Comparison of veterinarian and standardized client perceptions of communication during euthanasia discussions.

OBJECTIVE: To describe client and veterinarian perceptions of client-centeredness during euthanasia discussions and assess agreement between measures of these perceptions. DESIGN: Descriptive study. SAMPLE: Stratified random sample of 32 companion animal veterinarians in southern Ontario. PROCEDURES: 2 case scenarios (a geriatric dog with worsening arthritis and a cat with inappropriate urination) designed to initiate euthanasia discussions were presented by 2 different undisclosed standardized clients (USCs) to study veterinarian communication during clinical visits. At the end of appointments, the USC's identity was disclosed, and questionnaires to measure veterinarian and client perceptions of client-centeredness were completed. Agreement was assessed by statistical methods. RESULTS: Data were analyzed from 60 appointments (30/scenario). Of 10 questions, significant agreement was found between veterinarians and USCs for only 1 (extent to which relevant personal and family issues were discussed; κ = 0.43) for the dog scenario and 3 (extent of discussion of respective roles [κ = 0.43], better preparedness of the USC to make a euthanasia decision [κ = 0.42], and discussion of relevant personal and family issues [κ = 0.25]) for the cat scenario. When the USC and veterinarian disagreed, the veterinarian perceived that the client-centeredness components were addressed more thoroughly than did the USC. CONCLUSIONS AND CLINICAL RELEVANCE: Lack of agreement was found between USC and veterinarian perceptions, with USCs perceiving less client-centeredness in euthanasia discussions. This communication gap suggested the need for training of veterinarians in eliciting client perspectives and assessing lifestyle-social information, including client social support systems.

Using informatics and the electronic medical record to describe antimicrobial use in the clinical management of diarrhea cases at 12 companion animal practices.

Antimicrobial drugs may be used to treat diarrheal illness in companion animals. It is important to monitor antimicrobial use to better understand trends and patterns in antimicrobial resistance. There is no monitoring of antimicrobial use in companion animals in Canada. To explore how the use of electronic medical records could contribute to the ongoing, systematic collection of antimicrobial use data in companion animals, anonymized electronic medical records were extracted from 12 participating companion animal practices and warehoused at the University of Calgary. We used the pre-diagnostic, clinical features of diarrhea as the case definition in this study. Using text-mining technologies, cases of diarrhea were described by each of the following variables: diagnostic laboratory tests performed, the etiological diagnosis and antimicrobial therapies. The ability of the text miner to accurately describe the cases for each of the variables was evaluated. It could not reliably classify cases in terms of diagnostic tests or etiological diagnosis; a manual review of a random sample of 500 diarrhea cases determined that 88/500 (17.6%) of the target cases underwent diagnostic testing of which 36/88 (40.9%) had an etiological diagnosis. Text mining, compared to a human reviewer, could accurately identify cases that had been treated with antimicrobials with high sensitivity (92%, 95% confidence interval, 88.1%-95.4%) and specificity (85%, 95% confidence interval, 80.2%-89.1%). Overall, 7400/15,928 (46.5%) of pets presenting with diarrhea were treated with antimicrobials. Some temporal trends and patterns of the antimicrobial use are described. The results from this study suggest that informatics and the electronic medical records could be useful for monitoring trends in antimicrobial use.

Stray dog population health in Jodhpur, India in the wake of an animal birth control (ABC) program.

Our objectives were to (1) estimate the prevalence of various health indices in the stray dog population in Jodhpur, India and (2) determine if there was an association between an animal birth control (ABC) program and the prevalence of these health indices in this population. A prevalence survey of 323 sexually intact stray dogs >3 months caught from the streets of Jodhpur from September to November, 2005 indicated that low body condition score (70%), skin conditions (69%) and tick infestation (68%) were the most common health problems in this population. An observational study of 888 stray dogs on the streets of Jodhpur from March to April, 2006 revealed that sterilized dogs were more likely to have a higher body condition score (BCS) than sexually intact dogs when controlling for age, based on a multinomial regression model. However, sterilized dogs were more likely to have a skin condition than sexually intact dogs, based on a logistic regression model. Our observations of the surgical/kennel facility indicated that an effective tick control program was needed. Additionally, the current parasite control protocol at the kennel/shelter facility was inadequate to treat mange, a contact-transmitted skin disease. This is the first study to evaluate the associations between an ABC program and stray dog health, apart from rabies.

Use of the measure of patient-centered communication to analyze euthanasia discussions in companion animal practice.

