Patient variation in veterinary medicine--part II--influence of physiological variables

In veterinary medicine, the characterization of a drug's pharmacokinetic properties is generally based upon data that are derived from studies that employ small groups of young healthy animals, often of a single breed. In Part I of the series, we focused on the potential influence of disease processes, stress, pregnancy and lactation on drug pharmacokinetics. In this Part II of the series, we consider other covariates, such as gender, heritable traits, age, body composition, and circadian rhythms. The impact of these factors with respect to predicting the relationship between dose and drug exposure characteristics within an animal population is illustrated through the use of Monte Carlo simulations. Ultimately, an appreciation of these potential influences will improve the prediction of situations when dose adjustments may be appropriate.     

The gender shift in veterinary medicine: cause and effect.

The gender shift in veterinary medicine has paralleled other changes in debt and income. Cause and effect are complex and often confused. Popular notions of the priorities of the new generation of men and women are often not supported by research studies. Recent data reveal new insights into questions surrounding the gender issue.     

Pharmaco-epidemiology and -economics should be developed more extensively in veterinary medicine

Pharmaco-epidemiology, which has emerged within the last 20 years as a new discipline in human medicine, deals with the quantities of drugs consumed and their effects on populations in terms of epidemiological concepts and tools. To a lesser extent, it is also practised in veterinary medicine. The applications presented in this review are illustrative of pharmaco-epidemiological and -economical concepts. Assessment of drug consumption, the study of adverse drug effects, and the economic implications of drug use are the three main fields considered. Developments can be expected in veterinary medicine within the next few years relative to novel areas of interest such as antimicrobial resistance and new therapeutic class uses. These applications will require methodological progress and the elimination of current gaps. Pharmaco-epidemiological methods need to be developed, which implies close co-operation between statisticians, pharmacologists, veterinary practitioners and epidemiologists. A greater use of the term 'pharmaco-epidemiology' as a keyword in literature would facilitate recognition of this domain which associates closely epidemiology and pharmacology.     

150th anniversary of veterinary education and the veterinary profession in North America

This article is the first in a series of three to be published in the Journal of Veterinary Medical Education (JVME). These articles are abridged versions of six lectures that make up an elective course on the history of the veterinary profession in North America offered at Cornell University's College of Veterinary Medicine in spring 2010. The course was based in large part on an oral history collection titled "An Enduring Veterinary Legacy"(1) that captures interesting and relevant veterinary stories. The course was designed to increase awareness of the history of veterinary medicine as we approach the sesquicentennial of the American Veterinary Medical Association (AVMA) in 2013 and as we join with our international colleagues in marking the 250th anniversary of the establishment of the world's first veterinary college in Lyon, France, in 2011.(2) The overarching goal of this course and the articles is to record and also to share first-person stories that describe the development of veterinary education and the veterinary profession in North America from the mid-1860s to the present. In the process, it is hoped that this history will encourage respect, love, and admiration for the veterinary profession and an appreciation of veterinary medicine as a versatile profession. The articles are somewhat Cornell-centric because the lectures on which they are based were presented to Cornell students at their home institution. However, it is hoped that the events are representative of the broader American experience. For educators interested in the course itself, a brief synopsis and a summary of student evaluations for the first year of presentation is appended here and in subsequent articles in this series.     

Study of the influence of veterinary medical education on the moral development of veterinary students

Although veterinary medicine endorses high moral character and adherence to a code of ethics, to our knowledge, virtually no studies have examined the influence of veterinary medical education on the moral development of its students. Using the Kohlberg standard moral judgment interview, this study examined that relationship in a sample of 20 veterinary medical students (16.0% of the veterinary college's student body). The students were tested at the beginning and at the end of their veterinary medical education to determine whether their moral reasoning scores had increased to the same extent as those of other postgraduate students. It was found that normally expected increases in moral reasoning did not occur over the four years of veterinary medical education for these students, suggesting that their veterinary medical educational experience somehow inhibited their moral reasoning ability rather than facilitated it. With a range of moral reasoning scores between 313 and 436, the mean increase from first year to fourth year of 12.5 points was not statistically significant. Statistical analysis revealed no significant correlations between the moral reasoning scores on age or gender, although there were significant correlations with Medical College Admissions Test scores and grade point average scores.     

