Veterinarians' Self-Reported Behaviors and Attitudes toward Spectrum of Care Practices.

Access to veterinary care for animal owners is an important part of keeping animals healthy and keeping pets and people together whenever that is appropriate. Insufficient financial and other resources to allocate to veterinary care are major barriers for pet owners to receiving preventative, sick, and emergency services. The veterinary community has begun to incorporate offering a range of diagnostic and treatment options more intentionally in response to clients' inability to pay and to a lesser extent to mitigate other barriers to care. Many veterinarians are nonetheless oriented toward providing specialized and more sophisticated care based on their training. This study sought to identify the self-reported behaviors, knowledge, attitudes, and beliefs of veterinarians about offering a spectrum of care options (SoC) to clients. The finding that many reported offering SoC is encouraging. However, veterinarians who report comfort and confidence in a variety of aspects of clinical care were most likely to offer SoC. Practitioners in the field for 20 or more years were less likely to offer SoC to clients with financial limitations. Rural veterinarians were more likely to offer SoC to any client compared to urban veterinarians. These results provide a point of reference and potential focus for veterinarians who are not currently offering SoC as well as an exploration of veterinarians' reported knowledge, behaviors, attitudes, perceptions, and concerns about SoC.

Retrospective review reveals few complications of ovarian pedicle tie in 15,927 cats undergoing ovariohysterectomy at a large HQHVSN clinic and training facility in the United States: 2017-2018.

OBJECTIVE: To determine the rate of complications associated with the ovarian pedicle tie procedure in cats undergoing ovariohysterectomy and examine whether cat characteristics or surgeon experience level were associated with complications. ANIMALS: 15,927 cats that underwent ovariohysterectomy with the ovarian pedicle tie procedure between January 1, 2017, and December 31, 2018. PROCEDURES: Data were extracted from electronic and paper medical records. Complications were coded by a veterinarian blinded to surgeon experience level. Complications (pedicle drop or tear, pedicle hemorrhage, and pedicle-related death) were summarized as counts and percentages. Univariate associations between cat characteristics (eg, age, weight, reproductive status, and ownership) and surgeon experience level (clinic veterinarian vs training veterinarian or veterinary student) and each outcome were estimated separately for veterinarian and student training clinics. RESULTS: A pedicle drop or tear occurred in 0.3% (n = 49) of cats and was significantly more likely among veterinary students. Most (41/49 [84%]) pedicle drops and tears did not result in hemorrhage. Only 19 of 15,927 (0.12%) cats had pedicle-related hemorrhage, and in all instances, hemorrhage was corrected intraoperatively without serious complication or death. Cat characteristics and surgeon experience level were not related to pedicle hemorrhage. CLINICAL RELEVANCE: Results support previous evidence that the ovarian pedicle tie procedure is safe in cats undergoing ovariohysterectomy when performed by experienced surgeons or novice surgeons under supervision. Given the reduced anesthetic time associated with the procedure, the ovarian pedicle tie should be considered an acceptable standard practice in all practice settings.

Findings and prognostic indicators of outcomes for bitches with pyometra treated surgically in a nonspecialized setting.

OBJECTIVE: To determine the rate of survival to hospital discharge and identify indicators associated with poor outcomes among female dogs (bitches) with pyometra treated with ovariohysterectomy (OHE) in a nonspecialized setting. ANIMALS: 405 bitches diagnosed with pyometra at the American Society for the Prevention of Cruelty to Animals Animal Hospital from January 1, 2017, to February 8, 2019. PROCEDURES: For this retrospective study, medical records were searched and data collected including patient history, clinical signs, serum biochemical analyses results, and outcome (survival to hospital discharge, length of hospital stay, and uterine rupture). Logistic regression models were used to assess multivariable associations and identify potential predictive variables. RESULTS: The rate of survival to hospital discharge for bitches with pyometra treated with OHE was 97% (394/405); 44% (174/394) stayed in the hospital ≥ 2 nights, and 3% (11/390) had a ruptured uterus. Bitches with a high BUN concentration or heart murmur had greater odds of death after OHE; however, the model had low predictive power. Those with uterine rupture, inappetence, high concentrations of BUN or serum creatinine, low PCV, or dehydration had greater odds of hospitalization ≥ 2 nights. There were no significant predictors of uterine rupture. CLINICAL RELEVANCE: The rate of survival to hospital discharge was high for bitches with pyometra treated with OHE in a nonspecialized setting; therefore, general practitioners could expect similar outcomes. With this important procedure widely available in general practices, more pets can receive treatment for this life-threatening disease.

