3 Halloweenish but Preventable Horror StoriesOctober 20, 2014Around Halloween or not, some pretty scary things can occur in your practice. Here are ways to avoid them. 1. Sending a pet home with an IV catheter! Ms. Monster called the clinic to ask when her puppy, Eddie, was supposed to have a follow up appointment to have this “plastic thing” removed from his front leg. Surprised by that strange question, Carrie the receptionist asked Mrs. Monster to hold for a moment. She relayed the question to a technician and the doctor. Initially confused, they all suddenly remembered that Eddie was castrated four days ago. To their horror, they realize that Eddie must have gone home with his IV catheter still in place! Ms. Monster brought Eddie in and the staff removed the forgotten catheter. How embarrassing! One creative system to be sure every staff member, without exception, knows that a patient still has an IV catheter in place, is to use a simple color code. All catheters, once taped in, can be covered with a red bandage. Once the catheter is removed, before a patient is discharged, the area can be covered with a green bandage. This way, all team members, from the “front” to the “back” can easily …
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Why You Should Go Back to the Basics to Heal WoundsOctober 15, 2014Originally published in the October 2014 issue of Veterinary Practice News In the opinion of Sam Franklin, MS, DVM, Ph.D., Dipl. ACVS, wound healing is all about the phases of an injury. Dr. Franklin, an assistant professor of small animal orthopedic surgery at the University of Georgia College of Veterinary Medicine and a diplomate of the American College of Veterinary Sports Medicine and Rehabilitation, emphasized that effective management of wounds “really requires just three general things.” To start with, it requires that a veterinarian know the healing phases. Each phase is “well defined and well described” in textbooks and articles, he said, and any practitioner interested in managing wounds can and should learn them. “There are only four or five phases—depending upon the source consulted—and so learning about them is very feasible,” Franklin added. Additionally, a practitioner should be capable of evaluating a wound and accurately determining what stage of healing it’s in, he said. Finally, “As the wound progresses to the next step of healing, the practitioner then adjusts to the next set of treatments or bandages that are appropriate for that phase,” Franklin said. No Goop Forget the goop. That’s the advice from Randy Lynn, DVM, MS, Dipl. …
Why You Should Wake up to the Realities of AnesthesiaOctober 6, 2014Originally published in the October 2014 issue of Veterinary Practice News When she wanted to offer one crystal-clear message to veterinarians about anesthesia best practices, Christina Braun, Dr. Med. Vet, Dipl. ACVAA, offered one of her favorite quotes from J.W. von Goethe: “You only see what you know.” It’s unlikely the German writer and statesman was referring to anesthesia, but Dr. Braun thinks it’s a good point nonetheless. “Monitoring is the first step to improve anesthetic outcome,” said Braun, a professor in anesthesiology and perioperative intensive care medicine at the University of Veterinary Medicine in Vienna, Austria. She encourages general practice veterinarians to reach out to the American College of Veterinary Anesthesia and Analgesia (ACVAA) if they have questions or concerns, and pet owners may be referred to the group’s website for more information. “For example, I know of old cats and dogs that had such terrible teeth that they wouldn’t eat anymore,” Braun said. “Because they were old, the fear of anesthesia was so high that the owner didn’t want the general veterinarian to perform a dental cleaning —which, in pets, absolutely [requires] general anesthesia. “Contacting a diplomate of the ACVAA can help in learning about good ways to …
Is Plasma the Future of Veterinary Medicine?October 3, 2014Originally published in the October 2014 issue of Veterinary Practice News Early in the 1967 Oscar-winning movie “The Graduate,” Mr. McGuire provides young Benjamin, played by Dustin Hoffman, with one word of career advice: plastics. Jump ahead nearly a half century and Ron Robinson, the CEO of Veterinary Energy Technologies Inc., is trying to persuade investors to recognize the potential of an entirely different science: plasma. The future that Robinson envisions was on display in late August in Kansas City, Mo., where a panel of judges chose Veterinary Energy Technologies and its cold plasma invention as the winner of the $2,500 Innovation Award. Fourteen companies at the early or middle stage of their growth were given 10 minutes each onstage to highlight what they would like to introduce to the veterinary market if only investors would buy in to the idea and the business model with cash or expertise. Veterinary Energy Technologies earned the loudest applause at the KC Animal Health Corridor’s annual Investment Forum, but all 14 presenters achieved something more valuable than $2,500: the opportunity to advertise themselves to representatives from 40 financial funds and 88 animal health companies. Investors have bought into the hype, handing over $130 million …