浅析产蛋鸡用药物零日弃蛋期的制定

[摘要] 概述产蛋鸡（蛋鸡、种鸡及后备母鸡）用药物弃蛋期的制定考虑因素。根据欧盟EMA发布的欧盟最大残留限量制定指南、残留消除指南以及FDA发布的食品动物用新兽药对人类食品安全性评价的一般原则,结合已经批准的部分零日弃蛋期药物,浅析弃蛋期制定的方法和一般考虑。制定产蛋鸡用药物弃蛋期需要考虑最大残留限量、ADI合理分配、鸡蛋中药物的残留消除,其中最重要的因素是ADI合理分配。     

Observations of veterinary medicine students' approaches to study in pre-clinical years

RATIONALE FOR THIS STUDY: This study has two purposes. The first is to explore an instrument of evaluation of the approaches to study (deep, strategic, and surface) adopted by students in the pre-clinical years of their veterinary degree program. The second is to examine relationships between these approaches and a broad range of further factors deemed relevant to the veterinary medicine context. We envisage that a greater knowledge of how these students learn will aid curriculum reform in a way that will enrich the learning experience of veterinary students. METHODOLOGY: A questionnaire consisting of the 52-question Approaches to Study Inventory (ASI) and an additional 49 questions relating mainly to teaching, assessment, and study skills was distributed to 215 veterinary medicine (MVB) students in their pre-clinical years of study. Factor analysis was used to ensure that the ASI section of the questionnaire maintained previously reported structure. The internal reliability of the approaches measured was tested using Cronbach alpha analysis. The approaches were described as frequency distributions. Associations between the parameters (deep, strategic, and surface) and 49 additional context-specific factors were investigated using loglinear analysis. RESULTS: (1) Factor analysis revealed that the integrity and structure of the instrument in this context was generally comparable to previous studies. (2) The impact of a high workload was evident in the surface approach, with fear of failure becoming a strong motivating factor and syllabus boundness a widely used strategy. (3) Associations made between the approaches and 49 context-specific factors showed strong associations between both workload and lack of prior knowledge with the surface approach. (4) Grades were associated positively with both the deep and strategic approaches but negatively with the surface approach. (5) A range of learning and study skills were associated positively with the deep and strategic approaches and negatively with the surface approach. CONCLUSION: The ASI proved to be a reliable and insightful instrument, highlighting specific surface learning tendencies present in the group as well as a deep learning approach, the pattern of which deviates from previous studies on this subject. This study also confirms the value of some teaching practices as a means of supporting deep learning and perhaps challenging surface learning strategies. The prevalent perception of a high workload is notable, as is its positive association with surface learning.     

Work conditions, job preparation, and placement strategies for food-animal veterinarians

This study examines the responses of 1,047 human-resources personnel who recruit veterinarians for positions in their organizations. Work conditions in the organization, lifestyle and time-management issues, job benefits, job expectations, supervisor relations, and the physical demands of veterinary work are studied. Comparisons are made between four different occupational areas: food animals, mixed animals, companion animals, and industry positions in veterinary medicine. The findings portray a career in food animal medicine as very positive. Recruiters also make recommendations to colleges of veterinary medicine for strategies to improve the preparation and placement of their graduates.     

