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The Complete Journal for the Veterinary Health Care Team
CE Credit from Alfred State College, SUNY
VICKIE BYARD, CVT, VTS (Dentistry) Promoting the Importance of Veterinary Dentistry
Vol. 29 No. 2 | February 2008
DENTISTRY
Repair Options for Fractured Teeth
EQUINE ESSENTIALS Understanding Foal Development
Visit us at www.VetTechJournal.com
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GuestEditorial
The Complete Journal for the Veterinary Health Care Team
Vol. 29 No. 2
February 2008
EXECUTIVE EDITOR Hilda Guay 267-685-2435 | hguay@vetlearn.com EDITORIAL Jill Greshes, Associate Editor Liz Donovan, Assistant Editor 800-426-9119 x2446 | editor@VetTechJournal.com VETERINARY ADVISERS Dorothy Normile, VMD, Chief Medical Officer Beth Thompson, VMD, Medical Director SALES AND MARKETING Joanne Carson, National Account Manager 267-685-2410 | 609-238-6147 | jcarson@vetlearn.com Boyd Shearon, Account Manager 913-322-1643 | 215-287-7871 | bshearon@vetlearn.com Linda Costantini, Sales Representative 267-685-2422 | lcostantini@vetlearn.com Ray Lender, Executive Vice President 267-685-2417 | rlender@vetlearn.com DESIGN Michelle Taylor, Senior Art Director 267-685-2474 | mtaylor@vetlearn.com David Beagin, Art Director 267-685-2461 | dbeagin@vetlearn.com PRODUCTION Marissa Kuchta, Senior Production Manager 267-685-2405 | mkuchta@vetlearn.com Elizabeth Ward, Production Coordinator 267-685-2458 | eward@vetlearn.com CIRCULATION Barbara Horan, Circulation Specialist 267-685-2440 | bhoran@vetlearn.com Gina Donnelly, Customer Service Supervisor 800-426-9119 x2 | info@VetTechJournal.com PUBLISHED BY
780 Township Line Road • Yardley, PA 19067 PRESIDENT Derrick Kraemer Indexing: Veterinary Technician ® is included in the international indexing coverage of Index Veterinarius (CAB International), Focus On: Veterinary Science and Medicine (ISI), SciSearch (ISI), and Research Alert (ISI). Article retrieval systems include The Genuine Article (ISI) and The Copyright Clearance Center, Inc. Yearly author and subject indexes for Veterinary Technician are published in December.
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Dedication Drives the AVDT Jeanne R. Perrone, CVT, VTS (Dentistry), who was featured on the February 2005 cover of Veterinary Technician®, has dedicated her professional life to promoting veterinary dentistry. From 2002 to 2006, Jeanne held numerous positions — from dentistry technician to clinical coordinator to technician student supervisor — in the Dentistry and Oral Surgery Service at the University of Illinois School of Veterinary Medicine. In August 2006, she began working as a dentistry technician for Tampa Bay Veterinary Specialists in Largo, Florida. In addition, she is an adjunct professor at St. Petersburg College, where she teaches dentistry in the veterinary technology program. Jeanne became a Veterinary Technician Specialist in Dentistry in 2006. She also serves as the president of the Academy of Veterinary Dental Technicians (AVDT). In celebration of National Pet Dental Health Month, Jeanne shares the AVDT’s history, philosophy, and vision for the future. Since I became involved with the AVDT in 2001, we have faced numerous challenges and achieved many successes. The dedication of our members has helped to shape and define our role in the field of veterinary dentistry. We are 22 members strong now, and we have the drive and determination to guide us into the future. I think that the key to our success is our willingness to meet a challenge. When the veterinary community first invited us to share our knowledge, many of us stepped up to the challenge despite the fact that up until that point, we did not have writing skills, leadership experience, or public speaking skills. One of the primary goals of the AVDT is to promote dental education and encourage a quality standard of care. AVDT members lecture and write on dentistry topics as well as provide hands-on training. Our members have lectured at national, state, and regional conferences as well as association meetings. Some of our members have even used their own equipment to do on-site training at clinics. Our latest project has been collaborating with Hill’s Pet Nutrition on its National Pet Dental Health Month campaign. In addition, we have been working side by side with the American Veterinary Dental College, the Academy of Veterinary Dentistry, and the American Veterinary Dental Society to create a campaign that inspires clinics to meet high standards of dental care throughout the year. The AVDT believes that education is a gift that lasts a lifetime. As we continue to see improvement in pets’ lives because of better dental care, we are encouraged to share our knowledge and skills so that veterinary team members can provide quality care to their patients. Who gets tired of hearing owners exclaim that their pet is acting young again because its dental problems have been treated? I hope I never do.
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Contents
The Complete Journal for the Veterinary Health Care Team
February 2008
Volume 29, Issue 2
COLUMNS
For the benefit of those who wish to participate in the CE Program, the peerreviewed CE articles contained in Veterinary Technician® meet the standards set by Alfred State College for 0.5 credit hour. Documentation will be issued by Alfred State College, a State University of New York (SUNY) College of Technology.
102 Management Matters
All clinical articles are peer reviewed.
How to Avoid Asking Illegal Questions During an Interview
74
Katherine Dobbs, RVT, CVPM
Scaling New Heights in Dentistry
108 Behavior Boot Camp
NEW!
“Clicking” with Animals — A New Clicker Training Certification Program Julie Shaw, RVT
116 Equine Essentials Understanding Foal Development and Its Relevance to Raising Orphaned Foals
108 Clicker
Courtesy of ClickerTraining.com
Peter Olson
Sharon L. Crowell-Davis, DVM, PhD, DACVB
Training
FEATURES 74
Scaling New Heights in Dentistry — A Talk with Vickie Byard, CVT, VTS (Dentistry) Liz Donovan Vickie Byard, CVT, VTS (Dentistry), explains the importance of educating clients about oral health and encourages technicians to reach for their dreams.
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Veterinary Learning Systems’ Expert Summit on Pet Food: Part Two In the second part of the expert pet food summit, leading clinical nutritionists, nutrition industry experts, and veterinary professionals discuss commercial pet food regulations, homemade diets, and owner compliance.
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ON THE COVER Vickie Byard, CVT, VTS (Dentistry), positions the digital radiography unit to obtain dental radiographs of a Yorkshire terrier.
See page 74 Photographed by Peter Olson
www.VetTechJournal.com
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Contents
The Complete Journal for the Veterinary Health Care Team
February 2008
Volume 29, Issue 2
92
DEPARTMENTS 65 70 72 114 123 126 127 128 129 136
Guest Editorial Information Page Tech News Author Instructions Tech Tips Product Forum Index to Advertisers Market Showcase Classified Advertising Picture This!
CE ARTICLE 92
Options for Treating a Fractured Tooth Jodi A. Kristel, CVT, VTS (Dentistry) When a pet fractures a tooth, the owner must decide whether the tooth should be treated or extracted. Technicians who understand the basic anatomy of the tooth and are familiar with the options for treatment can help owners make an informed decision.
“The Pet Food Institute reported that 73% of consumers say they are confident or very confident in the safety of their pet food…” See page 89 68
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©2008 Stephanie Coffman/Shutterstock.com
Courtesy of Aggie-Angel Clinic
February Is Dental Health Month
Equine Essentials Correction — January 2008 In the Expert Summit on Pet Food: Part One, Dr. Julie Churchill’s credentials and affiliation should have been listed as follows: Julie Churchill, DVM, PhD Assistant clinical professor Small animal nutrition University of Minnesota www.VetTechJournal.com
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InformationCenter
The Complete Journal for the Veterinary Health Care Team
How to Contact Us Want to submit a manuscript? Check on your subscription? Send feedback?
Editorial Office VLS/Veterinary Technician 780 Township Line Road Yardley, PA 19067 Editorial Comments Phone: 800-426-9119, ext. 2446 Email: editor@VetTechJournal.com Fax: 800-556-3288 Submissions Please make sure that your contact information (full name and credentials [if applicable], mailing address, email address, and daytime phone number) is listed clearly on all submissions. Please follow up on submissions if you have not received an acknowledgment from our editorial office within 4 weeks. Manuscript Inquiries and Submissions Phone: 800-426-9119, ext. 2435 Email: hguay@vetlearn.com Fax: 800-556-3288 All Other Editorial Submissions Phone: 800-426-9119, ext. 2446 Email: editor@VetTechJournal.com Fax: 800-556-3288 Tech Tip Videos Visit www.VetTechJournal.com/ sharetechtip to upload your video.
Circulation and Subscription Inquiries If you are moving, please notify us 6 to 8 weeks in advance to ensure uninterrupted service. Send us your current mailing label with your old address and the effective date of change. For address changes, subscriptions, and other matters, please contact us by: Phone: 800-426-9119, option 2 Email: info@VetTechJournal.com Fax: 800-589-0036 Web: www.VetTechJournal.com Advertising and Sales Joanne Carson Phone: 267-685-2410 Email: jcarson@vetlearn.com Boyd Shearon Phone: 913-322-1643 Email: bshearon@vetlearn.com Linda Costantini Phone: 267-685-2422 Email: lcostantini@vetlearn.com Classified Advertising Liese Dixon Phone: 800-920-1695 Email: VetTechClassifieds@vetlearn.com Web: VetClassifieds.com
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Our Mission Veterinary Technician is designed to support and actively promote the professional status and value of veterinary technicians and assistants in their own eyes, in the eyes of their colleagues and employers, and within veterinary medicine as a whole. Veterinary Technician® (ISSN 8750-8990) is published monthly by Veterinary Learning Systems, a division of MediMedia USA, 780 Township Line Road, Yardley, PA 19067. Copyright © 2008 Veterinary Learning Systems. All rights reserved. Canada Post international publications mail product (Canadian distribution) sales agreement number 40014103. Return undeliverable Canadian addresses to MediMedia, PO Box 7224, Windsor, ON N9A 0B1. Printed in USA. No part of this issue may be reproduced in any form without written permission from the publisher. Periodicals postage paid at Morrisville, PA, and at additional mailing offices. Subscription rate: $46 for one year, $83 for two years, $119 for three years. Canadian and Mexican rates: $55 for one year, $102 for two years, $142 for three years. Foreign rate: $66 for one year, $119 for two years, $166 for three years. (All checks must be payable to Veterinary Learning Systems in U.S. funds drawn on a U.S. branch of a U.S. bank.) Selected back issues are available for $8 each (plus postage). Reprints are available for all Veterinary Technician articles; call 800-426-9119. POSTMASTER: Send address changes to Veterinary Technician, Veterinary Learning Systems, 780 Township Line Road, Yardley, PA 19067.
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Vol. 29 No. 2
February 2008
EDITORIAL BOARD Elaine Anthony, MA, CVT Kimberly Baldwin, LVT, VTS (ECC) Andrea Battaglia, LVT Dawn Bennett, DVM Tracy Blais, AS, BS, MEd, CVT Kathy Bliss, BS, LVT David Bolette, RVT, LATg Susan Bryant, CVT, VTS (Anesthesia) Melvin C. Chambliss, DVM Mindy Cohan, VMD Christina A. Cornelius, LVT Elizabeth G. Davis, DVM Harold Davis, Jr., BA, RVT, VTS (ECC, Anesthesia) Katherine Dobbs, RVT, CVPM Cheryl Holloway, RVT Tara Lang, BS, RVT Pepi F. Leids, DVM Donna Letavish, CVT Heidi Lobprise, DVM Rosandra (Rose) Manduca, DVM Betty A. Marcucci, VMD, MA Tracey M. Martin, LVT Laura McLain Madsen, DVM Trisha McLaughlin, CVT Kathryn E. Michel, DVM, MS Christopher Norkus, BS, CVT, VTS (ECC, Anesthesia) Jody Nugent-Deal, RVT Kristina Palmer-Holtry, RVT Karl M. Peter, DVM Ann Rashmir-Raven, DVM, MS Virginia Rentko, VMD Nancy Shaffran, RVT, VTS (ECC) Julie Shaw, RVT Margi Sirois, EdD, MS, RVT P. Alleice Summers, DVM Mary Tefend, MS, LVT, VTS (ECC) Kelly Towne-Collins, AAS, LVT Ann Wortinger, LVT, VTS (ECC) Any statements, claims, or product endorsements made in Veterinary Technician are solely the opinions of our authors and advertisers and do not necessarily reflect the views of the Publisher or Editorial Board.
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TechNews
MediMedia Animal Health Launches Vetstreet by Liz Donovan
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ecently, Veterinary Learning Systems’ parent company, MediMedia Animal Health, announced the formation of Vetstreet, an innovative online service that allows veterinary professionals to interact more effectively with their clients. This company combines two of MediMedia Animal Health’s recent acquisitions, VetInsite and Vetsuite. Vetstreet, located in Silver Spring, Maryland, will help the veterinary team communicate more easily with clients — with health reminders; health information tailored to each pet’s age, breed, and medical status; personalized status reports; and animated pet birthday greetings. The interactive service also allows clients to email the staff with questions and order prescription refills.
Orders will be shipped directly to the clients. The practice owner determines which products will be available and how much the products will cost; however, the Vetstreet platform manages the inventory and coordinates the shipment. Corporate partners, such as Bayer Animal Health, are lending logistical support to enable Vetstreet to mail products to clients. However, products
outside of the Bayer line also will be available through this service. VetInsite, acquired in December 2007, is a leading animal health communications company that specializes in strategic communications between veterinary hospitals and their clients and is currently used by more than 1,000 veterinary hospitals. Vetsuite, acquired in January 2008, is a collection of Internet-based tools and resources that enable veterinary practices to attract new business and improve services for current clients through its Web site hosting platform. It supports more than 1,900 hospital Web sites. For more information, call 888-7998387 or visit www.vetstreet.com.
ASPCA Data Link Breeds, Toxic Exposures To promote National Poison Prevention Week (March 16 to 22), the ASPCA released data obtained from reviewing calls to its Animal Poison Control Center (APCC). The number of calls involving dogs outnumbered those involving cats six to one. In addition, the data showed that certain breeds are more likely to ingest or be exposed to specific toxic substances. Technicians can use this information to educate clients about substances that are toxic to animals and explain the importance of making potentially poisonous items inaccessible to pets. Owners of pets identified in the ASPCA’s review as being at particular risk from the following substances may especially benefit from this information: Rodenticides or rat bait: The APCC received 409 calls regarding incidents in which Labrador retrievers ingested rat poison. “Some bait products contain inactive ingredients meant to attract rodents but which can also be attractive to pets,” says Steven Hansen, DVM, MS, 72
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MBA, DABT, DABVT, toxicologist and senior vice president of the APCC. Technicians should remind clients that if they use rodenticides, it is important to “place these products in areas that are completely inaccessible to companion animals,” Hansen advises. Sweet or fatty foods: Chihuahuas were the subject of 127 calls to the APCC regarding ingestion of sweet or fatty foods, which can wreak havoc on their small digestive systems. Yorkshire terriers were the subject of 88 calls related to ingestion of these foods. It is important to remind clients, however, that “sweets of any kind are not appropriate for dogs or cats, regardless of their size,” Hansen says. Improper use of permethrin: The APCC reported that the most frequent incident affecting domestic cats of a nonspecific breed was owners’ use of insecticides (such as flea products for dogs) that contain permethrin. These products are intended for use on dogs only and can be poisonous to cats. Therefore, Hansen
recommends that technicians remind clients to always read the label before using any flea products. Human medications: It was frequently reported that both Siamese and nonspecific domestic cats ingested human medications, including antidepressants, ibuprofen, and amphetamines. To keep cats away from these potentially deadly drugs, Hansen recommends that technicians instruct clients to keep prescription and over-the-counter drugs in closed cabinets. In 2007, the APCC handled more than 130,000 cases. To help owners reduce the number of incidents in which animals ingest or are exposed to toxic substances, technicians should use National Poison Prevention Week as an extra opportunity to educate clients about keeping their pets safe in the home. Technicians can also provide clients with contact information for the regular clinic and the local emergency hospital should their pet ingest a toxic substance. www.VetTechJournal.com
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TechNews
Veterinary Learning Systems Revamps Journal and Web Site Veterinary Technician® journal began the new year with a new look, and those changes are just the beginning. Veterinary Learning Systems (VLS), the publisher of Veterinary Technician, launched its new Web site, which can be accessed by visiting www.vetlearn.com or www.VetTechJournal.com. On the new site, readers are able to search archived Veterinary Technician articles, view classified advertisements, download forms for use in the clinic, post and view videotaped Tech Tips, and read up-to-date veterinary news. In the future, the site will expand to include a conference calendar that lists upcoming CE events specifically for technicians and a discussion board so that veterinary professionals can meet and network. “By incorporating more content in the future, we are working toward making VetLearn.com the be-all, end-all site for veterinary technicians,” says David Goldman, director of Web development for VLS. Subscribers are encouraged to visit the Web site and offer their feedback on the site and the new journal design.
GEORGIA Fort Valley State University (FVSU) and Zoo Atlanta have joined forces to offer veterinary technology students a 6- to 8-week internship working with exotic animals. One student per year will be selected to complete the internship. This student will receive hands-on clinical experience working with animals ranging from zebras to rhinos. The program was developed by Maria Crane, DVM, vice president of animal health at Zoo Atlanta, and Isaac Crumbly, PhD, vice president of career and collaborative programs at FVSU. “Now, our students will not only learn to care for domestic large animals, like horses, goats, sheep, and cows, they will also learn how to care for exotic large animals,” says Crumbly. “Through this program, Zoo Atlanta will continue to raise the standard of excellence in education by providing veterinary technology students with an informative, educational, and engaging experience,” says Dennis Kelly, president and CEO of Zoo Atlanta. Currently, 100 students are enrolled in the veterinary technology program at FVSU. The university offers the only 4-year veterinary technology program in Georgia. www.VetTechJournal.com
ILLINOIS In January, the Illinois Senate enacted legislation that protects the pets of domestic abuse victims. Illinois House Bill 9 enables judges to include animals in orders of protection, giving the petitioner exclusive custody, care, and control of the animal. The ASPCA, which worked with legislators to implement this bill, released the following statistics related to animals in domestic abuse situations: 83% of directors of the largest U.S. shelters for battered women indicated that women entering the shelters discussed incidents of pet abuse in the family. 71% of pet-owning women in shelters reported that a pet had been threatened, injured, or killed by their abuser. 49% of pet-owning victims who fled their abusers and entered shelters continued to worry about their animals after entering the shelter. “This bill goes a long way in ensuring that victims of domestic violence don’t have to fear for their pets,” says Ed Sayres, president and CEO of the ASPCA. The bill was unanimously passed by the Senate on May 22, 2007, and went into effect on January 1, 2008.
RHODE ISLAND Renee Rodgers has been named the 2007 Veterinary Technician of the Year by the Rhode Island Veterinary Technician Association and the Rhode Island Veterinary Med- Renee Rodgers ical Association. Since was named Rhode 2007 VetAugust 2005, Renee Island’s erinary Technician has been working as of the Year. a veterinary technician at the Rhode Island SPCA, where she vaccinates and provides nursing care to the shelter animals. Ernest Finocchio, DVM, president of the Rhode Island SPCA, described Renee’s dedication in his nomination letter. He writes, “In my two years of working with Renee, I discovered a dedicated and compassionate person who has never refused to take the extra step in making life more comforting to a sick or injured animal.” He adds that Renee has saved the lives of many sick or injured animals by taking them home to provide overnight nursing care. Renee also volunteers at shelter events and assists with the shelter’s fostering program. She lives in Greenville, Rhode Island. Congratulations, Renee!
Shalom Eagan, BS, CVT, VTS (ECC)
S TAT E N E W S
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Cover Story
Scaling New Heights in Dentistry Liz Donovan Veterinary Learning Systems
A Talk with Vickie Byard, CVT, VTS (Dentistry)
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Peter Olson
F
OR MOST PEOPLE, dentistry is probably not what comes to mind when they hear the words “instant gratification.” But for Vickie Byard, CVT, VTS (Dentistry), the dramatic improvement in her patients’ quality of life after a dental procedure provides her with that sense of reward. As the inpatient supervisor and dentistry coordinator at Rau Animal Hospital in Glenside, Pennsylvania, Vickie works one-on-one with clients to provide their pets with the highest possible level of periodontal care. By serving as the presidentelect and exam chairperson of Vickie spends quality time with Crayons, her 10-year-old domestic shorthaired cat. the Academy of Veterinary Dental Technicians (AVDT), Vickie strives to improve the quality of veterinary dentistry across the nation. She has lectured on dentistry at various conferences, including the Veterinary Technician® 2007 CE Seminar, where she inspires technicians to gain the confidence to reach for their dreams. “I think that technicians have a wealth of potential that has hardly been tapped,” Vickie says. Here, she tells us about disturbing dentistry statistics, the benefits of intraoral radiology, and the importance of believing in yourself.
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The potential for an animal poison emergency is always there, so we are too. A pill bottle accidently knocked off a sink. Everyday things can quickly become a poison emergency for a pet. It’s the reason the ASPCA® Animal Poison Control Center is here 24/7/365 to support you with critical recommendations. As the only center in North America dedicated solely to animals, we have an experienced team of board certified veterinary toxicologists* on staff with the special expertise needed to save a pet’s life. Our exclusive AnTox™database of more than one million cases of animal poisonings also gives us immediate access to crucial case information. When potential danger turns into a real emergency, don’t hesitate. Call us.
ORDER A FREE MAGNET Visit www.aspca.org/freemagnet for your free ASPCA Animal Poison Control Center magnet − an easy way to keep our emergency number handy. For information on our online Toxicology CE courses, visit www.apcc.aspca.org. No animals were harmed during the production of this ad.
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*American Board of Veterinary Toxicology www.abvt.org
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Cover Story
How did you get to this point in your career?
While working at my previous job, I was very limited in what I could do. The veterinarians at Rau really fostered my interests and encouraged me to grow professionally. I am so fortunate to have been trained in this environment. I now have the confidence to recognize new opportunities when they present themselves. It’s been a very exciting career so far, and I give my employer a lot of credit for helping me get to this point.
I knew from a young age that I wanted to work with animals, but my only experience with veterinary medicine was taking my own pets to the veterinarian. While researching veterinary careers, I learned about the veterinary technician profession. It seemed like a perfect fit, so I enrolled in Harcum College’s veterinary technology program. I graduated in 1981 and began working at a very small practice owned by a lovely married couple who were both veterinarians. At that clinic, I did only basic tasks — I restrained animals, cleaned kennels, mailed reminders, and answered phones, and I performed only limited lab work and emergency care. I thought that what I was doing was the extent of what was expected from a technician. In 1985, a series of events changed my life. I injured my back in a serious car accident and was temporarily unable to function at the clinic where I was working. When I was able to work again, I was offered a position at Rau Animal Hospital. As it turned out, these circumstances were the best thing that could have happened to me. I felt completely in over my head when I first started at Rau because the veterinarians there expected more from me than the other clinic ever had. I really had to learn to stretch my comfort zone and grow, but I thoroughly enjoyed the experience. I realized that veterinary medicine holds a lot of challenges for technicians.
How did you come to work in veterinary dentistry? I was first exposed to veterinary dentistry when I started working at Rau. I loved the immediate gratification of performing a dental procedure. The animals came in with mouths that were in bad shape, and when we were done with the procedure, their oral health was significantly better. I knew that there was a great need for dentistry in veterinary hospitals, and I wanted to learn more. In the early 1990s, the practice owner and I started attending dental wet labs and talking with board-certified veterinary dentists. In addition, I spent a week volunteering my services to Jan Bellows, DVM, DAVDC, DABVP, during which time I was able to ask him questions and absorb as much information as I could. It was such an empowering experience for me. The more I learned, the more I knew that I wanted to work in a position that focused solely on dentistry.
You were part of the organizing committee that formed the AVDT. Can you tell us about that experience?
V I TA L S TAT I S T I C S V I C K I E B YA R D Education AS in veterinary technology, Harcum College, Bryn Mawr, PA (1981)
Professional Associations American Veterinary Dental Society (member), AVDT (president-elect, exam chairperson), NAVTA (member), Pennsylvania Veterinary Technicians Association (member)
Vickie shares her home with two domestic shorthaired cats, Crayons (10 years old) and Sassy (9 years old). Crayons, nicknamed “Crazy Crayons,” is the star of Vickie’s toothbrushing training video for clients. 76
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Peter Olson
Pets
In 2000, the diplomates of the American Veterinary Dental College decided that there was a need for technicians to become specialized in dentistry. Dr. Bellows suggested I meet with like-minded technicians to investigate the formation of a dental technician specialty. I saw his encouragement as a great compliment, so I joined a group of other technicians from all over the country at the first AVDT meeting in Las Vegas. As a result of that meeting, we began a 4-year process of conducting research, forming committees, learning NAVTA requirements, and writing the petition to the Committee on Veterinary Technician Specialties to gain acceptance as an academy. It was arduous work, but I got to know some incredible technicians in the www.VetTechJournal.com
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COMFORTIS™
process, and I have had many opportunities become available to me since that time. I was selected as president-elect in 2001. I now concentrate on supporting the president and organizing committees within the academy. I will be named president at the Veterinary Dental Forum later this year. I also serve as the exam chairperson, so I spend a lot of time working on exam preparation each year. This includes setting up the venue, communicating with the candidates so that they know what to expect, making hotel arrangements, and administering and grading the exam.
