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Randomised clinical non-inferiority trial comparing two formulations of desoxycortone pivalate for the treatment of canine primary hypoadrenocorticism

Background

This clinical trial compared two formulations of desoxycortone pivalate (DOCP) for treating the mineralocorticoid deficit in dogs with primary hypoadrenocorticism (PH).

Methods

At veterinary clinics in the USA and France, dogs with PH (n=152) were randomised (3:1) to receive approximately monthly treatments with either the test product, Zycortal (Dechra), administered subcutaneously (n=113), or the control product, Percorten-V (Novartis Animal Health), administered intramuscularly (n=39), both at an initial dose of 2.2 mg/kg DOCP. Treatment administrators were unblinded; veterinarians assessing clinical signs were blinded; owners were blinded until at least day 90, the primary end point. Veterinarians assessed treatment outcome based on all of the following: clinical signs; sodium concentrations; potassium concentrations. Dogs received concurrent glucocorticoid therapy throughout the trial. Non-inferiority was assessed using a generalised linear mixed model to compare success rates between groups.

Results

Success rates at day 90 were similar between groups (per-protocol population at day 90: Zycortal 87/101, 86.2 per cent, Percorten-V 29/34, 85.1 per cent). Zycortal was non-inferior to Percorten-V as the upper limit of the 95 per cent CI for the difference between groups was 13.6 per cent. Polydipsia and polyuria were the most common clinical observations.

Conclusion

Both products, in combination with glucocorticoid therapy, were safe and effective in treating PH.

Categories: Journal news

Prognostic markers and assessment of a previously published clinical severity index in 109 hospitalised dogs with acute presentation of pancreatitis

Background

Acute pancreatitis (AP) is common in dogs. Nevertheless, validated clinical severity index (CSI) scoring systems to assess severity and guide treatment in current, large-scale studies are unavailable.

Methods

This is a retrospective study including 109 dogs. Pancreatitis was diagnosed based on clinical signs, abdominal sonographic evidence, positive pancreatic lipase assays and experts’ assessment consensus.

Results

The survival rate was 75 per cent (82 dogs). Azotaemia and presence of local complications (ie, ascites) and secondary complications (ie, acute kidney injury and acute respiratory distress syndrome) were significantly associated with death. In agreement with the previously published CSI, respiratory anomalies were significantly associated with death. However, in disagreement with that study, high scores in the kidney and local abdominal complication categories and the sum of scores of all nine categories, but not high gastrointestinal category score, were also significantly associated with death. A final CSI score of at least 4 was associated with death.

Conclusions

This study has validated a nine-category CSI, proven a useful assessment tool in dogs with AP. Several previously reported and novel prognostic markers were assessed.

Categories: Journal news

Mortality, clinical findings, predisposing factors and treatment of Clostridioides difficile colitis in Japanese thoroughbred racehorses

Background

Although Clostridioides difficile-associated diseases (CDAD) is considered to be associated with colitis in horses, few studies have been performed with a focus on the characteristics of CDAD in thoroughbred racehorses.

Methods

Between 2010 and 2018, a test for C. difficile was performed using faecal samples from 137 thoroughbred racehorses with colitis presenting with diarrhoea and fever. The mortality rate, clinical findings, predisposing factors and the selected treatments were investigated in a retrospective manner.

Results

Twenty-four cases were diagnosed as CDAD and 113 as non-CDAD. The mortality rate was significantly higher in the CDAD group (83 per cent) than that in the non-CDAD group (34 per cent). The levels of serum amyloid A, blood urea nitrogen and packed cell volume at initial presentation were also significantly higher, and those of total protein and albumin were significantly lower in the CDAD group. The development of CDAD was associated with the administration of antimicrobials, surgery and hospitalisation. No significant improvement in mortality was observed for any of the selected treatment in both groups.

Conclusion

CDAD in thoroughbred racehorses was identified as a high mortality disease with rapid progression of systemic inflammation and deterioration of the circulatory state. Further investigation is required to improve the treatment.

