BSAVA Scientific Newsletter

BSAVA Scientific Newsletter

Welcome to the third edition of the scientific newsletter – an initiative from the BSAVA to help support an evidence-based approach to veterinary medicine. The scientific newsletter includes details of recently published research and relevant scientific news covering a range of subject areas and small animal species. Please note that access to the full articles featured is not provided via this newsletter (unless the article is already open-access).

To ensure that we cover a diverse range of subject areas, we are working closely with our volunteers and affiliate groups to identify relevant resources of interest to the veterinary community. Thank you to everyone for your help and contributions so far. We really want to make sure that these newsletters and interesting and valuable to you, so if you have any suggestions for content or features, please do not hesitate to get in touch at [email protected]

Featured article

"Managing conflicting ethical concerns in small animal practice"

Whilst looking after the interests of a patient is a key priority for veterinary staff, there are many factors that may influence a vet’s clinical decision making. There are client considerations such as financial resources and emotional needs, personal aspirations to provide quality patient care and for personal development, and finally the desire to have a fulfilling yet balanced work life. At times these considerations may be conflicting and challenging to manage, for example, in the case of a client who has limited financial resources that prohibit the vet from providing a standard of care that they would consider best practice.

Read the full blog post here

Springer S, Sandøe P, Grimm H, Corr SA, Kristensen AT and Bøker Lund T (2021) Managing conflicting ethical concerns in modern small animal practice - A comparative study of veterinary decision ethics in Austria, Denmark and the UK.PLoS ONE, 16 (6):e0253420.

Journal Watch

1) Clinical reasoning in feline vestibular syndrome: which presenting features are the most important?

Grapes NJ, Taylor-Brown FE, Volk HA and De Decker S (from Journal of Feline Medicine and Surgery)

Objectives: The aim of this study was to evaluate whether clinical variables from the history, clinical presentation, and physical and neurological examinations of cats with vestibular syndrome were statistically predictive of the underlying diagnosis.

Methods: In total, 174 cats presenting with vestibular syndrome between January 2010 and May 2019 were investigated. Univariate statistical analysis of clinical variables was performed and those statistically associated with a diagnosis were retained for multivariable binary logistic regression modelling.

Results: The seven most prevalent diagnoses represented 95% of vestibular presentations, which included: otitis media/interna (n = 48), idiopathic vestibular syndrome (n = 39), intracranial neoplasia (n = 24), middle ear polyp (n = 17), feline infectious peritonitis (n = 13), thiamine deficiency (n = 13) and intracranial empyema (n = 11). Idiopathic vestibular syndrome was commonly associated with non-purebred cats and had 17.8 times the odds of an improving clinical progression (95% confidence interval [CI] 1.3–250.0; P = 0.03). Intracranial neoplasia was associated with older age and chronic onset of clinical signs, and was significantly more likely to have a central vestibular neuroanatomical localisation (95% CI 8.5–344,349,142.0; P = 0.015) with postural deficits on neurological examination. Thiamine deficiency was more common in female cats, with 52.6 times the odds of a waxing and waning clinical progression (95% CI 1.2–1000; P = 0.038) and 6.8 times the odds of presenting with bilateral vestibular signs (95% CI 1.0–45.7; P = 0.047) and wide excursions of the head (95% CI 1.0–45.7; P = 0.047). Middle ear polyps were associated with 8.8 times the odds of presenting with Horner syndrome (95% CI 1.5–50.0; P = 0.015).

Conclusions and relevance: Although it may be difficult to identify the underlying diagnosis in cats with vestibular syndrome from the presenting features alone, there are instances in which discrete clinical features may help to guide clinical reasoning when evaluating cats with vestibular presentations.

2) A Systematic Review of Environmental Sustainability in Veterinary Practice

Koytcheva MK, Sauerwein LK, Webb TL, Baumgarn SA, Skeels SA and Duncan CG (from Topics in Companion Animal Medicine)

A transition toward environmentally conscious business practices is underway in many sectors. For healthcare, the topic is both concerning and tragically ironic as hospitals have substantial environmental footprints, which are now known to contribute to significant health problems that the system itself was designed to treat. The human medical field has been proactive in taking steps to reduce waste and carbon emissions by identifying best practices to minimize such impacts. Characterization of needs and gaps has been addressed through reviews of the literature regarding environmental sustainability in the context of human hospitals. Our objective was to replicate methods used in a recent review of environmental sustainability in human hospitals to summarize information available to clinical veterinarians. Two search algorithms were used across 8 databases, however only 3 peer-reviewed opinion articles specific to veterinary medicine were identified. These papers included 1 on anesthesia and 2 on production animals. Interestingly, all articles were written by United Kingdom-based authors and none were specific to companion animal practice, the largest sector in the veterinary industry in the United States. Results of this review highlight need for research and communication that supports veterinary clinics in adopting more environmentally sustainable practices. Proposed starting points informed from research in other sectors, including 5 physical themes of energy efficiency, water, waste, sustainable procurement, and transportation, and human behaviur changes on the individual, group, and organizational levels, are discussed. Additional work is needed to support veterinarians and other animal health professionals to practice medicine in a way that upholds the veterinary profession's oath to promote the health of animals, the public, and the environment we all share.