Owner-reported long-term outcomes, quality of life, and longevity after hospital discharge following surgical treatment of pyometra in bitches and queens.

OBJECTIVE: Investigate long-term complications, survival times, general health and quality of life (QoL) outcomes, and longevity in female dogs and cats (bitches and queens, respectively) following hospital discharge after ovariohysterectomy (OHE) for pyometra. ANIMALS: 306 pet-owner-completed surveys and corresponding medical records for 234 bitches and 72 queens treated with OHE for pyometra at the American Society for the Prevention of Cruelty to Animals Animal Hospital between January 1, 2017, and December 31, 2019. PROCEDURES: A telephone and online survey was conducted to gather data about pet owners' perception of pet health and QoL following OHE for pyometra, and potential associations between survey results and medical record data were evaluated. Median survival time at a given age at OHE for pyometra was calculated with the use of maximum likelihood estimation of a survival-time regression model. RESULTS: 72 of the 121 (60%) eligible owners of queens and 234 of the 390 (60%) eligible owners of bitches completed the survey. Most owners reported that at the time of the survey, their pet's health and QoL were better or the same as before pyometra. Reported health and QoL outcomes were similar for pets > 8 versus ≤ 8 years of age. CLINICAL RELEVANCE: Our findings indicated that bitches and queens undergoing OHE for pyometra at older ages and without other severe health issues can expect to live their full life span. Veterinarians in private practice could expect similar outcomes.

Findings and prognostic indicators of outcomes for queens with pyometra treated surgically in a nonspecialized hospital setting.

OBJECTIVE: To describe findings, determine the rate of survival to hospital discharge, and identify prognostic indicators of poor outcomes for female cats (queens) with pyometra treated with ovariohysterectomy (OHE) in a nonspecialized setting. ANIMALS: 134 queens with pyometra diagnosed between January 1, 2017, and December 31, 2019. PROCEDURES: The medical records were retrospectively searched and data including patient history, clinical signs, blood work results, and outcome (survival to hospital discharge, length of hospitalization, and uterine rupture) were collected from medical records. Logistic regression models were used to assess potential predictors of outcomes. RESULTS: Dehydration (69% [83/121]) and absolute neutrophilia (83% [52/63]) were commonly reported. The rate of survival to hospital discharge was 100% (126/126; 95% CI, 97% to 100%) for queens treated with OHE; 33% (41/126) were hospitalized ≥ 2 nights, and 4% (5/120) had uterine rupture. Queens with abnormal serum ionized calcium concentration or signs of depressed mentation had greater odds (OR of 4.64 and 2.26, respectively) of ≥ 2 nights' hospitalization. Queens with high rectal temperature, closed pyometra, or heart murmur had greater odds (OR of 35.66, 17.37, or 16.06, respectively) of uterine rupture. CLINICAL RELEVANCE: Our findings indicated that OHE for pyometra in queens was highly successful even when performed in a nonspecialty hospital with high-quality basic supportive care, and we believe most general practitioners who offer OHE could expect to see similar outcomes. With more general-practice veterinarians comfortable treating pyometra in their clinics, OHE for pyometra will be available to more pets, ultimately saving more lives.

Community Veterinary Medicine Programs: Pet Owners' Perceptions and Experiences.

Many American pet owners struggle financially, and the COVID-19 pandemic has only exacerbated this problem. Yet, the positive effects that companion animals have in people's lives create the need for supportive systems to ensure that financial limitations, and other barriers, do not preclude pet ownership. To help address these barriers, and reach underserved communities, various forms of community-based veterinary medicine programs have been developed across the country. This study assesses two community-based veterinary programs in North Carolina, USA. In addition to perceptions surrounding veterinary services, this study paid specific attention to communication and respect; two additional elements needed for successful community-based veterinary programs. Surveys were given to clients accessing Asheville Humane Society (AHS) mobile veterinary care clinic and Asheville Humane Society (AHS) Affordable Pet Care Clinic. Results of the anonymous survey indicate that the majority of clients had positive veterinary care experiences in terms of both veterinary services and client communication. In conclusion, low-cost or free community veterinary programs-with effective communication, empathy, and cultural competence-can help open the door to future positive veterinary experiences for disadvantaged pet owners.

