ABSTRACT
BACKGROUND: Effective clinical communication can aid veterinarians in building good client relationships, increase adherence to recommendations and, ultimately, improve patient health and welfare. However, available information on veterinary communication in the equine context is limited. The objective of this study was to describe the communication of veterinary students in the equine environment who had previous communication training. Additionally, we assessed the suitability of the Roter Interaction Analysis System (RIAS) for the analysis of audio-video recordings of equine wellness consultations. METHODS: Twenty-seven equine wellness consultations performed by second-year Ross University School of Veterinary Medicine students were recorded in rural Kentucky, United States of America. Recordings were submitted to a professional coder who applied the RIAS to the equine context by expanding or adjusting code definitions. RESULTS: A substantial amount of utterances (i.e. segments of speech) were allocated to core communication skills including building rapport (30%), facilitation and client activation (24%) and education and counselling (23%). There was a large variation in utterances used among consultations of the same veterinary student and students; they did not appear anxious or nervous. CONCLUSIONS: Students made use of core communication skills, indicating that experiences from pre-clinical training could be transferred to equine practice. Furthermore, this study demonstrated that the RIAS could be considered for consecutive studies aiming to provide observational data on clinical communication in the equine context.
ABSTRACT
OBJECTIVE: To determine endogenous production of L-lactate and the clearance of exogenous sodium L-lactate (ExLC) in healthy adult horses. DESIGN: A sodium L-lactate solution (1 mmol/kg body weight qs to 500 mL final volume in 0.9% NaCl) was adminstered IV over 15 minutes. Blood samples for L-lactate concentration [LAC] measurement were collected immediately prior to infusion, at 5, 10, and 15 minutes during infusion and at 1 minute intervals for 15 minutes, at 30, 45, 60, 120, and 180 minutes postinfusion. Disposition modeling and pharmacokinetic analysis was performed using proprietary software. SETTING: University Teaching Hospital. ANIMALS: Six clinically healthy adult horses. MEASUREMENTS AND MAIN RESULTS: Median (range) baseline [LAC] was 0.43 (0.20-0.72) mmol/L for samples obtained every 3 hours over the 24 hours prior to ExLC and demonstrated variability primarily associated with horse. Median [LAC] immediately prior to ExLC was 0.43 (0.35-0.52) mmol/L. A 2-compartment model was used to specify the pharmacokinetic parameters. Median (range) ExLC was 1.05 (0.073-1.75) L·h(-1) ·kg(-1) and t(1/2) ß was 29.54 (20.8-38.6) min. Median lactate production based on basal [LAC] immediately prior to ExLC was was 0.49 (0.31-0.93) mmol·h(-1) ·kg(-1) . CONCLUSIONS: ExLC in healthy adult horses is greater than that of hyperlactemic human patients but similar to normolactemic-sick human patients examined using the same model, supporting development of species, and disease specific ExLC parameters.
