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Abstract

OBJECTIVE To study the effects of veterinarian communication (ie, the information provided and gaze and body direction) and vaccination style on the emotions and physiologic reactions experienced by clients and on clients' evaluation of the expertise and trustworthiness of the veterinarian.

DESIGN Simulation study.

PARTICIPANTS 20 small animal clients.

PROCEDURES Participants were shown 12 videos of a female veterinarian in which she first provided information about puppy vaccination and then performed the procedure. The veterinarian's behavior varied regarding the information provided about the vaccination (ie, scarce, factual, or emotional), her gaze and body direction (ie, direct or 30° averted), and her vaccination style (ie, routine or emotional). While the participants watched the videos, their corrugator supercilii muscle activity (corrugator supercilii muscles are activated when frowning) and skin conductance activity were measured. Participants also rated the emotions they experienced (ie, valence and arousal) and assessed the veterinarian's behavior (ie, expertise and trustworthiness).

RESULTS Overall, emotional information, a direct gaze and body direction, and an emotional vaccination style were associated with more pleasant emotions and higher ratings of the expertise and trustworthiness of the veterinarian's behavior by clients.

CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that through certain behavioral actions, veterinarians may positively affect the emotions and feelings experienced by clients during veterinary clinic visits, even in the case of vaccination visits, which can be considered routine visits from the viewpoint of the veterinarian.

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in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE To evaluate the knowledge of various veterinary specialists regarding various radiation safety matters and determine the availability of radiation safety training.

DESIGN Cross-sectional study.

SAMPLE 164 radiology, 81 internal medicine, and 108 emergency and critical care (ECC) specialists.

PROCEDURES An online survey was developed regarding knowledge of and training in radiation safety, and invitations were sent via email through the email lists of the veterinary internal medicine, ECC, and radiology specialty colleges. Responses were summarized, and comparisons were made between radiologists and internal medicine and ECC clinicians.

RESULTS 65.5% (38 /58) of respondents from academic institutions and 30.0% (33/110) of respondents from private practices indicated that radiation safety training was mandatory at their institution for personnel who work with ionizing radiation–emitting equipment, and 80.2% (85/106) and 56.6% (77/136), respectively, had received some radiation safety training. Low proportions of radiologists and internal medicine and ECC clinicians correctly identified the effective dose of ionizing radiation associated with 3-phase esophagography and 3-phase abdominal CT. Many radiologists (92/153 [60.1%]) and nonradiologists (92/179 [51.4%]) believed that the effective doses used in veterinary practice pose no increased risk of fatal cancer to their patients.

CONCLUSIONS AND CLINICAL RELEVANCE Radiation safety training, although more common in academia, was not universally available and may not meet radiography equipment license requirements for some institutions. Most radiologists, internal medicine clinicians, and ECC clinicians had a poor understanding of the amount of ionizing radiation associated with medical imaging procedures and the potential hazards to their patients.

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in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE To document the environmental stewardship practices (decisions and actions regarding use and disposal) of pet and human pharmaceuticals and personal care products (PPCPs) among pet-owning veterinary-care professionals (practicing veterinarians, veterinary students, and veterinary technicians and trainees) and environmental educators.

DESIGN Internet-based cross-sectional survey.

SAMPLE 191 pet owners (103 veterinary-care professionals and 88 environmental educators).

PROCEDURES Study participants were recruited by means of a 2-part internet survey distributed to veterinary-care professional and environmental educator networks of individuals residing in Washington state, Oregon, and southern California. Survey questions addressed motivators for environmental stewardship practices (ie, decisions and actions regarding use and disposal of pet and human PPCPs).

RESULTS Data were collected from 191 respondents; the response rate for individuals who self-selected to opt in was 78% (191/246). Of the 191 respondents, 42 (22%) stored pet pharmaceuticals indefinitely. The most common disposal method was the garbage (88/191 [46%]). Veterinary-care professionals counseled clients infrequently regarding environmental stewardship practices for PPCPs. Fifty-five percent (105/191) of all respondents preferred more environmentally friendly and clinically effective PPCPs.

CONCLUSIONS AND CLINICAL RELEVANCE Results of the present survey emphasized the urgent need for improved educational resources to minimize environmental contamination from improper disposal of PPCPs. Environmental and economic motivations among pet owners in the veterinary-care and education professions indicate further opportunities for outreach and institutional support.

Full access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE To assess the prevalence of medical errors (specifically, near misses [NMs] and adverse events [AEs]) and their personal and professional impact on veterinarians.

