Scotland calling: embracing a career abroad as an official veterinarian

Olivia Andronic qualified in Romania but had a yearning to work in the UK. Now a veterinary advisor at Food Standards Scotland, her unusual career took off after she applied for a role as a meat hygiene inspector.

Message from the President

Anna Judson invites you to help us spotlight the incredible care that Team Vet provides.

A decade of amplifying your voice

Since 2014, our Voice of the Veterinary Profession survey has played a pivotal role in supporting our campaigning and lobbying work, delivering insightful data, raising the profile of vets and their work through the media, driving legislative reform and shaping the profession.

A 'must-have' book for vets working with aquatic species

Reviewed by Matthijs Metselaar, a specialist in fish health and production.

Chickening out of seeing pet poultry? Gain confidence at BVA Live!

There aren't many poultry vets in the UK - and even fewer who focus on pet poultry. It is likely, therefore, that people who keep a few hens as pets will present them to their regular veterinary practice when they become unwell. Henrietta Kodilinye-Sims hopes her session at BVA Live will give vets who do not regularly see poultry the skills they need to approach these cases with confidence.

Sustainability and modern pet ownership

Booming pet ownership in the UK and elsewhere brings significant implications for the carbon pawprint. Yet it is unlikely people will ever stop owning pets, so how can pet ownership be made more sustainable? At BVA Live, Justine Shotton and Jen Gale will explore the role of vets in this complex area and how they can support clients in minimising the impact of their pets on the planet.

Finding a care plan that suits everyone

In a recent survey, Hannah Capon asked the owners of arthritic dogs what they would like vets to do differently. She'll be using her findings to help delegates at BVA Live better understand the owner experience of veterinary care and contextualise their approach accordingly.

Knowledge and perception about the welfare and mistreatment of dogs in Brazil

Animal welfare encompasses the overall well-being of an animal, spanning both its physical and mental health, assessable through potential measurements. It stands in contrast to mistreatment, which involves actions, direct or indirect, that endanger an animal's well-being. This study sought to appraise the factors influencing the Brazilian population's understanding of dog welfare and mistreatment. The survey questions were adapted from the Animal Welfare Examination Protocol, utilized by veterinarians to evaluate suspected passive abuse cases in dogs. Out of 1377 responses, 1353 were valid and analyzed. Among the 19 assessed indicators, 15 demonstrated an adequate response rate surpassing 90% of all 1353 responses. However, for three questions related to comfort, a smaller yet notable percentage of responses were only minimally adequate. Moreover, in one question within the comfort assessment, 186 participants (13.74%) provided inadequate responses. This implies that these people could potentially subject animals to a state of low Animal Welfare. Lack of knowledge emerged as a potential root of passive abuse, specifically negligence. In the assessment of nutritional indicators, water supply and quality received unanimous adequate responses. In evaluating comfort perceptions, significant associations were noted between gender, dog ownership, family income, and responses regarding resting surface. Regarding health indicators, the majority responded appropriately. Female gender and dog ownership correlated with providing the appropriate response, while not owning a dog was associated with minimally adequate responses. In the context of comfort indicators, "Hitting the Dog" also demonstrated an association with gender, with females tending towards appropriate responses. Given the lack of significant correlation between educational levels and the most suitable responses, it underscores the urgency of implementing environmental education programs in schools with a focus on animal protection.

Differences in perceptions and satisfaction exist among veterinarians employed at corporate versus privately owned veterinary clinics

OBJECTIVE

To compare and contrast the views of benefits and general work conditions of participants working in corporate hospitals compared to those working in privately owned hospitals.

SAMPLE

Veterinary members of the Veterinary Information Network (VIN) working as associate veterinarians in corporate- or privately owned hospitals.

METHODS

An electronic survey distributed via the VIN data collection portal.

RESULTS

A total of 896 responses from associate veterinarians working full time were received, of which 286 (31.9%) reported working in private practice and 610 (68.1%) in corporate practice. Fifty-five percent of participants indicated a preference for working in private practice compared to 12% preferring corporate practice. Veterinarians working in corporate practice were more likely to report receiving insurance (health, dental, life, and short-term disability), mental wellness programs (eg, counseling), wellness mobile apps, VIN membership, and continuing education paid by their employer than those working in privately owned practices. However, participants in private practice reported higher satisfaction with feeling known as an individual by upper management, hospital culture, the ability to fire difficult or abusive clients, and mentorship. Those working in corporate practices reported feeling more pressure than those in private practice to generate revenue and see more clients per shift.

