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 …
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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 …
Integrating Treatments For Joint PainSeptember 30, 2013 Combining holistic and conventional veterinary therapies, Michael Dym, VMD, advocates a four-pronged approach in using nutraceuticals to treat joint pain and arthritis in dogs and cats. He reports success with a glucosamine/MSN supplement, anti-oxidants, omega-3s and a homeopathic pain-killer, Traumeel, which he said is produced from natural ingredients. Dr. Dym practices holistic and integrative conventional veterinary medicine at Palms West Veterinary Hospital in Loxahatchee, Fla., and operates his own practice, making house calls in the Wellington, Fla., area. "Traumeel has been involved in human clinical studies and is proving as or more effective at reducing discomfort than NSAIDs,” Dym says. He says he has excellent results when treating both dogs and cats with it. Bonnie Mitchell, DVM, owner of Coastal Animal Clinic in Jensen Beach, Fla., recommends joint supplements as both a preventive and for treatment of dogs and cats with lameness issues. She says dogs seem to like chewable joint supplements—they think they are getting a treat. "It’s hard to get a cat to chew a tablet, so powder in their food works best for cats.,” she says. For an 80- to 90-pound dog, a loading dose can be expensive, so if Mitchell …
Dried-on Blood Is Biggest Enemy Of Surgical InstrumentsSeptember 30, 2013 In the bustle of a veterinary surgical ward, proper care of surgical instruments can easily be overlooked. But clinics that neglect proper cleaning and maintenance of equipment pay for such neglect in the long run in costly repairs and replacements. If properly cared for, surgical instruments can last the life of a practice, says Derek Lashua, director of marketing for Spectrum Surgical Instruments/STERIS Specialty Services in Stow, Ohio. The first step in proper care is to begin the cleaning process as soon as possible after surgery—within 20 minutes, he says. "Even if your instruments are not going to be sterilized until later, washing instruments shortly after surgery prevents blood from drying on them and is your best defense against staining, pitting and corrosion,” Lashua says. Cleaning, Sterilization Dried blood is the biggest enemy of surgical instruments, Lashua says. In fact, one of the most common problems his company sees is damage caused by dried-on blood and the use of improper cleaning solutions. If instruments can’t be washed immediately after surgery, clinic staff can use a pre-cleaning spray to prevent blood from drying on them, …
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 …
Surgical Insights: Care Of Neonates After A C-sectionSeptember 23, 2013 While rubbing babies and clearing their airways, we also should strive to prevent the three "hypos" in neonates: hypothermia, hypotension and hypoxia. We conclude our three-part article on C-sections with resuscitation and care of the neonates. It is time to change a few old habits and to embrace more modern techniques. Part 1 is here; Part 2 is here. 7. Resuscitation While rubbing babies and clearing their airways, we also should strive to prevent the three "hypos” in neonates: hypothermia, hypotension and hypoxia. Hypoxia is a constant battle during a C-section. The amniotic sac should be removed as soon as possible, and the mouth and airway must be cleared with a bulb syringe. "Don’t use too much suction,” reminds Margret Casal, DrMedVet, PhD, Dipl. European College of Animal Reproduction, University of Pennsylvania School of Veterinary Medicine, "as it could damage the delicate tissue of the pharynx and larynx.” Alternatively, a mucus suction device for human babies can be used, e.g., the poetically called "snotsucker nasal aspirator.” Hypothermia can be prevented by using warm towels straight out of the dryer, or a …