How has your involvement with the AVDT helped your career and the profession? Being involved with the AVDT has given me the opportunity to meet and network with some of the most incredible technicians and veterinarians in the world. It has also given my career diversity that I never would have imagined. If you asked me in 2000 whether I would ever author articles or speak to large groups, I wouldn’t have thought it possible. I have grown so much as a person and as a technician because of my involvement. Through the AVDT, I have had the opportunity to help other dedicated technicians set and achieve their career goals. Eventually, specialized technicians will be as valuable to the veterinary profession as nurse practitioners are to the human medical field. By obtaining their specialty status, veterinary technicians will be able to maintain their careers financially, which will lead to increased longevity in the field and increasing improvements in veterinary medicine. Now, I’m encouraging new technicians to join our academy. We currently have a board of technicians who have put a lot of effort into getting the AVDT started, but the same individuals can’t spend the next 20 years continuing to keep the academy going. We need new members who share our excitement so that they can teach the next crop of technicians. We don’t want this dream to be limited to a couple of years and then fizzle out. We need new technicians to say, “Thank you for teaching me. Now it’s my turn to show the next person.” That’s going to make all of our current efforts worthwhile because that’s where we have the opportunity to have growth in the profession. www.VetTechJournal.com
Off the Cuff Diamonds or pearls? Pearls, because they’re classic. What is your favorite TV show? Grey’s Anatomy, because it is medical and very human.
(spinosad) Chewable Tablets Brief Summary: Before using Comfortis chewable tablets, please consult the product insert, a summary of which follows: Caution: Federal (USA) law restricts this drug to use by or on the order of a licensed veterinarian. Dosage: Administer orally once monthly. Administer with food for maximum effectiveness. Recommended dose range is 13.5 – 27.3 mg/lb (30-60 mg/kg). Available in five tablet sizes for dogs ranging from 5 to 120 lbs. Dogs over 120 lbs should be administered the appropriate combination of tablets. Indications: COMFORTIS chewable tablets kill fleas and are indicated for the prevention and treatment of flea infestations (Ctenocephalides felis) on dogs for one month. Contraindications: There are no known contraindications for the use of COMFORTIS chewable tablets. Warnings: Not for human use. Keep this and all drugs out of the reach of children. Precautions: COMFORTIS chewable tablets are for use in dogs and puppies 14 weeks of age and older (see ANIMAL SAFETY). Use with caution in breeding females (see ANIMAL SAFETY). Use with caution in dogs with pre-existing epilepsy (see ADVERSE REACTIONS). The safe use of COMFORTIS chewable tablets in breeding males has not been evaluated. Adverse Reactions: In a well-controlled US field study, which included a total of 470 dogs (330 dogs treated with COMFORTIS chewable tablets and 140 dogs treated with an active control), no serious adverse reactions were observed with COMFORTIS chewable tablets. All reactions were regarded as mild and did not result in any dog being removed from the study. Over the 90-day study period, all observations of potential adverse reactions were recorded. Reactions that occurred at an incidence > 1% within any of the 3 months of observation are presented in the following table. The most frequently reported adverse reaction in dogs in the COMFORTIS chewable tablets and active control groups was vomiting. The occurrence of vomiting, most commonly within 48 hours after treatment, decreased with repeated doses of COMFORTIS chewable tablets. Percentage of Dogs (%) with Adverse Reactions Month 1 Month 2 Month 3 COMFORTIS Active COMFORTIS Active COMFORTIS Active Chewable Topical Chewable Topical Chewable Topical Tablets Control Tablets Control Tablets Control (N=330) (N=139a) (N=282) (N=124) (N=260) (N=125) Vomiting 12.7 12.2 7.8 3.2 5.8 4.8 Decreased Appetite 9.1 5.0 2.8 1.6 1.9 0.8 Lethargy 7.6 5.0 3.5 4.0 1.2 0.8 Diarrhea 6.7 5.0 4.3 0.8 1.2 0.0 Cough 3.9 5.0 0.4 2.4 0.0 0.0 Polydipsia 2.4 1.4 0.7 0.0 0.4 0.0 Vocalization 1.8 0.0 0.4 0.0 0.4 0.0 Increased Appetite 1.5 0.0 0.4 0.8 0.4 0.0 Erythema 1.5 0.0 0.4 0.0 0.4 0.0 Hyperactivity 1.2 1.4 0.0 0.0 0.4 0.0 Excessive Salivation 1.2 0.0 0.4 0.0 0.0 0.0
What personality characteristics do you despise? Apathy, hatred, and dishonesty. What is your favorite time of the day? Morning, because it is quiet and is an opportunity for planning and reflection. Lake, ocean, or river? I love all of them, but if I had to choose, I’d say river because I love to flyfish. What is your theme song? “A Piece of Sky,” from the Yentl soundtrack. What is your favorite thing about yourself? My willingness to try new things.
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a
This number (n=139) is less than the total number of dogs in the safety population for the active control group (n=140) because one dog joined the study late and was only dosed at Month 3. In US and European field studies, no dogs experienced seizures when dosed with COMFORTIS chewable tablets at the therapeutic dose range of 13.5-27.3 mg/lb (30-60 mg/kg), including 4 dogs with pre-existing epilepsy. Four epileptic dogs that received higher than the maximum recommended dose of 27.3 mg/lb (60 mg/kg) experienced at least one seizure within the week following the second dose of COMFORTIS chewable tablets, but no seizures following the first and third doses. The cause of the seizures observed in the field studies could not be determined. Animal Safety: COMFORTIS chewable tablets were tested in pure and mixed breeds of healthy dogs in well-controlled clinical and laboratory studies. No dogs were withdrawn from the field studies due to treatment-related adverse reactions. In a dose tolerance study, COMFORTIS chewable tablets were administered orally to adult Beagle dogs at average doses of up to 100 mg/kg once daily for 10 consecutive days (16.7 times the maximum recommended monthly dose). Vomiting was seen in 5 of 6 treated dogs during the first 6 days of treatment, usually within 2.5 hours of dosing. Treated females lost weight early in the treatment period, but their weights were similar to control dogs by the end of the 24-day study. COMFORTIS chewable tablets were not associated with any clinically significant changes in hematology, blood coagulation or urinalysis parameters; however, mild elevations in ALT occurred in all dogs treated with COMFORTIS chewable tablets. By day 24, ALT values had returned to near baseline levels. Phospholipidosis (vacuolation) of the lymphoid tissue, the long-term effects of which are unknown, was seen in all dogs treated with COMFORTIS chewable tablets. In a margin of safety study, COMFORTIS chewable tablets were administered orally to 6-week-old Beagle puppies at average doses of 1.5, 4.4, and 7.4 times the maximum recommended dose at 28-day intervals over a 6-month period. Vomiting was observed across all groups, including the control. Increased vomiting was observed at elevated doses, usually within 1 hour following administration. Vomiting at all doses decreased over time and stabilized when puppies were 14 weeks of age. The average daily and total weight gains of treated dogs were smaller than control dogs and were dose dependent. COMFORTIS chewable tablets were not associated with clinically significant changes in hematology, clinical chemistry, coagulation or urinalysis parameters. Phospholipidosis (vacuolation) of the lymphoid tissue was seen in some dogs in the 4.4X group and all dogs in the 7.4X group. The long term effects of phospholipidosis are unknown. Treatment with COMFORTIS chewable tablets was not associated with any other clinically significant adverse clinical observations, gross necropsy or histopathological changes. In a reproductive safety study, COMFORTIS chewable tablets were administered orally to female Beagles at 1.3 and 4.4 times the maximum recommended therapeutic dose every 28 days prior to mating, during gestation, and during a six-week lactation period. No treatment-related adverse effects were noted for conception rates in the dams, or for mortality, body temperature, necropsy, or histopathology findings for the dams or puppies. One dam from each treatment group experienced early pregnancy loss and one additional high dose dam aborted late term. The treated dams experienced more vomiting, especially at one hour post-dose, than the control dams. Puppies from dams treated at 1.3 times the maximum recommended therapeutic dose had lower body weights than puppies from control dams. Although puppy mortality between treated and control dams was not different, the puppies from the treated dams experienced more lethargy (4.4X group only), dehydration, weakness and felt cold to the touch (4.4X group only) than puppies from control dams. A pilot study without a control group was conducted to analyze milk from three lactating dogs treated with an experimental formulation of spinosad at 1.5 times the maximum recommended dose administered at day 28 of gestation and 24 hours prior to parturition. The data demonstrated that spinosyns were excreted in the milk of these dogs. Mortality and morbidity were greatest in puppies from the dam with the highest spinosyns level in milk. The spinosad milk: reference plasma exposure ratio calculated from this study ranged from 2.2 to 3.5. In well-controlled field studies, COMFORTIS chewable tablets were administered safely in conjunction with other frequently used veterinary products, such as vaccines, anthelmintics, antibiotics, steroids, flea and tick control products, anesthetics, NSAIDs, antihistamines, alternative/herbal remedies, shampoos, and prescription diets. Changes in hematology, clinical chemistry and urinalysis values were compared pre-and post-study and were unremarkable. Storage Information: Store at 20-25°C (68 -77°F), excursions permitted between 15 to 30°C (59 to 86°F). To obtain full product information please call 888-545-5973 or visit www.comfortis4dogs.com. NADA 141-277, Approved by FDA Manufactured for Elanco Animal Health, A Division of Eli Lilly & Co., Lilly Corporate Center, Indianapolis, IN 46285
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The most common adverse reaction recorded during clinical trials was vomiting. Other adverse reactions were decreased appetite, lethargy or decreased activity, diarrhea, cough, increased thirst, vocalization, increased appetite, redness of the skin, hyperactivity and excessive salivation. For important safety information and brief summary see page 77. Š2007 Eli Lilly and Company CF00083
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The only FDA-approved monthly flea protection that kills fleas and comes in a chewable, beef-flavored tablet. NEW Comfortis™ is the first and only oral flea protection approved by the FDA that kills fleas for a full month. Not only does it offer fast-acting, long-lasting flea protection, but Comfortis™ comes in a chewable, beef-flavored tablet that eliminates the messiness of topical flea treatments. To learn more about new Comfortis™, see your Lilly representative, distributor representative or call 1 (888) LillyPet. Available by prescription only. www.comfortis4dogs.com
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g Molly, iques usin n h c te g shin s toothbru onstrate as her model. m e d ie k Vic ese, er ’s Malt a cowork
A happy Molly snuggles with her owner, Jennif technology student at er Johnson, who is a ve Harcum College in Br yn Mawr, Pennsylvania terinary .
What do you enjoy most about lecturing? I love being able to travel all over the country and educate technicians about veterinary dentistry, especially those who have not yet been exposed to it. I like to see the reactions on technicians’ faces when I cite statistics about the number of animals that have periodontal disease. I want to motivate technicians to take that information back to their practice and communicate it to their employers and clients. Periodontal disease can be extremely debilitating, and 80% of the animals coming into veterinary practices are affected. It’s a horrible statistic, but it’s the truth. I believe that if I can help technicians learn and understand that statistic, I can play a part in improving the standard of care globally. If technicians have the knowledge and if they care about the animals, which I know they do, taking the time to educate the client is an easy leap. Our clients don’t come into the clinic already educated about veterinary dentistry. That’s our role as technicians — to give them what they need to make an informed decision about their pet’s care.
How do you educate clients on how to improve their pet’s oral health? Client education is an enormous part of my job. My biggest role is to work with clients 80
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Peter Olson
on Peter Ols
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to determine which treatments they will approve and what level of at-home care they can provide. When a client brings in a pet for a dental procedure, I evaluate the oral cavity, clean and chart the mouth, take intraoral radiographs, perform regional nerve blocks when needed, and support the veterinarian. He or she reviews the findings and recommends therapy. I then call the client. Based on patient temperament, the pathology that was found, and family commitment and economics, we formulate an individualized plan for success. When the pet is discharged after the treatment, I schedule a recheck appointment with the client for 7 to 10 days later. The rechecks are one of the most exciting parts of my job. I am able to hear so many wonderful stories about how these pets are acting like puppies or kittens again because they are no longer in pain from periodontal disease. I take this opportunity to start talking with the owner about how the health of the pet’s mouth can be maintained. I love seeing clients finally understand how important proper dental care is now that they have the knowledge and tools to provide exceptional at-home care for their pets. I tailor all my recommendations for at-home care to each client based on his or her individual www.VetTechJournal.com
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abilities. If clients are willing and toothbrushing is a possibility, I show them a video of me brushing my cat’s teeth. I teach clients how to make toothbrushing a daily routine. If toothbrushing is not a possibility, I may recommend a special diet, discuss various oral care products, or recommend frequent professional evaluation and treatments.
What advancements have been made in veterinary dentistry? The new Porphyromonas bacterin dental vaccine is one exciting advancement. The vaccine targets three anaerobic bacteria that are responsible for causing periodontal disease and bone loss. Its use is not yet widespread — it is currently being used in dogs that have a high risk of developing periodontal disease. Also, more and more veterinary professionals are now able to use intraoral radiology to see pathology beneath the surface. Statistics reveal that 60% of pathology in the mouth is located under the gums. At our clinic, we’ve seen an amazing growth potential by using this technology. Like many other practices, when we first got the intraoral radiology machine, we were hesitant to use it and did so only when necessary. We started to see that when we did use it, we found pathology in adjacent teeth that we didn’t know needed to be treated. All of a sudden, we were seeing firsthand all of the statistics that we had read. Now, we conduct radiology on every dental patient. This has not only helped us increase the standard of care but has also increased our clinic’s profits. The increased revenue has allowed us to staff the operating room with more employees and purchase more advanced equipment. I think it’s exciting to be able to see veterinary professionals using the proper equipment and recognizing unexpected pathology so that their efforts can be directed toward care.
What advice do you have for new technicians starting out in the profession? Technicians need to know that they’re in control of their own careers. The extent of their career comes from the amount of effort that they’re willing to put into it. My advice for technicians is: Don’t limit www.VetTechJournal.com
yourself, and don’t be lazy about your career. Get as much education as you can — whether from CE seminars or from less conventional educational experiences, such as volunteering. If you want to achieve your goals and you’re not in a workplace that fosters career advancement, then you’re not in the right place. If you dream about accomplishing something, you should do whatever it takes to realize your dream. Also, never turn down opportunities. You’re not going to know if you’re going to be good at something or if you’re going to like it until you try it. When I started working with the AVDT, I never thought about the fact that I’d be asked to speak in front of a room filled with technicians. I panicked when I found out that I’d be expected to do so. The first time I spoke, I realized how much fun it was to share my passion with others. I soon learned that it’s important to try something before you say that you can’t do it.
What hopes do you have for the profession? My hope is that technicians will be fully utilized and empowered to grow and learn to their fullest potential. Everyone who goes into veterinary technology does it because they love animals. I want technicians to take that and run with it — the more they learn about the profession, the more opportunities they will have to improve their patients’ quality of life. A friend’s mother once said to me, “If you ever have an opportunity to do something or go someplace — within reason — you should do it. You never know who you’re going to meet or what the experience is going to hold for you. Chances are that you’re going to learn something from it.” I took that advice to heart and went from a naive technician who didn’t know what her potential was to someone who gets to speak to technicians from all over the country and interact with board-certified veterinarians. I think it’s because I did exactly what my friend’s mother suggested. Even if I was a little nervous or scared, I said, “Let’s see what this experience could bring for me.” That’s what I would really like for technicians — for them to have a little courage in themselves. If I had a dream, it would be that everyone would have the confidence to try something new. Veterinary Technician | FEBRUARY 2008 81
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EXPERT SUMMIT ON
PET FOOD PART TWO
Julie Churchill, DVM, PhD Assistant clinical professor Small animal nutrition University of Minnesota
Leighann Daristotle, DVM, PhD Manager of scientific communications P&G Pet Care
Kathryn E. Michel, DVM, MS, DACVN Associate professor of nutrition Chief, section of medicine The University of Pennsylvania
Sean Delaney, DVM, MS, DACVN* Senior executive vice president Chief scientific and medical officer Director of special projects Natura Pet Products, Inc. *When this roundtable was held, Dr. Delaney was assistant clinical professor at the University of California–Davis.
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VETERINARY LEARNING SYSTEMS, publisher of Veterinary Technician®, assembled a group of professionals — including clinical nutritionists, nutrition industry experts, veterinarians, a veterinary technician/clinical instructor, and an FDA director — to emphasize the importance of pet nutrition, not only in treating certain diseases but also in helping to maintain health. In part two, the discussion focuses on commercial pet food regulations, risks associated with homemade diets, and compliance.
www.VetTechJournal.com
Lisa M. Freeman, DVM, PhD, DACVN
Phil Roudebush, DVM, DACVIM
Professor Department of clinical sciences Tufts Cummings School of Veterinary Medicine
Director of scientific affairs Hill’s Pet Nutrition
Dottie Laflamme, DVM, PhD, DACVN
Mary B. Tefend, MS, LVT, VTS (ECC)
Senior pet nutrition scientist Nestlé Purina PetCare Global Resources
Clinical instructor Auburn University
Daniel McChesney, PhD
Karen Todd-Jenkins, VMD
Director Office of surveillance and compliance Center for Veterinary Medicine FDA
Staff veterinarian Veterinary Learning Systems
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Pet Food Summit — Part Two
UNDERSTANDING COMMERCIAL PET FOOD REGULATIONS Kathryn E. Michel, DVM, MS, DACVN, Moderator: In light of the 2007 pet food recall, are existing regulations sufficient to ensure the health and well-being of companion animals when considering such food safety issues as ingredients, additives, and by-products? Dottie Laflamme, DVM, PhD, DACVN: There are issues at all levels. There are USDA issues in terms of guidelines and inspections, import issues, and domestic issues. And of course, pet food companies have their own standards for determining the nutritional value of the ingredients and for testing for known contaminants. All of the major pet food companies have their own programs set up to confirm that ingredients meet specifications and to look for known toxins, such as aflatoxin,a and other known problems. What happened in the 2007 recall was deliberate contamination of an ingredient with something that we wouldn’t even think to look for. There’s very little that can be done if somebody wants to deliberately put a toxin into a food, whether it’s for human or pet consumption. Daniel McChesney, PhD: The recent melamineb recall has brought to the forefront different ways we think about contaminants. In the past, we’ve looked at products and said what can likely go wrong with them. For example, when using corn as an ingredient, you look for aflatoxin. There are some broad issues: We might consider pesticides or other production mistakes. This is the first time in which strictly economic adulteration was involved; therefore, the lesson we need to learn from and now take into consideration is economic adulteration of a product. This surely could have been detected by not looking at total nitrogen content and mathematically converting it into a protein number, which is the way products are looked at now. A protein analysis might have detected a problem, but that’s hindsight.
The other thing is that pet food and animal feed are regulated under the adulteration provision of the Food, Drug, and Cosmetic Act. So the presumption is that a company will make a product that is not adulterated or unsafe, and that’s a fairly broad definition of adulteration. Even though most commercial pet food companies operate under GMPsc and sanitary SOPs,d there are no regulations that require them to follow GMPs for nonmedicated feeds, which are virtually all the pet foods. Having said that, most companies do operate under these guidelines, but that’s a limitation if you want to take action against a company because of a problem. We’ve started to see a rise in Salmonella organisms in commercial diets, which was unheard of in the past. I don’t have an explanation for the rise in Salmonella organisms. Michel: How have you detected this rise in Salmonella organisms? McChesney: Routine surveillance. We routinely check animal feeds for Salmonella spp and pesticides. Michel: So this trend is new? McChesney: Yes, and we are seeing Salmonella organisms in dry or bagged product as opposed to canned product. Canned product tends to be opened and used in a relatively short period, whereas bagged product tends to be opened and fed over an extended period. Salmonella spp, which are our major concern, tend to not be equally distributed throughout the product. It’s probably not there in high levels if you look at colonyforming units per some unit of size. It’s a small amount that’s just randomly there. It becomes important to talk about sampling — how many samples to take — because that’s the power of your testing. The FDA tends to take 10 — we call them subsamples, but everybody else would call them samples — and evaluate them by using an enrichment technique. c
a
Aflatoxin is a toxin produced by mold. In animals, it can cause liver damage and even liver cancer. b Melamine is a chemical compound used in fertilizer and the manufacturing of plastic.
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GMPs (Good Manufacturing Practices) are not necessarily laws but are legal guidelines that are set up to ensure the safety of the product being manufactured. d SOPs (standard operating procedures) are written instructions that explain how a process is done from start to finish.
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Pet Food Summit — Part Two
The pet food companies we’re dealing with now tended to take one sample and use a nonenrichment technique. Michel: During the pet food recall, we heard the FDA officials say that pet foods are regulated and are required to be safe and unadulterated, but what you have just said is that the actual steps necessary to ensure safety are not spelled out for the industry. McChesney: That’s right. Phil Roudebush, DVM, DACVIM: Let me make a comment, however, because there is a misperception that regulatory agencies and regulations are only there to protect the consumer, and that isn’t the case. Industry has a critical role. Let me use an example that’s totally outside the pet food industry. Every 5 years, a group that represents industry — airplane manufacturers, the government, academics — comes up with standards for lubricants that are used on commercial and private aircraft. Companies have the technical know-how and share that information, allowing the industry as a whole to come up with regulations that protect the users and also the companies because they know what the regulations are and the standards they have to meet. McChesney: Another point is that the Association of American Feed Control Officials (AAFCO) is always talked about as a regulatory body when in fact it’s not. It’s an association of state regulatory people, and it was set up as a vehicle to allow commercial trade among the states. Laflamme: I’d like to clarify the point further. There is a misperception that pet food regulations have been created by the pet food industry and that AAFCO is an industry-driven group or the Pet Food Institute (PFI) is a ruling body. We need to bear in mind that while there is an institute that contributes opinions about regulations, it doesn’t have the ability to establish regulations. AAFCO is not a regulatory body, but it is composed of regulatory people from all 50 states. Regulations are enforced on the state level by the various members of AAFCO. Could you clarify what group, if any, has 86
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oversight for the safety of ingredients imported into this country? McChesney: The FDA, and we regulate these under the adulteration or misbranding provisions of the Food, Drug, and Cosmetic Act. The FDA looks at about 1% of the products crossing the borders. The wheat gluten protein from China was stopped because it was adulterated. The FDA, however, cannot detect all adulterated product, so it ultimately falls to the company to make a safe product. The FDA is different from the USDA. The USDA has a person assigned to all slaughter plants that are making a USDA-regulated product. The FDA has 80% of the food and feed plants and 20% of the resources, so it doesn’t marry up particularly well. We count more on our industry partners to do the job correctly, and industry usually does. In the recent recall involving melamine, less than 1% of commercial foods were affected. Michel: The measures that are taken by companies to ensure the quality and safety of products and the sources of their ingredients are primarily on a voluntary basis. How can we educate people to look at the qualityassurance (QA) aspects of pet food manufacturing rather than just marketing? McChesney: It’s difficult because during the pet food recall, we worked closely with the companies and witnessed their processes, but we are not allowed to advertise this information or promote any company or its oversight measures. And when a company projects this information, it sounds self-serving. So the companies were caught in the middle. Leighann Daristotle, DVM, PhD: Most of the major pet food companies have been fairly vocal about the quality control in place and have QA programs accordingly. Roudebush: From a standards standpoint, Hill’s is owned by a consumer products company, and so pet food is internally regulated similar to any other consumer product. Colgate sets a standard for all products — whether toothpaste or dishwashing liquid or underarm deodorant — and that is what is followed for pet food. But is that approach www.VetTechJournal.com
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Thanks to OraVet™, Frankie got help with his halitosis problem – and he got Lucille. Frankie just wished his owner had started him on OraVet sooner.
OraVetTM is clinically proven to help reduce plaque and calculus formation. Left untreated, these conditions can lead to gum disease and bad breath. OraVet is an oral healthcare system that starts with your dental cleaning protocol and continues in the dog owner’s home. The OraVet system facilitates dog-owner compliance and helps improve the oral health of dogs. MAKE ORAVET A PART OF EVERY PROPHY. For more information, please contact your local Merial Sales Representative or Merial Sales Agent Representative, call us at 1-888-MERIAL-1 (1-888-637-4251) or visit www.oravet.com. ORAVET and FLIP THE LIP are trademarks of Merial. ©2008 Merial Limited, Duluth, GA. All rights reserved. OVT08CNFRNKTRADEAD.
