An Update on Antibiotics

Antibiotic resistance is a real ongoing issue and one that will keep having an impact until it is resolved by, hopefully, an alternative to antibiotics. Otherwise, as top doctor Prof Dame Sally Davies says, we will have a ‘post-antibiotic apocalypse’ and the 700,000 people who die a year due to drug resistant infections will have many more dying alongside them. As it is such a prevalent issue which has an impact on both veterinary and human medicine sectors, I have talked about it before (see here and here). However, there has been so much in the news in the past week alone (probably due to World Antibiotic Awareness Week coming up in November) that I thought it was time for an update. Continue reading “An Update on Antibiotics”

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Artificial Aggression?

There are always good and bad sides to everything: books, films, people and even animals. We as humans can be very quick to judge but perhaps the behaviour of animals, and who knows, even humans, is integral. If we find this is the case, then maybe we can work towards improving the behaviour of dogs and remove the stigma of certain breeds and maybe even psychopathic humans…?

I have heard many people say that a dog’s behaviour is the fault of the owner or even a child’s behaviour is the fault of the parent. After all, we are all shaped by our experiences and interactions. However, there has been a new discovery in dogs which possibly derails this: that the level of a hormone (oxytocin) plays a role in the sociability of dogs. The researchers at Linköping University in Sweden say that tendency of a dog to seek contact is dependent on the receptor sensitivity for oxytocin. This conclusion came from the results of a study based on experiments with 60 Golden Retrievers. They assessed the response when the dogs were given a nasal dose of oxytocin or saline solution. With this in their systems, they were taught how to open a lid to get a treat. Then the lid was made to be locked and the dogs were given the same task, this time being measured on how long it took for them to give up and ask for help from the owner who was in the room. The test showed that subjects with a genetic variant of the receptor reacted in a stronger manner to the oxytocin spray. It also demonstrated that the dogs tended to ask for help more quickly when they had the oxytocin than if they had the saline solution. Oxytocin is an interesting one, it is also called the ‘love hormone’ and plays a major part in childbirth. It is also released into our blood when we see something cute (like a dog) and respectively in theirs when they see us.

 

Image result for oxytocin
‘The Love Hormone’

 

This research was backed up by research performed by the University of Arizona, which showed that service dogs (who are bred for their placid temperament) have significantly higher levels of oxytocin in their blood than a normal dog. Another hormone was investigated and found to have a connection too: vasopressin. The more vasopressin, the higher the aggression levels were towards other dogs. Of course, any dog can show aggression if put into a stressful or threatening situation (it is important to know the signs to prevent being bitten) but some dogs are permanently more aggressive than others to fellow canines or humans. Thousands of people are hospitalised each year from dog bites and young children can sometimes even be killed by them. So the results of this study may have large implications in the future. Testosterone has historically been blamed for aggressive behaviour, however, some neutered dogs are still very aggressive, although castration often does help. Serotonin management (to increase the levels in the blood) is also used, which is believed to reduce aggression. This is because studies have been shown that aggressive dogs have low levels of serotonin in their blood and higher levels seem to lower the aggressive tendencies. These dogs might have altered levels of these hormones, causing aggression due to a traumatic experience and is in a kind of ‘hypervigilant state’ ever since (a bit like post-traumatic stress).

It seems it is not just dogs who are under the spotlight when it comes to aggression recently: there has been a new study released by the University of Helsinki looking at cats too. It has shown that the age of weaning has a direct impact on the later behaviour of the animal and that the usual 12 weeks weaning should actually be 14 weeks. The results were drawn from a multiple-choice online questionnaire which involved the Finnish owners of 5726 domesticated cats comprising 400 breeds. Extending the weaning time by at least two weeks would be, in the words of the researchers, easy and cost efficient and would improve the quality of life. Weaning before eight weeks of age was seen to increase aggression but not fear in the behaviour of the cats. Contrastingly, cats weaning over 14 weeks have a lower chance of aggression and stereotypic behaviour (including shyness, excessive grooming and wool sucking) than cats who were weaned at 12 weeks. The issue I can see with this is that it would cost more money for the breeders to keep the kittens for an extra fortnight. Cats are not traditionally trained and as ‘under control’ as many dogs, and more than 80% of the study cats having mild behavioural problems and 25% having serious problems. It was previously thought that the key socialisation period in cats ends at 8 weeks old but, evidently, separation from the mother and litter mates does have an impact on each kitten.

