Does manuka honey improve the speed of wound healing in dogs?

There is currently no published peer-reviewed evidence comparing the rate of healing of acute superficial wounds in dogs managed with and without medical-grade manuka honey. Therefore, the choice of wound management strategy should be based on other forms of evidence, such as expert opinion and narrative reviews

Decision making and welfare assessment in canine osteoarthritis

Little has previously been described about how or why owners, veterinary nurses or veterinary surgeons make decisions about pets under their care. The Animal Welfare Act (2006) and the Royal College of Veterinary Surgeons’ oath should ensure the health and welfare of pets in the United Kingdom (UK) is the central focus of those decisions. The aim of this thesis was to characterise the nature and basis of decisions made about the treatment and welfare of osteoarthritic dogs by owners, veterinary surgeons and veterinary nurses. Three studies were performed. Firstly, two rapid reviews identified and appraised the outcome measures used in the peer-reviewed literature to assess canine quality of life and canine osteoarthritis. Secondly, thirty-two interviews were performed with owners of dogs with osteoarthritis and five focus groups were performed with veterinary surgeons and veterinary nurses who manage osteoarthritic dogs. Thematic analysis performed on transcripts of those interviews and focus groups identified key themes. Thirdly, a prospective study was performed to test a novel home monitoring outcome measure for use by owners of osteoarthritic dogs, developed using data gathered in the previous studies. The first study found outcomes assessed in the peer-reviewed literature focus predominantly on physical health. Those assessments are frequently unvalidated, may be subject to bias and neglect other aspects of the dogs’ welfare impacted by osteoarthritis and its management. The second study identified four important themes in the interviews and focus group data in relation to decision making. Most owners were highly motivated to make good decisions about their dogs’ welfare. However, many barriers to dog-focused decisions were recognised including: incorrect prior knowledge; ineffective veterinary consultations, in part due to different language used by owners and veterinary surgeons; the lack of available, relevant evidence on which to base decisions; an inability to reliably interpret canine behaviour; and risk aversion. A wide range of impacts of canine osteoarthritis on the welfare of the dogs, their owners and the veterinary professionals caring for those dogs were described. The third study identified several significant deficits in existing outcome measures designed for owners to assess their osteoarthritic dogs. Dogs with osteoarthritis may have day-to-day variations in their physical health and demeanour and owners appear to assess a complex mix of inputs to, and indicators of, their dogs’ welfare when decision making. More work is needed to develop outcome measures that are relevant to owners and more accurately reflect all aspects of canine welfare. This thesis is the first in-depth body of work using evidence synthesis and qualitative methods to characterise how decisions are made about osteoarthritic dogs under veterinary care. Most decisions about osteoarthritic dogs are made by owners using unvalidated assessments with little veterinary guidance. Valid, relevant and practical outcome measures are needed to collect information on which decisions can be based. Evidence does not exist to guide the majority of decisions made; the evidence that does exist appears to be poorly disseminated, particularly amongst owners. Relevant evidence must be created through well designed clinical trials to support those decisions then widely disseminated. Veterinary consultations are not always effective in making decisions focused on the best interests of osteoarthritic dogs, particularly in relation to their welfare; differences in language and perspectives may play a significant part in this. Future work in this field should involve collaboration between owners, veterinary professionals in general and specialist practice, animal welfare scientists and experts in dog behaviour. Methodological approaches taken and conclusions drawn from this thesis may be relevant to many other veterinary diseases