OBJECTIVE: To characterize veterinarian-client communication with undisclosed standardized clients (USCs) during discussions regarding euthanasia of a pet. DESIGN: Descriptive study. SAMPLE POPULATION: 32 companion animal veterinarians (16 males and 16 females) in southern Ontario. PROCEDURES: During 2 clinic visits, 2 cases (a geriatric dog with worsening arthritis and a cat with inappropriate urination) designed to stimulate discussion regarding euthanasia of a pet were presented by different USCs (individuals trained to consistently present a particular case to veterinarians without disclosing their identity). Discussions were audio recorded and analyzed by use of the measure of patient-centered communication (MPCC [a tool to assess and score physician communication behaviors]). Veterinarian and client statements were classified by means of 3 patient-centered components: exploring both the disease and the illness experience, understanding the whole person, and finding common ground. RESULTS: 60 usable recorded discussions were obtained (31 veterinarians; 30 discussions/case). Overall, MPCC scores were significantly lower for the geriatric dog case. For both cases, veterinarians scored highest on finding common ground and lowest on exploring both the disease and the illness experience. Lack of exploration of client feelings, ideas, and expectations and the effect of the illness on the animal's function resulted in low scores among veterinarians. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that the use of USCs and the MPCC are feasible methods for analysis of veterinarian-client communication during companion animal euthanasia discussions. Findings suggested that some veterinarians do not fully explore client concerns or facilitate client involvement in euthanasia decision making.

Stray dog population demographics in Jodhpur, India following a population control/rabies vaccination program.

Animal Birth Control (ABC) is a program by which stray dogs are sterilized and vaccinated against rabies with the aim of controlling both dog population size and rabies. Population size and demographics of stray dogs were measured before and after implementation of an ABC program in Jodhpur, India. Dog population size declined (p<0.05) in three of five areas surveyed, showed a decreasing trend (p>0.05) in 1 area, and remained stable in 1 area between 2005 and 2007. By 2007, 61.8-86.5% of the free-roaming dog population was surgically sterilized and vaccinated for rabies in the areas surveyed. In March-May, 2007, adults comprised 80-96% of the free-roaming dog population, while subadults and puppies comprised 0-18 and 0-4%, respectively. The male:female ratio among dogs>3 months old was 1.4:1. A population demographic model predicted that at the current level of sterilization/rabies vaccination, vaccination coverage would remain above 70%, and the dog population would decrease by 69% reaching stability after 13-18 years. A surgical sterilization coverage under 40% would maintain the dog population at current levels.

Assessing reproductive patterns and disorders in free-ranging dogs in Jodhpur, India to optimize a population control program.

The objectives were to test the hypothesis that estrus and pregnancy are seasonal in free-ranging female dogs (>3 mo old) in Jodhpur, India, and to determine litter size, and the prevalence of fetal resorption in this population. The prevalence of estrus and pregnancy was determined in 5400 free-ranging bitches (trapped and released) at the time of ovariohysterectomy. In a separate study, the uteri and ovaries of 246 free-ranging bitches were examined to determine litter size and fetal resorption. The bitches exhibited seasonal estrus and pregnancy (P < 0.00001), with a higher percentage of bitches in estrus or pregnant during the late monsoon season (September to November) compared to the other three seasons. The mean litter size based on embryo/fetal counts was 4.6 (95% CI = 4.0-5.3; n = 40) and based upon placental site counts was 4.4 (95% CI = 3.9-4.8; n = 105). Prevalence of fetal resorption was 32.6% (95% CI = 20.5-47.5; n = 43) with a mean of 2.8 resorptions per litter in those with at least one resorption (95% CI = 1.8-3.8; n = 14). This was the first study to estimate previous litter size of non-pregnant, free-ranging dogs based upon placental sites. Litter size data from this study will be used in a population demographic model to predict the long-term impact of animal birth control (ABC) on the free-ranging dog population in Jodhpur. Increasing the efforts to surgically sterilize bitches prior to the time of year of peak pregnancy or whelping will help maximize the impact of an ABC program on the Jodhpur free-ranging dog population.

A prospective matched nested case-control study of bacterial gill disease outbreaks in Ontario, Canada government salmonid hatcheries.

Early-rearing salmonids in Ontario, Canada government fish hatcheries have been persistently affected by bacterial gill disease (BGD), and outbreaks at these locations have often been associated with high morbidity and mortality. The causative agent of BGD, Flavobacterium branchiophilum, is ubiquitous in fresh water, and outbreaks of BGD are considered to be associated with deleterious environmental conditions. This paper summarizes a 14-month rearing unit-level prospective nested matched case-control investigation at six Ontario government hatcheries (raising a total of six different salmonid species) to identify, and quantify the effects of, important predictors of BGD outbreaks. Ongoing husbandry data were collected on all early-rearing (<9 months of age) fish tank-lots ("tank-lot"=a group of fish from a specific lot existing in a single hatchery tank for a given period during the study time frame) at participating hatcheries, and all outbreaks of BGD were confirmed by light microscopy during the study period. Control tank-lots were selected at the end of the study and matched to individual cases based on time, hatchery, and species. Data were analyzed using logistic regression modeling, controlling for fish age. The final multivariable model indicated that affected tank-lots were significantly more likely to have had lower fish numbers, lower individual fish weights, higher mortality levels and higher feeding rates during the week preceding observed BGD outbreaks than were asymptomatic control tank-lots. Refinements in the observation and manipulation of these factors could therefore aid in the prevention of fish losses associated with observable BGD outbreaks. The predictive (as opposed to causal) nature of the identified factors needs to be considered, and further research is required to understand the relationships between these factors and BGD.

