An Eco-Friendly Ending
CLIENT COMMUNICATION TELEHEALTH PARASITESAPRIL 2022trends.aaha.orgAn Eco-Friendly EndingAquamation Gaining Popularity as Alternative to Cremation 24AAHA 2022 PainManagement Guidelinesfor Dogs and CatsExecutive Summary of the LatestGuidance from AAHA 35
Get SmartKeeping Upwith the BugsInnovating to Meetthe Challenges of PetParasitesby Maureen Blaney FlietnerParasites aren’t the most pleasantpart of veterinary practice work. Notonly must veterinary teams identifyand treat for parasites and educateclients, they must also stay vigilantto protect themselves from zoonoticdiseases. To make matters moreconcerning, parasites are spreading,migrating, and showing resistance tocertain treatments.Intestinal parasites continue to be onthe rise in the United States, accordingto Craig Prior, BVSc, CVJ, a boardmember and past president of theCompanion Animal Parasite Council(CAPC). “Every year on CAPC maps,we see more parasites showing upin areas they shouldn’t,” Prior said.“A lot of this is because parasites aredynamic, ever changing, and on themove. We’re also seeing parasite ratesgo up.”Prior noted a 2019 study byJason Drake, DVM, DACVM, thatrevealed increasing prevalence forroundworms and hookworms, and, forthe first time, apparent seasonality tocanine whipworms.“Every year on CAPC maps, we see moreparasites showing up in areas they shouldn’t.”—CRAIG PRIOR, BVSC, CVJ, VETERINARY CONSULTANTHookworm photo courtesy of Antech“We’re also seeing resistanthookworms. It started in the greyhoundpopulation in Florida and now hasmoved to the general dog population,”said Prior. “The conversation changeswhen you have resistant hookwormsbecause we don’t need to be helpingto further that resistance. We asveterinarians should be practicingpreventative medicine, preventingAPRIL 202255
disease in not just animals butin humans.”Ticks also are on the move.The Asian longhorned tick wasreported for the first time in the UnitedStates in 2017 in New Jersey. Able toreproduce without mating, it spreadrapidly. According to the Centers forDisease Control and Prevention (CDC),the tick is now found in 17 states fromArkansas to New York, and discoveredon pets, livestock, and wildlife.The lone star tick also continuesto expand its range and numbers,according to the CDC. It is now foundas far north as Maine and as far westas central Texas and Oklahoma. It cantransmit several bacteria and otherdisease-causing agents that cancause, for examples, cytauxzoonosisin cats and ehrlichiosis in dogs.What can be done? Trends reachedout to several sources who sharedhow they are innovating to meetthe challenges.Molecular DiagnosticsIn January, Antech Diagnosticslaunched a molecular testing platformfor parasites called KeyScreen GIParasite PCR.PCR (polymerasechain reaction)offers the mostsophisticateddiagnostic modalityM. Leutenegger, for the COVID virus.DMV, BSc,Antech’s molecularPhD, FVHtesting modality forparasites is essentially the same,offering the most sensitive test forparasites, explained Christian M.Leutenegger, DMV, BSc, PhD, FVH,director of molecular diagnostics atAntech Diagnostics.The testing platform identifieszoonotic and anthelminticdrug-resistant parasites thathave evolved to become a moreserious concern, a hallmark beingmultidrug-resistant hookworms, heexplained. It also is the most sensitivetest for parasites in veterinarymedicine, differentiating round- andtapeworms and identifying importantparasites such as Toxoplasma,whipworms, protozoa, and coccidia.Leutenegger said Antech is investingheavily in molecular technologies,which are key for fast and affordableparasite screening in wellness exams.He expected that the most importantcost and efficiency benefits forveterinary practices would be: Rapid access to highly actionable“Molecular testing is fundamentallydifferent and more sensitive than anyother kind of diagnostic testing. Itcan detect a much broader range ofparasites from one small sample. Ourtest currently detects 20 parasites.It accomplishes this by reading thegenetic material, or the DNA/RNA, ofa parasite,” said Leutenegger.information that will allow practicesto provide effective treatment fromthe first visit instead of having thepet return months later becausethey “still aren’t 100%.” The ability of veterinariansto practice pharmaceuticalstewardship because there isno risk of overtreatment if they“Molecular testing is fundamentallydifferent and more sensitive than anyother kind of diagnostic testing.”—CHRISTIAN M. LEUTENEGGER, DMV., BSC, PHD, FVH,ANTECH DIAGNOSTICSAncylostoma Trichuris56TRENDS MAGAZINEChristian M. Leutenegger, DMV, B.Sc., Ph.D., FVH, photo courtesy of Antech Diagnostics
