1
|
Arnecke AL, Schwarz S, Lübke-Becker A, Jensen KC, Bahramsoltani M. A Survey on Companion Animal Owners' Perception of Veterinarians' Communication About Zoonoses and Antimicrobial Resistance in Germany. Animals (Basel) 2024; 14:3346. [PMID: 39595398 PMCID: PMC11590884 DOI: 10.3390/ani14223346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2024] [Revised: 11/10/2024] [Accepted: 11/19/2024] [Indexed: 11/28/2024] Open
Abstract
The intimate bonds between humans and their pets create favourable conditions that support the mutual transmission of pathogens in either direction. In this context, veterinarians are essential in informing and educating pet owners about health risks linked to zoonotic pathogens and antimicrobial resistance (AMR). To effectively convey this information, veterinarians should have strong communication skills. To gather insights on pet ownership, veterinary consultations, and risk communication, an online questionnaire was used to survey dog and cat owners in Germany. The survey evaluated the frequency and perception of communication concerning zoonotic pathogens and AMR, deriving a communication score. The findings showed that pet owners rated veterinarian communication with a high average score, reflecting a high satisfaction level. The longer pet owners had been clients, the more frequently they received information on zoonoses and AMR, and the better they rated the communication. However, the results also indicated that the amount of information on zoonoses and/or AMR provided by veterinarians was still lower than desired by pet owners. Risk factors, including pathogen detection, vulnerable individuals, owning imported animals, and feeding them raw meat, fish, offal, or uncooked bones, were regularly present. These findings underscore the critical role of risk communication in preventing zoonoses and AMR.
Collapse
Affiliation(s)
- Amelie Lisa Arnecke
- Institute of Veterinary Anatomy, School of Veterinary Medicine, Freie Universität Berlin, Koserstraße 20, 14195 Berlin, Germany; (A.L.A.); (M.B.)
- Institute of Veterinary Pathology, Faculty of Veterinary Medicine, Leipzig University, An den Tierkliniken 33, 04103 Leipzig, Germany
| | - Stefan Schwarz
- Institute of Microbiology and Epizootics, School of Veterinary Medicine, Freie Universität Berlin, Robert-von-Ostertag-Straße 7, 14163 Berlin, Germany;
- Veterinary Centre for Resistance Research (TZR), School of Veterinary Medicine, Freie Universität Berlin, Robert-von-Ostertag-Straße 8, 14163 Berlin, Germany
| | - Antina Lübke-Becker
- Institute of Microbiology and Epizootics, School of Veterinary Medicine, Freie Universität Berlin, Robert-von-Ostertag-Straße 7, 14163 Berlin, Germany;
- Veterinary Centre for Resistance Research (TZR), School of Veterinary Medicine, Freie Universität Berlin, Robert-von-Ostertag-Straße 8, 14163 Berlin, Germany
| | - Katharina Charlotte Jensen
- Institute for Veterinary Epidemiology and Biostatistics, School of Veterinary Medicine, Freie Universität Berlin, Königsweg 67, 14163 Berlin, Germany;
| | - Mahtab Bahramsoltani
- Institute of Veterinary Anatomy, School of Veterinary Medicine, Freie Universität Berlin, Koserstraße 20, 14195 Berlin, Germany; (A.L.A.); (M.B.)
