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 …
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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 …
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 …
Facing Up To The Past After An Accidental SurgerySeptember 10, 2013 Declawing cats is my least-favorite elective surgery, but because my employer offers it, I long ago made up my mind to become very good at it and use the maximum possible pain medication that would be safe for the patient. Since our practice has an age and weight limit on declaw surgery, many patients present for simultaneous spay and declaw procedures. Two years ago, I accidentally declawed an 8-month-old, 5-pound kitten that was at the clinic for only a spay. When I began entering the surgeries into the computer, the surgery consent form stared back at me with the simple word SPAY. I gasped. No amount of squinting at the line or fiddling with the paper’s angle would change the fact: I made a mistake, the claws were in the wastebasket, and I had to cowgirl up and eat a slice of humble pie. Taking a deep breath, I called the client and put my cards on the table. I apologized, explained our pain management protocol and told her I would send home a bag of special cat litter used for declaw patients, all at my expense. Lucretia (not her real name) took the news …
The Mystery Is Solved!August 27, 2013 In my last blog, you heard about my Mickey, who was sickey. Well, the mystery has been solved! The abdominal ultrasound discovered an unsuspected culprit in the demise of his personality and comfort: pancreatitis. Wow, I didn’t see that coming! Considered acute, the poor guy must have been suffering with discomfort for several months; we know how painful pancreatitis can be for humans, and so we assume the same for animals. But in cats especially, it’s a difficult thing to detect. My main experience with pancreatitis comes from my years working in internal medicine and critical care, where our odds of pulling a dog through were pretty high, and our odds of pulling a cat through were dismal. Mickey’s hope rested on the fact that at least he was still nibbling food, and not consistently vomiting so we had a chance to turn things around. He has been responding to medical treatment thus far (famotidine and cerenia for nausea, and gabapentin for pain) and is finally showing some of his old personality! Such a relief … but it was so aggravating to have taken so long to identify the …
On Handling Outsized Risks From Bite-Sized PatientsAugust 22, 2013 Recently two of my clients found themselves heading to their nearby urgent care facility after their own pets bit them. Both clients openly acknowledged they'd disregarded my counsel, happily paid their bills, and promptly sought medical attention. At the risk of courting your derision along with your sympathy, I'll confess: Recently two of my clients found themselves heading to their nearby urgent care facility after their own pets bit them ... in my exam room! Bad, I know. What's worse is that I was physically present to witness both events. Though I'd urged each of these clients to keep their hands well away from their anxious pets—in the second case, imploring a client not to attempt clipping her own terrified cat's claws—they'd apparently felt compelled to ignore their pets' warning signs (along with my advice). The good news? Both clients openly acknowledged they'd disregarded my counsel, happily paid their bills, and promptly sought medical attention. I then made note of the events in their medical records, flagged the files for future reference ("Never allow this client to handle her own pets—no matter what she says!"), and called the following …
