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.

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.

Temporal patterns of human and canine Giardia infection in the United States: 2003-2009.

Giardia protozoa have been suspected to be of zoonotic transmission, including transmission from companion animals such as pet dogs to humans. Patterns of infection have been previously described for dogs and humans, but such investigations have used different time periods and locations for these two species. Our objective was to describe and compare the overall trend and seasonality of Giardia species infection among dogs and humans in the United States from 2003 through 2009 in an ecological study using public health surveillance data and medical records of pet dogs visiting a large nationwide private veterinary hospital. Canine data were obtained from all dogs visiting Banfield hospitals in the United States with fecal test results for Giardia species, from January 2003 through December 2009. Incidence data of human cases from the same time period were obtained from the CDC. Descriptive time plots, a seasonal trend decomposition (STL) procedure, and seasonal autoregressive moving-average (SARIMA) models were used to assess the temporal characteristics of Giardia infection in the two species. Canine incidence showed a gradual decline from 2003 to 2009 with no significant/distinct regular seasonal component. By contrast, human incidence showed a stable annual rate with a significant regular seasonal cycle, peaking in August and September. Different temporal patterns in human and canine Giardia cases observed in this study suggest that the epidemiological disease processes underlying both series might be different, and Giardia transmission between humans and their companion dogs seems uncommon.

Prevalence and risk factors for Giardia spp. infection in a large national sample of pet dogs visiting veterinary hospitals in the United States (2003-2009).

Estimates of the prevalence of intestinal infection of dogs with Giardia spp. in the United States vary widely. Risk factors for infection in a large sample of dogs over an extended period of time have not been well characterized. A national, electronic database of medical records was used to estimate the prevalence and identify risk factors for Giardia spp. infection among dogs visiting Banfield Pet Hospital™ located in 43 states in the United States. The overall prevalence of Giardia spp. Infection was 0.44% (95% CI: 0.43-0.45%) in approximately 2.5 million owned dogs who had a fecal flotation test performed from January 2003 to December 2009. A steady decrease in annual prevalence was observed, from a high of 0.61% in 2003 to 0.27% in 2009. Seasonal increases in prevalence were noted during the winter and summer months. Giardia spp. prevalence was highest in the Mountain region, especially Colorado (2.63%; 95% CI: 2.53-2.73%), and in puppies ≤0.5 year of age (0.63%; 95% CI: 0.61-0.64%). It was lowest for dogs of mixed breeding compared with pure breeds. Infection risk was 25-30% greater in sexually intact dogs compared to spayed and neutered dogs.

Evaluation of routinely collected veterinary and human health data for surveillance of human tick-borne diseases in North Carolina.

Tick-borne diseases are an important cause of human morbidity in North Carolina. This study evaluated the use of routinely collected veterinary hospital and human hospital emergency department (ED) data for earlier signal detection compared with routine reporting of tick-borne diseases to the North Carolina Division of Public Health in 2006 and 2007. The Early Aberration Reporting System was used to detect the earliest indication of an increase in number of dogs infested with ticks that were brought to veterinary hospitals and in number of people presenting to EDs with a tick-related chief complaint or who had an ED International Classification of Diseases diagnosis code of tick-borne disease. Results indicate that systematic monitoring of veterinary hospital and human ED data can detect increases in tick activity 4 weeks earlier than the current surveillance method, which would facilitate timely initiation of tick prevention and increased clinical awareness among veterinarians and physicians.

Feline hyperthyroidism: potential relationship with iodine supplement requirements of commercial cat foods.

UNLABELLED: ARTICLE RATIONALE: Since the late 1970s, there has been a significant increase in the prevalence of feline hyperthyroidism (FH). It is now recognized worldwide as the most common endocrinopathy of older cats, resembling toxic nodular goiter of older humans in iodine-deficient areas. The purpose of this article is to identify the potential for iodine concentrations in the diet to contribute to the etiology of FH. HISTORICAL CONTEXT: Iodine concentrations of commercial cat foods vary widely. A review of historical iodine recommendations revealed that the units of iodine supplementation changed in the 1970s. Given this change, foods minimally supplemented since the late 1970s would have been iodine deficient for most cats. PRACTICAL RELEVANCE: Iodine supplementation of commercial cat foods should be evaluated in the light of the iodine recommendations revised in 2006. Foods may remain deficient in iodine if supplemented at the minimum recommended concentration, possibly contributing to the development of FH.

