Current attitudes to,and use of,peri-operative analgesia in dogs and cats by veterinarians in New Zealand

AIM: To investigate the attitudes of veterinary practitioners in New Zealand to pain and analgesia, and their use of analgesic drugs, in dogs and cats.

METHODS: A questionnaire posted to 1,200 practising veterinarians was used to gather information about the use of analgesia in dogs and cats, assessment of pain, attitudes to pain relief, analgesic drugs and procedures used, factors affecting choice of analgesic agent, and veterinary demographics, continuing education and staffing.

RESULTS: Three hundred and twenty questionnaires with useable data were returned, a response rate of 28%. Male and female veterinarians were evenly represented. The analgesic agents most commonly used were morphine (opioids) and carprofen (a non-steroidal anti-inflammatory drug; NSAID). Use of peri-operative pain relief ranged from 50% for castration of cats to 91% for fracture repair in dogs. For most procedures, female veterinarians scored pain at a significantly higher level than their male colleagues. Fifty-eight percent of respondents considered their knowledge in the area of assessment and treatment of pain was adequate.

CONCLUSIONS: This survey was considered representative of veterinarians working in companion animal practice in New Zealand. Results indicated a relatively high use of peri-operative analgesia, including both pre-emptive and multi-modal analge- sia, in cats and dogs, although there was still some disparity between the perception of how painful a procedure was and the consequent use of pain relief.

CLINICAL RELEVANCE: The establishment of current attitudes and practices indicates to practising veterinarians how their own use of analgesics compares with that of their colleagues. It also provides information to educators on potential areas of focus, given that 42% of respondents felt their knowledge in the area of assessment and treatment of pain was inadequate.     

Current attitudes to, and use of, peri-operative analgesia in dogs and cats by veterinarians in New Zealand

AIM: To investigate the attitudes of veterinary practitioners in New Zealand to pain and analgesia, and their use of analgesic drugs, in dogs and cats. METHODS: A questionnaire posted to 1,200 practising veterinarians was used to gather information about the use of analgesia in dogs and cats, assessment of pain, attitudes to pain relief, analgesic drugs and procedures used, factors affecting choice of analgesic agent, and veterinary demographics, continuing education and staffing. RESULTS: Three hundred and twenty questionnaires with useable data were returned, a response rate of 28%. Male and female veterinarians were evenly represented. The analgesic agents most commonly used were morphine (opioids) and carprofen (a non-steroidal anti-inflammatory drug; NSAID). Use of peri-operative pain relief ranged from 50% for castration of cats to 91% for fracture repair in dogs. For most procedures, female veterinarians scored pain at a significantly higher level than their male colleagues. Fifty-eight percent of respondents considered their knowledge in the area of assessment and treatment of pain was adequate. CONCLUSIONS: This survey was considered representative of veterinarians working in companion animal practice in New Zealand. Results indicated a relatively high use of peri-operative analgesia, including both pre-emptive and multi-modal analgesia, in cats and dogs, although there was still some disparity between the perception of how painful a procedure was and the consequent use of pain relief. CLINICAL RELEVANCE: The establishment of current attitudes and practices indicates to practising veterinarians how their own use of analgesics compares with that of their colleagues. It also provides information to educators on potential areas of focus, given that 42% of respondents felt their knowledge in the area of assessment and treatment of pain was inadequate.     

A survey for small animal veterinarians regarding flea and tick control pesticide products

The Canadian Veterinary Medical Association administered a survey to capture the clinical experiences of small animal veterinarians regarding adverse effects observed in cats and dogs following the use of flea and tick control pesticide products. Results of this survey are discussed and compared with pesticide incident reports collected by Health Canada.     

Epidemiologic factors, clinical findings, and vaccination status of rabies in cats and dogs in the United States in 1988. National Study Group on Rabies

