Breeding policies and management of pedigree dogs in 15 national kennel clubs.

To improve the health and welfare of pedigree dogs, national kennel clubs (KCs) are key players in the governance and regulation of dog breeding. In a survey conducted to investigate differences between KCs in breeding policies and management of pedigree dogs, a questionnaire was completed by 15 KCs from 11 European countries (Austria, Belgium, Denmark, France, Germany, Ireland, Latvia, The Netherlands, Norway, Sweden and the United Kingdom) and four non-European countries (Australia, Mexico, Uruguay and the USA). The most important concerns reported by KCs were exaggerated morphological features and inherited disorders. A wide variety of information, tools and strategies was used to address these issues, with implementation differing across countries and breeds. KCs reported progress in the collection and provision of information related to canine health and welfare. Implementation of advanced breeding tools, such as genetic evaluation and online advisory mating tools, and balanced breeding strategies, endorsed by clubs and breeders, remain challenging and require further development.

Naturally Occurring Adrenocortical Insufficiency--An Epidemiological Study Based on a Swedish-Insured Dog Population of 525,028 Dogs.

BACKGROUND: Naturally occurring adrenocortical insufficiency (NOAI) in dogs is considered an uncommon disease with good prognosis with hormonal replacement treatment. However, there are no epidemiological studies with estimates for the general dog population. OBJECTIVES: To investigate the epidemiological characteristics of NOAI in a large population of insured dogs. ANIMALS: Data were derived from 525,028 client-owned dogs insured by a Swedish insurance company representing 2,364,652 dog-years at risk (DYAR) during the period between 1995-2006. METHODS: Retrospective cohort study. Incidence rates, prevalences, and relative risks for dogs with NOAI (AI with no previous claim for hypercortisolism), were calculated for the whole dog population, and for subgroups divided by breed and sex. Mortality rates were calculated and compared in dogs with NOAI and the remaining dogs overall. RESULTS: In total 534 dogs were identified with NOAI. The overall incidence was 2.3 cases per 10,000 DYAR. The relative risk of disease was significantly higher in the Portuguese Water Dog, Standard Poodle, Bearded Collie, Cairn Terrier, and Cocker Spaniel compared with other breeds combined. Female dogs overall were at higher risk of developing AI than male dogs (RR 1.85; 95% CI, 1.55-2.22; P < .001). The relative risk of death was 1.9 times higher in dogs with NOAI than in dogs overall. CONCLUSION AND CLINICAL IMPORTANCE: The data supports the existence of breed-specific differences in incidence rates of NOAI in dogs.

Incidence of Diabetes Mellitus in Insured Swedish Cats in Relation to Age, Breed and Sex.

BACKGROUND: Diabetes mellitus (DM) is a common endocrinopathy in cats. Most affected cats suffer from a type of diabetes similar to type 2 diabetes in humans. An increasing prevalence has been described in cats, as in humans, related to obesity and other lifestyle factors. OBJECTIVES: To describe the incidence of DM in insured Swedish cats and the association of DM with demographic risk factors, such as age, breed and sex. ANIMALS: A cohort of 504,688 individual cats accounting for 1,229,699 cat-years at risk (CYAR) insured by a Swedish insurance company from 2009 to 2013. METHODS: We used reimbursed insurance claims for the diagnosis of DM. Overall incidence rates and incidence rates stratified on year, age, breed, and sex were estimated. RESULTS: The overall incidence rate of DM in the cohort was 11.6 cases (95% confidence interval [CI], 11.0-12.2) per 10,000 CYAR. Male cats had twice as high incidence rate (15.4; 95% CI, 14.4-16.4) as females (7.6; 95% CI, 6.9-8.3). Domestic cats were at higher risk compared to purebred cats. A significant association with breed was seen, with the Burmese, Russian Blue, Norwegian Forest cat, and Abyssinian breeds at a higher risk compared to other cats. No sex predisposition was found among Burmese cats. Several breeds with a lower risk of DM were identified. CONCLUSIONS AND CLINICAL IMPORTANCE: Our results verify that the Burmese breed is at increased risk of developing DM. We also identified several previously unreported breeds with increased or decreased risk of DM.

