• Home
  • Uncategorised

Integrative equine sports medicine

  • Super User

View focus article 1

View focus article 2

View focus article 3

View focus article 4

Focus - Herd health - November 2018

Download as PDF

Integrative equine sports medicine

Sinead Devine MVB cVMA, certified animal chiropractor and assistant professor in Equine Clinical Studies, University College Dublin examines the increased use of complementary and alternative methods to manage lameness conditions in equines and decrease the risk of re-injury

Musculoskeletal disorders are the most common cause of wastage in equine athletes and lameness cases can be among the most challenging faced by equine practitioners. Horse owners are increasingly exploring complementary and alternative methods to manage lameness conditions and decrease the risk of re-injury. However, such complementary and alternative therapies are very controversial within veterinary medicine. Evidence-based veterinary medicine is defined as the use of current best evidence in making clinical decisions. While there is no single well-defined study answering all the questions on equine complementary therapies, more recently there are some well-designed, blinded, randomised, controlled studies done in the US that support the use of these therapies. For the equine clinician, is it useful to know what treatments exist and, possibly, where appropriate, to integrate complementary modalities into more traditional practise, on a case-by-case basis. Similarly, in the world of human medicine, evidence-based nonpharmacologic strategies are being sought for comprehensive pain care. Sport horse medicine in the US has embraced this integrative approach for the past decade, especially for competing horses, who suffer from chronic issues, eg. stiff joints, sore back, stiff neck, which compromise horse welfare and performance. Management of these athletes using acupuncture, chiropractic, laser therapy and massage can help prevent progression of these issues into breakdown injuries. Consultations begin with a thorough clinical exam and full work up of the lameness or performance issue, with imaging as appropriate. A diagnostic acupressure examination may then be performed.AcupunctureAcupuncture, from the Latin acus (needle) and pungere (to puncture), has been used to treat various medical conditions in humans for over 3,000 years. It is thought that people originally sought to relieve or alleviate pain through pressure from their fingers and this developed to the use of needles by the Neolithic Chinese. We now approach acupuncture from a scientific platform, given that abundant information exists concerning the connections between acupuncture anatomy, nerve stimulation, and neuromodulation of the peripheral, central and autonomic nervous system. Acupuncture points occur along the meridians all over the body and decreased electrical resistance can be measured at these points, needle insertion causes microtrauma and neurovascular reactions.Modern research shows that acupuncture point locations are in areas with a high density of free nerve endings (nervi vasorum), mast cells, small arterioles and lymphatic vessels. Some acupuncture points are located where nerve bundles penetrate the fascia, some where the cranial nerves exit the skull. The mechanism of action of acupuncture includes local, spinal, central and visceral effects. Stimulation at acupoints causes release of substance P and histamine. By stimulating endorphin, such as encephalin and adynorphin, acupuncture can modulate pain (neural-opiate theory). Acupuncture also causes the mid-brain to produce monoamine, a neurotransmitter that can in turn further inhibit pain. Needle insertion also stimulates mechanoreceptors, this activation can augment analgesia. Additionally, by causing the core region of the hypothalamus to release and distribute beta-endorphins, acupuncture influences the autonomic nervous system. Most horses tolerate insertion of acupuncture needles, they are not sedated for the assessment or the treatment. Aquapuncture is also described where saline or vitamin B12 is injected at particular points allowing the fluid to further treat the point with pressure over a period of time as it is absorbed. Acupuncture is often used in horses to treat neck and back pain, it can help where horses are compensating due to the effects of arthritis or navicular syndrome. UC Davis researchers have proven the use of acupressure points being used as a diagnostic tool for lameness. Further research is ongoing in its use to locate the site of most severe pain, particularly helpful in cases where multiple joints are affected. Reactivity at some points can help differentiate between hock or stifle pain. In some cases, acupuncture can help manage chronic on-going performance issues using less anti-inflammatory or intra-articular medications and keeping horses in competition, especially at FEI level. Treatment is possible throughout competition and is also useful in acute cases, eg. endurance horses immediately after competition. Electroacupuncture is a form of acupuncture where a small electric current is passed between pairs of acupuncture needles. During strong, low frequency electrical stimulation of needles in muscle, vigourous muscle contraction can occur. Some sensitive horses are uncomfortable with this stimulation, so it is always advised to start at a very low frequency. Transcutaneous electrical nerve stimulation (TENS) units are portable, battery-operated devices containing electrodes, within pads, that are attached to the skin surface. The popularity of TENS units for human patients has increased interest within the equestrian community, but long equine hair and a paucity of evidence means we should be cautious of anecdotal claims!Contraindications for acupuncture include any evidence of dermatitis or cellulitis on the horse’s skin, the horse should be dry and brushed clean prior to beginning treatment. Acupuncture needles can break while in situ, depending on patient movement etc and so horses should be supervised during treatment. Horses may try to bite at needles and may begin to kick out 5-10 minutes into treatment, even if they were initially relaxed, owner and vet should be aware of this.ChiropracticChiropractic is a manual therapy, often called ‘spinal manipulation’, the goal of which is to ensure smooth, coordinated movement of all spinal segments to optimise spinal joint neuromuscular function. ‘Chiropractic’ comes from the Greek words ‘praxis’ and ‘cheir’ meaning to practice or treat using hands. Chiropractic care for humans as a profession began in 1910 in the US and is now accepted by many human health insurance companies in Ireland. The equine chiropractic examination is to assess for reduced range of motion at a joint, called the ‘vertebral subluxation complex’. The fundamental principles are that hypomobility at the joint can lead to dysfunction and may be corrected with a chiropractic ‘adjustment’, a low amplitude, high velocity thrust in the specific joint plane. There is a common misconception, among owners, that there is a ‘rib out’ or that a bone is ‘out of place’, which is entirely false! The chiropractic adjustment is to restore optimal range of motion of the joint, which may subsequently alleviate inflammation and pressure on surrounding nerves and soft tissues. The practitioner must have a very accurate knowledge of spinal anatomy, the joint plane varies with location on the spine and adjustments must be performed on this plane to avoid trauma. Horses are also not sedated for this treatment. Concerns of owners requesting chiropractic care often include neck stiffness, head shaking, forelimb lameness, poor transitions, reduced suspension, reduced mobility/engagement in the back or pelvis. Protocols vary per case but may include weekly assessments and adjustments for three to four weeks for particular injuries.Low-level laser therapyTherapeutic lasers have been used on the equine athlete since the 80s in the US but are increasing in popularity in the past five years. Low-level laser therapy, or ‘cold laser therapy’ is a form of photo-therapy used to stimulate tissue repair and provide pain management. Focused red and infrared light stimulate tissue, at and below skin surface (and is also used at acupuncture points). In photobiomodulation, the biochemical effect of the low-level pulsed laser light, increases the production of cellular energy at the mitochondrial level and thus promotes cellular regeneration, production of collagen for tissue repair and vascular dilation and synthesis for better circulation. Massage The mechanism of action for massage therapy is not fully understood. Massage therapy may induce local biochemical changes that modulate local blood flow and regulate oxygenation in muscles, subsequently influencing neural activity at the spinal cord segmental level, thereby modulating the activities of subcortical nuclei that influence both mood and pain perception. Equine massage varies in intensity from light pressure to deep ‘interrogation’ of the musculature. The bulk and weight of a horse actually does not necessitate that initial manipulation be deep and powerful, in fact gentle progression and sensitivity should be used. Massage movements should go with the lay of the hair or sometimes transversely, but not counter. Alternative working at both superficial and deep level is often performed, progressively enlarging the examined area, to assess the variety of tensions at different levels. Some specific techniques include: with the flat of the hands, with fingertips, with elbow, mobilizing massage, drainage massage (to improve lymphatic drainage). Circular movements around a cramped muscle are made by working the fingers together as a solid unit on the skin. Kinesiotaping is sometimes used in conjunction with physical therapy and stretching.Other treatment modalities requested by clients may include Cranio-saccral therapy, described as a ‘light-touch hands-on therapy’. No equine veterinary studies yet exist to support the usefulness of this technique. Chinese herbs, homeopathy and aromatherapy are also requested by clients and current literature does not support their use for any specific equine conditions. Use of any such unregulated products may cross react or act as masking agents on drug tests and so strict caution should be exercised for competing horses.Integrative sport horse medicine can hugely benefit our equine patients, these modalities should complement our conventional or routine veterinary care, as they are adjuncts to, not a replacement for conventional veterinary medicine. In a circle of care between the horse, owner, trainer and vet, integrative medicine can help combine complementary therapies for improved patient outcomes.

