Is there any change in the prevalence of intestinal or cardiopulmonary parasite infections in companion animals (dogs and cats) in Germany between 2004-2006 and 2015-2017? An assessment of the impact of the first ESCCAP guidelines.

Main objective of the present nationwide study was to assess the impact of the ESCCAP guideline for the control of worm infections in dogs and cats 8-10 years after its first publication in Germany. A secondary aim was to determine the prevalence of canine and feline cardiopulmonary nematodes and intestinal protozoa. Faecal samples of 53,693 dogs and 26,491 cats in 2004-2006 as well as of 129,578 dogs and 45,709 cats in 2015-2017 routinely submitted by veterinarians to a private veterinary laboratory were examined using appropriate parasitological methods. In dogs, the prevalence of Toxocara and taeniid egg shedding was significantly lower in 2015-2017 (3.8 % and 0.16 %, respectively) than in 2004-2006 (4.6 % and 0.27 %, respectively). The prevalence of hookworm and Capillaria eggs was higher in the second study period (2.3 % and 0.77 %, respectively) than in the first (1.3 % and 0.6 %, respectively). For Toxascaris leonina (0.55-0.6 %) and Trichuris (0.8-0.9 %), the difference was not significant between the study periods. Dogs shed more often Angiostrongylus vasorum larvae in the second study (3.1 %) than in the first (1.0 %), whereas the prevalence of Crenosoma vulpis did not change significantly (2.2-2.6 %). Cystoisospora canis and C. ohioensis-like infections were less detected in the second study period (1.0 % and 2.1 %, respectively) than in the first (1.8 % and 2.7 %, respectively). Neospora-like oocysts and Sarcocystis sporocysts were more prevalent in the second study period (0.19 % and 0.13 %, respectively) than in the first (0.13 % and 0.06 %, respectively). The percentage of Giardia or Cryptosporidium coproantigen-positive samples was lower in the second study period (18.9 % and 6.7 %, respectively) than in the first (22.8 % and 10.0 %, respectively). In cats, the prevalence of egg shedding of T. cati, Capillaria and taeniids was significantly lower in 2015-2017 (3.5 %, 0.25 % and 0.1 %, respectively) than in 2004-2006 (4.8 %, 0.54 % and 0.22 %, respectively). No difference was recorded for hookworms (0.12-0.13 %) and Ts. leonina (0.04-0.05 %). Aelurostrongylus-like larvae were detected more often in the second study period (6.5 %) than in the first (2.6 %). Infections with Cystoisospora felis, C. rivolta, Toxoplasma-like coccids and Sarcocystis were less prevalent in the second study period (1.9 %, 0.7 %, 0.24 % and 0.02 %, respectively) than in the first (2.7 %, 1.1 %, 0.36 % and 0.1 %, respectively). The percentage of Giardia or Cryptosporidium coproantigen-positive samples was significantly lower in the second study period (10.6 % and 4.8 %, respectively) than in the first (15.4 % and 8.3 %, respectively). Although these results indicate a decline of the occurrence of most canine and feline intestinal parasites in Germany over the years, a transmission risk of zoonotic parasites remains. Therefore, the control of helminth infections in domestic dogs and cats continues to be a challenge for veterinarians and pet owners.

"Can we agree on that"? Plurality, power and language in participatory research.

Participatory epidemiology (PE) is a method that gathers data from groups through focus group interviews and participatory visual and scoring exercises. The method is often used in poor communities in low-income countries where it is hard to obtain conventional epidemiological data. This paper draws on research on the public sphere and democratic deliberation, along with research on language and interpretation, to suggest how PE research could be better equipped to account for diversity in local knowledge, include minority views and acknowledge power dynamics. These aspects are discussed under the three themes of 'plurality', 'power' and 'language'. A review of highly-cited PE literature suggests that PE research engages with plurality and power to a very limited extent, and only marginally more so with language and translation. Examples are taken from the authors' own PE research on African swine fever in -Uganda, classical swine fever in Germany, peste des petits ruminants (PPR) in Eastern Europe, and Ugandan pastoralists' understanding of cattle disease to provide more detail as to why conventional PE studies might fail to record issues of plurality, power and language, and also to suggest how this can be addressed. With reference to the literature on the public sphere and democratic deliberation, and on language and interpretation, this paper concludes with some suggestions as to how to take plurality, power and language into greater consideration in PE studies in future, thus improving the validity and reliability of PE data.

Why measuring outcomes is important in health care.

