Development, validation, and cut-off points for a questionnaire to measure sources of stress in veterinary medicine (SOS-VetMed).

BACKGROUND: Occupational stress is a serious problem in veterinary medicine; however, validated instruments to measure this problem are lacking. The aim of the current study was to address this literature gap by designing and validating a questionnaire and establishing the cut-off points for identifying veterinarians with high and low levels of stress. METHODS: The study involved two sub-studies with two Spanish samples. The first study (N = 30 veterinarians; 66.7% women; 63.33% from small animal clinics) investigated the factors related to the work environment that caused the most stress; the results were analyzed using thematic content analysis. The second study (N = 1082; 70.8% women; 71.4% from small animal clinics) involved designing and validating a questionnaire to measure sources of stress in veterinary medicine, as well as establishing the cut-off points for interpreting the results using receiver operating characteristics (ROC) curve analysis. RESULTS: The first study showed the main sources of stress and allowed items to be defined for the questionnaire. The second study validated the Sources of Stress in Veterinarian Medicine (SOS-VetMed) questionnaire and confirmed five sources of stress with adequate reliability and validity indices: "work overload," "work-family conflict," "emotional burden of work," "organizational factors," and "emergency problems." Exploratory and confirmatory factor analyses verified a structure of five factors (Cronbach's alpha values ranging between 0.92 and 0.69). The five subscales of the SOS-VetMed questionnaire were positively correlated with two indicators of distress: "psychological complaints" and "psychosomatic complaints." The cut-off points indicated that 45.83% and 19.95% of the veterinarians surveyed had high and low levels of stress, respectively. CONCLUSIONS: The results confirmed that the SOS-VetMed questionnaire could be used to determine the stress levels of veterinarians and to design intervention programs to improve their workplace health.

Workplace stressor factors, profiles and the relationship to career stage in UK veterinarians, veterinary nurses and students.

BACKGROUND: Veterinary professionals experience higher psychological distress and lower wellbeing compared with the general population. Identifying workplace stressors is key to understanding and alleviating these difficulties. OBJECTIVE: Identify the severity of workplace stressors in veterinary professions across different levels of professional experience. METHOD: A cross-sectional quantitative design was utilised via administration of a veterinary stressor questionnaire that measured the severity of 93 generic and veterinary-specific workplace stressors. RESULTS: A total of 658 participants reported stressor severity score. Factor analysis revealed four main stressor categories: workload and job demands, client relations stress, performance and accountability, patient care challenges. An inverse relationship was found between experience level and stressor severity scores. Furthermore, the most severe stressors varied as a function of career stage. FINDINGS AND IMPLICATIONS: Stressor severity tends to decrease with increasing experience levels. Stressors can be categorised by theme and unique stressor profiles can be derived for practitioners according to experience level. This knowledge can assist in the design and delivery of workplace support initiatives. CONCLUSIONS: Identify key stressors across different levels of experience is important in focusing efforts to support people in the workplace.

Understanding veterinary drug shop workers' knowledge and practices to identify drivers of antibiotic use in Vietnamese livestock farms.

BACKGROUND: Antimicrobial resistance (AMR) is a One Health issue and a major threat to animal and human health. Antibiotic use (ABU) drives AMR development, and several hotspots for ABU, and AMR, in livestock have been identified in Southeast Asia, including Vietnam. There are often multiple drivers of ABU at farms, and to identify all of them there is a need to look beyond farm level. OBJECTIVES: The overall aim of this study was to identify routines and/or competencies, related to antibiotic sales, among veterinary drug shop workers that may be improved in order to decrease the medically non-rational use of antibiotics in livestock production. METHODS: A questionnaire-based survey was conducted at 50 veterinary drug shops in northern Vietnam. RESULTS: Results showed high education and knowledge levels. According to the respondents, antibiotic treatment advice was almost always provided to the farmers, and the recommended treatment was most commonly based on recommendations for the specific disease. However, farmers had almost never had their animals properly diagnosed. Antibiotics were the most sold drug category, penicillins being the most common. Several broad-spectrum antibiotics were also quite frequently sold. Further, >50% of respondents recommended antibiotics for disease prevention. CONCLUSIONS: Even though education and knowledge levels might be high, several challenges can prevent drug shop workers from contributing to more prudent ABU at farms, for example, lack of proper diagnosis, commercial interests and individual farmer motives, often in combination with poor compliance to regulations.

