VPN Plus+ ExclusiveAntimicrobial stewardship: What it is and why it mattersAugust 4, 2020By Brennen McKenzie, MA, MSc, VMD, cVMAAntimicrobials have tremendous therapeutic benefits in human and veterinary patients. After vaccination, antibiotics are probably the most important medical intervention of the 20th century in terms of reducing suffering and death. Of course, antimicrobials can also have significant adverse effects. And any use of antimicrobials, including appropriate therapeutic use, creates a selection pressure that can result in emergence of antimicrobial resistance (AMR) or an increase in the abundance of resistant bacteria. Adverse effects and the development of resistance reduce the potential benefits of antibiotics. Antimicrobial stewardship is the concept of using antibiotics in a manner that maximizes their benefits, minimizes risks, and conserves the effectiveness of these important drugs.1 Changing when and how we use antibiotics is the key to achieving these goals. Antimicrobial stewardship involves three general strategies: 1) Preventing infectious disease occurrence 2) Reducing overall antimicrobial use 3) Using antimicrobials in ways that maximize the benefits, minimize the adverse effects, and reduce the development of antibiotic resistance Preventing infections Preventing bacterial infections automatically reduces the need for, and hence the use of, antimicrobials. This involves encouraging clients to provide appropriate husbandry and preventive care, including vaccination, proper nutrition, isolation of sick animals, and other prophylactic measures. Prevention of …
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VPN Plus+ ExclusiveBright ideas in veterinary ophthalmologyJuly 23, 2020The field of veterinary ophthalmology is always evolving, uncovering new theories, diagnostics, treatments, and surgeries. The Vision for Animals Foundation (VAF) is funding various ophthalmology studies, including one led by University of Missouri Veterinary Health Center resident Kayla Banks, DVM, that is comparing cleaning and sterilization protocols for diamond burr tips used in diamond burr debridement for canine superficial chronic corneal epithelial defects. Another study, led by Maggie Jinks, DVM, a resident at the Ohio State University Veterinary Medical Center, is looking at the role of extrinsic forces on lens cell mitosis. Lionel Sebbag, DVM, DACVO, assistant professor of veterinary clinical sciences at the Iowa State University College of Veterinary Medicine, says there are continued efforts in the veterinary ophthalmology community to find new diagnostic tools and therapies to improve patient comfort and vision. "For instance, there are task forces working on glaucoma and sudden acquired retinal degeneration syndrome (SARDS), two devastating diseases resulting in vision loss," he says. "Further, the recent advances in genetics are exciting, and it is only a matter of time before they fully benefit veterinary patients. "A better understanding of genetics will help reduce the prevalence of serious inherited ocular diseases, such as progressive retinal …
VPN Plus+ ExclusiveImproving the outlook for brain tumor patientsJuly 21, 2020The path to discover and perfect new cancer treatments is long and expensive. It can take more than a decade and cost over $2 billion to demonstrate the safety and efficacy of a new therapeutic before it reaches the marketplace. To expedite the process, researchers are thinking outside the box—or rather, outside their own species. The concept of comparative medicine (i.e. One Medicine) has great potential to accelerate the development of new cancer treatments. By examining the similarities and differences in biology among different species (e.g. dogs and humans), we gain increased understanding of the mechanisms of disease in each. This comparative medicine model, as demonstrated in the field of neuro-oncology by the Comparative Brain Tumor Consortium (CBTC), has already shown promising results. Launched by the Comparative Oncology Program (COP) of the National Cancer Institute (NCI) in 2015, CBTC comprises veterinarians, physicians, and basic researchers who have joined forces to improve outcomes for dogs and humans affected by brain cancer by using more predictive and accurate preclinical models. Laboratory animal models don't always adequately mimic the complex genetic, biologic, and environmental conditions of the human experience. Dogs get many of the same spontaneous cancers as humans, and their genome is …
