Shelf LifeDecember 30, 2009 When Richard Lisk, DVM, started offering five or six different heartworm products for sale to his clients, he thought he was enhancing his service. After all, the more choices the better, right? Not always. With experience and the help of practice consultant Wendy S. Myers of Communication Solutions in Highland Ranch, Colo., Dr. Lisk decided he wasn’t doing his clients—or himself—any favors by overstocking his retail space. “Clients don’t always know what products are best. They’re looking for medical advice,” says Lisk, owner and operator of two adjacent veterinary practices in Houston: Bay Glen Animal Hospital and the Feline Medical Center. So now Lisk carries one heartworm medication, in a 12-month supply, and he still feels the love from his clients. Plus, he frees up room in his hospitals and resources in his budget for other products and equipment. Practitioners know the decision to sell products as a service to clients comes with limitations. How practices best use their limited space can go a long way toward determining the success of the practice. Sales of products sometimes account for as much as 15 to 25 percent of a hospital’s revenue, say veterinarians and practice …
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Education Is Key In Diabetes MaintenanceDecember 30, 2009 More than 1.4 million U.S. companion animals have been diagnosed with diabetes. That’s one in every 500 dogs and one in every 200 cats. “Obesity is a leading factor in the increase of diabetes in dogs and cats,” says Tanya Civco, DVM, Dipl. ACVIM, an assistant professor at Auburn University. “We are seeing more diabetic animals because we are seeing more obese pets. “There are far more diabetic animals today than even five or 10 years ago.” These significant numbers attract the research interests of veterinarians and manufacturers alike. Specialists point the finger at conflicting causes. While some veterinarians believe diet plays a role in the increase, others say cats in particular suffer due to the loss of the lifestyle they evolved with. There is no dispute about the best route to achieve balance for patients: research and education. “There is a great deal of ongoing research in diabetes in dogs and cats,” says David Bruyette, DVM, medical director at VCA West Los Angeles Medical Hospital. “The disease is so common in both species that the newest research is focusing on newer insulin preparations such as lente insulins in dogs and cats—Vetsulin, pork insulin, …
New Wound Therapies Look PromisingDecember 30, 2009 Hard-to-heal wounds are time-consuming, costly and a frustration for veterinarians and clients. Side effects of long-term antibiotic use and patient pain are two of the reasons that researchers and veterinarians are trying to heal wounds faster. Photo courtesy of Dr. Tim Crowe. Sarah suffered a large hole in her frontal sinus and nasal passage when she was hit by a car. Her left eye ruptured from the impact. Experts say better methods of wound care exist, but the benefit of these alternatives isn’t widely documented for use in animals. This lack of statistical evidence slows the adoption of a better standard of care by primary caregivers. “Veterinarians don’t get information on hyperbaric oxygen treatment (HBOT) in school, and the lack of available data means they don’t consider using it,” says Tim Crowe, DVM, Dipl. ACVS, Dipl. ACVECC, chief of staff for Pet Emergency Clinics and Specialty Hospital in Ventura, Calif. “A practice would need to see enough patients in need of HBOT to validate the purchase of a machine, but I think the number of vets owning one will increase once the data showing its benefit in veterinary …
Regenerative MedicineDecember 4, 2009 Lymphoma is one of the most common cancers found in dogs, with a survival rate of 0 to 2 percent under current treatment methods. These poor statistics have researchers constantly looking for better ways to increase diagnosed dogs’ lifespan. Steven Suter, VMD, MS, Ph.D., Dipl. ACVIM, is performing bone marrow transplants using a leukapheresis machine to harvest healthy progenitor cells from a canine patient’s blood. “With this method, the dog receives standard chemotherapy drugs, often referred to as CHOP,” says Dr. Suter, assistant professor of medical oncology at North Carolina State University’s College of Veterinary Medicine. “Once in clinical remission, which means the dogs lymph nodes are of normal size, a high dose of Cytoxan (cyclophosphamide) is given to clear as much cancer as possible from the dog’s blood. About 10 days later, it is then given Neupogen (filgrastim), which costs about $2,000 per patient. This drug increases the dog’s white blood cell count and also drives stem cells, called CD34+ progenitor cells, out of the bone marrow and into the peripheral blood.” After six days of Neupogen, the dog is mildly sedated and connected to the leukapheresis machine, which harvests the CD34+ progenitor cells from …
Pressure’s On To Monitor Blood PressureSeptember 1, 2009 Blood pressure monitoring, long a staple in preventive human medicine, is increasingly being incorporated into veterinary practices to enable earlier detection of many common diseases in pets. Keven Gulikers, DVM, Dipl. ACVIM, of the Center for Veterinary Specialty Care in Carrollton, Texas, notes that blood pressure readings are becoming a more integral part of anesthetic monitoring. “And more family veterinarians are evaluating blood pressures in patients with diseases that can cause hypertension, such as chronic renal failure and Cushing’s disease,” he adds. Indeed, Nora Matthews, DVM, Dipl. ACVA, professor at Texas A&M University’s College of Veterinary Medicine, says regular blood pressure monitoring is commonly used to follow chronic diseases in pets. It is increasingly being incorporated into standard pet wellness programs. Thus, she notes, the cost of a blood pressure monitor is nominal when used on most patients in the practice. Routine Monitoring Andrew Schultz, director of veterinary monitoring and critical care for Sharn Veterinary Inc. of Tampa, Fla., agrees that acceptance and adoption of routine blood pressure screening is increasing, but he says it is still far lower than it should be. “Just think what happens every single time …
