Javma-journal of The American Veterinary Medical Association最新文献

{"title":"The combination of lomustine and corticosteroids is a valid chemotherapeutic option in cats with presumptive central nervous system lymphoma.","authors":"Claudia Pauciulo, Andrea Corda, Ilaria Tartari, Fabio Tocco, Elsa Murgia, Antonella Gallucci","doi":"10.2460/javma.25.07.0486","DOIUrl":"https://doi.org/10.2460/javma.25.07.0486","url":null,"abstract":"<p><strong>Objective: </strong>To describe the clinical outcomes of 10 cats diagnosed with CNS lymphoma treated with lomustine and corticosteroids.</p><p><strong>Animals: </strong>Clinical records of privately owned cats diagnosed with CNS lymphoma and presented to a neurological veterinary center were reviewed. Inclusion criteria were MRI, CSF analysis, treatment with corticosteroids and lomustine, and availability of detailed follow-up data. Cats with incomplete data, alternative diagnoses, or concomitant intracranial conditions as well as those improving after corticosteroid treatment before the diagnosis were excluded. Ten cats met the inclusion criteria.</p><p><strong>Clinical presentation: </strong>The median duration of clinical signs was 7 days. All patients presented with locomotor deficits; 90% exhibited ataxia. Paresis was observed in 60%, and spinal pain on palpation was also described in 60% of the cats. Cranial nerve abnormalities were identified in 30% and epileptic seizures were reported in 20% of the cats.</p><p><strong>Results: </strong>MRI revealed intracranial lymphoma in 40% and spinal lymphoma in 60% of the cases and contrast-enhancing lesions with meningeal involvement in most of the cases. One cat had elevated CSF cell counts; the others showed normal cell counts but atypical lymphocytes. Seven cats (70%) were still alive at the 3-month follow-up, with 3 (30%) maintaining improvement at 6 and 12 months. The treatment did not result in any significant adverse effect.</p><p><strong>Clinical relevance: </strong>The combination of lomustine and corticosteroids is a valid chemotherapeutic option in cats with CNS lymphoma. Larger prospective studies are warranted to compare efficacy of this treatment with that of other chemotherapeutic protocols.</p>","PeriodicalId":14658,"journal":{"name":"Javma-journal of The American Veterinary Medical Association","volume":" ","pages":"1-7"},"PeriodicalIF":1.8,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three-dimensional computed tomography analysis to assess the need for segmental femoral osteotomy in small-breed dogs with medial patellar luxation.","authors":"Yukari Nagahiro, Ai Itou, Nobuo Kanno, Yasuji Harada, Yasushi Hara","doi":"10.2460/javma.25.06.0360","DOIUrl":"https://doi.org/10.2460/javma.25.06.0360","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the quadriceps muscle length-to-femoral length ratio (QML:FL) as a predictor of segmental femoral osteotomy (SFO) necessity in small-breed dogs with medial patellar luxation.</p><p><strong>Methods: </strong>This retrospective study included 53 small-breed dogs (78 limbs) with medial patellar luxation. Medical records from 2008 to 2021 of dogs undergoing patellofemoral joint reconstruction were reviewed. Signalment, surgical records, and CT data were retrospectively analyzed. Patients were classified into 2 groups based on SFO performance: the group requiring SFO (SFO group) and the group where SFO was unnecessary (NSFO group). Regression analysis compared signalment and CT parameters between groups; statistically significant variables were incorporated into a multiple logistic regression analysis to assess factors correlated with SFO. Receiver operating characteristic curves were generated to determine QML:FL cutoff values for predicting SFO.</p><p><strong>Results: </strong>The SFO group included 26 limbs, while the NSFO group included 52 limbs. Compared to the NSFO group, the SFO group had significantly younger age, lower body weight, higher anatomical distal lateral femoral angle, and lower QML:FL. The QML:FL ratio was the only variable significantly associated with SFO (OR, 0.595; 95% CI, 0.445 to 0.797). The receiver operating characteristic curve identified 0.84 as the optimal cutoff value (sensitivity, 0.83; specificity, 0.96), with an area under the curve of 0.9571.</p><p><strong>Conclusions: </strong>QML:FL was a reliable preoperative indicator for SFO necessity in medial patellar luxation-affected small-breed dogs. This noninvasive measure enhanced surgical planning.