The application of medical informatics to the veterinary management programs at companion animal practices in Alberta,Canada: A case study

Companion animals closely share their domestic environment with people and have the potential to, act as sources of zoonotic diseases. They also have the potential to be sentinels of infectious and noninfectious, diseases. With the exception of rabies, there has been minimal ongoing surveillance of, companion animals in Canada. We developed customized data extraction software, the University of, Calgary Data Extraction Program (UCDEP), to automatically extract and warehouse the electronic, medical records (EMR) from participating private veterinary practices to make them available for, disease surveillance and knowledge creation for evidence-based practice. It was not possible to build, generic data extraction software; the UCDEP required customization to meet the specific software, capabilities of the veterinary practices. The UCDEP, tailored to the participating veterinary practices’, management software, was capable of extracting data from the EMR with greater than 99%, completeness and accuracy. The experiences of the people developing and using the UCDEP and the, quality of the extracted data were evaluated. The electronic medical record data stored in the data, warehouse may be a valuable resource for surveillance and evidence-based medical research.     

Avian anaesthesia related mortality and the associated risk factors in a UK zoological collection

ObjectiveTo analyse avian anaesthesia-related mortality in a UK zoological collection over a 5-year period and identify risk factors for mortality.Study designRetrospective cohort study.AnimalsA total of 135 individual birds across 37 species, anaesthetized during 206 events in a UK zoological collection between 1 January 2014 and 30 June 2019 (inclusive).MethodsAnaesthesia records were reviewed and variables such as age, body condition, weight, sex, duration of anaesthesia and health status were collated. Anaesthesia-related mortality was defined as those deaths occurring during anaesthesia and up to 7 days postanaesthesia. Outcome was analysed using multivariable conditional logistic regression. Overall mortality was defined and included birds euthanised during anaesthesia for non-anaesthesia related reasons. Data were summarised as median (range). A value of p < 0.05 was considered significant. Relative risks and 95% confidence intervals (95% CI) were calculated for the association between risk factors and anaesthetic death where a statistically significant difference was found.ResultsThe overall mortality rate was 10.19% (95% CI = 6.06–14.3%), while anaesthesia-related mortality was 3.88% (95% CI = 1.69–7.51%). Birds with an abnormal health status had a 15.53-fold (95% CI = 1.95–123.63) increased risk of death compared with those with a normal health status. The duration of anaesthesia was also a statistically significant risk factor (p = 0.021) in the univariable analysis, but not when combined with health status. No other variables were associated with anaesthesia-related mortality.Conclusions and clinical relevanceAbnormal health status and longer anaesthetic procedures were associated with a significantly increased risk of anaesthesia-related death in this population of birds. It is recommended that anaesthetic duration is minimized, and pre-existing diseases are diagnosed where possible prior to general anaesthesia of birds. Anaesthetizing healthy birds was associated with a low risk of mortality.     

Associations of veterinary services and farmer characteristics with the prevalences of brucellosis and border disease in small ruminants in Spain

We investigated the farm factors associated with the prevalences of brucellosis and border disease (BD) in small-ruminant herds in the Madrid region of Spain. These infections were used as models of diseases of well-known and totally unknown distribution, respectively, to assess the association between the perception of the importance of a given disease on the relative contributions of veterinary services and the farmer's attitudes to its prevention. Sera, farming-management information and data concerning veterinary assistance and farmer characteristics were collected from 60 sheep or goat herds. The overall sero-prevalence of brucellosis was 5.7% (complement fixation) and for BD was 17.9% (ELISA test). The relationship between sero-positivity and the variables in the questionnaire was assessed by multivariable analysis using random-effects logistic-normal regression. ‘Availability of veterinary services' was a major protective factor for brucellosis. In contrast, no association with veterinary services was observed for BD, whereas ‘membership in a farmers' organization' (a variable associated with good farming practice and animal care) was a protective factor. ‘Membership of a farmers' organisation' and two other farmer variables indicative of good husbandry (‘youth' and ‘schooling') were associated with a lower sero-prevalence of brucellosis in univariable analysis but they did not remain significant in the multivariable model. Our observations suggest that veterinary-activity variables predominate over non-specific protective farm factors related to good husbandry in the case the disease is subject to disease surveillance. This underscores the importance of organized control programs for veterinary services to be effective in terms of animal disease prevention.     

