Companion animal veterinarians discuss aspects of one health with pet owners during most veterinary appointments.

OBJECTIVE: To examine the prevalence and context of one-health conversations between veterinarians and clients in companion animal practice. SAMPLE: A random selection of 60 companion animal veterinarians; a convenience sample of 917 interactions from Southern Ontario, Canada. Of these, 100 audio-video-recorded interactions including 47 of 60 veterinarians were randomly selected for inclusion in this study. METHODS: Audio-video recordings were made of veterinarian-client-patient interactions between November 2017 and January 2019. A researcher-generated coding framework was developed and used to assess the prevalence and content of one-health topics communicated during veterinary appointments. RESULTS: Of the interactions assessed, 60 were preventive care and 40 were health problem appointments. Further, 78% (78/100) included at least 1 discussion related to one health. One-health topics included zoonoses (28% [28/100]), animal behavior (25% [25/100]), illness/disease (20% [20/100]), activity level/exercise (16% [16/100]), nutrition (16% [16/100]), dentistry (6% [6/100]), body weight (3% [3/100]), animal welfare (3% [3/100]), dog/cat bites (2% [2/100]), cannabis (2% [2/100]), and aging (1% [1/100]). Zoonotic diseases were mentioned in 65 appointments, 28 of which evolved into a one-health discussion. Antibiotics were discussed in 27 appointments, none of which were discussed in relation to one health (eg, antimicrobial resistance). CLINICAL RELEVANCE: Findings suggest that one-health topics are raised within most veterinary appointments. Opportunities exist for more comprehensive one-health conversations between veterinarians and their clients, particularly in relation to zoonotic diseases and antimicrobials.

Use of health parameter trends to communicate pet health information in companion animal practice: A mixed methods analysis.

BACKGROUND: Reviewing patient health parameter trends can strengthen veterinarian-client-patient relationships. The objective of this study is to identify characteristics associated with veterinarians' communication of health parameter trends to companion animal clients. METHODS: Using a sequential exploratory mixed methods design, independent pet owner (n = 27) and veterinarian (n = 24) focus groups were conducted and analysed via content analysis to assess perceptions of how health parameter trends are communicated by veterinarians. Subsequently, a quantitative assessment of video recorded veterinary appointments (n = 917) compared characteristics identified in focus groups with health parameter trend discussions in practice. A mixed logistic model was used to assess characteristics associated with the occurrence of weight trend discussions. RESULTS: Fifteen characteristics relating to veterinarians' use of health parameter trends were identified across focus groups. Veterinarians discussed 77 health parameter trends in relation to bodyweight (57/77), blood work (15/77) and other health parameters (5/77), within 73 (73/917) appointments. The odds of a weight trend discussion were higher if the veterinarian identified the pet as overweight or obese compared to an ideal bodyweight (odds ratio (OR) = 2.17; 95% confidence interval (CI) = 1.15-4.09; p = 0.016). CONCLUSION: Mention of a health parameter trend was uncommon and rarely included use of visual aids. Health parameter trends related to bodyweight were discussed reactively, rather than proactively.

Companion animal veterinarians' and veterinary clients' perceptions of information exchanged while communicating about blood tests.

BACKGROUND: Blood tests play a vital role in veterinary medicine, as they enable veterinarians to make decisions about their patients' medical care and provide opportunities to engage clients in veterinary care. The objective of this study was to explore perspectives of veterinary clients and veterinarians on current reporting practices for blood tests ordered in companion animal practice. The type of information communicated and client information seeking behaviours were examined. METHODS: Two online surveys were distributed using snowball sampling: one targeting veterinary clients and one targeting veterinarians. RESULTS: In total, 529 veterinary client and 416 veterinarian surveys were included in analyses. Significant differences were found between what blood test information veterinarian respondents felt they provided clients and what client respondents perceived they received with regard to their pet's blood tests. Almost 60% of clients somewhat or strongly agreed that they search the Internet if they do not understand why a test was ordered or what the results mean. Half of clients reported that they never receive a written report of their pet's blood work, 81% of whom were interested in receiving a copy. CONCLUSION: Results of this research demonstrate opportunities to improve veterinarians' and clients' communication about blood tests.

