JAVMA News Digest

JAVMA NEWS DIGEST provides a selection of articles, mostly condensed from JAVMA News. The complete articles are available at avma.org/JAVMANews.

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Dr. Ed Breitschwerdt, a professor of internal medicine and Bartonella researcher at North Carolina State University College of Veterinary Medicine, works with students and researchers at the Intracellular Pathogens Research Laboratory. (Courtesy of Idexx Laboratories)

Citation: American Journal of Veterinary Research 82, 7; 10.2460/ajvr.82.7.520

Bartonellosis: A zoonosis hidden in plain sight

Dr. Hilary Lucero always had seasonal allergies, but now it seemed like her hay fever had gone haywire.

It was spring 2018, and Dr. Lucero, a small animal veterinarian in Arizona, had symptoms of skin flushing, shortness of breath, heart racing, and eyelid swelling. After seeing multiple doctors, she suspected the underlying cause might be Bartonella infection. She was tested and had detectable titers of antibodies against two Bartonella species.

Dr. Lucero improved with treatment but got worse midway through and needed a few rounds of intravenous antimicrobials. She later suspected that she might also have been infected with Babesia, a tick-borne parasite, and tested positive. With additional treatment, she now feels almost completely recovered.

Veterinarians can and do contract many zoonoses from their animal patients, including bartonellosis—particularly cat scratch fever caused by B henselae, carried by cats and cat fleas. A study published in 2014 in the journal Vector-Borne and Zoonotic Diseases found DNA from at least one Bartonella species in 28% of 114 veterinarians and veterinary technicians.

According to the 2019 AAFP Feline Zoonoses Guidelines from the American Association of Feline Practitioners: “It is known that Bartonella species (particularly Bartonella henselae), the cause of cat scratch disease, peliosis hepatis, bacillary angiomatosis, bacterial endocarditis and a number of other human inflammatory syndromes such as polyarthritis, are present in the oral cavity, on the skin and on the claws of cats with Ctenocephalides felis infestations. Veterinary healthcare providers may be at greater risk of development of Bartonella species–associated syndromes from exposure to cats or infected C felis.”

Also according to the guidelines, “Currently, no drugs can consistently eliminate the Bartonella species carrier state from healthy cats and antibiotics like azithromycin can rapidly select for resistant strains.” The guidelines continue, “However, in some circumstances the veterinarian and physician may choose to test cats in contact with immunosuppressed people in a family or those with clinical manifestations of bartonellosis.”

Dr. Ed Breitschwerdt, a professor of internal medicine at North Carolina State University College of Veterinary Medicine, devotes much of his research to Bartonella species and bartonellosis in animals and humans, and he was an author of the 2014 study in Vector-Borne and Zoonotic Diseases. He co-founded Galaxy Diagnostics to offer Bartonella testing for humans and animals, with the tests for cats and dogs also available through a partnership with Idexx Laboratories.

Among the types of bartonellosis in humans, veterinarians and nonveterinarians alike most frequently develop cat scratch disease, which is definitively associated only with B henselae, Dr. Breitschwerdt said.

“Veterinarians are the canaries in the coal mine by which physicians will ultimately understand human bartonellosis,” he said.

In terms of prevention, he said, veterinarians should realize that Bartonella can infect almost every cell, so veterinarians could become infected if they cut themselves while performing surgery on a liver or are exposed to pathological effusions or other body fluids.

Avoiding bites and scratches is a recognized method for preventing Bartonella infection but is not always possible. Dr. Breitschwerdt advises veterinarians to wash out any bite or scratch immediately and preferably record in a personal medical record that a bite or scratch has occurred so they don't forget about it if they develop symptoms later.

Condensed from June 1, 2021, JAVMA News

FINDING THE SPREADERS OF CHRONIC WASTING DISEASE

A 5-millimeter section cut from a deer or elk ear can contain evidence of whether the animal is afflicted by a fatal contagious disease, according to one recent study.

Paired with an amplification assay that is more sensitive than tests typically used by animal health diagnostic laboratories, those small samples could make it easier to identify deer, elk, and moose with chronic wasting disease.

Research teams are working to improve tests used to find pathologic prions in live animals and carcasses, track animal movements and interactions related to CWD, and advance our understanding of the roles soil and plants have in disease transmission. As state wildlife departments better understand where the disease exists and its prevalence among wild and farmed herds, they hope to find ways to slow its spread.

