French Bulldogs differ to other dogs in the UK in propensity for many common disorders: a VetCompass study

Background

The French Bulldog is a highly popular dog breed but is linked with many serious health issues. A holistic view of breed health in French Bulldogs would assist efforts to appreciate the overall health strengths and weaknesses in the French Bulldog and to take appropriate steps to mitigate these.

Based on random sampling of French Bulldogs and non-French Bulldogs under primary veterinary care during 2016 within the VetCompass Programme, a cohort study design was used to estimate the one-year (2016) period prevalence of the most commonly diagnosed disorders in each group. Risk factor analysis used multivariable logistic regression modelling methods.

Results

The analysis included 2,781 French Bulldogs and 21,850 non-French Bulldogs. French Bulldogs were younger (1.51 years, IQR 0.86 – 2.77 vs. 4.48 years, IQR 1.94 – 8.14) (p < 0.001) and lighter (12.45 kg, IQR 11.00 – 14.03 versus 13.80 kg, IQR 8.10 – 25.12) (p < 0.001) than non-French Bulldogs. Of 43 common specific-level disorders across both groups, French Bulldogs had significantly increased adjusted odds of 20/43 (46.5 %) disorders and significantly reduced adjusted odds of 11/43 (25.6 %) disorders compared to non-French Bulldogs. Highly predisposed disorders in French Bulldogs included stenotic nares (OR 42.14; 95 % CI 18.50 to 95.99; p < 0.001), Brachycephalic Obstructive Airway Syndrome (OR 30.89; 95 % CI 20.91 to 45.64; p < 0.001), aural discharge (OR 14.40; 95 % CI 9.08 to 22.86; p < 0.001), skin fold dermatitis (OR 11.18; 95 % CI 7.19 to 17.40; p < 0.001) and dystocia (OR 9.13; 95 % CI 5.17 to 16.13; p < 0.001). At a grouped-level of diagnostic precision, French Bulldogs had increased adjusted odds of 12/32 (37.5 %) disorders and reduced adjusted odds of 6/32 (18.8 %) disorders compared to non-French Bulldogs.

Conclusions

These results identified ultra-predispositions with worryingly higher odds in French Bulldogs for several disorders, suggesting that the health of French Bulldogs has diverged substantially from, and may be lower than, the health of the wider non-French Bulldog population. Many of these predispositions are closely associated with the conformational extremes that define the French Bulldog breed. Shifting the typical conformation of the French Bulldog population towards a more moderate phenotype is proposed as a logical opportunity to reduce the serious health issues endemic in the French Bulldog breed.

The French Bulldog is currently a hugely popular dog breed in the UK. However, the breed is linked with a range of serious health issues. Using veterinary clinical data from the VetCompass Programme at the Royal Veterinary College, this study aimed to compare the frequency of common disorders in French Bulldogs against that of all remaining dogs to identify health strengths and weaknesses in French Bulldogs. This overall view of breed health can assist owners, breeders and veterinarians to take appropriate actions to improve the health of French Bulldogs.

From an overall population of 905,544 dogs, random samples of 2,781 French Bulldogs and 21,850 non-French Bulldogs were included in the analysis. French Bulldogs were younger (1.51 years versus 4.48 years) and lighter (12.45 kg versus 13.80 kg) than non-French Bulldogs. French Bulldogs had increased risk of 20/43 (46.5 %) specific disorders and decreased risk of 11/43 (25.6 %) specific disorders compared to non-French Bulldogs. The disorders with greatest relative risk in French Bulldogs compared to non-French Bulldogs were narrowed nostrils (x 42.14), Brachycephalic Obstructive Airway Syndrome (x 30.89), ear discharge (x 14.40), skin fold dermatitis (x 11.18) and difficulty giving birth [dystocia] (x 9.13). When the disorders were grouped into broad disease categories, French Bulldogs had increased risk of 12/32 (37.5 %) disorder groups and reduced risk of 6/32 (18.8 %) disorder groups compared to non-French Bulldogs.

This study suggests that the health of French Bulldogs is very different, and largely much poorer, that the health of the wider non-French Bulldog population. Many of these differences are closely associated with the extreme body shape that defines the French Bulldog breed. Shifting the body shape of French Bulldogs to become more moderate, and hence less extreme, is proposed as a logical opportunity to reduce the current serious and common health issues in the French Bulldog breed.

Frequency and risk factors for naturally occurring Cushing's syndrome in dogs attending UK primary-care practices

Objectives

To estimate the frequency and risk factors for Cushing's syndrome in dogs under UK primary veterinary care.

Materials and Methods

Dogs with Cushing's syndrome were identified by searching electronic patient records of primary‐care veterinary practices. Pre‐existing and incident cases of Cushing's syndrome during 2016 were included to estimate the 1‐year period prevalence. Incident cases were used to estimate the annual incidence and to identify demographic risk factors for the diagnosis of Cushing's syndrome in dogs, through multivariable logistic regression.

Results

Analysis included 970 pre‐existing and 557 incident cases of Cushing's syndrome from a population of 905,544 dogs. The estimated 1‐year period prevalence for Cushing's syndrome in dogs under veterinary care was 0.17% (95% confidence interval 0.16 to 0.18) and incidence was 0.06% (95% confidence interval 0.05 to 0.07). In multivariable logistic regression modelling, the Bichon frise (odds ratio=6.17, 95% confidence interval 4.22 to 9.00), Border terrier (5.40, 95% confidence interval 3.66 to 7.97) and Miniature schnauzer (3.05, 95% confidence interval 1.67 to 5.57) had the highest odds of Cushing's syndrome. The Golden retriever (0.24, 95% confidence interval 0.06 to 0.98) and Labrador retriever (0.30, 95% confidence interval 0.17 to 0.54) were the most protected breeds. Increasing age, bodyweight greater than the breed‐sex mean and being insured also showed increased odds of Cushing's syndrome.

