American Animal Hospital Association Research Articles

Remission of diabetes mellitus in a female dog intact

Diabetes Mellitus (DM) is one of the most common endocrinopathies among dogs. It is a set of metabolic disorders resulting from tissues' lack of sensitivity to insulin action and/or its relative or absolute deficiency. The clinical manifestations observed include polyuria, polydipsia, polyphagia, weight loss, persistent hyperglycemia, and glucosuria. Its classification and etiology in dogs are not yet well defined but may be associated with immunomediated, genetic, infectious, hormonal, metabolic, and some drug factors. According to the AHAA® 2018 guidelines (American Animal Hospital Association) for Diabetes Management in Dogs and Cats, therapeutic strategies in all cases include insulin therapy, dietary management, recognition, elimination/minimization of factors associated with insulin resistance. This report presents the case of an 8-year-old intact a dog, Yorkshire Terrier breed, presenting at the time of DM diagnosis clinical characteristics suggestive of diestrus and mammary nodule. The therapeutic approach was a new dietary management with commercial dry food as an adjunct for diabetics and calories appropriate to their body score condition, divided into equal meals before applying insulin and performing ovarian hysterectomy. After the start of treatment, a reduction in persistent hyperglycemia with improvement in clinical manifestations could be observed even before surgical approaches, as diestrus progressed to anestrus. It is concluded that, although canine DM remission is uncommon, it is possible when appropriate insulin therapy is instituted associated with dietary adjustment and reduction of factors causing insulin resistance.

Profitability of rural practice

There is a crisis in rural veterinary medicine as rural practitio­ners face challenges in different business environments. Rural veterinary practices are complex organizational systems with economic and demographic challenges directly associated with various causal conditions which affect practice profitability and efficiency. Supported by a grant from the U.S. Department of Agriculture, data was collected from 16 mixed rural veteri­nary practices in the southeastern United States over 4 years. A 3-year financial analysis found profits and owners’ compen­sation of 20.3% of gross revenues, cost of goods sold (COGS) of 37.8% of gross revenues, practice and doctor averages cli­ent transactions of $102 and $117, respectively. Population and income averages within 40 miles of the practice were 452,939 people with household incomes of $67,780. Compared to the averaged Well-Managed Practice Benchmarks 2019, American Animal Hospital Association 2019, and American Veterinary Medical Association 2017 data, potential causal conditions chal­lenges for rural practices limiting profitability are COGS, clini­cal revenue production, and clinical work efficiency.

Formal instruction and continuing education engagement as factors improving small animal general practitioners discussing nutrition with clients.

Evaluate whether general practitioners' formal small animal (canine and feline) nutrition instruction in veterinary school and the amount and type of continuing education engagement affect perceived self-reported confidence and frequency in discussing nutrition with clients. 403 small animal veterinarians who responded to an online survey distributed through the American Animal Hospital Association. Veterinarians were surveyed regarding perceived amount of formal instruction received in veterinary school, interest, time committed to self-education, and confidence in both self and staff knowledge in small animal nutrition. Of those veterinarians who responded to the survey, 57.1% (201/352) reported they received "none" or "very little" formal instruction in small animal nutrition, while 151 of 352 answered "some" or "a significant amount." Veterinarians with more formal instruction and veterinarians who reported spending more time in self-education had increased confidence in their own nutritional knowledge (P < .01) and that of their staff (P < .01). Veterinarians with self-reported significant formal instruction and veterinarians with higher continuing education engagement were more confident in their knowledge and their staff's knowledge regarding therapeutic and nontherapeutic small animal nutrition. Therefore, it is important for the profession to address veterinary nutrition education gaps in order to increase the veterinary healthcare team's engagement in nutritional discussions with their clients for both healthy and sick pets.

2022 AAFP/AAHA Antimicrobial Stewardship Guidelines.

2022 AAFP/AAHA Antimicrobial Stewardship Guidelines.

Risk factors and impact of COVID-19-related clinic closures on the detection of gastrointestinal parasites in dogs, a cross-sectional study.

