What You Need to Know About Oral Eosinophilic Diseases in Dogs and CatsJuly 20, 2015Originally published in the July 2015 issue of Veterinary Practice News. Loved this article and want to see more like it? Then subscribe today! I recently saw a 5-year-old, spayed Cavalier King Charles spaniel named Kaycee. Kaycee was presenting for a dental cleaning and possible extractions. Due to Kaycee’s signalment, I knew I should take a look at her soft palate during her conscious and anesthetized examinations. When I opened Kaycee’s mouth, I could see irregularity to the entire surface of the soft palate, with multiple areas of ulceration. Some of the areas of ulceration had areas of yellow punctate raised plaques. Cavaliers are commonly affected by a condition called eosinophilic stomatitis, which often manifests on the soft palate.1 This inflammatory condition is similar to eosinophilic granulomas in cats, but histologically, the disease in Cavaliers often lacks granuloma formation. Other dog breeds may be affected, including Alaskan malamutes, Siberian huskies, Labradors and Italian greyhounds (Figure 1). Soft palate lesions may also be solitary, circular, raised, yellow/pink lesions (Figure 2). Some dogs are presented with clinical signs of decreased appetite and drooling, but surprisingly, many dogs with significant changes to the soft palate …
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Why You Should Consider Nonsurgical Care for CCL DiseaseJune 8, 2015Originally published by June 2015 issue of Veterinary Practice News As someone who offers her thoughts on veterinary topics in print and online quite often, Narda G. Robinson, DO, DVM, MS, FAAMA, hears a great deal from pet owners and fellow practitioners about cranial cruciate ligament disease, a common aliment that can greatly impact a pet’s mobility and lifestyle. Just don’t try and tell her surgery is the “gold standard” for treating CCL disease. Nor should surgery always be presented as the best treatment, said Dr. Robinson, director at the CSU Center for Comparative and Integrative Pain Medicine at Colorado State University Veterinary Teaching Hospital. “My first question is: ‘What constitutes a ‘gold standard?’” Robinson said. “Is this based on opinion or scientific evidence? I’d prefer to see whatever is a ‘gold standard’ supported by evidence of benefit, safety and the least invasive approach possible rather than often-held opinions.” She noted that there are many instances of pelvic limb lameness that don’t require surgery, yet there isn’t enough evidence to say how a comprehensive rehabilitation program compares to various surgical outcomes for cruciate injury. “Based on what I’ve seen and heard from folks around the country, and even from other countries, …
Do Dogs and Cats Get Cavities?June 8, 2015Originally published in the June 2015 issue of Veterinary Practice News Dental caries (the medical term for cavities caused by tooth decay) are common in people but rare in our veterinary patients. Dental caries were first described in domesticated dogs in 1962.1 The NIH reports that 92 percent of adult humans between the age of 20 and 64 have cavities of their permanent teeth. The prevalence of caries in dogs is low, having been documented at 5 percent in a study of 435 dogs.2 Caries in cats are very rare (almost nonexistent). Etiology What’s the difference between caries and the more commonly seen veterinary problem of tooth resorption? The etiology of caries is due to a combination of having the right bacteria in the mouth (usually a bug called Streptococcus mutans) and having carbohydrate substrates for S. mutans to form acids that eat away at the surface of a tooth. Often times, even that is not enough to cause cavities. Often there is a genetic predilection of a developmental abnormality of a tooth to allow the enamel to be penetrated by these acids. The most common type of caries lesions is referred to as “pit-and-fissure” caries, which most commonly occurs …
Why Compliance Tops Flea and Tick Control MustsMay 11, 2015Originally published in the April 2015 issue of Veterinary Practice News The most effective flea- and tick-control products are the ones that pet owners will actually use according to the label recommendations. So believes Michael Murray, DVM, technical marketing director for U.S. Pet Parasiticides at Merial Ltd. of Duluth, Ga. “While that may seem simple and obvious on the surface, many important factors influence the outcome,” said Dr. Murray said. By probing into a pet’s routine with a few questions, veterinarians can ferret out those factors and help ensure compliance – leading to what is likely to be a better outcome for patients, Murray said. “First, what is the pet owner’s perception of the value, not the cost, of using flea and tick control for their pet?” he said. “This differs among pet owners, and finding out how clients spend time with their pets can provide important insights into how a parasite infestation would affect the relationship between the owner and their pet.” One question he suggested be posed to clients is whether a pet sleeps with a family member and how a flea or tick infestation would affect that interaction. He also suggested that veterinarians should find out if …
