The Changing World Of Veterinary Anesthesia Guidelines And MonitoringMay 2, 2012 UPDATE: AAHA released its anesthesia guidelines in early November. The American Animal Hospital Association is poised to release the first-of-its-kind small animal anesthesia guidelines. A task force comprising six board-certified veterinary anesthesiologists and a certified technician specializing in anesthesia created the approximately 10-page document in an 11-month timeframe. The AAHA guidelines is an all-inclusive, easily digestible document created for use by the entire veterinary team. With expanding anesthesia capabilities for the profession, Jason Merrihew, associate public relations manager at AAHA, says the association recognized the need to develop guidelines for veterinary professionals. He attributes the multitude of factors to consider when sedating or anesthetizing a healthy dog or cat, as well as the pet with one or more medical conditions a leading incentive. “AAHA’s guidelines include information on pre-anesthesia bloodwork, examination, equipment, staffing recommendations, monitoring from induction through recovery, pain management, drug choices, drug combinations, what drugs to use according to patients’ age, body type and temperament,” says Richard Bednarski, DVM, Dipl. ACVA, associate professor (anesthesia) at The Ohio State University in Columbus and chair for AAHA anesthesia guidelines. “These guidelines differ from the American College of Veterinary Anesthesiologists’ (ACVA) anesthesia monitoring guidelines because their …
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Keeping Hospice In Veterinary HandsMay 2, 2012 Our focus with this article is on people who compulsively collect old or sick animals and proclaim themselves operators of pet hospice homes or sanctuaries. Unfortunately, most of these self-proclaimed hospice workers use little to no veterinary medical supervision. Their collected animals suffer to death without proper pain management, comfort care or the human-animal bond. They might have started out as good Samaritans, working alone or with a group, rescuing animals and keeping a few, then a few more. Over time, they develop a strong urge to “save” more old and sick animals that were “abandoned.” That urge develops into a compulsive disorder. They collect more and more old, sick and special-needs animals. When their animals die, they exhibit tearful distress, blind denial or experience a pathological enlightenment. Their compulsiveness to collect more animals winds up harming their animals, themselves, their neighbors and their communities. A certain percentage of compulsive collectors of sick and old animals can maintain their operations for a time. But eventually many find themselves overworked, in debt, depressed and overwhelmed. The tipping point is when they acquire more animals than they can properly care for and house. Another tipping point into …
The Problematic Deciduous Canine ToothMay 1, 2012 I received a call from a referring veterinarian. He saw on his appointment book that a puppy was scheduled to have its four firmly rooted persistent deciduous canine teeth extracted. His 30-plus years of experience led him to conclude that firmly rooted deciduous canine teeth were among the most challenging extractions to perform. I agreed wholeheartedly. Looking for Answers What causes persistent deciduous teeth? To answer, we need to know what causes deciduous teeth to be normally shed. Resorption of permanent teeth is a pathological condition, but resorption of the deciduous tooth root is considered to be a physiologic process in which osteoclasts, osteoblasts and tooth-resorbing cells called odontoclasts work in concert to allow for resorption of the deciduous tooth root as the permanent tooth root moves into the area the deciduous root once occupied. As a result, the deciduous crown is shed. In cases where no permanent tooth is present, or if the permanent tooth is not in the correct location, the physiologic resorption of the deciduous tooth root does not occur at its regular time, and it may take years for the deciduous tooth root to resorb. Note that I used …
The Benefit Of Low Fat Pet Food In Dogs With GI DiseaseApril 27, 2012 Lipids are water-insoluble molecules that have many crucial functions in dogs. There are a variety of different lipids, but the only lipids that are routinely quantified in dogs are triglycerides and cholesterol. Hyperlipidemia refers to a state of abnormally increased blood concentrations of triglycerides, cholesterol or both. One indication for low-fat dietary intake in dogs with gastrointestinal disease is the management of dogs with hypertriglyceridemia with GI disease presumed to be due to or related to hypertriglyceridemia. The second indication is a group of dogs that have a normal serum triglyceride concentration, but have GI disorders resulting in difficulty to digest and/or absorb normal amounts of fat in pet food or dogs with lymphatic abnormalities. Hypertriglyceridemia is very common in dogs.1 In one recent study, 611 routine chemistry profiles in dogs performed at a private veterinary laboratory in Italy were evaluated and 33 dogs (5.4 percent) showed hypertriglyceridemia.1 Certain breeds have been identified as being much more commonly affected by hypertriglyceridemia. In a recent study of 192 healthy miniature schnauzers, 63 (32.8 percent) had hypertriglyceridemia.2 Definitive differentiation between primary or secondary hypertriglyceridemia is sometimes difficult, but is based on …
Your Patient Swallowed What?April 10, 2012 Entries are being accepted for Veterinary Practice News’ seventh annual “They Ate What?” radiograph contest, which highlights the dietary indiscretions committed by veterinary clients’ dogs, cats, snakes guinea pigs, cows and horses. The entry deadline is June 30, 2012. A digital single-lens reflex camera is the grand prize. Two runners-up will each receive a point-and-shoot digital camera. Winners will be announced in the September issue of Veterinary Practice News. Sound-Eklin of Carlsbad, Calif., is sponsoring the contest.< “With the proliferation of digital technology over the past few years, we expect to see many well-defined cases presenting an even greater variety of findings,” said Greg Stoutenburgh, vice president of marketing for Sound-Eklin. High-resolution radiographs must be submitted electronically, with “contest” in the subject line, to VPNeditor@bowtieinc.com. The submitter must include his or her name, the clinic name and address, a telephone number and a brief explanation of the case. Entries become the property of BowTie Inc., which reserves the right to use them in any publication, media or promotion. Contestants agree that their photo, text, name and city may be posted on BowTie websites and, in the case of the winners, on sponsor …
