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Ferrer‐Jorda E, Rodriguez‐Piza I. Complete recovery of a cyclophosphamide overdose after vincristine administration in a dog. VETERINARY RECORD CASE REPORTS 2023. [DOI: 10.1002/vrc2.591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
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Harper A. Management of febrile neutropenia in canine and feline oncology patients. IN PRACTICE 2022. [DOI: 10.1002/inpr.260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Harrer J, Fejös C, Zablotski Y, Hirschberger J, Wolf G, Rieger A, Mayer C, Dorsch R. Bacterial urinary tract infection and subclinical bacteriuria in dogs receiving antineoplastic chemotherapy. J Vet Intern Med 2022; 36:1005-1015. [PMID: 35524488 PMCID: PMC9151473 DOI: 10.1111/jvim.16410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 11/30/2022] Open
Abstract
Background Immunosuppressive treatment with glucocorticoids and cyclosporine increases the risk for positive urine cultures (PUCs) in dogs. Objective To investigate the prevalence and incidence of PUC in dogs diagnosed with cancer and treated with antineoplastic chemotherapy while distinguishing between subclinical bacteriuria (SB) and urinary tract infection (UTI). Animals Forty‐six client‐owned dogs with nonurogenital cancer treated with antineoplastic chemotherapy. Methods Prospective observational longitudinal clinical study. Dogs in which a urine culture was performed before the start of and at least once during antineoplastic chemotherapy were included. A McNemar's test was used to investigate if the prevalence of PUC increased during antineoplastic chemotherapy. Positive urine cultures were categorized into SB and UTI and multiple PUCs from the same dog and category were grouped together as 1 episode of PUC. Results Urine culture was positive in 21/185 urine samples in 8/46 dogs. Antineoplastic chemotherapy did not influence the prevalence of PUC (P = 1.00), which was 11% (5/46 dogs; 95% confidence interval: 5‐23%) before the start of and 13% (6/46 dogs; 95% confidence interval: 6‐26%) during antineoplastic chemotherapy. Eight dogs had 10 episodes of PUC; 7/10 episodes were classified as SB, and in 3/10 episodes UTI (chronic prostatitis, prostatic abscess, and emphysematous cystitis) was diagnosed. Escherichia coli was the most common pathogen, isolated in 9/10 episodes. Conclusions and Clinical Importance We did not find evidence that antineoplastic chemotherapy is a major predisposing factor for the development of PUC. Most dogs with PUC had SB.
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Affiliation(s)
- Julia Harrer
- Clinic of Small Animal Internal Medicine, Centre for Clinical Veterinary Medicine, Ludwig-Maximilian-University, Munich, Germany
| | - Csilla Fejös
- Clinic of Small Animal Internal Medicine, Centre for Clinical Veterinary Medicine, Ludwig-Maximilian-University, Munich, Germany
| | - Yury Zablotski
- Clinic of Small Animal Internal Medicine, Centre for Clinical Veterinary Medicine, Ludwig-Maximilian-University, Munich, Germany
| | - Johannes Hirschberger
- Clinic of Small Animal Internal Medicine, Centre for Clinical Veterinary Medicine, Ludwig-Maximilian-University, Munich, Germany
| | - Georg Wolf
- Department of Veterinary Sciences, Institute of Infectious Diseases and Zoonoses, Faculty of Veterinary Medicine, Ludwig-Maximilian-University, Munich, Germany
| | - Alexandra Rieger
- Department of Veterinary Sciences, Institute of Veterinary Pathology, Faculty of Veterinary Medicine, Ludwig-Maximilian-University, Munich, Germany
| | - Christian Mayer
- Department of Veterinary Sciences, Institute of Veterinary Pathology, Faculty of Veterinary Medicine, Ludwig-Maximilian-University, Munich, Germany
| | - Roswitha Dorsch
- Clinic of Small Animal Internal Medicine, Centre for Clinical Veterinary Medicine, Ludwig-Maximilian-University, Munich, Germany
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Bergstrand E, Tvedten HW, Lilliehöök I. Detection of frequent neutrophil misclassification by the ProCyte Dx in sick dogs and how to avoid it. J Small Anim Pract 2022; 63:603-608. [PMID: 35316864 PMCID: PMC9543681 DOI: 10.1111/jsap.13499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 02/16/2022] [Accepted: 03/01/2022] [Indexed: 11/28/2022]
