A SURVEY OF VETERINARY RADIATION FACILITIES IN 2010

A survey of veterinary radiation therapy facilities in the United States, Canada, and Europe was done in 2010, using an online survey tool, to determine the type of equipment available, radiation protocols used, caseload, tumor types irradiated, as well as other details of the practice of veterinary radiation oncology. The results of this survey were compared to a similar survey performed in 2001. A total of 76 facilities were identified including 24 (32%) academic institutions and 52 (68%) private practice external beam radiation therapy facilities. The overall response rate was 51% (39/76 responded). Based on this survey, there is substantial variation among facilities in all aspects ranging from equipment and personnel to radiation protocols and caseloads. American College of Veterinary Radiology boarded radiation oncologists direct 90% of the radiation facilities, which was increased slightly compared to 2001. All facilities surveyed in 2010 had a linear accelerator. More facilities reported having electron capability (79%) compared to the 2001 survey. Eight facilities had a radiation oncology resident, and academic facilities were more likely to have residents. Patient caseload information was available from 28 sites (37% of radiation facilities), and based on the responses 1376 dogs and 352 cats were irradiated in 2010. The most frequently irradiated tumors were soft tissue sarcomas in dogs, and oral squamous cell carcinoma in cats.     

Equine external beam radiation therapy: Techniques and challenges

Radiation therapy is becoming increasingly more available and in demand for small animal veterinary cases. Although there is a demand for radiation therapy in large animal cases, there are certain limitations of external beam radiation therapy for horses that restrict treatment options. Currently, there are only five veterinary teaching hospitals in the United States where external beam radiation therapy can be performed on horses and other large animals. This is in contrast to the roughly 80 facilities, both academic and private, available for small animals. The goal of this commentary is to give a brief overview of external beam radiation therapy and highlight the steps involved, and the technical difficulties faced, while treating horses with external beam radiation therapy.     

Anesthetic and analgesic techniques used for dogs undergoing ovariohysterectomies in general practice in the United States

ObjectiveTo acquire information about anesthesia and analgesia protocols used by United States (US) veterinarians in primary care practices when performing routine ovariohysterectomy in dogs.Study designCross-sectional survey.PopulationPrimary care veterinarians in the US.MethodsAn online anonymous survey, originally created in New Zealand, was modified with permission and made available to Veterinary Information Network (VIN) members. The survey asked questions about performing ovariohysterectomy in healthy adolescent dogs in the categories of preanesthetic evaluation, premedication and induction protocols, maintenance protocols and monitoring equipment, and postoperative analgesic and sedation protocols and pain assessments.ResultsA total of 1213 US veterinarians completed the survey. Respondents (n; %) reported performing preoperative laboratory tests [packed cell volume (135; 11%), complete blood cell count (889; 73%) and biochemistry panels (1057; 87%)] and preanesthetic examinations on the morning of surgery (1083; 90%). The most commonly administered drugs for premedication were acepromazine (512; 42%), hydromorphone (475; 39%) or butorphanol (463; 38%), with propofol (637; 67%) for induction of anesthesia and isoflurane (882; 73%) for maintenance of anesthesia. Most veterinarians reported placing intravenous catheters (945; 78%), administering electrolyte solutions (747; 67%) and providing heat support (1160; 96%). Perioperative and postoperative analgesia included local anesthetics (545; 45%), opioids (844; 70%) and non-steroidal anti-inflammatory drugs (NSAIDs) (953; 79%); NSAIDs were dispensed for home use (985; 81%). Dogs were most frequently discharged on the day of surgery (1068; 88%) and the owners were contacted (914; 75%) for follow-up within 1–2 days.Conclusions and clinical relevanceAnesthetic management for routine ovariohysterectomy in dogs varies among US veterinary VIN members. Information from this study is useful for all veterinarians for comparison with their practice management and for teachers of veterinary anesthesia to continue to emphasize options for analgesia.     