Current status of Equine Integrative Medicine Techniques Used in Equine Practice Kevin Haussler Journal of Equine Veterinary Science Vol 29 (August 2009). Acupuncture and Equine Rehabilitation Sarah le Jeune et al Veterinary Clinics of North America vol 32 (2016). Use of acupuncture in equine reproduction W.A. Schofield Theriogenology (2008). Acupuncture in equine stifle disease Michelotto et al Journal of Equine Veterinary Science vol 24 (2014). Successful Practice of Electroacupuncture Analgesia in Equine Surgery Sheta et al JAMS VOL 8 (2015). Equine Acupuncture :Incorporation Into Lameness Diagnosis and Treatment Allen M Shoen AAEP Proceedings (2000). Effect of chiropractic manipulations on the kinematics of back and limbs in horses with clinically diagnosed back problems Alvarez et al Equine Veterinary Journal vol 40 (2008). Evaluating the Benefits of Equine Massage Therapy: A Review of the Evidence and Current Practices Scott M Journal of Equine Veterinary Science vol 29 (2009). Physiotherarpy Asssessment for the Equine Athlete Goff L Veterinary Clinics of North America-Equine Practice, vol 32 (2016).

Click on images to enlarge

Assessment of neck mobility.

Chiropractic bale to achieve necessary height for line of correction – two bales needed for taller horses!

Use of cold laser.

Use of cold laser.

Kinesiotape.

Kinesiotape.

Maria Gomez-Sanchez, BSAPSC and physical therapist, RVN, equine CST of UCD Veterinary hospital, performing massage.

Continue reading

Influenza D virus in cattle

  • Super User

View focus article 1

View focus article 2

View focus article 3

View focus article 4

Focus - Herd health - November 2018

Download as PDF

Influenza D virus in cattle

Research was conducted this year at the Central Veterinary Research Laboratory, Department of Agriculture, Food, and Marine Laboratory Services to determine whether influenza D virus was present in cattle in Ireland and to investigate epidemiologic factors that might be related to this virus. Orla Flynn, a scientist at the Central Veterinary Research Laboratory, outlines the process and outcomes

