Caregiver burden in owners of a sick companion animal: a cross-sectional observational study.

Much recent work has focused on occupational stress in veterinary medicine, although little is known about the possible contribution of client-based factors. Clients providing care for a companion animal with protracted illness are likely to experience 'caregiver burden' and reduced psychosocial functioning, which may ultimately lead to increased veterinarian stress. This cross-sectional observational study assessed caregiver burden and psychosocial function in 238 owners of a dog or cat, comparing owners of an animal with chronic or terminal diseases (n=119) with healthy controls blindly matched for owner age/sex and animal species (n=119). Results showed greater burden, stress and symptoms of depression/anxiety, as well as poorer quality of life, in owners of companion animals with chronic or terminal disease (p<0.001 for all). Higher burden was correlated with reduced psychosocial function (p<0.001 for all). Owners of a sick companion animal exhibit elevated caregiver burden, which is linked to poorer psychosocial functioning. This knowledge may help veterinarians understand and more effectively handle client distress in the context of managing the challenges of sick companion animal caregiving. Future work is needed to determine whether clients with this presentation impact veterinarian stress and how burden in this population might be reduced.

Improving the delivery of veterinary services in Africa: insights from the empirical application of transaction costs theory in Uganda and Kenya.

This paper presents a summary of findings from a research project that examined institutional arrangements for providing animal health services in Uganda and Kenya. Given the need to find solutions to the pervasive governance challenges encountered in the delivery of veterinary services in Africa, the study applied transaction economics theory to generate recommendations on how to improve the delivery of these services and minimise livestock production risks, including those that pose a risk to human health, e.g. zoonoses. The most notable recommendations are as follows: i) lower- and middle-income countries should invest in creating an enabling environment that supports the relationship between professional veterinarians and para-professionals, to ensure the timely reporting, treatment and control of animal diseases; ii) the provision of veterinary extension services should not focus solely on household 'heads', but also on other household members, such as wives and children, and on herdsmen; iii) strong government engagement is required in the provision of veterinary services for pastoral or extensive livestock production systems, because normal market forces have failed to attract professional veterinarians and trained para-professionals from the private sector to work in these sectors; iv) farmers must be empowered to hold service providers accountable, by the development and trialling of tools that would enable them to measure the quality of services that they receive and to verify the qualifications of different service providers; v) investment in veterinary education is vital, to ensure that enough qualified veterinary staff are available to offer veterinary services to farmers.

L'auteur propose une synthèse des principales conclusions d'un projet de recherche consacré aux dispositifs institutionnels élaborés en Ouganda et au Kenya pour encadrer la prestation des services de santé animale. Face à la nécessité de trouver des solutions aux graves difficultés de gouvernance qui entravent la prestation de services vétérinaires en Afrique, cette étude s'est fondée sur la théorie des transactions économiques pour formuler quelques recommandations sur les moyens d'améliorer la prestation de ces services et de minimiser les risques affectant la production animale, y compris ceux qui peuvent menacer la santé publique, à savoir les zoonoses. Les principales recommandations de l'étude sont les suivantes : i) les pays à faible revenu et à revenu intermédiaire devraient s'investir dans la création d'un environnement propice à la coopération entre les vétérinaires professionnels et les para-professionnels vétérinaires, afin d'assurer la notification rapide, le traitement et la prophylaxie des maladies animales ; ii) les prestations de services vétérinaires de proximité ne doivent pas se limiter aux seuls « chefs de famille ¼ mais s'adresser également aux autres membres des foyers (les épouses et les enfants) ainsi qu'aux gardiens des troupeaux; iii) une mobilisation forte des pouvoirs publics est nécessaire pour assurer la prestation de services vétérinaires au sein des systèmes d'élevage pastoral ou extensif, dans la mesure où les forces spontanées du marché ont échoué à attirer les vétérinaires libéraux et les para-professionnels qualifiés du secteur privé dans ces territoires ; iv) les éleveurs doivent disposer des moyens de demander des comptes aux prestataires de services, ce qui suppose de concevoir et de tester des outils leur permettant d'évaluer la qualité des services rendus et de vérifier les qualifications des différents prestataires de services ; v) l'investissement dans l'enseignement de la médecine vétérinaire est d'une importance capitale pour garantir que les effectifs des personnels vétérinaires qualifiés sont suffisants pour assurer une prestation de services adéquate aux éleveurs.

