Value of repeated health screening in 259 apparently healthy mature adult and senior cats followed for 2 years.

BACKGROUND: Although regular health screening is recommended, long-term follow-up data in healthy aged cats are lacking. OBJECTIVES: Determine the most common conditions in a large group of apparently healthy older cats and which diseases are manifested within 2 years in cats confirmed to be healthy based on extensive health screening. ANIMALS: Client-owned cats. METHODS: Prospective study. Thorough history, physical examination, blood tests, and urinalysis were performed in 259 apparently healthy mature adult (7-10 years) and senior (>10 years) cats. Semi-annual follow-up examinations were performed in 201 confirmed healthy cats. RESULTS: At baseline, 21% of apparently healthy cats were not considered healthy but were diagnosed with International Renal Interest Society (IRIS) ≥ stage 2 chronic kidney disease (CKD; 7.7%) or hyperthyroidism (4.6%), among other disorders. Disease occurred significantly more frequently in senior cats compared with mature adult cats. In addition, 40% cats were overweight, 35% had moderate to severe dental disease, and 22% had abnormal cardiac auscultation findings. Within 2 years, 28% of mature adult and 54% of senior cats that were confirmed healthy at inclusion developed new diseases, most commonly IRIS ≥ stage 2 CKD (cumulative incidence, 13.4%), hyperthyroidism (8.5%), chronic enteropathy, hepatopathy or pancreatitis (7.5%), or neoplasia (7%). CONCLUSIONS AND CLINICAL IMPORTANCE: The high prevalence and 2-year incidence of physical examination abnormalities and systemic diseases in apparently healthy older cats argue for regular health screening in cats ≥7 years of age. Although more common in senior cats, occult disease also occurs in mature adult cats, and owners should be informed accordingly.

Musculoskeletal examination of the forelimb of the horse.

OBJECTIVE: The intention of this tutorial video is to illustrate the methods of examining the forelimb and neck of a horse in order to identify abnormalities that may be associated with lameness or disease. ANIMAL: A 16-year-old quarter horse gelding was used for examination. METHODS: The horse was examined for abnormalities by means of physical examination. RESULTS: The examination of the forelimb and neck of the horse was successfully completed. CLINICAL RELEVANCE: This examination technique is required to identify abnormalities in the equine forelimb and can be utilized during a lameness examination.

Physical examination and CT to assess thoracic injury in 137 cats presented to UK referral hospitals after trauma.

OBJECTIVES: The aim of the study was to describe clinical examination and thoracic CT (TCT) findings in cats after trauma, and to identify physical examination findings associated with both abnormalities on TCT and the need for therapeutic interventions. METHODS: A multicentre, retrospective, observational study was conducted. Cats admitted to the participating hospitals with a history of blunt trauma and that underwent TCT were eligible. Data were collected on signalment, history, physical examination, TCT findings and subsequent interventions. RESULTS: In total, 137 cats were included. Road traffic accidents (RTAs) were the most frequently reported cause of trauma (69%). Tachypnoea (32%), pale mucous membranes (22%) and dyspnoea (20%) were the most common abnormal findings on thoracic examination. The most frequently identified thoracic pathologies on TCT were atelectasis (34%), pulmonary contusions (33%), pneumothorax (29%) and pleural effusion (20%). Thoracocentesis was the most commonly performed intervention (12%), followed by chest drain placement (7%). A total of 45 (33%) cats had no physical examination abnormalities but did have abnormalities detected on TCT; six of these cats required interventions. Increasing numbers of thoracic abnormalities on clinical examination were associated with increasing likelihood of having abnormal findings on TCT (odds ratio [OR] 2.04, 95% confidence interval [CI] 1.21-3.44, P = 0.008) and of requiring an intervention (OR 1.82, 95% CI 1.32-2.51, P <0.001). CONCLUSIONS AND RELEVANCE: RTAs were the most common reported cause of blunt trauma. Atelectasis, pulmonary contusions and pneumothorax were the most common abnormalities identified on TCT, and thoracic drainage was the most utilised intervention. TCT may be useful in identifying cats with normal thoracic physical examination findings that have significant thoracic pathology, and a high number of abnormal findings on thoracic examination should raise suspicion for both minor and major thoracic pathology. The results of this study can be used to assist in selecting appropriate cases for TCT after blunt trauma.

