Photo by Dr. Linda Jorgensen
Sequoia Veterinary Hospital in San Carlos, California, stocks a cabinet-full of Hill's Pet Food diets. Dr. Linda Jorgensen, medical director of the practice, said she'd be "hard-pressed" to cut ties with Hill's despite her disappointment in how the company handled a recent vitamin D-related recall. "I have to say, when the recall first came out, Hill's was dead to me," she said. "But after, I started thinking, 'There are some foods that I still like.' Hopefully, the company will learn something from this."
It was out of frustration that Dr. Linda Jorgensen picked up a recalled can of Hill's Prescription Diet from her clinic shelf in mid-February and asked Midwest Laboratories to analyze its contents for vitamin D.
If Hill's Pet Nutrition wouldn't say how much vitamin D its recalled diets contained, the veterinary internist from San Carlos, California, vowed to get an idea. Unlike many of her colleagues, Jorgensen hadn't encountered patients sickened by the food. But she was "fed up" with a lack of information from the company whose diets she and other veterinarians regularly recommend for patients.
It took Midwest two weeks to test Jorgensen's sample. Results showed the vitamin D content to be four to five times the maximum allowance set by nutrient profile standards of the Association of American Feed Control Officials. Whether that's high enough to create toxicity is an open question, veterinary nutritionists say. What's more, extrapolating anything concrete from the results requires duplicating the test, at the very least.
At $250 a test, Jorgensen isn't doing more analysis. She's satisfied her curiosity.
"I just really wanted some sort of idea about what was going on," she said in an interview with the VIN News Service. "Hill's was not as forthcoming as they should have been, as quickly as they should have been. We heard about the recall from a drug rep for a different company. I think we got the recall letter from Hill's emailed to us well after that."
That sentiment is echoed by many who've criticized how Hill's handled the late-January recall of 25 varieties of Hill's Prescription Diet and Hill's Science Diet canned dog food, following reports of illness. More lots were withdrawn in February because they did not meet the company's formula specifications but not because they might make dogs sick, Hill's officials said.
Among veterinarians' chief complaints is that the company was slow to alert them — the very professionals who recommend Hill's diets — about the initial recall. Pet foods by Hill's and other brands that are labeled and marketed to treat medical conditions in dogs and cats do not require a written prescription. (However, guidance from the U.S. Food and Drug Administration says they should be "marketed only through and used under the direction of a licensed veterinarian.")
On message boards of the Veterinary Information Network, an online community for the profession and parent of the VIN News Service, practitioners say they were blindsided with clients' concerns long before hearing from Hill's directly.
In previous interviews with VIN News, Hill's explained that its first priority was to reach pet owners in an effort to stop dogs from eating the recalled foods. Too much vitamin D can sicken animals and sometimes cause death. Signs of an overdose in dogs range from drooling, constipation and/or vomiting, to seizing. Other common indicators include increased urination and thirst. High concentrations of vitamin D can cause hypercalcemia, which means the level of calcium in the bloodstream is abnormally high. Elevated calcium levels can cause bone loss and kidney or bladder stones, in addition to other maladies. If left untreated, the condition can result in renal failure and be fatal.
Veterinarians also find frustrating the company's lack of transparency about how the vitamin D mix-up happened — details that are important, given that company's purported use of nutritionists, research, high-end ingredients and quality control.
Dr. Christina Benton, a practitioner in New Berlin, Wisconsin, said she read a Facebook post about the recall on Jan. 31. Pet owners were posting to online forums about illnesses and deaths they believed were caused by recalled Hill's diets. Benton's practice contacted Hill's. A formal response, an official promised, was coming.
The following evening, Benton still was waiting.
"Meanwhile, clients were calling and sharing the Facebook posts and expecting us to have an answer," she said. "… I decided that if Hill's wasn't going to be on top of it, at least I could do my best, so I crafted an email and Facebook post about the recall to try to word things as professionally as possible without having much information to go off of.
"I don't think we ever heard a formal response from Hill's," she added. "The following week, our rep emailed us some piecemeal articles on how to proceed if we thought we had a case, but that was all."
Dr. Karen Christopherson said she can't criticize Hill's for first reaching out to pet owners. But after that, "I do think they really dropped the ball," she wrote on VIN. "They should have had a better emergency plan already in place for communicating with vets in the case of something like this happening …"
In an online apology to the public, Hill's blamed the recall on "human error" by a supplier of vitamin premix that the company refused to identify. Officials also have declined to say how many adverse reactions are tied to the recall or characterize them, citing ongoing efforts to review reports from pet owners and veterinarians.
At least 12 class action lawsuits are pending against the company. Hill's officials have not responded to the ongoing cases.