We detected influenza D virus in 18 nasal swab samples from cattle in Ireland that were clinically diagnosed with respiratory disease. Specimens were obtained from archived samples received for routine diagnosis during 2014-2016. Sequencing showed that virus from Ireland clustered with virus sequences obtained in Europe within the D/swine/ OK/1334/2011 clade. Influenza D virus is a recently characterised addition to the family Orthomyxoviridae. This virus was originally detected in pigs in the United States1; however, cattle are now believed to be the main reservoir species.2 Evidence suggests that this virus plays a role in bovine respiratory disease, although experimentally, it caused only mild disease by itself.3 Influenza D virus has been found to be associated with respiratory disease in feedlot cattle.4 The zoonotic potential of influenza D virus remains unclear; this virus can replicate in ferrets (a model for human influenza infection), and a seroprevalence of 91% was found in persons working closely with cattle.5 However, a study of 3,300 human respiratory samples from Scotland did not detect any influenza D virus-positive samples.6 This virus has been detected in bovine samples in several other countries, including France7, Italy8, Japan, and China.9 Cattle are a major part of the economy in Ireland, where there are ≈7 million.10 To determine whether influenza D virus was present in cattle in Ireland and to investigate epidemiologic factors that might be related to this virus, we conducted a cross-sectional study by using 320 nasal swab specimens from cattle with respiratory disease that were submitted to the Central Veterinary Research Laboratory for routine bovine viral pathogen testing during 2014-2016. We tested swab specimens by using real-time PCR for influenza D virus as described.1 We selected samples with a cycle threshold (Ct) ≤25 for further molecular characterisation by using three primer sets7 that are specific for the seven virus gene segments. We performed cDNA synthesis by using qScript cDNA SuperMix (Quantabio, Beverly, MA, USA) and PCR amplification by using AccuStart II PCR ToughMix (Quantabio). We processed PCR products by using Illustra ExoProStar 1-Step (GE Healthcare, Little Chalfont, UK) according to the manufacturer’s instructions before Sanger sequencing. We analysed sequence data by using DNASTAR Lasergene 12 SeqMan Pro (DNASTAR, Madison, WI, USA) and performed sequence alignment by using ClustalW in MEGA 5.01 (http://www.megasoftware. net/). We constructed phylogenetic trees by using the maximum-likelihood method in MEGA 5.01. Herd information for 2015 was available for 84 herds of origin of these nasal swab specimens. Data was obtained from the Animal Identification and Movement System database of the Department of Agriculture, Food, and Marine of Ireland (www.agriculture.gov.ie/animalhealthwelfare/animalidentificationmovement/cattle/irishbovineanimalidentificationsystem-overview/). We performed univariate statistical analysis by using Stata/SE141 (StataCorp LLC, College Station, TX, USA). Herd factors investigated for a possible association with influenza D virus herd status were herd size, numbers of stillbirths, dairy cows in herd, beef cows in herd, inward movements from markets, inward movements to farm, and carcasses moved to knackeries. FindingsA total of 18/320 samples were positive for influenza D virus by PCR. Of the 18 positive samples, 13 were also positive by PCR for one or two other viral pathogens (bovine herpesvirus 1, parainfluenza 3 virus, bovine coronavirus, bovine respiratory syncytial virus, bovine viral diarrhoea virus). Seven of the influenza D virus-positive specimens were from calves, two from weanlings, and one from a cow; other specimens were not described by animal age. Nine of the influenza D virus-positive samples had a Ct ≤25 and were selected for sequencing. We obtained partial sequences for five samples and deposited the sequences in GenBank (accession nos. KY992090–KY992103). Phylogenetic analysis (online Technical Appendix Figure 1, https://wwwnc.cdc.gov/EID/article/24/2/170759-Techapp1.pdf) showed that the five influenza D virus isolates from Ireland clustered with viruses from Europe in the D/swine/OK/1334/2011 clade. We also determined the distribution of positive and negative samples at county level in Ireland (online Technical Appendix Figure 2). Herd information was available for 10 of the influenza D virus-positive herds and for 74 comparison herds (for which the nasal swab specimens were negative for influenza D virus but which had clinical respiratory disease outbreaks). We found no associations between herd characteristics and influenza D virus status; this finding was determined by evaluating mean values with 95% CIs for infected herds and non-infected herds. ConclusionThis study confirms the emergence of influenza D virus in Ireland. Presence of the virus in nasal swab specimens submitted from routine respiratory disease cases supports the hypothesis that this virus plays a role in the bovine respiratory disease complex. Analysis of herds for infected cattle did not show any epidemiologic differences between influenza D virus infection and infection with other common respiratory viral pathogens. This finding is consistent with the hypothesis that influenza D virus might have limited effect by itself but can potentiate effects of other respiratory pathogens in causing respiratory disease.3,4 Detection of two virus lineages in Ireland clustering with viruses isolated in Europe within the D/swine/ OK/1334/2011 clade raises the issue of how influenza D virus might spread internationally. Surveillance efforts could be targeted for data on trade of live cattle, which is extensive within Europe. Further research is planned to investigate the seroprevalence of influenza D virus in cattle in Ireland and to determine the effect of this virus in a cattle farming context in this country.Orla Flynn is a scientist at the Central Veterinary Research Laboratory, Department of Agriculture, Food, and Marine Laboratory Services, Celbridge, Ireland. Her research interests include avian and mammalian pathogens affecting farmed animals.

Originally published: This article was originally published in Emerging Infectious Diseases, February 2018.Authors: Orla Flynn, Clare Gallagher, Jean Mooney, Claire Irvine, Mariette Ducatez, Ben Hause, Guy McGrath and Eoin Ryan. Author affiliations: Department of Agriculture, Food, and Marine Laboratory Services, Celbridge, Ireland (O. Flynn, C. Gallagher, J. Mooney, C. Irvine, E. Ryan); École Nationale Vétérinaire de Toulouse, Toulouse, France (M. Ducatez); Kansas State University College of Veterinary Medicine, Manhattan, Kansas, USA (B. Hause); University College Dublin, Dublin, Ireland (G. McGrath) DOI: https://doi.org/10.3201/eid2402.170759Address for correspondence: Eoin Ryan, Department of Agriculture, Food, and Marine Laboratory Services, Virology Division, Backweston Campus, County Kildare, Celbridge; eoin.ryan@agriculture.gov.ie

