Survey of US Veterinary Students on Communicating with Limited English Proficient Spanish-Speaking Pet Owners.

Veterinary schools and colleges generally include communication skills training in their professional curriculum, but few programs address challenges resulting from language gaps between pet owners and practitioners. Due to shifting US demographics, small animal veterinary practices must accommodate an increasing number of limited English proficient (LEP) Spanish-speaking pet owners (SSPOs). A national survey was conducted to assess the interest and preparedness of US veterinary students to communicate with LEP SSPOs when they graduate. This online survey, with more than 2,000 first-, second-, and third-year US veterinary students, revealed that over 50% of students had worked at a practice or shelter that had LEP Spanish-speaking clients. Yet fewer than 20% of these students described themselves as prepared to give medical information to an LEP SSPO. Over three-fourths of respondents agreed that communication with LEP SSPOs was important for veterinarians in general, and two-thirds agreed that communication with LEP SSPOs was important for themselves personally. Ninety percent of students who described themselves as conversant in Spanish agreed that they would be able to communicate socially with SSPOs, while only 55% said they would be able to communicate medically with such clients. Overall, two-thirds of students expressed interest in taking Spanish for Veterinary Professionals elective course while in school, with the strongest interest expressed by those with advanced proficiency in spoken Spanish. Bridging language gaps has the potential to improve communication with LEP SSPOs in the veterinary clinical setting and to improve patient care, client satisfaction, and the economic health of the veterinary profession.

Association of doxycycline prescriptions and tick-related emergency department visits in North Carolina.

OBJECTIVES: To compare the seasonal frequency of doxycycline prescriptions with tick-related emergency department (ED) visits in North Carolina, and to determine if doxycycline prescriptions are associated in time with an increase in the number of ED visits for a tick-related patient complaint or a subsequent diagnosis of a tick-borne infection. METHODS: Aggregate monthly counts of total dispensed doxycycline prescriptions for each North Carolina Piedmont Metropolitan Statistical Area (MSA) were compared with the proportions of tick-related ED visits from August 2007 through July 2009. RESULTS: Epidemic curves of tick-related ED visits for each of the 6 MSAs were characterized by increased frequency in the spring and summer months followed by a decline in the fall. However, the pattern of doxycycline prescriptions varied by MSA. Doxycycline prescriptions in Durham-Chapel Hill and Raleigh-Cary MSAs increased in the spring and summer, while for the 4 other Piedmont MSAs there was no consistent or pronounced spring-summer increase. CONCLUSION: Doxycycline prescription use did not always correlate well with suspected tick activity in North Carolina. Therefore, doxycycline prescription use cannot necessarily be used as a surrogate measure of tick activity for infectious disease surveillance until the reasons for this variability are better understood.

A Critical Needs Assessment for Research in Companion Animals and Livestock Following the Pandemic of COVID-19 in Humans.

Problem: The emergence of novel coronavirus (SARS-CoV-2) in Wuhan, China, in November 2019 and a growing body of information compel inquiry regarding the transmissibility of infection between humans and certain animal species. Although there are a number of issues to be considered, the following points are most urgent: The potential for domesticated (companion) animals to serve as a reservoir of infection contributing to continued human-to-human disease, infectivity, and community spread. The ramifications to food security, economy, and trade issues should coronavirus establish itself within livestock and poultry. The disruption to national security if SARS-CoV-2 and its fairly well-established effects on smell (hyposmia/anosmia) to critical military service animals including explosive detector dog, narcotics detector dog, specialized search dog, combat tracker dog, mine detection dog, tactical explosive detector dog, improvised explosive device detector dog, patrol explosive detector dog, and patrol narcotics detector dog, as well as multipurpose canines used by special operations such as used by the U.S. customs and border protection agency (e.g., Beagle Brigade). This article presents in chronological order data that both individually (as received independently from multiple countries) and collectively urge studies that elucidate the following questions. 1.What animal species can be infected with SARS-CoV-2, the likely sources of infection, the period of infectivity, and transmissibility between these animals and to other animal species and humans? 2.What are the best diagnostic tests currently available for companion animals and livestock? 3.What expressions of illness in companion and other animal species can serve as disease markers? Although it is recognized that robust funding and methodology need to be identified to apply the best scientific investigation into these issues, there may be easily identifiable opportunities to capture information that can guide decision and study. First, it may be possible to quickly initiate a data collection strategy using in-place animal gatekeepers, such as zookeepers, veterinarians, kennel owners, feed lots, and military animal handlers. If provided a simple surveillance form, their detection of symptoms (lethargy, hyposmia, anosmia, and others) might be quickly reported to a central data collection site if one were created. Second, although current human COVID-19 disease is aligning around areas of population density and cluster events, it might be possible to overlay animal species density or veterinary reports that could signal some disease association in animals with COVID-19 patients. Unfortunately, although companion animals and zoo species have repeatedly served as sentinels for emerging infectious diseases, they do not currently fall under the jurisdiction of any federal agency and are not under surveillance.

