Monday, June 26, 2017

Small changes, and other things I learned about Dr Jane Goodall

Dr Jane Goodall wants to see chimpanzees in protected natural habitat - not confined in baron captive environments.

Are you familiar with the work of Dr Jane Goodall? I was fortunate enough to see her public lecture in Sydney last week. Famous for her study of the chimpanzees in the Gombe Stream National Park – particularly the discovery that chimpanzees not only use but make tools – she has become an outspoken conservationist, travelling 300 days a year (even at the age of 84) to try to turn back the clock on species extinction.

She stood and spoke articulately and passionately for an hour, without any notes or cues, with the manner of Obi Wan Kenobi, about her early life and how attending a conference session in the 1980s on habitat destruction and species loss turned her into the activist she is today. Ironically she spent a lot of her early career battling the stigma (at least among her scientific peers) of being a leggy Nat Geo covergirl, but I got the impression that this in some ways spurred her to work even harder. So here are a few things I learned about "Jane".

She didn’t do it alone. When Jane was featured on the cover of National Geographic magazine in the 1960s it seemed that she was a gorgeous, jungle-dwelling solo scientist living only in the company of her study subjects (chimpanzees). In fact because of various restrictions she wasn’t allowed to go into the jungle alone initially, and furthermore had to be accompanied by not just anyone but a European. So her mum Vanne upped and went to the jungle. While Jane was climbing peaks and watching chimps all day, her mum was in the camp – surrounded by creatures who could be dangerous, coaxing snakes out of the tent and even contracting malaria from which she almost died. Jane’s mum lived well into her 90s. When her mum left Africa, Jane soon met and married a National Geographic photographer who helped her set up a research station.

She got her PhD before she got her undergraduate degree. Her boss, Dr Louis Leakey, talked to colleagues in Cambridge and recommended her, and Jane managed to complete her PhD. Over the years she certainly did do the equivalent work for both the undergrad and postgrad qualifications, but not in the order we’re used to. In her book Reasonsfor Hope, she talks about why it was beneficial for her to study chimpanzees without a formal scientific education first. I’m sure some scientists will disagree, but it’s an interesting argument.

She counters her despair about the planet, the complex issues of habitat loss and fragmentation, anthropogenic climate change, species extinction and environmental degradation by encouraging people to make very small changes in their lives. Not necessarily trying to change the world, but understanding that every little action taken – every plastic bag refused, every item recycled, every meatless meal, every nature strip reinvigorated, counts. (For example, you could make a difference by choosing to refuse single-use plastic in July and beyond – find out more here: http://www.plasticfreejuly.org/). Though Jane does a bit more than just act locally. In 1977 she founded the Jane Goodall Institute which among other things runs conservation projects around the world. But during her talk she was most excited about her Roots and Shoots program (founded in 1991), designed to teach and get young people involved in conservation.

You can even enroll in a free online course for educators, taught by Dr Goodall and colleagues. More info available on the Roots and Shoots website.

If she weren’t trying to convince people to act to save the planet, Dr Goodall assured the crowd that really she’s an introvert: she’d prefer to be home, in the house she grew up in, or “alone in a forest”.

You can read more about her work here.


Friday, June 23, 2017

Dogs in hospitals, brain surgery and biosecurity


Have you ever had to have a prolonged stay in hospital?

I recently spent some time with a human family member in a hospital. The staff were wonderful, but hospitals aren’t fun places to be. For a start, the patient is usually feeling anxious about their condition. And that condition is usually making them feel sick, and/or painful. For another thing, the patient has had to leave all their responsibilities at home – including companion animals who they may be missing terribly. And hospital can be a lonely place.

Should dogs be allowed in hospitals? The Royal College of Nursing in the UK has argued that there is scope to allow trained dogs on certain wards, and author Michele Hanson agrees. Read more here.

We’ve been reading neurosurgeon Henry Marsh’s books, Do No Harm and Admissions, a fascinating and scary-but-can’t-look-away insight into the challenges and grave responsibilities of brain surgery. If you don’t have time to read the books, you can listen to his interview with RichardFiedler here.

Are you a veterinarian who treats backyard livestock (this includes chickens)? The NSW Department of Primary Industries, Animal Health Australia and the AVA have teamed up to create an online course, which includes information on protecting staff and clients from zoonoses and other risks, and information about working with Government vets in disease surveillance. The course is free of charge and is open to veterinarians. For instructions on how to enrol, visit this site.


Monday, June 19, 2017

Is being a female veterinarian an issue?

Poodle, standard poodle
This poodle isn't female, but was at the AVA Conference chilling out in the exhibition hall.

