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 …
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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 …
AAHA releases 2019 Dental Care Guidelines for Dogs and CatsMarch 7, 2019The American Animal Hospital Association (AAHA) has updated its dental care guidelines with the goal of decreasing oral pain and improving the quality of life for dogs and cats. While not always apparent to pet owners, by the age of three, dogs and cats have some level of periodontal disease. Updated from the 2013 edition, the 2019 AAHA Dental Care Guidelines for Dogs and Cats are designed to help veterinary professionals expand their current client education efforts, so pet owners understand periodontal disease can be avoided through regular dental checkups and proper home care. The new guidelines also help veterinary practitioners address the fear of anesthesia among pet owners, as it is the most common reason for declining dental procedures. "Regular dental care is one of the most powerful ways we can improve the quality of life of our patients," said AAHA chief executive officer, Michael Cavanaugh, DVM, DABVP (emeritus). "AAHA continues to support the use of general anesthesia in dental procedures to promote appropriate diagnostic capabilities and decrease patient stress, injury, and risk of aspiration. Because home care is crucial in the support of a healthy, pain-free mouth, client communication and education remain central to these guidelines." Detailed …
Is banning "artificial" ingredients based on fear or science?March 1, 2019Since the late 1980s, individuals and organizations have been trying to warn the public about a deadly chemical known as dihydrogen monoxide (DHMO). Though widely used in the home and in commercial settings, including the health-care industry, this substance has been shown to cause severe lung damage and even death when inhaled in small quantities. Hundreds of thousands of people die annually from this cause.1 DHMO also can produce electrolyte disturbances and potentially fatal neurologic symptoms when taken orally, and it can cause severe burns and even explosions when heated.2 A number of surveys have found high levels of support for banning DHMO, and elected officials in several countries have explored taking such action, although DHMO remains ubiquitous.3,4 Given the obvious dangers of this chemical, why do public health agencies not take action to restrict it? It is possible that funding and political influence from industry impede regulatory action. However, it is more likely that governments have chosen not to ban DHMO because it is essential for life. Most people are surprised to learn this until they recognize the nontechnical name for this chemical—water. Is "chemical" a dirty word? The campaign against DHMO has been used as a humorous …
Cat declawing may soon be a thing of the past in CaliforniaFebruary 27, 2019Assemblyman Bill Quirk has introduced a bill that would ban the declawing of cats in California. "Declawed cats can suffer long-term physical complications as a result of declawing—it's not just a fancy manicure," Quirk said upon introducing AB 1230. "It's painful, unnecessary, and needs to stop… When this bill becomes law, only licensed veterinarians performing the procedure for specific therapeutic purposes will legally be able to declaw a cat, saving them from a lifetime of pain and possible lameness." The practice is already illegal in San Francisco, Los Angeles, and six other California cities. Further, in several other parts of the world, declawing has been banned. "Declawing is one of the most painful and unnecessary surgeries in all of veterinary medicine," said Jennifer Conrad, DVM, CVA, founder of the veterinarian-run nonprofit Paw Project. "We've seen what these cats go through. We are veterinarians who are standing up against the status quo because it is the right thing to do. We want veterinary medicine to be about helping animals, not helping couches." Studies have found declawed cats are more liable to bite or have other behavioral issues and often end up in animal shelters as a result.
