The impact of COVID-19 on access to canine integrative medical care in Michigan, USA, and Ontario and British Columbia, Canada.

OBJECTIVE: To determine the effects of the COVID-19 associated restrictions on the ability of owners in Michigan (MI), USA versus Ontario (ON) and British Columbia (BC), Canada, to obtain care for their chronically painful dogs. STUDY DESIGN: Cross-sectional survey. POPULATION: A total of 90 owners met the inclusion criteria for the study. METHODS: An anonymous electronic survey was distributed to owners at four veterinary integrative medicine (IM) clinics during July and August 2020. Two clinics in MI and one each in ON and BC were recruited. Owners were asked about availability of IM care preceding and during COVID-19 restrictions and their opinions of the impact of COVID-19 on their dog's health. The survey asked where owners sought care for their dogs, types of chronic conditions treated, therapeutic modalities used, and if owners had a medical background. Comparisons were made within and between groups. Thematic analysis, Fisher's exact test, chi-square analyses, McNemar's and Wilcoxon signed-rank tests for paired comparisons were performed (p < 0.05). RESULTS: During COVID-19 restrictions, access to IM care was better for dogs in ON and BC than in MI (p < 0.001). The negative effect of the pandemic restrictions to IM care on quality of life was perceived greater by owners in MI than those in ON and BC (p < 0.001). The owners' medical backgrounds had no effect on attempts to access care during this time (p = 0.76). CONCLUSIONS AND CLINICAL RELEVANCE: The results suggest that a widespread disease in humans had an adverse impact on animal welfare. Providers of veterinary care should use this experience to establish protocols to ensure continuity of care for chronically painful animals in the event of a similar situation in the future.

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.

[Spatial accessibility to animal health care - a GIS based analysis]. / Räumliche Zugänglichkeit zu tiermedizinischer Versorgung ­ eine GIS-basierte Analyse.

INTRODUCTION: Various studies from the past years examine the changing conditions and challenges in the veterinary sector. Secured access to public and private care services is a prerequisite for a holistically oriented health care system ("One Health"). In the present study, a multidimensional concept of accessibility to care services was used for the first time to determine and visualize the density of the animal health care system in Switzerland. Traditional indicators used to describe care structures focus either on availability or accessibility. In order to overcome the limitations of traditional indicators, the family of methods known as Floating-Catchment-Area-Methods (FCA) has been developed in care geographical research. The strength of FCA methods lies in the fact that they output accessibility independent of administrative boundaries and at the same time consider the spatial distance and available capacities. The study provides insight into the density of animal health care services using FCA methods and geographical information systems (GIS). Data on providers of veterinary services in the companion animal sector and, on the demand side, data on dogs and cats kept in Switzerland served as illustrative example. The result was interactive maps of the density of health care and the structure of spatial accessibility to veterinary providers and consumers. As expected, high spatial accessibility is found in the urban centers and the agglomerations of the Central Plateau. In contrast, spatial accessibility to medical services for dogs and cats is often lower in peripheral areas. Due to hitherto unavailable data, various analyses had to be postponed for the time being. For example, the model could of course be extended to all animal species and all types of medical services. In addition, it would also be possible to forecast the future density of health care, or to optimize the care system. Together with the relevant industry stakeholders, these gaps could be closed, and the model and the resulting findings could be further differentiated. The results should serve private actors in the concerned value chains, but also decision-makers in the public veterinary service, governmental authorities, agricultural bodies, universities, etc. as a basis for strategic decisions regarding the issue of medical supply density and care services in the animal sector.