Rearing unit-level factors associated with bacterial gill disease treatment in two Ontario, Canada government salmonid hatcheries.

Early-rearing salmonids in Ontario Ministry of Natural Resources (OMNR) fish hatcheries have been consistently affected by bacterial gill disease (BGD) (causative agent: Flavobacterium branchiophilum) for many years. Separate retrospective epidemiological investigations of BGD treatments at two OMNR fish hatcheries (Hatcheries A and B) for the 1999 production year were conducted using on-site hatchery records. Both investigations were carried out at the rearing unit-level, with early-rearing (<9 months of age) "tank-lot" as the unit of analysis to identify unique fish populations over time. Multivariable repeated measures logistic regression models were created for both hatchery datasets, controlling for lot-level and species effects. For Hatchery A, the species brook trout (Salvelinus fontinalis) and brown trout (Salmo trutta) were significantly associated with BGD treatment, as well as lower water exchange rate, and higher feeding and mortality percentages during the 2 weeks previous to BGD treatment. At Hatchery B, the species brook trout (S. fontinalis) and splake (Salvelinus namaycush x S. fontinalis) were significantly associated with BGD treatment, as well as lower individual fish weights and treatment for BGD during the previous week. These results emphasize the importance of water quality, feeding rate, fish size and prior mortality on the development of BGD. Significant hatchery and species effects were evident, and future observational research on BGD must account for these factors in their design and analysis.

Comparison of prices paid for feeder calves sold at conventional auctions versus special auctions of vaccinated or conditioned calves in Ontario.

OBJECTIVE: To determine whether vaccinated or conditioned feeder calves sold through special auctions in Ontario commanded a premium, compared with feeder calves sold at conventional auctions, and whether various physical characteristics of the calves were associated with the sale price. DESIGN: Cross-sectional study. ANIMALS: 14,037 calves sold through conventional and special auctions at the Keady Livestock Market during the fall of 1999 and 2000. PROCEDURE: Calves were observed as they were sold by lot in the auction ring. Lot characteristics and the price received for each lot were recorded. Multivariate analysis was used to estimate the effect of lot characteristics and sale type on price. RESULTS: Information was recorded for 2,601 calf lots. Multivariate analysis indicated that various lot characteristics were associated with sale price, with 68% of the variation explained by the model. Overall, lots sold at special auctions received a premium of 0.06 dollars/lb (Canadian dollars), compared with lots sold at conventional auctions. However, the premium varied with mean body weight of the lot and year. In addition, frame size, breed, body condition score, uniformity of the lot, weaning status, mean body weight, lot size, sex, year, and sale type were significantly related to sale price. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that producers selling calves at special auctions at this market received a premium, compared with producers selling calves at conventional auctions.

Health performance of feeder calves sold at conventional auctions versus special auctions of vaccinated or conditioned calves in Ontario.

OBJECTIVE: To compare health performance during the first 28 days in the feedlot for vaccinated or conditioned feeder calves sold through special auctions in Ontario with health performance for calves sold through conventional auctions in the province. DESIGN: Cohort study. ANIMALS: 12,313 calves sold through conventional and special auctions at the Keady Livestock Market during the fall of 1999 and 2000. PROCEDURE: Buyers of calf groups were approached at the auction market or contacted by telephone and asked to record the number of calves requiring treatment for bovine respiratory tract disease (BRD) during the first 28 days after purchase. RESULTS: 211 calf groups (> or = 20 calves/group) were followed up for 28 days after purchase. Multivariate logistic analysis indicated that vaccinated calves purchased through special auctions were 0.68 (95% confidence interval, 0.50 to 0.93) times as likely to receive treatment for BRD as were calves purchased at conventional auctions and that conditioned calves were 0.22 (95% confidence interval, 0.12 to 0.38) times as likely to receive treatment. Groups that received antimicrobials by injection on arrival at the feedlot were 0.64 (95% confidence interval, 0.43 to 0.96) times as likely to be treated as were groups that did not. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that vaccinated and conditioned calves were less likely to receive treatment for BRD during the first 28 days in the feedlot; however, there was no difference in mortality rate.