Infections with endoparasites, especially gastrointestinal helminths, are a common finding in client-owned dogs. The Community Practice section at the Ohio State University Veterinary Medical Center (OSU-VMC) follows Companion Animal Parasite Council, American Animal Hospital Association, and American Veterinary Medical Association guidelines for parasitology by recommending annual fecal analyses for dogs and prescribing year-round, broad-spectrum parasite preventatives. There is increasing interest in determining if parasite occurrence is changing in client-owned dogs. Therefore, a retrospective study was designed to examine risk factors associated with the detection of parasites in samples submitted to the OSU-VMC Clinical Veterinary Parasitology Diagnostic Laboratory. Of the 1198 canine fecal samples, 254 (21.2%) of these samples had a positive fecal analysis for gastrointestinal (GI) parasites. The age of the dog, time of year, reproductive status, purpose of fecal examination, GI signs, and type of parasite preventatives were assessed as potential risk factors for GI parasite infection in dogs. To determine if Coronavirus Disease 2019 (COVID-19)-associated hospital restrictions impacted the number of fecal examinations performed, data from January to December 2020, was compared to the same period in 2019. There was nearly a 50% reduction in canine fecal samples submitted to the OSU-VMC Clinical Veterinary Parasitology Diagnostic Laboratory in March 2020 compared to March 2019. At least one canine GI parasite was found in over 20% of all 1198 canine fecal samples (21.2%, 254/1198). The most commonly detected canine GI parasite in all the fecal samples was hookworm at 9.6% (115/1198), followed by Giardia sp. at 7.6% (91/1198). Age, use of parasite preventatives, breed, and reproductive status were found to be associated with parasite occurrence in the dog samples. Identifying such risk factors in dogs will guide veterinarians to advise annual fecal examinations more strongly to clients with high-risk dogs or when routine health visits are postponed for an extended period.

2021 AAHA/AAFP Feline Life Stage Guidelines*

ABSTRACT The guidelines, authored by a Task Force of experts in feline clinical medicine, are an update and extension of the AAFP–AAHA Feline Life Stage Guidelines published in 2010. The guidelines are published simultaneously in the Journal of Feline Medicine and Surgery (volume 23, issue 3, pages 211–233, DOI: 10.1177/1098612X21993657) and the Journal of the American Animal Hospital Association (volume 57, issue 2, pages 51–72, DOI: 10.5326/JAAHA-MS-7189). A noteworthy change from the earlier guidelines is the division of the cat’s lifespan into a five-stage grouping with four distinct age-related stages (kitten, young adult, mature adult, and senior) as well as an end-of-life stage, instead of the previous six. This simplified grouping is consistent with how pet owners generally perceive their cat’s maturation and aging process, and provides a readily understood basis for an evolving, individualized, lifelong feline healthcare strategy. The guidelines include a comprehensive table on the components of a feline wellness visit that provides a framework for systematically implementing an individualized life stage approach to feline healthcare. Included are recommendations for managing the most critical health-related factors in relation to a cat’s life stage. These recommendations are further explained in the following categories: behavior and environmental needs; elimination; life stage nutrition and weight management; oral health; parasite control; vaccination; zoonoses and human safety; and recommended diagnostics based on life stage. A discussion on overcoming barriers to veterinary visits by cat owners offers practical advice on one of the most challenging aspects of delivering regular feline healthcare.

