Development of learning objectives for neurology in a veterinary curriculum: part I: undergraduates

Background With an increasing caseload of veterinary neurology patients in first opinion practice, there is a requirement to establish relevant learning objectives for veterinary neurology encompassing knowledge, skills and attitudes for veterinary undergraduate students in Europe. With help of experts in veterinary neurology from the European College of Veterinary Neurology (ECVN) and the European Society of Veterinary Neurology (ESVN) a survey of veterinary neurologic learning objectives using a modified Delphi method was conducted. The first phase comprised the development of a draft job description and learning objectives by a working group established by the ECVN. In the second phase, a quantitative questionnaire (multiple choice, Likert scale and free text) covering 140 learning objectives and subdivided into 8 categories was sent to 341 ESVN and ECVN members and a return rate of 62% (n = 213/341) was achieved. Results Of these 140 learning objectives ECVN Diplomates and ESVN members considered 42 (30%) objectives as not necessary for standard clinical veterinary neurology training, 94 (67%) were graded to be learned at a beginner level and 4 (3%) at an advanced level. The following objectives were interpreted as the most important day one skills: interpret laboratory tests, perform a neurological examination and establish a neuroanatomical localization. In this survey the three most important diseases of the central nervous system included epilepsy, intervertebral disc disease and inflammatory diseases. The three most important diseases of the peripheral nervous system included polyradiculoneuritis, myasthenia gravis and toxic neuropathies. Conclusions The results of this study should help to reform the veterinary curriculum regarding neurology and may reduce the phenomenon of “Neurophobia”.</p

Evidence-Based Healthcare: The Importance of Effective Interprofessional Working for High Quality Veterinary Services, a UK Example

<p class="AbstractSummary"><strong>Objective: </strong></p><p class="AbstractSummary">To highlight the importance of evidence-based research, not only for the consideration of clinical diseases and individual patient treatment, but also for investigating complex healthcare systems, as demonstrated through a focus on veterinary interprofessional working.</p><p class="AbstractSummary"><strong>Background:</strong></p><p class="AbstractSummary">Evidence-Based Veterinary Medicine (EBVM) was developed due to concerns over inconsistent approaches to therapy being delivered by individuals. However, a focus purely on diagnosis and treatment will miss other potential causes of substandard care including the holistic system. Veterinary services are provided by interprofessional teams; research on these teams is growing.</p><p class="AbstractSummary"><strong>Evidentiary value:</strong></p><p class="AbstractSummary">This paper outlines results from four articles, written by the current authors, which are unique in their focus on interprofessional practice teams in the UK. Through mixed methods, the articles demonstrate an evidence base of the effects of interprofessional working on the quality of service delivery.</p><p class="AbstractSummary"><strong>Results:</strong></p><p class="AbstractSummary">The articles explored demonstrate facilitators and challenges of the practice system on interprofessional working and the outcomes, including errors. The results encourage consideration of interprofessional relationships and activities in veterinary organisations. Interprofessional working is an example of one area which can affect the quality of veterinary services.</p><p class="AbstractSummary"><strong>Conclusion: </strong></p><p class="AbstractSummary">The papers presented on veterinary interprofessional working are an example of the opportunities for future research on various topics within evidence-based healthcare.</p><p class="AbstractSummary"><strong>Application:</strong></p><p class="AbstractSummary">The results are pertinent to members of veterinary teams seeking to improve their service delivery, to educators looking to enhance their students’ understanding of interprofessional working, and to researchers, who will hopefully be encouraged to consider evidence-based healthcare more holistically. </p><br /> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access" /> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed" /

Owner perceptions of their cat's quality of life when treated with a modified University of Wisconsin-Madison protocol for lymphoma

The objectives of this study were to assess owner perceptions of their cat’s quality of life during treatment for lymphoma with a doxorubicin-containing multi-agent chemotherapy protocol, whether various health-related parameters correlated with quality of life scores, and to assess owner satisfaction with the protocol

The Evidence Behind the Treatment of Canine Idiopathic Epilepsy

Oral phenobarbital and imepitoin in particular, followed by potassium bromide and levetiracetam are likely to be effective for the treatment of canine idiopathic epilepsy. There is strong evidence supporting the use of oral phenobarbital and imepitoin as ‘first line’ medications. However, there remains a lack of evidence for targeted treatment for the various individual epileptic phenotypes and quite limited evidence on direct comparisons of the efficacy between various anti-epileptic drugs

The Evidence Behind the Diagnostic Investigation of Canine Idiopathic Epilepsy

<p><strong>Clinical bottom line</strong></p><p>There remains until recently an overall lack of clarity for the practical criteria for the diagnosis of canine idiopathic epilepsy. Signalment and an interictal neurological examination are vital for the diagnosis of idiopathic epilepsy. Despite the current insufficient evidence, the emerge of new diagnostic methods, such as cerebrospinal fluid and/or serum biomarkers, advanced functional neuroimaging techniques and electroencephalography, is likely to change the diagnostic approach in canine epilepsy in the near future.</p

