Factors associated with medical problems among young non-deployed U.S. military working dogs.

The goals of this project were to quantify medical problems among a population of Military Working Dogs (MWDs) and analyze factors associated with common medical conditions. Medical conditions recorded in veterinary Master Problem List (MPL) entries for 774 young, non-deployed, active MWDs were categorized and combined with demographic information to analyze risk factors. Most dogs were male (74%), German Shepherd (39%) or Belgian Malinois (31%) breeds, certified in Explosive Detection (60%), and had a dark coat color (83%). Ages ranged from one to six years, with an average of 2.6 years (± 0.5 years). Eighty-three percent of dogs had a non-surgical medical problem in their record. The most common non-surgical medical problems were dermatologic (25% of MPL entries), alimentary (21%), dental (15%), soft-tissue injury (10%), and musculoskeletal conditions (4%). Factors associated with each medical condition were breed (Odds Ratios 1.96-8.24), sex and spay/neuter status (ORs 1.78-5.77), occupational duty certification (ORs 2.65-3.62), military command location (ORs 2.32-7.44), and military branch (OR 5.16). As MWDs are a valuable asset for the Department of Defense, training and work conditions for the identified at-risk groups of MWDs should be further assessed to maximize their operational capabilities and assess the potential to serve as sentinel indicators for human diseases. Improved understanding of the most common medical problems affecting MWDs, and the identification of factors associated with these conditions, can help drive changes in their preventive care.

Animal-related injuries in veterinary services personnel, U.S. Army, 2001-2018.

Limited data exist on animal-related injuries in the U.S. Army veterinary service (VS). The purpose of this study was to determine the incidence of animalrelated injuries and the associated risk factors in VS personnel. A retrospective cohort study was conducted using military healthcare surveillance data on animal- related injuries in VS personnel from 2001-2018. Yearly incidence of medically diagnosed animal-related injuries ranged from 25-50 injuries per 1,000 person-years from 2001-2018. Linear regression showed no significant trend in the incidence rate per year over the study period (R2=0.005). Bites were the most common injury (86.5%), with dog bites (44.3%) being the most common injury type and dogs the most common species implicated. After controlling for sex, age group, race/ethnicity group, and occupation, adjusted incidence rate ratios (AIRRs) showed significantly elevated risk for animal-related injuries among females compared to males (AIRR=1.69; 95% confidence interval [CI]: 1.45-1.99), soldiers aged 17-29 compared to those aged 30 years or older (AIRR=2.55; 95% CI: 2.12-3.08), and technicians compared to veterinarians (AIRR=1.57; 95% CI: 1.30-1.89). Unlike the majority of published literature on veterinary occupational health and safety, this study showed a clear increased risk of diagnoses of injury among females compared to males.

Canine Tactical Combat Casualty Care (K9TCCC) Guidelines.

First introduced in 1996, Tactical Combat Casualty Care (TCCC) redefined prehospital, point-of-injury (POI), battlefield trauma care for the human combat casualty. Today, many consider TCCC as one of the most influential interventions for reducing combat-related case fatality rates from preventable deaths in human combat casualties. Throughout history, Military Working Dogs (MWDs) have proved and continue to prove themselves as force multipliers in the success of many military operations. Since the start of the Global War on Terror in 2001, these elite canine operators have experienced an upsurge in combat-related deployments, placing them at a higher risk for combat-related injuries. Until recently, consensus- based Canine-TCCC (K9TCCC) guidelines for POI battlefield trauma care did not exist for the MWD, leaving a critical knowledge gap significantly jeopardizing MWD survival. In 2019, the Canine Combat Casualty Care Committee was formed as an affiliate of the Committee on Tactical Combat Casualty Care with the intent of developing evidence- based, best practice K9TCCC guidelines. Modeled after the same principles of the human TCCC, K9TCCC focuses on simple, evidence-based, field-proven medical interventions to eliminate preventable deaths and to improve MWD survival. Customized for the battlefield, K9TCCC uniquely adapts the techniques of TCCC to compensate for canine-specific anatomic and physiological differences.

[Colonel Hermann Schwyter, equine surgeon, a formative personality of equine medicine]. / Oberst Hermann Schwyter, Oberpferdarzt, eine prägende Persönlichkeit der Pferdemedizin.