Parasite Challenges Get Smart know exactly what’s there andhow to treat it.Saving time and resources as themolecular test requires a verysmall sample—0.15 grams—whichcan be stored for 10 days aftercollection. Practice staff cansubmit the sample without anyspecial preparation and sendit refrigerated to the Antechlaboratory.“Veterinary practices are havingto serve more patients with fewerresources so the time and resourcebenefits of the more sensitive testcan’t be understated,” he explained.Leutenegger said this innovationwill provide a broader database ofthe prevalence and spectrum ofgastrointestinal parasites in pets, alevel of differentiation that currentdiagnostic modalities do not have.Other than for COVID PCR testing,molecular testing for parasites isn’twidely used in human medicine,explained Leutenegger. And whilethere are more and more PCR tests,turnaround time is often weeks.“You could argue that veterinarymedicine is once again ahead ofhuman medicine.”used one anthelmintic, determinedlack of efficacy, and then used acombination of different anthelminticclasses with appropriate follow-uptesting,” explained Antoinette Marsh,JD, MS, PhD, associate professor ofparasitology at Ohio State University.She also chairs the AmericanAssociation of Veterinary ParasitologistsHookworm Task Force.“Just because a dogis infected withhookworms doesn’tmean it is drugresistant. It reallyAntoinettemeans the ownerMarsh, JD,and veterinarianMS, PhDneed to worktogether to identify if it couldpotentially be drug resistance orsomething else because there areeffective treatments for GI parasites,including hookworms,” she noted.“We are seeing treatment successesat Ohio State by following dogsthat are initially hookworm fecalpositive. We document treatmentsuccess through subsequent fecalexaminations. Dogs are treated andthen, 12 to 14 days later, we get afollow-up fecal. If it cleared, we havesuccess. If it did not, then we checkwhat dewormer was used and if weneed to provide additional treatment.”A Hierarchy of ProtocolsAt Ohio State University, a study ofdrug-resistant hookworms is innovatingby bringing information learned fromother areas to companion animals.“Resistant nematodes are not new. It’snot something that sporadically justhappened in dogs. We have seen itcoming through our understanding ofthe treatment of livestock and horseparasites. Livestock practitioners“There’s a hierarchy of protocols weare currently using,” said Marsh, “suchas if we need to use a combinationtherapy of three different classesof dewormers or an alternativetreatment. Pablo Jimenez Castro,DVM, associate chair of the taskforce, provided laboratory-basedstudies to support this approach.”If a dog is positive for hookwormegg shedding, it needs to bemonitored and rechecked, she said.Veterinarians also need to learnwhether their clients are buyingdewormers off the internet andwhether they are being sourced fromreputable outlets.Marsh said she sees more challengesahead. Appropriate health anddiagnostic screening need to be donefor dogs involved in cross-country orinternational trips or rehomed afternatural catastrophes since someplaces have parasites other areasdo not. In addition, climate changeis allowing endo- and ectoparasitesto become established in new areas,she noted, pointing out that Ohio nowhas nine fewer frost days.Artificial IntelligenceZoetis’ Vetscan Imagyst uses thedeep learning of artificial intelligenceas its innovation to meet parasitechallenges. The first-of-its-kindtechnology allows for quickidentification of specific parasite eggsin fecal samples, thus saving time andeffort for technicians.