early and too fast,' says Alastair Mews, assistant chief veterinary officer with the RSPCA.

Brian Singleton, the former director of the Animal Health Trust, Britain's leading equine research centre, says: 'The epiphyseal growth plates are still open in the leg bones of a two-year-old horse. They are beginning to close in a three-year-old. Inevitably, these structures can be damaged by the stresses of training and racing. I strongly feel that two-year-old horses are just too young.'

Why the rush to race these horses before they're ready? Money, of course:

Racing exists for betting and the industry is dependent on the money betting generates. A horse has to show its speed and stamina in races restricted to two-year-olds to develop the form that will encourage punters to spend their money on classic races, such as the Derby, when they are three. To stop racing two-year-olds would force a complete overhaul of this system.

Then, this frank admission:

The cost of training an animal is at least £150 a week, and few trainers could afford to keep a horse off the racetrack for an extra year. According to Deborah Baker, president of the British Equine Veterinary Association, if two-year-old racing were curtailed, the industry would crumble.

To get a good, fair, balanced view of the entire situation as it exists in the British racing industry, read the whole thing. As far as I know, the problems and concerns of the US industry are similar, although the industry is, of course, much larger.

If you're not familiar with the physical arrangement of growth plates within bones, here is a diagram and a couple of x-rays to help you understand. All three involve the human knee, a joint which is easy for most of us to understand, since so many of us have had problems with our knees at one time or another, or have close family members who have. Therefore, we have probably seen knee x-rays before.

The diagram shows the locations of the growth plates in the bones of the human knee. Then, there are x-rays of a normal right knee and a severely injured left knee.

Here's the normal right knee.

The left knee has suffered a particularly nasty growth plate fracture classified as a "Salter-Harris Type IV." I've made a few notes on the picture to help you understand what you're seeing. The exact meaning of the classification system is not important. Suffice it to say that this type of fracture is a challenge to the skill of the finest orthopedic surgeons, and can never be expected to be completely normal regardless of the procedure used to repair it. The reason is that such a severe injury to an active growth plate can be expected to result in premature physeal closure – the cessation of growth before the bone has reached its full length.

In humans, premature physeal closure can result in one limb being considerably shorter than the other, or even in curvature of a limb if the injury occurs to either the forearm or the shin. Such cases require further corrective surgery, such as Ilizarov limb-lengthening procedures or wedge osteotomies and compression plating to straighten crooked limbs. If you're interested in knowing more about growth plate injuries in humans, here's an excellent reference from the National Institutes of Health: "Q&A: Growth Plate Injuries"

Many of these procedures are equally applicable to dogs and cats. The cost may be an insurmountable obstacle for many owners, but the procedures are not only technically feasible, but are now performed almost routinely in veterinary teaching hospitals and specialty surgery practices.

Horses, though, are a different matter. People who have never worked with them invariably don't understand, but the fact is that even in cases where the horse's owner is willing and able to pay the bill, and states plainly that money is no object, it is often impossible to save these horses. Those who may doubt that hard reality got a sad lesson 2 years ago in the case of Barbaro.

In that case, the horse broke only one of his hind legs. In addition, the skin was not torn open – thus, there was no bacterial contamination of the wound. Nevertheless, despite the great skill of the attending veterinarian and the determination of all involved to see the case through to a successful conclusion, we all know what happened.

Because of the additional stress placed upon it, the opposing, uninjured limb broke down and developed laminitis – founder. Some of the finest equine veterinarians in the profession tried their best to stop the process, but it inexorably progressed to the point where the tip of Barbaro's 3rd phalanx, the coffin bone, broke through the sole of his hoof. That in itself would have been a devastating complication, but when coupled with the condition of the opposing limb – fractured, repaired, and healing nicely, but still far from normal – his case rapidly became hopeless. At that point, the owners had to make the sad decision to authorize Barbaro's euthanasia.

Eight Belles never had a chance. Not only did she simultaneously break both of her forelimbs, but at the time of the injury, the bone came through the skin of the left leg, thus turning an already grave situation into a compound fracture. Thus, she had two insurmountable problems. First, she did not have one good limb to support her weight during a protracted healing period. Second, she had a contaminated lower leg wound – a bad enough situation in dogs and humans, but devastating in horses, which, despite their great strength, have far less innate infection-fighting ability than humans, small animals, or even cattle.

