Veterinary Technician | July 2009 by davidpsu

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The Complete Journal for the Veterinary Health Care Team

Vol. 30 No. 7 | July 2009

CE Credit from Alfred State College, SUNY

Lights, Camera,

Endoscopy A Talk with Ali McKenna, CVT

Preventing

Motion Sickness in Dogs

Visit us at www.VetTechJournal.com

1CE

Managing the Veterinary C R E D I T Laboratory New Lyme and CIV Vaccines Approved FDA Approves First Drug to Treat Feline Hyperthyroidism First Canine Mast Cell Tumor Therapy Approved

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Editor’sLetter

The Complete Journal for the Veterinary Health Care Team

July 2009

CHIEF TECHNICIAN EDITOR Marianne Tear, MS, LVT EDITORIAL STAFF Tracey L. Giannouris, MA, Executive Editor 267-685-2447 | tgiannouris@vetlearn.com Paul Basilio, Associate Editor 267-685-2421 | pbasilio@vetlearn.com Allyson Corcoran, Editorial Assistant 267-685-2490 | acorcoran@vetlearn.com VETERINARY ADVISER Dorothy Normile, VMD, Chief Medical Officer SALES AND MARKETING Boyd Shearon, Account Manager 913-322-1643 | 215-287-7871 | bshearon@vetlearn.com Joanne Carson, National Account Manager 267-685-2410 | 609-238-6147 | jcarson@vetlearn.com Lisa Siebert, Market Showcase 215-589-9457 | lsiebert@vetlearn.com DESIGN Michelle Taylor, Senior Art Director 267-685-2474 | mtaylor@vetlearn.com David Beagin, Art Director 267-685-2461 | dbeagin@vetlearn.com Bethany Wakeley, Production Artist Stephaney Weber, Production Artist OPERATIONS Marissa DiCindio, Director 267-685-2405 | mdicindio@vetlearn.com Elizabeth Ward, Production Manager 267-685-2458 | eward@vetlearn.com Christine Polcino, Traffic Manager 267-685-2419 | cpolcino@vetlearn.com For Circulation and Customer Service 800-426-9119, option 2 | info@VetTechJournal.com PUBLISHED BY

Summer always seems to be so hectic and so shortlived. The days are technically longer, but with the extended daylight comes an extended list of things to accomplish. There are only so many wonderful days to work outside and play with the dogs. It has been a few months since my rigorous spring cleaning, and I seem to have accumulated way too much stuff. In the education field, I don’t have the added stress of heartworm season, but the new term begins smack-dab in the middle of the dog days of summer. I can feel the stress levels rise, my impatience bubble to the surface and my joy fly out the window. But then something wonderful happens and brings everything back into focus. This year — aside from my adorable kids — the wonderful thing came in the form of a letter from a friend. Joni and I met this past February in Alaska, and she is one of the wonderful technician friends I have made over the years. Her letter was a simple “Hi, how are you, here’s what’s new in my life,” letter, but it helped readjust my attitude. She filled me in on our mutual friends and then she told me about her new additions. She is adopting a pony and had saved some kittens that she found in a bale of straw. As I read her letter, I couldn’t stop smiling. What technician doesn’t delight at the thought of a new pony or saving a litter of kittens or puppies? So, as this summer speeds by, take some time to enjoy it. Do something for yourself or for your pets. For example, my dogs and I will be taking one of our bustling, memory-filled walks to the frozen custard stand after I finish this letter. Remember all the good you have done this year and reach out to a friend; you may make their day or set them back on track. Marianne Tear, MS, LVT Chief Technician Editor

Glenn Triest

Vol. 30 No. 7

Stress, Ponies, and Custard

There are 171.7 million freshwater pet fish in the United States – more than cats and dogs combined.

780 Township Line Road • Yardley, PA 19067 PRESIDENT Derrick Kraemer

Our Mission

VETERINARY TECHNICIAN is designed to support and actively promote the professional status and value of veterinary technicians and assistants. 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 on our website.

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Veterinary Technician | JULY 2009

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EditorialBoard ALFRED STATE COLLEGE (CE ACCREDITATION) Melvin C. Chambliss, DVM Program Director

Donna Letavish, CVT Michigan State University–East Lansing

Heidi Lobprise, DVM, DAVDC Pfizer Animal Health

Kathleen M. Bliss, LVT, MALS CHIEF TECHNICIAN EDITOR

Kelly Collins, LVT Tracey M. Martin, LVT

Laura McLain Madsen, DVM Central Valley Veterinary Hospital Salt Lake City, Utah

Rosandra (Rose) Manduca, DVM Miami Dade College

Glenn Triest

Elaine Anthony, MA, CVT St. Petersburg College

Kimberly A. Baldwin, LVT, VTS (ECC)

Marianne Tear, MS, LVT

Cornell University

Program Director Veterinary Technology Program Baker College of Clinton Township, Michigan

Andrea Battaglia, LVT

SECTION EDITORS

Tracy Blais, BS, CVT, MEd

BEHAVIOR Julie Shaw, RVT

Animal Behavior Clinic Purdue University

Cornell University

Mount Ida College

David Bolette, RVT, LATg University of Pittsburgh

DENTISTRY Jeanne R. Perrone, CVT, VTS (Dentistry)

Susan Bryant, CVT, VTS (Anesthesia)

EQUINE DeeAnn Wilfong, BS, CVT

Mindy A. Cohan, VMD

Tampa Bay Veterinary Specialists

Littleton Large Animal Clinic Littleton, Colo.

NUTRITION Ann Wortinger, BIS, LVT, VTS (ECC, SAIM) Wayne State University

Tufts Cummings School of Veterinary Medicine

Mary Tefend Campbell, LVT, VTS (ECC) Fort Washington Veterinary Hospital

Harold Davis, BA, RVT, VTS (ECC, Anesthesia) University of California, Davis

Elizabeth Davis, DVM, PhD, DACVIM Kansas State University

Katherine Dobbs, RVT, CVPM, PHR interFace Veterinary HR Systems, LLC Appleton, Wis. 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.

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.

JULY 2009 | Veterinary Technician

Tara Lang, BS, RVT Critter Communications, LLC Cape Girardeau, Mo.

Betty A. Marcucci, MA, VMD VCA Burbank Veterinary Hospital

Trisha McLaughlin, CVT Newtown Veterinary Hospital Newtown, Pa.

Kathryn E. Michel, DVM, MS, DACVN University of Pennsylvania

Christopher Norkus, BS, CVT, VTS (ECC, Anesthesia) Ross University School of Veterinary Medicine Basseterre, St. Kitts, West Indies

Jody Nugent-Deal, RVT University of California, Davis

Kristina Palmer-Holtry, RVT University of California, Davis

Karl M. Peter, DVM Foothill College

Ann Rashmir-Raven, DVM, MS, DACVS Mississippi State University

Virginia T. Rentko, VMD, DACVIM Medway, Mass.

Nancy Shaffran, CVT, VTS (ECC) Pfizer Animal Health

Margi Sirois, EdD, MS, RVT Penn Foster College

P. Alleice Summers, MS, DVM Cedar Valley College

VETERINARY TECHNICIAN® (ISSN 8750-8990) is published monthly by Veterinary Learning Systems, a division of MediMedia USA, 780 Township Line Road, Yardley, PA 19067. Copyright ©2009 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: $129 for one year, $219 for two years, $349 for three years. (All checks must be payable to Veterinary Learning Systems in US funds drawn on a US branch of a US bank.) Selected back issues are available for $8 each (plus postage). Reprints are available for all VETERINARY TECHNICIAN articles; call 800-426-9119. POSTMASTER: Send address changes to Veterinary Technician, Veterinary Learning Systems, 780 Township Line Road, Yardley, PA 19067.

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Contents

July 2009

The Complete Journal for the Veterinary Health Care Team

Volume 30, Issue 7

Lights, Camera, Endoscopy!

ÂŠ2009 Peter Olson

When Ali McKenna, CVT, was first considered for the position as an endoscopy nurse at the University of Pennsylvania, she was met with resistance from some of the veterinarians. Read about her perseverance and dedication to all things endoscopic.

1CE CE ARTICLE CREDIT

14 Peer Reviewed

Managing the Veterinary Laboratory

Preventing Motion Sickness in Dogs

Heidi Moser, BA, RVT

Amy Breton, CVT, VTS (ECC)

Becoming an expert on every aspect of the veterinary clinic is difficult, and taking the time to learn how to properly manage the laboratory in a fast-paced environment may be a low priority. However, learning to maximize the effectiveness of the veterinary laboratory can benefit a practice in many ways. The peer-reviewed CE articles contained in VETERINARY TECHNICIAN meet the standards set by Alfred State College for 1.0 credit hour. Documentation will be issued by Alfred State College, a State University of New York (SUNY) College of Technology.

Tech News New Lyme and CIV Vaccines Approved .....................................................34 FDA Approves First Drug to Treat Feline Hyperthyroidism .......................36 First Canine Mast Cell Tumor Therapy Approved......................................37

Final View A Penny in Benny?

COLUMN 40

Management Matters Analyzing Your Software Needs Katherine Dobbs, RVT, CVPM, PHR, and Kristen Hoffman, BS

DEPARTMENTS Editorâ&#x20AC;&#x2122;s Letter . . . . . . . . . . . . . . . . . . . . . .1 Editorial Board . . . . . . . . . . . . . . . . . . . . .2 State News . . . . . . . . . . . . . . . . . . . . . .6 Tech Tips . . . . . . . . . . . . . . . . . . . . .8, 38 Product Forum . . . . . . . . . . . . . . . . . . .42 Market Showcase . . . . . . . . . . . . . . . . .44 Classified Advertising . . . . . . . . . . . . .45

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JULY 2009 | Veterinary Technician

Advertisers Index . . . . . . . . . . . . . . . .47 www.VetTechJournal.com

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YOU KNOW how sensitive cats can be. WE KNOW Contains core antigens recommended in AAFP Guidelines. 5

pure, nonadjuvanted 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 nonadjuvanted 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. 2 Day MJ, Schoon HA, Magnol JP, et al. A kinetic study of histopathological changes in the subcutis of cats injected with nonadjuvanted 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. ©2008 Merial Limited, Duluth, GA. All rights reserved. PUR08CNFELINECORAD.

• Effectively protect cats with different lifestyles Ask your Merial Representative about PUREVAX brand products, the only complete line of nonadjuvanted 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.

Your knowledge. Our science. Their health.

