August 26, 2025 • 21 mins
What if your pet's habit of eating socks, furniture stuffing, or other non-food items isn't simply bad behavior, but actually a cry for help? Dr. Julianna Perez's groundbreaking research reveals that pica – the consumption of non-food items – may be a clinical sign of chronic enteropathy in dogs and cats.
The discovery began in emergency rooms, where veterinarians noticed dogs returning repeatedly for foreign body obstructions. When they removed these objects surgically, they observed abnormal intestinal tissue with blunted villi, erosions, and ulcerations. This led Dr. Perez to systematically collect biopsies during these surgeries, with astonishing results: 99% of animals with pica showed evidence of chronic enteropathy, primarily lymphoplasmacytic enteritis.
Most surprising was the severity of inflammation found in these pets, despite many showing only subtle clinical signs that owners often dismissed as normal – occasional vomiting, picky eating, or mild digestive issues. The research challenges the common assumption that pica is primarily behavioral, suggesting that in adult animals over two years old, it should be considered a medical condition until proven otherwise.
"Pica is not because animals are misbehaved," emphasizes Dr. Perez, whose work was inspired by a heartbreaking case of a service dog that died after multiple foreign body obstructions. The study found mixed breeds (particularly doodles), pit bulls, and retrievers commonly affected, though all breeds can develop this condition.
For veterinarians, this research highlights the importance of taking biopsies during foreign body surgeries and looking beyond the immediate obstruction to investigate underlying causes. For pet owners, recognizing repeated pica as a potential medical issue could prevent dangerous obstructions and potentially save lives.
Listen as Dr. Perez shares her findings, discusses future research directions exploring nutritional and molecular aspects of pica, and offers practical advice for both veterinarians and pet owners dealing with this challenging condition.
JAVMA article: https://doi.org/10.2460/javma.25.02.0079
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
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Greenies Smart Essentials dryfood delivers complete, balanced
nutrition with science-backedrecipes.
Greenies Supplements, developedby a team of PhD animal
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(00:22):
digestion and more, Whether it'smealtime or mobility support.
Greenies helps you care foryour dog from the inside out.
Learn more at greeniescom.
Speaker 2 (00:35):
You are listening to Veterinary Vertex, a podcast of
the AVMA Journals.
In this episode, we chat aboutpica as a clinical sign of a
chronic enteropathy in dogs andcats, with our guest, juliana
Perez.
Speaker 3 (00:50):
Welcome listeners.
I'm Editor-in-Chief LisaFortier, and I'm joined by
Associate Editor Sarah Wright.
Today we have a fabulous formerCornell student, juliana,
joining us, and thanks so muchfor taking time out of your busy
schedule to be with us heretoday.
Thanks for having me here.
Speaker 4 (01:05):
I really appreciate it.
Just talking about all theresearch and all the work that's
gone into this, I reallyappreciate it.
Speaker 2 (01:12):
Of course, let's dive right in so before we started
recording or chatting earlier,how important of a topic as this
is, so we're really excited tochat with you more about this
today, and your article stateshow a significant number of
animals with pica and foreignbodies demonstrated evidence of
a chronic enteropathy.
Please share with our listenersthe background on this article.
Speaker 4 (01:31):
So essentially background on, it was as the
cases we were seeing coming inthrough the ER.
We work really close with an ERin the medicine department over
here in Arizona and started tonotice that a lot of these dogs
coming in for pica would berepeated episodes of pica, not
just one, two, three.
There was one that had aboutsix different foreign body
(01:53):
instances.
So we started noticing that aswe were pulling out the foreign
bodies going through theintestinal tract it was
extremely abnormal.
They would have like bluntedvilli, you know, erosions,
ulcerations, all that stuff whenwe were pulling out from the
stomach.
So kind of over time started tonotice as we noticed that,
(02:14):
started taking biopsies and theidea kind of came from well, if
these dogs with pica are havingthese abnormalities further down
in the intestinal tract, maybethere could be a cause to the
pica.
So what we started doing wastaking biopsies on every single
dog or cat that had pica andeventually we found that 99% of
(02:36):
them had evidence of a chronicenteropathy.
Hard to say, you know, is itinflammatory bowel disease?
Is it, you know, another typeof like malabsorption type of
thing?
But a lot of them hadcharacteristic findings of
lymphoplasm, acidic enteritis oreosinophilic, neutrophilic, all
of that stuff.
And it was interesting that wefound that in the intestinal
(02:59):
tract and plus sometimes in thestomach as well, a lot of times
in the stomach as well, but moreso in the intestinal tract.
And so there was kind of anargument where, well, if it's in
the stomach because of theobject rolling around, why is it
in the intestinal tract?
So then we started to kind ofcollect these cases and
eventually got to the pointwhere I was able to publish
(03:19):
enough of them.
There was enough evidence toshow that and eventually we got
it after some hard work andcases that came in through the
ER.
Speaker 2 (03:29):
Yeah, super cool topic and really glad too that
you guys were taking themsamples as well while you're in
there retrieving the objects.
I mean, what's another five, 10minutes getting samples?
Speaker 4 (03:47):
And it's, you know, going later on, a lot of the
times we find if they're areferral from another clinic or
for any reason and they've hadopen abdominal surgery or you
know other foreign bodies mightas well get the information
while you're in there.
