RESUMO
Breed specific paroxysmal dyskinesias are increasingly recognised in veterinary medicine. We aimed to characterise the phenomenology, clinical course and prevalence of a previously unreported paroxysmal dyskinesia in the Welsh terrier breed. Clinical records of five Welsh terriers with paroxysmal episodes were reviewed. Additionally, owners of Welsh terriers were invited to complete a questionnaire with the aim of characterising paroxysmal episodes in the wider breed population. Clinical examinations (n = 5) and diagnostic investigations (n = 3) of affected Welsh terriers were within normal limits, apart from mild-moderate ventriculomegaly on cranial magnetic resonance imaging (n = 3). The survey of Welsh terrier owners revealed episodes consistent with a paroxysmal dyskinesia in 41 (22.8%) of 177 respondents. Median age of onset was 59 months. Episodes were predominantly characterised by sustained hypertonicity with periods of limb flexion, abnormal head and body posture, with preserved consciousness. Episode duration ranged from 30 s to 30 min (median, 3 min 30 s), with frequency varying widely between dogs. Affected dogs demonstrated a stable to improving clinical course in most cases. This study investigated a previously unreported paroxysmal dyskinesia in Welsh terriers. Similar clinical signs within the breed were potentially consistent with an inherited cause, worthy of further investigation.
Assuntos
Coreia , Doenças do Cão , Animais , Coreia/genética , Coreia/veterinária , Doenças do Cão/diagnóstico , CãesRESUMO
The aetiology of canine idiopathic vestibular syndrome (IVS) remains unclear. In human medicine, characteristic magnetic resonance imaging (MRI) techniques are used to demonstrate differences in endolymph composition between affected and unaffected inner ears. The purpose of this study was to determine whether similar MRI techniques could help to detect changes in the inner ears of canine IVS patients. Medical records from two veterinary referral clinics were reviewed retrospectively. Dogs were included if they had a diagnosis of IVS, obvious lateralisation of clinical signs, and an MRI of the vestibular system. A region of interest (ROI) was manually outlined by defining the anatomical area of the inner ear in T2-weighted and fluid-attenuated inversion recovery (FLAIR) images. In order to calculate the ratio of FLAIR suppression of each ear, the mean grey value of the ROI was determined in both sequences. If a unilateral decrease in suppression was identified, it was compared with the direction of clinical signs. In total, 80 dogs were included in the study. There was a significantly lower degree of suppression on the affected compared to the unaffected side (0.8886 vs. 0.9348, respectively; P = 0.0021). In 92.5% of cases, there was agreement between the most suppressed side on MRI and the direction of clinical signs. This study provides preliminary evidence about the appearance of endolymph on MRI of dogs with IVS. Further studies are needed to investigate associations between the severity of MRI changes and prognosis.
Assuntos
Doenças do Cão/terapia , Orelha Interna , Sistema Vestibular , Animais , Cães , Orelha Interna/diagnóstico por imagem , Imageamento por Ressonância Magnética/veterinária , Prognóstico , Estudos RetrospectivosRESUMO
BACKGROUND: Vestibular syndrome is often accompanied by nausea. Drugs currently approved for its treatment have been developed to stop vomiting but not nausea. The efficacy of 5-HT3 receptor antagonists to reduce nausea has been described for chemotherapy, but not for nausea secondary to vestibular disorders. METHODS: Sixteen dogs with vestibular syndrome-associated nausea were included in the open-label, multicentre study. The intensity of nausea-like behaviour was analysed before ondansetron administration (0.5 mg/kg i.v.) and 2 h afterwards, using a validated 5-point-scale. The occurrence and frequency of salivation, lip licking, restlessness, vocalisation, lethargy, and vomiting were assessed. RESULTS: All dogs initially showed signs of nausea, whereas only 31% showed vomitus. The intensity of nausea was significantly reduced in all dogs (p ≤ 0.0001) 2 h after ondansetron administration, including the clinical signs of nausea analysed in 11 dogs (salivation [p = 0.0078], lip licking [p = 0.0078], restlessness [p = 0.0039], and lethargy [p = 0.0078]) except for vocalisation (p > 0.9999). CONCLUSIONS: The results provide preliminary evidence of the potential benefit of ondansetron in the treatment of nausea, which was present in all examined dogs. Vomiting was only observed in 5 dogs indicating that nausea can occur separately and should not be perceived only as a preceding stimulation of the vomiting centre.
