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Hello and welcome to the December
episode of Chattering with ISFM.

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I'm Nathalie Dowgray, head of ISFM
and host of this month's podcast.

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Our clinical spotlight this month
is focused on genetic testing,

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practical do's and don'ts for cats.

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Kelly St.

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Denis will be speaking with Leslie
Lyons about the practicalities of

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breeding cats free of health issues.

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But first, Yaiza Gomez Meijas
will be discussing client

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communication with Tamsin Durston.

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Could you tell us what positive
psychology consists of?

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Positive psychology is about adding
value to our lives, to the lives of the

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animals that we care  about, and we try
to help with our daily work through giving

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meaning, fulfilment and quality of life.

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So it's about really thinking about
how can I give this life more meaning?

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How can I create the conditions
in which lives can thrive.

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And that means that we need to really
understand what wellbeing means

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for our human species and all the
different animal species we care about

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it's not enough to be physically
well, the physiological approach

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would be, I want this animal to
have optimum physical fitness.

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I want them to be in the
best condition they can be.

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But actually the positive psychology
approach would say, and I want them to

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feel really good all the time, because
you can be in peak physical condition

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and be having a really bad time.

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And that's what positive psychology does.

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We want people and animals to flourish,
live lives that they are happy in

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and that they can really enjoy,
despite all the stresses of the world.

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Vets need to help caregivers change
their behaviour  to help their pets.

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Behaviour change is a term we are
hearing more in the sector these

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days, but can you give us an overview
of this human behaviour change?

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It is an emerging science.

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As a clinical animal behaviourist,
veterinary nurse and a dog training

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instructor, what I'm trying to do is
influence my clients, animal carers, to

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change their behaviour, to bring about
a sense of wellbeing in the animal.

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With veterinary clients, we want
them to comply, follow treatment

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regimes, keep their appointments.

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I might be asking a client to make
some real life routine changes

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that they might not be capable of.

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If you could make these changes
to your life, that would have a

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dramatic impact on your animal's
experience and physical health but

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how do we get people to do things?

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You can't tell somebody 'Just do this'
because none of us do what we're told.

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Behavioural change science is really
about understanding those influences

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on human  behaviour and thinking about
where, as a veterinary profession,

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we have leverage in the way an
individual and a society behaves.

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How do we exert our influence?

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How do we bring about behaviour
change that's lasting?

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Some of it involves changing
the environment to make the

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behaviour you want more likely.

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How do I set the conditions to
bring about the behaviour I want?

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How do I make that behaviour reinforcing?

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The threat of punishment
doesn't really work.

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In the animal world, we
don't use punishment.

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I don't recommend positive
punishment, it creates disconnect,

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that's not positive psychology.

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That's feeling frightened
and anxious all the time.

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How do we make behaving the
way we want feel good for them.

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It is difficult because
every single person and every

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single animal is so unique.

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They have their own motivations.

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It's about thinking we won't be able
to influence everybody, but how do we

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connect with most people to bring about
the  behaviour we want and then hope

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that other people will then see that
behaviour is successful and follow it.

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It's so interesting.

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Motivational interviewing is
one of the tools we can use.

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What is motivational interviewing?

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Motivational interviewing is a form of
positive psychology, it's a consulting

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style, developed in a very practical
way for healthcare professionals by

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two psychologists who are experts in
behaviour change and psychological

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behaviour change, Milner and Rolnick.

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And this came about at
the beginning of 2002.

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It's a type of consulting where rather
than actually trying to tell somebody

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what to do, you draw it out of them.

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You empower them to realise they can

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be the architect of their own change,
people need to emotionally buy into

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making change for their animal or
themselves, if they are emotionally

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connected, they're more likely  to do it.

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It's about being non judgmental and
seeing the client as an equal partner.

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It's challenging to think of the client as
an equal partner in their animal's care.

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But motivational interviewing really
thinks about the client's own argument

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for change, and drawing out their reasons,
and their reasons may differ from ours.

