The epidemiology of tick infestation in dog breeds in the UK.

OBJECTIVES: The purpose of this study is to report the prevalence and risk factors for tick infestation in dogs in the UK based on anonymised electronic patient records. MATERIALS AND METHODS: Clinical records of dogs under veterinary care in 2016 at clinics participating in the VetCompass Programme were followed over a 5-year period to identify cases of tick infestation. Risk factor analysis used multivariable logistic regression modelling. RESULTS: The study included 905,553 dogs. From a random sample, 1903 tick infestation cases were identified. The estimated 5-year (2014 to 2018) period prevalence was 2.03% (95% confidence interval: 2.00 to 2.06). Sixteen breeds showed increased odds compared with non-designer-crossbreed dogs. Breeds with the highest odds included Cairn terrier (odds ratio 2.86, 95% confidence interval 1.64 to 4.98), standard poodle (odds ratio 2.80, 95% confidence interval 1.25 to 6.29) and Goldendoodle (odds ratio 2.63, 95% confidence interval 1.17 to 5.91). Six breeds showed reduced odds, with lowest odds shown by Staffordshire bull terrier (odds ratio 0.35, 95% confidence interval 0.25 to 0.50), Rottweiler (odds ratio 0.35, 95% confidence interval 0.15 to 0.85) and Chihuahua (odds ratio 0.38, 95% confidence interval 0.26 to 0.55). Males had 1.24 (95% confidence interval 1.13 to 1.36) times the odds of females. Compared with non-designer-crossbred dogs, designer-crossbreed dogs had increased odds (odds ratio 1.81, 95% confidence interval 1.52 to 2.15). Compared with breeds with short coats, breeds with medium length coats (odds ratio 2.20, 95% confidence interval 1.96 to 2.48) showed increased odds. Breeds with V-shaped drop and pendulous ear carriage had higher odds compared with breeds with erect ear carriage. CLINICAL SIGNIFICANCE: These findings provide an evidence base for veterinary professionals to raise awareness of tick infestation as a preventable disorder in dogs in the UK and to support more effective prevention and therapeutic protocols based on targeted approaches.

Risk factors for unilateral cranial cruciate ligament rupture diagnosis and for clinical management in dogs under primary veterinary care in the UK.

This study aimed to evaluate demographic risk factors associated with unilateral cranial cruciate ligament (CCL) rupture diagnosis and to explore demographic and clinical risk factors associated with management of unilateral CCL rupture in dogs under primary veterinary care in the UK. A retrospective cohort study design was used. Clinical records were automatically searched and manually verified for incident cases of unilateral CCL rupture during 2019 and additional clinical management information extracted. Multivariable logistic regression modelling was used to evaluate associations between risk factors and: (1) CCL rupture diagnosis; and (2) clinical management (surgical or non-surgical). The analysis included 1000 unilateral CCL rupture cases and a random selection of 500,000 non-cases. After accounting for confounding factors, dogs aged 6 to < 9 years, male neutered and female neutered dogs, insured dogs, and Rottweiler, Bichon Frise, and West Highland White terrier breeds, in particular, had increased odds of unilateral CCL rupture diagnosis. Insured dogs and dogs ≥ 20 kg had increased odds of surgical management, while dogs ≥ 9 years and dogs with one non-orthopaedic comorbidity at diagnosis with CCL rupture had reduced odds. These findings inform identification of at-risk dogs, with Rottweilers and Bichon Frise particularly predisposed. Additionally, they contribute to a greater understanding of the clinical rationales used in primary-care veterinary practices to decide between surgical or non-surgical management of unilateral CCL rupture.

Demography, disorders and mortality of pet hamsters under primary veterinary care in the United Kingdom in 2016.

