An epidemiological study of diabetes mellitus in dogs attending first opinion practice in the UK

This study aimed to estimate the prevalence of canine diabetes mellitus (DM) in primary-care clinics in England, to identify risk factors associated with DM and to describe the survival of affected dogs. Cases of DM were identified within the electronic patient records of 89 small-animal practices. A nested case–control study identified risk factors for the diagnosis of DM using logistic regression models. Cox proportional hazards models were used to analyse variables associated with survival. Four-hundred and thirty-nine canine DM cases were identified, giving an apparent prevalence of 0.34% (95% CI 0.31% to 0.37%). Neutered males were at an increased risk of diabetes compared with entire males, whereas neutering was not associated with DM in females. When compared with crossbred dogs, Yorkshire terriers had increased odds, whereas German shepherd dogs and golden retrievers had lower odds of DM. Being classified as overweight and having a diagnosis of pancreatitis, hyperadrenocorticism or a urinary tract infection were positively associated with DM. Older dogs and those diagnosed with pancreatitis had a higher hazard of death, whereas insured and neutered dogs had a lower hazard. This study provides an objective assessment of canine DM using primary-care veterinary practice data and is a valuable benchmark against which future epidemiological trends in DM can be assessed and improvements in the management of DM in primary-care practice can be judged

Effect of whey protein isolate on rehydration after exercise

Studies have examined adding protein to carbohydrate-electrolyte rehydration drinks, but the effects of protein in isolation remain unknown. Ten subjects completed two trials in which they were dehydrated (~2% of pre-exercise body mass) by intermittent cycling in the heat. Subjects then rehydrated (150% total mass loss) over 1 h with mineral water (W) or mineral water plus 20 g·L-1 whey protein isolate (WP) and remained in the laboratory for a further 4 h. Blood and urine samples were provided pre-exercise, post-exercise, post-rehydration and every hour thereafter. From blood samples, serum osmolality, change in plasma volume and plasma albumin content was determined, whilst the volume and osmolality of urine samples were determined. There was no difference between trials for total urine volume (W: 1234 (358) mL; WP: 1306 (268) mL; P=0.409), drink retention (W: 40 (14) %; WP: 37 (14) %; P=0.322) or net fluid balance (W: -605 (318) mL; WP: -660 (274) mL; P=0.792) 4 h post-rehdyration. Plasma volume was greater 3 and 4 h post-drinking during WP and plasma albumin content relative to pre-exercise was increased 1-4 h post-drinking in WP only. These results suggest addition of 20 g·L-1 whey protein isolate neither enhances nor inhibits post-exercise rehydration, when a volume equivalent to 150% of sweat losses is ingested in 1 h. As post-exercise nutritional requirements are multifactorial (rehydration, glycogen resynthesis, myofibrillar/ mitochondrial protein synthesis), these data demonstrate that when post-exercise protein intake might benefit recovery or adaptation, this can be achieved without compromising rehydration

Is serum phosphorus control related to parathyroid hormone control in dialysis patients with secondary hyperparathyroidism?

Background Elevated serum phosphorus (P) levels have been linked to increased morbidity and mortality in dialysis patients with secondary hyperparathyroidism (SHPT) but may be difficult to control if parathyroid hormone (PTH) is persistently elevated. We conducted a post hoc analysis of data from an earlier interventional study (OPTIMA) to explore the relationship between PTH control and serum P. Methods The OPTIMA study randomized dialysis patients with intact PTH (iPTH) 300–799 pg/mL to receive conventional care alone (vitamin D and/or phosphate binders [PB]; n = 184) or a cinacalcet-based regimen (n = 368). For patients randomized to conventional care, investigators were allowed flexibility in using a non-cinacalcet regimen (with no specific criteria for vitamin D analogue dosage) to attain KDOQI™ targets for iPTH, P, Ca and Ca x P. For those assigned to the cinacalcet-based regimen, dosages of cinacalcet, vitamin D sterols, and PB were optimized over the first 16 weeks of the study, using a predefined treatment algorithm. The present analysis examined achievement of serum P targets (≤4.5 and ≤5.5 mg/dL) in relation to achievement of iPTH ≤300 pg/mL during the efficacy assessment phase (EAP; weeks 17–23). Results Patients who achieved iPTH ≤ 300 pg/mL (or a reduction of ≥30% from baseline) were more likely to achieve serum P targets than those who did not, regardless of treatment group. Of those who did achieve iPTH ≤ 300 pg/mL, 43% achieved P ≤4.5 mg/dL and 70% achieved P ≤5.5 mg/dL, versus 21% and 46% of those who did not achieve iPTH ≤ 300 pg/mL. Doses of PB tended to be higher in patients not achieving serum P targets. Patients receiving cinacalcet were more likely to achieve iPTH ≤300 pg/mL than those receiving conventional care (73% vs 23% of patients). Logistic regression analysis identified lower baseline P, no PB use at baseline and cinacalcet treatment to be predictors of achieving P ≤4.5 mg/dL during EAP in patients above this threshold at baseline. Conclusions This post hoc analysis found that control of serum P in dialysis patients was better when serum PTH levels were lowered effectively, regardless of treatment received

Border Terriers under primary veterinary care in England: demography and disorders

The Border Terrier is a working terrier type that is generally considered to be a relatively healthy and hardy breed. This study aimed to characterise the demography and common disorders of Border Terriers receiving veterinary care in England using de-identified electronic patient record data within the VetCompass™ Programme