THE CAREER PATH CHOICES OF VETERINARY RADIOLOGISTS

Concerns of a shortage of board certified specialists willing to work in academia have shadowed the medical and veterinary communities for decades. As a result, a number of studies have been conducted to determine how to foster, attract, and retain specialists in academia. More recently, there has been a growing perception that it is difficult for academic institutions to hire board certified veterinary radiologists. The objective of this study was to describe the career paths (academia vs. private sector) of veterinary radiologists and to determine what factors influenced their career path decisions. A mixed mode cross‐sectional survey was used to survey ACVR radiologists and residents‐in‐training, 48% (255/529) of which responded. There was a near unidirectional movement of radiologists from academia to the private sector: 45.7% (59/129) of the respondents who began their careers in academia had switched to the private sector while only 8% (7/88) had left the private sector for academia. If a shortage of academic radiologists exists, then perhaps the issue should be framed as a problem with retention vs. recruitment. The most influential factors in the decision to leave academia were remuneration (wages and benefits), lack of interest/enjoyment in research, geographical location, and family considerations. It is salient that average salaries increased by twofold after leaving academia for the private sector.     

A survey of current techniques in veterinary electrodiagnostics: EEG,spinal evoked and brainstem auditory evoked potential recording

A questionnaire on the techniques being used to record electroencephalograms, spinal evoked potentials and brainstem auditory evoked potentials was mailed to 34 neurologists at veterinary colleges and board certified veterinary neurologists in private practice in the United States and Canada. Nineteen replies (56%) were returned. A summary of the questionnaire is provided, which indicates the diversity of electrodiagnostic techniques currently used.     

Canine acute radiation dermatitis, a survey of current management practices in North America

Acute radiation‐induced dermatitis (ARID) is a common sequela of radiation therapy in dogs. There is no consensus regarding ARID management in human medicine and the standard of care in veterinary medicine has not been reported. The objective was to report the practice standards for ARID management in dogs in North America. The design used was a questionnaire survey. Fifty‐eight private and university teaching veterinary hospitals were contacted, 54 participated. The topical and oral medications used to treat ARID, prevent or treat bacterial infection, control pain and the indications for and timing of treatment initiation were the outcome measures. A minority of facilities (4/54, 7.5%) use exactly the same protocol regarding all parameters. There was agreement (>75% of facilities) with respect to the general use of oral antibiotics (77.8%), the need for pain control (92.6%) and the use of tramadol for pain control (76%), although the details of their use varied widely. There is a divergence of opinions regarding all details of ARID management in dogs except the general use of oral antibiotics and pain control medications.     

Fish Disease and Biosecurity: Attitudes,Beliefs, and Perceptions of Managers and Owners of Commercial Finfish Recirculating Facilities in the United States and Canada

Abstract

In recirculation finfish facilities in the United States and Canada, biosecurity utilization is neither consistent nor uniform. Seeking reasons for this situation, we examined the beliefs, perceptions, and attitudes of managers and owners of such facilities about fish disease and biosecurity utilization. A questionnaire was mailed in the fall of 2001 to the managers and owners of 152 finfish-rearing recirculation facilities in the United States and Canada to gather information on their attitudes, beliefs, and perceptions regarding fish disease and biosecurity. The response rate to the survey was 86%. This paper reports on a subset of the overall responses, the responses of managers and owners who identified their facility as a business operation. Although respondents had a positive attitude towards biosecurity utilization, they had different beliefs about which disease types were of greatest concern for their farm. Respondents also had differing perceptions on the risk of disease transmission associated with different activities on their farms. In addition, respondents had various beliefs about the practicality and effectiveness of different biosecurity measures and why the practice of biosecurity was important to their farms. This study gives quantitative evidence that different fish farmers perceive disease and the practice of biosecurity differently. This study indicates that recognition of the human dimensions element is an important first step in the creation of biosecurity policies, strategies, and procedures that will be readily accepted and implemented and consistently applied by fish farmers on their farms. The findings challenge the heretofore traditionally accepted belief that poor biosecurity practice on a farm is primarily related to lack of knowledge about biosecurity.     

