Prices for veterinary care of dogs, cats and horses in selected countries in Europe.

Introduction: In recent years, prices for veterinary care have received considerable attention in mainstream media, yet scientific literature has not delved into actual figures. This study aims to elucidate veterinary care costs for dogs, cats, and horses across five countries [Sweden (SE), Norway (NO), Denmark (DK), United Kingdom (UK), and Ireland (IR, with limited data)] through web searches. Methods: Utilising online business directories, we located URLs featuring veterinary care prices in autumn 2022, and repeated tri-monthly five times. Vetpris.se (VP), a price comparison site for SE, NO, and DK, emerged from the search. Additionally, we sought to compare price data from veterinary clinics (ranging from animal hospitals to small private clinics) using a similar approach to VP. We targeted elective procedures (e.g., gonadectomy, GDY) and common procedures (e.g., pyometra surgery in dogs). Results: Comparing data from the same clinics' websites and from VP within extraction from autumn 2022 to winter 2023/2024, median prices for dog and cat GDY were largely consistent. By October 2023, median prices for male cat GDY ranged from €72 (SE) to €230 (DK), and €130 (SE) to €361 (DK) for females; for dog GDY from €390 (SE) to €599 (DK) for males, and €461 (UK) to €1015 (DK) for females. Across sources, median prices for cat and dog GDY increased by 2-24% over a year for procedures with at least 10 clinics per extraction. Equine GDY (per sedation and local analgaesia) in SE saw a 64% increase by year-end, with a median price of €492. Emergency surgeries during regular-hours (e.g., pyometra and caesarean section) in SE were approximately €2,300 at the last extraction, marking a 27% increase for pyometra surgery during regular-hours and 15% after-hours compared to the previous year. Variability existed within and across countries and diagnoses/procedures. Discussion: Cross-validation suggested VP generally provided reliable information, though data points for emergencies were limited. Our web searching tool necessitated extensive manual verification, indicating room for further development. We recommend enhancing price transparency for animal owners to become better informed about the cost of veterinary care and be able to make informed choices.

Morbidity of insured Swedish cats between 2011 and 2016: Comparing disease risk in domestic crosses and purebreds.

BACKGROUND: Sources of population-based cat health information are scarce. The objective of this study was to determine disease frequency in cats using pet insurance data to inform health promotion efforts. METHODS: A descriptive analysis of cats insured with Agria Pet Insurance in Sweden (2011-2016) was performed. Incidence rates of broad disease categories were calculated based on veterinary care events and an exact denominator consisting of cat-years-at-risk. Rate ratios were calculated, comparing domestic crosses to all purebreds and specific purebreds to all other purebreds combined. RESULTS: The study included over 1.6 million cat-years-at-risk (78.5% were domestic crosses), 18 breeds and 24 disease categories. The most common disease categories causing morbidity in purebreds were digestive, whole body, injury, urinary lower, skin and female reproduction. Purebreds had the highest relative risk (compared to domestics crosses) in the female reproduction, heart, operation complication, respiratory lower and immunological disease categories. LIMITATIONS: There are typical limitations of secondary data, but they do not negate the overall value of such a large dataset. CONCLUSION: This study demonstrates how pet insurance data can be used to find breed-specific differences in the incidence of various disease categories in cats. This may be of importance for breeders, cat owners, veterinarians and researchers.

The epidemiology of stifle joint disease in an insured Swedish dog population.

