New guidance for pets exposed to rabies
The Rabies Laboratory at the Kansas State Veterinary Diagnostic Laboratory offers the rapid fluorescent foci inhibition test for rabies-neutralizing antibodies in serum. Veterinary student Morgan Taylor (far left) fixes slides in acetone in a chemical fume hood checking the cell layer. At the workbench, research assistants Sami Pralle (foreground) and Beth McQuade stain fixed slides. (Photo by Tommy Theis/K-State Photo Services)
Citation: American Journal of Veterinary Research 77, 4; 10.2460/ajvr.77.4.328
New guidance in the March 1 issue of JAVMA advises that cats and dogs that are exposed to rabies and are overdue for a vaccine can have a booster shot followed by an observation period rather than be subject to quarantine or euthanasia.
The recommendation appears in the 2016 edition of the Compendium of Animal Rabies Prevention and Control (J Am Vet Med Assoc 2016;248:505–517) from the National Association of State Public Health Veterinarians, along with other updates from the 2011 edition. Dr. Catherine M. Brown, co-chair of the compendium committee, described the compendium as a series of best practices that jurisdictions can choose to follow.
The update pertaining to out-of-date vaccination status follows publication in the Jan. 15, 2015, issue of JAVMA of a report on “Comparison of anamnestic responses to rabies vaccination in dogs and cats with current and out-of-date vaccination status” (J Am Vet Med Assoc 2015;246:205–211). According to the abstract, “Results indicated that dogs with out-of-date vaccination status were not inferior in their antibody response following booster rabies vaccination, compared with dogs with current vaccination status.”
Pet owners are not always aware when their cat or dog has been exposed to rabies, unfortunately. Dr. Brown reemphasized the need to vaccinate. She said, “The best protection against rabies in both an individual animal and in the population is to have all of them currently vaccinated against rabies.”
Dr. Michael C. Moore and colleagues at Kansas State University authored the study on whether cats and dogs overdue for a vaccine respond as well to a booster as cats and dogs with current vaccination status do.
Between 2010 and 2014, the researchers obtained serum samples from a total of 74 dogs and 33 cats that, according to the study abstract, “had been exposed to rabies and brought to a veterinarian for proactive serologic monitoring or that had been brought to a veterinarian for booster rabies vaccination.”
Results: “All animals had an antirabies antibody titer ≥ 0.5 IU/mL 5 to 15 days after booster vaccination. Dogs with an out-of-date vaccination status had a higher median increase in titer, higher median fold increase in titer, and higher median titer following booster vaccination, compared with dogs with current vaccination status.”
According to the report, “Because of the small number of cats in the study and the fact that most cats … had a titer ≥ 12 IU/mL 5 to 15 days after booster vaccination, proportional hazards analysis could not be used to analyze the response to booster vaccination in cats with current versus out-of-date vaccination status.”
The authors concluded, “Findings supported immediate booster vaccination followed by observation for 45 days of dogs and cats with an out-of-date vaccination status that are exposed to rabies, as is the current practice for dogs and cats with current vaccination status.”
The 2016 edition of the compendium also advises reducing the quarantine period from six months to four for unvaccinated cats and dogs exposed to rabies. The compendium committee based the guidance on unpublished data from states that provided information on the incubation period for rabies in unvaccinated cats and dogs.
There are cases in the literature of animals developing rabies more than six months after exposure, Dr. Brown noted, but these are extraordinarily rare. She said the mean incubation period is about six weeks.
The 2016 edition of the compendium includes a recommendation “to collect and report at the national level additional data elements on rabid domestic animals.” Dr. Brown said the committee hopes that explicitly encouraging data collection and reporting will result in a better evidence base to improve the compendium in the future.
Condensed from March 1, 2016, JAVMA News
Editing animals
An international collection of researchers is creating and phenotyping 20,000 mouse strains with different genes turned off in hopes of identifying contributors to human disease.
Gene editing in agriculture has produced pigs and cattle resistant to particular diseases and dairy cows lacking horns, and it promises to produce chickens resistant to heat and beef herds in which only the more profitable male calves are born.
At a December 2015 International Summit on Human Gene Editing, presenters described potential uses of gene editing in humans to reduce pregnancy loss and disabilities, avoid transmission of genetic diseases, and control HIV. They also described the risks of off-target cleavage in gene editing, the complexity of genetics, the risks of introducing permanent changes to the human gene pool, and the potential that people could use the technology to not only enhance disease resistance but also amplify sensory perceptions or select for favored eye colors.
