Use of aminoglycoside antibiotics in equine clinical practice; a questionnaire-based study of current use.

Veterinary use of the aminoglycoside antibiotics is under increasing scrutiny. This questionnaire-based study aimed to document the use of aminoglycosides with a particular focus on gentamicin. An online questionnaire was delivered to generalist equine veterinary surgeons and specialists in internal medicine to determine the perceived importance, frequency of use and routes of administration of the aminoglycoside antibiotics. A series of hypothetical scenarios were also evaluated regarding gentamicin. Data were compared to evaluate the impact of the level of specialisation on prescribing practices for different antibiotics using Chi-squared and Fischer's exact tests. Data were analysed from 111 responses. Gentamicin was commonly used empirically without culture and susceptibility testing. Generalists were more likely to use gentamicin only after susceptibility testing than specialists in a variety of clinical presentations including respiratory diseases, septic peritonitis, acute febrile diarrhoea, cellulitis and contaminated limb wounds (p < 0.01). Intravenous administration of gentamicin was most common, although inhaled and regional administration of gentamicin and amikacin were also described. Amikacin was most commonly used by intra-articular administration. Gentamicin was more likely to be used in high-risk procedures or contaminated surgeries (86% and 74%, respectively) compared with clean surgery (32%; p < 0.0001). Gentamicin was often used perioperatively in horses undergoing exploratory celiotomy and more commonly used in horses undergoing an enterotomy (90%) than without and enterotomy (79%; p = 0.04). Most respondents (86%) used gentamicin at a dose of 6.6 mg/kg in adults, with few changing their dosing strategies based on the presence of sepsis, although higher doses were more reported in foals (7-15 mg/kg) irrespective of the presence of sepsis. Aminoglycosides are widely used in equine practice and use outside current EU marketing authorisations is common. Stewardship of the aminoglycoside antibiotics could be enhanced in both generalists and specialists through the more frequent use of susceptibility testing, regional administration and dose adjustment, especially in foals.

Radiation protection challenges in applications of ionising radiation on animals in veterinary practice.

As we work towards a holistic approach to radiation protection, we begin to consider and integrate protection beyond humans to include, among other things, non-human biota. Non-human biota not only includes environmental flora and fauna, but also livestock, companion animals, working animals, etc. Although under consideration, there is currently little guidance in terms of protection strategies for types of non-human biota beyond wildlife. For example, in recent years, veterinary procedures that make use of ionising radiation have increased in number and have diversified considerably, which has made radiation protection in veterinary applications of ionising radiation more challenging, both for humans and the animal patients. In fact, the common belief that doses to professionals and members of the public from these applications will be very low to negligible, and doses to the animals will not be acutely harmful nor even affect their lifetime probability of developing cancer, needs to be revisited in the light of higher dose diagnostic and interventional techniques, and certainly in the case of therapeutic applications. This paper provides a brief overview of the initiatives of the International Commission on Radiological Protection concerning radiation protection aspects of veterinary practice, and poses a variety of perspectives for consideration and further discussion.

High-quality, high-volume spay-neuter: Access to care and the challenge to private practitioners.

IMPACT: Low-cost spay-neuter clinics were first established nearly 50 years ago in response to the numbers of dogs and cats euthanized in animal shelters. Since then, high-quality, high-volume spay-neuter (HQHVSN) clinics have been established throughout the USA and have contributed to a significant reduction in animal euthanasia in shelters. These clinics, specializing in efficient systems and surgical techniques, provide an avenue for clients who cannot afford surgery to sterilize their pets. These clinics have also helped animal shelters with limited financial resources implement spay-neuter prior to adoption policies. RESPONSE: The veterinary profession's reaction to HQHVSN clinics has been mixed; some practitioners question the quality of care provided or fear the loss of clientele, while others recognize the need for such clinics and support their development. CHALLENGES: As veterinary education has become more expensive and veterinary care more sophisticated, the cost of veterinary care, including spay-neuter surgery, has risen. With increasing costs, the numbers of pets that receive little or no veterinary care has increased. Indeed, a 2018 survey by the Access to Veterinary Care Coalition documented that more than 25% of pet-owning households in the USA experienced difficulties obtaining veterinary care for their pets and the most frequent barrier was financial. AIM: This review looks at the reality of HQHVSN clinics and what this means for the private practitioner. By adopting similar systems and techniques that lower the cost of spay-neuter surgery, practitioners could potentially pass on cost savings to clients. Moreover, the same principles may be applied to other aspects of basic care to further address access to care issues.

