Dental Implants In Small AnimalsJanuary 31, 2013 Implant dentistry and bone grafting in small animals today is where it was in human dentistry 20 years ago. Dental implants have been well proven to maintain alveolar bone and avoid alveolar collapse, improve mastication and bone density, avoid orthodontic problems and prevent canine alveolar collapse, which may avoid lip catching. It has also been well documented that the majority of implant failures occur in humans during the first year after implant placement. The main reasons for implant failure during the first three to six months prior to prosthetic replacement generally is poor surgical technique, poor patient selection or inadvertent overloading of the implant during osseointegration. The main reasons for failure of an implant after implant restoration is generally poor treatment planning or overloading of the implant during remodeling of the bone. Figure 1A: Tooth sectioned Courtesy K9 Implant solutions Figure 1B: Osteotomy being performed Figure 1C: Implant being placed After the first year, it is well documented that success rates are close to 100 percent due to the body’s individual ability to adapt …
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Treatment Options For Canine Cruciate Ligament Disease (CCLD)January 30, 2013 Due to the large volume of feedback received in response to the previously published Veterinary Practice News article on canine cruciate surgery, it is clear that some confusion exists regarding our current clinical management of patients with canine cruciate ligament disease (CCLD). Recognizing that there are, unfortunately, large knowledge gaps regarding the clinical efficacy of many treatments for this disease, we do our best to tailor our treatment recommendations to the specific needs of the patient and pet owner. While in some instances this may mean a non-surgical therapy approach, surgical treatment is provided as a component of the overall patient care for the majority of patients presented to the orthopedic service. Nonetheless, we prefer not to think about CCLD patient care (or clinical research) in terms of a simple “surgical versus non-surgical” dichotomous relationship; instead, we prefer the integrative approach of determining the best combination/choice of surgical, pain management, rehabilitation and complementary medicine techniques. The most important question we should ask ourselves is: “Which treatment combinations can provide the best long-term quality of life?” Obviously, the answer to this question differs based on patient signalment and athleticism, concurrent disease and owner’s expectations. The goal of this …
On Dishing Out The F-word And Dropping The O-bombDecember 20, 2012 Scanning my journals and trade magazines in search of news and notable literature, I came across a veterinarian-authored how-to piece explaining how we should approach the fraught topic of weight loss in pets. Go easy, the author urged, as pet owners are easily put off by language they may perceive as accusatory or judgmental. A veterinarian who charges into this subject without gentle preamble risks not only his client’s badly needed buy-in, he risks losing his client altogether. I might have read past this well-stated bit of advice except that it coincided with an email delivered by an indignant Miami Herald reader (I write a weekly pet advice column) who seemed to echo her sentiments: My veterinarian and I are on the outs. She’s been insisting for years that my cat is overweight and has now started using words like ‘fat’ and ‘obese’ to describe him. I’ve never denied that [my cat] can stand to lose a few pounds, but I think using that kind of language is just plain rude. Is this the kind of bedside manner being taught in vet school these days? Ouch, that stings! Yet we …
Obsessive Compulsive Disorder In AnimalsNovember 21, 2012 Since a publication by child psychiatrist Dr. Judith Rapoport, et al, in the Archives of General Psychiatry (1992), the term “compulsive disorder” has entered the veterinary lexicon. Before that, repetitive disorders of species were referred to as “stereotypies.” I’ve studied such behavior for nearly 30 years, the first 10 of which I believed I was studying stereotypies. My first observations were in horses engaging in “stall vices” like cribbing and weaving and stall walking. Later, I broadened my interest to include acral lick dermatitis and tail chasing in dogs and wool-sucking/pica and psychogenic alopecia in cats. I also had some interest in feather-picking in birds, chain chewing and bar biting in pigs and the plethora of repetitive disorders shown by zoo animals. I always believed the mechanism underlying these behaviors was essentially the same with, perhaps, certain species variations imposed on a common underlying theme. Early on, I was convinced that stereotypies were mediated by nature’s own morphine-like substances, the endorphins, as morphine antagonists blocked the behaviors I studied in horses and dogs. Dr. Rapoport’s 1992 article, however, changed the way we think about repetitive disorders and altered our approach to treatment. Rapoport showed …
Complex Partial Seizures Or Compulsive Behavior?November 21, 2012 Complex partial seizures are well recognized in human medicine and, according to some authorities, are more prevalent than tonic-clonic seizures. However, these focal electrical events are not widely acknowledged in veterinary medicine. It was a different story in the 1960s, when numerous automatonish behaviors were classified as partial seizures. A trip down memory lane to the Kirk’s Current Veterinary Therapy of 1960 or so is all it takes to be reminded of this fact. One of the reasons for the abandonment of the partial seizure diagnosis was the realization that many repetitive behaviors were not so much of seizure origin but actually were (obsessive) compulsive disorders—a completely different barrel of fish. But the realization that some behaviors could be compulsive doesn’t necessarily mean that partial seizures never occur. Odds are they should. Another reason for the unpopularity of diagnosing these conditions is that they often produce subtle—though frequently highly unusual—clinical signs. Simple partial seizures in people, which often precede complex partial seizures, may involve only altered perception, such as déjà vu or jamais vu. Both are tough to detect in a dog! But complex partial seizures, once developed, produce obvious clinical signs. The locus …
