250448 NZVNA VET NURSE JOURNAL JUNE 2021

VOLUME 27 No. 98
June 2021

Goat Caesarean
Gangrenous Mastitis
Global Worming

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CONTENTS

VOLUME 27 No. 98 JUNE 2021 04 President’s report by Julie Hutt
05 Letter from the Editor
EXECUTIVE COMMITTEE OFFICERS
by Antoinette Ratcliffe
President Julie Hutt
PO Box 35831 05 Membership secretary report
Browns Bay by Kathy Waugh
Auckland 0753
021 599 059 06 Gangrenous mastitis in a mature
[email protected] dairy cow by Alex Hansen

Vice-President Amy Ross 10 Interview with Renee Brown, VTS
021 852 664 - ECC by Marcia Fletcher
[email protected]
14 Bella the goat that wasn’t
Treasurer & Membership Secretary kidding by Vivian C Allis
Kathy Waugh
021 843 277 19 What to do when a ‘life quake’
[email protected] rocks your world by Julie South

National Secretary Luanne Corles 22 Global Worming by Dr Abi Chase
027 472 1072
[email protected] 10

JOURNAL EDITOR The New Zealand
Veterinary Nursing
Antoinette Ratcliffe Association would like
[email protected] to thank Hill’s™ Pet
Nutrition NZ, our gold
Assistant Editor: Catherine Taylor sponsors, for their
[email protected] continued support of the NZVNA and the
veterinary nursing profession.
COVER:

ILRI farm: Toggenburg ram
by International Livestock Research
Institute is licensed under CC BY-NC-SA 2.0

NZVNA FORMS OUR VISION 14

The registration or list badge order Caring for our community
forms, merchandise order forms and new
membership forms can now all be found on by promoting excellence
the website www.nzvna.org.nz or by emailing
[email protected]. in animal healthcare.

DISCLAIMER The New Zealand Veterinary Nursing
Association Journal is published by the New Zealand
Veterinary Nursing Association Incorporated (NZVNA).
The views expressed in the articles and letters do
not necessarily represent those of the NZVNA or the
editor, and neither the NZVNA nor the editor endorse
any products or services advertised. The NZVNA is
not the source of the information reproduced in
this publication and has not independently verified
the truth of the information. It does not accept any
legal responsibility for the truth or accuracy of the
information contained herein. Neither the NZVNA nor
the editor accepts any liability whatsoever for the
contents of this publication or for any consequences
which may result from the use of the information
contained herein or advice given herein. The provision
is intended to exclude the NZVNA, the editor and its
staff from all liability whatsoever, including liability for
negligence in the publication or reproduction of the
materials set out herein.

NZVNA

President’s report

How lucky we are here in beautiful Aotearoa, New Zealand. EBMa refers to the application of the best available research
This year in Ōtautahi Christchurch we will be able to to clinical care, which requires the integration of evidence
conference together again - in June for the equine stream, and with clinical expertise and patient values. By best available
in November for the companion animal stream. It has been research we mean clinically relevant i.e. patient-oriented
some time since we have been able to join colleagues, friends, research that ‘illuminates the accuracy and precision of
industry, and the veterinary community. As one of the few diagnostic tests, highlights the importance of prognostic
places in the world able to do this, we should make the most markers, establishes the efficacy and safety of therapeutic,
of this opportunity and plan to get some amazing continued rehabilitative, or preventive healthcare strategies, or seeks to
professional development. understand the patient experience’ (Pattani & Straus, n.d.).

Every few weeks, I get together with a group of veterinary We must strive to provide the highest quality of clinical
nurse/technician friends from around the world on Zoom. care to our patients, and to do this, we need to be prepared
During our last catch up the topic of “best practice” was to critically appraise our work and look for ways that we
brought up. The comment was made that, “There is no can improve it. We need to identify and address problems
such thing as best practice”. I am sure that many of you in the care delivered to our patients, and be able to gather
disagree with this statement. What is “best practice”? Is it information on the care being given. Clinic audits can be one
a group of methodologies, rules, concepts, a standardised way of gathering the data needed.
set of deliverables like reports and checklists? And because
someone said this is the way it should be done, does it mean Just because someone has recommended something, or
it’s correct? Is there a downside to having everything labelled written a book about it, does not mean that it is the right
“best practice”? One reason for having best practice in some solution or option for you. Look for the world leaders in
areas is that we avoid having to ‘reinvent the wheel’. Keeping veterinary medicine who continue to provide evidence based
things the same does not help you move forward. I am not information. Smart leaders do not play catch up.
saying that we should have a disregard for the existing
practices, but I ask you to critique them, decide if they are Julie
appropriate, and challenge them where you see fit.
Reference
In human and veterinary healthcare, we all strive for quality of Pattani, R., & Straus, S. (n.d.) What is EBM? BMJ. https://
care and clinical excellence, and use the terms “best practice”
and “clinical excellence”. Evidence-based medicine (EBMa) bestpractice.bmj.com/info/toolkit/learn-ebm/
plays an important part in being able to deliver high quality what-is-ebm/
care.

Call for nominations for the 2021 Vet Nurse of the Year

Hill’s Pet Nutrition NZ Ltd and the New Zealand Veterinary Nursing Association are proud to continue our partnership
in the hunt for the 2021 New Zealand Veterinary Nurse of the Year.

This year we have made a few edits to our form to encourage nominators to paint a more detailed picture of the
person you think should win the title of Veterinary Nurse of the Year 2021. Remember the more people that help you
with your nomination, the more detailed that picture is. You can also nominate yourself, because let’s face it...
all veterinary nurses are awesome!

Follow this link here to start getting your nominations in!
https://www.nzvna.org.nz/site/nzvna/files/Flyers/VNOTY%202021.pdf

4 June 2021

NZVNA

Letter from the Editor

My cat Cece couldn’t be happier that the cooler months | Above: Cece waiting for the electric blanket to magically turn on
are here, mostly because of the electric blanket, and of
course because her beloved owner comes home earlier
from the studio too. But even with the lovely cozy
wintery things that we get to enjoy, it can be hard to
stay motivated during these winter months. How about
keeping an eye out for an interesting case study to write
up for the journal? Or planning a research project for the
summer months? We’d be interested in hearing about
your ideas.

In this edition, Alex Hanson’s case study on gangrenous
mastitis explains the diagnosis and treatment of the
condition in a mature dairy cow, and in Bella the goat that
wasn’t kidding, Vivian Allis explains how Bella needed
assistance to give birth to triplets!

New NZVNA Executive Committee member, Marcia Fletcher,
interviews Renee Brown about her journey to become a
Veterinary Technician Specialist in Emergency and Critical
Care (VTS- ECC), while Julie South discusses change in
a veterinary practice in her article What to do when a
‘lifequake’ rocks your world.

Need a refresher on deworming? Dr Abi Chase provides us
with new findings in regards to Toxocara canis/cati, and
public health in her article Global Worming.

We hope you enjoy this winter edition, and remember, if
you have an idea for an article you’d like to write (or read),
please get in touch! I’m more than happy to give you the
resources you’ll need to get your writing published, while
you earn some CPD points at the same time.

