Stalking The Spay/Neuter StandardJanuary 12, 2012 In case you hadn’t noticed, the notion of the obligatory spay and neuter of 6-month-old pets is seriously at risk in the U.S. New veterinary research is inexorably chipping away at the 30-plus-year-old concept of peripuberal sterilization as the standard for idealized patient care. That’s not to say that prepuberal castration and ovariectomization of all pets isn’t desirable from a public policy standpoint—indeed, that may well remain the case everlastingly, despite the research. What’s in question is not the minimum standard of care (which still allows for the recommendation of spays and neuters at 6 months), but the optimum approach to individualized care. As veterinary medicine reaches for excellence in that highly profitable sector serving beloved pets whose owners expect the epitome of individualized care, the 6-month spay and neuter may well go the way of IV dexamethasone for cardiovascular shock—as in, it’s probably no longer considered a good idea. Granted, we don’t yet know the outcome of research into the model timing of spays and neuters, but if the large retrospective study out this past spring (JAVMA, May 15) is any guide, we’ll see more research in this vein for years to come. …
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An Otitis Externa Strategy That Limits The EngagementsJanuary 5, 2012 Donn W. Griffith, DVM, M.S., has battled otitis externa for 40 years, and he has developed an alternative way to engage the enemy. In fact, he doesn’t treat it as war at all. “The conventional Western approach says to identify the organism (causing the infection) and try to kill it,” said Dr. Griffith, whose practice is Animal Medical and Emergency Hospital in Columbus, Ohio. “The only problem is that, like in war, the enemy tends to recur.” So instead, Griffith’s Eastern-influenced goal is to restore balance. “You can go in and try to club all the bacteria to death, but then you might not know what the original fight was about,” he said. “So you’re doomed to repeat history. “I think one of the nicest things about alternative therapies is that they allow time to look for the cause of the problem,” Griffith continued. For 13 years, Deborah Brown has been promoting options other than antibiotics and steroids to neutralize ear infections. So she gets excited when she hears a practitioner like Dr. Griffith commit himself to an approach that includes alternative therapies. Brown is vice president of marketing for Pet King Brands …
Seeing Is Believing With Stem Cell TherapyJanuary 5, 2012 Veterinarians have seen so many technologies come and go over the years that they can’t help but ask, “Is this really the next level of treatment, or just another fad?” Today, stem cell therapy is much in vogue for the treatment of osteoarthritis and soft-tissue injuries. But will it become a conventional treatment, or is it a momentary phenomenon? Does stem cell therapy really work with pets, and do the benefits last? The science isn’t all that old. Veterinarians started hearing about stem cell therapy for horses in 2003 and as early as 2005 in small animals. While the potential was intriguing to veterinarians, the cell processing had to be outsourced. That meant two appointments for each patient. The tissue sample had to be sent to an outside laboratory, processed and returned. The cost to the client involved an outside processing fee of up to $1,500. Some veterinarians had a hard time selling the novel technology to animal owners. Then the technology began moving in-house, and success stories soon followed. One involved Thomas Newland, DVM, owner and medical director of Adobe Animal Hospital in Scottsdale, Ariz. His patient, Molly, a 3-year-old spayed female Lab/chow …
Is It Time To Invest In Class IV Laser Therapy?January 5, 2012 Since the first Class IV laser therapy booth appeared at the 2006 North American Veterinary Conference in Orlando, the modality has become arguably the fastest growing one in the veterinary profession. Why is everyone talking about laser therapy? Is it all hype? Why have more than 3,000 practices invested in it? To understand Class IV laser therapy’s rapid growth, one needs to recall practice trends of six years ago. Multi-million dollar marketing campaigns targeting pet owners transferred purchases of medications, food and products from veterinary practices to online and big-box pet stores. Similar direct-to-consumer campaigns focused on pharmaceutical solutions to pain management problems. These trends caught the attention of educated pet owners, which affected clinic revenue. The profession recognized this threat and developed renewed appreciation for sustainable practice-based service revenue, which could only be lost through competition from other practices. Clinical Considerations Class IV laser therapy does not treat conditions. Rather, it stimulates the body’s inherent healing mechanisms via a process called photobiomodulation or biostimulation. Pet owners searching for pain management solutions for older pets had begun to seek non-pharmaceutical, non-surgical solutions. Class IV therapy lasers provided the solution with a simple …
The Skinny On Herbs For The SkinJanuary 4, 2012 By Narda Robinson, DO, DVM A dizzying display of botanical products confronts shoppers scanning pet store aisles and natural pet magazines to find safe and effective alternatives for their dogs’ itchy, painful skin.1 The under-enforcement of federal regulations has given a green light to unfettered expansion of unproven cures. Consumers try their best to navigate the maze of claims and testimonials, left in the dark as to whether a product will help or harm their animals. The sheer number of botanical creams, ointments and lotions crammed on supplement shelves can cause canine caregivers to scratch their heads in confusion. Isn’t anyone minding the store when it comes to stocking herbal potions? Why do animal skin-care products still contain chaparral and comfrey when their well-publicized pyrrolizidine alkaloids are likely to end up ingested by an auto- or allo-groomer?2 How do companies reconcile the ethical issues involved in selling goldenseal and other endangered plants suffering from overharvesting and habitat elimination? Where is the appropriate labeling on potentially toxic essential oils?3 Even products for humans can be unsafe, as illustrated by …
