Petition: end unnecessary intubation of cats at U. Va.

This would seem to be a no-brainer, and I’m assuming the facts are as stated. It is a letter from a doctor who has created a petition on change.org.

I can’t even imagine if my beloved cats suffered the same fate as Alley, Fiddle and Kiki.

Alley, Fiddle and Kiki are three cats used in pediatric intubation trainings at the University of Virginia medical school. The details are horrific: they’re immobilized and helpless as plastic tubes are repeatedly forced down their throats – sometimes as many as 20 times each session. And Alley, Fiddle and Kiki have been enduring this torture for the last seven years.

As a pediatrician with over 25 years of experience, I know just how important proper intubation can be for premature babies. But it’s far more realistic to practice on a human simulator than a cat — which is why almost every other medical school has stopped using animals in trainings. I can’t believe UVA would keep abusing these defenseless creatures rather than following universities like Yale and Johns Hopkins.

There are only weeks before Alley, Fiddle and Kiki will be subjected to yet another year of this torture — a new round of pediatric residency students will start orientation on June 14. I’ve started an urgent petition on Change.org asking the university to stop using cats for training before classes start. Will you join me?

The university claims the cats are treated well — but I can’t imagine anyone agreeing to let his or her cat or dog at home suffer this sort of procedure month after month, year after year. I don’t see the difference between Alley, Fiddle, and Kiki at UVA, and my cats Beeto, Binky, Pounce, and Spooky at home.

I know from experience just how vital intubation can be — it saves lives. I’m simply asking the university to stop using this outdated and unnecessarily cruel method of teaching.

At least 94% of pediatric residency programs have stopped using cats because more ethical, effective methods are available. I’m convinced that if UVA hears from thousands of people across the community, it will realize it should do the same.

Help me make sure Alley, Fiddle and Kiki don’t endure another year of this torture.

Thanks for your help,

Dr. Roberta Gray

If there are equally effective ways to train doctors that don’t involve torturing animals, we are obliged to end that torture. You can find the petition at the link above, or here. I’ve signed it. There are 75,000 signatures, and about the same number to go.

49 Comments

  1. Posted May 16, 2012 at 5:49 pm | Permalink

    Signed, Facebooked and Tweeted, gladly.

  2. S A GOULD
    Posted May 16, 2012 at 5:57 pm | Permalink

    Posted to facebook.

  3. Posted May 16, 2012 at 5:58 pm | Permalink

    I appreciate this. Yes there is a way to end this, have them practice on veterinary patients who actually need intubation. Arthritic dogs were the first “lab animals” (except they were merely day patients with owners) to be given glucosamine as a Tx, later they looked into it for human use. This way actual animal patients who needed a drug got the meds they needed. A win win.

  4. Janice C
    Posted May 16, 2012 at 6:00 pm | Permalink

    Signed & thanks for letting us know.

  5. Jack
    Posted May 16, 2012 at 6:03 pm | Permalink

    I am at a loss to comprehend why you would start a petition when you admittedly do not know facts of the case. In the future, some due diligence would add considerably to your credibility. Meanwhile,check these sites for clarification:

    http://www.virginia.edu/catsmedical/

    http://www.virginia.edu/uvatoday/corrections/cats_medical_120112.html

    • whyevolutionistrue
      Posted May 16, 2012 at 6:14 pm | Permalink

      I read the response and I stand by what I said. The “belief” that cats are the best way to do this isn’t supported by any facts. And cut out the snark.

      • chascpeterson
        Posted May 17, 2012 at 12:16 am | Permalink

        ?
        What snark? I see three straightforward, declarative sentences.

        And the “belief” that “more ethical, effective methods are available” isn’t supported by any facts either.

        • gravelinspector
          Posted May 17, 2012 at 5:56 pm | Permalink

          Sounds like someone volunteering to be a intubation-training puppet.
          Oh, hang on : pediatric training, not adult medicine. So, correction :
          Sounds like someone volunteering their own children to be intubation-training puppets.
          That all sounds good to me. God would approve.

