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The Complete Journal for the Veterinary Health Care Team
CE Credit from Alfred State College, SUNY
Vol. 29 No. 3 | March 2008
KRISTEN WHITE, CVT The “Rewards” of Teaching Behavior Classes
VACCINES Transport, Storage, and Handling PARASITOLOGY IN PRACTICE Giardia Infection
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EditorsLetter_March_VT:VT
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Editor’sLetter
The Complete Journal for the Veterinary Health Care Team
Vol. 29 No. 3
March 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 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 EXECUTIVE VICE PRESIDENT Ray Lender 267-685-2417 | rlender@vetlearn.com 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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Top 10 Reasons Why You Should Join a Professional Association Technicians who are active in professional associations often tell me that the hardest part of being a member of an organization is trying to get and retain new members, especially younger members who can grow with the organization. Most people look for tangible benefits when joining an association, but the benefits cannot always be measured in material gains and may not even be apparent initially. If you don’t belong to a state or national association, you may not realize what you are missing. Among other benefits, joining a professional group can allow you to do the following: 1. Exchange ideas with other professionals with similar interests. For example, if you are interested in topics such as behavior, join the Society of Veterinary Behavior Technicians (SVBT). SVBT members are given list-serv access, allowing them to participate in online discussions about behavior cases with other professionals in the field. 2. Take advantage of CE opportunities. Many state and national associations hold annual CE events, which members usually can attend for a discounted rate. 3. Receive discounts on CE events as well as other services. For example, NAVTA members who visit the organization’s online Barnes & Noble bookstore can get textbooks at discounted rates. If you are going to school, this benefit more than pays for your membership. Textbooks can be extremely costly! 4. Access job postings in your locale or within your specialty. Many of the state technician associations list job openings in their print or electronic newsletters, which may include job postings that are not listed in local newspapers. 5. Hone your leadership skills. Are you rarely given the opportunity to demonstrate your leadership skills? Become an association board member and show your peers that you are not only a good leader but also a good decision maker. 6. Share your knowledge. Your knowledge is worth more than you know! In her guest editorial (February 2008), Jeanne R. Perrone, CVT, VTS (Dentistry), president of the Academy of Veterinary Dental Technicians (AVDT), said that one of the group’s goals is to get the word out about the importance of good dental health in pets. To help achieve this goal, some AVDT members even visit clinics and conduct on-site dental training. 7. Develop public-speaking skills. Many well-known technician lecturers admit that they never thought they could get up in front of their peers and lecture. Harold Davis, Jr., BA, RVT, VTS (ECC, Anesthesia), discussed this in his cover story (January 2007), and Vickie Byard, CVT, VTS (Dentistry), touched on this briefly in her cover story (February 2008). Harold and Vickie are now both considered prominent speakers within the profession. 8. Make new friends and network. Some of the people you meet through professional associations may become your lifelong friends and may even be able to recommend new career opportunities. 9. Advance your career. Once your name is associated with a professional association, you will be surprised at the number of people who will seek your opinion or advice. As you build your reputation within the industry, more opportunities will present themselves. 10. Act as a voice within the profession. If there is something that you want to change, other technicians likely feel the same way. By having the support of your peers, you can accomplish great things together!
Hilda Guay, Executive Editor
For meeting information, go to our Conference Calendar at www.VetTechJournal.com.
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Contents
The Complete Journal for the Veterinary Health Care Team
March 2008
Volume 29, Issue 3 For the benefit of those who wish to participate in the CE Program, the peer-reviewed 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.
150 On Her Best Behavior
All clinical articles are peer reviewed.
COLUMNS 168 Parasitology in Practice Giardia Infection — Diagnosis, Treatment, and Prevention William McLaughlin, CVT
173 Equine Essentials
FEATURES 150
On Her Best Behavior — A Talk with Kristen White, CVT Liz Donovan Kristen White, CVT, talks about her passion for animal behavior — from training her own pets to teaching puppy classes to her involvement with the Animal Behavior Network.
156
Frequently Asked Questions About Microchips Rhonda Windham, BSc, MVB In recent years, microchip implantation has gained popularity because it is a permanent, unalterable form of pet identification. This article provides answers to several frequently asked questions about microchips so that technicians can advise clients who are considering microchipping their pet.
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Rosanne Barwick, DipAVN (Surgical), EVN, VN, Cert SAN, ESMT ©2008 CDC/DPDx/Melanie Moser
Sandy Watkins
Subchondral Bone Cysts in the Equine Stifle
168 Giardia
Infection
ON THE COVER Kristen White, CVT, rewards her German shepherd, Holly, during a behavior demonstration.
See page 150 Photographed by Sandy Watkins
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Merial-Vaccines.qxp:VT
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YOU KNOW how sensitive cats can be. WE KNOW Contains core antigens recommended in AAFP Guidelines. 5
pure, non-adjuvanted feline vaccines. We know the last thing you want is post vaccinal inflammation at the injection site – so why risk exposing cats to adjuvants? With non-adjuvanted PUREVAX® feline vaccines, you can: • Provide protection and reduce the potential risks associated with adjuvants1,2 • Safely vaccinate kittens as young as 6 weeks of age3,4
1 Macy
DW. The potential Role and Mechanisms of FeLV Vaccine-Induced Neoplasms. Seminars in Vet Medicine and Surgery (Small Animal) 1995;10(4):234-237.
• Effectively protect cats with different lifestyles
2 Day MJ, Schoon HA, Magnol JP, et al. A kinetic study of histopathological
changes in the subcutis of cats injected with non-adjuvanted and adjuvanted multi-component vaccines. Vaccine 2007; 25:4073-4084. 3 Data on label. 4 As young as 8 weeks recommended for vaccination with PUREVAX Feline
Rabies and 9 weeks recommended for vaccination with PUREVAX Recombinant Feline Leukemia. 5 Richards JR, Elston TH, Ford RB, et al. The 2006 American Association of Feline
Practitioners Feline Vaccine Advisory Panel Report. J Am Vet Med Assoc. 2006;229(9):1405-1441. ®PUREVAX is a registered trademark of Merial. ©2007 Merial Limited, Duluth, GA. All rights reserved. PUR07PBCOREAD2.
Ask your Merial Representative about PUREVAX brand products, the only complete line of non-adjuvanted feline vaccines available. To order Merial vaccines, contact your Merial Sales Representative or call 1-888-Merial-1 (1-888-637-4251). For more information visit www.merial.com. Circle 175 on Reader Service Card
Your knowledge. Our science. Their health.
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Contents
The Complete Journal for the Veterinary Health Care Team
March 2008
Volume 29, Issue 3
161 Vaccine
DEPARTMENTS
Transport, Storage, and Handling
137 Editor’s Letter 142 Information Center 144 148 180 183 184
Tech News Industry Briefs Tech Tips Product Forum Index to Advertisers
185 Market Showcase 186 Classified Advertising
156
Peter Olson
Microchipping
CE ARTICLE Heather Flood
Vaccine Transport, Storage, and Handling Laura McLain Madsen, DVM Vaccines that are improperly handled and stored can be rendered ineffective; therefore, it is important for technicians to help design and implement vaccine protocols for their clinic.
“All horses undergoing general anesthesia are at risk of
postoperative myopathies.” See page 173
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180 Tech Tip of the Month
©2008 Yegor Korzh/Shutterstock.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
Art Inquiries Phone: 800-426-9119, ext. 2461 Email: dbeagin@vetlearn.com
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 TechnicianŽ (ISSN 8750-8990) is published monthly by Veterinary Learning Systems, a division of MediMedia USA, 780 Township Line Road, Yardley, PA 19067. Copyright Š 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 800-4269119. POSTMASTER: Send address changes to Veterinary Technician, Veterinary Learning Systems, 780 Township Line Road, Yardley, PA 19067.
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March 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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AVMA-Convention_USE.qxp:VT
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T H E J AC K L . M A RA S EM I NA RS O N V E T ERI NA RY T E C H N OLO G Y feature the most up-to-date information on current issues. Technicians are also invited to attend all educational programs and symposia for veterinarians. This year, the AVMA Annual Convention will feature 50-minute sessions. Coupled with additional educational blocks per day, you will have more choices in what is already veterinary medicine’s broadest continuing education program.
0ROGRAM !LL 9OUR
Anesthesia Canine Behavior Compassion Fatigue Emergency and Critical Care Avian Hematology and Cytology Small Animal Nutrition Dentistry Equine Massage Therapy/Rehabilitation
/WN
Small Animal Vaccines and Titers Technicians Role in Small Animal Practices Pain Management Poison Control Technicians Role in the Derm Patient I N T ERACT IV E L A B S Behavior Training Techniques Reptile Parasitology and Hematology
J U ST F OR T EC H NIC IA NS:
th avma annual convention july -,
Free lunch Saturday and Sunday courtesy of Hill’s Pet Nutrition and a special technician-only Monday evening reception sponsored by NAVTA and Hill’s.
To register at a special technician rate, or to view the entire educational program with the CE Session Finder, visit www.avmaconvention.org.
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TechNews
AKC and NAVTA Accepting Applications for 2008– 2009 Scholarships
“ Veterinary Technician” One
of the Top Five Jobs of 2008 W
The American Kennel Club (AKC) and NAVTA are accepting applications for the AKC/Bayer K9 Advantix veterinary technician scholarships for the 2008–2009 academic year. Bayer and the AKC are sponsoring the scholarships, which total $25,000. To be considered for a scholarship, a candidate must be a full-time student enrolled in an AVMA-accredited veterinary technology program and must be a member of NAVTA. Scholarships will be awarded based on an applicant’s academic achievement, activities related to small animals and/or research, and involvement in NAVTA. Applications, which must be received by May 1, 2008, will be mailed to all accredited veterinary technology schools; applicants may also download the form at www.akc.org/vetoutreach/ vt_scholarships.cfm.
hat does a veterinary technician have in common with a computer software engineer? Both professions are listed among the top five jobs of 2008 on CareerBuilder.com. According to the US Department of Labor Bureau of Labor Statistics’ Occupational Outlook Handbook, veterinary technician/technologist was ranked as the fifth fastest growing job. The Occupational Outlook Handbook projects that the profession will grow 41% by 2016. About 71,000 technicians were employed in this country in 2006, and that number is expected to rise to 100,000 by 2016. Employment in the veterinary technology field is expected to grow much faster than the average for several reasons, including the following: The limited number of new graduates from veterinary technology programs The need to replace technicians who will leave the profession The demand for high-quality pet care by owners who are becoming more knowledgeable about health care in general It is anticipated that as the demand for more advanced pet care arises, veterinary technicians will need to have more highly developed skills. This will create more opportunities for technicians to become specialized. Incidentally, veterinarians ranked ninth on the list. In 2006, there were about 62,000 veterinarians working in the United States. By 2016, it is projected that there will be 84,000 veterinarians. For more information about the outlook for the veterinary technology profession, visit www.bls.gov/oco/ocos183.htm#addinfo.
Behavior Society Speaks Out Against Punishment
Andrea Ball was introduced as the new executive director of NAVTA during last month’s Western Veterinary Conference. There, she met with veterinary professionals and industry partners to begin forming alliances. “I hope to expand our membership and the opportunities for our members as well as educate new graduates on the benefits of belonging to professional associations,” says Andrea. She also wants to promote the profession and the benefits of becoming certified and specialized. At the end of March, NAVTA will be moving its headquarters from Lafayette, Indiana, to Alexandria, Virginia, near Washington, DC. “There are many other veterinary associa144
MARCH 2008 | Veterinary Technician
tions in Washington, DC, so we hope to form alliances with them,” Andrea explains. Andrea has an Andrea Ball, the new director of extensive back- executive NAVTA, poses with ground in non- Skeeter, her mixedprofit organization breed dog. management. She previously served as senior director of the Agri/Washington Public Affairs Group in Washington, DC, where she currently resides. The previous NAVTA executive director, Patrick Navarre, BS, RVT, served from 1993 until January 2008. For more information about NAVTA, visit www.navta.net.
Courtesy of NAVTA
NAVTA Names New Executive Director
The American Veterinary Society of Animal Behavior (AVSAB) has issued a position statement on the use of punishment (e.g., choke chains, electronic barking collars, pinch collars) for behavior modification. Punishment can lead to “inhibition of learning, increased fear-related and aggressive behaviors, and injury to animals and people,” according to the AVSAB. Instead, the AVSAB recommends that behavior modification be achieved through consistent application of positive reinforcement while the animal is performing the appropriate behavior. “This approach promotes a better understanding of the pet’s behavior and better awareness of how humans may have inadvertently contributed to the development of the undesirable behavior,” the AVSAB statement claims. The AVSAB guidelines can be found online at www.avsabonline.org. www.VetTechJournal.com
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Love brings people and pets together. Our recovery system helps them stay that way. Here at AKC Companion Animal Recovery (AKC CAR), we’ve made it our mission to recover as many missing pets as possible. By keeping our ID System microchips affordable, we increase the number of animals who can be found if lost. And we offer prepaid enrollment in our 24/7 recovery service with no annual fees or added charges. But our commitment to animal welfare doesn’t end there: a not-for-profit organization, AKC CAR funds veterinary student scholarships, canine search and rescue grants and disaster relief efforts. To see how AKC CAR is making the world a better place for the animals we share it with, call us toll-free at 1-800-252-7894 or visit www.akccar.org/microchip.
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TechNews S TAT E N E W S
Recently, the 2007–2008 Wisconsin Student Association for Laboratory Animal and Veterinary Technicians (WSALAVT) at Madison Area Technical College (MATC) faced a challenge — there was a lack of funds available to support the organization and its donations to local humane societies. Members decided that a fundraiser was needed, and the WSALAVT’s secretary, Lysbeth Lesak, found a possible solution that would not only raise funds for the club but also promote the veterinary technology program at MATC. Lysbeth coordinated a pet calendar contest that got the entire student body involved by promoting the contest through other clubs on campus and spreading the word through a network of instructors as well as campuswide emails and posters. More than 60 entries were submitted, and the top 12 photos, as voted on by the WSALAVT executive committee, were used to create a 2008 calendar. The calendar sparked interest among faculty and students from all departments, not only the veterinary technology program.
Jada Fenske
by Jada Fenske
Lysbeth Lesak promoted her college’s veterinary technology association with a pet calendar fundraiser.
At press time, the calendar sale generated approximately $500, which the WSALAVT is donating to local humane societies and using to support the school’s animal adoption program. To purchase a calendar, send $15 to Madison Area Technical College, c/o Kay Bradley, 3550 Anderson Street, Madison, WI 53704. Make checks payable to WSALAVT. Jada Fenske is the copresident of the WSALAVT.
Updated AAEP Vaccination Guidelines Released by Allyson Corcoran The American Association of Equine Practitioners’ (AAEP) Infectious Disease Committee recently issued updated vaccination guidelines in which tetanus, Eastern/Western equine encephalomyelitis, West Nile virus, and rabies vaccines were listed as core vaccines. The guidelines also include a vaccination protocol for anthrax, a plan of action for the containment of infectious diseases during an outbreak, and instructions for proper storage and handling of vaccines. The AAEP Infectious Disease Committee comprises experts from various 146
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fields, including researchers, private practitioners, and USDA staff. Committee chair Mary Scollay, DVM, states that “[the subject of] infectious diseases has been moved to the forefront in terms of health issues in the last couple of years,” and the goal of the committee is to “keep the information that we offer people as current as possible.” Visit www.aaep.org/vaccination_ guidelines.htm to download a copy of the guidelines. Allyson Corcoran is an editorial assistant for Veterinary Forum.
MASSACHUSETTS Mount Ida College in Newton, Massachusetts, will receive $146,000 in federal assistance to help fund the expansion and enhancement of its veterinary technology program. These funds will go toward the college’s Campaign for the Center for Veterinary Technology — a $5 million undertaking to consolidate the college’s veterinary technology faculty offices, animal care facilities, classrooms, and laboratories under one roof. The new building will also include a kennel that is twice the size of the existing kennel and state-of-the-art surgery, recovery, and laboratory facilities. “[This new facility] will enhance Mount Ida’s ability to educate students so that they can make important contributions in a range of medical and biological research fields,” states Congressman Barney Frank, who supported the program’s expansion. The veterinary technology program at Mount Ida College is one of only 16 accredited baccalaureate programs in veterinary technology in the country. For more details, visit www.mountida.edu/ ccvt, email vettech@mountida.edu, or call the Mount Ida College Development Office at 617-928-4630. NORTH DAKOTA Tonah Sukut-Dickhaus, LVT, was named the 2007 Veterinary Technician of the Year by the North Dakota Veterinary Technician Association. Tonah graduated from North Dakota State University in 2002 and currently works at Casselton Veterinary Service in Casselton, North Dakota. Congratulations, Tonah!
