BSAVA Scientific Newsletter

BSAVA Scientific Newsletter

Welcome to the second 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 are 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

"What Would You Do?": How Cat Owners Make End-Of-Life Decisions and Implications for Veterinary-Client Interactions

Littlewood K, Beausoleil N, Stafford K and Stephens C (from Animals)

Cats are the most common companion animals in New Zealand. Advances in veterinary care means that cats are living longer and there are many older cats. End-of-life decisions about cats are complicated by owner–cat relationships and other psychosocial factors. Our study explored the ways in which end-of-life decisions were being made by owners of older and chronically ill cats in New Zealand and the role of their veterinarian in the process. Qualitative data were gathered via retrospective semi-structured interviews with 14 cat owners using open-ended questions. Transcripts of these interviews were explored for themes using template analysis and nine themes were identified. Four were animal-centered themes: cat behaviour change, pain was a bad sign, signs of ageing are not good, and the benefits of having other people see what owners often could not. Five were human-centered themes: veterinarians understanding owners’ relationships with their cat, normalizing death, the need for a good veterinarian to manage end of life, veterinary validation that owners were doing the right thing, and a strong desire to predict the time course and outcome for their cat. End-of-life decision making is complex, and the veterinarian’s role is often poorly defined. Our owners appreciated the expertise and validation that their veterinarian provided but continuity of care was important. Future research aimed at exploring the veterinarian’s perspective during end-of-life decision making for cats would be a valuable addition to the topic.

What would you do? see the blog post about this article.

Journal Watch

1) Hypercoagulability in dogs with chronic enteropathy and association with serum albumin concentration

Dixon A, Hall EJ, Adamantos S, Kathrani A, McGrath C and Black V (from Journal of Veterinary Internal Medicine)

Background: Dogs with protein-losing enteropathy (PLE) are at risk of developing a hypercoagulable state, but the prevalence of hypercoagulability in dogs with chronic enteropathies (CE) and normal serum albumin concentration is unknown.

Hypothesis: Dogs with CE are predisposed to a hypercoagulable state as assessed by thromboelastography (TEG) independent of serum albumin concentration.

Methods:Dogs with chronic gastrointestinal signs from suspected inflammatory CE between 2017 and 2019 were included. Thirty-eight were evaluated; every dog had a CBC, serum biochemistry panel, and abdominal imaging performed. The Canine Inflammatory Bowel Disease Activity Index (CIBDAI) was calculated. Thromboelastography was performed at presentation, and reaction time (R), kinetic time (K), α-angle, maximal amplitude (MA), and global clot strength (G) were recorded. Dogs were considered hypercoagulable if the G value was ≥25% above the reference interval.

Results: Seventeen of 38 (44.7%; 95% confidence interval [CI], 28.6-61.7%) dogs with CE were hypercoagulable. The G value did not differ between the 19 dogs with normal (≥28 g/L) serum albumin concentrations (9.05 kdyn/cm2; 95% CI, 7.26-10.84; SD 3.71) and 19 dogs with hypoalbuminemia (11.3 kdyn/cm2; 95% CI, 9.04-13.6, SD; 4.7; P = .11). The G value was negatively correlated with hematocrit, serum albumin concentration, and duration of signs and positively correlated with age.

Conclusions and Clinical Importance: Dogs with CE and normal serum albumin concentration can be hypercoagulable as measured by TEG.

2) Maintenance energy requirements in cats following controlled weight loss: an observational study

German AJ, Woods GRT, Flanagan J and Biourge V (from The Veterinary Journal)

There is a paucity of information regarding the phenomenon of weight regain after successful weight reduction in cats. This study aimed to estimate post-weight reduction maintenance energy requirements (MER) required to maintain stable weight in a group of pet cats. Nineteen cats that had successfully completed a controlled weight reduction programme were enrolled. For inclusion, at least 2 months of follow-up had to be available for review, and the maximum change in weight during maintenance was ±2%. Post-weight-reduction MER was estimated by determining dietary energy consumption from owner diary records. The Friedman test was used to compare bodyweight and energy intake at different stages of weight management. Simple and multiple linear regression were used to identify factors associated with post-weight-reduction MER.

The median (interquartile range) duration of weight maintenance was 179 days (119–408 days) and, during this time, MER was 273 ± 56.7 kJ per kg0.67 ideal bodyweight (IBW) per day. Post-weight reduction MER was greater than metabolisable energy intake at the end (233 ± 29.5 kJ IBW per kg0.67 per day; P < 0.001) but not the start (255 ± 38.6 kJ per kg0.67 IBW per day; P = 0.148) of the weight reduction period. Using simple and multiple linear regression, the only variable that was associated with post-weight reduction MER was the mean ME intake during weight reduction (r2 = 0.349, P = 0.008). Post-weight-reduction MER at the lower limits of MER recommendations for pet cats might predispose to weight regain during the weight maintenance phase.

