Pekka Olson

Breed Risk of Pyometra in Insured Dogs in Sweden

An animal insurance database containing data on over 200,000 dogs was used to study the occurrence of pyometra with respect to breed and age during 1995 and 1996 in Swedish bitches <10 years of age. A total of 1,803 females in 1995 and 1,754 females in 1996 had claims submitted because of pyometra. Thirty breeds with at least 800 bitches insured each year were studied using univariate and multivariate methods. The crude 12-month risk of pyometra for females <10 years of age was 2.0% (95% confidence interval = 1.9-2.1%) in 1995 and 1.9% (1.8-2.0%) in 1996. The occurrence of pyometra differed with age, breed, and geographic location. The risk of developing pyometra was increased (identified using multivariate models) in rough Collies, Rottweilers, Cavalier King Charles Spaniels, Golden Retrievers, Bernese Mountain Dogs, and English Cocker Spaniels compared with baseline (all other breeds, including mixed breed dogs). Breeds with a low risk of developing the disease were Drevers, German Shepherd Dogs, Miniature Dachshunds, Dachshunds (normal size), and Swedish Hounds. Survival rates indicate that on average 23-24% of the bitches in the databases will have experienced pyometra by 10 years of age. In the studied breeds, this proportion ranged between 10 and 54%. Pyometra is a clinically relevant problem in intact bitches, and differences related to breed and age should be taken into account in studies of this disease.

Mortality in insured Swedish dogs: rates and causes of death in various breeds

Data on over 222,000 Swedish dogs enrolled in life insurance in 1992 and 1993 were analysed. There were approximately 260 deaths per 10,000 dog-years at risk. Breed-specific mortality rates and causes of death are presented for breeds with more than 500 dogs at risk that had consistently high or low rates. Breed-specific mortality ranged from less than 1 per cent to more than 11 per cent. True rates and proportional statistics for the cause of death were calculated for the entire insured population (250 breeds) and cause-specific mortality rates were calculated for the breeds with the highest risk of dying of the most common causes. Trauma, tumours and problems related to the locomotor system together accounted for more than 40 per cent of all deaths or euthanasias. Although limited to insured dogs, these data cover approximately one-third of all Swedish dogs and provide baseline mortality data for further population-based studies on health and disease.

Validation of computerized Swedish dog and cat insurance data against veterinary practice records

Large computerized medical databases offer great potential for epidemiological research. However, data-quality issues must be addressed. This study evaluated the agreement between veterinary practice records and computerized insurance data in a large Swedish claims database. For the year 1995, the company insured over 320,000 dogs and cats. A total of 470 hard-copy records were sampled from claims for health care (n = 236) and life insurance (n = 234). Computerized insurance data for these claims were accessed and records from the attending veterinary practices were collected. For health and life claims, respectively, 79.2 and 72.8% of practice records were retrieved. Variables compared between the computer and practice records were breed, sex, date of birth and diagnosis for the claim. The degree of agreement was categorized as agreement, minor disagreement, major disagreement or data missing. Multivariable logistic regression was used to examine factors associated with errors. The observed agreement for breed and sex was excellent. There was 28.9 and 33.8% minor disagreement for the date of birth for health and life claims, respectively. This was mainly because, prior to 1993, the date of birth was coded as the first of January when more complete information was unavailable. Major disagreement (different year of birth) was low for both health and life claims. For health and life claims, the observed agreement for diagnosis was 84.0 and 84.9%, minor disagreement was 6.4 and 4.3%, and major disagreement 5.9 and 9.4%, respectively. Although there was no difference based on size of the veterinary clinic involved, there was a tendency for better agreement between the practice record and the computerized insurance data for claims from clinics with computerized practice records (n = 40) than for clinics with manual practice records (n = 286). Rates of discrepancy were affected by the clerk who processed the claims. Records processed by two of the 21 clerks had significantly more disagreements. Given the nature of the data, it was only possible to calculate a measure of observed agreement. In general, the agreement between data in the insurance-company database and from the practice records was excellent for demographic data such as breed and sex and fair for diagnostic information and date of birth. In general, the data are adequate to support ongoing research with due considerations of certain limitations.