Blame and shame in the veterinary profession: barriers and facilitators to reporting significant events.

Significant event reporting is an important concept for patient safety in human medicine, but substantial barriers to the discussion and reporting of adverse events have been identified. This study explored the factors that influence the discussion and reporting of significant events among veterinary surgeons and nurses. Purposive sampling was used to generate participants for six focus groups consisting of a range of veterinary professionals of different ages and roles (mean N per group=9). Thematic analysis of the discussions identified three main themes: the effect of culture, the influence of organisational systems and the emotional effect of error. Fear, lack of time or understanding and organisational concerns were identified as barriers, while the effect of feedback, opportunity for learning and structure of a reporting system facilitated error reporting. Professional attitudes and culture emerged as both a positive and negative influence on the discussion of error. The results were triangulated against the findings in the medical literature and highlight common themes in clinician's concerns regarding the discussion of professional error. The results of this study have been used to inform the development of the 'VetSafe' tool, a web-based central error reporting system.

Impact of decision to delivery time of fetal mortality in canine caesarean section in a referral population.

In human medicine, there is a recommended decision to delivery interval (DDI), which allows for the optimization of protocols and systematic review of hospital success. In veterinary medicine, no such guideline has been established or investigated. The purpose of this study was to investigate the relationship between the interval from the decision to perform a caesarean section and the delivery of the neonates and fetal mortality at the time of surgery. One hundred and fifty canine caesarean sections were evaluated retrospectively. Caesarean cases were dichotomized to those that had at least one perinatal death and cases where all puppies survived. Factors that increased the likelihood of at least one perinatal death at caesarean section were: cases that presented as an emergency caesarean section, the dam presenting with a fetus in the vaginal canal, the dam not having a history of previous caesareans sections, and being multiparous. Even though there was no association of DDI with likelihood of having perinatal death, timing related factors that increased the likelihood of having at least one perinatal death at caesarean section were: cases where total anaesthesia time was longer than 2 h; time from induction to start of surgery was longer than 45 min and surgical time longer than 75 min. In conclusion, time is a factor in the success of canine caesarean sections and further research is needed to better define the optimal decision to delivery time in canine caesarean sections in order to optimize fetal survival and hospital protocol success rates.

A survey of stereotactic radiation therapy in veterinary medicine.

Radiotherapy plays an important role in curative and palliative cancer treatment. As a novel radiation delivery technique, stereotactic radiotherapy utilizes three-dimensional-conformal treatment planning, high-precision beam delivery technology, and patient specific position verification to target tumors, often in one to five high-dose fractions. Currently, there is no consensus about best stereotactic radiotherapy practices in veterinary radiotherapy. The objective of this study was to document the breadth of perspectives, techniques, and applications of stereotactic radiotherapy in veterinary medicine. We conducted an online survey of American College of Veterinary Radiology members specializing in radiation oncology to assess how, when, and why stereotactic radiotherapy is being used. Both stereotactic radiotherapy users and nonusers completed the survey. The overall response and survey completion rates were 54% (67/123) and 87% (58/67), respectively. Overall, 55% of respondents reported providing stereotactic radiotherapy at their facility, with a median of 4.5 canine cases and one feline case per month. Delivery methods included C-arm linear accelerator with multi-leaf collimator, helical tomotherapy, and CyberKnife. Nonpituitary intracranial tumors, pituitary tumors, and sinonasal tumors were the most common cancers treated using stereotactic radiotherapy in both species. The most common fractionation scheme was three fractions of 10 Gy/fraction. The results of this survey suggest common availability of stereotactic radiotherapy in veterinary radiation facilities. These results provide valuable information regarding current stereotactic radiotherapy practices in veterinary medicine, and may provide an initial step toward standardizing methods and establishing consensus guidelines.

Publication Rate of Avian Medicine Conference Abstracts and Influencing Factors: 2011-2015.