Legal Exposure Might Not Be Worth The SavingsNovember 3, 2011 Some veterinarians believe they are helping clients reduce costs by ordering compounded drugs instead of medications approved by the U.S. Food and Drug Administration. But there’s a reason compounded drugs are cheaper than FDA-approved medications, pharmaceutical companies say. Compounding pharmacies’ quality-control procedures are rarely as stringent or comprehensive as the good manufacturing practices required by the FDA for approved products. Therefore, the safety and efficacy of compounded drugs are not guaranteed. In a case of therapeutic failure of a compounded product when an FDA-approved medication is available, the amount the veterinarian saves the client might turn a competitive advantage into a serious disadvantage. That prescription could leave the veterinarian exposed to legal liabilities because the FDA does not test or approve compounded drugs. Liability Dangers “Many times veterinarians don’t understand that they are the first in line in liability in the event that a compounded product goes bad,” says Denise E. Farris, Esq., owner of Farris Law Firm LLC in Kansas City, Mo. “If there is an adverse reaction, he or she is liable to the client for veterinary malpractice. The liability coverage may not cover that activity because most policies do not cover …
Two Simple Ways To Improve Patient CareNovember 1, 2011It's fascinating to me that every practice seems to have a different protocol to achieve similar results. For this column, we present better ways to intubate and scrub patients. Each doctor or technician probably has a different intubation protocol. I recently read a description of how we should probably all intubate. It was written by Sheilah Robertson, a board-certified anesthesiologist at the University of Florida College of Veterinary Medicine.1 Here's the idea: Most people test the cuff of a large endotracheal tube by inflating it with a syringe (aka "dry syringe," "air syringe" or "cuffer puffer"), waiting a few seconds, and deflating it. Then, some people lube the tip and the cuff of the tube with lubricating jelly (again, this specifically applies to large tubes). It seems that most do so on a deflated, folded cuff, which actually greatly decreases the benefits. Dr. Robertson suggests adding lube to an inflated cuff. Think about it. It wouldn't take any longer than doing both steps separately, but it would lubricate the cuff much more effectively—on 100 percent of its surface—instead of a few random spots. I have only witnessed one technician do that (surely there are more out there!) But …
In Wake Of EHV-1 Outbreak, Some Say Better Biosecurity Measures Are NeededSeptember 19, 2011 The equine herpesvirus (EHV-1) outbreak traced to an April National Cutting Horse Association event in Ogden, Utah, is over, according to a June 23 U.S. Department of Agriculture Animal and Plant Health Inspection Service (APHIS) situation report. Ninety cases of EHV-1, or equine herpesvirus myeloencephalopathy (EHM), were confirmed in nine states. Of the 90 cases, 54 were present at the Utah event. Thirteen horses linked to the incident died or were euthanized. “Financial losses from this outbreak go deep into six figures, maybe more,” said D. Paul Lunn, BvSc, MS, PhD, MRCVS, Dipl. ACVIM, a professor and head of the department of Clinical Sciences at the Voss Veterinary Teaching Hospital in the College of Veterinary Medicine and Biomedical Sciences at Colorado State University in Fort Collins, Colo. “That takes into considering event cancellations, the economic effect felt by communities in which the events would have taken place and treating sick animals. The USDA is conducting additional research on the outbreak which will offer a new analysis of the effect the outbreak had on the industry.” Dr. Lunn said the NCHA behaved responsibly by acting quickly and effectively when the virus spread at its event. …
Physical Rehab, Integrative Medicine As Growth OpportunitiesJuly 18, 2011 These are difficult times for many small businesses, and veterinary practices are no exception. Prior to the recession, industry reports indicated a declining trend in several metrics, including patient visits, transactions and new clients. Confirmation of this decline came earlier this year with the release of the Bayer Veterinary Care Usage Study. This study compiled industry data, extensively surveyed pet owners and presented it in a format that left little room for interpretation. The study also confirmed that declining veterinary metrics are not a result of a shrinking potential market base. From 1996-2006 the number of pets owned in the U.S. grew at a steady rate of approximately 10 million per year, but the number of veterinary visits, which had matched or exceeded this rate of growth until 2001, fell flat and began a slow decline. To reverse this trend, our profession needs to evaluate our ability to convert pet owners into active, educated clients. If there is a bright side, it is that the average per-transaction dollar amount has continued to grow, in most cases as a result of incremental fee increases. Yet even these increases have been unable to make up for the declining …
Supplements For Chronic ConditionsJune 9, 2011 Many people believe that supplements can help manage health issues and chronic conditions in their horses, leading to a more productive and better quality of life. Clinical and field experience has demonstrated that many health problems and disease conditions can be either prevented or effectively treated with proper nutrition and the use of specialty health products and supplements, says Roger V. Kendall, Ph.D., vice president of research and development at Vetri-Science Laboratories in Essex Junction, Vt. “[For example,] the use of antioxidants to reduce the damaging effects of free radicals in equines has found applications to deal with many metabolic issues,” he says. Though nutrients and other natural ingredients such as glucosamine and perna canaliculus (New Zealand green shell mussel) may work more slowly than selected drugs such as nonsteroidal anti-inflammatory drugs, Kendall says, in the long run they may enhance metabolic processes and help restore function and balance to the body. “Selected supplements and animal health products can contribute important metabolites for cellular regeneration, improve the flow of energy, enhance immune function, detoxify cellular toxins and improve enzyme activity,” he says. “Such supplements can contribute to the animal during times of stress and aid …