Despite the availability of rabies vaccination through private veterinarians and government-sponsored rabies control programs, rabies was reported in an average of 338 cats and dogs per year from 1980 through 1987 in the United States. Information was collected on 90% of the 183 cats and 97% of the 119 dogs that were reported to have rabies in the continental United States in 1988. The median age of rabid cats and dogs was 1 year, and 81% were from rural areas. Compared with rabid cats, rabid dogs were more likely to have been male (66 vs 42%, odds ratio = 2.6), to have been kept as pets (84 vs 43%, odds ratio = 6.8), and to have had reported contact with wildlife before onset of illness (38 vs 14%, odds ratio = 3.8). Rabid cats accounted for a greater proportion of human rabies postexposure prophylaxis, bites to people, and exposures to other animals than did rabid dogs. Although the clinical signs of rabies varied, rabid cats were more likely than dogs to have had aggressive behavior (55 vs 31%, odds ratio = 2.8). In contrast, rabid dogs were more likely than cats to have had an illness consistent with a paralytic process. The median period between onset of illness and death was 3 days (range, less than 1 to 10) in rabid cats and dogs that were allowed to die of rabies. Vaccine failures were documented in 3 (1%) rabid animals (2 cats and 1 dog). All animals had received only a single dose of vaccine in their lifetime and were vaccinated when they were between 3 and 6 months old.     

Current British veterinary attitudes to perioperative analgesia for dogs.

In March 1996, a questionnaire was sent to 2000 veterinary surgeons, primarily involved in small animal practice, to assess their attitudes to perioperative analgesic therapy in dogs, cats and other small mammals. This paper is concerned only with the data relating to dogs. The veterinary surgeons considered that pain was a consequence of all the surgical procedures specified, but there were differences in their treatment of pain. Some veterinarians considered that a degree of pain was necessary postoperatively to prevent excessive activity. In general, women and more recent graduates assigned higher pain scores to the procedures and were more likely to treat the pain with analgesics. A significant number of veterinarians consider the use of opiates or non-steroidal anti-inflammatory drugs before surgical procedures, but relatively few appear to use combinations of different classes of analgesics either before or after operations.     

Frequency of canine and feline tumors in a defined population.

The Tulsa Registry of Canine and Feline Neoplasms was the second animal tumor registry in the United States concerned with a defined population in a delimited geographic area. Only tumors histologically confirmed by registry pathologists were included in frequency statistics based on the annual dog and cat population presented to veterinarians. During the first registry year, about 1% of the 63,504 dogs and 0.5% of the 11,909 cats had one or more primary tumors. While the incidence rate for malignant tumors in dogs was similar to that in cats, the incidence of benign tumors of dogs was over 10 times that of cats. The most common tumors were sebaceous adenoma in dogs and lymphosarcoma in cats. Mammary cancer was the most common malignant tumor in dogs. Mammary tumors of female dogs were significantly more frequent in Pointers, Poodles and Boston Terriers, in that order, than in other breeds. A greater incidence of mammary tumors among intact compared to spayed female dogs was seen for virtually every age group except in the Pointer breed.     

Survey of intradermal skin testing practices in North America

Allergic skin diseases are commonly diagnosed by veterinarians. Inhalant-related allergic diseases are especially prevalent in companion animal species. Intradermal skin testing (IDST) is the usual method for diagnosis of these syndromes, and is often followed by hyposensitization treatment if an animal reacts to substances during testing. A mail survey of veterinarians in the United States and Canada was conducted to determine current procedures in use for IDST and opinions on results of IDST and hyposensitization. Results of the survey indicate that IDST procedures are not currently standardized and that there is wide variation in the methods used. Opinion regarding results of skin testing and hyposensitization was largely in agreement with previously published patient studies.     

Recent veterinary graduates over the last five decades: the first 10 years

OBJECTIVE: To describe changes that have occurred over the last five decades in the career paths of veterinarians during the first 10 years after they graduated. DESIGN: A questionnaire, sent by mail. PROCEDURE: A questionnaire seeking information on experiences as a recent graduate was sent to about 100 veterinarians who graduated in or about 1950, 1960, 1970, 1980, 1990 and 2000, and 68% responded. Data were entered onto an Excel spreadsheet, and analysed with the SAS System 8 for Windows. RESULTS: Fifty years ago, about half of the graduates worked initially for a government under a cadetship contract. About half of them then left the government, mainly for mixed practice, and > 40% of the cohort remained in mixed practice. Cattle were > 40% of the case-load over the first 10 years, and dogs and cats were 22% at both the first and tenth year. For graduates of 1970, the percentage in government service remained at 27 to 28% over the 10 years, but that in mixed practice decreased from 51 to 25% between the first and fifth year, and was then fairly constant. The percentage in small animal practice, much higher than for graduates of 1950 and 1960, was 37% in the first year, and 45% in the tenth year. Overall dogs and cats increased from 34 to 47% and that of cattle decreased from 39 to 25% of the case-load between the first and tenth year. The graduates of 1990 continued the trends towards an exodus from mixed practice, and decrease in cattle (19 to 9%) and increase in dogs and cats (63 to 79%). Data from graduates of 2000 point to a continuation of these trends. Female graduates tended to concentrate in small animal practice in each of the 10 years after they graduated. CONCLUSIONS: Over the last five decades, the career paths of veterinary graduates over their first 10 years have increasingly involved (a) leaving initial positions in mixed practice, (c) less work with production animals, and (c) more work with dogs and cats.     