International conferences on avian medicine and surgery aim to disseminate scientific and evidence-based information in the form of oral presentations and posters. Most manuscripts presented are printed in the conference proceedings as abstracts. Subsequent publication in a scientific peer-reviewed journal is the natural outcome of the research cycle, although studies have shown that the vast majority of conference abstracts are not published. The purpose of this study was to explore 1) the fate of abstracts presented in avian conferences (Association of Avian Veterinarians, European Association of Avian Veterinarians, International Conference on Avian Herpetological and Exotic Mammal Medicine) in the years 2011-2015, 2) assess the publication rate in peer-reviewed journals, 3) describe the time course of subsequent publication, and 4) identify factors associated with increased likelihood of publication. The results showed that 24% of conference abstracts were published within the next 2 years. Depending on the statistical model used, several factors were identified as associated with increased publication rate. North American papers seem to publish with more frequency (univariate model), while European papers had the opposite trend (multivariable model). Likewise, experimental studies were more prone to being published overall (univariate model), whereas retrospective observational studies had a lower rate of publication (multivariable model). Increasing the number of authors was also associated with increased publication rate. Most publications were published in the Journal of Avian Medicine and Surgery, which tends to suggest that this journal is the main journal of the specialty. Some parameters highlighted in this study may assist conference attendees to assess the likelihood of later publication.

Engineering controls in veterinary oncology: A survey of 148 ACVIM board-certified oncologists and environmental surveillance in 20 specialty hospitals.

Engineering controls (EC, facility and equipment barriers between hazards and people) are used to avoid exposure to chemotherapy drugs. In this study, American College of Veterinary Internal Medicine board-certified veterinary oncologists were surveyed about their use of containment primary EC (C-PEC) and supplemental EC (closed system transfer devices, CSTD). The survey was completed by 148 (38%) of practicing diplomates. All used EC. Both C-PEC and CSTD were used at 92% of hospitals; however, US Pharmacopoeial Convention Chapter <800> (USP <800>) standards were met at only 19% of hospitals and oncologists did not know the type of C-PEC at 18% of hospitals. Next, surface contamination and EC use were assessed with environmental surveillance for carboplatin, cyclophosphamide, doxorubicin, and vincristine in 20 veterinary specialty hospitals using a commercially available kit. No contamination with carboplatin, doxorubicin, or vincristine was detected, however, there was contamination with cyclophosphamide at 4 hospitals. Based on this study, most veterinary oncologists use C-PEC and CSTD, but few meet USP <800> standards. Current measures appear effective for preventing contamination with IV drugs, but additional measures are needed for oral drugs.

Treatment of canine cranial cruciate ligament disease. A survey of ACVS Diplomates and primary care veterinarians.

OBJECTIVE: To describe veterinarians' treatment recommendations and decision-making factors for dogs with cranial cruciate ligament disease (CCLD). METHODS: An online survey of American College of Veterinary Surgeons (ACVS)-Diplomates (surgeon group) and primary care veterinarians (practitioner group) was performed. The survey included questions on treatment recommendations for common case scenarios (small or large breed dog with complete or partial CCLD), treatment decision factors, non-surgical treatment options, and actual treatment, if any, provided for a client-owned dog as well as one owned by their family or close friend. RESULTS: The response rate was 42% for the surgeon group (n = 305/723) and four percent for the practitioner group (n = 1145/ 27,771). Extracapsular stabilization (ES) was the most common treatment recommendation for CCLD in small (9.1 kg) breed dogs amongst surgeons and practitioners. Tibial plateau levelling osteotomy (TPLO) was the most common treatment recommendation for CCLD in large (27.2 kg) breed dogs amongst both groups. The two most important treatment decision factors were dog size (78% of practitioners, 69% of surgeons) and activity level (63% of practitioners, 52% of surgeons). The most common treatment provided for a dog of their own or close relation in the surgeon group was TPLO (64%) followed by ES (15%), whereas in the practitioner group it was ES (38%) followed by TPLO (30%). CLINICAL SIGNIFICANCE: Extracapsular stabilization and TPLO are the most commonly employed surgical procedures in the surveyed population; dog size and activity level (but not age) are the major factors influencing treatment decisions.

A survey of veterinary radiation facilities in 2010.

