Jason W. Stull

Carbapenemase-producing carbapenem-resistant Enterobacterales (CP-CRE) represent a growing threat to veterinary patients. Although CP-CRE infections in companion animals remain relatively rare, outbreaks in veterinary hospitals are increasingly being reported. Case reports and epidemiologic studies also support CP-CRE transmission between people and animals, making emergence in companion animals both an animal health and public health problem. However, substantial knowledge gaps limit understanding of the human and animal health impacts of CP-CRE in companion animals and of effective prevention and control interventions. For example, the true prevalence of CP-CRE colonization in companion animals is unknown, longitudinal dynamics of carriage remain poorly defined, and specific risk factors for acquisition in veterinary hospitals and community settings require further study. There are also unique structural and cultural challenges to implementing veterinary infection prevention and control practices, and evidence-based best practices tailored to veterinary settings are lacking. Diagnostic and surveillance infrastructure for companion animals is also highly fragmented, with inconsistent carbapenemase testing availability, limited mandatory reporting, and minimal capacity to rapidly detect and respond to outbreaks. This review synthesizes current clinical and molecular epidemiology of CP-CRE in companion animals; identifies critical gaps in diagnostics, surveillance, and veterinary infection prevention and control implementation; and outlines research priorities needed to mitigate and control CP-CRE within veterinary facilities. The companion Currents in One Health by Granick et al, JAVMA , 2026, addresses the clinical implications of the emergence of CP-CRE in companion animals and strategies for veterinary practitioners to mitigate spread.

Carbapenem-resistant Enterobacterales (CRE) are an emerging, multidrug-resistant threat to human and animal health. Emergence is driven by antimicrobial use and multidirectional transmission pathways between humans, animals, and the environment. Carbapenems are essential drugs for treatment of multidrug-resistant infections in humans and, although not approved for veterinary use, are infrequently prescribed in dogs and cats in an extralabel manner. In the US, CRE detections in companion animals have recently increased. While prevalence of CRE in US companion animals is estimated to be low, outbreaks in veterinary hospitals demonstrate that CRE can be transmitted within animal healthcare settings, persist in the environment, and cause operational disruption. Exchange of CRE between companion animals and people has been documented. There are several important knowledge gaps about CRE in companion animals, including (1) uncertainties in true prevalence due to infrequent testing and underreporting; (2) lack of understanding of carbapenem resistance mechanisms because of inconsistent access to testing; (3) limited data on colonization dynamics; and (4) lack of information characterizing risk factors for acquisition. A coordinated One Health approach for surveillance and preparedness is essential to identify, prevent, and contain CRE. Here we provide veterinary professionals with a comprehensive, practical overview of CRE epidemiology, mechanisms of resistance, diagnostic considerations, therapeutic limitations, and infection prevention and control (IPC) practices. The companion Currents in One Health article by Frey et al, AJVR , forthcoming 2026, reviews the current understanding of carbapenemase-producing CRE in companion animals; identifies gaps in epidemiology, diagnostics, and infection control; and outlines priorities for future research.

Highly Pathogenic Avian Influenza (HPAI) infection outbreaks have been reported in dairy cattle in different countries. Infected dairy cows can shed large quantities of virus in milk, and therefore, the milking parlour may constitute an important airborne exposure setting for farm personnel. Although sustained human-to-human transmission of HPAI has not been documented, the potential of influenza viruses to cross the interspecies barrier warrants consideration of possible spill-over events leading to multiple transmission scenarios. In addition to farm workers, dairy farms are routinely visited by veterinary clinicians and students, potentially creating epidemiological links between farms and the wider community.This study aims to simulate community spillover from dairy cattle in a setting with a local Veterinary Teaching Hospital (VTH) servicing dairy farms. We utilise an agent-based model to simulate the transmission dynamics of HPAI within and around a VTH, integrating interactions between dairy cows, farms, veterinary personnel and the surrounding community. Our results suggest that, once infection is detected in the community, the most effective containment strategy is to rapidly monitor and quarantine farmers, thereby interrupting a key transmission pathway between farms and the community and substantially reducing the magnitude of the secondary infection peak. Additionally, implementing disinfection protocols and carrying out targeted vaccinations of veterinary personnel decreased the risk of them acting as vectors between infected farms, the VTH and the wider community. However, none of the evaluated strategies mitigated the initial community infection wave, emphasising the challenges of outbreak control without established monitoring and preventive measures.The modelling framework provides a structured representation of agent movements and transmission pathways, and can be adapted to incorporate updated transmission parameters for HPAI or other zoonotic and non-zoonotic pathogens disseminated through veterinary service networks.