Decision making and welfare assessment in canine osteoarthritis

Little has previously been described about how or why owners, veterinary nurses or veterinary surgeons make decisions about pets under their care. The Animal Welfare Act (2006) and the Royal College of Veterinary Surgeons’ oath should ensure the health and welfare of pets in the United Kingdom (UK) is the central focus of those decisions. The aim of this thesis was to characterise the nature and basis of decisions made about the treatment and welfare of osteoarthritic dogs by owners, veterinary surgeons and veterinary nurses. Three studies were performed. Firstly, two rapid reviews identified and appraised the outcome measures used in the peer-reviewed literature to assess canine quality of life and canine osteoarthritis. Secondly, thirty-two interviews were performed with owners of dogs with osteoarthritis and five focus groups were performed with veterinary surgeons and veterinary nurses who manage osteoarthritic dogs. Thematic analysis performed on transcripts of those interviews and focus groups identified key themes. Thirdly, a prospective study was performed to test a novel home monitoring outcome measure for use by owners of osteoarthritic dogs, developed using data gathered in the previous studies. The first study found outcomes assessed in the peer-reviewed literature focus predominantly on physical health. Those assessments are frequently unvalidated, may be subject to bias and neglect other aspects of the dogs’ welfare impacted by osteoarthritis and its management. The second study identified four important themes in the interviews and focus group data in relation to decision making. Most owners were highly motivated to make good decisions about their dogs’ welfare. However, many barriers to dog-focused decisions were recognised including: incorrect prior knowledge; ineffective veterinary consultations, in part due to different language used by owners and veterinary surgeons; the lack of available, relevant evidence on which to base decisions; an inability to reliably interpret canine behaviour; and risk aversion. A wide range of impacts of canine osteoarthritis on the welfare of the dogs, their owners and the veterinary professionals caring for those dogs were described. The third study identified several significant deficits in existing outcome measures designed for owners to assess their osteoarthritic dogs. Dogs with osteoarthritis may have day-to-day variations in their physical health and demeanour and owners appear to assess a complex mix of inputs to, and indicators of, their dogs’ welfare when decision making. More work is needed to develop outcome measures that are relevant to owners and more accurately reflect all aspects of canine welfare. This thesis is the first in-depth body of work using evidence synthesis and qualitative methods to characterise how decisions are made about osteoarthritic dogs under veterinary care. Most decisions about osteoarthritic dogs are made by owners using unvalidated assessments with little veterinary guidance. Valid, relevant and practical outcome measures are needed to collect information on which decisions can be based. Evidence does not exist to guide the majority of decisions made; the evidence that does exist appears to be poorly disseminated, particularly amongst owners. Relevant evidence must be created through well designed clinical trials to support those decisions then widely disseminated. Veterinary consultations are not always effective in making decisions focused on the best interests of osteoarthritic dogs, particularly in relation to their welfare; differences in language and perspectives may play a significant part in this. Future work in this field should involve collaboration between owners, veterinary professionals in general and specialist practice, animal welfare scientists and experts in dog behaviour. Methodological approaches taken and conclusions drawn from this thesis may be relevant to many other veterinary diseases

“You can be blind because of loving them so much”: the impact on owners in the United Kingdom of living with a dog with osteoarthritis

BackgroundThere is growing awareness that caring for a chronically ill pet may have a detrimental impact on their owner’s quality of life. Companion animal orthopaedic disease has received little research interest in this context. Canine osteoarthritis is known to negatively affect the welfare of many dogs in the United Kingdom, but its consequences for their owners has not previously been described. The aim of this study was to use a qualitative methodology to explore the impacts on a dog owner that occur following their dog’s diagnosis with osteoarthritis. Owners of osteoarthritic dogs based in the United Kingdom (UK) were recruited through veterinary practices to participate in semi-structured interview about life with their dog. Interviews were transcribed verbatim and thematic analysis was used to construct key themes. This publication describes the theme that focused on the impact(s) that the dog’s condition had had on the life of their owner.ResultsForty owners of 35 dogs of a range of breeds and ages were interviewed. A wide range of negative impacts on the physical, mental and financial health of owners were described. Few had any prior experience of canine osteoarthritis, and owners of young dogs appeared to be particularly affected by the diagnosis. Owners detailed increasing worry over time about their pet’s condition, frequently combined with a growing need to physically assist their dog. Sometimes this led them to seek information about, and purchase, adjunctive therapies and products. The dog’s reduced mobility and need for medications progressively limited their own lifestyles and ability to have time away from their pet. Owners typically described a strong bond with their dog as a motivator to provide ongoing care.ConclusionsThe negative impacts on owners of caring for an osteoarthritic dog appear multi-faceted and may be sustained over many years, particularly if the dog is young at diagnosis. Owners may be highly motivated to improve their dog’s mobility and to reduce the impact the condition has on their own lives, yet they may be unsure how to achieve this. Veterinary professionals should inform and support these owners as much as possible

“I always feel like I have to rush…”: pet owner and small animal veterinary surgeons’ reflections on time during preventative healthcare consultations in the United Kingdom

Canine and feline preventative healthcare consultations can be more complex than other consultation types, but they are typically not allocated additional time in the United Kingdom (UK). Impacts of the perceived length of UK preventative healthcare consultations have not previously been described. The aim of this novel study was to provide the first qualitative description of owner and veterinary surgeon reflections on time during preventative healthcare consultations. Semi-structured telephone interviews were conducted with 14 veterinary surgeons and 15 owners about all aspects of canine and feline preventative healthcare consultations. These qualitative data were thematically analysed, and four key themes identified. This paper describes the theme relating to time and consultation length. Patient, owner, veterinary surgeon and practice variables were recalled to impact the actual, versus allocated, length of a preventative healthcare consultation. Preventative healthcare consultations involving young, old and multi-morbid animals and new veterinary surgeon-owner partnerships appear particularly susceptible to time pressures. Owners and veterinary surgeons recalled rushing and minimizing discussions to keep consultations within their allocated time. The impact of the pace, content and duration of a preventative healthcare consultation may be influential factors in consultation satisfaction. These interviews provide an important insight into the complex nature of preventative healthcare consultations and the behaviour of participants under different perceived time pressures. These data may be of interest and relevance to all stakeholders in dog and cat preventative healthcare

