Veterinary Clients Research Articles

Comparison of outcomes in dogs undergoing hiatal hernia repair with and without use of a gastropexy: 41 cases (2012-2022).

To determine the difference in complication rate, gastrointestinal grade and requirement for ongoing medical and/or surgical management following hiatal hernia repair in dogs with and without gastropexy. Clinical records were reviewed retrospectively for dogs that had undergone surgical hiatal hernia repair at two veterinary referral centres between April 2012 and March 2022. Pre-operative grading of gastrointestinal signs and brachycephalic obstructive airway syndrome was performed. All dogs had an oesophagopexy and phrenoplasty. Referring primary veterinary practices and clients were contacted to obtain follow-up information. Fisher's exact tests and Mann Whitney tests were used to assess pre- and intra-operative similarities between groups. Wilcoxon signed rank tests were used to determine the changes in gastrointestinal grade at short- (<6 months) and long-term (>6 months) follow-up. Forty-one dogs which underwent oesophagopexy and phrenoplasty were included. Fifteen dogs had no gastropexy performed and 26 dogs had left-sided gastropexy performed. Dogs that underwent gastropexy(n=8, 29%, 95% CI: 13 to 51%) were significantly more likely to require further surgery related to the initial surgery or persistence of gastrointestinal signs compared to dogs that had no gastropexy (n=0, 0%, 95% CI: 0 to 18%) . This difference was not significant when dogs which had further surgery to address brachycephalic obstructive airway syndrome were excluded. Gastrointestinal grade significantly improved for both groups at both short- and long-term follow-up. There was no significant difference in overall complication rate, gastrointestinal grade or requirement for further medical treatment between groups. A left-sided gastropexy is not required for successful surgical repair of hiatal hernia in dogs provided oesophagopexy and phrenoplasty are performed.

The Value Matrix: a communication tool to support shared decision-making and the practice of Spectrum of Care.

To provide a video tutorial on use of the Value Matrix in clinical practice. Any animal for which a preference-sensitive decision can be made regarding their care. The veterinary professional gathers a comprehensive history from the veterinary client and uses this information, in further discussion with the client, to develop 2 or more evidence-informed options for the veterinary patient's care. With the use of the Value Matrix, options are captured on a whiteboard or piece of paper, and the advantages and disadvantages of each option as well as financial cost are visually presented and discussed. The Value Matrix is a clinical-communication tool for supporting shared decision-making between veterinary professionals and clients and for delivering the Spectrum of Care. The Value Matrix is a practical tool that can assist veterinary professionals in collaborating with clients on making preference-sensitive decisions, providing contextualized care, and achieving informed-client consent.

Clients prefer collaborative decision-making with veterinarians regardless of appointment type.

To determine clients' preferences for veterinarians' communication during decision-making in relation to 3 clinical contexts: preventive care, general problem (eg, illness or injury), and urgent appointments. A cross-sectional online questionnaire was distributed by use of snowball sampling to veterinary clients owning a pet. Demographic information was collected, and participants were then randomly assigned to a scenario reflecting one of the following clinical contexts (appointment types): preventive, general problem, or urgent. Discrete choice exercises were used to solicit client preferences for 5 aspects of veterinarians' communication approach to decision-making with clients in clinical contexts: amount of information, presentation of plan (options or a recommendation), communication of value, nature of client involvement, and communication of financial cost. Relative-preference scores were calculated using hierarchical bayesian modeling. Responses for 1,614 participants were included in the final analysis. The majority were female, lived in Canada, and were financially stable. Across clinical decision-making contexts, participants preferred to collaborate with the veterinarian, be offered options with a clear recommendation, be informed of present and future costs, and have benefits of any action regarding their pet's health explained to them. For the general-problem context, participants preferred veterinarians' communication to focus solely on concerns; in contrast, in preventive care and urgent contexts, participants preferred that communication include both normal findings and concerns. Irrespective of clinical decision-making context, participants preferred collaborative decision-making with a veterinarian. Veterinary professionals should consider, when possible, communication that supports a collaborative approach to decision-making with clients.

