Cat and dog owners' expectations and attitudes towards advanced veterinary care (AVC) in the UK, Austria and Denmark.

Modern veterinary medicine offers a level of care to cats and dogs similar to that available to their owners, including blood transfusions, chemotherapy and MRI scans. The potential benefits to the animals of owners who can afford such care are obvious, but there can also be negative consequences if owners with strong emotional attachments to their pets pursue treatments that significantly reduce the quality of the animal's life while attempting to prolong it. Moreover, caring for a chronically or seriously ill animal can lead to emotional distress and financial and practical challenges for the pet owner. A questionnaire was used to survey cat and dog owners from representative samples of citizens in the UK, Austria and Denmark, to investigate owners' expectations and attitudes towards advanced veterinary care, and the factors that might influence those views. Overall, 58.4% of the pet owners surveyed believed that their pets should have access to the same treatment options as humans, while 51.5% believed that they should have access to the same diagnostic tests as humans. Owners were most likely to be neutral on the question of whether advanced veterinary care has 'gone too far' (45.3%), and to disagree with the statement that advanced care is 'unnecessary' (40.1%). In all three countries, the level of attachment owners had to their pets was most strongly associated with attitudes towards advanced care, with owners scoring higher on Lexington Attachment to Pets Scale (LAPS) being more likely to expect advanced care to be available. Other factors such as owner age, living situation (alone or not), income or possession of pet insurance were less consistently with owner attitudes. Our findings will help inform veterinarians and other health care providers about pet owner expectations and attitudes towards advanced veterinary care, and contribute to the debate on increasing specialisation within the profession.

Seeing the benefits, but not taking advantage of them: Dog and cat owners' beliefs about veterinary telemedicine.

BACKGROUND: Telemedicine offers benefits to clients and their animals, but potential disadvantages are also being debated. METHODS: Using a questionnaire, we investigated dog and cat owners' (N = 2117) use of and beliefs about telemedicine and whether beliefs impact past and expected future use. RESULTS: Although the majority of owners are aware that telemedicine can lead to the risk of something being missed, they see great potential in remote consultation in terms of usefulness for follow-up appointments or improving access to a specialist. However, only 12% of dog owners and 6% of cat owners have used telemedicine, and around 25% of owners who have never used it would be willing to use it in the future. Owners with a larger number of recent veterinary visits were more likely to have used telemedicine. LIMITATIONS: Although a definition of 'telemedicine' was provided, respondents may have had different perceptions of what this meant. CONCLUSION: Owners of dogs and cats recognise the potential benefits of telemedicine, but there is a mismatch with the actual uptake. This not only raises questions about the current availability of telemedicine but also should increase veterinary professionals' understanding of its potential benefits in veterinary practice.

Do people really care less about their cats than about their dogs? A comparative study in three European countries.

Previous studies have shown that cat owners seem to care less about their cats than dog owners care about their dogs - both in terms of their emotional state of attachment and in their willingness to pay for services that potentially benefit the animals. One study speculated that this difference is "driven by the behavior of the pet" - that the behavior of dogs encourages care more than the behavior of cats - and therefore is a universal phenomenon. However, previous studies mostly relied on convenience sampling of owners and were undertaken in single countries. Based on responses to a questionnaire from cat and dog owners drawn from representative samples of citizens (18 to 89 years of age) in three different European countries, Denmark, Austria and the United Kingdom, we tested the degree to which owners care about their cats and dogs. We used four different measures: Lexington attachment to pets scale (LAPS), possession of pet health insurance, willingness to pay for life-saving treatment, and expectation of veterinary diagnostic and treatment options. Dog owners had higher LAPS scores in all countries. However, the difference between dog and cat owners was greater in Denmark than in Austria and the United Kingdom. More dogs than cats were insured in all three countries, but the ratio was much less skewed in favor of dogs in the United Kingdom compared to Denmark. In terms of expensive life-saving treatment, in every country, more dog owners than cat owners were willing to spend over a certain amount, but the differences were much more pronounced in Denmark compared to the United Kingdom. In Denmark and Austria, dog owners expected more veterinary treatment options to be available, but species made no difference to the expectations of UK owners. People care more about their dogs than their cats in all countries, but with a clear cross-country variation and a very modest difference in the United Kingdom. Therefore, it does not seem to be a universal phenomenon that people care much less about their cats than their dogs. This finding has practical implications for future efforts to expand the level of veterinary services provided for cat owners.

