Surgical Insights: Improve Histopath Results, Part 2November 30, 2011Improve Histopath Results, Part 2In our second installment, we continue our conversation from the June issue with pathologist Ken Mero, BS, MS DVM, PhD, of VetPath Services in Stone Ridge, N.Y., to learn when to consider special stains and how to help your pathologist help you.In our second installment, we continue our conversation from the June issue with pathologist Ken Mero, BS, MS DVM, PhD, of VetPath Services in Stone Ridge, N.Y., to learn when to consider special stains and how to help your pathologist help you.surgicalinsights, smlanimalSurgical Insights: Improve Histopath Results, Part 2Posted: Sept. 20, 2011, 8:35 p.m. EDT In our second installment, we continue our conversation from the June issue with pathologist Ken Mero, BS, MS DVM, PhD, of VetPath Services in Stone Ridge, N.Y., to learn when to consider special stains and how to help your pathologist help you. What are special stains and when should they be requested? Special stains are specialized procedures to identify specific cellular features using dyes with particular affinity for certain cellular constituents. Examples are Giemsa and toluidine blue, which have an affinity for mast cell granules, or silver stains for silver deposition on the cell walls of organisms such as …
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Wound Healing: Bandaging And BeyondNovember 17, 2011 Primary care veterinarians don’t always have equipment to care for severe wound cases, and owners might hesitate to call on a specialist in a down economy. So primary care veterinarians often are looking for new and economical options. “Regenerative medicine is an area veterinarians should be investigating,” says Jeff Wood, DVM, co-owner of American Animal Hospital Association-accredited Northside Veterinary Hospital in Hillsdale, Mich. “Compliance goes down each time a vet asks a client to come back for bandaging or additional treatment. This needs to be considered when selecting a treatment method.” Dr. Wood says clients of his rural practice often rely on him to provide total care to their pets. When referring wasn’t a common option, he and colleague Amy Boxberger, DVM, chose to run a proactive and progressive practice to better serve patients and clients. “Ten years ago we started using ACell Inc.’s MatriStem, a sterile, freeze-dried pig bladder bio-scaffold device we can apply in multiple areas of practice, including wound healing,” Wood says. “The product comes in a sheet or powder form. It has antibacterial properties, decreases inflammation and increases vascularization for site-specific regeneration.” The company says the scaffold consists of an intact …
Evidence Based Medicine: Neuromodulation And Kidney DiseaseNovember 4, 2011 If, as gerontologists insist, “Age is not a disease,” then why does getting old seem so hard for some?1 True, declaring that an animal companion’s declining organ function and pain are “just a result of getting old and there’s nothing we can do about it” is unacceptable. Furthermore, a hands-off approach may unjustly limit a caregiver’s options. Many human parents of dogs and cats want to do more; they need direction and information from their veterinarians about what to pursue and when. Accumulating evidence reveals that over time, the autonomic nervous system weakens in its ability to respond appropriately to endogenous and exogenous provocation. This may invoke a persistent state of vasomotor and glandular dysregulation that ultimately culminates in organ disrepair.2 However, certain natural, drug-free methods help offset age-related derangements in metabolic and musculoskeletal capacity. Termed “somatic afferent stimulation,” techniques such as acupuncture, massage and laser therapy aid autonomic function and circulatory health. Specifically, they bolster the endogenous capacity of the nervous system to autocorrect autonomic control of organ function.3 This translates into a host of potentially effective integrative medicine options for geriatric veterinary patients currently facing numerous end-of-life challenges, such …
Testing For WellnessOctober 21, 2011 Today’s in-house laboratories allow veterinarians to test patients’ blood for an increasing range of conditions and diseases—but what’s news about the devices is how practitioners are using them. Besides using analyzers to test sick patients, clinicians are also using them to keep them well. Kate Hunter, DVM, invested in a blood chemistry analyzer 15 years ago when she opened her practice, Carver Lake Veterinary Center in Woodbury, Minn. “We felt it was important to be able to do pre-surgical testing on all surgical patients and to be able to provide diagnostics on sick patients right away,” she says. By testing her surgical patients before the procedures, she says she and her team can identify the 10 percent of patients that have underlying disease and delay surgery or tailor their anesthetic protocol appropriately. The Good and the Bad “When we’re presented with sick patients, [in-house testing] has allowed us to discuss both normal and abnormal results face-to-face with owners at the time of their appointments,” Dr. Hunter says. “We are then able to provide any additional diagnostics or treatment needed right away. This has improved compliance and value.” …
Vets Feeling Pressure To Do More BP ChecksAugust 18, 2011 Human patients’ blood pressure is routinely measured during medical exams and surgical procedures. In the veterinary world, however, blood pressure is monitored in fewer than half of all patients under anesthesia and less often during clinical exams, according to estimates. The disparity traditionally has been linked to the equipment and its cost. “The veterinary profession has been plagued by inconsistent veterinary-specific monitoring equipment, which has made many practitioners gun-shy about incurring substantial equipment related expense,” says Robert Stein, DVM, Dipl. AAPM, executive director of the Veterinary Anesthesia and Analgesia Support Group. “Many veterinarians are frustrated by a piece of equipment purchased at a great price, often at a convention after hearing an energetic rep sing the monitor’s praises, only to have it become the most expensive door stop in the building.” Those days are changing. Manufacturers report that veterinarians are showing an elevated interest in veterinary blood pressure devices as the technology advances and the supporting evidence comes to light. Dr. Stein was an early believer in monitoring the blood pressure of every anesthetized patient. He started using the Dinamap 1846SX, a human monitor available on the secondary market, in 1995. “You learn …