There are more female veterinarians than ever in our profession, yet we continue to experience challenges.

At the recent AVA conference, Campbell Fisher – Managing Partner and Solicitor Director of FCB Group – gave a presentation about some of these challenges.
It’s hard to say exactly how many women in the profession, but according to a 2009 NAB survey it was 3500 – compared to just 471 in 1980. That figure has undoubtedly increased almost a decade later. In the 2016 AVA Veterinary Workforce Survey, 62 per cent of respondents were female – BUT the response rate was 14 per cent and studies have shown that women are more likely to respond to surveys. 

Yet there remains a shortage of female graduates working in rural communities, partly, it seems, because of longer hours, greater travel distances, more overtime and less availability of child care. In most countries including Australia it appears that men are more likely than women to own a practice and thus employ other veterinarians.

(In this fast-moving area it is perilous to cite “old” literature, but excellent paper by Heath and Lanyon looked at motivations for studying veterinary science 21 years ago. Key factors influencing men to study vet science were the desire to be independent of supervision and the financial attractiveness of veterinary practice. Key factors influencing women to study vet science were a love of animals, veterinarians on TV, an interest in living things and the scientific study of disease(Heath and Lanyon, 1996). If these trends are accurate and held over that time period, you can understand why males were drawn to practice ownership than females).

It seems that not all employers are up with the 2009 Commonwealth Fair Work Act, which provides entitlements including entitlements for pregnant employees, parental leave access and the right to request flexible work arrangements. For women employed for over 12 months in their current job, this means they can request flexible work arrangements (this might include varying hours worked, starting and finishing times etc). Under the Act, employers do need to consider these requests and respond in writing within 21 days, refusing a flexible work request only on “reasonable business grounds”.

In small clinics it could still be very hard to accommodate such requests due to the nature of the work.

Despite the existence of the Sex Discrimination Act, Mr Fisher argued that gender inequality continues in our profession. He cited a recent study which found that for every 100 women who got promoted from an entry level position to a management role, 130 men advance. Additionally, while employers might be educated about sex discrimination, not all clients are, and women may be subject to discrimination from clients. I remember some years ago I was locuming in a practice and a male client presented an aggressive German Shepherd for examination. Before he saw me he had decided this was beyond my capacity due to the fact that I am biologically female, and requested to see the male vet. My colleague had a fear of this breed due to a traumatic childhood experience, but the client absolutely insisted that he preferred that the dog was examined by a male. I don’t think anyone was happy in that situation, regardless of their gender and/or species.

It’s hard to believe in this day and age that people in any workplace (or any context really) are being discriminated against because of their gender or sex, but it happens. We need legislation, and education, to continue to fight it.

Reference


HEATH, T. J. & LANYON, A. 1996. A longitudinal study of veterinary students and recent graduates. 4. Gender issues. Aust Vet J, 74, 305-8.

Friday, June 16, 2017

Is there evidence for animal consciousness?

animal consciousness
The evidence for animal consciousness is overwhelming. The question is, should this prompt us to change our behaviour towards animals?

Are animals conscious, and to what extent? One area of scientific study used to answer this question has been human-animal relationships, and animals’ subjective experience of us. Studies have shown that different human individuals are perceived differently by animals. This leads to behaviour on a scale from avoidance to bonding.

Most people who live with non-human animals are aware of this, and interact with animals on the assumption that they are interacting with conscious beings (indeed, we assume this of other humans). Whether it’s a dairy cow or a dog, animals may respond with more or less enthusiasm, affection, even aggression, to different individuals. Hero headbutts me (in the nice way, as opposed to the Liverpool kiss kind of way), bolts from anyone who he hasn’t met before, and only lets individuals he is very used to within his personal space (and even then, there are varying levels of trust). He knows who is likely to feed him.

According to the authors of a recent scientific review, “this indicates that conscious, rather than strictly predetermined and automatic processes, may emerge in the development of human-animal relationships”(Le Neindre et al., 2017). In this review, a team of scientists cited 659 references, 75 per cent of which were sourced from international scientific journals and 33 per cent of which were published since 2010.