BACKGROUND: Hamsters are popular pets worldwide but there is limited evidence on the overall health issues of pet hamsters. This study aimed to characterise the demography, disorder prevalence and mortality of pet hamsters in the United Kingdom. METHOD: The VetCompass study included anonymised clinical records of 16,605 hamsters. RESULTS: The most common hamster species were Syrian (golden) (Mesocricetus auratus) (n=12,197, 73.45%), Djungarian (winter white dwarf) (Phodopus sungorus) (2286, 13.77%) and Roborovski hamsters (Phodopus roborovskii) (1054, 6.35%). The most prevalent precise-level disorders recorded across all hamsters were a presentation categorised as 'wet tail' (n=293, 7.33%), disorder undiagnosed (292, 7.30%), bite injuries from other hamsters (235, 5.88%), overgrown nail(s) (165, 4.13%), overgrown incisor(s) (159, 3.98%) and traumatic injury (152, 3.80%). The most prevalent disorders groups across all species of hamster were traumatic injury (n=616, 15.41%), enteropathy (450, 11.26%), ophthalmological disorder (445, 11.13%), skin disorder (362, 9.05%) and mass (361, 9.03%). The median age at death across all hamsters was 1.75 years (interquartile range: 0.83 to 2.20, range: 0.01 to 3.65). The most common causes of death at a precise level were wet tail (7.88%, 95% confidence interval: 6.35 to 9.66), abdominal mass (6.40%, 95% confidence interval: 5.01 to 8.03), neoplasia (5.38%, 95% confidence interval: 4.11 to 6.90) and dyspnoea (3.99%, 95% confidence interval: 2.9 to 5.34). CONCLUSION: This study provides veterinary professionals, educators, welfare scientists and owners with an evidence base on pet hamster health. A greater understanding of the common disorders of pet hamsters can support veterinary professionals to communicate more effectively with owners on key issues and outcomes to expect from hamster ownership.

Frequency and risk factors for naturally occurring Cushing's syndrome in dogs attending UK primary-care practices.

OBJECTIVES: To estimate the frequency and risk factors for Cushing's syndrome in dogs under UK primary veterinary care. MATERIALS AND METHODS: Dogs with Cushing's syndrome were identified by searching electronic patient records of primary-care veterinary practices. Pre-existing and incident cases of Cushing's syndrome during 2016 were included to estimate the 1-year period prevalence. Incident cases were used to estimate the annual incidence and to identify demographic risk factors for the diagnosis of Cushing's syndrome in dogs, through multivariable logistic regression. RESULTS: Analysis included 970 pre-existing and 557 incident cases of Cushing's syndrome from a population of 905,544 dogs. The estimated 1-year period prevalence for Cushing's syndrome in dogs under veterinary care was 0.17% (95% confidence interval 0.16 to 0.18) and incidence was 0.06% (95% confidence interval 0.05 to 0.07). In multivariable logistic regression modelling, the Bichon frise (odds ratio=6.17, 95% confidence interval 4.22 to 9.00), Border terrier (5.40, 95% confidence interval 3.66 to 7.97) and Miniature schnauzer (3.05, 95% confidence interval 1.67 to 5.57) had the highest odds of Cushing's syndrome. The Golden retriever (0.24, 95% confidence interval 0.06 to 0.98) and Labrador retriever (0.30, 95% confidence interval 0.17 to 0.54) were the most protected breeds. Increasing age, bodyweight greater than the breed-sex mean and being insured also showed increased odds of Cushing's syndrome. CLINICAL SIGNIFICANCE: As Cushing's syndrome is predominately diagnosed and managed in primary-care practice, this study provides valuable new information of its epidemiology in this setting. Demographics reported are supportive of previous work and additional novel associations identified, such as the Border terrier, could enhance the index of suspicion for veterinarians.

Epidemiology of periodontal disease in dogs in the UK primary-care veterinary setting.

