Alicorns, Gryphons, One Health, Zoonosis and other fantastical stuff

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As is common in my house (and likely the home of other parents…who are being honest), my kids recently schooled me on the appropriate word used to refer to a winged horse with a horn. For the uneducated (by the 10 and under crowd), the proper word, and apparently that used by ‘seriously everyone, Mom’, is an alicorn .

This newfound wisdom, together with a lengthy (and heated) follow-up debate on how to correctly spell Gryphon , got me thinking about a recent publication hatched from a survey of veterinary students, “Beliefs, Attitudes and Self-Efficacy Regarding One Health and Zoonosis Management”.

 

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The study was performed in the land of fantastical critters, Australia, with 175 senior year veterinary students (from 5 veterinary colleges) responding to a One Health and Zoonoses questionnaire.  Outlined objectives (key questions) were to, ‘explore the beliefs and attitudes of the students regarding One Health’, and ‘evaluate the students’ confidence in advising the general public on preventive health with respect to zoonotic disease’.

The study reported that the majority of participating veterinary students believed; 1) in the importance of One Health (97%), 2) that it was their duty to promote One Health (96%) and, 3) that vets were better equipped to do so than physicians (81%). Additionally, the students unanimously reported a willingness to collaborate and assist physicians in zoonotic disease concerns-cases. All good and unsurprising stuff.

Now the not-so-good news. Unfortunately, only 36% of the students felt like they had a framework to promote One Health and their reported confidence in diagnosing zoonoses was low, with only 22% reporting confidence in diagnosing zoonoses in wildlife, 39% in companion animals, and 36% in production animals.  

To be fair, these were 4th year students, some of whom may have been uncertain of their day 1 abilities (e.g., following graduation), as such it might have been useful to see how this compared to their confidence in non-zoonotic diseases. On the other hand, there appears to be a definite gap in what this group of students believed vs. their feeling on their abilities and skill set.

It’s difficult (and potentially crushing) to feel responsible for something (in this case human and animal health), yet poorly equipped to adequately provide resources, i.e. lacking a framework or adequate training. So, if we think that the results of this study may reflect the belief’s, attitudes and self-efficacy of other veterinary students, besides those surveyed in Australia, how do we move forward?  Certainly, additional training/resources in this field may be needed for our students (and practicing veterinarians?), in order to increase awareness and education.

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One thing that might help on the companion animal front could be to enlist (charm? bully?) a bunch of passionate veterinarians from all avenues of the profession (and all over the world) to write an infectious disease book targeted for veterinary students and general practitioners in order to assist with recognition of clinical signs, diagnosis and prevention.

We all do what we can (or should try?), and while the book isn’t perfect, and I suspect others (besides my kids) will tell me that a lot of it is wrong or can be improved…it’s a start to raising awareness, accessibility and hopefully drawing topics like infectious disease, zoonosis and One Health out of the poorly defined (murky? Phantasmagoric?) and into the veterinary day-to-day.

Regional K9 disease risks: How common is common?

The reality is… we don’t have much in the way of scientific evidence (aka publications) on the incidence of veterinary diseases (check out this earlier blog on prevalence and preventative care). There, I said it. Gasp…That means that on many of the occasions I tell dedicated dog and cat owners that things occur commonly, and it would be good to: a) test their pet for it, and b) protect their pet against it… I’m full of ‘poopie-caca’ as we say in my house…which likely isn’t a surprise (and is definitely well recognized in my house, i.e. that I am frequently full of @#$!).

This lack of evidence is true for Canada and globally. And, I’m quite aware that this dearth of literature is due to these types of studies being tough to do, i.e. requiring a number of general practice clinics to participate, organize, report and document disease appropriately (and accurately), perform data analysis and I think we won’t go into the odds of obtaining funding for a project of this type. Unfortunately, for all these reasons, veterinarians are left with making ‘guess-ti-mates’ when predicting and preparing for what diseases occur commonly.

