David B. Church

Longevity and mortality of owned dogs in England.

Improved understanding of longevity represents a significant welfare opportunity for the domestic dog, given its unparalleled morphological diversity. Epidemiological research using electronic patient records (EPRs) collected from primary veterinary practices overcomes many inherent limitations of referral clinic, owner questionnaire and pet insurance data. Clinical health data from 102,609 owned dogs attending first opinion veterinary practices (n=86) in central and southeast England were analysed, focusing on 5095 confirmed deaths. Of deceased dogs with information available, 3961 (77.9%) were purebred, 2386 (47.0%) were female, 2528 (49.8%) were neutered and 1105 (21.7%) were insured. The overall median longevity was 12.0 years (IQR 8.9-14.2). The longest-lived breeds were the Miniature poodle, Bearded collie, Border collie and Miniature dachshund, while the shortest-lived were the Dogue de Bordeaux and Great Dane. The most frequently attributed causes of death were neoplastic, musculoskeletal and neurological disorders. The results of multivariable modelling indicated that longevity in crossbred dogs exceeded purebred dogs by 1.2 years (95% confidence interval 0.9-1.4; P<0.001) and that increasing bodyweight was negatively correlated with longevity. The current findings highlight major breed differences for longevity and support the concept of hybrid vigour in dogs.

Prevalence of Disorders Recorded in Dogs Attending Primary-Care Veterinary Practices in England

Purebred dog health is thought to be compromised by an increasing occurence of inherited diseases but inadequate prevalence data on common disorders have hampered efforts to prioritise health reforms. Analysis of primary veterinary practice clinical data has been proposed for reliable estimation of disorder prevalence in dogs. Electronic patient record (EPR) data were collected on 148,741 dogs attending 93 clinics across central and south-eastern England. Analysis in detail of a random sample of EPRs relating to 3,884 dogs from 89 clinics identified the most frequently recorded disorders as otitis externa (prevalence 10.2%, 95% CI: 9.1–11.3), periodontal disease (9.3%, 95% CI: 8.3–10.3) and anal sac impaction (7.1%, 95% CI: 6.1–8.1). Using syndromic classification, the most prevalent body location affected was the head-and-neck (32.8%, 95% CI: 30.7–34.9), the most prevalent organ system affected was the integument (36.3%, 95% CI: 33.9–38.6) and the most prevalent pathophysiologic process diagnosed was inflammation (32.1%, 95% CI: 29.8–34.3). Among the twenty most-frequently recorded disorders, purebred dogs had a significantly higher prevalence compared with crossbreds for three: otitis externa (P = 0.001), obesity (P = 0.006) and skin mass lesion (P = 0.033), and popular breeds differed significantly from each other in their prevalence for five: periodontal disease (P = 0.002), overgrown nails (P = 0.004), degenerative joint disease (P = 0.005), obesity (P = 0.001) and lipoma (P = 0.003). These results fill a crucial data gap in disorder prevalence information and assist with disorder prioritisation. The results suggest that, for maximal impact, breeding reforms should target commonly-diagnosed complex disorders that are amenable to genetic improvement and should place special focus on at-risk breeds. Future studies evaluating disorder severity and duration will augment the usefulness of the disorder prevalence information reported herein.

Prevalence and risk factors for canine epilepsy of unknown origin in the UK

Epidemiological evaluation of canine epilepsy is an under-researched area. The objectives of this study were to estimate prevalence and investigate risk factors for epilepsy of unknown origin (EUO) among dogs attending primary veterinary practices in the UK. The clinical data analysed spanned a two-year period and included all dogs attending 92 primary veterinary clinics participating in the VetCompass project. Five hundred and thirty-nine EUO cases were identified giving a prevalence of 0.62% (95% CI 0.57% to 0.67%). Males were over 1.5 times as likely to have EUO compared with females (95% CI 1.44 to 2.06; P < 0.001). Of purebred dogs, the border terrier had 2.70 (95% CI 1.57 to 4.62; P < 0.001) and the German shepherd dog had 1.90 (95% CI 1.28 to 2.80; P=0.001) times increased odds of EUO compared with crossbred dogs. In addition, the West Highland white terrier had reduced odds (OR 0.23; 95% CI 0.08 to 0.62; P=0.004) of EUO compared with crossbred dogs (likelihood ratio test P < 0.0001). No association was found with neuter status, colour or weight. The current study highlights the clinical importance of epilepsy as a canine disorder in the UK. Increased awareness of sex and breed predispositions may assist clinicians with diagnosis. Further research is merited to evaluate the specific breed associations identified.

