Can you believe it .............

Anyway, it’s been lovely discussing this matter with you ladies and thank you for your interest in the topic. I now need to take care of other matters. However, if anybody reading this has an overseas dog or knows somebody who has and would like to converse further with me, either to share your experiences, or because you’ve got concerns around testing, or have a positive dog please do get in touch. I don’t use horse and hound very much so it would be better to get in contact with me via a private message on my Facebook page Brucella Canis RVN. I also have a designated email: BrucellaCanisRVN@email.com We also have a support group for owners whose dogs have tested positive where you can meet other owners in a similar situation. Please do reach out if you feel that you need that support because everybody needs helping hand now and then and you’ll find a very friendly community of people that understand. With that have a very good day everyone and I’ll bow out now. Best wishes, Louise
Ps. if anybody still feels that I should be reported to the RCVS then I supplied the link in my original post and as they are duty bound to investigate every complaint, you can rest assured that if there is a case to answer, for they will get in contact with me.
 
May I ask if you have any evidence that BC doesn’t cause fertility issues in humans? Just because it hasn’t been documented yet, doesn’t mean it can’t occur. I don’t think extrapolating from other Brucella species is the wrong thing to do when we can’t say if it will or won’t.

And do you think it’s wrong for a vet to PTS an animal suffering with clinical BC disease which cannot likely be cured?

An asymptomatic carrier (as found in one vet on screening) is a risk no? And a risk of clinical disease flare up at times of immune compromise from other factors? Ok it’s just one person, but is it fair to that one person? How many people is acceptable?

Sadly, PPE isn’t infallible, and there is still a risk to staff dealing with these animals in high risk procedures. Should it be acceptable for vet staff to be infected just because they uphold animal welfare? That feels like the old ‘so what if my dog bit you, you’re a vet, it’s your job’ when an owner doesn’t want to muzzle because it might upset their dog.

You mention ‘no evidence’ quite a bit when speaking of persistently infected, not clearing the bacteria, the symptoms it can cause. But no evidence doesn’t mean it can’t happen, or doesn’t happen, just that we don’t know. And a risk with assuming it’s ok when we don’t know if it’s ok, is that actually, it could really totally not be ok. Is it not better to be cautious?
 
It's also worth noting that Brucella canis which is being brought into this country by imported dogs, mainly from Eastern Europe, may also be able to infect cats and foxes if they are in close contact with an infected dog or its immediate environment.
 
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May I ask if you have any evidence that BC doesn’t cause fertility issues in humans? Just because it hasn’t been documented yet, doesn’t mean it can’t occur. I don’t think extrapolating from other Brucella species is the wrong thing to do when we can’t say if it will or won’t.

And do you think it’s wrong for a vet to PTS an animal suffering with clinical BC disease which cannot likely be cured?

An asymptomatic carrier (as found in one vet on screening) is a risk no? And a risk of clinical disease flare up at times of immune compromise from other factors? Ok it’s just one person, but is it fair to that one person? How many people is acceptable?

Sadly, PPE isn’t infallible, and there is still a risk to staff dealing with these animals in high risk procedures. Should it be acceptable for vet staff to be infected just because they uphold animal welfare? That feels like the old ‘so what if my dog bit you, you’re a vet, it’s your job’ when an owner doesn’t want to muzzle because it might upset their dog.

You mention ‘no evidence’ quite a bit when speaking of persistently infected, not clearing the bacteria, the symptoms it can cause. But no evidence doesn’t mean it can’t happen, or doesn’t happen, just that we don’t know. And a risk with assuming it’s ok when we don’t know if it’s ok, is that actually, it could really totally not be ok. Is it not better to be cautious?
Hello,

Thanks for your response and you make some really valuable points which I will now seek to address.