| |
Collapse
|
2
|
Kurnosova OP, Panova OA, Arisov MV. Prevalence of Giardia duodenalis in dogs and cats: Age-related predisposition, symptomatic, and asymptomatic cyst shedding. Vet World 2024; 17:379-383. [PMID: 38595671 PMCID: PMC11000481 DOI: 10.14202/vetworld.2024.379-383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 01/23/2024] [Indexed: 04/11/2024] Open
Abstract
Background and Aim Giardiasis is a protozoal disease that is globally prevalent in dogs and cats. The clinical manifestations vary, but asymptomatic cases have also been reported. This study aimed to estimate the prevalence of Giardia duodenalis in domestic dogs and cats, characterize the age susceptibility to this disease, and determine the frequency of cases in which cysts are combined with stool changes. Materials and Methods After centrifugation in a zinc sulfate solution (specific gravity = 1.32 g/cm3), feces of dogs (2761) and cats (1579) were examined microscopically. The age of the animals and the presence of coprological stool characteristics such as fecal odor, consistency, presence of mucus, and other pathological impurities were taken into account. Results G. duodenalis infection rates were 18.2% (215/1182) in dogs aged 1-12 months and 3.8% (60/1579) in dogs older than 12 months. The infection rate was 7.8% (48/615) in cats aged 1-12 months and 3.35% (33/994) in cats aged >12 months. The most frequently observed coprological abnormalities in cyst-positive animals were soft and/or mushy stool and pungent odor. In dogs, the frequency of these symptoms was 24.4% (67/275), 27.6% (76/275), and 36.4% (100/275) for soft stools, mushy stools, and pungent fecal odor, and 37.8% (31/82), 25.6% (21/82), and 19.5% (16/82), respectively. No stool changes were found when G. duodenalis cysts were detected in dogs in 24.7% (68/275) of cases and in cats in 24.4% (20/82). Conclusion G. duodenalis cysts are reported more frequently in domestic cats and dogs under 12 months of age than in dogs under 12 months of age. The presence of Giardia cysts is usually accompanied by a strong odor of feces and changes in their consistency. It can be concluded that it is necessary to conduct periodic surveillance for apparently healthy dogs and cats to rule out G. duodenalis infection.
Collapse
Affiliation(s)
- Olga P. Kurnosova
- Federal State Budget Scientific Institution, “Federal Scientific Centre VIEV” (FSC VIEV), 117218, Russia
| | - Olga A. Panova
- Federal State Budget Scientific Institution, “Federal Scientific Centre VIEV” (FSC VIEV), 117218, Russia
| | - Mikhail V. Arisov
- Federal State Budget Scientific Institution, “Federal Scientific Centre VIEV” (FSC VIEV), 117218, Russia
| |
Collapse
|
3
|
Šmit I, Potočnjak D, Matijatko V, Torti M, Jović I, Grden D, Crnogaj M, Beck R. The Influence of Giardia duodenalis on the Occurrence of Clinical Signs in Dogs. Vet Sci 2023; 10:694. [PMID: 38133245 PMCID: PMC10748341 DOI: 10.3390/vetsci10120694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/02/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023] Open
Abstract
Giardia duodenalis infections are common in dogs and are mainly caused by assemblages C and D. The aim of this study was to investigate the correlation between the presence of Giardia duodenalis and different Giardia assemblages detected in symptomatic and asymptomatic dogs and the occurrence of certain clinical signs. All the dogs included (n = 82) were clinically examined, and fecal samples were examined for other parasites and Clostridium spp. Also, G. duodenalis assemblages were detected and the occurrence of certain clinical signs was assessed. A total of 42/82 (51.2%) dogs were symptomatic and had one or more gastrointestinal signs, and 40/82 (48.8%) dogs were asymptomatic. G. duodenalis was found in 25/82 (30.5%) dogs: assemblage C in 10/25 (40%) and assemblage D in 15/25 (60%). Only Cryptosporidium spp. showed a higher coinfection rate with G. duodenalis but that did not have an influence on clinical sign appearance. There was no correlation between the presence of different assemblages of G. duodenalis and the sex of the host or the duration and appearance of certain clinical signs, except the presence of mucus in feces, which was more frequent in dogs invaded with G. duodenalis assemblage C. Further research of other assemblages is needed.
