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In an effort to recognize and address communicable and point-source epidemics in dog and cat populations, this project created a near real-time syndromic surveillance system devoted to companion animal health in the United States. With over 150 million owned pets in the US, the development of such a system is timely in light of previous epidemics due to various causes that were only recognized in retrospect. The goal of this study was to develop epidemiologic and statistical methods for veterinary hospital-based surveillance, and to demonstrate its efficacy by detection of simulated foodborne outbreaks using a database of over 700 hospitals. Data transfer protocols were established via a secure file transfer protocol site, and a data repository was constructed predominantly utilizing open-source software. The daily proportion of patients with a given clinical or laboratory finding was contrasted with an equivalent average proportion from a historical comparison period, allowing construction of the proportionate diagnostic outcome ratio and its confidence interval for recognizing aberrant heath events. A five-tiered alert system was used to facilitate daily assessment of almost 2,000 statistical analyses. Two simulated outbreak scenarios were created by independent experts, blinded to study investigators, and embedded in the 2010 medical records. Both outbreaks were detected almost immediately by the alert system, accurately detecting species affected using relevant clinical and laboratory findings, and ages involved. Besides demonstrating proof-in-concept of using veterinary hospital databases to detect aberrant events in space and time, this research can be extended to conducting post-detection etiologic investigations utilizing exposure information in the medical record.

This case-control study investigated factors associated with late initiation (i.e, initiation after the age of 17 years) of smoking among young women. The most significantly elevated odds ratios for late initiation were having a significant other who smoked and having friends who found smoking acceptable at initiation. Peers, especially significant others, played an important role in smoking initiation among young women. Prevention efforts should focus on strategies that reduce the acceptability of smoking in the social environment. (Am J Public Health. 1993;183:1333-1335), Women who start to smoke after age 17 tend to respond to the same types of influences as adolescents who begin smoking. In Minnesota, where 30% of women smokers between the ages of 18 and 30 start smoking after age 17, a study was conducted to investigate causes of smoking initiation among post-adolescent women. Having peers who smoke, especially spouses or significant others, and having the perception that smoking is socially acceptable tend to be highly associated with late onset of smoking among these women. Contrary to popular belief and anecdotal evidence, stressful life events were not significantly associated with late onset smoking. Other factors associated with late onset were poor high school grades, rare church attendance, and other 'problem' behaviors during high school. Prevention efforts should be directed at women with less education and focus on making smoking less socially acceptable.

Objectives: The aim of the study was to identify any dietary, signalment, geographic and clinical factors associated with hematuric struvite crystalluria (HSC) in a population of cats that visit general care veterinary hospitals in the USA. Methods: In total, 4032 cats that had a first-time diagnosis of HSC and 8064 control cats with no history of hematuria or crystalluria were identified from medical records of all cats examined between 2007 and 2011 at 790 US veterinary hospitals. Extracted variables included age, sex, neuter status, breed, diet, urinalysis results and history of cystitis. Potential associations between these variables and HSC were estimated. Results: Controlling for other factors, young cats fed a dry diet had an increased likelihood of HSC relative to young cats fed a non-dry diet. However, as age increased, the likelihood of HSC declined for cats fed a dry diet and increased for cats fed a non-dry diet. Moreover, the odds of HSC were significantly greater when cats were unneutered (vs neutered; odds ratio [OR] 45.52) or had a thin (vs heavy) body condition (OR 23.81), diagnosis of cystitis (OR 2.84), urine protein concentration >30 mg/dl (OR 4.72), alkaline (vs neutral) urine pH (OR 3.34), pyuria (OR 23.67) or bacteriuria (OR 2.24). Conclusions and relevance: The present study provides estimates of the strengths of association between HSC and certain signalment and clinical characteristics of cats. This information could help clinicians to perform a more directed screening for struvite crystalluria in certain cat populations. Follow-up studies that build on the findings of this study could explore the clinical importance of HSC in cats. [ABSTRACT FROM AUTHOR]

Background: There is an association between overweight status and life span in kenneled dogs, but a similar association has not been reported for pet dogs. Objectives: To examine the effects of being overweight in middle age on the life span of neutered client‐owned dogs. Animals Fifty‐thousand seven‐hundred eighty seven middle‐aged neutered client‐owned dogs attending a network of approximately 900 veterinary hospitals across North America. Methods: Retrospective case‐control study. For each of 12 breeds, groups of dogs aged between 6.5 and 8.5 years were identified as being in "overweight" or "normal" body condition. Within each breed and sex, differences in life span between dogs in normal body condition and overweight body condition in the 2 groups were then analyzed by Cox proportional hazards models. Results: For all breeds, instantaneous risk of death for dogs in overweight body condition was greater than those in normal body condition throughout the age range studied, with hazard ratios ranging from 1.35 (99.79% confidence interval [CI] 1.05‐1.73) for German Shepherd dog to 2.86 (99.79% CI 2.14‐3.83) for Yorkshire Terrier. In all breeds, median life span was shorter in overweight compared with normal weight dogs, with the difference being greatest in Yorkshire Terriers (overweight: 13.7 years, 99.79% CI 13.3‐14.2; normal: 16.2 years, 99.79% CI 15.7‐16.5) and least in German Shepherd dogs (overweight: 12.1 years, 99.79% CI 11.8‐12.4; normal: 12.5 years, 99.79% CI 12.2‐12.9). Conclusions and Clinical Importance: Veterinary professionals should consider promoting healthy body condition for dogs, particularly from midlife onward. [ABSTRACT FROM AUTHOR]

Canine juvenile-onset generalized demodicosis (JOGD) is a common skin disorder suspected to be associated with multiple risk factors, including breed predispositions. These risk factors have not been well documented in a large population. A retrospective case-control study was conducted by searching the electronic medical records of 1 189 906 dogs examined at 600 hospitals during 2006 in order to assess the risk factors associated with JOGD in the USA. Multivariate analyses were conducted using logistic regression to estimate the relative risk with the odds ratio for variables hypothesized to influence the risk for canine demodicosis. Breeds (odds ratio) found to have the greatest association with a diagnosis of JOGD were American Staffordshire terrier (35.6), Staffordshire bull terrier (17.1) and Chinese shar-pei (7.2). Nonbreed risk factors (odds ratio) significantly associated with a diagnosis of JOGD were the diagnosis of pyoderma (5.5), coccidiosis (2.7) or hookworms (1.5), short coat (1.9) and nonenrolment in a preventative care wellness plan (1.5). Documenting these risk factors may help veterinarians to prioritize differential diagnoses and will aid in the design of prospective studies to elucidate the pathogenesis of demodicosis in dogs. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to an article on risk factors linked with chronic kidney disease (CKD) in cats, evaluated at the Banfield Pet Hospitals across the U.S., in previous issue and a response from the author is also presented.

Tick-borne diseases are an important cause of human morbidity in North Carolina. This study evaluated the use of routinely collected veterinary hospital and human hospital emergency department (ED) data for earlier signal detection compared with routine reporting of tick-borne diseases to the North Carolina Division of Public Health in 2006 and 2007. The Early Aberration Reporting System was used to detect the earliest indication of an increase in number of dogs infested with ticks that were brought to veterinary hospitals and in number of people presenting to EDs with a tick-related chief complaint or who had an ED International Classification of Diseases diagnosis code of tick-borne disease. Results indicate that systematic monitoring of veterinary hospital and human ED data can detect increases in tick activity 4 weeks earlier than the current surveillance method, which would facilitate timely initiation of tick prevention and increased clinical awareness among veterinarians and physicians.