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Although some states are slowly reopening, we know things are still far from normal. To help you stay in the know, we will continue to keep you updated with the latest news about the pandemic and the veterinary industry.

View the video below for this week's top veterinary headlines:

Veterinary practice management consultant Bash Halow says practices will face 

several major challenges in the coming months

, including running a business during a recession, staff concerns about infection, cash-strapped clients cautious about spending, and persistent callouts and other HR issues.

Merck Animal Health has reached an agreement with Virbac to 

acquire the U.S. rights to Sentinel Flavor Tabs and Sentinel Spectrum Chews

The Association of American Veterinary Medical Colleges (AAVMC) has 

named Makenzie Peterson, MSc, as its first director for wellbeing

Videos

Check out this week's top veterinary headlines.

News wrap-up: This week's veterinary headlines, plus what the new normal could look like 

The inflammatory changes in the gut lining of patients suffering from IBD are thought to result from an overexuberant mucosal immune response to dietary antigens, intestinal pathogens and the patient’s own leukocytes.

In human medicine, serologic markers, including autoantibodies, are used clinically to aid diagnosis of IBD.

 A recent study explored the development of comparable assays in dogs,

 formatted as enzyme-linked immunosorbent assays to detect immunoglobulins (IgA, specifically) against various proteins associated with the immunologic triggers or with the humoral responseto these triggers.

Study subjects consisted of 151 dogs of varied breed, age and gender that presented for different reasons to three hospitals in Southern California. The dogs were grouped as follows:

70 dogs showing chronic gastrointestinal (GI) signs, including vomiting, diarrhea, anorexia and weight loss, for at least three weeks. Underlying infectious, endocrine and neoplastic diseases were ruled out. Intestinal biopsies, harvested at least 10 days after the last dosing of immunosuppressive or antimicrobial drugs, confirmed histologic changes consistent with IBD.

23 dogs presenting with GI signs that were episodic, of short duration and associated with underlying causes not related to IBD, such as dietary indiscretion and parasitism.

58 apparently healthy dogs, free of both current GI disease and a history ofrecurrent GI illness.

In dogs with IBD, biopsy samples were scored by a pathologist based on their severity. In 20 of these dogs, microorganisms were cultured and genetic regions of interest were amplified by polymerase chain reaction testing. Serum titers against genes of interest, including those coding for flagellin and the immune byproduct calprotectin, were measured, as were antibodies to microbial outer membrane porin C (OmpC), food-derived proteins (gliadins) and autoantibodies to canine polymorphonuclear leukocytes.

More than 85% of the dogs with IBD had visible endoscopic lesions in the duodenum or colon, with the most frequent diagnosis being lymphoplasmacytic enteritis followed by eosinophilic or mixed inflammation. Biopsies of the duodenum and colon, graded according to World Small Animal Veterinary Association guidelines, showed 9% of the dogs being severely affected, 48% moderately affected and 43% mildly affected.

Microbial communities, evaluated in 20 dogs with IBD, included 

Escherichia, Enterococcus, Enterobacter, Acinetobacter 

Autoantibody detection assays were performed to detect the presence of IgAs against immunologic elements.

Dogs with IBD had high rates of seropositivity against canine polymorphonuclear leukocytes (APMNA, 77%), canine calprotectin (ACNA, 43%), OmpC (ACA, 76%), flagellins (AFA, 39%) and gliadins (AGA, 54%).

For non-IBD sick dogs, 52% displayed positive titers against gliadins, indicating low specificity of this assay for IBD. Just 13% tested positive for APMNA, ACNA and ACA, while none tested positive for AFA. Among the normal cohort, 3% tested positive for ACA, and 8% to 9% were positive for the other four markers.

Differences between dogs with IBD and normal dogs were statistically significant for all of the markers. When comparing the IBD cohort and the non-IBD sick cohort, differences were statistically significant for all markers but gliadin.