2021 AAHA/AAFP Feline Life Stage Guidelines.

The guidelines, authored by a Task Force of experts in feline clinical medicine, are an update and extension of the AAFP-AAHA Feline Life Stage Guidelines published in 2010. The guidelines are published simultaneously in the Journal of Feline Medicine and Surgery (volume 23, issue 3, pages 211-233, DOI: 10.1177/1098612X21993657) and the Journal of the American Animal Hospital Association (volume 57, issue 2, pages 51-72, DOI: 10.5326/JAAHA-MS-7189). A noteworthy change from the earlier guidelines is the division of the cat's lifespan into a five-stage grouping with four distinct age-related stages (kitten, young adult, mature adult, and senior) as well as an end-of-life stage, instead of the previous six. This simplified grouping is consistent with how pet owners generally perceive their cat's maturation and aging process, and provides a readily understood basis for an evolving, individualized, lifelong feline healthcare strategy. The guidelines include a comprehensive table on the components of a feline wellness visit that provides a framework for systematically implementing an individualized life stage approach to feline healthcare. Included are recommendations for managing the most critical health-related factors in relation to a cat's life stage. These recommendations are further explained in the following categories: behavior and environmental needs; elimination; life stage nutrition and weight management; oral health; parasite control; vaccination; zoonoses and human safety; and recommended diagnostics based on life stage. A discussion on overcoming barriers to veterinary visits by cat owners offers practical advice on one of the most challenging aspects of delivering regular feline healthcare.

2020 AAHA/AAFP Feline Vaccination Guidelines.

The guidelines are a consensus report on current recommendations for vaccination of cats of any origin, authored by a Task Force of experts. The guidelines are published simultaneously in the Journal of Feline Medicine and Surgery (volume 22, issue 9, pages 813-830, DOI: 10.1177/1098612X20941784) and the Journal of the American Animal Hospital Association (volume 56, issue 4, pages 249-265, DOI: 10.5326/JAAHA-MS-7123). The guidelines assign approved feline vaccines to core (recommended for all cats) and non-core (recommended based on an individualized risk-benefit assessment) categories. Practitioners can develop individualized vaccination protocols consisting of core vaccines and non-core vaccines based on exposure and susceptibility risk as defined by the patient's life stage, lifestyle, and place of origin and by environmental and epidemiologic factors. An update on feline injection-site sarcomas indicates that occurrence of this sequela remains infrequent and idiosyncratic. Staff education initiatives should enable the veterinary practice team to be proficient in advising clients on proper vaccination practices and compliance. Vaccination is a component of a preventive healthcare plan. The vaccination visit should always include a thorough physical exam and client education dialog that gives the pet owner an understanding of how clinical staff assess disease risk and propose recommendations that help ensure an enduring owner-pet relationship.

2020 AAHA/AAFP Feline Vaccination Guidelines*

ABSTRACT The guidelines are a consensus report on current recommendations for vaccination of cats of any origin, authored by a Task Force of experts. The guidelines are published simultaneously in the Journal of Feline Medicine and Surgery (volume 22, issue 9, pages 813–830, DOI: 10.1177/1098612X20941784) and the Journal of the American Animal Hospital Association (volume 56, issue 4, pages 249–265, DOI: 10.5326/JAAHA-MS-7123). The guidelines assign approved feline vaccines to core (recommended for all cats) and non-core (recommended based on an individualized risk-benefit assessment) categories. Practitioners can develop individualized vaccination protocols consisting of core vaccines and non-core vaccines based on exposure and susceptibility risk as defined by the patient’s life stage, lifestyle, and place of origin and by environmental and epidemiologic factors. An update on feline injection-site sarcomas indicates that occurrence of this sequela remains infrequent and idiosyncratic. Staff education initiatives should enable the veterinary practice team to be proficient in advising clients on proper vaccination practices and compliance. Vaccination is a component of a preventive healthcare plan. The vaccination visit should always include a thorough physical exam and client education dialog that gives the pet owner an understanding of how clinical staff assess disease risk and propose recommendations that help ensure an enduring owner-pet relationship.

