BACKGROUND:Insulinoma is the most commonly diagnosed endocrine tumor of the pancreas in dogs. Current literature has predominately focused on referral management of insulinoma in dogs. HYPOTHESIS/OBJECTIVES:To describe clinical signs, management, and survival and to explore risk factors associated with clinical management undertaken for insulinoma in dogs under primary veterinary care in the United Kingdom. ANIMALS:Two hundred seventy-eight insulinoma cases identified from 225 0741 VetCompass study dogs within the United Kingdom in 2019. METHODS:Nested cohort study. Insulinoma cases were identified by manual review of electronic health records. Multivariable logistic regression was used to identify risk factors associated with clinical management. The Kaplan-Meier method with log rank test and multivariable Cox regression were used to identify risk factors associated with survival. RESULTS:Epileptiform seizures, weakness, collapse/syncope, and muscle fasciculations were the most commonly reported clinical signs. Spaniel breed dogs (OR 2.43, 95% CI 1.02-5.79), dogs with epileptiform seizures (OR 2.15, 95% CI 1.15-4.02) and referred dogs (OR 4.85, 95% CI 2.42-9.72) had increased odds of undergoing surgery, compared to non-spaniel breed dogs, dogs without epileptiform seizures, and non-referred dogs. Compared to dogs treated solely medically, dogs treated surgically had a lower hazard (HR 0.49, 95% CI 0.32-0.77) of dying. Referred dogs had a longer median survival time (673 days, IQR 221-1139) than non-referred dogs (275 days, IQR 55-735) (P < .001). CONCLUSIONS AND CLINICAL IMPORTANCE:This study identified that referral and surgical treatment are associated with improved clinical outcomes for dogs with insulinoma presenting to primary veterinary care.

The domestic dog is the most phenotypically variable mammalian species on earth but there is limited evidence on the overall health patterns within the subset of giant dog breeds. A VetCompass cohort study design was used to report the demography, one-year prevalence of common disorders and mortality of giant breed dogs under UK primary veterinary care during 2019. Giant breed dogs from 29 breeds combined to comprise 28,345 (1.26

The Golden Retriever Lifetime Study (GRLS) is a prospective cohort of dogs within the contiguous United States, designed to investigate health of Golden Retrievers, with cancer as a research focus. Mast cell tumour (MCT) represents the most common skin malignancy in dogs. This is the first exploration of MCT epidemiology within the GRLS cohort, and the first epidemiologic report specific to MCT in the Golden Retriever breed. MCT frequency was reported as proportion of the cohort, and incidence rate for first lifetime diagnosis. A lifetable was produced to assess incidence risk per year of age. The anatomical location, tissue origin and histopathologic grade of MCTs themselves were reported descriptively. Dogs with multiple MCT presentations or metastasis were further explored. Survival was compared between dogs with MCT and the remaining cohort, followed by a stratified analysis of time from first MCT diagnosis to death using Kaplan-Meier curves and the log-rank test. Within the cohort of 3,044 dogs, 164 (5.39

BackgroundLeishmaniosis in dogs is an important zoonotic disease, endemic in southern Europe but is increasingly being recorded in other parts of Europe including the UK. This study aimed to update the epidemiological knowledge of leishmaniosis in the UK dog population.MethodsThe estimated prevalence of leishmaniosis diagnosis in dogs under care at VetCompass UK participating practices in 2019 was calculated. Risk factor associations for leishmaniosis were investigated using mixed-effects multivariable logistic regression modelling. The spatial distribution of leishmaniosis was explored using standardised morbidity rates (SMR) at regional and county levels, and Moran's I was used to identify significant spatial autocorrelation.ResultsThe estimated annual prevalence was calculated as 0.0434% (95% CI 0.0427-0.0443) with 976 cases from this population of dogs (n = 2,250,741). Most of the dogs with leishmaniosis had originated from outside the UK (955/976, 97.9%) and of those, 60.8% (581) had already been diagnosed with leishmaniosis pre-import. In the risk factor analysis, the odds of leishmaniosis were higher in males (OR 1.29, 95% CI 1.12-1.49) and neutered dogs (OR 6.42, 95% CI 4.43-9.29) compared to female and entire dogs, respectively. Purebreds overall had lower odds of leishmaniosis compared to crossbreeds (OR 0.24, 95% CI 0.20-0.28) but there were specific breeds such as Brittany Spaniels (OR 53.0, 95% CI 25.3-111.1), Ibizan Hounds (OR 43.8, 95% CI 9.20-208.3) and English Pointers (OR 28.6, 95% CI 14.5-56.4) which had much higher odds of being a case compared to crossbreeds. Spatial analysis identified more leishmaniosis cases in southern England than were expected by random chance (SMR > 1).ConclusionsThis study identifies that imported animals are the commonest source of dogs having a leishmaniosis diagnosis. The breeds with very high odds for leishmaniosis may reflect selection bias towards breeds more likely to be imported, rescued or travelled from endemic areas rather than high intrinsic risk in these breeds towards leishmaniosis. These results support and update previous studies indicating that most cases are diagnosed in southern England.