Select Manual Assessment Techniques and Clinical Reasoning Skills Used in Canine Physical Rehabilitation Before Engaging in Manual Therapy Treatment.

Manual therapy is a cornerstone of physical therapy and canine physical rehabilitation. Although veterinary literature has tackled the topic of manual therapy treatments in animal patients, less attention has been paid to the assessment techniques and clinical reasoning skills that guide a practitioner toward determining if, when, and where manual therapies will be most effective. This article tackles the topics of clinical reasoning, the functional diagnosis, observational skills, and physical evaluation techniques that serve as prerequisites to the use of manual therapeutics.

2022 AAFP/ISFM Cat Friendly Veterinary Interaction Guidelines: Approach and Handling Techniques.

PRACTICAL RELEVANCE: The '2022 AAFP/ISFM Cat Friendly Veterinary Interaction Guidelines: Approach and Handling Techniques' (hereafter the 'Cat Friendly Veterinary Interaction Guidelines') support veterinary professionals with feline interactions and handling to reduce the impact of fear and other protective (negative) emotions, in so doing enhancing feline welfare and In implementing these Guidelines, team satisfaction and cat caregiver confidence in the veterinary team will increase as the result of efficient examinations, better experience, more reliable diagnostic testing and improved feline wellbeing. Veterinary professionals will learn the importance of understanding and appropriately responding to the current emotional state of the cat and tailoring each visit to the individual. CLINICAL CHALLENGES: Cats have evolved with emotions and behaviors that are necessary for their survival as both a predator and prey species. A clinical setting and the required examinations and procedures to meet their physical health needs can result in behavioral responses to protective emotions. Cat friendly interactions require understanding, interpreting and appropriately responding to cats' emotional states and giving them a perceived sense of control while performing the required assessment. EVIDENCE BASE: These Guidelines have been created by a Task Force of experts convened by the American Association of Feline Practitioners and the International Society of Feline Medicine, based on an extensive literature review and, where evidence is lacking, the authors' experience. ENDORSEMENTS: These Guidelines have been endorsed by a number of groups and organizations, as detailed on page 1127 and at catvets.com/interactions and icatcare.org/cat-friendly-guidelines.

Development of a multivariable prediction model to identify dairy calves too young to be transported to auction markets in Canada using simple physical examination and body weight.

Calves born on Eastern Canadian dairy farms that are not kept in the herds are traditionally sold through auction markets and are raised for meat purposes such as veal calves. Since February 2020, a new Canadian federal regulation has forbidden calves <9 d old to be sold through auction markets. However, in the absence of a real-time birth registry consultation system, it would be of interest to look for predictors that could be associated with age to allow identification of calves too young to be transported. In the current retrospective cross-sectional study, 1,178 calves with a declared birth date (411 calves aged <9 d old; 34.9%) were assessed in 2 large Québec auction sites. Easy-to-record covariates [body weight (BW), breed phenotype, and presence of an umbilical cord remnant] as well as other clinical signs (umbilical swelling, enlargement, umbilical pain, wet umbilicus, skin tent, sunken eyes, ocular and nasal secretion, and hide cleanliness) were assessed. Two logistic regression models using age as a dichotomous dependent variable (<9 d old vs ≥9 d old) were built. The first model (model 1) considered all covariates, which were selected after univariable analyses and a backward stepwise selection process, whereas a more pragmatic model (model 2) only included the 3 easy-to-record variables (i.e., BW, breed, umbilical cord). Both models had similar accuracy to detect calves <9 d old (sensitivity of 38.4 and 37.5%, and specificity of 85.7 and 84.6% for model 1 and 2, respectively). Model 2 was subsequently more specifically studied as it employs a faster and easier assessment. Decision thresholds were tested for their robustness based on misclassification cost term (MCT) analysis with various prevalence of calves <9 d old and various costs of false-negative:false-positive ratio. Despite statistical significance, model accuracy, even if refined with MCT analysis, was limited at the individual level, showing the limits of using physical signs and BW or their combination as a reliable proxy of age. The sensitivity of these models to find calves <9 d old was not to be used for monitoring compliance with the Canadian federal regulation. The relatively high model specificity may help to use this model as a rule-in test (i.e., targeting positive calves for further investigation) rather than a rule-out test (due to its low sensitivity).

