Twenty Years of Experience with Dairy Herd Health in Ontario

This article expresses observations on planned herd health for dairy cattle, based on experience gained in the Ambulatory Clinic practice of the Ontario Veterinary College. The author and his colleagues, especially Dr. R.A. Curtis, have initiated and delivered a preventive medicine approach to veterinary practice in the teaching program and teaching practice for the past 20 years. In addition, herd health presentations have been made to veterinary associations in every province in Canada and to many breed associations and producer organizations. The Canadian food animal veterinarian and his clients have been informed at meetings and by the media of the need, objectives, methods and benefits of dairy herd health and many veterinary practices now offer programs to their clients. Herd health has become a household word in Canada's dairy practices and dairy farms.

A formal herd health program is an important step to achieving total health management; but maximum returns on investment can only be realized after three or four generations of cattle have been reared on the program.

In conclusion, herd health practice has been a very satisfying aspect of veterinary medicine and a profitable and valued service for our clients. Maintenance of health involves the application of all knowledge and procedures which veterinarians have to offer.

     

An Epidemiological Survey of Therapy and Diagnostic Procedures Used by Norwegian Small Animal Practitioners in Cases of Nasal Mite (Pneumonyssoides caninum) Infection in Dogs

Forty per cent of the members of the Norwegian Small Animal Veterinary Association (NSAVA) returned a questionnaire regarding the treatment and diagnosis of canine nasal mite infection in their practices in 1996. A total of 2392 dogs were treated for this infection by 156 NSAVA members in clinical practice in that year, averaging 15.3 treated dogs per veterinarian. An estimated minimum of 6000 Norwegian dogs were treated for nasal mite infection in 1996, at an estimated cost of treatment exceeding 3.3 million NOK. Fifty-nine per cent of the practitioners included at least a case history and clinical examination as diagnostic criteria prior to initiating treatment for nasal mite infection. Fewer than 10% routinely performed more thorough diagnostic procedures, and only 1.8% of the diagnoses were verified prior to treatment. A total of 27 different treatment regimens, involving either subcutaneously injected ivermectin or orally administered milbemycin oxime, were routinely used by NSAVA veterinarians to treat these dogs. Seventy-two (53%) of the veterinarians used ivermectin exclusively, 14 (10%) used milbemycin oxime exclusively, while 50 (37%) used both ivermectin and milbemycin oxime. No other drugs were used. Evaluation of treatment was made by assessing resolution of the clinical signs following treatment, and 97% of the veterinarians were satisfied with the effect of the treatment regimen they used. Adverse side-effects following treatment for nasal mite infection in 1996 were seen on 9 occasions; 4 following ivermectin administration and 2 following milbemycin oxime treatment, while in 3 cases no information on the drug used was provided. The risk of adverse reactions to treatment of nasal mite infection in dogs was 0.4%.     

Questionnaire on the incidence and control of fleas in dogs and cats presented to German small animal practices

2590 small animal practitioners in Germany have been asked by a questionnaire from which 1694 (65.4%) replied. 1186 of these veterinarians (70%) often see ectoparasite infestation. Fleas are predominant and occur on cats (1016/60%), followed by dogs (424/25%), small mammals and birds (254/15%). Flea infestations on dogs and cats are observed throughout the year, but the prevalences are generally higher during the summer season. The results reveal that topically administered spot-on formulations is the most popular method used for flea control. The most common applied antiparasitic substances both in dogs and in cats were fipronil (535/31.6%; 690/40.7%), imidacloprid (290/17.1%; 417/24.6%) and selamectin (267/15.8%; 319/18.8%). Due to 771 (45.5%) of the answering veterinarians the animal owner himself, and according 694 (41%) respectively 229 (13.5%) of the replies the veterinarian or the veterinary technician applies the antiparasiticide onto the skin. 1457 veterinarians (86%) administer compounds against adult fleas and their developmental stages also in the animal's environment.     

