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Advanced Vet Care: what do dog owners expect? My May 2024 “Best of Health” article

Ian J Seath ♦ May 13, 2024

Recently, the Competitions and Markets Authority (CMA) announced that they are planning to launch a formal investigation into the veterinary market after identifying “multiple concerns” in their initial review. Coincidentally, a recent transnational study delved into the expectations and attitudes of dog and cat owners towards modern Advanced Veterinary Care (AVC), shedding light on crucial aspects of this discussion. For most dog owners, they’re not just pets; they’re integral parts of our families. Consequently, discussions around their healthcare have become more nuanced and important than ever before. The study (Exploring Owners’ Attitudes Towards Advanced Veterinary Care: A Transnational Study; Corr et al), conducted across the UK, Austria, and Denmark, posed questions regarding the accessibility and necessity of AVC for pets, comparing responses and drawing insightful conclusions. The research used questionnaires to gather opinions from around 2,100 dog and cat owners in the 3 countries. The countries were chosen because of the diversity in the veterinary sector, with smaller independent practices more common in Austria, larger ones in Denmark, and large corporate-owned ones in the UK.

The paper says that “the definition of advanced veterinary care (AVC) is constantly evolving, but it sits at one end of a spectrum of appropriate care, as all veterinary treatment must meet the standard”. 

The “Spectrum of Care” refers to the range of medical interventions and treatments available for a particular condition or ailment. In the context of veterinary medicine, the Spectrum of Care encompasses a variety of options that vets can offer to address the health needs of animals and is designed to provide comprehensive healthcare options tailored to the individual needs of each animal. Vets work collaboratively with pet owners to determine the most appropriate course of action based on factors such as the animal’s health status, medical history, prognosis, and the owner’s preferences and resources. 

Perplexing choices for pet owners

Recent advances in veterinary medicine have introduced a wealth of sophisticated diagnostic tools and treatment options for our canine companions. However, navigating this evolving landscape can be perplexing for pet owners. A striking finding from the study was that half of the pet owners surveyed believed their pets should have access to the same diagnostic tests as humans, with nearly 60% advocating for similar treatment options. This shows a significant shift in the perception of pets as valued members of the family, deserving of healthcare akin to humans. 

Interestingly, while owners generally disagreed with the notion that advanced care for pets is ‘unnecessary,’ they were more neutral on whether it has ‘gone too far.’ This suggests a nuanced understanding among owners, weighing the benefits of advanced care against potential drawbacks. While over half expressed a desire for their dog to have access to advanced diagnostic procedures, such as endoscopy and MRI, a significant portion did not. This disparity highlights the importance of open communication between vets and pet owners. A thorough discussion concerning the necessity and efficacy of each diagnostic test in the context of the dog’s specific medical situation is crucial.

Factors influencing attitudes

Emotional attachment emerged as the most influential factor shaping owners’ attitudes towards AVC. The study used the LAPS (Lexington Attachment to Pets Scale) to measure attachment levels, revealing a strong correlation between higher attachment scores and the belief that pets should have access to advanced treatment options. This emphasises the profound emotional bonds between owners and their pets, driving advocacy for comprehensive veterinary care. This also aligns with the growing recognition of the human-animal bond as a significant factor in veterinary medicine.

Country-specific variances

The study identified a geographical influence on access to AVC. Owners in the UK, for instance, reported a higher expectation of encountering advanced diagnostic and treatment options at their primary veterinary practice. Approximately half of the owners surveyed expected advanced options such as endoscopy, arthroscopy, CT, and/or MRI to be available at their usual veterinary practice. This can likely be attributed to the greater prevalence of specialised practices within the UK. Conversely, owners in Denmark were more likely to require referrals to specialists for these procedures. This could be due to a difference in the veterinary infrastructure of each country or potentially a more cost-conscious approach among Danish dog owners.

Financial considerations and pet insurance

Obviously, advanced veterinary diagnostic and treatment procedures can be expensive and are, therefore, only available to pets whose owners can afford it (with or without insurance cover). Surprisingly, neither income nor possession of pet insurance consistently predicted owner attitudes towards AVC. This challenges assumptions about the role of financial status in determining pet healthcare preferences. Instead, the study suggests that the strength of the human-animal bond drives owners’ willingness to invest in advanced care, regardless of financial considerations.

Research participation

Exploring owners’ willingness to enrol their pets in research studies uncovered more insights. While the majority supported vets’ contributions to advancing veterinary care, fewer were inclined to enrol their own pets. However, owners with higher attachment scores were more likely to agree, indicating a link between emotional investment in pets and support for research programmes.

In conclusion, the study offers valuable insights into the complex landscape of owner attitudes towards advanced veterinary care. While emotional attachment emerged as a key determinant, other factors such as cultural context and financial considerations also play significant roles. The ethical considerations surrounding AVC are also crucial. The study aptly highlights that while advanced treatments offer undeniable benefits, they should not supersede an animal’s quality of life. Most dog owners, the study suggests, prioritise a balance between extending their pet’s life and ensuring they are not subjected to undue suffering through excessive or unnecessary interventions. While advanced care is great, it’s not always the answer. Most owners agree they wouldn’t want their dog to suffer through unnecessary treatments just to buy a few extra days. Finding the right balance between quality of life and cost of care is key. As we continue to navigate discussions surrounding pet healthcare, it will be interesting to see what recommendations emerge from the CMA review and how the veterinary sector responds, particularly the corporate-owned sector.

Understanding and Addressing BOAS: A Call to Action for Responsible Dog Breeders (Best of Health – April 2024)

Ian J Seath ♦ April 10, 2024

In a recent study by Åsbjer et al. (2024), Swedish researchers explored the awareness, experiences, and opinions of various stakeholders, including 1806 dog owners, 557 vets, 1357 breeders, and 108 show judges, regarding Brachycephalic Obstructive Airway Syndrome (BOAS) and related health issues. The findings are both eye-opening and concerning, highlighting the need for further action from a range of stakeholders.

