FELINE FOCUS
CPD
Enthusiastic welcome for ISFM in Malaysia A capacity audience of 225 veterinary surgeons from 19 countries gathered in Kuala Lumpur, Malaysia, in late February to update their knowledge on liver and kidney disease in the cat at the ISFM Asia Pacific Feline Congress held in partnership with Royal Canin. The majority of delegates were from Malaysia and Korea, although some had travelled from as far afield as the USA and various European countries to attend.
Speakers and ISFM representatives at the Congress (from left): Fabienne Dethioux, Rachel Korman, Ross Tiffin, Martha Cannon, Claire Bessant and Andy Sparkes
The President of the Malaysian Small Animal Veterinary Association, Dr Nadzariah Cheng Abdullah (centre), met with Dr Andy Sparkes, Veterinary Director of ISFM and Fabienne Dethioux of Royal Canin (ISFM’s Congress partner) to discuss setting up a Malaysian feline group
The Congress lectures were held in the grand surroundings of the Renaissance Hotel, Kuala Lumpur
The Congress venue, the Renaissance Hotel, located in the middle of Kuala Lumpur’s Golden Triangle, provided stunning views of the Petronas Twin Towers, the world’s tallest twin buildings and a key landmark in the city. Courtesy of Satashi Higashiyama
Yuki Hattori (left), founder of the Tokyo Feline Medical Centre, is congratulated by Andy Sparkes, on attaining ‘gold’ Cat Friendly Clinic (CFC) scheme accreditation. The Tokyo Feline Medical Centre is the first practice to gain CFC status in Japan
Epidemiological study into mycobacterial disease: call for cases Following on from PhD studies into the epidemiology of environmental mycobacterial infections, Dr Carolyn O’Brien, an Australian specialist in feline medicine, has launched a website (www.mycovet.com) dedicated to collecting further data on the incidence of feline mycobacterial diseases to provide a worldwide perspective. Dr O’Brien hopes that veterinarians and owners will contribute details of affected animals via an online survey over the next few years, to build up a large database of cases. The collected data will be used purely for epidemiological purposes and will not be passed on to a third party or used for financial gain. The site also
contains information for cat owners on the diagnosis and management of feline tuberculosis, leprosy and environmental saprophytic mycobacterial infections (eg, rapidly growing mycobacteria and members of the Mycobacterium avium complex). Also listed are useful contacts for veterinarians, such as details of Mycobacterium Reference Laboratories, and experts in the diagnosis and treatment of feline mycobacterial disease. Dr O’Brien intends to develop the resource, and any suggestions or requests for additional information or contributions such as images (with owner permission) are most welcome.
JFMS CLINICAL PRACTICE
441
FELINE FOCUS
Feline advocates
In conversation: Tony Buffington This is the first of an occasional series of interviews with ‘movers and shakers’ who have helped to shape ideas and have driven the development of knowledge in feline medicine. Nicolette Joosting, a veterinarian at the Vancouver Feline Hospital in Canada, speaks with Tony Buffington in this first conversation.
What is it about feline idiopathic cystitis that you find so interesting?
Q
I think it is the opportunity to work on a mystery. I have gone from thinking that most cases were diet-related to thinking that most are a consequence of the effects of adverse early life experiences on the sensitivity of the nervous system. And I think we still have a lot more to discover. Before I retire, I plan to finish a prospective observational study of kittens from 8 weeks to 2 years of age to investigate the effects of multimodal environmental modification (MEMO) on health outcomes, obesity and Pandora syndrome. This will take 7–10 years. Developmental origins in health and disease are so important, both from the point of view of helping us understand disease, but I would say, in particular, helping us understand disease prevention. I would like to see more young colleagues researching in this field.
A
If you had to campaign on a particular feline issue, what would it be?
Q
I am campaigning! It is to find ways to explain the inestimable value of environmental enrichment, starting from the moment people acquire a cat and continuing for the rest of its life. I would like to help people understand cats for what they really are, rather than what they imagine them to be. An issue facing feline medicine today is the current level of understanding of cats by many veterinarians, which limits their ability to work with them effectively and enjoyably. My proudest moment,
A
442
JFMS CLINICAL PRACTICE
career-wise, has been to see our enrichment work move in the direction of ‘standard of practice’ for cats, without reference to us specifically. To help with this, I am working on an iBook and a publically available iTunes U course to try to make information available to more people. At the ISFM Riga conference, I will spend a fair bit of time talking about how to identify cats and kittens at risk of ‘Pandora syndrome’, MEMO and the current information and tools we have to help. What advice would you give to anyone wanting to start a career in feline medical research?