Changes in the glomerular filtration rate of 27 cats with hyperthyroidism after treatment with radioactive iodine

Hyperthyroidism is a common endocrinopathy of older cats and is associated with an increased glomerular filtration rate (gfr). Renal dysfunction is also common in older cats and may develop after they have been treated for hyperthyroidism. This paper describes the changes in the gfr of 27 hyperthyroid cats in the six months after their treatment with radioactive iodine (131I), and evaluates whether any commonly measured pretreatment parameters (serum biochemistry, systolic blood pressure, urine specific gravity) could predict a clinically significant decline in renal function. The gfr of all the cats had decreased one month after treatment, and the mean gfr was significantly lower. There was no further significant change in gfr between one and six months. The only independent variable associated with the final gfr was the pretreatment plasma glucose concentration (P=0·003).

Prevalence of disorders recorded in cats attending primary-care veterinary practices in England

Improved understanding of absolute and relative prevalence values for common feline disorders could support clinicians when listing differential diagnoses and also assist prioritisation of breeding, research and health control strategies. This study aimed to analyse primary-care veterinary clinical data within the VetCompass project to estimate the prevalence of the most common disorders recorded in cats in England and to evaluate associations with purebred status. It was hypothesised that common disorders would be more prevalent in purebred than in crossbred cats. From a study population of 142,576 cats attending 91 clinics across Central and South-East England from 1 September 2009 to 15 January 2014, a random sample of 3584 was selected for detailed clinical review to extract information on all disorders recorded. The most prevalent diagnosis-level disorders were periodontal disease (n = 499; prevalence, 13.9%, 95% confidence intervals [CI], 12.5-15.4), flea infestation (n = 285; prevalence, 8.0%; 95% CI, 7.0-8.9) and obesity (n = 239; prevalence, 6.7%; 95% CI, 5.7-7.6). The most prevalent disorder groups recorded were dental conditions (n = 540; prevalence, 15.1%, 95% CI, 13.6-16.6), traumatic injury (n = 463; prevalence, 12.9%; 95% CI, 11.6-14.3) and dermatological disorders (n = 373; prevalence, 10.4%; 95% CI, 9.2-11.7). Crossbred cats had a higher prevalence of abscesses (excluding cat bite abscesses) (P = 0.009) and hyperthyroidism (P = 0.002) among the 20 most common disorders recorded. Purebreds had a higher prevalence for coat disorders (P <0.001). Veterinarians could use these results to focus their diagnostic and prophylactic efforts towards the most prevalent feline disorders. The study did not show an increased prevalence of common disorders in purebred cats compared with crossbred cats. Primary-care veterinary clinical data were versatile and useful for demographic and clinical feline studies.

Chronic Kidney Disease in Dogs in UK Veterinary Practices: Prevalence, Risk Factors, and Survival

BACKGROUND The prevalence for chronic kidney disease (CKD) in dogs varies widely (0.05-3.74%). Identified risk factors include advancing age, specific breeds, small body size, and periodontal disease. HYPOTHESIS/OBJECTIVES To estimate the prevalence and identify risk factors associated with CKD diagnosis and survival in dogs. Purebred dogs were hypothesized to have higher CKD risk and poorer survival characteristics than crossbred dogs. ANIMALS A merged clinical database of 107,214 dogs attending 89 UK veterinary practices over a 2-year period (January 2010-December 2011). METHODS A longitudinal study design estimated the apparent prevalence (AP) whereas the true prevalence (TP) was estimated using Bayesian analysis. A nested case-control study design evaluated risk factors. Survival analysis used the Kaplan-Meier survival curve method and multivariable Cox proportional hazards regression modeling. RESULTS The CKD AP was 0.21% (95% CI: 0.19-0.24%) and TP was 0.37% (95% posterior credibility interval 0.02-1.44%). Significant risk factors included increasing age, being insured, and certain breeds (Cocker Spaniel, Cavalier King Charles Spaniel). Cardiac disease was a significant comorbid disorder. Significant clinical signs included halitosis, weight loss, polyuria/polydipsia, urinary incontinence, vomiting, decreased appetite, lethargy, and diarrhea. The median survival time from diagnosis was 226 days (95% CI 112-326 days). International Renal Interest Society stage and blood urea nitrogen concentration at diagnosis were significantly associated with hazard of death due to CKD. CONCLUSIONS AND CLINICAL IMPORTANCE Chronic kidney disease compromises dog welfare. Increased awareness of CKD risk factors and association of blood biochemistry results with survival time should facilitate diagnosis and optimize case management to improve animal survival and welfare.