Assuntos
Náusea/veterinária , Ondansetron/uso terapêutico , Doenças Vestibulares/veterinária , Administração Intravenosa/veterinária , Animais , Antieméticos/administração & dosagem , Antieméticos/uso terapêutico , Cães , Náusea/tratamento farmacológico , Ondansetron/administração & dosagem , Doenças Vestibulares/tratamento farmacológico , Vômito/tratamento farmacológico , Vômito/veterináriaRESUMO
There are sparse published scientific data on associations between neutering and the severity and survival of dogs with idiopathic epilepsy. This study aimed to explore the timing of neutering with respect to onset of seizures in dogs with idiopathic epilepsy. Associations between neutering and both age of onset of seizures and the occurrence of cluster seizures or status epilepticus were examined. Survival analysis investigated the effects of sex-neuter categories. The median survival time of Border collies was compared with data previously reported in literature. The study included veterinary primary-care clinical data on 117 Labrador retrievers and 57 Border collies diagnosed with idiopathic epilepsy from the VetCompass project in the UK. The majority (74.2%; P≤0.001) of neutered cases were neutered before the onset of seizures. Age (years) at onset of seizures did not differ between dogs intact at time of onset and dogs neutered before onset of seizures (males 3.6 vs. 3.7; P=0.468 and females 3.4 vs. 4.1; P=0.154). Neuter status was not associated with the occurrence of cluster seizures (males P=0.947 and females P=0.844). Dogs intact at onset of seizures had longer median survival times than dogs neutered before onset of seizures (males, 1436 days vs. 1234 days; P=0.019; females, 1778.5 days vs. 1261 days; P=0.027). Median survival time of 1393 days for Border collies was longer than previously reported (P≤0.001). These results do not support recommendations to neuter dogs with idiopathic epilepsy within an evidence-based treatment plan.
Assuntos
Doenças do Cão/epidemiologia , Epilepsia/veterinária , Esterilização Reprodutiva/veterinária , Animais , Estudos de Coortes , Doenças do Cão/etiologia , Doenças do Cão/mortalidade , Cães , Epilepsia/epidemiologia , Feminino , Masculino , Linhagem , Atenção Primária à Saúde , Estudos Retrospectivos , Fatores de Risco , Esterilização Reprodutiva/efeitos adversos , Análise de Sobrevida , Reino Unido/epidemiologia , Medicina VeterináriaRESUMO
Pregabalin is the first-line treatment for neuropathic pain (NeP) in humans. Dogs with Chiari-like malformation and syringomyelia (CM/SM) associated with NeP could benefit from pregabalin. The aim of this study was to evaluate the efficacy of pregabalin for NeP in dogs with CM/SM. Eight dogs with symptomatic CM/SM were included in a double-masked, randomised, crossover placebo-controlled clinical trial. All dogs received anti-inflammatory drugs as base-line treatment during placebo or pregabalin phase of 14±4 days each. Analgesic efficacy was assessed with a daily numerical rating scale (NRS) recorded by dog owners (0-10, 10=worst pain) and quantitative sensory testing at baseline, placebo and pregabalin phases. Blood samples were collected to report pregabalin exposure and to assess renal function. Daily NRS scores recorded by dog owners in the pregabalin group were lower than in the placebo group (P=0.006). Mechanical thresholds were higher with pregabalin compared to baseline or placebo (P=0.037, P<0.001). Cold latency at 15°C was prolonged on the neck and humeri with pregabalin compared to baseline (P<0.001 for both) or placebo (P=0.02, P=0.0001). Cold latency at 0°C was longer on pregabalin compared to baseline and placebo (P=0.001, P=0.004). There was no pregabalin accumulation between first and last dose. This study demonstrates the efficacy of pregabalin for the treatment of NeP due to CM/SM on daily pain scores recorded by dog owners. Pregabalin significantly reduced mechanical hyperalgesia, cold hyperalgesia (0°C) and allodynia (15°C) compared to placebo. Pregabalin was non-cumulative and well tolerated with occasional mild sedation.