INTRODUCTION: The biography of Colonel Hermann Schwyter, equine surgeon of the Swiss Army from 1928 to 1937, and the history of training of farriers in Switzerland since the 18th century are presented. Hermann Schwyters dissertation examined the changes of equine hoof confirmation as a result of standing and gait in approximately 2,000 horses and numerous anatomical specimens. He defines the foot placement, describes possible variations, their causes and effects. Significant is also his study of the compression pathology in horses and mules. His recommendations are still valid today. The present article refers to his authored textbook "The Swiss military farrier" and to his established journal, which is bearing the same title.

INTRODUCTION: On présente la biographie du colonel Hermann Schwyter, vétérinaire en chef de l'armée suisse de 1928 à 1937 et l'historique de la formation des maréchaux en Suisse depuis le XVIIIe siècle. Dans sa thèse, Hermann Schwyter a examiné l'évolution de la forme du pied du cheval en fonction des aplombs et des allures sur environ 2000 chevaux et de nombreuses préparations. Il a défini la position normale du pied, décrit les déviations, leurs causes et leurs effets. Il faut également souligner son étude sur les dommages dus aux pressions chez les chevaux et les mulets. Ses recommandations sont toujours valables aujourd'hui. Il est également fait référence à son ouvrage «Le maréchal-ferrant militaire suisse¼ ainsi qu'au journal portant le même titre qu'il avait créé.

Interventions Performed on Multipurpose Military Working Dogs in the Prehospital Combat Setting: A Comprehensive Case Series Report.

INTRODUCTION: The military working dog (MWD) has been essential in military operations such as Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF). MWDs sustain traumatic injuries that require point of injury and en route clinical interventions. The objective of this study was to describe the injuries and treatment military working dogs received on the battlefield and report their final disposition. METHODS: This was a convenience sample of 11 injury and treatment reports of US MWDs from February 2008 to December 2014. We obtained clinical data regarding battlefield treatment from the 160th Special Operations Aviation Regiment (SOAR) database and supplemental operational sources. A single individual collected the data and maintained the dataset. The data collected included mechanism of injury, clinical interventions, and outcomes. We reported findings as frequencies. RESULTS: Of the 11 MWD casualties identified in this dataset, 10 reports had documented injuries secondary to trauma. Eighty percent of the cases sustained gunshot wounds. The hindlegs were the most common site of injury (50%); however, 80% sustained injuries at more than one anatomical location. Seventy percent of cases received at least one clinical intervention before arrival at their first treatment facility. The most common interventions included trauma dressing (30%), gauze (30%), chest seal (30%), and pain medication (30%). The survival rate was 50%. CONCLUSION: The majority of the MWD cases in this dataset sustained traumatic injuries, with gunshot being the most common mechanism of injury. Most MWDs received at least one clinical intervention. Fifty percent did not survive their traumatic injuries.

In Vitro Compatibility of Canine and Human Blood: A Pilot Study.

Military working dogs (MWDs) are force multipliers that are exposed to the same risks as their human counterparts on the battlefield. Hemostatic resuscitation using blood products is a cornerstone of damage control resuscitation protocols for both humans and dogs. Canine-specific blood products are in short supply in mature theaters due to logistic and regulatory concerns and are almost nonexistent in austere environments, whereas human blood products are readily available at most surgical facilities. The objective of this study was to evaluate the in vitro compatibility of human and canine blood by using standard crossmatching techniques with the canine blood acting as the recipient and the human blood acting as the donor. Blood samples were collected from 20 government-owned canines (GOCs) and 7 healthy human volunteers in addition to washed red blood cells (RBCs) from a commercial blood typing kit. Major and minor crossmatches were conducted as well as a protein denatured crossmatch. All samples in this study showed strong cross-reactivity, with the majority demonstrating profound hemolysis and a minority showing substantial agglutination. Based on the results of this study, transfusion of human blood to an MWD cannot be recommended at this time.

Concepts of Prehospital Advanced Airway Management in the Operational K9: A Focus on Cricothyrotomy.

Similar to people, airway obstruction is a potentially preventable cause of combat and line of duty death for civilian law enforcement Operational K9s (OpK9) and military working dogs (MWD). Basic (i.e., body positioning, manual maneuvers, bag-valve-mask ventilation) and advanced (i.e., endotracheal intubation, surgical airways) airway techniques are designed to establish a patent airway, oxygenate and ventilate, and protect from aspiration. A surgical airway (cricothyrotomy [CTT] or tracheostomy [TT]) is warranted for difficult airway scenarios in which less invasive means fail to open an airway (aka "Cannot intubate, cannot oxygenate"). In people, the surgical CTT is the preferred surgical airway procedure; most human prehospital providers are not even trained on the TT. Currently, only the TT is described in the veterinary literature as an emergent surgical airway for MWDs. This article describes the novel approach of instituting the surgical CTT for managing the canine difficult airway. The information provided is applicable to personnel operating within the US Special Operations Command as well as civilian tactical emergency medical services that may have the responsibility of providing medical care to an OpK9 or MWD.