Antoinette

Membership Secretary report

Are your details up to date on our database? If you have A reminder that we don’t send out renewal letters, this is all
moved house lately, don’t forget to let me know. done automatically through the website by email. We also
don’t send out new membership cards each year, instead you
Do you have a workmate who has not been receiving emails will receive an email that lets you know that your membership
or the journal lately? Please remind them to get in touch – it has been renewed for another year.
might be that their membership has lapsed or their details
have changed. Kathy

June 2021 5

GANGRENOUS MASTITIS

Gangrenous mastitis in a mature dairy cow

By Alex Hansen BVT, Whitianga Vets Body condition score: 5/5
Weight: ~550kg
Introduction
Mastitis refers to the disease or inflammation of the The dairy farm has 250 hectares of flat – rolling land with
mammary gland. It can occur in all species with a 600 mixed breed cows (Friesian, Cross-bred, and Jersey),
mammary gland and is a common large animal health issue and a 50-bale rotary cowshed. Springer cows and heifers
in dairy production. In New Zealand, pathogenic bacteria are kept in an indoor barn until they calve. They are then
that can cause mastitis can be classified as environmental: moved out onto pasture. Whilst in the calving shed they
where the cow contracts the bacteria from sources in the are fed concentrate and maize silage.
environment (soil, faeces), or contagious, where the cow
contracts the bacteria from other cows in the herd, often The patient first presented on a Wednesday; she
from poor hygiene in the milking shed. Environmental had not yet calved but was showing signs of stage 1
bacteria include Streptococcus uberis and Escherichia coli, hypocalcaemia with mild ataxia and muscle tremors. A
and infection of the mammary gland due to these bacteria brief physical exam was performed and aside from clinical
commonly occur in early lactation (McDougall et al., 2007). signs suggestive of stage 1 hypocalcaemia, no other
The most common bacterium responsible for contagious abnormalities were noted. A rectal exam was performed
mastitic infections is Staphylococcus aureus. This, and E. by the attending veterinarian to assess for signs of
coli, are the most common cause of black mastitis in cattle labour. The veterinarian’s opinion was that she was not
(Shafi, Gupta & Bansal, 2015). ready to deliver her calf.

Gangrenous mastitis, also known as black mastitis, is a Following the physical exam, the cow was administered
relatively rare condition with a high mortality rate, which an intra-ruminal slow-release bolus of calcium,
occurs when the blood supply to the mammary gland is and a 500mL bag of Calcium Borogluconate 37.5%
affected and the tissue begins to die and becomes necrotic. subcutaneously over the ribs to raise blood calcium levels.
After the tissue becomes necrotic, there is no treatment to She was then returned to the calving shed.
cure the affected gland. Aggressive treatment is required to
save the cow (Phiri, Muleya & Mwape, 2010). The following Friday (two days after initial presentation)
the veterinarian was called after the cow went down in
This is a case of gangrenous mastitis in a five-year-old the yards at milking time. On presentation she was in
Friesian cow. Unfortunately, she was euthanised by the sternal recumbency and unable/unwilling to attempt
farmer after her condition deteriorated over the 24 hours to stand. The farmer reported that she had improved
following the initial diagnosis and treatment. following the last visit and had calved unassisted
Thursday afternoon.
History
Signalment Physical Exam
Age: 5 years Mentation: depressed
Sex: Female Heart rate: 150bpm (60 - 90bpm)
Breed: Friesian Respiration rate: 80 (10 - 30)
Temperature: 38.7°C (38-39°C)
Alex completed her Bachelor of Veterinary Technology at Massey Mucous membranes: injected, tacky
University in 2020. Throughout the degree she developed a Gut sounds: quiet, no pings auscultated
special interest in production animal medicine and herd health.
Alex is looking forward to developing her skills in both small The cow had a prolonged skin tent and enophthalmos
animal nursing and production animal veterinary medicine, as of the eye was noted, indicating marked dehydration. A
she enters her first job in mixed practice. muco-purulent bilateral nasal discharge was noted; in
combination with the injected mucous membranes and
sclera, this is indicative of septicaemia. Upon examination
of the udder there was a dark red discharge from the

6 June 2021

GANGRENOUS MASTITIS

front right mammary gland, and the skin on the teat was Discussion
sloughing and becoming a dark red-black colour (Figure Unfortunately, the next morning she was unable to
1). On initial examination, the discolouration was limited stand, inappetent and markedly dehydrated. Based on
to the teat and the gland was soft on palpation, however, this further deterioration overnight, the farmer elected
throughout the duration of the physical exam the dark to euthanise the cow. On a brief gross post-mortem
skin discolouration tracked further up the udder and the examination, widespread discolouration of the affected
gland became firmer. quarter could be seen (Figure 2).

Diagnosis Bacteriology of the milk samples collected was not
Based on the clinical signs found during the physical performed, therefore identification of the pathogen that
exam the veterinarian formed a main differential caused this case of gangrenous mastitis was not possible.
diagnosis of gangrenous mastitis.
If further treatment had been administered this would
Gangrenous mastitis has a grave prognosis, however have involved surgical intervention to remove the
it was suspected that it had been caught early in the necrotic gland. Amputation of the affected quarter can be
disease process. The farmer was advised of the prognosis performed under cranial epidural and local anaesthesia
and was given the option of immediate aggressive (Phiri, Muleya & Mwape, 2010). As the tissue is dead, if
treatment or euthanasia. He elected to initiate treatment. it is not surgically removed and the animal survives, the
gangrenous quarter will eventually slough off. Surgical
Treatment intervention before this happens allows for faster healing
Blood and milk samples were taken prior to administering and recovery (Shafi, Gupta & Bansal, 2015).
any medications. Flunixin meglumine (50mg/mL) was
administered at a dose rate of 2.2mg/kg slow IV, to control Conclusion
pyrexia and inflammation associated with mastitis. Gangrenous mastitis is an uncommon development
Marbofloxacin 160mg/mL was administered at 10mg/kg of clinical mastitis with high mortality rates reported.
intramuscularly in the anterior neck, for broad spectrum This case occurred very acutely, with death of the
antibiotic cover. tissue observed during the physical examination as
spreading discolouration on the udder. The farmer opted
500mL of 40% Dextrose and ~500mL 0.9% NaCl was to euthanise the cow rather than have a veterinarian
administered IV to provide energy and help correct perform invasive surgery.
dehydration. Approximately 40 litres of starter drench
was administered using an Aggers Rumen pump, to Quarter amputation has been reported as a successful
provide further energy and additional supplementation of treatment of gangrenous mastitis in some cases. Phiri
calcium and magnesium. The cow was then encouraged to et al. (2010) reported a successful amputation, where
stand and was able to rise and walk to the shed, although the cow recovered well and remained highly productive
she was very ataxic. in the remaining quarters. Cable et al. (2004) performed
mastectomies in 20 ruminants (goats and cows) and
Figure 1: Dark red discharge from the front right mammary reported good outcomes in animals in good condition.
gland, and the skin on the teat was sloughing and becoming a
dark red-black colour Figure 2: Widespread discolouration of the affected quarter