Aggressive clients in Dutch veterinary practice

Aggressive clients seem to be becoming more common. This article describes a study in which questionnaires on client behaviour were sent to veterinary assistants and veterinarians in randomly selected practices in the Netherlands. Results showed that 26.4% of the veterinarians and 29.3% of the assistants had experienced aggressive clients in the last year. Age, experience, and sex of the veterinarian or assistant did not influence the frequency with which aggressive clients were encountered. The same was true for the type of veterinary practice (companion animals, farm animals, horses, etc). The risk of encountering aggressive clients was higher among practices in large towns and in practices with a small turnover Of the veterinarians who had encountered aggressive clients at least once in their career, 31% has taken some kind of action after the aggressive encounter Nearly a quarter (24.9%) of veterinary practices have adopted a Risk Inventarization and Evaluation (RI&E) approach to preventing client aggression and 26.6% of practices have adopted another approach. While veterinarians tend not to consider aggression a big problem, they are often open to the suggestion that more attention should be paid to aggression in veterinary practice.     

Leptospirosis in a Small Animal Veterinarian: Reminder to Follow Standardized Infection Control Procedures

A small animal veterinarian in Washington State developed leptospirosis after an occupational exposure. Approximately 10 days prior to the onset of illness, he examined a healthy appearing pet rat for fleas, which urinated on his un‐gloved hands. Although the veterinarian washed his hands after the examination, his hands had abrasions from gardening. The veterinarian was hospitalized for 12 days and was able to return to work part‐time 1 month following discharge. This illness may have been prevented if the veterinarian had been wearing gloves during the examination as recommended by the National Association of State Public Health Veterinarians (NASPHV), Veterinary Infection Control Committee, in its Compendium of Veterinary Standard Precautions for Zoonotic Disease Prevention in Veterinary Personnel (2008). This case alerts us to the need for small animal veterinarians to minimize their infection risk by practising recommended infection control procedures. Veterinarians should establish and follow a written infection control plan based on the standardized infection control approach adopted by the NASPHV to minimize their risk of occupational zoonotic infections.     

Survey of veterinarians' recommendations for treatment and control of intestinal parasites in dogs: public health implications

A systematic, random sample of 450 small and mixed-animal practitioners was selected from the client list of a prominent veterinary pharmaceutical and animal health company. A telephone survey was conducted, using a standard questionnaire, to assess whether current veterinary practices concerning prophylaxis and treatment of canine roundworm (Toxocara canis) and hookworm (Ancylostoma spp) infections are adequate to prevent transmission to human beings. Analysis of results focused on 3 questions related to prevention: practitioner's frequency of client education regarding zoonotic potential of roundworms and hookworms, pup age at which veterinarian recommends first anthelmintic treatments, and proportion of veterinarians recommending prophylactic drug administration for pups and nursing bitches. Despite the proven association of household pet dogs and human toxocariasis, only a third (148/450) of veterinarian respondents routinely discussed the potential zoonotic hazards of canine roundworms with their clients. A total of 29% (130/450) of veterinarians surveyed either never discussed these potential hazards or discussed them only when asked by their clients. With regard to anthelmintic treatment practices, 31% (140/450) of veterinarians surveyed recommended that pups first be examined and treated for intestinal parasites within 4 weeks of age. Thirty-three percent (163/450) recommended first examination and deworming at 5 to 6 weeks of age, and 36% (163/450) suggested that it be done at or after 7 weeks of age. Less than half (208/450) of veterinarians administered anthelmintics prophylactically to at least some pups and dogs. Sixty-four percent (287/450) of respondents recommended routine testing and treatment of nursing bitches.(ABSTRACT TRUNCATED AT 250 WORDS)     

Current British veterinary attitudes to the use of perioperative antimicrobials in small animal surgery

