Ecologic and symbiotic approaches to animal welfare, animal rights, and human responsibility

Veterinarians confronted with situations involving animal welfare, animal rights, and human responsibility assume practical importance in the relationships of veterinarians with clients and other constituencies. To help resolve these situations, the authors briefly compare economics and ethics and discuss the types of rights. An attempt is made to bring animal welfare and animal rights into the same conceptual framework, using an ecologic approach. This reaches the thesis that the less human beings allow animals the right of self-determination, the more we should exercise responsibility in their care and welfare. Actively exercised human responsibility in all uses of animals is offered as a practical and valid alternative to the extreme of abolitionism. This alternative also is applied in a cautionary way to the role of veterinary medicine in specieism. The veterinary profession is urged to be active in the middle ground of the field of animal rights and to firmly establish its relationships to animal welfare and human responsibility.     

Veterinary medicine protecting and promoting the public's health and well-being

Dr. Calvin Schwabe's vision of "One Medicine" has long inspired many in the public health community to strive toward bringing human and veterinary medicine together to improve the public's health and well-being around the world. In an increasingly human-dominated world, as Dr. Schwabe suggested many years ago, human health provides the most-logical unifying or apical cause in veterinary medicine's hierarchy of values. Veterinarians in all aspects of the profession-have opportunity and responsibility to protect the health and well-being of people in all that they do, including protecting food security and safety; addressing threats to antibiotic sensitivity; preventing and controlling zoonotic emerging infectious diseases; protecting environments and ecosystems; participating in bio- and agro-terrorism preparedness and response; using their skills to confront non-zoonotic diseases (such as malaria, HIV/AIDS, vaccine preventable diseases, chronic diseases and injuries); strengthening the public-health infrastructure; and advancing medical science through research. This article provides an overview of contributions made by veterinarians in each of these areas, and discusses the challenges to be overcome and the need for strategic thinking and action to achieve the vision of "one medicine".     

Vaccination against the feline immunodeficiency virus: the road not taken

Natural infection of domestic cats by the feline immunodeficiency virus (FIV) causes acquired immunodeficiency syndrome (AIDS). FIV is genetically related to human immunodeficiency virus (HIV), and the clinical and biological features of infections caused by feline and human viruses in their respective hosts are highly analogous. Although the obstacles to vaccinating against FIV and HIV would seem to be of comparable difficulty, a licensed vaccine against feline AIDS is already in widespread use in several countries. While this seemingly major advance in prevention of AIDS would appear to be highly instructive for HIV vaccine development, its message has not been heeded by investigators in the HIV field. This review endeavours to relate what has been learned about vaccination against feline AIDS, and to suggest what this may mean for HIV vaccine development.     

Computer applications. An overview

Applications are programs that are designed for specific tasks. They may be written by the ultimate user or by commercial programmers. Personally written software offers the benefit of a custom solution and adaptability to changing conditions but at a very high cost. Vendor software is cheaper, but more general in nature. It may be difficult for some practitioners to find commercial software that exactly duplicates their operation, and adaptations will add expense. Software maintenance may not be available or it may mean additional cost. Veterinarians can profit from practice management packages, computer-aided diagnostics, educational software, and other programs. Computers must solve the users' problems or they are worthless. With appropriate applications, they represent one of the most cost-effective instruments in the practice.     

The impact of zoonotic diseases transmitted by pets on human health and the economy

In the context of all causes of human morbidity and mortality, or even within the context of all infectious diseases affecting the public health, pet-associated zoonotic infections are of moderate importance. The data documented in Table 1, however, indicate that they do exact significant human health and economic costs. If complete data were available for all of the infections shown in Table 1, the costs would be considerably higher. Moreover, most of these diseases are preventable through educating the public, particularly pet owners, of the zoonotic potential of these diseases, so that they may take precautions to minimize the risks leading to infection. These measures include appropriate health care of pets to eliminate infectious agents, reducing the number of uncontrolled, ownerless pets as well as unwanted or poorly supervised pets, preventing pets from soiling public places with their feces, excluding animals from areas where children play, enforcing leash laws, and promoting responsible pet ownership. Veterinarians, physicians, and public health agencies can aid in these efforts; ultimately, however, the responsibility lies with the pet owner.     

