Complex Partial Seizures Or Compulsive Behavior?November 21, 2012 Complex partial seizures are well recognized in human medicine and, according to some authorities, are more prevalent than tonic-clonic seizures. However, these focal electrical events are not widely acknowledged in veterinary medicine. It was a different story in the 1960s, when numerous automatonish behaviors were classified as partial seizures. A trip down memory lane to the Kirk’s Current Veterinary Therapy of 1960 or so is all it takes to be reminded of this fact. One of the reasons for the abandonment of the partial seizure diagnosis was the realization that many repetitive behaviors were not so much of seizure origin but actually were (obsessive) compulsive disorders—a completely different barrel of fish. But the realization that some behaviors could be compulsive doesn’t necessarily mean that partial seizures never occur. Odds are they should. Another reason for the unpopularity of diagnosing these conditions is that they often produce subtle—though frequently highly unusual—clinical signs. Simple partial seizures in people, which often precede complex partial seizures, may involve only altered perception, such as déjà vu or jamais vu. Both are tough to detect in a dog! But complex partial seizures, once developed, produce obvious clinical signs. The locus …
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Questioning Canine Cruciate Ligament SurgeryNovember 16, 2012 Imagine you twisted your knee and your doctor diagnosed an injured anterior cruciate ligament. What if she offered you only surgery or euthanasia (hypothetically legalized for humans)? Would you explore alternatives or accept this false dilemma? Would it change your mind if you discovered that more enlightened surgeons are exhorting their colleagues to stop cutting cruciates at least until patients have undergone a month or more of conservative care? In the same vein, why do some veterinary surgeons limit options for dogs, forcing clients to choose between breaking their hearts and breaking their banks? Yes, canine and human stifles differ, but the chronicity and persistence of canine cruciate disease argues in favor of a long-term, rehabilitative and integrative approach, not for bone saws. Moreover, far from being a slam-dunk diagnosis and treatment, confusion lingers. Unknowns persist about whether a lameness is indeed due to cruciate injury and if so, what caused it. Furthermore, “The ideal treatment modality for cranial cruciate ligament (CrCL) injury has yet to be determined...”1 Consumers want options.2-6 Many in our profession insist that only surgery or euthanasia allows dogs to avoid a life …
6 Tips For Keeping Patients Safe Under AnesthesiaOctober 22, 2012Refining anesthesia protocols has been at the top of practitioners’ to-do lists since the American Animal Hospital Association released its anesthesia guidelines for dogs and cats. Patient safety is a primary goal in all anesthetic procedures, so to minimize risks, consider these tips for creating a successful outcome for patients undergoing anesthesia. 1. Pay particular attention to the induction and recovery phases, as these are the most critical, says the University of Georgia’s Jane Quandt, DVM, Dipl. ACVA, Dipl. ACVECC, of Athens, Ga. “Induction [is critical because] we are taking animals to the point of unconsciousness,” said Dr. Quandt. “And in recovery they regain consciousness and must cope with the demands of tissue trauma and going back to room air if they were on inhalant anesthesia.” She also notes that the recovery phase may be the most overlooked by general practitioners. “Recovery may be overlooked a bit because once [patients] are conscious we tend to move on to the next patient.” Daniel K. Edge, DVM, MBA, veterinary liaison manager for Abbott Animal Health in Abbott Park, Ill., agrees, and notes the findings of a 2006 study. “According to the Confidential Enquiry into Perioperative Small Animal Fatalities, 64 percent of …
A Call For Calorie Counts On Pet Food LabelsOctober 15, 2012If your exam room observations are anything like mine you’ll have noticed the girth of your patients gradually expand over the past couple of decades. It didn’t happen overnight, and yet it sometimes seems there must be something new in the water for our pets to have plumped up so impressively. So what have we done to address it? Fight fires, mostly. Though we may put our scales, tape measures and body conditioning score know-how to work, getting pet owners to smell the coffee is a losing proposition more often than not. Our overstuffed culture has a way of besting us at every turn. In fact, if we’re honest with ourselves, we’ll cop to the notion that NSAIDs and insulin are our tools of choice for combating the problem of excess poundage in our patient populations. So even when we do manage to eke out some wins, it’s painfully evident we’re still the big losers in this war. Hence, why so many of us have stopped trying to run in place on the back end of this issue. Prevention, we now claim, holds the key to weight management. Because once they’ve gone glutton, tanked up and porked out, the odds …
Probiotics For Pets Support Total WellnessOctober 9, 2012 It was a sunny Tuesday afternoon, and Sean Cater had a feeling something was wrong. A 48-ounce package of chicken lay on his kitchen floor, empty. Bits of wrapping trapped in the yellow Styrofoam fray littered the tile, then the carpet, leading Cater to the inevitable culprit: his 4-year-old greyhound, Shark Face. Shark’s belly was slightly larger than usual, the pinkish gray skin pulled just slightly tighter to her body. Cater’s gut had told him something was amiss, and now he had proof. Gut feelings do matter. Shark-Face’s tummy rumbled as the day continued. Even more than that, Cater was thinking about things many pet owners do not: Shark’s brain, joints, heart and general attitude. Cater is a graphic designer for Vetri-Science Laboratories of Vermont. He takes it upon himself to regularly ask questions about pet health, and knows something many pet owners do not: Digestion is a connective activity. We habitually associate intuition with our guts, so much so that bad news becomes hard to swallow, we get lumps in our throats, and we come to know emotions through our stomachs, from the deepest pits to the flightiest butterflies. Finding a Connection The …