Descriptive epidemiological study of the use of antimicrobial drugs by companion animal veterinarians in New Zealand

Abstract

AIM: To describe the patterns of use of antimicrobial drugs by veterinary surgeons treating commonly presented bacterial infections in companion animals in New Zealand.

METHODS: A postal survey of 800 randomly selected companion animal veterinarians practicing in New Zealand was conducted between August and December 2008. Data were collected regarding the antimicrobials prescribed for recent cases of skin, ear and urinary tract infections; the use of culture and susceptibility testing; and veterinarian characteristics such as proportion of time spent treating companion animals and recent attendance at continuing professional development (CPD) events. Potential associations within the data were explored using extended mosaic plots and multivariable regression models.

RESULTS:Completed surveys from 393 respondents were available for analysis, providing data on systemic antimicrobial drug use for 1,799 cases of presumptive bacterial infections. The most frequently prescribed drugs were amoxicillin-clavulanic acid (864 cases, 48%), cephalexin (558, 31%), and fluoroquinolones (198, 11%). Of 359 cases of canine superficial pyoderma, 157 (44%) were treated with amoxicillin-clavulanic acid and 155 (43%) were treated with cephalexin with median reported treatment durations of 7 and 10 days, for these two drugs respectively. Culture and susceptibility tests had been used in 376 of 1,984 (19%) of all reported cases and 160 (43%) of these were suspected urinary tract infections. Practitioners that spent 100% of their time treating companion animals and who had attended a CPD course related to companion animals within the 12 months prior to completing the survey were more likely to submit a sample for culture and susceptibility testing and to prescribe longer courses of antimicrobials for the treatment of canine pyoderma than practitioners who spent less than 100% of their time treating companion animals and had not attended a CPD course in the last 12 months.

CONCLUSIONS: Broad-spectrum drugs considered by the World Health Organisation to be critically important for human health, such as fluoroquinolones and amoxicillin-clavulanic acid, are amongst the most frequently prescribed antimicrobials in companion animal medicine, and these drugs are often prescribed without submitting a sample for culture and susceptibility testing.

CLINICAL RELEVANCE: Many cases of superficial pyoderma were treated for less than the recommended duration of 21 days, which may contribute to a higher rate of recurrent pyoderma and the development of drug resistance within the causal bacteria. Veterinarians should be aware that the use of fluoroquinolones, in particular, should be based upon the results of a culture and susceptibility test.     

Analysis of the costs of veterinary education and factors associated with financial stress among veterinary students in Australia

Objective

To investigate the course‐related and other costs involved in obtaining a veterinary education in Australia and how these costs are met. The study also aimed to identify sociodemographic and course‐related factors associated with increased financial stress.

Methods

Students from seven Australian veterinary schools were surveyed using an online questionnaire. A total of 443 students participated (response rate 17%). Responses to survey items relating to finances, employment and course‐related costs were compared with sociodemographic factors and prior research in the area of student financial stress.

Results

Respondents reported spending a median of A$300 per week on living costs and a median of A$2,000 per year on course‐related expenses. Over half of respondents received the majority of their income from their parents or Youth Allowance (56%). A similar proportion (55%) reported that they needed to work to meet basic living expenses. Circumstances and sociodemographic factors linked to perceived financial stress included requiring additional finances to meet unexpected costs during the course; sourcing additional finances from external loans; an expected tuition debt at graduation over A$40,000; being 22 years or older; working more than 12 hours per week; living costs above A$300 per week; and being female.

Conclusion

The costs involved in obtaining a veterinary education in Australia are high and over half of respondents are reliant on parental or Government income support. Respondents with certain sociodemographic profiles are more prone to financial stress. These findings may have implications for the psychological health, diversity and career plans of veterinary students in Australia.     

Proportion of pet cats registered with a veterinary practice and factors influencing registration in the UK

Registration of a cat with a veterinary practice is likely to be a critical factor for access to key preventative medicine. A cross-sectional study was conducted to collect data in the United Kingdom on the registration status of cats and potential explanatory variables. These data were also used to identify potential sources of bias associated with selecting controls from veterinary registered populations of cats due to differences between registered and unregistered cats. Cat owners reported that 13.6% (84/616) of their cats had not been registered with a veterinary practice since living at their current address. Multivariable logistic regression indicated that unregistered cats were significantly more likely than registered cats to be entire, to have not been vaccinated within the previous year, to be living in households in Northern Ireland and in households with an annual income <￡10,000.(1) Whilst the neuter status and the vaccination status of the cat are likely to result from non-registration, the household location and annual income are factors that can be used to inform future interventions designed to increase the proportion of veterinary registered cats.     