In 2012, a group of leading scientists gathered and signed the Cambridge Declaration of Consciousness. After a preamble, which you can read here, they declared: 
“The absence of a neocortex does not appear to preclude an organism from experiencing affective states. Convergent evidence indicates that non-human animals have the neuroanatomical, neurochemical, and neurophysiological substrates of conscious states along with the capacity to exhibit intentional behaviours. Consequently, the weight of evidence indicates that humans are not unique in possessing the neurological substrates that generate consciousness. Nonhuman animals, including all mammals and birds, and many other creatures, including octopuses, also possess these neurological substrates”(Low et al., 2012).
Essentially, animals do experience emotions, they have episodic memory, social structures that rely on social cognitive abilities, and many exhibit metacognition (thinking about thinking). They have the equipment to generate consciousness (even if it’s different to ours). But it stopped there. The big question is, how should this information change our treatment of animals?

The recent review, published by the European Food Safety Authority, is comprehensive and summarises our knowledge about consciousness – of humans as well as animals. It states that, among other things, 
“As for animals, human consciousness might be best described as the emerging product of interactions between different functional layers constituted by perceptual, attentional, mnesic, emotional and evaluative competencies which revolve around a central node supporting core regulations involved in vigilance and central rhythms. Upon the perception of a stimulus of interest, several of these layers are activated and interact to ultimately produce interpretations and intentionality which are externalised through the expression of conscious actions. Thus, processes related to consciousness allow the emergence of responses which have greater complexity and content than the simple combination or addition of individual responses to separate systems”.(Le Neindre et al., 2017)

The authors of the recent report go a step beyond the signatories of the Cambridge Declaration of Consciousness, stating that “the different levels and contents of consciousness documented in animals should give rise to commensurate ethical considerations, especially regarding domestic animals used in farming, research, work, sports or companionship”(Le Neindre et al., 2017).

For anyone with an interest in animal welfare, consciousness (in any species) or ethics, these documents are worth a read. The evidence demands that we consider some confronting questions. What are the implications for veterinarians? What are the implications for society as a whole? Should we change current practices? Which ones? How? 

References

LE NEINDRE, P., BERNARD, E., BOISSY, A., BOIVIN, X., CALANDREAU, L., DELON, N., DEPUTTE, B., DESMOULIN-CANSELIER, S., DUNIER, M., FAIVRE, N., GIURFA, M., GUICHET, J.-L., LANSADE, L., LARRÈRE, R., MORMÈDE, P., PRUNET, P., SCHAAL, B., SERVIÈRE, J. & TERLOUW, C. 2017. Animal Consciousness. EFSA Supporting Publications, 14, 1196E-n/a.

LOW, P., PANKSEPP, J., REISS, D., EDELMAN, D., VAN SWINDEREN, B. & KOCH, C. 2012. The Cambridge Declaration of Consciousness. In: LOW, P. (ed.) Francis Crick Memorial Conference on Consciousness in Human and non-Human Animals. Churchill College, University of Cambridge.

Monday, June 12, 2017

The acute abdomen, the philosophy of surgery, and why we need to look after our doctors

Gastrointestinal foreign body; acute abdomen; abdominal surgery
A gastrointestinal foreign body in situ - one of the most common causes of an acute abdomen in the dog. Not so much in human adults.

Have you ever wondered if your doctor has had a decent sleep, or a proper and nourishing meal? It was a question I was unexpectedly confronted with last week when a very close human family member was admitted to hospital with an acute abdomen. It became rapidly apparent that this was a surgical condition.

Due to a series of unfortunate events, the surgery was delayed. Patient X was meant to be transported to a larger hospital, but this didn’t occur due to the patient transport staff member calling in sick. As most surgeons know, at some critical point, time is bowel. So it was concerning that the surgery – scheduled for the morning – was not going to be addressed until late in the evening, when the on-call surgeon had been working constantly on critical cases and hadn’t had a break, and Patient X had been enduring discomfort for 48 hours. Free abdominal fluid had been detected on ultrasound.

To the team’s credit, everything went well. Patient X is recovering (I am so used to veterinary patients that I was shocked that I was able to converse with Patient X on the phone post anaesthesia. I wish our patients could call us and tell us things like “my throat is a bit sore from the ET tube” or “this pain relief is working really well”, or Whatsapp a cheery hospital selfie. It must at least be helpful to be hospitalised in a facility staffed by members of one’s own species). And no, it wasn't a foreign body but an obstruction which occurred secondary to an adhesion which occurred secondary to a previous surgery. (Disappointingly, at least for me, there was no surgical photo). 

The following day, when the surgical registrar called to update me, he was amused that I asked him if he’d had some sleep. But I was serious. We need to look after our health care professionals.

The French vascular surgeon Rene Leriche, in The Philosophy of Surgery, wrote that “The best surgeons are those who are able to maintain their fitness and comfort during the long-lasting jobs” back in 1951. (He also wrote that “Every surgeon carries about him a little cemetery, in which from time to time he goes to pray, a cemetery of bitterness and regret, of which he seeks the reason for certain of his failures” – an important acknowledgement, but somewhat concerning to recall when you know the patient, and you know there is a correlation between hypoglycaemia, hypohydration and errors).