A survey of veterinary radiation therapy facilities in the United States, Canada, and Europe was done in 2010, using an online survey tool, to determine the type of equipment available, radiation protocols used, caseload, tumor types irradiated, as well as other details of the practice of veterinary radiation oncology. The results of this survey were compared to a similar survey performed in 2001. A total of 76 facilities were identified including 24 (32%) academic institutions and 52 (68%) private practice external beam radiation therapy facilities. The overall response rate was 51% (39/76 responded). Based on this survey, there is substantial variation among facilities in all aspects ranging from equipment and personnel to radiation protocols and caseloads. American College of Veterinary Radiology boarded radiation oncologists direct 90% of the radiation facilities, which was increased slightly compared to 2001. All facilities surveyed in 2010 had a linear accelerator. More facilities reported having electron capability (79%) compared to the 2001 survey. Eight facilities had a radiation oncology resident, and academic facilities were more likely to have residents. Patient caseload information was available from 28 sites (37% of radiation facilities), and based on the responses 1376 dogs and 352 cats were irradiated in 2010. The most frequently irradiated tumors were soft tissue sarcomas in dogs, and oral squamous cell carcinoma in cats.

Analysis of the distribution of veterinary antimicrobial products to veterinarians in Germany in 2011 and 2012.

For the implementation of risk management measures against the development and spread of antimicrobial resistances it is important to gain a quantitative insight into the use of veterinary antimicrobial agents. Since 2011, all pharmaceutical companies and wholesalers in Germany are required to report their sales data of veterinary antimicrobial products (VAPs). In 2011, 1706 t of antimicrobially active substances were sold to veterinarians registered in Germany, in 2012 the amount decreased to 1619 t. Tetracyclines and penicillins had the largest shares in both years, followed by sulfonamides, macrolides and polypeptides. Amoxicillin alone accounted for more than a quarter of the total amounts of all sold antimicrobials. In regard to AMR it is most important to limit the use of critically important antimicrobials, namely fluoroquinolones and 3rd and 4th generation cephalosporins. While in both years these groups accounted for less than 1% of the amount of sold antimicrobials, this does not reflect adequately their use, since they are used in much lower doses. Furthermore, it is worrying that the sales of fluoroquinolones and 3rd generation cephalosporins increased by 26% and 14%, respectively, between 2011 and 2012, while the sales of 4th generation cephalosporins decreased only by 2%. More than 95% of the active substances were contained in VAPs intended for oral application; only fluoroquinolones, 3rd and 4th generation cephalosporins as well as fenicols were primarily or even exclusively applied by injection.

[Clinical-diagnostic hit rates and differential diagnoses depending on the sampling site of 2109 presumptively malignant canine and feline tumour submissions]. / Klinisch-diagnostische Trefferquoten und Differenzialdiagnosen bei 2109 kaninen und felinen Tumorproben mit Malignitätsverdacht. Evaluierung in Abhängigkeit der Entnahmelokalisation.

OBJECTIVE: The frequency of correct clinical presumptive diagnosis and the spectrum of important differential diagnoses were investigated in common canine and feline malignant tumours. MATERIAL AND METHODS: Based on 2109 presumptive malignant tumour samples submitted to the Institute of Veterinary Pathology of the Justus-Liebig-University, Giessen, the hit rates of the presumed diagnoses of the submitting veterinarians and the actual histopathological diagnosis were calculated for the specific sampling sites. These hit rates were statistically evaluated for significant deviations between the different sampling sites using the chi-square test and Fisher's exact test. Additionally, the more common differential diagnoses with respect to the sampling site were established. RESULTS: This compilation of histopathological diagnoses, with respect to the varying sampling sites, combined with the hit rates of the presumed diagnoses of the submitting veterinarians, yields quantitative knowledge on the frequency of occurrence, correct clinical diagnosis and macroscopic appearance of the malignant tumours investigated. The correctness of the presumptive clinical diagnosis largely depends on tumour type and localization. For the more frequent tumours, it varies from 19% to 83%. CONCLUSION AND CLINICAL RELEVANCE: The results show the importance of a histopathological evaluation of all tumour samples as the presumptive clinical diagnosis based on appearance only corresponds in a few cases with the histopathological diagnosis.

Non-accidental injuries found in necropsies of domestic cats: a review of 191 cases.

Animal cruelty is defined as a deliberate action that causes pain and suffering to an animal. In Brazil, legislation known as the Environmental Crimes Law states that cruelty toward all animal species is criminal in nature. From 644 domestic cats necropsied between January 1998 and December 2009, 191 (29.66%) presented lesions highly suggestive of animal cruelty. The main necroscopic finding was exogenous carbamate poisoning (75.39%) followed by blunt-force trauma (21.99%). Cats from 7 months to 2 years of age were the most affected (50.79%). In Brazil, violence is a public health problem and there is a high prevalence of domestic violence. Therefore, even if laws provide for animal welfare and protection, animals are common targets for violent acts. Within a context of social violence, cruelty toward animals is an important parameter to be considered, and the non-accidental lesions that were found are evidence of malicious actions.