Serologic markers in IBD represent the host’s immune response to translocation of bacteria and dietary proteins across the intestinal mucosal barrier, as well as to leukocytes and other immunologic components that play a role in the inflammatory changes present in chronic enteropathies.

This study focused on IgA because of its key role in mucosal immunity. IgA seropositivity was present at a significant rate for polymorphonuclear leukocytes, calprotectin, bacterial OmpC, flagellins and gliadins. Prevalences ranged from 39% to 79%, depending on the marker.

IgA associated with leukocytes (APMNA) had marked prevalence (77%) in the IBD cohort. Also notable in the IBD cohort was the bacterial OmpC (ACA) response (76%), which aligns with the abundance of Enterobacteriaceae in dogs with IBD.

The discriminating performance for the APMNA and ACA markers was excellent. For APMNA, seropositivity for IBD dogs versus non-IBD sick and normal dogs was 77% versus 13% and 9%, respectively. For ACA, seropositivity was 76% versus 13% and 3% for IBD versus non-IBD sick and normal dogs, respectively. The investigators’ analysis of the ACA performance parameters suggested 95% specificity and 85% sensitivity, coupling it tightly to the diagnosis of IBD.

The findings in this study provide evidence of serologic markers for microbes and immune physiologic processes tied to IBD. These markers might one day serve as data points used in the diagnosis of IBD. The markers described in this report might be incorporated into later studies aimed at differentiating dogs with and without IBD, and defining discrete subsets of affected dogs to better target treatments and nail down prognoses.

Dr. Capuzzi, who earned her BS and VMD degrees from the University of Pennsylvania, works in small animal practice in the Philadelphia area and is a published author. She has written for 

The Philadelphia Inquirer, Time, Business Philadelphia, Dog Fancy 

, among others. She is especially interested in public health and animal welfare, and is involved with several organizations whose missions are to improve the lives of domesticated and wild animals.

1. Xavier RY, Podolsky DK. Unravelling the pathogenensis of inflammatory bowel disease. 

2. Allenspach K, Luckschander N, Styner M, et al. Evaluation of assays for perinuclear antineutrophilic cytoplasmic antibodies and antibodies to 

in dogs with inflammatory bowel disease. 

3. Mancho C, Sainz A, Garcia-Sancho M, et al. Detection of perinuclear antineutrophil cytoplasmic antibodies and antinuclear antibodies in the diagnosis of canine inflammatory bowel disease. 

4. Nakamura RM, Matsutani M, Barry M. Advances in clinical laboratory tests for inflammatory bowel disease. 

5. Estruch JJ, Barken D, Bennett N, et al. Evaluation of novel serological markers and autoantibodies in dogs with inflammatory bowel disease. 

Articles


Identifying IBD is often a challenge, but the recent discovery of serum-based markers for canine IBD may make diagnosing this disease in dogs quicker, cheaper and less invasive. 


Analyzing serologic calling cards of inflammatory bowel disease 

Dogs’ super sniffers have the ability to help locate missing people, find narcotics and and even detect cancer. Now, researchers believe that dogs can add another skill to their list: the ability to detect changes in thermal radiation, according to a study published in 

Researchers from Lund University in Sweden and Eötvös Loránd University in Hungary conducted complementary experiments to determine the ability of the canine nose to detect thermal radiation. All of the radiating heat used in the experiements was too weak to be felt by human hands, even at short distances.

In the first double-blinded experiment, three healthy adult pet dogs were trained to choose between two objects. At first, the dogs were unable to see or smell any differences between the objects. But when the researchers created a slight temperature difference between the two items, all three dogs successfully detected the object that was giving off weak thermal energy.

In the second study, the researchers scanned the brains of 13 pet dogs from various breeds using functional magnetic resonance imaging. The dogs were presented with objects giving off weak or neutral thermal radiation. The brain scans demonstrated that the dogs were more responsive to the objects that gave off weak thermal radiation.