Treating Marijuana ToxicityJuly 13, 2011 When veterinarians think of regionally specific illness, toxicity caused by consumption of native plants and exposure to infectious organisms typically comes to mind. In preparation for a move to Southern California, I studied the effects of sago palm ingestion and inhalation of Coccidioidomycosis with the anticipation of the conditions I would be diagnosing and treating in my clinical practice. I did not anticipate that I would end up treating such a large number of dogs presenting with clinical signs consistent with marijuana (cannabis sativa) consumption. As the sale of medical marijuana is legal in many California cities, dispensaries provide human patients with smokable or edible products. Unfortunately, humans can carelessly leave these products in locations accessible to their curious pets, leading to ingestion. Clinical Signs Although a pet could show signs of marijuana toxicity post-inhalation, the majority of cases I see are due to suspected or known oral ingestion. I have treated dogs almost exclusively, yet cats can be similarly affected. A 2002 study of 250 cases of marijuana exposure showed dogs to be the primary cannabis consumption culprits (96 percent). Cats followed in a distant second place (3 percent), and other species made …
The Health Benefits Of Therapeutic FastingJuly 11, 2011 Fasting and the calorie restricted diet have both shown benefits for human and animal health as well as a lengthening of lifespan.1 Fasting consists of stopping food, but there are a number of variations that allow the consumption of juice, supplements or other items. Calorie-restricted diets usually aim to reduce the caloric intake to 70 percent of what is considered “normal,” either on a daily basis or by alternate day extreme restriction. For humans, multiple nutrient-dense foods are consumed, with an emphasis on fruits and vegetables. For animals, calorie restriction research usually involves restricting the diet to 70 percent of whatever the control animals are eating. Even without an increase in nutrient density, these animal studies show improved health, less degenerative disease and increased lifespan. Calorie restriction induces a cellular response that results in decreased free radical production, increased resistance to free radical effects and production of other protective proteins.2 Oxidative stress resulting in clinical3 or subclinical chronic inflammation is considered to be the primary cause of aging and age-related degenerative disease.4,5 Ironically, as the benefits of fasting and a calorie-restricted diet gain increasing research support, both the human and the …
Stop Procrastinating! Radiograph Contest Entries Due June 30May 23, 2011 Have you ever looked at a radiograph of an animal’s belly and wondered, “What the heck were they thinking when they swallowed that?” You’re not alone. In fact, we invite you submit your favorite have-to-see-it-to-believe-it radiograph for your chance to win cool prizes. But you better get moving. Entry deadline is June 30 for Veterinary Practice News’ sixth annual “They Ate What?” radiograph contest, which highlights the dietary indiscretions committed by veterinary clients’ dogs, cats, snakes guinea pigs, cows and horses. A Canon 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 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 …
Endoscopy: Not Just For SpecialistsMay 23, 2011 Endoscopy, commonly used for biopsies, gastropexies and laparoscopic ovariohysterectomies, is becoming more popular with veterinarians for more complex procedures. As the use of non-invasive methods increases, many veterinarians are learning to use endoscopic equipment. While a veterinarian investing in endoscopy equipment might not perform all possible procedures, he or she can offer many cutting-edge treatments. “There are many benefits to performing endoscopic surgery,” says Athens, Ga., surgical consultant Clarence Rawlings, DVM, MS, Ph.D., Dipl. ACVS. “The patient experiences less stress, less pain and can return to normal performance levels faster. Clients often have an aversion to major surgery but are often more comfortable with a less invasive procedure. As veterinarians, we feel like we’re doing a better job when using it for the right procedures.” Dr. Rawlings says new equipment is always exciting to use, but he warns against using endoscopic equipment for the wrong reasons. Other options may be available, he says, and sometimes a case may need to be referred. “I’m always asking myself if I should perform another physical exam, more blood work or perform an ultrasound,” Rawlings says. “Make sure you’ve run through those things first and, of course, have client …
It Might Be Time To Adjust Clinic FeesApril 22, 2011Top customer service can make clients feel higher fees are worth it. Veterinarians often wonder how to adjust their fees to compensate for losses attributed to clients’ postponing pets’ annual exams and vaccine updates. Many advisers recommend re-evaluating fees annually and adjusting rates accordingly, but advise against decreasing fees across the board. Packaging services and remaining competitive on shopped-for products and services, such as spays and neuters, veterinarians can help meet their bottom lines, say certified public accountants. The consultants add that maintaining customer service is priority. “We monitored a client’s practice for four months after she decreased her fees on flea and tick products and she didn’t sell more,” says Michael Porrello, a CPA at Lacher McDonald & Co. CPAs in Seminole, Fla. “This is a common outcome when fees are reduced. The clients who would have come to the practice even without the fee reduction are just getting a better deal, while the veterinarian loses revenue. Granted, the fee reduction in this case wasn’t heavily marketed, but marketing is often an area in which practices could use an improvement.” Possible to Lose Money Experts say the economy is just the current reason being …