Measuring the success of canine and feline preventative healthcare consultations: a systematic review

Preventative healthcare consultations account for a large proportion of the veterinary caseload. This novel study is the first to methodically review all literature on canine and feline preventative healthcare consultations. Previous research has found these consultations to be different from health problem consultations in terms of communication style and content. Identifying relevant evidence and previously validated methods of measuring the success of these consultations will be useful when implementing strategies for optimisation. The aim of this study was to identify and assess the quality of existing literature which describes and/or measures the success of preventative healthcare consultations.Database searches of CAB Abstracts and Medline were conducted to identify published literature. Google searches were then conducted to identify any additional published or grey literature. Results were systematically screened to determine whether the returned sources were about cats and/or dogs, whether they related to preventative healthcare, and whether they described and/or measured the success of preventative healthcare consultations. For primary research citations which only described preventative healthcare consultations, data were extracted on the aspects of the consultations described. For citations which additionally measured the success of the consultations, the measures used, sampling technique, key results and key weaknesses were also extracted. Of 17538 citations identified in total during the database searches, a total of seven relevant primary research citations were identified. All of these citations described aspects of the preventative healthcare consultation, such as consultation length, health problems discussed, actions taken and communication style. Only one primary research citation measured success of the consultation, using veterinarian satisfaction to determine success. In addition, 30 narrative citations, including expert opinion pieces, textbooks, guidelines without transparent methodology and conference presentations were identified. Google searches identified 224 relevant narrative citations, and five of the seven primary research citations identified by the database searches, but did not identify any additional relevant primary research citations. The results suggest that, despite accounting for around a third of all consultations, there is relatively little evidence describing preventative healthcare consultations and only one measure of success has been described for these consultations. This presents potential challenges when implementing strategies to optimise these consultations, as measures which are useful and relevant to veterinary practice should first be identified. Identifying useful measures of success will allow future strategies designed to maximise the benefits of these consultations to be meaningfully assessed for efficacy

Could it be osteoarthritis? How dog owners and veterinary surgeons describe identifying canine osteoarthritis in a general practice setting

Canine osteoarthritis is a common, painful condition that is typically managed in a general practice setting. Osteoarthritis may have significant negative impacts on the welfare of both dogs and their owners. Anticipated early clinical signs of canine osteoarthritis and the preferred route to its diagnosis are well described by veterinary subject experts in published literature. However, little is known about changes owners first recognise in a dog ultimately diagnosed with osteoarthritis, how they make decisions about when to present that dog to a general practitioner, or whether the described diagnostic pathways are followed by general practitioners. The aim of this research was to investigate how dog owners and veterinary surgeons describe identifying and diagnosing canine osteoarthritis.Owners of osteoarthritic dogs were recruited for semi-structured interview, and veterinary surgeons working in general practice were invited to take part in practice-based focus groups. Transcripts from both datasets were thematically analysed using a contextualist epistemology with an ontology based on critical realism to construct convergent themes from latent and semantic codes. Thirty-two interviews were completed with 40 owners from 32 households who discussed 35 dogs with osteoarthritis, and 26 veterinary surgeons engaged in four practice-based focus groups.Owners described identifying a wide range of acute and chronic, typically subtle and intermittent, behavioural and demeanour changes prior to their dogs’ osteoarthritis diagnosis. Few attributed these changes to canine osteoarthritis, and some waited many months before presenting their dog to a veterinary practice. Veterinary surgeons described a consistent ‘typical osteoarthritis’ presentation that they recognised through history taking and clinical examination. Their diagnostic work-up rarely followed that advocated by subject experts for reasons including lack of time and perceptions that it would not change the outcome. Many veterinary surgeons described frustration that some owners did not accept their recommendations to provide analgesia for affected dogs. Short consultation lengths, poor awareness of owner knowledge levels, and lack of recognition of the importance of owners’ prior knowledge, beliefs and assumptions may contribute to these consultations being perceived as challenging by some veterinary surgeons and owners.This research demonstrates that veterinary surgeons and owners want dogs with clinical signs of osteoarthritis to be happy and comfortable, but that ineffective communication and lack of trust in the consulting room may be a barrier. Our data identifies many new avenues for future research and improved communication strategies that could facilitate earlier identification and treatment of canine osteoarthritis in general practice