No doubt, those unfamiliar with horses will be second-guessing the decision to euthanize Eight Belles for some time to come. In my opinion, though, there is no question that they did the right thing.

While we can never prevent every accident, we can easily prevent the vast majority of these gallant young racehorses from experiencing the sort of violent, agonizing end that we have now seen twice within two years. Just as we no longer permit child labor in this country, we should no longer tolerate the spectacle of immature horses racing their hearts out for our amusement, and putting their very lives in peril in the process.

UPDATE: We might have known this was coming – PETA has weighed in: "PETA wants Eight Belles jockey suspended after filly's death". As usual, they've got it wrong. This tragedy was not the jockey's fault. He was just doing his job. The only aspect of PETA's faxed letter that makes any sense is their demand for limits on the age of racehorses. In that respect, and only in that respect, PETA and I agree. Otherwise, in my opinion, their fax was a waste of valuable fax paper.

4/20/09 NOTE: If you came here to read about Eight Belles, you'll also want to learn about the latest outrage, the unfolding tale of an Equine Massacre.

Future Doctors

Back in 2004, while I was still practicing veterinary medicine, my assistants were two sisters. Each of them, Tabatha and Sabrina, had two children, an older boy and a younger girl. Both of the girls, 5-year-old Brianna and 7-year-old Kristina, were so fascinated by my work that they decided to follow in my footsteps and become veterinarians themselves when they grow up.

Whenever they had a chance, the two little cousins liked to don cap and mask and observe operations. here's what they looked like – with and without their masks.

 

Brianna

 

§§§§§

 

Kristina

 

Four years later, Kristina seems to have changed her mind, and now has decided to become a lawyer. Brianna, though, is still determined to be a veterinarian. She'll make it, too, as long as she maintains her focus and doesn't get sidetracked by distractions – such as boys. (When I mentioned that to Tabatha, her mother, the instant response was, "Oh, that's all right, I won't let her date until after she's married!") Both are exceptionally bright, capable, well-mannered children with the potential to achieve whatever goals they set for themselves.

Hat tip: Sabrina, Kristina's mother and Brianna's aunt, who took the surgery pictures.

Journalistic Incompetence - or Laziness?

Suppose, for a moment, that back in 1989, someone had decided that the existing Touch-Tone phones didn't suit him, and decided to build his own from scratch. Let's say that he did a very good job and came up with a phone which worked exactly the same as those which had already been available for over 25 years, but incorporated such significant design improvements that other people wanted one like it. Then, let's imagine that 9 years later, he and his wife started a business manufacturing their custom-built phones, and managed to succeed. Now, in March, 2008, they continue to run their business.

That would be an admirable accomplishment, as anyone who has ever started a small business would agree. But would it also be news of national significance? AP seems to think so.

Yesterday's local paper, the Lebanon Democrat, ran this AP story, Hot Wheels For Disabled Pets, which had appeared earlier on the CBS News website. It's a nice human interest item, but as any veterinarian could have told them, it's not news. Such custom-fitted canine "wheelchairs" have been commercially available for over 40 years from the K-9 Carts Company of Oxford, Maryland, which started to manufacture them while I was attending veterinary school at Cornell (1966-70).

Cornell didn't buy the commercially available carts, but used to make their own from 6-foot lengths of aluminum alloy splint rod, a pair of Little Red Wagon-type wheels, padding, and tape. That was the procedure during the entire time I was there, had been for many years before I arrived, and may, for all I know, still be today.

The carts were first used while the late Dr. Ellis P. Leonard ran the Small Animal Hospital at Cornell, which was from 1948 until his retirement in 1969. Dr. Leonard himself probably came up with the idea, but proving it might be difficult, since he passed away in 1991.

Under Dr. Leonard's guidance, Cornell adopted strict aseptic standards for veterinary surgery identical to those used by human hospitals. Later, he introduced spinal surgery for dogs paralyzed by intervertebral disc disease, including fenestration, hemilaminectomy, and dorsal decompressive laminectomy, and brought aboard other skilled veterinary surgeons to perform the procedures.