Q
Do a PhD in a leading laboratory studying a human disease that also occurs in cats – such as obesity, type 2 diabetes, a zoonosis – to develop the naturally occurring disease in cats as a translational animal model. This improves the chances of getting National Institutes of Health (NIH)-level funding, so both humans and cats win! In feline medicine, we are plagued by a lack of independent research funding.
A
What has been your favourite article in the JFMS and why?
Q A
There is certainly more than one but the article that comes to mind is by Dorothy P Laflamme and Steven S Hannah, ‘Discrepancy between use of lean body mass or nitrogen balance to determine protein requirements for adult cats’ (JFMS 2013; 15: 691–697). There are several reasons why I like this paper. Nutritionists know that nitrogen balance studies are inadequate for determining optimum protein requirements – telling other people
Tony Buffington DVM, MS, PhD, Diplomate ACVN, has been researching feline lower urinary tract disease for over 30 years, and this is how we know him best – as the driving force behind the Indoor Cat Initiative, MEMO and current concepts of feline idiopathic cystitis, work that has significantly improved our understanding of cats and how to care for them. He started out in nutritional research – looking at arginine deficiency in cats – at the University of California, Davis, cat colony. His current area of research is exploring the role of epigenetic modulation of gene expression in feline urological syndrome, idiopathic cystitis and other medically unexplained syndromes. Dr Buffington has authored over 100 scientific publications and 30 book chapters, and coauthored the Manual of Veterinary Dietetics. His career is peppered with an incredible number of lifetime achievement awards. A nutritionist at heart, he has applied his knowledge to benefit both human and veterinary medicine, is an active member of several national and international societies, and continues to engage student minds at Ohio State University where he is Professor of Clinical Nutrition. Dr Buffington is the lead author on a special article in this issue of JFMS on ‘Pandora syndrome’ and a keynote speaker at next month’s ISFM Congress in Riga, where he will be speaking on evidencebased medicine, Pandora syndrome and clinical nutrition.
FELINE FOCUS
that is a good thing. Looking at lean body mass was very interesting, and the fact that they gave minimum protein needs as 5 g/kg, at least a g/kg more than I would have guessed, is important. What I like most about the paper is its potential implication in the current discussion about cats and carbohydrates: perhaps the true issue is not that there is too much carbohydrate, but not enough protein. It would take a separate set of experiments to tease that out. Maybe if we could ask a question like that we could get people to start thinking about the carbohydrate/protein thing again, in a different way. I think there is a whole lot more to nutrition than the ingredient composition of the diet. It is the amino acid composition, not the ingredients. One of the many challenges for nutritionists is to help people understand what is marketing and what is nutritional science. The ingredients are marketing. There is so much noise out there that the issues of body condition scoring and food puzzles and environmental enrichment are just drowned out when it comes to information on how to feed our cats. I have written on that for Vetstreet.com and I will definitely be talking about that in Riga. You list in your research interests ‘personality type and learning style’ – does that morph into the FIC research in itself?
Q
There has been very little work done on personality type in cats, and people are going to need to work on it and develop that science. What appears to be true in human patients with central sensitivity syndromes or medically unexplained syndromes is that they tend towards a different personality style that is more nervous and anxious, or are more perceptive about their surroundings. I would certainly say that we have found that in cats as well – that they are more sensitive to their surroundings, they have higher acoustic startle responses, those kind of things. In other words, what has been found in personality types in chronic pain syndromes in humans also applies to cats.
A
We might have found just enough to develop the hypothesis but we haven’t tested that hypothesis. Questions are whether that personality type is due to genetics, and to what extent is it due to genetics, epigenetics and environment. One of the things I am quite interested in is the determination by behavioral studies of personality types, as behavior depends on context, and one of the things we saw in the FIC cats is that when we brought them into the colony, not only did all their signs go away but their behavior changed. It can be difficult to determine personality type unless animals have been in an enriched environment for at least 6 months so that they have been able to express who they really are. I don’t know of a good way to document the quality of the environment except to ask about it; and of course that’s fraught with difficulty. Those are challenges for the next generation and I am getting to the point in my career that we are looking for people to take over this study. What do you think will be the biggest change in the veterinary profession over the next 10 years?
