Companion Animal Clinics Research Articles

Isoflurane treatment for refractory and super-refractory status epilepticus in dogs.

Resistant epileptic episodes, such as refractory status epilepticus (RSE) and super-refractory status epilepticus (SRSE), are neurological emergencies that require immediate medical treatment. Although inhalational anesthetics, such as isoflurane (ISO), have been proposed as a means of seizure control in dogs, there is currently a lack of both experimental and clinical studies on this subject. This is a retrospective clinical study. Records of dogs that received ISO for the management of RSE and SRSE during their intensive care unit (ICU) hospitalization at the Companion Animal Clinic of the Aristotle University of Thessaloniki were included in the present study. The study period spanned from February 2013 to March 2023. Dogs were identified as responders (R) when RSE/SRSE ceased after ISO administration, and the dogs were successfully discharged from the ICU after ISO discontinuation. Dogs were identified as non-responders (NR) when RSE/SRSE ceased after ISO administration, but RSE/SRSE reoccurred after ISO discontinuation. Additional data about the number and time of ISO cycles, the time of ICU hospitalization, the side effects of ISO administration, and an additional administration of antiepileptic drugs (AEDs) and anesthetic drugs were also recorded. A total of 20 dogs with 26 recorded RSE/SRSE episodes and 26 anesthetic cycles with ISO were included in the present study. The clinical termination of seizure activity was achieved 100% (26/26) in all episodes. In 73.1% (19/26) of the episodes, ISO administration resulted in successful RSE/SRSE treatment. Poor outcome was recorded in 26.9% (7/26) of the episodes because RSE/SRSE reoccurred after ISO discontinuation, and the dogs were euthanatized or died due to cardiac arrest. Inspiratory ISO ranged between 0.5 and 4.0%. The median time of the anesthetic cycles with ISO was 12.67 h (4.00-62.00). The median duration of the ICU hospitalization was 48.00 h (24.00-120.00). At least one ISO-related side effect was recorded in 23 out of 26 (88.5%) episodes. To the authors' knowledge, this is the first clinical study that addresses the administration of ISO for RSE/SRSE treatment in dogs. The use of ISO may be beneficial in terminating RSE/SRSE; however, further prospective studies are necessary to confirm this observation.

Lumbar spinal arachnoid diverticulum in a cat

AbstractA 5‐year‐old, domestic, shorthair, male, neutered cat was referred to the Companion Animal Clinic with a history of paraparesis and urinary incontinence, alongside recurrent urinary tract infections. Magnetic resonance imaging of the lumbar vertebral column revealed a space‐occupying spinal cyst‐like lesion located at the level of fifth and sixth lumbar vertebrae. Surgical treatment consisted of dorsal laminectomy and durectomy, resulting in decompression. Histopathology findings were indicative of spinal arachnoid diverticulum. Postoperatively, the cat exhibited gradual hindlimb and tail motor improvement, and recovery of voluntary urination. Complete resolution of the neurological signs was achieved at 3 months after surgery. No signs of recurrence were noted till the time of writing this report, 14 months postoperatively. To the authors’ knowledge, this is the first case report of a spinal arachnoid diverticulum in the lumbosacral vertebral column in a cat.

Risk Factors for Fractures of Dogs in Quezon City, Philippines

A retrospective case-control study was conducted in dogs with bone fractures presented at the Veterinary Teaching Hospital - Diliman Station, Companion Animal Clinic, College of Veterinary Medicine, University of the Philippines Los Baños from January 2016 to December 2021. One hundred sixty-one dogs were diagnosed with bone fractures. Limping was the most common chief complaint with falling from a height being the most common cause. Close, complete, and oblique fractures were the most prevalent fracture type. Around 29.81% of the cases were given medications only and 16.77% were treated with external coaptation. Among the cases treated with external coaptation, only fourteen came back for follow-up with fully healed bone fractures. The mean age of dogs with bone fractures was 2.30 years old and was seen as a significant risk factor regardless of age group. Dogs fed with dry dog food and table food were 0.35 and 0.50 less likely to have bone fractures, respectively. The body weight, body condition scores, and dog breeds were not significant risk factors while the abode of the animal was a significant risk factor regardless whether the animal is indoor or outdoor. Age, diet, and abode were found to be significantly associated with bone fractures.

