A scoping review on the use of reflection and reflective portfolio learning in veterinary education.

Introduction: In veterinary education, reflection and reflective portfolio learning aim to enhance professional development. Although reflection and reflective portfolio learning are widely used in teaching and healthcare, their demonstrable impact on veterinary education is unclear. Although the benefits are uncertain, reflection may provide potential for self-development and help to prepare students for clinical practice. The aim of this work was to review research into reflective practice and reflective portfolio learning, to find evidence for its use in teaching, to confirm how it is best implemented to optimise professional development and to identify gaps for future research. Methods: This scoping review was conducted according to the Joanna Briggs Institute guidelines adhering to review methodology. Ten databases were searched and screened for reflection and portfolio learning as a primary source of data. Of 29,933 texts identified by title and/or abstract, 51 final works were screened in full. Of these, 16 papers that gathered evidence on reflection were included. Results: The results confirmed a growing evidence base for reflection in the veterinary field. In total, six works demonstrated a positive impact on professional development. Written reflective assignments were the most common methods of implementation, with 11 papers referencing their use. Other methods included group discussion and facilitated reflection. Conclusions: This review identified numerous gaps for research, including validating the methods of implementation, exploring the efficacy of methods other than written reflection, examining how reflection is used at different stages of the veterinary career and study of different models of reflection to identify which are most useful.

INSL3 Variation in Dogs Following Suppression and Recovery of the HPG Axis.

Insulin-like peptide 3 (INSL3) is a constitutive product of mature, adult-type Leydig cells of the testes and consequently in most mammals is an ideal biomarker with which to monitor pubertal development. A new heterologous time-resolved fluorescence immunoassay was developed and validated to measure circulating INSL3 in the blood of adult male dogs. Compared to other species, INSL3 concentration is low with marked variation between individuals, which appears to be independent of breed, age, or weight. A model system was then used in which a cohort of beagle dogs was subject to a GnRH-agonist implant to suppress the HPG axis and spermatogenesis, followed by implant removal and recovery. Unlike testosterone, INSL3 levels were not fully suppressed in all animals by the GnRH agonist, nor was the recovery of Leydig cell function following implant removal uniform or complete, even after several weeks. In dogs, and dissimilar from other species (including humans), Leydig-cell INSL3 appears to be quite variable between individual dogs and only weakly connected to the physiology of the HPG axis after its suppression by a GnRH-agonist implant and recovery. Consequently, INSL3 may be less useful in this species for the assessment of testis function.

Digital postprocessing analysis of prostatic perfusion in neutered dogs.

B-mode ultrasound is routinely performed to evaluate the prostate gland in neutered dogs, although, the detection of malignancies may be challenging. Contrast-enhanced ultrasound (CEUS) has shown to be useful for the assessment of prostatic perfusion in normal and diseased dogs, although the interpretation of contrast ultrasonographic features may still be subjective. A quantitative tool for evaluating prostatic perfusion might improve the reliability of the results in terms of early detection of prostate neoplasia in neutered dogs. The present study aimed to evaluate the applicability of a postprocessing analysis tool to CEUS of the prostate in healthy neutered dogs, to provide quantitative measurements, and to study the influence of individual characteristics on prostatic regression. Twenty-three neutered dogs underwent a B-mode and CEUS examination of the prostate to acquire data about prostatic morphology and microcirculation. The prostate was imaged using a 5-7.5 MHz linear transducer and contrast was administered intravenously. Videoclips were analyzed by using Qontrast software and a postprocessing digital analysis tool (ImageJ) to measure perfusion peak intensity, time to peak, and vascularization ratio at the moment of the peak, which were then related to body weight, age, and time elapsed since orchiectomy. Correlation tests revealed higher vascularization in younger compared with older dogs (P < .05) and in smaller compared with larger dogs (P < .05). Time elapsed since orchiectomy (P > .05) did not affect prostatic perfusion. Contrast-enhanced ultrasound and the postprocessing analysis tool ImageJ allowed analysis of vascular perfusion in all dogs and have the potential to improve the diagnostic possibilities for andrological examination.