Prevalence of intestinal nematode parasitism among pet dogs in the United States (2003-2006).

OBJECTIVE: To estimate prevalence of intestinal nematode parasitism among pet dogs in the United States and characterize risk factors for infection. DESIGN: Retrospective period prevalence survey. ANIMALS: 1,213,061 dogs examined at 547 private veterinary hospitals in 44 states from January 1, 2003, through December 31, 2006. PROCEDURES: Data were obtained from electronic medical records of all dogs that had at least 1 fecal flotation test. Risk factors for intestinal nematode parasitism were identified by means of multivariable logistic regression analysis. RESULTS: 2,785,248 fecal flotation tests were performed during the study period. When results for only the first test in each dog were considered, prevalences of Toxocara, Ancylostoma, and Trichuris parasitism were 5.04%, 4.50%, and 0.81%, respectively. Dogs < 0.5 years old had higher odds of Toxocara and Ancylostoma parasitism, compared with dogs > 5.0 years old; sexually intact male and female dogs had higher odds of parasitism, compared with spayed female dogs; toy dogs had lower odds of parasitism, compared with dogs in other breed groups; and dogs living in the mountain region had lower odds of parasitism, compared with dogs living in other regions. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that age, body weight, sex, breed, and geographic region were risk factors for intestinal nematode parasitism among pet dogs in the United States.

Companion animals as sentinels for community exposure to industrial chemicals: the Fairburn, GA, propyl mercaptan case study.

OBJECTIVES: This study utilized the electronic medical records of six veterinary hospitals (operated by Banfield, The Pet Hospital) in the vicinity of Fairburn, Georgia, to assess the health of dogs and cats following the unintentional release of propyl mercaptan from a waste-processing facility. METHODS: Standardized electronic medical records were used to define clinical syndromes (eye inflammation, gastrointestinal, respiratory, fever, general weakness/change in mental state) in dogs and cats. The frequency and geographic distribution of each syndrome was evaluated before, during, and after the chemical release, using control charts, density maps, change in average mean distance from a suspected point source of chemical release, space-time statistics, and autoregressive integrated moving averages. RESULTS: No consistent pattern of change in syndromic events was observed following the suspected release of propyl mercaptan. Some syndromes, including respiratory syndrome in cats, gastrointestinal syndrome in dogs, and eye inflammation syndrome in both cats and dogs, showed a change in time and spatial patterns following the release of propyl mercaptan into the community. These changes were consistent with clinical signs observed in people during a previous propyl mercaptan release in California as well as the release in Fairburn. CONCLUSIONS: A systematic review of electronic medical records of dogs and cats exposed to release of propyl mercaptan showed no conclusive and consistent evidence of adverse health effects. Methods for the use of medical records of pets for detecting environmental hazards require further development and evaluation.

Temporal association of implementation of the Arizona Health Care Cost Containment System (AHCCCS) with changes in dental-related emergency department visits in Maricopa County from 2006 to 2012.