A questionnaire was sent to 2951 mixed and small animal veterinary practices to examine the use of perioperative antimicrobials in cats and dogs in the UK. The percentage of respondents who always used antimicrobials in two surgical procedures classified according to NRC criteria as 'clean' was 25.3 per cent for removal of a 1 cm cutaneous mass and 32.1 per cent for routine prescrotal castration. Factors considered important in decision-making about when to use antimicrobial agents included immunosuppression, presence of a drain, degree of wound contamination, potential for spillage of visceral contents and implantation of prosthesis. The most common antimicrobial agents mentioned were potentiated amoxicillin (98.0 per cent), amoxicillin (60.5 per cent), clindamycin (21.8 per cent), enrofloxacin (21.7 per cent), cephalexin (18.6 per cent) and metronidazole (12.7 per cent). Forty-three per cent of all responding veterinarians listed a long-acting preparation for perioperative use. The routes used were subcutaneous (76.1 per cent), intravenous (25.8 per cent), intramuscular (19.8 per cent), oral (13.5 per cent) and topical (7.7 per cent). Antimicrobials were given before surgery (66.6 per cent), during surgery (30.2 per cent), immediately after surgery (12.0 per cent) and after surgery (6.3 per cent). This survey has identified the suboptimal use of perioperative antimicrobials in small animal surgery with improvements needed with respect to timing, duration, choice of antimicrobial and a more prudent selection of surgical cases requiring prophylaxis.     

Surgical Wound Infection Rates in Dogs and Cats Data from a Teaching Hospital

Two thousand sixty-three surgical procedures were performed on 1992 patients (1715 dogs and 277 cats). In a retrospective analysis, the procedures were categorized according to the expected degree of wound contamination, and corresponding wound infection rates were determined. The number of procedures in each category and the percent that became infected were as follows: clean (1100, 2.5%), clean-contaminated (554, 4.5%), contaminated (172, 5.8%), and dirty (237, 18.1%). The administration of antibiotics significantly reduced the frequency of wound infection in clean surgical procedures performed by senior veterinary students (p less than 0.05), but not in clean elective procedures performed by faculty or resident surgeons that required 90 minutes or less to complete. There was a significant correlation between elevation of rectal temperature postoperatively and increased duration of the surgical procedure. However, the rectal temperature measured the day after surgery was not an accurate predictor of wound infection.     

Horse Racing and Veterinary Practices in New Jersey

The New Jersey horse racing industry has declined over the last 5 years as indicated by decreases in the number of racing days, stallions standing, mares bred, and foals registered. These changes were hypothesized to have potential negative consequences for veterinary practices. The objective of the survey was to investigate changes in veterinary practice revenue and staff over a five-year period. Members of the New Jersey Association of Equine Practitioners completed a survey detailing their involvement in the horse racing industry and breeding of racehorses. A response rate of 49% was achieved with 45% of respondents indicating they were involved in the horse racing industry as a veterinarian. Respondents indicated they decreased (44%), did not change (17%), or increased (39%) their number of staff because of changes in the horse racing industry over the past 5 years. In a similar manner, veterinarians reported decreases (48%), no change (22%), or increases (30%) in revenue. Practice revenue from the breeding of racehorses and its associated components either decreased (91%) or did not change (9%) over the past 5 years because of changes in the horse racing industry. Results indicate declines in the horse racing industry had minimal impact on veterinary practices involved in this sector of the industry. Veterinarians and practices involved in racehorse breeding and its associated components, in contrast, were negatively impacted by changes in the horse racing industry.     

Survey of Equine Nutrition: Perceptions and Practices of Veterinarians in Georgia,USA

Equine nutrition plays a critical role in equine health. The veterinarian is an expected major source of equine nutrition information, yet little evidence exists to evaluate this assumed role, particularly from the veterinarian’s perspective. The aim of this study was to investigate the knowledge and confidence levels and practices and perceptions regarding equine nutrition by surveying equine clinicians in Georgia, USA. A sample representative of a cross-section of equine veterinarians participated in the survey: response rate was 20%. Veterinarians reported that although their level of equine nutrition knowledge had improved since graduation, their confidence levels varied when giving nutritional advice on a number of prevalent nutritional-related conditions. Their confidence level in giving nutritional advice on colic was the highest and on hyperkalemic periodic paralysis the lowest. The majority of veterinarians had not taken any recent equine nutrition continuing education, mainly owing to lack of courses available; however, the majority expressed an interest in taking future courses, particularly if offered online. Although the veterinary profession was considered to be an important source of equine nutrition information, almost one-quarter of veterinarians offered no equine nutrition counseling to their clients. More than two-thirds of veterinarians reported having no access to a referral equine nutrition service, but would be likely to use one if it were available. The results of this survey reveal equine nutrition perceptions and practices from an equine clinician perspective. Several areas of concern are highlighted, questioning the quality, responsibility, and provision of equine nutrition in Georgia, USA, and are suggestive of a far more wide-reaching problem, requiring further research.     