Longevity and mortality of cats attending primary care veterinary practices in England

Enhanced knowledge on longevity and mortality in cats should support improved breeding, husbandry, clinical care and disease prevention strategies. The VetCompass research database of primary care veterinary practice data offers an extensive resource of clinical health information on companion animals in the UK. This study aimed to characterise longevity and mortality in cats, and to identify important demographic risk factors for compromised longevity. Crossbred cats were hypothesised to live longer than purebred cats. Descriptive statistics were used to characterise the deceased cats. Multivariable linear regression methods investigated risk factor association with longevity in cats that died at or after 5 years of age. From 118,016 cats attending 90 practices in England, 4009 cats with confirmed deaths were randomly selected for detailed study. Demographic characterisation showed that 3660 (91.7%) were crossbred, 2009 (50.7%) were female and 2599 (64.8%) were neutered. The most frequently attributed causes of mortality in cats of all ages were trauma (12.2%), renal disorder (12.1%), non-specific illness (11.2%), neoplasia (10.8%) and mass lesion disorders (10.2%). Overall, the median longevity was 14.0 years (interquartile range [IQR] 9.0–17.0; range 0.0–26.7). Crossbred cats had a higher median longevity than purebred cats (median [IQR] 14.0 years [9.1–17.0] vs 12.5 years [6.1–16.4]; P <0.001), but individual purebred cat breeds varied substantially in longevity. In cats dying at or after 5 years (n = 3360), being crossbred, having a lower bodyweight, and being neutered and non-insured were associated with increased longevity. This study described longevity in cats and identified important causes of mortality and breed-related associations with compromised longevity.

Approaches to canine health surveillance

Effective canine health surveillance systems can be used to monitor disease in the general population, prioritise disorders for strategic control and focus clinical research, and to evaluate the success of these measures. The key attributes for optimal data collection systems that support canine disease surveillance are representativeness of the general population, validity of disorder data and sustainability. Limitations in these areas present as selection bias, misclassification bias and discontinuation of the system respectively. Canine health data sources are reviewed to identify their strengths and weaknesses for supporting effective canine health surveillance. Insurance data benefit from large and well-defined denominator populations but are limited by selection bias relating to the clinical events claimed and animals covered. Veterinary referral clinical data offer good reliability for diagnoses but are limited by referral bias for the disorders and animals included. Primary-care practice data have the advantage of excellent representation of the general dog population and recording at the point of care by veterinary professionals but may encounter misclassification problems and technical difficulties related to management and analysis of large datasets. Questionnaire surveys offer speed and low cost but may suffer from low response rates, poor data validation, recall bias and ill-defined denominator population information. Canine health scheme data benefit from well-characterised disorder and animal data but reflect selection bias during the voluntary submissions process. Formal UK passive surveillance systems are limited by chronic under-reporting and selection bias. It is concluded that active collection systems using secondary health data provide the optimal resource for canine health surveillance.

Evaluation of a continuous glucose monitoring system in cats with diabetes mellitus.

A continuous glucose monitoring system (CGMS) was evaluated in 14 cats with naturally occurring diabetes mellitus. The device measures interstitial fluid glucose continuously, by means of a sensor placed in the subcutaneous tissue. All cats tolerated the device well and a trace was obtained on 15/16 occasions. There was good correlation between the CGMS values and blood glucose concentration measured using a glucometer (r=0.932, P<0.01). Limitations to the use of the CGMS are its working glucose range of 2.2–22.2 mmol/l (40–400 mg/dl) and the need for calibration with a blood glucose measurement at least every 12 h. When compared to a traditional blood glucose curve, the CGMS is minimally invasive, reduces the number of venepunctures necessary to assess the kinetics of insulin therapy in a patient and provides a truly continuous glucose curve.

Investigation of serum IGF-I levels amongst diabetic and non-diabetic cats

Since insulin-like growth factor-I (IGF-I) was first discovered as a mediator of glucose homeostasis, it has been extensively investigated in diabetes research in humans, rodents and primates. To date, however, relatively little work has been carried out on this hormone in the cat, despite the pathophysiological similarities between human and feline diabetes mellitus, as well as the relatively common nature of the disease in cats. This study reports on the IGF-I concentrations of 42 insulin treated diabetic cats and 25 normal cats. Diabetic subjects were grouped according to length of insulin treatment as either short, medium or long term. Analysis of variance (ANOVA) and Fischers pair-wise comparisons revealed that mean IGF-I levels in short-term diabetic cats were significantly lower than those in normal cats whilst mean levels in long-term diabetics were significantly higher. The direction and extent of these alterations may have implications for our understanding of the pathophysiology of feline diabetes mellitus and for the use of this hormone in the diagnosis of acromegaly in diabetic cats.