Assuntos
Analgésicos/uso terapêutico , Doenças do Cão/tratamento farmacológico , Neuralgia/veterinária , Pregabalina/uso terapêutico , Siringomielia/veterinária , Animais , Malformação de Arnold-Chiari/tratamento farmacológico , Malformação de Arnold-Chiari/veterinária , Estudos Cross-Over , Cães , Método Duplo-Cego , Feminino , Hiperalgesia , Masculino , Neuralgia/tratamento farmacológico , Medição da Dor , Siringomielia/tratamento farmacológicoRESUMO
Canine spinal arachnoid diverticulae (SAD) are characterised by focal cerebrospinal fluid dilatations within the subarachnoid space, most commonly associated with nonpainful paresis and ataxia secondary to chronic compressive myelopathy. Numerous imaging techniques have been described for diagnosis of this condition, including myelography, computed tomography myelography, and magnetic resonance imaging (MRI). The present retrospective study investigated the utility of cine balanced fast field echo (cine bFFE) MRI sequences in measuring pulsatile flow in 12 dogs with SAD. The secondary aim was to determine the prevalence and location of syringes in relation to SAD, as the co-occurrence of these conditions has not been previously reported. The degree of SAD pulsation was calculated as the change in area per cardiac cycle on sagittal (n = 12/12) and transverse (n = 7/12) cardiac-gated cine bFFE MRI sequences. Pulsation was identified on all sequences, with a median ratio of change in SAD area of 0.14 (range, 0.10-0.27; n = 12) on sagittal cine bFFE and 0.23 (range, 0.05-0.53; n = 7) on transverse cine bFFE sequences. Significant differences between minimum and maximum SAD dimensions were identified on sagittal (P = 0.002) and transverse measurements (P = 0.018). A moderate prevalence of syringomyelia was identified (n = 6/12; 50%) on T2W sequences, occurring both cranial (n = 4/12; 33%) and caudal (n = 2/12; 17%) to the SAD. These results support the ability of cine bFFE sequences to identify dynamic pulsation of canine SAD. This technique is currently limited by banding artifacts and its inability to quantify flow velocity and abnormal flow jets.
Assuntos
Malformação de Arnold-Chiari/veterinária , Doenças do Cão/diagnóstico por imagem , Compressão da Medula Espinal/veterinária , Siringomielia/veterinária , Animais , Malformação de Arnold-Chiari/diagnóstico por imagem , Doenças do Cão/líquido cefalorraquidiano , Cães , Feminino , Imagem Cinética por Ressonância Magnética/veterinária , Masculino , Linhagem , Compressão da Medula Espinal/diagnóstico por imagem , Espaço Subaracnóideo/diagnóstico por imagem , Siringomielia/diagnóstico por imagemRESUMO
CASE HISTORY Thirteen cats developed ophthalmic complications following dental procedures in Australia and New Zealand between December 2014 and February 2018. All cats had at least one maxillary tooth extracted and some received a transoral maxillary nerve block. CLINICAL FINDINGS Ocular signs were identified at a median of 1.5 (min 0, max 14) days following elective dental procedures and included fibrin in the anterior chamber, aqueous flare, vision loss and miosis. Response to medical management was poor overall, with 7/13 (54%) cats undergoing subsequent enucleation and one cat was subjected to euthanasia shortly after the dental procedure due to ocular disease. The remaining five cats were managed medically. Of these, four exhibited signs of persistent inflammation at the last ophthalmic assessment, and one was subsequently subjected to euthanasia due to reasons unrelated to ocular health. Active inflammation resolved in one cat, however the lesions caused by previous inflammation persisted. PATHOLOGICAL FINDINGS Assessment of six enucleated globes showed a variety of pathological changes, with marked fibrinous exudation and suppurative inflammation as predominant features. A scleral penetration site was identified in three globes. Four globes had lens capsule rupture and phacoclastic uveitis. DIAGNOSIS Endophthalmitis following iatrogenic globe penetration during routine dental procedures. CLINICAL RELEVANCE This case series demonstrates that globe penetration during dental procedures carries a poor prognosis for the eye. Clinicians should be aware of the risks of ocular trauma during dental procedures in cats and great care should be taken to avoid ocular penetration, particularly during tooth extractions. Transoral maxillary nerve blocks should be avoided or used with extreme caution in cats.