Ethnic differences in oral health and use of dental services:cross-sectional study using the 2009 Adult Dental Health Survey

Background Oral health impacts on general health and quality of life, and oral diseases are the most common non-communicable diseases worldwide. Non-White ethnic groups account for an increasing proportion of the UK population. This study explores whether there are ethnic differences in oral health and whether these are explained by differences in sociodemographic or lifestyle factors, or use of dental services. Methods We used the Adult Dental Health Survey 2009 to conduct a cross-sectional study of the adult general population in England, Wales and Northern Ireland. Ethnic groups were compared in terms of oral health, lifestyle and use of dental services. Logistic regression analyses were used to determine whether ethnic differences in fillings, extractions and missing teeth persisted after adjustment for potential sociodemographic confounders and whether they were explained by lifestyle or dental service mediators. Results The study comprised 10,435 (94.6 %) White, 272 (2.5 %) Indian, 165 (1.5 %) Pakistani/Bangladeshi and 187 (1.7 %) Black participants. After adjusting for confounders, South Asian participants were significantly less likely, than White, to have fillings (Indian adjusted OR 0.25, 95 % CI 0.17-0.37; Pakistani/Bangladeshi adjusted OR 0.43, 95 % CI 0.26-0.69), dental extractions (Indian adjusted OR 0.33, 95 % CI 0.23-0.47; Pakistani/Bangladeshi adjusted OR 0.41, 95 % CI 0.26-0.63), and <20 teeth (Indian adjusted OR 0.31, 95 % CI 0.16-0.59; Pakistani/Bangladeshi adjusted OR 0.22, 95 % CI 0.08-0.57). They attended the dentist less frequently and were more likely to add sugar to hot drinks, but were significantly less likely to consume sweets and cakes. Adjustment for these attenuated the differences but they remained significant. Black participants had reduced risk of all outcomes but after adjustment for lifestyle the difference in fillings was attenuated, and extractions and tooth loss became non-significant. Conclusions Contrary to most health inequalities, oral health was better among non-White groups, in spite of lower use of dental services. The differences could be partially explained by reported differences in dietary sugar

Corneal ulcerative disease in dogs under primary veterinary care in England: epidemiology and clinical management

Abstract Background Corneal ulcerative disease (CUD) has the potential to adversely affect animal welfare by interfering with vision and causing pain. The study aimed to investigate for the first time the prevalence, breed-based risk factors and clinical management of CUD in the general population of dogs under primary veterinary care in England. Results Of 104,233 dogs attending 110 clinics participating within the VetCompass Programme from January 1st to December 31st 2013, there were 834 confirmed CUD cases (prevalence: 0.80%, 95% confidence interval (CI) 0.75–0.86). Breeds with the highest prevalence included Pug (5.42% of the breed affected), Boxer (4.98%), Shih Tzu (3.45%), Cavalier King Charles Spaniel (2.49%) and Bulldog (2.41%). Purebred dogs had 2.23 times the odds (95% CI 1.84–2.87, P < 0.001) of CUD compared with crossbreds. Brachycephalic types had 11.18 (95% CI 8.72–14.32, P < 0.001) and spaniel types had 3.13 (95% CI 2.38–4.12, P < 0.001) times the odds for CUD compared with crossbreds. Pain was recorded in 385 (46.2%) cases and analgesia was used in 455 (54.6%) of dogs. Overall, 62 (7.4%) cases were referred for advanced management and CUD contributed to the euthanasia decision for 10 dogs. Conclusions Breeds such as the Pug and Boxer, and conformational types such as brachycephalic and spaniels, demonstrated predisposition to CUD in the general canine population. These results suggest that breeding focus on periocular conformation in predisposed breeds should be considered in order to reduce corneal disease

Effect of whey protein isolate on rehydration after exercise

Studies have examined adding protein to carbohydrate–electrolyte rehydration drinks, but the effects of protein in isolation remain unknown. Ten subjects completed two trials in which they were dehydrated (~2 % of pre-exercise body mass) by intermittent cycling in the heat. Subjects then rehydrated (150 % total mass loss) over 1 h with mineral water (W) or mineral water plus 20 g L−1 whey protein isolate (WP) and remained in the laboratory for a further 4 h. Blood and urine samples were provided pre-exercise, post-exercise, post-rehydration and every hour thereafter. From blood samples, serum osmolality, change in plasma volume and plasma albumin content was determined, whilst the volume and osmolality of urine samples were determined. There was no difference between trials for total urine volume [W: 1,234 (358) mL; WP: 1,306 (268) mL; P = 0.409], drink retention [W: 40 (14) %; WP: 37 (14) %; P = 0.322] or net fluid balance [W: −605 (318) mL; WP: −660 (274) mL; P = 0.792] 4-h post-rehydration. Plasma volume was greater 3 and 4 h post-drinking during WP, and plasma albumin content relative to pre-exercise was increased 1–4 h post-drinking in WP only. These results suggest that addition of 20 g L−1 whey protein isolate neither enhances nor inhibits post-exercise rehydration, when a volume equivalent to 150 % of sweat losses is ingested in 1 h. As post-exercise nutritional requirements are multifactorial (rehydration, glycogen resynthesis, myofibrillar/mitochondrial protein synthesis), these data demonstrate that when post-exercise protein intake might benefit recovery or adaptation, this can be achieved without compromising rehydration