A new strategy has been introduced in human health care, namely, achieving the best outcomes for the lowest cost and thus maximizing value for patients. In value-based care, the only true measures of quality are the outcomes that matter to patients. When outcomes are measured and reported, it fosters improvement and adoption of best practices, thus further improving outcomes. Understanding outcomes is central in providing value and represents an opportunity for redefining veterinary patient care. Value is created by improving the outcomes of patients with a particular clinical condition over the full cycle of care, which normally involves multiple specialties and care sites. To be successful, a key aspect of value based care is working as teams (integrated practice units) centered around the patient's clinical condition. As veterinary medicine has become more specialized and more complex, multidisciplinary communication and trust among the care team are paramount in providing value to patients (and clients). Use of patient-reported outcomes is an essential aspect for improving clinical care, because it enhances the connections among doctors and with patients. Designing and implementing owner-reported outcomes in veterinary clinical practice will lead to an understanding of the effects of treatments on outcomes and quality of life (QOL) of our patients from the owner's perspective, a key way to assess a veterinary patient's QOL.

Building the foundation for veterinary register-based epidemiology: A systematic approach to data quality assessment and validation.

Epidemiological studies often use data from registers. Data quality is of vital importance for the quality of the research. The aim of this study was to suggest a structured workflow to assess the quality of veterinary national registers. As an example of how to use the workflow, the quality of the following three registers was assessed: the Central Husbandry Register (CHR), the database for movement of pigs (DMP) and the national Danish register of drugs for veterinary use (VetStat). A systematic quantitative assessment was performed, with calculation the proportion of farms and observations with "poor quality" of data. "Poor" quality was defined for each measure (variable) either as a mismatch between and/or within registers, registrations of numbers outside the expected range, or unbalanced in- and outgoing movements. Interviews were conducted to make a complementary qualitative assessment. The proportion of farms and observations within each quality measure varied. This study highlights the importance of systematic quality assessment of register data and suggests a systematic approach for such assessments and validations without the use of primary data.

Are we adequately evaluating subsidized veterinary services? A scoping review.

The World Health Organization (WHO) and the World Organization for Animal Health (OIE) both recognize the importance of veterinary services in controlling zoonotic diseases, in preventing human injury, and in protecting the welfare of non-human animals. Furthermore, both organizations recommend regular evaluations of veterinary programs. Accordingly, we conducted a scoping review to collate the available peer-reviewed evaluations of subsidized small animal veterinary services in terms of the effects on animal and public health. We summarized the evaluation methods used, identified key journals in this disparate literature, and identified gaps in knowledge. CAB Abstracts, PubMed, and Scopus were searched, yielding 1441 records published between 2009 and 2016 for initial screening. After examining titles and keywords, abstracts, and finally full articles, we identified 32 relevant papers that evaluated 27 distinct programs. The global distribution was broad, with half of the papers evaluating programs in Africa or Asia, all of which were rabies vaccination programs targeting dogs. Three program evaluation categories were identified: zoonotic disease prevention (9 papers), animal welfare and control (9 papers), and One Health promotion (14 papers). Nearly three-quarters (72%) of the papers used more than one method for collecting data. The most common data sources were questionnaires (22 papers) and administrative records, such as medical charts (21 papers). The most common indicators used for animal health-related program assessments were the number of animals reached by the program (27 papers) and any changes in animal population demographics (22 papers). These indicators were found in all three types of program evaluations (i.e., zoonotic disease prevention, animal welfare/control, and One Health promotion). For public health-related program assessments, the most common indicators consisted of determining barriers to a veterinary program's success (13 papers), followed by costs of a program (11 papers), changes in perceived threats or nuisances (11 papers), and community knowledge of a zoonotic disease (11 papers). The small number of papers identified in this review, n = 32, underscores that comprehensive evaluations of subsidized veterinary services are uncommon in the peer-reviewed literature. Yet, when performed, such evaluations can help guide program delivery and future research. Given the high stakes and the high costs of subsidized veterinary services, greater efforts in program evaluation are warranted.

Why has it taken so long to improve cat care?

Claire Bessant argues that although great strides have been made in understanding the clinical needs of cats, the veterinary sector has been slow to make progress in improving their wellbeing in veterinary clinics, and more needs to be done to meet the welfare needs of cats.

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.

Participatory Policy Making by Dairy Producers to Reduce Anti-Microbial use on Farms.

Pressures for more responsible use of anti-microbial (AM) medicines in food animals are likely to increase from policymakers and the food industry, including retailers. To address this challenge, participatory approaches to welfare interventions and disease prevention may also be necessary alongside more conventional regulatory measures. This article describes the process of enabling groups of dairy producers to use a participatory policy making approach to develop an AM stewardship policy. The policy includes measures agreed to by all producers for more responsible use of AMs, whilst maintaining or improving dairy herd health and welfare. This process provided a unique opportunity for collaboration and dialogue between producers, veterinarians, industry and researchers. Its participatory nature encouraged comprehensive learning for all involved. This integration of science with producers' knowledge and experience led to credible and practical recommendations designed to deliver real and lasting change in AM use. The multidisciplinary nature of this research marks a significant contribution to embedding social science skills and approaches into the veterinary sphere. As an initial step in creating better understanding of how participatory approaches with farmers can be applied in a UK context and more widely, this work serves as a pilot for promoting more responsible use of veterinary medicines in other livestock species.