Assuntos
Doenças do Gato/etiologia , Endoftalmite/veterinária , Enucleação Ocular/veterinária , Ferimentos Oculares Penetrantes/veterinária , Bloqueio Nervoso/veterinária , Extração Dentária/veterinária , Animais , Austrália , Gatos , Odontologia/métodos , Odontologia/veterinária , Endoftalmite/complicações , Eutanásia Animal , Oftalmopatias/complicações , Oftalmopatias/veterinária , Enucleação Ocular/efeitos adversos , Ferimentos Oculares Penetrantes/complicações , Ferimentos Oculares Penetrantes/etiologia , Feminino , Masculino , Bloqueio Nervoso/efeitos adversos , Nova Zelândia , Extração Dentária/efeitos adversos , Extração Dentária/métodosRESUMO
Psychiatric comorbidities affect a large percentage of people with epilepsy and have a detrimental impact on their quality of life. Recently, behavioural comorbidities, with similar characteristics to human psychiatric diseases, have been identified in dogs with idiopathic epilepsy. In particular, behaviours motivated by the fear-anxiety emotional system have been found to be associated with the occurrence of idiopathic epilepsy in both dogs receiving anti-epileptic drugs, and drug-naïve dogs. There has been little research into the relationship between epilepsy and behavioural signs, and even less into potential treatment protocols. The following article will review available literature from human medicine to describe the current state of knowledge about the bi-directional relationship between anxiety and epilepsy, draw parallels from reported anxiogenic and anxiolytic properties of anti-epileptic drugs and attempt to provide pharmaceutical and behavioural guidance for veterinary patients with epilepsy and comorbid anxiety.
Assuntos
Ansiedade , Doenças do Cão/terapia , Cães/psicologia , Epilepsia/veterinária , Animais , Ansiolíticos/uso terapêutico , Anticonvulsivantes/uso terapêutico , Terapia Cognitivo-Comportamental , Comorbidade , Epilepsia/tratamento farmacológico , Qualidade de VidaRESUMO
BACKGROUND: Intranasal administration of benzodiazepines has shown superiority over rectal administration for terminating emergency epileptic seizures in human trials. No such clinical trials have been performed in dogs. OBJECTIVE: To evaluate the clinical efficacy of intranasal midazolam (IN-MDZ), via a mucosal atomization device, as a first-line management option for canine status epilepticus and compare it to rectal administration of diazepam (R-DZP) for controlling status epilepticus before intravenous access is available. ANIMALS: Client-owned dogs with idiopathic or structural epilepsy manifesting status epilepticus within a hospital environment were used. Dogs were randomly allocated to treatment with IN-MDZ (n = 20) or R-DZP (n = 15). METHODS: Randomized parallel-group clinical trial. Seizure cessation time and adverse effects were recorded. For each dog, treatment was considered successful if the seizure ceased within 5 minutes and did not recur within 10 minutes after administration. The 95% confidence interval was used to detect the true population of dogs that were successfully treated. The Fisher's 2-tailed exact test was used to compare the 2 groups, and the results were considered statistically significant if P < .05. RESULTS: IN-MDZ and R-DZP terminated status epilepticus in 70% (14/20) and 20% (3/15) of cases, respectively (P = .0059). All dogs showed sedation and ataxia. CONCLUSIONS AND CLINICAL IMPORTANCE: IN-MDZ is a quick, safe and effective first-line medication for controlling status epilepticus in dogs and appears superior to R-DZP. IN-MDZ might be a valuable treatment option when intravenous access is not available and for treatment of status epilepticus in dogs at home.
