University of Minnesota seeks participants for skin disease studyApril 5, 2019University of Minnesota (UMN) College of Veterinary Medicine is looking for candidates to enroll in an allergic skin disease study. The clinical trial will assess the safety and efficacy of a topical gel for dogs with atopic dermatitis (AD), which is a skin condition that causes severe itching and is hard to manage. According to the researchers, many of the current treatments produce unwanted side effects or they do not fully treat the symptoms. The study will last 14 days and will require the participants to visit UMN on day zero, seven, and 14. The dogs' owners will be required to use a topical gel on areas of their pets' skin and keep a medication diary throughout the duration. During the visits, Sheila Torres, DVM, MS, PhD, DACVD, will examine and assess the participants. Blood samples will be taken every visit and urine samples on day zero and 14. There is no cost, and at the end of the study dog owners will be eligible for to a $200 debit card. To participate dogs must: • have a short hair coat; • have red and inflamed skin, especially on their belly and/or paws; • have a …
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Omega-3 supplements and hypothyroidism linked to decline of T-zone lymphomaApril 4, 2019A study at Colorado State University (CSU) has found dogs who receive omega-3 fatty acid supplements or have hypothyroidism may be less likely to develop T-zone lymphoma (TZL). The findings come from Morris Animal Foundation-funded researchers who looked at associations of the environment and health history of TZL among golden retrievers. T-zone lymphoma is a type of cancer, which progresses slowly and is usually found in older dogs. It is predominantly found in golden retrievers; however, Anne Avery, DVM, PhD, associate professor in the department of microbiology, immunology, and pathology at CSU, believes the underlying causes of the tumor are shared across breeds. "Although controlled prospective studies would be necessary to firmly establish protection by omega-3 fatty acids, our observations raise the possibility of a simple intervention, which may help reduce the frequency of this disease," Dr. Avery says. "We were also a little surprised to discover defective genes leading to another, seemingly unrelated disorder— hypothyroidism—are more common in dogs who do not develop T-zone lymphoma." More than 350 golden retrievers were used in the study, which looked at health history questionnaires and blood or biological samples. The dogs were divided into two groups. One of the groups …
CVMA and California veterinarians clash over blood banksApril 4, 2019A showdown is brewing between the California Veterinary Medical Association (CVMA) and a group of veterinarians over whether closed-colony blood banks should continue to operate. Known as the California Pet Blood Bank Modernization Act, AB 366 bill is aimed at changing the existing law requiring animal blood banks collect blood exclusively from so-called "closed colonies." Critics say donor animals are confined to cages and kennels for months or years. Instead, the bill looks to allow blood banks to collect animal blood in a community-based, voluntary setting, similar to programs in place in other states. The bill is getting support from 72 veterinarians, including practitioners and medical directors at some of California's largest veterinary hospitals, and faculty and clinicians at the University of California, Davis. "The current situation in California is egregiously unbalanced," they say in a letter to California's assembly agriculture committee. "Hundreds of dogs—including many who have already endured months or years of suffering in the greyhound racing industry—are kept confined for months or years in situations that range from inadequate to appalling. Lack of sufficient oversight and inspection, coupled with a lack of transparency, has resulted in years of suffering by dogs in California's closed colonies. There …
What does 503B compounding mean for the future of veterinary medicine?April 3, 2019Modern compounding—often referred to as 503A—is a niche business, providing patient-specific formulations to satisfy individual needs. Because commercially available drugs are marketed almost exclusively for humans, compounding has become an essential resource for veterinary medicine. Veterinarians often depend on 503A pharmacies to provide preparations at lower concentrations and in more palatable dosage forms to optimize treatment for their patients. However, without proper management and regulations, 503A compounding can potentially be detrimental. Presently, 503A pharmacies are not required to adhere to Current Good Manufacturing Practice (cGMP) objectives put forth by the U.S. Food and Drug Administration (FDA) to ensure pharmaceuticals achieve a specified standard of safety. The quality of products produced in a 503A facility depend on the pharmacy's voluntary conformance with cGMP, which can be substantially cost-prohibitive, requiring anywhere from $50,000 to $100,000-plus of investment for a single formulation. Testing on raw materials and finished products may be performed to an extent depending on the facility, but the data are often incomplete, testing only one or two factors while omitting others that would affect the product's overall quality. The variability of cGMP compliance from pharmacy to pharmacy paves the way for omissions in procedures that can lead to patient harm. …
FDA approves treatment for urinary incontinence in dogsApril 2, 2019PROIN ER, a tablet for the control of urinary incontinence in dogs, has been approved by the U.S. Food and Drug Administration (FDA). The drug treats urethral sphincter hypotonus, which occurs due to a dog's age and weakening muscles in the urethra. PROIN Chewable Tablets have already been approved by the FDA; however, they are to be administered twice a day, whereas PROIN ER is a once-a-day extended-release formulation. The effectiveness of PROIN ER was observed in a clinical study comprising 119 dogs that had been previously diagnosed with urethral sphincter hypotonus and had been taking PROIN Chewable Tablets. The timeline of the clinical study went as follows: • For the first week, the owners documented whether the dog received the PROIN Chewable Tablet doses and noted the number of urinary accidents the dog had; • Dogs were then given PROIN ER for the first 28 days and the owners proceeded to take note of how many accidents occurred in a day; • In the fourth week, the number of urinary accidents was compared to the first week. It was found 75 of the 104 dogs who completed the study had no accidents on either tablet;