Q
My biggest worry about the future is the medical education bubble, which if you believe the analysis recently published in the New England Journal of Medicine, will affect veterinary medicine first. I think that community practice – and my definition of community practice is that community practitioners are those people that do prediction and prevention – is what is undervalued. One of the problems of the increase in expenditures in medical education generally is that people continue to move into the specialties because, for a while, there is more money there. Educational institutes have run into the problem because veterinary medicine, as far as I know, is about 80% community practice and 20% specialty practice, but the universities are just the opposite, 20% of the education is in community medicine prevention and prediction, and 80% is specialty (ie, find it and fix it after it is already broken).
A
There is going to be a whole lot more community practice in human medicine because they see all of the savings in prediction and prevention. It is just like ‘Pandora syndrome’; I don’t have the answers to these things but I sure think we ought to be talking about them.
Books
Bite-sized review Animal welfare in veterinary practice James Yeates. Wiley-Blackwell, UFAW, 2013. Paperback, 212 pages. Price £34.99. ISBN 978444334876.
Positives This book encourages practitioners to view issues from a number of perspectives, some of which may be novel, and provides strategies and tools to facilitate a logical approach to ensuring a positive welfare legacy. It is a valuable addition to a veterinary library and could be used to stimulate team discussion and promotion of welfare-focused practice. Negatives Some practitioners may find the idea of assimilating formal welfare assessment too time consuming. While various qualitative and quantitative examples are included, the inclusion of a practiceapplicable welfare assessment tool as an appendix may increase uptake. Target audience Vets in practice. Comment Vets can easily overlook welfare considerations in practice and it is important that we critically evaluate our inherent biases as outlined in this book. A very relevant and timely volume that highlights the veterinarian’s unique role in ensuring animal welfare. Ratings (out of five) Feline-specific content Practice resource Value for money Overall reviewer rating Karen Hiestand BVSc, MSc, MRCVS JFMS CLINICAL PRACTICE
443
FELINE FOCUS
Survey
Vets’ perceived role of stress in common feline diseases There are several common feline conditions in which stress is thought to play a role, yet the extent to which stress is considered by the vet, if at all, depends on the condition in question and the country of origin of the vet. These were the findings of a survey of 520 vets carried out by Ceva in 2013. The survey was performed in four countries: France (120 vets), Germany (100), UK (101) and USA (200). All selected veterinary clinics were mostly or solely small animal practices, and all had both canine and feline patients (ie, no feline-only practices). Six common conditions were investigated: recurrent cystitis, alopecia or overgrooming, obesity, respiratory tract infection, chronic digestive problems and anorexia (see Figure 1). Stress is thought to be a predisposing or aggravating factor in these conditions. For each, clinicians were asked, ‘How often do you investigate the potential effect of stress by asking the owners questions related to the cat’s environment and behaviour?’ In terms of clear overall trends, from the vets’ perspective, two chronic conditions were clearly associated with a potential stress problem in the cat: recurrent cystitis problems (feline idiopathic cystitis) and alopecia due to overgrooming (Figure 1a,b). When a cat is presented with one of these two medical conditions, the vet will frequently ask the owners questions relating to the cat’s living environment and their behaviour. However, two other common feline conditions (obesity and respiratory tract infections, Figure 1c,d) were less likely to be considered during the consultation as being linked to a potential stress problem affecting the cat. The findings in cases of chronic digestive problems and anorexia were less clear-cut, but more balanced between countries. Ceva believes that this market research supports the need for further focus on investigating potential stress factors in the cat’s environment when presented with certain diseases, as well as finding ways to decrease these stress factors as part of planned treatment.
(a) Recurrent cystitis problems
(b) Alopecia or overgrooming
(c) Obesity
(d) Respiratory tract infection
(e) Chronic digestive problems
(f) Anorexia
Figure 1(a–f) Common conditions for which clinicians were asked ‘How often do you investigate the potential effect of stress by asking the owners questions related to the cat’s environment and behaviour?’. Courtesy of Bio’Sat
‘Cats for all seasons’ photography competition
International Cat Care, in conjunction with Your Cat and Digital Photographer magazines, is looking for beautiful images of cats to feature in a 2015 calendar that will be sold to raise funds for the charity’s welfare work (see www.icatcare.org/in-action/our-projects). There is a £500 first prize and the winning picture will feature on the cover of the calendar. Other photographs will be chosen to illustrate each month. All
winners will receive five copies of the calendar plus International Cat Care merchandise. Winning images will be displayed at the International Cat Care’s awards event in London. For more information and to take part, visit www.icatcare.org and enter via the photography competition link. Terms and conditions apply. < Deadline for entries is July 25, 2014.