        • Jesus H. Christ
          Posted May 20, 2012 at 2:57 am | Permalink

          @chascpeterson

          Over 90% of pediatric residency programs do not use cats. That sounds like a fact.

    • DV
      Posted May 18, 2012 at 7:58 am | Permalink

      So the end justifies the means?

  6. Elf Eye
    Posted May 16, 2012 at 6:12 pm | Permalink

    I am curious as to why you are “assuming the facts are as stated”?

    • Adam M.
      Posted May 16, 2012 at 7:07 pm | Permalink

      Should he have assumed they were otherwise? :-)

      (Or if you’re coming from the other angle, stating one’s assumptions is just honest writing.)

  7. Simon Hayward
    Posted May 16, 2012 at 6:15 pm | Permalink

    My gut reaction is that the basic premise is implausible, and I certainly don’t know the specifics here. However, cats (in a research setting) are a USDA-regulated species and as such the regulations covering their use are pretty strict. Multiple interventions must be scientifically justified, and I can see no reason for a repeated intervention of this type in individual animals. (Cost is not an allowable factor in such calculations – if it costs more to buy more cats so that each is only used once – tough). Also all protocols, and training protocols such as this are particularly scrutinized, must justify that animal use is absolutely necessary and that other models – and a lot of the dummy-type models are now very good – cannot feasibly be used.

    I should also note that it is cheaper for an institution to buy in dummies than to pay several dollars a day each to house the cats. I don’t know what UVAs feline per diem is but I doubt it’s cheap – my own institution charges $9.04 per cat per day for housing, so it’s likely in that range – so for three cats that’s $9898 per year.

    For a procedure such as intubation it seems unlikely (in my considerable experience) that an IACUC would permit this use (and if it has really been going on for seven years the group would have had to renew the protocol a number of times.)So on a number of levels I do wonder about the veracity of the story.

    I have heard a number of unfounded scare stories of this nature. So, please excuse me for reserving judgement and not signing anything – yet.

    • Posted May 17, 2012 at 12:10 pm | Permalink

      Jack’s comment (#5 on the list) provides links to two UVa responses to criticiques against using the cats. FWIW, that appears to verify the story of the cats being used.

  8. Elf Eye
    Posted May 16, 2012 at 6:18 pm | Permalink

    Here is a link to the Commonwealth Attorney’s report on the three cats mentioned in the petition: http://www.virginia.edu/uvatoday/corrections/Comm_Atty_response_to_PCRM.pdf.

    • Simon Hayward
      Posted May 16, 2012 at 6:26 pm | Permalink

      Well I guess that blows my implausibility argument out of the water!

    • Posted May 16, 2012 at 7:15 pm | Permalink

      So, according to the Commonwealth attorney’s investigation, students report that using the cats is superior to the mannequin for learning intubation.

    • Posted May 17, 2012 at 12:18 pm | Permalink

      I read the report far enough to see the attorney believes that whatever pain may be instigated during the procedure is permanently blocked by temporary anesthetic use, both general and topical. Perhaps, were he to have his thumb anesthetized, then hit with a hammer, he could learn, after the anesthesia wears off, whether there will be pain from the scientific procedure.

  9. Posted May 16, 2012 at 6:32 pm | Permalink

    Done

  10. Midaztouch
    Posted May 16, 2012 at 6:32 pm | Permalink

    Wtf?!? I intubate people all day long and it never would have even occurred to me to learn how to do it on cats. It’s just not necessary. I’ve never intubated a non-human in my life, yet I *somehow* still manage to get the tube in the right hole. I sign the petition in the memory of Joey the cat. He was one hell of a cat.

  11. Posted May 16, 2012 at 7:42 pm | Permalink

    @Midaztouch You realize intubating adults is not the same as intubating infants. I doubt many parents want their 9 month olds being used as training subjects for pediatric residents.

    re the post and letter. I see several times other methods are mentioned as being superior with no data, links, or definitive examples to back these statements up. The one exception is the human simulator aka plastic doll, which I expect is not a good surrogate for a human child, except in the looks department, a plastic throat is not the same as flesh and blood.