Susan Kieffer, LVT
Wisconsin Student Raises Funds with Pet Calendar
Tonah Sukut-Dickhaus, LVT, was named North Dakota’s Veterinary Technician of the Year.
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TechNews
Highlights from the NAVC Conference Courtesy of NAVC
A
B
Courtesy of NAVC
(A) Mary Beth Leininger, DVM, director of professional affairs at Hill’s Pet Nutrition, and Harry Latshaw, MS, RVT, VTS (Anesthesia), at the 2008 Hill’s Award Ceremony. Harry was named the 2008 Dr. Jack L. Mara Memorial Lecturer. (B) Charlotte Donohue, RVT, VTS (ECC), accepts the Technician Speaker of the Year Award from 2008 NAVC President Jorge Guerrero, DVM, PhD.
Paige Allen, MS, RVT, (left) program chair for the NAVC veterinary technology program, is interviewed by Aggie Kiefer, LVT, for a PrimeTime segment.
B
C
A At the NAVTA meeting held at NAVC, (A) Patrick Navarre, BS, RVT, (left) and Carlene Decker, BS, CVT, (right) were honored for their years of service with NAVTA. Richard Ford, DVM, MS, DACVIM, DACVPM, (center) thanked Pat and Carlene for their numerous contributions to the profession. (B) The Brevard Community College NAVTA Student Chapter was recognized as Student Chapter of the Year. From left to right: Jodi Lorenz; Mary Adams; Lori Renda-Francis, BBA, MA, LVT, NAVTA representative; Michelle Earltinez, CVT, club sponsor/NAVTA student chapter advisor; Cathleen Stirling; Alex Morey; and Jessica Maloy. (C) Annette Poirier, BS, CVT, (left) president of the Florida Veterinary Technician Association (FVTA), and Bonnie Heatwole, CVT, winner of the Fort Dodge Animal Health Pet Wellness Contest. Bonnie is also a member of the FVTA.
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IndustryBriefs
Bayer Animal Health Celebrates Baytril’s 20th Anniversary Twenty years ago, Bayer Animal Health introduced Baytril (enrofloxacin), the first fluoroquinolone approved for veterinary use. The antimicrobial was first approved in tablet form for dogs in 1988. Two years later, it was approved for use in cats and was released in an injectable form for dogs. The most recent addition to the Baytril product line was Baytril Otic in 2000. This product was the first veterinary fluoroquinolone otic preparation for the treatment of canine otitis externa.
AQHA Approves Use of EQUIOXX Effective January 1, 2008, the American Quarter Horse Association (AQHA) Executive Committee approved the use of EQUIOXX (firocoxib), giving competitors across the country another way to relieve osteoarthritis pain and inflammation in horses. This approval allows AQHA competitors to use EQUIOXX at the recommended dose 12 hours before competition for up to 14 consecutive days. EQUIOXX, which is manufactured by Merial, provides 24 hours of pain relief and is administered as an oral paste.
Nestlé Purina Enters the Pet Fort Dodge Animal Health Announces Insurance Business This spring, Nestlé Purina PetCare Company plans to offer Plans for a New Research and PurinaCare, a comprehensive, easy-to-use insurance plan. Development Facility The plan will offer two different options with various monthly Fort Dodge Animal Health announced plans to expand its operations by building a $40 million research and development facility, which will be located in the Kansas Bioscience Park in Olathe, Kansas. More than 200 employees are expected to be hired to staff the 150,000–sq ft facility.
premiums and deductibles. Both plan options will provide coverage for illness, injuries and accidents, hospitalization, surgery, prescription medications, and hereditary conditions. The PurinaCare plus Preventive Care Plan also will cover routine care. PurinaCare will directly reimburse clients.
Hill’s Pet Nutrition Teams Up with the AVMA
Pfizer Animal Health Helps to Fund Laminitis Research
In response to the growing epidemic of obesity in pets, Hill’s Pet Nutrition and the AVMA have formed the Alliance for Healthier Pets — Obesity Awareness and Prevention Program. This program will offer creative ways for veterinarians and veterinary technicians to educate clients about the impact that obesity has on their pets. A 2008 Obesity Awareness and Prevention Kit can be obtained by calling 888-7-PETFIT or visiting www.petfit.com.
Pfizer Animal Health and the National Thoroughbred Racing Association have partnered to increase awareness about laminitis by supporting the Barbaro Memorial Fund. The awareness campaign will include displays as well as several promotions, including “Riding with Barbaro” bracelets. Horse enthusiasts, owners, trainers, and other horse industry personnel are encouraged to go to RidingwithBarbaro.org to make a donation and to learn more about how to get involved with the fund.
Wedgewood Pharmacy Introduces an Exchange Program
Jennifer Thissen, CVT, from Cocoa, Florida, and Rick Marrinson, DVM, owner of Longwood Veterinary Clinic in Longwood, Florida, weigh Jeb, one of Dr. Marrinson’s patients, as part of the launch of the PetFit Tour. 148
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In response to veterinarian requests to address the short shelf life of compounded medications, Wedgewood Pharmacy has introduced the Refresh Exchange Program. This program allows veterinary professionals to exchange unopened, expired compounded veterinary medications that are in the company’s regular formulary of more than 6,000 medications, including those prepared by other pharmacies. The key exceptions are controlled substances and oncology-related medications. Compounded medications, which are custom made based on a script from a veterinarian, have a much shorter shelf life — generally 30 days to 6 months — than manufactured drugs. To take advantage of this program, veterinarians must register at www.wedgewoodpharmacy.com/refresh. www.VetTechJournal.com
NCVTSA ad_VT0308.qxp:VT
2/19/08
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Veterinary Technician Specialists: Taking It To The Next Level NATIONAL CONFERENCE OF
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Qualifies for 15 CE hours Meets CE requirements for veterinary technician specialty certification Sponsored in part by Pfizer Animal Health and Hill’s Pet Nutrition
2008 Program HIghlights AVECCT
Donna Oakley, CVT, VTS (ECC) Transfusion Support of the Bleeding Patient Recent Advances in Canine and Feline Blood Compatibility Blood Transfusion: Monitoring for Adverse Events Angel Rivera, CVT, VTS (ECC) An Introduction to the Concept of Immunoneuroendocrine Exhaustion Severe Sepsis: Do the Current Human Guidelines Have a Place in Veterinary Medicine? Hypovolemic Shock
AVTA
Susan Barbour, CVT, LAT, VTS (Anesthesia) Preanesthetic Evaluation in Small Animals Cardiovascular Monitoring Respiratory Monitoring Sharon Kaiser-Klingler, RVT, VTS (Anesthesia) Balanced Anesthesia for the Small Animal Patient Blood Gas Analysis in Small Animal Anesthesia Exotic Animal Anesthesia in Private Practice
AVDT
Susan Berryhill, BS, RVT, VTS (Dentistry), and Jeanne Perrone, CVT, VTS (Dentistry) Monitoring the Dental Patient … It’s Not “Just a Dental”! Charting Every Dental Patient: A Case-Based Approach to Accurate Charting What’s New in Dentistry? How Is the “Human Side” Influencing the Care We Provide?
A JOINT PRESENTATION BY Academy of Veterinary Emergency & Critical Care Technicians Academy of Veterinary Technician Anesthetists* Academy of Veterinary Dental Technicians* Academy of Internal Medicine Veterinary Technicians* in partnership with VLS, publisher of Veterinary Technician® *Provisional recognition from the Committee on Veterinary Technician Specialties (CVTS) of NAVTA
Gerianne Holzman, CVT, VTS (Dentistry) Endodontics for the Veterinary Technician Orthodontic Therapy for Malocclusions The Whys and Hows of Prosthodontic Treatment
AIMVT
Lisa Estrin, BS, CVT, LVT Rescue Me: What’s Up with Rescue Protocols for Lymphoma? Diagnostic Imaging in Oncology Radiation Therapy: A Ray of Hope Angela Randels, CVT, VTS (ECC) The Ins and Outs of Fluid Therapy Electrolyte Imbalances Addison’s Disease: Why Does It Get Missed?
For program details visit us at www.ncvtsa.org
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On Her Best Behavior A Talk with Kristen White, CVT
Liz Donovan Veterinary Learning Systems
A
FTER TRAINING a bird to play basketball and a deaf dog to follow commands, helping clients effectively modify their pets’ undesirable behaviors is a snap for Kristen White, CVT. Kristen, a behavior technician and practice manager at the Animal and Bird Hospital of Clearwater in Clearwater, Florida, says her aim is to strengthen the bond between her clients and their pets. As part of her mission, she teaches puppy classes and educates owners about the importance of socialization and environmental enrichment. “My goal is to keep that puppy in the owner’s home for the rest of its life,” says Kristen, who also serves as president of the Society of Veterinary Behavior Technicians (SVBT) and as a part-time behavior technician with the Animal Behavior Network, an online behavior resource for both veterinary professionals and pet owners. Here, she tells us about successful behavior modification techniques and why technicians are in an ideal position to teach puppy classes. When did you start your career, and how did you become interested in animal behavior?
Kristen with her German shepherd, Holly, and her scarlet macaw, Ernie.
Fifteen years ago, I began working as a technician at the Animal and Bird Hospital, where I received on-the-job training. In 2000, I enrolled at St. Petersburg College to earn an associate’s degree in veterinary technology. There, I became interested in animal behavior when I took a behavior course taught by Ginny Price, MS, CVT. She required each student to clicker train a dog and a cat. I had recently adopted a German shepherd puppy, so I used her as my clicker-training subject. The technique was so successful that I started researching animal behavior and taking more classes on behavior topics. I then convinced the owners of the Animal and Bird Hospital to offer puppy classes and behavior modification services. The puppy classes are now my favorite part of my job.
Sandy Watkins
What do you teach in your classes?
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I think it’s really important to socialize and desensitize puppies, so I help owners introduce their puppy to new situations to help the pet become less afraid of different sights, textures, and sounds. For one class, I bring in toys and objects that move, make noise, www.VetTechJournal.com
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Have you encountered any challenges during puppy training?
V I TA L S TAT I S T I C S K R I S T E N W H I T E
Professional Associations SVBT (president), NAVTA (member)
Education AS in veterinary technology, St. Petersburg College, St. Petersburg, Florida (2004); working toward a BS in veterinary technology at St. Petersburg College.
Family
I have a deaf American bulldog puppy in my class, which is an interesting challenge. The owner was hesitant about signing up for the class because she didn’t think she would be able to train a deaf dog. I encouraged her to join because it isn’t necessary to speak to teach a dog commands. When first teaching a dog a command, I instruct clients to not say anything — we use food lures and affection to help the dog associate the command with the action we want the dog to perform. So it’s really quite easy to teach a deaf dog. After several weeks of training, the bulldog is already able to target — he touches his nose to his owner’s hand. He periodically watches his owner. If the owner holds her hand out, he stops what he’s doing and runs over to her and shoves his nose into her hand.
educate the client. So as technicians, we are able to discuss behavior problems with the owner at each appointment and, if necessary, have the veterinarian address the problem. I make sure that each client in my class gets as much information about behavior issues as possible. I give clients handouts and sign them up for weekly puppy parenting email lessons from the Animal Behavior Network.
Why is it beneficial for technicians to teach puppy classes?
What is the Animal Behavior Network, and how are you involved in it?
By holding puppy classes at the hospital, the technician creates a bond between the hospital and the client and puppy. After completing the class, puppies don’t mind coming to the hospital. They’re excited to see the staff, so they’re more compliant during procedures, and veterinary visits are less stressful for both the owner and the pet. Having puppy classes at the hospital is also beneficial from a medical perspective because technicians see the animal over the course of its life and have ongoing opportunities to
The Animal Behavior Network is an online resource for pet owners and veterinary professionals who want information on animal behavior. The Web site (www.animalbehavior.net) was founded by Rolan Tripp, DVM, who is well known for his behavior expertise. Through the network, Dr. Tripp offers consultations for veterinarians who are treating pets with behavior problems. Veterinary practices nationwide can participate in the Network to better educate their clients on behavior-related issues. I work
www.VetTechJournal.com
Kristen and her husband, Eric, have a 6-year-old son, Kyle, and a 13-month-old daughter, Jessica.
Pets Holly (7-year-old German shepherd), Cody (9-year-old Maine coon), Haley (8-year-old Maine coon), Toby (10-year-old munchkin cat), Ernie (24-year-old scarlet macaw), Fig (6-year-old Quaker parrot), and Dora and Diego (2-year-old leopard geckos)
Sandy Watkins
or light up. On another night, the clients wear costumes. We also get the puppy used to being handled as it would be during a veterinary exam — we manipulate its feet, trim its nails, and look in its ears and mouth. To help the puppy become comfortable meeting and playing safely with other dogs, we have a supervised off-leash play period for the animals. I talk to clients about common puppy behavior problems, especially those involving biting and housetraining, because they are the two main issues of concern for owners. Then, I go over basic puppy obedience, such as the “sit,” “stay,” “come,” and “down” commands and loose-leash walking. I do a lot of customized training and troubleshooting because not every dog learns in the same way.
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You hear about behavior cases from all over the country. Does one case stand out in your mind? Through the Animal Behavior Network, I helped a client with a Jack Russell terrier that had severe separation anxiety. One day, the dog jumped through a front window and fell 15 feet to the ground. Although the dog wasn’t injured, it needed behavior modification treatment to resolve the separation anxiety. I helped the owner follow the vetPERSONAL INTEREST
Sew Much to Do
K
risten may keep busy at work with her many responsibilities, but in her free time, she finds ways to tap into her creative side. One of her favorite activities is sewing. “I learned to cross-stitch as a child because I was laid up for an entire summer after I underwent surgery following an accident,” says Kristen. She continued to sew after she recovered, and in high school, she competed in clothes sewing competitions at the local and state levels. As an adult, she uses her sewing talent to make Halloween costumes for her family. Some of the costumes she has created include devils, penguins, and Wizard of Oz characters. Her needlework skills also extend to quilting. Kristen is in a quilting guild that creates quilts for needy children. Her other hobbies include photography, cake decoKristen and her son, Kyle, rating, rollerblading, and spending time with her family. are off to see the wizard in Kristen’s Halloween creations. She also works as a scrapbooking consultant from home. 152
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By teaching puppy classes, Kristen helps bond clients and puppies to the hospital.
Sandy Watkins
as a behavior technician for the Network. I help coach veterinary teams that want to set up behavior services in the practice, such as puppy day care and socialization classes. Veterinary practices use the Network to enroll clients and staff in animal behavior education courses, which cover topics such as aggression, destruction, and contented confinement. The Network offers easy online library access to animal behavior education resources. It also provides standardized behavior education and protocols so that all veterinarians who are members can ensure that staff provide reliable information when educating clients.
erinarian’s behavioral treatment regimen and Dr. Tripp’s behavior modification plan, and in about 4 months, the dog’s behavior improved dramatically. We used several techniques in this case. With the first one, which Dr. Tripp calls “invisible dog” or “independence training,” clients are instructed to ignore the pet except when rewarding good behavior with treats or working on commands. The dog can’t solicit attention, and the owner controls when he or she wants to give the dog attention. The technique changes the dog’s perception, and the dog learns more acceptable behavior, which includes becoming less “clingy” with the owner. Another technique we used is called “close tethering,” which involves helping a dog to relax and accept restricted activity with the client in the room. This technique has a calming effect on the dog. We also changed the client’s routine to desensitize the dog to the departure cues, and the attending veterinarian prescribed temporary antianxiety drugs to decrease the dog’s stress level during training. At the end of the treatment period, the owner could leave the house without the dog having panic attacks. That was a really rewarding case.
You also provide avian behavior modification and training services at the hospital. How did you get involved in that kind of work? I work for a veterinarian with an interest in avian medicine, and the Animal and Bird www.VetTechJournal.com
HomeAgain_USE.qxp:VT
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This exciting addition to an already comprehensive suite of pet recovery services covers any medical cost incurred as a result of a lost pet incident, with only a $50 deductible. This coverage includes medications, X-rays, surgery and animal hospital stays.
No other pet recovery service protects your patients like HomeAgain®. Proactive Pet Recovery Network
For more information, call 1-888-HOMEAGAIN or visit HomeAgain.com. Lost Pet Alerts
24/7 Emergency Medical Assistance
Lost Pet Medical Insurance
Pet Insurance provided by
HomeAgain is a registered trademark of Schering-Plough Home Again LLC. Copyright © 2007. Schering-Plough Home Again LLC. All rights reserved. Complimentary Lost Pet Medical Insurance covers a lost pet for up to $3,000 of emergency medical treatment (less a $50 deductible) for injuries the pet suffers while lost, upon proof of a lost pet incident. Once enrolled in HomeAgain®, pet owner must call to activate insurance coverage.
