A Pilot Study Examining the Experience of Veterinary Telehealth in an Underserved Population Through a University Program Integrating Veterinary Students.

Cost and transportation are two commonly cited barriers to accessing health care in both human and veterinary medicine within underserved communities. While human medicine has utilized telehealth as a means of breaking down this barrier, limited research exists to describe its use in veterinary medicine. The Pets for Life (PFL) program has partnered with the Penn Vet Shelter Medicine Program to provide veterinary appointments to clients, at no cost to the client, in underserved zip codes through virtual telehealth visits. These visits incorporated veterinary students as part of their clinical rotations through a service learning based model. Between January and August 2021, 31 PFL clients and nine veterinary students completed surveys to describe the role of telehealth in addressing barriers to accessing veterinary care, their perceptions of telehealth appointments, the human-animal bond, and changes in veterinary student empathy. PFL clients completed the survey immediately following their telehealth appointment, and veterinary students completed surveys prior to and following their participation in the PFL appointments during the rotation. Nearly 25% of clients reported that they would not have been able to secure transportation and 58% reported they would not have been able to afford an appointment at an in-person veterinary clinic. The population of clients who responded that cost was a significant barrier to accessing care did not entirely overlap with those who responded that transportation was a significant barrier to accessing care, indicating support for the use of telehealth in providing an alternative modality to address transportation challenges as a barrier to accessing veterinary care. Additional data suggests that both client and student experience was overwhelmingly positive, providing support for further service learning initiatives in veterinary student education. Further research is warranted to continue to assess the emerging role of telehealth in improving veterinary care for underserved communities.

Outbreak of feline infectious peritonitis (FIP) in shelter-housed cats: molecular analysis of the feline coronavirus S1/S2 cleavage site consistent with a 'circulating virulent-avirulent theory' of FIP pathogenesis.

Case series summary: This case series describes three shelter-housed cats concurrently diagnosed with feline infectious peritonitis (FIP). The cats were from a cohort of seven surrendered from the site of a house fire. The three cats presented with mild upper respiratory signs. Within 10 days they clinically declined: progressive signs included pyrexia, icterus, lethargy, anorexia and cavitary effusions. Necropsy followed by histopathology and immunohistochemistry confirmed a diagnosis of FIP in all three. Molecular analysis of the causative feline coronavirus (FCoV) revealed varied amino acid alterations in the spike gene both between cats and between sample types in individual cats. A fourth cat from the cohort remained healthy in the shelter but succumbed to FIP 6 weeks post-adoption. Relevance and novel information: This case series places FCoV genetic sequences in the context of clinical signs in a small shelter outbreak. Each of the three cats concurrently developed a slightly different clinical presentation. PCR amplification and genetic sequencing revealed that two cats shared an S1/S2 cleavage site mutation (R790S) previously described to be associated with the development of FIP; one of the cats had an additional S1/S2 cleavage site mutation (R793S). The third cat had a single, identical S1/S2 point mutation (R790G) unique from the other two cats; the R790G mutation has not been previously reported. This case series provides interesting data on point mutations associated with the development of FIP and provides support for a 'circulating virulent-avirulent theory' of FIP pathogenesis in a small shelter outbreak.

Genetic mapping of distal femoral, stifle, and tibial radiographic morphology in dogs with cranial cruciate ligament disease.

Cranial cruciate ligament disease (CCLD) is a complex trait. Ten measurements were made on orthogonal distal pelvic limb radiographs of 161 pure and mixed breed dogs with, and 55 without, cranial cruciate partial or complete ligament rupture. Dogs with CCLD had significantly smaller infrapatellar fat pad width, higher average tibial plateau angle, and were heavier than control dogs. The first PC weightings captured the overall size of the dog's stifle and PC2 weightings reflected an increasing tibial plateau angle coupled with a smaller fat pad width. Of these dogs, 175 were genotyped, and 144,509 polymorphisms were used in a genome-wide association study with both a mixed linear and a multi-locus model. For both models, significant (pgenome <3.46×10-7 for the mixed and< 6.9x10-8 for the multilocus model) associations were found for PC1, tibial diaphyseal length and width, fat pad base length, and femoral and tibial condyle width at LCORL, a known body size-regulating locus. Other body size loci with significant associations were growth hormone 1 (GH1), which was associated with the length of the fat pad base and the width of the tibial diaphysis, and a region on CFAX near IRS4 and ACSL4 in the multilocus model. The tibial plateau angle was associated significantly with a locus on CFA10 in the linear mixed model with nearest candidate genes BET1 and MYH9 and on CFA08 near candidate genes WDHD1 and GCH1. MYH9 has a major role in osteoclastogenesis. Our study indicated that tibial plateau slope is associated with CCLD and a compressed infrapatellar fat pad, a surrogate for stifle osteoarthritis. Because of the association between tibial plateau slope and CCLD, and pending independent validation, these candidate genes for tibial plateau slope may be tested in breeds susceptible to CCLD before they develop disease or are bred.