They've also not detailed just how the excess vitamin D got into the diets — information veterinarians say the company owes them. So far, officials at Hill's have been short on details, declining to share the identity of its vitamin premix supplier apart from confirming that it's a "well-known" U.S.-based company. The finished product is manufactured at a Hill's plant in Topeka, Kansas.
In an interview last month with VIN News, Dr. Jolle Kirpensteijn, chief professional veterinary officer at Hill's U.S., said the company is "examining this very, very thoroughly."
"There was a supplier error in the manufacturing of vitamin premix," he said. "We realize that this is not good for pet patients, pet parents or veterinarians."
Tom DiPiazza, director of corporate communications for Colgate-Palmolive Company, owner of Hill's, said the company has been working with veterinarians directly. "We will — as always — provide them with the one-on-one consultation and attention that Hill's is known for," he said by email. "This direct communication is a hallmark of Hill's and appreciated by the veterinarians we serve."
Dr. Meghan Ellis, who runs a mobile veterinary clinic in Sanford, North Carolina, is looking for more than guidance from Hill's. She wants to know exactly what happened.
Until two years ago, Ellis owned a brick-and-mortar practice and pet store. Drawing from her experience selling both regular and prescription diets, she said the Hill's recall exemplifies what's wrong with the pet food industry as a whole.
"Almost every pet food manufacturer buys premixes from a common source, even if they manufacture their own foods in their own plants. But most don't manufacture their own foods," Ellis wrote in a VIN message board discussion. "They basically give a recipe to a co-packer and abdicate all control over the manufacture of their own foods. They have to hope that their co-packers uphold the same values as far as safety that they do. Unfortunately co-packers are under intense pressure to make the food as cheaply as possible. ... This is how we get melamine, too much or too little vitamin D, and frankly most other problems that spread over many different manufacturers.
"Hill's just got caught up in the latest mistake," she added.
More confounding, Ellis continued by phone, is a general lack of transparency among the giants of prescription pet foods — Hill's, Purina and Royal Canin — diets manufacturers promote as beneficial for sick patients.
"[The manufacturing processes] are all protected by trade secrets, and it's ridiculous," she said. "We're not just selling these diets, we're recommending and prescribing them, saying 'This is what you should take.' And we don't even know how they're made. We don't know exactly how they're tested."
Dr. Bryce Fleming said that Royal Canin exemplifies how Hill's should handle recalls. The practitioner from British Columbia, Canada, referenced a 2006 recall by Royal Canin, in which the company pulled thousands of canned dog food products from shelves because they contained excess vitamin D. A vitamin premix from a third-party supplier was at fault, the company explained.
"We had several patients with sky-high calcium levels, and at least one with elevated renal values as a result," Fleming recalled. "Royal Canin … picked up the problem themselves after they noticed a trend across North America. [T]hey triggered the publication, the recall and they actively sought out affected animals, provided intellectual and financial support and eventually explained the entire situation."
Fleming continued: "Something is seriously wrong at Hill's if they think staying silent and looking away is a good strategy."
Dr. Jonathan Stockman, a veterinary nutritionist at Colorado State University, surmised how the vitamin D mishap at Hill's might have occurred, though he acknowledged having no inside information. "… Some possibilities include a faulty vitamin premix, a calculation error, or an incorrect analysis," he wrote on VIN. "A problem in the premix, which is used for several products, would explain how multiple products that likely use the same mix were affected."
Laying out expectations
Resources for veterinarians
Benton offers tips for how the company can repair its damaged relationship with veterinarians. She suggests that Hill's:
- Better communicate with their sales representatives so they feel more equipped and empowered to answer practitioners' questions.
- Provide fast, direct communication with veterinary clinics to explain what happened during recalls. "If I was able to craft a well-laid-out email, there is no reason Hill's could not have sent a mass email … so that everyone was on the same page," she said.
- Communicate directly with customers so they do not direct their anger to veterinarians. "It is hard enough to convince owners we are not the ‘bad guy' by prescribing these Rx diets, so to leave us to fend for ourselves against the horde was not appreciated."
- Improve quality-control testing. "I would not expect this from Hill's. … A life-threatening ingredient issue should never have made it to store shelves from such a reputable company."
- Inform the profession about the steps Hill's is taking to ensure this never happens again.
Jorgensen, the veterinarian from Santa Clara who ordered her own test of a can of Hill's dog food, echoed some of Benton's ideas.
"Transparency, that's what can help," she suggested. "All this has been extraordinarily frustrating; that's why I sent in the can. If Hill's wasn't going to tell me how much vitamin D was in the food, I was going to get a number myself.
"This is what happens when you get a little angry," she added.
VIN News Service commentaries are opinion pieces presenting insights, personal experiences and/or perspectives on topical issues by members of the veterinary community. To submit a commentary for consideration, email firstname.lastname@example.org.