CWD is an always-fatal neurologic disease of deer that is spread through saliva, urine, feces, and contaminated plants and soil. Affected animals are present in at least 26 U.S. states and three Canadian provinces.

The America's Conservation Enhancement Act, which became law in October 2020, calls for creation of a federal CWD task force within the U.S. Fish and Wildlife Service, with participation from the Department of Agriculture Animal and Plant Health Inspection Service and the U.S. Geological Survey. The law directs the task force to create and enact an interstate action plan for federal agencies, local governments, and the farmed cervid industry.

Condensed from June 15, 2021, JAVMA News

AVMA ANIMAL HEALTH STUDIES DATABASE REACHES 5 YEARS, 500 LISTINGS

Pet owners who enroll their pet in a clinical trial have a really special perspective, said Dr. Sarah Moore, curator of neurological studies for the AVMA Animal Health Studies Database.

“Most people who are interested in having their pet participate in veterinary clinical research do so because of a shared interest in getting the best care possible for their pet combined with a drive to help contribute to advancements that may help make future care better for other pets with the same disease,” said Dr. Moore, a professor of canine clinical and comparative medicine at The Ohio State University and director of the university's Blue Buffalo Veterinary Clinical Trials Office.

The AVMA Animal Health Studies Database, online at avma.org/findvetstudies, connects veterinary researchers recruiting for clinical trials with veterinarians and animal owners. In June, the AAHSD marked the fifth anniversary of its launch. The AAHSD also recently surpassed 500 listings of clinical trials.

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Dr. Jessica Quimby examines Beast's abdomen. Beast is participating in a clinical trial at The Ohio State University looking at the impact of diet on kidney disease. (Courtesy of The Ohio State University)

Citation: American Journal of Veterinary Research 82, 7; 10.2460/ajvr.82.7.520

As of mid-April, the breakdown of studies by species was 436 studies involving dogs, 66 involving cats, 17 involving horses, four involving agricultural animals, and five involving exotic animals. The preponderance of studies were in the following fields: 267 in oncology, 80 in internal medicine, 38 in neurology or neurosurgery, 29 in orthopedics, and 19 in cardiology.

Go to jav.ma/clinicaltrials to see a gallery of photos of patients participating in veterinary clinical trials at The Ohio State University. A 2019 paper in Topics in Companion Animal Medicine describes the AAHSD in detail and is available at jav.ma/aahsd.

Condensed from June 1, 2021, JAVMA News

ONLINE TOOL RANKS ZOONOTIC THREAT POTENTIAL

A new online risk assessment tool developed by infectious disease scientists evaluates wildlife viruses to estimate their zoonotic spillover and pandemic potential.

The tool, SpillOver, is an open-source watchlist of newly discovered viruses ranked according to their threat potential. It's meant to help policymakers and scientists prioritize viruses for further characterization, surveillance, and risk-reducing interventions.

Developed by scientists at the University of California-Davis, with contributions from researchers around the world, SpillOver is linked to a study published in the Proceedings of the National Academy of Sciences.

The authors identified the most relevant viral, host, and environmental risk factors for virus spillover.

The authors then ranked the risks associated with 887 wildlife viruses, using data collected from a variety of sources, including information on viruses detected by the U.S. Agency for International Development's Emerging Pandemic Threats project called Predict, which UC-Davis' One Health Institute led from 2009-20.

Topping the list of wildlife viruses were 12 known human pathogens, which was expected and validates the tool's utility, the study stated. Notably, SpillOver ranked several newly discovered coronaviruses as having a higher risk for spillover than some viruses already known to be zoonotic. The watchlist includes a novel coronavirus provisionally named PREDICT_CoV-35, which ranked within the top 20.

SARS-CoV-2 currently ranks second out of the 887 viruses analyzed, after Lassa virus and before Ebola virus. That may seem counterintuitive, the authors noted, given the SARS-CoV-2 virus's global impact. They explain that the tool is ranking the potential for another spillover beyond what has happened historically.

Condensed from June 1, 2021, JAVMA News

ASIAN AMERICAN, PACIFIC ISLANDER COMMUNITY DISCUSSES RACISM DURING PANDEMIC

As a veterinarian, Dr. Eunice Yuh has experienced occasional racism from clients in the form of ignorant comments and blatantly offensive jokes. During the pandemic, she and other Asian American and Pacific Islander people have faced even more.