Luteal phase decrease in packed cell volume in healthy non-pregnant and pregnant bitches.

OBJECTIVES: To establish packed cell volume (PCV) ranges for non-pregnant, pregnant and post-partum bitches from day 10 of proestrus, investigating any relationship with parity and litter size. METHODS: This prospective cohort study used 37 healthy breeding bitches to examine PCV counts from routine blood samples collected every 4 weeks, from day 10 of proestrus, as part of routine PCV monitoring. RESULTS: For pregnant (n = 19) and non-pregnant (n = 18) bitches, PCV decreased until week 8 (corresponding to 8.5 ± 1.1 days before whelping for pregnant bitches) and recovered by 16-20 weeks after the initial sample; bitches that whelped average and large litters showed greater declines. PCV began to recover sooner for bitches that had previously whelped one or two litters compared to bitches that had previously whelped three or more litters. There was a significant three-way interaction between time after the onset of proestrus, litter size and the number of previous litters which demonstrated that the large decrease in PCV for bitches that had previously whelped three or more litters only occurred in bitches that were expecting an average or large sized litter. CLINICAL SIGNIFICANCE: Chronological variation in PCV for pregnant and non-pregnant bitches was established during the reproductive cycle. There was no evidence to suggest that routine PCV measurement for normal, healthy bitches would be beneficial. However, knowledge from this study may be useful when deciding whether to prospectively monitor a bitch where there is a history of previous pregnancy-related anaemia, when performing a caesarean section due to the anticipated blood loss during surgery, or when examining blood profiles for post-litter bitches.

A Prospective Cohort Study Investigating the Impact of Neutering Bitches Prepubertally or Post-Pubertally on Physical Development.

No previous large prospective cohort studies have been identified that have investigated the impact of the surgical neutering of bitches before or after known puberty on their growth and physical development. This study was designed to examine the data on physical development, vulval size, and conformation for bitches neutered by ovariohysterectomy before puberty (PPN, n = 155) or after puberty (control, n = 151) using a prospective cohort study design. Data were gathered at six- and 17-months of age using bespoke physical assessment forms and digital images of the vulva. PPN bitches had greater changes in height measurements (mean difference = 2.039, SEM = 0.334, 91% CI = 1.471 to 2.608, p < 0.001) and smaller changes in the measurements of vulval length (mean difference = -0.377, SEM = 0.079, 91% CI = -0.511 to -0.243, p < 0.001) and width (mean difference = -0.221, SEM = 0.063, 91% CI = -0.328 to -0.113, p < 0.001) between six- and 17-months of age than for the control bitches. Although not significant, the PPN bitches were taller (mean 58.5 vs. 56.6 cm) and heavier (mean 28.3 vs. 27.3 kg) with smaller vulval size measurements (mean vulval length 2.8 vs. 3.2 cm, mean vulval width 1.7 vs. 2.1 cm) at 17-months of age. At 17-months of age, significantly more PPN bitches had vulvas that appeared juvenile (Yates' Chi-square = 14.834, D.F. = 1, p < 0.001) and recessed (Yates' Chi-square = 7.792, D.F. = 1, p = 0.005) at the physical assessment, and significantly more PPN bitches had vulvas that appeared 'recessed/inverted' on the examination of digital images (Chi-square = 9.902, D.F. = 1, p = 0.002). The results from this study suggest no contraindications to prepubertal ovariohysterectomy for large breed bitches. However, any longer-term health implications of these differences in physical development need to be investigated and better understood prior to recommendations being made.

Effect of neutering timing in relation to puberty on female dog behaviour-A scoping review.

BACKGROUND: There are contradictory findings in the literature relating to the effects of timing of neutering on bitch behaviour that make decision making regarding neutering timing difficult. METHODS: A scoping review was designed to identify and chart the evidence on the effect of neutering timing in relation to puberty on the behaviour of female domesticated dogs. A protocol was registered, and literature searches were conducted in CAB Abstracts, Medline and Web of Science. Studies were reviewed against the inclusion criteria. Data on study and population characteristics and behavioural outcomes were extracted for the final included studies. RESULTS: A total of 1048 publications were reviewed; 13 were retained for inclusion and charting. Only one of the two studies that classified bitches as pre- or postpubertal presented results for the analysis of behaviours. The remaining 11 studies classified bitches by age at neutering. LIMITATIONS: Since the scoping review searches were conducted, further relevant studies may have become available. The search strategy may not have identified all available literature; however, databases were used that provide high levels of coverage of veterinary literature. CONCLUSION: This scoping review identified a lack of evidence to document the impact of neutering bitches before or after puberty on behaviour.