OBJECTIVE: To evaluate changes in emergency department (ED) dental-related visits in Maricopa County before and after the elimination of dental benefits for adult Medicaid-insured patients as of October 2010. METHODS: Hospital visits extracted from a hospital discharge dataset were used to calculate a yearly rate ratio of dental-related versus non-dental-related ED visits (as a comparison group) for adults, children, and payer types. Changes in ED visits over time were evaluated from 2006 to 2012. RESULTS: Overall, 1.3 percent of all ED visits (8,030,767) were for dental-related purposes. Medicaid-insured patients accounted for 41.9 percent and 44.3 percent of all dental-related ED visits in 2006 and 2012, respectively. The rate ratio for the percentage of dental-related versus non-dental-related ED visits in each age category and payer type showed little fluctuation over time indicating no evidence of change in the dental-related ED visits as a proportion of the overall number of visits due to the cuts in the dental benefits for adult Medicaid-insured patients. CONCLUSION: We found no evidence that cuts in dental benefits for adult Medicaid-insured patients resulted in increased dental-related ED visits in Maricopa County during the study period. Rather, we found evidence of a shift in payer type after the 2010 policy change where dental-related ED visits by self-paid patients increased as dental-related ED visits by Medicaid-insured patients decreased. Such payer shifts will result in high uncompensated care burdens for providers and, ultimately, governmental payers.

Use of biomass fuel is associated with infant mortality and child health in trend analysis.

Biomass fuel used for cooking results in widespread exposure to indoor air pollution (IAP), affecting nearly 3 billion people throughout the world. Few studies, however, have tested for an exposure-response relationship between biomass fuel and health outcomes. The aim of this study was to explore the relationship between biomass fuel, infant mortality, and children's respiratory symptoms. Eighty households in a rural community in Ecuador were selected based on their use of biomass fuel and questioned regarding a history of infant mortality and children's respiratory symptoms. Carbon monoxide (CO) and particulate matter (PM) were measured in a subset of these homes to confirm the relationship between biomass fuel use and IAP. Results showed a significant trend for higher infant mortality among households that cooked with a greater proportion of biomass fuel (P=0.008). Similar trends were noted for history of cough (P=0.02) and earache (P<0.001) among children living in these households.

Prevalence of and risk factors for canine tick infestation in the United States, 2002-2004.

Knowledge of the geographic range and seasonal activity of vector ticks is important for determining which people or animals are at risk of acquiring tick-borne infections. Several time-consuming methods requiring large-scale organization are used to map geographic and seasonal variations in tick distribution. A cost-effective, complementary approach to study tick distribution using a large nation-wide veterinary database is described in this paper. Prevalence of canine tick infestation in 40 states was estimated by analyzing electronic medical records of more than 8 million dog visits to Banfield veterinary hospitals in 2002-2004. Prevalence was defined as the proportion of dog visits in which tick infestation was recorded, and was expressed per 10,000 dog visits with 95% confidence intervals (CI). The overall prevalence (CI) of tick infestation was 52 (51, 53) dogs per 10,000 dog visits. Among states, Oklahoma (249 [229, 271) dogs with ticks per 10,000 dog-visits), Arkansas (242 [213, 274]), Connecticut (136 [119, 155]), West Virginia (130 [105, 161]), and Rhode Island (122 [97, 154]) ranked highest in prevalence of canine tick infestation. Overall prevalence peaked from May through July, although monthly prevalence varied by geographic region. In multiple logistic regression, younger dogs, male dogs, and sexually intact dogs, were at increased risk of tick infestation. Toy breeds were least likely to be infested, but no linear pattern of risk was evident with body weight. Identified risk factors should enable veterinarians to prevent tick infestation in pet dogs although differences in risk of tick infestation may be related to outdoor activity of dogs. Feasibility of collecting information for surveillance of vectors ticks on a national level using this large, electronic veterinary database is discussed.

Time trends and risk factors for diabetes mellitus in cats presented to veterinary teaching hospitals.

Veterinary Medical Data Base records of cats with diabetes mellitus (DM) from 1970 through 1999 were reviewed to identify trends in hospital prevalence of DM and potential host risk factors. Hospital prevalence increased from eight cases per 10,000 in 1970 to 124 per 10,000 in 1999 (P < 0.001). Case fatality percent at first visit decreased from 40% to 10% (P < 0.001). Hospital prevalence increased in all age groups (P < 0.002). There was no apparent seasonal pattern in hospital prevalence. Significant risk factors included male gender, increasing age for both genders (P < 0.001), increasing weight for males (P < 0.001), and mixed vs pure breed for females (P = 0.006).

Purdue University-Banfield National Companion Animal Surveillance Program for emerging and zoonotic diseases.

