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Thorn free

17 Jun, 15 | by Assistant Editor


In a recent case report, Marthinus Jacobus Hartman and colleagues report the successful laparoscopic removal of a thorn granuloma from the abdomen of a wild captive cheetah.


Image: Mark Probst

Image: Mark Probst

An 11-year-old cheetah was presented for routine laparoscopic ovariectomy during a cheetah sterilisation project in Namibia. While under anaesthesia, a mid-abdominal mass was palpated and visualised by ultrasonography as a highly vascularised round 6 cm diameter well-vascularised mass, not associated with any specific abdominal organ, in the mid right abdominal cavity (Fig 1). Ultrasound-guided fluid aspiration revealed a cloudy and turbid-appearing fluid, which on centrifugation had a sizeable cellular pellet.

FIG 1: Sagittal transabdominal ultrasound images of the thorn-induced granuloma. (a) The granuloma is seen between the measured callipers with the echogenic exudate caudal to the mass. (b) Image slightly more medially. Colour flow Doppler illustrates the vascularity of the mass

FIG 1: Sagittal transabdominal ultrasound images of the thorn-induced granuloma. (a) The granuloma is seen between the measured callipers with the echogenic exudate caudal to the mass. (b) Image slightly more medially. Colour flow Doppler illustrates the vascularity of the mass


The differential diagnoses considered before surgery were intraomental neoplasia or a foreign body granuloma.

The cheetah was prepared for laparoscopy for ovariectomy and surgical removal of the mass. A single incision laparoscopic surgery (SILS) port was placed immediately caudal to the umbilicus, and the mass embedded in omentum (Fig 2) was found, secured and freed using coagulation without major haemorrhage.

FIG 2: Ometalised granulomatous mass suspended by a Babcock forceps with some free blood in the peritoneal cavity

FIG 2: Ometalised granulomatous mass suspended by a Babcock forceps with some free blood in the peritoneal cavity


After introduction of the extraction bag through the SILS port (Fig 3) and intra-abdominal deployment (Fig 4), the mass was placed into the bag (Fig 5) and retrieved through the port. Ovariectomy was completed and the peritoneal cavity was lavaged before the surgical site was routinely closed.

FIG 3: Introduction of an extraction bag via the 5–12 mm single incision laparoscopic surgery port

FIG 3: Introduction of an extraction bag via the 5–12 mm single incision laparoscopic surgery port


FIG 4: Deployment of the extraction bag inside the peritoneal cavity

FIG 4: Deployment of the extraction bag inside the peritoneal cavity


FIG 5: Resected mass is placed into the extraction bag

FIG 5: Resected mass is placed into the extraction bag


The patient recovered uneventfully.

Subsequent macroscopic examination of the excised mass revealed a firm yellow-white soft tissue mass containing a 25 mm thorn-like structure (Fig 6) resembling that of the Sickle or Chinese lantern bush, a common thorn tree in Northern Namibia.

FIG 6: Thorn foreign body removed from the granuloma

FIG 6: Thorn foreign body removed from the granuloma


This is the first report to describe the laparoscopic removal of a foreign body-induced granuloma from the abdomen of a cheetah. Granuloma formation in this species has not been well described. Similarly, reports on laparoscopic surgery in this species are sparse, particularly those describing the laparoscopic excision of abdominal masses. They have, however, been used for laparoscopy in dogs, horses and tigers using three or four separate ports. The use of these bags or pouches has also not been described with SILS.

Entrance of the thorn into the abdominal cavity remains speculative, but it could have either entered percutaneously or via the gastrointestinal tract

This technique promises to be especially useful in wild carnivores, allowing rapid recovery and lowering the risk of postoperative surgical wound complications.

A much more detailed account with further pictures and a video clip of the procedure can be found here.