Developments in surgical fluid therapy rates in veterinary medicine

PICO question&#x0D; Is there sufficient evidence to show surgical fluid therapy delivered at the recommended 3 mL/kg/hour for cats and 5 mL/kg/hour for dogs leads to a better outcome compared with widely accepted rates of 10 mL/kg/hour for both cats and dogs?&#x0D; &#x0D; Clinical bottom line&#x0D; Category of research question&#x0D; Treatment&#x0D; The number and type of study designs reviewed&#x0D; Five studies were appraised. Two of these were opinion pieces, with one non-comparative prospective study, one randomised controlled trial, and one case control study.&#x0D; Strength of evidence&#x0D; Weak&#x0D; Outcomes reported&#x0D; Currently there is limited evidence to show that the surgical fluid therapy recommendations made by the 2013 Journal of the American Animal Hospital Association guidelines (Davis et al., 2013) for cats and dogs lead to a better outcome than accepted fluid therapy rates used. Fluid overload in humans can cause long-term adverse effects, however the same effects have yet to be shown specifically in veterinary patients&#x0D; Conclusion&#x0D; No evidence was found that provides strong, conclusive evidence that the 2013 recommendations by the American Animal Hospital Association and American Association of Feline Practitioners leads to a better outcome for both cats and dogs. The resulting research outlined below identifies a need to conduct clinical studies on the effects of fluid therapy on cats and dogs, and identify clear monitoring protocols to minimise and ideally avoid, fluid overload. When adequate, valid clinical studies have been carried out, this will provide sufficient information for the development of evidence-based recommended rates of fluid therapy for veterinary medicine, in a range of contexts&#x0D; &#x0D; How to apply this evidence in practice&#x0D; The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.&#x0D; Knowledge Summaries are a resource to help reinforce or inform decision-making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.&#x0D; &#x0D;

Looking after the end-of-life patient: four case studies

Patients that are in the fifth life stage (end-of-life) often present with multiple problems, which makes them challenging cases. Often, these patients are very vulnerable, and this is sometimes overlooked. This article aims to provide a brief and basic overview of looking after the end-of-life patient, whether at home or in hospital, by utilising a framework adapted from the 2016 International Association of Animal Hospice and Palliative Care, and American Animal Hospital Association Guidelines (IAAHPC/AAHA).

Pilot study evaluating the monitoring of canine diabetes mellitus in primary care practice

ObjectivesThis study aimed to describe how canine diabetes mellitus (CDM) is monitored in primary care practice (PCP) and to report outcomes.DesignRetrospective case review.SettingPCP.Participants40 dogs of 22 different pedigrees and five...

Using a Standardized Client Encounter in the Veterinary Curriculum to Practice Veterinarian-Employer Discussions about Animal Cruelty Reporting.

Animal cruelty is the antithesis of animal welfare. Because veterinarians take an oath to protect animal welfare, they are professionally obligated to report animal cruelty. Several US states have mandatory reporting laws for veterinarians, and both the American Veterinary Medical Association (AVMA) and the American Animal Hospital Association support reporting. Some state veterinary practice acts, such as Arizona's, also require reporting. Despite this, animal cruelty is not always emphasized in veterinary curricula. As a result, not all veterinary students and graduates feel comfortable recognizing signs of animal cruelty and may not be aware of the resources that are available to them when considering reporting. AVMA suggests that practices develop their own protocols for identifying signs that patients may have been victims of cruelty and consulting on cases with senior colleagues with regard to when to report. To enhance student comfort with these conversations, Midwestern University College of Veterinary Medicine developed a standardized client encounter titled "Grizabella's Final Fight." I hope that other colleges of veterinary medicine will adapt this teaching tool to allow students the opportunity to practice discussions surrounding animal cruelty reporting in the context of state-specific legislation that guides their code of professional conduct.

