Abstract
Introduction: ‘Economic euthanasia’, defined as euthanasia of pets due to financial constraints despite treatable illness, is common in veterinary emergency medicine. Gastric dilatation-volvulus (GDV) in dogs is inexpensive to diagnose and has a high survival rate with corrective, but costly, surgery. Without surgery, GDV is lethal. The proportion of dogs with GDV euthanized pre-surgery emerged as a reliable metric of economic euthanasia. If the COVID-19 pandemic aggravated economic distress in dog owners compromising their ability to afford pet healthcare, an increase in pre-surgical euthanasia in dogs with GDV would be expected. We hypothesized that in dogs with GDV, the risk of pre-surgical euthanasia during the COVID-19 pandemic increased compared to such risk before the pandemic. Methods: In this case-control study, we included non-referred dogs with GDV that presented to 11 US veterinary hospitals. Dogs were cases if they were euthanized pre-surgery, and controls if they underwent surgical treatment. Exposure positive dogs were those presenting during the initial surge of unemployment due to COVID-19 (March 16 - July 5 2020), exposure negative dogs were those during the same period in 2019. Univariate analyses and binary logistic regression models were developed to quantify the association between COVID-19 status (present, absent) and euthanasia risk, adjusting for the effect of known confounders. The significance level was set at p < 0.05. Results: We recorded 118 dogs with GDV over the 2 time periods, with 30% of non-exposed and 52% of exposed pets being euthanized pre-surgery (OR, 2.6; 95% CI, 1.2-5.4). After adjusting for age, breed, comorbidities and recumbency, the odds of euthanasia for dogs presenting during COVID-19 were 2.7 (95% CI 1.1 to 6.3) times those of dogs presented in 2019. Old age (OR, 2.6; 95% CI, 1.1 to 6.1), but no other explanatory variables, were associated with pre-surgical euthanasia. Conclusions: Our findings show that in this study population, dogs with GDV presented in the period March 16 to July 5 2020 had a greater risk of euthanasia compared with dogs presented in the same period the year before. It is our inference that economic consequences arising from the COVID-19 pandemic directly impacted on the level of veterinary care owners were able to provide for their pets.
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