Circle 131 on Reader Service Card
HA-311
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How can clients provide a stimulating environment for their bird?
Sandy Watkins
I recommend that bird owners make their birds forage for food, instead of putting their food in a bowl. Foraging toys are available for this purpose. In the wild, birds spend a lot of time foraging for food — in fact, so do undomesticated dogs and cats. By just setting their food down in front of them, we’re basically giving our pets the equivalent of fast food. If the bird has to look for its food, it’s less likely to have a behavior problem, like screaming, feather picking, or aggression. Realistically, most clients aren’t home interacting with their bird all day. If owners give their bird puzzle toys or foraging toys, the animal has something to do other than sitting in its cage while the owner is at work. Ernie shows off her skating technique!
In addition to training puppies and birds, you are president of the SVBT. How did you become involved with this organization? I found out about the SVBT while I was in school, and I became a member. Several years later, Ginny Price, who knew me from when I took her advanced behavior class at St. Petersburg College, asked if she could nominate me for president. I was named president-elect in 2006 and president in 2007. I coordinate our annual
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Kristen and Ernie demonstrate their “stick ‘em up” routine.
Sandy Watkins
Hospital used to have a nonprofit aviary for breeding and research. I worked with the birds there and developed an interest in avian medicine. When I started studying animal behavior, my interest in birds and my interest in behavior evolved into an interest in avian behavior. There aren’t a lot of people educated to address behavior problems in birds, but birds are actually very easy to train. Two years ago, I adopted a 22-year-old scarlet macaw. She already knew quite a few tricks, but I’ve added to her repertoire. If I say, “Stick ’em up,” she puts her wings up; she also shakes her head as if to say “yes” or “no” on command, she rollerskates, and she plays basketball. This kind of interaction is fun for the owner and is really good environmental enrichment for the bird.
meetings and lecture on behavior topics, and I am working with the other board members to increase membership and eventually offer our own CE seminars.
Why should technicians join the SVBT? The SVBT is a great resource for technicians with an interest in behavior because the organization has such a vast knowledge base. It serves as a forum for technicians to exchange ideas and discuss cases. Members include some very experienced technicians, like Ginny Price; Donna Dyer, CVT; and Julie Shaw, RVT. So, members have access to advice from reliable sources on behavior, which is a great way to get educated if they don’t have the time, funds, or ability to travel to behavior seminars.
What advice do you have for technicians who are interested in animal behavior? Do a lot of research, and attend as many CE seminars as you can. Join the SVBT. Encourage your veterinary practice to participate in the Animal Behavior Network to help bring behavior services and puppy classes into your hospital. I think technicians are hesitant to start their own puppy classes because they don’t think that they’re qualified. I was also hesitant in the beginning. I thought, “I’m not a dog trainer — what makes me able to do this?” But technicians already have experience providing client education. That is the important part of teaching a puppy class. We didn’t have behavior services at my practice until I got involved. Now we have day care and boarding with group play for dogs, and we offer behavior modification services for all types of animals. It all started with a puppy class. www.VetTechJournal.com
Lepto_USE.qxp:VT
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Even in wildly different neighborhoods, there’s no escaping leptospirosis. Whether dogs live in a condo or in the backyard, more of them than ever are at risk for leptospirosis – a deadly, zoonotic disease spread by rats, raccoons, squirrels and other wildlife.1,2,3 Protect your patients with LeptoVax™. Its unique subunit purification process is designed to reduce cellular debris for enhanced safety. And with six convenient combinations to choose from, LeptoVax easily accommodates your canine patients and protocols. Contact your Fort Dodge Animal Health representative. Because, wild as it seems, chances are lepto is in your neighborhood, too.
LeptoVax
™
©2007 Fort Dodge Animal Health, a division of Wyeth.
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1. Michael P. Ward, et al. Prevalence of and risk factors for leptospirosis among dogs in the United States and Canada: 677 cases (1970-1998). JAVMA, Vol. 220, No. 1, January 1, 2002. 2. George E. Moore, et al. Canine Leptospirosis, United States, 2002-2004. Emerging Infectious Diseases, www.cdc.gov/ncidod/eid/vol12no03/05-0809.htm. Vol. 12, No. 3, March 2006. 3. Michael P. Ward, et al. Evaluation of environmental risk factors for leptospirosis in dogs: 36 cases (1997-2002). JAVMA, Vol. 225, No. 1, July 1, 2004.
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Peer Reviewed
Frequently Asked Questions About
Microchips
Rhonda Windham, BSc, MVB Fifth Avenue Veterinary Specialists New York
A
CCORDING TO the US Pet Ownership & Demographics Sourcebook, more than 72 million dogs and almost 82 million cats were owned as pets in the United States in 2006.1 Of the pet owners surveyed, almost half indicated that their pets were viewed as family members.1 For all families that consider pets to be a vital part of their lives, having a pet stray or become lost can be a traumatic experience. Making sure that pets have more than one form of identification — identification tags on their collars as well as a tattoo or microchip — can give them a better chance of being reunited with their owners should they become lost. Even dogs and cats that are kept primarily indoors should have identification because they can easily slip out of a door that is not closed properly. Each method of identification has benefits and limitations. All pets should have identification tags on their collars; however, collars can sometimes be separated from the pet. Tattoos are not always ideal because they are invasive and can fade over time. In addition, it is often unclear who should be contacted when a pet with a tattoo is found. Over the past decade, microchip implantation has become an increasingly popular method of pet identification. Just like the other forms of identification, microchip implantation has advantages as well as disadvantages. Since the goal is always to keep pets with their owners, veterinary technicians should encourage all owners to provide some form of identification for their pets. In order to discuss all of the options pet owners have available to them, technicians should be knowledgeable about microchips so that they can answer any questions that clients may have.
What is a microchip, and how does it work? A microchip is an inert, rice-sized cylindrical device that is sealed in a biocompatible glass (soda lime) covered by a sheath to prevent migration.2,3 The device requires no 156
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batteries and is implanted in the animal’s subcutaneous tissue using a hypodermic needle.2 The microchip emits a low-power radiofrequency identification (RFID) signal when activated by a scanner.2,3 The scanner decodes the identification number transmitted from the chip and displays the number on its screen. Because each microchip is associated with a specific registry or database service, the veterinary professional must then contact the appropriate service and provide it with the identification number from the microchip. In turn, the service provides the veterinary professional with the owner’s contact information.
Do all microchips emit the same frequency? No. As new companies entered the microchip market, new frequencies as well as scanners were introduced. In 1996, the International Organization for Standardization (ISO) established 134.2 kHz as the standard frequency for microchips used in animals.2 Although ISO standards are being followed in most countries, including Canada, Europe, Asia, and Australia,2 the United States does not follow these standards. Therefore, US www.VetTechJournal.com
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Peer Reviewed
microchip manufacturers do not have to make only 134.2-kHz microchips. As a result, three different frequencies — 125 kHz, 128 kHz, and 134.2 kHz — are used in this country. In addition to the different frequencies, some of the microchips are encrypted. In 2007, the USDA ruled that it did not have the authority to require manufacturers to follow ISO standards.2 According to the Coalition for Reuniting Pets and Their Families, fewer than 25% of lost pets in this country are reunited with their owners.4 However, in countries where ISO technology is used, the reunification rate is much higher.4 For example, in the United Kingdom, 47% of lost pets are reunited with their owners.4
How many types of scanners are currently available, and how do they work? In the United States, three types of scanners are available: Scanners that read non-ISO chips Forward-reading scanners or scanners that read ISO chips only Forward- and backward-reading scanners or “universal” scanners, which can detect both ISO and non-ISO chips Some scanners are able to display a “microchip detected” message even if they cannot decode the identification number. When a veterinary professional sees this message, he or she will know that the animal has a microchip but that another type of scanner is needed to read the chip. When using a portable handheld scanner, it is important to make sure that the batteries are fully charged.5 Because the scanners emit and receive electromagnetic energy, electronic equipment (e.g., computer equipment) or metallic objects (e.g., stainless-steel tables) may cause interference.5 Therefore, when scanning an animal, it is important to remain at least 3 feet away from any of these objects.5 The scanner should be held closely to the animal so that it is touching or brushing against the animal’s fur.5 Scanning should begin at the standardized implantation site for that species and the geographic location.5 The scanner is usually moved slowly from the animal’s head to its back and from shoulder to shoulder or in concentric circles around the target area and slowly expanded www.VetTechJournal.com
Heather Flood
Barbara D. Pacitti, CVT, of Newtown Veterinary Hospital in Newtown, Pennsylvania, demonstrates how to properly scan a dog for a microchip.
to a larger area. Some scanner manufacturers suggest moving the scanner in a figureeight pattern.5 Because of the positioning of the microchip, it may be necessary to slowly rock the reader from side to side. It is important to keep in mind that universal scanners take a few seconds longer to detect the RFID signal. Other areas, including the side of the neck, shoulder, or the forelimbs, should be scanned in case the microchip migrated or was placed in a nontraditional site.5
How is the microchip implantation procedure performed? Microchip implantation can be performed during a routine office visit because traditional implantation does not require sedation. In dogs and cats, the microchip is injected subcutaneously between the animal’s shoulder blades.5 Although this is the standard site in most countries, it is important to note that implantation sites can vary by country. For example, in continental Europe (excluding the United Kingdom and the Republic of Ireland), microchips are implanted subcutaneously in the midway region of the left side of the neck.5 In horses, microchips are implanted within the nuchal ligament of the neck about halfway between the ears and the withers.5 This is standard placement in all countries except Australia, where the microchip is implanted intramuscularly on the left side of the neck after clipping and applying a local anesthetic. In agricultural animals used for meat production, the microchip is implanted subcutaneously at the base of the left ear, on the cartilage.5 Microchips are also used in wildlife Veterinary Technician | MARCH 2008 157
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Peer Reviewed COMFORTIS™ (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
Some Common Microchips Providers Frequency (kHz) AKC (American Kennel Club) 125 AVID (American Veterinary Identification Service) 125 HomeAgain (Schering-Plough Animal Health) 125 resQ (Bayer Animal Health) 134.2
Primary Database AKC CAR AVID USA PETtrac and HORSEtrac HomeAgain PETMAXX
and other exotic species (e.g., birds, reptiles, amphibians) as a form of permanent identification. Placement varies not only by species but also by weight (e.g., in the case of birds).5 If scanning an unfamiliar species (e.g., during rescue relief work), it is important to become familiar with all possible implantation sites.a
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 should owners do to help ensure the effectiveness of this system? The veterinary technician should instruct the owner to immediately fill out the paperwork that is provided by the microchip manufacturer and return the completed paperwork to the appropriate registry or database. If the registry or database center does not have the owner’s contact information, implantation of the microchip is pointless. In addition, technicians should remind clients who are moving to contact the registry to update their information.
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
What are the advantages of microchipping a pet? Implanting a microchip in a pet provides a permanent, unalterable form of identification. Since the microchip does not require batteries, it will last for the lifetime of the pet. If a pet strays or becomes lost, a microchip increases the chances that the pet will be reunited with its owner. In addition, microchips can be used to resolve ownership disputes when a pet is stolen. During natural disasters, implanted microchips can be used to help identify animals that are rescued; this was evidenced during Hurricanes Rita and Katrina.6
Does microchipping a pet have any disadvantages? Microchip implantation has a few disadvantages; however, these disadvantages are largely outweighed by the successful reunification of pets with their owners. The primary a
For more information about the various implantation sites in different species, visit www.wsava.org/Site1099.htm.
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The only FDA-approved monthly flea protection that kills fleas and comes in a chewable, beef-flavored tablet.
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 product label, including important safety information, see page 158.
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
©2007 Eli Lilly and Company CF00085R1
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disadvantage of microchipping is that many scanners read only certain types of chips. Another disadvantage is that there is no national database or registry in the United States for the storage and retrieval of microchip identification and ownership information. The individual who scans the animal must contact the correct registry in order to obtain the owner’s contact information. Migration of the microchip, although infrequent, is the most common complication associated with the procedure.2 Other problems, such as failure of the microchip, hair loss, infection, swelling, and tumor formation, have been reported in low numbers.2 The World Small Animal Veterinary Association Microchip Committee reviewed reports that microchip implantation may cause cancer and concluded that taking into account the small number of cases that have been reported compared with the large number of animals that have been microchipped, the risk of the chips causing cancer is extremely small, if it exists at all.7 In addition, since the British Small Animal Veterinary Association established its microchip adverse reaction program more than 10 years ago, more than 3.7 million pets in the United Kingdom have been microchipped and only two tumors have been reported.7
What tips can be given to owners when deciding to have their pet microchipped? Owners who do not travel with their pets should select a microchip that is used by local shelters, animal control agencies, veterinary clinics, and emergency hospitals in that particular area. If the owner travels extensively with the pet, an ISO chip might be more beneficial. In addition, owners should provide their pets with more than one form of identification because there is
ABOUT THE AUTHOR
Rhonda Windham, BSc, MVB
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no guarantee that just one method will effectively identify a lost pet.
Conclusion Technicians must stress to clients the importance of providing proper identification for their pets. In addition to using collars with visible identification tags, microchip implantation is a reliable way to recover a lost or stray pet. Any fees associated with having a pet microchipped may seem nominal if the pet becomes lost and is returned safely because of the microchip. In addition, microchipping is encouraged by numerous professional organizations, including The Humane Society of the United States, the American Kennel Club, and the American Society for the Prevention of Cruelty to Animals.
References 1. American Veterinary Medical Association: US Pet Ownership & Demographics Sourcebook. Schaumberg, IL, American Veterinary Medical Association, 2007. 2. American Veterinary Medical Association: Microchipping of Animals. Accessed February 2008 at www.avma.org/issues/microchipping/ microchipping_bgnd.asp. 3. Stein FJ, Geller SC, Carter JC: Evaluation of microchip migration in horses, donkeys, and mules. JAVMA 223:1316–1319, 2003. 4. World Small Animal Veterinary Association: United States Microchip Report — 2006. Accessed February 2008 at www.wsava.org/Microchip Comm4.htm. 5. World Small Animal Veterinary Association: Microchip Implantation Sites Update — 1999. Accessed February 2008 at www.wsava.org/Site1099.htm. 6. McConnico RS, French DD, Clark B, et al: Equine rescue and response activities in Louisiana in the aftermath of Hurricanes Katrina and Rita. JAVMA 231:384–392, 2007. 7. World Small Animal Veterinary Association: Microchip Identification. Accessed February 2008 at www.wsava.org/MicrochipID.htm.
Rhonda began her career as a veterinary technician and then decided to pursue her veterinary degree in Dublin, Ireland. She currently works as a small animal clinician at Fifth Avenue Veterinary Specialists in New York. Rhonda’s personal interests include feline medicine. When not working, she enjoys taking spinning classes and playing chess. Rhonda has two cats, Mini Mu (from Ireland) and Miao-Lo.
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CE Article #1
Vaccine Transport, Storage,
P
and Handling
Laura McLain Madsen, DVM Central Valley Veterinary Hospital Salt Lake City, Utah
ROPER TRANSPORT, STORAGE, AND HANDLING of vaccines are issues that are frequently overlooked when creating or implementing vaccine protocols. Between the time a vaccine leaves the manufacturer’s plant and the time it is injected into an animal, there are many opportunities for inadvertent contamination or inactivation. By being aware of these potential “weak points” in a vaccine protocol, technicians can help ensure that vaccines are not rendered ineffective because of improper handling.