Oral anatomy of the dog and cat in veterinary dentistry practice.

The study of anatomy is important to accomplish any kind of surgical and medical procedure and to understand the physiology and diseases of animals. It is no different in veterinary dentistry. The study of oral anatomy helps the veterinarian to accomplish any kind of surgical procedure more quickly and with less damage to tissues, especially in cases of major oral surgery. In fact, under-standing the anatomy is easier when this knowledge is acquired directly, with surgical application. This article describes the essentials of the oral anatomy of the dog and cat, correlating this knowledge with the dental procedures to be used by veterinarians as a guide.     

Recommendations on vaccination for Latin American small animal practitioners: a report of the WSAVA Vaccination Guidelines Group

The World Small Animal Veterinary Association Vaccination Guidelines Group has produced global guidelines for small companion animal practitioners on best practice in canine and feline vaccination. Recognising that there are unique aspects of veterinary practice in certain geographical regions of the world, the Vaccination Guidelines Group undertook a regional project in Latin America between 2016 and 2019, culminating in the present document. The Vaccination Guidelines Group gathered scientific and demographic data during visits to Argentina, Brazil and Mexico, by discussion with national key opinion leaders, visiting veterinary practices and review of the scientific literature. A questionnaire survey was completed by 1390 veterinarians in five Latin American countries and the Vaccination Guidelines Group delivered continuing education at seven events attended by over 3500 veterinarians. The Vaccination Guidelines Group recognised numerous challenges in Latin America, for example: (1) lack of national oversight of the veterinary profession, (2) extraordinary growth in private veterinary schools of undetermined quality, (3) socioeconomic constraints on client engagement with preventive health care, (4) high regional prevalence of some key infectious diseases (e.g. feline leukaemia virus infection, canine visceral leishmaniosis), (5) almost complete lack of minimal antigen vaccine products as available in other markets, (6) relative lack of vaccine products with extended duration of immunity as available in other markets, (7) availability of vaccine products withdrawn from other markets (e.g. Giardia vaccine) or unique to Latin America (e.g. some Leishmania vaccines), (8) accessibility of vaccines directly by pet owners or breeders such that vaccination is not delivered under veterinary supervision, (9) limited availability of continuing education in veterinary vaccinology and lack of compulsion for continuing professional development and (10) limited peer-reviewed published scientific data on small companion animal infectious diseases (with the exception of leishmaniosis) and lack of support for such academic research. In this document, the Vaccination Guidelines Group summarises the findings of this project and assesses in evidence-based fashion the scientific literature pertaining to companion animal vaccine-preventable diseases in Latin America. The Vaccination Guidelines Group makes some recommendations on undergraduate and postgraduate education and academic research. Recognising that current product availability in Latin America does not permit veterinarians in these countries to vaccinate according to the global World Small Animal Veterinary Association guidelines, the Vaccination Guidelines Group makes a series of “pragmatic” recommendations as to what might be currently achievable, and a series of “aspirational” recommendations as to what might be desirable for the future. The concept of “vaccine husbandry” is addressed via some simple guidelines for the management of vaccine products in the practice. Finally, the Vaccination Guidelines Group emphasises the global trend towards delivery of vaccination as one part of an “annual health check” or “health care plan” that reviews holistically the preventive health care needs of the individual pet animal. Latin American practitioners should transition towards these important new practices that are now well embedded in more developed veterinary markets. The document also includes 70 frequently asked questions and their answers; these were posed to the Vaccination Guidelines Group during our continuing education events and small group discussions and should address many of the issues surrounding delivery of vaccination in the Latin American countries. Spanish and Portuguese translations of this document will be made freely available from the on-line resource pages of the Vaccination Guidelines Group.     