A Look at Veterinary Patient Warming SystemsSeptember 9, 2014 As animal surgical procedures become longer and more complex, the need to keep patients from becoming hypothermic is greater than ever. “The veterinary industry is starting to better understand the medical value that fluid warming and whole body temperature management can offer to the surgical and critical patient,” says Judith Rossi, vice president of global communications for Smiths Medical of Norwell, Mass. “Patient warming is now recognized as one of the most valuable enhancements used to help improve outcomes in patient care.” The number of veterinary patient warming systems available is greater than ever. Dovelewis emergency animal hospital Under the towel is the Hot Dog Warmer, used to keep this patient warm during preparation for abdominal surgery. “The industry is steadily moving to the next generation of patient warming with blankets that warm with a conductive fabric technology,” says John Bayard, senior product manager for Augustine Biomedical + Design of Eden Prairie, Minn. “It’s hard to believe, but before this breakthrough the last big innovation in patient warming was over 25 years ago with the invention of forced-air warming blankets.” Nick Papinchak, an equipment consultant with apexx Veterinary Equipment of …
Vets Say Why they Use Laser TherapyAugust 20, 2014 Veterinarians are adopting and implementing therapeutic lasers at practices across the country. The therapy's effectiveness is still debated in some quarters — though less so than in the past — so why have they taken the plunge? The consensus among practitioners interviewed for this story is that the results speak for themselves—the lasers are effective at treating injuries and speeding healing with little to no side effects. And with a relatively gentle learning curve and quick return on investment, they say lasers are a no-brainer for their practices. Tales from Veterinarians On the Fence Linda Baty, DVM, of East Brook Animal Clinic in Waverly, Tenn., began offering laser therapy as a low-cost alternative to surgery for such injuries as ligament tears and back problems. “We were faced with keeping dogs on painkillers for the rest of their lives or even putting them down,” she said. “So we were looking for therapy that would relieve the pain and put them back to some function without going through major surgery [such as ACL repairs] if [the client] couldn’t afford that.” Though she had done a fair amount of research, Dr. Baty was still hesitant. “It wasn’t until …
What You Need to Know Acupuncture and SepsisJuly 29, 2014Unless sepsis is on your radar, you might well miss it. Sepsis is defined as “a syndrome of microbial infection complicated by systematic inflammation which may subsequently lead to organ dysfunction, shock, and death.”1 The cat with a severe bite wound, the dog with peritonitis and the puppy with parvo may all develop sepsis, but their clinical presentations may vary dramatically. In addition to interspecies differences, diagnosis can prove difficult because of the many ways in which sepsis mimics critical conditions. The diagnosis also eludes clinicians who fail to see the big picture of constellating clinical, physiologic and laboratory changes signaling sepsis. This accounts for many missed opportunities for early intervention and life-saving care.2 That said, even after sepsis is diagnosed, treatment can be daunting and ineffectual. In humans, sepsis leads to over 750,000 hospital admissions and 200,000 deaths each year. The comparative incidence of sepsis in dogs and cats is unknown.3,4 How it Happens How sepsis happens is not fully understood but likely involves an over-exuberant release of inflammatory cytokines in response to a provocation, whether infection, ischemia, injury, trauma or cancer.5 The patient may develop SIRS, i.e., systemic inflammatory response syndrome and progress to MODS, or multiple organ dysfunction syndrome, …
Merck Releases 12-Week Flea, Tick MedicineMay 20, 2014Merck Animal Health today upped the ante in the world of flea and tick preventives with a flavored chew proven to be effective for 12 weeks at a time. "Bravecto is a breakthrough innovation that offers pet owners and veterinarians something that no other product does—the longest-lasting oral flea and tick prevention currently available," said KJ Varma, senior vice president of research and development at Summit, N.J.-based Merck. The product is indicated to kill fleas for 12 weeks, the black-legged tick, American dog tick and brown dog tick for 12 weeks, and the Lone Star tick for eight weeks. The 12-week claims do not apply to dogs less than 6 months old. The active ingredient, fluralaner, is a new ectoparasiticide belonging to the isoxazoline group, Merck noted. The chew may be given to help control flea allergy dermatitis, the manufacturer added. Bravecto's five dosages are based on a dog's weight: 4.4 to 9.9 pounds, 9.9 to 22 pounds, 22 to 44 pounds, 44 to 88 pounds and 88 to 123 pounds. Clinical trials revealed the most common adverse reactions to be vomiting, decreased appetite, diarrhea, lethargy, polydipsia and flatulence.
How To Perform A Thorough Oral ExaminationMay 15, 2014 Courtesy Dr. John Lewis Figure 1: Laceration on ventral suface of a dog's tongue Published in the April 2014 issue of Veterinary Practice News. It was the day after Valentine's Day, and the East Coast was in the throes of yet another snowstorm. An 8-year-old male great Dane presented to our hospital through the emergency service for sudden onset of bleeding from either the mouth or nose at home. The dog had a prior history of immune mediated thrombocytopenia, so it was a surprise when a complete blood count showed a normal platelet count. The patient was not very cooperative for a conscious oral examination, and no source of bleeding was visible because bleeding had subsided prior to the patient's arrival. The pet owners declined an anesthetized oral exam, but two hours later a second and more severe episode of bleeding brought the owners and the pet back to the hospital. The dog's face and front legs were drenched in blood, and packed cell volume and total protein were found to be 24/6.0. During the active bleed, it became obvious that the bleeding was arising from the oral cavity. The patient …
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 …