CLINICAL RELEVANCE

There are positives and negatives of corporate-owned hospitals when compared to privately owned practices. Corporate hospitals may be well positioned to make large organizational-level changes that can improve work culture and, as a result, the well-being and retention of small animal practitioners.

Securing lethal means for suicide: a focus group study exploring perceptions and barriers among practicing veterinarians

OBJECTIVE

Veterinarians are at higher risk for suicide than the general population, and 1 reason for this may be veterinarians' access to and knowledge of pentobarbital-a common suicide method in this population. One possible approach to reducing suicide risk is means safety. This study examined the acceptability and feasibility of means safety protocols in the veterinary workplace.

SAMPLE

43 veterinarians from a mix of specialty areas aged 26 to 53 years, currently practicing in the United States, recruited via social media and listservs.

METHODS

Participants completed a 60- to 90-minute focus group with pre- and post-test surveys. Focus group content was qualitatively analyzed.

RESULTS

Survey responses indicated that that 30% (n = 13) of veteriarians reported storing their pentobarbital unlocked at least part of the time. During focus group discussion, participants perceived work/life balance or being overwhelmed as the most common suicide risk factor in veterinarians, with normalizing mental health emerging as a primary way to improve mental health in veterinarians. Additionally, adding an extra lockbox for pentobarbital/firearms emerged as the most acceptable and feasible means safety method. Finally, at post-test, veterinarians increased in willingness to implement storage protocol changes (P = .02) and were more likely to endorse concern about a coworker's suicide risk than concern about their own suicide risk (P < .01) as a reason to change pentobarbital storage methods.

CLINICAL RELEVANCE

Results from this study will inform public messaging campaigns and policy changes for pentobarbital storage and suicide prevention efforts in the veterinary workplace at the individual and organizational level.

The moral deliberation pathway in veterinary practice: a qualitative study

BACKGROUND

Veterinarians may face various ethical decisions and potential moral conflicts in clinical practice. The ethical decision-making process often leads to a satisfying resolution. However, when such a process is accompanied by a perceived inability to act according to a person's values, it can lead to psychological distress that characterises moral distress. Theoretical models in professions such as nursing attempt to explain the evolution of moral conflict into moral distress. In veterinary professionals, a model has been proposed to explain this pathway (the moral deliberation pathway). However, empirical data are still lacking on whether veterinary clinicians experience a moral deliberation pathway as hypothesised.

METHODS

Using thematic analysis, this qualitative study investigates veterinary clinicians' experiences with moral distress and aims to explain the moral deliberation pathway in these veterinarians.

RESULTS

The results suggest that veterinarians' experiences with moral distress follow a deliberation process that can be explained by the proposed moral deliberation pathway. Experiencing a moral conflict leads to moral stress, then either to moral distress or resolution into moral comfort.

LIMITATIONS

Self-selection of participants and possible recollection bias may have biased the findings.

CONCLUSIONS

The empirical data provided by this study can inform future research and intervention strategies to identify, measure and manage moral distress in the veterinary context.

Relieving veterinarians' workloads and stress: leveraging Australia's veterinary technologists and nurses

Like the rest of the world, Australia is in the throes of a dire shortage of veterinarians, while the demand for veterinary professional services grows. This combination has a very real impact on veterinarians' workload and stress, with significant mental health impacts. Times have changed in our profession and it is time for a change in our practice. We need to look at a different way of managing veterinary workloads and demands and, in particular, better utilise our paraprofessional staff. It is the solution right under our noses embracing our veterinary technologists and nurses.

Psychological safety, purpose, path, and partnership reduce associate veterinarian desire to leave current employment

OBJECTIVE

To identify demographic and employment variables associated with an associate veterinarian's intent to remain at their organization in the next 5 years and to assess the impact of positive leadership in the practice and on veterinarians' well-being.

SAMPLE

2,037 associate veterinarians in private practice who participated in the 2021 and 2022 AVMA Census of Veterinarians surveys.

PROCEDURES

Associate veterinarian demographic and employment information was used in regression analysis to determine the likelihood of remaining employed at their organization in the next 5 years and the impact leadership has on an associate veterinarian's employment.