The researchers could tell from the scans that the left somatosensory cortex within the dogs' brains was more responsive to the weak thermal energy, noting that this indicates the possibility that dogs can sense weak hot spots and that the left somatosensory cortex is activated by a dog that is detecting infrared radiation.

“The study is consistent with other research that describes the combined dog nose and brain as a sophisticated platform for processing a broad range of signals,” says Gary Settles, an emeritus professor of mechanical engineering at Pennsylvania State University.

 for details on this study, including study limitations and directions for future research.

Balínt A, Andics A, Gácsi M, et al. Dogs can sense weak thermal radiation. 

https://doi.org/10.1038/s41598-020-60439-y

Dogs have long been known for their superior ability to detect scents. A new study shows that those snouts may be able to detect heat as well.

Dogs can detect differences in thermal energy

Mental health among veterinary professionals is receiving significant attention from the largest global veterinary association, including creation of a 

tasked with maintaining and advancing the health and wellbeing of veterinary professionals around the world.

Results from the World Small Animal Veterinary Association’s (WSAVA) recent online survey illustrate that stress and diminished wellbeing are a significant problem in the veterinary profession worldwide.

“Veterinarians care for our animal companions, but the question is, who is caring for them?” asks Nienke Endenburg, PhD, a psychologist at the University of Utrecht’s veterinary school in the Netherlands and cochair of WSAVA’s Professional Wellness Group Committee. “As a global community, we wanted to gain a clear understanding of the challenges faced by our members around the world and to find out both what they have in common and where their experience differs.”

Launched at the 2019 WSAVA World Congress in Toronto, the online survey—which was translated into six languages—was completed by 4,258 veterinary professionals. The respondents were predominantly women (81.7%) with a median age of 35. Although the survey was open to all veterinary professionals, veterinarians comprised 73.1% of the respondents, followed by staff (21.3%) and students (2.9%).

Some of the significant findings include:

Mental wellbeing is a particular issue in Asia, Africa, Europe and North America.

Oceania, a collection of islands in the Asia-Pacific region, is the highest-performing area in terms of wellbeing.

Veterinary technicians/nurses experience a significantly higher volume of mental health issues.

Older veterinary professionals are more satisfied with their careers.

The wellbeing of younger and female members of the profession is most at risk.

Veterinarians are significantly more satisfied with their careers than are veterinary nurses/technicians.

Although the survey uncovered undeniable similarities in how veterinary professionals feel their mental wellbeing is being compromised by their careers, there were notable differences in how particular regions respond to the severity of the issue and even the root causes.

“Nurses do not get paid an amount that reflects their worth,” said a 

8-year-old female veterinary nursing student from the United Kingdom. “In both human and animal medical settings, nurses are stretched thin across the field and are not recognized for their work. I feel this contributes a lot to the feelings of low self-worth within the nursing role.”

In Asia and Africa, there remains a reluctance to talk about mental health issues. “Mental illness has a stigma so people don't admit it or seek treatment,” said another respondent, a 39-year-old female veterinarian from Malaysia.

Dr. Endenburg agrees that people in certain areas of the world remain hesitant to speak about their struggles with mental health. “A lot of people believe that poor professional wellness, suicide and burnout are problems only in the Western world and that it is not an issue in Africa or Asia,” she told dvm360 in an exclusive interview.

However, the high level of response to the survey confirms that wellness is very important to all veterinary professionals. “It doesn’t matter where you are on the globe,” Dr. Endenburg adds.

In the coming months, WSAVA’s Professional Wellness Group will establish a centralized online location for original and repurposed materials that veterinary professionals can utilize as guidelines to address burnout and initiate conversations about wellbeing within their hospitals.

Dr. Endenburg says that since reading through the personal comments some respondents chose to include and by analyzing the quantitative data, she recognizes the need to make mental health part of the education process. “Students learn how to take care of patients, but they need to learn how to take care of themselves," she says. "I want to see it become standard in the curriculum that students are taught how to take care of their health and welfare.”