Clinical Significance

As Cushing's syndrome is predominately diagnosed and managed in primary‐care practice, this study provides valuable new information of its epidemiology in this setting. Demographics reported are supportive of previous work and additional novel associations identified, such as the Border terrier, could enhance the index of suspicion for veterinarians.

Understanding Antibiotic Use in Companion Animals: A Literature Review Identifying Avenues for Future Efforts

Addressing antibiotic use is essential to tackle antimicrobial resistance, a major human and animal health challenge. This review seeks to inform stewardship efforts in companion animals by collating research insights regarding antibiotic use in this group and identifying overlooked avenues for future research and stewardship efforts. The development of population-based methods has established that antibiotics are frequently used in companion animal care. Research insights are also contributing toward an in-depth comprehension of the contexts to antibiotic use. Qualitative approaches, for example, have enabled a nuanced understanding in four key areas: interactions with owners, clinical and financial risk management, time pressures, and clinic dynamics. This review identifies that much of the existing research frames antibiotic use as the result of choices made by the individuals at the interface of their use. Future research and policy endeavours could look beyond the moment of prescribing to consider the societal structures and networks in which companion animal antibiotic use is entangled. A diversification in research approaches and frameworks through which antibiotic use is understood will facilitate the identification of additional targets for stewardship initiatives beyond providing information and awareness campaigns.

Frequency and predisposing factors for canine otitis externa in the UK - a primary veterinary care epidemiological view

BACKGROUND

Otitis externa is a commonly diagnosed disorder in dogs and can carry a high welfare impact on affected animals. This study aimed to report the prevalence and explore the role of breed and aural conformation as predisposing factors for canine otitis externa in the UK. The study used a cohort design of dogs under UK primary veterinary care at clinics participating in the VetCompass Programme during 2016. Risk factor analysis used multivariable logistic regression modelling.

RESULTS

The study included a random sample of 22,333 dogs from an overall population of 905,554 dogs under veterinary care in 2016. The one-year period prevalence of otitis externa was 7.30% (95% confidence interval [CI]: 6.97 to 7.65). Breed and ear carriage were the highest ranked risk factors. Compared with crossbred dogs, sixteen breed types showed increased odds, including: Basset Hound (odds ratio [OR] 5.87), Chinese Shar Pei (OR 3.44), Labradoodle (OR 2.95), Beagle (OR 2.54) and Golden Retriever (OR 2.23). Four breeds showed protection (i.e. reduced odds) of otitis externa: Chihuahua (OR 0.20), Border Collie (OR 0.34), Yorkshire Terrier (OR 0.49) and Jack Russell Terrier (OR 0.52). Designer breed types overall had 1.63 times the odds (95% CI 1.31 to 2.03) compared with crossbred dogs. Compared with breeds with erect ear carriage, breeds with pendulous ear carriage had 1.76 times the odds (95% CI 1.48 to 2.10) and breeds with V-shaped drop ear carriage had 1.84 times the odds (95% CI 1.53 to 2.21) of otitis externa.

CONCLUSIONS

Breed itself and breed-associated ear carriage conformation are important predisposing factors for canine otitis externa. Greater awareness of these associations for both predisposed and protected breeds could support veterinary practitioners to promote cautious and low-harm approaches in their clinical advice on preventive care for otitis externa, especially in predisposed breeds.

Epidemiology of periodontal disease in dogs in the UK primary-care veterinary setting

Objectives

Periodontal disease is a frequent diagnosis of dogs and can have severe negative impacts on welfare. It was hypothesised that breeds with skull shapes that differ most in conformation from the moderate mesocephalic skull shape have higher odds of periodontal disease.

Materials and Methods

The cohort study included a random sample of dogs under primary veterinary care in 2016 from the VetCompass Programme database. Risk factor analysis used random effects multivariable logistic regression modelling.

Results

The study included a random sample of 22,333 dogs. The 1‐year period prevalence for diagnosis with periodontal disease was 12.52% (95% CI: 12.09 to 12.97). Eighteen breeds showed increased odds compared with crossbred dogs. Breeds with the highest odds included Toy Poodle (odds ratio 3.97, 95% confidence intervals 2.21 to 7.13), King Charles Spaniel (odds ratio 2.63, 95% confidence interval 1.50 to 4.61), Greyhound (odds ratio 2.58, 95% confidence interval 1.75 to 3.80) and Cavalier King Charles Spaniel (odds ratio 2.39, 95% confidence interval 1.85 to 3.09). Four breeds showed reduced odds compared with crossbreds. Brachycephalic breeds had 1.25 times the odds (95% confidence interval 1.11 to 1.42) of periodontal disease compared with mesocephalic breeds. Spaniel types had 1.63 times the odds (95% confidence interval 1.42 to 1.87) compared with non‐spaniel types. Increasing adult bodyweight was associated with progressively decreasing odds of periodontal disease.

Clinical Significance

The high prevalence identified in this study highlights periodontal disease as a priority welfare concern for predisposed breeds. Veterinarians can use this information to promote improved dental care in predisposed dogs, especially as these dogs age.

