Tailoring vaccine protocols to benefit the patient and practiceMay 22, 2019More and more pet owners are starting to question veterinarians and their staff about the need for vaccinating their pets due to misinformation on the internet, as well as sensationalized stories about pets who may, or may not, have experienced a vaccine reaction. Those in opposition of vaccines are passionate about their views, while those in favor are equally vehement on the subject. Is one side right and the other wrong, or is there common ground to be found? Likely a little of both. Not all is yet known about the immune system, and there is still research that needs to be done. As such, recommendations offered today are based on current information, with the full knowledge they could change in the future. Not what they used to be Vaccines were developed to help prevent infectious disease, which they do, and vaccine technology has advanced tremendously since the inception of vaccinology. Vaccine opponents often argue ingredients such as adjuvants (e.g. aluminum, mercury, formaldehyde, and foreign proteins) are reasons to not vaccinate, as they can be the cause of adverse advents. This was true in the past; however, many vaccines have been "purified" over the years through the removal of …
SPONSORED CONTENTThe Case for Year-Round Heartworm Prevention and Affordable OptionsVeterinarians are often more than just clinicians - they’re advisors, educators, and, increasingly, financial counselors. In today’s economy, pet owners may hesitate to invest in year-round prevention due to budget constraints; but, skipping even a few months of heartworm protection can have serious consequences. + Learn More
Is fear driving the anti-vaccine movement?May 22, 2019Vaccines are one of the most effective means for preventing disease ever developed and one of the great triumphs of scientific medicine. Widespread vaccination of children has dramatically reduced—and in some cases eliminated—infectious diseases that have plagued humanity for thousands of years. There is less research evidence for the impact of vaccination in companion animals, but there is ample reason to believe vaccines have been equally successful in dogs and cats.3–7 Any veterinarian old enough to remember the emergence of canine parvovirus (CPV) in the U.S. in the late 1970s, for example, would probably testify to the efficacy of vaccination in reducing the incidence of this disease.5–7 There also is compelling evidence showing the reduction of both canine and human rabies cases due to vaccination programs aimed at dogs.8–12 And similar to smallpox, the veterinary disease rinderpest was eradicated largely due to the use of an effective vaccine.13 Vaccines and autism Despite the evident success of vaccination in reducing morbidity and mortality, there has always been controversy about the practice.14 The introduction of widespread vaccination in children was initially met with resistance and legal challenges. There was fear about the safety of vaccines, as well as resistance rooted in …
Covetrus signs deal with Mars Petcare for exclusive dental health and medication productsMay 8, 2019Covetrus is now the exclusive supplier of Mars Petcare's Greenies Dental Treats and Pill Pockets. The deal allows veterinarians to purchase the products for both their in-clinic and ecommerce/auto-ship channels, helping to differentiate themselves from online competitors. "With our customer reach, differentiated go-to-market strategy, and our industry-leading service organization, Covetrus is uniquely suited to partner with Mars Petcare to drive increased adoption of dental health solutions and medication administration tools for our customers and their clients," says Matt Leonard, Covetrus's executive vice president, president of North America and global supply chain officer. "This new partnership highlights the opportunity we have at Covetrus to continuously help support veterinarians deliver cost-effective solutions and enhance their client experience." Both Greenies Dental Treats and Pill Pockets are designed to simplify oral care and medicating solutions for pet owners.
Experts weigh in on ear examsMay 7, 2019Ears. They're the bane of veterinarians and clients alike, not to mention the dogs and cats who must contend with itchy or painful ear conditions caused by environmental and food allergies, bacteria and yeast overgrowth, mites, foreign bodies, trauma, tumors, or polyps. Ear problems can spring from many different sources. That makes it essential to conduct a thorough exam, be familiar with some of the other disorders that can lead to ear problems, and know what to ask owners to bring out clues to the cause. Itch triggers Allergies are probably the number one cause of ear inflammation. Once ears become inflamed, secondary infections caused by overgrowth of normal populations of bacteria or yeast in the ear typically follow. The result is exudate, pain, and worsening inflammation. Young animals in multipet households or hoarding situations may pass ear mites (Otodectes cynotis) back and forth, especially if they aren't on a monthly preventive, are fed a poor diet, or are sick. Demodex canis is another mite that can affect young or old animals who are immune-suppressed. Less commonly, endocrine diseases (e.g. Cushing's or hypothyroidism), as well as certain autoimmune disorders, can cause ear problems. Take hypothyroidism. "Those dogs commonly will have …
New CAPC study shows Lyme disease is spreadingMay 7, 2019Research from the Companion Animal Parasite Council (CAPC) indicates seroprevalence of Lyme disease in dogs is not only increasing in the Northeast, where it is considered endemic, but also spreading into areas that were previously thought to not be at risk for this serious, zoonotic tick-borne disease. ("Seroprevalence" in this case refers to the prevalence of dogs exposed to Borrelia burgdorferi, the pathogen responsible for causing Lyme disease in the U.S. based on serologic tests—hereafter referred to as "prevalence.") Study results were published in the December 2018 issue of Environmetrics, the official journal of The International Environmetrics Society (TIES). This milestone study, titled "A Large-scale Spatio-temporal Binomial Regression Model for Estimating Seroprevalence Trends," suggests canine prevalence rates for Lyme disease are rising and that those rates are increasing most in areas where the pathogen has recently encroached. Specifically, exposure in dogs to B. burgdorferi is rising in states not traditionally considered to be areas of high Lyme risk. Significant increases in the percentage of dogs testing positive for exposure have also been seen in areas that have not yet reported significant human incidence. These findings suggest canine Lyme prevalence could serve as an early warning system for changes in …