TM
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Encourage each client to “Flip the Lip™” and check their pet’s teeth.
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Pet Food Peer Summit Reviewed — Part Two
right for pet food? I don’t know. But we need to start somewhere. If a certain number of complaints per 100,000 units produced are made, then that triggers an additional evaluation from quality control. McChesney: In the most recent melamine issue, the FDA received about 18,000 calls, but when we asked for records and talked to veterinarians, there was virtually no diet history. When we asked, “What did you feed?,” the answer generally was, “Whatever happened to be in the cabinet at the time.” It may or may not have been related. We probably have 400 or 500 clinical records and pathology results, and after reviewing the information, there was nothing about how long a dog had been on this diet or what it had been eating — nothing on its diet history. This information is not routinely asked or documented in veterinary records.
Mary B. Tefend, MS, LVT, VTS (ECC): Or, veterinarians could use their technicians because, typically, they spend more time in the exam room with the client than the veterinarian does. We have been talking a lot about educating students and veterinarians but have not mentioned technician education. That needs to be right up in the forefront — educating technicians on how to take a good patient history, including obtaining a diet history. This could ensure documentation if a product or quality control is questioned. Roudebush: The reality is that most of us think if the company is reputable, then it is assumed that quality-control procedures are in place. Michel: That reasoning is partly why there was outrage, at least among a certain segment of the pet-owning population, about whether the recall could have been prevented last spring. There was concern that no one was minding the store. One of the things I always tell students is that people think that products are a lot more regulated than they are. People assume that the government — even though they don’t want big government — is watching out for them. And so they are absolutely shocked and appalled when something happens, whether it’s Escherichia coli in spinach, Salmonella organisms in peanut butter, or melamine in dog food. They are upset that it happened.
“Educating technicians on how to take a good patient history, including obtaining a diet history, needs to be right up in the forefront.” Mary B. Tefend, MS, LVT, VTS (ECC)
We did a lot of work with Banfield, The Pet Hospital, and there was no diet history in any of those records. Now, Banfield is adding that as a required field. Based on what we’ve seen, diet history is rarely asked by veterinarians. Roudebush: From what we saw in reviewing records for the recall, there may be documentation — usually an invoice for a therapeutic food dispensed by the hospital — but you’re right, documentation of what the animal is eating, including snacks, is lacking. None of that information was asked. It could easily be done by obtaining a dietary history and making that part of the medical record. 88
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Karen Todd-Jenkins, VMD: Which brings up two questions: Do you think that consumers are recovering from what happened? And second, at some point, is food sourcing going to have to be on the label? McChesney: Unfortunately, if you tried to include the country of origin on pet food labeling, you’d probably have 30 countries listed. Michel: Regarding the first question, absolutely. The PFI reported that 73% of consumers say they are confident or very confident in the safety of their pet food, according to three rounds of public opinion surveys conducted www.VetTechJournal.com
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by the PFI. Results also show that nearly an identical percentage say they are staying with their preferred brand of food. Laflamme: And that survey was conducted soon after the recall, so the probability is great that those numbers are even higher now. Julie Churchill, DVM, PhD: If we were building a wish list of what we want veterinary professionals to know, it would be the importance of and how to take a diet history because it’s really the cornerstone of practicing sound clinical nutrition.
Sean Delaney, DVM, MS, DACVN: I think we should ask why owners would feed their pet a homemade diet and will the industry respond. Making a homemade diet balanced is a lot of work. Perhaps the owners feel that with a homemade diet, they know what they’re feeding their pet. I think there’s also the aspect that there are owners who inherently believe that raw or homemade diets are how their pet should be fed. Laflamme: Since the recall, more pet owners are feeding homemade diets, and we’re starting to receive reports about signs of nutritional deficiency associated with some of the homemade diets. Are any of you experiencing that too?
Michel: In terms of obtaining a complete diet history, the veterinary technician could play a prominent role in that. We send clients home all the time with a diet history form and ask them to write down what’s in their cupboard. I know that some clinics have put the form on the Web so it can be downloaded in advance of an office visit. There are different ways to do it, but it’s Kathryn E. Michel, DVM, MS, DACVN often not going to happen. The bottom line is, in Tefend: We’ve seen patients with chronic this day and age, we’re not going to be able vomiting and diarrhea. Recently, we treated to teach the modern veterinary student a patient not for deficiency but for calcium everything he or she needs to know. The overload because the owner was feeding a mantra in the veterinary schools has been that we need to teach students to be able to homemade diet and read that prepared think critically and find the information. All foods can be low in calcium. So the owner of the companies produce information. The started giving the pet calcium supplements. Because the animal was older, we were worFDA has information on its Web site, and ried about renal problems that could be there are many CE courses, but veterinariassociated with hypercalcemia. ans have to actively seek that information. So in answer to your question, we are HOMEMADE DIETS treating more patients for nutrition-related Michel: The pet food recall prompted some problems since the pet food recall. owners to consider feeding their pet a homemade diet. What are some key things Churchill: I wholeheartedly agree that there that practitioners and veterinary technicians is a place for homemade diets when they should be able to talk to their clients about are complete and balanced. However, I frein terms of alternatives to commercial pet quently see well-meaning owners make foods or conventional commercial pet substitutions to the recipe until, over time, foods? What are some of the issues that they “diet drift” occurs and the diet no longer need to be informed about? resembles the original formulation.
“The Pet Food Institute reported that 73% of consumers say they are confident or very confident in the safety of their pet food, according to three rounds of public opinion surveys conducted by the PFI.”
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Conducting a
Substitutions are made for various reasons: difficulty finding a calcium supplement, desire for variety, etc. At times, clients add potentially unsafe ingredients because of ignorance. Owners may not realize that some of the things that are human grade, such as grapes, wine, and beer, can be toxic to pets.
Successful Staff Meeting
Tefend: And in some cases, the owners are using the proper ingredients, but they overcook by Kristen Hoffman, BS them to the point that the nutrients are gone. Veterinary
nician should find out why not. Diet may be a crucial part of treatment. For example, if a patient is treated for pancreatitis, recurrence can be prevented through diet. At the university, we see more than 100 patients a week, so follow-up would be extremely difficult. So it would help if a system was established to communicate better with the referring veterinarian. He or she could then be made aware of our recommendation and follow up with the client to prevent recurrence.
Roudebush: Compliance involves much more than owner compliance, and we’ve had a tendency as a profession to place all blame or focus on owner compliance. An AAHA compliance study, however, showed that the largest communication gap occurred during the initial dietary recommendation made by the veterinarian. It’s that initial recommendation and the acceptance by the client Phil Roudebush, DVM, DACVIM that are important. As part of the AAHA study, veterinarians were videotaped while talking to clients. Lisa M. Freeman, DVM, PhD, DACVN: Because of The study findings indicated that veterinarithese latest concerns, we as veterinary proans think they’ve made a specific recommenfessionals must clear up the myths and misdation, but they really haven’t. conceptions about commercial pet foods. In the study, 80% of the veterinarians said, We need to warn owners about the risks “Oh yes, I made a dietary recommendation.” associated with homemade and raw food But only 10% or 15% of the owners said, diets. If an owner really feels strongly about “Well, yes, they made that recommendation.” feeding a homemade diet, then both the For example, if a patient has chronic kidney owner and veterinarian should have the diet disease and there’s clear evidence that a theraformulated properly by someone who peutic renal food can prolong the patient’s knows what they’re doing. The owner needs survival and quality of life, the veterinarian’s to be given instructions on how to prepare recommendation should strongly urge client the food properly, and the veterinary staff compliance by saying, “We need to make a must monitor the pet on a regular basis. dietary change because the evidence is clear that doing so will significantly make a differENCOURAGING COMPLIANCE ence in your pet.” Then when the technician Michel: How can veterinary professionals comes into the room, she or he should reencourage owners to feed their pet a diet by saying, “The OMMUNICATION within a veterinary practice isinforce vitalthat to recommendation practice that is appropriate? doctor has prescribed this food, and here’s development and success. The practice managerinformation is responsible about the recommendation.” Tefend: When a pet is discharged and a dietary The receptionist should call the owner or forcommunicating policies and procedures; upholding the practice’s recommendation is made, there should be schedule an office visit in 6 weeks to see how mission, standards, and core values; a pet comfortable some follow-up. A system shouldand be setcreating up so the is doing and recommend continuing that someone on the staff calls the owner in a nutritional management as needed. environmentmonth for feedback and generation of new ideas. One tool a practice to see how the pet is transitioning. If I think making a strong, clear recommenmanager may to communicate these a staff theuse pet isn’t being fed the new diet, the topics tech- isdation up meeting. front is important.
“Compliance involves much more than owner compliance, and we’ve had a tendency as a profession to place all blame or focus on owner compliance.”
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Options for Treating * a Fractured Tooth
T
OOTH FRACTURES ARE COMMON in cats and dogs.1 Teeth may fracture when an animal chews on hard objects, fights with another animal, or experiences an impact injury (e.g., as a result of being hit by an automobile). When an animal has an open tooth fracture, in which the pulp is exposed, the treatment options available are root canal, vital partial pulpectomy, or extraction. Although a pet may be referred to a board-certified veterinary dentist for treatment, understanding the basic anatomy of the tooth is essential for veterinary technicians, who may evaluate a pet that presents to the practice with a fractured tooth. Structure of the Tooth The teeth of cats and dogs are structurally the same but differ in size and shape. The crown of a tooth refers to the portion that is visible above the gingival margin. The root lies
Jodi A. Kristel, CVT, VTS (Dentistry) University of Pennsylvania
below the gingival margin and is attached to alveolar bone by the periodontal ligament.2 When evaluating a tooth fracture, it is important to determine whether it extends under the gingival margin and into the root or whether only the crown is involved. The crown of a tooth is covered with enamel, a dense, smooth material.2 Enamel is the hardest tissue in the body; however, it is susceptible to wear and damage and cannot repair itself.3 During tooth development, ameloblasts are responsible for secretion of the enamel matrix. Enamel, which is usually white, can appear yellow — if the underlying dentin is exposed — and can be stained over time. The dentin layer lies beneath the enamel. Dentin is a hard material that is usually yellow in color. It is produced by odontoblasts, which continue to deposit layers throughout an animal’s life, resulting in narrowing of the pulp cavity (discussed below) with age. Dentin can *Laws regarding who is allowed to perform veterinary dental procedures vary from state to state. Therefore, technicians should check with their local veterinary medical board before performing any dental procedures.
Enamel Dentin Pulp chamber Crown
Gingiva Root canal Mucosa Cortex of alveolar bone (lamina dura)
Root
Cementum Apex
Apical delta
Periodontal ligament
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be divided into three main types: primary, secondary, and tertiary. Primary dentin is formed before tooth eruption, secondary dentin is formed after the adult tooth erupts, and tertiary (reparative) dentin forms in response to trauma to the tooth.3 The thin layer of calcified tissue that covers the root surface is called cementum. Cementoblasts are responsible for producing cementum, which is one of the supporting structures of the tooth.3 The periodontal ligament, which connects the tooth to the alveolar bone, surrounds and cushions the tooth and is embedded in the cementum. The periodontal ligament contains nerve fibers that transmit sensory information (e.g., pain, heat, cold).3 Radiographic changes in the periodontal ligament (e.g., widening of the periodontal space, periapical lucencies) may indicate periodontal and/or endodontic disease. The pulp is located in the pulp cavity, which comprises the pulp chamber and root canal. The pulp is the innermost layer of the tooth and consists of blood and lymphatic vessels, nerves, collagen fibers and other connective tissue, and odontoblasts. Because it contains the nerves of the tooth, the pulp is responsible for pain transmission.3 The apex, which is the tip of the root, is usually open in animals less than 18 months of age and closes as animals mature.3 Young animals, which have an open root apex and relatively thin dentinal walls, are not good candidates for root canal therapy in the event of a tooth fracture; therefore, procedures such as vital partial pulpectomy or extraction may be better options.
CHEWABLES CAUTION: Federal (U.S.A.) law restricts this drug to use by or on the order of a licensed veterinarian. INDICATIONS: For use in dogs to prevent canine heartworm disease by eliminating the tissue stage of heartworm larvae (Dirofilaria immitis) for a month (30 days) after infection and for the treatment and control of ascarids (Toxocara canis, Toxascaris leonina) and hookworms (Ancylostoma caninum, Uncinaria stenocephala, Ancylostoma braziliense). DOSAGE: HEARTGARD® Plus (ivermectin/pyrantel) Chewables should be administered orally at monthly intervals at the recommended minimum dose level of 6 mcg of ivermectin per kilogram (2.72 mcg/lb) and 5 mg of pyrantel (as pamoate salt) per kg (2.27 mg/lb) of body weight. The recommended dosing schedule for prevention of canine heartworm disease and for the treatment and control of ascarids and hookworms is as follows: Dog Chewables Ivermectin Pyrantel Weight Per Month Content Content Up to 25 26 - 50 51 - 100
When patients present to the veterinary practice with a
fractured tooth,
it is important to determine whether the pulp is exposed.
Oral Examination When patients present to the veterinary practice with a fractured tooth, it is important to determine whether the pulp is exposed (i.e., an open fracture). This type of fracture is usually painful and requires immediate medical attention. A fracture in which the enamel and/or dentin is chipped but the pulp is not exposed (i.e., a closed fracture) may not require immediate treatment1; however, the tooth should be assessed radiographically every 6 to 12 months. The patient is anesthetized so that a detailed oral examination with thorough charting can be performed. An area of pulp exposure can be found with the use of a fine-tipped dental www.VetTechJournal.com
Veterinary Technician | FEBRUARY 2008
1 1 1
68 mcg 136 mcg 272 mcg
57 mg 114 mg 227 mg
Color Coding 0n Foil-Backing and Carton Blue Green Brown
HEARTGARD Plus is recommended for dogs 6 weeks of age and older. For dogs over 100 lb use the appropriate combination of these chewables. ADMINISTRATION: Remove only one chewable at a time from the foil-backed blister card. Return the card with the remaining chewables to its box to protect the product from light. Because most dogs find HEARTGARD Plus palatable, the product can be offered to the dog by hand. Alternatively, it may be added intact to a small amount of dog food.The chewable should be administered in a manner that encourages the dog to chew, rather than to swallow without chewing. Chewables may be broken into pieces and fed to dogs that normally swallow treats whole. Care should be taken that the dog consumes the complete dose, and treated animals should be observed for a few minutes after administration to ensure that part of the dose is not lost or rejected. If it is suspected that any of the dose has been lost, redosing is recommended. HEARTGARD Plus should be given at monthly intervals during the period of the year when mosquitoes (vectors), potentially carrying infective heartworm larvae, are active. The initial dose must be given within a month (30 days) after the dog’s first exposure to mosquitoes. The final dose must be given within a month (30 days) after the dog’s last exposure to mosquitoes. When replacing another heartworm preventive product in a heartworm disease prevention program, the first dose of HEARTGARD Plus must be given within a month (30 days) of the last dose of the former medication. If the interval between doses exceeds a month (30 days), the efficacy of ivermectin can be reduced. Therefore, for optimal performance, the chewable must be given once a month on or about the same day of the month. If treatment is delayed, whether by a few days or many, immediate treatment with HEARTGARD Plus and resumption of the recommended dosing regimen will minimize the opportunity for the development of adult heartworms. Monthly treatment with HEARTGARD Plus also provides effective treatment and control of ascarids (T. canis, T. leonina) and hookworms (A. caninum, U. stenocephala, A. braziliense). Clients should be advised of measures to be taken to prevent reinfection with intestinal parasites. EFFICACY: HEARTGARD Plus Chewables, given orally using the recommended dose and regimen, are effective against the tissue larval stage of D.immitis for a month (30 days) after infection and, as a result, prevent the development of the adult stage. HEARTGARD Plus Chewables are also effective against canine ascarids (T. canis, T. leonina) and hookworms (A. caninum, U. stenocephala, A. braziliense). ACCEPTABILITY: In acceptability and field trials, HEARTGARD Plus Chewables were shown to be an acceptable oral dosage form that was consumed at first offering by the majority of dogs. PRECAUTIONS: All dogs should be tested for existing heartworm infection before starting treatment with HEARTGARD Plus which is not effective against adult D. immitis. Infected dogs must be treated to remove adult heartworms and microfilariae before initiating a program with HEARTGARD Plus. While some microfilariae may be killed by the ivermectin in HEARTGARD Plus at the recommended dose level, HEARTGARD Plus is not effective for microfilariae clearance. A mild hypersensitivitytype reaction, presumably due to dead or dying microfilariae and particularly involving a transient diarrhea, has been observed in clinical trials with ivermectin alone after treatment of some dogs that have circulating microfilariae. Keep this and all drugs out of the reach of children. In case of ingestion by humans, clients should be advised to contact a physician immediately. Physicians may contact a Poison Control Center for advice concerning cases of ingestion by humans. Store at controlled room temperature of 68°F - 77°F (20°C - 25°C). Excursions between 59°F - 86°F (15°C - 30°C) are permitted. Protect product from light. ADVERSE REACTIONS: In clinical field trials with HEARTGARD Plus, vomiting or diarrhea within 24 hours of dosing was rarely observed (1.1% of administered doses). The following adverse reactions have been reported following the use of HEARTGARD: Depression/lethargy, vomiting, anorexia, diarrhea, mydriasis, ataxia, staggering, convulsions and hypersalivation. SAFETY: HEARTGARD Plus has been shown to be bioequivalent to HEARTGARD, with respect to the bioavailability of ivermectin. The dose regimens of HEARTGARD Plus and HEARTGARD are the same with regard to ivermectin (6 mcg/kg). Studies with ivermectin indicate that certain dogs of the Collie breed are more sensitive to the effects of ivermectin administered at elevated dose levels (more than 16 times the target use level) than dogs of other breeds. At elevated doses, sensitive dogs showed adverse reactions which included mydriasis, depression, ataxia, tremors, drooling, paresis, recumbency, excitability, stupor, coma and death. HEARTGARD demonstrated no signs of toxicity at 10 times the recommended dose (60 mcg/kg) in sensitive Collies. Results of these trials and bioequivalency studies, support the safety of HEARTGARD products in dogs, including Collies, when used as recommended. HEARTGARD Plus has shown a wide margin of safety at the recommended dose level in dogs, including pregnant or breeding bitches, stud dogs and puppies aged 6 or more weeks. In clinical trials, many commonly used flea collars, dips, shampoos, anthelmintics, antibiotics, vaccines and steroid preparations have been administered with HEARTGARD Plus in a heartworm disease prevention program. In one trial, where some pups had parvovirus, there was a marginal reduction in efficacy against intestinal nematodes, possibly due to a change in intestinal transit time. HOW SUPPLIED: HEARTGARD Plus is available in three dosage strengths (see DOSAGE section) for dogs of different weights. Each strength comes in convenient cartons of 6 and 12 chewables. For customer service, please contact Merial at 1-888-637-4251. 1
Marketing Dynamics; Monthly share report, Vet dispensed treatments; 4/01/07; data on file.
2
Of dogs showing a preference in three studies conducted by independent investigators, dogs preferred HEARTGARD Plus Chewables over INTERCEPTOR® (milbemycin oxime) FLAVOR TABS® by a margin of 37 to 1; data on file at Merial.
3
Results of a survey of more than 12,500 households by AC Nielsen. Data on file at Merial.
4
Guarantee void where prohibited by law. Payment obligation of Merial limited solely to that specified in official Plus Guarantee terms and conditions; any and all other costs expressly excluded. ®HEARTGARD and the Dog & Hand logo are registered trademarks of Merial. ®INTERCEPTOR is a registered trademark of the Novartis Corporation. ®FLAVOR TABS is a registered trademark of Novartis AG. ©2007 Merial Limited, Duluth, GA. All rights reserved. HGD07NAAUGTRDAD
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Courtesy of the University of Pennsylvania
CE Article #1
Exposed or open pulp canals.
Radiograph of a second molar with a periapical abscess on each root (arrows).
explorer. When performing dental charting, it is important to check the crowns of all teeth for open pulp cavities. Pulp exposure can be confirmed when the tip of the explorer falls into the exposed cavity. When the pulp is exposed, oral bacteria can enter the tooth, resulting in pulp necrosis, infection, and root abscessation.3 A common clinical finding is swelling of the alveolar processes of the infected tooth and maxillofacial swelling due to cellulitis. This swelling may be responsive to antibiotics; however, if the fractured tooth is not treated or extracted, the abscess may return after antibiotic treatment is stopped.2 Open tooth root abscesses commonly drain externally through the skin or intraorally at the mucogingival junction of the infected tooth.
with a facial abscess, its teeth should be checked for fractures. A tooth can be worn down gradually over time and appear to be fractured, with a brown spot in the center; however, when explored, the tooth surface has a smooth, glass-like feel. In this case, the tooth may have repaired itself with tertiary dentin and does not likely need further treatment.2 After the oral examination, any findings should be confirmed by radiography.
Courtesy of the University of Pennsylvania
Treatment
Internal fistula draining tracts at the mucogingival junction.
The teeth most commonly fractured are the upper fourth premolars in dogs and the canines in both dogs and cats. Because patients with a fracture of the upper fourth premolar often present with facial swelling ventral to the medial canthus of the eye, they are sometimes incorrectly diagnosed with an eye problem. Therefore, if a patient presents 94
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When a patient presents to the veterinary practice with an open tooth fracture, the three treatment options are standard root canal therapy, vital partial pulpectomy, and extraction. The option selected depends on the duration of the problem and the age of the animal, as well as the owner’s preference. By discussing the treatment options and their associated follow-up requirements, veterinary staff can help owners select the most appropriate option for their pet. For example, after patients undergo root canal therapy or vital partial pulpectomy, regular followup — including radiographic examination under anesthesia — is necessary. Therefore, an animal that is often stressed or aggressive or that has a systemic illness, such as renal disease, may not be a good candidate for either procedure. In these cases, tooth extraction may be a better option.