Emergence of OXA-48-producing Enterobacter hormaechei in a Swiss companion animal clinic and their genetic relationship to clinical human isolates.

Enterobacter hormaechei producing the carbapenemase OXA-48 was identified repeatedly in infections in companion animals hospitalized at a Swiss veterinary clinic where OXA-48-producing Klebsiella pneumoniae was previously reported. To determine the genetic relatedness of animal and human E. hormaechei strains collected in Switzerland during 2017-22 and their mobile genetic elements. Hybrid assemblies for phylogenetic and comparative analysis of animal (n = 9) and human (n = 25) isolates were obtained by sequencing with Illumina, PacBio and Oxford Nanopore Technologies. Antimicrobial susceptibility was tested by broth microdilution. The animal strains were identified as E. hormaechei subsp. xiangfangensis ST114 (n = 6) and ST418 (n = 2), and E. hormaechei subsp. hoffmannii ST78 (n = 1). Human E. hormaechei belonged to subspecies steigerwaltii (n = 10), xiangfangensis (n = 13), hoffmannii (n = 1) and hormaechei (n = 1), with a heterogeneous ST distribution differing from the animal strains, except for two ST114. Core-gene SNP analysis confirmed the clonality of the animal ST114 and ST418 isolates (0 to 10 SNPs), and close relatedness of animal and human ST114 strains (80-120 SNPs). The strains harboured the blaOXA-48 gene on ca. 63 kb IncL-type plasmids (n = 27); on ca. 72 kb IncL plasmids co-harbouring blaCTX-M-14 (n = 2); and on ca. 150-180 kb IncFIB (n = 4) or hybrid IncFIB/IncL (n = 1) plasmids. The blaOXA-48-harbouring plasmids and the blaDHA-1-carrying ISCR1 element in one animal ST114 and both ST418 clones were likely acquired from previously spreading K. pneumoniae strains. Common ecological niches favour the spread of plasmid-borne carbapenemases among Enterobacterales and the emergence of MDR E. hormaechei clones.

Economic and Structural Aspects of Companion Animal Clinics in Turkey Operated by Veterinarians Graduated from Istanbul University

Economic and Structural Aspects of Companion Animal Clinics in Turkey Operated by Veterinarians Graduated from Istanbul University

Genomic Medicine in Canine Periodontal Disease: A Systematic Review.

Genomic medicine has become a growing reality; however, it is still taking its first steps in veterinary medicine. Through this approach, it will be possible to trace the genetic profile of a given individual and thus know their susceptibility to certain diseases, namely periodontal disease. This condition is one of the most frequently diagnosed in companion animal clinics, especially in dogs. Due to the limited existing information and the lack of comprehensive studies, the objective of the present study was to systematically review the existing scientific literature regarding genomic medicine in canine periodontal disease and determine which genes have already been studied and their probable potential. This study followed the recommendations of the PRISMA 2020 methodology. Canine periodontal disease allied to genomic medicine were the subjects of this systematic review. Only six articles met all of the inclusion criteria, and these were analyzed in detail. These studies described genetic variations in the following genes: interleukin-6, interleukin-10, interleukin-1, lactotransferrin, toll-like receptor 9, and receptor activator of nuclear factor-kappa B. Only in two of them, namely interleukin-1 and toll-like receptor 9 genes, may the identified genetic variations explain the susceptibility that certain individuals have to the development of periodontal disease. It is necessary to expand the studies on the existing polymorphic variations in genes and their relationship with the development of periodontal disease. Only then will it be possible to fully understand the biological mechanisms that are involved in this disease and that determine the susceptibility to its development.