Gender, age, breed and distribution of morbidity and mortality in insured dogs in Sweden during 1995 and 1996.

More than 200,000 dogs insured by one Swedish company at the beginning of either 1995 or 1996 were included in a retrospective, cross-sectional study. They could be covered for veterinary care at any age, but were eligible for life insurance only up to 10 years of age. Accessions for veterinary care that exceeded the deductible cost were used to calculate the risk of morbidity. The morbidity and mortality data have been stratified by gender, age, breed, location and human population density. In each year, 13 per cent of the dogs experienced at least one veterinary care event and the mortality risk was 3-0 per cent. The risk of morbidity varied with age, gender, breed, and location. The risk of mortality increased principally with age. It was possible to derive population-based risks of morbidity and mortality from these insurance data.

Mortality of swedish horses with complete life insurance between 1997 and 2000 : variations with sex, age, breed and diagnosis

The aim of this study was to evaluate the potential usefulness of the database maintained by the Swedish insurance company Agria for providing mortality statistics on Swedish horses. Mortality statistics (incidence rates and survival) were calculated, both crudely and stratified by sex, age, breed, breed group and diagnosis, for the horses with complete life insurance, which covers most health problems. The total mortality was 415 (95 per cent confidence interval [CI] 399 to 432) deaths per 10,000 horse-years at risk, and the diagnostic mortality, including only deaths with an assigned diagnosis, was 370 (95 per cent CI 355 to 386) deaths per 10,000 horse-years at risk. The diagnostic mortality of geldings was 459 (95 per cent CI 431 to 487), of mares 345 (95 per cent CI 322 to 365) and of stallions 214 (95 per cent CI 182 to 247) deaths per 10,000 horse-years at risk. The mortality rates increased with age and differed widely between breeds. Survival analysis showed that the median age at death of the horses enrolled before they were one year of age was 18·8 years. The most common cause of death or euthanasia was joint problems, which were responsible for 140 (95 per cent CI 130 to 149) deaths per 10,000 horse-years at risk. The results of multivariable models developed by using Poisson regression generally agreed well with the crude results.

Age pattern of mortality in eight breeds of insured dogs in Sweden

The objective of this study was to use several methods to describe the age patterns for risk of death in selected breeds of dogs insured for life in a Swedish animal-insurance company in 1996. Data on eight breeds were analyzed for age at death (including euthanasia). If dogs left the insurance for reasons other than death, they were regarded as censored. Dogs were only insured up to 10 years of age. Four analytical approaches were used. First, descriptive statistics of age distributions (e.g. breed-specific median ages at death, breed- and age-specific mortality risks) were computed. Second, age-specific estimates of survival were calculated using the formula: survival=(1-risk(age<1 year))(1-risk(age 1<2 year))... (1-risk(age 9<1 0 year)). Third, Cox regression (proportional-hazards model) was used to estimate survival and hazard functions. Finally, hierarchically coded Poisson regression was used to determine age-specific cut-points in the risk of death. The hazards from Cox and the incidence-density rates from the hierarchically coded models were transformed to estimates of risk: risk=1-exp¿-(hazard)¿ or 1-exp¿-(incidence-density rate)¿. The breeds studied were Beagle, Bernese mountain dog, Boxer, Cavalier King Charles spaniel, Drever, German shepherd dog, Mongrel and Poodle, together representing over 50000 dogs each year. The yearly breed-specific mortality risk varied between 1.7% (Poodle) and 6.5% (Bernese mountain dog). In all breeds, the risk of death increased with age but the pattern varied by breed. The probability of survival at 5 years of age varied between 94% (Cavalier King Charles spaniel and Poodle) and 83% (Bernese mountain dog, Drever, German shepherd dog) and the survival at 10 years between 83% (Poodle) and 30% (Bernese mountain dog). The survival estimates from Cox and those derived using the combined-risk formula were similar. The cut-point risk estimates provided a simplified picture of when the risk of death changed significantly compared to previous age categories. As anticipated, breeds differed widely in survival up to 10 years of age and there were marked differences in age patterns of mortality. The implications of these findings should be considered in multivariable analyses, where the confounding effect of age is often controlled for using a single age variable common to several breeds.