It's just less invasive in thefuture, less costly to the owner
, less surgical procedures inthe future of that animal.
(04:07):
So, um, we ended up doing itand it's, it wasn't too bad that
a lot of them did well afterthe fact and stuff like that.
So, um, it's, I'm pretty proudof it.
It's a really good topic to doand, uh, hopefully I can expand
a little bit more on the topictoo as you should be.
Speaker 2 (04:24):
Yes.
What are some of the importanttake-home messages from this
article?
Speaker 4 (04:27):
PICA is not because animals are misbehaved.
I would say in my paper we kindof classify in asking
behaviorists the cutoff forbehavioral PICA was about two
years of age.
I did have a lot of animalsthat were like one and a half,
2.1 month or 1.95 months thingslike that and I was able to
(04:51):
clarify with a couple ofbehaviorists that that's kind of
the age.
They find that that picabehavior because of adolescence
goes away.
And so I would say pica is notbecause if they're older than
two years of age it's notbecause they're bad animals or
because, you know, maybeenvironmental enrichment sure
that could be a part of it.
But I do think a big part of itis a clinical sign of a chronic
(05:14):
enteropathy and if you addressit a lot of the times it goes
away, if not improves quite abit with therapy.
So that's kind of the big hometakeaway.
Speaker 3 (05:24):
Well, I look forward to my daughter's dogs growing
out of it.
I've lost four pair of cheatersin as many weeks and at the
last pair, like she's verystealth and I can hear the
crunch and like I don't careabout them.
Right, but I do care about thechunk of the lens that she might
swallow.
Speaker 4 (05:41):
yeah, oh my gosh, no, my cat she's.
She used to chew on cords and,uh, she eventually grew out of
it eventually.
But you always get worried.
It's like, oh, there's amissing cord, you know my iphone
, or something like that.
So I, I understand completely.
But, um, I think that's thebiggest, the big home takeaway
is it's a sign of a clinical, ofa clinical enteropathy, or
(06:03):
chronic enteropathy would be mybiggest thing.
Speaker 3 (06:06):
Yeah, it's a Bernadudo highly likely.
Speaker 4 (06:10):
Yeah, those.
I love doodles.
Honestly, that's what I want.
I'm looking for a doodle like arescue or anything like that,
but they're.
They were the most common breed, the mixed breeds they call
them in our population and it'sfunny because they're so common
in Arizona and Scottsdale, socommon.
Like my physical therapist hasone, my friends have them, so
(06:30):
yeah, super common.
And then I think the second one, pit bulls, goldens, labradors,
those guys.
But it's fine, you deal with itand you get it treated, managed
and they do fine.
A lot of their animals did fine, but they're trouble.
Speaker 3 (06:47):
It is such a cool topic for you know,
veterinarians and trainers andeverybody owners right.
What sparked your interest inpursuing this as a research
project?
Speaker 4 (06:57):
So when I was an intern I was over at Angel
Memorial Boston and I had thiscase.
It was a military veteran andhis dog.
It was a service dog and thedog ended up having three
foreign body obstructions, endedup getting surgery every single
time.
I unfortunately got the dog atthe fourth time and they went in
(07:22):
.
There were so many adhesionsand the guy was not educated on
training and basket muzzles,treatment therapy, things like
that and the dog ended upgetting an enterotomy adhesions
everywhere and unfortunately thedog ended up dying because they
did de-kiss because of how badit was.
(07:42):
So I think that really triggeredmy inspiration for this topic
and avoiding so many casescoming in for chronic interrupt
the other signs were it.
My biggest thing was how couldI help all these animals and how
could we avoid death in thefuture, because it's such a
common thing and unfortunatelyI'm not a surgeon, right, I
(08:06):
don't cut things.
I see things on a referralbasis for internal issues and so
what could I do to kind of helpthis?
And that was the biggest case.
I think it will always staywith me and it's just so
heartbreaking.
You know, you see an adultcrying for and the dog was five
years old, so that's thetoughest thing and I think
that's really kind of sparked myinterest in GI disease and
(08:28):
noticing this is kind of thebiggest thing, really just kind
of tug at the heartstrings.
But that was the biggestinspiration for this and really
just what else could I do tohelp without cutting things open
, because that's not what I do.
So that was kind of the bigthing for me.
Speaker 3 (08:45):
Sounds like a tough and inspiring case.
It is, yeah.
Speaker 4 (08:49):
Sad and just, yeah, it's just, it's tough.
And we see a lot of these andyou know they'll go to surgery
and a lot of them end up dyingbecause, you know, either
because they did this they goseptic or it's just it's sad,
and then they're all young.
They're all young, that's thething.
They're not like, they're 10,12, you know, a lot of them are
like four, five, six, seven, andit's like you just wish you
(09:10):
could have done more, I think.
And that's kind of where I'm atwith this topic.
So the more awareness, thebetter.
Speaker 3 (09:23):
In my mind, just to kind of help veterinarians
recognize this disease and helpanimals in the future really is
my goal.
Yeah, sarah, asked you a littlebit earlier what some of the
most salient points of thearticle, but every time we do a
study we are surprised by things, which then engenders more
research.