1.Hause BM, Ducatez M, Collin EA, Ran Z, Liu R, Sheng Z, et al. Isolation of a novel swine influenza virus from Oklahoma in 2011 which is distantly related to human influenza C viruses. PLoS Pathog. 2013;9:e1003176. http://dx.doi.org/10.1371/ journal.ppat.1003176  2. Hause BM, Collin EA, Liu R, Huang B, Sheng Z, Lu W, et al. Characterization of a novel influenza virus in cattle and swine: proposal for a new genus in the Orthomyxoviridae family. MBio. 2014;5:e00031-14. http://dx.doi.org/10.1128/mBio.00031-14  Ferguson L, Olivier AK, Genova S, Epperson WB, Smith DR, Schneider L, et al. Pathogenesis of influenza D virus in cattle.  J Virol. 2016;90:5636-42. http://dx.doi.org/10.1128/JVI.03122-15  Ng TF, Kondov NO, Deng X, Van Eenennaam A, Neibergs HL, Delwart E. A metagenomics and case–control study to identify viruses associated with bovine respiratory disease. J Virol. 2015;89:5340-9. http://dx.doi.org/10.1128/JVI.00064-15  White SK, Ma W, McDaniel CJ, Gray GC, Lednicky JA.  Serologic evidence of exposure to influenza D virus among persons with occupational contact with cattle. J Clin Virol. 2016;81:31-3. http://dx.doi.org/10.1016/j.jcv.2016.05.017  Smith DB, Gaunt ER, Digard P, Templeton K, Simmonds P.  Detection of influenza C virus but not influenza D virus in  Scottish respiratory samples. J Clin Virol. 2016;74:50-3.  http://dx.doi.org/10.1016/j.jcv.2015.11.036 Ducatez MF, Pelletier C, Meyer G. Influenza D virus in cattle, France, 2011–2014. Emerg Infect Dis. 2015;21:368-71.  http://dx.doi.org/10.3201/eid2102.141449  Chiapponi C, Faccini S, De Mattia A, Baioni L, Barbieri I,  Rosignoli C, et al. Detection of influenza D virus among  swine and cattle, Italy. Emerg Infect Dis. 2016;22:352-4.  http://dx.doi.org/10.3201/eid2202.151439  Murakami S, Endoh M, Kobayashi T, Takenaka-Uema A,  Chambers JK, Uchida K, et al. Influenza D virus infection  in herd of cattle, Japan. Emerg Infect Dis. 2016;22:1517-9.  http://dx.doi.org/10.3201/eid2208.160362  Department of Agriculture, Food, and Marine Laboratory Services. Age profile for dairy and beef animals, 2017 [cited 2017 Sep 20]. https://www.agriculture.gov.ie/ animalhealthwelfare/animalidentificationmovement/cattle/ bovinebirthandmovementsmonthlyreports/

Continue reading

Vets urged to play their part during World Antibiotic Awareness Week

  • Super User

View focus article 1

View focus article 2

View focus article 3

View focus article 4

Focus - Herd health - November 2018

Download as PDF

Vets urged to play their part during World Antibiotic Awareness Week

November 12-18 is World Antibiotic Awareness Week and the World Organisation for Animal Health (OIE) is calling on vets to handle and administer antibiotics with care

Being in contact with both animals and farmers, vets are on the frontline in the battle against antimicrobial resistance (AMR), according to the OIE. It says that tackling pathogen resistance to antimicrobials is a priority for the organisation, citing misuse and overuse of antimicrobials in animals, humans or plants as a major factor driving the emergence and development of AMR. Below, the OIE outlines best practice for all vets when dealing with antimicrobials and antibiotics. When and how should antimicrobials be used? Only after a clinical examination of the animal(s) by a veterinarian or trained animal health professional. Only when necessary, taking into consideration the OIE List of Antimicrobial Agents of Veterinary Importance. Only in addition to, and never in replacement of, good animal husbandry practices, hygiene, biosecurity and vaccination programmes. Only by making an appropriate choice of antimicrobial agent based on clinical experience and diagnostic laboratory information when possible. Always in addition to detailed information on treatment protocols and withdrawal times. How to choose the appropriate antimicrobial? Take into account: Farm records of previous antimicrobial use and epidemiological history of the farm; Clinical experience and diagnostic insight; Diagnostic laboratory information when available (culture and sensitivity testing); Pharmacodynamics (activity against pathogens involved); Pharmacokinetics (tissue distribution, efficacy at infection site); and The OIE list of antimicrobials of veterinary importance when choosing your treatment.  What to do if first-line treatment fails? Second-line treatment should be based on results of diagnostic tests including sensitivity testing. In the absence of test results a different class or sub-class should be used. Can combinations of antimicrobials be used? Only if supported by scientific evidence. What should be written on the prescription for antimicrobials? Dosage regimen (dose, treatment intervals, duration of treatment). Withdrawal periods for meat and milk. Amount of antimicrobial (to be) provided, depending on dosage and number of animals. Labelling of all veterinary drugs supplied. When is extra-label or off-label antimicrobial use allowed? In agreement with national legislation. When appropriate registered product isn’t available. With client's informed consent. It is the vet’s responsibility to define the conditions of responsible use, including the dosage regimes, route of administration and withdrawal period, in these cases taking into account recommendations of the OIE List.What data should be recorded by the vet? Quantities of antimicrobials used per animal species. Details of all antimicrobials supplied to each farm. Treatment schedules (including animal ID and withdrawal period). Antimicrobial susceptibility data. Comments concerning the response of animals to treatment. Adverse reactions including lack of response due to antimicrobial resistance. For more details, refer to the OIE international standards: Article 6.9.6. Responsibilities of veterinarians of the OIE Terrestrial Animal Health Code. Article 6.2.7. Responsibilities of veterinarians and other aquatic animal health professionals of the OIE Aquatic Animal Health Code. OIE List of Antimicrobial Agents of Veterinary Importance.

Once bacteria are resistant, the antimicrobial agent (or medicine) is ineffective and can no longer help to control or treat diseases. This phenomenon is called antimicrobial resistance (AMR). AMR is a threat to the health and welfare of animals, whether aquatic or terrestrial. Resistant bacteria can circulate between humans, animals and the environment and do not respect borders. It is therefore, a global human and animal health concern. Misuse and overuse of antimicrobials in animals, humans or plants is a major factor driving the emergence and development of AMR. Indeed, any inappropriate use of antimicrobials (unnecessary use, use against non-susceptible bacteria or virus, under-dosage, etc.) increases the risk of resistance development.

Continue reading

AMR – a challenge to vets, farmers and herd health

  • Super User

View focus article 1

View focus article 2

View focus article 3

View focus article 4

Focus - Herd health - November 2018

Download as PDF

AMR – a challenge to vets, farmers and herd health

At CAVI 2018, Donal Lynch MVB Cert DHH, from Donal Lynch Veterinary Practice and XL Vets, hosted a session on antimicrobial resistance (AMR) and the challenges it poses to veterinary practitioners and farmers. In this article, Donal revisits this most serious topic and the impact of AMR on herd health