Disease patterns and incidence of immune-mediated disease in insured Swedish Nova Scotia Duck Tolling Retrievers.

In this study, morbidity in insured Nova Scotia Duck Tolling Retriever (NSDTR) dogs from Sweden was investigated and compared with all other breeds and other retriever breeds. In addition to describing common morbidities in NSDTRs, the hypotheses that NSDTRs are predisposed to lymphoma, immune-mediated rheumatic disease (IMRD) and steroid-responsive meningitis-arteritis (SRMA) were tested. Included in the study were 445,336 dogs; of which, 2890 were NSDTRs that had been covered by veterinary insurance from the Agria Insurance Company (Stockholm, Sweden) at some point during the years 1995-2006. Incidences of various health problems were calculated using the number of veterinary visits as the numerator and the exact time at risk as the denominator. Overall, morbidity was higher in NSDTRs compared with all other breeds, but similar compared with other retriever breeds. The most common causes of veterinary visits in NSDTRs were injuries, gastrointestinal disease and locomotor disorders, with NSDTRs at increased risk of these compared with all other breeds. The incidences for IMRD, SRMA and lymphoma were significantly higher in NSDTRs than in all other dog breeds and all other retriever breeds. The study describes morbidity in NSDTRs, and identifies several disorders to which the breed is predisposed.

Disease patterns in 32,486 insured German shepherd dogs in Sweden: 1995-2006.

The aims of this retrospective study were to describe the morbidity and mortality in German shepherd dogs (GSD) in Sweden, based on insurance data, and to test the hypothesis that GSDs are predisposed to immune-related diseases. Morbidity was defined as incidence rates and based on veterinary care events. Mortality was defined as mortality rates and based on life insurance data. The study included 445,336 dogs, 7.3 per cent GSDs, covered by both veterinary care and life insurance between 1995 and 2006 in the Swedish insurance company Agria (Agria Insurance Company, Stockholm, Sweden). For veterinary care events (morbidity) GSDs were most over-represented for immunological disease, with a relative risk (RR) of 2.7, compared with the risk in all other breeds combined. The most common disease category (morbidity) in GSDs was skin disorders with an incidence rate of 346.8 cases per 10,000 dog years at risk. The highest RR for cause of death in GSDs compared with all other breeds was for skin conditions (RR=7.8). Locomotor disorders were the most common cause of death in GSDs. The GSD is predisposed to immune-related disorders, such as allergies, circumanal fistulae and exocrine pancreatic atrophy, with significantly increased risk compared with all other breeds.

Current status of canine cancer registration - report from an international workshop.

This is a report from a workshop on canine cancer registration hosted at the Norwegian School of Veterinary Science in Oslo in August 2010. The aim is to present a summary of the current efforts to gather data on canine (and feline) cancer based on information from participants at the workshop. A definition and classification of cancer registries is provided together with an inventory of the databases presented. Particular focus is placed on the distinction between population-based and hospital-based cancer registries. Future challenges are discussed and issues relating to harmonization of diagnostic coding, defining the population-at-risk, individual animal identification and data quality are included. Finally, other groups working within the field of cancer registration in companion animals are encouraged to contact the authors for future collaboration.

Lifestyle risk factors for progesterone-related diabetes mellitus in elkhounds - a case-control study.

OBJECTIVES: This study aims to investigate lifestyle risk factors for the development of progesterone-related diabetes mellitus in female elkhounds. METHODS: Owners of 48 diabetic elkhounds and 58 healthy elkhounds were interviewed by phone concerning lifetime diet and exercise routines. A logistic model was developed to assess the impact of diet and exercise on diabetes diagnosis. The agreement between lifetime owner-perceived body condition score (BCS) and veterinary-perceived BCS at inclusion was estimated in healthy control dogs using the Kappa statistic. RESULTS: The model showed that diabetic dogs had increased odds for having been overweight (before diagnosis) compared with controls (OR=2·8, 95% confidence interval 1·1-7·5, P=0·034). Although feeding other food than commercial dog feed was associated with diabetes case status, the effect was not significant after BCS was entered into the model. The overall agreement between lifetime owner- and veterinary-perceived BCS at inclusion in the study was 75% and had a Kappa statistic of 0·16 (P=0·12). CLINICAL SIGNIFICANCE: This study indicates that a high owner-perceived lifetime BCS is associated with progesterone-related diabetes in elkhounds.