El autor resume las conclusiones de un proyecto de investigación en el que se estudiaron los dispositivos institucionales destinados a prestar servicios zoosanitarios en Uganda y Kenia. Dada la necesidad de encontrar soluciones para los omnipresentes problemas de buen gobierno que lastran la prestación de servicios veterinarios en África, en el estudio se aplicó la teoría de la economía de transacción para formular una serie de recomendaciones sobre la manera de mejorar la prestación de dichos servicios y reducir al mínimo los riesgos para la producción ganadera, en particular aquellos que entrañen una amenaza para la salud humana, como las zoonosis. Las recomendaciones más destacadas son las siguientes: i) los países de nivel bajo o medio de renta deben invertir en la creación de condiciones que favorezcan la relación entre los veterinarios profesionales y los paraprofesionales, con objeto de lograr una mayor puntualidad en la notificación, el tratamiento y el control de las enfermedades animales; ii) la prestación de servicios de divulgación veterinaria no debe ir dirigida únicamente a los «cabezas de familia¼, sino también a los demás miembros de la unidad familiar (esposa e hijos, por ejemplo) y a los encargados de cuidar de los rebaños; iii) en sistemas de producción ganadera pastoral o extensiva la prestación de servicios veterinarios exige una fuerte participación del sector público, puesto que los mecanismos de mercado no han servido para atraer a veterinarios profesionales y a paraprofesionales cualificados del sector privado para que trabajen en esos sectores; iv) es preciso habilitar a los pequeños productores para que sean exigentes con los proveedores de servicios, elaborando y aplicando experimentalmente herramientas que los capaciten para enjuiciar la calidad de los servicios que reciben y comprobar las cualificaciones de los distintos proveedores de servicios; v) es esencial invertir en la enseñanza de la veterinaria a fin de lograr que haya una dotación suficiente de veterinarios cualificados para ofrecer servicios veterinarios a los productores.

Achieving an optimal allocation of resources for animal health surveillance, intervention and disease mitigation.

The primary role of animal health economics is to inform decision-making by determining optimal investments for animal health. Animal health surveillance produces information to guide interventions. Consequently, investments in surveillance and intervention must be evaluated together. This article explores the different theoretical frameworks and methods developed to assess and optimise the spending of resources in surveillance and intervention and their technical interdependence. The authors present frameworks that define the relationship between health investment and losses due to disease, and the relationship between surveillance and intervention resources. Surveillance and intervention are usually considered as technical substitutes, since increased investments in surveillance reduce the level of intervention resources required to reach the same benefit. The authors also discuss approaches used to quantify externalities and non-monetary impacts. Finally, they describe common economic evaluation types, including optimisation, acceptability and least-cost studies.

L'économie de la santé animale a pour rôle primordial d'étayer la prise de décisions en définissant les meilleurs investissements en santé animale. Les activités de surveillance de la santé animale permettent de réunir les informations nécessaires pour guider les interventions. Par conséquent, il est nécessaire d'évaluer en même temps les investissements dans la surveillance et ceux dans les interventions. Les auteurs exposent les différents cadres théoriques et méthodologiques permettant d'évaluer et d'optimiser l'utilisation des ressources allouées à la surveillance et aux interventions et en font ressortir l'interdépendance technique. Les cadres présentés mettent en rapport les investissements dans la santé avec les pertes dues aux maladies et définissent les relations entre les ressources allouées à la surveillance et celles allouées aux interventions. La surveillance et les interventions sont généralement considérées comme des substitus tecniques, dans la mesure où toute augmentation des investissements dans la surveillance réduit d'autant le volume des ressources allouées aux interventions, pour un bénéfice équivalent. Les auteurs examinent également les approches utilisées pour quantifier les externalités ainsi que les impacts non monétaires. Enfin, ils décrivent plusieurs types d'évaluations économiques courantes, dont l'optimisation, l'acceptabilité et les analyses du moindre coût.

