Javma-journal of The American Veterinary Medical Association最新文献

Background: Air pollution is a major global health threat that is expected to worsen, yet its effects on domestic animals remain poorly understood. The objective of this scoping review was to synthesize existing evidence on associations between ambient air pollutants and health outcomes in domestic animals and to identify gaps to guide future research.

Methods: A scoping review was conducted following the Arksey and O'Malley framework and Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines with 2 search databases (PubMed and Web of Science) using terms related to domestic animals, air pollutants, and potential health outcomes on August 15, 2024. Eligible studies included research evaluating associations between ambient air pollutant exposures and domestic animal health outcomes. Studies assessing indoor air quality or experimental exposures were excluded. Results were synthesized descriptively and narratively.

Results: 29 studies were included, examining dogs, horses, cattle, sheep, and goats. Reported outcomes spanned cardiopulmonary, neurologic, ophthalmologic, immunologic, metabolic, reproductive, behavioral, performance, production, and mortality. Evidence demonstrated parallels with human health, particularly respiratory and neurologic effects, but cardiovascular and reproductive outcomes were notably underrepresented relative to human literature. Research publications related to air pollution and domestic animal health have increased in recent years, reflecting growing recognition of its contributions to animal health outcomes.

Clinical relevance: Veterinarians are increasingly confronted with questions about the health impacts of poor air quality. This review consolidates current evidence, identifies vulnerable populations, and highlights air pollution as an emerging risk to domestic animal health. Expanding research will strengthen veterinarians' ability to recognize, mitigate, and advise on pollution-related health impacts.

Objective: To evaluate veterinarians' intention to use metronidazole for treatment of canine acute diarrhea (CAD) and compare their knowledge, attitudes, and beliefs to evidence-based guidelines. To determine whether intentions of more recent DVM graduates and veterinarians in academic settings were more closely aligned with guidelines.

Methods: Veterinarians were surveyed in January 2025 via an online platform to understand their knowledge and intention to use antibiotics for the treatment of CAD using the Theory of Planned Behavior model. Data were analyzed descriptively and inferentially to determine relationships between variables.

Results: Veterinarians (n = 1,626), who broadly endorse the principles of antimicrobial stewardship (AS), continue to prescribe metronidazole under conditions of clinical uncertainty. While a minority of veterinarians reported frequent use of metronidazole (18% [295/1,626]), nearly half believed that both clients (49% [796/1,626]) and their professional peers (44% [718/1,626]) often or always expected it. New graduates and veterinarians in academic settings demonstrated attitudes and intentions more aligned with current prescribing guidelines for CAD than their peers. Awareness of AS guidelines for CAD did not significantly correlate with a reported lower frequency of prescribing metronidazole.

Conclusions: Veterinarians' intentions to prescribe metronidazole for CAD are shaped more profoundly by their attitudes toward clinical risk and their perceptions of social pressure than by their knowledge of clinical guidelines alone.

Clinical relevance: Future AS efforts must explore the efficacy of educational campaigns to address the complex, human elements of clinical decision-making, fostering practice environments that make the right choice the easy choice.

Objective: To evaluate the accuracy and precision of user groups using common syringe-and-needle combinations found in small animal general practice.

Methods: 30 participants were divided into 3 groups (novice, beginner, and expert) based on level of experience. Participants prepared 180 syringes (sixty 0.5-mL insulin syringes, sixty 1-mL tuberculin syringes with 25-gauge needle, sixty 1-mL tuberculin syringes with 22-gauge needle) with 3 volumes of sterile water (0.02, 0.12, and 0.43 mL). Accuracy and precision were calculated, and mixed-effect modelling was used to evaluate the impact of syringe type, volume, and participant characteristics.

Results: The greatest precision was seen with the smallest needle for the smallest volume. All participants tended to overfill volumes with larger syringe-and-needle combinations. The 1-mL syringe with larger needles was the least accurate. However, with larger volumes the percent difference in prepared versus expected volume (ie, the effect of overfilling) was reduced compared to smaller volumes. The beginner group was nearly 2 times as likely to prepare an accurate volume within ± 20% of the intended volume compared to experts (OR, 2.29; 95% CI, 1.33 to 3.93).