"Sewing Is Part of Our Tradition": A Case Study of Sewing as a Strategy for Arts-Based Inquiry in Health Research With Inuit Women.

In this article, we present a case study of sewing as a strategy for arts-based inquiry in health research, situated within a broader project that highlighted Nunavut Inuit women's childbirth experiences. Five focus groups were hosted as sewing sessions with pregnant women (N = 19) in Iqaluit, Nunavut (2017-2018). Women's reflections on the sessions, and the significance of sewing to Inuit, were integrated with researchers' critical reflections to examine the value of sewing as a strategy for arts-based inquiry within a focus group method: results related to the flexibility of the sessions; how collective sewing created space for voicing, sharing, and relating; sewing as a tactile and place-specific practice tied to Inuit knowledge and tradition; and lessons learned. Our results underscore the possibilities of arts-based approaches, such as sewing, to enhance data gathering within a focus group method and to contribute to more locally appropriate, place-based methods for Indigenous health research.

Evaluating shared decision-making between companion animal veterinarians and their clients using the Observer OPTION5 instrument.

BACKGROUND: Communication practices used by veterinarians can impact client's involvement in decision-making. The objective of this study was to evaluate the level of client involvement in veterinary care decisions and factors impacting client involvement. METHODS: A random sample of practising companion animal veterinarians and a convenience sample of pet owners were recruited. Each consultation was audio-video recorded and analyzed using the Observer OPTION5 instrument, adapted from human medicine, to assess veterinarians' level of shared decision-making. A mixed linear model was used to assess statistical associations between veterinarian, client and appointment-level factors and OPTION5 scores. RESULTS: Sixty veterinarians and 909 of their clients were audio-video recorded during a consultation, of which 717 interactions included a decision identified for analysis using the OPTION5 instrument. Elements consistent with shared decision-making were uncommon, with a mean OPTION5 score of 22.6 (median = 20.0; sd = 13.05; range = 0-75) out of 100. OPTION5 scores were positively associated with the length of the appointment and negatively associated with the veterinarian's years in practice when controlling for statistical interaction between client income and appointment type. CONCLUSION: Findings suggest an opportunity exists for veterinarians to incorporate more client involvement through increased use of shared decisionmaking behaviours during veterinary consultations.

Pet owners' and veterinarians' perceptions of information exchange and clinical decision-making in companion animal practice.

One of the most complex aspects of the veterinarian-client-patient interaction is the clinical decision-making process. Research suggests that the approach to communication used by veterinarians can impact veterinary clients' involvement in the decision-making process and their ultimate satisfaction. Using different approaches to the decision-making process may affect how information is exchanged and consequently how decisions are made. The objective of this study was to determine pet owners' expectations with respect to information exchange and decision-making during veterinarian-client-patient interactions and to compare veterinarians' perceptions of those expectations and the challenges they face in meeting them. Five pet owner focus groups (27 owners) and three veterinarian focus groups (24 veterinarians) were conducted with standardized open-ended questions and follow-up probes. Thematic analysis of the transcribed data was conducted to identify trends and patterns that emerged during the focus groups. Three pet owner-based themes were identified: 1) understanding the client; 2) providing information suitable for the client; and 3) decision-making. In addition, three barriers for veterinarians affecting information exchange and decision-making were identified: 1) time constraints; 2) involvement of multiple clients; and 3) language barriers. Results suggest that pet owners expect to be supported by their veterinarian to make informed decisions by understanding the client's current knowledge, tailoring information and educating clients about their options. Breakdowns in the information exchange process can impact pet owners' perceptions of veterinarians' motivations. Pet owners' emphasis on partnership suggests that a collaborative approach between veterinarians and clients may improve client satisfaction.

Ontario Veterinary College First-Year Veterinary Students' Perceptions of Companion Animal Nutrition and Their Own Nutrition: Implications for a Veterinary Nutrition Curriculum.