Specific causes of morbidity among Swedish horses insured for veterinary care between 1997 and 2000

The principal aim of this study was to analyse the incidence of disease due to general and more specific causes among over 100,000 horses covered by complete insurance for veterinary care by a Swedish insurance company during 1997 to 2000. The database was used to calculate the rate of cause-specific morbidity in horses of different ages, sexes and breed groups kept in different regions with different human population densities. The joints were the most commonly affected part of the body, followed by unspecified/whole body, the skin and the digestive system. The most common specific diagnosis was fetlock arthritis, followed by lameness of undefined origin, other locomotor problems, traumatic injuries to the skin, arthritis in several joints, and colic. Geldings had the highest rate of at least one disease event in the joints, unspecified/whole body, skeletal or respiratory system, whereas in the other four major systems the difference between the sexes was marginal.

Gender, age and breed pattern of diagnoses for veterinary care in insured dogs in Sweden during 1996

More than 200,000 dogs insured for veterinary care by one Swedish company at the beginning of 1996 were included in a retrospective cross-sectional study. Data from receipts for visits to veterinarians that were part of reimbursed veterinary care events, whose cost exceeded the deductible cost, were used to calculate the risk of cause-specific morbidity, both in total and stratified by gender, age and breed. Diagnoses were described by organic system, for example, cardiovascular, and by disease process, for example, neoplastic. The most commonly affected system was the integument followed by the gastrointestinal and genital systems. The genital system was the most commonly affected system in females, within which 50 per cent of the affected bitches had pyometra. Inflammatory processes were most common, followed by symptomatic conditions, traumatic injuries and neoplastic conditions.

Morbidity of Swedish horses insured for veterinary care between 1997 and 2000: variations with age, sex, breed and location

The aim of this study was to evaluate the potential usefulness of the database maintained by the Swedish insurance company Agria for providing disease statistics on Swedish horses. The demography of the horses insured for veterinary care during the period 1997 to 2000 was recorded and the incidence of morbidity, defined as horses that required veterinary care that cost more than the policy excess, was calculated. Yearly incidences were calculated for horses that required veterinary care at least once, first overall, and then for horses with complete insurance, by sex, age, breed group, breed, location and human population density. Poisson regression was applied to a multivariable model to produce estimates of relative risk adjusted for other factors in the model, such as age. The total number of horse-years at risk for those with complete insurance was over 72,000 each year. The annual incidence rate for horses that required veterinary care at least once varied from 1080 to 1190 events per 10,000 horse-years at risk; for geldings the averaged incidence rate was 1398 events, for mares it was 1042 events, and for stallions it was 780 events per 10,000 horse-years at risk. There were considerable variations in incidence rate between breeds.

Enterotoxigenic Escherichia coli (ETEC) and Klebsiella pneumoniae isolated from dogs with diarrhoea

Faecal samples from 148 dogs with diarrhoea and from 15 healthy dogs were cultured for bacterial pathogens with enterotoxigenic properties. The aim of the study was to define the toxin profile (production of heat-labile [LT] and heat-stable [ST] toxins) and possible surface fimbrial antigens. Enterotoxigenic bacteria were isolated from 6 (4.1%) dogs with diarrhoea, four of these were Escherichia coli and two were Klebsiella pneumoniae. The E. coli strains and K. pneumoniae strains were producing both LT and ST toxins. The LT toxin from these strains was not neutralized by human anti-LT serum or anti-choleragen and did not cause coagglutination with Staphylococcus aureus coated with anti-human-LT. This suggests that the LT toxin produced by these canine isolates is non-identical to LT toxin from human strains. Three of the ETEC strains were haemagglutinating and showed surface hydrophobic properties. Electron microscopy showed that canine ETEC isolates possessed fimbriae of two different types: thick (5-5.5 nm) and thin (2-3 nm).