Cerclage Wire for Rostral Mandibular InstabilityMay 6, 2015Originally published in the April 2015 issue of Veterinary Practice News Last month we discussed iatrogenic mandibular fractures of the rostral mandible, specifically the iatrogenic parasymphyseal fracture. One of the repair techniques for this fracture, and for traumatic symphyseal separation, is use of a cerclage wire placed behind the canine teeth. Though most practitioners are familiar with this seemingly basic procedure, there are subtle nuances of placement that will help your patients thrive following placement of the cerclage. No. 1. Not every patient with instability requires placement of a cerclage wire Some animals, especially brachycephalic small-breed dogs and some cats, may have significant symphyseal laxity as an incidental finding on anesthetized oral examination. If the patient is not showing signs of discomfort or jaw locking, symphyseal laxity is not likely causing any problems. In cases with no recent history of trauma, placement of a cerclage wire will likely not allow for a long-term decrease in laxity without a more invasive procedure such as symphysiodesis (cutting into the fibrous joint of the symphysis and encouraging scar tissue formation), and this is often not necessary. No. 2. Step-by-step: placement Before placing a cerclage wire, the intraoral soft tissues dorsal to the …
Why the Basics Still Apply to Canine Skin AllergiesMay 4, 2015Originally published in the April 2014 issue of Veterinary Practice News Prevention, diagnosis and good management are still the most important elements of treating a dog with allergic skin disease, experts say, despite the presence of a potentially game-changing medication. “Apoquel has helped a lot of dogs, but you still need to implement good parasite control, including flea prevention, and you still need to ID the potentially underlying adverse reactions,” said Jeanne B. Budgin, DVM, Dipl. ACVD, president of the American Academy of Veterinary Dermatology. “In my opinion, Apoquel is not a replacement for diagnostics directed at identifying the cause of allergic skin disease,” Dr. Budgin said. Apoquel soared in popularity upon its release in January 2014. Many practitioners experienced a shortage of the drug when manufacturer Zoetis of Florham Park, N.J., ran low on supplies and faced production issues. Shortage Dr. Budgin, who works at Animal Specialty Center in Yonkers, N.Y., said she hasn’t experienced the shortage. She said she’s been able to keep patients that were started on Apoquel on the treatment. For others, the shortage has been an issue. One such affected practitioner is Christine Zewe, DVM, a resident in dermatology at Cummings School of Veterinary Medicine …
Survey: Clients Want to Know About ParasitesApril 30, 2015Originally published in the March 2015 issue of Veterinary Practice News Tens of thousands of dollars in additional revenue may be a series of phone calls away for U.S. veterinary hospitals. The Companion Animal Parasite Council and Bayer Animal Health in January released the results of a survey that found that 90 percent of U.S. pet owners want to hear about local spikes in pests such as disease-carrying ticks and heartworm-transmitting mosquitoes. Pet owners are willing to open their wallets, too, with 89 percent saying they likely would schedule an appointment to get their pet tested if a heightened parasite risk was communicated. The survey’s sponsors forecast that a two-doctor practice that informed clients about urgent parasitic risks in their home county and delivered related services could generate from $163,000 to $789,000 a year in extra revenue, depending on the level of pet owner response. “It’s amazing what some fairly simple changes can do financially for our profession,” said Karen E. Felsted, MS, DVM, CPA, CVPM, founder of president of PantheraT, a practice consulting firm in Dallas. She is the former CEO of the National Commission on Veterinary Economic Issues. Dr. Felsted was joined by CAPC leaders Susan E. Little, …
How to Avoid the Iatrogenic Jaw FractureApril 13, 2015Originally published in the March 2015 issue of Veterinary Practice News? Not a subscriber? Subscribe today! If you extract enough firmly rooted mandibular canine teeth in your lifetime, basic anatomy suggests that you may find yourself to be the creator of an iatrogenic jaw fracture. The root of the mandibular canine tooth of dogs and cats makes up a large portion of the rostral mandible and it is nearly twice as long as the crown of the tooth. Bone is very thin between the lingual surface of the root and the caudal symphysis. Photos © 2014 John R. Lewis, NorthStar VETS. Radiograph of an iatrogenic jaw fracture that occurred during attempted extraction of the left mandibular canine tooth in a cat. Iatrogenic jaw fractures that occur during canine tooth extraction tend to be parasymphyseal fractures rather than symphyseal separations. Forces required to deliver this tooth root may also, in some cases, be sufficient to result in fracture of the bone. Here are some tips that I’ve learned on how to avoid iatrogenic fracture. Dental Rads Take dental radiographs and adjust your therapeutic approach accordingly. Dental radiographs are important from both diagnostic and therapeutic …
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 …