Treatment of a case of feline infectious peritonitis with cyclosporin A

1 Jun, 15 | by Assistant Editor

Feline infectious peritonitis (FIP), which is caused by certain strains of feline coronavirus, is a progressive and usually fatal disease for which there is currently no cure or effective treatment. It is a disease which continues to challenge vets and its diagnosis is a crushing blow to owners who will inevitably lose their cherished cats.

There is an important and unique immunological component to the pathology of the disease and there is evidence that some immunosuppressive drugs may offer hope. However, current treatments may induce short-term remission in a small percentage of cats.

Cyclosporin A (CsA) has recently been shown to exert potent antiviral activities in several in vitro systems, including against coronaviruses. However, whether CsA has clinically relevant activity against coronaviruses remains unknown.

Yoshikazu Tanaka and colleagues report a case of effusive FIP in which treatment with CsA resulted in a sustained reduction in viral copy number and pleural fluid volume and was accompanied by clinical improvement.

A 14-year-old female domestic shorthair cat was presented with persistent fever, anorexia and jaundice for a month. A general clinical examination showed a substantial pleural effusion, and laboratory investigation revealed a significant feline coronavirus antibody titre and a low packed-cell volume, as well as signs indicative of liver damage. Pleural fluid was yellowish, viscous and remarkably dense. Coronavirus antigen was demonstrated within macrophages in the pleural fluid and real-time quantitative reverse transcription PCR (RT-qPCR ) revealed 1.6×10 6 copies/ml in pleural fluid, which is higher than that in other cases of effusive FIP that the authors had encountered. The diagnosis of FIP was based on the clinical presentation and clinicopathological, cytological and RT-qPCR findings.

Type-I interferon treatment for two months did not result in improvement in pleural fluid volume and viral copy number and treatment was stopped. Following discussion with the owner, treatment with a daily dose of modified cyclosporin A (CsA) was started. The volume of pleural fluid decreased and became undetectable within four days of starting CsA therapy. The condition of the cat improved, it became more alert and regained a normal appetite, and therefore CsA administration was stopped. However, the pleural fluid accumulated within four days of stopping CsA treatment. Treatment was recommenced and again the pleural fluid levels disappeared and the viral load decreased substantially. Over a two-month period, during which a low dose of CsA was maintained, no clinical abnormalities were detected, the anaemia resolved and biochemical parameters returned to normal.

Unfortunately, about two months after CsA treatment was stopped, viral load gradually increased but no clinical abnormalities were detected until about seven months after treatment was stopped. The cat’s clinical condition deteriorated and it died shortly after.

The study suggests that the potential therapeutic effects of CsA in combination with other therapeutic agents should be evaluated.

Full details of the investigations carried out, treatment and outcome can be found here.

Nominations sought for Veterinary Record Innovation Award

18 May, 15 | by Assistant Editor

VR Innovation

Veterinary Record is launching a new award to recognise innovation in the veterinary sphere.

The Veterinary Record Innovation Award is open to individuals and veterinary teams whose innovation has brought about a change or improvement in any aspect of veterinary practice. This change might relate to a particular aspect of clinical practice or have had a broader impact on veterinary activity.

We welcome a broad range of nominations, which might include, for example, a clinical innovation in medicine or surgery, work that has influenced policymakers, a campaign to improve animal health and welfare, a practice educating owners on responsible ownership, or something that has changed how the business of veterinary practice is conducted.

Nominations can be made on behalf of a candidate but self-nominations will also be considered. Nominations should be between 500 and 800 words, and explain what the innovation is, what the impact has been and why it should be considered for the award. Evidence to substantiate the nomination should be included. In addition, video nominations can also be included. Entries should be entitled ‘Veterinary Record Innovation Award’ and e-mailed to The closing date for nominations is July 1, 2015.

The award will be presented at the BVA Members’ Day in Edinburgh on September 24. The awards ceremony will also include the presentation of the Veterinary Record Impact Award (formerly the William Hunting Award;VR, November 23, 2013, vol 173, pp 497-498), which recognises the research paper published in Veterinary Record in the previous year that is considered to have had the most significant practical impact.