RESULTS

Higher levels of burnout, living in an urban community, and working in corporate practice were associated with lower odds of remaining in the next 5 years. Associates who worked in a practice in which they believed their leaders practiced positive leadership had higher odds of remaining in the next 5 years. An increase in a practice's leadership index was associated with a likelihood to remain employed over the next 5 years. Decreases in the leadership index were associated with higher burnout levels among associates, more work experience, working more hours, and specialty/referral practices.

CLINICAL RELEVANCE

Findings supported anecdotal evidence that lack of positive leadership in a private practice may lead to higher odds of retention issues in a practice, as well as lower job satisfaction, organizational commitment, and workplace well-being among associates. Positive leadership practices might provide protective factors to critical veterinary business outcomes like team member retention and engagement.

On-site communication skills education increases client-centered communication in four companion animal practices

OBJECTIVE

To evaluate veterinarian-client communication before and after a 15-month on-site communication skills training intervention.

PROCEDURES

Multipractice, pretest-posttest intervention study.

SAMPLE

A convenience sample of 4 companion animal practices owned by a single practice group in Austin, Texas (n = 9 veterinarians; 170 audio recordings).

RESULTS

After intervention, visits were 8 minutes longer (P = .005), and veterinarians' client-centered scores increased significantly (2.30 vs 2.72; P = .006). Veterinarians' biomedical questions decreased by nearly a third (P = .0007), while veterinarians' facilitation (ie, partnership-building) statements were 1.15 times as great (P = .04) after intervention due to an increase in asking for the client's opinion (P = .03) and use of back-channel statements (P = .01). Agenda-setting skills, including agenda-setting questions (P = .009), summary of the client's agenda (P = < .0001), and a check for remaining concerns (P = .013), increased significantly after intervention. Clients asked 1.9 times as many lifestyle-social related questions (P = .02) and provided 1.3 times as much lifestyle-social information (P = .0004) after the intervention. Additionally, clients offered 1.4 times as many emotion-handling statements (P = .0001), including showing concern (P = .03) and optimism, reassurance, or encouragement (P < .0001), after intervention. Paraverbally, clients presented as more anxious/nervous (P = .03) and emotionally distressed/upset (P = .02) after the intervention.

CLINICAL RELEVANCE

Results suggest that client-centered communication skills increased after intervention. This study builds upon previous case-based studies examining practice-based communication training, emphasizing that long-term interventions positively enhance veterinarian-client communication, which is likely to have a positive impact on client and patient care.

Veterinarians and moral distress

OBJECTIVE

Assess veterinarians' reported levels of moral distress and professional well-being. Determine the predictive value of moral distress, controlling for demographic factors, on veterinarians' levels of Professional Fulfillment, Work Exhaustion, Disengagement, and Burnout.

SAMPLE

Members of the Veterinary Information Network.

PROCEDURES

An electronic survey distributed via the Veterinary Information Network data collection portal.

RESULTS

A total of 1,919 veterinarians completed the survey. For both associates and owners, gender and age were significant predictors of moral distress with younger female veterinarians reporting higher levels of distress than older male veterinarians. For associates, age was a positive predictor and moral distress score was a negative predictor of Professional Fulfillment. Age was a negative predictor, and female gender and moral distress score were both positive predictors for Work Exhaustion. For Interpersonal Disengagement and Burnout, age was a negative predictor and moral distress score was a positive predictor. For owners, age was a positive predictor and moral distress score was a negative predictor for Professional Fulfillment. Age was a negative predictor, and female gender and moral distress score were both positive predictors of Work Exhaustion, Interpersonal Disengagement, and Burnout.

CLINICAL RELEVANCE

We found that, controlling for age and gender, higher levels of moral distress predicted lower levels of Professional Fulfillment and higher levels of Work Exhaustion, Interpersonal Disengagement, and Burnout. Given the prevalence of moral distress and its impact on mental health, it is imperative that the veterinary field provide training and education on how to recognize and navigate ethical conflicts.

Reducing occupational distress in veterinary medicine personnel with acceptance and commitment training: a pilot study

AIMS

To determine whether an educational programme targeting the reaction of veterinary personnel to difficult client interactions reduced burden transfer, stress and burnout in veterinary staff.

METHODS

Employees of three small-animal veterinary hospitals in the south-western United States of America were recruited and randomised to intervention (educational programme; n = 16) or control (no intervention; n = 18) groups. Participants of this randomised, parallel arms trial completed pre-programme assessment including the Burden Transfer Inventory (BTI), Perceived Stress Scale, and Copenhagen Burnout Inventory. Assessment was followed by two, group-format educational sessions, based on acceptance and commitment training, tailored to reducing reactivity to difficult veterinary client interactions (intervention group only). After training was completed, both groups were assessed using the same measures and the intervention participants provided use and acceptability ratings.

