10 minute read
EAGLE POST
Thomas Donnelly, BVSc, DipVP, DipACLAM reports from the US.
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Eagle Post
Many of this column’s readers have likely heard of the stories using ivermectin to treat or prevent COVID-19 in humans. Last August, in a Health Alert from the U.S. Centers for Disease Control and Prevention, poison control centers across the US were seeing a sharp spike in reports of people suffering adverse health effects after taking animal ivermectin. Peoplewere purch-asing various highlyconcentrated animal ivermectin drug formulations such as pour-on, injectable, paste, and drench intended for horses, cattle, and sheep, and taking these drugs made some people very sick. The US Food and Drug Administration asked veterinarians to help share important safety information about the misuse of animal ivermectin to prevent or treat COVID-19 in people.1 To assist, the FDA developed a sign available for download to either pass out or post in veterinary practices reminding people about the dangers of treating themselves with animal ivermectin.2 Human consumption was so widespread that the Center for Veterinary Medicine of the FDA was hearing reports of decreased availability of certain animal ivermectin products in some areas of the country.
Why was ivermectin touted as an anti-COVID-19 treatment? Surprisisingly it was not misinformation, for there was a brief period when it was thought ivermectin could be an active treatment for COVID-19. It was not when the in vitro data first came out. Therapeutic concentrations were not achievable in humans. Nor when the anecdotal reports poured in and sometimes made the news. Not when the results appeared evaluating ivermectin use and lower death rates from COVID-19 in some countries, mainly from tropical regions in South America and Asia. And not when non-medically trained people pushed ivermectin with enthusiasm religious in its intensity. Their treatment “protocols,” with a hodgepodge of antimicrobials (including ivermectin), immunomodulators, and vitamins --the kitchen sink approach -- strained credibility.
Infectious disease physicians’ greatest hope for ivermectin came just over a year ago, when Dr. Andrew Hill, a well-respected clinical researcher in HIV research at the University of Liverpool, UK, presented results from a meta-analysis of twenty-three randomized controlled trials.3 Hewould later also give this presentation to the NIH Guidelines panel. He found the risk-ratio for death with ivermectin was 0.17 (95 per cent confidence interval 0.08, 0.35), an 83 per cent reduction in the risk of dying from COVID-19. Outcomes for other endpoints (viral clearance, clinical recovery, hospitalization) also favored treatment over controls.
In retrospect, Hill acknowledged that the data were incomplete but remained strongly suggestive of clinical benefit. Furthermore, he had been regularly communicating with researchers conducting the five largest studies. They reassured him repeatedly that the data were sound. On January 4, 2021, the New England Journal of Medicine came out with a blog entitled “Ivermectin for COVID-19 -- Breakthrough Treatment or Hydroxychloroquine Redux?”4
The clinical trials data for ivermectin looked stronger than they ever did for hydroxychloroquine, but the evidence was not yet at the “practice changing” level. Results from at least 5 randomized clinical trials were expected soon that might further inform the decision. However, National Institutes of Health (NIH) treatment guidelines still recommended against using ivermectin to treat COVID-19. What happened next? Hill submitted the meta-analysis to the journal Open Forum Infectious Diseases in early 2021. At that point, there were still no readily available effective outpatient treatments for COVID-19. Something inexpensive, safe, and widely available would have been most welcome. After peer review and some revisions, Hill reduced the survival effect size for ivermectin to 56% (still highly significant) due to some additional studies, and his paper was accepted for publication.5 The editors simultaneously solicited a thoughtful editorial entitled “Ivermectin for the Treatment of COVID-19 Disease: Too Good to Pass Up or Too Good to Be True?”6 And unfortunately, the second part of the title turned out to be the case --too good to be true. Many meta-analysis studies were highly flawed, and one was outright fraudulent. The fake data problem became known shortly after the meta-analysis appeared in print. Hill promptly contacted the journal when the news broke. He immediately retracted the original paper and, even better,submitted adetailed analysis of what went wrong.7 It includes a revealing figure, which shows how the effect size of ivermectin on survival drops to meaningless by excluding the fraudulent and potentially flawed studies.