GaitKeeper: a system for measuring canine gait

It is understood gait has the potential to be used as a window into neurodegenerative disorders, identify markers of subclinical pathology, inform diagnostic algorithms of disease progression and measure the efficacy of interventions. Dogs’ gaits are frequently assessed in a veterinary setting to detect signs of lameness. Despite this, a reliable, affordable and objective method to assess lameness in dogs is lacking. Most described canine lameness assessments are subjective, unvalidated and at high risk of bias. This means reliable, early detection of canine gait abnormalities is challenging, which may have detrimental implications for dogs’ welfare. In this paper, we draw from approaches and technologies used in human movement science and describe a system for objectively measuring temporal gait characteristics in dogs (step-time, swing-time, stance-time). Asymmetries and variabilities in these characteristics are of known clinical significance when assessing lameness but presently may only be assessed on coarse scales or under highly instrumented environments. The system consists an inertial measurement unit, containing a 3-axis accelerometer and gyroscope coupled with a standardized walking course. The measurement unit is attached to each leg of the dog under assessment before it is walked around the course. The data by the measurement unit is then processed to identify steps and subsequently, micro-gait characteristics. This method has been tested on a cohort of 19 healthy dogs of various breeds ranging in height from 34.2 cm to 84.9 cm. We report the system as capable of making precise step delineations with detections of initial and final contact times of foot-to-floor to a mean precision of 0.011 s and 0.048 s, respectively. Results are based on analysis of 12,678 foot falls and we report a sensitivity, positive predictive value and F-score of 0.81, 0.83 and 0.82 respectively. To investigate the effect of gait on system performance, the approach was tested in both walking and trotting with no significant performance deviation with 7249 steps reported for a walking gait and 4977 for a trotting gait. The number of steps reported for each leg were approximately equal and this consistency was true in both walking and trotting gaits. In the walking gait 1965, 1790, 1726 and 1768 steps were reported for the front left, front right, hind left and hind right legs respectively. 1361, 1250, 1176 and 1190 steps were reported for each of the four legs in the trotting gait. The proposed system is a pragmatic and precise solution for obtaining objective measurements of canine gait. With further development, it promises potential for a wide range of applications in both research and clinical practice

Owner and veterinary surgeon perspectives on the roles of veterinary nurses and receptionists in relation to small animal preventative healthcare consultations in the United Kingdom

Veterinary receptionists and veterinary nurses rarely feature in published practice-based research, yet are integral to small animal veterinary practice in the United Kingdom (UK). The aim of this study was to investigate the perspectives of UK-based owners and veterinary surgeons about veterinary nurses and receptionists in relation to their role in preventative healthcare. Semi-structured telephone interviews were conducted with 15 dog and cat owners and 14 veterinary surgeons. Interview transcripts were thematically analysed. Reception staff were identified as having a range of important roles, from rapport building to providing healthcare information and advice. The perceived importance of those roles appeared to differ between owners and veterinary surgeons. Veterinary nurses were described as performing a diversity of roles in relation to preventative healthcare, both in the reception area and in the consulting room. Many owners, and some veterinary surgeons, expressed uncertainty about the remit and status of veterinary nurses in relation to providing veterinary advice. This study identifies for the first time the degree of responsibility for preventative healthcare given to veterinary receptionists and veterinary nurses in UK small animal practices. Further work is needed involving reception and nursing staff to fully appreciate and define their roles in small animal practice

Owners and veterinary surgeons in the United Kingdom disagree about what should happen during a small animal vaccination consultation

Dog and cat vaccination consultations are a common part of small animal practice in the United Kingdom. Few data are available describing what happens during those consultations or what participants think about their content. The aim of this novel study was to investigate the attitudes of dog and cat owners and veterinary surgeons towards the content of small animal vaccination consultations. Telephone interviews with veterinary surgeons and pet owners captured rich qualitative data. Thematic analysis was performed to identify key themes. This study reports the theme describing attitudes towards the content of the consultation. Diverse preferences exist for what should be prioritised during vaccination consultations, and mismatched expectations may lead to negative experiences. Vaccination consultations for puppies and kittens were described to have a relatively standardised structure with an educational and preventative healthcare focus. In contrast, adult pet vaccination consultations were described to focus on current physical health problems with only limited discussion of preventative healthcare topics. This first qualitative exploration of UK vaccination consultation expectations suggests that the content and consistency of adult pet vaccination consultations may not meet the needs or expectations of all participants. Redefining preventative healthcare to include all preventable conditions may benefit owners, pets and veterinary surgeons, and may help to provide a clearer structure for adult pet vaccination consultations. This study represents a significant advance our understanding of this consultation type