Spatio-temporal distribution and agroecological factors associated with canine leptospirosis in Great Britain

Leptospirosis is an important global zoonotic disease that affects a wide range of mammalian species. Canine leptospirosis outbreaks have been reported after metereological events such as flooding (eg. in Brazil and the United States of America) suggesting an environmental association, but there has been no such study in Great Britain (GB). The distribution of cases across GB is also unreported. Objectives of this study were to: (1) assess the spatio-temporal variation of leptospirosis test submissions (2) explore associations between agroecological risk factors and distribution of different canine leptospirosis serogroups in GB, and (3) generate probability of presence maps for the different serogroups. Data analysed comprised laboratory submissions (n = 3986) to IDEXX laboratories between 1st January 2009 and 31st December 2018 for PCR or MAT leptospirosis testing. Spatial and seasonal scan statistics were used to investigate spatial and temporal clustering of positive tests, logistic regression was used to identify significant agroecological risk factors for positive tests, and the Maxent algorithm was used to model the environmental niche of four serogroups. There was an increased risk of a positive test result in the West Midlands of England (relative risk = 2.16) and between October and January (relative risk = 1.54). Logistic regression identified season and region to be significantly associated with a positive diagnosis,with higher odds of a positive test in Autumn (OR = 1.86 95 %CI 1.29-2.69) and Winter (OR = 1.51, 95 %CI 1.02-2.23) and in the East (OR = 2.20, 95 %CI = 1.31-3.71) and West Midlands (OR = 2.32, 95 %CI 1.45-3.71). The increased test-positive proportion in Autumn together with the increased odds of a positive diagnosis in Autumn suggests there may be a seasonal pattern to the canine leptospirosis in GB. The most important variable associated with higher leptospirosis presence in all ecological niche models was higher average annual temperature. The importance and retention of other variables differed between serogroups. Overall, a higher probability of leptospirosis presence was predicted in southern England and a low probability in Scotland and northern England. Although leptospirosis vaccine usage provides protection against the majority of serogroups identified here, one is not represented in the currently licensed vaccine formulations and therefore leptospirosis should remain a differential diagnosis in vaccinated dogs demonstrating consistent clinical signs of the disease.

Disorder predispositions and protections of Labrador Retrievers in the UK

The Labrador Retriever is one of the most popular dog breeds worldwide, therefore it is important to have reliable evidence on the general health issues of the breed. Using anonymised veterinary clinical data from the VetCompass Programme, this study aimed to explore the relative risk to common disorders in the Labrador Retriever. The clinical records of a random sample of dogs were reviewed to extract the most definitive diagnoses for all disorders recorded during 2016. A list of disorders was generated, including the 30 most common disorders in Labrador Retrievers and the 30 most common disorders in non-Labrador Retrievers. Multivariable logistic regression was used to report the odds of each of these disorders in 1462 (6.6%) Labrador Retrievers compared with 20,786 (93.4%) non-Labrador Retrievers. At a specific-level of diagnostic precision, after accounting for confounding, Labrador Retrievers had significantly increased odds of 12/35 (34.3%) disorders compared to non-Labrador Retrievers; osteoarthritis (OR 2.83) had the highest odds. Conversely, Labrador Retrievers had reduced odds of 7/35 (20.0%) disorders; patellar luxation (OR 0.18) had the lowest odds. This study provides useful information about breed-specific disorder predispositions and protections, which future research could evaluate further to produce definitive guidance for Labrador Retriever breeders and owners.

Frequency, breed predisposition and demographic risk factors for overweight status in dogs in the UK

OBJECTIVES

To evaluate the prevalence and risk factors for overweight status in dogs under primary veterinary care in the UK.

MATERIALS AND METHODS

A retrospective study design was used to estimate the 1-year (2016) period prevalence of overweight status. The clinical records were randomly ordered and manually validated for dogs with overweight status during 2016. Univariable and multivariable logistic regression modelling were used to evaluate associations between risk factors (breed, brachycephalic status, adult bodyweight, bodyweight relative to breed-sex mean, age, sex-neuter and insurance) and overweight status.

RESULTS

There were 1580 of 22,333 dogs identified as overweight during 2016. The estimated 1-year period prevalence for overweight status recorded in dogs under veterinary care was 7.1% (95% confidence interval 6.7-7.4). After accounting for confounding factors, eight breeds showed increased odds of overweight status compared with crossbred dogs. The breeds with the highest odds included the Pug (OR 3.12, 95% confidence interval 2.31 to 4.20), Beagle (OR 2.67, 1.75 to 4.08), Golden Retriever (OR 2.58, 1.79 to 3.74) and English Springer Spaniel (OR 1.98, 1.31 to 2.98). Being neutered, middle-aged and insured were additionally associated with overweight status.

CLINICAL SIGNIFICANCE

Targeted overweight prevention strategies should be prioritised for predisposed breeds, such as Pugs and Beagles. The findings additionally raise questions about further preventative efforts following neutering. The prevalence estimate suggests veterinary professionals are underreporting overweight status and therefore could be missing key welfare opportunities.

Keratoconjunctivitis sicca in dogs under primary veterinary care in the UK: an epidemiological study

OBJECTIVES

To estimate the frequency and breed-related risk factors for keratoconjunctivitis sicca (KCS) in dogs under UK primary veterinary care.

METHODS

Analysis of cohort electronic patient record data through the VetCompass Programme. Risk factor analysis used multivariable logistic regression.

RESULTS

There were 1456 KCS cases overall from 363,898 dogs [prevalence 0.40%, 95% confidence interval (CI) 0.38-0.42] and 430 incident cases during 2013 (1-year incidence risk 0.12%, 95% CI 0.11-0.13). Compared with crossbreds, breeds with the highest odds ratio (aOR) for KCS included American cocker spaniel (aOR 52.33: 95% CI 30.65-89.37), English bulldog (aOR 37.95: 95% CI 26.54-54.28), pug (aOR 22.09: 95% CI 15.15-32.2) and Lhasa apso (aOR 21.58: 95% CI 16.29-28.57). Conversely, Labrador retrievers (aOR 0.23: 95% CI 0.1-0.52) and border collie (aOR 0.30: 95% CI 0.11-0.82) had reduced odds. Brachycephalic dogs had 3.63 (95% CI 3.24-4.07) times odds compared to mesocephalics. Spaniels had 3.03 (95% CI 2.69-3.40) times odds compared to non-spaniels. Dogs weighing at or above the mean bodyweight for breed/sex had 1.25 (95% CI 1.12-1.39) times odds compared to body weights below. Advancing age was strongly associated with increased odds.

