How To Perform A Thorough Oral ExaminationMay 15, 2014 Courtesy Dr. John Lewis Figure 1: Laceration on ventral suface of a dog's tongue Published in the April 2014 issue of Veterinary Practice News. It was the day after Valentine's Day, and the East Coast was in the throes of yet another snowstorm. An 8-year-old male great Dane presented to our hospital through the emergency service for sudden onset of bleeding from either the mouth or nose at home. The dog had a prior history of immune mediated thrombocytopenia, so it was a surprise when a complete blood count showed a normal platelet count. The patient was not very cooperative for a conscious oral examination, and no source of bleeding was visible because bleeding had subsided prior to the patient's arrival. The pet owners declined an anesthetized oral exam, but two hours later a second and more severe episode of bleeding brought the owners and the pet back to the hospital. The dog's face and front legs were drenched in blood, and packed cell volume and total protein were found to be 24/6.0. During the active bleed, it became obvious that the bleeding was arising from the oral cavity. The patient …
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The Anesthetized Intraoral ExaminationMay 15, 2014 Working ends of an ODU 11/12 explorer, left, and an UNC periodontal probe, right. Courtesy of John Lewis, VMD, BVMS, Dipl. ACVS In last month's column, we discussed the components of the conscious intraoral and extraoral examination. The conscious examination, however, reveals only so much. A comprehensive oral examination requires anesthesia to obtain a complete assessment of oral health and disease. In particular, the periodontium (the attachment structures of the teeth) cannot be evaluated without using a probe at multiple sites around each tooth. Each patient deserves an individual treatment plan based on appropriate diagnostics. The same hold true for teeth: The adult dog's mouth contains 42 patients and the adult feline mouth contains 30 patients that require individual attention. Use your dental probe, explorer and dental radiographs to determine if each and every tooth will be able to provide pain-free function or if it is non-salvageable. Start the anesthetized exam by assessing those structures that were not adequately assessed in the conscious examination: tonsils, pharynx, soft palate, caudal tongue, caudal buccal mucosa. Identify each of these structures as normal or abnormal and document this information on the dental record. Determine the …
Dr. Danner's DooziesMay 5, 2014 From dog breeders performing at-home ear-crop surgeries to hydrocodone-addicted veterinary staff members, Dan G. Danner, DVM, has seen some bonafide doozies during his service on the Oklahoma State Board of Veterinary Medical Examiners and the board of directors of the American Association of Veterinary State Boards. Dr. Danner, a 1978 graduate of Oklahoma State University's Center for Veterinary Health Sciences, was appointed to the Oklahoma veterinary board (OSBVME) in 2003 by the governor and reappointed in 2008, serving two five-year terms. Before stepping down last year, he served as secretary-treasurer for three years, vice president for two years and president for four. During his tenure, he also served on five committees of the American Association of Veterinary State Boards and spent the last three years on its board of directors. "In Oklahoma, we've had cases as bizarre as a mixed-animal practitioner whose daughter graduated from veterinary school but couldn't pass the national board exam, yet she worked for her dad for years as a DVM," said Danner. "This was back in the days when drugs like diazepam and ketamine weren't as closely regulated, and it was harder to …
How I Will Help Out Matt Damon This ChristmasDecember 19, 2013 A 14-year-old girl in Zambia was walking to get water for her family. The daily walk took so much time that she couldn’t go to school full time. She dreamed of becoming a nurse and living in the big city. Her dreams could come true if she only has access to a well closer to home. She wouldn’t have to spend her time looking for water to get what we take for granted every day: clean clothes, drinking water and a flushable toilet. Ironically, some municipalities are piping water right under their communities but people cannot access it when they live on $2 to $5 a day. We have a tradition in our household: Christmas day is when we make donations to various charities. Every year is a struggle: who do we choose? This year, we will make a donation alongside Matt Damon to a new worthy cause. Read on… More people own cell phones than toilets In many parts of Africa and India, almost 800 million people (more than twice the population of the USA) lack access to clean water. A staggering 2.5 billion people are without toilets. More people own …
