General Veterinary Practitioners Research Articles

European Network for Optimization of Veterinary Antimicrobial Therapy (ENOVAT) guidelines for antimicrobial use in canine acute diarrhoea

Acute diarrhoea is a common presentation in dogs, and a common reason for antimicrobial prescription and nutraceutical use. This evidence-based guideline provides recommendations for antimicrobial and probiotic treatment of canine acute diarrhoea (CAD). A multidisciplinary panel developed the recommendations by adhering to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. The opinions of stakeholders (general veterinary practitioners and dog owners) were collected and incorporated to ensure the applicability of this guideline. Four strong recommendations informed by high certainty evidence, and three conditional recommendations informed by very low or low certainty evidence, were drafted by the panel, along with an ungraded section on diagnostic work-up of dogs with acute diarrhoea. The ENOVAT guidelines initiative encourages national or regional guideline makers to use the evidence presented in this document, and the supporting systematic review, to draft national or local guidance documents.

Generating evidence on antibiotic use across human and animal health sectors using the World Health Organization’s Access, Watch, Reserve (AWaRe) classification: Exploratory pilot study in rural Pune, India

Background and Aim: Human antibiotic formulations in animal feed for therapeutic and non-therapeutic purposes have contributed to antimicrobial resistance worldwide; however, little evidence is available in low- and middle-income countries. We aimed to generate evidence of antibiotic use across the human and animal health sectors by investigating the overlap in antibiotic use in community settings in rural blocks of Pune District, India, following the World Health Organization’s (WHO) Access, Watch, Reserve (AWaRe) classification. Materials and Methods: An exploratory pilot study using a cross-sectional design in two randomly selected rural blocks of the Pune district included 138 interviews with general physicians (GPs, n = 62), pharmacists (n = 60), and veterinary practitioners (n = 16) using semi-structured interview schedules and the WHO AWaRe classification. IBM-Statistical Package for the Social Sciences, Version 21.0 software was used for descriptive statistics and to calculate the proportions of the different antibiotic groups. The WHO AWaRe classification was used to describe antibiotic use by the study participants and to assess the overlap in antibiotic use. Results: Our study provides evidence of an overlap in human and animal antibiotic use in rural community settings across the human and animal health sectors. Amoxicillin (access group), penicillin (access group), and ofloxacin (watch group) were used in both human and animal health. Amoxicillin and penicillin were used to treat common bacterial infections, ofloxacin was used to treat skin infections in humans and animals, and ofloxacin was used to treat pneumonia in animals and urinary bladder infections in humans. In contrast, azithromycin (watch group), cefixime (watch group), and amoxicillin (Access Group), with or without other antibiotics, were the most commonly used antibiotics by GPs in humans. Conclusion: We confirmed the overlap in antibiotic use across the human and animal health sectors in rural community settings, suggesting the need for interventions following the One Health approach. Further, research is required to assess the patterns of this overlap, as well as behavior, knowledge, and potential solutions to help avoid this overlap and prevent the rampant use of antibiotics in the animal and human health sectors in rural community settings. Keywords: antimicrobial resistance, antibiotics use, overlap, rural India, WHO AWaRe.

Rare complex fistulations of frontal sinus, occulo‐nasal and oro‐nasal passages due to nasal form of canine transmissible venereal tumour

AbstractUnusual manifestations in commonly occurring diseases often mislead the diagnostic approaches of general veterinary practitioners. A 2.5‐year‐old male Spitz dog was evaluated for frequent episodes of nasal discharges. With no resolution of signs with treatments, the dog was brought to the Teaching Veterinary Hospital. On presentation, the dog had purulent nasal discharge from the right nostrils, right eye and from an opening in the right frontal sinus region along with mild swelling on the right nasal region and stertor. Anterior rhinoscopy confirmed the concurrent presence of frontal sinus, oculo‐nasal and oro‐nasal fistula. Endoscopic aspirations and washing confirmed an extra genital form of canine transmissible venereal tumour. Interestingly no genital lesions were seen. Treatment with vincristine resulted in complete remission with no further relapses over the last 8 years. Chronic nasal signs should be taken as warning signs and nasal washings should be evaluated for possible tumour cells, as observed in this study.