Extant research shows veterinarians face increasing challenges in discussing nutrition with clients despite receiving professional nutrition education in the veterinary medical curriculum. This article's aim is to elicit student veterinarians' baseline nutrition-related perceptions and nutrition information-seeking behaviors at the time of entering veterinary school. Participants were newly enrolled veterinary students at the Ontario Veterinary College (n = 120). Focus group discussions (n = 19) informed the design of an online questionnaire capturing students' demographics and perceptions of their own and their pets' nutrition. Students reported being influenced by individual factors (e.g., time), social networks (e.g., family), and surrounding environment (e.g., cost, contradictory media messages). Overall, 58% of students considered themselves knowledgeable about pet nutrition when commencing veterinary school, with 71% prioritizing their pets' diets as much as their own. Students' confidence in finding pet nutrition information was correlated with perceived accessibility (r = .76, p = .001) and perceived quantity of information available on pet nutrition (r = .83, p = .001), but not quality of information (r = .13, p = .03). In general, students relied on and trusted veterinarians for nutrition advice. However, 94% of students mistrusted pet food companies' motivations. Our data support that students entering veterinary school have their own perceptions on pet nutrition that impact nutrition education, suggesting this as an important consideration in the design and delivery of a veterinary nutrition curriculum. Veterinary medical faculty should be encouraged to discuss baseline nutrition information and address any misconceptions to prepare students for future consultations with clients.

A cross-sectional study of pet owners' attitudes and intentions towards nutritional guidance received from veterinarians.

BACKGROUND: Beliefs of pet owners strongly influence their decision-making surrounding their pets' diet. Thus, nutritional guidance is an essential component of veterinary practice and integral to managing rising rates of pet obesity. This study examined pet owners' trust of, perceived effectiveness of, and intentions to follow nutritional guidance received from their veterinarian in managing their pets' diet. METHODS: A cross-sectional study of 1402 dog and cat owners in the USA and Canada was conducted using an online questionnaire tool. Data were analysed using descriptive statistics and logistic regression modelling. RESULTS: Clients are concerned about the effectiveness of veterinary nutrition recommendations. Cat owners were more likely than dog owners to consider the nutritional guidance they receive from veterinarians effective for their pets' diet (1.75, P=0.04). Length of pet ownership, feeding dry diets and frequency of veterinary visits were all positively associated with owners considering veterinary nutritional guidance to be effective in managing pets' diet. CONCLUSION: Identifying these perspectives can aid in developing strategies to provide nutrition support to pet owners to improve their perceptions of, self-efficacy with, and compliance with veterinary nutrition recommendations.

National trends in sexual health indicators among gay and bisexual men disaggregated by ethnicity: repeated cross-sectional behavioural surveillance in New Zealand.

OBJECTIVES: To assess trends in sexual health outcomes among men who have sex with men (MSM) disaggregated by ethnicity. DESIGN: Repeated cross-sectional. SETTING: Behavioural surveillance data from 2006, 2008, 2011 and 2014 were collected in-person and online across Aotearoa New Zealand. PARTICIPANTS: Eligible participants were self-identified men aged 16 years or older who reported sex with another man in the past 5 years. We classified 10 525 participants' ethnicities: Asian (n=1003, 9.8%), Maori (Indigenous people of Aotearoa New Zealand, n=1058, 10.3%), Pacific (n=424, 4.1%) and European (n=7867, 76.8%). OUTCOME MEASURES: The sexual health outcomes examined were >20 recent (past 6 months) male sexual partners, past-year sexually transmitted infection (STI) testing, past-year STI diagnosis, lifetime and past-year HIV testing, lifetime HIV-positive diagnosis and any recent (past 6 months) condomless anal intercourse with casual or regular partners. RESULTS: When disaggregated, Indigenous and ethnic minority groups reported sexual health trends that diverged from the European MSM and each other. For example, Asian MSM increased lifetime HIV testing (adjusted OR, AOR=1.31 per survey cycle, 95% CI 1.17 to 1.47) and recent HIV testing (AOR=1.14, 95% CI 1.02 to 1.28) with no changes among Maori MSM or Pacific MSM. Condomless anal intercourse with casual partners increased among Maori MSM (AOR=1.13, 95% CI 1.01 to 1.28) with no changes for Asian or Pacific MSM. Condomless anal intercourse with regular partners decreased among Pacific MSM (AOR=0.83, 95% CI 0.69 to 0.99) with no changes for Asian or Maori MSM. CONCLUSIONS: Population-level trends were driven by European MSM, masking important differences for Indigenous and ethnic minority sub-groups. Surveillance data disaggregated by ethnicity highlight inequities in sexual health service access and prevention uptake. Future research should collect, analyse and report disaggregated data by ethnicity to advance health equity.

