Insurance data for research in companion animals: benefits and limitations

The primary aim of this article is to review the use of animal health insurance data in the scientific literature, especially in regard to morbidity or mortality in companion animals and horses. Methods and results were compared among studies on similar health conditions from different nations and years. A further objective was to critically evaluate benefits and limitations of such databases, to suggest ways to maximize their utility and to discuss the future use of animal insurance data for research purposes. Examples of studies on morbidity, mortality and survival estimates in dogs and horses, as well as neoplasia in dogs, are discussed

Head and pelvic movement asymmetries at trot in riding horses in training and perceived as free from lameness by the owner

Recent studies evaluating horses in training and considered free from lameness by their owners have identified a large proportion of horses with motion asymmetries. However the prevalence, type and magnitude of asymmetries when trotting in a straight line or on the lunge have not been investigated. The aim of this study was to objectively investigate the presence of motion asymmetries in riding horses in training by identifying the side and quantifying the degree and type (impact, pushoff) of forelimb and hind limb asymmetries found during straight line trot and on the lunge. In a cross-sectional study, vertical head and pelvic movement symmetry was measured in 222 Warmblood type riding horses, all without perceived performance issues and considered free from lameness by their owners. Body-mounted uni-axial accelerometers were used and differences between maximum and minimum head (HDmax, HDmin) and pelvic (PDmax, PDmin) vertical displacement between left and right forelimb and hind limb stances were calculated during straight line trot and on the lunge. Previously reported symmetry thresholds were used. The thresholds for symmetry were exceeded in 161 horses for at least one variable while trotting in a straight line, HDmin (n = 58, mean 14.3 mm, SD 7.1), HDmax (n = 41, mean 12.7 mm, SD 5.5), PDmax (n = 87, mean 6.5 mm, SD 3.10), PDmin (n = 79, mean 5.7 mm, SD 2.1). Contralateral and ipsilateral concurrent forelimb and hind limb asymmetries were detected in 41 and 49 horses, respectively. There was a linear association between the straight line PDmin values and the values on the lunge with the lame limb to the inside of the circle. A large proportion (72.5%) of horses in training which were perceived as free from lameness by their owner showed movement asymmetries above previously reported asymmetry thresholds during straight line trot. It is not known to what extent these asymmetries are related to pain or to mechanical abnormalities. Therefore, one of the most important questions that must be addressed is how objective asymmetry scores can be translated into pain, orthopedic abnormality, or any type of unsoundness

Orthopaedic health status of horses from 8 riding schools - a pilot study

<p>Abstract</p> <p>Background</p> <p>Orthopaedic injury is the most common reason for lameness and wastage in sport and leisure horses. Studies on racehorses have shown differences in injury risk between trainers and training strategies. The aim was to study between riding school variation in orthopaedic health status by clinical examination and horses age, and control for change of examiner, in schools with previous high (n = 4) and low (n = 4) insurance utilisation.</p> <p>Methods</p> <p>Horses (n = 99) at 8 riding schools were examined for conformation, movement in all gaits, standing flexion tests and palpation by two veterinary surgeons (in some schools only one). Indexes of findings were created for total health, movements, limbs, conformation and back palpation.</p> <p>Results</p> <p>Logistic regression analyses showed that findings increased with age (walk, trot, canter, conformation left hind limb, palpation fore limbs, hooves and flexion tests) or decreased with age (conformation right fore limb). Significant differences in findings were found between riding schools and examiner for seven and eight criteria each (partly overlapping). Increasing indexes were significantly associated with one examiner (total health, movements, back palpation), increasing age (total health, movements) or more time at the school (limbs). The back palpation index was highest at 5 < 8 years since acquisition.</p> <p>Conclusion</p> <p>The age distribution differed markedly between riding schools and age affected several types of findings. This, combined with the two opposite groups of insurance use, shows that schools with low insurance utilisation had previously been able to "avoid" using the insurance, maybe even on similar types of cases if these were more promptly/differently handled indicating differential coverage of disease data in the insurance database. The examiner effect was clearly demonstrated. For some findings, the amount of clinical observations differed by school, even when examiner and age was adjusted for. Most findings were of minor importance, including slight movement irregularities. Orthopaedic status varies between riding schools. We hypothesize that this is associated with management factors that warrant further study.</p

Withers vertical movement asymmetry in dressage horses walking in different head -neck positions with and without riders

