Getting Started With Chinese HerbsJune 3, 2010 Some veterinarians are worried about the safety and possible toxicity of Chinese herbs,1 but this is not a concern when you buy from the companies commonly used by veterinary herbalists. Companies in China that do not have an American counterpart may add adulterants or toxic substances.2 Which companies have quality-control procedures and follow U.S. good manufacturing practices? Examples include Golden Flowers, Health Concerns, Jin Tang Herbals, K’an Herbals, May Way, Natural Path and World Herbs (Darcy Naturals).3 All these companies examine raw herbs to ensure the right species, avoid the use of toxic species and submit both the raw ingredients and the final product to laboratory tests. In addition, one company uses organic herbs. At least three of the companies import raw herbs from China and process them in the U.S. The companies belong to quality assurance groups such as the National Animal Supplement Council4 and the Chinese Herbal Medicine Coalition5, which work with the Food and Drug Administration to establish certification standards for safe and effective use of their products. All have experienced herbalists as founders or staff members. All give or sponsor continuing education, enabling practitioners to better understand …
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In-House Analyzers Can Be Good FitJune 3, 2010 Is it time to bring the laboratory in-house? Given today’s flattened economic climate and veterinary practitioners’ shrinking caseload, a full lab suite in the office could serve new and existing clients, deliver a higher level of patient care—and allow clinics to tap into the revenue stream flowing to commercial laboratories. Calculating a Return on Investment With a quick keyword search, the Internet delivers dozens of return-on-investment, or ROI, calculators to help determine whether a capital purchase can be financially justified, say industry experts. The majority of the calculators asked for these key figures: Original investment, or initial cost of the item The interest rate (if any) The term of the loan (if any) Number of procedures done How much will be charged for each procedure If the cost of the equipment exceeds the estimated income, clinics may consider sticking with commercial laboratories or adjusting how much they charge for blood work or chemistry panels.
World Vets: Inside JobMay 11, 2010 Colorful drawings of whales and other sea creatures decorate a room that in less than a morning is transformed from a primary-school science lab into one of the most efficient veterinary clinics in all of Honduras. I’m here to help, but that’s me near the deep-blue block wall, feeling like a complete fish out of water. As a volunteer, the only thing I can claim in common with the clinic’s cadre of professionals, including five experienced U.S. veterinarians, is the official World Vets scrub shirt I received in the mail. Hey, at least when I first put it on I looked like I belonged. That illusion shatters quickly when, after patient training, veterinary technician Laurie Doton asks me to fill a syringe with a pre-surgery sedative. What I hear is, “Please cut yourself and bleed all over the cement floor, causing curious children and their parents to look at each other in horror as they wonder just exactly what they’ve gotten their pets into.” OK, so it isn’t that bad. Most of the horror is my own as I scramble to stop the flow of embarrassment, finally employing my no-longer-blue shirt to keep my A-positive …
Ultrasound Sees Ultrarapid GrowthMay 4, 2010 Once a specialty diagnostic with limited use in the veterinary field, ultrasound has evolved into a widely accepted—and expected—standard of care. John Feleciano, DVM, Dipl. ACVR, VDIC manager of radiology with Idexx Laboratories in Clackamas, Ore., says ultrasound no longer is an optional service. Case Study Eric Lindquist, DMV, Dipl. ABVP, the founder and CEO of SonoPath.com, participated in a study of intraoperative ultrasound for precise biopsy and resection of transabdominally detected intestinal lesions in three cats. He explains the ultrasound of the patient, a 14-year-old FS DSH that presented for vomiting and weight loss. No abnormalities were seen on bloodwork or urinalysis. The intraoperative ultrasound was performed in order to identify the intestinal wall lesion seen during the transabdominal sonogram. The intestinal lesion could not be seen by the surgeon on exploratory laparotomy given that the intestinal serosa was not involved in the pathological process, but the intestinal wall was focally infiltrated with lymphoma. Moreover, the extent of the lesion could not be seen either unless it was defined by the ultrasound image. Ultrasound allowed for adequate resection of the lesion since the clinical sonographer …
Therapeutic DietsMay 4, 2010 Explaining to pet owners the difference between a therapeutic diet and one found on a store shelf can help boost sales and improve compliance, experts say. The average client may not realize that diets found in pet and grocery stores lack the benefits offered by therapeutic diets sold only in veterinary offices. Industry nutritionists say veterinarians need to convey that therapeutic foods are comprised of ingredients developed and tested by researchers producing the diet. While many pet food companies producing maintenance diets perform clinical tests for palatability, digestibility and nutritional value, therapeutic diets are tested using cell cultures and evaluating individual ingredients in animals with spontaneous disease. “Therapeutic diets are formulated for use with specific conditions, therefore the formulations are more defined and quality control is typically higher than over-the-counter foods,” says Joseph W. Bartges, DVM, Ph.D., Dipl. ACVIM, Dipl. ACVN. “For example, diets designed for kidney failure or diabetes mellitus use specific ingredients and have a nutritional profile that is based on the condition and are designed to help in managing a patient with that specific condition.” Do therapeutic diets extend the life of an animal? Conclusive evidence is lacking, but Dr. Bartges, a …