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StateNews

ARIZONA

The Board of Directors of the Veterinary Health Care Team of Arizona unanimously approved its 2009–2010 officers at a meeting held at the Buttes Resort in Tempe. Tosha Mallery, CVT, of Sun City Animal Hospital in Sun City, will serve as president. President-elect is Sandra Moore, CVT, of Apollo College in Phoenix. Dana Champion, CVT, VTS (Dentistry), of Sun City Animal Hospital, was elected vice president, and Mandy Price, CVPM, of Ingleside Animal Hospital in Prescott, will serve as the secretary/treasurer. Kristi Smith, CVT, owner of The Original Who’s the Boss? Inc., in Phoenix, is the immediate past president. Congratulations to the new officials. VT COLORADO On June 27, the Colorado Association of Certified Veterinary Technicians (CACVT) held their annual Goal and Leadership Conference. This conference is designed to gather all members of the leadership team and to establish the association’s goals for the upcoming year. The conference also marks the beginning of a new year for a new executive board as they are sworn in to their new positions. The CACVT welcomed the new president Cecilia Garza, RVT, CVT, vice-president Julie Willer, CVT, secretary Jasmin Robinson, CVT, and Treasurer Krista Heitt, CVT. Congratulations were offered to newly elected officers: president-elect Roxane Rocks, CVT, vice president-elect Tara Raske, CVT, secretary-elect Kimberly Schmidt, CVT, and treasurer-elect Debi Fay, CVT. 6

JULY 2009 | Veterinary Technician

MICHIGAN The Michigan Association of Veterinary Technicians (MAVT) is pleased to introduce their new quarterly newsletter, VET TECH insider. VET TECH insider contains educational articles, local and national CE opportunities, technician tips, member spotlights and more. Membership applications are available at www.mavt.us. The MAVT also is pleased to announce the winners of its 2009 scholarships. Lianna Nagle, a Baker College-Clinton Township veterinary technician student, took top honors, earning a $500 MAVT Student Scholarship award with her essay on the human–animal bond. The Ann Wortinger $250 Nutritional Scholarship, sponsored by Michigan Veterinary Specialists, was awarded to Wayne County Community College student

Henry Crosson. Henry’s winning essay about reptilian nutrition will be featured in an upcoming issue of VET TECH insider. Both students will receive free admittance to the 2009 MAVT Fall Conference, where their scholarship awards will be presented. Visit www. mavt.us for more information. NEW JERSEY The New Jersey Veterinary Technicians and Assistants (NJVTA) continues to make headway with its own certification program. The new website, njvta.com, contains news and links to membership and certification applications. Summer and fall CE opportunities will be announced on the website. The Atlantic Coast Veterinary Conference takes place during National Veterinary Technicians Week, Oct. 12-15. At about this time last year, the NJVTA was without a credentialing program and unsure if they could fill all of the board positions. The NJVTA now has a new board and support from the veterinary and corporate communities. The NJVTA will be sending two representatives to the NAVTA workshop in August to bring back plenty of great ideas to further the group’s goals. NEW YORK The New York State Association of Veterinary Technicians (NYSAVT) has elected new officers. The new officers are: • President: Stephanie Leech, LVT • President-elect: Lori Tyler-Oschner, LVT • Secretary: Raeleen Willard, LVT • Treasurer: Steve Smith, LVT • Immediate past president: Kathleen Bliss, LVT Tina Lynch, Capital District representative, will be this year’s state fair coordinator. The theme this year will be disaster relief. The exhibit will be in the Veterinary Hall of Health on Sep. 5 and 6. VT www.VetTechJournal.com

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TechTips

TIP of the MONTH

To prevent any mix-ups when spinning blood samples — especially PCVs — place a small plastic card on the machine and keep a dry erase marker nearby. Write the name of the patient on the card to prevent any confusion. Tammy MacLeod, RCT, VTS ECC Calgary, Alberta, Canada

Courtesy of Beth Frey

Keeping Organized

Our clinic uses a label maker to stay organized. On each cabinet in the clinic, there are labels that list everything in the cabinet. By labeling the cabinets, everyone can find what she or he needs and everything can be returned to its proper place. Beth Frey West Chester, Pa. JULY 2009 | Veterinary Technician

In addition to routine cleaning chores, we have a unique twice-yearly cleaning system. Each employee chooses a room and cleans it from top to bottom — including furniture, windows and trash cans. The room is then checked for cleanliness by two coworkers. If the room passes inspection, the employee can begin cleaning another room. The employee who completes the most rooms wins a small prize or clinic privilege, such as choosing the radio station during a shift. Eddie C. Farmer Summerfield, Fla. When an infectious animal enters an exam room, we hang laminated pictures of dogs, cats or dogs and cats together on the door to warn everyone of what animals need to be kept out of the room. For example, if a patient comes in with an infection that only a dog could contract, we hang the picture of the dog. If a patient comes in with an infection that affects both cats and dogs, we hang the picture of the dog and cat together. The pictures also have the date the room can be used again after it has been disinfected. Heather Pressdee Cheswick, Pa. When we receive shipments of supplies, we place colored stickers that

Courtesy of Judy Lethbridge

Courtesy of Mark McKee

To prevent a mess if the contents of a centrifuge tube spill during transportation to the garbage, we wrap a piece of twisted paper towel around the tube. If any liquid does spill, it will be absorbed in the towel and a messy cleanup will be avoided. Mark McKee Rye, N.H.

A New Spin

correspond with the expiration year on the outside of the containers. For example, red stickers signify 2009 and green stickers 2010. We then write the expiration date on the sticker. We also have a chart that lists what years each color corresponds to. This allows us to quickly scan the items and determine what is about to expire. Kelly Astorga Whippany, N.J.

Each published Tip of the Month contributor receives a surprise gift in addition to $50.

Many hospitals use dry erase boards and timers for certain treatments. We combined them into a timer/white board system. The system consists of a small white board with Velcro strips along the side and timers that have Velcro on the back, so they are always attached to the board. The timers are color-coded to correspond with a marker color, which allows for easy tracking of timed treatments. Judy Lethbridge Winter Park, Fla. When we admit a patient to our hospital, we remove its collar and leash and store it in a divided drawer. The drawers are numbered and correspond to their kennel number. That way we don’t lose them! Technicians at Kronenwetter Veterinary Care Mosinee, Wis.

(continues on page 38)

www.VetTechJournal.com

With the introduction of the first vaccine for canine influenza,

only the love is contagious. Now you can provide your patients with more comprehensive protection against respiratory infection. Love is not the only thing in the air. Canine influenza virus (CIV) has been confirmed in dogs across 30 states and the District of Columbia, and its prevalence is rising.1 And because most dogs are naive to the virus, virtually every naive dog exposed will become infected.2 CIV is highly contagious and sometimes deadly. Clinical signs associated with CIV can be confused with kennel cough making accurate diagnosis difficult. Now you can broaden the respiratory protection you currently offer to patients with the addition of the first vaccine for canine flu, Canine Influenza Vaccine, H3N8. Canine Influenza Vaccine, H3N8 —a killed virus vaccine from Intervet/Schering-Plough Animal Health—significantly decreases clinical signs of disease and reduces viral shedding, and its safety has been confirmed in a study involving more than 700 dogs.3

Notice: This product license is conditional. As with all USDA conditionally licensed products, data submitted to the USDA supports a reasonable expectation of efficacy. Safety was established in trials involving more than 700 dogs.

So while CIV, like love, can be easily spread and hard to identify, it no longer has to be so overwhelming. To learn more, contact your Intervet/Schering-Plough Animal Health representative, visit www.doginfluenza.com, or call our technical services team at 800-224-5318.

References: 1. Syndromic surveillance data of Cynda Crawford, DVM, PhD, University of Florida, and Edward Dubovi, PhD, Cornell University. 2. Key facts about canine influenza. CDC Website. Available at: http://www.cdc. gov/flu/canine. Accessed May 1, 2009. 3. Data on file, Intervet/Schering-Plough Animal Health. Copyright © 2009 Intervet International B.V. All rights reserved. SPAH-VC-284:9412

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Cover Story

Lights, Camera,

Endoscopy! I

t’s not every day that a technician can award a pair of underwear to a veterinarian, but for Ali McKenna, CVT, it’s a typical Monday — sort of. Normally, she would be teaching endoscopic procedures to veterinary residents at the Matthew J. Ryan Veterinary Hospital of the University of Pennsylvania, but on this particular Monday Ali decided to add a little flair to her curriculum. After she and her students extracted a pair of royal blue underwear from a dog during a foreign-body retrieval, Ali held onto the underwear and, during an end-of-year awards ceremony, presented it to the resident who excelled most in foreign-body retrieval. But it was not easy for Ali to get where she is today. In 1996, Ali was approached by her supervisor to become the first endoscopy nurse at the Ryan Veterinary Hospital because the internists were getting overwhelmed with procedures. “My supervisor said, ‘You’re not going to just clean the equipment; we want you to become intimate with endoscopy, learn how to do the procedures and teach the new residents,’” Ali explains. But she had to prove herself to some of the veterinarians. “They were very resistant to letting a technician to do something that only veterinarians did previously,” she says. “It was a struggle to get some of the senior doctors to teach me and let me do procedures.” Initially, Ali was allowed to view procedures, then assist and eventually perform endoscopy on her own. Despite the experience she gained, Ali still met resistance outside the hospital. After about a year of performing endoscopies, Ali’s hospital wanted to send her to an endoscopic program, as a formality. “My supervisors tried to send me to the program that our residents go to, and the instructor said ‘no,’” Ali explains. “He couldn’t accept a technician into his program because it was far too competitive.” So, Ali went to a different program. Since then, Ali has performed endoscopy on dogs, cats, ducks, parrots, cheetahs, penguins and even snakes. She says she enjoys the ingenuity required to perform endo-

Allyson Corcoran Editorial Assistant

JULY 2009 | Veterinary Technician

“You can see inside the organs, sample them and therapeutically

help the patient.” Ali McKenna, CVT

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Cover Story

scopic procedures on varying anatomies. “Endoscopic procedures can be difficult because the anatomy and the plane of anesthesia can differ,” says Ali. “I find it challenging to not only do the procedure in a smooth and skillful fashion but also to get it done properly and get samples rapidly.” She mentions that when performing an upper gastrointestinal endoscopy, it is difficult to maneuver the scope — “You go into the mouth, down the esophagus and into the stomach, but then it gets harder because you have to get into the small intestine through the pyloric sphincter.” However, Ali explains, endoscopy can be mastered with practice and time. During a recent procedure, Ali had to biopsy an esophageal mass in a Labrador retriever, but traditional methods were not working. The esophageal mucosa was too thick and tough. Ali used alligator forceps and attempted to break down the mucosal layer of the mass, which helped, but she was still not able to get a deep enough sample. So, Ali rummaged around the room and found an aspiration catheter, which she used to aspirate a deeper biopsy sample. “I not only enjoy the procedure itself but also the troubleshooting and ‘MacGyver-ing’ that goes along with trying to get something out or trying to put something in that isn’t standard,” Ali explains. Aside from the ingenuity, Ali appreciates the practical value of endoscopy — “You can see inside the organs, sample them and therapeutically help the patient.” For instance, Ali says, if a patient presents with a foreign body lodged in the esophagus, she can noninvasively enter the esophagus, see what the object is and pull it out without ever having to make an incision. “I think it’s really cool to see the inside of an animal. I like to see the function of the different parts of the body, like peristalsis, and what the mucosa looks like in different areas,” says Ali. “It’s like an undersea adventure, live and in action.”