The superimposed influences of different head and neck positions (HNPs) and rider effects on symmetry in sound horses have not been studied. Our aim was to investigate the effects of HNPs and rider on thesymmetry in minimum height of the withers at the walk. Seven high-level dressage horses were studied with and without rider in six HNPs: HNP1, free position; HNP2, dressage competition position; HNP3,flexed poll position; HNP4, over-flexed position; HNP5, extended raised position; and HNP6, forward downward position. Kinematic and vertical ground reaction force data were recorded during 15 s trialson an instrumented treadmill. In mixed models, difference in the minimal height of the withers in earlyleft vs right forelimb stance was modelled as dependent variable. The more restricted HNP3 (T-values2.62 to 1.98, 118 DF,P¼0.001 to<0.05) and HNP5 (P¼0.002 to<0.05) were generally less symmetrical while unridden and more symmetrical while ridden, compared with the free (HNP1) or forward downward (HNP6) positions. Both with and without rider, when the withers dropped lower in earlystance of one forelimb, this was associated with shorter protraction at the start of stance in the ipsilateral hind limb, and shorter stance overlaps between this hind limb and the other limbs during diagonalsupport, 3-limb support with two forelimbs and one hind limb, and ipsilateral support. HNP effects on withers movement asymmetry differed between unridden and ridden conditions. The considerablevariation between horses stresses the need for trainers to use individualized training programs to address horse asymmetry

Radiographic parameters for diagnosing sand colic in horses

<p>Abstract</p> <p>Background</p> <p>Ingestion of sand can cause colic, diarrhoea and weight loss in horses, but these signs are unspecific and can have many other causes. The amount of sand that induces disease may vary between individuals. To avoid over-diagnosing, it is important to determine the amount of sand that can be found in horses without clinical signs of gastrointestinal disease. The aim of this study was to use previously suggested parameters for establishing a radiographic diagnosis of sand colic, and compare these findings between a sand colic group and a control group.</p> <p>Methods</p> <p>Abdominal radiographs were obtained in 30 horses with a complaint unrelated to the gastrointestinal tract. In addition, archived abdominal radiographs of 37 clinical cases diagnosed with sand impaction were investigated. The size of the mineral opacity indicative of sand in the abdomen was measured and graded according to a previously published protocol based on height and length. Location, homogeneity, opacity and number of sand accumulations were also recorded.</p> <p>Results</p> <p>Twenty out of 30 control horses (66%) had one or more sand accumulations. In the present study; height, length and homogeneity of the accumulations were useful parameters for establishing a diagnosis of sand colic. Radiographically defined intestinal sand accumulation grades of up to 2 was a common finding in horses with no clinical signs from the gastrointestinal tract whereas most of the clinical cases had much larger grades, indicating larger sand accumulations.</p> <p>Conclusion</p> <p>Further work to establish a reliable grading system for intestinal sand content is warranted, but a previously proposed grading system based on measurements of height and length may be an alternative for easy assessment of sand accumulations in the meantime. The present study indicates that a grade 1 – 2 sand accumulation in the intestine is a frequent finding in horses. When working up a case with clinical signs from the gastrointestinal tract, one or more accumulations of this grade should not be considered the cause until other possibilities have been ruled out.</p

Visual lameness assessment in comparison to quantitative gait analysis data in horses

Background Quantitative gait analysis offers objective information to support clinical decision-making during lameness workups including advantages in terms of documentation, communication, education, and avoidance of expectation bias. Nevertheless, hardly any data exist comparing outcome of subjective scoring with the output of objective gait analysis systems. Objectives To investigate between- and within-veterinarian agreement on primary lame limb and lameness grade, and to determine relationships between subjective lameness grade and quantitative data, focusing on differences between (1) veterinarians, (2) live vs video assessment, (3) baseline assessment vs assessment following diagnostic analgesia. Study design Clinical observational study. Methods Kinematic data were compared to subjective lameness assessment by clinicians with >= 8 years of orthopaedic experience. Subjective assessments and kinematic data for baseline trot-ups and response to 48 diagnostic analgesia interventions in 23 cases were included. Between and within-veterinarian agreement was investigated using Cohen's Kappa (kappa). Asymmetry parameters for kinematic data ('forelimb lame pattern', 'hindlimb lame pattern', 'overall symmetry', 'vector sum head', 'pelvic sum') were determined, and used as outcome variables in mixed models; explanatory variables were subjective lameness grade and its interaction with (1) veterinarian, (2) live or video evaluation and (3) baseline or diagnostic analgesia assessment. Results Agreement on lame limb between live and video assessment was 'good' between and within veterinarians (median kappa = 0.64 and kappa = 0.53). There was a positive correlation between subjective scoring and measured asymmetry. The relationship between lameness grade and objective asymmetry differed slightly between (1) veterinarians (for all combined parameters, p-values between P < .001 and 0.04), (2) between live and video assessments ('forelimb lame pattern', 'overall symmetry', both P <= .001), and (3) between baseline and diagnostic analgesia assessment (all combined parameters, between P < .001 and .007). Main limitations Limited number of veterinarians (n = 4) and cases (n = 23), only straight-line soft surface data, different number of subjective assessments live vs from video. Conclusions Overall, between- and within-veterinarian agreement on lame limb was 'good', whereas agreement on lameness grade was 'acceptable' to 'poor'. Quantitative data and subjective assessments correlated well, with minor though significant differences in the number of millimetres, equivalent to one lameness grade between veterinarians, and between assessment conditions. Differences between baseline assessment vs assessment following diagnostic analgesia suggest that addition of objective data can be beneficial to reduce expectation bias. The small differences between live and video assessments support the use of high-quality videos for documentation, communication, and education, thus, complementing objective gait analysis data