OBJECTIVES: Periodontal disease is a frequent diagnosis of dogs and can have severe negative impacts on welfare. It was hypothesised that breeds with skull shapes that differ most in conformation from the moderate mesocephalic skull shape have higher odds of periodontal disease. MATERIALS AND METHODS: The cohort study included a random sample of dogs under primary veterinary care in 2016 from the VetCompass Programme database. Risk factor analysis used random effects multivariable logistic regression modelling. RESULTS: The study included a random sample of 22,333 dogs. The 1-year period prevalence for diagnosis with periodontal disease was 12.52% (95% CI: 12.09 to 12.97). Eighteen breeds showed increased odds compared with crossbred dogs. Breeds with the highest odds included Toy Poodle (odds ratio 3.97, 95% confidence intervals 2.21 to 7.13), King Charles Spaniel (odds ratio 2.63, 95% confidence interval 1.50 to 4.61), Greyhound (odds ratio 2.58, 95% confidence interval 1.75 to 3.80) and Cavalier King Charles Spaniel (odds ratio 2.39, 95% confidence interval 1.85 to 3.09). Four breeds showed reduced odds compared with crossbreds. Brachycephalic breeds had 1.25 times the odds (95% confidence interval 1.11 to 1.42) of periodontal disease compared with mesocephalic breeds. Spaniel types had 1.63 times the odds (95% confidence interval 1.42 to 1.87) compared with non-spaniel types. Increasing adult bodyweight was associated with progressively decreasing odds of periodontal disease. CLINICAL SIGNIFICANCE: The high prevalence identified in this study highlights periodontal disease as a priority welfare concern for predisposed breeds. Veterinarians can use this information to promote improved dental care in predisposed dogs, especially as these dogs age.

Keratoconjunctivitis sicca in dogs under primary veterinary care in the UK: an epidemiological study.

OBJECTIVES: To estimate the frequency and breed-related risk factors for keratoconjunctivitis sicca (KCS) in dogs under UK primary veterinary care. METHODS: Analysis of cohort electronic patient record data through the VetCompass Programme. Risk factor analysis used multivariable logistic regression. RESULTS: There were 1456 KCS cases overall from 363,898 dogs [prevalence 0.40%, 95% confidence interval (CI) 0.38-0.42] and 430 incident cases during 2013 (1-year incidence risk 0.12%, 95% CI 0.11-0.13). Compared with crossbreds, breeds with the highest odds ratio (aOR) for KCS included American cocker spaniel (aOR 52.33: 95% CI 30.65-89.37), English bulldog (aOR 37.95: 95% CI 26.54-54.28), pug (aOR 22.09: 95% CI 15.15-32.2) and Lhasa apso (aOR 21.58: 95% CI 16.29-28.57). Conversely, Labrador retrievers (aOR 0.23: 95% CI 0.1-0.52) and border collie (aOR 0.30: 95% CI 0.11-0.82) had reduced odds. Brachycephalic dogs had 3.63 (95% CI 3.24-4.07) times odds compared to mesocephalics. Spaniels had 3.03 (95% CI 2.69-3.40) times odds compared to non-spaniels. Dogs weighing at or above the mean bodyweight for breed/sex had 1.25 (95% CI 1.12-1.39) times odds compared to body weights below. Advancing age was strongly associated with increased odds. CLINICAL SIGNIFICANCE: Quantitative tear tests are recommended within yearly health examinations for breeds with evidence of predisposition to KCS and might also be considered in the future within eye testing for breeding in predisposed breeds. Breed predisposition to KCS suggests that breeding strategies could aim to reduce extremes of facial conformation.

Frequency, breed predisposition and demographic risk factors for overweight status in dogs in the UK.

OBJECTIVES: To evaluate the prevalence and risk factors for overweight status in dogs under primary veterinary care in the UK. MATERIALS AND METHODS: A retrospective study design was used to estimate the 1-year (2016) period prevalence of overweight status. The clinical records were randomly ordered and manually validated for dogs with overweight status during 2016. Univariable and multivariable logistic regression modelling were used to evaluate associations between risk factors (breed, brachycephalic status, adult bodyweight, bodyweight relative to breed-sex mean, age, sex-neuter and insurance) and overweight status. RESULTS: There were 1580 of 22,333 dogs identified as overweight during 2016. The estimated 1-year period prevalence for overweight status recorded in dogs under veterinary care was 7.1% (95% confidence interval 6.7-7.4). After accounting for confounding factors, eight breeds showed increased odds of overweight status compared with crossbred dogs. The breeds with the highest odds included the Pug (OR 3.12, 95% confidence interval 2.31 to 4.20), Beagle (OR 2.67, 1.75 to 4.08), Golden Retriever (OR 2.58, 1.79 to 3.74) and English Springer Spaniel (OR 1.98, 1.31 to 2.98). Being neutered, middle-aged and insured were additionally associated with overweight status. CLINICAL SIGNIFICANCE: Targeted overweight prevention strategies should be prioritised for predisposed breeds, such as Pugs and Beagles. The findings additionally raise questions about further preventative efforts following neutering. The prevalence estimate suggests veterinary professionals are underreporting overweight status and therefore could be missing key welfare opportunities.