A prospective cohort study investigating the peri- and postoperative outcomes following ovariohysterectomy in bitches neutered prepubertally or post-pubertally.

The aim of this prospective cohort study was to investigate perioperative and postoperative outcomes for bitches that were neutered at different times in relation to puberty (rather than age). Three hundred and six Labrador and Golden Retriever crossbreed bitches were neutered before (prepubertal neuter [PPN], n = 155) or after puberty (Control, n = 151) by experienced veterinarians at one of four veterinary practices (VP1-4). Data were gathered from veterinarians at the time of neutering and from bitch caregivers for the 14-day period after neutering using purpose-designed questionnaires. PPN bitches had shorter surgery durations than Control bitches (OR = 0.877, 91% CI = 0.800 to 0.961, P = 0.015). Longer surgery durations were reported for bitches that had intraoperative complications (OR = 1.620, 91% CI = 1.397 to 1.879, P < 0.001). Shorter surgery durations were reported for VP1 compared to all other veterinary practices (OR = 1.189 to 1.534, P < 0.001). There was no difference in the number of PPN or Control bitches that had perioperative complications (PPN: 3.9%, n = 6; Control: 7.7%, n = 11) and no bitch had more than one perioperative complication reported. For the 14-day postoperative period, fewer PPN (1.3%, n = 2) compared to Control bitches (8.9%, n = 13) had wound discharge (Chi-square = 11.151, D.F = 1, P = 0.001) or showed inappetence (PPN: 2.9%, n = 4; Control: 17.3%, n = 19, Chi-square = 14.884, D.F. = 1, P < 0.001). There was no difference in the number of PPN and Control bitches that had redness or swelling of the wound (52 PPN, 48 Control), showed attention to the wound (6 PPN, 6 Control), required veterinary attention (25 PPN, 23 Control), or that showed any other unusual behaviours: discomfort (27 PPN, 16 Control), uncharacteristic irritability (2 PPN, 4 Control), or uncharacteristic licking or chewing of parts of the body (15 PPN, 6 Control). Bitches neutered at VP2-4 were more likely to have wound redness or swelling reported than those neutered at VP1 (OR = 3.109 to 4.076, P = 0.003). Future studies should consider the impact of veterinary practice on results. These results for peri and postoperative complications could suggest that prepubertal ovariohysterectomy may be a suitable option for neutering bitches. However, it is recommended that they be interpreted together with evidence relating to the impacts on other factors including behaviour and longer-term health in order to make fully informed decisions.

A Prospective Cohort Study Investigating the Behavioural Development of Bitches in a Guide Dog Training Programme Neutered Prepubertally or Post-Pubertally.

There are few studies that investigate the effect of neutering bitches before or after puberty. The majority of current literature examining the impact of the timing of neutering on health and behaviour has used age rather than the onset of puberty as the key variable. The aim of this prospective cohort study was to investigate the effects of timing of neutering in relation to puberty on behaviour in female dogs reared and trained in an assistance dog programme. The study examined data for bitches neutered before or after puberty to compare scores for six behavioural factors (training and obedience, aggression, fear and anxiety, excitability, attachment and attention-seeking, and social behaviour) measured at 1 and 3 years of age. Labrador and Golden Retriever crossbreed bitches were neutered before (n = 155) or after (n = 151) puberty. Neutering before or after puberty had no impact on mean scores for the six behavioural factors at 1 or 3 years of age. When examining the change in behavioural factor scores between 1 and 3 years of age, only aggression behavioural factor scores were influenced by neutering before or after puberty. Bitches neutered after puberty were less likely to have aggression factor scores that increased between 1 and 3 years of age (OR = 0.959, 90% CI = 0.924 to 0.995, p = 0.06). However, the majority of bitches scored "0" for aggression at both time points (indicating no aggression behaviours were observed), and the number of bitches for which scores increased between 1 and 3 years of age was low (before puberty = 20, after puberty = 9). This is consistent with very mild aggressive behaviours being observed in a small number of animals and is, therefore, of questionable concern. The results suggest that, for Labrador and Golden Retriever crossbreed bitches, neutering before or after puberty has little to no effect on future behaviour. It is recommended that decisions about the timing of neutering are not informed solely by impacts on behaviour, but that they also consider evidence relating to the impacts on bitch health and well-being.