Promotion of Private Veterinary Practice in Ghana: Perceptions of Veterinarians and Veterinary Technicians

A study was designed to identify factors perceived by veterinarians and veterinary technicians as likely to promote private veterinary practice in Ghana. The participatory appraisal approach was used. The response rates were 88% (n = 90), 100% (n = 9) and 86% (n = 200) for government field veterinarians, private veterinarians and government veterinary technicians, respectively. Significant proportions of government field veterinarians (67%, n = 79), and veterinary technicians (64%, n = 167) were willing to go into private practice if the necessary push was given. Factors perceived as likely to motivate them to go into private practice included availability of capital to cover start-up costs; provision of a vehicle; prospect of higher income; availability of loans with low interest rates; availability of credit facilities from suppliers; stable macroeconomic environment with low interest and inflation rates; high pet, poultry and livestock populations at locations earmarked for private practice; leasing of vacant government premises for use as clinic and for accommodation; and enforcement of legislation on private practice, especially that against moonlighting by government veterinarians and technicians. These should be considered and used in the promotion of private veterinary practice in Ghana.     

Survey of academic veterinarians' clinical practice in cardiopulmonary–cerebral resuscitation

Objective: To document the clinical practice of cardiopulmonary–cerebral resuscitation (CPCR) among academic veterinarians. Design: Survey. Setting: Eight colleges of veterinary medicine in the United States. Subjects: Two hundred and one academic veterinarians. Interventions: The survey was distributed by hand by the authors into the mailboxes of small animal faculty, residents, and interns. Demographic variables, questions regarding number of cardiopulmonary arrests (CPA) supervised and number successful, do not attempt resuscitation discussions, and Likert‐style questions about client presence during CPCR, appropriateness of CPCR, and CPCR decision‐making were included. Multiple linear regression models were constructed to determine the effect of multiple questions on different target variables of interest. Measurements and main results: Numerous differences were noted based on institution, gender, specialty, and position. Most institutions did not have a standard resuscitation consent form. Most respondents believed the client, house officer, and senior clinician should determine whether to perform resuscitation or not. Quality of life was the most significant determinant of whether to resuscitate or not, followed by long‐term prognosis, then short‐term prognosis. Conclusions: Veterinarians differ in many aspects of their approach to CPA and resuscitation. Creating consensus within the veterinary profession would benefit client service and patient care.     

A retrospective analysis of radiation oncology related scientific articles in the journal Veterinary Radiology and Ultrasound: Trends over 40 years (1976‐2015)

The journal Veterinary Radiology & Ultrasound is a veterinary specialty journal devoted to the fields of veterinary diagnostic imaging and radiation oncology. The purpose of this retrospective, observational study is to evaluate progressive trends in radiation oncology articles published in Veterinary Radiology & Ultrasound during the 40‐year period (1976‐2015) and describe a shift of trends through several viewpoints. This 40‐year period was divided into four subperiods: Period 1 (1976‐1985), Period 2 (1986‐1995), Period 3 (1996‐2005), and Period 4 (2006‐2015). These articles were divided into six categories based on the nature of the study: 1) studies related to teletherapy with endpoints being patient outcome, 2) radiation therapy dosimetry/planning, 3) patient setup, 4) reviews, 5) case reports, and 6) others. The number of radiation oncology articles in Veterinary Radiology & Ultrasound has increased over the 40‐year period. The number of authors per article has increased between Periods 1 and 3. The number of articles related to linear accelerator has increased between Periods 3 and 4. The median number of treated patients per clinical article related to teletherapy ranged from 15 to 21, which has not changed significantly over the 40‐year period. The most commonly used radiation therapy protocols during Periods 2 and 3 were fine‐fractionated protocols (defined as 10 or more fractions), whereas coarse‐fractionated protocols were more common during Periods 1 and 4. Findings from this study highlight the notable changes of trends in veterinary radiation oncology articles published in Veterinary Radiology & Ultrasound, which clearly reflect changes in the field of veterinary radiation oncology during the past 40 years.     