Awareness of vaccine transport, storage, and handling issues is greater in human medicine than in veterinary medicine because of the risk of epidemic diseases such as polio, influenza, and smallpox. By reviewing research on human vaccination protocols, veterinary professionals can learn a great deal about proper vaccine handling. Typical vaccines used in veterinary medicine include modified-live virus (MLV) vaccines, killed and adjuvanted vaccines, and recombinant vaccines. The different forms of vaccines have different susceptibilities to storage conditions. The term cold chain is used in human medicine to emphasize the importance of keeping vaccines at an appropriate temperature throughout the chain of transport, storage, and administration. Exposure to temperatures outside the recommended range can lead to reduced protection against infectious disease.1,2 MLV vaccines require close attention to the cold chain because they tend to be more heat sensitive than other types of vaccines.3,4 In general, published guidelines are limited. However, according to the 2006 American Association of Feline Practitioners Feline Vaccine Advisory Panel report, temperatures that are too cold can also adversely affect vaccines. For example, adjuwww.VetTechJournal.com
vanted vaccines are sensitive to freezing temperatures because the adjuvant may separate from the antigen and form a precipitate. This precipitate may not be visible in the vial but may cause local inflammation when injected.5 In addition to excessive cold and heat, exposure to light can cause vaccines to be rendered ineffective.5
Storage Virtually all of the vaccines used in small and large animal veterinary medicine, including both lyophilized (freeze-dried) and liquid forms, must be stored in the dark between 35°F (2°C) and 45°F (7°C). A few veterinary vaccines (e.g., some poultry and fish vaccines) must be kept frozen; technicians working with frozen vaccines should contact the manufacturer for specific storage instructions. Vaccines requiring refrigeration must be stored in a designated refrigerator. This should be a standard-size refrigerator with a separate freezer compartment — not a mini dorm-style refrigerator — to ensure better temperature control.1,2,6 The temperature inside a refrigerator can vary, with warmer temperatures in the door and vegetable bins and colder temperatures near the cold air outlet from the freezer to the refrigerator. For this reason, Veterinary Technician | MARCH 2008 161
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CE Article #1 Vaccines Tips for Safe Vaccine Transport, Storage, and Handlinga–f General
Designate primary and backup personnel to be in charge of vaccine inventory, storage, and handling. Maintain a vaccine inventory log that notes the vaccine’s quantity, manufacturer, brand, lot number, expiration date, date of arrival, and arrival condition. When a shipment arrives, check the temperature inside the shipping box and immediately refrigerate the vaccines. Use only the diluent supplied with the vaccine. Do not reconstitute or draw up the vaccine into the syringe until it is needed. Avoid mixing different vaccines in the same syringe unless licensed for that use. Properly dispose of syringes and needles in a sharps container. Transport
Use an insulated cooler to transport vaccines. Keep a thermometer in the cooler. Maintain the temperature between 35°F– 45°F (2°C–7°C). Use refrigerated or frozen packs as needed to maintain the appropriate temperature in the cooler. Place insulation (e.g., bubble wrap) between the vaccine vials and the frozen pack to prevent direct contact. Keep the vaccines in their original packaging. Keep the cooler in the interior of the vehicle instead of the trunk or truck bed to minimize exposure to extreme temperatures. Storage Keep vaccines in a standard-size refrigerator with a separate freezer compartment. Keep a good-quality thermometer in the vaccine storage refrigerator. Maintain the refrigerator between 35°F– 45°F (2°C–7°C). Do not store vaccines in a mini dorm-style refrigerator. Do not keep vaccines in the door, in vegetable bins, against the walls, or against the cold air inlet of the refrigerator. Do not overpack the refrigerator. Store vaccines in their original packaging.
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Stack vaccines by type, and rotate the stock so that the batch with the earliest expiration date is used first. Record the temperature twice daily on a log sheet. If the temperature is above or below the recommended range, notify the supervisor and call an appliance repairperson if necessary. Store jugs of water in the vaccine refrigerator to help maintain steady temperatures. Check the refrigerator seals regularly. Make sure all staff members close the refrigerator door tightly after opening. Do not store food or beverages in the vaccine refrigerator. Mark the refrigerator’s electrical outlet with “do not unplug” signs. Power Outage
Have a written protocol addressing power outages. If the outage is ongoing, consider moving vaccines to a place where they can be maintained at the appropriate temperature. Do not open the refrigerator or freezer until power is restored. As soon as power is restored, record the temperature in the refrigerator and the duration of the outage. Do not discard the affected vaccines. Mark the affected vaccines so that they can be easily identified. Call the vaccine manufacturer for guidance regardingwhether the vaccines may still be used. a Immunization Action Coalition: Don’t Be Guilty of These Errors in Vaccine Storage and Handling. Accessed January 2008 at www.immunize.org/catg.d/p3036.pdf. b Immunization Action Coalition: Vaccine Handling Tips. Accessed January 2008 at www.immunize.org/catg.d/ p3048.pdf. c Immunization Action Coalition: Maintaining the Cold Chain During Transport. Accessed January 2008 at www.immunize.org/catg.d/p3049.pdf. d Immunization Action Coalition: Emergency Response Worksheet. Accessed January 2008 at www.immunize .org/catg.d/p3051.pdf. e Immunization Action Coalition: Checklist for Safe Vaccine Handling and Storage. Accessed January 2008 at www.immunize.org/catg.d/p3035chk.pdf. f Centers for Disease Control and Prevention: Vaccine Handling, Storage and Administration Guidance for Panel Physicians. Accessed January 2008 at www.cdc.gov/ ncidod/dq/pdf/ti_vacc_handl_admin_guid.pdf.
vaccines should be kept in the center of the refrigerator, far enough from the freezer compartment to prevent them from freezing.1,2 Storing jugs of water in the refrigerator may also help to prevent temperature fluctuations. Vaccines should be kept in their original packaging, and boxes should be rotated so that the newest batch (with the latest expiration date) is in the back and is used last.6 Food and beverages should not be stored in the vaccine refrigerator. This violates Occupational Safety and Health Administration regulations. In addition, frequently opening the refrigerator to retrieve food can also lead to temperature fluctuations.2 Equally important to keeping vaccines refrigerated is monitoring and logging the refrigerator’s temperature. The clinic should designate a primary person and a backup person to be responsible for the vaccine cold chain.4 A good-quality thermometer should be kept in the middle of the vaccine refrigerator, and the refrigerator temperature should be checked twice daily (i.e., at the start and finish of the business day).1,2,4 The temperature should be recorded in a log book, with the exact time it was checked and the initials of the individual who is monitoring the temperature; if the temperature in the vaccine refrigerator is outside the recommended range (i.e., <35°F [2°C] or >45°F [7°C]), the log provides a visual trigger to take action. If the temperature goes above or below the recommended range, immediate investigation is required. It should be verified that the door seals are intact and that the door shuts tightly. The thermostat should be adjusted if necessary, and an appliance repairperson should be called if needed. The exact temperature and action taken should be documented in the log book. In case of a power outage, the refrigerator should not be opened until power has been restored.1 When power is restored, the temperature inside the refrigerator should be immediately checked and logged, along with the duration of the power outage. The affected vaccines should not be discarded but should be marked and kept separate from unaffected vials.1,2,4 The manufacturers of the vaccines should be called for guidance. Depending on the duration of the outage and the ending temperature in the refrigerator, the vaccines may still be usable. If a prolonged power outage is anticipated (e.g., because of a hurricane or other www.VetTechJournal.com
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natural disaster), the vaccines may be moved off-site to a location that will not be affected.2 Detailed studies of the degradation of veterinary vaccines exposed to inappropriate temperatures have not been published. Storage at room temperature for a couple of hours is most likely insignificant, but it is unknown at what temperature and length of exposure inactivation becomes a concern.7 More detailed studies exist for human vaccines and show that the rate of inactivation varies considerably by pathogen, strain, vaccine formulation, manufacturer, and exact environmental conditions.8 For example, measles vaccines are quite stable in the lyophilized form but are inactivated within hours of reconstitution.8
Transport Vaccines are frequently transported in large animal practices and in small animal house-call practices. The cold chain must be maintained during transport. Vaccines should be kept in an insulated cooler. Frozen ice packs or refrigerated packs should be used as needed to maintain the temperature between 35°F (2°C) and 45°F (7°C). The temperature in the cooler should be monitored and logged immediately before and after transport. A layer of insulation should be tucked between the vaccine box and the ice pack to prevent direct contact, which www.VetTechJournal.com
could result in freezing temperatures in the vaccine vial. The cooler should be kept in the passenger cabin of the vehicle; temperatures in a trunk or truck bed could get too hot in summer or too cold in winter.9
Handling For lyophilized vaccines, only the diluent that is provided with the vaccine should be used.5 Generally, diluents do not need to be refrigerated, but it is usually more convenient to keep them in the refrigerator with their corresponding vaccines. A new, sterile syringe and needle should always be used for drawing up and administering a vaccine. Vaccines should not be reconstituted or drawn up into the syringe until needed. Not only may the reconstituted vaccine be more temperature sensitive than the nonreconstituted vaccine, but there is also a risk of bacterial contamination and overgrowth if the syringe is left for a prolonged period. In addition, there is a risk of “mistaken identity” because many vaccines look similar in the syringe.2 The American Association of Feline Practitioners recommends using vaccines within 30 minutes of reconstitution.5 Some veterinary vaccines are available in multidose vials. When using a multidose vial, the veterinarian should ensure that the vial has
Free download! A Vaccine Temperature Log can be downloaded at www.VetTechJournal.com.
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CE Article #1 Vaccines
Introducing resQ from Bayer Animal Health ®
been thoroughly mixed before withdrawing a dose and take steps to minimize contamination of the vial.10 Standard sharps safety procedures should be followed to prevent accidental needlesticks. This is of particular concern with brucellosis vaccines because the vaccine agent is live and zoonotic.11
Each year, six to eight million pets go missing and enter a shelter—shockingly, only 22% are ever reunited with their owners. And while the advent of microchips has helped, many older systems still charge for database registration and rely on the clients to update their own information. As a result, many thousands of microchipped pets aren’t reunited with their owners when lost.
Conclusion Despite greater awareness of the vaccine cold chain in human medicine, there are still gaps in implementation. A 2001 survey of pediatric clinics found that 4% of clinics had a vaccine refrigerator temperature higher than 48°F (9°C), 15% had a refrigerator temperature lower than 34°F (1°C), 10% did not have a thermometer in the refrigerator, and 62% lacked complete temperature logs.6 Although no similar studies exist in veterinary medicine, the numbers may be similar. Veterinary technicians are a critical link in the vaccine cold chain. Many clinics do not have procedures in place for monitoring vaccine storage temperatures; therefore, technicians have opportunities to help design and implement vaccine storage and handling protocols.
Bayer wants to change this. resQ uses PetLink.net, the database that encourages pet registration and updates. Only resQ: • Removes the financial barrier to registration with a true no-cost pet registration database. and • Proactively cross-references the PetLink database with the National Change of Address System to continually update contact information of the 18% of the population that moves each year.
References 1. Centers for Disease Control and Prevention: Guidelines for maintaining and managing the vaccine cold chain. MMWR Morb Mortal Wkly Rep 52(42):1023–1025, 2003. 2. Kroger AT, Atkinson WL, Marcuse EK, et al: General recommendations on immunization: Recommendations of the advisory committee on immunization practices. MMWR Morb Mortal Wkly Rep 55(RR15):1–48, 2006.
For more information on resQ, contact Bayer Account Services at 800-633-3796, your Bayer Representative or visit BayerDVM.com.
3. Day MJ: The future of vaccines. Proc West Vet Conf:2005. 4. Pickering LK, Wallace G, Rodewald L: Too hot, too cold: Issues with vaccine storage. Pediatrics 118(4):1738–1739, 2006. 5. Richards JR, Elston TH, Ford RB, et al: The 2006 American Association of Feline Practitioners Feline Vaccine Advisory Panel report. JAVMA 229(9):1405–1441, 2006. 6. Bell KN, Hogue CJ, Manning C, Kendal AP: Risk factors for improper vaccine storage and handling in private provider offices. Pediatrics 107(6):E100, 2001. 7. Hustead DR: What you can and cannot learn from reading a vaccine label. Vet Clin North Am Small Anim Pract 31(3):539–556, 2001. 8. Galazka A, Milstien J, Zaffran M: Thermostability of Vaccines. Geneva, Global Programme for Vaccines and Immunization, World Health Organization, 1998. Accessed January 2008 at http://whqlibdoc.who.int/ hq/1998/WHO_GPV_98.07.pdf. 9. Immunization Action Coalition: Maintaining the Cold Chain During Transport. Accessed January 2008 at www.immunize.org/catg.d/ p3049.pdf. 10. American Veterinary Medical Association: Veterinary Biologics, June 2007. Accessed January 2008 at www.avma.org/products/scientific/ biologics.pdf. 11. National Association of State Public Health Veterinarians: Compendium of Veterinary Standard Precautions: Zoonotic Disease Prevention in Veterinary Personnel. Accessed January 2008 at www.avma.org/services/ Compendium_of_Veterinary_Standard_Precautions_2006.pdf.
iMAX Blacck Label readerr
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So I saw a
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Just then, out of nowhere, I smelled a
four blocks away
and I booked it. By the time I took a break to use the I was lost. Fortunately, my vet recommended database made it easy to reunite with my even though I’m in the
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, I realized , and their superior © 2008 Bayer HealthCare LLC, Animal Health Division, Shawnee Mission, Kansas 66201. Bayer, the Bayer Cross and resQ are trademarks of Bayer.
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CE Article #1 Vaccines
ABOUT THE AUTHOR
Laura McLain Madsen, DVM
Laura is an associate veterinarian at the Central Valley Veterinary Hospital in Salt Lake City, Utah. She also serves on the editorial board of Veterinary Technician. Laura and her husband, Loren, share their home with two daughters, Bridget and Katelyn, and three pets: Harry (a Norwich terrier; pictured with Laura), Leyla (a shepherd mix), and Clyde (a cat). In her spare time, Laura enjoys gardening, reading, and traveling.
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. Vaccine efficacy can be affected by a. excessive cold. b. excessive heat. c. exposure to light. d. all of the above 2. Vaccines should be stored in which temperature range? a. 2°F to 7°F (-17°C to -14°C) b. 10°F to 20°F (-12°C to -7°C) c. 20°F to 32°F (-7°C to 0°C) d. 35°F to 45°F (2°C to 7°C) 3. The term cold chain refers to the a. precipitate that forms when an adjuvanted vaccine is frozen. b. maintenance of proper vaccine temperature throughout transport and storage. c. frozen ice packs that can be used in an insulated cooler. d. thermometers used to monitor the temperature in the refrigerator. 4. If a clinic experiences a power outage, the technician should not a. discard all vaccines that may have been exposed to warm temperatures. b. mark all vaccines that may have been exposed to warm temperatures. c. record the temperature inside the refrigerator as soon as power is restored. d. contact the vaccine manufacturers for advice. 166
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Go to www.VetTechJournal.com now to take this CE Test.
5. Which statement regarding vaccine transport is false? a. Vaccines should be kept in an insulated cooler during transport. b. The cooler should be kept in the passenger cabin of the vehicle to prevent exposure to extreme temperatures. c. The temperature inside the cooler should be monitored with a thermometer. d. Frozen ice packs or refrigerator packs should be placed in direct contact with the vaccines to ensure that they are kept cold. 6. In the clinic, vaccines should be stored in a. a mini dorm-style refrigerator. b. the vegetable bins of a standard-size refrigerator. c. the center of a standard-size refrigerator. d. the door of a standard-size refrigerator. 7. Ideally, vaccines should be reconstituted and drawn up into the syringe ______________ before use. a. immediately b. 1 hour c. 6 hours d. 24 hours
8. If the temperature in the vaccine refrigerator is above or below the recommended range, which of the following steps should be followed? a. The door seals should be checked to make sure that they are intact. b. The thermostat should be adjusted if necessary. c. An appliance repairperson should be contacted immediately, if necessary. d. all of the above 9. A refrigerator temperature log book should include a. date and time. b. exact temperature. c. initials of the individual monitoring the temperature. d. all of the above 10. According to ______________ regulations, food and beverages should not be stored in the vaccine refrigerator. a. FDA b. Centers for Disease Control and Prevention c. Occupational Safety and Health Administration d. none of the above
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Kills Adult Fleas
Kills Flea Eggs
Kills Ticks Kills Flea Larvae
FAST 3
Grand Slam. FRONTLINE® Plus contains two powerful active ingredients that kill ticks and fleas (adults, eggs and larvae) to provide extra protection for pets. • Fipronil kills adult fleas in multiple ways (by working on at least 3 different sites in their nervous system),1,2 kills ticks, and keeps killing all month long. • (S)-methoprene kills flea eggs and larvae to break the flea life cycle. That’s how FRONTLINE Plus eliminates existing infestations and protects pets against reinfestation.
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FRONTLINE Plus also: • Aids in control of sarcoptic mange infestations. • Rapidly eliminates infestations of chewing lice. • Is approved for use on breeding, pregnant or lactating dogs and cats, as well as puppies and kittens 8 weeks of age and older.
To stop fleas and ticks, your recommendation counts.
For more details, visit www.FRONTLINE.com 1
Zhao X, Yeh JZ, Salgado VL, Narahashi T. Fipronil is a potent open channel blocker of glutamate-activated chloride channels in cockroach neurons. J Pharm Exp Ther 2004;310(1):192-201. 2 Ikeda T, Zhao X, Kono Y, Yeh JZ, Narahashi T. Fipronil modulation of glutamate-induced chloride currents in cockroach thoracic ganglion neurons. Neurotoxicology 2003;24:807-815. 3 Data on file at Merial. 4 McCall JW, Alva R, Irwin JP et al. Comparative efficacy of a combination of fipronil/(S)-methoprene, a combination of imidacloprid/ permethrin, and imidacloprid against fleas and ticks when administered topically to dogs. J Appl Res Vet Med 2004;2(1):74-77.
