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Biomedical waste is a well-recognized environmental problem, yet less is known about the waste generated in the delivery of veterinary care compared to human medicine. The objective of this project was to develop and pilot a waste audit protocol for veterinary medicine that could inform waste management at a US university veterinary teaching hospital and the broader veterinary community. We conducted a multi-day review of the Colorado State University Veterinary Teaching Hospital’s small animal surgery and anesthesia units to measure the types and amounts of waste generated during routine surgeries. Metrics included total weight, number of bags, and individual counts for specific items of concern and items with sustainable alternatives. We calculated frequencies and percentages of waste by waste audit material category and noted any erroneous materials sorted. Despite waste being a prioritized sustainability issue in veterinary medicine, this work highlighted opportunities for better education on managing and optimizing existing resources through behavior modification. This article explores ways the 5Rs (Rethink, Reduce, Reuse, Recycle, Research) could be better operationalized in veterinary hospitals.

Climate change is a worldwide health problem. Veterinarians and other health professionals have been called upon to participate in mitigation and adaptation efforts to protect animals and people. The objectives of this article are to review the ways in which climate change impacts animal health and highlight ways in which veterinarians and other animal health professionals can engage on the topic. Disease in terrestrial and aquatic species as well as domesticated and wild animals occurs through a series of shared exposure pathways (temperature, air, water, food, vector-borne disease, extreme events, and welfare). To meaningfully address this problem, the veterinary profession must recognize climate change as part of a complex and interwoven collection of sustainability challenges. Proposed actions include leading by example, building new partnerships, and promoting education, policy, and research. Veterinary professionals are key contributors to global health initiatives and trusted messengers of health information. Lending our voices and actions to address the climate crisis and related sustainability issues will go a long way to protect the health of all species.

Competency-based veterinary education focuses on the knowledge and clinical skills required to generate a productive and confident practitioner. Accurate identification of clinically relevant core competencies enables academic institutions to prioritize which new and foundational information to cover in the limited time available. The goal of this study was to aggregate the opinions of veterinary practitioners about small animal core competencies in veterinary orthopedics. An online 20-question survey was distributed with questions regarding respondent demographics, education, practice type, caseload, involvement in orthopedic procedures, access to referral hospitals, frequency of orthopedic condition presentation and procedure performance, and proposed percent allocation of various orthopedic curriculum topics. Responses were included from 721 respondents, largely first-opinion veterinarians (81%, n = 580/721). The majority (58%; n = 418/721) of respondents performed less than 10% of the orthopedic surgeries themselves and, 37% ( n = 266/721) reported never performing orthopedic surgery; of those performing surgeries, 78% ( n = 354/455) performed less than six orthopedic procedures monthly. The five most common orthopedic conditions seen included: generalized osteoarthritis, patellar luxation, cranial cruciate ligament disease, hip dysplasia/arthritis, and muscle/tendon injuries. Median respondent scores for the percentage which a topic should comprise in an ideal orthopedic curriculum were 20% each for ‘orthopedic exam’ and for ‘non-surgical orthopedic knowledge’, 15% each for ‘non-surgical orthopedic skills,’ ‘orthopedic imaging (radiographs),’ and ‘surgical orthopedic knowledge,’ 10% for ‘surgical orthopedic skills,’ and 2% for ‘advanced orthopedic imaging.’ Based on these results, a curriculum focusing on the most clinically relevant orthopedic conditions with an emphasis on diagnosis establishment and non-surgical treatments is proposed.

Climate change poses a significant and increasing threat to global health. While veterinarians play integral roles in public and environmental health, the profession has been less engaged in the topic of climate change relative to their human medical counterparts. The objective of this study was to synthesize veterinary students’ perceptions and knowledge about the relationship between veterinary medicine and climate change to identify educational gaps and opportunities. An online questionnaire was disseminated to American Veterinary Medical Association (AVMA)-accredited veterinary colleges through the Student American Veterinary Medical Association newsletter. Respondents were overwhelmingly confident that climate change is happening, is due to human activities, and is impacting both human and animal health. Veterinary students also expressed the belief that veterinarians should take a leadership role on the issue of climate change, especially through promoting environmental sustainability in clinical practice. Despite this enthusiasm, most students reported a lack of educational opportunities within their veterinary programs. The results of this survey highlight opportunities for the development of educational resources on the topic, many of which could complement existing material such as that devoted to practice management, economics, and client communication. Veterinarians have the potential to meaningfully contribute to both mitigation and adaptation efforts around climate change; however, they must be equipped with the tools to do so.