ACVIM small animal consensus statement on safe use of cytotoxic chemotherapeutics in veterinary practice

The purpose of this report is to offer a consensus opinion of ACVIM oncology diplomates and technicians on the safe use of cytotoxic chemotherapeutics in veterinary practice. The focus is on minimizing harm to the personnel exposed to the drugs: veterinary practitioners, veterinary technicians, veterinary staff, and pet owners. The safety of the patient receiving these drugs is also of paramount importance, but is not addressed in this statement. Much of the information presented is based on national recommendations by Occupational Safety and Health Administration, National Institute for Occupational Safety and Health, United States Pharmacopeia, and other published regulations. These directives reflect an abundance of caution to minimize exposure to medical personnel, but large‐scale studies about the consequences of long‐term occupational exposure are not available in veterinary medicine. Challenges in the delivery of optimal treatment safely and economically to veterinary patients in general practice without access to a veterinary oncologist or other specialist, because of costs or proximity, remain.     

Internationalizing veterinary education in the 21st century

This paper presents the results of a survey conducted in the spring of 2001 to assess international activities at colleges of veterinary medicine in North America. A questionnaire was sent to all 31 colleges of veterinary medicine in the United States and Canada, of which 22 responded. Of those schools responding to the survey, 86% have International Veterinary Medicine (IVM) programs and most have faculty involved in internationally oriented research (95%), in teaching IVM (74%), in mentoring veterinary students in IVM (84%), and in international consultancies (84%). Funding sources for faculty international activities include foundations, intramural funds, curriculum development grants, endowment/development funds, and sabbaticals. Foreign animal diseases are the most commonly taught international topic. The increasing importance of international veterinary issues is leading to the internationalization of the veterinary education in North America. Most IVM programs include activities of both faculty and students. Greater collaboration between faculty and programs across schools would allow schools to benefit from each other's strengths in IVM education.     

Retention of surgery specialists in academia: a critical agenda

Recruitment and retention of specialists to academia appears to be a growing problem in university teaching hospitals. Members of the American College of Veterinary Surgeons (ACVS) believe that the movement of surgery specialists to practice may have an impact on the training of veterinary students and surgery residents. To address these concerns, 1,071 ACVS diplomates and 60 department heads and hospital directors from all veterinary schools in North America were surveyed to determine whether a problem exists, the extent of the problem, and potential reasons for migration of specialists to practice. Responses were obtained from 620 ACVS diplomates (58 per cent) and 38 department heads and hospital directors (63%) from 28 different universities. The responses confirmed a net movement of surgery specialists from academia to practice. Eighty seven percent of department heads and hospital directors believed there was a shortage of small animal surgery specialists in academia; this information was supported by the fact that 47% responded that they had open positions and 68% had difficulty filling positions in the last five years. The demand was slightly less for large animal surgery specialists, and 42 per cent of respondents indicated that they had open positions. Financial considerations were the most common reason for surgery specialists to move from academia to private practice. Seventy-six percent of responding ACVS diplomates in private practice had a total compensation package valued at greater than $125,000 per year, whereas 77.8% of diplomates in academia had total compensation valued at $125,000 or less. Most universities offer starting salaries (not including benefits) for recently certified surgery specialists ranging from $70,000 to $90,000. Reasons for moving from academia to practice besides financial considerations included undesirable location of university hospitals; lack of interest in research; and a belief that university administration was not supportive of surgery specialists. Many academic surgery specialists were frustrated by the requirement for productivity in research, teaching, and service for promotion in tenure-track positions.     

Racial, cultural, and ethnic diversity within US veterinary colleges

A comprehensive survey containing 30 questions regarding racial, cultural, and ethnic issues was sent electronically to each of the member colleges within the Association of American Veterinary Colleges (AAVMC) during 2005. Responses were received from 25 of the 28 veterinary colleges in the United States and two foreign colleges. Most colleges had more than one respondent complete the survey. Since the respondents were not identified and were not uniform in regards to position within each college, some responses might have reflected the individual respondent's views rather than the college's actual situation or philosophy. The information gained from this survey demonstrates strong trends in attitudes to and practices with respect to diversity in US veterinary colleges. Three major areas were addressed in the survey-college and university environment and cultures, faculty and curriculum, and recruitment and retention of veterinary students from underrepresented minorities. In many instances, the survey confirmed a lack of knowledge about diversity issues at the respondents' institutions. These survey results will serve as a benchmark for gauging changes in the profession's racial, cultural, and ethnic demographics in the future and as a foundation upon which to build effective diversity programs.     