INTRODUCTION: Ces dernières années, divers travaux ont examiné l'évolution des conditions cadres et des défis dans le secteur vétérinaire. L'assurance d'un accès aux soins publics et privés est une condition préalable à un système de santé holistique (« One Health ¼). Dans le travail présent, on a tenté pour la première fois d'enregistrer et de visualiser la densité d'approvisionnement du système de soins vétérinaires en Suisse en utilisant un concept multidimensionnel d'accessibilité aux offres de soins. Les indicateurs traditionnels pour décrire les structures de soins se concentrent soit sur la disponibilité soit sur l'accessibilité. Afin de contrer les limites des indicateurs traditionnels, la famille de méthodes du Floating-Catchment-Area (FCA) s'est développée dans la recherche en géographie sanitaire. La force des méthodes FCA est qu'elles fournissent un accès indépendamment des limites administratives, tout en tenant compte de la distance spatiale et de la capacité disponible. Ce travail permet d'avoir un aperçu de la densité de l'offre vétérinaire en utilisant la méthodologie FCA en tenant compte de systèmes d'information géographique (SIG). Les données sur les prestataires de services vétérinaires dans le secteur des animaux de compagnie et sur la demande concernant les chiens et les chats vivant en Suisse ont servi d'exemple. Le résultat a été des cartes interactives de la densité de l'offre et de la structure de l'accessibilité spatiale aux prestataires vétérinaires et de celle des consommateurs. Comme prévu, il existe un degré élevé d'accessibilité spatiale dans les centres urbains et les agglomérations du plateau suisse. En revanche, l'accessibilité spatiale aux services vétérinaires pour chiens et chats est souvent plus basse dans les zones périphériques. En raison de données indisponibles précédemment, diverses analyses ont dû être abandonnées dans un premier temps. Ce modèle pourrait être étendu à toutes les espèces animales et aux diverses offres vétérinaires. En outre, il serait également possible de faire des prévisions sur la future densité de l'offre ou sur son optimisation. Conjointement avec les acteurs de la branche concernés, ces lacunes pourraient être comblées avec certitude et le modèle et les résultats qui en résulteraient seraient encore plus différenciés. Les résultats sont destinés à aider les acteurs privés dans les chaînes de valeur ajoutée, mais ils pourraient aussi servir de base aux décideurs des services vétérinaires publics, aux autorités d'exécution, aux organes de l'agriculture, aux universités, etc., pour prendre des décisions stratégiques autour du thème de la densité de l'offre médicale dans le secteur animal.

[Einfluss eines komplementärmedizinischen telefonischen Beratungssystems auf den Antibiotikaeinsatz bei Nutztieren in der Schweiz]. / Influence of a Complementary and Alternative Medical Advisory Program by Telephone on the Use of Antibiotics in Livestock in Switzerland.

Hintergrund: Der Antibiotikaeinsatz bei Nutztieren fördert die Entwicklung antibiotikaresistenter Bakterien. Die Komplementärmedizin könnte einen Beitrag zur Reduktion von Antibiotika leisten, wird bisher jedoch nicht flächendeckend angeboten. Das Beratungsprogramm "Kometian" unter-stützt teilnehmende Landwirte darin, ihre Tiere komplementärmedizinisch zu behandeln. Methoden und Resultate: 128 von 223 teilnehmenden Betrieben nutzten in den ersten 3 Projektjahren die telefonische Beratung von Kometian. Die Mehrheit der Landwirte hielt Milchkühe. Frühestens 1 Woche nach der Kometianberatung wurde eine telefonische Nachfrage beim Tierbesitzer hinsichtlich des Gesundheitszustandes des Tieres durchgeführt. Es konnten so 661 Beratungsfälle recherchiert werden. In 486 Fällen erfolgte keine weitere schulmedizinische Behandlung, in 373 Fällen gab der Landwirt einen Behandlungserfolg an. Von 188 angefragten und seit mindestens einem Jahr an Kometian teilnehmenden Betrieben stellten 46 ihre Behandlungsjournale zur Verfügung. Die betriebliche antibiotische Behandlungsinzidenz sank signifikant (p < 0,001) von 27 vor Beitritt auf 18 Behandlungen pro 100 Tiere im ersten Jahr. Schlussfolgerung: Es scheint, dass Kometian einen Beitrag dazu leisten konnte, den Antibiotikaeinsatz auf Betriebsebene zu reduzieren. BACKGROUND: A regular use of antibiotics in farm animals is assumed to induce antibiotic-resistant bacteria. Complementary and alternative medicine (CAM) may contribute to a reduction of antibiotic use but it is not extensively offered by Swiss veterinarians. The advisory program "Kometian" supports farmers in treating their animals with CAM. METHODS AND RESULTS: 128 out of 223 participating farmers used the telephone consultations of Kometian in the first 3 years of the project. The majority of the farmers kept dairy cattle. No sooner than 1 week after such a consultation, the famer was questioned by phone about the health progress of the animal. Thus, the development of health could be verified in 661 cases (of 714). 486 cases were not treated further by conventional medicine; in 373 cases the farmer reported a positive treatment effect. Of 188 examined farms, which had participated in the advisory program for at least 1 year, 46 made their treatment records available. The incidence of antibiotic treatment decreased significantly (p < 0.001) from 27 before entering the program to 18 treatments per 100 animals in the first year. CONCLUSION: It seems that the advisory program Kometian could contribute to reduce the use of antibiotics on the farm level.

Randomised controlled trials of veterinary homeopathy: characterising the peer-reviewed research literature for systematic review.

