Medicine

Case Study: Therapeutic Laser Fights Acute Otitis

October 9, 2012

Kathleen Bryan knows exactly how fast a Jack Russell terrier can sprint. She has tried to cleanse the ears and administer medication when her dog Petey has had a bad case of otitis. “He sees the bottle coming and I can’t catch him,” said Bryan, who counts three Jack Russells among the many animals she and her husband care for on their 100-acre spread in Jackson, Tenn. “The dogs share our bedroom, and no one sleeps when Petey is scratching and whining.” The details of a particularly bad bout of otitis externa that Petey endured in June 2008 illustrate the role laser therapy can play in aiding treatment and speeding recovery. The case marked the first time that John C. Godbold Jr., DVM, had used his Companion Therapy Class IV laser as an adjunct to his protocol for treating an ear infection at his clinic, Stonehaven Park Veterinary Hospital in Jackson. Before In the following case study, Dr. Godbold’s notes are indicated in italics. Patient Petey, a 2-year-old, 20-pound Jack Russell terrier with a history of atopic allergies that target the ear canals. Problem Acute exacerbation of chronic …

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Therapeutic Lasers Are Used In Variety Of Clinical Applications

October 9, 2012

In the last few years, there has been a dramatic increase in the use of therapeutic lasers in veterinary medicine. Industry leaders estimate that 20 percent of veterinary practices in North America use a therapy laser, and they report that its use is rapidly expanding overseas. Additionally, veterinary distributors uniformly say that therapy lasers are one of their fastest-growing product categories. The therapeutic effect of lasers has been studied for almost 40 years, and most of the work to understand its mechanisms of action has been accomplished with in-vitro research. Thousands of papers have been written on the subject, and there does seem to be consensus that lasers of an appropriate therapeutic wavelength that deliver effective doses of laser energy stimulate a photobiochemical cascade of events at the cellular level which relieves pain, reduces inflammation and increases microcirculation. These three effects result in an accelerated healing. Armed with this understanding, clinicians have treated a growing and remarkable range of conditions; any patients in pain or patients with inflammation benefit from laser therapy. In addition to treating dogs and cats, laser therapists have treated small birds, reptiles and pocket pets. Veterinarians report the laser assists …

Treating And Preventing Dental Disease In Geriatric Pets

October 2, 2012

We all know that our patients suffer from the same dental problems that we all do. Dogs and cats feel dental pain and discomfort just as we do, and yet it is far more common for them to have significant dental problems because they don’t get regular dental care. The biggest reason that pets often do not receive the dental care they need is because they rarely show obvious signs of pain or problems, which means that they suffer in silence. Oral/dental disease is by far the No. 1 medical problem in dogs and cats. It is estimated that more than 70 percent of dogs and cats have some form of periodontal disease by just two years of age. Research suggests these shocking numbers actually underestimate the incidence of dental disease. To find out if your patient has periodontal disease, lift his/her lip and look for tartar or redness and swelling of the gums (Figures 1). If the breath smells, it is a sure sign of an oral infection. A new method for determining the level of gum disease in animals is provided by a simple technology called Orastrip QuickCheck Canine. This quick …

Introducing Veterinary CO2 Laser Surgery In Japan

October 2, 2012

I am an owner of a busy small animal veterinary hospital in Nagoya, Japan. One day I encountered a book on CO2 laser surgery and became fascinated with the technology that brings less bleeding, less swelling, less pain and less risk of infection. It goes without saying that less stress during and after surgical treatment is the best for humans and for animals. I decided to learn more about small animal soft tissue laser surgery in the USA, and did so for two years at various private practices and at Louisiana State University. At the same time I studied to become a diplomate of the American Board of Laser Surgery (ABLS). Learning the art of laser surgery from the best veterinary laser surgeons in the U.S. and through ABLS allowed me to select the best surgical laser for my hospital back home. Figure 2 Types of Medical Lasers It is important to select the type of surgical laser by its wavelength and how it interacts with the tissue. Medical lasers can be assigned to one of three categories: WYSIWYG stands for “What you see is what you get.” This type is suitable …

Prebiotics, Probiotics And Intestinal Health

September 27, 2012

While prebiotics and probiotics are often confused or thought of as one and the same, their commonalities end with their stint in the intestine. Prebiotics are fiber that feeds the beneficial microorganisms residing in the intestine. Probiotics are live microorganisms that when ingested, can enhance intestinal microbial balance. Prebiotics have been used in pet foods for decades, probably without pet owners even knowing it. But probiotics’ delicate handling needs means they’re sold in sachets and capsules. They are in something of a state of hibernation, according to Grace Long, DVM, MS, MBA, director of veterinary technical marketing for Nestlé Purina PetCare in St. Louis. The microorganisms become active when they enter the intestine. “Probiotics are heat and moisture sensitive, so it would be very difficult to incorporate them directly into the kibble,” Dr. Long says. “The most effective way of keeping probiotics alive in the packaging process is in a cool, dry environment away from air exposure. Not all probiotics sold in the veterinary market have evidence to support their claims, so veterinarians should make sure that the levels of microorganisms are guaranteed and that the manufacturer can provide support of efficacy.” Evidence …

Easy Ways To Improve Histopath Results, Part 2

September 24, 2012

In our second installment, we continue our conversation from the June issue with pathologist Ken Mero, BS, MS DVM, PhD, of VetPath Services in Stone Ridge, N.Y., to learn when to consider special stains and how to help your pathologist help you. What are special stains and when should they be requested? Special stains are specialized procedures to identify specific cellular features using dyes with particular affinity for certain cellular constituents. Examples are Giemsa and toluidine blue, which have an affinity for mast cell granules, or silver stains for silver deposition on the cell walls of organisms such as fungi. Some are quick, single-step procedures, and others are complex, multi-step, labor-intensive and time-consuming techniques. When should we request special stains? When to perform a special stain and which one(s) is probably best decided by the pathologist, although the clinician could inquire about that possibility when the diagnosis is less specific than desired. A seasoned pathologist is likely to appreciate which cases might benefit from a special stain and those in which it is likely to be a waste of time and expense. Special stains all have a cost due to the price of the …

Easy Ways To Improve Your Histopath Results, Part 1

September 24, 2012

Fine-needle aspirate or biopsy? Slice or dice? Vials or bags? We asked pathologist Ken Mero, DVM, Ph.D. (VetPath Services, Stone Ridge, N.Y.) some important questions about histopathology samples. We often remove large masses that won’t fit in a regular formalin jar, or half a mandible that we can’t cut into. How should we handle these samples? Here are a few options: • Use a larger jar, because you can’t fold a mandible • Allow fixation for several days at the clinic in a large container, later transferring to a smaller container with a smaller quantity of formalin for transport • Select one or more portions of a large mass for transport in a reasonably sized formalin jar or possibly several jars • Pack the specimen in formalin-soaked gauze sponges or towels in a suitable, reasonably sized container. The sample can then be transferred into an adequate volume of formalin at the laboratory. The main detriment to the latter is limited penetration of formalin from the specimen surface into its interior and therefore the potential for central autolysis and impaired histologic interpretation. If you submit a large specimen in plastic bags …

A Discussion On Fluid Therapy Management For Veterinary Patients

September 21, 2012

Few topics are as controversial as the “ideal” fluid rate during surgery. To clarify the situation, we talked to Bill Muir III, DVM, Ph.D., Dipl. ACVA, Dipl. ACVECC, and Chief Medical Officer of the Animal Medical Center in New York City. Why is intraop fluid therapy so debated? Perioperative and more specifically intraoperative fluid therapy continue to be enigmatic and controversial subjects due to varying opinions regarding the type and amount of fluid to administer, inadequate monitoring techniques and most importantly a lack of evidence defining “best practice.” Conventional intraoperative fluid administration for most is “recipe based” (ml/kg/hr) and administered at rates that cannot be justified either physiologically or medically. Contemporary rates of intraoperative fluid administration (10-15 ml/kg/hr) are defended based on insensible water losses, the conjectured severity of surgically induced tissue trauma and anesthesia-induced increases in intravascular volume (vasodilatation). Regardless, little, if any, evidence has been generated to support these recommendations. What do anesthesiologists do in humans? Recent evidence generated by studies conducted in humans and experimental animals suggest that a more “restrictive,” rather than “liberal,” approach for fluid administration should be practiced. This practice likely decreases morbidities associated with excessive fluid administration, such as pulmonary gas …

How To Make Anesthesia Safer, Part 1