Visceral haemangiosarcoma is considered clinically aggressive in dogs, with perceived poor prognosis often leading to euthanasia at presentation. This study aimed to determine survival times and prognostic factors in dogs with haemangiosarcoma under first-opinion care. Dogs clinically diagnosed with haemangiosarcoma in first-opinion practice in 2019 were identified in VetCompass electronic health records and examined to capture variables potentially associated with survival. Median survival time (MST) from diagnosis was calculated for the whole population, those histopathologically confirmed and based on primary tumour location. Binary logistic regression was used to explore differences between dogs that died on the day of diagnosis and those that survived ≥1 day. Cox proportional hazards modelling explored factors associated with time to death in dogs surviving ≥1 day. Across all cases (n = 788), overall MST was 9.0 days (95%CI:5.0–15.0, range: 0–1789) and proportional 1-year survival was 12.0% (95%CI:9.7–15.0%). Dogs with splenic (MST = 4.0 days, 95%CI 0.0–9.0) and cutaneous haemangiosarcoma (MST = 119.0 days,95%CI:85.0–248.0) had MST greater than 0 days. Of dogs with a histopathological diagnosis of haemangiosarcoma, overall MST was longer at 105 days (95% CI 84–133 days) and additionally, location-specific MST were longer. For both clinically diagnosed cases and histopathologically confirmed cases, increasing tumour size was associated with increased hazard of death while cutaneous location and surgery were associated with reduced hazard of death. A very short survival time was identified for haemangiosarcoma under first-opinion care. Although survival time was longest for cutaneous cases, the actualised prognosis was poor overall for haemangiosarcoma. However, a common prevailing view of extremely poor prognosis for haemangiosarcoma could be promoting frequent euthanasia at presentation and therefore leading to a self-fulfilling prophecy and low survival times. Further exploration of the potential effect of perceived prognosis is warranted. This study provides valuable information for contextualised care and dialogues with clients in first-opinion practice.

ABSTRACT Background Diabetes mellitus (DM) is a common endocrinopathy in cats. General population epidemiology and mortality studies on DM are lacking. Objectives Describe the incidence, prevalence, risk factors, and mortality for DM in cats under primary veterinary care in the United Kingdom (UK). Animals Random sample of 1053 confirmed DM cases from 1 255 130 cats in VetCompass. Methods Retrospective cohort study with a nested case–control study. Period prevalence and incidence risk of DM for 2019 were calculated. Multivariable logistic regression modeling was used to identify risk factors for DM. Results Annual prevalence was 0.39% (95% confidence interval [CI]: 0.37–0.42). Incidence risk (2019) was 0.14% (95% CI, 0.13–0.16). Mean age and median adult body weight of incident cases diagnosed with DM was 11.8 ± 3.5 years (n = 371) and 5.9 kg (interquartile range: 4.6–7.1, n = 327). Odds of DM were increased in cats ≥ 9.0 years (odds ratio [OR]: 5.11, CI, 4.10–6.24) compared with cats 4.5–9.0 years. Burmese (OR: 2.07, CI, 1.29–3.31) and Burmillas (OR: 8.30, CI, 2.59–26.62) had increased odds, whereas Bengals (OR: 0.24, CI: 0.06–0.98) and Ragdolls (OR: 0.11, CI: 0.02–0.80) had decreased odds of DM compared with crossbreeds. Of 51.2% (192/375) cats dead within 3 years of diagnosis, 93.0% (176/192) were euthanized; 19.7% (35/178) were euthanized ≤ 3 days after diagnosis. Conclusions and Clinical Importance Almost 1/250 cats in the UK live with DM annually. Burmillas were predisposed to DM, and protection against DM was shown in Bengals and Ragdolls. Early mortality associated with DM diagnosis in cats is high.

