Ultrasound and telemedicineMay 27, 2019Don't just send him an ultrasound image and think he'll do business with you. "I will not read ultrasound images unless I've taught the person through doing the ultrasound," said Anthony J. Fischetti, DVM, MS, DACVR, department head of diagnostic imaging at the Animal Medical Center in New York, and president of Veterinary Ultrasound Society of the American College of Veterinary Radiologists (ACVR). "If I'm just reading still images from someone I haven't trained, I won't read them. I won't take their money, I won't try to make a diagnosis, and I kind of wish my colleagues would do the same," Dr. Fischetti said. Why? There's just too much to get wrong, he said. "You can make so many things look abnormal with ultrasound if you don't know the orientation of the probe or how the image was made," Fischetti said. In human medicine, often a relationship is already developed between those performing the ultrasound and the radiologist, so there's a level of trust and comfort. "We're just not there with veterinary medicine yet, and I'm personally against most telemedicine ultrasound," Fischetti said. Building relationships to improve trust and communication is also of utmost importance for Nathan C. Nelson, …
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Gathering vital patient information with ultrasoundMay 27, 2019Anthony J. Fischetti, DVM, MS, DACVR, department head of diagnostic imaging at the Animal Medical Center in New York, had just finished his shift. It had been an odd day; two dogs that had turned yellow had been brought into the clinic. The first patient, an older dog, had a tumor at the entrance of the gall bladder into the intestines—a common bile duct obstruction. The second patient had collapsed, experiencing diarrhea and vomiting. "I used the ultrasound to diagnose that it wasn't the liver," said Dr. Fischetti. "It turned out the dog was hemolyzing." An old, corroded coin in the dog's stomach was causing zinc toxicity. Thanks to the ultrasound images, the endoscopist retrieved the coin and the dog improved. Fischetti, who also is president of Veterinary Ultrasound Society of the American College of Veterinary Radiologists (ACVR), as well as other experts, say ultrasound is a safe and simple way to get more information on ailing patients. "I think the real value of ultrasound is its noninvasive nature," said Nathan C. Nelson, DVM, MS, DACVR, a clinical associate professor of radiology at the North Carolina State University College of Veterinary Medicine. Why use ultrasound? Key considerations for adding …
Dogs can alert human risk to Lyme diseaseMay 27, 2019Health-care providers can now use dogs as a way to measure human risk for Lyme disease, according to a study by Companion Animal Parasite Council (CAPC). "This research shows how man's best friend continues to safeguard humans as a sentinel to alert humans where they are at greatest risk for Lyme disease," says CAPC executive director, Christopher Carpenter, DVM. "The model established in this research breaks new ground to give residents, travelers, and health-care providers a county-level map to help them identify areas of risk across the country." Through the study, researchers quantified the relationship between canine seroprevalence for the disease-causing bacterium, Borrelia burgdorferi, and Lyme disease in humans. Seroprevalence is used to calculate the number of dogs testing positive among all tested dogs within a county. The study showed a correlation between human incidence and dog seroprevalence. According to researchers, they were able to study more than seven years of nationwide canine diagnostic data as a result of dogs being tested annually for exposure to Borrelia burgdorferi. The collected data represented more than 400 million data points, which is usually difficult to obtain when looking directly at ticks and the environment. "By combining sophisticated statistical modeling with this …
Four bold questions about hand asepsisMay 24, 2019Hand asepsis is one of the most critical components of surgical asepsis to lower the risk of nosocomial diseases. In this column, we answer four critical and bold questions related to hand asepsis. Could you lose your driver's license by scrubbing in? With the emergence of alcohol-based hand-rub solutions (ABHRS), you may be concerned that with repeated use, you could have enough alcohol in your bloodstream to lose your driver's license. Alcohol is indeed absorbed through the skin, and you inhale plenty of it while scrubbing (or "rubbing"). So could a breathalyzer test be positive? A 2006 Australian study1 looked at 20 health-care workers and their use of ABHRS repeatedly over a short period of time: 30 applications in an hour! Then serum and breath ethanol and isopropanol absorption were assessed. Traces of ethanol were detectable in the breath of 30 percent of subjects at one to two minutes after application and in the serum of 10 percent of them at five to seven minutes postexposure. Serum isopropanol levels were undetectable at all time points. Even though ethanol did have a positive result, whether through cutaneous absorption or inhalation of fumes, neither level would be considered positive during a police-issued …
Cone-beam computed tomography in dentistry and oral surgeryMay 24, 2019Computed tomography (CT) has revolutionized our ability to detect subtle hard and soft tissue abnormalities of the maxillofacial region. Cone-beam computed tomography (CBCT) is creating much buzz amongst veterinary dentists when it comes to dental/maxillofacial diagnostic tools. What is the difference between CBCT and conventional CT? Rather than a collection of thin, closely spaced slices obtained with a fan-shaped beam of conventional CT, CBCT has both an X-ray generator and detector that rotates around the patient, capturing data with a cone-shaped beam. Both modalities can be used to create very helpful 3-D reconstructions of the areas of interest, although CBCT provides increased detail of dentoalveolar structures. One veterinary study compared CBCT's diagnostic image quality with that of 64-multidetector row CT sagittal slices. Four blinded evaluators compared CBCT and 64-multidetector row CT images. Trabecular bone, enamel, dentin, pulp cavity, periodontal ligament space, lamina dura and "overall impression" were scored. Images captured with CBCT were found to be significantly superior in image quality when compared to images acquired with 64-multidetector CT in all categories.1 Inka, the jaguar My first experience with CBCT was with a patient from the Elmwood Park Zoo in Norristown, Pa. Inka is a five-year-old jaguar that fractured …
