ACTH Stimulation Testing: A Low-Dose ProtocolApril 17, 2009Based on abstracts presented at the 23rd Annual ACVIM Forum in Baltimore (2005). ACTH stimulation testing is a common procedure in small-animal practice used for diagnosing both hypoadrenocorticism and hyperadrenocorticism. Pituitary versus Adrenal When diagnosing hyperadrenocorticism, the most common screening tests are the ACTH stimulation test and the low-dose dexamethasone suppression test. Each has advantages and disadvantages. It has been shown that the LDDS is more sensitive with fewer false negatives, but less specific with more false positives than the ACTH stimulation test in dogs with significant non-adrenal illness, especially liver disease. The LDDS test has an advantage in that it is possible to differentiate between pituitary and adrenal tumor dependent disease in approximately 30 percent to 50 percent of cases. Test results typical for hyperadrenocorticism would have a cortisol value greater than 1.4 µg/dL at eight hours. It is the four-hour sample that helps to differentiate the cause of hyperadrenocorticism. If the four-hour sample is either below 1.4 µg/dL or 50 percent lower than the baseline or eight-hour value, it is consistent with PDH. Synthetic ACTH ACTH stimulation testing has become significantly more expensive since the cost of synthetic ACTH has increased. An ACTH gel is available, but the …
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How To Stay Busy During Your Clinic’s RecessApril 17, 2009Children take recess from school; consumers are taking recess from spending. What will you do during your hospital’s recess? Unlike our children, we do not have the options of jump-rope or kickball; instead, we must focus on hitting home runs with our clients and playing hide-and-seek with missing charges as a few ways to stay busy during our hospitals’ recess. Practitioners, take comfort! Though five recessions have occurred since 1973, spending on veterinary care has remained constant or increased1. Despite these observations, some practitioners have felt the effects of a recession. These veterinarians report that they have noticed a decline in client growth and client purchases within their practice or heard of the same from neighboring practices. Many believe recession effects tend to spread region by region, state by state and town by town. For example, as a result of auto industry cutbacks and auto workers on strike, Michigan veterinarians report a financial decline in their practices, as many of their clients are/were auto industry employed: • For example, Chrysler alone will terminate 8,500 to 10,000 hourly workers within 2007-086. • Early-retirement and buyout packages have achieved 78 percent of that goal this year6. On the other side …
How To Efficiently Biopsy Lumps, BumpsApril 17, 2009 During a routine visit, an owner points out a mass on the medial hock of her 6-year-old boxer. A strange-looking 8–year-old German shepherd has a huge nasal mass. A 10-year-old Labrador has a large, firm mass along the entire caudal thigh. What are your rule-outs? What do you tell your clients? • “Just watch it.” • “Come back for a recheck in six months.” • “Big surgeons make big incisions. Let’s amputate the body part in question.” • “I would recommend further testing.” Obviously, all Veterinary Practice News readers chose the fourth and only reasonable answer. The classic expression “Just watch it” has been dubbed the three deadliest words in veterinary medicine. Yes, “further testing” is in order. Either a fine-needle aspirate (FNA) or a biopsy should be performed. Because they provide information about the architecture, in addition to the cell types, biopsies tend to be more accurate and informative than FNAs. Here are some suggestions for taking biopsies. Core Biopsy For skin and subcutaneous masses, many surgeons favor a spring-loaded Tru-cut biopsy needle. There are a variety of manufacturers, diameters and lengths. What is needed depends on the nature and …
Elysse Orchard, DVM: Placing Animals As Top Professional PriorityApril 17, 2009 As the sole veterinarian at Chimp Haven in Keithville, La., Elysse Orchard, DVM, gave medical attention to more than 119 retired chimpanzees formerly used in biomedical research. Although Dr. Orchard recently took a position at Louisiana State University, she still works part-time at Chimp Haven and her accomplishments at the facility are monumental. She helped develop non-invasive techniques to assess chimpanzee health concerns while minimizing human risk, including a three-lead ECG probe to get heart rate and wave form evaluations. She even tested a blood glucose transmitter on herself before introducing it to chimps to ensure their comfort. Her career had a fairly exotic beginning. "My first veterinary job was in Liberia, West Africa, as the director of medical services for chimpanzees used in biomedical research that were retired to island habitats," Orchard says. Orchard completed her residency in primate medicine at the University of California, Davis, in 1990. "Prior to becoming a veterinarian, I was a certified veterinary technician, a laboratory animal technologist and a graduate from grooming school. After finishing a Bachelor of Science degree in biology, I realized the dream of becoming a veterinarian, with the …
Grappling With Quality Of Life And Over-treatment IssuesApril 17, 2009 I was asked to speak on some tough topics at the Human-Animal Bond Track and at the Personal/Professional Development Track Ethics Sessions during the 144th AVMA Meeting in DC. The assigned topics for me were: Maintaining Quality of Life at The End of Life during the Human-Animal Bond (HAB) Sessions and Preventing Over-treatment at a Veterinary Cancer Referral Clinic during the Ethics Sessions. Dr. Richard Timmins, President of the American Association of Human-Animal Bond Veterinarians, selected the theme of Quality of Life (Q of L) for the HAB track. The Bustad Memorial Lecture was given by Dr. Richard Meadows and titled, Practical Ways to Improve Q of L in Dogs. Dr. Frank McMillan compared the scientific view with the intuitive view in his papers, What Do We Mean by Q of L?, and Research Questions Regarding Q of L. Dr. Melissa Bain discussed Behavioral Management to Promote Q of L. Dr. Marsha Heinke, CPA, spoke on Making Q of L the Focus of the Practice Team. Dr. Timmins clarified O of L for Animals in Confinement. Dr. Bernie Rollins, Ph.D. of Bioethics at CSU, organized the Ethics theme at AVMA meeting, which dealt with conflicts and ethical …