Hypoadrenocorticism in dogs under UK primary veterinary care: frequency, clinical approaches and risk factors.

OBJECTIVES: To estimate the frequency, clinical approaches and risk factors of hypoadrenocorticism in dogs under UK primary veterinary care. MATERIALS AND METHODS: Dogs diagnosed with hypoadrenocorticism were identified from the UK VetCompass™ programme by searching anonymised electronic patient records. Pre-existing and newly diagnosed cases of disease during 2016 were included. Cases were further sub-categorised as having a laboratory-confirmed or presumed diagnosis of hypoadrenocorticism based on the information recorded in the electronic patient records. Descriptive data were manually extracted. Multivariable logistic regression methods were used to identify demographic risk factors. RESULTS: There were 177 hypoadrenocorticism cases identified from 905,543 dogs in 2016; 72 laboratory-confirmed and 105 presumed. The 1-year period prevalence for hypoadrenocorticism in all dogs was 0.06% (95% confidence interval: 0.05-0.07%). The most common presenting clinical signs in laboratory-confirmed dogs were lethargy (51/66, 77.3%), anorexia (48/66, 66.7%) and vomiting (48/66, 66.7%). Hyperkalaemia was reported in 47 of 53 (88.7%), hyponatraemia in 46 of 53 (86.8%). Median sodium: potassium ratio was 19.00 (interquartile range: 16.20-20.60). Breed, age, neuter status and insurance status were associated with a laboratory-confirmed diagnosis of hypoadrenocorticism. No sex association with hypoadrenocorticism was observed in the multivariable model. The standard poodle had 51.38 times the odds (95% CI: 14.49-182.18) of hypoadrenocorticism compared with crossbreeds. The labradoodle and West Highland white terrier also had increased odds. CLINICAL SIGNIFICANCE: This is the first epidemiological study to report on hypoadrenocorticism in dogs within the UK primary-care population. These results provide benchmark data of current veterinary activity relating to hypoadrenocorticism in primary-care practices.

Unravelling the health status of brachycephalic dogs in the UK using multivariable analysis.

Brachycephalic dog breeds are regularly asserted as being less healthy than non-brachycephalic breeds. Using primary-care veterinary clinical data, this study aimed to identify predispositions and protections in brachycephalic dogs and explore differing inferences between univariable and multivariable results. All disorders during 2016 were extracted from a random sample of 22,333 dogs within the VetCompass Programme from a sampling frame of 955,554 dogs under UK veterinary care in 2016. Univariable and multivariable binary logistic regression modelling explored brachycephaly as a risk factor for each of a series of common disorders. Brachycephalic dogs were younger, lighter and less likely to be neutered than mesocephalic, dolichocephalic and crossbred dogs. Brachycephalic differed to non-brachycephalic types in their odds for 10/30 (33.33%) common disorders. Of these, brachycephalic types were predisposed for eight disorders and were protected for two disorders. Univariable and multivariable analyses generated differing inference for 11/30 (30.67%) disorders. This study provides strong evidence that brachycephalic breeds are generally less healthy than their non-brachycephalic counterparts. Results from studies that report only univariable methods should be treated with extreme caution due to potential confounding effects that have not been accounted for during univariable study design or analysis.

The use of hydrolysed diets for vomiting and/or diarrhoea in cats in primary veterinary practice.