Over the last decades, biosecurity has received increasing attention in veterinary medicine and was recently integrated as a competency for One Health field epidemiology framework by international bodies. It is also a standard in the European System of Evaluation of Veterinary Training and in the accreditation of veterinary colleges by the American Veterinary Medical Association Council on Education. To help veterinary students and staff acquire biosecurity skills within veterinary education establishments, we first develop animal biosecurity research, and we spread its results through four interconnected instruments: biosecurity standard operating policies and procedures, a dedicated biosecurity website, an annual biosecurity day, and the production of checklists to assess the biosecurity level of compliance. The use of biosecurity standard operating procedures, the number of visits on the faculty biosecurity website, the number of people trained, and regular biosecurity audits performed are all factors that have contributed to the animal biosecurity to comply with the requirements of the European Association of Establishments for Veterinary Education and by the Council on Outcomes-based Veterinary Education, in the CBVE 2.0 book published by the American Association of Veterinary Medical Colleges. These approaches also contribute to the acquisition and maintenance of the accreditation delivered by the ad hoc bodies. The participation of students in the process allows a better comprehension and appropriation of animal biosecurity.

Objective: Using a case-based example, to provide a video tutorial on the use of a framework to identify, review, and communicate to a pet owner (veterinary client) evidence-based findings that enable the provision of spectrum-of-care options for patient management, demonstrate use of the Value Matrix, and inform shared decision-making. Animals: Any veterinary patient for which evidence-based care options along the continuum of acceptable care (often referred to as spectrum of care) is sought. Methods: Evidence-based veterinary medicine involves identifying a relevant clinical question facing the patient, client, and veterinarian and acquiring and appraising the evidence, informing the options applied to the unique case. An easily followed framework informs this process to maximize success in identifying existing veterinary evidence. Several tools, including the Value Matrix, allow for effective client communication of the options for the patient, highlighting the advantages and disadvantages for each option for situation-specific criteria. Results: Evidence-based options are identified and communicated easily, even for complex clinical questions for which there is minimal published existing evidence. Clinical Relevance: This tutorial provides practical tools that can assist veterinary professionals in collaborating with clients on making evidence-based decisions, are integral to practicing broadly across the spectrum of care, and can be adapted to each unique pet, pet owner, geography, and veterinary clinic scenario.

Objective: For horses presenting for colic to a referral hospital in Atlantic Canada, we aimed to describe clinical findings, diagnosis, treatment, and outcome for draft breeds; identify associations between clinical findings, diagnosis, treatment, and outcome for draft compared to nondraft breeds; and identify the overall impact of draft breed on mortality. Methods: A retrospective review of equine colic cases presenting to the Atlantic Veterinary College (2004 to 2023). Logistic regression models were used to assess associations between parameters and draft breed and mortality. Results: A total of 721 horse colic events were included in the study; 68 (9.4%) were categorized as draft breeds. Among draft breeds, large intestine nonstrangulating obstruction was the most frequent diagnosis (30.9%), followed by GI-related medical (23.5%) and open (19.1%). Draft breeds did not significantly differ from nondraft breeds in the type of management received (medical or surgical). At admission, draft breeds were significantly more likely to have an increased heart rate and elevated abdominal protein, peripheral lactate, total protein, and fibrinogen concentrations. Fifty-nine percent of draft breed cases survived until discharge. In multivariable analysis, draft breeds did not significantly differ from nondraft breeds in survival. Conclusions: Although draft breeds presenting with colic were more likely than nondraft breeds to present with variables associated with nonsurvival, draft breed status was not an overall predictor for nonsurvival at this referral institution. Clinical Relevance: This study describes the clinical findings, diagnosis, treatment, and outcomes for draft breeds experiencing colic at a referral institution. Draft breed status was not a predictor for nonsurvival.

