VPN Plus+ ExclusiveA look inside the open-hospital model of veterinary careAugust 5, 2022By Brennen McKenzie, MA, MSc, VMD, cVMAOne approach I have experienced and believe deserves greater study and broader adoption, is the open-hospital model.3For most of my career, I have worked in a hospital that encourages clients to be with their pet at any time while they are in our care, whether in the exam room for a routine checkup, hospitalized in the ICU, and even during dentistry, surgery, or other invasive procedures.
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VPN Plus+ ExclusiveManaging sepsisJune 10, 2022By Brennen McKenzie, MA, MSc, VMD, cVMAManaging sepsis is a great example of the challenge of practicing evidence-based medicine in an evidence-poor environment. Extrapolation from evidence in humans and reasoning from physiologic first principles are rational and necessary strategies, but, of course, they sometimes lead to practices that turn out to be ineffective or even counterproductive in veterinary patients.
VPN Plus+ ExclusiveWhen in doubt, cut it out! But by how much?April 13, 2022By Brennen McKenzie, MA, MSc, VMD, cVMARegardless of its mysterious provenance, the 3-cm margin for MCT excision has been widely adopted. Given the technical difficulty of this practice and the risk of post-surgical complications, it is likely many patients have suffered such complications or even been denied treatment for their disease due to the lack of an available veterinarian comfortable performing such an aggressive surgical excision. The adoption of standards without strong evidence has real-world consequences for our patients.
VPN Plus+ ExclusiveDo you have a conflict of interest?February 10, 2022By Brennen McKenzie, MA, MSc, VMD, cVMAA conflict of interest is simply one category of bias that can influence the outcome of scientific research. In ordinary use, the term “bias” has negative connotations as it mostly refers to various forms of prejudice or discrimination against groups of people. However, in the parlance of EBM, “bias” simply means any factor that systematically distorts the results of scientific research away from the truth.
VPN Plus+ ExclusiveWhat are general practitioners good for? A lot!December 15, 2021By Brennen McKenzie, MA, MSc, VMD, cVMAMaking a case for the many advantages of being a GP – for both vets and patients
VPN Plus+ ExclusiveDiagnostic tests: the good, the bad, and the uglyOctober 7, 2021By Brennen McKenzie, MA, MSc, VMD, cVMADiagnostic testing is not an oracle, which we consult blindly in the hope of replacing confusion with wisdom. It is a targeted process of collecting and evaluating specific information in the context of our existing understanding, and altering that understanding incrementally to better approximate reality and inform our actions.
VPN Plus+ ExclusiveFrom antioxidants to vitamins, many supplements lack official testingJuly 22, 2021By Brennen McKenzie, MA, MSc, VMD, cVMASkipping steps in the scientific process wastes time and resources, and it ultimately hurts patients. Those who may choose an insufficiently tested supplement over a proven therapy because they believe it to be safer or more effective based on low-quality evidence can be harmed by the supplement or by delaying truly effective treatment
VPN Plus+ ExclusiveCurrent lifespan patterns in dogsJune 3, 2021By Brennen McKenzie, MA, MSc, VMD, cVMAResearch efforts are ongoing, and rapidly expanding, to aid our understanding of how aging happens to develop preventative and therapeutic interventions to delay age-associated disease, disability, and death.
VPN Plus+ ExclusiveStem cell therapies – leaping before looking?March 31, 2021By Brennen McKenzie, MA, MSc, VMD, cVMAAs often happens, preliminary research in laboratory animals and in human medicine led to relatively rapid commercialization and clinical use of stem cell treatments in veterinary medicine well before robust clinical trial evidence in companion animals with natural disease had been developed. Fortunately, as better evidence has been slowly accumulated, it is looking more and more like we may have “guessed right” in this case: the risks to our patients are minimal (though not negligible) and there may well be meaningful benefits.
VPN Plus+ ExclusiveVeterinary medicine's shameful secret: Making it up as we go along?January 21, 2021By Brennen McKenzie, MA, MSc, VMD, cVMAMany experienced veterinarians would admit to themselves we often feel uncertain about our knowledge, training, and skill when performing infrequent requests we are rarely called on to perform and which we have minimal training or experience with.