Survey of gastrointestinal coccidian parasites of pet birds in Tehran

ABSTRACT Birds of various families and genera comprise a notable proportion of veterinary clients in veterinary practice. Regarding the scarcity of information on avian coccidia in pet birds, this study was designed to investigate and identify the diversity of gastrointestinal coccidian protozoa in caged pet birds. Accordingly, droppings samples were collected in 2.5% potassium dichromate and examined for the presence of oocysts by wet smear and by flotation with the saturated salt solution. Detected oocysts were further morphologically specified. Special Modified Ziehl-Neelsen stain was used for the detection of Cryptosporidium spp. oocysts. Out of the 145 droppings that were collected for parasitological investigations, it was discovered that a Japanese quail (Coturnix japonica) had a Cryptosporidium sp. infection (1/145: 0.7%). Additionally, Isospora spp. was found in a common mynah and a canary (2/145: 1.4%), while Eimeria sp. was detected in a canary (1/145: 0.7%). Studied birds were clinically normal and no signs of intestinal infection were observed. The oocysts are described morphologically in detail and compared with the available data. Periodic faecal examination should be recommended for monitoring intestinal parasites in pet birds both from a public health perspective for Cryptosporidium and for avian host health in the case of non-zoonotic parasites. Additionally, the identification of parasite/host species composition will enhance our understanding of species diversity and the variety of hosts that coccidian parasites are capable of infecting.

Involvement of veterinary students in the placement of intravenous catheters in adult horses in a teaching hospital does not significantly increase the rate of catheter complications.

To determine whether student involvement in intravenous catheter (IVC) placement increases the risk for complications and to report the rate and types of complications associated with IVCs in adult horses in a university teaching hospital. 455 IVCs placed in 394 horses. Data relevant to IVC placement and removal were retrieved from an electronic medical record search including records of adult horses from January 1 to December 31, 2022. Data retrieved from records included the role of the individual who prepared the site and placed the IVC, site of IVC placement, and type of IVC. The reason for removal of the IVC and presence or absence of detectable changes within the vein at the time of removal were documented in addition to clinical data, allowing for classification of each case. Data were reviewed retrospectively, and statistical analyses were performed using mixed-effects logistic regression models. Significance was set at P ≤ .05. The overall rate of complications was 15.6%, and the most common type of complication was swelling of the vein. Students were involved in 87 of 455 IVC site preparations and placements, and there were no statistically significant differences in complication rates between IVC sites prepared or placed by veterinary students versus nonstudent personnel. Veterinary personnel and clients may be hesitant to allow student involvement in IVC placement in horses, but these data suggest that student involvement does not increase the risk of IVC complications.

Life with pets study: lower income veterinary clients' perception of pets' quality of life.

Perception of quality of life for cats and dogs of low-income Spanish and English-speaking veterinary clients attending problem focused or routine veterinary visits is an important area of focus for community based veterinary service providers. Using a qualitative approach, 50 New York City based American Society for the Prevention of Cruelty to Animals (ASPCA) veterinary clients completed semi-structured interviews as well as a survey about their perception of life with their pets. Veterinary clients shared both human-animal bond (HAB) related and quality of life (QoL) related factors in their daily experience of life with their pets. Results indicated that this demographic perceives QoL similarly to previous QoL research that either does not report sample demographics or reports sample demographics with more affluence. Moreover, 60% of qualitative excerpts included both HAB and QoL themes and 40% were discretely HAB or QoL. An analog single item 10-point scale measuring veterinary client perception of their pets QoL did not differentiate between sample demographics at a statistically significant level. Finally, pet QoL literature has not traditionally reflected diverse demographic identities of veterinary clients or widely included reliable and valid measures of the human-animal bond (HAB). These results support the importance of measuring the HAB when researching pet QoL and provide evidence that lower-income Spanish and English-speaking veterinary clients are similarly bonded and attentive to their pets as other demographics.