RESULTS

Intervention participants rated the programme as useful and appropriate, and reported that programme techniques were used a median of 43 (min 9, max 68) times during the 2 weeks prior to retesting. Relative to pre-programme scores, median post-programme scores for reaction (subscore of BTI) to difficult client interactions decreased in the intervention group (33 vs. 54; p = 0.047), but not in the control group (51 vs. 59; p = 0.210). Changes in median scores for stress and burnout from pre- to post-programme were non-significant for both groups.

CONCLUSIONS

This pilot and feasibility trial showed high rates of acceptability and use by participants, as well as promising reductions in burden transfer. A larger scale clinical trial with follow-up at extended time points is needed to more fully examine the efficacy of this novel programme.

CLINICAL RELEVANCE

Preliminary findings suggest this programme may be a useful approach to reducing occupational distress for individuals working in veterinary practice.

Exploring Valued Personality Traits in Practicing Veterinarians

We examined differences in valued Big Five personality traits of small animal veterinarians between members and nonmembers of the veterinary medicine community. Between fall 2019 and spring 2020, data were collected from an online survey sent to eligible persons across a US midwestern state. Eligible persons included veterinary office clients (i.e., pet owners) and persons practicing/training in veterinary medicine. Participants completed demographic questions and 10 Likert scale items about which Big Five personality characteristics they prefer in a veterinarian. Descriptive data were determined and checked for assumptions of linearity and normality. Data for the primary analyses were analyzed using Spearman's correlations and Kruskal-Wallis H tests. Participants who were members of the veterinary community of practice valued the characteristic openness more than clients but valued emotional stability less than clients. Moreover, tests revealed that young adults (aged 18-24) valued extraversion more than all other age groups but least valued agreeableness. Last, participants aged 55 and older valued agreeableness and emotional stability more than the 18-44 age groups. Findings indicate individuals from different membership and age groups have varying preferences in what personality traits they expect in a veterinarian. Clients care more about their veterinarian being able to handle adversity. Older adults want their veterinarian to be trusting and creative. These findings encourage veterinary medical education to spotlight the development of skills congruent with these desired personality traits. Gaining such skills will be useful for veterinarians who seek to grow or build lasting relationships with clientele and colleagues.

The moral of the Swaledale tups

A story from early in Liz Barton's career demonstrates the high expectations those in the veterinary world often have of themselves - and the value of self-compassion. Being kind to oneself is something she and her colleagues are now trying to embed widely.

Perception of poultry veterinarians on the use of antimicrobials and antimicrobial resistance in egg production

This study aimed to describe the perception of veterinarians who work with commercial laying hens in the state of Rio Grande do Sul, Brazil, regarding the use of antibiotics and their possible impacts on animal, human, and environmental health. A descriptive epidemiological study was carried out through face-to-face or web conferencing interviews with the veterinarians that provide technical assistance at commercial laying hen operations. A standardized and structured questionnaire was developed based on the literature and expert opinion, which contained 1 opened and 40 closed questions. Conventional non-probabilistic sampling was used, based on an initial list of 15 veterinarians registered in the Poultry Production Association of Rio Grande do Sul, followed by the snowball technique. The acquisition of 26 contacts of veterinarians was accomplished, and 16 were interviewed. Through the answers obtained it was possible to verify that the interviewees' understanding regarding both the antibiotic resistance impact and the decision-making about the use of antibiotics seem to be linked to their practical experiences. Besides that, according to the veterinarians, farmers can acquire and administer the antimicrobials on their farms. Moreover, both farm storage and administration of lower doses of antibiotics than the recommended one could be contributing factors to resistant bacteria selection. Furthermore, controversially, the professionals believed that resistant bacteria can be transmitted to humans from eggs, but they said that there are no bacteria in eggs. Therefore, the veterinarians´ practices can be improved considering national and international guidelines on antimicrobial resistance to minimize the development of resistance. Finally, it is expected that the present results will contribute to a more complex discussion about antimicrobial resistance, helping to formulate public policies in the egg production industry.