Scoping review of end-of-life decision-making models used in dogs, cats and equids.

BACKGROUND: End-of-life decisions for companion animals can be stressful for veterinarians and owners, and when delayed result in poor animal welfare. Delayed euthanasia has been identified as a particularly prominent issue for horses. This scoping review aimed to identify the available literature on veterinary decision-making models, which can support end-of-life planning. METHODS: A protocol was preregistered, and a structured literature search was performed on six electronic databases. Publications were reviewed against specifically developed eligibility criteria. Data from original studies and narrative-type reviews were extracted separately, and the components of each model were charted. RESULTS: A total of 2211 publications were identified, 23 met the inclusion criteria and were included in the final review. Eight were original research studies and 15 were narrative reviews or similar. Publications were not indexed uniformly, increasing the difficulty of discovering relevant sources. The end-of-life decision-making process comprised three stages: (1) making the decision, (2) enacting the decision and (3) aftercare. Twenty key components of decision-making models were identified, although no publication reflected all of these. CONCLUSIONS: A lack of original research studies and equine-specific publications was identified. Shared decision-making models for euthanasia in veterinary practice should include all three stages and consider species-specific issues.

Comparative pathology of dog and human prostate cancer.

Though relatively rare in dogs, prostate cancer (PCa) is the most common non-cutaneous cancer in men. Human and canine prostate glands share many functional, anatomical and physiological features. Due to these similarities, canine PCa has been proposed as a model for PCa in men. PCa is typically androgen-dependent at diagnosis in men and for this reason, androgen deprivation therapies (ADT) are important treatments for advanced PCa in men. In contrast, there is some evidence that PCa is diagnosed more commonly in castrate dogs, at which point, limited therapeutic options are available. In men, a major limitation of current ADT is that progression to a lethal and incurable form of PCa, termed castrate-resistant prostate cancer (CRPC), is common. There is, therefore, an urgent need for a better understanding of the mechanism of PCa initiation and progression to CRPC to enable the development of novel therapeutic approaches. This review focuses on the functional, physiological, endocrine and histopathological similarities and differences in the prostate gland of these species. In particular, we focus on common physiological roles for androgen signalling in the prostate of men and dogs, we review the short- and longer-term effects of castration on PCa incidence and progression in the dog and relate how this knowledge may be relevant to understanding the mechanisms of CRPC in men.

Environmental risk factors in puppies and kittens for developing chronic disorders in adulthood: A call for research on developmental programming.

Many dogs and cats are affected by chronic diseases that significantly impact their health and welfare and relationships with humans. Some of these diseases can be challenging to treat, and a better understanding of early-life risk factors for diseases occurring in adulthood is key to improving preventive veterinary care and husbandry practices. This article reviews early-life risk factors for obesity and chronic enteropathy, and for chronic behavioral problems, which can also be intractable with life-changing consequences. Aspects of early life in puppies and kittens that can impact the risk of adult disorders include maternal nutrition, establishment of the gut microbiome, maternal behavior, weaning, nutrition during growth, growth rate, socialization with conspecifics and humans, rehoming and neutering. Despite evidence in some species that the disorders reviewed here reflect the developmental origins of health and disease (DOHaD), developmental programming has rarely been studied in dogs and cats. Priorities and strategies to increase knowledge of early-life risk factors and DOHaD in dogs and cats are discussed. Critical windows of development are proposed: preconception, gestation, the suckling period, early growth pre-neutering or pre-puberty, and growth post-neutering or post-puberty to adult size, the durations of which depend upon species and breed. Challenges to DOHaD research in these species include a large number of breeds with wide genetic and phenotypic variability, and the existence of many mixed-breed individuals. Moreover, difficulties in conducting prospective lifelong cohort studies are exacerbated by discontinuity in pet husbandry between breeders and subsequent owners, and by the dispersed nature of pet ownership.