</p><p><strong>Clinical relevance: </strong>QML:FL allowed objective assessment of SFO necessity, improving individualized treatment strategies for femoral patellar joint reconstruction.</p>","PeriodicalId":14658,"journal":{"name":"Javma-journal of The American Veterinary Medical Association","volume":" ","pages":"1-10"},"PeriodicalIF":1.8,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caudal esophageal twist sign may help in differentiating between 360° gastric dilatation-volvulus and gastric dilatation in dogs.","authors":"Elizabeth A Maxwell, Rachel E Rivenburg, Tanya Mitjans, Natalie J Almodovar, Lucinda L van Stee, Stacy D Meola, Emily C Pearce, Cody P Doyle, Diego A Portela, Federico R Vilaplana Grosso","doi":"10.2460/javma.25.06.0431","DOIUrl":"https://doi.org/10.2460/javma.25.06.0431","url":null,"abstract":"<p><strong>Objective: </strong>To identify radiographic features of dogs with 360° gastric dilatation volvulus (GDV) distinguishable from those associated with GD.</p><p><strong>Methods: </strong>A multi-institutional medical record review was performed for cases of canine 360° GDV between April 2008 and September 2022. Gastric dilatation cases were retrieved from a single academic institution.</p><p><strong>Results: </strong>Radiographs of 29 client-owned dogs surgically diagnosed with 360° GDV and 38 dogs with GD were included. The most common radiographic findings in dogs with a 360° GDV included the gastric fundus located caudoventrally (lateral; 100%), the pyloric antrum located craniodorsally (lateral; 88%), an abnormally shaped and sized spleen (36%), and decreased peritoneal detail (81%). When marked esophageal gas dilatation was present, a funnel shape to the caudal esophagus (ie, \"caudal esophageal twist sign\") was appreciable in all dogs presenting with volvulus. However, orogastric decompression prior to radiographs resulted in mild to no esophageal gas dilatation, hindering radiographic identification of this sign. In dogs with GD, the gastric fundus was in the craniodorsal position (lateral) and left cranial abdomen (ventrodorsal or dorsoventral) in 100% of cases. The pyloric antrum was in the right cranial abdomen (ventrodorsal or dorsoventral views) in 100%. The spleen and peritoneal detail were normal in all dogs with GD.</p><p><strong>Conclusions: </strong>The funnel-shaped caudal esophagus (caudal esophageal twist sign) was compatible with 360° GDV in dogs with moderate or severe esophageal gas dilatation and was absent in dogs with GD.</p><p><strong>Clinical relevance: </strong>This new radiographic feature of 360° GDV may help practitioners distinguish between 360° GDV and GD.</p>","PeriodicalId":14658,"journal":{"name":"Javma-journal of The American Veterinary Medical Association","volume":" ","pages":"1-7"},"PeriodicalIF":1.8,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What to call your medical records-based study.","authors":"Sarah C Totton, B Alexander Fonseca Martinez, Annette M O'Connor","doi":"10.2460/javma.25.06.0425","DOIUrl":"https://doi.org/10.2460/javma.25.06.0425","url":null,"abstract":"<p><p>In veterinary clinical research, the terms \"retrospective study\" and \"prospective study,\" when not accompanied by a description of the observational study design, are prone to misinterpretation. Cohort, case-control, cross-sectional, and case series may all be retrospective or prospective depending on the sampling timing. In this Viewpoint article, we present a simple tool and use published clinical examples to help investigators accurately identify and report their study designs. As the timing of data collection and the study design impact the risk of bias, we remind authors that \"retrospective\" (or its antonym, \"prospective\") should always be accompanied by a study design term.</p>","PeriodicalId":14658,"journal":{"name":"Javma-journal of The American Veterinary Medical Association","volume":" ","pages":"1-4"},"PeriodicalIF":1.8,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chelonian sedation and anesthesia-a retrospective assessment of protocols, outcomes, and challenges in 250 cases (2000-2023).","authors":"Chloé J Thorbrogger, Ashley M Rasys, Braxton T Gise, Jane E Quandt, Stephen J Divers","doi":"10.2460/javma.25.04.0289","DOIUrl":"https://doi.org/10.2460/javma.25.04.0289","url":null,"abstract":"<p><strong>Objective: </strong>To assess the anesthetic events of chelonians at a university hospital, identify shortcomings with record-keeping, and evaluate anesthesia-related mortality.