Nine Steps For Pain-Free Nine LivesJanuary 30, 2014 Do you think cats feel pain? Does everyone on your team think that? What do your clients think about pain in cats, and what do you say to them to make them think that? Because owned cats outnumber dogs in the U.S. and Canada, that makes them the most popular pet in North America. Still, they receive far less veterinary care than their canine "cousins”–according to recent studies, about 50 percent less. In recent years, a lot of good things have happened to improve cat health–research, guidelines, continuing education, feline practice board certification, feline health initiatives, new medications and products, and even a collaborative feline health and welfare organization, CATalyst Council. So what advances have you made in your practice to identify and treat cats in pain? If you think you can do better, here are nine steps to take to show that you are committed to caring for cats. With compassion, collaboration and consideration of creature comfort, you’ll be seeing them throughout their nine lives. 1. Team agreement: Cats DO experience pain, just like dogs and people. This can start as a simple written, electronic …
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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 …
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), …
More "Zebras": Mandibular SwellingsDecember 17, 2013 My November and December columns focused on zebras. Not the actual animals, but rather the zebra diagnosis, that rare clinical presentation that may mimic a more common abnormality. I finished my November column by asking readers to share with me any zebras they have encountered. Linda Molesworth, VMD, of Huntingtown, Md., sees a zebra more frequently than most of us, because she is the proud owner of Zena (see photo above). Let’s continue to discuss dental/orofacial zebra diagnoses, in the context of mandibular swellings in dogs. Signalment—age, breed and sex—may be a very important component of the information gathered when creating a list of differential diagnoses. Take the example of a patient that presents for a ventral mandibular swelling. Many a mandibular swelling has been caused by a nonvital tooth with endodontic infection, often as a result of a tooth fracture, or extension of periodontal disease to the level where it can invade the endodontic system of a tooth. However, numerous other possible causes exist. If unilateral mandibular swelling is seen in a 14-year-old dog, the nonzebra diagnosis of neoplasia would come to mind. However, if nonpainful swellings were occurring in both mandibles of a …
The Lastest On The Deadly Canine ParvovirusDecember 3, 2013 While parvovirus’s clinical signs and treatment principles haven’t appreciably changed in recent years, our knowledge base on disease transmission and patient prognosis has vastly improved. At the CVC veterinary conference in Kansas City in August, Stephen C. Barr, BVSc, spoke to attendees on all things parvo. Some of his key points follow. Parvoviruses are extremely hardy, and remain infectious in the environment for more than five months. Not all disinfectant products work on parvo. Barr recommends a 1:30 bleach solution (5 percent sodium hypochlorite). Leukocyte numbers, character help track the course of parvo By Lou Anne Epperley, DVM For Veterinary Practice News The ELISA “snap” test for canine parvovirus is an efficient initial diagnostic test. Then, leukocyte counts and character can provide hints of the virus’s progress and the patient’s prognosis, according to Stephen C. Barr, BVSc, infectious disease specialist at Cornell University College of Veterinary Medicine. Barr told veterinarians at the CVC veterinary conference in Kansas City that CPV-2 infection causes necrolysis of myeloid and erythroid stem cells in bone marrow. …
Wellness Plans Allow Vet Clients To Budget For Pets’ Preventive CareDecember 3, 2013 In the minds of most veterinarians there’s a plan for just about every pet they see to ensure that pet’s immediate and long-term medical needs. But the reality, according to proponents of wellness plans, is that those details too often go unrelated to pet owners. "We really do have a full-year plan for their pets in our head,” said Carol McConnell, DVM, MBA, chief veterinary medical officer with Veterinary Pet Insurance of Brea, Calif. "When a pet comes in you look at the age, where they live, and other factors, and you formulate a plan.” It’s a detailed plan, Dr. McConnell said, adding, "But we’re clearly not good an explaining it to clients.” VPI in January launched a wellness service for veterinarians to offer clients called "Preventive & Wellness Services, which McConnell pronounces as "paws.” "We are basically positing ourselves as a silent partner with veterinarians,” McConnell said. She said the service is proving popular, with between 2,000 and 3,000 plans across the U.S. in place through more than 100 practices. Jeffrey S. Klausner, DVM, MS, Dipl. ACVIM, senior vice president and …
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 …