AVMA guide for veterinary medical waste management

Lawmakers have enacted a variety of laws and regulations to ensure proper disposal of certain potentially infectious or otherwise objectionable waste. The veterinary medical profession supports scientifically based regulations that benefit public health. In 1988, Congress passed the Medical Waste Tracking Act, a federal program that mandates tracking certain regulated waste. Several types of waste generated in the typical clinical veterinary medical practice are considered regulated veterinary medical waste. Discarded needles, syringes, and other sharps; vaccines and vials that contained certain live or attenuated vaccines; cultures and stocks of infectious agents and culture plates; research animals that were exposed to agents that are infectious to human beings and their associated waste; and other animal waste that is known to be potentially harmful to human beings should be handled as regulated veterinary medical waste. Regulated veterinary medical waste should be handled with care. It should be decontaminated prior to disposal. The most popular, effective methods of decontamination are steam sterilization (autoclaving) and incineration. Chemical decontamination is appropriate for certain liquid waste. Waste should be packaged so that it does not spill. Sharps require rigid puncture- and leak-resistant containers that can be permanently sealed. Regulated veterinary medical waste that has not been decontaminated should be labeled with the universal biohazard symbol. Generators retain liability for waste throughout the entire disposal process. Therefore, it is essential to ensure that waste transporters and disposal facilities comply with state and federal requirements. Veterinary practices should maintain a written waste management program and accurate records of regulated veterinary medical waste disposal. Contingency planning and staff training are other important elements of a veterinary medical waste management program. The guide includes a model veterinary medical waste management program; however, it does not address all the variations in state and local regulations. Veterinarians should obtain copies of state and local laws and regulations and modify AVMA's model plan to create an individualized practice plan that complies with federal, state, and local laws and regulations. State and local veterinary medical organizations should monitor state and local regulation to influence decisions that affect veterinarians and to keep their members informed of changing requirements. Veterinarians and veterinary medical organizations must stay involved so that regulations do not unfairly burden the veterinary medical profession.     

Diseases transmitted from pets to man: an evolving concern for veterinarians.

Pets are not a major source of human infections but they can transmit certain diseases to man. This transmission usually is complex, requiring close contact with pets or their excretions and frequently involves a breach of sound hygienic practice. In some instances, pathogens of animal origin are acquired inadvertently because infectivity can persist after evidence of gross contamination has gone. Veterinarians participate in controlling zoonotic diseases by encouraging rabies vaccination and hygienic treatment of pet feces and urine, by supporting community efforts toward responsible pet ownership and by advising on precautions for handling sick animals. It is recommended that veterinarians discourage the keeping of wild or exotic animals as pets and excess fondling of pets (particularly by children and pregnant women). Clients and kennel workers should be advised to use caution with animals that have aborted.     

Hidden costs of food production: the veterinarian's role

Veterinarians who work in food-animal production and food safety help to deliver food policy by enabling farmers to supply safe, affordable food. However, existing food policy reflects a production bias and is increasingly being criticized for its hidden costs. These costs include reduced animal welfare, the inflated risk of anti-microbial resistance, and the current pandemic of human obesity and overweight. Veterinarians do not generally recognize that this is the context within which they do their work. In this article, I review this context and argue that veterinary students should be taught about it. I also argue that the profession should join with food-policy analysts, ethicists, and others who are already calling for a rethinking of food policy, so that new policy might meet the full wealth of problems and not just some.     

Antimicrobial drug use in veterinary medicine

Recognizing the importance of antimicrobial resistance and the need for veterinarians to aid in efforts for maintaining the usefulness of antimicrobial drugs in animals and humans, the Board of Regents of the American College of Veterinary Internal Medicine charged a special committee with responsibility for drafting this position statement regarding antimicrobial drug use in veterinary medicine. The Committee believes that veterinarians are obligated to balance the well-being of animals under their care with the protection of other animals and public health. Therefore, if an animal's medical condition can be reasonably expected to improve as a result of treatment with antimicrobial drugs, and the animal is under a veterinarian's care with an appropriate veterinarian-client-patient relationship, veterinarians have an obligation to offer antimicrobial treatment as a therapeutic option. Veterinarians also have an obligation to actively promote disease prevention efforts, to treat as conservatively as possible, and to explain the potential consequences associated with antimicrobial treatment to animal owners and managers, including the possibility of promoting selection of resistant bacteria. However, the consequences of losing usefulness of an antimicrobial drug that is used as a last resort in humans or animals with resistant bacterial infections might be unacceptable from a public or population health perspective. Veterinarians could therefore face the difficult choice of treating animals with a drug that is less likely to be successful, possibly resulting in prolonged or exacerbated morbidity, to protect the good of society. The Committee recommends that voluntary actions be taken by the veterinary profession to promote conservative use of antimicrobial drugs to minimize the potential adverse effects on animal or human health. The veterinary profession must work to educate all veterinarians about issues related to conservative antimicrobial drug use and antimicrobial resistance so that each individual is better able to balance ethical obligations regarding the perceived benefit to their patients versus the perceived risk to public health. Specific means by which the veterinary profession can promote stewardship of this valuable resource are presented and discussed in this document.     

