Ryane Englar

Interests

Research

veterinary medical education, curricular design, pre-clinical curricular design, clinical communication, communication models, Calgary–Cambridge guide (CCG), relationship-centered care, critical thinking, self-reflection, self-awareness, cultural humility, awareness of others, diversity and inclusion (D&I)

Teaching

clinical skills, professional skills, performing the comprehensive physical examination, medical record-keeping (SOAP notes) and other forms of documentation

Courses

Scholarly Contributions

Books

• Englar, R. (2021). Pet-Specific Care. Hoboken, New Jersey: Wiley-Blackwell.
  More info

  Pet-specific care refers to a practice philosophy that seeks to proactively provide veterinary care to animals throughout their lives, aiming to keep pets healthy and treat them effectively when disease occurs. Pet-Specific Care for the Veterinary Team offers a practical guide for putting the principles of pet-specific care into action. Using this approach, the veterinary team will identify risks to an individual animal, based on their particular circumstances, and respond to these risks with a program of prevention, early detection, and treatment to improve health outcomes in pets and the satisfaction of their owners. The book combines information on medicine and management, presenting specific guidelines for appropriate medical interventions and material on how to improve the financial health of a veterinary practice in the process. Comprehensive in scope, and with expert contributors from around the world, the book covers pet-specific care prospects, hereditary and non-hereditary considerations, customer service implications, hospital and hospital team roles, and practice management aspects of pet-specific care. It also reviews specific risk factors and explains how to use these factors to determine an action plan for veterinary care. This important book: Offers clinical guidance for accurately assessing risks for each patient Shows how to tailor veterinary care to address a patient’s specific risk factors Emphasizes prevention, early detection, and treatment Improves treatment outcomes and provides solutions to keep pets healthy and well Written for veterinarians, technicians and nurses, managers, and customer service representatives, Pet-Specific Care for the Veterinary Team offers a hands-on guide to taking a veterinary practice to the next level of care.
• Englar, R. (2021). The Veterinary Workbook of Small Animal Clinical Cases. U.K.: 5M Books.
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  This workbook is intended to be a bridge between classroom learning and clinical training; to improve patient care and clinician confidence in practice. Common presentations in small animal practice are presented as real-world case studies while the reader is guided through work-up, critical thinking and problem solving to run the consultation efficiently. Key concepts of anatomy, physiology, radiology, clinical pathology, medicine and surgery are covered and readers are guided through history-taking and diagnostics to perform an effective consultation. Cases discussed include vaccinating the new kitten, castrating the new puppy, the puppy with diarrhoea, the blind cat, the head-shaking dog, the itchy dog. Categories of complaints covered include body weight, urinary problems, the digestive system, respiratory issues, eye problems, skin and soft tissue complaints, cardiovascular, reproductive, aural and neurological complaints. The aim is to present a problem-first approach and to encourage readers to think like clinicians rather than students by instilling a case-based problem solving approach.
• Englar, R. E., Craig, M., Lobprise, H. B., Ward, E., Downing, R., Kendall, K., McLeod, K. C., Becker, M., Haworth, D., Weinstein, P., Howell, A., & Ley, J. (2021). Pet‐Specific Considerations. doi:10.1002/9781119540687.ch6
• Englar, R. (2020). A Guide to Oral Communication in Veterinary Medicine. U.K.: 5M Publishing.
  More info

  Good communication skills provide better clinical outcomes and help avoid minor as well as major mistakes. Approximately 60-80% of negligence claims against vets are related to poor communication, with new graduates especially vulnerable. Communication skills are a growing part of the curriculum in veterinary schools, recognising how fundamental clear communication is to good practice. A Guide to Oral Communication in Veterinary Medicine covers why communication skills are important, the structure of typical communications and suggested approaches, veterinary specific communication pathways, and sample scripts between vet and client. Scenarios covered include everyday communication, dealing with challenging situations, different species, different settings, and communication within the veterinary team. The aim is to instill confidence and competence, build professionalism, and avoid problems. Most current teaching is based on a toolbox approach developed from the human medicine model. However, there is no set standard for teaching methodology, which is why this is primarily a book for students, but also includes a section for educators to provide guidance in this nascent subject.