What were some of thesurprising findings from this
article?
Speaker 4 (09:36):
Yeah, I think the most surprising finding was that
.
I think the fact that they allhad evidence of
lymphoplasmocytic enteritis,even though a lot of the dogs
weren't nuances, little clinicalsigns, you know they would puke
a couple times a month and theowner would say, you know,
that's normal for them, you know.
(10:06):
Or picky appetite that's areally common one, we find or
having GERD signs, things likethat, and the signs were not too
bad.
So eventually we got to thepoint where when we got that
lymphoplasm acidic enteritis,that to me says that this is
severe chronicity and a lot ofthem would be severe.
So I think that was the mostinteresting finding that I came
(10:27):
out because I didn't think wewere going to find, you know,
severe or moderate lymphoplasmacidic enteritis Me.
I thought maybe you know, maybesome mild changes, some, you
know, a little bit of fibrosis,nothing.
I think that was the biggestinteresting finding and just
kind of following the severityof helicobacter associated with
(10:49):
the stomach severity was not aninteresting finding but a lot of
people that do gastroenterologyresearch, it kind of fits with
that as well.
So I thought that wasinteresting too, given that a
lot of the times in thoseresearch articles you'll see,
you know they're vomiting orthey're losing weight, things
like that.
Not a lot of these animals hadthe weight loss or the vomiting,
(11:09):
it was more so the pica, thepicky appetite, the GERD-like
signs, things like that.
So I thought that was the moreinteresting ones that I took
from the paper.
When we got all the statscrunched and all the interesting
findings from the paper andstuff.
Speaker 2 (11:24):
Sounds like a good educational topic for both pet
owners and veterinarians alike.
Right?
No, that's my goal.
So, that being said, what arethe next steps for research in
FICA?
Speaker 4 (11:34):
I yeah, I mean, I think so for me it's good that
you know biopsies are great andI think so for me it's good that
you know biopsies are great.
We got that.
I would like to find because Ithink there's more.
So at the molecular level, forme I would like to see you know,
are there any othermicronutrients that they're
missing?
Are there any iron metabolitesin these samples, potentially
(11:56):
that they could be missing?
A lot of the research I found inhuman medicine where you know
people that were pregnant,people that are common, that
they could be missing.
A lot of the research I foundin human medicine where you know
people that were pregnant,people that are common, that
they're anemic, things like that.
But a lot of my animals weren'tpregnant, anemic, these
behavioral issues, they werekind of beyond that.
So I'd like to go more intokind of the molecular level
(12:16):
nutrients, things like that, tokind of see I'm looking.
Got a new job in California soI'm trying to go and kind of
talk to where I'm going to nextto see are there opportunities
for me to kind of look more intoit To see you know, are there
any other things that maybewe're just not getting the whole
clinical picture, becausethat's not available to us.
(12:37):
Maybe there are human hospitalsthat potentially do do this and
maybe I can incorporate thatinto my next future sample
population, things like that.
But that's the biggest thingI'm interested in to see Because
, yeah, they may be nauseous,they may not feel good, but it's
not as black and white and Ithink there's more to it.
(12:58):
I think that we're just notseeing, and that's kind of my
next goal for my next kind ofadventure in research for me.
Speaker 2 (13:05):
Very cool.
Well, we look forward tohopefully seeing more of your
future work too.
So AI is a really hot topic.
We've seen this a lot anddefinitely it's even becoming
more popular, I think, too, as aresearch topic in veterinary
medicine and scholarlypublishing.
Do you see a role for AI in thearea of research that you're
pursuing?
Speaker 4 (13:22):
on.
But really for the, I think forthe details getting details
from a lot of the records,getting details from referral
(13:45):
vets, things like that a numbercrunching, I think that would be
super helpful.
I think that's kind of wherethe role of AI that I see it in
I'm kind of like it makes me alittle uncomfortable for AI to,
you know, maybe diagnose thingsand interpret things, because I
think AI misses that humanquality that we can look at the
clinical picture, we can look atthe little nuanced things, the
trends of things.
So I would say, keep AI to thenumber crunching, the detail
(14:09):
association.
I'm a millennials kid so I'mvery less AI, the better, I
think, for that regard.
But it is neat, right, it issuper, it has its place, totally
for it.
You know, I have colleaguesthat are younger than myself and
they're doing the records withlike GPT and all these things.
So more power to them.
I'm all school, I use paper allday.
Speaker 2 (14:31):
Yeah, one of my best school classmates.
Actually, over the weekend sheposted a really funny video that
she had made at her clinicwhere she was like I'd like to
see AI try to replace like this,and it was her and a technician
working to like restrain thefractious cat and then like pill
the fractious cat and they hadhim like in the quote, unquote,
panini press.
You know he makes moreefficient but not replacing us.
Speaker 4 (14:51):
Right, right, no, that's great, yeah, no there's a
lot of that and it has itsplace, I think one day, but I
don't know.
Speaker 2 (15:03):
I'm still hesitant.
For those of you just joiningus, we're discussing pica as a
clinical sign of a chronicenteropathy, and dogs and cats
with our guest Juliana, and mychronic enteropathy cat decided
to join us.
You can see her ear here.
You're watching the video.
Speaker 3 (15:16):
Hey, giuliani, we talked briefly.