Collapse
Affiliation(s)
- Iva Šmit
- Clinic for Internal Diseases of the Faculty of Veterinary Medicine, University of Zagreb, 10000 Zagreb, Croatia; (I.Š.)
| | - Dalibor Potočnjak
- Clinic for Internal Diseases of the Faculty of Veterinary Medicine, University of Zagreb, 10000 Zagreb, Croatia; (I.Š.)
| | - Vesna Matijatko
- Clinic for Internal Diseases of the Faculty of Veterinary Medicine, University of Zagreb, 10000 Zagreb, Croatia; (I.Š.)
| | - Marin Torti
- Clinic for Internal Diseases of the Faculty of Veterinary Medicine, University of Zagreb, 10000 Zagreb, Croatia; (I.Š.)
| | - Ines Jović
- Clinic for Internal Diseases of the Faculty of Veterinary Medicine, University of Zagreb, 10000 Zagreb, Croatia; (I.Š.)
| | - Darko Grden
- Clinic for Internal Diseases of the Faculty of Veterinary Medicine, University of Zagreb, 10000 Zagreb, Croatia; (I.Š.)
| | - Martina Crnogaj
- Clinic for Internal Diseases of the Faculty of Veterinary Medicine, University of Zagreb, 10000 Zagreb, Croatia; (I.Š.)
| | - Relja Beck
- Department for Bacteriology and Parasitology, Croatian Veterinary Institute, 10000 Zagreb, Croatia
| |
Collapse
|
4
|
Kanski S, Weber K, Busch K. [Feline and canine giardiosis: An Update]. TIERARZTLICHE PRAXIS. AUSGABE K, KLEINTIERE/HEIMTIERE 2023; 51:411-421. [PMID: 38056479 DOI: 10.1055/a-2191-1723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Abstract
Giardia duodenalis is a facultative pathogenic intestinal parasite. Giardiosis in dogs and cats may appear with or without clinical signs. Typical signs include diarrhea with or without vomiting. The prevalence in young animals is high and may amount to up to 50%. There are 8 different genotypes (A - H), which are called assemblages. Assemblages C and D are most common in dogs and assemblage F most frequent in cats. However, animals may also be infected with the zoonotically effective assemblages A and B or exhibit mixed infections. The immunofluorescence test (IFA), the enzyme-linked immunosorbent assay (ELISA) and fecal centrifugation using zinc sulphate solution are currently recommended as diagnostic methods. Polymerase chain reaction (PCR) may be used to determine the corresponding assemblage. Approved treatments for giardiosis include fenbendazole and metronidazole. In addition, undertaking specific hygiene measures is warranted. Only animals showing clinical signs or those living in the same household with high-risk patients (e. g. immunosuppressed humans) are recommended to receive medication. The aim of treatment is clinical improvement of the diseased dogs and cats. Frequently, complete elimination of Giardia is not attained.
Collapse
Affiliation(s)
- Sabrina Kanski
- Medizinische Kleintierklinik, Ludwig-Maximilians-Universität München
| | - Karin Weber
- Medizinische Kleintierklinik, Ludwig-Maximilians-Universität München
| | - Kathrin Busch
- Medizinische Kleintierklinik, Ludwig-Maximilians-Universität München
| |
Collapse
|
5
|
Sun J, Qin Z, Fu Y, Qin H, Sun M, Dong H, Chao L, Zhang L, Li J. Assessment of potential zoonotic transmission of Giardia duodenalis from dogs and cats. One Health 2023; 17:100651. [PMID: 38116451 PMCID: PMC10728314 DOI: 10.1016/j.onehlt.2023.100651] [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: 07/09/2023] [Accepted: 11/07/2023] [Indexed: 12/21/2023] Open
Abstract
Giardia duodenalis is one of the major causes of diarrhea among humans, especially in young children. Statistical analysis revealed that the pooled prevalence of G. duodenalis in humans, dogs, and cats was 9.72% (10,921/112383), 15.60% (7510/48140), and 14.53% (1125/7740), respectively. Unquestionably, the canine-specific assemblages C and D and the feline-specific assemblage F were the dominant genotypes in dogs and cats, respectively. Additionally, the prevalence of zoonotic G. duodenalis assemblages (A and B) in dogs and cats was 23.07% (875/3792) and 41.42% (169/408), respectively, implying that the potential transmission of G. duodenalis from dogs and cats to human infection cannot be ignored. The highest frequency of potentially zoonotic assemblages was found among working dogs (3.55%, 25/705) and the 1-5 age group (22.92%, 11/48). In summary, dogs and cats have a significant role in the zoonotic transmission of G. duodenalis due to their close contact with humans and the higher frequency presence of zoonotic assemblages. Further studies are necessary to explore the presence of G. duodenalis among humans and animals and in environmental samples. Researchers should adopt a one-health approach to gain a deeper understanding of G. duodenalis in dogs and cats and potential transmission routes to humans.
