Best of Health – my 3rd article for Our Dogs

We’re well into the season of Breed Club Annual General Meetings and these are mostly timed to ensure Secretaries can submit their Annual Returns to the Kennel Club. One of the KC’s requirements is that clubs include a Health Report.

This has generated an interesting discussion among some Breed Health Coordinators about the format and content of these reports. BHCs are probably the people most likely to prepare these reports on behalf of their clubs or council.

Many breeds have a long history of producing an annual report; for example the English Springer Spaniels have been doing this since 1999. Their report is produced by the joint BHCs Lesley Bloomfield and Louise Scott each year, which they send to all 8 ESS Clubs for distribution to their members and for publishing on their websites and elsewhere, as appropriate. Each Club also uses this document as the Health Report that they are each required to submit to the KC with their annual returns.  Louise says “The Breed Clubs are happy for us to produce this report on their behalf (probably not least because it saves them having to compile something themselves!) and it also means the Breed is able to submit a coordinated response on health issues”. You can read the ESS annual reports since 2008/9 by visiting www.englishspringer.orgor www.sesss.org.

Val Jones, BHC for the Flatcoated Retrievers, says they produce a Health Report which is read out at their AGM and then sent to the KC with the FCR Society’s Annual Returns. The health report is then uploaded onto the Society’s website so that it is available to read by the general public (www.flatcoated-retriever-society.org) The Flatcoats also have a Tumour Survey which was originated in 1988 by the late Sheila Godbolt and is run by the ‘Trustees of the Tumour Survey’ who read a report written by Dr Jane Dobson at every FCRS AGM. A Tumour Study report for 2014 can be read on the website.  The Trustees are a  private group of people which run the scheme, but have the full support of the Flatcoated Retriever Society. This seems like a real demonstration of commitment to be open about the problems currently being investigated in the breed.

Our Dachshund Health Committee produces an Annual Health Report which is published in January (www.dachshundhealth.org.uk). It now follows the format proposed in the KC’s Breed Health Strategy Guide, first published in 2012. A 1-page summary is available for all our clubs to submit with their Annual Returns.

I have to say that we shamelessly stole the idea for an annual report from the English Springer Clubs when our Breed Council was first established. We had a long history of working on health matters, but surprisingly, nobody had ever suggested all the good work should be summarised in one place each year.

The process of writing an Annual Health Report needn’t be onerous, particularly if a breed takes a team-based approach by having a Health Committee, as well as a BHC. There’s plenty of guidance available from the KC and the network of BHCs are always willing to share their experience with clubs that are perhaps less experienced.

Surely, with all the focus on pedigree dog health, every breed should now have an Annual Health Report which is publicly available. Then, anyone can see exactly what health issues are being prioritised in a breed (if any), based on health survey data, and the progress being made to address them.

Everyone who knows me will be aware that I love data! Sad, but true. It’s been obvious for a few years that there simply hasn’t been enough good data to help focus the work required for breed health improvement, or to refute the emotion-laden claims of those who criticise pedigree dogs. Sir Patrick Bateson mentioned this in his 2009 report but thankfully, there are now various initiatives underway to address this issue. In my last article I mentioned the fantastic work being done by the VetCompass team who are collecting and analysing data from first referral veterinary practices.

VetCompass operates at the Big Data end of the spectrum, but there’s also lots of useful work being done at a smaller scale. For example, one of the Breed Health Coordinators recently shared some data about canine spays and the complications that can arise. The data came from a veterinary practice’s routine spays during 2012-13, covering 243 spays and about 50 different pedigree breeds, plus a few cross-breeds.

Age Number of spays
1 and under 71
13 months -3 years 113
4-7 years 44
8-10 years 10
11+ years 5

 

In the “1 and under” age group, most were spayed at 10-11 months which is after their first season [practice policy]. Two that were spayed at 6 months and pre- season would have been at their owner’s choice.

Very few ‘old’ bitches are spayed routinely; usually older bitches present with a pyometra.

19% of the cases showed some level of post-operative complications, including 1 death associated with renal failure. 80% of the complications were accounted for by four reasons:

  • 30% Suture reaction – A swelling under the wound due to internal sutures – no treatment usually needed
  • 21% Vomiting and diarrhoea – Spays are sent home with Metacam and this tends to be the cause so owners are advised to stop it
  • 17% Infected wound – Tends to happen when the dog licks wound – always noted in clinical audit book to check not a problem with sterility in theatre.
  • 11% Renal – discussed below…

BoH 3

 

Interestingly, renal cases seem to be over-represented in this recent 2 year sample; in 11 years at the practice there were a total of 11 spay renal cases, with 3 deaths.

Acute renal failure post-operatively may be due to blood pressure dropping during the operation [blood supply is cut off from kidneys and they have to process anaesthetic and anti-inflammatory which causes failure]. Some bitches who don’t recover well from the operation [appearing ‘hung-over], don’t eat, vomit [particularly after being given pain relief meds], and drink and urinate more. Some are actually not that ill, but just ‘aren’t right’. If treated quickly and aggressively, they recover and kidney function returns completely to normal, with no lasting effects.

Renal problems had never been noted in those bitches given i/v fluids during the operation or in those who had normal blood pressure measurements during surgery. This particular practice now offers clients reduced cost fluids for bitch spays . They currently give the pain relief during the operation [usually near the end] but they are now considering giving this in the pre-med. Apparently, many other practices do this, so it is in the bitch’s system before the operation and is given at a time when her blood pressure measure is normal.

The practice has also ruled out individual vets and the length of the surgery as contributing factors in these renal failures. They have had no recent renal failure cases and many clients are now choosing to have the i/v fluids during the operation.

This struck me as a good example of a veterinary practice making use of its available data to identify the root causes of problems and to adopt improvements. What crossed my mind was where do vets turn to if they want evidence-based guidance on what are the best procedures for any particular type of treatment. Maybe it’s the University of Nottingham’s Centre for evidence based veterinary medicine which has been around for at least 5 years. Sadly, there only seem to be 7 best practice reports available via their website: http://bestbetsforvets.org

Finally, on the subject of data, there is a great initiative from our Norfolk Terrier friends who are conducting a Breed Health Survey which you can download here: http://www.norfolkterrierclub.co.uk/health-testpage2014.htm
I hope they get a good response and will look forward to seeing the results.

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