Chronic Vomiting in Cats isn’t Normal After AllJanuary 22, 2014 A study of 100 cats with a history of chronic vomiting, weight loss, chronic diarrhea or a combination was recently accepted for publication by the Journal of the American Veterinary Medical Association.1 The authors, whom I led, concluded that chronic small bowel disease likely is the cause of these clinical signs in hundreds of thousands of cats. Chronic vomiting, present in 73 percent of the cases, is so common that many veterinarians and cat owners have made excuses for it. The top four reported to me over the years are: * He eats too fast; * She has a sensitive stomach; * It’s just hairballs; and * “He’s just a puker,” to quote one of my clients. Consequently, the typical approach has been the use of diets for “sensitive stomachs,” diets for hairballs, hypoallergenic diets, medications for hairballs and antiemetics (metoclopramide, ondansetron, maropitant, famotidine, etc.). Often there is improvement in clinical signs, but rarely are they completely relieved. In addition, the improvement often diminishes over time. My two clinical associates and two pathologists teamed with me to better understand the cause of chronic small bowel disease in cats. One …
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Three Techniques to Treat Toe FracturesJanuary 22, 2014 Although metacarpal and metatarsal fractures are fairly common injuries in cats and dogs, the best way to treat is somewhat controversial. Incomplete or complete fractures of one or two metacarpal/metatarsal bones can be treated with external coaptation. The splint should immobilize the carpus/tarsus completely to be effective. Generally, external coaptation requires six to 12 weeks to achieve bony union. Splints should be changed at least weekly to decrease the risk of pressure sores in an at-risk area because of the lack of soft tissue coverage. If three or four metacarpal/tarsal bones are fractured and displacement is present, external coaptation may be a poor choice. When multiple bones are fractured, the splint cannot maintain reduction properly, and while union may occur, the recovery will be prolonged and deformity is likely. Surgery is considered a better choice in such cases. Indications for surgery Internal fixation is used for simple or comminuted metacarpal/metatarsal bone fractures or in patients with three or four fractured bones. In multiple bone fractures, the fixation can be used for all fractured bones or for metacarpal/metatarsal bones 3 and 4 only, i.e. weight-bearing toes. Options for fixation include plating or wiring (rarely performed), …
Veterinary Nutrition And You: Redefining The Future Of Pet FoodDecember 3, 2013 I’ve been to AVMA, NAVC, CVC and ACVIM and, after attending at least five of each of the above conferences over the past 15 years, I can attest that they’ve all got loads to offer. But that’s not to say there aren’t other international-level conferences worth your while. Take WINSS, for example. The Waltham International Nutritional Sciences Symposium is arguably the world’s premier pet nutrition conference. Yet until Mars invited me to attend this year’s October meeting in Portland, Ore., I’d never thought to venture outside the confines of my own customary conference rotation. Which would’ve been a shame. Not only would I have lost out on some killer doughnuts (Portland’s VooDoo Doughnuts fries up the finest), this meeting established that attending smaller symposia treating niche-ier topics can prove even more rewarding than the usual suspects. After all, there’s nothing quite so stimulating as some crisp non-tropical air, a fistful of fried dough, a huge conference hall teeming with veterinary nutritionists and three days chock-a-block with talks, presentations, hot topic sessions and even a bit of entertaining dissent. Most exciting of all, however, was not the banter that arose after one speaker attempted to dispel …
Dissecting The Cat-Dog Healthcare DisparityNovember 14, 2013 Unless you’ve been hiding under a rock lately, you’ve doubtless borne witness to the latest round of handwringing within our national community. This time it’s to do with our nation’s most populous but least served companion animal species: the cat. Though statistics tracking both canine and feline hospital visits reveal a significant downward direction, cats are far less likely to receive the routine treatment we’ve collectively determined they deserve. Yes, it seems that some cat lovers don’t care for their feline pets to the same tune they do their dogs. So say those of us who observe the differences between how people treat their own beloved cats and dogs on a daily basis. And so say our collegial powers that be. A Look at Numbers Because of this, Bayer Healthcare and the American Association of Feline Practitioners teamed up to confirm our suspicions with the Veterinary Care Usage Study III: Feline Fidings. Here’s a quick summary of the basic findings I received firsthand at a lunchtime panel discussion-style press event at the American Veterinary Medical Association conference in Chicago this past summer: * 52 percent of cats hadn’t seen a veterinarian within the past …
Staffs Embrace Laser TherapyNovember 14, 2013 Beside compassion, perhaps the most useful implement in the toolbox of Pamela Iles, practice manager and technician at Cat Haven Veterinary Clinic in Birmingham, Ala., is a laser beam. Cat Haven uses therapeutic lasers in a number of cases and for a variety of purposes: to treat arthritis and wounds; to help with nerve regeneration; for post-surgical pain relief; for sinusitis treatments. The clinic also uses laser therapy for calming purposes. Gingivitis, chronic otitis and renal disease are also on the long list of ailments that call for breaking out the therapeutic laser at Cat Haven, which purchased it last summer. Courtesy of Litecure LLC "We have seen remarkable results in virtually a short period of time,” said Iles, who has seen a great many cats regain nerve function and benefit from increased mobility. "The laser is improving the quality of life for many of our patients. Arthritic cats can run and jump, cats with sinusitis can breathe, cats with nerve damage can walk again. There are just never–ending possibilities.” But the bottom line is that laser therapy can improve a clinic’s functionality and bring in more income …