BACKGROUND: Stifle joint diseases (SJD) are common in dogs and include a variety of diagnoses. The objective of the study was to provide an overview of the epidemiology of SJD in insured dogs. METHODS: An historical single cohort study of dogs insured in Agria Pet Insurance (2011-2016) in Sweden was performed. Incidence and relative risk (RR) of SJD was calculated for the whole dog population and for subgroups divided by breed, breed group and sex. RESULTS: The study population included almost 600,000 insured dogs (>1.7 million dog-years). Ninety-three different stifle joint diagnoses were reported in 9624 dogs, and the most common were cruciate ligament rupture and patellar luxation. The incidence of SJD was 55.4 cases per 10,000 dog-years at risk. Bulldog and boerboel had the highest RR of SJD. The breeds that accounted for the highest proportion of all SJD claimed dogs were mixed breed and Labrador retriever. Female dogs had a slightly increased RR compared with male dogs (RR 1.06, p = 0.006). The incidence increased yearly during the observation period. CONCLUSION: The study demonstrates breed-specific differences in incidence of SJD in dogs, which may be of importance for breeders, dog owners and veterinarians.

Use of the measure of patient-centered communication to analyze euthanasia discussions in companion animal practice.

OBJECTIVE: To characterize veterinarian-client communication with undisclosed standardized clients (USCs) during discussions regarding euthanasia of a pet. DESIGN: Descriptive study. SAMPLE POPULATION: 32 companion animal veterinarians (16 males and 16 females) in southern Ontario. PROCEDURES: During 2 clinic visits, 2 cases (a geriatric dog with worsening arthritis and a cat with inappropriate urination) designed to stimulate discussion regarding euthanasia of a pet were presented by different USCs (individuals trained to consistently present a particular case to veterinarians without disclosing their identity). Discussions were audio recorded and analyzed by use of the measure of patient-centered communication (MPCC [a tool to assess and score physician communication behaviors]). Veterinarian and client statements were classified by means of 3 patient-centered components: exploring both the disease and the illness experience, understanding the whole person, and finding common ground. RESULTS: 60 usable recorded discussions were obtained (31 veterinarians; 30 discussions/case). Overall, MPCC scores were significantly lower for the geriatric dog case. For both cases, veterinarians scored highest on finding common ground and lowest on exploring both the disease and the illness experience. Lack of exploration of client feelings, ideas, and expectations and the effect of the illness on the animal's function resulted in low scores among veterinarians. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that the use of USCs and the MPCC are feasible methods for analysis of veterinarian-client communication during companion animal euthanasia discussions. Findings suggested that some veterinarians do not fully explore client concerns or facilitate client involvement in euthanasia decision making.

Prevalence and nature of cost discussions during clinical appointments in companion animal practice.

OBJECTIVE: To determine prevalence and nature of cost discussions between veterinarians and pet owners during clinical appointments in companion animal practice. DESIGN: Cross-sectional descriptive study. SAMPLE POPULATION: 20 veterinarians in companion animal practice in eastern Ontario and 350 clients and their pets. PROCEDURES: 200 veterinarian-client-patient interactions were randomly selected from all videotaped interactions and analyzed with the Roter interaction analysis system. Additional proficiency codes and blocking functions were developed to capture the prevalence, nature, and context of cost discussions. RESULTS: 58 of the 200 (29%) appointments that were analyzed included a discussion of cost. During 38 of these 58 (66%) appointments, the discussion involved costs associated with the veterinarian's time or with services provided by the veterinarian. Overall, reference to a written estimate was made during only 28 of the 200 (14%) appointments. Cost discussions were most common during appointments in which a decision related to diagnostic testing or dentistry was made. Appointments were significantly longer when a cost discussion was included than when it was not. CONCLUSIONS AND CLINICAL RELEVANCE: Results of the present study suggested that discussions related to cost were relatively uncommon during clinical appointments in companion animal practice and that written estimates were infrequently used to aid these discussions. When discussions of cost did occur, veterinarians appeared to focus on explaining costs in terms of the veterinarian's time or services provided by the veterinarian, rather than on the medical information that could be obtained or the benefits to the future health or function of the pet.

Occurrence of antimicrobial resistant bacteria in healthy dogs and cats presented to private veterinary hospitals in southern Ontario: A preliminary study.