Effects of a single dose of orally administered gabapentin in dogs during a veterinary visit: a double-blinded, placebo-controlled study.

OBJECTIVE: To evaluate the effects of a single dose of orally administered gabapentin in alleviating stress at a veterinary visit in privately owned dogs. Animals: 22 healthy client-owned dogs (1.5 to 8.5 years old) were enrolled in this study. PROCEDURES: Each dog received a 50-mg/kg oral dose of either gabapentin or placebo 2 hours before the beginning of each visit protocol. The dog's behavioral responses were coded from recorded video clips during a 5-minute-long standardized physical examination and pre- and post-physical examination phases. The veterinary technician separately rated each greeting behavior at each visit. Physiological variables during veterinary visits (ie, eye surface temperature and salivary cortisol concentrations) were also compared between the pre- and post-physical examination phases. The owner was queried 24 hours after a visit to determine the incidence of adverse events. RESULTS: The greeting test score, eye surface temperature, and cortisol concentrations did not differ substantially between the gabapentin and placebo treatment groups. Lip licking frequency during the physical examination phase was significantly lower in the gabapentin treatment group than in the placebo group (P = 0.001). Lip licking frequency during the pre- and post-physical examination phases was also significantly lower in the gabapentin treatment group than in the placebo treatment group (P = 0.004). No serious adverse events were reported by the owners following gabapentin treatment. CLINICAL RELEVANCE: Results showed that the 50-mg/kg dose of gabapentin was well tolerated without serious adverse effects in healthy dogs. Further studies are recommended of dogs with documented stress in response to a veterinary visit.

Normal feline reproduction: The tom.

PRACTICAL RELEVANCE: Understanding the normal reproductive anatomy and physiology of the male cat is important for successful breeding. Veterinarians may be called in to troubleshoot when fertility and pregnancy rates decrease in a cattery. By understanding the normal physical parameters, as well as breeding behavior, the veterinarian is better equipped to assess the infertility issue. Also, clients are increasingly requesting breeding soundness examinations prior to mating or purchase. Semen collection is more difficult in the cat than in the dog but can still be accomplished in a clinical setting and provides important information when confronted with breeding males. AIM: The aim of this review is to provide a practical overview of the breeding male. The reader will receive information on time of puberty, normal reproductive anatomy (both external and internal), and breeding management practices to optimize fertility. The most up-to-date semen collection techniques are discussed, as are sedation/anesthesia options. Also, historical literature on the basic anatomy of the male reproductive system is reviewed, such as how the penile spines work and when they appear; this information is specific to the cat. EVIDENCE BASE: The information in this article is based on the author's experience, as well as drawing on historical and current literature, and provides the most up-to-date review as possible.

Twenty-five components of a baseline, best-practice companion animal physical exam established by a panel of experts.