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This need to ‘guess-ti-mate’ disease occurrence and what’s high risk (or not) is true for myriad concerns in dogs and cats and includes multiple (most) infectious diseases, e.g. canine parvovirus, leptospirosis, Lyme and other tick-borne diseases. As such, DVMs frequently end up relying on the willingness of veterinary diagnostics labs to share test results, extrapolating from the few studies performed at large veterinary centers that in most cases probably don’t accurately reflect the risks for local pets, and/or word of mouth in order to predict regional infectious disease risks.

Our collaborative research team (University of Guelph and PEI) has been working to try and address this lack of information for pets in Canada. As mentioned in earlier blogs, we’re analyzing a dataset of leptospirosis testing of dogs (Lepto results compared to human population). However, we’re also working on this from another angle in Atlantic Canada and in Ontario through the Canadian K9 Lifetime Study, to collect information that allows for further information on specific dog disease incidence and risk.

It’s too soon to submit the paper, but I will share that it’s been interesting to see the leptospirosis test results on puppies and dogs (vaccinated for lepto and not) and the serovar differences between Ontario and Atlantic Canada. I suspect (and hope) that when we expand the study later this summer into Quebec and western Canada there will be further illumination on leptospirosis and tick-borne disease in dogs nationally. Hopefully work like this will allow us to capture true disease incidence information for dogs (and their people) allowing us to best ensure the health of our pets.

Research efforts such as these occur thanks to the participation of the over 400 dog owners and their respective dedicated veterinary teams enrolled in the study to date.

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Happy early birthday Canadian K9 Lifetime Study- it’s been amazing to watch you grow! Due our successful enrollment in Ontario and Atlantic Canada we’ll be closing the study to new puppy enrollment in Ontario, Nova Scotia and Prince Edward Island on July 1, 2019. Thanks so much to all of our dedicated veterinary clinics and pet-owner participants. It’s amazing to work with a community of people who are devoted to dog health and continue to be engaged with annual reevaluations so that we can learn all about these puppies as they grow into dogs!

Veterinary Lyme Disease Study:

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The diagnosis, treatment and prevention of canine Lyme disease has posed a challenge for the veterinary profession. Drs. Katie Clow (OVC), Scott Weese (OVC) and Michelle Evason (AVC) are interested in Canadian veterinary knowledge, attitudes and practices surrounding Lyme disease, in the hopes of targeting future education and research. If you are a practicing Canadian veterinarian, please contact kclow@uoguelph.ca for the link to our brief, anonymous online survey to help achieve our mutual goal of improved canine health. (University of Guelph REB#19-02-029).

What do you think is best (important) for your dog when it gets an infection?

Canadian K9 Lifetime Study Participant Survey on Antibiotic Use in Dogs

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Studies that look at knowledge, attitudes and perceptions (KAPs) of the general public on various subjects are growing more and more common.

Grain of salt…as more common isn’t the same as ‘common’ and on the whole this type of research isn’t common or done all that often, particularly in veterinary medicine. This is a shame, as knowing what pet-owners (aka veterinary clients) think, know, believe and perhaps most importantly want-need for their pets is REALLY important. After all, optimum health for pets and raising that bar is a team effort- isn’t it? And for me, KAP surveys are the first step in bridging what is sometimes a gap between pet-owners and vets. As a vet, I’m very aware that pet-owners usually know better than I do what does (or doesn’t) work for their fur babies. And, as a pet-owner, this is definitely how I feel about my E. setters, i.e. I know way more about what they need than any vet, including my husband- who also happens to be a vet.

To that end (i.e. investigating KAPs of pet-owners), the Canadian K9 Lifetime Study will stay on track with our annual expansion of study goals, and this spring (year #3 of the study!) we will continue our work on canine welfare and health by adding to our original agenda of infectious disease (specifically tick-borne, aka Lyme disease (2017) and leptospirosis (2018)), nutrition, exercise and general health to include assessment of KAPs surrounding antibiotic use (2019).