OBJECTIVE: To describe responses of cats prescribed a hydrolysed diet with or without concurrent medication for chronic vomiting and/or diarrhoea of undetermined aetiology. MATERIALS AND METHODS: Anonymised records of 512,213 cats under UK veterinary care in 2016 from the VetCompass database were searched using relevant terms for hydrolysed diets. The records of 5000 (90%) of 5569 cats with evidence of receiving a hydrolysed diet were randomly reviewed for gastrointestinal indication, prior and concurrent medication and response after hydrolysed dietary intervention. A poor response was defined as evidence of receiving antibiotic or glucocorticoid treatment for vomiting/diarrhoea at visits after the onset of the diet or death from gastrointestinal signs for at least 6 months follow-up. RESULTS: Of 977 cats prescribed a hydrolysed diet for chronic vomiting/diarrhoea, 697 (71%) were first prescribed the diet without concurrent antibiotics or glucocorticoids while 280 (29%) first received the diet with these medications. Thirty-four per cent of cats in the former group and 61% in the latter had a poor response. Cats older than 6 years and cats prescribed antibiotic and/or glucocorticoid for vomiting/diarrhoea before and concurrently with the diet had higher odds of poor response. CLINICAL SIGNIFICANCE: Although variations in our observations may reflect severity of signs or prescribing habits of primary-care veterinary surgeons, our study suggests there is merit in trialling a hydrolysed diet first as a sole therapy in cats with chronic vomiting/diarrhoea when diagnostic investigations do not reveal a cause, before resorting to antibiotic and/or glucocorticoid therapy for cases that respond poorly.

Juvenile-onset and adult-onset demodicosis in dogs in the UK: prevalence and breed associations.

OBJECTIVES: To explore epidemiological features of demodicosis relevant to UK veterinary general practitioners. Breed risk factors were proposed as distinct between juvenile-onset and adult-onset disease. MATERIALS AND METHODS: The study used anonymised clinical data on dogs under primary veterinary care at practices enrolled in the UK VetCompass Programme. Case inclusion required recording of a final demodicosis diagnosis for a dermatological condition that was present during the 2013 study period. Risk factor analysis used multivariable logistic regression modelling. RESULTS: In dogs aged <2 years (juvenile-onset), the 1-year period prevalence was 0.48% (95% confidence interval: 0.45 to 0.52). Compared with crossbred dogs, seven breeds showed increased odds of diagnosis with demodex: British bulldog, Staffordshire bull terrier, Chinese shar-pei, dogue de Bordeaux, pug, French bulldog and boxer. Additionally, six breeds showed reduced odds of juvenile demodicosis: Lhasa apso, bichon frise, Labrador retriever, German shepherd dog, shih-tzu and Chihuahua. In dogs aged >4 years (adult-onset), the 1-year period prevalence was 0.05% (95% confidence interval: 0.0.04 to 0.06). Six breeds showed increased odds of demodicosis compared with crossbred dogs: Chinese shar-pei, shih-tzu, West Highland white terrier, pug, boxer and Border terrier. CLINICAL SIGNIFICANCE: Juvenile-onset demodicosis is much more common (about 10 times higher) than the adult-onset form. Knowledge of the predisposed breeds for these two presentations can assist with diagnosis and support the concept of distinct aetiopathogenetic phenotypes.

Associations between neutering and early-onset urinary incontinence in UK bitches under primary veterinary care.

OBJECTIVES: To investigate association between neutering and early-onset urinary incontinence in bitches under primary veterinary care in the UK. MATERIALS AND METHODS: A retrospective cohort study of bitches within VetCompass born between January 1, 2010 and December 31, 2012 that were followed until March 31, 2018. The clinical records were automatically searched and manually validated for incontinence cases. Incidence risk and rate over the study period were calculated. Cox regression modelling separately evaluated the hazard of urinary incontinence and association with neutering: (1) from the date of birth for all bitches, both neutered and entire; and, (2) from the date of neutering for the neutered subset. Other variables considered included breed, bodyweight and veterinary practice group. RESULTS: Overall, 492 bitches were identified with early-onset urinary incontinence from a total of 72,971 included in the study period. Incidence risk was 0.68% (95% confidence intervals 0.62 to 0.74), while incidence rate increased with age. After accounting for confounding factors, increased hazard of early-onset urinary incontinence was identified in: (1) neutered bitches, with the effect increasing with age; and, (2) bitches neutered before 6 months, within the first 2 years following neutering. In both models, increased hazard was additionally associated with increasing bodyweight and breed. CLINICAL SIGNIFICANCE: Neutering itself and early-age neutering (<6 months) are major risk factors for early-onset urinary incontinence. These results should be taken into account in making evidence-based recommendations on neutering and its timing.