    While it’s great that other institutions do not use cats, it does not follow that this is because other methods are better. It could also be because these institutions folded to pressure from animal rights groups or even difficulties with internal review boards (IACUC). Many countries make it exceedingly difficult to do genetic research, based on this argument the USA should too.

    If there truly are more effective methods, I would rather see a hyperlink to the data than a variety of font colors and bolding. I am not an advocate for using animals when other methods are as good if not better. However, this letter seems little different than any information put out by PETA or the Humane Society of USA when they argue that animal use in research is the most unethical immoral act.

    • Posted May 17, 2012 at 12:21 pm | Permalink

      You assume @Midaztouch does not and has never intubated an infant or neonate. I saw no evidence to suggest this is a valid assumption.

    • Jesus H. Christ
      Posted May 20, 2012 at 3:01 am | Permalink

      Calm down, Lorax. Are babies dying by the thousands every day because they couldn’t be properly intubated by an anesthetist that didn’t have access to a cat when s/he trained?

  12. Adam M.
    Posted May 16, 2012 at 7:51 pm | Permalink

    I came here to sign the petition, but I must say that I’ve been convinced by the posted links that PCRE is exaggerating its case and that there may be valid pedagogical reasons to use cats. At least some of the students involved have testified that the cats are much superior to the simulators, and an investigation into the matter found that PCRE’s claims of cruelty were (at least legally) baseless.

    It seems that each cat is in fact used in only one “session” per year, not continually as PCRE makes it seem. Once per year doesn’t sound so horrific, although I don’t know how long a session is.

    The use of the word “torture” seems unjustified, too. Their keepers seem to do their best to make the lives of the cats as good as they can be under the circumstances. They use anesthesia to ensure the cats aren’t in physical pain, tune the formulation based on individual cat responses to minimize adverse reactions, repeatedly check for trauma or irritation, and end the session if the cat becomes too stressed. That isn’t the MO of a torturer. I realize that the cats may be suffering some fear and mental anguish, but if that is torture then perhaps most uses of animals by humans (e.g. farming) involve torture.

    • Posted May 17, 2012 at 12:27 pm | Permalink

      Many of my surgical patients have spoken through weak voices to complain of sore throat and painful swallowing after a single, adult human, professional intubation by professional anesthesiologists with many years of practice beyond their training. UVa’s cat lab involves re-intubating cats over and over. How many times? The letter suggested the cats were examined every four to six (if I recall correctly) intubations — not attempts, but intubations, so failed attempts, adding to tissue trauma, don’t count. If each cat is examined five times in the residents’ lab, that would be some 20 intubations per cat, just to try to put this in perspective. The tissues of the throat are delicate, moist mucosal membranes. They’re not designed for such use.

  13. Midaztouch
    Posted May 16, 2012 at 8:28 pm | Permalink

    Lorax, I have intubated many infants. The reality is that at training institutions, patients ARE treated by residents. Yes, even infants. Perhaps if the parents were aware that the residents had practiced on cats first, then maybe they would be okay letting the resident have at their 9 month old. I would go on but it’s my bedtime and typing on an iPhone sucks.

    • Posted May 17, 2012 at 12:30 pm | Permalink

      I would add that, as a medical student, I drew blood from and then performed a spinal tap on an 8 day old infant, under the guidance and tutelage of the senior/chief resident who held the baby in position. Medical/surgical training is a form of apprenticeship.

  14. Posted May 16, 2012 at 11:14 pm | Permalink

    I signed the petition, but with a reservation. I’ve signed a petition from change.org before and after I did, I received an endless procession of requests to sign other petitions. I was finally able to get them to stop contacting me and here I go again…But after I came out of anaesthesia from my last major surgery, they would not remove the tube going down my throat even though I was very upset about it. They kept saying my blood pressure had to come down before they would remove it and I kept getting more and more upset with them which I’m sure raised my bp. The tube was horrible. I feel sorry for the cats.