Background Regular physical activity (PA) promotes health and can prevent and treat diseases among both humans and dogs. Unfortunately, most U.S. adults do not meet PA recommendations, and many dogs are also insufficiently active. Veterinary-prescribed PA programs have shown some success in increasing activity among overweight dogs, but the impacts of such programs have not yet been tested for efficacy among otherwise-healthy dogs and owners. In addition, although wearable devices that monitor PA and provide individuals with feedback (e.g., progress toward a daily step goal) can effectively increase human PA, it is unclear what impact similar wearable devices have on human and dog PA when the PA-monitoring devices are worn by dogs. The present study assessed the impact of an 8-week veterinary-prescribed PA program on activity and health among dogs and their owners, and randomized participants (n = 59) to two groups: one in which PA was measured but not visible to participants (n = 30), and one in which PA was measured and real time feedback was visible through a wearable device (n = 29). Results Participants in both groups showed significant PA increases over the course of the 8-week program. Biomedical testing performed at the veterinary clinic facilitated early diagnosis of systemic illness in one human participant. The frequency of hypertension in human participants decreased significantly from baseline to the end of the program (week 8). Other health indices (e.g., BMI in humans, body weight and BCS in dogs) improved, albeit not to a statistically significant extent, over the course of the program. There were no significant differences on the outcomes of interest between the two experimental conditions. Conclusions Veterinary-prescribed PA programs appear promising for increasing PA among insufficiently active but otherwise healthy dogs as well as their owners. Additional testing of veterinary-prescribed PA is warranted, particularly at other types of veterinary clinics (e.g., private practices). Incorporating wearable devices permitting owners to track canine PA did not appear necessary for obtaining these benefits; however, additional studies investigating alternative devices or different time periods may be warranted.

Hypertensive disorders of pregnancy (HDP) are associated with maternal and neonatal morbidity as well as postpartum hospital readmission. This study seeks to characterize differences among patients with postpartum readmissions related to HDP. This is a retrospective study of patients with HDP admitted at an urban tertiary care center from January 2019 to November 2019 following the implementation of a standardized readmission workflow for patients with HDP at a single institution. Medical information up to 6 weeks postpartum was collected by chart review. The primary outcome was readmission. Secondary outcomes included reason for readmission, location of initial evaluation, and blood pressure values at time of readmission. A total of 729 patients with HDP delivered over the study period, 79.7% (N = 581) of whom were Black and 11.0% (N = 80) of all patients were readmitted within 6 weeks of delivery. Patients who were older, privately insured, and with chronic hypertension/cardiac disease were more likely to be readmitted. There was no difference in readmission rate by race. However, Black patients were more likely to be readmitted for preeclampsia with severe features (43.3% vs 10.0% non-Black, p = 0.01). Black patients who were readmitted were more likely to be initially evaluated in the emergency room compared to non-Black patients (43.3% vs 15.0%, p = 0.03). Our results suggest although readmission rates did not differ by race, there are significant differences at the patient and system level between Black and non-Black patients readmitted to the hospital after a pregnancy affected by HDP.

This study aimed to evaluate womens' perspectives about current and novel preeclampsia testing methods at an urban tertiary medical center.This was an observational survey study conducted between October 1, 2020 and December 31, 2020. Subjects were eligible if they were ≥ 18 years of age and had a diagnosis of gestational hypertension, preeclampsia, or superimposed preeclampsia at the time of delivery. Informed consent was obtained, and the 26-question survey was administered after delivery. A detailed medical record review was completed for respondents (patients) and their neonates.A total of 100 women were included in the study. The majority of participants were Black (78%) and/or on Medicaid (51%). Most respondents agreed that they fully trust their doctor and medical team (96%) and that the newest medical tests, treatments, and technologies should always be used (91%). Most women (80%) at least somewhat agreed they have enough knowledge about preeclampsia and its complications. Over 90% of women agreed a test to predict complications of preeclampsia would be useful to them. Most women reported a rule out test would be useful to them because it would help them worry less (68%), reduce hospitalizations (32%) and reduce interventions (17%).There was majority support for novel methods such as biomarker testing among this cohort. Most patients reported the test would decrease worry associated with preeclampsia development and complications.

To test the ability of a hospital-wide, bundled quality-improvement initiative to improve postpartum maternal blood pressure control and adherence to postpartum follow-up among patients with hypertensive disorders of pregnancy.This quality-improvement initiative consisted of a bundle of clinical interventions including health care professional and patient education, a dedicated nurse educator, and protocols for postpartum hypertensive disorders of pregnancy care in the inpatient, outpatient and readmission setting. We implemented this initiative in patients with hypertensive disorders of pregnancy starting in January 2019 at the University of Chicago. The study period was divided into four periods, which correspond to preintervention, distinct bundle roll outs, and postintervention. Our primary outcome was postpartum hypertension visit adherence. Secondary outcomes included blood pressure values and antihypertensive medication use in the immediate postpartum and outpatient postpartum time periods. We then stratified our outcomes by race to assess whether the effect size differed.A total of 926 patients who delivered between September 2018 and November 2019 were included. Postpartum hypertension visit adherence improved from preintervention period compared with the full implementation period (33.5% vs 59.4%, P.001). Blood pressure in the first 24 hours postpartum decreased from preintervention compared with full implementation (preintervention median [interquartile range] systolic blood pressure 149 mm Hg [138, 159] vs 137 [131, 146] in postimplementation; P.001). After implementation, fewer patients experienced a blood pressure of 140/90 mm Hg or higher at the first postpartum blood pressure check, when compared with preintervention (39.1% vs 18.5%, P=.004). The effect size did not differ by race.A bundled quality-improvement initiative for patients with hypertensive disorders of pregnancy was associated with improved postpartum visit adherence and blood pressure control in the postpartum period.