3) Evaluation of urine dipstick for proteinuria assessment in pet rabbits

Agúndez MG and Porquet NC (from Veterinary Record)

Background: Naturally occurring kidney disease (KD) in pet rabbits has not been fully characterized. It has been previously suggested that proteinuria, especially when associated with isosthenuria, may be an early indicator of KD prior to azotaemia in rabbits. The aim of the current study was to assess the diagnostic utility of the urinary protein dipstick test (UPDT) for detecting proteinuria in rabbit urine samples as a useful diagnostic tool in clinical setting.

Methods: Three hundred urinalyses from 156 pet rabbits were retrospectively analysed by comparing the UPDT with the urine protein:creatinine ratio (UPC) to assess its diagnostic performance in detecting proteinuria, defined as UPC > 0.3. Sensitivity, specificity, positive and negative predictive values (NPVs) were determined.

Results: When urine-specific gravity (USG) was ≤1.024 and a UPDT result of >0 was considered proteinuric, the specificity and positive predictive value (PPV) were both 100%. Following the same criteria, specificity and PPV decreased to 92.1% and 92.5% when USG was ≤1.038. NPVs were poor.

Conclusion: In rabbits, a UPDT result > 0 is indicative of proteinuria (UPC > 0.3) when the USG is ≤1.024. In all other cases, proteinuria should be measured using the UPC.

4) Treatment of feline atopic syndrome - a systematic review

Mueller RS, Nuttall T, Prost C, Schulz B and Bizikova P (from Veterinary Dermatology)

Background: Feline allergic skin disease and asthma occur regularly in small animal practice.

Objectives: To provide evidence-based recommendations for small animal practitioners on the treatment of feline atopic syndrome (FAS).

Methods and materials: The authors reviewed the literature available before February 2020, prepared a detailed evidence-based literature review and made recommendations based on the evaluated evidence.

Results: Sixty-six papers and abstracts were identified describing treatment interventions for FAS and evaluated to establish treatment recommendations. For many treatment options, the papers were retrospective, open studies or case reports.

Conclusions and clinical relevance: In this review, there was good evidence for the efficacy of systemic glucocorticoids and ciclosporin, and limited evidence for the efficacy of topical glucocorticoids, oclacitinib and allergen-specific immunotherapy in feline atopic skin syndrome. Evidence pointed to low-to-moderate efficacy for antihistamines, fatty acids and palmitoyl ethanolamide. In feline asthma, there was good evidence for the efficacy of oral and inhaled glucocorticoids, and limited evidence of moderate efficacy for allergen-specific immunotherapy. Evidence supported low-to-moderate efficacy of mesenchymal stem cells, inhaled lidocaine and oclacitinib as treatments for feline asthma. For almost all therapeutic options (with the exception of glucocorticoids and ciclosporin), more randomised controlled trials are needed.

Other news/resources: 

Feline pancytopenia update

After noticing an increase in cats presenting with pancytopenia in May, the RVC started gathering data from UK vets. The RVC’s investigations showed a strong association between this syndrome and specific diets and therefore welcomed the Food Standards Agency's (FSA) product recall notice. The RVC’s investigations are ongoing and they are still collecting data from vets, as well as testing food samples and samples from affected cats. They have not yet found a definitive cause for the syndrome.

Sadly, the RVC are now aware of over 450 affected cats. Common signs that owners of affected cats note include lethargy and loss of appetite, although in some cases they see signs of spontaneous bleeding or bruising. If you have seen a cat with unexplained severe thrombocytopenia and/or neutropenia with or without concurrent anaemia, please complete the following survey.

The RVC are urging vets to register every cat thought to be affected in order to gather as much data as possible. Data gathered so far has been very helpful in pushing the investigation forwards and continued help is needed to determine the effect of the food recall on this syndrome. Thank you so much to everyone who has contributed so far.

Invitation to join UTI trial

The Small Animal Medicine Society (SAMSoc) have recently launched a prospective study designed to establish the optimal duration of antibiotic therapy for dogs with a presumptive urinary tract infection. The Society needs help from vets in primary care practice to enrol eligible cases and help recruit 900 cases over the next 1-2 years.

The study is called STOP on SUNDAY as all eligible cases (female dogs of between 6 months and 10 years of age presenting with acute onset lower urinary tract signs) will be given sufficient antibiotics such that the course finishes on the following Sunday evening. This will allow comparison of 3,4,5,6 and 7 day courses of antibiotics. Optimising the duration of antibiotic therapy is a key step in the battle against antimicrobial resistance.

For further information, visit the SAMSoc website.

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

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

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