Root Canal Therapy The goal of standard root canal therapy is to remove the source of infection — the inflamed pulp — and maintain the function of the tooth.3 Root canal therapy is indicated in patients with a fractured crown with pulp exposure, www.VetTechJournal.com
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HEARTGARD Plus harnesses the irresistible power of real beef for heartworm prevention and the control of roundworms and hookworms in dogs. What dogs are getting: • The #1 veterinarian-recommended heartworm preventive1 • Treatment and control of common canine parasites (roundworms and hookworms) that can cause zoonotic disease in humans, including children • The real-beef taste dogs prefer 37:12 • The preventive owners prefer to give 3:1 over the next leading brand3 • The HEARTGARD Plus Guarantee of Satisfaction4 HEARTGARD is well tolerated. All dogs should be tested for heartworm infection before starting a preventive program. Following the use of HEARTGARD, digestive and neurological side effects have rarely been reported. For more information, please visit www.HEARTGARD.com. Circle 190 on Reader Service Card
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CE Article #1 a worn tooth with pulp exposure, a carious lesion that extends into the pulp chamber, a nonvital discolored tooth, a tooth crown that appears opaque when transilluminated, or an avulsed tooth that was reimplanted.4 Root canal therapy is also indicated when there is radiographic evidence of a periapical lucency.4 The root canal procedure is divided into several stages; radiographs should be taken at each stage. Following radiographic confirmation of the tooth fracture, a round carbide bur on a high-speed handpiece is used to access the pulp chamber. A small opening is created through the enamel into the pulp chamber to enable straight-line access to the apex.4 Cleaning and shaping of the canal involves the use of items such as reamers, Hedstrom files, irrigation syringes, barbed broaches, paper points, a ruler, endodontic stops, and college pliers; endodontic chelating agents such as RC-Prep MicroDose (Premier Products Co.; Plymouth Meeting, PA); solutions such as sodium hypochlorite; and various root canal filling materials. Materials used to fill the canal include zinc oxide–eugenol (ZOE) and gutta-percha points. ZOE is a common sealant used in veterinary dentistry.5 It is nonirritating and antimicrobial, with a long working time. ZOE is mixed on a glass slab with a number 5 spatula. When ZOE is mixed to the proper consistency, a halfinch string will form when the spatula is lifted off the slab.5 A spiral filler placed on a reduction gear contra-angle on a low-speed handpiece can be used to insert the ZOE into the canal.4 Gutta-percha is an inert rubbery material derived from the latex of tropical trees such as Palaquium gutta. Most commonly used
B
C
D Courtesy of the University of Pennsylvania
A
is the beta form, which is soft and flexible to allow for compaction into the canal.5 Guttapercha points are available in different sizes to accommodate various canal widths and lengths. Gutta-percha can also be heated in a cannula syringe and injected into the canal.4 Spreaders and pluggers are used to condense the gutta-percha to adequately fill the canal without dead space. The final stage of the root canal procedure involves placing restorative material over the access and fracture sites. Three types of restorative material used in dentistry are composites, glass ionomers, and amalgams.5 Composites are commonly used in veterinary dentistry. Some owners may prefer composites for their pet because they produce the most aesthetically pleasing results. They are available in various shades of white to match the tooth color. Glass ionomers are often used as an intermediate layer above the gutta-percha and root canal sealer and beneath the final composite restoration. Amalgams are usually used on the occlusal surfaces of the back teeth because of the compression forces exerted on these teeth. Amalgams are the strongest of the three restoratives, but there are several disadvantages to their use.4 Because they are silver in color, they produce the least aesthetically pleasing results. They also contain mercury; therefore, veterinary staff exposure to mercury is a concern. However, the potential for exposure can be minimized if the amalgam is supplied in capsule form; the capsule contains a protective membrane to prevent personnel from handling the material. Undercut preparation, in which dentin and enamel are removed, is required to hold the amalgam in place. In addition, amal-
A fractured tooth at various stages of root canal therapy. Note the new access site created in the tooth (A). Both the access site and the fracture site were widened to allow easier cleaning, obturation, and placement of the restorative material. The same tooth with zinc oxide–eugenol and gutta-percha in place (B) and at the completion of root canal therapy (C). The tooth has a smooth coronal surface with intact restorations. Note that mild gingival inflammation is present; this is temporary and is common postoperatively. Lateral intraoral radiograph of the same tooth obtained with a bisecting-angle technique (D). The radiograph shows complete endodontic obturation, a solid glass ionomer intermediate layer, and complete composite resin restoration of both the access and fracture sites. A small air bubble can be seen between the glass ionomer and composite resin layers. An air bubble may affect the success of the procedure; ideally, the tooth should be free of air bubbles and have a complete fill. 96
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gam placement requires that more tooth material be removed compared with placement of the other restoratives. Amalgam has also been shown to corrode, causing a black line to develop around the margin of the restoration over time.4 During restoration, dentin conditioner is applied to the dentin, and etching gel is applied to the enamel to remove any tooth debris from the access and fracture sites.5 Conditioning and etching also create irregularities that help the bonding agents adhere. A primer is then applied to prepare the surface for the bonding adhesive. Composite material is placed in layers that are 1 to 2 mm thick; each layer must be cured according to the manufacturer’s directions.5 Depending on the material, light curing or chemical curing may be used. More than one layer may be necessary to completely overlap the margins of the access and fracture sites. The tooth surface is then contoured and polished smooth with trimming burs and sanding disks of various grits.5 In certain situations, a crown may be placed to prevent further destruction of the tooth. The most common material used for crowns is semiprecious metal.4 The decision to place a metal
crown involves consideration of the patient’s lifestyle. A metal crown should be placed in working dogs (e.g., police, military, prison, guide).4 Metal crown placement requires additional expenses and increased anesthesia time. A disadvantage to applying a metal crown is that more of the enamel or tooth surface must be removed, causing further weakening of the tooth.5 Options include a full jacket crown that covers the whole tooth or a partial crown that covers a portion of the tooth.4 The tooth must be prepared to allow a tight fit, and impressions and models need to be made and sent to a dental laboratory for crown fabrication. A temporary crown is usually created from acrylic or composite material to protect the tooth until the permanent metal crown can be placed. In some cases, standard root canal therapy may be unsuccessful. Clinically, the most obvious signs of unsuccessful treatment are continued periapical disease with abscessation, facial swelling, and formation of a sinus tract — an opening in the mucogingival junction or external skin associated with an inflamed or infected area of the tooth root.6 If it is suspected that the procedure was unsuccessful, radiographs should be taken to pro-
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D Disorientation, awareness
Gets lost in familiar locations Goes to wrong side of door (e.g. hinge side) Is less responsive to stimuli
2 2 3
1 1 1
1 0 0
0 0 0
I Interaction
Decreased greeting behavior Alterations or problems with social hierarchy
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S Sleep-wake cycle
Increased daytime sleep
3
2
2
1
H House-soiling, learning & memory
Indoor elimination Impaired working ability Decreased ability to perform tasks
1 3 3
0 2 2
0 1 1
0 1 1
A Activity: decreased or repetitive
Pacing or aimless wandering Decreased exploration or activity: apathy Appetite decrease or disinterest
3 3 2
1 2 1
0 1 0
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CE Article #1 vide definitive confirmation. A periapical lucency may indicate continued infection.6 If the root canal procedure fails, a second procedure (with better obturation) or extraction may be performed. If the previous technique appears to be adequate, then surgical root canal therapy may be attempted.6 Surgical root canal therapy, in contrast to standard root canal therapy, involves incising the skin or alveolar mucosa near the affected tooth, performing alveolectomy or apicoectomy, accessing the root canal through the cut apical end of the root, and sealing the canal with a retrograde filling.4
Vital Partial Pulpectomy
Glossary Alveolectomy Surgical removal of part of the alveolar process Ameloblast Cell involved in the formation of enamel Apexogenesis Stimulation to make the end of the tooth root close in a damaged tooth with healthy pulp Apicoectomy Surgical removal of the tooth root apex Cellulitis Diffuse inflammation of the skin and soft tissues caused by a bacterial infection Cementoblast Large cell involved in cementum formation Mucogingival junction Junction between the oral mucosa and the attached gingiva Obturation Filling of the root canal with a sealing agent Odontoblast Cell responsible for depositing dentin Periapical lucency Lesion at the tooth root apex seen radiographically
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Standard root canal therapy involves complete removal of the pulp, whereas vital partial pulpectomy involves removal of only the infected pulp.2 In certain situations, vital partial pulpectomy may be performed instead of root canal therapy. For example, vital partial pulpectomy may be performed in a fractured tooth with pulp exposure in an animal younger than 18 months if the fracture occurred within 2 weeks of presentation. An animal older than 18 months that presents with a fractured tooth with pulp exposure may also be a good candidate for vital partial pulpectomy if the fracture occurred within 48 hours of presentation.4 Vital partial pulpectomy allows for further apexogenesis, root lengthening, and narrowing of the pulp cavity. This procedure requires both clinical and radiographic monitoring to check for any signs of failure. The risk of failure is greater for vital partial pulpectomy than for root canal therapy because bacteria present in the root canal may infect the remaining pulp. Standard root canal therapy may be needed if vital partial pulpectomy is unsuccessful.4 Therefore, clients should be informed of this risk when deciding among the treatment options.
Extraction Because of the cost and follow-up care associated with root canal therapy and vital partial pulpectomy, extraction may be the only option. Extraction is usually performed by, or under the supervision of, a veterinarian. Extraction is indicated in patients with a fracture in a primary (deciduous) tooth, a fracture that extends below the gingival margin, a
FEBRUARY 2008 | Veterinary Technician
root fracture, a tooth in which more than onethird of the root is compromised, severely worn teeth, or severe periodontal disease, as well as in older animals with extremely narrow and inaccessible root canals.2 Extraction may also be performed in patients with a systemic condition if they cannot undergo the follow-up anesthetic induction needed for radiographic assessment of treated teeth.
Follow-Up Care Postoperative care of patients that undergo root canal therapy, vital partial pulpectomy, or extraction should include the use of pain medication for at least 3 days; patients may also receive a course of antibiotics. Another important part of root canal therapy and vital partial pulpectomy is follow-up radiography at 6 months and yearly thereafter.4 During follow-up visits, the patient will need to be anesthetized so that intraoral radiographs of the treated tooth can be taken. In addition, follow-up visits may be combined with dental prophylaxis, which requires general anesthesia.
Role of the Technician During the oral examination, the technician charts the patient’s teeth. When a patient undergoes root canal therapy or vital partial pulpectomy, the technician mixes and prepares the necessary materials, takes radiographs, and provides the veterinary dentist with the appropriate instruments.1 The technician also plays an important role in providing postoperative home care instructions to the client.
Conclusion During the regular patient checkup, the technician should carefully evaluate the pet’s oral cavity for any signs of tooth fracture or other abnormal findings. In patients with an open tooth fracture, root canal therapy or vital partial pulpectomy can be a successful treatment option that maintains the function of the tooth while eliminating discomfort and improving the pet’s quality of life. In some patients, however, extraction may be the only option. It is important that technicians help clients understand the available options for treatment, as well as the associated follow-up requirements, so that the clients can choose the procedure that is most appropriate for their pet. www.VetTechJournal.com
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Peer Reviewed
References
1. Kesel ML: Veterinary Dentistry for the Small Animal Technician. Ames, IA, Iowa State University Press, 2000, pp 167, 233, 235.
2. Harvey CE, Emily PP: Small Animal Dentistry. St. Louis, Mosby, 1993, pp 156–211. 3. Wiggs RB, Lobprise HB: Veterinary Dentistry: Principles and Practice. Philadelphia, LippincottRaven, 1997, pp 280–321.
ABOUT THE AUTHOR
Jodi A. Kristel,
CVT, VTS (Dentistry)
4. Holmstrom SE, Frost P, Eisner ER: Veterinary Dental Techniques for the Small Animal Practitioner. Philadelphia, WB Saunders, 1998, pp 348–407, 462–463. 5. Holmstrom SE: Veterinary Dentistry for the Technician and Office Staff. Philadelphia, WB Saunders, 2000, pp 252–270. 6. Niemiec BA: Fundamentals of endodontics. Vet Clin North Am Small Anim Pract 35(4):837–868, 2005.
“Fractured teeth are often left untreated,” says Jodi. “A tooth fracture is painful and requires appropriate therapy — there are more options than simply pulling the tooth.” Jodi is a veterinary dental technician at the University of Pennsylvania School of Veterinary Medicine. She and Bonnie Miller, RDH, started their own business, VetDent CE Associates, which provides Web-based dental education to technicians and veterinarians, and they are planning to publish a book on dental techniques. Jodi and her husband, Anthony, have two daughters, Olivia and Samantha, along with a cat, Wylie.
Article #1 CE Test The article you have read qualifies for 0.5 credit hour. To receive credit from Alfred State College, choose the best answer to each of the following questions. Either fax (800-589-0036) your answers or participate online.
1. __________ dentin is formed after the adult tooth erupts. a. Primary c. Tertiary b. Secondary d. a and c 2. What is the innermost layer of the tooth? a. dentin c. pulp b. cementum d. gingiva 3. Which of the following regarding enamel is false? a. Enamel is a smooth, dense material that covers the crown. b. Enamel is not susceptible to damage and wear. c. Enamel is the hardest tissue in the body. d. Although usually white, enamel can appear yellow or brown over time. 4. The periodontal ligament a. connects the tooth to the alveolar bone. b. surrounds and cushions the tooth. c. is embedded in the cementum. d. all of the above www.VetTechJournal.com
5. Which of the following is not a permanent restorative surface material used in veterinary dentistry? a. composite c. ZOE b. glass ionomer d. amalgam 6. Pulp exposure can be confirmed when a. the tip of the explorer falls into the exposed cavity. b. the tip of the explorer glides over the smooth surface of the crown. c. a dark spot is seen on the enamel. d. the tooth is discolored. 7. Root canal therapy involves removal of the a. dentin and cementum. b. periodontal ligament. c. crown, pulp, and periodontal ligament. d. entire pulp. 8. A metal crown should be a. placed on any tooth that undergoes root canal therapy. b. recommended for most working dogs.
Go to www.VetTechJournal.com now to take this CE Test.
c. used during vital partial pulpectomy. d. placed on a fractured deciduous tooth. 9. Vital partial pulpectomy may be performed in a fractured tooth with pulp exposure in a patient younger than 18 months if the fracture occurred within __________ of presentation. a. 2 weeks b. 3 weeks c. 1 month d. none of the above 10. Which of the following regarding sealants is true? a. ZOE is the most common sealant used in veterinary dentistry. b. ZOE is an inert rubber material derived from the latex of tropical trees. c. Gutta-percha cannot be heated for the procedure. d. ZOE has a short time frame in which it can be used.
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Quick Course Nutraceuticals: They Do Have a Place in Your Practice An estimated 40% to 60% of Americans regularly use supplements,1 and approximately one-third of our pets are also receiving them.2 Understanding how supplements work and helping clients select and use them appropriately in their pets should be a focus for veterinarians who are seeking to offer more comprehensive patient care. What are nutraceuticals? Nutraceuticals have been defined as â&#x20AC;&#x153;nondrug substances produced in a purified or extracted form and administered orally to provide agents required for normal body structure and function with the intent of improving health and well-being.â&#x20AC;?3,4 As the term implies, nutraceuticals have characteristics of both nutrients and
pharmaceutical agents, although they are not regulated as either.5 Many products are considered nutraceuticals, including some dietary supplements (e.g., fatty acid supplements, glucosamine, chondroitin sulfate, methylsulfonylmethane [MSM], Sadenosyl-L-methionine [SAMe], superoxide dismutase [SOD]), specific nutrients (e.g., carnitine), and some botanical or herbal products (e.g., avocado/soybean unsaponifiables [ASU], silybin). Nutraceuticals should not claim to treat or cure disease; rather they are intended to be complementary management options for patients and are administered to help promote improved body function and assist in the long-term management of certain chronic conditions as part of a multimodal approach.6 As the popularity of nutraceuticals grows, many veterinarians
Selecting an Appropriate Nutraceutical Nutraceutical
Indications
Glucosamine, chondroitin sulfate, ASU
OA, joint health protection, surgeries involving a joint
SAMe, silybin
Liver disease, including hepatic lipidosis and chronic active hepatitis, prophylactic use in pets administered potentially hepatotoxic drugs
Long-chain omega-3 fatty acids
Support of skin/coat health, heart health, nervous system/trainability, kidney function, immune system, and overall wellness
SOD
Conditions of oxidative stress, such as pancreatitis, liver and kidney disease, retroviral disease, and obesity
Carnitine
Hepatic lipidosis in cats
Sponsored by Nutramax Laboratories, Inc.
are embracing their use and incorporating them into practice. 7,8 The role of nutraceuticals in wellness medicine Our pets are living longer, and certain conditions such as altered metabolism, decreased mobility, and changing nutritional needs tend to accompany advancing age. Wellness medicine seeks to identify and address these problems early to enhance overall wellness and prolong life. Nutraceuticals are not medications and they are not intended to replace conventional medicines or therapies, but they can fit very comfortably into a wellness medicine approach to patient care. Nutraceuticals can generally be administered for longer periods than some conventional medications, and they can help support patients during and after use of conventional therapies. For example, glucosamine, chondroitin sulfate, and ASU can be administered along with an NSAID initially and then potentially continued alone long-term to promote improved joint function in a dog with osteoarthritis, and although antimicrobials cannot be given indefinitely, SAMe can be administered long-term to promote better liver function in the face of a chronic liver condition. Of course, as with any other therapy, nutraceuticals must be selected and used appropriately to optimize their benefit to patients.
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PRICING NUTRACEUTICALS IN YOUR PRACTICE
There is a difference Safety, efficacy, and manufacturing standards are not well regulated for nutraceuticals. Product labeling is an issue because products don’t always contain the labeled ingredients in the stated amounts, and other unlisted ingredients may also be present.5 Likewise, lack of published adverse events is not a guarantee of safety because nutraceutical manufacturers are not required to report veterinary adverse events. Veterinarians should ask the manufacturer for safety data on their brand. Nutraceuticals are among the therapies addressed in the AVMA Guidelines for Complementary and Alternative Veterinary Medicine.9 Under these guidelines, veterinarians are encouraged to examine the medical literature and establish a diagnosis and client–patient relationship before implementing any therapeutic measure.
Manufacturing standards and quality control are largely up to individual manufacturers,
so it does matter where veterinarians purchase nutraceuticals. FDA also has a website containing tips for savvy supplement users (http://www.cfsan. fda.gov/~dms/ds-savvy.html) that includes the recommendation to contact the manufacturer for information about its brand. Ultimately, manufacturing standards and quality control are largely up to individual manufacturers, so it does
Pricing nutraceuticals requires a different strategy than that traditionally applied to prescription medications. Products that are intended to be used lifelong shouldn’t be marked up in the same manner as drugs meant for short-term use. Tactics for pricing these products should be similar to those used for pricing therapeutic diets. The economic value of nutraceuticals to your practice lies in the fact that these products are meant for long-term, repetitive sales. If the product is priced too high, clients will seek less expensive purchase options or discontinue using the product altogether. Noncompliance benefits no one, and ultimately the pet pays the price for our marketing mistake. Look to the MSRP (manufacturer’s suggested retail price) as a good indicator of how to price your products appropriately. Residual product sales such as nutraceuticals are highly profitable because they require no additional effort or resources from your team. With proper planning and a logical pricing structure, nutraceuticals can become an important part of your practice both as a viable option and an economic asset. By Dr. Ernie Ward Seaside Animal Care Calabash, North Carolina matter where veterinarians purchase nutraceuticals. Nutramax Laboratories, Inc. (Edgewood, MD) produces nutraceuticals for both human and veterinary use and is an industry leader in maintaining high manufacturing and testing standards as well as publishing research on its products. Veterinarians are encouraged to research the literature critically when deciding which products and manufacturers to support.9 Veterinarians are often asked for advice and direction regarding nutraceutical use in pets. And as pets continue to live longer and clients search for ways to improve quality of life for them, the need for more accurate information will grow. By improving our understanding of nutraceuticals, veterinarians can better help clients select and use these agents appropriately. In the long run, patients benefit through more complete management of overall health and improved quality of life.
COMING SOON! Wellness Therapy— Joint Health Beyond NSAIDs
References 1. Ervin RB, Wright JD, Reed-Gillette D: Prevalence of leading types of dietary supplements used in the Third National Health and Nutrition Examination Survey, 1988-1994. Advance Data from Vital and Health Statistics, No. 349. Hyattsville, MD: National Center for Health Statistics, 2004. 2. National Animal Supplement Council. Regulating supplements for non-human food chain animals. Available at: http://nasc.cc/index.php? option=com_content&task=view&id=19&Itemid =41. Accessed 11/19/07. 3. Boothe DM: Balancing fact and fiction of novel ingredients: definitions, regulations and evaluation. Vet Clin North Am Small Anim Pract 34(1):7–38, 2004. 4. Lerman A, Lockwood B: Nutraceuticals in veterinary medicine. Pharm J 278:51–55, 2007. 5. Boothe DM: Nutraceuticals in veterinary medicine. Part II: safety and efficacy. Compend Contin Educ Pract Vet 20(1):15–21, 1998. 6. Boothe DM: Nutraceuticals in veterinary medicine. Part I: definitions and regulations. Compend Contin Educ Pract Vet 19(11):1248–1255, 1997. 7. Anderson MA, Slater MR, Hammad TA: Results of a survey of small-animal practitioners on the perceived clinical efficacy and safety of an oral nutraceutical. Prev Vet Med 38(1):65–73, 1999. 8. Schoen AM: Results of a survey on educational and research programs in complementary and alternative veterinary medicine at veterinary medical schools in the United States. JAVMA 216(4):502–509, 2000. 9. Alternative and Complementary Therapies Task Force: An insight into the AVMA guidelines for complementary and alternative veterinary medicine. JAVMA 218(11):1729–1731, 2001.
This information has not been peer reviewed and does not necessarily reflect the opinions of, nor constitute or imply endorsement or recommendation by, the Publisher or Editorial Board. The Publisher is not responsible for any data, opinions, or statements provided herein.
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ManagementMatters
How to Avoid
Asking Illegal Questions During an Interview Katherine Dobbs, RVT, CVPM interFace Veterinary HR Systems, LLC Appleton, Wisconsin Author’s Note: Even with more than 10 years’ experience in interviewing and hiring support staff, I still find this process to be one of the most challenging aspects of managing a veterinary practice. During an interview, it is important to ask questions that will help determine whether a candidate would be a good fit for the practice. However, the practice should be aware that certain questions cannot legally be asked. This month’s column focuses on the interview process from the legal standpoint. When management knows which questions are illegal to ask during an interview, the practice can focus on developing a system to identify individuals who will make great additions to the team.
M
ANY HUMAN RESOURCES (HR) tasks, such as interviewing, are guided largely by employment laws that are constantly changing. It is important that managers obtain information about specific laws and their application in the management of the veterinary practice. But it is just as important to keep up with the changing realm of HR. Laws change, and their applications change as discrimination cases go to court and establish case law precedents.
Katherine Dobbs, RVT, CVPM Katherine Dobbs is the regular author of Management Matters. Katherine is the founder of the Veterinary Emergency and Specialty Practice Association (www.vespa-home.org), which is dedicated to helping emergency and specialty practice managers and other veterinary professionals manage their clinics more effectively. She recently started her own consulting business, interFace Veterinary HR Systems, LLC. If there is a topic that you would like Katherine to address, contact her directly at ManagementMatters@sbcglobal.net.
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During an interview, questions that could be considered discriminatory are prohibited. Knowing which questions are inappropriate to ask during the interview can help the practice avoid claims of discrimination. Below are examples of prohibited interview questions.
Prohibited Questions What is your date of birth? During the interview, it is not legal to ask any age-related questions, including indirect questions such as “What year did you graduate from high school?” or “How old are your children?” After the candidate is hired, the hiring manager can ask the individual to provide proof that he or she is 18 years of age or older or can produce a work permit. The Age Discrimination in Employment Act protects job candidates from age discrimination, particularly those 40 years of age or older.
FEBRUARY 2008 | Veterinary Technician
Are you a US citizen? It is illegal to try to determine a candidate’s national origin by asking questions regarding citizenship. For example, the manager cannot ask, “Of what country are you a citizen?” or “When did you acquire citizenship?” Similarly, the manager cannot ask any questions about race or ancestry. He or she also cannot require that the candidate produce naturalization papers or first papers (declarations of intention) during the hiring process. However, the candidate can be told that if he or she is hired, proof of legal authorization to work in the United States must be provided. After being hired, the individual will be required to complete an I-9 form and provide documents that verify his or her identity and employment eligibility.
Have you ever been in the military? Although the hiring manager can ask the candidate about job-related military experiwww.VetTechJournal.com
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Pfizer-Domiter2_USE.qxp:VT
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NADA 141-267, Approved by FDA.