  • I don’t have any evidence that it does not cause fertility issues, and I have never said that I don’t. It is not impossible that we will not, at some point, identify an association, and therefor a cautious awareness of a link being made between adverse pregnancy outcomes and Brucella infection in other species is reasonable. However, we should also recognise that these other species are more pathogenic generally in respect of causing illness in humans, and that, despite this, the evidence base for causing adverse pregnancy outcomes is still mixed and not necessarily demonstrated in countries providing similar levels of medical provision/maternal healthcare to the UK. It is quite remarkable that we have a zoonotic pathogen first identified in the 1960s and yet, here in 2024, we still do not appear to have any published scientific reports from case studies upwards to implicate Brucella canis in adverse pregnancy outcomes or any wider fertility related issues. While we cannot rule out a possible association we also should take a risk management approach proportionate to what is known. Be cautiously aware of the possibility, but still go on living your life basically.
  • No, I don’t think it is wrong for a vet to euthanase an animal suffering from clinical Brucella canis disease. I don’t think it has been demonstrated that an animal showing clinical signs cannot ‘likely be cured’ only that some dogs appear to respond well to treatment, others less well. This is a decision to be taken in conjunction with the owner based on a holistic welfare assessment and wider circumstances, and every decision to treat or euthanase is unique to that situation. However, what I do think is wrong is for a vet to effectively take the decision out of the owner’s hands by either:
  • a. Blanket denial of veterinary care to try to treat the Brucella canis infection (leaving the owner with no choice if they want to comply with the UK’s Animal Welfare Act), or
  • b. By giving owners inaccurate, misleading, or even deliberately false information that artificially inflates risk of treatment being unsuccessful or the owner, family, neighbours, or wider community suffering adverse effects in order to elicit consent to euthanasia. That is not informed consent.
Unfortunately, I deal regularly with owners in both of those situations regularly. Brucella canis does not need to be a death sentence for the dog. There are dogs living here in the UK that did/do have an active Brucella canis infection, where the owner did elect to treat, and which are still living good quality lives several years later. But not always, and again, it comes back to the individual situation. It is worth noting though that most dogs being diagnosed with Brucella canis antibodies do not have any clinical signs, have been apparently healthy for often many years (sometimes 10 years + of history) and are picked up on a routine screening. Despite this they are sometimes being encouraged to euthanase to prevent physical suffering current or future. I am yet to be convinced that is good quality clinical decision making based on a skilful synthesis of the clinical, epidemiological and diagnostic evidence base.

  • I am not quite sure of the point being made in paragraph 3. Are we talking here about humans or dogs? I am assuming dogs and the threat this poses then to humans. An asymptomatic patient can be risk, yes, and I concur that it is possible for a dormant infection to resurface. However, again, this comes back to proportionate risk management. Brucella canis infection is a hazard, that risk management steps can be taken to manage. Normally we would seek though to take steps in veterinary practice to contain or minimise a risk consistent with continuing to provide the patient with access to high quality veterinary care. We are veterinary professionals. It is what we trained to do and we have the tools at our disposal to do this effectively and safely. I would be concerned that any veterinary practice that it that unsure of its standards of biosecurity that it feels that it cannot provide a wide range of veterinary procedures (both surgical and non-surgical) to a dog that may have Brucella canis has more fundamental biosecurity weaknesses that would make me concerned as a client that my animal is not safe at this practice from a whole host of pathogens. Brucella canis is a pathogen that is predominantly spread through reproductive tissue/fluids, has not been clearly linked to increased risk in veterinary professionals, and has been risk assessed as very low/low by human health risk assessment experts. The fundamental role of a veterinary professional is to ensure the health and welfare of the nation’s animals. I fail to see how euthanasing an animal in preference to treating it for a disease that is low/very low risk would be considered a reasonable adjustment or risk mitigation measure.
2nd part of the reply to follow.
 
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Hello,

Thanks for your response and you make some really valuable points which I will now seek to address.