CLINICAL SIGNIFICANCE

Quantitative tear tests are recommended within yearly health examinations for breeds with evidence of predisposition to KCS and might also be considered in the future within eye testing for breeding in predisposed breeds. Breed predisposition to KCS suggests that breeding strategies could aim to reduce extremes of facial conformation.

Incidence and demographic risk factors for leptospirosis in dogs in the UK

OBJECTIVES

To estimate the annual incidence risk of leptospirosis diagnosis in practice-attending dogs in the UK during 2016 and identify risk factors for diagnosis.

METHODS

Incidence of leptospirosis diagnosis in dogs during 2016 was estimated from dogs in primary-care practices from the VetCompass Programme (n = 905,543). A case-control study of laboratory cases (n = 362) versus VetCompass controls explored factors (age, sex, neutering, breed, Kennel Club group, urban-rural location, indices of deprivation) associated with leptospirosis diagnosis through multivariable logistic regression.

RESULTS

Annual incidence risk of leptospirosis in the VetCompass population was 0.8 cases per 100,000 dogs (0.0008%, 95% CI 9.1 × 10^-8 -5.2 × 10^-5 ). Adult dogs, especially 1- < 5 years olds (odds ratio [OR] = 0.38, 95% CI 0.27-0.54), and dogs attending urban clinics (OR = 0.26, 95% CI 0.19-0.35) had reduced odds of leptospirosis versus dogs < 1 year old and rural dogs, respectively. Dogs attending clinics in less deprived areas had increased odds of diagnosis (OR = 3.63, 95% CI 2.28-5.78) compared to crossbreds, Cocker Spaniels (OR = 4.25, 95% CI 2.65-6.84), Collies (OR = 3.53, 95% CI 2.22-5.62) and Lurchers (OR = 3.49, 95% CI 1.50-8.11) had increased odds of diagnosis.

DISCUSSION

Leptospirosis is rarely diagnosed in clinical practice, suggesting that many true cases may be missed. Demographic risk factors identified here may inform the index of suspicion and encourage increased use of confirmatory diagnostic testing.

Proportion and risk factors for death by euthanasia in dogs in the UK

The loss of a pet can be particularly distressing for owners, whether the method of death is euthanasia or is unassisted. Using primary-care clinical data, this study aimed to report the demographic and clinical factors associated with euthanasia, relative to unassisted death, in dogs. Method of death (euthanasia or unassisted) and clinical cause of death were extracted from a random sample of 29,865 dogs within the VetCompass Programme from a sampling frame of 905,544 dogs under UK veterinary care in 2016. Multivariable logistic regression modelling was used to evaluate associations between risk factors and method of death. Of the confirmed deaths, 26,676 (89.3%) were euthanased and 2,487 (8.3%) died unassisted. After accounting for confounding factors, 6 grouped-level disorders had higher odds in euthanased dogs (than dogs that died unassisted), using neoplasia as the baseline. The disorders with greatest odds included: poor quality of life (OR 16.28), undesirable behaviour (OR 11.36) and spinal cord disorder (OR 6.00). Breed, larger bodyweight and increasing age were additional risk factors for euthanasia. The results highlight that a large majority of owners will face euthanasia decisions and these findings can support veterinarians and owners to better prepare for such an eventuality.

Dog breeds and body conformations with predisposition to osteosarcoma in the UK: a case-control study

Background

Osteosarcoma is an aggressive and painful bone neoplasm in dogs. Previous studies have reported epidemiological associations suggesting that large body mass, long bone length and the genetics of certain breeds including the Rottweiler are associated with elevated osteosarcoma risk. However, these studies were often limited by selection bias and confounding factors, and have rarely offered insights into breed-associated protection for osteosarcoma. The current study includes 1756 appendicular and axial osteosarcoma cases presenting to VPG Histology (Bristol, UK) compared against a control population of 905,211 dogs without osteosarcoma from primary care electronic patient records in the VetCompass™ dataset.

Methods and study design

Retrospective, case-control study. Multivariable logistic regression analysis explored associations between demographic risk factors (including breed, chondrodystrophy, age, sex/neuter status, skull-shape, and body mass) and osteosarcoma of all anatomical sites.

Results

We identified several breeds with increased and reduced odds of osteosarcoma. At highest risk were the Rottweiler and Great Dane, with > 10 times the odds of osteosarcoma compared with crossbreds, and the Rhodesian Ridgeback, which has not featured in previous lists of at-risk breeds for osteosarcoma, and had an odds ratio of 11.31 (95% confidence interval 7.37–17.35). Breeds at lowest risk of osteosarcoma (protected breeds) included the Bichon Frise, the French Bulldog and the Cavalier King Charles Spaniel, all with odd ratios of less than 0.30 compared with crossbreds. Body mass was strongly associated with osteosarcoma risk; dogs over 40 kg exhibited osteosarcoma odds of 45.44 (95% confidence interval 33.74–61.20) compared with dogs less than 10 kg. Chondrodystrophic breeds had an osteosarcoma odds ratio of 0.13 (95% confidence interval 0.11–0.16) compared with non-chondrodystrophic breeds.

Conclusions

This study provides evidence of strong breed-associated osteosarcoma risk and protection, suggesting a genetic basis for osteosarcoma pathogenesis. It highlights that breeds selected for long legs/large body mass are generally overrepresented amongst at-risk breeds, whilst those selected for short leg length/small body mass are generally protected. These findings could inform genetic studies to identify osteosarcoma risk alleles in canines and humans; as well as increasing awareness amongst veterinarians and owners, resulting in improved breeding practices and clinical management of osteosarcoma in dogs.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40575-021-00100-7.