Wombat fatigue: marsupial regains mobility after pioneering surgery

20 Feb, 15 | by Assistant Editor


If you are ever faced with a juvenile hairy-nosed wombat with a limp, the recently published case report by Gail Anderson and colleagues (published in Veterinary Record Case Reports and found here) should contain a salutary lesson.

The authors were presented with a male juvenile hand-raised southern hairy-nosed wombat, which weighed 7.5 kg and was approximately 13 months old. He had been rescued from his dead mother’s pouch about seven months earlier and raised by a carer using southern hairy-nosed wombat milk replacer (yes – it does exist!). His carer had noted he was reluctant to walk and this lameness became progressively worse.



A southern hairy-nosed wombat. Photo: Eva Hejda


Clinical observation showed that he was reluctant to move and, when encouraged to do so, he had severe lameness in both hindlimbs and a ‘shuffling’ gait. The wombat was placed under general anaesthesia and palpation of the stifles elicited crepitus on both sides but no obvious joint effusion. It was not possible to fully extend the stifles. No other abnormalities were found on clinical examination. Stifle radiographs revealed displacement of the distal femoral metaphyses due to bilateral type 1 Salter-Harris epiphyseal fractures.

Distal femoral metaphyses have a mottled, radiolucent, appearance. Proximal femoral epiphyses were flattened and showed delayed development consistent with epiphyseal dysplasia. The right proximal femoral epiphysis was slightly more irregular and flattened compared with the left proximal femoral epiphysis. The lower lumbar spine was normal according to radiographs.



The left (top) and right (bottom) stifle joints of the wombat before surgery.



Radiographs of a normal southern hairy-nosed wombat of the same age were not available for comparison and, to the author’s knowledge, are not available in the literature. This situation is a common problem for veterinarians treating lesser-studied wildlife species.

After discussion with his carer, he was scheduled for surgery to attempt to reduce the epiphyseal fractures. If left untreated, it was unlikely that he would have regained normal mobility and function. The wombat was, however, given a guarded prognosis, partly because the injury appeared to be chronic and other radiographic changes had been observed.

Induction of anaesthesia was somewhat problematic as endotracheal intubation was difficult, probably due to the relatively small diameter of a wombat’s trachea and excessive mucus production.

The surgical procedure was similar to that commonly used for the repair of comparable fractures in dogs. Using a small osteotome and mallet, the cartilaginous and bony epiphyseal piece was elevated and freed from its caudally displaced position and gently levered back into a position more cranially. Once reduced, the epiphyseal piece was secured with two 1.5 mm diameter Kirschner wires.



Radiograph of the right stifle following surgery. The white cross shows the K-wires used to immobilise the fracture. The left side looked the same as this after surgery.


The wombat recovered quickly and uneventfully from general anaesthesia and was given postoperative analgesia. Once he was moving freely and starting to hide in its custom-made pouch (a fleece-lined pillowcase), he was left in a quiet, dimly lit cage and closely supervised.

The wombat was discharged to his carer once he was moving normally in his pouch, with instructions to restrict his activity for two weeks. He continued to eat well, although he showed initial discomfort and limited mobility. However, he continued to improve and by four months after surgery, he was walking with good extension of his hindlimbs and normal action. His carer felt that he had made a complete recovery.

A video of the wombat four months after surgery showing excellent recovery and mobility can be viewed here:

Similar hindlimb injuries in pouch young have been frequently observed by vets working in Australia. It is thought that forcible removal of a juvenile wombat from its dead mother’s pouch is the usual cause. However, this report, adding as it does to the limited resources available for this species, shows that excellent outcomes can be achieved following this type of injury in wombats.

More details, images and discussion about this case can be found at Veterinary Record Case Reports


2014 – a year of One Health

29 Dec, 14 | by Assistant Editor


In 2014, Veterinary Record published a series of articles exploring the links between animal, human and environmental health. While the fundamental idea behind One Health is by no means new, as outlined in an article by Abigail Woods and Michael Bresalier in June, it is beginning to be taken more seriously in the veterinary sector and further afield, due, at least in part, to the increasing complexity of global health problems in both animals and people.