Prevalence of Disorders Recorded in Dogs Attending Primary-Care Veterinary Practices in England

Purebred dog health is thought to be compromised by an increasing occurence of inherited diseases but inadequate prevalence data on common disorders have hampered efforts to prioritise health reforms. Analysis of primary veterinary practice clinical data has been proposed for reliable estimation of disorder prevalence in dogs. Electronic patient record (EPR) data were collected on 148,741 dogs attending 93 clinics across central and south-eastern England. Analysis in detail of a random sample of EPRs relating to 3,884 dogs from 89 clinics identified the most frequently recorded disorders as otitis externa (prevalence 10.2%, 95% CI: 9.1-11.3), periodontal disease (9.3%, 95% CI: 8.3-10.3) and anal sac impaction (7.1%, 95% CI: 6.1-8.1). Using syndromic classification, the most prevalent body location affected was the head-and-neck (32.8%, 95% CI: 30.7-34.9), the most prevalent organ system affected was the integument (36.3%, 95% CI: 33.9-38.6) and the most prevalent pathophysiologic process diagnosed was inflammation (32.1%, 95% CI: 29.8-34.3). Among the twenty most-frequently recorded disorders, purebred dogs had a significantly higher prevalence compared with crossbreds for three: otitis externa (P = 0.001), obesity (P = 0.006) and skin mass lesion (P = 0.033), and popular breeds differed significantly from each other in their prevalence for five: periodontal disease (P = 0.002), overgrown nails (P = 0.004), degenerative joint disease (P = 0.005), obesity (P = 0.001) and lipoma (P = 0.003). These results fill a crucial data gap in disorder prevalence information and assist with disorder prioritisation. The results suggest that, for maximal impact, breeding reforms should target commonly-diagnosed complex disorders that are amenable to genetic improvement and should place special focus on at-risk breeds. Future studies evaluating disorder severity and duration will augment the usefulness of the disorder prevalence information reported herein

Validation of computerized diagnostic information in a clinical database from a national equine clinic network

BACKGROUND: Computerized diagnostic information offers potential for epidemiological research; however data accuracy must be addressed. The principal aim of this study was to evaluate the completeness and correctness of diagnostic information in a computerized equine clinical database compared to corresponding hand written veterinary clinical records, used as gold standard, and to assess factors related to correctness. Further, the aim was to investigate completeness (epidemiologic sensitivity), correctness (positive predictive value), specificity and prevalence for diagnoses for four body systems and correctness for affected limb information for four joint diseases. METHODS: A random sample of 450 visits over the year 2002 (nvisits=49,591) was taken from 18 nation wide clinics headed under one company. Computerized information for the visits selected and copies of the corresponding veterinary clinical records were retrieved. Completeness and correctness were determined using semi-subjective criteria. Logistic regression was used to examine factors associated with correctness for diagnosis. RESULTS: Three hundred and ninety six visits had veterinary clinical notes that were retrievable. The overall completeness and correctness were 91% and 92%, respectively; both values considered high. Descriptive analyses showed significantly higher degree of correctness for first visits compared to follow up visits and for cases with a diagnostic code recorded in the veterinary records compared to those with no code noted. The correctness was similar regardless of usage category (leisure/sport horse, racing trotter and racing thoroughbred) or gender.For the four body systems selected (joints, skin and hooves, respiratory, skeletal) the completeness varied between 71% (respiration) and 91% (joints) and the correctness ranged from 87% (skin and hooves) to 96% (respiration), whereas the specificity was >95% for all systems. Logistic regression showed that correctness was associated with type of visit, whether an explicit diagnostic code was present in the veterinary clinical record, and body system. Correctness for information on affected limb was 95% and varied with joint. CONCLUSION: Based on the overall high level of correctness and completeness the database was considered useful for research purposes. For the body systems investigated the highest level of completeness and correctness was seen for joints and respiration, respectively