</p><p><strong>Methods: </strong>This retrospective study evaluated medical records of sedated or anesthetized chelonians between March 2000 and October 2023. Anesthetic parameters were analyzed using cases with complete anesthesia records. Compiled information included patient details, health status, procedure(s), anesthetic agents, anesthesia times, and vitals.</p><p><strong>Results: </strong>220 of the 250 anesthetic events identified had detailed records available for analysis. Comprehensive review of the reports highlighted areas needing improvement with record-keeping and identified the most commonly employed anesthetic agents. Alfaxalone, hydromorphone, dexmedetomidine/medetomidine, midazolam, and ketamine were the most popular for premedication, while propofol and, more recently, alfaxalone were the most common for induction. For maintenance, most cases relied on inhalants, with a preference toward isoflurane, while alfaxalone was favored for injectables. Of the 250 cases reviewed, 237 recovered, 8 were humanely euthanized, and 5 failed to recover. The latter all had preexisting pathology identified at necropsy.</p><p><strong>Conclusions: </strong>Since 2020, data showed a growing trend toward the use of maintenance alfaxalone constant rate infusions over inhalants. Over time, the quality of record-keeping improved, aside from time record-keeping. Standardizing anesthesia sheets with a designated area for research-related values, paired with implementing an automated vitals recording system, is suggested to improve record-keeping.</p><p><strong>Clinical relevance: </strong>General anesthesia can be safely and effectively performed in healthy chelonians. Suggestions for improvement include consistently performing preanesthetic bloodwork to screen for preexisting disease, clearly defining anesthesia start and end times, and reducing subjectivity in record-keeping.</p>","PeriodicalId":14658,"journal":{"name":"Javma-journal of The American Veterinary Medical Association","volume":" ","pages":"1-9"},"PeriodicalIF":1.8,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reproductive status and abnormal clinical signs after surgery are positively associated with hemoabdomen and autotransfusion in cats after ovariohysterectomy.","authors":"Sharon Pailler, Carolyn R Brown, Jessica K Conn, Veronica H Accornero","doi":"10.2460/javma.25.06.0394","DOIUrl":"https://doi.org/10.2460/javma.25.06.0394","url":null,"abstract":"<p><strong>Objective: </strong>To identify the frequency and factors associated with hemoabdomen and the need for autotransfusion in cats undergoing spay surgery in the high-quality, high-volume spay/neuter context.</p><p><strong>Methods: </strong>Licensed veterinary technicians recorded information about clinical signs and other variables of interest during and after spay surgery of queens at least 5 months of age that were spayed in ASPCA Community Medicine spay/neuter clinics between March 30, 2022, and January 9, 2024. These data were matched with additional medical data extracted from the medical records and analyzed with bivariate statistics for significant relationships.</p><p><strong>Results: </strong>The analysis included 9,513 queens; 970 queens (10.6%) experienced intraoperative bleeding, and 77 queens (0.8%) experienced a major intraoperative bleed. Twenty-eight queens (0.3%) received an autotransfusion; 2 of those received an autotransfusion during the surgery, and the remaining 26 queens received an autotransfusion postoperatively. A higher proportion of queens in heat, in late-stage pregnancy, and after pregnancy experienced abdominal bleeding. A higher proportion of pregnant queens required an autotransfusion. Capillary refill time > 2 seconds, pale mucous membranes, and extended recovery time after surgery were significantly positively related to intraoperative bleeding and requiring an autotransfusion.</p><p><strong>Conclusions: </strong>Major bleeds and autotransfusions were rare. Reproductive status was associated with abdominal bleeding. Delayed recovery and signs of anemia and/or poor peripheral perfusion after surgery can be an indicator of postoperative bleeding requiring autotransfusion.</p><p><strong>Clinical relevance: </strong>While severe hemoabdomen from ovariohysterectomy is rare, clinicians can use this information to promptly identify and manage abdominal bleeding from ovariohysterectomy.</p>","PeriodicalId":14658,"journal":{"name":"Javma-journal of The American Veterinary Medical Association","volume":" ","pages":"1-6"},"PeriodicalIF":1.8,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cats requiring autotransfusion after spay surgery have high survival rates.","authors":"Sharon Pailler, Carolyn R Brown, Jessica K Conn, Veronica H Accornero","doi":"10.2460/javma.25.06.0395","DOIUrl":"https://doi.org/10.2460/javma.25.06.0395","url":null,"abstract":"<p><strong>Objective: </strong>To determine the survival rate and factors influencing the survival of queens requiring autotransfusion after ovariohysterectomy.