Exposure to air pollution, including criteria pollutants such as fine particulate matter (PM2.5) and ozone (O3), has been associated with morbidity and mortality in mammals. As a genetically homogenous population that is closely monitored for health, dairy cattle present a unique opportunity to assess the association between changes in air pollution and mammalian health. Milk yield decreases in the summer if temperature and humidity, measured by the Temperature Humidity Index (THI). As O3 levels increase with warmer temperatures, and summer PM2.5 may increase with wildfire smoke, dairy cows may serve as a useful sentinel species to evaluate subacute markers of inflammation and metabolic output and ambient pollution. Over two years, we assessed summertime O3 and PM2.5 concentrations from local US EPA air quality monitors into an auto-regressive mixed model of the association between THI and daily milk production data and bulk tank somatic cell count (SCC). In unadjusted models, a 10 unit increase THI was associated with 28,700 cells/mL (95% CI: 17,700, 39,690) increase in SCC. After controlling for ambient air pollutants, THI was associated with a 14,500 SCC increase (95% CI: 3,400, 25,680), a 48% decrease in effect compared to the crude model. Further, in fully adjusted models, PM2.5 was associated with a 105,500 cells/mL (95% CI: 90,030, 121,050) increase in SCC. Similar results were found for milk production. Results were amplified when high PM2.5 days (95th percentile of observed values) associated with wildfire smoke were removed from the analyses. Our results support the hypothesis that PM2.5 confounds the relationships between THI and milk yield and somatic cell count. The results of this study can be used to inform strategies for intervention to mitigate these impacts at the dairy level and potentially contribute to a model where production animals can act as air quality sentinels.

Black people have a disproportionately higher risk of hypertensive disorders of pregnancy and postpartum complications than White people but historically lower rates of postpartum follow-up. Few studies have investigated telehealth in the postpartum population.This study aimed to investigate whether rapid switch to telehealth with audio-based visits during the COVID-19 pandemic decreased racial disparities in postpartum hypertension follow-up adherence.This retrospective cohort study included all the patients with hypertensive disorders of pregnancy who delivered between December 2019 and June 2020 at an urban tertiary care center. A preexisting postpartum hypertension quality improvement initiative was in place at this institution. Follow-up adherence within 6 weeks postpartum and at the 6-week visit were compared before February 15, 2020 (pretelehealth period) and following March 14, 2020 (post-telehealth period), with a 1-month implementation or washout period. The blood pressures at these visits were compared between time periods as a secondary outcome.A total of 473 patients were included in this analysis, of whom 76.3% were non-Hispanic Black. There were 215 and 258 patients in the pre- and post-telehealth cohorts, respectively. Among those who attended follow-up, the proportion of visits done over telehealth went from 0% pretelehealth to 98.0% post-telehealth. The proportion of postpartum hypertension follow-up attendance changed from 48.5% to 76.3% among non-Hispanic Black people (P.0001) and from 73.1% to 76.7% among non-Hispanic White people (P=.76), leaving only a 0.4% racial gap (P=.97). This resulted in an elimination of the racial disparities in the post-telehealth period.Transition to telehealth with audio-based visits at the onset of the COVID-19 pandemic improved attendance at postpartum hypertension visits among non-Hispanic Black people. This, therefore, led to significant decreases in the racial disparities in follow-up rates at our institution in the setting of an existing quality improvement initiative. Further research should focus on the intentional use of telehealth in improving maternal outcomes, especially among the non-Hispanic Black people.

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 behavior 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.

Coxiella burnetii is an intracellular bacterial pathogen that can be associated with significant reproductive disease or acute mortality in livestock and wildlife. A novel marine mammal-associated strain of C. burnetii has been identified in pinnipeds of the northwestern Pacific Ocean. Little is known about C. burnetii infection in regard to reproductive success or population status. Our objective was to characterize the severity and extent of histologic lesions in 117 opportunistically collected placentas from presumed-normal northern fur seals (Callorhinus ursinus) in July 2011 on St. Paul Island, Alaska, US, where a high placental prevalence of C. burnetii had been reported. Sections were examined by histology and immunohistochemistry and impression smears with modified acid-fast stain. The nature and frequency of histologic changes were compared with target COM1 PCR-confirmed C. burnetii positive and negative placentas. Overall, histologic changes were similar to placental lesions described in aborting ruminants; however, changes were variable within and between placentas. Vasculitis and occasional intracellular bacteria were seen only in C. burnetii PCR-positive placentas. Dystrophic mineralization, edema, and inflammation were seen in PCR-positive and negative placentas, although they were statistically more common in PCR-positive placentas. Results suggest that C. burnetti and associated pathologic changes are multifocal and variable in placentas from these presumably live-born pups. Therefore, multiple sections of tissue from different placental areas should be examined microscopically, and screened by PCR, to ensure accurate diagnosis as the genomes per gram of placenta may not necessarily represent the severity of placental disease. These limitations should inform field biologists, diagnosticians, and pathologists how best to screen and sample for pathogens and histopathology in marine mammal placental samples.

Physical inactivity remains a global epidemic leading to an estimated 5 million preventable deaths per year. Although there exist numerous public-health campaigns aimed at increasing physical activity (PA), a potentially fruitful but underexplored avenue to promote both human and animal health is veterinary-prescribed PA programs. The aim of this study was to determine the feasibility and acceptability of incorporating veterinary-prescribed PA programming into a diverse array of clinic settings. Participants (n = 722 veterinary-clinic staff (VS), n = 1028 dog owners (DOs)) completed an online survey assessing: (a) the perceived importance of PA for promoting health and preventing disease, (b) willingness to participate in a veterinary-prescribed PA program, and (c) potential benefits and barriers of such a program. Both groups of participants indicated that PA is important for both human and animal health (97% and 98% of VS and 92% and 93% of DOs said PA is very or extremely important for animal and human health, respectively). Additionally, most participants in both groups expressed an interest in participating in a veterinary-prescribed PA program in the future, with only 11% of DOs and 10% of VS saying they were not interested. Benefits and barriers of this type of intervention for both practitioners and patients were also identified. Incorporating veterinary-prescribed PA programming into veterinary clinics seems to be acceptable to both DOs and VS. Additionally, many VS believe such programming would be feasible at their clinics, thus, pursuing such programs appears to be a promising avenue for promoting human and animal health.