Performing surgery in goats. Part 1: preparation and regional anaesthesia

Background: The population of goats within the UK continues to rise and, according to latest Defra figures, now totals approximately 111,000 animals. With this comes the increasing likelihood that general practitioners will have something to do with these fascinating and characterful farmed species. The UK goat sector is one of the most diverse within the agricultural setting, being comprised of three main commercial wings: dairy, meat and fibre, and the remainder spread across pedigree and/or show stock, public attraction stock, small holder stock and those kept exclusively as pets. All these different settings have multiple and intertwining crossovers, which means the manner in which our caprine patients are kept, handled, managed and cared for can be equally disparate. The general practitioner must be aware of the circumstances and surroundings in which the animals are kept. Additionally, goats are generally of a gregarious and hierarchical nature, which can lead them into harm's way or mischief, and may necessitate various veterinary interventions.Aim of the article: This article, the first in a two part series, aims to equip general veterinary practitioners with the necessary knowledge and top tips for performing regional anaesthetic techniques in this species, while also highlighting how to stay on the right side of the law when it comes to available pharmaceuticals.

Guide to diagnosing and treating neoplasia in ferrets

Background: Statistics for the actual incidence of neoplasia in pet ferrets are not currently available; however, multiple case reports of different types of neoplasia in this species are described in the literature. The majority of tumours are seen in animals older than three years of age, and multiple types of neoplasia can occur in the same ferret.Aim of the article: This article provides an overview of the most common ferret neoplasms seen by general veterinary practitioners, and aims to help practitioners approach these cases with more confidence. The endocrine, haemolymphatic and integumentary systems are most commonly affected, with adrenocortical tumours and insulinoma at the top of the list.

Feline upper respiratory tract disease - Computed tomography and laboratory diagnostic.

Background and Aim:Upper respiratory tract disease (URTD) is prevalent in cats, and diagnosis can be challenging. This study aimed to determine the most common causes of cat URTD in Latvia and describe computed tomography (CT) and laboratory diagnostic findings.Materials and Methods:The present retrospective study included a total of 94 cats who were diagnosed with URTD. All cats underwent CT, and 50 of them had additional diagnostic tests, such as histology and respiratory infection polymerase chain reaction (PCR) testing.Results:The most common CT finding was rhinosinusitis (55.32%) followed by nasal neoplasia (26.6%) and nasopharyngeal polyp (14.89%), but in three cats, a cause of respiratory symptoms was larynx neoplasia, nasal dermoid cyst, and an oronasal fistula. PCR test showed that the most cause of rhinosinusitis was Mycoplasma felis. Nasopharyngeal polyp as the primary diagnosis was identified in 14 cats from 3 months to 6 years, with an average age of 1.85 ± 1.915 years, and 54% of cats were female. Nasal neoplasia as a primary CT diagnosis was determined in 25 cats at the age of 5–18 years, with an average age of 10.56 ± 3.416 years. Histology diagnosis included four types of neoplasia – squamous cell carcinoma, sarcoma, adenocarcinoma, and aplastic carcinoma.Conclusion:This study describes the most common CT and laboratory findings in cats with URTD. Included information will be helpful for general veterinary practitioners and researchers and will update their knowledge on feline URTD.

Diagnosis and clinical management of canine leishmaniosis by general veterinary practitioners: a questionnaire-based survey in Portugal

BackgroundCanine leishmaniosis (CanL) can be appropriately managed following international recommendations. However, few studies have assessed the preferred protocols in real-life veterinary practice and whether these are in line with the guidelines. This survey aimed to investigate the current trends in the clinical management of CanL among veterinary practitioners in Portugal, taking into consideration different scenarios of infection/disease and the awareness of and application by veterinary practitioners of the current guidelines.MethodsA questionnaire-based survey was conducted online using an electronic platform. The following topics were surveyed: (i) general characteristics of the responding veterinarian; (ii) the preferred protocols used for the diagnosis, treatment and prevention of CanL, considering different theoretical scenarios of infection/disease; and (iii) the responding veterinarian’s current knowledge and application of the existing guidelines on CanL. After internal validation, the survey was distributed online, for 2 months, via Portuguese social network veterinary groups. Data were collected for descriptive analysis.ResultsEighty-six replies were obtained. Analysis of the results showed that the preferred diagnostic techniques varied widely according to the theoretical scenario of infection/disease. In general daily practice, serology testing (enzyme-linked immunosorbent assay [ELISA]) was the most used tool (67.4%). The preferred matrices used for PCR test were lymph nodes (62.3%) and/or bone marrow (59.0%). Regarding treatment, for subclinical infection/stage I CanL, 51.2% of the respondents did not prescribe any medical treatment, but 98.8% proceeded with both monitoring and preventive measures. Among those who prescribed a treatment (n = 42), most chose domperidone (47.6%). For the treament of stages IIa, IIb and III CanL, allopurinol/meglumine antimoniate (MA) was chosen by 69.8, 73.3 and 51.2% of respondents, respectively, followed by allopurinol/miltefosine (20.9, 19.8 and 38.4%, respectively). In contrast, dogs with stage IV CanL were mostly treated with allopurinol/miltefosine (48.8%) rather than with allopurinol/MA (23.3%). The use of repellents was the preferred preventive strategy (98.8%). About 93.0% of responders were aware of the existence of guidelines, and most of these veterinarians consulted the guidelines of the LeishVet group and the Canine Leishmaniosis Working Group; however, 31.3% reported that they did not follow any specific recommendations.ConclusionsOf the veterinarians responding to the survey, most reported following international guidelines for the clinical management of CanL. While allopurinol/MA was the preferred therapeutic protocol for the treatment of stages II/III CanL, allopurinol/miltefosine was the first choice for the treatment of stage IV CanL, possibly due to the unpredictable effect of MA on renal function. This study contributes to a better understanding of the trends in practical approaches to the treatment of CanL in Portugal.Graphical