Role Reversal Although traditionally veterinarians teach technicians, Ali has no qualms with role reversal when she is instructing veterinary residents. “I enjoy passing on the knowledge,” she says. “I also enjoy when the light goes on and someone exclaims ‘Oh that’s how you do it!’” Apparently, Ali teaches her students well. In 2001, she received an excellence in teaching award from her students. Ali’s influence even extends outside the classroom: “I lectured at a conference one year, and there was a social afterward. I was walking by a group of students that I recognized from my lecture, and I heard one of them saying to the other, ‘Hey, remember when Ali McKenna said to do it like this?’ I got all tingly and proud because they were excited about something that they learned in my lecture.” ©2009 Peter Olson

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Back to Basics With more than 20 years as a veterinary technician, Ali has learned many skills. When she is not performing or teaching endoscopic procedures, Ali spends her time handling nurse practitioner appointments Veterinary Technician | JULY 2009

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V I TA L S TAT I S T I C S : A L I M C K E N N A Current Employment Nurse practitioner of internal medicine, fluid therapy and endoscopy, Matthew J. Ryan Veterinary Hospital, University of Pennsylvania, Philadelphia, Pa.

Education Associate’s degree in animal health technology, Harcum College, Bryn Mawr, Pa. (1988); Basic and Intermediate Flexible Endoscopy Course by Dr. Todd Tams, VCA Antech, Washington State University, Pullman, Wash. (1998) ©2009 Peter Olson

Awards Excellence in teaching award, Veterinary Medical Student Government, University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pa. (2001) and acting as a nurse in the fluid therapy ward. In the past, Ali has served as the acting head nurse of the intensive care unit and also a renal nurse practitioner. But, Ali reveals there can be a downside to being a highly specialized professional at a teaching hospital. When Ali wanted a change, she moved from Philadelphia to Memphis, Tenn., to work at a referral practice, and it was there that she realized she might need a refresher in some basic areas. “I didn’t remember how to do a complete blood count, I didn’t know how to do a fecal and I didn’t know how to answer questions about vaccination and things like that,” Ali admits. One day, Ali was asked to anesthetize a dog that had a diaphragmatic hernia: “I said, ‘You realize I haven’t done anesthesia since 1987, but I’m sure I can figure it out!’ And the reason I could figure it out is because of my critical care experience and of course from school.”

To Be or Not to Be — a Vet With such a diverse and advanced skill set, Ali admits that she often hears that she should become a veterinarian. “I get it all the time, and my response is ‘I don’t want to be a veterinarian because they don’t get to do what I do,’” she explains. “I would not want to spend my time diagnosing, researching and coming up with plans and orders. I want to spend my time hands-on, healing and caring for the patient.” And that is exactly what Ali does. She says that caring for critically ill patients can be draining but she finds solace in the comfort she provides. “One of the hardest things in our field is dealing with the pain and suffering of the animals and having to watch them go through it,” says Ali. “But even if an animal dies, as long as I did everything I could to help make its stay here comfortable and I provided the best care and treatment possible, then I feel like I’ve done my job.” VT

Beginner’s Luck When Ali performed her first endoscopic procedure — a retroflex rhinoscopy — she was sure it would be a routine procedure. However, when Ali looked at the screen displaying the endoscopic camera image, she was surprised and excited by what she saw. “Often, you don’t even see anything, and here there was a big tumor taking up the nasal passages of this dog,” Ali explains. “It was bad for the dog and sad because he had a tumor, but it had a positive outcome. I just remember thinking ‘Cool!’” To remind herself of that first procedure, Ali printed out a snapshot, framed it and hung it up in her house.

JULY 2009 | Veterinary Technician

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Preventing

Motion Sickness in Dogs

ccording to a 2006 pet owner market research study, approximately 7.2 million dogs suffered from motion sickness (kinetosis) that year, but only 25% of the dogs received veterinary treatment for the condition.1 Because of pharmacologic advances and a better understanding of how to prevent emesis, pet owners have more viable options for helping nauseated dogs. This report is an overview of human- and veterinary-labeled pharmaceuticals and alternative medicine options for preventing motion sickness in dogs. Motion sickness typically manifests as signs of nausea and discomfort, such as excessive drooling, pacing, panting, swallowing, or lip licking.2 In some cases, these signs progress to abdominal heaving followed by vomiting.3

Amy Breton CVT, VTS (ECC)

What Causes Motion Sickness? Although the cause of motion sickness is not fully understood, the condition is generally thought to be caused by an inner-ear disturbance after repeated motion, such as that of a car, plane, or boat.4,5 Motion sickness is most common in puppies and young dogs. Although many dogs out14

JULY 2009 | Veterinary Technician

grow motion sickness,4,5 it can be a lifelong problem for others.6 Most hypotheses about the cause of motion sickness involve a sensory problem regarding the eyes and/or ears and the brain, causing the pet to become nauseated. The most popular hypothesis is that humans and animals become motion sick when the eyes tell the brain that the body is not moving, but the inner ears sense motion, resulting in the transmission of mixed signals to the brain.4 For example, when a person is on a boat, he or she may be at ease on the top deck because the horizon is a solid visual reference indicating that the boat is moving. When the individual steps below deck, however, he or she may become seasick because of the absence of a visual reference indicating motion. The confusion between the two simultaneous signals can lead to a vestibular emesis response.4 Another hypothesis suggests that the sensory confusion signals the brain to respond in the same way it would to the ingestion of a neurotoxin.4 When the brain receives both signals, it decides that the â&#x20AC;&#x153;incorrectâ&#x20AC;? signal should be ignored and that toxin ingestion is the culprit. This trigwww.VetTechJournal.com

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gers a stress response of the sympathetic nervous system, which causes the stomach to empty its contents in an attempt to rid itself of a toxin.4 Regardless of the specific reason for motion sickness, the vestibular system is always involved. Numerous studies have attempted to induce motion sickness in humans and animals whose vestibular pathway has been interrupted or removed.4 According to these studies, motion sickness cannot be induced.4 When an animal becomes nauseated, certain receptors in the brain are stimulated. All vomiting stimuli, including those from the vestibular system, ultimately converge in the emetic center, located in the medulla oblongata. The emetic center receives input from the higher centers of the brain, the gastrointestinal tract, the vestibular apparatus, and the chemoreceptor trigger zone (CRTZ).5 Drugs used to treat vomiting act on these receptors. The M1-cholinergic and H1-histaminergic receptors need to be targeted to prevent or treat vomiting caused by motion sickness.5 Ideally, treatment should be aimed at preventing signals from both receptors.5 However, little research on motion sickness has been conducted in dogs. Previous studies have produced poor results.6 Motion sickness also can lead to behavior problems.7 Some dogs may anticipate nausea related to motion sickness and may vomit before a vehicle is in motion.7 This is a learned response â&#x20AC;&#x201D; the dog may stop experiencing motion sickness but will continue to vomit. Furthermore, dogs that have had motion sickness may vomit because they are frightened by situations that caused the condition, even after they have stopped experiencing motion sickness.7 Therefore, it is important to desensitize puppies to cars. In older dogs, it may be difficult to determine whether vomiting is caused by motion sickness or by fear. In some instances, motion sickness may occur when motion is accompanied by specific factors, such as environmental temperature, humidity, or the position of the dog.6 A behavior evaluation may be necessary to determine the specific reason.7

Early Intervention Owners can take many simple actions to help their dogs. First, any dog suspected of having motion sickness should not be fed for at least 3 hours before a trip.7 Motion sickness is caused by specific factors in some dogs, so simply allowing an affected dog to breathe fresh air or to stand may alleviate motion sickness.6 All fearful puppies and adult dogs should be slowly desensitized to vehicles by first spending time in a vehicle for fun (e.g., affection, playing with a favorite toy) without 16

JULY 2009 | Veterinary Technician

traveling anywhere. Eventually, the vehicle should be turned on while the owner offers affection or the dogâ&#x20AC;&#x2122;s favorite toy. The owner should then drive for 30 seconds, stop, and reward the dog. The time in the vehicle should be gradually increased so the dog associates it with affection and security. If the dog shows signs of fear or nausea, desensitization should be stopped immediately and resumed at a later time. Appropriate desensitization can take many weeks or months and should progress slowly so the dog barely notices a change.7 Systematic desensitization works well for puppies or dogs that vomit because of anxiety or fear.7 However, an estimated 15% of all dogs suffer from true motion sickness.8 Behavior modification using systematic desensitization will likely not help a vestibular issue.7 When dealing with a truly motion-sick dog, owners have both pharmaceutical and alternative medical options. Each dog is different, so what may work for one dog may not work for another.

Pharmaceutical Options Common medications for treating motion sickness in dogs include phenothiazines, such as acepromazine and chlorpromazine. Acepromazine is labeled for the prevention of motion sickness, but chlorpromazine is not. Acepromazine is a sedative and tranquilizer and is generally prescribed to help reduce anxiety or fear.9 Chlorpromazine is primarily used as an antiemetic and occasionally as a tranquilizer.9 While both drugs have antiemetic properties, they can cause significant sedation. Depending on the dose, these drugs may cause long-lasting sedation at a high level.7 They also can cause confusion and a decrease in blood pressure in dogs.9 The effects of these drugs in dogs may vary and may depend on the breed. While these drugs have been used to sedate dogs for travel, they are no longer commonly recommended for preventing motion sickness.9 Dimenhydrinate and diphenhydramine are humanlabeled antihistamines that block the histaminic (H1) receptor of the CRTZ.9 It has been suggested that when an H1-histamine blocking agent is used, an M1-cholinergic receptor blocker should be added to control emetic signals originating from the vestibular apparatus.5,10 The most common adverse reactions to many antihistamines are central nervous system depression (sedation) and anticholinergic effects, such as dry mouth and urinary retention.9 Diarrhea, vomiting, and anorexia occur rarely.9 Antihistamines are not recommended for use in pregnant dogs.9 It is recommended to administer these medications approximately 30 minutes before a ride in a vehicle, and the effects last 3 to 6 hours.9 www.VetTechJournal.com

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Glossary Acupressure: The treatment of disorders by using manual pressure at points on the skin Acupuncture: The treatment of disorders by inserting small needles into the skin at points where the flow of energy is thought to be blocked Antihistamine: A drug that blocks the action of histamine Desensitization (to fearful situations): A process that makes an animal less responsive to an overwhelming fear by repeated exposure to the feared situation or object in a controlled situation Histamine: A compound released by immune cells that plays a large role in the production of allergic reactions Neuropeptide: A peptide released by the nervous system that carries communication between nerves

Courtesy of Amy Breton

Maropitant citrate (Cerenia, Pfizer Animal Health) is approved for treating and preventing acute vomiting and preventing vomiting caused by motion sickness in dogs. Maropitant citrate works by blocking the action of substance P, which is found in the highest concentration in the emetic center.6 Substance P is a neuropeptide that helps regulate mood, anxiety, stress, respiratory rhythm, pain, nausea, and vomiting.11 The receptor for substance P is NK1.11 NK1 receptors are found in the CRTZ and the emetic center.11 When substance P binds to the NK1 receptor, vomit-

ing occurs.12 By blocking the binding of substance P to NK1 receptors, emetic stimuli are interrupted. It has been shown in dogs that blocking substance P from the NK1 receptor is effective in preventing vomiting due to motion sickness.7 In a study in which 122 dogs with a history of motion sickness were given maropitant citrate 2 hours before travel, 7% vomited; in contrast, 55% of dogs in a placebo group vomited.2 In contrast to preventing vomiting that is not due to motion sickness, a higher dose of maropitant citrate is needed to prevent vomiting due to motion sickness. Maropitant citrate is administered once a day but cannot be administered for more than 2 consecutive days. It should be administered only to dogs older than 16 weeks.2,13 Approximately 2 hours before riding in a vehicle, the dog should be given a dose of maropitant citrate with a small amount of food. Studies have shown that it can take 1 to 2 hours for maropitant citrate to take effect.2 If the dog must take an unexpected car ride, maropitant citrate may still be effective if given only 1 hour before the ride. The most common side effect of maropitant citrate is hypersalivation, which affected approximately 12% of the study dogs.13 The drug is not currently approved for use in pregnant or lactating dogs.13

