DEVELOPMENT AND EVALUATION OF A STANDARDIZED SYSTEM FOR THE ASSESSMENT OF LOCOMOTOR HEALTH IN ELEPHANTS UNDER HUMAN CARE.

Although lameness is a common problem in elephants (Asian elephant [Elephas maximus] and African elephants Loxodonta africana and Loxodonta cyclotis) under human care, there has not been a standardized lameness assessment system to date. This study developed and evaluated a standardized system for the assessment of locomotion in elephants under human care regardless of husbandry system. In total, 72 elephants out of a possible 73 in the United Kingdom and Ireland were filmed from behind, from in front, and from both sides. Using a questionnaire and a select panel of elephant specialists, a zoo veterinarian, and a locomotion expert, a numerical rating scoring (NRS) system was proposed. Locomotion was scored on a 4-point scale with numerical values 0-4 corresponding to specific criteria as follows: 0 = clinically sound, 1 = stiffness, 2 = abnormal tracking, and 4 = reluctance to bear weight. The intra- and interobserver repeatability of five veterinary surgeons using this system was determined and compared with a visual analog scale (VAS) expressed as a 100-mm line. Overall intraobserver reliability was moderate (Cohen's kappa [κ] = 0.676) and interobserver reliability was fair (κ = 0.37) for the presence of lameness. Interobserver agreement improved from the first scoring to second scoring from slight agreement to fair agreement for stiffness and reluctance to bear weight. Abnormal tracking had moderate intraobserver agreement for both scoring sessions. There were wide widths of agreement for the VAS interobserver (67 mm); however, they were narrower for the intraobserver (33 mm). The developed NRS can be used on freely moving elephants to evaluate elephant locomotion, regardless of husbandry methods, and has been shown to be more reliable than a VAS.

Survey investigating factors affecting recruitment and retention in the UK veterinary nursing profession.

BACKGROUND: Recruitment and retention have been identified as contributing factors to workforce shortages in the veterinary team. METHODS: Results from veterinary nurses to an online questionnaire regarding recruitment and retention were analysed. RESULTS: Veterinary nurses had few job changes (median 2); however, 53.8% (n = 1060) reported they were likely or very likely to leave their employment within 2 years. Respondents who were recently qualified (p < 0.001) and on lower salaries (p < 0.001) were significantly more likely to plan to leave. The most frequently chosen reasons to stay in a position were team, location and working hours, while reasons to leave were salary, management and work-life balance. Respondents most disliked 'dealing with people', remuneration and work-life balance and would like to change the salary, management and team aspects. Employers reported difficulty in employing an experienced veterinary nurse. LIMITATIONS: A questionnaire simplifies the nature of retention. Also, a comparatively low number of responses was received, with overrepresentation of some groups. It was conducted in 2018; however, it still provides a useful comparison for studies regarding recent world events. CONCLUSION: The shortage of veterinary nurses is due in part to the lack of retention within the profession. Adequate recompense for work undertaken and value attributed to the role are suggested as contributing factors.

Effects of sand, asphalt and 3-degree hind toe or heel elevation on horse kinematics.

BACKGROUND: Although the effects of both the surfaces and plantar angles on equine locomotion have been widely discussed, limited scientific data are available. METHODS: Our objectives were to determine the effects of two surfaces (asphalt and sand) and of 3-degree hind toe or heel elevation on horse kinematics in an experimental study. Six saddle horses were shod with a reference shoeing (REF), characterized by a fore aluminium (REF F) and hind steel racehorse (REF H) shoeing. Two dimensional kinematic videos compared horse's kinematic parameters when walking and trotting on asphalt and sand. On asphalt, REF was also compared with REF F and a modified REF H with additional 3-degree hind-toe or -heel wedges. RESULTS: On asphalt versus sand, horses had, at the trot, a shorter stride duration and forelimb maximal retraction, and at walk and trot, a greater fetlock, carpus, elbow and tarsus extension, a greater fore and hind limbs maximal protraction and a shorter hind limbs maximal retraction. Increasing the plantar angle decreased the tarsus and hind fetlock extension, in contrast to fore-limb, on asphalt during the stance phase. CONCLUSIONS: These findings could be useful to adapt rehabilitation programs related to fore and hind limb pathologies, at slow gaits.

The effect of curve running on distal limb kinematics in the Thoroughbred racehorse.