Insulinoma is the most common pancreatic tumor diagnosed in dogs. This study aimed to report incidence risk, breed predispositions and other demographic risk factors for insulinoma diagnosed in dogs under primary veterinary care in the UK. The VetCompass Program supports research on anonymized electronic health records (EHRs) from dogs under UK veterinary care. This study included all VetCompass EHRs from dogs under primary veterinary care during 2019. Multivariable logistic regression analysis was used to evaluate demographic risk factors for insulinoma diagnosis. Of 2,250,741 study dogs, 278 were confirmed as insulinoma cases at any date. The estimated 2019 incidence risk was 0.003% (95% CI 0.002–0.004%). Compared to crossbreeds, predisposed breeds included Dogue de Bordeaux, German Pointer, Flat Coated Retriever, Boxer and West Highland White Terrier. The Labrador Retriever showed decreased odds for insulinoma diagnosis. Additionally, being a terrier breed and being a breed predisposed to other endocrine cancers were associated with increased odds for insulinoma diagnosis. Other risk factors associated with increased odds for insulinoma diagnosis included being female neutered, being 9 - <15 years of age, having an adult median bodyweight of 20 - <30 kg and having a bodyweight above the median for the sex/breed. This is the first study to report the epidemiology of canine insulinoma in dogs under primary veterinary care, resulting in crucial leads for further research in the epidemiology and etiology of canine insulinoma and possible links of canine insulinoma with other canine endocrine cancers. Additionally, the results can aid veterinarians to identify dogs at greater risk of insulinoma.

The Yorkshire Terrier is a long-established and commonly owned dog breed. This study aimed to explore anonymised primary-care veterinary clinical data from the VetCompass Programme to characterise the demography, common disorders and longevity of the general population of Yorkshire Terriers in the UK in 2016. Yorkshire Terriers composed 28,032 (3.10

This study aimed to characterise the demography, common disorders, cause-specific mortality and life expectancy of the general population of Ragdoll cats under primary veterinary care in the UK in 2019. The study used a retrospective cohort design of all cats under UK primary veterinary care within VetCompass Programme during 2019. The clinical records of a random sample of 2,025 Ragdolls were reviewed to identify every disorder recorded during 2019. Ragdolls comprised 21,358 (1.70

INTRODUCTION:Natural eyelid conformation is essential for normal function and health of the ocular surface. However, many modern dog types are deliberately bred for abnormal eyelid conformation associated with severe health and welfare issues. This study aimed to report the prevalence, demographic risk factors and clinical management under primary veterinary care for conformational eyelid disorders in dogs. METHODS:The study explored the anonymised clinical records of all dogs under UK primary veterinary care within the VetCompass Programme during 2019. Risk factor analysis used multivariable logistic regression modelling. RESULTS:From 2,250,417 dogs under primary veterinary care in 2019, the analysis included a random sample of 3,029 confirmed conformational eyelid disorder cases that included 2,752 (90.86%) entropion and 344 (11.36%) ectropion cases. After accounting for the subsampling process, the annual prevalence for overall conformational eyelid disorder in dogs was 0.36% (95% CI: 0.35-0.37). The annual prevalence for entropion in dogs overall was 0.33% (95% CI: 0.32-0.34). Breeds with highest annual prevalence for entropion were Shar-Pei (15.41%, 95% CI 14.00-16.91), Chow Chow (9.28%, 95% CI 7.64-11.14) and Neapolitan Mastiff (6.88%, 95% CI 3.02-13.14). The estimated annual prevalence for ectropion in dogs overall was 0.04% (95% CI: 0.04-0.05). Breeds with the highest annual prevalence for ectropion were Neapolitan Mastiff (4.30%, 95% CI 1.41-9.77), Saint Bernard (1.72%, 95% CI 0.86-3.05) and Basset Hound (1.59%, 95% CI 0.94-2.49). Surgical management was carried out for 414/2275 (18.20%) of the incident (2019) entropion cases and 12/305 (3.93%) of the incident (2019) ectropion cases. CONCLUSIONS:Normalisation of conformation-related health issues in certain high profile dog breeds have been discussed as a canine welfare priority for over half a century. The current results suggest that substantial work remains to be done to ensure good innate health for all dogs.