Alternative Options

It has been suggested that acupressure and acupuncture may help treat motion sickness; however, their efficacy is unknown.14,15 There have been more studies in humans that show the benefit of acupuncture compared with the benefit of acupressure.15 For many owners, however, acupuncture is simply not an option because of the expense. To date, no research has been conducted on continuous acupressure treatment methods in dogs. Research has shown that ginger may be effective in treating motion sickness in humans.14 Conversely, a NASAsponsored study at Louisiana State University in 1984 concluded that ginger did not help reduce or prevent vomiting when given 2 hours before a motion event.15 The efficacy of ginger in veterinary medicine is unknown.16 For any effectiveness to occur, it is recommended to administer ginger extract All fearful dogs should be slowly desensitized to vehicles by ďŹ rst spending time in a vehicle for fun instead of products that contain some (e.g., aďŹ&#x20AC;ection, playing with a favorite toy) without traveling anywhere. Placing a familiar object in ginger, such as gingersnap cookies or the car, such as a dog bed, may assist in desensitization. ginger ale.16 JULY 2009 | Veterinary Technician

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Other natural herbs, such as Panax ginseng, black horehound, chamomile, fringe tree, peppermint, meadowsweet, and lemon balm, may help with nausea as well.16 There is little to no published information regarding the safe and effective use of these herbs in dogs.16

The Role of Veterinary Technicians Because veterinary technicians are often the first (or last) staff members to speak to clients, they may be asked to clarify information about motion sickness. The client may have already tried some treatments and found them to be ineffective and may be unaware that new medications and options have become available. During the annual visit and initial puppy visit, motion sickness can be addressed by asking the owner if the dog became sick in the car on the way to the clinic. If the answer is yes, the technician can alert the veterinarian so he or she can speak to the owner about the options for treating motion sickness. If a puppy has motion sickness, it is important to speak to the owner about systematic desensitization to avoid a learned fear of the car later in life. Owners often assume that puppies will outgrow motion sickness, but without early intervention and treatment, motion sickness may become worse. VT

References

1. Pfizer Animal Health US Market Research Report. 2006. 2. Benchaoui H, Siedek E, Puente-Redondo V, et al. Efficacy of maropitant for preventing vomiting associated with motion sickness in dogs. Vet Rec 2007;161:444-447. 3. Twedt D. Vomiting. In: Ettinger E, Feldman C. Textbook of Veterinary Internal Medicine, ed 5. Philadelphia: WB Saunders; 2000:117-121. 4. Park E. Motion Sickness. In: General Medical Officer (GMO) Manual: Clinical Section. Wilmette, Il: Brookside Press; 1999. 5. Mears W, Encarnacion H, Parra J, Sadler V. Vomiting. Comp Contin Educ Pract Vet 2009;31:122-131. 6. Conder G, Sedlacek H, Boucher J, Clemence R. Efficacy and safety of maropitant, a selective neurokinin 1 receptor antagonist, in two randomized clinical trials for prevention of vomiting due to motion sickness dogs. J Vet Pharmacol Ther 2008;31:528-532. 7. Overall K. Clinical Behavioral Medicine for Small Animals. St. Louis: Mosby; 1997. 8. Drs. Foster and Smith Educational Staff. Pharmacy spotlight: Cerenia. Accessed April 2009 at www.drsfostersmith.com. 9. Plumb D. Plumbâ&#x20AC;&#x2122;s Veterinary Drug Handbook. Ames, Iowa: Wiley-Blackwell; 2005. 10. Washabau RJ, Elie S. Antiemetic therapy. In: Kirk RW, Bonagura JD, eds. Kirkâ&#x20AC;&#x2122;s Current Veterinary Therapy XII Small Animal Practice. Philadelphia: WB Saunders; 1995:679-684. 11. Shraffran N. The Vomiting stops here. Proc Int Vet Emerg Crit Care Symp 2008. 12. Marks J, Stoppler M. Motion Sickness. Accessed April 2009 at www.medicinenet.com. 13. Pfizer Animal Health. Cerenia drug package insert. Accessed June 2009 at www. pfizerah.com. 14. Robinson N. Evidence-Based Practice of Acupuncture. Proc West Vet Conf 2004. 15. Ehrlich S. Motion Sickness. Accessed April 2009 at www.umm.edu. 16. Silver R. The 10 herbs your clients most want to know about. Proc West Vet Conf 2005.

ABOUT THE AUTHOR

Amy Breton, CVT, VTS (ECC)

Amy works as the emergency department head technician at the Veterinary Emergency and Specialty Center of New England in Waltham, Mass.

JULY 2009 | Veterinary Technician

www.VetTechJournal.com

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ÂŠ2009 Peter Olson

CREDIT

Managing the

Veterinary Laboratory B

ecoming an expert on every aspect of the veterinary clinic is difficult, and taking the time to learn how to properly manage the laboratory in a fast-paced environment may be a low priority. However, learning to maximize the effectiveness of the veterinary laboratory can benefit a practice in many ways. Honed laboratory skills can lead to reliable patient results and the ability to track disease more accurately.1â&#x20AC;&#x201C;4 In addition, a well-managed laboratory has fewer instrument malfunctions, and when equipment problems do arise, troubleshooting is easier. As the focus of veterinary practice has changed over the

Heidi Moser, BA, RVT

JULY 2009 | Veterinary Technician

years, the in-house laboratory has become a reliable profit center. In most veterinary reference laboratories, veterinary technicians work with clinical laboratory scientists who are certified to work in human hospitals and diagnostic laboratories. Through education and work experience, medical laboratory technicians (MLTs) and medical technologists (MTs) develop a solid understanding of important aspects of the laboratory, such as quality control and troubleshooting.1,2 Having a veterinary technician with a laboratory background on staff is advantageous because he or she will have gained experience and knowledge from labwww.VetTechJournal.com

Dogs don’t have teeth to spare. But up to 80% of dogs may not be getting the oral care they need. Recommend daily GREENIES® Dental Chews to control plaque and tartar buildup and help keep teeth healthy between cleanings. Because a dog’s teeth are as irreplaceable as the rest of him. Earn oral care CE credit at vet.greenies.com. A daily dose of prevention ®/™ Trademarks © Nutro Products, Inc. 2009

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oratory coworkers. However, because most practices typically do not have such a person on staff, it is important to designate one or two people to oversee the laboratory and be responsible for instrument maintenance and quality control.

Quality Control Every instrument in a clinic must be tested regularly to ensure that it is working properly.1–4 Reference laboratories normally run standards on their analyzers once each shift or after a certain number of samples have been processed. Human hospitals and laboratories run controls with each batch of samples. Control results, along with the technician’s initials, should be logged into a computer program or tracked on a graph to visually assess trends. This graph should be kept in a common area so all persons using the laboratory can access it. The results for each quality control session should be checked for accuracy according to the ranges set by the manufacturer before samples from patients are tested. Results are considered accurate when they are close to the mean (average) value of the range.1–4 If an instrument has multiple levels of quality control, a schedule can be established so that only two of the levels are run each day, thereby reducing costs of supplies and technician time. For example, consider an instrument with three levels of standard quality control. Levels one and two can be assayed on Monday, levels two and three on Tuesday, and levels one and three on Wednesday. This pattern can simply be repeated later in the week. The schedule should be posted near the instrument so everyone has easy access to it. Technicians must also evaluate the precision (reproducibility) of quality control results. Precision indicates the similarity between one result and the next.1–4 For example, if one day’s standards are at the high end of the range and the next day’s numbers are at the low end of the range, there may be a problem with the instrument; however, further investigation is necessary to rule out other problems. Although the values are within range on both days, the difference in control values from one day to the next will be reflected in patient results. This could be the difference between normal and abnormal values in the patients that are tested that day. Proper handling and storage are important when using quality control material.1,2,4 Many products come ready to use, but some require reconstitution. Reconstitution generally involves mixing a powder with a liquid. Make sure to read the instructions on the package insert. If a certain type of water, such as distilled or deionized water, is required, do not use tap water instead.1,2 Mix gently and frequently, and allow the product to sit for the recommended time before use. For best results, designate certain pipettes or other equipment for this purpose. Most products need to be refrigerated and should be allowed to reach room temperature before use; these products should be returned to the refrigerator immediately after use. The person who opens a new bottle should initial and date the bottle. Some products have a limited shelf-life after being opened or reconstituted.

Instrument Maintenance If quality control values begin to drift toward one end of the range, an instrument may need to be calibrated. Calibrators “set” the analyzer to certain 24

JULY 2009 | Veterinary Technician

www.VetTechJournal.com

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1. Reeder CJ, GrifďŹ n CE, Polissar NL, et al. Comparative adrenocortical suppression in dogs with otitis externa following topical otic administration of four different glucocorticoid-containing medications. Vet Therap. 2008;9:111-121. 2. Rubin J, Walker RD, Blickenstaff K, Bodies-Jones S, Zhao S., Antimicrobial resistance and genetic characterization of ďŹ&#x201A;uoroquinolone resistance of Pseudomonas aeruginosa isolated from canine infections., Vet microbiol. 2008 Mar 4; [Epub ahead of print] SPAH-MO-96

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1CE CREDIT

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Figure 1. Cleaning oil from microscopes after each use results in longer life of the objectives and less cost to the clinic.

points.1,4 In general, controls and calibrators are available for purchase from the instrument’s manufacturer. To avoid instrument drift, periodic calibrations may be necessary. All equipment must be recalibrated when new batches of reagents are purchased. Check the instrument’s user manual for additional suggested calibration intervals, and record dates of calibration in the quality control log. Chemistry and hematology analyzers use reagents— substances that induce chemical reactions. Reagents require proper handling and storage.1,4 When a shipment arrives at the clinic, promptly refrigerate reagents that require refrigeration. Also, check the expiration dates when unpacking the shipment. If the expiration date is near and the reagent will likely not be used by that date, ask the supplier for replacement stock with a later expiration date. Some companies will send a replacement at no additional cost. All instruments require regular cleaning and preventive maintenance.1,4 After the initial purchase of an analyzer, the manufacturer generally sends a technical representative to train veterinary staff how to use and care for the equipment. The representative should demonstrate all maintenance that the instrument requires. If an instrument is purchased used, the user manual will detail the required maintenance. It is advisable to designate one person in the clinic to perform regular maintenance and keep a maintenance log, which can assist with troubleshooting. Like all equipment, microscopes and centrifuges are affected by wear and improper use. Cleaning oil from microscopes after each use results in longer life of the objectives and less cost to the clinic. Periodic cleaning and calibration of centrifuges and replacement of parts www.VetTechJournal.com