By initiating the conversation before graduation, Dr. Endenburg also hopes the experience will become normalized. “If we can talk about [mental health] then we can also solve the problem. Not only is it better for you to talk about it, but it is better for animal welfare and therefore the entire veterinary team.”

She also believes that a vital aspect of ensuring positive wellbeing for all veterinary professionals is determining which established programs currently have the most impact. “There are a lot of great toolkits available, like those from 

 in the United Kingdom,” she says. “I would like to see which of these programs are proving to be the most beneficial.” Could methods being integrated into practices in America help veterinary professionals in Europe or other areas of the world?

“The results of our research provide a unique global view of this important issue and we look forward to discussing these with our expert colleagues and exploring practical solutions that respect the regional, economic and cultural differences of our membership,” Dr. Endenburg says. “It will be an important first step toward bringing about positive change and enhancing the wellbeing of veterinarians globally.”

Following its worldwide survey of mental health and wellbeing in the veterinary profession, WSAVA vows to take steps to advance the health and welfare of veterinary teams around the world. 

Starting a global dialogue about mental health in veterinary medicine

The first step in managing diarrhea is characterizing it, according to Scott Owens, DVM, MS, DACVIM, an internist at MedVet Indianapolis. “There are many causes of diarrhea in cats,” Dr. Owens said during a recent 

. “Is it acute or chronic? Is is intra- or extra-intestinal? How severely are the intestines affected?”

Differentiating between small- and large-bowel diarrhea can streamline the diagnostic process. Small-bowel diarrhea, which is more common in cats, tends to be subtle and smoldering. It typically features large volume, low frequency, marked chronicity, associated weight loss and lack of straining, mucus or blood.

Large-bowel diarrhea, more common in dogs and often associated with dietary indiscretion, is more dramatic because it is generally acute and characterized by frequent trips to the litter box, tenesmus and bloody, mucoid stool. In cats, Dr. Owens said, diarrhea is usually mixed bowel in nature.

Before anything else, a fecal test should be run to rule out parasites. Large-bowel diarrhea signals intestinal parasites in cats and, particularly in kittens, is typically caused by roundworms, hookworms and coccidia. False-negatives are possible, as ova are shed intermittently, so a broad-spectrum dewormer should be considered.

Routine blood work to detect underlying causes of diarrhea might point to pancreatitis (low sensitivity for amylase/lipase), liver disease or nephropathy. In older cats, especially those with concurrent weight loss, a thyroxine (T4) test should be run to assess for hyperthyroidism.

If diarrhea is acute and severe, abdominal ultrasonography can be used to evaluate the five layers of the intestines (lumen, mucosa, submucosa, muscularis and serosa), mesenteric lymph nodes, pancreas and common bile duct.

For chronic and non–life-threatening diarrhea, a feeding challenge might uncover food-responsive diarrhea. A hydrolyzed diet, such as Royal Canin Ultamino or Hill’s Prescription Diet z/d, or a novel protein diet, is fed exclusively for a minimum of three weeks.

Dr. Owens summarized a study of 55 cats with idiopathic diarrhea.

Thirty percent responded to hypoallergenic diets and were diagnosed with food allergy. Large-bowel diarrhea and wheat/gluten sensitivity were found to be smoking guns in cats.

Dr. Owens said he sees a lower prevalence of feline food allergy in his own practice. While no definitive testing is available, he noted that he is more likely to diagnose food allergy in cats that are also pruritic.

Infectious diarrhea, more prevalent in young cats and/or those from catteries, generally causes acute large-bowel diarrhea. A fecal polymerase chain reaction (PCR) panel can identify common agents: 

, coronavirus, feline panleukopenia virus, 

Antibiotics, such as metronidazole and tylosin, can treat many of these pathogens effectively, as well as the general dysbiosis associated with them. Probiotics such as FortiFlora (Purina Pro Plan) can also be used to level out the disrupted gut flora that attends primary infectious and other enteritides.