Conclusions: Errors in volume preparation ± 20% of expected, especially with the smallest volumes, were most common when larger needles were used. Smaller syringe-and-needle combinations improved precision.

Clinical relevance: Clinical practitioners should be aware of the inaccuracies encountered when preparing small volumes of injectable medications frequently used in veterinary practice. Greater experience does not guarantee greater accuracy. Clinically significant errors of at least ± 20% are common, especially when preparing very small volumes.

Objective: Access to veterinary care remains a significant barrier for many pet owners. Community-based learning opportunities are increasingly recognized as a way to address these gaps while fostering student development. This qualitative study aimed to understand more about the student learning experience through veterinary community engagement opportunities.

Methods: Using a retrospective qualitative study design, we examined reflective journals from veterinary students following a shelter medicine rotation at the University of Pennsylvania between January 2015 and July 2019. The journals were analyzed with the use of collaborative qualitative content analysis.

Results: 53 veterinary students were included in the study. Eight major themes emerged from their journals, including student perspectives of owners, pets, neighborhoods, community outreach, and self; the learning process; the role of pets as social catalysts; and trust. Students frequently described shifts in their perceptions toward pet owners. Both the depth (time invested) and breadth (diversity of experiences) of community outreach experiences contributed uniquely to students' acquisition of soft skills critical to excellence in clinical practice, including social competence, cultural humility, and contextualized decision-making.

Conclusions: These findings suggest that structured, reflective, ethical community-based experiential learning can challenge the hidden curriculum, foster emotional intelligence, and better prepare veterinary students for real-world practice.

Clinical relevance: Incorporating sustained, diverse, and ethically grounded community engagement into veterinary curricula may empower future veterinarians to navigate complex social contexts and more effectively serve all types of populations.

Objective: The purpose of the study was to evaluate the proportional reporting of neurological adverse events (AEs) associated with feline topical parasiticide products containing macrocyclic lactones (MLs; including eprinomectin) and emodepside by use of postapproval pharmacovigilance data. The intent was to provide veterinarians prescribing these products for their feline patients with the overall comparative context of neurological AE reporting for these products, which have been characterized as substrates for P-glycoprotein transporters.

Methods: The openFDA and EudraVigilance Veterinary Data Warehouse databases were queried for neurological AEs cumulatively reported through December 31, 2024, for marketed parasiticide products containing MLs (eprinomectin, selamectin, moxidectin) and emodepside for topical administration to cats. The frequencies of neurological AE reporting were compared between products with proportional report rates and disproportionality statistical measures.

Results: The reporting frequencies of neurological AEs associated with these feline topical parasiticide products were similar. For all products, ataxia was the most frequently reported neurological AE, with proportional report rates ranging from 5.3% to 14.0%. Proportional report rates ranged from 1.7% to 10.7% for convulsion and muscle tremor.

Conclusions: An evaluation of pharmacovigilance data from 2 different sources revealed no evidence of greater proportional reporting for neurological AEs specific to the use of eprinomectin-containing products in cats than for other MLs or emodepside.

Clinical relevance: These findings supported the conclusion that ML-containing products (including eprinomectin-containing products) and emodepside are comparable in the frequencies and types of neurological AEs associated with feline topical parasiticide products described as substrates for P-glycoprotein transporters.

Objective: The objective of this study was to determine the median time to return of negative thoracic pressure via thoracostomy tube following thoracic surgery in canines and felines without preoperative pneumothorax or pleural effusion and discuss complications associated with their use.

Methods: This was a retrospective case series with client-owned canines (n = 31) and felines (7). Medical records of canines and felines presented to a referral hospital for surgery during which a thoracostomy tube(s) was placed were reviewed. Animals with preoperative pneumothorax or pleural effusion were excluded. Total volumes of air and fluid were recorded in addition to respiratory rate, effort, and postoperative complications.

Results: 31 canines and 7 felines met inclusion criteria. Included procedures were diaphragmatic herniorrhaphy (44.7%), pericardioperitoneal herniorrhaphy (5.0%), lung lobectomy for mass excision or torsion (31.5%), vascular anomaly correction (15.8%), and other thoracic procedures (5.2%). Overall postoperative thoracostomy tube complication rate was 5.2%. Two patients died prior to discharge from complications unrelated to the thoracostomy tube. The median time to reestablish negative pressure was 0.5 hours (95% CI, 0 to 2 hours), and the median duration a thoracostomy tube was maintained was 8 hours (95% CI, 6 to 9.75 hours).