Evaluation of associations between owner presence and indicators of fear in dogs during routine veterinary examinations.

OBJECTIVE: To evaluate the influence of owner presence on behavioral and physiologic indicators of fear in dogs during routine physical examinations. ANIMALS: 32 client-owned dogs. PROCEDURES: Dogs underwent a standardized, video-recorded examination consisting of 6 phases (examination of the head, lymph node palpation, body palpation, axillary temperature measurement, heart rate assessment, and respiratory rate assessment) with or without their owner present in a randomized, controlled study. Behaviors reported to be indicative of fear, including reduced posture, avoidance, escape, lip licking, body shaking, yawning, and vocalizing, were assessed during each phase, and physiologic measurements were assessed during relevant phases by the investigator. Owner presence and sex and age of dogs were investigated for associations with behavioral signs of fear; behavioral and physiologic measurements were compared between groups (owner present vs owner absent). RESULTS: Dogs in the owner-present group had a lower rate of vocalizations, lower mean axillary temperature, and higher rate of yawning than dogs in the owner-absent group. Female dogs in the owner-absent group had a higher heart rate than females and males in the owner-present group and males in the owner-absent group, and the rate of lip licking decreased as age increased in the owner-present group. The presence of reduced body posture and rates of lip licking, avoidance behavior, and escape behavior were associated with examination phase. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that, when practical, owners should be encouraged to remain with their dog during routine veterinary examinations. However, effects of owner presence during procedures require further investigation. (J Am Vet Med Assoc 2020;257:1031-1040).

Ethnicity classification systems for public health surveys: experiences from HIV behavioural surveillance among men who have sex with men.

BACKGROUND: Race and ethnicity classification systems have considerable implications for public health, including the potential to reveal or mask inequities. Given increasing "super-diversity" and multiple racial/ethnic identities in many global settings, especially among younger generations, different ethnicity classification systems can underrepresent population heterogeneity and can misallocate and render invisible Indigenous people and ethnic minorities. We investigated three ethnicity classification methods and their relationship to sample size, socio-demographics and sexual health indicators. METHODS: We examined data from New Zealand's HIV behavioural surveillance programme for men who have sex with men (MSM) in 2006, 2008, 2011, and 2014. Participation was voluntary, anonymous and self-completed; recruitment was via community venues and online. Ethnicity allowed for multiple responses; we investigated three methods of dealing with these: Prioritisation, Single/Combination, and Total Response. Major ethnic groups included Asian, European, indigenous Maori, and Pacific. For each classification method, statistically significant associations with ethnicity for demographic and eight sexual health indicators were assessed using multivariable logistic regression. RESULTS: Overall, 10,525 MSM provided ethnicity data. Classification methods produced different sample sizes, and there were ethnic disparities for every sexual health indicator. In multivariable analysis, when compared with European MSM, ethnic differences were inconsistent across classification systems for two of the eight sexual health outcomes: Maori MSM were less likely to report regular partner condomless anal intercourse using Prioritisation or Total Response but not Single/Combination, and Pacific MSM were more likely to report an STI diagnosis when using Total Response but not Prioritisation or Single/Combination. CONCLUSIONS: Different classification approaches alter sample sizes and identification of health inequities. Future research should strive for equal explanatory power of Indigenous and ethnic minority groups and examine additional measures such as socially-assigned ethnicity and experiences of discrimination and racism. These findings have broad implications for surveillance and research that is used to inform public health responses.