Like Cornell grad went toBoston.
Angel, you've got a lot oftraining and all that adds up,
but getting across the finishline with getting the article
all the way to publication, is awhole nother beast.
How did all that training helpyou write this article and get
it all the way across?
Speaker 4 (15:35):
Yeah, gosh, that's a great question.
I think the biggest thing isthe perseverance.
I got a lot of people that kindof told me you know, this is
not, it's not realistic, it'snot an ideal topic, it's not
something that me people willargue with.
You know, the experts likeKenny Simpson or Marks over at
(15:57):
Davis, things like that, and youknow I think it's more so the
perseverance and really like,doing all of these internships,
doing all of these, theresidency unit, I mean things
like that, I think really kindof pushed me to doing working
harder it.
It helped, obviously, gettingmy, my credentialing in as well,
(16:18):
because I needed that.
But I really think the biggestpoint was you know, what can I
prove to these big gurus?
That that I can prove and andsee, you know, hey, like yeah,
I'm a young grad, but I thinkthere's other things we're
missing, not just like dietrelated, not just you know what
I mean, all of these things.
Speaker 3 (16:36):
I can't wait to see Simmo and say, hey, you're a big
guru, it's out on VeterinaryVertex.
Speaker 4 (16:41):
Right, right, no, no, yeah, he's, he's.
Yeah, I had him as a teachertoo, and man he was, he was a
he's a very big guru in the GIworld.
So, yeah, I mean him, stanleyMarks, all those guys, and what
could I prove?
And that's what I like, youknow, I like what could I prove
that people don't think is thetypical, what is the norm?
Speaker 2 (17:02):
You know, I like to prove people wrong and that's
just kind of who I am as aperson and that's just kind of
what the goal was yeah, we havea lot of these like myth buster
episodes, I feel like on thepodcast, where people are like
looking at things that alwaystraditionally like been thought
and they have the evidence toshow either otherwise or to
validate what we've been doing.
So, right, those were episodes.
(17:23):
All right, juliana.
So this next set of questionsis going to be really important
for our listeners.
We're gonna take all the greatinformation you shared with us
today.
Try to boil it down to like onetake-home message that people
need to know.
What is one piece ofinformation the veterinarian
should know about pica and dogsand cats?
Speaker 4 (17:39):
That at a certain age it is not a behavioral problem,
it's evidence of a chronicneuropathy.
I would say that's the biggesttake-home and really pay
attention to that, because theydo it for a reason, it's not
just because, would be mybiggest take-home message.
Speaker 2 (17:58):
And on the other side of the relationship, what's one
thing that clients should know?
Speaker 4 (18:01):
I think clients should be cognizant of really
kind of keeping an eye on theirpets, the biggest thing being
that they can become obstructedand I think that's kind of the
biggest takeaway for owners andreally recognizing that they do
it once, maybe behavioral ifthey're a certain age, but if
(18:22):
they're older and they keepdoing it, I would think that's
when you should really get itaddressed.
Speaker 3 (18:29):
That's really nice and concise.
Thanks again.
Great to see you again.
Yeah, nice to see you too.
Thank you so much for your time.
I appreciate it.
Yeah, we always like to endwith a kind of a fun question,
and for you, we'd like to knowwhat is your favorite animal
fact.
Speaker 4 (18:43):
Yes, so my favorite animal fact a group of flamingos
is called a flamboyance.
I thought that was the funniestthing ever and I think that's
kind of my fun fact to people.
Speaker 2 (18:56):
I love that.
The local zoo here, brookvilleZoo, chicago.
They started doing these likeflamingo walks they call them
where they have the flamingoscome out in like a kind of like
a group and they walk around aportion of the zoo and the
visitors get to like see them upclose, which is really cool and
engaging.
But the first thing I thoughtof when you said that fact- I
was like oh, flamingo walk no, Ilove it.
Speaker 4 (19:13):
When I was little they used to have a little
petting area and you could petthe flamingos they're.
They're very aggressive though,so I got bit so I wouldn't
recommend it.
So I was like seven so, andthen I got bit by an emu, like a
couple years later.
So birds, yeah, snowbirds, no,thanks yeah, but that's my
(19:35):
interesting, uh, animal factvery nice, I love that.
Speaker 2 (19:40):
Yeah, we are at the beach with some friends this
weekend and I have a friendwho's terrified of any kind of
bird oh yeah, there was like abird that was encroaching on her
because she's yeah, lisa'sraising her hand lisa's like me
too when she was having a snackand the birds were like walking
over.
So I was like, all right, herewe go having a snack and the
birds were like walking over.
So I was like, all right, herewe go.
Animal science 101.
I was walking with my armsoutstretched to make myself
bigger, to get them to move.
So bird herder that's great.
Speaker 4 (20:03):
No, my mom has a cockatoo and the cockatoo, uh,
it's bit me a few times.
So I'm like no more.
No more birds for me.
I'm good, I'll stay away.
I'm good.
Cats and dogs precious cats, Ilove them, they're good, but
birds I'm I'm good, I'll stayaway.
I'm good with cats and dogsprecious cats, I love them,
they're good, but birds, I'mdone, I'm done, so I love that.
Speaker 2 (20:19):
We need people like you.