3) Antimicrobial resistance profiles of bacteria associated with lower respiratory tract infections in cats and dogs in England

Mavrides DE, Morgan AL, Na JG, Graham PA and McHugh TD (from Veterinary Record)

Background: Bacterial lower respiratory tract infections (bLRTIs) are common and potentially life threatening in cats and dogs. Antibiotic treatment is often initiated before the diagnosis of bLRTI; therefore improved knowledge of the aetiology and antibiotic susceptibility patterns of these infections is essential to inform empiric antibiotic choices.

Methods: A retrospective study of microbiological, cytological results and their drug susceptibilities from lower respiratory samples (n = 1989) processed in a UK commercial laboratory between 2002 and 2012 was carried out.

Results: Thirty-nine per cent of feline samples and 50% of canine samples were positive for bacterial growth with most yielding a single organism (72% and 69%, respectively). Bordetella bronchiseptica (20.2% from dogs and 2.3% from cats), Pasteurella spp. (23.2%, 31.8%), E. coli (16.2%, 13.6%) and Pseudomonas spp. (11.1%, 11.4%) were most frequently isolated from cytologically positive samples which contained intracellular bacteria (10%, 14%). Amoxycillin-clavulanate, cephalothin, cefovecin, oxytetracycline and trimethoprim/sulfamethoxazole showed modest in vitro activity against E. coli from dogs (approximately 70% susceptibility). Pseudomonas spp. were resistant to enrofloxacin (50%), ticarcillin (25%) and marbofloxacin (13%) but showed lower or zero resistance to aminoglycosides (approximately 7%) and ciprofloxacin (0%). Multi drug resistance (acquired resistance to three or more antimicrobial drug classes) was particularly common among E. coli isolates, with 23% from feline samples and 43% from canine samples.

Conclusion: Resistance to certain first-choice antibiotics was detected in bLRTIs highlighting the need for continued monitoring and sound evidence to inform decision-making in the management of these infections.

4) First-line management of canine status epilepticus at home and in hospital-opportunities and limitations of the various administration routes of benzodiazepines

Charalambous M, Volk HA, Van Ham L and Bhatti SFM (from BMC Veterinary Research)

Status epilepticus (SE) or prolonged epileptic seizure activity is a common neurological emergency with a high mortality rate and, if left untreated, can lead to irreversible cerebral damage and systemic complications. Fast and effective first-line management is of paramount importance, particularly in the at-home management of seizures where drug administration routes are limited. Benzodiazepines (BZDs) have been exclusively used in veterinary medicine for decades as first-line drugs based on their high potency and rapid onset of action. Various administration routes exist in dogs, such as oral, intravenous, intramuscular, rectal, and intranasal, all with different advantages and limitations. Recently, intranasal drug delivery has become more popular due to its unique and favourable characteristics, providing potential advantages over other routes of drug administration in the management of canine SE. This narrative review provides an outline of the management of SE at home and in a hospital setting, discusses considerations and challenges of the various routes of BZD administration, and evaluates the impact of intranasal drug administration (nose-brain pathway) for controlling canine SE at home and within hospital settings.

Other news/resources: 

Improving the care of British wildlife casualties

The successful management of wildlife casualties depends on the effectiveness of all stakeholders including veterinary practices, rescuers/rehabilitators, and the public. Many veterinary practices work closely with wildlife rehabilitation centres, which are often charities, to provide a vital service caring for native wildlife. However, while the Veterinary Surgeons Act and RCVS Code of Conduct relate equally to indigenous British wildlife as to other species, the treatment of wildlife casualties can be challenging for veterinary practices in terms of knowledge and expertise, professional time, and costs. As a consequence, veterinary care is not always available or appropriate, with potential negative consequences for animal welfare.

To help guide veterinary professionals and practices on wildlife casualty care, a group comprising vets and vet nurses, wildlife rehabilitators and animal welfare charities has produced a series of short video recordings, aimed primarily at veterinary undergraduates, new and recent graduates, and veterinary nursing staff. These are available on the Born Free Foundation’s website, together with an ‘information hub’ containing links to relevant publications and other resources relating to British wildlife.

The videos and related resources can be found here.

Additional information will be developed to promote good practice both to the profession and the wider public.

BSAVA Research Notice Board 

The BSAVA research notice board is an area of the website which lists ongoing clinical research projects from BSAVA members. Projects are in-line with BSAVA values and mission to promote excellence in small animal practice through science. You can find details of current projects and how to get involved here.

Upcoming events

Each of BSAVA's affiliate groups offer specialist knowledge and outstanding CPD. A number of the affiliate groups have upcoming events during Autumn 2021:

  • British Veterinary Rehabilitation and Sports Medicine Association (BVRSMA): The Shoulder Conundrum - from the pet to the elite sport dog, 17th October 2021.
  • European Association of Veterinary Diagnostic Imaging - British and Irish Division (EAVDI-BID): Online Autumn Meeting, 1st and 2nd November 2021.
  • Small Animal Medicine Society (SAMSoc): Autumn conference 2021, 3rd November 2021.
  • British Veterinary Dermatology Study group (BVDSG) Autumn Meeting: Cutaneous Oncology, 6th November 2021.
  • Veterinary Cardiology Society (VCS): 2021 Autumn Meeting, 12th - 13th November 2021.
  • British Veterinary Orthopaedic Association (BVOA) Autumn Meeting 2021 "Unnatural Selection: The Clinical Impact of Breed in Small Animal Orthopaedics", 18th - 20th November. 2021

For more information on the above events, please click here.

For more information on our affiliate groups, please click here.

The BSAVA Scientific Newsletter is sent quarterly by email to BSAVA members .

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