Target trial emulation applies design principles from randomised controlled trials (RCTs) to the analysis of observational data, potentially replicating RCT results in real-world settings. The EPIC trial reported that pimobendan delays the onset of congestive heart failure (CHF) and extends survival in dogs with preclinical degenerative mitral valve disease (DMVD). The current study aimed to explore the extent to which target trial emulation approximates the EPIC trial results in a primary-care setting. Grade IV/VI murmur diagnosis was defined as the treatment intervention stage. There were 928 dogs ≥ 6 years and ≤ 15 kg at first grade IV/VI murmur diagnosis recorded from January 1, 2016, to December 31, 2018 in the VetCompass database included in the study. A causal inference “target trial emulation” approach using VetCompass anonymised clinical data was designed to replicate the EPIC trial with adaptation for a primary-care setting and to address immortal time bias, confounding bias and loss to follow-up. After bias adjustments to establish causal effects using observational data, the 5-year CHF cumulative incidence was lower in dogs prescribed pimobendan (34.1%, 95% CI 26.5–42.0) than dogs not prescribed pimobendan (56.3%, 95% CI 52.8–59.8). Dogs prescribed pimobendan had 311 fewer days of health lost to CHF (95% CI 224–395 days) within 5 years. Dogs prescribed pimobendan lived longer (adjusted mean survival time 1051 days, 95% CI 967–1125) than dogs not prescribed pimobendan (905 days, 95% CI 871–940 days). This study demonstrates that target trial emulation within veterinary research can replicate findings from RCTs. Clinically, the current findings suggest that preclinical grade IV murmur diagnosis may offer an appropriate intervention stage to begin pimobendan therapy in dogs with presumed DMVD.

Beagles are a popular companion animal dog breed and are generally stated to be a healthy breed. This VetCompass study aimed to report the demography, common disorders and mortality of Beagles under primary veterinary care in the UK. Anonymised clinical records within VetCompass were followed over time to extract disorder and mortality data during 2019 on Beagles under primary veterinary care in the UK. Beagles comprised 19,906 (0.88

Standard bodyweights are an essential component of calculations that summarise many population-level measures in companion animals, including the defined daily doses for veterinary species (DDDVet) reporting antimicrobial usage. Standard species bodyweights may originate from data derived from clinical records, but current methods to obtain these values risk inaccuracy because they exclude measurements obtained from juvenile animals and consider only individuals that have achieved stable adult bodyweight. This study aimed to improve the accuracy of standard population level species bodyweights through the development of a prediction modelling approach to estimate point mean population bodyweight in dogs, cats, rabbits, and guinea pigs. Data were obtained from the VetCompass database and included bodyweight measurements from approximately three million dogs, two million cats, 220,000 rabbits and 62,000 guinea pigs across 1,800 veterinary practices in the United Kingdom. Initially, Loess models were used to identify the age at which juvenile animals transitioned from growth to stable adult bodyweight. Linear mixed effects models were developed to predict juvenile growth, calibrated such that predicted cessation of growth matched that observed in the Loess models. The prediction models were then used to adjust bodyweight measurements obtained from clinical records of juvenile patients, allowing historical measurements to be included for estimation of a point mean population bodyweight on a subsequent specified target date. Juvenile growth transitioned to stable adult bodyweight at approximately 14 months in dogs, and 13 months in cats, rabbits, and guinea pigs. Point mean whole-population bodyweights estimated on 31st December for each year 2014 - 2023 found that the mean bodyweight of cats, rabbits, and guinea pigs was approximately 4.2 kg, 2.3 kg, and 1.0 kg respectively and changed little over this time period. However, dogs showed a trend to lower mean bodyweight over time, with a mean value of 17.6 kg in 2014, reducing to 16.1 kg by 2023.