As a result, and because at that time, it was one of only a few places in the country then offering such surgery, Cornell attracted referrals of paralyzed dogs from all over the Northeast. While I was there, the Small Animal Clinic was always caring for a number of recuperating Dachshunds, and occasionally other breeds. Every day during lunch hour, there was a regular routine in which each dog able to participate was put into his own custom-fitted cart and allowed to exercise. During good weather, they were taken outside to the lawn, but if the weather was inclement, the dogs were allowed to run up and down the highly polished terrazzo corridor.

The dogs loved it, and it was really heartwarming to see them enjoying themselves running around in their little carts. Surprisingly, even though the dogs were allowed to exercise together, I don't remember ever seeing a fight. Once in a while, one would make a mess, but that was expected, and those who were supervising their exercise period were always prepared for that eventuality.

The unnamed reporter who wrote the article could easily have ascertained most of those facts with a simple Google search, and could have learned the rest by interviewing a few older veterinarians. Instead, he or she took the lazy route and just parroted back what these cart makers told him.

Where were the editors who are supposed to supervise the reporters? Didn't anyone up the entire chain of command realize that the use of canine carts is a practice that has been in common use for at least half a century?

It appears that the owners of the canine cart company which was the subject of the article managed to pull off a brilliant public relations coup in the tradition of Jay Conrad Levinson's Guerilla Marketing Excellence. The reporter eagerly took the bait and wrote a story implying that these people were the originators of the idea, and all of the others engaged in the business had sprung up afterwards, following their example. That's bad enough, but even worse is the fact that the reporter completely failed to mention the complications that inevitably accompany the use of these carts. The article implies that once a dog is fitted with his cart, he becomes normal except for the fact that he can't use his hind legs.

Unfortunately, it's not quite that simple. If a dog can't move his hind legs because of a neurologic problem, whether disc disease, myelopathy, or any other condition causing paraplegia, in most cases, he also can't empty his bladder. That means that someone must manually express his bladder at least 3 times a day until such time as function returns — which may be never. Failure to do it faithfully — and thoroughly — will result in the development of a urinary infection. Even with the best of care, these dogs are very prone to develop such infections.

There are several other problems with which owners of such dogs must be prepared to deal, often on a long-term basis. The K-9 Cart Company discusses them in considerable detail here, because before pet owners make the commitment to undertake the care of severely disabled pets, they need to be fully aware of all of the ramifications of their decision. This news article, though, doesn't even mention those common complications, thus giving pet owners the mistaken impression that if their pet should become paralyzed, they need only order a canine "wheelchair," and everyone will live happily ever after.

If only that were true.

Fleas - An Ongoing War

NOTE: Some of the photographs linked to this article are, quite frankly, gross. It is your choice whether or not to click the links and look at them, so don't say you weren't warned!

If you're a dog or cat owner, once again, it's time to begin fighting fleas in earnest. During warm, humid weather, they are capable of reproducing with amazing speed. Each female lays about 200 eggs. Under ideal conditions of temperature and humidity, those eggs can become adults in as little as three weeks. Thus. within a month, just ten reproducing females can generate a population of over 267,000 offspring in various stages of development.

Sounds like an invasion, doesn’t it? In a manner of speaking, it is. It happens every year about this time, and continues until the cold weather hits. While the weather remains moderate, the problem grows worse and worse — unless you take measures to repel the invasion.

lt helps to approach the problem in the right frame of mind. This is war. Don’t underestimate your enemy, the flea. Having been practicing their act for millions of years, fleas are exceedingly good at what they do. It is possible for you to win this war, but don’t expect victory to be easy. As in any war, start by learning as much as you can about the enemy. Then use your knowledge to develop a suitable strategy which takes full advantage of his weaknesses. Your strategy, and the tactics to implement it, must be tailored to suit your individual circumstances. If you fight with ineffective or inappropriate weapons, or even if you use the right weapons in the wrong way, you’ll lose.

Fleas are wingless, jumping insects which are obligate blood-suckers. In other words, in order to survive and reproduce, they must have blood meals. (Matter of fact, the scientific name of the order of fleas, Siphonaptera, just about says it all. In Greek, it means “wingless siphon.”) Following a blood meal, young adult female fleas mate, then proceed to lay large numbers of fertilized eggs a few at a time.