Dispensing antimicrobials to farmers in Wales: The roles and experiences of veterinary practice staff.

BACKGROUND: Veterinary practice staff are directly involved in the dispensing of prescription veterinary medicines (POM-Vs) to farmers as prescribed by registered veterinary surgeons to animals 'under their care'. The role of veterinary practice staff has, to date, been underresearched. The objective of this study was to investigate the roles played by veterinary practice staff, exploring their expectations and perceptions of the front-of-house (FoH) role, their interactions with clients in day-to-day veterinary practice and their experiences relating to the dispensing of POM-Vs. METHODS: Thematic analysis was used to analyse data from 20 semi-structured interviews of veterinary practice staff. Participants were recruited from 80% of the large animal or mixed species veterinary practices across Wales. RESULTS: Four key themes-'piggy in the middle', learning on the job, practice organisation and facilitating change-were identified, illustrating the multifaceted and diverse nature of this type of employment. LIMITATIONS: This study is not intended to be representative of the perceptions of FoH staff on the dispensing of antimicrobials. Larger-scale studies are required to substantiate these findings. CONCLUSION: Understanding the roles of non-clinical veterinary staff allows practice managers and veterinary surgeons to better identify and meet training and staffing needs and improves recognition of this key area of practice work.

Client and employee engagement measures predict resignations of veterinary support staff: An analysis of UK companion animal practice data.

BACKGROUND: This study aimed to identify factors associated with veterinary support staff resigning from UK companion animal veterinary practices. METHODS: Cross-sectional employment data from support staff working across a group of veterinary practices on 31 December 2020 were retrospectively analysed. The support staff were categorised as those who remained at, or resigned from, their practice over the following 12-month period. The proposed risk factors for future resignations were analysed using multivariable binary logistic regression modelling. RESULTS: In total, 398 of 2068 (19.2%) veterinary support staff resigned during the study period. Factors associated with greater odds of future resignations included lower staff engagement (employee net promoter score; odds ratio [OR] = 0.99; 95% confidence interval [CI] 0.99-1.00; p < 0.001), lower client practice engagement (net promoter score; OR = 0.98; 95% CI 0.97-1.00; p = 0.012), shorter tenure (OR = 0.92; 95% CI 0.90-0.95; p < 0.001), recent parental leave (OR = 2.37; 95% CI 1.38-4.07; p = 0.002) and younger age (OR = 0.99; 95% CI 0.98-1.00; p = 0.017). LIMITATIONS: Data were collected retrospectively and were not recorded for research purposes. CONCLUSIONS: Employee and client net promoter scores are important predictors of resignations and could be useful tools for managers. Recent parental leave is a predictor of support staff attrition, and 'return to work' interventions may present an opportunity to improve retention.

Laparoscopy and thoracoscopy in small animal surgery: A 2020 survey of small animal diplomate and resident veterinary surgeons.

OBJECTIVE: To document the utilization and training of laparoscopic and thoracoscopic minimally invasive surgery (MIS) techniques within the American, European, Australian and New Zealand Colleges of Small Animal Veterinary Surgeons (ACVS, ECVS, and ANZCVS) in 2020. STUDY DESIGN: Observational study. SAMPLE POPULATION: Diplomates and residents of the ACVS, ECVS, and FANZCVS. METHODS: An electronic survey was sent using veterinary list servers. Questions were organized into categories evaluating (1) the demographics of the study population and the caseload, (2) comfort level with specific procedures, (3) motivating factors and limitations, and (4) surgical training and the role of the governing bodies. RESULTS: Respondents included 111 practicing surgeons and 28 residents. Respondents' soft-tissue MIS caseloads had increased since they first started performing MIS; however, most respondents were only comfortable performing basic laparoscopy. Over half of the respondents agreed on the patient benefits and high standard of care provided by MIS. Perceived adequate soft-tissue training in MIS during residency was strongly associated with perceived proficiency at the time of survey response. Most respondents agreed that the specialty colleges should take a more active role in developing standards for soft-tissue MIS, with residents agreeing that a required standardized course would be beneficial. CONCLUSION: Soft-tissue MIS is widely performed by diplomates and residents. Perceived adequate soft-tissue MIS training was strongly associated with perceived proficiency. CLINICAL SIGNIFICANCE: There is substantial underutilization of advanced MIS techniques in veterinary specialty surgical practice, which might be improved by a stronger focus on MIS training during residency.