Questioning Canine Cruciate Ligament SurgeryNovember 16, 2012 Imagine you twisted your knee and your doctor diagnosed an injured anterior cruciate ligament. What if she offered you only surgery or euthanasia (hypothetically legalized for humans)? Would you explore alternatives or accept this false dilemma? Would it change your mind if you discovered that more enlightened surgeons are exhorting their colleagues to stop cutting cruciates at least until patients have undergone a month or more of conservative care? In the same vein, why do some veterinary surgeons limit options for dogs, forcing clients to choose between breaking their hearts and breaking their banks? Yes, canine and human stifles differ, but the chronicity and persistence of canine cruciate disease argues in favor of a long-term, rehabilitative and integrative approach, not for bone saws. Moreover, far from being a slam-dunk diagnosis and treatment, confusion lingers. Unknowns persist about whether a lameness is indeed due to cruciate injury and if so, what caused it. Furthermore, “The ideal treatment modality for cranial cruciate ligament (CrCL) injury has yet to be determined...”1 Consumers want options.2-6 Many in our profession insist that only surgery or euthanasia allows dogs to avoid a life …
6 Tips For Keeping Patients Safe Under AnesthesiaOctober 22, 2012Refining anesthesia protocols has been at the top of practitioners’ to-do lists since the American Animal Hospital Association released its anesthesia guidelines for dogs and cats. Patient safety is a primary goal in all anesthetic procedures, so to minimize risks, consider these tips for creating a successful outcome for patients undergoing anesthesia. 1. Pay particular attention to the induction and recovery phases, as these are the most critical, says the University of Georgia’s Jane Quandt, DVM, Dipl. ACVA, Dipl. ACVECC, of Athens, Ga. “Induction [is critical because] we are taking animals to the point of unconsciousness,” said Dr. Quandt. “And in recovery they regain consciousness and must cope with the demands of tissue trauma and going back to room air if they were on inhalant anesthesia.” She also notes that the recovery phase may be the most overlooked by general practitioners. “Recovery may be overlooked a bit because once [patients] are conscious we tend to move on to the next patient.” Daniel K. Edge, DVM, MBA, veterinary liaison manager for Abbott Animal Health in Abbott Park, Ill., agrees, and notes the findings of a 2006 study. “According to the Confidential Enquiry into Perioperative Small Animal Fatalities, 64 percent of …
A Call For Calorie Counts On Pet Food LabelsOctober 15, 2012If your exam room observations are anything like mine you’ll have noticed the girth of your patients gradually expand over the past couple of decades. It didn’t happen overnight, and yet it sometimes seems there must be something new in the water for our pets to have plumped up so impressively. So what have we done to address it? Fight fires, mostly. Though we may put our scales, tape measures and body conditioning score know-how to work, getting pet owners to smell the coffee is a losing proposition more often than not. Our overstuffed culture has a way of besting us at every turn. In fact, if we’re honest with ourselves, we’ll cop to the notion that NSAIDs and insulin are our tools of choice for combating the problem of excess poundage in our patient populations. So even when we do manage to eke out some wins, it’s painfully evident we’re still the big losers in this war. Hence, why so many of us have stopped trying to run in place on the back end of this issue. Prevention, we now claim, holds the key to weight management. Because once they’ve gone glutton, tanked up and porked out, the odds …
Probiotics For Pets Support Total WellnessOctober 9, 2012 It was a sunny Tuesday afternoon, and Sean Cater had a feeling something was wrong. A 48-ounce package of chicken lay on his kitchen floor, empty. Bits of wrapping trapped in the yellow Styrofoam fray littered the tile, then the carpet, leading Cater to the inevitable culprit: his 4-year-old greyhound, Shark Face. Shark’s belly was slightly larger than usual, the pinkish gray skin pulled just slightly tighter to her body. Cater’s gut had told him something was amiss, and now he had proof. Gut feelings do matter. Shark-Face’s tummy rumbled as the day continued. Even more than that, Cater was thinking about things many pet owners do not: Shark’s brain, joints, heart and general attitude. Cater is a graphic designer for Vetri-Science Laboratories of Vermont. He takes it upon himself to regularly ask questions about pet health, and knows something many pet owners do not: Digestion is a connective activity. We habitually associate intuition with our guts, so much so that bad news becomes hard to swallow, we get lumps in our throats, and we come to know emotions through our stomachs, from the deepest pits to the flightiest butterflies. Finding a Connection The …
Prebiotics, Probiotics And Intestinal HealthSeptember 27, 2012 While prebiotics and probiotics are often confused or thought of as one and the same, their commonalities end with their stint in the intestine. Prebiotics are fiber that feeds the beneficial microorganisms residing in the intestine. Probiotics are live microorganisms that when ingested, can enhance intestinal microbial balance. Prebiotics have been used in pet foods for decades, probably without pet owners even knowing it. But probiotics’ delicate handling needs means they’re sold in sachets and capsules. They are in something of a state of hibernation, according to Grace Long, DVM, MS, MBA, director of veterinary technical marketing for Nestlé Purina PetCare in St. Louis. The microorganisms become active when they enter the intestine. “Probiotics are heat and moisture sensitive, so it would be very difficult to incorporate them directly into the kibble,” Dr. Long says. “The most effective way of keeping probiotics alive in the packaging process is in a cool, dry environment away from air exposure. Not all probiotics sold in the veterinary market have evidence to support their claims, so veterinarians should make sure that the levels of microorganisms are guaranteed and that the manufacturer can provide support of efficacy.” Evidence …