The series seems to have captured imaginations, with the articles being discussed on social media, as well as within the pages of Veterinary Record; the journal has received a large number of letters on the topic this year (for example, here, here and here). In fact, there has been such interest that what was originally conceived as a series lasting 12 months will now be extended into 2015. It was found that there were simply too many interesting and important One Health topics and experts willing to write about them to cram into one year.

All of the articles in the One Health series are, and will continue to be, free to view.

The scene was set in January by Paul Gibbs, in a widely read article charting the recent history of the discipline.

In February, Patrick Wall discussed the role of One Health approaches in maintaining food safety, highlighting the fact that vets play an important part in ensuring human health by safeguarding the health of food-producing animals.

The next article in the series, written by Daniel Mills and Sophie Hall, looked at the human-animal bond, demonstrating that the One Health approach is by no means limited to infectious zoonotic diseases, but that animals can impact on the mental health and broader physical health of people. This article also contained one of the most striking images in the series (below).


A therapy goat being taken to visit residents of a care home. Image: Kristin Streff/AP/Press Association Images

A therapy goat being taken to visit residents of a care home. Image: Kristin Streff/AP/Press Association Images

Chris Oura’s article, published in April, looked at vectorborne pathogens, giving examples of how One Health approaches have been successfully used to control Japanese encephalitis virus in Southeast Asia, West Nile virus in the USA and Rift Valley fever in Saudi Arabia.

In May, Matthew Dixon, Osman Dar and David Heymann discussed emerging infectious diseases, including the One Health lessons learned following the first two pandemics of the 21st Century: SARS and influenza. They argued that the paradigm for One Health interventions needed to shift from a multidisciplinary response to disease outbreaks to the surveillance and prevention of zoonotic diseases.

As already mentioned, Woods and Bresalier’s article on the history of One Health gave an overview of the history of the concept, showing that its roots go much farther back than most people previously thought.

In July, Dilys Morgan gave an example of One Health in action, outlining the work of the Human Animal Infections and Risk Surveillance (HAIRS) group and in particular its response to the emergence of Schmallenberg virus in 2011.

Next, a team of researchers from the University of Glasgow including Sarah Cleaveland looked at whether a One Health approach could be used to tackle rabies. Among their conclusions was that there is compelling evidence that a One Health approach could work to eliminate the disease, but that it remains unclear whether the necessary collaborative partnerships could be built.

Kendra Stauffer and Lisa Conti’s article in October looked at how One Health can play a key role in emergency preparedness plans. Citing One Health issues that arose following Hurricane Katrina and the Fukushima Daiichi disaster, they discussed how some governments are beginning to include One Health considerations when preparing for disasters.

Andy Stringer’s article, published in November, discussed how improving animal health can have positive impacts on the livelihoods and health of poor people, especially those in developing nations.

Finally, in an article published this month, Peter Sandoe and colleagues looked at obesity in companion dogs and cats. They noted that obesity in people is, in some ways, linked with obesity in their pets, stating that a two-way approach is needed to tackle this complex issue. 

The breadth of topics covered in the series shows that the One Health approach is relevant to a wide range of health issues. In 2015, Veterinary Record will continue to publish feature articles on this important topic, with the aim of promoting One Health and stimulating debate.

Shock and awn: two unusual cases of grass seed ingestion in dogs

4 Dec, 14 | by Assistant Editor


It is well known that the common or garden grass seed is the root of many problems in veterinary practice. Two recent articles published in Veterinary Record Case Reports (here and here) describe less common, but serious consequences following the ingestion of a grass awn by dogs.

Case 1

A 15-month-old female mixed-breed hunting dog weighing 16.5 kg was referred with a three-day history of change in bark, progressively worsening dyspnoea, decreased appetite and dullness. The onset of clinical signs was shortly after hunting. On admission, the bitch showed abduction of the forelimbs and inspiratory dyspnoea. Thoracic auscultation revealed muffled heart and dull lung sounds in the caudodorsal part of the thorax, as well as crackles on the caudal lung lobes.