Non-neoplastic anal sac disorders in UK dogs: Epidemiology and management aspects of a research-neglected syndrome

BACKGROUND

Non-neoplastic anal sac disorders (ASD) are frequent presentations for dogs in primary-care practice but evidence-based information on disease occurrence and risk is sparse. This study estimates prevalence, breed associations and other risk factors as well as reporting on clinical management.

METHODS

A cohort study of dogs attending VetCompass practices between 1 January 2013 and 31 December 2013. Risk factor analysis used multivariable logistic regression methods.

RESULTS

Of 104,212 dogs attending 110 UK practices, the 1-year period prevalence of ASD was 4.40% (95% CI: 4.22-4.57). Compared to crossbreds, six breeds showed increased odds of ASD (Cavalier King Charles spaniel, King Charles spaniel, Cockapoo, Shih-tzu, Bichon Frise and Cocker spaniel), and six breeds showed reduced odds (Labrador Retriever, Border collie, Staffordshire Bull Terrier, Lurcher, German Shepherd Dog and Boxer). Brachycephalic types had 2.6 times the odds for ASD compared to dolichocephalic types. Medication prescribed for ASD included antimicrobials (n = 480, 20.24%) and analgesics (n = 284, 11.97%). Anal sacculectomy was performed in under 1% of cases.

CONCLUSIONS

High prevalence, strong breed predispositions and evidence of severity suggested from the antimicrobial and analgesic therapies combined with current substantial knowledge gaps identify ASD as a key research-neglected syndrome in dogs.

Prevalence of commonly diagnosed disorders in UK dogs under primary veterinary care: results and applications

Background

Although dogs are a commonly owned companion animal in the UK, the species experiences many health problems that are predictable from demographic information. This study aimed to use anonymised veterinary clinical data from the VetCompass™ Programme to report the frequency of common disorders of dogs under primary veterinary care in the UK during 2016 and to explore effects associated with age, sex and neuter status.

Results

From an available population of 905,543 dogs under veterinary care at 886 veterinary clinics during 2016, the current study included a random sample of 22,333 (2.47 %) dogs from 784 clinics. Prevalence for each disorder was calculated at the most refined level of diagnostic certainty (precise-level precision) and after grouping to a more general level of diagnostic precision (grouped-level precision). The most prevalent precise-level precision disorders recorded were periodontal disease (prevalence 12.52 %, 95 % CI: 12.09–12.97), otitis externa (7.30 %, 95 % CI: 6.97–7.65) and obesity (7.07 %, 95 % CI: 6.74–7.42). The most prevalent grouped-level disorders were dental disorder (14.10 %, 95 % CI: 13.64–14.56), skin disorder (12.58 %, 95 % CI: 12.15–13.02) and enteropathy (10.43 %, 95 % CI: 10.04–10.84). Associations were identified for many common disorders with age, sex and neuter.

Conclusions

The overall findings can assist veterinarians and owners to prioritise preventive care and to understand demographic risk factors in order to facilitate earlier diagnosis of common disorders in dogs. The information on associations with age, sex and neuter status provides additional contextual background to the complexity of disorder occurrence and supports targeted health controls for demographic subsets of dogs.

Hypoadrenocorticism in dogs under UK primary veterinary care: frequency, clinical approaches and risk factors

Objectives

To estimate the frequency, clinical approaches and risk factors of hypoadrenocorticism in dogs under UK primary veterinary care.

Materials and Methods

Dogs diagnosed with hypoadrenocorticism were identified from the UK VetCompass™ programme by searching anonymised electronic patient records. Pre‐existing and newly diagnosed cases of disease during 2016 were included. Cases were further sub‐categorised as having a laboratory‐confirmed or presumed diagnosis of hypoadrenocorticism based on the information recorded in the electronic patient records. Descriptive data were manually extracted. Multivariable logistic regression methods were used to identify demographic risk factors.

Results

There were 177 hypoadrenocorticism cases identified from 905,543 dogs in 2016; 72 laboratory‐confirmed and 105 presumed. The 1‐year period prevalence for hypoadrenocorticism in all dogs was 0.06% (95% confidence interval: 0.05‐0.07%). The most common presenting clinical signs in laboratory‐confirmed dogs were lethargy (51/66, 77.3%), anorexia (48/66, 66.7%) and vomiting (48/66, 66.7%). Hyperkalaemia was reported in 47 of 53 (88.7%), hyponatraemia in 46 of 53 (86.8%). Median sodium: potassium ratio was 19.00 (interquartile range: 16.20‐20.60). Breed, age, neuter status and insurance status were associated with a laboratory‐confirmed diagnosis of hypoadrenocorticism. No sex association with hypoadrenocorticism was observed in the multivariable model. The standard poodle had 51.38 times the odds (95% CI: 14.49‐182.18) of hypoadrenocorticism compared with crossbreeds. The labradoodle and West Highland white terrier also had increased odds.

Clinical Significance

This is the first epidemiological study to report on hypoadrenocorticism in dogs within the UK primary‐care population. These results provide benchmark data of current veterinary activity relating to hypoadrenocorticism in primary‐care practices.

Unravelling the health status of brachycephalic dogs in the UK using multivariable analysis

Brachycephalic dog breeds are regularly asserted as being less healthy than non-brachycephalic breeds. Using primary-care veterinary clinical data, this study aimed to identify predispositions and protections in brachycephalic dogs and explore differing inferences between univariable and multivariable results. All disorders during 2016 were extracted from a random sample of 22,333 dogs within the VetCompass Programme from a sampling frame of 955,554 dogs under UK veterinary care in 2016. Univariable and multivariable binary logistic regression modelling explored brachycephaly as a risk factor for each of a series of common disorders. Brachycephalic dogs were younger, lighter and less likely to be neutered than mesocephalic, dolichocephalic and crossbred dogs. Brachycephalic differed to non-brachycephalic types in their odds for 10/30 (33.33%) common disorders. Of these, brachycephalic types were predisposed for eight disorders and were protected for two disorders. Univariable and multivariable analyses generated differing inference for 11/30 (30.67%) disorders. This study provides strong evidence that brachycephalic breeds are generally less healthy than their non-brachycephalic counterparts. Results from studies that report only univariable methods should be treated with extreme caution due to potential confounding effects that have not been accounted for during univariable study design or analysis.