Assuntos
Anticonvulsivantes/uso terapêutico , Diazepam/uso terapêutico , Doenças do Cão/tratamento farmacológico , Midazolam/uso terapêutico , Estado Epiléptico/veterinária , Administração Intranasal/veterinária , Administração Retal , Animais , Anticonvulsivantes/administração & dosagem , Anticonvulsivantes/efeitos adversos , Diazepam/administração & dosagem , Diazepam/efeitos adversos , Cães , Feminino , Masculino , Midazolam/administração & dosagem , Midazolam/efeitos adversos , Estado Epiléptico/tratamento farmacológicoRESUMO
There is a complex bidirectional relationship between stress and epilepsy. Stressful stimuli and subsequent cortisol release act as a trigger for seizure activity in some individuals with epilepsy, and seizure activity itself may act as a stressor to the affected individual. Epilepsy is the most common chronic neurological condition in domestic dogs and requires chronic management by their human carers, impacting upon the quality of life of both dog and carer. Seizures occur unpredictably and may be stressful for carers to witness and manage. In the present study we investigated the role of seizure activity as a stressor, measuring the effect of spontaneously occurring seizure activity in dogs with epilepsy upon their own cortisol levels and that of their carers. Furthermore, we tested whether individual differences in HPA reactivity were associated with owner personality characteristics and the quality of the dog-carer relationship. Saliva samples were obtained from sixteen dog-carer dyads in the home setting 20 and 40minute post-seizure, and at time-matched points on the following (non-seizure) day. Significant differences in cortisol levels were found in dogs at 40minute post-seizure (265.1% increase), and at 20minute post-seizure in their carers (40.5% increase). No associations were found between cortisol reactivity and the strength of the dog-carer bond. Carers with higher neuroticism scores exhibited higher cortisol levels at both post-seizure sampling points. As there was a gender bias in the carer sample (15/16 were female), and there are known sex differences in cortisol reactivity in response to psychological stress, the conclusions of this study may be limited to female carers. These findings are the first to objectively demonstrate the acutely stressful effects of seizures in dogs with epilepsy and their carers.
Assuntos
Cuidadores , Doenças do Cão/fisiopatologia , Vínculo Humano-Animal , Convulsões/veterinária , Estresse Psicológico/fisiopatologia , Animais , Cuidadores/psicologia , Cães , Feminino , Humanos , Hidrocortisona/análise , Masculino , Pessoa de Meia-Idade , Neuroticismo/fisiologia , Saliva/química , Convulsões/fisiopatologia , Convulsões/psicologia , Fatores Sexuais , Estresse Psicológico/etiologia , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Little is reported about the role of medical management in the treatment of spinal arachnoid diverticula (SAD) in dogs. OBJECTIVES: To describe the outcome of 96 dogs treated medically or surgically for SAD. ANIMALS: Ninety-six dogs with SAD. METHODS: Retrospective case series. Medical records were searched for spinal arachnoid diverticula and all dogs with information on treatment were included. Outcome was assessed with a standardized questionnaire. RESULTS: Fifty dogs were managed medically and 46 dogs were treated surgically. Dogs that underwent surgery were significantly younger than dogs that received medical management. No other variables, related to clinical presentation, were significantly different between both groups of dogs. The median follow-up time was 16 months (1-90 months) in the medically treated and 23 months (1-94 months) in the surgically treated group. Of the 38 dogs treated surgically with available long-term follow-up, 82% (n = 31) improved, 3% (n = 1) remained stable and 16% (n = 6) deteriorated after surgery. Of the 37 dogs treated medically with available long-term follow-up, 30% (n = 11) improved, 30% (n = 11) remained stable, and 40% (n = 15) deteriorated. Surgical treatment was more often associated with clinical improvement compared to medical management (P = .0002). CONCLUSIONS AND CLINICAL IMPORTANCE: The results of this study suggest that surgical treatment might be superior to medical treatment in the management of SAD in dogs. Further studies with standardized patient care are warranted.
Assuntos
Cistos Aracnóideos/veterinária , Doenças do Cão/cirurgia , Aminas/uso terapêutico , Animais , Cistos Aracnóideos/tratamento farmacológico , Cistos Aracnóideos/cirurgia , Carbazóis/uso terapêutico , Ácidos Cicloexanocarboxílicos/uso terapêutico , Doenças do Cão/tratamento farmacológico , Cães , Feminino , Gabapentina , Masculino , Prednisona/uso terapêutico , Estudos Retrospectivos , Inquéritos e Questionários , Resultado do Tratamento , Ácido gama-Aminobutírico/uso terapêuticoRESUMO
BACKGROUND: Outcome of acute experimental spinal cord injury is strongly associated with tissue perfusion and oxygenation. Cardiopulmonary depression could affect outcome in dogs undergoing general anesthesia for surgical treatment of thoracolumbar intervertebral disk extrusion (IVDE). HYPOTHESIS/OBJECTIVES: To evaluate the effects of general anesthesia on functional outcome in dogs undergoing surgery to treat thoracolumbar IVDE. ANIMALS: Eighty-four client-owned dogs with acute thoracolumbar IVDE treated by decompressive hemilaminectomy. METHODS: Exploratory, retrospective observational study. Medical records were reviewed for clinical presentation and anesthetic monitoring variables, including duration of anesthesia and surgery, hypotension, bradycardia, temperature, and respiratory parameters. Multivariable regression tree analysis was performed to explore associations between anesthetic variables and functional outcome scores after 6 weeks, as well as return to ambulatory status. RESULTS: Episodes of bradycardia (69%) and hypotension (57%) were frequent. Across all outcome measures, regression tree analysis highlighted functional grade at presentation as the primary determining factor, and among pain perception negative dogs, there was a possible association between increased duration of surgery and poorer outcome. In dogs with intact pain perception, duration of bradycardia, mean body temperature, and mean end-tidal carbon dioxide were highlighted. CONCLUSIONS AND CLINICAL IMPORTANCE: Exploratory statistical methods can facilitate hypothesis-generating studies to inform prospective investigations in veterinary medicine. Although the mechanism is uncertain, increased duration of surgery might be associated with poorer outcome in pain perception negative dogs with thoracolumbar IVDE.