Development and validation of an instrument for measuring appointment-specific client satisfaction in companion-animal practice.

Healthcare research recognizes that 'satisfaction' is an important health outcome of the medical encounter. As a result, many healthcare professions have pursued the development and validation of instruments for measuring patient satisfaction. However, veterinary medicine has developed and properly validated few instruments for measuring client satisfaction. This paper describes the development and psychometric assessment of an instrument for measuring appointment-specific client satisfaction in companion-animal practice. We developed the Client Satisfaction Questionnaire (CSQ) in four main phases. Phase I relied on a series of six pet-owner focus groups (n=32) to explore clients' expectations of veterinary care to provide a basis for constructing items for the CSQ. Phase II involved developing items for a first draft of the CSQ, using the content and themes taken from the pet-owner focus groups. In phase III we pre-tested the first draft with six veterinarians in companion-animal practice and a convenience sample of their clients (n=129). Data from the pre-test were used to test the initial psychometric characteristics of each item. Together with participant feedback, these findings were used to design the final, 15-item CSQ. Phase IV involved psychometrically testing the final, 15-item CSQ as part of a larger observational study involving 20 veterinarians and 344 of their clients. We used data from this sample to assess the reliability and validity of the CSQ in companion-animal practice. Assessment was based on descriptive statistics, principal-component analysis, generalizability theory and linear mixed modeling. Findings demonstrate excellent reliability (G-coefficient for internal consistency=0.96) and support the face, content and construct validity of the CSQ as a measure of appointment-specific client satisfaction in companion-animal practice.

Age patterns of disease and death in insured Swedish dogs, cats and horses.

From 1995 to the present Agria Animal Insurance, Sweden (Agria Djurförsäkring, Stockholm, Sweden) has provided data on both health care and life insurance claims for descriptive and analytical research. From these data we have published extensively on insured dogs and horses and have recently submitted a study on cat mortality. Over the periods studied most extensively (1995-2002 for dogs, 1997-2004 for horses and 1999-2006 for cats), Agria has insured approximately 200,000 dogs, 100,000 horses and up to 200,000 cats per year. Estimates based on formal research or market surveys suggest that Agria insures approximately 40% of both the Swedish dog and horse populations and 50% of the purebred cat population. Where animal insurance is so widely embraced, the Agria-insured populations are likely to be representative of the national population. This paper focuses on age patterns of disease, differences between breeds and genders, body system and disease process and changes over time. An increase in survival over the years for dogs and cats is undoubtedly affected by owner, societal and veterinary factors relative to the availability of, and willingness and ability to access, and continue, veterinary care. In addition, marked differences in survival across breeds suggest that comparisons between people and companion animals in terms of health, disease and longevity must consider these complexities.

Mortality of life-insured Swedish cats during 1999-2006: age, breed, sex, and diagnosis.

BACKGROUND: A cat life insurance database can potentially be used to study feline mortality. HYPOTHESIS: The aim was to describe patterns of mortality in life-insured Swedish cats. Cats: All cats (<13 years of age) with life insurance during the period 1999-2006 were included. METHODS: Age-standardized mortality rates (MR) were calculated with respect to sex (males and females), age, breed, and diagnosis. Survival to various ages is presented by time period and breed. RESULTS: The total number of cats insured was 49,450 and the number of cat-years at risk (CYAR) was 142,049. During the period, 6,491 cats died and of these 4,591 cats (71%) had a diagnosis, ie, were claimed for life insurance. The average annual MR was 462 deaths per 10,000 CYAR (95% confidence interval, 431-493). Sex-specific rates did not differ significantly. The overall mortality of the Persian and the Siamese groups was higher than that of several other breeds. Overall and breed-specific (for most breeds) survival increased with time when analyzed by 2-year periods. The 6 most common diagnostic categories (ignoring cats recorded as dead with no diagnosis) were urinary, traumatic, neoplastic, infectious, cardiovascular, and gastrointestinal. The MR within diagnostic categories varied by age and breed. CONCLUSIONS AND CLINICAL IMPORTANCE: In this mainly purebred, insured cat population, the overall mortality varied with age and breed but not with sex. The increase in survival over time is likely a reflection of willingness to keep pet cats longer and increased access to and sophistication of veterinary care.