The development of antimicrobial resistance is due to exposure of bacteria to antibiotics. This generation has seen a growing emphasis on appropriate choice of antibiotics to treat specific bacterial infections and avoidance of their use where possible. However, any exposure – either appropriate or inappropriate – is continually contributing to the AMR problem as bacteria have the potential to develop resistance (as a result of exposure). This exposure may be intended in cases such as salmonellosis being treated with a cephalosporin, or environmental e-coli coming in contact with oxytetracyline being excreted in animal faeces. Great potentialVets, together with their farming clients, have made enormous strides in reducing the amount of antibiotics being used in Irish farming since the start of this century. Herd health has become the norm with a realisation that prevention of disease is the key to protecting profitability of any farming enterprise. Vets are key in assisting the Irish farmer through vet-led herd health in preventing the destruction of the potential created by genetics and realised by good farming management. A 24-hour, seven-days-a-week, fire brigade response to disease will always be a cornerstone of veterinary practice in Ireland – we are one of the only professions that still provide such a service to our patients and clients. In this context, we need to continue to make the most appropriate choice of treatments, whether this includes an antibiotic or not.Herd health is a holistic approach towards preventing disease and maximising the potential of a farming enterprise in a sustainable, environmentally and animal-welfare friendly manner. It is said that genetics creates the potential, management realises that potential and disease has the potential to destroy it. VaccinationVaccination rates have increased rapidly year on year with a growing realisation of the importance of prevention being better than cure. However, vaccination alone is not good enough without the benefits of appropriate farming practices. We have looked at cases of bovine neonatal diarrhoea caused by cryptosporidium parvum where contributing causative factors have included parasitism in the cows, ventilation issues in the winter housing, bedding conditions, colostrum management and genetic predisposition.For Irish vets, the key to reducing the development of bacteria resistant to the antibiotics that we have currently available to us is to reduce the total amount being used. We expect to achieve this by working towards healthier animals, which deliver a greater profit to the farmer for producing a quality product. ManagementYear on year there is significant growth in preventative medications such as vaccinations, which have become a cornerstone of preventative medicine plans for us. Vaccinations alone will not prevent disease and improvements in management have delivered the progress necessary to make this realisable. Educational initiatives where the vet is the conduit of information flow to the farmer have addressed areas such as dry cow management, colostrum management, general hygiene, parasite, stress control and housing management. CAVI 2018At the recent CAVI 2018 conference in Mullingar, interactive discussion sessions looked at two individual example cases where there were deficiencies in farm management that led to disease outbreak that required antibiotic treatment. The remit of the discussion was to identify the shortcomings, as well as the practical and cost-effective ways forward while protecting the food supply in an environmentally sustainable way that was animal-welfare friendly and led to a reduced requirement for antibiotics. Vets of all ages and career stages were present – students, newly qualified, retired, and from several different sectors of the profession, including pharmaceutical. Both cases considered the human side of the issues and some potential difficulties in supporting management, when other factors were contributing to stress on the farm manager such as financial constraints, particularly in a year such as this where there was a massive increase in the cost of feeding due to the summer drought.Case 1The first case involved a calf-to-beef system where there was an outbreak of mycoplasma bovis pneumonia during the milk feeding stage. The groups quickly identified issues with sourcing of calves and associated stresses in mixing from multi-sources as well as the difficulties with a shed that was not purpose-built. The easy solution is to build a purpose-built calf shed and source all the calves from one source on one day, but this is not so practical. The solutions included batch-buying; identifying the farms that had the best early-calf management through total protein and ZST results; and buying preferentially from these farms going forward. The shed needed attention and a practical, cost-effective suggestion to address this issue was to install a positive pressure fan and duct – this would be a short-term solution, with a view to designing a shed and business plan for the long-term. Vaccination on arrival was agreed to be fundamental and check-ups of the diet and bedding quality were agreed to be key to the vaccine working well.Case 2The second case involved a dairy farm that had expanded beyond the available housing facilities and experienced difficulties with clinical mastitis following on from an inappropriate choice of intramammary. The advice from the group included more detailed looking at records, better advice and more appropriate choices around drying off, including weather conditions, time of day and numbers to be done at one time. There was also significant discussion around housing options and ways to manage with limited resources. Solutions included outwintering on appropriate land and medium-term shed expansion with a detailed business and cashflow plan. Herd healthBoth cases demonstrated the abilities of the veterinary profession to address complicated herd animal-health issues while being cognisant of the real-life challenges created by other issues such as financial pressures and business difficulties on farm. I believe that the best way to manage AMR on-farm is by reducing the use of antibiotics through sustainable, long-term, disease-control plans, drawn up in consultation between the farmer and their local vet who has a holistic knowledge of the farm, to produce healthy animals in a welfare-friendly way.

Click on images to enlarge

Continue reading

Physiotherapy – an unusual case for treatment

  • Super User

Nursing - November 2018

Download as PDF

Physiotherapy – an unusual case for treatment

Although veterinary physiotherapy is a new and growing industry in Ireland, its versatility as a treatment option has been acknowledged for decades in the UK. Veterinary physiotherapist, Jane Tyrrell RVN AdvCertVPhys, discusses how it was used, along with traditional techniques, to assist in the recovery of a very unusual patient