Spaying and urinary incontinence in bitches under UK primary veterinary care: a case-control study.

OBJECTIVES: To evaluate associations between spaying and urinary incontinence in bitches under primary veterinary care in the UK. MATERIALS AND METHODS: A case-control study was nested within the study population of 333,910 bitches, which included all bitches within the VetCompass database with an electronic patient record in 2016 or in both 2015 and 2017. The electronic records were searched automatically for urinary incontinence cases, which were manually reviewed for inclusion. All non-cases were included as controls. Additional demographic and clinical information was extracted on cases and controls. RESULTS: The study included 427 incident cases and 1708 controls that were presented between November 1, 2014 and October 31, 2017. Prior spaying was associated with increased odds of urinary incontinence (odds ratio: 3.01; 95% CIs: 2.23 to 4.05). Increased odds of urinary incontinence were additionally associated with increasing age and increasing bodyweight. Age at spay was not associated with urinary incontinence. CLINICAL SIGNIFICANCE: The findings support spaying as a major risk factor associated with urinary incontinence, but age at spay appears to be of less clinical importance. These results will help assist clinicians in making evidence-based recommendations on spaying while taking other considerations for urinary incontinence into account.

Prognostic factors in dogs with presumed degenerative mitral valve disease attending primary-care veterinary practices in the United Kingdom.

BACKGROUND: Prognostic risk factors were identified for dogs with degenerative mitral valve disease (DMVD) monitored by veterinary cardiologists. The value of these measurements has not been determined in the wider primary care setting. OBJECTIVES: To evaluate whether plasma cardiac biomarkers and data obtained from routine history-taking and physical examination are predictive of survival in dogs with DMVD attending primary care practice. ANIMALS: Eight-hundred and ninety-three dogs with a presumptive diagnosis of DMVD recruited from 79 primary care veterinary practices in the United Kingdom. METHODS: Prospective cohort study. Primary care veterinary practitioners recorded clinical data. Plasma N-terminal pro B-type natriuretic peptide (NT-proBNP) and cardiac troponin I (cTnI) were measured at presentation. Cox regression models evaluated associations between risk factor variables and hazard of death (all-cause mortality and cardiac-related death). Flexible parametric models generated predicted survival probabilities for dogs with different combinations of prognostic risk factor variable values. RESULTS: Dogs with higher NT-proBNP and cTnI concentrations, higher heart rates, older dogs, females, and those reported to be exercise intolerant, dyspneic, and diagnosed with selected comorbidities had an increased hazard of death due to any cause. Dogs with higher concentrations of plasma biomarkers, higher heart rates, and heart murmur intensities, those with exercise intolerance and those receiving potent diuretics had a higher hazard of cardiac-related death. CONCLUSIONS AND CLINICAL IMPORTANCE: Cardiac biomarkers and key clinical findings identified in this study can help primary care veterinary practitioners identify dogs with DMVD that are at highest risk of death.

Urinary incontinence in male dogs under primary veterinary care in England: prevalence and risk factors.