Managing Hyperthyroidism With Food? Check ComplianceApril 3, 2012 The team at VCA West Los Angeles Animal Hospital was puzzled. Veterinarians had recently begun managing feline hyperthyroidism with nutrition, using a pet food formally launched in October 2011, Hill’s Prescription Diet y/d Feline Thyroid Health. The food limits dietary iodine intake, and the staff was finding that in the majority of cats, thyroid levels returned to normal within three weeks of transitioning to the food. But one patient’s thyroid levels had barely budged—even though the owner insisted the cat had been fed only the recommended food. So team members started probing, says David Bruyette, DVM, Dipl. ACVIM, medical director at the hospital. Was the cat getting treats? Never. Did it sneak bites from other food bowls? Not that the owner knew. Finally, a new fact emerged: The owner had been out of town for 10 days. And it turned out that when the affected cat’s food bowl ran empty, the owner’s husband had simply re-filled it with the same food that the other cats in the household ate, Bruyette says. Bingo. “This food is so good at limiting iodine that if the (cat’s condition) is not improving, there’s an incredibly high chance …
Hill’s Updates Guidelines For Y/d FelineApril 3, 2012 After the launch of its Prescription Diet y/d Feline Thyroid Health pet food last year, Hill’s Pet Nutrition Inc. of Topeka, Kan., has released an updated set of guidelines and algorithms to assist veterinary care providers who are managing hyperthyroid patients with the food. Hyperthyroidism is one of the most common diseases in middle-aged and older cats. Resulting from too-high levels of thyroid hormone (T4) and increased metabolism, the illness can cause a range of clinical findings, from hypertension to ravenous appetite, weight loss and excessive urination. Some cats also have concurrent kidney disease. Traditional treatment options have included radioactive iodine, the medication methimazole to control levels of thyroid hormone, or a thyroidectomy. A decade in the making, Prescription Diet y/d Feline gives veterinarians a new management tool—and so far, says David Bruyette, DVM, Dipl. ACVIM, medical director of VCA West Los Angeles Animal Hospital, it has been working. Since June, Dr. Bruyette and his veterinary health care team have been using the therapeutic cat food to manage newly diagnosed feline hyperthyroid patients and those previously diagnosed that are transitioning from anti-thyroid medication. “What we’ve seen …
FHS May Have Underlying Schizophrenic LinkApril 3, 2012 Feline hyperesthesia syndrome (FHS) is an enigmatic and controversial behavioral and medical condition that most often affects Oriental cat breeds. I saw my first case many years ago in a Siamese cat that displayed the three cardinal signs: excessive skin rippling or twitching (hence the alternative designation “rolling skin disease”), bouts of manic self-grooming, often initiated by stroking the cat along its back (”hyperesthesia”), and widely dilated pupils during bouts of the behavior. The cat had just bitten one of our students, who was trying to restrain him, sending the student to the hospital for intravenous antibiotic treatment. Mercurial aggression, while being restrained, is another feature of FHS in some cats. Other odd behaviors associated with the syndrome include periods of freezing in position while staring vacuously into space, sudden bouts of running away from what appears to be some unseen enemy and apparent hallucinations (visually following things that aren’t there). Learning More In the early days, feline hyperesthesia syndrome was described as a compulsive disorder or stereotypy, but over time I became skeptical of the label to the point where I now consider it incorrect. The first seeds of doubt regarding the compulsive disorder …
Fabulous Feline Fling!March 26, 2012 Close your eyes, and imagine this…well, you can’t read this if your eyes are closed, so have someone else read it to you with your eyes closed…but not if that person is a prankster, because something bad might happen to you while you’re closing your eyes…so use your best judgment. So where were we? Ah yes, telling you what to imagine. I would have loved to get photos for you, and I did get a digital recording, but I’m not so sure they want this running on VPN’s website! It was a few mornings ago. I walk into the kitty palace, the room in which my four cats nap and eat, and the first thing I notice when I open the door is green plant material on the floor. Now we have bunnies, too, so my first thought is hay. But no, I open the door a little more and find the large plastic sack that used to hold all of their catnip, but now most of it is spread out on the floor! I open the door a little further, and see plastic trash bags askew in the room. Hmm, now they are usually stored …
The Case Of The ‘Tummy Tuck’ I Just Couldn’t Get PastMarch 21, 2012 If I hadn’t seen it for myself, I wouldn’t have believed it. A pre-vet student who works for me finally wore me down and convinced me to Google it. That’s when I settled in with my morning coffee to watch a 30-minute video on the merits and how-tos of “tummy tucking” for cats. Tummy-tucking? Seriously? Apparently. And it was awful (as you might have expected it would be). In this case, undertaken in a mobile surgical unit on what appeared to be a middle-aged domesticated shorthair female with an average-sized “belly pooch,” the cat was subjected to a 30-minute procedure dedicated to removing as much subcutaneous fat as possible. Horrible. More so when you consider that one of the major complications with liposuction (done in humans with “lipo-wands” designed for the task) is the potential destruction of blood supply to the overlying skin and, therefore, full-thickness skin necrosis. This complication is rare when the procedure is performed correctly, seeing these wands are specifically designed to leave major vessels intact. But in the cat and dog (distinct from humans) the blood supply to the overlying skin is even more tenuous. While humans have multiple musculocutaneous vessels scattered …