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I want the client to do certain things
because it will make the animal feel

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better, but the client, their reason for
doing it may be completely different.

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To really engage with motivation it's
about establishing rapport where they

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feel they can actually share with you.

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In veterinary practice, in my experience
some clients won't open up to certain

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conditions, but will come out and talk
to the receptionist, or they'll talk

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to a different person in the practice
because they come out and go, I didn't

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want to say to the vet, but actually
my dog's growling at the grandkids,

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what can I do?

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And they perhaps haven't wanted
to say to the vet or  nurse

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because they feel embarrassed.

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Might be judged.

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They feel this is my animal.

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I should know what to do.

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Asking another person for
help makes you vulnerable.

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The concept of motivational interviewing
is about understanding the client's

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perspective, being respectful of
their needs and wishes, setting

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the situation so they feel they can
open up, really listening to their

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language, thinking about where they
are at this point in their life with

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their relationship with their animal.

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How willing to change are they and by
change I mean to follow our treatment

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plan, because that will involve changes
even if it is just three times a day

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now you're going to be giving this
medicine, it affects their daily routine.

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They might not physically have the
capability, how often do we hand out

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medicine and we don't check with people?

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Are you okay opening the bottle of this?

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Do you have someone to help you?

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It might be somebody with arthritis
who struggles to open medicine bottles,

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but they don't want to say, and unless
we try to draw out  what might be

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barriers to following our treatment
regime, we perhaps set them up to fail.

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Let's say it could be a diabetic
cat, rather than saying to the

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client, I want you to inject the
cat, to look at litter trays, etc.

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Actually, talking to the client and
saying, what do you know about diabetes?

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It's saying to the client, have
you heard of this condition,?

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Do you know anyone who's experienced this?

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What's your feeling about it?

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That tells us where they are and how
receptive they might be and you're

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seeking permission from the client
with motivational interviewing to

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talk to them about treatment regimes.

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That emphasises their autonomy
because we want them to feel powerful.

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We want them to feel as if
they are making the decision.

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Rather than saying, this is what
you have to do, we can say would

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it be okay if I shared different
options for treating your cat?

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And then you can tell me, and you
can decide what you feel would

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work best for your situation,
your lifestyle, and your family.

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And ultimately,  your cat.

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And that really, it hands back power to
the client to feel as if they are with

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you as a partner in helping their animal,
which is important because they're more

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likely to commit to our treatment plans.

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And now, Kelly St.

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Denis will be speaking with Lesley
Lyons about her JFMS Clinical

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Spotlight article, Genetic Testing
Practical Do's and Don'ts for Cats.

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Welcome Dr Lyons.

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Oh, thank you, Kelly.

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It's wonderful to join you today.

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could you tell us about what a variant is?

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A gene is made up of a
specific DNA sequence.

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Those sequences for any given gene are
very well conserved, meaning they're the

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same throughout various different animals.

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We tend now to use the word DNA
variant instead of mutation because

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everyone gets the wrong idea with
mutation, that mutation is bad.

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So changing a base pair or a sequence
within the DNA code, that's the

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variation that we're talking about.

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You've actually changed an adenine for
guanine or you can flip a sequence.

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There's all kind of different ways you
can have variants and variants occur

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through mutation and that's a good thing,
though, because if we don't have mutation,

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we don't develop genetic diversity.

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The genetic diversity we have now
is due  to historical mutations,

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some are good, some bad, most are
neutral and really don't do anything.

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And so it's actually my job to figure
out what mutations are good and

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bad and which ones are neutral and
what we should do with those guys.

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Very cool.

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Thank you for explaining that.

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I noticed we have a feline genome
sequence and the online Mendelian

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inheritance and animals list.

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OMIA.

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Yes.

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OMIA.

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I like that.

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That's good.

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What can veterinarians do with this list?

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What is the O M I A and
how would we use it?

