Ask Appropriate Questions When Shopping For MonitorNovember 22, 2010 Choosing the right patient monitor for your veterinary practice can be a daunting task, but the keys are determining what’s right for your needs, doing your homework, and asking a lot of questions before signing on the dotted line, say industry experts. Here are some things to keep in mind while shopping. Determine Parameters Are you looking for something to monitor just blood pressure or something that measures multi-parameters? The American Animal Hospital Association and the American College of Veterinary Anesthesiologists recommend monitoring blood pressure, ECG/HR, CO2 and SpO2 (blood oxygen saturation). It’s also a good idea to check out your state’s Veterinary Medical Association guidelines. The more parameters, the higher the cost, and one of the most expensive parameters to monitor is the end-title CO2 (ETCO2), which measures the amount of carbon dioxide exhaled by the animal, said Dan Kozisek, customer service director of Bionet of Tustin, Calif. “In the past, they’d have to buy a unit with [ETCO2] included, and that would’ve added $3,000 to $4,000 to the price,” he said. A relatively recent advancement is a monitor that is “ETCO2 ready,” making it easy for practitioners to start with …
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Butter: A Story Of Compassion And HealingNovember 19, 2010 For many, the spiritual aspect of the bond spins a vibrant web that catches us and holds us together, at least for the pet’s lifetime and often longer. Pawspice, my name for pet hospice, is a bigger part of our practice as the recession deepens and families can’t afford first-line care for their pets. Is Pawspice a containing structure for witnessing this thread more often? Is it the loom that holds the elements, emotions and threads of the human-animal bond? A Spiritual Bond As a beloved pet nears the end of life, pet owners often tell me about the transcendent elements in their relationship. The spiritual threads in their bond spin into a very meaningful realm that may extend after the pet has passed. This was the case for Carole Kammen and her beloved yellow Labrador retriever, Butter. A friend told Carole to call me for advice after Butter’s cutaneous lymphoma became resistant to the best of care at the University of California, Davis. Butter “found” Carole only four years previously, as a 9-year-old retired service dog. Butter became so attached to Carole that it became obvious to Carole and Butter’s owner that Butter …
Cost Issues Plague Recession-Battered Clients, DVMsOctober 21, 2010 The human-animal bond does not weaken during recessions, but many caregivers feel more financial and emotional stress when their pets are sick. These days, we might see three or four clients in a row who have serious financial concerns. Some of us recall previous recessions and felt more prepared to deal with this one. But few of us were prepared to endure and share the burdens of a prolonged economic downturn. This recession continues to batter our clientele with job cutbacks, unemployment, falling property values, foreclosures, maxed-out credit cards, health care issues, etc. This unrelenting pressure pushes a big percentage of our clientele deeper into debt and desperation and causes anxiety and heartbreak on both sides of the veterinary exam table when their pets are sick. During my first recession, many of our well-intended clients requested payment plans. Our facility became burdened with accounts receivable that climbed as high as $250,000. Our well-intended clients “slow paid” or “no paid.” Dr. Villalobos Shares Her Thoughts on Each Scenario Example 1: Five thousand dollars is a lot of money. It is tempting to take this case to small claims court because the veterinarian did everything correctly, but …
Holiday Nutrition A Challenge For Pets, TooOctober 20, 2010 Winter months in general and the holidays in particular mean colder weather, more time indoors and increased access to large portions of decadent foods—for both people and their pets. Just a single season of increased caloric intake combined with a sedentary lifestyle can have significant effects on the health of a pet. But a little client education can go a long way. Craig Prior, BVSc, medical director and partner at Nashville’s Murphy Road Animal Hospital and partner at the Nashville and Rivergate Pet Emergency Clinics in Tennessee, says veterinarians can serve as valuable partners in reducing the ill effects the holidays can have on pet health. “In the winter, there’s definitely a holiday splurge going on,” he says. “Clients have the attitude that it’s OK because the pet will lose the weight in the summer. That’s a bad mindset to get into, and it’s up to us to try to break it. After all, it will get harder to lose that weight over time.” S. Dru Forrester, DVM, MS, Dipl. ACVIM, a scientific affairs representative for Hill’s Pet Nutrition in Topeka, Kan., agrees. “Unless there is an increase in exercise and play activities indoors …
Home Monitoring Key To Diabetic RegulationOctober 18, 2010Compliance also improves when client has stake in management Home blood glucose monitoring is the care standard for human diabetics. In humans, glucose is typically monitored four to six times per day. Exogenous insulin by injection is contraindicated without home monitoring. This is a safety issue, as glucose values in humans vary significantly day to day. This same daily variability has been documented in dogs and cats. Variables known to influence glucose in both species include stress, excitement, exercise, quality and quantity of diet, as well as amount of insulin absorbed from the subcutaneous tissue. Varying the injection site leads to different absorption. For this reason, the author does not advise rotation of the injection site. If local inflammation associated with repeat injections occurs, the injection site is changed to a new site rather than rotated between sites. Variability in glucose also occurs in the absence of an explainable cause. Inconsistent glucose values are a source of frustration for veterinarians and owners. Once daily glucose monitoring is instituted, the magnitude of the fluctuations becomes apparent. Simply stated, every day is not the same. In the absence of home monitoring, one is unlikely …