Demographics and costs of colic in Swedish horses.

BACKGROUND: Colic is an important cause of morbidity and mortality in horses. In Sweden, an insurance database with diagnostic medical information is maintained on >30% of the nation's horse population. HYPOTHESIS: The objective was to describe the occurrence of colic, defined by costly veterinary care and life claims, in horses at 1 insurance company during 1997-2002. HORSES: All horses (<21 years of age) with complete insurance for veterinary care and life during the period 1997-2002 were included. METHODS: Colic was defined as conditions where the main clinical sign was abdominal pain and the problem was related to the gastrointestinal system. The analyses included measures of incidence by sex, breed group, age categories, geographical location (urban/other), survival to and survival after colic, medical cost for colic, and multivariable modeling of risk factors related to the event of colic. RESULTS: In all, 116,288 horses contributed to 341,564 horse years at risk (HYAR). There were 3,100 horses with a colic diagnosis, of which 27% were settled for life insurance. The median gross cost for veterinary care was 4,729 Swedish Kronor (SEK). The overall occurrence and mortality rate of colic was 91 and 24 events per 10,000 HYAR. Survival after colic at 1 month was 76% (95% confidence interval: 75-78%). CONCLUSIONS AND CLINICAL IMPORTANCE: The occurrence of colic varied with breed group, age, and season. The mortality rates probably reflected the true mortality of colic. The veterinary care rates most likely underestimated of the risk colic because they represent relatively costly events.

Mortality of Swedish horses with complete life insurance between 1997 and 2000: variations with sex, age, breed and diagnosis.

The aim of this study was to evaluate the potential usefulness of the database maintained by the Swedish insurance company Agria for providing mortality statistics on Swedish horses. Mortality statistics (incidence rates and survival) were calculated, both crudely and stratified by sex, age, breed, breed group and diagnosis, for the horses with complete life insurance, which covers most health problems. The total mortality was 415 (95 per cent confidence interval [CI] 399 to 432) deaths per 10,000 horse-years at risk, and the diagnostic mortality, including only deaths with an assigned diagnosis, was 370 (95 per cent CI 355 to 386) deaths per 10,000 horse-years at risk. The diagnostic mortality of geldings was 459 (95 per cent CI 431 to 487), of mares 345 (95 per cent CI 322 to 365) and of stallions 214 (95 per cent CI 182 to 247) deaths per 10,000 horse-years at risk. The mortality rates increased with age and differed widely between breeds. Survival analysis showed that the median age at death of the horses enrolled before they were one year of age was 18.8 years. The most common cause of death or euthanasia was joint problems, which were responsible for 140 (95 per cent CI 130 to 149) deaths per 10,000 horse-years at risk. The results of multivariable models developed by using Poisson regression generally agreed well with the crude results.

Mortality in over 350,000 insured Swedish dogs from 1995-2000: II. Breed-specific age and survival patterns and relative risk for causes of death.

This study continues analysis from a companion paper on over 350,000 insured Swedish dogs up to 10 years of age contributing to more than one million dog-years at risk during 1995-2000. The age patterns for total and diagnostic mortality and for general causes of death (trauma, tumour, locomotor, heart and neurological) are presented for numerous breeds. Survival estimates at five, eight and 10 years of age are calculated. Survival to 10 years of age was 75% or more in Labrador and golden retrievers, miniature and toy poodles and miniature dachshunds and lowest in Irish wolfhounds (91% dead by 10 years). Multivariable analysis was used to estimate the relative risk for general and more specific causes of death between breeds accounting for gender and age effects, including two-way interactions. Older females had tumour as a designated cause of death more often than males in most breeds, but not in the Bernese mountain dog. Information presented in this and the companion paper inform our understanding of the population level burden of disease, and support decision-making at the population and individual level about health promotion efforts and treatment and prognosis of disease events.

