Nutrition And Advanced Diagnostics Can Combat Parasite Plagues, Other GI ConditionsNovember 9, 2011 Primary care veterinarians and internal medicine specialists alike say gastrointestinal (GI) disease comprises up to 25 percent of their caseloads. Diagnosing and treating the array of chronic cases can be complex. With new pet foods created to prevent or maintain certain GI conditions, new in-house testing and diagnostic tools, more patients and clients can eliminate acute disease or minimize symptom flare ups in maintaining chronic cases. “Parasites, digestive disturbances and food allergies are the most commonly seen GI issues,” says Cade Wilson, DVM, of Carter County Animal Hospital P.C. Ardmore, Okla. “But giardia, GI cancer, GDV are other conditions that require more work to treat. Giardia could be difficult to identify before the new SNAP giardia test was developed and chronic conditions require diagnostic tools or surgery to identify.” Richard E. Goldstein, DVM, Dipl. ACVIM, Dipl. ECVIM, associate professor of small animal medicine at Cornell University, says SNAP tests such as the giardia and pancreatitis tests have brought testing in-house, minimizing missed disorders/diagnosis and expediting treatment. “It takes less than 10 minutes to get a result from SNAP tests,” Dr. Goldstein says. “The shelf life is good and they’re economical. They’ve improved patient care for …
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Evidence Based Medicine: Neuromodulation And Kidney DiseaseNovember 4, 2011 If, as gerontologists insist, “Age is not a disease,” then why does getting old seem so hard for some?1 True, declaring that an animal companion’s declining organ function and pain are “just a result of getting old and there’s nothing we can do about it” is unacceptable. Furthermore, a hands-off approach may unjustly limit a caregiver’s options. Many human parents of dogs and cats want to do more; they need direction and information from their veterinarians about what to pursue and when. Accumulating evidence reveals that over time, the autonomic nervous system weakens in its ability to respond appropriately to endogenous and exogenous provocation. This may invoke a persistent state of vasomotor and glandular dysregulation that ultimately culminates in organ disrepair.2 However, certain natural, drug-free methods help offset age-related derangements in metabolic and musculoskeletal capacity. Termed “somatic afferent stimulation,” techniques such as acupuncture, massage and laser therapy aid autonomic function and circulatory health. Specifically, they bolster the endogenous capacity of the nervous system to autocorrect autonomic control of organ function.3 This translates into a host of potentially effective integrative medicine options for geriatric veterinary patients currently facing numerous end-of-life challenges, such …
Two Simple Ways To Improve Patient CareNovember 1, 2011It's fascinating to me that every practice seems to have a different protocol to achieve similar results. For this column, we present better ways to intubate and scrub patients. Each doctor or technician probably has a different intubation protocol. I recently read a description of how we should probably all intubate. It was written by Sheilah Robertson, a board-certified anesthesiologist at the University of Florida College of Veterinary Medicine.1 Here's the idea: Most people test the cuff of a large endotracheal tube by inflating it with a syringe (aka "dry syringe," "air syringe" or "cuffer puffer"), waiting a few seconds, and deflating it. Then, some people lube the tip and the cuff of the tube with lubricating jelly (again, this specifically applies to large tubes). It seems that most do so on a deflated, folded cuff, which actually greatly decreases the benefits. Dr. Robertson suggests adding lube to an inflated cuff. Think about it. It wouldn't take any longer than doing both steps separately, but it would lubricate the cuff much more effectively—on 100 percent of its surface—instead of a few random spots. I have only witnessed one technician do that (surely there are more out there!) But …
Diabetes UpdateOctober 31, 2011 Diabetes mellitus affects 1 in 400 cats and is on the rise, possibly because of increased obesity rates, according to Morris Animal Foundation. Intervet Schering-Plough, now owned by Merck Animal Health, makers of Vetsulin (porcine insulin zinc suspension), says about 1 in 500 dogs suffer from the signs of diabetes mellitus. A Merck market study of more than 200 veterinarians showed that 70 percent had between one and 10 diabetic canine patients, while 26 percent said they treat 11 or more diabetic canine patients. With such a significant number of feline and canine patients affected by the disease, primary care veterinarians and specialists alike have voiced concern about a significant industry issue—the availability of insulin brands they have grown to rely on. “There’s always a concern that something will go off the market,” says Richard Goldstein, DVM, Dipl. ACVIM, Dipl. ECVIM, associate professor of small animal medicine at Cornell University in Ithaca, N.Y. “The trend in human medicine decides if an insulin brand will be available for veterinary use, considering many insulin forms vets use are actually created for the human market.” Dr. Goldstein says human medical practitioners are trending toward using combinations of short- …
Testing For WellnessOctober 21, 2011 Today’s in-house laboratories allow veterinarians to test patients’ blood for an increasing range of conditions and diseases—but what’s news about the devices is how practitioners are using them. Besides using analyzers to test sick patients, clinicians are also using them to keep them well. Kate Hunter, DVM, invested in a blood chemistry analyzer 15 years ago when she opened her practice, Carver Lake Veterinary Center in Woodbury, Minn. “We felt it was important to be able to do pre-surgical testing on all surgical patients and to be able to provide diagnostics on sick patients right away,” she says. By testing her surgical patients before the procedures, she says she and her team can identify the 10 percent of patients that have underlying disease and delay surgery or tailor their anesthetic protocol appropriately. The Good and the Bad “When we’re presented with sick patients, [in-house testing] has allowed us to discuss both normal and abnormal results face-to-face with owners at the time of their appointments,” Dr. Hunter says. “We are then able to provide any additional diagnostics or treatment needed right away. This has improved compliance and value.” …