Collapse
Affiliation(s)
- Jingjing Sun
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou 450046, China
- International Joint Research Laboratory for Zoonotic Diseases of Henan, Zhengzhou 450046, China
- Key Laboratory of Quality and Safety Control of Poultry Products, Ministry of Agriculture and Rural Affairs, Zhengzhou 450046, China
| | - Ziyang Qin
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou 450046, China
- International Joint Research Laboratory for Zoonotic Diseases of Henan, Zhengzhou 450046, China
- Key Laboratory of Quality and Safety Control of Poultry Products, Ministry of Agriculture and Rural Affairs, Zhengzhou 450046, China
| | - Yin Fu
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou 450046, China
- International Joint Research Laboratory for Zoonotic Diseases of Henan, Zhengzhou 450046, China
- Key Laboratory of Quality and Safety Control of Poultry Products, Ministry of Agriculture and Rural Affairs, Zhengzhou 450046, China
| | - Huikai Qin
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou 450046, China
- International Joint Research Laboratory for Zoonotic Diseases of Henan, Zhengzhou 450046, China
- Key Laboratory of Quality and Safety Control of Poultry Products, Ministry of Agriculture and Rural Affairs, Zhengzhou 450046, China
| | - Mengqing Sun
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou 450046, China
- International Joint Research Laboratory for Zoonotic Diseases of Henan, Zhengzhou 450046, China
- Key Laboratory of Quality and Safety Control of Poultry Products, Ministry of Agriculture and Rural Affairs, Zhengzhou 450046, China
| | - Haiju Dong
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou 450046, China
| | - Liqin Chao
- Medical School, Henan University of Chinese Medicine, Zhengzhou 450046, Henan, China
| | - Longxian Zhang
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou 450046, China
- International Joint Research Laboratory for Zoonotic Diseases of Henan, Zhengzhou 450046, China
- Key Laboratory of Quality and Safety Control of Poultry Products, Ministry of Agriculture and Rural Affairs, Zhengzhou 450046, China
| | - Junqiang Li
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou 450046, China
- International Joint Research Laboratory for Zoonotic Diseases of Henan, Zhengzhou 450046, China
- Key Laboratory of Quality and Safety Control of Poultry Products, Ministry of Agriculture and Rural Affairs, Zhengzhou 450046, China
| |
Collapse
|
6
|
Kurnosova OP, Panova OA, Arisov MV. The prevalence of potentially zoonotic intestinal parasites in dogs and cats in Moscow, Russia. Helminthologia 2023; 60:44-51. [PMID: 37305673 PMCID: PMC10251758 DOI: 10.2478/helm-2023-0009] [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: 10/07/2022] [Accepted: 03/06/2023] [Indexed: 06/13/2023] Open
Abstract
This study was aimed to determine the prevalence of Toxocara canis/cati, Strongyloides stercoralis, Giardia spp., and Cryptosporidium spp., which occur and are potentially zoonotic to humans in domestic dogs and cats in Moscow (Russia). The fecal flotation method and larvae detection by microscopy of a direct feces smear were performed to detect Toxocara, Giardia spp., and Cryptosporidium spp. The total parasitic prevalence in dogs was as follows: Giardia spp.: 10.2 % (226/2208), Cryptosporidium spp.: 2.7 % (60/2208), T. canis: 2 % (45/2208), S. stercoralis larvae: 1.1 % (25/2208). The younger animals under were infected more than those over 12 months of age (p<0.001). The preva