Well, thank you so much,juliana.
We appreciate you being hereand sharing your insight, too,
about your article with ourlisteners.
Speaker 4 (20:27):
Yeah, thank you guys so much for inviting me and
thank you for showing interestin my paper.
It means a lot, honestly itdoes, and it's just it's nice to
kind of get this topic kind ofout there.
Not even the recognition aboutthe paper, it's really for the,
you know, the animals and whatwe can do different to kind of
reduce death, reduce thiscomorbidities and treat them.
(20:49):
So I think I really appreciateyour guys's time.
Speaker 2 (20:53):
Of course, and to our listeners.
You can read Juliana's articlein Javma.
I'm Sarah Wright with LisaFortier.
Be on the lookout for nextweek's episode and don't forget
to leave us a rating interviewon Apple Podcasts or whatever
platform you listen to.
From the makers of vet-recommended Greenies dental
treats comes an easy way tosupport your dog's wellness.
Greenies Smart Essentials dryfood delivers complete, balanced
nutrition with science-backedrecipes.
Greenies Supplements, developedby a team of PhD animal
nutritionists, offers options tohelp support healthy joints,
(00:22):
digestion and more, Whether it'smealtime or mobility support.
Greenies helps you care foryour dog from the inside out.
Learn more at greeniescom.
Speaker 2 (00:35):
You are listening to Veterinary Vertex, a podcast of
the AVMA Journals.
In this episode, we chat aboutpica as a clinical sign of a
chronic enteropathy in dogs andcats, with our guest, juliana
Perez.
Speaker 3 (00:50):
Welcome listeners.
I'm Editor-in-Chief LisaFortier, and I'm joined by
Associate Editor Sarah Wright.
Today we have a fabulous formerCornell student, juliana,
joining us, and thanks so muchfor taking time out of your busy
schedule to be with us heretoday.
Thanks for having me here.
Speaker 4 (01:05):
I really appreciate it.
Just talking about all theresearch and all the work that's
gone into this, I reallyappreciate it.
Speaker 2 (01:12):
Of course, let's dive right in so before we started
recording or chatting earlier,how important of a topic as this
is, so we're really excited tochat with you more about this
today, and your article stateshow a significant number of
animals with pica and foreignbodies demonstrated evidence of
a chronic enteropathy.
Please share with our listenersthe background on this article.
Speaker 4 (01:31):
So essentially background on, it was as the
cases we were seeing coming inthrough the ER.
We work really close with an ERin the medicine department over
here in Arizona and started tonotice that a lot of these dogs
coming in for pica would berepeated episodes of pica, not
just one, two, three.
There was one that had aboutsix different foreign body
(01:53):
instances.
So we started noticing that aswe were pulling out the foreign
bodies going through theintestinal tract it was
extremely abnormal.
They would have like bluntedvilli, you know, erosions,
ulcerations, all that stuff whenwe were pulling out from the
stomach.
So kind of over time started tonotice as we noticed that,
(02:14):
started taking biopsies and theidea kind of came from well, if
these dogs with pica are havingthese abnormalities further down
in the intestinal tract, maybethere could be a cause to the
pica.
So what we started doing wastaking biopsies on every single
dog or cat that had pica andeventually we found that 99% of
(02:36):
them had evidence of a chronicenteropathy.
Hard to say, you know, is itinflammatory bowel disease?
Is it, you know, another typeof like malabsorption type of
thing?
But a lot of them hadcharacteristic findings of
lymphoplasm, acidic enteritis oreosinophilic, neutrophilic, all
of that stuff.
And it was interesting that wefound that in the intestinal
(02:59):
tract and plus sometimes in thestomach as well, a lot of times
in the stomach as well, but moreso in the intestinal tract.
And so there was kind of anargument where, well, if it's in
the stomach because of theobject rolling around, why is it
in the intestinal tract?
So then we started to kind ofcollect these cases and
eventually got to the pointwhere I was able to publish
(03:19):
enough of them.
There was enough evidence toshow that and eventually we got
it after some hard work andcases that came in through the
ER.
Speaker 2 (03:29):
Yeah, super cool topic and really glad too that
you guys were taking themsamples as well while you're in
there retrieving the objects.
I mean, what's another five, 10minutes getting samples?
Speaker 4 (03:47):
And it's, you know, going later on, a lot of the
times we find if they're areferral from another clinic or
for any reason and they've hadopen abdominal surgery or you
know other foreign bodies mightas well get the information
while you're in there.
It's just less invasive in thefuture, less costly to the owner
, less surgical procedures inthe future of that animal.
(04:07):
So, um, we ended up doing itand it's, it wasn't too bad that
a lot of them did well afterthe fact and stuff like that.
So, um, it's, I'm pretty proudof it.
It's a really good topic to doand, uh, hopefully I can expand
a little bit more on the topictoo as you should be.
Speaker 2 (04:24):
Yes.
What are some of the importanttake-home messages from this
article?
Speaker 4 (04:27):
PICA is not because animals are misbehaved.
I would say in my paper we kindof classify in asking
behaviorists the cutoff forbehavioral PICA was about two
years of age.
I did have a lot of animalsthat were like one and a half,
2.1 month or 1.95 months thingslike that and I was able to
(04:51):
clarify with a couple ofbehaviorists that that's kind of
the age.