Inflammatory bowel disease (IBD) and intestinal lymphoma can mimic one another. Both feature chronic diarrhea, typically small bowel, accompanied by malabsorption and weight loss. On physical examination, body condition is typically poor. Abdominal palpation may reveal thickened, ropey intestines and some degree of sensitivity.

Small-cell, versus large-cell, lymphoma, is often manageable, particularly the T-cell version. But diagnosis is hampered by the fact that lymphoma behaves like IBD.

Furthermore, histopathology sometimes fails to differentiate between the two, although immunohistochemistry and PARR testing (PCR for antigen receptor rearrangements) can identify monoclonal lymphocyte populations suggestive of lymphoma.

“A very high percentage of cats might fly through as IBD,” Dr. Owens said. “But when you get to PARR, you see that 80% of them have lymphoma.” Dr. Owens shared two look-alike case examples.

Sophie, a 14-year-old female, spayed, domestic medium-hair cat, had a six-month history of watery to soft small-bowel diarrhea and progressive weight loss. An indoor-outdoor cat, Sophie was active and her appetite was good. On physical exam, her body condition score (BCS) was 3/9, she had some muscle wasting and her coat was unkempt. Her intestines felt ropey, and her abdomen tensed on palpation.

Sophie’s fecal was negative. Urinalysis, blood chemistry and T4/free T4 results were normal. Her complete blood count (CBC) was normal but for a mild, nonregenerative anemia. Specific gastrointestinal (GI) tests—indicated in cases of chronic enteropathy with weight loss—were conducted. Sophie’s trypsin-like immunoreactivity (TLI) test was normal, essentially ruling out exocrine pancreatic insufficiency (EPI); her Spec fPL (Idexx Laboratories) was in the gray zone, indicating mild pancreatitis or triaditis; her folate level was normal; and her cobalamin level was low, suggesting infiltrative small-bowel disease with intestinal malabsorption.

Abdominal ultrasonography revealed hypertrophied small intestines and, more importantly, diffuse thickening of the muscle. “This very prominent thickening of the muscularis layer stands out in cats with prominent GI disease,” Dr. Owens said.

The primary diagnostic differentials were IBD and GI small cell lymphoma, with idiopathic enteritis,chronic pancreatitis and intestinal parasitism also on the list. Endoscopy was performed and biopsy samples were taken: The intestinal mucosa was inflamed and gelatinous. Histopathology showed massive lymphocyte infiltration, and diffuse small cell lymphoma was diagnosed.

After the first few weeks of treatment, which included corticosteroids, metronidazole, chlorambucil and vitamin B12, Sophie’s diarrhea began to resolve and her weight rebounded. She lived another few years on the chlorambucil protocol.

Mona, a 14.5-year-old female, spayed Manx cat, had a 5-month history of diarrhea, some vomiting and inappetence, and weight loss. On physical exam, Mona had a BCS of 3/9, muscle wasting, unthrifty appearance, patchy alopecia, and mild pain on cranial abdomen palpation. Her CBC and T4 were normal, and her alanine aminotransferase was mildly elevated. Urinalysis showed epithelial cells and white blood cells. Her Spec fPl was normal, her folate high (sometimes seen with dysbiosis) and her cobalamin low.

Abdominal ultrasound revealed prominent mesenteric lymph nodes, mildly thickened intestinal muscularis and a large bladder stone. The differential diagnosis included IBD, GI small cell lymphoma and EPI (TLI results pending).

During surgery to remove the bladder stone, the pancreas was observed to be shrunken and the bowel thickened. Intestinal and mesenteric lymph node biopsies were taken. Histopathology revealed reactive lymph nodes and a moderate, diffuse lymphoplasmacytic enteritis, as well as numerous mucus-producing goblet cells. The diagnosis was mild-to-moderate IBD, plus EPI (TLI ultimately came back low).

Mona was treated with pancreatic enzymes, a steroid taper and a course of cobalamin injections. She lived another four years.

