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  • Author or Editor: Christopher M. Fulkerson x
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Abstract

OBJECTIVE

To assess the impact of prophylactic omeprazole and famotidine on the incidence and severity of gastrointestinal (GI) adverse events (AEs) in dogs with cancer treated with single agent piroxicam.

ANIMALS

39 dogs with a cytologic or histologic diagnosis of cancer with no history of GI disease and received piroxicam.

PROCEDURES

A prospective, randomized, placebo-controlled, double-blinded clinical trial was performed. All dogs received piroxicam (0.3 mg/kg [0.14 mg/lb], PO, q 24 h) and either omeprazole (1 mg/kg [0.45 mg/lb], PO, q 12 h), famoti-dine (1 mg/kg, PO, q 12 h), or placebo (lactose; PO, q 12 h). Monthly assessments of GI AEs were performed and scored by using the Veterinary Comparative Oncology Group's Common Terminology Criteria for Adverse Events (version 1.1).

RESULTS

Compared with dogs in the placebo group, more dogs in the omeprazole group (84.6% vs 36.4%) and famotidine group (80.0% vs 36.4%) experienced GI AEs by day 56. The severity of GI AEs was higher in the omeprazole group, compared with the placebo group.

CONCLUSIONS AND CLINICAL RELEVANCE

Omeprazole was not helpful in reducing the frequency or severity of GI AEs and was associated with more frequent and severer GI AEs in dogs with cancer treated with single agent piroxicam. Proton-pump inhibitors and H2-receptor antagonists should not be prescribed as prophylaxis with NSAIDs for dogs with cancer. (J Am Vet Med Assoc 2021;259:385-391)

Full access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

Chemotherapy is widely used in veterinary oncology but carries real and perceived risks of adverse events (AEs). Human cancer patients perceive AEs from chemotherapy as more severe than do their attending physicians. It is currently unknown whether this discrepancy exists in veterinary oncology. This survey study’s aim was to assess differences in the ways that pet owners and veterinary oncologists perceive chemotherapy-related AEs. We hypothesized that veterinary oncologists would accept higher grade AEs and tolerate a greater risk of AEs of any grade than pet owners.

SAMPLE

152 pet owners and 111 veterinary oncologists.

METHODS

Separate surveys were derived for pet owners and veterinary oncologists. Respondents were asked to define maximally acceptable AE scores and risks of AEs given 3 hypothetical outcomes of treatment: (1) cure, (2) extension of life, and (3) improved quality of life. Statistical tests were used to compare responses between groups.

RESULTS

Veterinary oncologists accepted higher grade AEs if the hypothetical goal of chemotherapy was cancer cure (P = .003) or extension of life (P = .026), but owners accepted higher grade AEs if the goal of chemotherapy was to improve quality of life (P = .002). Owners accepted greater risk of moderate (P < .0001) or serious (P < .0001) AEs across the 3 treatment outcomes.

CLINICAL RELEVANCE

This was the first study to assess how pet owners and veterinary oncologists differ in their perception of chemotherapy-related AEs. These initial results may help to frame discussions with pet owners on the expectations of chemotherapy.

Restricted access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

An acceptance and commitment training (ACT) educational program targeting reaction to difficult client interactions recently demonstrated efficacy in reducing burden transfer, stress, and burnout in veterinary healthcare teams. The current noninferiority trial compared effectiveness of the original program with a self-paced version.

SAMPLE

Employees of 2 corporate veterinary groups were randomized to live (n = 128) or self-paced (124) conditions. The workshop and assessments were completed by 137 (55 live and 82 self-paced).

PROCEDURES

Asynchronous modules containing the same content as the original program were placed on in-house veterinary clinic learning systems. Participants of this parallel arms trial completed pretest measures of burden transfer, stress, and burnout. Following assessment, the 3-week ACT program was delivered via videoconferencing (live) or asynchronous modules (self-paced). At post-test and 1-month follow-up, measures were repeated, with added assessment of knowledge, helpfulness ratings, and usage of techniques. A subset (n = 33) of participants repeated measures 9 to 12 months as an extended follow-up.

RESULTS

Program helpfulness was rated more highly by live versus self-paced participants. Self-paced showed better program retention. No differences in knowledge or use of program techniques (> 5 times daily) emerged. Relative to pretest, both conditions showed reduced burden transfer, stress, and burnout at post-test and follow-up; no differences by condition emerged. Participants completing extended follow-up maintained improvement from baseline.

CLINICAL RELEVANCE

Findings suggest a learning system–based version of this program can improve occupational distress in veterinary healthcare teams, with gains maintained over time. The flexibility of this format promotes program completion and allows broader dissemination.

Open access
in Journal of the American Veterinary Medical Association