Mapping the maternal health research landscape in Nunavut: A systematic search & critical review of methodology.

Nunavut's maternal healthcare system is characterized by rapid transition from community-based birth to a practice of obstetric evacuation and institutionalized birth. Given calls for Inuit self-determination in research, maternal health research - which informs healthcare practices and policies - may need to be conducted differently, using different research methodologies, to include Inuit women's voices and lived experiences. In light of these calls, this article systematically synthesized the published maternal health literature in Nunavut and critically examined reported research methods. This systematic search and critical review involved a comprehensive database search and multi-level eligibility screening conducted by two independent reviewers. Data on the temporal, geographic, methodological, and topical range of studies were extracted, then descriptive statistics were calculated to summarize these data. A hybrid inductive and deductive qualitative analysis of the full-text articles was conducted to critically analyze research methodology. The initial search yielded 2656 distinct articles and twenty-eight articles met the inclusion criteria. These articles were published from 1975 to 2016, mostly used quantitative research methodology (71.4%), were written from clinical perspectives (57.1%), and focused on maternity care (53.6%). Emergent themes related to both the contributions and areas for growth of research methodology in the conceptualization, initiation, implementation, reporting, and knowledge mobilization stages of the research process. This review revealed opportunities for maternal health researchers to: redress the ongoing impacts of colonization; further include Inuit definitions of health and perspectives on birth in study designs; explore new methodologies that resonate with Inuit ways of knowing; continue (re)aligning research with community priorities; and move from consultation and collaborative partnership in research to Inuit leadership and data ownership. Indeed, this review illustrates that at each step of the research process, opportunity exists for Inuit perspectives and active involvement to shape and define maternal health research in Nunavut.

Cross-sectional survey of cat handling practices in veterinary clinics throughout Canada and the United States.

OBJECTIVE: To assess handling techniques commonly used during routine examinations and procedures used for calm, fearful, and aggressive cats by veterinarians and nonveterinarian staff at Canadian and US veterinary practices and to evaluate demographic factors associated with those handling techniques. SAMPLE: 310 veterinarians and 944 nonveterinarians who handle cats at Canadian and US veterinary practices. PROCEDURES: An online questionnaire was developed to evaluate respondent demographics and use of common cat handling practices and techniques. A snowball sampling method was used to send a link to the questionnaire to members of Canadian and US veterinary-affiliated groups. Descriptive statistics were generated; logistic regression was used to identify demographic factors associated with the use of minimal and full-body restraint with scruffing during routine examination and procedures for fearful and aggressive cats. RESULTS: Full-body restraint was used to handle cats of all demeanors, although its frequency of use was greatest for fearful and aggressive cats. Veterinarians and nonveterinarians who graduated from veterinary training programs before 2006 were less likely to use full-body restraint for cats of all demeanors, compared with nonveterinarians who did not graduate or graduated between 2006 and 2015. Other factors associated with decreased use of full-body restraint included working at an American Association of Feline Practitioners-certified practice and working at a Canadian practice. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that full-body restraint is commonly used to handle cats. Further research is necessary to determine whether current handling recommendations are effective in decreasing stress for cats during veterinary visits.

The Perceived Importance, Emphasis, and Confidence in Veterinary Nutrition Education of First-Year Canadian and US Veterinary Students.