Seasonal variation in the hip score of dogs as assessed by the New Zealand Veterinary Association hip dysplasia scheme.

AIM: To determine whether there is a seasonal variation in the phenotypic hip score of dogs born in New Zealand as assessed by the New Zealand Veterinary Association (NZVA) canine hip dysplasia (CHD) scheme. METHODS: Data from dogs born in New Zealand between 1988 and 2009 that have been scored for CHD were retrospectively evaluated for the effect of month of birth on radiographic phenotype. Data included both the total score and the subtotal score, comprising Norberg's angle, the subluxation score and changes to the cranial acetabular edge, for each dog. Datasets were created for all breeds combined and for the four most populous breeds using the scheme (German Shepherd dog, Labrador Retriever, Golden Retriever and Rottweiler) and stratified according to month of birth and season. Due to the skewed nature of the data, a Kruskal-Wallis Rank Sum test was used to test for statistical significance. Additionally, χ² analysis was performed using the median of each dataset (proportion above/below the median). The null hypothesis was that there would be no effect of month of birth, and hence seasonality, on hip phenotype for dogs born and scored in New Zealand by the NZVA. RESULTS: For all breeds combined, month of birth had an effect on total and subtotal NZVA CHD scores (p<0.001) with a lower total hip score in the autumn months of March and April than other months. When individual large breed data were analysed, there was an effect of month of birth on total and subtotal scores for the Labrador Retriever and the Rottweiler (p ≤ 0.05), but not the German Shepherd dog or Golden Retriever breeds. CONCLUSIONS: Being born in the autumn was associated with a protective effect on hip phenotype in some breeds. These results suggest that weather and/or another seasonal factor may have a significant environmental effect on the phenotype of the coxofemoral joint. CLINICAL RELEVANCE: The protective effect of being born in autumn suggests that a decreased level of exercise during subsequent development over winter may positively impact on final coxofemoral joint conformation. Whilst statistically significant, the magnitude of the sparing effect is not likely to be clinically relevant. However, this study, in concert with other studies, may suggest that the effects of exercise can be manipulated to improve hip phenotype.

Homeopathic prescribing for chronic conditions in feline and canine veterinary practice.

INTRODUCTION: The peer-review literature contains no controlled clinical research of homeopathy in cats and very little in dogs. MAIN OBJECTIVE: To collect clinical outcomes data systematically from individualised homeopathic treatment of cats and dogs that would help to inform controlled research in feline and canine homeopathy. METHODS: Twenty-one homeopathic veterinary surgeons recorded data systematically from consecutive feline and canine patients over a 12-month period. Records included: date; patient and owner identity (anonymised); medical problem treated; whether new or follow-up (FU) appointment; chronic or acute condition; owner-assessed clinical outcome (7-point scale, range -3 to +3) compared with first appointment. RESULTS: Data from 400 cats comprised a total of 372 individual chronic problems, of which 270 had FU assessment. Data from 1504 dogs comprised a total of 1408 individual chronic problems, of which 1070 had FU assessment. In both species, 22% of FUs in chronic cases received conventional medicines concurrently. In cats, 117 different chronic medical conditions in total were treated with homeopathy. Five of those conditions included ≥20 cases, in which owner-reported outcomes (in decreasing rank order of frequency) were: dermatitis (69.6% patients with +2 or +3 outcome, 0% patients with -2 or -3 outcome); renal failure (57.1%, 14.3%); overgrooming (57.1%, 7.2%); arthritis (80.0%, 0%); hyperthyroidism (66.7%, 0%). In dogs, of 301 different chronic medical conditions treated in total, those most commonly recorded (≥20 cases) were: dermatitis (66.2% with +2 or +3 outcome, 5.4% with -2 or -3 outcome); arthritis (80.2%, 0.8%); pyoderma (75.8%, 0%); colitis (85.2%, 0%); fear (31.6%, 0%); epilepsy (63.6%, 4.5%); otitis externa (72.7%, 0%); diarrhoea (68.2%, 0%); urinary incontinence (73.7%, 0%); aggression (57.1%, 0%); spondylosis (81.0%, 0%); lymphoma (40.0%, 6.7%). CONCLUSIONS: A programme of controlled research in veterinary homeopathy for these feline and canine conditions is clearly indicated.