During racing, injury is more likely to occur on a bend than on a straight segment of track. This study aimed to quantify the effects of galloping at training speeds on large radius curves on stride parameters and limb lean angle in order to assess estimated consequences for limb loading. Seven Thoroughbred horses were equipped with a sacrum-mounted inertial measurement unit with an integrated GPS, two hoof-mounted accelerometers and retro-reflective markers on the forelimbs. Horses galloped 2-4 circuits anticlockwise around an oval track and were filmed at 120 frames per second using an array of ten cameras. Speed and curve radius were derived from GPS data and used to estimate the centripetal acceleration necessary to navigate the curve. Stride, stance and swing durations and duty factor (DF) were derived from accelerometer data. Limb markers were tracked and whole limb and third metacarpus (MCIII) angles were calculated. Data were analysed using mixed effects models with a significance level of p < 0.05. For horses galloping on the correct lead, DF was higher for the inside (lead) leg on the straight and on the curve. For horses galloping on the incorrect lead, there was no difference in DF between inside and outside legs on the straight or on the curve. DF decreased by 0.61% of DF with each 1 m s-2 increase in centripetal acceleration (p < 0.001). Whole limb inclination angle increased by 1.5° per 1 m s-1 increase in speed (p = 0.002). Limb lean angles increase as predicted, and lead limb function mirrors the functional requirements for curve running. A more comprehensive understanding of the effects of lean and torque on the distal limb is required to understand injury mechanisms.

Investigation of factors affecting recruitment and retention in the UK veterinary profession.

BACKGROUND: Recruitment and retention is currently of major concern and has resulted in the veterinary profession being returned to the UK's Shortage Occupation List in 2019. METHODS: An online questionnaire of veterinary employees and employers investigating factors contributing to leaving/staying in current employment and the profession. The questionnaire was distributed via specialist veterinary associations' email lists and social media from September to October 2018. RESULTS: Respondents had few job changes (median 3), however, 43.7 per cent (n=2390) reported that they were likely or very likely to leave their employment within two years. Vets who were recently qualified, on lower salaries and female were more likely to plan to leave. Most frequently chosen reasons to stay in a position were: team, location and family. Most commonly cited reasons to leave were: work-life balance, management and salary. Respondents most disliked dealing with people, work-life balance and the physical/emotional impacts of the job. They would most like to change the hours worked, team aspects and management. Employers suggested that it was difficult to employ a veterinary surgeon, especially an experienced individual. CONCLUSION: The current retention crisis is due in part to the differing requirements between modern-day veterinary employees, their employers, the public and the profession.

The Effect of Tungsten Road Nails on Upper Body Movement Asymmetry in Horses Trotting on Tarmac.

Tungsten road nails are commonly used by farriers to increase grip between the hoof and the ground surface. There is limited evidence relating the use of road nails to the fundamental mechanics of movement. Grip is important for efficient deceleration on landing and subsequent propulsion, but this must be balanced against an amount of slip to divide the landing force into horizontal as well as vertical subcomponents. Here, we conducted an intervention study to quantify the effect of lateral heel road nail placement on weight bearing and propulsion in 10 horses trotting on tarmac. Wireless inertial measurement units measured vertical movement asymmetry. Differences in head and pelvic movement asymmetry before/after subsequent application of laterally placed road nails to forelimb and hindlimb hooves in a randomized order were compared to zero value (no change) with a one-sample t-test, P < .05. Left-to-right tuber coxae movement amplitude difference was significantly more negative (-3.25 mm, P = .03), suggesting more right than left tuber coxae movement amplitude, after application of a road nail to the left hindlimb. No movement asymmetries at the poll, withers, or sacrum were detected after nail placement (all P > .055). Pelvic movement indicates a very small increase in weight bearing and propulsion provided by the hindlimb with a laterally placed road nail compared to the contralateral hindlimb. Further work is needed to investigate slip- and grip-related parameters at the level of the hoof and to investigate the long-term consequences of very small changes in movement asymmetry.

Computed Tomographic Evaluation of Adjacent Segment Motion after Ex Vivo Fusion of Equine Third and Fourth Cervical Vertebrae.