  15. stevehayes13
    Posted May 16, 2012 at 11:36 pm | Permalink

    Signed.

  16. chascpeterson
    Posted May 16, 2012 at 11:45 pm | Permalink

    I’m assuming the facts are as stated

    May I suggest you as a reviewer for my next grant proposal?

    In response to some of the comments, it’s not about 9-month-olds. The exercise simulates intubation of a premature neonate. Apparently (according to the UVa link posted above) in a real emergency situation, this has to be correctly completed in 30-60 sec or the kid dies. Hence the practice on live, squirmy little mammals with a real tongue and epiglottis in the way. Cats (or ferrets) are traditionally, and still evidently commonly, used for this purpose.
    Whether a plastic doll is real enough or not does not seem to fall into the realm of ‘fact’ either way.

    • chascpeterson
      Posted May 17, 2012 at 12:08 am | Permalink

      just noticed that the ferret article linked is full-text. The first couple paragraphs make the case for the defense.
      I suggest reading it before assuming/signing.

      • Nyanko Sensei
        Posted May 17, 2012 at 1:43 am | Permalink

        Hi chas thanks for providing the insight. Since it’s training for a special situation, it seems UVA is trying to balance risk (hurting cats) versus benefit.

        That said, the two things I would note from the links provided:

        Given that the cats are administered a general anesthetic and a topical anesthetic I don’t know how much “fight” they would provide or really how squirmy they can be. I had assumed that they (the cats) were not given any or very little in the way of premeds, since a 30-60 second window would preclude this in a premature neonate. But since they are sedated the issue is probably the trainees getting comfortable with working with live tissue and a model of a smaller airway.

        The second is that, as the ferret article points out, the airway of a adult cat is not anatomically similar in size to a neonate, it’s too large. So, in that case , the trainees are not working with the most accurate model of the neonate anyway.

        So since the animals they are working on don’t accurately mimic the size of the airways the trainees would be working with in a neonate and aren’t struggling, the main benefit seems to be working with an airway model that has live tissue and is associated with a living breathing entity.

        I’m conflicted. I’m glad that UVA is trying to provide what they believe is the best experience for their trainees. I don’t know if they have the best model for neonates.

        The ferret paper and the studies referenced shows that there is a need for more and better training of physicians in acute airway management of children. The paper would argue the best experience comes from working with live animals. Some of the papers they reference don’t all recommend this specifically, so much as more training and better training (ref 18-19).

        Manikins and simulators do have a way to go but over time they have improved and provide a better and more accurate experience. We use them in mock code blues where I work. They are anatomically correct (tongue and epiglottis included) and they can be quite difficult to intubate. As a non-MD, I’ve heard the residents and interns say that it’s not the same when it comes to intubating a live person in the ER. The thing is, it never will be. But at least they had the experience and were able to practice the techniques they would then use later in the ER or ICU.

        Sorry to ramble for so long, it’s a difficult subject. Where do we draw this ethical line and who do we draw the line for?

        • Posted May 17, 2012 at 12:36 pm | Permalink

          Your comment, along with knowledge of the thousands of potential pets “euthanized” by overcrowded shelters, makes me wonder whether live animals need be used at all. If animals are going to be killed (and yes, if they’re not terminally ill, it’s not really “euthanisia”), too often with truck exhaust, the carbon monoxide would provide for fairly realistic tissue coloration, and no live animals would have to be used, at all. (Better, of course, to avoid these deaths, but that is work still in progress.)

  17. bonetired
    Posted May 17, 2012 at 1:36 am | Permalink

    “Ultimately, if you accept the evolutionary theory, you dismiss ethics, you don’t have to abide by a set of moral codes, you determine your own conscience based on your own desires.”

    From that loony surgeon a couple of posts back. Judging by the various level of outrage shown here (plus to be fair a couple of sceptics) I think that that particular argument is pretty well demolished……….