Conclusions: The duration for which thoracostomy tubes were maintained exceeded that needed for reestablishment and maintenance of negative thoracic pressure.

Clinical relevance: Clinicians should consider limiting thoracostomy tube use to the immediate 2-hour postoperative period, as the majority of cases did not exceed 10 mL/kg of air and fluid production across the duration of thoracostomy tube use. Overall complication rate was low (5%).

Objective: To highlight clinical and clinicopathologic differences between kittens with feline infectious peritonitis-associated uveitis (FIP-AU) versus those with an otherwise similar feline undifferentiated resolving uveitis (FURU).

Methods: Clinical and clinicopathologic data were compared between 22 kittens with FURU and 8 with necropsy-confirmed FIP-AU examined between January 1, 1985, and December 31, 2022.

Results: Sex, lifestyle, seasonality, household cat numbers and systemic signs were similar in both groups. Feline undifferentiated resolving uveitis occurred predominantly in domestic-breed kittens from shelters, whereas FIP-AU was more frequent in purebred or stray cats. Duration of ocular signs before presentation was 1 to 2 weeks for FURU versus > 2 months for FIP-AU. Feline undifferentiated resolving uveitis was more commonly associated with episcleral hyperemia while FIP-AU was more commonly associated with corneal edema, dyscoria, rubeosis iridis, iridal congestion/thickening, posterior synechia, or keratic precipitates. Corneal edema and chemosis were more severe in FIP-AU. No eyes with FURU had fundic abnormalities whereas 6 of 11 eyes with FIP-AU had chorioretinitis. All kittens with FIP-AU presented bilaterally whereas 5 of 15 kittens in which FURU was ultimately bilateral, initially presented unilaterally. Hyperproteinemia, hyperglobulinemia, and hyperbilirubinemia occurred only with FIP-AU. Neither likelihood of a positive coronavirus titer nor titer magnitude differed between groups.

Conclusions: Kittens can develop bilateral fibrinous uveitis with keratic precipitates, systemic signs of illness, and serum coronavirus antibodies which resolves without sequelae following empirical treatment. Syndromic assessment-including careful fundic examination-can help differentiate FURU from FIP-AU and should precede antiviral therapy.

Clinical relevance: Resolution of uveitis during antiviral treatment does not confirm FIP. Comprehensive diagnostic evaluation is essential to avoid misdiagnosis and inappropriate treatment.

Canine osteoarthritis (OA) is a major contributor to chronic pain, mobility loss, and premature euthanasia. Although multimodal care is standard, many dogs experience incomplete relief, adverse events, or limited access to care. Radiosynoviorthesis (RSO) is a targeted IA therapy that delivers localized radiation to inflamed synovial tissue, reducing synovial effusion and alleviating joint pain. While various RSO agents have been used for over 70 years in human medicine to manage inflammatory joint disease, tin-117m (Sn-117m) is the first RSO agent adapted for veterinary use and approved for the treatment of canine OA. Sn-117m is a radionuclide emitting low-energy conversion electrons with minimal tissue penetration and, unlike systemic radiotherapeutics, Sn-117m remains confined within the joint capsule and does not form radioactive metabolites. This containment minimizes environmental contamination and limits caregiver exposure. This narrative review synthesized current evidence on the clinical use of Sn-117m RSO in dogs, addressing therapeutic efficacy and effectiveness, safety, and caregiver radiation exposure. Sn-117m offers a minimally invasive alternative to fill this treatment gap. Following a single injection for OA, prospective clinical trials report sustained improvements in objective gait analysis and caregiver-reported pain scores with benefits lasting up to 12 months. Modeled and measured radiation exposures for caregivers remain below US Nuclear Regulatory Commission limits, allowing outpatient use without isolation. This review evaluated existing data, highlighted regulatory and implementation considerations, and identified areas of potential further research. Long-term outcome tracking and expanded joint-specific data could help refine the use of RSO in human and veterinary medicine.