OBJECTIVE: To estimate prevalence and identify demographic risk factors for urinary incontinence in male dogs. METHODS AND METHODS: The study population included all dogs within the VetCompass database from September 1, 2009 to July 7, 2013. Electronic patient records were searched for urinary incontinence cases; demographic and clinical information were extracted and analysed. RESULTS: Of 109,428 male dogs attending 119 clinics in England, there were an estimated 1027 dogs diagnosed with urinary incontinence, giving a prevalence of 0.94% (95% confidence interval: 0.88 to 1.00). Breeds with highest odds of incontinence in male dogs (compared with mixed breed dogs) included the bull mastiff (odds ratio: 17.21, 95% confidence interval: 6.65 to 44.56, case=5, non-case=314, P<0.001), Irish red setter (odds ratio: 12.79, 95% confidence interval: 4.83 to 33.84, case=5, non-case=142, P<0.001), fox terrier (odds ratio: 9.60, 95% confidence interval: 3.68 to 25.05, case=5, non-case=176, P < 0.001), bulldog (odds ratio: 5.72, 95% confidence interval: 2.24 to 14.59, case=5, non-case=929, P<0.001) and boxer (odds ratio: 3.65, 95% confidence interval: 1.84 to 7.25, case=10, non-case=1470, P<0.001). Increased odds of urinary incontinence were associated with greater age (age 9 to 12 years, odds ratio: 10.46, 95% confidence interval: 6.59 to 16.62, n=12,348, P<0.001) and being insured (odds ratio: 1.96, 95% confidence interval: 1.53 to 2.51, n=26,202, P<0.001). There was no association with castration or bodyweight using multi-variable analysis. CLINICAL SIGNIFICANCE: The overall prevalence of urinary incontinence in male dogs is approximately 1%, which may be higher than expected given the sparsity of reports describing this problem. In contrast to bitches, neutering and bodyweight were not associated with greater odds of urinary incontinence, which is important when giving neutering advice.

Urinary incontinence in bitches under primary veterinary care in England: prevalence and risk factors.

OBJECTIVES: To estimate prevalence and demographic risk factors for urinary incontinence in bitches under primary veterinary care in England. METHODS: The study population included all bitches within the VetCompass database from September 1, 2009 to July 7, 2013. Electronic patient records were searched for urinary incontinence cases and additional demographic and clinical information was extracted. RESULTS: Of 100,397 bitches attending 119 clinics in England, an estimated 3108 were diagnosed with urinary incontinence. The prevalence of urinary incontinence was 3·14% (95% confidence intervals: 2·97 to 3·33). Medical therapy was prescribed to 45·6% cases. Predisposed breeds included the Irish setter (odds ratio: 8·09; 95% confidence intervals: 3·15 to 20·80; P< 0·001) and Dobermann (odds ratio: 7·98; 95% confidence intervals: 4·38 to 14·54; P< 0·001). Increased odds of a diagnosis of urinary incontinence were associated with: (1) weight at or above the mean adult bodyweight for the breed (odds ratio: 1·31; 95% confidence intervals: 1·12 to 1·54; P< 0·001), (2) age 9 to 12 years (odds ratio: 3·86; 95% confidence intervals: 2·86 to 5·20, P< 0·001), (3) neuter status (odds ratio: 2·23; 95% confidence intervals: 1·52 to 3·25, P< 0·001) and (4) being insured (odds ratio: 1·59; 95% confidence intervals: 1·34 to 1·88, P< 0·001). CLINICAL IMPACT: Clinical Impact: Urinary incontinence affects just over 3% of bitches overall but affects more than 15% of bitches in high-risk breeds including the Irish setter, Dobermann, bearded collie, rough collie and Dalmatian. These results provide an evidence base for clinicians to enhance clinical recommendations on neutering and weight control, especially in high-risk breeds.

Gastric dilation-volvulus in dogs attending UK emergency-care veterinary practices: prevalence, risk factors and survival.

OBJECTIVE: To report prevalence, risk factors and clinical outcomes for presumptive gastric dilation-volvulus diagnosed among an emergency-care population of UK dogs. METHODS: The study used a cross-sectional design using emergency-care veterinary clinical records from the VetCompass Programme spanning September 1, 2012 to February 28, 2014 and risk factor analysis using multivariable logistic regression modelling. RESULTS: The study population comprised 77,088 dogs attending 50 Vets Now clinics. Overall, 492 dogs had presumptive gastric dilation-volvulus diagnoses, giving a prevalence of 0·64% (95% Confidence interval: 0·58 to 0·70%). Compared with cross-bred dogs, breeds with the highest odds ratios for the diagnosis of presumptive gastric dilation-volvulus were the great Dane (odds ratio: 114·3, 95% Confidence interval 55·1 to 237·1, P<0·001), akita (odds ratio: 84·4, 95% Confidence interval 33·6 to 211·9, P<0·001) and dogue de Bordeaux (odds ratio: 82·9, 95% Confidence interval 39·0 to 176·3, P<0·001). Odds increased as dogs aged up to 12 years and neutered male dogs had 1·3 (95% Confidence interval 1·0 to 1·8, P=0·041) times the odds compared with entire females. Of the cases that were presented alive, 49·7% survived to discharge overall, but 79·3% of surgical cases survived to discharge. CLINICAL SIGNIFICANCE: Approximately 80% of surgically managed cases survived to discharge. Certain large breeds were highly predisposed.