The prevalence and patterns of antimicrobial susceptibility of fecal Escherichia coli, Salmonella spp., extended beta-lactamase producing E. coli (ESBL-E. coli), methicillin-resistant Staphylococcus aureus (MRSA), and methicillin-resistant Staphylococcus pseudintermedius (MRSP) were determined for healthy dogs (n = 188) and cats (n = 39) from veterinary hospitals in southern Ontario that had not had recent exposure to antimicrobials. The prevalence of antimicrobial resistance in E. coli was as follows: streptomycin (dogs - 17%, cats - 2%), ampicillin (dogs - 13%, cats - 4%), cephalothin (dogs - 13%, cats - < 1%), and tetracycline (dogs - 11%, cats - 2%). Eleven percent of dogs and 15% of cats had isolates that were resistant to at least 2 antimicrobials. Cephamycinase (CMY)-2 producing E. coli was cultured from 2 dogs. No Salmonella spp., ESBL-E. coli, MRSA, or MRSP isolates were recovered. The observed prevalence of resistance in commensal E. coli from this population was lower than that previously reported in companion animals, but a small percentage of dogs may be a reservoir for CMY-2 E. coli.

Comparison of veterinarian and standardized client perceptions of communication during euthanasia discussions.

OBJECTIVE: To describe client and veterinarian perceptions of client-centeredness during euthanasia discussions and assess agreement between measures of these perceptions. DESIGN: Descriptive study. SAMPLE: Stratified random sample of 32 companion animal veterinarians in southern Ontario. PROCEDURES: 2 case scenarios (a geriatric dog with worsening arthritis and a cat with inappropriate urination) designed to initiate euthanasia discussions were presented by 2 different undisclosed standardized clients (USCs) to study veterinarian communication during clinical visits. At the end of appointments, the USC's identity was disclosed, and questionnaires to measure veterinarian and client perceptions of client-centeredness were completed. Agreement was assessed by statistical methods. RESULTS: Data were analyzed from 60 appointments (30/scenario). Of 10 questions, significant agreement was found between veterinarians and USCs for only 1 (extent to which relevant personal and family issues were discussed; κ = 0.43) for the dog scenario and 3 (extent of discussion of respective roles [κ = 0.43], better preparedness of the USC to make a euthanasia decision [κ = 0.42], and discussion of relevant personal and family issues [κ = 0.25]) for the cat scenario. When the USC and veterinarian disagreed, the veterinarian perceived that the client-centeredness components were addressed more thoroughly than did the USC. CONCLUSIONS AND CLINICAL RELEVANCE: Lack of agreement was found between USC and veterinarian perceptions, with USCs perceiving less client-centeredness in euthanasia discussions. This communication gap suggested the need for training of veterinarians in eliciting client perspectives and assessing lifestyle-social information, including client social support systems.

Veterinary-care events and costs over a 5-year follow-up period for warmblooded riding horses with or without previously recorded locomotor problems in Sweden.

Our objective was to determine the amount, type and cost of veterinary care during a 5-year follow-up period, in Swedish warmblooded riding horses with and without locomotor problems as recorded in 1997. The study population comprised horses with complete insurance both for veterinary care and life during 1997. The horses were followed from the beginning of January 1998 to the end of December 2002. The exposed cohort was composed of 1558 horses that had experienced >or=1 veterinary-care event because of locomotor problems in 1997 (LP-cohort). The exposure-negative (LN) cohort was composed of 16,513 horses that had no recorded locomotor problem during 1997. For the outcome of locomotor problems during the follow-up period, stratified incidence proportions and a repeated-measures multivariable-logistic regression model in general produced the same conclusions. An interaction between year and cohort showed larger odds ratios (ORs) in the first year of follow-up compared to later (OR 4.8 and 1.2 in the LP- and LN-cohort, respectively), but a smaller difference during the subsequent years (in the 5th year OR 1.8 and 1.0, respectively). Horses with life-insurance values of >30,000 SEK in the LP- and LN-cohorts had ORs of 4.7 (99% CI 3.9, 5.6) and 2.6 (99% CI 2.3, 2.9), respectively. For life-insurance values of

A focus group study of veterinarians' and pet owners' perceptions of veterinarian-client communication in companion animal practice.

