What does 503B compounding mean for the future of veterinary medicine?April 3, 2019Modern compounding—often referred to as 503A—is a niche business, providing patient-specific formulations to satisfy individual needs. Because commercially available drugs are marketed almost exclusively for humans, compounding has become an essential resource for veterinary medicine. Veterinarians often depend on 503A pharmacies to provide preparations at lower concentrations and in more palatable dosage forms to optimize treatment for their patients. However, without proper management and regulations, 503A compounding can potentially be detrimental. Presently, 503A pharmacies are not required to adhere to Current Good Manufacturing Practice (cGMP) objectives put forth by the U.S. Food and Drug Administration (FDA) to ensure pharmaceuticals achieve a specified standard of safety. The quality of products produced in a 503A facility depend on the pharmacy's voluntary conformance with cGMP, which can be substantially cost-prohibitive, requiring anywhere from $50,000 to $100,000-plus of investment for a single formulation. Testing on raw materials and finished products may be performed to an extent depending on the facility, but the data are often incomplete, testing only one or two factors while omitting others that would affect the product's overall quality. The variability of cGMP compliance from pharmacy to pharmacy paves the way for omissions in procedures that can lead to patient harm. …
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Five trends in pet medical insuranceApril 3, 2019The human-animal bond is evolving, and pet parents want their canine and feline family members to live longer, healthier lives. As human life expectancy and quality increase, we want our loyal companions with us well into their/our senior years, because, let's face it, those years come far too soon. Veterinary medicine, in parallel with human medicine, has advanced leaps and bounds over the years. As a result, veterinarians can now routinely detect and treat disease before clinical signs of illness ever appear. Pet parents are expecting and demanding their pets are treated as family. But more often than not, budgeting is problematic. With human-quality medicine comes the cost of care for advanced, though, routinely available diagnostics, such as digital X-rays, ultrasound, and blood chemistry analysis. Yet, six out of 10 Americans don't have $500 in savings for an unplanned expense.1 The widespread budgeting challenge became even more evident for federal workers (including veterinarians) with the government shutdown earlier this year. Many pet owners and veterinarians are quickly realizing quality medical insurance can help fill the financial gap so their pets can have access to the treatments recommended by their trusted family veterinarian. Yet, just as the human-animal bond is evolving, …
USDA no longer experimenting on cats and kittensApril 3, 2019The U.S. Department of Agriculture's (USDA's) Agricultural Research Service (ARS) says it will no longer carry out parasite experiments on cats and kittens, a practice that ultimately resulted in their being euthanized. The announcement comes weeks after U.S. congressmen Brian Mast and Jimmy Panetta introduced the Kittens in Traumatic Testing Ends Now Act of 2019. At the time, Mast said the USDA was breeding kittens for the sole purpose of feeding them raw meat laced with Toxoplasma gondii (T. gondii), a parasite considered to be a leading cause of death from foodborne illness in the U.S. ARS says cats were used in the research because they are the only host in which T. gondii can complete its life cycle and produce oocysts. The kittens were then killed even though they were healthy. In May 2018, the USDA reviewed its procedures after hearing feedback from its customers and stakeholders. ARS maintains cats have not been infected with toxoplasmosis pathogens or euthanized since September 2018. "Food safety research in ARS is of paramount importance for agriculture and the public we serve," said ARS administrator, Chavonda Jacobs-Young, PhD. "We are continually assessing our research and priorities and aligning our resources to the …
AVMA publishes guidelines for the depopulation of animalsApril 3, 2019 The American Veterinary Medical Association (AVMA) has released Guidelines for the Depopulation of Animals, a set of procedures and direction designed to help veterinarians make humane decisions in critical situations. "Humanely ending the lives of animals is one of the most difficult, but necessary, tasks for veterinarians to oversee," says chair of the AVMA panel on depopulation, Steven Leary, DVM, DACLAM. "During times of crisis or major catastrophe, depopulation of affected animals may sometimes be the most ethical and compassionate action." According to AVMA, depopulation balances the need to respond swiftly and avoid further devastation with the most humane method of death possible in response to pressing circumstances. The new guidelines are designed to ensure animal welfare is considered and achievable during an emergency, and provides procedures for the possibility of urgent situations. The depopulation guidelines are part three of AVMA's Humane Endings guidance. The others are the AVMA Guidelines for the Euthanasia of Animals and the AVMA Guidelines for the Humane Slaughter of Animals.
WellHaven Pet Health partners with Fear Free to train veterinary professionalsApril 2, 2019WellHaven Pet Health says it is partnering with Fear Free to provide training to its medical staff on emotional well-being, enrichment, and reducing fear, anxiety, and stress in pets. "Adopting Fear Free across our practices will result in better medicine, better business, increased safety, and improved practice culture," says WellHaven Pet Health chief medical officer, Bob Lester, DVM. The partnership will allow WellHaven Pet Health to achieve American Animal Hospital Association (AAHA) certification in all its clinics. "Their commitment to the emotional and physical well-being of pets demonstrates WellHaven Pet Health's leadership in the field of veterinary medicine," says Marty Becker, DVM, Fear Free CEO and founder and columnist for Veterinary Practice News. "Fear Free is proud to partner with them in creating better experiences for pets, people, and the profession."