This chapter provides an overview of the impacts of climate change and the shared benefits of diverse collaborations to adapt to this important threat to animal, man and environmental health.

Objective: To assess how pet owners perceive the role of veterinary medicine in addressing climate change and animal health and determine if there is a client-driven economic incentive to establish sustainable veterinary business practices.Sample: 1,044 dog and/or cat owners residing in the United States who had used veterinary services within the last 3 years.Procedures: An online Amazon mTurk survey about climate change and the perceived effects on client-owned dogs and cats was distributed to pet owners.Results: Most respondents believe climate change is occurring, and two-thirds of pet owners would value knowing their veterinarian received training on the animal health impacts of climate change. Over half of the respondents would pay more for veterinary services at a clinic with a reduced environmental impact. Additionally, clients would value some form of sustainability certification to aid in identification of such practices. Demographic influences found to be statistically significant included age, political ideology and where one resides (i.e., urban, suburban, or rural) whereas gender and income level, were not found to be significant.Conclusions and Clinical Relevance: Our data suggest there is an economic incentive for veterinary professionals to be knowledgeable about the health impacts of climate change and to implement and market sustainable practice initiatives. Prioritizing sustainable practice initiatives and climate change education in veterinary practices has the potential to mutually benefit both practitioner and client through shared patient health and financial incentives.

OBJECTIVE To quantitatively measure the amount of pressure induced at the calcaneus and cranial tibial surface of dogs by use of 2 cast configurations. ANIMALS 13 client- or student-owned dogs. PROCEDURES Pressure sensors were placed over the calcaneus and cranial tibial surface. Dogs then were fitted with a fiberglass cast on a pelvic limb extending from the digits to the stifle joint (tall cast). Pressure induced over the calcaneus and proximal edge of the cast at the level of the cranial tibial surface was simultaneously recorded during ambulation. Subsequently, the cast was shortened to end immediately proximal to the calcaneus (short cast), and data acquisition was repeated. Pressure at the level of the calcaneus and cranial tibial surface for both cast configurations was compared by use of paired t tests. RESULTS The short cast created significantly greater peak pressure at the level of the calcaneus (mean ± SD, 0.2 ± 0.07 MPa), compared with peak pressure created by the tall cast (0.1 ± 0.06 MPa). Mean pressure at the proximal cranial edge of the cast was significantly greater for the short cast (0.2 ± 0.06 MPa) than for the tall cast (0.04 ± 0.03 MPa). CONCLUSIONS AND CLINICAL RELEVANCE A cast extended to the level of the proximal portion of the tibia caused less pressure at the level of the calcaneus and the proximal cranial edge of the cast. Reducing the amount of pressure at these locations may minimize the potential for pressure sores and other soft tissue injuries.

Over the past several decades there has been a precipitous decline of northern fur seals (Callorhinus ursinus; NFS) at their breeding grounds on the Pribilof Islands in the Bering Sea. The cause of this decline is likely multifactorial and could include changes in environmental parameters, prey abundance and distribution as well as exposure to pathogens and pollutants. Evaluation of inflammatory markers and antioxidant levels of the current population of fur seals in addition to hematologic and biochemical profiles could provide important information regarding health and subclinical or clinical disease in this population. Serum and plasma samples were obtained from clinically healthy adult female NFS and references intervals were determined for multiple parameters that can be altered in response to the presence of disease and environmental stressors. We established a reference interval for cytokines involved in acute inflammation and infection (TNFa, IL1, IL6, IL8, KC, IL10, C-reactive Protein) by utilizing commercially available canine cross-reactive antibodies. Reference intervals were also established for reactive oxygen species (hydrogen peroxide and malondialdehyde), as well as antioxidant levels (vitamin E and selenium) and acute phase proteins evaluated by serum electrophoresis. To improve the ability to compare and interpret indicators of health and disease in this species, we developed reference intervals for commonly utilized hematologic and biochemical tests in addition to the aforementioned markers of oxidative stress and inflammatory biomarkers. There were several animals identified as outliers indicating that they may have had subclinical illness or inflammation. Further investigation utilizing these tests in clinically ill animals and comparison to animals that exhibit normal behavior and no overt signs of illness could increase our understanding of the utility of measuring these parameters in this species.