La economía de la sanidad animal tiene por función básica fundamentar la adopción de decisiones por el expediente de determinar cuáles son las inversiones óptimas desde el punto de vista zoosanitario. La vigilancia zoosanitaria genera información con la cual orientar las intervenciones. Por consiguiente, es necesario evaluar conjuntamente las inversiones en vigilancia y las destinadas a intervenciones. Los autores examinan los diferentes métodos y marcos teóricos que se han elaborado para evaluar y optimizar el gasto de recursos en labores de vigilancia y en intervenciones, así como su interdependencia técnica. En este sentido, presentan una serie de marcos que definen la relación entre inversiones en sanidad y pérdidas por enfermedades y la relación entre recursos para vigilancia y recursos para intervenciones. En general se considera que la vigilancia y las intervenciones son técnicamente interdependientes, toda vez que una mayor inversión en vigilancia reduce la cuantía de los recursos para intervenciones que hacen falta para obtener el mismo beneficio. Los autores también reflexionan sobre los métodos empleados para cuantificar los factores externos (externalidades) y las repercusiones no monetarias. Por último, describen los tipos más frecuentes de evaluación económica, como los de optimización, aceptabilidad o análisis del costo mínimo.

In Vitro Assessment of the Probiotic Potential of Lactococcus lactis LMG 7930 against Ruminant Mastitis-Causing Pathogens.

Mastitis in dairy ruminants is considered to be the most expensive disease to farmers worldwide. Recently, the intramammary infusion of lactic acid bacteria has emerged as a potential new alternative to antibiotics for preventing and treating bovine mastitis. In this study we have investigated in vitro the probiotic potential of Lactococcus lactis LMG 7930, a food-grade and nisin-producing strain, against mastitis-causing pathogens. We have characterized its carbohydrate fermentation and antibiotic susceptibility profiles, cell surface properties and antimicrobial activity, as well as its capabilities to adhere to and inhibit the invasion of pathogens into the bovine mammary epithelial cell line BME-UV1d. We found that L. lactis LMG 7930 was sensitive to tested drugs, according to the EFSA Panel on Additives and Products or Substances used in Animal Feed (FEEDAP), and showed an improved carbohydrate fermentation capacity compared to starter strains. Moreover, the strain exhibited antagonistic properties towards many of the pathogens tested. It presented medium surface hydrophobicity, a low basic property and no electron acceptor capability. It showed low auto-aggregation and no co-aggregation abilities towards any of the tested pathogens. The strain was one of the most adhesive to bovine mammary epithelial cells among tested bacteria, but its internalisation was low. The strain did not affect significantly pathogen invasion; however, a trend to decrease internalization of some pathogens tested was observed. In conclusion, our results suggest that this strain might be a promising candidate for the development of new strategies of mastitis control in ruminants. Future investigations are needed to evaluate its safety and efficacy under field conditions.

An antemortem guide for the assessment of stranded Australian sea snakes (Hydrophiinae).

Marine snakes of the subfamily Hydrophiinae are obligate ocean dwellers, unlike their amphibious counterparts, the sea kraits (Laticaudinae), and as such they are often referred to as 'true' sea snakes. This specialization means that the presence of a true sea snake on a beach is atypical and likely indicates disease or injury. Traumatic injuries such as eye, jaw, and spinal lesions have been observed in stranded sea snakes and may present as acute injury or progress to chronic debilitation. Diseases, such as neoplasia, leukemia, and parasite overburden, have also been seen in wild sea snakes, and these animals may present similarly. Sick, moribund, or deceased sea snakes are intermittently found washed ashore along Australian beaches, and these specimens may prove valuable as bioindicators of marine health. This review is intended as a guide to the diagnostic investigation of sick or injured sea snakes by suitably qualified people.

Veterinary applications of induced pluripotent stem cells: regenerative medicine and models for disease?