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Education
Campaign
Impressive line-up for AAFP conference
Better regulation required for permethrin
This year, the AAFP Conference is taking place in Indianapolis, a city that offers a huge selection of arts, attractions, historical sites and eclectic cultural districts. Not only will attendees be offered discounts to explore all that the city has to offer in and around downtown Indianapolis, they will also have unparalleled access to material exclusively geared towards feline medicine. With three educational tracks, including one para-professional track, this year’s AAFP Conference will highlight feline gastroenterology and endocrinology.
The AAFP has endorsed the ISFM’s protect against permethrin poisoning campaign. According to the AAFP Feline Welfare Committee: ‘Many canine flea products, both veterinary and over-the-counter, here in the US also contain levels of permethrins deemed toxic to cats. Endorsement of this program by the AAFP will help to extend the reach of this campaign throughout the world and help prevent suffering and deaths among cats worldwide.’ ISFM launched a campaign for better regulation of the sale of permethrin-containing products in August 2013. As a result of the campaign, a leading pet superstore in the UK put a prompt on tills reminding staff to ask customers during the checkout process if they were aware of the risk to cats in the home when purchasing a permethrin-based spot-on dog flea treatment. Over 50 websites which sell flea treatments online were contacted by ISFM and asked to print warnings if they sold these treatments. Both AAFP and ISFM plan to actively promote the campaign this year. To add your vote go to www.icatcare.org/permethrin/petition
Distinguished speakers We are excited to announce a superb line-up of distinguished speakers. As experts in their fields, they are ready to present on a number of topics that will interest both the experienced feline practitioner and those looking to expand their knowledge of feline medicine. Speakers include: < Dr Catherine Scott-Moncrief and Dr Audrey Cook, who will discuss a variety of aspects of diabetes; < Dr Mark Peterson, who will present topics on hyperthyroidism; < Dr Kenneth Simpson, who will present on pancreatitis, persistent vomiting and chronic gastrointestinal disease; < Dr Sharon Center, who will present on hepatic lipidosis and liver syndromes/diseases; < Dr Michael Lappin, who will present on infectious diseases; and < Dr Gary Norsworthy and Dr Craig Webb, who will present new research on chronic small bowel disease in cats and stem cell therapy in feline chronic enteropathy.
Location Indianapolis is host to famous events like the Indianapolis 500 and Super Bowl XLVI in 2012. It is also known for its high-rated restaurants, the largest children’s museum in the world, the Indianapolis Zoo, the Indianapolis Museum of Art, and the Circle Centre, which is a four-level
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JFMS CLINICAL PRACTICE
mall and a downtown landmark. There are plenty of things to do and see while you are in this gorgeous city.
Social events Join your colleagues at the many social events offered throughout the conference, like the Boehringer Ingelheim Welcome Reception and the Bayer Exhibitors’ Happy Hour Reception. Also offered will be a remarkable Elanco Offsite Event at the Indiana State Museum where guests will wander the galleries, take gondola rides through the canal, feast on fine dining, and dance the night away.
Exhibit hall From the experienced feline practitioner to new practitioners or those looking to expand their knowledge, you can be sure the 2014 AAFP Conference will be bustling with enthusiasm. Because attendees are looking for new and improved solutions to offer in their practice, we have secured a large exhibit hall to showcase this year’s exhibitors! For more information on programs, speakers, registration, accommodation and travel go to www.catvets.com/education
Weight Management Guidelines The AAFP has recently endorsed the American Animal Hospital Association’s Weight Management Guidelines for Dogs and Cats. These guidelines were developed to help the practicing veterinarian raise awareness of the negative health consequences of excess weight, promote the prevention of excess weight, and offer suggestions and tools for the management of weight loss and long-term maintenance of healthy weight. To access this resource, visit www.catvets.com/guidelines/ endorsements.