AVMA health insurance in limbo following court rulingApril 2, 2019The American Veterinary Medical Association (AVMA) is not backing away on its promise to deliver health insurance plans to its members following a ruling by a federal district court judge. Last week, the judge sent a recent rule allowing association health plans back to the Department of Labor to revisit certain aspects of it the court found objectionable. "We are disappointed, obviously, but we knew this was a possibility, and we know this isn't the final word," says AVMA president, John de Jong, DVM. "Veterinarians across the country were very pleased the AVMA was poised to again sponsor health plans, and we're not giving up on that effort. We are evaluating all our options, and we will continue to advocate for the interests of veterinarians, including access to high-quality, affordable health plans through our association." Association-sponsored health insurance plans were part of membership in AVMA for 60 years until the Affordable Care Act (ACA) forced it to end in 2013. While aware of the potential legal challenges, AVMA decided to move forward in its efforts to once again offer its members a health insurance program beginning in several states in July.
FDA approves treatment for urinary incontinence in dogsApril 2, 2019PROIN ER, a tablet for the control of urinary incontinence in dogs, has been approved by the U.S. Food and Drug Administration (FDA). The drug treats urethral sphincter hypotonus, which occurs due to a dog's age and weakening muscles in the urethra. PROIN Chewable Tablets have already been approved by the FDA; however, they are to be administered twice a day, whereas PROIN ER is a once-a-day extended-release formulation. The effectiveness of PROIN ER was observed in a clinical study comprising 119 dogs that had been previously diagnosed with urethral sphincter hypotonus and had been taking PROIN Chewable Tablets. The timeline of the clinical study went as follows: • For the first week, the owners documented whether the dog received the PROIN Chewable Tablet doses and noted the number of urinary accidents the dog had; • Dogs were then given PROIN ER for the first 28 days and the owners proceeded to take note of how many accidents occurred in a day; • In the fourth week, the number of urinary accidents was compared to the first week. It was found 75 of the 104 dogs who completed the study had no accidents on either tablet;
AHS releases new heartworm recommendationsApril 2, 2019The American Heartworm Society (AHS) has released its 2018 Canine Heartworm Guidelines. The guidelines recommend yearly screenings for dogs more than seven months of age, the use of heartworm preventive medications, and reduced exposure to mosquitoes. It also suggests veterinarians recommend the use of Environmental Protection Agency- (EPA-) approved mosquito repellents for heat-treating a pet patient's serum. It is especially important for pet owners in Texas to follow the guidelines as mosquitoes are extremely widespread, according to the Texas Veterinary Medical Association (TVMA). The most telltale signs a dog has been infected is a persistent cough, difficulty breathing, intolerance to exercise, decreased appetite, and weight loss, while cats will suffer from lethargy, vomiting, or asthma. It is very common for the first indication of heartworm to be a sudden collapse or death. Preventing the disease in dogs is easy, safe, and affordable, whereas treatment is not. There is currently no treatment for cats. Testing and treating for heartworm can be difficult, which is why prevention is key to protecting pets. See the website to view the updated guidelines.
Vital pulp therapy in dogs and catsMarch 29, 2019Last month, we discussed the rationale behind and approach to conventional (orthograde) endodontic therapy. Orthograde root canal therapy removes the entire contents of the pulp chamber in the root canal system. Vital pulp therapy is a different kind of endodontic procedure, performed instead on teeth that have had recent pulp exposure. Determining whether it's best to perform vital pulp therapy or orthograde root canal therapy for an individual tooth is a judgment call. Most dentists gravitate toward orthograde root canal therapy whenever possible, since it involves removing the entire contents of the pulp and minimizes the likelihood of possible future pain and infection by not leaving to chance whether remaining pulp maintains its vitality. However, orthograde root canal therapy may not be an option for young teeth, as they lack a closed apex. In the past, it was a rule of thumb that vital pulp therapy be performed within 48 hours of pulp exposure in dogs older than 18 months of age and within two weeks in dogs younger than 18 months of age. However, the sooner vital pulp therapy is performed after pulp exposure, the better the chance of success. Therefore, even when a patient is younger than 18 …
How nurses can grow your revenueMarch 29, 2019What is the difference between an under- and top-performing health-care team? Let's say you schedule appointments every 30 minutes. In an eight-hour workday, one doctor sees 14 patients and has an average transaction of $160, generating $2,240 in revenue. Your average doctor transaction should be 3.2 to 3.5 times your exam fee, according to the Well-Managed Practice Benchmarks Study.1 If you leverage your nursing team and schedule time based on the reason for the visit, you could see 21 patients per day, producing $3,360 per veterinarian and averaging three patients per hour. Revenue rises when you add dental income that nurses deliver. How can nurses help you grow revenue? Follow these steps: Check your staff-to-doctor ratio Every employee feels the hospital is short-staffed. Chances are you may have the right number of employees, but are using them inefficiently. Aim for a staff-to-doctor ratio of 4.7 team members per full-time veterinarian, according to WTA Consultants in Columbus, Ohio.2 This support staff includes two nurses, one veterinary assistant, one receptionist, and 0.7 managers. Assign doctor-nurse teams Designate daily which staff will be outpatient nurses (exams) and inpatient nurses (treatment area). Assign two nurses or assistants to each veterinarian. This medical team …