Colic in the British military working horse population: a retrospective analysis.

Colic is a common and potentially life-threatening condition of horses. Multiple risk factors have been previously identified and it is known that a careful management routine can help reduce colic rates. The British military working horse population represents a unique cohort of horses that are intensively managed with a strict regimen. This retrospective study examined the incidence and mortality rate of colic within this population, as well as the signalment of affected horses, and compared these with the general population. Data for 717 horses over a five-year period (2008-2012) were analysed. Of these, 163 horses (22.7 per cent) experienced 267 colic episodes and 13 horses (1.8 per cent) died because of colic. Recurrent colic was experienced by 35 per cent (57/163) of horses. The incidence of colic was 11.1 episodes per 100 horse-years and of colic-related death was 0.5 deaths per 100 horse-years. Horses purchased from mainland Europe were more likely to suffer from colic (OR 4.6; P<0.001) and from recurrent colic (OR 6.0; P=0.005) than horses purchased from Ireland. Only 3 per cent (8/267) of colic episodes were treated surgically. It was concluded that the incidences of colic and colic-related deaths within the British military working horse population are similar to those of the general horse population.

Clinical Update: Concepts of Prehospital Traumatic Hemorrhage Control in the Operational K9.

Major trauma often involves varying degrees of hemorrhage. Left unattended, any amount of trauma-induced hemorrhage may rapidly become life threatening. Similar to humans, Operational canines (OpK9s) can suffer penetrating trauma and blunt trauma that lead to compressible and noncompressible hemorrhage. Preserving organ function and saving the life of a massively bleeding OpK9 require the implementation of immediate and effective hemostatic measures. Effective hemorrhage control interventions for the exsanguinating OpK9 are similar to those for humans: direct pressure, wound packing, hemostatic agents and devices, pressure bandage, and, possibly, tourniquet application. Although tourniquet application is a life-saving intervention in humans experiencing extremity hemorrhage, it is not considered a necessary, immediate-action life-saving intervention for canines with extremity injuries. This article provides a brief description of the basic methods for identifying life-threatening hemorrhage and achieving immediate hemostasis in the bleeding OpK9 during the prehospital period.

Remembering the fallen.

This month marks the centenary of the end of the First World War. Here, Bruce Vivash Jones reflects on the War's impact on vets and war horses.

Blood Lead Toxicity Analysis of Multipurpose Canines and Military Working Dogs.

Special Operations Forces and their accompanying tactical multipurpose canines (MPCs) who are involved in repeated live-fire exercises and military operations have the potential for increased blood lead levels and toxicity due to aerosolized and environmental lead debris. Clinical lead-toxicity symptoms can mimic other medical disorders, rendering accurate diagnosis more challenging. The objective of this study was to examine baseline lead levels of MPCs exposed to indoor firing ranges compared with those of nontactical military working dogs (MWDs) with limited or no exposure to the same environment. In the second part of the study, results of a commercially available, human-blood lead testing system were compared with those of a benchtop inductively coupled plasma-mass spectrometry (ICP-MS) analysis technique. Blood samples from 18 MPCs were tested during routine clinical blood draws, and six samples from a canine group with limited exposure to environmental lead (nontactical MWDs) were tested for comparison. There was a high correlation between results of the commercial blood-testing system compared with ICP-MS when blood lead levels were higher than 4.0µg/dL. Both testing methods recorded higher blood lead levels in the MPC blood samples than in those of the nontactical MWDs, although none of the MPC samples tested contained lead levels approaching those at which symptoms of lead toxicity have previously been reported in animals (i.e., 35µg/dL).

Prehospital Care of Canine Gastric Dilatation and Volvulus.

The intent of the Operational K9 (OpK9) ongoing series is to provide the Special Operations Medical Association community with clinical concepts and scientific information on preventive and prehospital emergency care relevant to the OpK9. Often the only medical support immediately available for an injured or ill OpK9 in the field is their handler or the human Special Operations Combat Medic or civilian tactical medic attached to the team (e.g., Pararescueman, 18D, SWAT medic). The information is applicable to personnel operating within the US Special Operations Command as well as civilian Tactical Emergency Medical Services communities that may have the responsibility of supporting an OpK9.

