"OUR DOGS has been by far the Foundation's greatest
supporter and we could not have achieved nearly as much
without it." - Jill Moss, Founder, Bella Moss Foundation
"MRSA has been building up gradually in the animal population."- David Lloyd, professor of dermatology at the Royal Veterinary College, North Mymms
Bella and Jill pictured in happier times
A CAMPAIGN was launched at Crufts 2005 to tackle one of the most worrying diseases to threaten the health of the UK’s pets. Shocking evidence has emerged that the ‘superbug’ MRSA - Methicillin-Resistant Staphylococcus Aureus - that kills over 5,000 patients a year in British hospitals, due to lack of basic hygiene is now killing pets in the same way. The new campaign, spearheaded by bereaved dog owner Jill Moss, has urged vets to clean up their surgeries and operating theatres.
Bella, a ten-year-old Samoyed dog is believed to be one of the first recorded cases of a dog dying of MRSA in the UK. Her owner, actress Jill Moss, 35, of Edgware, north London formed the Bella Moss Foundation in her memory to educate pet owners and vets about the risks to animals.
Jill Moss believes that Bella may have picked up the infection while undergoing surgery for a routine knee operation, although the north London veterinary surgery in question – part of a chain of surgeries - denies this. She is now calling for tighter guidelines for veterinary practices, including better hygiene practices.
On July 17th 2004 Bella was doing what all dogs do – chasing a squirrel, when she ruptured her cruciate ligament in the knee. Jill rushed her to the surgery, where a vet performed immediate surgery, usually a straightforward procedure to repair the damage. Bella was allowed home after treatment, but she became ill in the week following surgery, and the vets treated her for postoperative pain. Her wound burst open with pus and she was admitted as an emergency. After one week as an in-patient at the hospital her condition worsened.
Jill continues: "I removed her from this surgery that I had trusted for years and fought to get her into a specialist orthopaedic vet hospital in Bedfordshire. On the day we arrived, she had to undergo emergency surgery. I was informed that the infection in her leg (which had been present now for two weeks and untreated) was MRSA and had eaten away at her ligaments. The treatment she received at the specialist hospital saved her life and the plan was after her discharge that she would have reconstructive surgery on the knee. On admission, Bella was in septic shock with pneumonia and hours from death. The first veterinary hospital had not detected any of this."
Following her discharge from the specialist hospital, Bella became ill again. The referral hospital advised that the journey back to them was too long and that Jill should take her to the first vets as an emergency. This she did, based on an assurance from the senior partner that all would be done for Bella, but events took a tragic turn.
"The last three days of Bella’s life I was confined in a room with her and the vet staff refused to treat her because of MRSA and I had to nurse her myself," says Jill.
Although Jill was more than prepared to give Bella as much care as she possibly could, - which included cleaning her up when she was incontinent - there were things that she could not do on her own, such as turning her over.
"To be denied help to do even this simple thing filled me with distress, and it was only through the help of one of the vets that Bella didn’t spend the whole of her last forty-eight hours in that bleak consulting room," says Jill.
At times, Jill couldn’t find anyone on duty to help her and was reduced to phoning the hospital switchboard from her mobile phone. Eventually, in desperation, she phoned the surgeon who operated on Bella, whilst he holidayed in France, to beg him for help. The vet authorised extra care for Bella, but it was too little, too late.
Bella, usually so talkative and expressive, was now almost just a shell. Jill knew she now had to think the unthinkable, knowing that Bella wouldn’t get better, but without the senior vet, a person she had trusted in the past, she had no one to talk it through with. Thankfully, the next day, the senior vet arrived and after he saw her and they had talked, Jill agreed that Bella should be put sleep.
"We took her out into the garden again so that she would have those sounds and sights around her for her last minutes, and at 1.30 pm on August 21st, she had passed away. But I was still here, and with the terrible memory of those last 48 hours," continues Jill. "I feel that Bella died unnecessarily, before her time, and because of the ignorance and failure of professionals. But I also blame myself for not being more knowledgeable than the professionals who were supposed to care for her, as if, somehow, I should have been able to see something they didn’t."