June 2021 7

GANGRENOUS MASTITIS

However, when there was systemic illness associated with References
the udder infection, such as septicaemia, the outcome Alleh, A. J., Barrington, G. M. & Parish, S. M. (2008).
tended to be poor. There was also higher risk associated
with mastectomies in cows due to the potential for severe Physiologic mastectomy via flank laparotomy.
blood loss. Allen et al. (2008) describes an option to reduce Veterinary Clinics of North America: Food animal practice,
this risk by performing a physiologic mastectomy. Ligation 24(3), 511–516.
of the external pudendal artery decreases absorption Cable, C.S., Peery, K. & Fubini, S. L. (2004). Radical
of toxins into the blood and results in gland atrophy. mastectomy in 20 ruminants. Veterinary Surgery, 33(3),
Amputation of the teat allows the gland to drain as it 263–266.
atrophies and sloughs. Physiologic mastectomy can be McDougall, S., Arthur, D. G., Bryan, M. A., Vermunt, J. J., &
performed under local or regional anaesthesia with the cow Weir, A. M. (2007). Clinical and bacteriological response
standing, which removes the risks of general anaesthesia. to treatment of clinical mastitis with one of three
intramammary antibiotics. New Zealand Veterinary
In conclusion, gangrenous mastitis often results in Journal, 55, 161–170.
death or euthanasia of a cow due to the requirement Phiri, A.M., Muleya, W., & Mwape, K.E. (2010). Management
for immediate and aggressive treatment. Where medical of chronic gangrenous mastitis in a 3-year-old cow
management is not effective, there are some options for using partial (quarter) mastectomy. Tropical Animal
surgical intervention. Due to the cost of these procedures, Health and Production, 42, 1057–1061.
surgery is mainly considered in animals with high genetic Shafi, T. A., Gupta, D. K., & Bansal, B. K. (2015). Diagnosis and
merit or otherwise valuable animals. treatment of gangrenous mastitis in crossbred cows.

Intas Polivet, 16(2), 276–279.

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June 2021 9

INTERVIEW

Interview with Renee Brown VTS - ECC

By Marcia Fletcher
NZVNA Executive Committee member

As many of you would know, being accepted for, sitting, continued my drive to learn even more. If there were
and passing speciality examinations is no easy task. It procedures or diseases I was unfamiliar with, I would
takes immense determination and dedication, always go home and research them. I thought the more I tried
looking towards that end goal. to understand diseases and their detrimental effects on
the body, the better monitoring and nursing care I could
I am extremely proud to say that we have gained another provide my patients.
specialist technician. She may have moved to Australia to
pursue her dream job, but we still get to claim her! Over the years working in emergency and ICU, my skills
advanced in handling various emergencies and the
Renee Brown is now a Veterinary Technician Specialist complexities they bring. However, I was still driven to have
in Emergency and Critical Care (VTS – ECC). I had the
pleasure of not only working with Renee for several 10 June 2021
years, but also seeing her knowledge and skills flourish. I
caught up with Renee to find out what it takes to become
an ECC specialist technician – and during COVID-19 times
no less!

What made you want to become a specialist in emergency
and critical care?
To be honest, I didn’t even know this existed until I
secured a job in a referral veterinary teaching hospital
early in my veterinary nursing career. This exposed
me to various complicated cases, and the challenges
veterinarians and nurses had to overcome to see these
patients survive. This was exciting, as previously I felt
my nursing skills were only utilised as a glorified cleaner
and animal attendant. Being at a teaching hospital,
I was blown away listening to nurses explain how to
perform procedures to veterinary students. I always
knew I wanted to improve my understanding of why I
was doing something, rather than just being told what to
do. Working with experienced nurses and observing their
knowledge and skills, I aspired to grow as a young nurse
and achieve my full nursing potential.

When I started working in the emergency department at
the teaching hospital, it opened my eyes to a new way
of nursing. Monitoring and assisting patients from the
brink of death to eventually walking out of the hospital
was the best feeling in the world. Knowing that I played
an integral part in a patient’s stabilisation and recovery

INTERVIEW

a deeper knowledge and understanding of emergency certain position and show the calculator every time I used
and critical care. Working alongside a VTS in Anaesthesia/ it. I couldn’t look around the room as the proctor could
Analgesia over the years helped me realise that pursuing assume I was reading a poster or attempting to cheat by
my VTS certification in ECC would provide me with the other means. It was stressful and distracting for me to
in-depth knowledge I was so eager to obtain. worry about those details, while watching the clock, and
recalling all of my study material.
Was the process difficult from NZ/Australia? How was the examination process?
No, not at all. Everything for the AVECCTN was online. I’m not going to lie, the exam was really tough. I had three
Making sure I had enough exposure to a variety of cases hours to complete the exam and the time went really fast.
for the first two sections of the VTS was the hardest Then the added stress of uploading the exam at the end
process. and watching that circle continuously turn for minutes
that seemed like hours, hoping it didn’t drop out and lose
There are three parts to the Veterinary Technician my exam at the last minute. I remember when the exam
Specialists in Emergency and Critical Care certification: finally uploaded, I started to bawl my eyes out, then sent
a text to my fiancé to let him know it was all done, and to
Stage one is needing a minimum of 5,760 hours bring home a good wine and cake.
working in emergency and critical care, proof of my Awaiting the six weeks for results was such an emotional
veterinary nursing diploma, a minimum of 25 hours of roller coaster. I had convinced myself I had failed the
continuing professional development in ECC, employment exam to the point that I had already started making a
history, references from two American board-certified whole new study plan to re-sit the exam next year.
veterinarians, and lastly, completion of a three-page skills Once the results were in, my fiancé, Matt, opened my
task list varying from placing central lines to intraosseous email as I couldn’t bring myself to look at it. Matt paused
catheterisation, and all components of CPR. for a second to double check the email and then we
started hugging, yelling and jumping up and down as if
Stage two consists of writing four thorough case reports we had won Lotto. It was a truly euphoric moment, yet I
and completing up to 65 case logs within a one year am still in shock and disbelief that I did it.
period, and stage three is a multi-choice three hour exam. How do you feel after gaining your VTS ECC?
It was certainly a flood of happiness, excitement and relief
What was it like remotely sitting exams? knowing that all the hard work and personal sacrifices we
Sitting the exam remotely due to COVID-19 was extremely made as a whānau was worth it.
stressful. I needed a computer that would run the
software flawlessly, so I had to borrow a laptop and June 2021 11
just prayed it would work. I was monitored by the exam
proctors through the camera to make sure I was not
cheating. This meant I had to continually show the camera
both sides of my scrap piece of paper and place it in a