Induced pluripotent stem cells (iPSCs) can now be derived from a tissue biopsy and represent a promising new platform for disease modelling, drug and toxicity testing, biomarker development and cell-based therapies for regenerative medicine. In regenerative medicine, large animals may represent the best models for man, and thereby provide invaluable systems in which to test the safety and the potential of iPSCs. Hence, testing iPSCs in veterinary species may serve a double function, namely, developing therapeutic products for regenerative medicine in veterinary patients while providing valuable background information for human clinical trials. The production of iPSCs from livestock or wild species is attractive because it could improve efficiency and reduce costs in various fields, such as transgenic animal generation and drug development, preservation of biological diversity, and because it also offers an alternative to xenotransplantation for in vivo generation of organs. Although the technology of cellular reprogramming using the so-called 'Yamanaka factors' is in its peak expectation phase and many concerns still need to be addressed, the rapid technical progress suggests that iPSCs could contribute significantly to novel therapies in veterinary and biomedical practice in the near future. This review provides an overview of the potential applications of iPSCs in veterinary medicine.

Parenteral nutrition: formulation, monitoring, and complications.

Because decreased caloric and nutrient intake can complicate the course of both mild and serious illness, parenteral nutrition (PN) is an important feeding modality for patients unable to receive adequate enteral nutrition. Although the effectiveness of PN has not been proven in animals, human studies have shown that using PN in appropriately selected cases can improve clinical outcome, reduce hospitalization time, and even reduce the overall cost of patient care. PN formulations for animals are readily available through pharmacies. This article provides practitioners with basic information on calculating and using PN in patients. Information is also provided on monitoring patients receiving PN as well as ways to identify and overcome common complications in animals receiving PN.

Pet insurance--essential option?

As Hawn (2) says, "insurance is about risk and peace of mind." She reports that the American Humane Society supports pet insurance because companion animals are able to be treated for disease or accidents that are life-threatening where, otherwise, they would have been euthanized. For veterinarians, she suggests that pet insurance allows them to practice veterinary medicine "as if it were free." It is inevitable that pet insurance will grow as a recourse for veterinary fees. This may be a savior to some families whose budget is stretched to the limit at a critical moment in the health care of their cherished pet. We in the veterinary profession have an advantage over other professions. We have seen the good, the bad, and the ugly of insurance, as it applies to human health and dental care. If we work hand-in-hand with our own industries, collectively we may be able to develop a system that wins for everyone, with fees that allow practice to thrive and growth strategies that accommodate new treatment and diagnostic modalities, as well as consistent and exemplary customer service. The path ahead is always fraught with bumps and potholes. We can be a passive passenger and become a victim of the times or an active driver to steer the profession to a clearer route. Pet insurance is but one of the solutions for the profession; the others are a careful assessment of our fees--charging what we are worth, not what we think the client will pay; business management; customer service; leadership of our health care team; lifelong learning; and more efficient delivery systems. Let us stop being a victim, stop shooting ourselves in the professional foot, and seize the day!

[Therapy or euthanasia? How far may (and should) the veterinarian go in the treatment of an animal?]. / Therapieren oder euthanasieren? Wie weit darf (und soll) der Tierarzt in der Behandlung eines Tieres gehen?

Veterinarians are often faced with the question of whether they should treat or--in accordance with the animal owner--to end the life of a pet animal. This situation can be described as a moral dilemma. Can this moral dilemma be solved? The author argues that we have special moral obligations to care for pet animals. The special, quasi-personal relationships between pet animal and animal owners provide veterinarians in most cases with moral reasons to carry out the treatment.

Sustainable improvement of animal health care by systematic quality risk management according to the HACCP concept.

This paper addresses the principles of the Hazard Analysis Critical Control Point (HACCP) concept as applied to animal health management strategy. Characteristics of the concept were analysed and compared with those of current animal health care strategies for disease risk identification and herd health management, insurance, and certification. HACCP is a hybrid strategy of quality control at both production process and product level. Animal health is considered a particular quality feature. We show that process control (expressed in terms of controlling both general and specific disease risk factors) and product control (expressed in terms of testing animals or animal products for specific disease agents) could form the basis for improving animal health. We conclude that HACCP provides ample opportunity for preventive health action and risk management at a relatively low cost in terms of labour, finance and documentation expenditure, at both the farm and sector level. Epidemiological field studies are currently needed to identify critical control points and to design HACCP procedures for livestock producers. In the long run, HACCP based animal health care can be further developed into a quality control systems approach to cover all aspects that are related, either directly or indirectly, to animal health.