Assuntos
Anestesia Geral/veterinária , Descompressão Cirúrgica/veterinária , Doenças do Cão/cirurgia , Deslocamento do Disco Intervertebral/veterinária , Laminectomia/veterinária , Anestesia Geral/efeitos adversos , Anestesia Geral/métodos , Animais , Bradicardia/induzido quimicamente , Bradicardia/veterinária , Descompressão Cirúrgica/métodos , Cães , Feminino , Hipotensão/induzido quimicamente , Hipotensão/veterinária , Deslocamento do Disco Intervertebral/cirurgia , Laminectomia/métodos , Masculino , Estudos Retrospectivos , Vértebras Torácicas/cirurgia , Resultado do TratamentoRESUMO
OBJECTIVES: To summarise clinical presentation, diagnostic findings and long-term outcome for dogs clinically diagnosed with meningoencephalomyelitis of unknown origin affecting the spinal cord alone. METHODS: Medical records were reviewed for dogs diagnosed with presumptive spinal-only meningoencephalomyelitis of unknown origin between 2006 and 2015. RESULTS: 21 dogs were included; the majority presented with an acute (43%) or chronic (52%) onset of neurological signs. Ambulatory paresis was the most common neurological presentation (67%). Neurological examination most commonly revealed a T3-L3 myelopathy, and spinal hyperaesthesia was a common finding (71%). A spinal cord lesion was visible in 90% of cases on magnetic resonance imaging. Eighteen lesions (86%) showed parenchymal contrast enhancement and 17 lesions (81%) showed contrast enhancement of overlying meninges. All dogs were treated with immunosuppressive doses of glucocorticosteroids, sometimes combined with cytosine arabinoside. At time of data capture, 10/21 dogs (48%) had died or been euthanased because of the condition. Overall median survival time was 669 days. CLINICAL SIGNIFICANCE: Meningoencephalomyelitis of unknown origin should be considered in the differential diagnosis of dogs presenting with a progressive myelopathy. Magnetic resonance imaging features can possibly help to distinguish presumptive meningoencephalomyelitis of unknown origin from other more common spinal diseases. Overall, long-term survival is guarded, approximately 50% of dogs will die or be euthanased despite appropriate therapy.
Assuntos
Doenças do Cão/diagnóstico , Encefalomielite/veterinária , Meningoencefalite/veterinária , Doenças da Medula Espinal/veterinária , Medula Espinal/diagnóstico por imagem , Animais , Citarabina/uso terapêutico , Doenças do Cão/tratamento farmacológico , Cães , Encefalomielite/diagnóstico , Encefalomielite/tratamento farmacológico , Feminino , Glucocorticoides/uso terapêutico , Imunossupressores/uso terapêutico , Imageamento por Ressonância Magnética/veterinária , Masculino , Meningoencefalite/diagnóstico , Meningoencefalite/tratamento farmacológico , Estudos Retrospectivos , Resultado do TratamentoRESUMO
This retrospective questionnaire study evaluates the perceptions of veterinary clients of the informed consent process and the consent form in a veterinary referral hospital. Replicating a validated perception survey from human medicine, 470 clients at the Queen Mother Hospital for Animals were surveyed on their perceptions during the consenting process through postal survey examining their understanding, experience and recall of informed consent. Of the 165 responses (35 per cent response rate), the majority of clients recalled the process and signing the form; however, half of the clients did not feel in control (51 per cent) or reassured (53 per cent) by the process. There was limited understanding of the purpose of consent, with 45 per cent thinking it removed their right to compensation for negligence and 31 per cent thought the veterinarian could do something different from the agreed procedure. Sixty per cent of clients did not read the form, as they trusted their veterinarian, but 33 per cent of clients felt frightened by the process. This survey highlights the need to understand the process of consent from the client's perspective, and adapt the consenting process to incorporate this into professional communication to ensure that the professional and contractual objectives of consent are met fully.