Imaging of Canine Neoplastic Reproductive Disorders.

Diagnostic imaging plays an essential role in the diagnosis and management of reproductive neoplasia in dogs and cats. The initial diagnosis, staging, and planning of surgical and radiation treatment and the response to therapy all involve imaging to varying degrees. Routine radiographs, ultrasound, nuclear medicine, and cross-sectional imaging in the form of computed tomography (CT) and magnetic resonance imaging (MRI) are routinely used in canine reproductive disorders. The choice of imaging modality depends on many factors, including the level of referral and the pathological information required. The biological behaviour of the tumour also guides the choice of imaging in cancer staging, and imaging may play an important role in guiding serial tumour biopsy during the course of therapy. The sophistication of imaging modalities is increasing exponentially. Each modality has advantages and disadvantages in terms of cost, availability, sensitivity, specificity, and qualities of anatomic versus functional imaging.

Environmental chemicals in dog testes reflect their geographical source and may be associated with altered pathology.

In humans and dogs, a temporal decline in semen quality and increased incidence of testicular cancer is hypothesised to be associated with exposure to anthropogenic chemicals, particularly during fetal development. Human studies suggest that differential exposures to environmental chemicals may be associated with geographical differences in male reproductive health. Here we investigate testicular chemical profiles and pathologies in dogs residing in the UK [West Midlands (WM), East Midlands (EM), South East (SE)], Denmark (Copenhagen) and Finland (Vantaa). Testes, surplus from routine castrations, contained region specific differences in relative concentrations of diethylhexyl phthalate (DEHP), polybrominated diphenyl ethers (PBDE) and polychlorinated biphenyls (PCB). Relative to UK regions, testes from dogs living in Finland and Denmark had higher concentrations of PBDE and lower concentrations of DEHP and PCBs. Regional differences in the UK in PCB concentrations were also observed. Dog testes from Finland had fewer pathologies, reduced testicular area stained for Sertoli and germ cells and evidence of reduced cellular proliferation. Since the geographical differences in testis pathologies in dogs parallel reports of regional differences in human testicular cancer, we postulate that this may reflect chemical effects within the testis and that this may be related to environmental influences on male reproductive function.

Contrast-Enhanced Ultrasound Imaging of Prostate Gland in Neutered Dogs.

Prostatic neoplasia (PN) occurs in 5-7% of dogs with prostatic disease, with castrated dogs having the same or higher prevalence when compared to intact dogs. Considering the promising results achieved by performing contrast-enhanced ultrasound (CEUS) in intact dogs to detect PN, the present study aimed to acquire data on the prostatic perfusion pattern in neutered dogs. CEUS was performed in 64 neutered dogs, using a 5-7.5 MHz linear transducer with coded harmonic capability, dedicated analytical software, and a second-generation contrast agent, SonoVue. After B-mode evaluation was performed to assess mean prostate volume, the CEUS examination was undertaken. The flow of contrast agent was visible 10 s after injection. The subcapsular vessels were highlighted and produced rapid peripheral rim enhancement. Subsequently, the contrast agent reached the prostatic urethra via the parenchymal arterioles and gradually reached the entire prostate. Perfusion peak intensity (PPI) and time to peak (TTP) values were respectively 45.3% and 34.1 s. The measured parameters were compared with those obtained in previous studies on intact dogs with normal and with pathological patterns. In this study, CEUS showed features that may be promising for its use as a diagnostic tool for early detection of PN in neutered dogs.

Qualitative study of the influence of horse-owner relationship during some key events within a horse's lifetime.