INTERVIEW

After acquiring my VTS-ECC certification I have been just too tired to study at all, while on the days off I really
offered some amazing job opportunities. One as a senior had to push and motivate myself to carry on and study.
ECC nurse working directly with a criticalist, and the other I reminded myself how hard I had worked for two years
as an ECC nursing educator. I am so excited to be working to get to the opportunity to sit the VTS exam and with
both of these roles as they fuse together all my skills into only six months to study, I was not going to give up. I was
my dream job. fortunate enough to have a supportive network, which
included a study group that helped me stay focused, and
What is one of the most memorable cases you have looked we were able to tautoko/support each other through the
after in your career? mayhem. I studied wherever I could, including listening
I have been a part of so many cases that it is hard to to podcasts while walking to work and reading the study
narrow it down to just one. But the most memorable cases material on lunch breaks and after work. Being able to
were those that were in hospital for weeks to months, look back and see that all the hard work finally paid off in
or those that received really intense stabilisation and the end is immensely rewarding.
treatment. I have enjoyed nursing patients through days
on a ventilator, providing recumbent care with multiple If you’re not sure where to begin upskilling in ECC, there
transfusions with an array of drug constant rate infusions are plenty of free continuing education lectures out there.
(tree of life). Unfortunately, the ones that don’t make it If you haven’t studied in a while and all you remember is
due to finances or cardiac arrest can leave me emotionally how long and painful it was to study, then it’s all about
drained. But through my VTS training, I have learned finding your passion. Once you discover that subject you
to take my experiences from all my cases and use that find interesting, then watching webinars doesn’t feel like
knowledge for future patients. studying, and can become therapeutic when you have
those light bulb moments. Understanding the reasons
Some of my other memorable cases can be those patients behind why you’re doing something is more fulfilling than
that were critical, yet very aggressive, which can make doing something because you’re told to do it. Whether
stabilisation and treatment challenging. I love that your passion is in anaesthesia, surgery, emergency,
after a period of time these patients develop a mutual dermatology, oncology, internal medicine or any other
respect with the nurses and actually become excited to field, there is continuing education for it all. I would
see you walk into the ICU, and greet you with a tail wag. encourage any nurse to take the plunge and dive into CPD
The feeling that your care and compassion has helped - the more knowledge you have, the more you can assist
break down barriers and earned a patient’s trust is an and advocate for patients under your care.
absolutely heart-melting moment.
Will you come back to NZ one day?
What would you say to other nurses looking to upskill in I was gutted when I couldn’t complete my VTS exam
the ECC field? in New Zealand, but new opportunities awaited me in
Do it. It is never too late to expand your knowledge. I Australia. One day I would love to work in Aotearoa
had to overcome several obstacles in my quest for the again. We are fortunate in New Zealand that there are no
VTS-ECC. I am a very tactile learner and learn by physical predators to harm our animals, but in Australia I have the
interactions and repetitive actions. This meant I had to opportunity to learn how to nurse patients with snake
work out a way to retain the knowledge I was reading bites, tick paralysis and heartworm. I would love to bring
from textbooks and articles. I decided to completely these experiences, as well as my VTS knowledge, back to
change my career and work in a general practice NZ to inspire nurses and advise them on the complexities
veterinary clinic, thinking it would give me more time to working overseas can bring.
study. However, the pandemic hit and veterinary clinics in
Australia were an essential service, so the shifts became I’m honoured to be the first kiwi VTS-ECC and hope to
extremely long and, with the strict lockdown rules, it inspire Māori tamariki and veterinary nurses to follow
was physically and emotionally stressful and draining their dreams and to just go for it. You never know unless
dealing with clients in full PPE equipment in the parking you try. I look forward to the new opportunities this
lot in 34°C weather. On some days I worked I found I was certification presents.

12 June 2021

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GOAT CAESAREAN

Bella the goat who wasn’t kidding

By Vivian C Allis BVT RVT, VetSouth Winton History
Bella is a heavily pregnant goat 145 days along, who
Introduction has been in good body condition and had been doing
Parturition in goats is generally uneventful with an well (Figure 1). On Tuesday the 18th of September the
incidence of dystocia in less than 5% of cases (Stewart owner noticed that Bella was more restless and looked
& Shipley, 2014). Dystocia occurs either when the first uncomfortable so she rang the veterinarian in case Bella
or second stages of parturition are delayed or when the was going into labour and needed assistance.
first stage fails to progress to the next stage within 30
minutes (Purohit, 2006; Sharma et al., 2014). Therefore, if Initial assessment
a doe has been in active labour for more than 30 minutes On Tuesday evening Bella did not show any signs of active
with no progress she will likely require assistance which labour, she presented as
may be in the form of a caesarean section (Stewart and • Walking, eating, sitting and drinking normally
Shipley, 2014). According to Ali (2011), the most common • Her mentation was bright alert responsive (BAR)
causes of dystocia in goats include ringwomb (complete • She was not nest-bedding
or partial failure of cervical dilation), foetal malposition, • There were no signs of being in active labour
narrow pelvis, and simultaneous presentation of twins • No milk let-down was present yet
or triplets. Other minor causes of dystocia may include • Her cervix was still fully closed on palpation and felt
feto-maternal mismatch, vaginal prolapse, uterine torsion
and uterine inertia. In this case, the goat suffered from almost like a closed fist from the side
ringwomb, failure of cervical dilation (Ali, 2011). • Her vitals were all within the normal range:

On the evening of the 18th of September Massey Farm - Heart rate (HR) was 70 bpm (70-80 bpm)
Services received an after hours call about a maiden goat, - Respiratory rate (RR) was 30 brpm (16-34 brpm)
named Bella, who was possibly going into labour. This
case report aims to provide an overview of what nursing Figure 1: Bella at Massey Farm Services
care should be considered when a heavily pregnant goat
with a closed cervix is presented showing signs of labour.
The nursing care described in this report follows Bella’s
case, a goat who wasn’t kidding, and hence required a
caesarean section.

Patient’s details and history
Name: Bella
Species: Goat
Breed: Toggenburg x Boer
Coat colour: Brown/white
Age: Approximately 2 years
Sex: Maiden pregnant female
Weight: ~ 60 kgs

Vivian is a recent Bachelor of Veterinary Technology graduate
from Massey University. She is originally from the Netherlands
and has been in New Zealand for over seven years now. She is a
registered veterinary technician and recently started her job at
VetSouth Winton as a large animal veterinary technician.