Abstract
Objectives A common and severe error in identifying neutrophils in feline blood samples by the IDEXX ProCyte Dx haematology analyser (ProCyte) has been reported. The hypothesis was that the same or similar error would be identified during analysis of canine blood samples and that white blood cell dot plot evaluation would be critical to detect and avoid erroneous results. Materials and Methods Eighty‐six canine blood samples collected for clinical diagnosis of hospital patients were evaluated. Differential leukocyte counts were determined by the ProCyte Dx, ADVIA 2120 and manual methods. ProCyte neutrophil percentage results were considered unacceptable if the result was 15% different than percentage results from both ADVIA 2120 and manual counts. ProCyte WBC dot plots and instrument flags were evaluated for correctness. Results The ProCyte neutrophil counts were unacceptably lower than the ADVIA 2120 and manual neutrophil counts in 13 samples (15% of 86 samples). Neutrophils misclassified by the instrument were erroneously classified as monocytes and/or lymphocytes. All these samples were from patients with systemic inflammation. The error could be eliminated by rejecting results from samples with incorrect separation of cell clusters in the ProCyte WBC dot plots. Clinical Significance The ProCyte neutrophil count error with canine blood samples is common, severe and might affect clinical decisions. Operators of the instrument must evaluate white blood cell dot plots for correctness to avoid the error.
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Affiliation(s)
- E Bergstrand
- University Animal Hospital, Swedish University of Agricultural Sciences, Box 7054, 75007, Uppsala, Sweden
| | - H W Tvedten
- Clinical Pathology Laboratory, Swedish University of Agricultural Sciences, Box 7054, 75007, Uppsala, Sweden
| | - I Lilliehöök
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Sciences, Swedish University of Agricultural Sciences, Uppsala, 75007, Sweden
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Lawson HC, Musser ML, Regan R, Moore AS, Hohenhaus A, Flesner B, Johannes CM. Toxicity, outcome, and management of anthracycline overdoses in 16 dogs. J Vet Intern Med 2021; 36:234-243. [PMID: 34825413 PMCID: PMC8783333 DOI: 10.1111/jvim.16325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 11/11/2021] [Accepted: 11/17/2021] [Indexed: 12/01/2022] Open
Abstract
Background Despite multiple reports of chemotherapy overdoses (ODs) in human and veterinary medicine, anthracycline ODs have been described infrequently. Hypothesis/Objectives Describe toxicities, treatments, and overall outcome after anthracycline OD in dogs. Animals Twelve mitoxantrone (MTX) and 4 doxorubicin (DOX) ODs were evaluated. Methods Multicenter retrospective analysis. The American College of Veterinary Internal Medicine oncology and internal medicine listservs were solicited for cases in which a chemotherapy OD occurred. Results Sixteen anthracycline cases were collected. Anthracycline ODs occurred because of an error in chemotherapy preparation (n = 9), or dose miscalculation (n = 7). The overall median OD was 1.9× (range, 1.4‐10×) the prescribed amount. Most ODs were identified immediately after drug administration (n = 11), and the majority of patients were hospitalized on supportive care (n = 11) for an average of 8 days (range, 3‐34 days). Adverse events after the OD included neutropenia (94%), thrombocytopenia (88%), anemia (63%), diarrhea (63%), anorexia (56%), vomiting (38%), lethargy (31%), and nausea (25%). Two patients did not survive the OD. High grade neutropenia was common and did not appear to be mitigated by the administration of filgrastim. Conclusions and Clinical Importance All patients received supportive care after identifying the OD and death was uncommon. Further evaluation is needed to determine ideal therapeutic guidelines anthracycline OD.
