Risk factors for unilateral cranial cruciate ligament rupture diagnosis and for clinical management in dogs under primary veterinary care in the UK

Pegram, Camilla; Brodbelt, Dave C.; Diaz-Ordaz, K.; Chang, Yi‐Jen; Hekkel, Anna Frykfors von; Church, David; O'Neill, D G

doi:10.1016/j.tvjl.2023.105952

Cited by 8 publications

(5 citation statements)

References 34 publications

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“…Previous research has reported breed protection in ECS from several orthopaedic disorders including osteoarthritis, hip dysplasia, cruciate ligament disease, elbow dysplasia, and stifle joint disease in general [ 22 , 26 , 27 , 64 – 66 ]. In the current study, the ECS had significantly lower odds of osteoarthritis (OR 0.37) and patellar luxation (OR 0.48) compared to non-ECS, and the prevalence of both conditions was also low in ECS (0.76 and 0.56%, respectively).…”

Section: Discussionmentioning

confidence: 99%

English Cocker Spaniels under primary veterinary care in the UK: disorder predispositions and protections

Engdahl,

Brodbelt,

Cameron

et al. 2024

Canine Med Genet

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Background The English Cocker Spaniel (ECS) is one of the most popular dog breeds in the UK but information on disorder predisposition and protection is limited. Using anonymised veterinary clinical data from the VetCompass™ Programme, this study aimed to compare disorder predisposition and protection between the ECS and the remaining dogs under primary veterinary care in the UK during 2016. Electronic patient records for random samples of ECS and non-ECS were reviewed. The most common disorders diagnosed during 2016 were extracted and compared using multivariable logistic regression, controlling for confounders. Results The analysis included random samples of 2510/10,313 (24.3%) ECS and 7813/326,552 (2.39%) non-ECS. After accounting for confounding by age, sex, bodyweight within breed-sex, insurance status and veterinary practice group, the ECS had increased odds of 21/43 (48.85%) disorders at fine-level precision, with highest odds for aural discharge (odds ratio (OR) 14.66, 95% confidence interval (CI): 7.73–30.90, P < 0.001) and keratoconjunctivitis sicca (OR 7.64, 95% CI: 4.33–14.14, P < 0.001) and lowest odds for atopic dermatitis (OR 0.14, 95% CI: 0.05–0.31, P < 0.001) and allergy (OR 0.14, 95% CI: 0.06–0.28, P < 0.001). Conclusions This study provides evidence for strong predisposition to aural and ocular disorders and protection from hypersensitivity disorders in the ECS. These results can aid dog owners, breeders, and veterinarians to better monitor health in ECS, and promote earlier diagnosis with improved prognosis. Further, the results can help breeding organisations establish key priorities the health-based reforms of the ECS.

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Section: Discussionmentioning

confidence: 99%

English Cocker Spaniels under primary veterinary care in the UK: disorder predispositions and protections

Engdahl,

Brodbelt,

Cameron

et al. 2024

Canine Med Genet

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“…This important study showed a markedly higher incidence of CCL rupture diagnosis among breeds of large body size, a female preponderance for CCL rupture, and earlier age at ligament rupture among breeds at highest risk. However, patient-level data on duration of gonad exposure, bilateral vs. unilateral rupture, adult height, or body condition were unavailable in this study and in another epidemiological study 23 , elevating the need for a complementary study that could evaluate these potential correlates of lifetime cruciate ligament survival.…”

Section: Introductionmentioning

confidence: 90%

Correlates of estimated lifetime cruciate ligament survival inform potential rupture risk reduction strategies: findings from the Exceptional Aging in Rottweilers Study