Educational intervention to improve infection prevention and control practices in four companion animal clinics in Switzerland

Infection prevention and control (IPC) practices vary among companion animal clinics and outbreaks with carbapenemase-producing Enterobacterales (CPE) have been described. This study investigates the effect of an IPC intervention (introduction of IPC protocols, IPC lectures, hand hygiene campaign) in four companion animal clinics. IPC practices, environmental and hand contamination with antimicrobial-resistant microorganisms (ARM) and hand hygiene (HH) were assessed at baseline and one and five months after intervention. IPC scores (% maximum score) improved from (median, range) 57.8% (48.0-59.8%) to 82.9% (81.4-86.3%) one month after intervention. Cleaning frequency assessed by fluorescent tagging increased from (median, range) 16.7% (8.9-18.9%) to 30.6% (27.8-52.2%) one months and 32.8% (32.2-33.3%) five months after intervention. ARM contamination was low in three clinics at baseline and undetectable after intervention. One clinic showed extensive contamination with ARM including CPE before and after intervention (7.5-15.5% ARM-positive and 5.0-11.5% CPE-positive samples). Mean HH compliance [95% CI] improved from 20.9% [19.2-22.8%] to 42.5% [40.4-44.7%] one and 38.7% [35.7-41.7%] five months after intervention. Compliance was lowest in the pre-operating preparation area at baseline (11.8% [9.3-14.8%]) and in the ICU after intervention (28.8% [23.3-35.1%]). HH compliance was similar in veterinarians (21.5% [19.0-24.3%]) and nurses (20.2% [17.9-22.7%]) at baseline but higher in veterinarians (46.0% [42.9-49.1%]) than nurses (39.0% [36.0-42.1%]) one month after intervention. The IPC intervention improved IPC scores, cleaning frequency and HH compliance in all clinics. Adapted approaches might be needed in outbreak situations.

Quantifying topical antimicrobial use before and during participation in an antimicrobial stewardship programme in Dutch companion animal clinics.

The emergence of bacterial strains resistant to topical antimicrobials in both human and veterinary medicine has raised concerns over retaining the efficacy of these preparations. Yet, little information is available regarding the use of topical antimicrobials in either sector for planning targeted interventions. This study aims to quantify the use of topical antimicrobials in 44 Dutch companion animal clinics before and during their participation in an antimicrobial stewardship programme (ASP), to explore the effect of the intervention on topical antimicrobial use (AMU). Hence, prescription and clinic animal population data, collected from July 2012 until June 2018 were used. Specifically, the period from July 2012 until June 2015 was defined as pre-intervention period, whereas clinics started to participate in the ASP from March 2016 onwards. As quantification metric, the Defined Daily Dose for Animals (DDDA) was used and a mixed effect times series model with auto-regression was applied to monthly topical AMU data. The intervention effect was modelled using a step function with a change in (linear) time trend and clinic characteristics, as potential determinants of topical AMU, were assessed using a multivariable regression model. A seasonal pattern was identified, in the pre-intervention period, where topical AMU was highest in July-August and lowest in February-March. In addition, total topical AMU appeared to significantly decrease over time in the pre-intervention period and the proportion of dogs in the clinic was positively associated with topical AMU. The intervention effect was significant only for second line and for skin product AMU. This study demonstrates that during participation in an ASP, second line and skin product AMU decreased in Dutch companion animal clinics. Additionally, this study demonstrates the existence of a seasonal effect and a decrease in topical AMU over time already before introduction of a targeted intervention.

Massive Spread of OXA-48 Carbapenemase-Producing Enterobacteriaceae in the Environment of a Swiss Companion Animal Clinic.

Background: Companion animal clinics contribute to the spread of antimicrobial resistant microorganisms (ARM) and outbreaks with ARM of public health concern have been described. Methods: As part of a project to assess infection prevention and control (IPC) standards in companion animal clinics in Switzerland, a total of 200 swabs from surfaces and 20 hand swabs from employees were collected during four days in a medium-sized clinic and analyzed for extended spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E), carbapenemase-producing Enterobacteriaceae (CPE), vancomycin-resistant enterococci (VRE), and methicillin-resistant staphylococci (MRS). Results: A total of 22 (11.0%) environmental specimen yielded CPE, 14 (7.0%) ESBL-E, and 7 (3.5%) MRS; MR Staphylococcus aureus were isolated from two (10.0%) hand swabs. The CPE isolates comprised Escherichia coli, Klebsiella pneumoniae, Enterobacter hormaechei, Citrobacter braakii, and Serratia marcescens. Whole genome sequencing revealed that all CPE carried closely related blaOXA-48 plasmids, suggesting a plasmidic spread within the clinic. The clinic exhibited major deficits in surface disinfection, hand hygiene infrastructure, and hand hygiene compliance. CPE were present in various areas, including those without patient contact. The study documented plasmidic dissemination of blaOXA-48 in a companion animal clinic with low IPC standards. This poses a worrisome threat to public health and highlights the need to foster IPC standards in veterinary clinics to prevent the spread of ARM into the community.