Assessing and comparing disease prevention knowledge, attitudes, and practices among veterinarians in Illinois, United States of America.

Veterinarians play an essential role in safeguarding and promoting animal and human health by timely reporting of notifiable diseases to animal and public health agencies and by educating animal owners on effective disease prevention measures. Moreover, clinical veterinarians can prevent the transmission and spread of zoonotic diseases by adopting effective biosecurity practices in their clinics. An online questionnaire was administered between October and November 2021 to veterinarians registered with the Illinois State Veterinary Medical Association. Veterinarians were surveyed on their disease risk perception, biosecurity practices, and disease reporting knowledge. In total, 104 veterinarians (64 % females and 46 % males) completed the questionnaire, of whom 88 % were veterinarians working in clinical practice (88 % companion animals and 12 % bovine or swine), while 12 % were employed in non-clinical settings. The disease-reporting knowledge score was higher for veterinarians with biosecurity training (IRR: 1.35; 95 % CI: 1.47-1.75). Compared to large animal veterinarians, companion animal veterinarians had lower odds of having biosecurity training (OR=0.68; 95 % CI=0.02-0.28) and were less familiar with current biosecurity guidelines (OR=0.12; 95 % CI = 0.03-0.51). Veterinarians familiar with biosecurity guidelines had a higher probability (OR=4.4; 95 % CI: 1.21-16.28) of perceiving biosecurity practices as practical while working with animals. Conversely, veterinarians who perceived that they could transmit diseases to animals had lower odds (OR: 0.42; 95 % CI: 0.20-0.91) of wearing protective clothing while dealing with confirmed cases of zoonotic diseases. Based on our study results, a gap in disease-reporting knowledge was identified among companion animal veterinarians. Biosecurity training improved the disease-reporting knowledge of veterinarians, suggesting that providing continuing education for veterinarians would be beneficial to disease reporting. A disconnect between disease risk perception and biosecurity practices was identified and further studies are needed to understand this discrepancy to design effective education programs.

Survey-based investigation of sports and leisure horse owners' approaches to, and expectations of, equine veterinary care.

BACKGROUND: Client satisfaction depends on the balance between expectations and service experience. Previous research identified seven aspects of equine veterinary professional conduct that are important for client satisfaction: quality of care, quality of service, horsemanship, transfer of knowledge, financial aspects, interpersonal skills and professionalism. METHODS: By employing a cross-sectional study design through a survey-based investigation, horse owners' initial contact preferences and their perceptions of the importance of various aspects of veterinary care in different scenarios were explored. Categories included professional versus amateur and competitive versus non-competitive horse owners. Quantitative data analysis was performed. RESULTS: Data from 1153 participants revealed that horse owners promptly contacted veterinarians for colic (92.7%) but delayed for lameness (51.8%) and pre-purchase examinations (63.0%). Overall, quality of care emerged as the most important aspect of veterinary care for horse owners, with financial aspects considered least important. Competitive and professional horse owners prioritised financial aspects and professionalism, whereas non-professional and non-competitive horse owners prioritised quality of care and interpersonal skills (p < 0.005). LIMITATIONS: Survey distribution relied on a snowball effect, internet access was necessary and the study exclusively represents the Western equine community. Potential bias should be acknowledged. CONCLUSION: The perceived importance of various aspects of veterinary care varies depending on the nature of the consultation and the horse owner type. Tailoring veterinary services can improve client satisfaction by aligning with diverse expectations.