Wound Care 101 And BeyondSeptember 30, 2013 Dr. Schmiedt, assistant professor of soft tissue surgery at the University of Georgia Veterinary Teaching Hospital, advises a back-to- basics approach. "I am something of a Luddite here,” Schmiedt said. "When dealing with hard-to-handle wounds, I think veterinarians should revert to the basics of wound healing. There is always a biological basis for why a wound won’t heal.” A wound stuck in the inflammatory and debridement stage, for example, is possibly being prevented from moving to the repair phase by dead or necrotic tissue, or an infection, or "some magic treatment one keeps slathering on,” he said. "If a wound is stuck in the repair phase with a granulation bed that will not contract and epithelialize, this is usually because the tension is too great for the myofibroblasts, there is infection or inappropriate wound care,” Schmiedt said. "Identifying that biological problem and correcting it is critical. Reverting to the latest device, cream or treatment is not the answer to getting wounds to heal.” Varied Approaches Bryden J. Stanley, BVMS, MACVSc, MVetSc, Dipl. ACVS, an associate professor in the surgery department at the Small Animal Clinical …
Animals Have Emotions, But What About ‘Theory Of Mind’?September 30, 2013We have come a long way since the Descartian view that animals are mindless machines or the Pavlovian or Skinnerian assessments that animals simply react to their environment reflexively and/or behave only in response to positive or negative reinforcement. Scientific thinking about animals’ cognitive processes has been stifled since the turn of last century by the likes of C. Lloyd Morgan’s famous canon which states that, "In no case is an animal activity to be interpreted in terms of higher psychological processes if it can be fairly interpreted in terms of processes which stand lower in the scale of psychological evolution and development.” According to this canon, anyone who ascribed an underlying emotion to an animal’s behavior was simply being anthropomorphic, projecting human feelings onto what were merely "dumb animals.” The extreme behaviorist’s view that animals’ behavior is to be observed and measured but not interpreted prevailed through much of the last century. Even ethologists, who studied the behavior of animals in the wild, did so more by observation and note-taking than by trying to ascribe behaviors to internal motivation or thought processes. To do so at the time would have been heresy. A Different Approach The …
Practical Tips To Improve Fluid Therapy ProtocolsSeptember 30, 2013 When you design a fluid therapy plan, three factors come into play: the patient history, the presenting complaint and the physical exam. What do you use as a maintenance fluid rate? How about your surgical rate? What if your patient is hypotensive? If you are unsure about what should be done, we have good news for you. A panel of experts from the American Animal Hospital Association and the American Association of Feline Practitioners recently published fluid therapy guidelines. Remember that these are suggestions, not a new definition of standard of care for fluid therapy. Yet these excellent guidelines are full of practical tips to improve fluid therapy protocols for sick, hypovolemic and anesthetized patients. They probably represent what most specialists would do and recommend in 2013. What follows is not an exhaustive summary of the article, but a review of some important points, especially as they relate to the surgery world. 1 Replacement vs. maintenance fluids When you design a fluid therapy plan, three factors come into play: the patient history, the presenting complaint and the physical exam. This information will help you determine whether there are changes in volume, content or distribution. …
Heaven And Hell In The Shelter WorldSeptember 23, 2013 Elliot’s owner thought she was wise by having her 1-year-old male pit bull neutered at a local low-cost spay and neuter clinic. A neuter for $25—what a bargain! Something went wrong with the surgery. Five days later, Elliot presented at the local emergency clinic for a grossly swollen prepuce and scrotum, along with ventral abdominal edema. Severe bruising covered most of the scrotum, and some of the skin was necrotic. He was lethargic, anorexic and extremely uncomfortable. The $25 castration included nothing more than the procedure itself. No medications, not even pain medications, were dispensed, and no written discharge instructions were provided. A scrotal ablation was discussed with the owner but she elected conservative treatment—hydrotherapy, cephalexin, tramadol and carprofen. Two days later, Elliot was back in the ER. This time, necrosis and infection were even more obvious. A scrotal ablation was the right thing to do. The perioperative protocol included antibiotics, pain medications and IV fluids, including a constant rate infusion. He was hospitalized overnight and recovered very well. The day after surgery, he was a different dog—immensely more comfortable. Big Money …
The 3 Surgical Options For C-SectionsSeptember 23, 2013 We continue describing our 10 steps for a happy C-section. [See Part 1, "The art and science of a safe C-section,” in the July issue.] This month, in the second of three parts, we focus on anesthesia and surgery. Our goals: safety and speed. 5. Anesthesia Melissa Goodman, DVM, board-qualified in the American College of Theriogenologists at Veterinary Reproductive Services in West Chester, Pa., skips premedication, and prefers masking patients down. She uses the smallest possible dose of propofol only if needed, e.g. in brachycephalic and fractious patients. When giving drugs to the dam, you are indirectly giving them to the babies. Many drugs are rapidly carried through the placental barrier and consequently affect the offspring. This may make resuscitation efforts more difficult. For example, acepromazine, ketamine and atropine can flow through the placenta, so they should be avoided. Glycopyrrolate, if needed, is a better choice than atropine. Choosing an anesthesia protocol that is safe for a caesarean patient is tricky at best. Because hypoxia is a concern for the patient and the neonates, pre-oxygenation for five to 10 minutes is an important precaution. Patients are then intubated and placed on isoflurane or …