Genomic Investigation of Two Acinetobacter baumannii Outbreaks in a Veterinary Intensive Care Unit in The Netherlands.

Acinetobacter baumannii is a nosocomial pathogen that frequently causes healthcare-acquired infections. The global spread of multidrug-resistant (MDR) strains with its ability to survive in the environment for extended periods imposes a pressing public health threat. Two MDR A. baumannii outbreaks occurred in 2012 and 2014 in a companion animal intensive care unit (caICU) in the Netherlands. Whole-genome sequencing (WGS) was performed on dog clinical isolates (n = 6), environmental isolates (n = 5), and human reference strains (n = 3) to investigate if the isolates of the two outbreaks were related. All clinical isolates shared identical resistance phenotypes displaying multidrug resistance. Multi-locus Sequence Typing (MLST) revealed that all clinical isolates belonged to sequence type ST2. The core genome MLST (cgMLST) results confirmed that the isolates of the two outbreaks were not related. Comparative genome analysis showed that the outbreak isolates contained different gene contents, including mobile genetic elements associated with antimicrobial resistance genes (ARGs). The time-measured phylogenetic reconstruction revealed that the outbreak isolates diverged approximately 30 years before 2014. Our study shows the importance of WGS analyses combined with molecular clock investigations to reduce transmission of MDR A. baumannii infections in companion animal clinics.

Organization and management of companion animal clinics in Istanbul established by veterinarians graduated from Istanbul University

Besides being healthcare units, veterinary clinics are enterprises which contributes to national economy and supply employment opportunity for the public. It is important to know the clinic’s general structure, equipment facilities and provided services in order to determine the powerful and vulnerable areas of the companion animal sector and make required supports. In this study, a face-to-face survey was applied to veterinary clinic owners who graduated from Istanbul University and have veterinary clinics in Istanbul. The results indicated that most of the veterinary clinics are single-storey, have 2 exam rooms and have one operation room. Pet boarding and per coiffeur services were provided by the majority of the clinics but ambulance and parking lot was not sufficiently provided. Clinics have made various medical equipment investments and the number of clinics having diagnostic tools are high. In terms of the patient demographics, it was determined that 62.6% of the patients were cats and 32.8% of the patients were dogs. Majority of the patients were between 2-5 of age. Mini-small dog breeds were the dominant breeds which was followed by medium-size dog breeds. Sex distribution was determined as similar between cat and dog patients. Furthermore, it was found that 73.8% of the dogs and 65.7% of cats make regular visits. In conclusion, companion animal clinics in Istanbul were determined to have fragmented and independent structure which results in high competition. In order to be successful in this competition it was determined that veterinary clinics make investments on their medical equipment and diversify their services.

Socio-demographic characteristics and economic structures of companion animal clinics in Istanbul established by veterinarians graduated from Istanbul University