Three litres of air was aspirated from the chest and supplementary oxygen was delivered via a facemask. Thoracic radiography showed elevation of the heart from the sternum and increased thoracic lucency due to the presence of pleural air. The edges of the caudal lung lobes were retracted from the chest wall and an area of soft tissue opacity was evident in the area of the caudal vena cava, the caudal border of the heart and the cupula of the diaphragm.



Radiograph showing elevation of the heart from the sternum, the presence of pleural air and an area of soft tissue opacity between the caudal vena cava, the caudal border of the heart and the cupula of the diaphragm


Soon after radiography the dog developed severe dyspnoea and cyanosis. Thoracentesis was repeated and 2500 cm3 of air was removed while the syringe plunger was forced back, indicating tension pneumothorax.

Tension pneumothorax is an emergency condition in which a flap of tissue acts as a one-way valve so that air entering the pleural space during inspiration cannot be expelled during expiration. This is a rapidly deteriorating state that must be recognised and treated quickly, otherwise it may prove fatal.



The arrow shows a grass awn adhering to the parietal pleura


An emergency exploratory thoracotomy was performed and a grass awn was found adherent to the parietal pleura of the right 10th intercostal space and a 2 mm rupture, covered with fibrin, was identified in the ventral surface of the right caudal lung lobe. A partial lung lobectomy was performed. The dog recovered uneventfully, and was discharged two days after surgery. On re-examination two and six months later, the dog was normal and thoracic radiography revealed no abnormalities.

Case 2

In another case, a six-month-old male neutered crossbred dog presented with a two-week history of pain on opening the mouth and intermittent lethargy. There was also a history of mild blepharospasm of the right eye and pyrexia. On referral, ophthalmic examination revealed mild exophthalmia of the right eye, with a small amount of third eyelid protrusion and decreased retropulsion of the globe. There was marked pain on opening the mouth and palpation over the right temporal region of the skull.

Ocular ultrasound showed increased echogenicity of the tissue within the retrobulbar space and marked diffuse signal on Doppler examination. MRI of the brain and orbit revealed dependent fluid in the right frontal sinus and nasal cavity with mucosal thickening suggesting local rhinitis and sinusitis. There was hyperintense retrobulbar tissue thickening along the lateral aspect of the orbital lamella of the frontal bone, and evidence of regional myositis.


F2.large (1)

MRI images of the brain and orbit. These images show a marked degree of contrast enhancement in the retrobulbar tissue, periorbital tissue and frontal sinus mucosa


Right exophthalmos was present, likely due to diffuse retrobulbar swelling. Despite this, orbital structures were preserved.

Exploratory craniectomy was performed. And three grass seeds and approximately 4 ml of yellow, high viscosity fluid were removed from the surgical site, which was then lavaged with warm saline. Postoperatively the dog was maintained on intravenous amoxicillin and clavulanic acid before being discharged on oral medication.

Four months after the cessation of antibiotic therapy the dog was re-examined and the owner reported no problems when the dog opened its mouth. The dog was also reported to have returned to a normal life and general physical, neurological and ophthalmic examinations were unremarkable.

More details, images and discussion about these cases can be found here and here.

Simply bred: could global exchange of cryopreserved canine semen be preventing genetic isolation of populations?

20 Nov, 14 | by Assistant Editor


New research suggests that the global exchange of frozen semen from dogs of registered breeds may be reducing genetic divergence between geographically distant dog populations. The study, published in Veterinary Record, looked at similarities between groups of dogs in South Africa and the UK. 


According to rules set out by the Kennel Club in the UK (KCUK) and the Kennel Union of Southern Africa (KUSA), for a dog to be registered as a recognised breed, it must have five generations of ancestors of the same breed. Regulations such as this create a genetic barrier, limiting the number of genes that cross between breeds and reducing genetic diversity within breeds.

