The Sweet Side of Managing Open WoundsMarch 10, 2015Originally published in the February 2015 issue of Veterinary Practice News Pictures courtesy of Dr. Karol Mathews Medical grade honey can be poured directly into an open wound. There is something satisfying about treating an open wound successfully. As with many veterinary endeavors, there are multiple ways to do so. Some are clearly better than others. Most hospitals have their “goo” of choice: silver sulfadiazine, antibiotic ointment, sugar Betadine (a.k.a. “sugardine”), steroid cream, zinc oxide, trypsin ointment. Some of these products have some research behind them, while many others are supported by mere belief—sometimes surprisingly strong—as sole scientific evidence. Meanwhile, sugar and honey have been widely used in human medicine for centuries. Both are safe, effective, readily available and cost-effective. Karol Mathews, DVM, a board-certified criticalist and professor emerita at the Ontario Veterinary College in Guelph, Ontario, Canada, has written extensively about their use in veterinary medicine.*“It is interesting how we seem to rediscover ancient remedies that actually work,” she says Pictures courtesy of Dr. Karol Mathews: Sugar is poured onto a lap sponge that will be wrapped around a wound on the distal limb. Back to the Future There are accounts of using honey …
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The High and Low Points of AquapunctureMarch 6, 2015Originally published in the January 2015 issue of Veterinary Practice News When standard acupuncture needling seems out of the question—a patient is too restless to sit still for 10 to 15 minutes—some acupuncturists turn to a related technique called aquapuncture. Instead of relying on the traditional tapered-tip, stainless steel acupuncture needle, aquapuncture uses a hypodermic needle to introduce fluid into acupuncture points. This makes aquapuncture a relatively new technique in acupuncture chronology, as the hypodermic needle was not invented until the late 1800s. In the much shorter, decades-long history of veterinary acupuncture in North America, many remember old-time practitioners traveling from barn to barn with a bottle of fluid they kept in their hot trucks throughout the summer, injecting their recipe of vitamins, homeopathics and sometimes more questionable substances into horses’ backs through a series of open hypodermic needles standing parallel to the spine.1 Scientific acupuncturists tend to eschew this approach because these open needles offer a ready conduit through which bacteria may migrate deeply into tissues, risking abscess formation. Then there is the problem of chemical incompatibility within the solution. Even today, one hears about some practitioners performing aquapuncture using mixtures of various natures, such as DMSO, lidocaine and …
Where do you Stand on the Antibiotics Debate?March 4, 2015Originally published in the February 2015 issue of Veterinary Practice News Choosing the right antibiotics—or whether to prescribe them—is far from a straightforward matter, and as concern grows over excessive antibiotics use, there’s a lot to consider. From the start, veterinarians are taught the correct use of antibiotics, which includes making a proper diagnosis, taking cultures and assessing sensitivities to choose the right antibiotic. It’s the next step in the process that becomes more difficult for veterinarians, said clinical pharmacist Sue Duran, RPh, MS, Ph.D., a fellow in the American Society of Health-System Pharmacists and the chairwoman of the board certification committee for the International College of Veterinary Pharmacy. “Both human and animal clinicians experience peer pressure from owners to prescribe antibiotics for their patients,” said Duran, a clinical pharmacist with the Auburn University College of Veterinary Medicine. J. Scott Weese, DVM, DVSc, Dipl. ACVIM, said pinning down the “whys” behind antibiotics overprescribing is difficult. “There are various reasons unnecessary prescribing can happen,” said Weese, an associate professor in the department of pathobiology at the University of Guelph’s Ontario Veterinary College in Canada. In some cases, antibiotics are used without a reasonable suspicion of a bacterial infection, such as …