Pilot information on the health behaviors and perceptions of adult, dog owning, Pokmon GO players in the US was gathered via an anonymous, on-line survey. A total of 269 participants provided details about their playing habits, daily exercise routines, and interactions with their family and dog, and how these were impacted by playing the game. Playing Pokmon GO affected the amount of time players spent with other people and pets, with 43.2% of respondents reporting an increased amount of time spent with family/household members and 52.3% reporting they spent more time with their dog. Additionally, 62.9% of participants reported spending more time walking their dog since starting to play. A statistically significant increase in amount of exercise obtained was found when comparing pre-to post-game levels. A number of respondents reported feeling less anxious leaving the house (38.6%), interacting with strangers (39.7%), and going to new places (39.4%) after they began playing Pokmon GO. In conclusion, playing Pokmon GO appears to positively impact all areas studied, suggesting a new opportunity to enhance both mental and physical health. Participants spent more time with family and pets after starting to play Pokmon GO.Increased amount of time walking their dog and exercising after starting to play.Anxiety about leaving the house was reduced after starting to play Pokmon GO.Reduced anxiety about interacting with strangers and visiting new places.Pokmon GO could be a new opportunity to enhance both mental and physical health.

The COVID-19 pandemic has catalyzed the use of novel teaching modalities to enhance the provision of remote veterinary education. In this study, we describe the use of immersive virtual reality (iVR) as a teaching aid for veterinary medicine students during their orthopedics clinical rotation. Student sentiments were assessed using voluntary electronic surveys taken by veterinary students before and after the rotation. The most noteworthy benefits students reported were improved engagement with the course content, information retention, radiographic interpretation, and clinical reasoning skills. Obstacles encountered during the initial stages of the program included financial and temporal investment in equipment and content development, technical troubleshooting, and motion sickness. Though it is unlikely that iVR will ever fully replace hands-on learning experiences, it presents an educational opportunity to supplement traditional learning methods, motivate students, and fill information gaps. As iVR technology continues to evolve and improve, potential applications in the veterinary curriculum grow, making the modality’s use progressively more advantageous. Although this study describes its application in an orthopedic setting, the versatility of the iVR modality lends the potential for it to be implemented in a number of clinical and didactic settings.

Climate change is one of the greatest public health threats of the twenty-first century. Recent surveys of veterinary students and practicing veterinarians have highlighted their concerns about the impacts of climate change on animal health and a strong desire to be knowledgeable about the practice and promotion of environmental sustainability within clinical practice. Most American Veterinary Medical Association (AVMA)–accredited veterinary schools have a veterinary teaching hospital (VTH) where veterinary students receive their core clinical education. Given this, VTHs may provide opportunities for students to learn how veterinary clinics can decrease their environmental footprint and actions they could incorporate into their future clinical work. To assess the feasibility of and support for introducing environmentally sustainable practices into VTHs, we distributed an anonymous online survey to all AVMA-accredited veterinary schools with an associated VTH. Responses were received from 843 individuals representing 23 VTHs in 7 countries. While the overwhelming majority of responding personnel believe this is an important topic, there is little evidence that sustainable behaviors are being practiced or showcased within VTHs. Respondents were most interested in working to increase recycling and reduce general waste and energy consumption within their hospitals. In addition to a lack of educational resources, funding was a commonly identified barrier to incorporating more environmentally sustainable practices. These results add to the growing evidence that enhanced incorporation of sustainability into veterinary medical education at all stages is needed and that VTHs provide a unique opportunity to lead by example.

Early warning systems for climate change adaptation, preparedness and response will need to take into consideration the range of factors that can drive risk and vulnerability. There are no data from which to nominate the most effective, efficient and reliable wildlife health signals for public health planning, but there is growing opinion that wildlife health could signal public health vulnerability related to climate change. The objective of this commentary is to explore the potential for wildlife to contribute to climate change early warning for public health protection in Canada. Wildlife impact many determinants of human health through both direct and indirect mechanisms; several of which are strongly interconnected. There is a long history of wildlife serving as bio-sentinels for environmental pollutants and pathogens. Wildlife health could support public health threat detection, risk assessment and risk communication by detecting and tracking infectious and non-infectious hazards, being bio-sentinels of effects of new or changed hazards, providing biologically understandable information to motivate changes in personal risk behaviours and providing insights into new and unanticipated threats. Public health risk communication and strategic planning priorities for climate change could benefit from a wildlife health intelligence system that collects data on incidents of disease and hazard discovery as well as information on social and environmental conditions that affect risk perception and likelihoods of human exposure or harms.

Little is currently known about the pacing gait in dogs and it has been speculated that pacing may be utilized by dogs with musculoskeletal pathology. The goals of the present study were to determine if pacing in dogs is associated with musculoskeletal disease and to establish if controlled speed impacts pacing. Dogs underwent orthopedic and lameness assessments. Musculoskeletal pathology, when identified, was further defined with radiography of the affected area. Dogs were considered musculoskeletally normal (MSN) if no pathology was detected and they had no history of musculoskeletal disease. All others were considered musculoskeletally abnormal (MSA). Animals were then evaluated for pacing using digital-video-imaging under three conditions: Off-lead, lead-controlled, and on a treadmill. Thirty-nine dogs were enrolled (MSN: n = 20; MSA: n = 19). Overall, pacing was observed more frequently in dogs under lead-controlled than off-lead conditions (P < 0.001). Lead-controlled MSN dogs were observed to pace significantly more frequently (n = 17/20) than lead-controlled MSA dogs (n = 10/19; P = 0.029). There was no significant difference within each group for the frequency of pacing under treadmill or off-lead conditions. Pacing always occurred at speeds between a walk and a trot, speeds ranged from 0.98 to 2.84 m/s, (mean 1.8 m/s). Pacing was demonstrated in MSN and MSA dogs under all study conditions. Pacing should be considered a gait variation that can be observed in clinically normal dogs. Relative speed and leash walking was determined to be a factor in the use of the pacing gait. Key words: Pacing, gait analysis, lameness, canine locomotion, symmetrical gait, lateral gait, amble.