Vital pulp therapy in dogs and catsMarch 29, 2019Last month, we discussed the rationale behind and approach to conventional (orthograde) endodontic therapy. Orthograde root canal therapy removes the entire contents of the pulp chamber in the root canal system. Vital pulp therapy is a different kind of endodontic procedure, performed instead on teeth that have had recent pulp exposure. Determining whether it's best to perform vital pulp therapy or orthograde root canal therapy for an individual tooth is a judgment call. Most dentists gravitate toward orthograde root canal therapy whenever possible, since it involves removing the entire contents of the pulp and minimizes the likelihood of possible future pain and infection by not leaving to chance whether remaining pulp maintains its vitality. However, orthograde root canal therapy may not be an option for young teeth, as they lack a closed apex. In the past, it was a rule of thumb that vital pulp therapy be performed within 48 hours of pulp exposure in dogs older than 18 months of age and within two weeks in dogs younger than 18 months of age. However, the sooner vital pulp therapy is performed after pulp exposure, the better the chance of success. Therefore, even when a patient is younger than 18 …
Seven options to provide life-saving oxygenMarch 28, 2019There is arguably nothing more heart-wrenching than a patient who is suffocating. How you handle these patients could be the difference between life and death. Some colleagues can be hesitant to admit these patients and may advise clients to take them to an emergency or referral facility that may be much farther away. It doesn't have to be that way. Short-term, there really is no risk to oxygen therapy. So even if the disease process were not oxygen-responsive, there is no harm in providing therapy while you figure things out, assess the severity of the disease, and obtain diagnostics. Providing oxygen is an easy way to buy time. Empower your nurses to start some sort of oxygen therapy when your patient is exhibiting any of the following situations: • dyspnea of any kind; • shortness of breath; • abnormal respiratory sounds; • cyanotic gums; • severe anemia or hemorrhage; • increased respiratory rate; • head trauma; and/or • lateral recumbency. Although arterial blood gas analysis would be the most accurate way to assess pulmonary function, it is rarely available in general practice. Pulse oximetry is a cheaper and more available option. You …
Stoner news: Struvite diets for cats and dogsMarch 28, 2019While struvite uroliths may in some cases require surgical intervention, the recommended standard of care by the American College of Veterinary Internal Medicine (ACVIM) is medical dissolution with a therapeutic diet formulated to alter urine acidity and encourage water consumption. Dietary dissolution of struvite stones is both effective and inexpensive. Therapeutic diets limit calculogenic compounds (e.g. phosphorus and magnesium) and acidify urine. That makes the urine a less welcoming environment for stone formation and dissolves stones that are present. Concerns medical dissolution places pets at risk of urethral obstruction are not borne out by the literature, according to the ACVIM consensus statement, published in the Journal of Veterinary Internal Medicine (JVIM) in 2016. Dietary management itself has changed as well. The shift from struvite-only dissolution or prevention diets to combination struvite dissolution/prevention and calcium oxalate prevention diets is the biggest change in management of these uroliths, says Cailin Heinze, VMD, Dipl. ACVN, assistant professor of nutrition at Cummings School of Veterinary Medicine at Tufts University. Causes differ Struvite uroliths occur in both dogs and cats, but have different causes. In dogs, struvite stones—the most common type seen—develop almost exclusively as a result of urinary tract infections (UTIs) caused by …
Asymptomatic bacteriuria—To treat or not to treat?March 28, 2019Veterinarians and pet owners are highly motivated to find discrete, fixable problems when pets are unwell. Owners want the reassurance and sense of control that comes with knowing what the problem is and taking action. Veterinarians want to help our patients, while also satisfying clients. Their expectation is that we offer some clear preventive or therapeutic intervention justifying their time and the expense of coming to see us, as well as reassure them about their pets' condition. Finally, our medical training often emphasizes diagnosis and treatment as the core responsibility for a doctor; the importance of knowing when not to take action is frequently underemphasized.1,2 Such inherent bias toward finding and treating problems creates discomfort and resistance when scientific evidence suggests we should avoid some tests or treatments. Though there is widespread awareness of the risks of overdiagnosis and overtreatment in human medicine, these are relatively new and controversial concepts in the veterinary field.3,4 My own efforts in this column and elsewhere to suggest we might sometimes do better not to run a test (e.g. pre-anesthetic bloodwork)5 or prescribe a treatment (e.g. lysine)6 have generated the kind of pushback often greeting such suggestions. Nevertheless, we have a responsibility to …
Laser therapy—Indications and contraindicationsMarch 27, 2019Photobiomodulation—a.k.a laser therapy—has become commonplace in veterinary medicine, with knowledge gained over the last eight to 10 years coming from evidence-based data and shared clinical experience. Achieving predictable and reproducible results with laser therapy is dependent on properly managed treatments, proper dosing, effective use of therapy laser hardware and software, and appropriate treatment technique.1 Low-level laser therapy (LLLT) applies low-level (low-power) lasers to the surface of or in orifices of the body. Whereas high-power lasers are used in laser medicine to cut or destroy tissue, application of low-power lasers is said to relieve pain or stimulate and enhance cell function. Laser therapy is a unique and extremely gentle form of treatment with the ability to stimulate tissue healing, virtually without side effects. It is very different from laser surgery, as it avoids heating the tissue, which can cause cell and tissue damage. As such, photobiomodulation is often called "cold laser" therapy.2 What's it for? Laser therapy has been postulated to exert three main effects: reduction of pain, modulation of inflammation, and acceleration of healing.3 The primary categories with the strongest support—largely via experimental studies—include its use in pain, wounds, musculoskeletal conditions, neurologic pathology, and in conjunction with complementary medicine techniques …