I digress. It’s important that doctors are not overworked, are well-supported, take decent breaks, eat nourishing food and get recharging sleep. In an article last week in The Conversation, Professor Alex Broom put it succinctly: “Doctors who feel better will make fewer mistakes and solve problems faster.” (Read the full article here - he also makes the point that stressed doctors are less motivated to participate in continuing education, yet “participation in continuing education improves professional practice, and, crucially, patient outcomes”).

The Australian Medical Association lists some excellent resources on its website, many of which are just as relevant to veterinarians and nurses too. You can access those here.

We need to look after those people that look after others. In terms of vets, we’re working on The Vet Cook Book which should be published later this year. This is designed to promote collegiality and conversation but also provides some helpful resources – and recipes. You can follow the facebook page

Fortunately, and thanks to excellent care despite many challenges, patient X is doing well, having been discharged home for cage bed rest (without an Elizabethan collar).

In other news, an exhibition which opened on June 9 highlights the plight of victims of domestic violence and their companion animals. This looks like an amazing initiative and worth seeing.

If you’re in Sydney, SAT reader Kerry shared this info about doggy degustation events (obviously not for the canine on an elimination or prescription diet).


Thursday, June 8, 2017

Five minutes with behaviour vet Nicole Lobry de Bruyn

Nicole Lobry de Bruyn and Murphy.
Nicole Lobry de Bruyn is an animal behaviour veterinarian and teacher based in Western Australia. Her life was changed by adoption of a dog with a mental health issue, and a career change followed. She's also an accomplished author and blogger. She now runs ANIMAL sense

I finally met her in person at the Australian Veterinary Association annual conference where she was soaking up the behaviour sessions in the scientific program.

What’s your day job?

My day job is both teaching animal behaviour to undergraduate veterinarians and running ANIMAL Sense – a private small animal veterinary consultancy business.

What sparked your interest in animal behaviour?

It was a slow burn. Firstly, I adopted a dog reactive dog from the clinic only to discover I didn’t know how to treat him and my search ended in much confusion from trainers. I went on journey of discovery using science and compassion as my base.

What are the key behaviour problems you see in companion animals?

Nearly all behaviour problems are a result of fear and anxiety and arise through genetics, environment and learning.

How are behavioural disorders diagnosed?

Through extensive questionnaire assessment of history, observation of the animal and rule out of medical conditions.

How do behavioural disorders impact on the welfare of animals and people?

It impacts the quality of life of both people and pets. There is lots of evidence saying how good pet owning is for humans, but having a mentally ill pet can be very stressful to a family and giving them the support they need is very rewarding.

Are there any ways to prevent behaviour problems developing in animals, or is it simply a matter of treating them as they arise?

As much as possible breeders should be selecting for temperament, providing positive early socialisation experiences and owners should be counselled on how dogs learn – therefore only ever using positive reinforcement techniques.

What non-human do you share your life with and how did you meet?

Border Terrier Murphy obtained from a breeder at 5 months of age.

Any advice you’d like to share with veterinarians and future veterinarians?

Practice vet medicine with compassion for yourself your clients and their companions. Be guided by science. Always follow an ethical approach when changing behaviour – least intrusive, minimally aversive methods.


Thanks Nicole for answering our questions. If you’re at the AVA conference and have not yet signed up, or if you want to come along, the Australian Veterinarians in Behaviour Interest Group is running a workshop on Friday. Sign up here. http://conference.ava.com.au/

Tuesday, June 6, 2017

Tackling antimicrobial resistance


antimicrobial resistance, AMR
How can vets help fight antimicrobial resistance?

Want to access free resources to help you tackle antimicrobial resistance?

Australian Chief Veterinary Officer Dr Mark Schipp provided a very sobering plenary discussion about the impact of antimicrobial resistance on the wellbeing of humans, animals and the environment. 

Dr Schipp said: “The present situation is unsustainable, the global trends can’t be missed.” We need detailed surveillance on antimicrobial use, and the funding to facilitate this. 

In the meantime individual veterinarians and practices can do their bit.

The Australian Veterinary Association has published a selection of guidelines designed to reduce antimicrobial resistance, and you don't need to be a member to access these.




For those with an interest in this area, the Australian Society for Infectious Diseases is hosting a summit on antimicrobial resistance on June 29 in Melbourne. Find out more here.