Institution of Military Working Dog Physical Profile Record to Clarify Medical Readiness Category Status.

The current medical readiness category (CAT) status system used for military working dogs (MWDs) simply outlines the deployability of an MWD. This system, however, does not detail any other restrictions or the reason for assigning the current CAT status. The question is often raised as to whether the MWD can continue to work and perform everyday duties despite not being a CAT I. Using the Physical Profile Record system established for human providers, a system was adapted for MWDs. This system will allow Veterinary Corps Officers to give specific instructions to the handler and owning unit about the nature, progression, and details of injury or dysfunction beyond the CAT status. Furthermore, the ability to track chronic conditions and duration of illness will increase overall readiness of a kennel.

[Dental care to military dogs].

Oketz is a military special unit that operates different dog species for various missions. The dogs get routine medical and dental treatments in order to maintain their health and function. The dental treatment is based on the principles of contemporary dentistry for small animals. Furthermore, these working dogs need special care due to higher risk to trauma and attrition. The dogs go through routine dental examination and prophylactic dental cleaning. Each dental procedure is performed under general anesthesia; therefore it is well planned ahead including all the pre-operative workup needed. The article presents the current concepts of dental treatment of dogs especially in respect to their activity.

Changes in movement symmetry over the stages of the shoeing process in military working horses.

Military working horses perform a high proportion of work on road surfaces and are shod frequently to deal with high attrition rates. The authors investigate the influence of shoeing on movement symmetry as an indirect indicator of mechanical differences affecting force production between contralateral limbs. In this quantitative observational study, inertial sensor gait analysis was performed in 23 Irish sport type horses (4-21 years, 1.58-1.85 m) in full ceremonial work at the King's Troop, Royal Horse Artillery. Changes in two movement symmetry measures (SI: symmetry index; MinDiff: difference between displacement minima) for head and pelvic movement were assessed at four stages of routine shoeing: 'old shoes', 'shoes removed', 'trimmed', 'reshod'. Horses were assessed applying shoes to the front limbs (N=10), to the hindlimbs (N=10) or both (N=3). Changes in head movement symmetry between conditions were small and inconsistent. Changes in pelvic movement symmetry were small and showed significant differences between shoeing stages (SI: P=0.013, MinDiff: P=0.04) with most symmetrical pelvic movement after trimming. In military working horses with high frequency shoeing small changes in movement symmetry were measured. All significant changes involved trimming, which indicates that future studies should in particular assess changes before/after trimming and investigate longer shoeing intervals.

Impact of North Atlantic Treaty Organization Policies and Procedures on Combined Medical Operations: Food and Water Safety and Veterinary Support.

Effective multilateral military operations such as those conducted by the North Atlantic Treaty Organization (NATO) require close cooperation and standardization between member nations to ensure interoperability. Failure to standardize policies, procedures, and doctrine prior to the commencement of military operations will result in critical interoperability gaps, which jeopardize the health of NATO forces and mission success. To prevent these gaps from occurring, US forces must be actively involved with NATO standardization efforts such as the Committee of the Chiefs of Medical Services to ensure US interests are properly represented when NATO standards are developed and US doctrine and procedures will meet the established NATO requirements.

Role of Human Health Care Providers and Medical Treatment Facilities in Military Working Dog Care and Accessibility Difficulties with Military Working Dog Blood Products.

The use of military working dogs (MWDs) in support of military operations has increased dramatically over recent years, as they have proven to be our most reliable deterrent to improvised explosive devices. Healthcare delivery for MWDs in combat presents unique challenges and requires extensive collaboration between veterinarians and human health care providers (HCPs). A successful example is the incorporation of MWD emergency care for nonveterinary HCPs into the Joint Trauma System Clinical Practice Guidelines, which has proven to be a helpful product. Additional challenges that need further solutions include MWDs as patients in human medical treatment facilities (MTFs) and the procurement of appropriate canine blood components in an operational environment. It is often necessary for MWDs to be treated as patients in human MTFs, however, there is no Department of Defense guidance to support this activity. Access to MWD blood products is limited to collection of fresh whole blood in the operational setting. Similar to humans, specific blood component therapy, such as fresh frozen plasma, is often indicated for sick or injured MWDs. Currently there is no formal system in place to deliver any blood products for MWDs or to facilitate collection in theater.