10 golden rules of cancer surgeryFebruary 20, 2019Surgery plays a critical role in the management of cancer. One significant advantage of surgery is a chance at an immediate cure—after a single session. No other treatment modality can offer that. Here are 10 rules that must be followed to ensure the best possible surgical outcome. Do the math: Surgery is only 10 percent of the entire story. What follows mainly pertains to skin masses, but it applies to any tumor, even intrathoracic or intra-abdominal. 1) Client communication Whenever a mass is discovered, it is important to take the time to prepare the client for the worst, while hoping for the best. Don't sugarcoat things. Don't make assumptions. Don't claim to have microscopic vision. Don't overpromise. Remember, for example, that a mast cell tumor is called "the great imitator" for a reason. It can feel like anything, including a lipoma. 2) Preop workup Even though we typically say you can't diagnose cancer by looking at blood work, it will occasionally show abnormalities, such as infection, hypercalcemia, or increased liver values. Staging the patient (i.e. determining the extent of the disease) is a mandatory part of the preop workup. Before surgery is ever considered, perform three views of the thorax …
Before you change the diet…February 7, 2019Naughty Girl is a healthy six-month old terrier puppy who is being fed a complete and balanced commercial growth food. She lives with Bad Boy, a four-year old beagle-spaniel cross who is fed an adult maintenance dog food. Bad Boy is brought to your clinic for a two-day history of vomiting and acting sluggish (or punky). Your physical exam reveals some pain on abdominal palpation and a lab test for canine pancreas-specific lipase is "abnormal," suggesting an elevated lipase level. Your suspicion of pancreatitis is high and, after rehydrating the dog with fluids, you send him home on a fat-restricted therapeutic diet. Is a diet change warranted in this situation? Nutrition textbooks and veterinary nutritionists refer to dietary fat as a "nutrient of concern" or "key nutritional factor" when talking about nutritional management for patients with pancreatitis. However, before automatically switching a patient's diet, conduct a thorough nutritional assessment to get the whole picture of what's happening in the home environment. Performing a nutritional assessment involves collecting information about the patient, the diet, and feeding management (Baldwin, et. al. 2010). This is not a process that involves extra time or work—a nutritional assessment begins with routine information collected about …
GI issues tricky to diagnose, treatFebruary 6, 2019From intestinal parasites to irritable bowel disease (IBD), dietary indiscretion to food allergies, gastrointestinal issues are among the most common problems veterinarians see. While they might seem straightforward, they can be difficult to diagnose and treat for a number of reasons. Chronic diarrhea and vomiting may not be brought to your attention until it has been going on for a while without improving or begins to worsen in severity. And, of course, diarrhea and vomiting can be seen with diseases unrelated to the GI tract. Once the GI tract is pinpointed as the source of the problem, the signs can still have many potential causes. Radiographs show only faint shadows of the intestines, making interpretation difficult. Gastrointestinal problems can resolve on their own in three to five days, but when they don't, additional diagnostics, therapeutic trials, and medication can be the next step. Fortunately for pets, owners, and veterinarians, more companies are beginning to develop drugs and run clinical trials specifically for cats and dogs with GI disease, says M. Katherine Tolbert, DVM, PhD, DACVIM, clinical associate professor of medicine at Texas A&M University College of Veterinary Medicine & Biomedical Sciences. "There are a lot of new drugs that …
Understanding congestive heart failureFebruary 5, 2019Congestive heart failure (CHF) is described by medical professionals as more of a syndrome than a disease. Yet, when pet owners are often attuned to "disease," how can veterinarians best convey what CHF really is to their clients? "Congestive heart failure can result from a variety of different types of underlying heart disease," says Emily Karlin, DVM, Dipl. (cardiology), clinical instructor at Cummings School of Veterinary Medicine at Tufts University. "When we say CHF, we generally are referring to fluid buildup somewhere it should not be, as a result of heart dysfunction. We can see left-sided CHF (fluid buildup in the lungs—pulmonary edema), resulting in cough or trouble breathing, or right-sided CHF (fluid buildup in the abdomen or around the lungs—ascites or pleural effusion), resulting in abdominal distension or trouble breathing. Basically, CHF is a potential outcome of having heart disease." Recognizing signs and symptoms When it comes to differentiating CHF from heart disease, paying attention to clinical signs and symptoms is key. "Asymptomatic, or occult, heart disease is often detected based on physical exam abnormalities—such as a heart murmur, cardiac gallop, or arrhythmia—or sometimes by echocardiographic screening, but the animal is feeling well at home with no clinical …
How 3-D printing benefits presurgical planning for angular limb deformityFebruary 4, 2019 The surgical treatment of limb deformities in dogs has historically been approached by taking preoperative measurements using radiographic orthogonal views. When calculations for the osteotomy location, hardware type, and size were determined, the information was transferred to the patient in the operating theatre. Although using this procedure can result in satisfactory outcomes, there are many cases involving severe deformities where preoperative planning can be very difficult. Having a 3-D model closely approximating the actual limb can significantly benefit the preoperative plan. Enter 3-D printing Three-dimensional printing (3DP) is proving to be a very useful technique in veterinary orthopedic applications, particularly as it relates to preoperative planning. Production of multiple models that are scaled on a one-to-one ratio to the patient can allow the surgeon to accurately plan surgical procedures. Using these techniques for preoperative planning can provide several benefits, including lessening time under anesthesia and lowering its associated risks, as well as decreasing surgical site infection. Although it is expensive, the cost of employing 3DP can be justified when considering the benefit of shorter surgeries, less anesthetic time, and facilitating more consistent results to avoid subsequent revision surgeries. In the majority of cases, the use of 3-D modeling is …