OBJECTIVE: To compare veterinarians' and pet owners' perceptions of client expectations with respect to veterinarian-client communication and to identify related barriers and challenges to communication. DESIGN: Qualitative study based on focus group interviews. PARTICIPANTS: 6 pet owner focus groups (32 owners) and 4 veterinarian focus groups (24 companion animal veterinarians). PROCEDURES: Independent focus group sessions were conducted with standardized open-ended questions and follow-up probes. Content analysis was performed on transcripts of the focus group discussions. RESULTS: Five themes related to veterinarian-client communication were identified: educating clients (ie, explaining important information, providing information up front, and providing information in various forms), providing choices (ie, providing pet owners with a range of options, being respectful of owners' decisions, and working in partnership with owners), using 2-way communication (ie, using language clients understand, listening to what clients have to say, and asking the right questions), breakdowns in communication that affected the client's experience (ie, owners feeling misinformed, that they had not been given all options, and that their concerns had not been heard), and challenges veterinarians encountered when communicating with clients (ie, monetary concerns, client misinformation, involvement of > 1 client, and time limitations). CONCLUSIONS: Results suggested that several factors are involved in providing effective veterinarian-client communication and that breakdowns in communication can have an adverse effect on the veterinarian-client relationship.

Veterinarian-client-patient communication during wellness appointments versus appointments related to a health problem in companion animal practice.

OBJECTIVE: To compare the clinical interview process, content of the medical dialog, and emotional tone of the veterinarian-client-patient interaction during wellness appointments and appointments related to a health problem in companion animal practice. DESIGN: Cross-sectional descriptive study. SAMPLE POPULATION: A random sample of 50 companion animal practitioners in southern Ontario and a convenience sample of 300 clients and their pets. PROCEDURE: For each practitioner, 6 clinical appointments (3 wellness appointments and 3 problem appointments) were videotaped. The Roter interaction analysis system was used to analyze the resulting 300 videotapes. RESULTS: Wellness appointments were characterized by a broad discussion of topics, with 50% of data-gathering statements and 27% of client education statements related to the pet's lifestyle activities and social interactions. Wellness appointments included twice as much verbal interaction with the pet as did problem appointments, and the emotional atmosphere of wellness appointments was generally relaxed. There were more social talk, laughter, statements of reassurance, and compliments directed toward the client and pet. In contrast, during problem appointments, 90% of the data gathering and client education focused on biomedical topics. Coders rated veterinarians as hurried during 30 of the 150 (20%) problem appointments; they rated clients as anxious during 39 (26%) problem appointments and as emotionally distressed during 21 (14%). CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that veterinarian-client-patient communication differed between wellness and problem appointments. Owing to the emphasis on biomedical content during problem appointments, veterinarians may neglect lifestyle and social concerns that could impact patient management and outcomes, such as client satisfaction and adherence to veterinarian recommendations.

Validation of computerized Swedish horse insurance data against veterinary clinical records.