They find that that picabehavior because of adolescence
goes away.
And so I would say pica is notbecause if they're older than
two years of age it's notbecause they're bad animals or
because, you know, maybeenvironmental enrichment sure
that could be a part of it.
But I do think a big part of itis a clinical sign of a chronic
(05:14):
enteropathy and if you addressit a lot of the times it goes
away, if not improves quite abit with therapy.
So that's kind of the big hometakeaway.
Speaker 3 (05:24):
Well, I look forward to my daughter's dogs growing
out of it.
I've lost four pair of cheatersin as many weeks and at the
last pair, like she's verystealth and I can hear the
crunch and like I don't careabout them.
Right, but I do care about thechunk of the lens that she might
swallow.
Speaker 4 (05:41):
yeah, oh my gosh, no, my cat she's.
She used to chew on cords and,uh, she eventually grew out of
it eventually.
But you always get worried.
It's like, oh, there's amissing cord, you know my iphone
, or something like that.
So I, I understand completely.
But, um, I think that's thebiggest, the big home takeaway
is it's a sign of a clinical, ofa clinical enteropathy, or
(06:03):
chronic enteropathy would be mybiggest thing.
Speaker 3 (06:06):
Yeah, it's a Bernadudo highly likely.
Speaker 4 (06:10):
Yeah, those.
I love doodles.
Honestly, that's what I want.
I'm looking for a doodle like arescue or anything like that,
but they're.
They were the most common breed, the mixed breeds they call
them in our population and it'sfunny because they're so common
in Arizona and Scottsdale, socommon.
Like my physical therapist hasone, my friends have them, so
(06:30):
yeah, super common.
And then I think the second one, pit bulls, goldens, labradors,
those guys.
But it's fine, you deal with itand you get it treated, managed
and they do fine.
A lot of their animals did fine, but they're trouble.
Speaker 3 (06:47):
It is such a cool topic for you know,
veterinarians and trainers andeverybody owners right.
What sparked your interest inpursuing this as a research
project?
Speaker 4 (06:57):
So when I was an intern I was over at Angel
Memorial Boston and I had thiscase.
It was a military veteran andhis dog.
It was a service dog and thedog ended up having three
foreign body obstructions, endedup getting surgery every single
time.
I unfortunately got the dog atthe fourth time and they went in
(07:22):
.
There were so many adhesionsand the guy was not educated on
training and basket muzzles,treatment therapy, things like
that and the dog ended upgetting an enterotomy adhesions
everywhere and unfortunately thedog ended up dying because they
did de-kiss because of how badit was.
(07:42):
So I think that really triggeredmy inspiration for this topic
and avoiding so many casescoming in for chronic interrupt
the other signs were it.
My biggest thing was how couldI help all these animals and how
could we avoid death in thefuture, because it's such a
common thing and unfortunatelyI'm not a surgeon, right, I
(08:06):
don't cut things.
I see things on a referralbasis for internal issues and so
what could I do to kind of helpthis?
And that was the biggest case.
I think it will always staywith me and it's just so
heartbreaking.
You know, you see an adultcrying for and the dog was five
years old, so that's thetoughest thing and I think
that's really kind of sparked myinterest in GI disease and
(08:28):
noticing this is kind of thebiggest thing, really just kind
of tug at the heartstrings.
But that was the biggestinspiration for this and really
just what else could I do tohelp without cutting things open
, because that's not what I do.
So that was kind of the bigthing for me.
Speaker 3 (08:45):
Sounds like a tough and inspiring case.
It is, yeah.
Speaker 4 (08:49):
Sad and just, yeah, it's just, it's tough.
And we see a lot of these andyou know they'll go to surgery
and a lot of them end up dyingbecause, you know, either
because they did this they goseptic or it's just it's sad,
and then they're all young.
They're all young, that's thething.
They're not like, they're 10,12, you know, a lot of them are
like four, five, six, seven, andit's like you just wish you
(09:10):
could have done more, I think.
And that's kind of where I'm atwith this topic.
So the more awareness, thebetter.
Speaker 3 (09:23):
In my mind, just to kind of help veterinarians
recognize this disease and helpanimals in the future really is
my goal.
Yeah, sarah, asked you a littlebit earlier what some of the
most salient points of thearticle, but every time we do a
study we are surprised by things, which then engenders more
research.
What were some of thesurprising findings from this
article?
Speaker 4 (09:36):
Yeah, I think the most surprising finding was that
.
I think the fact that they allhad evidence of
lymphoplasmocytic enteritis,even though a lot of the dogs
weren't nuances, little clinicalsigns, you know they would puke
a couple times a month and theowner would say, you know,
that's normal for them, you know.
(10:06):
Or picky appetite that's areally common one, we find or
having GERD signs, things likethat, and the signs were not too
bad.
So eventually we got to thepoint where when we got that
lymphoplasm acidic enteritis,that to me says that this is
severe chronicity and a lot ofthem would be severe.
So I think that was the mostinteresting finding that I came
(10:27):
out because I didn't think wewere going to find, you know,
severe or moderate lymphoplasmacidic enteritis Me.
I thought maybe you know, maybesome mild changes, some, you
know, a little bit of fibrosis,nothing.
