Palliative And Hospice Care Come Of AgeApril 23, 2012 Palliative care and pet hospice are emerging as viable professional options that every practitioner can and should offer the owners of terminally ill pets. Veterinary practices will encounter more issues with terminal diseases, especially cancer, because pets are living longer as family members in very caring homes. High-tech facilities can maintain seriously injured or ill animals for long periods. Modern technology forces pet owners into the dilemma of pulling the plug or enduring costly and potentially futile life support. Instead of offering only this either/or model, veterinarians should give clients the option to take terminal pets home on palliative care to die in the comfort and support of the hospice setting, or as I refer to it, Pawspice. Minimalist Medicine Patriarchal veterinarians relate to their clients authoritatively. They generally tell pet owners what to think and what to do rather than help them decide. They direct, persuade or control clients to elect either aggressive care or euthanasia. This dictatorial approach sends the message, “I am practicing ‘My way or the highway’ medicine.” Many pet owners flee this style of practice, which patriarchal veterinarians might claim is down to earth and practical. On the other …
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Reflections On The International Symposium On Veterinary Hospice CareApril 23, 2012 Reflections on the International Symposium on Veterinary Hospice CareReflections on the International Symposium on Veterinary Hospice CarebondbeyondPosted: April 28, 2008By Alice Villalobos, DVM The first pet hospice conference’s purpose was to merge the medical aspects of end-of-life care with the psychosocial and spiritual aspects. According to Kathryn D. Marocchino, Ph.D., president and founder of the Nikki Hospice Foundation, this collaborative meeting was the first of its kind and brought together a diverse group of health care workers. Marocchino organized the symposium at the University of California, Davis. Hospice professionals like Dr. Marrochino, hospice volunteers, nursing and medical staff, psychologists, grief counselors, social workers, bereavement facilitators, death educators, veterinary chaplains, pastoral counselors, animal-health care workers, shelter and SPCA staff, animal communicators, pet cemetery personnel, pet massage therapists and pet-sitters including interested lay people assembled to discuss the medical and emotional aspects of hospice care. This unusual group of human-animal bond oriented people sat side by side with general practitioners, specialists, holistic veterinarians, registered technicians, animal nurses, students, practice managers and philanthropists who maintain private or non-profit pet hospice facilities. Marrochino’s goal was to develop a comprehensive, broad-based approach to veterinary hospice care. This may not …
Bonus Content: Let’s Regard End Of Life As A Distinct StageApril 23, 2012 EDITORS' NOTE: This is special bonus content for Dr. Villalobos' article, Let's Regard End of Life as a Distinct Stage. To read the full story, click here. Here are three examples of the End of Life stage: 1) Hemangiosarcoma in dogs is often diagnosed at extremely advanced stages after acute collapse from a hemoabdomen crisis. Those with rampant metastases are advised that surgery is unhelpful. These TIPs are immediately in late EoL phase. Most terminally ill patients would be offered the gift of euthanasia at the emergency clinic. Some might be released with a belly wrap, steroids, Yunnan Paio and pain medication with a signed consent form, to go home for hospice care and farewell with home euthanasia. 2) Hemangiosarcoma dogs with hemoabdomen from ruptured splenic lesions that undergo splenectomy may go from crisis to good health following surgery. Overall survival times are 89 days and not much better with treatment. These TIPs are in the middle EoL phase. We are seeking these dogs for a clinical trial using T-Cyte. Contact me at dralicev@aol.com. 3) …
Helping Clients Afford To Say ‘Yes’April 5, 2012 No one better understands the value of the human-animal bond than veterinarians. But as small-business owners with considerable overhead invested, veterinarians know that good practice management calls for responsible fee collection. Technological improvements increase pet owners’ expectations for good outcomes, though advanced procedures and care demand additional equipment and training, which also add to costs. This is where third-party financing can help boost a veterinarian’s bottom line. Practices can make financing available so that patients who don’t have insurance, cash or credit lines, or choose not to use them, can select and pay for the optimal treatment. “The ability of veterinarians to care for pets has grown exponentially with the advancement and availability of technology,” says Mary Beth Leininger, DVM. “We can fix things we couldn’t fix before.” Dr. Leininger is vice president of veterinary relations for ASPCA Pet Health Insurance, a subsidiary of the Hartville Group, with headquarters in Canton, Ohio. “People have a strong connection to their pets,” she says. “They consider them members of the family. So when the pet needs treatment, it is not so much that we have to talk them into the procedure and the cost. …
Warming To The RoleApril 5, 2012 When clinics add laser therapy to their pain-management arsenal, veterinary technicians often become the point people—and the most ardent advocates—of the technological advance. In the beginning, however, it’s not unusual for them to harbor a healthy dose of skepticism. Anneke Van Tricht is among those who took no convincing. In fact, before she’d ever used the Companion Therapy Class IV Laser that is now her veterinary tool of choice, she was sure it would ease patients’ pain and increase their mobility. You might even say she felt it in her bones. Especially in her vertebrae. “I had experienced the benefits of laser therapy on the human side with my own back (injury) five years ago,” said Van Tricht, a veterinary technician at Midway Animal Hospital in Seminole, Fla. “It saved me from surgery. For me, it’s a miracle.” Wielding the hand piece of relief is now one of her favorite tasks, Van Tricht said. Not only does it give her the chance to have a direct effect on patients’ quality of life, it makes her a driver of a significant source of new revenue for the practice. Not all clinic duties carry such rewards, …
