10 Tips for Veterinary Surgery LoversApril 7, 2015Originally published in the March 2015 issue of Veterinary Practice News You don’t have time to make every mistake in your career, especially in surgery: A mistake could cause significant harm to a pet, get you in a sticky situation or cost your patient his life. These suggestions are meant to start a reflection, not to offend anyone. They apply to new grads as well as seasoned surgery lovers. 1) Make it Big “Big surgeons make big incisions.” Unless you are performing minimally invasive surgery, don’t make mini-laparotomies. Sure, you can remove a spleen or a gastric foreign body through a short incision. However, stopping there would be a disservice to your patient; that’s only half of your job. The other half is to perform a thorough laparotomy, from the liver to the bladder. 2) Perfect Your Suture Pet owners will never appreciate how flawless a surgery you performed on Kiki. The only thing they see, and they may see for the next 10 years, is your skin suture. So work hard at crafting the prettiest skin suture possible. Learn how to close dead space. Strive to appose skin spots neatly. Strive to get rid of dog ears. Figure out where you …
Find Out Why Once Every Three Years is the Trend in VaccinationsApril 2, 2015Originally published in the March 2015 issue of Veterinary Practice News After speaking with hundreds of practicing veterinarians over the past two years about vaccines and vaccination protocols, Richard Ford, DVM, has found that practitioners are slowly trending away from all vaccines to all pets every year. “I believe it is fair to say that some trends are emerging,” said Dr. Ford, a co-author on both the American Animal Hospital Association canine vaccination task force and the American Association of Feline Practitioners feline vaccination advisory panel. He has noted a growing the tendency to incorporate triennial boosters for core vaccines in dogs (distemper, parvovirus, adenovirus-2) and cats (panleukopenia, herpesvirus, calicivirus). “In speaking with vaccine sales representatives from around the country, I would estimate about half of the practices today routinely incorporate the three-year recommendation for core vaccines,” Ford said. Ford sees this largely as a good thing. “The science is abundantly clear on this point,” Ford said. “While some vaccines must be administered annually to sustain a reasonable level of protective immunity, others – namely the core vaccines – provide years of protective immunity in the majority of dogs/cats that are vaccinated. There is simply no medical …
Why Feline Kidney Insufficiency is Still Tricky to TreatMarch 13, 2015Gary Norsworthy, DVM, Dipl. ABVP (Feline), owner of Alamo Feline Health Center in San Antonio, believes veterinarians should be careful when using the term “kidney failure” in talking to cat owners. To determine kidney function, creatinine and BUN (blood urea nitrogen) tests are conducted. Kidney failure occurs in a dog in which the creatinine value from blood tests is over 2.5 mg/dl, giving a dog a month or two to live. A creatinine number over 2.4 signals kidney trouble for a cat, yet actual kidney failure for a cat doesn’t start until that number reaches 5.0 or 5.5 mg/dl, Dr. Norsworthy said. Poor word choice can come into play when a veterinarian gets blood test results back with a creatinine value over 2.4 for a cat, he said. “Many cats are diagnosed with kidney failure that don’t have failure,” he said. Insufficiency Norsworthy said that in such cases he advises practitioners to use the term “kidney insufficiency,” a phrase he considers more accurate to describe cats in this range. “That’s an important distinction,” he said. “If you use the term ‘failure,’ owners wonder if their cat’s about to die. So cats often get euthanized when they shouldn’t.” With proper …
What You Need to Know About Jaw LockingMarch 13, 2015Originally published in the February 2015 issue of Veterinary Practice News Last month, we discussed differential diagnoses for cats that are unable to close their mouths. One possible cause for cats’ and dogs’ inability to close the mouth is open-mouth jaw locking, which is rare enough that you may not have learned of it in veterinary school. Photo © 2012, John R. Lewis, University of Pennsylvania Figure 1: Open-mouth jaw locking in a Persian cat. Note the mouth is locked open so wide that there is no contact between maxillary and mandibular teeth. The slight shift of the mandible to the right suggests locking is occurring on the right. Clinical Signs and Etiology In cases of open-mouth jaw locking (OMJL), cats and dogs present with the mouth wide open, and the lower jaw often has shifted to the side where the coronoid process (the tip of the ramus) is locking on the ventrolateral aspect of the zygomatic arch (Figure 1). On presentation, patients may be drooling, pawing at the face and vocalizing. The defining clinical trait that allows OMJL to be distinguished from other possible causes of inability to close the mouth on conscious examination is that …