CPD
Enthusiastic welcome for ISFM in Malaysia A capacity audience of 225 veterinary surgeons from 19 countries gathered in Kuala Lumpur, Malaysia, in late February to update their knowledge on liver and kidney disease in the cat at the ISFM Asia Pacific Feline Congress held in partnership with Royal Canin. The majority of delegates were from Malaysia and Korea, although some had travelled from as far afield as the USA and various European countries to attend.
Speakers and ISFM representatives at the Congress (from left): Fabienne Dethioux, Rachel Korman, Ross Tiffin, Martha Cannon, Claire Bessant and Andy Sparkes
The President of the Malaysian Small Animal Veterinary Association, Dr Nadzariah Cheng Abdullah (centre), met with Dr Andy Sparkes, Veterinary Director of ISFM and Fabienne Dethioux of Royal Canin (ISFM’s Congress partner) to discuss setting up a Malaysian feline group
The Congress lectures were held in the grand surroundings of the Renaissance Hotel, Kuala Lumpur
The Congress venue, the Renaissance Hotel, located in the middle of Kuala Lumpur’s Golden Triangle, provided stunning views of the Petronas Twin Towers, the world’s tallest twin buildings and a key landmark in the city. Courtesy of Satashi Higashiyama
Yuki Hattori (left), founder of the Tokyo Feline Medical Centre, is congratulated by Andy Sparkes, on attaining ‘gold’ Cat Friendly Clinic (CFC) scheme accreditation. The Tokyo Feline Medical Centre is the first practice to gain CFC status in Japan
Epidemiological study into mycobacterial disease: call for cases Following on from PhD studies into the epidemiology of environmental mycobacterial infections, Dr Carolyn O’Brien, an Australian specialist in feline medicine, has launched a website (www.mycovet.com) dedicated to collecting further data on the incidence of feline mycobacterial diseases to provide a worldwide perspective. Dr O’Brien hopes that veterinarians and owners will contribute details of affected animals via an online survey over the next few years, to build up a large database of cases. The collected data will be used purely for epidemiological purposes and will not be passed on to a third party or used for financial gain. The site also
contains information for cat owners on the diagnosis and management of feline tuberculosis, leprosy and environmental saprophytic mycobacterial infections (eg, rapidly growing mycobacteria and members of the Mycobacterium avium complex). Also listed are useful contacts for veterinarians, such as details of Mycobacterium Reference Laboratories, and experts in the diagnosis and treatment of feline mycobacterial disease. Dr O’Brien intends to develop the resource, and any suggestions or requests for additional information or contributions such as images (with owner permission) are most welcome.
JFMS CLINICAL PRACTICE
441
FELINE FOCUS
Feline advocates
In conversation: Tony Buffington This is the first of an occasional series of interviews with ‘movers and shakers’ who have helped to shape ideas and have driven the development of knowledge in feline medicine. Nicolette Joosting, a veterinarian at the Vancouver Feline Hospital in Canada, speaks with Tony Buffington in this first conversation.
What is it about feline idiopathic cystitis that you find so interesting?
Q
I think it is the opportunity to work on a mystery. I have gone from thinking that most cases were diet-related to thinking that most are a consequence of the effects of adverse early life experiences on the sensitivity of the nervous system. And I think we still have a lot more to discover. Before I retire, I plan to finish a prospective observational study of kittens from 8 weeks to 2 years of age to investigate the effects of multimodal environmental modification (MEMO) on health outcomes, obesity and Pandora syndrome. This will take 7–10 years. Developmental origins in health and disease are so important, both from the point of view of helping us understand disease, but I would say, in particular, helping us understand disease prevention. I would like to see more young colleagues researching in this field.
A
If you had to campaign on a particular feline issue, what would it be?
Q
I am campaigning! It is to find ways to explain the inestimable value of environmental enrichment, starting from the moment people acquire a cat and continuing for the rest of its life. I would like to help people understand cats for what they really are, rather than what they imagine them to be. An issue facing feline medicine today is the current level of understanding of cats by many veterinarians, which limits their ability to work with them effectively and enjoyably. My proudest moment,
A
442
JFMS CLINICAL PRACTICE
career-wise, has been to see our enrichment work move in the direction of ‘standard of practice’ for cats, without reference to us specifically. To help with this, I am working on an iBook and a publically available iTunes U course to try to make information available to more people. At the ISFM Riga conference, I will spend a fair bit of time talking about how to identify cats and kittens at risk of ‘Pandora syndrome’, MEMO and the current information and tools we have to help. What advice would you give to anyone wanting to start a career in feline medical research?
