A qualitative study exploring the perceived effects of veterinarians' mental health on provision of care.

Introduction: Veterinary medicine is a rewarding, yet demanding profession with a myriad of occupational stressors that can impact the mental health of veterinarians. Stress, mental health outcomes, and associated risk factors amongst veterinarians have been well-researched. Much less research has investigated how high stress and/or poor mental health can impact veterinarians' provision of care. Methods: One-on-one research interviews were conducted with 25 veterinarians at a Canadian veterinary conference in July 2016 and verbatim transcripts were produced from the audio recordings. The research team collaboratively analyzed the interviews using thematic analysis. Results: Five themes described the perceived impacts of high stress and/or poor mental health: perceived negative impacts on interactions with (1) co-workers and (2) clients; (3) reduced concentration; (4) difficulty in decision making; and (5) reduced quality of care. Discussion: These results highlight the perceived impacts of self-reported high stress and/or poor mental health on veterinary team dynamics, the potential to impact case outcomes, and possibly endanger patient safety. Interventions to help mitigate the impacts of high stress and poor mental health are discussed.

Comparison of food-animal veterinarians' and producers' perceptions of producer-centered communication following on-farm interactions.

BACKGROUND: Human medicine has demonstrated that a patient-centered physician-patient relationship is more effective than the traditional physician-centered model. Objectives were to explore food-animal veterinarians' and producers' perceptions of producer-centered communication (VPPC and PPPC), during on-farm interactions and examine associated factors. METHODS: A cross-sectional sample of food-animal veterinarians and their clients were recruited in Ontario, Canada. Immediately following on-farm veterinarian-producer interactions, the producer and veterinarian independently completed a questionnaire assessing PPC. Symmetry of paired responses between veterinarians and producers was examined. Employing listwise deletion, independent mixed linear regression models were developed to determine factors associated with PPPC and VPPC, respectively. RESULTS: Two hundred and three paired veterinarian and producer survey responses were analysed. Significant asymmetry (p-value < 0.05) was observed, with veterinarians assessing PPC lower than producers. Based on data from 32 veterinarians and 159 producers, the only factor associated with PPPC was veterinarian burnout (PPPC decreased with burnout). Based on data from 32 veterinarians and 155 producers, factors positively associated with VPPC included veterinarian compassion satisfaction (VPPC increased with compassion satisfaction), length of interaction (VPPC increased with length of interaction) and producers identifying as female (VPPC higher with female producers). CONCLUSION: Producer's positive PPPC is encouraging, yet veterinarians should be aware that mental health parameters may impact producers' and their own perceptions of PPC. Further examining veterinarians' delivery of PPC is important for food-animal practice.

Factors associated with food-animal producer visit-specific satisfaction following on-farm interaction with a veterinarian.

BACKGROUND: Effective communication has been found to have positive associations with client satisfaction, client adherence and veterinarian satisfaction in companion animal medicine. Better understanding the role of communication on these outcomes, specifically producer satisfaction, is likely to benefit food-animal medicine. Objectives were to identify factors associated with producer visit-specific satisfaction following on-farm veterinarian-producer interactions and evaluate the validity of the Client Satisfaction Questionnaire for use in food-animal medicine. METHODS: A cross-sectional sample of practicing food-animal veterinarians and their producer clients were recruited in Ontario, Canada. Immediately following the veterinarian-producer interaction, producers completed a questionnaire that assessed their visit-specific satisfaction and their perception of the producer-centeredness of the interaction. Veterinarians completed a questionnaire that assessed their perception of the interaction's producer-centeredness. A linear regression model was developed to identify factors associated with producer visit-specific satisfaction. RESULTS: Forty-one veterinarians and 207 producers participated. Factors associated with producer visit-specific satisfaction included producer age (satisfaction decreased with age), producer gender (males less satisfied) and producer perception of producer-centeredness score (satisfaction increased with producer perception of producer-centeredness score). CONCLUSION: Findings raise awareness of the importance of a producer's perception of producer-centeredness in food-animal practice and encourage its use by food-animal veterinarians in working towards positive outcomes.

Evaluation of the Precision Xtra meter for monitoring blood ß-hydroxybutyrate concentrations in late-gestation ewes.