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Affiliation(s)
- Haylie C Lawson
- College of Veterinary Medicine, Iowa State University, Ames, Iowa, USA
| | - Margaret L Musser
- College of Veterinary Medicine, Iowa State University, Ames, Iowa, USA
| | | | - Antony S Moore
- Veterinary Oncology Consultants, Lake Innes, New South Wales, Australia
| | | | - Brian Flesner
- College of Veterinary Medicine, University of Missouri, Columbia, Missouri, USA
| | - Chad M Johannes
- College of Veterinary Medicine, Iowa State University, Ames, Iowa, USA
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Aspinall S, Desmas I, Bazelle J. Use of eltrombopag and granulocyte colony‐stimulating factor in treatment of lomustine overdose in a dog. VETERINARY RECORD CASE REPORTS 2021. [DOI: 10.1002/vrc2.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Abstract
As drug-resistant pathogens emerge and spread globally, antimicrobial (especially antibiotic) treatments are becoming less effective. As infections become more complex and costly to treat in humans and animals, antimicrobial resistance (AMR) is a global challenge of real and increasing scale and complexity. If we do not act for the long term and with sustainability in mind, the annual deaths we see currently, numbering 700,000 globally, will rise each year to 10 million by 2050. To effectively contain and mitigate AMR, we need more evidence of the drivers and impacts of AMR on human, animal and environmental health, and the links between them. We also need to turn evidence into action and tailored, sustainable approaches for countries and communities, which put clinicians and patients at the centre. Excellent research is underway across the world into innovation (including new treatments, diagnostics and vaccines), infection prevention and behavioural interventions. In this article, we explore how, where and why research should be intensified, with increased collaboration and transparency, to strengthen global health security and secure the future of modern medicine for patients globally.
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Curran K, Leeper H, O′Reilly K, Jacob J, Bermudez LE. An Analysis of the Infections and Determination of Empiric Antibiotic Therapy in Cats and Dogs with Cancer-Associated Infections. Antibiotics (Basel) 2021; 10:antibiotics10060700. [PMID: 34208146 PMCID: PMC8230819 DOI: 10.3390/antibiotics10060700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/04/2021] [Accepted: 06/09/2021] [Indexed: 11/16/2022] Open
Abstract
Cancer patients commonly develop infectious complications over the course of the disease. One thousand patients receiving treatment for an oncologic disease at a single veterinary teaching hospital were retrospectively reviewed for concurrent infections. A total of 153 confirmed bacterial infections were identified, 82 of which were abscesses or wounds, 13 of which were respiratory infections, 3 of which were ear infections, and 55 of which were urinary tract infections. It was observed that the majority of the infections were caused by bacteria that are normally associated with that specific site location. Escherichia coli was the most common pathogen linked to infections in general, but Staphylococcus pseudintermedius was a frequently identified pathogen associated with wound infections. The susceptibility to diverse antimicrobials varied with the site of infection. Eleven cases (7.1%) were caused by opportunistic infections of the site, and E. coli and Pseudomonas aeruginosa were the pathogens isolated. Those bacteria were resistant to many antibiotics but showed susceptibility to aminoglycosides, imipenem, quinolones, and polymyxin B. In conclusion, veterinary patients with cancer or those under treatment for tumors develop infections by commonly encountered bacteria in the different sites of the body, with a susceptibility to antibiotics that is not out of line from what is expected. A small subset of cases developed opportunistic infections, with microbes that were more resistant to many classes of antibiotics.
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Affiliation(s)
- Katie Curran
- Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, OR 97331, USA; (K.C.); (H.L.)
| | - Haley Leeper
- Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, OR 97331, USA; (K.C.); (H.L.)