From March 19, 2020, to Feb. 28, 2021, there have been a reported 3,795 hate incidents against AAPI people, according to data from Stop AAPI Hate, a national reporting center that tracks hate incidents against AAPI people. Over 10% of reported incidents were physical assaults, according to a national report released in March. Businesses and public places, including streets and parks, were the primary sites of incidents.

The AAPI community has been falsely blamed for SARS-CoV-2, the virus that causes COVID-19, because some evidence suggests the virus originated in Wuhan, China.

About 5.5% of students at U.S. veterinary colleges identify as Asian, according to 2020 data reports from the American Association of Veterinary Medical Colleges.

“Even in the diverse neighborhood in California that I live in, I have faced racism,” said Dr. Yuh, who practices in Sacramento, California. “In the beginning of the pandemic, I walked by a mother while grocery shopping as she pulled her child close, whispering to her, ‘Try to stay away from them.'”

Dr. Yuh's parents were from South Korea, but she was born in Washington, D.C., before her family moved to Atlanta.

Condensed from June 15, 2021, JAVMA News

ABLEISM IN VETERINARY MEDICINE

When Dr. Brandy Duhon started attending Louisiana State University School of Veterinary Medicine, she asked for the door handles to be changed so she could open them.

Dr. Duhon, now a clinical instructor of shelter medicine and surgery at the veterinary school, contracted bacterial meningitis in 1995 and, as a result, has damage in both her legs and had both her hands amputated.

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Dr. Brandy Duhon, a clinical instructor of shelter medicine and surgery at Louisiana State University School of Veterinary Medicine, had both her hands amputated after contracting bacterial meningitis in 1995. She turns surgical gloves inside out when she uses them. (Courtesy of Dr. Duhon)

Citation: American Journal of Veterinary Research 82, 7; 10.2460/ajvr.82.7.520

“I have had a lot of challenges, to say the least, but overall I have overcome those,” Dr. Duhon said. “I get upset and discouraged, but I have never looked at a task and said no.”

In recent years, veterinary colleges have made efforts to reduce barriers for people with disabilities in veterinary education, but people with disabilities have historically had difficulties gaining acceptance or thriving in higher education.

People who have one or more disabilities make up about 9% of academic scientists, according to a recent report on women, minorities, and people with disabilities from the National Center for Science and Engineering Statistics at the National Science Foundation.

Jay Dolmage, PhD, founding editor of the Canadian Journal of Disability Studies and author of “Academic Ableism,” spoke during the session “Ableism in Graduate Education” at the American Association of Veterinary Medical Colleges annual meeting, held March 4-6.

“Wherever you teach, your campus is full of stairs,” Dr. Dolmage said during the keynote. “The steps have something to say. Access to the university is a movement upward, and only the truly fit survive the climb.”

Condensed from June 15, 2021, JAVMA News

CLINICS SEE ANNUAL GROWTH IN REVENUE, VISITS

Growth continues for veterinary clinics, according to the Veterinary Industry Tracker from analytics company VetSuccess and the AVMA, which monitors daily revenue and visits across thousands of veterinary practices.

As of March 1, year-over-year revenue increased, on average, 9.1%, and patient visits increased 3.0%. Revenue increased in every category except that revenue for boarding and grooming and for over-the-counter medicines remained flat.

Pet owners are saying yes to getting more products and services during their visits. The number of line items per visit increased 7.22%, said Katie McClean, managing director of VetSuccess. She and Matthew J. Salois, PhD, chief economist for the AVMA, spoke during the AVMA Axon webinar “Exploring industry trends of today and tomorrow” on April 30.

McClean said the amount that owners are paying for products and services also went up about 10%. VetSuccess hopes to dig more into which products and services those are exactly and whether clinics have seen an increase in the number of visits per patient.

And while practices have increased prices, which contributes to greater revenue, McClean said, the increase in prices wasn't as important a factor as the average service revenue. VetSuccess also hopes to find more information in this area soon.

When looking at whether certain clients are contributing more to increased revenue, McClean said, “We found that no one group or type is contributing a higher proportion than any other type. Active clients, lapsed, lapsing, and new are all pretty consistent across the board post–March 2020.”

Condensed from June 15, 2021, JAVMA News

VETERINARY STUDENTS, FACULTY MEMBERS ADMINISTER COVID-19 VACCINES

A number of veterinary students, residents, and faculty and staff members at Iowa State University College of Veterinary Medicine were trained to administer COVID-19 vaccines to humans. About 30 people from the veterinary college volunteered for the training to be vaccinators at ISU mass vaccination clinics.

