Validation of an abbreviated instrument to assess veterinary client caregiver burden.

BACKGROUND: Caregiver burden is present in many clients managing illness in a companion animal, but current assessment tools are time-consuming and lack normative reference values. OBJECTIVES: Statistical reduction of items in a measure of caregiver burden to create an abbreviated version, validation of the abbreviated version, and calculation of reference values. ANIMALS: None. METHODS: This study was conducted using observational methods. Owners of an ill cat or dog were recruited through social media (n = 429). Veterinary clients with an ill (n = 459) or healthy (n = 961) cat or dog were recruited through a general veterinary and an academic hospital with multiple specialties. The study was conducted in 3 stages: (a) reduction of the Zarit Burden Interview (ZBI) adapted for use in pets via factor and item analyses, (b) psychometric validation of the abbreviated instrument, and (c) standardization of the abbreviated (7 items) and full (18 items) measures. RESULTS: A 7-item measure showed high correlations with the full measure (r = 0.88-0.93) and good internal consistency (α = .71-.75) across samples of veterinary clients with an ill cat or dog. This abbreviated measure correlated significantly (P < .001) and positively with stress (r = 0.40-0.75) and negatively with quality of life (r = -0.32 to -0.56). Reference values derived from clients with a healthy companion animal suggest "normal" burden ranges of 0 to 17 on the full measure and 0 to 8 on the abbreviated version. CONCLUSIONS AND CLINICAL IMPORTANCE: For situations precluding full assessment of client caregiver burden, this brief 7-item version can be used with good internal consistency and validity. Reference values can help determine if a client's caregiver burden is increased.

An overview of animal health and communication constraints in smallholder farming systems of Machakos County, Kenya.

Information sharing is an important pillar for any strategy that aims to control infectious diseases especially in farms and systems that are connected. A study was designed to analyze practices related to sharing of animal health information and identify health constraints affecting livestock keeping in smallholder farming systems of Mwala in Machakos County. Data were collected through focus group discussions (number of groups = 3) and one-on-one questionnaire interviews (n = 172). These were analyzed using both descriptive and thematic approaches. The most (33%; n = 158) feared animal disease was pneumonia which was also the most (62%) frequently reported health problem. Rabies, Newcastle disease, and east coast fever were ranked high by the farmer groups. Current animal management practices, for example, failure to confine dogs, predispose the community to a number of health risks including bites from rabid animals. Smallholder farmers in Mwala utilize a number of options to communicate animal health problems; such sharing is, however, constrained by a number of factors including bad roads, poor coverage of mobile networks, and bad relationships between animal health providers and the farmers themselves. Some of the reasons why farmers delay the reporting of disease problems included the tendency for one to first try local herbal formulations, the bad times when cases are observed, and the unavailability of reliable animal health providers at the time when the farmers need them. This study has provided useful baseline data that can then be used to (1) design a village-based animal disease reporting system which is currently lacking in the surveyed villages and (2) support the county government's efforts to manage animal diseases including zoonoses, through better reporting, for improved health, nutrition, and livelihoods.

Predicting caregiver burden in general veterinary clients: Contribution of companion animal clinical signs and problem behaviors.

Caregiver burden, found in many clients with a chronically or terminally ill companion animal, has been linked to poorer psychosocial function in the client and greater utilization of non-billable veterinary services. To reduce client caregiver burden, its determinants must first be identified. This study examined if companion animal clinical signs and problem behaviors predict veterinary client burden within broader client- and patient-based risk factor models. Data were collected in two phases. Phase 1 included 238 companion animal owners, including those with a sick companion animal (n=119) and matched healthy controls (n=119) recruited online. Phase 2 was comprised of 602 small animal general veterinary hospital clients (n=95 with a sick dog or cat). Participants completed cross-sectional online assessments of caregiver burden, psychosocial resources (social support, active coping, self-mastery), and an item pool of companion animal clinical signs and problem behaviors. Several signs/behaviors correlated with burden, most prominently: weakness, appearing sad/depressed or anxious, appearing to have pain/discomfort, change in personality, frequent urination, and excessive sleeping/lethargy. Within patient-based risk factors, caregiver burden was predicted by frequency of the companion animal's signs/behaviors (P<.01). Within client-based factors, potentially modifiable factors of client reaction to the animal's signs/behaviors (P=.01), and client sense of control (P<.04) predicted burden. Understanding burden may enhance veterinarian-client communication, and is important due to potential downstream effects of client burden, such as higher workload for the veterinarian. Supporting the client's sense of control may help alleviate burden when amelioration of the companion animal's presentation is not feasible.