DESIGN Cross-sectional study.

SAMPLE Members of the Veterinary Information Network (n = 46,481).

PROCEDURES An electronic survey regarding veterinarians' experiences with NMs and AEs was distributed via email to an online veterinary community between September 24 and October 21, 2015. Responses were summarized and compared between genders by means of the χ2 test.

RESULTS 606 veterinarians completed the survey (1.3% response rate). Overall, 447 (73.8%) respondents reported involvement in ≥ 1 NM (n = 389 [64.2%]) or AE (179 [29.5%]). The NMs had a short-term (≤ 1 week) adverse impact on professional life for 68.0% (261/384) of respondents and longer-term negative impact for 36.4% (140/385). The impact on respondents' personal lives was similar (63.6% [245/385] and 33.5% [129/385], respectively). For AEs, these numbers were 84.1% (148/176), 56.2% (99/177), 77.8% (137/176), and 50.6% (89/175), respectively. Both NMs and AEs were more likely to negatively impact female veterinarians than male veterinarians.

CONCLUSIONS AND CLINICAL RELEVANCE These findings suggested that many veterinarians experience emotional distress after a medical error. Support should be provided to mitigate this adverse impact on the wellbeing of veterinarians and, potentially, their future patients.

Full access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE To develop a comprehensive taxonomy of practice-related stressors experienced by US veterinarians.

DESIGN Cross-sectional survey.

SAMPLE A subset of 1,422 US veterinarians who provided written (vs selected) responses to a question in a previous survey regarding practice-related stressors.

PROCEDURES Using grounded theory analysis, 3 researchers inductively analyzed written survey responses concerning respondents’ main practice-related stressors. In 5 iterations, responses were individually coded and categorized, and a final list of practice-related stressor categories and subcategories was iteratively and collaboratively developed until theoretical and analytic saturation of the data was achieved.

RESULTS A taxonomy of 15 categories of broad practice-related stressors and 40 subcategories of more specific practice-related stressors was developed. The most common practice-related stressor categories included financial insecurity (n = 289 [20.3%]), client issues (254 [17.9%]), coworker or interpersonal issues (181 [12.7%]), and work-life balance (166 [11.7%]). The most common subcategories were clients unwilling to pay (118 [8.3%]), low income (98 [6.9%]), cost of maintaining practice (56 [3.9%]), and government or state board policies (48 [3.4%]).

CONCLUSIONS AND CLINICAL RELEVANCE This study provided a comprehensive list of the types of practice-related stressors experienced by US veterinarians, building a foundation for future research into relationships between job stress and mental health in this population. Frequency data on the various stressors provided an initial understanding of factors that might be contributing to high stress rates among US veterinarians.

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in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE To determine whether basic laparoscopic skills acquired during training in the horizontal plane would transfer to the vertical plane and vice versa.

DESIGN Evaluation study.

SAMPLE POPULATION 26 first- and second-year veterinary students with no prior laparoscopic skills training or surgical experience.

PROCEDURES Participants were nonrandomly assigned to 2 groups. Group 1 (n = 15) underwent laparoscopic skills training in the horizontal plane, and group 2 (17) underwent laparoscopic skills training in the vertical plane. Following training, participants were tested on their ability to perform 5 laparoscopic tasks, first in the horizontal plane and then the vertical plane (group 1) or first in the vertical plane and then in the horizontal plane (group 2). All training and testing were performed with an augmented-reality laparoscopic simulator.

RESULTS 3 participants in each group did not complete the study. For group 1, scores for 3 of the 5 tasks were significantly worse when tested in the vertical plane than when tested in the horizontal plane. For group 2, scores for 2 of the 5 tasks were significantly worse when tested in the horizontal plane than when tested in the vertical plane. For 3 tasks, the difference in scores for the training versus orthogonal plane was significantly lower for group 2 than for group 1.

CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that basic laparoscopic skills acquired in 1 plane frequently did not transfer to the orthogonal plane. Because veterinary surgeons may be required to treat patients in various positions, development of laparoscopic training models to simulate the vertical plane is recommended.

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in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE To determine drug content (potency) of compounded doxycycline formulations for veterinary use and of US FDA–approved doxycycline formulations for human use < 24 hours after receipt (day 1) and after 21 days of storage under recommended conditions (day 21).

DESIGN Evaluation study.