This study was conducted in Istanbul in order to determine the socio-demographic characteristics and economic situation of the companion animal clinics which are operated by veterinarians graduated from the Istanbul University, Faculty of Veterinary Medicine. In total 199 veterinarians participated at the study and the survey was conducted face to face with clinic only owners. As a result, the average age of the clinicians was 43.8 and the professional experience 18.2 years. Time period between graduation and starting to professional life was 3.6 month. Most of the clinicians had positive insights regarding their graduated faculty and also the profession’s future. The average working hour was determined as 10.4 hours and most of the clinicians stated that they were not able to spare sufficiant time for their private life. In the study it was reported that pet owners’ average annual expenditure was found to be $ 402 for cats and $ 645 for dogs. For a single clinic the average number of veterinarians was determined as 2.4 and technicians was 0.8% as well as total number of employees was 5.1. The average monthly net income of the veterinarians was determined as $ 2796 and the average amount of uncollectible receivables was $ 3783 per clinic. The results of the study points that the companion animal industry in Istanbul should be improved in some conditions such as long working hours, number of qualified veterinarian/technicians and uncollectible receivables. In order to make contribution to this improvement goal, beside the medical traninig in the veterinary curriculum, technical and practical clinic management traninigs should also be echanced.

The impact of coronavirus disease 2019 (COVID-19) in Japanese companion animal clinics.

The coronavirus disease 2019 (COVID-19) pandemic has had a tremendous impact on people’s lives throughout the world. A cross-sectional study was conducted to clarify the influence of COVID-19 on Japanese companion animal clinics. A self-administered electronic questionnaire regarding the incidence of COVID-19, hygiene management, the influence on clinical service and employment, and mental stress of staff was conducted for workers in animal clinics between 1 May and 10 June 2021. Questions concerning the hygiene management before the occurrence of COVID-19, under the first state of emergency, and at the time of the survey were asked using the Likert scale. Kessler 6 (K6) was used as an indicator of mental distress. In total, 430 individuals responded. Of these, 4.9% experienced COVID-19 infection in staff. Hygiene management was strengthened, but no particular practice was statistically associated with the occurrence of COVID-19 cases in staff. In Nakaya’s variation of Scheffe’s paired comparison, the highest prioritized goal in the clinics was the prevention of nosocomial infection with COVID-19. The prevalence of serious mental illness (K6 >=13) was 11.1% (95% confidence interval: 6.3–18.6%). Multivariable negative binomial regression found four risk factors for psychological distress: veterinary nurse (P=0.016 with veterinarians and P<0.01 with other staff), female (P=0.004), fear of infection at work (P<0.001), and stress by refraining from going out (P<0.001). Directors of clinics are recommended to take care of female veterinary nurses for distress.

Simulation of the effect of low-cost companion animal clinics on the market for veterinary services.

To understand the market dynamics of companion animal veterinary services through the simulation of willingness to pay and willingness to wait as consumer behavior attributes. Numerical distributions for the willingness to pay and willingness to wait of simulated potential clients of companion animal clinics. Simulations were run by use of numerical distributions to create demand curves and analyze market dynamics across 2 market segments (price sensitive and price insensitive) and different price dispersion between clinics. The simulations suggested that the profit-maximizing price of a full-service clinic created a natural segmentation of the companion animal veterinary market, with a majority of clients coming from the price-insensitive segment. The simulation of 2 clinics (full-service and low-cost) with 2 market segments showed an increase in the overall market for veterinary services when a low-cost clinic was present. In addition, the lower the price charged at the low-cost clinic, the greater the profits for the full-service clinic. The presence of multiple prices for the same services, or price dispersion, in a market increases the overall market value and services more clients. Discouraging low-cost companion animal practices from entering the market decreases efficiency by leaving a population of pet owners unserved and ultimately reduces the overall market for veterinary services and the economic viability of veterinary practices.

Hand Hygiene Evaluation Using Two Different Evaluation Tools and Hand Contamination of Veterinary Healthcare Workers in a Swiss Companion Animal Clinic.

Hand hygiene (HH) is the most important measure to prevent nosocomial infections. HH compliance in companion animal clinics has been reported to be poor. The present study compared an online application with the WHO evaluation form to assess the WHO five moments of HH in a Swiss companion animal clinic. In 202 hand swabs from 87 staff members, total viable count (TVC) before and after patient contact was evaluated and the swabs were tested for selected antimicrobial resistant microorganisms of public health importance. HH compliance (95% confidence interval) was 36.6% (33.8–39.5%) and was similar when assessed with the two evaluation tools. HH differed between hospital areas (p = 0.0035) and HH indications (p < 0.0001). Gloves were worn in 22.0% (18.0–26.6%) of HH observations and were indicated in 37.2% (27.3–48.3%) of these observations. Mean TVC before patient contact was lower (0.52 log CFU/cm2) than after patient contact (1.02 log CFU/cm2) but was similar before patient contact on gloved and ungloved hands. Three hand swabs (1.5% (0.4–4.3%)) were positive for methicillin-resistant Staphylococcus aureus. Gloving should not be regarded as a substitute for HH. Overall, HH in companion animal medicine should urgently be fostered.