More Options for Bad Joints in Aging PetsMarch 2, 2015Originally published in the February 2015 issue of Veterinary Practice News There’s no shortage of ways for a veterinarian to approach the treatment of joint problems in aging pets. For dogs in particular, a path taken from several fronts is recommended by Brenda S. Kennedy, DVM, MS, of Canine Companions for Independence. “A multimodal approach is necessary to reduce pain and minimize further degeneration in the joints,” Dr. Kennedy said. “This is especially true for senior pets, who are more likely to be in a more advanced stage of the disease process.” Kennedy was to speak in January at the North American Veterinary Community conference in Orlando, Fla. Her talk was titled “Canine Longevity: Strategies to Extend Healthspan.” The multimodal therapy she refers to can include the use of nonsteroidal anti-inflammatories (NSAIDs), analgesics such as tramadol, amantadine and gabapentin, or injectable polysulfated glycosaminiglycans like Adequan, or products like oral glucosamine, chondroitin, methylsulfonylmethane (MSM), as well as omega-3 fatty acids. Adjunct therapies like acupuncture and physical rehabilitation may also be beneficial, she added. Start With Diet, Exercise The basics of diet and exercise are a message that Kennedy and other experts drive home. “Maintenance of a lean body condition along with …
More Pot for Pet Owners Means Pets Get Access TooFebruary 27, 2015As many states move to legalize or decriminalize medical and recreational marijuana use, more pets may be exposed to marijuana smoke and edible products as their human owners increasingly gain legal access. According to the public information non-profit ProCon.org, which has created a chart of medical marijuana laws state-by-state, medical marijuana is now legal in 23 states and Washington, D.C. This November, Oregon, Alaska and Washington, D.C. joined Colorado and Washington State when ballot measures passed to allow the sale and use of recreational marijuana. Veterinarians in these states which have recently voted to legalize are looking to the examples of Washington and Colorado for what to expect. A 2012 study published in the Journal of Veterinary Emergency and Critical care looked at the increase in reports of marijuana toxicity in dogs at two Colorado hospitals in five years following the legalization of medical marijuana in that state. The study found the number of marijuana poisoning cases in dogs at two Colorado veterinary hospitals quadrupled during the 5-year period. This correlated with a 146-fold increase in the registration of people with medical marijuana cards. Two of the dogs, which had ingested baked products made …
Why Enthusiasm is Growing for Emerging TechnologyFebruary 17, 2015Telemedicine, 3-D printing, radiology and biotechnology are among the terms that could dominate the veterinary technology landscape in the years to come. “I see huge potential for 3-D printing in veterinary medicine,” said Diane McClure, DVM, Ph.D., Dipl. ACLAM, an associate professor in laboratory animal medicine for the College of Veterinary Medicine at Western University of Health Sciences in Pomona, Calif. Orthotic and prosthetic applications for 3-D printing technology are at the proof-of-concept stage, and they will become more conventional in the future, said Denis J. Marcellin-Little, DVM, Dipl. ACVS, Dipl. ECVS, Dipl. ACVSMR. Dr. Marcellin-Little, a professor of orthopedic surgery at the North Carolina State University College of Veterinary Medicine, collaborated with the Center for Additive Manufacturing and Logistics and the North Carolina Aquarium in Roanoke Island in the 3-D manufacture of a custom brace for a green sea turtle that suffered an open fracture to its right radius and ulna. The brace enabled the turtle, Augie, to eventually heal. According to those caring for Augie, the turtle became well enough to swim without the brace but was not yet ready to be released into the ocean. “3-D scanning and printing will revolutionize the field,” Marcellin-Little said. “It is …
How Electrochemotherapy Opens Doors to Additional TreatmentFebruary 4, 2015Electrochemotherapy has received considerable attention in the last few years as an emerging therapeutic. Until recently its availability has been confined to outside the United States, but this is now changing and a brief review of the technology is both necessary and timely as more oncologists in North America take advantage of this new technology. Electrochemotherapy involves combining a normally poorly absorbed chemotherapy agent and the delivery of an electrical field directly to the tumor. The tumor is exposed to an electric field for a few milliseconds, which causes the tumor cells to become porous for up to an hour after the procedure and allows for an increase of up to a thousandfold in the local absorption of the chemotherapy. Electrochemotherapy has been successfully used to treat cancer forms that ordinarily cannot be treated with chemotherapy or in situations where chemotherapy no longer has any effect. Electrochemotherapy also can treat patients who have previously been treated with radiation. To date, the primary experience clinically has been with cutaneous disease such as malignant melanoma, recurrent breast cancer, squamous cell carcinoma and Kaposi sarcoma. The published literature indicates that solid tumors of all histological types are sensitive to treatment with electrochemotherapy. Evidence …