Disease control during the colonial period in Australia

The first permanent European settlers of Australia arrived in 1788 to establish a penal colony at Sydney, New South Wales (NSW). As the colony grew and wool production increased, more free settlers and emancipists developed farming in inland Australia. During the 1840s veterinarians commenced arriving in small numbers but they were not closely associated with the development and execution of disease control programs, which was left to lay inspectors of stock. The arrival of William Tyson Kendall and coordinated action with Graham Mitchell led to the establishment of a private veterinary college following the passage of veterinary surgeons legislation in Victoria. From this time, veterinarians came to be appointed to positions formerly occupied by lay inspectors and the veterinary profession was able to take up the role of planning and executing government-led disease control programs. From a colony relying on wool for export to the UK, technical advancements in meat freezing and pasture improvement widened the range and increased the quantity of exported products. Before the advent of veterinary advances, sheep scab was eradicated, a vaccine was developed for anthrax and glanders infection of horses was prevented entry to Australia. Graduates from the Melbourne Veterinary College spread across Australia and in this period a conservative quarantine policy was developed following inaction to control an outbreak of contagious bovine pleuropneumonia (CBPP) and the escape of rabbits to form a plague across the continent. Coordinated control of CBPP had to await the next century and advancement of technology increased our understanding of bacteriology and immunity of infectious diseases. Veterinary services were provided to the militia sent by the colonies to the Boer Wars in South Africa 1987-1901 and the veterinarians from Victoria were led by an Australian trained veterinarian.     

Obesity in the dog

Canine obesity is a common condition in veterinary practice, and has been associated with a number of serious medical conditions likely to reduce the length and quality of a pet's life. Therefore, it represents an important condition for the veterinarian to manage. This paper reports a study conducted by veterinarians in practice using controlled calorie reduction for the management of overweight dogs. In the study weight losses of 14 per cent were achieved over a 12 week period. Details of this study are discussed.     

Infection control practices and zoonotic disease risks among veterinarians in the United States

OBJECTIVE-To assess the knowledge and use of infection control practices (ICPs) among US veterinarians. DESIGN-Anonymous mail-out population survey. PROCEDURES-In 2005 a questionnaire was mailed to US small animal, large animal, and equine veterinarians who were randomly selected from the AVMA membership to assess precaution awareness (PA) and veterinarians' perceptions of zoonotic disease risks. Respondents were assigned a PA score (0 to 4) on the basis of their responses (higher scores representing higher stringency of ICPs); within a practice type, respondents' scores were categorized as being within the upper 25% or lower 75% of scores (high and low PA ranking, respectively). Characteristics associated with low PA rankings were assessed. RESULTS-Generally, respondents did not engage in protective behaviors or use personal protective equipment considered appropriate to protect against zoonotic disease transmission. Small animal and equine veterinarians employed in practices that had no written infection control policy were significantly more likely to have low PA ranking. Male gender was associated with low PA ranking among small animal and large animal veterinarians; equine practitioners not working in a teaching or referral hospital were more likely to have low PA ranking than equine practitioners working in such institutions. CONCLUSIONS AND CLINICAL RELEVANCE-Results indicated that most US veterinarians are not aware of appropriate personal protective equipment use and do not engage in practices that may help reduce zoonotic disease transmission. Gender differences may influence personal choices for ICPs. Provision of information and training on ICPs and establishment of written infection control policies could be effective means of improving ICPs in veterinary practices.     

Exploration of developmental approaches to companion animal antimicrobials: providing for the unmet therapeutic needs of dogs and cats

AAVPT Workshop White Paper Committee. Exploration of developmental approaches to companion animal antimicrobials: providing for the unmet therapeutic needs of dogs and cats. J. vet. Pharmacol. Therap. 33 , 196–201. The American Academy of Veterinary Pharmacology and Therapeutics (AAVPT) and the United States Pharmacopeia (USP) co‐sponsored a workshop to explore approaches for developing companion animal antimicrobials. This workshop was developed in response to the shortage of antimicrobials labeled for dogs and cats, as there is a shortage of approved antimicrobials for the range of infectious diseases commonly treated in small animal practice. The objective of the workshop was to identify alternative approaches to data development to support new indications consistent with the unmet therapeutic needs of dogs and cats. The indications for currently approved antimicrobials do not reflect the broader range of infectious diseases that are commonly diagnosed and treated by the veterinarian. Therefore, the labels for these approved antimicrobials provide limited information to the veterinarian for appropriate therapeutic decision‐making beyond the few indications listed. Industry, veterinary practice, and regulatory challenges to the development of new antimicrobial indications were discussed. The workshop resulted in short‐ and long‐term recommendations. Short‐term recommendations focus on the use of additional data considerations for product labeling. Long‐term recommendations center on legislative or regulatory legal initiatives. The workshop recommendations will need collaboration from industry, academia, and regulatory authorities and a legal shift in the drug approval and availability processes.     