| | - Kathy O′Reilly
- Department of Biomedical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, OR 97331, USA;
- Oregon Veterinary Diagnostic Laboratory, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, OR 97331, USA;
| | - Joelle Jacob
- Oregon Veterinary Diagnostic Laboratory, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, OR 97331, USA;
| | - Luiz E. Bermudez
- Department of Biomedical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, OR 97331, USA;
- Department of Microbiology, College of Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, OR 97331, USA
- Correspondence:
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Horta RS, Souza LM, Sena BV, Almeida IO, Jaretta TA, Pimenta MM, Reche Júnior A. LOPH: a novel chemotherapeutic protocol for feline high-grade multicentric or mediastinal lymphoma, developed in an area endemic for feline leukemia virus. J Feline Med Surg 2021; 23:86-97. [PMID: 32684120 PMCID: PMC10741351 DOI: 10.1177/1098612x20926893] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The aim of this study was to establish the safety and efficacy of a novel multidrug lomustine-based chemotherapeutic protocol for cats with high-grade multicentric or mediastinal lymphoma, in an area endemic for feline leukemia virus (FeLV). METHODS This prospective study included owned cats, diagnosed (cytologically) with multicentric or mediastinal lymphoma and treated with the LOPH (lomustine, vincristine [Oncovin; Antibióticos do Brasil], prednisolone and hydroxydaunorubicin [doxorubicin]) protocol. A complete blood count was performed before every chemotherapy session and any significant abnormalities recorded as possible related toxicities. Median survival time (MST) and disease-free interval were estimated by Kaplan-Meier curves. RESULTS Twenty-one cats were included in this study. Nineteen (90.5%) tested positive for FeLV and were therefore considered to have persistent viremia. Complete response was reported in 81% (n = 17/21), while three had partial remission and one had no response. Seven cats finished the induction protocol within 20-31 weeks (23.1 ± 4.5; median 20) and all seven received a maintenance protocol. The MST (lymphoma-related survival) for the 21 cats was 214 days. The MST was 214 days for cats with mediastinal lymphoma (n = 13), but it was not reached for multicentric lymphoma (n = 8; P = 0.9). The MST of cats with persistent FeLV antigenemia was 171 days. Grade I anorexia and vomiting occurred in 19% of the cats (n = 4/21). Hematologic toxicity was found in 100% of the cats at some point during their treatment, but it was mostly grade I or II. Neutropenia, thrombocytopenia and anemia occurred in 16/21, 21/21 and 15/21 cats, respectively. CONCLUSIONS AND RELEVANCE The LOPH protocol was well tolerated by cats with lymphoma and persistent FeLV viremia, and resulted in a better MST than similar studies with other protocols. Novel studies and controlled trials are necessary in order to evaluate the efficacy of different protocols according to the lymphoma subtype, anatomic form and FeLV status.
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Affiliation(s)
- Rodrigo S Horta
- Department of Veterinary Medicine and
Surgery, Veterinary School, Federal University of Minas Gerais, Belo Horizonte, MG,
Brazil
| | - Larissa M Souza
- Department of Veterinary Medicine, Vila
Velha University, Vila Velha, ES, Brazil
| | - Bruna V Sena
- Prof. Ricardo Alexandre Hippler
Veterinary Hospital, Vila Velha University, Vila Velha, ES, Brazil
| | - Isabella O Almeida
- Prof. Ricardo Alexandre Hippler
Veterinary Hospital, Vila Velha University, Vila Velha, ES, Brazil
| | - Tâmara A Jaretta
- Department of Veterinary Medicine, Vila
Velha University, Vila Velha, ES, Brazil
| | | | - Archivaldo Reche Júnior
- Faculty of Veterinary Medicine and
Zootechny, University of São Paulo (USP), São Paulo, Brazil
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Marcum BA, Li Z, Turek JJ, Moore GE, Nolte DD, Childress MO. Biodynamic signatures from ex vivo bone marrow aspirates are associated with chemotherapy-induced neutropenia in cancer-bearing dogs. Vet Med Sci 2020; 7:665-673. [PMID: 33369129 PMCID: PMC8136957 DOI: 10.1002/vms3.423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 11/18/2020] [Accepted: 12/09/2020] [Indexed: 12/27/2022] Open
Abstract
Background Neutropenia is the most common dose‐limiting side effect of cytotoxic chemotherapy in cancer‐bearing dogs. Biodynamic imaging (BDI) is a functional imaging technology that measures dynamic light scattering from living, three‐dimensional tissues to characterize intracellular motion within those tissues. Previous studies have associated BDI biomarkers with tumour sensitivity to chemotherapy agents in dogs with naturally occurring cancer. We hypothesized that BDI, performed ex vivo on bone marrow aspirate samples, would identify dynamic biomarkers associated with the occurrence of specific degrees of neutropenia in tumour‐bearing dogs receiving doxorubicin chemotherapy. Materials and Methods Bone marrow aspirates were collected from 10 dogs with naturally occurring cancers prior to initiation of doxorubicin treatment. BDI was performed on bone marrow samples treated ex vivo with doxorubicin at 0.1, 1, 10 and 100 μM along with 0.1% DMSO as a control. Dogs then were treated with doxorubicin (30 mg/m2, intravenously). Peripheral blood neutrophil counts were obtained on the day of treatment and again 7 days later. Receiver operating characteristic curves identified provisional breakpoints for BDI biomarkers that correlated with specific changes in neutrophil counts between the two time points. Results Provisional breakpoints for several BDI biomarkers were identified, specifying dogs with the largest proportionate change in neutrophils and with neutropenia that was grade 2 or higher following doxorubicin treatment. Conclusions Biodynamic imaging of bone marrow aspirates may identify those dogs at greater risk for neutropenia following doxorubicin chemotherapy. This approach may be useful for pre‐emptively modifying chemotherapy dosing in dogs to avoid unacceptable side effects.