Prevalence of 17 feline behavioral problems and relevant factors of each behavior in Japan.

Undesirable behaviors exhibited by cats are regarded as feline behavioral problems. Like canine behavioral problems, feline behavioral problems are commonly reported by owners. Thus, in order to advise cat owners appropriately, veterinarians, particularly general veterinary practitioners, are encouraged to have sufficient knowledge of these problems. However, in ordinary Japanese homes, only a small number of feline behavioral problems have been investigated in terms of prevalence and relevant factors. Comprehensive survey data may improve understanding of feline behavioral problems. In the present study, we distributed an online survey including general information and questions about 17 feline behaviors which can be problematic for owners, to investigate: (1) the prevalence of feline behavioral problems, (2) the most common behavioral problems, and (3) relevant factors for each behavior. We collected 1,376 valid responses. Among all cats, 75.7% exhibited at least one behavioral problem. “Pica” and “Showing fear while on the examination table” were the most frequently reported behavioral problems. To identify factors related to the expression of each behavior, we conducted multiple logistic regression analyses, with the presence of behaviors as objective variables and cats’ general information as explanatory variables. Age, sex, breed, number of cats in the household, and type of residence were each associated with more than one behavior. The present study revealed the prevalence of 17 feline behavioral problems in Japanese homes and relevant factors of each behavior. These findings will help veterinarians understand and address feline behavioral problems.

Guide to skin diseases in rabbits

Background: Dermatological conditions are a very common presentation of pet rabbits to the veterinarian. The aetiology varies; problems such as pododermatitis and parasitic and bacterial infections constitute a higher percentage...

Prevalence of canine Babesia and Ehrlichia co-infection and the predictive value of haematology.

Canine babesiosis and ehrlichiosis are important tick-borne infections in South Africa. Many South African general veterinary practitioners perceive co-infection with Ehrlichia spp. as a common occurrence in dogs with babesiosis. Studies about the prevalence of co-infection in South African dogs are lacking. This retrospective study aimed to determine the prevalence of Ehrlichia co-infection in dogs with babesiosis. Additionally, the predicative value of specific haematological variables for co-infection was evaluated. The study population consisted of 205 dogs diagnosed with canine babesiosis presented to the Onderstepoort Veterinary Academic Hospital (OVAH) in 2006 and between 2011 and 2013. The Babesia-infected dogs were grouped based on presence or absence of an Ehrlichia spp. co-infection. Ehrlichia spp. co-infection was confirmed using polymerase chain reaction. Positive and negative predictive values (PPVs and NPVs) of leukopenia or thrombocytopenia for co-infection were also calculated. The prevalence of Babesia spp. and Ehrlichia spp. co-infection in this cohort of dogs was 2%. In the babesiosis dogs, the PPV of leukopenia for co-infection with Ehrlichia spp. was 1.3%, and the NPV 97.4%. Similarly, the PPV and NPVs of thrombocytopenia for co-infection were 2.1% and 100%, respectively. Co-infection with Ehrlichia spp. was a rare occurrence in dogs with babesiosis presented to the OVAH. Normal leukocyte or platelet counts confidently ruled out the presence of concurrent ehrlichiosis in this cohort of dogs. However, the diagnosis of Ehrlichia co-infection based on the presence of thrombocytopenia or leukopenia would have been associated with false positive results in more than 97.4% of cases.

