No abstract

Euthanasia of companion animals in veterinary emergency medicine is a common cause of death. Euthanasia is economic when it is the consequence of the pet owner's inability to afford essential treatment while a viable medical alternative to euthanasia exists. Gastric dilatation-volvulus (GDV) is an acute life-threatening emergency condition of dogs; if left untreated, rapid death is highly likely. Surgical treatment leads to survival of around 80-90% of dogs; however, such treatment is costly. Therefore, pre-surgical euthanasia may be largely economically motivated. Having pet insurance, a financial instrument to reduce the burden of unforeseen veterinary medical costs on pet owners, would be expected to abolish the risk for pre-surgical economic euthanasia. We therefore aimed to determine whether pet insurance attenuates the risk of pre-surgical economic euthanasia in dogs with GDV. Non-referred dogs (n = 260) with GDV and known insurance status seen at 24 emergency clinics over a 2-year period were included. Relevant data (e.g., insurance status, age, comorbidities, outcome) were retrospectively extracted from a pet insurer's claim records (insured animals) or from electronic medical records of participating hospitals (non-insured animals). Forty-one percent of dogs (106 of 260 dogs) did not survive to hospital discharge; 82 (77%) of non-survivors died before surgery, all through euthanasia. The pre-surgical euthanasia rate was 10% in insured and 37% in non-insured dogs (p < 0.001). When adjusted for the effect of age, deposit size, comorbidities, and blood lactate concentration, the absence of insurance increased the odds of pre-surgical euthanasia by a factor of 7.4 (95% CI 2.0 to 37; p = 0.002). Of dogs undergoing surgery, 86% survived to hospital discharge. Overall, 80% of insured animals and 53% of non-insured animals survived to hospital discharge (p < 0.001). Thus, insurance was associated with a marked decrease in risk of pre-surgical euthanasia indicating that the cause of pre-surgical euthanasia of dogs with GDV is predominantly economic in nature. The rate of pre-surgical euthanasia in dogs with GDV may emerge as a suitable marker to quantify economic decision making of pet owners and to measure the impact of financial interventions aimed at mitigating economic duress associated with cost of veterinary emergency care.

Knowledge of the most common presenting complaints and diagnoses in companion animals is valuable in preparing veterinary students and veterinarians to manage the most frequently observed conditions in clinical practice. Pet insurance databases provide access to large sample populations and have been previously used to describe disease incidence in companion animals. The aim of this study was to determine the incidence of presenting complaints and diagnoses in insured Australian dogs through the use of a pet insurance database. Analysis of a de‐identified dataset containing pet insurance claims associated with presenting complaints and diagnoses from 488,472 insured Australian dogs insured in the years 2016 and 2017, was performed. Annual incidence rates of presenting complaints and diagnoses were calculated and expressed as, number of events per 1,000 dog years at risk. The presenting complaints with the highest incidence were vomiting (14.21 events per 1,000 dog years at risk in 2016, 15.80 events per 1,000 dog years at risk in 2017) and pruritus (8.79 events per 1,000 dog years at risk in 2016, 10.30 events per 1,000 dog years at risk in 2017). Presenting complaints affecting the gastrointestinal system were the most common (19.20 events per 1,000 dog years at risk in 2016, 20.77 events per 1,000 dog years at risk in 2017). The diagnoses with the highest incidence were otitis externa (34.12 events per 1,000 dog years at risk in 2016, 34.82 events per 1,000 dog years at risk in 2017) and dermatitis (28.05 events per 1,000 dog years at risk in 2016, 29.99 events per 1,000 dog years at risk in 2017). Diagnoses affecting the integument were the most common (216.56 events per 1,000 dog years at risk in 2016, 219.06 events per 1,000 dog years at risk in 2017). The results from this study can aid in the design of relevant veterinary curricula and may be helpful in prioritising research on common clinical conditions.