Serotonin and Tryptophan Serum Concentrations in Shelter Dogs Showing Different Behavioural Responses to a Potentially Stressful Procedure

In mammals, serotonin (5-HT) levels depend on the availability of tryptophan (TRP). Low 5-HT concentrations have been linked to behavioural disorders in dogs. This study aimed at investigating possible differences in dogs’ serum TRP and 5-HT concentrations according to their behavioural response to a potentially stressful procedure. Thirty-nine physically healthy shelter dogs, 15 females and 24 males, mean age = 5.6 years, were categorized by a certified veterinary behaviourist according to their behavioural response to medical examination and blood collection, in: relaxation, stress signals, tension without growling, tension with growling, escape attempts, and aggression attempts. Extraction and quantification of 5-HT and TRP were performed using a HLPC method. Data were statistically analysed, applying Chi-square and Spearman tests. Results showed no significant difference in TRP (χ2 = 2.084, p = 0.555) nor 5-HT (χ2 = 0.972, p = 0.808) serum concentrations among different categories of dogs; however, some categories were underrepresented (relaxation = 20.5%, stress signals = 30.8%, tension without growling = 43.6%, tension with growling = 5.1%, escape attempts = 0%, aggression attempts = 0%). No correlation between serum TRP and 5-HT concentrations was found (ρ = 0.086, p = 0.602). Serum 5-HT levels do not seem to be associated with dogs’ behavioural response to a stressful situation nor with serum TRP concentrations. The relationship between serum TRP and 5-HT concentrations and behaviour needs further research

Quantitative Behavioral Analysis and Qualitative Classification of Attachment Styles in Domestic Dogs: Are Dogs with a Secure and an Insecure-Avoidant Attachment Different?

Since several modified Strange Situation Procedures (SSP) have been used to investigate dog-to-owner attachment, in this study two different samples of dog-owner dyads underwent two modified versions of the SSP. Dogs’ attachment style to the owner was assessed based on a novel adaptation of the attachment pattern classification used for infant-caregivers. Dogs’ behavioral data were collected using continuous sampling and, in the second protocol, also with a scoring system for greeting and social play. In both studies, secure and avoidant dogs’ behavior was compared using the Mann Whitney test, while differences within each group across episodes were analyzed using the Wilcoxon paired sample test. The classification seemed to be effective at identifying both avoidant and secure attachment patterns in dogs. As expected, differences in key attachment behaviors, such as proximity/contact seeking toward the caregiver, between secure and avoidant dogs were more evident in the final episodes of the test. Differently from secure dogs, avoidant dogs did not show an increase in proximity/contact seeking behavior with the caregiver in any of the procedures. Further studies with larger samples are needed to support the effectiveness of this classification and investigate on the remaining attachment styles

The Emotional Impact of Patient Loss on Brazilian Veterinarians

Simple Summary Unlike human physicians, veterinarians may follow their patients throughout their lifetime, from conception to end-of-life care. Due to the high involvement with the animal, healthcare providers (veterinarians and veterinary staff) are likely to be exposed, together with the caregivers, to the impact of negative events including death and euthanasia. The degree course of veterinary medicine should contain a course that prepares future veterinarians for bad news delivery in order to better handle these challenging situations. Along with the need to further explore this topic, veterinarians should be taught how to recognize psychological fatigue and avoid burnout, seek medical and psychotherapeutic advice, look for ways to lessen these effects and make it easier to identify workers who are most susceptible to burnout early on.Abstract Veterinarians, unlike human physicians, could potentially care for the patient for several years, from conception to end-of-life care. Because of their close relationship with the animal, healthcare providers (for example, veterinarians and staff) are more likely to be affected by bad events and end-of-life care. The purpose of this study was to assess the emotional impact of patients' deaths on Brazilian veterinarians; 549 Brazilian veterinarians (78.3% females) completed a 20-item online questionnaire. Females were more emotionally affected than males by having to talk to the owner about their animal's death and more emotionally affected by the animal's death itself. Furthermore, the emotional impact of an animal's death was heavily influenced by the number of animals euthanized and varied greatly across veterinarians based on their age, with vets over 50 years old being less affected than vets between the ages of 31 and 40. The majority of responders (91.0%) were not trained to deal with grief during their degree. Those who had some training reported being less affected by bereavement. These findings indicate that patient death is a significant emotional concern for veterinarians. Specific education during the degree course, aimed at preparing future veterinarians to deal with death and death communication, is lacking but necessary