  18. Egbert
    Posted May 17, 2012 at 3:39 am | Permalink

    My first reaction was that I was horrified. Then I realized that “The details are horrific: they’re immobilized and helpless as plastic tubes are repeatedly forced down their throats” was misleading, as the cats are anesthetized, thus they’re immobilized and don’t feel pain. This only happens four times a year, and only to one cat each quarter.

    I am against experimentation on animals, and if there is an alternative then that must be used. But I am also against misleading propaganda.

    • gbjames
      Posted May 17, 2012 at 5:13 am | Permalink

      Ditto. I’ve seen too much PETA propaganda to sign petitions without a good deal more evidence than is provided here.

  19. Posted May 17, 2012 at 5:44 am | Permalink

    Signed. because, Science should always be looking toward the future, finding a better way, progressive, rather than perpetuating the status quo, stuck in the past and stagnant. amused, however, with those on here that don’t do intubations arguing about it with those who actually do it.

    • rhetoric
      Posted May 17, 2012 at 7:48 am | Permalink

      “amused, however, with those on here that don’t do intubations arguing about it with those who actually do it.”

      You realize that the folks at UVA involved in this program ‘actually do it’, right?

    • Posted May 18, 2012 at 5:25 am | Permalink

      I won’t speak for the others, but it I simply wanted at least a link to some data on the effectiveness of these ‘other’ techniques. Those who do intubations have an important voice (and you’ll note many of those were voiced after I posted not before). However, the plural of anecdote is not data or does that only apply to faith healers?

      It’s an interesting discussion, I don’t think anyone is knee jerk reacting with ‘YAY cats are used needlessly’. I think a poorly written letter (the comparison with PETA flyers is striking) with no evidence is being called into question. Yet those in support of the letter (and I am in that camp if there is supporting evidence) have ignored the concerns raised and resort to essentially the arguments used by apologetics.

      • gbjames
        Posted May 18, 2012 at 5:28 am | Permalink

        Word.

  20. Posted May 17, 2012 at 7:33 am | Permalink

    As a former veterinary nurse I have to say, I have also intubated many cats and dogs, without ever harming the animal.

    If people here are claiming you can do serious harm to an infant (who I assume is also sedated or should be if they’re not), then it’s one hell of a claim to then turn around and say that cats who have this done multiple time by inexperienced students won’t suffer any pain.

    If anyone here found which drugs were used, I’d be curious. Note the cheap drugs often to immobilize / sedate cats in lab settings (ketamine, valium) have NO anesthetic effect and even in combination with a short acting isoflurane will not prevent lingering pain from the procedure.

    If they’re so sure a simple intubation cannot be learned on a high tech model, they can damn well wait until an actual cat patient comes in needing the procedure.

  21. rhetoric
    Posted May 17, 2012 at 7:47 am | Permalink

    So UVA has documentation and a full explanation of their technique. This guy has constant appeals to emotion, with no documentation.

    Not signed.

  22. mordacious1
    Posted May 17, 2012 at 9:07 am | Permalink

    I wonder if when they adopt these cats out, they give the new owners a written statement that says, “Under no circumstance are you to play the string game with this cat using plastic tubing. The university will not be responsible for your medical bills if you disregard this advice”.

  23. Nom de Plume
    Posted May 17, 2012 at 9:44 am | Permalink

    What about rats? Mice? Monkeys?

  24. Chris Moss
    Posted May 17, 2012 at 1:41 pm | Permalink

    Much as I love my cats, it might have been better for my mental health to have been given practice on something when, in 1983, I rotated into paediatrics as a senior house officer (junior resident in N America) in a north London hospital where I was the only paeds doc in the hospital except for the consultants doing ward rounds twice a week. I discovered the first night on the labour ward that a Cardiff (shouldered, uncuffed) tube and a McGill laryngoscope are surprisingly easy to use in a flexible neonatal larynx. But what if it hadn’t been easy?


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