Categories: Journal news

Proposed evidence-based veterinary medicine manifesto

By Suzanne Jarvis

In 2019, Vet Record hosted a workshop at Evidence Live – a conference designed to disseminate and implement better evidence for better healthcare – on whether the evidence-based medicine manifesto that had been developed for human healthcare was suitable for veterinary use.

We published the debate along with a draft evidence-based veterinary medicine manifesto for better health (VR, 3 August 2019, vol 186, pp 128-131).

We also made a commitment to publish a final version of the manifesto in 2020, and plan to do this at the beginning of September. We publish the proposed manifesto here (Box 1).

Proposed evidence-based veterinary medicine manifesto for better health

It is proposed that veterinary professionals and other stakeholders should act according to the following principles to improve evidence-based veterinary medicine:

  • Vet professionals are the advocates of animals – patients not clients are the primary...

  • Categories: Journal news

    Moving beyond words on diversity

    Mandisa Greene has made history by becoming the first black president of the RCVS.

    As she said at her inauguration, this would have been unthinkable for any woman – let alone a black woman – when the college was set up in 1844.

    While her presidency is a visible symbol of progress on a road to making the profession more diverse, many will no doubt agree with Greene that there remains plenty to do to widen access to vet surgeon degrees and careers.

    This week, in an interview with me, Greene describes how she is keen to see the vet profession become truly reflective of diverse 21st century Britain (see pp 52–53). She brings a positive message – she doesn’t think the profession is institutionally racist, and, since the UK has no shortage of gifted black and minority ethnic people, she believes positive change will happen (albeit not overnight).

    ...
    Categories: Journal news

    RCVS questioned over its financial reserves

    By Josh Loeb

    Senior figures at the RCVS were quizzed about the college’s financial reserves strategy at its annual general meeting on 10 July.

    Financial documents released by the college in advance revealed that it has approaching £20 million in its reserves – a sum that, some have argued, might be used, at least in part, to fund a fees cut for vets and vet nurses.

    At the meeting, which took place virtually, a letter submitted by the BVA president Daniella Dos Santos on behalf of members of the association was read out. In it, Dos Santos asked for more detail about what the college planned to do with its extensive financial safety cushion.

    She said: ‘We note that in the Annual Report and Financial Statements 2019 the RCVS reported £18.7 million in reserves – £10.1 million above the target of £8.6 million.

    ‘Specifically, I would like to ask...

    Categories: Journal news

    Tighter wildlife monitoring needed

    Global wildlife experts are calling for improvements to pathogen testing and tracking in wildlife to reduce the risk of future pandemics in people.

    Scientists from the Wildlife Disease Surveillance Focus Group, which includes experts from the University of Edinburgh, say that to prevent another pandemic on the scale of the current Covid-19 outbreak, there must be greater wildlife testing in areas that are at high risk of emerging infectious diseases, and more advanced technology should be used.

    The focus group has outlined its concerns and recommendations in an article published in the journal Science. Its recommendations include increasing lab testing capacity in areas where there is significant interaction between wildlife and people, and improving testing technology, particularly the use of portable DNA sequencers.

    Read the full story online at https://bit.ly/3eQVtu6

    Categories: Journal news

    Pioneering farm loses its bTB-free status

    By Josh Loeb

    Gatcombe Farm in Devon, noted for being a successful test bed for pioneering approaches to controlling bovine TB (bTB), has lost its officially TB free (OTF) status.

    Fourteen of the farm’s dairy cows recently failed the routine annual tuberculin skin test and at postmortem examination three were subsequently found to have lesions, confirming infection.

    Now cattle vet Dick Sibley, who provides vet services to the farm, is calling for more innovative approaches to manage the disease.

    Gatcombe’s 300-strong dairy herd had been chronically infected with bTB for around seven years when farmer Robert Reid asked Sibley to help him tackle the problem in 2014.

    Sibley introduced a suite of new measures, including strict biosecurity and an innovative ‘enhanced testing’ regime using the Actiphage and Idexx ELISA blood tests and PCR testing of faecal samples. Also no badger culling was permitted.