Treatments affecting dog behaviour: something to be aware of

ALTHOUGH dog behaviour problems are a leading cause of relinquishment and euthanasia (Salman and others 1998), only 11 per cent of veterinarians surveyed in a USA study strongly agreed that...

Survey of UK-based veterinary surgeons' opinions on the use of surgery and chemotherapy in the treatment of canine high-grade mast cell tumour, splenic haemangiosarcoma and appendicular osteosarcoma

The objective of this study was to determine the frequency of recommendation of adjuvant chemotherapy by UK-based general veterinary practitioners (GVPs) for canine patients with high-grade mast cell tumours (HGMCTs),...

Veterinarians' attitudes towards chronic pain

A PAPER summarised on p 428 of this issue of Veterinary Record on the attitudes of veterinary surgeons to chronic pain in dogs (Bell and others 2014) poses some interesting...

The case against the use of dental implants in dogs and cats

Veterinary dentistry has made great strides providing treatments that were once available only to people. When performed for the medical benefit of animals, procedures such as professional dental cleaning, root canal treatment, and even, in selected cases, periodontal surgery and orthodontic correction can prevent and treat disease, improve quality of life, and enhance and sustain the human-animal bond. Veterinarians are now being urged to provide for dogs and cats another sophisticated procedure that has become common in human dentistry: dental implants (ie, implants designed to replace missing teeth, consisting of a metal part inserted into the underlying bone to support a prosthodontic appliance). We argue, however, that data suggesting dental implants are safe and beneficial in humans cannot be extrapolated to animals, that evidence regarding the safety and efficacy of dental implants in dogs and cats is currently insufficient to justify their use, and that the claimed medical and qualityof-life benefits associated with dental implants in dogs and cats do not outweigh the potential risks associated with them. For these reasons, we do not believe that dental implants should be placed in dogs and cats. It is not possible to estimate how many dogs or cats in the United States have received implants, although the number thus far appears to be small. We are aware that dental implants have been placed in privately owned dogs by diplomates of the American Veterinary Dental College (AVDC), and it is likely that some general veterinary practitioners have placed implants in dogs and cats. It may also be the case that human dentists have placed dental implants under the supervision of veterinarians. Although the number of veterinarians presently placing dental implants in dogs and cats is probably limited, this could change, and quickly. Lec

Musculoskeletal imaging in the cat: what's normal? What's abnormal?

Despite the increasing availability of ultrasonography, computed tomography and magnetic resonance imaging (MRI), radiography remains the primary imaging modality for the assessment of feline musculoskeletal disease in practice. In many respects, having a more feline-focused approach to radiography will reward the clinician with better quality images and, hence, a greater likelihood of a correct diagnosis. Correct interpretation of radiographic films requires familiarity with some of the unique aspects of normal feline skeletal anatomy. For optimal patient management, the clinician also needs an appreciation of the distinct advantages of advanced imaging modalities in certain circumstances, in particular for head trauma patients. When considering what equipment is most suitable for musculoskeletal imaging, the small size of our feline patients means that image resolution is of primary importance. Choosing an x-ray system (film-screen or digital) that offers more detail, and selecting ultrasound probes of a higher frequency than would be used on larger canine patients, will go some way to improving the diagnostic yield of any feline imaging study. If there is the option of referral for MRI, and a choice between high-field and low-field MRI systems for the feline patient, a high-field system will always provide more detail. This review, drawing on the author's experience and established imaging and anatomical principles, aims to assist general veterinary practitioners in their approach to feline musculoskeletal imaging. It provides an overview of the imaging choices and techniques for different regions of the body, and gives examples of normal anatomy that is peculiar to the cat.

Environmental enrichment: practical strategies for improving feline welfare.

