Telemedicine in veterinary practice

Veterinary surgeons have a long tradition of consulting one another about problem cases and many have unwittingly practised telemedicine when discussing cases by telephone or by sending laboratory reports by telefax. Specific veterinary telemedicine applications have been in use since the early 1980s, but little research has been undertaken in this field. The Pubmed and CAB International databases were searched for the following Boolean logic-linked keywords; veterinary and telemedicine, veterinary and telecare, animal and telemedicine, animal and telecare and veterinary and e-mail and an additional search was made of the worldwide web, using Google Scholar. This returned 25 papers which were reviewed. Of these only 2 report research. Sixteen papers had no references and 1 author was associated with 13 papers. Several themes emerge in the papers reviewed. These include remarks about the use of telemedicine, the benefits that can and are derived from the use of telemedicine, areas of practice in which telemedicine is being used, ethical and legal issues around the practice of telemedicine, image standards required for telemedicine, the equipment that is required for the practice of telemedicine, advice on ways in which digital images can be obtained and educational aspects of telemedicine. These are discussed. Veterinary practice has lagged behind its human counterpart in producing research on the validity and efficacy of telemedicine. This is an important field which requires further research.     

Working practices of cattle foot trimmers used for footcare in dairy cattle compared with those of veterinary surgeons for treatment of lameness in large animal practice

A questionnaire was sent to 270 veterinary surgeons and 135 cattle foot trimmers, investigating their perceptions on lameness and associated pain, with particular emphasis on dairy cattle. Response rates were 58 and 51%, respectively, but the number of respondents fully answering each question varied. Cattle foot trimming methods, opinions on pain associated with lameness and methods used to control pain were investigated. Responses of both groups were compared. No veterinary surgeon attended more than 50 lame cattle per month. The 'Dutch Method' of foot trimming was always used by 47% of veterinary respondents and 89% of trimmers. Both groups considered lameness to be potentially painful. Orthopaedic shoes were used by 79% of responding veterinary surgeons and 97% of trimmers (P < 0.001) to alleviate weightbearing by diseased digits. Housing lame cows on straw was regularly recommended by approximately one-third of both groups. Around a third of veterinary surgeons used local anaesthetics when treating lame cattle. Only 27% used analgesics when treating lame cattle.     

Investigating the opinions of donkey owners and veterinary surgeons towards pain and analgesia in donkeys

The aim of this questionnaire‐based study was to identify which analgesics are currently prescribed to donkeys in clinical practice and to collect opinions from veterinary surgeons and donkey owners on the importance of different pain‐related behaviours in donkeys. Questionnaires were completed by 143 veterinary surgeons and 93 donkey owners. Phenylbutazone, flunixin, detomidine and butorphanol were reported as the most frequently used analgesics in donkeys. Most veterinary surgeons reported administering these drugs at the horse dose rate and dosing interval, which may be inappropriate in the donkey. Four pain‐related behaviours were identified as very important by veterinary surgeons and owners: dullness for colic‐associated pain, keeping the foot lifted, and lameness for foot and limb pain and inability to chew properly for head and dental pain. This is a more limited behavioural repertoire than has recently been identified to be associated with pain in the donkey and suggests that the respondents were reporting perceived wisdom as to what people think are the behavioural signs associated with pain or were not interpreting pain‐related behaviours correctly.     

Survey of the frequency and perceived stressfulness of ethical dilemmas encountered in UK veterinary practice

The scale of the ethical challenges faced by veterinary surgeons and their perceived stressful consequences were investigated via a short questionnaire, completed by 58 practising veterinary surgeons. Respondents were asked to report how frequently they faced ethical dilemmas, and to rate on a simple numerical scale (zero to 10) how stressful they found three common scenarios. Fifty seven per cent of respondents reported that they faced one to two dilemmas per week, while 34 per cent stated they typically faced three to five dilemmas per week. The three scenarios provided were all rated as highly stressful with 'client wishing to continue treatment despite poor animal welfare' rated as the most stressful (median 9). The female veterinary surgeons gave two of the scenarios significantly higher stress ratings than the male veterinary surgeons. Stress ratings were not influenced by number of years in practice (which ranged from one to more than 25 years). The results show that veterinary surgeons regularly face ethical dilemmas and that they find these stressful. This has implications for the wellbeing of veterinary surgeons and supports the case for increased provision of training and support, especially for those who entered the profession before undergraduate ethics teaching was widely available.     