Tailoring vaccine protocols to benefit the patient and practiceMay 22, 2019More and more pet owners are starting to question veterinarians and their staff about the need for vaccinating their pets due to misinformation on the internet, as well as sensationalized stories about pets who may, or may not, have experienced a vaccine reaction. Those in opposition of vaccines are passionate about their views, while those in favor are equally vehement on the subject. Is one side right and the other wrong, or is there common ground to be found? Likely a little of both. Not all is yet known about the immune system, and there is still research that needs to be done. As such, recommendations offered today are based on current information, with the full knowledge they could change in the future. Not what they used to be Vaccines were developed to help prevent infectious disease, which they do, and vaccine technology has advanced tremendously since the inception of vaccinology. Vaccine opponents often argue ingredients such as adjuvants (e.g. aluminum, mercury, formaldehyde, and foreign proteins) are reasons to not vaccinate, as they can be the cause of adverse advents. This was true in the past; however, many vaccines have been "purified" over the years through the removal of …
Is fear driving the anti-vaccine movement?May 22, 2019Vaccines are one of the most effective means for preventing disease ever developed and one of the great triumphs of scientific medicine. Widespread vaccination of children has dramatically reduced—and in some cases eliminated—infectious diseases that have plagued humanity for thousands of years. There is less research evidence for the impact of vaccination in companion animals, but there is ample reason to believe vaccines have been equally successful in dogs and cats.3–7 Any veterinarian old enough to remember the emergence of canine parvovirus (CPV) in the U.S. in the late 1970s, for example, would probably testify to the efficacy of vaccination in reducing the incidence of this disease.5–7 There also is compelling evidence showing the reduction of both canine and human rabies cases due to vaccination programs aimed at dogs.8–12 And similar to smallpox, the veterinary disease rinderpest was eradicated largely due to the use of an effective vaccine.13 Vaccines and autism Despite the evident success of vaccination in reducing morbidity and mortality, there has always been controversy about the practice.14 The introduction of widespread vaccination in children was initially met with resistance and legal challenges. There was fear about the safety of vaccines, as well as resistance rooted in …
Service dogs can lead to a better life for ownersMay 21, 2019Service dogs improve the quality of life for their owners, according to a new study. Due to an increase in demand for service dogs, researchers at Purdue University College of Veterinary Medicine determined a need for using standardized measures to look at the relationship between the human-animal bond and psychosocial outcomes among people with service dogs over a four-year period. Elanco Animal Health funded the study. "Our goal was to apply strong science in quantifying the effects these dogs can have on well-being," says Maggie O'Haire, PhD, associate professor of human-animal interaction at Purdue University. "The research also reveals the distinctive role a service dog may have in the lives of the families of those individuals." Of the 154 recruited participants, 97 people who used a mobility or medical service dog displayed better psychosocial health, including higher levels of social and emotional functioning, and better functioning at work and/or school in comparison to the 57 who were on a waiting list. "Previous smaller and chiefly qualitative studies have found preliminary evidence service dogs can have psychosocial benefits among individuals with physical disabilities, but the research has been limited," said Tony Rumschlag, DVM, director, consulting veterinarians, U.S. companion animal business …
Treat aspiration pneumonia like a bossMay 13, 2019With a 25 percent death rate, aspiration pneumonia should be taken seriously. Treatment traditionally includes hospitalization, IV fluids and antibiotics (often a cephalosporin combined with enrofloxacin), oxygen therapy, nebulization, and coupage.
ASU begins clinical study for cancer-preventing vaccineMay 10, 2019An Arizona State University (ASU) professor has begun a five-year clinical study examining the effectiveness of a cancer-preventing vaccine for dogs. Stephen Johnston, PhD, a scientist, professor at the School of Life Sciences, and director of the Biodesign Center for Innovations in Medicine, developed the vaccine over a span of 12 years. He says his goal is to change the way veterinarians treat cancer by preventing it before it can start. Over the course of the five-year study, 800 dogs will either be given the vaccine or a placebo and will be monitored. The University of Wisconsin (UW) School of Veterinary Medicine, Colorado State University (CSU) and University of California (UC), Davis are also participating in the trial. "We're testing a totally novel way of creating an anticancer immune response," says David Vail, DVM, DACVIM (oncology), professor and board-certified oncologist at the UW School of Veterinary Medicine. "The holy grail would be to prevent cancer as opposed to waiting for it to start and then treating it." The vaccine is designed to target common canine cancers, including lymphoma, osteosarcoma, hemangiosarcoma, and mastocytomas. At the beginning, two sets of vaccines will be given every two weeks and then annually. The …