Staffordshire Bull Terriers in the UK: their disorder predispositions and protections

Background

The Staffordshire Bull Terrier is a popular dog breed in the UK but there is limited reliable evidence on disorder predispositions and protections within the breed. Using anonymised veterinary clinical data from the VetCompass™ Programme, this study aimed to identify common disorders with predisposition and protection in the Staffordshire Bull Terrier. The study hypothesised that Staffordshire Bull Terriers would have higher odds of aggression compared with non-Staffordshire Bull Terriers.

Results

The clinical records of a random sample of dogs of all types were reviewed to extract the most definitive diagnoses for all disorders existing during 2016. A combined list from the 30 most common disorders in Staffordshire Bull Terriers and the 30 most common disorders in non-Staffordshire Bull Terriers was generated. Multivariable logistic regression was used to report the odds of each of these disorders in 1304 (5.8%) Staffordshire Bull Terriers compared with 21,029 (94.2%) non-Staffordshire Bull Terriers. After accounting for confounding, Staffordshire Bull Terriers had significantly increased odds of 4/36 (11.1%) disorders compared to non-Staffordshire Bull Terriers with highest odds for seizure disorder (OR 2.06; 95% CI 1.24 to 3.40; p = 0.005). Conversely, Staffordshire Bull Terriers had reduced odds of 5/36 (13.9%) disorders, with lowest odds for patellar luxation (OR 0.15; 95% CI 0.04 to 0.61; p = 0.008). There was no significant difference in the odds of aggression between Staffordshire Bull Terriers compared with non-Staffordshire Bull Terriers (OR 1.09; 95% CI 0.75 to 1.58; p = 0.644).

Conclusions

This study provides a reliable evidence base of breed-specific disorder predispositions and protections that can be used by breeders to optimise breeding decisions. The findings can assist prospective owners of Staffordshire Bull Terriers to make informed decisions when acquiring a dog. From the relative number of predispositions to protections identified, there is no evidence that Staffordshire Bull Terriers have higher overall health problems than non-Staffordshire Bull Terriers.

The use of hydrolysed diets for vomiting and/or diarrhoea in cats in primary veterinary practice

OBJECTIVE

To describe responses of cats prescribed a hydrolysed diet with or without concurrent medication for chronic vomiting and/or diarrhoea of undetermined aetiology.

MATERIALS AND METHODS

Anonymised records of 512,213 cats under UK veterinary care in 2016 from the VetCompass database were searched using relevant terms for hydrolysed diets. The records of 5000 (90%) of 5569 cats with evidence of receiving a hydrolysed diet were randomly reviewed for gastrointestinal indication, prior and concurrent medication and response after hydrolysed dietary intervention. A poor response was defined as evidence of receiving antibiotic or glucocorticoid treatment for vomiting/diarrhoea at visits after the onset of the diet or death from gastrointestinal signs for at least 6 months follow-up.

RESULTS

Of 977 cats prescribed a hydrolysed diet for chronic vomiting/diarrhoea, 697 (71%) were first prescribed the diet without concurrent antibiotics or glucocorticoids while 280 (29%) first received the diet with these medications. Thirty-four per cent of cats in the former group and 61% in the latter had a poor response. Cats older than 6 years and cats prescribed antibiotic and/or glucocorticoid for vomiting/diarrhoea before and concurrently with the diet had higher odds of poor response.

CLINICAL SIGNIFICANCE

Although variations in our observations may reflect severity of signs or prescribing habits of primary-care veterinary surgeons, our study suggests there is merit in trialling a hydrolysed diet first as a sole therapy in cats with chronic vomiting/diarrhoea when diagnostic investigations do not reveal a cause, before resorting to antibiotic and/or glucocorticoid therapy for cases that respond poorly.

Side Effects to Systemic Glucocorticoid Therapy in Dogs Under Primary Veterinary Care in the UK

Objectives: Systemic glucocorticoids are widely used in companion animals. This study aimed to estimate the frequency, describe the characteristics and to evaluate risk factors for common side effects to systemic glucocorticoid therapy in dogs under primary veterinary care in the UK.

Methods: A cohort study using VetCompass™ data from 455,557 dogs under primary veterinary care during 2013 estimated the frequency of side effects to systemic glucocorticoid therapy occurring within 31 days of therapy. Risk factors for the most common side effects, polyuria and polydipsia (PUPD), were evaluated using multivariable logistic regression modeling (P < 0.05).

Results: During 2013, 28,472 study dogs received systemic glucocorticoids (6.2%, 95% CI 6.2–6.3). Review of the records of 3,000 randomly selected treated dogs identified 148 (4.9%, 95% CI 4.2–5.7%) dogs with at least one side effect recorded within 31 days of therapy. The most frequent side effects were polydipsia (39.2% of total presenting signs), polyuria (28.4%), vomiting (16.2%) and diarrhea (14.9%), dogs receiving only oral systemic glucocorticoids (odds ratio, OR: 3.72) and dogs receiving both oral and injectable systemic glucocorticoid (OR: 10.71) had increased odds of PUPD compared with dogs receiving only injectable systemic glucocorticoid. Focusing on the active substance used, treatment with prednisolone tablets only (OR: 3.53) and treatment with both prednisolone tablets and injectable dexamethasone sodium phosphate (OR: 7.62) showed increased odds of PUPD compared to treatment with injectable dexamethasone sodium phosphate only.