14 June 2021

GOAT CAESAREAN

- Pulse was of good quality and in sync with the HR • Vaginal prolapse
- Mucous membranes (MM) were pink and moist • Uterine torsion
- Capillary refill time (CRT) was less than 1 second (1-2 • Uterine inertia
Treatment
seconds) As mentioned before, Bella suffered from ringwomb.
- Temperature was 39°C (38 - 39.5°C) Non-surgical treatment options may include manual
assistance of the birth process or various medical and
Consequently, there was no reason to intervene straight hormonal therapies (Ali, 2011; Hanie, 2006). However,
away as there were no obvious abnormalities observed in this type of dystocia manual dilation is generally
during her physical exam. However, we did administer an unsuccessful and can cause severe damage to the birth
intramuscular (IM) injection of oxytocin (5 IU/mL) 10 IU canal (Ismail, 2017). Calcium borogluconate and/or
per goat IM to help stimulate labour, induce milk let-down estradiol benzoate are examples of medical therapy used
and increase the chances of successful vaginal delivery in goats for treatment of ringwomb with satisfactory
(Lavie et al., 2018). results. Prostaglandin F2a (PGF2a) 5-10mg per goat IM
(Smith and Sherman, 2009) is an example of hormonal
Progress therapy used to treat ewes and does with ringwomb
Bella had been doing well until Thursday afternoon, and dead foetuses. Ali (2011), reported that PGF2a
which was when we were visiting the lifestyle block to had a success rate of 22% in ewes and 69% in goats,
weigh, drench and collect faecal samples from the rest of respectively. The cervical dilation occurred within a mean
the goats. Around 3:30pm she started showing nesting time of 63 hours for ewes and 42 hours for does. However,
behaviour and soon after she was actively straining. We since the goat kids in this particular case were still alive
performed a physical examination on her to check her this treatment option was less preferable compared to
vital signs. All her vitals again were normal. Her HR was Figure 2: Delivery of a kid during the caesarean
75 bpm, RR was 30 brpm, pulse was of good quality and
symmetrical to the HR, her temperature was 39°C, her MM June 2021 15
were pink and moist and her CRT < 1 second. However, she
had become increasingly restless and was experiencing
uterine contractions. During her vaginal examination the
cervix was palpated to check whether it had started to
dilate yet. Unfortunately, it was still closed and it was
thought that a head could be felt pushed up against the
cervix. As a result, the vet diagnosed her with ringwomb,
which is partial or complete failure of cervical dilation.
In order to decide on the best treatment option for Bella,
a transabdominal ultrasound was performed. These
examinations were carried out to help determine the health
status of the dam, the condition of the birth canal, the
degree to which the cervix had dilated and the viability of
the foetus (Fubini et al., 2002; Tibany & van Metre, 2004).
On the transabdominal ultrasound we found at least one
foetal heartbeat. We took Bella back to the clinic to monitor
her closely for the next few hours in case we needed to
intervene quickly and require a caesarean section.

Differential diagnoses
Possible causes for dystocia in goats that may require an
emergency caesarean (Stewart & Shipley, 2014):
• Complete or partial (ringwomb) failure of cervical

dilation
• Malposition
• Feto-maternal mismatch
• Two or more kids presenting at the same time

GOAT CAESAREAN

surgical intervention with a caesarean section. is why we dosed her at 80kg. In addition, we gave her
a subcutaneous (SQ) injection of meloxicam 20mg/mL
We opted for a caesarean section as the best treatment (1mL/20kg). We chose meloxicam for the analgesic, anti-
plan for Bella as she had gone into the first stage of inflammatory and anti-pyretic properties as it belongs to
labour on Thursday afternoon while her cervix was the enolic acid group of non-steroidal anti-inflammatory
still fully closed. This meant she had complete failure drugs (NSAIDs). According to Hu et al, (2017), NSAIDs
of cervical dilation which is one of the indications for provide effective analgesia and anti-inflammatory
caesarean during parturition in goats. Bella was not functions by inhibiting cyclooxygenase (COX) and thus
sedated or under GA for her caesarean, instead she was blocking the production of prostaglandins (PGs) and
fully conscious and sitting on the surgery table. She did thromboxane (TX).
receive local anaesthetic for pain relief. Aftercare and follow up
Overnight we checked Bella every four to six hours and
An L-block was given to desensitise the surgical site using noticed her cervix was starting to gradually dilate and she
2% Lidocaine (20mg/mL) SQ. The L-block consisted of 1% was now trying to pass the placenta. Bella and the triplets
lidocaine solution which was made by diluting the 30mL did well overnight. She was mothering them immediately
of lidocaine with 30mL of saline so that we could use a after surgery and soon after they were happily nursing.
larger volume (Holtgrew-Bohling, 2020) without going On Friday afternoon they were able to go back home.
over the maximal dose of lidocaine which is as low as Bella was prescribed meloxicam 20mg/mL (1mL/20kg)
10mg/kg of body weight (Matthews, 2009). Goats and and amoxicillin trihydrate (Betamox) 150mg/mL (10mL/
particularly goat kids are sensitive to the toxic effects kg) to take home for administration every second day
of lidocaine which include drowsiness and respiratory for two days, with the final dose being on Monday 24th
depression (Matthews, 2009). As a result, the total dose September.
of lidocaine given by local infiltration should not exceed At Bella’s post surgical check up on the following Tuesday
10mg/kg. A risk of convulsions is associated with a dose she presented bright, alert and responsive (BAR). There
of 6mg/kg IV or 10mg/kg IM. Consequently, care must be was a small amount of swelling around the stitches but
taken not to exceed the recommended doses of lidocaine nothing of major concern as the wound was healing well
in goats which are: 30mL of 2% lidocaine in 45-70kg goats and there were no signs of infection. Photographs were
and 40-50mL in >70kg goats (Matthews, 2009). Figure 3: Resuscitation of a goat kid by using a syringe to
aspirate mucus from the kid’s airways
The caesarean section was performed successfully with
no complications and to our surprise produced three 16 June 2021
healthy live kids (Figure 4). There were two nanny kids,
Toledo, and Trumpet and one billy kid, named Alfredo.

Immediately after a kid was delivered (Figure 2) a vet
student or technician holding a towel would take the kid
and gently start rubbing it. This had several functions
including drying the kid, removing the foetal membranes
as well as stimulating the lungs to start working. One
of the kids had mucous removed from its airway with a
syringe, as it was initially struggling to breath (see Figure
3). This kid also received oxygen supplementation, but
other than that the triplets were all healthy and in good
condition.

Bella was administered an IM injection of amoxicillin
trihydrate (Betamox®) 150mg/mL (10mL/kg). Amoxicillin is
a broad spectrum penicillin antibiotic and is widely used
in many animal species for treatment of several infections
(Fernandez et al., 2007). Even though we estimated her
weight at 60kg it is better to give slightly more amoxicillin
to ensure that it is effective as it is not very toxic, which

GOAT CAESAREAN

sent to the veterinarian prior to removing the sutures to and Veterinary Sciences, 4(2), 95-108.
check surgical site healing (Figure 5a). The owner then Fernandez, C., Modamio, P., Mestorino, N., Errecalde,
removed the sutures with the veterinarian’s approval
(Figure 5b). J. O., Mariño, E. L. (2007). Pharmacokinetics of
sodium and trihydrate amoxicillin in sheep after
Discussion intravenous and intramuscular administration.
Reflecting on how the case progressed it seems we may Journal of Veterinary Pharmacology and Therapeutics,
not have needed to perform a caesarean after all. However, 30(3), 263-266. https://doi-org.ezproxy.massey.
at the time we could not have known that she would Figure 5a: Bella’s surgical site pre-suture removal
eventually end up being ready to kid by herself. So, at the
time, with the information we had and after seeing how Figure 5b: Surgical site post suture removal
Bella’s condition changed, opting for a caesarean seemed
like the best solution for Bella and her unborn kids.