A better understanding of canine and feline aggression could really open up opportunities for treatments in both species as well as in humans. This is particularly important as an increased aggression is one of the main reasons why cats and dogs are given up to shelters which is unfair on the animal if this could be prevented or better understood. It could also have implications for people with aggression problems, as castration is a debatable and perhaps extreme solution – especially if there are doubts that it is effective in dogs and cats…! Regulation of oxytocin is currently being used in humans to help autism, schizophrenia and post-traumatic stress disorder. There are clinical trials looking into trying to create a behavioural response by their use too. There is definitely a wide future for the use of hormones in the control of certain conditions, including aggression, the problem would be when to use them in humans and if there would be any side effects. There are lots of ideal situations where this could be in use: world peace, no crime, no wars etc. etc. but I feel these could be achieved without the use of such a drug. Also, if it could be used on the enemy in a war to make them not at all aggressive then it would an unfair win and could kill millions of people. However, to treat illness, disease or conditions then this could be a vital tool in the future for both animals and humans.

Avian Flu

Avian Flu was a big issue in this country at the start of this year (as I saw on my lambing placement where they also kept chickens) which lead me to research into it. On the 13th of September this year, the Government Chief Vet announced that the UK had met standards to declare itself Avian Influenza H5N8 free, despite the disease still circulating in Europe. However, last year, the same event occurred and the disease was back by December and, well, it might be back again this year and could be a big problem if it comes back as one of the strains which is zoonotic (can infect humans). This was the case in 1997 when the H1N1 bird flu strain spread starting in Hong Kong. Recently, the BBC also launched an app to gather data to investigate the effect a pandemic would have – which is said to currently be the greatest threat to our race (download the app here and help them gather data about the number of people you meet in a day). Along with the effect on us humans, if any strain of the disease took hold of the country, it would mean a loss of economy and animals for the farmers and the country. Continue reading “Avian Flu”

Slaughter Without Stunning

One ethical has hit the news recently: slaughter without stunning. The reason it is ethical is that it is intertwined with religious belief that animals should be alive when slaughter occurs. The BVA is concerned that there has been a dramatic increase in the number of animals receiving this fate. Reportedly, 18.5% of chickens this year (from 3% in 2013) and 24.4% of sheep and goats between April and June weren’t stunned (an increase from 15% in 2013). Interestingly, the number of cattle slaughtered without stunning actually dropped from 2% to 1% in the same time period. 2013 was when legislation was passed which said that animals didn’t need to be stunned if they were being slaughtered for religious purposes. This issue is affecting the UK, except Scotland which claims that there is no non-stun slaughter in their country.

Stunning is the process which causes the animal to lose consciousness so that they cannot feel pain before the throat is cut, causing rapid blood loss and a quick death (called sticking). Stunning can be undertaken by a bolt or an electrical current being passed into the brain, or by using a gas mixture (currently carbon dioxide).

CCTV was made compulsory in all abattoirs in England during August 2017 for the purpose of monitoring animal welfare at slaughter. The results of this could cause failing slaughterhouses to face criminal investigation or lose staff licences. The concern that the BVA has about slaughter without stunning is that it affects millions of individual animals and so it is an important welfare issue. It is especially important as the supply of meat from these animals who aren’t being stunned massively outstrips the demand from the religious communities for which it was produced and so it is entering the mainstream market unlabelled. It has been estimated that less than half of all meat slaughtered in the Jewish method is sold in Kosher shops. The BVA want the meat which is in the mainstream domain to be clearly labelled to allow the consumer a choice in the products they eat, and the producers to review the supply and demand matching. They have campaigned for the reintroduction of the law which says all animals must be stunned on the grounds of animal welfare.

