BSAVA Congress 2024 – Day One Round-up
22 March 2024
High quality science is the driving force behind every advance made in the veterinary care provided for the nation’s pets. But not every contribution to the scientific literature is the result of a carefully crafted research project – some published papers offer information that is misleading or even outright wrong.
How can busy veterinary practitioners have trust in the information that are given? – and what can they do to ensure that the evidence available on new diagnostic methods or treatments for veterinary patients meets the highest scientific and ethical standards?
These questions were at the core for one of the main sessions on the first day of the BSAVA’s annual Congress in Manchester on March 21. Speakers told their professional colleagues about the difficulties facing anyone seeking to “sort the wheat from the chaff” when thousands of research papers are published each year in all branches of veterinary medicine.
The problems of ensuring that only the finest quality research papers appear in journals published online or in print is not peculiar to the veterinary world. It is an issue in all scientific endeavours, as pointed out by Martin Whitehead, clinical director of the Chipping Norton veterinary hospital in Oxfordshire. He said that across the scientific spectrum, some 10,000 papers have been retracted in 2023 by their authors or publisher after mistakes emerged or the findings were challenged.
The reasons for these retractions will vary but Dr Whitehead noted that quality is not always the main focus of companies involved in scientific publishing. Also companies producing pharmaceutical products will encourage the researchers to produce papers that promote their own products. Veterinary science has its own particular problems, notably the scarcity of funding for purely clinical research compared with human medicine and basic bioscience. A large proportion of the studies appearing in veterinary journals will have been written by inexperienced junior researchers who will be under pressure to have papers accepted for publication during their training.
Another factor that can influence the quality of published science is the conscious or unconscious biases that affect all scientists and may influence the conduct or reporting of all experiments, suggested Rachel Dean, former head of the Centre for Evidence-Based Veterinary Medicine at the Nottingham vet school. She said veterinary practitioners should be encouraged to understand and recognise the causes of bias to ensure that this sort of error does not influence the management of their own clinical caseload.
Even more importantly, veterinary practitioners should be to encouraged to contribute to improving standards of clinical research. Compared with human medicine research, researchers in the field face two significant challenges – that lack of funding to carry out research in companion animal species and as a consequence, the small numbers of animals involved in most vet studies. This ensures that the study will have low statistical power and its results may not be particularly trustworthy, she said.
The BSAVA’s own charity PetSavers is one of the very few sources of funding for clinical studies in companion animal species, noted Professor Clare Rusbridge of the University of Surrey, whose own career in researching neurological disease in dogs was started by a grant in 1995 from the charity then called the Clinical Studies Trust Fund.
Major national funding bodies for biomedical science like the Wellcome Trust have little interest in the conditions affecting pets, preferring to fund studies that might have implications in human medicine. That is why there have been many studies on degenerative brain diseases in laboratory rodents rather than dogs, which share the environment of their human owners and are much closer biologically. And that is why drugs being developed to treat Alzheimers-like diseases in mice have failed repeatedly, she suggested.
Professor Dean suggested that the way forward for biomedical research is to use the observations made in veterinary patients and the skills of those responsible for treating them. She reckoned that the way to improve the quality of veterinary clinical studies would be to carry out fewer but larger and better resourced projects.
This would require a new model for conducting research in the veterinary arena. It would involve greater collaboration, not only between the university and referral practice clinicians currently responsible for most published research on companion animals, but also with much greater involvement from first opinion practitioners.
The closeness of the links between human and veterinary medicine was also demonstrated in another series of presentations on the first day at BSAVA Congress. An international panel of speakers discussed the potential impact on the health of cats of a group of drugs developed for the management of human diabetes.
Anna Lena Kraemer from the University of Glasgow was a contributor to the session on the SGLT2 (sodium glucose cotransporter -2) drug velaglifozin (Senvelgo; Boehringer Ingelheim), which was licensed in the UK to treat feline diabetes in October 2023.
Dr Kraemer explained the potential value of this agent in achieving better control of blood glucose levels by blocking the resorption of glucose in the kidneys, allowing it to be flushed away in the urine. Crucially, the drug is presented in a palatable liquid form which can be given orally once daily, rather than needing twice daily injections of insulin and will therefore be much less stressful for the patient.
However, veterinarians must be aware of the potentially fatal adverse effects of the drug which may cause euglycaemic diabetic ketoacidosis. This risk may be avoided by the careful selection of patients and close monitoring of blood and urine samples from the treated cats. It is wise to avoid giving the drug to animals with significant comorbidities and those that are already sick, vomiting or inappetent, she said.
As in human patients, drugs used in animals can have adverse effects not only on the patient but on its wider environment, especially if the agents are used or disposed of unwisely. So veterinary professionals have followed the lead of their NHS colleagues in encouraging animal owners to return any antimicrobial drugs prescribed for their animals that have not been used. The unused products can then be incinerated rather than thrown away which can potentially encourage the spread of antibiotic resistant bacteria.
Mary Bawn is communications director for RUMA Companion Animal and Equine, the body bringing together veterinary and pharmaceutical industry organisations to promote the responsible use of medicines in non-farmed species. She reported the results of the second amnesty of veterinary antibiotics in which animal owners are encouraged to return unused medicines to the dispensing practice. This has resulted in a threefold increase in the volume of drugs being taken back, rather than being saved for another occasion or simply thrown away.
Fergus Allerton, who has led the BSAVA’s involvement in the initiative, said the amnesty showed the value of raising awareness in clients of the importance of properly disposing of unwanted medicines. It was hoped that the concept could be applied to other classes of drugs that might cause environmental harm, such as wormers. It was also important to encourage the safe disposal of antimicrobial drugs in other countries.