The aim was to evaluate the agreement between computerized insurance data in a large Swedish horse insurance database and the information in the corresponding clinical records (CR). A random sample of 400 veterinary care and 140 life claims was included. Information on name of the horse, breed and gender, year of birth, specific diagnosis and system diagnosis (e.g. joints, digestive and skeletal) was compared between sources. The concordance for demographic variables was categorized as agreement, disagreement or data missing. For diagnostic information, the categories were agreement, minor disagreement and major disagreement and for system information agreement or disagreement. There were missing values for demographic information in the CR, varying from 2% for name to 16% for breed. The overall agreement for demographic information was >94% (disregarding missing data), 92% for system and 84% for specific diagnosis. For veterinary care and life claims, the observed agreement for diagnosis was 85 and 83%, minor disagreement 6 and 5%, and major disagreement 9 and 12%, respectively. Using the CR data as gold standard, for the systems evaluated (joints, digestive, skeletal, skin and hooves), sensitivity varied between 62% (skin) and 89% (digestive) whereas the specificity was >96% for all systems. The positive predictive values ranged from 86% (skin) to 97% (digestive). Logistic regression analysis was used to examine factors associated with agreement for diagnosis. Analyses were performed separately for veterinary care and life claims. Factors examined were type of visit (clinic/field), treating veterinarian/clinic (categorized as district veterinarians, private practitioners, small clinics, medium clinics and, for the clinics with > or =20 claims, the specific clinics), computerized or manual CR, processing clerk, whether the CR was included in the paper file, if the claim was rejected or reimbursed, system diagnosis and if a immediate settlement (in analysis for veterinary care claims) or death certificate (in analysis for life claims) was included in the paper file. For veterinary care claims, in the logistic regression model type of visit was significantly associated with agreement, with clinic visits generating better agreement than field visits.

A focus group study of veterinarians' and pet owners' perceptions of the monetary aspects of veterinary care.

OBJECTIVE: To compare veterinarians' and pet owners' perceptions of client expectations with respect to the monetary aspects of veterinary care and identify challenges encountered by veterinarians in dealing with pet owners' expectations. DESIGN: Qualitative study based on focus group interviews. PARTICIPANTS: 6 pet owner focus groups (32 owners) and 4 veterinarian focus groups (24 companion animal veterinarians). PROCEDURES: Independent focus group sessions were conducted with standardized open-ended questions and follow-up probes. Content analysis was performed on the focus group discussions. RESULTS: Pet owners expected the care of their animal to take precedence over monetary aspects. They also expected veterinarians to initiate discussions of costs upfront but indicated that such discussions were uncommon. Veterinarians and pet owners differed in the way they related to discussions of veterinary costs. Veterinarians focused on tangibles, such as time and services. Pet owners focused on outcome as it related to their pet's health and well-being. Veterinarians reported that they sometimes felt undervalued for their efforts. A suspicion regarding the motivation behind veterinarians' recommendations surfaced among some participating pet owners. CONCLUSIONS: Results suggested that the monetary aspects of veterinary care pose barriers and challenges for veterinarians and pet owners. By exploring clients' expectations, improving communication, educating clients, and making discussions of cost more common, veterinarians may be able to alleviate some of the monetary challenges involved in veterinarian-client-patient interactions.

Moving from information and collaboration to action: report from the 3rd International Dog Health Workshop, Paris in April 2017.

BACKGROUND: Breed-related health problems in dogs have received increased focus over the last decade. Responsibility for causing and/or solving these problems has been variously directed towards dog breeders and kennel clubs, the veterinary profession, welfare scientists, owners, regulators, insurance companies and the media. In reality, all these stakeholders are likely to share some responsibility and optimal progress on resolving these challenges requires all key stakeholders to work together. The International Partnership for Dogs (IPFD), together with an alternating host organization, holds biennial meetings called the International Dog Health Workshops (IDHW). The Société Centrale Canine (French Kennel Club) hosted the 3rd IDHW, in Paris, in April, 2017. These meetings bring together a wide range of stakeholders in dog health, science and welfare to improve international sharing of information and resources, to provide a forum for ongoing collaboration, and to identify specific needs and actions to improve health, well-being and welfare in dogs. RESULTS: The workshop included 140 participants from 23 countries and was structured around six important issues facing those who work to improve dog health. These included individualized breed-specific strategies for health and breeding, extreme conformations, education and communication in relation to antimicrobial resistance, behavior and welfare, genetic testing and population-based evidence. A number of exciting actions were agreed during the meeting. These included setting up working groups to create tools to help breed clubs accelerate the implementation of breed-health strategies, review aspects of extreme conformation and share useful information on behavior. The meeting also heralded the development of an online resource of relevant information describing quality measures for DNA testing. A demand for more and better data and evidence was a recurring message stressed across all themes. CONCLUSIONS: The meeting confirmed the benefits from inclusion of a diverse range of stakeholders who all play relevant and collaborative parts to improve future canine health. Firm actions were set for progress towards improving breed-related welfare. The next international workshop will be in the UK in 2019 and will be organized by the UK Kennel Club.