Mortality in over 350,000 insured Swedish dogs from 1995-2000: I. Breed-, gender-, age- and cause-specific rates.

This study presents data on over 350,000 insured Swedish dogs up to 10 years of age contributing to over one million dog-years at risk (DYAR) during 1995-2000. A total of 43,172 dogs died or were euthanised and of these 72% had a claim with a diagnosis for the cause of death. The overall total mortality was 393 deaths per 10,000 DYAR. Mortality rates are calculated for the 10 most common breeds, 10 breeds with high mortality and a group including all other breeds, crudely and for general causes of death. Proportional mortality is presented for several classifications. Five general causes accounted for 62% of the deaths with a diagnosis (i.e. tumour (18%), trauma (17%), locomotor (13%), heart (8%) and neurological (6%)). Mortality rates for the five most common diagnoses within the general causes of death are presented. These detailed statistics on mortality can be used in breed-specific strategies as well as for general health promotion programs. Further details on survival and relative risk by breed and age are presented in the companion paper (Egenvall et al. 2005).

Morbidity of Swedish horses insured for veterinary care between 1997 and 2000: variations with age, sex, breed and location.

The aim of this study was to evaluate the potential usefulness of the database maintained by the Swedish insurance company Agria for providing disease statistics on Swedish horses. The demography of the horses insured for veterinary care during the period 1997 to 2000 was recorded and the incidence of morbidity, defined as horses that required veterinary care that cost more than the policy excess, was calculated. Yearly incidences were calculated for horses that required veterinary care at least once, first overall, and then for horses with complete insurance, by sex, age, breed group, breed, location and human population density. Poisson regression was applied to a multivariable model to produce estimates of relative risk adjusted for other factors in the model, such as age. The total number of horse-years at risk for those with complete insurance was over 72,000 each year. The annual incidence rate for horses that required veterinary care at least once varied from 1080 to 1190 events per 10,000 horse-years at risk; for geldings the averaged incidence rate was 1398 events, for mares it was 1042 events, and for stallions it was 780 events per 10,000 horse-years at risk. There were considerable variations in incidence rate between breeds.

Specific causes of morbidity among Swedish horses insured for veterinary care between 1997 and 2000.

The principal aim of this study was to analyse the incidence of disease due to general and more specific causes among over 100,000 horses covered by complete insurance for veterinary care by a Swedish insurance company during 1997 to 2000. The database was used to calculate the rate of cause-specific morbidity in horses of different ages, sexes and breed groups kept in different regions with different human population densities. The joints were the most commonly affected part of the body, followed by unspecified/whole body, the skin and the digestive system. The most common specific diagnosis was fetlock arthritis, followed by lameness of undefined origin, other locomotor problems, traumatic injuries to the skin, arthritis in several joints, and colic. Geldings had the highest rate of at least one disease event in the joints, unspecified/whole body, skeletal or respiratory system, whereas in the other four major systems the difference between the sexes was marginal.

Survey of veterinary technical and professional skills in students and recent graduates of a veterinary college.

OBJECTIVES: To determine perceptions of veterinary technical and professional skills among veterinary students and recent graduates. DESIGN: Cross-sectional study. SAMPLE POPULATION: 281 students and 142 recent graduates from the Ontario Veterinary College. PROCEDURE: A survey was designed and administered to first- through fourth-year students and veterinarians who had graduated either 1 or 6 years before survey administration. RESULTS: Overall response rate was 70%. Learning about technical and professional skills was highly valued. Most participants felt they had not received instruction about professional skills, but those who had felt more competent about them. Perceptions of competence increased slightly with increased comfort discussing emotional veterinary issues with instructors. Neither gender nor increased age was related to increased feelings of competence. Almost all fourth-year students felt competent and comfortable about examining an animal with the client present, assessing suffering, diagnosing parvovirus infection, performing surgery, and working as group members. However, many did not feel competent or comfortable about delivering bad news, setting time limits yet providing quality service, helping clients with limited funds make treatment decisions, dealing with demanding people, and euthanasia. Feelings of competence and comfort were closely related but were not identical. CONCLUSIONS AND CLINICAL RELEVANCE: In the interests of best preparing entry-level veterinarians, technical and professional skills need to be emphasized in a learning environment where students feel comfortable discussing emotional veterinary issues. A professional skills curriculum addressing underlying self-awareness, communication, and interpersonal issues, as well as procedural matters, would likely increase the proportion of fourth-year students who feel competent and comfortable about professional skills by the end of their undergraduate training.