A National Companion Animal Surveillance Program (NCASP) was established at Purdue University to monitor clinical syndromes and diseases using the electronic medical records of >80,000 companion animals visiting >500 Banfield hospitals weekly in 44 states. With funding from the Centers for Disease Control and Prevention, NCASP was initially developed for syndromic surveillance of Category A agents of bioterrorism. Surveillance was expanded through inclusion of electronic reports from Antech Diagnostics, a nationwide network of integrated veterinary diagnostic laboratories serving >18,000 private veterinary practices. NCASP characterizes and displays temporal and spatial patterns of diseases in dogs, cats, and other companion animals. It detects unusual clusters of potential emerging/zoonotic infections and monitors flea and tick activity. Data is processed and analyzed using SAS and ESRI software products. The NCASP can be used by veterinarians to enhance their practice of evidence-based medicine by providing information needed to individualize vaccine protocols for animals in specific geographic areas.

Relationship of pulmonary function among women and children to indoor air pollution from biomass use in rural Ecuador.

Approximately half the world uses biomass fuel for domestic energy, resulting in widespread exposure to indoor air pollution (IAP) from biomass smoke. IAP has been associated with many respiratory diseases, though it is not clear what relationship exists between biomass use and pulmonary function. Four groups containing 20 households each were selected in Santa Ana, Ecuador based on the relative amount of liquid petroleum gas and biomass fuel that they used for cooking. Pulmonary function tests were conducted on each available member of the households 7 years of age. The pulmonary functions of both children (7-15 years) and women (16 years) were then compared between cooking fuel categories using multivariate linear regression, controlling for the effects of age, gender, height, and exposure to tobacco smoke. Among the 80 households, 77 children and 91 women performed acceptable and reproducible spirometry. In multivariate analysis, children living in homes that use biomass fuel and children exposed to environmental tobacco smoke had lower forced vital capacity and lower forced expiratory volume in 1s (P<0.05). However, no significant difference in pulmonary function was observed among women in different cooking categories. Results of this study demonstrate the harmful effects of IAP from biomass smoke on the lung function of children and emphasize the need for public health efforts to decrease exposure to biomass smoke.

Evaluation of clinicopathologic features, response to treatment, and risk factors associated with idiopathic neutropenia in dogs: 11 cases (1990-2002).

OBJECTIVE: To evaluate the clinicopathologic features, response to treatment, and risk factors associated with idiopathic neutropenia in dogs. DESIGN: Retrospective case series. ANIMALS: 11 dogs. PROCEDURES: Medical records of dogs with idiopathic neutropenia were reviewed. Signalment, history, clinical signs, and response to treatment were recorded and compared with that in dogs with neutropenia attributable to known causes and to dogs without neutropenia (controls). RESULTS: Compared with dogs with neutropenia attributable to known causes, dogs with idiopathic neutropenia had lower neutrophil counts and were younger. When compared with control dogs, age < 4 years was identified as a risk factor for developing idiopathic neutropenia. In all dogs with idiopathic neutropenia, remission of neutropenia occurred within 18 days after administration of prednisone (2 to 4 mg/kg [0.9 to 1.8 mg/lb], PO, daily) and no serious complications or infections developed. CONCLUSIONS AND CLINICAL RELEVANCE: An immune-mediated pathogenesis should be considered for dogs with idiopathic neutropenia in which the cause is not known. Severe neutropenia and young age were significantly associated with idiopathic neutropenia in dogs. Prognosis appeared to be excellent with prednisone treatment.

Use of veterinary services by Latino dog and cat owners with various degrees of English-language proficiency.

OBJECTIVE: To characterize patterns of dog and cat ownership and veterinary service use among Latino dog and cat owners with various degrees of English-language proficiency. DESIGN :Cross-sectional telephone survey. SAMPLE: Data from 393 Latino pet owners. PROCEDURES: Telephone surveys were conducted with Latino dog and cat owners from a random sample of US households to determine the number of dogs and cats owned, factors associated with veterinary service use, and satisfaction with veterinary care. RESULTS: 393 of 1,026 (38.3%) respondents were pet owners. Two hundred fifty-nine of 330 (78.5%) dog owners and 70 of 115 (60.9%) cat owners reported taking their pet to the veterinarian in the past 12 months, most commonly for vaccination or examination or because of illness. Respondents were most satisfied with veterinary care provided, least satisfied with cost, and moderately satisfied with quality of communication. English-language proficiency was not significantly associated with whether owners sought veterinary care. A large proportion of respondents who wanted to receive pet health information in Spanish described themselves as speaking English well or very well. CONCLUSIONS AND CLINICAL RELEVANCE: Although having limited proficiency in English was not associated with Latino pet owners seeking veterinary care, opportunities exist for veterinary personnel to improve communications with these clients. Personnel can assess their clients' language needs by asking each about the language in which they would prefer to receive their pet's health information.