I completely agree with the stunning of animals due to animal welfare, however, life is never really that simple. Jewish and Muslim communities are exempt from the law dictating stunning before slaughter. The Jewish Shechita and Muslim Halal slaughter methods are different but both require cutting the animal’s throat with a very sharp knife, often without pre-stunning. There are regulations for non-stunning slaughter, such as that the throat must be cut by a rapid, uninterrupted movement of a knife, severing both carotid arteries and both jugular veins and that the knife used must be inspected immediately before killing. According to both Jewish and Muslim religious laws, the animals must be fully alive before slaughter but there are different interpretations of this (i.e. that stunning animals may be compliant with them), but during one week in September 2013, around 84% of animals being killed were stunned before they were slaughtered by the Halal method. According to the AHDB, in 2011, the UK Muslim population accounted for 24% lamb and 16% of mutton consumption. The same organisation has predicted that this has increased since then. The issues with slaughtering conscious animals are that they require a high level of restraint and the distress and pain caused to the animal is great before it loses consciousness (5-7 seconds for sheep and 22-40 second for cattle). It has been suggested that any animal not pre-stunned should receive a post-cut stun, so reducing the suffering.

I have no issue with religious beliefs and customs – they must be respected and upheld. This issue needs to move away from Muslim and Jewish laws and be more focused on animal welfare, which should be the priority in the process of slaughter as, after all, it is about the individual animal involved. I think it is unnecessary that the supply for non-stun meat far exceeds the demand as it means that many animals are being slaughtered in more pain than necessary. The meat in the mainstream market should definitely be labelled as ‘not stunned’ as it would give the consumer a choice and potentially bring the issue to a wider audience. It may also make the suppliers of this meat produce less of it and so stun the animals whose meat will enter the mainstream market. In my opinion, the post-cut stun could be a way forward for those people who believe stunning goes against their religion – it would reduce pain to an extent and still allow this meat to be religiously acceptable. There are enough people who eat this type of meat to reduce the number of animals which are slaughtered in this way without having a detrimental effect on the industry. However, there is no simple answer to this dilemma and there is always controversy surrounding religious and ethical issues, but I think a compromise could be reached. For example, the post-stunning of animals slaughtered under religious law which says the animals should be fully alive but also the reduction of the number of animals undergoing this type of slaughter to meet the demand that exists in this country.

Sarcoids

Sarcoids are maybe something you haven’t heard about before, but they are the most common type of skin tumour in equids (horses etc.) with owner reported frequency at 5.8%. They look a lot like warts but can be so destructive locally that some vets go as far to say that they are a type of skin cancer.

The condition is caused by the Bovine Papilloma Virus (BPV) and parts of this virus (the DNA and protein) have been found on flies, meaning they could potentially be spreading the disease. Mostly found on the abdomen, back legs, sheath, chest and around the eyes and ears, they can appear in clusters or as single tiny lumps. These areas are where flies typically gather on the horse, giving a little more evidence for fly transmission. The lumps cannot metastasise (spread to the internal organs). The most commonly affected age group is the young-middle age category and there may some horses who are genetically predisposed. This is because some of the lumps can ulcerate and become infected, which attracts flies in the summer so they remain open sores which won’t heal on their own. Horses do not die from sarcoids, however, if quality of life is low or if they are unable to work as a result, they may be put to sleep. There are different types of sarcoid:

  • Occult – a patch of hair loss with a grey surface, can be confused with ringworm. Common on the face, neck and between the back legs
  • Verrucose – wart-like, grey and scaly but deeper than occult. More irregular in shape and usually multiple lesions
  • Nodular – lumps under thin and shiny skin, vary in size and occur around the groin and eyelids
  • Fibroblastic – aggressive fleshy masses that can begin from a skin wound and sometimes grow rapidly, often ulcerated and ‘hanging on a stalk’ (pedunculated) or extremely invasive into the surrounding skin
  • Mixed – combination of two or more types, often of different ages, forming a ‘colony’
  • Malevolent – the most aggressive type which spreads through the skin and lymph vessels, with cords of tumour tissue plus nodules and secondary ulcerative lesions

