What’s Your Diagnosis? Identifying Pleural EffusionApril 17, 2009 Signalment:10-year-old female spayed Labrador retriever History: 24 hours of progressive respiratory distress Questions: 1. What are the primary findings? 2. What do you think is the primary reason for the clinical signs? Radiographic findings: Increased soft tissue opacity is noted and is causing the pleural fissures and margins of the lung to be identified. The heart and ventral diaphragm are silhouetted by this opacity. The pleural fissures that are seen are wider at the periphery than centrally. Follow-up radiographs taken after thoracocentesis which revealed a hemorrhagic fluid show an obvious mass effect in the right cranial ventral thorax adjacent to the right side of the heart. Radiographic interpretation: Pleural effusion. This is causing a silhouette sign with the intrathoracic structures and removal of the fluid reveals a large mass effect in the cranial thorax. Neoplasia is the primary rule-out in this situation. Discussion: Knowledge of the pertinent anatomy of the thoracic structures facilitates understanding the abnormal. …
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Managing Human Resources Within The Veterinary PracticeApril 17, 2009 Veterinarians who choose practice ownership or hospital management positions quickly find out they could use a crash course in human resources management. While veterinarians may be well-trained and well-versed in how to manage medical cases, most of them have little experience in managing people. Surveys of managers in various professions show that more and more time is spent resolving staff problems or concerns, often leaving little time for other management duties. Human resource (HR) issues within the veterinary practice are handled by the owner, hospital director or a practice/office manager. Regardless of who handles the HR issues, it is important to have set policies and an action plan for all areas of the practice. In short, every practice needs a policies and procedure manual that clearly outlines protocols. The manual should be reviewed by an attorney to ensure it is valid and not in violation of employees' rights. The practice owner, whether heavily involved with HR issues or not, should be directly involved in assembling the procedure manual. Practice management seminars both within and outside the veterinary profession can provide the nuts and bolts of how to plan a policy manual and what to include. In addition, …
Home Euthanasia A Valuable ServiceApril 17, 2009 Jonathan Leshanski, DVM, offers housecall euthanasia because he knows from personal experience the importance of the service to ailing animals and their emotionally distraught owners. "Before I became a veterinarian, I owned a cat named Hobbs who had terrible panic attacks that almost qualified as seizures anytime we took him out of the house," said Dr. Leshanski, owner of At Home Veterinary in New York City and former president of the American Assn. of Housecall Veterinarians. "I took him to the veterinarian when the time finally came to have him euthanized, and I felt miserable over the fact that the last 40 minutes of his life were spent in abject terror. "It was a terrible ending for a beloved pet, and I decided then that when I became a veterinarian, one of the things I would do was offer home visits-including euthanasia." Today, Leshanski performs a minimum of five home euthanasia procedures a week-much to the appreciation of his grieving clients. "My clients are incredibly grateful," Leshanski said. "Many have been with me since I got my license. Others are strangers who call me asking for help because their own veterinarians won't leave their …
To Protect And ServeApril 17, 2009 Follow Veterinary Practice News on Twitter at @vetpetnews. Travel Service Opportunities World Vets Home base: Deer Park, Wash. Selected upcoming trips: Loreto, Baja California, Mexico, May 31-June 7; Belize in Summer ’08; Ecuador from Nov. 3-12; Gambia in winter ’08-’09. Contact: info@worldvets.org, 509-276-8387 More info: www.worldvets.org Spay Panama Home base: Bethania, Panama, and Miami Selected upcoming trips: Unavailable Contact: doctor@spaypanama.org, 507-261.5542 More info: www.spaypanama.org Christian Veterinary Mission Home base: Seattle Selected upcoming trips: India from Aug. 6-15, Pakistan in November, Mongolia (ongoing). Contact: info@cvmusa.org, 206-546-7569 More info: www.cvmusa.org Animal Balance Home base: San Francisco Selected upcoming trips: Galapagos Islands in September, Samoa (tentative – date TBA) Contact: volunteer@animalbalance.org More info: www.animalbalance.net For Susan Paseman, the idea began in Cozumel, the Mexican island that boasts the kind of tourist-friendly resort experience Paseman used to find a lot more attractive than she …
Plan Now For RetirementApril 17, 2009 The new tax law has greatly expanded the opportunities for retirement savings. Every veterinary practice should have a business retirement plan by 2002. The right retirement plan costs nothing because it allows funds that would be lost to taxes to provide retirement benefits for long-term employees. But what plan is best for your practice? Each practice and practice owner is unique, and plans are so diverse that the wrong decision could waste thousands of dollars in needless fees or substandard investment results. Because this is a complex area, you should carefully review all available options. Don't be swayed by sales pitches, glossy brochures or professional association endorsements. Demand to see how different plans would work in your practice. You may consider retaining a qualified, independent benefits specialist to evaluate your alternatives. Re-evaluate your current plans to ensure they are still appropriate, considering the new opportunities. You should make these decisions now, as the new provisions take effect in January 2002, and a plan cannot begin to accept salary deferrals until it is officially adopted. Here are the major developments in the new law: 1. The individual contribution dollar limit has been increased …
