There has been a recent move toward active learning pedagogies in veterinary education, with increasing use of a blended approach that incorporates both online resources and live classroom sessions. In this study, an established veterinary pre-clinical course in introductory animal health was transitioned from a traditional didactic lecture delivery mode to a flipped classroom approach with core content delivered online. This study compared the experiences of two cohorts of students who studied the same course in the different formats in consecutive years. Online learning resources included short video segments and a variety of short problems and activities. Online materials were complemented with weekly small-group case-based learning classes facilitated by academic staff. A mixed methods evaluation strategy was applied using student grades, surveys, and focus groups to compare student academic performance, satisfaction, and engagement between the two cohorts. The flipped classroom cohort achieved significantly higher grades in the written answer section of the final examination. Student satisfaction with learning resources was also higher in this cohort. However, satisfaction with other aspects of the course was largely the same for both cohorts. This study revealed some of the challenges associated with achieving adequate student preparation for class using online resources. The outcomes of this study have implications for veterinary educators considering the design and development of new online learning resources.
This case report highlights the necessity for veterinarians to monitor for additional complications not commonly considered in acute carbamate toxicoses.
iHCa is more prevalent in cats with septic peritonitis than described previously. Failure of iCa to normalize during hospitalization may be a negative prognostic indicator. iHCa may be predictive of a longer LOH and ICU stay, but is not necessarily associated with a poorer prognosis.
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.
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