DEMOGRAPHY OF SMALL ANIMAL CASES IN ASSIUT BETWEEN YEARS 2007-2010: A RETROSPECTIVE STUDY OF 312 CASES

DEMOGRAPHY OF SMALL ANIMAL CASES IN ASSIUT BETWEEN YEARS 2007-2010: A RETROSPECTIVE STUDY OF 312 CASES

NASHWA E WALY^* and REHAB K. SAYED^**

^*Division of Internal Veterinary Medicine, Faculty of Veterinary Medicine, Assiut University, Assiut, Egypt.

^**Post-graduate student at the Division of Infectious Diseases, Animal Medicine Department, Faculty of Veterinary Medicine, Assiut University, Assiut 71526, Egypt.

__________________________________________________________________________________________

                                        ABSTRACT

_________________________________________________________________________________________

__________________________________________________________________________________________

Keywords: Demography, Cats, Retrospective study, Small Animal Clinic (SAC).

__________________________________________________________________________________________

INTRODUCTION

The ongoing, systematic collection, analysis, and interpretation of disease-related data is essential to the planning, implementation and evaluation of small animal practice. Publications that documents the demography of small animal medicine in western countries is limited to specific disease studies as opposed to a complete analysis of the demography of cats and dogs presented at clinics (Bland, Guthrie-Jones et al., 2009; Lederer, Rand et al., 2009; Toribio, Norris et al., 2009; Aptekmann and Schwartz, 2011; Gunn-Moore, McFarland et al., 2011). The availability of such data is a valuable source that directs investments in veterinary care products and medications equally. Because of the close proximity in which both small animals and humans live, case surveys and studies is an important resource for public health practices (Moore and Lund, 2009). Availability of similar studies makes it feasible to justify specialized clinics whether for a single species (e.g. feline-only practices) or referral clinics (e.g. cardiology clinics) and should be a component of feasibility studies. Such uses and functions include the facilitation of planning for appropriate interventions and evaluating the effectiveness of diagnosis and treatment measures. All uses, however, are influenced by the quality and quantity of information collected (Moore and Lund, 2009). This information is currently unavailable for small animal practices in Egypt or the middle-east although in certain countries and in major cities (e.g. Cairo and Alexandria), small animal clinics have been present for over 30 years.

In this study, we report the demography of small animal cases examined at the Small Animal Clinic at the Faculty of Veterinary Medicine, Assiut University in Egypt.

MATERIALS and METHODS

Collection of Data

Data for this study were obtained by reviewing records of cases examined at the Small Animal Clinic, Faculty of Veterinary Medicine, Assiut University, Egypt between years 2007 and 2009. Both canine and feline case records were included. Aspects of analysis included: total number of cases, species, breed, age, sex, cause for admission and diagnostic outcome.  Only cases with complete data sets were included in this study (n= 312), with total traffic reading 545 cases.

Statistical analysis

All data except total number of cases were presented as percentage of the total for each species. For age, simple statistical analysis was carried out to present results as range, mean and median for each species / year. Microsoft office 2007 excel was used to generate these data.

RESULTS

The total number of feline and canine cases, percentage of male versus female and total case traffic (total number including repeat visits) is summarized in Table 1. Over the first reviewed year (2007) the number of cases was very small totalling ten feline cases and only four canine cases with a total traffic of 20 cases. The number of cases tripled in the following two years. Feline male/ female ratio remained the same over the analysis period (1:1) whereas that of canine cases was 100% females in the first studied year which then turned into the expected 1:1 male/female ratio in the following two years with the increase of total number of cases seen.

The age of feline cases seen ranged from 1 to 132 months old over the three reported years, with an average age of 16.4 and a median of 10 months old. The age range for dogs seen at the clinic over the three year period ranged from 0.5 to 132 months old with an average of 40.6 and a median of eight months.  The detailed set of results for each reported year is summarized in Table 2.

The most popular feline breeds to the owners were longhaired cats (Persian, Turkish Angora and European Longhair) which occupied 80% of the total in the first year and 61-63% in the following two years (Table 3, Fig 1). For dog owners, the most popular dog breed was the Griffon. More canine breeds were represented in the following two years with an obvious increase of the number of Rottweiler breed (15 %). Details of breed percentages over the three-year period are summarized in Table 4 and   Fig. 2. 