Between Leisure and Pressure-Veterinarians' Attitudes towards the Care of Competition Horses in Germany, Austria and Switzerland.

Equine veterinarians face a range of challenges when attending competition horses. Athletic goals may significantly impact veterinary decision making, and the veterinarian's work can be complicated by reputational considerations and rival opinions during an assessment of whether a horse is "fit to compete". Using an online questionnaire, we found that the majority of German, Austrian and Swiss equine veterinarians (N = 172) surveyed agreed that the owners of competition horses are more likely than owners of leisure horses to approach them with clear treatment ideas, and that the former have higher expectations of the medical services provided. The data also show that the veterinarian's reputation plays a more important role in the competition sphere. Using a case vignette, we established that, on the grounds of equine welfare, the majority of respondents indicated that they would decide against starting a dressage horse with low-grade lameness in a competition. Those respondents who indicated that they would approve a start of the dressage horse indicated that a horse with a low-grade lameness was fit enough "to compete". We conclude that clearer definitions of phrases, such as "fit to compete", may be helpful in guiding veterinarians as they discharge their professional responsibilities during competitions and reduce the reputational stress they experience in this working context.

Complications secondary to endotracheal intubation in dogs and cats: A questionnaire-based survey among veterinary anaesthesiologists.

OBJECTIVE: To investigate anaesthesiologists' attitudes towards endotracheal intubation and the perceived incidence of complications secondary to endotracheal intubation in dogs and cats. STUDY DESIGN: A cross-sectional online questionnaire-based study. METHODS: Using an online questionnaire distributed via electronic mail, the perceived incidence of complications secondary to endotracheal intubation in dogs and cats was investigated. Attitudes towards endotracheal intubation, average caseload and percentage of animals intubated were examined. The study population consisted of Diplomates, Residents, and residency trained members of the American and European Colleges of Veterinary An(a)esthesia and Analgesia. Univariate descriptive statistics were calculated. For each complication, a mean incidence score (MIS) was calculated, ranging from 1 (never) to 5 (always). Additionally, a Wilcoxon signed-rank test and binary regression analyses were performed. A p value ≤ 0.05 was considered significant. RESULTS: The overall response rate was 35.1%, with a completion rate of 26.6%. Most dogs and cats undergoing general anaesthesia were intubated. Endotracheal intubation was viewed as an integral part of modern anaesthesia. Significant differences were found in the incidence of 16 of the 24 examined complications between dogs and cats (p ≤ 0.001). The most frequently perceived complications were reported to be cuff leak (MIS 3.20) and coughing during intubation (MIS 3.10) in dogs, and coughing (MIS 3.01) and laryngeal spasm during intubation (MIS 2.91) in cats. Sociodemographic and practice-specific aspects did not appear to play a significant role in the reported incidence of complications. CONCLUSIONS AND CLINICAL RELEVANCE: Endotracheal intubation was considered a state-of-the-art technique by the respondents. It was associated with a perceived low incidence of major complications and more frequent minor ones. Differences between dogs and cats need to be accounted for. Considering the retrospective and self-reporting nature of this survey, true incidences might differ.

Compete or Cooperate with 'Dr. Google'? Small Animal Veterinarians' Attitudes towards Clients' Use of Internet Resources-A Comparative Study across Austria, Denmark and the UK.