Feeding Enrichment in a Captive Pack of European Wolves (Canis Lupus Lupus): Assessing the Effects on Welfare and on a Zoo's Recreational, Educational and Conservational Role

This study investigated the effects of two feeding enrichment programs on the behaviour of a captive pack of European wolves (Canis lupus lupus) and their correlation with both zoo visitors' interest towards the exhibit and their overall perception of the species. Behavioural data (exploration, stereotypies, social interactions, activity/inactivity rates) were collected on four male wolves during four two-week long phases: initial control, hidden food, novel object, final control. Three observation sessions were performed daily: before, during and after feeding. Number of visitors and their permanence in front of the exhibit were recorded. After watching the wolves, visitors were asked to fill out a brief questionnaire in order to investigate their perception of captive wolf welfare, as well as their attitude towards wolf conservation issues. Despite the high inter-individual variability in their behavioural response, all wolves seemed to benefit from feeding enrichment. With regard to visitors, interest in the exhibit increased when enrichment was provided. Visitors' perception of the level of welfare of wolves improved if they attended a feeding session, especially during the novel object phase. Visitors' attitude towards wolf conservation issues also improved during feeding sessions, regardless of enrichment provision

Physiological indicators of acute and chronic stress in securely and insecurely attached dogs undergoing a strange situation procedure (SSP): Preliminary results

The quality of the attachment bond towards the caregiver may affect the dog’s physiological responses to stressful stimuli. This study aimed to measure chronic and acute physiological parameters of stress in ten securely and ten insecurely attached dogs. The twenty experimental subjects were selected from a sample of dogs that participated with their owners in the Strange Situation Procedure. Saliva samples were collected before (T0) and after (T1) the test. Blood pressure, heart rate, respiratory rate, and rectal temperature were measured after the test, only. At this time, a hair sample was also collected. RM ANOVA was used to analyse cortisol concentrations between secure and insecure dogs at T0 and T1. Mann–Whitney U test or T test were used for other physiological parameters. Insecure dogs had significant higher salivary cortisol concentrations than secure dogs at T1 (p = 0.024), but only a non-significant trend towards higher cortisol concentrations at T0 (p = 0.099). Post-test heart rate also tended to be higher in insecure compared to secure dogs (p = 0.077). No significant differences in hair cortisol concentration were found. The quality of attachment may affect the dog’s physiological response to acute stress, at least when related to separation from the caregiver. The effect of attachment on chronic stress requires further investigation

Cat-Owner Relationship and Cat Behaviour : Effects of the COVID-19 Confinement and Implications for Feline Management

The aim of this study was to explore the effects of the Italian COVID-19 lockdown on the cat-owner relationship and on cat behaviour. In order to do so, we used a questionnaire to obtain information on the owner and cat's demographics, living environment, cat behaviour, and possible changes in some aspects of the cat-owner relationship. The questionnaire was distributed online when the lockdown was still ongoing and was completed by 548 cat owners, mainly women. Our findings suggest that the greater amount of time that owners spent at home with their cats, as a consequence of the social restrictions, had a positive effect on the owner's perception of their relationship with their cat (e.g., higher frequency of interaction, greater emotional closeness, reduced perceived costs of caring for the cat). Similarly, the lockdown seemed to have improved the welfare of many cats, as suggested by the positive changes in many of their behaviours, even for those cats with pre-existing behavioural problems. Overall, our findings suggest that the lockdown provided many cats with a more thriving physical and social environment. They also highlight the need to reconsider some cat management practices commonly implemented in non-exceptional circumstances. The restrictive measures implemented to stem the spread of COVID-19 abruptly changed the lives of many cats and their owners. This study explored whether the lockdown in Italy affected the cat-owner relationship, as well as cat behaviour and welfare. A survey that included questions on owner and cat's demographics, living environment, cat behaviour and a modified version of the Cat/Dog Relationship Scale (C/DORS) was distributed online during the lockdown and was completed by 548 cat owners, mainly women (81.6%). With regard to the C/DORS subscales, both emotional closeness and cat-owner interactions increased during confinement, as opposed to a reduction in perceived costs. The effect of the type of job, family role and owner's age on the C/DORS scores suggests that the relationship improved for those owners that, due to the lockdown, increased the time spent with their cats. For 58.8% of respondents, their cat's general behaviour did not change, but when changes occurred, they were mostly positive (20.4%). Attention-seeking and demanding behaviours were the most increased during lockdown (25.7%). Cats with pre-existing problematic behaviours tended to either remain stable or improve during confinement. The overall positive effects of lockdown-related environmental changes on a cat's behaviour suggest that some aspects of commonly implemented cat management practices should be revised to improve cat welfare in normal circumstances