"I cannot bring Bella back but I do hope that the Bella Moss Foundation help to ensure that no other animal or owner has to suffer as I have. I hope that people will be able to challenge the way their pet is treated, and use the knowledge of my experience to get better treatment in the future."
In June, just three months after Jill began her campaign, the British Veterinary Association announced that vets were to be issued with new guidelines in an attempt to fight the spread of MRSA. The Association had initially pooh-poohed Jill’s claims, but then, warned that the number of cases would continue to rise, urged its members to take precautions, and have now congratulated Jill on taking the issue forward so successfully through the press!
Dr Freda Scott-Park, president-elect of the BVA, said the Association wanted to ensure vets were aware that the bug can transfer between humans and farm herds or pets, particularly dogs. She said young, old and sick animals could be particularly vulnerable to the bug.
Dr Scott-Park tried to allay fears of cross-species infection by saying there were no proven recorded cases of MRSA jumping from animal to human. "We are far more concerned that it passes from humans to animals. That is the more likely path," she said.
A set of guidelines issued to vets will include a call to use sterile gloves, masks and scrub suits during all operations. One senior vet commented that if all these hygiene precautions were put into place this would "add £25 to £30 to simple procedures."
Jill counters this suggestion with simple arithmetic. "I’ve spoken to medical suppliers," she says. "Gowns are negligible in cost and, if properly cleaned at the right temperature, can easily be sterilised and used again. Masks, caps and gloves cost a few pence each and are sold in bulk.
How can that add £25 or £30 to a simple operation? Unless someone is thinking of profiteering out of owners’ natural concern for their pets’ welfare and should owners not at least be informed of this choice?"
However, things have moved on apace and Jill’s campaign has been noticed. She has been invited to sit as a member of the MRSA sub group of the DEFRA Anti-Microbial Resistance Committee, and attended her first meeting in July 2005.
Meanwhile, new cases of MRSA in pets are being reported at the rate of five to seven per month. Since November, three dogs have died of MRSA contracted post-operatively.
Katrina, one of the pet owners who have been in touch with Jill through the Foundation, recently found herself in need of practical help and support. Jill was able to liaise with the Royal Veterinary College in getting Katrina’s Staffordshire Terrier Jessie, referred for tests. Katrina made the journey down from East Anglia with Jessie who spent two nights at the RVC. News was good, however, and Jessie’s expected surgery was found to be unnecessary at this time, so more tests would be carried out in the next few months.
"Jessie was very lucky, thanks to the dedication and prompt action of the RVC," says Jill. “Bella wasn’t so lucky, and tragically, there may be other pets that also may not have that luck unless the matter of MRSA in pets – as in humans – is given serious attention."
"I sat on the floor of the veterinary hospital as Bella slowly drowned in her own bodily fluids because they would not give her the treatment she needed," said Jill. "No dog owner should have to go through that, ever. Better hygiene is required, better treatment for MRSA is needed, but slowly, gradually, the message is getting through.
"Bella was a unique dog, my soulmate, my closest companion. But her death will not have been in vain if we can make sure that no other pet dies of MRSA, which is totally preventable."
The Foundation at Crufts
The Bella Moss Foundation will be present at Crufts again this year to continue
its work in promoting awareness of MRSA and other serious infections in pets.
Jill Moss told OUR DOGS: "Crufts is a huge event and gives us the opportunity to make new contacts and renew old ones as part of our strategy to raise awareness. We will be visiting different exhibitors as part of our work and letting the press know how important an issue this is.
"But most importantly, it’s also an unparalleled opportunity to again meet real pet owners who may not have heard of our work yet, and who may know nothing of Bella’s story or the issues related to serious infections. That is the real purpose of what the Foundation does. I’d also like to say that OUR DOGS has been by far the Foundation's greatest supporter and we could not have achieved nearly as much without it."