(dexmedetomidine hydrochloride) Sterile Injectable Solution â&#x20AC;&#x201C; 0.5 mg/mL For intramuscular and intravenous use in dogs and for intramuscular use in cats CAUTION: Federal law restricts this drug to use by or on the order of a licensed veterinarian. INDICATIONS: DEXDOMITOR is indicated for use as a sedative and analgesic in dogs and cats to facilitate clinical examinations, clinical procedures, minor surgical procedures, and minor dental procedures. DEXDOMITOR is also indicated for use as a preanesthetic to general anesthesia in dogs. CONTRAINDICATIONS: Do not use DEXDOMITOR in dogs or cats with cardiovascular disease, respiratory disorders, liver or kidney diseases, or in conditions of shock, severe debilitation, or stress due to extreme heat, cold or fatigue. As with all alpha2-adrenoceptor agonists, the potential for isolated cases of hypersensitivity, including paradoxical response (excitation), exists. HUMAN WARNINGS: Not for human use. Keep out of reach of children. Dexmedetomidine hydrochloride can be absorbed following direct exposure to skin, eyes, or mouth, and may cause irritation. In case of accidental eye L_WVZ\YL Ă&#x2026;\ZO ^P[O ^H[LY MVY TPU\[LZ 0U JHZL VM accidental skin exposure, wash with soap and water. Remove contaminated clothing. Appropriate precautions should be taken while OHUKSPUN HUK \ZPUN Ă&#x201E;SSLK Z`YPUNLZ (JJPKLU[HS [VWPJHS (including ocular) exposure, oral exposure, or exposure by injection could cause adverse reactions, including sedation, hypotension, and bradycardia. Seek medical attention immediately. Users with cardiovascular disease (for example, hypertension or ischemic heart disease) should take special precautions to avoid any exposure to this product. Caution should be exercised when handling sedated animals. Handling or any other sudden stimuli, including noise, may cause a defense reaction in an animal that appears to be heavily sedated. The material safety data sheet (MSDS) contains more detailed occupational safety information. To report adverse reactions in users or to obtain a copy of the 4:+: MVY [OPZ WYVK\J[ JHSS Note to physician: This product contains an alpha2adrenergic agonist. PRECAUTIONS: For cats, the concurrent use of DEXDOMITOR prior to or with an anesthetic has not been evaluated. Dexmedetomidine in cats has not been evaluated in the presence of other sedatives. Dexmedetomidine sedation is not recommended for cats with respiratory disease. Adverse reaction reports for dexmedetomidine include a cat with severe dyspnea and respiratory crackles diagnosed as acute pulmonary edema. The catâ&#x20AC;&#x2122;s health history was not known and the cat recovered with treatment. (S[OV\NO UV[ VIZLY]LK PU [OL MLSPUL Ă&#x201E;LSK Z[\K` ^P[O dexmedetomidine, rare cases of delayed pulmonary edema, some resulting in death, have been reported in cats that received medetomidine (another alpha2agonist), usually in conjunction with anesthesia. In these cases, dyspnea due to the delayed onset of pulmonary edema developed up to 3 days after medetomidine administration. Dexmedetomidine should not be administered in the presence of preexisting hypotension, hypoxia, or bradycardia. Due to the pronounced cardiovascular effects of dexmedetomidine, only clinically healthy dogs and cats should be treated. Animals should be frequently monitored for cardiovascular function and body temperature during sedation or anesthesia. Intramuscular ANTISEDAN (atipamezole) may be routinely used to rapidly reverse the effects of dexmedetomidine in dogs. Since analgesic as well as sedative effects will be reversed, pain management may need to be addressed. In the event of apnea, accompanied by bradycardia and cyanotic mucous membranes, additional oxygen should be supplied. Administration of ANTISEDAN (atipamezole) to dogs exhibiting these signs is warranted. Atipamezole has not been evaluated as a routine dexmedetomidine reversal agent in cats. A decrease in body temperature is likely to occur during sedation with dexmedetomidine unless externally maintained. Once established, hypothermia may persist longer than sedation and analgesia. To prevent hypothermia, treated animals should be kept warm and at a constant temperature during the procedure, and until full recovery. Nervous or excited animals with high levels of endogenous catecholamines may exhibit a reduced pharmacological response to alpha2-adrenoceptor agonists like dexmedetomidine. In agitated animals, the
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onset of sedative/analgesic effects could be slowed, or the depth and duration of effects could be diminished or nonexistent. Therefore, allow dogs and cats to rest X\PL[S` MVY [V TPU\[LZ HM[LY PUQLJ[PVU 9LWLH[ dosing has not been evaluated. Reversible corneal opacity may occur during sedation in cats. An eye lubricant should be applied to prevent corneal desiccation that may result from a reduction PU [OL ISPUR YLĂ&#x2026;L_ K\YPUN ZLKH[PVU Spontaneous muscle contractions (twitching) can be expected in some dogs sedated with dexmedetomidine. The use of dexmedetomidine as a preanesthetic in KVNZ ZPNUPĂ&#x201E;JHU[S` YLK\JLZ [OL HTV\U[ VM PUK\J[PVU and maintenance anesthetic requirements. Careful patient monitoring during anesthetic induction and maintenance is necessary to avoid anesthetic overdose. Analgesia resulting from preanesthetic dexmedetomidine in dogs is dose-dependent, and may not provide adequate pain control during the postoperative or postprocedural period. Additional pain management should be addressed as needed. Administration of anticholinergic agents in dogs at the same time or after dexmedetomidine could lead to adverse cardiovascular effects (secondary tachycardia, prolonged hypertension, and cardiac arrhythmias). However, an anticholinergic drug may be administered at least 10 minutes before dexmedetomidine for the prevention of the dexmedetomidine-induced reduction in heart rate. Therefore, the routine use of anticholinergics simultaneously with, or after dexmedetomidine in dogs, is not recommended. The use of anticholinergics in the presence of dexmedetomidine has not been evaluated in cats. Dexmedetomidine has been evaluated only in fasted dogs; therefore, its effects on fed dogs (for example, the occurrence of vomiting) have not been characterized. In cats, there is a high frequency of vomition whether fed or fasted; therefore, fasting is recommended to reduce stomach contents. Dexmedetomidine has not been evaluated in dogs younger than 16 weeks of age, in cats younger than 12 weeks of age, or in geriatric dogs and cats. Dexmedetomidine has not been evaluated for use in breeding, pregnant, or lactating dogs or cats. ADVERSE REACTIONS: Canine sedation/analgesia field study: In the Ă&#x201E;LSK Z[\K` safety analysis, 106 dogs received dexmedetomidine and 107 received medetomidine. Dogs ranged from 16 weeks to 16 years of age, representing 49 breeds. The following table shows the number of dogs displaying each clinical observation (some dogs experienced more than one adverse reaction). Table 4: Adverse reactions during the canine sedation/ HUHSNLZPH Ă&#x201E;LSK Z[\K` Dexmedetomidine Medetomidine Total n=106 Total n=107
Severe bradycardia
0
0
1
0
0
1
Tachycardia
0
0
0
1
1
0
Diarrhea
1
0
0
3
1
1
Emesis
4
7
4
2
3
6
Urinary incontinence
0
0
0
0
0
1
Self trauma
0
2
1
2
1
0
Other clinical signs observed in dogs treated with dexmedetomidine include decreased respiratory rate and hypothermia. Feline sedation/analgesia field study: The field study safety analysis included 242 cats (122 received dexmedetomidine; 120 received _`SHaPUL [V `LHYZ VM HNL HUK YLWYLZLU[PUN 19 breeds. The following table shows the number of cats reported with an adverse reaction (some cats experienced more than one adverse reaction). Table 6: Adverse reactions during the feline Ă&#x201E;LSK Z[\K` Dexmedetomidine Xylazine n=122 n=120 Vomiting
70
82
Urinary incontinence
6
11
Hypersalivation
4
Involuntary defecation
4
1
Hypothermia
2
1
Diarrhea
2
0
Arrhythmia
1
2
Corneal ulcer
1
0
Cyanosis
1
0
Dyspnea
1
0
The most frequently observed adverse reaction was vomiting in both fasted and fed cats. Other infrequent clinical signs observed in cats treated with dexmedetomidine included fatigue, anorexia, cystitis, and peripheral vascular disorder. One incidence of dyspnea was reported, 43 minutes after dexmedetomidine administration during an oral examination/dental procedure. Prior to dexmedetomidine, the cat was free of clinical signs, but had a history of asthma and respiratory infection. The cat responded successfully to treatment. INFORMATION FOR OWNERS: Due to the rare possibility of delayed onset of pulmonary edema which has been associated with administration of other alpha2adrenergic agonists in cats, animal owners should notify their veterinarian immediately if their cat experiences KPMĂ&#x201E;J\S[` IYLH[OPUN STORAGE INFORMATION: Store at controlled YVVT [LTWLYH[\YL Â&#x2021;* Â&#x2021;- 7YV[LJ[ MYVT freezing.
(\ZJ\S[LK \UPKLU[PĂ&#x201E;LK arrhythmias
19
20
Severe bradycardia requiring treatment
1
1
Apnea requiring treatment
1
0
HOW SUPPLIED: DEXDOMITOR is supplied in 10-mL, T\S[PKVZL ]PHSZ JVU[HPUPUN TN VM KL_TLKL[VTPKPUL hydrochloride per mL.
Slow onset of sedation (exceeding 30 minutes)
1
1
U.S. Patent No. 4,910,214 DEXDOMITORÂŽ is a trademark of Orion Corporation.
Ineffectiveness (dog standing throughout the study)
3
2
2
0
Prolonged recovery
1
4
Orion Pharma Orion Corporation Espoo, Finland
;HISL ! (K]LYZL YLHJ[PVUZ K\YPUN [OL JHUPUL WYLHULZ[OLZPH Ă&#x201E;LSK Z[\K`
+P] VM 7Ă&#x201E;aLY 0UJ NY, NY 10017
PRECAUTIONS: 1. Handling: Antisedan can produce an abrupt reversal of sedation; therefore, dogs that have recently received Antisedan should be handled with caution. The potential for apprehensive or aggressive behavior should be considered in the handling of dogs emerging from sedation, especially in dogs predisposed to nervousness or fright. Also, avoid situations where a dog might fall. 2. Sedation relapse: While atipamezole does reverse the clinical signs associated with medetomidine or dexmedetomidine sedation, complete physiologic return to pretreatment status may not be immediate or may be temporary, and dogs should be monitored for sedation relapse. Sedation relapse is more likely to occur in dogs that receive an alpha2-agonist by the IV route, compared to dogs that are sedated using the IM route. Animals should be monitored closely for persistent hypothermia, bradycardia, and depressed respiration, until signs of recovery persist. 3. Analgesia reversal: Atipamezole reverses analgesic effects as well as sedative effects. Additional procedures for the control of pain may be required. 4. Debilitated dogs: The safety of atipamezole has not been evaluated in dogs with compromised health. Geriatric, debilitated, and ill dogs are more likely to experience adverse reactions associated with the administration of alpha2-antagonists (as well as alpha2agonists). Dogs with abnormalities associated with the cardiovascular system are especially at risk. Breeding dogs: Antisedan has not been evaluated in breeding dogs; therefore, the drug is not recommended for use in pregnant or lactating dogs, or in dogs intended for breeding. 6. Minimum age and weight: Antisedan has not been evaluated in dogs less than 4 months of age or in dogs weighing less than 4.4 lbs (2 kg).
STORAGE INFORMATION: Store protected from SPNO[ H[ JVU[YVSSLK YVVT [LTWLYH[\YL Â&#x2021;Âś Â&#x2021;* Â&#x2021;Âś Â&#x2021;-
Distributed by:
;OL VJJ\YYLUJL VM H\ZJ\S[LK \UPKLU[PĂ&#x201E;LK HYYO`[OTPHZ (some at multiple time points) decreased following the administration of atipamezole. Canine preanesthesia ďŹ eld study: The preanesthesia Ă&#x201E;LSK Z[\K` ZHML[` HUHS`ZPZ PUJS\KLK KVNZ IL[^LLU TVU[OZ HUK `LHYZ VM HNL YLWYLZLU[PUN IYLLKZ enrolled for elective procedures conducted under general anesthesia. The following table shows the number of dogs within a treatment group that showed each clinical sign (some dogs experienced more than one adverse reaction).
HUMAN WARNINGS: Not for human use. Keep out of reach of children. Atipamezole hydrochloride can be absorbed and may cause irritation following direct exposure to skin, eyes, or mouth. In case of accidental L`L L_WVZ\YL Ă&#x2026;\ZO ^P[O ^H[LY MVY TPU\[LZ 0U JHZL of accidental skin exposure, wash with soap and water. Remove contaminated clothing. If irritation or other adverse reaction occurs (for example, increased heart rate, tremor, muscle cramps), seek medical attention. In case of accidental oral exposure or injection, seek medical attention. Caution should be used while OHUKSPUN HUK \ZPUN Ă&#x201E;SSLK Z`YPUNLZ Users with cardiovascular disease (for example, hypertension or ischemic heart disease) should take special precautions to avoid any exposure to this product. The material safety data sheet (MSDS) contains more detailed occupational safety information. To report adverse reactions in users or to obtain a copy VM [OL 4:+: MVY [OPZ WYVK\J[ JHSS Note to Physician: This product contains an alpha2adrenergic antagonist.
ADVERSE REACTIONS: Occasional vomiting may occur. At times, a period of excitement or apprehensiveness may be seen in dogs treated with atipamezole. Other effects of atipamezole include hypersalivation, diarrhea, and tremors.
Mfd by:
Severe hypothermia requiring treatment
CONTRAINDICATIONS: Since atipamezole is always used concomitantly with dexmedetomidine or medetomidine, it should not be used in dogs with the following conditions: cardiac disease, respiratory disorders, liver or kidney diseases, dogs in shock, severely debilitated dogs, or dogs stressed due to extreme heat, cold or fatigue. Administration of atipamezole is contraindicated in dogs with a known hypersensitivity to the drug.
November 2007
HOW SUPPLIED: Antisedan is supplied in 10-mL, T\S[PKVZL ]PHSZ JVU[HPUPUN TN VM H[PWHTLaVSL hydrochloride per mL. < : 7H[LU[ 5VZ
NADA #141-033, Approved by FDA
" "
AntisedanÂŽ, DexdomitorÂŽ, and DomitorÂŽ are trademarks of Orion Corporation.
(atipamezole hydrochloride) Developed and manufactured by:
Treatment Groups Induction Anesthetic:
Propofol
Sterile Injectable Solutionâ&#x20AC;&#x201D;5.0 mg/mL
Barbiturate
Dexmedetomidine and Medetomidine Reversing Agent
Preanesthetic 0 0 Dose: mcg/ mcg/ mcg/ mcg/ mcg/ mcg/ m2 m2 m2 m2 m2 m2 n=32 n=32 n=32 n=32 n=32 n=32 Ventricular premature contractions
0
2
0
4
1
0
For intramuscular use in dogs only CAUTION: Federal law restricts this drug to use by or on the order of a licensed veterinarian. INDICATIONS: Antisedan is indicated for the reversal of the sedative and analgesic effects of Dexdomitor (dexmedetomidine hydrochloride), and Domitor (medetomidine hydrochloride) in dogs.
Distributed by:
+P] VM 7Ă&#x201E;aLY 0UJ NY, NY 10017 November 2007
MgmtMatters_Feb_VT:Columns_Template_VT
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ManagementMatters
Guidelines to Follow During the Hiring Process Treat all candidates the same way. The same criteria and selection process
should be used for all candidates. For example, the manager can check candidates’ references and conduct background checks, as long as the candidate has given written permission. However, background checks cannot be performed solely for the purpose of checking a candidate who seems questionable. Focus on the job to be performed. Interview questions should focus only on the candidate’s suitability for the job. Ensure that staff know the practice’s interviewing policy. Although the
hiring manager may know the difference between a legal and an illegal question, other staff may not. If the practice requests or requires working interviews or observation periods with candidates, staff should be trained so that they know which questions can and cannot be asked. Keep all applications and résumés for a year, even those for individuals
©2008 Raisa Kanareva/Shutterstock.com
ence or training, he or she cannot ask about the candidate’s military status or type of discharge from military service (e.g., whether the discharge was honorable) because this information is not pertinent to the performance of the job at the practice.
Have you ever been arrested? The hiring manager cannot ask whether a candidate has been arrested because an arrest is not an indication of guilt. However, he or she can ask, “Have you ever been convicted of a crime? If so, provide details.” The manager must then consider the person’s answer before automatically discounting him or her as a potential candidate. Deciding to not hire an individual based on whether he or she has been convicted of a crime is discriminatory; for more information on this topic, consult your state laws. In general, if there is a direct relationship between the nature of the conviction and the job to be performed or the environment of the workplace, then it is legal to not consider the applicant as a potential candidate. However, the manager should seek advice from the practice’s attorney. www.VetTechJournal.com
who were not interviewed or hired. This step of the process is probably one of the most overlooked but can protect the practice from claims of discrimination. If the employee selection process is ever questioned, the retained applications and résumés can demonstrate the practice’s protocol. For example, if the practice is accused of not hiring someone based on gender, the applications and résumés of candidates who were not considered for interviews can demonstrate that some candidates were eliminated because they did not meet the minimum job requirements, based on the job description. Further, these documents provide statistical or demographic information. If more women historically applied for the position, then the likelihood of hiring a man was lower. The bottom line is, keep all résumés and applications for a year, and ensure that no one ever writes on these documents. Keep any notations separate because résumés and applications are legal documents that should not be altered.
Do you wish to be addressed as Mrs. or Ms.? The manager cannot ask any question that leads to a discussion of marital status, including both direct questions (“Are you married?”) and indirect questions (“Would your husband need health insurance coverage?”). Marital status is not relevant to a candidate’s ability to perform a job.
Have you ever had a problem with drugs or alcohol? The manager cannot ask questions about drug or alcohol abuse because a current or past drug or alcohol problem is considered a disability to the same extent that physical or mental conditions are classified as disabilities. The Americans with Disabilities Act prohibits discrimination against any person with Veterinary Technician | FEBRUARY 2008 105
MgmtMatters_Feb_VT:Columns_Template_VT
RECONCILE™ (fluoxetine hydrochloride) Chewable Tablets
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ManagementMatters
Caution: Federal (USA) law restricts this drug to use by or on the order of a licensed veterinarian.
a disability. Even if a candidate has an obvious health problem, the manager cannot question the candidate about the condition. What the manager can and should do, however, is present the job description to the candidate — along with an outline of the physical requirements of the job — and ask whether he or she can perform all the tasks required, with or without reasonable accommodation.
Indications: RECONCILE chewable tablets are indicated for the treatment of canine separation anxiety in conjunction with a behavior modification plan. Contraindications: RECONCILE chewable tablets should not be used in dogs with epilepsy or history of seizures, nor given concomitantly with drugs that lower the seizure threshold (e.g., phenothiazines). RECONCILE chewable tablets should not be given in combination with, or within 14 days of discontinuing, a monoamine oxidase inhibitor. RECONCILE chewable tablets are contraindicated in dogs with a known hypersensitivity to fluoxetine HCl or other SSRIs. Observe a 6-week washout interval following discontinuation of therapy with RECONCILE chewable tablets prior to the administration of any drug that may adversely interact with fluoxetine or its metabolite, norfluoxetine. Human Warnings: Not for use in humans. Keep out of reach of children. In case of accidental ingestion seek medical attention immediately. Precautions: RECONCILE chewable tablets have not been clinically tested for the treatment of other behavioral disorders and are not recommended for the treatment of aggression. Studies in breeding, pregnant, or lactating dogs and in patients less than 6 months of age have not been conducted.
Appropriate Questions
Seizures may occur in dogs treated with RECONCILE chewable tablets, even in dogs without a history of epilepsy or seizures (see ADVERSE REACTIONS).
The following are examples of the types of questions that can be asked during an interview:
RECONCILE chewable tablets have not been evaluated with drugs that affect the cytochrome P450 enzyme system and should be used with caution when co-administered with any drug that affects this system. Studies to assess the interaction of RECONCILE chewable tablets with tricyclic antidepressants (TCAs) (e.g., clomipramine) have not been conducted. The minimum washout period to transition dogs from TCAs to RECONCILE chewable tablets has not been evaluated. Data demonstrate that TCAs are cleared 4 days following discontinuation.1, 2
What is your educational background? What experience makes you qualified for the job?
Adverse Reactions: In two North American field studies involving 427 dogs, the following adverse reactions were observed at a rate of ≥1% in dogs treated with RECONCILE chewable tablets (n=216): calm/lethargy/depression (32.9%), decreased appetite (26.9%), vomiting (17.1%), shaking/shivering/tremor (24%), diarrhea (21%), restlessness (16%), excessive vocalization (including whining) (13%), aggression (9%), otitis externa (6%), disorientation (5%), incoordination (5%), constipation (3%) and excessive salivation (3%).
Do you have any licenses/certifications relevant to the job? Do you have reliable transportation?
Other adverse reactions: Seizures: One of 112 dogs in the control group and three of 117 dogs that received RECONCILE chewable tablets experienced the serious adverse reaction of seizures during or up to 45 days after the end of the treatment period. One dog that was treated with RECONCILE chewable tablets experienced two seizures 10 days after the end of therapy and, despite escalating phenobarbital doses, died in status epilepticus approximately six months after the first seizure, In the second study, one of 99 dogs treated with RECONCILE chewable tablets and one of 99 dogs treated with the control tablet experienced the serious adverse reaction of seizures. Lastly, in a European multi-site study, one dog treated with a daily dose of 0.4 mg/kg for one month experienced one seizure one week after discontinuing therapy.
Would you be willing to travel? Would you be available to work overtime?
Are you a member of any organizations, and if so, which ones?
Weight loss: In field studies, a weight loss ≥5% (relative to pre-study body weight) was observed in 58 (29.6%) of dogs treated with RECONCILE chewable tablets and 24 (13.0%) of control dogs. No dogs were withdrawn from clinical studies due to weight loss alone.
Although the manager can ask candidates to indicate whether they are members of any organization that they believe may be pertinent to job experience, such as veterinary or management organizations, he or she cannot ask candidates to name all organizations with which they are affiliated because confidential information, such as religious or political affiliations, could be revealed.
Dose reduction: Twenty dogs in the RECONCILE chewable tablet group and five control dogs required a dose reduction due to unacceptable adverse reactions, the majority intermittent and mild, generally anorexia, vomiting, shaking and depression. Lowering the dose eliminated or reduced the severity of these reactions in the RECONCILE chewable tablet group only, while resumption of the full dose resulted in a return of the initial adverse reactions in approximately half the affected dogs. One dog experienced recurrence of severe adverse reactions, which necessitated its withdrawal from the study. Additionally, two dogs required a second dose reduction of RECONCILE chewable tablets. Animal Safety: In a one-year laboratory safety study, dogs were dosed daily at 1, 4.5 and 20 mg/kg/day of fluoxetine in a gelatin capsule, corresponding to 0.87, 3.9 and 17.4 mg/kg/day of RECONCILE chewable tablets (the average ratio of fluoxetine AUC values for RECONCILE chewable tablets/fluoxetine capsule = 1.15). Three of five female dogs in the 20 mg/kg group died or were euthanatized during the first six months of the study. The high dose was decreased to 10 mg/kg/day (equivalent to 9.7 mg/kg/day of RECONCILE chewable tablets) for the last six months, and all remaining dogs completed the study. One dog in the 1 mg/kg group (0.87 mg/kg/day of RECONCILE chewable tablets) and two in the 20 mg/kg group (17.4 mg/kg/day of RECONCILE chewable tablets) experienced a seizure. Aggressive behavior, ataxia, salivation at dosing, hyperesthesia, nystagmus, thin body condition, weakness, lethargy, diarrhea and head tilt were noted in the high dose group. Anorexia, tremors, decreased pupillary light response, mydriasis, vomiting and decreased weight gain were observed in all treatment groups, although more frequently in the high dose group. All abnormal observations except decreased weight gain resolved by the end of a two-month recovery period. Evidence of phospholipidosis was noted in the lung, liver, adrenal glands, lymph nodes, spleen, retina and white blood cells of all groups, which resolved during the recovery period. Fluoxetine caused no marked or consistent effects on hematology, blood chemistries or urinalysis. Mild bradycardia was present in a dose-dependent manner in the two higher dose groups only. There were no effects noted on gross organ examination.
Conclusion
Resources Society for Human Resource Management: www.shrm.org Society membership includes a subscription to HR Magazine, which provides current information for HR professionals in any industry.
To obtain full product information please call 888-545-5973 or visit www.reconcile.com NADA #141-272 Approved by FDA ©2007 Eli Lilly and Company REC005305-3P370CVBR1 1
2
Plumb DC. Amitriptyline. Veterinary Drug Handbook 5th Edition (Pocket Edition). Iowa State Press. Ames, IA. Page 39, 2002. Hewson CJ, et.al. The pharmacokinetics of clomipramine and desmethylclomipramine in dogs: parameter estimates following a single oral dose and 28 consecutive daily doses of clomipramine. J Vet Pharmacol Therap 21:214-222, 1998.
106
When hiring staff, managers must know which questions are appropriate to ask during an interview and which questions can get the practice into legal trouble. It is difficult enough for a practice to find qualified candidates without having to worry about whether its interview process is legally sound. When managers know which questions they can and cannot ask, they are able to focus their energy on identifying candidates who could become exceptional new team members.
FEBRUARY 2008 | Veterinary Technician
www.VetTechJournal.com
EliLilly_Reconcile_USE.qxp:VT
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Good dog There’s a new way to help a good dog overcome by separation anxiety. Approved by the FDA, Reconcile™ is a chewable, flavored tablet most dogs enjoy as a treat. Clinical trials show that taken once daily, Reconcile™, combined with a program such as the simple BOND™ behavior modification plan, can make a profound difference. Within eight weeks, 73% of dogs treated with Reconcile™ chewable tablets showed significant improvement as compared to behavior modification alone (51%). 42% of dogs showed improvement within the first week, which was significantly greater than with behavior modification alone (18%).
Find out how you can improve your prognosis for your clients’ pets. Contact us at www.reconcile.com or 1-888-LillyPet.
©2007 Eli Lilly and Company. REC005305-3P370AVAR10
The most common adverse reactions recorded during clinical trials were calm or lethargy, reduced appetite, vomiting, shaking, diarrhea, restlessness, excessive vocalization, aggression and, in infrequent cases, seizures. For product label, including important safety information, see page 106.
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ClickerTraining_Feb_VT:VT
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BehaviorBootCamp
“Clicking” with Animals Courtesy of ClickerTraining.com
A New Clicker Training Certification Program Author’s Note: I travel all over the world giving lectures on animal behavJulie Shaw, RVT* ior modification techniques, and veterinary professionals frequently ask me Purdue University how they can learn more about animal behavior and training. Veterinarians West Lafayette, Indiana and veterinary technicians often tell me that when they were in school, the programs didn’t offer enough courses on behavior-related topics. I encountered the same obstacles when I was a student. So in an attempt to further my behavior education after I graduated with a veterinary technology degree in 1983, I began attending continuing education seminars on animal behavior and training. I spent several years teaching clients how to train their pets using traditional training methods, which involved punishment and negative reinforcement, until I learned of the work of Karen Pryor, a pioneer of the force-free animal training method known as clicker training. I have used clicker training ever since, and it has helped me become a better animal trainer and communicator. A new clicker training certification program, the Dog Trainer Program at the Karen Pryor Academy for Animal Training & Behavior, has recently been introduced, and this program makes humane and professional animal training more accessible to veterinary professionals and trainers.
