Objective—To evaluate the present and future supply
of veterinarians in California, in light of changing
trends in animal ownership.
Sample Population—Human and animal populations,
including populations of veterinarians, throughout
the United States.
Procedures—Data on animal and human populations
were compiled from a number of sources, including
the US Census Bureau, American Veterinary Medical
Association, State of California Department of
Finance, and State of California Veterinary Medical
Board. The distribution of veterinarians in California
was contrasted with other health professionals in
California and with that of veterinarians in other
states. Recent changes in veterinary medical demographics
in California were quantified and used to
develop in-state projections about the supply of veterinarians
for the next 20 years.
Results—Although California is the most populous of
the 50 states, only 7 states had fewer veterinarians
per capita. Furthermore, California ranked next to last
among states in increase of number of veterinarians
between 1990 and 1995. Los Angeles County had the
smallest per-capita number of veterinarians among 9
populous California counties. During that period,
California had a net gain of only 6 veterinarians who
were exclusively or predominantly large-animal or
Conclusions and Clinical Relevance—If current
trends continue, the per-capita number of veterinarians
will continue to decrease in California. To maintain
the current ratio of 17.8 veterinarians/100,000 people in
California in the future, we estimate that an additional
50 veterinarians above the currently predicted increase
will be required annually. (J Am Vet Med Assoc 2000;216:1753–1757)
Objective—To determine prevalence of initial clinical
signs and risk factors for acquired myasthenia gravis
(MG) in cats.
Design—Retrospective case-control study.
Animals—105 cats from the United States, Canada,
and the United Kingdom with a confirmed diagnosis
of acquired MG and 510 cats with other neuromuscular
disorders, including generalized weakness,
megaesophagus, and dysphagia (control group).
Procedures—Records were retrieved from a database
containing results of serum samples tested for
acetylcholine receptor antibodies. Signalment, including
breed, age, and state or country of origin, month
of onset, and initial clinical signs were obtained. An
acetylcholine receptor antibody titer > 0.3 nmol/L was
diagnostic for acquired MG. Unconditional logistic
regression was used for statistical analysis.
Results—Compared with mixed-breed cats, the
breed with the highest relative risk of acquired MG
was the Abyssinian (including Somali). Significant differences
between sexes were not detected. There
was no compelling evidence for a difference in risk of
developing MG between states or countries. Relative
risk increased after 3 years of age. The most common
clinical signs were generalized weakness without
megaesophagus and weakness associated with a cranial
mediastinal mass. Focal signs, including megaesophagus
and dysphagia without signs of generalized
weakness, were also evident.
Conclusions and Clinical Relevance—A breed predisposition
for acquired MG in Abyssinians (and related
Somalis) was observed. Clinical signs were variable
and included generalized weakness, megaesophagus,
and dysphagia. A cranial mediastinal
mass was commonly associated with MG in cats. ( J
Am Vet Med Assoc 2000;216:55–57)
Objective—To quantify incidence of vaccination practices,
postvaccinal reactions, and vaccine site-associated
sarcomas in cats.
Animals—31,671 cats vaccinated in the United
States and Canada by veterinarians with World Wide
Procedure—Veterinarians used secure Web-based
survey forms to report data regarding administered
vaccines, postvaccinal inflammatory reactions, vaccine
site-associated sarcomas, and detailed information
and history on each sarcoma. Data were collected
from Jan 1, 1998 to Dec 31, 2000, allowing a 1- to
3-year follow-up of vaccinated cats.
Results—Participants reported administering 61,747
doses of vaccine to 31,671 cats; postvaccinal inflammatory
reactions developed in 73 cats (11.8 reactions/
10,000 vaccine doses), and qualifying vaccine
site-associated sarcomas developed in 2 cats (0.63
sarcomas/10,000 cats; 0.32 sarcomas/10,000 doses
of all vaccines).
Conclusions and Clinical Relevance—These findings
indicate that the incidence of vaccine site-associated
sarcomas is low and is not increasing.
Thoughtful consideration of the relative risks and benefits
of specific vaccines remains the best means of
reducing the incidence of sarcomas. It is not necessary
to remove postvaccinal granulomas unless
malignant behavior is apparent or they persist > 4
months. (J Am Vet Med Assoc 2002;220:1477–1482)
Objective—To determine reference values, intertest correlations, and test-retest repeatability of Schirmer tear test 1 (STT-1), phenol red thread test (PRTT), tear film breakup time (TFBUT), tear osmolarity, and meibometry in healthy cats.
Animals—135 healthy domestic cats aged 0.5 to 12.8 years.
Procedures—Each test was performed once in 120 cats and repeated in 40. Pearson correlation was used to assess correlation among tests. Intraclass correlation coefficients (ICCs) and 95% limits of agreement (LOA) were used to evaluate test-retest repeatability.