Assuntos
Atitude Frente a Saúde , Consentimento Livre e Esclarecido/psicologia , Encaminhamento e Consulta , Medicina Veterinária , Animais , Humanos , Consentimento Livre e Esclarecido/legislação & jurisprudência , Preferência do Paciente/estatística & dados numéricos , Satisfação do Paciente/estatística & dados numéricos , Estudos Retrospectivos , Inquéritos e Questionários , Reino UnidoRESUMO
BACKGROUND: Intervertebral disc disease (IVDD) represents a major problem in the Dachshund, with at a relative risk of IVDD 10-12 times higher than other breeds, and an estimated 19-24 % of Dachshunds showing clinical signs related to IVDD during their lifetime. A variety of genetic, physical and lifestyle-related risk factors for IVDD have previously been identified, with some conflicting findings. As such, advising owners and breeders regarding best-practice for IVDD prevention is challenging at present. This study aimed to (i) estimate prevalence of IVDD in six Dachshund varieties, and (ii) identify risk factors associated with IVDD diagnosis from a wide variety of demographic, conformational, dietary, activity and exercise-related variables. RESULTS: A web-based survey "Dachs-Life 2015" was carried out from January-April 2015, with responses received for 2031 individual Dachshunds. Three-hundred and ten dogs were classed as Cases based on veterinary-diagnosis of IVDD, and 56 dogs were excluded from further analyses due to a lack of veterinary-diagnosis of their clinical signs. The remaining1665 dogs with no previous signs of IVDD were classified as Non-Cases. The overall prevalence of IVDD was 15.7 % (95 % CI: 14.1-17.3). Breed variety was significantly associated with IVDD risk, with the highest prevalence seen in the Standard Smooth-Haired (24.4 %, 95 % CI: 22.5-26.3) and lowest in the Standard Wire-Haired (7.1 %, 95 % CI: 6.0-8.2). Older dogs and neutered dogs were at increased odds of IVDD. Of the lifestyle risk factors, univariable analysis identified dogs that exercised for <30 min per day, were not allowed to jump on and off furniture, or were supplemented with glucosamine or chondroitin were at increased odds of IVDD, whereas dogs that exercised for more than 1 h per day, that were considered highly or moderately active by their owners, and those that showed at Open or Championship shows were at decreased odds of IVDD. CONCLUSIONS: In line with previous reports, IVDD is commonly diagnosed in the Dachshund, with significant differences in prevalence between Dachshund varieties. Lifestyle risk factors were identified which are hypothesis-generating for future prospective studies, and can inform an evidence-based approach to mitigating IVDD risk for Dachshund owners and breeders.
RESUMO
Chiari-like malformation/syringomyelia (CM/SM) in dogs describes a developmental disorder that can cause pain and reduced quality of life. This retrospective study aimed to report the period prevalence, clinical signs and risk factors for diagnosis of symptomatic CM/SM in the veterinary primary-care setting using a cross-sectional design. The study population included all dogs within the VetCompass Programme (September 1, 2009-June 13, 2014). Overall, the period prevalence of symptomatic CM/SM was 0.05 per cent (95 per cent CI 0.04 per cent to 0.06 per cent) for all breeds. The period prevalence in the Cavalier King Charles Spaniel (CKCS) was 1.6 per cent (95 per cent CI 1.2 to 2.06). Other breeds at increased odds included the King Charles Spaniel (KCS), Affenpinscher, Chihuahua and Pomeranian. Insured dogs had 4.6 times the odds (95 per cent CI 2.95 to 7.17) of having a diagnosis of CM/SM compared with uninsured dogs. Pain was the most commonly associated clinical sign (67 dogs, 72 per cent). Analgesics were prescribed to 72 (77.4 per cent) of the symptomatic dogs. Despite its low overall period prevalence, the high proportion of affected dogs identified with chronic pain suggests a significant welfare issue. Financial implications could impede the diagnostic process and lead to underestimation of the true prevalence. This study may help to inform clinicians about the clinical relevance and the need for improved awareness of clinical signs, particularly in high-risk breeds, to optimise the management of CM/SM in primary-care practice.