The revised results highlighted the need for rigorous quality assessments in COVID-19 drug trials, for authors to share patient-level data, and for efforts to avoid publication bias for registered studies. Since then, a review has been published based on these issues.8
References
1. Food and Drug Administration. CVM Letter to Veterinarians and Retailers: Help Stop Misuse of Animal Ivermectin to Prevent or Treat COVID-19 in Humans. 2021; content.govdelivery.com/accounts/ USFDA/bulletins/2eef57b. 2. Food and Drug Administration. Veterinary Ivermectin Safety Alert. 2021; www.fda.gov/media/151853/ download. 3. You Tube. Ivermectin meta-analysis by Andrew Hill. 2020; www.you tube.com/watch?v=yOAh7GtvcOs 4.Sax PE. Ivermectin for COVID-19 --Breakthrough Treatment or Hydroxychloroquine Redux? 2021; blogs.jwatch.org/hiv-id-observations/ index.php/ivermectin-for-covid19-breakthrough-treatmentor-hydroxychloroquine redux/2021/ 01/04/. 5. Hill A, Garratt A, Levi J, et al. Meta-analysis of Randomized Trials of Ivermectin to Treat SARS-CoV-2 Infection. Open Forum Infect Dis 2021;8:ofab358. doi:10.1093/ ofid/ofab358 6. Siedner MJ. Ivermectin for the Treatment of COVID-19 Disease: Too Good to Pass Up or Too Good to Be True? Open Forum Infect Dis 2021;8:ofab318. doi:10.1093/ofid/ ofab318 7. Hill A, Mirchandani M, Pilkington V. Ivermectin for COVID-19: Addressing Potential Bias and Medical Fraud. Open Forum Infect Dis 2022;9: ofab645.doi:10.1093/ofid/ ofab645 8. Smith EM. Reimagining the peerreview system for translational health science journals. Clin Transl Sci 2021;14:1210-1221. doi:10.1111/ cts.13050
Revisiting porcine circovirus disease diagnostic criteria in the current Porcine circovirus 2 epidemiological context
Current knowledge on porcine circovirus diseases (PCVD) caused by Porcine circovirus 2 (PCV-2) includes the subclinical infection (PCV-2-SI), systemic (PCV-2-SD) and reproductive (PCV-2-RD) diseases, and porcine dermatitis and nephropathy syndrome (PDNS). Criteria to establish the diagnosis of these conditions have not changed over the years; thus, the triad composed by clinical signs, lesions and viral detection in lesions are still the hallmark for PCV-2-SD and PCV-2-RD. In contrast, PCV-2-SI diagnosis is not usually performed since this condition is perceived to be controlled by default through vaccination. PDNS is diagnosed by gross and histopathological findings, and PCV-2 detection is not recognized as a diagnostic criterion. Molecular biology methods as a proxy for PCVD diagnoses have been extensively used in the last decade, although these techniques should be mainly considered as monitoring tools rather than diagnostic ones. What has changed over the years is the epidemiological picture of PCV-2 through the massive use of vaccination, which allowed the decrease in infectious pressure paralleled with a decrease in overall herd immunity. Consequently, the need for establishing the diagnosis of PCVD has increased lately, especially in cases with a PCV-2-SD-like condition despite vaccination. Therefore, the objective of the present review is to update the current knowledge on diagnostic criteria for PCVDs and to contextualize the interest of using molecular biology methods in the overall picture of these diseases within variable epidemiological scenarios of PCV-2 infection. Joaquim Segalés123,Marina Sibila34 Vet Sci. 2022 Mar 2;9(3): 110.doi: 10.3390/vetsci9030110. 1Unitat Mixta d'Investigació IRTA-UAB en Sanitat Animal, Centre de Recerca en Sanitat Animal (CReSA), Campus de la Universitat Autònoma de Barcelona (UAB), Bellaterra, 08193 Barcelona, Catalonia, Spain. 2Departament de Sanitat i Anatomia Animals, Facultat de Veterinària, Campus de la Universitat Autònoma de Barcelona (UAB), Bellaterra, 08193 Barcelona, Catalonia, Spain. 3OIE Collaborating Centrefor the Research and Control of Emerging and Re-emerging Swine Diseases in Europe (IRTA-CReSA), Bellaterra, 08193 Barcelona, Catalonia, Spain. 4IRTAPrograma de Sanitat Animal, Centrede Recerca en Sanitat Animal (CReSA), Campus de la Universitat Autònoma de Barcelona (UAB), Bellaterra, 08193 Barcelona, Catalonia, Spain.