Testing, Treating Feline HyperthyroidismApril 8, 2010 Hyperthyroidism is the most common endocrinopathy of older cats. The disease usually results from adenomatous hyperplasia or adenoma of the thyroid gland; carcinomas are relatively rare. In 70 percent of cases the thyroid gland changes are bilateral. Many clinical signs can be seen, with weight loss being present in about 90 percent of cases and polyphagia in about 50 percent of cases.1 Hyperactivity, polyuria/polydipsia, tachycardia, arterial hypertension, vomiting, diarrhea, panting, generalized weakness and a variety of other signs can be seen. In rare instances, apathetic hyperthyroidism can occur with weakness, inappetance and marked lethargy. Diagnosis in most cases is straightforward in that most cats will have an elevated total T4 values. In some instances, especially with other underlying disease or in older cats, total T4 may still be in the normal reference range. In this situation, additional testing can be useful, especially free T4 with a dialysis procedure. Testing for fT4 is less useful as a screening test since falsely elevated fT4 concentrations can be found in normal cats. In rare instances additional testing such as the T3 suppression test will be needed to confirm a diagnosis. Treating Hyperthyroidism …
Other Ways To Manage Feline HyperthyroidismApril 8, 2010Radioactive Iodine This is the treatment of choice if available and affordable. Ideally, only abnormal tissue will be destroyed and normal tissue should be spared. It’s equally effective if abnormal tissue is not located in the thyroid gland. Can also be used with adenocarcinomas (higher dose required). Cats do have to be relatively stable clinically to be treated and need to eat in clinic if treatment is to occur. Most cats are euthyroid within one or two months of treatment. Percutaneous Ethanol Injection This treatment has a learning curve, so an experienced operator is needed. Only one thyroid gland should be treated at a given time even if both thyroid glands are enlarged; the contralateral gland should be treated at a later date. The results with treatment of cats with unilateral involvement has been good, while hyperthyroidism has uniformly reoccurred in those with bilateral disease. Laryngeal paralysis is a common complication, which may be permanent or transient; bilateral laryngeal paralysis may be fatal. Horner’s also can occur. Surgical Thyroidectomy This is an effective, permanent treatment for hyperthyroidism with bilateral thyroidectomy being recommended given …
Injecting Insight Into VaccinationsMarch 4, 2010 The low cost of companion animal vaccines has translated into high client compliance, and up to one-fourth of global animal health product revenue comes from vaccines. But things get complicated when veterinarians use vaccines in ways not approved by the U.S. Department of Agriculture or as recommended by the manufacturer. Many manufacturer labels recommend that core vaccinations be given every year, but some veterinarians are administering them every three years. “It’s absolutely possible that the vaccines work for much longer, but the companies have not done the tests to prove that and have no legal or financial motivation to do so,” says Kate E. Creevy, DVM, MS, Dipl. ACVIM, an assistant professor at the University of Georgia. Federal law gives veterinarians some leeway under certain circumstances. “Please realize that every time we do that [booster less than annually] we are technically out of compliance with the legal use of the vaccine in question,” Dr. Creevy says. “To be covered under the federal exception, we must have an established veterinarian-client relationship and must explain this extralabel use to the client. Thus, there are still veterinarians who do not feel comfortable doing that.” To help …
Fleas Persist, But Reason Isn’t ResistanceMarch 2, 2010 Veterinarians are in a tough spot when a client challenges the efficacy of spot-on insecticides. They can’t force the client to follow product directions, nor can they administer the flea control every month. Asking a client about product application, the home environment and untreated pets can reveal a potentially resolvable situation. However, more often than not, the owner projects a sterling report of by-the-book compliance and a bewilderment of continued flea propagation. Attempting to resolve the infestation, veterinarians often switch to a different product and the resistance tale grows. “What clients are likely seeing are new fleas from the environment as opposed to fleas surviving after a proper spot-on application,” says Michael Dryden, DVM, Ph.D., a professor of veterinary parasitology in Kansas State University’s Department of Diagnostic Medicine and Pathobiology. “I have investigated homes that by owner description sound like there could be a resistance problem but found, when I looked closer, there was always a reason for the failure. None was ever resistance.” Without an investigation, experts say, it’s difficult to know why fleas persist on a client’s pet after treatment. One thing researchers agree on is it’s not a resistance issue. “Resistance …
Arthritis Rehabilitation: A Team EffortFebruary 7, 2010 Persuading a client to dedicate time and money to a pet’s potentially lifelong arthritis rehabilitation isn’t easy, experts say. But educating owners to be proactive can delay the onset and severity of the disease and lead to a more therapy-receptive client. A dog receives electrical muscle stimulation after arthroscopy for arthritis. More modalities than ever are available for patients suffering from arthritis pain, certified veterinary rehabilitators say. The key to maximizing the benefits, they say, lies in veterinary and client education along with an appropriate diagnosis. “Arthritis rehabilitation is a multimodal process,” says Janet B. Van Dyke, DVM, CCRT, CEO of the Canine Rehabilitation Institute in Wellington, Fla. “Veterinarians interested in expanding this area of their practice should consider becoming certified in rehabilitation. A lot can be learned in the three to four months it takes to complete the certification process.” Veterinarians looking to provide rehabilitation services need a general understanding of the available therapies, Dr. Van Dyke says. Back to School Deep-water swimming strengthens muscles and improves aerobic fitness without taxing the joints. More veterinarians are educating themselves on the best practices in animal rehabilitation through the Canine …