Coalitions of touch: Balancing restraint and haptic soothing in the veterinary clinic

This article responds to recent calls to further incorporate the study of animal health care into the sociology of health and illness. It focuses on a theme with a long tradition in medical sociology, namely clinical communication, but explores matters distinctive to veterinary practice. Drawing on video recordings of 60 consultations across three small animal veterinary clinics in the United Kingdom, we explore how clients and veterinarians (or "vets") fashion fleeting "coalitions of touch," that aptly position the animal to enable the performance of medical work, often in the face of physical resistance. Building on recent developments in the study of haptic sociality, we analyse how care and emotional concern for animal patients is communicated through various forms of embodied action; thus, how the problematics of forced care and restraint are mitigated through distinctive ways of touching and holding animal patients. Moreover, while prior studies of small animal veterinary work have highlighted the significance of talk within the clinician-animal-client triad, we reveal the fundamentally embodied and collaborative work of managing and controlling patients during sometimes intense and fast-moving episodes of veterinary care.

Feline neonatology: From birth to commencement of weaning - what to know for successful management

PRACTICAL RELEVANCE

Despite considerable interest in the field of companion animal reproduction, feline neonatology remains largely unstudied. This contrasts with the need for a more professional veterinary approach to newborn kittens and feline husbandry, across the pet, breeding cattery and rescue shelter settings, to reduce kitten mortality.

GLOBAL IMPORTANCE

Feline neonatology has relevance for veterinarians around the world as cats are continuing to become established as popular companion animals.

CLINICAL CHALLENGES

Perinatal mortality in cats is remarkably high. Therefore, adequate neonatal evaluation and assistance at birth, careful monitoring of kittens in the vulnerable period until weaning begins, assessment of maternal factors and well-informed management of orphans are crucial in helping to reduce kitten losses.

AIM

This review aims to deepen the basic knowledge of the veterinary clinical team regarding the characteristics of feline newborns under normal conditions at birth through to the commencement of weaning. Much of the information is also relevant to breeders and rescue/shelter caregivers.

EVIDENCE BASE

In compiling the present review, the authors have drawn on specific feline research data, where available, complemented by data extrapolated from scientific publications on newborn dogs, and also their own and their colleagues' professional clinical experience.

Evaluation of the Attitudes and Confidence of Veterinary Undergraduates toward Working with Cats in the Veterinary Hospital Environment

An understanding of feline behavior is required to successfully handle cats in the hospital environment and avoid triggering escalation to fear-aggression due to heightened anxiety. Some veterinary students appear to misinterpret feline behavioral cues, resulting in frustration and poor success when performing basic handling. This article investigates the following in regard to veterinary students and feline handling: (a) attitudes toward working with feline patients in the hospital environment; (b) experience of working with feline patients; (c) satisfaction in acquisition of feline handling and examination skills; and, (d) confidence in feline handling skills; and to explore influencing factors. An electronic questionnaire was circulated to fourth and final year veterinary students (May 2012) and final year students (June 2013) for anonymous voluntary completion. One hundred and seventy-three of 293 students completed the questionnaire. Of final year respondents, 87/115 (75.7%) indicated that they enjoy interacting with cats in veterinary hospitals; 95/115 (82.6%) indicated that they were satisfied with their cat handling skills; 105/115 (91.3%) felt confident handling quiet and wriggly cats; significantly fewer 63/115 (54.8%) felt confident handling unpredictable cats (p < .05). Factors significantly affecting confidence in handling unpredictable cats included: frequency of examination practice during extra-mural studies (p < .05), enjoyment of interacting with cats in veterinary hospitals (p < .05), self-perceived understanding of feline behavior (p < .05), self-perceived ability to interpret cats' behavioral expressions (p < .05), satisfaction with cat handling skills (p < .05), and perception of feline versus canine handling ability (p < .05).

Exploring the Factors that Affect the Happiness of South African Veterinarians

Happiness is a new field of study in various fields, including health care and veterinary science. Workplace-related happiness, or subjective well-being in the work environment, has become a prominent research field. The happiness of veterinarians has gained academic interest globally over recent years. Previous research indicated that increased happiness levels of employees have social, personal and possible financial gain for employers and employees. The objectives of this study were to determine the factors that affect the happiness of South African veterinarians and develop a conceptual model based on the identified factors. A cross-sectional study using a quantitative survey was conducted using a standardized questionnaire. Of 2,182 registered veterinarians, 360 practicing veterinarians completed the survey and the results were statistically analyzed using exploratory factor analysis. The results indicated that the factors influence in the workplace, social relationships, satisfaction with work-life balance, purpose, optimism, work satisfaction, work stress, and leisure were identified as having significant statistical relationships with the happiness of veterinarians. Managerial recommendations are provided based on the research findings. This study is the first known study to examine the factors that affect the happiness levels of veterinarians. The study forms the base for similar research to be conducted in other countries.

