Melbourne Veterinary School - Research Publications
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ItemDifferences in the clinical practice of small animal CPR before and after the release of the RECOVER guidelines: Results from two electronic surveys (2008 and 2017) in the United States and Canada(Wiley, 2020-11)Objective To assess whether the clinical approach to CPR has changed following the publication of the Reassessment Campaign on Veterinary Resuscitation (RECOVER) guidelines in 2012. Design Internet-based survey. Setting Academia and referral practice. Subjects Four hundred and ninety-one small animal veterinarians in clinical practice in the United States and Canada. Interventions An internet-based survey assessing the clinical approach to small animal CPR was circulated with the assistance of veterinary professional organizations on 2 separate occasions: prior to (2008) and following (2017) publication of the 2012 (RECOVER) guidelines. Survey questions identical to both surveys solicited details of clinician approaches to CPR preparedness, basic life support (BLS), and advanced life support (ALS). Respondents were grouped into level of expertise (board-certified specialists [BCS, n = 202] and general practitioners in emergency clinics [GPE, n = 289]), and year of response to the survey (2008, n = 171; 2017, n = 320). Measurements and Main Results Compliance with the RECOVER guidelines pertaining to CPR preparedness (P < 0.01), BLS (P < 0.01), and ALS P < 0.01) was consistently higher in respondents to the 2017 survey compared to those of the 2008 survey. Being a BCS was associated with significantly higher compliance with the RECOVER recommendations than GPE in the domains of preparedness (P = 0.02), BLS (P < 0.01), and ALS (P < 0.01). Increases in age of the respondent had a negative effect on compliance with the BLS guidelines (P < 0.01), while gender had no effect. Conclusions Compared to 2008, current practices in small animal CPR in the North American emergency and critical care community shifted toward those recommended in the RECOVER guidelines across all CPR domains. This supports the notion that uptake of the RECOVER guidelines among veterinary emergency or critical care clinicians was sufficient to lead to a change in the practice of CPR.
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ItemEffect of a second treatment of prostaglandin F2α during the Ovsynch program on fixed-time artificial insemination conception rates and luteolysis in split-calving, pasture-fed dairy cows(WILEY, 2020-05)OBJECTIVE: To compare fixed-time artificial insemination (FTAI) conception rates and serum progesterone concentrations at the time of FTAI for cows treated with the original Ovsynch program (OV) with those treated with a modified Ovsynch (MO) program. DESIGN: This was a randomised clinical trial. METHODS: The study used five split-calving, pasture-based dairy herds in Southwest Victoria, Australia. Controls (n = 851) received the OV program: day 0 gonadotropin-releasing hormone, day 7 prostaglandin F2α (PGF), day 9 gonadotropin-releasing hormone and FTAI at day 10. The treatment group (n = 852) received a MO program with an additional prostaglandin injection on day 8. Subsets of cows from each group were sampled for blood progesterone at the time of FTAI. RESULTS: The treatment group demonstrated FTAI conception rates that were 7% (95% confidence interval 2%-12%) greater than the control group. After adjusting for the effect of age, days in milk at Mating Start Date and herd, the odds of conception using FTAI was 1.36 (95% confidence interval 1.12-1.66) times greater for treatment group cows compared with control group cows. The variability of serum progesterone concentrations at the time of FTAI was significantly less for treatment group cows compared with control group cows. CONCLUSION: For Holstein-Friesian and Holstein-Friesian cross-bred cows managed in pasture-based dairy herds in southern Australia, a MO protocol, including a second injection of prostaglandin F2α on day 8, increased FTAI conception rates compared with cows receiving the OV protocol.
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ItemThe Effect of Pet Insurance on Presurgical Euthanasia of Dogs With Gastric Dilatation-Volvulus: A Novel Approach to Quantifying Economic Euthanasia in Veterinary Emergency Medicine(FRONTIERS MEDIA SA, 2020-12-08)Euthanasia of companion animals in veterinary emergency medicine is a common cause of death. Euthanasia is economic when it is the consequence of the pet owner's inability to afford essential treatment while a viable medical alternative to euthanasia exists. Gastric dilatation-volvulus (GDV) is an acute life-threatening emergency condition of dogs; if left untreated, rapid death is highly likely. Surgical treatment leads to survival of around 80-90% of dogs; however, such treatment is costly. Therefore, pre-surgical euthanasia may be largely economically motivated. Having pet insurance, a financial instrument to reduce the burden of unforeseen veterinary medical costs on pet owners, would be expected to abolish the risk for pre-surgical economic euthanasia. We therefore aimed to determine whether pet insurance attenuates the risk of pre-surgical economic euthanasia in dogs with GDV. Non-referred dogs (n = 260) with GDV and known insurance status seen at 24 emergency clinics over a 2-year period were included. Relevant data (e.g., insurance status, age, comorbidities, outcome) were retrospectively extracted from a pet insurer's claim records (insured animals) or from electronic medical records of participating hospitals (non-insured animals). Forty-one percent of dogs (106 of 260 dogs) did not survive to hospital discharge; 82 (77%) of non-survivors died before surgery, all through euthanasia. The pre-surgical euthanasia rate was 10% in insured and 37% in non-insured dogs (p < 0.001). When adjusted for the effect of age, deposit size, comorbidities, and blood lactate concentration, the absence of insurance increased the odds of pre-surgical euthanasia by a factor of 7.4 (95% CI 2.0 to 37; p = 0.002). Of dogs undergoing surgery, 86% survived to hospital discharge. Overall, 80% of insured animals and 53% of non-insured animals survived to hospital discharge (p < 0.001). Thus, insurance was associated with a marked decrease in risk of pre-surgical euthanasia indicating that the cause of pre-surgical euthanasia of dogs with GDV is predominantly economic in nature. The rate of pre-surgical euthanasia in dogs with GDV may emerge as a suitable marker to quantify economic decision making of pet owners and to measure the impact of financial interventions aimed at mitigating economic duress associated with cost of veterinary emergency care.