A veterinary nurse's guide to the Modified Glasgow Coma Scale

The Modified Glasgow Coma Scale is a resource that was developed to assess and monitor patients with altered neurological status. It incorporates three categories of examination: level of consciousness; motor activity; and brain stem reflexes. Each category is assigned a score from 1–6 and scores are added together giving an overall score of between 3–18. The lower the score, the poorer the prognosis. Scores should be taken at several intervals over a period of time which will provide a trend which gives crucial information to the veterinary team to aid in clinical decision making. The ability to accurately perform the assessment and interpret the results is a skill veterinary nurses can become proficient at and therefore be able to accurately report and discuss patient progress with the veterinary team and clients.

What do veterinary professionals and clients want? Using discrete choice methods in veterinary research to determine preferences.

Discrete choice methods (DCMs) are a suite of research techniques for identifying individual preferences using choice information. Widely utilized by other fields yet rarely employed in veterinary research, DCMs have tremendous potential to improve veterinary healthcare by understanding and incorporating owner and veterinary professionals' (encompassing veterinarians, veterinary clinicians, technicians, receptionists, attendants, etc) preferences to optimize the care continuum. DCMs have several advantages over other stated preference methods, such as ranking and ratings, including improved data quality and actionability. However, they are not a panacea, and limitations that may affect DCMs' application to the veterinary field are outlined alongside realistic mitigation strategies. The information provided aims to increase awareness of DCMs and their utility in veterinary research and encourage greater uptake as a more robust method for measuring preferences.

Microaggressions in veterinary communication: what are they? How are they harmful? What can veterinary professionals and educators do?

Trusting relationships between veterinary professionals and clients are important for the well-being of people and the ultimate health of their animals. Yet, microaggressions pose a threat to these relationships. Defined as slights or indignities wielded against people with marginalized identities, microaggressions inflict a unique form of harm that reaffirms negative stereotypes enmeshed in systems of racism, sexism, classism, and beyond. In this article, we explore how microaggressions work and how they are applicable in veterinary settings. We also offer initial suggestions for veterinary professionals and educators to better understand and counteract their damage in the profession.

Values conflict resolution

The values and personal beliefs of veterinary staff and clients can be a cause of conflict. Understanding how values contribute to conflict improves the veterinary nurse's ability to minimise and resolve these conflicts. This article describes the key issues of value conflict and methods for resolving such conflicts in the veterinary environment.

Conversation Analysis of Clients' Active Resistance to Veterinarians' Proposals for Long-Term Dietary Change in Companion Animal Practice in Ontario, Canada.

The impact of nutrition on animal health requires effective diet-related treatment recommendations in veterinary medicine. Despite low reported rates of veterinary clients' adherence with dietary recommendations, little is known about how clients' resistance to nutritional proposals is managed in the talk of veterinary consultations. This conversation-analytic study investigated clients' active resistance to veterinarians' proposals for long-term changes to cats' and dogs' diets in 23 segments from 21 videotaped appointments in Ontario, Canada. Clients' accounts suggested the proposals themselves or nutritional modifications were unnecessary, inappropriate, or unfeasible, most often based on patients' food preferences, multi-pet feeding issues, current use of equivalent strategies, or current enactment of the proposed changes. Resistance arose when veterinarians constructed proposals without first gathering relevant diet- and patient-related information, soliciting clients' perspectives, or educating them about the benefits of recommended changes. Veterinarians subsequently accommodated clients' concerns more often when resistance involved patient- or client-related issues rather than clients' lack of medical knowledge. The design of subsequent proposals accepted by clients frequently replaced dietary changes in the initial proposals with nutritional or non-nutritional alternatives and oriented to uncertainty about adherence. This study provides evidence-based findings for developing effective communication training and practice guidelines in nutritional assessment and shared decision-making.