We are inviting study members to participate in a short survey regarding antibiotic use in dogs. The survey is designed to gather information about pet owners’ perceptions and preferences when treating their pet for an infection. The study is funded by the Ontario Veterinary College Pet Trust.  The survey is voluntary and anonymous.

The survey is open to all Lifetime study participants.

For more information or to complete the survey, please click here: SURVEY  

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As always, we want to thank you for your continued participation in the Canadian K9 Lifetime Study. We cannot do this important work for canine health and welfare without your ongoing participation. It is nothing short of incredible to see our study dogs grow from fuzzy puppies to young dogs!

Top 5 ways to ‘Prevent an animal associated injury this season’

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This Easter weekend, during various holiday time-points (i.e. E. Bunny egg hunt, over-indulgence on anti-oxidant containing treats, grading exams, travel and yard work), the family and I came up with a:

Top 5 things to remember to keep yourself (and your family) safe from an animal associated injury or infectious disease’ list.

Although we hope 1-4 below are also on your ‘They did what?!@’ list, we’ve learned over the years that common sense just ain’t so common…So, without further ado, here is our spring-themed (think bunnies, chicks, lambs) list of things to consider, as we hop, flap, bounce or caper into a new season:

 

Top 4 things NOT to do, and 1 thing TO do:

1.      Don’t run over dead animals with your lawn mower- especially those ‘wascally wabbits’. I repeat, ‘Avoid this like the plague’. Yes, I am writing about tularemia…

2.      Don’t kiss your (anyone else’s or your child’s class pet) hedgehog on the mouth- or anywhere else.

3.      Replace ‘hedgehog’ in #2 with chick, duckling, rat, guinea pig, gecko, bearded dragon, frog, or snake, and same thing…don’t do it.

4.      Don’t do a mouth castration on your (or anyone else’s or your child’s class pet) lamb. Once again, this is applicable to many (ANY) species, i.e. Do not do this.

5.      Do download (and pass along) these freely available dog and cat colouring pages. Prevention of dog and cat bites begins with education and awareness on animal behaviour- and it’s easiest to learn when it’s simple and fun…at least that’s true for me.

 

 

 

 

 

 

 

Filtered lenses and Consensus: More than a poor rhyme?

This spring saw the birth (i.e. recent publication) of a few veterinary consensus guidelines, on topics ranging from hemolytic anemia , dental care, to antibiotic use.

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What’s so exciting about that you ask? Well…Consensus guidelines can be wonderfully helpful in animal health decision-making for vets and pet-owners, because (provided they are done well) these publications strive to provide evidence-supported recommendations on topics that veterinarians commonly face with the end-goal of benefiting animal (and in some cases human) health. I suspect that’s why guidelines of this type sometimes appear to be cropping up quicker than April showers in Canada, in other words…most of us are still getting snow.

Much as I heart an easily searched for (and freely available online) guideline, as with anything one reads (barring fiction) it’s probably important to apply a level of scrutiny prior to acceptance and application. Simply put, consider reading guidelines (or any other scientific article) with a few questions in mind. For example:

1)      ‘What’s the clinical question(s) being asked by this summary…and is it actually relevant to my veterinary patients, own pet, the area I live, etc.?’

2)      ‘Will this recommendation bring about an outcome that is different (and hopefully better) compared with: a) another therapy (or diagnostic), or b) doing nothing at all?’

To help with this style of assessment, (i.e. if critical review isn’t something you routinely do- or like myself- you may be distracted by the NHL playoffs (Go Jets Go: and new season of Game of Thrones- OMG! Dragons ), think about reading with a checklist that helps assess the quality of the overall publication and research referenced within. There are a number of these checklists available online. Here’s an example of a few:

https://www.cliniciansbrief.com/article/top-5-steps-practice-evidence-based-veterinary-medicine;

http://guides.osu.edu/vetmed/EBVM 

Getting to the guidelines… two of the publications below are revisions of prior guidelines and one is brand-new. They are all worth a read for various reasons- the most important of these being improvement of animal health. However, if you’ve got some free time over the upcoming E. Bunny associated holiday, try reading these without filtered lenses (i.e. using an evidence-based checklist) to see how they rate- and whether that scrutiny changes how you think they apply to (and most importantly will benefit) your pet or patient, your veterinary hospital and you.