Reference intervals (RIs) for biochemical analytes provide baseline values for assessing physiologic status and health. We established RIs for commonly assessed blood-based analytes for polar bears from the southern Beaufort Sea. These RIs fill a knowledge gap that will inform assessments of polar bear health in a changing Arctic., Accurate reference intervals (RIs) for commonly measured blood-based analytes are essential for health monitoring programmes. Baseline values for a panel of analytes can be used to monitor physiologic and pathophysiologic processes such as organ function, electrolyte balance and protein catabolism. Our reference population includes 651 serum samples from polar bears (Ursus maritimus) from the southern Beaufort Sea (SB) subpopulation sampled in Alaska, USA, between 1983 and 2016. To establish RI for 13 biochemical analytes, we defined specific criteria for characterizing the reference population and relevant subgroups. To account for differences in seasonal life history characteristics, we determined separate RI for the spring and fall seasons, when prey availability and energetic requirements of bears differ. We established RI for five subgroups in spring based on sex, age class and denning status, and three subgroups in fall based on sex and age class in females only. Alkaline phosphatase activities were twice as high in subadult as in adult polar bears in spring (zmales = 4.08, Pmales

A Delphi exercise involving 17 senior national parks’ biologists in the United States of America and Canada examined how evolving concepts of wildlife health resonated with Parks’ needs. Participants examined wildlife health as a multi-factorial cumulative effect that provides capacity to cope with a changing world. They agreed that this concept of health was consistent with Parks’ goals and provided insight on various aspects of wildlife health in national parks. Social and environmental determinants of health were perceived to be greater threats to wildlife health than etiological hazards such as pathogens, the more typical focus of wildlife health efforts. While social and anthropogenic factors are primary drivers of these threats, participants did not explicitly rank social variables as the more important drivers of wildlife health nor did the majority view health as a social construct. The results clearly show support for moving toward a contemporary approach of wildlife health management, as opposed to disease management, and for the need of collective, team-based approaches to protecting the suite of determinants of health.

OBJECTIVE To determine the influence of a novel surgical guide on the accuracy and technical difficulty of closing wedge osteotomies (CWO). STUDY DESIGN Ex vivo experimental study. SAMPLE POPULATION Canine tibia models (n = 40). METHODS A 20° cranial CWO (CCWO) was created without (standard procedure; STCCWO) or with the aid of a novel wedge osteotomy guide (WOCCWO). Procedures were performed by diplomate (n = 4) and resident (n = 6) surgeons, with each performing 2 STCCWO followed by 2 WOCCWO. To prevent bias, surgeons were unaware of the study purpose until after completing the STCCWO. The wedges were evaluated by comparing the deviation from the 20° target angle, divergence of the 2 osteotomies (osteotomy divergence angle [ODA]), and measurements of the wedge height at the caudomedial cortex (CMC) and caudolateral cortex (CLC). Technique difficulty was explored through a surgeon questionnaire. RESULTS The WOCCWO resulted in smaller mean ODA (WOCCWO = 0.86°, SD ± 0.38°, P < .001), and smaller mean difference between CMC and CLC (WOCCWO = 0.29 mm, SD ± 0.19, P < .001) than for the STCCWO (4.22°, SD ± 2.16° and 1.39 mm, SD ± 0.65 respectively). Deviation from the target 20° wedge angle was greater after STCCWO (1.46°, SD ± 1.27°) than after WOCCWO (0.53°, SD ± 0.33°, P = .004). No difference was reported regarding the difficulty of the procedures, but resident surgeons stated that they were more likely to use the guide in a clinical setting compared with diplomates. CONCLUSION The wedge osteotomy guide improved the accuracy of CCWO compared with standard technique. CLINICAL SIGNIFICANCE The clinical significance of the differences detected in this study is unclear and warrants in vivo investigation.

A 6-year-old, male castrated, mixed-breed dog was referred to the James L. Voss Veterinary Teaching Hospital at Colorado State University for bicavitary effusion. On examination, the dog was tachycardic and tachypneic with bilaterally decreased lung sounds. Thoracic and abdominal ultrasonic examination revealed pleural and peritoneal effusions, which were aspirated and submitted for fluid analysis and cytology. Both cavity fluids were classified as exudates with a large population of vacuolated mononuclear cells. Multiplex immunocytochemistry (ICC) for cytokeratin and vimentin demonstrated exclusively cytokeratin expression, indicating these cells were of epithelial origin. A full diagnostic evaluation was performed, including CBC, clinical chemistry, a pet-side test for heartworm disease, ehrlichiosis, Lyme disease, and anaplasmosis, imaging modalities of thorax, abdomen, and heart, urinalysis, and fine-needle aspirations of spleen, liver, and popliteal lymph nodes. The dog was diagnosed with pleural and peritoneal carcinoma with presumed carcinomatosis. A single dose of intracavitary carboplatin was administered before discharge, and over a period of 2 weeks, 5 thoracocenteses were performed. A subcutaneous mass was noted at a thoracocentesis site one week after initial presentation. Cytology of the mass was consistent with carcinoma, and neoplastic seeding of the tumor cells from the thoracocentesis was suspected. The dog was euthanized 15 days after the first visit, and a necropsy was performed. Findings were consistent with carcinomatosis secondary to anaplastic pulmonary carcinoma with transient subcutaneous seeding of neoplastic cells during routine thoracocentesis. This case demonstrates the utility of multiplex ICC in the clinical setting.