Pre-mortem risk factors for mortality in kittens less than 8 weeks old at a dedicated kitten nursery.

OBJECTIVES: Kittens have unique requirements for care in a shelter setting given their higher susceptibility to infectious disease and socialization needs. Significant time and resources are necessary to care for this vulnerable population and dedicated kitten nurseries are one way to meet the requirements of kittens too young for neutering and rehoming. However, young kittens remain at a higher risk of dying relative to adult cats, even in specialized settings. Efforts to investigate kitten mortality have focused on post-mortem findings and little is known about pre-mortem clinical signs that may be associated with death. The purpose of this study was to elucidate predictors of mortality in underage kittens. METHODS: The medical records of kittens aged <8 weeks reared in a kitten nursery in New York City during 2017 were examined. The data collected included signalment (estimated age and weight at intake, sex), physical findings (body condition score [BCS]), clinical signs (weight loss, anorexia, diarrhea, upper respiratory tract infection [URI]), diagnoses (panleukopenia, trauma), how early in the feline breeding season the kitten entered (April-November), and whether the kitten had died or was euthanized. The data were analyzed using Cox proportional hazard modeling with 1353 kittens to identify factors associated with any death or euthanasia. RESULTS: Elevated risk of dying was found for kittens in the lightest weight group (13 times greater), diagnosed with panleukopenia (13 times greater), exhibiting weight loss (>9 times greater), diagnosed with URI (almost four times greater), exhibiting anorexia (three times greater), identified with a low BCS at intake (two times greater) and experiencing diarrhea (almost two times greater). CONCLUSIONS AND RELEVANCE: These findings identify clinical signs and diagnoses that can serve as prognostic indicators for underage kitten survival in a shelter/rescue setting and can aid in enhancing protocols for monitoring, intervention and euthanasia decision-making.

Impact of the Timing of Spay-Neuter Related to Transport on Disease Rates in Relocated Dogs.

Companion animal relocation programs are an important method to address geographic and resource disparities in pet overpopulation through transport from areas with high homeless pet populations to areas with high adopter demand. Despite mitigation by following best practices, a potential risk of animal relocation is increased disease incidence related to infectious disease spread and the effects of stress during transport. Surgical sterilization may compound disease risk due to the impact of surgical stress on disease susceptibility and the potential for disease exposure from other patients. Our study aimed to provide information about disease and surgical complication incidence as relates to the timing of surgical sterilization in relocated dogs. A population of 431 dogs relocated to a shelter in Washington State was monitored for disease while at the destination shelter and immediately post-adoption. No increased disease incidence was identified for dogs altered within two weeks of transport at the destination shelter compared with those altered within two weeks prior to transport at the source shelter. Because of disparities addressed by relocation programs, surgical sterilization of relocated companion animals is typically best performed at the destination shelter. Our study indicates that disease incidence is not increased by spay-neuter at the destination shelter.

Welfare of cats 5-29 months after perineal urethrostomy: 74 cases (2015-2017).

