Veterinary Vertex
Veterinary Vertex is a weekly podcast that takes you behind the scenes of the clinical and research discoveries published in the Journal of the American Veterinary Medical Association (JAVMA) and the American Journal of Veterinary Research (AJVR). Tune in to learn about cutting-edge veterinary research and gain in-depth insights you won’t find anywhere else. Come away with knowledge you can put to use in your own practice – along with a healthy dose of inspiration to remind you what you love about veterinary medicine.
Veterinary Vertex
Unveiling the Risks of Leash-Related Injuries Among Dog Walkers
Discover how an everyday activity like dog walking could be trickier than it seems, especially for seniors, as we delve into a riveting conversation with Dr. Rodrigo Rosa. This episode casts a spotlight on the rise of leash-related injuries and how they disproportionately affect women over 65. Uncover the nuances behind these statistics, including the alarming rate of serious injuries such as traumatic brain injuries. Rodrigo's insights challenge us to consider the gaps in safety data - from dog breeds to leash types - and the importance of preventative strategies tailored to vulnerable demographics.
Turning the leash on the conversation, Rodrigo's revelations extend beyond the data, fostering a broader dialogue about the intersection of human and canine health within our communities. Despite the scare of injuries, dog walking remains a low-risk, high-reward activity for most, though surprisingly underutilized by dog owners.
JAVMA article: https://doi.org/10.2460/javma.23.11.0608
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Speaker 3:You're the one, I want Dogs should be tested for existing heartworm infection prior to starting a preventive. To learn more, visit NextGuardPlusCliniccom. You're listening to Veterinary Vertex, a podcast of the AVMA Journals. In this episode, we chat about leash-related injuries associated with dog walking with our guest, Rodrigo Rosa.
Speaker 4:Welcome to Veterinary Vertex. I'm Editor-in-Chief Lisa Fortier, I'm joined by Associate Editor Sarah Wright, and today we had Rodrigo joining us. Rodrigo, I know you're super busy, so thank you for taking time out of your day to be here with us today.
Speaker 2:It is my pleasure. Thank you for having me.
Speaker 3:All right, let's walk on over, Rodrigo. Your JAVMA article discusses leash-related injuries associated with dog walking. Please share with our listeners the background on this study.
Speaker 2:Yeah, so I've been a veterinarian for a number of years. In early last spring I decided that I wanted to go back to the training path in hopes of matching with a residency a surgery residency, that is. And then, looking at my curriculum, my resume, I realized that one thing that I really needed was some research experience. So I looked at opportunities and found out that the AO group, with which I had taken courses before, is a wonderful group and they had a program known as AO Access that matches mentors and mentees for both clinical and non-clinical competency. So that sounds like a good idea. So I applied and went through the modules. It was a great program. I was very fortunate to get matched with Dr Rich Buckley, who is a orthopedic trauma surgeon a human trauma surgeon at the University of Calgary in Canada. He was a great mentor and he was actually the one who suggested this theme as something we could look into and perhaps get something published.
Speaker 3:Yeah, it's a really cool topic, so thank you for sharing it with Javma Sure. And what were some of the?
Speaker 2:pivotal findings from this study. Yeah, this was interesting. So we looked at the literature covering the last 20 years and once we screened all the available articles and papers, we found that eight papers matched our inclusion criteria, six of which utilized the National Electronic Injury Surveillance System that is operated by the US Consumer Product Safety Commission, and some of the findings. I mean we were hoping to find more information. That we eventually did, and that was one of the wonderful things about the review process. I learned a lot with it to really determine what we can and cannot conclude from the available data. But some of the important things were one that the number of injuries did increase about two and a half fold over the last 20 years. The relative risk for women aged 65 or older was higher than for men of similar age and then younger individuals. Most injuries were finger injuries, fractures, although the second most common injury was actually traumatic brain injury. Shoulder sprains were common as well. That said, the majority of injuries were mild and treated as outpatient basis, meaning less than 10% of all cases required hospitalization.
Speaker 2:And one thing that we tried to convey was that, even though the relative risk for that specific section of the population is proportionally higher, the absolute risk of injury remains pretty low.
Speaker 2:To put it in perspective, like in 2018, there were 1,035 reported emergency room visits per 10,000 individuals in the US and 105 leash-related injuries per million people roughly one in 10,000. So the risk overall of walking a dog is low, but, yes, for an individual that is the older, that is female and perhaps with some admittedly assumed risk factors related to the dog, yes, it can be harmful and something that physicians and veterinarians should be aware of and, if the situation requires, yes, make the owner aware of and try to address that. It requires, yes, make the owner aware of and try to address that. What we found, unfortunately, was that this database, this national database, lacks information concerning dog breed, temperament, leash type, environmental conditions. It is very much human, patient focused, which is understandable, which is understandable, but it lacks information that would give us veterinarians more say information or ammunition, so to speak, to deal with, to identify risk factors that could be improved upon in our canine population.
Speaker 4:Yeah, thank you, rodrigo, you just teed up my next question.