Gonadectomies are the most commonly performed surgical procedures in dogs. The benefits and risks associated with gonadectomy in dogs have been broadly investigated. Due to concerns associated with ovariectomy, some pet-owners and veterinarians are considering surgical alternatives which terminate the capacity for reproduction without removal of the gonads to preserve functions of the gonadal hormones. The objective of this study was to determine the feasibility of complete resection of the glandular portion of the uterus with hysterectomy (HE). Using a prospective cadaveric and an ex-vivo design, uterine resection was performed cranially and caudally to the cervix, and at the proper ligament to simulate routine ovariohysterectomy and HE. Using microscopic evaluation procedures, there was identification of glandular tissue at the surgical margin of all samples resected cranially to the cervix and no glandular tissue in the samples resected caudally to the cervix. Half of the samples from the uterine horns contained glandular tissue. The results of the present study indicate ligation and transection of the uterus caudally to the cervix (as recommended for HE) allows for complete resection of glandular tissues, however, transection at the proper ligament may not. The clinical relevance of retention of para-ovarian uterine glandular tissue is unknown. Additional research is needed where there is investigation of the consequences and surgical technique for HE before there is widespread clinical use of this procedure.

Regular physical activity (PA) is a health promoting behavior that transcends species. The collective evidence of a positive relationship between PA and health in both people and animals suggests that implementation of outdoor, dog-associated activities to increase PA may synergistically enhance both human and dog health. A systematic literature review was performed to identify research investigating objective, quantitative health outcomes in both dogs and people exercising together. Within the confines of the search, only 2 studies fulfilled the criteria for complete review. One study was administered through a veterinary clinic and another through a human health care provider. Both studies focused on obesity treatment, either for the dog or for both the dog and the owner. Collectively this work demonstrates the feasibility of simultaneously promoting health in both groups through PA; however there are limitations to the generalizability of the findings. Additional research is needed to further investigate the feasibility and effectiveness of PA promotion in primary care veterinary clinics as well as the use of animal-assisted PA promotion as a preventative, not just therapeutic, tool. As diseases that can be prevented, at least in part, by regular PA are now the leading causes of morbidity and mortality in developed countries, veterinarians have the potential to significantly impact not only the health of their patients, but also that of the public.

Objectives To report our experience with thoracoscopic lung lobectomy in dogs with primary lung tumors and compare the long-term outcome between dogs with primary lung tumors treated with lobectomy via thoracoscopy or thoracotomy. Study Design Retrospective case series; case–control study. Animals Thirteen dogs with primary lung tumors treated with thoracoscopic lung lobectomy; case-matched cohort of 9 dogs with primary lung tumors treated with lobectomy via thoracotomy. Methods Medical records from dogs that underwent thoracoscopic lung lobectomy at a single institution were reviewed. Only cases with primary lung tumors were included. Surgical complications and conversion rate were reported. Cases without conversion and with clean margins on histologic examination were matched on prognostic criteria to cases with primary lung tumors treated with lobectomy via thoracotomy. Survival was compared between thoracoscopy and thoracotomy. Results Thirteen dogs with primary lung tumors that measured 2.2–7 cm underwent thoracoscopic lung lobectomy. Nine dogs were diagnosed with carcinoma and 4 with histiocytic sarcoma. There were 3 conversions to open thoracotomy because of poor visualization. There were no differences in short-term outcome between dogs that had their procedures completed via thoracoscopy and those that were converted to thoracotomy. Nine dogs with clean margins were matched with 9 dogs treated via thoracotomy. Mean (standard deviation) followup was 367 (327) days for dogs undergoing thoracoscopy and 603 (612) days for dogs undergoing thoracotomy. The 2-year survival rate was 44% for thoracoscopy and 56% for thoracotomy (P = .942). Conclusion Selected primary lung tumors in dogs can be safely resected with thoracoscopy and not affect long-term outcome.

Recent decline of sea ice habitat has coincided with increased use of land by polar bears (Ursus maritimus) from the southern Beaufort Sea (SB), which may alter the risks of exposure to pathogens and contaminants. We assayed blood samples from SB polar bears to assess prior exposure to the pathogens Brucella spp., Toxoplasma gondii, Coxiella burnetii, Francisella tularensis, and Neospora caninum, estimate concentrations of persistent organic pollutants (POPs), and evaluate risk factors associated with exposure to pathogens and POPs. We found that seroprevalence of Brucella spp. and T. gondii antibodies likely increased through time, and provide the first evidence of exposure of polar bears to C. burnetii, N. caninum, and F. tularensis. Additionally, the odds of exposure to T. gondii were greater for bears that used land than for bears that remained on the sea ice during summer and fall, while mean concentrations of the POP chlordane (ΣCHL) were lower for land-based bears. Changes in polar bear behavior brought about by climate-induced modifications to the Arctic marine ecosystem may increase exposure risk to certain pathogens and alter contaminant exposure pathways.