Journals/Publications

• Englar, R. E., Leal, R. O., Galac, S., Ferreira, R. L., Vicente, G., Fontes, A. P., Dias, M. J., & Oliveira, J. (2022). Ultrasonographic Detected Adrenomegaly in Clinically Ill Cats: A Retrospective Study. Veterinary Sciences. doi:10.3390/vetsci9080420
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  This retrospective study aimed to assess the prevalence of ultrasonographic detected adrenomegaly in clinically ill cats, evaluating the final established diagnosis, describe adrenal ultrasound findings and if the adrenomegaly was suspected or incidental. Abdominal ultrasonography reports of cats presenting to a veterinary teaching hospital between October 2018 and February 2021 were retrospectively reviewed. Cats showing adrenomegaly (one or both glands having a dorsoventral axis >4.8 mm) were selected and medical records respectively evaluated. Nine-hundred and eighty-three ultrasonographical reports were selected, of which, 68 (7%) disclosed adrenomegaly. European/Domestic Short-Hair (62/68; 91%) male (44/68; 65%) castrated (35/44; 80%) cats were overrepresented. Adrenomegaly was an incidental finding in 62/68 (91%) cats while in 6/68 (9%) it was identified in the context of investigating a potential adrenal disease. Concerning established diagnosis, chronic kidney disease was overrepresented (25/68; 37%), followed by endocrinopathies (20/68; 29%). Adrenomegaly was bilateral in 53% (36/68) of cases. In unilateral cases (32/68; 47%), it was more prevalent on the left side (23/32; 72%), with a normal-sized contralateral adrenal gland. Left adrenal demonstrated a larger size and a tendency to oval shape. This study assesses the prevalence of adrenomegaly in clinically ill cats, reinforcing it can be an incidental ultrasound finding.
• Baptista, R., Englar, R., São Braz, B., & Leal, R. O. (2021). Survey-Based Analysis of Current Trends for Prescribing Gastrointestinal Protectants among Small-Animal General Practitioners in Portugal. Veterinary sciences, 8(5).
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  In both human and veterinary healthcare, gastrointestinal protectants (GIPs) are considered a staple of clinical practice in that they are prescribed by general practitioners (GPs) and specialists alike. Concerning GIP use, overprescription of proton pump inhibitors (PPIs) has become a growing concern among human healthcare providers. This trend has also been documented within veterinary practice, prompting the American College of Veterinary Internal Medicine (ACVIM) to publish a consensus statement in 2018 concerning evidence-based indications for GIP use. This observational cross-sectional study evaluated self-reported prescribing protocols among Portuguese GPs to determine whether there is adherence to the consensus guidelines. Respondents were Portuguese GPs recruited by social media posts in veterinarian online forums. Data were collected from 124 respondents concerning their GIPs of choice and their rationales for prescribing them. Data were mined for prescription patterns and protocols. Among GIPs, PPIs were prescribed more often. Rationales for use included gastrointestinal ulceration and erosion (GUE), prophylactic management of nonerosive gastritis, pancreatitis, reflux esophagitis, and steroid-induced ulceration. Once-daily administration of PPIs was the most frequent dosing regime among respondents. Ninety-six percent of PPI prescribers advocated that the drug be administered either shortly before or at mealtime. Forty-nine percent of respondents supported long-term use of PPIs. Fifty-nine percent of respondents acknowledged discontinuing PPIs abruptly. This study supports that Portuguese GPs commonly prescribe GIPs in accordance with ACVIM recommendations to medically manage GUE. However, misuse of GIPs does occur, and they have been prescribed where their therapeutic value is debatable. Educational strategies should target GPs in an effort to reduce GIP misuse.
• Englar, R. (2021). Use of Deoxycorticosterone Pivalate by Veterinarians: A Western European Survey. Veterinary Sciences, 8(11), 271. doi:https://doi.org/10.3390/vetsci8110271
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  This study aims to gather knowledge about the use of deoxycorticosterone pivalate (DOCP) by Western European Veterinarians (WEV) in dogs with typical hypoadrenocorticism. An observational cross-sectional study was conducted using an online survey, translated into four languages and disseminated to veterinary affiliates and mailing lists in six countries of Western Continental Europe. Respondents were tasked to share their therapeutic approach to hypoadrenocorticism, whether they preferred DOCP or fludrocortisone and the specific practical use of DOCP. One-hundred and eighty-four responses were included. Of these, 79.9% indicated that they preferred prescribing DOCP over fludrocortisone as a first-line treatment for mineralocorticoid supplementation. A total of 154 respondents had used DOCP at least once. Eighty percent of those who reported their initial dosage prescribed 2.2 mg/kg. After starting DOCP, 68.2% of the respondents assess electrolytes 10 and 25 days after administration following manufacturer instructions. In stable dogs, electrolytes are monitored quarterly, monthly, semi-annually, and annually by 44.2%, 34.4%, 16.9%, and 4.6% of respondents respectively. When treatment adjustment is required, 53% prefer to reduce dosage while 47% increase the interval between doses. Overall, DOCP is the preferred mineralocorticoid supplementation among WEV. Reported variability underlies the need to investigate the best strategies for DOCP use and therapeutic adjustments.