What is your client thinking and why should you care?

Zoe Belshaw is coordinating our new series that gives an insight into what clients' experiences are and how you can help them. Here, she outlines how the series came into being.

Caregiver burden in owners of a sick companion animal: a cross-sectional observational study.

Much recent work has focused on occupational stress in veterinary medicine, although little is known about the possible contribution of client-based factors. Clients providing care for a companion animal with protracted illness are likely to experience 'caregiver burden' and reduced psychosocial functioning, which may ultimately lead to increased veterinarian stress. This cross-sectional observational study assessed caregiver burden and psychosocial function in 238 owners of a dog or cat, comparing owners of an animal with chronic or terminal diseases (n=119) with healthy controls blindly matched for owner age/sex and animal species (n=119). Results showed greater burden, stress and symptoms of depression/anxiety, as well as poorer quality of life, in owners of companion animals with chronic or terminal disease (p<0.001 for all). Higher burden was correlated with reduced psychosocial function (p<0.001 for all). Owners of a sick companion animal exhibit elevated caregiver burden, which is linked to poorer psychosocial functioning. This knowledge may help veterinarians understand and more effectively handle client distress in the context of managing the challenges of sick companion animal caregiving. Future work is needed to determine whether clients with this presentation impact veterinarian stress and how burden in this population might be reduced.

Board-invited review: Using behavior to predict and identify ill health in animals.

We review recent research in one of the oldest and most important applications of ethology: evaluating animal health. Traditionally, such evaluations have been based on subjective assessments of debilitative signs; animals are judged ill when they appear depressed or off feed. Such assessments are prone to error but can be dramatically improved with training using well-defined clinical criteria. The availability of new technology to automatically record behaviors allows for increased use of objective measures; automated measures of feeding behavior and intake are increasingly available in commercial agriculture, and recent work has shown these to be valuable indicators of illness. Research has also identified behaviors indicative of risk of disease or injury. For example, the time spent standing on wet, concrete surfaces can be used to predict susceptibility to hoof injuries in dairy cattle, and time spent nuzzling the udder of the sow can predict the risk of crushing in piglets. One conceptual advance has been to view decreased exploration, feeding, social, sexual, and other behaviors as a coordinated response that helps afflicted individuals recover from illness. We argue that the sickness behaviors most likely to decline are those that provide longer-term fitness benefits (such as play), as animals divert resources to those functions of critical short-term value such as maintaining body temperature. We urge future research assessing the strength of motivation to express sickness behaviors, allowing for quantitative estimates of how sick an animal feels. Finally, we call for new theoretical and empirical work on behaviors that may act to signal health status, including behaviors that have evolved as honest (i.e., reliable) signals of condition for offspring-parent, inter- and intra-sexual, and predator-prey communication.

Sickness behavior, its mechanisms and significance.

Recent studies have begun to clarify the pathogenesis of sickness behavior. Cytokines released by macrophages, dendritic cells and mast cells act on the brain to trigger behavioral changes in infected animals. The major cytokines, interleukin-1, tumor necrosis factor alpha, and others, all act on the hypothalamus to provoke alterations in the normal homeostatic condition. These include elevated body temperature, increased sleep, and loss of appetite as well as major alterations in lipid and protein metabolism leading to significant weight loss. Some of these changes are clearly directed towards enhancing the normal immune responses. The benefits of others such as appetite loss are unclear. It is also important to recognize that other animals may recognize sickness behavior as a sign of weakness and mark the victim out for targeting by predators. As a result, some prey species may work very hard to mask their sickness, a response that serves to complicate veterinary diagnosis.

Feeding behaviour and nutrient selection in an insect Manduca sexta L. and alterations induced by parasitism.