Veterinary Technician | JULY 2009

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Glossary Accuracy — closeness of a result to the actual or true value Calibration — method used to set an instrument to certain data points using products (standards) with known values Material safety data sheet (MSDS) — information on a particular chemical substance, such as the melting, boiling, and flash points; toxicity; health effects; reactivity; storage and disposal requirements; and spill procedures Mean — average value of a series of numbers Personal protective equipment (PPE) — gloves, goggles, masks, gowns, etc. used for personal safety when working with potentially hazardous materials Precision — reproducibility and consistency in results Quality assurance — method of ensuring consistent and reliable results; encompasses every aspect of the laboratory Quality control — method of ensuring that an individual instrument or test is functioning properly Range — a series of numbers including the lowest allowed value to the highest allowed value Reagent — a substance that participates in a chemical reaction Standard — a product with a known value that is used as a part of quality control or calibration Standard operating procedure (SOP) — a written procedure offering a detailed description of how to perform a certain task as needed also help the veterinary laboratory operate smoothly.1,4

Troubleshooting When quality controls are out of range, many technicians may not know how to proceed. Follow these steps when troubleshooting: Step 1. Repeat any control that is out of range. Perhaps improper technique or the wrong bottle of control was used. If the second run is within range, you can generally proceed with running patient samples. Step 2. If the repeated result is still out of range, examine the bottle of control to see when it was opened. If it is old or very little liquid is left, open a new bottle. Reconstitute it, if needed, and allow it to sit as recommended. This can be a time-consuming process, but if it is rushed, the control may not mix properly and may be 28

JULY 2009 | Veterinary Technician

rendered useless, costing the clinic even more time and money. Step 3. If the new, properly handled quality control does not work, instrument maintenance or calibration may need to be performed. Check the logs to see when they were last performed. Step 4. Along with checking maintenance and calibration logs, examine the reagent(s) to see how long it has been in use and if it has expired. Replace good reagent only after repeating the controls and calibrating the instrument to try to correct the problem. Step 5. If all of the above steps have been taken, it is necessary to call technical support. Instrument service may need to be scheduled. In many cases, a service contract is included with the purchase of an instrument; in other cases, such as when used equipment is purchased, it is advisable to purchase a service package, as some companies charge a large fee for a service call.

Working with the Reference Laboratory Many practices have an in-house laboratory and use outside testing as well. This can be very cost effective for a practice. Some tests are not ordered very often, so buying a new instrument or keeping a little-used reagent on hand can be costly.3,4 Purchasing an instrument may be advisable if a practice begins ordering a certain test often. Eventually, the savings make up for the initial cost, but purchasing equipment for some results, such as electrolyte or digoxin levels, will not be cost effective. These tests can be sent to a reference laboratory. When you send samples to a reference laboratory, your samples join many similar shipments from other clinics. It is important for technicians to clearly label all samples with the animal’s complete name, regardless of whether the sample is sent to a reference laboratory or is analyzed in house.1 Good quality control and state-of-the-art equipment are useless if canine blood drawn for a routine complete blood count becomes confused with feline blood meant for FIV testing. Make certain to include the requisition with the sample and thoroughly and accurately prepare the paperwork to avoid delays in testing. It is often helpful to include other relevant information about the patient’s case. For example, if the veterinarian suspects Babesia infection, note it on the requisition.

Quality Assurance Some people confuse quality control with quality assurance; the two are related but different. Quality control is www.VetTechJournal.com

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specific to a particular instrument in the laboratory, whereas quality assurance denotes an all-encompassing approach to the laboratory.1 Factories often have quality assurance departments or personnel who systematically examine the product and the methods of production. In the veterinary clinic, particularly in the laboratory, there also are ways to verify results and methods. One way is to ensure that employees are trained correctly and consistently.1 Creating standard operating procedures (SOPs), which are periodically evaluated and updated, is a good place to start. Check-off sheets can serve this purpose as well. Once all employees are properly trained, “blind” samples can be given to each technician to be evaluated. Chemistry and hematology samples with known results can be distributed to determine whether each employee uses proper technique. Previously evaluated blood smears and urine specimens can also be used as blind samples to ensure that results are consistent from one technician to another. Continuing education for staff is required. Technicians can be assigned topics to research and present as time allows. If a staff member reports unusual findings on a blood smear, urinalysis, or fecal flotation, encourage him or her to set aside the sample so that everyone may examine it and learn. Urine and fecal wet preps can be set inside a Petri dish with moistened gauze to keep them readable.

Safety Safety in the veterinary clinic is commonly viewed as avoiding cat scratches and dog bites, but body fluids and chemicals can also be hazardous. While animals do not transmit notorious infectious agents such as HIV or hepatitis C, they may transmit several zoonotic diseases. In addition, some quality control products are derived from human serum. Therefore, personal protective equipment (PPE)1,2 should be worn when working with body fluids or handling standards. Reagents and cleaners can be caustic to skin and eyes. If there is potential for splashing, safety glasses should be worn in addition to gloves — particularly if you are working with any basic solutions. For instance, bleach can be dangerous if it enters the eyes. The clinic must have a material safety data sheet (MSDS) book that describes every chemical used in the laboratory and any potential dangers.1 VT

References 1. Turgeon ML. Clinical Laboratory Science: The Basics and Routine Techniques, ed 4. St. Louis: Mosby; 1999. 2. Walters NJ, Estridge BH, Reynolds AP. Basic Medical Laboratory Techniques, ed 4. Albany, NY: Delmar Publishers; 2000. 3. Duncan JR, Prasse KW, Mahaffey EA. Veterinary Laboratory Medicine: Clinical Pathology, ed 4. Ames: Iowa State University Press; 2003. 4. Hendrix CM, Sirois M. Laboratory Procedures for Veterinary Technicians, ed 5. St. Louis: Mosby; 2007. (CE test is on page 32)

ABOUT THE AUTHOR

Heidi Moser, BA, RVT Heidi resides in northeastern Ohio and has worked in a veterinary diagnostic laboratory for the past 7 years. She is currently pursuing a BS in Clinical Laboratory Science at Youngstown State University, Ohio, and has a BA in English Literature.

JULY 2009 | Veterinary Technician

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Article #1 FREE CE Test The article you have read qualifies for 1.0 credit hour. To receive credit from Alfred State College, choose the best answer to each of the following questions. Take the test online at www.VetTechJournal.com.

1. Your glucose quality control results for the past 5 days are 103, 135, 99, 85, and 122 mg/dl, respectively (reference range: 80–110 mg/dl). Your results are _________. a. accurate b. precise c. both accurate and precise d. neither accurate nor precise 2. Your phosphorous quality control results for the past four days are 8.8, 8.9, 8.8, and 9.0 mg/dl, respectively (reference range: 9.0–9.4). Your results are ____________. a. accurate b. precise c. both accurate and precise d. neither accurate nor precise 3. If an instrument has multiple levels of quality control, a schedule can be established so that only ____ of the levels are run each day, which can reduce costs. a. two b. three c. five d. ten 4. Oil on microscopes should be removed ________. a. daily b. monthly c. after every shift d. after each use 5. If two technicians in the laboratory obtain two completely different results on a differential count, this indicates a problem with ____________. a. Diff-Quik stain b. hematology instrument precision c. quality assurance d. the microscope’s objectives

6. Important records to have available in the laboratory include __________. a. the instrument maintenance and service logs b. the quality control log c. written procedures d. all of the above 7. In general, the first step when troubleshooting a quality control result that is out of range is to ______________. a. calibrate the instrument b. repeat the test with the same bottle of control c. open a new bottle of control d. call for service 8. If a technician splashes a reagent in his or her eye, the __________ should be consulted immediately. a. SOP b. MSDS c. PPE d. none of the above; reagents are harmless 9. _______ induce chemical reactions. a. Reagents b. Standards c. Solvents d. Controls 10. ______ is specific to any particular instrument in the laboratory. a. Quality assurance b. Quality control c. Standard d. Precision

Take this CE test for FREE! Go to www.VetTechJournal.com. 32

JULY 2009 | Veterinary Technician

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TechNews

New Lyme and CIV Vaccines Approved

ROSELAND, N.J. — Intervet/ Schering-Plough Animal Health has announced the availability of two new vaccines for the prevention of Lyme disease and canine influenca virus (CIV). Nobivac Lyme targets outer surface proteins (Osp) A and C, which are involved in the transmission of canine Lyme disease. The vaccine induces the production of highly specific antibodies, called borreliacidal antibodies, that kill Borrelia burgdorferi, the causative agent of Lyme disease. Nobivac Lyme is administered by giving two doses subcutaneously, 2 to

burgdorferi at multiple points during the infection process,” said Rhonda LaFleur, PhD, group leader, biologicals research and development at Intervet/Schering-Plough Animal Health. “OspA borreliacidal antibodies only kill Borrelia organisms while they are in the tick’s midgut. OspC borreliacidal antibodies, however, kill spirochetes in the tick midgut, spirochetes that are migrating from the midgut to the tick’s salivary glands and spirochetes that are introduced into the dog.” The clinical signs of disease range from subtle lameness to high fever,

4 weeks apart, with an annual booster thereafter. Safety studies demonstrated virtually no site reactions. B. burgdorferi is transmitted to the dog by the bite of an infected tick. When the tick attaches and begins feeding, the bacteria multiply in the tick’s midgut. The bacteria then migrate to the salivary glands of the tick and enter the dog’s skin at the site of attachment. “This vaccine represents a major advance in the prevention of Lyme disease in dogs because it induces OspC borreliacidal antibodies that can kill B.

swollen lymph nodes, lameness and loss of appetite. Rarely, a dog infected with Lyme disease can develop severe clinical signs that, if left untreated or treated too late, can result in permanent damage to the heart, kidneys, nervous system and joints. Ticks carrying the Lyme diseasecausing bacteria have been found throughout the United States. In other news, the company’s first CIV vaccine was granted a conditional product license by the USDA for use by veterinarians in the United States. “Canine influenza is a highly conta-

JULY 2009 | Veterinary Technician

gious respiratory infection that has a significant impact on dogs housed in shelters, kennels and communal facilities,” said Cynda Crawford, DVM, PhD, clinical assistant professor of shelter medicine at the University of Florida College of Veterinary Medicine. “The availability of a vaccine can help prevent the medical, financial and emotional costs associated with this new virus.” Canine influenza was first identified in the United States in 2004 and has been detected in dogs in 30 states and the District of Columbia, according to Dr. Crawford and Edward J. Dubovi, PhD, professor of virology at the Cornell University College of Veterinary Medicine. Most dogs have no immunity to canine influenza because it is a novel pathogen and, therefore, the infection can spread quickly through animal shelters, adoption groups, pet stores, boarding kennels, veterinary clinics and any location where dogs congregate. According to the US Centers for Disease Control and Prevention (CDC), there is no evidence of transmission of the virus from dogs to people. In 2006, the American Veterinary Medical Association (AVMA) called for the development of a vaccine against the spread of the disease, stating “there is urgent need for an effective canine influenza vaccine to improve the health and welfare of animals and reduce the financial impacts of canine influenza.” VT www.VetTechJournal.com