AAFP-AAHA: feline life stage guidelines.

BACKGROUND AND GOALS: Cats have become the most popular pet in the United States, yet statistics about veterinary care for cats remain troubling. Although most owners consider their cats to be family members, cats are substantially underserved, compared with dogs. In 2006, owners took their dogs to veterinarians more than twice as often as cats, averaging 2.3 times/year, compared with 1.1 times/year for cats, and significantly more dogs (58%) than cats (28%) were seen by a veterinarian one or more times/year. Cat owners often express a belief that cats 'do not need medical care'. Two reasons for this misconception are that signs of illness are often difficult to detect, and cats are perceived to be self-sufficient.(2) One role of the veterinarian is to develop a partnership with cat owners that will pave the way for a lifelong health care plan. These guidelines aim to outline an evidence-based life stage wellness program to aid the veterinary medical team in delivering the best comprehensive care for cats. Specific goals are to provide: *Recommendations for optimal health care for cats throughout the different life stages. *Practical suggestions and tools to facilitate improved veterinary visits and to enhance the client-veterinarian clinical encounter. *A foundation from which to access sources of additional information. LIFE STAGE CLASSIFICATION: Distinct life stages (age groups) in cats are not well defined, in part because individual animals and body systems age at different rates, a process that is influenced by many factors. These guidelines follow one convenient classification (see box below). These age designations help to focus attention on the physical and behavioral changes that occur at different stages (eg, congenital defects in kittens, obesity prevention in the junior cat). It must be recognized, however, that any age groupings are inevitably arbitrary demarcations along a spectrum, and not absolutes. EVIDENCE-BASED HEALTH CARE: Supporting references for specific recommendations are supplied where possible, and any previously published guidelines on particular topics are referred to where relevant. Readers should note, however, that the guidelines panel was hampered in its efforts by the relative paucity of disease incidence data by age group that is available, and there is an urgent need for research to guide the future of evidence-based feline health care.

Association between radiographic assessment of hip status and subsequent incidence of veterinary care and mortality related to hip dysplasia in insured Swedish dogs.

Our objective was to evaluate the association between grading of hip status as assessed by radiographic examination (hip screening) and subsequent incidence of veterinary care and mortality related to hip dysplasia (HD) in five breeds of insured dogs in Sweden. Screening results for hip status from the Swedish Kennel Club and data on veterinary care and mortality from the insurance company Agria were merged based on the registration number of the dog. Dogs of five breeds (Bernese Mountain Dogs, German Shepherds, Golden Retrievers, Labrador Retrievers, and Rottweilers) screened during 1995-2004 and covered by an insurance plan for veterinary care or life at the time of screening were included. The study populations included between 1667 and 10,663 dogs per breed. Breed-specific multivariable Cox proportional-hazards analyses were performed to evaluate the impact of radiographic hip status on time from hip screening to first HD-related veterinary and life claim, respectively. The effects of gender, birth season, and a time-varying covariate of year were also studied. Additional analyses, on the five breeds combined, were performed to investigate the effects of hip status, breed, and the interaction between hip status and breed. The effect of hip status was highly significant (P<0.001) for both life and veterinary claims related to HD in all five breeds with increased hazard ratio (HR) for deteriorating hip status. Dogs with moderate or severe hip status at screening had a markedly increased hazard of HD-related veterinary care and mortality compared with dogs assessed as free or mild. The time-varying covariate of year showed a significantly higher HR in the last time period for German Shepherds and Labrador Retrievers in the analyses of veterinary claims. In the analyses on all five breeds, German Shepherds had the highest HR for both veterinary care and mortality related to HD, followed by Bernese Mountain Dogs. Golden and Labrador Retrievers had the lowest HR. The effect of hip status on the hazard was the same irrespective of breed. However, as a consequence of differences between breeds in overall risk, the predictive ability of screening results for subsequent incidence of HD-related problems for individual dogs was breed-dependent. Based on the strong association between radiographic hip status and incidence of HD-related veterinary care and mortality, and the previously reported moderate heritability of hip status, we conclude that selection based on screening results for hip status can be expected to reduce the risk of HD-related clinical problems.