OBJECTIVE: To establish the components of a best-practice, baseline companion animal physical exam (CAPE). SAMPLE: 25 small animal veterinary internists and 20 small animal primary care veterinarians, all teaching the CAPE at veterinary colleges in the US, Canada, and Australia. PROCEDURES: Using the Delphi Method of Consensus, 3 rounds of online questionnaires were sent to participants. The first round included demographic questions, questions about teaching the physical exam, and an open-ended question allowing participants to record details of how they conduct a CAPE. In the second round, participants were asked to rate components of the CAPE, which were derived from round 1, as "always examine," "only examine as needed," or "undecided." Following round 2, any component not reaching 90% consensus (set a priori) for the response "always examine" was put forth in round 3, with a summary of comments from the round 2 participants for each remaining component. RESULTS: 35 components of a baseline CAPE were identified from round 1. The 25 components that reached 90% consensus by the end of round 3 were checking the oral cavity, nose, eyes, ears, heart, pulse rate, pulse quality, pulse synchrony, lungs, respiratory rate, lymph nodes, abdomen, weight, body condition score, mucous membranes, capillary refill time, general assessment, masses, haircoat, skin, hydration, penis and testicles or vulva, neck, limbs, and, in cats only, thyroid glands. CLINICAL RELEVANCE: The findings establish an expert panel's consensus on 25 components of a baseline, best-practice CAPE that can be used to help inform veterinary curricula, future research, and the practice of veterinarians.

Implementation of a Blended Learning Module to Teach Handling, Restraint, and Physical Examination of Cats in Undergraduate Veterinary Training.

Cats can be easily stressed in a clinical (training) setting and may show unpredictable reactions and patterns of defensive aggression. This can be a complicating factor in undergraduate veterinary training. Inexperienced veterinary students can evoke defensive feline behavior that negatively affects learning outcomes and animal welfare. As a result, restraint techniques and physical examination of cats was hardly practiced in pre-clinical training at Utrecht University. To overcome this, a new blended learning module was developed using a lecture on feline behavior; e-learning modules about feline behavior, handling, restraint, and physical examination skills; and redesigned practical sessions in which live animals and manikins were used. The aim of this study was to investigate how students' perceptions of competence and confidence changed regarding feline behavior, handling, restraint, and physical examination skills after the new module was implemented. Questionnaires were used for quantitative analysis, and focus groups were used for qualitative analysis. The results show that compared with students who followed the standard module, students who participated in the blended learning module scored higher in feeling confident with handling animals, feeling competent to perform physical examination on cats, and ability to assess whether a cat is stressed. Students with less experience with cats were more likely to show improvement in assessing a cat's stress level than students who had much experience with cats. The results demonstrate that the blended learning module improves students' learning outcomes regarding feline skills training and adds to reduction, refinement, and replacement of the use of live cats.

Clinical evaluation of the effects of a single oral dose of gabapentin on fear-based aggressive behaviors in cats during veterinary examinations.

OBJECTIVE: To investigate the effects of a single oral dose of gabapentin on fear-based aggressive behaviors (FABs) in cats during veterinary examinations. ANIMALS: 55 healthy pet cats (26 with and 29 without a history of FAB during veterinary visits [FAB and untreated control groups, respectively]). PROCEDURES: A standardized 9-step clinical examination protocol (with patient compliance scored from 0 to 9 according to the highest completed step) was tested on untreated control group cats. The protocol was then used in a double-blind, randomized, placebo-controlled, crossover-design trial in which FAB-group cats received owner-administered gabapentin (100 or 200 mg/cat) or placebo capsules 2 hours before the first of 2 veterinary visits and received the alternate treatment before the second visit ≥ 1 day later. Ease of administration (scored from 1 [very difficult] to 4 [very easy]) and adverse effects were recorded. Compliance scores were compared between treatments for the FAB group and between FAB and untreated control groups. Changes in scores between treatments for the FAB group were used to investigate associations between selected variables and the outcome of interest. RESULTS: FAB group compliance scores after gabapentin administration (median, 9; range, 0 to 9) were significantly higher than scores after placebo administration (median 0.5; range, 0 to 7) and did not differ from scores for the untreated control group. Owner scores indicated capsule administration was easy. Adverse effects (most commonly drowsiness, myorelaxation, and ataxia) resolved ≤ 10 hours after detection. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested oral administration of gabapentin to cats 2 hours before a veterinary visit can reduce FAB during physical examination, enabling more complete evaluation.

BIOMEDICAL EVALUATION OF THE GOLDEN-CROWNED SIFAKA (PROPITHECUS TATTERSALLI) IN DARAINA, MADAGASCAR.