OBJECTIVE: Surgical fusion of vertebral segments is a treatment option for horses with cervical stenotic myelopathy or cervical fracture.Degenerative disease affecting adjacent vertebral segments is a reported complication following surgical vertebral fusion in other species, termed adjacent segment disease. The aim of this study was to evaluate the impact of cervical vertebral fusion on the biomechanics of adjacent vertebral segments in the horse. STUDY DESIGN: Neck specimens of 12 horses were assessed using computed tomographic imaging. Range of motion (ROM) was determined by measuring the maximum sagittal flexion, extension and lateral bending between C2 and C5. C3/4 was subsequently fused using a standard locking compression plate and locking head screws and computed tomographic scans and ROM measurements were repeated. RESULTS: Prior to intervertebral fusion, a significant increase in ROM along the vertebral segments from cranial to caudal was observed. Range of motion measurements of C3/4 decreased significantly after fusion (p = 0.01).Range of motion of the adjacent segments (C2/3 and C4/5) did not change significantly after fusion. CONCLUSION: Fusion of one cervical intervertebral joint did not affect the ROM of the adjacent vertebral segments. Further research investigating the implications of vertebral fusion on the intervertebral pressure in the equine patient is indicated.

Faculty's Perception of a Research Project Embedded in the Undergraduate Veterinary Curriculum.

In this article, we describe faculty's perception of a research project embedded in the final year of the undergraduate veterinary curriculum and look at factors associated with overall perceptions of the project. We hypothesized that faculty would have a dichotomous attitude toward the research project, with faculty viewing it either positively or negatively, and that this opinion of the project would be largely influenced by the background of the faculty member-in particular, her or his role at the Royal Veterinary College. We explored this hypothesis via a questionnaire consisting of 26 questions in categorical format, Likert-scale format, and ranking format. The questions addressed faculty demographics, faculty's perceptions of the project, and generic skills. Faculty had an overall positive view of the project and found it to be a useful part of the undergraduate curriculum (83.3% found it to be useful or very useful). Faculty's perception of the project was influenced by their role at the college (p = .017), the species with which they primarily work (p = .05), and their opinion on the time spent supervising the final-year project (p = .003). We concluded that faculty view research as an important and useful part of the undergraduate veterinary curriculum.

Women in veterinary leadership positions: their motivations and enablers.

BACKGROUND: Despite now having higher numbers of women than men within the veterinary profession, there are substantially less women in leadership roles. Research, primarily in other professions, has focussed on barriers to leadership and sometimes overlooked facilitators and motivators. This study aimed to explore the motivating factors for female veterinary surgeons to become leaders, to identify potential strategies to increase female leadership. METHODS: Sixteen female leaders from academia, professional bodies, industry and clinical practice took part in semistructured interviews. Interviews were analysed using a thematic analysis approach. RESULTS: Two themes were developed: 'Potential for positive influence' and 'Requirement of external enablers'. Participants wanted to influence change for themselves, including work-life balance and developing their role, and for others through a position of influence. They wanted to inspire and mentor the future generation of leaders. External enablers allowed this transition to occur, including formal mentors and informal support systems, opportunities for growth and increased responsibility, and leadership training. CONCLUSION: Potential strategies to increase female leaders include the promotion of female role models, increasing awareness of training and increasing work flexibility. The profession could improve its support of the next generation of leaders and celebrate the successful female leaders we already possess.

The Effect of Training on Stride Duration in a Cohort of Two-Year-Old and Three-Year-Old Thoroughbred Racehorses.

Objective gait monitoring is increasingly accessible to trainers. A more comprehensive understanding of 'normal' gait adaptations is required. Forty two-year-old thoroughbred racehorses were recruited when entering training and followed for 22 months. Gait analysis was performed by equipping each horse with an inertial measurement unit with inbuilt GPS (GPS-IMU) mounted on the dorsum. Horses were exercised as per their regular training regimen. Data were analysed using a linear mixed model. For two-year-old horses, there was a non-linear pattern of stride duration (SD) over time (p < 0.001) with SD decreasing initially and then 'flattening off' over time (linear and quadratic coefficients -0.29 ms/week and 0.006 ms/week2). Horses showed an increase in SD of 2.21 ms (p < 0.001) per 100 m galloped, and over time, SD decreased by 0.04 ms (p < 0.001) with each 100 m galloped per week. Three-year-old horses overall showed no change in SD over time (p = 0.52), but those that had a period of time off showed a decrease in SD of -0.59 ms per week (p = 0.02). They showed an increase in SD of 1.99 ms (p < 0.001) per 100 m galloped, and horses that had a period of time off showed an increase in stride duration of 1.05 ms per 100 m galloped (p = 0.01) compared to horses which did not have time off. Horses demonstrate an adaptation to high-speed exercise over time. SD decreases with training when other factors are controlled for in naïve horses.