PREDICT identifies precipitating events associated with the clinical course of acutely decompensated cirrhosis

Background & Aims: Acute decompensation (AD) of cirrhosis may present without acute-on-chronic liver failure (ACLF) (ADNo ACLF), or with ACLF (AD-ACLF), defined by organ failure(s). Herein, we aimed to analyze and characterize the precipitants leading to both of these AD phenotypes. Methods: The multicenter, prospective, observational PREDICT study (NCT03056612) included 1,273 non-electively hospitalized patients with AD (No ACLF = 1,071; ACLF = 202). Medical history, clinical data and laboratory data were collected at enrolment and during 90-day follow-up, with particular attention given to the following characteristics of precipitants: induction of organ dysfunction or failure, systemic inflammation, chronology, intensity, and relationship to outcome. Results: Among various clinical events, 4 distinct events were precipitants consistently related to AD: proven bacterial infections, severe alcoholic hepatitis, gastrointestinal bleeding with shock and toxic encephalopathy. Among patients with precipitants in the AD-No ACLF cohort and the AD-ACLF cohort (38% and 71%, respectively), almost all (96% and 97%, respectively) showed proven bacterial infection and severe alcoholic hepatitis, either alone or in combination with other events. Survival was similar in patients with proven bacterial infections or severe alcoholic hepatitis in both AD phenotypes. The number of precipitants was associated with significantly increased 90day mortality and was paralleled by increasing levels of surrogates for systemic inflammation. Importantly, adequate first-line antibiotic treatment of proven bacterial infections was associated with a lower ACLF development rate and lower 90-day mortality. Conclusions: This study identified precipitants that are significantly associated with a distinct clinical course and prognosis in patients with AD. Specific preventive and therapeutic strategies targeting these events may improve outcomes in patients with decompensated cirrhosis. Lay summary: Acute decompensation (AD) of cirrhosis is characterized by a rapid deterioration in patient health. Herein, we aimed to analyze the precipitating events that cause AD in patients with cirrhosis. Proven bacterial infections and severe alcoholic hepatitis, either alone or in combination, accounted for almost all (96-97%) cases of AD and acute-on-chronic liver failure. Whilst the type of precipitant was not associated with mortality, the number of precipitant(s) was. This study identified precipitants that are significantly associated with a distinct clinical course and prognosis of patients with AD. Specific preventive and therapeutic strategies targeting these events may improve patient outcomes. (c) 2020 European Association for the Study of the Liver. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

The PREDICT study uncovers three clinical courses of acutely decompensated cirrhosis that have distinct pathophysiology

Acute decompensation (AD) of cirrhosis is defined as the acute development of ascites, gastrointestinal hemorrhage, hepatic encephalopathy, infection or any combination thereof, requiring hospitalization. The presence of organ failure(s) in patients with AD defines acute-on-chronic liver failure (ACLF). The PREDICT study is a European, prospective, observational study, designed to characterize the clinical course of AD and to identify predictors of ACLF. A total of 1,071 patients with AD were enrolled. We collected detailed pre-specified information on the 3-month period prior to enrollment, and clinical and laboratory data at enrollment. Patients were then closely followed up for 3 months. Outcomes (liver transplantation and death) at 1 year were also recorded. Three groups of patients were identified. Pre-ACLF patients (n = 218) developed ACLF and had 3-month and 1-year mortality rates of 53.7% and 67.4%, respectively. Unstable decompensated cirrhosis (UDC) patients (n = 233) required ≥1 readmission but did not develop ACLF and had mortality rates of 21.0% and 35.6%, respectively. Stable decompensated cirrhosis (SDC) patients (n = 620) were not readmitted, did not develop ACLF and had a 1-year mortality rate of only 9.5%. The 3 groups differed significantly regarding the grade and course of systemic inflammation (high-grade at enrollment with aggravation during follow-up in pre-ACLF; low-grade at enrollment with subsequent steady-course in UDC; and low-grade at enrollment with subsequent improvement in SDC) and the prevalence of surrogates of severe portal hypertension throughout the study (high in UDC vs. low in pre-ACLF and SDC). Acute decompensation without ACLF is a heterogeneous condition with 3 different clinical courses and 2 major pathophysiological mechanisms: systemic inflammation and portal hypertension. Predicting the development of ACLF remains a major future challenge. ClinicalTrials.gov number: NCT03056612. Lay summary: Herein, we describe, for the first time, 3 different clinical courses of acute decompensation (AD) of cirrhosis after hospital admission. The first clinical course includes patients who develop acute-on-chronic liver failure (ACLF) and have a high short-term risk of death - termed pre-ACLF. The second clinical course (unstable decompensated cirrhosis) includes patients requiring frequent hospitalizations unrelated to ACLF and is associated with a lower mortality risk than pre-ACLF. Finally, the third clinical course (stable decompensated cirrhosis), includes two-thirds of all patients admitted to hospital with AD - patients in this group rarely require hospital admission and have a much lower 1-year mortality risk