The clinical application of evidence-based enrichment strategies for the domestic cat housed in a variety of confined environments, ranging from the veterinary cage to the domestic home, is of particular importance - both in relation to providing opportunity for appropriate feline behaviour, and in the prevention and treatment of behavioural and associated health problems (eg, feline lower urinary tract disease associated with negative emotional states such as generalised anxiety). Environmental enrichment has gained particular relevance in the light of current animal welfare legislation. For example, in the UK, the Animal Welfare Act 2006 stipulates that owners/keepers have a duty of care to their animal(s) that includes allowing the animal to exhibit normal behaviour patterns. Research into environmental enrichment as a means of improving animal welfare is still very much in its infancy, particularly in relation to the domestic cat. Thus, evidence-based studies are somewhat sparse and more are needed to validate current recommended enrichment practices. This article aims to assist general veterinary practitioners to recognise how cats respond to confinement, and to understand what constitutes environmental enrichment, to help them implement or advise on appropriate enrichment strategies for cats confined in a hospital cage, home environment (particularly an indoor-only home), or cattery or rescue shelter, based on published evidence to date.

Evaluation of veterinarian and veterinary student knowledge and clinical use of pulse oximetry

We hypothesized that veterinarians and veterinary students may lack key knowledge about pulse oximetry, which may result in this type of patient monitor not being used on appropriate patient populations or to its full capabilities. A questionnaire was developed to assess an individual's knowledge and understanding of pulse oximetry. Residents and specialists in anesthesiology and critical care at several academic institutions were surveyed first to assess the questionnaire for clarity and to serve as a control group. General veterinary practitioners (GPs) attending continuing education courses at the University of Georgia were surveyed over a 24-month period. Students entering their senior year anesthesiology rotation at the University of Georgia were also surveyed. Residents and specialists (69% correct responses) scored significantly higher than senior students (46%), who scored significantly higher than GPs (34%). Only 15% of GPs and 21% of senior students reported that they had received training in pulse oximetry in school. Those who had received training scored significantly higher than those who did not. Many GPs did not report using a pulse oximeter on their critical patients under anesthesia, a group that would be expected to benefit from its use. Veterinarians have a poor understanding about how pulse oximetry works, the information provided by pulse oximetry, and how to best apply it to their patients. Furthermore, the respondents did not use pulse oximeters in a manner that would derive the most information and result in the greatest benefit to the patient relative to the cost of the instrument. Didactic training in veterinary curricula and during continuing education opportunities continues to be necessary in order to produce veterinarians, who have an understanding of the technologies available that can be used to improve patient care.

Evaluating Veterinarians’ and Veterinary Students’ Knowledge and Clinical Use of Pulse Oximetry

We hypothesized that veterinarians and veterinary students may lack key knowledge about pulse oximetry, which may result in this type of patient monitor not being used on appropriate patient populations or to its full capabilities. A questionnaire was developed to assess an individual's knowledge and understanding of pulse oximetry. Residents and specialists in anesthesiology and critical care at several academic institutions were surveyed first to assess the questionnaire for clarity and to serve as a control group. General veterinary practitioners (GPs) attending continuing education courses at the University of Georgia were surveyed over a 24-month period. Students entering their senior-year anesthesiology rotation at the University of Georgia were also surveyed. Residents and specialists (69% correct responses) scored significantly higher than senior students (46%), who scored significantly higher than GPs (34%). Only 15% of GPs and 21% of senior students reported that they had received training in pulse oximetry in school. Those who had received training scored significantly higher than those who had not. Many GPs did not report using a pulse oximeter on their critical patients under anesthesia, a group that would be expected to benefit from its use. Veterinarians have a poor understanding of how pulse oximetry works, the information it provides, and how best to apply it to their patients. Furthermore, the respondents did not use pulse oximeters in a manner that would yield the most information and result in the greatest benefit to the patient relative to the cost of the instrument. Didactic training in veterinary curricula and during continuing education opportunities continues to be necessary in order to produce veterinarians who have an understanding of the technologies available to improve patient care.

Modern elements of informed consent for general veterinary practitioners.

Modern elements of informed consent for general veterinary practitioners.

A field investigation of kennel cough: Incubation period and clinical signs

AbstractA study of the incubation period and clinical signs of kennel cough was undertaken by collating and analysing information obtained by postal questionnaires from a random sample of general veterinary practitioners in the United Kingdom. Agent‐specific incubation periods were inferred from the vaccinal status of affected dogs. The mean and range of the incubation period for Bordetella bronchiseptica infection were 6‐5 days and two to 14 days, respectively; similar descriptive statistics for canine parainfluenza virus (CPIV) infection were 4–5 days and one to eight days. Local clinical signs (cough, nasal discharge and gagging/retching) were present in animals in all vaccinal categories. One or more systemic clinical signs (pyrexia and anorexia) were identified in 32 per cent of cases. No association was detected between vaccinal status against B bronchiseptica and CPIV, and clinical signs.