Veterinary Conversations about Euthanasia: A Call for Compassionate Communication Training

ABSTRACT This study focused on communication between veterinary professionals and clients when pet owners are considering the euthanasia of a pet. Sixteen veterinarians and veterinary technicians participated in semi-structured interviews. The prevalent theme mentioned by participants about what they regarded as most important when discussing euthanasia was, to use a general term, caring. All participants stressed the importance of caring, voicing comments that reflected the need to convey sympathy, empathy, or co

Veterinary professionals' weight-related communication when discussing an overweight or obese pet with a client.

Pet weight may be difficult for veterinary professionals to address with clients, particularly when pets are overweight or obese. The objective of this study was to characterize the communication processes and content of weight-related conversations occurring between veterinary professionals and clients. Audio-video recordings of 917 veterinarian-client-patient interactions involving a random sample of 60 veterinarians and a convenience sample of clients. Companion animal veterinarians in southern Ontario, Canada, were randomly recruited, and interactions with their clients were audio-video recorded. Interactions were reviewed for mentions of weight, then further analyzed by means of a researcher-generated coding framework to provide a comprehensive assessment of communication specific to weight-related interactions. 463 of 917 (50.5%) veterinary-client-patient interactions contained an exchange involving the mention of a single patient's (dog or cat) weight and were included in final analysis. Of the 463 interactions, 150 (32.4%) involved a discussion of obesity for a single patient. Of these, 43.3% (65/150) included a weight management recommendation from the veterinary team, and 28% (42/150) provided clients with a reason for pursuing weight management. Findings illustrate opportunities to optimize obesity communication to improve the health and wellbeing of veterinary patients.

Veterinarians' use of the Talking Physical Exam as a communication tool.

To describe veterinarians' communication of the companion animal physical exam (CAPE) to veterinary clients and to identify factors associated with the number of physical exam components communicated by veterinarians to clients. 376 video-recorded veterinarian-client-patient interactions, involving 60 veterinarians. 18 CAPE components were studied in relation to veterinarians' use of 7 communication-related parameters. A mixed linear regression model was used to assess veterinarian, patient, and appointment factors associated with the number of components conveyed by a veterinarian. Veterinarians conveyed 1,566 of 2,794 (56.1%) of the components that they examined to clients, as having been examined. Of those components that were examined and conveyed by veterinarians, the impact of the finding was communicated for 496 of 1,566 (31.7%) of the components. Visual aids and take-home literature were each used in relation to an examined component during 15 of the 376 interactions (4%). A significant association was found between number of CAPE components conveyed and gender of the veterinarian (females conveyed 1.31 more), as well as the type of appointment (2.57 more were conveyed in wellness appointments and 1.37 more in problem appointments, compared to rechecks). Findings identify an opportunity for veterinarians to further emphasize components of the CAPE, which may in turn increase clients' perceived value of the CAPE due to understanding the benefits for their pet. This may be accomplished with the Talking Physical Exam, in which veterinarians discuss CAPE components findings with clients in real time, and the relevance of the findings to the patient's health.

Mask wearing in the veterinary practice

The clinical environment of a veterinary practice relies on personal protective equipment (PPE) for infection and biosecurity control, especially in areas such as the operating theatre room, dental suites and isolation wards. PPE places a barrier between staff and exposure risk and helps prevent the spread of pathogens between animals and staff. Before the COVID-19 pandemic, face masks were mainly required in clinical areas that posed the highest risk. However, as a result of SARS-CoV-2, the virus causing COVID-19, being spread by airborne transmission, face masks have been worn throughout all areas of practice, reducing the emission of the virus carrying particles when worn by an infected person. This article discusses the evidence-based research for the effectiveness of face coverings in the control of the spread of COVID-19. It also considers the social and psychological impacts to veterinary staff, clients and patients with doing so. Information on COVID-19 was gathered from government and scientific studies and research conducted by the Royal College of Veterinary Surgeons (RCVS) and Dogs Trust relating to the impacts of the COVID-19 pandemic on animals and veterinary nurses.