Q
Do a PhD in a leading laboratory studying a human disease that also occurs in cats – such as obesity, type 2 diabetes, a zoonosis – to develop the naturally occurring disease in cats as a translational animal model. This improves the chances of getting National Institutes of Health (NIH)-level funding, so both humans and cats win! In feline medicine, we are plagued by a lack of independent research funding.
A
What has been your favourite article in the JFMS and why?
Q A
There is certainly more than one but the article that comes to mind is by Dorothy P Laflamme and Steven S Hannah, ‘Discrepancy between use of lean body mass or nitrogen balance to determine protein requirements for adult cats’ (JFMS 2013; 15: 691–697). There are several reasons why I like this paper. Nutritionists know that nitrogen balance studies are inadequate for determining optimum protein requirements – telling other people
Tony Buffington DVM, MS, PhD, Diplomate ACVN, has been researching feline lower urinary tract disease for over 30 years, and this is how we know him best – as the driving force behind the Indoor Cat Initiative, MEMO and current concepts of feline idiopathic cystitis, work that has significantly improved our understanding of cats and how to care for them. He started out in nutritional research – looking at arginine deficiency in cats – at the University of California, Davis, cat colony. His current area of research is exploring the role of epigenetic modulation of gene expression in feline urological syndrome, idiopathic cystitis and other medically unexplained syndromes. Dr Buffington has authored over 100 scientific publications and 30 book chapters, and coauthored the Manual of Veterinary Dietetics. His career is peppered with an incredible number of lifetime achievement awards. A nutritionist at heart, he has applied his knowledge to benefit both human and veterinary medicine, is an active member of several national and international societies, and continues to engage student minds at Ohio State University where he is Professor of Clinical Nutrition. Dr Buffington is the lead author on a special article in this issue of JFMS on ‘Pandora syndrome’ and a keynote speaker at next month’s ISFM Congress in Riga, where he will be speaking on evidencebased medicine, Pandora syndrome and clinical nutrition.
FELINE FOCUS
that is a good thing. Looking at lean body mass was very interesting, and the fact that they gave minimum protein needs as 5 g/kg, at least a g/kg more than I would have guessed, is important. What I like most about the paper is its potential implication in the current discussion about cats and carbohydrates: perhaps the true issue is not that there is too much carbohydrate, but not enough protein. It would take a separate set of experiments to tease that out. Maybe if we could ask a question like that we could get people to start thinking about the carbohydrate/protein thing again, in a different way. I think there is a whole lot more to nutrition than the ingredient composition of the diet. It is the amino acid composition, not the ingredients. One of the many challenges for nutritionists is to help people understand what is marketing and what is nutritional science. The ingredients are marketing. There is so much noise out there that the issues of body condition scoring and food puzzles and environmental enrichment are just drowned out when it comes to information on how to feed our cats. I have written on that for Vetstreet.com and I will definitely be talking about that in Riga. You list in your research interests ‘personality type and learning style’ – does that morph into the FIC research in itself?
Q
There has been very little work done on personality type in cats, and people are going to need to work on it and develop that science. What appears to be true in human patients with central sensitivity syndromes or medically unexplained syndromes is that they tend towards a different personality style that is more nervous and anxious, or are more perceptive about their surroundings. I would certainly say that we have found that in cats as well – that they are more sensitive to their surroundings, they have higher acoustic startle responses, those kind of things. In other words, what has been found in personality types in chronic pain syndromes in humans also applies to cats.
A
We might have found just enough to develop the hypothesis but we haven’t tested that hypothesis. Questions are whether that personality type is due to genetics, and to what extent is it due to genetics, epigenetics and environment. One of the things I am quite interested in is the determination by behavioral studies of personality types, as behavior depends on context, and one of the things we saw in the FIC cats is that when we brought them into the colony, not only did all their signs go away but their behavior changed. It can be difficult to determine personality type unless animals have been in an enriched environment for at least 6 months so that they have been able to express who they really are. I don’t know of a good way to document the quality of the environment except to ask about it; and of course that’s fraught with difficulty. Those are challenges for the next generation and I am getting to the point in my career that we are looking for people to take over this study. What do you think will be the biggest change in the veterinary profession over the next 10 years?