Conclusion
In this specific case, opting to perform a caesarean was
the best choice of action as it provided the best chance
for the kids to be born alive and it also minimised the
risk of Bella’s cervix tearing during the birthing process.
In conclusion, it is very important to decide on the best
treatment option in a timely manner, as the outcome and
survival rates of the dam and neonates are significantly
affected by the length of time between labour
commencing and the surgical intervention being started.
It was a great experience to see a caesarean section being
performed in such a fascinating and quickly evolving case.

Referencing
Ali, A.M.H. (2011). Causes and management of dystocia in

small ruminants in Saudi Arabia. Journal of Agricultural

Figure 4: Bella with her triplets post-surgery

June 2021 17

GOAT CAESAREAN

ac.nz/10.1111/j.1365-2885.2007.00843.x s00404-018-4721-9
Fubini, S., Heath, A. M., & Pugh, D.G. (2002). Sheep and goat Matthews, J. (2009). Diseases of the Goat (3rd ed.). Wiley.
Purohit, G.N. (2006). Dystocia in the sheep and goat. A
medicine. Saunders. PMCid:PMC2173981
Hanie, E. A. A. (2006). Large Animal Clinical Procedures for review. Indian Journal of Small Ruminants, 12(1), 1-12.
Sharma, A., Kumar, P., Singh, M., & Vasishta, N. (2014).
Veterinary Technicians. Elsevier.
Holtgrew-Bohling, K. (2020). Ovine and Caprine surgical Retrospective analysis of dystocia in small ruminants.
Intas Polivet. 15, 287-289.
procedures. In K. Holtgrew-Bohling (Eds.), Large animal Smith, M. C., & Sherman, D. M. (2009). Appendix A: Formulary
clinical procedures for veterinary technicians (4th ed., of Some Drugs Used in Goats and Suggested Dosages In:
pp. 544-551). Elsevier. Goat Medicine (2nd ed., pp. 807-814). John Wiley & Sons
Hu, X. Y., Luan, L., Guan, W., Shi, J., Zhao, Y. B., & Fan, H. G. Inc DOI: 10.1002/9780813818825.app1
(2017). Tolfenamic acid and meloxicam both provide an Stewart, J. L., & Shipley, C. F. (2014). Parturition
adequate degree of postoperative analgesia in dogs in Goats. Merck Veterinary Manual. https://
undergoing ovariohysterectomy. Veterinarni Medicina, www.merckvetmanual.com/management-and-
62(06), 333–341. doi: 10.17221/143/2016-VETMED. nutrition/management-of-reproduction-goats/
Ismail, Z. B. (2017). Dystocia in sheep and goats: outcome parturition-in-goats
and fertility following surgical and non-surgical Tibany, A., & van Metre, D. (2004). Chapter 19 - Surgery of
management. Macedonian Veterinary Review, 40(1), the Sheep and Goat Reproductive System and Urinary
91-96. http://dx. doi.org/10.1515/macvetrev-2017-0012 Tract. In S. L. Fubini & N. G. Ducharme (Eds.), Farm animal
Lavie, A., Shinar, S., Hiersch, L., Ashwal, E, Yogev Y, & Aviram, surgery (pp. 527-547). Saunders.
A. (2018). Uterine electrical activity, oxytocin and labour:
translating electrical into mechanical. Archives of
Gynaecology and Obstetrics, 297, 1405–1413 DOI: 10.1007/

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18 June 2021

LIFEQUAKE

What to do when a ‘lifequake’ rocks your world

By Julie South Recruitment Consultant VetStaff Controllable Event Uncontrollable
You’re made
Greek philosopher Heraclitus once said “the only constant You decide it’s time Change in redundant or
is change”; this has never been truer for the majority of for a new job so employment your clinic is sold/
the world than right now. The world as we knew it, has start job hunting bought
changed. Your doctor gives
You decide it’s time Change in you a potentially
Today we have the old normal, the new normal, and this to start getting health life threatening
normal. But what if you’re totally normalled-out? What if more active / health diagnosis
you just can’t handle any more normal? What do you do healthy / lose
then? weight Landlord puts
your house up for
Depending on which article or research you read, there You buy / sell your Change in sale
are many different ways for you to handle change. house or decide address
Equally, there are a variety of types of change. it’s time to live
somewhere else
The aim of this article is to help you simplify change into
that which you can control and that which you can’t. One of the most important beliefs you can adopt in your
life is that you control how you feel and respond to
Firstly, it’s important to realise that with change, the only situations. Sure, people can press your buttons – but it’s
way out is through. To attempt to keep the status quo up to you how you react to their button-pressing.
requires more mental energy and heartbreak. It’s also
pointless, because change is constant. Four change strategies to reduce your stress levels
Managing change and the resultant stress levels that
The three things you have control over: accompany different situations in your life takes practice.
• Your thoughts: you control what goes on inside your Such practice is easier to incorporate when you’re not up
to your neck in change or stress to start with. Here are
head, four strategies you can incorporate into your life to help
• Your attitude: you choose whether you’re a nice person you manage change:

to be around or not, and 1. Expect change to happen
• Your reaction to situations/people: you control what Back in the 1970s, Salvatore Maddie, a researcher at
the University of Chicago, studied employees who were
comes out of your mouth and how you react affected by change due to the deregulation of their
industry. Some had trouble coping, whilst others thrived
Voluntary vs Involuntary | Controllable (Maddie, 1987, as cited in APA, 2003). What separated the
vs Uncontrollable two groups?
According to Bruce Feiler (2020), who first penned the
term “lifequake”, almost half of change that happens in Those who thrived had the attitude that change happens,
our lives is voluntary (what I refer to as controllable) and and it’s up to them to learn to adapt to it by looking for
the other half is involuntary (uncontrollable). the silver lining. Those who struggled kept referring back
to ‘the good old days’. They were consumed with trying to
Following are a few life-changing events brought about work out if their luck had turned bad. They were focussing
from each end of the un/controllable spectrum: on trying to return to a place that no longer existed (the
‘old normal’).
Julie enjoys matching veterinary clinics and professionals
together. She sees recruitment as the perfect way to combine her Where is your focus? Are you still yearning for the old
love of marketing, people and animals. Working nationwide, she’s normal? When you look back, what did you like and dislike
always up for coffee dates. about that time? No situation is 100% perfect, so if you find

June 2021 19

LIFEQUAKE

yourself hankering for ‘the good old days’, start thinking “We but mirror the world. All the tendencies present in
about what you didn’t like about life back then. Start the outer world are to be found in the world of our body.
putting today into perspective – the good times of today If we could change ourselves, the tendencies in the world
(there will be some if you look deep and hard enough) would also change. As a man changes his own nature, so
compared with the bad times of the good old days. does the attitude of the world change towards him. This
is the divine mystery supreme. A wonderful thing it is and
What can you control about where you’re at right now? the source of our happiness. We need not wait to see what
others do.” (Citatis, n.d.)
You control your thoughts!
Using baby steps, what changes can you make about the
2. Identify your FEAR (False Expectation Appearing Real) situation you’re in today? Taking action, regardless of
Let’s face it, how many of your fears have manifested in how seemingly minor it might appear, over time, makes a
real life? Probably not many. huge difference.