I think that was the biggestinteresting finding and just
kind of following the severityof helicobacter associated with
(10:49):
the stomach severity was not aninteresting finding but a lot of
people that do gastroenterologyresearch, it kind of fits with
that as well.
So I thought that wasinteresting too, given that a
lot of the times in thoseresearch articles you'll see,
you know they're vomiting orthey're losing weight, things
like that.
Not a lot of these animals hadthe weight loss or the vomiting,
(11:09):
it was more so the pica, thepicky appetite, the GERD-like
signs, things like that.
So I thought that was the moreinteresting ones that I took
from the paper.
When we got all the statscrunched and all the interesting
findings from the paper andstuff.
Speaker 2 (11:24):
Sounds like a good educational topic for both pet
owners and veterinarians alike.
Right?
No, that's my goal.
So, that being said, what arethe next steps for research in
FICA?
Speaker 4 (11:34):
I yeah, I mean, I think so for me it's good that
you know biopsies are great andI think so for me it's good that
you know biopsies are great.
We got that.
I would like to find because Ithink there's more.
So at the molecular level, forme I would like to see you know,
are there any othermicronutrients that they're
missing?
Are there any iron metabolitesin these samples, potentially
(11:56):
that they could be missing?
A lot of the research I found inhuman medicine where you know
people that were pregnant,people that are common, that
they could be missing.
A lot of the research I foundin human medicine where you know
people that were pregnant,people that are common, that
they're anemic, things like that.
But a lot of my animals weren'tpregnant, anemic, these
behavioral issues, they werekind of beyond that.
So I'd like to go more intokind of the molecular level
(12:16):
nutrients, things like that, tokind of see I'm looking.
Got a new job in California soI'm trying to go and kind of
talk to where I'm going to nextto see are there opportunities
for me to kind of look more intoit To see you know, are there
any other things that maybewe're just not getting the whole
clinical picture, becausethat's not available to us.
(12:37):
Maybe there are human hospitalsthat potentially do do this and
maybe I can incorporate thatinto my next future sample
population, things like that.
But that's the biggest thingI'm interested in to see Because
, yeah, they may be nauseous,they may not feel good, but it's
not as black and white and Ithink there's more to it.
(12:58):
I think that we're just notseeing, and that's kind of my
next goal for my next kind ofadventure in research for me.
Speaker 2 (13:05):
Very cool.
Well, we look forward tohopefully seeing more of your
future work too.
So AI is a really hot topic.
We've seen this a lot anddefinitely it's even becoming
more popular, I think, too, as aresearch topic in veterinary
medicine and scholarlypublishing.
Do you see a role for AI in thearea of research that you're
pursuing?
Speaker 4 (13:22):
on.
But really for the, I think forthe details getting details
from a lot of the records,getting details from referral
(13:45):
vets, things like that a numbercrunching, I think that would be
super helpful.
I think that's kind of wherethe role of AI that I see it in
I'm kind of like it makes me alittle uncomfortable for AI to,
you know, maybe diagnose thingsand interpret things, because I
think AI misses that humanquality that we can look at the
clinical picture, we can look atthe little nuanced things, the
trends of things.
So I would say, keep AI to thenumber crunching, the detail
(14:09):
association.
I'm a millennials kid so I'mvery less AI, the better, I
think, for that regard.
But it is neat, right, it issuper, it has its place, totally
for it.
You know, I have colleaguesthat are younger than myself and
they're doing the records withlike GPT and all these things.
So more power to them.
I'm all school, I use paper allday.
Speaker 2 (14:31):
Yeah, one of my best school classmates.
Actually, over the weekend sheposted a really funny video that
she had made at her clinicwhere she was like I'd like to
see AI try to replace like this,and it was her and a technician
working to like restrain thefractious cat and then like pill
the fractious cat and they hadhim like in the quote, unquote,
panini press.
You know he makes moreefficient but not replacing us.
Speaker 4 (14:51):
Right, right, no, that's great, yeah, no there's a
lot of that and it has itsplace, I think one day, but I
don't know.
Speaker 2 (15:03):
I'm still hesitant.
For those of you just joiningus, we're discussing pica as a
clinical sign of a chronicenteropathy, and dogs and cats
with our guest Juliana, and mychronic enteropathy cat decided
to join us.
You can see her ear here.
You're watching the video.
Speaker 3 (15:16):
Hey, giuliani, we talked briefly.
Like Cornell grad went toBoston.
Angel, you've got a lot oftraining and all that adds up,
but getting across the finishline with getting the article
all the way to publication, is awhole nother beast.
How did all that training helpyou write this article and get
it all the way across?
Speaker 4 (15:35):
Yeah, gosh, that's a great question.
I think the biggest thing isthe perseverance.
I got a lot of people that kindof told me you know, this is
not, it's not realistic, it'snot an ideal topic, it's not
something that me people willargue with.
You know, the experts likeKenny Simpson or Marks over at
(15:57):
Davis, things like that, and youknow I think it's more so the
perseverance and really like,doing all of these internships,
doing all of these, theresidency unit, I mean things
like that, I think really kindof pushed me to doing working
harder it.
It helped, obviously, gettingmy, my credentialing in as well,
(16:18):
because I needed that.