While there are several species of fleas, almost all of those that plague both our dogs and our cats are actually cat fleas, Ctenocephalides felis.



Flea eggs are normally laid while the flea is aboard your pet, but the smooth, dry eggs do not remain where they are deposited. Like grains of salt, they fall off and land on whatever surface is handy. If conditions are ideal, as, for instance, in your pet’s bed, the eggs will hatch out in as little as one week. Under adverse conditions, they can lie dormant for long periods of time. Their tough shells make them extremely resistant to hostile environments. Even insecticides will not kill them. Outdoors, prolonged spells of extremely hot, dry weather will destroy a lot of them, but indoors, they can survive for at least one or two years.

The larvae which hatch from the flea eggs are tiny, hairy legless white worm-like creatures. They do not normally live on your pet, but remain in nooks and crannies near their birthplace. Within a small area, they wiggle around quite actively in search of food. They especially like carpets, but are equally at home in upholstered furniture, behind baseboards, or even in cracks and crevices in hard-surfaced floors. Outdoors, they are quite comfortable in your lawn.

Their main dietary staple is “flea dirt,” the tiny black specks of (yuck) feces left by the adult fleas. It consists of partially digested blood, thus furnishing the larvae with the blood meals they require to mature. Larvae also eat other small particles of organic debris which they discover In their explorations. A favorite snack is the egg packet of a common dog tapeworm, Dipylidium caninum. Thus, the life cycles of two unwelcome parasites intertwine, with one parasite — the tapeworm — using the other as transportation in return for being used as food by the flea. When a larva which has eaten a tapeworm egg packet later matures Into an adult flea, its body will contain tapeworm larvae called cysticercoids. If that flea is accidentally swallowed by a pet attempting to scratch itself with its teeth, the tapeworm larvae will mature into adult tape-worms. Two or three weeks later, you may notice the little tapeworm segments, resembling moving cucumber seeds, in your pet’s stool, crawling around on its hindquarters, or dried out and stuck to its fur.

Flea larvae pass through three stages, called instars, before spinning debris-covered translucent silk cocoons, thus entering the “pupa” stage. Under ideal conditions. such as in a house with a nice, deep carpet which has not been vacuumed for quite a while, they can spin their cocoons just one week after first hatching from the egg. Under less favorable conditions, such as they might encounter outdoors, they can remain in the larval stage for as long as seven months.



Flea larvae are vulnerable to adverse conditions, such as hot, dry weather. In the controlled environment of our homes. temperature and humidity remain well within the flea’s comfort zone. But they are vulnerable to insecticides. The proper type used at the appropriate time can be one of your most effective weapons against the enemy.

The timing of your application is quite important, because if you wait too long, those vulnerable flea larvae will spin cocoons around themselves and progress to the pupa stage. At that point, any measures you take to kill the pupae within the cocoons will be ineffective. The pupae will continue to develop within their impervious shelters, then emerge as adults as though nothing ever happened. Cocoons are highly resistant to insecticides. Just about the only weapon which will kill them effectively is a flame-thrower — not too practical for use on your living room carpet. At that point in the flea life cycle, all you can do is vacuum thoroughly with a good power brush using a powerful vacuum cleaner with a disposable dustbag, then dispose of the bag immediately after you're finished — by burning if possible.

The main reason fleas can survive and multiply so successfully is their remarkable flexibility. Most creatures can only complete their life cycles under a certain rather narrow range of conditions. However. fleas have developed the ability to cycle under a surprisingly broad variety of circumstances.

One of their principal strategies is to adjust the length of the various phases of their life cycle to suit the ambient conditions — temperature. humidity, and availability of food. Consider, for instance, how they change from pupa to adult.

Under perfect conditions — temperature between 65° and 80°F, relative humidity between 70 and 85%. and readily available food (such as your dog or cat), a flea can emerge from its cocoon as a hungry adult in as little as one week. But they are quite capable of revising their schedule as needed. If they sense that conditions are not suitable. they can delay their emergence for as long as a year or more. It is not too hard to conceive of a creature enclosed in a cocoon being aware of the surrounding temperature and humidity, but how can it possibly know whether food is available?

