Asymptomatic bacteriuria—To treat or not to treat?March 28, 2019Veterinarians and pet owners are highly motivated to find discrete, fixable problems when pets are unwell. Owners want the reassurance and sense of control that comes with knowing what the problem is and taking action. Veterinarians want to help our patients, while also satisfying clients. Their expectation is that we offer some clear preventive or therapeutic intervention justifying their time and the expense of coming to see us, as well as reassure them about their pets' condition. Finally, our medical training often emphasizes diagnosis and treatment as the core responsibility for a doctor; the importance of knowing when not to take action is frequently underemphasized.1,2 Such inherent bias toward finding and treating problems creates discomfort and resistance when scientific evidence suggests we should avoid some tests or treatments. Though there is widespread awareness of the risks of overdiagnosis and overtreatment in human medicine, these are relatively new and controversial concepts in the veterinary field.3,4 My own efforts in this column and elsewhere to suggest we might sometimes do better not to run a test (e.g. pre-anesthetic bloodwork)5 or prescribe a treatment (e.g. lysine)6 have generated the kind of pushback often greeting such suggestions. Nevertheless, we have a responsibility to …
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Laser therapy—Indications and contraindicationsMarch 27, 2019Photobiomodulation—a.k.a laser therapy—has become commonplace in veterinary medicine, with knowledge gained over the last eight to 10 years coming from evidence-based data and shared clinical experience. Achieving predictable and reproducible results with laser therapy is dependent on properly managed treatments, proper dosing, effective use of therapy laser hardware and software, and appropriate treatment technique.1 Low-level laser therapy (LLLT) applies low-level (low-power) lasers to the surface of or in orifices of the body. Whereas high-power lasers are used in laser medicine to cut or destroy tissue, application of low-power lasers is said to relieve pain or stimulate and enhance cell function. Laser therapy is a unique and extremely gentle form of treatment with the ability to stimulate tissue healing, virtually without side effects. It is very different from laser surgery, as it avoids heating the tissue, which can cause cell and tissue damage. As such, photobiomodulation is often called "cold laser" therapy.2 What's it for? Laser therapy has been postulated to exert three main effects: reduction of pain, modulation of inflammation, and acceleration of healing.3 The primary categories with the strongest support—largely via experimental studies—include its use in pain, wounds, musculoskeletal conditions, neurologic pathology, and in conjunction with complementary medicine techniques …
Nationwide members paid $119 million to treat their dogs and catsMarch 21, 2019Nationwide members spent $119 million in 2018 to treat their dogs and cats. The pet health insurance company analyzed its database of more than 725,000 insured pets to determine the top 10 most common conditions that prompted veterinary visits. "Pet owners are encouraged to schedule regular medical checkups as recommended by their veterinarians to prevent many common, yet problematic medical conditions," says Nationwide vice president and chief veterinary officer, Carol McConnell, DVM, MBA. "Early detection can be key. The majority of medical conditions on the top 10 list can be successfully managed if treated promptly by a veterinarian." The following conditions affect dogs and cats the most, according to Nationwide: Dogs 1) skin allergies 2) ear infection 3) noncancerous skin mass 4) diarrhea/intestinal upset 5) skin infection 6) vomiting/upset stomach 7) arthritis 8) dental disease 9) anal gland inflammation 10) bladder urinary tract disease Cats 1) bladder/urinary tract disease 2) dental disease 3) chronic kidney disease 4) vomiting/upset stomach 5) diarrhea/intestinal upset 6) excessive thyroid hormone 7) upper respiratory infection 8) skin allergies 9) diabetes 10) heart valve malfunction
Talking the talk—What to say when clients prefer raw dietsMarch 21, 2019One only needs to pay attention to the news or trending items on Facebook to see the spate of pet food recalls happening in our country. And with an uptick of pet parents feeding their dogs raw or freeze-dried raw food, it is important veterinarians have honest and open conversations with their clients about concerns surrounding these diets. The following is American Veterinary Medical Association's (AVMA's) position statement on raw diets: "AVMA discourages the feeding to cats and dogs of any animal-source protein that has not first been subjected to a process to eliminate pathogens because of the risk of illness to cats and dogs, as well as humans." Katy Nelson, DVM, medical director of Pet Health for Stop Aging Now, agrees. "Cooking or pasteurization through the application of heat until the protein reaches an internal temperature adequate to destroy pathogenic organisms has been the traditional method used to eliminate pathogens in animal-source protein, although the AVMA recognizes that newer technologies and other methods, such as irradiation, are constantly being developed and implemented," Dr. Nelson says. "Most veterinarians are going to listen to the governing body of our profession, as well as the Centers for Disease Control (CDC) and …
Keep more flea and tick preventive purchases in-clinicMarch 20, 2019When pet owners needed to purchase parasite control products, they traditionally went to their local veterinarian. However, the influx of retail businesses (both online and brick and mortar) competing in this market has created a financial feasting frenzy on clinic profits. "We have moved from having a near monopoly on the sale of flea/tick products to the current situation where less than half of clients are now purchasing their flea/tick products from their veterinarian," says Lowell Ackerman, DVM, DACVD, an independent consultant, author, and lecturer. In most veterinary hospitals, pharmaceuticals represent 25 to 30 percent of revenue, according to Dr. Ackerman. As the bulk of that revenue comes from the sale of parasite control products, this "erosion" of sales is both significant and troubling. Reel 'em back in Reasons as to why pet owners have strayed beyond home base varies. Cost, convenience, and just not knowing the benefits of purchasing from their veterinarian are examples. When it comes to product pricing, veterinarians need to be competitive, but they don't need to be the low-price leader, according to Ackerman. "Clients see most noninjectable parasite control products as commodities, and it is easy for them to compare prices across different sources," …