There are significant welfare concerns regarding the plight of working donkeys (Equus asinus) in developing countries. To-date, however, there has been limited work assessing the welfare of donkeys in many parts of Africa, including Kenya. This study aimed to characterise the unique welfare concerns of working donkeys in Meru County, Kenya. Baseline information was gathered, concerning challenges with feeding, working conditions and disease faced by owners and drivers with differences between pack and cart donkeys investigated. To this end, 102 donkeys underwent evaluation using a Standardised Equine Based Welfare Assessment Tool (SEBWAT) and 58 owners were surveyed. Important welfare concerns, including low body condition scores (BCS) (median [IQR] 2 [1.5, 2.5 out of 5]), hobbling (81/102; 79%) and mutilation wounds (49/102; 48%) were identified in all donkeys. The following categories registered significant physical differences between cart and pack donkeys: signalment (cart 100% male, pack 21% male); BCS (median cart 2.0, pack 1.5); and presence of skin wounds on the neck (cart 30%, pack 0%). Behaviour was assessed with differences noted in chin contact avoidance (cart 56%, pack 97%), tail tuck presence (cart 46%, pack 97%), number of donkeys owned (median cart 2, pack 1), reported administration of de-worming medication by owners (cart 95%, pack 17%), and occurrence of reported illness (cart 81%, pack 38%). This initial survey addresses welfare concerns related to the Meru County donkey population and will serve as a useful benchmark for future assessments as well as targeted interventions, including the introduction of modified carts to the region.

Background: Donkeys ( Equus asinus ) in East Africa are recognised as working with poorly designed harnesses and carts. The donkey cart used in regions of Africa, specifically Meru County, Kenya, appears to place the cart's weight solely on the donkey's mid‐cervical region. The ventral area of the neck is vulnerable to external pressure on the trachea, which is superficially located. Objectives: To compare the presence and severity of endoscopic abnormalities in the upper airway and trachea of Meru County working cart donkeys compared to pack donkeys. To determine associations between endoscopic and physical evidence of harness injury. Study Design: Cross‐sectional. Methods: At voluntary health clinics, physical examination and endoscopy of the upper airway and trachea were evaluated and recorded at rest on 66 donkeys (38 cart donkeys and 28 pack donkeys). The presence and grade of tracheal collapse, tracheal ring abnormalities, tracheal mucus, and pharyngitis were subsequently determined on the endoscopy recordings by blinded evaluators. Results: Significant associations were identified between work type and tracheal collapse severity, ring abnormalities, pharyngitis, hairless skin, and thickened skin, with these findings more common in cart than pack donkeys (all p < 0.03). Moderate tracheal collapse (grade 3) was present in 40% (95% CI: 24%–57%) of cart and 0% (0%–12%) of pack donkeys. Intra‐tracheal ring abnormalities were noted in 45% (29%–62%) of cart and 0% (0%–12%) of pack donkeys. Physical examination findings were significantly and positively associated with endoscopy findings (all p < 0.002). Main Limitations: Standing endoscopy was performed at rest and dynamic endoscopy during the pulling of carts was not performed. Conclusion: Moderate tracheal collapse was seen in cart donkeys when compared to pack donkeys. Physical examination findings at rest were associated with and moderately predictive of tracheal collapse.

Veterinary services’ rising cost is an increasing barrier to pet care. Spectrum of care (SpOC) refers to evidence-based veterinary medicine options along the socioeconomic spectrum. To meet growing pet owner financial constraints and pet care needs, training to equip veterinarians with competencies to provide SpOC as Day One graduates is argued to be added as part of the veterinary curriculum. Objectives of our prospective pre- and post-survey study were to (a) determine baseline self-reported knowledge, attitudes, and competencies (KACs) surrounding SpOC in third-year DVM students; (b) develop and assess impact of a SpOC course on student self-reported SpOC KACs; and (c) obtain student feedback on the course and future SpOC training. Enrolled students (n = 35) completed the pre-survey (n = 35) and post-survey (n = 33). Results indicated that students were aware of the need for SpOC training within the veterinary curriculum, and positive changes occurred in self-reported KAC from pre- to post-survey. Students tended (p = .08) to predict better outcomes in SpOC cost-barrier scenarios from pre- (34%) to post-survey (76%), such as reduced perceived likelihood of euthanasia (63%–39%) and unsuccessful outcomes (40%–27%). Most students (31/33, 94%) predicted the course would benefit them in clinical practice and had preferred future training preferences (online modules [70%], seminars [60%], webinars [58%]). Data indicate benefits in student self-reported KACs following the SpOC course, warranting formal course inclusion, with tracking of students into clinical practice to document objective KAC impacts and perhaps similar course rollout to other institutions.