Where do you Stand on the Antibiotics Debate?March 4, 2015Originally published in the February 2015 issue of Veterinary Practice News Choosing the right antibiotics—or whether to prescribe them—is far from a straightforward matter, and as concern grows over excessive antibiotics use, there’s a lot to consider. From the start, veterinarians are taught the correct use of antibiotics, which includes making a proper diagnosis, taking cultures and assessing sensitivities to choose the right antibiotic. It’s the next step in the process that becomes more difficult for veterinarians, said clinical pharmacist Sue Duran, RPh, MS, Ph.D., a fellow in the American Society of Health-System Pharmacists and the chairwoman of the board certification committee for the International College of Veterinary Pharmacy. “Both human and animal clinicians experience peer pressure from owners to prescribe antibiotics for their patients,” said Duran, a clinical pharmacist with the Auburn University College of Veterinary Medicine. J. Scott Weese, DVM, DVSc, Dipl. ACVIM, said pinning down the “whys” behind antibiotics overprescribing is difficult. “There are various reasons unnecessary prescribing can happen,” said Weese, an associate professor in the department of pathobiology at the University of Guelph’s Ontario Veterinary College in Canada. In some cases, antibiotics are used without a reasonable suspicion of a bacterial infection, such as …
More Options for Bad Joints in Aging PetsMarch 2, 2015Originally published in the February 2015 issue of Veterinary Practice News There’s no shortage of ways for a veterinarian to approach the treatment of joint problems in aging pets. For dogs in particular, a path taken from several fronts is recommended by Brenda S. Kennedy, DVM, MS, of Canine Companions for Independence. “A multimodal approach is necessary to reduce pain and minimize further degeneration in the joints,” Dr. Kennedy said. “This is especially true for senior pets, who are more likely to be in a more advanced stage of the disease process.” Kennedy was to speak in January at the North American Veterinary Community conference in Orlando, Fla. Her talk was titled “Canine Longevity: Strategies to Extend Healthspan.” The multimodal therapy she refers to can include the use of nonsteroidal anti-inflammatories (NSAIDs), analgesics such as tramadol, amantadine and gabapentin, or injectable polysulfated glycosaminiglycans like Adequan, or products like oral glucosamine, chondroitin, methylsulfonylmethane (MSM), as well as omega-3 fatty acids. Adjunct therapies like acupuncture and physical rehabilitation may also be beneficial, she added. Start With Diet, Exercise The basics of diet and exercise are a message that Kennedy and other experts drive home. “Maintenance of a lean body condition along with …
Drug Maker Putney Celebrates Regulatory SuccessesJanuary 15, 2015Fresh off government approval of four generic animal drugs, manufacturer Putney Inc. this week reported receiving the go-ahead for a fifth: Enrofloxacin Antibacterial Injectable Solution. The generic version of Bayer Animal Health’s Baytril Antibacterial Injectable Solution is indicated for the treatment of bacterial infections in dogs. The Putney drug won the approval of the U.S. Food and Drug Administration’s Center for Veterinary Medicine, giving the company its fifth FDA endorsement in five months. Putney President and CEO Jean Hoffman credited the Portland, Maine, company’s research and development team for the recent approvals. “Only six generic pet medicines were approved by the FDA in 2014, and four of them were Putney products,” Hoffman said. The latest achievement made Putney the only manufacturer with an FDA-approved generic of enrofloxacin for pets in both flavored tablet and injectable dosage forms. The company’s Enrofloxacin Flavored Tablets are formulated for dog and cats. A rollout date for Enrofloxacin Injectable Solution was not announced. Three of the four Putney drugs approved in 2014—Dexmedetomidine HCl, Meloxicam Solution for Injection and Carprofen Chewable Tablets—are in veterinary pharmacies. The fourth, Carprofen Sterile Injectable Solution, is expected to be released soon, the company stated. Putney’s last approved drug of 2014, Carprofen Chewable Tablets, …