As veterinary nurses, we are unfazed by explosive leavings, whatever the direction. We are proficient in ignoring the rancid smell of anal glands on our clothes. And we are top of the class in smiling and nodding as people tell us how lucky we are to cuddle with puppies all day long. However, in between the regular glamours of the job, we are challenged by more and more irregular cases, those that force us to delve into our repository of knowledge generated throughout our academic careers. In particular, in terms of physiotherapy, although we have been armed with the foundations, we tend to think of physiotherapy as it relates to canine and equine practice, as research is limited otherwise. So, when we are faced with these cases, how do we approach them? How do we care for and facilitate the recovery of other species, outside the ‘norm’? To demonstrate the novel use of physiotherapy techniques in the recovery of a candidate patient, a case study of a Galah cockatoo that suffered significant trauma to her right leg is being used. This case is discussed below in detail, including the initial examination, the examination by a specialist avian vet, the physiotherapy treatment plan employed and the bird’s recovery to date. Case in questionThe patient in question, a 10-year-old female Galah cockatoo, was found with threads from a fleece bed wrapped around her right leg between the tibiotarsus and the digits. It was estimated that she had been in this way for four to five hours. On initial examination, by the attending specialist avian vet, blood perfusion to the limb was noted as being good and there seemed to be no fractures present on palpation. However, the intertarsal joint had significant swelling and there was no deep pain reflex on three of the four digits of that limb. The vet decided to forego X-rays and administer Meloxicam with a view to re-examining the limb two weeks later. The recovery phase was initiated on the following day with basic practices being employed to reduce stress within the patient’s environment. Although she was able to use the limb, it was circumducted with every stride to avoid using the tarsus. Therefore, she was immediately moved from her cage to a small animal crate with several layers of towels as bedding and a very low and wide perch to prevent further injury while the limb healed. Birds tend to find wider rougher perches easier to grip, but in addition to this, the rougher perches also provide increased proprioceptive input for the damaged nerves. While in her crate, she was observed as favouring the use of her beak to manoeuvre instead of using her injured limb. TreatmentPhysiotherapy treatment was then started in earnest with the use of pulsed magnetic field therapy (PMFT) for analgesia, nerve regeneration and inflammation reduction. In practice, cryotherapy could be used instead to provide some analgesia and vasoconstriction. During these sessions, she was discouraged from using her beak in place of the limb. Initially, sessions were carried out two to three times daily and proprioceptive exercises were included later to stimulate nerve impulses. Due to the nature of the injury and the restriction of movement outside of supervised sessions, the patient was prone to weight gain, so treats were offered sparingly and more interactive rewards such as play were used instead. The patient was encouraged to complete proprioceptive tracks (Figure 1), ranging from corners of different types of flooring such as gym mats, towels, carpets and slate, as well as cat litter and wobble cushions. Great care had to be taken with these tracks as the patient’s wings were not clipped and she tended to fly to the end of the course if it was too long. At this stage, although she was progressing well, her deep pain responses had still not returned. Unfortunately, 11 days after the initial trauma she self-mutilated her toes, removing P2 and P3 in two of the digits. She was rushed to a local vet where she was bandaged, transferred to an avian vet and two days later, underwent surgery to amputate P1 from both digits. She returned home one day post-op and PMFT was used to aid in the reduction of the swelling and for pain relief in conjunction with her medications (oral Meloxicam and Tramadol). Phototherapy or thermotherapies could not be used every day as the limb was bandaged. However, both red and blue light therapies were used when the bandage was reapplied every three days. Also, during this time, and while the digits were exposed, we worked on flexing and extending the phalangeal and metatarsal-phalangeal joints on her remaining digits as well as the joints further up the leg which were all held in stasis due to the bandage. We also encouraged correct positioning of her limbs and remaining digits during this time by allowing her to partially weight-bear with her remaining digits on that limb. This may not always be possible as it requires the bird to remain calm while being held. Luckily, this cockatoo had been trained to be held for nail clipping, so this wasn’t as foreign a concept to her as it might be to other birds. If there is any doubt about the patient's ability to remain calm, this exercise should be avoided as it may cause injury to the patient as well as injury to the handler. At four weeks post-op, it was decided to remove the bandage and the remaining dissolvable sutures. The wound was not completely healed but the restriction on the joints caused by the bandage warranted the slightly earlier removal. During the time between removal of the bandage and complete healing of the wound, a home-made collar was used to prevent her from mutilating the area further. As the collar can cause balancing issues and instability, she had padding on her foot for almost a month. In addition to this, she was given more towels on her flooring and soft ban was used under the vet wrap on her perch. Her bedding had to be changed multiple times daily to prevent faecal contamination of the wound. At this point, phototherapy (both red and blue light) was reintroduced on a daily basis.RecoveringThe therapy continued, to encourage correct foot placement and simple step up exercises from hand to hand (as if she was climbing stairs) were used to strengthen her perching grip (Figure 2). Once the wound had healed, her collar was removed. Her physiotherapy sessions then decreased gradually from daily to once per week. As it stands now, her grip has improved substantially, she has been reintroduced to her normal cage and is using the injured limb more often than her beak. She still had padded vet-wrapped perches for a few months afterwards while she continued physiotherapy and relearned how to perch with only two digits, but now smaller perches (both smooth and rough) have been introduced to allow her to contract her grip even more and aid in improving her balancing. She has also begun flying again and we are working on getting her to land on a hand rather than a floor/chair to also encourage her to place her digits correctly around a finger as well as continuing to employ proprioceptive tracks to improve her grip and use of the toes.Given how slow her progress has been due to the longer wound-healing time, she has done remarkably well. This case was significantly more challenging than digit amputations in other species due to the dexterity that birds are required to have when it comes to their digits. However, when equipped with the foundation knowledge and a workable schedule of individual smaller goals, buckets of patience and a bit of ingenuity, many outside the ‘norm’ cases can be aided with even the most basic physiotherapy techniques allowing us to bring our patients through to recovery in everyday practice. It should be noted that the physiotherapy carried out in this case study was performed by a trained veterinary physiotherapist. So, with this in mind, if you are unclear or unsure of any methods used, speak to a trained physiotherapy professional before attempting to employ a similar schedule of therapy.

Click on images to enlarge

Continue reading

Are you ready for PAYE Modernisation?

  • Super User

Business - November 2018

Download as PDF

Are you ready for PAYE Modernisation?

To raise awareness of PAYE Modernisation, which comes into force in 2019, Revenue has published an information leaflet, PAYE Modernisation – Are You Ready? Ann Tighe, strategic business development manager, Thesaurus Software, helps you to prepare for changes coming down the line