The nutritive value of selected commercial dry dog foods

Received: 2015-11-03 | Accepted: 2015-11-06 | Available online: 2016-03-24 dx.doi.org/10.15414/afz.2016.19.01.25-28 The goal of this study was to analysed and compared the nutrients content of dry dog foods with nutrient content, which is declared by the manufacturer of the dry dog foods. 15 dry dog foods bought in the Slovak republic were analysed for dry matter, crude protein, crude fat, crude fiber, nitrogen free extract and ash concentration. Nutrients analysis of dry dog foods were realised in Laboratory of Quality and Nutritional Value of Feeds. We found, that only 6 from 15 dry dog food samples were in interval ± 5% from declared crude protein concentration; no sample was in interval ± 5% from declared crude fat concentration; only 2 from 15 dry dog food samples were in interval ± 5% from declared crude fiber concentration; only 4 from 15 dry dog food samples were in interval ± 5% from declared ash concentration. Analysed dry dog food samples have very different nutritive value in comparison to declared nutritive value on bale. The highest shortage was detected by the fat concentration. The highest excess was detected by the fiber concentration. Keywords : dogs, dry food, nutrients concentration, evaluation References ALVAREZ, E. and SANCHEZ, P. (2006) Dietary fiber. Nutricion Hospitalaria , vol. 21, Suppl., pp. 60-71. BAUER, J.E. 2006. Facilitative and functional fats in diets of cats and dogs. In Journal of the American Veterinary Medical Association , vol. 229, pp. 680-684. CASE, L. et al. (2011). Canine and Feline Nutrition: a resource for companion animal professionals . 3. ed. Missouri: Elsevier. HANUSOVSKÝ, O. (2014). Changes in minerals in colostrum of sows. In XX. scientific conference of students of Faculty of agrobiology and food resources. Nitra 23.4.2014 . Nitra: Slovak University of Agriculture in Nitra, pp. 29 (in Slovak). HARLOW, J. (1997) US pet food trends. Proceedings of the pet food forum . Chicago: Watts Publishing, pp. 355-364. HERKEĽ, R., VARGA, B. and MAJLAT, M. (2014). The analysis of fatty acids content in different plant oils. In IX. Scientific conference of PhD.-students with international participation. Nitra 14.11.2014 . Nitra: Slovak University of Agriculture in Nitra, pp. 34-37. KALLFELZ, F.A. (1989) Evaluation and use of pet foods: general consideration in using pet foods for adult maintenance. Veterinary Clinics of North America: Small Animal Practice , vol. 19, pp. 387-403. KRONFELD, D.S. (1982) Protein quality and amino acid profiles of common dog foods. Journal of the American Animal Hospital Association , vol. 18, pp. 679-683. LASEK, O., MILEJSKA, P. and KOWALSKI, Z.M. (2013) The use of gas-test techniques to study the fermentation process in the intestines of dogs. In DORSZEWSKI, P. et al. (eds.) Proc. conf. XLII Scientific Conference CAN CAS PAS. Bydgoszcz 18-20.9.2013 . Bydgoszcz: University of Technology and Life Science, pp. 165-166. MUDŘIK, Z. et al. (2014). Specification of calculating the energy needs for dogs used for a dogtrekking and canicross. In Lazar days of nutrition and veterinary dietetics XI. Kosice 2-3.9.2014 . Kosice: University of Veterinary Medicine and Pharmacy in Kosice, pp. 179-182. (in Czech). PISOVA, A. 2015. Organic matter digestibility of corn silage for horses. In XXI. scientific conference of students of Faculty of Agrobiology and Food Resources. Nitra 22.4.2015 . Nitra: Slovak University of Agriculture in Nitra, pp. 48 (in Slovak). SAMUELSON, A.C. and CUTTER, G.R. (1991) Dog biscuits: an aid in canine tartar control. The Journal of Nutrition , vol. 121, pp. S162. TVAROŽKOVA, K. (2015) Evaluation of the nutritional content of the granules and comparison of the composition of selected rations for dogs. In XXI. scientific conference of students of Faculty of Agrobiology and Food Resources. Nitra 22.4.2015. Nitra: Slovak University of Agriculture in Nitra, pp. 49 (in Slovak). TVRDA, E. et al. (2013) Mineral nutrients and male fertility. Journal of Microbiology, Biotechnology and Food Science , vol. 3, no. 1, pp. 1-14. VARGA, B. (2014) Profile of fatty acids in olive and hemp oils. In XX. scientific conference of students of Faculty of agrobiology and food resources. Nitra 23.4.2014 . Nitra: Slovak University of Agriculture in Nitra, pp. 40 (in Slovak). Regulation of the Slovak Ministry of Agriculture no. 2145 / 2004 - 100 (2004) about sampling of feeds and about laboratory testing and evaluation of feeds, pp. 342 (in Slovak).

WSAVA Guidelines for the vaccination of dogs and cats.