Enteric diseases in pigs from weaning to slaughter

The general aim of this thesis was to study enteric diseases in growing pigs, with special reference to diseases caused by Brachyspira hyodysenteriae and Lawsonia intracellularis. The occurrence of enteric diseases in “growers” is a problem of increasing importance in Sweden and an understanding of the mechanisms by which the microorganisms causes enteric diseases is essential to develop good prophylactic measures. The most important microorganisms involved in enteric diseases in grower pigs were identified as Lawsonia intracellularis and Brachyspira pilosicoli, as determined by necropsy, microbiological and histopathological examinations performed on representative growing pigs from good and poor performing herds. Diagnostic methods based on polymerase chain reaction for L. intracellularis in tissue or faecal samples were established and the results related to those obtained by necropsy and serology. An internal control, a mimic, was constructed to demonstrate inhibition of the PCR reactions and to evaluate different preparation methods. The methods for the demonstration of L. intracellularis in tissue samples were sensitive and specific, and the bacteria were reliably identified in faeces from pigs with overt disease. A number of factors interacting in the clinical expression of swine dysentery were evaluated. In this work, group-housing of pigs and the addition of 50% soybean meal in feed was shown to predispose for infection. A model was developed that enabled the sequential monitoring of disease in single animals by repeated endoscopy and biopsy sampling through a caecal cannula. This reduced the number of experimental animals required and increased the accuracy of the study. The general condition of the animal was not affected. The model was used to study the development of experimentally induced swine dysentery and the sequential development of lesions was characterised by histopathology and immunohistochemistry. An increase in the acute phase proteins serum amyloid A and haptoglobin and in monocytes was seen when haemorrhagic dysentery occurred

Epidemiology of canine atopic dermatitis

Canine atopic dermatitis (CAD) is a chronic, allergic skin disease associated with IgE-mediated reactions to environmental allergens. Atopic dermatitis/eczema in humans shares many similarities with CAD and is an increasing problem in industrialized countries. This increase has been attributed to lifestyle and environment factors. The current knowledge about the epidemiology of CAD is limited. The aim of this thesis was therefore to investigate the incidence of and potential risk factors for the development of CAD. Three of the included studies involve the use of a large animal-insurance database. The database includes information about a large number of healthy and diseased individuals over time, but it was not collected for research purposes and data-quality issues needed to be addressed. A validation of the diagnosis CAD in the insurance database showed that although the vast majority of the recorded cases could be considered allergic, the important differential diagnosis cutaneous adverse food reactions had not been ruled out for many patients. The overall incidence rate of CAD was 1.7 cases per 1000 dog years at risk. Several factors were found to be associated with an increased risk of CAD in the insured population; living in an urban area or in the south of Sweden, being born in the autumn and belonging to a high-risk breed. Furthermore, a spatial analysis showed that the incidence of CAD increased by increasing human population density and increasing annual rainfall, and was decreased in the north of Sweden and if there was no veterinary dermatologist present in the county. Finally, a case-control study was performed where 12 veterinarians collected CAD cases from the three identified high-risk breeds; boxer, bullterrier and West Highland white terrier. The main finding was that feeding a diet containing home-made/ non-commercial ingredients to the bitch during lactation protected her offspring from developing CAD. In conclusion, a strong breed predisposition for CAD was seen. Evidence of an increased incidence of CAD in densely populated areas exists but might be biased by the locations of veterinary dermatologists. The potential of using diet for primary prevention of CAD is interesting but randomized controlled clinical trials are required to support this finding

First report of caprine abortions due to Chlamydia abortus in Argentina.

Infectious abortions of goats in Argentina are mainly associated with brucellosis and toxoplasmosis. In this paper, we describe an abortion outbreak in goats caused by Chlamydia abortus. Seventy out of 400 goats aborted. Placental smears stained with modified Ziehl-Neelsen stain showed many chlamydia-like bodies within trophoblasts. One stillborn fetus was necropsied and the placenta was examined. No gross lesions were seen in the fetus, but the inter-cotyledonary areas of the placenta were thickened and covered by fibrino-suppurative exudate. The most consistent microscopic finding was found in the placenta and consisted of fibrinoid necrotic vasculitis, with mixed inflammatory infiltration in the tunica media. Immunohistochemistry of the placenta was positive for Chlamydia spp. The results of polymerase chain reaction targeting 23S rRNA gene performed on placenta were positive for Chlamydia spp. An analysis of 417 amplified nucleotide sequences revealed 99% identity to those of C. abortus pm225 (GenBank AJ005617) and pm112 (GenBank AJ005613) isolates. To the best of our knowledge, this is the first report of abortion associated with C. abortus in Argentina

Cardiovascular-renal axis disorders in the domestic dog and cat: a veterinary consensus statement

OBJECTIVES There is a growing understanding of the complexity of interplay between renal and cardiovascular systems in both health and disease. The medical profession has adopted the term "cardiorenal syndrome" (CRS) to describe the pathophysiological relationship between the kidney and heart in disease. CRS has yet to be formally defined and described by the veterinary profession and its existence and importance in dogs and cats warrant investigation. The CRS Consensus Group, comprising nine veterinary cardiologists and seven nephrologists from Europe and North America, sought to achieve consensus around the definition, pathophysiology, diagnosis and management of dogs and cats with "cardiovascular-renal disorders" (CvRD). To this end, the Delphi formal methodology for defining/building consensus and defining guidelines was utilised. METHODS Following a literature review, 13 candidate statements regarding CvRD in dogs and cats were tested for consensus, using a modified Delphi method. As a new area of interest, well-designed studies, specific to CRS/CvRD, are lacking, particularly in dogs and cats. Hence, while scientific justification of all the recommendations was sought and used when available, recommendations were largely reliant on theory, expert opinion, small clinical studies and extrapolation from data derived from other species. RESULTS Of the 13 statements, 11 achieved consensus and 2 did not. The modified Delphi approach worked well to achieve consensus in an objective manner and to develop initial guidelines for CvRD. DISCUSSION The resultant manuscript describes consensus statements for the definition, classification, diagnosis and management strategies for veterinary patients with CvRD, with an emphasis on the pathological interplay between the two organ systems. By formulating consensus statements regarding CvRD in veterinary medicine, the authors hope to stimulate interest in and advancement of the understanding and management of CvRD in dogs and cats. The use of a formalised method for consensus and guideline development should be considered for other topics in veterinary medicine