Association of kidney disease measures with risk of renal function worsening in patients with type 1 diabetes

Background: Albuminuria has been classically considered a marker of kidney damage progression in diabetic patients and it is routinely assessed to monitor kidney function. However, the role of a mild GFR reduction on the development of stage 653 CKD has been less explored in type 1 diabetes mellitus (T1DM) patients. Aim of the present study was to evaluate the prognostic role of kidney disease measures, namely albuminuria and reduced GFR, on the development of stage 653 CKD in a large cohort of patients affected by T1DM. Methods: A total of 4284 patients affected by T1DM followed-up at 76 diabetes centers participating to the Italian Association of Clinical Diabetologists (Associazione Medici Diabetologi, AMD) initiative constitutes the study population. Urinary albumin excretion (ACR) and estimated GFR (eGFR) were retrieved and analyzed. The incidence of stage 653 CKD (eGFR < 60 mL/min/1.73 m2) or eGFR reduction > 30% from baseline was evaluated. Results: The mean estimated GFR was 98 \ub1 17 mL/min/1.73m2 and the proportion of patients with albuminuria was 15.3% (n = 654) at baseline. About 8% (n = 337) of patients developed one of the two renal endpoints during the 4-year follow-up period. Age, albuminuria (micro or macro) and baseline eGFR < 90 ml/min/m2 were independent risk factors for stage 653 CKD and renal function worsening. When compared to patients with eGFR > 90 ml/min/1.73m2 and normoalbuminuria, those with albuminuria at baseline had a 1.69 greater risk of reaching stage 3 CKD, while patients with mild eGFR reduction (i.e. eGFR between 90 and 60 mL/min/1.73 m2) show a 3.81 greater risk that rose to 8.24 for those patients with albuminuria and mild eGFR reduction at baseline. Conclusions: Albuminuria and eGFR reduction represent independent risk factors for incident stage 653 CKD in T1DM patients. The simultaneous occurrence of reduced eGFR and albuminuria have a synergistic effect on renal function worsening

The Dog–Owner Relationship: Refinement and Validation of the Italian C/DORS for Dog Owners and Correlation with the LAPS

The Cat/Dog–Owner Relationship Scale (C/DORS) can be administered to both dog and cat owners. However, the scale as a whole has never been validated on a sample of dog owners. Furthermore, it has never been translated into Italian. The aim of this study was to translate the C/DORS into Italian, modify its response scale in order to improve the degree of response variability, and test its validity and reliability on a sample of dog-owners. Exploratory factor analysis revealed the same three-factor structure (Perceived Emotional Closeness = PEC, Pet–Owner Interactions = POI, Perceived Costs = PC) as the original English version, although some items had to be removed because of low- or cross-loadings. The validity of the construct was confirmed by confirmatory factor analysis, by the correlations between each of the subscales and the C/DORS total score, and by the correlations with the Lexington Attachment to Pets Scale. Cronbach’s α values for each subscale were above acceptable levels. Student owners scored higher on PEC and POI than owners with other occupations. Owners of dogs with behavioural problems scored lower on PEC and higher on PC. Keeping the dog outdoor was associated with lower POI. Finally, pet dog owners scored higher on PEC than AAI dog owners