1. Case Study #4 What About the Dog? www.environmentalhealthproject.org

2.  John L is a patient seeing you for blood pressure control. John and his wife have been living in their house for the past 10 years.  2 years ago, natural gas drilling began in the community.  Shortly after drilling started, they noticed a “funny taste” in their well water.  They also noticed that their dog, a 4 year old Labrador retriever, was refusing to drink the water. 724.260.5504

3.  The dog subsequently developed diarrhea and died after several months. John had the water tested and was told that it was “drinkable.” He is concerned that the dog’s illness may he related to his own risk.  As his physician, how should you respond to his question about the dog? 724.260.5504

4. Animals as Sentinels? Early warning? “gasp! ” 724.260.5504

5. What Makes an Animal a Sentinel?  Greater susceptibility compared to humans  Greater exposure to “shared risk” in environment: (drainage ditch, indoor air, etc.)  Shorter latency 724.260.5504

6. Animal Health and Natural Gas Extraction Activities  Anecdotal reports of illnesses in pets, farm animals, wildlife 724.260.5504

7. Talking to Patients about Illness in Animals- Challenges  Physician lack of veterinary knowledge  Veterinarians supposed to treat animals, physicians treat humans  Lack of referral/consultation network 724.260.5504

8. Steps to Follow-up on Reports of Animal Illness  1) Acknowledge patient’s concerns (many patients very affected by pet illness and death)  2) Ask if a veterinarian made any diagnosis.  3) Assess Exposure (environmental history): what were the dog’s exposures and were these exposures shared with humans?  4) Communicate with animal health professional or health department 724.260.5504

9. State Resources  Dr. Craig Shultz, State Veterinarian  Pennsylvania Department of Agriculture, Animal Health and Diagnostic Services Bureau, Harrisburg, PA 17110  Phone: 717-772-2852  Email: crashultz@state.pa.us  Dr. James Rankin, Jr., State Public Health Veterinarian  Pennsylvania Department of Health, Harrisburg, PA  Phone: 717-346-4524  Email: jrankin@state.pa.us 724.260.5504