In this study, the reason for presenting cases was split according to the owner’s complaint combined with the outcome of examination into general health check and/or routine vaccination (GHC), Urinary, Dermatological, Gastroenterological (GI), Respiratory, Reproductive, Traumatic, Ophthalmological, and Neurological. For feline cases in the first year, the most common cause for presentation was GHC, GI and reproductive problems (21%) each. In the following two years, cases with dermatological problems increased (16% and 32%) respectively. A large % of cases were still seen for GHC reaching 29.6% in the third year. Detailed results of all other causes for presentation is summarized in Table 5 and examples of cases seen at the clinic is presented in Plate 1. 

Dogs were presented to the clinic in year 2007 with dermatological problems (66.6%) and for reproductive consultation (33.3%). However, these percentages changed dramatically over the following two years with GHC being the primary cause for presentation (24% and 44% respectively). The second most common cause for presentation was GI disturbance and trauma came in third. Detailed percentages of all causes of presentation are summarized in table 5. Percentage of cases coming in for routine vaccination only was small, ranging from 17.7% to 33.3% for cats over the three studied years, and limited to 0% to 20 % for dogs (data not shown).

The percentage of animals that died on presentation or soon thereafter was small and causes of these fatalities were intestinal obstruction, organophosphate toxicity, liver disease, rabies, FLUTD and an untreated case of mega-colon in cats whereas causes of death in dogs were intestinal obstruction, post-surgical and pneumonia (Table 6).

                                            (a)                                                                                               (b)

 (c)

Plate 1: Examples of feline and canine cases presented at the Small Animal Clinic, Assiut University. a) Catheterised cat suffering from feline lower urinary tract disease, b) A germen shepherd puppy with kennel cough; c) a kitten with severe dehydration.

Table 1:  Logistics of feline and canine cases submitted to the Small Animal Clinic 2007-2009

Total feline or canine cases represents the total number of cases submitted to the clinic, total feline or canine traffic represents the number of cases including repeat visits of the same case. FC, female cats; MC, male cats; CF, canine females; CM, canine males.

Table 2: Statistical analysis of age of cases submitted to Small Animal Clinic.

Min, minimum age, Max, maximum age of cases submitted to the clinic.

Table 3: Percentage of breeds of cats submitted to the Small Animal Clinic over the three studied years.

Percentage of each breed calculated from the total number of cases submitted each year.

Table 4: Percentage of breeds of dogs submitted to the Small Animal Clinic over the three studied years.

Percentage of each breed calculated from the total number of cases submitted each year.

Table 6: Percentage of fatalities and survival rates of cases submitted to the Small Animal Clinic over the three studied years.

Percentage is calculated of the total traffic of cases for each year.

DISCUSSION

In this study, records of cases presented at the Small Animal Clinic, Faculty of Veterinary Medicine at Assiut University between years 2007-2009 were reviewed and data analyzed for demography of small animals in the area as well as owner’s attitudes towards small animal veterinary care. Owner’s attitudes were not questionnaire-based but were deduced from the number of cases over the three year period as well as feedback and follow up data availability.

The dramatic increase in number of cases in the second and third year suggests that there is a small animal owner community that is connected through word-of-mouth as the opening of the clinic was not advertised. 

Except for dogs in the first studied year, the male/female ratio was 1:1 in both dogs and cats.  Although there was no similar demographic studies to compare our finding to, similar results were reported in studies of risk factor to behavioral problems in dogs (Angela Gonza´lez Martı´nez, Fco. Javier Die´guez Casalta et al., 2011). The sex bias occurring in the first year was due to the very small number of presented cases so it cannot be considered as a sign for owner-preference to one sex of the other. The cats and dogs included in this study can be considered a random sample of the pet population and in Egypt, the majority of people who keep pets, prefer cats over dogs due to both religious reasons and ease of keeping indoor cats as most people live in apartments rather than houses with gardens. Some of our clients are breeders and they often favor one sex over the other but the number of dogs included in this study did not specifically come from breeders. These findings are different from a previous report studying the demography of the cat population in Sydney, Australia were there was significantly more females than males and the majority was neutered (Toribio, Norris et al., 2009). Our records also show that none of these cats or dogs was neutered. Discussing the issue with the owners revealed that it was either because they were too worried about their pet being put under anesthesia, they kept the animals for breeding or they just thought it was unfair on the animal to deprive them of their God-given right to procreate. We noticed that this attitude is starting to change as owners can’t keep all the offspring and they are finding it hard to find homes for all of them. 

The cases visiting the clinic in this study represent a random sample of the pet population in Assiut governorate.  In both dogs and cats, although the age range was wide, the mean and median indicate a shift to the younger age in the population. This could be due to the increase in number of people acquiring new pets in Assiut as suggested by the increase in case number as well as cases coming for a GHC over the three year period or it could be due to the lack of extensive veterinary care geared to older aged pets as the teaching clinic was the first clinic to deal with small animals in the governorate. This hypothesis will be resolved by the continued analysis and study of change in demography of the submitted cases in following years.