    Under this approach, the farm became...

    Categories: Journal news

    Ultra running vet enters the history books

    Vet Sabrina Verjee has become the first woman to complete the Wainwright challenge – scaling 214 summits in the Lake District back-to-back.

    The 325-mile challenge, encompassing all the peaks listed in Alfred Wainwright’s original guide to the Lakeland fells, took her 6 days, 17 hours and 51 minutes to complete and was a welcome break from her busy vet work, especially during the Covid-19 lockdown, she said.

    A keen ultra runner, Verjee (pictured right) is no stranger to multiday events, and won the women’s category in the Montane Spine race along the Pennine Way last year.

    Speaking to Vet Record, she said: ‘I’ve wanted to do it for a long while, to do all the Wainwrights in one go. I really enjoyed it. It was pretty epic.

    ‘It was also a nice break from work. I own my own practice and staffing got slimmed down to me, working on...

    Categories: Journal news

    New RCVS president marks a first for the college

    By Josh Loeb

    Mandisa Greene has made history by becoming the first black president of the RCVS.

    Elected to RCVS council in 2014, Greene was invested as president on 10 July during a virtual ceremony due to the Covid-19 outbreak.

    In a lighthearted speech, her predecessor Niall Connell praised Greene as ‘one of the fastest walkers on council’, adding: ‘She regularly accompanies me in the three miles from Belgravia House [RCVS headquarters] back to Euston station.

    ‘Similarly, she will power through this year as a fantastic president and role model. I shall be proud to work alongside you this year, Mandisa, as you become the 149th president of the RCVS.’

    In her acceptance speech as president, Greene said: ‘When the RCVS was founded in 1844, this would have been unthinkable – that a woman, let alone a black woman, would become president.

    ‘While in many ways it demonstrates progress,...

    Categories: Journal news

    Would diversity quotas work for the profession?

    Quotas and positive discrimination might be worth considering as part of efforts to speed up the process of making the veterinary profession more diverse, experts have suggested.

    Research psychologist Pete Jones, who is an expert in unconscious bias and who has developed tools to help curb racial prejudice in workplaces, told Vet Record that he was ‘coming round to the idea’ of discriminating in favour of candidates from ethnic minority backgrounds in order to boost diversity.

    Positive discrimination – whereby particular candidates are given preferential treatment in employment processes based on their ethnic background – has been used in the USA and the police service in Northern Ireland.

    In an interview with Vet Record, Jones said that positive discrimination and quotas could create significant problems, such as applicants selected under positive discrimination or quotas suffering adverse reactions from others or doubts they were up to the job.

    I’m now...

    Categories: Journal news

    Hong Kong vets may top up the UKs vet capacity

    The UK veterinary workforce could soon get a boost from Hong Kong.

    Up to 172 vets practising in Hong Kong are already registered with the RCVS

    Up to 172 vets practising in the former British territory are already registered with the RCVS.

    They may be eligible to work in the UK under the newly announced immigration pathway designed for people wishing to flee Hong Kong following the Chinese Communist Party’s imposition of a new national security law that is regarded by pro-democracy supporters as an assault on civil liberties.

    Recently outlined by the UK government, the immigration scheme grants all British national (overseas) passport holders (and their dependants) the right to remain, work and study in the UK for five years.

    After that, they will be able to apply for settled status and, after a further year, seek citizenship.

    Many vets in Hong Kong work in shelter medicine,...

    Categories: Journal news

    'Change is a marathon, not a sprint

    Mandisa Greene is a name for the history books. As the first black president of the RCVS, she strives to increase diversity in the professions. Here, Josh Loeb chats to her about her plans for the year.

    Categories: Journal news

    LWP update 2: paraprofessional regulation

    Over the next few months, we will explore the key recommendations contained in the recent report of the RCVS Legislation Working Party (LWP) from those directly involved in making them. Here, veterinary nurses council member Liz Cox discusses the LWP’s recommendations around the future of paraprofessional regulation.