  • I don’t have any evidence that it does not cause fertility issues, and I have never said that I don’t. It is not impossible that we will not, at some point, identify an association, and therefor a cautious awareness of a link being made between adverse pregnancy outcomes and Brucella infection in other species is reasonable. However, we should also recognise that these other species are more pathogenic generally in respect of causing illness in humans, and that, despite this, the evidence base for causing adverse pregnancy outcomes is still mixed and not necessarily demonstrated in countries providing similar levels of healthcare to the UK. It is quite remarkable that we have a zoonotic pathogen first identified in the 1960s and yet, here in 2024, we still do not appear to have any published scientific reports from case studies upwards to implicate Brucella canis in adverse pregnancy outcomes or any wider fertility related issues. While we cannot rule out a possible association we also should take a risk management approach proportionate to what is known. Be cautiously aware of the possibility, but still go on living your life basically.
  • No, I don’t think it is wrong for a vet to euthanase an animal suffering from clinical Brucella canis disease. I don’t think it has been demonstrated that an animal showing clinical signs cannot ‘likely be cured’ only that some dogs appear to respond well to treatment, others less well. This is a decision to be taken in conjunction with the owner based on a holistic welfare assessment and wider circumstances, and every decision to treat or euthanase is unique to that situation. However, what I do think is wrong is for a vet to effectively take the decision out of the owner’s hands by either:
  • Blanket denial of veterinary care to try to treat the Brucella canis infection (leaving the owner with no choice if they want to comply with the UK’s Animal Welfare Act), or
  • By giving owners inaccurate, misleading, or even deliberately false information that artificially inflates risk of treatment being unsuccessful or the owner, family, neighbours, or wider community suffering adverse effects in order to elicit consent to euthanasia. That is not informed consent.
Unfortunately, I deal regularly with owners in both of those situations regularly. Brucella canis does not need to be a death sentence for the dog. There are dogs living here in the UK that did/do have an active Brucella canis infection, where the owner did elect to treat, and which are still living good quality lives several years later. But not always, and again, it comes back to the individual situation. It is worth noting though that most dogs being diagnosed with Brucella canis antibodies do not have any clinical signs, have been apparently healthy for often many years (sometimes 10 years + of history) and are picked up on a routine screening. Despite this they are sometimes being encouraged to euthanase to prevent physical suffering current or future. I am yet to be convinced that is good quality clinical decision making based on a skilful synthesis of the clinical, epidemiological and diagnostic evidence base.

  • I am not quite sure of the point being made in paragraph 3. Are we talking here about humans or dogs? I am assuming dogs and the threat this poses then to humans. An asymptomatic patient can be risk, yes, and I concur that it is possible for a dormant infection to resurface. However, again, this comes back to proportionate risk management. Brucella canis infection is a hazard, that risk management steps can be taken to manage. Normally we would seek though to take steps in veterinary practice to contain or minimise a risk consistent with continuing to provide the patient with access to high quality veterinary care. We are veterinary professionals. It is what we trained to do and we have the tools at our disposal to do this effectively and safely. I would be concerned that any veterinary practice that it that unsure of its standards of biosecurity that it feels that it cannot provide a wide range of veterinary procedures (both surgical and non-surgical) to a dog that may have Brucella canis has more fundamental biosecurity weaknesses that would make me concerned as a client that my animal is not safe at this practice from a whole host of pathogens. Brucella canis is a pathogen that is predominantly spread through reproductive tissue/fluids, has not been clearly linked to increased risk in veterinary professionals, and has been risk assessed as very low/low by human health risk assessment experts. The fundamental role of a veterinary professional is to ensure the health and welfare of the nation’s animals. I fail to see how euthanasing an animal in preference to treating it for a disease that is low/very low risk would be considered a reasonable adjustment or risk mitigation measure.
2nd part of the reply to follow.
2nd part:

  • PPE is not infallible and we will all know examples of when this is accidently breached, or indeed, when it has just not been used appropriately. However, again, we come back to risk quantification. For infection to occur during a PPE breach we would need multiple factors to co-occur, from the dog to have a current active infection, to the tissue being handled to contain the bacteria, to there being a clear entry point for the bacteria to enter via during that specific breach, and so. That is just to become infected. Then, as most people do not appear show clinical signs/become unwell we then have to model the risk of this. To put in perspective, if for a given outcome events A, B, C all need to co-occur and if only these 3 events are needed for outcome Z to occur, and if A, B, and C all independently have a 1% risk of occurrence, then the % risk of outcome Z occurring would be: ((0.01 x 0.01 x 0.01)*100) = (0.000001 x 100) = 0.0001%. If we add in another necessary independent event D with a 1% risk of occurring then we the % risk of Z is now: 0.000001%! So to return to practice: how often are there PPE breaches in your practice during a given procedure? What is the likely % risk that the dog being treated is seropositive for Brucella canis and, if positive, that this represents a genuine positive result (i.e. has Brucella canis antibodies), that this is associated with a current active infection as opposed to a historic infection? And, for a given procedure what is the risk of you coming into contact with a particular tissue/fluid? And so on. While we cannot say that no risk exists we also need to be cognisant of the likely risk that of exposure that exists given a conjunction of events generally needs to co-occur.
  • However, that does not mean that we should just ignore the risk and it is reasonable to do a risk assessment and look for areas within the practice where biosecurity could be improved to better promote staff safety while seeking to continue providing high quality veterinary care. For example, are there areas where biosecurity could be improved to reduce risk further (e.g. vet nurses not clearing up theatre and de-ratcheting body parts from artery forceps with bare hands while waiting for the patient to recover? More regular hand hygiene measures? Etc). I am not saying ignore staff safety, but my value judgement here is that we are trained professionals who have the capacity to continue providing high quality veterinary care and that this is also consistent with protection of staff safety and that this would be more consistent with the role and remit of the veterinary professional. Our NHS colleagues continued caring from Covid-19 patients and that was killing them – we are killing our patients out of fear of a pathogen that has never been linked in the scientific literature to a human death or an adverse pregnancy outcome, and that has been assessed as low/very low risk to humans, and that we have the tools at our disposal to further mitigate risk for.
  • So, to address your final point. Absolutely we should be cautious, and seek to take risk mitigation measures as we would do for any hazard in the veterinary practice, whether that is from spilt liquid on the floor to a dog or cat that looks like it might be a bite risk. If any veterinary professional did not routinely take measures to minimise/manage risk while delivering healthcare to animals I would potentially have fitness to practice concerns. But those measures should be proportionate to the absolute and relative threat posed, and that is what is sometimes not happening in UK veterinary practices and it is not always clear what underpins this as veterinary professionals deal with likely greater risks regularly without this degree of fear and exaggeration of threat. I think we need to be scrutinising this in greater detail to better understand what is the motivational drivers underpinning this but on the shop floor but also at more senior levels intra- and extra-veterinary profession.
Thank you for engaging with the discussion though and for raising valuable points here that should be explored. This is a zoonotic infectious disease at the end of the day so it is right that we do keep this in mind when reviewing the risks.
 
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It's also worth noting that Brucella canis which is being brought into this country by imported dogs, mainly from Eastern Europe, may also be able to infect cats and foxes if they are in close contact with an infected dog or its immediate environment.

The evidence for infection in cats is pretty poor. There is limited evidence to suggest they mount an immune response when experimentally infected but clinical disease does not seem to occur other than potentially transient 'off colour'. The UK government Brucella experts do not think that we need to be concerned about testing cats, even cats living in households with Brucella canis positive dogs. That is an epidemiologically significant lack of concern given that many cats in the UK have outdoors access and likely signifies current lack of worry about this mechanism of transfer.

Brucella canis has been demonstrated in wild canids so that is a theoretical concern. However, again, the practical significant of this is unclear. Given that it is increasingly becoming clear that the primary mechanism of transfer is reproductive, given the likely very low levels of prevalence within the UK, along with multiple other factors from behaviour biology to stability of the pathogen outside the dog, etc we need to consider that probability of infection is likely to be low. But, yes, that would be a possibility, and we also could not discount the possibility that it is already endemic to foxes and has been for years. It has never been researched to the best of my knowledge in UK wild canids. We do know that in circa 1980, in a small scale prevalence study of dogs, 2 dogs out of roughly 140 (from memory published in the Vet Record) were reported positive for Brucella canis. I could find nothing to suggest that this had been followed up with any further research. Both dogs were UK born albeit to 'foreign' (USA from memory but again don't take my word for it, if that detail is important confirm it as my memory could be wrong) parents. So Brucella canis is certainly not a new phenomenon to the UK, it is just under more scrutiny at present due to probably increased global interest in this disease but also the growth in popularity of imported dogs over the last decade or so.