NEUROLOGIC AND COMPUTED TOMOGRAPHY FINDINGS IN SEA TURTLES WITH HISTORY OF TRAUMATIC INJURY.

Boat strikes have been widely documented as a major cause of anthropogenic trauma and mortality in sea turtles. Axial trauma in these species involves the head and/or carapace and may cause severe damage to the nervous and pulmonary systems. The aims of this study were to develop an updated protocol for neurologic examinations in sea turtles, to describe computed tomography (CT) findings in sea turtles with sustained trauma, and to associate CT findings with neurologic status in sea turtles with and without traumatic injury. Ten sea turtles were examined, six green (Chelonia mydas) and four loggerhead (Caretta caretta) turtles: seven underwent neurologic and CT examinations, two had CT examinations only, and one had a neurologic examination only. The updated neurologic examination protocol was considered useful in differentiating normal from abnormal neurologic status, however some of these tests remain unreliable in sea turtles. Sea turtles with no history of trauma were found to have normal carapace shape, vertebral column, and neurologic status. Sea turtles with history of traumatic injury (more than 10 years prior to examination) had findings dependent on trauma site. Those with head trauma had variable presentations dependent on location of injury; while those with carapace trauma had varying degrees of kyphosis, lordosis, and scoliosis of the carapace, vertebral fractures, and paraparesis. Kyphosis of the carapace was associated with vertebral fractures detected on CT; however, the severity of vertebral abnormalities was not associated with the severity of neurologic deficits. These findings suggest that a combination of neurologic and CT examination may be beneficial in determining clinical significance of carapace deformation and associated neurologic deficits in sea turtles with traumatic injury.

Computed tomographic dimensions of the normal adult equine eye.

There are limited data on whether the dimensions of the equine eye and its internal structures change with bodyweight in horses. The aim of this study was to identify whether the size of the equine eye and its individual structures varied in a predictable manner with bodyweight, and to examine the reliability of computed tomography (CT) scans in the measurement of the equine eye. Ninety horses which had undergone CT examination of the head for non-ocular disease were included. All measurements of the eye were performed twice on all eyes by the same operator to quantify intra-operator agreement, and in 10 cases were also performed by a second operator to quantify inter-operator agreement. Agreement was excellent for all but the rostrocaudal measurement of the anterior chamber, which was fair. The following variables correlated significantly with bodyweight: anterior-posterior size of the globe (correlation coefficient: 0.586) and posterior segment (correlation coefficient: 0.554); the latero-medial size of the globe (correlation coefficient: 0.452), anterior chamber (correlation coefficient: 0.504) and posterior segment (correlation coefficient: 0.455); and the orbital fossa diameter (correlation coefficient: 0.219). The lens size and anterior-posterior distance of the anterior chamber did not correlate significantly with bodyweight. These results suggest that overall eye size and the size of the orbital fossa change with the bodyweight of the horse, but lens size remains consistent, and that CT measurements of the internal structures of the eye are repeatable and reproducible. This information aids in interventional procedures for ocular pathology and assessment of normal anatomy.

Anatomy Teaching, a "Model" Answer? Evaluating "Geoff", a Painted Anatomical Horse, as a Tool for Enhancing Topographical Anatomy Learning.

Development of new methods for anatomy teaching is increasingly important as we look to modernize and supplement traditional teaching methods. In this study, a life-sized equine model, "Geoff," was painted with surface and deep anatomical structures with the aim of improving students' ability to convert theoretical knowledge into improved topographical anatomy knowledge on the live horse. Third and fourth year veterinary medicine students (n = 45) were randomly allocated into experimental (used "Geoff") and control (used textbook) groups. The efficacy of the model was evaluated through a structured oral exam using a live horse. Questionnaires gathered information on student confidence and enjoyment of the task. There was no significant difference in the performance of experimental and control groups either immediately (44±20% vs. 40±21%; P = 0.504) or 9 weeks after the learning intervention (55±17% vs. 55±20%; P = 0.980). There were however specific questions on which the experimental group performed better than controls, and for which gender effects were apparent. The students using "Geoff" showed a transient gain in confidence following the session (Likert scale 2.7 to 3.6) however the initial increase was no longer present at the second test. There was a significant influence of gender on confidence with greater confidence gains in females in the Experimental group. The students found the model to be extremely useful and both groups found the sessions enjoyable. The model will be of benefit as a complementary learning tool for students.

