ABSTRACT
INTRODUCTION: 'Economic euthanasia', defined as euthanasia of pets due to financial constraints despite treatable illness, is common in veterinary emergency medicine. Gastric dilatation-volvulus (GDV) in dogs is inexpensive to diagnose and has a high survival rate with corrective, but costly, surgery. Without surgery, GDV is lethal. The proportion of dogs with GDV euthanized pre-surgery emerged as a reliable metric of economic euthanasia. If the COVID-19 pandemic aggravated economic distress in dog owners compromising their ability to afford pet healthcare, an increase in pre-surgical euthanasia in dogs with GDV would be expected. We hypothesized that in dogs with GDV, the risk of pre-surgical euthanasia during the COVID-19 pandemic increased compared to such risk before the pandemic. METHOD(S): In this case-control study, we included nonreferred dogs with GDV that presented to 11 US veterinary hospitals. Dogs were cases if they were euthanized presurgery, and controls if they underwent surgical treatment. Exposure positive dogs were those presenting during the initial surge of unemployment due to COVID-19 (March 16 - July 5 2020), exposure negative dogs were those during the same period in 2019. Univariate analyses and binary logistic regression models were developed to quantify the association between COVID-19 status (present, absent) and euthanasia risk, adjusting for the effect of known confounders. The significance level was set at p < 0.05. RESULT(S): We recorded 118 dogs with GDV over the 2 time periods, with 30% of non-exposed and 52% of exposed pets being euthanized pre-surgery (OR, 2.6;95% CI, 1.2-5.4). After adjusting for age, breed, comorbidities and recumbency, the odds of euthanasia for dogs presenting during COVID-19 were 2.7 (95% CI 1.1 to 6.3) times those of dogs presented in 2019. Old age (OR, 2.6;95% CI, 1.1 to 6.1), but no other explanatory variables, were associated with pre-surgical euthanasia. CONCLUSION(S): Our findings show that in this study population, dogs with GDV presented in the period March 16 to July 5 2020 had a greater risk of euthanasia compared with dogs presented in the same period the year before. It is our inference that economic consequences arising from the COVID-19 pandemic directly impacted on the level of veterinary care owners were able to provide for their pets.
ABSTRACT
Introduction: Historically, visitation of critically ill animals had been common in veterinary ICUs, with visits chaperoned by both veterinarians and the nursing team. Visits may represent a source of comfort and information for owners, but may also be time-consuming to veterinary staff. During the COVID-19 pandemic, almost all specialty/emergency veterinary hospitals pivoted to curb-side service, and typically highly limited client entry into the building for staff safety. Similar restrictions on visitation were instituted in human ICUs, leading to stress among clinicians, nurses, and patient families. The proposed study aimed to assess the visitation policies reported by critical care veterinarians and technicians and the spectrum of effects on veterinary team members. Method(s): An electronic survey was distributed to the emergency and critical care community using email and social media. The study was exempted by the institutional review board. Survey questions included demographics, COVID-19 hospital policies, and questions about the impact of restricting visitation. Descriptive statistics were used. Result(s): There were 326 respondents to the survey, with veterinarians (53%) and veterinary technicians/assistants (40%) being the most common. Visitation restrictions were reported by 286 (88%) participants. Of those, 264 (81%) reported permitting visits only for euthanasia/endof life discussion and/or on a case-by case arrangement and 20 (6%) allowed no visitation at all. By comparison, prior to COVID-19, 309 (95%) respondents reported no visitation restrictions. For the veterinary team, 244 (75%) felt sad if they had to decline a visit, while 211 (65%) reported feeling anxious and/or guilty. Most respondents (218;67%) felt the owners were understanding. Restricting visits was perceived to improve time for patient care for 195 (60%) respondents, decrease overall workload for 192 (59%) respondents, and decrease stress for 137 (42%) respondents. Conclusion(s): Visitation restriction impacts veterinary staff both positively and negatively;careful evaluation of visitation policies is warranted. The impact on owners should also be evaluated.