Prevalence of antimicrobial resistance at two private veterinary referral hospitals

Antimicrobial resistance (AMR) is an emerging human and animal issue. The frequency of resistance to high importance antimicrobials, isolation of microbes of One Health importance and the nature and frequency of multi-drug resistant (MDR) profiles in Australian small animal referral practice have not been described previously. Medical databases of two private small animal referral hospitals in Queensland, Australia were reviewed for culture and susceptibility (C&S) results from 1 January to 31 December 2020. Hospital site (H1 and H2), culture sample, C&S results and MDR were documented for samples from services operating at both locations. There were 631 microbial isolates and 386 susceptibility profiles from 438 samples. The predominant organism was Staphylococcus pseudintermedius at H1 (n = 95) and Escherichia coli at H2 (n = 23). The majority of samples were integumentary (H1 n = 216, H2 n = 75) or urogenital (H1 n = 74, H2 n = 70). MDR isolates were reported at both hospitals, and were significantly more likely at H1 (69/262, 26.3% vs. 12/121, 9.9%; P < 0.001). High levels of AMR including MDR profiles were reported at the two hospitals evaluated, but they had significantly different resistance patterns and microbial profiles. These results highlight the need to practice appropriate antimicrobial stewardship in veterinary medicine, and are supportive for individual hospital surveillance with antibiograms.

Retrospective assessment of ophthalmic disease development in domestic dogs and cats when hospitalised with tick paralysis caused by Ixodes holocyclus

OBJECTIVE

To investigate the incidence and predisposing factors leading to the development of corneal ulcers and the loss of a palpebral reflex in hospitalised canine and feline patients with tick paralysis (TP).

ANIMALS STUDIED

A total of 102 dogs and 100 cats retrospectively were assessed from previously hospitalised patients.

METHODS

A retrospective cohort study was performed on 102 different canine and 100 different feline patients who were hospitalised for TP from October 2020-January 2022. Patient data were collected, and logistic regression was conducted to determine factors affecting the palpebral reflex and the development of corneal ulcers.

RESULTS

Corneal ulcers occurred in 23/102 (22.5%) dogs during hospitalisation and were strongly associated with an incomplete palpebral reflex ipsilaterally during hospitalisation (P < 0.001), hospitalisation ≥3 days (P = 0.004), mechanical ventilation ≥3 days (P = 0.015) or a tick location cranial to C1 (P = 0.003). An incomplete palpebral reflex during hospitalisation was observed in 29/102 (28.4%) dogs and was significantly associated with decreasing patient weight (P = 0.018), increasing days hospitalised (P = 0.001), having a tick found cranial to C1 (P = 0.004), highest recorded GP grade (P = 0.01), highest recorded RP grade (P = 0.005), use of amoxycillin-clavulanic acid during hospitalisation (P = 0.002) and use of piperacillin/tazobactam during hospitalisation (P = 0.003). There was a significant association between the loss of a complete palpebral reflex and mortality during hospitalisation in dogs (OR = 4.5, P = 0.029). Corneal ulcers occurred in 10/100 (10.0%) cats during hospitalisation, and was significantly more likely to occur to an eye if an incomplete palpebral reflex was observed ipsilaterally during hospitalisation (OR = 20.1, P < 0.0001) and with increasing patient age (P = 0.019). The absence of a complete palpebral reflex during hospitalisation was observed in 18/10 (18.0%) cats and was significantly associated with increasing days hospitalised (P = 0.034). There was no significant association between the loss of a complete palpebral reflex and mortality during hospitalisation in cats.

CONCLUSIONS

The frequency of corneal ulcers and loss of palpebral reflexes were significant in dogs and cats hospitalised by TP, with many factors contributing to the risk of these developing.

Primary anastomosis of segmental external auditory canal atresia in one dog

This report describes a case of canine segmental external auditory canal atresia (EACA). The dog was managed medically with non-steroidal anti-inflammatory drugs until clinical deterioration, at which time a novel and successful end-to-end anastomosis surgical repair was performed. At the 30 day postoperative re-examination, the dog was clinically well and otoscopy confirmed that there was no evidence of auditory canal stenosis. The patient remained free of ongoing issues 20 months after the surgery. End-to-end anastomosis should be considered for treatment of developmental segmental EACA in the canine.

Comparing veterinarians' attitudes to and the potential influence of pet health insurance in Austria, Denmark and the UK

BACKGROUND

Health insurance offers many benefits to clients and veterinarians, such as the ability to perform necessary and possibly cost-intensive medical interventions without financial constraints, or to potentially prevent euthanasia based on financial challenges. However, concerns about negative consequences, such as the overuse of diagnostic tests or overtreatment, have also been raised.

METHODS

Using an online questionnaire distributed via e-mail, which included a section on health insurance, we investigated the relative number of insured dogs and cats treated by Austrian, Danish and UK veterinarians (N = 636) and the attitudes of those veterinarians toward health insurance. Further, using a case vignette, we examined whether coverage by health insurance may influence treatment suggestions.

RESULTS

Even though veterinarians in all three countries believe that health insurance reduces stress since clients' financial resources will be less important, we found that Austrian veterinarians are more likely to agree that health insurance is unnecessary compared to Danish and UK veterinarians. Further, many raised the concern that insurance policies influence clinical decisions; and less than half supported the idea of making insurance mandatory. A majority of veterinarians in Austria and the UK thought that insurance can lead to the overuse of diagnostic tests, and in the UK a majority also thought that it can lead to overtreatment. Using case vignettes, we found that veterinarians were significantly more likely to suggest a CT scan to a client with an insured animal, in contrast to a client with stated financial limitations. Further, UK veterinarians were more likely to suggest a CT scan to a client with an insured animal, in contrast to a client without insurance.