lence rates were along these lines: Giardia spp. (18.2 %), Cryptosporidium spp. (5.7 %), T.canis (3 %), S. stercoralis larvae (2.3 %). The overall prevalence in cats was as follows: Giardia spp. - 5.2 % (71/1350), Cryptosporidium spp. - 4.8 % (65/1350), T. cati - 4.1 % (56/1350). Similarly to dogs, the infection rates were higher in cats under 12 months of age Giardia spp. (8.2 %), Cryptosporidium spp. (8.6 %), T. cati (7.5 %. Analysis of combined infections in dogs revealed the following combinations: Giardia spp. and Cryptosporidium spp. (35.5 %) larvae of S. stercoralis sp. and Giardia spp. (32.3 %), T.canis and Giardia spp. (22.6 %), T.canis and Cryptosporidium spp. (6.6 %), T.canis and S.stercoralis and (3.2 %), respectively. In cats, only two coinfections by Giardia spp. and Cryptosporidium spp. (58.3 %), and T.cati with Giardia spp. (41.7 %) were noticed. Further research is needed to study the spread of parasitic diseases in pet animals. The data will improve countermeasures to prevent these diseases' spread among animals and humans.
Collapse
Affiliation(s)
- O. P. Kurnosova
- Federal State Budget Scientific Institution, Russian Academy of Sciences, Moscow, Russia
| | - O. A. Panova
- Federal State Budget Scientific Institution, Russian Academy of Sciences, Moscow, Russia
| | - M. V. Arisov
- Federal State Budget Scientific Institution, Russian Academy of Sciences, Moscow, Russia
| |
Collapse
|
7
|
Retrospective Survey of Dog and Cat Endoparasites in Ireland: Antigen Detection. Animals (Basel) 2022; 13:ani13010137. [PMID: 36611746 PMCID: PMC9817875 DOI: 10.3390/ani13010137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/14/2022] [Accepted: 12/28/2022] [Indexed: 12/31/2022] Open
Abstract
Endoparasites of dogs and cats, play an important role in both veterinary medicine and public health. Untreated and stray dogs and cats, in particular, play an important role in contaminating the environment with important zoonotic parasites. Thus, the aim of this study was to estimate the prevalence of intestinal parasites in stray dogs and cats using highly sensitive and specific copro-antigen tests. Archive faecal samples from previous surveys conducted between 2016−2019 from dogs (n = 789) and cats (n = 241) were included in this study. The IDEXX Fecal Dx™ antigen panel was used for the detection of Toxocara, hookworms, Trichuris and the SNAP™ Giardia antigen assay was used for the detection of Giardia infection. Giardia duodenalis was the most common parasite (26%, n = 205) detected in the dogs, followed by ascarids (17.6%, n = 139) and hookworms (5.3%, n = 42). Trichuris vulpis was only detected in 1 dog. Ascarids (23.2%, n = 56) was the most common parasite detected in the cats, followed by Giardia (12.9%, n = 31) and hookworms (n = 7, 2.9%). No whipworms were detected in cats. Overall, there was little difference in the positivity between sexes in both dogs and cats. However, in terms of age, adolescent dogs (<3 years) and kittens (<1 year) had the highest parasite prevalence overall, with G. duodenalis and ascarids being the most prevalent. This study shows a high prevalence of parasite infection in untreated and stray dogs and cats in the greater Dublin area in Ireland. Since they live in synanthropic conditions and can roam over vast distances they can contaminate public areas and pose a risk to both humans and owned pets that utilise these spaces. It is therefore important to raise public awareness and increase the knowledge on zoonotic parasites.