Application of Advanced Imaging Modalities in Veterinary Medicine: A Review.

Veterinary anatomy has traditionally relied on detailed dissections to produce anatomical illustrations, but modern imaging modalities, now represent an enormous resource that allows for fast non-invasive visualizations in living animals for clinical and research purposes. In this review, advanced anatomical imaging modalities and their applications, safety issues, challenges, and future prospects of the techniques commonly employed for animal imaging would be highlighted. The quality of diagnostic imaging equipment in veterinary practice has greatly improved. Recent advances made in veterinary advanced imaging specifically about cross-sectional modalities (CT and MRI), nuclear medicine (PET, SPECT), and dual imaging modalities (PET/CT, PET/MR, and SPECT/CT) have become widely available, leading to greater demands and expectations from veterinary clients. These modalities allow for the creation of three-dimensional representations that can be of considerable value in the dissemination of clinical diagnosis and anatomical studies. Despite, the modern imaging modalities well established in developed countries across the globe, it is yet to remain in its infancy stage in veterinary practice in developing countries due to heavy initial investment and maintenance costs, lack of expert interpretation, a requirement of specialized technical staff and need of adjustable machines to accommodate the different range of animal sizes. Therefore, veterinarians should take advantage of these imaging techniques in designing future experiments by considering the availability of these varied imaging modalities and the creation of three-dimensional graphical representations of internal structures.

Assessing the Impact of a Virtual Shelter Medicine Rotation on Veterinary Students' Knowledge, Skills, and Attitudes Regarding Access to Veterinary Care.

Strong bonds commonly form between companion animals and people of all socio-demographic backgrounds, yet many pet owners face numerous barriers to accessing veterinary care for their companion animals. For example, they may have difficulties paying for care; they may lack veterinary practices in their community; and they may experience language barriers that impede their ability to utilize veterinary services. Various strategies exist that can help veterinarians address the diverse needs of pet owners in their communities, but these techniques are not commonly covered in the veterinary school curriculum. This study explored how including in-depth, purposefully curated information about access to veterinary care issues within a required shelter medicine rotation impacted fourth-year veterinary students' knowledge, skills, and attitudes regarding the problems clients commonly face when seeking access to veterinary care. Students participated either in a control group of a virtual, four-week rotation delivered via Zoom meetings and self-study, or in an experimental group that additionally completed an interactive online learning module. The online module heavily featured issues surrounding access to veterinary care. Irrespective of which version of the rotation students enrolled, their opinions grew more favorable from pretest to post-test regarding the role of not-for-profit veterinary clinics in communities, as did their expectations that veterinarians should provide affordable treatment options. Additionally, students in the experimental group demonstrated from pretest to post-test increased awareness of the potential for implicit bias toward pet owners within veterinary practice and showed a reduction in their tendency to be judgmental of veterinary clients. By the end of the study, students in the experimental group also expressed greater confidence in their ability to offer incremental care treatment options to veterinary clients. These findings suggest that providing content that focuses on increasing access to veterinary care enhances students' awareness of the need to offer a variety of treatment and payment options to clients. Findings from this study can inform curriculum design in veterinary schools and continuing education programs for veterinary professionals.

Veterinary professionals’ experiences with human caregivers when providing animal hospice and palliative care

