4 Aug 2020
Alex Gough’s latest Research Review also looks at studies into canine parvovirus vaccine compliance, vertebral disease in pugs and the effect of vet clothing on client trust.
Alex Gough
Job Title
Image © James Steidl / Adobe Stock.
Good evidence exists for the use of angiotensin-converting enzyme (ACE) inhibitors in dogs with heart failure, but the evidence for their use in preclinical myxomatous mitral valve disease (MMVD) is mixed – and so use in this situation is controversial.
Borgarelli et al1 aimed to examine whether administration of spironolactone and the ACE inhibitor benazepril can delay the onset of heart failure and cardiac-related death in dogs with preclinical MMVD.
A total of 184 dogs with preclinical MMVD with enlarged left atria and left ventricles were included in this prospective, randomised, single-blinded, placebo-controlled study.
The median time to the primary end point of the first occurrence of heart failure or cardiac death was 902 days in the treatment group and 1,139 days in the control group, but this was not significant. Other secondary measures, such as left atrial size and N-terminal prohormone of brain natriuretic peptide, were lower in the treatment group than the control group.
The authors noted that while this study failed to show that spironolactone and benazepril delay heart failure, evidence existed of effects on cardiac remodelling, which could be important.
Canine parvovirus (CPV) is a common, vaccine-preventable disease with a high morbidity and mortality rate.
Kelman et al2 performed a survey to assess the attitude of Australian veterinary surgeons to the disease with regards to compliance with vaccination guidelines, and perceptions on the disease’s prevalence and mortality rate. All Australian small animal hospitals were included in the survey and 23.5% replied, which equated to 534 hospitals.
The survey respondents underestimated the prevalence of CPV by a factor of 10 times, and those hospitals that didn’t see CPV cases underestimated by 20 times. However, vets overestimated the mortality of the disease by nearly 3 times.
In total, 27% of vets used some degree of titre testing to assess immunity, and some of these substituted evidence of sufficient immunity for vaccination.
Nearly half of vets finished the vaccine course earlier than global recommendations and a small percentage recommended a revaccination interval for puppies longer than guidelines or label recommendations.
The authors noted that overestimating mortality may lead to over-recommendation of euthanasia and non-compliance with vaccination guidelines may lead to dogs being left at risk of infection.
Vertebral disease in pug patientsPugs are prone to vertebral disease for various genetic and conformational reasons.
Rohdin et al3 performed a prospective clinicopathological study of 30 pugs with a thoracolumbar myelopathy of at least a month duration, causing hindlimb paresis and ataxia, that had had a full neurological examination and a postmortem examination.
A total of 18 dogs underwent CT, 17 underwent MRI and 27 underwent CSF examination, either before or immediately after death; 80% of cases were incontinent, and 24 of the dogs had meningeal fibrosis and malacic destruction of the cord parenchyma. Vertebral lesions and inflammation were common.
The authors concluded that focal spinal cord destruction, vertebral lesions and meningeal fibrosis were common in pugs with chronic myelopathy.
Urethral catherisation is a useful technique with a variety of purposes, but can be technically challenging in females – especially small dogs and cats.
Abrams et al4 described a novel two-catheter technique and compared this with traditional methods (blind in cats and with digital palpation in dogs). A total of 24 cats and 15 dogs lighter than 10kg were included in the study.
Three different operators performed the technique – two board-certified surgeons, one of whom had experience with the technique; and one intern unfamiliar with the technique.
For each subject, one catheter placer performed the catheterisation with the novel technique and with a traditional method, and the time and success of catheterisation were recorded, with a limit of three minutes maximum. In total, 80% of cases were successfully catheterised within the time limit using the new technique, compared to 44% for the traditional techniques.
The authors concluded that this method may be more useful than traditional methods of urethral catheterisation for small dogs and cats.
Multicentric lymphoma is a common neoplasia of dogs and tends to respond well to chemotherapy treatment initially, but often relapses and becomes refractory to treatment over time, limiting survival time.
Cawley et al5 performed an open-label, prospective, single-arm clinical trial to assess the safety and efficacy of L-asparaginase (L-ASP) and rabacfosadine (RAB) given concurrently to dogs with relapsed multicentric lymphoma.
The overall response rate was 67%, with 41% of dogs managing a complete response. In dogs with a complete response, the median progression free survival time was 144 days, with a range up to 428 days. The median progression free survival time for all dogs was 63 days.
The authors concluded that this drug combination appears to be safe and efficacious in treating dogs with relapsed multicentric lymphoma.
Veterinarians’ clothing is becoming increasingly scrutinised to improve infection control. However, what vets wear may also affect clients’ perceptions of that vet.
Coe et al6 performed a questionnaire-based survey of 449 pet owners to assess how attire affected trust and confidence from clients. A female or male model vet was dressed in various outfits, including formal, surgical scrubs, casual shirt and jeans or lab coat with khaki trousers.
In total, 71% of those surveyed believed attire was important, and the type of attire was associated with scores reflecting the client’s trust, confidence and comfort in that vet. However, the model gender was also associated with trust and comfort scores, as was the education level of the person surveyed.
The authors concluded that vets should consider what they wear and the impact it has on clients’ perceptions.
Ehrlichia species are tick-borne organisms that are common in certain geographical locations and becoming more common in others.
Burton et al7 performed a retrospective matched cohort study to see if an association existed between exposure to these organisms in dogs and the risk of developing chronic kidney disease (CKD).
Dogs with a positive antibody result to an Ehrlichia species in their medical records were included, and compared to dogs matched for age, location and breed.
A total of 22,440 patients and controls were included in the study. The relative risk of CKD in patients exposed to Ehrlichia species was 2.12.
The authors concluded that finding positive Ehrlichia species antibodies in dogs in areas in which Ehrlichia canis was endemic was associated with an increased incidence of CKD.