Circle 183 on Reader Service Card ®FRONTLINE is a registered trademark of Merial. ®ADVANTAGE is a registered trademark of Bayer Healthcare. ®K9 ADVANTIX is a registered trademark of Bayer Aktiengesellschaft. ©2007 Merial Limited, Duluth, GA. All rights reserved. FLE07ADSGRANDSLAMPG.
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ParasitologyinPractice
Giardia Infection
William McLaughlin, CVT Whiting Veterinary Clinic Whiting, New Jersey
Diagnosis,Treatment, and Prevention
Causative Agent The genus Giardia comprises several species of protozoan parasites. Infection with Giardia spp is common in humans and animals, including wildlife. Pets can be infected with the parasite after drinking from lakes, streams, springs, or shallow wells that have been contaminated with feces containing Giardia cysts.1 Crowding increases the risk of trans-
mission; therefore, cases may be more common in kennels and catteries.1 Whether transmission takes place between host species is unclear. The Giardia spp of most interest to small animal clinics are Giardia felis, Giardia canis, and Giardia intestinalis (which is also known as Giardia lamblia and Giardia duodenalis). It was previously thought that G. felis was host specific to cats, G. canis to dogs, and G. intestinalis to other species, including humans. However, one study reported that G. intestinalis genotypes were isolated in dogs, indicating that transmission between species may occur.2 Advances in molecular epidemiology have enabled Giardia parasites isolated from animals and environmental samples to be genotyped.3 These genotypes, known as assemblages, are categorized using the letters A through G, according to the susceptible species.4 Assemblages A and B are potentially zoonotic. Assemblage A has been found in humans as well as in dogs and cats, whereas assemblage B has been found in humans and dogs but not in cats.5 Assemblages C through G are generally animal host specific and have not been found in humans.6
©2008 CDC/DPDx/Melanie Moser
A
NIMALS ACQUIRE giardiasis — the disease caused by Giardia infection — when they swallow the cystic form of the Giardia parasite, which colonizes the intestine. Infected animals may present to the veterinary practice with nonspecific clinical signs, such as diarrhea; therefore, if a parasitic infection is suspected, a thorough patient history should be obtained, a physical examination should be performed, and a fecal study should be conducted. Veterinary technicians who understand how parasitic infections are transmitted can educate clients to help prevent transmission.
Photomicrograph of a blue-stained G. intestinalis trophozoite (trichrome stain, original magnification х1,000).
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ParasitologyinPractice All the organisms in these assemblages look identical under a microscope and can only be differentiated using techniques such as polymerase chain reaction or DNA sequencing analysis.6
Life Cycle The life cycle of the Giardia parasite consists of a cyst stage and a trophozoite stage; like other infections caused by intestinal protozoa, Giardia infection is usually transmitted by cysts via the oralâ&#x20AC;&#x201C;fecal route.1,7,8 Giardia cysts can be transmitted directly between hosts or on fomites, such as food or certain water sources (e.g., untreated municipal water, backwoods streams, lakes) contaminated with human or animal feces.1,9 Although the cysts are susceptible to desiccation and heat, they can survive for long periods under cool, moist conditions or in cold water.1 Once ingested, a Giardia cyst releases one or two trophozoites in the small intestine.1 Trophozoites have flagella, which are hairlike structures that whip back and forth,
allowing them to move around. Trophozoites attach to the intestinal wall and reproduce by dividing in two. Many of the dividing trophozoites encyst as they travel distally in the intestines.1 Cysts and trophozoites can both be found in the feces of infected animals, although trophozoites are not usually found in firm or semiformed feces.1,10
Clinical Signs and Prevalence The most common clinical sign associated with giardiasis in dogs and cats is small intestine diarrhea (which is usually pale and greasy). However, infected dogs and cats often demonstrate no â&#x20AC;&#x201D; or intermittent â&#x20AC;&#x201D; clinical signs. Giardia infection occurs more often in young animals.1 Reported prevalence rates vary widely, ranging from 20% to 50% in puppies, approximately 10% in well-attended adult dogs, and up to 100% in breeding kennels.1,11,12 The prevalence rate in cats ranges from 1.4% to 11%, and approximately 2% to 10% of dogs and cats are subclinical carriers.1,11,13 Giardiasis is usually not life threatening.1 Diarrhea is often self-limiting in animals that
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ParasitologyinPractice develop clinical signs. Severe diarrhea may be accompanied by dehydration, lethargy, and anorexia.10 Chronic small bowel diarrhea with weight loss and intermittent vomiting or large bowel diarrhea with excess fecal mucus, hematochezia, or tenesmus may also occur.10
Diagnosis
Glossary Desiccation_Excessive loss of moisture Fomite_Object or substance that can be contaminated with and transmit infectious organisms Hematochezia_Passage of bloody stool Sensitivity_Likelihood that a test will correctly identify an animal as having the disease in question Specificity_Likelihood that a test will correctly identify an animal as not having the disease in question Tenesmus_Painful but ineffectual
urge to defecate or urinate Teratogenic_Able to cause congenital anomalies Zoonotic_Able to be transmitted from animals to humans
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Although direct fecal smear and fecal flotation testing have been used to diagnose giardiasis, the parasite is frequently misdiagnosed or underdiagnosed using only these methods.4,14 Giardia cysts can be mistaken for yeast bodies, which have a similar size and shape.14 Intermittent shedding also complicates consistent diagnosis.4 The Companion Animal Parasite Council recommends testing symptomatic dogs and cats using a combination of direct smear, fecal flotation with centrifugation, and fecal ELISA testing.4 Repeat testing may be necessary to identify infection in symptomatic dogs and cats. A direct smear is used primarily to detect trophozoites in diarrheic stool. Trophozoites can be identified by their teardrop shape and concave ventral disk.10 To perform a direct smear, a small sample of fresh feces is mixed with a few drops of saline on a glass slide; Lugol’s iodine may be added to aid identification.4,10 Fecal flotation with centrifugation is used primarily to detect Giardia cysts in solid or semisolid stool. Approximately 2 g of feces is mixed with a solution of zinc sulfate and centrifuged for 3 to 5 minutes at 1,500 rpm to 2,000 rpm. As with the direct smear method, Lugol’s iodine may be added to aid identification.4,10 The SNAP Giardia test (IDEXX Laboratories) is the first commercially available Giardia ELISA designed specifically for detection of the Giardia antigen in dog and cat feces. The test uses a small sample and can be conducted in 8 minutes in a veterinarian’s office. The sensitivity of this test is 85% to 90%, and the specificity is 95% to 99%.15,a
Treatment In the United States, none of the drugs used for giardiasis treatment in humans have a
For more information on sensitivity and specificity, see “Understanding Common Endocrine Tests” on page 362 of our June 2007 issue.
MARCH 2008 | Veterinary Technician
currently been approved for use in dogs and cats, although off-label use of certain drugs has been successful in canine and feline patients.16 Fenbendazole has been shown to be effective against Giardia spp and has not been associated with any teratogenic effects.14,16 The dosage of fenbendazole used in dogs is 50 mg/kg PO sid for 3 days; the dosage used in cats is the same, but the duration is 3 to 5 days.17 Metronidazole has also been used to treat Giardia infection in dogs and cats. The dosage of metronidazole used in dogs is 25 mg/kg PO bid for 5 to 7 days; the dosage used in cats is 10 to 25 mg/kg PO bid for 5 days.17 Metronidazole has antibacterial as well as antiinflammatory properties. However, it is only 67% to 74% effective in eliminating the Giardia parasite from dogs and can cause adverse effects, such as anorexia, vomiting, and neurologic problems.14 When planning a therapeutic regimen, veterinary staff should discuss the available treatments and the associated side effects with the client.
Environmental Controls In addition to pharmacotherapeutic treatment, it is important to implement environmental controls to help reduce the risk of reinfection.14 In a cool environment, Giardia cysts can remain infective for a long period; therefore, cleaning and prompt removal of feces can limit environmental contamination. Steam cleaning or treatment with a quaternary ammonium compound is effective for killing cysts. Hard surfaces can be disinfected and should be allowed to dry, making the cysts susceptible to desiccation.1,14 Potentially contaminated water should be boiled for at least 1 minute or filtered; the filter should have an absolute pore size of at least 1 µm or be rated by the National Standards Foundation for cyst removal. Disinfection with chlorine or iodine may also destroy the cysts, but this method is less reliable than boiling or filtration.1 Because it is difficult to decontaminate soil, grass, or standing water,4 outdoor pets are at greater risk of reinfection than indoor pets. The owner can reduce this risk by picking up stool immediately after the pet eliminates. If possible, the owner should reduce the pet’s exposure to potentially contaminated water sources. www.VetTechJournal.com
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ParasitologyinPractice Vaccination Giardia vaccines for dogs and cats are being marketed. In 2006, however, both the American Animal Hospital Association and the American Association of Feline Practitioners released vaccination guidelines indicating that these vaccines are currently not recommended for routine use.18,19 Insufficient evidence currently exists to support routine Giardia vaccination for giardiasis prevention or therapy; however, vaccination may be beneficial for high-risk populations (e.g., animals in kennels), animals living in endemic areas, and animals prone to reinfection.1,4,10 Veterinarians and technicians should discuss the advantages and disadvantages of Giardia vaccination with owners, who are likely to have questions regarding whether use of the vaccine is appropriate for their pet.
Zoonotic Potential Clients may also have questions regarding whether they can contract giardiasis from infected pets or vice versa. Although Giardia infections in humans usually result from
Giardia Assemblages and Susceptible Speciesa,b Assemblage
Susceptible Species
A
Humans, cats, dogs, livestock, beavers, guinea pigs
B
Humans, dogs, beavers, rats
C
Dogs
D
Dogs
E
Large animals (e.g., cattle), goats, pigs, sheep
F
Cats
G
Rats
a Monis PT, Andrews RH, Mayrhofer G, et al: Novel lineages of Giardia intestinalis identified by genetic analysis of organisms isolated from dogs in Australia. Parasitology 116:7–19, 1998. b Thompson RC: Giardiasis as a re-emerging infectious disease and its zoonotic potential. Int J Parasitol 30(12– 13):1259–1267, 2000.
ingestion of contaminated food or water or person-to-person transmission, the potential for zoonotic transmission from dogs or cats is still unclear. Therefore, clients who are immunocompromised should limit their exposure to Giardia-infected pets.4 Clients
The immune systems of puppies and kittens are still developing and often compromised. Research supports antioxidant supplementation in young pets for improved immune response to vaccinations.* Try ProAnimal®, a quality antioxidant and immune boosting supplement they’ll think is a treat! *Chew BP, Park JS, Wong TS, Kim HW, Weng BB, Byrne KM, Hayek MG, Reinhart GA (2000) Dietary beta-carotene stimulates cell-mediated and humoral immune response in dogs. The Journal of Nutrition Aug;130(8):1910-3.
Circle 127 on Reader Service Card From the makers of Proanthozone®, ProNeurozone®, ProQuiet®, ProMotion®, Prosamine®, ProMotionEQ® for dogs, cats and horses. ©2007 Animal Health Options
“The Antioxidant Company since 1990”
800-845-8849 Sign up for AHO’s monthly Animal Health Tips at
www.animalhealthoptions.com
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ParasitologyinPractice should be advised to seek medical attention if they develop gastrointestinal symptoms following exposure to an infected pet.4 Human-to-animal infection transmission is also possible; therefore, infected owners should wash their hands with soap and water before feeding or handling their pet.1
Recommendations for Clients with Giardia-Infected Pets Treat all pets in the household simultaneously. Bathe the affected pet with shampoo to remove fecal debris and cysts. Wash hands thoroughly with soap and water after handling an infected pet. Remove feces daily while wearing gloves. Sanitize surfaces by steam-cleaning or using commercially available disinfectants. Allow surfaces to dry thoroughly. Arrange for infected pets to undergo a posttreatment fecal examination to determine whether the treatment was successful.
Conclusion When a patient presents to the veterinary practice with diarrhea, staff should determine whether the patient’s history or lifestyle places it at risk for Giardia infection (e.g., if the pet was recently adopted from a shelter or frequently drinks water from potentially contaminated sources). Symptomatic, at-risk patients should undergo a fecal examination. If a patient is diagnosed with Giardia infection, it should receive pharmacotherapy (e.g., metronidazole, fenbendazole), and the veterinary technician should educate the owner on the importance of implementing environmental controls, when possible, to prevent reinfection and to reduce the potential for cross-transmission. By understanding the life cycle of Giardia spp and methods for treating and preventing infection, technicians can serve as a resource for owners and teach them how to keep their pets healthy.
References 1. Center for Food Security & Public Health, Iowa State University: Giardiasis. Accessed February 2008 at www.cfsph.iastate.edu/Factsheets/pdfs/ giardiasis.pdf. 2. Abe N, Kimata I, Iseki M: Identification of genotypes of Giardia intestinalis isolates from dogs in Japan by direct sequencing of the PCR amplified glutamate dehydrogenase gene. J Vet Med Sci 65(1):29–33, 2003. 3. Thompson RC: Epidemiology and zoonotic potential of Giardia infections [abstract], in Sterling CR, Adam RD (eds): World Class Parasites: Volume 8. The Pathogenic Enteric Protozoa: Giardia, Entamoeba, Cryptosporidium and Cyclospora. Norwell, MA, Kluwer Academic Publishers, 2004. 4. Companion Animal Parasite Council: Protozoa:
ABOUT THE AUTHOR
William McLaughlin, CVT 172
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Giardiasis Guidelines. Accessed February 2008 at www.capcvet.org/?p=Guidelines_Giardiasis& h=0&s=0. 5. Lappin MR: Feline zoonotic diseases. World Small Anim Vet Assoc World Congress Proc:2004. 6. Trout JM, Santín M, Fayer R: Prevalence of Giardia duodenalis Genotypes in Adult Dairy Cows. Accessed February 2008 at arsserv0.tamu.edu/research/ publications/Publications.htm?seq_no_115=203442. 7. Wiser MF: Intestinal Protozoa. Accessed February 2008 at www.tulane.edu/~wiser/protozoology/ notes/intes.html. 8. Lappin MR: Giardia spp. and Tritrichomonas foetus infections. West Vet Conf Proc:2006. 9. Marshall MM, Naumovitz D, Ortega Y, Sterling CR: Waterborne protozoan pathogens. Clin Microbiol Rev 10(1):67–85, 1997. 10. Leib MS: Giardia infection in dogs and cats. Atlantic Coast Vet Conf Proc:2003. 11. Kirkpatrick CE: Enteric protozoan infections, in Greene CE (ed): Infectious Diseases of the Dog and Cat. Philadelphia, WB Saunders, 1990, pp 804–814. 12. Papini R, Gorini G, Spaziani A, Cardini G: Survey on giardiosis in shelter dog populations. Vet Parasitol 128(3–4):333–339, 2005. 13. Hill SL, Cheney JM, Taton-Allen GF, et al: Prevalence of enteric zoonotic organisms in cats. JAVMA 216(5):687–692, 2000. 14. Tams TR: Diarrhea caused by Giardia and Clostridium perfringens enterotoxicosis. Atlantic Coast Vet Conf Proc:2001. 15. University of California–Davis: Giardiasis: Veterinarian Only Information Sheet. Accessed February 2008 at www.sheltermedicine.com/ portal/vet_is_giardiasis.shtml. 16. Barr SC: Enteric protozoal infections, in Greene CE (ed): Infectious Diseases of the Dog and Cat, ed 3. St. Louis, Elsevier, 2006, pp 736–742. 17. Giardiasis, in Kahn CM (ed): The Merck Veterinary Manual, ed 9. Whitehouse Station, NJ, Merck & Company, 2005, pp 171–172. 18. American Animal Hospital Association: 2006 AAHA Canine Vaccine Guidelines, Revised. Accessed February 2008 at www.aahanet.org/Public Documents/VaccineGuidelines06Revised.pdf. 19. American Association of Feline Practitioners: The 2006 American Association of Feline Practitioners Feline Vaccine Advisory Panel Report. Accessed February 2008 at www.aafponline.org/ resources/guidelines/2006_Vaccination_ Guidelines_JAVMA_%20PDF_Plus.pdf.