Blood samples were collected from late-gestation ewes to determine the agreement of a point-of-care (POC) Precision Xtra meter and a standard laboratory test for ß-hydroxybutyrate (BHBA). Fresh whole blood samples were immediately tested with the POC instrument, and serum samples were analyzed with a standard commercial biochemical analyzer. Ewes were classified as having ketonemia if their BHBA concentrations were ≥800 µmol/L. Scatter plots, paired t-tests, Bland-Altman limits of agreement, and Gwet AC1 tests were used to compare results. The 2 tests had very good agreement. The values between instruments were not statistically different based on paired t-tests ( p = 0.312). The intercept and slope of a linear mixed model, containing the standard test results as an outcome and the POC meter results as a predictor, were 0.02 (95% CI: 0.00, 0.04) and 0.98 (95% CI: 0.96, 1.01), respectively. When the samples were classified into ketonemic classes (non-ketonemic and ketonemic) based on BHBA concentrations obtained from each test, the Gwet AC1 statistic was 0.94 (95% CI: 0.91, 0.97; p < 0.001). The ketosis classification agreed in 95% of samples. Based on the Bland-Altman plot and limits of agreement, the optimal cutoff to diagnose ketonemia with the POC meter was 1,000 µmol/L, which is 200 µmol/L higher than the laboratory BHBA medical decision limit. The Precision Xtra meter provided excellent correlation and substantial agreement with the standard laboratory technique for measuring blood BHBA in late-gestation ewes.

The association of serum ß-hydroxybutyrate concentration with fetal number and health indicators in late-gestation ewes in commercial meat flocks in Prince Edward Island.

Late-gestation ewes are susceptible to ketonemia resulting from high energy requirement for fetal growth during the last few weeks of pregnancy. High lamb mortality is a possible consequence of effects of ketonemia on both ewes and lambs. Determining risk factors to ketonemia is a fundamental step to identify ewes at risk, in order to avoid losses caused by ketonemia. Serum ß-hydroxybutyrate (BHBA) concentrations of 384 late-gestation ewe samples were determined. Physical examinations, including body condition, FAMACHA© and hygiene scoring, were performed. Udders and teeth were also examined. Fecal floatation was performed to detect gastrointestinal helminth eggs of the ewe fecal samples. General feeding management practices and season at sampling were recorded. Litter sizes were retrieved from lambing records. Factors associated with log serum BHBA concentration were determined using a linear mixed model, with flock and lambing groups as random effects. The mean serum BHBA concentration was 545.8 (±453.3) µmol/l. Ewes with a body condition score (BCS) of 2.5-3.5 had significantly lower log BHBA concentrations than ewes with a BCS of ≤2.0, by 19.7% (p = 0.035). Ewes with a BCS of >3.5 had a trend toward higher log BHBA concentrations compared to ewes with a BCS of 2.5-3.5. Ewes with a FAMACHA© score of 3 had significantly higher log BHBA concentrations than ewes with a FAMACHA© score of 1 or 2, by 12.1% (p = 0.049). Ewes in which gastrointestinal helminth eggs were detected had significantly higher log BHBA concentrations than ewes in which helminth eggs were not detected, by 12.3% (p = 0.040). An increased litter size was associated with higher log BHBA concentration (p ≤ 0.003), with the log BHBA concentrations of ewes having twins, triplets, and quadruplets or quintuplets were higher than those of ewes having singleton by 19.2%, 30.4%, and 85.2%, respectively. Season at sampling confounded the association between log BHBA concentration and FAMACHA© score, and therefore was retained in the final model even though it was not statistically significant. Intra-class correlation coefficients at the flock and lambing group levels were 0.14 and 0.32, respectively.

Bulk tank milk selenium and its association with milk production parameters in Canadian dairy herds.

An observational study was conducted in 63 Canadian dairy farms to evaluate the association of bulk tank milk selenium (Se) concentration (BTSe) with average daily milk yield, milk fat and milk protein, bulk tank somatic cell count (BTSCC), and the probability of being a Staphylococcus aureus-positive herd. Bulk tank milk samples collected between March 2007 and February 2008 were evaluated for BTSCC, S. aureus culture status, and BTSe. Mean BTSe was 0.51 ± 0.15 µmol/L; no herds were classified as deficient or marginal based on BTSe. Bulk tank milk Se was unconditionally associated with milk production; however, adjusting by region indicated a confounding effect of this variable. There was no relationship between BTSe and BTSCC. Higher values of BTSe were associated with lower risk of being a S. aureus-positive herd, possibly as a result of a more robust udder immune response, or as a result of providing Se at a higher rate as one component of an udder health program that reduces risk of being S. aureus positive.

Effects of selenium source on measures of selenium status and immune function in horses.