Julie Shaw, RVT
Julie Shaw, RVT, has been the senior animal behavior technologist at Purdue University’s Animal Behavior Clinic since 1999. She currently organizes and helps teach Purdue’s popular DOGS! course on behavior modification principles and techniques, lectures to veterinary professionals nationally and internationally, is the chairwoman of the organizing committee for the Academy of Veterinary Behavior Technicians, and is on the faculty of the Karen Pryor Academy. Julie received the 2006 NAVC Veterinary Technician Speaker of the Year Award and was named the 2007 Dr. Jack L. Mara Memorial Lecturer.
108
I
HAD MY FIRST EXPERIENCE with animal training more than 20 years ago, with my own dog. I attended a traditional training class, which used a method I called “yank and thank.” We waited for the dog to “get it wrong,” then yanked on its choke collar and promptly “thanked it” by offering praise. This method makes as little sense to me now as it did then, but at the time, I knew of no other options. Over the next 7 years, I became a connoisseur of the “yank and thank” method and taught it to hundreds of clients. However, a life-changing event made me reconsider the value of this method. In 1994, I discovered that my son had cerebral palsy. Over the next couple of years, it became my mission to train a service dog to assist him. I realized that a child with a disability would not be able to control a dog using the “yank and thank” method and that I would have to find a different approach to animal training. Coincidentally, an acquaintance sent me Karen Pryor’s book Getting Started: Clicker Training for Dogs (formerly called A Dog & a Dolphin 2.0: An Introduction to Clicker Training), which changed my life forever. When
FEBRUARY 2008 | Veterinary Technician
the first edition of the book was published in 1996, many deemed clicker training a fad, but I have used this method to train two service dogs for my son and currently teach hundreds of veterinary professionals and trainers how to use clicker training techniques to modify behavior.
Clicker Training Overview Clicker training is a form of behavior modification in which a clicker is used to mark the desired behavior. When an animal performs a desired behavior, the technician or trainer must immediately push on the clicker *Julie Shaw, RVT, discloses that she is affiliated with the Karen Pryor Academy for Animal Training & Behavior.
www.VetTechJournal.com
Summit-Vectra_USE.qxp:VT
1/22/08
4:27 PM
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For Superior Protection, They Look to You. Introducing veterinarian-exclusive* Vectra 3D™— A new monthly topical that repels and kills fleas, ticks, and mosquitoes through Day 30 Kills 96% of fleas in 6 hours M Repels and kills ticks that may transmit Lyme disease, Rocky Mountain Spotted fever, babesiosis, ehrlichiosis, and hepatozoonosis M Remains effective after bathing and swimming M
For more information, or to order Vectra 3D™, visit summitvetpharm.com or call 800-999-0297 Introducing a NEW molecule for an age-old problem
Protecting Their Pets. Protecting Your Practice.
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Vectra 3D and Bloodhound are trademarks of Summit VetPharm. ©2007 Summit VetPharm LLC. Fort Lee, NJ 07024 9/07 V3D-005-07
*Veterinarian exclusivity ensured by
Technology
ClickerTraining_Feb_VT:VT
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BehaviorBootCamp
The animal will begin to learn how to manipulate its environment in order to earn a
“click” and a subsequent reward.
device and then follow that action by giving the animal a reward. The timing of the click is essential because the animal associates the click with the behavior being performed. Adding positive reinforcement (e.g., a treat) will increase the likelihood that the animal will perform the desired behavior. The clicker works faster than giving a verbal cue, and the sound of the clicker is always consistent and loud enough that the animal will not confuse it with other sounds. Initially, the trainer should press on the clicker and reward small behaviors that are headed in the direction of the goal. For example, when first teaching a puppy to “sit,” the clicker should be pressed and a reward offered when the dog crouches. However, as the dog begins to associate the “crouched” position with the click and subsequent treat, the “click” and reward should be offered only when the dog sits. As the animal becomes conditioned to the clicker, the clicker can be used to teach more advanced behaviors, assist with the desensitization process, and change the animal’s emotional response to a situation. The animal will begin to learn how to manipulate its environment in order to earn a “click” and a subsequent reward. Karen Pryor, who studied marine mammal biology and behavioral psychology extensively, first developed clicker training while working with dolphins in the 1960s. Since then, this method has been used successfully on numerous species — from fish to dogs and cats to horses.
Clicker Training Certification Program Not all animal trainers are well educated in behavior, and some still use outdated or even abusive techniques. Therefore, before recommending a trainer to a client, it is important to learn what techniques the trainer uses. The Karen Pryor Academy for Animal Training & Behavior was recently founded to help foster the development of qualified, caring, and dedicated animal trainers as well as to serve as a resource for veterinary professionals and trainers who want to learn the clicker training method. The academy’s Dog Trainer Program, which takes approximately 6 months to complete, combines distance learning with hands-on teaching. Courses consist of online classes and a series of 2-day live workshops, which are taught by instructors in several US cities and Canada. The work110
FEBRUARY 2008 | Veterinary Technician
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ScheringPlough_TriHeart_USE.qxp:vt
1/22/08
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SPAH-THP-75R *Manufacturer mail-in coupon. 1. September 2000, ANADA 200-338, Palatability of Chewable Tablets, Heska Corporation Submission.
Tri-Heart is a registered trademark of Schering-Plough Animal Health Corporation. Copyright Š 2008 Schering-Plough Animal Health Corporation. All rights reserved.
Proven Protection, Superior Value and the Most Comprehensive Guarantee.
Proven Medicine (Ivermectin/Pyrantel) Heartworm, hookworm and roundworm prevention. Flavored Chewable Tablets that Dogs Love Study confirms that 94% of dogs love Tri-HeartÂŽ Plus.1 Guarantee Covers More Tests, Treatments and Offers More Compensation. Improved Client Compliance FREE compliance clock, e-mail reminders and client education material. Cost-Effective Up to 40% clinic savings! $5 Client Saving Coupons* With 12-month purchase (no-limit per household). Helps promote 12-month protocol and better compliance!
Get it all.
SEE PRESCRIBING INFORMATION ON PAGE 110.
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All dogs should be tested for heartworm infection before starting a preventive program. In a small percentage of ivermectin/pyrantel treated dogs, digestive and neurological side effects may occur.
TriHeartPlus.com
ClickerTraining_Feb_VT:VT
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BehaviorBootCamp shops are taught in a positive learning atmosphere with peer support. The program also teaches trainers to maintain a positive relationship with clients. Students are taught not only how to become good trainers but also how to be excellent teachers for their clients. In my experience, dog trainers too often fail to recognize that a lack of communication with the owner can affect the success of the pet’s training. Graduates of the academy become Karen Pryor Academy Certified Training Partners and are subject to a policed credentialing process (i.e., credentials can be revoked). Veterinary practices that refer clients to a certified trainer can be confident that the trainer is well qualified and has met the highest standards of achievement, expertise, and ethics in the animal training profession. If the Karen Pryor Academy existed 15 years ago, there is no question that I would have applied to become a student. Back then, if I had access to the academy’s resources, the knowledge I gained would have propelled my career forward 10 years! Working with the Dog Trainer Program has been one of the most rewarding and stimulating experiences of my 25-year career as a veterinary professional and dog trainer.
Oral solution for use in dogs only.
CAUTION: Federal (USA) law restricts this drug to use by or on the order of a licensed veterinarian. INDICATIONS: SLENTROL (dirlotapide) Oral Solution is indicated for the management of obesity in dogs. CONTRAINDICATIONS: SLENTROL should not be used in cats. SLENTROL increases the risk of producing hepatic lipidosis during weight loss in obese cats. SLENTROL is not recommended for use in dogs currently receiving long-term corticosteroid therapy. Do not use in dogs with liver disease. WARNINGS: Not for use in humans. Keep this and all drugs out of reach of children. Adverse reactions associated with humans ingesting dirlotapide include: abdominal distention, abdominal pain, diarrhea, flatulence, headache, increased serum transaminases, nausea, and vomiting. SLENTROL may cause eye-irritation. If accidental eye exposure occurs, flush the eyes immediately with clean water. PRECAUTIONS: Safety in breeding, pregnant, or lactating dogs has not been established. Caution should be taken when considering any weight loss program in growing dogs, including treatment with SLENTROL. SLENTROL has not been evaluated in dogs less than 1 year of age. All dogs should undergo a thorough history and physical examination that includes laboratory tests to screen for underlying conditions. Pre-existing endocrine disease, including hyperadrenalcorticalism (Cushing’s disease), should be managed prior to use of SLENTROL. SLENTROL may produce a mild to moderate elevation in serum hepatic transaminase activity. If the elevation in alanine aminotransferase (ALT) activity is mild, continue SLENTROL and monitor as needed. If there is a marked elevation in ALT activity above the normal reference range or there is a simultaneous increase in aspartate aminotransferase (AST), alkaline phosphatase (ALP), γ-glutamyl transferase (GGT), or total bilirubin, discontinue treatment with SLENTROL. Elevations in hepatic transaminase activity usually decrease when SLENTROL is discontinued. The safety of SLENTROL use in dogs has not been evaluated beyond 1 year. ADVERSE REACTIONS: The adverse reactions associated with treatment with SLENTROL include vomiting, loose stools/diarrhea, lethargy, and anorexia. These adverse reactions were mainly observed during the first month of treatment or during the week after a dose increase. Vomiting was usually mild in severity, of short duration, and resolved with continued SLENTROL treatment. The SLENTROL-treated dogs generally had an increased frequency and duration of vomiting and diarrhea compared to the control dogs. The control dogs received corn oil. Adverse Reactions During Weight Loss: Percentage of Patients with Reported Signs Treatment
Control n = 88
SLENTROL n = 170
Vomiting Diarrhea Lethargy Anorexia Constipation Dehydration
21.6% 6.8% 3.4% 2.3% 1.1% 0%
24.7% 12.4% 9.4% 7.6% 2.4% 1.2%
Conclusion Although many animal training methods exist, I have experienced firsthand the success of Karen Pryor’s clicker training method. The clicker training method is taught throughout the world and is the subject of countless books. Animals of various species have been successfully trained using its positive, force-free techniques, and clicker training is now widely used to solve communication problems between animals and humans. Through the Karen Pryor Academy for Animal Training & Behavior, veterinary professionals and trainers can now gain access to standardized, humane, and professional animal training education. I am especially proud to be on the faculty of the Karen Pryor Academy. The clicker training method has changed my life both personally and professionally.
In addition to the adverse reactions listed above, there were other abnormal findings. Many control and SLENTROL-treated dogs had dental disease, abnormal skin and ear findings, and lameness/arthritis. The incidence of these findings were similar in both control and SLENTROL-treated groups and most dogs had similar lesions noted pre-treatment. Two dogs in the SLENTROL treatment group developed corneal ulcers. One SLENTROL-treated and one control dog developed signs consistent with pancreatitis. One treated dog developed inappropriate urination and defecation and another treated dog developed polyuria and polydipsia. A 5-year-old Beagle with no medical history of seizures in the SLENTROL treatment group had a seizure on Day 52 of the study. The dog continued to receive SLENTROL until additional seizures occurred 11 and 12 days later. The investigator referred the case to a neurologist and the seizures continued approximately twice weekly. The neurologist found no lesions that support the causality of the seizures. A 5-year-old Dachshund developed a hepatopathy after 82 days of treatment and was withdrawn from the study for vomiting, increased hepatic enzymes, and anorexia. Vomiting continued for a few days after stopping treatment and the dog was hospitalized due to the anorexia. ALT activity levels continued to rise after all clinical observations resolved. During weight stabilization, vomiting (16.1%) and lethargy (4.8%) were the most frequent adverse reactions associated with treatment with SLENTROL. Other adverse reactions included diarrhea (1.6%), anorexia (1.6%), and ataxia (1.6%). In the post-treatment period, a 6 year old spayed female Chihuahua, was found dead by the owner 7 days after stopping dirlotapide therapy. The cause of death was not conclusive but did not appear to be related to the dirlotapide therapy. Some dogs treated with SLENTROL displayed a mild to moderate elevation in serum hepatic transaminase activity early in treatment that decreased over time while treatment continued. Hepatic transaminases generally returned to normal when treatment was discontinued (See Precautions for further information). Serum Chemistry Results: Percentage of Dogs Control n = 88 Serum Analyte ALT a > 120 IU/L AST b > 60 IU/L ALP c > 125 IU/L Cholesterol > 320 mg/dL
SLENTROL n = 170
Pre d
Post e
Pre d
Post e
3.4% 0% 11.4% 14.8%
6.0% 4.8% 16.9% 9.6%
4.7% 3.5% 17.6% 14.7%
9.9% 9.2% 9.9% 4.6%
Resources Selected Books by Karen Pryor Don’t Shoot the Dog: The New Art of Teaching and Training. New York, Bantam Books, 1999.
a ALT = serum alanine aminotransferase activity, b AST = serum aspartate aminotransferase activity, c ALP = serum alkaline phosphatase activity. Dogs with ALP activity > 325 IU/L were excluded from the study. d Pre = % of dogs with values above the laboratory reference range at pre-treatment. e Post = % of dogs with values above the laboratory reference range after 4 months of treatment.
Getting Started: Clicker Training for Dogs. Waltham, MA, Sunshine Books, 2005. Web Sites www.karenpryoracademy.com — The site provides information about the Karen Pryor Academy for Animal Training & Behavior.
To report a suspected adverse reaction call Pfizer Animal Health at 1-800-366-5288. For a copy of the Material Safety Data Sheet (MSDS) for SLENTROL oral solution call 1-800-733-5500. STORAGE INFORMATION: Store in original container at room temperature 15° to 30° C (59° to 86° F). HOW SUPPLIED: SLENTROL is available in 20, 50 and 150 mL bottles containing 5 mg/mL of dirlotapide in solution. U.S. Patent No. 6,720,351
www.clickertraining.com — Information about clicker training for the general public can be accessed on the site.
NADA #141-260, Approved by FDA
www.svbt.org — The Society of Veterinary Behavior Technicians’ official Web site provides information for veterinary technicians who are interested in animal behavior.
Distributed by: Div. of Pfizer Inc NY, NY 10017
820 600 000 October 2006
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SLENTROL W OR K S —
TAKE UP TO 20% OFF
AVERAGE WEIGHT LOSS OF 3% PER MONTH SLENTROL provides a medically appropriate approach to weight loss with steady and dependable results —97.8% of dogs that completed a 4-month study lost weight. Mean weight loss was 11.8%1 SLENTROL works by decreasing appetite and reducing food intake SLENTROL should be used as part of an overall weight-management program that includes a nutritionally balanced diet and exercise
Individual results will vary. Of the 141 dogs completing the study, maximum body weight loss was 29.5%; 1 dog lost no weight and 2 gained weight to a maximum of 1.8%.1 SLENTROL should not be used in cats, dogs receiving long-term corticosteroid therapy, or in dogs with liver disease. The most common side effect is vomiting. In addition, dogs may experience diarrhea, lethargy, or anorexia. The client should be made aware that if any of these signs persist for more than 2 days the dog should be re-evaluated. SLENTROL is not for use in humans under any circumstances.
For more information, please visit www.SLENTROL.com Circle 138 on Reader Service Card
See Page 112 for Product Information Summary
Reference: 1. Data on file. 1962C-60-03-671 (addendum). Pfizer Inc, New York, NY.
© 2007 Pfizer Inc. All rights reserved.
Printed in USA/August 2007
LESS WEIGHT. MORE LIVING.
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EquineEssentials
Understanding
Sharon L. Crowell-Davis, DVM, PhD, DACVB† The University of Georgia
Foal Development and Its Relevance to Raising Orphaned Foals*
D
URING THE WINTER AND SPRING MONTHS, broodmares are getting ready to give birth; therefore, veterinary professionals must start to prepare for the birth and care of young foals. Whether veterinarians and equine technicians are raising a single foal or are responsible for a large herd *Adapted from Crowell-Davis SL: Underfoal development and its of broodmares and their progeny, understanding normal foal standing relevance to raising orphaned foals. Equine 2(6):318–323, 2007; development is essential to knowing what to expect as foals Compend reprinted with permission. Dr. Crowell-Davis discloses that she has mature. It is also important to raise orphaned foals to be received financial support from CEVA Animal Health and Merial. both physically and behaviorally normal.
©2008 Stephanie Coffman/Shutterstock.com
†
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Prepare them for the great outdoors with K9 Advantix. ®
When it comes to repelling and killing fleas, ticks and mosquitoes, there’s really no comparison. Recommend K9 Advantix today. K9 Advantix is for use on dogs only. © 2007 Bayer HealthCare LLC, Animal Health Division, Shawnee Mission, Kansas 66201. Bayer, the Bayer Cross and K9 Advantix are trademarks of Bayer. Frontline is a trademark of Merial. Based on EPA-accepted labels.
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EquineEssentials Major Periods of Foal Development2,3 Period
Age (Months)
Main Characteristics of Foal Behavior
Dependence
1
Stays close to mother Nurses frequently Spends substantial time in recumbency Coprophagy peaks Flehmen peaks in colts
Socialization
2–3
Social interactions peak Play peaks Snapping peaks Allogrooming peaks
Stabilization and developing independence
≥4
Time budgeting progressively becomes more like that of an adult
Dependence The first month of a foal’s life is called the period of dependence, during which the foal is most dependent on the mare for nourishment and protection and has the least contact with other members of the herd. During the first week of life, the foal remains within 16 feet (5 meters) of its mother more than 99% of the time. Play is infrequent, consisting mainly of short bucks and runs while close to the mother. In addition, foals of this age are particularly likely to play with the mare’s tail, ears, mane, and halter. The mare is generally tolerant of this behavior. Although foals rarely graze during this time, foals only 1 day old may nibble a little grass. Ungulates (i.e., hoofed mammals) are classified into two groups: followers and hiders.1 When followers are young, they follow and remain with the mother and, in herd species, the herd. Thus, followers rely on the presence of adults for protection from predators. Followers nurse frequently. In contrast, when hiders are young, their mothers take them to areas of tall grass or brush, where they hide, remaining still for many hours. Nursing bouts are infrequent but long among hiders. Horses are classified as followers. Nursing is very frequent, occurring about four to five times per hour during the daytime in the first week and gradually decreasing in frequency over subsequent weeks and months; at the end of the first month, however, the foal still 118
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nurses two to three times per hour. Nursing bouts are typically short, lasting approximately 1 to 1.5 minutes. This is an important consideration in rearing orphaned foals (i.e., they should be fed small amounts frequently to closely match their natural nursing schedule). Coprophagy of maternal feces peaks and is considered normal during the first few weeks of a foal’s life. At this age, foals can differentiate the feces of their mother from that of a nonlactating, nonpregnant mare and selectively eat only their mother’s feces, even when they do not see the source of the feces. Research in other species suggests that maternal feces produced during early lactation are a source of important nutrients, including deoxycholic acid, which is necessary for normal deposition of myelin in the developing nervous system and for protection from infantile enteritis. Therefore, normal development of orphaned foals may be facilitated by ensuring that they have access to the feces of healthy females in early lactation (see the box on page 120).2–6 Flehmen, in which the foal’s head and upper lip are raised and air is inhaled deeply, driving molecules from the environment into the vomeronasal organ, peaks during this time, especially in colts. During the first month of life, colts perform flehmen almost once per hour, while fillies do it approximately once every 5 hours. Almost one-third of the incidents in which colts perform flehmen are in response to urination by a nearby herd member. Research in other species indicates that exposure to urinary pheromones is essential for normal growth and sexual development. As this may also be the case in horses,6 it is advisable to soak rags in the urine of other horses and hang the rags in the stall or paddock of orphaned foals. Urine of mares in estrus may be particularly important, although this idea is only hypothetical at this point.2,3,5 During the first week of life, foals spend almost one-third of the daylight hours in recumbency, lying on their sternum or side. The amount of time spent in this state steadily declines with maturity and is gradually replaced with increasing periods of upright rest, in which a horse engages its stay apparatus to rest and enter slow-wave www.VetTechJournal.com
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EquineEssentials sleep while standing. While foals do engage in some (3% to 4% of the daylight hours) upright rest during the first week of life, their amount of upright rest does not match that of adults in the same environment until the fifth month of life.
Socialization The second and third months of a foal’s life are the primary period of socialization. The foal begins leaving its mother’s side more frequently, often to interact with other members of the herd, if it is part of one. While adults often ignore the foal — perhaps after a brief investigation — or even drive it away, foals do interact with each other in this period, leading to the formation of playgroups. The amount of time spent in play peaks during this period and is the same for colts and fillies. However, fillies engage in more running, jumping, and bucking play, while colts engage in more play that mimics combat. This is logical, as colts must begin to master combat skills at a young age. In playgroups, foals learn the boundaries of how roughly they can behave toward their peers. For example, a colt that bites a filly too hard is likely to be kicked and subsequently not played with by that filly for a time. During this period, rates of coprophagy are high in colts and fillies, and rates of flehmen are high in colts but decline from the earlier peak. Therefore, if it is impossible to raise a foal with or close to other horses, continued provision of urine-soaked rags may be beneficial. Also, continued access to the feces of
Special Care for Orphaned Foals in Addition to Providing Milk Do not keep the foal socially isolated from its species. Ideally, provide a nurse mare that accepts foals that are not her own. If this is impossible, the presence of friendly geldings, nonlactating mares, or older foals will at least provide the orphan with the opportunity to learn essential social skills. In the foal’s first 3 months of life, allow the foal access to the feces of healthy mares in the first month of lactation. In the foal’s first 3 months of life, soak rags in the urine of various mares, including those in estrus, and hang the rags where the foal has access to them. This is especially important when raising orphaned colts. When the foal is 2 to 3 months of age, provide opportunities for it to interact with peers. This is important in helping the foal learn normal social behavior, particularly inhibition of aggression. 120
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mares in early lactation may be important for optimal health and development. Mutual grooming, also called allogrooming, peaks at this time. Equids allogroom by using their incisors to scratch and gently bite the skin of the withers, neck, and crest of their grooming partner. Horses have difficulty grooming these areas on their own, so there is a direct benefit of allogrooming. At this age, fillies allogroom approximately twice as often as do colts. If colts and fillies are in a herd, fillies allogroom with both sexes approximately equally or at least in the same proportion as the sex composition of the herd. However, colts allogroom almost exclusively with fillies; same-sex allogrooming is uncommon among males, unless few or no fillies are present. The differences in filly and colt allogrooming are consistent with the lifelong social experiences of the two sexes. In the wild, females remain in multifemale groups in which social bonds between the herd members are important; males live in all-male bachelor groups only until they are strong enough to successfully compete for access to groups of mares. A stallion’s relationship with other stallions is primarily combative, not affiliative. However, the ability of a stallion to establish and maintain affiliative relationships with mares may be important to its success with a band of mares. Snapping, in which the foal retracts the commissure of the lips and makes rapid up-and-down movements of the mandible, peaks during socialization. The foal may also turn its pinnae so that the concave surface is directed laterally and ventrally and/or flex its carpus while it is snapping. Snapping is commonly interpreted as a submissive behavior. However, submissive behaviors function to inhibit aggression by more dominant animals. Snapping does not do this and may, in fact, trigger aggression. Snapping most frequently occurs when a 2- to 3-month-old foal encounters another herd member because the other member approaches or walks past the foal or when the foal approaches an unfamiliar herd member. Snapping occurs mainly in response to the proximity of adults and may be a displacement behavior resulting from a foal’s conflicting motivation to interact with or run away from a stranger. The head and mouth movements of nursing foals and snapping foals are very similar.2,3,7 www.VetTechJournal.com
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Example of a foal performing flehmen.
Glossary Carpus Segment of the limb between the radius and ulna and metacarpus; also called the knee in horses Enteritis Inflammation of the intestinal mucosa Flehmen Behavior in which the horse extends its head, elevates its upper lip, and inhales, exposing the incisors; this creates a venturi effect that presumably brings chemicals into contact with the vomeronasal organ; it is usually, but not always, performed after sniffing urine, amniotic fluid, or other substances, including liniment Pheromone Substance produced by an animal that triggers a chemical behavioral response in members of the same species Pinna The outer projecting part of the ear
Stabilization and Developing Independence Four months of age and older is the period of stabilization and developing independence. During this period, adult maintenance behaviors such as grazing steadily increase in duration and frequency, and foal-typical behaviors steadily decrease. The growing foal’s daily activities become more like those of adults. The foal models its grazing after the mother’s grazing, at least in terms of time spent. For example, a 21-week-old foal grazes approximately 60% of the time that its mother is grazing but only 9% of the time that its mother is not grazing. By the fifth month of life, foals spend approximately half of the daylight hours grazing; adults spend approximately 70% of that time grazing. While nursing becomes less frequent, it still occurs one to two times per hour at 6 months of age and is probably an important form of social interaction with the mother, although the percentage of total nutrients provided by the mother is small at this point. In the wild,
Courtesy of Sharon L. Crowell-Davis, DVM, PhD, DACVB
EquineEssentials foals nurse until their mother gives birth to a new foal, at which point the mare typically does not allow the older foal to continue nursing. In the domestic situation, foals are often weaned from their mother at a relatively young age, usually because of human convenience or tradition. However, as long as the mare is in good health and can maintain an acceptable weight, weaning should be delayed to allow continued social development.