Elanco Completes Takeover of Novartis Animal HealthJanuary 9, 2015Novartis Animal Health is no more. The division of Swiss-based Novartis AG officially merged with Elanco Animal Health as of Jan. 1 in a $5.4 billion sale to Elanco’s parent company, Eli Lilly and Co. One day later, Novartis’ U.S. line of Sentinel canine heartworm and flea preventives was spun off to competitor Virbac for $410 million to satisfy regulators’ concerns. The marriage of Novartis Animal Health and Elanco created the world’s second-largest veterinary pharmaceutical company after Zoetis Inc. “Elanco’s acquisition of Novartis Animal Health brings together two strong companies with a passion for serving the customer,” said Rob Aukerman, president of North American commercial operations for Elanco. “We will continue to offer the products our customers trust, while significantly investing in the development of new solutions to our customers’ greatest unmet needs.” Absent from the Elanco portfolio are Sentinel Flavor Tabs and Sentinel Spectrum, which Fort Worth, Texas-based Virbac will now sell. The line generated more than $90 million in U.S. sales in 2014. Virbac also took on an undisclosed number of Novartis employees—“predominantly commercial teams,” according to the company. “The addition of these strong brands to Virbac’s current portfolio of products, together with the doubling …
AVMA to Weigh Spay/Neuter Policy ChangeDecember 5, 2014The American Veterinary Medical Association board of directors is recommending that practitioners who participate in spay/neuter clinics follow the standards of care outlined by the Association of Shelter Veterinarians. The idea is among six new resolutions that the AVMA House of Delegates may vote on in January during the governing body’s regular winter session in Chicago. The spay/neuter proposal, Resolution 3, would clarify the current policy, which advises veterinarians working at spay/neuter clinics to abide by the AVMA’s Principles of Veterinary Medical Ethics. The possible move to Association of Shelter Veterinarians medical care guidelines would keep veterinarians up to date with current standards of practice, the board of directors noted. “Because of a wide range of geographic and demographic needs, a variety of programs have been developed to increase delivery of spay/neuter services to targeted populations of animals,” the revised policy reads in part. “These include stationary and mobile clinics, MASH-style operations, shelter services, feral cat programs and services provided through private practitioners. “These services should conform to current standards of practice as described by the Association of Shelter Veterinarians’ veterinary medical care guidelines for spay/neuter programs.” Among other proposals scheduled for consideration in January are: Resolution 1: …
Abbott, Merck, Purina Team Up on Diabetes CampaignNovember 18, 2014Cats and dogs diagnosed with diabetes during a visit to a participating veterinary clinic in March 2015 will receive a gift bag designed to help their owners manage the disease. The giveaway is part of the new Diabetes Pet Care Alliance, a campaign created by Abbott Animal Health, Merck Animal Health and Nestlé Purina PetCare to raise awareness about diabetes in pets and encourage more screenings. The sponsors say the incidence of diabetes—1 in 250 cats and 1 in 500 dogs—is rising and that pets are underdiagnosed. Veterinary hospitals that enroll in the program at www.usa.petdiabetesmonth.com will receive materials designed to educate clients and local pet owners about the clinical signs of diabetes. The hospitals—up to 1,000 can participate—are encouraged to dedicate time to diabetes screenings in March. Pets newly diagnosed with the disease will go home with a free diabetes management kit containing: An AlphaTrak blood glucose monitoring system from Abbott Animal Health. A 10 mL vial of Vetsulin (porcine insulin zinc suspension) from Merck Animal Health. A bag of Purina Veterinary Diets food—either DM Dietetic Management Feline Formula or DCO Dual Fiber Control Canine Formula. November is National Diabetes Month.