The flea has two mechanisms. First, it can sense vibrations. Footfalls — even those of a cat — cause a mature pupa to hatch out immediately into an adult ready to start feeding and breeding. Second, it can actually detect the slight increase of carbon dioxide in the air caused by the exhaled breath of a mammal — which may be either four-legged or two-legged.

Ever had the experience of returning to a closed-up house which has been vacant for a while? For instance, maybe you went on vacation for a week or two and boarded your pet while you were gone. Upon your return, you may have encountered a surprise welcoming committee composed of thousands of freshly-hatched adult fleas ravenously seeking their first blood meal. While they would have preferred your pet, they weren’t that picky. Since dog or cat blood was not available, yours would do just fine. What happened, of course, is that during your absence, a large number of flea pupae matured inside their cocoons, but chose not to emerge because there was nothing around for them to eat. When you entered and walked across the carpet, your footsteps served as a flea dinner bell. Chow time!!

Now, you can understand that the vibrations of your vacuum cleaner will signal mature flea cocoons to hatch out inside the dust bag. If you have a severe flea problem, change bags immediately after you vacuum the first time. Seal the bag with tape, take it right outside. and burn it if possible, or at least dispose of it in an outside receptacle. Otherwise, those hungry, newly-hatched adult fleas will find their way out of the vacuum cleaner bag — back into your home. After that, take measures to kill any live fleas in the bag when you vacuum. Suck a few mothballs or some flea powder into the vacuum before you start. (CAUTION: Mothballs are deadly to cats, and are attractive playthings. Don’t leave them around where pets can get hold of them!) Frequent vacuuming may sound like an unglamorous low-tech suggestion, but it works extremely well, is very inexpensive — and is non-poisonous!

Once they have finished their meal, the fleas’ next order of business Is to mate and begin to lay eggs. The flea need mate only once. Her body contains an organ called a spermatheca which stores sperm and fertilizes all of the eggs she subsequently lays during the remainder of her life. During that time, which may last anywhere from several weeks to a year, she will periodically jump aboard the nearest warm-blooded animal for another all-she-can-eat buffet. Following her meal, she will lay anywhere from 18 to 28 eggs, thus starting the life cycle over again. During her entire lifespan, she will lay anywhere from about 50 to about 600 eggs. with an average total production of about 200.

Whenever you are fighting a war. if you really expect to have a chance of winning, you must develop a suitable strategy and tactics. Flea-fighting strategy, just like our national defense, is based upon a triad. But in this case. Instead of land-based missiles, submarine-based missiles, and manned bombers, it’s “treat the pet, treat the house, and treat the yard.” Only by attacking the flea enemy on all three fronts can you successfully break its life cycle. and thus win the war.

The specific tactics you should use to implement your strategy must be tailored to your individual circumstances. What is appropriate for hunting dogs who live in an outdoor pen and sleep in a doghouse would be totally inappropriate for a poodle who lives in your house and sleeps on your bed. What works fine for fleas on dogs may be lethal to cats as well as to their fleas. Here are a few general suggestions:

START EARLY
Why give the enemy a chance to bring in thousands of reinforcements? That s exactly what you do if you waited until late summer before you begin to fight. This spring. keep in mind that each flea you allow to survive may very well return the favor by producing over 25,000 offspring in just one month. Simple. inexpensive measures taken now will make it unnecessary to mount massive, complex, and costly campaigns later in the season.

COVER ALL THE BASES
Early in World War II, France placed its reliance upon an elaborate system of fixed fortifications known as the Maginot Line. When the Germans attacked, though. they used a highly mobile, flexible force of tanks to out-flank the Maginot Line by going where it wasn’t. They simply ignored the neutral status of Belgium and The Netherlands and drove their armored columns right through those defenseless countries into the heart of France. Before they could react, the French were overrun and occupied.

Don’t be like the French and expect the fleas to be polite enough to attack only by the route you have chosen to defend. Fleas fight dirty. They will find the chinks in your armor and overrun your house before you know it. Keep in mind that all three possible routes of attack need to be covered — the pet. the house. and the yard — and take effective measures to defend all of them.