Veterinary medicine is increasingly affected by animal owners having the opportunity to become better informed on pet health issues by using various internet resources. Using an online questionnaire including a section on clients' use of internet resources to obtain medical information, this study aimed to investigate veterinarians' estimates of the percentage of clients using internet resources, how often clients question veterinarians' professional medical advice based on online information, and veterinarians' attitudes towards clients' use of internet resources, across Austrian, Danish, and UK veterinarians (n = 641). The results show that 48.8% of respondents estimated that 40-79% of their clients use internet resources to find medical information. Further, 70-80% of respondents stated that they are occasionally challenged by clients questioning their advice based on online information. Although veterinarians recognized the potential advantages related to clients' use of internet resources, such as an increased acceptance of advanced diagnostics and treatments, they also highlighted clients' increased expectations or false impressions of small animal practices as potentially negative aspects in this context. As internet use increases, it seems likely that these issues will become increasingly important in the future.

Digital opportunities to connect and complain - the use of Facebook in small animal practice.

BACKGROUND: Social media is increasingly used in small animal practice, enabling veterinarians to connect with clients and promote their business online. It can also be used by clients to quickly distribute complaints via online communities. MATERIAL/METHODS: Using a questionnaire study we investigated Austrian, Danish and UK veterinarians' attitudes towards Facebook, the contents of clients' online complaints and how they were handled by veterinarians (N = 648). RESULTS: In Denmark and the UK, around 90% of practices had a Facebook page, in contrast to 40% of Austrian practices. Most Danish and UK veterinarians agreed that the use of Facebook was relevant and expected by clients. Agreement was lower among Austrian veterinarians, probably reflecting the lower uptake of social media there. In particular, younger veterinarians and those who actively used Facebook for the practice, could see benefits. In all three countries, we found that clients most frequently complained about treatment costs. Most veterinarians preferred to actively deal with clients' complaints, either replying online or discussing them directly. CONCLUSIONS: We recommend future research focusing on veterinarians' personal use of social media and on clients' use of and attitudes towards social media in the veterinary context.

Wanna See My Dog Pic? A Comparative Observational Study of the Presentation of Animals on Online Dating Profiles in Vienna and Tokyo.

Online dating applications offer new ways for people to search for social contacts. While previous studies have indicated that the inclusion of animals in profiles can increase users' dating success rates, the question of how many users display animals, and what kinds of animals are shown on dating profiles, has not yet been empirically investigated. Using a structured observational study of profiles in Vienna and Tokyo on a popular online dating app (n = 2400), we therefore looked at how many profiles show animals and what kinds of animals are shown. We found that 15.5% of the investigated profiles had at least one photo showing an animal. In both cities, dogs were the most frequently shown animal. Taking the cities together, they appeared in 46.4% of the animal pictures, as compared with cats at 25.7%. Other animals such as exotic animals (9.9%), farm animals (6.4%) or horses (4.6%) played a minor role. Users were significantly more likely to show cats in Tokyo (35.8%) than they were in Vienna (18.0%). We found that users in Vienna; women; and older adults were more likely to present animals on their profiles than were users in Tokyo; men; and younger users. Sexual orientation showed no significant differences in the analyses.

Comparing veterinarians' attitudes to and the potential influence of pet health insurance in Austria, Denmark and the UK.

BACKGROUND: Health insurance offers many benefits to clients and veterinarians, such as the ability to perform necessary and possibly cost-intensive medical interventions without financial constraints, or to potentially prevent euthanasia based on financial challenges. However, concerns about negative consequences, such as the overuse of diagnostic tests or overtreatment, have also been raised. METHODS: Using an online questionnaire distributed via e-mail, which included a section on health insurance, we investigated the relative number of insured dogs and cats treated by Austrian, Danish and UK veterinarians (N = 636) and the attitudes of those veterinarians toward health insurance. Further, using a case vignette, we examined whether coverage by health insurance may influence treatment suggestions. RESULTS: Even though veterinarians in all three countries believe that health insurance reduces stress since clients' financial resources will be less important, we found that Austrian veterinarians are more likely to agree that health insurance is unnecessary compared to Danish and UK veterinarians. Further, many raised the concern that insurance policies influence clinical decisions; and less than half supported the idea of making insurance mandatory. A majority of veterinarians in Austria and the UK thought that insurance can lead to the overuse of diagnostic tests, and in the UK a majority also thought that it can lead to overtreatment. Using case vignettes, we found that veterinarians were significantly more likely to suggest a CT scan to a client with an insured animal, in contrast to a client with stated financial limitations. Further, UK veterinarians were more likely to suggest a CT scan to a client with an insured animal, in contrast to a client without insurance. CONCLUSION: In conclusion, we found that veterinarians, in general, were in favour of health insurance, and that greater coverage may increase more cost-intensive veterinary care. Our findings also raise a potential ethical challenge of health insurance causing differential access to clinical care for patients.