Manduca sexta L. larvae exhibit broad food acceptance with regard to nutrient content during the first 3 days of the last stadium. Larvae fed diets with a constant combined level of casein and sucrose, but variable ratios, display a linear relationship between protein and carbohydrate intake. Larvae grow best on a diet with equal nutrients, but will consume an excess of one nutrient in order to obtain an adequate amount of the other, as nutrient ratio shifts. Parasitized larvae feed similarly, but the nutrient ratio does not affect growth. Unparasitized larvae regulate intake of protein and carbohydrate when offered choices of protein-biased and carbohydrate-biased diets having combined nutrient levels of 120 g/l, but with variable ratios. Larvae normally consume equal amounts of nutrients, regardless of ratio, and grow similarly. As combined nutrient level is reduced in one diet, larvae abandon regulation and feed randomly. Parasitized larvae offered choice diets with 120 g/l combined nutrients do not regulate nutrient intake. Consumption of nutrients varies widely, but growth is unaffected. Larvae offered choices of diets having equal amounts of casein and sucrose but variable fat (corn oil), fail to regulate fat intake, although both unparasitized and parasitized larvae prefer a diet containing higher fat.

Causes of poor welfare in large animals during transport.

The welfare of animals during transport should be assessed using a range of behavioural, physiological and carcass quality measures. In addition, health is an important part of welfare so the extent of any disease, injury or mortality resulting from, or exacerbated by, transport should be measured. Many of the indicators are measures of stress in that they involve long-term adverse effects on the individual. Key factors affecting the welfare of animals during handling and transport which are discussed are: attitudes to animals and the need for training of staff; methods of payment of staff; laws and retailers' codes; genetics, especially selection for high productivity; rearing conditions and experience; the mixing of animals from different social groups; handling procedures: driving methods; stocking density; increased susceptibility to disease and increased spread of disease.

Evaluation of stress during transport.

Domestic animals are transported for a variety of reasons including breeding, biomedical purposes, slaughter and, in the case of sporting horses, for competitions, pleasure activities or ceremonial proceedings. Studies to determine the amount of stress on farm animals during transport often have highly variable results and are difficult to interpret. The reaction of animals to stressors depends on the duration and intensity of the stressors, the animal's previous experience, its physiological status and the immediate environmental restraints. Behavioural, haematological, haematochemical, physiological and neuro-hormonal (beta-endorphin, ACTH, cortisol, iodothyronines) variables are discussed on the basis of handling, loading and transport procedures of animals.

Construct models in veterinary behavioural medicine: lessons from the human experience.

Veterinary behavioural medicine is marked by inconsistency in the naming and description of animal behavioural disorders, potentially hindering research and reducing the clinical utility of diagnoses. Sources of diagnostic inconsistency are suggested and parallels with human psychiatry are identified. This paper questions the use of categorical models as the basis for classification and reviews criticisms of categorical approaches in psychiatry. Evidence is presented to suggest an inconsistency between discrete categories and the structure of animal behavioural disorders. The potential benefits of exploring alternative models are discussed. It is concluded that it is important to move away from an approach based on advocacy and towards objective assessment of all available data. Existing diagnoses should be viewed as hypothetical constructs, with the underlying hypotheses being identified and subject to investigation. It is emphasized that global communication, empirical investigations and critical review are necessary for the development of a solid scientific basis within veterinary behavioural medicine.

El estrés en los équidos / Equine stress

Los caballos son una especie muy sensible al estrés, una respuesta aguda de estrés induce un aumento en las concentraciones de cortisol plasmático. A corto plazo, moviliza energía, pero la producción de cortisol mantenida crónicamente contribuye al agotamiento de los músculos, a la hipertensión y a la alteración del sistema inmune y fertilidad. Esta respuesta de estrés crónico varía las concentraciones de cortisol plasmático según el estímulo que lo origina y la especie animal que se ve afectada. En este trabajo se revisan las diversas aportaciones sobre el tema: cómo afecta el transporte al estrés de los équidos (según la distancia, condiciones climatológicas y de transporte). También se estudia la relación entre estrés y ejercicio considerando varias variables como la edad del caballo, esfuerzo realizado en el ejercicio y condiciones ambientales. Por último, se considera la relación que existe entre estrés y enfermedad, teniendo en cuenta cómo afecta cada patología y la influencia de la evolución clínica en la concentración de cortisol plasmático (AU)