Evaluation of a novel communication and consultation skills model (WISE COACH) on dog owner perceptions of veterinarians and projected spending on veterinary care

OBJECTIVE

To assess the impact of a novel communication and consultation skills model (WISE COACH [WC]) on dog owner perceptions of veterinarians and projected spending on veterinary care.

SAMPLE

1,200 US dog owners who had visited a veterinarian within the prior 18 months.

PROCEDURES

Video recordings of 2 staged client consultations were made, with the veterinarian following the WC recommendations in one video and not following them in the other (control). Participants were randomly assigned to view one of the videos and completed an online survey to assess their perceptions and projected spending. Qualitative responses were coded to identify themes.

RESULTS

The veterinarian was rated significantly higher in the WC video than in the control video for the characteristics first impression, skilled and knowledgeable, cares about me, cares about my pet, and communicates clearly, and was rated significantly lower for the characteristic rushed or abrupt. Participants who viewed the WC video were significantly more likely to follow the veterinarian's recommendations, return to see the veterinarian, and recommend the veterinarian. They were also approximately 1.4 times as likely to approve the full recommended treatment plan, and their projected total spending was approximately 15% higher than projected spending for participants who viewed the control video.

CLINICAL RELEVANCE

Results showed improved client perceptions, client retention, quality of patient care, and financial metrics when the veterinarian followed the WC recommendations. Further study is needed to determine whether this model may also improve veterinarian well-being by improving client relationships and decreasing resistance to recommendations.

Understanding Incoming Canadian and US Veterinary Students' Attitudes and Perceptions of Their Dietary Habits and Levels of Physical Activity

As critical components of individual well-being, nutrition and physical activity have important physical and psychological implications. Veterinary students face demanding schedules and potentially high rates of psychological distress. Though veterinary students' strategies for healthy eating have been explored, factors influencing their ability to achieve a healthy diet are less understood. This study assesses incoming veterinary students' perceived attitudes to their dietary habits and physical activity levels. Incoming students (n = 322) at five Canadian and five randomly selected US veterinary schools completed a questionnaire inquiring about demographic information, dietary attitudes and habits, and activity levels. More than half (58%) of students perceived their diet to be moderately healthy. A desire to feel better and have more energy was the most reported (79%) motivating factor to modifying personal eating habits and was significantly associated with improved odds of having a perceived healthy diet (OR = 2.22, p < .024). A busy lifestyle was perceived as a barrier to changing current eating habits by 92% of respondents. Students reporting a desire to maintain their health (OR = 3.42, p < .001) and moderate (OR = 2.81, p < .003) or high (OR = 2.30, p < .044) routine physical activity levels were also more likely to perceive their diet as healthy. Findings show that incoming veterinary students' perceptions may influence their goals of achieving a healthy lifestyle. An understanding of incoming veterinary students' barriers and motivators could be applied in future research to assist students in achieving personalized goals.

A preliminary study on assessment of wellbeing among veterinary medical house officers

Mental wellness is an important topic among practicing veterinarians. Peer reviewed studies focusing on veterinary house officers' wellbeing are lacking in veterinary medicine. The aim of this study was to assess wellbeing of house officers using validated surveys for anxiety, burnout, depression, and quality of life. A cross-sectional survey of 103 house officers (residents, interns, and fellows) was performed. Respondents were invited to voluntarily complete the online surveys. Anxiety, burnout, depression, and quality of life were assessed using the Generalized Anxiety Disorder (GAD-7), Maslach Burnout Inventory (MBI), Patient Health Questionnaire (PHQ-9), and Short Form-8 (SF-8), respectively. Descriptive statistics were calculated. For qualitative analysis, respondents were requested to rate their perception of the level of stress regarding various work-related stressors. The first survey was completed in 2017 with 60 respondents of which 51 (85%) identified as females and nine (15%) identified as males. The second survey was completed in 2018 with 43 respondents of which 35 (81.4%) identified as females and 8 (18.6%) identified as males. Respondents reported high levels of burnout characterized by high levels of emotional exhaustion and lack of personal accomplishment but reported mild levels of anxiety and depression. The mental component of their quality of life score was lower than the general US population, whereas the physical component score was consistent with the general US population. Respondents indicated moderate scores of stress for concerns regarding patient management, research, teaching, work-life balance, relationships, organizational skills, time management, finances, and the mental and emotional impact of the work environment. The high levels of burnout, and low mental quality of life in house officers require specific intervention programs to improve wellbeing.

