The 10 Commandments Of Referral BlissJanuary 4, 2010 Most referred surgery cases lead to a healthy patient, a happy client and a pleased referring veterinarian. Little is learned from a well-oiled referral process, but we can all learn from the rare mishap, occasional slip-up and infrequent diplomatic fiasco. I asked several general practitioners and surgeons from across the U.S. to share stories of surgical cases that should have been routine but turned into a difficult situation. From these discussions come our ever-so-slightly tongue-in-cheek 10 commandments of referral bliss. 1. Thou shalt not use aspirin in vain Photo courtesy of Dr. Phil Zeltzman. This cat, with bilateral sacroiliac luxations, was referred as a paralyzed patient. Aspirin may be an acceptable drug in specific cases, but because of its effect on platelets, it rarely is a surgeon’s best friend. In a perfect world, a seven-day wash-out period should be respected before surgery. This is annoying but doable with an elective procedure such as a ruptured cruciate ligament. But it becomes tricky when the client lives two hours away and needs to drive back one week later. And it is plain risky in …
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Freedom From FolkloreJanuary 4, 2010 The aggressive marketing of Chinese veterinary herbs in the U.S. clouds the longstanding tradition of Western veterinary herbal medicine. As authors in an integrative medicine journal acknowledged, “The rise in popularity of complementary and alternative medicine over the past few decades has placed greater demands on medical practitioners to explain and justify their own systems of knowledge and practice.”1 Their research further illuminated the disparity in objectivity and reliability between Western medical and Eastern diagnostic approaches. Why should we turn over our patients’ health and well-being to a primitive and poorly understood system of Chinese medicine when we can reclaim our heritage of herbal prescribing and still provide quality health care? By first establishing a clear-cut diagnosis, we can determine whether plant-based compounds will offer safe and appropriate treatment. We may even introduce Asian herbs if they meet muster, or decide that no herbs can replace the benefits of medication for a given illness. The following list provides a sampling of evidence pertaining to both Western and Asian herbs administered to dogs. Boswellia Veterinarians will find bos-wellia in canine products designed to treat arthritis and inflammatory bowel disease. Its anti-inflammatory effects are well characterized. …
New Guidelines Published To Promote Appropriate Wellness Care For CatsJanuary 4, 2010 The American Association of Feline Practitioners and the American Animal Hospital Association have released the AAFP/AAHA Feline Life Stage Guidelines, developed to promote appropriate wellness care for cats. These guidelines recommend cats be seen by a veterinarian at least once a year, regardless of the cat's age. The need for such guidelines was identified by the CATalyst Council, a national initiative to champion the cat, in light of "alarming" statistics reported in the 2007 American Veterinary Medical Association U.S. Pet Ownership and Demographics Sourcebook. For instance, the sourcebook revealed that the number of cats kept as pets outnumber dogs, yet receive significantly less veterinary care. Further studies have indicated that an inability to recognize signs of illness of injury is a key factor as to why cat owners are unaware of their cat’s medical needs, according to AAFP and AAHA. In addition, the associations note that the concern of a stressful veterinary visit for both cat and owner is a contributing deterrent to veterinary visits for cats. The aim of the guidelines is to help veterinarians act in partnership with cat owners which will in turn enhance the client-veterinary bond, according to AAFP and AAHA. Specifically, …
Down With Live-Plucked DownJanuary 4, 2010 Many of us like to sleep under down-stuffed comforters and on soft down-filled pillows. When it’s cold, there is something special about the lightweight warmth and breathability of down-filled jackets and coats. Down fills bedding, clothing, gloves, furniture and other heat-preserving items for people. Most high-quality down for commercial use comes from the soft layer of smaller feathers that cover the skin of geese and ducks. The sourcing and production of down goes back hundreds of years. While at the American Veterinary Medical Association conference in Seattle last July, I stopped by the Animal Welfare Institute booth and picked up its fall quarterly magazine, which included an article titled “Down on the Goose and Duck Farm.” It reported on a 2009 Swedish TV documentary that estimated today’s down is provided to manufacturers either as a byproduct from ducks and geese slaughtered for meat or by live plucking. Defining the Term What is live plucking? I had to clarify this question for myself. It seemed offensive to me from the start to learn that down feathers might be plucked or harvested from live geese and ducks. Live plucking is the rapid pulling off of feathers from …
Top Dog: Kirk Weicht, DVMJanuary 4, 2010 Dr. Kirk Weicht, winner of the ‘Thank Your Vet for a Healthy Pet’ contest, keeps the well-being of pet owners and staff in sight. Diana Beck’s 11-year-old German shepherd mix was ill. Having recently moved to the Dallas-Fort Worth area, Beck didn’t have a veterinarian, so she chose the hospital closest to home, where she met Kirk Weicht, DVM. Dr. Weicht diagnosed a tumor on the dog’s uterus and performed surgery, Beck says. But even more importantly, he gently explained everything, including the fact that had the dog been spayed, the tumor probably never would have developed. (Courtesy of Margaret Bryant Photography) Three types of salamander larvae “I hate to admit it, but up until then I thought that if you spayed or neutered a pet, it would make them fat, so I had never done it,” Beck says. “Until that time I was very uneducated in responsible pet ownership. No one, up until Dr. Weicht, had educated us enough to help us extend our pets’ lives and give them a better quality of life.” Twenty-five years later, Weicht is still Beck’s veterinarian, having helped her …