• Englar, R. E., Schettler, K. A., & Ostrom, S. A. (2021). Survey of communication challenges that impact relationships between veterinarians and dog or cat breeders and proposed solutions for retaining breeders as clients. Journal of the American Veterinary Medical Association, 258(4), 407-415.
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  To characterize communication challenges between veterinarians and dog or cat breeders and elicit their perspectives on how professional relationships between the two might be improved.
• Salah, E., Abouelfetouh, M. M., Englar, R. E., Ding, M., & Ding, Y. (2021). Cardiorespiratory Effects of Three Infusion Doses of Adenosine in Conscious Goats: A Preliminary Study. Veterinary sciences, 8(8).
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  Adenosine (AD) has been implicated in human healthcare as an endogenous signaling nucleotide in both physiologic and pathologic states. The effects of AD on cardiorespiratory parameters in ruminants has not yet been studied. The objective of this study was to evaluate the cardiac and respiratory changes that resulted from an intravenous AD infusion in goats. Six clinically healthy adult goats weighing 28 ± 2 kg were randomly assigned to one of four treatments in a crossover design with a seven day washout period. The goats received a 0.9 % saline solution (SAL treatment) and three AD treatments (AD 50, 100 and 200) intravenously at a dose rate of 50, 100 and 200 μg/kg/min. Cardiorespiratory and key cardiac parameters were measured before the treatment (baseline), during the infusion (dInf) and at 1, 3, 5 and 10 min after each infusion was discontinued. The AD 100 produced a significant increase in HR ( = 0.001) and the AD 200 resulted in significant rises in HR ( = 0.006) and RR ( = 0.001) compared with the baseline. This study concluded that the AD infusion could trigger an increase in HR and RR in a dose-dependent manner in healthy goats.
• Dias, M. J., Mouro, S., Englar, R. E., & Leal, R. O. (2020). Nasal foreign bodies identified by rhinoscopy in dogs: 42 cases. The Journal of small animal practice, 61(12), 752-756.
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  To evaluate signalment, clinical presentation, location and type of nasal foreign bodies identified by rhinoscopy in dogs.
• Englar, R. E., Jones, J. L., Rinehart, J., Spiegel, J. J., Sidaway, B. K., & Rowles, J. (2018). Teaching Tip: Development of Veterinary Anesthesia Simulations for Pre-Clinical Training: Design, Implementation, and Evaluation Based on Student Perspectives. Journal of Veterinary Medical Education, 45(2), 232-240. doi:10.3138/jvme.1016-163r
• Show, A., & Englar, R. E. (2018). Evaluating Dog- and Cat-Owner Preferences for Calgary-Cambridge Communication Skills: Results of a Questionnaire.. Journal of veterinary medical education, 45(4), 534-543. doi:10.3138/jvme.0117-002r1
  More info

  Veterinary client retention by companion animal practices is influenced by whether the client feels connected to the healthcare provider. Effective communication between the veterinarian and the client facilitates that connection. To prepare new graduates for success in clinical practice, many colleges of veterinary medicine are now incorporating communication into the curriculum to emphasize its importance in establishing and maintaining the veterinarian-client relationship. A 2016 focus group study by Englar et al. evaluated dog and cat owner communication preferences for Calgary-Cambridge Guide (CCG) communication skills and concluded that dog and cat owners may have different communication needs. This study was conducted to confirm whether species-based communication preferences exist among veterinary clients. A questionnaire was distributed online and on-site, within veterinary teaching hospitals and private practices. Based upon 215 submissions from dog owners and 166 from cat owners, the communication preferences of dog and cat owners overlap. Both dog and cat owners prioritize reflective listening as the most important foundational CCG communication skill, and both prioritize asking permission as the most important core CCG skill. However, dog owners valued open-ended questions more than cat owners, and cat owners valued empathy more than dog owners. Survey limitations were largely demographic: participants were predominantly female and between the ages of 18-40 years. Survey data may therefore not be representative of the perspective of males and/or those >40 years of age.