10 Tips to Control Your Vet Clinic’s InventoryApril 14, 2016Inventory management may not be the sexiest topic, but it is a key area you should focus on. It’s easy, it doesn’t take much time, and it can save you a significant amount of money. Here are 10 tips to help you better manage your inventory. 1. Consolidate products and manufacturers Trying to pinch pennies and find the absolute best price on every product requires expensive labor. If you buy additional products from the same manufacturer, you might get a bundling promotion. This is a discount offered when you combine, for example, vaccines, medications and paraciticides into one order. 2. Choose one major distributor Having your ordering person compare every product ordered across several suppliers is laborious. By consolidating your orders with a single distributor, you very likely become a “key account.” A key account gets better (and consistent) prices, service and attention from the outside and inside sales reps. 3. Get two people involved Ideally, you should choose one trustworthy person to do the ordering and a different person to unpack products. They can switch jobs every once in a while. This will help you catch mistakes and decrease …
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How Would You Diagnose This Case?April 14, 2016In this photo: Lateral thoracic radiograph of a 10-year-old female Bichon. Questions: Describe the lesions on this radiograph. What is your differential diagnosis? If an outside cause is responsible, what are some possible etiologies?
Avoid supplement surprisesApril 13, 2016Industry analysts estimate that the size of the U.S. dietary supplement industry on the human side has grown to somewhere between $12 billion and $37 billion annually.1 While demand has increased steadily across the globe, so has competition between companies, prompting some to consider cost-cutting opportunities that can compromise quality and, once discovered, erode consumer confidence.
When to Use Miniplates for Mandibular FracturesApril 12, 2016Jaw fractures happen. Sometimes they occur due to trauma, but I see just as many pathologic fractures due to periodontal disease in small-breed dogs. Pathologic fractures are challenging when they are unilateral, but when they occur bilaterally, they affect normal function in a life-threatening way. Whenever possible, I repair a mandibular fracture with a noninvasive technique involving interdental wiring and composite splinting (see Dental Pearls, October 2015). This is an elegant technique that utilizes teeth adjacent to the fracture line as anchors by weaving wire between the teeth, etching the teeth and placing plastic composite over the teeth. Unfortunately, dogs with pathologic fractures secondary to periodontal disease usually require widespread extraction of diseased teeth in the area of the fracture. Therefore, inter-dental wiring often is not an option. In these cases I like to use miniplates. Miniplates have been documented as a valid option for maxillofacial fractures in dogs and cats for over 20 years.1 Case Discussion Bigger isn’t always better. Take, for example, the case of Taz, a 9-year-old Chihuahua. Taz presented to Dr. Bonnie Shope at Veterinary Dental Services in Boxborough, Mass., with severe halitosis, decreased appetite and lethargy. A …
A Brief Look at Veterinary AcupunctureApril 11, 2016 National Geographic has created a mini-documentary called "Treating Animals With Acupuncture" that gives you a brief glimpse into the world of veterinary acupuncture. According to the video description: "Horses have been receiving acupuncture for almost as long as people have—since the practice began in China some 2,500 years ago. As beasts of burden, horses were of tremendous value to the Chinese, and their health was almost as important as that of their owners. Today veterinary acupuncturists can treat nearly any animal, from a bear to a porcupine to a dog. Training courses, such as those from the International Veterinary Acupuncture Society, teach licensed veterinarians how to incorporate acupuncture into their practice. Acupuncture is thought to have arrived in the U.S. in the 1800s with the immigration of Chinese doctors. It wasn't until the 1970s, however, that acupuncture's popularity began to take hold. Though limited studies qualify it as evidence-based medicine, those who practice acupuncture say that the effects can be explained in physiological terms. Veterinary acupuncture has been performed on both domesticated pets and zoo animals. The latter must be sedated while the needles are inserted, but most pets are accepting or unfazed. As the video points out …