Results—Median (95% central range) values were 18 mm/min (9 to 34 mm/min) for STT-1, 29 mm/15 s (15 to 37 mm/15 s) for PRTT, 12.4 seconds (9.1 to 17.7 seconds) for TFBUT, 322 mOsm/L (297 to 364 mOsm/L) for osmolarity, and 32 meibometry units (MU; 11 to 114 MU) for peak meibometry value. The STT-1 and PRTT values were positively correlated. Age was weakly associated with TFBUT and osmolarity. Meibometry measurements were higher for strips that contacted the tear film (285 MU) than for those that touched the eyelid margin only (32 MU). All ICCs were < 0.75, and 95% LOA were wide.
Conclusions and Clinical Relevance—Tear deficiency should be suspected in cats with STT-1 < 9 mm/min, PRTT < 15 mm/15 s, or TFBUT < 9 to 10 seconds. Generally poor correlation among tests suggested that thorough tear film analysis requires performance of multiple tests in concert. Relatively poor test-retest repeatability should be considered when repeated tests are used to monitor tear film dysfunction and response to treatment.
Objective—To evaluate results of root canal treatment
Sample Population—127 tooth roots in 64 dogs.
Procedure—Radiographs obtained before surgery,
immediately after surgery, and during follow-up
examinations after surgery were evaluated by 2 individuals.
Treatment was considered successful if the
periodontal ligament space was normal and possible
preoperative root resorption, if present, had ceased.
Treatment was considered to show no evidence of
failure if possible preoperative root resorption had
ceased but a preexisting periapical lesion had
remained the same or only decreased in size and not
complete resolved. Treatment was considered to
have failed if a periapical lesion or root resorption
developed subsequent to endodontic treatment, if a
preexisting periapical lesion had increased in size, or
if possible preoperative root resorption appeared to
continue after endodontic treatment.
Results—Follow-up time ranged from 1 to 60 months
(mean, 13 months). Treatment was classified as successful
for 87 (69%) roots, as showing no evidence of
failure for 33 (26%) roots, and as having failed for 7
(6%) roots. The success rate was lower for canine
teeth than for maxillary fourth premolar teeth. Roots
with a preexisting periapical lucency or preexisting
root resorption had lower success rates. The use of
intracanal medication and the method and quality of
obturation were not associated with outcome.
Conclusions and Clinical Relevance—Results suggest
that root canal treatment offers a viable option
for salvage of periodontally sound but endodontically
diseased teeth in dogs. (J Am Vet Med Assoc
Objective—To compare clinical, microbiologic, and clinicopathologic findings among horses infected with Clostridium difficile that had toxin A in their feces, horses with evidence of C difficile infection that were negative for toxin A in their feces, and horses with diarrhea that were negative for C difficile infection.
Animals—292 horses and foals with diarrhea.
Procedures—Feces were submitted for microbial culture and tested for the C difficile antigen glutamate dehydrogenase and for toxin A with a commercial ELISA.
Results—Horses with toxin A in their feces had higher band neutrophil count, rectal temperature, hospitalization time prior to the onset of diarrhea, and total hospitalization time than did horses without evidence of C difficile infection, and 32 of the 33 (97%) horses with toxin A in their feces had received antimicrobials prior to the onset of diarrhea. Horses with toxin A in their feces had a significantly higher mortality rate than did horses negative for toxin A in their feces. Sensitivity and specificity of the ELISA for detection of C difficile antigen were 93% and 88%, when assay results were compared with results of microbial culture following direct plating, and 66% and 93%, when assay results were compared with results of microbial culture following broth enrichment.
Conclusions and Clinical Relevance—Results provided some evidence that horses positive for toxin A had more severe clinical disease than did horses with evidence of C difficile infection that were negative for toxin A and horses with diarrhea without evidence of C difficile infection.
OBJECTIVE To determine small animal veterinarians’ opinions and actions regarding costs of care, obstacles to client education about veterinary care costs, and effects of economic limitations on patient care and outcome and professional career satisfaction and burnout.
DESIGN Cross-sectional survey.
SAMPLE 1,122 small animal practitioners in the United States and Canada.
PROCEDURES An online survey was sent to 37,036 veterinarians. Respondents provided information regarding perceived effects of client awareness of costs and pet health insurance coverage on various aspects of practice, the influence of client economic limitations on professional satisfaction and burnout, and proposals for addressing those effects.
RESULTS The majority (620/1,088 [57%]) of respondents indicated that client economic limitations affected their ability to provide the desired care for their patients on a daily basis. Approximately half (527/1,071 [49%]) of respondents reported a moderate-to-substantial level of burnout, and many cited client economic limitations as an important contributing factor to burnout. Only 31% and 23% of respondents routinely discussed veterinary costs and pet insurance, respectively, with clients before pets became ill, and lack of time was cited as a reason for forgoing those discussions. Most respondents felt improved client awareness of veterinary costs and pet health insurance would positively affect patient care and client and veterinarian satisfaction.