Diagnostic alternatives used by veterinary surgeons for the recording of udder diseases in the Norwegian Health Card System for Cattle

A questionnaire, in which 7 cases of udder disease were described, was distributed to 890 veterinarians in Norway. They were requested to classify the cases according to the diagnostic alternatives listed in the Norwegian Health Card System for Cattle (NHCSC). The NHCSC recordings are used for progeny testing of bulls, for disease monitoring, and for research purposes. The aim of this study was to evaluate the quality of the recordings for udder diseases. The questionnaire was answered by 633 veterinary surgeons. Four cases of clinical mastitis (CM) with abnormal secretion as well as other clinical signs of inflammation were correctly classified as CM by almost 100% of the veterinary surgeons. A cow in the final stage of lactation, showing no clinical signs except for clots in the milk, was considered not to be a clinical case by more than 25% of the veterinary surgeons. A typical case of subclinical mastitis (SM) was reported as SM by 83% of the veterinary surgeons, and as CM by 16%. A subclinical case with a recent history of clots in the secretion was classified as SM by 66% of the veterinary surgeons, but almost 40% either reported CM as their sole diagnosis or considered the case to be CM in combination with SM. Of the clinical cases, those exhibiting marked local signs of inflammation and a systemic reaction were correctly classified as acute clinical mastitis (ACM) by 96%-98% of the veterinary surgeons. In the NHCSC, the diagnostic alternatives for cases of CM are ACM and chronic clinical mastitis (CCM). One case, for which the diagnosis subacute clinical mastitis was appropriate according to standard definitions, was classified as CCM by 66%, and as ACM by 6%. Based on the information given in the questionnaire, the diagnosis for 2 of the clinical cases could have been either ACM or CCM, and for both cases each of these 2 alternatives was reported by more than 43% of the veterinary surgeons. A teat lesion, which was present together with ACM in one cow, was reported by 91% of the veterinary surgeons.     

Non-accidental injury in companion animals in the Republic of Ireland

: Non-accidental injury (NAI), animal abuse and "battered pet" syndrome are terms used to identify "the intentional harm of an animal". The terms include, but are not limited to, wilful neglect, inflicting injury, pain or distress, or malicious killing of an animal. Three categories of abuse are recognised: physical, sexual and neglect.A postal survey was conducted to determine the extent to which NAI was recognised by veterinary surgeons in urban, semi-rural and rural veterinary practices in the Republic of Ireland. The questionnaire was sent to 600 veterinarians; completed submissions were received from 115 respondents (19.2%).The occurrence of NAI was acknowledged by 106 (92.2%) of the respondents and cases had been seen by 50 (43.3%) of them, comprised of 36.2% of urban veterinary surgeons from rural towns and of 82% of urban practitioners. In 59% of cases the client indicated the injury was non-accidental; 39 (67.2%) of the 58 reported cases involved a single event. Signs that made veterinary surgeons suspicious of NAI included inconsistent history, untreated injuries, recurring injuries, meekness of the animal, suspicious behaviour of the owner and injuries consistent with abuse. The types of injuries observed included burns, lacerations, gunshot wounds, poisoning, injury to genitalia, bruising and fractures.The findings of this study are comparable with those from other countries. Most but not all veterinary surgeons in Ireland recognise NAI and animal abuse is of significant concern in rural and urban communities as evidenced by this survey of practising veterinary surgeons.     

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.     