1)      Antimicrobial use for infectious urinary tract diseases

2)      Dental care

3)      Diagnosis and treatment of Immune mediated hemolytic anemia

The tick came back the very next day....

He just wouldn’t stay away.

 Continuing on the weather-related theme from the last post, aka you know you’re getting old when, you:

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1) chat about the weather constantly, and

2) mis-reference Fred Penner sung songs.

However, just like the yellow cat in ‘The cat came back’ song, the driving or drizzling rain outside is a ‘Meow’ call of return- in this case of spring. Somewhat less desirable than the thought of spring (and similar to the wails of the reluctant cat-owner in the song), temperatures at and rising above 4’Celsius also mean that ticks have ‘come back’ from their winter nap and are actively seeking a blood meal.

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This spring, in order to help with the concerns related to tick surge in Canada, there are a few new groups (of humans) forming with specific goals related to obtaining information on and educating about the rise of ticks in (and across ) Canada, tick risk and related disease.

Here’s three of these newer websites and a brief summary of their goals:

Canadian Lyme Disease Research Network:  

Goal to reduce Lyme disease impact on Canadians by uniting various groups (patients, researchers, etc.) in research activities.

The Canadian Pet Tick Survey from Pets and Ticks:  

Performing tick identification (& testing) on ticks found attached to companion animals in order to provide information on tick risk in Canada.

Tick Talk for Pet-owners from The Canadian Veterinary Medical Association (CVMA):

An educational website directed at pet-owners to provide information on ticks and tick risks.

 There are a number of different ways to obtain information related to risk and disease, and sometimes it seems that a focus on working together (i.e. all groups communicating) for key health care goals gets a bit lost in the effort to info-gather.

It’s great to see collaboration between veterinarians, vets and pet-owners, and also between vets and those who focus on the 2 legged (i.e. human health care workers-researchers). Working together seems essential (at least IMHO) to provide a One Health perspective, and drive awareness of potential outcomes of tick bites and the consequent need for prevention for all of us- dogs, humans, other mammals and cats…whether you agree with that ear-worm of a song or not.

 

 

 

Winter turns to Spring turns to...Ticks

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The whimsy of weather keeps every Canadian connected with (and frequently at the mercy of) nature. And, while the country is currently getting a blast of chill, we’re also entering the ‘end of February’ slide to spring-summer steam.

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So, whether you’re dreaming of prepping your garden, getting ready for bird-watching or anticipating the start of lobster season (Oops- that’d be me!), be aware that the incoming warmth also feels good to creepy crawlies, i.e. ticks. Temperatures above 4’Celsius mean tick bites and the consequent need for tick bite prevention- for you and your 4 footed family members.

If ticks do bite and attach, it's pretty important to remove them, identify (ID) them AND test them for potential pathogens. Tick testing provides awareness of what’s ‘out there’ and enables a One Health approach to education on risk, disease and prevention for animals as well as people. Since Canada’s public health monitoring of ticks on companion animal program has been discontinued, a gap has needed to be filled. As such, tick identification (& testing) on ticks found attached to companion animals will be starting again this spring. This ID and testing will be performed as a collaborative approach through Canadian veterinary clinics nationally and coordinated through the the Canadian Pet Tick Survey on www.petsandticks.com.

Additional information can be found on the Canadian Pet Tick Survey and this latest blog posted by lead researcher Dr. Katie Clow:

https://www.petsandticks.com/news/calling-all-veterinary-clinics-join-the-canadian-pet-tick-survey

Similar to the Canadian K9 Lifetime Study (UPDATE), these types of studies can only be performed through dedicated veterinary clinic and pet-owner involvement. Having a mutual goal of improving health (for the 4 and 2 legged) Canadians across the country is a wonderful thing !