PAYE Modernisation – Are You Ready? highlights the vital steps for new and existing employers to undertake in advance of January 1, 2019, in order to succeed in the imminent taxation system revolution. The key idea behind PAYE Modernisation is that all communication between employer and Revenue will happen in real time. This means that Revenue can ensure that the correct tax deduction is being made at the right time for every employee. A similar concept has already successfully been rolled out in the UK, called Real Time Information. Ultimately, employers will need to submit payroll information to Revenue every pay period. This will always ensure that Revenue has accurate information for employees. Communication is key to ensure a smooth implementation of PAYE Modernisation for all employers. The benefits of planning ahead should not be overlooked. PAYE Modernisation will apply to every employer in Ireland, large and small, therefore, a good plan will be crucial to your success. Having a plan in place means that you can allocate sufficient time and resources to be ready to comply with PAYE Modernisation, for example: Payroll processing bureaus will need to devise a plan to ensure that payroll information is received in a timely manner from clients; and Employers should ensure they have a plan in place to cater for when the payroll operator is on annual/sick leave, etc. To effectively overcome the upcoming challenges, employers are being encouraged to focus on the quality and accuracy of the data they provide to Revenue. Employers are also being advised to follow several easy steps to guarantee its overall success when it does come into effect in 2019:• Register as an employer (for new employers); Verify the PPSN provided by employees (eg. check it against a Public Services Card, P45 or other Revenue or Department of Social Protection correspondence) and where the employee does not hold a PPSN, they should contact the Department of Social Protection to apply for one; Register all employees with Revenue (ie. P45 or P46 where the employee has no P45). Where the new employee has not worked in Ireland before, the employee must register the employment online using the Jobs and Pension service available in myAccount. The Jobs and Pension service can also be used by employees who are changing from one employment to another. Once the employment has been registered, Revenue will issue a tax credit certificate; Issue a P45 when an employee ceases employment and submit it to Revenue; Ensure an up-to-date tax credit certificate has been received for each employee. The leaflet outlines the basis of tax, which should be applied on the first payday of a new tax year in the event that an up-to-date tax credit certificate for that year is not received; and Ensure a complete PAYE, PRSI and USC record for each employee is held at the end of the tax year. Thesaurus Software and BrightPay have welcomed the upcoming PAYE changes. Paul Byrne, director of Thesaurus Software Ltd, stated during the Revenue's public consultation process held in December 2016: “Whatever system is adopted, it is important that it represents a step forward for all parties. We are already committed to not charging our customers for the additional development involved. In addition, we are considering making a free version of our software available for micro employers, those with one employee.”

Click for more information

Continue reading

Novel tools in the assessment of dog welfare in veterinary practice

  • Super User

Small animal - November 2018

Download as PDF

Novel tools in the assessment of dog welfare in veterinary practice

In veterinary medicine, health status is often equated with animal welfare; however, this measure alone provides no information about the patient’s emotional state and general welfare. Rachel Malkani MSc BSc (Hons) LSHC-S, a PhD student in Veterinary Medicine and Science at the University of Surrey, outlines some of the ways in which dog welfare can be established today

The effects of the treatment, hospitalisation experience, and possible side effects are rarely a consideration; yet, may negatively impact welfare to a greater extent than the medical condition itself. The five freedoms are often parameters used to measure welfare. However, the absence of pain, hunger, fear and distress, etc. is not indicative of good welfare and positive experiences, merely the lack of negative experiences. Affective experiences are subjective states that cannot be measured directly in animals; therefore, there is a major knowledge gap in the assessment of emotional states in animals. Many behavioural and physiological tests exist to measure welfare but are not feasible in the veterinary practice environment and a major caveat is that these tests show emotional arousal, not emotional valence (i.e. positive or negative affective state). Moreover, in companion animals such as dogs, tests cannot be standardised due to the variation in previous experiences and individual differences. Thus, reliable methods of measuring positive affective states are essential to infer good welfare. Infrared thermographyOne method that has proven to be a useful tool in measuring a physiological response to stress is infrared thermography (IRT). When an animal becomes stressed, the hypothalamic-pituitary-adrenal (HPA) axis is activated (Zamora-González et al. 2013), resulting in sympathetic mediated peripheral vasoconstriction to divert blood from the periphery to the core organs (Stewart et al. 2005). This causes surface temperature to drop and an increase in core temperature, which is termed stress-induced hyperthermia. Thermal imaging works by detecting naturally emitted thermal irradiation and enables cutaneous temperature recordings to be measured. By detecting these changes in temperature, IRT has become a useful tool in measuring subtle changes in affective state. An intrinsic benefit to IRT is that it is non-invasive. Many other physiological indicators of stress such as cortisol measurement and core temperature require invasive techniques to obtain, which are not practical in veterinary practice and may result in an increased stress response confounding the welfare assessment. Behaviour is an alternative measure of welfare; however, unless you know the patient well, behavioural indicators of stress are not always reliable due to factors such as individual variability (sex, breed, personality, environment, previous experience, etc.). Therefore, a physiological measure such as IRT alongside behaviour will likely provide more accurate results when measuring welfare states in veterinary inpatients. A number of studies have evaluated the use of IRT as a measure of affective state in a number of species, including dogs (Vianna & Carrive, 2005; Jerem et al. 2015; Travain et al. 2015; Foster & Ijichi, 2017). The available literature highlights that the region of interest used to measure surface body temperature can increase or decrease depending on the anatomical region measured and the investigated species. In dogs, eye (lacrimal caruncle) temperature is reported to indicate general arousal; however, ear temperature has been shown to differentiate between positive or negative affective states in dogs (Riemer et al. 2016). During negative emotional states, pinna temperature will decrease from baseline, and when experiencing positive affective states, temperature will increase from baseline.IRT can be easily implemented into the veterinary practice as a measure of welfare. Basic thermal imaging cameras start from approximately £200 and more advanced cameras up to £80,000. The FLIR ONE PRO® camera is a small device that is attached to smartphones and the FLIR C2® is a small portable camera; both are inexpensive and have a thermal sensitivity of <0.1°c. Most thermal cameras have video functionality; this allows both real time measurements and long-term recording to assess welfare over time.To measure surface temperature of the pinna, a spotmeter can be used. The spotmeter on the camera screen is simply pointed at the apex of the pinna and the temperature is displayed. The colour palette of the image can also be changed to easily visualise temperature differences (Figure 1). This provides us with instantaneous results to assess whether the dog is in a positive (increase from baseline) or negative (decrease from baseline) emotional state during or following a procedure, veterinary consultation etc. Another potential benefit of IRT is that ear temperature is reported to be a reliable indicator of core temperature; therefore, IRT may also be used as a non-invasive alternative measure to rectal temperature (Zanghi, 2016). However, further research is needed to validate this.A drawback to the use of IRT in companion dogs is that ears that are fluffy or excessively hairy will need to be shaved. Consent will need to be obtained from owners to shave regions of their dogs; however, this should be acceptable to most owners if we manage their expectations and explain it will allow us to monitor how their dog is feeling. An additional disadvantage to IRT is that thermal radiation is reflected and does not penetrate through transparent plastic or glass. If dogs are hospitalised in transparent kennels, doors will need to be opened to obtain readings; however, this may confound the measurement by causing a change in the dog’s emotional state. Despite this, the increasing amount of evidence presents promising results, and IRT is likely to be a useful tool in the assessment of animal welfare. Further research is being conducted to assess the use of IRT as a valid tool in the measure of welfare and affective state in dogs.Animal Welfare Assessment GridThe Animal Welfare Assessment Grid (AWAG) is a validated tool that monitors the welfare of animals and is highly adaptable to any species. The system was developed by the University of Surrey, School of Veterinary Medicine in collaboration with Public Health England. The AWAG assesses physical health, psychological wellbeing, environmental comfort, and veterinary and management procedural events. The tool encompasses the five domains of animal welfare and draws attention to the temporal component of welfare that is often overlooked (Wolfensohn et al. 2018). Each parameter (physical, psychological, procedural and environment) is subdivided into a number of factors that contribute to the overall score. For example, the physical score would encompass the patient’s general condition, clinical assessment, pain control, inappetence, activity level etc. Within each parameter, various factors are scored between one and ten. Each factor score is defined using descriptors for each number to reduce scoring bias. A score of one indicates the best possible state (lowest possible impact on welfare), whilst a score of 10 would be the worst possible state (highest possible impact on welfare), for each respective factor. For each parameter, mean factor scores are calculated and this allows the clinician to ascertain what parameters are impacting quality of life at that time-point (Wolfensohn et al. 2015)In addition to the ability to quantify quality of life at a given time-point, the tool provides a visual representation of the animal’s welfare state. The axis displays the four parameters. Each factor score is calculated, and the relevant scores are marked on the x and y axis. These points are joined together to create a polygon and the total area covered is calculated to derive a cumulative welfare score at that particular point in time (Figure 2).If significant changes in welfare are seen, the tool can show which factors have contributed to these changes and intervention can be undertaken to improve the animal’s wellbeing. This is particularly important in hospitalised patients as it allows veterinary staff to assess the welfare impact of clinical interventions and environment, as well as physical and emotional health to determine what factors are influencing welfare. Veterinary staff can then enhance the factors that contribute to positive welfare and reduce or change elements that are negatively impacting welfare. The AWAG represents a valuable tool for veterinary professionals as it equips vets with a valid, fast, non-invasive, objective measure of welfare. The tool is currently being further developed to strengthen the transferability of AWAG to as wide a field of experimental disciplines as possible, and to incorporate additional features. Developments include: improving the ease of installation and setup of the software, making it more accessible for individual users and small companies, updating the user interface to ensure maximum usability, while providing an intuitive, user-friendly layout (NC3Rs 2018). As the majority of staff in veterinary practice have smartphones or access to tablets, the AWAG is easily accessible for veterinary staff.In summary, both infrared-thermography and The Animal Welfare Assessment Grid are proving to be promising, novel tools in the assessment of positive and negative welfare states in dogs. Utilising instruments that can reliably demonstrate the affective state of patients, and furthermore, establish the factors influencing welfare in individuals, will help to improve the experiences dogs have in the veterinary practice.