Current Status of Antimicrobial Drug Use in Japanese Companion Animal Clinics and the Factors Associated With Their Use.

The Japanese National Action Plan on Antimicrobial Resistance (AMR) was adopted to strengthen AMR surveillance and monitoring in companion animals. The Japanese Veterinary Antimicrobial Resistance Monitoring (JVARM) system monitors the sale of veterinary antimicrobial drugs by pharmaceutical companies, and the sale of human drugs by principal wholesale companies to companion animal (dogs and cats) clinics. However, the data do not include sales by local drug suppliers and personal importation to companion animal clinics in Japan. The purposes of this study were to estimate total antimicrobial drug use by companion animal clinics in Japan and to identify the factors associated with their use. In 2018, questionnaires gathering data on attributes of the clinic and volumes of antimicrobial drugs used were sent to 212 clinics across Japan by the Japan Veterinary Medical Association. Out of the clinics, 170 valid questionnaires were returned (80.2% response rate). Antimicrobial drugs were categorized first as human, veterinary, or imported drugs and then further categorized as important drugs (critically important drugs for humans and second-choice veterinary drugs) or others. Total antimicrobial drug use was estimated based on the number of clinics reported in 2016. The relationships between antimicrobial drug use and various questionnaire items were analyzed using non-parametric regression analysis. Total antimicrobial drug use was estimated at 29.9t, which was 2.1 times higher than reported by the JVARM survey on the sales of antimicrobial drugs. In terms of total use, important drugs and human drugs accounted for 12.6 and 61.8%, respectively. Clinic income per veterinarian was associated with total antimicrobial use per veterinarian. The proportion of important drugs among all antimicrobial drugs used in a clinic was high in recently established clinics with middle-aged and older directors.

Analysis of companion animal clinics in Istanbul in terms of some physical structures, technical equipment, patients and management

With the increasing in companion animal (pet) adoption in the recent years, clinics are now becoming businesses enterprises. In parallel with this increase in ownership, a significant number of veterinarians have started to choose companion animal area. According to records there is a total of 7915 ministry licensed enterprises in Turkey (Ministry of Agriculture and Forestry, 2021a) and 749 of them are established in Istanbul (Ministry of Agriculture and Forestry, 2021b). For this reason, Istanbul has been determined as the study site. In this research, it is aimed to determine the physical structures, technical equipment, patient distribution and to analyze the business activities and problems encountered of the companion animal veterinary clinics in Istanbul. Survey studies were conducted mostly face-to-face (96%) in 225 clinics in Istanbul between April 2019 and April 2021. At the end of the research, it was determined that the majority of the clinics in Istanbul were 100-200 square meters in size, single storey, with 1 examination room. In addition, 96,0% of the clinics are rental and 74,2% of which are sole corporation. In terms of investment, all clinics has a microscopic examination set. Vast majority (95.0%) have X-ray devices and 87.0% analysers. In terms of patient distribution, cats represents 61.9% and dogs represents 33.0%. In the age distribution, those between the ages of 2-5 constitute the largest group for both cats and dogs. The most common reason for the first visit is vaccination with 39.6%. With the research, it has been observed that clinics are generally small-medium in size (81,3%) and independent clinics. The fact that large and chain enterprises are almost non-existent causes both the amount of investment and the expenditure required for promotional activities to be high. From this point of view, it is clearly seen that clinics should become more professional enterprises. In order to do that veterinarians always try to improve business and administrative capabilities by attending to training events.