There was a very poor representation of pure breeds among the cat population and the ratio was 3:1 to the DSH cats unlike reports of cat population in Sydney, Australia (Toribio, Norris et al., 2009). Discussing why the owner picked a certain breed indicated that the majority just liked cats but no specific breed. Also most owners were not aware of availability of other pure and eccentric breeds in Egypt. A considerable number reported that ever since they were children they acquired cats and that to them each cat is different and has its own charm but they were not really interested in how the cat looked in terms of specific breed details. In general, longhaired cats were most favorable, and most owners called any longhaired cat a Persian. Owners also referred to pure bred Persian as “PeckyFace” and the non-pure bred as “MoonFace” Persian. This terminology is known among Egyptian breeders and the authors are not aware of the origin of such terminology but it is agreed-on by most longhaired cat-owners.

Unlike cat owners, dog owners are very breed-oriented. The majority owned a specific pure breed and knew the characteristics it should have to belong to that specific breed. The Petit Basset Griffon Vendéen, referred to by owners as “Griffon”, was the most popular breed among clinic visitors. All Griffon dogs were indoor-only pets. The second most popular was the Rottweiler and Egyptian BlackWood/Jack, a breed known only among Egyptian dog breeders but not designated as a breed by any international breed association. This breed is a mix between the German shepherd and the Egyptian Mountain dog. Other breeds were also represented in the study such as the Belgian Shepherd, Doberman, Pekingese, Great Dane, Bull Mastiff and the Japanese Spitzer. The interest in pure-bred dogs is really on the increase and the number of dog breeders is also increasing. Dog breeders are either considers it as a lucrative business or they are real dog-lovers and have a genuine interest in how pure the breed is.

To our knowledge, no previous analyses were published documenting the percentage of each diagnostic outcome (specialty) to the overall case load of a certain clinic or institute. Therefore it was difficult to compare our data to previous studies. Several publications exist, however, documenting similar demographic analysis of a single problem (Nodtvedt, Bergvall et al., 2006; Nodtvedt, Egenvall et al., 2006; Nodtvedt, Guitian et al., 2007; Osborne, Lulich et al., 2009; Toribio, Norris et al., 2009; Borge, Tonnessen et al., 2011). The majority of both canine and feline patients were presented for a GHC, followed by those presented with dermatological problems and gastrointestinal problems for cats and traumatic injuries for dogs. Pet shops are not monitored for hygienic standards for the sold pets in Egypt, which explains the prevalence of dermatological problems in presented cats (ear mite infestation, dermatophytosis and mange). Dogs on the other hand are not sold in pet shops; they are distributed by breeders who maintain higher standards for the bred puppies to match the cost of acquiring one by the owner. On average, people pay 3000-8000 L.E. for a Blackwood, and a higher price for foreign breeds which compels the breeders to maintain these high hygienic and health standards for their dogs. 

The increase in number of cats and dogs presented for GHC indicates the increase of owner-awareness of the importance of routine checks and vaccinations to the health of their pets.

In this study, it was noticeable that there were no canine cases presented with urinary tract disorders for the whole of the three-year period. It is possible to correlate that to the age range of dogs we were seeing as the demography of the sample is shifted to the younger age.  It has been reported that canine urinary tract disturbance (e.g. urolithiasis) is more prevalent in the 5-11 year age range (Keith D. Rogers, 2011; Vrabelova, Silvestrini et al., 2011). 

Understanding patterns of disease in animal populations is required to efficient control of disease and animal health maintenance. Keeping track of morbidity and mortality rates of cases treated in small animal clinics is also important for quality control purposes. A sudden surge of mortality rates of cases diagnosed with treatable disease may point to problems in practice. Unfortunately, studies or records of population-based information on incidence of disease and death in companion animals have been scarce. In western countries, the availability of data from animal insurance companies and computer-based database systems makes it feasible to acquire such information (Bonnett, Egenvall et al., 1997; Bonnett, Egenvall et al., 2005; Egenvall, Bonnett      et al., 2005; Egenvall, Bonnett et al., 2006; Bonnett and Egenvall 2010). In our study, the overall mortality of cats and dogs seen at the SAC was very low. Analysis of case records for more recent years is underway and comparing the results of this report to the following ones will be very informative regarding increase or decrease of complexity of cases we see as well as our standard of practice.