References
1. Lent PC: Mother-infant relationships in ungulates, in Geist V, Walther W (eds): The Behaviour of Ungulates and Its Relation to Management. Morges, Switzerland, International Union for the Conservation of Nature and Natural Resources, 1974, pp 14–55. 2. Crowell-Davis SL: Developmental behavior. Vet Clin North Am Equine Pract Behav 2(3):569–586, 1986. 3. Crowell-Davis SL: Normal behavior and behavior problems, in Kobluk CN, Ames TR, Geor RJ (eds): The Horse: Diseases and Clinical Management. Philadelphia, WB Saunders, 1995, pp 1–21. 4. Crowell-Davis SL, Claude AB: Coprophagy by foals: Recognition of maternal feces. Appl Anim Behav Sci 24:267–272, 1989. 5. Crowell-Davis SL, Houpt KA: Coprophagy by foals: Effect of age and possible functions. Equine Vet J 17(1):17–19, 1985.
6. Crowell-Davis SL, Houpt KA: The ontogeny of flehmen in horses. Anim Behav 33:739–745, 1985. 7. Crowell-Davis SL, Houpt KA, Burnham JS: Snapping by foals of Equus caballus. Zeit Tierpschol 69:42–54, 1985.
In this article on foal development, Dr. Crowell-Davis discusses the different stages of foal development and stresses the importance of raising orphaned foals so that Sharon L. Crowell-Davis, they are both physically and behaviorally normal. She DVM, PhD, DACVB says, “Foals, like humans, proceed through a complex series of developmental phases involving motor, sensory, cognitive, and behavioral changes; however, unlike in human development, there is little educational material available about this important stage in the horse’s life cycle.” Sharon is a professor of veterinary behavior at the University of Georgia College of Veterinary Medicine. She was one of the founding diplomates of the American College of Veterinary Behaviorists (ACVB). In addition, she has served as president of the ACVB and the American Veterinary Society of Animal Behavior. She credits her parents for encouraging her to pursue her dreams during a time when women were discouraged from entering the field of veterinary medicine. In addition, she says that it would have been difficult spending “thousands of hours following mares and foals around pastures” if it hadn’t been for her husband, Bill, who faithfully brought her sandwiches! ABOUT THE AUTHOR
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TIP of the MONTH
Each published Tip of the Month contributor receives a Veterinary Technician® scrub top in addition to $50.
Since instruments are sometimes taken from the exam rooms and not returned, I created a color-coding system to ensure that each room contains all the instruments needed for an examination. I assigned a color to each room and applied instrument tape of the same color to important items in the room, such as nail trimmers, stethoscopes, thermometers, and bandage scissors. With this system, all instruments are returned to the appropriate exam room. Carmen Sperle, CVT Stoughton, WI
If an air bubble develops in an IV line while a patient is receiving IV fluids, insert an 18-gauge needle into the primary set’s injection port and then clamp off the line between the patient and the injection port. The air bubble will run through the line and out the hub of the needle. If the patient is on an IV infusion pump, be sure to unclamp the line from the pump. Monica Henderson and Jacob Privette Summerville, SC It can be difficult to peel off the tape under and around an IV catheter, so I rub vegetable oil on the tape with a cotton swab. This makes the tape easier to remove. Vanessa Gaglione Berkeley, CA When light-sensitive drugs are added to IV fluids, I cover the IV fluid bag with an oven mitt. The mitt can also be used to keep fluids warm www.VetTechJournal.com
when treating hypothermic patients. Near the top of the mitt, cut a small hole so that the mitt can be hung on an IV pole or stand. To prevent the hole from fraying, apply glue around the edges. Magda Sobanski Charlotte, NC
All Dressed Up I use a stockinette to protect a drain tube or incision on the upper body of a small animal that is less than 10 lb. I cut the stockinette to length and add two holes for the animal’s front legs. The stockinette fits like a sweater and prevents the animal from licking the area. Danielle DeHaas, CVT Helena, MT At our clinic, we had to remove a tumor from a rat. After the procedure, we applied an Elizabethan collar made from old x-ray film. To create the collar, we cut the film into a circular shape that was large enough to prevent the animal from
licking the incision. Then we cut a line from the outside of the film to the middle and cut another circle in the middle of the film to fit the animal’s neck. Finally, we used bandage tape around the edges of the inner circle to protect the animal’s neck from sharp edges, and we used bandage tape to secure the collar on the animal. Heather Clifford Randolph, VT
Courtesy of Heather Clifford, Randolph, VT
Tricks of the Trade
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TechTips
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In our hospital, if an animal refuses to eat, we smear a small amount of wet food on the animal’s paw or nose. The animal will usually lick the food off and become interested in eating. Sharon Teasley, RVT Temple, GA At our clinic, clients whose pets are on prescription diets often mention that they have trouble finding prescription treats to give their pets. We recommend that clients purchase a can of the prescription food, cut the food into slices, and bake them. The baked slices of food can then be given as treats. Tara Bechtol Cincinnati, OH
This way, the instruments are easy to find. Dana Johnston-Smith, RVT Seattle, WA To keep Elizabethan collars organized and easily accessible, we hang them from shower curtain rings placed on a towel rack that is secured to the wall. The collars are arranged by size for easy identification. We placed the towel rack in the basement stairway so that the collars are out of sight. Gayle DiMenna, CVT Bethany, CT
TECH TIP CHALLENGE $50 paid for each published response! What tips do you have for handling and restraining large birds? Deadline for responses: March 17
Answers to our Tech Tip Challenge or other Tech Tip submissions should be sent to: Email: editor@VetTechJournal.com Fax: 800-556-3288 Mail: VLS/Veterinary Technician, 780 Township Line Road, Yardley, PA 19067 We pay $50 for each tip, question, or solution selected for publication. Submissions should not exceed 100 words and will be edited for length and clarity. Photos are welcome. Be sure to include your full name, address, and daytime phone number so that we can contact you. Videotape your tech tips and upload them to www.VetTechJournal.com/sharetechtip. We will pay $100 for every Tech Tip video that we post on www.VetTechJournal.com. Tech Tips are compiled by VLS Assistant Editor Liz Donovan.
Courtesy of Gayle DiMenna, CVT, Bethany, CT
Food for Thought
Tidy Tidbits In our exam rooms and treatment area, we attach bandage scissors, suture scissors, hemostats, and other commonly used metal instruments to magnetic strips placed in an easily accessible location.
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ProductForum Absorbine
Andover Healthcare
Stall Safe Disinfectant and Sanitizer
“No Chew!” PetFlex Bandages
Approved by the US Environmental Protection Agency, Stall Safe disinfectant and sanitizer has been developed to prevent the spread of contagious viruses and bacteria in horse barns, stalls, and trailers, as well as on equipment. Absorbine states that Stall Safe is a proven virucide, bactericide, and mildewstat that is more effective than chemicals such as bleach, ammonia, and iodine. The company claims that regular use of Stall Safe can eliminate Staphylococcus aureus, Salmonella spp, porcine rotavirus, and infectious bovine rhinotracheitis virus. The product is available in a kit that contains a bottle of Stall Safe concentrate, which makes 2 gallons of solution; an ergonomically designed mixing bottle; and a motorized sprayer. Each gallon of solution can treat the walls and floors of four or more stalls. 800-628-9653, ext. 477 䡲 www.absorbine.com Circle 101 on Reader Service Card
800-432-6686 䡲 www.andoverhealthcare.com Circle 102 on Reader Service Card
Dechra Veterinary Products
A VMA V Accr AVMA Accredited
Veter Veterinary TTechnology echn Degrees D egre • Associate’s Associate’s degree degree
Andover Healthcare announces the release of its “No Chew!” PetFlex printed cohesive, flexible bandages. The company states that the bitter taste of the bandages prevents pets from biting, tearing, or chewing them. The “No Chew!” PetFlex is available in 2- and 4-inch sizes. Andover Healthcare claims that the bandages in its PetFlex line are twice as strong as other cohesive bandages and are resistant to sweat and water. In addition, they are easy to apply; no scissors are required because the patented EasyTear technology allows for a clean hand-tear.
e n i l On
• Bachelor’s degree
(727) 27 7) 341-4SPC www.spcollege.edu/hec/vt w.spcollege.edu/hec/vt
St. Petersburg u g College urg Excellence in education uccation i since i 1927 1 Circle 181 on Reader Service Card
Muricin Ointment
Muricin ointment is now available for treating bacterial skin infections in dogs. The ointment contains mupirocin, a naturally occurring broadspectrum antibiotic that inhibits the growth of various gram-positive and gram-negative bacteria. Muricin is indicated for topical treatment of skin infections such as superficial pyoderma caused by Staphylococcus aureus and Staphylococcus intermedius. 913-327-0015 䡲 www.dechra-us.com Circle 103 on Reader Service Card
For more information about the products highlighted in this section, fill out and return the Reader Service Card inserted between pages 88 and 89 of this issue. The product and service descriptions presented in Product Forum are provided by the manufacturers and are not necessarily endorsed by Veterinary Technician.
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ProductForum Nestlé Purina PetCare Company
Pro Plan Selects Pet Food To meet the growing demand for natural pet food, Nestlé Purina PetCare Company has added new products to its line of Selects formulas for cats and dogs. The products for dogs contain no corn, no animal by-products, and no artificial colors, flavors, or preservatives. The new canned Pro Plan Selects dog products, including varieties such as natural chicken and brown rice or natural turkey and barley, are formulated with antioxidants and contain grains and potatoes. The new variety of dry dog food, natural salmon and brown rice, is rich in omega-3 fatty acids and contains antioxidants. The company claims that the new canned Pro Plan Selects products for cats, including varieties such as natural chicken and brown rice or natural yellowfin tuna and mackerel, provide high-quality protein and are rich in antioxidants. The new dry formulas for cats, including natural salmon and brown rice, contain 40% protein, antioxidants, vitamin A, and taurine. The Pro Plan Selects canned products come in a 5.5-oz size for dogs and a 3-oz size for cats. The dry formula for dogs is available in 6-lb, 17.5-lb, and 33-lb bags; the dry formulas for cats are available in 3.5-lb and 7-lb bags. 800-776-7526 䡲 www.proplan.com 䡲 Circle 104 on Reader Service Card
Index to Advertisers For more information about products advertised in this issue, see the Reader Service Card inserted between pages 88 and 89.
Company American College of Veterinary Internal Medicine Animal Health Options ASPCA Bayer Animal Health Fort Dodge Animal Health The Greenies Company Hill’s Pet Nutrition Lilly Merial NCVTSA Nestlé Purina PetCare Company Nutramax Laboratories Pet King Brands Pfizer Animal Health Schering-Plough Animal Health St. Petersburg College Summit VetPharm Veterinary Learning Systems Vetstreet
Product 2008 ACVIM Forum
Reader Service # 198
ProNeurozone Animal Poison Control Center K9 Advantix ProMeris Greenies dental chews Pets Need Dental Care, Too Prescription Diet Canine t/d Comfortis Reconcile Heartgard Plus Merial EDU OraVet 2008 National Conference of Veterinary Technician Specialty Academies Purina Veterinary Diets OM Overweight Management Canine Dry Formula Dasuquin Biotene Brushless Starter Kits Clavamox Dexdomitor Slentrol Tri-Heart Plus Online Veterinary Technology Program Vectra 3D VetLearn.com The New Way Clinics and Clients Connect
127 184 195 160 136 139 193 190 129 151
Page # 91 97 75 117 Cover 4 85 Cover 2 (US only) Cover 2 (Canada only) 77, 78–79 106, 107 93, 95 67 87 119
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124–125
192 148 194 196 138 176 181 203
69 115 71 (US only) 103, 104 112, 113 110, 111 126 109 121 Cover 3
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The following advertisers appear in our Market Showcase section, which begins on page 128. MED I.D. Petknap, Inc. Veterinary Solutions
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BIPS Capsules X-Ray Identification System Pet Burial Bags World’s Best Dog & Cat Muzzle
135 135 168 147
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World’s Best Dog & Cat Muzzle The durable, soft plastic Vetsol cat & dog muzzle goes on easily, is comfortable, and stays put! Great for exams, drawing blood, taking x-rays, and grooming.
get more exposure for your market SHOWCASE ad!
Catheter Guards Save time and money by protecting your patients’ IV catheters.
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VETERINARY SOLUTIONS PO BOX 16195, SEATTLE, WA 98116-0195
www.vetsol.com • becky@vetsol.com 858-232-0081
BONUS!
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highly qualified leads for your sales force. FOR MORE INFORMATION OR TO PLACE AN AD, CONTACT LINDA COSTANTINI Phone 800-426-9119, ext 2422, or 267-685-2422 • Fax 201-231-6373 Email lcostantini@vetlearn.com or VetTechClassifieds@vetlearn.com
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ClassifiedAdvertising TECHNICIANS WANTED
TECHNICIANS WANTED
ALABAMA – Madison Veterinary Hospital is accepting applications for licensed veterinary technicians who would enjoy working in a fast-paced, four-veterinarian, small animal practice with an emphasis on surgery and dentistry. Our technical gadgets include ultrasound, digital radiology, endoscope, and digital dental radiology. We also offer dental restoratives! We have a grooming facility and extensive boarding with our own boarding staff. Learn more about us at our website: www.madisonvet.com. We are looking for an outgoing, energetic person who works well in a busy environment. The position is full-time with a flexible work schedule. We offer CE; 401(k); health insurance; uniform allowance; discounted pet care; and paid sick, holiday, and vacation days. Please contact Angelique Lawrence at 256837-9171 or madvet@aol.com.
raphy (expanding to all digital radiography soon). Our patients are mainly small and exotic animals. We offer competitive wages with pay differentials for weekends, swing, and grave shifts and great benefits, including health, dental, paid vacation, flexible spending, CE allowance, uniform allowance, employer-matched 401(k), and very generous discounts on health care, food, and supplies for your pets. The ideal candidates are professional, self-motivated, and interested in advancing their skills working in a vibrant team environment with other technicians and doctors. Licensed or experienced candidates are preferred, but all interested applicants are encouraged to email resumes to adobeanimal@comcast.net. For more information, visit www.adobe-animal.com.
ALABAMA – Technicians wanted for busy AAHA-accredited hospital in beautiful northeast Alabama. Applicants must have experience in a technician capacity at a veterinary hospital or be a recent graduate of a veterinary technology program. We offer digital radiography, ultrasound, laser surgery, orthopedics, and much more. Team members enjoy such benefits as BC/BS, paid time off based on hours worked, healthy pet benefits, and a family-oriented environment. Must be available and willing to work evenings, weekends, and holidays. Visit our website at www.amc vets.com. Please send cover letter and resume to: Tech, PO Box 2414, Anniston, AL 36202 or email bonniediehl@ amcvets.com.
CONNECTICUT – Experienced veterinary technician needed for three-DVM small animal hospital located 1 hour from NYC near beautiful Candlewood Lake. Utilize all of your skills while you help us transition into our new, state-of-theart, 8,800–sq. ft. hospital. Management responsibilities if desired. Excellent compensation. Phone 203-775-3679, fax 203-775-9496; www.BrookfieldAnimalHospital.com.
ALASKA – Experienced licensed or unlicensed technician needed for busy emergency hospital open evenings, weekends, and holidays. Have your days free to see the sights of Alaska. Competitive wages, health and dental insurance, vacation pay, and continuing education opportunities. Send resume to PET Emergency Treatment, 2320 East Dowling Road, Anchorage, AK 99507. CALIFORNIA – Full-service thoroughbred racehorse facility seeks an energetic, friendly, organized, and self-motivated individual to join our team full-time. Experienced or licensed veterinary technician wanted; must be proficient in giving intravenous/intramuscular injections, drawing blood, preparing and dosing medications, and assisting veterinarians. Foaling experience a plus! Benefits available. Please fax resume to 805-693-1644 or email to info@ magalifarms.com. CALIFORNIA – Excellent career opportunities for com-
passionate, skilled veterinary technicians in our state-ofthe-art, AAHA-accredited, multispecialty referral hospital. We are currently seeking experienced critical care/emergency and surgical technicians to join our team. RVT/VTS and anesthesia experience a plus. Salary commensurate with experience. Benefits include health insurance, CE, 401(k). Contact Mary Rattray at 818-244-7977. Send resume to Animal Specialty Group, 4641 Colorado Blvd., Los Angeles, CA 90039. Website www.asgvets.com; email asgvets@asgvets.com; fax 818-507-9418.
CALIFORNIA – Full-time technician/receptionist needed for modern small animal clinic with an ocean view. Excellent pay and benefits including vacation, continuing education and health insurance. Fax resume to 949-499-4698 or call 949-499-4190.
CALIFORNIA – Are you looking to improve your current
skills and gain new ones in an exciting, team-oriented environment? Adobe Animal Hospital in Los Altos is looking for veterinary technicians and assistants to join our team of 20 doctors and over 100 support staff at our 24-hour, AAHA-accredited facility. With dedicated ICU, surgery, and client-relations technicians, our staff prides itself on working in a collaborative atmosphere as a complete medical team. Our state-of-the-art facility includes an in-house laboratory, ultrasound, endoscopy, and digital dental radiog-
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DELAWARE – Certified and/or experienced technicians
needed for multiple part-time (4 to 6 hours) shifts at new veterinary imaging center in New Castle County. MUST be proficient in IV catheter placement and have a strong anesthesia background and sound ability to monitor patient vitals. This position could lead to full-time employment and — for the right individual — the opportunity to manage an anesthesia team. Please fax resume to 610918-9938.
FLORIDA – Veterinary technician needed for small animal
practice in Tallahassee. Located in a great university community close to the Gulf Coast. Salary and benefits for fulltime. Contact Dr. Carter for an application and interview: 850-878-4799.
FLORIDA – Pensacola. Outgoing CVT needed for small
animal practice with an emphasis on dentistry and surgery. Health, IRA, bonus, uniforms, CE, sick leave, paid vacation, and relocation allowance are available. Contact Dr. Ashley at 850-479-2222; email drashley@mchsi.com; www.cordovaamc.com.
TECHNICIANS WANTED
FLORIDA Coral Springs Animal Hospital, a primary care/multispecialty/critical care/emergency facility, open 24 hours/day, is always accepting applications for enthusiastic, motivated, compassionate, dedicated, quality-minded AHTs and CVTs or similarly experienced technicians without a degree. New graduates are encouraged to apply. We practice professional, excellent veterinary medicine and surgery with the highest degree of ethics and integrity. We are looking for individuals who want to use their veterinary nursing technical skills to the fullest. Technicians with the desire to work at a premium facility that has a great record of retaining excellent veterinary nurses are encouraged to apply. Salary is commensurate with experience but will range from $28,000–$40,000+ plus shift pay differentials. We also have a generous benefits package that includes health and dental insurance, paid vacation, paid sick or personal days, paid holidays, CE, uniform allowance, retirement plan with employer matching, bonuses, discounted pet care. Drug-free workplace. Four-day workweek. Please visit our website at www.coralspringsanimalhosp.com. Please send resume to: Coral Springs Animal Hospital 1730 University Dr. Coral Springs, FL 33071 Attn: Megan Kelly, Nurse Manager Phone 954-753-1800; Fax 954-343-0238
FLORIDA - VETERINARY TECHNICIANS/NURSES We are a state-of-the-art small animal referral practice located in West Palm Beach. Our in-house veterinarians and consultants specialize in emergency and critical care, surgery, internal medicine, oncology, neurology, cardiology, radiology, and behavior sciences. We have a place for you, whatever your interests may be!
Qualities we require in a technician/nurse include the following: • Clinical as well as interpersonal skills • Desire to directly assist with case management • Self-motivator and active team member • New graduates welcome! Excellent compensation adds to our quality working environment. Additional benefits include medical and dental insurance, 401(k) retirement plan, paid vacation, uniform reimbursement, CE, and discounted services for your own pets! The greater West Palm Beach area is a growing, pleasant region of Florida with a comfortable climate. With magnificent beaches lining the Atlantic coast and one of the largest wilderness areas in the United States, outdoor recreational activities abound. Just a short drive to Miami Beach will bring you to the multicultural center of south Florida. Two hours north will take you to the Orlando area where you will find a number of theme parks and the Kennedy Space Center.
If interested, please call and/or fax your resume to our HR Director, Jennifer, at Palm Beach Veterinary Referral & Critical Care Center at 561-434-5700. Fax: 561-296-2888 • Email: pbvrs@earthlink.net Veterinary Technician | FEBRUARY 2008 129
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ClassifiedAdvertising TECHNICIANS WANTED
TECHNICIANS WANTED GEORGIA – Consider practice in beautiful Atlanta. Whether
you are thinking about relocation or are already in this area, please consider a position with Georgia Veterinary Specialists. At GVS, you will find many specialty areas to utilize your skills and love for animals. We seek experienced, highly skilled technicians, assistants, and kennel assistants to join our 24-hour emergency, critical care/specialty referral practice. Along with recent facility expansion and the ever-increasing number of motivated, skilled doctors, our hospital requires more technical coverage. You'll find excellent pay, strong benefits package, 401(k), and vacation. Qualified candidates, please submit a resume, cover letter, and salary request to Human Resources: aflower@gvsvet.com or fax 404-459-0835. If you hope to practice where you and your skills will be valued...COME, GROW WITH US!
(352) 392-2235 ext. 5428 recruiter@vetmed.ufl.edu.
FLORIDA – MIAMI VETERINARY SPECIALISTS is a state-of-the-art veterinary referral practice with multiple board-certified specialists on site. MVS practices high-quality, cutting-edge veterinary medicine. MVS is looking for highly enthusiastic, self-motivated, experienced team players to join our fast-growing technician staff. Work to your fullest capability with our specialists assisting in: Ultrasonography • Endoscopy • Oncologic surgery • Neurologic surgery • Dermatology • Fluoroscopy • Orthopedic surgery • Soft tissue surgery • Internal medicine • 24-hour emergency care • And much more Specialized duties include: patient monitoring (including anesthesia), ICU and critical care, surgical prep, sterility assistance, specialized diagnostics and treatments, radiography, and the ability to think and handle responsibility. Benefits include: 401(k), CE, paid vacation, medical/dental insurance, pet discounts, and more. New graduates welcome. Interested veterinary technicians, please apply in person: Miami Veterinary Specialists, 8601 Sunset Drive, Miami, FL 33143 or fax resume to 305-665-2821, Attn: Brad, or call 305-665-2820 for more information. www.mvshospital.com
130 FEBRUARY 2008 | Veterinary Technician
ILLINOIS - Veterinary Specialty Center is a state-of-the-art multidisciplinary specialty referral hospital located in the northern suburbs of Chicago. There are great opportunities for certified technicians and veterinary assistants to join our team. Our growing specialties include surgery, internal medicine, oncology, cardiology, nephrology, neurology, radiology/imaging, emergency and critical care, dermatology, physical therapy, behavior, and ophthalmology. We have an excellent work environment with outstanding compensation and benefits. For more information on these exciting and challenging opportunities, please contact: Evelyn Feekin Veterinary Specialty Center 1515 Busch Parkway, Buffalo Grove, IL 60089 Fax 847-459-1848 • Phone 847-459-7535 x312 or email at efeekin@vetspecialty.com.
ILLINOIS - Twenty-four–hour emergency/critical care and specialty referral hospital in Chicago’s northern suburbs seeks experienced technicians for emergency/critical care and specialty departments. Seeking a rewarding and challenging career? Animal Emergency and Critical Care Center is emerging as one of the area’s fastest-growing veterinary centers. Board-certified specialists head up each discipline of the specialty referral practice: internal medicine, cardiology, surgery, neurology/neurosurgery, and imaging. A team of talented and dedicated emergency doctors completes our professional staff. All are committed to providing cutting-edge care 24/7. We are a high-energy, high-performing organization providing a learning environment for energetic, dedicated technicians. Fax Sheri at 847-564-9604. Email srothschild@aercenter.com. Competitive salary and benefits package
LOOK NO FURTHER.
We’ve got your ideal job!
TECHNICIANS WANTED ILLINOIS EXPERIENCED TECHNICIANS and CVTs WANTED Are you a professional? We have full-time positions open for CVTs or experienced emergency and critical care technicians to become members of our team. Our hospital is a 24-hour emergency and treatment center that features specialty surgery, critical care, and internal medicine. Our team of veterinarians and technicians is here because they believe that emergency and critical care offers the opportunity to practice the highest level of veterinary medicine. Sound challenging? We think so! We are looking for technicians who have the desire to learn and want to expand their knowledge and acquire new skills in these specialty fields. We offer a competitive salary and complete benefits package.