INTRODUCTION: Systematic review of the research evidence in veterinary homeopathy has never previously been carried out. This paper presents the search methods, together with categorised lists of retrieved records, that enable us to identify the literature that is acceptable for future systematic review of randomised controlled trials (RCTs) in veterinary homeopathy. METHODS: All randomised and controlled trials of homeopathic intervention (prophylaxis and/or treatment of disease, in any species except man) were appraised according to pre-specified criteria. The following databases were systematically searched from their inception up to and including March 2011: AMED; Carstens-Stiftung Homeopathic Veterinary Clinical Research (HomVetCR) database; CINAHL; Cochrane Central Register of Controlled Trials; Embase; Hom-Inform; LILACS; PubMed; Science Citation Index; Scopus. RESULTS: One hundred and fifty records were retrieved; 38 satisfied the acceptance criteria (substantive report of a clinical treatment or prophylaxis trial in veterinary homeopathic medicine randomised and controlled and published in a peer-reviewed journal), and were thus eligible for future planned systematic review. Approximately half of the rejected records were theses. Seven species and 27 different species-specific medical conditions were represented in the 38 papers. Similar numbers of papers reported trials of treatment and prophylaxis (n=21 and n=17 respectively) and were controlled against placebo or other than placebo (n=18, n=20 respectively). Most research focused on non-individualised homeopathy (n=35 papers) compared with individualised homeopathy (n=3). CONCLUSION: The results provide a complete and clarified view of the RCT literature in veterinary homeopathy. We will systematically review the 38 substantive peer-reviewed journal articles under the main headings: treatment trials; prophylaxis trials.

Evidence-based complementary and alternative veterinary medicine--a contradiction in terms?

Complementary and Alternative Medicine (CAM) like acupuncture, herbal medicine and homeopathy is increasingly used in the treatment of human and animal disease. On the other hand, CAM is discussed controversially, especially in the context of Evidence-Based Veterinary Medicine (EBVM). This paper provides a balanced analysis of the currently available data on CAM in human and veterinary medicine. In conclusion, little rigorous research data concerning the efficacy and safety of CAM has been published. However, acupuncture is gaining increasing acceptance in academic medicine, based on several metaanalyses that show efficacy for specific conditions. In practice, decisions concerning CAM therapies should also be based on the best available evidence provided by scientifically valid data. This implies that CAM interventions must be validated by stringent high quality research to obtain an objective and replicable overview of efficacy and safety. Nevertheless, trials should be designed according to important aspects of CAM therapies (e.g. individual treatment). In conclusion, Evidence-Based Alternative Veterinary Medicine is not a contradiction in terms.

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.

Database on veterinary clinical research in homeopathy.

OBJECTIVE: The aim of the present report is to provide an overview of the first database on clinical research in veterinary homeopathy. PROCEDURES: Detailed searches in the database 'Veterinary Clinical Research-Database in Homeopathy' (http://www.carstens-stiftung.de/clinresvet/index.php). RESULTS: The database contains about 200 entries of randomised clinical trials, non-randomised clinical trials, observational studies, drug provings, case reports and case series. Twenty-two clinical fields are covered and eight different groups of species are included. The database is free of charge and open to all interested veterinarians and researchers. CONCLUSION: The database enables researchers and veterinarians, sceptics and supporters to get a quick overview of the status of veterinary clinical research in homeopathy and alleviates the preparation of systematical reviews or may stimulate reproductions or even new studies.

The use of zootherapeutics in folk veterinary medicine in the district of Cubati, Paraíba State, Brazil.

BACKGROUND: The present work addresses the use of zootherapy in folk veterinary medicine (ethnoveterinary) by the residents of the municipal district of Cubati, microregion of Seridó, Paraíba State, Brazil. It sought to identify the principal animals used as medicinal sources for zootherapeutics and to contribute to the preservation and sustainability of this traditional knowledge. METHODS: Field research was undertaken on a weekly or biweekly basis during the period November, 2006, to January, 2007. Free, semi-structured, and open interviews were made with local residents of the municipal district of Cubati (in both urban and rural settings) as well as with venders in public markets. A total of 25 individuals of both sexes were interviewed (with ages varying from 26 to 78 years) although only 16 were finally chosen as informants as these people demonstrated the greatest degree of knowledge concerning zootherapeutics. Graphs and percentages were generated using Microsoft Excel 2007 software, and the species were identified by photographic registration and subsequent bibliographical surveys. RESULTS: Mammals constitute the main medicinal zootherapeutic source for folk veterinary medicines in the studied area, both in terms of the total number of species used and the frequency of their citation. Sheep (Ovis aries), pigs (Sus scrofa), cattle (Bos taurus), and foxes (Cerdocyon thous) were mentioned by 62.5, 43.75, 37.5, and 31.25% of the informants, respectively, as being used in folk veterinary medicine. Additionally, chameleons (Iguana iguana), chickens (Gallus domesticus), and rattlesnakes (Crotalus durissus) were mentioned by 75, 43.75, and 31.25% of the informants, respectively. Relatively simple animal illnesses, such as furuncles, or injuries resulting from embedded thorns or skin eruptions are responsible for the largest number of zootherapeutic treatment, while, diseases of greater complexity, such as rabies and brucellosis, were not even mentioned. Fat from various animals constituted the most frequently cited resource used for its medicinal-veterinary properties. CONCLUSION: The examination of folk knowledge and health practices allows a better understanding of human interactions with their local environment, and aids in the formulation of appropriate strategies for natural resource conservation.

