The Future Is Now In Veterinary Dentistry, Oral SurgeryApril 4, 2013 Veterinary dentistry and oral surgery are relatively young specialties, and advances are made each year in how we diagnose and treat patients with oral and craniofacial diseases. This article highlights just a few of the upcoming, and recently unveiled, advances in veterinary dentistry and oral surgery. Point-of-Care Diagnostics Diagnostic tests that provide answers, sooner rather than later, are always appealing. One example of a recently released test is the OraStrip QuickCheck Canine, from PDx Bio Tech of Lexington, Ky. When run across the maxillary gingival margin, this strip measures the concentration of thiols in canine oral fluid of the gingival margin and provides a visual signal related to the thiol concentration. Thiols are produced by anaerobic bacteria and are responsible for halitosis of periodontal origin. These strips are perhaps most helpful in a general practice setting as an educational tool for pet owners, providing a scale of severity for owners to see. Since much of the disease associated with periodontitis is beneath the gingiva, the strips serve as a semi-quantitative visual gauge. Other possible point-of-care diagnostics may arise in the future from the field of salivary proteomics, as described in a recent proceedings …
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Treatments For Osteoarthritis In Pets Continue To EvolveApril 3, 2013 Twenty years ago, veterinarians' approaches to treating osteoarthritis pain in companion animals were, for lack of a better word, rudimentary. “We had so few tools and even less understanding of pain pathophysiology,” said Robin Downing, DVM, of The Downing Center for Animal Pain Management in Windsor, Colo. “We were still locked into thinking that dogs and cats experienced pain differently from humans.” Aspirin was the drug of choice back then, said Dr. Downing, as well as “‘bute' [phenylbutazone] with the occasional joint corticosteroid injection,” said Michael C. Petty, DVM, Dipl. American Academy of Pain Management, owner of the Animal Pain Center of Arbor Pointe Veterinary Hospital in Canton, Mich. Both practitioners pinpoint a significant breakthrough in veterinary medicine that began to shift veterinary practitioners' approaches to managing osteoarthritis pain. “When Pfizer Animal Health came out with Rimadyl, it changed the entire game,” said Dr. Petty, who is also the president of the International Veterinary Academy of Pain Management. “Not only did we have an amazing new product to treat OA, Pfizer did a great job in teaching veterinarians how to recognize the signs of OA in dogs.” The 1997 launch of the first …
Of 'Mutt Tests' And The Muddled Politics Of Dog Breed IDApril 1, 2013 It was 2007 when canine geneticists threw us an unexpected bone. After spending years mapping the entire canine genome, they had encountered an unanticipated application for their findings. They'd make use of their accumulated knowledge to help tease out the true purebred provenance of even the motliest mutt. These so-called “mutt tests,” officially termed “dog breed identification genetic tests,” were the very first of their breed. Which is probably why the results seemed a bit sketchy. And probably why so few of us bothered to try them. Testing, Testing As a blogger, however, I felt compelled to put these tests to the test. When I did, the results seemed head-slappingly silly. I mean, it was hard to look at a medium breed, short-nosed dog and consider the Chihuahua an acceptable answer to the question of black-box parentage. It was this kind of seemingly off-the-wall answer that left dog owners feeling fleeced and the vet profession bewildered. Which is why, despite its sound scientific roots, the less charitably inclined took to renaming the “Wisdom Panel” the “witless panel.” (Ouch!) But fast-forward five years and things are definitely looking up for these test makers. Over time, …
8 Pearls Of Wisdom Gleaned From My Referring VeterinariansMarch 6, 2013 By keeping an open mind, specialists can learn from veterinary practice generalists. Here are eight pearls gleaned from some of my referring veterinarians. Plumpness penalty Dr. Lynn recently explained that she charges more to perform abdominal surgery on an overweight or obese pet than she does for the same procedure on a lean patient. Her reasoning most commonly applies to ovariohysterectomies. “It makes sense because surgery will be tougher, it will take longer, and it is riskier,” she explains. In addition, it is quite possible that you will need more suture material. Subtle title As the saying goes, “It’s not what you say, it’s how you say it.” A colleague gave it a new twist when she wanted to organize a conference for her clients. In spite of a large sign under the clinic name that said “Free seminar on hip dysplasia,” few pet owners responded. Then she had a revelation. Few clients will happily admit that their dogs have hip dysplasia, even subconsciously. Once she realized that, she changed her title. The street sign soon said “Free seminar on hip health,” and reservations poured in! Infusion precision …
Dental Implants In Small AnimalsJanuary 31, 2013 Implant dentistry and bone grafting in small animals today is where it was in human dentistry 20 years ago. Dental implants have been well proven to maintain alveolar bone and avoid alveolar collapse, improve mastication and bone density, avoid orthodontic problems and prevent canine alveolar collapse, which may avoid lip catching. It has also been well documented that the majority of implant failures occur in humans during the first year after implant placement. The main reasons for implant failure during the first three to six months prior to prosthetic replacement generally is poor surgical technique, poor patient selection or inadvertent overloading of the implant during osseointegration. The main reasons for failure of an implant after implant restoration is generally poor treatment planning or overloading of the implant during remodeling of the bone. Figure 1A: Tooth sectioned Courtesy K9 Implant solutions Figure 1B: Osteotomy being performed Figure 1C: Implant being placed After the first year, it is well documented that success rates are close to 100 percent due to the body’s individual ability to adapt …