Thank you for your valuable points of discussion.
 
That information came directly from the HAIRS risk assessment that you have mentioned.

I think your key starting point really for the concern that you have there in relation to it not being as dangerous as thought, would be to read the HAIRS report 2023 link that I’ve shared in one of my other posts. That is the government risk assessment based on the current evidence base that we have for BC. That report was finalised in roughly July 20 23 and so is relatively up to date. That’s partly based on worldwide information and also partly based on epidemiological data collected within the UK since we started to become aware of BC.
 
There being no paragraphs is a ridiculous reason to ignore someone

It's not ridiculous, I can't read it either and neither can I read 'stream of consciousness' stuff with no punctuation or capitals, it makes my brain hurt. I used to kick off at the posters through frustration, but wised up and just put them on UI instead as it's not their fault I can't deal with it.
Understanding works both ways.

I'm sure you're well aware that not all of our brains work the same way. As someone who likes to ding on and on and on about things ;) the least I can do is press the return key a few times.
 
It's not ridiculous, I can't read it either and neither can I read 'stream of consciousness' stuff with no punctuation or capitals, it makes my brain hurt. I used to kick off at the posters through frustration, but wised up and just put them on UI instead as it's not their fault I can't deal with it.
Understanding works both ways.

I'm sure you're well aware that not all of our brains work the same way. As someone who likes to ding on and on and on about things ;) the least I can do is press the space bar a few times.
I believe it is ridiculous because it took me a minute to add spaces so people could read it.
It is not as if the text was not editable.

Complaining about things that are easily changeable just so you don’t have to take notice of someone’s opinion isn’t fair.

I’m glad you would press the space bar a few times but I’m very sick of peoples obsession with disregarding people opinions because of grammar and spelling on this forum.
 
I believe it is ridiculous because it took me a minute to add spaces so people could read it.
It is not as if the text was not editable.

Complaining about things that are easily changeable just so you don’t have to take notice of someone’s opinion isn’t fair.

I’m glad you would press the space bar a few times but I’m very sick of peoples obsession with disregarding people opinions because of grammar and spelling on this forum.

It's not an obsession, it's not disregarding it, it's very hard for some people with brains like mine to read and understand, to be able to regard it? It's easy *for you*.
Looks like tolerance only works one way 🤷🏼‍♀️

If you read my post I haven't actually agreed or disagreed with anything the person has actually said. Mainly because it's incredibly off-putting for someone like me to look at.
I do enough digging through documents in my work so I'm not going to correct someone else's work in my leisure time.
 
I believe it is ridiculous because it took me a minute to add spaces so people could read it.
It is not as if the text was not editable.

Complaining about things that are easily changeable just so you don’t have to take notice of someone’s opinion isn’t fair.

I’m glad you would press the space bar a few times but I’m very sick of peoples obsession with disregarding people opinions because of grammar and spelling on this forum.
I’m afraid I also couldn’t read it. It’s not an obsession on my part.
 
It's not an obsession, it's not disregarding it, it's very hard for some people with brains like mine to read and understand, to be able to regard it? It's easy *for you*.
Looks like tolerance only works one way 🤷🏼‍♀️

If you read my post I haven't actually agreed or disagreed with anything the person has actually said. Mainly because it's incredibly off-putting for someone like me to look at.
I do enough digging through documents in my work so I'm not going to correct someone else's work in my leisure time.
You quoted me not the other way around
I have no problem if you don’t have the time to accommodate someone.
I have a problem with people above pointing out that their opinion isn’t worth reading because their grammar is lacking.