STAY ALERT
Fleas are masters of camouflage and sneak attacks. It is amazing how hard they can be to see on your pet, particularly if it has a thick coat. Fleas can even hide on a short-haired white cat. If your pet has a long, dense coat about the same color as a flea. it may be harboring thousands of fleas before you notice their presence — unless you make the time to look for them. Every so often, get your pet into a well-lighted area and over a light-covered surface, such as an old white sheet. Using fingers or a comb, look through the fur all the way down to the skin. Concentrate especially on the rump, the head and neck, and the underside of the abdomen. If he has fleas, you should be able to see them scooting away from you, trying to get under cover. Then check out that light-colored surface. See any black specks that look sort of like pepper? That’s flea dirt, or more specifically, flea manure. Its presence is conclusive evidence that fleas have recently been on your pet, even though you might not find any at that time. If you’re not sure whether or not some black specks you found are flea dirt, wet them with a small drop of water. If they dissolve into what looks like blood, they were flea dirt. all right.

USE EFFECTIVE WEAPONS
Since fleas are such a universal problem, scores of companies have come out with hundreds of products which they claim are The Big Breakthrough for fighting fleas. Sad experience has probably taught you that most of these products are worthless or close to it. Obviously, you cannot win your war against fleas if you try to fight them with weapons that don’t work. While cost is always a consideration, performance must take priority. Have you really saved any money when you decided to use a less expensive product that didn’t get the job done?

USE SAFE WEAPONS
With just a few exceptions, all of the weapons available to us in the flea war are poisons. So use ONLY flea-killers which are labeled as being safe for your intended purpose. NEVER treat a cat with any flea preparation which is not specifically labeled as being safe for use on cats. The consequences of using a “dogs-only” preparation on a cat can be tragic. Don’t use a chemical intended for outdoor use only when you spray your house. Don’t use a premises treatment on your pet. Read and follow label directions. If you’re not sure how to use something, don’t guess — ask someone who knows what he’s talking about. After all, you don't want any "friendly fire" casualties in the flea war.

BE REALISTIC
If you have a flea problem of truly monumental proportions, don’t expect to solve it overnight. If your initial attack has been properly executed, you will make a huge dent In the flea population. That’s great, but it’s not time to hold the victory celebration just yet. In any massive infestation. some fleas will manage to survive even the most vigorous attack. If you don’t conduct mopping-up operations at the proper intervals, those few survivors will quickly multiply to tens of thousands. That doesn’t mean that your initial efforts failed — only that you weren’t persistent or consistent enough. If you look for the “magic bullet” which will somehow kill off all the fleas with no effort on your part, you’re going to be disappointed. Those who believe the exaggerated claims in the television and magazine ads only end up helping to enrich the peddlers of useless junk. But the good news is that it is possible to control even the worst flea invasion. All you have to do is get some good advice on what to use and how to use it, then follow that advice to the letter. Victory will not come instantaneously, but it will come.

Effective Weapons

OUTDOOR PREMISES
There is, in my opinion, only one product worth using to control fleas on your lawn. It is so much better than anything else available that there is simply no comparison. That's Diazinon Liquid, which you can find at any garden supply department or farm store. Apply it using a sprayer of some kind. A simple hose-end sprayer, which you can pick up at the same place you buy the Diazinon, works fine. If you’ve got a more elaborate sprayer, so much the better. Carefully read the directions on the can and add the right amount of concentrate to the sprayer. Then spray your entire yard. Do that three times at 10-day intervals, and the problem will be under control. In very wet weather, you may have to repeat the treatment once a month. Of course, while you're spraying, and for 20-30 minutes afterwards, keep your children and pets out of the yard. Once the diazinon spray has dried, your yard will be safe and flea-free. (I do not believe Diazinon Granules work nearly as well against fleas as does the spray, although they are excellent for tick infestations.)

INDOOR PREMISES
Inside your house, be sure to use a preparation containing an insect growth regulator, such as methoprene. By itself, it is not the entire solution, so it should be applied along with an effective insecticide. The contact spray form is a bit more work to apply than the foggers, but it is far more effective against fleas, which, after all, are not flying insects. With a contact spray, you can direct the active ingredients into the areas where the fleas hide — carpets, upholstery, cracks and crevices around baseboards, floors beneath beds and overstuffed furniture, etc. Thus, you can use a smaller amount of active ingredient, and do a far more effective job by placing it precisely where it will do the most good. You will not have to abandon your house for 3 hours, you will not have to open all your windows and doors to air the place out for 30 minutes upon your return, and you will get better results at lower cost.