</p><p><strong>Methods: </strong>Medical records were searched for queens > 5 months of age that received an autotransfusion following spay surgery between January 1, 2022, and January 9, 2024. Information about clinical signs, findings during surgery, additional transfusions, and survival outcomes were extracted from the records and analyzed for significant bivariate relationships.</p><p><strong>Results: </strong>56 queens received an autotransfusion; 47 (83.9%) survived to discharge. The presence of abnormal findings during surgery was significantly negatively associated with survival. None of the other factors explored had a significant relationship with survival after autotransfusion.</p><p><strong>Conclusions: </strong>The survival rate of queens that received an autotransfusion after discharge was high, similar to previous reports of survival rates in dogs and cats receiving traditional transfusions. Underlying conditions were negatively associated with survival after autotransfusion.</p><p><strong>Clinical relevance: </strong>Autotransfusion is an effective treatment for surgery-associated abdominal bleeding. This lifesaving procedure could be applied to other contexts where there is significant blood loss into the abdomen or other space from which the blood can be collected and safely readministered to the patient, thereby adding a transfusion option along the spectrum of care, increasing access to a lifesaving treatment that may otherwise be unavailable.</p>","PeriodicalId":14658,"journal":{"name":"Javma-journal of The American Veterinary Medical Association","volume":" ","pages":"1-5"},"PeriodicalIF":1.8,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antimicrobial use in equine patients at a veterinary teaching hospital in the northeastern United States reveals opportunities for enhanced stewardship.","authors":"Pamela S Velarde, Kevin J Cummings, Charisse LaPointe, Gillian A Perkins","doi":"10.2460/javma.25.06.0373","DOIUrl":"https://doi.org/10.2460/javma.25.06.0373","url":null,"abstract":"<p><strong>Objective: </strong>To assess the use of systemic antimicrobial agents in equine patients and identify areas where their use could be reduced.</p><p><strong>Methods: </strong>A retrospective study evaluating the electronic medical records for all equine visits in which systemic antimicrobials were given at a veterinary teaching hospital for 1 year (2021). Negative binomial regression analysis was used to evaluate factors associated with antimicrobial prescription rate.</p><p><strong>Results: </strong>Systemic antimicrobials were prescribed for 33.5% (543 of 1,622) of equine visits. For most visits (89.1%), ≤ 3 antimicrobials were given. The antimicrobial prescription rate was higher in patients with confirmed or suspected infection and in patients that died or were euthanized. Highest-priority critically important antimicrobials were used infrequently (13.6% [74 of 543]). Equine patients undergoing clean surgeries (n = 122) received antimicrobials on the day of surgery, with many receiving > 24 hours of treatment (65). Approximately 24% of nonsurgical patients received antimicrobials when there was no evidence of infection. Culture was performed infrequently (15.7%).</p><p><strong>Conclusions: </strong>Systemic antimicrobials were given during a third of the equine visits in 2021. The limited use of highest-priority critically important antimicrobials suggests that clinicians were not using these medications for first-line treatment. Areas for improvement include documenting the clinician's justification for antimicrobial use along with type, duration, and reasons for de-escalation and/or escalation of therapy; reducing perioperative use, especially for clean surgeries; and increasing the submission of samples for culture.</p><p><strong>Clinical relevance: </strong>Antimicrobial resistance continues to be a global concern, and veterinarians can reduce the use of antimicrobials by critically evaluating their own use and modifying behaviors to align with current evidence-based recommendations.