Investing In High-Quality Cages Can Provide Many Happy ReturnsApril 17, 2009 Life moves fast at Metropolitan Veterinary Referral Services, where a 24-hour intensive-care unit forms the hub of a bustling internal medicine specialty practice. Still, Eric Goullaud, DVM, Dipl. ACVIM, finds time to reflect. The way he sees it, he has no other choice. “Because we are a specialty practice that professes to be the best around, we have had to make significant capital outlays,” says Dr. Goullaud, owner and operator of the Eden Prairie, Minn., hospital. “I bet I have $300,000 to $400,000 invested (in devices and equipment). So return on investment has to be part of the equation.” Before adding technological advances such as ultrasound, digital X-ray and video endoscopy, Goullaud made sure he or others crunched the numbers, multiplying a fair cost for services by a projected number of procedures. Before he invested in the cages that are now the centerpiece of his intensive care unit, his calculations were less exacting. Basically, he knew he had to have them and he knew he wanted the best. It turns out the cages “have to be the most cost-effective thing in the clinic,” he notes. “The return on investment has to be thousands upon …
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What’s Your Diagnosis? Identifying Peritoneal AirApril 17, 2009 Signalment: 15–year-old female, spayed domestic shorthair with history of gastrointestinal lymphoma. History: Patient presented for labored breathing and lethargy. Thoracic radiographs were obtained. Questions: What are the primary findings? What do you think is the primary reason for the clinical signs? Radiographic Findings: The heart is mildly enlarged and the atria are prominent, suggestive of cardiomyopathy. The pulmonary parenchyma and pulmonary vessels are normal. In the viewable cranial abdomen, there are multiple, free, round gas bubbles noted. Of particular note is the bubble of air noted in the vicinity of the liver on the left lateral view adjacent to the diaphragm. There are other accumulations of air noted as small gas bubbles that are not conforming to the GI tract in the cranial ventral abdomen. The right side of the abdominal side of the diaphragm is visible on the VD view. There is also loss of surface detail noted in the midventral abdomen around the small bowel. Radiographic Interpretation: Free peritoneal air. Possible effusion in the mid-abdomen. Possible mild cardiomyopathy without evidence of heart failure. Visceral Surface Detail: Visualization of structures in the abdominal cavity is due to the differential radiopacity of the …
Ease Of Use And Training Smooths Transition To DRApril 17, 2009 George Myatich, VMD, doesn’t claim to be a technological wizard. But, then, he has found he doesn’t have to be, even as he vaults into the digital age of veterinary medicine. In November, when Dr. Myatich converted his Hidden Valley Animal Clinic of McMurray, Penn., to digital radiography, he ditched his wet system and film cassettes without trepidation, he says. “I’ve been in practice for 34 years, so I’m an old-school veterinarian,” Myatich says. “But since I was first introduced to digital radiography about five years ago, I’ve been rolling around the idea and wanting to take advantage of the benefits.” Getting an image in five to eight seconds was a key benefit that helped hook Myatich on digital. So was the chance to manipulate images to improve the quality or to focus on an area of highest concern. However, he says, it was the ease of the transition to digital radiography that cemented his appreciation for the new technology. “Our technicians were eager to make the change, and it turned out it wasn’t that big of a challenge for any of us. I’m not an Einstein, but everything was fairly straightforward.” Like …
What's Your Diagnosis?Evaluating The VasculatureApril 17, 2009Click here to claim one hour of continuing education credit with this article. Signalment: 11-year-old male, castrated Chinese crested dog History: Patient presented on emergency for labored breathing and a wet cough. He had been coughing for about a week. Thoracic radiographs were obtained. Questions to Answer: What are the primary findings? What do you think is the primary reason for the clinical signs? Radiographic Findings: The heart is enlarged and measures just over 3 intercostal spaces wide. The vertebral heart score is approximately 11.5. There is dorsal displacement of the entire trachea, suggestive of ventriculomegaly. There is straightening of the caudal cardiac waist, consistent with left atrial enlargement. The pulmonary vein to the cranial lung lobe is larger than the corresponding artery. A diffuse, interstitial pattern is noted in the caudal dorsal lung fields. Radiographic interpretation: Enlarged heart, particularly the left side, consistent with chronic valvular disease. Enlarged pulmonary veins and an interstitial pattern in the caudal lungs are most consistent with pulmonary edema from congestive left-sided heart failure. The first step …
A Measure Of Sample IntegrityAugust 29, 2008It seems innocuous enough—draw some blood, perform some tests and take a giant leap toward an accurate diagnosis. Just don’t forget about the potential red flags—even the ones that present as yellow or opaque. Hemolysis, lipemia and icterus are three common endogenous interferants that can sabotage precise blood chemistry analysis. That’s true whether you perform blood work in-house our send out for analysis. “All hematology is affected by sample-integrity issues, whether you have a $10,000 analyzer or a $150,000 one,” says Craig Tockman, DVM, director of professional services for Abaxis, a leading maker of point-of-care blood analyzers in Union City, Calif. Dr. Tockman also owns and operates two veterinary hospitals in St. Louis. Threats to Test Results There are two overriding considerations when dealing with these interferences, experts say. The first is to ensure your system provides an alert when hemolysis, lipemia and icterus occur at levels that threaten the dependability of test results. The second key step is to employ clear and strict methods to prevent interferants from compromising otherwise reliable findings. Care in drawing, handling and storing blood should always be a primary consideration. “A lot of it is education on the proper way to draw and to …