Breed risk of pyometra in insured dogs in Sweden.

An animal insurance database containing data on over 200,000 dogs was used to study the occurrence of pyometra with respect to breed and age during 1995 and 1996 in Swedish bitches <10 years of age. A total of 1,803 females in 1995 and 1,754 females in 1996 had claims submitted because of pyometra. Thirty breeds with at least 800 bitches insured each year were studied using univariate and multivariate methods. The crude 12-month risk of pyometra for females <10 years of age was 2.0% (95% confidence interval = 1.9-2.1%) in 1995 and 1.9% (1.8-2.0%) in 1996. The occurrence of pyometra differed with age, breed, and geographic location. The risk of developing pyometra was increased (identified using multivariate models) in rough Collies, Rottweilers, Cavalier King Charles Spaniels, Golden Retrievers, Bernese Mountain Dogs, and English Cocker Spaniels compared with baseline (all other breeds, including mixed breed dogs). Breeds with a low risk of developing the disease were Drevers, German Shepherd Dogs, Miniature Dachshunds, Dachshunds (normal size), and Swedish Hounds. Survival rates indicate that on average 23-24% of the bitches in the databases will have experienced pyometra by 10 years of age. In the studied breeds, this proportion ranged between 10 and 54%. Pyometra is a clinically relevant problem in intact bitches, and differences related to breed and age should be taken into account in studies of this disease.

Predictors of owner response to companion animal death in 177 clients from 14 practices in Ontario.

OBJECTIVE: To identify predictors of grief and client desires and needs as they relate to pet death. DESIGN: Cross-sectional mail survey. SAMPLE POPULATION: 177 clients, from 14 randomly selected veterinary practices, whose cat or dog died between 6 and 43 days prior to returning the completed questionnaire. PROCEDURE: Veterinary practices were contacted weekly to obtain the names of clients whose pets had died until approximately 200 clients were identified. Clients were contacted by telephone, and a questionnaire designed to measure grief associated with pet death was mailed to those willing to participate within 1 to 14 days of their pet's death. The questionnaire measured potential correlates and modifiers of grief and included three outcome measures: social/emotional and physical consequences, thought processes, and despair. Demographic data were also collected. RESULTS: Approximately 30% of participants experienced severe grief. The most prominent risk factors for grief included level of attachment, euthanasia, societal attitudes toward pet death, and professional support from the veterinary team. CONCLUSIONS AND CLINICAL RELEVANCE: Bivariate and multivariate analyses highlighted the impact owners' attitudes about euthanasia and professional intervention by the veterinary team had on reactions to pet death. Owners' perceptions of societal attitudes, also a predictor of grief, indicate that grief for pets is different than grief associated with other losses.

Gender, age and breed pattern of diagnoses for veterinary care in insured dogs in Sweden during 1996.

More than 200,000 dogs insured for veterinary care by one Swedish company at the beginning of 1996 were included in a retrospective cross-sectional study. Data from receipts for visits to veterinarians that were part of reimbursed veterinary care events, whose cost exceeded the deductible cost, were used to calculate the risk of cause-specific morbidity, both in total and stratified by gender, age and breed. Diagnoses were described by organic system, for example, cardiovascular, and by disease process, for example, neoplastic The most commonly affected system was the integument followed by the gastrointestinal and genital systems. The genital system was the most commonly affected system in females, within which 50 per cent of the affected bitches had pyometra. Inflammatory processes were most common, followed by symptomatic conditions, traumatic injuries and neoplastic conditions.