Orthotics, Prosthetics Move Beyond DIYJanuary 21, 2015Experts in veterinary orthotics and prosthetics do not point to emerging technologies as the most significant development in the field over the past few years. They credit accelerated knowledge and interest. Denis J. Marcellin-Little, DVM, Dipl. ACVS, Dipl. ACVSMR, also acknowledges the 2011 Hollywood movie “Dolphin Tale.” The film centered on the relationship between a boy and a dolphin that was given a prosthetic tail. “The most significant advancement over the last five years is the growing awareness in the general public of the potential of external devices to help companion animals,” said Dr. Marcellin-Little, a professor of orthopedic surgery at the North Carolina State University College of Veterinary Medicine. Numerous magazine articles and expanded use of the Internet and social media have helped spur interest in orthotics and prosthetics for pets, he said. Because of the growing recognition that animals, and not just humans, can have limbs and other damaged or lost body parts augmented to improve their lives, more pet owners are turning to orthotics and prosthetics, experts said. Lindsey M. Labinich OrthoPets patient Nakio got four prosthetic legs. Better Alternative The human-animal bond has helped move pets from possession to family member status, said …
New Therapies Take Hold in Fight Against CancerJanuary 19, 2015Originally published in the January 2015 issue of Veterinary Practice News The year 2015 is an exciting time to be a veterinary oncologist as we shift away from decades-old chemotherapy regimens and toward a host of emerging therapies for veterinary cancer. More pets are developing cancer, a leading cause of death in companion animals, because they are living longer. Newer therapies are the outcome of research based on need and predominantly from advances in the human oncology arena. Animals with naturally occurring cancer are a driving force to industry, allowing pharmaceutical companies to continue their progress against the dreaded disease for the benefit of both people and companion animals. Improving treatment outcomes stems from staging the patient (i.e., identifying the cancer within the body and any other diseases present) as cancer management is always planned in the best interest of the patient. For the primary care veterinarian, a shift to twice-a-year exams focusing on a complete physical examination has facilitated early identification. In addition, combining laboratory testing and advanced imaging with thoracic radiographs and abdominal ultrasound has afforded early screening in managing many cancers and setting realistic expectations. Indeed, many practitioners have reallocated their thinking—basic diagnostic tests are just as …
How Great a Surgeon Are You?December 11, 2014Originally published in the December 2014 issue of Veterinary Practice News "A great surgeon is someone who makes a difficult surgery look easy," a colleague once told me. How do you know if you are a good surgeon? How do you know if you are a great one? What does it even mean to be good or great? Does it mean saving all your patients? Does it mean not shaking like a leaf while suturing? Does it mean being worshipped by your technicians? Does it mean knowing it all? Does it mean getting flowers from every pet owner? Trying to define which qualities we strive for, I submitted a challenging question to a number of board-certified surgeons, in the U.S. and abroad: What qualities does a great surgeon have? I heard so many excellent answers that I can share only the top 10—those mentioned the most frequently. 1. Be Ethical Ironically, the most important trait of a surgeon, based on the number of similar responses, is knowing when not to perform surgery. "A chance to cut may not be a chance to cure,” said Joe Harari. “Case selection is king; technique is the prince,” confirmed Steve Withrow. “Integrity goes beyond …