Veterinarians play a critical role in providing nutrition consultation and supporting clients to adopt healthy dietary habits for their pets; thus applicable, informative nutrition education in veterinary schools is essential. The aim of this study was to explore incoming veterinary students' perceived importance, emphasis, and confidence in the veterinary nutrition education they will receive. First-year veterinary students at all 5 Canadian and 5 randomly selected US veterinary schools were invited to complete a 31-item questionnaire. Response rate was 34.6% (n = 326). Descriptive statistics and multivariate logistic regression were performed. While most students (92%) considered nutrition education to be an important component of veterinary training, 64% felt it will not be a subject of great emphasis. Veterinary students at schools with a board-certified veterinary nutrition faculty were more likely to perceive higher emphasis on nutrition education (p < 0.001). In the multivariate analysis, academic self-efficacy was a positive predictor of students' perceived confidence in how well they anticipate their nutrition education that will prepare them for their clinical roles (p = 0.003). Examining the perceptions of veterinary students entering veterinary school is an important aspect to consider in the design and delivery of a veterinary nutrition curriculum and maybe equally important for students entering other professional health programs.

Getting a grip: cats respond negatively to scruffing and clips.

Use of scruffing and scruffing tools (eg, clipnosis clips) to immobilise cats is contentious, and cat handling guidelines vary in recommendations regarding these techniques. The current study examined whether cats show negative responses to the following restraint methods: (1) scruff (n=17), (2) clip application to the dorsal neck skin (n=16) and (3) full body (a known negative; n=19). Each cat was also handled with passive restraint (control) for comparison. During handling, cats were examined for behavioural (side/back ear positions, vocalisations, lip licking) and physiological (pupil dilation ratio, respiratory rate) responses. Full-body restrained cats showed more negative responses than passively restrained cats (respiratory rate: p=0.006, F3,37=4.31, p=0.01; ear p=0.002, F3,49=6.70, p=0.0007; pupil: p=0.007, F3,95=14.24, p=0.004; vocalisations: p=0.009, F3,49=4.85, p=0.005) and scruff-restrained cats (pupil: p=0.009; vocalisations: p=0.04). Clip restraint resulted in more negative responses than passive (pupil: p=0.01; vocalisations: p=0.007, ear p=0.02) and scruff restraint (pupil p=0.01; vocalisations: p=0.02). No differences were detected between full-body restraint, known to be aversive, and clip restraint. Full-body restraint and clip restraint resulted in the greatest number of negative responses, scruffing resulted in fewer negative responses and passive restraint showed the least number of responses. We therefore recommend against the use of full-body and clip restraint, and suggest that scruff restraint should be avoided when possible.

Students' Experiences of Seeking Web-Based Animal Health Information at the Ontario Veterinary College: Exploratory Qualitative Study.

BACKGROUND: Although searching for health information on the internet has offered clear benefits of rapid access to information for seekers such as patients, medical practitioners, and students, detrimental effects on seekers' experiences have also been documented. Health information overload is one such side effect, where an information seeker receives excessive volumes of potentially useful health-related messages that cannot be processed in a timely manner. This phenomenon has been documented among medical professionals, with consequences that include impacts on patient care. Presently, the use of the internet for health-related information, and particularly animal health information, in veterinary students has received far less research attention. OBJECTIVE: The purpose of this study was to explore veterinary students' internet search experiences to understand how students perceived the nature of Web-based information and how these perceptions influence their information management. METHODS: For this qualitative exploratory study, 5 separate focus groups and a single interview were conducted between June and October 2016 with a sample of 21 veterinary students in Ontario, Canada. RESULTS: Thematic analysis of focus group transcripts demonstrated one overarching theme, The Overwhelming Nature of the Internet, depicted by two subthemes: Volume and Type of Web-based Health Information and Processing, Managing, and Evaluating Information. CONCLUSIONS: Integrating electronic health information literacy training into human health sciences students' training has shown to have positive effects on information management skills. Given a recent Association of American Veterinary Medical Colleges report that considers health literacy as a professional competency, results of this study point to a direction for future research and for institutions to contemplate integrating information literacy skills in veterinary curricula. Specifically, we propose that the information literacy skills should include knowledge about access, retrieval, evaluation, and timely application of Web-based information.

Effect of a Standardized Four-Week Desensitization and Counter-Conditioning Training Program on Pre-Existing Veterinary Fear in Companion Dogs.