Help Provide Peace Of Mind For ClientsOctober 6, 2010 As practicing veterinarians, we are constantly faced with pet owners making that difficult decision between life and death, treatment or euthanasia. And, unfortunately, more often than not, the decision is financially based. In the process of discussing the nature of the needed care, we frequently offer the client “options” for treatment: radiographs vs. labwork; medication vs. surgery; IV fluids vs. SQ fluids. While discussing the cost of recommended care, we also need to offer the “options” for payment. Two of these options—pet insurance and third-party payment plans—were once thought to be competitive entities. Actually, they are quite synergistic. Here’s how: Synergy at Work In its business definition, synergy can be defined as a state in which two or more agents, entities, factors, processes, substances or systems work together in a particularly fruitful way that produces an effect greater than the sum of their individual effects. It’s also expressed as “The whole is greater than the sum of its parts.” The owner of an insured pet has the security and peace of mind of knowing that if her pet becomes ill she has the insurance to reimburse a portion of what she has paid out. The …
Animal Welfare Speaker Lays An EggOctober 5, 2010 In August we learned that well over 1,000 people had been sickened by salmonella because of tainted eggs. The subsequent media coverage jangled our profession’s nerves as the poultry industry reeled from accusations of lax oversight and poor sanitation, offering critics easy jugular access on hot-button issues like crowded housing, battery caging and industry ethics. The timing of the crisis, which prompted the largest egg recall in U.S. history, was propitious. I’d just attended an animal welfare symposium at the American Association of Avian Pathologist (AAAP) Conference, and let it suffice to say I was not impressed. “Animal Welfare: Reality, Perception and Thinking Outside the Box” was the symposium’s title. On the basis of this verbiage alone I was prepared to attend a morning-long series of lectures, disagreeable and contentious though many of the concepts and comments might be to a fledgling small-flock consultant like me. Yet it seemed obvious that an organization willing to undertake creative, “outside the box” thinking was interested in progressive approaches to the many welfare problems. Sign me up! Abandon the Bond? In anticipation, I dissected all the AVMA and AAAP position statements on poultry welfare. I devoured …
Do you own a spleen?October 1, 2010BY PHIL ZELTZMAN, DVM, DACVS, CERTIFIED FEAR FREE Dr. M. is a funny woman. When she interviews potential technicians, she knows not to ask illegal questions, such as marital status, ethnic origin and age. Yet without blinking an eye, she asks possible hires if they have a spleen. This was so intriguing to me that of course I had to investigate. Our colleague explained: "I read once in a human morbidity and mortality review that if you do not have your spleen and you are bitten by a dog, the bite has the potential to be fatal. There have been reports of deaths in spleen-less people because of the organ's role in our immunity. Since I've read this article, I thought I should make sure any potential technician does own a spleen." Indeed, an old JAVMA article* describes dysgonic fermenter-2 infections. Since then, the "fastidious, gram-negative, opportunistic" bacterium was renamed Capnocytophaga canimorsus. More recently, Scott Weese, DVM, DACVIM, has written about this topic in his excellent blog (wormsandgermsblog.com). His is an associate professor in the Department of Pathobiology at the University of Guelph, Ontario. Simply said, our internist has become an infectious disease specialist. Here how …
Aim High, Go Low On Weight-Loss PlanSeptember 23, 2010 Dr. Todd Towell has some simple advice for owners of fat cats and obese dogs: Don’t feed the oversized pet you see. Instead, portion out meals while visualizing the much-leaner animal deep inside. “Think of it like those Russian nesting dolls,” says Towell, DVM, MS, Dipl. ACVIM, the senior manager of scientific communications at Hill’s Pet Nutrition. “You want to feed that core pet in the center, not the one on the outside with the layers of fat.” When dealing with pet owners, T樂威壯 owell keeps her weight-loss message as basic and understandable as possible. But she acknowledges that for veterinarians seeking to craft a successful pound-dropping plan, things can get more complicated. Truth is, the first step—determining a pet’s optimal weight—can be a doozy. That’s because research is exposing the conventional scoring systems for assessing body condition as the bearers of unreliable results, Towell says. The commonly used five- and nine-point scales for assessing a dog or cat’s condition max out at 40 to 45 percent body fat. But these days it’s not uncommon for veterinarians to see patients with 60 to 70 percent body fat.Such animals quite …
A Case Study: Putting Shine On Titan’s Golden YearsSeptember 20, 2010Every day, the weight of Titan’s 12 years seemed to exact a new toll. And the German shepherd wasn’t the only one toting the burden of his decline. His owner, Rachael Carlson, felt for her beloved pet as he suffered through one infection after another and struggled with pain and inflammation in his aging joints. “His anal sacs were always infected and had bloody secretions,” Carlson says. “He was constantly on antibiotics, and we had to go see our veterinarian over and over. Plus, he was having a difficult time getting on the bed and couch, and he fell down a lot. “We were considering euthanasia.” That seems eons ago, Carlson says, though it’s been just 18 months since a reprieve first surfaced via a concerted and consistent approach to Titan’s treatment featuring Class IV laser therapy. Safe to say, his improvement has fed the quality-of-life meter for both dog and owner. “Our intent was simply to help Titan be more comfortable,” Carlson says. “We’ve gotten much more than that.” Here is a closer look at the role therapeutic laser played in improving the quality of an aging pet’s life. Patient Titan, an 81-pound, 12-year-old neutered male German …