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TechNews

FDA Approves First Drug to Treat Feline Hyperthyroidism By Marie Rosenthal, MS The Food and Drug Administration (FDA) recently gave marketing approval to Dechra Veterinary Products for Felimazole (methimazole), the first veterinary drug approved to treat feline hyperthyroidism. Felimazole will be available in 2.5- and 5-mg specially coated tablets to make it easier for owners to pill. “Veterinarians have used methimazole for many years, but it was a human drug offlabel,” said Tim Allen, DVM, DACVIM, technical services veterinarian at Dechra. “Owners are taking the human drug, which is a 5-mg and 10-mg tablet, and are splitting it, so the cats don’t get the exact dose. In addition, the cat is exposed to the bitter taste of this compound. Now we have a 2.5mg tablet, which is the right size for the cat and is coated as well. “As a veterinarian, it is nice to know that an FDA-approved drug meets the strict requirements of the FDA,” he added. The FDA evaluated two openlabel studies, conducted in the United Kingdom and the United States, showing the efficacy and safety of Felimazole. Success was measured by a decrease in the production of thyroid hormones (thyroxine [T4] levels) and improvement in clinical signs. A total of 166 pet cats with hyperthyroidism were treated with Felimazole. By day 42 of treatment, 77% of cats in the UK study saw a drop in total T4 levels and 81% improved clinically, according to Allen. 36

JULY 2009 | Veterinary Technician

In the US study, 61% of 105 evaluable cats were considered treatment successes by day 42. The researchers saw a significant decrease in T4 concentration and improved clinical signs. “Hyperthyroidism is one of the most common diseases in middle-aged and

Felimazole was recently approved to treat feline hyperthyroidism.

senior cats,” said Bernadette Dunham, DVM, PhD, director of the FDA Center for Veterinary Medicine. For this reason, the American Association of Feline Practitioners Senior Care Guidelines recommend annual T4 testing in older cats. Veterinarians faced with a hyperthyroid cat have several options for treatment, Allen said, which is aimed at controlling excess thyroid hormone production. Besides antithyroid therapy, treatment options include surgery and radioactive iodine (iodine 131; 131I). Each has pros and cons, he said. Thyroidectomy can provide a complete cure, but there are risks to performing surgery in older, sick cats. 131 I is an effective treatment because the cat does not need daily medication,

but it is hazardous, and cats must be quarantined for 5 to 7 days posttreatment. During that time, contact with the cat should be minimal. In addition, owners must take care when handling the cat and its waste for 30 days. There is a role for Felimazole even if a veterinarian decides to use a nonmedical therapy, Allen said. “The cat should be treated with Felimazole for 30 days before nonmedical treatment so it is in the best possible shape before the procedure,” he said. The most common side effects associated with Felimazole include changes in food consumption, lethargy, vomiting and diarrhea. Less common effects are anemia and reduced platelet counts. “For the first group [of common adverse effects], some of those issues may resolve on their own. You can continue treatment,” Allen said. “Sometimes reducing the dose will help. Blood changes, which are rare, are indications that the drug should be stopped.” Veterinarians should monitor total T4 values, and those values should be used in conjunction with clinical signs to adjust the dose, according to Allen. The starting dose should be 2.5 mg q12h, according to Dana Fertig, DVM, manager of technical services at Dechra. After 3 weeks, the dose should be titrated to effect, based on the cat’s serum total T4 levels. “Because of the rare hematologic problems, a periodic complete blood count would be appropriate, too,” Allen said. Felimazole should be available to veterinarians by the end of July, Dechra officials said. VT www.VetTechJournal.com

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TechNews

FDA Approves Mast Cell Tumor Therapy MONTREAL — The Food and Drug Administration (FDA) gave marketing approval to Pfizer Animal Health for a targeted therapy for canine cancer. Palladia (toceranib phosphate) will be indicated to treat Patnaik grade II or III recurrent cutaneous mast cell tumors with or without regional lymph node involvement, company officials said here at the 2009 American College of Veterinary Internal Medicine (ACVIM) Forum and Canadian Veterinary Medical Association Convention. Pfizer estimated that 1.2 million new canine cancer cases are reported in the United States each year. Palladia, a receptor tyrosine kinase inhibitor, blocks the activity of key receptors for angiogenesis, as well as

receptors critical for tumor survival. “At the completion of a Palladia clinical study, approximately 60% of dogs had their tumors disappear, shrink or stop growing. Also, we determined that dogs with tumors that responded to Palladia experienced an improved quality of life,” said Cheryl London, DVM, PhD, DACVIM (Oncology), an associate professor at The Ohio State University College of Veterinary Medicine. George Fennell, vice president of the companion animal division at Pfizer, said that the company will introduce Palladia to board-certified specialists through its specialty hospi-

tal liaisons. “The experience gained during this time will enable us to support veterinarians more effectively when the product becomes available for purchase in early 2010,” he said. Palladia can be given in a veterinary clinic or in the home by a dog’s caregiver. According to the package insert, dogs should receive an initial dose of 3.25 mg/kg body weight PO every other day. Dose reductions of 0.5 mg/kg to a minimum dose of 2.2 mg/kg PO every other day may be indicated. In addition, doses may be interrupted for up to 2 weeks to manage adverse events. For specific prescribing information, visit VT www.palladia-pi.com.

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TechTips Stick ‘Em

Hot and Cold

Clients who have diabetic animals often wonder what to do with used insulin needles. An old soda bottle can be used as a sharps collection container. The client can then be reminded to bring the bottle to the clinic for proper disposal. Tiffany Maler Selden, N.Y.

We created our own flexible ice packs by using the hard frozen gel packs included with cold product shipments. We thaw the packs and empty them into a large plastic baggie. We then mix in a slightly less than equal amount of rubbing alcohol and put the baggie into the freezer. The alcohol prevents the gel from freezing solid, so the resulting ice pack is flexible and molds to the patient. Sue Anderson Carson City, Nev.

Samples

Courtesy of Jordin Tillson

To help keep patients warm during anesthesia and postoperative care, we use expired IV fluid bags heated in the microwave for 4 to 5 minutes. We inject 0.5 cc of new methylene blue or insert a fluorescein stain into a 3-cc syringe with needle and dilute it with the fluid in the heating bag to keep people from using the heated bags for anything else. Cristina Duran Pembroke Pines, Fla.

Courtesy of Beth Bosse

We use Vacutainer (BD) adapters for obtaining blood samples from freshly placed IV catheters. These are commonly used in human medicine and are just right for patients with coagulopathies. They are also handy when patients are critical and time is crucial. Jordin Tillson Roseville, Mich.

Tricks of the Trade

When mailing lab samples in Vacutainer (BD) tubes to reference labs, we use old 6-mL and 12-mL syringe casings. The rigid plastic casing adds protection to the sample tube and also serves as a container if the tube leaks in transit. Beth Bosse Falmouth, Maine 38

To help maintain a pet’s temperature when under anesthesia, we place baby/infant socks on all four of its paws. This helps to keep the pet’s body temperature up by lessening heat loss from its extremities. The socks are inexpensive and can be washed and reused. Jill Tally Greenville, Ill.

JULY 2009 | Veterinary Technician

Rabbits tend to bite their IV fluid line, and it is difficult to use e-collars on them because of stress. To prevent the biting the line, we sterilize used 5-cc syringes and put them around the IV line. First, cut the tip of the syringe, then remove the plunger and push the line through the syringe. To make sure the rabbit is not able to move the syringes, we tape them together. We also put some

Courtesy of Mariève Paquin

(continued from page 8)

Elastoplast tape on the IV loop at the end to make a bunny-proof IV line. Mariève Paquin Lanoraie, Quebec, Canada Instead of using a metal stylette in endotracheal tubes for intubating cats, I like to use polypropylene urinary catheters. I find they are softer, more flexible and decrease the chances of tracheal tearing. Differentsized catheters will fit in the different-sized tubes, and one end can be bent and secured with tape and Vetrap (3M) to create a loop for easier handling. Erica Zelenkov Tacoma, Wash.

TECH TIP SUBMISSIONS We pay $50 for each tip, question or solution selected for publication. Submissions should not exceed 100 words and will be edited for length and clarity. Include your full name, email and daytime phone number. Photos make tips more interesting: To submit a photo, it should be a minimum of 300 dpi and submitted as a jpg or tif file.

Videotape and upload your tech tips to www.VetTechJournal.com/sharetechtip We pay $100 for each Tech Tip video posted on www.VetTechJournal.com.

Tech Tip submissions should be sent to: Email: editor@VetTechJournal.com Fax: 800-556-3288 Mail: VLS/Veterinary Technician 780 Township Line Road Yardley, PA 19067

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ManagementMatters

Analyzing Your

Software Needs Choosing software upgrades requires input from the entire staﬀ

he available selection of veterinary practice management software is constantly changing — vendors create new products, unveil unique offerings to supplement existing products and introduce new applications to better integrate their software into the clinic setting. In light of new and updated products, it is helpful to reassess the clinic’s software needs from time to time. Doctors, technicians and receptionists may all use the practice management software, so when it is time to consider adding or changing software it is useful to obtain everyone’s opinion. As members of the practice team, technicians know what is lacking from current software and the ways an upgrade could beneﬁt the practice. It is important that each department’s perspective be represented to reach a balanced decision about this major investment and to ensure that any new or upgraded software is used efﬁciently.

Katherine Dobbs, RVT, CVPM, PHR and Kristen Hoffman, BS

Creating Wish Lists The practice management needs of a veterinary hospital can vary by department, so it may be difficult to define the ideal software package. One way to determine which software options your practice needs is to focus on daily job duties. When the announcement is made that the practice is considering a software switch, have each department in the practice begin working on a “wish list.” Each team member in the department can then contribute his or her ideas to the list. Team members should list the functions they would like the new software to offer, plus any routine frustrations they have with the current software. For example, a technician who stocks inventory may wish that the 40

JULY 2009 | Veterinary Technician

software had a better inventory control function, while another technician may list his or her frustration with a cumbersome invoicing application.

Meeting of the Minds After the lists are complete, the members of each department (e.g., front ofﬁce, kennel area) should meet to go over their wish list, eliminate duplicate suggestions, and glean any new ideas. The ﬁnal lists from these initial meetings can then be combined during a full staff meeting. When the management team has consolidated and reviewed the wish lists from the staff, it can begin to compare the available software options, using the staff’s problems and suggestions as a function checklist.

Technician Considerations in Software Selection Medical record entry for recording treatment notes and client updates Whiteboard for recording treatments of hospitalized patients Fee entry for creating invoices for hospitalized patients Inventory module for creating perpetual inventory systems and integrating with automatic vendor systems Integration of lab and imaging to enhance and complete the medical record Communication for sending and receiving records and images between practices Intranet for maintaining staff schedules, SOPs, procedure manuals, time clock, etc.

www.VetTechJournal.com

ManagementMatters Meeting With Vendors After the internal research is complete, vendors should be called in for demonstrations. The “bells and whistles” of individual software options may offer attractive style but no substance, so it is important to follow the staff wish list. Show the list to each vendor and ﬁnd out which of your needs each system can meet. Record the success rate for each vendor, then narrow your list to the vendors that can meet the most needs. Do not let sales presentations distract you from your ultimate mission. While sales representatives want to demonstrate the most eye-catching features of their software, you need to keep your eye on the practical applications and ensure that you get the most useful system you can afford.