Many dogs show signs of fear during veterinary appointments. It is widely recommended to use desensitization and counter-conditioning training to reduce this fear. However, the efficacy of this method for reducing veterinary fear has not been examined. We assessed the effect of a standardized four-week training program on behavioural and physiological signs of fear in dogs with pre-existing veterinary fear. Owned dogs were randomly allocated to receive training (n = 15) or no training (n = 22; Control). Owners of dogs in the training group were instructed to perform exam-style handling on their dog and to visit the veterinary clinic weekly. Owners of control dogs were given no instructions. Fear responses were assessed before and after the training period by a blinded observer during clinic arrival and examination. Despite motivated owners volunteering to participate in the current study, 44% of owners were non-compliant to this training program. During examination, control dogs had higher odds (95% confidence Interval (CI)) of reduced posture compared to trained dogs (Odds ratio (OR): 3.79, CI: 1.03-16.3). Fear scores for trained dogs lowered during the second examination (p = 0.046), and 86.7% of dog owners reported a reduction in their dog's fear levels across the training period (p = 0.007). When entering the clinic (p = 0.002) and during examination (p = 0.002), trained female dogs had a higher rate of lip licking than control females. The training program did not influence temperature, heart rate, respiratory rate, avoidance, trembling, vocalizations, or willingness and encouragement to step on the scale. Results suggest that this four-week training program was mildly effective at reducing veterinary fear in dogs. Further research is necessary to explore the efficacy of longer, more intensive, and individualized training programs.

Factors associated with hematuric struvite crystalluria in cats.

OBJECTIVES: The aim of the study was to identify any dietary, signalment, geographic and clinical factors associated with hematuric struvite crystalluria (HSC) in a population of cats that visit general care veterinary hospitals in the USA. METHODS: In total, 4032 cats that had a first-time diagnosis of HSC and 8064 control cats with no history of hematuria or crystalluria were identified from medical records of all cats examined between 2007 and 2011 at 790 US veterinary hospitals. Extracted variables included age, sex, neuter status, breed, diet, urinalysis results and history of cystitis. Potential associations between these variables and HSC were estimated. RESULTS: Controlling for other factors, young cats fed a dry diet had an increased likelihood of HSC relative to young cats fed a non-dry diet. However, as age increased, the likelihood of HSC declined for cats fed a dry diet and increased for cats fed a non-dry diet. Moreover, the odds of HSC were significantly greater when cats were unneutered (vs neutered; odds ratio [OR] 45.52) or had a thin (vs heavy) body condition (OR 23.81), diagnosis of cystitis (OR 2.84), urine protein concentration >30 mg/dl (OR 4.72), alkaline (vs neutral) urine pH (OR 3.34), pyuria (OR 23.67) or bacteriuria (OR 2.24). CONCLUSIONS AND RELEVANCE: The present study provides estimates of the strengths of association between HSC and certain signalment and clinical characteristics of cats. This information could help clinicians to perform a more directed screening for struvite crystalluria in certain cat populations. Follow-up studies that build on the findings of this study could explore the clinical importance of HSC in cats.

Milestone Educational Planning Initiatives in Veterinary Medical Education: Progress and Pitfalls.

Three milestone educational planning initiatives engaged the veterinary medical profession in the United States and Canada between 1987 and 2011, namely the Pew National Veterinary Education Program, the Foresight Project, and the North American Veterinary Medical Education Consortium. In a quantitative study, we investigated the impact of these initiatives on veterinary medical education through a survey of academic leaders (deans, previous deans, and associate deans for academics from veterinary medical schools that are members of the Association of American Veterinary Medical Colleges) to assess their perspectives on the initiatives and eight recommendations that were common to all three initiatives. Two of the recommendations have in effect been implemented: enable students to elect in-depth instruction and experience within a practice theme or discipline area (tracking), and increase the number of graduating veterinarians. For three of the recommendations, awareness of the issues has increased but substantial progress has not been made: promote diversity in the veterinary profession, develop a plan to reduce student debt, and develop a North American strategic plan. Lastly, three recommendations have not been accomplished: emphasize use of information more than fact recall, share educational resources to enable a cost-effective education, and standardize core admissions requirements. The educational planning initiatives did provide collaborative opportunities to discuss and determine what needs to change within veterinary medical education. Future initiatives should explore how to avoid and overcome obstacles to successful implementation.