WSAVA Guidelines for the vaccination of dogs and cats.

WSAVA person in profile

Abstract Dr Walt Ingwersen graduated in 1982 from the Ontario Veterinary College and went on to become editor of the Journal of the American Animal Hospital Association and Vice President of the WSAVA.

2015 AAHA/AAFP pain management guidelines for dogs and cats.

The robust advances in pain management for companion animals underlie the decision of the American Animal Hospital Association (AAHA) and American Association of Feline Practitioners (AAFP) to expand on the information provided in the 2007 AAHA/AAFP Pain Management Guidelines. The 2015 Guidelines summarize and offer a discriminating review of much of this new knowledge. Pain management is central to veterinary practice, alleviating pain, improving patient outcomes, and enhancing both quality of life and the veterinarian-client-patient relationship. These Guidelines support veterinarians in incorporating pain management into practice, improving patient care. The management of pain requires a continuum of care that includes anticipation, early intervention, and evaluation of response on an individual patient basis. A team-oriented approach, including the owner, is essential for maximizing the recognition, prevention and treatment of pain in animals. The Guidelines include both pharmacologic and non-pharmacologic modalities to manage pain; they are evidence-based insofar as possible and otherwise represent a consensus of expert opinion. Behavioral changes are currently the principal indicator of pain and its course of improvement or progression, and the basis for recently validated pain scores. Post-surgical pain is eminently predictable but a strong body of evidence exists supporting strategies to mitigate adaptive as well as maladaptive forms. Chronic pain is dominated by degenerative joint disease (DJD), which is one of the most significant and under-diagnosed diseases of cats and dogs. DJD is ubiquitous, found in pets of all ages, and inevitably progresses over time; evidence-based strategies for management are established in dogs, and emerging in cats.

Reputation management on facebook: awareness is key to protecting yourself, your practice, and the veterinary profession.

From the Social media use by health professionals occurs in a digital environment where etiquette has yet to be solidly defined. The objectives of this study were to explore veterinarians' personal use of Facebook, knowledge of privacy settings, and factors related to sharing personal information online. All American Animal Hospital Association member veterinarians with a valid e-mail address (9469) were invited to complete an online survey about Facebook (e.g., time spent on Facebook, awareness of consequences, types of information posted). Questions assessing personality dimensions including trust, popularity, self-esteem and professional identity were included. The response rate was 17% (1594 of 9469); 72% of respondents (1148 of 1594) had a personal Facebook profile. Veterinarians were more likely to share information on Facebook than they would in general. Trust, need for popularity, and more time spent on Facebook predicted more disclosure of personal information on Facebook. Awareness of consequences and increased veterinary experience predicted lesser disclosure. As veterinary practices use Facebook to improve client services, they need also to manage risks associated with online disclosure by staff. Raising awareness of reputation management and consequences of posting certain types of information to Facebook is integral to protecting the individual, the practice, and the veterinary profession.

Guidelines for vaccination of dogs and cats in Korea.

This guideline contains the recommended vaccination schedules of dogs and cats from World Small Animal Veterinary Association (WSAVA) and American Animal Hospital Association (AAHA). In 2010, WSAVA published guidelines for the vaccination of dogs and cats. And, in 2011, AAHA also published guidelines for vaccination of dogs. In Korea, there is no published guideline for vaccination of dogs and cats yet. Therefore, the plane of vaccination also reports the present situation of vaccination schedule of dogs and cats in Korean animal hospitals.

Current knowledge about the risks and benefits of raw meat–based diets for dogs and cats

The feeding of RMBDs to dogs and cats has received increasing attention in recent years. The American Animal Hospital Association,1 AVMA,2 and Canadian Veterinary Medical Association3 have adopted statements discouraging the inclusion of raw or undercooked animal-source protein in dog and cat diets. The Delta Society's Pet Partners Program expressed concern that pets in a therapy animal program could be shedding pathogens in the presence of immunocompromised humans and other at-risk human populations. Therefore, they adopted in 2010 a policy that precludes animals that eat RMBDs from participating in their therapy animal program.4