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Nestlé Purina PetCare Company has recalled nine lots of Purina Pro Plan Veterinary Diets EL Elemental dry dog food due to potentially elevated levels of vitamin D.

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Veterinarians want insight into how a diet made by Nestlé Purina PetCare Company for dogs with food sensitivities and digestive health problems ended up containing excessive vitamin D, such that the company has had to issue two recalls within a four-week span. 

Two lots of Purina's Pro Plan Veterinary Diets EL Elemental were recalled on Friday, in addition to seven lots recalled in February, according to a company news release. 

The expanded recall follows an internal investigation that uncovered "new information" about a production error by a U.S. supplier of vitamin premix, the news release said. Vitamin D is an essential ingredient in pet food that can be toxic when ingested in excess.

Some members of the Veterinary Information Network, an online community for the profession, want a better explanation. "In my mind, it seems it would be a problem easily avoided by screening all premixes on arrival and testing all batches of food before release," Dr. Laurie Martin, a practitioner in Lombard, Illinois, wrote in a message board discussion. 

"I need someone to sit me down and explain why this is not done or, if it is done, what are the limitations," responded Dr. Cecilia Villaverde, a board-certified veterinary nutritionist in Ireland. "Might have to do with the analytical complexity of measuring vitamin D, but I really do not know."

Officials at Purina say they suspected that certain batches of the diet might contain excess amounts of vitamin D following "two separate confirmed cases" of dogs with signs of toxicity. "Each had been on the diet but recovered once taken off," according to the first recall announcement, dated Feb. 8. 

Signs of vitamin D toxicity in dogs range from drooling, constipation and vomiting to seizing. Other common indicators include increased thirst and urination. Too much vitamin D can cause hypercalcemia, which is abnormally high calcium levels in the bloodstream. Elevated calcium can lead to bone loss and kidney or bladder stones, in addition to other maladies. Left untreated, the condition can lead to renal failure and be fatal.

Purina Pro Plan Veterinary Diets EL Elemental isn't typically found on store shelves. The diet is formulated to be highly digestible and made for dogs with a history of adverse reactions to food, including allergies and gastrointestinal problems. Purina said it sells the therapeutic diet through veterinary clinics and select retailers that are able to validate that the purchase is recommended by a veterinarian.

Excessive vitamin D in pet food has been a recurring theme over the years. In February 2006, it caused Royal Canin to recall thousands of canned pet foods sold exclusively at veterinary clinics, following reports of sick dogs and cats. Vitamin premix from a third-party supplier was to blame, according to the company.

In 2018 and 2019, a rash of vitamin D-linked pet-food recalls by a dozen or so canine kibble manufacturers, including Sunshine Mills, ELM Pet Foods, Natural Life Pet Products and Hill's Pet Nutrition, prompted speculation that the brands involved all got their premixed vitamins from the same supplier. 

The Hill's recall alone involved approximately 675,000 cases of canned dog food sold between Sept. 1, 2018, and May 31, 2019, which sickened hundreds of animals, some fatally. The company later agreed to pay $12.5 million to aggrieved owners in a class-action settlement. 

According to court records and financial filings, the batches of contaminated foods contained a premix formulated by DSM Nutritional Products Inc., a worldwide vitamin supplier to companies in animal and nutritional health, with manufacturing facilities in Fort Worth, Texas, and headquarters in New Jersey. The documents revealed that a DSM employee accidentally added an extra drum of vitamin D instead of a drum of vitamin E to batches of Hill's dog food. 

Purina has not publicly identified its vitamin premix supplier. Company officials did not respond to emails and a phone call from the VIN News Service.

The company pledged in a news release not to let the mixup happen again: "We sincerely apologize to pet owners and veterinarians for the concerns and inconvenience this recall has caused. ... All necessary measures are being taken to ensure this error is never repeated."