Speaker 2:I'm just going to caution you not to talk about advanced aged women. No, senior man it's. I try to be cognizant of it, of course, but I think, uh, yes, uh, over 65, how about?
Speaker 4:I know I'm just giving you grief, as you. As you just said, this is mostly about human injuries, but, as a veterinarian, what sparked your research interest in dog walking injuries um?
Speaker 2:Yes, this actually was based on my mentor's suggestion, initially based on his impressions. So I had, over the years, as a general practitioner, two episodes two clients who were badly injured walking their dogs. One the dogs actually, you know, trip her and the second one was a leash related injury like almost a degloving injury in her hands. So I had seen those, but this is over a period of like 15 years, right? So when the topic came up, I said, well, yeah, I realized this is a potential risk and let's look into it. On the other side, rick had, as a orthopedic trauma surgeon, the impression that over the years, these injuries became more frequent. His impression is that they were usually women and usually in the winter. This is Canada, granted, so maybe ground conditions come to play to that. We could not verify that in the data, by the way. So, yeah, I think those are the two sides, that um that created the interest to look into this.
Speaker 2:Um, one of the things I did I think that's kind of interesting because most clients I guess we do the same thing is once I, once rich and I decided to, uh, look into this. I did the most obvious thing I googled it. So find out how, how, how likely it is to be injured and walking a dog, and I came across a couple of like major media outlet reports on some of these very papers and the way they reported it. Well, it was mostly accurate. It just gave me the impression that walking a dog is dangerous. I was like gosh. You know, if I was over 65, I was like I'm not sure if I'm going to walk my dog. Seems like a dangerous thing to do. So I think gosh, that does not seem to be in tune with my experience as a veterinarian. So the more reason to look into that. And, as I mentioned before, yes, the relative risk can be higher for that subgroup of the population.
Speaker 2:Our assumption, since we can't corroborate with data, is that the dog demeanor, dog size, the leash kind, all these things perhaps play a part in that risk, but overall, in the absolute risk, it's still quite low walking a dog. So we hope that this presents the data in a way that does not dissuade people from walking their dogs. We looked at the data to look at how many people actually walk their dogs and was surprised to find out that less than 50% of dog owners actually walk their dogs and while the health benefits of physical activity for humans are pretty much unquestionable. Now I'd say there is data looking at how much more likely it is that people will exercise if they own a dog. It's not really conclusive. There's some papers showing that there is a difference, others not as much, but it seems to me like there are not just physical but psychological benefits of owning a dog, of walking a dog. So our hope is that people continue to do that and, yes, be mindful of certain risks, but realizing the risk is not that high.
Speaker 4:Yeah, all very, very good points. And even though it's human injuries, as you said, as a veterinarian, we often get asked about leashes and oh, my friend got hurt and those sorts of things. Yeah, so this is really important and, selfishly, we're very grateful for it. But why did you decide to share this manuscript with Javma?
Speaker 2:Well, first, because Javma is, at least in my view, the leading journal of our profession. Right, obviously it reaches all veterinarians. And talking to Rick as well, he said, yeah, if I was to look at something in the veterinary literature I would start with Javma. So there we go. That tells me that it reaches physicians as well. But if they are to look up information concerning Pats, they're going to go to JAVMA. So it'll be a good way to present a topic that has this translational medicine appeal right To present to both veterinarians and physicians alike.
Speaker 4:Very, very good, thank you, and hopefully the podcast too. You've touched, rodrigo, a little bit on some of the very important findings. Every time we do a study, there's things you're like wow, I didn't expect to see that. What were some of those surprising findings from this study?
Speaker 2:Yes, I was surprised to find out how little information there was concerning the PET right, and maybe I shouldn't have been as surprised, but I was because I figured gosh shouldn't have been as surprised, but I was because I figured gosh.
Speaker 2:You know, if a person shows up to an emergency room with an injury, yes they document some of the pertinent information regarding the injury and obviously they focus on the human patient. That is obvious. But I was surprised to find out how little information there was related to the circumstances of the injury. I think, okay, if an accident happened, how can we learn from that to prevent it from happening again? Right, and there's very little. There's very little documented. Usually they just document it was a dog, but there's nothing about dog size, temperament. Has this happened again? What was the kind of leash used? Were there more than one dog?
Speaker 1:Things like that right.
Speaker 2:So we were hoping to be able to draw more conclusions by having that on hand, but, as it turns out, the information is just not available.
Speaker 3:And for our listeners just joining us. We're discussing leash-related injuries associated with dog walking with our guest, Rodrigo Rosa. So, Rodrigo, as you mentioned, you decided to kind of go back and pursue some advanced training. How has your advanced training prepared you to write this manuscript?