OBJECTIVES: The objective of this study was to evaluate the long-term quality of life in cats following perineal urethrostomy. METHODS: This study comprised a retrospective case series of 74 cats with urinary obstructions that received perineal urethrostomies at the American Society for the Prevention of Cruelty to Animals (ASPCA) Animal Hospital between September 2015 and July 2017. Medical records were reviewed for information on the number of obstructions prior to surgery, urinary tract problems at the time of surgery and other potential factors influencing long-term welfare. Owners were surveyed by telephone and text 5-29 months after their cat's surgery. Responses were compiled and analyzed to determine owner perception of welfare postsurgery, and to identify patterns in medical history and welfare outcomes. RESULTS: In total, 105 cat owners were eligible for the survey; 74 responded. Altogether, 100% of responding individuals reported at least the same quality of life postsurgery compared with the cat's quality of life before demonstrating urinary problems (48% reported better). On a quality-of-life scale of 1-10 (10 = excellent), 100% of responding cat owners reported at least 7; 75% reported 10. CONCLUSIONS AND RELEVANCE: Quality-of-life outcomes for cats 5-29 months after receiving perineal urethrostomy surgery were reported to be very good. Given this finding, and that perineal urethrostomy surgery should mitigate future blockages, we suggest considering perineal urethrostomy surgery as a standard tool to manage urinary obstructions in cats. The needs of the specific client and patient, including risks, costs and welfare of the cats, should drive the options for management of urinary obstructions in male cats.

Evaluation of a Community's Risk for Canine Parvovirus and Distemper Using Antibody Testing and GIS Mapping of Animal Shelter Intakes.

This cross-sectional study aimed to identify where dogs with negative antibody tests to canine parvovirus (CPV) and canine distemper virus (CDV) originated when entering a community shelter, using a commercially available ELISA antibody test and Geographic Information Systems mapping. Of 2745 canines entering during a three-month period, 1056 test results were obtained. Dogs or puppies weighing over 2 lb were eligible if they could be humanely, nonchemically restrained for phlebotomy. Age and minor health issues weren't exclusions. Dogs were excluded if trained personnel were concerned health would be compromised by phlebotomy. Blood samples were collected within 24 hours of entry. Four hundred and twenty-seven (40%) dogs had positive antibody test results for both viruses, 422 (40%) were positive for CPV, 37 (4%) were positive for CDV, and 170 (16%) were negative for both. Mapping revealed geographic patterns for dogs with negative antibody tests. This shelter admitted dogs with negative CPV and/or CDV antibody tests from defined community areas. Targeting vaccination efforts in communities to areas where dogs with negative antibody tests originate could be an effective wellness strategy.

The Impact of Excluding Food Guarding from a Standardized Behavioral Canine Assessment in Animal Shelters.

Many shelters euthanize or restrict adoptions for dogs that exhibit food guarding while in the animal shelter. However, previous research showed that only half the dogs exhibiting food guarding during an assessment food guard in the home. So, dogs are often misidentified as future food guarders during shelter assessments. We examined the impact of shelters omitting food guarding assessments. Nine shelters conducted a two-month baseline period of assessing for food guarding followed by a two-month investigative period during which they omitted the food guarding assessment. Dogs that guarded their food during a standardized assessment were less likely to be adopted, had a longer shelter stay, and were more likely to be euthanized. When the shelters stopped assessing for food guarding, there was no significant difference in the rate of returns of food guarding dogs, even though more dogs were adopted because fewer were identified with food guarding behavior. Additionally, the number of injuries to staff, volunteers, and adopters was low (104 incidents from a total of 14,180 dogs) and did not change when the food guarding assessment was omitted. These results support a recommendation that shelters discontinue the food guarding assessment.

Estimating the Availability of Potential Homes for Unwanted Horses in the United States.

There are approximately 200,000 unwanted horses annually in the United States. This study aimed to better understand the potential homes for horses that need to be re-homed. Using an independent survey company through an Omnibus telephone (land and cell) survey, we interviewed a nationally projectable sample of 3036 adults (using both landline and cellular phone numbers) to learn of their interest and capacity to adopt a horse. Potential adopters with interest in horses with medical and/or behavioral problems and self-assessed perceived capacity to adopt, constituted 0.92% of the total sample. Extrapolating the results of this survey using U.S. Census data, suggests there could be an estimated 1.25 million households who have both the self-reported and perceived resources and desire to house an unwanted horse. This number exceeds the estimated number of unwanted horses living each year in the United States. This study points to opportunities and need to increase communication and support between individuals and organizations that have unwanted horses to facilitate re-homing with people in their community willing to adopt them.

Welfare Impacts of Spay/Neuter-Focused Outreach on Companion Animals in New York City Public Housing.