10 Helpful Hacks for Veterinary SurgeonsApril 11, 2016Veterinary surgeons, like all specialists, have all kinds of little tricks that help prevent brain damage, decrease frustration and get answers faster. Here are 10 hacks to help you diagnose and treat better and faster. 1. Diagnose an MPL Diagnosing a medial patellar luxation can be difficult in a tense patient. A simple way to help with the diagnosis is to grab the foot and hock and rotate them internally. This will displace the tibial crest and patellar tendon medially, which will help luxate the patella more easily. If the luxation is lateral, the foot and hock are rotated externally. To be thorough, rotate the foot and hock both ways to rule in or out the possibility of a patellar luxation of any type. This simple test should be part of any physical exam, especially in small dogs that are at risk. 2. Have the ultrasound reflex Think of your last frustrating ADR abdominal case. What did you do? A physical exam? Blood work? More blood work? Radiographs? Much time, frustration and money could be saved if an ultrasound were performed early in the …
How to Treat Gingival HyperplasiaMarch 22, 2016My February column — What to Do When Gums Overgrow Their Boundaries — discussed possible etiologies of gingival hyperplasia. Recall a 5-year-old male Rhodesian ridgeback who was presented for evaluation of proliferative gingival enlargement and focal areas of gingival recession over most of the lateral surfaces of the maxillary canine teeth (Figure 1-A). Nearly every tooth in the mouth was affected at least mildly by gingival enlargement, though the canines and incisors were most severely affected (Figure 2-A). This month we will discuss the treatment of gingival enlargement. JOHN LEWIS, VMD, FAVD, DIPL. AVDC Figure 1-A: The right maxillary quadrant showing generalized gingival hyperplasia and gingival recession over the labial (vestibular) surface of the right maxillary canine tooth (tooth 104). Terminology Last month we discussed the terminology of gingival enlargement vs. gingival hyperplasia. Worth discussing here are terms related to the surgical treatment of gingival enlargement. The two terms often used are gingivectomy and gingivoplasty. Human textbooks refer to gingivectomy as the excision of gingiva to eliminate periodontal pockets, including reshaping, or “-plasty,” of the gingiva as part of the process. At least one veterinary text refers to excision of gingiva to remove periodontal …
Is music part of your treatment plan?March 17, 2016Music is happening all around us—on our smartphones, in the doctor’s office, in movies and on football fields. Depending on its tone, tempo and pattern, music can activate pleasure centers of the brain, or induce emotional states laced with fear, tension, aggression or sadness.
How a Misplaced Sponge Can Return to Bite YouMarch 15, 2016Forgetting a surgical sponge inside a veterinary patient is a taboo yet all-too-common situation. Because of blatant underreporting, reliable statistics do not exist in veterinary surgery, and few are available in human surgery. Sponge retention is a risk any time sponges are used in surgery, regardless of the procedure. Since retained sponges were first described in human surgery in 1884, they remain the most common accidentally retained surgical foreign bodies. This can lead to many complications after surgery, not to mention the potential of resulting medicolegal implications. Understanding the reasons for sponge retention can help you devise strategies to avoid this embarrassing pitfall. Small sponges, especially when soaked in blood, can be difficult to see in the surgical field. Not discarding used sponges immediately increases this risk. In deeper surgical areas, such as thoracic or abdominal body cavities, the use of small sponges creates an unnecessary risk of retention because they easily may become lost in the process. Also, using free small sponges without first attaching them to a hemostat or sponge forceps increases this risk. Phil Zeltzman, DVM, DACVS, CVJ A retained lap sponge attached to …
The Curious Case of the Inflated Endotracheal TubeMarch 10, 2016A dog was intubated before a dental procedure. The cuff was inflated. Then the endotracheal tube was tied to the dog’s muzzle with recycled IV tubing. As the patient was waking up after the procedure, the technician proceeded to extubate the dog. She deflated the cuff … but the endotracheal tube was difficult to remove. She kept pulling and eventually managed to remove the tube from the trachea. To her surprise, the cuff was still inflated, as shown in Picture 1. (See below.) Phil Zeltzman, DVM, DACVS, CVJ Picture 1. What is wrong with that picture? Please formulate your response and then see the answer by clicking on the second page. The reason the cuff could not be deflated fully (Picture 2) is because the tie, made of recycled IV fluid tubing, was placed inadvertently over the pilot tube (picture 3). The pilot tube is the name of the small tube that goes from the cuff to the balloon, where air is injected (picture 4). PHIL ZELTZMAN, DVM, DACVS, CVJ Picture 2