Stakeholder perceptions of thoroughbred yearling sales endoscopy in Australia: can we do better?

OBJECTIVE: To identify thoroughbred industry stakeholders' views on the yearling sales endoscopy in Australia. DESIGN: Semi-structured qualitative group interviews with equine veterinarians, thoroughbred breeders and yearling purchasers. METHODS: Twenty-nine experienced thoroughbred industry stakeholders participated in online focus groups: (1) equine veterinarians involved in yearling endoscopy; (2) thoroughbred breeders; and (3) yearling buyers. The focus groups were audio and video recorded and digital whiteboards were available. Data was transcribed, live-coded and analysed thematically. RESULTS: The main themes identified included the uncertainty surrounding the relationship between yearling laryngeal function and future performance, especially the significance of yearlings with grade 3 out of 5 laryngeal function; interobserver variability in the laryngeal function grade assigned by veterinarians to the same endoscopic exam; and the presence of intra-horse variability in laryngeal function over different time points. DISCUSSION: Stakeholders raised multiple concerns about the current yearling sales endoscopy process in Australia. Recommendations to address these concerns include further investigation into the race performance of yearlings identified with grade 3 laryngeal function; training of veterinarians to reduce inter-observer variability; and the need to determine the most appropriate grading system to use in yearlings. Future research should evaluate the significance of intra-horse variability in a yearling population.

International survey of equine orthopaedic specialists reveals diverse treatment strategies for horses with overriding spinous processes.

BACKGROUND: Overriding spinous processes, also known as 'kissing spines', are one of the most common causes of back pain in horses. The aim of this study was to investigate which options for diagnosis and treatment are preferred by equine orthopaedic specialists and assess which techniques are used for local injection. METHODS: An online survey was distributed among members of the European/American College of Veterinary Surgeons, the European/American College of Veterinary Sports Medicine and Rehabilitation, the International Society of Equine Locomotor Pathology and nationally recognised advanced equine orthopaedic practitioners. RESULTS: The survey was completed by 353 respondents. The injection techniques most commonly used involve placing two needles abaxial to the interspinous space (42%) under ultrasonographic guidance (32%) or one needle in the midline (35%) between two spinous processes. The most popular combination for overriding dorsal spinous process therapy was local injection (26.7%) combined with controlled exercise (25.5%). Manual therapy was considered by 42% of European and 25% of American specialists (p = 0.01). Surgical intervention as a first-line treatment was recommended mainly by specialists working in the United States, the UK or Ireland (p = 0.001). Overall, most equine orthopaedic veterinarians (71%; n = 201) preferred conservative management and recommended surgery only for horses that did not respond to conservative therapy. LIMITATIONS: Respondents' personal bias may have skewed the findings. CONCLUSIONS: Despite a growing body of evidence, the therapeutic approach to 'kissing spines' in horses is influenced by professional specialisation and regional preferences. Variations in injection techniques and differing criteria for surgical intervention warrant further investigation.

Factors Associated with Inappropriate Use of Antibiotics Among Animal Health Professionals in Selected Districts of Rwanda, 2021.

BACKGROUND: Antibiotic resistance is a global health concern. Humans can acquire antibiotic resistance through human-to-human transmission, from the environment, via the food chain, and through the contact with animals. The National Action Plan on antimicrobial resistance 2020-2024 highlights the prudent use of antibiotics in veterinary activities as the key element in keeping antibiotics effective. We determined the factors associated with misuse of antibiotics among animal health professionals in Rwanda. METHODS: This was a cross-sectional study that enrolled animal health field professionals from five districts, where stratified random sampling was used to select one district by each province of Rwanda. Structured questions were used during face-to-face interviews. The misuse of antibiotics was defined as the use of antibiotics for reasons other than treatment, the non-completion of required courses, or the use of a high dose (i.e., an overdose) of antibiotics. We collected socio-demographic data of respondents, as well as elementary knowledge and perceptions on veterinary antibiotics and antibiotic resistance. A backward stepwise logistic regression model was used to identify the factors that were predictive of the inappropriate use of antibiotics. RESULTS: There were 256 respondents to the survey. Of those, 198 were male and 58 were female. Almost three quarters of respondents (n = 174/256; 68%) reported the misuse of antibiotics at least once in the previous 12 months. The final logistic regression analysis identified the following factors to be predictive of antibiotics misuse: aged ≤ 24 years (aOR 0.92; 95% CI [0.88, 0.96]; p < 0.001); low trust in veterinary antibiotics available in the local market (aOR 8.45; 95% CI [4.18, 17.07]; p < 0.01), insufficient knowledge about basic understanding of antibiotics and antibiotic resistance (aOR 2.78; 95% CI [1.38, 5.58], p < 0.01) and not acquiring any continuing education (aOR 1.97; 95% CI [1.02, 4.19]; p = 0.04). CONCLUSIONS: This study identified inadequate perceptions of proper antibiotic use among animal health professionals. There is a need for continuous education on appropriate antibiotic use among animal health professionals to lessen the negative impact of antibiotic resistance on public health security.