Influences of carprofen and the experience of the surgeon on post-castration pain in lambs and young sheep

This study evaluated the influences of carprofen and the experience of the surgeon on post‐castration pain in lambs and young sheep castrated in the field. A total of 201, 1–6‐week‐old lambs with a mean body mass of 11.0 ± 2.4 kg (mean ± SD) were castrated after local application of 4 mL lidocaine (2%). Preoperatively lambs were given either 20 mg carprofen SC or an equal volume of saline in a randomized order. A further 34 sheep, aged 6 months, with a mean body mass of 36.0 ± 4.5 kg were castrated after local application of 7 mL lidocaine (2%). Preoperatively sheep received 2 mg kg^?1 carprofen SC or an equal volume of saline in a randomized order. Lidocaine was injected SC in front of, behind and into each spermatic cord. All surgery was performed using the same Burdizzo clamp (jaw 45 mm wide, handles 225 mm) either by students or experienced veterinary surgeons. Pain was assessed preoperatively and at 24, 48 and 72 hours after castration by two independent observers unaware of the treatment group. Observers scored pain using a visual analog scale (100 mm) after applying gentle pressure onto the scrotal region ( Thornton & Waterman‐Pearson 1999 ). Swelling of the scrotal region was scored as ‘severe’, ‘present but not severe’ and ‘not present’. The VAS scores were compared using a Mann–Whitney test, p < 0.05 was considered significant. Swelling was compared using Fisher's exact test. In lambs, no significant differences in pain scores between those treated with carprofen or saline were noted by either observer (p > 0.48) at any of the three assessment times. However, the number of lambs with severe or present swelling of the scrotal region was significantly lower in those receiving carprofen (8% versus 18%, p = 0.028). Lambs castrated by students showed significantly higher pain scores (23% versus 13%, p < 0.001 at 24 hours; 20% versus 13%, p = 0.0062 at 48 hours; 16% versus 10%, p = 0.0088 at 72 hours) and significantly more swelling (18% versus 8%, p = 0.0189) of the scrotal region than those castrated by veterinary surgeons. Young sheep receiving carprofen preoperatively had significantly lower pain scores (12 mm versus 25 mm, p = 0.037) 24 hours after surgery compared to sheep receiving saline. No scrotal swelling was obvious in sheep. Juvenile sheep but not lambs, receiving carprofen preoperatively showed reduced pain scores up to 24 hours after surgery. Carprofen reduced swelling of the scrotum in lambs. Lambs castrated by experienced surgeons scored lower VAS scores at all times and showed less swelling of the scrotal region.     

Assessment of veterinary practitioners in the British Isles' approaches towards the management of canine osteoarthritis

The aim of this questionnaire-based retrospective study was to ascertain veterinary practitioners in the British Isles' approaches to osteoarthritis in dogs. The Mann-Whitney U test, Kruskal-Wallis test and multiple ordinal logistic regression were used to compare demographic data with treatment options. Questionnaires were returned by 228 practitioners (a response rate of 22.8 per cent). The majority of responses were from males (70 per cent). Eighty-six per cent (188 of 220) of the respondents had graduated from veterinary schools in the UK and Ireland. Veterinarians who had graduated less recently used exercise modulation less frequently (P<0.004, odds ratio [OR]=1.06) and ranked exercise modulation as less important (P=0.008, OR=1.04). Veterinarians who had graduated outside the UK or Ireland were less likely (P=0.033, OR=0.46) to use exercise modulation than those who had graduated in the UK or Ireland. Veterinarians who had graduated more recently were less likely (P=0.008, OR=0.95) to use medications. Female veterinary surgeons were less likely to rank medications as important (P<0.0001, OR=0.29) and less likely to rank corticosteroids as important (P=0.046, OR=0.42) than male veterinary surgeons. Practitioners who had graduated outside the UK or Ireland were less likely (P=0.01, OR=0.30) to rank corticosteroids as important. There was a significant mild negative correlation between the frequency of use of structure-modifying osteoarthritis drugs (SMOADs) and practitioners' opinions on rank importance (-0.32, P<0.0001). Medications such as SMOADs and nutraceuticals were ranked as not important but were used frequently. Overall, age, sex, the university of graduation and the number of canine consultations per day had an impact on the practitioners' treatment protocols.     

Emergency Presentations of the Exotic Small Mammalian Herbivore Trauma Patient

Trauma is a common complaint by owners of small exotic mammalian herbivores (e.g., rabbits, rodents) presented to veterinary hospitals. The term “trauma” is a broad disease category applied to patients with physical debilitation associated with injury often classified as “blunt,” “penetrating,” or “burn” in origin. Because many small exotic mammalian herbivores are prey animals, clinical signs of trauma may be masked until the effects of the injury outweigh the innate nature to survive. Small exotic mammalian herbivores are disproportionately sensitive to stress; thus, pain management and supportive care are extremely important during the initial stages of trauma management. Small exotic mammals differ slightly from other companion animals (e.g., dogs, cats) in regard to common trauma presentations. However, with a few therapeutic modifications (e.g., antibiotic selection, avoidance of corticosteroids, preventing self-trauma), treatment of small exotic mammalian herbivore trauma cases follows the same conventional guidelines used for other companion animals.     