Background Accelerometer-based activity monitoring is a promising new tool in veterinary medicine used to objectively assess activity levels in dogs. To date, it is unknown how device orientation, attachment method, and attachment of a leash to the collar holding an accelerometer affect canine activity data. It was our goal to evaluate whether attachment methods of accelerometers affect activity counts. Eight healthy, client-owned dogs were fitted with two identical neck collars to which two identical activity monitors were attached using six different methods of attachment. These methods of attachment evaluated the use of a protective case, positioning of the activity monitor and the tightness of attachment of the accelerometer. Lastly, the effect of leash attachment to the collar was evaluated. For trials where the effect of leash attachment to the collar was not being studied, the leash was attached to a harness. Activity data obtained from separate monitors within a given experiment were compared using Pearson correlation coefficients and across all experiments using the Kruskal-Wallis Test. Results There was excellent correlation and low variability between activity monitors on separate collars when the leash was attached to a harness, regardless of their relative positions. There was good correlation when activity monitors were placed on the same collar regardless of orientation. There were poor correlations between activity monitors in three experiments: when the leash was fastened to the collar that held an activity monitor, when one activity monitor was housed in the protective casing, and when one activity monitor was loosely zip-tied to the collar rather than threaded on using the provided metal loop. Follow-up, pair-wise comparisons identified the correlation associated with these three methods of attachment to be statistically different from the level of correlation when monitors were placed on separate collars. Conclusions While accelerometer-based activity monitors are useful tools to objectively assess physical activity in dogs, care must be taken when choosing a method to attach the device. The attachment of the activity monitor to the collar should utilize a second, dedicated collar that is not used for leash attachment and the attachment method should remain consistent throughout a study period.

Most programs for monitoring the welfare of wildlife populations support efforts aimed at reaching discrete management objectives, like mitigating conflict with humans. While such programs can be effective, their limited scope may preclude systemic evaluations needed for large-scale conservation initiatives, like the recovery of at-risk species. We discuss select categories of metrics that can be used to monitor how polar bears (Ursus maritimus) are responding to the primary threat to their long-term persistence—loss of sea ice habitat due to the unabated rise in atmospheric greenhouse gas (GHG; e.g., CO2) concentrations—that can also provide information on ecosystem function and health. Monitoring key aspects of polar bear population dynamics, spatial behavior, health and resiliency can provide valuable insight into ecosystem state and function, and could be a powerful tool for achieving Arctic conservation objectives, particularly those that have transnational policy implications.

As coyotes (Canis latrans) adapt to living in urban environments, the opportunity for cross-species transmission of pathogens may increase. We investigated the prevalence of antibodies to pathogens that are either zoonotic or affect multiple animal species in urban coyotes in the Denver metropolitan area, Colorado, USA, in 2012. We assayed for antibodies to canine parvovirus-2, canine distemper virus, rabies virus, Toxoplasma gondii, Yersinia pestis, and serotypes of Leptospira interrogans. Overall, 84% of the animals had antibodies to canine parvovirus-2, 44% for canine distemper virus, 20% for T. gondii (IgG), 28% for Y. pestis, and 4% for L. interrogans serotype Grippotyphosa. No neutralizing antibodies were detected to rabies virus, T. gondii (IgM), or L. interrogans serotypes other than Grippotyphosa. With 88% of animals exposed to at least one pathogen, our results suggest that coyotes may serve as important reservoirs and sentinels for etiologic agents.

Brucella species infect a wide range of hosts with a broad spectrum of clinical manifestations. In mammals, one of the most significant consequences of Brucella infection is reproductive failure. There is evidence of Brucella exposure in many species of marine mammals, but the outcome of infection is often challenging to determine. The eastern Pacific stock of northern fur seals (NFSs, Callorhinus ursinus) has declined significantly, spawning research into potential causes for this trend, including investigation into reproductive health. The objective of the current study was to determine if NFSs on St. Paul Island, Alaska have evidence of Brucella exposure or infection. Archived DNA extracted from placentas ( n = 119) and serum ( n = 40) samples were available for testing by insertion sequence (IS) 711 polymerase chain reaction (PCR) and the Brucella microagglutination test (BMAT), respectively. As well, placental tissue was available for histologic examination. Six (5%) placentas were positive by PCR, and a single animal had severe placentitis. Multilocus variable number tandem repeat analysis profiles were highly clustered and closely related to other Brucella pinnipedialis isolates. A single animal was positive on BMAT, and 12 animals had titers within the borderline range; 1 borderline animal was positive by PCR on serum. The findings suggest that NFSs on the Pribilof Islands are exposed to Brucella and that the organism has the ability to cause severe placental disease. Given the population trend of the NFS, and the zoonotic nature of this pathogen, further investigation into the epidemiology of this disease is recommended.

Objective To determine the incidence of fibular penetration during placement of the Synthes® locking TPLO plate with and without the use of a jig. Study Design Cadaveric, experimental study. Sample Population Cadaveric paired pelvic limbs (n = 8) from skeletally mature dogs. Methods Limbs were assigned to 1 of 2 groups (jig-less-TPLO = no jig used; jig-TPLO = jig used). Synthes® locking TPLO plates were applied using proximal screws of excessive length to facilitate identification of fibular penetration. Screw tip locations were identified by dissection and frequency of fibular penetration was compared between groups. Results None of the jig-TPLO limbs and 6 (75%) of jig-less-TPLO limbs had fibular penetration, a difference that was statistically significant. Fibular penetration was most frequently associated with the most proximal screw. Conclusions A significantly higher incidence of fibular penetration occurs when Synthes® locking TPLO is performed without use of a jig.