Getting to the root of pyodermaMay 7, 2019Scaling, hair loss, papules, pustules, and epidermal collarettes. All are clinical signs pointing toward canine pyoderma. The culprit may seem clear at first glance; however, veterinarians must look at the bigger picture to address the underlining issue. It's important to first understand the meaning of pyoderma, particularly regarding the depth of infection, says Elizabeth Layne, DVM, Dipl. ACVD, clinical instructor at the University of Wisconsin-Madison, School of Veterinary Medicine. The most common form of pyoderma is superficial bacterial folliculitis, a bacterial infection of the upper part of the hair follicle, caused by Staphylococcus pseudintermedius. Deep bacterial infections (presented as swelling, nodular lesions, and oozing draining tracts) can occur, but that is a different diagnostic and therapeutic approach, Dr. Layne adds. Superficial bacterial pyoderma is almost always secondary to some kind of skin abnormality, such as atopic dermatitis. Other skin diseases (e.g. flea allergy dermatitis, sebaceous adenitis, or primary seborrhea) can also result in superficial pyoderma, Layne notes. Systemic illness or immune compromise may lead to superficial bacterial pyoderma as well. Since pyoderma commonly masks another condition, a vicious treatment cycle can ensue if the underlining problem isn't identified. "Veterinarians often recognize the signs of infection and treat with antibiotics …
Taking ECGs to the next levelMay 6, 2019The ECG has been a routine test in veterinary practice for decades, and is commonly used for diagnostic purposes, as well as an anesthesia and critical-care monitoring tool. Although the principles of ECG diagnosis remain the same, the ways in which an electrocardiogram can be recorded have changed in recent years. Some of the changes in technology now allow general practices to have access to services that were previously only provided by specialty clinics. Some of the newer technologies also allow screening ECGs to be obtained easier and faster than their conventional counterparts. Why get an ECG? When obtaining a "standardized" ECG, we generally have been taught to use alligator clips and to place the patient in right lateral recumbency. This, of course, requires time and generally two people: one to restrain the animal and the other to run the machine. Further, this technique generally is not amenable to exam room use. A newer option is to consider using a direct chest lead. To decide which technique is best for a particular clinic, it is important to know what ECGs can be used for. The simplest and most important feature of an ECG is it allows a definitive rhythm diagnosis …
Surgical endodontics: When all else fails...May 6, 2019In my previous two columns, we looked at conventional (orthograde) root canal therapy, along with vital pulp therapy. This time, we will discuss surgical (retrograde) endodontics. In instances where orthograde root canal therapy has failed, a decision needs to be made to either perform a second orthograde root canal therapy or to proceed to the next step: surgical endodontics. Extraction would be a third option for a failed root canal procedure if the owner no longer chooses to salvage the endodontically diseased tooth. Besides its use as a treatment when orthograde root canal therapy fails, retrograde root canal therapy may be the chosen course of action when an instrument breaks off while performing an orthograde procedure. Instruments most likely to break off in the canal include Lentulo spiral paste fillers, barbed broaches, and rotary files. Sometimes the detached instrument portion can be entombed in endodontic filling material during orthograde obturation, but if not, a retrograde procedure may be warranted. The procedure What is surgical root canal therapy? A surgical approach is made over the apical portion of the root, and bone is carefully removed to expose the root area (Figure 1). The apical 4 mm of the root is surgically …
How to improve your surgical skillsMay 6, 2019What can you do to improve your surgical skills? Assuming your career path does not include a surgery internship or a residency and board certification, here are some tips to raise the surgical bar. Prerequisites Some traits are self-understanding. In order to perform surgery, you need to have dexterity and think in 3D. You'll also need the following: "Good hands"—no shaking allowed. A keen sense of observation. Observe the patient. Observe the tissue. Observe others perform surgery. Some will teach you what to do, while others will teach you what not to do. Use the correct suture material, the correct needle, and the correct size. Know and apply the seven principles of William Stewart Halsted, MD, our 19th-century forefather (see The basics of surgery). Speaking of forefathers… believe the sayings they crafted: "Measure twice, cut once." "If it's worth taking out, it's worth turning in" (i.e. masses belong in the lab, not the trash). "There are routine surgeries, but there is no routine anesthesia." "Dilution is the solution to pollution." It is critical to thoroughly understand anatomy, indications, and surgical approaches. Reading books to acquire a good understanding of anatomy and a great knowledge of approaches is a must. But …
Is cranberry effective for treating UTIs?April 29, 2019Like most herbal remedies, cranberry has traditionally been employed for a wide variety of unrelated problems, ranging from diseases of the liver and stomach to blood disorders and even cancer.1 These days, however, it is pretty firmly established in the minds of pet owners—and many veterinary professionals—as useful for urinary tract infections (UTIs). It may be surprising, then, to learn there is little convincing evidence to support the effectiveness of cranberry in preventing or treating UTI. The question of whether cranberries, in some form, have value in treating or preventing UTIs is a pretty old one. In addition to historical claims among herbal medicine practitioners, there are scientific references on the subject going back to the 1960s.2 An early theoretical rationale for using cranberry to treat UTIs was it inhibited bacterial growth by acidifying the urine.3,4 However, later research has not substantiated this theory, and this rationale is no longer commonly used to explain the purported benefits of cranberry in preventing or treating a UTI.1,5 The more popular theory today is compounds in cranberry juice, particularly a group called proanthocyanidins, interfere with the attachment of some bacteria to the bladder mucosa, reducing colonization and the establishment of infection.6,7 This …