“One of the thingswe have learnedfrom COVID is thattime is everythingfor technicians andveterinarians. AndRichard E.Goldstein, DVM,now there is such aDACVIM (SAIM),shortage ofDECVIM-CAtechnicians,” saidRichard E. Goldstein, DVM, DACVIM(SAIM), DECVIM-CA, vice presidentand chief medical officer at ZoetisGlobal Diagnostics, Medical Affairs.“This deep learning algorithm givesus real-time results and saves anestimated 15 minutes for a technicianon every sample.”Antoinette Marsh, JD, MS, PhD, photo courtesy of Antoinette Marsh. Richard E. Goldstein, DVM, DACVIM (SAIM), DECVIM-CA photo courtesy of Zoetis Global DiagnosticsAPRIL 202257
Trichuris ParasiteWith AAHA recommending frequenttesting for parasites, it’s a lot forveterinarians to accomplish, saidGoldstein. The Vetscan Imagystcan do the fecal at the level of aparasitologist within 10 minutes atthe veterinary hospital. It uses acontained sample, with one gram putin a tube for two minutes and onedrop put on a slide into the device.“Five to seven minutes later, theresults are in, and you can talk tothe owner in real time. If the pet isnegative, that’s great. If it has giardia,hookworms, roundworms, and such,you can take care of that at the time,helping with compliance issues andgiving you back tech time.”The algorithm lives in the cloud,not on the device itself. Upgradedperiodically and taught byboard-certified parasitologists,the algorithm reviews thousandsof identified images to learn todifferentiate. It can identify 99%of the parasites seen in the US,said Goldstein.Just-in-Time LearningFlipping tick-bite preventioneducation from a just-in-caseapproach to a just-in-time approach isthe inspiration behind innovative tickefforts this spring.58TRENDS MAGAZINEDouble Cystisospora ParasiteToxocara Parasite“What we’velearned fromTickSpotters, ournationwidecrowd-sourced tickThomas N.survey, is that whileMather, PhDmost people learnabout ticks andtick-bite prevention using just-incase approaches such as lectures,brochures, and media reports whenthey actually have a tick encounter, itcan be difficult to accurately recall thatinformation,” explained Thomas N.Mather, PhD, professor and director ofthe Center for Vector-Borne Diseases,University of Rhode Island.one is going to scan a QR code,”explained Mather. “Well, we haveall learned how to scan a QR codebecause we were buying takeoutfood or looking at drink menus. Itseems like the timing is right.”He said TickSpotters is a goodexample because there is nevergoing to be someone more interestedin potentially taking action than theperson who has just taken a tick offtheir pet or child. With TickSpotters, aperson who encounters a tick, snapsa photo, and submits it then receivesthe identification and best nextactions to take.The first venture launched thisspring is a tick warning sign with atwist—a QR code, a bar code thatcan be scanned by a smartphonefor information.“Before the pandemic, I would havesaid that this is stupid because noA typical tick warning sign mayinclude such unactionable items aswear light-colored clothing.“Then the person looks down at hisblue jeans and says ‘Aw, crap. I’msunk.’ Or the sign advises to applyrepellants, but no one has broughtany along. These are not in-themoment actions one can take,”said Mather.On the other hand, a QR codeon a sign can link a person tothe BeReadyForTicks landingpage containing prioritized,regionalized information.Another just-in-time innovation theteam is working on is customizabledog ID tag blanks already etchedon the back with a high-resolutionBeReadyForTicks QR code. It linksowners with best next actions for theirmost likely scenario—just finding atick on their pet.The QR on the tag will guide theowner to confirming the tick’sidentification but also link the pet’sParasite photos courtesy of Zoetis’ VETSCAN . Thomas Mather, PhD photo courtesy of University of Rhode Island.