Veterinarians and moral distress.

OBJECTIVE: Assess veterinarians' reported levels of moral distress and professional well-being. Determine the predictive value of moral distress, controlling for demographic factors, on veterinarians' levels of Professional Fulfillment, Work Exhaustion, Disengagement, and Burnout. SAMPLE: Members of the Veterinary Information Network. PROCEDURES: An electronic survey distributed via the Veterinary Information Network data collection portal. RESULTS: A total of 1,919 veterinarians completed the survey. For both associates and owners, gender and age were significant predictors of moral distress with younger female veterinarians reporting higher levels of distress than older male veterinarians. For associates, age was a positive predictor and moral distress score was a negative predictor of Professional Fulfillment. Age was a negative predictor, and female gender and moral distress score were both positive predictors for Work Exhaustion. For Interpersonal Disengagement and Burnout, age was a negative predictor and moral distress score was a positive predictor. For owners, age was a positive predictor and moral distress score was a negative predictor for Professional Fulfillment. Age was a negative predictor, and female gender and moral distress score were both positive predictors of Work Exhaustion, Interpersonal Disengagement, and Burnout. CLINICAL RELEVANCE: We found that, controlling for age and gender, higher levels of moral distress predicted lower levels of Professional Fulfillment and higher levels of Work Exhaustion, Interpersonal Disengagement, and Burnout. Given the prevalence of moral distress and its impact on mental health, it is imperative that the veterinary field provide training and education on how to recognize and navigate ethical conflicts.

Application of the multi-theory model to explain veterinarians' intentions to use telehealth/telemedicine.

BACKGROUND: Telehealth adoption is being fueled by both technological breakthroughs and societal demands; however, veterinarians have yet to fully embrace the concept of telemedicine, limiting its use and potential benefits. The goal of this study was to evaluate how effective the multi-theory model (MTM) of health behaviour change explains the initiation and sustenance of telehealth use among veterinarians. METHODS: For this cross-sectional study, a research company was contracted to disseminate the MTM-based online survey to veterinarians currently engaged in clinical practice within the United States. RESULTS: A total of 243 veterinarians participated in this study. The most frequently reported age group among participants was 31-40 years (33.7%, n = 82). It was also noted that the majority of participants were female (70.0%, n = 170) and white (76.5%, n = 186). Hierarchical multiple regression showed that participatory dialogue (p = 0.037), species (p = 0.013) and previous monthly telehealth use (p = 0.040) were significant explanatory variables of initiation of telehealth use. Moreover, emotional transformation (p < 0.001) and previous monthly telehealth use (p = 0.035) were significant explanatory variables of sustenance of telehealth use. LIMITATIONS: The data were collected in July 2020, during a global pandemic, in which telehealth use surged across a variety of professions. As a result, the findings of the study may not be relevant in periods when there is no pandemic. CONCLUSIONS: Based on the findings of this study, researchers, educators and veterinary professionals should consider using MTM as theoretical framework to develop interventions to enhance telehealth use.

Dutch veterinary graduates leaving practice: A mixed-methods analysis of frequency and underlying reasons.