A focus group study of veterinarians' and pet owners' perceptions of the monetary aspects of veterinary care

OBJECTIVE: To compare veterinarians' and pet owners' perceptions of client expectations with respect to the monetary aspects of veterinary care and identify challenges encountered by veterinarians in dealing with pet owners' expectations. DESIGN: Qualitative study based on focus group interviews. PARTICIPANTS: 6 pet owner focus groups (32 owners) and 4 veterinarian focus groups (24 companion animal veterinarians). PROCEDURES: Independent focus group sessions were conducted with standardized open-ended questions and follow-up probes. Content analysis was performed on the focus group discussions. RESULTS: Pet owners expected the care of their animal to take precedence over monetary aspects. They also expected veterinarians to initiate discussions of costs upfront but indicated that such discussions were uncommon. Veterinarians and pet owners differed in the way they related to discussions of veterinary costs. Veterinarians focused on tangibles, such as time and services. Pet owners focused on outcome as it related to their pet's health and well-being. Veterinarians reported that they sometimes felt undervalued for their efforts. A suspicion regarding the motivation behind veterinarians' recommendations surfaced among some participating pet owners. CONCLUSIONS: Results suggested that the monetary aspects of veterinary care pose barriers and challenges for veterinarians and pet owners. By exploring clients' expectations, improving communication, educating clients, and making discussions of cost more common, veterinarians may be able to alleviate some of the monetary challenges involved in veterinarian-client-patient interactions.     

Ocular manifestations of systemic disease in the dog and cat. Recent developments

The number of canine and feline clinical diseases that may be manifested as ocular dysfunction continues to increase. Veterinarians are often presented with sick patients who also have eye disease. Conversely, animals are examined for eye disease that on closer inspection also have a systemic illness. A decision must be made; is there a relationship between the observed ocular and systemic problem, or are they separate morbid processes? If they are related, can the ocular signs be used to better define the systemic illness, chart its course, or establish a prognosis? It is hoped this article will aid the clinician in gaining a better perspective on the complex relationship between the eyes and systemic disease.     

General concepts in zoonotic disease control.

It is unlikely that human beings acquire a zoonotic infection from healthy cats without ectoparasites. The benefits of cat ownership to human mental health are well established. Veterinarians and physicians should work together closely to provide accurate information to cat owners so that logical decisions concerning cat ownership can be made by the owner.     

Guide to Venomous Reptiles in Veterinary Practice

Venomous reptiles are common in zoo, research, and private collections. These animals will require veterinary care at some time during their captivity, and treating venomous reptiles can be both challenging and rewarding. Extensive training and experience in handling venomous reptiles, particularly snakes, is required before making the important decision on whether to add these patients to one’s practice. Veterinarians who have a desire to treat venomous reptiles should be familiar with proper equipment, handling techniques, and special considerations required for these species. Veterinarians should also be prepared in the event of an emergency and aware of specific medical conditions affecting these species.     

Methicillin-resistant Staphylococcus aureus: an emerging pathogen in small animals

Methicillin-resistant Staphylococcus aureus (MRSA) is an important nosocomial pathogen in humans and is increasingly implicated in community-associated infections in people. In household pets, MRSA infections are uncommon but are on the rise, possibly because of the increased prevalence of human MRSA in the community. Clinical MRSA infections in some animals can be life threatening and difficult to treat; however, other animals may develop mild disease or only become colonized. Veterinarians should be aware of the concerns regarding MRSA and should develop an understanding of appropriate disease surveillance, diagnostic testing, and infection control in order to lessen the impact of MRSA on small animals.     

Systemic Cryptococcus albidus infection in a Doberman Pinscher.

Cryptococcus albidus is a saprophytic, encapsulated yeast usually found in air, both outdoor and indoor, and sometimes on human skin. It is not usually considered to be a primary pathogen. Most cryptococcal infections of humans and animals are caused by Cryptococcus neoformans. Several cases of C. albidus infection have been reported in humans over the past 20 years. In the veterinary literature, 2 equine cases have been described: genital infection and mycotic keratitis. The present report is the first documented case of C. albidus systemic infection in a dog. Veterinarians and diagnosticians should be aware that C. albidus may be a potential canine pathogen.     

