How to Diagnose and Treat Uroabdomen CasesNovember 3, 2014Tucker, a 3-year-old border collie, was rushed to your hospital after getting hit by a car at 9 a.m. He is lucky, as he escaped without any fracture or major laceration. He only seems to have a few skin scrapes. You stabilize Tucker throughout the day, and he looks much better by that evening. He is kept overnight for IV fluids and pain medications. By the next morning, you are disappointed to see that Tucker’s condition has worsened overnight. Blood work and abdominal X-rays make you strongly suspect a bladder rupture. Ultrasound confirms it without a doubt. Fortunately, Dr. Jennifer Stafford, a double-boarded colleague in critical care and internal medicine at VCA Veterinary Referral Associates in Gaithersburg, Md., comes to the rescue with a full write-up on uroabdomen (JR Stafford, et al. “A clinical review of pathophysiology, diagnosis, and treatment of uroabdomen in the dog and cat.” J Vet Emerg Crit Care 2013, Vol 23, N 2, p. 216-229). As in Tucker’s case, most uroabdomen cases are caused by blunt trauma to the abdomen, such as getting hit by a car. The chances of this happening depend on the degree of bladder distention at the time of the trauma. Uroabdomen …
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4 Myths About AcupunctureOctober 27, 2014What looks like acupuncture, feels like acupuncture and employs the same instruments as acupuncture but is practiced by physical therapists (PTs)? Dry needling is defined by the American Physical Therapy Association as “a skilled intervention that uses a thin filiform needle to penetrate the skin and stimulate underlying myofascial trigger points, muscular and connective tissues for the management of neuromusculoskeletal pain and movement impairments. Dry needling (DN) is a technique used to treat dysfunctions in skeletal muscle, fascia and connective tissue, and diminish persistent peripheral nociceptive input, and reduce or restore impairments of body structure and function leading to improved activity and participation.”1 The PT description of DN resembles that of scientific medical acupuncture: “The performance of modern dry needling by physical therapists is based on Western neuroanatomy and modern scientific study of the musculoskeletal and nervous system.”2 A big difference between PTs and medical acupuncturists is that physician and veterinarian medical acupuncturists treat not only pain and myofascial dysfunction but also address digestive, immunologic, cardiopulmonary and a host of other disorders. As with acupuncture, DN requires clean needling technique and awareness of underlying anatomy to avoid complications such as major vessel or organ puncture. …
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 …
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 …
12 Ways to Avoid Surgical MistakesSeptember 22, 2014 What follows might very well become my most controversial surgical column. This list of 12 surgical mistakes is hardly exhaustive. It is, however, meant to start a reflection, rather than to offend anybody. 1) Skills The challenge with surgery is that a seemingly straightforward procedure can suddenly become much more complicated. Having the necessary skills set is the whole dilemma. Examples include the “routine” cystotomy, canine or feline, which in fact required a urethrostomy; the “routine” splenic mass, which in fact was a hepatic mass; the “routine” enterotomy, which in fact turned into a resection and anastomosis of three feet of jejunum. Could you handle any of these situations? 2) Indications Just because you have a hammer, even if you are a hammer expert, does not mean that every problem is a nail. Not all fractures can be pinned; some require a plate and screws. Not all cases of otitis externa can be treated by a Zepp procedure; many require a total ear canal ablation. Not all ACL tears can be treated with lateral nylon sutures; some patients require fancier procedures, such as a tibial plateau leveling osteotomy or a tibial …
Veterinarian Wins High Praise for Saving GoldfishSeptember 16, 2014 George the goldfish is back in his home pond after an Australian veterinarian successfully removed a brain tumor. The 45-minute operation on an uncommon veterinary patient cost the owners a couple of hundred dollars, according to Lort Smith Animal Hospital, and brought admiration from around the world as news and photographs of the surgery went viral. “Thanks for treating fish with the respect they deserve,” one Facebook user wrote on the clinic’s page. “That might be the coolest thing I’ve ever seen,” another wrote. “And to those that question the use of financial resources for a goldfish, some varieties can fetch amazingly high prices. Some are treasured pets. Who are we to judge?” The International Brain Tumor Alliance weighed in as well, stating, “We have heard of dogs and cats having brain tumors removed, but this is the first time we have heard of a fish undergoing brain surgery. Way to go, George!” The doctor was Tristan Rich, BVSc, who heads exotics and wildlife medicine at the Melbourne hospital. “The fish was having trouble eating, getting around and he was getting bullied by other fish,” Dr. Rich told The Telegraph newspaper. …
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 …
How the Laparoscopic-Assisted Spay EvolvedAugust 26, 2014 Published in the August 2014 issue of Veterinary Practice News. When Ray Cox, DVM, first took laparoscopy courses in the 1980s, some veterinarians were already performing laparoscopic-assisted ovariohysterectomies. But the procedure took two to three people operating through three ports, and even the best surgeons needed 2.5 hours to complete a spay, so the modality wasn’t practical compared to the traditional spay. But today, Dr. Cox said, even surgeons who take the longest to do a lap-assisted spay need less than 20 minutes. They can also look around inside the animal, basically doing a mini-exploratory during every procedure. In little more than a decade, the lap-assisted spay has become a procedure that can be used often enough for the general practitioner to develop a skill set in rigid endoscopy and make the equipment a practical addition to a clinic. Rigid endoscopy can be used for liver biopsy, prophylactic gastropexy, cryptorchid surgery and cystoscopy, among other procedures, all of which can add to the return on investment. Intrigued by those early courses, Cox began working to refine the procedure. He didn’t know it then, but he would become one of the pioneers of …