Trust, education can build vaccine complianceMarch 18, 2019Can people control their exposure to whatever virus du jour is making the rounds? No—and that's the point veterinarians should stress among vaccine-wary clients, says Tony Rumschlag, DVM, director of consulting veterinarians, companion animal at Elanco Animal Health. "We cannot in all circumstances control our pets' exposure to disease," he says. "We can help prevent disease in our beloved pets by simply following an appropriate vaccination protocol." As in human medicine, some veterinary clients are expressing concern over the necessity and safety of vaccines for companion animals. "Because some of the diseases we vaccinate against are not as prevalent as in the past, both on the human and animal side, people start to lose sight of the value of vaccines," Dr. Rumschlag explains. "When vaccination rates decrease, these diseases tend to reappear. And I understand how pet owners can forget the extent of parvo and distemper cases we saw in the 1980s and early '90s." Rumschlag says that while there is a lot of science backing the safety and value of vaccines, many of the concerns about them are based more on emotions. "Veterinarians who have treated dogs infected with preventable diseases, such as parvo and distemper, need to …
Salt Lake City, Utah, tops the list of heartworm cities for February in the U.S.March 15, 2019Salt Lake City, Utah, was the number one city for heartworms in February according to Companion Animal Parasite Council's (CAPC's) top 10 list. The monthly report warns pet owners, veterinarians, and pet-related service providers of U.S. metropolitan areas with highest percentage increase in positive heartworm tests. CAPC is devoted to monitoring and reporting emerging threats to pets. "The new CAPC Top 10 Cities Heartworm Report demonstrates heartworm disease—transmitted by mosquitoes—is a national threat to pets who are increasingly vulnerable to this debilitating and potentially fatal illness in most communities across the country," says CAPC board member, Michael Yabsley, MS, PhD, FRES. These are the U.S. cities with the highest percentage increase in positive heartworm tests for February: 1) Salt Lake City, Utah 2) Alexandria, Va. 3) Riverside, Calif. 4) Topeka, Kans. 5) El Paso, Tex. 6) Paterson, N.J. 7) Chesapeake, Va. 8) Reno, Nev. 9) Modesto, Calif. 10) Boise, Idaho "It takes just one heartworm-infected dog in an area to become a reservoir of infection, increasing the number of infected mosquitoes and ultimately spreading the heartworm parasite to unprotected dogs and cats," Yabsley says. "This is why CAPC recommends monthly …
U.S. congressmen introduce bill to end deadly experiments on kittensMarch 11, 2019A new bill has been introduced to get the U.S. Department of Agriculture (USDA) to stop performing harmful experiments on felines. U.S. congressmen Brian Mast and Jimmy Panetta have introduced the Kittens in Traumatic Testing Ends Now Act of 2019. "The fact we need a piece of legislation to tell the federal government to stop killing kittens is ridiculous on its face, but what's even worse is when you hear the government is actually breeding hundreds of these cats just to intentionally feed them parasite-ridden raw meat and then kill them even though they're perfectly healthy," Mast says. "These tests are awful, abusive, and unnecessary, not to mention a serious misuse of millions of taxpayer dollars. This needs to stop now." "This common sense, bipartisan bill will require the USDA to adhere to the same animal welfare standards the department is charged to uphold," Panetta says. "While I strongly support scientific research, taxpayer money and federal resources should be spent on advancing scientific research in an ethical manner, not on inflicting pain on innocent kittens in outdated experiments. I hope this bill helps us get closer to ending this cruel practice.
Getting to the bottom of root canal therapyMarch 8, 2019Anyone who has tried to extract a firmly rooted mandibular canine tooth in a dog or cat has likely muttered the phrase, "There's got to be a better way," (amongst other muttered phrases!) while performing the frustrating procedure. In some cases, there is indeed a better way. Although root canal therapy is not an option for every diseased tooth, it is an elegant way to treat dead teeth and teeth with pulp exposure. Terminology, development, and anatomy Endodontics refers to the study and treatment of the inside of the tooth (pulp) and periapical tissues, the latter of which are located around the tip (apex) of the tooth root. The pulp consists of nerves, blood vessels, lymphatics, and connective tissue. Pulp tissue is found in the pulp chamber of the crown and the root canal of the root. The pulp communicates with the periapical tissues through numerous small openings in the apex of the tooth root called the apical delta. Dental pulp is important for the development of the tooth in a young animal. Cells called odontoblasts continually produce dentin internally throughout the tooth's life. This makes the walls of the root and crown thicker. Recently erupted teeth have walls that …
Banfield Foundation commits $1 million to keep pets and domestic abuse victims togetherMarch 7, 2019The Banfield Foundation says it is investing $1 million in its Safer Together initiative to help victims of domestic violence and their pets find pet-friendly shelters. According to a recent study, up to 89 percent of pet-owning domestic violence victims report their abuser has threatened, injured, or killed the family pet. Further, about six to 10 percent of domestic violence shelters allow animals onsite. The Safe Together grant would allow qualifying nonprofit organizations to apply for funding as they increase their capacity to help people and pets escape domestic violence. "Through our work and the work of other outstanding organizations, we hope to create a world where victims never have to choose between their own safety and the safety of their loved ones, including their pets," says Banfield Foundation executive director, Kim Van Syoc. "Victims often remain in a dangerous environment because they do not have access to a pet-friendly shelter or program, and we believe saving the life of a pet can save the life of a human. Pets play an essential role in families, particularly during crises like domestic violence. Keeping pets safe and healthy helps ensure they remain a vital part of their …