One recent technology, CRISPR-Cas9, is so efficient and specific that it is changing the outlook for gene editing.
A recent article (Curr Opin Virol 2015:12;85–90) indicates companies interested in using the technology for gene therapies have raised more than $600 million in venture capital and public markets since 2013, remarkable considering the first patent for use of CRISPR technology in eukaryotic cells was issued in April 2014.
How the technology will be regulated and how well editing will be accepted are uncertain, but those working with the technology see opportunities to advance medical science and reduce animal suffering.
Alison L. Van Eenennaam, PhD, center, and graduate student Lindsay Upperman hold Holstein cattle born with a gene edited so that they grow without horns, as is typical of Angus cattle. (Courtesy of Karin Higgins/University of California-Davis)
Citation: American Journal of Veterinary Research 77, 4; 10.2460/ajvr.77.4.328
Condensed from March 15, 2016, JAVMA News
Education council responds to feedback
The AVMA Council on Education continues to work toward re-recognition by the U.S. Department of Education as the accreditor of veterinary schools and colleges in the United States.
To satisfy USDE requirements, the COE made a more concerted push in 2015 to solicit feedback from stakeholders through a variety of avenues, such as hosting four listening sessions. The COE has compiled a report summarizing its analysis of and response to the feedback it received from stakeholders. The report is available at http://jav.ma/COEreport.
Meanwhile, the COE submitted its compliance report to the USDE in time for the Oct. 9, 2015, deadline, according to Dr. Karen Martens Brandt, director of the AVMA Education and Research Division. The COE will once again go before the USDE National Advisory Committee on Institutional Quality and Integrity, in June; the period for public comment prior to the meeting hadn't been announced as of press time. After the meeting, NACIQI's decision, along with the USDE staff analyst's recommendation, will be forwarded to the undersecretary of education, who will decide on continued COE recognition.
In other COE news, the council proposed revisions for Standard 3 (Physical Facilities and Equipment), Standard 4 (Clinical Resources), Standard 5 (Information Resources), and Standard 6 (Students) this year as part of its regular review of standards. COE members approved revisions to two other standards at its September 2015 meeting: Standard 10 (Research) and Standard 11 (Outcomes Assessments). Also, the COE voted this past July to reinstate Dr. Mary Beth Leininger of Lawrence, Kansas, to the council after a 17-month hiatus.
In response to a U.S. Department of Education directive, members of the AVMA Council on Education held four listening sessions in 2015. Here, COE members talk before the start of one Jan. 18, 2015, at the North American Veterinary Community Conference in Orlando, Florida.
Citation: American Journal of Veterinary Research 77, 4; 10.2460/ajvr.77.4.328
Condensed from March 15, 2016, JAVMA News
DeHaven to retire as AVMA CEO
Dr. Ron DeHaven will retire this summer after nine years as the AVMA's executive vice president and CEO.
While a specific retirement date has not been set, Dr. DeHaven will likely remain at the AVMA's helm until shortly after the Association's annual convention in San Antonio this August.
Dr. Ron DeHaven
Citation: American Journal of Veterinary Research 77, 4; 10.2460/ajvr.77.4.328
“The Board of Directors respectfully acknowledges Dr. DeHaven's announcement of retirement and is grateful for the many years of dedicated service that he has brought to the AVMA,” said AVMA Board Chair John de Jong. “Ron's retirement creates an opportunity for the board to select a new CEO to continue the excellent work that he has started.”
Dr. DeHaven (Purdue ’75) joined the AVMA staff in August 2007 after 28 years of service with the Department of Agriculture's Animal and Plant Health Inspection Service, most recently as administrator.
“When I came to the AVMA, I joined what is an amazing staff guided by committed, talented volunteer leadership that gives their all to our members, our association, and our profession,” he said. “There is much left to do, and I will be fully committed in my role at the AVMA over the next several months. The profession, our staff, and the members I serve deserve nothing less.”
AVMA President Joe Kinnarney said, “On behalf of the entire membership, I would like to thank Dr. DeHaven for his dedication to the AVMA and bringing us to the next level. The result of his leadership for the past eight years has been a stronger, more member-focused AVMA.”
Condensed from March 1, 2016, JAVMA News
AVMA revises policy on feral cats to encourage collaboration
The AVMA has revised its policy on “Free-roaming Abandoned and Feral Cats” to encourage collaboration among veterinarians, humane groups, and wildlife conservation entities “to reduce the number of free-roaming abandoned and feral cats in a humane and ethical manner.”