Spay/neuter (S/N) programs aim to reduce shelter intake and euthanasia. However, there is little published evidence of a causal effect between S/N programs and shelter intake or euthanasia. To uncover any ancillary effects of S/N, this study examined the impact of S/N door-to-door outreach on welfare-related outcomes and attitudes around S/N in underserved areas of New York City. There was no significant difference between a group receiving intensive outreach and a comparison group on whether they had rehomed a companion animal in the last year. There was a significantly higher level of saturation of S/N in the intensive-outreach area. A significantly higher percentage of those in the intensive-outreach group reported knowing at least 1 way to get help for their companion animals and that the caregiver-defined general well being of nonhuman animals in their neighborhood was better during the previous year. These data suggest that intensive S/N outreach has an impact on the level of saturation of S/N, the perceived efficacy of caregivers to find help if needed, and the perception that animal welfare is being improved.

A community-based study to examine the epidemiology of human cystic echinococcosis in Rio Negro Province, Argentina.

Although cystic echinococcosis (CE) is an important public health problem in Rio Negro Province, current epidemiological data for CE, in this region of Argentina, are not available. Therefore, a community-based study, which incorporated diagnostic imaging and a questionnaire, was conducted in Ingeniero Jacobacci, a small town in southern Rio Negro Province. This study sought to assess the prevalence of human CE, in the study population, and to evaluate epidemiologic factors associated with CE transmission within the study area. Of the 560 individuals who volunteered to participate in the study, 189 (34%) were children and 371 (66%) were adults. All study participants were screened for CE using abdominal ultrasound scanning, with CE-positive or suspect individuals also receiving thoracic radiographs. The overall prevalence of CE was 7.1% (40/560), with 1.6% (3/189) of children, and 10% (37/371) of adults diagnosed as CE-positive. Although 92.5% (37/40) of the CE-positive individuals had only hepatic lesions, two participants had both hepatic and pulmonary lesions, and one participant had a single renal lesion. Approximately 92% (340/371) of the adult study participants completed the questionnaire, which was used to identify factors associated with an increased risk for human infection. Age, level of education, dog ownership, and contact with sheep were found to be significantly associated with CE status. This study demonstrated that CE continues to be highly endemic in this region of Rio Negro Province, Argentina. In addition, community-based ultrasound screening surveys are a noninvasive, effective approach to case detection at the community level.

Biochemical survey of free-roaming cats (Felis catus) in New York City presented to a trap-neuter-return program.

Free-roaming cats in New York, NY, USA, that presented to a trap-neuter-return program were surveyed for biochemical data. One hundred and one cats had blood collected for a plasma biochemistry panel after the induction of surgical anesthesia. Reference intervals for 18 analytes were generated for the sample population, along with age-specific reference intervals when statistically appropriate. Age groups (juveniles and adults) differed in 10 of the 18 analytes measured, including protein levels and albumin/globulin ratio, aspartate aminotransferase, alkaline phosphatase, creatine kinase, creatinine, phosphorus, calcium and potassium. No differences were found between males and females. This is the first report of biochemical reference intervals for a group of free-roaming cats within the USA.

Concentrated tea tree oil toxicosis in dogs and cats: 443 cases (2002-2012).

OBJECTIVE: To determine the frequency, types, and severity of clinical signs; geographic distribution; and treatment information associated with toxicosis caused by 100% tea tree oil (TTO) in dogs and cats in the United States and Canada. DESIGN: Retrospective case series. ANIMALS: 337 dogs and 106 cats with evidence of exposure to 100% TTO. PROCEDURES: 10-year incident data were retrieved from the ASPCA Animal Poison Control Center database from January 2002 to December 2012. Only evidenced or witnessed incidents assessed as toxicosis or suspected toxicosis were included. Signalment, amount of TTO used, intention of use, and outcome information were evaluated. Severity of illness and correlations with breed, sex, age, and weight were determined. RESULTS: TTO was intentionally used in 395 of 443 (89%) animals. The amount used ranged from 0.1 to 85 mL. Incidents were reported from 41 states, the District of Columbia, and 4 Canadian provinces. Exposure route was cutaneous in 221 (50%) animals, cutaneous and oral in 133 (30%), and oral in 67 (15%). Clinical signs developed within 2 to 12 hours and lasted up to 72 hours. The most common signs were increased salivation or drooling, signs of CNS depression or lethargy, paresis, ataxia, and tremors. A significant association with severity of illness was found for age and weight, with higher prevalence of major illness in younger and smaller cats. CONCLUSIONS AND CLINICAL RELEVANCE: Intentional or accidental use of 100% TTO in dogs or cats caused serious signs of CNS depression, paresis, ataxia, or tremors within hours after exposure and lasting up to 3 days. Younger cats and those with lighter body weight were at greater risk of developing major illness.