我国兽医药学科近年研究与应用进展(Ⅰ)

兽药(含饲料药剂)是实现现代养殖的物质基础。本文通过2009与2011年全国10次和11次兽医药理毒理学术研讨会的论文[1,2]综述,介绍兽医药学科技近年研究与应用进展,分为:重要主题,基础药理与临床治疗学,兽药代谢动力学与药物残留,抗菌药与细菌耐药性,中草药及化药新剂型新制剂的研发等5部分。     

Clinical study on the effect of biotin on skin conditions in dogs

In a collaborative study with small-animal veterinary surgeons, dogs with fur and skin conditions were treated with biotin (approximately 5 mg biotin/10 kg body weight/day) for 3 to 5 weeks. In total 119 cases could be treated which were reported to show symptoms such as dull coat, brittle hair, loss of hair, scaly skin, pruritus or dermatitis. Cases requiring other treatments with e.g. glucocorticoids, were excluded from the study. In 60% of the cases all symptoms were reported to be cured after the biotin treatment and in a further 31% an improvement was noted; in only 9% no effect was recorded. All breeds responded but to a variable extent: e.g. in Poodles the response was lower (no response in 6 out of 11 cases) than in Alsatians where all improved and 14 out of 29 were completely cured. The results confirm the favourable effect of biotin for treatment of fur and skin conditions in dogs.     

Development of a model animal welfare act curriculum

Animal-welfare issues are often controversial and frequently have an emotional component. Veterinarians have extensive knowledge, experience, and scientific perspective and are arguably the professionals best suited to advise and develop recommendations on animal welfare. The development of an Animal Welfare Act (AWA) teaching module is a first step toward educating veterinary students about animal welfare. This article presents the current development status of this curriculum project, which is intended to be a valuable addition to the evolving veterinary education on animal welfare.     

Response evaluation criteria for peripheral nodal lymphoma in dogs (v1.0)–a veterinary cooperative oncology group (VCOG) consensus document

Standardized assessment of response to therapy for lymphoma in dogs is lacking, making critical comparisons of treatment protocols difficult. This Veterinary Cooperative Oncology Group (VCOG) consensus document, based on the recommendations of a subcommittee of ACVIM board-certified veterinary oncologists, was unanimously adopted at the 29th Annual Conference of the Veterinary Cancer Society (VCS) by the VCOG membership. It has integrated guidance from the response assessment criteria established for lymphoma in human patients using standards available in routine veterinary oncology practices that are simple, repeatable and consistently applicable. These guidelines are intended only for use in dogs, where peripheral lymphadenopathy represents the principal component of their disease and as such do not critically assess extranodal disease (e.g., primary cutaneous, central nervous system, gastrointestinal). It is hoped these guidelines will be widely adopted and serve to facilitate the comparison of current and future treatment protocols used in the therapy of dogs.     

A pilot study examining a proprietary herbal blend for the treatment of canine osteoarthritis pain

Osteoarthritis is the most common joint disease in dogs. Despite the use of nonsteroidal anti-inflammatory drugs (NSAIDs), many owners seek natural therapies; either to augment the response to NSAIDs, or as a replacement. Substantial research has been directed to investigation of novel therapies. A randomized, double-blinded, controlled study was conducted to assess the efficacy of a herbal remedy for treatment of canine osteoarthritis pain. Client-owned dogs (N = 24) with osteoarthritis were enrolled between 2 veterinary hospitals. Each dog underwent veterinary and owner assessment at 0, 4, and 8 weeks, using the Canine Brief Pain Inventory and Hudson activity scale. Blood was collected for a complete blood (cell) count (CBC) and serum chemistry analysis. The product was deemed to be safe and well-tolerated at the manufacturer recommended dosage, with no significant changes seen in the CBC or serum biochemical analyses. Aside from1 dog that developed gastrointestinal upset, all other dogs tolerated the supplement without complication. The supplement did not statistically improve clinical signs in dogs based on veterinary or owner assessments of lameness. There was a treatment/time effect when assessing veterinary pain scores; however, post-hoc analysis suggests no observable benefit of treatment compared with the placebo group at any time point.     