BACKGROUND: There is a lack of research exploring how the horse-human relationship influences horse owners' decision-making. The aim of this study was to investigate how an owner's relationship with their horse affects decisions around key events during their horse's lifetime. METHODS: An online survey and semi-structured telephone interviews were conducted with horse-owners. The online survey asked horse owners about their experiences of decision-making and their relationship with their horse and identified interview participants. Two semi-structured interviews were conducted with 11 horse owners on their experience of purchasing and euthanasia of horses. Interviews were recorded and transcribed, and thematic analysis was performed. RESULTS: There were 938 responses to the online survey. The majority of owners considered their horse to be a member of the family (92.9%, 808/870). The mean amount spent annually on their horse was £9215 (range £324-14,240). Seven themes were identified in the interviews including mismatching of horse and rider; financial, time, welfare and personal obligations involved in horse ownership; shared-decision making; the horse's quality of life; guilt and responsibility grief surrounding euthanasia decisions. CONCLUSION: This study highlighted the strong owner-horse relationship, the significant obligations involved in horse ownership and the emotional impact of euthanasia decisions.

Cross-sectional study of UK horse owner's purchase and euthanasia decision-making for their horse.

BACKGROUND: This cross-sectional study aimed to investigate factors affecting horse owners' purchase and euthanasia decisions that had been identified in a qualitative study. METHODS: An online survey on horse owners' purchase and euthanasia decisions and experiences was distributed using snowball sampling. Inclusion criteria were previous experience of purchase or euthanasia decisions. Descriptive data analyses (mean, median, mode and frequency percentages) were performed. RESULTS: There were 451 participants from the UK and Ireland, 97% were female with a median age of 45 years. Participants most frequently did not seek any advice when deciding what type of horse to purchase (38.6%, 169/438) or if it was priced appropriately (48.7%, 214/439). Most participants were satisfied with their purchase and would purchase their horse again (84.9%, 370/436). The most frequent reasons for euthanasia were injury/illness with low chance of survival (55.2%, 201/364), poor quality of life (42.6%, 155/363) and long-term injury (35.7%, 130/364). Most participants sought advice or guidance when making end-of-life decisions (87.5%, 328/375), and 55% (243/440) had a euthanasia plan in place. CONCLUSIONS: Owners show limited advice-seeking behaviour on key aspects of purchase decisions. Owners frequently seek advice on euthanasia decisions, and the majority of decisions were based on welfare concerns.

Concurrent and Predictive Criterion Validity of a Puppy Behaviour Questionnaire for Predicting Training Outcome in Juvenile Guide Dogs.

Working dog organisations regularly assess the behaviour of puppies to monitor progression. Here, we tested the predictive validity (for predicting success in guide dog training) of a shortened version of a previously developed juvenile dog behaviour questionnaire (the refined puppy walker questionnaire, r-PWQ) and compared it with the Canine Behavioral Assessment and Research Questionnaire (C-BARQ). The r-PWQ is used by Guide Dogs UK, whereas the C-BARQ was designed for pet dogs and is used by some other guide dog schools internationally. A cohort of dogs aged eight months (n = 359) were scored concurrently on the r-PWQ and C-BARQ. Analogous traits between the questionnaires were evaluated for internal consistency and association with training outcome and compared for concurrent validity. The r-PWQ was associated with training outcome for five scales (r-Excitability, Trainability, Animal Chase, r-Attachment and attention seeking and Distractibility) and the C-BARQ for two scales (Excitability and Separation-related behaviour). There were significant correlations between analogous C-BARQ and r-PWQ trait scores (p < 0.001) except for Separation-related behaviour and questionnaire scales had similar internal consistencies. The r-PWQ may be more suitable to use with guide dog schools. However, due to the correlation between analogous scales (except for "Distractibility") some scales could be substituted for one another when reviewing the behaviour of dogs between guide dog schools using different questionnaires.

Mixed methods investigation of the use of telephone triage within UK veterinary practices for horses with abdominal pain: A Participatory action research study.

