9 Apr 2024
Alex Gough reviews recent studies into identifying animal pain, accessibility of care, lymphoma in dogs, prebiotics, canine urothelial carcinoma, pancreatitis in cats and smartphone-based ECGs.
Alex Gough
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It is the overarching responsibility of veterinary surgeons to minimise pain in their patients, but recognising the signs can be challenging. Validated pain assessment scales can assist in this, but are not necessarily widely used.
Menéndez et al1 conducted a survey to evaluate Spanish veterinarians’ attitude to pain management and assessment – 292 vets were included in the study, and it was found that the respondents had a high degree of concern regarding pain, with 44% assessing levels of pain in every patient. However, only 28% used validated pain scales, despite widespread awareness of their existence. Where they were used, 94% used the Glasgow Composite Measure Pain Scale for dogs and 93% used the Feline Grimace Scale for cats; 85% of vets who did not use these scales were interested in starting to make use of them.
Difficulties with incorporating these scales into practice included lack of training, lack of time, lack of staff and the need to develop a habit. The authors concluded that Spanish vets were aware of validated pain scales, but that they were underused, and suggested an opportunity existed to implement nationwide training to help with their uptake.
Accessibility of veterinary care is of vital importance for domestic animals. Nichols et al2 performed an analysis of trends in accessing veterinary care for companion animals in Canada using data from 2007-2020. The growth in the entire veterinary workforce over this time was 38%, and 49% for companion animal vets.
Client numbers increased 1.3% and the pet population grew 17%. Pets that had received veterinary care in the previous year increased by 25% over this time period. Pets that had not received veterinary treatment increased 1.8%, and a decrease in percentage of pets that were receiving treatment was reported. Gross and net revenues per client increased by 99% and 112% respectively, while cumulative inflation across this period was 21%
The authors concluded that a large number of pets were not receiving veterinary treatment in a given year, and the overall trend was for fewer clients per vet, with each client paying more. The authors, therefore, recommended that accessible care provision was encouraged and regulated for.
Galacto-oligosaccharides (GOS) are so-called prebiotics, which encourage the growth of probiotic bacteria. Corbee3 performed a cross-over study to assess the effect of GOS on the faeces of healthy dogs and cats, with 20 dogs and 20 domestic shorthair cats fed a commercially available dog or cat food with or without a topping containing GOS for 56 days. Faecal characteristics and microbiota were analysed. In dogs, GOS addition led to an increase in carbohydrate fermentation, whereas in cats an increase in amino acid fermentation was seen.
The authors concluded that in both dogs and cats, GOS may improve faecal microbiota and increase the production of metabolites that are beneficial to gut health.
Lymphoma is a common neoplasm of dogs, but large granular lymphocyte lymphoma (LGLL) is a rare form of the disease, with little information on the literature regarding its clinical characteristics. Yale et al4 performed a retrospective study to look at its presentation, behaviour, outcome and prognostic indicators. A total of 65 dogs were included. Labrador retrievers accounted for 29% of cases. Lethargy and inappetence were the most common presenting signs; 33% had a hepatosplenic location and 21% were gastrointestinal; 31% of cases had blood or bone marrow involvement; 74% of dogs treated with maximum tolerated chemotherapy dose showed a response, with older dogs and dogs with cytopenias being less likely to respond.
However, the median progression-free interval of treated dogs was only 17 days and the median overall survival time was only 28 days. Nevertheless, 9.4% of cases survived to six months and 3% to one year.
The authors concluded that dogs with LGLL have a moderate response to chemotherapy but a poor overall survival.
The medical use of smartphones is being increasingly explored. Alibrandi et al5 performed a study to assess the feasibility and reliability of a new smartphone-based six-lead ECG in dogs and compare its performance to a standard six-lead ECG. All traces were reviewed blindly by an expert who judged whether the traces were of acceptable quality, performed measurements and made a diagnosis.
All smartphone traces were judged acceptable, and no difference was observed in heart rate, interval duration or mean electrical axis between the smartphone and standard ECGs. However, the amplitude of P waves and R waves tended to be underestimated by the smartphone ECG. A perfect agreement was noted in diagnosis of sinus rhythm, atrial fibrillation, ventricular arrhythmia, atrioventricular block and bundle branch block.
The authors concluded that the smartphone-based six lead ECG is clinically reliable in dogs and could be useful for telemedicine.
Canine urothelial carcinoma (UC) is a fatal cancer of dogs. A marked breed predisposition exists in the Scottish terrier, making this breed useful to research causal factors associated with the disease. Knapp et al6 performed a survey of owners of 120 Scottish terriers older than six years over a three-year period. Histologically conformed UC was found in 32 of the 120 dogs, and living in a household with cigarette smokers was associated with an odds ratio of 6.3 of developing the cancer. Living within a mile of a marsh or a wetland was associated with an odds ratio of 21.2, and a history of bladder infections with an odds ratio of 3.9.
The authors concluded that second-hand smoke was an important cause of UC in this breed.
Diagnosis of pancreatitis in cats is challenging given its non-specific clinical signs and imaging findings. The feline-specific pancreatic lipase assay (Spec fPL) can be useful in assisting with diagnosis. Forman7 et al performed a prospective cross-sectional study aimed to establish a reference interval for the assay and to determine sensitivity and specificity – 41 healthy cats and 141 cats with signs consistent with pancreatitis, as well as 786 serum samples with known fPLI concentrations were included in the study.
A reference range of 0.7 to 3.5ug/L was determined, and a concentration of 5.4 ug/L or more was the diagnostic cutoff for pancreatitis, which was associated with a sensitivity of 79.4% and a specificity of 79.7%.
The authors concluded that Spec fPL is a useful test for feline pancreatitis.