Outcomes from homeopathic prescribing in veterinary practice: a prospective, research-targeted, pilot study.

BACKGROUND AND AIMS: Targeted research development in veterinary homeopathy is properly informed by the systematic collection and analysis of relevant clinical data obtained by its practitioners. We organised a pilot data collection study, in which 8 Faculty of Homeopathy veterinarians collected practice-based clinical and outcomes data over a 6-month period. METHODS: A specifically designed Excel spreadsheet enabled recording of consecutive clinical appointments under the following headings: date; identity of patient and owner (anonymised); age, sex and species of patient; medical condition/complaint treated; whether confirmed diagnosis, chronic or acute, new or follow-up case; owner-assessed outcome (7-point Likert scale: -3 to +3) compared with first appointment; homeopathic medicine/s prescribed; other medication/s for the condition/complaint. Spreadsheets were submitted monthly by e-mail to the project organisers for data checking, synthesis and analysis. RESULTS: Practitioners submitted data regularly and punctually, and most data cells were completed. 767 individual patients were treated (547 dogs, 155 cats, 50 horses, 5 rabbits, 4 guinea-pigs, 2 birds, 2 goats, 1 cow, and 1 tortoise). Outcome from two or more homeopathic appointments per patient condition was obtained in 539 cases (79.8% showing improvement, 6.1% deterioration, 11.7% no change; outcome not recorded in 2.4% of follow-ups). Strongly positive outcomes (scores of +2 or +3) were achieved in: arthritis and epilepsy in dogs and, in smaller numbers, in atopic dermatitis, gingivitis and hyperthyroidism in cats. CONCLUSIONS: Systematic recording of data by veterinarians in clinical practice is feasible and capable of informing future research in veterinary homeopathy. A refined version of the spreadsheet can be used in larger-scale research-targeted veterinary data collection.

Estudo retrospectivo de casos clínicos homeopáticos atendidos no serviço ambulatorial veterinário do IHFL, Ribeirão Preto, no período entre setembro de 1986 a dezembro de 2003 / Retrospective study of clinical homeopathic cases cared by the IHFL (escrito Veterinarian Ambulatory from September 1986 to December 2003

Este trabalho avaliou o desenvolvimento do serviço ambulatorial veterinário do Instituto Homeopático François Lamasson (IHFL) no período entre setembro de 1986 a dezembro de 2003. Quatrocentas fichas de animais atendidos no ambulatório foram analisadas quanto ao perfil do paciente (espécie, raça, sexo, idade e procedência) e quanto aos dados clínicos (incidência das doenças, exames complementares e medicamentos receitados). Foi concluído que o ambulatório teve um grande crescimento no período entre 1993 a 1996 e, nos últimos dois anos, ocorreu um restabelecimento e aumento do número de casos atendidos, fatos que refletem as oscilações em relação ao atendimento homeopático e demonstram que muito ainda precisa ser feito para consolidá-la como especialidade terapêutica frente à população

Investigation of calf health and welfare on dairy farms in south-west England.

A questionnaire was designed to investigate calf health and welfare on dairy farms in the south west of England with regard to the degree of compliance with the Welfare of Farmed Animals (England) Regulations 2000. The level of veterinary involvement in calf rearing and management on dairy farms in the south west of England was also assessed. The questionnaire was sent to 32 large animal practices in the catchment area of the Veterinary Laboratories Agency--Langford. Compliance with the regulations was found to be variable. The requirements for the isolation of sick calves, provision of bovine colostrum within six hours of birth, the provision of fresh, clean water and restrictions concerning tethering were not well complied with. However, the requirements for twice-daily feeding and inspection, visual and tactile contact between calves, access to forage and the provision of clean, dry bedding were well complied with. The results also suggested that there was some lack of veterinary input into the health and welfare of calves on dairy farms visited by the practices routinely and non-routinely.