Treatment Options For Canine Cruciate Ligament Disease (CCLD)January 30, 2013 Due to the large volume of feedback received in response to the previously published Veterinary Practice News article on canine cruciate surgery, it is clear that some confusion exists regarding our current clinical management of patients with canine cruciate ligament disease (CCLD). Recognizing that there are, unfortunately, large knowledge gaps regarding the clinical efficacy of many treatments for this disease, we do our best to tailor our treatment recommendations to the specific needs of the patient and pet owner. While in some instances this may mean a non-surgical therapy approach, surgical treatment is provided as a component of the overall patient care for the majority of patients presented to the orthopedic service. Nonetheless, we prefer not to think about CCLD patient care (or clinical research) in terms of a simple “surgical versus non-surgical” dichotomous relationship; instead, we prefer the integrative approach of determining the best combination/choice of surgical, pain management, rehabilitation and complementary medicine techniques. The most important question we should ask ourselves is: “Which treatment combinations can provide the best long-term quality of life?” Obviously, the answer to this question differs based on patient signalment and athleticism, concurrent disease and owner’s expectations. The goal of this …
What You Need to Know About Sexual Aggression In Neutered CatsJanuary 28, 2013Sexual behavior by cats is a pretty gnarly business. A male waits for his moment and then darts after the female, pouncing on her from behind, biting her in the neck and pinning her to the ground, while he intromits his barbed penis. As he withdraws, the backward-pointing spines on his penis lacerate the female's vagina, causing her to scream and roll away, and she may smack him if he doesn't get out of range quickly enough. All in all, a pretty unpleasant sounding experience though, surprisingly, the female will tolerate such ravishes multiple times from multiple suitors when she is at the peak of estrus. Most of us don't want this type of behavior going on in our homes, and neither do most pet owners want an intact male cat around for other reasons; notably, intact males are generally more aggressive, frequently engage in objectionable marking and mounting behavior, and have a constant eye for the door, particularly when a neighboring queen is in heat. That's why most cat owners who are not specialist cat breeders gladly accept neutering, in addition to birth control reasons. Mega Masculine Kitty As we all know, neutering is very successful in cats …
On Dishing Out The F-word And Dropping The O-bombDecember 20, 2012 Scanning my journals and trade magazines in search of news and notable literature, I came across a veterinarian-authored how-to piece explaining how we should approach the fraught topic of weight loss in pets. Go easy, the author urged, as pet owners are easily put off by language they may perceive as accusatory or judgmental. A veterinarian who charges into this subject without gentle preamble risks not only his client’s badly needed buy-in, he risks losing his client altogether. I might have read past this well-stated bit of advice except that it coincided with an email delivered by an indignant Miami Herald reader (I write a weekly pet advice column) who seemed to echo her sentiments: My veterinarian and I are on the outs. She’s been insisting for years that my cat is overweight and has now started using words like ‘fat’ and ‘obese’ to describe him. I’ve never denied that [my cat] can stand to lose a few pounds, but I think using that kind of language is just plain rude. Is this the kind of bedside manner being taught in vet school these days? Ouch, that stings! Yet we …
Obsessive Compulsive Disorder In AnimalsNovember 21, 2012 Since a publication by child psychiatrist Dr. Judith Rapoport, et al, in the Archives of General Psychiatry (1992), the term “compulsive disorder” has entered the veterinary lexicon. Before that, repetitive disorders of species were referred to as “stereotypies.” I’ve studied such behavior for nearly 30 years, the first 10 of which I believed I was studying stereotypies. My first observations were in horses engaging in “stall vices” like cribbing and weaving and stall walking. Later, I broadened my interest to include acral lick dermatitis and tail chasing in dogs and wool-sucking/pica and psychogenic alopecia in cats. I also had some interest in feather-picking in birds, chain chewing and bar biting in pigs and the plethora of repetitive disorders shown by zoo animals. I always believed the mechanism underlying these behaviors was essentially the same with, perhaps, certain species variations imposed on a common underlying theme. Early on, I was convinced that stereotypies were mediated by nature’s own morphine-like substances, the endorphins, as morphine antagonists blocked the behaviors I studied in horses and dogs. Dr. Rapoport’s 1992 article, however, changed the way we think about repetitive disorders and altered our approach to treatment. Rapoport showed …
Complex Partial Seizures Or Compulsive Behavior?November 21, 2012 Complex partial seizures are well recognized in human medicine and, according to some authorities, are more prevalent than tonic-clonic seizures. However, these focal electrical events are not widely acknowledged in veterinary medicine. It was a different story in the 1960s, when numerous automatonish behaviors were classified as partial seizures. A trip down memory lane to the Kirk’s Current Veterinary Therapy of 1960 or so is all it takes to be reminded of this fact. One of the reasons for the abandonment of the partial seizure diagnosis was the realization that many repetitive behaviors were not so much of seizure origin but actually were (obsessive) compulsive disorders—a completely different barrel of fish. But the realization that some behaviors could be compulsive doesn’t necessarily mean that partial seizures never occur. Odds are they should. Another reason for the unpopularity of diagnosing these conditions is that they often produce subtle—though frequently highly unusual—clinical signs. Simple partial seizures in people, which often precede complex partial seizures, may involve only altered perception, such as déjà vu or jamais vu. Both are tough to detect in a dog! But complex partial seizures, once developed, produce obvious clinical signs. The locus …