In a study published last year, Mellanby and others found that, in the UK, rottweilers, boxers and German shepherd dogs had the highest levels of inbreeding of the breeds studied. Labrador retrievers and border collies had lower levels of inbreeding (although genetic analysis showed that inbreeding was still present in these breeds). They also assessed a population of Jack Russell terriers, which are not recognised as a breed by KCUK, although they are by KUSA. Perhaps unsurprisingly, this non KCUK-registered population had the highest levels of genetic diversity in the study.


195_9594 copy

Jack Russell terriers are not recognised as a breed by the UK Kennel Club, but they are by the Kennel Union of South Africa

While each individual breed is genetically distinct, it was not known whether dogs of a particular breed in one country differed genetically from those in another. If boxer breeders in the UK tended only to breed from UK stock, it would be expected that this population would begin to genetically diverge from boxers in other countries. In other words, is a collie from Cape Town similar to one from Carlisle? Do the genes of a dobermann in Durban resemble those of one in Durham? These were some of the questions that an international team of researchers from institutions in the UK and South Africa sought to answer in a recent study published in Veterinary Record.

‘We had found that different dog breeds had different levels of genetic variation,’ says Kim Summers, one of the authors of the study. ‘We also knew that there were restrictions about importing animals into some countries, so we wanted to find out whether this meant that dogs of the same breed in two countries had started to diverge genetically’.

DNA material was obtained from German shepherd dogs, labrador retrievers and Jack Russell terriers that were brought to the University of Pretoria veterinary clinic in South Africa. The DNA was analysed and compared with that of DNA from UK dogs that had been analysed in a previous study.

The study yielded several interesting results. First, a coincidental finding was that many dogs thought to be purebred were actually of mixed breed origins. While these misclassified dogs had the physical traits of the breed they were classified as, in-depth genetic analysis showed that almost a third (four out of 14) of the South African labrador retrievers and one of 26 German shepherd dogs actually had mixed breed ancestry. Several of the South African dogs studied were also found to have had one parent from the registered breed and another that was a mixed breed

‘Most studies in the past have used only pedigree dogs registered with a breed association,’ said Prof Summers. ‘We were interested in how well the breed could be identified by looking at the dog, because correct identification of breed is important for knowing which genetic variants might be important in diseases the dog may have.’

Perhaps even more surprisingly, population analysis revealed that within each breed, dogs were remarkably similar regardless of the country.



A boxer dog. Boxers are a registered breed in both the UK and Southern Africa


‘We found that our genetic markers could not distinguish dogs of one breed based on their country of origin,’ Prof Summers explains. ‘So there was a genetic signature for labrador retrievers that was the same in South Africa as in the UK.’ 

The fact that dogs in the UK were found to be similar to dogs of the same breed half way across the world is puzzling. This would indicate that there is a reasonable amount of genetic admixture between dogs of the same breed. One way that this could occur, the authors suggest, is through the use of cryopreserved canine semen for artificial insemination. This has been available to dog breeders for some 50 years and it is now possible for semen to be frozen and transported long distances before being used in breeding. This worldwide exchange of genetic material could be preventing genetic isolation from occurring within breeds, despite vast geographical distances.

‘Breed associations and breeders are very concerned with the health of their breed’, said Prof Summers. ‘Encouraging the use of a wide range of sires and reducing matings between relatives will maximise genetic diversity and ensure that breeds are similar and healthy across the world.’


Researchers investigate what really goes on in small animal consultations

5 Nov, 14 | by Assistant Editor


New open access research published in Veterinary Record indicates that almost half of veterinary consultations last longer than the 10 minutes allocated and that preventive medicine consultations last just as long as consultations for a specific health problem. The results raise issues to do with practice management, as well as the importance of educating veterinary students about comorbidities. 