Risk factors associated with the antimicrobial resistance of staphylococci in canine pyoderma

This study reports the susceptibility to antimicrobial agents of staphylococci (n=105) isolated from dogs, and the factors associated with this resistance. The study animals were 23 healthy dogs (group A), 24 with first-time pyoderma (group B), and 27 with recurrent pyoderma that had undergone long-term antibiotic treatment (group C). Staphylococci were more commonly isolated from the pyoderma-affected than the healthy dogs (p<0.0001). Some 78% of the isolates were resistant to at least one antimicrobial agent. Resistance to amoxicillin-clavulanate, cephalosporins (OR 4.29, 95% CI [1.15, 16.3] respectively), enrofloxacin (OR 9.47, 95% CI [1.53, 58.5]) and ciprofloxacin (OR 79.7 95% CI [3.26, 1947.4]) was more common among group C isolates. Some 32% of all the isolates were multiresistant (MR) and 10.4% were methicillin-resistant (MRS). The probability of isolating MRS staphylococci in group C increased by a factor of four (95% CI [1.18, 17.9]) compared to A plus B. Multi-resistant (MR) isolates were obtained more commonly from urban than rural dogs (OR 3.79, 95% CI [1.09, 13.17]). All the MRS staphylococci encountered were obtained from urban dogs and more commonly from male dogs (p=0.07). This study shows that dogs bred in urban habitat, with a history of antibiotic therapy in the past year represents significant risk of being carriers of isolates resistant to methicillin (MRS) and other antimicrobials. These factors should be considered before applying an antimicrobial treatment in veterinary clinics.     

Validation of the Warwick–Edinburgh Mental Well-being Scale (WEMWBS) as an overall indicator of population mental health and well-being in the UK veterinary profession

The Warwick–Edinburgh Mental Well-being Scale (WEMWBS) was evaluated as an indicator of mental health and well-being within the veterinary profession in a cross-sectional study among a representative sample of 3200 veterinary surgeons practising in the UK. The WEMWBS mean score for the sample was 48.85 (95% confidence interval 48.43–49.28). The score showed a negative correlation with anxiety and depressive symptoms and a positive correlation with favourable psychosocial working conditions. A 1 unit increase in score was associated with reduced odds of reporting having experienced suicidal thoughts in the previous 12 months, and reduced odds of reporting depressive or anxiety symptoms of clinical significance. The results support the validity of the scale as an overall indicator of population mental health and well-being for this occupational group.     

A case-control study of risk factors for brucellosis seropositivity in Portuguese small ruminants herds

A case–control study involving 255 small ruminants herds randomly selected was carried out in Portugal between January and December 2004, to identify risk factors associated with brucellosis seropositivity.

To achieve this objective, two groups of herds selected according their prevalence status were compared: “cases” (farms with seroprevalence higher than 5%, n = 123) and “controls” (farms seronegatives, n = 132). A carefully structured questionnaire was used to collect data from each herd. A statistical analysis to compare “case” versus “control” herds was performed with the variables obtained from the questionnaire and the seroprevalence results. The effects on seroprevalence of several variables such as: individual characteristics; farm management practices; farm characteristics; animal health; knowledge and characteristics of farmers were evaluated. Data were analysed using logistic regression. Univariable analysis was used to screen the variables used in the logistic regression model. Nine variables were associated with brucellosis seropositivity in univariable analysis p < 0.10. These variables were retained for multivariable logistic regression model. Regression model identified five variables as risk factors for seropositivity. The odds of brucellosis were increased: herds with more than 116 animals (OR = 2.99); in herds with no cleaned-watering places (OR = 3.05); in herds with insufficient manure removal and insufficient cleaning of premises (OR = 2.87); in introduction of animals from non-free brucellosis herds or from herds of unknown status (OR = 12.11). In the other hand, farmers’ age (the eldest) was related to decreased odds (OR = 0.4).

Potential risk factors identified in this study were consistent factors associated with brucellosis seropositivity and support current recommendations for the control of brucellosis. Considering the paucity of epidemiological reports on brucellosis in the Northeast of Portugal and the absence of any data concerning factors related to either the prevention or the spread of the disease, our results could make a useful contribution towards the prevention of small ruminants brucellosis in the area.     