Find some quiet time to look at exactly what you’re afraid Remember: you control your thoughts, and your actions!
of. Get a clean sheet of paper, or maybe start a new page
in your journal, and start listing every single FEAR you Action Plan - implement one strategy at a time
have about the situation you’re in. Beside each FEAR, When it feels like everything around you is falling apart
identify a Plan B – if that FEAR became a reality what and you find yourself overwhelmed, take one strategy
would you do? Having a plan ahead of time helps you feel from above – the one that feels the easiest – and go from
like you’re in control. there.

Ask yourself whether the FEAR is real or imagined? Is it If they all feel hard, then hit FEAR head-on! A fast way to
something you can directly control or not? If you could gain control is to identify what FEAR conversations you’re
control it, what would you do? What would that look like? having with yourself, and then work your way through
What would you change? them one at a time.

Remember: you control your thoughts! I also highly recommend getting into the habit of having
an ‘Attitude of Gratitude’ journal – spend five minutes
3. Reframe the situation each day reflecting back, identifying all the things you’re
The more we focus on the negative, the easier it is to get grateful for. This is something I do and, when I feel like
into a downward spiral where everything gets blown out nothing is going right and everyone in the whole wide
of proportion and your whole world looks like it’s about to world is against me (of course they’re not!), in those
implode. times I’m super-grateful for getting the washing dry
outside on the line. Or for drinking my coffee while it was
Look at the problematic situation and reframe it into still hot without getting interrupted. Little things can
something positive. It doesn’t matter how miniscule sometimes be the biggest things to be grateful for.
that positive element is – identify something. Anything.
Practicing an ‘Attitude of Gratitude’ is essential – the more References
you look for positives in your life on a daily basis, the American Psychological Association. (2003). Turning
easier it is to see them when things aren’t going quite to
plan. Lemons into Lemonade: Hardiness Helps People Turn
Stressful Circumstances into Opportunities. https://www.
Once you’ve got one positive aspect, you’ll be on the path apa.org/research/action/lemon
to changing your outlook whereby you can start taking Citatis (n.d.) Mahatma Gandhi quotes. https://citatis.com/
control and look for more positive aspects. a2762/264826/
Feiler, B. (2020). Life is in the transitions: Mastering change
Remember: you control your thoughts! at any age. Penguin Press.

4. Be the change you want to see 20 June 2021
Although “be the change you want to see” isn’t quite what
Mahatma Gandhi said, it’s still excellent advice. This is
what he actually said:

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June 2021 21

GLOBAL WORMING

Global Worming

By Dr Abi Chase BSc(Hons) BVMS PhD and neuropsychiatric disorders (Fan, 2020), to decreased
Boehringer Ingelheim cognitive function in children and young adults (Erickson
et al., 2015; Walsh and Haseeb, 2012). However, HT is rarely
I have a snow globe on my desk filled with ticks. That on a differential list, particularly when clinical signs in
may sound disgusting, but it’s pretty fascinating to stare children are as nondescript as fever, abdominal pain,
at. In fact, parasites in general are fascinating when you nausea and wheezing, and therefore it’s rarely diagnosed
consider their complex life cycles and characteristics, that (Ma et al., 2018). As a clinical veterinarian, I have to
include an ability to modify the behaviour of their hosts. admit I only gave Toxocara a thought in pregnant bitches
That said, my admiration for parasites was recently called and puppies. I knew about larval migrans in the eyes of
into question when I reviewed an article on Toxocara children, but understood this was so rare that it warranted
species. It made me go home, worm all the animals in my limited concern. But as I’ve now discovered, research
house, research medication for my children (not advised shows a wide range of syndromes are caused by Toxocara
– this was done in panic), and start picking up poo left by larvae. Humans become infected by ingesting eggs or
other people’s dogs. Here’s why. infective larvae, for example through eating raw meat
or children eating soil. Larvae penetrate the intestinal
The veterinarian’s role in public health wall and are transported to different tissues through the
Research in the past few years has investigated the bloodstream (Strube et al., 2013). The persistence of larvae
associations between human toxocariasis, caused by the in the brain, eye, liver and muscle can cause a broad range
dog and cat parasites Toxocara canis/cati, and a variety of clinical symptoms that occur most often in children
of human diseases – and leading parasitologists are now (Despommier, 2003). There are four distinct syndromes,
recommending more frequent deworming to protect public and these are described in Table 1.
health (Pennelegion et al., 2020). As veterinarians and
veterinary nurses can have a significant influence in the Prevalence
prevention of Toxocara infection by advising appropriate Humans
deworming and reducing environmental contamination, Before you panic, consider the prevalence of HT and the
it’s extremely important that we’re aware of emerging relative risk of infection. Research has estimated the
research and recommendations in this field. worldwide prevalence of HT in healthy humans at 19%; this
has increased non-significantly in the past few decades
Human Toxocariasis and varies widely between countries (Rostami et al.,
Human toxocariasis (HT) is a significantly underdiagnosed 2019). Table 2 summarises the seroprevalence data in New
public health issue around the world (Rostami et al., 2019). Zealand, with these studies linking higher seropositivity
It can cause a wide range of diseases, from childhood among children, people with myalgic encephalomyelitis,
asthma (Momen et al., 2018), urticaria (Vinas et al., 2020) recently pregnant people, those who have close regular
contact with dogs, or people in a rural location. Numerous
Abi has been working as a technical veterinarian at Boehringer screening studies have also found higher seroprevalence
Ingelheim since 2016. She moved to NZ from the UK with her in certain populations, such as asthmatic children (Momen
kiwi husband in 2013 working as a clinical veterinarian in et al., 2018) and farmers (Deutz et al., 2005; Strube et
Canterbury. Abi graduated from University of Glasgow Veterinary al., 2020). The small number of veterinarians sampled
School (2006), has a first class degree in Animal Science from in Christchurch in 1987 did not have a significantly
University of Edinburgh and a PhD in Veterinary Parasitology. higher seroprevalence than the general population.
She particularly enjoys problem solving with veterinarians and However, in Austria, two percent of apparently healthy
farmers and is a strong advocate for science and evidence-based individuals were seropositive, compared to 27% (37/137) of
solutions. veterinarians (Deutz et al., 2005).

22 June 2021

GLOBAL WORMING

Table 1: The four syndromes seen in human toxocariasis. A review of the clinical syndromes was published in The Lancet in 2018
(Ma et al., 2018).

Visceral larva migrans Covert/common toxocariasis Ocular larva migrans Neural larva migrans

Most common syndrome Challenging syndromes to Rare but most Rare in middle-aged people
in infected people, diagnose clinically because of commonly reported in but emerging evidence of
particularly children non-specific symptoms. children 3-16 years. developmental effects in
under 10. children.