Consultations are a major part of small animal practice, with small animal vets often meeting a large number of clients and patients each day. Generally speaking, 10 minutes is allocated for each consultation, but the amount of time required to address all of the client’s concerns can often exceed 10 minutes. Furthermore, consultations are often complex interactions in which a wide range of potential health problems are discussed.

In human medicine, large amounts of research has been conducted into the nitty gritty of how consultations work and the types of issues that are discussed. This has shown that more lengthy consultations tend to lead to more issues being discussed and better detection and management of certain conditions. However, until now, veterinary consultations have been less well understood.

A group of researchers at the University of Nottingham recently sought to fill these knowledge gaps by conducting some in-depth research into small animal consultations in the UK. They wanted not only to better understand how long consultations last and what happens during a consultation, but also to develop a tool that would make it easy to analyse veterinary consultations in depth. Their results are reported in two articles recently published in Veterinary Record (found here and here), both of which are open access.

Natalie Robinson, one of the authors of the studies, explains the idea behind them.

‘When the Centre for Evidence-based Veterinary Medicine was first set up at the University of Nottingham, one of our first questions was “What should our research priorities be?”’, she said. ‘We needed to make sure our research was relevant to first-opinion practitioners, so examining the veterinary caseload to determine what practitioners see and do every day was the first logical step. By examining consultations in greater depth, we can start to identify the important decision-making points during the consultation. This will allow us to generate new evidence which can support veterinary decision-making and hopefully lead to improved patient care.’

Eight small animal practices in England and Scotland took part in the study. The team observed a large number of consultations in detail, and recorded what they saw using a specially developed tool.



The research showed that small animal consultations often ran over the allocated 10 minutes



One of the studies assessed how long consultations tended to last. The researchers timed 182 consultations involving 203 animals in two of the participating practices in England.

They found that there was a huge range in the length of consultations. The shortest consultation observed lasted for just 51 seconds, while the longest lasted for 36 minutes and 45 seconds. Almost half (48 per cent) of consultations exceeded the 10 minutes allocated. Perhaps unsurprisingly, consultations in which more problems were discussed, or which involved more patients, tended to last longer.

‘One of the things that surprised us is that preventive medicine consultations lasted just as long as consultations for a specific health problem’, said Dr Robinson. ‘Preventive medicine consultations are often seen as “quick and easy” but the results would suggest that this is not necessarily the case. In fact it would appear that preventive medicine consultations may be even more complex than other types of consultations, with even more problems discussed, and so are an important part of the healthcare of our pets.’


Looking at consultations in more detail

In another part of the study, a total of 1720 consultations (involving 1901 patients) were recorded and analysed. The results make interesting reading.

The first key finding was that a total of 4486 problems were discussed for the 1901 patients, an average of 2.4 problems per patient. In almost two-thirds of consultations, more than one problem was discussed. The highest number of problems discussed in one session was eight.

‘Interestingly, fewer problems were discussed for rabbits than for cats or dogs,’ said Dr Robinson. ‘While there could be a range of reasons for this finding, it could be that vets and owners are less familiar with identifying health problems in this species. Previous work within our group has suggested that vets feel there is less information available for rabbits than for dogs or cats, so it could be that rabbit medicine is an important area for the generation of new evidence.’ The previous study she refers to was published in Veterinary Record earlier this year.



In almost two-thirds of consultations, more than one problem was discussed. The highest number of problems discussed in one session was eight.


More health problems were also discussed in consultations involving older animals, while when younger animals were presented, preventive medicine was more likely to be discussed.

While the results answer some questions, they also raise others. For example, if consultation length varies so widely, should vets begin to offer different types of appointments? The authors suggest that practices could set up geriatric clinics specifically aimed at older animals in which appointments are longer, ensuring enough time for all problems to be discussed.

They also note that the findings could have implications for veterinary education, as they show that comorbidities are common and consultations can be complex.

‘We need to make sure that training in consultation skills adequately prepares veterinary undergraduates for the realities of first-opinion practice,’ said Dr Robinson. ‘The findings suggest that first-opinion consultations often involve dealing with multiple problems and comorbidities within a single consultation, meaning the decision-making process is often complex.’