VPN Plus+ ExclusiveWhy offering a 401(k) plan is a good ideaJuly 16, 2020As a veterinary practice owner, taking care of your employees is paramount to hiring and keeping wonderful staff around. By offering great benefits, you are showing they matter to you both in and out of the office. One extremely valuable benefit to offer is a 401(k), which allows your employees to put away money for retirement. In the past, practice owners may have felt a 401(k) was too costly or complex for small veterinary clinics to provide, but that's no longer the case. With the modern 401(k), you don't need to worry about having extensive investment knowledge, or even a lot of time to manage the plan. You'll get access to features that can make it both easier and less expensive for both you and your employees. How a modern 401(k) can help your practice According to a recent survey by Capital One, 94 percent of small business owners who offer a 401(k) plan say it helps with their recruitment and retention of employees. By providing this benefit, you show you value their contribution and want to help them invest in their future. Setting up a 401(k) can sound daunting, but it doesn't have to be. Here's what you can …
VPN Plus+ ExclusiveWhat is website accessibility and could you be at risk for a lawsuit?July 14, 2020Most business owners are familiar with the Americans with Disabilities Act (ADA) and the requirements this law imposes on them to make their facilities accessible to those with disabilities. For businesses that are "places of public accommodation" (e.g. veterinary practices), access includes providing on-site features including wheelchair ramps, handicap accessible bathrooms, and parking spots. In the past few years, there has been increasing debate around whether a company's website is an extension of a place of business and must be accessible just like its physical counterpart. The ADA does not speak directly to this question and the Department of Justice (DOJ), which is responsible for interpreting the act, has not weighed in on the matter. This ambiguity in the law has led to a wave of litigation, suggesting businesses with "inaccessible websites" are violating the ADA and are subject to penalties. While it is difficult to identify out-of-court settlements, according to the ADA, the maximum civil penalty for a first violation under title III ranges from $55,000 to $75,000. For a subsequent violation, the new maximum is $150,000. In 2019, there were thousands of lawsuits filed against businesses and tens of thousands of legal demand letters. In the fall of …
VPN Plus+ ExclusiveThe pee line: How to plan for and respond to leg lifters in your practiceJuly 9, 2020As industry professionals, you do everything you can to keep your clinic sparkling clean. However, there is one particular situation that poses a unique challenge... dealing with those notorious little leg lifters! Everybody knows accidents happen, but whether the patient is large or small, urine of any kind is still extremely damaging to certain materials, interacting negatively with your floors, walls, and other areas. This article provides tips, tricks, and methods on how you can protect your clinic against the damages of pet urine... because let's face it, when you've got to go, you've got to go! A smelly situation Dog urine poses a significant threat to surfaces due to its chemical makeup. While all urine is primarily water (with inorganic salts and nitrogen-rich by-products, such as uric acid and creatine), dog urine is highly concentrated, and therefore, much more destructive. (Did you know dog urine can even etch stone?). To make things worse, pee can soak through wall and floor materials, and get trapped out of reach of your cleaning efforts. Through absorption, it penetrates the core of porous surfaces, and that is where the real problem begins. As urine breaks down and dries, it becomes more challenging to …
VPN Plus+ ExclusiveIs it time to upgrade your payment system?July 7, 2020Many veterinarians are content using outdated payment systems in their practices, rather than dive into the unknown of adopting a new platform. However, using older technology (i.e. legacy systems) can negatively impact your bottom line, putting your practice or hospital at a competitive disadvantage and preventing you from optimizing efficiencies and/or growing your business. Not only that, but given the current situation with COVID, ensuring your system encourages contactless payment is critical to maintaining a safe workplace environment. Legacy systems can be costly to your practice, as hardware or software requires regular maintenance. Most IT experts will tell you that providing adequate support for outdated platforms is expensive, and in some cases, impossible. There also is the issue of security. When systems enter legacy territory, companies stop supporting and updating them. This can put your veterinary practice at higher risk for costly and disastrous data breaches. Despite these concerns, there is still reluctance among veterinary practices to update their payment systems. How do you know when it is time to turn in your old equipment? How do you select the right system for your practice? If your clinic is experiencing any of the following issues, it may be time to …