Association between costly veterinary-care events and 5-year survival of Swedish insured warmblooded riding horses.

Our objective was to estimate the 5-year survival to death in insured warmblooded riding horses (as reflected by a life-insurance claim) in horses with or without at least one costly veterinary-care event (VCE) in 1997. We also determined the impacts of gender, age, previous diagnosis of veterinary claim, geographic variables, cost for veterinary claims and life-insurance value upon the survival. The design was a retrospective cohort study using a population of warmblooded riding horses insured in a Swedish animal-insurance company (Agria Insurance, P.O. 70306, SE-107 23 Stockholm, Sweden) in 1997. All horses in this population had insurance both for veterinary-care and life ("complete" insurance reimbursing the insurance holder for most medical problems). We followed two cohorts (2,495 horses with > or = 1 VCE and 15,576 horses with no VCE in year 1997). The median VCE cost in horses with > or =1 VCE was 3,800 SEK, with 10th and 90th percentiles of 1,400 and 11,400 SEK respectively. In total 944 of the 2,495 horses (38%) in the VCE-positive cohort and 2,962 of the 15,576 horses (19%) in the VCE-negative cohort had died (had a settled life-insurance claim) after the follow-up time. An exponential-regression model showed that geldings had a higher risk of claimed death compared to mares and mares had a higher risk compared to stallions. The risk of death increased linearly with age. The risk of death increased with increasing life-insurance value. Horses with previous lameness had the lowest survival, and for high-cost claims this increased risk was not associated with age.

Heart disease as a cause of death in insured Swedish dogs younger than 10 years of age.

BACKGROUND: Population-based information on disease occurrence is paramount in clinical decision making and in designing preventative measures, but such information is scarce. HYPOTHESIS: The risk of cardiac death is higher in certain breeds and mortality varies by age and sex. DOGS: Dogs that were life insured by an animal insurance company between 1995 and 2002. METHODS: The mortality pattern for heart disease in insured dogs up to 10 years of age was studied. The influences of sex, age, breed, month, and geographic location were investigated by means of incidence rates, proportions, and survival proportions. Cox proportional hazards regression was used to model time to heart disease. RESULTS: 405,376 dogs contributed to a denominator of 1,431,933 dog-years at risk (DYAR) and 3,049 dogs had been assigned a cardiac-related diagnosis as cause of death. The cardiac-related mortality for dogs <10 years of age, was 21.3 deaths per 10,000 DYAR. This mortality in males and females was 27.3 deaths and 15.4 deaths per 10,000 DYAR, respectively. Twelve of 54 breeds had a point estimate above the overall rate. The 3 breeds with the highest point estimates were: Irish Wolfhounds, Cavalier King Charles Spaniels, and Great Danes (rates of 356, 247, and 179 deaths per 10,000 DYAR, respectively). CONCLUSIONS AND CLINICAL IMPORTANCE: Breed, age, and sex affect cardiac mortality in certain breeds of dogs, but no effects of month and geographic location were identified. These findings can assist clinicians in establishing diagnoses, and can assist breeders in defining priorities for preventative measures.

Veterinarian-client-patient communication patterns used during clinical appointments in companion animal practice.