The effects of selenium (Se) supplementation and source on equine immune function have not been extensively studied. This study examined the effects of oral Se supplementation and Se source on aspects of innate and adaptive immunity in horses. Fifteen horses were assigned to 1 of 3 groups (5 horses/group): control, inorganic Se (sodium selenite), organic Se (Se yeast). Immune function tests performed included: lymphocyte proliferation in response to mitogen concanavalin A, neutrophil phagocytosis, antibody production after rabies vaccination, relative cytokine gene expression in stimulated lymphocytes [interferon gamma (IFNγ), interleukin (IL)-2, IL-5, IL-10, tumor necrosis factor alpha (TNFα)], and neutrophils (IL-1, IL-6, IL-8, IL-12, TNFα). Plasma, red blood cell Se, and blood glutathione peroxidase activity were measured. Plasma and red blood cell Se were highest in horses in the organic Se group, compared with that of inorganic Se or control groups. Organic Se supplementation increased the relative lymphocyte expression of IL-5, compared with inorganic Se or no Se. Selenium supplementation increased relative neutrophil expression of IL-1 and IL-8. Other measures of immune function were unaffected. Dietary Se content and source appear to influence immune function in horses, including alterations in lymphocyte expression of IL-5, and neutrophil expression of IL-1 and IL-8.

Les effets d'un supplément de sélénium (Se) ainsi que sa source sur la fonction immunitaire équine n'ont pas été étudiés à fond. On examina dans la présente étude les effets d'un supplément oral en Se et les sources de Se sur des éléments de l'immunité innée et adaptative de chevaux. Quinze chevaux ont été assignés à un de trois groupes (5 chevaux/groupe); témoin, Se inorganique (sélénite de sodium), et Se organique (Se provenant de levures). Les tests de fonctions immunitaires effectués étaient : prolifération lymphocytaire en réponse au mitogène concanaviline A, phagocytose par les neutrophiles, production d'anticorps après vaccination anti-rabique, expression relative des gènes des cytokines de lymphocytes stimulés [interferon gamma (IFNγ), interleukine (IL)-2, IL-5, IL-10, facteur de nécrose tumorale alpha (TNFα)], et de neutrophiles (IL-1, IL-6, IL-8, IL-12, TNFα). Le Se plasmatique et des globules rouges, ainsi que l'activité de la glutathion peroxydase ont été mesurés. Le Se plasmatique et des globules rouges étaient plus élevés chez les chevaux dans le groupe de Se organique, comparativement au groupe recevant le Se inorganique ou le groupe témoin. Un supplément de Se organique entraîna une augmentation d'expression relative d'IL-5 par les lymphocytes, comparativement au Se inorganique ou aucun Se. Un supplément de Se augmenta l'expression relative d'IL-1 et IL-8 par les neutrophiles. Les autres mesures des fonctions immunitaires n'étaient pas affectées. Le contenu et les sources de Se alimentaire semblent influencer les fonctions immunitaires des chevaux, incluant des altérations dans l'expression d'IL-5 par les lymphocytes, et l'expression d'IL-1 et IL-8 par les neutrophiles.(Traduit par Docteur Serge Messier).

The selenium and vitamin E status of horses in Prince Edward Island.

Serum selenium (Se), vitamin E, and resting thyroid hormone concentrations were measured in 201 horses in Prince Edward Island (PEI). Selenium concentrations were either marginal (0.0053 to 0.1200 ppm) or deficient (< 0.0053 ppm) in 79% of horses based on current reference ranges for Se in serum. Aged and young adult pleasure horses had a higher prevalence of inadequate Se concentrations compared to racehorses and broodmares (82% and 97% versus 45% and 72%, respectively). Overall, 13% of horses had inadequate (< 200 µg/dL) serum vitamin E concentrations; most of these were young pleasure horses. No horses were hypothyroid and, contrary to findings in other species, there was a positive relationship between serum thyroxine and Se concentrations (P < 0.05). We conclude that Se deficiency is widespread in PEI horse populations, especially in pleasure horses, and vitamin E deficiency is more common in young pleasure horses. Micronutrient supplementation practices employed by PEI horse owners appear inadequate to ensure sufficiency.

The selenium status of dairy herds in Prince Edward Island.

Bulk tank milk selenium (Se) concentration was compared with mean serum Se concentration in 15 herds and was found to be an accurate reflection of the herd Se status. The Se status of 109 Prince Edward Island (PEI) dairy herds was monitored for 1 year using bulk tank milk Se concentration. Fifty-nine percent of the herds surveyed were, at some point, found to be marginal or deficient in Se, putting them at risk of disease and suboptimal production. The periods of greatest risk of deficiency were fall and winter, at which time 5% and 4%, respectively, of herds sampled fell in the range considered truly deficient in Se. Herds in which Se supplementation was provided in the form of a commercial dairy concentrate were over 4 times more likely to be Se-adequate than herds not using this method, and adjusted average daily milk yield was 7.6% greater in herds determined to be Se-adequate when compared with Se-marginal herds. We conclude that many dairy producers in PEI are providing insufficient supplementary Se in the ration to meet the recommended Se intake for lactating cows.