Brief: These results can assist veterinarians to optimize therapeutic selection for reduced side effect, to inform owners on common side effects, and help protect the welfare of pets and their owners.

What drives antimicrobial prescribing for companion animals? A mixed-methods study of UK veterinary clinics

Antimicrobial use in companion animals is a largely overlooked contributor to the complex problem of antimicrobial resistance. Humans and companion animals share living spaces and some classes of antimicrobials, including those categorised as Highest Priority Critically Important Antimicrobials (HPCIAs). Veterinary guidelines recommend that these agents are not used as routine first line treatment and their frequent deployment could offer a surrogate measure of 'inappropriate' antimicrobial use. Anthropological methods provide a complementary means to understand how medicines use makes sense 'on-the-ground' and situated in the broader social context. This mixed-methods study sought to investigate antimicrobial use in companion animals whilst considering the organisational context in which increasing numbers of veterinarians work. Its aims were to i) to epidemiologically analyse the variation in the percentage of antimicrobial events comprising of HPCIAs in companion animal dogs attending UK clinics belonging to large veterinary groups and, ii) to analyse how the organisational structure of companion animal practice influences antimicrobial use, based on insight gained from anthropological fieldwork. A VetCompass^TM dataset composed of 468,665 antimicrobial dispensing events in 240,998 dogs from June 2012 to June 2014 was analysed. A hierarchical model for HPCIA usage was built using a backwards elimination approach with clinic and dog identity numbers included as random effects, whilst veterinary group, age quartile, breed and clinic region were included as fixed effects. The largest odds ratio of an antimicrobial event comprising of a HPCIA by veterinary group was 7.34 (95% confidence interval 5.14 - 10.49), compared to the lowest group (p < 0.001). Intraclass correlation was more strongly clustered at dog (0.710, 95% confidence interval 0.701 - 0.719) than clinic level (0.089, 95% confidence interval 0.076 -0.104). This suggests that veterinarians working in the same clinic do not automatically share ways of working with antimicrobials. Fieldwork revealed how the structure of the companion animal veterinary sector was more fluid than that depicted in the statistical model, and identified opportunities and challenges regarding altering antimicrobial use. These findings were organised into the following themes: "Highest priority what?"; "He's just not himself"; "Oh no - here comes the antibiotics police"; "We're like ships that pass in the night"; and "There's not enough hours in the day". This rigorous mixed-methods study demonstrates the importance of working across disciplinary silos when tackling the complex problem of antimicrobial resistance. The findings can help inform the design of sustainable stewardship schemes for the companion animal veterinary sector.

Diabetes mellitus in dogs attending UK primary-care practices: frequency, risk factors and survival

Background

Diabetes mellitus (DM) is an important endocrine disorder of dogs. The objectives of this study were to estimate prevalence and incidence of DM in dogs, and to explore risk factors for DM and the survival of DM cases in primary-care clinics in the UK.

Results

A case-control study nested in the cohort of dogs (n = 480,469) aged ≥3 years presenting at 430 VetCompass clinics was used to identify risk factors for DM, using multivariable logistic regression. Overall 409 new and 863 pre-existing DM cases (total 1272) were identified in 2016, giving an apparent annual prevalence of 0.26% (95% confidence interval (CI): 0.25–0.28%), and an annual incidence risk of 0.09% (95%CI: 0.08–0.09%) in dogs aged ≥3 years. Factors associated with increased odds for DM diagnosis were all age categories > 8 years, female entire dogs (odds ratio (OR): 3.03, 95% CI 1.69–5.44, p < 0.001) and male neutered dogs (OR: 1.99, 95% CI 1.18–3.34, p = 0.010) compared to male entire dogs, Border Terriers (OR: 3.37, 95% CI 1.04–10.98, p = 0.043) and West Highland White Terriers (WHWT) (OR: 2.88, 95% CI 1.49–5.56, p = 0.002) compared to crossbreeds. Dogs that had received previous glucocorticoid treatment (OR: 2.19, 95% CI 1.02–4.70, p = 0.044) and those with concurrent conditions (documented obese, pancreatitis, hyperadrenocorticism) also had increased odds for DM diagnosis.

Cox regression modelling was used to evaluate factors associated with survival in the 409 incident DM cases in 2016. Increased hazard of death following diagnosis of DM was shown in dogs that were ≥ 10 years age, Cocker Spaniels (HR: 2.06, 95% CI 1.06–4.01, p = 0.034) compared to crossbreeds, had a blood glucose (BG) level at diagnosis > 40 mmol/L (HR: 2.73, 95% CI 1.35–5.55, p = 0.005) compared to < 20 mmol/L at diagnosis, or had received previous glucocorticoid treatment (HR: 1.86, 95% CI 1.21–2.86, p = 0.005). Dogs at reduced hazard of death included neutered dogs (HR: 0.58, 95% CI 0.42–0.79, p = 0.001), Border Collies (HR: 0.39, 95% CI 0.17–0.87, p = 0.022) and those starting insulin treatment (HR: 0.08 95% CI 0.05–0.12, p < 0.001).

Conclusions

Certain breeds and concurrent health conditions are associated with an increased risk of DM. In addition to certain signalment factors, a high BG level at diagnosis and prior glucocorticoid treatment were adversely associated with survival of dogs with DM.

Epidemiology and clinical management of elbow joint disease in dogs under primary veterinary care in the UK

Background

Conditions affecting the elbow joint are a common cause of lameness in dogs. Primary-care veterinary clinical data are now recognised as a valuable research resource. Using data from the VetCompass Programme, this study aimed to report the frequency and risk factors for elbow joint disease in dogs under primary veterinary care in the UK and describe clinical management.