Collapse
|
8
|
Drake J, Sweet S, Baxendale K, Hegarty E, Horr S, Friis H, Goddu T, Ryan WG, von Samson-Himmelstjerna G. Detection of Giardia and helminths in Western Europe at local K9 (canine) sites (DOGWALKS Study). Parasit Vectors 2022; 15:311. [PMID: 36057606 PMCID: PMC9440314 DOI: 10.1186/s13071-022-05440-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 08/13/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Intestinal parasite contamination from infected dogs can place other dogs and humans at risk. A study was initiated to estimate the prevalence of canine intestinal parasitism by collecting fecal samples in cities across Western Europe. METHODS Fresh fecal samples were collected from 2469 dogs visiting 164 parks in 33 cities across 12 countries. Each owner responded to a questionnaire focusing on their dog's signalment and recent anthelmintic treatment history. The collected samples were examined for hookworms, whipworms, ascarids and Giardia using a coproantigen diagnostic immunoassay and microscopy following centrifugal flotation. RESULTS Nematodes or Giardia were detected in at least one sample from 100% of cities and in 93.3% of parks. Nematodes were detected in 57% of parks. Overall, 22.8% of dogs tested positive for an intestinal parasite, with Giardia being the most commonly identified parasites (17.3% of dogs, 83.5% of parks). For nematode infection, 7.6% of all dogs tested positive, with 9.9% of dogs aged < 1 year infected, 7.7% of those aged 1-3 years, 7.3% of those aged 4-6 years and 6.6% of those aged ≥ 7 years. Among the nematodes detected, ascarids were the most prevalent (3.6% of dogs, parks, 28.7% of parks), being most common in dogs aged < 1 year but also present in older dogs, including those aged ≥ 7 years. Hookworms and whipworms were detected in 3.2% and 2.3% of dogs of all ages, respectively, and in 37.2% and 17.7% of parks, respectively. A larger proportion of fecal samples tested positive with the coproantigen immunoassay than with centrifugal flotation. Positive test results for Giardia were sevenfold higher when both diagnostic tests were used than when centrifugal flotation alone was used, and there were 60% more positive test results for nematodes when both tests were used than when flotation alone was used. Overall, 77.2% of owners reported previous anthelmintic treatment, among whom at least 62.7% failed to follow recommended treatment frequency. Dogs receiving anthelmintic within the previous month had a lower percentage of nematode infection than those in which > 1 month had passed since the previous dose. CONCLUSIONS The prevalence estimates of intestinal parasite infections in dogs reported here highlight the need for owner education concerning guidelines for regular testing and treatment, even in older dogs. Failure to adhere to guidelines can result in ongoing transmission of these infections, including those with zoonotic potential. Combining coproantigen immunoassay with centrifugal flotation for diagnostic testing and regular anthelmintic treatment are important measures for ensuring optimal intestinal parasite control.
Collapse
Affiliation(s)
- Jason Drake
- Elanco Animal Health, 2500 Innovation Way, Greenfield, IN, 46140, USA
| | - Sarah Sweet
- IDEXX Laboratories, Inc., 1 IDEXX Dr, Westbrook, ME, 04092, USA
| | | | - Evan Hegarty
- IDEXX Laboratories, Inc., 1 IDEXX Dr, Westbrook, ME, 04092, USA
| | - Stephanie Horr
- IDEXX Laboratories, Inc., 1 IDEXX Dr, Westbrook, ME, 04092, USA
| | - Hanne Friis
- IDEXX Europe B.V, Scorpius 60, Hoofddorp, The Netherlands
| | - Troy Goddu
- IDEXX Laboratories, Inc., 1 IDEXX Dr, Westbrook, ME, 04092, USA
| | - William G Ryan
- Ryan Mitchell Associates LLC, Westfield, NJ, 07090, USA.
| | | |
Collapse
|