Complete medical examinations were performed on 25 wild golden-crowned sifaka (Propithecus tattersalli) from northeastern Madagascar. Each animal received a complete physical examination and weight, body temperature, heart rate, and respiratory rate were documented. Blood samples were collected for packed cell volume, estimated total white blood cell count, serum biochemical profile, fat-soluble vitamin analysis, trace mineral analysis, and Toxoplasma gondii serology. All animals examined were adults and determined to be in good health and body condition. No ectoparasites were observed. Fecal samples were collected for endoparasite examination and bacterial culture; while no endoparasites were observed, fecal samples from two females cultured positive for Bacillus cereus. One male lemur had a positive antibody titer to Toxoplasma gondii immunoglobulin G. These baseline health data provide an important foundation for continued monitoring of this critically endangered species.

Respiratory Distress in the Adult and Foal.

Respiratory distress in the horse and foal is an emergency. Managing equine respiratory distress in the field starts with appropriate assessment of the patient to determine whether the breathing obstruction stems from the upper or lower respiratory tract or is nonrespiratory in origin. From a thorough, but efficient, physical examination to point-of-care ultrasound and endoscopy, the veterinarian has many tools in the field to help diagnose the patient.

Orthopedic and ultrasonographic examination findings in 128 shoulders of 64 ultra-endurance Alaskan sled dogs.

OBJECTIVE: To determine the location and periarticular shoulder-muscle-abnormalities detected via orthopedic examinations and ultrasonography in ultra-endurance Alaskan sled-dogs, returned from an ultra-endurance sled-dog-race prior to finishing it. STUDY DESIGN: Prospective clinical study. SAMPLE POPULATION: Sixty-four dogs (128 shoulders). METHODS: Dogs were classified based on clinical evidence of shoulder pain (SP versus control). Orthopedic examination findings, shoulder-abduction-angles (SAA; before- and during-anesthesia), and ultrasonographic findings were recorded. Relationships between orthopedic and ultrasonographic abnormalities were compared. RESULTS: Pain was elicited on 55/128 shoulders; 73 shoulders were pain-free. The most common painful structures included the biceps-tendon (BT; 30%), triceps-muscle (28%), and infraspinatus-muscle (25%). SAA ranged between 25° and 75° among groups, including pain-free shoulders in dogs without lameness. SAA was greater when dogs were anesthetized (46.3° ± 14.0° vs. 47.8° ± 12.0°; p = .03), especially in SP (mean increase of 3.49° ± 8.85°) compared to control (0.03° ± 7.71°, p = .009). Overall, 103 ultrasonographic abnormalities were detected (SP: 44; control: 59). The most common ultrasonographic abnormality was fluid surrounding the biceps tendon, similarly distributed between groups (SP: 39/44; control: 57/59). Most chronic ultrasonographic abnormalities affected the BT (15/103 abnormalities). No associations were detected between ultrasonographic abnormalities and clinical findings. CONCLUSION: Shoulder abduction varied greatly and reached up to 75° in normal joints. Ultrasonographic shoulder-muscle abnormalities were common but did not seem associated with clinical findings. CLINICAL SIGNIFICANCE: Interpretation of shoulder abduction warrants caution, and the presence of fluid around the BT may reflect a physiologic adaptation to racing, rather than a pathologic change in ultra-endurance Alaskan sled-dogs.

Influence of instructor-to-student ratio for teaching suturing skills with models.