If you can’t read it or don’t want to that’s perfect and you move on.
I’m happy to help and make accommodations so I added paragraphs for everyone.

It’s not about tolerance it’s about being nice. And the comments made about their lack of paragraphs were not nice.
 
You quoted me not the other way around
I have no problem if you don’t have the time to accommodate someone.
I have a problem with people above pointing out that their opinion isn’t worth reading because their grammar is lacking.

If you can’t read it or don’t want to that’s perfect and you move on.
I’m happy to help and make accommodations so I added paragraphs for everyone.

It’s not about tolerance it’s about being nice. And the comments made about their lack of paragraphs were not nice.

There's probably nothing wrong with the grammar, that wasn't the main thrust of my comment. You could have also moved on rather than called those of us who expressed an issue 'ridiculous'.

Why does the said poster need my accommodation, as you put it, but they can't accommodate others? Again, it sounds pretty one sided.

It's not about being 'nice', (is calling someone else's issue 'ridiculous' nice?). What is the difference between being 'tolerant' and 'nice'?
Is 'nice' only when you agree with it?
(An English teacher once told us off for using 'nice', he said it was a 'nothing word' 🤣)

Anyhoo, I just meant to merely explain that I have the type of brain that just nopes out when they see that type of text. I can't comment on the points as I find it illegible, well done to those who can manage it.
It seems like I am not the only one, maybe the poster would get more feedback/discussion if they made a few accommodations 😀
 
Grammar, spelling, punctuation, etc. are all very important if you want to be understood, it’s what they were invented for. It’s not just an optional quirk.
Particularly if you are trying to convince people about your professional opinion and highlighting your qualifications to do so.
 
I think it would be good if people could get their point across using fewer words. I tend to lose interest when I have to wade through reams of it
Yeah, ChatGPT just seems to use ALL of the words available. I couldn’t be arsed arguing with a machine, good on the rest of you for continuing.
 
Yeah, ChatGPT just seems to use ALL of the words available. I couldn’t be arsed arguing with a machine, good on the rest of you for continuing.
It reminds me of undergraduates who write a lot, in the hope that it makes them sound as if they know and understand the subject.
 
I have been watching this unfold on the sidelines as I wasn’t a member and I couldn't comment.
I may be incorrect but from my observations it appears that they only person commenting on here that actually has a professional Veterinary background is Louiseandsadie.

As this person has been open about who she actually is I took the opportunity to check out her qualifications, she is a registered RVN as well as holding a PhD and has lectured veterinary professionals in evidence based veterinary practice.
Evidence based diagnosis is exactly what she is advocating here, she is for pre import testing and accepts that we need to mitigate the risks. What she is trying to do is stop dogs who have tested positive on a test that has a high risk of false positives being euthanised unnecessarily or denied Veterinary treatment. When the risk has been downgraded to low for Veterinary professionals and very low for the general population.

I personally will be following the science and listen to someone who has read the papers(large blocks of text) who has spent the last last year researching this, talking to Vets and scientists and more importantly dealing with people who are actually experiencing this with their dogs.
Than believe the rhetoric of someone who by their own admission can’t be bothered to read what has been written because they find it too difficult and have better things to do.
 
Hi BlueDiamond, welcome to the forum! Interesting first post!

In case you might think I am thick or something, I actually have been reading and writing for a living for over 20 years, and am reading in my spare time, a collection of academic essays (which the authors have kindly put into paragraphs), but unfortunately large blocks of text make my brain itch and are an instant turn-off, so it doesn't really matter how interesting/informative the content is.
Like I say, my father was personally involved in the fight against bovine brucellosis for many years and observed the work of veterinarians and I will be interested to hear what he has to say on the subject :)

I notice your mate hasn't denied using Chat GTP, or maybe she has and my brain/eyes were too boggled to read it. I do see there are bullet points and paragraphs on some of the posts now which is a lot easier for people like me to read, particularly on a phone/smaller device, it looks a lot better on a desktop PC.
 
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