The Anesthetized Intraoral ExaminationMay 15, 2014 Working ends of an ODU 11/12 explorer, left, and an UNC periodontal probe, right. Courtesy of John Lewis, VMD, BVMS, Dipl. ACVS In last month's column, we discussed the components of the conscious intraoral and extraoral examination. The conscious examination, however, reveals only so much. A comprehensive oral examination requires anesthesia to obtain a complete assessment of oral health and disease. In particular, the periodontium (the attachment structures of the teeth) cannot be evaluated without using a probe at multiple sites around each tooth. Each patient deserves an individual treatment plan based on appropriate diagnostics. The same hold true for teeth: The adult dog's mouth contains 42 patients and the adult feline mouth contains 30 patients that require individual attention. Use your dental probe, explorer and dental radiographs to determine if each and every tooth will be able to provide pain-free function or if it is non-salvageable. Start the anesthetized exam by assessing those structures that were not adequately assessed in the conscious examination: tonsils, pharynx, soft palate, caudal tongue, caudal buccal mucosa. Identify each of these structures as normal or abnormal and document this information on the dental record. Determine the …
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Chinese Herbs: Selling StrychnineMarch 25, 2014 Weary of worrying about what's in Chinese products?1 What about when Chinese products are made in America?2 Do we drop our concerns then? Perhaps we are heading to a future where Chinese and American manufacturing standards become one and the same. In mid-2013, a Chinese company purchased Smithfield Foods Inc., one of the largest pork producers in the United States3. If approved, this deal will mark the "largest takeover of a U.S. company by a Chinese firm." Eat up, America. Enjoy your pork. Never mind that "In recent weeks, China's news media have reported sales of pork adulterated with the drug clenbuterol, which can cause heart palpitations." The list goes on, and includes "pork sold as beef after it was soaked in borax; rice contaminated with cadmium; arsenic-laced soy sauce; popcorn and mushrooms treated with fluorescent bleach; bean sprouts tainted with a animal antibiotic"4 and so on. Chinese herbal products pose problems as well, saddled with a long history of adulteration and contamination. An investigation by Harvard researchers showed that 100 percent of the raw Chinese herbal medicines analyzed contained at least one heavy metal, with a third showing the presence of every metal they tested …
The Highs and Lows of Medical Marijuana for DogsMarch 13, 2014 The cannabis trade, also known as “cannabis-ness,” has evolved from a budding homegrown operation into a blossoming industry, projected to top $10 billion in the next five years,1 signaling the emergence of “Big Marijuana.”2 But, medical marijuana for dogs? Whether or not veterinarians are ready, it’s already here. Certainly, rigorous scientific research should precede its sale for the canine consumer, but the public isn’t waiting. Customers are purchasing products laced with cannabis for dogs or sharing some of their own stash with their cats. Veterinarians may rebuke the notion, dismissing it as “untried, unproven and unregulated.”3 A few brave, outspoken professionals have taken a more proactive approach. One created a cannabis tincture called “Canine Companion,” designed to relieve pain, inflammation and other cancer-related or end-of-life health issues.4 Testimonials favoring veterinary cannabis, even on the AVMA website, speak highly of the improvements they see such as rapidly replenishing quality of life and restoring mobility to animals otherwise unwilling or unable to ambulate. In addition, it has restored appetite and reduced reliance on mainstream pharmaceuticals that the animal could not tolerate.5 Taking a Closer Look Given the seemingly immense potential of “pot for pets,” why …