Phaeochromocytoma (PCC) is a tumour arising from the adrenal gland in dogs that can be challenging to diagnose. This study aimed to describe the incidence risk, breed predispositions and other demographic risk factors associated with the diagnosis PCC in dogs receiving primary veterinary care in the UK. All anonymised VetCompass Programme electronic health records from dogs receiving primary veterinary care in the UK during 2019 were included. Demographic risk factor analysis used multivariable logistic regression modelling. Out of a study population of 2,250,741 dogs, 92 were confirmed as PCC cases at any time point. The estimated 2019 incidence risk for PCC diagnosis was 1 per 100,000 dogs. The Soft-Coated Wheaten Terrier, German Pointer and Miniature Schnauzer showed significant breed predispositions for the diagnosis of PCC compared with crossbred dogs. Terrier breeds and breeds predisposed to other endocrine tumours were found to have increased odds of being diagnosed with PCC. Furthermore, neutered males and dogs aged between 9 and under 15 years were also associated with increased odds of PCC diagnosis. This study is the first to describe the epidemiology of PCC in dogs receiving primary veterinary care, providing new information concerning demographic risk factors and helping to improve clinical recognition of PCC for veterinary clinicians. Moreover, results from this study facilitate further research in the possible links of canine PCC with other canine endocrine tumours and the existence of concurrent endocrine neoplasia in dogs. Additionally, the results allow researchers to more robustly define useful PCC study populations for future comparative oncology studies.

Little information has been published on the recorded disorders of pet chelonia. This cohort study aimed to report on demography, commonly recorded disorders and mortality recorded in chelonia under UK primary veterinary care in 2019. Electronic health records on a random sample of chelonia in VetCompass during 2019 were reviewed to extract species, recorded disorder and mortality data. Of 2,040 chelonia reviewed, 1,923 (94.26%) were recorded as tortoises, 74 (3.63%) terrapins and 43 (2.11%) turtles. Of the 811 (42.17%) tortoises with species information recorded, the most common species were Hermann's tortoises (Testudo hermanni) (311, 38.35%), Horsfield's tortoises (Testudo horsfieldii) (259, 31.94%) and Mediterranean spur-thighed tortoises (154, 18.99%). The most commonly recorded disorders were beak abnormalities (16.72%), overgrown nails (11.47%) and shell abnormalities (9.80%). The most common recorded causes of death were "disorder undiagnosed" (44.55%), dog bite (5.45%) and anorexia (3.96%). Of 178 deaths with age recorded, the median age at death was 7.32 years (IQR 2.50-15.14). Short temporal windows within the clinical records and often limited clinical workups were a frequent limitation to the precision of the recorded disorder terms. This is the largest study of chelonia to date. It has highlighted the most commonly recorded disorders of chelonia of which many are often linked to husbandry.

BACKGROUND:Dental disease is a painful and highly prevalent condition in companion rabbits. However, the dental disease management techniques currently employed by UK primary-care veterinarians and potential associated clinical welfare implications are scarcely described. METHODS:Anonymised clinical records from primary-care practices participating in the VetCompass programme in 2019 were manually reviewed to identify cases of dental disease in rabbits. Clinical welfare implications were assessed through retrospective analysis of clinical signs, diagnostics and treatment information. RESULTS:A total of 2219 rabbit dental disease cases were recorded in 2019. The most frequently recorded clinical signs were reduced food intake (25.1%) and reduced faecal output (10.9%). Diagnostic dental radiography was performed in 2.2% of cases. Tooth trimming (including using burs, rasps and nail clippers) was conducted on 34.0% of cases; 6.1% of rabbits undergoing cheek teeth trimming had the procedure performed while conscious. Dietary modification was recommended for 21.5% of cases. Dental disease was the primary reason for death or a contributory factor in 51.2% of the cases that died. LIMITATIONS:Accurate dental disease diagnosis relies on detailed veterinary examination and confidence in diagnosing rabbit dental disease, which may vary. CONCLUSION:Dental disease is a major welfare concern for rabbits, as indicated by the high frequency of detrimental clinical signs, the potentially suboptimal treatment methods used in some cases and its frequency as a full or contributory cause of death. Greater owner and veterinarian awareness of dental disease signs and further veterinary education on appropriate diagnostic and treatment methods could improve the welfare of affected rabbits.