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Monique Reid, then a fourth-year veterinary student, practices performing a vaccination on a mannequin human arm at the Iowa State University College of Veterinary Medicine. (Photo by Christopher Gannon/Iowa State University)

Citation: American Journal of Veterinary Research 82, 7; 10.2460/ajvr.82.7.520

Abigail Swanson, then a fourth-year student, said the training, which is offered by personnel from ISU, included a CPR certification course, practicing injections with mannequin arms, and learning safe needle practices.

“I did not expect to have as much fun as I did,” Swanson said about the vaccination clinics. She volunteered twice. “I didn't know how I would react to dealing with humans rather than animals, but it was busy and moved smooth. I have a minor interest in public health, and I figured that this would be a good opportunity, and now I can tell people that I helped in a major way with the pandemic.”

Dr. Dan Grooms, dean of the ISU veterinary college, was trained to administer COVID-19 vaccines, too. He said volunteering with COVID-19 vaccination programs is a way that the veterinary profession is helping during the pandemic.

“This is another great example of how veterinarians are a part of the response to an issue such as this,” Dr. Grooms said. “It's one health.”

Condensed from June 15, 2021, JAVMA News

DETECTION DOGS IDENTIFY COVID-19 INFECTIONS

Results of a recent study suggest people with COVID-19 produce a scent that is identifiable by trained detection dogs.

The researchers plan further study in hopes they could develop detection dogs that would help protect people at public gatherings.

An announcement from the University of Pennsylvania School of Veterinary Medicine indicates nine detection dogs tested in a study involving urine samples identified SARS-CoV-2 infection with 96% accuracy. School officials said those results would be used in a subsequent investigation into whether dogs can be trained to distinguish between body odors of people who are positive for SARS-CoV-2 infection, negative for infection, or vaccinated.

An announcement from Penn Vet indicates the study results support the existence of an odor that is produced by humans in response to SARS-CoV-2 infection and is detectable by dogs.

An article describing the results, published April 14 in PLOS One, a journal from the Public Library of Science, states that the researchers procured saliva and urine samples from hospitalized children and adults who were positive for SARS-CoV-2. They also received control samples from SARS-CoV-2–negative patients at the same children's hospital and from adult volunteers who had negative tests for SARS-CoV-2 and lacked COVID-19 symptoms. The research team tested the dogs using samples from infected individuals, samples from controls, and distraction scents such as garlic, marinade, and marker ink on paper.

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A dog trained and tested in a study on detecting SARS-CoV-2 infections in humans (Courtesy of Penn Vet)

Citation: American Journal of Veterinary Research 82, 7; 10.2460/ajvr.82.7.520

Condensed from June 15, 2021, JAVMA News

EDUCATION COUNCIL SCHEDULES SITE VISITS

The AVMA Council on Education has scheduled site visits to six schools and colleges of veterinary medicine for the remainder of 2021.

Comprehensive site visits are planned for the University of Arizona College of Veterinary Medicine, July 18-22; Tuskegee University College of Veterinary Medicine, Aug. 29-Sept. 2; Long Island University College of Veterinary Medicine, Oct. 10-14; Virginia-Maryland College of Veterinary Medicine, Oct. 24-28; Mississippi State University College of Veterinary Medicine, Nov. 7-11; and The Ohio State University College of Veterinary Medicine, Nov. 14-18.

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 July 1, 2021, JAVMA News

  • Dr. Ed Breitschwerdt, a professor of internal medicine and Bartonella researcher at North Carolina State University College of Veterinary Medicine, works with students and researchers at the Intracellular Pathogens Research Laboratory. (Courtesy of Idexx Laboratories)

  • Dr. Jessica Quimby examines Beast's abdomen. Beast is participating in a clinical trial at The Ohio State University looking at the impact of diet on kidney disease. (Courtesy of The Ohio State University)

  • Dr. Brandy Duhon, a clinical instructor of shelter medicine and surgery at Louisiana State University School of Veterinary Medicine, had both her hands amputated after contracting bacterial meningitis in 1995. She turns surgical gloves inside out when she uses them. (Courtesy of Dr. Duhon)

  • Monique Reid, then a fourth-year veterinary student, practices performing a vaccination on a mannequin human arm at the Iowa State University College of Veterinary Medicine. (Photo by Christopher Gannon/Iowa State University)

  • A dog trained and tested in a study on detecting SARS-CoV-2 infections in humans (Courtesy of Penn Vet)

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