‘Ultimately, we need more evidence to support decision-making in patients with comorbidities, which will benefit not only undergraduate education, but also the wider veterinary profession and the patients they treat.’


Land of open glory: widening access to veterinary research

24 Oct, 14 | by Assistant Editor


This week saw the eighth annual Open Access Week, in which academics and researchers from around the world shared expertise on open access publishing while campaigning for it to become the norm.

Since its inception in the 1990s, the online open access movement has made significant headway. There are now hundreds of fully open access journals (including Veterinary Record Open), the contents of which are absolutely free.

Print journals have also seen a significant change; nowadays, many academic journals are ‘hybrid’, offering both subscription and open access options. Veterinary Record falls into this category and has published a range of influential open access articles this year alone, including a review of TB vaccination and a study of antibiotic use in animals across Europe.

Open access publishing has been shown to increase the impact of research. Studies (for example, here, here and here) have shown that open access research is cited more often. Advocates of open access suggest that making the results of studies freely available can have a beneficial impact on patient care as well. If practising vets have the latest information at their fingertips, this could lead to new and better treatment options being adopted more quickly. The fact that studies published in this way are available to anyone in the world with an internet connection means that vets working in developing countries, who may otherwise not have journal subscriptions, have access to cutting edge research and can implement this to improve animal health.

To celebrate Open Access Week and promote open access publishing in the veterinary sector, Veterinary Record and Veterinary Record Open are offering a 15 per cent discount on article processing charges for any articles submitted before November 20, 2014.

If you’re thinking of submitting a manuscript to Veterinary Record or Veterinary Record Open, consider making it open access. Full details of the offer can be found here.

Cat’s eyes shed light on vascular anomalies

20 Oct, 14 | by Assistant Editor


An article recently published in Veterinary Record Case Reports describes an unusual case of sudden blindness in a pet cat…

When an eight-year-old female cat presented with an acute onset of blindness, lethargy and poor appetite, the first-opinion vet could be forgiven for not expecting the final diagnosis. The cat was referred to a neurologist, to whom the owners mentioned that she had had several previous episodes of lethargy since she was a kitten, usually lasting less than 24 hours.

On examination, the cat was stunted, had copper-coloured irises and a protruding tongue. The neurological examination revealed several cognitive, cranial nerve and generalised motor abnormalities. Neuroanatomical localisation was consistent with a diffuse forebrain disease.

MRI and routine cerebrospinal fluid analysis revealed no significant findings. However, an abdominal ultrasound scan demonstrated that the splanchnic venous flow was diverted away from the liver (that is hepatofugal flow), via an anomalous tortuous vessel. The liver parenchyma appeared normal and the rest of the abdominal ultrasound was unremarkable. A blood ammonia level measured immediately after sample collection, supported the diagnosis of hepatic encephalopathy secondary to a splenosystemic shunt.

Portosystemic shunts (PSS) are vascular anomalies redirecting the blood from the portal circulation to the systemic circulation. Congenital PSSs, the most common type identified in cats, are the result of an abnormal embryonic vasculature development, and are usually diagnosed in young animals. Acquired PSSs are usually secondary to portal hypertension leading to the opening of pre-existing fetal blood vessels. Signs of hepatic encephalopathy often wax and wane, but neurological signs, including seizures are common.


Simplified representation of the vascular anomaly observed in the cat

CVC, caudal vena cava; GI, gastrointestinal; SV, splenic vein; PV, portal vein


The patient quickly responded to medical treatment and the owners reported in a follow-up consultation five months later that the cat has been completely normal without any episode of abnormal behaviour or visual deficits.

This case raises the importance of considering a PSS as a possible cause of acute onset of neurological signs in adult cats. Additionally, it suggests a potential good response to medical treatment for splenosystemic shunts.

Read about this case in more detail here, including videos (found under supplementary data).

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