Managing conflicting ethical concerns in modern small animal practice-A comparative study of veterinarian's decision ethics in Austria, Denmark and the UK.

Small animal veterinarians frequently have to manage conflicting interests. Beside the key consideration of the patient's interests, small animal veterinarians are often challenged to consider not only client's emotional needs, but also their own personal aspirations to provide quality patient care and to make a good living as a professional. Further, veterinarians have an interest in continuous professional development and the use of the newest treatments, which may influence their decision-making process. Based on published work, we hypothesize the existence of four decision ethics orientations that veterinarians can use to manage potentially conflicting concerns. These are: the patient-focused, the client-empathetic, the client-devolved and the development-oriented decision ethics orientations. We surveyed small animal veterinarians in Austria, Denmark, and the UK using a questionnaire (N = 648), and successfully identified the four decision ethics orientations in all three countries. The patient-focused and client-empathetic decision ethics orientations are salient in all countries, whereas Danish and UK veterinarians are slightly more client-empathetic and client-devolved compared to their Austrian colleagues. Across countries our findings show that experienced and older veterinarians tend to be more client-empathetic. Younger and less experienced professionals are more development-oriented compared to their older and more experienced colleagues. In contrast to other studies investigating ethical issues in small animal practice, we found no evidence that gender plays a decisive role in the tendency towards any decision ethics orientation. We also show that veterinarians with a higher client-empathetic orientation and development-orientation more often discuss the possibility of health insurance with clients who do not have it. The present study provides a first empirical insight into how veterinarians manage challenging expectations and ethical concerns as part of decision making in modern small animal practice.

"Patients' interests first, but "⁻Austrian Veterinarians' Attitudes to Moral Challenges in Modern Small Animal Practice.

Small veterinary practice is experiencing steady improvement in diagnostics and therapies which enable veterinarians to offer evermore advanced medical care for their patients. This focus group study of veterinarians (n = 32) examined the impact of these improvements and the potential challenges they introduce in small animal practice. It shows that while advanced diagnostics and therapies deliver benefits in patient care, they also add complexities to decision-making. Although the veterinarians participating in the study were aware of their duty to act in the best interests of the animal, their decisions were highly dependent on factors such as the client's financial background and the emotional bond between client and animal, as well as the veterinarian's place of work, and level and field of specialization, and certain economic aspects of the practice. The overall conclusion is that small animal veterinarians are increasingly torn between serving the best interests of the animal, medical feasibility and contextual factors related to the client, the veterinarian, and professional colleagues. Further, the findings suggest that services are not only oriented towards the provision of medical care in a strict medical sense. On top of this, veterinarians need to deal with various expectations and wishes of clients which influence their decision-making. As it will be shown, factors like the possibility of referring patients to specialist veterinarians or prompt diagnostic results influence their decision-making.

Austrian Veterinarians' Attitudes to Euthanasia in Equine Practice.

Euthanasia of companion animals is a challenging responsibility in the veterinary profession since veterinarians have to consider not only medical, but also legal, economic, emotional, social, and ethical factors in decision-making. To this end; an anonymous questionnaire-based survey of Austrian equine veterinarians examines the attitudes to the euthanasia of equine patients in a range of scenarios; to identify factors which may influence decisions on the ending of a horse's life. This paper describes the distributions of demographic and attitude variables. Mann-Whitney U tests were used to test the associations of gender, work experience, and equine workload with attitudes in relation to euthanasia statements and case scenarios. In total, 64 respondents (response rate = 23.4%) completed the questionnaire. The study showed that veterinarians consider contextual and relational factors in their decision-making. They are aware of owners' emotional bonds with their horses and financial background, however, requests for convenience euthanasia are typically rejected. Although some significant differences between the tested variables emerged, the attitudes of the veterinarians were shown to be largely shared. In conclusion, veterinarians are aware of the multiple factors that influence their decision-making and gave indications as to the weight of animal- and owner-related factors in the handling of euthanasia.