AAHA Dental Anesthesia Mandate Comes Under FireSeptember 30, 2013Dental cleanings done without general anesthesia are safe and effective in many cases, according to a pilot study that challenges a new American Animal Hospital Association mandate requiring anesthesia and intubation for all dental patients. The rule, part of the updated 2013 AAHA Dental Care Guidelines for Dogs and Cats, has a few veterinary hospitals contemplating abandonment of their AAHA accreditation. Many who oppose the mandate have been using anesthesia-free dentistry in their practices for years without problems. "I totally oppose the policy,” said Kristy Lund, DVM, co-owner of Lund Animal Hospital in Boca Raton, Fla., which has been accredited for more than 25 years. "I’m up for renewal in November and I’m not renewing.” Dr. Lund has offered non-anesthetic dentistry for seven years. The study, published in the fall issue of Integrative Veterinary Care Journal, looked at Professional Outpatient Preventive Dentistry (POPD), an anesthesia-free service performed by trained technicians who are qualified by examination by the American Society of Veterinary Dental Technicians and work under a veterinarian’s supervision. Pet Dental Services (PDS) of Costa Mesa, Calif., and West Palm Beach, Fla., which helped fund the research, carries out 15,000 POPD cleanings a year at veterinary clinics in 11 states. …
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Web Vet Launches Court Fight With Texas RegulatorsJune 10, 2013 A Texas veterinarian is challenging a state law that bars practitioners from dispensing advice to pet owners without ever examining the animal. Ronald Hines, DVM, Ph.D., began offering free email and telephone veterinary consultations through his website, 2ndchance.info, in 2002. He moved to a pay model in 2003, initially charging $8.95 and then $58 a case, according to his lawsuit, filed April 8 in U.S. District Court in Brownsville. Dr. Hines, represented by the Arlington, Va.-based Institute for Justice, alleges that the Texas State Board of Veterinary Medical Examiners violated his constitutional rights to freedom of speech and due process by barring him from remotely advising pet owners in Texas and overseas. He has suspended the online practice. "This case is much bigger than me,” Hines said. "I’m fighting for the right of all Americans to be able to freely and openly share their thoughts and advice online, and for pet owners to have access to the knowledge they need to best care for the animals they love.” A spokeswoman for the Texas board declined to comment. The agency moved against the Cameron County veterinarian in March 2012, 10 years after he launched the …
Not The Heartworms You Used To KnowMay 7, 2013 Heartworm is a very complex parasite, and so is the disease it causes, explained Wallace Graham, DVM, president of the American Heartworm Society. "Many practitioners think of heartworm in the same terms as they did 10 years ago, and there is so much more about the organism and the disease that we know now that we didn’t know then,” said Graham, who is also an associate veterinarian at VCA Oso Creek Animal Hospital in Corpus Christi, Texas. "This information has implications on the decisions we make concerning testing and treatment.” Living worms damage the pulmonary arterial walls, lungs and heart if left untreated, but so do dying and dead worms. Dying and dead worms lodge in the arteries, block blood flow, cause platelets to cluster, and elicit an inflammatory cascade that severely damages the cardiovascular and respiratory systems, leading to problems like thromboembolism, Graham said. And the chances of severe cardiovascular or respiratory response to treatment are directly related to the worm burden. Multimodal Attack To mitigate this damage, AHS recommends a multimodal approach to treating heartworms. The goal of treatment is to eliminate all stages of the …
Ticks, Ticks & More TicksMarch 28, 2013 Tick infestations of dogs and cats are important not only because ticks are nuisance blood-sucking parasites but also because they can transmit a variety of diseases. Pet owners often get frustrated when they use a tick product yet still find ticks on their pets. A number of factors contribute to problems with ticks, such as an increase in tick populations, changing tick distributions and our inability to control native wildlife tick hosts. The tick species that most commonly infest dogs in North America are: Amblyomma americanum (Lone Star tick) Amblyomma maculatum (Gulf Coast tick) Dermacentor occidentalis (Pacific Coast tick) Dermacentor variabilis (American dog tick) Dermacentor andersoni (Rocky Mountain wood tick) Ixodes pacificus (Western black legged tick) Ixodes scapularis (black legged tick) Otobius megnini (Spinose ear tick) Rhipicephalus sanguineus (brown dog tick) While we often use the same products to combat ticks as we use to combat fleas, there are substantial …
Jack Walther, DVM: A ‘Veterinarian’s Veterinarian’January 24, 2013 What does someone have to do to get the Western Veterinary Conference named after him? Plenty, considering that before this year the WVC bestowed the honor only five times. February 2013 will be No. 6, when the Dr. Jack Walther 85th Annual Western Veterinary Conference opens in Las Vegas. During his 48-year relationship with the WVC, Walther, DVM, has done more than examine the latest exhibitor offerings, attend seminars and hob-knob with other veterinarians. He has served as a WVC committee chairman since 2002, as a board member for more than 12 years and as conference president in 2005. Add to that his presidency of the American Veterinary Medical Association a decade ago and all he’s done for patients, clients and the profession throughout Nevada and the nation. “Dr. Jack Walther is a veterinarian’s veterinarian,” offered Dennis McCurnin, DVM, MS, Dipl. ACVS, the WVC’s current president. “He has served the WVC for 48 years and has been involved in nearly every office and committee.” Walther is appreciative of the tribute, which includes a ceremony that starts at 7 p.m. Feb. 17, 2013, before comedian Jake Johannsen’s show. “If I could write an end to …