    Categories: Journal news

    Wales bans wild animals in circuses

    A Bill to ban the use of wild animals in travelling circuses in Wales has passed its final vote in the Senedd.

    The Bill was introduced just over a year ago, following a consultation that found that 97 per cent of respondents would support the introduction of a ban.

    It follows existing bans in Scotland and England and will become law on 1 December, subject to royal assent.

    Lesley Griffiths, minister for environment, energy and rural affairs in Wales, said the Bill would ‘address the ethical concerns of people across Wales’ by banning the use of wild animals in travelling circuses.

    She said: ‘The use of wild animals for entertainment in this way is outdated – wild animals are sentient beings with complex needs, and they should not be seen as commodities for our entertainment.’

    Claire Lawson, RSPCA assistant director for external relations in Wales, said the move made...

    Categories: Journal news

    Endorsements sought for EBVM manifesto

    Vet Record will be publishing an evidence-based veterinary medicine (EBVM) manifesto in September 2020.

    In 2019, Vet Record hosted a workshop at Evidence Live – a conference designed to disseminate and implement better evidence for better healthcare – on whether the evidence-based medicine manifesto that had been developed for human healthcare was suitable for veterinary use.

    A draft EBVM manifesto for better health was published along with a commitment to publish a final version of the manifesto in 2020 (VR, 3 August 2019, vol 185, p 131).

    The proposed final manifesto is available to view here https://bit.ly/3htHQ61. Vet Record will use it to encourage better evidence-based veterinary practice, and is calling on organisations to support the ethos of the manifesto.

    The names of those companies, institutions and associations that have endorsed the manifesto will also be published.

    If you would like to endorse the manifesto or have...

    Categories: Journal news

    New deputy chief vet appointed

    Richard Irvine has been named as the new deputy chief veterinary officer for the UK.

    Irvine (pictured) is an experienced vet with a background in animal health and welfare policy and science. He is currently deputy director for global animal health and trade in Defra, and has overseen a number of successful market access gains, including recent agreements on exporting UK beef to China, the USA and Japan.

    Before this, he led the APHA’s surveillance intelligence unit and was head of the national reference laboratory for viral diseases of poultry at APHA Weybridge.

    Irvine said: ‘I am truly delighted to have been appointed, and to be able to both contribute to the work of maintaining and developing the animal health and welfare status of the UK, and represent these interests internationally. It is a privilege to support our farming and food industry in this role.’

    ...

    Categories: Journal news

    RCVS is a good place for work for women

    The RCVS has been rated as one of the top medium-sized organisations in the UK for women to work in.

    The college was rated fifth in the medium employer category (for organisations with between 51 and 250 employees) in the Great Place to Work Foundation’s Best Workplaces for Women awards.

    The awards assess the quality of a workplace for women, examining factors such as pay, recognition, fairness, development, representation in senior leadership, and policies around leave and flexible working for those with caring responsibilities.

    The RCVS says it has recently strengthened its policies around flexible and home working and also carries out regular audits on pay, other work-based benefits and recognition.

    RCVS CEO Lizzie Lockett said the award demonstrated the great strides the college had made over the past few years to make the RCVS a fairer and more flexible workplace.

    ‘With a majority female senior team and workforce,...

    Categories: Journal news

    Animation on Cryptosporidium control

    The Moredun Research Institute has produced a short animation outlining the management tools available to farmers to help control Cryptosporidium.

    The parasite Cryptosporidium parvum can be spread between animals and people. It is one of the most frequently diagnosed diarrhoea-causing pathogens in young calves in the UK, as well as one of the top four pathogens causing diarrhoea in young children in developing countries globally.

    Infected calves shed millions of parasite eggs in their faeces and these can survive in the environment for long periods of time, acting as a source of infection for other calves and people.

    The disease can be costly in terms of long-term production losses, diagnostics, treatment and supportive therapy.

    The animation explains how reducing the amount of the parasite in the environment reduces production losses. Good husbandry – ensuring calves get sufficient good-quality colostrum after birth – and good management, such as disinfecting sheds...

    Categories: Journal news
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