Coughing, wheezing, Children: fever, anorexia, headache, Immune response Fever and headache. Possible
myalgia and eczema. wheezing, nausea, abdominal pain, to migrating or dead associations with seizures,
Additionally, long-term vomiting, lethargy, sleepiness and larvae causes visual schizophrenia, cognitive
effects such as the behavioural disorders, pulmonary impairment. deficits, idiopathic Parkinson’s
development of asthma symptoms, limb pain, cervical disease and dementia.
and promotion of lymphadenitis and hepatomegaly. Cognitive or developmental
pulmonary fibrosis. Adults: weakness, pruritus, delays (eg, reduced reading
rash, pulmonary dysfunction, or working memory ability) in
pulmonary insufficiency and children who become infected
abdominal pain. is concerning.

Dogs and cats animals. A Dutch study that sampled adult pet dogs
The most commonly used tool for estimating prevalence monthly for a median of 14 months found prevalence to
in dogs and cats is coproscopy (the analysis of stool be 4.5%, with 32.1% of the dogs shedding eggs in faeces
samples). In a recent review and meta-analysis of at least once during that period (Nijsse et al., 2016).
published studies on Toxocara spp., dogs were found to Studies in New Zealand show a nine percent prevalence
have a global prevalence of 11.1% (Rostami et al., 2020). in working dogs in the central North Island (O’Connell et
However, the prevalence was lower in older, healthy al., 2019) and Hawke’s Bay (Matthews, 2016). In a 2015

| Above: Toxocara canis in a dog intestine

June 2021 23

GLOBAL WORMING

Table 2: Summary of Toxocara spp. prevalence studies in humans in New Zealand. When prevalence is reported in the human
population, it is estimated by the presence of anti-Toxocara spp. antibodies in serum

Group % anti-Toxocara antibodies Number Median age and/or range

1984. Hydatid Control Officers’ Annual Conference. Study undertaken by Christchurch School of Medicine (Clemett et al., 1985)

Hydatid control officers 25.6% 90 43 (21-66)

1985. Hydatid Control Officers’ Annual Conference. Study undertaken by Christchurch School of Medicine (Clemett et al.,

1985)

Hydatid control officers 28.4% 102 43 (20-67)

1987. Veterinarian samples taken from a Christchurch NZVA regional network meeting. Dog owners and breeders sampled

at the 1986 Kennel Club Centennial Show. Study undertaken by Christchurch School of Medicine (Clemett et al., 1987)

Urban adult blood donors 2.8% 318 34.1 (17-61)

(Christchurch)

Urban student blood donors 3.4% 119 16.4 (16-18)

(Christchurch)

Rural blood donors (Canterbury) 7% 187 33.9 (16-59)

Rural student donors (Canterbury) 3.1% 33 16.8 (16-19)

Veterinarians (Christchurch) 5.6% 18 40 (27-66)

Dog breeders/exhibitors 13.9% 79 41 (11-66)

1988. Sera collected from urban and rural areas. Study undertaken by Christchurch School of Medicine (Williamson et al.,

1988)

Cord blood (neonates) 1% 88 1 day

Postpartum mothers 33% 75 No data

Myalgic encephalomyelitis patients 25% 79 No data

Rural Māori children (Kāeo) 51% 49 11-14

Rural European children (Kāeo) 30% 44 11-14

Urban Māori children (Whāngarēi) 43% 40 14-16

Urban European children (Whāngarēi) 15% 41 14-16

Urban Māori children (Ōtara) 31% 26 14-15

Urban European children (Ōtara) 22% 9 14-15

Urban Pacific Islander children (Ōtara) 31% 26 14-15

Rural European children (East Coast) 44% 25 7-12

Rural Māori children (East Coast) 83% 87 9-12

2007. 82 rural and 58 urban blood donors in Waikato. Study undertaken by Waikato Hospital (Zarkovic et al., 2007)

Adult blood donors (Waikato) 0.7% 140 43 (17-69)

survey, one pet dog (17 years old) from 36 tested (three Is it time to update the treatment advice we give?
percent) was positive, as were three pet cats (two under It’s extremely easy to treat Toxocara, with choices
one year old, one age unknown) from 31 tested (9.7%) including tasty chews for dogs and spot-on products for
(Woollett et al., 2016). Dogs are more often implicated in cats. Given that the prepatent period of Toxocara spp. is
HT than other animals, but we can’t dismiss the role of the just over a month, worming monthly is the best way to
domestic cat. A recent survey of public spaces in New York minimise egg shedding in animals. However, the common
showed Toxocara cati as the predominant Toxocara spp., advice to worm every three months has been around for
leading the authors to conclude that feral or untreated decades, and it appears veterinarians are reluctant to
cats represent a significant source of environmental update it based on two main objections: one, Toxocara
contamination (Tyungu et al., 2020). spp. have low prevalence in adult animals and cause

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GLOBAL WORMING

little to no clinical disease, and two, over-medication Key recommendations
could cause resistance. The fact that infection in adults The European Scientific Counsel for Companion Animal
is less common than it is in juveniles should be weighed Parasites provides research-based, independent advice to
against the comparatively large ratio of adults to puppies veterinarians and pet owners. It recommends that adult
and kittens; this means adults account for a significant dogs and cats who go outside be wormed four times a
proportion of eggs entering the environment (Morgan year, or monthly if they are fed raw meat, are working
et al., 2013). In addition, unnecessary drug exposure and or therapy dogs, are in contact with children under five
resistance should always be considered when prescribing years (that includes if dogs or cats go near areas where
prophylaxis, but not at the expense of minimising zoonotic children play such as playgrounds or sandboxes), and/
risk and safeguarding children’s health (Pennelegion or live with individuals who are immunocompromised.
et al., 2020). Veterinarians’ worries about resistance I’ve always been in the ‘let kids eat soil’ camp, and there’s
development (Matthews, 2016) are understandable when lots of evidence to suggest that ingesting small numbers
we look at production animals. Production animals are of all sorts of allergens and microbes prevents some
in closed environments where those animals that shed autoimmune diseases (Robinson et al., 2010). Toxocara
eggs are all treated at the same time. Therefore the is not one of those. The veterinary community has an
only contamination on pasture would be from resistant important role in protecting public health as well as animal
parasites that survived treatment. The epidemiology for health and there are many ways to reduce environmental
pets is very different. Parasites of dogs and cats have large contamination from Toxocara.
natural reservoirs of infection (refugia) (Pennelegion et
al., 2020) that are not exposed to dewormers, such as For readers wanting more information, a good resource
birds, rodents and feral cats, and of course the numerous is a webinar by Eric Morgan, a Professor of Veterinary
pet owners who are actively providing refugia for us Parasitology at Queen’s University Belfast. The webinar
(they probably use a neighbouring practice). Given this, is aptly titled Toxocara Canis: How safe is that sandpit?
an argument for not treating monthly to reduce the risk It can be viewed online at https://bit.ly/3eHtFdv. Since
of resistance development doesn’t make sense. We would this video is from the UK, veterinary professionals
be deliberately withholding treatment and allowing in New Zealand should use professional discretion if
zoonotic worm eggs to be shed into the environment – a applying it here.
practice that’s difficult to justify on public health grounds.
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