Brian Theodore Wicks

As a vet working in mixed practice, he relished the camaraderie of working with colleagues, farmers and clients, and developed a special interest in cattle fertility. He was considered to be a ray of sunshine.

Diagnosis and clinical management of canine leishmaniosis by general veterinary practitioners: a questionnaire-based survey in Portugal

BACKGROUND

Canine leishmaniosis (CanL) can be appropriately managed following international recommendations. However, few studies have assessed the preferred protocols in real-life veterinary practice and whether these are in line with the guidelines. This survey aimed to investigate the current trends in the clinical management of CanL among veterinary practitioners in Portugal, taking into consideration different scenarios of infection/disease and the awareness of and application by veterinary practitioners of the current guidelines.

METHODS

A questionnaire-based survey was conducted online using an electronic platform. The following topics were surveyed: (i) general characteristics of the responding veterinarian; (ii) the preferred protocols used for the diagnosis, treatment and prevention of CanL, considering different theoretical scenarios of infection/disease; and (iii) the responding veterinarian's current knowledge and application of the existing guidelines on CanL. After internal validation, the survey was distributed online, for 2 months, via Portuguese social network veterinary groups. Data were collected for descriptive analysis.

RESULTS

Eighty-six replies were obtained. Analysis of the results showed that the preferred diagnostic techniques varied widely according to the theoretical scenario of infection/disease. In general daily practice, serology testing (enzyme-linked immunosorbent assay [ELISA]) was the most used tool (67.4%). The preferred matrices used for PCR test were lymph nodes (62.3%) and/or bone marrow (59.0%). Regarding treatment, for subclinical infection/stage I CanL, 51.2% of the respondents did not prescribe any medical treatment, but 98.8% proceeded with both monitoring and preventive measures. Among those who prescribed a treatment (n = 42), most chose domperidone (47.6%). For the treament of stages IIa, IIb and III CanL, allopurinol/meglumine antimoniate (MA) was chosen by 69.8, 73.3 and 51.2% of respondents, respectively, followed by allopurinol/miltefosine (20.9, 19.8 and 38.4%, respectively). In contrast, dogs with stage IV CanL were mostly treated with allopurinol/miltefosine (48.8%) rather than with allopurinol/MA (23.3%). The use of repellents was the preferred preventive strategy (98.8%). About 93.0% of responders were aware of the existence of guidelines, and most of these veterinarians consulted the guidelines of the LeishVet group and the Canine Leishmaniosis Working Group; however, 31.3% reported that they did not follow any specific recommendations.

CONCLUSIONS

Of the veterinarians responding to the survey, most reported following international guidelines for the clinical management of CanL. While allopurinol/MA was the preferred therapeutic protocol for the treatment of stages II/III CanL, allopurinol/miltefosine was the first choice for the treatment of stage IV CanL, possibly due to the unpredictable effect of MA on renal function. This study contributes to a better understanding of the trends in practical approaches to the treatment of CanL in Portugal.

VetGDP 2: building new vet confidence

In this article, the second in our series from the RCVS, Linda Prescott-Clements explains how the Veterinary Graduate Development Programme (VetGDP) will offer new vets the support of VetGDP advisers. Also, on page 340, established new graduate mentor Charlotte Moody gives her perspective on the importance of the adviser's role.

It's good to talk, but it matters how we do it'

Rosie Allister explains that although talking about suicide can be a good thing and can create opportunities to help, it must be done in a responsible way so that it doesn't cause further harm.

Survey of perceptions and attitudes of an international group of veterinarians regarding antibiotic use and resistance on dairy cattle farms