Transaction To Form Butler Schein Animal Health CompletedJanuary 4, 2010 Butler Schein Animal Health has officially formed. Henry Schein Inc. and Butler Animal Health Supply first announced the planned merger on Nov. 30. The transaction closed on Dec. 31. The new company, based in Dublin, Ohio, is 50.1 percent owned by Henry Schein and 49.9 percent owned by the owners of Butler Animal Health Supply, including Oak Hill Capital Partners and The Ashkin Family Group. Combined revenue for the last 12 months was about $850 million on a U.S. General Accepted Accounting Principles basis. About 900 Butler Schein Animal Health team members, including about 300 field sales representatives and about 200 telesales and customer support representatives, will serve animal health customers in all 50 states. Oak Hill Capital Partners is a private equity firm with offices in Stamford, Conn.; Menlo Park, Calif.; and New York. The Ashkin Family Group distributes veterinary and dental products. The Jericho, N.Y.-based company is also involved in a variety of other businesses. <HOME> Butler Schein Animal Health has officially formed. Henry Schein Inc. and Butler Animal Health Supply first announced the planned merger on Nov. 30. Butler Schein Animal Health has officially formed. Henry …
Changing The World, One Patient At A TimeJanuary 4, 201012/21/2009 - Would you have euthanized this patient? 12/07/2009 - Spay a pet, save a life 11/16/2009 - How (In)competent Are You? A local colleague, Dr. L, generated quite a stir in our referral community. Her dog Ursula, a 9 -year-old golden retriever, was recently diagnosed with hemoabdomen, widespread liver cancer and pulmonary metastasis, probably all due to hemangiosarcoma. Strangely, Ursula never missed a meal, and her liver values were normal. There wasn't much to do, besides making her comfortable. I suggested to my referring vet that she look into Pawspice. Remember, dear reader, Pawspice is the concept developed by oncologist and Veterinary Practice News columnist Alice Villalobos, DVM. Pawspice is hospice care for terminally sick patients, whether they have cancer, liver or kidney or heart failure, or the owner can't afford treatment. Dr. L was mentally prepared to euthanize her right away, but Ursula perked up. After some research, she decided to give IV fluids, steroids, vitamin C, coenzyme Q10, a chinese herb called skullcap (aka Scutellaria baicalensis or baical), claimed to have some anti-cancer properties, and even an equivalent of reiki. Unfortunately, Ursula's health declined. She likely had another bleeding episode, and after 10 days, she was euthanized. The story could …
Shelter Crosses Line, Some Vets ContendDecember 30, 2009 Stanislaus County, Calif., is laying claim to the nation’s first private veterinary practice and government alliance, a project that some veterinarians see as unfair competition in the world of low-cost spay/neuter clinics. The county has one of the highest euthanasia rates in the nation, with a 35-year-old shelter that was built to house 200 animals but accommodates more than 400 on an average day. Photo courtesy of Dr. Kwane Stewart. Dr. Kwane Stewart oversees the Stanislaus County animal shelter in Central California. Of the 21,000 animals taken to the Stanislaus County Department of Animal Services from June 2008 through June 2009, 14,357 were euthanized. This rate, 68 percent, was emotionally draining for the 30 staff members and cost taxpayers $1.7 million. “We euthanize 80 to 90 animals a day in peak season,” says Kwane Stewart, DVM, the Stanislaus County veterinarian. The euthanasia rate caused public outcry for years, but 2009 was the year the county Board of Supervisors folded to the community’s request. The board approved an $8.7 million, 33,360-square-foot facility, a fully equipped hospital and housing for 567 animals. The new facility, set …
Trends In Clinic DesignDecember 30, 2009 Hydrotherapy equipment? Check. Bereavement room? Check. TVs in the waiting room? Check. Bland design? No. Building a veterinary hospital today requires detailed planning that accommodates all of a practice’s clients and modalities while leaving options for future specialty services. And it should be done, architects say, in a visually appealing and practical way while keeping individual budgets and practice needs in mind. Photo Courtesy of BDA Architecture Architecture of Albuquerque, N.M., designs post-surgical areas in which patients can recover in the open for closer monitoring. “General practitioners are trending toward offering more and more services like those found in human medicine,” says Warren Freedenfeld of the architectural firm Rauhaus Freedenfeld and Associates of Boston and Laguna Hills, Calif. “Hydrotherapy, CAT scans and MRIs all need to be considered in new designs. Basically everyone wants to pack a lot into a small envelope.” While some equipment requires a lot of room, new technology can save space. Digital radiography, for example, has eliminated the need for a darkroom and X-ray storage. Sustainable Design Thoughts of LEED certification (Leadership in Energy and Environmental Design) often cross the minds of …
Voice For Justice: Melinda Merck, DVMDecember 30, 2009 When authorities were trying to build the infamous dogfighting case against Michael Vick, they weren’t sure exactly what to look for or how to prove it. But forensic scientist Melinda Merck, DVM, did. After excavating the graves of some of the pit bulls and analyzing their remains, she pieced together the horrific details of their deaths. Some had been hanged; others had been shot. Her expertise helped put the National Football League quarterback in prison and brought more attention to what’s becoming an important new tool in law enforcement. Now senior director of veterinary forensics at the American Society for the Prevention of Cruelty to Animals in New York, Dr. Merck is on the front lines of this rapidly growing specialty, combining the techniques of human forensic science with the specialized knowledge of veterinary medicine. “It’s not about punishment or getting people put into jail; it’s about protecting the animals,” Merck says. “If we’re not the voice for that animal, who is?” On-the-Job Training In the emerging field of veterinary forensic science, Merck, 45, is a star—profiled by National Public Radio and People magazine, sought after as a speaker and consultant. …