tick protection with a message for theowner. “You protect me once a month.Now, protect yourself by sprayingyour shoes with permethrin oncea month.”ParaprobioticsSafety concerns prompted studiesinto a new avenue of attack againstgastrointestinal nematodes that affecthumans and animals—paraprobiotics.Cry5B IBaCC offersa potentially newproduct to addressthe growing threatof gastrointestinalRaffi V.worms in animalAroian, PhDand human health.The engineeredbacterium that safely treatshookworms in animal models now justneeds veterinary and human healthpharmaceutical development partnersto push it forward, according to RaffiV. Aroian, PhD, professor of molecularmedicine at University ofMassachusetts Chan Medical School.Aroian, who developed thistechnology with his colleague andpartner Professor Gary Ostroff, PhD,explained that this paraprobiotic isnot a small-molecule or chemicalanthelmintic but a crystal protein fromBacillus thuringiensis, a natural soilbacteria family. Proteins like it fromthis bacterium have been used formore than 60 years in environmentalapplications against insects.Studies of the bacterium show it isnontoxic, effective, stable at roomtemperature, and easily delivered,and it can be mass produced by ascalable process that can be madeinexpensively anywhere in the world,he noted.Shridula Hegde, first year veterinary student (left); Antoinette Marsh, associate professor(center); and Cristina Iazbik, blood bank staff; who are part of an OSU CVM team investigatingdrug-resistant canine hookworms, along with Caroline, a recently retired racing greyhound,who is being evaluated for parasite shedding.Unlike drugs, Cry5B IBaCC worksby a different mechanism andhas been shown to attack a widevariety of gastrointestinal worms,said Ostroff. He explained that thebenefits are provided as a result ofworm-selective interactions betweenthe paraprobiotics, the crystal proteinpayload, and nematode parasitegastrointestinal system.“While a probiotic is a livemicroorganism that confers ahealth benefit when you take it, aparaprobiotic is a dead microorganismthat confers a health benefit whentaken,” said Aroian. “Even thoughprobiotics are considered safe, withinany given population there’s always apopulation of humans or animals thatwill adversely react to a live bacterium.Even for the safest probiotics, that’strue. So a paraprobiotic, a deadprobiotic, removes that concern.“When you kill bacteria, you alsogreatly reduce any concerns abouta shelf life. You put a probiotic on aRaffi V. Aroian, PhD photo courtesy of University of Massachusetts Chan Medical School.shelf and it rapidly loses its vitality.If you give a paraprobiotic, it’salready dead. It can’t lose its vitality.It’s a much more stable product onthe shelf.”Another reason for choosing thisavenue is because of environmentalcontamination issues, he noted.“Because the bacterium is dead, itcan’t replicate in the environmentso you’re not contaminating theenvironment with live bacteria. Youminimize concerns about an avenueof resistance developing, which isalways an issue with deworming drugsbecause they’re excreted into thefeces. There’s always a chance with adrug in the environment at suboptimalconcentrations that it helps to developresistant parasites.”Maureen Blaney Flietner isan award-winning freelancewriter living in Wisconsin.APRIL 202259
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With AAHA recommending frequent testing for parasites, it's a lot for veterinarians to accomplish, said Goldstein. The Vetscan Imagyst can do the fecal at the level of a parasitologist within 10 minutes at the veterinary hospital. It uses a contained sample, with one gram put in a tube for two minutes and one drop put on a slide into the device.
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and it absorbs many interests from different parts. Caofeidian eco-city plan presents some attempts on how to build a coastal eco-city under severe conditions. However, it shows that eco-city planning is far from quite perfect, and there are lots of things to be done. KEYWORDS: Eco-city, Conventional planning, Eco-city planning, Caofidian
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existing theoretical systems in Translation Studies. Keywords: Eco-translatology, eco-translation paradigm, comparative study, eco-holism, oriental eco-wisdom 1. Introduction In the field of translation studies, there have been continuous investigations and comments on contemporary translation
