How To Test, Interpret Thyroid FunctionJanuary 16, 2012 Hypothyroidism is the most common endocrine disorder of dogs. More than 80 percent of cases result from autoimmune thyroiditis, the heritable autoimmune disease that progressively destroys the thyroid gland. Classical clinical signs of hypothyroidism only appear once more than 70 percent of the gland is destroyed. Accurate diagnosis may be difficult because thyroid dysfunction produces a wide range of clinical signs, many of which are subtle and mimic those of other causes. Hyperthyroidism is a common endocrine disorder of older cats. Diagnosis can be confounded by concurrent kidney, gastrointestinal and liver disease, as total T4 concentration can be suppressed into the normal reference range. To facilitate diagnosis of thyroid disorders, veterinarians need to routinely employ more complete thyroid profiles, and there is a need to balance affordability with accuracy. Testing Overview Total T4: Measures bound (> 99 percent) and unbound (< 1 percent) circulating T4. While T4 is the most widely used initial screening test for thyroid disorders, relying on this test alone is a primary reason for the misdiagnosis of canine and feline thyroid disorders. T4 concentration is affected by non-thyroidal illness (NTI) and certain medications (e.g. phenobarbital, corticosteroids and sulfonamides), …
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Is Early Neutering Hurting Pets?January 16, 2012Early neutering has become the norm in the U.S. Some states are asking voters to pass initiatives requiring citizens to sterilize their pets no later than puberty. Overpopulation is the driver. But what if large-scale studies found that early neutering jeopardizes the health of our pets? What if we found enough epidemiological evidence that early neutering of pet dogs may open them to orthopedic, behavioral, immunologic and oncologic issues? A veterinarian who treats canine athletes has raised questions about early neutering. In an opinion article, Christine Zink, DVM, Ph.D., Dipl. ACVP, weighs the advantages and disadvantages of early versus late neutering when considering the performance and health of canine athletes. The article, “Early Spay-Neuter Considerations for the Canine Athlete: One Veterinarian’s Opinion,” appears on Dr. Zink’s website. Click here to review the thought-provoking article and to look at the references. Zink assembled 18 references to support her article. Some show that dogs spayed or neutered early are taller than dogs spayed at an older age. Zink notes that sex hormones have a role in bone density. She concludes that the structural and physiological differences in dogs neutered early may be the reason veterinarians are seeing a …
Gentle Man, Strong LeaderJanuary 6, 2012 For Roy Smith, DVM, it was always about the cats. Ever since he was a 14-year-old aspiring veterinarian, Dr. Smith knew he wanted to open a feline-only practice that allowed him to treat his preferred species. Fifty years later, his dream has been fulfilled—and then some. Smith owns and operates Central Texas Cat Hospital in Round Rock, Texas, and is the president-elect of the American Association of Feline Practitioners. “I love our profession and think it’s the greatest one in the world,” he says, emphasizing his dedication to both his clients and the veterinary community. “We have a lot of challenges coming our way right now to keep it that way, and it’s what keeps me going. There are a lot of good people helping out, and I want to do the same for the veterinarians coming along. Pass it on. It’s what keeps me going.” Roy Smith, DVM, with Howie, the stray cat who was discovered near a trash bin with a mangled eye and in a coma. Smith nursed him back to health. The formerly feral cat now calls Central Texas Cat Hospital home. His efforts caught the attention of the …
Supplement Can Bolster Pets’ Anxiety TreatmentJanuary 5, 2012When it comes to pets, fears, anxieties and phobias are more common than most people realize. In people—at least some of them—logic and reasoning can be used to help that person understand that an object, noise or event is not as scary as it may seem. But for pets, their perception is their reality. No amount of discussion or psychotherapy can change their minds about a situation that seems threatening or dangerous to them. In a national online survey about anxiety in pets, nearly 40 percent of pet owners who responded say they have at least one pet that experiences anxiety.1 Possible contributing factors to anxious behavior may be a lack of proper socialization, some traumatic event, genetic predisposition, and even cognitive decline. As an animal ages, hearing and sight may be compromised, and with confusion or even discomfort from arthritis, that can result in a more stressed or anxious pet. Nearly a third of the owners who responded to the online survey say their pets’ fears and anxieties are “extremely or very” problematic, while 44 percent say it is “somewhat” problematic. And 70 percent say the anxiety their pet experiences occurs “fairly often” or “frequently.” It …
Let’s Regard End Of Life As A Distinct StageJanuary 4, 2012 While I discussed end of life (EoL) care with Dr. Don DeForge on Connecticut radio, an exciting idea flashed through my mind. We were finishing a 45-minute discussion when I said, “It is time for us to declare, once and for all, that end of life is a distinctly new stage of life. Veterinarians were taught to support four main stages of life. We were not educated to focus our professional attention and develop the skills and expertise for the very important and inevitable ‘End of Life Stage.’ “We need to provide more EoL services because society’s human-animal bond demands more care in this area despite the recession and fewer office visits.” The main life stages we are educated to support are: • Puppy and kitten stage • Adult stage • Senior stage • Geriatric stage I propose a fifth life stage, the End of Life Stage. It is the only life stage that can occur during the other stages. With luck, EoL may not impose itself on the kitten and puppy stage, but sometimes it does. Let’s start thinking about EoL as an inevitable life stage that deserves more focus and expertise in management. …
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 …
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 …