Homemade diets: attributes, pitfalls, and a call for action

At one time, it was estimated that the majority of dogs and cats in the United States received 90% or more of their nutrition from complete and balanced commercially prepared foods, and this estimate was reaffirmed in a 2004 survey. However, 4 years and several pet food and treat recalls later, fewer pet owners are feeding commercial pet food products exclusively and more are asking questions and looking for alternatives. As in any market-driven economy, there are many more alternative diets and food products available today from which pet owners may select. A difficult to measure but growing number of clients are feeding homemade diets that provide 100% of their pet's nutrition, while a larger number are feeding a combination of products, treats, and home prepared meals. Most practitioners can attest to this increase in their client's interest in homemade meals and to having insufficient knowledge to assist them. At a time when motivated clients are considering homemade for their pets as an alternative, veterinarians are less than adequately versed in canine and feline nutrition and dietary options. The article addresses the two most important health issues concerning pet owners and veterinarians about homemade diets: nutritional integrity and food safety.     

Estimate of the annual economic impact of treatment of cranial cruciate ligament injury in dogs in the United States

OBJECTIVE: To estimate the economic impact to veterinary clients for the medical and surgical treatment of rupture of the cranial cruciate ligament (RCCL) in dogs for the year 2003. DESIGN: Economic impact survey. SAMPLE POPULATION: 501 diplomates of the American College of Veterinary Surgeons (ACVS) indicating that their area of surgical emphasis was small animal orthopedic surgery or small animal general and orthopedic surgery and 4,000 veterinarians indicating to the AVMA that their professional area was small animal practice exclusive or mixed animal practice (at least 80% small animal). PROCEDURE: Veterinarians were surveyed concerning the cost for medical and surgical treatment of RCCL for 2003. The economic impact was calculated by multiplying the number of RCCL surgeries performed by the mean cost of surgery. This was added to the number of RCCL cases managed medically multiplied by the mean cost of medical management. This estimate for survey responders was extrapolated to the total number of veterinarians in the study population for the ACVS or AVMA. RESULTS: Estimates for the total cost of surgery were $171,730,134.72 and $1,020,167,907 for veterinarians in the ACVS and AVMA populations, respectively. The cost of medical management was $2,885,687.86 and $126,558,155.16 for veterinarians in the ACVS and AVMA populations, respectively. After combining the ACVS and AVMA populations, we estimated that owners spent $1.32 billion for the treatment of RCCL in the United States in 2003. CONCLUSIONS AND CLINICAL RELEVANCE: RCCL is a prevalent, costly injury. Results may motivate veterinary and consumer agencies to prioritize funding for a better understanding of the injury.     

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.     

Clinical features and outcome in dogs and cats with obsessive-compulsive disorder: 126 cases (1989-2000)

OBJECTIVE: To determine clinical features and outcome in dogs and cats with obsessive-compulsive disorder (OCD). DESIGN: Retrospective study. ANIMALS: 103 dogs and 23 cats. PROCEDURES: Records of patients with OCD were analyzed for clinical features, medication used, extent of behavior modification, and outcome. RESULTS: Most dogs affected with OCD had been obtained from breeders. Male dogs significantly outnumbered females (2:1). Female cats outnumbered male cats by 2:1 in a small sample. Most affected dogs lived in households with 2 or more humans and other dogs or cats, and had some formal training. Client compliance with behavior modification was high. A combination of behavior modification and medication resulted in a large decrease in intensity and frequency of OCD in most animals. Clomipramine was significantly more efficacious for treatment in dogs than was amitriptyline. Only 1 dog and 1 cat were euthanatized because of OCD during the study. CONCLUSIONS AND CLINICAL RELEVANCE: OCD in dogs does not appear to be associated with lack of training, lack of household stimulation, or social confinement. In cats, OCD may be associated with environmental and social stress. Obsessive-compulsive disorder appears at the time of social maturity and may have sporadic and heritable forms. With appropriate treatment (consistent behavior modification and treatment with clomipramine), frequency and intensity of clinical signs in most dogs and cats may decrease by > 50%. Success appears to depend on client understanding and compliance and the reasonable expectation that OCD cannot be cured, but can be well controlled.     