Methoprene and other insect growth regulators work primarily by stopping the pupae from ever developing into adult fleas, thus effectively breaking their life cycle. They remain active, although odorless and invisible, for long periods of time — up to 30 weeks (210 days). Flea larvae encountering an insect growth regulator when they hatch out of the egg will grow and develop normally until they reach the pupa stage. Once they have spun their cocoons, though, further development ceases. It is as though they think they’ve grown up when they haven’t. After a while, they will dry out and die inside their cocoons.

Methoprene (and possibly other insect growth regulators) has another interesting effect: it causes adult fleas to lay deformed, non-viable eggs. In my opinion, though, this phenomenon is oversold in flea product advertising. While it's certainly interesting, and may even be peripherally useful, I think it's far more effective to kill the adult fleas. That way, they lay no eggs at all.

If you used only methoprene in your house, an acceptable level of flea control would take many months to achieve. That's why it should be used In combination with conventional insecticides in order to kill as many larvae and adults outright as possible.

Incidentally, methoprene is not for outdoor use. Sunlight breaks it down very quickly, so it would be wasted.

In conjunction with spraying, plan on thorough vacuum cleaning twice a week until your flea problem is under control. Not only will you remove large numbers of eggs, larvae, cocoons. and adults from your carpets, you will also remove the food supply which flea larvae require to survive and develop. By thoroughly vacuuming, preferably with a cleaner equipped with a power rug-cleaning brush, you will remove tremendous amounts of flea dirt from your carpets.

Depending upon your circumstances. you may also be able to use another simple. cheap. safe low-tech method: a flea trap. You can buy a commercial one — a gizmo with a built-in light and a tray holding a sheet of flypaper. But you can easily make a very effective one out of a couple of items that most people already have around the house. All you need is a wide, shallow pan, such as an old cookie sheet, and a small light capable of throwing a directional spot. A high-intensity reading light is perfect. Set it up at night, just before everyone goes to bed. Set the pan on the floor in the middle of a flea-infested, carpeted room and fill it about half-full with water containing a little hand dishwashing detergent (so the fleas will drown instead of hopping out). Then set up the lamp so that it shines on the water in the pan and nowhere else. Shut off the room lights so that everything is pitch black except for the pan. and you’re all set. The light attracts the fleas, who jump into the soapy water. If you can. you may wish to close the room off for the night, so that your pet can’t get in and play with the trap. In the morning, carry a bucket to the tray and dump the contents right in, rather than trying to carry the tray and sloshing soapy water and drowned fleas all over your carpet.

PET TREATMENT
Many people think that all they have to do to control fleas is to find that one special magic bullet to use on their pet. That strategy will be just about as successful as the Maginot Line was against Hitler's Panzer divisions — it’s an excellent way to be outflanked and overrun before you know what's hit you. If you have a flea problem, regardless of what you use on your pet, if that's all you do, it won't work. The obvious reason is that fleas are so good at reproducing. For every flea you manage to kill on your pet, there will be hundreds more to take its place — unless you eliminate them from the premises.

Pet treatment is the most variable and complex of the three areas of flea control. What you use and how you use it depends upon many factors, including the species of your pet, the severity of your flea problem, your chosen means of housing the pet. the presence of children, and your personal preference. Potential problems such as a pet’s allergy to fleas or an owner‘s allergy to pyrethrins must also be taken into account.

Light flea infestations should not be taken lightly. Before you know it, they turn into severe problems. Take effective measures at the earliest sign that your pet has picked up fleas. At that stage you may only need to treat the pet in order to end the problem. However, once a flea infestation has become established in your home, you'll need to do more. If you don't, you'll be fighting an enemy which has an endless supply of fresh, hungry reinforcements — and your pet will be miserable.

I could tell you what my favorite pet flea treatment is, but I won't, because my recommendations might very well not be appropriate for your situation. By all means, consult local veterinarians for advice on which specific products and procedures they recommend. They know what works best in their areas, and are the best-qualified people to prescribe exactly what your pet needs.