Foster S and Ijichi C. 2017. The association between infrared thermal imagery of core eye temperature, personality, age and housing in cats. Applied Animal Behaviour Science 189: 79-84. Jerem P, Herborn K, McCafferty D, McKeegan D and Nager R. 2015. Thermal Imaging to Study Stress Non-invasively in Unrestrained Birds. Journal of visualized experiments : JoVE: e53184. Riemer S, Assis L, Pike TW and Mills DS 2016 Dynamic changes in ear temperature in relation to separation distress in dogs. Physiology & Behavior 167: 86-91. Travain T, Colombo ES, Heinzl E, Bellucci D, Prato Previde E and Valsecchi P. 2015. Hot dogs: Thermography in the assessment of stress in dogs (Canis familiaris)—A pilot study. Journal of Veterinary Behavior: Clinical Applications and Research 10: 17-23. Vianna DML and Carrive P. 2005. Changes in cutaneous and body temperature during and after  conditioned fear to context in the rat. The European journal of neuroscience 21: 2505-12. Wolfensohn S, Sharpe S, Hall I, Lawrence S, Kitchen S and Dennis M. 2015. Refinement of welfare  through development of a quantitative system for assessment of lifetime experience. Animal Welfare 24: 139-149. Zanghi BM. 2016. Eye and Ear Temperature Using Infrared Thermography Are Related to Rectal Temperature in Dogs at Rest or With Exercise. Frontiers in veterinary science 3: 111.

1. What region is reported to be a reliable indicator of affective state in dogs using infrared thermography?A. Carpal padB. Ear pinnaeC. ScleraD. Digital padE. Distal tail2. How sensitive are infrared cameras commonly employed for animal use?A. >1°CB. <0.5°CC. >0.1°CD. <0.75°CE. <0.1°C3. What type of kennel should be used to obtain an accurate reading?A. Glass-fronted B. Clear-tempered glassC. Stainless-steel rodD. Plastic-frontedE. Stainless-steeled panelled4. The Animal Welfare Assessment Grid was developed by?A. The World Health OrganizationB. The University of Surrey Vet School and The National Institute for Health and Care ExcellenceC. The University of Surrey Vet School and Public Health EnglandD. The UK Public Health Network and The University of Surrey Vet SchoolE. The University of Surrey, School of Veterinary Medicine5. The Animal Welfare Assessment Grid evaluates four main parameters that affect welfare. These are?A. Physical, psychological, procedural, environmentalB. Physical, activity, diet, proceduralC. Psychological, procedural, environmental, co-morbiditiesD. Psychological, time of procedure, physical, activityE. Procedural, environmental, sex, past-experienceAnswers: B, E, C, C, A. D, C, D, E, A

Click on images to enlarge

Thermal image of dog with colour palette key.

Figure 2. Visual representation of welfare scores over time.

Continue reading