Effect of single-cat versus multi-cat home history on perceived behavioral stress in domestic cats (Felis silvestrus catus) in an animal shelter.

This study investigates the effect of living with other cats in a prior home on stress levels of cats recently surrendered to an animal shelter. A total of 63 cats was evaluated using a Cat-Stress-Score and an approach test. Cats were categorized in terms of previous home history with or without other cats. No significant difference was found in stress scores between cats from single-cat households and those from multiple-cat households, although single cats that had been in the shelter less than 4 days demonstrated higher stress levels. No significant difference was found between the two groups in terms of approach results. Results of this study suggest that, in traditional individual cage settings, cats that are not accustomed to living with other cats may experience more stress in the initial few days of attempting to adjust to shelter existence. Through the use of such assessments, shelter personnel may develop an increased awareness to the needs of these cats and attempt to provide measures to improve their well-being within the shelter environment.

A survey of North American shelter practices relating to feline upper respiratory management.

An internet-based survey was conducted to determine common strategies for control of feline upper respiratory infections (URI) in animal shelters. Two hundred and fifty-eight North American shelters responded, representing a spectrum of 57% private non-profit, 27% municipal and 16% combined private non-profit-municipal shelters. All but nine shelters reported having a regular relationship with a veterinarian, 53% had full-time veterinarians and 62% indicated full-time (non-veterinarian) medical staff. However, in 35% of facilities, non-medical shelter management staff determined what medication an individual cat could receive, with 5% of facilities making that decision without indicating the involvement of a veterinarian or technician. Ninety-one percent of shelters had an isolation area for clinically ill cats. The most commonly used antimicrobial was doxycycline (52%), followed by amoxicillin/clavulanic acid (33%). Shelters are using a wide range of prevention measures and therapeutics, leaving room for studying URI in different settings to improve understanding of optimal protocols.

Associations between cerebrospinal fluid biomarkers and long-term neurologic outcome in dogs with acute intervertebral disk herniation.

OBJECTIVE: To examine associations between CSF biomarkers, initial neurologic dysfunction, and long-term ambulatory outcome in dogs with acute intervertebral disk herniation (IVDH). DESIGN: Prospective clinical study. ANIMALS: 54 dogs with acute thoracolumbar IVDH and 16 clinically normal dogs. PROCEDURES: For each dog, variables, including CSF myelin basic protein (MBP), lactate, calcium, glucose, and total protein concentrations; nucleated cell count; and creatine kinase (CK) and aspartate aminotransferase activities, were measured. For dogs with thoracolumbar IVDH, initial neurologic function was characterized by use of a modified Frankel score (MFS; determined on a scale of 0 to 5, where 0 represented paraplegia with no deep nociception and 5 represented paraspinal hyperesthesia only). Long-term follow-up was assessed. RESULTS: Among dogs with thoracolumbar IVDH, those with CSF CK activity ≤ 38 U/L had a 35-fold increase in the odds of long-term ambulation, compared with the odds in dogs with CSF CK activity > 38 U/L, adjusting for neurologic functioning at the evaluation. The CSF lactate, calcium, and glucose concentrations and aspartate aminotransferase activity were not predictive of long-term ambulatory outcome. Data analysis revealed that long-term functional recovery was > 98% for affected dogs, regardless of their initial MFS, when CSF CK activity was ≤ 38 U/L and MBP concentration was ≤ 3 ng/mL. CONCLUSIONS AND CLINICAL RELEVANCE: In dogs with acute thoracolumbar IVDH, CSF CK activity and MBP concentration appeared to be prognostic indicators and, along with initial MFS, can be used to predict long-term ambulatory outcome.