Results

From 455,069 dogs under veterinary care, the one-year period prevalence for elbow joint disease diagnosis was 0.56% (95% CI: 0.53-0.60). Of 616 incident cases, the most common specific variants of elbow joint disease were osteoarthritis (n = 468, 75.97%), elbow dysplasia (190, 30.84%) and traumatic (41, 6.66%). The most common signs described by the owners were lameness (n = 466, 75.65%), difficulty exercising (123, 19.97%) and pain (86, 13.96%). The most common findings recorded on veterinary examination were pain (n = 283, 45.94%), lameness (278, 45.13%) and reduced range of movement (243, 39.45%). Common medications used included non-steroidal anti-inflammatory drugs (n = 544, 88.31%), tramadol (121, 19.64%) and disease modifying agents (118, 19.16%). Of 109 deaths involving euthanasia with information available from the 616 incident cases, elbow joint disease contributed to the decision to euthanase in 45 (41.28%) dogs.Five breeds showed increased odds of elbow joint disease compared with crossbred dogs: Rottweiler (OR: 6.16, 95% CI 3.89-9.75), Labrador Retriever (OR: 5.94, 95% CI 4.65-7.60), German Shepherd Dog (OR: 4.13, 95% CI 2.88-5.93), Golden Retriever (OR: 3.11, 95% CI 1.93-5.00) and English Springer Spaniel (OR: 2.00, 95% CI 1.26-3.18). Additional risk factors included having an adult bodyweight that was equal or higher than their breed/sex mean, advancing age, being male, being neutered, being insured and larger bodyweight.

Conclusions

Elbow joint disease is a relatively common diagnosis in dogs and has a high welfare impact as evidenced by the high proportion of cases recorded with pain, lameness and analgesic therapy. There are strong breed predispositions, in particular for large breed dogs. These findings present a clear case for improved breeding programmes to reduce the burden of elbow joint disease.

Demography and commonly recorded clinical conditions of Chihuahuas under primary veterinary care in the UK in 2016

BACKGROUND

The Chihuahua, the world's smallest dog breed, is a popular breed in the UK today. The VetCompass™ Programme collates de-identified clinical records from primary-care veterinary practices in the UK for epidemiological research. This study aimed to characterise the demography, age at death and common disorders of Chihuahuas under primary veterinary care during 2016 in the UK.

RESULTS

Chihuahuas comprised 11,647/336,865 (3.46%) dogs under veterinary care during 2016. The annual proportional birth rate for Chihuahuas rose from 1.01% in 2005 to 5.35% in 2016. Median adult bodyweight was 3.4 kg (interquartile range [IQR]: 2.7-4.3, range 0.8-9.8).). Median age was 2.8 years (interquartile range [IQR] 1.6-4.9). Median age at death from this young expanding population was 8.2 years (IQR 3.5-12.1). Females (10.2 years) outlived males (6.9 years) (Mann-Whitney U test: P = 0.005). The most common grouped causes of death were heart disease (18.8%, 95% CI: 10.9-29.0), lower respiratory tract disorder (16.3%, 95% CI: 8.9-26.2) and traumatic injury (13.8%, 95% CI: 7.1-23.3). The most common specific disorders were periodontal disease (13.5%, 95% CI: 12.6-14.4), obesity (5.9%, 95% CI: 5.3-6.5), retained deciduous dentition (5.7%, 95% CI: 5.1-6.4), anal sac impaction (4.9%, 95% CI: 4.4-5.5) and aggression (4.2%, 95% CI: 3.7-4.8). Among the 28 most common fine-level disorders, males had statistically (P <  0.005) higher probability than females for 5 disorders (aggression, heart murmur, otitis externa, conjunctivitis and upper respiratory tract infection). There were no disorders with statistically (P <  0.005) higher prevalence in females.

CONCLUSIONS

This study documented rising ownership and a currently youthful population of Chihuahuas in the UK. These results suggest that the Chihuahua is currently undergoing a popularity boom but veterinarians need to be watchful for welfare issues related to impulse purchase of Chihuahua puppies by owners with limited experience of dog care. Periodontal disease, obesity, retained deciduous dentition, anal sac impaction and aggression were identified as common health issues within the breed. The unique veterinary care needs of this popular miniature breed suggest that veterinarians should consider the value of advanced training in anesthesia and dentistry in small-sized dogs.

Geographic distribution and environmental risk factors of lymphoma in dogs under primary-care in the UK

OBJECTIVES

To integrate external data sources with VetCompass postcode data to explore the spatial distribution and examine potential associations with environmental risk factors in dogs diagnosed with lymphoma at primary care veterinary practices.

MATERIALS AND METHODS

Cases of lymphoma were identified from electronic patient records of 455,553 dogs under primary veterinary care during 2013 in the UK. Cases were defined as either laboratory-confirmed or non-laboratory-confirmed. Disease maps at the postcode-district level were used to define the geographic distribution of lymphoma incidence and spatial clustering was explored. Environmental risk factors from external data sources were transferred to a compatible format and logistic regression modelling was used to examine associations between environmental herbicide, fungicide and radon concentrations with lymphoma.

RESULTS

From the denominator population of 455,553 dogs, 279 lymphoma cases (187 with laboratory confirmation and 93 without) were identified. Heterogeneous geographic variation was observed with weak evidence of clustering around London and the south-west of England. Herbicide and fungicide exposures were weakly associated with a diagnosis of lymphoma in the univariable analysis. After accounting for the age at diagnosis and breed in the multivariable analysis, herbicide exposure was associated with a diagnosis of lymphoma.

CLINICAL SIGNIFICANCE

The heterogeneous distribution of lymphoma in UK dogs provides further evidence for geographic variation of lymphoma, perhaps in part associated with underlying environmental risk factors. The results suggest an association between environmental herbicide and canine lymphoma.