OBJECTIVE: To evaluate the influence of instructor to student ratio on the effectiveness and efficiency of teaching suturing skills to veterinary students. STUDY DESIGN: Prospective randomized study. SAMPLE POPULATION: Second-year veterinary students (N = 121). METHODS: Students were randomly divided into three groups to participate in four 2-hour skills laboratory sessions in which suturing of the subcutaneous tissue was taught by using a simple continuous pattern, suturing of the skin was taught by using continuous patterns, suturing of the skin was taught by using interrupted patterns, and suturing of hollow organs was taught by using inverting patterns. For each laboratory, the groups were taught by using instructor-to-student ratios of 1:6, 1:8, and 1:10 on a rotating basis. Students were surveyed at the end of each laboratory, and underwent individual performance assessments at the end of each laboratory session and again at the end of the semester in an objective structured clinical examination (OSCE). RESULTS: For each of the four in-laboratory assessments and the OSCE, no difference in performance was detected between groups. When they were surveyed, students in all groups reported that there was an adequate number of instructors in the laboratory and that they received help in a timely fashion when help was requested (median for all groups = agree). CONCLUSION: For students with prior surgical skills education and with the use of prelaboratory instructional videos, teaching at the 1:10 instructor-to-student ratio was efficient and effective. CLINICAL SIGNIFICANCE: Good educational outcomes may be reached with a 1:10 instructor-to-student ratio or, potentially, fewer instructors, depending on the educational aids present in the laboratory and students' prior level of experience.

[Taking body temperature in cattle - critical evaluation of an established diagnostic test]. / Messung der Körpertemperatur beim Rind ­ eine altbewährte Methode kritisch hinterfragt.

Measuring the body temperature is an essential component of the clinical examination of bovines. Next to its value for the diagnosis of diseases, body temperature also is an important value in clinical studies concerning estrus detection, calving time point prediction, or the evaluation of heat stress. This systematic review critically evaluates different methods of measuring bovine body temperature including rectal measurement, vaginal or ruminal temperature loggers, milk temperature, and infrared body surface thermography. Although body temperature measurement is a commonly employed and established diagnostic test, a close look at scientific studies displays multiple factors influencing body temperature data. The variability of results emphasizes the relevance of critically evaluating new measuring methods before introducing them into research or routine practice. Especially in terms of identifying specific cut-off values, i. e. for fever defined as body temperature > 39.5°C, the precision of the method is of importance, as the acquired values possess a high degree of influence on the veterinary decision taking process.

Transportation and Routine Veterinary Interventions Alter Immune Function in the Dog.

Rapid activation of the hypothalamic pituitary adrenal axis and the sympathetic nervous system are hallmarks of the acute stress response and these systems interact with the immune system by signaling though glucocorticoid and adrenergic receptors on immune cells. There is limited information about the effect of these physiologic responses on immunologic parameters of pet dogs enrolled in clinical studies. The objective of this study was to evaluate how travel, instrumentation, and hospitalization alter immunologic parameters in pet dogs. Blood was collected from healthy dogs in a home environment and from healthy dogs at the time of presentation to the hospital and after instrumentation and 24 hours of hospitalization. We found that lipopolysaccharide (LPS)-induced downregulation of toll like receptor 4 (TLR4) was blunted in dogs exposed to stress. Neutrophil and monocyte major histocompatibility complex class II (MHCII) expression increased after transportation to the veterinary hospital but then became similar to that of the control dogs at the end of hospitalization. Peripheral blood mononuclear cell cytotoxicity function was blunted in dogs exposed to the stress of transportation as well as hospitalization. Neutrophil apoptosis was greater in dogs exposed to stress compared to controls although this effect significantly decreased after hospitalization stress. Conversely, stress did not alter induced or spontaneous cytokine production from leukocytes, neutrophil or monocyte expression of TLR4, LPS-induced downregulation of monocyte TLR4, LPS-induced neutrophil and monocyte expression of MHCII or peripheral blood lymphocyte phenotype. Transportation and instrumentation/hospitalization stress should be considered when interpreting immunologic studies in pet dogs.

Environment and Feline Health: At Home and in the Clinic.

Environmental optimization of both the home and the veterinary clinic not only is important for promoting good emotional and cognitive health for domestic cats but also contributes to the promotion of good physical health. All 3 aspects of the feline health triad are interconnected. Inappropriate learning can occur resulting in perpetuation of behavioral responses and confirmation of emotional associations. In addition, the physiologic responses to compromised emotions and sustained negative emotional motivation can be involved in the triggering, maintenance, and increased significance of a range of physical health issues, including urinary tract, gastrointestinal, and dermatologic disease and chronic pain.