Comparison of emergence times and quality between isoflurane and sevoflurane in rhesus macaque ( Macaca mulatta) undergoing neurosurgical procedure.

Volatile agents for anaesthesia are widely used for anaesthetizing laboratory primates, and isoflurane is one of the most frequently used agents. Sevoflurane has been shown to offer a more rapid recovery than isoflurane in a number of species, but no comparisons have been made in non-human primates. This study compared the recovery characteristics of isoflurane and sevoflurane in rhesus macaques undergoing experimental neurosurgery. Twelve primates (7 males and 5 females) were randomly allocated to the treatment groups. They were sedated with ketamine (10 mg/kg) and anaesthesia was induced with propofol (usually 8 mg/kg intravenously [IV]). Anaesthesia was maintained with either sevoflurane (SEVO) (2.2 ± 0.4%) or isoflurane (ISO) (1.2 ± 0.2%) and alfentanil (0.2-0.5 µg/kg/min IV) for 332-592 min. Animals were mechanically ventilated. Meloxicam (0.3 mg/kg) and methylprednisolone infusion (5.4 mg/kg/h) were also administered. Time to extubation after cessation of anaesthesia was significantly shorter with sevoflurane (ISO: 7.0 ± 1.8 min; SEVO: 3.6 ± 1.5; *P = 0.005) as was the time to the animal sitting unaided (ISO: 15.7 ± 8.2 min; SEVO: 7.1 ± 1.7 min; *P = 0.004) . No significant difference in the quality of recovery following isoflurane or sevoflurane anaesthesia was found. In conclusion, isoflurane and sevoflurane are both suitable volatile agents for the maintenance of general anaesthesia in rhesus macaques undergoing experimental neurosurgical procedures. The two volatile agents presented a similar emergence quality profile, however sevoflurane anaesthesia was associated with a faster recovery, offering the possibility of conducting earlier post-operative neurological assessment.

Attitudes of Austrian veterinarians towards euthanasia in small animal practice: impacts of age and gender on views on euthanasia.

BACKGROUND: Euthanasia of pets has been described by veterinarians as "the best and the worst" of the profession. The most commonly mentioned ethical dilemmas veterinarians face in small animal practice are: limited treatment options due to financial constraints, euthanizing of healthy animals and owners wishing to continue treatment of terminally ill animals. The aim of the study was to gain insight into the attitudes of Austrian veterinarians towards euthanasia of small animals. This included assessing their agreement with euthanasia in exemplified case scenarios, potentially predicted by demographic variables (e.g. gender, age, working in small animal practice, employment, working in a team, numbers of performed euthanasia). Further describing the veterinarians' agreement with a number of different normative and descriptive statements, including coping strategies. A questionnaire with nine euthanasia scenarios, 26 normative and descriptive statements, and demographic data were sent to all members of the Austrian Chamber of Veterinary Surgeons (n = 2478). RESULTS: In total, 486 veterinarians answered sufficiently completely to enable analyses. Responses were first explored descriptively before being formally analysed using linear regression and additive Bayesian networks - a multivariate regression methodology - in order to identify joint relationships between the demographic variables, the statements and each of the nine euthanasia scenarios. Mutual dependencies between the demographic variables were found, i.e. female compared to male veterinarians worked mostly in small animal practice, and working mostly in small animal practice was linked to performing more euthanasia per month. CONCLUSIONS: Gender and age were found to be associated with views on euthanasia: female veterinarians and veterinarians having worked for less years were more likely to disagree with euthanasia in at least some of the convenience euthanasia scenarios. The number of veterinarians working together was found to be the variable with the highest number of links to other variables, demographic as well as ethical statements. This highlights the role of a team potentially providing support in stressful situations. The results are useful for a better understanding of coping strategies for veterinarians with moral stress due to euthanasia of small animals.