Demographic trends for animal care and control agencies in Ohio from 1996 to 2004

OBJECTIVE: To examine changes between 1996 and 2004 in regard to numbers of animals handled, medical care provided, expenses, numbers of employees, and agency policies for animal care and control agencies in Ohio. DESIGN: Cross-sectional survey. SAMPLE POPULATION: 223 animal care and control agencies. PROCEDURES: A questionnaire was mailed to animal care and control agencies in Ohio to collect information for 2004; results were compared with published results of a similar survey. RESULTS: 165 of the 223 (74%) agencies responded. Estimated total number of animals handled in 2004 was 315,519, which represented a decrease of 7% compared with 1996. However, although number of dogs taken in decreased 17%, number of cats taken in increased 20%. Between 1996 and 2004, the euthanasia rate decreased from 65.3% to 56.8%, and the adoption rate increased from 24.5% to 33.6%. Number of dogs euthanatized decreased 39%, but number of cats euthanatized increased 14%. The proportion of agencies with a spay-neuter policy increased from 56% to 71%, and the proportion that maintained an association with a veterinarian increased from 39% to 80%. For dogs handled by county dog warden agencies, the odds of euthanasia were higher if the agency did not have a spay-neuter policy (odds ratio, 1.36). CONCLUSIONS: Results suggest that the status of dogs handled by animal care and control agencies in Ohio improved between 1996 and 2004, but that the status of cats deteriorated.     

World Wide Web-based survey of vaccination practices,postvaccinal reactions,and vaccine site-associated sarcomas in cats

OBJECTIVE:To quantify incidence of vaccination practices, postvaccinal reactions, and vaccine site-associated sarcomas in cats. DESIGN: Epidemiologic survey. Animals-31,671 cats vaccinated in the United States and Canada by veterinarians with World Wide Web access. PROCEDURE: Veterinarians used secure Web-based survey forms to report data regarding administered vaccines, postvaccinal inflammatory reactions, vaccine site-associated sarcomas, and detailed information and history on each sarcoma. Data were collected from Jan 1, 1998 to Dec 31, 2000, allowing a 1- to 3-year follow-up of vaccinated cats. RESULTS: Participants reported administering 61,747 doses of vaccine to 31,671 cats; postvaccinal inflammatory reactions developed in 73 cats (11.8 reactions/10,000 vaccine doses), and qualifying vaccine site-associated sarcomas developed in 2 cats (0.63 sarcomas/10,000 cats; 0.32 sarcomas/10,000 doses of all vaccines). CONCLUSIONS AND CLINICAL RELEVANCE: These findings indicate that the incidence of vaccine site-associated sarcomas is low and is not increasing. Thoughtful consideration of the relative risks and benefits of specific vaccines remains the best means of reducing the incidence of sarcomas. It is not necessary to remove postvaccinal granulomas unless malignant behavior is apparent or they persist > 4 months.     

Pain alleviation in animals: attitudes and practices of Finnish veterinarians

A questionnaire was sent to 911 Finnish veterinarians to assess their attitudes and practices to pain relief in animals. Responses to statements about recognition and treatment of pain were either to agree or to disagree. The pain caused by specified surgical and clinical conditions was rated. Inquiries were also posed about the number of analgesics available and their use in specific surgical procedures and clinical situations. The questionnaires were returned by 441 respondents. Women and younger veterinarians generally rated pain higher and treated it more frequently than men and older colleagues. Younger veterinarians and those in larger practices also had more analgesics available than older veterinarians and those in smaller practices. Respondents agreed with the statement that relieving pain is beneficial for animals. However, large differences were present in the frequency of use of pain alleviation between different animal species undergoing similar operations and between clinical conditions scored equally in the numerical rating of pain. The severity and clinical relevance of feline pain is probably often underestimated, as cats were less likely to receive analgesics than dogs after similar operations.     

Factors affecting the use of postincisional analgesics in dogs and cats by Canadian veterinarians in 2001

Factors affecting the postincisional use of analgesics for ovariohysterectomy (OVH) in dogs and cats were assessed by using data collected from 280 Canadian veterinarians, as part of a national, randomized mail survey (response rate 57.8%). Predictors of analgesic usage identified by logistic regression included the presence of at least 1 animal health technician (AHT) per 2 veterinarians (OR = 2.3, P = 0.004), and the veterinarians' perception of the pain caused by surgery without analgesia (OR = 1.5, P < 0.001). Linear regression identified the following predictors of veterinarians' perception of pain: the presence of more than 1 AHT per 2 veterinarians (coefficient = 0.42, P = 0.048) and the number of years since graduation (coefficient = -0.073, P < 0.001). Some of these risk factors are similar to those identified in 1994. The results suggest that continuing education may help to increase analgesic usage. Other important contributors may be client education and a valid method of pain assessment.     