Q
My biggest worry about the future is the medical education bubble, which if you believe the analysis recently published in the New England Journal of Medicine, will affect veterinary medicine first. I think that community practice – and my definition of community practice is that community practitioners are those people that do prediction and prevention – is what is undervalued. One of the problems of the increase in expenditures in medical education generally is that people continue to move into the specialties because, for a while, there is more money there. Educational institutes have run into the problem because veterinary medicine, as far as I know, is about 80% community practice and 20% specialty practice, but the universities are just the opposite, 20% of the education is in community medicine prevention and prediction, and 80% is specialty (ie, find it and fix it after it is already broken).
A
There is going to be a whole lot more community practice in human medicine because they see all of the savings in prediction and prevention. It is just like ‘Pandora syndrome’; I don’t have the answers to these things but I sure think we ought to be talking about them.
Books
Bite-sized review Animal welfare in veterinary practice James Yeates. Wiley-Blackwell, UFAW, 2013. Paperback, 212 pages. Price £34.99. ISBN 978444334876.
Positives This book encourages practitioners to view issues from a number of perspectives, some of which may be novel, and provides strategies and tools to facilitate a logical approach to ensuring a positive welfare legacy. It is a valuable addition to a veterinary library and could be used to stimulate team discussion and promotion of welfare-focused practice. Negatives Some practitioners may find the idea of assimilating formal welfare assessment too time consuming. While various qualitative and quantitative examples are included, the inclusion of a practiceapplicable welfare assessment tool as an appendix may increase uptake. Target audience Vets in practice. Comment Vets can easily overlook welfare considerations in practice and it is important that we critically evaluate our inherent biases as outlined in this book. A very relevant and timely volume that highlights the veterinarian’s unique role in ensuring animal welfare. Ratings (out of five) Feline-specific content Practice resource Value for money Overall reviewer rating Karen Hiestand BVSc, MSc, MRCVS JFMS CLINICAL PRACTICE
443
FELINE FOCUS
Survey
Vets’ perceived role of stress in common feline diseases There are several common feline conditions in which stress is thought to play a role, yet the extent to which stress is considered by the vet, if at all, depends on the condition in question and the country of origin of the vet. These were the findings of a survey of 520 vets carried out by Ceva in 2013. The survey was performed in four countries: France (120 vets), Germany (100), UK (101) and USA (200). All selected veterinary clinics were mostly or solely small animal practices, and all had both canine and feline patients (ie, no feline-only practices). Six common conditions were investigated: recurrent cystitis, alopecia or overgrooming, obesity, respiratory tract infection, chronic digestive problems and anorexia (see Figure 1). Stress is thought to be a predisposing or aggravating factor in these conditions. For each, clinicians were asked, ‘How often do you investigate the potential effect of stress by asking the owners questions related to the cat’s environment and behaviour?’ In terms of clear overall trends, from the vets’ perspective, two chronic conditions were clearly associated with a potential stress problem in the cat: recurrent cystitis problems (feline idiopathic cystitis) and alopecia due to overgrooming (Figure 1a,b). When a cat is presented with one of these two medical conditions, the vet will frequently ask the owners questions relating to the cat’s living environment and their behaviour. However, two other common feline conditions (obesity and respiratory tract infections, Figure 1c,d) were less likely to be considered during the consultation as being linked to a potential stress problem affecting the cat. The findings in cases of chronic digestive problems and anorexia were less clear-cut, but more balanced between countries. Ceva believes that this market research supports the need for further focus on investigating potential stress factors in the cat’s environment when presented with certain diseases, as well as finding ways to decrease these stress factors as part of planned treatment.
(a) Recurrent cystitis problems
(b) Alopecia or overgrooming
(c) Obesity
(d) Respiratory tract infection
(e) Chronic digestive problems
(f) Anorexia
Figure 1(a–f) Common conditions for which clinicians were asked ‘How often do you investigate the potential effect of stress by asking the owners questions related to the cat’s environment and behaviour?’. Courtesy of Bio’Sat
‘Cats for all seasons’ photography competition
International Cat Care, in conjunction with Your Cat and Digital Photographer magazines, is looking for beautiful images of cats to feature in a 2015 calendar that will be sold to raise funds for the charity’s welfare work (see www.icatcare.org/in-action/our-projects). There is a £500 first prize and the winning picture will feature on the cover of the calendar. Other photographs will be chosen to illustrate each month. All
winners will receive five copies of the calendar plus International Cat Care merchandise. Winning images will be displayed at the International Cat Care’s awards event in London. For more information and to take part, visit www.icatcare.org and enter via the photography competition link. Terms and conditions apply. < Deadline for entries is July 25, 2014.