Rehab Becoming More MainstreamAugust 6, 2009 Physical therapy has been intertwined with human medicine for most of a century. In fact, early practitioners were called “reconstruction aides.” But the application of physical therapy modalities to veterinary practice is comparatively recent. Photo by Dara Lyon Warner. An exercise stair, one of several types of equipment used with patients at Animal Rehabilitation and Wellness Hospital in Raleigh, N.C. Animal Rehabilitation and Wellness Hospital—ARWI.com —in Raleigh, N.C., is one of a relative handful of facilities dedicated exclusively to veterinary rehabilitation. The University of Tennessee, which offers a certificate program in canine rehabilitation, lists 275 certified practitioners in the U.S. and only 27 in the rest of the world. Animal Rehabilitation and Wellness Hospital was born of founder and CEO Annie Janis’ grief over losing her beloved dog, Tanana, to degenerative disc disease. Treatment options were minimal and rehabilitation was nonexistent. “Surgery was offered, but I was told she would probably never walk again,” Janis says. “If (rehabilitative therapy) had been available, I feel she would have stayed healthier, stronger and it would have increased her life span.” Sometime later, when Janis was seeking a veterinary …
Echocardiography Can Retool A PracticeJune 10, 2009 The down economy has led many veterinarians to place continuing education and equipment purchases on hold, but business experts say companies should use the time to their advantage and retool. Adding a modality such as echocardiography is one way to attract “A” clients and make use of any extra time you or your technicians may have. Echocardiography debuted in the veterinary industry by means of specialty practice, but now general practitioners are increasingly getting involved and even investing in training technicians to perform echocardiography. From 65 to 70 percent of U.S. veterinary practices have some form of ultrasound equipment and find that clients are willing to spring for the exam fees. “Providing echocardiography exams as an inhouse offering shows that you want to continue to improve the standard of care you give to patients,” says Clint Roth, DVM, regional sales director of Sound Technologies Inc. of Carlsbad, Calif. “Echocardiography is one of the few technologies that gives you dynamic information about the strength and level of function of the heart. It is integral in the diagnosis of canine and feline heart conditions, and at least 70 percent of clients will OK this type of procedure.” …
Raw Diets Linked To SalmonellaJune 9, 2009 Veterinarians have a responsibility to provide pet owners with information about zoonotic disease that gives a realistic appraisal of any risks pets could present to the household’s human inhabitants and how to minimize this risk. This is especially true if the household contains small children or immuno-compromised individuals. While there are myriad potential patho-gens, this article will focus on one major concern: Salmonellosis. Why It’s Important Salmonellosis was in the headlines continuously last summer (2008) during a large outbreak associated with contaminated food. In this outbreak, at least 1,438 people were proved to be infected and 282 were hospitalized.1 Food-associated outbreaks are not unusual because contaminated food is the primary way that humans become infected with Salmonella. The infection can be acquired from meats and eggs, but many outbreaks have been linked to other sources such as sprouts, peanut butter, tomatoes or, recently, chili peppers. The majority of humans who become ill are young. The rate of diagnosed illness in children under 5 years old is five times higher than any other age group. This probably relates to the disease’s affecting children more severely than otherwise healthy adults. It is estimated that Salmonellosis causes 1.4 …
Musculoskeletal MiraclesMay 6, 2009 A year and a half ago, Mel and Helen King noticed their very fast poodle Josephine slowing as she ran the agility courses on which she had become a champion. A few weeks later, she became lame. The Kings, of Silver Creek, Wash., took her to an orthopedic surgeon who diagnosed a partial tear in her cruciate ligament and recommended surgery. “That would have ended her career and I didn’t want to do it,” Helen King says. “She lives for agility.” After researching options, the Kings opted for stem cell therapy, part of the rapidly emerging field of regenerative veterinary medicine. A photomicrograph of a cluster of equine adipose-derived regenerative cells. The techniques are being used in horses and dogs to treat tendon and ligament injuries, osteoarthritis and, to a limited degree, fractures. Stem cells are being used in other countries to treat humans with musculoskeletal problems, but the procedure is still in clinical trials in the U.S. Vet-Stem Inc., a Poway, Calif., company founded in 2002, has used its patented process to treat more than 3,200 horses and 1,500 dogs. Some 1,179 veterinarians have completed the firm’s free online training. …
Palliative Options In Cancer CareMay 6, 2009 While we have increasingly advanced therapies for treating canine and feline cancer, sometimes the most appropriate treatment is palliation. Palliative therapy is defined as reducing or removing the symptoms of a disease or a disorder, not curing it. By this definition, the majority of veterinary cancer care falls under the umbrella of palliation. While achieving a cure in most of our patients would be desirable, doing so at the expense of an animal’s quality of life contradicts the most basic principle of veterinary oncology. The most common comment I hear during oncology consultations is that clients do not want to extend an animal’s life at the expense of their quality of life. I always tell my clients that while I don’t believe animals understand the concept of time, I think they understand quality of life and how they feel as they live in the present. Though palliative treatment is often focused on relieving the pain of a tumor or cancer, or relieving the suffering caused by a tumor, pain isn’t necessarily the only reason for providing palliative care. Owners may not recognize that besides pain, there may be many other components to an animal’s suffering, …
