Veterinary Record最新文献

Background: Antimicrobial stewardship (AMS) initiatives are imperative to safeguard antimicrobials and reduce resistance. Across the UK, AMS relies in part on the self-regulation of the veterinary profession, particularly in farm animal practice, alongside voluntary schemes and quality assurance systems. In Europe, AMS initiatives are often statutory and require responsibility from several sectors. Consideration of broader AMS initiatives, potentially unfamiliar to the Welsh veterinary profession, could optimise future policy and align it with the requirements of Welsh veterinarians.

Methods: AMS initiatives were collated from nations with long-standing low antimicrobial use. A survey was constructed permitting veterinarians' evaluation of initiative feasibility and effectiveness (collectively, 'acceptability') within Welsh farm animal practice.

Results: Veterinarian-directed AMS initiatives, particularly those implemented within individual practices, were considered most acceptable. Initiatives that demanded cooperation from entities outside practices, or those regarded as punitive, were less acceptable.

Limitations: The findings of this voluntary survey may be biased towards particularly motivated respondents in the veterinary sector. Additionally, the cause or effect of the recorded professional behaviour is not known in this study.

Conclusion: Future antimicrobial policy should consider AMS acceptability by veterinarians, alongside farmers and other stakeholders, to promote compliance and attainment. The study data suggest that veterinarians may perceive continuous professional development/knowledge exchange as being most acceptable, alongside activities allied to a strong veterinarian‒client prescribing relationship. Continued support should focus on expanding these areas. Decoupling (ie, abolishing the professional licence for veterinarians to both prescribe and dispense medicines) was viewed as least acceptable by veterinarians in this study.

Background: Tremors have been reported as a neurological sign in cats with hepatic encephalopathy due to congenital portosystemic shunts (HE-CPSS) or postattenuation neurological syndrome (PANS).

Methods: The clinical records of cats diagnosed with HE-CPSS and manifesting tremors between 2003 and 2023 were retrospectively reviewed to characterise the clinical features of the tremors.

Results: Nineteen cats with HE-CPSS were included, of which 17 manifested tremors at admission and two had PANS. Domestic shorthair was the most common breed (12/19). Tremors were the only neurological sign in six of the 19 cats. Tremor localisation was generalised (10/19) or focal to the head (8/19) or a limb (1/19). Most tremors were episodic and non-intentional (15/19), occurring usually at rest with occasional intentional features (4/19). Of the 14 cats for which 1-month follow-up was available, tremors discontinued in nine after surgical or medical management.

Limitations: The limitations of this study included its retrospective nature and the lack of video recordings, brain magnetic resonance imaging and electrophysiological evaluation of tremors in all cases.

Conclusions: A diagnosis of HE-CPSS or PANS should be considered in cats with generalised or focal tremors.

Background: Dental disease is a common but often under-recognised condition in horses, possibly due to an inability to recognise clinical signs of oral discomfort. Some dental disorders are reportedly more painful than others, but there is no current metric by which dental pain can be objectively assessed. This study aimed to determine whether a facial expression-based pain scale offered an objective and reliable method for assessing dental pain in horses. It was hypothesised that dental disorders affecting the periodontium would produce high pain scores.

Methods: Twelve horses with dental disease were evaluated for pain using a numerical rating scale (NRS) and a horse grimace scale (HGS) by blinded observers using still, lateral photographs.

Results: Interobserver reliability was poor across all observers when both the NRS (intraclass correlation coefficient [ICC] = 0.36) and the HGS (ICC = 0.27) were used in horses with dental disease. The highest mean scores were given for horses with equine odontoclastic tooth resorption and hypercementosis (EOTRH) and periodontal disease (PD).

Limitations: This study has a small sample size of both horses and questionnaire respondents, and the respondent demographics are not representative of the wider veterinary population Furthermore, no positive or negative controls were used for the pain scoring.

Conclusions: The results of this study indicate the unreliability of tools designed for identifying acute pain for assessing chronic pain, such as dental pain. A more dental-specific ethogram is required to accurately identify dental pain in horses. Both the NRS and HGS produced the highest mean scores for EOTRH and PD, supporting existing literature that these conditions are associated with more obvious signs of pain.