Waters,

Fu,

Carrillo

et al. 2023

Sci Rep

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Cranial cruciate ligament (CCL) rupture is one of the most commonly diagnosed orthopedic conditions of pet dogs, making estimated lifetime cruciate ligament survival an attractive endpoint for studies attempting to define clinical and genetic correlates of rupture risk reduction. Early life experiences contribute significantly to the origins of adult health outcomes, yet our current understanding of modifiable susceptibility factors that drive the high frequency of CCL rupture remains limited. We reasoned that combining lifetime medical history with standardized late-life assessment of lifetime cruciate ligament survival and detailed phenotyping of each dog for selected risk variables would provide a sensitive approach to identify factors that would differentiate between lifelong avoidance versus susceptibility to ligament rupture. Here, we report results of Kaplan–Meier analysis of estimated lifetime cruciate ligament survival and Cox proportional hazards modeling to assess risk variables in a lifetime cohort study of 123 purebred Rottweilers, a breed at high risk for veterinarian-diagnosed CCL rupture. We show that gonad removal during the 24-month developmental period is adversely associated with three measures of susceptibility—increased incidence of CCL rupture, multiplicity (bilateral rupture), and accelerated time to initial CCL failure. Our analysis reveals two other phenotypes—short adult height and the production of offspring (in females)—are associated with significant CCL rupture risk reduction. Together, the results provide clues to an early endocrine influence on lifetime cruciate ligament survival. Further, we identify two distinct clinical syndromes of CCL failure, providing a disease subtyping framework to advance future progress in genetic epidemiology, pathogenesis, and prediction. By conducting an evaluation of estimated lifetime CCL survival in dogs, we show that cruciate ligament survival may be jeopardized by gonad removal during the developmental period. Avoidance of such early environmental adversity may represent an actionable method for the control of canine CCL disease in certain breeds.

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“…The case definition for early-onset UI required a final diagnosis of UI before 8.5 years of age [ 3 ]. In line with VetCompass methods used in several previous studies [ 33 – 36 ], candidate UI cases were identified by applying search terms relevant to the diagnosis and management of UI in the clinical notes and treatment fields (including incont*, usmi, urin* leak*, incompet*, propal*, incuri* and urilin). The search findings were merged, and a random subset of these candidate cases had their clinical notes examined manually in detail to identify bitches that met the UI case definition.…”

Section: Methodsmentioning

confidence: 99%

Later-age neutering causes lower risk of early‐onset urinary incontinence than early neutering–a VetCompass target trial emulation study

Pegram,

Diaz-Ordaz,

Brodbelt

et al. 2024

PLoS ONE

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There is growing evidence supporting clinically important associations between age at neutering in bitches and subsequent urinary incontinence (UI), although much of this evidence to date is considered weak. Target trial emulation is an innovative approach in causal inference that has gained substantial attention in recent years, aiming to simulate a hypothetical randomised controlled trial by leveraging observational data. Using anonymised veterinary clinical data from the VetCompass Programme, this study applied the target trial emulation framework to determine whether later-age neutering (≥ 7 to ≤ 18 months) causes decreased odds of early-onset UI (diagnosed < 8.5 years) compared to early-age neutering (3 to < 7 months). The study included bitches in the VetCompass database born from January 1, 2010, to December 31, 2012, and neutered between 3 and 18 months old. Bitches were retrospectively confirmed from the electronic health records as neutered early or later. The primary outcome was a diagnosis of early-onset UI. Informed from a directed acyclic graph, data on the following covariates were extracted: breed, insurance status, co-morbidities and veterinary group. Inverse probability of treatment weighting was used to adjust for confounding, with inverse probability of censoring weighting accounting for censored bitches. The emulated trial included 612 early-age neutered bitches and 888 later-age neutered bitches. A pooled logistic regression outcome model identified bitches neutered later at 0.80 times the odds (95% CI 0.54 to 0.97) of early-onset UI compared with bitches neutered early. The findings show that later-age neutering causes reduced odds of early-onset UI diagnosis compared with early-age neutering. Decision-making on the age of neutering should be carefully considered, with preference given to delaying neutering until after 7 months of age unless other major reasons justify earlier surgery. The study is one of the first to demonstrate successful application of the target trial framework to veterinary observational data.

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Risk factors for unilateral cranial cruciate ligament rupture diagnosis and for clinical management in dogs under primary veterinary care in the UK

Cited by 8 publications

References 34 publications

English Cocker Spaniels under primary veterinary care in the UK: disorder predispositions and protections

English Cocker Spaniels under primary veterinary care in the UK: disorder predispositions and protections

Correlates of estimated lifetime cruciate ligament survival inform potential rupture risk reduction strategies: findings from the Exceptional Aging in Rottweilers Study

Later-age neutering causes lower risk of early‐onset urinary incontinence than early neutering–a VetCompass target trial emulation study

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