Sustainability and economic investments in animal health systems.

The paper outlines a framework for shaping and prioritising improvements to investments in animal health systems in order to improve their sustainability. The framework includes financial inputs that can be separated between core investments and day-to-day expenditures. The latter financial inputs should differentiate between avoiding losses in production and reducing wider societal impacts such as negative implications for trade and the environment. Overall the framework provides information on the financial costs of the animal health system and the animal health outcomes that, if collected over time, will allow the efficiency of resource use across the system to be measured. It discusses an application of the framework using existing data, which highlighted problems with measuring and costing veterinary inputs, and with quantifying the range of outputs and the impact of veterinary activities. The paper recommends that the framework proposed is reviewed and compared with work that has been carried out on the human health accounting systems. A true application of the framework will require data sets that can differentiate between public-sector, private-sector and non-governmental organisation investments and the cost of day-to-day animal health goods and services paid by animal owners. Data sets are also needed on animal health outcomes in order to compare investments with animal health outcomes and thereby: demonstrate the success of previous investments, identify weaknesses in the investment profile and ensure that future investments sustain an animal health system, which functions well.

Les auteurs exposent les grandes lignes d'un cadre permettant de définir et de hiérarchiser les améliorations à apporter aux investissements dans les systèmes de santé animale en vue d'une meilleure durabilité. Le cadre prévoit les apports financiers à prendre en compte, qui peuvent être répartis en investissements de fond et dépenses de fonctionnement. Ces derniers apports devraient établir une distinction entre les pertes de production qu'ils permettent d'éviter et l'atténuation d'impacts sociétaux plus larges tels que les effets négatifs des maladies sur le commerce et l'environnement. Dans l'ensemble, le cadre fournit des renseignements sur les coûts financiers d'un système de santé animale et sur les résultats obtenus ; collectées sur des durées longues, ces données permettront de mesurer l'efficacité de l'utilisation des ressources au sein du système. Les auteurs analysent les résultats d'une application du cadre à partir de données existantes, qui mettent en évidence les problèmes liés à la mesure et au chiffrage du coût des intrants vétérinaires et à la quantification des divers extrants et de l'impact des prestations vétérinaires. Les auteurs recommandent que le cadre proposé soit réexaminé et comparé à d'autres travaux relatifs aux systèmes de gestion financière de la médecine humaine. Une véritable application du cadre devra faire appel à des séries de données capables de différencier les investissements suivant leur provenance (secteur public, secteur privé, organisations non gouvernementales) et le coût des biens et services courants de santé animale pris en charge par les propriétaires d'animaux. Il faudra également disposer de données sur les résultats obtenus en santé animale afin de comparer les investissements avec ces résultats et de démontrer ainsi le succès des investissements réalisés, identifier les points faibles de la stratégie d'investissement et s'assurer que les investissements à venir soutiennent un système de santé animale qui fonctionne bien.

Los autores describen sucintamente un marco destinado a formular y jerarquizar medidas de mejora de las inversiones en los sistemas de sanidad animal para lograr que estos sean más sostenibles. Dicho marco incluye las aportaciones económicas, que pueden dividirse en inversiones básicas y gastos corrientes. Dentro de estas aportaciones conviene distinguir entre aquellas destinadas a evitar pérdidas productivas y aquellas que apuntan a reducir consecuencias de mayor calado para la sociedad, por ejemplo efectos negativos sobre el comercio o el medio ambiente. Globalmente, el marco ofrece información sobre los costos económicos del sistema de sanidad animal y los resultados zoosanitarios que, cuantificados a lo largo del tiempo, permitirán medir la eficiencia con que el conjunto del sistema utiliza los recursos. Los autores refieren una aplicación del marco en la que se emplearon datos concretos, lo que puso de manifiesto la existencia de problemas para medir las aportaciones veterinarias y evaluar su costo y para cuantificar los diversos resultados y efectos de la actividad veterinaria. Así pues, los autores abogan por revisar el marco propuesto y compararlo con el trabajo ya realizado en relación con sistemas de «contabilidad¼ de la salud humana. Para aplicar realmente este marco harán falta conjuntos de datos que permitan discriminar entre las inversiones del sector público, las del sector privado y las de organizaciones no gubernamentales y determinar el costo que tienen los bienes y servicios zoosanitarios cotidianos para los propietarios de animales. También se necesitan conjuntos de datos sobre los resultados zoosanitarios, que sirvan para comparar las inversiones con los resultados obtenidos en sanidad animal y, de este modo, demostrar el éxito de inversiones previas, detectar deficiencias en los patrones de inversión y asegurarse de que las futuras inversiones vengan a sostener un sistema de sanidad animal que funcione debidamente.