More specifically, the policy “encourages collaborative efforts to identify humane and effective alternatives to the destruction of healthy cats for animal control purposes, while minimizing their negative impact on native wildlife and public health.”
The AVMA House of Delegates adopted revisions to the policy during its regular winter session, Jan. 9 in Chicago, after debating two contentious points regarding managed colonies of free-roaming cats. The first is the addition of a statement that the AVMA does not oppose euthanasia for colonies not achieving attrition and posing active threats to the area. The second is the absence of mention of enclosures for management of colonies.
The AVMA Animal Welfare Committee reviewed the policy on free-roaming cats in accordance with the five-year review cycle. According to background, the committee “believed the policy could be revised to reflect new information, help build consensus, and provide leadership per the management of free-roaming unowned cats.”
The committee collaborated with the AVMA Committee on Environmental Issues and the AVMA Council on Public Health and Regulatory Veterinary Medicine over a period of two years to update the policy. The revisions expanded all four sections of the policy: “Education,” “Encouragement of State and Local Ordinances,” “Non-lethal Strategies” (previously “Managed Cat Colonies”), and “Research.”
The policy is available at www.avma.org/policy.
Condensed from March 1, 2016, JAVMA News
Renal guidelines a fluid resource
As common as kidney disease is in companion animal practice, many practitioners in the U.S. may not be aware there are guidelines on diagnosing and treating it.
Dr. Larry D. Cowgill, who sits on the board of the International Renal Interest Society, said that though the IRIS guidelines have been adopted in the scientific literature, their degree of recognition in general practice is not known.
The guidelines, posted at www.iris-kidney.com, comprise the IRIS statement on Staging of Chronic Kidney Disease, IRIS Treatment Recommendations for CKD, guidelines on Grading of Acute Kidney Injury, and consensus recommendations for Treatment of Canine Proteinuric Kidney Disease.
Each year, the board reviews the guidelines and bases any revisions on clinical evidence in the published literature.
There were three revisions in 2014 and 2015. The first involved making the terms designating arterial blood pressure more descriptive. In the second change, IRIS recommended that patients with IRIS stage 1 chronic kidney disease and persistent proteinuria not only be monitored and thoroughly examined but also receive standard treatment for proteinuria.
Conditional addition of symmetric dimethylarginine as a renal biomarker to the staging guidelines was the third change. Idexx Laboratories developed an assay for measuring SDMA concentration in serum or plasma. Last July, its reference laboratories began including this test with all chemistry panels, at no additional charge.
Dr. Cowgill said new information suggested SDMA might be an adjunct or serve a complementary role to serum creatinine.
The ultimate question is whether the SDMA test will improve clinical outcomes.
Condensed from March 15, 2016, JAVMA News
Bain receives Bustad award for human-animal bond research
Dr. Melissa Bain has devoted her veterinary career to enhancing the human-animal bond through research on companion animal behavior problems, enrichment for shelter animals, and the effects of various training methods on dog behavior.
In recognition of her efforts, Dr. Bain received the 2016 Bustad Companion Animal Veterinarian of the Year Award on Jan. 7 during the AVMA Veterinary Leadership Conference in Chicago.
“I love nurturing the relationships between people and their pets,” Dr. Bain said later. She oversees the Clinical Behavior Service at the University of California-Davis School of Veterinary Medicine, where she is also director of professional student clinical education.
“Understanding an owner's struggles when faced with their pet's behavior issues and helping them find a way to live a happier, healthier life together is extremely gratifying,” she added. “It is heartbreaking to see a well-loved pet euthanized or relinquished to a shelter due to behavior issues.”
Dr. Melissa Bain
Citation: American Journal of Veterinary Research 77, 4; 10.2460/ajvr.77.4.328
Named for the late Dr. Leo K. Bustad, the Bustad Companion Animal Veterinarian of the Year Award recognizes the outstanding work of veterinarians in preserving and protecting human-animal relationships. The AVMA, the American Veterinary Medical Foundation, and Pet Partners sponsor the award.
Dr. Bain (Illinois ’94) was nominated by colleague and mentor Dr. Benjamin L. Hart, distinguished professor emeritus at the UC-Davis School of Veterinary Medicine.
“Dr. Bain is an unquestionable leader in integrating the essence of the field of human-animal interactions—in all its ramifications—with veterinary clinical behavior, animal welfare, and the mental health of veterinarians,” Dr. Hart said.