The study revealed that while most stakeholders are well aware of the health problems associated with brachycephaly, there is a significant divide in opinions on how to address these issues effectively. Vets, for instance, are highly supportive of banning breeding from severely brachycephalic dogs or even halting the breeding of these breeds altogether, with a staggering 75.9% in favour of the latter. In contrast, only 8.5% of show judges supported a complete breeding ban, reflecting a deeper disagreement on the importance of adhering to breed standards versus prioritising health and welfare.

The study also found that one-third of owners of brachycephalic breeds had personally experienced owning a dog with BOAS-related health problems. Moreover, nearly all vets (94.8%) had diagnosed or treated at least one brachycephalic dog with BOAS-related issues, underscoring the magnitude of this problem. The vets in the study also had a perception of an increasing prevalence of BOAS-related health issues over time.

There were clear disagreements and polarised views highlighted by the study. A disagreement was noted among stakeholders regarding further measures to be taken and the importance of adhering to breed standards. Show judges were more inclined to prioritise following breed standards, even if associated with health issues, compared to other stakeholder groups. Owners of brachycephalic dogs with clinical signs were more likely to perceive BOAS-related health issues as a serious threat and support further measures compared to owners without such experiences. Breeders of brachycephalic breeds were less supportive of further measures and banning breeding compared to breeders of non-brachycephalic breeds.

In Sweden, actions have been in place for several years; such as:

• Breed-specific instructions for show judges regarding exaggerated features, including brachycephaly, were introduced in Sweden in 2009.
• A system for vets to report BOAS surgeries to the Swedish Kennel Club was established.
• Several conferences focusing on BOAS have been arranged for show judges, breeders, and vets.
• National and international welfare and veterinary organisations have made statements and guidelines regarding BOAS, concluding that health issues related to BOAS are a serious welfare problem and require immediate action with multi-stakeholder collaboration.

Responsible breeders have a pivotal role to play in addressing this issue. The study’s findings serve as a reminder that we need to take decisive action to ensure the well-being of the dogs we breed and the preservation of these breeds, albeit with demonstrably improved health, for generations to come.

It’s also worth reminding ourselves of some of the key initiatives and actions taken in the UK to tackle this issue:

1. The Kennel Club in the UK has developed Breed Health and Conservation Plans for the brachycephalic breeds, including French Bulldogs, Pugs, and English Bulldogs. These plans outline breed-specific strategies to improve health and address issues like BOAS.

2. In 2019, the University of Cambridge Veterinary School introduced a Respiratory Function Grading Scheme for brachycephalic breeds. This scheme aims to assess the degree of respiratory impairment in these dogs and provide guidance for responsible breeding.

3. A Brachycephalic Working Group was established in the UK in 2016, comprising representatives from various stakeholders, including veterinary organisations, welfare groups, and breed clubs. This group has published consensus statements and guidelines to raise awareness and promote responsible breeding practices for brachycephalic breeds.

4. The Kennel Club’s “Breed Watch” programme monitors all breeds for points of concern, including exaggerated features that may cause health issues like BOAS. Breeds in Category 3 are subject to additional scrutiny during dog shows.

5. Various veterinary and animal welfare organisations in the UK, such as the British Veterinary Association (BVA) and the Royal Society for the Prevention of Cruelty to Animals (RSPCA), have launched awareness campaigns to educate the public about the health risks associated with brachycephalic breeds and the importance of responsible breeding and ownership.

While these initiatives represent significant efforts to address BOAS in the UK, the research paper suggests that more comprehensive and collaborative actions may still be needed to tackle this issue effectively across all stakeholder groups, including: 

Collaborative Efforts: Establish open channels of communication and knowledge-sharing among breeders, vets, show judges, and dog owners. We should foster a shared understanding of the severity of BOAS-related health issues and their impact on the welfare of brachycephalic breeds.

Responsible Breeding Practices: Implement rigorous health screening protocols for breeding stock, including respiratory function tests and evaluation of anatomical features. Breeders should prioritise breeding dogs with moderate or non-exaggerated physical characteristics to reduce the risk of BOAS and related health issues.

Review and Revise Breed Standards: The KC continues to collaborate with breed clubs to review and revise breed standards, emphasising the importance of health and functionality over exaggerated physical features. We need clear guidelines and objective criteria for evaluating conformational traits related to brachycephaly.

Education and Awareness: Develop comprehensive educational programmes and campaigns targeting breeders, show judges, and potential owners of brachycephalic breeds. These should emphasise the importance of prioritising health and welfare over physical appearance or breed standards.

Regulation and Enforcement: If we don’t see improvements, we can expect calls for stronger regulations and legislation regarding the breeding and sale of brachycephalic dogs with severe anatomical exaggerations. Existing laws and regulations aimed at promoting responsible breeding practices and preventing the propagation of inherited disorders could be applied more rigorously.

Research and Continuous Monitoring: The KC supports and funds ongoing research efforts to understand the genetic, anatomical, and physiological factors contributing to BOAS and related health issues. Breed clubs should conduct regular monitoring and data collection to track the prevalence and impact of BOAS in the brachycephalic breeds.

By embracing these actions, collectively we can address the health and welfare concerns associated with BOAS in brachycephalic breeds. As responsible breeders, it is our duty to prioritise the well-being of these dogs, ensuring their quality of life and promoting responsible breeding practices. I strongly recommend anyone reading this also to read the KC’s 2023 “Play your part” report with its comprehensive call to action for multiple stakeholders.