SAMPLE FDA-approved doxycycline tablets (100 mg), capsules (100 mg), and liquid suspension (10 mg/mL) and compounded doxycycline formulations from 3 pharmacies (tablets [25, 100, and 150 mg; 1 product/source], chews [100 mg; 1 product/source], and liquid suspensions or solution [6 mg/mL {2 sources} and 50 mg/mL {1 source}]).

PROCEDURES Doxycycline content was measured in 5 samples of each tablet, chew, or capsule formulation and 5 replicates/bottle of liquid formulation on days 1 and 21 by liquid chromatography and compared with US Pharmacopeia acceptable ranges.

RESULTS All FDA-approved formulations had acceptable content on days 1 and 21. On day 1, mean doxycycline content for the 3 compounded tablet formulations was 89%, 98%, and 116% (3/5, 5/5, and 1/5 samples within acceptable ranges); day 21 content range was 86% to 112% (1/5, 5/5, and 4/5 samples within acceptable ranges). Day 1 content of chews was 81%, 78%, and 98% (0/5, 0/5, and 5/5 samples within acceptable ranges), and that of compounded liquids was 50%, 52%, and 85% (no results within acceptable ranges). No chews or compounded liquid formulations met USP standards on day 21.

CONCLUSIONS AND CLINICAL RELEVANCE FDA-approved doxycycline should be prescribed when possible. Whole tablets yielded the most consistent doxycycline content for compounded formulations.

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in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE To identify milk component alterations that might be useful for detecting cows with rumen indigestion.

DESIGN Prospective case-control study.

ANIMALS 23 Holstein cows with rumen indigestion (cases) and 33 healthy cohorts (controls) from 1 herd.

PROCEDURES Cases were defined as cows between 30 and 300 days postpartum with a > 10% decrease in milk yield for 2 consecutive milkings or > 20% decrease in milk yield from the 10-day rolling mean during any milking, abnormally decreased rumen motility, and no other abnormalities. Each case was matched with 2 healthy cows (controls) on the basis of pen, parity, days postpartum, and mean milk yield. Some cows were controls for multiple cases. All cows underwent a physical examination and collection of a rumen fluid sample for pH measurement at study enrollment. Individual-cow milk yield and milk component data were obtained for the 16 milkings before and after study enrollment. Rumen motility and pH and milk components were compared between cases and controls.

RESULTS Rumen motility for cases was decreased from that of controls. Cases had an abrupt increase in milk fat percentage and the milk fat-to-lactose ratio during the 2 milkings immediately before diagnosis of rumen indigestion. Receiver operating characteristic analyses revealed that a 10% increase in the milk fat-to-lactose ratio had the highest combined sensitivity (57%) and specificity (85%) for identifying cows with rumen indigestion.

CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that a positive deviation in the milk fat-to-lactose ratio might be useful for identifying cows with rumen indigestion.

Full access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE To assess rates of intraoperative complications and conversion to laparotomy associated with supervised veterinary students performing laparoscopic ovariectomy in dogs.

DESIGN Retrospective case series.

ANIMALS 161 female shelter dogs for which elective laparoscopic ovariectomy had been performed by supervised senior (fourth-year) veterinary students from 2010 through 2014.

PROCEDURES Medical records of all dogs were reviewed and data collected regarding duration of surgery, surgical complications and other characteristics, and whether conversion to laparotomy was required.

RESULTS Laparoscopic ovariectomy was performed with a 2-cannula technique and a 10-mm vessel-sealing device for hemostasis in all dogs. A Veress needle was used for initial insufflation in 144 (89.4%) dogs; method of insufflation was not reported for the remaining 17 (10.6%) dogs. Mean ± SD duration of surgery was 114.90 ± 33.40 minutes. Surgical complications, all classified as minor blood loss, occurred in 24 (14.9%) dogs. These included splenic puncture during insertion of the Veress needle (n = 20 [12.4%]) and minor bleeding from the ovarian pedicle (4 [2.5%]). Splenic puncture required no intervention, and ovarian pedicle bleeding required application of the vessel-sealing device an additional time to control the bleeding. Two ovaries were dropped in the abdominal cavity at the time of removal. Both were retrieved without complication. Conversion to laparotomy was not required for any dog. All dogs were discharged from the hospital within 24 hours after surgery.

CONCLUSIONS AND CLINICAL RELEVANCE Laparoscopic ovariectomy in dogs was performed safely by closely supervised novice surgeons, with only minor intraoperative complications encountered and no need for conversion to laparotomy.

Full access
in Journal of the American Veterinary Medical Association