William McLaughlin, who has been a veterinary technician since 1994, works at Whiting Veterinary Clinic in Whiting, New Jersey. He lives in Middletown, New Jersey, with his wife, Jamie, and their two teenage children, Sean and Kirsten. The family has a shih tzu puppy, Pepe, and a parakeet, Bibi. Bill is an avid cyclist and has been a member of the Somerset Wheelmen since 2003. www.VetTechJournal.com
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Subchondral Bone Cysts in the Equine Stifle
A
Rosanne Barwick, DipAVN (Surgical), EVN, VN, Cert SAN, ESMT Marion duPont Scott Equine Medical Center Leesburg, Virginia
15-MONTH-OLD, 1,000-lb (453.6-kg) American quarter horse filly, which was intended for use as a halter horse, presented with bilateral hindlimb lameness and hock effusion of approximately 1 week’s duration. Radiography revealed subchondral cystic lesions in both stifles. The patient underwent bilateral stifle arthroscopy, and microfracture of the subchondral bone was performed to stimulate cartilage repair. History The patient had been previously diagnosed as heterozygous for hyperkalemic periodic paralysis (HPP). This disease can often be controlled by avoiding high-potassium feeds (see box on page 174). For this reason, the amount of grain was reduced and divided into several feedings because grain can stimulate insulin-mediated movement of potassium across cell membranes. The filly was asymptomatic, but it was important to monitor her for clinical signs of an attack (i.e., fasciculations, sweating, muscular weakness, respiratory stridor, and stressinduced elevations in heart and respiratory rates).1,2 The filly had been treated 9 months earlier for bilateral flexural deformity of the carpi. At that time, the owner had declined a lameness evaluation to investigate the underlying problem. Therapy consisted of oxytetracycline (44 mg/kg IV sid for 3 days), stall and small-paddock rest, and corrective trimming. Two-degree Equilox heel wedges were recommended to ease the strain on the superficial digital flexor muscles and deep digital flexor tendons. Desmotomy of the superior check ligament (superficial digital flexor tendon) was recommended if there was no improvement with conservative treatment. The www.VetTechJournal.com
This American quarter horse presented with a history of lameness.
owner was advised to monitor the filly for persistent flexural deformity or lameness and buckling at the knees and to bring the filly to the hospital if either recurred.
Findings At presentation, the filly appeared to be in good overall condition. However, bilateral hock and stifle effusion were evident. Lameness examination (walking in a straight line on a hard surface) revealed that the horse was lame in both hindlimbs. Baseline trotting examination in a straight line revealed grade 4/5 lameness in the left hindlimb and grade 2/5 lameness in the right hindlimb. Flexion testing exacerbated the problem. The filly had moderately positive findings in right upper hindlimb (hock and stifle) flexion and right stifle flexion; findings were strongly positive in left upper hindlimb (hock and stifle) flexion. Based on the clinical findings, bilateral stifle and hock radiography were recommended under standing sedation using detomidine (0.01 mg/kg IV). Stifle radiography included lateral, caudocranial, caudolateral–craniomedial, and caudomedial– craniolateral oblique views. Routine views of the hocks included lateral, plantarolateral–dorsomedial oblique, dorsoplantar, Veterinary Technician | MARCH 2008 173
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EquineEssentials and dorsolateral–plantaromedial oblique perspectives. The radiographs were obtained using a digital radiography system (Eklin Medical Systems). Results revealed a large subchondral cystic lesion of the medial femoral condyle in the left stifle, which appeared as a defined lucent area with a sclerotic rim and a communication with the joint. The right stifle was found to have a similar lesion with subchondral bone sclerosis, indicating a chronic condition. The left hock showed slight lysis of the medial malleolus of the tibia and enthesiophyte formation associated with the proximal intertarsal joint. There was evidence of changes in the right hock, affecting the medial malleolus of the tibia and lateral trochlear ridge of the talus. Based on these diagnostic findings, bilateral stifle and hock arthroscopy under general anesthesia were recommended.
Surgical Preparation To reduce the risk of a stress-related HPP episode during hospitalization, the filly was kept quiet and warm, with access to small amounts of her customary grass hay (which is lower in potassium than alfalfa). Preoperative electrocardiography to assess cardiac output and rhythm revealed no abnormalities. If the patient had developed hyperkalemia, there would have been an increased T wave amplitude, a markedly decreased P wave amplitude, a widening of the QRS complexes, and an irregular ventricular rate.
Hyperkalemic Periodic Paralysis a Hyperkalemic periodic paralysis (HPP) is an inherited muscle disease caused by a genetic mutation. The genetic defect, which has been identified only in descendants of the American quarter horse sire Impressive, produces an altered, but functional, sodium ion channel. Sodium channels control the contraction of muscle fibers. If potassium levels in the blood fluctuate (e.g., when a horse is fasted and then consumes a high-potassium feed such as alfalfa), the channel may leak, causing involuntary muscle contractions. Hyperkalemia causes the number of muscle contractions to increase, making the horse susceptible to sporadic episodes of muscle tremors, weakness, paralysis, and/or collapse. A DNA test for HPP identifies the specific genetic mutation in descendants of Impressive. Heterozygous horses are not as severely affected as homozygous horses, and not all horses with HPP experience adverse effects. However, owners should be aware that stress and/or hyperkalemia, as well as environmental factors (e.g., dietary changes, fasting, general anesthesia, concurrent illness, exercise restriction), can trigger clinical signs of muscle dysfunction. a Spier SJ, University of California–Davis: Hyperkalemic Periodic Paralysis (HYPP). Accessed February 2008 at www.vgl.ucdavis.edu/ services/hypp.php.
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Physical findings were within normal limits, as were blood values. Serum potassium levels were not monitored. The filly was fasted for 9 hours preoperatively but allowed access to water. A 14-gauge IV catheter was placed aseptically into the left jugular vein on the morning of surgery. One hour before surgery, tetanus toxoid (1 ml IM) and phenylbutazone (2.2 mg/kg IV) were administered. Additionally, the filly’s stifles and hocks were clipped, her feet were scrubbed, her tail was braided, and her mouth was rinsed. Stress-free induction of anesthesia was accomplished in a padded box using xylazine hydrochloride (0.5 to 1.1 mg/kg IV). Five minutes later, diazepam (0.01 to 0.2 mg/kg IV) was administered, followed by ketamine hydrochloride (2 mg/kg IV). The filly was intubated with a 26-mm endotracheal tube and maintained on isoflurane vaporized in 100% oxygen under intermittent positive-pressure ventilation with a mechanical ventilator at a peak pressure of 20 to 25 cm H2O. Tidal volume was set at 1 L/100 kg, with a respiratory rate of 6 to 8 breaths/min. A continuous infusion of dobutamine hydrochloride (0.25 to 5.0 μg/kg/min) was given to increase cardiac contractility and therefore maintain a mean arterial pressure of more than 70 mm Hg. An intraarterial 23-gauge catheter was aseptically placed into the transverse facial artery for direct intraoperative monitoring of arterial pressure. Intravenous sodium chloride was administered at 10 ml/kg/hr to support circulating blood volume and arterial pressure. Use of a potassium-containing IV isotonic solution was avoided. The horse’s heart rate and rhythm were closely monitored, and no abnormalities were detected. A constant-rate infusion of calcium gluconate 20% (0.2 to 0.4 ml/kg IV) diluted in a dextrose 5% solution was administered to raise the muscle membrane threshold potential and decrease membrane excitability. To prevent the potential development of hyperkalemia (associated with HPP), dextrose 5% was chosen to reduce serum potassium levels and enhance intracellular potassium transport. Blood gas analysis was performed during the procedure to assess pH and ventilatory status to prevent acidosis and maintain homeostasis. The filly was placed in dorsal recumbency on a padded Kimsey operating table with www.VetTechJournal.com
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B
Tools used during arthroscopy. (A) Left to right: 4-mm blunt/ conical obturator, 4-mm sharp pyramidal trocar, 5-mm arthroscopic cannula, and 30°, 4-mm arthroscope. (B) Top to bottom: McIlwraith rongeur, FerrisSmith rongeur, and Cushing pituitary rongeur.
the hindlimbs suspended from an overhead horizontal bar. The stifles were flexed at 90° for access to the femorotibial joints, reducing the risk of femoral nerve paralysis. The forelimbs were allowed to rest in a natural position and tied. The surgical sites were aseptically prepared with chlorhexidine gluconate 4% and isopropyl alcohol 70%.
Surgery A lateral approach was chosen for insertion of a 30°, 4-mm arthroscope into the cranial compartment of both medial femorotibial joints, leaving a clear area for instrument placement.3 An 18-gauge, 3.5-cm spinal needle was inserted to retrieve a sample of synovial fluid and confirm correct placement into the joint. Lactated Ringer’s solution (60 ml) was administered to distend the joint. An 8-mm skin incision was made
using a #11 blade caudal to the lateral patellar ligament, cranial to the long digital extensor tendon, and 2 cm proximal to the tibial crest. A 5-mm arthroscopic cannula with a conical obturator was directed medially and slightly caudally to penetrate the medial septum in the lateral aspect of the medial femorotibial joint. The obturator was then removed, and the 4-mm arthroscope was inserted. Entry into the joint was confirmed by visualization of joint surfaces and the egress of fluid. After the lesion was located, an instrument portal was created using the same techniques as for the arthroscope portal. Using a cranial approach, an 8-mm incision was made between the middle and medial patellar ligaments, approximately 2 cm proximal to the tibial crest.3 The arthroscopic cannula and conical obturator were inserted Stifle arthroscopy in progress.
During arthroscopy of the left medial femoral condyle, an Adson hook probe was used to palpate and evaluate the depth of the lesion. www.VetTechJournal.com
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EquineEssentials through the fat pad in a slightly proximal, caudal, and axial direction until they penetrated the medial joint capsule. The portal permitted contact between the instruments and the lesion, enabling effective manipulation. An Adson hook probe was used to ascertain the texture and depth of the cartilage defect. Ferris-Smith (4 × 10) and Cushing pituitary (4 × 10) rongeurs were used to remove the defective articular cartilage overhanging the defect to gain access to the lesion. Bruns curettes were employed to remove the soft, defective cartilage and subchondral bone to facilitate debridement of the bone cyst. Special attention was given to removal of the cyst’s fibrous membrane, which contains inflammatory cytokines.4 Findings included a large, type 2, 1.5- to 2-cm subchondral bone defect in the left stifle with soft, irregular overlying articular cartilage. The lesion was 1.5 cm deep, and the subchondral bone within the cyst was soft. In the right stifle, a type 1, 1-cm defect was identified with a depth of 1 cm. To stimulate cartilage repair, microfracture of the subchondral bone was performed in the left stifle around the rim of the cyst. A micropick awl (Sontec) with a 35° angled tip
Subchondral Bone Cysts Subchondral bone cysts (subchondral cystic lesions or osseous cyst-like lesions) are relatively common in horses.6,25 All breeds are susceptible, but Warmbloods and thoroughbreds are especially vulnerable.8 The condition can occur at any age, but it usually manifests 2 to 5 years after the horse commences work. Lameness can vary from mild to severe, with or without joint distention.21,22 There are many reasons why these cysts can occur, but two causes are more common. The first cause is linked to osteochondrosis, a disease of the cartilage–bone unit in young horses characterized by defective endochondral ossification (i.e., failure of normal cell differentiation and calcification) at the metaphysis or epiphysis. The second cause is traumatic defects in the cartilage surface that allow synovial fluid to leak into the underlying subchondral bone; this can result in cyst formation, inflammation, and bone resorption. The configuration of the cartilage defect and the increase in pressure from the synovial fluid may determine the degree of lameness.6 Cysts are classified as type 1, 2, or 3. Type 1 lesions are 10 mm or less in depth, appearing as shallow, saucer- or dome-shaped defects. Type 2 lesions are greater than 10 mm in depth and are typically domed, conical, or spherical. Type 3 lesions are flattened or have irregular contours of the subchondral bone.8 The medial femoral condyle is the most common site for subchondral cystic lesions. Most cysts are unilateral, but approximately 30% to 40% of cases involve bilateral cysts, which tend to occur in immature horses. Lesions have also been found in the distal first phalanx, proximal second phalanx, radius, carpus, distal third metacarpus, third metatarsus, tarsal bones, tibia, and shoulder. 176
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was used to make multiple, uniform 3-mm perforations 2 to 3 mm apart to cover the cystic rim. Lavage of the joint was performed under pressure (HydroFlex Fluid System, Davol), and a 4.5-mm egress cannula was used to remove any remaining defective tissue and debris. The skin portals were apposed with 2-0 monofilament nylon sutures in a simple, interrupted pattern. The portals were covered with an adhesive dressing. Because of the patient’s prolonged anesthetic exposure, it was decided that hock arthroscopy would not be performed.
Recovery and Postoperative Care All horses undergoing general anesthesia are at risk of postoperative myopathies. Therefore, it is essential to have emergency drugs (e.g., calcium gluconate 20%) readily available. Signs of postoperative myopathy include sweating, muscle tremors, and paralysis or difficulty rising. In addition, dextrose 5% and insulin were available in case of HPP-related problems. Because the patient had HPP, it was important to avoid undue stress by ensuring a quiet, smooth recovery. Recovery was uneventful, but the filly was uncomfortable 1 hour after surgery. Phenylbutazone (4.4 mg/kg IV) and butorphanol tartrate (0.02 mg/kg IV) were administered for analgesia; alternatively, epidural anesthesia or a lidocaine infusion could have been used. The horse remained comfortable overnight; her vital parameters were within normal limits, and she was bright and alert and was eating well. There were no clinical signs of fasciculations or sweating. On discharge 2 days postoperatively, strict stall rest was advised for 2 months with phenylbutazone (2.2 mg/kg PO bid) for 5 days and then once a day for 3 days. The sutures were to be removed 10 to 14 days later by the owner’s veterinarian, after which the filly would be hand-walked. A minimum of 4 months of pasture rest was recommended before initiating any work.
Outcome The filly was reexamined at the time of suture removal, 14 days postoperatively. In patients with a full-thickness defect, extrinsic repair involves formation of a hematoma and clot followed by granulation tissue; this would be the expected stage of recovery 14 www.VetTechJournal.com
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EquineEssentials days after surgery. Healing would proceed to fibrous tissue and then fibrocartilage, with the entire progression to structural integrity taking approximately 12 months. However, as the fibrous lining of the cyst releases nitric oxide, prostaglandin E2, and neutral metalloproteinases, these inflammatory cytokines could retard healing and cause lesions to expand.4 The patient was uncomfortable and reluctant to move. Lameness examination revealed grade 4/5 to 5/5 lameness in the left hindlimb and grade 3/5 lameness in the right hindlimb. Bilateral stifle radiography was repeated and revealed no significant changes in the right stifle, but enlargement of the cyst was evident in the left stifle. Radiographic appearance may not be a good predictor of healing, as it often underestimates the amount of repair tissue and fails to detect secondary cyst development. Radiographic findings frequently lag behind clinical signs as well.5,6 Nuclear scintigraphy may also be used to localize lameness but was not used in this case because it may not be diagnostic in younger horses because of their growth plates and generally increased bone metabolism. The fillyâ&#x20AC;&#x2122;s left and right medial femorotibial joints were injected with triamcinolone acetonide (9 mg) to suppress the inflammatory mediators responsible for inflammation of the synovial membrane. However, her condition had further deteriorated a week later, with grade 4/5 to 5/5 lameness in the left hindlimb and grade 3/5 lameness in the right hindlimb. Because the fillyâ&#x20AC;&#x2122;s prognosis was poor and she was unlikely to attain the soundness required for a halter horse, the owner elected euthanasia and gave permission for a gross necropsy. The necropsy revealed that multifocal, focally extensive, nodular intertrabecular medullary fibrosis with cystic degeneration had replaced a substantial part of the articular surface of the distal medial femoral condyles. These findings demonstrated that the radiographic assessment did not show the true extent of healing and lesion depth.7,8
Case Commentary American quarter horses diagnosed with subchondral bone cysts have a poorer prognosis for soundness compared with other breeds. This could be due to the fact that quarter horses with this condition typically www.VetTechJournal.com
At necropsy, the medial femoral condyle was sliced, showing the width and depth of the lesion.
present for examination at a later age than do thoroughbreds, which are often diagnosed at less than 3 years of age.9 In this case, however, the patient presented at 15 months of age. American quarter horses also tend to have a greater muscle mass for their size because of their physical activities and are capable of rapid growth enhanced by diet. All of these issues can negatively influence the prognosis for return to work. In thoroughbreds under 3 years with types 1 and 2 lesions but without other significant medical risk factors, the recovery rate for racing soundness after arthroscopic debridement has been reported to be 56% to 72%.9,10 Arthroscopic debridement and curettage, with the addition of microfracture, was the surgical technique of choice in this case because it has been reported to yield a better functional outcome than debridement alone.11,12 Subchondral bone microfracture is performed to augment articular cartilage healing without compromising the stability of the subchondral bone plate.12,13 It is thought to produce a rough surface in the defect to which a clot can easily adhere, initiating the repair process. The practicality of the procedure is also an advantage in many equine practices. Veterinary Technician | MARCH 2008 177
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Glossary Curettage_Removal of tissue or growths from the wall of a cavity or other surface using a curette Debridement_Excision of dead tissue or foreign material from or near a lesion to expose healthy tissue Desmotomy_Cutting or division of a ligament Fasciculation_Small local involuntary muscular contraction visible under the skin Hyperkalemia_Abnormally high concentration of potassium in the blood Myopathy_Disease of muscle or muscle tissue
In this case, additional techniques to improve the repair and regeneration of cartilage may have been beneficial. New methods are producing encouraging results, including chondrocyte transplantation with insulinlike growth factor 1 grafting, autologous osteochondral grafting, and mesenchymal stem cell grafting with or without bone substitutes.14–23 However, such techniques are restricted to specialized practices with access to tissue culture and engineering. Intralesional corticosteroid therapy (e.g., 6 to 20 mg triamcinolone acetonide), with or without bone marrow to hold the corticosteroids in situ, is a simple, cost-effective treatment that has been reported to have favorable effects on lameness; it is believed to reduce local bone inflammation, arrest cyst progression, and promote cyst healing.6,24,25 This therapy could have been administered at the time of arthroscopy and may have produced better results than postoperative intraarticular corticosteroids.6,24 Conservative measures have also been used to treat subchondral bone cysts, including rest and controlled exercise, NSAIDs (e.g., phenylbutazone or firocoxib with or without intraarticular medication), corticosteroids, hyaluronic acid, polysulfated glycosaminoglycan, and autogenous conditioned serum interleukin-1 receptor antagonist protein. However, these approaches can prolong healing and may not resolve lameness. Selecting the appropriate treatment for equine subchondral bone cysts is challenging because little is known about the pathophysiology.6 The purpose of any treatment, especially in this case, is to resolve lameness and achieve adequate soundness for the horse’s intended occupation.