Implementing Changes Selecting the optimal system for your practice’s needs and switching software are major undertakings. They represent a substantial investment of money and time, yet the reasons for switching can be compelling, such as better patient care, more efﬁcient capturing of charges, and, ultimately, cost savings (e.g., staff time, paper) for the practice.

Changing systems is not a decision to take lightly, however, and the entire team needs to be involved. Each person has to use the practice management software in different ways, so everyone needs to have a voice. The more each team member is heard, the more likely he or she will be to have patience with the learning curve that comes with any integration of new technology in the veterinary practice. VT

ABOUT THE AUTHOR

Katherine Dobbs, RVT, CVPM, PHR Katherine is the founder of the Veterinary Emergency and Specialty Practice Association (www. vespassociation.org). She has her own consulting firm, interFace Veterinary HR Systems, LLC. Contact her at ManagementMatters@sbcglobal.net.

Kristen Hoﬀman, BS Kristen is the hospital administrator at Veterinary Imaging Center, an MRIexclusive practice in Ambler, Pa. She is vice president of VESPA and leads a regional specialty and emergency management group. Contact her at KristenHoffmanVIC@comcast.net.

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Pathogen Test

Lister Shearing Equipment has launched the Libretto super clipper. The Libretto has a small body and a quiet motor, as well as a high clipper speed. The clipper comes in royal purple and has three power options, a 12 V power pack, a wall adapter, and a 12 V car adapter. It comes with a carrying case and accessories.

Antech Diagnostics has released a new molecular diagnostic test for the five most common causes of feline upper respiratory disease. The FastPanel PCR Feline Upper Respiratory Profile tests a single sample for feline calicivirus, feline herpesvirus-1, Bordetella bronchiseptica, Chlamydophila felis, and Mycoplasma felis. Test results are available in 1 to 3 days.

815-548-8388 • www.lister-shearing.co.uk

800-872-1001 • www.antechdiagnostics.com

Aloka Company Ltd.

Ultrasound

The FDA has approved Palladia, Pfizer’s new canine cancer therapy drug. Palladia, the first canine cancer therapy, is an oral medication indicated to treat Patnaik grade II or III recurrent cutaneous mast cell tumors with or without regional lymph node involvement. It will be available for purchase in early 2010.

Aloka has enhanced the ProSound Alpha 7 ultrasonography console. The device has an ergonomic design with a height-adjustable console, is the smallest, lightest system in its class, and consumes 40% less electricity than previous models. The ProSound has extensive storage capabilities, including USB and DVD storage.

800-366-5288 • www.pfizerah.com

800-872-5652 • www.aloka.com

Pfizer Animal Health

Canine Cancer Therapy

KOE® (Kennel Odor Eliminator) & AOE® Deodorizing Wipes

A VMA V Accr AVMA Accredited

Veter Veterinary TTechnology echn Degrees D egre • Associate’s Associate’s degree d egree

KOE® ELIMINATES, not masks, even old, impregnated odors from cages, runs, walls and other large areas.

e n i l On

• Bachelor’s degree

AOE® WIPES are great for anal glands, ears and cleaning cages for small animals and birds.

For a FREE SAMP For SAMPLE PLE ccall: all: 888-873-3442 888-873-3442 FFax: ax: 816-873-3223 816-873-3223 email: sales@thornell.com sales@thorneell.com www.thornell.com www.thornell.coom

(727) 27 7) 341-4SPC www.spcollege.edu/hec/vt w.spcollege.edu/hec/vt

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ProductForum Intervet/Schering-Plough Animal Health

Purina Veterinary Diets

Pet Recovery

Dry Dog Food

HomeAgain is a national pet recovery service offered by Intervet/Schering-Plough that includes microchipping and registration. HomeAgain provides live pet-recovery specialists, “lost pet” alerts at veterinary clinics and shelters, and 24-hour emergency assistance, medical insurance, and travel expenses.

Purina Veterinary Diets has introduced EN Gastroenteric Canine Dry Formula enhanced with bovine colostrum. Designed for puppies and dogs with a range of gastrointestinal conditions, the formula can help stabilize intestinal microflora with digestible protein and carbohydrate sources, low fiber and moderate fat content.

888-466-3242 • www.homeagain.com

800-879-1266 • www.purinaveterinarydiets.com

Antal Products

Veterinary Products Laboratories

Pet Memorial

Stress Relief Tablets

The Pet Memorial Set, offered by Antal Products, is a traditional and affordable way for owners to lay their beloved pet to rest. The set includes a pet loss booklet, memorial marker, certificate, and biodegradable casket in a classic design. The set is offered with an optional display rack and is designed for those who wish to have a home service.

Veterinary Products Laboratories has introduced Harmonease Chewable Tablets for dogs, a blend of extracts from Magnolia officinalis and Phellodendron amurense that binds to selective CNS targets associated with stress, but not to those for lethargy and muscle relaxation.

724-532-2890 • www.antalproducts.com

AFP Imaging Corporation

Imaging ImageV PACS is a picture archiving and communication system designed for veterinary use. It allows viewing of conventional and digital radiographs, as well as CCD, ultranographic, endoscopic, and digital dental images. The device integrates with other AFP offerings. ImageV PACS is available alone or with the Konica Regius Model 110 CR.

800-592-6666 • www.afpimaging.com

Devlin Keyboards

Computer Peripherals The CleanKey keyboard and mouse are designed to be durable and waterproof for better infection control, hygiene, and ruggedness. Both devices are fully waterproof, even when completely submerged in liquid, and have a “clean key,” which stops data being sent to the computer, allowing cleaning at the point of use.

+44 (0) 1256 467367 • devlin.co.uk

888-241-9545 • www.vpl.com

IDEXX Reference Laboratories

Practice Management System Idexx Reference Laboratories and ImproMed have launched IDEXX LabREXX within the newest release of the ImproMed Infinity Practice Management system. The program can increase practice efficiency by eliminating the need for manual test requisitions and can help reduce lost charges from outside lab tests. Users can access the LabREXX test requisition form to automatically populate it with information directly from a patient’s electronic medical record. Tests are then selected from a menu.

877-838-9273 • www.idexx.com/labrexx

Neogen

Colorful Collars Neogen has added a full line of functional and colorful e-collars to its line of veterinary products. The Funcol collars feature paw prints in seven different colors for easy identification of the different sizes, which range from 7.5 cm to 30 cm. The collars are made from tough, scratch- and tear-resistant polypropylene that is easy to clean. They are quickly and easily assembled and lock securely with a click-lock tab.

www.neogen.com www.VetTechJournal.com

VT Veterinary Technician | JULY 2009 43

MarketShowcase For More Information About These Products and Services, email productinfo@ForumVet.com.

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Place Your Ad Dollars Where They Make Sense

Market Showcase Discover the beneﬁts of Market Showcase!

36,307 Total qualiﬁed circulation of Veterinary Technician of readers take some purchasing action after reading 90% Veterinary Technician every Market Showcase ad receives bonus exposure PLUS through the digital journals at VetLearn.com! 1

Contact Lisa Siebert to place your ad today. Call 215-589-9457 or email lsiebert@vetlearn.com. 1. Source: Dec 2008 BPA statement. 2. Source: Baxter Research adView 4, July 2008 Veterinary Technician.

Publisher’s Disclaimer: Advertising appearing in this issue does not necessarily reflect the opinions nor constitute or imply endorsement or recommendation by the Publisher. The Publisher is not responsible for any statements or data made by the Advertiser.

JULY 2009 | Veterinary Technician

www.VetTechJournal.com

ClassifiedAdvertising EDUCATIONAL OPPORTUNITIES Develop an animal behavior specialty in your practice or from your home! Earn an MS, BS, or AS degree in companion animal science, behavior, training, and counseling. Qualify for certification by ACABC’s professional credentialing board. Study via online courses, 5-day hands-on residencies, and community externships. Low-cost tuition financing. Outstanding PhD and veterinary faculty. American College of Applied Science; 800-403-DEGREE; http://www.amcollege.us. Licensed by Florida DOE CIE #3145 .

TECHNICIANS WANTED ALABAMA – Auburn University’s College of Veterinary Medicine invites applications for Director of the Critical Care Nursing Program. Responsibilities include instructing technicians and veterinary students; scheduling staff; developing ICU protocols; administering the blood donor program; facilitating research data collection; and developing CE programs. Qualified candidates have some college/vocational credits or a degree, with course work in animal health, a science, or a related field. A minimum of 8 years’ experience in a specialty ICU with at least 1 year of supervisory experience is also required. For a complete job description and online application instructions, please visit www.vetmed. auburn.edu/index.pl/employment. Application review begins after June 12, 2009. AA/EOE. ALASKA – Full-/part-time LVT or veterinary assistant with 2 years’ experience wanted to join outgoing team at 24/7 AAHA-accredited emergency hospital in beautiful Anchorage. Emergency experience a plus. Technician interns welcome. Competitive wages, health and dental, paid vacation, CE. Assistance with traveling expenses available. Fax resume to 907-274-5133 or email akbmd@ clearwire.net. Visit www.petemergencytreatment.com. ARKANSAS – Busy, two-doctor AAHA-accredited hospital in Little Rock seeks a full-time CVT or state-certificate–eligible technician. A motivated team player will find an excellent opportunity for professional development at our well-established practice that continues to grow. We are semi-paperless and well-equipped with an in-house lab, ultrasound, and support equipment. There’s much to do in the capital city and numerous outdoor activities are a short drive away. We offer a competitive salary, vacation/personal time, health insurance, CE, and a profit-sharing plan. No emergency duty. Email Sarah at sarahcvt2008@yahoo.com or fax your resume to 501-225-2488.

TECHNICIANS WANTED

FLORIDA – Miami Veterinary Specialists is a state-of-the-art referral practice that provides highquality, cutting-edge veterinary medicine. We are always seeking highly enthusiastic, self-motivated, experienced team players to join our fast-growing technician staff. New graduates welcome. Work to your fullest capability assisting our onsite board-certified specialists in: Ultrasonography • Computed Tomography (CT Scans) • Endoscopy • Fluoroscopy • Dermatology • Oncologic Surgery • Neurologic Surgery • 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, and digital radiography. The ability to think and handle responsibility is a must! Our benefits package includes a 401(k), CE, paid vacation, medical/dental insurance, pet discounts, and more. 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. For more information, call 305-665-2820 or visit www.mvshospital.com. FLORIDA – Two full-time technicians needed in Pensacola at multi-doctor practice that is currently pursuing AAHAaccreditation and will offer acupuncture next spring. Candidates must be self-motivated, hard-working, team-oriented, and dedicated to client service and patient care. Experience required; license/certiﬁcation preferred. Please email resume and three professional references to ksmith@navyblvd.com.

TECHNICIANS WANTED

FLORIDA Coral Springs Animal Hospital is always accepting applications from enthusiastic, motivated, compassionate, dedicated, quality-minded CVTs and 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 at our general/specialty/emergency/critical care facility, which is open 24/7. We are looking for individuals who want to utilize their veterinary nursing skills to the fullest. Technicians with the desire to work at a premium facility that has a great record of retaining excellent veterinary professionals are encouraged to apply. Salary is commensurate with experience but will range from $32,000–$44,000+ 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, and discounted pet care. Drug-free workplace. Flexible scheduling. Please visit us and take a virtual tour of our brand-new 39,000–sq. ft. state-of-the-art facility at www.coralspringsanimalhosp.com. Please send resume to: Coral Springs Animal Hospital 2160 North University Drive Coral Springs, FL 33071 Attn: Shayne Gardner, Hospital Manager. Phone 954-753-1800 • Fax 954-343-0238.