CONCLUSION

In conclusion, we found that veterinarians, in general, were in favour of health insurance, and that greater coverage may increase more cost-intensive veterinary care. Our findings also raise a potential ethical challenge of health insurance causing differential access to clinical care for patients.

Expectations and experiences of practising veterinarians throughout an 8-week mindfulness-based stress reduction programme

AIMS

To explore practising veterinarians' expectations of an 8-week mindfulness training programme, their perceived barriers to participating in the programme, their experiences of the programme and the extent to which they continued to engage in mindfulness practices following training.

METHODS

Participants were 10 companion animal veterinarians practising in Auckland, New Zealand. All took part in an 8-week mindfulness-based training programme. A longitudinal qualitative design was used: data were collected by structured interviews prior to the programme, upon completion of the programme and 3 months after completion. Data were analysed using thematic analysis to identify recurring themes, or patterns, within the data.

RESULTS

Before commencing the programme, participants generally thought mindfulness training would provide some benefits for wellbeing but were otherwise not clear on what to expect. The main concerns about taking part were time constraints and apprehensions about potentially having to share personal information, and consequently how they might be perceived by other participants. On completion of the training programme, the opportunity to share experiences within the group with the support of a trained facilitator was reported as the most valuable aspect of the programme, rather than the mindfulness practices themselves. At the 3-month follow-up, participants reported they had learnt some useful techniques for managing stressful thoughts and situations, but despite the perceived benefits, few were still practicing mindfulness techniques.

CONCLUSIONS AND CLINICAL RELEVANCE

Training in mindfulness practices may have some value for helping practicing veterinarians manage their wellbeing, but it is not a complete solution in itself. Participants reported that the greatest benefits came from facilitated peer support.

Measuring satisfaction in the small animal consultation and its relationship to consult length

BACKGROUND

Measuring satisfaction is a useful metric of success of any interaction, but very few validated instruments exist for measuring the satisfaction of the veterinary surgeon (vet) and the client in veterinary consultations. Additionally, there has been no research examining the impact of consultation length on satisfaction. The aim of this observational study was to investigate the use of a single-question graphic scale to assess vet and client satisfaction and the impact of consultation length on satisfaction.

METHODS

Information on consultation timing was collected for 65 health problem consultations across six practices. These measurements were compared with postconsultation measurements of client and vet satisfaction.

RESULTS

A comparison between the long-form and single-question satisfaction instruments demonstrated significant correlation for both vet and client tools (ρ=0.609, P<0.005 and ρ=0.483, P<0.005, respectively). The average client satisfaction with the consultation was high; however, vet satisfaction levels were significantly lower (U=1073, P<0.005). Increased consult length was associated with increased vet satisfaction (ρ=0.332, P=0.007) but not increased client satisfaction.

CONCLUSION

These results demonstrate that the graphic scale is an appropriate proxy for the pre-existing long-form questionnaires available for both vets and clients. Further research is required to examine the disparity identified between vet and client satisfaction.

Toxoplasma gondii seroprevalence in veterinarians in Finland: Older age, living in the countryside, tasting beef during cooking and not doing small animal practice associated with seropositivity

Practising veterinary medicine has an inherent risk of exposure to zoonotic agents, including the protozoan parasite Toxoplasma gondii. We screened sera of veterinarians authorized to work in Finland for the presence of specific immunoglobulin G antibodies against T. gondii with an enzyme-linked fluorescent assay, and evaluated potential risk factors for T. gondii seropositivity from extensive questionnaire data with almost 1,300 quantitative variables. We used a causal diagram approach to address the complexity of the life cycle of the parasite and its numerous possible transmission routes, and built a multivariable binomial logistic regression model to identify risk factors that are particularly relevant for veterinarians. The samples and questionnaire data were collected in 2009. Altogether, 294 veterinarians, almost 15% of the Finnish veterinary profession, were included in the study. The median age was 39 years, and the majority, 86%, were women. Altogether, 43 (14.6%; 95% confidence interval: 10.9-19.0) of the 294 veterinarians tested seropositive for T. gondii. According to the final model, veterinarians who were at least 40 years old had 2.4 times higher odds to be seropositive than younger veterinarians; veterinarians who lived in the countryside had 4.0 times higher odds to be seropositive than veterinarians who lived in towns; female veterinarians who tasted beef during cooking had 2.6 times higher odds to be seropositive than male veterinarians who did not taste beef during cooking; and veterinarians who did not do small animal practice had 2.3 times higher odds to be seropositive than those who did. The results illustrate the numerous transmission routes of T. gondii.

Prevalence of Antibodies Against Hepatitis E Virus in Veterinarians in Estonia

In this cross-sectional study, we investigated veterinarians in Estonia for evidence of exposure to hepatitis E virus (HEV). In 2012, we collected sera from 158 persons attending a veterinary conference, of whom 156 completed a questionnaire covering their background information. Altogether 115 persons reported they had obtained a veterinary degree and were included in this study. The sera were tested for presence of antibodies against HEV using a commercial enzyme linked immunosorbent assay and a commercial immunoblot assay in series. A sample was considered antibody-positive if it tested positive with both tests. Antibody-positive samples were further examined for the presence of HEV RNA. Three (2.6%) of the 115 veterinarians tested positive for immunoglobulin G antibodies against HEV, whereas no immunoglobulin M antibodies against the virus were detected. The antibody-positive veterinarians were small animal practitioners. Pigs comprised no or small part of their working time or patients. No HEV RNA was detected in the antibody-positive samples. The prevalence of antibodies against HEV in veterinarians in Estonia was lower than what has been observed in veterinarians in other countries.