Conclusion This case highlighted some of the clinical, diagnostic, and surgical techniques employed in evaluating and treating a horse with lameness resulting from bilateral subchondral bone cysts. Several factors affected the outcome. The filly had bilateral lesions requiring surgery, and a significant amount of articular cartilage was involved. A guarded prognosis for soundness was indicated because both lesions were at least 1 cm deep. Further detracting from this prognosis were evidence of osteochondrosis in the hock joints and a history of 178
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bilateral flexural limb deformity of the carpi (i.e., developmental orthopedic disorders). This case required excellent nursing and communication skills. It was important to provide the owner with daily updates and to give comfort at the time of euthanasia. The head clinician also needed regular reports on the filly’s demeanor, lameness, and medical parameters during hospitalization to guide treatment adjustments and additional instructions. Other factors included special anesthetic considerations and monitoring for signs associated with HPP. Research is continuing to improve the treatment of this challenging orthopedic condition.23
References 1. Naylor JM: Equine hyperkalemic periodic paralysis: Review and implications. Can Vet J 35(5):279–285, 1994. 2. Zeilmann M: HYPP — Hyperkalemic periodic paralysis in horses [in German]. Tierarztl Prax 21(6):524–527, 1993. 3. McIlwraith CW, Nixon AJ, Wright IM: Diagnostic and Surgical Arthroscopy in the Horse, ed 3. Fort Collins, CO, Mosby-Elsevier, 2005, pp 197–268. 4. von Rechenberg B, Guenther H, McIlwraith CW, et al: Fibrous tissue of subchondral cystic lesions in horses produce local mediators and metalloproteinases and cause bone resorption in vitro. Vet Surg 29(5):420–429, 2000. 5. Jackson WA, Stick JA, Arnoczky SP, Nickels FA: The effect of compacted cancellous bone grafting on the healing of subchondral bone defects of the medial femoral condyle. Vet Surg 29(1):8–16, 2000. 6. Foerner JJ: Cartilage repair: Injection of equine subchondral bone cysts: 73 horses. ACVS Vet Symp:36–37, 2007. 7. Jeffcott LB, Kold SE, Melsen F: Aspects of the pathology of stifle bone cysts in the horse. Equine Vet J 15(4):304–311, 1983. 8. Jeffcott LB, Kold SE: Clinical and radiological aspects of stifle bone cysts in the horse. Equine Vet J 14(1):40–46, 1982. 9. Smith MA, Walmsley JP, Phillips TJ, et al: Effect of age at presentation on outcome following arthroscopic debridement of subchondral cystic lesions of the medial femoral condyle: 85 horses (1993– 2003). Equine Vet J 37(2):175–180, 2005. 10. Howard RD, McIlwraith CW, Trotter GW: Arthroscopic surgery for subchondral cystic lesions of the medial femoral condyle in horses: 41 cases (1988–1991). JAVMA 206(6):842–850, 1995. 11. Frisbie DD, Morisset S, Ho CP, et al: Effects of calcified cartilage on healing of chondral defects treated with microfracture in horses. Am J Sports Med 34(11):1824–1831, 2006.
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EquineEssentials 12. Frisbie DD, Trotter GW, Powers BE, et al: Arthroscopic subchondral bone plate microfracture technique augments healing of large chondral defects in the radial carpal bone and medial femoral condyle of horses. Vet Surg 28(4):242–255, 1999. 13. Hanie EA, Sullins KE, Powers BE, Nelson PR: Healing of full-thickness cartilage compared with full-thickness cartilage and subchondral bone defects in the third carpal bone. Equine Vet J 24(5):382–386, 1992. 14. Bodó G, Hangody L, Szabó Z, et al: Arthroscopic autologous osteochondral mosaicplasty for the treatment of subchondral cystic lesion in the medial femoral condyle in a horse. Acta Vet Hung 48(3):343–354, 2000.
*US orders only. Contact info.vls@ medimedia.com for other pricing.
15. Kold SE, Hickman J: Results of treatment of subchondral bone cysts in the medial condyle of the equine femur with autogenous cancellous bone graft. Equine Vet J 16(5):414–418, 1984.
“AN EXCELLENT REFERENCE SOURCE AND TEACHING AID, AND I HIGHLY RECOMMEND IT.”
16. Fortier LA, Nixon AJ: New surgical treatments for osteochondritis dissecans and subchondral bone cysts. Vet Clin North Am Equine Pract 21(3):673–690, 2005. 17. Nixon AJ, Fortier LA, Williams J, Mohammed H: Enhanced repair of extensive articular defects by insulin-like growth factor 1-laden fibrin composites. J Orthop Res 17(4):475−487, 1999. 18. Hendrickson DA, Nixon AJ, Grande DA, et al: Chondrocyte-fibrin matrix transplants for resurfacing extensive articular cartilage defects. J Orthop Res 12(4):485–497, 1994. 19. Gao J, Dennis JE, Solchaga LA, et al: Repair of osteochondral defect with tissue-engineered two-phase composite material of injectable calcium phosphate and hyaluronan sponge. Tissue Eng 8(5):827– 837, 2002.
Randy Eggleston, DVM, DACVS The University of Georgia
20. Goodrich LR, Nixon AJ: Cartilage repair: The chondrocyte graft. ACVS Vet Symp:35–37, 2004. 21. Dyson SJ: Radiography and radiology, in Ross MW, Dyson SJ (eds): Diagnosis and Management of Lameness in the Horse. St. Louis, Elsevier, 2003, p 158. 22. Walmsley JP: The stifle, in Ross MW, Dyson SJ (eds): Diagnosis and Management of Lameness in the Horse. St. Louis, Elsevier, 2003, pp 461–462. 23. Nixon AJ: Cartilage repair: Stem cells for cartilage repair. ACVS Vet Symp:31–35, 2007. 24. Frisbie DD, Kawcak CE, Trotter GW, et al: Effects of triamcinolone acetonide on an in vivo equine osteochondral fragment exercise model. Equine Vet J 29(5):349–359, 1997. 25. Ray CS, Baxter GM, McIlwraith CW, et al: Development of subchondral cystic lesions after articular cartilage and subchondral bone damage in young horses. Equine Vet J 28:225–232, 1996.
“When a horse presents with lameness, it is important to look beyond the obvious Rosanne Barwick, causes and to take into account any underlying conditions,” says Rosie, who is a lameDipAVN (Surgical), ness/surgery service technician at the EVN, VN, Cert SAN, ESMT Marion duPont Scott Equine Medical Center in Leesburg, Virginia. She credits her mother, Angie, with inspiring her to have a strong work ethic and says that she is grateful for the opportunity to learn from challenging cases. When she is not working, Rosie enjoys traveling, horse riding, and yoga. ABOUT THE AUTHOR
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TIP of the MONTH ©2008 Yegor Korzh/Shutterstock.com
At our clinic, we have walkie-talkies that are available for use by clients and staff. We give a walkie-talkie to clients who are visiting a pet before it is euthanized. This allows clients to spend time with their pet without being interrupted; and when they are finished visiting, they can use the walkie-talkie to contact the veterinarian. We also give a walkie-talkie to clients who are visiting a critical care patient or a patient at risk of seizures so that they can quickly alert the staff if the animal is in distress. Staff members use a walkie-talkie as a safeguard in case they need to contact other staff during potentially unsafe situations, such as when dealing with an angry client or walking a dog outside after dark. Renae Hamrick, RVT Columbus, OH
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Heart to Heart
Now “Ear” This!
I advise clients to administer their pet’s monthly heartworm preventative on a date that can be easily remembered, such as the first or last day of the month. Also, some companies offer automatic monthly reminder systems via email alerts or specially designed alarm clocks to help clients remember to give the preventative. Patrick Rolston, LVT Glendale, AZ
Instead of using tape to support an animal’s ears after ear crop surgery, foam pipe insulation can be used for this purpose. The foam can be cut to fit comfortably inside the ears. It provides stability and support but is less messy and more breathable than tape. Stacy Divine Windsor, MO
I compiled a list of clients who have difficulty remembering to administer monthly heartworm and/or flea medication. On the first day of each month, I call the clients on the list and remind them to give their pet the medication. Clients love the extra effort, and the friendly reminders benefit our patients. Renee Reynolds Woodstock, GA
If drawing blood from a vein is difficult, especially in an animal that is old or sick, it is helpful to place a warm compress on the blood-draw site. After about a minute, the warmth of the compress will dilate the vessels in that area, making the blood draw much easier. Patsy Osmond, RVT Truro, Nova Scotia, Canada
MARCH 2008 | Veterinary Technician
Back to the Drawing Board
When I need to obtain a small blood sample for a heartworm or leukemia test, I use an insulin syringe for the blood draw. The needle is tiny, so some animals may not mind the puncture. Gina Snow, LVT Mt. Vernon, ME Our clinic uses 3/10 -ml insulin syringes to administer small quantities of medication, such as medetomidine and butorphanol, to puppies and kittens. These syringes are especially useful because they have a 29gauge needle, which makes them almost painless for injections, and are accurate to 0.01 ml. We also use the syringes to obtain small blood samples for blood glucose curves. Tammy Randall Charlotte, NC www.VetTechJournal.com
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TECH TIP CHALLENGE
In the November issue, we asked how you recommend that clients obtain a free-catch urine sample. Here are some of your responses:
We use a long-handled soup ladle to catch a urine sample for urinalysis. The person holding the ladle can stay at a safe distance so that urine doesn’t splash on his or her hands. The veterinary technicians of Babcock Hills Veterinary Hospital San Antonio, TX To collect urine from an animal, I turn a resealable sandwich bag inside out and place my hand inside, forming a “glove.” I cup my hand and catch the urine in the “pocket” that forms. I then use my other hand to turn the bag right-side out and seal the bag. I discuss this method with clients so that they can use it at home when they have to collect a sample and bring it into the clinic. Karla Myers, LVT Richmond, ME
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Julie Squibb
We suggest that owners use a clean, dry disposable pie plate to catch urine from a female dog. When obtaining a sample from a male dog, it is helpful to use a plastic mug with a handle. The handle allows the owner to keep a strong grip on the mug if the dog bumps the owner’s hand while putting its leg down. Sylvia Alt, LVT Dearborn, MI We instruct clients to attach a small container to the end of a broomstick and use the broomstick to position the container under the animal. This technique is especially helpful when collecting a sample from nervous or shy animals. If clients don’t have a container, we suggest that they make one by cutting a 1L plastic soda bottle in half. Julie Squibb Lively, Ontario, Canada
Note: Any container used to collect a urine sample must be clean, dry, and free of food or detergent residue.
Karla Myers
We save vaccine trays and give them to clients to take home when they need to collect a free-catch urine sample. The trays are shallow, so they fit under smaller dogs, and they have “dimples” that prevent the urine from splashing out. We give clients a pair of gloves to keep their hands clean and a syringe to collect the urine from the tray. Rose Eastman, LVT Bellingham, WA
Babcock Hills Veterinary Hospital
To Catch a Urine Sample
We give clients a kit of tools to use to obtain a freecatch urine sample. The kit includes a long-handled soup ladle, which the client later returns to us; rubber gloves; a large-volume syringe; and plastic urine tubes. If all our ladles have been loaned out, we recommend that clients use a large, empty yogurt or cottage cheese container. Lori Davis Shoreline, WA
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Pet King Brands
Biotene Veterinarian Brushless Starter Kit
Medi-Dose, Inc./EPS, Inc.
Nasal Spray Bottles EPS has added 25-ml nasal spray bottles to its line of liquid packaging containers. The bottles are manufactured with a natural low-density polyethylene, which makes them easy to squeeze. The bottles include spray-mist inserts and dip tubes to provide wide area coverage when squeezed. This product is packaged in cases of 144.
Pet King Brands now offers the Biotene veterinarian brushless starter kit. The products in the kit use two patented enzyme systems designed to remove plaque biofilm. The kit includes a 1-oz drinking water additive, a 1¼-oz therapeutic mouthwash, and a ¾-oz maintenance oral gel. The manufacturer claims that this product is ideal to include in new puppy and kitten kits or to dispense after dental prophylaxes.
800-523-8966 䡲 www.medidose.com Circle 101 on Reader Service Card
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IDEXX Laboratories
Equine Infectious Disease Tests Equine Biodiagnostics, a division of IDEXX Laboratories, is now offering three reference laboratory tests to help practitioners quickly and accurately identify infectious diseases in equine patients. The tests identify equine herpes virus type 1 (EHV-1), West Nile virus (WNV), and Lyme disease. The EHV-1 test differentiates between “wild type” and neuropathogenic strains of the disease, the WNV test detects an immunoglobulin M response elicited by recent WNV infections, and the Lyme disease test detects infection with Borrelia burgdorferi and/or Anaplasma phagocytophilum (formerly called Ehrlichia equi). All three tests help practitioners determine specific causes of neurologic disease in patients.
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ProductForum Davis Manufacturing
Orchard Collection Shampoos
The Bio-Ray DCV digital dental system is now available through Dentalaire. The DCV system uses the Digital Imaging and Communications in Medicine (DICOM) client viewer and allows capturing, viewing, printing, uploading, and downloading of case studies, among other features. The Bio-Ray DCV system incorporates the same high-quality sensor as the Bio-Ray SDX.
Davis Manufacturing has added Pink Grapefruit and Honey Almond shampoos to its line of Orchard Collection shampoos. The shampoos are pH balanced and scented with essential oil extracts. The manufacturer claims that these products condition and replenish moisture as well as create a glossy, healthy, and manageable coat. Other scents in this line include Cherry Berry, Tropical Coconut, and Fresh Apple. The shampoos come in 12-oz and 1-gallon sizes and dilute 10 to 1.
800-866-6881 䡲 www.dentalaireproducts.com Circle 104 on Reader Service Card
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Index to Advertisers For more information about products advertised in this issue, see the Reader Service Card inserted between pages 176 and 177.