VETERINARY TECHNICIAN Professional Reprints offer a great opportunity for you to distribute information to your colleagues, clients and customers. Reprints serve as a valuable tool for: • Continuing education • Product promotion • Client services

• Private distribution • Students For a FREE quote today, call Christine Polcino at 267-685-2419, or email cpolcino@vetlearn.com.

Don’t read it and forget it. Spread the word with professional quality reprints from www.VetTechJournal.com

Veterinary Technician | JULY 2009 45

ClassiﬁedAdvertising TECHNICIANS WANTED

TECHNICIANS WANTED

FLORIDA Veterinary Technicians/Nurses We are a state-of-the-art small animal emergency/critical care and referral hospital located in West Palm Beach. Fueled by a dedicated team of professionals, our practice specializes in emergency/critical care, surgery, internal medicine, oncology, neurology, cardiology, radiology, and ophthalmology. We have a place for you, whatever your interests may be! Qualities required in our technicians and nurses include: • Clinical and interpersonal skills • Desire to directly assist with case management • Self-motivated and team-oriented New graduates welcome! Excellent compensation adds to our quality working environment. Additional benefits include medical and dental insurance, 401(k), paid vacation, uniform reimbursement, CE, and discounted services for your pets! Please call Jennifer at Palm Beach Veterinary Specialists: 561-434-5700; and/or send your resume, Attn: Jennifer: Fax: 561-296-2888; Email: careers@palmbeachvetspecialists.com.

FLORIDA – Experienced full- and part-time nurses needed at an established and recently expanded small animal emergency hospital, located only a few miles from the beach in sunny Jacksonville. Come enjoy a family-like atmosphere where our doctors are always willing to share knowledge and CE is available and encouraged. Our patient care is second to none! We are well-equipped with digital x-ray, ultrasound, vital scan monitor, Doppler blood pressure, StatSpin, full in-house lab, infusion pumps, endoscope, and much more. Competitive pay based on experience with generous beneﬁts package for full-time employees. Nights, holidays, and weekend hours required. Fax resume to 904-223-3084 or email to emergencypetcare@bellsouth.net.

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.

L OO K N O F U R TH E R .

We’ve got your ideal job! 46

JULY 2009 | Veterinary Technician

SCHOOL OF VETERINARY MEDICINE INDIANA – The Veterinary Teaching Hospital at the Purdue University School of Veterinary Medicine is seeking veterinary technicians. Our challenging RVT positions will perfect your current skills and provide opportunities for professional growth, both clinically and academically. Candidates must be graduates of AVMA-accredited technology programs and licensable in Indiana within six months of hire. We offer competitive salaries and excellent benefits. The VTH includes both a large and small animal hospital, supporting laboratories, and other service facilities. We are dedicated to providing the highest quality routine veterinary care and specialized services in a hands-on training environment. You will enjoy a varied caseload and assist in the education of technician and veterinary students in areas such as: intensive care/ emergency medicine; soft tissue and orthopedic surgery; internal medicine; radiology; and others. Current openings are posted at www.purdue.edu/ hr/Employment (click “Regular Staff Positions,” select “Basic Search,” then select “School of Veterinary Medicine Admin” under “Organization”). For more information, please contact Mrs. Dannell Smith: Veterinary Teaching Hospital, 625 Harrison Street, West Lafayette, IN 47907 Phone: 765-496-9585 • Fax: 765-496-1166; Email: smithde@purdue.edu.

AA/EOE.

PENNSYLVANIA 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.

Place Your Classiﬁed Ad Download our complete classified advertising rate card and order form at www.VetClassifieds.com/pdf or call 800-920-1695

ClassiﬁedAdvertising TECHNICIANS WANTED PENNSYLVANIA – Busy companion animal practice in Lancaster County seeks experienced full-time CVT to assist with basic procedures, provide emergency care, and perform other duties. Some evening/weekend hours. Competitive salary/beneﬁts. Send resume to 717-464-4082 or mtbuchhholz1@comcast.net. Website: www.willowrunvetclinic.com.

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, AAHAaccredited 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 LVTs and Student Technicians The LifeCentre for Veterinary Emergency & Specialty Care in Leesburg has full-/parttime positions available in our emergency/ critical care department for LVTs and student technicians. 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, on-site MRI machine. We offer the right individuals the opportunity to join our team and be challenged and appreciated by our doctors, staff, and clients. We offer competitive pay and benefits, including health insurance, 401(k), CE allowance, moving allowance, vacation, and personal paid leave. $1,500 sign-on bonus for full-time LVTs! Please email your resume to: LeesburgLVT@aol.com or fax to 703-777-3396, Attn: Human Resources.

VIRGINIA – Small animal practice in Chesapeake seeking full-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 bvcwebmail@brentwoodvetclinic.com. Website: www.brentwoodvetclinic.com.

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TECHNICIANS WANTED AdvertisersIndex

TECHNICIANS WANTED

Want Free Information About These Products and Services? Send an email to productinfo@VetTechJournal.com. Abaxis VetScan VSpro Coagulation Analyzer ................................................................................................................................ 7 Animal Health Options Proanthozone Derm ....................................................................................................................................................... 37 ASPCA Animal Poison Control Center ......................................................................................................................................... 17 Bayer Animal Health Advantage for Cats ........................................................................................................................................................... 3 Drontal Plus .................................................................................................................................................................... 29 K9 Advantix..................................................................................................................................................................... 15 Greenies Dental Chews .................................................................................................................................................................. 23 Hill’s Pet Nutrition Prescription Diet r/d Canine ........................................................................................................Cover 2 (Canada only), 13 Iams ProActive Health ..................................................................................................................................... Cover 2 (US Only) IDEXX Laboratories Preanesthetic Evaluation ................................................................................................................................................ 35 ImproMed Celebrating Thirty Years .................................................................................................................................................. 41 International Veterinary Emergency & Critical Care Symposium IVECCS 2009 ................................................................................................................................................................... 31 Intervet/Schering-Plough Animal Health Canine Influenza Vaccine .................................................................................................................................................. 9 Mometamax ................................................................................................................................................................... 25 Lilly Comfortis ........................................................................................................................................................................ 21 Merial PUREVAX Feline Vaccines .................................................................................................................................................. 5 Novartis Animal Health CEforVetsandTechs.com .................................................................................................................................................. 19 Purina Veterinary Diets OM Overweight Management Canine Dry Formula ..................................................................................................Cover 4 Sharn Veterinary Cardell Monitors.............................................................................................................................................................. 33 St. Petersburg College Online Veterinary Technology Program .......................................................................................................................... 42 Thornell Corp. KOE Odor Eliminator and AOE Deodorizing Wipes ........................................................................................................... 42 Veterinary Learning Systems Vetlearn.com .................................................................................................................................................................. 39 Vetstreet Practice Management and Communication Tool....................................................................................................... 26, 27 Western Veterinary Conference WVC 2010 ............................................................................................................................................................... Cover 3 Advertising appearing in this issue does not necessarily reflect the opinions nor constitute or imply endorsement or recommendation by the Publisher. The Publisher is not responsible for any statements or data made by the Advertiser.

MarketShowcase

The following advertisers appear in our Market Showcase section on page 44.

National Band and Tag Company Online Interactive Order System

Well Animal Institute Anesthesia-Free Teeth Cleaning for Dogs and Cats

Petknap Pet Burial Bags

WhereTechsConnect.com Job Source and Marketplace for Vet Techs

Veterinary Solutions Cat and Dog Muzzles and Catheter Guards

Veterinary Technician | JULY 2009 47

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FinalView

A Penny in Benny? Submitted by Djana Zivkovic, CVT, VCA Alameda East Veterinary Hospital, Denver, Colo.

enny, an 8-year-old cocker spaniel, presented to our clinic for zinc toxicosis, possibly caused by ingestion of a penny. Radiographs taken by the referring veterinarian were brought in by Benny’s owner. After Benny was admitted to the intensive care unit, we obtained new abdominal radiographs, which confirmed the presence of a round, apparently metallic, object in Benny’s abdomen. The complete blood count (CBC) and differential CBC revealed a packed cell volume of 18%, a slightly low platelet count, and marked acanthocytes. A chemistry panel showed a high bilirubin level, and Benny’s urine was the color of port wine. Further laboratory results confirmed the zinc toxicosis diagnosis, and exploratory surgery was planned to retrieve the penny. To the surprise of the surgeon and the night staff, the surgery did not reveal a penny. What was found instead was a perfectly round, penny-sized, pink tablet. After speaking with the owner, it was discovered that Benny had eaten a tablet of Pepto-Bismol (Procter & Gamble) a few days before presentation. Pepto-Bismol tablets are radioopaque and the size and the shape of a penny. It is unknown why the tablet did not dissolve in the abdomen. After zinc toxicosis was ruled out, we were left to figure out what was causing Benny’s anemia. Because cocker spaniels are prone to immune-mediated hemolytic anemia (IMHA) and Benny’s blood work was consistent with the condition, a diagnosis was made. Benny was then hospitalized and treated.

Do You Have a Unique Case to Share? Send us your interesting case with clinical images — radiographs and/or high-resolution photographs that help tell the story. Provide a 100- to 150-word description of what the images are showing, and include information about the animal’s recovery. We pay $75 per published case. Send submissions by email to editor@VetTechJournal.com, or mail to VLS/Veterinary Technician, 780 Township Line Road, Yardley, PA 19067. 48

JULY 2009 | Veterinary Technician

www.VetTechJournal.com

VETERINARY TECHNICIAN lives depend on your skills

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Value that’s unbeatable … low fees with no increase if you register by August 31, 2009 Enjoyable, accessible location … fun, food, freebies, and the constant playfulness of Las Vegas Nonstop amenities … complimentary comedy, concert, Technician Fair, and Technician Lounge

2010 registration is OPEN and hotels offer

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wvc.org Simple, speedy, secure

82nd Annual Western Veterinary Conference Questions: call 702-739-6698 toll-free 866-800-7326

Mandalay Bay Resort and Casino | Las Vegas | February 14-18, 2010

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client compliance. We offer a nutritional approach that helps you do both. A unique combination of high protein and isoflavones in Purina Veterinary Diets® OM Overweight Management® Canine Dry Formula helps achieve healthy weight loss and helps reduce weight rebound. OM Canine Canned Formula provides another palatable and therapeutic option to drive compliance. And Lite Snackers® Canine Treats complement both with a low-calorie treat. OM Overweight Management® Formula is also available in Feline Dry and Canned. Start improving more lives today. 1-800-222-VETS (8387) www.purinavets.com/weight | user name: purinavets | password: nutrition

Trademarks owned by Société des Produits Nestlé S.A., Vevey, Switzerland

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Making a difference in the lives of overweight patients not only means recommending the right diet, it also means gaining

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WHAT FEEDS YOU?