A Research on some socio-demographic characteristics of companion animal veterinarians and economic structures of companion animal clinics in Istanbul

Having a pet has become an important phenomenon in recent years and Istanbul stands out as the largest market. The aim of the study is to shine a spotlight on both the veterinarians working in this field and the students who plan to work by examining the economic status of clinics and the socio-demographic structures of veterinarians in Istanbul. Studies were conducted mostly face-to-face in 225 clinics between April 2019 and April 2021. The questionnaires were sent to a small number of veterinarians via e-mail. The first findings were that 42.4% and 63.6% of the mean age of the clinicians are male and the majority were Istanbul University graduates with 77.3%. Vast majority had a negative attitude towards the opening of new faculties (24.9% Bad - 75.1% Very Bad), and the majority (79.1%) had a negative attitude towards the provision of veterinary medicine education in foundation universities. According to the study, for the year 2020 the average monthly earning was 17618 TL (2499 USD) and 28.4% were less than 10000 TL (1418 USD). The largest income item was vaccination with 28.8%, and the largest expense item was drug expenditures with 23.9%. It had been determined that the average rental price paid was 9569 TL (1357 USD). According to the results, the average annual expenditure was 2822 TL (400 USD) for cats and 4516 TL (641 USD) for dogs. In addition, the annual average uncollectible receivables per clinic has been determined as 28444 TL (4034 USD), which meant a large loss of approximately 21 million TL (approx. 3 million USD) on a provincial basis. In general, the research concluded that veterinarians were satisfied with their professions with deficiencies in basic business information and could spend little time on their social lives due to long hours of work. From this point of view, it is of utmost importance to regulate the working conditions and to increase education programs in business matters during university year and beyond.

Development and Pilot of an Interactive Online Course on Antimicrobial Stewardship in Companion Animals.

A holistic approach to antimicrobial use (AMU) and prescribing is needed to combat the problem of antimicrobial resistance (AMR). Previously, an antimicrobial stewardship programme (ASP) was developed, introduced, and evaluated in 44 Dutch companion animal clinics, which resulted in an optimization of AMU. As a follow-up to this, an online course was developed to promote awareness of AMU, AMR, and responsible antimicrobial prescribing. The aim of this paper is to describe the development and pilot, including evaluation, of this course, which will be disseminated more widely among Dutch companion animal veterinarians. The interactive programme consists of a major e-learning component and two online, face-to-face meetings. The course comprises five different parts corresponding with five consecutive weeks. Theory on several topics is offered, for example on AMU and AMR in general, Dutch regulations and guidelines on veterinary AMU, behavioural change, and possible methods to quantify AMU. Additionally, several assignments are offered, for example to reflect upon one’s own current antimicrobial prescribing behaviour. Interactive discussion and peer-to-peer learning are promoted. Since September 2020, the course has been offered in a pilot phase, and the feedback is promising. Evaluation of the pilot phase will result in recommendations for further optimization and dissemination.

Hand hygiene compliance in companion animal clinics and practices in Switzerland: An observational study.

Background: Hand hygiene (HH) is one of the most important measures to prevent healthcare‐associated infections. Data on HH compliance in companion animal veterinary institutions in Europe are sparse. Methods: This observational study assessed HH according to WHO standards in three large and two medium‐sized clinics and two primary care practices in Switzerland. Associations with HH indication, professional group, clinical area and institution were determined using a generalized linear mixed effects model. Results: Based on 2056 observations, overall HH compliance [95% confidence interval] was 32% [30%‐34%]. HH compliance was highest in the consultation area (41% [38%‐45%]) and after contact to body fluids (45% [40%‐50%]), and lowest in the pre‐OR area (20% [15%‐24%]) and before clean/aseptic procedures (12% [9%‐15%]). Veterinarians showed a higher HH compliance (37% [34%‐40%]) than veterinary nurses (25% [22%‐28%]). HH compliance was lower before clean/aseptic procedures compared to all other indications (all p < 0.015 except ‘before touching a patient’ in medium‐sized clinics/practices, p = 0.095) and higher in the consultation area compared to all other areas in large clinics (all p < 0.04). Conclusion: Effective HH training should urgently be promoted for all veterinary personnel with special emphasis on the importance of HH before clean/aseptic procedures.