Feminization of veterinary medicine in the Netherlands 1925-2000

The feminisation of veterinary medicine occurred in The Netherlands, as elsewhere in the world, in the course of the twentieth century. In 1930, Jeannette Voet (1907-1979) was the first female veterinarian graduate of the Faculty of Veterinary Medicine of Utrecht University. In contrast with the first Dutch female physician who graduated in 1878, Jeannette Voet was not an active feminist. Instead, she concentrated on the development of various fields of veterinary medicine during her career. Nevertheless, she played an important role in the acceptance of women in Dutch veterinary medicine. The integration of women into all areas of the veterinary profession was a gradual process. Meat inspection, in particular, proved to be rather conservative in its acceptance of female veterinarians. The number of women veterinarians in the profession increased only gradually throughout the twentieth century. In 1970, women represented not more than 5 % of all veterinarians in The Netherlands. A significant increase in female students was first observed in the 1980s. The large influx of city girls who are primarily interested in companion animal and horse medicine is still quite remarkable. The average percentage of female first-year students between 1988 and 1992 was 60; over the last 5 years, this increased to 70%. Between 1988 and 1999, the average percentage of female graduates grew from 35 to 60%. Consequently, the proportion of Dutch female veterinarians increased from 5 to 25% between 1970 and 2000. In spite of this development, the representation of women veterinarians among policymaking officials, leading veterinary authorities and academic staff (particularly at the professor level) is still quite low. From this point of view, veterinary medicine could still be considered as 'a man's job'. Feminisation of veterinary medicine is often explained by an increase in the numbers of companion animals and horses and part-time jobs or by a different, gender-based attitude towards animals. Another, simpler, explanation is that fewer male students are attracted to veterinary medicine because they can make more money in other professions. More historical sociological research, including a comparison with feminisation in other sciences and broader society, is necessary to obtain a deeper insight into this phenomenon. Regardless, feminisation is likely to further change the veterinary profession in the near future.     

Exotic animal corporate practice.

I have attempted to give insight into many of the aspects of a corporate veterinary job in the retail pet industry. Understand that these are my experiences, and corporate jobs are as diverse as the number of corporations in this field. My experiences have been positive because I have been fortunate enough to become an integral part of a company with an outstanding company ethic regarding animal care and business as a whole. This is a dream position for a veterinarian who wishes to make a far-reaching difference for animals. At PETCO I am the Animal Advocate and I do have the responsibility to look at every situation through the eyes of the animals. I take this responsibility very seriously and understand that every decision I make has a lasting impact on not only the animals we sell but also the associates who daily give their heart and soul as they care for the animals in our stores. This is the way I have chosen to make a difference in the world: by using my veterinary education as well as my life experiences in ways that are very different from the James Herriot of old-different from the advanced veterinary practices in this new millennium but steadfastly following the same principles we promised to uphold when we took the veterinary oath... Being admitted to the profession of veterinary medicine, I solemnly swear to use my scientific knowledge and skills for the benefit of society through the protection of animal health, the relief of animal suffering,the conservation of livestock resources, the promotion of public health, and the advancement of medical knowledge. I will practice my profession conscientiously, with dignity, and in keeping with the principles of veterinary medical ethics. I accept as a lifelong obligation the continual improvement of my professional knowledge and competence.     

Acute respiratory distress syndrome in dogs and cats: a review of clinical findings and pathophysiology

Objective: To review the clinical and pathophysiologic aspects of acute respiratory distress syndrome (ARDS) in dogs and cats. Data sources: Data from human and veterinary literature were reviewed through Medline and CAB as well as manual search of references listed in articles pertaining to acute lung injury (ALI)/ARDS. Human data synthesis: Since the term ARDS was first coined in 1967, there has been a abundance of literature pertaining to this devastating syndrome in human medicine. More complete understanding of the complex interactions between inflammatory cells, soluble mediators (e.g., tumor necrosis factor, interleukin (IL)‐6, IL‐8, platelet activating factor) and the clinical patient has provided for timely recognition and mechanistically based protective strategies decreasing morbidity and mortality in human patients with ARDS. Veterinary data synthesis: Although little is known, ARDS is becoming a more commonly recognized sequela in small animals. Initial case reports and retrospective studies have provided basic clinical characterization of ARDS in dogs and cats. Additionally, information from experimental models has expanded our understanding of the inflammatory mechanisms involved. It appears that the inflammatory processes and pathologic changes associated with ARDS are similar in dogs, cats, and humans. Conclusions: Unfortunately, current mortality rates for ARDS in small animals are close to 100%. As our capability to treat patients with advanced life‐threatening disease increases, it is vital that we develop a familiarity with the pathogenesis of ARDS. Understanding the complex inflammatory interactions is essential for determining effective preventative and management strategies as well as designing novel therapies for veterinary patients.     