CONCLUSIONS AND CLINICAL RELEVANCE Results suggested most small animal practitioners believe the veterinary profession needs to take action at educational and organizational levels to inform pet owners and educate and train veterinary students and veterinarians about the costs of veterinary care.
Objective—To determine the effects of stress in cats with feline idiopathic cystitis (FIC) by evaluating bladder permeability, sympathetic nervous system function, and urine cortisol:creatinine (C:Cr) ratios during periods of stress and after environmental enrichment.
Animals—13 cats with FIC and 12 healthy cats.
Procedure—Cats subjected to an acute-onset moderate stressor for 8 days received IV injections of fluorescein. Serum fluorescein concentrations were determined and compared with those of controls to evaluate bladder permeability, and urine C:Cr ratios were compared to evaluate function of the hypothalamic-pituitary-adrenal (HPA) axis. Plasma catecholamine concentrations were analyzed in a subset of cats. After 8 days of moderate stress, cats were moved to an enriched environment, and tests were repeated after 21 days.
Results—Serum fluorescein concentrations were significantly higher in cats with FIC at all time points. In the cats in which plasma catecholamine concentrations were determined, concentrations of dihydroxyphenylalanine, norepinephrine, and dihyroxyphenylglycol were significantly higher in cats with FIC at all time points, whereas no differences in urine C:Cr ratio between groups were observed.
Conclusion and Clinical Relevance—Cats with FIC appeared to have altered bladder permeability, most notably during the period of initial stress. The increase in plasma dihydroxyphenylalanine concentration suggests that there may be stress-induced increase in the activity of tyrosine hydroxylase, which catalyzes the rate-limiting step in catecholamine synthesis. In contrast, no effects of stress on C:Cr ratios were observed, which suggests there was dissociation between the sympathetic nervous system and HPA-axis responses to stress.
Objective—To examine the effects of orally administered
L-lysine on clinical signs of feline herpesvirus
type 1 (FHV-1) infection and ocular shedding of FHV-1
in latently infected cats.
Animals—14 young adult, FHV-1-naive cats.
Procedure—Five months after primary conjunctival
inoculation with FHV-1, cats were rehoused and
assigned to receive 400 mg of L-lysine in food once
daily for 30 days or food only. On day 15, all cats
received methylprednisolone to induce viral reactivation.
Clinical signs of infection were graded, and viral
shedding was assessed by a polymerase chain reaction
assay throughout our study. Peak and trough plasma
amino acid concentrations were assessed on day
Results—Fewer cats and eyes were affected by conjunctivitis,
and onset of clinical signs of infection was
delayed on average by 7 days in cats receiving
L-lysine, compared with cats in the control group;
however, significant differences between groups
were not demonstrated. Significantly fewer viral
shedding episodes were identified in the treatment
group cats, compared with the control group cats,
after rehousing but not following corticosteroidinduced
viral reactivation. Mean plasma L-lysine concentration
was significantly increased at 3 hours but
not at 24 hours after L-lysine administration. Plasma
arginine concentration was not significantly altered.
Conclusion and Clinical Relevance—Once daily
oral administration of 400 mg of L-lysine to cats latently
infected with FHV-1 was associated with reduced
viral shedding following changes in housing and husbandry
but not following corticosteroid administration.
This dose caused a significant but short-term increase
in plasma L-lysine concentration without altering plasma
arginine concentration or inducing adverse clinical
effects. (Am J Vet Res 2003;64:37–42)
Objective—To evaluate areas of articular contact of
the proximal portions of the radius and ulna in normal
elbow joints of dogs and the effects of axial load on
size and location of these areas.
Sample Population—Forelimbs obtained from
cadavers of 5 adult mixed-breed dogs.
Procedure—After forelimbs were removed, liquidphase
polymethyl methacrylate was applied to articular
surfaces of the elbow joint, and limbs were axially
loaded. Articular regions void of casting material were
stained with water-soluble paint. Relative articular contact
areas were determined by computer-assisted
image analyses of stained specimens. Repeatability of
the technique was evaluated by analyses of casts from
bilateral forelimbs of 1 cadaver. Incremental axial loads
were applied to left forelimbs from 4 cadavers to
determine effects of load on articular contact.
Results—Specific areas of articular contact were
identified on the radius, the craniolateral aspect of the
anconeus, and the medial coronoid process. The
medial coronoid and radial contact areas were continuous
across the radioulnar articulation. There was no
articular contact of the medial aspect of the anconeus
with the central trochlear notch. Coefficients of variation
of contact areas between repeated tests and
between contralateral limbs was < 20%. Significant
overall effects of axial load on contact area or location
were not identified.
Conclusions—Three distinct contact areas were evident
in the elbow joint of dogs. Two ulnar contact
areas were detected, suggesting there may be physiologic
incongruity of the humeroulnar joint. There
was no evidence of surface incongruity between the
medial edge of the radial head and the lateral edge of
the medial coronoid process. (Am J Vet Res 2000;61: