How To Make Anesthesia Safer, Part 1September 21, 2012 Achieving low mortality and low morbidity is not good enough in 2012. Our goals should also include excellent analgesia, patient comfort and minimal stress. The American Animal Hospital Association recently published another great white paper, this time on the art of anesthesia. The “guidelines are not meant to establish a universal anesthetic plan or legal standard of care,” explain the authors (R. Bednarski et al., “AAHA Anesthesia Guidelines for Dogs and Cats,” JAAHA 2011, Vol. 47, p. 377–385). But they are an excellent review of common practices. Full disclosure: What follows is not a summary of the article, but the first of a two-part review of a few great points made by the authors. 1. Breed-specific Concerns Despite common concerns expressed by owners of certain breeds, “Few are documented,” the authors remind us. Two exceptions: Brachycephalic dogs and cats clearly have a higher risk of upper airway obstruction. Sight hounds may have a slower recovery when propofol or thiopental are used. Since thiopental is not available in the U.S., this is a good reminder to be cautious with propofol in those breeds. We asked Richard Bednarski, …
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CO2 Laser Uses For Equine VeterinariansSeptember 6, 2012 I have been using lasers (CO2 and diode) in my equine-only practice for the last six years. I have discovered many uses that have immensely expanded my surgical and therapeutic capabilities. While the diode is primarily used for endoscopic surgery of the upper respiratory and urogenital regions, most of my laser use involves the CO2 surgical laser, which brings many benefits to my equine procedures. The CO2 laser’s wavelength of 10,600 nm is highly absorbed by soft tissue;1 this unique aspect of the carbon dioxide laser enables precise dissection and vaporization of soft tissue with minimum hemorrhage as well as reduced postoperative pain and swelling (due to the coagulation of nerve endings and lymphatics along the edges of incisions). Whether doing incisions, excisions, dissections or ablations, CO2 laser surgery is always noncontact; therefore it minimizes tissue trauma while providing a strong sterilizing effect by killing surface bacteria. CO2 Laser Uses With my CO2 laser, I have been impressed with the reduced inflammation and swelling of the surgery sites, especially in cases involving castration of the mature stallion. Small bleeders may be controlled by raising the handpiece away from the tissue, …
Therapeutic Photobiomodulation: A Necessary Component Of A Veterinary Pain Management StrategySeptember 5, 2012 The primary role of the veterinarian is to control pain and suffering and the range of tools and methods to accomplish this is ever-increasing. Therapeutic photobiomodulation, such as provided by therapy lasers, has become an important element in a multimodal approach to pain management. The analgesic effects achieved with the administration of therapeutic photobiomodulation are well documented in the literature. The first of the peer-reviewed papers appeared in 1991 with the bulk of the documentation detailing the mechanisms and the effectiveness of this modality being presented from 2009 to 2012.1-5 Practicing scientific, evidence-based medicine does not allow us to merely believe: “photons enter, a miracle happens, and then the pain is gone!” The mechanisms resulting in this physiological achievement are clearly understood. Photons, within the infrared spectrum, act on the endogenous photoreceptors, or chromophores, of the individual cells resulting in a biochemical cascade of events. A combination of localized and systemic enzymatic, chemical, and physical events effectively produce a state of analgesia.6-9 Increased Endorphin Release Once the target cells receive a therapeutic dosage of photonic energy, there is a release of beta endorphins.10 “Endorphin” comes from …
Class IV Laser Therapy For Canine Ear InfectionsSeptember 5, 2012 Laser therapy is arguably the fastest growing modality in the veterinary profession. To this point, many veterinary clinics offer Class IV laser therapy as a treatment for small animal conditions such as arthritis, sprains and strains and back pain, as well as post-surgical soft tissue trauma and lick granulomas.1 Laser therapy is supported by more than 20 years of evidence-based medicine2 and is being discovered as a means to assist faster, stronger closure of wounds.3 Some veterinarians are moving beyond the musculoskeletal and wound healing applications of laser therapy and finding it an effective treatment for canine ear infections. This article will explain Class IV laser therapy technique in treating ear infections; it will discuss safety and mechanisms of action, along with testimonials from veterinarians who have discovered success in treating canine ear infections. Class IV therapy lasers utilize infrared wavelengths that penetrate skin and bone to deliver an optimum therapeutic dosage to the targets inside the body.4 Distinct wavelengths target different cellular components in the tissue with the end result of increased circulation and oxygen delivery along with enhanced cellular metabolic activity.
Safety, Efficacy Still Key To Supplement SalesAugust 28, 2012 Pet supplement sales are expected to yield $1.66 billion this year, slightly slower growth than was projected before the economic downturn, according to market research company Packaged Facts. Although supplements have a niche in the pet industry, a lack of evidence of safety and efficacy for many products limits full veterinary acceptance and adoption. Many animal supplement manufacturers seek veterinary acceptance, but some practitioners are reluctant to recommend products without evidence to support label claims. The need versus financial feasibility to perform trials on all supplements continues to be debated. “As a supplement manufacturer, [I believe] safety tests at a minimum should be performed,” says Todd Henderson, DVM, president of Nutramax Laboratories in Lancaster, S.C. “But proven efficacy is necessary if veterinary recommendations are expected. Most companies say they have performed product tests that are available in their files, but just didn’t publish them. This is not acceptable. There’s no way to determine if it’s all smoke and mirrors or if it’s a genuine, effective product.” Setting Standards The National Animal Supplement Council (NASC), a self-policing nonprofit group comprising industry players, is dedicated to enforcing standards within the animal supplement industry. However, the …
How 'Green' Are Your Omega-3 Supplements?August 28, 2012 With so many omega-3 supplements on the market, how does one choose a good one? Palatability? Price? Purity? Plant, algae, krill or fish? Farmed or wild, from European or Pacific waters, or out of the Artic or Antarctic biospheres? For “One Health” professionals, a cost-benefit analysis of the safety and effectiveness of omega-3 supplements should take into account stress on the ecosystem through overexploitation of resources along with the risk of contaminating patients’ systems with cancer-causing chemicals. Polluted Oceans That the ocean is polluted is no surprise. Noxious agents such as mercury, pesticides, organochlorines and radionuclides1 may land in fish and their oils. Consider this from FishOilSafety.com:2 “Millions of people who take fish oil for health benefits have been kept in the dark about the levels of PCBs and other contaminants they may be swallowing with the omega-3s.” “Some supplements contain labels that say ‘treated to remove contaminants,’ but those labels do not tell consumers how much is left after such ‘treatment.’” “Despite knowing about these potential threats for years, the FDA has allowed supplement makers to provide misleading …
Manage Cancer Patients In 5 StepsAugust 27, 2012 Universal guidelines for the management of cancer patients are difficult to define. Clearly, every tumor, every situation, every patient is different. But let’s try to define five general rules anyway. Step 1 The first challenge is to suspect or recognize cancer. It may seem straightforward with a skin mass, but it can be much more challenging in the intestine or the bladder. Confirming the suspicion is the next step, and it usually involves a fine needle aspirate (FNA) or a biopsy. Let’s simplify and only consider skin masses. There are two main FNA techniques: aspiration and trephination. The traditional aspiration technique requires a needle and a syringe. The needle is introduced into the tumor in various directions, while negative pressure is applied to the syringe. “The microtrauma created may cause bleeding, which will lead to hemodilution of the sample,” Explains Ken Mero, DVM, Ph.D., a pathologist at Histology of Stone Ridge in Stone Ridge, N.Y. Another method is the trephination technique, which doesn’t involve negative pressure and reduces the risk of hemodilution. Tiny cores of the mass are harvested without using negative pressure, which may allow a higher cellular yield by avoiding hemodilution. …
Analgesia & Anesthesia Give Lysa Posner, DVM, Something To Talk AboutAugust 13, 2012As an associate professor of anesthesiology at North Carolina State University College of Veterinary Medicine, Lysa Posner, DVM, Dipl. ACVA, is used to giving lectures and teaching students about what she knows best: veterinary anesthesiology. In fact, about 25 percent of her job is spent in lecture halls. While other aspects of her job—overseeing anesthetized animals in the teaching hospital and being involved in anesthesia-related research—keep Dr. Posner busy, she still finds time to speak at two national veterinary conferences a year and to various state organizations. Lecture topics vary year to year, but a hot topic of late has been analgesia, she says. Most veterinarians are trained in only one or two ways to stop pain, which are good ways, Posner says, but there are a lot more methods that can be used. “You have to separate anesthesia, which makes you unconscious, from interrupting the pain pathway,” she notes. For example, she says, “If I just make you sleep and hit you on the toe with a hammer, you won’t feel it while you are asleep but the minute you wake up you will, because that whole pathway is activated. “If I can stop that pathway when you wake …
When It Comes To Radiation, ALARA Can Save Your LifeAugust 9, 2012 You’ve never met ALARA, but she’s your best friend. In the radiology world, ALARA stands for “as low as reasonably achievable.” The goal is to minimize radiation exposure by using any reasonable technique. Not only is it about protecting people (and patients), it is also a regulatory requirement at any veterinary practice in the nation. There are four ways to decrease radiation exposure: Time Minimize. the time of exposure. Certainly, modern X-ray machines tend to make all the decisions these days, but it’s worth making sure that it is truly designed to minimize the time of exposure. The concept makes sense: The shorter the time of exposure, the smaller the radiation dose. Shielding. Leaded aprons, glasses, thyroid shields and gloves have only one purpose: to protect you and your team from X-rays. Interestingly, they’re not there for decoration purposes. It is important to remember that they do not protect from the primary beam, only scatter radiation. Distance. The farther a body part is from the source of radiation, the less the exposure. More specifically, if your free hand is twice as far from the source of X-rays, the radiation exposure …
Lasers Offer A Therapeutic Plan For PainAugust 6, 2012 Anecdotal evidence citing successful outcomes with therapeutic lasers are becoming more frequent and have spurred research at the University of Tennessee, College of Veterinary Medicine. While only a handful of studies have been conducted exploring the use of laser therapy for veterinary medicine, the Tennessee veterinary college, pending grant approval, will investigate the penetration depth of class IV lasers in living animal tissue, according to Darryl Millis, DVM, associate professor of orthopedic surgery and directory of surgical services. “We will be exploring three approaches to treating canine arthritis,” Dr. Millis says. “Low level laser treatment, transcutaneous electrical nerve stimulation and acupuncture will be investigated. Veterinarians need objective data.” Some veterinarians cite the lack of scientific evidence supporting therapeutic laser efficacy as a deterrent in integrating the therapy into their practices, while those who have used the equipment report great success. “I was skeptical when I first started using the class IV laser, because it’s difficult to realize the benefit of light,” says Tim Montague, DVM, of Eads Animal Hospital in Eads, Tenn. “Now, I’ve been using the laser for two years and I continue to be amazed in ways the laser helps to reduce pain, decrease inflammation, improve …