Evaluation of a welfare assessment tool to examine practices for preventing, recognizing, and managing pain at companion-animal veterinary clinics.

Successful prevention, recognition, and treatment of pain are integral to ensuring veterinary patient welfare. A canine and feline welfare assessment tool, incorporating verbal interviews with veterinarians using open-ended questions, was developed to assess pain management practices that safeguard and improve patient welfare. The tool was evaluated in 30 companion- and mixed-animal veterinary clinics in Ontario in order to assess its reliability, feasibility, and validity, while also benchmarking current practices. Responses were analyzed according to a scoring scheme developed based on published literature and expert opinion. Based on weighted kappa statistics, interview scoring had substantial inter-observer (Kw = 0.83, 0.73) and near-perfect intra-observer (Kw = 0.92) agreement, which suggests that the tool reliably collects information about pain management practices. Interviews were completed at all recruited clinics, which indicates high feasibility for the methods. Validity could not be assessed, as participants were reluctant to share information about analgesic administration from their clinical records. Descriptive results indicated areas for which many veterinarians are acting in accordance with best practices for pain management, such as pre-emptive and post-surgical analgesia for ovariohysterectomy patients, and post-surgical care instructions. Areas that offer opportunity for enhancement were also highlighted, e.g., training veterinary staff to recognize signs of pain and duration of analgesia in ovariohysterectomy patients after discharge. Overall, based on this limited sample, most veterinarians appear to be effectively managing their patients' pain, although areas with opportunity for enhancement were also identified. Further research is needed to assess trends in a broader sample of participants.

Être en mesure de prévenir, reconnaitre, et traiter la douleur avec succès est essentiel pour assurer le bien-être des patients vétérinaires. Un outil d'évaluation du bien-être des chiens et des chats, incorporant une entrevue orale avec des vétérinaires avec des questions ouvertes, a été développé pour évaluer les pratiques de gestion de la douleur qui sauvegarde et améliore le bien-être des patients. L'outil a été évalué dans 30 cliniques vétérinaires pour animaux de compagnie et cliniques mixtes en Ontario afin de vérifier la fiabilité, la faisabilité, et la validité, tout en réalisant un étalonnage des pratiques actuelles. Les réponses ont été analysées selon un schéma de pointage basé sur la littérature publiée et l'opinion d'expert. Sur la base des statistiques kappa pondérées, les pointages des entrevues avaient un accord inter-observateur marqué (Kw = 0,83, 0,73) et un accord intra-observateur presque parfait (Kw = 0,92), ce qui suggère que l'outil a permis d'obtenir des informations fiables sur les pratiques de gestion de la douleur. Les entrevues ont été complétées dans toutes les cliniques recrutées, ce qui indiquait une excellente faisabilité pour les méthodes utilisées. La validité n'a pu être vérifiée car les participants étaient réfractaires à partager de l'information sur l'administration d'analgésique à partir de leurs dossiers médicaux. Les résultats indiquent que plusieurs vétérinaires agissent en concordance avec les bonnes pratiques de gestion de la douleur pour l'analgésie préventive et post-chirurgicale des patients subissant une ovariohystérectomie et les instructions pour les soins post-chirurgie. D'autres domaines ont été identifiés comme nécessitant des améliorations, e.g. former le personnel de la clinique à reconnaitre les signes de douleurs et la durée de l'analgésie chez les patients ayant eu une ovariohystérectomie après leur congé. De manière générale, sur la base de cet échantillonnage limité, la plupart des vétérinaires semble gérer la douleur de leurs patients de manière efficace, bien que des améliorations à faire aient été identifiées. De la recherche supplémentaire est requise pour évaluer les tendances dans un échantillonnage plus grand de participants.(Traduit par Docteur Serge Messier).