Interested candidates, please contact Cathie Moses at 847-548-5300 or fax your resume to 224-656-5180. Email: sshogren@aetcenter.com.
MARYLAND – Certified/registered technician or experi-
enced assistant needed for a full-time position at our busy, four-doctor small animal practice. Olney-Sandy Spring Veterinary Hospital is a progressive, AAHA-accredited hospital where technicians are utilized to their fullest potential in the areas of surgical assistance, anesthesia monitoring, dentistry, radiology, laboratory, nursing care, and client education. Eligible candidates must be available weekday evenings and Saturdays and must have experience in a small animal hospital. Benefits include health insurance, paid vacation and CE, 401(k), and more. Send resume to Denise Sharp: fax 301-570-5121 or email petpalds@aol.com. Please visit our website at www.ossvh.com.
MARYLAND – Experienced veterinary technician needed for progressive, high-quality, state-of-the-art referral and emergency center. Located on 30 acres in Frederick. Great salary and working conditions. Fax resume and cover letter to 301-874-8880 or email jfinnegan@greenbriarpethospital.com. Visit our website at www.greenbriarpethospital.com. MARYLAND Veterinary Technician Supervisor Atlantic Veterinary Internal Medicine, in Annapolis and Towson, is currently hiring full-time registered or experienced veterinary technicians as well as an experienced technician supervisor. Both offices are part of the Chesapeake Veterinary Referral Center and are convenient to Baltimore, historic Annapolis, and Washington, D.C. Applicants should be compassionate, detail-oriented, and organized. We offer an excellent benefit package including health, dental, 401(k), and much more! Please call Kim Thomas at 800-788-2872 or fax resume to 410-224-2295. Visit our Web site at www.atlanticvetintmed.com to meet our doctors and staff.
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TECHNICIANS WANTED
MASSACHUSETTS – Veterinary technician and tech- NEW JERSEY – NEW state-of-the-art hospital opening Febnician assistant needed for three-doctor practice located in Boxborough. Country setting with easy access to Routes 2 and 495. Seeking individuals with excellent client/coworker communication skills and high standard of patient care to work in exam, surgical, and treatment areas. Rotating schedule includes weekend and evening hours. Competitive compensation; benefits available. Contact Karen at 978-263-0995 or fax resume to 978263-8912.
MASSACHUSETTS – Rapidly growing, three-doctor small
animal hospital in Chelmsford is seeking an experienced, motivated team player to join our technician staff. Full-time position with benefits. Salary commensurate with experience. Please fax resume to Chelmsford Animal Hospital at 978-256-4965.
ruary 2008! This is your chance to really make a difference. Seeking happy, motivated, enthusiastic technicians. Check us out at www.barnsidevethospital.com or email vetbythesea@ barnsidevethospital.com for employment brochure. Howell – central shore area – farms and the beach!
NEW JERSEY – Licensed or experienced technician wanted for small animal practice in Edgewater. We practice high-quality medicine for upscale clientele who consider their pets to be part of the family. We use state-of-the-art equipment including high-speed fiber-optic dental unit, dental radiographs, video otoscopy, electrocautery, Doppler and oscillometric blood pressure, pulse oximetry, and ECG and offer on-site ultrasound and endoscopy. We are looking for someone who is motivated, dedicated, has good communication skills, and is willing to continue to learn. Competitive salary, retirement plan, medical insurance, and continuing education. Call Dr. Bill Freedman 201-313-7000. NEW YORK – Bideawee seeks licensed veterinary techni-
cians for its Manhattan location to work with veterinarians in providing care for our resident animals in the adoption center and for private client animals. Send cover letter/resume to greg.carastro@bideawee.org or fax 212-532-4210.
NEW YORK – Licensed or license-eligible veterinary techni-
cian wanted for a three-doctor practice on eastern Long Island. We are a compassionate and caring staff who work well together in a great work environment. Candidate will be allowed to practice a full range of technician duties in a well-equipped, state-ofthe-art hospital. Competitive salary with excellent benefits. Call Julie at 631-324-7900 or fax resume to 631-324-9433.
NEW YORK – Great opportunity for licensed or licenseeligible veterinary technician at Central Animal Hospital in Scarsdale, 30 minutes from NYC. We are a team-oriented, six-doctor/six-tech, AAHA-accredited small animal hospital with the latest equipment. Benefits: 4-day work week, competitive salary, CE, medical, six paid holidays, 2 weeks vacation, 401(k)/profit sharing plans. Apartment available. NO night emergencies! Call Paul Staar 914723-1250.
TECHNICIANS WANTED NORTH CAROLINA – Come enjoy the “Land of Water-
falls” in Brevard as a certified veterinary technician in a well-established small animal practice. Applicant must be licensed or license-eligible. Competitive salary/excellent benefits. If you are interested in a career working with a highly motivated, energetic team, please send your resume to: PO Box 181, Brevard, NC 28712 or call 828-884-3647.
NORTH CAROLINA – Twenty-four-hour, AAHA-accred-
ited veterinary hospital in Matthews seeks outstanding, dedicated, full-time licensed technicians or assistants with minimum of 2 years emergency/critical care experience. Nights, weekends, and holidays required. Generous benefits and compensation. Email resume to Emergency Veterinary Clinic: EVC6440@aol.com.
OHIO – The Veterinary Referral Clinic & Emergency Center in Bedford Heights is looking for full- or part-time registered (or eligible) veterinary technicians to work in the emergency center and specialty hospital. $2,000 SIGN-ON BONUS when hired for our busy emergency center! We offer an outstanding wage with shift differential; comprehensive medical and dental health insurance; 401(k)/profit sharing; paid vacation; sick, personal, and holiday time off; uniform allowance; pet care discounts and allowances; and compensation for continuing education and license fees. Please contact Kathy George, Hospital Administrator, at KGeorge@nvanet.com or fax resume to 216-831-5980.
The next available issue
is APRIL, which closes FEBRUARY 27
RECRUITING VETERINARY TECHNICIANS WHO WANT TO BUILD A CAREER AND ADVANCE IN THEIR AREAS OF SPECIALTY MICHIGAN – Small animal emergency/referral hospital in Kalamazoo is in need of another LVT. Board-certified surgeon and emergency/critical care specialist on staff. LVT duties will include anesthesia, surgical assistance, intensive care nursing, radiology, and clinical laboratory work. Full-time position with excellent salary and benefits. Send resume to Southwest Michigan Animal Emergency/Referral Hospital, 6039 South Westnedge Avenue, Portage, MI 49002; fax to 269-323-3636; or phone 269760-4056. NEW JERSEY – RVT needed for busy, two-doctor, AAHA-
accredited small animal practice in beautiful Sussex County. Must be a motivated self-starter and team player with proficiency in technical and client relation skills. Competitive salary; benefits include vacation/personal time, health insurance, uniforms, CE, 401(k). Fax cover letter and resume to 973-729-4092, attn: Diane or email dvanlear59@yahoo.com.
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Cornell University Hospital for Animals is growing and needs veterinary technicians interested in expanding their knowledge and skill levels in the areas of:
Anesthesia Critical Care/Triage Equine Farm Animal Outstanding salary, individualized orientation, mentor program, tuition reimbursement, technician CE, health and dental insurance. If you have an AVMA-approved degree in veterinary technology, have/are eligible for New York State licensure, and have experience in a fast-paced environment, send cover letter and resume to:
Ms. Kimberly Baldwin, LVT, VTS (ECC) Manager of Nursing Services Cornell University Hospital for Animals Box 35 CVM, Ithaca, NY 14583-6401 Check our website: www.vet.cornell.edu/hospital. Veterinary Technician | FEBRUARY 2008 131
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ClassifiedAdvertising TECHNICIANS WANTED
TECHNICIANS WANTED
OHIO
Gwynedd Veterinary Hospital and Emergency Service is a busy 24-hour medical care and referral facility with a 16-doctor and 30-technician team providing comprehensive care and ER services, located 45 minutes northwest of Philadelphia. We have two board-certified specialists on our staff who regularly perform endoscopy, ultrasound, and orthopedic surgery. Our clients appreciate the excellent patient care delivery that we offer, including digital radiography, in-house coagulation testing, multilumen catheterization, capnography, and TPN. Salary is commensurate with experience. Your colleagues are talented and focused on quality patient care using the latest techniques and medications. We offer a flexible schedule and excellent benefits.
Registered Veterinary Technicians Needed Metropolitan Veterinary Hospital is in need of registered veterinary technicians to assist with our high-volume, state-of-the-art central hospital and referral center. We offer a wide range of services: internal medicine, surgery, neurology, ophthalmology, cardiology, and emergency and critical care. Primary responsibilities would include assisting with animal care, basic laboratory duties, diagnostic techniques, and surgical procedures, with a secondary function involving client contact, reception skills, and personal technical development. Candidates must be licensed RVTs in Ohio with a proven ability to function in a fast-paced environment. New and experienced technicians welcome. We offer competitive wages, health benefits, uniforms, paid time off, and a rewarding work environment. If you are interested in joining our team, please send your resume to: Metropolitan Veterinary Hospital, Attn: Human Resources 1053 South Cleveland-Massillon Road, Akron, OH 44321 Fax 330-666-0519 or email to s.steen@metropolitanvet.com (subject: Registered Veterinary Technician).
PENNSYLVANIA - We are a specialty/ referral/emergency and critical care practice located in Valley Forge. We have a brand new 18,000–sq. ft. facility with state-of-the-art diagnostic and therapeutic equipment. We offer a competitive salary, multiple health care packages, CE compensation, 401(k), personal pet discounts, and a generous amount of vacation time. Three- to 4-day work schedule for the emergency service and 4- to 5-day work schedule for specialty. University level medicine in a fun and relaxed environment. Contact Julie Banyacski, CVT, VTS (ECC), at 610-666-1050 or fax 610-666-1199.
PENNSYLVANIA Experienced technician needed for 24-hour fullservice emergency AAHA-accredited veterinary practice located in the beautiful Pocono Mountains, 90 minutes from New York City and Philadelphia. We are a six-doctor small animal and exotics clinic with a strong surgical and orthopedic background, currently seeking night and overnight technicians. Weekends are a must. Person must be self-motivated, a team player, and possess great people skills. Competitive salary, continuing education, and benefits offered based on experience.
Visit our hospital at www.creaturecomfortsvet.net. Call Liz after 4 PM at 570-992-0400; fax resume to 570-992-4713, Attn: Liz; or email lmbccvs@hotmail.com.
132 FEBRUARY 2008 | Veterinary Technician
Please fax resume to 215-699-7754 Attn: Cindy Lorenz Email: gwyneddvethosp@comcast.net Visit our website at: www.gwyneddvethospital.com.
TECHNICIANS WANTED PENNSYLVANIA – Full- or part-time veterinary technician position available for a compassionate team player at our busy, five-doctor, AAHA-accredited small animal practice in Wyomissing. Experience preferred; salary/benefits commensurate with experience. To join our team, call 610-3722121 or fax resume to 610-372-0903. SOUTH CAROLINA – Our new veterinary hospital in Lex-
ington is looking for certified veterinary technicians and assistants. We are a progressive, one-doctor, small animal hospital located just west of Columbia with close access to lake, ocean, mountains, and other recreation. Full- and parttime positions available. All replies confidential. Email current resume to 452ocr@gmail.com.
TENNESSEE – We are growing again and have openings for two licensed or license-eligible veterinary technicians. Pet Emergency Treatment Service offers after-hours emergency care for dogs and cats in the Brentwood/Franklin area. We have one part-time and three full-time emergency doctors, six full-time LVTs, and other great support staff. We are next door to an established daytime surgery specialty practice. Excellent pay and benefits for the right candidate. Rotating schedule has large blocks of time off. Email your resume and inquiry to PETSEmergency@aol.com or call 615-554-7387. TENNESSEE – New feline-exclusive practice in Chat-
Professional Services Technician I Leading veterinary industry continuing education provider located in Yardley, Pennsylvania, is seeking a Professional Services Technician. The Professional Services Technician will be responsible for answering incoming or placing outgoing calls, emails, or faxes to provide technical product support on pharmaceuticals, biologics, and other animal health products as per client contracts. This includes market research and guarantee claim data collection, entry, and processing. The technician will be responsible for performing technically accurate and timely reporting of adverse events by following contractual standard operating procedures. The preferred candidate, who may or may not be a licensed/certified veterinary technician, must be a detail-oriented team player with the ability to communicate technical subjects to colleagues, peers, and external clients. The individual must have exceptional communication and interpersonal skills and the ability to multitask. Strong computer skills using MS Office are required. This position offers a competitive compensation plan, health benefits, and matched 401(k). Please send cover letter and resume, which must include salary requirements, to Attn HR: email jobs@medimedia.com or fax 267-685-2952. EOE.
tanooga seeks licensed or license-eligible full-time technician. Experience preferred; dedication, compassion, and a willing attitude absolutely required. Competitive wages, continuing education, and benefits based on experience. Contact Dr. Marcia Toumayan: 423-752-0737 or jobs@ChattCatVet.com. Website: www.ChattCatVet.com.
TEXAS
Veterinary Technician The University of Texas Medical Branch at Galveston needs a full-time (40 hours/week) veterinary technician to provide technical expertise in all aspects of anesthesia; aseptic surgery support; pre- and postoperative care; and clinical and laboratory support services. Responsibilities will include administering treatments as directed by supervisors; anesthesia induction, maintenance and monitoring; surgical/veterinary record-keeping; operation, set-up, and maintenance of surgical equipment and the operating suite; radiograph exposure and development; sample collection and processing; and participating in daily rounds and health checks. High school diploma or equivalent plus 2 years of related experience required. AALAS certification (ALAT level), RVT, or equivalent preferred. Interested candidates should apply online at www.utmb.edu/hcm (Job Title: Veterinary Technician; Job ID #5031). UTMB at Galveston is an equal opportunity, affirmative action institution that proudly values diversity. Candidates of all backgrounds are encouraged to apply.
TEXAS – The Animal Emergency Center of West Houston,
the fastest-growing AAHA-accredited emergency center in the country, is currently looking to hire compassionate, confident, motivated, team-oriented, and experienced nurses for full-time positions in our state-of-the-art facility. Potential candidates should show a willingness to learn, love to interact with people, have good typing skills, and have knowledge of Microsoft Word and Excel. Candidates
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TECHNICIANS WANTED
TECHNICIANS WANTED
should be able to multitask and be willing to work nights, weekends, and holidays. We offer very competitive wages (to be determined with experience) and benefits (health insurance, vacation, sick time, CE, license fees, uniform allowance, etc.). Interested candidates can email their resumes to aecwh.aecwh@hotoffice.net or fax to 832-5938388.
seven-doctor, AAHA-accredited practice expanding our state-of-the-art facility and need a new licensed veterinary technician to help us grow. Our fully utilized current staff of four LVTs is very team oriented and always works to provide the best care possible. The position offers competitive salary and benefits. Please contact us at taylordvm03@ yahoo.com or 540-230-9030. We are located in Centreville, VA 20121.
McAuliff or Barb Cotton. Fax 540-891-4698 or call 540891-1275.
UTAH - We are seeking skilled veteri-
nary technicians with a perfect mix of technical and client service capabilities for a high-energy practice in the quaint 9th and 9th district in beautiful Salt Lake City. Our brand-new, state-of-the-art, AAHA-accredited facility is now open. Full-time positions are now available with very competitive wages, great benefits, and team-based work environment. Commitment to excellent patient care and client service a must! Highly motivated technicians who thrive in a fast-paced, challenging, and rewarding position may fax resumes with an intro letter to 801-328-9158 or email info@upcvet.com www.uvhdc.com
VIRGINIA – We are looking for a full- or part-time LVT to
join our growing AAHA-accredited practice. Our four-doctor/two-LVT small animal practice has great clients and a well-trained, highly committed staff and we need another eager LVT to grow with us. Duties include providing nursing care, taking radiographs, monitoring anesthesia, assisting in surgeries, collecting and processing laboratory specimens, and giving routine vaccines. We offer boarding and grooming services, so your knowledge and skills will be put to good use. We offer highly competitive benefits, including paid vacation, continuing education, and insurance. Salary commensurate with skills and experience. Please contact Sherry Meier, Office Manager; Ross W. Moore, DVM; or Toni Connell, DVM: Independent Hill Veterinary Clinic, 13444 Dumfries Road, Manassas, VA 20110; call 703-791-2083; or email kirby13444@aol. com. Calls preferred.
VIRGINIA – Centreville Animal Hospital is a small animal
*Source: June 2007 BPA Statement
practice with a family-friendly environment. We are a
VIRGINIA Experienced Veterinary Technicians Wanted. The LifeCentre for Veterinary Emergency & Specialty Care in Leesburg has full-/part-time licensed technician positions available in our emergency/critical care and internal medicine departments. We are seeking skilled, experienced, compassionate individuals to meet the expanding needs of our emergency and specialty practice located in northern Virginia. Our group recently moved into a brand-new, stateof-the-art, 18,300–sq. ft. facility that was designed from the ground up as a referral hospital. The facility has all the toys, including CT, digital radiography, ultrasound, in-house lab equipment, telemetry, and new MRI machine on site. We offer the ability for the right individuals to join our team and be challenged and appreciated by the doctors, staff, and clients. We offer competitive pay ($1,500 signing bonus) and benefits, including health insurance, 401(k), CE allowance, moving allowance, vacation, and personal paid leave. Please email your resume to: LeesburgLVT@aol.com or fax to 703-777-3396 Attention: Human Resources.
VIRGINIA – Well-established, progressive animal hospital in search of motivated LVT to join our talented team. Practice established in 1994, relocated to a brand new 8,000–sq. ft. building in 2002. Located 5 minutes from beautiful historic Fredericksburg and an hour from Richmond and Washington, DC. Our state-of-the-art equipment includes sevoflurane, endoscopes, IDEXX work station, modern dental equipment, ultrasound, laser, digital x-ray, and physical therapy pool. Please contact Dr. Stephen
Virginia ~ Experienced emergency veterinary technicians wanted...
Are you tired of the same old daily routine? Would you like the opportunity to participate in progressive veterinary medicine? The Regional Veterinary Referral Center in Springfield is looking for experienced technicians to work in our emergency and critical care department. Successful candidates should possess technical expertise, strong client relation skills, and an intense desire to learn and grow in their job experience. This position offers a competitive salary with benefits and continuing education opportunities. We also have a great staff and working environment. If you feel that you would enjoy the challenge of progressive veterinary medicine, please call: Lynn Chiappane or Sue Mordi at 703-451-8900 or fax resume to 703-451-3343. VIRGINIA – Seeking highly motivated and responsible licensed veterinary technician to join Veterinary Internal Medicine Practice in Manassas. Applicant must be a team player, hard working, and willing to work in a fast-paced environment. Great benefits package. Starting salary $35,000/year. Available position: Monday–Friday 3:00–11:00, occasional Saturday AM shifts. Fax resume to 703-368-4703 or call Dee/Dr. Smith at 703-330-8809.
reach over 18,300 paid subscribers* with your ad in Veterinary Technician classifieds. We also offer discounts for multiple ad placements, both in one journal and across our line of publications—Compendium, Compendium Equine, Veterinary Technician, Veterinary Forum, and Product Forum & Market News. Classified Advertising LIESE DIXON Phone 800-920-1695 or 267-685-2491 • Fax 201-231-6373 Email VetTechClassifieds@vetlearn.com Market Showcase Display Advertising LINDA COSTANTINI Phone 800-426-9119, ext 2422, or 267-685-2422 • Fax 201-231-6373 Email lcostantini@vetlearn.com or VetTechClassifieds@vetlearn.com
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ClassifiedAdvertising TECHNICIANS WANTED
TECHNICIANS WANTED
VIRGINIA – Small animal practice
WASHINGTON – Alpine Animal
in Chesapeake seeking full-/part-time LVT. Technical skills fully utilized in modern, well-equipped facility. Caring, compassionate team player with organizational skills and experience desired. Excellent pay and benefits. Fax resume/references to Brentwood Veterinary Clinic at 757-485-1388 or email dpcleek@cox.net.
WASHINGTON – Licensed veterinary technician for small
animal practice. Four- and 5-day shifts per week. One Saturday per month. Two doctors, two technicians, four assistants per shift. Come join the fun with quality people practicing exemplary medicine. Marine View Veterinary Hospital, Des Moines. Contact Dr. Felts at mvpetdocs@ earthlink.net
Hospital in Issaquah is looking for a new, energetic team member. We're a large AAHA-accredited hospital, just east of Seattle, that offers 24-hour emergency care with our excellent day practice, including ultrasound, endoscopy, digital radiology, and an AVECCT specialist. We need an LVT to work with our day practice in surgery—a great opportunity to utilize your skills in a learning environment and work with our specialist! The ideal candidate is self-motivated, compassionate, skilled, fun, and a great team player! Benefits: signing bonus, competitive salary, CE compensation, MDV, matching 401(k), license dues, pet benefits, vacation/sick days, uniforms. Send resume to Allison Perkins, RVT. Fax 425-391-7439 or email allison.perkins@vcamail.com.
TECHNICIANS WANTED WASHINGTON – Fast-paced, six-doctor, AAHA-accredited hospital located in Seattle is looking for a responsible, enthusiastic, full-time LVT or experienced assistant with lots of initiative who is committed to high-quality animal care and superior client service in a team-oriented atmosphere. Benefits include health and dental insurance, 401(k), CE, uniforms, and more. Salary DOE. Contact David, technician supervisor: Elliott Bay Animal Hospital, 2042 15th Avenue West, Seattle, WA 98119; telephone 206-2857387; fax 206-285-9074; email dzajac@elliottbayah.com. Visit www.elliottbayah.com.
WISCONSIN – CVT position available for five-doctor practice. Use ALL of your skills with laser, ultrasound, laparoscopy, echocardiography, and more. Excellent pet benefits, vacation, CE allowance, health insurance. For more information, contact Melinda at 920-434-1010, or send resume to Animal Hospital of Howard, 635 Cardinal Lane, Green Bay, WI 54313.
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Available Discounts* ❏ Single ad placed in multiple issues (e.g., one ad placed for 2 months in Veterinary Forum) ❏ Single ad placed in multiple journals (e.g., one ad placed for 1 month each in Veterinary Forum and Compendium) ❏ Single ad in multiple journals for multiple months (e.g., one ad placed for 2 months each in Veterinary Forum and Compendium) Add-On Options ❏ Early Internet Exposure — Place your ad on VetClassifieds.com 30 days before your first issue release date. ❏ Confidential Forwarding Service — Direct inquiries to our attention; we send them to you. ❏ Deluxe Package — Add a box border and bold contact information. Choose from six styles (see below). ❏ Premium Package — Deluxe package plus your logo (email as high-res tiff, jpeg, or eps file). Deluxe/Premium Package Style Sample (circle letter) A B C
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ORDERING INFORMATION Mail or fax order form and your ad to: Classified Advertising,Veterinary Learning Systems, 780 Township Line Road,Yardley, PA 19067 • Fax 201-231-6373 Email your ad and payment information to: VetForumClassifieds@vetlearn.com CompendiumClassifieds@vetlearn.com VetTechClassifieds@vetlearn.com CompendiumEquineClassifieds@vetlearn.com
For more information about classified advertising, call Liese Dixon at 800-920-1695 (toll-free) or 267-685-2491. For information regarding placing a display ad in Market Showcase, call Linda Costantini at 800-426-9119, ext. 2422 (toll-free), or 267-685-2422.
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PICTURE TH!S A client came into our clinic with a kitten that had severely deformed front paws. The kitten wouldn’t let us touch the paws to examine them. After putting the kitten under anesthesia for a spay procedure, we saw that she had a toenail growing off the pads on both front feet.
Banfield, The
Sh Pet Hospital,
reveport, LA.
A “Nail” of a Tale
. , Shreveport, LA e Pet Hospital Th d, el nfi Ba the staff at Submitted by
An Odd Couple This bird and kitten were found and raised together. The bird liked to follow the kitten everywhere or just ride on her back.
Submitted
Send submissions by Email: editor@VetTechJournal.com Mail: VLS/Veterinary Technician 780 Township Line Road Yardley, PA 19067
136
FEBRUARY 2008 | Veterinary Technician
by Mike Co nner, Lexin gton Boule vard
Animal Hosp ital,
Sugar Land , TX.
Mike Con
Send us your interesting, extraordinary, or even amusing images. They can be radiographs, cytology slides, photographs, or any type of unique image. Provide a brief description of what the image is showing, along with your name and contact information. We pay $50 per published image.
ner
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