A comparison of GlideScope video laryngoscopy versus direct laryngoscopy intubation in the emergency department.

OBJECTIVES: The first-attempt success rate of intubation was compared using GlideScope video laryngoscopy and direct laryngoscopy in an emergency department (ED). METHODS: A prospective observational study was conducted of adult patients undergoing intubation in the ED of a Level 1 trauma center with an emergency medicine residency program. Patients were consecutively enrolled between August 2006 and February 2008. Data collected included indication for intubation, patient characteristics, device used, initial oxygen saturation, and resident postgraduate year. The primary outcome measure was success with first attempt. Secondary outcome measures included time to successful intubation, intubation failure, and lowest oxygen saturation levels. An attempt was defined as the introduction of the laryngoscope into the mouth. Failure was defined as an esophageal intubation, changing to a different device or physician, or inability to place the endotracheal tube after three attempts. RESULTS: A total of 280 patients were enrolled, of whom video laryngoscopy was used for the initial intubation attempt in 63 (22%) and direct laryngoscopy was used in 217 (78%). Reasons for intubation included altered mental status (64%), respiratory distress (47%), facial trauma (9%), and immobilization for imaging (9%). Overall, 233 (83%) intubations were successful on the first attempt, 26 (9%) failures occurred, and one patient received a cricothyrotomy. The first-attempt success rate was 51 of 63 (81%, 95% confidence interval [CI] = 70% to 89%) for video laryngoscopy versus 182 of 217 (84%, 95% CI = 79% to 88%) for direct laryngoscopy (p = 0.59). Median time to successful intubation was 42 seconds (range, 13 to 350 seconds) for video laryngoscopy versus 30 seconds (range, 11 to 600 seconds) for direct laryngoscopy (p < 0.01). CONCLUSIONS: Rates of successful intubation on first attempt were not significantly different between video and direct laryngoscopy. However, intubation using video laryngoscopy required significantly more time to complete.

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.

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).

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.

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.

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.

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.

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.

Epidemiologic study of relationships between consumption of commercial canned food and risk of hyperthyroidism in cats.

OBJECTIVE: To determine whether the increasing prevalence of feline hyperthyroidism is the result of aging of the cat population and whether consumption of canned foods at various times throughout life is associated with increased risk of hyperthyroidism. DESIGN: Retrospective and case-control studies. STUDY POPULATION: Medical records of 169,576 cats, including 3,570 cats with hyperthyroidism, evaluated at 9 veterinary school hospitals during a 20-year period, and 109 cats with hyperthyroidism (cases) and 173 cats without hyperthyroidism (controls). PROCEDURE: Age-adjusted hospital prevalence of hyperthyroidism was calculated by use of Veterinary Medical Database records. On the basis of owners' questionnaire responses, logistic regression was used to evaluate associations between consumption of canned food and development of hyperthyroidism. RESULTS: Age-specific hospital prevalence of feline hyperthyroidism increased significantly from 1978 to 1997. Overall, consumption of pop-top canned (vs dry) food at various times throughout life and each additional year of age were associated with greater risk of developing hyperthyroidism. In female cats, increased risk was associated with consumption of food packaged in pop-top cans or in combinations of pop-top and non-pop-top cans. In male cats, increased risk was associated with consumption of food packaged in pop-top cans and age. CONCLUSIONS AND CLINICAL RELEVANCE: These findings suggest that the increasing prevalence of feline hyperthyroidism is not solely the result of aging of the cat population and that canned foods may play a role.

Effect of anticonvulsant dosages of potassium bromide on thyroid function and morphology in dogs.

A placebo-controlled experiment was performed to evaluate the effect of potassium bromide on the canine thyroid gland. Basal total thyroxine, free thyroxine, and basal thyrotropin serum concentrations were evaluated over a 6-month period in potassium bromide-treated and control dogs. A thyrotropin-releasing hormone stimulation test was also performed in all dogs at the beginning and conclusion of the study. Thyroid histopathology was compared between treated and control dogs at the end of the study. No difference was detected in any parameter between the two groups at the end of the study. A decline in thyroid hormone concentrations over the course of the study did occur in both groups of dogs. Potassium bromide does not appear to have a significant effect on canine thyroid function or morphology.

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.