Occupational stress,work-home interference and burnout among Belgian veterinary practitioners

There have been few formal studies on stress in veterinary surgeons and, in the rare studies available, stress is not examined jointly through the levels of job strain and job engagement, the sources of stress in the issue of work environment and the work-home interference. The authors' goal in this study was to analyse job engagement, job strain, burnout, work-home interference and job stress factors among 216 Belgian veterinary surgeons. Rural practice was compared to small animal and mixed activity. The mean job strain and job engagement level in veterinary surgeons was not higher than what we found in other working populations. However, 15.6% of the group were found to be suffering from high burnout. Rural practitioners had a lower level of job engagement than small animal veterinary surgeons. These small animal practitioners had a lower level of job strain than the mixed practitioners. The level of burnout did not differ significantly across the three types of activity. In comparison to other Belgian and Dutch workers, veterinary surgeons perceived more negative work-home interference. Bovine and mixed practitioners were the most concerned with this problem. The two most important sources of stress reported by bovine practitioners were relations to farmers and working time management (including emergencies and availability).     

Costs of veterinary services and vaccines/drugs used for prevention and treatment of diseases in 86 Colorado cow-calf operations participating in the National Animal Health Monitoring System (1986-1988)

Eighty-six cow-calf operations involved in the Colorado National Animal Health Monitoring System were monitored for a 12-month period, and data were collected on the incidence, prevention, and costs of disease. The costs of veterinary services and vaccines/drugs used in the treatment and prevention of disease conditions in these beef herds were determined and expressed on a per cow basis. Beef producers in this study spent an average of $2.04 ($0 to $29.88) per cow annually on veterinary services for treatment of disease conditions. The cost of veterinary services was a relatively small percentage (5.4%) of the total mean cost of disease incidence. The reproductive tract disease class was the most costly class in terms of veterinary services for disease treatment ($0.99/cow). Dystocia was the disease condition with the largest veterinary treatment cost. The total mean annual cost of drugs used in the treatment of disease conditions was $1.22/cow. The enteric, miscellaneous, and respiratory tract disease classes had similar mean drug costs for disease treatment and ranged from $0.31 to $0.39/cow. The total mean annual cost of veterinary services for administration of preventive measures in these herds was $1.85/cow ($0 to $12.03). Pregnancy examination, breeding soundness examination in bulls, brucellosis vaccination, pulmonary arterial pressure test, and campylobacteriosis vaccination accounted for over 90% of the money spent for preventive veterinary services. Approximately 60% of the total mean annual disease prevention cost was attributed to the purchase of vaccines/drugs ($6.59/cow).(ABSTRACT TRUNCATED AT 250 WORDS)     

Effects of a pilot training program on veterinary students' pain knowledge, attitude, and assessment skills

The prevention and management of pain is fundamental to the practice of both human and veterinary medicine. The recognition and treatment of pain represents an important indicator of the quality of care delivered in human hospitals and veterinary hospitals. Yet, both human and veterinary health care professionals have cited inadequate knowledge as a significant barrier to effective pain management. The aims of this pilot study were twofold: (1) to gauge veterinary medical students' current attitudes regarding their training in pain management and (2) to assess the impact of training and practice on the use of a canine acute pain assessment teaching tool. Participants, third-year professional veterinary medical students, completed a 16-item survey questionnaire before a 30-minute training session on pain assessment using the teaching tool and completed it again after training and a one-week practice period. Questions related to canine pain, assessment of canine pain, pain management education in the professional veterinary curriculum, and an example case presentation (video) were included in the survey. The analysis of survey results indicated that professional veterinary medicine students find value in didactic and clinical training in canine pain assessment. Additionally, use of the canine acute pain teaching tool in conjunction with a training program improved students' knowledge and skill in assessment while pointing out the importance of further training. Differences with regard to gender and tracking were found and warrant further exploration.