Petfood Forum Seeks Speakers For April 2009 ConferenceApril 17, 2009Petfood Industry magazine is looking for veterinarians and other pet food industry professionals to speak at its annual Petfood Forum, to be held April 20-22 in Rosemont, Ill. The forum, geared for pet food industry executives worldwide, is accepting submissions of abstracts for noncommercial oral and poster presentations on the topics of nutrition and ingredients; packaging; safety and regulatory issues; processing and production subjects; market data, trends and predictions; company profiles; and new products. Click here for details, call 815-966-5544 or e-mail tphillips@wattnet.net. Abstracts must be received by Sept. 30. Petfood Industry magazine is published by Watt Publishing Co., which focuses on the agrifood and woodworking industries. <HOME>
Some UTI Remedies Validated By ResearchApril 17, 2009 For those looking for non-pharmacologic alternatives to treat uncomplicated urinary tract infections several options exist. Some are "old cures" now validated by rigorous research. Various over-the-counter formulas await motivated consumers who have grown tired of treating their animals with antibiotics and are fearful that with each course, they are fostering more resistant strains of bacteria. Typically, herbal mixtures may contain botanical diuretics, urinary antiseptics, anti-adhesion plants or anti-inflammatory agents. Fortunately, most of the products enticing consumers appear relatively innocuous, at least based on information gleaned from human trials. Additional options, such as probiotics and acupuncture, may not typically be considered "first-line" alternatives for UTIs, but could be helpful integrative adjuncts, nonetheless. Diuretic Herbs Herbal diuretics span a continuum in terms of strength.1 Weak diuretics include plants such as cleavers, horsetail and pipsissewa. Dandelion and stinging nettle fall in the moderate category, while parsley, celery, birch, lovage, and goldenrod rank as strong diuretics. Parsley's diuretic effect, recognized since ancient times, appears to be mediated through an inhibitory action on the sodium-potassium pump.2 Each of these plants also has a spectrum of other benefits. For example, parsley and its relative, celery, possess calcium channel-blocking …
Veterinary Parasite Center Receives Novartis GrantApril 17, 2009Veterinary Parasite Center Receives Novartis Grant Veterinary Parasite Center Receives Novartis Grant newsline Novartis Animal Health of Greensboro, N.C., has donated $225,000 to the Oklahoma State University Foundation to become the first industry partner of the university's National Center for Veterinary Parasitology, the company announced Jan. 6. The grant will help make the center operational by providing support for laboratory renovations and related start-up costs, according to the foundation, OSU's principal fund-raising organization. Renovations are scheduled to begin in 2009 and graduate studies in 2010. As a founding partner, Novartis will help guide and develop the center as a member of its advisory board and interact with graduate students and residents in training. Ultimately, OSU sees the center becoming a national resource for diagnostic testing that will help train clinically oriented veterinary parasitologists. "In the last several years, there has been a decline of veterinary parasitology training in the U.S.," said Michael Lorenz, DVM, Dipl. ACVIM, dean of the Center for Veterinary Health Sciences. "The NCVP is an opportunity for us to continue training in the discipline of veterinary parasitology and to provide a source for national diagnostic testing." <HOME>
Groomed For SuccessApril 17, 2009 Ideal for surgery out of the office, the Andis Vet Pak Super AGR+ clipper kit puts together a top-performing rechargeable clipper, two batteries, a charger stand and a car charger adapter. The metallic green Super AGR+ clipper, which Andis calls “the industry's most powerful cordless rotary motor clipper,” runs continuously for one hour with a high speed of 3,800 strokes per minute. Its #40 surgical stainless steel CeramicEdge blade even cuts through wet hair. “We’ve reduced the weight of the clipper by 20 percent and the size by 10 percent but kept the same level of power as a corded clipper,” says Fred Koeller, vice president of marketing at Andis in Racine, Wis. Also new: two new powerful AGP model clippers with their own touch of style. Pick your favorite – the purple Super 2 Speed Clipper, running at 4,400 strokes per minute, or the green 2 Speed Clipper, at 3,400 strokes per minute. Both are equipped with a 4x4 blade drive, offering 25 percent more torque for faster cutting, even through mats or thick coats. For pricing information or to find a local distributor, call (800) 558-9441 or visit www.andis.com. …
Dr. Sherman To Speak On Afghan Project At AVMAApril 17, 2009 David M. Sherman, DVM, MS, Dipl. ACVIM, will discuss his ongoing work in Afghanistan at a presentation at the American Veterinary Medical Assn. convention in New Orleans this month. His lecture, “Providing Animal Health Care in Afghanistan,” will be held at 10 a.m. July 19 in Auditorium B at the convention center. The talk is based on his work in Afghanistan to set up a community-based veterinary network and is part of the conference's "One Medicine" subsection. Dr. Sherman is the author of “Tending Animals in the Global Village” (Blackwell, 2002), in which, according to Amazon.com, he discusses global trends that affect how the veterinary profession serves society and how veterinary professionals define their roles. “This is an agrarian culture that depends on livestock for its existence,” says Sherman about his work in Afghanistan. He is a Massachusetts veterinarian and an international expert on goat health. As much as 70 percent of the Afghan population earns a living from animals, at least in part. Sherman and his work will be profiled in the August issue of Veterinary Practice News. <HOME>