OBJECTIVE: To identify communication patterns used by veterinarians during clinical appointments in companion animal practice. DESIGN: Cross-sectional descriptive study. SAMPLE POPULATION: A random sample of 50 companion animal practitioners in southern Ontario and a convenience sample of 300 clients and their pets. PROCEDURE: For each practitioner, 6 clinical appointments (3 wellness appointments and 3 appointments related to a health problem) were videotaped. The Roter interaction analysis system was used to analyze the resulting 300 videotapes, and cluster analysis was used to identify veterinarian communication patterns. RESULTS: 175 (58%) appointments were classified as having a biomedical communication pattern, and 125 (42%) were classified as having a biolifestyle-social communication pattern. None were classified as having a consumerist communication pattern. Twentythree (46%) veterinarians were classified as using a predominantly biomedical communication pattern, 19 (38%) were classified as using a mixed communication pattern, and 8 (16%) were classified as using a predominantly biolifestyle-social communication pattern. Pattern use was related to the type of appointment. Overall, 103 (69%) wellness appointments were classified as biolifestyle-social and 127 (85%) problem appointments were classified as biomedical. Appointments with a biomedical communication pattern (mean, 11.98 minutes) were significantly longer than appointments with a biolifestyle-social communication pattern (10.43 minutes). Median relationship-centered care score (ie, the ratio of client-centered talk to veterinarian-centered talk) was significantly higher during appointments with a biolifestyle-social communication pattern (1.10) than during appointments with a biomedical communication pattern (0.40). CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that veterinarians in companion animal practice use 2 distinct patterns of communication. Communication pattern was associated with duration of visit, type of appointment, and relationship-centeredness. Recognition of these communication patterns has implications for veterinary training and client and patient outcomes.

Incidence of and survival after mammary tumors in a population of over 80,000 insured female dogs in Sweden from 1995 to 2002.

The main objective of this study was to describe the incidence of mammary tumors (MTs) and the survival after MTs, in female dogs between 3 and 10 years of age (insured for veterinary care and with life insurance in a Swedish animal-insurance company) from 1995 to 2002. Measures of incidence are presented crudely, by breed and across age categories and birth cohorts (1991-1998). The survivals until MT diagnosis and after a MT diagnosis were computed. The overall incidence for any MT claim was 111 dogs per 10,000 dog-years at risk (DYAR). The overall MT rate in the 1992 and 1993 birth cohorts was 154 dogs per 10,000 DYAR. The incidence for any MT claim increased with age and varied by breed, from 319 dogs per 10,000 DYAR in the English springer spaniel to 5 dogs per 10,000 DYAR in the rough-haired collie. At the ages 6, 8 and 10 years, 1%, 6% and 13% respectively, of all females had at least one MT claim. The MT mortality was 6 deaths per 10,000 DYAR and increased with age. The overall-case fatality was 6%.

Validation of a Neospora caninum iscom ELISA without a gold standard.

Neospora caninum is an intracellular parasite which causes abortion in cattle worldwide. One problem in the validation of the different methods for demonstration of this parasite is the lack of an appropriate gold standard. To validate an immunostimulating complex (iscom) enzyme-linked immunoassay (ELISA) used to detect antibodies to N. caninum, sera from 244 cattle in five Swedish dairy herds infected with N. caninum were analysed. The sera also were analysed by a standard indirect-fluorescent antibody test (IFAT). The results obtained by the two tests were compared using the Gibbs sampler. Gibbs sampling is a latent-class approach based on Bayesian statistics; neither test is assumed to be more correct in stating the true status of infection. The Gibbs sampler was run using both informative and non-informative prior probabilities. We also simulated different cut-offs in the iscom ELISA (providing data to inform selection of optimal cut-off values for different applications). The ELISA produced fewest incorrect test results over all at a cut-off value of 0.200. The sensitivity and specificity at this cut-off were 99 and 96%, respectively. The IFAT had a high specificity (99%) but a lower sensitivity (78%) than expected-confirming that the IFAT cannot be treated as a true gold standard. Sensitivity and specificity of the ELISA were presented in a two-graph receiver operating characteristic (TG-ROC) plot. Any cut-off between 0.150 and 0.300 will have both sensitivity and specificity > or =95%. Optical densities of < or =0.150 and > or =0.550 (or > or =0.350) were suggested as limits to rule out and rule in infection, respectively.