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Affiliation(s)
- Blake A Marcum
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA
| | - Zhe Li
- Department of Physics and Astronomy, College of Science, Purdue University, West Lafayette, IN, USA
| | - John J Turek
- Department of Basic Medical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA
| | - George E Moore
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA
| | - David D Nolte
- Department of Physics and Astronomy, College of Science, Purdue University, West Lafayette, IN, USA
| | - Michael O Childress
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA
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Bisson JL, Fournier Q, Johnston E, Handel I, Bavcar S. Evaluation of a 0.75 × 10 9 /L absolute neutrophil count cut-off for antimicrobial prophylaxis in canine cancer chemotherapy patients. Vet Comp Oncol 2019; 18:258-268. [PMID: 31600416 DOI: 10.1111/vco.12544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 09/28/2019] [Accepted: 09/30/2019] [Indexed: 12/29/2022]
Abstract
Absolute neutrophil count (ANC) cut-offs for antimicrobial prophylaxis in veterinary cancer chemotherapy patients are empirical and vary between institutions. Evidence based cut-offs are vital for antimicrobial stewardship, particularly as global antimicrobial resistance rises. The primary objectives of this study were to evaluate the tolerability of a <0.75 × 109 /l ANC cut-off for antimicrobial prophylaxis in dogs after receiving chemotherapy and its impact on antimicrobial prescription. Predicted nadir ANCs (pnANCs) were stratified into six groups (<0.75 × 109 /l [receiving antimicrobial prophylaxis], 0.75-0.99 × 109 /l, 1-1.49 × 109 /l, 1.5-1.99 × 109 /l, 2.0-3.59 × 109 /l and 3.6-12 × 109 /l [reference interval]). The incidences of post-nadir febrile neutropenia (FN) and non-haematological toxicity (NHT) were compared between groups. Five hundred and eighty-six pnANCs were recorded for 181 dogs. There were four episodes of post-nadir FN and 90 episodes of post-nadir NHT. There was no significant difference in incidence of post-nadir FN (P = .063) or post-nadir NHT (P = .084) between pnANC groups. Antimicrobial prophylaxis was prescribed following 8.8% of the chemotherapy administrations; had cut-off values of <1.0 × 109 /l or <1.5 × 109 /l been used it would have been prescribed in 15.3% and 25.8% of cases respectively. An ANC cut-off of <0.75 × 109 /l for antimicrobial prophylaxis appears to be well tolerated and minimizes the prescription of antimicrobials.
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Affiliation(s)
- Jocelyn L Bisson
- The Royal (Dick) School of Veterinary Studies and the Roslin Institute, The University of Edinburgh, Roslin, UK
| | - Quentin Fournier
- The Royal (Dick) School of Veterinary Studies and the Roslin Institute, The University of Edinburgh, Roslin, UK
| | - Emily Johnston
- The Royal (Dick) School of Veterinary Studies and the Roslin Institute, The University of Edinburgh, Roslin, UK
| | - Ian Handel
- The Royal (Dick) School of Veterinary Studies and the Roslin Institute, The University of Edinburgh, Roslin, UK
| | - Spela Bavcar
- The Royal (Dick) School of Veterinary Studies and the Roslin Institute, The University of Edinburgh, Roslin, UK
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