Factors influencing veterinary students career choices and attitudes to animals

The purpose of the study was to investigate the influence of demographic and experiential factors on first-year veterinary students career choices and attitudes to animal welfare/rights. The study surveyed 329 first-year veterinary students to determine the influence of demographic factors, farm experience, and developmental exposure to different categories of animals on their career preferences and on their attitudes to specific areas of animal welfare and/or rights. A significant male gender bias toward food-animal practice was found, and prior experience with particular types of animals--companion animals, equines, food animals--tended to predict career preferences. Female veterinary students displayed greater concern for possible instances of animal suffering than males, and prior experience with different animals, as well as rural background and farm experience, were also associated with attitude differences. Seventy-two percent of students also reported that their interactions with animals (especially pets) had strongly influenced the development of their values. Animals ranked second in importance after parents in this respect. The present findings illustrate the importance to issues of animal welfare of the cultural context of past experience and influences on attitude development. The results also suggest that previous interactions with animals play a critical role in guiding veterinary students into their chosen career, as well as in helping to determine their specific employment preferences within the veterinary profession. From an animal welfare perspective, the dearth of women choosing careers in food-animal practice is a source of concern.     

Photobiomodulation Therapy in Veterinary Medicine: A Review

Laser therapy, or photobiomodulation, has rapidly grown in popularity in human and veterinary medicine. With a number of proposed indications and broad, sometimes anecdotal, use in practice, research interest has expanded aimed at providing scientific support. Recent studies have shown that laser therapy alters the inflammatory and immune response as well as promotes healing for a variety of tissue types. This review will cover the history of the modality, basic principles, proposed mechanisms of action, evidence-based clinical indications, and will guide the practitioner through its application in practice.     

Clustering of reported cases of leptospirosis among dogs in the United States and Canada

A retrospective study was conducted to determine whether cases of leptospirosis diagnosed among dogs in the United States and Canada were clustered in time, space, or time-and-space. The study population was estimated--based on first examination of each dog--to consist of 1,035,366 dogs examined at 22 veterinary teaching hospitals between 1983 and 1998. The veterinary medicine database was searched for records of dogs in which a diagnosis of leptospirosis was made during the study period. The scan statistic (Poisson model) was used to examine for clustering of cases, using recorded date of diagnosis and the location of the veterinary teaching hospital at which the diagnosis was made. Three-hundred and forty dogs diagnosed with leptospirosis were identified. Cases were clustered in the period of 1992-1998. A cluster of dogs diagnosed at three veterinary teaching hospitals located in the midwest of the United States was identified. The composition of this spatial cluster was influenced by the age and gender distribution of the population at-risk. A cluster of cases involving 143 dogs diagnosed with leptospirosis between 9 April 1993 and 14 December 1998 at six veterinary teaching hospitals located in the midwest of the United States was identified. This time-space cluster was not influenced by the age, gender or breed distribution of the population of dogs presented at veterinary teaching hospitals during the study period. Leptospirosis was clustered during the 1990s in the midwest of the United States. Dog risk factors (age, gender, breed) do not explain the clustering that was observed. Leptospira serovar or environmental factors might be responsible for the clustering of canine leptospirosis in the United States and Canada.     

Providing stewardship and leadership for the future of veterinary medical research: a responsibility of the veterinary colleges

As we contemplate responsibilities as well as opportunities in research, it is fair to begin by considering why research is, or should be, important to veterinary schools and colleges, to our profession, and to society. Veterinary research is conducted in many venues, such as colleges of veterinary medicine, veterinary science departments, comparative medicine departments, medical schools, and many other university departments, as well as in industry laboratories, governmental agencies, and other organizations. But schools and colleges of veterinary medicine have a unique and historic responsibility to ensure that our veterinary medical research programs are sufficient in quality, capacity, and depth to meet the research needs of our society. Consequently, my comments will be oriented toward veterinary schools and colleges.     