Cystotomy practices and complications among general small animal practitioners in Ontario, Canada

Cystotomy is a common surgical procedure in small animal veterinary medicine, yet common pre-, intra-, and post-operative practices have not been described. This survey evaluated cystotomy practices of 106 veterinarians in Ontario. The majority of respondents reported practices consistent with standard recommendations, but some deficiencies in antimicrobial and analgesic use, as well as intra- and post-operative practices, were identified. Some factors associated with the likelihood that practitioners reported recurrent urolithiasis or urinary tract infection are contrary to typical recommendations, such as the association of the use of absorbable, multifilament suture or a dorsal (versus ventral) incision and a lesser likelihood of reporting post-operative urinary tract infections. While care must be taken interpreting these statistical associations, the results suggest that objective assessment of common cystotomy recommendations (use of monofilament, absorbable suture) is required. Re-assessment of certain peri-operative practices, such as analgesic and antimicrobial administration, and post-operative testing, is required for a minority of practitioners.     

Attitudes and concerns of Canadian animal health technologists toward postoperative pain management in dogs and cats.

Three hundred and twenty-two Canadian animal health technologists (AHTs) were surveyed to determine their attitudes toward postoperative pain management in dogs and cats following 6 surgical procedures, their concerns regarding the use of opioid analgesics, and their role within veterinary practices with respect to postoperative pain control. Two hundred and sixty-four (82%) returned the questionnaire. Pain perception was defined as the average of pain rankings for dogs and cats (on a scale of 1 to 10) following abdominal surgery, or the value for dogs or cats if the AHT worked with only 1 of the 2 species. Maximum concern about the risks associated with the postoperative use of morphine or oxymorphone was defined as the highest rating assigned to any of the 6 risks evaluated in either dogs or cats. Animal health technologists reported significantly higher pain perception scores than did veterinarians who completed a similar survey 2 years previously. Higher pain perception scores were associated with decreased satisfaction with the adequacy of analgesic therapy in their practice, higher pain control goals, and attendance at continuing education within the previous 12 months. The majority of AHTs (55%) agreed that one or more risks associated with the use of morphine or oxymorphone outweighed the benefits. The 3 issues that were perceived to pose the greatest risk were respiratory depression, bradycardia, and sedation and excitement, for dogs and cats, respectively. Most AHTs (68%) considered their knowledge related to the recognition and control of pain to be adequate, compared with 24% of veterinarians who responded to a similar previous survey. As for veterinarians, experience gained while in practice was ranked as the most important source of knowledge, while the technical program attended was ranked as least important. Over 88% of the AHTs provided nursing care during the postoperative period, monitored animals for side effects of postoperative analgesic therapy, informed veterinarians when animals were in pain, recommended analgesic therapy when they believed it was warranted, reported that animals received analgesics when they believed it was warranted, administered analgesics under the instruction of a veterinarian, and believed they were part of a team working to provide adequate postoperative pain control.     

Current controversies in equine antimicrobial therapy

Controversies exist regarding the use, misuse and potential overuse of antimicrobial treatments in foals and adults. When antimicrobials are required for treatment of infectious diseases, veterinarians should follow a logical approach and not simply reach for the newest drug. Targeted, single drug therapy is probably best, and culture and sensitivity testing should be undertaken. The most likely infectious agent, potential drug toxicities, and age‐appropriate dose and route should be considered. The development of an increasing number of different multiple drug resistant pathogens requires that veterinarians use antimicrobial drugs responsibly to protect veterinary patients and the public at large.