</p>","PeriodicalId":14658,"journal":{"name":"Javma-journal of The American Veterinary Medical Association","volume":" ","pages":"1-8"},"PeriodicalIF":1.8,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Owner-reported experiences are similar for dogs experiencing euthanasia or unassisted death: evaluation of the Dog Aging Project's End of Life Survey free-text responses.","authors":"Jacob Ryave, Ian Kutrybala, Janice O'Brien, Audrey Ruple, Vanessa Wilkins, Sarah M Schmid, Jessica M Hoffman, Taylor Reiter, Virginia R Fajt, Kate E Creevy","doi":"10.2460/javma.25.07.0464","DOIUrl":"https://doi.org/10.2460/javma.25.07.0464","url":null,"abstract":"<p><strong>Objective: </strong>To compare experiences of owners whose dogs underwent euthanasia versus unassisted death, focusing on quality of life (QOL), medical signs, and emotional responses.</p><p><strong>Methods: </strong>We evaluated Dog Aging Project End of Life Survey free-text responses submitted between January 20, 2021, and January 28, 2022. Responses from owners whose dogs experienced euthanasia (n = 70) or unassisted death (n = 70) were evaluated. Dog QOL themes (eg, changes to activity level, appetite, mobility) and positive or negative owner emotions and experiences were identified. Themes that recapitulated response variables provided within forced-choice items were identified. Suddenness of death, time between death and completion of the End of Life Survey, and word and character counts were tabulated. Responses between dog groups (euthanasia vs unassisted death) were compared, either by comparing independent proportions of reported themes (Fisher exact test) or mean values (t test).</p><p><strong>Results: </strong>Suddenness of death was more common in unassisted death than euthanasia (19 of 49 vs 1 of 49). No significant differences were found between groups for QOL measures, negative or positive experiences, length of response, or time to survey completion. Nearly half of all free-text responses repeated indicators of decreased QOL or medical signs previously queried as forced-choice responses (43 of 98 for both).</p><p><strong>Conclusions: </strong>Owner-reported QOL for their dogs and description of positive and negative emotions or experiences at the time of their dogs' deaths were similar whether dogs experienced euthanasia or unassisted death.</p><p><strong>Clinical relevance: </strong>Regardless of the manner of death, owners reported similar experiences and may have benefited from similar grief support.</p>","PeriodicalId":14658,"journal":{"name":"Javma-journal of The American Veterinary Medical Association","volume":" ","pages":"1-7"},"PeriodicalIF":1.8,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Owner-reported financial limitations negatively impact emergency veterinary teams.","authors":"Emily McCobb, Elizabeth Rozanski, Seana Dowling-Guyer","doi":"10.2460/javma.25.06.0361","DOIUrl":"https://doi.org/10.2460/javma.25.06.0361","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to explore the impacts of owner-reported financial limitations (oFLs) on emergency veterinarians and technicians and their opinions about some novel approaches to addressing access to care challenges.</p><p><strong>Methods: </strong>Anonymous, internet-based survey of small animal veterinarians and staff at emergency hospitals in the US.</p><p><strong>Results: </strong>While over 425 people responded to the survey, results are presented for 207 veterinarians and 154 technicians. Nearly 95% of the veterinarian respondents reported seeing clients with oFLs impacting care of the pet at least weekly, and nearly 75% reported seeing conditions that could have been prevented if the pet had more regular veterinary care at least weekly. A significant proportion of respondents reported being bothered by being unable to provide care when clients had oFLs, with more technicians expressing distress than veterinarians.</p><p><strong>Conclusions: </strong>Having clients with oFLs is common in emergency practice and impacts the care that can be provided as well as the well-being of the care team. More options for affordable emergency care are needed.</p><p><strong>Clinical relevance: </strong>Results suggested that emergency room veterinarians commonly work with clients with oFLs and that having clients who cannot afford recommended treatment for their pets causes moral distress for veterinarians. Exploring options to increase access to care on a practice and community level should help to reduce moral distress for practitioners and expand the reach of emergency and urgent care services.</p>","PeriodicalId":14658,"journal":{"name":"Javma-journal of The American Veterinary Medical Association","volume":" ","pages":"1-11"},"PeriodicalIF":1.8,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}