 

Credit: Horse and Hound

The treatment of sarcoids is very important as there is a risk of other sarcoids growing elsewhere in the animal. Treating sarcoids is also often difficult as they are invasive and can be in tricky locations. The treatment option chosen depends on the location, type, size and number of sarcoids and there is always a high risk of reoccurrence. Options for treatment include:

  • Surgery – high failure rate as the wound often heals poorly and the sarcoid frequently recurs but this can be prevented by a wide margin
  • Ligation – applying a tight band around the base of the growth. There is a high risk of leaving tumour cells behind which can regrow and it can be painful for the horse
  • Cryotherapy – freezing the tumour to destroy it. Often requires repeated treatments using general anaesthesia
  • Immune therapy – injection of substances which stimulate the immune system to eliminate the tumour. Works well for sarcoids around the eye, but several treatments are needed, often under heavy sedation
  • Topical treatment – special creams which work well in some cases, particularly in smaller superficial lesions
  • Radiation therapy – This has been shown to be effective but the danger of radiation makes it expensive and general anaesthesia is required. BCG can be used for sarcoids which aren’t located on the legs, which is also the vaccine for TB!
  • Laser removal – a surgical laser is used to remove the tumour

I saw a case in a mixed practice where they used ligation on the tumour (although they were waiting to see what happened with another as it was on the prepuce) and another at an equine hospital where laser removal surgery was performed to remove the lumps. These are the more treatable cases but frequently they are not amenable to surgery or treatment with topical agents. Usually, with sarcoids around the eyes (periorbital sarcoid), radiotherapy is used but previous invasive treatments for sarcoids elsewhere are no longer available due to health and safety regulations.

Therefore, AHT scientists were keen to come up with something to help and they have discovered a new technique for treatment of periorbital sarcoids which doesn’t cause any significant adverse effects. It has been welcomed as the most effective treatment for the condition as so far and it involved high dose rate brachytherapy (HCRB) – a mouthful, I know! The research was done over the past 18 months, using HCRB to treat periorbital sarcoids which was found to be a more safe and effective way to deliver radiotherapy. The procedure also only lasts for a few minutes so there is a shorter recovery time which, in turn, increases team safety and avoids the need for insolation as the animals do not come out radioactive. Once the two doses, one week apart, have been completed using specialised catheters, the individual will hopefully not ever develop sarcoids in that area again.

Evidently, this is a major breakthrough in the treatment of periorbital sarcoids but with no long term results and only a small number of horses trialled, it may not be all that we think. It definitely has the potential to change the treatment of these sarcoids for the better but only time will tell the scale of the improvement.

 

Camera to see a Camera…?

A new camera has been developed which can locate an endoscope’s position through 20cm of human tissue. This means that it has incredible potential in medical procedures in both human and animal medicine. It works by tracking the light on the end of the probe. Before, X-rays or other expensive equipment would have had to be used to track the endoscope. It is also currently difficult to track the device due to the tendency of light to scatter or bounce off the tissues and organs inside the body. The new camera can detect individual photons and it can measure the time it takes for light to pass through the tissue, so can track the endoscope’s precise position. This means it has the potential to be used during procedures, causing minimum invasion.

The technology was first developed as part of a project by the University of Edinburgh and Heriot-Watt University to develop a range of new technologies to aid the diagnosis and treatment of lung diseases

The camera can detect individual photons. Pic: University of Edinburgh
The new camera. Pic: University of Edinburgh

This story is particularly interesting to me as I saw various procedures involving endoscopy at my Equine Hospital placement in the summer. While I was there, I saw the amazing diagnostic potential of endoscopy in problems such as lameness and the incredible detail in which a tissue or structure can be studied and even operated on using an endoscope as a guide. With more inaccessible areas of use than the fetlock or hock, such as the intestines, I can easily see how it is difficult to know exactly where the device is inside the patient. This new technology may also help in diagnosis to determine the precise loci of the injury or infection.