Abstract A significant role in veterinary medical practices is the provision of end-of-life (EOL) care to pets and their clients. Yet, U.S. veterinarians report being dissatisfied with the level of training they receive on EOL issues in their veterinary medical programs ( Dickinson et al., 2011 ). At the same time, the ubiquity of veterinary information on the Internet (e.g., “Dr. Google”) has the potential for instilling pet owners with a false sense of expertise that veterinarians must then negotiate when providing EOL care. In this context, we surveyed 86 veterinary members of the International Association for Animal Hospice and Palliative Care (IAAHPC) to explore whether and/or how veterinary medical information clients obtain from the Internet impacts the veterinarians’ delivery of EOL care to those clients’ pets; we similarly investigate the information that veterinarians prefer their clients knew before meeting with them to provide EOL care. In light of the inherent challenges of EOL veterinary care outlined above, we learn from veterinarians what they feel are the most challenging and rewarding aspects of providing palliative and hospice care. Using qualitative thematic coding, our results show, in sum, that veterinary information from the Internet is both helpful and harmful to veterinarian interactions with clients; veterinarians wished clients understood the value of hospice and palliative care as an EOL care option and that grief is normal; and veterinarians report a most positive aspect of dealing with these issues is the gratitude clients show for helping their pets die peacefully.

Ethical Challenges Posed by Advanced Veterinary Care in Companion Animal Veterinary Practice.

Simple SummaryVeterinary care of companion animals, particularly dogs and cats, continues to advance, with some companion animals receiving a standard of care equal to or exceeding that of human patients. While this has the potential to improve animal welfare and benefit other stakeholders, including animal owners and veterinary team members, it also poses ethical challenges. We discuss key ethical challenges associated with AVC, including its relationship to standards of veterinary care, its potential to perpetuate poor quality of life and suffering, cost and accessibility of veterinary care, conflicts of interest, and concerns about experimentation without appropriate ethical review. We conclude by suggesting some strategies for veterinary teams and other stakeholders, such as professional bodies and regulators, to address these concerns.Advanced veterinary care (AVC) of companion animals may yield improved clinical outcomes, improved animal welfare, improved satisfaction of veterinary clients, improved satisfaction of veterinary team members, and increased practice profitability. However, it also raises ethical challenges. Yet, what counts as AVC is difficult to pinpoint due to continuing advancements. We discuss some of the challenges in defining advanced veterinary care (AVC), particularly in relation to a standard of care (SOC). We then review key ethical challenges associated with AVC that have been identified in the veterinary ethics literature, including poor quality of life, dysthanasia and caregiver burden, financial cost and accessibility of veterinary care, conflicts of interest, and the absence of ethical review for some patients undergoing AVC. We suggest some strategies to address these concerns, including prospective ethical review utilising ethical frameworks and decision-making tools, the setting of humane end points, the role of regulatory bodies in limiting acceptable procedures, and the normalisation of quality-of-life scoring. We also suggest a role for retrospective ethical review in the form of ethics rounds and clinical auditing. Our discussion reenforces the need for a spectrum of veterinary care for companion animals.

Exploring Valued Personality Traits in Practicing Veterinarians.

We examined differences in valued Big Five personality traits of small animal veterinarians between members and nonmembers of the veterinary medicine community. Between fall 2019 and spring 2020, data were collected from an online survey sent to eligible persons across a US midwestern state. Eligible persons included veterinary office clients (i.e., pet owners) and persons practicing/training in veterinary medicine. Participants completed demographic questions and 10 Likert scale items about which Big Five personality characteristics they prefer in a veterinarian. Descriptive data were determined and checked for assumptions of linearity and normality. Data for the primary analyses were analyzed using Spearman's correlations and Kruskal-Wallis H tests. Participants who were members of the veterinary community of practice valued the characteristic openness more than clients but valued emotional stability less than clients. Moreover, tests revealed that young adults (aged 18-24) valued extraversion more than all other age groups but least valued agreeableness. Last, participants aged 55 and older valued agreeableness and emotional stability more than the 18-44 age groups. Findings indicate individuals from different membership and age groups have varying preferences in what personality traits they expect in a veterinarian. Clients care more about their veterinarian being able to handle adversity. Older adults want their veterinarian to be trusting and creative. These findings encourage veterinary medical education to spotlight the development of skills congruent with these desired personality traits. Gaining such skills will be useful for veterinarians who seek to grow or build lasting relationships with clientele and colleagues.