FCV Adapts, Evolves Into New StrainsSeptember 28, 2011 When David Bowie sang “Time may change me,” he may have been writing of feline calicivirus (FCV). This virus is not content to live the peaceful life of genetic stability adopted by its feline respiratory disease associate, feline herpesvirus-1 (FHV), but rather is constantly morphing and shifting into new strains. Why does FCV behave this way, what are the implications for cats, and what are the implications for feline vaccines? A major reason for FCV’s mutability is its simple genetic material, which comprises a single strand of RNA. When the virus infects a cat’s respiratory cell (or perhaps some other location in the body) and wants to replicate, it first has to convert this single strand of RNA back to DNA for duplication, then make multiple copies of the DNA back into RNA again, to be subsequently packaged and sent out as fresh virions looking for new cells. It is easy to see that this process can open multiple opportunities for changes or mutations to the RNA base order. Additionally, as there is no second strand of genetic material in the virus that might serve as a correction template to match the base pairs, then any change …
How To Cater To CatsSeptember 28, 2011 We are fortunate to live in a society that celebrates the poise, beauty and quirky personality of cats; with more than 93.6 million owned in the United States, cats outrank dogs as the most widely owned pet by more than 17 percent.1 The big question, then, is why, with an increasing population, do cats represent an ever-shrinking portion of most general practices’ active patients? Why does the average feline examination generate $203 in comparison to $225 for the average canine examination?2 It’s as if cats are looked upon as second-class citizens when it comes to veterinary care. The oft-cited reason is their independent and stoic nature, as well as their tendency to mask pain and illness. But this explanation fails to get to the root of the problem—the failure of our industry to educate cat owners on the importance of wellness care. The unfortunate result for a large number of practices is that vaccines, rather than wellness and preventive care, have become the initiator for a feline veterinary visit. There have been attempts to overcome this lack of knowledge and client education. For example, the American Association of Feline Practitioners has been offering …
Feline Stem Cell Therapy Shows PromiseSeptember 28, 2011 Rosemarie Williams, DVM, owner of The Sound Cat Veterinary Hospital in Wilmington, N.C., introduced stem cell therapy to her feline-only practice in April and says preliminary results look promising. Dr. Williams is studying the effects of adipose-derived stem cell therapy on chronic inflammatory bowel disease and chronic inflammatory kidney disease in cats. Before Williams’ clinical trial, stem cell therapy had been primarily used in canine and equine osteoarthritis, hip dysplasia, ligament and cartilage injuries. “About 3 to 5 percent of cats age 5 and older suffer from IBD and at least 30 percent of senior cats have some level of kidney disease,” Williams says. “I’m hopeful this therapy can minimize clinical symptoms and even eliminate disease in some cases. There’s much about the therapy’s effect on cats that is still unknown. I’ve treated six cats with IBD and symptoms have regressed. I hope to treat at least 50 within a year-long timeframe. “All the cats that underwent treatment are gaining weight, indicating that their intestinal tracts are absorbing nutrients more efficiently,” she added. Williams injects stem cells harvested from the cats’ adipose tissue intravenously. In dogs, the tissue is usually administered directly into muscles …
Vets Feeling Pressure To Do More BP ChecksAugust 18, 2011 Human patients’ blood pressure is routinely measured during medical exams and surgical procedures. In the veterinary world, however, blood pressure is monitored in fewer than half of all patients under anesthesia and less often during clinical exams, according to estimates. The disparity traditionally has been linked to the equipment and its cost. “The veterinary profession has been plagued by inconsistent veterinary-specific monitoring equipment, which has made many practitioners gun-shy about incurring substantial equipment related expense,” says Robert Stein, DVM, Dipl. AAPM, executive director of the Veterinary Anesthesia and Analgesia Support Group. “Many veterinarians are frustrated by a piece of equipment purchased at a great price, often at a convention after hearing an energetic rep sing the monitor’s praises, only to have it become the most expensive door stop in the building.” Those days are changing. Manufacturers report that veterinarians are showing an elevated interest in veterinary blood pressure devices as the technology advances and the supporting evidence comes to light. Dr. Stein was an early believer in monitoring the blood pressure of every anesthetized patient. He started using the Dinamap 1846SX, a human monitor available on the secondary market, in 1995. “You learn …
Treating Marijuana ToxicityJuly 13, 2011 When veterinarians think of regionally specific illness, toxicity caused by consumption of native plants and exposure to infectious organisms typically comes to mind. In preparation for a move to Southern California, I studied the effects of sago palm ingestion and inhalation of Coccidioidomycosis with the anticipation of the conditions I would be diagnosing and treating in my clinical practice. I did not anticipate that I would end up treating such a large number of dogs presenting with clinical signs consistent with marijuana (cannabis sativa) consumption. As the sale of medical marijuana is legal in many California cities, dispensaries provide human patients with smokable or edible products. Unfortunately, humans can carelessly leave these products in locations accessible to their curious pets, leading to ingestion. Clinical Signs Although a pet could show signs of marijuana toxicity post-inhalation, the majority of cases I see are due to suspected or known oral ingestion. I have treated dogs almost exclusively, yet cats can be similarly affected. A 2002 study of 250 cases of marijuana exposure showed dogs to be the primary cannabis consumption culprits (96 percent). Cats followed in a distant second place (3 percent), and other species made …