Reactions to tick antitoxin serum and the role of atropine in treatment of dogs and cats with tick paralysis caused by Ixodes holocyclus: a pilot survey

OBJECTIVE: To determine the incidence and nature of adverse reactions of dogs and cats to tick antitoxin serum and to re-evaluate the role of atropine in the treatment of tick paralysis. DESIGN: A retrospective questionnaire of veterinarians. PROCEDURE: Questionnaires were posted to 320 veterinarians in tick-endemic regions of Australia. Questions referred to dogs and cats treated for tick paralysis over a period of three years: the number treated, treatment protocols and adverse systemic reactions to tick antitoxin serum. Ninety completed questionnaires were returned and responses analysed. RESULTS: Veterinarians reported that approximately 3% of dogs exhibited adverse reactions immediately following treatment with tick antitoxin serum. Eighteen percent of these reactions were described as anaphylaxis, with the remaining 82% attributed to the Bezold-Jarisch reflex. Six percent of cats treated with tick antitoxin serum reacted adversely and the majority of reactions (63%) were ascribed to the Bezold-Jarisch reflex. Atropine was used routinely by 10% of responding veterinarians in the treatment of dogs and cats with tick paralysis. A similar number of veterinarians used atropine only in selected cases. Most veterinarians (76%) reported that they never used atropine in the treatment of tick paralysis in either dogs or cats. Within the survey population, premedication with atropine reduced the number of Bezold-Jarisch reactions following tick antitoxin administration approximately five-fold in dogs and four-fold in cats. CONCLUSIONS: Data from this pilot survey indicate that more cats than dogs have adverse systemic reactions to tick antitoxin serum and that the majority of these reactions in both dogs and cats could be related to the Bezold-Jarisch reflex. The number of reactions to tick antitoxin serum in dogs and cats could be significantly reduced by the routine use of atropine prior to administration of tick antitoxin serum.     

Animal abuse and family violence: survey on the recognition of animal abuse by veterinarians in New Zealand and their understanding of the correlation between animal abuse and human violence

AIMS: To establish the incidence, frequency and type of deliberate animal abuse seen in veterinary practice in New Zealand, and ascertain veterinarians' knowledge of human abuse within the families where animal abuse was occurring. To explore attitudes of veterinarians to and knowledge about the correlation between animal abuse and human violence, and their perceived role in dealing with such issues. METHODS: A postal questionnaire was sent to practising veterinarians in New Zealand. It covered demographics, frequency and type of animal abuse cases seen, awareness of violence towards humans, within families where animal abuse was seen, the methods used for managing animal and human abuse, the incidence of psychological abuse of animals, and the attitudes of veterinarians towards and their beliefs about the link between animal abuse and human violence. RESULTS: A total of 383/1,412 (27% response rate) questionnaires with useable data were returned. Within the group of respondents, the sexes were evenly represented; 40% of respondents worked in small-animal practice, 50% in mixed practice and 10% in large-animal practice. Deliberate animal abuse had been seen by 63% of respondents in the last 5 years; 37% of these had seen such cases once a year or less, while 9% had seen abuse cases at least four times a year. Dogs were the species most commonly reported as abused, followed, in numerical order, by cats, cattle and horses. Among respondents who had seen deliberate animal abuse, 16% either knew of (4%) or suspected (12%) human abuse within the families of the abused animals. A clear majority of responding veterinarians agreed with the statement that people who abuse their animals are more likely to abuse their children (77%) or spouse (70%). CONCLUSIONS: The survey indicated that the majority of respondents had seen cases of animal abuse within the previous 5 years, and dogs were the species most often reported abused. Responding veterinarians felt a strong ethical duty to deal with cases of animal abuse, but they were less comfortable about issues of human abuse, even though the awareness of the link between abuse of animals and abuse of humans was relatively high. CLINICAL RELEVANCE: The greater the awareness of animal abuse and its linkage with human abuse, the greater the possibility that veterinarians can contribute in a meaningful way to the reduction of violence in society.