BACKGROUND: This study aimed to evaluate the frequency of veterinarians graduated between 2009 and 2019 in the Netherlands leaving practice, their reasons for leaving and the relative importance of these reasons. METHODS: Study 1 (focus group sessions, n = 14) of this project was aimed at defining the reasons Dutch veterinarians have for leaving veterinary practice within 10 years of graduation. In study 2, the frequency of veterinarians leaving veterinary practice and the relative importance of the reasons for leaving identified in study 1 were investigated through a cross-sectional digital survey. A career in veterinary practice was defined as working in first- or second-line veterinary practice. Leaving practice was defined as ending employment in veterinary practice. RESULTS: The results of study 1 yielded 20 reasons given by veterinarians to leave veterinary practice within 10 years of graduation. One of the reasons obtained by this study was not mentioned in literature before: leaving veterinary practice as a pre-planned career path. Study 2 demonstrated that the mean percentage of respondents from graduation years 2009 to 2014 who left practice within 5 years of graduation was 16.8%. The most important reasons respondents gave for this career move were poor work-life balance, excessive workload, insufficient remuneration and perceived lack of employer support. CONCLUSION: A substantial number of veterinarians leave veterinary practice within 5 years of graduation. The most important reasons for this decision are excessive job demands or insufficient job resources. Furthermore, these reasons are a result of negative experiences regarding organisation of work, management and remuneration.

Perceptions of the impact of the RCVS Certificate in Advanced Veterinary Practice on the careers of its graduates.

BACKGROUND: This study aimed to investigate the perceived effect of the RCVS Certificate in Advanced Veterinary Practice (CertAVP) on its graduates, with respect to career advancement, professional practice and contentment with work in the veterinary industry. METHODS: A cross-sectional online survey of CertAVP graduates was performed, utilising descriptive analysis of Likert scales, logistic regression of demographic variable associations with key outcomes and free-text analysis. RESULTS: The majority (89%) of the 103 respondents felt that the CertAVP led to improvements in professional practice, 56% felt it had helped advance their career and 55% stated it had improved their contentment with work in the veterinary industry. The CertAVP was perceived to improve evidence-based practice, clinical governance, intellectual satisfaction and encourage lifelong learning, but was not perceived to improve work-life balance. LIMITATION: Due to potential response bias, this study may not represent the wider population. CONCLUSION: Despite respondents reporting career advancement, this was only reflected in mentorship and managing more complex cases; respondents neither felt that the CertAVP resulted in promotion, a pay rise or new leadership roles, nor did it afford greater flexibility in their working schedule.

An Investigation into Equine Nutrition Knowledge and Educational Needs of Equine Veterinarians.

This study investigated equine nutrition knowledge and educational needs of licensed veterinarians in the United States who were exclusively or predominately equine practitioners. It found veterinarians regard their peers as an important resource of nutritional knowledge, ranking ahead of all other sources except a PhD equine nutritionist. Interestingly, only 21% of veterinarians felt good about their knowledge level in equine nutrition after graduating from veterinary school. Although veterinarians in this study reported equine nutrition to be an area of weakness, 75% had not pursued continuing education in the field of nutrition within the last year. Additionally, they devoted only 65 minutes per year on average to improving their knowledge of equine nutrition, yet the majority (82.2%) had been providing nutritional advice to clients. This study revealed that time spent practicing veterinary medicine increases (p < .001) a veterinarian's self-perceived knowledge level of equine nutrition, shifting from just below average after graduation from veterinary school to just above average at the time of this study. The majority (70%) of veterinarians in this study believe nutrition is very important in their practice philosophy, and 71% showed interest in taking online continuing education courses; thus, curriculum should be developed and offered in areas of need as identified by this study. These areas include insulin resistance, equine gastric ulcer syndrome, equine metabolic syndrome, performance horses, equine pituitary pars intermedia dysfunction, equine polysaccharide storage myopathy, and arthritis/joint pain, along with how to assess nutritional status during general wellness examinations.

Self-Reporting of Risk Pathways and Parameter Values for Foot-and-Mouth Disease in Slaughter Cattle from Alternative Production Systems by Kenyan and Ugandan Veterinarians.