Mortality due to trauma in cats attending veterinary practices in central and south-east England.

OBJECTIVES: To identify important demographic and spatial factors associated with the risk of trauma and, more specifically, road traffic accident-related mortality, relative to other diagnoses in cats. METHODS: A sample of 2738 cats with mortality data derived from the VetCompass primary-care veterinary database was selected for detailed study. Generalised linear models investigated risk factors for mortality due to trauma and due to road traffic accidents versus other causes. RESULTS: A greater proportion of younger cats died through traumatic and road traffic accident-attributed causes relative to other causes of mortality. There was no apparent association of trauma- or road traffic accident-related death with urban environments or areas where there is increased human population density. CLINICAL SIGNIFICANCE: These findings highlight that veterinary advice which aims to reduce the likelihood of death through trauma, and specifically road traffic accidents, should focus on demographic attributes including age. All geographical locations should be considered as of equal risk.

Pasireotide Long-Acting Release Treatment for Diabetic Cats with Underlying Hypersomatotropism.

BACKGROUND: Long-term medical management of hypersomatotropism (HS) in cats has proved unrewarding. Pasireotide, a novel somatostatin analogue, decreases serum insulin-like growth factor 1 (IGF-1) and improves insulin sensitivity in cats with HS when administered as a short-acting preparation. OBJECTIVES: Assess once-monthly administration of long-acting pasireotide (pasireotide LAR) for treatment of cats with HS. ANIMALS: Fourteen cats with HS, diagnosed based on diabetes mellitus, pituitary enlargement, and serum IGF-1 > 1000 ng/mL. METHODS: Uncontrolled, prospective cohort study. Cats received pasireotide LAR (6-8 mg/kg SC) once monthly for 6 months. Fructosamine and IGF-1 concentrations, and 12-hour blood glucose curves (BGCs) were assessed at baseline and then monthly. Product of fructosamine concentration and insulin dose was calculated as an indicator of insulin resistance (Insulin Resistance Index). Linear mixed-effects modeling assessed for significant change in fructosamine, IGF-1, mean blood glucose (MBG) of BGCs, insulin dose (U/kg) and Insulin Resistance Index. RESULTS: Eight cats completed the trial. Three cats entered diabetic remission. Median IGF-1 (baseline: 1962 ng/mL [range 1051-2000 ng/mL]; month 6: 1253 ng/mL [524-1987 ng/mL]; P < .001) and median Insulin Resistance Index (baseline: 812 µmolU/L kg [173-3565 µmolU/L kg]; month 6: 135 µmolU/L kg [0-443 µmolU/L kg]; P = .001) decreased significantly. No significant change was found in mean fructosamine (baseline: 494 ± 127 µmol/L; month 6: 319 ± 113.3 µmol/L; P = .07) or MBG (baseline: 347.7 ± 111.0 mg/dL; month 6: 319.5 ± 113.3 mg/dL; P = .11), despite a significant decrease in median insulin dose (baseline: 1.5 [0.4-5.2] U/kg; 6 months: 0.3 [0.0-1.4] U/kg; P < .001). Adverse events included diarrhea (n = 11), hypoglycemia (n = 5), and worsening polyphagia (n = 2). CONCLUSIONS AND CLINICAL IMPORTANCE: Pasireotide LAR is the first drug to show potential as a long-term management option for cats with HS.