For full details about the Bella Moss Foundation, see the Charity website http://www.thebellamossfoundation.com
and the Campaign website: http://www.pets-mrsa.com
What Is MRSA?
MRSA - Methicillin-Resistant Staphylococcus Aureus - sometimes referred to in the media as the ‘Superbug’, kills around 5,000 human patients a year. It affects both humans and animals. MRSA is a bacterium that, under normal conditions, is relatively harmless.
Every human being lives with different kinds of bacteria (Staphylococcus included) in our bodies and on our skin without harmful effects, but problems can occur when they get into the blood stream or tissue through a cut or broken skin, particularly if a person and animal’s immune system is weakened.
MRSA can be so difficult to treat that in some cases it is fatal. Lack of hygiene in the nation’s hospitals is cited as the primary cause of many of the cases of MRSA – and the same obviously applies to Veterinary hospitals and surgeries.
MRSA In Pets – The Facts:
Although some members of the veterinary profession initially dismissed Jill Moss’ claims out of hand, scientific research has borne out her own data. A leading UK microbiology laboratory in the UK has cultured swabs from 310 cases of MRSA in pets over a period of two-and-a-half years.
Another study took place at the Queen Mother Hospital (RVC) in Potters Bar, Herts, in which all staff were swabbed and tested showed that 17.9% were carrying the bacteria.
Experts believe the spread of MRSA to animals is of concern, and are demanding more research into the risks, but have also stressed that the chances of the bug transferring to humans is small. David Lloyd, professor of dermatology at the Royal Veterinary College, North Mymms, first documented MRSA in small animals in 1999 when 11 dogs were diagnosed with the infection, although none died. Professor Lloyd was the first veterinary professional to research the risks involved.
"MRSA has been building up gradually in the animal population," said Professor Lloyd. "Although we have warned about it for some years, it was only recently people started to listen. "We want to determine the risks of MRSA transmission and infection amongst owners and pets. If you have a weak immune system and the dog has MRSA there could be transfer, but this is rare. The bigger risk is that the human MRSA carrier will transfer MRSA to a sick pet."
Annette Loeffler of the RCVS who is assisting Professor Lloyd in his research praised the Foundation saying: "There has been a worrying increase in the numbers of pets reported with MRSA infection. The causes for this seem to be complex and research to understand this emerging infection in animals and people is continuing. The Bella Moss foundation has been very helpful explaining to pet owners the complexity of issues involved."
The Bella Moss Foundation Conference
The 1st International Conference on MRSA in Animals to be held on19th/21st June at the University of Liverpool in Leahurst, Wirral is a major step forward in bringing the issues around MRSA to the veterinary profession. With some of the world’s most eminent veterinary leaders speaking, we expect the research and clinical aspects to be thoroughly explored and opened up to practicing vets.
This event, which the Bella Moss Foundation is holding in partnership with the University of Liverpool, is the first to make MRSA in animals the focus. Moss commented: "We believe that it shows that there is a new awareness in the veterinary world of the risk to animals of MRSA and a desire to prevent it becoming as big a threat to animal health as it is to humans."
* For details of the 1st International Conference on MRSA in Animals, see website: http://pcwww.liv.ac.uk/vetvirology/mrsaconference.htm
The Practice Standard Scheme
The Foundation is strongly in favour of a compulsory or statutory system that improves the overall standard of veterinary practice.
Jill said: "Although the RCVS has launched its Practice Standard Scheme, the Bella Moss Foundation believes that the evidence shows that there has been too little take-up by new practices to show that the scheme is valued in any way by practicing vets, and that the scheme itself is too limited in scope.
"The only way that overall standards can be improved in the short term and thus improve confidence in veterinary services is by making good practice a requirement rather than an option.
This would help narrow the gap between the best and the worst of practices and force the profession as a whole to think more collectively about issues such as infection control."