Prebiotics, Probiotics And Intestinal HealthSeptember 27, 2012 While prebiotics and probiotics are often confused or thought of as one and the same, their commonalities end with their stint in the intestine. Prebiotics are fiber that feeds the beneficial microorganisms residing in the intestine. Probiotics are live microorganisms that when ingested, can enhance intestinal microbial balance. Prebiotics have been used in pet foods for decades, probably without pet owners even knowing it. But probiotics’ delicate handling needs means they’re sold in sachets and capsules. They are in something of a state of hibernation, according to Grace Long, DVM, MS, MBA, director of veterinary technical marketing for Nestlé Purina PetCare in St. Louis. The microorganisms become active when they enter the intestine. “Probiotics are heat and moisture sensitive, so it would be very difficult to incorporate them directly into the kibble,” Dr. Long says. “The most effective way of keeping probiotics alive in the packaging process is in a cool, dry environment away from air exposure. Not all probiotics sold in the veterinary market have evidence to support their claims, so veterinarians should make sure that the levels of microorganisms are guaranteed and that the manufacturer can provide support of efficacy.” Evidence …
Can Dogs Suffer From Post Traumatic Stress Disorder?September 24, 2012 Post traumatic stress disorder, or PTSD, is not a fully recognized veterinary behavioral phenomenon but some believe it exists and is probably more common than we think. I have taught veterinary students about PTSD for many years, my initiation into this ongoing phobia being a particular case I saw many years ago. The dog in question was shot by a Boston police officer who thought the dog was going to attack him while he was pursuing a suspect. In fact, the dog was only charging along behind him, energized by the excitement and commotion. The .38-caliber bullet entered through the dog’s head, just missing vital structures and traveled along the dog’s neck, finally coming to rest in the chest wall. The dog sank to the ground in a pool of blood and his distraught owner was quickly on the scene trying to revive him. As it turns out, the dog was not dead but close to it and heading down a path of no return, but his owner quickly scooped him up and brought him to nearby Angell Memorial Animal Hospital where the ICU staff worked wonders, plugged the leak (so to speak) and brought …
Nerve Blocks Take The Bite Out Of Small Animal Oral SurgerySeptember 21, 2012 Aside from an uncomplicated professional cleaning, nearly every dental procedure may result in intraoperative or postoperative discomfort. The most effective approach to pain relief is pre-emptive analgesia. This prevents the windup phenomenon, a perceived increase in pain intensity due to repeated stimulus of nerve fibers. Local anesthetics work by blocking sodium channels in neuron cell membranes, preventing development of an action potential. In addition to the benefit of preventing windup pain, nerve blocks decrease the amount of inhalant anesthetic gas needed, potentially improving intraoperative blood pressures and allowing for easier maintenance of necessary anesthetic plane. Depending on the type of local anesthetic used, nerve blocks may provide up to 10 hours of postoperative analgesia. Although they are often called local anesthetics, we use them more commonly in oral surgery to provide regional anesthesia of specific nerves to block an entire region of the body (e.g. the right maxilla). Materials Needed Some veterinary dentists prefer to use a dental aspirating syringe—like what human dentists use—that allows for aspiration and injection with one hand, theoretically causing less movement of the needle tip when aspirating. At the University of Pennsylvania, our doctors use standard 3cc or …
Julia Avery, DVM: Overcoming Challenges AbroadSeptember 21, 2012 Various challenges can arise when working abroad, such as getting used to a new culture and/or adapting to a new schedule. For Julia Avery, DVM, her biggest challenge in Baghdad, Iraq, is making the most of the limited veterinary medical supplies. “The lack of supplies and equipment is the worst challenge,” says Dr. Avery, who has been working for the American K-9 Detection Services (AMK9) since September 2011. The Lake Mary, Fla.-based company offers contract working dog detection services to a variety of clients, including government agencies. Avery, who through the company is part of the U.S. Baghdad Embassy Security Force, works as a civilian veterinarian taking care of the roughly 200 contract working dogs. The dogs protect the U.S. Embassy and U.S. Consulates by detecting explosives at entry check points and other areas and sweeping venues or routes that may be utilized by the ambassador or other VIPs, among other duties. Overcoming Limits To help overcome some of the medical supply limitations, Avery has networked with many of the human providers to acquire most of the needed medications and dry goods. Still, there are other challenges to contend with, such as poor mail service—Avery …
Multimodal Approach To OsteoarthritisSeptember 4, 2012 Osteoarthritis (OA) has long been recognized as an important source of chronic pain in people, with over 70 percent age 65 or older showing radiographic evidence of it. OA has emerged as the leading cause of chronic pain in pets. About 20 percent of dogs, independent of age, suffer the effects of osteoarthritis. Recent data suggests that 100 percent of cats 10 or older exhibit radiographic signs consistent with osteoarthritis. The veterinary profession does not face any other cause of morbidity as widespread as this. Because the incidence is so high, veterinary health care teams are obligated to expand our understanding of how best to manage patients suffering from OA. One of the most important developments in chronic pain management has been the recognition of the complex nature of the nervous system’s processing of pain. Pain involves many receptors and neurotransmitters and many different mechanisms and actions. The malleability, or plasticity, of the nervous system in the face of pain provides the opportunity for both central and peripheral sensitization, the result of which is often debilitating and difficult-to-reat pain. In animal patients who suffer from chronic OA pain, traditional monotherapy—the use of a single agent …