Balancing fact and fiction of novel ingredients: definitions, regulations and evaluation.

Veterinarians have an opportunity to help educate their clients regarding the safety and efficacy of novel ingredients used by their clients. This is no small task because of the lack of acceptable information. Clients should be counseled regarding the lack of scientific evidence and be encouraged to discriminate fact from fiction, including many testimonials. Safety should be of primary concern, and clients should be encouraged not to neglect traditional therapies in lieu of novel ingredients unless clinical evidence of efficacy exists. Quality assurance is equally important and cannot be underestimated. Clients are likely to resort to less expensive products. Clients should be directed to the advice offered by the Arthritis Foundation as follows: "When a supplement has been studied with good results, find out which brand was used and buy that." Although skepticism is encouraged regarding any unknown product with medicinal indications, open mindedness should also guide the veterinarian as these products are considered. Indeed, veterinarians should take actions to ensure that the use of these compounds is accomplished within the confines of the veterinary-client-patient relationship, thus ensuring the role of the veterinarian in the health and well-being of animals, regardless of the modality of therapy. The veterinary profession should support the development of standards that might guide manufacturers of novel ingredients to meet criteria that protect the consumer. Likewise, we should encourage manufacturers and agencies to fund veterinary clinical trials to provide evidence for the use of these potentially exciting compounds. Above all else, the veterinarian needs to become a credible resource of information about the possible role of these products. The lack of a regulatory mechanism that establishes the safety and efficacy of these products is not justification for ignoring the potential therapeutic benefit of some of these products. Veterinarians should follow the advice of the Arthritis Foundation, which notes: "Since glucosamine is self-prescribed ... health care professionals are not regarded [to have] objective advice. This situation must change. It is time for the profession to accommodate the possibility that many nutritional products may have valuable therapeutic effects" [61].     

Ferrets. Examination and preventive medicine.

As ferrets are anatomically and physiologically similar to dogs and cats, the basic elements of ferret examination, disease processes, and preventive health are familiar to small-animal practitioners. Like other domestic carnivores, ferrets are tolerant of handling and medical procedures, especially compared with rabbits, rodents, and most nondomestic mammals. These characteristics make ferrets amenable to many of the highly specialized diagnostic and therapeutic techniques that are now available in small-animal practice. Veterinarians who wish to add ferrets to their practices should be familiar with the ferret literature, but they should not forget to draw from the wealth of knowledge in canine and feline medicine when managing unusual or difficult ferret cases.     

The role of social work in a veterinary hospital setting

Social workers can assist veterinarians and their clients in dealing with such difficult situations as euthanasia decisions, grief reactions, and professional stress. They are already at work at The Animal Medical Center, where they counsel clients individually and in groups, consult with veterinarians on client relations and how to cope with their own stress, and develop educational programs for employees and others.     

Animal sexual abuse in a female sheep

A case of animal sexual abuse and sadism in a female sheep is described. The animal suffered severe genital tract injury most likely caused by the insertion and manipulation of a branch of wood and by penile penetration by a human male. Postmortem examination revealed multiple perforations of the vagina with massive haemorrhages. Animal sexual abuse is a complex diagnostic problem in veterinary medicine. Reported cases are often linked to sadism and often lead to the animal's death. Veterinarians should keep in mind animal sexual abuse as a differential diagnosis in cases of anogenital injuries of unknown origin.     

Principles and Practice of Therapeutic Exercise for Horses

Physical therapists are an integral component of the medical team in human health care. They are backed by a solid foundation of basic science and clinical research. Veterinarians have only recently begun to incorporate physical therapy into clinical practice, but without formal research that validates therapeutic interventions specific to equine patients. The purpose of this article is to present a series of therapeutic exercises adapted for horses based on knowledge and experience of human physical therapy, equine biomechanics, and the types of movement dysfunction commonly seen in the performance horse. Injuries, lameness and musculoskeletal pain syndromes, frequently encountered in equine practice, are disorders that may be successfully addressed with physical therapy. Incorporating standard therapeutic interventions based on clinical success in humans, basic science research, or expert opinion is possible with the understanding that these techniques will ultimately be accepted or refuted when their success or failure is formally documented. This review is designed to stimulate discussion and encourage research that will add to the knowledge base and lead to effective therapeutic protocols in the equine patient.