Company American Kennel Club American Veterinary Medical Association Animal Health Options Bayer Animal Health Fort Dodge Animal Health The Greenies Company Hill’s Pet Nutrition Lilly Merial NCVTSA Novartis Animal Health Schering-Plough St. Petersburg College VetDent CE Associates Veterinary Learning Systems
Product Reader Service # Companion Animal Recovery ID System 155 AVMA Annual Convention/Jack L. Mara 189 Seminars on Veterinary Technology ProAnimal 127 resQ LeptoVax 133 ProMeris 195 Greenies dental chews 160 Prescription Diet Canine j/d Prescription Diet Canine r/d 132 Comfortis 156 Frontline Plus 183 PureVax 175 2008 National Conference of Veterinary Technician Specialty Academies Sentinel HomeAgain Lost Pet Medical Insurance 131 Online Veterinary Technology Program 181 New Dental Seminars 130 A Guide to Equine Joint Injection and Regional Anesthesia Veterinary Technician® Is Now Free VetLearn.com
Page # 145 143 (US only) 171 164, 165 155 Cover 4 (US only) 141 Cover 2 (Canada only) Cover 2 (US only) 158, 159 167 139 149 Cover 4 (Canada only) 153 183 169 179 181 Cover 3
The following advertisers appear in our Market Showcase section, which begins on page 185. MED I.D. Petknap, Inc. Veterinary Solutions
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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.
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ClassifiedAdvertising TECHNICIANS WANTED
TECHNICIANS WANTED
TECHNICIANS WANTED
ALASKA – Experienced licensed or unlicensed techni- CONNECTICUT – Five-doctor, veterinarian-owned, AAHAcian 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.
accredited hospital in Norwalk needs a technician. Work in a fun environment that promotes teamwork and personal growth. Great salary and benefits, including continuing education at national meetings. Contact Dr. Michele Lamothe at 203-846-3495 or email brah@aol.com. Visit us at www.broadriveranimalhospital.com.
CALIFORNIA – Excellent career opportunities for FLORIDA – Veterinary technician needed for small animal compassionate, skilled veterinary technicians in our state-of-the-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; email asgvets@asgvets.com; fax 818-507-9418; website: www.asgvets.com.
CALIFORNIA – Are you looking to improve your current skills and gain new ones in an exciting, teamoriented 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 radiography (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.
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practice in Tallahassee. Located in a great university community close to the Gulf Coast. Salary and benefits for full-time. Contact Dr. Carter for an application and interview: 850-878-4799.
(352) 392-2235 ext. 5428 recruiter@vetmed.ufl.edu.
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 www.VetTechJournal.com
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ClassifiedAdvertising TECHNICIANS WANTED
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 GEORGIA – Consider practice in beautiful Atlanta.
*Source: June 2007 BPA Statement
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
TECHNICIANS WANTED 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!
ILLINOIS Tired of fleas and fecals? Our small veterinary ophthalmology practice needs a full- or part-time technician. No weekend hours! New graduates and not-so-new retirees welcome. For more information, please call 630-964-7771, fax 630-964-0307, or email veterinaryvision@yahoo.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
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.
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.
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 and 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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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.
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.
NEW JERSEY Red Bank Veterinary Hospital, a busy referral and emergency practice located at the Jersey shore, provides a great opportunity for advancement and continued training in all aspects of veterinary medicine. Come join our team of highly skilled technicians in our state-of-the-art, 58,000–sq. ft. facility! We have openings for general treatment technicians and in the exotics, oncology, critical care, and surgery specialties. RBVH also provides cardiology, dental, dermatology, emergency, internal medicine, neurology, ophthalmology, and physical therapy services. Competitive compensation and benefits packages. Credentialed or exam-eligible technicians preferred. Fax resume to 732-704-9504.
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
Technicians/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.
NEW YORK – Progressive small animal practice in Horseheads seeks an LVT. We are committed to high-quality, compassionate care and excellent customer service. Competitive salary/benefits. Send resume to Lake Road Animal Hospital, 3065 Lake Road, Horseheads, NY 14845; fax 607-733-3656; or email lakeroad@stny.rr.com. 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.
MASSACHUSETTS – Veterinary technician and techni- MICHIGAN – Enthusiastic part- or full-time LVT wanted
cian 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 978-263-8912.
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.
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We’ve got your ideal job! 188 MARCH 2008 | Veterinary Technician
TECHNICIANS WANTED
for small animal practice in Kalamazoo. Utilize all of your skills performing anesthesia, radiology, laser surgery, dentistry, and more. Competitive salary plus benefits: CE, SIMPLE IRA, vacation, and more. Send resume to Oshtemo Veterinary Hospital, Box 346, Oshtemo, MI 49077; fax 269-375-4707; or email oshtemovet@sbcglobal.net.
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.
NEW JERSEY – NEW state-of-the-art hospital opening February 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
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
Technicians/Assistants Wanted The Center for Specialized Veterinary Care in Westbury is a state-of-the-art facility looking for experienced, motivated, compassionate LVTs, license-eligible technicians, and assistants. We are open 24 hours a day, 365 days a year. Departments include ICU, treatment, internal medicine, surgery, radiology, oncology, dermatology, neurology, and more. Sign-on bonus or contribution to moving costs for the right candidate! If you have the skills and compassion to make a difference in the life of a pet and want to earn a competitive salary and enjoy great benefits, then contact Toni Stovall at tstovall@vetspecialist.com or fax resume to 516-420-0122.
NEW YORK – Great opportunity for licensed or license-
eligible 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 workweek, 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.
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RECRUITING VETERINARY TECHNICIANS WHO WANT TO BUILD A CAREER AND ADVANCE IN THEIR AREAS OF SPECIALTY 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. OHIO
Registered Veterinary Technicians Needed
NORTH CAROLINA North Carolina State University’s College of Veterinary Medicine is growing! The 110,000–sq. ft. Randall B. Terry Jr. Companion Animal Medical Center is scheduled to open in winter 2009. We are currently recruiting for the following positions: • Large Animal Hospital Manager, # 100180 • Large Animal Hospital Supervisor, # 44032 • Veterinary Emergency Technician Manager, # 44214 • Veterinary Technician, Registered, # RVT-0108 • Veterinary Assistant, # VA-0108 • Large Animal Attendant, # 100214 • Small Animal Patient Care Coordinator
Please visit the NCSU website at jobs.ncsu.edu for details about numbered positions and to apply online. Alternatively, you may fax resume and cover letter to Jim Brawley at 919-513-6225. NCSU is an equal opportunity/affirmative action employer and welcomes all persons without regard to sexual orientation. ADA contact: 919-515-3148
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).
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TECHNICIANS WANTED 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.
PENNSYLVANIA
Technicians Wanted Veterinary Referral Center + Emergency Services (VRC) is seeking experienced and/or certified technicians. We have full- and part-time day shifts available in our emergency service as well as weekday night shifts in our ICU department. Our generous benefits package includes a competitive salary; opportunities for shift differential; health and dental care; 401(k); CE compensation; disability; paid time off; and significant personal pet discounts. VRC is located in the serene suburbs of Chester County, 30 miles west of Philadelphia. This year marks our third anniversary in our 25,000–sq. ft. state-of-the-art facility. Our team is comprised of 16 doctors, many specialized in their fields. Our highly qualified nursing staff contributes to the fun atmosphere while providing exceptional care to our patients. Like our doctors, many of our nurses have achieved or are seeking specialty certification. VRC offers 24-hour emergency service with a dedicated critical care unit opening in March. Other specialties within our practice include internal medicine, radiology, dermatology, cardiology, orthopedic and soft tissue surgery, and dentistry. For more information, please contact Amy Shields, CVT: call 610-647-2004 ext 157 or email ashields@vetreferral.com. Please visit our nursing page at www.vetreferral.com today!
PENNSYLVANIA Certified veterinary technician wanted to join our team. Exeter Veterinary Hospital is a four-veterinarian, progressive, computerized, AAHA-accredited companion animal hospital east of Reading. Duties include, but are not limited to, in-house laboratory, radiology, surgery, dentistry, and client services. We are a well-equipped facility including an ultrasound, laser, endoscope, and complete dental room. Benefits package includes a retirement plan; uniform allowance; holiday, sick, and vacation pay; as well as continuing education. If interested, please contact Jenessa, staff manager, or Richard Rosato, hospital manager, at 610-779-2300 or fax resume to 610-779-3166.
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PENNSYLVANIA – The University of Pittsburgh’s Division of Laboratory Animal Resources is seeking two full-time research technicians for its newly constructed Biosafety Level 3 Regional Biocontainment Laboratory (RBL) at the Oakland campus. This exciting and dynamic position integrates veterinary technology, laboratory animal husbandry, and research support skills. Job duties include medical surveillance; diagnostic support; routine treatments; providing/assisting with bleeding, surgery, endoscopy, imaging studies, and necropsies; general facility maintenance; training research personnel; and record-keeping. The position requires some weekend/holiday hours. Candidates must have a degree from an AVMA-accredited veterinary technology program or bachelor’s degree and/or relevant work experience; possess strong written and verbal communication skills; be proficient with Microsoft Office; and be capable of heavy lifting and adequately performing duties while wearing the personal protective equipment required in a biosafety level 3 facility. Knowledge of research and animal facility practices is desirable. This position requires successful completion of the university’s medical surveillance programs and a Department of Justice security clearance for work with select agents and toxins, as required by federal regulation. Salary is commensurate with experience and qualifications. The University of Pittsburgh provides excellent tuition benefits and attractive medical and retirement packages. Apply online at www.pittsource.com for staff position #01214656 or #0121468. Please contact Dr. Anita Trichel, RBL Clinical Director, at trichel@cvr.pitt.edu with questions. AA/EOE.
SOUTH CAROLINA – Progressive, busy, one-doctor small animal practice in Sumter is seeking full-time CVTs, experienced technicians, assistants, and receptionists. We offer competitive wages, benefits, and major holidays off with no emergency work. Fax resume to 803469-6084.
and have knowledge of Microsoft Word and Excel. Candidates 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 832-593-8388.
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.
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. 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 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.
Please fax resume to 215-699-7754 Attn: Cindy Lorenz Email: gwyneddvethosp@comcast.net Visit our website at: www.gwyneddvethospital.com.
190 MARCH 2008 | Veterinary Technician
TEXAS – Highly respected emergency/critical care veterinary hospital in Austin seeks an energetic technician with an open mind for learning who is looking for mentorship and to build technical skills. We are a progressive, emergency-only hospital with state-of-the-art equipment, owned and operated by a board-certified emergency/critical care veterinarian. Great team atmosphere with excellent compensation, benefits, and matching 401(k). Must be able to work overnights, weekends, and holidays. Please fax resume to 512-331-6591.
$1,000 Sign-On Bonus We are seeking experienced technicians and RVTs for our progressive, after-hours emergency hospital located in North Houston. Practice in a new, state-of-the-art facility with the highest standards of patient care. We offer a great work environment, an excellent salary/benefits package, uniforms, CE, flexible schedules, and a terrific support staff. This is veterinary emergency medicine at its best! $1,000 SIGN-ON BONUS! Send resume to hr@aeucc.com.
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,
UTAH - We are seeking skilled veterinary 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 fourdoctor/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
practice with a family-friendly environment. We are a 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.
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ClassifiedAdvertising TECHNICIANS WANTED 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, state-of-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 hos-
pital 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 McAuliff or Barb Cotton. Fax 540-891-4698 or call 540-891-1275.
VIRGINIA
Technician Wanted Full-time, experienced technician wanted to join a great staff at our state-of-the-art facility in Leesburg. Position requires a hard-working, dependable, motivated, and cheerful person. Hours include afternoon shifts and some Saturdays. Full benefits package, including 401(k), health insurance, and paid leave. Please contact Kelli Boswell: call 703-777-7781 (Monday-Friday 8–6, Saturday 9–12) or email kelli@noahvets.com.
VIRGINIA – We are seeking a team-oriented, experienced, motivated licensed veterinary technician. Dum-
TECHNICIANS WANTED
TECHNICIANS WANTED
fries Animal Hospital is a five-doctor small animal and exotics practice located 15 miles south of the Beltway in northern Virginia. Come and share your commitment to patient care and client education with our team of four LVTs and six highly skilled veterinary assistants, along with the rest of our well-trained veterinary team. Our technicians are encouraged to utilize their technical skills daily. Duties include surgical and hospital patient care, anesthesia, dentistry, radiology, laboratory work, as well as exam room appointments. Hours are flexible with an occasional Saturday. We offer very competitive wages, health and dental insurance, vacation time, sick time, paid CE, license fees, a Simple IRA, and an employee quarterly bonus program. Fax resume to Becky Ash at 703-2217225 or email dah01@earthlink.net. You may visit our website at www.dumfriesanimalhospital.com.
great staff and offer only the best medicine to our patients. Must be a team player and have an upbeat attitude. Flexible schedule and excellent compensation, including bonuses, retirement plan, health insurance, and CE. Email resume to cvilledogdoc@yahoo.com.
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 – Experienced veterinary technician needed for well-equipped, two-doctor, small animal/exotics practice in Virginia Beach. Solid technical skills, good interpersonal skills, and team-player mentality required. Well-established clientele and cooperative, skilled, friendly staff. Providence Square Veterinary Clinic: phone 757-495-2961; fax 757495-6986; email chrysnz@aol.com. VIRGINIA – Licensed veterinary technician needed in beautiful Charlottesville! We have wonderful clients and a
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 3–11, occasional Saturday AM shifts. Fax resume to 703-368-4703 or call Dee/Dr. Smith at 703-330-8809. VIRGINIA – Small animal practice 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 – 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 highquality animal care and superior client service in a teamoriented 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; phone 206-285-7387; fax 206-285-9074; email dzajac@ elliottbayah.com. Visit www.elliottbayah.com. WASHINGTON – Our well-equipped, five-veterinarian, AAHA-accredited facility in Lacey is hiring one or two fullor part-time LVTs. We are a fun-loving team that works to provide awesome patient care. Your skills will be fully utilized. Both new and experienced LVTs are welcome to apply. Contact Mayme Revel, Operations Manager: 360438-9623 or mtnviewvet@comcast.net. Check us out at www.mountainviewvet.com.
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
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ClassifiedAdvertising TECHNICIANS WANTED WASHINGTON – Alpine Animal 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
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WASHINGTON – Licensed veterinary technician WISCONSIN – CVT position available for five-doctor practice. needed for our rapidly growing small animal hospital. We are looking for a full- or part-time self-motivated team player who is interested in advancing his or her skills. We offer a 4/10 workweek, competitive wages, 401(k), medical benefits, and holiday/sick pay for fulltime employees. Please fax resume to 360-876-1482 or email hospital@kitsapvet.com.
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.
WISCONSIN – Veterinary Specialty & Emergency Care
is looking for CVTs for its surgery and critical care services in our new 23,000–sq. ft. small animal emergency and referral center in Madison. We put an emphasis on teamwork and a healthy, happy work environment. Group health plan, 401(k), vacation/sick days, CE allowance. Experience preferred, but a positive personality is required. Send resume Attn: Barb Bachman: Veterinary Specialty & Emergency Care, 1848 Waldorf Blvd., Madison, WI 53719; fax: 608-845-2200; or email vsec@vetspecialtycare.com.
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Your Talent. Our Team. As the nation's largest network of veterinary hospitals and clinical laboratories, we know that our support staff and professionals are critical to our success. That's why we offer competitive salaries and generous benefits, including: • Medical, dental and vision insurance • 401(k) retirement plan • Generous discount for personal pet care • Continuing education opportunities • Transfer opportunities and relocation • Exciting career advancement opportunities and specialty tech positions
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• Flexible scheduling These are just a few of the reasons why some of the nation's top veterinary professionals consider joining VCA Animal Hospitals to be their smartest career move yet. Of course, working in one of VCA's state-of-the-art facilities also has its advantages! Join us in one of our specialty hospitals and multi-doctor progressive practices. Come share your talent with our team and be a part of our family of over 1,800 doctors and 180 board certified specialists. We offer positions in 38 states and have more than 450 locations across the United States.
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Available A vailable from m the following authorized authorize ed veterinary distributors: distributorrs: $6- 2ESOURCES s 'REEAT 7ESTERN !NIMAL (EALTH 3UPPLY s (EENRY 3CHEIN !NIMAL (EALTH s -IDWEST 6ET 3UPPLY s .,3 !NIMAL (EALTH $6- 2ESOURCES s 'REAT 7ESTERN !NIMAL (EALTH 3UPPLY s (ENRY 3CHEIN !NIMAL (EALTH s -IDWEST 6ET 3UPPLY s .,3 !NIMAL (EALTH .ELSON ,ABORATORIES s 0ENN 6ET 3UPPLY s 0#) !NIMAL (EALTH s 6ET 0HARM s 6ICTOR -EDICAL #OMPANY s 7EBSTER 6ET 3UPPLY s )6%3#/ .ELSON ,ABORATORIES s s 0ENN 6ET 3UPPLY s 0#) !NIMAL (EALTHH s 6ET 0HARM s 6ICTOR -EDICAL #OMPAANY s 7EBSTER 6ET 3UPPLY s )6%3#/ ProMeris is a registered trademark of o Wyeth. ©2008 Fort Dodge Animal Health, a division of Wyeth.