VPN Plus+ ExclusiveWhy creating a good flap mattersJuly 2, 2020A flap is tissue that is raised from its bed and left attached on at least one side. The base through which the attachment and circulation is maintained is called the pedicle. In oral surgical procedures, flaps allow exposure of the underlying alveolus and root surface, while preserving attached gingiva to facilitate suturing in a fashion that reduces or eliminates the periodontal pocket and promotes reattachment to the root surface in cases of mucogingival surgery. Extracting teeth due to advanced periodontal disease is undoubtedly the most common surgical procedure performed in companion animal practice. As such, a solid understanding of flaps is warranted. Classifying flaps Partial- or split-thickness (mucosal) flaps leave the periosteum at the donor site, avoid larger blood vessels, and allow suture placement in the periosteum. Partial-thickness flaps are indicated where there are thin bony plates; in areas of dehiscence or fenestration where bone must be protected; and in areas where bone loss is permanent. Full-thickness flaps gain visibility and access for osseous surgery, root planing, and pocket elimination. A full-thickness flap, which includes the periosteum, can be elevated by blunt dissection using a periosteal elevator in a rocking motion until the periosteum is peeled away from …
VPN Plus+ ExclusivePhoto op: How thermal imaging is helping keep pets healthyJune 30, 2020Thermal imaging devices are in use for many applications where quick identification of temperature change is helpful. Thermography is used in industry, outer space, the military, by your local HVAC guy, and for medical screening. Currently, thermal imaging is in the news because of temperature-screening devices used in airports. As businesses, social venues, and event and travel spaces develop safer protocols for gathering people, temperature screening has become widespread. Temperature screening thermography uses a variety of devices ranging from low-end handheld scanners up to medical-grade devices with the same detailed specifications required for evaluation of human and veterinary patients. High-end temperature screening systems use facial recognition software to calculate body temperature from the medial canthus of the eye, which is the most accurate superficial point for evaluating core body temperature.1 These systems measure temperatures from six feet away, allowing for safe, contactless use. Further, they "flag" elevated temperature; the person then undergoes a secondary screening protocol. Medical thermography is more than 70 years old. Early devices were expensive, cumbersome, and not practical for widespread clinical application. In 1980, reports began validating thermal imaging as a tool for the evaluation of musculoskeletal conditions in horses.2,3 By 2001, multiple publications had established …
VPN Plus+ ExclusiveIs immunotherapy the key to wiping out canine cancer?June 24, 2020An intact and functional immune system is essential to protect an organism against invading pathogens and infectious disease. However, the immune system also plays a pivotal role in identifying and eliminating transformed cells that, if left unchecked, would progress to cancer. Clinical evidence of the immune system's ability to control cancer comes from a number of observations in both the veterinary and medical settings. Consider the following examples: Cats receiving chronic immunosuppression following renal transplant have a higher incidence of lymphoma compared with the general feline population1,2 Spontaneous regression of transmissible venereal tumor is associated with an increased proportion of tumor-infiltrating cytotoxic CD8+ T cells3 Canine osteosarcoma patients that develop bacterial infections after limb-sparing surgery experience significantly prolonged survival times.4 The presence of tumor-specific, cytotoxic T cells within tumors, such as ovarian carcinoma, confers a favorable prognosis,5 whereas infiltration with regulatory or suppressor T cells confers a worse prognosis6 These observations, coupled with two decades of experimentation in murine cancer models, indicate that finding ways to initiate, augment, and broaden a patient's antitumor immune response holds promise for the treatment and possible prevention of cancer. Indeed, this is the aim of cancer immunotherapy, and recent advances in this field have …