Veterinarians are the main source of information for farmers regarding the responsible use of antibiotics in farm animals and how to reduce the risk of antibiotic resistance. Consequently, understanding how veterinarians perceive their clients' and colleagues' antibiotic use and their own beliefs about the development of antibiotic resistance is essential to determining areas in which antibiotic use practices can be improved to minimize the emergence of antibiotic resistance. An international cross-sectional study was carried out using a questionnaire designed to elucidate perceptions, attitudes, and concerns of dairy veterinarians regarding antibiotic use and the emergence of antibiotic resistance in dairy farming. The questionnaire was initially administered to veterinarians attending the International Bovine Mastitis Conference in Milano, Italy, 2018, followed by veterinarian members of the National Mastitis Council, and all conference registrants. A total of 71 participants from 21 countries participated in the survey, the majority were from the United States and member countries of the European Union. Logistic regression analysis was conducted to identify predictors of veterinarians' level of concern about the development of antibiotic resistance on their clients' farms. Associations were described with odds ratios (ORs) and the associated 95 % confidence intervals (95 % CIs). Free text responses where participants shared their views on the reason for overprescribing antibiotics by veterinarians were analyzed using thematic analysis. Participants perceived that nearly half of their clients overuse or inappropriately use antibiotics, and nearly half of their colleagues overprescribe or inappropriately prescribe antibiotics. After controlling for other factors, the odds of veterinarians being concerned about antibiotic resistance on dairy farms they served decreased by a factor of 0.91 for each additional year of participants' experience working with dairy cattle (OR = 0.91, 95 % CI = 0.84-0.99). Participants concerned about antibiotic resistance on clients' dairy farms were also more likely to consider better adherence to drug labelling as important for reducing farmers' antibiotic use (OR = 6.86, 95 % CI = 1.21-38.93). Thematic analysis revealed four themes surrounding the perceived reasons for veterinarians' overprescribing of antibiotics: (i) knowledge, (ii) attitudes, (iii) barriers, and (iv) rules and regulations. The study findings will aid in the development of strategies to improve antibiotic use in dairy farming and educational initiatives looking to enhance the communication between veterinarians and farmers about judicious use of antibiotics.

Clinical reasoning in canine vestibular syndrome: Which presenting factors are important?

BACKGROUND

Although the use of clinical reasoning has been evaluated for several neurological presentations, this approach has not yet been investigated for dogs with vestibular syndrome.

METHODS

Two hundred and thirty-nine dogs presenting with vestibular syndrome were included in this retrospective study. Univariate analysis of variables (clinical history, signalment, clinical presentation and neurological examination findings) was performed. Variables with p < 0.3 were selected for logistic regression.

RESULTS

Ninety-five percent of dogs were represented by eight conditions: idiopathic vestibular disease (n = 78 dogs), otitis media interna (n = 54), meningoencephalitis of unknown origin (n = 35), brain neoplasia (n = 26), ischaemic infarct (n = 25), intracranial empyema (n = 4), metronidazole toxicity (n = 3) and neoplasia affecting the middle ear (n = 3). Idiopathic vestibular disease was associated with higher age, higher bodyweight, improving clinical signs, pathological nystagmus, facial nerve paresis, absence of Horner's syndrome and a peripheral localisation. Otitis media interna was associated with younger age, male gender, Horner's syndrome, a peripheral localisation and a history of otitis externa. Ischaemic infarct was associated with older age, peracute onset of signs, absence of strabismus and a central localisation.

CONCLUSIONS

Discrete clinical features can be used to identify the most likely diagnosis in dogs with vestibular syndrome.

Pet owners' and veterinarians' perceptions of information exchange and clinical decision-making in companion animal practice

One of the most complex aspects of the veterinarian-client-patient interaction is the clinical decision-making process. Research suggests that the approach to communication used by veterinarians can impact veterinary clients’ involvement in the decision-making process and their ultimate satisfaction. Using different approaches to the decision-making process may affect how information is exchanged and consequently how decisions are made. The objective of this study was to determine pet owners’ expectations with respect to information exchange and decision-making during veterinarian-client-patient interactions and to compare veterinarians’ perceptions of those expectations and the challenges they face in meeting them. Five pet owner focus groups (27 owners) and three veterinarian focus groups (24 veterinarians) were conducted with standardized open-ended questions and follow-up probes. Thematic analysis of the transcribed data was conducted to identify trends and patterns that emerged during the focus groups. Three pet owner-based themes were identified: 1) understanding the client; 2) providing information suitable for the client; and 3) decision-making. In addition, three barriers for veterinarians affecting information exchange and decision-making were identified: 1) time constraints; 2) involvement of multiple clients; and 3) language barriers. Results suggest that pet owners expect to be supported by their veterinarian to make informed decisions by understanding the client’s current knowledge, tailoring information and educating clients about their options. Breakdowns in the information exchange process can impact pet owners’ perceptions of veterinarians’ motivations. Pet owners’ emphasis on partnership suggests that a collaborative approach between veterinarians and clients may improve client satisfaction.