Preparedness of small animal veterinary practices to communicate with Spanish-speaking pet owners with limited proficiency in English.

OBJECTIVE: To investigate the preparedness of small animal veterinary personnel to communicate with Spanish-speaking pet owners with limited English-language proficiency (LEP). DESIGN: Cross-sectional telephone survey. SAMPLE: Data from 383 small animal veterinary practices. PROCEDURES: Telephone surveys were conducted with veterinarians and office or practice managers from a random sample of US small animal veterinary practices in 10 states to estimate the number of Spanish-speaking pet owners with LEP visiting these practices, proportion of practices that used services to facilitate communication with Spanish-speaking clients with LEP, and degree of veterinarian satisfaction with their communication with those clients. RESULTS: Responses were obtained from 383 of 1,245 (31%) eligible practices, of which 340 (89%) had Spanish-speaking clients with LEP and 200 (52%) had such clients on a weekly basis. Eight percent of practices had veterinary personnel who were conversant or fluent in spoken Spanish. Veterinarians who depended on clients' friends or family to translate were significantly less satisfied with client communication than were those who could converse in Spanish with clients directly. Availability of Spanish-speaking staff and offering of Spanish-language resources were associated with an increase in the number of Spanish-speaking clients with LEP seen on a weekly basis. Industry- and practice-generated Spanish-language materials were offered at 32% (124/383) and 21% (81/383) of practices, respectively; 329 (86%) practices had no Spanish-language marketing. CONCLUSIONS AND CLINICAL RELEVANCE: Opportunities were identified for improving communication with pet owners with LEP in the veterinary clinical setting, which could ultimately positively impact patient well-being and client compliance.

Prevalence and risk factors for protozoan and nematode infections among children in an Ecuadorian highland community.

In order to create a parasite prevention program for Santa Ana, Ecuador, we worked with local physicians to identify the prevalence and risk factors for intestinal parasitic infection among children. Two hundred households were randomly selected and asked to submit three stool samples from a selected child. Information from direct observation and questionnaires was used to determine environmental and behavioral risk factors for parasitic infection. Prevalence of any parasitic infection was 65.6% of the 189 children who submitted fecal samples. Parasitic infections included Entamoeba histolytica/E. dispar (46.6%), Giardia lamblia (18.5%) and Ascaris lumbricoides (20.1%). In a multivariate logistic model, risk factors (P<0.05) for E. histolytica/E. dispar included >1 month since antiparasitic treatment, not adding chlorine to drinking water, children not washing their hands before eating, and having a fewer number of electrical appliances in the home. The risk factor identified for G. lamblia was children not washing their hands before eating. Risk factors for A. lumbricoides included >6 months since antiparasitic treatment and having a fewer number of electrical appliances in the home. This study may have implications for other communities throughout the developing world.

Epidemiological aspects of Visceral Larva Migrans in children living at São Remo Community, São Paulo (SP), Brazil.

In preparation for a study of risk factors for Visceral Larva Migrans of children living in São Remo Community, São Paulo (SP), Brazil, fecal samples were collected from 41 dogs younger than one year of age, 338 serum samples from children ages 1-15 years and 37 soil samples, during March-June 2001. Fecal and soil samples were examined for the presence of Toxocara spp. eggs and serum samples were evaluated by ELISA for antibodies to Toxocara canis. Of the fecal, serum and soil samples tested, 39.0%, 26.9% and 29.7%, respectively, were positive, suggesting the possibility of the presence of Visceral Larva Migrans in children.

A placebo-controlled trial of two intranasal vaccines to prevent tracheobronchitis (kennel cough) in dogs entering a humane shelter.