How To Deal with Clients' GriefApril 17, 2009 Most people can't verbalize their feelings of relief when it follows the death of a family member, friend or pet. It is a struggle to care for a sick pet. Our clients need our emotional support when they tell us about their frustration, guilt, anxiety and hope. As professionals, we need to identify and deal with the symptoms of anticipatory grief. We must also understand why a family has anxiety or reluctance about treating a very sick pet. Here is a letter that opened the door to a much-needed discussion that might help you deal with concerned clients. Dr. Villalobos, My question is whether or not it's worth having our pet dog, Butch, on chemo just to give him a couple more months. My concern is that we may, as a family, have to experience more emotional ups and downs than if we didn't treat him at all and just let the disease take its course. As the spouse of a cancer patient who died in 1990 and as a hospice social worker, I know that one of the most difficult aspects of having a loved …
Organize Your References in 10 Easy StepsApril 17, 2009Look around your office. Do you see unread journals? Proceedings from the last meeting you attended? Cut-out articles you may need to refer to in the future? The last issue of Veterinary Practice News? Here are some tips to get organized once and for all. Organizing continuing education resources can be daunting. It seems that the flow of journals into your inbox never stops! You can purchase software that helps you track articles. The main disadvantage of using software is that you need to find time to type every article reference, title and author for the system to work. One typo and you may never find your article. In addition, you still need a filing system to organize your articles. And of course there’s the cost factor. I prefer a simple and cheap but efficient paper system that has proven extremely helpful and invariably reliable over the years. It was shared by a fellow board-certified surgeon, and it just doesn’t get any better or simpler! Let’s go over 10 simple steps to make your own version. 1. Create your personal list of topics The idea is to start a list of all the topics you are interested in. Since this …
Are Live-Terminal Laboratories Necessary?April 17, 2009 Follow Veterinary Practice News on Twitter at @vetpetnews. The use of animals for teaching in veterinary schools is becoming increasingly controversial. All 28 AVMA-accredited schools have different policies on how animals are used in their veterinary education programs. Some schools have moved away from the use of animals in their teaching programs while others have significantly reduced the numbers of animals used. Many more are looking for alternatives. Tufts University has discontinued the use of live-terminal animals in its teaching program. Western University, which opened its veterinary school last month, will not involve live-terminal animals in its education from the onset. Will these trends compromise the expertise a veterinary student needs to acquire before going into actual practice? Will societal pressures and animal rights activism force a uniform policy on all veterinary schools? The subject begs discussion and promises to pick up momentum in the years ahead. Veterinary Practice News and a panel of industry professionals opened that discussion at the American Veterinary Medical Association annual convention in Denver in July. Ronald Banks, DVM, Dipl. ACLAM, Dipl. ACVPM; Jan Ilkiw, BVSc, Ph.D.; Anthony Knight, BVSc, Dipl. ACVIM; and Lisa Parshley, …
Staff Matters: Dealing With Difficult ClientsApril 17, 2009 Follow Veterinary Practice News on Twitter at @vetpetnews. Difficult clients come in so many varieties, from clients anxious about a pet's impending surgery to those upset about their bill, that most practice managers agree it's nearly impossible to plan for every possible scenario. Because mishandling a disgruntled client can have serious repercussions for a practice, veterinary consultants stress the importance of responding quickly and appropriately to these challenges. Pay Attention Rule number one: "Listen, listen, listen!" advised Carin Smith, DVM, owner of the Washington-based consulting firm Smith Veterinary Services. "No one will listen to you until you listen to them." It may be counterintuitive to respond calmly to a client's rant, but doing so can defuse a volatile situation, Dr. Smith said. Mitigation is better than damage control, said Cecelia Soares, DVM, MS, a veterinarian and marriage and family therapist in Walnut Creek, Calif. "Just like vaccinations for distemper, there are verbal vaccinations for potential behavior problems," she said. "You can prevent a lot of common complaints by simply giving people information." That includes letting clients know when a doctor is running behind and keeping them informed of any changes …
Odor Eliminators Are Breath Of Fresh AirApril 17, 2009 Follow Veterinary Practice News on Twitter at @vetpetnews. A veterinary clinic can be an awfully smelly place. The cause of the unpleasantness ranges from “accidents” by incontinent or unhousebroken animals to odors from relieving anal sacs and male cat spray to your everyday kennel and laundry room stench. “A person working in an area contaminated with a malodor can become completely oblivious to it,” said Michael McGuire, president of Thornell Corp. of Smithville, Mo., which makes odor eliminators for veterinary clinics throughout the U.S. and Canada. “Yet the odor could be highly offensive to someone just entering the area.” Clients are especially sensitive. They worry about germs and infectious disease, and their trust may falter if floors, walls, countertops and cages aren’t kept sparkling clean and fresh-smelling. “Ideally, it is best to control the odor at its source before it becomes airborne,” McGuire says. “This process is easier when you can simply add an odor elimination product to your standard cleaning solution. However, it may become necessary to treat or freshen the air as well as eliminate the source. “Humans especially don’t like odors containing sulfur or nitrogen molecules.” …