BACKGROUND: Telephone triage is an integral part of modern patient care systems in human medicine, and a key component of veterinary practice care systems. There is currently no published research on telephone triage within the veterinary profession. OBJECTIVE: To investigate current approaches to telephone triage of horses with abdominal pain (colic) in veterinary practice and develop new resources to support decision-making. STUDY DESIGN: Participatory action research using mixed-methods approach. METHODS: An online survey assessed current approaches to telephone triage of horses with colic in UK veterinary practices. Structured group and individual interviews were conducted with four equine client care (reception) teams on their experiences around telephone triage of colic. Evidence-based resources, including an information pack, decision flow chart and recording form, were developed and implemented within the practices. Participant feedback was obtained through interviews six months after implementation of the resources. RESULTS: There were 116 participants in the online survey. Management and client care staff (53/116) felt less confident giving owner advice (p<0.01) and recognising critical indicators (p = 0.03) compared to veterinary surgeons and nurses (63/116). Thirteen themes were identified in the survey relating to owner advice; exercise and owner safety were most frequently mentioned, but conflicting guidance was often given. Fourteen client care staff were interviewed. They were confident recognising colic during a telephone conversation with an owner and identified the most common signs of critical cases as sweating and recumbency. The new resources received positive feedback; the decision flow chart and information on critical indicators were identified as most useful. After resource implementation, there was an increase in confidence in recognising critical cases and giving owners advice. MAIN LIMITATIONS: Limited sample population. CONCLUSIONS: This study described existing approaches to telephone triage, identified variations in advice given, and worked with client care teams to develop new resources to aid decision-making.

Indicators of 'critical' outcomes in 941 horses seen 'out-of-hours' for colic.

BACKGROUND: This study aimed to describe the presentation and outcomes of horses with signs of colic (abdominal pain) seen 'out-of-hours' in equine practice. METHODS: This was a retrospective study of horses seen 'out-of-hours' with colic by two equine veterinary practices between 2011 and 2013. Case outcomes were categorised as 'critical' or 'not critical'. A critical outcome was defined as requiring medical or surgical hospital treatment, or resulting in euthanasia or death. A non-critical outcome was defined as resolving with simple medical treatment. A hierarchical generalised linear model was used to identify 'red flag' parameters (aspects of signalment, history and presenting clinical signs) associated with critical outcomes. RESULTS: Data were retrieved from 941 cases that presented with colic; 23.9 per cent (n=225/941) were critical. Variables significantly associated with the likelihood of a critical outcome in the final multivariable model were increased heart rate (P<0.001), age of the horse (P=0.013) and abnormal mucous membrane colour (P<0.001). Overall 18 per cent (n=168/941) of cases were euthanased. CONCLUSIONS: This study highlights the mortality associated with colic. The 'red flag' parameters identified should be considered an essential component of the primary assessment of horses with colic.

Retrospective case series to identify the most common conditions seen 'out-of-hours' by first-opinion equine veterinary practitioners.

BACKGROUND: The study aim was to describe conditions seen 'out-of-hours' in equine practice. METHODS: This was a retrospective case series of first opinion 'out-of-hours' cases seen at two equine practices between 2011 and 2013. Data were retrieved on case presentation, diagnostic testing, treatment administered and outcome, and diseases categorised using a systems-based coding system. A hierarchical logistic regression, formulated using a generalised linear model, was used to identify clinical variables associated with a binary outcome of 'critical' cases (required hospitalisation or euthanasia or died). RESULTS: Data from 2602 cases were analysed. The most common reasons for 'out-of-hours' visits were colic (35 per cent, n=923/2620), wounds (20 per cent, n=511/2620) and lameness (11 per cent, n=288/2,620). The majority of cases required a single treatment (58 per cent, n=1475/2550), 26 per cent (n=656/2550) needed multiple treatments and 13 per cent (n=339/2550) were euthanased. Eighteen per cent (n=480/2602) of cases had a critical outcome. Increased heart rate at primary presentation was associated with critical outcome in both practices (Practice A, OR 1.07 (95 per cent confidence interval 1.06 to 1.09), Practice B OR 1.08 (95 per cent confidence interval 1.07 to 1.09; p<0.001)). CONCLUSION: Colic, wounds and lameness were the most common equine 'out-of-hours' conditions; 13 per cent of cases were euthanased. Further research is required into out-of-hours euthanasia decision-making.