A placebo-controlled field trial was conducted to compare the effectiveness of intranasal (IN) vaccines containing Bordetella bronchiseptica and canine-parainfluenza virus, with (IN-BPA) or without (IN-BP) canine-adenovirus type 2, for prevention of kennel cough at a humane shelter. Dogs were examined on admission to the shelter and those without respiratory signs of disease were assigned daily, on a rotating basis, to receive one of three vaccines. We enrolled 972 healthy dogs. Dogs were monitored for up to 30 days post-vaccination for coughing and other clinical signs of respiratory disease. Thirty-three (10.7%; 95% confidence interval (CI): 7.2%, 14.2%) dogs in the IN-BP group, 36 (10.2%; CI: 7.0%, 13.4%) [corrected] dogs in the IN-BPA group, and 42 (13.5%; CI: 9.7%, 17.3%) [corrected] dogs in the IN-P group coughed spontaneously for > or = 1 day within 30 days of vaccination (P = 0.37). The IN-BP and IN-BPA vaccines were 20.7 and 24.4% effective, respectively, in reducing coughing compared with a placebo vaccine. The strongest prognostic factor for coughing (regardless of vaccine group) was the number of days spent at the shelter, with each additional day increasing the risk of coughing by 3% (95% CI: 1.01, 1.06) [corrected] The low incidence of coughing in the shelter during this study precluded observation of differences in vaccine effectiveness. No differences in vaccine-associated adverse events (coughing, sneezing, nasal or ocular discharge) were noted during the first 3 days post-administration or thereafter.

Influence of host factors on survival in dogs with malignant mammary gland tumors.

The purpose of our study was to determine if specific host factors, such as age at diagnosis, obesity, and hormone status, influence the prognosis of canine mammary gland carcinomas and to confirm if previously reported risk factors (ie, histologic subtype, tumor size, and World Health Organization [WHO] stage) were important in a large series of affected dogs. Ninety-nine female dogs with mammary gland carcinomas, no previous therapy, an excisional biopsy, and known cause of death were studied. No significant association with survival was noted for age at diagnosis (chronologic or physiologic), obesity, or hormone status (ie, spayed versus intact, regardless of time of being spayed). Of the tumor factors analyzed, the histologic subtype anaplastic carcinoma (P = .02), WHO stage I (P = .01), evidence of metastasis at the time of diagnosis (P = .004), and tumor size of 3 cm or smaller (P = .005) all significantly influenced survival. Dogs that were classified as having tumor-related mortality had a shorter postoperative survival compared to dogs that died of other causes (14 months versus 23 months; P = .03). In conclusion, histologic subtype, WHO stage, and tumor size remain important prognostic factors in canine mammary gland tumors. Further study of other prognostic factors is needed to determine which tumors are adequately addressed with local therapy only and which dogs may require adjuvant treatment with chemotherapy.

Laser flaremetric evaluation of experimentally induced blood-aqueous barrier disruption in cats.

OBJECTIVES: To determine whether aqueous humor flare, measured by use of laser flaremetry, was proportional to aqueous humor protein concentration and to use laser flaremetry to evaluate disruption of the blood-aqueous barrier (BAB) in cats. ANIMALS: 30 healthy adult cats. PROCEDURE: Laser flaremetry values for all eyes were compared with aqueous humor protein concentrations determined by use of a Coomassie blue microprotein assay. Laser flaremetry was then performed on both eyes before (0 hours) and 4, 8, and 26 hours after initiation of topical application of 2% pilocarpine (q 8 h) to 1 eye of 9 cats or paracentesis of the anterior chamber of 1 eye of 8 cats. Intraocular pressure and pupil size were also determined. Aqueous humor protein concentration was extrapolated from flare values by use of linear regression. RESULTS: There was a linear relationship between flare values and aqueous humor protein concentrations. Topical application of 2% pilocarpine and paracentesis of the anterior chamber caused a breakdown of the BAB that was detected by use of laser flaremetry. The highest mean flare readings after application of pilocarpine or paracentesis were 24.4 and 132.8 pc/ms, respectively, which corresponded to aqueous humor protein concentrations of 85.5 and 434.9 mg/dl, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: Paracentesis of the anterior chamber resulted in a more severe breakdown of the BAB in cats than topical application of 2% pilocarpine. Laser flaremetry may be a useful clinical method to detect increases in aqueous flare and, hence, disruptions of the BAB in cats.