CONCLUSION

Maintaining similar analyses and publications is important as it can identify the sudden elevation in disease frequency and link it to a specific event in time. Availability of electronic records and software should make this constant monitoring process simple and straight forward.

ACKNOWLEDGEMENT

The authors are indebted to the clients for bringing their pets to our clinic and consenting to use the data in our research, without which, this study could not have been achieved. This manuscript was prepared at UC Davis where Dr Waly was on a sabbatical leave, the use of UC Davis Library resources is greatly appreciated and the authors would like to thank Dr Leslie Lyons for the invitation to the lab and sharing of resources.

REFERENCES

Angela Gonza´lez Martı´nez, G.N.S.P. and Fco. Javier Die´guez Casalta, M.L.S.R.R. (2011): "Risk factors associated with behavioral problems in dogs." Journal of Veterinary Behavior 6: 225-231.

Aptekmann, K.P. and Schwartz, D.S. (2011): "A survey of owner attitudes and experiences in managing diabetic dogs." Vet. J. 190(2):    e122-4.

Bland, I.M. and Guthrie-Jones, A. (2009): "Dog obesity: owner attitudes and behaviour." Prev. Vet. Med. 92(4): 333-40.

Bonnett, B.N. and Egenvall, A. (2010): "Age patterns of disease and death in insured Swedish dogs, cats and horses." J. Comp. Pathol. 142 Suppl 1: S33-8.

Bonnett, B.N. and Egenvall, A. (2005): "Mortality in over 350,000 insured Swedish dogs from 1995-2000: I. Breed-, gender-, age- and cause-specific rates." Acta Vet Scand 46(3): 105-20.

Bonnett, B.N. and Egenvall, A. (1997): "Mortality in insured Swedish dogs: rates and causes of death in various breeds." Vet. Rec. 141(2):   40-4.

Borge, K.S. and Tonnessen, R. (2011): "Litter size at birth in purebred dogs--a retrospective study of 224 breeds." Theriogenology 75(5): 911-9.

Egenvall, A. and Bonnett, B.N. (2006): "Heart disease as a cause of death in insured Swedish dogs younger than 10 years of age." J. Vet. Intern. Med. 20(4): 894-903.

Egenvall, A. and Bonnett, B.N. (2005): "Mortality in over 350,000 insured Swedish dogs from 1995-2000: II. Breed-specific age and survival patterns and relative risk for causes of death." Acta. Vet. Scand 46(3): 121-36.

Gunn-Moore, D.A. and McFarland, S.E. (2011): "Mycobacterial disease in a population of 339 cats in Great Britain: II. Histopathology of 225 cases, and treatment and outcome of 184 cases." J. Feline Med. Surg. 13(12): 945-52.

Keith D. Rogers; Boyd Jones; Larry Roberts; Michael Rich; Nicola Montalto and Sophie Beckett (2011): "Composition of uroliths in small domestic animals in the United Kingdom." The Veterinary Journal 188:      228-230.

Lederer, R. and Rand, J.S. (2009): "Frequency of feline diabetes mellitus and breed predisposition in domestic cats in Australia." Vet. J. 179(2): 254-8.

Moore, G.E. and Lund, E. (2009): "Disease reporting and surveillance: where do companion animal diseases fit in?" Vet. Clin. North. Am. Small Anim. Pract. 39(2): 225-40.

Nodtvedt, A. and Bergvall, K. (2006): "Canine atopic dermatitis: validation of recorded diagnosis against practice records in 335 insured Swedish dogs." Acta. Vet. Scand. 48: 8.

Nodtvedt, A. and Egenvall, A. (2006): "Incidence of and risk factors for atopic dermatitis in a Swedish population of insured dogs." Vet. Rec. 159(8): 241-6.

Nodtvedt, A. and Guitian, J. (2007): "The spatial distribution of atopic dermatitis cases in a population of insured Swedish dogs." Prev. Vet. Med. 78(3-4): 210-22.

Osborne, C.A. and Lulich, J.P. (2009): "Analysis of 451,891 canine uroliths, feline uroliths, and feline urethral plugs from 1981 to 2007: perspectives from the Minnesota Urolith Center." Vet. Clin. North Am. Small Anim. Pract. 39(1): 183-97.

Toribio, J.A. and Norris, J.M. (2009): "Demographics and husbandry of pet cats living in Sydney, Australia: results of cross-sectional survey of pet ownership." J. Feline Med. Surg. 11(6): 449-61.

Vrabelova, D. and Silvestrini, P. (2011): "Analysis of 2735 canine uroliths in Spain and Portugal. A retrospective study: 2004-2006." Res. Vet. Sci. 91(2): 208-11.