ASVCP quality assurance guidelines: external quality assessment and comparative testing for reference and in-clinic laboratories.

The purpose of this document is to educate providers of veterinary laboratory diagnostic testing in any setting about comparative testing. These guidelines will define, explain, and illustrate the importance of a multi-faceted laboratory quality management program which includes comparative testing. The guidelines will provide suggestions for implementation of such testing, including which samples should be tested, frequency of testing, and recommendations for result interpretation. Examples and a list of vendors and manufacturers supplying control materials and services to veterinary laboratories are also included.

Assessment of an implant-skin interface scoring system for external skeletal fixation of dogs.

OBJECTIVE To assess intraobserver repeatability and interobserver and in vivo versus photographic agreement of a scoring system for the implant-skin interface (ISI) of external skeletal fixation (ESF). SAMPLE 42 photographs of ISIs from 18 dogs for interobserver agreement and intraobserver repeatability and 27 photographs of ISIs from 6 dogs for in vivo versus photograph agreement. PROCEDURES An ISI inflammation scoring system was developed. It included scales for 6 metrics (erythema, drainage amount, drainage type, swelling, hair loss or lack of hair regrowth, and granulation tissue). Photographs of the ISI of ESF were obtained by use of a standard protocol and evaluated to determine intraobserver repeatability and interobserver agreement (Cronbach α; 4 raters) of the ISI score. Agreement between in vivo and photographic ISI scores (2 raters) and correlation between median scores across metrics were evaluated. RESULTS 42 photographs met the inclusion criteria. Overall intraclass correlation coefficients ranged from 0.922 to 0.975. Interobserver overall Cronbach α ranged from 0.835 to 0.943. For in vivo versus photographic assessment, 27 ISIs in 6 dogs and their photographs were evaluated. The Cronbach α for both raters ranged from 0.614 to 0.938. Overall, the Cronbach α ranged from 0.725 to 0.932. Mean photographic scores were greater than mean in vivo scores for each metric. Pearson correlation coefficients ranged from 0.221 to 0.923. Erythema, swelling, and granulation were correlated with all other metrics. CONCLUSIONS AND CLINICAL RELEVANCE In this study, an ISI scoring system used in this study had high repeatability and agreement and may therefore be considered for use in clinical situations. Photographic scores were not equivalent to in vivo scores and should not be used interchangeably.

Antimicrobial dispensing by Ontario dairy veterinarians.

This questionnaire-based cross-sectional study was designed to capture the demographics of dairy practitioners in Ontario and to describe aspects of antimicrobial dispensing on-farm and over-the-counter by these veterinarians. The information collected revealed that the prescription status of a drug and the level of veterinary-client-patient relationship were important elements of dispensing policies. Over-the-counter dispensing records were incomplete, while only a small proportion of on-farm dispensing records contained pertinent information and directions as required by the Veterinarians Act. While respondents recognized that antimicrobial use in dairy herds could lead to resistance in cattle, few indicated that this was a significant public health issue. Veterinarians can play a key role in antimicrobial stewardship, part of which is the provision of complete written dispensing instructions to producers for antimicrobial use in dairy cattle.

La distribution des agents antimicrobiens par les vétérinaires qui s'occupent des vaches laitières en Ontario. Cette étude en coupe transversale a été réalisée à partir de réponses recueillies d'un questionnaire qui ciblait les données démographiques des praticiens des fermes laitières de l'Ontario en plus de décrire les habitudes de dispense des doses d'agents antimicrobiens in situ par les vétérinaires ou en vente libre auprès des distributeurs. Cette information nous a permis de reconnaître que le statut de l'agent antimicrobien prescrit et le niveau de relation entre le vétérinaire-client-patient sont des éléments très importants de la politique de dispense. Les données concernant les agents antimicrobiens achetés sans prescription étaient incomplètes dans les points de vente et seulement une petite proportion des données internes à la ferme contenait les informations et les dosages tels que requis par la loi sur les vétérinaires. Les répondants reconnaissaient que l'utilisation des agents antimicrobiens chez les vaches laitières pouvait élever leur résistance à ceux-ci, mais peu d'entre eux mentionnaient que ceci engendrait une réelle inquiétude pour la santé publique. Les vétérinaires ont donc un rôle clé à jouer et ils devront être assidus en fournissant, par écrit, des instructions complètes sur les prescriptions d'agents antimicrobiens aux producteurs de vaches laitières.(Traduit par les auteurs).