Assuntos
Malformação de Arnold-Chiari/veterinária , Doenças do Cão/diagnóstico , Doenças do Cão/epidemiologia , Dor/veterinária , Siringomielia/veterinária , Analgésicos/uso terapêutico , Animais , Malformação de Arnold-Chiari/complicações , Malformação de Arnold-Chiari/diagnóstico , Malformação de Arnold-Chiari/epidemiologia , Cruzamento , Estudos Transversais , Cães , Inglaterra/epidemiologia , Feminino , Seguro/estatística & dados numéricos , Masculino , Dor/tratamento farmacológico , Dor/etiologia , Prevalência , Atenção Primária à Saúde , Estudos Retrospectivos , Fatores de Risco , Siringomielia/complicações , Siringomielia/diagnóstico , Siringomielia/epidemiologiaRESUMO
Although long-term outcomes of meningoencephalitis of unknown aetiology (MUA) in dogs have been evaluated, little is known about short-term survival and initial response to therapy. The aim of this study was to evaluate possible prognostic factors for 7-day survival after diagnosis of MUA in dogs. Medical records were reviewed for dogs diagnosed with MUA between 2006 and 2015. Previously described inclusion criteria were used, as well as 7-day survival data for all dogs. A poor outcome was defined as death within 1 week. Of 116 dogs that met inclusion criteria, 30 (26%) died within 7 days of diagnosis. Assessed variables included age, sex, bodyweight, duration of clinical signs and treatment prior to diagnosis, venous blood glucose and lactate levels, white blood cell count on complete blood count, total nucleated cell count/total protein concentration/white blood cell differentiation on cerebrospinal fluid (CSF) analysis, presence of seizures and cluster seizures, mentation at presentation, neuroanatomical localisation, imaging findings and treatment after diagnosis. Multivariate analysis identified three variables significantly associated with poor outcome; decreased mentation at presentation, presence of seizures, and increased percentage of neutrophils on CSF analysis. Despite initiation of appropriate treatment, more than a quarter of dogs died within 1 week of diagnosis of MUA, emphasising the need for evaluation of short-term prognostic factors. Information from this study could aid clinical staff to provide owners of affected dogs with prognostic information.
Assuntos
Doenças do Cão/tratamento farmacológico , Imunossupressores/uso terapêutico , Meningoencefalite/veterinária , Animais , Doenças do Cão/diagnóstico , Doenças do Cão/etiologia , Cães , Feminino , Londres , Longevidade , Masculino , Meningoencefalite/diagnóstico , Meningoencefalite/tratamento farmacológico , Meningoencefalite/etiologia , Análise Multivariada , Prognóstico , Estudos Retrospectivos , Fatores de TempoRESUMO
Idiopathic epilepsy (IE) is a common chronic neurological disease of the dog. Previous studies of anti-epileptic drug (AED) treatment have indicated that acceptable AED adverse effects are as important to owners as reductions in seizure frequency. AEDs in both dogs and human beings are frequently associated with the adverse-effect ataxia. The aim of this study was to compare ataxia levels in dogs with IE treated chronically with phenobarbitone or imepitoin, the two currently available first-line AED treatments. The gait of 6 imepitoin-treated dogs, 8 phenobarbitone-treated dogs and 10 age-matched healthy control dogs were compared. Fifty strides from a walking gait were analysed for each dog, quantifying ataxia via the variability in six established gait parameters. Three variables differed significantly between groups: lateral distance between (i) pelvic paw placements, (ii) thoracic paw placements and (iii) stance time, which were significantly more variable in the phenobarbitone-treated dogs than imepitoin-treated or control dogs. These results indicate that dogs treated with phenobarbitone experience ataxia compared with controls and imepitoin-treated dogs. Conversely, there was no difference between imepitoin-treated dogs and controls. These results along with further research are needed to quantify AEDs adverse effects, to help vets and owners make more informed drug-choices.