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I use it all the time.

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And so if I'm wondering whether a
disease has been documented in a cat,

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I can go to PubMed, put in that
disease, say domestic cat, and get

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everything or I'm more likely to
go to OMIA and try the same search

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because if it's been documented,
it'll bring up  all the scientific

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publications that describe that disease.

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If a genetic mutation has been
identified, it will bring up

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the genetic information as well.

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This should be where you go and not to Dr.

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Google, right?

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And, you're going to find all the
scientific information that you need for a

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disease or particularly for a DNA variant.

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It's a wonderful resource.

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I did have a look at it.

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It looks quite amazing.

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And for our listeners, like Dr.

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Lyons does explain in the
clinical spotlight article how

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to approach it for our purposes.

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Another concept that you discuss
in the clinical spotlight article

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is that concept of validation.

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Whether it's actually resulting in
a disease phenotype, for example,

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I wonder if you could explain
that for us a little bit too?

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Yeah, there's two aspects to that.

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First off, when we identify a
DNA variant, it's usually within

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a specific breed or population.

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And so, that variant can get into
other populations by different methods.

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One is by crossbreeding.

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So a good example is Persians
with polycystic kidney disease.

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They have bred to Scottish Folds and
Selkirk Rex and other breeds as well.

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And so they've moved polycystic kidney
disease into those breeds as well.

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But sometimes you could have the
exact same mutation occur again.

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And a good example of that is pyruvate
kinase deficiency, where historically

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we know that it caused disease in
Abyssinians and Somalis, but now we see

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it in Bengals, and I think a commercial
lab has documented into Maine Coons.

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And so you could see that it would
go into Bengals because Bengals used

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Abyssinians early in their development.

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But gee, why a Maine Coon?

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How did it get there?

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So we're not sure if that's a new mutation
or the same mutation and there's been some

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type of crossbreeding that we don't know.

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And so you always need to, when
these mutations show up in other

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breeds that are unexpected, you
should do a validation process.

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Do we find disease associated
with that same mutation?

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We do know that the genetic background
of an individual, meaning other genetic

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mutations that an individual has, can
sometimes override a disease and cause

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something called incomplete penetrance.

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You have a mutation that should cause a
disease but you don't have the disease.

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And we're now starting to
understand the mechanisms which

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cause incomplete penetrance.

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That doesn't mean we shouldn't
try to eliminate those variants,

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we have to figure out whether
they cause disease or not.

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If they  do, we should be
working towards trying to really

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eradicate them as much as we can.

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Is there value for us if we find a
cat with HCM and it's not a Maine

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Coon, to send for whole genome
sequencing to see if there's a

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different mutation causing the disease?

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Is value to the research community?

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Is there value to the
pet caregiver or breeder?

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Yeah, absolutely.

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First I would order the two tests for
ragdolls and Maine coon cats, because

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you never know, as we get more data,
then we get more or less confidence.

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So should you sequence a cat?

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If you sequence a cat, you
might find the causal variant.

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That chance is about 50 50, 60 40,
that you would find it from DNA

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sequencing, and if you did, now you
know that mutation, if it's a breed

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cat, probably a lot more important
because then you want to make sure

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that's not segregating within the breed.

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If it's a random bred cat, probably
that  cat's not going to be breeding.

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However, we're always moving forward
with, if we know the gene and

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mutation, targeted therapies, drug
therapies and immunotherapies are

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being developed that can be an option.

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So DNA sequencing could give you a chance
to figure out whether you know the gene

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and the mutation and maybe that will lead
you to a targeted therapy for the cat.

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Thank you for listening.

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If you're an ISFM member, don't forget
you can access the full version of

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the podcast and all the other ISFM
member benefits including congress

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recordings, monthly webinars, the
clinical club, the discussion forum, and

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much much more at portal.icatcare.org.

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We'll be back again next month
with more from the world of

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feline medicine and JFMS.