BackgroundAcute diarrhoea is a common canine veterinary presentation in the UK. This study aimed to report the incidence, demographic risk factors and clinical management for acute diarrhoea diagnosed under primary veterinary care in the UK in 2019.MethodsA cohort study design with a cross-sectional analysis was applied to anonymised VetCompass clinical data. Risk factor analysis used multivariable logistic regression modelling.ResultsThe analysis included a random sample of 1,835 confirmed incident acute diarrhoea cases in 2019 from an overall study population of 2,250,417 dogs. After accounting for subsampling, the estimated one-year incidence risk for acute diarrhoea in dogs overall was 8.18% (95% CI: 7.83-8.55). Of the first acute diarrhoea event in 2019 for the 1,835 cases, 1473 (80.27%) had only one physical visit for veterinary care related to the acute diarrhoea. The most common comorbid clinical signs with acute diarrhoea included vomiting (n = 812, 44.25%), reduced appetite (508, 27.68%) and lethargy (444, 24.20%). Overall, 538 (29.32%) cases were recorded as haemorrhagic diarrhoea. The most common clinical managements were probiotics (n = 1094, 59.62%), dietary management (807, 43.98%), antibiosis (701, 38.20%) and maropitant (441, 24.03%). Six breeds showed increased odds of acute diarrhoea compared with crossbred dogs: Maltese (OR 2.17, 95% CI 1.25-3.77), Miniature Poodle (OR 2.17, 95% CI 1.19-3.95), Cavapoo (OR 2.07, 95% CI 1.32-3.25), German Shepherd Dog (OR 1.69, 95% CI 1.29-2.22), Yorkshire Terrier (OR 1.51, 95% CI 1.15-1.98) and Cockapoo (OR 1.36, 95% CI 1.05-1.74). The odds of diagnosis increased in dogs aged under 3 years and dogs aged over 9 years, compared to dogs aged 4-5 years.ConclusionsThis study confirms acute diarrhoea as a common clinical condition in dogs managed under primary veterinary care, with 1-in-12 dogs diagnosed each year. The identified breed predispositions suggest some genetic element to the condition. The clinical outcomes following veterinary care appear to be very positive, with over 80% of acute diarrhoea cases not receiving a second veterinary visit. However, antibiotic use remained frequent, despite years of recommendation to the contrary and raises concerns about unnecessary antibiotic therapy for this condition.

BACKGROUND:Tail injuries in dogs can severely impact welfare and pose clinical challenges. This study aimed to describe the annual incidence and clinical management of tail injury in UK dogs under primary care and identify risk factors. METHODS:A nested case‒control design was used within a cohort of dogs under primary care in the UK in 2019. Clinical records were automatically searched and manually verified to identify incident tail injury cases and extract management data. Multivariable logistic regression was then used to evaluate associations between potential risk factors and tail injury diagnosis. RESULTS:The analysis included 285 tail injury cases and 285,000 randomly selected controls. The estimated annual incidence risk for tail injury was 0.23%. Increased odds of injury were observed in boxers, English springer spaniels and cocker spaniels; dogs aged less than 2 years; male entire, male neutered and female neutered dogs; working and gundog breeds; and dogs weighing between 20 and 30 kg. Systemic analgesia and antibiosis were prescribed in 45.6% and 32.6% of cases, respectively. Surgical amputation was undertaken in 9.1% of cases. LIMITATIONS:This study relied on retrospective electronic health record data. Only factors consistently recorded in clinical records were available. CONCLUSION:Tail injury is relatively uncommon but carries serious welfare risks. Identifying high-risk groups offers valuable insights for veterinarians, breeders and policymakers.