A case-control study of factors associated with pelvic and tibial stress fractures in Thoroughbred racehorses in training in the UK

Few epidemiological studies have investigated risk factors for musculoskeletal injury occurring in Thoroughbred racehorses during training, although it is the major cause of wastage in the racing industry. We recently conducted a large-scale epidemiological study to estimate the incidence of fracture in racehorses in training in the UK and to identify associated risk factors. Thirteen racehorse trainers provided data on horses in their care, with daily recording of training information and provision of details on any fractures incurred. Data were collected for 2 years, including two consecutive flat racing seasons (1999 and 2000). This paper describes findings from a nested case-control study investigating factors associated with the occurrence of pelvic and tibial stress fractures in our study population. Cases were identified from the main study and defined as horses with a pelvic or tibial stress fracture, confirmed through routine diagnostic imaging. Randomly selected controls were matched on date of fracture in the case. Age and gender of the horse, its exercise history and training surfaces were examined as explanatory variables. Exercise was quantified as cumulative distances cantered and worked at high speed in 30- and 60-day periods prior to date of fracture in the case. Conditional logistic regression was used to construct multivariable models for the 30- and 60-day periods, respectively. We hypothesised that larger cumulative exercise distances would be associated with an increased risk of pelvic or tibial stress fracture and that different training surfaces would be associated with differences in fracture risk. In the 30-day period, when adjusting for trainer, the risk of pelvic or tibial stress fracture increased with increasing distance cantered, reaching a peak at around 50 km, after which the risk reduced. This trend was not obvious in the 60-day period, with no significant association between exercise distances and risk of stress fracture. Predominant use of one particular sand-based all-weather surface was related to an increased risk of pelvic or tibial stress injury, although this finding should be interpreted with caution. Surface maintenance and construction may play a role; variables that were not considered in the current analyses, which were based on a relatively small number of cases. Trainer was associated with differences in stress fracture risk after adjusting for exercise distances and surface but age and gender were not.     

A systematic review and meta-analysis of factors associated with anthelmintic resistance in sheep

Background

Anthelmintic drugs have been widely used in sheep as a cost-effective means for gastro-intestinal nematode (GIN) control. However, growing anthelmintic resistance (AHR) has created a compelling need to identify evidence-based management recommendations that reduce the risk of further development and impact of AHR.

Objective

To identify, critically assess, and synthesize available data from primary research on factors associated with AHR in sheep.

Methods

Publications reporting original observational or experimental research on selected factors associated with AHR in sheep GINs and published after 1974, were identified through two processes. Three electronic databases (PubMed, Agricola, CAB) and Web of Science (a collection of databases) were searched for potentially relevant publications. Additional publications were identified through consultation with experts, manual search of references of included publications and conference proceedings, and information solicited from small ruminant practitioner list-serves. Two independent investigators screened abstracts for relevance. Relevant publications were assessed for risk of systematic bias. Where sufficient data were available, random-effects Meta-Analyses (MAs) were performed to estimate the pooled Odds Ratio (OR) and 95% Confidence Intervals (CIs) of AHR for factors reported in ≥2 publications.

Results

Of the 1712 abstracts screened for eligibility, 131 were deemed relevant for full publication review. Thirty publications describing 25 individual studies (15 observational studies, 7 challenge trials, and 3 controlled trials) were included in the qualitative synthesis and assessed for systematic bias. Unclear (i.e. not reported, or unable to assess) or high risk of selection bias and confounding bias was found in 93% (14/15) and 60% (9/15) of the observational studies, respectively, while unclear risk of selection bias was identified in all of the trials. Ten independent studies were included in the quantitative synthesis, and MAs were performed for five factors. Only high frequency of treatment was a significant risk factor (OR = 4.39; 95% CI = 1.59, 12.14), while the remaining 4 variables were marginally significant: mixed-species grazing (OR = 1.63; 95% CI = 0.66, 4.07); flock size (OR = 1.02; 95% CI = 0.97, 1.07); use of long-acting drug formulations (OR = 2.85; 95% CI = 0.79, 10.24); and drench-and-shift pasture management (OR = 4.08; 95% CI = 0.75, 22.16).

Conclusions

While there is abundant literature on the topic of AHR in sheep GINs, few studies have explicitly investigated the association between putative risk or protective factors and AHR. Consequently, several of the current recommendations on parasite management are not evidence-based. Moreover, many of the studies included in this review had a high or unclear risk of systematic bias, highlighting the need to improve study design and/or reporting of future research carried out in this field.