Strategically Timed Heartworm Prevention is RiskyMarch 13, 2014 In some northern states, heartworm prevention for pets is a relatively new necessity in “mosquito season,” much less during winter months, which probably prompted a letter published in January’s Journal of the American Veterinary Association. “Heartworm development unit data suggest a 3.5- to 4-month heartworm transmission season in Wisconsin and indicate that although mosquitoes may be seen during the winter, they almost certainly will not contain infective larvae,” states the letter to the editor by James C. Frank, DVM, of Milwaukee in the Jan. 1 issue. “What, then, is the evidence to support current recommendations for year-round administration of heartworm preventatives in the north half of the country?” The thoroughly-researched and well-written letter by Dr. Frank cited referenced research studies in Georgia, Louisiana and northern Florida that demonstrated a zero percent heartworm transfer rate between Dec. 15 and April 15. “This winter, absence of heartworm transmission was also found during a second and a third winter, despite having microfilaremic dogs housed in kennels adjacent to uninfected dogs,” Frank wrote. The study found an 86 percent heartworm transfer rate from April 15 to Aug. 15, and a 73 percent transfer rate from Aug. 15 through Dec. 15, …
Hindsight IS 20-20February 27, 2014Personally, well professionally, I’ve never really liked dealing with eyeballs. One of the first emergency cases I ever saw was a Lhasa or some such dog with an eyeball “popped out” … that was enough to make me question my new career path, needless to say! So I’ve never learned much about eyes, considering that to be an area I could safely steer away from. Then, as always, my own pet’s eyeballs became the concern, and it was literally staring me back in the face. Georgia, my little rescue dog that picked ME as her person (even though I kept telling her that I’m a CAT person), started squinting one eye, then both, six weeks ago. I was on the road, so my partner took her promptly to the vet, who suspected conjunctivitis. I returned from the road the next night, a Friday, and all weekend long I watched as she seemed very uncomfortable. She kept her eyes squinty, but she ate, and in her stoic way, didn’t let on just how MUCH pain she felt. Monday I kept my scheduled recheck, and …
How To: Anesthesia Pt. 1February 22, 2014 brightcove.createExperiences(); Click here to watch Part 2. 4/30/2012 1:05 PM
Cruciates: Less Cutting, More Self-RepairFebruary 10, 2014 What is it about the cruciate that makes so many want to intervene with blades and power tools? After all, the cruciate has feelings, too, and the limb has a vested interest in remaining intact. With the lame dog, shouldn’t we investigate thoroughly to find out the facts before surgery? We can’t uncut a tibia that has been refashioned after that of a human. Ancillaries Where there is a department of surgery, let us also assemble departments of wellness, rehabilitation and scientific integrative medicine. Let us foster healthy debate and critique, so that forward-thinking orthopedic surgeons and like-minded individuals are no longer accused of “making waves” and performing “surgical (or professional) suicide.”1 I agree that, “In this era, it is important to re-evaluate and modify traditional treatment approaches with information gleaned from evidence-based medicine.”2 We now have evidence that the minimally invasive extracapsular repair approach known as the TightRope, far less traumatic than the tibial plateau leveling osteotomy (TPLO) and tibial tuberosity advancement (TTA), demonstrates the highest safety–to–efficacy ratio over the long term, allowing dogs to avoid catastrophic complications and the intensive trauma of revisionist methods.3 The time has come for a …
Sleep Well, Hurt LessFebruary 7, 2014Thankfully, more practices are adopting patient-centric, rather than practice- or staff-centric, orientations, meaning that patients’ comfort, healing and wellness needs are coming to the forefront instead of being seen as a luxury. Specific examples include sure-footing surfaces for spinal cord injured patients and quiet music to support the healing process. It may translate into adding cat towers and other feline friendly appointments, thick pads with clean, washable and soft cloths for the surface that allow for examination and treatment on the floor instead of only on cold, steel tables. Such forward-looking practices institute measures that at the very least meet standard of care, such as controlling pain in a multimodal fashion so that patients can sleep. This typically requires individually tailored integrative and pharmacologic protocols that alleviate pain and address and/or prevent spinal cord windup. Ensuring that an animal receives restorative sleep requires appropriate analgesia, not just tranquilizing them into a stupor to stop them from vocalizing in pain. The latter does little to protect the nervous system in a health-supporting manner. Zzzzzzzzzzzz Many of us experience the value of a good night’s sleep, especially after going to bed achy and tired and awaken refreshed, ready for a new …