Myasthenia gravis in dogs with an emphasis on treatment and critical care management

Objective – To review the human and veterinary literature on the pathophysiology of myasthenia gravis (MG) and describe treatment options for clinical use in people and animals. Data Sources – Human and veterinary clinical reports, studies and reviews, textbooks, and recent research findings in MG from 1996 present, with a focus on treatment and patient management. Human Data Synthesis – MG is a well‐described condition in people with new research and treatment options available. Many of the newest therapeutic options available in veterinary medicine for MG are based on current strategies used in people with this condition. Seronegative MG is well described in people and provides insight to clinical cases encountered in veterinary medicine when the index of suspicion is high though serologic tests are negative. Veterinary Data Synthesis – Previous studies in veterinary medicine focused on the use of acetylcholinesterase inhibitors as the main form of treatment in canine MG. Recent studies, mainly case series and case reports, emphasize the use of immunomodulatory treatments as an alternative for long‐term treatment. However, there are no randomized, controlled studies on treatment with immunomodulatory therapy for MG in dogs available to assess the efficacy of this treatment strategy. Conclusions – Although early recognition of clinical signs is most important in the outcome of patients with MG, further understanding the pathophysiology of MG may lead to earlier diagnosis and novel treatment strategies. The discovery of additional autoantibodies against striated muscle proteins in dogs, should enhance our understanding of diseases affecting the neuromuscular junction. In addition, clinical data for canine MG could be applied to other autoimmune disorders.     

Clinical Trials in Veterinary Medicine: A New Era Brings New Challenges

Randomized clinical trials (RCTs) are among the most rigorous ways to determine the causal relationship between an intervention and important clinical outcome. Their use in veterinary medicine has become increasingly common, and as is often the case, with progress comes new challenges. Randomized clinical trials yield important answers, but results from these studies can be unhelpful or even misleading unless the study design and reporting are carried out with care. Herein, we offer some perspective on several emerging challenges associated with RCTs, including use of composite endpoints, the reporting of different forms of risk, analysis in the presence of missing data, and issues of reporting and safety assessment. These topics are explored in the context of previously reported veterinary internal medicine studies as well as through illustrative examples with hypothetical data sets. Moreover, many insights germane to RCTs in veterinary internal medicine can be drawn from the wealth of experience with RCTs in the human medical field. A better understanding of the issues presented here can help improve the design, interpretation, and reporting of veterinary RCTs.     

A scoping review of autoantibodies as biomarkers for canine autoimmune disease

BackgroundAutoantibody biomarkers are valuable tools used to diagnose and manage autoimmune diseases in dogs. However, prior publications have raised concerns over a lack of standardization and sufficient validation for the use of biomarkers in veterinary medicine.ObjectivesSystematically compile primary research on autoantibody biomarkers for autoimmune disease in dogs, summarize their methodological features, and evaluate their quality; synthesize data supporting their use into a resource for veterinarians and researchers.AnimalsNot used.MethodsFive indices were searched to identify studies for evaluation: PubMed, CAB Abstracts, Web of Science, Agricola, and SCOPUS. Two independent reviewers (AET and ELC) screened titles and abstracts for exclusion criteria followed by full‐text review of remaining articles. Relevant studies were classified based on study objectives (biomarker, epitope, technique). Data on study characteristics and outcomes were synthesized in independent data tables for each classification.ResultsNinety‐two studies qualified for final analysis (n = 49 biomarker, n = 9 epitope, and n = 34 technique studies). A high degree of heterogeneity in study characteristics and outcomes reporting was observed. Opportunities to strengthen future studies could include: (1) routine use of negative controls, (2) power analyses to inform sample sizes, (3) statistical analyses when appropriate, and (4) multiple detection techniques to confirm results.ConclusionsThese findings provide a resource that will allow veterinary clinicians to efficiently evaluate the evidence supporting the use of autoantibody biomarkers, along with the varied methodological approaches used in their development.