Speaker 2:Yeah. So since I lacked research experience to be able to again apply for residency, I wanted to gain more of that again apply for residency. I wanted to gain more of that some experience, even some basic training. So I looked at AO and in addition to the mentorship program, ao Access, they have the AO Program for Education and Excellence in Research, or AO Peer, and that was a lovely program because it presents several modules discussing all of the different aspects of the scientific method, so one can learn about the different types of studies a little bit about, like, basic statistics and some about medical writing. So it was lovely because I got to take that course first and I said, okay, this is great. Now I got to apply it to something and writing this narrative review was a good way to get started in a smaller project than, say, a larger study and I guess it worked out. I matched the residency. I'll be starting residency next summer.
Speaker 3:Congratulations. We look forward to hopefully seeing an original research submission from you then too, as you prepare for boards.
Speaker 2:Thank you.
Speaker 3:Now this next set of questions is really important for our listeners. What is the one piece of information the veterinarian should know before discussing leash-related injuries associated with dog walking with a client?
Speaker 2:Yeah, that's very important. So, again, it was difficult to draw as many conclusions as we hope, but looking at the information available, we can conclude that the majority of injuries were caused by dogs pulling on a leash. That seems to be a recurring theme in all these papers. So, that said, for the veterinarian I think it'd be important to identify one. Does my client fall into that category? Again, is it a female? Of course, I get it that the age topic is not a very palatable one most of the time, but I think it's reasonable to say okay, this is an adult, this may be a senior person.
Speaker 2:Is a female? Well, what kind of dog does she have? Is it a little like very quiet, well-behaved little Shih Tzu? Fine. But is it an athletic one-year-old Labrador that doesn't know how to walk on a leash? That is a potential problem, right. That could be harmful. So I think it's important to bring up the topic. Second, realizing that leash pulling is not only the result of inappropriate conditioning, but it can be a sign of behavioral abnormalities as well, right? Anxiety, fear, aggression, all of which can lead to leash pulling. So if that scenario is encountered, it would be ideal to, I think, advise the client about the risks and recommend something to address that. It might be consultation with a qualified trainer or perhaps referral to a board-certified behaviorist. I think that's how I would think about the contents of this paper in the context of a practicing veterinarian.
Speaker 3:And then, on the other side of the relationship, what's one thing clients should consider around leash-related injuries associated with dog walking?
Speaker 2:I think it's similar as well. Again, I wish I could recommend other things regarding type of leash and training, but we don't have the data. So, based on what we have, I think the same idea, I'd say if your dog cannot or will not walk comfortably on leash, then, yes, please bring this up to your veterinarian. He or she are the most qualified person to advise you and to give recommendations for training or perhaps for behavioral assessment. This is very important having a dog that can walk comfortably. Again, the senior individuals were not the only ones injured here. There were younger individuals that had similar injuries. So we know it can happen and having this, just realizing that pulling on leash is not okay, a dog should be able to walk comfortably. There's also the dog side of the issue. Right, we do have literature to show that leash pulling can be harmful to the dog. There are documented cases of tracheal injury. So the more reason to address the problem with your veterinarian if you notice that it is something consistently there.
Speaker 4:Yeah, I love how you brought it both to the human side and the dog, not just dog behavior but dog injury. So thank you for pointing out those really important combined facts and you pointed out some really cool AO programs and you probably already know. But I'm going to give out a shout to our veterinary colleague, dr Mark Markell, who's the first president of the AO Foundation. So well done, mark, to represent our wonderful profession.
Speaker 2:Yes, it's a really great group. I'm actually going to attend one of their courses now in April. It's a wonderful group. It's very inclusive. It is worldwide. I think I would highly recommend for any veterinarian to be involved in it.
Speaker 4:Yeah, that's great, Rodrigo. As we wind down, we'd like to ask a little bit more of a personal question. What we'd like to know is what is the oldest or the most interesting item on your desk or in your desk drawer?
Speaker 2:Yeah, it's a pity that I'm not on my desk right now, but I would show you. When I decided to pursue advanced training, my wife and daughter is still in New Hampshire, actually, where we reside, and I am here in South Carolina and I'll be here for the next like four years, so my daughter said, and I visit them every couple of months. But my daughter said that I needed something or someone to keep me company when I'm studying. So she looked at her toy she's seven years old, by the way. She looked at her toys and she found this little pink plastic pig. It's a cute little thing and she made a little pearl necklace for it and said that I should keep it in my desk as the office pig and that would keep me company. So I have it next to my computer. When I had it when I was writing this article.
Speaker 3:Just out of curiosity. Are those radiographs behind you? Is that a TPLO?
Speaker 2:Yes, it is. Okay, I thought, so I can be in this exam room here after the previous appointment to have a quiet spot for the interview.
Speaker 3:Very nice, just. Thank you so much, rodrigo. We appreciate you being here today and for sharing your manuscript with Javma.
Speaker 2:It was my pleasure. Thank you both for being here.
Speaker 3:And for our listeners. You can read Rodrigo's article and print Javma or online using your favorite search engine. I'm Sarah Wright with Lisa Fortier. We want to thank each of you for joining us on this episode of the Veterinary Vertex podcast. We love sharing cutting edge veterinary research with you and we want to hear from you. Be sure to leave us a rating and review on Apple podcasts or whatever platform you listen to.