JFMS CLINICAL CLINICAL PRACTICE PRACTICE JFMS
445
FELINE FOCUS
Education
Campaign
Impressive line-up for AAFP conference
Better regulation required for permethrin
This year, the AAFP Conference is taking place in Indianapolis, a city that offers a huge selection of arts, attractions, historical sites and eclectic cultural districts. Not only will attendees be offered discounts to explore all that the city has to offer in and around downtown Indianapolis, they will also have unparalleled access to material exclusively geared towards feline medicine. With three educational tracks, including one para-professional track, this year’s AAFP Conference will highlight feline gastroenterology and endocrinology.
The AAFP has endorsed the ISFM’s protect against permethrin poisoning campaign. According to the AAFP Feline Welfare Committee: ‘Many canine flea products, both veterinary and over-the-counter, here in the US also contain levels of permethrins deemed toxic to cats. Endorsement of this program by the AAFP will help to extend the reach of this campaign throughout the world and help prevent suffering and deaths among cats worldwide.’ ISFM launched a campaign for better regulation of the sale of permethrin-containing products in August 2013. As a result of the campaign, a leading pet superstore in the UK put a prompt on tills reminding staff to ask customers during the checkout process if they were aware of the risk to cats in the home when purchasing a permethrin-based spot-on dog flea treatment. Over 50 websites which sell flea treatments online were contacted by ISFM and asked to print warnings if they sold these treatments. Both AAFP and ISFM plan to actively promote the campaign this year. To add your vote go to www.icatcare.org/permethrin/petition
Distinguished speakers We are excited to announce a superb line-up of distinguished speakers. As experts in their fields, they are ready to present on a number of topics that will interest both the experienced feline practitioner and those looking to expand their knowledge of feline medicine. Speakers include: < Dr Catherine Scott-Moncrief and Dr Audrey Cook, who will discuss a variety of aspects of diabetes; < Dr Mark Peterson, who will present topics on hyperthyroidism; < Dr Kenneth Simpson, who will present on pancreatitis, persistent vomiting and chronic gastrointestinal disease; < Dr Sharon Center, who will present on hepatic lipidosis and liver syndromes/diseases; < Dr Michael Lappin, who will present on infectious diseases; and < Dr Gary Norsworthy and Dr Craig Webb, who will present new research on chronic small bowel disease in cats and stem cell therapy in feline chronic enteropathy.
Location Indianapolis is host to famous events like the Indianapolis 500 and Super Bowl XLVI in 2012. It is also known for its high-rated restaurants, the largest children’s museum in the world, the Indianapolis Zoo, the Indianapolis Museum of Art, and the Circle Centre, which is a four-level
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mall and a downtown landmark. There are plenty of things to do and see while you are in this gorgeous city.
Social events Join your colleagues at the many social events offered throughout the conference, like the Boehringer Ingelheim Welcome Reception and the Bayer Exhibitors’ Happy Hour Reception. Also offered will be a remarkable Elanco Offsite Event at the Indiana State Museum where guests will wander the galleries, take gondola rides through the canal, feast on fine dining, and dance the night away.
Exhibit hall From the experienced feline practitioner to new practitioners or those looking to expand their knowledge, you can be sure the 2014 AAFP Conference will be bustling with enthusiasm. Because attendees are looking for new and improved solutions to offer in their practice, we have secured a large exhibit hall to showcase this year’s exhibitors! For more information on programs, speakers, registration, accommodation and travel go to www.catvets.com/education
Weight Management Guidelines The AAFP has recently endorsed the American Animal Hospital Association’s Weight Management Guidelines for Dogs and Cats. These guidelines were developed to help the practicing veterinarian raise awareness of the negative health consequences of excess weight, promote the prevention of excess weight, and offer suggestions and tools for the management of weight loss and long-term maintenance of healthy weight. To access this resource, visit www.catvets.com/guidelines/ endorsements.