Digital Radiography Is Becoming NormApril 5, 2012 Remember when Caparsolate was used to treat heartworms? When halothane was the most common inhalant anesthesia? Or when X-ray film was developed by hand-dipping a metal frame into tanks of solution in a darkroom, then hanging it to dry? New veterinary graduates may have to Google “Caparsolate” and “halothane,” and in the near future they may have a hard time finding a veterinary practice that still develops X-ray film. Digital radiography, which eliminates the darkroom, chemicals and manually filed plastic film, moseyed into veterinary medicine in the early 2000s, hit its stride around 2004, and today is galloping full-tilt into mainstream use. “The technology has gotten better, the software has gotten better and the prices on the client side have gotten better,” said Seth Wallack, DVM, Dipl. ACVR, who practices in San Diego. “The time of the early-adopter of digital is over, and now it’s more mainstream. It’s becoming the norm.” Digital technology is much faster than conventional radiography, and the software allows adjustment of brightness, contrast, zoom and pan on a single exposure. As long as the patient is positioned correctly, most everything else can be fixed by the machine’s controls. “Digital radiography …
Is This Town Too Small?March 30, 2012 Remember the old westerns, where the good guy (or bad guy) would say, “This town ain’t big enough for the two of us.” Something similar is happening in veterinary medicine. The “guys” are boarded specialists versus non-boarded but highly experienced generalists, and I’m not sure which one is the bad guy and which is the good guy. Actually, I’m not convinced that the town is too small for the two of them. Recently at American Animal Hospital Association in Denver, I hosted a table called “Building Referral Relationships,” where up to 10 people who registered in advance got the opportunity to come brainstorm, share and learn from each other about a topic they selected. As people gathered at our table, silly me thought that I needed to find out whose camp they were in, the referrers or the referring. Turns out most of them wore both hats. Several were generalists who may refer a patient on to a specialist in some instances, but they were also highly experienced (particularly orthopedic surgeons) so they received referrals from the community based on their reputation. Quite an interesting discussion took place. It actually reminds me of the struggle the …
The Pitfalls Of A Practical ProfessionMarch 28, 2012 My parents are both educated as architects. However, neither one of them practices architecture except when the stray job materializes or when willing-to-impose daughters like me ask them to design their new house. It’s not that they’re not impressively talented with awards and accolades to show for their progressively green brand of minimalist architecture. Neither have they lapsed into early retirement. Rather, it’s more to do with how the rug’s been pulled out from under their profession’s foundation over the past 30 years. Let that be a lesson to our profession. Indulge me as I explain how: In the ’80s, the architecture profession underwent a transformation with the rise of the technical, specialized architect. This new breed was distinct from the traditional architect, formerly schooled in overseeing the conception and construction of a structure from start to finish in a holistic sort of way (think Antoni Gaudí, Frank Lloyd Wright and Louis Kahn, among other 20th century luminaries). The advent of this highly specialized architect, fueled in part by the computerization of the profession via AutoCAD, was attended by a concurrent decline in the perceived need to educate architects broadly as artists, craftsmen, theoreticians, engineers …
Lucrative Tools For Boosting BusinessMarch 27, 2012 It’s time to rethink the way we conduct business in our veterinary practices. Times have changed and practice owners and managers must seek new ways to meet the needs of pet owners, while at the same time ensuring that their businesses remain profitable. One of the most critical elements of this change is the creation and active dissemination of a written financial policy that defines a practice’s payment options. Only 52 percent of veterinarians report actually having a written financial policy1, and we have done ourselves no favors by making the discussion of payment as difficult and uncomfortable as possible—in most cases leaving our front desk people the miserable job of trying to obtain a payment or deposit from a pet owner with little or no funds. They must then scurry off to get someone “higher up” to handle the situation, which eats up time and energy. Even if that policy has been written, many employees and clients have no idea what it is, although they know it has been disregarded often enough to realize it has little meaning. Consider how much simpler things would be if payment options and expectations were …
Unwanted Horses And Hungry HumansMarch 22, 2012 A friend recently wrote: “Horse meat ... why would anyone in their right mind want to eat it??? Very important issue. … Boo on Canada.” Attached was a link to a video. My friend’s attitude and this video made me imagine a possible win-win solution to end some of our world’s misery. I love and respect horses. As former president of the American Association of Human-Animal Bond Veterinarians and the current president of the Society for Veterinary Medical Ethics, I have carefully examined the sad situation that has inadvertently developed for unwanted horses since the ban on slaughter took effect five years ago. My empathy and grief for these horses spurred me to organize a two-hour equine ethics session at the American Veterinary Medical Association last July. My guest speaker, Dr. Robert M. Miller, an equine behaviorist as well as cartoonist and philosopher, spoke of major equine ethics problems from many viewpoints. Dr. Miller discussed horses’ roles as beloved companion animals, private sport horses, race horses, work horses—all the way down the human-animal bond scale to being livestock. Wild horses have it worse, because they forage on …