Condensed from March 1, 2016, JAVMA News
Analysis finds veterinary prices flat for 2009 to mid-2015
Prices for canine veterinary services were flat from 2009 through June 2015, at least on invoices submitted by policyholders with Nationwide pet health insurance.
Nationwide, formerly known as Veterinary Pet Insurance, and Purdue University Krannert School of Management introduced the Nationwide-Purdue Veterinary Price Index in January 2015 at the North American Veterinary Community Conference. Updates were announced in July 2015 at the AVMA Annual Convention and in January 2016 at the NAVC Conference. The index now draws on data from more than 6 million claims.
The initial analysis “revealed a widening gap not only between the Veterinary Price Index and general perception of price hikes, but also between the Veterinary Index and federal reports that showed veterinary pricing increasing faster than the rate of overall consumer inflation,” according to a summary in the January 2016 report.
Policyholders with Nationwide pay their veterinarian, then submit invoices for reimbursement of covered services. Purdue economists analyze prices for common treatments, weighting the index by services purchased in 2013—when about 25 percent of spending in the data set for canine veterinary services was on wellness care, such as physical examinations, and 75 percent was on other medical care, such as treatment for otitis externa.
Prices for canine veterinary services increased just 0.1 percent from 2009 through June 2015, while the consumer price index increased 12.2 percent. Prices for canine wellness care increased 12.9 percent, but prices for canine medical care decreased 3.3 percent.
Reports on the Nationwide-Purdue Veterinary Price Index are at www.nationwidedvm.com/studies-and-research.
Condensed from March 15, 2016, JAVMA News
AVMA giving help on veterinary feed directives
Veterinarians who want help filing veterinary feed directives can use a model form and instructions provided by the AVMA.
The Association published the model form in January, and it is available to members at http://jav.ma/avmavfd.
And separate general descriptions of information needed in a VFD are available at http://jav.ma/vfdinstructions.
Food and Drug Administration officials have forecast expanded use of VFDs, which are similar to prescriptions, as pharmaceutical companies agree to eliminate over-the-counter availability of many feed- and water-use antimicrobials by December 2016. The change will require veterinarian oversight of antimicrobials in drug classes considered important to human medicine.
Affected antimicrobials administered in water will be available only by prescription, whereas feed-administered products will be available by prescription or VFD.
From March 15, 2016, JAVMA News
Education council schedules site visits
The AVMA Council on Education has scheduled site visits to four schools and colleges of veterinary medicine for the remainder of 2016.
Comprehensive site visits are planned for the Murdoch University School of Veterinary and Biomedical Sciences in Western Australia, July 10–15, and the University of Pennsylvania School of Veterinary Medicine, Dec. 4–8. Consultative site visits are scheduled for the University of Bristol School of Veterinary Sciences in the U.K., Oct. 16–20, and the University of Cambridge Department of Veterinary Medicine in the U.K., Nov. 6–10.
The council welcomes written comments on these plans or the programs to be evaluated. Comments should be addressed to Dr. Karen Martens Brandt, Director, Education and Research Division, AVMA, 1931 N. Meacham Road, Suite 100, Schaumburg, IL 60173. Comments must be signed by the person submitting them to be considered.
From April 15, 2016, JAVMA News
House of Delegates will reach out to AVMA members by email
Representatives of state VMAs in the AVMA House of Delegates soon will be reaching out to AVMA members by email.
During the regular winter session of the House, Jan. 9 in Chicago, delegates adopted a resolution recommending that the AVMA Board of Directors establish a system to allow direct, two-way communication via email between representatives of state VMAs and the AVMA members residing in the respective states. The House Advisory Committee submitted the resolution, and the Board had recommended approval.
The resolution was a response to concerns that because not all AVMA members are also members of their state VMAs, representatives of state VMAs in the House might not be reaching all AVMA members in their state.
The statement about the resolution indicates that the intent is to increase communication between AVMA members and their AVMA representatives, facilitate scanning for professional issues by delegates, and allow for immediate and direct communication from AVMA members to AVMA leadership.
The plan is for delegates of state VMAs to email AVMA members in the respective states up to twice per year with information relevant to AVMA and the state association. In addition, after the regular winter session of the House and the regular annual session every summer, the AVMA will send special editions of the AVMA@Work electronic newsletter to provide session summaries along with email addresses for members' state VMA and Board representatives.
From March 1, 2016, JAVMA News