Countries in which foot-and-mouth disease (FMD) is endemic may face bans on the export of FMD-susceptible livestock and products because of the associated risk for transmission of FMD virus. Risk assessment is an essential tool for demonstrating the fitness of one's goods for the international marketplace and for improving animal health. However, it is difficult to obtain the necessary data for such risk assessments in many countries where FMD is present. This study bridged the gaps of traditional participatory and expert elicitation approaches by partnering with veterinarians from the National Veterinary Services of Kenya (n = 13) and Uganda (n = 10) enrolled in an extended capacity-building program to systematically collect rich, local knowledge in a format appropriate for formal quantitative analysis. Participants mapped risk pathways and quantified variables that determine the risk of infection among cattle at slaughter originating from each of four beef production systems in each country. Findings highlighted that risk processes differ between management systems, that disease and sale are not always independent events, and that events on the risk pathway are influenced by the actions and motivations of value chain actors. The results provide necessary information for evaluating the risk of FMD among cattle pre-harvest in Kenya and Uganda and provide a framework for similar evaluation in other endemic settings.

Off label use of human approved drugs in treatment of dogs in the Republic of Serbia.

Since drug companies are driven by the need to produce profit they are unwilling to make large investments in the development of new drugs if there is no market large enough to justify such investment. For this reason, veterinarians face a major obstacle - the veterinary drug market is not very profitable, which sometimes leads to not having a licensed drug available for treatment in veterinary practice. In this case, the cascade procedure allows veterinarians to, under certain circumstances, prescribe human approved drugs. The aim of our study was to analyze the pattern of human approved drugs prescription for 150 medical records of dogs participating in the survey. The results show that antimicrobial agents were the most commonly prescribed drugs for animals (50%) of all human approved drugs, and beta-lactams (38.6%) were the most widely used antibiotic classes. The most common general conditions for therapeutic use of antimicrobials in this study were digestive, skin and respiratory disorders. Our study shows that the frequency of bacterial culture, susceptibility testing and cytology was very low. Even though the off-label use of human approved drugs in animal practice is regulated by law, the results of this study indicate the need for more specific strategies and guidelines for such use. This may represent a potential for improvement by raising veterinarians' awareness toward more prudent use of human drugs.

The current situation of Angiostrongylus vasorum in Romania: a national questionnaire-based survey.

BACKGROUND: Angiostrongylus vasorum (Nematoda, Metastrongyloidea) is a vascular nematode that resides in the pulmonary arteries and the right side of the heart of a wide variety of carnivores, with an indirect life cycle using coprophagic gastropods as intermediate hosts. For domestic dogs, the infection with A. vasorum can be asymptomatic, but more frequently, it is associated with a wide range of clinical manifestations like cardio-respiratory signs, bleedings, neurological signs, and ocular problems which can lead to death when not treated accordingly. Angiostrongylosis was confirmed for the first time in Romania in red foxes (Vulpes vulpes) in 2017 and two years later a seroepidemiologic study was conducted among domestic dogs. However, to this date, no clinical canine angiostrongylosis cases were published in Romania. The aim of the present paper was to evaluate the knowledge about canine angiostrongylosis among veterinarians in Romania and to update the distribution of this disease using a national wide anonymous questionnaire. RESULTS: Overall, 147 unique responses were submitted, from 31 out of 42 counties. Twelve veterinarians (8%) from 8 counties (26%) acknowledged diagnosing a case of angiostrongylosis including 5 from the Bucharest and 1 from each of the remaining seven counties. All affected dogs had respiratory distress, 75% suffered cardiopathy, 16% coagulopathies and 8% neurological signs. Case diagnosis was based mostly on larval detection by coprology (67%) and serological antigen detection test (42%). CONCLUSIONS: Romanian veterinarians are aware of canine angiostrongylosis and a significant number have clinical experience with the disease. Epidemiological studies are now needed to assess its distribution in the country, and further efforts are required to improve understanding of the disease, its diagnostic and treatment methods among veterinarians.