Skeletal pathology and variable anatomy in elephant feet assessed using computed tomography.

Foot problems are a major cause of morbidity and mortality in elephants, but are underreported due to difficulties in diagnosis, particularly of conditions affecting the bones and internal structures. Here we evaluate post-mortem computer tomographic (CT) scans of 52 feet from 21 elephants (seven African Loxodonta africana and 14 Asian Elephas maximus), describing both pathology and variant anatomy (including the appearance of phalangeal and sesamoid bones) that could be mistaken for disease. We found all the elephants in our study to have pathology of some type in at least one foot. The most common pathological changes observed were bone remodelling, enthesopathy, osseous cyst-like lesions, and osteoarthritis, with soft tissue mineralisation, osteitis, infectious osteoarthriti, subluxation, fracture and enostoses observed less frequently. Most feet had multiple categories of pathological change (81% with two or more diagnoses, versus 10% with a single diagnosis, and 9% without significant pathology). Much of the pathological change was focused over the middle/lateral digits, which bear most weight and experience high peak pressures during walking. We found remodelling and osteoarthritis to be correlated with increasing age, more enthesopathy in Asian elephants, and more cyst-like lesions in females. We also observed multipartite, missing and misshapen phalanges as common and apparently incidental findings. The proximal (paired) sesamoids can appear fused or absent, and the predigits (radial/tibial sesamoids) can be variably ossified, though are significantly more ossified in Asian elephants. Our study reinforces the need for regular examination and radiography of elephant feet to monitor for pathology and as a tool for improving welfare.

COMPUTED TOMOGRAPHIC APPEARANCE OF MELANOMAS IN THE EQUINE HEAD: 13 CASES.

Melanomas are one of the most common neoplasms in the horse and are frequently found in the head region. There is a genetic predisposition in horses with a gray hair coat. Computed tomography (CT) is frequently used in referral practice to evaluate the equine head but there are few reports describing the CT appearance of melanomas in this location. The aim of this retrospective, case series study was to describe characteristics in a group of horses with confirmed disease. Case records from two referral hospitals were reviewed, and 13 horses were identified that had undergone CT of the head, with a diagnosis of melanoma based on cytology, histopathology, or visual assessment of black (melanotic) tissue. A median of 11 melanomas was identified per horse (range 3-60), with a total of 216 masses. Melanomas were found most frequently in the parotid salivary gland, guttural pouches, surrounding the larynx and pharynx and adjacent to the hyoid apparatus. In noncontrast CT images, all melanomas were hyperattenuating (median; 113.5 Hounsfield units (HU), IQR; 26 HU) compared to masseter musculature (median; 69 HU, IQR; 5.5 HU). Fifty-six (25.9%) masses were partially mineralized and 41 (19.4%) included hypoattenuating areas. Histopathological assessment of these melanomas suggested that the hyperattenuation identified was most likely a result of abundant intracytoplasmic melanin pigment. Melanomas of the equine head appeared to have consistent CT features that aided detection of mass lesions and their distribution, although histopathological analysis or visual confirmation should still be obtained for definitive diagnosis.

IMAGING DIAGNOSIS-THE COMPUTED TOMOGRAPHIC APPEARANCE OF A GIANT CELL TUMOR AFFECTING THE MANDIBLE IN A PYGMY GOAT.

A 3-year-old male neutered pygmy goat presented for evaluation of a progressive mandibular swelling and inappetence. A computed tomographic (CT) scan of the head and thorax was performed under general anesthesia. Computed tomography revealed an extensive multiloculated, markedly expansile lesion within the right hemimandible, which involved the articular surface of the temporomandibular joint. The goat was euthanased due to a poor prognosis and postmortem examination confirmed the diagnostic imaging findings. Histopathology was strongly suggestive of a multinucleated giant cell tumor, therefore this condition should be considered as a differential diagnosis in goats presenting with expansile mandibular mass lesions.