EPI is uncommon in cats. The main clinical sign is weight loss. Affected cats also experience diarrhea due to maldigestion, malabsorption and dysbiosis. “It’s not uncommon to see some pretty severe bacterial overgrowth with EPI,” Dr. Owens said.

In cats, the chief underlying cause of EPI is chronic pancreatitis. Acinar atrophy can also lead to EPI, but less so in cats than in dogs.

Dr. Capuzzi is a small animal veterinarian and journalist based in the Philadelphia area.

1.  Guilford WG, Jones BR, Markwell PJ, et al. Food sensitivity in cats with chronic idio[athic gastrointestinal problems. 

Causes of feline diarrhea range from simple infection to cancer. By characterizing the diarrhea and running simple tests, the practitioner can identify the pathology and stop the mess. 

Feline diarrhea: Let the diagnostic clues flow

The Association of American Veterinary Medical Colleges (AAVMC) has named Glen Hoffsis, DVM, MS, DACVIM, as the recipient of the 2020 Senator John Melcher, DVM Leadership in Public Policy Award. Established in 2007, this annual award recognizes leadership in public policy that advances veterinary medical education and success in advocating for veterinary medical education on a national or international scale.

In addition to Dr. Hoffsis, AAVMC has recently rewarded five other university-based veterinarians for professional excellence, achievement and service in academic veterinary medicine:

 from The Ohio State University College of Veterinary Medicine, received the 2019 AAVMC Distinguished Veterinary Teacher Award, presented by Zoetis.

 from the University of California, Davis College of Veterinary Medicine, is the recipient of the 2020 AAVMC Excellence in Research Award.

 from the University of Sydney School of Veterinary Science, and 

 from Purdue University College of Veterinary Medicine are joint recipients of the 2020 Iverson Bell Award.

 the Carl B. King Dean of Veterinary Medicine at Texas A&M University College of Veterinary Medicine and Biomedical Sciences, was awarded the 2020 AAVMC Billy E. Hooper Award for Distinguished Service.

“Every day, educators and researchers at our member institutions make outstanding contributions to academic veterinary medicine that inspire others, contribute to medical breakthroughs and work to educate upcoming generations of veterinarians,” says AAVMC Chief Executive Officer Andrew T. Maccabe, DVM, JD, MPH, in a press release about the announcement.

Dr. Hoffsis has an extensive resume as a leader within academic veterinary medicine, including more than 20 years of experience as the dean of three veterinary medical colleges. He was founding dean of the Lincoln Memorial University (LMU) College of Veterinary Medicine in Tennessee, where he currently serves as special assistant to LMU’s president. Previously, he served as dean of the University of Florida College of Veterinary Medicine and The Ohio State University College of Veterinary Medicine.

At LMU, Dr. Hoffsis led a team that created more than 300 clinical affiliate distributive education sites for fourth-year veterinary students. At the University of Florida, he was instrumental in developing multiple educational programs, including rehabilitation, advanced cancer therapy, hyperbaric and alternative therapy, emergency and critical care, and wellness care.

Gary Vroegindewey, DVM, MSS, DACVPM, director of LMU’s One Health Program, nominated Dr. Hoffsis, writing that he is “an acknowledged thought leader in the modernization and delivery of veterinary education,” and that his many deserving accomplishments extend beyond veterinary medicine to encompass economics, public health, research, practice and public policy.

Dr. Hoffsis is past president of the AAVMC and the American Association of Bovine Practitioners. He has served on the board of directors of Banfield Pet Hospitals and is the former chair of the FDA’s Veterinary Medicine Advisory Committee. In 2018, he received the American Veterinary Medical Association’s Meritorious Service Award.

“My experience with the FDA made me see the importance of veterinarians interacting with major policymakers,” Dr. Hoffsis said in a 

 created by the AAVMC. “Public policy is really important for veterinarians to be engaged in, and the leaders of our academic institutions probably are the key leaders.”

A three-time veterinary school dean, Dr. Glen Hoffsis has had a major impact on both veterinary education and public policy. 

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