Free PMC article
Low and no-contact euthanasia: associated ethical challenges experienced by veterinary team members during the early months of the COVID-19 pandemic
Background: During the ongoing COVID-19 pandemic, many veterinary practices around the world have shifted to a low or no-contact consultation model to ensure the safety of their team members and clients, and comply with public health orders, while continuing to provide veterinary care. Methods: We performed reflexive thematic analysis on a subset of data collected using a mixed-methods survey of veterinary team members globally. Results: There were 540 valid responses available for analysis. Low and no-contact euthanasia were raised as a common and/or stressful ethical challenge for 22.8 per cent of respondents. We identified five key themes: no-contact euthanasia as a unique ethical challenge; balancing veterinary team safety with the emotional needs of clients; low and no-contact protocols may cause or exacerbate fear, anxiety, and distress in veterinary patients; physical distancing was more challenging during euthanasia consultations; and biosecurity measures complicated communication around euthanasia and end-of-life decision making. Recommendations: In light of concerns highlighted by respondents, werecommend the development of a toolkit of protocols that will assist veterinary team members in performing low-contact euthanasia in a range of circumstances, in alignment with their values and professional ethical codes. Professional bodies may be involved To page 30
Aims: To gather data on the calf management and rearing practices of a subset of dairy farmers in the south-west region of Western Australia. Methods: A30-minute face-to-face survey was conducted with dairy cattle producers in the south-west region of Western Australia from April-June 2019 to determine pre-weaning calf rearing practices. Participation was voluntary, using a self-selected subset of dairy farmers registered with a regional extension group. The questionnaire assessed three broad categories: farm demographics, colostrum harvesting and management and calf rearing practices. Results: The study response rate was 34/140 (24 per cent). The following key areas were identified where there were deviations from recognised best practice: Precalving: no transition diet was fed pre-calving on 4/34 (12 per cent) of farms, and on afurther 5/34 (15 per cent) it was fed for less than 3 weeks; mixing of heifers and adult cows in the calving paddocks occurred in 24/34 (70 per cent) of the farms, with 15 per cent (5/34) of the farms using calving induction. During calving 14/34 (41 per cent) of the farms did not disinfect navels of new-born calves; although 23/34 farmers stated that they collected calves within 6hours of birth, data on frequency of calf pick-up (2/34 did not separate calves and dams and 19/34 picked up only once per day) indicated that on 21/34 farms (62 per cent) the reality was that calves werepicked up >12 hours after birth. Colostrum quality was not assessed appropriately on 18/34 (53 per cent) farms and farmers overestimated how soon after birth it was administered: 23/34 (68 per cent) reported feeding it within 6 hours of calving, despite 62 per cent picking up calves >12 hours after calving. Regarding calf rearing practices, no pain relief before or after dehorning was used on 20/34 (59 per cent) farms, calf bedding was removed infrequently (<weekly) on 26/35 (76 per cent) farms and appropriate isolation of sick calves was only reported by 14/34 (41 per cent) farmers. Conclusion and clinical relevance: Although limited by the low response rate, this is the first survey of dairy calf rearing practices in the south-western region of Western Australia. We found evidence of at least one process inconsistent with industry best-practice on 34/140 (24 per cent) of responding farms and all farms had more than one sub-optimal calf rearing practice. This highlights the need to improve calf rearing in this region and identifies key areas of deficiency for further study and extension to producers. JW Aleri12,A D Fisher34,J Gogoi-Tiwari1,F K Waichigo5 , HR Sodagari1 , PC Irons1 , ID Robertson1 NZ Vet J. 2022 Mar 7; 1-7.doi: 10.1080/00480169.2022.2042413. Online ahead of print. 1School of VeterinaryMedicine, College of Science, Health, Engineering and Education, Murdoch University, Murdoch, WA, Australia. 2Centrefor Animal Production and Health, FutureFoods Institute, Murdoch University, Murdoch, WA, Australia. 3Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Werribee, Victoria, Australia. 4Animal Welfare Science Centre, University of Melbourne, Victoria, Parkville, Australia. 5Brunswick VeterinaryServices, Brunswick Junction, WA, Australia.
Coevolution of relative brain size and life expectancy in parrots
Previous studies have demonstrated a correlation between longevity and brain size in a variety of taxa. Little research has been devoted to understanding this link in parrots; yet parrots arewell-known for both their exceptionally long lives and cognitive complexity.Weemployed a large-scale comparative analysis that investigated the influence of brain size To page30