Training the veterinary public health workforce: a review of educational opportunities in US veterinary schools

This article presents the results of an Internet-based review conducted in January and February 2003 to assess the educational opportunities available in veterinary public health, epidemiology, and preventive medicine at the 27 veterinary schools in the United States. Most professional veterinary curricula are designed to train students for careers as highly qualified private practitioners, although there is an increased need for veterinary perspectives and contributions in the public health sector. The future of veterinary public health relies on the opportunities available in education to teach and encourage students to pursue a career of public service. The results of this review indicate the availability of a wide variety of required courses, electives, and post-graduate training programs to veterinary students in the United States. Veterinary students are exposed to a median of 60 hours of public health, epidemiology, and preventive medicine in required stand-alone courses in these areas. Four veterinary schools also have required rotations for senior students in public health, preventive medicine, or population medicine. Contact time for required public health, epidemiology, and preventive medicine courses ranges from 30 to 150 contact hours. Advanced training was available in these subjects at 79% of the 27 schools. Greater collaboration between veterinary schools, schools of public health, and the professional public health community will increase exposure to and opportunities in public health to all future veterinarians.     

Academic and private practice partnerships in veterinary radiology residency training

As veterinary radiologists devote greater time to telemedicine consultation, residency training must evolve to reflect the skills of these services. The contribution of private practice/consultant radiologists to residency training has traditionally been minimal but academic and private practice partnerships in education and research can provide the framework for a well‐rounded residency. These partnerships can also lessen the impact of workforce shortages in academia and provide financial compensation to academicians through external consultation. The purpose of this commentary is to review existing collaborative interactions between academic and private practice veterinary radiologists; with a focus on ways to sustain, improve, and cautiously increase the number of veterinary radiology training programs.     

The future of specialty practice

The delivery of veterinary care to companion animals by board-certified clinical specialists in private practice in the United States has grown dramatically since 1990. Virtually all mid-sized to large metropolitan areas are served by clinical specialists, frequently in multiple locations. Private specialty practice is highly fragmented, and very few data exist regarding the dynamics of this segment of the profession. This article is based on the personal opinions of the author, acquired through observation and experience.     

Survey of veterinary extension in the United States

OBJECTIVE: To assess veterinary extension in the United States as perceived by veterinary extension personnel. DESIGN: Cross-sectional survey. SAMPLE POPULATION: Extension veterinarians in the United States. PROCEDURE: 2 surveys were designed and mailed to extension veterinarians listed by the USDA and the American Association of Extension Veterinarians. RESULTS: 34 states had > or = 1 extension veterinarian. The majority (> 60%) of extension veterinarians did not commit time to resident education and were not involved in research activities. Paradoxically, 23% of responding extension veterinarians did not report extension work. Programs for food animal producers, horse owners, and companion animal owners were provided by 100, 63, and 37% of states, respectively. Continuing education (CE) programs were provided for food animal veterinarians, equine veterinarians, and companion animal veterinarians by 96, 63, and 52% of states, respectively. Challenges facing veterinary extension included limited recognition of veterinary extension activities by universities, lack of university personnel to support CE programs, and decreased support for companion animal extension programs. CONCLUSIONS AND CLINICAL RELEVANCE: Extension veterinarians need to identify and clearly articulate the mission of veterinary extension, develop more collaborative programs across regions, and continue to serve as catalysts to bring diverse constituents together. Extension veterinarians must distinguish their mission not solely as information transfer, which can be accomplished in a variety of ways outside of extension, but as a coherent and consistent program of education and policy developed on a national level and distributed locally.