But I really think the biggestpoint was you know, what can I
prove to these big gurus?
That that I can prove and andsee, you know, hey, like yeah,
I'm a young grad, but I thinkthere's other things we're
missing, not just like dietrelated, not just you know what
I mean, all of these things.
Speaker 3 (16:36):
I can't wait to see Simmo and say, hey, you're a big
guru, it's out on VeterinaryVertex.
Speaker 4 (16:41):
Right, right, no, no, yeah, he's, he's.
Yeah, I had him as a teachertoo, and man he was, he was a
he's a very big guru in the GIworld.
So, yeah, I mean him, stanleyMarks, all those guys, and what
could I prove?
And that's what I like, youknow, I like what could I prove
that people don't think is thetypical, what is the norm?
Speaker 2 (17:02):
You know, I like to prove people wrong and that's
just kind of who I am as aperson and that's just kind of
what the goal was yeah, we havea lot of these like myth buster
episodes, I feel like on thepodcast, where people are like
looking at things that alwaystraditionally like been thought
and they have the evidence toshow either otherwise or to
validate what we've been doing.
So, right, those were episodes.
(17:23):
All right, juliana.
So this next set of questionsis going to be really important
for our listeners.
We're gonna take all the greatinformation you shared with us
today.
Try to boil it down to like onetake-home message that people
need to know.
What is one piece ofinformation the veterinarian
should know about pica and dogsand cats?
Speaker 4 (17:39):
That at a certain age it is not a behavioral problem,
it's evidence of a chronicneuropathy.
I would say that's the biggesttake-home and really pay
attention to that, because theydo it for a reason, it's not
just because, would be mybiggest take-home message.
Speaker 2 (17:58):
And on the other side of the relationship, what's one
thing that clients should know?
Speaker 4 (18:01):
I think clients should be cognizant of really
kind of keeping an eye on theirpets, the biggest thing being
that they can become obstructedand I think that's kind of the
biggest takeaway for owners andreally recognizing that they do
it once, maybe behavioral ifthey're a certain age, but if
(18:22):
they're older and they keepdoing it, I would think that's
when you should really get itaddressed.
Speaker 3 (18:29):
That's really nice and concise.
Thanks again.
Great to see you again.
Yeah, nice to see you too.
Thank you so much for your time.
I appreciate it.
Yeah, we always like to endwith a kind of a fun question,
and for you, we'd like to knowwhat is your favorite animal
fact.
Speaker 4 (18:43):
Yes, so my favorite animal fact a group of flamingos
is called a flamboyance.
I thought that was the funniestthing ever and I think that's
kind of my fun fact to people.
Speaker 2 (18:56):
I love that.
The local zoo here, brookvilleZoo, chicago.
They started doing these likeflamingo walks they call them
where they have the flamingoscome out in like a kind of like
a group and they walk around aportion of the zoo and the
visitors get to like see them upclose, which is really cool and
engaging.
But the first thing I thoughtof when you said that fact- I
was like oh, flamingo walk no, Ilove it.
Speaker 4 (19:13):
When I was little they used to have a little
petting area and you could petthe flamingos they're.
They're very aggressive though,so I got bit so I wouldn't
recommend it.
So I was like seven so, andthen I got bit by an emu, like a
couple years later.
So birds, yeah, snowbirds, no,thanks yeah, but that's my
(19:35):
interesting, uh, animal factvery nice, I love that.
Speaker 2 (19:40):
Yeah, we are at the beach with some friends this
weekend and I have a friendwho's terrified of any kind of
bird oh yeah, there was like abird that was encroaching on her
because she's yeah, lisa'sraising her hand lisa's like me
too when she was having a snackand the birds were like walking
over.
So I was like, all right, herewe go having a snack and the
birds were like walking over.
So I was like, all right, herewe go.
Animal science 101.
I was walking with my armsoutstretched to make myself
bigger, to get them to move.
So bird herder that's great.
Speaker 4 (20:03):
No, my mom has a cockatoo and the cockatoo, uh,
it's bit me a few times.
So I'm like no more.
No more birds for me.
I'm good, I'll stay away.
I'm good.
Cats and dogs precious cats, Ilove them, they're good, but
birds I'm I'm good, I'll stayaway.
I'm good with cats and dogsprecious cats, I love them,
they're good, but birds, I'mdone, I'm done, so I love that.
Speaker 2 (20:19):
We need people like you.
Well, thank you so much,juliana.
We appreciate you being hereand sharing your insight, too,
about your article with ourlisteners.
Speaker 4 (20:27):
Yeah, thank you guys so much for inviting me and
thank you for showing interestin my paper.
It means a lot, honestly itdoes, and it's just it's nice to
kind of get this topic kind ofout there.
Not even the recognition aboutthe paper, it's really for the,
you know, the animals and whatwe can do different to kind of
reduce death, reduce thiscomorbidities and treat them.
(20:49):
So I think I really appreciateyour guys's time.
Speaker 2 (20:53):
Of course, and to our listeners.
You can read Juliana's articlein Javma.
I'm Sarah Wright with LisaFortier.
Be on the lookout for nextweek's episode and don't forget
to leave us a rating interviewon Apple Podcasts or whatever
platform you listen to.
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